NOTICE. *Copyright 2000 Louisiana Department of Labor, Office of Workers compensation. Maximum Fee Allowance Schedule Office of Workers' Compensation

Transcription

1 NOTICE The five-digit numeric codes and descriptions included in the Medical Reimbursement Schedule are obtained from the Physicians Current Procedural Terminology, copyright 1999 by the American Medical Association (CPT). CPT is a listing of descriptive terms and numeric identifying codes and modifiers for reporting medical services and procedures performed by physicians and other health care providers. This publication includes only CPT numeric identifying codes and modifiers for reporting medical services and procedures that were selected by the Louisiana Department of Labor, Office of Workers Compensation. Any use of CPT outside the fee schedule should refer to the Physicians Current Procedural Terminology, copyright 1999 American Medical Association and any update thereto. These CPT publications contain the complete and most current listing of CPT descriptive terms and numeric identifying codes and modifiers for reporting medical services and procedures. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of the Physicians Current Procedural Terminology, copyright 1999, by the American Medical Association. All rights reserved. *Copyright 2000 Louisiana Department of Labor, Office of Workers compensation Maximum Fee Allowance Schedule Office of Workers' Compensation CPT Global Maximum Code Mod Description Days Allowance Integ sys head or saliv glands; nos 5 + TM Plastic repair of cleft lip 6 + TM Blepharoplasty 5 + TM Electroconvulsive therapy 4 + TM Ext, mid, & inner ear inc bx; nos 5 + TM Otoscopy 4 + TM Tympanotomy 4 + TM Procedures on eye nos 5 + TM Lens surgery 6 + TM Corneal transplant 6 + TM Vitrectomy 6 + TM Iridectomy 6 + TM Ophthalmoscopy 4 + TM Nose & accessory sinuses nos 5 + TM Nose, radical surgery 7 + TM Nose, biopsy, soft tissue 4 + TM Intraoral procedures, inc bx nos 5 + TM Intraoral, repair of cleft palate 6 + TM CPT codes and descriptions only are copyright 1999 American Medical Association 1

2 00174 Intraoral exc retropharyngeal tumor 6 + TM Intraoral radical surgery 7 + TM Procedures on facial bones; nos 5 + TM Facial bones; radical surgery 7 + TM Intracranial procedures; nos 11 + TM Subdural taps 5 + TM Burr holes 9 + TM Skull fracture 9 + TM Intracranial vascular procedures 15 + TM Intracranial proc sitting position 13 + TM Spinal fluid shunting procedures 10 + TM Electrocoag intracranial nerve 6 + TM Integ sys neck, inc subcut tissue 5 + TM Neck procedures exc integ system 6 + TM Needle biopsy of thyroid 3 + TM Major vessels of neck; nos 10 + TM Major vesels neck; simple ligation 5 + TM Ant integ system chest; nos 3 + TM Reconstructive procedures on breast 5 + TM Radical/mod radical breast 5 + TM Radical/mod breast w/node dissect 13 + TM Cardioversion 4 + TM Clavicle & scapula; nos 5 + TM Clavicle & scapula; radical surgery 6 + TM Biopsy of clavicle 3 + TM Partial rib resection; nos 6 + TM Thoracoplasty 10 + TM Rib resection; radical procedures 13 + TM Procedures on esophagus 15 + TM Closed chest procedures nos 6 + TM Needle biopsy of pleura 4 + TM Pneumocentesis 4 + TM Mediastinoscopy 8 + TM Transvenous pacemaker insertion 4 + TM Access central venous circulation 4 + TM Transvenous cardioverter/defibrill 7 + TM Thoracotomy procedures; nos 13 + TM Decortication 15 + TM Pleurectomy 15 + TM Pulmonary resect w/thoracoplasty 15 + TM Repair trauma trachea/bronchi 15 + TM Heart, pericardium, w/o pump 15 + TM Heart, pericardium, w/ pump 20 + TM Heart, heart/lung transplant 20 + TM Cervical spine & cord; nos 10 + TM Post cervical laminectomy sitting 13 + TM Thoracic spine & cord; nos 10 + TM CPT codes and descriptions only are copyright 1999 American Medical Association 2

3 00622 Thoracolumbar sympathectomy 13 + TM Procedures in lumbar region; nos 8 + TM Lumbar sympathectomy 7 + TM Chemonucleolysis 10 + TM Extensive spine/cord procedures 13 + TM Upper anterior abdominal wall nos 3 + TM Percutaneous liver biopsy 4 + TM Upper posterior abdominal wall 5 + TM Upper gi endoscopic procedures 5 + TM Hernia repairs upper abdomen nos 4 + TM Lumbar & ventral hernias 6 + TM Omphalocele 7 + TM Transabd repair diaphragm hernia 7 + TM Major abdominal blood vessels 15 + TM Intraperitoneal proc upper abd; nos 7 + TM Partial hepatectomy 13 + TM Pancreatectomy, partial or total 8 + TM Liver transplant (recipient) 30 + TM Lower anterior abdominal wall; nos 3 + TM Panniculectomy 5 + TM Intestinal endoscopic procedures 5 + TM Lower posterior abdominal wall 5 + TM Hernia repairs lower abdomen; nos 4 + TM Ventral & incisional hernias 6 + TM Intraperitoneal proc lower abd; nos 6 + TM Amniocentesis 4 + TM Abdominoperineal resection 7 + TM Radical hysterectomy 8 + TM Pelvic exenteration 8 + TM Cesarean section 7 + TM Cesarean hysterectomy 8 + TM Cont epidural analgesia, c-section 7 + TM Extraperitoneal proc lower abd; nos 6 + TM Renal procedures/donor nephrectomy 7 + TM Radical prostatectomy 7 + TM Total cystectomy 8 + TM Radical prostatectomy 7 + TM Adrenalectomy 10 + TM Renal transplant (recipient) 10 + TM Cystolithotomy 5 + TM Lithotripsy, w/ water bath 7 + TM Lithotripsy, w/o water bath 5 + TM Major lower abdominal vessels; nos 15 + TM Inferior vena cava ligation 10 + TM Transvenous umbrella insertion 5 + TM Perineal integumentary system; nos 3 + TM Anorectal procedure 4 + TM CPT codes and descriptions only are copyright 1999 American Medical Association 3

