| Code | Description | Amount |
|---|---|---|
| 06005 | EMERGENCY VISIT - PLASTIC SURGERY | $103.45 |
| 06007 | VISIT, OFFICE, PLASTIC SURGERY | $25.24 |
| 06008 | VISIT, HOSPITAL, PLASTIC SURGERY | $36.44 |
| 06009 | VISIT, HOME, PLASTIC SURGERY | $46.51 |
| 06010 | CONSULTATION, PLASTIC SURGERY | $97.77 |
| 06012 | CONSULTATION, LIMITED OR REPEAT, PLASTIC SURGERY | $47.91 |
| 66007 | TELEHEALTH SUBSEQUENT OFFICE VISIT PLASTIC SURGERY | $25.24 |
| 66008 | TELEHEALTH SUBSEQUENT HOSPITAL VISIT -PLASTIC SURG | $36.44 |
| 66010 | TELEHEALTH MAJOR CONSULTATION, PLASTIC SURGERY | $97.77 |
| 66012 | TELEHEALTH REPEAT OR LIMITED CONSULT PLASTIC SURG | $47.91 |
| Code | Description | Amount |
|---|---|---|
| 06028 | ABSCESS - WEB SPACE OPERATION ONLY | $71.00 |
| 06029 | ABSCESS - WEB SPACE UNDER GENERAL ANAESTHETIC | $253.02 |
| 06042 | ABSCESS - MID PALMER/THENAR/DORSAL | $253.02 |
| 06197 | TENOSYNOVITIS, ACUTE | $253.02 |
| 06198 | TENOSYNOVITIS - ULNA OR RADIAL BURSA | $253.02 |
| 07025 | TEMPORAL ARTERY BIOPSY | $139.64 |
| 07027 | ABSCESS - DEEP - GENERAL ANAESTHETIC | $202.07 |
| 07028 | SURAL NERVE - BIOPSY OF | $175.95 |
| 07041 | ABDOMEN ASPIRATION/CHEST | $75.44 |
| 07045 | ANTERIOR CLOSED SPACE ABSCESS - OP ONLY | $100.68 |
| 07059 | ABSCESS - DEEP - LOCAL/REGIONAL ANESTHESIA | $80.85 |
| 07061 | WOUND INFECTION - POST-OP/GA | $201.86 |
| 07685 | PILONIDAL CYSTS OR SINUS - EXCISION OR MARSUPIALI | $275.36 |
| 11402 | ASPIRATION - BURSA/SYNOVIAL SHEATH, ETC. | $23.06 |
| 11445 | BIOPSY - OPEN - HAND/WRIST | $240.93 |
| 13600 | BIOPSY - MUCOSA/SKIN (OPERATION ONLY) | $51.28 |
| 13601 | BIOPSY - FACIAL AREA (OPERATION ONLY) | $51.28 |
| 13605 | ABSCESS - SUPERFICIAL | $43.93 |
| 13630 | PARONYCHIA | $35.09 |
| 61291 | BIOPSY, NOT SUTURED | $25.24 |
| 61292 | BIOPSY,NOT SUTURED,MULTIPLES SM SITTING,MAX4(EXTRA | $5.06 |
| 70084 | ABSCESS - PILONIDAL CYST/SINUS - INCISION/DRAINAGE | $100.61 |
| Code | Description | Amount |
|---|---|---|
| 70155 | Debridement of skin and subcutaneous tissue restricted to genitalia and perineum for necrotizing infection (Fournier’s Gangrene) (stand alone procedure) | $408.73 |
| 70158 | DEBRIDEMENT SKIN/SUBCUTANEOUS TISSUE,UP TO 5% BODY SURFACE AREA | $233.97 |
| 70159 | DEBRIDEMENT SKIN/SUBCUTANEOUS TISSUE; EACH SUB 5% OF BODY SURFACE AREA | $116.99 |
| 70162 | DEBRIDEMENT SKIN/SUB/NECROTIC FASCIA / 1ST 5% OF BODY SURFACE AREA | $259.98 |
| 70163 | DEBRIDEMENT SKIN/SUB/NECROTIC FASCIA/EACH SUB 5% OF BODY SURFACE AREA | $129.99 |
| 70165 | DEBRIDEMENT SKIN/FASCIA/MUSCLE/BONE;UP TO 1ST 5% OF BODY SURFACE AREA | $285.96 |
| 70166 | DEBRIDEMENT SKIN/FASCIA/MUSCLE/BONE; EACH SUB 5% OF BODY SURFACE AREA | $142.99 |
| 70168 | ACTIVE WOUND MGMT-ACUTE PHASE AFTER DEBRIDEMENT | $77.99 |
| 70169 | ACTIVE WOUND MGMT/IN OR ACUTE PHASE AFT DEBRIDEMNT | $124.78 |
| Code | Description | Amount |
|---|---|---|
| 00190 | ELECTROSURG./CRYOTHERAPY FOR REMOVAL OF WARTS ETC. | $31.23 |
