AMBULATORY SURGERY CENTER MAXIMUM ALLOWABLE FEE SCHEDULE THIS IS YOUR WISCONSIN MEDICAID MAXIMUM ALLOWABLE FEE SCHEDULE, WHICH IS IN EFFECT AS OF THE DATE OF THIS REPORT. WISCONSIN MEDICAID CERTIFIED PROVIDERS WILL BE REIMBURSED FOR SERVICES PROVIDED TO PROGRAM RECIPIENTS AT THE LOWER OF THEIR USUAL AND CUSTOMARY CHARGE, OR THE MAXIMUM ALLOWABLE FEE. SERVICES REIMBURSED BASED ON PROVIDER SPECIFIC (CONTRACTED RATES) AND REGIONAL OR SPECIALTY BASED RATES ARE NOT INCLUDED IN THIS FEE SCHEDULE. NOTE: BADGERCARE PLUS BENCHMARK PLAN MEMBERS WILL BE RESPONSIBLE FOR A $15.00 COPAYMENT PER AMBULATORY SURGERY CENTER VISIT. A SINGLE COPAYMENT OF $15.00 IS ASSESSED PER PATIENT VISIT, REGARDLESS OF THE NUMBER OF SERVICES PROVIDED DURING THAT VISIT. ALTHOUGH THE FEE SCHEDULE DOES NOT ADDRESS THE VARIOUS COVERAGE LIMITATIONS ROUTINELY APPLIED BY WISCONSIN MEDICAID BEFORE FINAL PAYMENT IS DETERMINED (E.G., RECIPIENT AND PROVIDER ELIGIBILITY, BILLING INSTRUCTIONS, FREQUENCY OF SERVICES, THIRD PARTY LIABILITY, COPAYMENT, AGE RESTRICTIONS, PRIOR AUTHORIZATION, ETC.), IT DOES CONTAIN THE FOLLOWING INFORMATION: PROC/M1/M2/TM PROC - THE PROCEDURE CODE RECOGNIZED BY WISCONSIN MEDICAID TO IDENTIFY THE SERVICE PROVIDED. M1/M2 - ONE OR TWO APPLICABLE MODIFIER(S) AFFECTING REIMBURSEMENT AMOUNT. TM - DESCRIPTIVE MODIFIER USED TO CONVEY INFORMATION FORMERLY CONVEYED BY TOS. NOTE: IN CERTAIN INSTANCES THE MODIFIER LISTED IS BEING USED BOTH TO CONVEY INFORMATION FORMERLY CONVEYED BY TOS AND TO AFFECT THE REIMBURSEMENT AMOUNT. IN THESE INSTANCES THE MODIFIER WILL BE DISPLAYED TWICE, ONCE IN THE M1 OR M2 COLUMN AND ONCE IN THE TM COLUMN, EVEN THOUGH IT WILL ONLY BE BILLED ONCE ON THE CLAIM DETAIL. DESCRIPTION - AN ABBREVIATED DESCRIPTION OF THE PROCEDURE CODE PROVIDER TYPE - ALL APPLICABLE PERFORMING PROVIDER TYPES FOR THE PROCEDURE CODE. SEE TABLE I FOR A LISTING OF PROVIDER TYPES APPLICABLE TO THIS SCHEDULE. PAC - THE PRICING ACTION CODE IDENTIFIES NON-COVERED SERVICES OR THE SOURCE AND METHOD OF PRICING THE PROCEDURE (REFER TO TABLE II). EFFECT DATE - THE EFFECTIVE DATE OF SERVICE ON OR AFTER WHICH THE MAXIMUM ALLOWABLE FEE APPLIES. MAX FEE - MAXIMUM ALLOWABLE FEES FOR THE PROCEDURE CODES LISTED. IF A MAX FEE IS NOT INDICATED, USE THE PAC AND TABLE II TO DETERMINE THE REASON (E.G., PAC 220 INDICATES SERVICE NOT COVERED; PAC 21J INDICATES INDIVIDUAL CONSIDERATION, ETC.). THIS INFORMATION IS INTENDED TO HELP YOU UNDERSTAND THE WISCONSIN MEDICAID MAXIMUM ALLOWABLE FEE SCHEDULE. IF YOU HAVE QUESTIONS, PLEASE CONTACT WISCONSIN MEDICAID PROVIDER SERVICES AT: (608) 221-9883 OR (800) 947-9627* *WHEN REQUESTING INFORMATION, PLEASE BE SPECIFIC AS TO WHICH PROVIDER TYPE YOU ARE REFERRING (I.E. AMBULATORY SURGERY CENTER). TABLE I PROVIDER TYPES 70 – AMBULATORY SURGERY CENTER TABLE II PRICING ACTION CODES (PAC) 11J, 21J - INDIVIDUAL CONSIDERATION, MEDICAL CONSULTANT 120, 220 - NON-COVERED SERVICE, NOT A WISCONSIN MEDICAID BENEFIT 170, 270 - PAID AT THE LOWER OF THE BILLED AMOUNT OR MAXIMUM ALLOWABLE FEE ACCORDING TO PROVIDER TYPE TABLE III MODIFIERS MODIFIER DESCRIPTION -------------- ------------------------------------------------------------------------------------- None PROC DESCRIPTION PROC M1 M2 TM PROVIDER TYPE PAC EFFECT MAX FEE DATE 0016T DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG; CHOROIDAL NEOVASCULARIZATION), TRANSPUPI 0016T 70 220 01/01/02 0017T DESTRUCTION OF MACULAR DRUSEN, PHOTOCOAGULATION 0017T 70 220 01/01/02 0019T EXTRACORPOREAL SHOCK WAVE THERAPY; INVOLVING MUSCULOSKELETAL SYSTEM 0019T 70 220 01/01/02 0027T ENDOSCOPIC LYSIS EPIDURAL ADHESIONS W/ DRCT VISUAL USING MECH MEANS/SLTN INJCT INC RAD L 0027T 70 220 01/01/03 0031T SPECULOSCOPY 0031T 70 220 01/01/03 0032T SPECULOSCOPY; WITH DIRECTED SAMPLING 0032T 70 220 01/01/03 0062T PERCUTANEOUS INTRADISCAL ANNULOPLASTY,ANY METHOD EXCEPT ELECTROTHERMAL,UNILAT/BILAT INCL 0062T 70 220 07/01/04 0063T PERCUTANEOUS INTRADISCAL ANNULOPLASTY,UNILTL/BILTL,FLUOROSCOPIC GUIDANCE,1+ ADDTL LEVELS 0063T 70 220 07/01/04 0071T FOCUSED ULTRASOUND ABLTN OF UTERINE LELOMYOMATA,INCL MR GUIDANCE;VOL <200 CC OF TISSUE 0071T 70 220 01/01/05 0072T FOCUSED ULTRASOUND ABLTN OF UTERINE LELOMYOMATA,INCL MR GUIDANCE;VOL >OR= 200 CC TISSUE 0072T 70 220 01/01/05 0075T TRNSCATHTR PLCMNT XTRACRNIAL VRTEBRL/INTRATHORACIC CAROTID ARTERY STNT;INCLD SUPVSN/INTE 0075T 70 220 01/01/05 0076T TRANSCATHETER PLACEMENT OF EXTRACRANIAL VERTEBRAL OR INTRATHORACIC CAROTID ARTERY STENTS 0076T 70 220 01/01/05 0077T IMPLANTING AND SECURING CEREBRAL THERMAL PERFUSION PROBE, INCLD TWIST DRILL OR BURR HOLE 0077T 70 220 01/01/05 0078T ENDOVSLR REPAIR USING PROSTH OF ABDML AORTIC ANRYSM, PSEUDOANRYSM OR DISSECT, ABDML AORT 0078T 70 220 01/01/05 0079T PLACEMENT OF VISCERAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF ABDML AORTIC ANEUR 0079T 70 220 01/01/05 0080T ENDOVASCULAR REPAIR OF ABDOMINAL AORTIC ANEURYSM,RADIOLOGICAL SUPERVISION & INTRPRTATION 0080T 70 220 01/01/05 0081T PLACEMENT OF VISCERAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF ABDOMINAL AORTIC A 0081T 70 220 01/01/05 0084T INSERTION OF A TEMPORARY PROSTATIC URETHRAL STENT 0084T 70 220 01/01/05 0088T SUBMUCOSAL RADIOFREQUENCY TISSUE VOLUME REDUCTION OF TONGUE BASE, ONE/MORE SITES PER SES 0088T 70 220 01/01/05 0090T TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH,INCL DISCECTOMY TO PREPARE INTERSPACE CERVICL 0090T 70 220 01/01/06 0092T TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH, INCL DISKECTOMY; EACH ADDITIONAL INTERSPACE 0092T 70 220 01/01/06 0093T REMOVAL OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH CERVICAL; SINGLE INTERSPACE 0093T 70 220 01/01/06 0095T REMOVAL OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH; EACH ADDITIONAL INTERSPACE 0095T 70 220 01/01/06 0096T REVISION OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH CERVICAL; SINGLE INTERSPACE 0096T 70 220 01/01/06 0098T REVISION OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH; EACH ADDITIONAL INTERSPACE 0098T 70 220 01/01/06 0099T IMPLANTATION OF INTRASTROMAL CORNEAL RING SEGMENTS 0099T 70 220 01/01/06 0100T PLCMT OF SUBCONJUNCTIVAL RETINAL PROSTHESIS RECVR & PULSE GENERATOR,IMPLANTATION INTRA-C 0100T 70 220 01/01/06 0101T EXTRACORPOREAL SHOCK WAVE INVOLVING MUSCULOSKELETAL SYSTEM, NOS, HIGH ENERGY 0101T 70 220 01/01/06 0102T EXTRACORPOREAL