4 00904 Radical perineal procedure 7 + TM Vulvectomy 4 + TM Perineal prostatectomy 6 + TM Transurethral procedures; nos 3 + TM Tur bladder tumor(s) 5 + TM Transurethral resection prostate 5 + TM Post turp bleeding 5 + TM Fragment/removal ureteral calculus 5 + TM Male external genitalia; nos 3 + TM Seminal vesicles 6 + TM Undescended testis 4 + TM Radical orchiectomy, inguinal 4 + TM Radical orchiectomy, abdominal 6 + TM Orchiopexy, unilateral or bilateral 4 + TM Complete amputation of penis 4 + TM Rad amp penis w/ bil ing lymphad 6 + TM Rad amp penis w/ bil ing/iliac lymp 8 + TM Insertion of penile prosthesis 4 + TM Vaginal procedures; nos 3 + TM Colpotomy, colpectomy, colporrhaphy 4 + TM Vaginal hysterectomy 6 + TM Vaginal delivery 5 + TM Cervical cerclage 4 + TM Culdoscopy 5 + TM Hysteroscopy 4 + TM Cont epidural analgesia, vag del 5 + TM Bony pelvis 6 + TM Body cast application or revision 3 + TM Interpelviabdominal amputation 15 + TM Rad proc tumor pelvis, 8 + TM Closed procedures symphysis pubis 4 + TM Open proc symphysis pubis/sacroilia 8 + TM Obturator neurectomy; extrapelvic 3 + TM Intrapelvic 4 + TM Closed procedures hip joint 4 + TM Arthroscopic procedures hip joint 4 + TM Open procedures hip joint; nos 6 + TM Hip disarticulation 10 + TM Total hip replacement or revision 8 + TM Revision of total hip arthroplasty 10 + TM Closed procedures upper femur 4 + TM Open procedures upper femur; nos 6 + TM Amputation 5 + TM Radical resection 8 + TM Nerves, muscles, etc, upper leg 4 + TM Veins upper leg, including explore 3 + TM Arteries upper leg, inc bypass; nos 8 + TM CPT codes and descriptions only are copyright 1999 American Medical Association 4

5 01272 Femoral artery ligation 4 + TM Femoral artery embolectomy 6 + TM Nerves, muscles, etc, knee 4 + TM Closed procedures lower femur 4 + TM Open procedures lower of femur 5 + TM Closed procedures knee joint 3 + TM Arthroscopic procedures knee joint 3 + TM Closed procedures uppr tibia/fibula 3 + TM Open procedures upper tibia/fibula 4 + TM Open procedures on knee joint; nos 4 + TM Total knee replacement 7 + TM Disarticulation at knee 5 + TM Cast apply, remove, repair knee 3 + TM Veins of knee & popliteal area; nos 3 + TM Arteriovenous fistula 6 + TM Arteries knee & popliteal area nos 5 + TM Popliteal thromboendarterectomy 8 + TM Popliteal excision & graft 8 + TM Closed proc lwr leg, ankle, & foot 3 + TM Arthroscopic procedures ankle joint 3 + TM Nerves, muscles, etc, lower leg 3 + TM Repair ruptured achilles tendon, 5 + TM Gastrocnemius recession 5 + TM Open procedures bones lower leg 3 + TM Radical resection 4 + TM Osteotomy/osteoplasty tibia/fibula 4 + TM Total ankle replacement 7 + TM Lower leg cast, removal, or repair 3 + TM Arteries lower leg, inc bypass; nos 8 + TM Embolectomy, direct or catheter 6 + TM Veins of lower leg nos 3 + TM Venous thrombectomy, dir catheter 5 + TM Nerves, muscles, etc, shoulder 5 + TM Closed proc humeral head & neck 4 + TM Arthroscopic procedures shoulder 4 + TM Open procedures humeral head & neck 5 + TM Radical resection 6 + TM Shoulder disarticulation 9 + TM Interthoracoscapular amputation 15 + TM Total shoulder replacement 10 + TM Arteries of shoulder & axilla nos 6 + TM Axillary-brachial aneurysm 10 + TM Bypass graft 8 + TM Axillaryfemoral bypass graft 10 + TM Procedures veins shoulder & axilla 4 + TM Shoulder cast, removal, repair nos 3 + TM Shoulder spica 4 + TM CPT codes and descriptions only are copyright 1999 American Medical Association 5

