Adopted Regulation February 18, 2010



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58563

1,253.18

Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)

58565

1,381.63

Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants

58600

1,223.95

Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral

58615

718.67

Occlusion of fallopian tube(s) by device (e.g., band, clip, Falope ring) vaginal or suprapubic approach

58660

1,156.00

Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)

58661

1,156.00

Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)

58662

1,156.00

Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method

58670

1,065.17

Laparoscopy, surgical; with fulguration of oviducts (with or without transection)

58671

1,065.17

Laparoscopy, surgical; with occlusion of oviducts by device (e.g., band, clip, or Falope ring)

58672

1,156.00

Laparoscopy, surgical; with fimbrioplasty

58673

1,156.00

Laparoscopy, surgical; with salpingostomy (salpingoneostomy)

58800

583.12

Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach

58805

1,223.95

Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); abdominal approach

58820

835.76

Drainage of ovarian abscess; vaginal approach, open

58900

583.12

Biopsy of ovary, unilateral or bilateral (separate procedure)

58970

162.42

Follicle puncture for oocyte retrieval, any method

58974

162.42

Embryo transfer, intrauterine

58976

162.42

Gamete, zygote, or embryo intrafallopian transfer, any method

59000

59.40

Amniocentesis; diagnostic

59001

222.97

Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)

59012

109.03

Cordocentesis (intrauterine), any method

59015

48.04

Chorionic villus sampling, any method

59020

25.32

Fetal contraction stress test

59025

13.31

Fetal non-stress test

59070

109.03

Transabdominal amnioinfusion, including ultrasound guidance

59072

109.03

Fetal umbilical cord occlusion, including ultrasound guidance

59076

109.03

Fetal shunt placement, including ultrasound guidance

59100

1,223.95

Hysterotomy, abdominal (e.g., for hydatidiform mole, abortion)

59150

1,682.76

Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy

59151

1,682.76

Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy

59160

583.12

Curettage, postpartum

59200

32.46

Insertion of cervical dilator (e.g., laminaria, prostaglandin) (separate procedure)

59300

70.11

Episiotomy or vaginal repair, by other than attending physician

59320

505.45

Cerclage of cervix, during pregnancy; vaginal

59412

718.67

External cephalic version, with or without tocolysis

59414

718.67

Delivery of placenta (separate procedure)

59812

673.95

Treatment of incomplete abortion, any trimester, completed surgically

59820

673.95

Treatment of missed abortion, completed surgically; first trimester

59821

673.95

Treatment of missed abortion, completed surgically; second trimester

59840

673.95

Induced abortion, by dilation and curettage

59841

673.95

Induced abortion, by dilation and evacuation

59866

109.03

Multifetal pregnancy reduction(s) (MPR)

59870

673.95

Uterine evacuation and curettage for hydatidiform mole

59871

673.95

Removal of cerclage suture under anesthesia (other than local)

60000

282.94

Incision and drainage of thyroglossal duct cyst, infected

60100

44.47

Biopsy thyroid, percutaneous core needle

60200

1,053.12

Excision of cyst or adenoma of thyroid, or transection of isthmus

60280

1,133.86

Excision of thyroglossal duct cyst or sinus;

60281

1,133.86

Excision of thyroglossal duct cyst or sinus; recurrent

60300

58.43

Aspiration and/or injection, thyroid cyst

61000

260.53

Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial

61001

260.53

Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps

61020

210.93

Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection

61026

210.93

Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment

61050

210.93

Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure)

61055

210.93

Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment (e.g., C1-C2)

61070

164.13

Puncture of shunt tubing or reservoir for aspiration or injection procedure

61215

987.38

Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter

61330

1,521.12

Decompression of orbit only, transcranial approach

61334

1,521.12

Exploration of orbit (transcranial approach); with removal of foreign body

61790

560.00

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (e.g., alcohol, thermal, electrical, radiofrequency); gasserian ganglion

61791

415.46

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (e.g., alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract

61880

713.37

Revision or removal of intracranial neurostimulator electrodes

61885

10,265.47

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array

61886

15,328.85

Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to two or more electrode arrays

61888

682.77

Revision or removal of cranial neurostimulator pulse generator or receiver

62194

276.38

Replacement or irrigation, subarachnoid/subdural catheter

62225

429.45

Replacement or irrigation, ventricular catheter

62230

959.29

Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system

62252

43.50

Reprogramming of programmable cerebrospinal shunt

62263

276.38

Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days

62264

407.15

Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (e.g., catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day

62267

162.48

Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming

62268

210.93

Percutaneous aspiration, spinal cord cyst or syrinx

62269

320.09

Biopsy of spinal cord, percutaneous needle

62270

127.29

Spinal puncture, lumbar, diagnostic

62272

127.29

Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)

62273

212.41

Injection, epidural, of blood or clot patch

62280

276.38

Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid

62281

276.38

Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic

62282

276.38

Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)

62287

1,240.70

Aspiration or decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous discectomy, percutaneous laser discectomy)

62292

260.53

Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar

62294

210.93

Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal

62310

276.38

Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic

62311

276.38

Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal)

62318

276.38

Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic

62319

276.38

Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal)

62350

959.29

Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy

62355

456.74

Removal of previously implanted intrathecal or epidural catheter

62360

959.29

Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir

62361

9,847.26

Implantation or replacement of device for intrathecal or epidural drug infusion; non-programmable pump

62362

9,847.26

Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming

62365

848.85

Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion

62367

15.58

Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming



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