SHOCK WAVE, HIGH ENERGY, PERFORMED BY PHY, REQ'G ANESTH OTHER THAN LOCAL, 0102T 70 220 01/01/06 0123T FISTULIZATION OF SCLERA FOR GLAUCOMA, THROUGH CILIARY BODY 0123T 70 220 01/01/06 0124T CONJUNCTIVAL INCISION W/POSTERIOR JUXTASCLERAL PLCMT OF PHARMACOLOGICAL AGENT (DOES NOT 0124T 70 220 01/01/06 0137T BIOPSY, PROSTATE, NEEDLE, SATURATION SAMPLING FOR PROSTATE MAPPING 0137T 70 220 01/01/06 0141T PANCREATIC ISLET CELL TRANSPLANTATION THROUGH PORTAL VEIN, PERCUTANEOUS 0141T 70 220 01/01/06 0142T PANCREATIC ISLET CELL TRANSPLANTATION THROUGH PORTAL VEIN, OPEN 0142T 70 220 01/01/06 0143T LAPAROSCOPY, SURGICAL, PANCREATIC ISLET CELL TRANSPLANTATION THROUGH PORTAL VEIN 0143T 70 220 01/01/06 0155T LAPARSCPY,SURGCL;IMPLANTN/REPLACMNT OF GASTRIC STIMULATION ELECTRODES,LESSER CURVATURE 0155T 70 220 01/01/07 0156T LAPAROSCOPY,SURGICAL;REVISION OR REMOVAL OF GASTRIC STIMULTN ELECTRODES,LESSER CURVATURE 0156T 70 220 01/01/07 0157T LAPAROTOMY, IMPLANTATION/REPLACEMENT OF GASTRIC STIMULATION ELECTRODES, LESSER CURVATURE 0157T 70 220 01/01/07 0158T LAPAROTOMY, REVISION OR REMOVAL OF GASTRIC STIMULATION ELECTRODES, LESSER CURVATURE 0158T 70 220 01/01/07 0163T TOTAL DISC ARTHROPLASTY ANTERIOR APPROACH, INCLUDING DISCECTOMY TO PREPARE INTERSPACE 0163T 70 220 01/01/07 0164T REMOVAL OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH, LUMBAR, EA ADDITIONAL INTERSPACE 0164T 70 220 01/01/07 0165T REVISION OF TOTAL DISC ARTHROPLASTY, ANTERIOR APPROACH, LUMBAR, EA ADDITIONAL INTERSPACE 0165T 70 220 01/01/07 0166T TRANSMYOCARDIAL TRANSCATHETER CLOSURE OF VENTRICULAR SEPTAL DEFECT, W/IMPLANT, NO BYPASS 0166T 70 220 01/01/07 0167T TRANSMYOCARDIAL TRANSCATHETER CLOSURE OF VENTRICULAR SEPTAL DEFECT, W/IMPLANT, W/BYPASS 0167T 70 220 01/01/07 0168T RHINOPHOTOTHERAPY, INTRANASAL APPLICATION OF ULTRAVIOLET AND VISIBLE LIGHT, BILATERAL 0168T 70 220 01/01/07 0169T STEREOTACTIC PLACEMENT OF INFUSION CATHETER(S) IN BRAIN FOR DELIVERY OF THERAPUTIC AGENT 0169T 70 220 01/01/07 0170T REPAIR OF ANORECTAL FISTULA WITH PLUG (EG. PORCINE SMALL INTESTINE SUBMUCOSA SIS) 0170T 70 220 01/01/07 0171T INSERTION OF POSTERIOR SPINOUS PROCESS DISTRACTION DEVICE, LUMBAR; SINGLE LEVEL 0171T 70 220 01/01/07 0172T INSERTION OF POSTERIOR SPRINOUS PROCESS DISTRACTION DEVICE, LUMBAR, EA ADDIONAL LEVEL 0172T 70 220 01/01/07 0173T MONITORING OF INTRAOCULAR PRESSURE DURING VITRECTOMY SURGERY(LIST SEPARATELY IN ADDITION 0173T 70 220 01/01/07 0176T TRANSLUMINAL DILATION OF AQUEOUS OUTFLOW CANAL, WITHOUT RETENTION OF DEVICE OR STENT 0176T 70 220 01/01/07 0177T TRANSLUMINAL DILATION OF AQUEOUS OUTFLOW CANAL, WITH RETENTION OF DEVICE OR STENT 0177T 70 220 01/01/07 0184T EXCISION OF RECTAL TUMOR, TRANSANAL ENDOSCOPIC MICROSURGICAL APPROACH (IE, TEMS) 0184T 70 220 01/01/08 10021 FINE NEEDLE ASPIRATION; W/O IMAGING GUIDANCE 10021 70 270 07/01/02 103.38 10022 FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE 10022 70 270 07/01/02 103.38 10040 FSASC-ACNE SURGERY 10040 70 270 07/01/02 103.38 10060 FSASC-INC & DRAIN OF ABSCESS 10060 70 270 07/01/02 103.38 10061 FSASC-INC & DRAIN OF ABSCESS 10061 70 270 07/01/02 103.38 10080 FSASC-INC & DRAIN OF PILONIDAL CYST 10080 70 270 07/01/02 103.38 10081 FSASC-INC & DRAIN OF PILONIDAL CYST 10081 70 270 07/01/02 103.38 10120 FSASC-INC & REMOV OF FOREIGN BODY/ SUBCUTANEOUS TISSUES 10120 70 270 07/01/02 206.78 10121 FSASC-INC & REMOV OF FOREIGN BODY/ SUBCUTANEOUS TISSUES 10121 70 270 07/01/02 206.78 10140 INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION 10140 70 270 07/01/02 206.78 10160 FSASC-PUNCTURE ASPIRATION OF ABCESS/ HEMATOMA/ BULLA/ OR CYST 10160 70 270 07/01/02 103.38 10180 INCISION AND DRAINAGE/ COMPLEX/ POSTOPERATIVE WOUND INFECTION 10180 70 21J 11/28/78 11000 FSASC-DEBRID OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN 11000 70 270 07/01/02 103.38 11001 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS/INFECTED SKIN;EACH ADDITIONAL 10% OF BODY SURFACE 11001 70 270 07/01/02 103.38 11004 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSUE 11004 70 21J 01/01/05 11005 DEBRDMNT OF SKIN,SUBCUT TISSUE/MSCLE/FASCIA FOR NECROTIZING SFT TISSUE INFECT;ABDOM WALL 11005 70 21J 01/01/05 11006 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, NECROTIZING SOFT TISSUE:EXTERNAL GENITALIA 11006 70 21J 01/01/05 11008 REMOVAL OF PROSTHETIC MATERIAL/MESH,ABDOMINAL WALL FOR INFECTION (EG,FOR CHRONIC/RECURRE 11008 70 21J 01/01/05 11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC. OPEN FRACTURE(S) AND/OR DISLOC. 11010 70 21J 01/01/97 11011 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC. OPEN FRACTURE(S)AND/OR DISLOC.S 11011 70 21J 01/01/97 11012 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC. OPEN FRACTURE(S)AND/OR DISLOC. 11012 70 21J 01/01/97 11040 FSASC-DEBRIDEMENT OF ABRASIONS 11040 70 270 07/01/02 206.78 11041 SKIN/ FULL THICKNESS 11041 70 21J 11/28/78 11042 SKIN AND SUBCUTANEOUS TISSUE 11042 70 270 07/01/02 206.78 11043 SKIN/ SUBCUTANEOUS TISSUE AND MUSCLE 11043 70 270 07/01/02 310.14 11044 SKIN/SUBCUTANEOUS TISSUE/ MUSCLE AND BONE 11044 70 270 07/01/02 206.78 11055 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; SINGLE LESION 11055 70 21J 01/01/98 11056 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; TWO TO FOUR LESIONS 11056 70 21J 01/01/98 11057 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; MORE THAN FOUR LESIONS 11057 70 21J 01/01/98 11100 BIOPSY OF SKIN, SUBCUT TISSUE &/OR MUCOUS MEMBRANE, UNLESS OTHERWISE LISTED;SINGL LESION 11100 70 270 07/01/02 103.38 11101 BIOPSY OF SKIN,SUBCUTANEOUS TISSUE/MUCOUS MEMBRANE;EACH SEPARATE/ADDITIONAL LESION 11101 70 270 07/01/02 103.38 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCL 15 LESIONS 11200 70 270 07/01/02 103.38 11201 REMOVAL OF SKIN TAGS,MULTIPLE FIBROCUTANEOUS TAGS,ANY AREA;EACH ADDITIONAL TEN LESIONS 11201 70 270 07/01/02 103.38 11300 SHAVING OF EPIDERMAL/DERMAL LESION, SINGLE, TRNK, ARM OR LEG; DIAMETER 0.5 CM OR LESS 11300 70 21J 01/01/93 11301 SHAVING OF EPIDERMAL/DERMAL LESION, SINGLE, TRNK, ARMS OR LEGS; DIAMETER 0.6 TO 1.0 CM 11301 70 21J 01/01/93 11302 SHAVING OF EPIDERMAL/DERMAL LESION, SINGLE, TRNK, ARMS OR LEGS; DIAMETER 1.1 TO 2.0 CM 11302 70 21J 01/01/93 11303 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE, TRUNK, ARMS OR LEGS; DIAMETER OVER 2.0 CM 11303 70 21J 01/01/93 11305 SHAVING OF