6 01710 Nerves, muscles, etc, of upper arm 3 + TM Tenotomy, elbow to shoulder, open 5 + TM Tenoplasty, elbow to shoulder 5 + TM Tenodesis, rupt long tendon biceps 5 + TM Closed procedures humerus & elbow 3 + TM Arthroscopic procedures elbow joint 3 + TM Open procedures humerus & elbow nos 4 + TM Osteotomy of humerus 5 + TM Repair nonunion/malunion of humerus 5 + TM Radical procedures 6 + TM Excision cyst or tumor of humerus 5 + TM Total elbow replacement 7 + TM Arteries of upper arm & elbow; nos 6 + TM Embolectomy 6 + TM Veins of upper arm & elbow; nos 3 + TM Phleborrhaphy 4 + TM Repair a-v fistula 6 + TM Nerves, muscles, etc, forearm/wrist 3 + TM Closed proc lwr arm, wrist or hand 3 + TM Open proc lwr arm, wrist or hand 3 + TM Total wrist replacement 6 + TM Arteries forearm, wrist, & hand nos 6 + TM Embolectomy 6 + TM Vascular shunt, shunt revision 6 + TM Veins forearm, wrist, & hand nos 3 + TM Phleborrhaphy 4 + TM Forearm, wrist, or hand cast applic 3 + TM Inj procedure pneumoencephalography 7 + TM Inj procedure myelography lumbar 5 + TM Inj procedure cervical 5 + TM Inj procedure posterior fossa 9 + TM Inj procedure discography lumbar 5 + TM Inj procedure discography cervical 6 + TM Arteriograms, needle carotid/vert 5 + TM Arteriograms, retro, brach/femoral 5 + TM Cardiac catheterization 7 + TM Angioplasty 7 + TM CAT/MRI 7 + TM Harvest organ(s) brain dead patient 7 + TM Regional iv local anesthetic agent Daily mgmt epidur/subarach drug adm Daily mgmt intravenous pat. cntrld Unlisted anesthesia procedure(s) BR Acne surgery 10 $ Drainage of skin abscess 10 $ Drainage of skin abscess 10 $ Drainage of pilonidal cyst 10 $154 CPT codes and descriptions only are copyright 1999 American Medical Association 6

7 10081 Drainage of pilonidal cyst 10 $ Remove foreign body 10 $ Remove foreign body 10 $ Drainage of hematoma/fluid 10 $ Puncture drainage of lesion 10 $ Complex drainage, wound 10 $ Surgical cleansing of skin 0 $ Debride infected skin add-on. $ Debride skin, fx $ Debride skin/muscle, fx. 0 $ Debride skin/muscle/ bone, fx. 0 $ Surgical cleansing, abrasion 0 $ Surgical cleansing of skin 0 $ Cleansing of skin/tissue 0 $ Cleansing of tissue/muscle 10 $ Cleansing tissue/muscle/bone 10 $ Trim skin lesion... 0 $ Trim skin lesions, 2 to 4. 0 $ Trim skin lesions, over 4. 0 $ Biopsy of skin lesion 0 $ Biopsy, skin add-on... $ Removal of skin tags 10 $ Remove skin tags add- on. $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Shave skin lesion 0 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $414 CPT codes and descriptions only are copyright 1999 American Medical Association 7

8 11440 Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal, sweat gland lesion 90 $ Removal, sweat gland lesion 90 $ Removal, sweat gland lesion 90 $ Removal, sweat gland lesion 90 $ Removal, sweat gland lesion 90 $ Removal, sweat gland lesion 90 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Removal of skin lesion 10 $ Trim nail(s)... 0 $ Debride nail, $ Debride nail, 6 or more. 0 $ Removal of nail plate 0 $ Remove nail plate, add on. $ Drain blood from under nail 0 $ Removal of nail bed 10 $ Remove nail bed/finger tip 10 $ Biopsy, nail unit 0 $ Reconstruction of nail bed 10 $ Reconstruction of nail bed 10 $ Excision of nail fold, toe 10 $ Removal of pilonidal lesion 10 $ Removal of pilonidal lesion 90 $ Removal of pilonidal lesion 90 $ Injection into skin lesions 0 $ Added skin lesion injections 0 $88 CPT codes and descriptions only are copyright 1999 American Medical Association 8

9 11920 Correct skin color defects 0 BR Correct skin color defects 0 BR Correct skin color defects. $ Therapy for contour defects 0 BR Therapy for contour defects 0 BR Therapy for contour defects 0 BR Therapy for contour defects 0 BR Insert tissue expander(s) 90 $1, Replace tissue expander 90 $1, Remove tissue expander(s) 90 $ Insert contraceptive cap BR Removal of contraceptive cap BR Remove/reinsert contra cap BR Implant hormone pellet(s). 0 BR Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Repair superficial wound(s) 10 $ Closure of split wound 10 $ Closure of split wound 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $ Layer closure of wound(s) 10 $740 CPT codes and descriptions only are copyright 1999 American Medical Association 9

10 12057 Layer closure of wound(s) 10 $ Repair of wound or lesion 10 $ Repair of wound or lesion 10 $ Repair wound/lesion add-on. BR Repair of wound or lesion 10 $ Repair of wound or lesion 10 $ Repair wound/lesion add-on. BR Repair of wound or lesion 10 $ Repair of wound or lesion 10 $ Repair wound/lesion add-on. BR Repair of wound or lesion 10 $ Repair of wound or lesion 10 $ Repair of wound or lesion 10 $ Repair wound/lesion add-on. BR Late closure of wound 90 $ Skin tissue rearrangement 90 $ Skin tissue rearrangement 90 $ Skin tissue rearrangement 90 $ Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin tissue rearrangement 90 $1, Skin graft... 0 $ Skin graft add-on... $ Skin pinch graft procedure 90 $ Skin split graft $1, Skin split graft add- on. $ Skin split graft $1, Skin split graft add- on. $ Skin full graft procedure 90 $ Skin full graft add-on $ Skin full graft procedure 90 $ Skin full graft add-on $ Skin full graft procedure 90 $1, Skin full graft add-on $ Skin full graft procedure 90 $1, Skin full graft add-on $ Skin homograft $ Skin homograft add-on. $ Skin heterograft $ Skin heterograft add- on. $ Form skin pedicle flap 90 $1, Form skin pedicle flap 90 $1, Form skin pedicle flap 90 $992 CPT codes and descriptions only are copyright 1999 American Medical Association 10