| 00218 | CURETTAGE AND ELECTROSURGERY OF SKIN CARCINOMA | $60.92 |
| 00219 | CURETTAGE SKIN CARCINOMA, ADDITIONAL LESION | $30.46 |
| 06112 | ABRASIVE SURGERY <1/4 OF FACE | $125.76 |
| 06113 | ABRASIVE SURGERY 1/4 TO 1/2 OF FACE | $244.35 |
| 06114 | ABRASIVE SURGERY - FULL FACE | $519.89 |
| Code | Description | Amount |
|---|---|---|
| 06182 | GANGLIA OF TENDON SHEATH OR JOINT | $180.91 |
| Code | Description | Amount |
|---|
| Code | Description | Amount |
|---|---|---|
| 61300 | WOUNDS-UP TO 5CM-OTHER THAN FACE, SIMPLE CLOSURE | $136.01 |
| 61301 | WOUNDS-UP TO 5CM-FACE(BLEEDERS &/OR LAYERED CLOSUR | $201.50 |
| 61302 | WOUNDS-5.1 TO 10CM-OTHER THAN FACE, SIMPLE CLOSURE | $241.80 |
| 61303 | WOUNDS-5.1 TO 10CM-FACE(BLEEDERS &/OR LAYERED CLOS | $251.88 |
| 61304 | WOUNDS-10.1 TO 15CM-OTHER THAN FACE, SIMPLE CLOSUR | $282.10 |
| 61305 | WOUNDS-10.1 TO 15CM-FACE(BLEEDERS &/OR LAYERED CLO | $352.63 |
| 61306 | WOUNDS-15.1CM OR MORE-OTHER THAN FACE, SIMPLE CLOS | $302.25 |
| 61307 | WOUNDS-15.1CM OR MORE-FACE(BLEEDERS &/OR LAYERED | $403.01 |
| 61308 | COORDINATION OF ANESTHETIC SVCS-FOR LACERATION EXT | $201.50 |
| Code | Description | Amount |
|---|---|---|
| 06075 | LIPS AND EYELID WOUNDS COMPLICATED | $336.88 |
| 06076 | NOSE AND EAR WOUNDS COMPLICATED | $423.19 |
| 06077 | COMPLICATED LACERATION OF THE SCALP CHEEK AND NECK | $330.65 |
| 06238 | REPAIR OF COMPLICATED FINGERTIP INJURY | $199.55 |
| 70150 | LACERATIONS - TONGUE/FLOOR OF MOUTH - COMPLICATED | $268.49 |
| Code | Description | Amount |
|---|---|---|
| 61310 | LESIONS & SCARS-TRUNK, ARMS & LEGS-< 5CM | $120.90 |
| 61311 | LESIONS & SCARS-TRUNK, ARMS & LEGS - 5-10CM | $156.16 |
| 61312 | LESIONS & SCARS-TRUNK, ARMS & LEGS- > 10CM | $231.73 |
| 61313 | LESIONS & SCARS-FACE, SCALP, NECK, ETC. < 5CM | $167.25 |
| 61314 | LESIONS & SCARS-FACE, SCALP, NECK, ETC. 5-10 CM | $221.65 |
| 61315 | LESIONS & SCARS-FACE, SCALP, NECK, ETC. > 10CM | $272.03 |
| 61316 | LESIONS & SCARS-EYELIDS, EARS, LIPS, ETC. < 2CM | $176.31 |
| 61317 | LESIONS & SCARS-EYELIDS, EARS, LIPS, ETC. 2-4 CM | $211.58 |
| 61318 | LESIONS & SCARS-EYELIDS, EARS, LIPS, ETC. >4 CM | $287.14 |
| 61319 | EXCISION OF LESION(IN HOSP),TUMOUR-FREE MARGIN-EXT | $100.75 |
| Code | Description | Amount |
|---|---|---|
| 06026 | SKIN GRAFT; ARTERIAL ISLAND FLAP | $351.28 |
| 06030 | FLAPS FROM A DISTANCE-UPPER EXTREMITY-INIT STAGE | $587.07 |
| 06031 | FLAPS FROM A DISTANCE -UPER EXTREMITY-2ND STAGE | $467.99 |
| 06032 | SKIN GRAFTS; FLAPS FROM A DISTANCE, LOWER,INITIAL | $704.97 |
| 06033 | FLAPS FROM A DISTANCE - FIRST STAGE -PER OPERATION | $351.28 |
| 06034 | FLAPS FROM A DISTANCE-MINOR 2ND STAGE PER OPERATIO | $233.64 |
| 06035 | FLAPS FROM A DISTANCE, DELAYING A FLAP(OPER ONLY) | $162.26 |
| 06148 | HAIR BEARING SCALP VACULAR ISLAND FLAP TO EYEBROW | $480.38 |
| 06171 | SYNDACTYLY LOCAL FLAP - FIRST CLEFT | $253.02 |
| 06172 | SYNDACTYLY WITH SKIN GRAFT - FIRST CLEFT | $450.17 |
| 06177 | NEUROVASCULAR PEDICLE | $738.89 |