EDIPERMAL/DERMAL LESION, SNGL; SCLP, NCK, HANDS, FT, GNTLS; DIAM 0.5 CM/LESS 11305 70 21J 01/01/93 11306 SHAVING OF EPIDERMAL/DERMAL LESION, SNGL, SCLP, NCK, HANDS, FT, GNTLS; DIAM 0.6-1.0 CM 11306 70 21J 01/01/93 11307 SHAVING OF EPIDERMAL/DERMAL LESION, SNGL, SCLP, NCK, HANDS, FT, GNTLS; DIAM 1.1-2.0 CM 11307 70 21J 01/01/93 11308 SHAVING OF EPIDERMAL/DERMAL LESION, SINGLE, SCLP, NCK, HANDS, FT, GNTLS; DIAM OVR 2.0 CM 11308 70 21J 01/01/93 11310 SHAVING OF EPIDERM/DERMAL LESION, SGL; FACE/EAR/EYELID/NSE/LIP/MUC MEM; DIAM 0.5 CM/LESS 11310 70 21J 01/01/93 11311 SHAVING OF EPIDERM/DERMAL LESION, SGL; FACE/EAR/EYELID/NSE/LIP/MUC MEM; DIAM 0.6-1.0 CM 11311 70 21J 01/01/93 11312 SHAVING OF EPIDERM/DERMAL LESION, SGL; FACE/EAR/EYELID/NSE/LIP/MUC MEMB; DIAM 1.1-2.0 CM 11312 70 21J 01/01/93 11313 SHAVING OF EPIDERM/DERMAL LESION, SGL; FACE/EAR/EYELID/NSE/LIP/MUC MEMB; DIAM OVR 2.0 CM 11313 70 21J 01/01/93 11400 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM 0.5 CM OR LESS 11400 70 270 07/01/02 103.38 11401 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM 0.6 - 1.0 CM 11401 70 270 07/01/02 206.78 11402 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM 1.1 - 2.0 CM 11402 70 270 07/01/02 206.78 11403 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM 2.1 - 3.0 CM 11403 70 270 07/01/02 206.78 11404 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM 3.1 - 4.0 CM 11404 70 270 07/01/02 206.78 11406 EXCISION, BENIGN LESION INCL MARGINS, EXC SKIN TAG, TRNK/ARM/LEG; DIAM OVER 4.0 CM 11406 70 270 07/01/02 206.78 11420 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI 0.5 CM/LESS 11420 70 270 07/01/02 103.38 11421 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI 0.6-1.0 CM 11421 70 270 07/01/02 103.38 11422 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI 1.1-2.0 CM 11422 70 270 07/01/02 103.38 11423 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI 2.1-3.0 CM 11423 70 270 07/01/02 103.38 11424 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI 3.1-4.0 CM 11424 70 270 07/01/02 103.38 11426 EXCISION, BENIGN LESION W/ MARGIN, EXC SKIN TAG, SCLP/NCK/HAND/FEET/GENIT;DI OVER 4.0 CM 11426 70 270 07/01/02 103.38 11440 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM 0.5 CM OR LESS 11440 70 270 07/01/02 103.38 11441 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM 0.6 TO 1.0 CM 11441 70 270 07/01/02 103.38 11442 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM 1.1 TO 2.0 CM 11442 70 270 07/01/02 103.38 11443 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM 2.1 TO 3.0 CM 11443 70 270 07/01/02 103.38 11444 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM 3.1 TO 4.0 CM 11444 70 270 07/01/02 103.38 11446 EXCISION, OTHER BENIGN LESION W/ MARGIN FACE/EAR/EYELID/NOSE/LIPS; DIAM OVER 4.0 CM 11446 70 270 07/01/02 103.38 11450 EXCISION OF SKIN AND SUBCUT TISSUE FOR HIDRADENITIS, AXILLARY; W SIMP OR INTERMED REPAIR 11450 70 270 07/01/02 103.38 11451 EXCISION OF SKIN & SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH COMPLEX REPAIR 11451 70 21J 11/28/78 11462 EXCISION OF SKIN & SUBCUT TISSUE FOR HIDRADENITIS, INGUINAL; W SIMPLE OR INTERMED REPAIR 11462 70 21J 11/28/78 11463 EXCISION OF SKIN & SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH COMPLEX REPAIR 11463 70 21J 11/28/78 11470 EXC OF SKIN & SUBCUT TISSUE FOR HIDRADENITIS/PERIANAL/PERINEAL/UMBIL;W SIMP/INTERMD REPA 11470 70 270 07/01/02 310.14 11471 EXC OF SKIN & SUBCUT TISSUE FOR HIDRADENITIS/PERIANAL/PERINEAL/UMBILICAL;W COMPLX REPAIR 11471 70 21J 11/28/78 11600 EXCISION, MALIGNANT LESION INCLD MARGINS, TRUNK, ARMS, OR LEGS; DIAMETER 0.5 CM OR LESS 11600 70 270 07/01/02 103.38 11601 EXCISION, MALIGNANT LESION INCLD MARGINS, TRUNK, ARMS, OR LEGS; DIAMETER 0.6 TO 1.0 CM 11601 70 270 07/01/02 103.38 11602 EXCISION, MALIGNANT LESION INCLD MARGINS, TRUNK, ARMS, OR LEGS; DIAMETER 1.1 TO 2.0 CM 11602 70 270 07/01/02 103.38 11603 EXCISION, MALIGNANT LESION INCLUD MARGINS,TRUNK, ARMS/LEGS; EXCISED DIAM 2.1-3.0 CM 11603 70 270 07/01/02 103.38 11604 EXCISION, MALIGNANT LESION INCLUD MARGINS,TRUNK, ARMS/LEGS; EXCISED DIAM 3.1-4.0 CM 11604 70 270 07/01/02 103.38 11606 EXCISION, MALIGNANT LESION INCLUD MARGINS,TRUNK, ARMS/LEGS; EXCISED DIAM OVER 4.0 CM 11606 70 270 07/01/02 103.38 11620 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FEET,GENITAL;EXCISED DIAM 0.5 CM < 11620 70 270 07/01/02 103.38 11621 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FEET,GENITAL;EXCISED DM 0.6-1.0 CM 11621 70 270 07/01/02 103.38 11622 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FEET,GENITAL;EXCISED DM 1.1-2.0 CM 11622 70 270 07/01/02 103.38 11623 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FEET,GENITAL;EXCISED DM 2.1-3.0 CM 11623 70 270 07/01/02 103.38 11624 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FEET,GENITAL;EXCISED DM 3.1-4.0 CM 11624 70 270 07/01/02 103.38 11626 EXCISION,MALIG LESION INCLUD MARGINS,SCALP,NECK,HANDS,FT,GENITAL;EXCISED DM OVER 4.0 CM 11626 70 270 07/01/02 103.38 11640 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DIAM 0.5 CM < 11640 70 270 07/01/02 103.38 11641 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DM 0.6-1.0 CM 11641 70 270 07/01/02 103.38 11642 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DM 1.1-2.0 CM 11642 70 270 07/01/02 103.38 11643 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DM 2.1-3.0 CM 11643 70 270 07/01/02 206.78 11644 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DM 3.1-4.0 CM 11644 70 270 07/01/02 103.38 11646 EXCISION,MALIG LESION INCLUD MARGINS,FACE,EARS,EYELIDS,NOSE,LIPS;EXCISED DM OVER 4.0 CM 11646 70 270 07/01/02 103.38 11719 TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER 11719 70 21J 01/01/98 11720 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE 11720 70 270 07/01/02 103.38 11721 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE 11721 70 270 07/01/02 103.38 11730 FSASC-AVULSION OF NAIL PLATE/ PARTIAL OR COMPLETE/ SIMPLE 11730 70 270 07/01/02 103.38 11732 AVULSION OF NAIL PLATE,PARTIAL OR COMPLETE,SIMPLE;EACH ADDITIONAL NAIL PLATE 11732 70 270 07/01/02 103.38 11740 FSASC-EVACUATION OF SUBUNGUAL HEMATOMA 11740 70 270 07/01/02 103.38 11750 FSASC-EXC OF NAIL & NAIL MATRIX/ PARTIAL OR COMPLETE 11750 70 270 07/01/02 103.38 11752 WITH AMPUTATION OF TUFT OF DISTAL PHALANX 11752 70 270 07/01/02 310.14 