11 15576 Form skin pedicle flap 90 $ Skin graft procedure 90 $ Skin graft procedure 90 $ Skin graft procedure 90 $ Skin graft procedure 90 $ Transfer skin pedicle flap 90 $ Muscle-skin graft, head/neck 90 $2, Muscle-skin graft, trunk 90 $2, Muscle-skin graft, arm 90 $2, Muscle-skin graft, leg 90 $2, Island pedicle flap graft 90 $1, Neurovascular pedicle graft 90 $1, Free muscle flap, microvasc. 90 $4, Free skin flap, microvasc. 90 $4, Free fascial flap, microvasc. 90 $4, Composite skin graft 90 $1, Derma-fat-fascia graft 90 $1, Hair transplant punch grafts 0 BR Hair transplant punch grafts 0 BR Abrasion treatment of skin 90 $ Abrasion treatment of skin 90 $ Abrasion treatment of skin 90 $ Abrasion treatment of skin 90 $ Abrasion treatment of lesion 10 $ Abrasion, lesions, add on. $ Chemical peel, face, epiderm 90 $ Chemical peel, face, dermal 90 $ Chemical peel, nonfacial 90 $ Chemical peel, nonfacial 90 $ Salabrasion 90 $ Salabrasion 90 $ Plastic surgery, neck 90 $1, Revision of lower eyelid 90 $ Revision of lower eyelid 90 $ Revision of upper eyelid 90 $ Revision of upper eyelid 90 $1, Removal of forehead wrinkles BR Removal of neck wrinkles BR Removal of brow wrinkles BR Removal of face wrinkles BR Removal of skin wrinkles BR Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $1,113 CPT codes and descriptions only are copyright 1999 American Medical Association 11

12 15837 Excise excessive skin tissue 90 $1, Excise excessive skin tissue 90 $ Excise excessive skin tissue 90 $ Graft for face nerve palsy 90 $2, Graft for face nerve palsy 90 $2, Graft for face nerve palsy 90 $4, Skin and muscle repair, face 90 $2, Removal of sutures BR Removal of sutures 0 $ Dressing change,not for burn 0 $ Test for blood flow in graft 0 $ Suction assisted lipectomy BR Suction assisted lipectomy BR Suction assisted lipectomy BR Suction assisted lipectomy BR Removal of tail bone ulcer 90 $ Removal of tail bone ulcer 90 $1, Remove sacrum pressure sore 90 $ Remove sacrum pressure sore 90 $1, Remove sacrum pressure sore 90 $1, Remove sacrum pressure sore 90 $1, Remove sacrum pressure sore. 90 $1, Remove sacrum pressure sore 90 $2, Removal of pressure sore 90 $ Removal of pressure sore 90 $1, Removal of pressure sore 90 $1, Removal of pressure sore 90 $1, Remove hip pressure sore. 90 $2, Remove thigh pressure sore 90 $ Remove thigh pressure sore 90 $1, Remove thigh pressure sore 90 $1, Remove thigh pressure sore 90 $1, Remove thigh pressure sore. 90 $2, Remove thigh pressure sore 90 $2, Removal of pressure sore BR Initial treatment of burn(s) 0 $ Treatment of burn(s) 0 $ Treatment of burn(s) 0 $ Treatment of burn(s) 0 $ Treatment of burn(s) 0 $ Treatment of burn(s) 0 $ Incision of burn scab 90 $ Destroy benign/premal lesion. 10 $ Destroy lesions, $ Destroy lesions, 15 or more. 10 $ Destruction of skin lesions 90 $ Destruction of skin lesions 90 $931 CPT codes and descriptions only are copyright 1999 American Medical Association 12

13 17108 Destruction of skin lesions 90 $1, Destruct lesion, $ Destruct lesion, 15 or more. 10 $ Chemical cautery, tissue 0 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Destruction of skin lesions 10 $ Chemosurgery of skin lesion. 0 $ nd stage chemosurgery 0 $ rd stage chemosurgery 0 $ Followup skin lesion therapy 0 $ Extensive skin chemosurgery 0 $ Cryotherapy of skin 10 $ Skin peel therapy 10 $ Hair removal by electrolysis BR Skin tissue procedure BR Drainage of breast lesion 0 $ Drain breast lesion add-on. $ Incision of breast lesion 90 $ Injection for breast x-ray 0 $ Biopsy of breast 0 $ Biopsy of breast 10 $ Nipple exploration 90 $ Excise breast duct fistula 90 $ Removal of breast lesion. 90 $ Excision, breast lesion 90 $ Excision, addl breast lesion. $ Removal of breast tissue 90 $ Removal of breast tissue 90 $ Remove breast tissue, nodes 90 $1, Removal of breast 90 $1, Removal of breast 90 $1,035 CPT codes and descriptions only are copyright 1999 American Medical Association 13

14 19200 Removal of breast 90 $1, Removal of breast 90 $1, Removal of breast 90 $1, Removal of chest wall lesion 90 $1, Revision of chest wall 90 $2, Extensive chest wall surgery 90 $2, Place needle wire, breast 0 $ Place needle wire, breast. $ Suspension of breast 90 $1, Reduction of large breast 90 $2, Enlarge breast 90 $ Enlarge breast with implant 90 $1, Removal of breast implant 90 $ Removal of implant material 90 $ Immediate breast prosthesis $1, Delayed breast prosthesis 90 $1, Breast reconstruction 90 $1, Correct inverted nipple(s) 90 $ Breast reconstruction 90 $2, Breast reconstruction 90 $2, Breast reconstruction 90 $3, Breast reconstruction 90 $2, Breast reconstruction 90 $3, Breast reconstruction 90 $3, Breast reconstruction 90 $3, Surgery of breast capsule 90 $1, Removal of breast capsule 90 $1, Revise breast reconstruction 90 $1, Design custom breast implant 0 BR Breast surgery procedure BR Incision of abscess 10 $ Incision of deep abscess 10 $ Explore wound, neck $1, Explore wound, chest.. 10 $ Explore wound, abdomen 10 $ Explore wound, extremity. 10 $ Excise epiphyseal bar. 90 $1, Muscle biopsy 0 $ Deep muscle biopsy 0 $ Needle biopsy, muscle 0 $ Bone biopsy, trocar/needle 0 $ Bone biopsy, trocar/needle 0 $ Bone biopsy, excisional. 10 $ Bone biopsy, excisional 10 $ Open bone biopsy 10 $ Open bone biopsy 10 $ Injection of sinus tract 10 $112 CPT codes and descriptions only are copyright 1999 American Medical Association 14