| 61320 | EXCISION OF MALIGNANT LESIONS-10-50CM - EXTRA | $60.45 |
| 61321 | EXCISION OF MALIGNANT LESIONS-51-100CM-EXTRA | $130.98 |
| 61322 | EXCISION OF MALIGNANT LESIONS-OVER 100CM-EXTRA | $181.35 |
| 61325 | ADVANCEMENT FLAP-FACE, NECK OR SCALP (2.1 TO 5 CM) | $231.73 |
| 61326 | ADVANCEMENT FLAP-OTHER AREAS (2.1 TO 5 CM) | $180.35 |
| 61327 | ADVANCEMENT FLAP-FACE, NECK OR SCALP(5.1 TO 10 CM) | $352.63 |
| 61328 | ADVANCEMENT FLAP-OTHER AREAS (5.1 TO 10CM) | $231.73 |
| 61329 | ADVANCEMENT FLAP - DEFECTS MORE THAN 10 CM | $390.92 |
| 61330 | FLAPS - TRUNK - DEFECT UP TO 40 CM | $241.80 |
| 61331 | FLAPS - TRUNK - DEFECT 40 CM TO 100 CM | $322.40 |
| 61332 | FLAPS - TRUNK - DEFECT GREATER THAN 100 CM | $420.51 |
| 61333 | FLAPS - ARMS, LEGS AND SCALP - DEFECT UP TO 6 CM | $181.35 |
| 61334 | FLAPS - ARMS,LEGS AND SCALP-DEFECT 6 CM TO 19 CM | $221.65 |
| 61335 | FLAPS-ARMS,LEGS AND SCALP-DEFECT > 19 CM | $455.42 |
| 61336 | FLAPS-OTHER AREAS(AXILLA,CHEEKS,FACE,ETC)UPTO 6CM | $303.48 |
| 61337 | FLAPS-OTHER AREA(AXILLA,CHEEKS,FACE,ETC)6CM-19CM | $344.20 |
| 61338 | FLAPS-OTHER AREA(AXILLA,CHEEKS,FACE,ETC)-DEFECT>19 | $465.52 |
| 61339 | FLAPS-EARS,EYELIDS,LIPS AND NOSE-DEFECT UPTO 6 CM | $344.45 |
| 61340 | FLAPS-EARS,EYELIDS,LIPS AND NOSE-DEFECT 6 CM TO | $454.51 |
| 61341 | FLAPS-EARS,EYELIDS,LIPS AND NOSE-DEFECT > 19 CM | $505.47 |
| 61342 | REVISION OF GRAFT - LESS THAN 2 CM | $201.50 |
| 61343 | REVISION OF GRAFT - BETWEEN 2 AND 5 CM | $241.80 |
| 61344 | REVISION OF GRAFT - GREATER THAN 5 CM | $282.10 |
| 61324 | ADVANCEMENT FLAP-NOSE,LIDS,LIPS OR SCALP-UP TO 2CM | $183.37 |
| Code | Description | Amount |
|---|---|---|
| 06046 | SPLIT THICKNESS FREE SKIN GRAFT; < 6.5 SQ. CM. | $248.85 |
| 06047 | SKIN GRAFTS - SPLIT THICKNESS - FREE - 65 SQ. CM | $301.87 |
| 06048 | SKIN GRAFTS - SPLIT THICKNESS - FREE - 650 SQ. CM | $385.38 |
| 06049 | SPLIT THICKNESS FREE SKIN GRAFTS; EACH 6.5 > 650 | $7.36 |
| 06050 | SKIN GRAFTS - REGIONS OF MAJOR JOINTS AND HANDS | $429.43 |
| 06051 | SKIN GRAFTS - FUNCTIONAL AREAS - FINGER TIP | $248.85 |
| 06052 | SKIN GRAFTS - HEAD AND NECK - 65 SQ. CM OR LESS | $309.86 |
| 06053 | SKIN GRAFT; FUNCTIONAL AREAS: HEAD & NECK > 65 CM | $413.83 |
| 06054 | SKIN GRAFTS - HEAD AND NECK - IN EXCESS OF 195 SQ | $1,026.27 |
| 06058 | SKIN GRAFTS; FUNCTIONAL AREAS; MAJOR JOINTS, LATE | $519.89 |
| 61350 | FULL-THICKNESS GRAFT-TRUNK (2 TO 19 CM) | $226.69 |
| 61351 | FULL-THICKNESS GRAFT-ARMS, LEGS,SCALP (2 TO 19CM) | $287.14 |
| 61352 | FULL-THICKNESS GRAFT-AXILLA,CHEEKS,CHIN, ETC (2 TO | $352.63 |
| 61353 | FULL-THICKNESS GRAFT-EARS,EYELIDS,LIPS AND NOSE (2 | $392.94 |
| 61354 | GRAFT (PINCH,SPLIT OR FULL THICKNESS)-OPEN AREA-UP | $251.88 |
| Code | Description | Amount |
|---|---|---|
| 06110 | CHEEKS -FACIAL PARALYSIS -DYNAMIC SLINGS(UNILATERL | $779.84 |
| 06111 | CHEEKS- FACIAL PARALYSIS STATIC SLINGS (UNILATERAL | $645.70 |
| 06120 | FACIAL PARALYSIS COMPOSITE REPAIR | $831.83 |