11755 BIOPSY OF NAIL UNIT (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL & LATERAL NAIL FOLDS) 11755 70 270 07/01/02 206.78 11760 FSASC-RECONSTRUCTION OF NAIL BED 11760 70 270 07/01/02 103.38 11762 FSASC-RECONSTRUCTION OF NAIL BED 11762 70 270 07/01/02 103.38 11765 WEDGE EXCISION OF SKIN OF NAIL FOLD (EG,FOR INGROWN TOENAIL) 11765 70 270 07/01/02 103.38 11770 FSASC-EXC OF PILONIDAL CYST OR SINUS 11770 70 270 07/01/02 206.78 11771 FSASC-EXC OF PILONIDAL CYST OR SINUS 11771 70 270 07/01/02 103.38 11772 FSASC-EXC OF PILONIDAL CYST OR SINUS 11772 70 270 07/01/02 103.38 11900 FSASC-INJECTION/ INTRALESIONAL 11900 70 270 07/01/02 103.38 11901 FSASC-INJECTION/ INTRALESIONAL 11901 70 270 07/01/02 103.38 11920 FSASC-TATTOOING/ INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE 11920 70 220 01/01/06 11921 FSASC-TATTOOING/ INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE 11921 70 220 01/01/06 11922 TATTOOING,INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS;EACH ADD. 20.0 SQ CM 11922 70 220 01/01/06 11950 FSASC-SUBCUTANEOUS INJ"FILLING" MATERIAL 11950 70 270 07/01/02 103.38 11951 FSASC-SUBCUTANEOUS INJ"FILLING" MATERIAL 11951 70 270 07/01/02 103.38 11952 FSASC-SUBCUTANEOUS INJ"FILLING" MATERIAL 11952 70 270 07/01/02 103.38 11954 FSASC-SUBCUTANEOUS INJ"FILLING" MATERIAL 11954 70 270 07/01/02 103.38 11960 INSERTION OF TISSUE EXPANDER(S) FOR OTHER THAN BREAST, INCL SUBSEQUENT EXPANSION 11960 70 270 07/01/02 447.98 11970 REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROSTHESIS 11970 70 21J 11/28/78 11971 REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF PROSTHESIS 11971 70 270 07/01/02 206.78 11975 INSERTION, IMPLANTABLE CONTRACEPTIVE CAPSULES 11975 70 220 01/01/92 11976 REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES 11976 70 220 01/01/92 11977 REMOVAL WITH REINSERTION, IMPLANTABLE CONTRACEPTIVE CAPSULES 11977 70 220 01/01/06 11980 SUBCUTANEOUS HORMONE PELLET IMPLANTATION (IMPLANTATION OF ESTRADIOL &/OR TESTOSTERONE PE 11980 70 21J 01/01/00 11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT 11981 70 270 07/01/02 103.38 11982 REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT 11982 70 270 07/01/02 103.38 11983 REMOVAL WITH REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT 11983 70 270 07/01/02 103.38 12001 FSASC-SIMP REP OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12001 70 270 07/01/02 103.38 12002 FSASC-SIMP REP OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12002 70 270 07/01/02 103.38 12004 FSASC-SIMP REP OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12004 70 270 07/01/02 103.38 12005 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12005 70 270 07/01/02 103.38 12006 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12006 70 270 07/01/02 103.38 12007 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF SCALP/ NECK/ AXILLAE 12007 70 270 07/01/02 103.38 12011 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12011 70 270 07/01/02 103.38 12013 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12013 70 270 07/01/02 103.38 12014 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12014 70 270 07/01/02 103.38 12015 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12015 70 270 07/01/02 103.38 12016 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12016 70 270 07/01/02 103.38 12017 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12017 70 270 07/01/02 103.38 12018 FSASC-SIMP RER OF SUPERFICIAL WOUNDS OF FACE/ EARS/ EYELIDS 12018 70 270 07/01/02 103.38 12020 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE 12020 70 21J 11/28/78 12021 WITH PACKING 12021 70 270 07/01/02 310.14 12031 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12031 70 270 07/01/02 103.38 12032 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12032 70 270 07/01/02 103.38 12034 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12034 70 270 07/01/02 103.38 12035 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12035 70 270 07/01/02 103.38 12036 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12036 70 270 07/01/02 103.38 12037 FSASC-LAYER CLOSURE OF WOUNDS OF SCALP/ AXILLAE/ TRUNK AND/OR 12037 70 270 07/01/02 103.38 12041 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12041 70 270 07/01/02 103.38 12042 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12042 70 270 07/01/02 103.38 12044 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12044 70 270 07/01/02 103.38 12045 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12045 70 270 07/01/02 103.38 12046 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12046 70 270 07/01/02 103.38 12047 FSASC-LAYER CLOSURE OF WOUNDS OF NECK/ HANDS/ FEET AND/OR 12047 70 270 07/01/02 103.38 12051 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12051 70 270 07/01/02 103.38 12052 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12052 70 270 07/01/02 103.38 12053 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12053 70 270 07/01/02 103.38 12054 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12054 70 270 07/01/02 103.38 12055 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12055 70 270 07/01/02 103.38 12056 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12056 70 270 07/01/02 103.38 12057 FSASC-LAYER CLOSURE OF WOUNDS OF FACE/ EARS/ EYELIDS/ NOSE 12057 70 270 07/01/02 103.38 13100 FSASC-REPAIR/ COMPLEX/ TRUNK 13100 70 270 07/01/02 103.38 13101 FSASC-REPAIR/ COMPLEX/ TRUNK 13101 70 270 07/01/02 103.38 13102 REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST IN ADDITION TO PRIMARY PROC) 13102 70 21J 01/01/00 13120 FSASC-REPAIR/ COMPLEX/ SCALP/ ARMS/ AND/OR LEGS 13120 70 270 07/01/02 206.78 13121 RSASC-REPAIR/ COMPLEX/ SCALP/ ARMS/ AND/OR LEGS 13121 70 270 07/01/02 103.38 13122 REPAIR, COMPLEX, SCALP, ARMS &/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST IN ADDITION T 13122 70 21J 01/01/00 13131 FSASC-REPAIR/ COMPLEX/ FOREHEAD/ CHEEKS/ CHIN/ MOUTH/ NECK 13131 70 270 07/01/02 206.78 13132 FSASC-REPAIR/ COMPLEX/ FOREHEAD/ CHEEKS/ CHIN/ MOUTH/ NECK 13132 70 270 07/01/02 103.38 13133 REPAIR, COMPLEX, FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXILLAE...;EACH ADDITIONAL 5 CM OR LESS 13133 70 21J 01/01/00 13150 FSASC-REPAIR/ COMPLEX/ EYELIDS/ NOSE/ EARS AND/OR LIPS 13150 70 270 07/01/02 103.38 13151 FSASC-REPAIR/ COMPLEX/ EYELIDS/ NOSE/ EARS AND/OR LIP 13151 70 270 07/01/02 103.38 13152 FSASC-REPAIR/ COMPLEX/ EYELIDS/ NOSE/ EARS AND/OR LIPS 13152 70 270 07/01/02 103.38 13153 REPAIR, COMPLEX, EYELIDS, NOSE, EARS &/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST IS AD 13153 70 21J 01/01/00 13160 SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, ENTENSIVE OR COMPLICATED 13160 70 270 07/01/02 310.14 14000 FSASC-ADJACENT TISSUE TRANSFER OR REARRANEMENT/ TRUNK 14000 70 270 07/01/02 103.38 14001 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ TRUNK 14001 70 270 07/01/02 103.38 14020 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ SCALP 14020 70 270 07/01/02 103.38 14021 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, 14021 70 270 07/01/02 310.14 14040 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ FORHEAD 14040 70 270 07/01/02 206.78 14041 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ FOREHEAD 14041 70 270 07/01/02 103.38 14060 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ EYELIDS 14060 70 270 07/01/02 310.14 14061 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ EYELIDS 14061 70 270 07/01/02 103.38 14300 FSASC-ADJACENT TISSUE TRANSFER OR REARRANGEMENT/ MORE THAN 30 SQ CM 14300 70 270 07/01/02 103.38 14350 FSASC-FILLETED FINGER OR TOE FLAP/ INCLD PREPARATION OF RECIPIENT SITE 14350 70 270 07/01/02 103.38 15002 SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS,BURN ESCHR 15002 70 21J 01/01/07 15003 SURGICAL PREP OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS;EACH ADDTL 100 SQ CM/1% BODY 15003 70 21J 01/01/07 15004 SURGICAL PREP OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS;FACE,SCALP,FEET/100 SQ CM-1% 15004 70 21J 01/01/07 15005 INCISIONAL REL OF SCAR CONTRACTURE,EA ADDTL 100 SQ CM/EA ADDTL 1% BODY AREA OF INFANT(S) 15005 70 21J 01/01/07 15040 HARVEST OF SKIN FOR TISSUE CULTURED SKIN AUTOGRAFT, 100 SQ CM OR LESS 15040 70 21J 01/01/06 15050 FSASC-PINCH GRAFT/ SINGLE OR MULTIPLE/ TO COVER SMALL 15050 70 270 07/01/02 103.38 15100 SPLIT-THICK AUTOGRAFT, TRNK, ARMS, LEGS; 1ST 100 SQ CM/LESS, OR 1% BODY OF INFANT/CHILD 15100 70 270 07/01/02 206.78 15101 SPLIT GRAFT,TRUNK,ARMS,LEGS;EA ADD 100 SQ CM OR 1% BODY AREA,INFANTS & CHILDREN 15101 70 270 07/01/02 206.78 15110 EPIDERMAL AUTOGRAFT,TRUNK,ARMS,LEGS:1ST 100 SQ CM OR LESS,OR 1% OF BODY AREA INFANTS/CHI 15110 70 21J 01/01/06 15111 EPIDERMAL AUTOGRAFT,TRUNK,ARMS,LEGS:EA ADD'L 100 SQ CM OR EA ADD'L 1% BODY AREA INFANTS/ 15111 70 21J 01/01/06 15115 EPIDERMAL AUTOGRFT,FACE,SCALP,ORBITS,GENITALIA;1ST 100 SQ CM OR 1% BODY OF INFNTS/CHILD 15115 70 21J 01/01/06 15116 EPIDERMAL AUTOGRAFT,FACE,SCALP,ORBITS,GENIT;EA ADD'L 100 SQ CM OR ADD'L 1% BODY OF INFNT 15116 70 21J 01/01/06 15120 SPLIT-THICK AUTOGRFT,FACE,SCALP,ORBITS,GENIT;1ST 100 SQ CM/LESS,OR 1% BODY INFANTS/CHILD 15120 70 270 07/01/02 206.78 15121 SPLIT GRAFT,FACE,SCALP,EYELIDS,MOUTH,NECK,...;EACH ADD. 100 SQ CM,OR 1% BODY AREA, 15121 70 270 07/01/02 206.78 15130 DERMAL AUTOGRFT; FIRST 100 SQ CM OR LESS, OR ONE PERCENT BODY AREA OF INFANTS/CHILDREN 15130 70 21J 01/01/06 15131 DERMAL AUTOGRFT; ADDITIONAL 100 SQ CM, OR ONE PERCENT BODY AREA OF INFANTS AND CHILDREN 15131 70 21J 01/01/06 15135 DERMAL AUTGRFT; FIRST 100 SQ CM OR LESS, OR ONE PERCENT BODY AREA OF INFANTS/CHILDREN 15135 70 21J 01/01/06 15136 DERMAL AUTGRFT; EACH ADDTNL 100 SQ CM, OR EACH ADDTNL 1% BODY AREA OF INFANTS/CHILDREN 15136 70 21J 01/01/06 15150 TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25 SQ CM OR LESS 15150 70 21J 01/01/06 15151 TISSUE CULTURED EPIDERMAL AUTOGRAFT; ADDITIONAL 1 SQ CM TO 75 SQ CM 15151 70 21J 01/01/06 15152 TISS CULTRD EPDRML AUTOGRFT;ADDTNL 100 SQ CM,OR ADDTNL 1% BODY AREA OF INFANTS/CHILDREN 15152 70 21J 01/01/06 15155 TISSUE CULTURED EPIDERMAL AUTOGRAFT; FIRST 25 SQ CM OR LESS 15155 70 21J 01/01/06 15156 TISSUE CULTURED EPIDERMAL AUTOGRAFT; ADDITIONAL 1 SQ CM TO 75 SQ CM 15156 70 21J 01/01/06 15157 TISS CULTRD EPDRML AUTOGRFT;EACH ADDTNL 100 SQ CM,ADDTNL 1% BODY AREA INFANTS/CHILDREN 15157 70 21J 01/01/06 15170 ACELLULAR DERMAL REPLACEMENT; FIRST 100 SQ CM OR LESS, OR 1% BODY AREA INFANTS/CHILDREN 15170 70 21J 01/01/06 15171 ACELLULAR DERMAL REPLACEMENT; EA ADDTL 100 SQ CM. OR EA ADDTL 1% BODY AREA INFANT/CHILD 15171 70 21J 01/01/06 15175 ACELLULAR DERMAL REPLACEMENT;FACE,SCALP,ETC; 100 SQ CM OR LESS,OR 1% BODY AREA OF INFANT 15175 70 21J 01/01/06 15176 ACELLULAR DERMAL REPLACEMENT;ORBITS,GENITALIA,MULTIPL DIGITS, 100 SQ CM OR EACH ADDTL 1% 15176 70 21J 01/01/06 15200 FSASC-FULL THICKNESS GRAFT/ FREE/ INCLD DIRECT CLOSURE 15200 70 270 07/01/02 206.78 15201 FULL THICKNESS GRAFT,FREE,INCLUDING DIRECT CLOSURE OF DONOR SITE,TRUNK;EA ADD 20 SQ CM 15201 70 270 07/01/02 103.38 15220 FSASC-FULL THICKNESS GRAFT/ FREE/ INCLD DIRECT CLOSURE 15220 70 270 07/01/02 206.78 15221 FULL THICKNESS GRAFT,FREE,INC DIRECT CLOSURE DONOR SITE,SCALP,ARMS,LEGS;EA ADD 20 SQ CM 15221 70 270 07/01/02 103.38 15240 FSASC-FILL THICKNESS GRAFT/ FREE/ INCLD DIRECT CLOSURE 15240 70 270 07/01/02 103.38 15241 FULL THICKNESS GRAFT,FREE,INC DIRECT CLOSURE DONOR SITE,FOREHEAD,...;EA ADD 20 SQ CM 15241 70 270 07/01/02 103.38 15260 FSASC-FULL THICKNESS GRAFT/ FREE/ INCLD DIRECT CLOSURE OF DONOR 15260 70 270 07/01/02 103.38 15261 FULL THICKNESS GRAFT,FREE,INC DIRECT CLOSURE DONOR SITE,NOSE,EARS,...EA ADD 20 SQ CM 15261 70 270 07/01/02 103.38 15300 ALLOGRAFT SKIN FOR TEMP WOUND CLOSURE;1ST 100 SQ CM OR <. PR 1% BPDU AREA OMFAMTS/CHILD 15300 70 21J 01/01/06 15301 ALLOGRAFT SKIN FOR TEMP WOUND CLOSURE;EACH ADDTL 100 SQ CM OR ADDTL 1% BODY AREA;INFANTS 15301 70 21J 01/01/06 15320 ALLOGRAFT SKIN FOR TEMP WOUND CLOSURE;FIRST 100 SQ CM OR <,OR 1% BODY AREA INFANTS/CHILD 15320 70 21J 01/01/06 15321 ALGRFT SKIN FOR TEMP WOUND CLOSURE;ADDTNL 100 SQ CM,OR ADDTNL 1% BODY AREA INFNTS/CHILD 15321 70 21J 01/01/06 15330 ACELLULAR DERMAL ALLOGRAFT;FIRST 100 SQ CM OR LESS,OR 1% BODY AREA OF INFANTS/CHILDREN 15330 70 21J 01/01/06 15331 ACELLULAR DERMAL ALLOGRAFT;EACH ADDTNL 100 SQ CM,OR ADDTNL 1% BODY AREA OF INFANTS/CHILD 15331 70 21J 01/01/06 15335 ACELLULAR DERMAL ALLOGRAFT; 1ST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS/CHILDRN 15335 70 21J 01/01/06 15336 ACELLULAR DERMAL ALLOGRAFT; EA ADDTL 100 SQ CM, OR EA ADDTL 1% BODY AREA OF INFNTS/CHILD 15336 70 21J 01/01/06 15340 TISSUE CULTURED ALLOGENEIC SKIN SUBSTITUTE; FIRST 