15 20501 Inject sinus tract for x-ray 0 $ Removal of foreign body 10 $ Removal of foreign body 10 $ Inj tendon/ligament/cyst 0 $ Drain/inject joint/bursa 0 $ Drain/inject joint/bursa 0 $ Drain/inject joint/bursa 0 $ Treatment of bone cyst 10 $ Insert and remove bone pin 10 $ Apply,remove fixation device 0 $ Application of head brace 90 $ Application of pelvis brace 90 $ Application of thigh brace 90 $ Halo brace application 90 $ Removal of fixation device 10 $ Removal of support implant 10 $ Removal of support implant 90 $ Apply bone fixation device 90 $ Apply bone fixation device 90 $ Adjust bone fixation device 90 $ Remove bone fixation device 90 $ Replantation, arm, complete. 90 $5, Replant, forearm, complete. 90 $7, Replantation hand, complete. 90 $8, Replantation digit, complete. 90 $4, Replantation digit, complete. 90 $3, Replantation thumb, complete. 90 $4, Replantation thumb, complete. 90 $4, Replantation foot, complete. 90 $5, Removal of bone for graft 90 $ Removal of bone for graft 90 $ Remove cartilage for graft 90 $ Remove cartilage for graft 90 $ Removal of fascia for graft 90 $ Removal of fascia for graft 90 $ Removal of tendon for graft 90 $ Removal of tissue for graft 90 $ Spinal bone allograft. BR Spinal bone allograft. $ Spinal bone autograft. BR Spinal bone autograft. $ Spinal bone autograft. $ Record fluid pressure,muscle 0 $ Microvascular fibula graft 90 BR Iliac bone graft, microvasc. 90 $5, Mt bone graft, microvasc. 90 $5, Other bone graft, microvasc. 90 $5,010 CPT codes and descriptions only are copyright 1999 American Medical Association 15

16 20969 Bone/skin graft, microvasc. 90 $6, Bone/skin graft, iliac crest. 90 $6, Bone-skin graft, metatarsal 90 BR Bone-skin graft, great toe 90 BR Electrical bone stimulation 0 $ Electrical bone stimulation 0 $ Us bone stimulation... 0 BR Musculoskeletal surgery BR Incision of jaw joint 90 $1, Resection of facial tumor 90 $ Excision of bone, lower jaw 90 $ Excision of facial bone(s) 90 $ Contour of face bone lesion 90 $1, Removal of face bone lesion 90 $ Remove exostosis, mandible 90 $ Remove exostosis, maxilla 90 $ Removal of face bone lesion 90 $1, Removal of jaw bone lesion 90 $ Removal of jaw bone lesion 90 $ Removal of jaw bone lesion 90 $1, Extensive jaw surgery 90 $2, Removal of jaw joint 90 $1, Remove jaw joint cartilage 90 $1, Remove coronoid process 90 $1, Prepare face/oral prosthesis. 10 $2, Prepare face/oral prosthesis. 90 $5, Prepare face/oral prosthesis. 90 $3, Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 10 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Prepare face/oral prosthesis 90 BR Maxillofacial fixation 90 $ Interdental fixation 90 $ Injection, jaw joint x-ray 0 $ Reconstruction of chin 90 $ Reconstruction of chin 90 $ Reconstruction of chin 90 $1, Reconstruction of chin 90 $1, Augmentation lower jaw bone 90 $ Augmentation lower jaw bone 90 $1, Reduction of forehead 90 BR CPT codes and descriptions only are copyright 1999 American Medical Association 16

17 21138 Reduction of forehead 90 BR Reduction of forehead 90 BR Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort. 90 $2, Reconstruct midface, lefort 90 BR Reconstruct midface, lefort 90 BR Reconstruct midface, lefort 90 BR Reconstruct midface, lefort 90 BR Reconstruct midface, lefort 90 BR Reconstruct midface, lefort 90 BR Reconstruct orbit/forehead 90 BR Reconstruct orbit/forehead 90 BR Reconstruct entire forehead 90 BR Reconstruct entire forehead 90 BR Contour cranial bone lesion 90 BR Reconstruct cranial bone 90 BR Reconstruct cranial bone 90 BR Reconstruct cranial bone 90 BR Reconstruction of midface 90 BR Reconstruct lower jaw bone. 90 $2, Reconstruct lower jaw bone 90 $2, Reconstruct lower jaw bone. 90 $2, Reconstruct lower jaw bone 90 $2, Reconstruct lower jaw bone 90 $2, Reconstruct upper jaw bone 90 $1, Augmentation of facial bones 90 $1, Reduction of facial bones 90 $ Face bone graft 90 $1, Lower jaw bone graft 90 $1, Rib cartilage graft 90 $1, Ear cartilage graft 90 $1, Reconstruction of jaw joint 90 $2, Reconstruction of jaw joint 90 $2, Reconstruction of jaw joint 90 $2, Reconstruction of lower jaw 90 $2, Reconstruction of jaw 90 $1, Reconstruction of jaw 90 $1, Reconstruct lower jaw bone 90 $3, Reconstruction of jaw 90 $2, Reconstruction of jaw 90 $3, Reconstruct lower jaw bone 90 $2, Reconstruction of orbit 90 $2, Revise eye sockets 90 $2,609 CPT codes and descriptions only are copyright 1999 American Medical Association 17