| 06129 | COMBINED COMPLETE REPAIR AS ABOVE AND RHYTIDECTOMY | $938.37 |
| 06151 | ULCER DECUBITUS PLASTIC SURGERY | $860.25 |
| 06159 | TRAM FLAP RECONSTRUCTION OF MASTECTOMY DEFECT | $1,014.16 |
| 61152 | ABDOMINAL PANNICULECTOMY, SECONDARY TO INTERTRIGO | $787.29 |
| 61156 | MYOCUTANEOUS/FASCIA CUTANEOUS FLAP - SM MUSCLES | $439.83 |
| 61157 | MYOCUTANEOUS/FASCIA CUTANEOUS FLAP - MED MUSCLES | $623.87 |
| 61158 | MYOCUTANEOUS/FASCIA CUTANEOUS FLAP - MAJOR MUSCLES | $757.06 |
| Code | Description | Amount |
|---|---|---|
| 61250 | LIPOTRANSFER - ASPIRATION - VOLUME < 20 ML | $80.96 |
| 61251 | LIPOTRANSFER - ASPIRATION - VOLUME 21-60 ML | $101.20 |
| 61252 | LIPOTRANSFER - ASPIRATION - VOLUME > 60 ML | $141.68 |
| 61260 | LIPOTRANSFER - INJECTION FUNCTIONAL AREA: < 20ML | $121.44 |
| 61261 | LIPOTRANSFER - INJECTION FUNCTIONAL AREA: > 20 ML | $182.17 |
| 61270 | LIPOTRANSFER-INJECTION NONFUNCTIONAL AREA: < 20ML | $101.20 |
| 61271 | LIPOTRANSFER-INJECTION NONFUNC AREA: 21 TO 60 ML | $141.68 |
| 61272 | LIPOTRANSFER-INJECTION NONFUNCTIONAL AREA: > 60ML | $182.17 |
| Code | Description | Amount |
|---|---|---|
| 06175 | POLLICIZATION | $1,142.02 |
| 06176 | DIGITAL TRANSPLANT | $945.62 |
| 06185 | TENDON GRAFT | $700.38 |
| 06186 | TENOPLASTY - ONE TENDON | $229.90 |
| 06187 | TENOPLASTY - TWO OR MORE TENDONS | $374.25 |
| 06188 | TENOLYSIS | $389.22 |
| 06189 | TENOLYSIS - EACH ADDITIONAL | $144.36 |
| 06193 | PALMAR FASCIECTOMY - EXTENSIVE | $430.48 |
| 06194 | PALMAR FASCIECTOMY - WITH SKIN GRAFTING | $557.33 |
| 06195 | SILASTIC ROD | $458.73 |
| 06203 | TENDON TRANSFER HAND AND WRIST | $445.38 |
| 06204 | TENDON TRANSFER HAND AND WRIST - EACH ADDITIONAL | $162.26 |
| 57270 | PLANTAR FASCIA: OPEN RELEASE OR PARTIAL EXCISION | $268.73 |
| 61363 | FLEXOR-PRIMARY OR SECONDARY REPAIR - FIRST TENDON | $374.25 |
| 61364 | FLEXOR - SECOND TO SIXTH TENDON REPAIR (EXTRA) | $187.13 |
| 61365 | FLEXOR - SEVENTH TO ELEVENTH TENDON REPAIR (EXTRA) | $93.57 |
| 61366 | FLEXOR - TWELFTH AND OVER TENDON REPAIR (EXTRA) | $46.79 |
| 61368 | EXTENSOR - PRIMARY OR SECONDARY REPAIR - FIRST TEN | $235.26 |
| 61369 | EXTENSOR - SECOND TO SIXTH TENDON REPAIR (EXTRA) | $117.63 |
| 61370 | EXTENSOR -SEVENTH TO ELEVENTH TENDON REPAIR(EXTRA) | $58.80 |
| 61371 | EXTENSOR - TWELFTH AND OVER TENDON REPAIR (EXTRA) | $29.40 |
| Code | Description | Amount |
|---|---|---|
| 06055 | SKIN GRAFTS - CAVITY GRAFTING - EYE SOCKET | $437.74 |
| 06056 | SKIN GRAFTS/CAVITY GRAFTING/EYE SOCKET WITH MUCOSA | $670.65 |
| 06057 | SKIN GRAFTS - CAVITY GRAFTING - NOSE | $390.97 |
| 06060 | SKIN GRAFTS - CAVITY GRAFTING - MOUTH | $519.89 |
| 06061 | SKIN GRAFTS/CAVITY GRAFTING - LINING PEDICLE FLAPS | $298.43 |
| 06062 | BONE CAVITY GRAFTING IN LARGE BONE OVER 7.5 CM | $437.74 |
| 06064 | BONE CAVITY IN SMALL BONE - CAVITY GRAFTING | $253.02 |
| 06065 | BONE CAVITY IN LARGE BONE - CAVITY GRAFTING | $308.81 |
| 06066 | CAVITY GRAFTING; ABSENCE OF VAGINA - CONGENITAL | $578.11 |