25 SQ CM OR LESS 15340 70 21J 01/01/06 15341 TISSUE CULTURED ALLOGENEIC SKIN SUBSTITUTE; EACH ADDITIONAL 25 SQ CM 15341 70 21J 01/01/06 15360 TISSUE CULTURD ALLOGNC DRML SUBSTITUTE;1ST 100 SQ CM OR <,OR 1% BODY AREA OF INFNTS/CHLD 15360 70 21J 01/01/06 15361 TISS CULTRD ALLOGNC DRML SUBSTITUTE;ADDTNL 100 SQ CM,OR ADDTNL 1% BODY OF INFNTS/CHILD 15361 70 21J 01/01/06 15365 TISS CULTRD ALLOGNC DRML SUB,FACE,NECK,EARS;1ST 100 SQ CM OR LESS,OR 1% BODY INFNTS/CHIL 15365 70 21J 01/01/06 15366 TISS CULTRD ALLOGNC DRML SUBSTITUTE,EA ADDTNL 100 SQ CM,OR 1% BODY OF INFNTS/CHILDREN 15366 70 21J 01/01/06 15400 XENOGRAFT,SKIN,FOR TEMP WOUND CLOSURE;1ST 100 SQ CM OR <,OR 1% BODY AREA OF INFNTS/CHILD 15400 70 270 07/01/02 103.38 15401 XENOGRAFT,SKIN,FOR TEMP WOUND CLOSURE;EA ADDTL 100 SQ CM,OR ADDTL 1% BODY AREA OF INFNTS 15401 70 21J 01/01/99 15420 XENOGRFT SKIN FOR TEMP WOUND CLOSURE;1ST 100 SQ CM OR LESS,OR 1% BODY OF INFNTS/CHILDREN 15420 70 21J 01/01/06 15421 XENOGRFT SKIN,FOR TEMP WOUND CLOSURE;EA ADDTNL 100 SQ CM,OR 1% BODY OF INFNTS/CHILDREN 15421 70 21J 01/01/06 15430 ACELLULAR XENOGRAFT IMPLANT, FIRST 100 SQ CM OR LESS, OR 1% BODY OF INFNTS/CHILDREN 15430 70 21J 01/01/06 15431 ACELLULAR XENOGRAFT IMPLANT; EA ADDTL 100 SQ CM, OR ADDTL 1% BODY AREA OF INFNTS/CHILDRN 15431 70 21J 01/01/06 15570 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; TRUNK 15570 70 21J 01/01/92 15572 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; SCALP, ARMS, OR LEGS 15572 70 21J 01/01/92 15574 FORMATION DIRECT/TUBED PEDICLE, W/WITHOUT TRANSFER; FOREHEAD,CHEEK,CHIN,MOUTH,NECK,AXILL 15574 70 21J 01/01/92 15576 FORMATION OF DIRECT/TUBED PEDICLE, W/WITHOUTTRANSFER; EYELIDS,NOSE,EARS,LIPS OR INTRADRL 15576 70 270 07/01/02 310.14 15600 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT TRUNK 15600 70 270 07/01/02 103.38 15610 FSASC-INTERMEDIATE "DELAY" OF ANY FLAP/ PRIMARY "DELAY" OF SMALL FLAP 15610 70 270 07/01/02 103.38 15620 FSASC-INTERMEDIATE "DELAY" OF ANY FLAP/ PRIMARY "DELAY" OF SMALL FLAP 15620 70 270 07/01/02 103.38 15630 FSASC-INTERMEDIATE "DELAY" OF ANY FLAP/ PRIMARY "DELAY" OF SMALL FLAP 15630 70 270 07/01/02 103.38 15650 FSASC-TRANSFER/INTERMED/ OF ANY PEDICLE FLAP 15650 70 270 07/01/02 103.38 15731 FOREHEAD FLAP W/ PRESERV OF VASCLR PEDICLE(EG,AXIAL PATTERN FLAP,PARMEDIAN FOREHEAD FLAP 15731 70 21J 01/01/07 15732 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; HEAD AND NECK (EG, TEMPORALIS, MASSETER M 15732 70 220 01/01/93 15734 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP 15734 70 220 01/01/93 15736 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP 15736 70 220 01/01/93 15738 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP 15738 70 220 01/01/93 15740 FLAP; ISLAND PEDICLE 15740 70 270 07/01/02 103.38 15750 FLAP; NEUROVASCULAR PEDICLE 15750 70 270 07/01/02 103.38 15756 FREE MUSCLE OR MYOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS 15756 70 21J 01/01/97 15757 FREE SKIN FLAP WITH MICROVASCULAR ANASTOMOSIS 15757 70 21J 01/01/97 15758 FREE FASCIAL FLAP WITH MICROVASCULAR ANASTOMOSIS 15758 70 21J 01/01/97 15760 GRAFT; COMPOSITE (FULL THICKNESS OF EXT EAR OR NASAL ALA), INCL PRIMARY CLOSURE, DONOR 15760 70 270 07/01/02 206.78 15770 FSASC-GRAFT 15770 70 270 07/01/02 103.38 15775 FSASC-PUNCH GRAFT FOR HAIR TRANSPLANT 15775 70 220 01/01/04 15776 FSASC-PUNCH GRAFT FOR HAIR TRANSPLANT 15776 70 220 01/01/04 15780 DERMABRASION; TOTA FACE CEG, ACNE SCARRING, FINE WRINKLING, RHYTIDS, GENERAL KERATOSIS) 15780 70 270 07/01/02 206.78 15781 DERMABRASION; SEGMENTAL, FACE 15781 70 270 07/01/02 206.78 15782 DERMABRASION; REGIONAL, OTHER THAN FACE 15782 70 270 07/01/02 206.78 15783 DERMABRASION 15783 70 220 01/01/04 15786 FSASC-ABRASION 15786 70 270 07/01/02 103.38 15787 ABRASION;EACH ADDITIONAL FOUR LESIONS OR LESS(LIST IN ADDITION TO PRIMARY PROCEDURE) 15787 70 270 07/01/02 103.38 15788 CHEMICAL PEEL, FACIAL; EPIDERMAL 15788 70 21J 01/01/94 15789 CHEMICAL PEEL, FACIAL; DERMAL 15789 70 21J 01/01/94 15792 CHEMICAL PEEL, NONFACIAL; EPIDERMAL 15792 70 21J 01/01/94 15793 CHEMICAL PEEL, NONFACIAL; DERMAL 15793 70 21J 01/01/94 15819 CERVICOPLASTY 15819 70 220 01/01/04 15820 FSASC-BLEPHAROPLASTY/ LOWER EYELIDS 15820 70 270 07/01/02 206.78 15821 FSASC-BLEPHAROPLASTY/ LOWER EYELIDS 15821 70 270 07/01/02 206.78 15822 FSASC-RHYTIDECTOMY/ UPPER EYELIDS 15822 70 270 07/01/02 206.78 15823 FSASC-RHYTIDECTOMY/ UPPER EYELIDS 15823 70 270 07/01/02 103.38 15824 FSASC-RHYTIDECTOMY 15824 70 270 07/01/02 206.78 15825 FSASC-RHYTIDECTOMY NECK W/PLATYSMAL TIGHTINING 15825 70 270 07/01/02 206.78 15826 FSASC-RHYTIDECTOMY 15826 70 270 07/01/02 206.78 15828 FSASC-RHYTIDECTOMY 15828 70 270 07/01/02 206.78 15829 RHYTIDECTOMY; SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM (SMAS) FLAP 15829 70 21J 11/28/78 15830 EXCISION, EXCESSIVE SKIN & SUBCUTANEOUS TISSUE; ABDOMEN, INFRAUMBILICAL PANNICULECTOMY 15830 70 21J 01/01/07 15832 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); THIGH 15832 70 270 07/01/02 310.14 15833 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); LEG 15833 70 270 07/01/02 103.38 15834 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); HIP 15834 70 270 07/01/02 103.38 15835 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); BUTTOCK 15835 70 270 07/01/02 103.38 15836 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); ARM 15836 70 270 07/01/02 103.38 15837 EXCISION, EXCESSIVE SKIN AND SUBCUTAEOUS TISSUE (INCLUDING LIPECTOMY); FOREARM OR HAND 15837 70 270 07/01/02 103.38 15838 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY);SUBMENTAL FAT PAD 15838 70 21J 11/28/78 15839 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); OTHER AREA 15839 70 270 07/01/02 447.98 15840 FSASC-GRAFT FOR FACIAL NERVE PARALYSIS 15840 70 270 07/01/02 103.38 15841 FSASC-GRAFT FOR FACIAL NERVE PARALYSIS 15841 70 270 07/01/02 103.38 15842 GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE FLAP BY MICROSURGICAL TECHNIQUE 15842 70 270 07/01/02 103.38 15845 FSASC-GRAFT FOR FACIAL NERVE PARALYSIS 15845 70 270 07/01/02 103.38 15847 EXCISION,EXCESS SKIN & SUBCUTNS TISSUE,ABDOMEN (INCL UMBLCL TRANSPSTN & FASCIAL APPLIC) 15847 70 21J 01/01/07 15850 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON 15850 70 270 07/01/02 310.14 15851 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL) OTHER SURGEON 