18 21261 Revise eye sockets 90 $3, Revise eye sockets 90 $4, Revise eye sockets 90 $2, Revise eye sockets 90 $2, Augmentation cheek bone 90 $1, Revision orbitofacial bones 90 $1, Revision of eyelid 90 $ Revision of eyelid 90 $ Revision of jaw muscle/bone 90 $ Revision of jaw muscle/bone 90 $ Cranio/maxillofacial surgery BR Treatment of skull fracture 0 $ Treatment of nose fracture 0 $ Treatment of nose fracture 10 $ Treatment of nose fracture 10 $ Repair of nose fracture 90 $ Repair of nose fracture 90 $ Repair of nose fracture 90 $1, Repair nasal septal fracture 90 $ Repair nasal septal fracture 90 $ Repair nasoethmoid fracture 90 $ Repair nasoethmoid fracture 90 $1, Repair of nose fracture 90 $1, Repair of sinus fracture 90 $1, Repair of sinus fracture 90 $2, Repair of nose/jaw fracture 90 $1, Repair of nose/jaw fracture 90 $1, Repair of nose/jaw fracture 90 $1, Repair of nose/jaw fracture 90 $2, Repair cheek bone fracture 10 $ Repair cheek bone fracture 10 $ Repair cheek bone fracture 90 $1, Repair cheek bone fracture 90 $1, Repair cheek bone fracture 90 $2, Repair eye socket fracture 90 $1, Repair eye socket fracture 90 $1, Repair eye socket fracture 90 $1, Repair eye socket fracture 90 $1, Repair eye socket fracture 90 $1, Treat eye socket fracture 90 $ Repair eye socket fracture 90 $ Repair eye socket fracture 90 $ Repair eye socket fracture 90 $1, Repair eye socket fracture 90 $1, Treat mouth roof fracture 90 $ Repair mouth roof fracture 90 $1, Repair mouth roof fracture 90 $1,466 CPT codes and descriptions only are copyright 1999 American Medical Association 18

19 21431 Treat craniofacial fracture 90 $ Repair craniofacial fracture 90 $1, Repair craniofacial fracture 90 $3, Repair craniofacial fracture 90 $2, Repair craniofacial fracture 90 $3, Repair dental ridge fracture 90 $ Repair dental ridge fracture 90 $ Treat lower jaw fracture 90 $ Treat lower jaw fracture 90 $ Treat lower jaw fracture 90 $ Treat lower jaw fracture 90 $ Treat lower jaw fracture 90 $1, Repair lower jaw fracture 90 $1, Repair lower jaw fracture 90 $1, Repair lower jaw fracture 90 $1, Repair lower jaw fracture 90 $2, Reset dislocated jaw 0 $ Reset dislocated jaw 90 $ Repair dislocated jaw 90 $1, Treat hyoid bone fracture 90 $ Repair hyoid bone fracture 90 $ Repair hyoid bone fracture 90 $ Interdental wiring 90 $ Head surgery procedure BR Drain neck/chest lesion 90 $ Drain chest lesion 90 $ Drainage of bone lesion 90 $ Biopsy of neck/chest 10 $ Remove lesion neck/chest 90 $ Remove lesion neck/chest 90 $ Remove tumor, neck or chest 90 $1, Partial removal of rib 90 $ Partial removal of rib 90 $1, Removal of rib $1, Removal of rib and nerves 90 $1, Partial removal of sternum 90 $1, Sternal debridement 90 $ Extensive sternum surgery. 90 $2, Extensive sternum surgery 90 $2, Revision of neck muscle 90 $ Revision of neck muscle/rib 90 $1, Revision of neck muscle 90 $ Revision of neck muscle 90 $ Reconstruction of sternum 90 $1, Repair of sternum separation 90 $1, Treatment of rib fracture 90 $ Treatment of rib fracture 90 $293 CPT codes and descriptions only are copyright 1999 American Medical Association 19

20 21810 Treatment of rib fracture(s) 90 $1, Treat sternum fracture 90 $ Repair sternum fracture 90 $1, Neck/chest surgery procedure BR Biopsy soft tissue of back 10 $ Biopsy soft tissue of back 90 $ Remove lesion, back or flank 90 $ Remove tumor of back 90 $1, Remove part of neck vertebra. 90 $1, Remove part, thorax vertebra 90 $1, Remove part, lumbar vertebra 90 $ Remove extra spine segment. $ Remove part of neck vertebra. 90 $1, Remove part, thorax vertebra 90 $1, Remove part, lumbar vertebra 90 $1, Remove extra spine segment. $ Revision of neck spine 90 $2, Revision of thorax spine 90 $2, Revision of lumbar spine 90 $2, Revise, extra spine segment. $ Revision of neck spine 90 $2, Revision of thorax spine 90 $2, Revision of lumbar spine 90 $2, Revise, extra spine segment. $ Treat spine process fracture 90 $ Treat spine fracture.. 90 $ Treat spine fracture.. 90 $1, Treat odontoid fx w/o graft. 90 BR Treat odontoid fx w/ graft. 90 BR Treat spine fracture.. 90 $2, Treat neck spine fracture. 90 $2, Treat thorax spine fracture. 90 $2, Treat each add spine fx. $ Manipulation of spine 10 $ Neck spine fusion $3, Neck spine fusion $2, Thorax spine fusion $3, Lumbar spine fusion $3, Additional spinal fusion. $ Spine & skull spinal fusion. 90 $3, Neck spinal fusion $3, Neck spine fusion $2, Thorax spine fusion $2, Lumbar spine fusion $3, Spine fusion, extra segment. $ Lumbar spine fusion $2, Spine fusion, extra segment. $745 CPT codes and descriptions only are copyright 1999 American Medical Association 20