| Code | Description | Amount |
|---|---|---|
| 06078 | MINOR BURNS; DRESSING (IN HOSP CARE ONLY) | $57.19 |
| 06079 | SURGICAL DEBRIDEMENT; MINOR BURNS, EACH 5% OF BODY | $121.44 |
| 06080 | BURNS; SUBSEQUENT SURG DEBRIDEMENT; EACH 5% BODY | $30.14 |
| 06081 | BURNS SURGICAL EXCISION - FIRST 5% OF BODY SURFACE | $373.28 |
| 06082 | BURNS SURGICAL EXCISION/EACH ADDITIONAL 5% OF BODY | $202.41 |
| 06083 | BURNS, SEVERE, GENERAL CARE - FIRST HOUR | $253.02 |
| 06084 | BURNS, SEVERE, GENERAL CARE - SUBSEQUENT HOURS | $202.41 |
| Code | Description | Amount |
|---|---|---|
| 06087 | INCISION SUBPERIOSTEAL ABSCESS | $253.02 |
| Code | Description | Amount |
|---|---|---|
| 06240 | INTERDENTAL AND INTERMAXILLARY WIRING | $442.64 |
| 06241 | GUNNING SPLINTS IMPRESSION | $454.46 |
| 06242 | MANDIBLE -OPEN REDUCTION - UNILATERAL | $657.38 |
| 06243 | MANDIBLE -OPEN REDUCTION - BILATERAL | $859.80 |
| 06244 | MANDIBLE -OPEN REDUCTION AND WIRING - UNILATERAL | $758.59 |
| 06245 | MANDIBLE -OPEN REDUCTION AND WIRING - BILATERAL | $961.00 |
| 06246 | REMOVAL OF SUTURES, INTRA-ORAL SPLINTS, UNDER GA | $299.23 |
| 06250 | FACE, FRACTURE LE FORTE - HORIZONTAL | $961.00 |
| 06251 | FACE, FRACTURE LE FORTE - PYRAMIDAL | $1,062.20 |
| 06252 | FACE, FRACTURE LE FORTE/CRANIO-FACIAL DYSJUNCTION | $1,204.28 |
| 06253 | WIRE SUSPENSION, CRANIOMAXILLARY | $1,103.53 |
| 06260 | MAXILLARY FRACTURE ZYGOMATIC - TEMPORAL ELEVATION | $325.78 |
| 06261 | MAXILLARY FRACTURE ZYGOMATIC - OPEN REDUCTION AND | $632.66 |
| 06262 | MAXILLARY FRACTURE ZYGOMATIC - REDUCTION | $454.52 |
| 06265 | MAXILLARY FRACTURE ZYGOMATIC - ARCH - TEMPORAL | $353.77 |
| 06266 | ZYGOMATIC ARCH/OPEN REDUCTION/INTEROSSEOUS WIRING | $442.93 |
| 06270 | ORBITAL FLOOR FRACTURE | $738.44 |
| 06271 | ALVEOLAR FRACTURE - ONE TOOTH EXTRACTION | $127.25 |
| 06272 | ALVEOLAR FRACTURE - ADDITIONAL TEETH | $79.12 |
| 06273 | FRACTURE-ALVEOLUS; ARCH BAR FIXATION | $406.57 |
| 06280 | TEMPORO-MANDIBULAR JOINT; MENISCECTOMY | $442.93 |
| 06281 | TEMPORO-MANDIBULAR JOINT; CONDYLECTOMY | $506.85 |
| 06282 | TEMPORO-MANDIBULAR ARTHROPLASTY | $720.71 |
| 06291 | MANDIBULAR RESECTION; TUMOURS; ENUCLEATION | $602.02 |
| 06292 | MANDIBULAR RESECTION; TUMOURS; WITH BONE GRAFT | $854.37 |
| 06293 | BONE GRAFT JAW, AUTOLOGOUS | $537.86 |
| 06294 | BONE GRAFT JAW, NON-AUTOLOGOUS | $496.16 |
| Code | Description | Amount |
|---|---|---|
| 03080 | BILAT ORBITAL ADVANCEMENT-HYPERTELORISM TEAM-NEURO | $2,218.61 |
| 03081 | UNILATERAL ORBITAL ADVANCEMENT-TEAM PROC-NEUR | $2,058.21 |
| 03082 | BILATERAL ORBITAL ADVANCEMENT-TEAM PROC-NEURO | $2,752.99 |
| 06300 | OSTEOTOMIES, MAXILLO-FACIAL; LE FORT 1, HORIZONTAL | $1,121.70 |
| 06301 | OSTEOTOMIES, MAXILLO-FACIAL LE FORT II - PYRAMIDAL | $1,389.03 |
| 06302 | MAXILLO-FACIAL OSTEOTOMY; LE FORT III INTRACRANIAL | $2,886.05 |
| 06303 | MAXILLO-FACIAL OSTEOTOMY; LE FORT III EXTRACRANIAL | $2,458.33 |
| 06304 | OSTEOTOMIES, MAXILLO-FACIAL - MALAR MAXILLIARY | $1,282.09 |
