| Code |
|
Description |
Old Price |
New Price |
Allowable |
| 10060 |
|
I&D of Abscess |
$88.00 |
|
$69.51 |
| 10061 |
|
I&D Abscess Complicated/Multi |
$126.00 |
|
$107.17 |
| 10140 |
|
Incision & Drainage |
$120.00 |
|
$99.64 |
| 10180 |
|
I & D Complex |
$1,200.00 |
|
$1,010.80 |
| 11000 |
|
Biopsy of Skin Single Lesion |
$60.00 |
|
$31.16 |
| 11042 |
|
Debridement/Skin/Sub Tissue |
$180.00 |
|
$153.98 |
| 11043 |
|
Debridement/Subcutaneous Tissue |
$273.00 |
|
$241.87 |
| 11100 |
|
Biopsy of Skin |
$83.00 |
|
$71.22 |
| 11401 |
|
EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0 CM |
$113.00 |
|
$95.87 |
| 11403 |
|
EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0 CM/> |
$137.00 |
|
$114.70 |
| 11404 |
|
EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM |
$600.00 |
|
$516.33 |
| 11406 |
|
EXC B9 LES MRGN XCP SK TG T/A/L > 4.0 CM |
$843.00 |
|
$516.33 |
| 11424 |
|
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM |
$843.00 |
|
$516.33 |
| 11426 |
|
EXC B9 LES MRGN XCP SK TG S/N/H/F/G > 4.0CM |
$1,140.00 |
|
$1,010.80 |
| 11441 |
|
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM |
$126.00 |
|
$104.43 |
| 11442 |
|
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM |
$128.00 |
|
$114.02 |
| 11443 |
|
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM |
$152.00 |
|
$126.00 |
| 11444 |
|
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM |
$600.00 |
|
$516.33 |
| 11446 |
|
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M > 4.0CM |
$1,140.00 |
|
$1,010.80 |
| 11600 |
|
EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/< |
$145.00 |
|
$124.97 |
| 11622 |
|
EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM |
$180.00 |
|
$155.79 |
| 11624 |
|
EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM |
$843.00 |
|
$516.33 |
| 11626 |
|
EXCISION MALIGNANT LESION S/N/H/F/G > 4.0 CM |
$1,140.00 |
|
$1,010.80 |
| 11641 |
|
EXCISION MALIGNANT LES F/E/E/N/L 0.6-1.0 CM |
$174.00 |
|
$146.89 |
| 11642 |
|
EXCISION MALIGNANT LES F/E/E/N/L 1.1-2.0 CM |
$191.00 |
|
$161.61 |
| 11643 |
|
EXCISION MALIGNANT LES F/E/E/N/L 2.1-3.0 CM/> |
$200.00 |
|
$177.02 |
| 11644 |
|
EXCISION MALIGNANT LES F/E/E/N/L 3.1-4.0 CM |
$600.00 |
|
$516.33 |
| 11646 |
|
EXCISION MALIGNANT LESION F/E/E/N/L > 4.0 CM |
$1,175.00 |
|
$1,010.80 |
| 11900 |
|
Intralesional Injection Up To 7 |
$63.00 |
|
$0.00 |
| 11901 |
|
Intralesional Inj Over 7 |
$81.00 |
|
$0.00 |
| 12001 |
|
Simple Repr Sprfcl Wound 2.5cm |
$55.00 |
|
$0.00 |
| 12004 |
|
Simple Repr Sprfcl Wound 7.6cm |
$55.00 |
|
$0.00 |
| 12005 |
|
Simple Repr Sprfcl Wound 12.6cm – 20.0cm |
$180.00 |
|
$153.98 |
| 12011 |
|
Repair Laceration 25cm or Less |
$55.00 |
|
$0.00 |
| 12013 |
|
Repair Laceration 26 to 50cm |
$55.00 |
|
$0.00 |
| 12014 |
|
Repair Laceration 51-75cm |
$55.00 |
|
$0.00 |
| 12037 |
|
REPAIR INTERMEDIATE S/A/T/E > 30.0 CM |
$1,545.00 |
|
$777.07 |
| 12052 |
|
REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-53.0 CM/> |
$180.00 |
|
$153.98 |
| 13121 |
|
REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM |
$270.00 |
|
$241.87 |
| 13132 |
|
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM |
$270.00 |
|
$241.87 |
| 13151 |
|
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM |
$270.00 |
|
$241.87 |
| 13152 |
|
REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM |
$270.00 |
|
$241.87 |
| 13160 |
|
Surgical Wound Dehiscence |
$1,362.00 |
|
$777.07 |
| 14000 |
|
ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 CM/< |
$860.00 |
|
$777.07 |
| 14001 |
|
ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM |
$860.00 |
|
$777.07 |
| 14020 |
|
ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/< |
$860.00 |
|
$777.07 |
| 14021 |
|
ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM |
$860.00 |
|
$777.07 |
| 14040 |
|
ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/< |
$860.00 |
|
$777.07 |
| 14041 |
|
ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM |
$860.00 |
|
$777.07 |
| 14060 |
|
ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/< |
$860.00 |
|
$777.07 |
| 14061 |
|
ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM |
$860.00 |
|
$777.07 |
| 14301 |
|
Adj Tissue Trans 30.1-60cm |
$1,600.00 |
|
$1,342.90 |
| 14302 |
|
ADD’lt Adj Tissue Trans 30 sq cm |
$1,001.00 |
|
$0.00 |
| 15002 |
|
Wnd Prep 1st 100sq CM or 1% |
$898.00 |
|
$777.07 |
| 15004 |
|
Escisional Prep For Graft |
$258.00 |
|
$241.87 |
| 15220 |
|
FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/< |
$866.00 |
|
$777.07 |
| 15221 |
|
FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM< |
$300.00 |
|
|
| 15240 |
|
FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/< |
$885.00 |
|
$777.07 |
| 15260 |
|
FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/< |
$860.00 |
|
$777.07 |
| 15730 |
|
MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES |
$1,610.00 |
|
$1,342.90 |
| 15731 |
|
FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE |
$1,610.00 |
|
$1,342.90 |
| 15732 |
|
MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NCK |
$1,362.00 |
|
$1,288.24 |
| 15733 |
|
MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL |
$1,610.00 |
|
$1,342.90 |
| 15740 |
|
FLAP ISLAND PEDICLE |
$860.00 |
|
$777.07 |
| 15760 |
|
GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA |
$1,362.00 |
|
$777.07 |
| 15770 |
|
GRAFT DERMA-FAT-FASCIA |
$1,600.00 |
|
$1,342.90 |
| 15821 |
|
BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD |
$1,362.00 |
|
$777.07 |
| 15823 |
|
BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN |
$862.00 |
|
$777.07 |
| 15824 |
|
RHYTIDECTOMY FOREHEAD |
$1,362.00 |
|
$777.07 |
| 15825 |
|
RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING |
$1,362.00 |
|
$1,342.90 |
| 15826 |
|
RHYTIDECTOMY GLABELLAR FROWN LINES |
$898.00 |
|
$1,342.90 |
| 15828 |
|
RHYTIDECTOMY CHEEK CHIN&NECK |
$1,300.00 |
|
$1,342.90 |
| 15850 |
|
REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON |
$300.00 |
|
$241.87 |
| 17000 |
|
Destruct Benigh/Premalig Les |
$88.00 |
|
|
| 17106 |
|
Destruct Cutaneous Vasc Lesion |
$224.00 |
|
$153.98 |