21 22800 Fusion of spine $2, Fusion of spine $4, Fusion of spine $4, Fusion of spine $3, Fusion of spine $3, Fusion of spine $4, Kyphectomy, 1-2 segments. 90 $4, Kyphectomy, 3 or more. 90 $4, Exploration of spinal fusion 90 $1, Insert spine fixation device. $1, Insert spine fixation device. BR Insert spine fixation device. $1, Insert spine fixation device. $1, Insert spine fixation device. $2, Insert spine fixation device. $1, Insert spine fixation device. $1, Insert spine fixation device. $1, Insert pelv fixation device. $ Reinsert spinal fixation 90 $1, Remove spine fixation device 90 $1, Apply spine prosth device. $ Remove spine fixation device 90 $1, Remove spine fixation device 90 $1, Spine surgery procedure BR Remove abdominal wall lesion 90 $ Abdomen surgery procedure BR Removal of calcium deposits. 90 $ Release shoulder joint 90 $1, Drain shoulder lesion 10 $ Drain shoulder bursa 10 $ Drain shoulder bone lesion. 90 $1, Exploratory shoulder surgery. 90 $1, Exploratory shoulder surgery. 90 $1, Biopsy shoulder tissues 10 $ Biopsy shoulder tissues 90 $ Removal of shoulder lesion. 10 $ Removal of shoulder lesion 90 $ Remove tumor of shoulder 90 $1, Biopsy of shoulder joint. 90 $ Shoulder joint surgery 90 $ Remove shoulder joint lining. 90 $1, Incision of collarbone joint. 90 $ Explore,treat shoulder joint 90 $1, Partial removal, collarbone 90 $ Removal of collarbone 90 $1, Remove shoulder bone, part. 90 $1, Removal of bone lesion 90 $802 CPT codes and descriptions only are copyright 1999 American Medical Association 21

22 23145 Removal of bone lesion 90 $1, Removal of bone lesion 90 $ Removal of humerus lesion 90 $1, Removal of humerus lesion 90 $1, Removal of humerus lesion 90 $1, Remove collarbone lesion 90 $ Remove shoulder blade lesion 90 $ Remove humerus lesion 90 $1, Remove collar bone lesion. 90 $1, Remove shoulder blade lesion. 90 $1, Remove humerus lesion. 90 $1, Partial removal of scapula 90 $ Removal of head of humerus 90 $1, Removal of collarbone 90 $1, Removal of shoulderblade 90 $1, Partial removal of humerus. 90 $2, Partial removal of humerus 90 $2, Partial removal of humerus 90 $2, Remove shoulder foreign body 10 $ Remove shoulder foreign body. 90 $ Remove shoulder foreign body. 90 $1, Injection for shoulder x-ray 0 $ Muscle transfer, shoulder/arm. 90 $2, Muscle transfers 90 $2, Fixation of shoulderblade 90 $1, Incision of tendon & muscle. 90 $1, Incise tendon(s) & muscle(s). 90 $1, Repair of tendon(s) $1, Repair of tendon(s) 90 $1, Release of shoulder ligament 90 $1, Repair of shoulder $2, Repair biceps tendon.. 90 $1, Remove/transplant tendon. 90 $1, Repair shoulder capsule. 90 $1, Repair shoulder capsule. 90 $2, Repair shoulder capsule. 90 $2, Repair shoulder capsule 90 $2, Repair shoulder capsule. 90 $2, Repair shoulder capsule. 90 $2, Reconstruct shoulder joint. 90 $2, Reconstruct shoulder joint. 90 $2, Revision of collarbone 90 $1, Revision of collarbone 90 $1, Reinforce clavicle 90 $1, Reinforce shoulder bones. 90 $2, Treat clavicle fracture 90 $ Treat clavicle fracture 90 $460 CPT codes and descriptions only are copyright 1999 American Medical Association 22

23 23515 Repair clavicle fracture 90 $1, Treat clavicle dislocation 90 $ Treat clavicle dislocation 90 $ Repair clavicle dislocation 90 $1, Repair clavicle dislocation 90 $1, Treat clavicle dislocation 90 $ Treat clavicle dislocation 90 $ Repair clavicle dislocation 90 $1, Repair clavicle dislocation 90 $1, Treat shoulderblade fracture 90 $ Treat shoulderblade fracture 90 $ Repair scapula fracture 90 $1, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Repair humerus fracture 90 $1, Repair humerus fracture 90 $3, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Treat humerus fracture 90 $1, Treat shoulder dislocation 90 $ Treat shoulder dislocation 90 $ Repair shoulder dislocation 90 $1, Treat dislocation/ fracture. 90 $ Treat dislocation/ fracture. 90 $1, Treat dislocation/fracture 90 $ Repair dislocation/fracture 90 $1, Fixation of shoulder 10 $ Fusion of shoulder joint. 90 $2, Fusion of shoulder joint. 90 $2, Amputation of arm & girdle 90 $2, Amputation at shoulder joint 90 $2, Amputation follow-up surgery 90 $ Shoulder surgery procedure BR Drainage of arm lesion 10 $ Drainage of arm bursa. 10 $ Drain arm/elbow bone lesion 90 $ Exploratory elbow surgery. 90 $ Release elbow joint 90 $1, Biopsy arm/elbow soft tissue 10 $ Biopsy arm/elbow soft tissue. 90 $ Remove arm/elbow lesion 90 $ Remove arm/elbow lesion 90 $ Remove tumor of arm/elbow 90 $1, Biopsy elbow joint lining. 90 $ Explore/treat elbow joint 90 $1, Remove elbow joint lining. 90 $1, Removal of elbow bursa 90 $555 CPT codes and descriptions only are copyright 1999 American Medical Association 23

24 24110 Remove humerus lesion 90 $1, Remove/graft bone lesion 90 $1, Remove/graft bone lesion 90 $1, Remove elbow lesion 90 $ Remove/graft bone lesion 90 $ Remove/graft bone lesion 90 $1, Removal of head of radius 90 $ Removal of arm bone lesion 90 $1, Remove radius bone lesion 90 $1, Remove elbow bone lesion 90 $1, Partial removal of arm bone. 90 $1, Partial removal of radius. 90 $1, Partial removal of elbow. 90 $1, Radical resection of elbow. 90 $1, Extensive humerus surgery 90 $2, Extensive humerus surgery 90 $2, Extensive radius surgery 90 $1, Extensive radius surgery 90 $1, Removal of elbow joint 90 $1, Remove elbow joint implant 90 $ Remove radius head implant 90 $ Removal of arm foreign body 10 $ Removal of arm foreign body. 90 $ Injection for elbow x-ray 0 $ Muscle/tendon transfer 90 $1, Arm tendon lengthening 90 $ Revision of arm tendon 90 $ Repair of arm tendon 90 $1, Revision of arm muscles 90 $1, Revision of arm muscles 90 $1, Repair of biceps tendon. 90 $1, Repair arm tendon/ muscle. 90 $1, Repair of ruptured tendon. 90 $1, Repair of tennis elbow 90 $ Repair of tennis elbow 90 $ Repair of tennis elbow 90 $ Repair of tennis elbow 90 $ Revision of tennis elbow 90 $1, Reconstruct elbow joint. 90 $1, Reconstruct elbow joint 90 $2, Reconstruct elbow joint 90 $2, Replace elbow joint $2, Reconstruct head of radius 90 $1, Reconstruct head of radius 90 $1, Revision of humerus 90 $1, Revision of humerus 90 $2, Revision of humerus 90 $1,926 CPT codes and descriptions only are copyright 1999 American Medical Association 24

25 24430 Repair of humerus 90 $2, Repair humerus with graft 90 $2, Revision of elbow joint. 90 $1, Decompression of forearm 90 $1, Reinforce humerus $1, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Repair humerus fracture 90 $1, Repair humerus fracture 90 $1, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Treat humerus fracture 90 $1, Repair humerus fracture 90 $1, Repair humerus fracture 90 $1, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Treat humerus fracture 90 $1, Repair humerus fracture 90 $1, Treat humerus fracture 90 $ Treat humerus fracture 90 $ Repair humerus fracture 90 $1, Treat humerus fracture 90 $1, Repair elbow fracture 90 $2, Repair elbow fracture 90 $2, Treat elbow dislocation 90 $ Treat elbow dislocation 90 $ Repair elbow dislocation 90 $1, Treat elbow fracture 90 $ Repair elbow fracture 90 $1, Treat elbow dislocation 10 $ Treat radius fracture 90 $ Treat radius fracture 90 $ Repair radius fracture 90 $1, Repair radius fracture 90 $1, Treatment of ulna fracture 90 $ Treatment of ulna fracture 90 $ Repair ulna fracture 90 $1, Fusion of elbow joint. 90 $1, Fusion/graft of elbow joint. 90 $1, Amputation of upper arm 90 $1, Amputation of upper arm 90 $1, Amputation follow-up surgery 90 $ Amputation follow-up surgery 90 $1, Amputate upper arm & implant 90 $1, Revision of amputation 90 $2, Revision of upper arm 90 BR Upper arm/elbow surgery BR CPT codes and descriptions only are copyright 1999 American Medical Association 25

26 25000 Incision of tendon sheath. 90 $ Decompression of forearm 90 $ Decompression of forearm 90 $1, Drainage of forearm lesion 90 $ Drainage of forearm bursa. 90 $ Treat forearm bone lesion. 90 $1, Explore/treat wrist joint. 90 $1, Biopsy forearm soft tissues 10 $ Biopsy forearm soft tissues. 90 $ Removal of forearm lesion 90 $ Removal of forearm lesion 90 $ Remove tumor, forearm/wrist 90 $1, Incision of wrist capsule. 90 $ Biopsy of wrist joint. 90 $ Explore/treat wrist joint 90 $ Remove wrist joint lining. 90 $ Remove wrist joint cartilage. 90 $ Remove wrist tendon lesion 90 $ Remove wrist tendon lesion 90 $ Reremove wrist tendon lesion 90 $ Remove wrist/forearm lesion 90 $1, Remove wrist/forearm lesion 90 $1, Excise wrist tendon sheath 90 $ Partial removal of ulna 90 $1, Removal of forearm lesion 90 $ Remove/graft forearm lesion 90 $1, Remove/graft forearm lesion 90 $1, Removal of wrist lesion 90 $ Remove & graft wrist lesion 90 $ Remove & graft wrist lesion 90 $ Remove forearm bone lesion 90 $ Partial removal of ulna 90 $1, Partial removal of radius 90 $ Extensive forearm surgery 90 $1, Removal of wrist bone 90 $ Removal of wrist bones 90 $1, Partial removal of radius 90 $ Partial removal of ulna. 90 $ Injection for wrist x-ray 0 $ Remove forearm foreign body. 90 $ Removal of wrist prosthesis 90 $ Removal of wrist prosthesis 90 $1, Repair forearm tendon/muscle 90 $ Repair forearm tendon/muscle 90 $1, Repair forearm tendon/muscle 90 $1, Repair forearm tendon/muscle 90 $ Repair forearm tendon/muscle 90 $761 CPT codes and descriptions only are copyright 1999 American Medical Association 26