| 06305 | OSTEOTOMIES, MANDIBULAR MAXILLO-FACIAL/UNILATERAL | $800.90 |
| 06306 | OSTEOTOMIES, MANDIBULAR MAXILLO-FACIAL - BILATERAL | $961.30 |
| 06307 | OSTEOTOMIES, PRE-MAXILLARY SET BACK | $800.90 |
| 06308 | MANDIBULAR OSTEOTOMY/INTERNAL FIXATION/UNILATERAL | $816.94 |
| 06309 | MANDIBULAR OSTEOTOMY - INTERNAL FIXATION/BILATERAL | $1,175.16 |
| 06310 | OSTEOTOMY - ORBITAL ADVANCEMENT - UNILATERAL | $2,779.12 |
| 06311 | OSTEOTOMY - ORBITAL ADVANCEMENT | $3,099.91 |
| 06312 | OSTEOTOMY - INTRACRANIAL CORRECTION HYPERTELORISM | $3,741.50 |
| 06313 | OSTEOTOMY - ORBITAL EXPANSION | $2,992.98 |
| 06314 | OSTEOTOMY - CANTHOPEXY | $560.32 |
| 61380 | BIL ORBITAL ADVANCEMENT-HYPERTELORISM(TEAM PLAST | $2,218.61 |
| 61381 | UNILATERAL ORBITAL ADVANCEMENT-TEAM PROC-PLASTIC | $2,058.21 |
| 61382 | BILATERAL ORBITAL ADVANCEMENT-TEAM PROC-PLASTIC | $2,752.99 |
| Code | Description | Amount |
|---|---|---|
| 02298 | CRYOSURGICAL TREATMENT OF TURBINATES - UNILATERAL | $151.95 |
| 02299 | CRYOSURGICAL TREATMENT OF TURBINATES - BILATERAL | $189.93 |
| 02306 | SUBMUCOUS RESECTION OF SEPTUM | $164.60 |
| 02351 | NASAL REFRACTURE REQUIRING LATERAL OSTEOTOMIES | $354.53 |
| 02352 | RECONSTRUCTION OF NASAL TIP, ALA AND COLUMELLA | $417.85 |
| 02353 | NASAL TIP, ALA AND COLUMELLA/EXTERNAL RECONSTRUCT | $559.68 |
| 02354 | RHINOPLASTY/COMPLETE - WITH SMR TO INCLUDE NASAL | $607.79 |
| 02355 | RHINOPLASTY/SMR, COMPLETE - WITHOUT SKIN GRAFTING | $770.39 |
| 02364 | NASAL FRACTURE - SIMPLE REDUCTION | $63.29 |
| 02365 | NASAL FRACTURE - REDUCTION AND SPLINTING | $126.62 |
| 06109 | RHINOPLASTY - REMOVAL OF HUMP | $236.32 |
| 06115 | RHINOPLASTY - FOREHEAD, 2 OPERATIONS | $910.85 |
| 06116 | RHINOPLASTY - COMPOSITE GRAFT | $328.57 |
| 06117 | RHINOPHYMA | $332.56 |
| 06118 | RHINOPLASTY; BONE GRAFT TO NOSE - AUTOLOGOUS | $596.67 |
| 06119 | RHINOPLASTY; BONE GRAFT NOSE, NON-AUTOLOGOUS | $489.74 |
| 06123 | NASAL FRACTURE-COMMINUTED-WIRE PLATE FIXATION | $304.76 |
| 06124 | NASAL FRACTURE - WIRE PLATE FIXATION - OPEN REDUCT | $529.30 |
| Code | Description | Amount |
|---|---|---|
| 06130 | AURICLE - ACCESSORY | $253.02 |
| 06131 | OTOPLASTY - OUTSTANDING EARS(UNILATERAL) | $315.45 |
| 06132 | MICROTIA - PARTIAL | $374.25 |
| 06133 | MICROTIA - TOTAL MAJOR | $931.37 |
| 06134 | MICROTIA - TOTAL MINOR | $304.76 |
| 06135 | PREAURICULAR SINUS - SIMPLE | $253.02 |
| 06180 | PREAURICULAR SINUS - COMPLICATED | $302.06 |
| 61031 | OTOPLASTY-OUTSTANDING EARS(BILATERAL) | $473.17 |
| Code | Description | Amount |
|---|---|---|
| 06136 | ABBE OPERATION | $636.35 |
| 06137 | MOUTH ROTATION FLAP TO LIP | $544.84 |
| 06138 | CLEFT LIP - BILATERAL | $1,053.26 |
| 06139 | CLEFT LIP - UNILATERAL | $553.89 |
| 06140 | WEDGE RESECTION - LIP VERMILION | $199.08 |
| 06141 | WEDGE RESECTION OF LIP SULCUS | $248.85 |
| 06142 | PHARYNGOPLASTY, PHARYNGEAL FLAP | $538.93 |
| 06143 | PHARYNGEAL FLAP PUSH BACK | $745.31 |
| 06144 | CLEFT LIP, BILATERAL | $745.31 |
| 06145 | CLEFT PALATE | $549.62 |
| 06146 | LIP SHAVE - VERMILLIONECTOMY | $396.16 |
| 06147 | PALATAL CLEFT - BONE GRAFT | $608.43 |
| 06181 | LIP ADHESION FOR CLEFT PALATE | $390.29 |
| Code | Description | Amount |
|---|---|---|
| 06150 | MAMMOPLASTY(UNILATERAL) | $523.92 |
| 06157 | NIPPLE-AREOLAR RECONSTRUCTION | $336.99 |
| 06164 | BREAST REPLACEMENT - UNILATERAL | $402.64 |
| 06165 | BREAST REPLACEMENT - BILATERAL | $604.23 |
| 06178 | BREAST IMPLANT - EXCISION/PATHOLOGIC CAPSULE | $343.95 |
| 06179 | BREAST IMPLANT - EXCISION ONLY | $243.87 |
| 61050 | MAMMOPLASTY (BILATERAL) | $785.87 |
| 61054 | BILATERAL MASTECTOMY IN THE CONTEXT OF GRS | $1,465.27 |
| 61166 | MASTOPEXY, BALANCING UNILATERAL(ISOLATED PROCEDURE | $452.91 |
| 61167 | MASTOPEXY BALANCING WITH CONTRALATERAL BREAST SURG | $302.03 |
| Code | Description | Amount |
|---|---|---|
| 06127 | LYMPHOEDEMA - ENTIRE LEG | $694.83 |
| 06128 | LYMPHOEDEMA - LOWER LIMB | $1,038.79 |
| 06167 | THOMPSON PROCEDURE LYMPHOEDEMA - FOREARM | $351.28 |
| 06168 | THOMPSON PROCEDURE LYMPHOEDEMA - UPPER EXTREMITY | $233.64 |
| 06169 | THOMPSON PROCEDURE LYMPHOEDEMA-LOWER EXTREMITY LEG | $587.08 |
| 06170 | THOMPSON PROCEDURE LYMPHOEDEMA - LOWER EXTREMITY | $587.08 |
| Code | Description | Amount |
|---|---|---|
| 03207 | MICROSURGICAL REMOVAL OF NEOPLASM/MAJOR PERIPHERAL | $809.12 |
| 06210 | MICRONEURAL SURGERY; NEUROLYSIS - EXTERNAL | $285.94 |
| 06211 | MICRONEURAL SURGERY; NEUROLYSIS - INTRANEURAL | $435.67 |
| 06212 | MICROFASCICULAR NEURORRAPHY - DIGITAL OR PALMAR | $285.94 |
| 06213 | MICROFASCICULAR NEURORRAPHY - MAJOR NERVE | $610.35 |
| 06214 | INTRAFASCICULAR NERVE GRAFT - DIGITAL OR PALMAR | $428.39 |
| 06215 | INTRAFASCICULAR NERVE GRAFT - MAJOR NERVE | $1,247.73 |
| 06216 | MICROVASCULAR SURGERY - ARTERY OR VEIN | $670.45 |
| 06217 | MICROREIMPLANTATION - DIGIT OR EXTREMITY | $3,085.74 |
| 06220 | MICROVASCULAR SURGICAL FREE FLAP | $3,084.95 |
| 06259 | MICROSURGICAL REMOVAL NEOPLASM, DIGITAL/PALMAR | $333.54 |
| Code | Description | Amount |
|---|---|---|
| 06221 | BONE GRAFT - METACARPAL, PHALANX | $253.02 |
| Code | Description | Amount |
|---|---|---|
| 06222 | FINGER FRACTURE - PHALANX | $125.76 |
| 06223 | FRACTURE - METACARPAL | $125.76 |
| 06224 | FRACTURE - DISTAL PHALANGES, FIRST | $149.52 |
| 06225 | FRACTURE - DISTAL PHALANGES, EACH ADDITIONAL | $125.76 |
| 61222 | CRIF PHALANGEAL OR METACARPAL FRACTURE (MID/PRXML) | $194.05 |
| 61223 | ORIF PHALANGEAL OR METACARPAL FRACTURE (MID/PRXML) | $264.70 |
| 61224 | OPEN (COMPOUND) HAND FRACTURES PRIMARY WOUND MGMT | $40.66 |
| 61225 | OPEN (COMPOUND)HAND FRACTURES-SECONDARY WOUND MGMT | $81.23 |
| Code | Description | Amount |
|---|---|---|
| 06228 | ARTHROPLASTY OF METACARPOPHALANGEAL/INTERPHALANGEA | $342.18 |
| 06229 | ARTHRODESIS OF METACARPOPHALANGEAL/INTERPHALANGEAL | $304.76 |
| 06231 | HAND JOINTS - RHEUMATOID - RECONSTRUCTION | $984.82 |
| 06232 | PROSTHESIS - FINGER JOINT - FIRST JOINT | $257.71 |