15851 70 270 07/01/02 310.14 15852 DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA (OTHER THAN LOCAL) 15852 70 270 07/01/02 103.38 15860 INTRAVENOUS INJECTION OF AGENT (EG, FLUORESCEIN) TO TEST VASCULAR FLOW IN FLAP OR GRAFT 15860 70 21J 11/28/78 15876 SUCTION ASSISTED LIPECTOMY 15876 70 220 01/01/90 15877 SUCTION ASSISTED LIPECTOMY 15877 70 220 01/01/90 15878 SUCTION ASSISTED LIPECTOMY 15878 70 220 01/01/90 15879 SUCTION ASSISTED LIPECTOMY 15879 70 220 01/01/90 15920 FSASC-COCCYGECTOMY 15920 70 270 07/01/02 103.38 15922 EXCISION, COCCYGEAL PRESSURE ULCER, WITH COCCYGECTOMY; WITH FLAP CLOSURE 15922 70 270 07/01/02 103.38 15931 EXCISION/ SACRAL PRESSURE ULCER/ WITH PRIMARY SUTURE; 15931 70 21J 11/28/78 15933 FSASC-EXC/SACRAL DECUBITUS ULCER 15933 70 270 07/01/02 103.38 15934 EXCISION, SACRAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE 15934 70 21J 11/28/78 15935 WITH OSTECTOMY 15935 70 21J 11/28/78 15936 EXCISION,SACRAL PRESSURE ULCER,IN PREP FOR MUSCLE OR MYOCUTANEOUS FLAP OR GRAFT CLOSURE; 15936 70 21J 11/28/78 15937 WITH OSTECTOMY 15937 70 21J 11/28/78 15940 FSASC-EXC/ISCHIAL DECUBITUS ULCER 15940 70 270 07/01/02 103.38 15941 FSASC-EXC/ISCHIAL DECUBITUS ULCER 15941 70 270 07/01/02 206.78 15944 EXCISION, ISCHIAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE; 15944 70 21J 11/28/78 15945 WITH OSTECTOMY 15945 70 21J 11/28/78 15946 EXCISION,ISCHIAL PRESSURE ULCER,W/OSTECTOMY,IN PREP FOR MUSCLE/MYOCUTANEOUS FLAP OR SKIN 15946 70 21J 11/28/78 15950 FSASC-EXC/TROCHANTERIC DECUBITUS ULCER 15950 70 270 07/01/02 103.38 15951 FSASC-EXC/TROCHANTERIC DECUBITUS ULCER 15951 70 270 07/01/02 103.38 15952 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH SKIN FLAP CLOSURE; 15952 70 270 07/01/02 103.38 15953 FSASC-EXC/TROCHANTERIC DECUBITUS ULCER 15953 70 270 07/01/02 103.38 15956 EXCISION,TROCHANTERIC PRESSURE ULCER,IN PREP FOR MUSCLE/MYOCUTANEOUS FLAP OR SKIN GRAFT 15956 70 21J 11/28/78 15958 WITH OSTECTOMY 15958 70 21J 11/28/78 15999 UNLISTED PROCEDURE/ EXCISION PRESSURE ULCER 15999 70 21J 11/28/78 16000 FSASC-INIT RX/FIRST DEGREE BURN/ WHEN NO MORE THAN LOCAL 16000 70 270 07/01/02 103.38 16020 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS; INITIAL OR SUBSEQUENT; SMALL 16020 70 270 07/01/02 103.38 16025 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; MEDIUM 16025 70 270 07/01/02 103.38 16030 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE 16030 70 270 07/01/02 103.38 16035 ESCHAROTOMY; INITIAL INCISION 16035 70 270 07/01/02 103.38 16036 ESCHAROTOMY; EACH ADDITIONAL INCISION (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE) 16036 70 21J 01/01/01 17000 DESTRUCTION, PREMALIGNANT LESIONS; FIRST LESION 17000 70 270 07/01/02 103.38 17003 DESTRUCTION BY ANY METHOD,ALL BENIGN/PREMALIGNANT LESIONS;2ND THROUGH 14 LESIONS, EACH 17003 70 270 07/01/02 103.38 17004 DESTRUCTION, PREMALIGNANT LESIONS, 15 OR MORE LESIONS 17004 70 21J 01/01/98 17106 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS 17106 70 21J 03/01/91 17107 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS 17107 70 21J 03/01/91 17108 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS 17108 70 270 07/01/02 447.98 17110 DESTRUCTION, OF BENIGN LESIONS OTHER THEN SKIN TAGS/CUTANEOUS VASCULAR LESIONS; UP TO 14 17110 70 270 07/01/02 103.38 17111 DESTRUCTION BY ANY METHOD OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; 15 OR MORE LES 17111 70 21J 01/01/98 17250 CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA) 17250 70 270 07/01/02 103.38 17260 DESTRUCTION, MALIGNANT LESION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURG 17260 70 21J 01/01/92 17261 DESTRUCT MALIG LESION, ANY METHOD, TRUNK, ARMS OR LEG; LESION DIAMETER 0.6 TO 1.0 CM 17261 70 21J 01/01/92 17262 DESTRUCT MALIG LESION,ANYMETHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM 17262 70 21J 01/01/92 17263 DESTRUCT MALIG LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM 17263 70 21J 01/01/92 17264 DESTRUCT MALIGN LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM 17264 70 21J 01/01/92 17266 DESTRUCT MALIGN LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 4.0 CM 17266 70 21J 01/01/92 17270 DESTRUCTION, MALIGNANT LESION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURG 17270 70 21J 01/01/92 17271 DESTRUCT MALIGN LESION, ANY METHOD, SCALP/NECK/HANDS/FEET/GENITALIA; DIAMETR .6 - 1.0 CM 17271 70 21J 01/01/92 17272 DESTRUCT MALIGN LESION, ANY METHOD, SCALP/NECK/HANDS/FEET/GENITALIA; DIAMETER 1.1-2.0 CM 17272 70 21J 01/01/92 17273 DESTRUCT MALIGN LESION, ANY METHOD, SCALP/NECK/HANDS/FEET/GENITALIA; DIAMETER 2.1-3.0 CM 17273 70 21J 01/01/92 17274 DESTRUCT MALIGN LESION, ANY METHOD, SCALP/NECK/HANDS/FEET/GENITALIA; DIAMETER 3.1-4.0 CM 17274 70 21J 01/01/92 17276 DESTRUCT MALIGN LESION, ANY METHOD, SCALP/NECK/HANDS/FEET/GENITALIA; DIAMETER OVR 4.0 CM 17276 70 21J 01/01/92 17280 DESTRUCT MALIG LESION,FACE/EARS/EYELIDS/NOSE/LIPS/MUCS MEMBRANE;LESION DIAM 0.5 CM &LESS 17280 70 21J 01/01/92 17281 DESTRUCT MALIG LESION, ANY METHOD-FACE/EAR/EYELIDS/NOSE/LIPS/MUCS MEMBRANE; 0.6-1.0 CM 17281 70 21J 01/01/92 17282 DESTRUCT MALIG LESION, ANY METHOD-FACE/EAR/EYELIDS/NOSE/LIPS/MUCS MEMBRANE; 1.1-2.0 CM 17282 70 21J 01/01/92 17283 DESTRUCT MALIG LESION, ANY METHOD-FACE/EAR/EYELIDS/NOSE/LIPS/MUCS MEMBRANE; 2.1-3.0 CM 17283 70 21J 01/01/92 17284 DESTRUCT MALIG LESION, ANY METHOD-FACE/EAR/EYELIDS/NOSE/LIPS/MUCS MEMBRANE; 3.1-4.0 CM 17284 70 21J 01/01/92 17286 DESTRUCT MALIG LESION, ANY METHOD-FACE/EAR/EYELIDS/NOSE/LIPS/MUCS MEMBRANE; OVER 4.0 CM 17286 70 21J 01/01/92 17311 MICROSCPC EXAM & PREP INVOLV MUSCLE,BONE,NERVES,VESSELS;1ST STAGE,UP TO 5 TISSUE BLOCKS 17311 70 21J 01/01/07 17312 MICROSCPC EXAM & PREP INVOLV MUSCLE,BONE,NERVES,VESSELS;EA ADDTL STAGE AFTER 1ST STAGE 17312 70 21J 01/01/07 17313 MICROSCPC EXAM & PREP INCL ROUTINE STAIN(S) OF TRUNK,ARMS,LEGS;1ST STAGE,UP TO 5 TISSUE 17313 70 21J 01/01/07 17314 MICROSCPC EXAM & PREP INCL ROUTINE STAIN(S) OF TRUNK,ARMS,LEGS;EA ADDTL STAGE AFTER 1ST 17314 70 21J 01/01/07 17315 MICROSCPC EXAM & PREP,EACH ADDITIONAL BLOCK AFTER 1ST 5 TISSUE BLOCKS,ANY STAGE 17315 70 21J 01/01/07 17340 CRYOTHERAPY (C02 SLUSH, LIQUID N2) FOR ACNE 17340 70 270 07/01/02 103.38 17360 FSASC-CHEMICAL EXFOLIATION FOR ACNE 17360 70 270 07/01/02 103.38 17380 FSASC-ELCTROLYSIS EPILATON 1/2 HR EACH 17380 70 