| 06233 | PROSTHESIS - FINGER JOINT - SUBSEQUENT JOINTS | $146.49 |
| 06234 | SYNOVECTOMY - RHEUMATOID DISEASE | $348.59 |
| 06235 | INTRINSIC RELEASE - JOINTS | $253.02 |
| 06236 | METACARPO/INTERPHALANGEAL JOINT - CLOSED REDUCTION | $124.42 |
| 06237 | METACARPO/INTERPHALANGEAL JOINT - OPEN REDUCTION | $253.02 |
| Code | Description | Amount |
|---|---|---|
| 03196 | PERIPHERAL NERVE - MOBILIZATION AND TRANSPOSITION | $279.38 |
| 03198 | NEURECTOMY OF MAJOR PERIPHERAL NERVE | $220.77 |
| 03200 | PERIPHERAL NERVE SUTURE SECONDARY & TRANSPOSITION | $570.96 |
| 03201 | PERIPHERAL NERVE SUTURE SECONDARY | $434.47 |
| 03205 | NERVE GRAFT | $428.60 |
| 06156 | NEUROMA TRANSPLANT | $253.02 |
| 06255 | PERIPHERAL NERVE SUTURE: MINOR | $253.02 |
| 06256 | NERVE REPAIR - PALMAR | $253.02 |
| 06257 | PERIPHERAL NERVE SUTURE: MAJOR | $400.31 |
| 06258 | PERIPHERAL NERVE/NEUROLYSIS - EXPLORATION | $254.74 |
| Code | Description | Amount |
|---|---|---|
| 06200 | TATTOOING SURGERY FACIAL AREA - < 1/4 OF FACE | $113.84 |
| 06201 | TATTOOING SURGERY FACIAL AREA - 1/4 TO 1/2 FACE | $233.64 |
| 06202 | TATTOOING SURGERY FACIAL AREA - FULL FACE | $351.28 |
| 06205 | TATTOOING SURGERY NON-FACIAL AREA - < 6.5 SQ. CM | $59.31 |
| 06206 | TATTOOING SURGERY NON-FACIAL AREA - < 65 SQ. CM | $117.43 |
| 06207 | TATTOOING SURGERY NON-FACIAL AREA - < 650 SQ. CM | $233.64 |
| Code | Description | Amount |
|---|---|---|
| 07522 | LOCAL EXCISION OF PAROTID TUMOR | $202.10 |
| Code | Description | Amount |
|---|---|---|
| 52555 | SHOULDER/CLAVICLE/HUMERUS TENDON TRANSFER | $509.68 |
| Code | Description | Amount |
|---|---|---|
| 06019 | SKIN GRAFTS - SINGLE OR MULTIPLE FLAPS < 2CM | $156.57 |
| 06020 | SKIN GRAFTS - SINGLE | $321.04 |
| 06021 | SKIN GRAFTS/SINGLE WITH FREE SKIN GRAFT SECONDARY | $403.90 |
| 06022 | SKIN GRAFTS - MULTIPLE | $565.45 |
| 06023 | SKIN GRAFTS - MULTIPLE WITH FREE SKIN GRAFT | $643.13 |
| 06024 | SKIN GRAFT; EYEBROW/EYELID, LIP, EAR, NOSE SINGLE | $291.77 |
| 06025 | SKIN GRAFT; EYEBROW/EYELID/LIP/EAR/NOSE; TWO STAGE | $466.13 |
| Code | Description | Amount |
|---|---|---|
| 06015 | REMOVAL OF EXTENSIVE SCARS PER CM OVER 5 CM | $8.44 |
| 06016 | REMOVAL OF TUMOR OR SCAR UNDER GA, UP TO 5 CM | $126.26 |
| 06017 | REMOVAL OF TUMOUR; 5 CM TO 10 CM | $258.91 |
| 06018 | REMOVAL OF TUMOR - MORE THAN 10 CM | $447.40 |
| 06040 | FINGER, PHALANX MULTIPLE SKIN GRAFT FREE | $291.77 |
| 06041 | FULL THICKNESS FREE SKIN GRAFTS; EYELID/NOSE/LIP | $349.88 |
| 06043 | SKIN GRAFT - FINGER TIP - FULL THICKNESS | $247.86 |
| 06044 | SKIN GRAFTS - FULL THICKNESS - FREE - SOLE OR PALM | $291.77 |
| 06045 | FREE SKIN GRAFT; FULL THICKNESS - TOE PULP GRAFT | $247.86 |
| 06069 | EXCISION OF TUMOR OR SMALL SCAR - FACE | $88.03 |
| 13612 | EXTENSIVE LACERATION GREATER THAN 5CM | $13.15 |
| 13620 | EXCISION TUMOR OF SKIN/SCAR UP TO 5CM | $65.53 |
| 13621 | EXCISION ADDITIONAL TUMOR OF SKIN/SCAR UP TO 5CM | $32.76 |