220 01/01/04 17999 FSASC-UNLISTED PROCEDURE/ SKIN/ MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE 17999 70 21J 07/01/92 19000 FSASC-PUNCTURE ASPIRATION/CYST 19000 70 270 07/01/02 206.78 19001 PUNCTURE ASPIRATION OF BREAST CYST;EACH ADDITIONAL CYST(LIST IN ADD. TO PRIMARY PROC) 19001 70 270 07/01/02 206.78 19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP 19020 70 270 07/01/02 206.78 19030 INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR GALACTOGRAM 19030 70 21J 11/28/78 19100 BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, NOT USING IMAGING GUIDANCE(SEPERATE PROCED) 19100 70 270 07/01/02 206.78 19101 BIOPSY OF BREAST; OPEN, INCISIONAL 19101 70 270 07/01/02 206.78 19102 BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, USING IMAGING GUIDANCE 19102 70 21J 01/01/01 19103 BIOPSY OF BREAST;PERCUTANEOUS,AUTOMATED VACUUM ASSISTED OF ROTATING BIOPSY DEVICE,USING 19103 70 21J 01/01/01 19105 ABLATION,CRYOSURGICAL,OF FIBROADENOMA,INCLUDING ULTRASOUND GUIDANCE,EACH FIBROADENOMA 19105 70 21J 01/01/07 19110 NIPPLE EXPLORATION/ W/WO EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPILLOMA DUCT 19110 70 21J 11/28/78 19112 EXCISION OF LACTIFEROUS DUCT FISTULA 19112 70 21J 11/28/78 19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, M/F, 1 OR MORE LESIO 19120 70 270 07/01/02 206.78 19125 EXCISION OF BREAST LESION ID'D BY PRE-OP PLACEMENT OF RADIOLOGICAL MARKER; SINGLE LESION 19125 70 270 07/01/02 447.98 19126 EXCISION OF BREAST LESION ID'D BY PRE-OP PLACEMENT OF RADIOLOGICAL MARKER;EACH ADDTL LES 19126 70 270 07/01/02 310.14 19260 EXCISION OF CHEST WALL TUMOR INCLUDING RIBS 19260 70 21J 11/28/78 19271 EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC 19271 70 21J 11/28/78 19272 EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, WITH PLASTIC 19272 70 21J 11/28/78 19290 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST 19290 70 270 07/01/02 723.66 19291 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST; EACH ADDITIONAL LESION 19291 70 21J 01/01/93 19295 IMAGE GUIDED PLACEMENT,METALLIC LOCALIZATION CLIP,PERCUTANEOUS,DURING BREAST BIOPSY (LIS 19295 70 21J 01/01/01 19296 PLCMT OF RADIOTHPY AFTERLOADING BALLOON CATH; ON DATE SEPARATE FROM PARTIAL MASTECTOMY 19296 70 21J 01/01/05 19297 PLCMT OF RADIOTHPY AFTERLOADING BALLOON CATH; CONCURRENT W/PARTIAL MASTECTOMY 19297 70 21J 01/01/05 19298 PLCMT OF RADIOTHPY AFTERLOADING BRACHYTHPY CATH, INCLUDES IMAGING GUIDANCE 19298 70 21J 01/01/05 19300 MASTECTOMY FOR GYNECOMASTIA 19300 70 21J 01/01/07 19301 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); 19301 70 21J 01/01/07 19302 MASTCTMY,PARTIAL(EG,LUMPECTMY,TYLECTMY,QUADRANTCTMY,SEGMENTCTMY);W/ AXILLARY LYMPHADCTMY 19302 70 21J 01/01/07 19303 MASTECTOMY, SIMPLE, COMPLETE 19303 70 21J 01/01/07 19304 MASTECTOMY, SUBCUTANEOUS 19304 70 21J 01/01/07 19305 MASTECTOMY, RADICAL, INCLUDING PECTORAL MUSCLES, AXILLARY LYMPH NODES 19305 70 21J 01/01/07 19306 MASTECTOMY, RADICAL, INCL PECTORAL MUSCLES, AXILLARY & INTERNAL MAMMARY LYMPH NODES 19306 70 21J 01/01/07 19307 MASTECTOMY,MODIFIED RADICAL,INCL AXILLARY LYMPH NODES,W/ OR W/O PECTORALIS MINOR MUSCLE 19307 70 21J 01/01/07 19316 FSASC-MASTOPEXY 19316 70 270 07/01/02 310.14 19318 REDUCTION MAMMAPLASTY 19318 70 270 07/01/02 447.98 19324 FSASC-MAMMAPLASTY/ AUGMENTATION; WITHOUT PROSTHETIC IMPLANT 19324 70 270 07/01/02 206.78 19325 FSASC WITH PROSTHETIC IMPLANT 19325 70 270 07/01/02 206.78 19328 FSASC-REMOVAL OF INTACT MAMMARY IMPLANT 19328 70 270 07/01/02 206.78 19330 REMOVAL OF IMPLANT MATERIAL 19330 70 21J 11/28/78 19340 IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY/ MASTECTOMY OR RECONSTRUCTI 19340 70 21J 11/28/78 19342 DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY/ MASTECTOMY OR RECONSTRUCTION 19342 70 270 07/01/02 447.98 19350 NIPPLE/AREOLA RECONSTRUCTION 19350 70 270 07/01/02 310.14 19355 CORRECTION OF INVERTED NIPPLES 19355 70 21J 07/01/77 19357 BREAST RECONSRUCT, 1MMED/DELAYED, W/TISSUE EXPANDER, INCLUDING SUBSUQUENT EXPANS1ION 19357 70 21J 01/01/92 19361 BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP, WITHOUT PROSTHETIC IMPLANT 19361 70 21J 01/01/92 19364 BREAST RECONSTRUCTION WITH FREE FLAP 19364 70 21J 11/28/78 19366 BREAST RECONSTRUCTION WITH OTHER TECHNIQUE 19366 70 21J 11/28/78 19367 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAN)SINGLE PE 19367 70 21J 01/01/95 19368 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP(TRAN) SINGLE PE 19368 70 21J 01/01/95 19369 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP(TRAN)DOUBLE 19369 70 21J 01/01/95 19370 OPEN PERIPROSTHETIC CAPSULOTOMY/ BREAST 19370 70 21J 11/28/78 19371 PERIPROSTHETIC CAPSULECTOMY/ BREAST 19371 70 270 07/01/02 447.98 19380 REVISION OF RECONSTRUCTED BREAST 19380 70 270 07/01/02 723.66 19396 PREPARATION OF MOULAGE FOR CUSTOM BREAST IMPLANT 19396 70 21J 11/28/78 19499 FSASC-UNLISTED PROCEDURE BREAST 19499 70 21J 07/01/92 20000 INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO 20000 70 270 07/01/02 206.78 20005 INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO 20005 70 21J 11/28/78 20100 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) NECK 20100 70 21J 01/01/96 20101 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) CHEST 20101 70 21J 01/01/96 20102 EXPLORATION OF PENETRATING WOUND(SEPARATE PROCEDURE) ABDOMEN/FLANK/BACK 20102 70 21J 01/01/96 20103 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) EXTREMITY 20103 70 21J 01/01/96 20150 EXCISION OF EPIPHYSEAL EAR, WITH/WITHOUT AUTOGENOUS SOFT TISSUE GRAFT OBTAINED THROUGH S 20150 70 21J 01/01/97 20200 FSASC-BIOPSY/ MUSCLE; 20200 70 270 07/01/02 206.78 20205 BIOPSY, MUSCLE; 20205 70 270 07/01/02 310.14 20206 BIOPSY/ MUSCLE/ PRECUTANEOUS NEEDLE 20206 70 21J 11/28/78 20220 BIOPSY, BONE, TROCAR OR NEEDLE; 20220 70 21J 11/28/78 20225 BIOPSY, BONE, TROCAR OR NEEDLE; DEEP (EG. VERTEBRAL BODY, FEMUR) 20225 70 21J 11/28/78 20240 BIOPSY,BONE,OPEN;SUPERFICIAL (EG,ILIUM,STERNUM,SPINOUS PROCESS,RIBS,TROCHANTER OF FEMUR) 20240 70 270 07/01/02 206.78 20245 BIOPSY, EXCISIONAL; 20245 70 270 07/01/02 447.98 20250 BIOPSY, VERTEBRAL BODY, OPEN; 20250 70 21J 11/28/78 20251 BIOPSY, VERTEBRAL BODY, OPEN; 20251 70 21J 11/28/78 20501 INJECTION OF SINUS TRACT; DIAGNOSTIC (SINOGRAM) 20501 70 21J 11/28/78 20520 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE