2015 facility scoring methodology for blue select · 2017. 6. 21. · 2015 facility scoring...
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2015 Facility Scoring Methodology for Blue Select
In keeping with its goal of providing members with high-quality, lower-cost health care, Blue Cross Blue Shield of North Carolina (BCBSNC) developed the following methodology to best evaluate the quality and efficiency of partner facilities. Based on evaluation results, BCBSNC will designate in-network facilities as Tier 1 or Tier 2 for its 2015 Blue Select plan. This document describes the methodology used by BCBSNC for the Tiered Network product (Blue Select) for 2015 and is provided for informational purposes only. Physician designation ratings are a guide to choosing a physician, practice or medical group. Because ratings have a risk of error, they should not be the sole basis for selecting a doctor. Patients should confer with their physician before making a decision.
Designation Overview Tier designation is made at the facility level and only includes In-network Facilities contracted with BCBSNC. In-network Facilities are designated as Tier 1 or Tier 2. BCBSNC will base its Tier 1 designation on quality and efficiency. To be designated as Tier 1, a Facility must first meet the quality criteria. Facilities that are unable to meet the quality criteria (described below) for the network are automatically designated with a Tier 2 status. Facilities that potentially qualify for Tier 1 based on their quality evaluation will then be evaluated against BCBSNC’s efficiency criteria (described below) to determine if the Facility meets the standards for Tier 1 status. Facilities that meet both the quality and efficiency standards are designated with a Tier 1 status. Facilities that meet the quality standard, but do not attain the efficiency standard, are designated with a Tier 2 status (with exceptions for Critical Access facilities as defined by CMS).
Tiered Network Product Quality Thresholds for Facilities For facilities, BCBSNC has introduced a methodology that utilizes Hospital Compare, a database administered by the Centers for Medicare and Medicaid Services (CMS). Leveraging data downloaded on March 13, 2014 from the CMS website (http://medicare.gov/hospitalcompare/), each facility was examined for their quality performance on twelve measures, listed below, as reported in the database.
Measure Reporting Period
1 Hospital 30-day mortality rate for heart attack. 7/1/09 – 6/30/12
2 Hospital 30-day readmission rate for heart attack. 7/1/09 – 6/30/12
3 Hospital 30-day mortality rate for heart failure. 7/1/09 – 6/30/12
4 Hospital 30-day readmission rate for heart failure. 7/1/09 – 6/30/12
5 Hospital 30-day mortality rate for pneumonia. 7/1/09 – 6/30/12
6 Hospital 30-day readmission rate for pneumonia. 7/1/09 – 6/30/12
7 Heart failure patients given discharge instructions. 4/1/12 – 3/31/13
8 Heart attack patients given PCI within 90 minutes of arrival. 4/1/12 – 3/31/13
9 Heart attack patients given a prescription for a statin at discharge. 4/1/12 – 3/31/13
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Measure Reporting Period
10 Pneumonia patients whose initial emergency room blood culture was performed prior to the administration of the first hospital dose of antibiotics.
4/1/12 – 3/31/13
11 Pneumonia patients given the most appropriate initial antibiotic(s). 4/1/12 – 3/31/13
12 Weighted measure representing HCAHPS question "How do patients rate the hospital, overall?" Response scale 1 (poor) to 10 (excellent). Weighted score calculated by summing the products of (1*Percent rating 6 or lower), (2*Percent rating 7 or 8), and (3*Percent rating 9 or 10). Resulting score falls between 100 and 300, higher value is better.
4/1/12 – 3/31/13
Facilities were awarded one point for each measure on which they reported data and performed above the 25th percentile. Percentile distributions were calculated using data for all BCBSNC-contracted, non-government acute care facilities in North Carolina, plus two in Virginia that are considered eligible for the Tiered product. Each facility’s earned points were summed and divided by the number of potential points; if data were not reported for a measure due to low volume, the earned and potential points were both reduced accordingly. Final scores ranged from 0 to 100% and represent the percent of measures for which the facility meets the minimum quality standard. Facilities were required to score at or above 67% across measures to be deemed quality eligible allowing them to be assessed on efficiency criteria to determine tier designation; those scoring below 67% were automatically designated Tier 2 and were not given the opportunity to bid into Tier 1. Please note that BCBSNC will examine quality scores on an annual basis to determine if a facility’s tier designation should be reclassified based on updated quality information. Tiered Network Product Efficiency Threshold for Facilities With the quality standards in place, BCBSNC then analyzed claims to stratify facilities on the basis of efficiency performance. The objective of this analysis was to identify “automatic” Tier 1 (no proposal required) and proposal-eligible Tier 2 Facilities. Facilities were assigned to categories based on bed size, total volume, transfers and the provision of certain types of services including burns, trauma, transplants, maternity, hip and knee arthroplasty, spine surgery, oncology, complex cardiology, and complex neurology. Bed size was obtained from the NC Division of Health Services Regulation and service volume was determined from claims for calendar year 2013. Peer cohorts were established using Cohort Analysis, which identifies patterns of similarity in the selected characteristics and then classifies Facilities into groups, called “Peer Cohorts” here forward.
Cohort Variable Defined as DRGs/MDCs defining service line
Hospital Beds Total hospital beds (Source: NC Division of Health Services Regulation, downloaded 1/30/2013 from www.ncdhhs.gov/dhsr/reports.htm)
N/A
Total Volume Total volume All
Transfer Dichotomous indicator if volume of cases as a result of a transfer from another facility designated by discharge status => 10
All
Maternity Volume of maternity cases / total volume MDC 14
Hip & Knee Arthroplasty
Volume of hip and knee arthroplasty cases/total volume
DRGs 209, 558, 471, 789, 818, 558, 471, 817
Spine Surgery Dichotomous indicator if volume of spinal surgery cases => 10
DRGs 756, 755, 558, 807, 884, 806, 865, 864
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Cohort Variable Defined as DRGs/MDCs defining service line
Oncology Dichotomous indicator if volume of oncology cases >= 10
MDC 17, DRGs 010, 011, 146, 147, 172, 173, 203, 257, 258, 259, 260, 274, 303, 306, 307, 318, 319, 336, 337, 338, 346, 354, 355, 357, 363, 366, 367
Complex Cardiology
Dichotomous indicator if volume of complex cardiology cases >= 10
DRGs 104, 105, 106, 107, 108, 109, 115, 545, 546, 547, 548, 549, 850, 851, 852
Complex Neurology
Dichotomous indicator if volume of craniotomy cases >= 10
DRGs 001, 002, 530, 738, 739, 879
Burns or Trauma Dichotomous indicator if total volume of trauma or burns => 10
Burns=MDC 22; Trauma=MDC 25
Transplants Dichotomous indicator if total volume of transplants => 10
DRGs 103, 302, 480, 795, 803, 804, 805
Next, two metrics of efficiency performance were constructed based on inpatient and outpatient claims for Facilities within each Peer Cohort. Data preparation and analytical approaches for the evaluation are described below.
Inpatient Costs Analyses were conducted on inpatient case data for services performed between January 2013 – December 2013.
Includes Inpatient allowed facility costs only (i.e. no professional or ancillary costs)
Lines of business: Blue Options (Group Underwritten, ASO, State Health Plan, CDHP), Blue Advantage (Individual, CDHP), Blue Select, Blue Value.
Excludes denials, Medicare crossovers, COB, and State Health Plan retirees.
To reduce the effect of outliers, allowed costs were truncated at the 95th percentile by AP-DRG. Analysis is limited to those AP-DRGs performed at least 30 times at a minimum of two facilities statewide.
Two inpatient cost metrics were computed for “facility specific allowed costs” and the “average costs”. o Average costs were calculated for each AP-DRG within a Peer Cohort if there were at least 30 cases in a
minimum of 2 facilities; if there was insufficient volume within a Peer Cohort, the costs reflect the average cost for Facilities statewide.
o Your facility specific allowed costs and the average costs were summed separately for all cases with sufficient AP-DRG / CPT volume.
Both Inpatient and Outpatient costs were forward-adjusted to reflect each facility’s new fee schedule increases for the next calendar year once the final summary amounts were tabulated.
All DRGs were evaluated. If DRGs are missing, there was not enough volume to be evaluated. In the following table, "Cohort" refers to the DRG analysis within the cohort only. "Statewide" refers to the DRG analysis done statewide due to the low volume.
AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
001 CRANIOTOMY AGE >17 W CC statewide statewide cohort statewide
002 CRANIOTOMY AGE >17 W/O CC cohort cohort cohort
010 NERVOUS SYSTEM NEOPLASMS W CC statewide statewide statewide cohort statewide
011 NERVOUS SYSTEM NEOPLASMS W/O CC statewide statewide statewide
012 DEGENERATIVE NERVOUS SYSTEM DISORDERS statewide statewide statewide statewide statewide
013 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA statewide statewide statewide statewide cohort
014 STROKE W INFARCT statewide cohort cohort cohort cohort
018 CRANIAL & PERIPHERAL NERVE DISORDERS W CC statewide statewide statewide statewide statewide
020 NERVOUS SYSTEM INFECTION EXCEPT VIRAL statewide statewide statewide statewide statewide
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MENINGITIS
021 VIRAL MENINGITIS statewide statewide statewide statewide cohort
024 SEIZURE & HEADACHE AGE >17 W CC statewide statewide statewide cohort cohort
025 SEIZURE & HEADACHE AGE >17 W/O CC statewide cohort statewide cohort cohort
034 OTHER DISORDERS OF NERVOUS SYSTEM W CC statewide statewide statewide statewide statewide
035 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC statewide statewide statewide statewide statewide
063 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES statewide statewide cohort statewide
065 DYSEQUILIBRIUM statewide statewide statewide statewide statewide
068 OTITIS MEDIA & URI AGE >17 W CC statewide statewide statewide statewide statewide
069 OTITIS MEDIA & URI AGE >17 W/O CC statewide statewide statewide statewide statewide
070 OTITIS MEDIA & URI AGE <18 statewide statewide statewide statewide statewide
073 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17 statewide statewide statewide statewide statewide
075 MAJOR CHEST PROCEDURES statewide statewide cohort cohort cohort
076 OTHER RESP SYSTEM O.R. PROCEDURES W CC statewide statewide statewide statewide statewide
078 PULMONARY EMBOLISM statewide cohort cohort cohort cohort
079 RESPIRATORY INFECTIONS & INFLAMMATIONS EXC SIMPLE PNEUMONIA AGE >17 W CC statewide statewide statewide statewide statewide
082 RESPIRATORY NEOPLASMS statewide statewide statewide statewide cohort
087 PULMONARY EDEMA & RESPIRATORY FAILURE statewide cohort statewide statewide cohort
088 CHRONIC OBSTRUCTIVE PULMONARY DISEASE statewide cohort cohort statewide cohort
089 SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC statewide cohort cohort cohort cohort
090 SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC statewide cohort statewide statewide cohort
094 PNEUMOTHORAX W CC statewide statewide statewide statewide
095 PNEUMOTHORAX W/O CC statewide statewide statewide statewide
096 BRONCHITIS & ASTHMA AGE >17 W CC statewide cohort statewide statewide cohort
097 BRONCHITIS & ASTHMA AGE >17 W/O CC statewide cohort statewide statewide statewide
101 OTHER RESPIRATORY SYSTEM DIAGNOSES W CC statewide statewide statewide statewide statewide
105 CARDIAC VALVE & OTHER MAJOR CARDIOTHORACIC PROC W/O CARDIAC CATH statewide cohort cohort
107 CORONARY BYPASS W/O PTCA W CARDIAC CATH statewide cohort statewide cohort
108 OTHER CARDIOTHORACIC PROC W/O PDX CONGENITAL ANOMALY statewide statewide statewide
109 CORONARY BYPASS W/O PTCA W/O CARDIAC CATH statewide statewide cohort cohort
110 MAJOR CARDIOVASCULAR PROCEDURES W CC statewide statewide cohort cohort
111 MAJOR CARDIOVASCULAR PROCEDURES W/O CC statewide statewide statewide
112 PERCUTANEOUS CARDIOVASCULAR PROC W/O AMI,HEART FAILURE OR SHOCK statewide statewide cohort cohort
116 OTHER PERMANENT CARDIAC PACEMAKER IMPLANT statewide statewide statewide statewide statewide
121 CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE statewide cohort statewide statewide cohort
122 CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE statewide cohort cohort cohort cohort
124 CIRCULATORY DISORD EXCEPT AMI, W CARD CATH & COMPLEX DIAG statewide statewide cohort cohort cohort
125 CIRCULATORY DISORD EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG statewide cohort cohort cohort
127 HEART FAILURE & SHOCK statewide cohort cohort cohort cohort
130 PERIPHERAL VASCULAR DISORDERS W CC statewide statewide statewide statewide cohort
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
131 PERIPHERAL VASCULAR DISORDERS W/O CC statewide statewide statewide statewide statewide
134 HYPERTENSION statewide cohort cohort statewide cohort
138 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC statewide cohort cohort cohort cohort
139 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC statewide cohort cohort cohort cohort
140 ANGINA PECTORIS statewide statewide statewide statewide statewide
141 SYNCOPE & COLLAPSE W CC statewide statewide statewide statewide statewide
142 SYNCOPE & COLLAPSE W/O CC statewide statewide statewide statewide statewide
143 CHEST PAIN statewide cohort statewide statewide cohort
144 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC statewide statewide statewide statewide statewide statewide
145 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC statewide statewide statewide statewide
146 RECTAL RESECTION W CC statewide statewide statewide statewide statewide
147 RECTAL RESECTION W/O CC statewide statewide statewide statewide statewide
148 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC statewide cohort cohort cohort cohort
149 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC statewide cohort cohort cohort cohort statewide
150 PERITONEAL ADHESIOLYSIS W CC statewide statewide statewide statewide cohort
151 PERITONEAL ADHESIOLYSIS W/O CC statewide cohort statewide statewide cohort
152 MINOR SMALL & LARGE BOWEL PROCEDURES W CC statewide statewide statewide statewide statewide
153 MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC statewide statewide statewide cohort statewide
154 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W CC statewide statewide statewide statewide cohort
155 STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC statewide statewide statewide cohort cohort
157 ANAL & STOMAL PROCEDURES W CC statewide statewide statewide statewide
158 ANAL & STOMAL PROCEDURES W/O CC statewide statewide statewide statewide statewide
159 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC statewide statewide statewide statewide statewide statewide
160 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC statewide statewide statewide cohort cohort
165 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC statewide statewide statewide statewide
167 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC statewide statewide statewide statewide statewide
170 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC statewide statewide statewide statewide
171 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC statewide statewide statewide statewide
172 DIGESTIVE MALIGNANCY W CC statewide statewide statewide statewide statewide
174 G.I. HEMORRHAGE W CC statewide cohort cohort cohort cohort
175 G.I. HEMORRHAGE W/O CC statewide cohort cohort cohort cohort
176 COMPLICATED PEPTIC ULCER statewide statewide statewide statewide statewide
179 INFLAMMATORY BOWEL DISEASE statewide cohort statewide cohort cohort
180 G.I. OBSTRUCTION W CC statewide cohort statewide cohort cohort
181 G.I. OBSTRUCTION W/O CC statewide cohort cohort cohort cohort
182 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORD AGE >17 W CC statewide cohort cohort cohort cohort statewide
183 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORD AGE >17 W/O CC statewide cohort cohort cohort cohort statewide
188 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC statewide cohort cohort cohort cohort
189 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC statewide statewide statewide statewide cohort
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
191 PANCREAS, LIVER & SHUNT PROCEDURES W CC statewide cohort statewide
192 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC statewide statewide statewide
198 CHOLECYSTECTOMY W/O C.D.E. W/O CC statewide statewide statewide statewide statewide
202 CIRRHOSIS & ALCOHOLIC HEPATITIS statewide statewide statewide statewide statewide
203 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS statewide statewide statewide statewide
204 DISORDERS OF PANCREAS EXCEPT MALIGNANCY statewide cohort cohort cohort cohort
205 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC statewide statewide statewide cohort statewide
207 DISORDERS OF THE BILIARY TRACT W CC statewide statewide statewide statewide statewide statewide
208 DISORDERS OF THE BILIARY TRACT W/O CC statewide statewide statewide statewide statewide
209 MAJ JOINT & LIMB REATTACH PROC OF LOW EXT, EXC HIP, EXC FOR COMP cohort cohort cohort cohort cohort cohort
210 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC statewide statewide statewide statewide statewide
211 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC statewide statewide statewide cohort cohort statewide
212 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE <18 statewide statewide cohort statewide
218 LOWER EXTREM & HUMER PROC EXC HIP,FOOT,FEMUR AGE >17 W CC statewide statewide statewide cohort cohort statewide
219 LOWER EXTREM & HUMER PROC EXC HIP,FOOT,FEMUR AGE >17 W/O CC statewide cohort cohort cohort cohort statewide
220 LOWER EXTREM & HUMER PROC EXC HIP,FOOT,FEMUR AGE <18 statewide statewide statewide statewide statewide
224 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC statewide statewide statewide statewide
225 FOOT PROCEDURES statewide statewide statewide statewide statewide
226 SOFT TISSUE PROCEDURES W CC statewide statewide statewide statewide statewide statewide
227 SOFT TISSUE PROCEDURES W/O CC statewide statewide statewide statewide statewide
234 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC statewide cohort statewide statewide
239 PATHOLOGICAL FRACTURES & MUSCSKELET & CONN TISS MALIGNANCY statewide statewide statewide statewide statewide
240 CONNECTIVE TISSUE DISORDERS W CC statewide statewide statewide statewide statewide statewide
243 MEDICAL BACK PROBLEMS statewide statewide statewide cohort cohort
247 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE statewide statewide statewide statewide statewide
248 TENDONITIS, MYOSITIS & BURSITIS statewide statewide statewide statewide statewide
257 TOTAL MASTECTOMY FOR MALIGNANCY W CC statewide statewide statewide statewide statewide
258 TOTAL MASTECTOMY FOR MALIGNANCY W/O CC statewide statewide statewide cohort cohort
261 BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION statewide statewide statewide statewide
269 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC statewide statewide statewide statewide statewide
270 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC statewide statewide statewide statewide statewide
276 NON-MALIGNANT BREAST DISORDERS statewide statewide statewide statewide statewide
277 CELLULITIS AGE >17 W CC statewide cohort cohort cohort cohort
278 CELLULITIS AGE >17 W/O CC statewide cohort cohort cohort cohort statewide 279 CELLULITIS AGE <18 statewide statewide statewide statewide cohort statewide
285 AMPUTAT OF LOW LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS statewide statewide statewide statewide statewide
286 ADRENAL & PITUITARY PROCEDURES statewide cohort statewide
288 GASTRIC PROCEDURES FOR OBESITY cohort cohort cohort cohort cohort
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
290 THYROID PROCEDURES statewide statewide cohort statewide statewide
294 DIABETES AGE >35 statewide cohort cohort cohort cohort
295 DIABETES AGE <36 statewide cohort cohort cohort cohort
296 NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC statewide cohort cohort cohort cohort
297 NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC statewide statewide statewide statewide cohort statewide
298 NUTRITIONAL & MISC METABOLIC DISORDERS AGE <18 statewide statewide statewide cohort cohort
300 ENDOCRINE DISORDERS W CC statewide statewide statewide statewide statewide
301 ENDOCRINE DISORDERS W/O CC statewide statewide statewide statewide
302 KIDNEY TRANSPLANT statewide
303 KIDNEY,URETER & MAJ BLADDER PROC FOR NEOPLASM statewide statewide statewide cohort cohort
304 KIDNEY,URETER & MAJ BLADDER PROC FOR NON-NEOPLASM W CC statewide statewide statewide statewide
305 KIDNEY,URETER & MAJ BLADDER PROC FOR NON-NEOPLASM W/O CC statewide statewide statewide cohort statewide
310 TRANSURETHRAL PROCEDURES W CC statewide statewide statewide statewide statewide
311 TRANSURETHRAL PROCEDURES W/O CC statewide statewide statewide statewide statewide
315 OTHER KIDNEY & URINARY TRACT PROCEDURES statewide statewide statewide statewide
316 RENAL FAILURE statewide cohort cohort cohort cohort statewide
320 KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC statewide cohort statewide statewide cohort
321 KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC statewide statewide statewide statewide cohort
322 KIDNEY & URINARY TRACT INFECTIONS AGE <18 statewide statewide statewide statewide statewide
323 URINARY STONES W CC, &/OR ESW LITHOTRIPSY statewide statewide statewide statewide cohort
324 URINARY STONES W/O CC statewide statewide statewide statewide
331 OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC statewide statewide statewide statewide statewide
334 MAJOR MALE PELVIC PROCEDURES W CC statewide statewide statewide statewide
335 MAJOR MALE PELVIC PROCEDURES W/O CC statewide statewide cohort cohort cohort
350 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM statewide statewide statewide statewide statewide
357 UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY statewide statewide statewide statewide statewide
358 UTERINE & ADNEXA PROC FOR CA IN SITU & NON-MALIGNANCY W CC statewide cohort statewide cohort cohort
359 UTERINE & ADNEXA PROC FOR CA IN SITU & NON-MALIGNANCY W/O CC statewide cohort cohort cohort cohort
361 LAPAROSCOPY OR INCISIONAL TUBAL INTERRUPTION statewide statewide statewide statewide statewide
368 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM statewide statewide statewide statewide statewide
369 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS statewide statewide statewide statewide
370 CESAREAN SECTION W CC statewide cohort cohort cohort cohort
371 CESAREAN SECTION W/O CC statewide cohort cohort cohort cohort
372 VAGINAL DELIVERY W COMPLICATING DIAGNOSES statewide cohort cohort cohort cohort
373 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES statewide cohort cohort cohort cohort
374 VAGINAL DELIVERY W STERILIZATION &/OR D&C cohort cohort statewide cohort
375 VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C statewide statewide statewide statewide
376 POSTPARTUM & POST ABORTION DIAGNOSES cohort statewide cohort cohort
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
W/O O.R. PROCEDURE
377 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE statewide statewide statewide statewide
378 ECTOPIC PREGNANCY statewide statewide statewide statewide statewide
379 THREATENED ABORTION statewide statewide cohort cohort
380 ABORTION W/O D&C statewide statewide statewide statewide
395 RED BLOOD CELL DISORDERS AGE >17 statewide cohort cohort cohort cohort
397 COAGULATION DISORDERS statewide statewide statewide cohort statewide
398 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC statewide statewide statewide cohort cohort
399 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC statewide statewide statewide statewide statewide
403 LYMPHOMA & NON-ACUTE LEUKEMIA W CC statewide statewide statewide statewide
410 CHEMOTHERAPY statewide statewide cohort cohort
415 O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES statewide statewide statewide cohort cohort statewide
416 SEPTICEMIA AGE >17 statewide cohort cohort cohort cohort
418 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS statewide statewide statewide cohort cohort
419 FEVER OF UNKNOWN ORIGIN AGE >17 W CC statewide statewide statewide statewide statewide
420 FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC statewide statewide statewide statewide
421 VIRAL ILLNESS AGE >17 statewide statewide statewide statewide statewide
422 VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE <18 statewide statewide cohort statewide
423 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES statewide statewide statewide statewide statewide
425 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION statewide statewide statewide cohort cohort
426 DEPRESSIVE NEUROSES statewide cohort cohort cohort cohort
427 NEUROSES EXCEPT DEPRESSIVE statewide statewide statewide statewide statewide
430 PSYCHOSES cohort cohort cohort cohort cohort
442 OTHER O.R. PROCEDURES FOR INJURIES W CC statewide statewide statewide statewide statewide
443 OTHER O.R. PROCEDURES FOR INJURIES W/O CC statewide statewide statewide cohort cohort statewide
447 ALLERGIC REACTIONS AGE >17 statewide statewide statewide statewide statewide
449 POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC statewide cohort statewide cohort cohort
450 POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC statewide cohort cohort statewide statewide
451 POISONING & TOXIC EFFECTS OF DRUGS AGE <18 statewide statewide statewide cohort
452 COMPLICATIONS OF TREATMENT W CC statewide statewide statewide cohort statewide
453 COMPLICATIONS OF TREATMENT W/O CC statewide statewide statewide statewide statewide
461 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES statewide statewide statewide statewide statewide
462 REHABILITATION statewide cohort statewide statewide cohort
463 SIGNS & SYMPTOMS W CC statewide statewide statewide cohort cohort
464 SIGNS & SYMPTOMS W/O CC statewide statewide statewide statewide
468 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS statewide statewide cohort cohort cohort statewide
469 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS statewide cohort cohort statewide cohort
470 UNGROUPABLE
471 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY statewide statewide statewide statewide cohort statewide
477 NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS statewide statewide statewide statewide cohort
478 OTHER VASCULAR PROCEDURES W CC statewide statewide statewide statewide statewide
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
479 OTHER VASCULAR PROCEDURES W/O CC statewide statewide statewide
482 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES statewide statewide
491 MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY statewide statewide statewide cohort cohort statewide
493 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC statewide cohort cohort statewide cohort
494 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC statewide cohort cohort cohort cohort
530 CRANIOTOMY W MAJOR CC statewide cohort statewide
531 NERVOUS SYSTEM PROCEDURES EXCEPT CRANIOTOMY W MAJOR CC statewide statewide statewide statewide statewide
532 TIA, PRECEREBRAL OCCLUSIONS, SEIZURE & HEADACHE W MAJOR CC statewide statewide cohort cohort
533 OTHER NERVOUS SYSTEM DISORD EXCEPT TIA, SEIZURE & HEADACHE W MAJOR CC statewide cohort cohort cohort cohort
538 MAJOR CHEST PROCEDURES W MAJOR CC statewide statewide statewide cohort cohort
539 RESPIRATORY PROCEDURES EXCEPT MAJOR CHEST W MAJOR CC statewide statewide statewide statewide statewide
540 RESPIRATORY INFECTIONS & INFLAMMATIONS EXC SIMPLE PNEUMONIA W MAJOR CC statewide statewide statewide statewide statewide
541
SIMPLE PNEUMONIA & OTH RESPIRATORY DISORD EXC BRONCHITIS, ASTHMA W MAJOR CC cohort cohort cohort cohort cohort
543 CIRC DISORDERS EXCEPT AMI, ENDOCARDITIS, CHF & ARRHYTHMIA W MAJOR CC statewide cohort cohort cohort cohort
544 CHF & CARDIAC ARRHYTHMIA W MAJOR CC statewide cohort cohort cohort cohort
545 CARDIAC VALVE PROCEDURE W MAJOR CC statewide cohort cohort
546 CORONARY BYPASS W MAJOR CC statewide statewide cohort cohort
547 OTHER CARDIOTHORACIC PROCEDURES W MAJOR CC statewide statewide
549 MAJOR CARDIOVASCULAR PROCEDURES W MAJOR CC statewide statewide statewide cohort cohort
550 OTHER VASCULAR PROCEDURES W MAJOR CC statewide statewide cohort cohort cohort
551 ESOPHAGITIS, GASTROENTERITIS & UNCOMPLICATED ULCERS W MAJOR CC statewide cohort cohort cohort cohort
552
DIGEST SYST DISORD EXCEPT ESOPH,GASTROENT & UNCOMPL ULCERS W MAJOR CC statewide cohort cohort cohort cohort
553 DIGEST SYST PROC EXC HERNIA & MAJOR STOMACH OR BOWEL PROC W MAJOR CC statewide statewide statewide cohort cohort
555 PANCREAS,LIVER & OTH BIL TRACT PROC EXCEPT LIVER TRANSPLNT W MAJOR CC statewide statewide
556 CHOLECYSTECTOMY AND OTHER HEPATOBILIARY PROCEDURES W MAJOR CC statewide statewide statewide statewide statewide
557 HEPATOBILIARY AND PANCREAS DISORDERS W MAJOR CC statewide cohort cohort cohort cohort
558 MAJOR MUSCULOSKELETAL PROCEDURES W MAJOR CC statewide statewide cohort cohort cohort statewide
559 NON-MAJOR MUSCULOSKELETAL PROCEDURES W MAJOR CC statewide statewide statewide cohort cohort
560 MUSCULOSKEL DISORD EXC OSTEO,SEPTIC ARTH & CONN TISSUE DIS W MAJOR CC statewide statewide statewide cohort statewide
561 OSTEOMYELITIS, SEPTIC ARTHRITIS & CONN TISSUE DISORDER W MAJOR CC statewide statewide statewide cohort statewide
563 OTHER SKIN DISORDERS W MAJOR CC statewide statewide statewide statewide cohort
564 SKIN & BREAST PROCEDURES W MAJOR CC statewide statewide statewide statewide statewide
565 ENDOCRINE, NUTRIT & METAB PROC EXCEPT LOWER LIMB AMPUTAT W MAJOR CC statewide statewide statewide statewide statewide
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AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
566 ENDOCRINE, NUTRIT & METAB DISORD EXC EATING DISORDER OR CF W MAJOR CC statewide cohort cohort cohort cohort
567 KIDNEY & URINARY TRACT PROCEDURES EXCEPT KIDNEY TRANSPLANT W MAJOR CC statewide statewide statewide cohort statewide
568 RENAL FAILURE W MAJOR CC statewide cohort cohort cohort cohort
569 KIDNEY & URINARY TRACT DISORDERS EXCEPT RENAL FAILURE W MAJOR CC statewide cohort cohort cohort cohort
573 NON-RADICAL FEMALE REPRODUCTIVE PROCEDURES W MAJOR CC statewide statewide statewide statewide
574 BLOOD, BLOOD FORMING ORGANS & IMMUNOLOGICAL DISORDERS W MAJOR CC statewide statewide statewide cohort cohort
576 ACUTE LEUKEMIA W MAJOR CC statewide statewide statewide
577 MYELOPROLIF DISORDERS & POORLY DIFFERENTIATED NEOPLASMS W MAJOR CC statewide statewide statewide cohort statewide
580 SYSTEMIC INFECTIONS & PARASITIC DISORD EXCEPT SEPTICEMIA W MAJOR CC statewide statewide statewide cohort cohort
581 SYSTEMIC INFECTIONS & PARASITIC DISORDER PROCEDURES W MAJOR CC statewide cohort cohort cohort cohort
582 INJURIES, POISONINGS & TOXIC EFFECTS OF DRUGS EXC MULTIPLE TRAUMA W MAJOR CC statewide cohort cohort cohort cohort
583 PROCEDURES FOR INJURIES EXCEPT MULTIPLE TRAUMA W MAJOR CC statewide statewide statewide statewide statewide
584 SEPTICEMIA W MAJOR CC statewide cohort cohort cohort cohort
585
MAJOR STOMACH,ESOPHAGEAL,DUODENAL,SMALL & LARGE BOWEL PROC W MAJOR CC statewide cohort cohort cohort cohort
586 ENT & MOUTH DISORDERS AGE >17 W MAJOR CC statewide statewide statewide statewide statewide
588 BRONCHITIS & ASTHMA AGE >17 W MAJOR CC statewide statewide statewide statewide statewide
607 NEONATE, BIRTHWT 1000-1499G, W/O SIGNIF O.R. PROC, DISCHARGED ALIVE statewide statewide cohort cohort
611 NEONATE, BWT 1500-1999G, W/O SIGN O.R. PROC,W MULT MAJ PROB OR MV 96+ HRS statewide statewide statewide statewide
612 NEONATE, BIRTHWT 1500-1999G, W/O SIGNIF O.R. PROC, W MAJOR PROB statewide statewide statewide cohort
613 NEONATE, BIRTHWT 1500-1999G, W/O SIGNIF O.R. PROC, W MINOR PROB statewide statewide statewide statewide
614 NEONATE, BIRTHWT 1500-1999G, W/O SIGNIF O.R. PROC, W OTHER PROB statewide statewide statewide cohort
618 NEONATE, BIRTHWT 2000-2499G, W/O SIGNIF O.R. PROC, W MAJOR PROB statewide statewide statewide cohort
619 NEONATE, BIRTHWT 2000-2499G, W/O SIGNIF O.R. PROC, W MINOR PROB statewide statewide statewide statewide
620 NEONATE, BWT 2000-2499G, W/O SIGNIF O.R. PROC, W NORM NEWBORN DIAG statewide cohort statewide cohort cohort
621 NEONATE, BIRTHWT 2000-2499G, W/O SIGNIF O.R. PROC, W OTHER PROB statewide statewide statewide cohort
626 NEONATE, BWT >2499G, W/O SIGN O.R. PROC,W MULT MAJ PROB OR MV 96+ HRS statewide statewide cohort cohort
627 NEONATE, BIRTHWT >2499G, W/O SIGNIF O.R. PROC, W MAJOR PROB cohort cohort cohort cohort
628 NEONATE, BIRTHWT >2499G, W/O SIGNIF O.R. PROC, W MINOR PROB cohort cohort cohort cohort
629 NEONATE, BWT >2499G, W/O SIGNIF O.R. PROC, W NORMAL NEWBORN DIAG statewide cohort cohort cohort cohort
630 NEONATE, BIRTHWT >2499G, W/O SIGNIF O.R. PROC, W OTHER PROB cohort cohort statewide cohort
639 NEONATE, TRANSFERRED <5 DAYS OLD, BORN HERE cohort statewide statewide cohort
650 HIGH RISK CESAREAN SECTION W CC cohort cohort cohort cohort
11
AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
651 HIGH RISK CESAREAN SECTION W/O CC cohort cohort cohort cohort
652 HIGH RISK VAGINAL DELIVERY W STERILIZATION AND/OR D&C statewide statewide statewide cohort
714 HIV W SIGNIFICANT RELATED DIAGNOSIS statewide statewide statewide statewide
731 SPINE, HIP, FEMUR OR LIMB PROC FOR MULTIPLE SIGNIFICANT TRAUMA statewide statewide
732 OTHER O.R. PROCEDURE FOR MULTIPLE SIGNIFICANT TRAUMA statewide cohort statewide
733 HEAD, CHEST AND LOWER LIMB DIAGNOSES OF MULTIPLE SIGNIFICANT TRAUMA statewide statewide statewide statewide
739 CRANIOTOMY AGE <18 W/O CC cohort statewide
740 CYSTIC FIBROSIS statewide statewide cohort statewide
744 OPIOID ABUSE OR DEPENDENCE W CC statewide statewide statewide statewide statewide
745 OPIOID ABUSE OR DEPENDENCE W/O CC statewide cohort cohort statewide cohort
748 COCAINE OR OTHER DRUG ABUSE OR DEPENDENCE W/O CC statewide statewide statewide statewide statewide
750 ALCOHOL ABUSE OR DEPENDENCE, W CC statewide cohort cohort statewide cohort
751 ALCOHOL ABUSE OR DEPENDENCE, W/O CC cohort cohort cohort statewide cohort
755 SPINAL FUSION W CC statewide statewide statewide cohort cohort statewide 756 SPINAL FUSION W/O CC statewide statewide cohort cohort cohort statewide
757 BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC statewide statewide statewide statewide statewide
758 BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC statewide statewide statewide cohort cohort statewide
761 TRAUMATIC STUPOR & COMA, COMA >1 HR statewide statewide statewide
763 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE <18 statewide statewide statewide
767 TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC statewide statewide statewide statewide
768 SEIZURE & HEADACHE AGE <18 W CC statewide statewide statewide
769 SEIZURE & HEADACHE AGE <18 W/O CC statewide statewide statewide cohort cohort
772 SIMPLE PNEUMONIA & PLEURISY AGE <18 W CC statewide statewide statewide statewide cohort
773 SIMPLE PNEUMONIA & PLEURISY AGE <18 W/O CC statewide statewide statewide cohort
774 BRONCHITIS & ASTHMA AGE <18 W CC statewide statewide statewide cohort
775 BRONCHITIS & ASTHMA AGE <18 W/O CC statewide cohort statewide cohort cohort
777 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORD AGE <18 W/O CC statewide statewide cohort statewide
784 ACQUIRED HEMOLYTIC ANEMIA OR SICKLE CELL CRISIS AGE <18 statewide statewide statewide statewide
786 MAJOR HEAD & NECK PROCEDURES FOR MALIGNANCY statewide cohort statewide statewide
789
KNEE REVISION OR MAJ JOINT & LIMB REATTACH PROC OF LOW EXT, EXC HIP,FOR COMP statewide statewide statewide statewide cohort statewide
793 PROC FOR MUL SIG TRAUMA EXC CRANIOTOMY W NON-TRAUMATIC MAJOR CC statewide statewide cohort statewide
796 LOWER EXTREMITY REVASCULARIZATION W CC statewide statewide statewide statewide statewide
797 LOWER EXTREMITY REVASCULARIZATION W/O CC statewide statewide statewide statewide statewide
804 AUTOLOGOUS BONE MARROW TRANSPLANT statewide
807 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC statewide statewide statewide statewide statewide
808 PERCUTANEOUS CARDIOVASCULAR PROC W AMI,HEART FAILURE OR SHOCK statewide cohort cohort cohort
810 INTRACRANIAL HEMORRHAGE statewide statewide cohort cohort
813 NONBACTERIAL GASTROENTERITIS & ABDOMINAL PAIN AGE >17 W CC statewide cohort cohort cohort cohort
814 NONBACTERIAL GASTROENTERITIS & statewide cohort cohort cohort cohort
12
AP DRG Code Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ABDOMINAL PAIN AGE >17 W/O CC
816 NONBACTERIAL GASTROENTERITIS & ABDOMINAL PAIN AGE <18 W/O CC statewide statewide statewide statewide statewide
817 HIP REVISION OR HIP REPLACEMENT FOR COMPLICATIONS statewide statewide statewide statewide cohort statewide
818 HIP REPLACEMENT EXCEPT FOR COMPLICATIONS cohort cohort cohort cohort cohort cohort
820 MALFUNCTIONS, REACTIONS & COMP OF GU DEVICE/GRAFT/TRANSPLANT statewide statewide statewide statewide statewide
828 NON-EXTENSIVE BURNS W/O INHAL INJ, CC OR SIGNIFICANT TRAUMA statewide
832 TRANSIENT ISCHEMIA statewide cohort statewide statewide cohort
836 SPINAL PROCEDURES W CC statewide statewide statewide statewide statewide
837 SPINAL PROCEDURES W/O CC statewide statewide cohort statewide statewide
838 EXTRACRANIAL PROCEDURES W CC statewide statewide statewide statewide cohort
839 EXTRACRANIAL PROCEDURES W/O CC statewide statewide statewide statewide
853 PERCUTANEOUS CARDIOVASCULAR PROCEDURE W DRUG-ELUTING STENT W AMI statewide statewide cohort cohort cohort
854 PERCUTANEOUS CARDIOVASCULAR PROCEDURE W DRUG-ELUTING STENT W/O AMI statewide statewide cohort cohort cohort
864 CERVICAL SPINAL FUSION W CC statewide statewide statewide cohort cohort statewide 865 CERVICAL SPINAL FUSION W/O CC statewide statewide cohort cohort cohort statewide
867 LOCAL EXCISION & REMOVAL OF INT FIX DEVICES EXCEPT HIP & FEMUR W/O CC statewide statewide statewide statewide statewide
876 CHEMO W ACUTE LEUKEMIA AS SDX OR W USE OF HIGH DOSE CHEMO AGENT statewide statewide cohort cohort
877 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. statewide statewide statewide cohort statewide
878 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. statewide statewide statewide statewide
880 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT statewide statewide statewide statewide
881 RESPIRATORY SYSTEM DIAGNOSIS W MV 96+ HRS statewide statewide statewide statewide cohort
882 RESPIRATORY SYSTEM DIAGNOSIS W MV <96 HRS statewide cohort statewide cohort cohort
883 LAPAROSCOPIC APPENDECTOMY statewide cohort cohort cohort cohort
884 SPINAL FUSION EXC CERV W CURVATURE OF THE SPINE OR MALIGNANCY cohort cohort statewide
885 OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE statewide statewide statewide statewide
886 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE cohort cohort cohort cohort
Outpatient Costs Includes Outpatient allowed facility costs (POS=22, POS=23) only (i.e. no professional or ancillary costs)
Dates of Service: January 2013 - December 2013
Lines of business: Blue Options (Group Underwritten, ASO, State Health Plan, CDHP), Blue Advantage (Individual, CDHP), Blue Select, Blue Value.
Excludes denials, Medicare crossovers, COB, and State Health Plan retirees.
To reduce the effect of outliers, claims with allowed costs below the 5th percentile by CPT were dropped and allowed costs were truncated at the 95th percentile by CPT.
CPTs were limited to those CPTs performed at least 30 times in at least 2 facilities statewide.
13
CPTs were further limited to those CPTs where CPT code is required according to BCBSNC policy titled “Provider Update: Effective April 10, 2012 – BCBSNC Requires CPT and HCPCS Codes to be Included on UB-04 Claim Submissions”.
Analysis excludes CPTs associated with the following revenue code groupings: o Pharmacy o IV Therapy o Laboratory o Pathology o Blood and Blood Components o Administration, Processing, and Storage for Blood and Blood Components o Physical Therapy o Occupational Therapy o Speech Therapy - Language Pathology o Free-Standing Clinic o Hemodialysis - Outpatient or Home o Peritoneal Dialysis - Outpatient or Home o Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home o Continuous Cycling Peritioneal Dialysis (CCPD) - Outpatient or Home o Miscellaneous Dialysis o Other Therapeutic Services.
Your “facility specific allowed costs” and the “average costs” were also calculated for each facility’s outpatient costs.
o Average costs were calculated for each AP-DRG within a Peer Cohort if there were at least 30 cases in a minimum of 2 facilities; if there was insufficient volume within a Peer Cohort, the costs reflect the average cost for Facilities statewide.
o Your facility specific allowed costs and the average costs were summed separately for all cases with sufficient AP-DRG / CPT volume.
Both Inpatient and Outpatient costs were forward-adjusted to reflect each facility’s new fee schedule increases for the next calendar year once the final summary amounts were tabulated.
For example, if a facility had a $100,000 inpatient facility specific cost based on calendar year 2012 data, and had a 4% fee schedule increase effective 4/1/2013, then the Inpatient facility specific cost for that facility would be increased to $104,000 for comparison purposes. Note: Increases are prorated to reflect when the increase went into effect during the calendar year. To forward-adjust the average cost metrics, the Peer Cohort weighted average increase was blended with the statewide weighted average increase by facility based on how much each group contributed to the development of that facility’s average costs. Once the facility specific allowed costs and the average cost metrics were forward-adjusted, the facility specific cost metric was divided by the average cost metric for both inpatient and outpatient to create efficiency ratios. The efficiency ratios were normalized to ensure that the weighted average for both inpatient and outpatient in any given Peer Cohort was 1.0. Finally, each facility’s inpatient and outpatient normalized efficiency factors were blended using the aggregate allowed Inpatient and Outpatient charges for their Peer Cohort. For example, if Peer Cohort six had 60% of allowed charges associated with inpatient and 40% associated with outpatient the inpatient normalized efficiency factor blend would be 60% inpatient/ 40% outpatient. Note: If the normalized efficiency factor for a facility is 1.10 that would imply the facility is 10% less efficient than the Peer Cohort average.
14
Next, all facilities were categorized into seven macro regions made up of various combinations of the 16 regions as defined by the DOI per the Affordable Care Act. Facilities were categorized based where the majority of its claims dollars originated from based on patient address. A crosswalk of these regional definitions by county is provided below. Facilities that fell at or below the lowest 20th percentile of normalized efficiency factor within their given macro region were deemed automatic Tier 1 and all other facilities were deemed to be request for proposal-eligible Tier 2. CMS defined Critical Access facilities were excluded from this process and were also given automatic Tier 1 status.
County ACA
Region Macro Region
ALAMANCE Region 11 Triangle
ALEXANDER Region 2 Asheville
ALLEGHANY Region 3 Asheville
ANSON Region 4 Charlotte
ASHE Region 3 Asheville
AVERY Region 1 Asheville
BEAUFORT Region 16 Eastern
BERTIE Region 12 Eastern
BLADEN Region 9 Fayetteville
BRUNSWICK Region 15 Wilmington
BUNCOMBE Region 1 Asheville
BURKE Region 2 Asheville
CABARRUS Region 4 Charlotte
CALDWELL Region 2 Asheville
Camden Region 12 Eastern
CARTERET Region 16 Eastern
CASWELL Region 11 Triangle
CATAWBA Region 2 Asheville
CHATHAM Region 11 Triangle
CHEROKEE Region 1 Asheville
CHOWAN Region 12 Eastern
CLAY Region 1 Asheville
CLEVELAND Region 5 Charlotte
COLUMBUS Region 15 Wilmington
CRAVEN Region 16 Eastern
CUMBERLAND Region 9 Fayetteville
CURRITUCK Region 12 Eastern
DARE Region 16 Eastern
DAVIDSON Region 6 Triad
DAVIE Region 6 Triad
DUPLIN Region 15 Wilmington
DURHAM Region 11 Triangle
EDGECOMBE Region 14 Eastern
FORSYTH Region 6 Triad
FRANKLIN Region 13 Triangle
County ACA
Region Macro Region
GASTON Region 5 Charlotte
Gates Region 12 Eastern
Graham Region 1 Asheville
GRANVILLE Region 10 Triangle
Greene Region 14 Eastern
GUILFORD Region 7 Triad
HALIFAX Region 12 Eastern
HARNETT Region 9 Fayetteville
HAYWOOD Region 1 Asheville
HENDERSON Region 1 Asheville
HERTFORD Region 12 Eastern
HOKE Region 9 Fayetteville
HYDE Region 16 Eastern
IREDELL Region 2 Asheville
JACKSON Region 1 Asheville
JOHNSTON Region 13 Triangle
Jones Region 16 Eastern
LEE Region 11 Triangle
LENOIR Region 16 Eastern
LINCOLN Region 5 Charlotte
MACON Region 1 Asheville
MADISON Region 1 Asheville
MARTIN Region 12 Eastern
MCDOWELL Region 1 Asheville
MECKLENBURG Region 4 Charlotte
MITCHELL Region 1 Asheville
MONTGOMERY Region 8 Fayetteville
MOORE Region 8 Fayetteville
NASH Region 14 Eastern
NEW HANOVER Region 15 Wilmington
NORTHAMPTON Region 12 Eastern
ONSLOW Region 15 Wilmington
ORANGE Region 11 Triangle
Pamlico Region 16 Eastern
PASQUOTANK Region 12 Eastern
15
County ACA
Region Macro Region
PENDER Region 15 Wilmington
PERQUIMANS Region 12 Eastern
PERSON Region 11 Triangle
PITT Region 14 Eastern
POLK Region 1 Asheville
RANDOLPH Region 7 Triad
RICHMOND Region 9 Fayetteville
ROBESON Region 9 Fayetteville
ROCKINGHAM Region 7 Triad
ROWAN Region 4 Charlotte
RUTHERFORD Region 1 Asheville
SAMPSON Region 9 Fayetteville
SCOTLAND Region 9 Fayetteville
STANLY Region 4 Charlotte
STOKES Region 6 Triad
County ACA
Region Macro Region
SURRY Region 6 Triad
SWAIN Region 1 Asheville
TRANSYLVANIA Region 1 Asheville
Tyrrell Region 16 Eastern
UNION Region 4 Charlotte
VANCE Region 10 Triangle
WAKE Region 13 Triangle
WARREN Region 10 Triangle
WASHINGTON Region 16 Eastern
WATAUGA Region 3 Asheville
WAYNE Region 14 Eastern
WILKES Region 3 Asheville
WILSON Region 14 Eastern
YADKIN Region 6 Triad
YANCEY Region 1 Asheville
All CPTs were evaluated. In the following table, "Cohort" refers to the CPT analysis within the cohort only. "Statewide" refers to the DRG analysis done statewide due to the low volume. Outpatient CPT information was not used to determine Peer Cohorts.
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
00100 Anesthesia for procedures on salivary glands, including biopsy cohort cohort cohort cohort
00102
ANESTHESIA FOR PROCEDURES ON INTEGUMENTARY SYSTEM OF HEADAND/OR SALIVARY GLANDS, INCLUDING BIOPSY; PLASTIC REPAIR OF CLEFT LIP statewide
00103 BLEPHAROPLASTY cohort cohort cohort cohort cohort
00104 ANESTHESIA FOR ELECTROCONVULSIVE THERAPY cohort cohort
00120 ANESTHESIA FOR PROCEDURES ON EXTERNAL, MIDDLE, ANDINNER EARINCLUDING BIOPSY; NOT OTHERWISE SPECIFIE D cohort cohort cohort cohort
00124 OTOSCOPY statewide
00126 TYMPANOTOMY cohort cohort cohort cohort
00140 ANESTHESIA FOR PROCEDURES ON EYE; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00142 LENS SURGERY cohort cohort cohort cohort cohort
00144 CORNEAL TRANSPLANT cohort cohort cohort
00145 VITRECTOMY cohort cohort cohort
00148 OPHTHALMOSCOPY statewide
00160 ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00162 RADICAL SURGERY statewide
00164 BIOPSY, SOFT TISSUE statewide
00170 ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00172 REPAIR OF CLEFT PALATE cohort cohort
00174 EXCISION OF RETROPHARYNGEAL TUMOR cohort cohort
00176 RADICAL SURGERY statewide
00190 ANESTHESIA FOR PROCEDURES ON FACIAL BONES; NOT cohort cohort cohort cohort cohort
16
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OTHERWISE SPECIFIED
00192 RADICAL SURGERY (INCLUDING PROGNATHISM) statewide
00210 ANESTHESIA FOR INTRACRANIAL PROCEDURES, NOT OTHERWISE SPECIFIED cohort cohort
00211 Anesthesia for intracranial procedures; craniotomyor craniectomy for evacuation of hematoma statewide
00215 ELEVATION OF DEPRESSED SKULL FRACTURE, EXTRADURAL (SIMPLE OR COMPOUND) statewide
00220 SPINAL FLUID SHUNTING PROCEDURES statewide
00300 ANESTHESIA FOR ALL PROCEDURES ON INTEGUMENTARY SYSTEM OF NECK, INCLUDING SUBCUTANEOUS TISSUE cohort cohort cohort cohort cohort
00320
ANESTHESIA FOR ALL PROCEDURES ON ESOPHAGUS, THYROID, LARYNX, TRACHEA AND LYMPHATIC SYSTEM OF NECK; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00322 NEEDLE BIOPSY OF THYROID (FOR PROCEDURES ON CERVICAL SPINE AND CORD, SEE 00600, 00604, 00670) statewide
00326 ANESTHESIA, LARYNX & TRACHEA PROC; CHILDREN <1 YR cohort cohort
00350 ANESTHESIA FOR PROCEDURES ON MAJOR VESSELS OF NECK; NOT OTHERWISE SPECIFIED cohort cohort
00352 SIMPLE LIGATION (FOR ARTERIOGRAPHY, SEE 01916) statewide
00400
ANESTHESIA FOR PROCEDURES ON ANTERIOR INTEGUMENTARY SYSTEM OF CHEST, INCLUDING SUBCUTANEOUS TISSUE; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00402 RECONSTRUCTIVE PROCEDURES ON BREAST (EG. REDUCTIONOR AUGMENTATION MAMOPLASTY, MUSCLE FLAPS) cohort cohort cohort cohort cohort
00404 RADICAL OR MODIFIED RADICAL PROCEDURES ON BREAST cohort cohort cohort cohort cohort
00406 RADICAL OR MODIFIED RADICAL PROCEDURES ON BREAST WITH INTERNAL MAMMARY NODE DISSECTION cohort cohort cohort
00410 ELECTRICAL CONVERSION OF ARRHYTHMIAS cohort cohort cohort cohort
0042T
CEREBRAL PERFUSION ANALYSIS USING COMPUTED TOMOGRAWITH CONTRAST ADMIN. INCLUDING POST-PROCESSING OF PARAMETRIC MAPS WITH DETERM. OF CEREBRAL BLOOD VOLAND MEAN TRANSIT TIME statewide
00450 ANESTHESIA FOR PROCEDURES ON CLAVICLE AND SCAPULA; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort cohort
00454 BIOPSY OF CLAVICLE statewide
00470 ANESTHESIA FOR PARTIAL RIB RESECTION; NOT OTHERWISE SPECIFIED statewide
00474 RADICAL PROCEDURES (EG. PECTUS EXCAVATUM) statewide
00520
ANESTHESIA FOR CLOSED CHEST PROCEDURES (INCLUDING ESOPHAGOSCOPY, BRONCHOSCOPY, DIAGNOSTIC THORACOSCOPY); NOT OTHERWISE SPECIFIED cohort cohort cohort cohort
00524 PNEUMOCENTESIS statewide
00528
ANESTHESIA FOR CLOSED CHEST PROCEDURES; MEDIASTINOSCOPY AND DIAGNOSTIC THORACOSCOPY NOT UTILIZING 1 LUNG VENTILATION cohort cohort cohort cohort
00530 ANESTHESIA FOR TRANSVENOUS PACEMAKER INSERTION cohort cohort cohort
00532 ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION cohort cohort cohort cohort cohort
00534
ANESTHESIA FOR TRANSVENOUS INSERTION OR REPLACEMENT OF CARDIOVERTER/DEFIBRILLATOR (FOR TRANSTHORACIC APPROACH, USE 00560) cohort cohort cohort cohort
00537 ANESTHESIA FOR CARDIAC ELECTROPHYSIOLOGIC PROCEDURES INCLUDING RADIOFREQUENCY ABLATION cohort cohort cohort
00540
ANESTHESIA FOR THORACOTOMY PROCEDURES INVOLVING LUNGS, PLEURA, DIAPHRAGM, AND MEDIASTINUM (INCLUDING SURGICAL THORACOSCOPY); NOT OTHERWISE SPECIFIED cohort cohort
00548 INTRATHORACIC PROCEDURES ON THE TRACHEA AND BRONCHI statewide
00600 ANESTHESIA FOR PROCEDURES ON CERVICAL SPINE AND CORD; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort
00604 POSTERIOR CERVICAL LAMINECTOMY IN SITTING POSITION cohort cohort
17
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
00620 ANESTHESIA FOR PROCEDURES ON THORACIC SPINE AND CORD; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort
00625
ANESTHESIA FOR PROCEDURES ON THE THORACIC SPINE AND CORD, VIA AN ANTERIOR TRANSTHORACIC APPROACH; NOT UTILIZING 1 LUNG VENTILATION statewide
00630 ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00635 ANESTHESIA FOR PROCEDURES IN LUMBAR REGION; DIAGNOSTIC OR THERAPEUTIC LUMBAR PUNCTURE. cohort cohort cohort
00640
ANESTHESIA FOR MANIPULATION OF THE SPINE OR FOR CLOSED PROCEDURES ON THE CERVICAL, THORACIC OR LUMBAR SPINE statewide
00670 ANESTHESIA FOR EXTENSIVE SPINE AND SPINAL CORD PROCEDURES (EG, HARRINGTON ROD TECHNIQUE) cohort cohort cohort cohort
00700 ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED cohort cohort cohort
00702 PERCUTANEOUS LIVER BIOPSY statewide
00730 ANESTHESIA FOR PROCEDURES ON UPPER POSTERIOR ABDOMINAL WALL cohort cohort
0073T
COMPENSATOR-BASED BEAM MODULATION TREATMENT DELIVERY OF INVERSE PLANNED TREATMENT USING THREE OR MORE HIGH RESOLUTION (MILLED OR CAST) COMPENSATOR CONVERGENT BEAM MODULATED FIELDS, PER statewide
00740 ANESTHESIA FOR UPPER GASTROINTESTINAL ENDOSCOPIC PROCEDURES cohort cohort cohort cohort cohort
00750 ANESTHESIA FOR HERNIA REPAIRS IN UPPDER ABDOMEN; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00752 LUMBAR AND VENTRAL (INCISIONAL)HERNIAS AND/OR WOUND DEHISCENCE cohort cohort cohort
00754 OMPHALOCELE statewide
00770 ANESTHESIA FOR ALL PROCEDURES ON MAJOR ABDOMINAL BLOOD VESSELS statewide
00790
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPERABDOMEN INCLUDING LAPAROSCOPY, NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00792 PARTIAL HEPATECTOMY (EXCLUDING LIVER BIOPSY) statewide
00797 ANESTHESIA, INTRAPERITONEAL PROC, UPPER ABDOMEN W/LAPAROSCOPY; GASTRIC RESTRICT MORBIID OBESITY cohort cohort cohort cohort
00800 ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort
00810 ANESTHESIA FOR INTESTINAL ENDOSCOPIC PROCEDURES cohort cohort cohort cohort cohort cohort
00820 ANESTHESIA FOR PROCEDURES ON LOWER POSTERIOR ABDOMINAL WALL cohort cohort cohort
00830 ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00832 VENTRAL AND INCISIONAL HERNIAS cohort cohort cohort cohort
00834 ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN NOT OTHERWISE SPECIFIED, UNDER 1 YEAR OF AGE cohort cohort cohort cohort
00836
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN NOT OTHERWISE SPECIFIED, INFANTS LESS THAN 37 WEEKGESTATIONAL AGE AT BIRTH AND LESS THAN 50 WEEKS GESTATIONAL AGE AT TIME OF SURGERY statewide
00840
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWERABDOMEN INCLUDING LAPAROSCOPY; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00846 RADICAL HYSTERECTOMY cohort cohort cohort
00851 ANESTHESIA, INTRAPERITONEAL PROC, LOWER ABDOMEN W/LAPAROSCOPY; TUBAL LIGATION/TRANSECTION cohort cohort cohort cohort
00860
ANESTHESIA FOR EXTRAPERITONEAL PROCEDURES IN LOWERABDOMEN, INCLUDING URINARY TRACT; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00862 RENAL PROCEDURES, INCLUDING UPPER 1/3 OF URETER, OR cohort cohort cohort cohort
18
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
DONOR NEPHRECTOMY
00865 RADICAL PROSTATECTOMY (SUPRAPUBIC, RETROPUBIC cohort cohort cohort cohort
00866 ADRENALECTOMY statewide
00870 CYSTOLITHOTOMY cohort cohort cohort
00872 ANESTHESIA FOR LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE; WITH WATER BATH cohort cohort
00873 WITHOUT WATER BATH cohort cohort cohort
00880 ANESTHESIA FOR PROCEDURES ON MAJOR LOWER ABDOMINALVESSELS; NOT OTHERWISE SPECIFIED statewide
00902 ANORECTAL PROCEDURE (INCLUDING ENDOSCOPY AND/OR BIOPSY cohort cohort cohort cohort cohort
00904 RADICAL PERINEAL PROCEDURE cohort cohort
00906 VULVECTOMY cohort cohort cohort
00908 PERINEAL PROSTATECTOMY cohort cohort cohort
00910
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDINGURETHROCYSTOSCOPY); NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00912 TRANSURETHRAL RESECTION OF BLADDER TUMOR(S) cohort cohort cohort cohort cohort
00914 TRANSURETHRAL RESECTION OF PROSTATE cohort cohort cohort cohort cohort
00918 WITH FRAGMENTATION AND/OR REMOVAL OF URETERAL CALCULUS cohort cohort cohort cohort cohort
00920 ANESTHESIA FOR PROCEDURES ON MALE EXTERNAL GENITALIA; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00921 VASECTOMY, UNILATERAL/BILATERAL cohort cohort cohort cohort
00922 SEMINAL VESICLES statewide
00924 UNDESCENDED TESTIS, UNILATERAL OR BILATERAL statewide
00926 RADICAL ORCHIECTOMY, INGUINAL cohort cohort cohort cohort
00928 RADICAL ORCHIECTOMY, ABDOMINAL cohort cohort
00930 ORCHIOPEXY, UNILATERAL OR BILATERAL cohort cohort cohort cohort
00938 INSERTION OF PENILE PROSTHESIS (PERINEAL APPROACH) cohort cohort cohort cohort
00940
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
00942 COLPOTOMY, COLPECTOMY, COLPORRHAPHY cohort cohort cohort cohort cohort
00944 VAGINAL HYSTERECTOMY cohort cohort cohort cohort cohort
00948 CERVICAL CERCLAGE cohort cohort cohort cohort
00952 HYSTEROSCOPY cohort cohort cohort cohort cohort
01112 ANESTHESIA FOR BONE MARROW ASPIRATION AND/OR BIOPSY, ANTERIOR OR POSTERIOR ILIAC CREST cohort cohort cohort
01120 ANESTHESIA FOR PROCEDURES ON BONY PELVIS statewide
01130 ANESTHESIA FOR BODY CAST APPLICATION OR REVISION statewide
01170 ANESTHESIA FOR OPEN PROCEDURES INVOLVING SYMPHYSIS PUBIS OR SACROILIAC JOINT cohort cohort cohort
01190 INTRAPELVIC statewide
01200 ANESTHESIA FOR ALL CLOSED PROCEDURES INVOLVING HIP JOINT cohort cohort cohort cohort
01202 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF HIP JOINT cohort cohort cohort cohort
01210 ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort
01214 TOTAL HIP REPLACEMENT OR REVISION cohort cohort
01220 ANESTHESIA FOR ALL CLOSED PROCEDURES INVOLVING UPPER 2/3 OF FEMUR statewide
01230 ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER 2/3 OF FEMUR; NOT OTHERWISE SPECIFIED cohort cohort
01232 AMPUTATION statewide
01250 ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES cohort cohort cohort cohort cohort
19
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
TENDONS, FASCIA, AND BURSAE OF UPPER LEG
01260 ANESTHESIA FOR ALL PROCEDURES ON INVOLVING VEINS OF UPPER LEG, INCLUDING EXPLORATION cohort cohort cohort cohort
01270
ANESTHESIA FOR PROCEDURES INVOLVING ARTERIES OF UPPER LEG, INCLUDING BYPASS GRAFT; NOT OTHERWISE SPECIFIED statewide
01320
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF KNEE AND/OR POPLITEAL AREA cohort cohort cohort cohort cohort
01340 ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER 1/3 OF FEMUR statewide
01360 ANESTHESIA FOR ALL OPEN PROCEDURES ON LOWER 1/3 OF FEMUR cohort cohort cohort
01380 ANESTHESIA FOR ALL CLOSED PROCEDURES ON KNEE JOINT cohort cohort cohort cohort cohort
01382 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF KNEE JOINT cohort cohort cohort cohort cohort
01390 ANESTHESIA FOR ALL CLOSED PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA statewide
01392 ANESTHESIA FOR ALL OPEN PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA cohort cohort cohort cohort cohort
01400 ANESTHESIA FOR OPEN PROCEDURES ON KNEE JOINT; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
01402 TOTAL KNEE REPLACEMENT cohort cohort cohort cohort
01420 ANESTHESIA FOR ALL CAST APPLICATIONS, REMOVAL, OR REPAIR INVOLVING KNEE JOINT cohort cohort
01430 ANESTHESIA FOR PROCEDURES ON VEINS OF KNEE AND POPLITEAL AREA; NOT OTHERWISE SPECIFIED cohort cohort
01462 ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER LEG, ANKLE, AND FOOT cohort cohort cohort cohort cohort
01464 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF ANKLE JOINT cohort cohort cohort cohort
01470
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOOT;NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
01472 REPAIR OF RUPTURED ACHILLES TENDON, WITH OR WITHOUT GRAFT cohort cohort cohort cohort cohort
01474 GASTROCNEMIUS RECESSION (EG. STRAYER PROCEDURE) statewide
01480 ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWE LEG, ANKLE, AND FOOT; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
01482 RADICAL RESECTION cohort cohort cohort
01484 ODTEOTOMY OR OSTEOPLASTY OF TIBIA AND/OR FIBULA cohort cohort cohort
01490 ANESTHESIA FOR LOWER LEG CAST APPLICATION, REMOVAL, OR REPAIR statewide
01500 ANESTHESIA FOR PROCEDURES ON ARTERIES OF LOWER LEGINCLUDING BYPASS GRAFT; NOT OTHERWISE SPECIFIED. statewide
01520 ANESTHESIA FOR PROCEDURES ON VEINS OF LOWER LEG; NOT OTHERWISE SPECIFIED statewide
01522 VENOUS THROMBECTOMY,DIRECT OR WITH CATHETER statewide
0159T
Computer aided detection, including computer algorithm analysis of MRI image data for lesion detection/ characterization, pharmacokinetic analysis, with further physician review for interpretation, br statewide
01610 ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF SHOULDER AND AXILLA cohort cohort cohort cohort cohort
01620
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERAL HEAD ABD NECK, STERNOCLAVICULAR JOINT, ACROMIOCLAVICULAR JOINT, AND SHOULDER JOINT cohort cohort cohort cohort
01622 ANESTHESIA FOR ARTROSCOPIC PROCEDURES OF SHOULDER JOINT cohort cohort cohort cohort
01630
ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD ANDNECK, STERNOCLAVICULAR JOINT, ACROMIOCLAVICULAR JOINT, AND SHOULDER JOINT; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
20
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
01650 ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; NOT OTHERWISE SPECIFIED statewide
01680 ANESTHESIA FOR SHOULDER CAST APPLICATION, REMOVAL OR REPAIR; NOT OTHERWISE SPECIFIED statewide
01710
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPPER ARM AND ELBOW; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
01712 TENOTOMY, ELBOW TO SHOULDER, OPEN cohort cohort
01714 TENOPLASTY, ELBOW TO SHOULDER statewide
01716 TENODESIS, RUPTURE OF LONG TENDON OF BICEPS cohort cohort cohort cohort
01730 ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERUS AND ELBOW cohort cohort cohort cohort
01732 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF ELBOW JOINT statewide
01740 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
01742 OSTEOTOMY OF HUMERUS statewide
01744 REPAIR OF NONUNION OR MALUNION OF HUMERUS cohort cohort cohort cohort
01756 RADICAL PROCEDURES cohort cohort
01758 EXCISION OF CYST OR TUMOR OF HUMERUS statewide
01760 TOTAL ELBOW REPLACEMENT statewide
01770 ANESTHESIA FOR PROCEDURES ON ARTERIES OF UPPER ARMAND ELBOW; NOT OTHERWISE SPECIFIED cohort cohort cohort
01780 ANESTHESIA FOR PROCEDURES ON VEINS OF UPPER ARM AND ELBOW; NOT OTHERWISE SPECIFIED statewide
01810
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF FOREARM, WRIST, ANDHAND cohort cohort cohort cohort cohort
01820 ANESTHESIA FOR ALL CLOSED PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES HAND cohort cohort cohort cohort cohort
01830 ANESTHESIA FOR OPEN PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES; NOT OTHERWISE SPECIFIED HAND cohort cohort cohort cohort cohort
01832 TOTAL WRIST REPLACEMENT cohort cohort
01840 ANESTHESIA FOR PROCEDURES ON ARTERIES OF FOREARM, WRIST, AND HAND; NOT OTHERWISE SPECIFIED cohort cohort
01844 ANESTHESIA FOR VASCULAR SHUNT, OR SHUNT REVISION, ANY TYPE (EG. DIALYSIS) cohort cohort cohort cohort
0184T Excision of rectal tumor, transanal endoscopic microsurgical approach (i.e., TEMS), including muscularis propria (i.e., full thickness) cohort cohort cohort
01850 ANESTHESIA FOR PROCEDURES ON VEINS OF FOREARM, WRIST, AND HAND; NOT OTHERWISE SPECIFIED statewide
01916 ANESTHESIA FOR ARTERIOGRAMS, NEEDLE; CAROTID OR VERTEBRAL cohort cohort cohort
0191T Insertion of anterior segment aqueous drainage device, without extraocular reservoir; internal approach, into the trabecular meshwork cohort cohort
01920
ANESTHESIA FOR CARDIAC CATHETERIZATION INCLUDING CORONARY ARTERIOGRAPHY AND VENTRICULOGRAPHY (NOT TO INCLUDE SWAN-GANZ CATHETER) statewide
01922 ANESTHESIA FOR NON-INVASIVE IMAGING OR RADIATION THERAPY cohort cohort cohort cohort cohort
01924 ANESTHESIA THERAPEUTIC INTERVENTIONAL RADIOL, ARTERIAL SYSTEM NOS cohort cohort cohort
01925 ANESTHESIA THERAPEUTIC INTERVENTIONAL RADIOL ARTERIAL SYSTEM; CAROTID/CORONARY statewide
01926 ANESTHESIA THERAPEUTIC INTERVENTIONAL RADIOL ARTERIAL SYSTEM; INTRACRANIAL/INTRACARDIAC/AORTIC cohort cohort
0192T INSERTION OF ANTERIOR SEGMENT AQUEOUS DRAINAGE cohort cohort cohort
01930 ANES, THERAPEUTIC INTERVEN RADIOL, VENOUS/LYMPHATISYSTEM W/O CENTRAL CIRC ACCESS; NOS cohort cohort cohort cohort
01931 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL statewide
21
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
RADIOLOGICAL PROCEDURES INVOLVING THE VENOUS/LYMPHATIC SYSTEM (NOT TO INCLUDE ACCESS TO THE CENTRAL CIRCULATION); INTRAHEPATIC OR PORTAL CIRCULATION (E.G., TR
01936 Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic cohort cohort
01951
ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EX- CISION OR DEBRIDEMENT WITH OR WITHOUT SKIN GRAFT- ING, ANY SITE, FOR TOTAL BODY SURFACE AREA (TBSA) TREATED DURING ANESTHESIA AND SURGERY; LESS 1% TOT statewide
01960 ANESTHESIA FOR; VAGINAL DELIVERY ONLY statewide
01962 ANESTHESIA FOR; URGENT HYSTERECTOMY FOLLOWING DELIVERY statewide
01965 ANESTHESIA FOR INCOMPLETE OR MISSED ABORTION PROCEDURES cohort cohort cohort cohort
01966 ANESTHESIA FOR INDUCED ABORTION PROCEDURES cohort cohort
01968 CESAREAN DELIVERY FOLLOWING NEURAXIAL LABOR ANALGEANESTHESIA ADD'L ANESTHESIA statewide
01991
ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK OR INJECTION IS PERFORMED BY A DIFFERENT PHYSICIAN OR OTHER QUALIFIEDHEALTH CARE PROFESSIONAL); OTHER THAN THE PRONE P statewide
01992
ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK OR INJECTION IS PERFORMED BY A DIFFERENT PHYSICIAN OR OTHER QUALIFIEDHEALTH CARE PROFESSIONAL); PRONE POSITION cohort cohort cohort cohort
0227T Anoscopy, high resolution (HRA) (with magnificaiton and chemical agent enhancement); with biopsy(ies) statewide
0238T Transluminal peripheral atherectomy, including radiological supervision and interpretation; iiac artery, each vessel statewide
0240T
ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY WITH INTERPRETATION AND REPORT; WITH HIGH RESOLUTION ESOPHAGEAL PRESSURE TOPOGRAPHY cohort cohort
0249T Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance statewide
0275T
Percutaneous laminotomy/laminectomy (intralaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy) and method under statewide
0291T
Intravascular optical coherence tomography (coronary native vessel or graft) during diagnostic evaluation and/or therapeutic intervention, including imaging supervision, interpretation, and report; in statewide
0296T
External electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; recording (includes connection and initial recording) cohort cohort
0297T
External electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; scanning analysis with report cohort cohort
0334T
Sacroiliac joint stabilization for arthrodesis, percutaneous or minimally invasive (indirect visualization), includes obtaining and applying autograftor allograft (structural or morselized), when per statewide
0360 OR SERVICES statewide
0402 ULTRASOUND statewide
10021 FINE NEEDLE ASPIRATION; W/OUT IMAGING GUIDANCE cohort cohort cohort cohort
10022 FINE NEEDLE ASPIRATION; W/IMAGING GUIDANCE cohort cohort cohort cohort cohort
10040 *ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OFMULTIPLE MILIA, COMEDONES, CYSTS, PUSTULES) statewide
10060
*INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE,SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUSABSCESS, CYST, FURUNCLE, OR PARONYCHIA); SIMPLE OR SINGLE cohort cohort cohort cohort cohort cohort
22
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
10061
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVEHIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA); COMPLICATED OR MULTIPLE cohort cohort cohort cohort cohort
10080 *INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE cohort cohort cohort cohort cohort cohort
10081 INCISION AND DRAINAGE OF PILONIDAL CYST; COMPLICATED cohort cohort cohort cohort cohort
10120
*INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES;SIMPLE *INCISION AND REMOVAL OF FOREIGNBODY, SUBCUTANEOUS TISSUES; cohort cohort cohort cohort cohort cohort
10121
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUSTISSUES; COMPLICATED INCISION AND REMOVAL OF FOR EIGN BODY, SUBCUTANEOUS TISSUES; cohort cohort cohort cohort
10140 *INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUIDCOLLECTION cohort cohort cohort cohort cohort
10160
*PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST*PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST cohort cohort cohort cohort cohort
10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUNDINFECTION cohort cohort cohort cohort
11000 *DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO10% OF BODY SURFACE cohort cohort cohort cohort cohort
11005
DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSUE INFECTION ABDOMINAL WALL WITH OR WITHOUT FASCIAL CLOSURE cohort cohort cohort
11008
Removal of prosthetic material or mesh, abdominal wall for infection (e.g., for chronic or recurrentmesh infection or necrotizing soft tissue infecti on) statewide
11010
Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues cohort cohort cohort cohort
11011
Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle statewide
11012
Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone cohort cohort cohort cohort cohort
11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less cohort cohort cohort cohort cohort cohort
11043 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less cohort cohort cohort cohort cohort cohort
11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less cohort cohort cohort cohort cohort cohort
11045
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in additionto code for primary procedure) cohort cohort cohort cohort cohort cohort
11046
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (Listseparately in addition to code for primary proced cohort cohort cohort cohort cohort
11047
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary proc cohort cohort cohort
11055
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN cohort cohort cohort cohort cohort cohort
11056
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); TWO TO FOUR LESIONS PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN cohort cohort cohort cohort cohort
11057
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN FOUR LESIONS PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG,CORN statewide
11100
BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE(INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED (SEPARATE PROCEDURE); SINGLE LESION cohort cohort cohort cohort cohort cohort
11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS cohort cohort cohort cohort
23
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MEMBRANE(INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE LISTED (SEPARATE PROCEDURE); EACH SEPARATE/ADDITIONAL LESION (LIST
11200
*REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANYAREA; UP TO AND INCLUDING 15 LESIONS *REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY cohort cohort cohort cohort cohort
11201
Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to code for primary procedure) cohort cohort cohort
11300
*SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION,TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM ORLESS cohort cohort cohort
11301 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK,ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0CM cohort cohort cohort
11302 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK,ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0CM cohort cohort
11306
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP,NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM cohort cohort cohort
11308
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP,NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 2.0 CM statewide
11310
*SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE,EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; 0.5 CM OR LESS cohort cohort cohort cohort
11311
SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM statewide
11400
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS cohort cohort cohort cohort cohort
11401
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM cohort cohort cohort cohort cohort cohort
11402
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM cohort cohort cohort cohort cohort cohort
11403
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM cohort cohort cohort cohort cohort cohort
11404
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM cohort cohort cohort cohort cohort cohort
11406
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 4.0 CM cohort cohort cohort cohort cohort cohort
11420
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS cohort cohort cohort cohort cohort cohort
11421
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM cohort cohort cohort cohort cohort cohort
11422
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM cohort cohort cohort cohort cohort cohort
11423
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM cohort cohort cohort cohort cohort cohort
11424
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM cohort cohort cohort cohort cohort cohort
11426
EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTEDELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0 CM cohort cohort cohort cohort cohort cohort
11440 EXCISION, OTHER BENIGN LESION (UNLESS LISTED cohort cohort cohort cohort cohort
24
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS
11441
EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM cohort cohort cohort cohort cohort
11442
EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 1.1 TO 2.0 CM cohort cohort cohort cohort cohort
11443
EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 2.1 TO 3.0 CM cohort cohort cohort cohort
11444
EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 3.1 TO 4.0 CM cohort cohort cohort cohort
11446
EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER OVER 4.0 CM cohort cohort cohort cohort
11450
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,AXILLARY; WITH SIMPLE OR INTERMEDIATE REPAIR cohort cohort cohort cohort cohort
11451 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,AXILLARY; WITH COMPLEX REPAIR cohort cohort cohort
11462
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,INGUINAL; WITH SIMPLE OR INTERMEDIATE REPAIR cohort cohort cohort cohort
11463 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,INGUINAL; WITH COMPLEX REPAIR statewide
11470
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,PERIANAL, PERINEAL, OR UMBILICAL; WITH SIMPLE OR INTERMEDIATE REPAIR cohort cohort cohort cohort cohort
11471
EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS,PERIANAL, PERINEAL, OR UMBILICAL; WITH COMPLEX REPAIR cohort cohort
11600 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER 0.5 CM OR LESS cohort cohort cohort
11601 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER 0.6 TO 1.0 CM cohort cohort cohort cohort
11602 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER 1.1 TO 2.0 CM cohort cohort cohort cohort cohort
11603 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER 2.1 TO 3.0 CM cohort cohort cohort cohort cohort
11604 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER 3.1 TO 4.0 CM cohort cohort cohort cohort
11606 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESIONDIAMETER OVER 4.0 CM cohort cohort cohort cohort cohort
11620
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER 0.5 CM OR LESS EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort cohort
11621
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort cohort
11622
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort
11623
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort cohort
11624
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort cohort
11626
EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,GENITALIA; LESION DIAMETER OVER 4.0 CM EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, cohort cohort cohort cohort
11640 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, cohort cohort cohort
25
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
LIPS;LESION DIAMETER 0.5 CM OR LESS
11641 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;LESION DIAMETER 0.6 TO 1.0 CM cohort cohort cohort cohort
11642 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;LESION DIAMETER 1.1 TO 2.0 CM cohort cohort cohort cohort cohort
11643 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;LESION DIAMETER 2.1 TO 3.0 CM cohort cohort cohort cohort
11644 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;LESION DIAMETER 3.1 TO 4.0 CM cohort cohort cohort
11646 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;LESION DIAMETER OVER 4.0 CM cohort cohort cohort cohort
11719 TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER cohort cohort
11720 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVEDEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE cohort cohort cohort cohort
11721
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MOREDEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE cohort cohort cohort
11730 *AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE cohort cohort cohort cohort cohort cohort
11732
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACHADDITIONAL NAIL PLATE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
11740 EVACUATION OF SUBUNGUAL HEMATOMAEVACUATION OF SUBUNGUAL HEMATOMA cohort cohort cohort cohort cohort
11750
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL; EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, cohort cohort cohort cohort cohort
11752
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL; WITH AMPUTATION OF TUFT OF DISTAL PHALANX cohort cohort cohort
11755
BIOPSY OF NAIL UNIT, ANY METHOD (EG, PLATE, BED, MATRIX,HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS) (SEPARATE PROCEDURE) cohort cohort
11760 REPAIR OF NAIL BEDREPAIR OF NAIL BED cohort cohort cohort cohort cohort
11762 RECONSTRUCTION OF NAIL BED WITH GRAFTRECONSTRUCTION OF NAIL BED WITH GRAFT statewide
11765
WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWNTOENAIL) WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN cohort cohort cohort cohort cohort
11770 EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE cohort cohort cohort cohort cohort cohort
11771 EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE cohort cohort cohort cohort cohort cohort
11772 EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED cohort cohort cohort cohort cohort cohort
11900 *INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVEN LESIONS cohort cohort
11901 *INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS statewide
11921
TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUEPIGMENTS TO CORRECT COLOR DEFECTS OF SKIN, INCLUDING MICROPIGMENTATION; 6.1 TO 20.0 SQ CM statewide
11950
SUBCUTANEOUS INJECTION OF FILLING MATERIAL (EG, COLLAGEN); 1CC OR LESS SUBCUTANEOUS INJECTION OF FILLING MATERIAL (EG, COLLAGEN); 1 statewide
11951
SUBCUTANEOUS INJECTION OF "FILLING" MATERIAL (EG, COLLAGEN);1.1 TO 5.0 CC SUBCUTANEOUS INJECTION OF"FILLING" MATERIAL (EG, COLLAGEN); statewide
11952
SUBCUTANEOUS INJECTION OF "FILLING" MATERIAL (EG, COLLAGEN);5.1 TO 10.0 CC SUBCUTANEOUS INJECTION OF "FILLING" MATERIAL (EG, COLLAGEN); statewide
11954
SUBCUTANEOUS INJECTION OF "FILLING" MATERIAL (EG, COLLAGEN);OVER 10.0 CC SUBCUTANEOUS INJECTION OF "FILLING" MATERIAL (EG, COLLAGEN); statewide
11960 INSERTION OF TISSUE EXPANDER(S) FOR OTHER THAN cohort cohort
26
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
BREAST,INCLUDING SUBSEQUENT EXPANSION
11970 REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROSTHESIS cohort cohort cohort cohort cohort cohort
11971 REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OFPROSTHESIS cohort cohort cohort cohort cohort
11980
SUBCUTANEOUS HORMONE PELLET IMPLANTATION(IMPLANTATION OF ESTRADIOL AND/OR TESTOSTERONE PELLETS BENEATH THE SKIN cohort cohort cohort
11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT cohort cohort cohort cohort cohort
11982 REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT cohort cohort cohort cohort
11983 REMOVAL W/REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT cohort cohort
12001
*SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK,AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS cohort cohort cohort cohort cohort cohort
12002
*SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK,AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.6 CM TO 7.5 CM cohort cohort cohort cohort cohort cohort
12004
*SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK,AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 7.6 CM TO 12.5 CM cohort cohort cohort cohort cohort cohort
12005
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE,EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 12.6 CM TO 20.0 CM cohort cohort cohort cohort cohort
12006
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE,EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 20.1 CM TO 30.0 CM cohort cohort cohort cohort
12007
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE,EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); OVER 30.0 CM cohort cohort
12011
*SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS,NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS cohort cohort cohort cohort cohort cohort
12013
*SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS,NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.6 CM TO 5.0 CM cohort cohort cohort cohort cohort
12014
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 5.1 CM TO 7.5 CM cohort cohort cohort cohort cohort
12015
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 7.6 CM TO 12.5 CM cohort cohort cohort cohort cohort
12016
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 12.6 CM TO 20.0 CM cohort cohort cohort cohort
12020 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE cohort cohort cohort cohort cohort
12021 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING cohort cohort
12031 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);2.5 cm or less cohort cohort cohort cohort cohort
12032 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);2.6 cm to 7.5 cm cohort cohort cohort cohort cohort cohort
12034 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);7.6 cm to 12.5 cm cohort cohort cohort cohort cohort cohort
12035 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);12.6 cm to 20.0 cm cohort cohort cohort cohort cohort
12036 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);20.1 cm to 30.0 cm cohort cohort cohort cohort
12037 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet);over 30.0 cm cohort cohort cohort
12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less cohort cohort cohort cohort cohort
27
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
12042 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm cohort cohort cohort cohort cohort
12044 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm cohort cohort cohort cohort cohort cohort
12045 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm cohort cohort cohort
12046 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm statewide
12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less cohort cohort cohort cohort cohort cohort
12052 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm cohort cohort cohort cohort cohort cohort
12053 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm cohort cohort cohort cohort
12054 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm cohort cohort cohort cohort cohort
12055 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm cohort cohort cohort
12056 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm statewide
13101 REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM cohort cohort cohort cohort
13102
REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
13120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM cohort cohort cohort
13121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM cohort cohort cohort cohort cohort
13122
REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS;EACH ADDITIONAL 5 CM OR LESS(LIST SEPARATELY IN ADDITIOTO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
13131
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK,AXILLAE, GENITALIA, HANDS AND/OR FEET; 1.1 CM TO 2.5 CM REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN,MOUTH, NECK, cohort cohort cohort cohort cohort
13132
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK,AXILLAE, GENITALIA, HANDS AND/OR FEET; 2.6 CM TO 7.5 CM REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN,MOUTH, NECK, cohort cohort cohort cohort cohort
13133
REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK,AXILLAE, GENITALIA, HANDS AND/OR FEET;EACH ADDITIONAL 5 CM OR LESS(LIST SEPARATELY IN ADDITON TO PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
13150 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.0 CM OR LESS cohort cohort cohort
13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM cohort cohort cohort cohort
13152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM cohort cohort cohort cohort cohort
13153
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
13160 SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE,EXTENSIVEOR COMPLICATED cohort cohort cohort cohort cohort
14000
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 cohort cohort cohort cohort
14001
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT10.1 SQ CM TO 30.0 SQ CM ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT cohort cohort cohort cohort
14020
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMSAND/OR LEGS; DEFECT 10 SQ CM OR LESS ADJACENTTISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS cohort cohort cohort cohort
28
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
14021
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMSAND/OR LEGS; DEFECT 10.1 SQ CM TO 30.0 SQ CM ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS cohort cohort cohort cohort
14040
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS,CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS cohort cohort cohort cohort cohort
14041
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS,CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10.1 SQ CM TO 30.0 SQ CM cohort cohort cohort cohort
14060
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE,EARS AND/OR LIPS; DEFECT 10 SQ CM OR LESS ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, cohort cohort cohort cohort cohort
14061
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE,EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0SQ CM ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, cohort cohort cohort cohort
14301 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; DEFECT 30.1 SQ CM TO 60.0 SQ CM cohort cohort cohort cohort
14302
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; EACH ADDITIONAL 30.0 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
14350 FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATIONOFRECIPIENT SITE statewide
15002
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITEBY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR SCAR (INCLUDING SUBCUTANEOUS TISSUES), OR INCISIONAL RELEASE OF SCAR CONTRACTURE, TRUNK, ARMS, LEGS; FIRS cohort cohort cohort cohort
15003
Surgical preparation or creation of recipient siteby excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each cohort cohort
15004
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITEBY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR SCAR (INCLUDING SUBCUTANEOUS TISSUES), OR INCISIONAL RELEASE OF SCAR CONTRACTURE, FACE, SCALP, EYELIDS, M cohort cohort cohort cohort cohort
15100
SPLIT GRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM ORLESS, OR ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT 15050) cohort cohort cohort cohort cohort cohort
15101
SPLIT GRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM,OR EACH ADDITIONAL ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO cohort cohort
15115
EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/ORMULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN statewide
15120
SPLIT GRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS,ORBITS, GENITALIA, HANDS, FEET AND/OR MULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR ONE PERCENT OF BODY AREA OF INFANTS cohort cohort cohort cohort
15121
SPLIT GRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS,ORBITS, GENITALIA, HANDS, FEET AND/OR MULTIPLE DIGITS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL ONE PERCENT OF BODY statewide
15130
DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR ONE PERCENT OF BODY AREA OF INFANTSAND CHILDREN statewide
15135
DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN cohort cohort cohort cohort
15200
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OFDONOR SITE, TRUNK; 20 SQ CM OR LESS FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF cohort cohort cohort
15220 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE cohort cohort cohort cohort
29
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OFDONOR SITE, SCALP, ARMS, AND/OR LEGS; 20 SQ CM OR LESS FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF
15221
Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) statewide
15240
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OFDONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; 20 SQCM OR LESS cohort cohort cohort cohort cohort cohort
15260
FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OFDONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIPS;20 SQ CM OR LESS cohort cohort cohort cohort cohort
15261
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedu statewide
15271
APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM;FIRST 25 SQ CM OR LESS WOUND SURFACE AREA cohort cohort cohort cohort cohort
15272
APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM;EACH ADDITIONAL 25 SQ CM WOUND SURFACE AREA, OR P ART THEREOF (LIST SEPARATELY IN ADDITION TO CODE F cohort cohort cohort cohort
15273
APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FIRST 100 SQ CM WOUND SURFACE AREA, OR 1% OF BODY AREA OF INFANTS AND CHILDREN cohort cohort cohort cohort
15274
APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; EACH ADDITIONAL 100 SQ CM WOUND SURFACE AREA, OR PART THEREOF, OR EACH ADDITIONA cohort cohort cohort cohort
15275
APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LES cohort cohort cohort cohort cohort
15276
APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ statewide
15574
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUTTRANSFER; FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS OR FEET cohort cohort
15576
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUTTRANSFER; EYELIDS, NOSE, EARS, LIPS, OR INTRAORAL cohort cohort
15600 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); ATTRUNK cohort cohort
15610 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); ATSCALP, ARMS, OR LEGS statewide
15620
DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); ATFOREHEAD, CHEEKS, CHIN, NECK, AXILLAE, GENITALIA, HANDS (EXCEPT 15625), OR FEET cohort cohort cohort
15630 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); ATEYELIDS, NOSE, EARS, OR LIPS cohort cohort
15650 TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG, ABDOMEN TO WRIST, "WALKING" TUBE), ANY LOCATION cohort cohort
15731 FOREHEAD FLAP WITH PRESERVATION OF VASCULAR PEDICLE (EG, AXIAL PATTERN FLAP, PARAMEDIAN FOREHEAD FLAP) cohort cohort
15732
MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; HEAD AND NECK(EG, TEMPORALIS, MASSETER, STERNOCLEIDOMASTOID, LEVATOR SCAPULAE) cohort cohort cohort cohort cohort
15734 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; TRUNK cohort cohort cohort
15736 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPEREXTREMITY cohort cohort cohort
15738 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; cohort cohort
30
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
LOWEREXTREMITY
15740 FLAP; ISLAND PEDICLE REQUIRING IDENTIFICATION AND DISSECTION OF AN ANATOMICALLY NAMED AXIAL VESSEL statewide
15760 GRAFT; COMPOSITE (EG, FULL THICKNESS OF EXTERNAL EAR ORNASAL ALA), INCLUDING PRIMARY CLOSURE, DONOR AREA cohort cohort cohort
15770 GRAFT; DERMA-FAT-FASCIA statewide
15776
PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15 PUNCH GRAFTSPUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN15 PUNCH GRAFTS statewide
15777
IMPLANTATION OF BIOLOGIC IMPLANT (EG, ACELLULAR DERMAL MATRIX) FOR SOFT TISSUE REINFORCEMENT (EG, BREAST, TRUNK) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
15781 Dermabrasion; segmental, face cohort cohort cohort
15821 BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNIATED FATPAD statewide
15822 BLEPHAROPLASTY, UPPER EYELID; cohort cohort cohort
15823 BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID cohort cohort cohort cohort cohort cohort
15829 RHYTIDECTOMY; SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM (SMAS)FLAP statewide
15830
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ABDOMEN, INFRAUMBILICAL PANNICULECTOMY cohort cohort cohort cohort
15839 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); OTHER AREA cohort cohort
15847
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY), ABDOMEN (EG, ABDOMINOPLASTY) (INCLUDES UMBILICAL TRANSPOSITION AND FASCIAL PLICATION) (LIST SEPARATELY IN ADDITION TO CODE FOR PR statewide
15850 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAMESURGEON cohort cohort cohort cohort
15851 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL),OTHER SURGEON cohort cohort
15852 DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA(OTHER THAN LOCAL) cohort cohort cohort
15876 SUCTION ASSISTED LIPECTOMY; HEAD AND NECK statewide
15877 SUCTION ASSISTED LIPECTOMY; TRUNK cohort cohort cohort
15878 SUCTION ASSISTED LIPECTOMY; UPPER EXTREMITY statewide
15879 SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY statewide
15931
EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE;EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE; statewide
15946
EXCISION, ISCHIAL PRESSURE ULCER, WITH OSTECTOMY, INPREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE statewide
16000 INITIAL TREATMENT, FIRST DEGREE BURN, WHEN NO MORETHANLOCAL TREATMENT cohort cohort cohort cohort cohort
16020
*DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT;WITHOUT ANESTHESIA, OFFICE OR HOSPITAL, SMALL *DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; cohort cohort cohort cohort cohort
16025
*DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT;WITHOUT ANESTHESIA, MEDIUM (EG, WHOLE FACE OR WHOLE EXTREMITY) cohort cohort cohort cohort
16030
DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE (EG, MORE THAN1 EXTREMITY, OR GREATER THAN 10% TOTAL BODY SURFA CE AREA) cohort cohort cohort
17000
Destruction (eg, laser surgery, electrosurgery, cryosurgery chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratosis) first lesion cohort cohort
31
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
17003
DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGICAL CURETTEMENT, ALL BENIGN OR PREMALIGNANT LESIONS (EG, ACTINIC KERATOSES) OTHER THAN SKIN TAGS OR CUTANEOUS statewide
17004
Destruction (eg, laser surgery, electrosurgery, cryosurgery chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratosis) 15 or more lesions statewide
17106
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG,LASER TECHNIQUE); LESS THAN 10 SQ CM DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, cohort cohort cohort
17107
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG,LASER TECHNIQUE); 10.0 - 50.0 SQ CM DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, cohort cohort
17108
DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG,LASER TECHNIQUE); OVER 50.0 SQ CM DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS(EG, statewide
17110
Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions cohort cohort cohort cohort cohort
17111 DESTRUCTION BY ANY METHOD OF FLAT WARTS, MOLLUSCUMCONTAGIOSUM, OR MILIA; 15 OR MORE LESIONS cohort cohort cohort
17250 *CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA) cohort cohort cohort cohort cohort cohort
17260
*DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,ARMS ORLEGS; LESION DIAMETER 0.5 CM OR LESS *DES TRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR statewide
17261
DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS ORLEGS; LESION DIAMETER 0.6 TO 1.0 CM DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR statewide
17270
*DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,NECK,HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS *DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, statewide
17271
DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK,HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, statewide
17280
*DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS,EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS statewide
17311
MOHS MICROGRAPHIC TECHNIQUE, INCLUDING REMOVAL OF ALL GROSS TUMOR, SURGICAL EXCISION OF TISSUE SPECIMENS, MAPPING, COLOR CODING OF SPECIMENS, MICROSCOPIC EXAMINATION OF SPECIMENS BY THE SURGEON, AND H statewide
17312
MOHS MICROGRAPHIC TECHNIQUE, INCLUDING REMOVAL OF ALL GROSS TUMOR, SURGICAL EXCISION OF TISSUE SPECIMENS, MAPPING, COLOR CODING OF SPECIMENS, MICROSCOPIC EXAMINATION OF SPECIMENS BY THE SURGEON, AND H statewide
17340 *CRYOTHERAPY (CO2 SLUSH, LIQUID N2) FOR ACNE statewide
17999
UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUSTISSUE UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS cohort cohort cohort cohort cohort cohort
19000 *PUNCTURE ASPIRATION OF CYST OF BREAST; cohort cohort cohort cohort cohort
19001
PUNCTURE ASPIRATION OF CYST OF BREAST; EACH ADDITIONAL CYST (LIST SEPARATELY IN ADDITION TO CODE FORPRIMARY PROCEDURE) cohort cohort cohort cohort
19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS,DEEP cohort cohort cohort cohort cohort cohort
19030 INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM ORGALACTOGRAM cohort cohort cohort
32
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
19100 *BIOPSY OF BREAST; NEEDLE CORE (SEPARATE PROCEDURE) cohort cohort cohort cohort
19101 BIOPSY OF BREAST; INCISIONAL cohort cohort cohort cohort cohort
19102 BIOPSY OF BREAST; PERCUTANEOUS, NEEDLE CORE, USINGIMAGING GUIDANCE cohort cohort cohort cohort cohort cohort
19103
BIOPSY OF BREAST; PERCUTANEOUS, AUTOMATED VACUUM ASSISTED OR ROTATING BIOPSY DEVICE, USING IMAGING GUIDANCE cohort cohort cohort cohort cohort
19110
NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARYLACTIFEROUS DUCT OR A PAPILLOMA LACTIFEROUS DUCT cohort cohort cohort cohort cohort
19112 EXCISION OF LACTIFEROUS DUCT FISTULA statewide
19120
EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN ORMALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LES ION, NIPPLE OR AREOLAR LESION (EXCEPT 19300), OPEN, MALE OR FEMALE, 1 OR MORE LESIONS cohort cohort cohort cohort cohort cohort
19125
EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERATIVEPLACEMENT OF RADIOLOGICAL MARKER; SINGLE LESION cohort cohort cohort cohort cohort
19126
EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVEPLACEMENT OF RADIOLOGICAL MARKER; EACH ADDITIONAL LESION SEPARATELY IDENTIFIED BY A RADIOLOGICAL MARKER (LIST cohort cohort cohort cohort
19260 EXCISION OF CHEST WALL TUMOR INCLUDING RIBS cohort cohort
19290 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST; cohort cohort cohort cohort cohort cohort
19291
PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST; EACH ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE cohort cohort cohort cohort
19295
IMAGE GUIDED PLACEMENT, METALLIC LOCALIZATION CLIP, PERCUTANEOUS, DURING BREAST BIOPSY/ASPIRATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort cohort
19297
Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; c statewide
19298
PLACEMENT OF RADIOTHERAPY AFTERLOADING BRACHYTHERAPY CATHETERS INTO BREAST FOR INTERSTITIAL RADIOELEMENT APPLICATION FOLLOWING PARTIAL MASTECTOMY, INCL IMAGING GUIDANCE statewide
19300 MASTECTOMY FOR GYNECOMASTIA cohort cohort cohort cohort
19301 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); cohort cohort cohort cohort cohort cohort
19302
MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); WITH AXILLARY LYMPHADENECTOMY cohort cohort cohort cohort
19303 MASTECTOMY, SIMPLE, COMPLETE cohort cohort cohort cohort cohort
19304 MASTECTOMY, SUBCUTANEOUS cohort cohort cohort cohort cohort
19305 MASTECTOMY, RADICAL, INCLUDING PECTORAL MUSCLES, AXILLARY LYMPH NODES cohort cohort
19307
MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH NODES, WITH OR WITHOUT PECTORALIS MINOR MUSCLE, BUT EXCLUDING PECTORALIS MAJOR MUSCLE cohort cohort cohort cohort cohort
19316 MASTOPEXY cohort cohort cohort cohort cohort cohort
19318 REDUCTION MAMMAPLASTY cohort cohort cohort cohort cohort cohort
19324
MAMMAPLASTY, AUGMENTATION; WITHOUT PROSTHETIC IMPLANTMAMMAPLASTY, AUGMENTATION; WITHOUT PROSTHETIC IMPLANT statewide
19325
MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANTMAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT cohort cohort cohort
19328 REMOVAL OF INTACT MAMMARY IMPLANTREMOVAL OF INTACTMAMMARY IMPLANT cohort cohort cohort cohort cohort
19330 REMOVAL OF MAMMARY IMPLANT MATERIALREMOVAL OF cohort cohort cohort
33
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MAMMARY IMPLANT MATERIAL
19340
IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWINGMASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING cohort cohort cohort cohort cohort cohort
19342
DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION DELAYEDINSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEX Y, cohort cohort cohort cohort cohort cohort
19350 NIPPLE/AREOLA RECONSTRUCTION cohort cohort cohort cohort
19355 CORRECTION OF INVERTED NIPPLES statewide
19357 BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUEEXPANDER, INCLUDING SUBSEQUENT EXPANSION cohort cohort cohort cohort cohort cohort
19361 Breast reconstruction with latissimus dorsi flap, without prosthetic implant cohort cohort cohort
19364 BREAST RECONSTRUCTION WITH FREE FLAP statewide
19366 BREAST RECONSTRUCTION WITH OTHER TECHNIQUE cohort cohort cohort cohort cohort
19367
BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINISMYOCUTANEOUS FLAP(TRAM), SINGLE PEDICLE, INCLUDING CLOSURE OF DONOR SITE; statewide
19370 OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST cohort cohort cohort cohort
19371 PERIPROSTHETIC CAPSULECTOMY, BREAST cohort cohort cohort cohort cohort
19380 REVISION OF RECONSTRUCTED BREAST cohort cohort cohort cohort cohort cohort
19396 PREPARATION OF MOULAGE FOR CUSTOM BREAST IMPLANT statewide
19499 UNLISTED PROCEDURE, BREAST cohort cohort
20005 Incision and drainage of soft tissue abscess, subfascial (ie, involves the soft tissue below the deep fascia) cohort cohort cohort
20101 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); CHEST cohort cohort
20102 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE);ABDOMEN/FLANK/BACK cohort cohort
20103 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE);EXTREMITY cohort cohort cohort cohort cohort
20200 BIOPSY, MUSCLE; SUPERFICIAL cohort cohort cohort
20205 BIOPSY, MUSCLE; DEEP cohort cohort cohort cohort
20206 *BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE cohort cohort cohort cohort
20220
BIOPSY, BONE, TROCAR OR NEEDLE; SUPERFICIAL (EG, ILIUM,STERNUM, SPINOUS PROCESS, RIBS) BIOPSY, BONE, TROCAR OR NEEDLE; SUPERFICIAL (EG, ILIUM, cohort cohort cohort cohort
20225
BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (VERTEBRAL BODY,FEMUR) BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (VERTEBRAL BODY, cohort cohort cohort cohort cohort
20240
BIOPSY, BONE, EXCISIONAL; SUPERFICIAL (EG, ILIUM, STERNUM,SPINOUS PROCESS, RIBS, TROCHANTER OF FEMUR) BIOPSY, BONE, EXCISIONAL; SUPERFICIAL (EG, ILIUM, STERNUM, cohort cohort cohort cohort cohort
20245 BIOPSY, BONE, EXCISIONAL; DEEP (EG, HUMERUS, ISCHIUM, FEMUR) cohort cohort cohort
2028F
Foot examination performed (includes examination through visual inspection, sensory exam with monofilament, and pulse exam - report when any of the 3 components are completed) (DM) statewide
20500 *INJECTION OF SINUS TRACT; THERAPEUTIC (SEPARATE PROCEDURE) cohort cohort
20501 *INJECTION OF SINUS TRACT; DIAGNOSTIC (SINOGRAM) cohort cohort cohort cohort
20520
*REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE *REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE cohort cohort cohort cohort cohort
20525
REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR cohort cohort cohort cohort
20526 INJECTION, THERAPEUTIC (LOCAL ANESTHETIC CORTICOSTEROID); CARPAL CANAL cohort cohort cohort cohort cohort
34
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
20550 *INJECTION, TENDON SHEATH, LIGAMENT, TRIGGER POINTS ORGANGLION CYST cohort cohort cohort cohort cohort
20551 INJECTION; TENDON ORIGIN/INSERTION cohort cohort
20552 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S);1 OR 2 MUSCLE(S) cohort cohort cohort cohort cohort cohort
20553 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S);3 OR MORE MUSCLE(S) cohort cohort cohort cohort cohort cohort
20600
*ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT,BURSA OR GANGLION CYST (EG, FINGERS, TOES)*ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SM ALL JOINT, cohort cohort cohort cohort cohort cohort
20605
*ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATEJOINT, BURSA OR GANGLION CYST (EG, TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW OR ANKLE, OLECRANON BURSA) cohort cohort cohort cohort cohort cohort
20610
*ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT ORBURSA (EG, SHOULDER, HIP, KNEE JOINT, SUBACROMIAL BURSA) *ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR cohort cohort cohort cohort cohort cohort
20612 ASPIRATION &/OR INJECTION, GANGLION CYST(S) ANY LOCATION cohort cohort cohort cohort cohort
20615 ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYST cohort cohort cohort
20650
*INSERTION OF WIRE OR PIN WITH APPLICATION OF SKELETALTRACTION, INCLUDING REMOVAL (SEPARATE PROCEDURE) *INSERTION OF WIRE OR PIN WITH APPLICATION OF SKELETAL statewide
20660 Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) cohort cohort
20661 APPLICATION OF HALO, INCLUDING REMOVAL; CRANIALAPPLICATION OF HALO, INCLUDING REMOVAL; CRANIAL cohort cohort
20665 REMOVAL OF TONGS OR HALO APPLIED BY ANOTHER INDIVIDUAL statewide
20670
*REMOVAL OF IMPLANT; SUPERFICIAL, (EG, BURIED WIRE, PIN ORROD) (SEPARATE PROCEDURE) *REMOVAL OF IMPLANT; SUPERFICIAL, (EG, BURIED WIRE, PIN OR cohort cohort cohort cohort
20680
REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METALBAND, NAIL, ROD OR PLATE) REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL cohort cohort cohort cohort cohort cohort
20690 APPLICATION OF A UNIPLANE (PINS OR WIRES IN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM cohort cohort cohort
20692
APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORETHAN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYST EM (EG, ILIZAROV, MONTICELLI TYPE) cohort cohort cohort cohort
20693
ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEMREQUIRINGANESTHESIA (EG, NEW PIN(S) OR WIRE(S) AN D/OR NEW RING(S) OR BAR(S)) cohort cohort
20694 REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM cohort cohort cohort cohort cohort
20696
APPLICATION OF MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL FIXATION WITH STEREOTACTIC COMPUTER-ASSISTED ADJUSTMENT (EG, SPATIAL FRAME), INCLUDING IMAGING; INITIAL AND SUBSEQU statewide
20822 REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES DISTAL TIP TOSUBLIMIS TENDON INSERTION); COMPLETE AMPUTATION cohort cohort
20900 Bone graft, any donor area; minor or small (e.g., dowel or button) cohort cohort cohort cohort cohort
20902 Bone graft, any donor area; major or large cohort cohort cohort
20912 Cartilage graft; nasal septum cohort cohort cohort cohort cohort
20924 Tendon graft, from a distance (e.g., palmaris, toeextensor, plantaris) cohort cohort cohort cohort cohort
20926 Tissue grafts, other (e.g., paratenon, far, dermis) cohort cohort cohort cohort cohort
20930 Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure) cohort cohort cohort cohort cohort cohort
20931 Allograft, structural, for spine surgery only (List separately in addition to cohort cohort cohort cohort
35
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
code for primary procedure)
20936
Autograft for spine surgery only (includes harvesting the graft); local (e.g. ribs, spinous process,or laminar fragments) obtained from the same inci sion cohort cohort cohort cohort cohort
20937 Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) cohort cohort cohort
20938
Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) cohort cohort cohort cohort
20982
ABLATION, BONE TUMOR(S) (EG, OSTEOID OSTEOMA, METASTASIS) RADIOFREQUENCY, PERCUTANEOUS, INCLUDING COMPUTED TOMOGRAPHIC GUIDANCE cohort cohort cohort
20999 UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL cohort cohort cohort cohort cohort
21011 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; LESS THAN 2 CM statewide
21012 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; 2 CM OR GREATER cohort cohort cohort cohort
21013
EXCISION, TUMOR, SOFT TISSUE OF FACE AND SCALP, SUBFASCIAL (EG, SUBGALEAL, INTRAMUSCULAR); LESS THAN2 CM cohort cohort
21014
EXCISION, TUMOR, SOFT TISSUE OF FACE AND SCALP, SUBFASCIAL (EG, SUBGALEAL, INTRAMUSCULAR); 2 CM OR GREATER cohort cohort cohort cohort
21015 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FACE OR SCALP; LESS THAN 2 CM statewide
21016 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FACE OR SCALP; 2 CM OR GREATER cohort cohort cohort cohort
21025 EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS);MANDIBLE cohort cohort
21026 EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS);FACIAL BONE(S) statewide
21030 EXCISION OF BENIGN TUMOR OR CYST OF FACIAL BONE OTHER THANMANDIBLE statewide
21032 EXCISION OF MAXILLARY TORUS PALATINUS statewide
21034 EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER THANMANDIBLE statewide
21040
EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMPLEEXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMPLE cohort cohort
21046 EXCISION, BENIGN TUMOR/CYST, MANDIBL; INTRA-ORAL OSTEOTOMY & PARTIAL MANDIBULECTOMY cohort cohort cohort
21047 EXCISION, BENIGN TUMOR/CYST, MANDIBLE: EXTRA-ORAL OSTEOMOTY & PARTIAL MANDIBULECTOMY statewide
21048 EXCISION, BENIGN TUMOR/CYST, MAXILLA; INTRA-ORAL OSTEOTOMY statewide
21060
MENISCECTOMY, PARTIAL OR COMPLETE, TEMPOROMANDIBULAR JOINT(SEPARATE PROCEDURE) MENISCECTOMY, PARTIAL OR COMPLETE, TEMPOROMANDIBULAR JOINT statewide
21070 CORONOIDECTOMY (SEPARATE PROCEDURE) statewide
21085
IMPRESSION AND CUSTOM PREPARATION; ORAL SURGICAL SPLINTIMPRESSION AND CUSTOM PREPARATION; ORAL SURGICAL SPLINT statewide
21089 UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDUREUNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE statewide
21110
APPLICATION OF INTERDENTAL FIXATION DEVICE FOR CONDITIONSOTHER THAN FRACTURE OR DISLOCATION, INCLUDES REMOVAL cohort cohort
21120
GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC MATERIAL) GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC cohort cohort
21121 GENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECEGENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECE statewide
36
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
21122
GENIOPLASTY; SLIDING OSTEOTOMIES, TWO OR MORE OSTEOTOMIES(EG, WEDGE EXCISION OR BONE WEDGE REVERSAL FOR ASYMMETRICAL CHIN) statewide
21123
GENIOPLASTY; SLIDING, AUGMENTATION WITH INTERPOSITIONAL BONEGRAFTS (INCLUDES OBTAINING AUTOGRAFTS) GENIOPLASTY; SLIDING, AUGMENTATION WITH INTERPOSITIONAL BONE statewide
21141
RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENTMOVEMENT IN ANY DIRECTION (EG, FOR LONG FACE SYNDROME), WITHOUT BONE GRAFT statewide
21142
RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENTMOVEMENT IN ANY DIRECTION, WITHOUT BONE GRAFT RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENT statewide
21143
RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES,SEGMENT MOVEMENT IN ANY DIRECTION, WITHOUT BONE GRAFT RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES, statewide
21145
RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENTMOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) cohort cohort cohort
21147
RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES,SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, UNGRAFTED BILATERAL cohort cohort
21181 RECONSTRUCTION BY CONTOURING OF BENIGN TUMOR OF CRANIALBONES (EG, FIBROUS DYSPLASIA), EXTRACRANIAL cohort cohort
21196
RECONSTRUCTION OF MANDIBULAR RAMI AND/OR BODY, SAGITTALSPLIT; WITH INTERNAL RIGID FIXATION RECONSTRUCTION OF MANDIBULAR RAMI AND/OR BODY, SAGITTAL cohort cohort cohort cohort
21198 OSTEOTOMY, MANDIBLE, SEGMENTALOSTEOTOMY, MANDIBLE,SEGMENTAL statewide
21210 GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDESOBTAINING GRAFT) statewide
21215 GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT) cohort cohort
21230 GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, NOSE OR EAR(INCLUDES OBTAINING GRAFT) cohort cohort
21235 GRAFT; EAR CARTILAGE, AUTOGENOUS, TO NOSE OR EAR (INCLUDESOBTAINING GRAFT) cohort cohort cohort cohort
21240
ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUTAUTOGRAFT (INCLUDES OBTAINING GRAFT) ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT cohort cohort cohort
21244
RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSOSTEAL BONEPLATE (EG, MANDIBULAR STAPLE BONE PLATE)RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRAN SOSTEAL BONE statewide
21246
RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEALIMPLANT; COMPLETE RECONSTRUCTION OF MANDIBLE ORMAXILLA, SUBPERIOSTEAL statewide
21282 LATERAL CANTHOPEXY cohort cohort
21299
UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDUREUNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE statewide
21315
*CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUTSTABILIZATION *CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUT cohort cohort cohort cohort
21320
CLOSED TREATMENT OF NASAL BONE FRACTURE; WITH STABILIZATION CLOSED TREATMENT OF NASAL BONE FRACTURE;WITH STABILIZATION cohort cohort cohort cohort cohort
21325
OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATEDOPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED cohort cohort cohort
21330 OPEN TREATMENT OF NASAL FRACTURE; COMPLICATED, WITH statewide
37
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
INTERNALAND/OR EXTERNAL SKELETAL FIXATION OPEN TREATMENT OF NASAL FRACTURE; COMPLICATED, WITH INTERNAL
21335
OPEN TREATMENT OF NASAL FRACTURE; WITH CONCOMITANTOPENTREATMENT OF FRACTURED SEPTUM OPEN TREATMENT OF NASAL FRACTURE; WITH CONCOMITANT OPEN cohort cohort cohort
21336
OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUTSTABILIZATION OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT cohort cohort cohort
21337
CLOSED TREATMENT OF NASAL SEPTAL FRACTURE, WITH ORWITHOUTSTABILIZATION CLOSED TREATMENT OF NASAL S EPTAL FRACTURE, WITH OR WITHOUT cohort cohort cohort cohort cohort
21343
OPEN TREATMENT OF DEPRESSED FRONTAL SINUS FRACTUREOPEN TREATMENT OF DEPRESSED FRONTAL SINUS FRACTURE statewide
21346
OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); WITH WIRING AND/OR LOCAL FIXATIONOPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II statewide
21347
OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); REQUIRING MULTIPLE OPEN APPROACHES OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II statewide
21355
*PERCUTANEOUS TREATMENT OF FRACTURE OF MALAR AREA,INCLUDINGZYGOMATIC ARCH AND MALAR TRIPOD, WITH MA NIPULATION *PERCUTANEOUS TREATMENT OF FRACTURE OFMALAR AREA, INCLUDING statewide
21356
OPEN TREATMENT OF DEPRESSED ZYGOMATIC ARCH FRACTURE (EG,GILLIES APPROACH) OPEN TREATMENT OF DEPRESSED ZYGOMATIC ARCH FRACTURE (EG, cohort cohort cohort cohort
21360
OPEN TREATMENT OF DEPRESSED MALAR FRACTURE, INCLUDINGZYGOMATIC ARCH AND MALAR TRIPOD OPEN TREATMENTOF DEPRESSED MALAR FRACTURE, INCLUDING cohort cohort
21365
OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVINGCRANIAL NERVE FORAMINA) FRACTURE(S) OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD; WITH INTERNAL FIXATION AND cohort cohort cohort cohort
21386
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE;PERIORBITAL APPROACH OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; cohort cohort cohort
21390
OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE;PERIORBITAL APPROACH, WITH ALLOPLASTIC OR OTHER IMPLANT OPEN TREATMENT OF ORBITAL FLOOR "BLOWOUT" FRACTURE; cohort cohort cohort
21406
OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT BLOWOUT; WITHOUTIMPLANT OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT BLOWOUT; WITHOUT cohort cohort
21421
CLOSED TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE), WITH INTERDENTAL WIRE FIXATION ORFIXATION OF DENTURE OR SPLINT statewide
21422
OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT ITYPE); OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I cohort cohort
21423
OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT ITYPE); COMPLICATED (COMMINUTED OR INVOLVINGCRANIAL NERVE FORAMINA), MULTIPLE APPROACHES cohort cohort
21440
CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGEFRACTURE (SEPARATE PROCEDURE) CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGE statewide
21451
CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATIONCLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATION cohort cohort cohort
21452 PERCUTANEOUS TREATMENT OF MANDIBULAR FRACTURE, WITH EXTERNALFIXATION PERCUTANEOUS TREATMENT OF statewide
38
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MANDIBULAR FRACTURE, WITH EXTERNAL
21453
CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTALFIXATION CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTAL cohort cohort cohort
21461
OPEN TREATMENT OF MANDIBULAR FRACTURE; WITHOUT INTERDENTALFIXATION OPEN TREATMENT OF MANDIBULAR FRACTURE; WITHOUT INTERDENTAL statewide
21462
OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTALFIXATION OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTAL cohort cohort cohort
21465
OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTUREOPENTREATMENT OF MANDIBULAR CONDYLAR FRACTURE cohort cohort
21470
OPEN TREATMENT OF COMPLICATED MANDIBULAR FRACTURE BYMULTIPLE SURGICAL APPROACHES INCLUDING INTERNAL FIXATION, INTERDENTAL FIXATION, AND/OR WIRING OF DENTURES OR SPLINTS cohort cohort
21480
CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION;INITIALOR SUBSEQUENT CLOSED TREATMENT OF TEMPORO MANDIBULAR DISLOCATION; INITIAL cohort cohort cohort cohort
21497 INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE statewide
21499 UNLISTED MUSCULOSKELETAL PROCEDURE, HEAD statewide
21501
INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFTTISSUES OF NECK OR THORAX; INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT cohort cohort cohort
21550 BIOPSY, SOFT TISSUE OF NECK OR THORAX cohort cohort cohort cohort
21552 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort cohort
21554
EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort cohort cohort cohort
21555 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort cohort cohort
21556 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5CM cohort cohort cohort cohort
21557 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF NECK OR ANTERIOR THORAX; LESS THAN 5 CM cohort cohort
21600 EXCISION OF RIB, PARTIAL statewide
21627 STERNAL DEBRIDEMENT statewide
21685 HYOID MYOTOMY AND SUSPENSION statewide
21720 DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPENOPERATION; WITHOUT CAST APPLICATION statewide
21800
CLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED, EACHCLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED, EACH cohort cohort
21899 UNLISTED PROCEDURE, NECK OR THORAX cohort cohort cohort
21920 BIOPSY, SOFT TISSUE OF BACK OR FLANK; SUPERFICIAL cohort cohort
21925 BIOPSY, SOFT TISSUE OF BACK OR FLANK; DEEP statewide
21930 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort
21931 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort
21932 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort cohort
21933 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort cohort cohort
21936 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF BACK OR FLANK; 5 CM OR GREATER statewide
22102
PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG,SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; LUMBAR cohort cohort
39
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
22114
PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONYLESION, WITHOUT DECOMPRESSION OF SPINAL CORD OR NERVE ROOT(S), SINGLE VERTEBRAL SEGMENT; LUMBAR statewide
22318
OPEN TREATMENT AND/OR REDUCTION OF ODONTOID FRACTURE(S) AND OR DISLOCATION(S) (INCLUDING OS ODONTOIDEUM), ANTERIOR APPROACH, INCLUDING PLACEMENT OF INTERNAL FIXATION; WITHOUT GRAFTING statewide
22520
PERCUTANEOUS VERTEBROPLASTY (BONE BIOPSY INCLUDED WHEN PERFORMED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; THORACIC cohort cohort cohort
22521
PERCUTANEOUS VERTEBROPLASTY (BONE BIOPSY INCLUDED WHEN PERFORMED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; LUMBAR cohort cohort
22522
PERCUTANEOUS VERTEBROPLASTY (BONE BIOPSY INCLUDED WHEN PERFORMED), 1 VERTEBRAL BODY, UNILATERAL OR BILATERAL INJECTION; EACH ADDITIONAL THORACIC OR LUMBAR VERTEBRAL BODY (LIST SEPARATELY IN ADDITION T cohort cohort
22523
PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (FRACTURE REDUCTION AND BONE BIOPSY INCLUDED WHEN PERFORMED) USING MECHANICAL DEVICE, 1VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATI cohort cohort cohort cohort
22524
PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (FRACTURE REDUCTION AND BONE BIOPSY INCLUDED WHEN PERFORMED) USING MECHANICAL DEVICE, 1VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATI cohort cohort cohort cohort
22525
PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (FRACTURE REDUCTION AND BONE BIOPSY INCLUDED WHEN PERFORMED) USING MECHANICAL DEVICE, 1VERTEBRAL BODY, UNILATERAL OR BILATERAL CANNULATI cohort cohort cohort cohort
22548
ARTHRODESIS, ANTERIOR TRANSORAL OR EXTRAORAL TECHNIQUE,CLIVUS-C1-C2 (ATLAS-AXIS), WITH OR WITHOUT EXCISION OF ODONTOID PROCESS statewide
22551
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 cohort cohort cohort cohort cohort cohort
22552
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List cohort cohort cohort cohort cohort
22554
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMALDISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); CERVICAL BELOW C2 cohort cohort cohort cohort cohort
22558
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMALDISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR cohort cohort
22565 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
22585
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMALDISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); EACH ADDITIONAL INTERSPACE (LIST SEPARATELY cohort cohort
22600 ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLELEVEL; CERVICAL BELOW C2 SEGMENT cohort cohort cohort cohort
22612
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; LUMBAR (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED) cohort cohort
22614
ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLELEVEL; EACH ADDITIONAL VERTEBRAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
22630 ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, SINGLEINTERSPACE; LUMBAR cohort cohort cohort
22633
ARTHRODESIS, COMBINED POSTERIOR OR POSTEROLATERAL TECHNIQUE WITH POSTERIOR INTERBODY TECHNIQUE INCLUDING LAMINECTOMY AND/OR DISCECTOMY SUFFICIENT TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), cohort cohort
22830 EXPLORATION OF SPINAL FUSION cohort cohort
40
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
22840
POSTERIOR NON-SEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD TECHNIQUE, PEDICLE FIXATION ACROSS 1 INTERSPACE, ATLANTOAXIAL TRANSARTICULAR SCREW FIXATION, SUBLAMINAR WIRING AT C1, FACET SCREW FIXATION) cohort cohort cohort cohort
22842 Posterior segmental instrumentation (e.g., pediclefixation, dual rods with multiple hooks and subla minar wires); 3 to 6 vertebral segments cohort cohort
22845 Anterior instrumentation; 2 to 3 vertebral segments cohort cohort cohort cohort cohort
22846 Anterior instrumentation; 4 to 7 vertebral segments cohort cohort cohort
22849 REINSERTION OF SPINAL FIXATION DEVICEREINSERTION OF SPINAL FIXATION DEVICE statewide
22850
REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG,HARRINGTON ROD) REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, cohort cohort
22851
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) tovertebral defect or interspace (List separately i n addition to code for primary procedure) cohort cohort cohort cohort cohort cohort
22852
REMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATIONREMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATION cohort cohort
22855 REMOVAL OF ANTERIOR INSTRUMENTATIONREMOVAL OF ANTERIOR INSTRUMENTATION cohort cohort
22899 UNLISTED PROCEDURE, SPINEUNLISTED PROCEDURE, SPINE cohort cohort cohort
22900 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort cohort
22901 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort
22902 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort
22903 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort
22905 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF ABDOMINAL WALL; 5 CM OR GREATER cohort cohort
22999 UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTEM cohort cohort cohort cohort cohort
23000 REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREOUSDEPOSITS, ANY METHOD cohort cohort
23020 CAPSULAR CONTRACTURE RELEASE (EG, SEVER TYPE PROCEDURE) cohort cohort
23030 INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESSORHEMATOMA cohort cohort
23044
ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT,INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OFFOREIGN BODY ARTHROTOMY, ACROMIOCLAVICULAR, STE RNOCLAVICULAR JOINT, cohort cohort
23065 BIOPSY, SOFT TISSUE OF SHOULDER AREA; SUPERFICIAL statewide
23071 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort cohort
23073 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort cohort cohort cohort
23075 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort
23076 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort cohort
23120 CLAVICULECTOMY; PARTIAL cohort cohort cohort cohort cohort cohort
23130 ACROMIOPLASTY OR ACROMIONECTOMY, PARTIAL, WITH OR WITHOUTCORACOACROMIAL LIGAMENT RELEASE cohort cohort cohort cohort cohort
23140 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFCLAVICLE OR SCAPULA; cohort cohort
23150 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFPROXIMAL HUMERUS; statewide
23156 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFPROXIMAL HUMERUS; WITH ALLOGRAFT statewide
41
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
23200 RADICAL RESECTION OF TUMOR; CLAVICLE statewide
23330
REMOVAL OF FOREIGN BODY, SHOULDER; SUBCUTANEOUSREMOVAL OF FOREIGN BODY, SHOULDER; SUBCUTANEOUS statewide
23331
REMOVAL OF FOREIGN BODY, SHOULDER; DEEP (EG, NEERHEMIARTHROPLASTY REMOVAL) REMOVAL OF FOREIGN BODY,SHOULDER; DEEP (EG, NEER statewide
23350 INJECTION PROCEDURE FOR SHOULDER ARTHROGRAPHY cohort cohort cohort cohort cohort cohort
23395 MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM; SINGLE cohort cohort cohort
23405 TENOTOMY, SHOULDER AREA; SINGLE TENDON cohort cohort cohort cohort
23410 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF);ACUTE cohort cohort cohort cohort cohort cohort
23412 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF);CHRONIC cohort cohort cohort cohort cohort
23415 CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUTACROMIOPLASTY cohort cohort cohort
23420 RECONSTRUCTION OF COMPLETE SHOULDER (ROTATOR) CUFFAVULSION,CHRONIC (INCLUDES ACROMIOPLASTY) cohort cohort cohort cohort cohort
23430 TENODESIS OF LONG TENDON OF BICEPS cohort cohort cohort cohort cohort cohort
23440 RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS statewide
23450 CAPSULORRHAPHY, ANTERIOR; PUTTI-PLATT PROCEDURE ORMAGNUSON TYPE OPERATION cohort cohort
23455 CAPSULORRHAPHY, ANTERIOR; WITH LABRAL REPAIR (EG, BANKARTPROCEDURE) cohort cohort cohort cohort
23460 CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH BONE BLOCK cohort cohort
23462 CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH CORACOID PROCESSTRANSFER cohort cohort cohort cohort cohort
23465 CAPSULORRHAPHY, GLENOHUMERAL JOINT, POSTERIOR, WITH ORWITHOUT BONE BLOCK cohort cohort
23466 CAPSULORRHAPHY, GLENOHUMERAL JOINT, ANY TYPEMULTI-DIRECTIONAL INSTABILITY cohort cohort
23470
ARTHROPLASTY, GLENOHUMERAL JOINT; HEMIARTHROPLASTYARTHROPLASTY, GLENOHUMERAL JOINT; HEMIARTHROPLASTY cohort cohort cohort
23472
ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOIDAND PROXIMAL HUMERAL REPLACEMENT (EG, TOTALSHOULDER)) ARTHROPLASTY, GLENOHUMERAL JOINT; TOT AL SHOULDER (GLENOID cohort cohort cohort
23474
REVISION OF TOTAL SHOULDER ARTHROPLASTY, INCLUDINGALLOGRAFT WHEN PERFORMED; HUMERAL AND GLENOID COM PONENT cohort cohort cohort
23480 OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; cohort cohort
23485
OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; WITHBONE GRAFT FOR NONUNION OR MALUNION (INCLUDES OBTAINING GRAFT AND/OR NECESSARY FIXATION) cohort cohort cohort cohort cohort
23500
CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT cohort cohort cohort
23505
CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITH MANIPULATIONCLOSED TREATMENT OF CLAVICULAR FRACTURE; WITH MANIPULATION statewide
23515 Open treatment of clavicular fracture, includes internal fixation when performed cohort cohort cohort cohort cohort cohort
23525
CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITHMANIPULATION CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITH cohort cohort
23530
OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE ORCHRONIC; OPEN TREATMENT OF STERNOCLAVICULARDISLOCATION, ACUTE OR cohort cohort
42
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
23540
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION;WITHOUTMANIPULATION CLOSED TREATMENT OF ACROMIOC LAVICULAR DISLOCATION; WITHOUT statewide
23545
CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION;WITHMANIPULATION CLOSED TREATMENT OF ACROMIOCLAV ICULAR DISLOCATION; WITH cohort cohort
23550
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE ORCHRONIC; OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR cohort cohort cohort cohort cohort cohort
23552
OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE ORCHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT) OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR cohort cohort cohort cohort cohort
23585 Open treatment of scapular fracture (body, glenoidor acromion) includes internal fixation, when per formed cohort cohort
23600
CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICALNECK) FRACTURE; WITHOUT MANIPULATION CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL cohort cohort
23605
CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICALNECK) FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION cohort cohort cohort cohort
23615
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation when performed, includes repair of tuberosity(s)when performed; cohort cohort cohort cohort cohort
23630 Open treatment of greater humeral tuberosity fracture, includes internal fixation when performed cohort cohort cohort cohort cohort
23650
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION;WITHOUT ANESTHESIA CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; cohort cohort cohort cohort cohort
23655
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION;REQUIRING ANESTHESIA CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; cohort cohort cohort cohort cohort
23660 OPEN TREATMENT OF ACUTE SHOULDER DISLOCATIONOPEN TREATMENT OF ACUTE SHOULDER DISLOCATION statewide
23665
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OFGREATER HUMERAL TUBEROSITY, WITH MANIPULATION CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF cohort cohort cohort cohort
23670 Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation when performed cohort cohort cohort cohort
23675
CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL ORANATOMICAL NECK FRACTURE, WITH MANIPULATION CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL OR cohort cohort
23680 Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internalfixation when performed statewide
23700
*MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDINGAPPLICATION OF FIXATION APPARATUS (DISLOCATION EXCLUDED) cohort cohort cohort cohort cohort cohort
23929 UNLISTED PROCEDURE, SHOULDER cohort cohort cohort cohort cohort
23930 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESSOR HEMATOMA statewide
23931 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; BURSA cohort cohort
24000
ARTHROTOMY, ELBOW, INCLUDING EXPLORATION, DRAINAGE, ORREMOVAL OF FOREIGN BODY ARTHROTOMY, ELBOW, INCLUDING EXPLORATION, DRAINAGE, OR statewide
24006 ARTHROTOMY OF THE ELBOW, WITH CAPSULAR EXCISION FOR CAPSULARRELEASE (SEPARATE PROCEDURE) cohort cohort cohort cohort
24065 BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; SUPERFICIAL statewide
24071 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOWAREA, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort cohort cohort
24073 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR cohort cohort cohort
43
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ELBOWAREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GRE ATER
24075 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOWAREA, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort
24076
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOWAREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort
24079
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF UPPER ARM OR ELBOW AREA; 5 CM ORGREATER statewide
24101
ARTHROTOMY, ELBOW; WITH JOINT EXPLORATION, WITH ORWITHOUTBIOPSY, WITH OR WITHOUT REMOVAL ARTHROTOM Y, ELBOW; WITH JOINT EXPLORATION, WITH OR WITHOUT cohort cohort cohort cohort cohort
24102 ARTHROTOMY, ELBOW; WITH SYNOVECTOMY cohort cohort
24105 EXCISION, OLECRANON BURSA cohort cohort cohort cohort cohort cohort
24110 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; statewide
24120 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF HEADOR NECK OF RADIUS OR OLECRANON PROCESS; cohort cohort cohort
24130 EXCISION, RADIAL HEAD cohort cohort
24140 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), HUMERUS cohort cohort cohort cohort cohort
24147
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS), OLECRANONPROCESS cohort cohort cohort
24149
RADICAL RESECTION OF CAPSULE, SOFT TISSUE, AND HETEROTOPICBONE, ELBOW, WITH CONTRACTURE RELEASE (SEPARATE PROCEDURE) cohort cohort cohort cohort
24155 RESECTION OF ELBOW JOINT (ARTHRECTOMY) statewide
24200
REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA;SUBCUTANEOUS REMOVAL OF FOREIGN BODY, UPPER ARM ORELBOW AREA; statewide
24201
REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; DEEP(SUBFASCIAL OR INTRAMUSCULAR) REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; DEEP statewide
24220 INJECTION PROCEDURE FOR ELBOW ARTHROGRAPHY cohort cohort cohort cohort cohort
24300 MANIPULATION, ELBOW, UNDER ANESTHESIA cohort cohort cohort cohort
24301 MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR ELBOW,SINGLE (EXCLUDING 24320-24331) statewide
24305 TENDON LENGTHENING, UPPER ARM OR ELBOW, EACH TENDON statewide
24310
TENOTOMY, OPEN, ELBOW TO SHOULDER, EACH TENDONTENOTOMY, OPEN, ELBOW TO SHOULDER, EACH TENDON cohort cohort
24320
TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT FREEGRAFT, ELBOW TO SHOULDER, SINGLE (SEDDON-BROOKES TYPE PROCEDURE) statewide
24331 FLEXOR-PLASTY, ELBOW (EG, STEINDLER TYPE ADVANCEMENT); WITH EXTENSOR ADVANCEMENT statewide
24340 TENODESIS OF BICEPS TENDON AT ELBOW (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
24341
REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACHTENDON ORMUSCLE, PRIMARY OR SECONDARY (EXCLUDES R OTATOR CUFF) cohort cohort cohort cohort cohort cohort
24342 REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL,WITH OR WITHOUT TENDON GRAFT cohort cohort cohort cohort cohort cohort
24343 REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, W/LOCALTISSUE cohort cohort cohort cohort
24344 RECONSTRUCTION LATERAL COLLATERAL LIGAMENT ELBOW, W/TENDON GRAFT W/HARVESTING, GRAFT cohort cohort cohort
24345 REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, W/LOCAL TISSUE cohort cohort
24346 RECONSTRUCTION MEDIAL COLLATERAL LIGAMENT ELBOW, cohort cohort cohort cohort cohort
44
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
W/TENDON GRAFT W/HARVESTING, GRAFT
24357 Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer's elbow); percutaneous statewide
24358 Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer's elbow); debridement,soft tissue and/or bone, open cohort cohort cohort cohort cohort
24359
Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer's elbow); debridement,soft tissue and/or bone, open with tendon repair or reattachment cohort cohort cohort cohort cohort cohort
24360 ARTHROPLASTY, ELBOW; WITH MEMBRANE (EG, FASCIAL) cohort cohort
24363
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (EG, TOTAL ELBOW) statewide
24365 ARTHROPLASTY, RADIAL HEAD; cohort cohort cohort
24366 ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT cohort cohort cohort cohort cohort
24400 OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXATION statewide
24430 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE) cohort cohort cohort
24435 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIAC OR OTHERAUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort
24500
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT statewide
24505
CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHMANIPULATION, WITH OR WITHOUT SKELETAL TRACTION CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITH cohort cohort cohort cohort
24515
OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE OPEN TREATMENTOF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, cohort cohort cohort cohort cohort
24516
OPEN TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS cohort cohort
24530
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLARHUMERALFRACTURE, WITH OR WITHOUT INTERCONDYLAR EX TENSION; WITHOUT MANIPULATION cohort cohort cohort
24535
CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLARHUMERALFRACTURE, WITH OR WITHOUT INTERCONDYLAR EX TENSION; WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION statewide
24538
PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR ORTRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT INTERCONDYLAR EXTENSION cohort cohort cohort cohort cohort
24545
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation when performed; without intercondylar extension cohort cohort cohort cohort
24546 Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation when performed; with intercondylar extension cohort cohort cohort
24560
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT MANIPULATION CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR cohort cohort
24565
CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITH MANIPULATION CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR statewide
24575 Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation when performed cohort cohort cohort cohort
24576
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL ORLATERAL; WITHOUT MANIPULATION CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR cohort cohort cohort
24577
CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL ORLATERAL; WITH MANIPULATION CLOSED TREATMENTOF HUMERAL CONDYLAR FRACTURE, MEDIAL OR statewide
24579 Open treatment of humeral condylar fracture, medial, or lateral, includes cohort cohort cohort cohort cohort
45
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
internal fixation when performed
24582
PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLARFRACTURE,MEDIAL OR LATERAL, WITH MANIPULATION PE RCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR FRACTURE, cohort cohort
24586
OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/ OR PROXIMAL RADIUS); cohort cohort cohort cohort
24600
TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIATREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA cohort cohort cohort cohort cohort
24605
TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA cohort cohort cohort cohort cohort
24620
CLOSED TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATIONAT ELBOW (FRACTURE PROXIMAL END OF ULNA WITH DISLOCATION OF RADIAL HEAD), WITH MANIPULATION cohort cohort cohort
24635
Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation when performed cohort cohort cohort cohort
24640
*CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD,"NURSEMAID ELBOW", WITH MANIPULATION *CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, cohort cohort cohort cohort cohort
24650
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT cohort cohort cohort
24655
CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHMANIPULATION CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITH cohort cohort cohort cohort cohort
24665 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; cohort cohort cohort cohort cohort
24666
Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement cohort cohort cohort
24670 Closed treatment of ulnar fracture, proximal end (e.g., olecranon or coronoid process[es]); without manipulation cohort cohort
24675 Closed treatment of ulnar fracture, proximal end (e.g., olecranon or coronoid process[es]); with manipulation cohort cohort cohort cohort
24685 Open treatment of ulnar fracture, proximal end (e.g., olecranon or coronoid process[es]), includes internal fixation when performed cohort cohort cohort cohort cohort cohort
24999 UNLISTED PROCEDURE, HUMERUS OR ELBOW cohort cohort cohort cohort cohort
25000 INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DEQUERVAIN'SDISEASE) cohort cohort cohort cohort cohort cohort
25001 INCISION, FLEXOR TENDON SHEATH, WRIST (FLEXOR CARPI RADIALIS) statewide
25020 DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST; FLEXOR OREXTENSOR COMPARTMENT statewide
25024 DECOMPRES FASCIOTOMY, FOREARM &/OR WRIST, FLEXOR & EXTENSOR COMPART; W/O DEBRIDE NONV MUSCLE/NERV statewide
25028 INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS ORHEMATOMA statewide
25035 INCISION, DEEP, BONE CORTEX, FOREARM AND/OR WRIST (EG,OSTEOMYELITIS OR BONE ABSCESS) statewide
25040
ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITHEXPLORATION, DRAINAGE, ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITH statewide
25071 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort
25073 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 3 CM OR GREATER cohort cohort
25075 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort
25076 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST cohort cohort
46
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN3 CM
25077
RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOREARM AND/OR WRIST AREA; LESS THAN 3 CM statewide
25085 CAPSULOTOMY, WRIST (EG, CONTRACTURE) cohort cohort
25100 ARTHROTOMY, WRIST JOINT; WITH BIOPSY cohort cohort
25101 ARTHROTOMY, WRIST JOINT; WITH JOINT EXPLORATION, WITH ORWITHOUT BIOPSY, WITH OR WITHOUT REMOVAL BODY cohort cohort cohort
25105 ARTHROTOMY, WRIST JOINT; WITH SYNOVECTOMY cohort cohort
25107 ARTHROTOMY, DISTAL RADIOULNAR JOINT INCLUDING REPAIR OFTRIANGULAR CARTILAGE, COMPLEX cohort cohort cohort
25110 EXCISION, LESION OF TENDON SHEATH, FOREARM AND/OR WRIST cohort cohort cohort cohort cohort
25111 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY cohort cohort cohort cohort cohort cohort
25112 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); RECURRENT cohort cohort cohort cohort
25115
RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARMTENDON SHEATHS (EG, TENOSYNOVITIS, FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); FLEXORS cohort cohort cohort cohort cohort cohort
25116
RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARMTENDON SHEATHS (EG, TENOSYNOVITIS, FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); EXTENSORS, WITH OR cohort cohort cohort cohort
25118 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLECOMPARTMENT; cohort cohort cohort cohort cohort cohort
25120
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF RADIUSOR ULNA (EXCLUDING HEAD OR NECK OF RADIU S AND OLECRANON PROCESS); cohort cohort
25126
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF RADIUSOR ULNA (EXCLUDING HEAD OR NECK OF RADIU S AND OLECRANON PROCESS); WITH ALLOGRAFT statewide
25130 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF CARPALBONES; cohort cohort cohort
25135
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF CARPALBONES; WITH AUTOGRAFT (INCLUDES OBTAININ G GRAFT) statewide
25150 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION ORDIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS); ULNA statewide
25151
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION ORDIAPHYSECTOMY) OF BONE (EG, FOR OSTEOMYELITIS); RADIUS cohort cohort
25210 CARPECTOMY; 1 BONE cohort cohort cohort
25215 CARPECTOMY; ALL BONES OF PROXIMAL ROW cohort cohort cohort cohort cohort
25230 RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE) cohort cohort cohort
25240 EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPEOR MATCHED RESECTION) cohort cohort cohort
25246 INJECTION PROCEDURE FOR WRIST ARTHROGRAPHY cohort cohort cohort cohort cohort
25248
EXPLORATION WITH REMOVAL OF DEEP FOREIGN BODY, FOREARM ORWRIST EXPLORATION WITH REMOVAL OF DEEP FOREIGN BODY, FOREARM OR statewide
25259 MANIPULATION, WRIST, UNDER ANESTHESIA cohort cohort
25260 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;PRIMARY, SINGLE, EACH TENDON OR MUSCLE cohort cohort cohort cohort cohort
25263 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;SECONDARY, SINGLE, EACH TENDON OR MUSCLE statewide
25265
REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;SECONDARY, WITH FREE GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON OR MUSCLE statewide
25270 REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/ORWRIST;PRIMARY, SINGLE, EACH TENDON OR MUSCLE cohort cohort cohort cohort
47
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
25275 REPAIR, TENDON SHEATH, EXTENSOR FOREARM &/OR WRISTW/FREE GRAFT cohort cohort cohort cohort
25280 LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TENDON,FOREARM AND/OR WRIST, SINGLE, EACH TENDON cohort cohort cohort
25290
TENOTOMY, OPEN, FLEXOR OR EXTENSOR TENDON, FOREARMAND/ORWRIST, SINGLE, EACH TENDON TENOTOMY, OPEN, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR cohort cohort cohort cohort cohort
25295 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON cohort cohort cohort
25310 TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR,FOREARM AND/OR WRIST, SINGLE; EACH TENDON cohort cohort cohort cohort cohort cohort
25312
TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR,FOREARM AND/OR WRIST, SINGLE; WITH TENDON GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON cohort cohort cohort
25316
FLEXOR ORIGIN SLIDE (EG, FOR CEREBRAL PALSY, VOLKMANNCONTRACTURE), FOREARM AND/OR WRIST; WITH TENDON(S) TRANSFER cohort cohort
25320
CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, ANY METHOD (EG,CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR cohort cohort cohort cohort cohort
25332 ARTHROPLASTY, WRIST, WITH OR WITHOUT INTERPOSITION, WITH OR WITHOUT EXTERNAL OR INTERNAL FIXATION cohort cohort cohort cohort
25337
RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY BY SOFT TISSUE STABILIZATION (EG, TENDON TRANSFER, TENDON GRAFT OR WEAVE, cohort cohort cohort
25360 OSTEOTOMY; ULNA statewide
25365 OSTEOTOMY; RADIUS AND ULNA statewide
25390 OSTEOPLASTY, RADIUS OR ULNA; SHORTENING cohort cohort cohort cohort
25391 OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTOGRAFT statewide
25400 REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITHOUTGRAFT (EG, COMPRESSION TECHNIQUE) cohort cohort cohort cohort cohort
25405 REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH ILIACOR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort cohort cohort
25415 REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITHOUTGRAFT (EG, COMPRESSION TECHNIQUE) cohort cohort cohort
25425 REPAIR OF DEFECT WITH AUTOGRAFT; RADIUS OR ULNA statewide
25431 REPAIR, NONUNION, CARPAL BONE (EXCLUDING CARPAL SCAPHOID) W/GRAFT, EACH BONE cohort cohort cohort cohort
25440
REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, WITH ORWITHOUT RADIAL STYLOIDECTOMY (INCLUDES OBTAINING GRAFT AND NECESSARY FIXATION) cohort cohort cohort cohort cohort cohort
25445 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIUM statewide
25447 ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS cohort cohort cohort cohort cohort cohort
25500
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITHOUT statewide
25505
CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATIONCLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION cohort cohort cohort cohort
25515 Open treatment of radial shaft fracture, includes internal fixation when performed cohort cohort cohort cohort
25525
Open treatment of radial shaft fracture, includes internal fixation when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes percutaneous cohort cohort
25526
Open treatment of radial shaft fracture, includes internal fixation when performed and open treatment of distal radioulnar joint dislocation (Galeazzifracture/ dislocation), includes internal fixatio cohort cohort cohort
25530 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF ULNAR SHAFT cohort cohort
48
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
FRACTURE; WITHOUT
25535
CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION cohort cohort cohort cohort
25545 Open treatment of ulnar shaft fracture, includes internal fixation when performed cohort cohort cohort
25560
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES;WITHOUT MANIPULATION CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; cohort cohort cohort
25565
CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITHMANIPULATION CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITH cohort cohort cohort cohort cohort
25574 Open treatment of radial AND ulnar shaft fractures, with internal fixation when performed; of radiusOR ulna cohort cohort cohort cohort
25575 Open treatment of radial AND ulnar shaft fractures, with internal fixation when performed; of radiusAND ulna cohort cohort cohort cohort cohort
25600
Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation includes closed treatment of fracture of ulnar styloid when performed; without manipulation cohort cohort cohort cohort cohort
25605
CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES ORSMITH TYPE) OR EPIPHYSEAL SEPARATION, WITH OR WITHOUT FRACTURE OF ULNAR STYLOID; WITH MANIPULATION cohort cohort cohort cohort cohort
25606 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION cohort cohort cohort cohort cohort
25607
OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION cohort cohort cohort cohort cohort cohort
25608
OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 2 FRAGMENTS cohort cohort cohort cohort cohort cohort
25609
OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 3 OR MORE FRAGMENTS cohort cohort cohort cohort cohort cohort
25622
CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE;WITHOUT MANIPULATION CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; cohort cohort
25624
CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE;WITH MANIPULATION CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; statewide
25628 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation when performed cohort cohort cohort cohort cohort
25635
CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPALSCAPHOID (NAVICULAR)); WITH MANIPULATION, EACH BONE CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL cohort cohort cohort cohort
25645
OPEN TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPALSCAPHOID (NAVICULAR)), EACH BONE OPEN TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL cohort cohort cohort cohort cohort
25650 CLOSED TREATMENT OF ULNAR STYLOID FRACTURECLOSED TREATMENT OF ULNAR STYLOID FRACTURE cohort cohort cohort
25651 PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE cohort cohort cohort
25652 OPEN TREATMENT OF ULNAR STYLOID FRACTURE cohort cohort cohort cohort cohort
25660 CLOSED TREATMENT OF RADIOCARPAL OR INTERCARPAL DISLOCATION, 1 OR MORE BONES, WITH MANIPULATION cohort cohort
25671 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION statewide
25675
CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITHMANIPULATION CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH cohort cohort
25690
CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATIONCLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION statewide
25800 ARTHRODESIS, WRIST; COMPLETE, WITHOUT BONE GRAFT statewide
49
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(INCLUDESRADIOCARPAL AND/OR INTERCARPAL AND/OR CARPOMETACARPAL JOINTS)
25805 ARTHRODESIS, WRIST; WITH SLIDING GRAFT statewide
25810 ARTHRODESIS, WRIST; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort cohort
25820 ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG,INTERCARPAL OR RADIOCARPAL) cohort cohort
25825 ARTHRODESIS, WRIST; WITH AUTOGRAFT (INCLUDES OBTAININGGRAFT) cohort cohort cohort cohort
25999 UNLISTED PROCEDURE, FOREARM OR WRIST cohort cohort cohort cohort
26010 *DRAINAGE OF FINGER ABSCESS; SIMPLE cohort cohort cohort cohort cohort
26011 *DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON) cohort cohort cohort cohort
26020 DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH cohort cohort cohort
26025 DRAINAGE OF PALMAR BURSA; SINGLE, BURSA statewide
26034 INCISION, BONE CORTEX, HAND OR FINGER (EG, OSTEOMYELITIS OR BONE ABSCESS) cohort cohort cohort
26035 DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJURY (EG,GREASE GUN) statewide
26040 FASCIOTOMY, PALMAR (EG, DUPUYTRENS CONTRACTURE);PERCUTANEOUS cohort cohort cohort
26045 FASCIOTOMY, PALMAR (EG, DUPUYTRENS CONTRACTURE); OPEN,PARTIAL cohort cohort cohort cohort
26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER) cohort cohort cohort cohort cohort cohort
26075
ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVALOF LOOSE OR FOREIGN BODY; METACARPOPHALANGEAL JOI NT, EACH cohort cohort
26080
ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVALOF LOOSE OR FOREIGN BODY; INTERPHALANGEAL JOINT, EACH cohort cohort
26110 ARTHROTOMY WITH BIOPSY; INTERPHALANGEAL JOINT, EACH statewide
26111 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; 1.5 CM OR GREATER cohort cohort cohort cohort cohort
26113
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); 1.5 CM OR GREATER cohort cohort
26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; LESS THAN 1.5CM cohort cohort cohort cohort cohort cohort
26116
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM cohort cohort cohort cohort
26117 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF HAND OR FINGER; LESS THAN 3 CM statewide
26118 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF HAND OR FINGER; 3 CM OR GREATER statewide
26121
FASCIECTOMY, PALM ONLY, WITH OR WITHOUT Z-PLASTY, OTHERLOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT) cohort cohort
26123
FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLEDIGITINCLUDING PROXIMAL INTERPHALANGEAL JOINT, WI TH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING cohort cohort cohort cohort
26125
FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLEDIGITINCLUDING PROXIMAL INTERPHALANGEAL JOINT, WI TH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING cohort cohort cohort cohort
26130 SYNOVECTOMY, CARPOMETACARPAL JOINTSYNOVECTOMY, CARPOMETACARPAL JOINT statewide
26140
SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDINGEXTENSOR RECONSTRUCTION, EACH INTERPHALANGEAL JOINT SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDING cohort cohort
26145 SYNOVECTOMY, TENDON SHEATH, RADICAL cohort cohort cohort cohort
50
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(TENOSYNOVECTOMY),FLEXOR TENDON, PALM AND/OR FINGER, EACH TENDONSYNOVECTOMY, TENDON SHEATH, RADICAL (TENOSYNOVEC TOMY),
26160 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST,MUCOUS CYST, OR GANGLION), HAND OR FINGER cohort cohort cohort cohort cohort cohort
26170 Excision of tendon, palm, flexor or extensor, single, each tendon statewide
26180 Excision of tendon, finger, flexor or extensor, each tendon cohort cohort
26185 SESAMOIDECTOMY, THUMB OR FINGER (SEPARATE PROCEDURE) statewide
26200 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFMETACARPAL; cohort cohort cohort cohort cohort
26210 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFPROXIMAL, MIDDLE OR DISTAL PHALANX OF FINGER; cohort cohort cohort cohort cohort
26215
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROFPROXIMAL, MIDDLE, OR DISTAL PHALANX OF FINGER; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort
26230 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); METACARPAL statewide
26235
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER statewide
26236
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); DISTAL PHALANX OF FINGER cohort cohort cohort cohort
26262 RADICAL RESECTION OF TUMOR, DISTAL PHALANX OF FINGER statewide
26320 REMOVAL OF IMPLANT FROM FINGER OR HAND statewide
26340 MANIPULATION, FINGER JOINT, UNDER ANESTHESIA, EACH JOINT statewide
26350
REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY OR SECONDARY WITHOUT FREE GRAFT, EACH TENDON cohort cohort cohort cohort
26352
REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); SECONDARY WITH FREE GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON statewide
26356
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN DIGITAL FLEXORTENDON SHEATH (EG, NO MAN'S LAND); PRIMARY, EACH TENDON cohort cohort cohort cohort
26357
REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN DIGITAL FLEXORTENDON SHEATH (EG, NO MAN'S LAND); SECONDARY,EACH TENDON cohort cohort cohort cohort
26370 REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACTSUPERFICIALIS TENDON; PRIMARY, EACH TENDON cohort cohort cohort cohort cohort cohort
26373
REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACTSUPERFICIALIS TENDON; SECONDARY WITHOUT FREE GRAFT, EACH TENDON cohort cohort cohort
26410 REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHOUTFREE GRAFT, EACH TENDON cohort cohort cohort cohort
26412 REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHFREE GRAFT (INCLUDES OBTAINING GRAFT), EACHTENDON cohort cohort
26415
EXCISION OF EXTENSOR TENDON, IMPLANTATION OF PROSTHETIC ROD FOR DELAYED TENDON GRAFT, HAND OR FINGER statewide
26418 REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY;WITHOUT FREE GRAFT, EACH TENDON cohort cohort cohort cohort cohort
26420
REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY; WITH FREE GRAFT (INCLUDES OBTAINING GRAFT) EACH TENDON cohort cohort cohort
26426
REPAIR OF EXTENSOR TENDON, CENTRAL SLIP, SECONDARY(EG,BOUTONNIERE DEFORMITY); USING LOCAL TISSUE(S) , INCLUDING LATERAL BAND(S), EACH TENDON cohort cohort cohort cohort
26432 CLOSED TREATMENT OF DISTAL EXTENSOR TENDON INSERTION, WITHOR WITHOUT PERCUTANEOUS PINNING (EG, cohort cohort cohort
51
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MALLET FINGER)
26433 REPAIR OF EXTENSOR TENDON, DISTAL INSERTION, PRIMARY ORSECONDARY; WITHOUT GRAFT (EG, MALLET FINGER) cohort cohort cohort
26437 REALIGNMENT OF EXTENSOR TENDON, HAND, EACH TENDON cohort cohort cohort cohort cohort
26440 TENOLYSIS, FLEXOR TENDON; PALM OR FINGER; EACH TENDON cohort cohort cohort cohort
26442 TENOLYSIS, FLEXOR TENDON; PALM AND FINGER, EACH TENDON statewide
26445 TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER; EACH TENDON cohort cohort cohort cohort
26450 TENOTOMY, FLEXOR, PALM, OPEN, EACH TENDONTENOTOMY,FLEXOR, PALM, OPEN, EACH TENDON statewide
26455 TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON cohort cohort
26460
TENOTOMY, EXTENSOR, HAND OR FINGER, OPEN, EACH TENDONTENOTOMY, EXTENSOR, HAND OR FINGER, OPEN, EACH TENDON cohort cohort
26471 TENODESIS; OF PROXIMAL INTERPHALANGEAL JOINT, EACHJOINT cohort cohort cohort cohort
26474 TENODESIS; OF DISTAL JOINT, EACH JOINT statewide
26479 SHORTENING OF TENDON, FLEXOR, HAND OR FINGER, EACHTENDON statewide
26480
TRANSFER OR TRANSPLANT OF TENDON, CARPOMETACARPAL AREA ORDORSUM OF HAND; WITHOUT FREE GRAFT, EACH TENDON cohort cohort cohort cohort cohort cohort
26483
TRANSFER OR TRANSPLANT OF TENDON, CARPOMETACARPAL AREA ORDORSUM OF HAND; WITH FREE TENDON GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON cohort cohort cohort
26485 TRANSFER OR TRANSPLANT OF TENDON, PALMAR; WITHOUT FREETENDON GRAFT, EACH TENDON statewide
26489 TRANSFER OR TRANSPLANT OF TENDON, PALMAR; WITH FREE TENDONGRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON statewide
26492 OPPONENSPLASTY; TENDON TRANSFER WITH GRAFT (INCLUDESOBTAINING GRAFT), EACH TENDON cohort cohort cohort
26497 TRANSFER OF TENDON TO RESTORE INTRINSIC FUNCTION; RING ANDSMALL FINGER statewide
26500 RECONSTRUCTION OF TENDON PULLEY, EACH TENDON; WITHLOCALTISSUES (SEPARATE PROCEDURE) statewide
26502
RECONSTRUCTION OF TENDON PULLEY, EACH TENDON; WITHTENDON ORFASCIAL GRAFT (INCLUDES OBTAINING GRAFT) (SEPARATE PROCEDURE) statewide
26510 CROSS INTRINSIC TRANSFER statewide
26516 CAPSULODESIS, METACARPOPHALANGEAL JOINT; SINGLE DIGIT cohort cohort
26520 CAPSULECTOMY OR CAPSULOTOMY; METACARPOPHALANGEAL JOINT, EACHJOINT cohort cohort cohort cohort cohort
26525 CAPSULECTOMY OR CAPSULOTOMY; INTERPHALANGEAL JOINT, EACHJOINT cohort cohort cohort
26530 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; EACH JOINT cohort cohort cohort cohort
26531 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETICIMPLANT, EACH JOINT statewide
26535 ARTHROPLASTY, INTERPHALANGEAL JOINT; EACH JOINT cohort cohort cohort cohort
26536 ARTHROPLASTY, INTERPHALANGEAL JOINT; WITH PROSTHETICIMPLANT, EACH JOINT cohort cohort
26540 REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEALORINTERPHALANGEAL JOINT cohort cohort cohort cohort cohort
26541
RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEALJOINT, SINGLE; WITH TENDON OR FASCIAL GRAFT (INCLUDES OBTAINING GRAFT) cohort cohort
26542
RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEALJOINT, SINGLE; WITH LOCAL TISSUE (EG, ADDUCTOR ADVANCEMENT) statewide
26545 RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGEAL JOINT, SINGLE, INCLUDING GRAFT, EACH cohort cohort
52
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
JOINT
26546
REPAIR NON-UNION, METACARPAL OR PHALANX, (INCLUDESOBTAININGBONE GRAFT WITH OR WITHOUT EXTERNAL OR I NTERNAL FIXATION) cohort cohort cohort
26548 REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE,INTERPHALANGEAL JOINT cohort cohort
26560 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS statewide
26561 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS AND GRAFTS statewide
26562 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; COMPLEX(EG, INVOLVING BONE, NAILS) cohort cohort
26565 OSTEOTOMY; METACARPAL, EACH cohort cohort
26567 OSTEOTOMY; PHALANX OF FINGER, EACH statewide
26568 OSTEOPLASTY, LENGTHENING, METACARPAL OR PHALANX statewide
26580 REPAIR CLEFT HAND statewide
26587 RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUEAND BONE statewide
26600
CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUTMANIPULATION, EACH BONE CLOSED TREATMENT OFMETACARPAL FRACTURE, SINGLE; WITHOUT cohort cohort cohort cohort
26605
CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHMANIPULATION, EACH BONE CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH cohort cohort cohort cohort
26608
PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH cohort cohort cohort cohort cohort
26615 Open treatment of metacarpal fracture, single, includes internal fixation when performed, each bone cohort cohort cohort cohort cohort cohort
26641
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITHMANIPULATION CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITH statewide
26645
CLOSED TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION,THUMB (BENNETT FRACTURE), WITH MANIPULATIONCLOSED TREATMENT OF CARPOMETACARPAL FRACTURE DIS LOCATION, cohort cohort
26650 Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation cohort cohort cohort cohort
26665 Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation when performed cohort cohort cohort
26670
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE, WITH MANIPULATION; WITHOUT ANESTHESIA cohort cohort
26675
CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE, WITH MANIPULATION; REQUIRING ANESTHESIA statewide
26676
PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPALDISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE, WITH MANIPULATION cohort cohort
26685 Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint statewide
26700
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE,WITH MANIPULATION; WITHOUT ANESTHESIA CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, cohort cohort cohort cohort cohort
26705
CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE,WITH MANIPULATION; REQUIRING ANESTHESIA CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATI ON, SINGLE, cohort cohort cohort
26720
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL ORMIDDLE PHALANX, FINGER OR THUMB; WITHOUT MANIPULATION, EACH CLOSED TREATMENT OF PHALANGEALSHAFT FRACTURE, PROXIMAL OR cohort cohort cohort
53
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
26725
CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL ORMIDDLE PHALANX, FINGER OR THUMB; WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION, EACH cohort cohort cohort cohort cohort
26727
PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB, WITH MANIPULATION, EACH cohort cohort cohort cohort cohort cohort
26735
Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation when performed, each cohort cohort cohort cohort cohort cohort
26742
CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVINGMETACARPOPHALANGEAL OR INTERPHALANGEAL JOINT; WITH MANIPULATION, EACH cohort cohort cohort cohort
26746 Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each cohort cohort cohort cohort cohort cohort
26750
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER ORTHUMB; WITHOUT MANIPULATION, EACH CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR cohort cohort cohort cohort
26755
CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER ORTHUMB; WITH MANIPULATION, EACH CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR cohort cohort cohort cohort cohort
26756
PERCUTANEOUS SKELETAL FIXATION OF DISTAL PHALANGEALFRACTURE, FINGER OR THUMB, EACH PERCUTANEOUS SKELETAL FIXATION OF DISTAL PHALANGEAL cohort cohort cohort cohort
26765 Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation when performed, each cohort cohort cohort cohort cohort cohort
26770
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION,SINGLE, WITH MANIPULATION; WITHOUT ANESTHESIA CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCA TION, cohort cohort cohort cohort cohort
26775
CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION,SINGLE, WITH MANIPULATION; REQUIRING ANESTHESIA CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, cohort cohort cohort cohort
26785 Open treatment of interphalangeal joint dislocation, includes internal fixation when performed, single cohort cohort cohort cohort
26841 ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH ORWITHOUTINTERNAL FIXATION; cohort cohort
26842
ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH ORWITHOUTINTERNAL FIXATION; WITH AUTOGRAFT (INCLUDE S OBTAINING GRAFT) statewide
26843 ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THANTHUMB; statewide
26844 ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THANTHUMB; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) statewide
26850 ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUTINTERNAL FIXATION; cohort cohort cohort
26852
ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUTINTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) statewide
26860 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNALFIXATION; cohort cohort cohort cohort cohort cohort
26861
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNALFIXATION; EACH ADDITIONAL INTERPHALANGEAL JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
26862
ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNALFIXATION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) statewide
26910
AMPUTATION, METACARPAL, WITH FINGER OR THUMB (RAYAMPUTATION), SINGLE, WITH OR WITHOUT INTEROSSEOUS TRANSFER cohort cohort
26951
AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY,ANY JOINTOR PHALANX, SINGLE, INCLUDING NEURECTOMI ES; WITH DIRECT CLOSURE cohort cohort cohort cohort cohort
54
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
26952
AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY,ANY JOINTOR PHALANX, SINGLE, INCLUDING NEURECTOMI ES; WITH LOCAL ADVANCEMENT FLAPS (V-Y, HOOD) cohort cohort cohort cohort
26989 UNLISTED PROCEDURE, HANDS OR FINGERS cohort cohort cohort cohort cohort cohort
26990 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEPABSCESS OR HEMATOMA statewide
26992 INCISION, BONE CORTEX, PELVIS AND/OR HIP JOINT (EG,OSTEOMYELITIS OR BONE ABSCESS) statewide
27000 TENOTOMY, ADDUCTOR OF HIP, PERCUTANEOUS (SEPARATE PROCEDURE) statewide
27001 TENOTOMY, ADDUCTOR OF HIP, OPEN cohort cohort
27006 TENOTOMY, ABDUCTORS AND/OR EXTENSOR(S) OF HIP, OPEN(SEPARATE PROCEDURE) statewide
27025 FASCIOTOMY, HIP OR THIGH, ANY TYPE statewide
27033
ARTHROTOMY, HIP, INCLUDING EXPLORATION OR REMOVAL OF LOOSEOR FOREIGN BODY ARTHROTOMY, HIP, INCLUDING EXPLORATION OR REMOVAL OF LOOSE statewide
27036
CAPSULECTOMY OR CAPSULOTOMY, HIP, WITH OR WITHOUT EXCISIONOF HETEROTOPIC BONE, WITH RELEASE OF HIP FLEXOR MUSCLES (IE, GLUTEUS MEDIUS, GLUTEUS MINIMUS, TENSOR FASCIA LATAE, RECTUS statewide
27040 BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; SUPERFICIAL statewide
27043 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort
27045 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort
27047 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM statewide
27048 EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM statewide
27059 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF PELVIS AND HIP AREA; 5 CM OR GREATER statewide
27062 EXCISION; TROCHANTERIC BURSA OR CALCIFICATION cohort cohort cohort cohort cohort cohort
27066
Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed cohort cohort
27080 COCCYGECTOMY, PRIMARY cohort cohort
27086
*REMOVAL OF FOREIGN BODY, PELVIS OR HIP; SUBCUTANEOUS TISSUE*REMOVAL OF FOREIGN BODY, PELVIS OR HIP;SUBCUTANEOUS TISSUE statewide
27093 INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITHOUT ANESTHESIA cohort cohort cohort cohort cohort cohort
27095 INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITH ANESTHESIA cohort cohort cohort cohort cohort
27096
INJECTION PROCEDURE FOR SACROILIAC JOINT, ANESTHETIC/STEROID, WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT) INCLUDING ARTHROGRAPHY WHEN PERFORMED cohort cohort cohort cohort cohort cohort
27130
ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETICREPLACEMENT (TOTAL HIP REPLACEMENT), WITH ORWITHOUT AUTOGRAFT OR ALLOGRAFT cohort cohort cohort
27146 OSTEOTOMY, ILIAC, ACETABULAR OR INNOMINATE BONE; statewide
27176 TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE ORMULTIPLE PINNING, IN SITU cohort cohort
27187
PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING)WITH OR WITHOUT METHYLMETHACRYLATE, FEMORAL NECK AND PROXIMAL FEMUR statewide
27193
CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION,DIASTASIS OR SUBLUXATION; WITHOUT MANIPULATIONCLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOC ATION, statewide
27216 Percutaneous skeletal fixation of posterior pelvicbone fracture and/or dislocation, for fracture pa tterns that disrupt the pelvic ring, unilateral statewide
55
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(includes ipsilateral ilium, sacroiliac joint and/or
27227
OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVINGANTERIOR OR POSTERIOR (ONE) COLUMN, OR A FRACTURE RUNNING TRANSVERSELY ACROSS THE ACETABULUM, WITH INTERNAL FIXATION statewide
27230
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK;WITHOUT MANIPULATION CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK; statewide
27232
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK;WITH MANIPULATION, WITH OR WITHOUT SKELETALTRACTION CLOSED TREATMENT OF FEMORAL FRACTURE, P ROXIMAL END, NECK; statewide
27235
PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMALEND, NECK, UNDISPLACED, MILDLY DISPLACED, OR IMPACTED FRACTURE cohort cohort
27236
OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK,INTERNAL FIXATION OR PROSTHETIC REPLACEMENT (DIRECT FRACTURE EXPOSURE) cohort cohort cohort
27240
CLOSED TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, ORSUBTROCHANTERIC FEMORAL FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION statewide
27245
OPEN TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC ORSUBTROCHANTERIC FEMORAL FRACTURE; WITH INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE statewide
27250
CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUTANESTHESIA CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT cohort cohort cohort
27252
CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; REQUIRINGANESTHESIA CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; REQUIRING cohort cohort
27256
*TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL,INCLUDING CONGENITAL OR PATHOLOGICAL), BY ABDUCTION, SPLINT OR TRACTION; WITHOUT ANESTHESIA, WITHOUT MANIPULATION statewide
27257
*TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL,INCLUDING CONGENITAL OR PATHOLOGICAL), BY ABDUCTION, SPLINT OR TRACTION; WITH MANIPULATION,REQUIRING ANESTHESIA statewide
27258
OPEN TREATMENT OF SPONTANEOUS HIP DISLOCATION(DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL), REPLACEMENT OF FEMORAL HEAD IN ACETABULUM (INCLUD ING statewide
27265
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION;WITHOUT ANESTHESIA CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; cohort cohort cohort cohort
27266
CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION;REQUIRING REGIONAL OR GENERAL ANESTHESIA CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; cohort cohort cohort cohort
27275 *MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA cohort cohort
27280 ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAININGGRAFT) cohort cohort
27299 UNLISTED PROCEDURE, PELVIS OR HIP JOINT cohort cohort cohort cohort
27301 INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA,THIGH OR KNEE REGION cohort cohort cohort cohort
27303 INCISION, DEEP, WITH OPENING OF BONE CORTEX, FEMUROR KNEE(EG, OSTEOMYELITIS OR BONE ABSCESS) statewide
27305 FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN cohort cohort cohort cohort cohort
27310
ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION) ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF cohort cohort cohort cohort cohort
27323 BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA; SUPERFICIAL statewide
56
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
27327 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort
27328 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort cohort cohort
27331
ARTHROTOMY, KNEE; INCLUDING JOINT EXPLORATION, BIOPSY, ORREMOVAL OF LOOSE OR FOREIGN BODIES ARTHROTOMY, KNEE; INCLUDING JOINT EXPLORATION, BIOPSY, OR cohort cohort cohort
27332 ARTHROTOMY, WITH EXCISION OF SEMILUNAR CARTILAGE(MENISCECTOMY) KNEE; MEDIAL OR LATERAL cohort cohort cohort cohort
27333 ARTHROTOMY, WITH EXCISION OF SEMILUNAR CARTILAGE(MENISCECTOMY) KNEE; MEDIAL AND LATERAL statewide
27334 ARTHROTOMY, WITH SYNOVECTOMY KNEE; ANTERIOR OR POSTERIOR statewide
27337 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort cohort
27339 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER cohort cohort cohort
27340 EXCISION, PREPATELLAR BURSA cohort cohort cohort cohort cohort
27345 EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (EG, BAKERSCYST) cohort cohort cohort cohort
27347 EXCISION OF LESION OF MENISCUS OR CAPSULE (EG, CYST,GANGLION), KNEE cohort cohort cohort cohort
27350 PATELLECTOMY OR HEMIPATELLECTOMY cohort cohort cohort
27355 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF FEMUR; cohort cohort cohort
27356 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOROF FEMUR;WITH ALLOGRAFT statewide
27360
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY) BONE, FEMUR, PROXIMAL TIBIA AND/OR FIBULA (EG, OSTEOMYELITIS OR BONE ABSCESS) statewide
27364 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF THIGH OR KNEE AREA; 5 CM OR GREATER statewide
27370 INJECTION PROCEDURE FOR KNEE ARTHROGRAPHY cohort cohort cohort cohort
27372 REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA cohort cohort cohort
27380 SUTURE OF INFRAPATELLAR TENDON; PRIMARY cohort cohort cohort cohort cohort
27381 SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTRUCTION,INCLUDING FASCIAL OR TENDON GRAFT cohort cohort
27385 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIMARY cohort cohort cohort cohort
27386
SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT statewide
27394 LENGTHENING OF HAMSTRING TENDON; MULTIPLE TENDONS,1 LEG statewide
27395 LENGTHENING OF HAMSTRING TENDON; MULTIPLE TENDONS,BILATERAL statewide
27396 Transplant or transfer (with muscle redirection orrerouting), high (e.g., extensor to flexor); sing le tendon statewide
27403 ARTHROTOMY WITH MENISCUS REPAIR, KNEE cohort cohort cohort
27405 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE;COLLATERAL cohort cohort cohort cohort cohort cohort
27407 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE;CRUCIATE cohort cohort cohort cohort
27412 AUTOLOGOUS CHONDROCYTE IMPLANTATION, KNEE statewide
27415 OSTEOCHONDRAL ALLOGRAFT, KNEE, OPEN cohort cohort cohort cohort
27418 ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE) cohort cohort cohort cohort
27420 RECONSTRUCTION OF DISLOCATING PATELLA; (EG, HAUSERTYPEPROCEDURE) cohort cohort cohort cohort cohort
27422 RECONSTRUCTION OF DISLOCATING PATELLA; WITH cohort cohort cohort cohort cohort cohort
57
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
EXTENSORREALIGNMENT AND/OR MUSCLE ADVANCEMENT OR RELEASE(EG, CAMPBELL, GOLDWAITE TYPE PROCEDURE)
27424 RECONSTRUCTION OF DISLOCATING PATELLA; WITH PATELLECTOMY statewide
27425 LATERAL RETINACULAR RELEASE (ANY METHOD) cohort cohort cohort cohort cohort
27427 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;EXTRA-ARTICULAR cohort cohort cohort cohort cohort cohort
27428 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;INTRA-ARTICULAR (OPEN) cohort cohort cohort cohort cohort
27429 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;INTRA-ARTICULAR (OPEN) AND EXTRA-ARTICULAR cohort cohort
27430 QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE) cohort cohort cohort cohort cohort
27435 CAPSULOTOMY, POSTERIOR CAPSULAR RELEASE, KNEE cohort cohort cohort
27437 ARTHROPLASTY, PATELLA; WITHOUT PROSTHESIS cohort cohort cohort
27438 ARTHROPLASTY, PATELLA; WITH PROSTHESIS statewide
27440 ARTHROPLASTY, KNEE, TIBIAL PLATEAU; statewide
27442 ARTHROPLASTY, FEMORAL CONDYLES OR TIBIAL PLATEAU(S), KNEE; cohort cohort
27445 ARTHROPLASTY, KNEE, HINGE PROSTHESIS (EG, WALLDIUSTYPE) statewide
27446 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL ORLATERALCOMPARTMENT cohort cohort cohort cohort
27447
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE REPLACEMENT) cohort cohort
27448 OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITHOUT FIXATION statewide
27450 OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION statewide
27457
OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OROSTEOTOMY (INCLUDES CORRECTION OF GENU VARUS(BOWLEG) OR GENU VALGUS (KNOCK-KNEE)); AFTER EPI PHYSEAL CLOSURE statewide
27472
REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD ANDNECK; WITH ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT) statewide
27475 ARREST, EPIPHYSEAL, ANY METHOD (EG, EPIPHYDIODESIS); DISTAL FEMUR cohort cohort
27477 ARREST, EPIPHYSEAL, ANY METHOD (EG, EPIPHYDIODESIS); TIBIAAND FIBULA, PROXIMAL statewide
27485 ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL TIBIA ORFIBULA (EG, GENU VARUS OR VALGUS) cohort cohort cohort
27486 REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; 1 COMPONENT statewide
27488
REMOVAL OF PROSTHESIS, INCLUDING TOTAL KNEE PROSTHESIS,METHYLMETHACRYLATE WITH OR WITHOUT INSERTION OF SPACER, KNEE statewide
27495 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING)WITH OR WITHOUT METHYLMETHACRYLATE, FEMUR statewide
27500
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUTMANIPULATION CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUT cohort cohort
27502
CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHMANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITH cohort cohort cohort
27506
OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUTEXTERNAL FIXATION, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/ORLOCKING SCREWS statewide
27508 CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITHOUT MANIPULATION statewide
58
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR
27509
PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTALEND, MEDIAL OR LATERAL CONDYLE, OR SUPRACONDYLAR OR TRANSCONDYLAR, WITH OR WITHOUT INTERCONDYLAR EXTENSION, OR statewide
27514 Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation when performed cohort cohort cohort
27516
CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION;WITHOUT MANIPULATION CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION; statewide
27524
OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNALFIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR cohort cohort cohort cohort
27530
CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU);WITHOUT MANIPULATION CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); cohort cohort
27532
CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU);WITH OR WITHOUT MANIPULATION, WITH SKELETAL TRACTION CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); cohort cohort cohort
27535 Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation when performed cohort cohort cohort cohort
27536
OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU);BICONDYLAR, WITH OR WITHOUT INTERNAL FIXATION OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLAT EAU); cohort cohort cohort
27540 Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation when performed cohort cohort
27550
CLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIACLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIA statewide
27552
CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIACLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA cohort cohort cohort
27560
CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIACLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA cohort cohort cohort cohort cohort
27562
CLOSED TREATMENT OF PATELLAR DISLOCATION; REQUIRINGANESTHESIA CLOSED TREATMENT OF PATELLAR DISLOCATION; REQUIRING cohort cohort cohort
27566
OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUTPARTIAL OR TOTAL PATELLECTOMY OPEN TREATMENTOF PATELLAR DISLOCATION, WITH OR WITHOUT cohort cohort cohort
27570
*MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA(INCLUDES APPLICATION OF TRACTION OR OTHER FIXATION DEVICES) cohort cohort cohort cohort cohort cohort
27590 AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; statewide
27599 UNLISTED PROCEDURE, FEMUR OR KNEE cohort cohort cohort cohort cohort
27600 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERALCOMPARTMENTS ONLY cohort cohort cohort cohort
27601 DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY cohort cohort
27602 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S) cohort cohort cohort
27603 INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS ORHEMATOMA cohort cohort cohort cohort
27606 TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATEPROCEDURE); GENERAL ANESTHESIA cohort cohort cohort cohort
27610
ARTHROTOMY, ANKLE, INCLUDING EXPLORATION, DRAINAGE, ORREMOVAL OF FOREIGN BODY ARTHROTOMY, ANKLE, INCLUDING EXPLORATION, DRAINAGE, OR cohort cohort cohort
27612 ARTHROTOMY, POSTERIOR CAPSULAR RELEASE, ANKLE, WITH ORWITHOUT ACHILLES TENDON LENGTHENING cohort cohort
27614 BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA; DEEP cohort cohort cohort
59
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(SUBFASCIALOR INTRAMUSCULAR)
27616 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF LEG OR ANKLE AREA; 5 CM OR GREATER statewide
27618 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA,SUBCUTANEOUS; LESS THAN 3 CM cohort cohort cohort cohort cohort
27619 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA,SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM cohort cohort cohort cohort cohort
27620
ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH ORWITHOUTBIOPSY, WITH ARTHROTOMY, ANKLE, WITH JOIN T EXPLORATION, WITH OR WITHOUT cohort cohort cohort cohort
27625 ARTHROTOMY, WITH SYNOVECTOMY, ANKLE; cohort cohort cohort cohort
27626 ARTHROTOMY, WITH SYNOVECTOMY, ANKLE; INCLUDINGTENOSYNOVECTOMY cohort cohort cohort cohort
27630 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKLE cohort cohort cohort cohort cohort
27632 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA,SUBCUTANEOUS; 3 CM OR GREATER cohort cohort cohort cohort
27634 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA,SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER statewide
27635 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA ORFIBULA; cohort cohort cohort cohort cohort
27637
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA ORFIBULA; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) statewide
27638 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA ORFIBULA; WITH ALLOGRAFT cohort cohort cohort cohort
27640 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); TIBIA cohort cohort cohort cohort
27641 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, ORDIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); FIBULA cohort cohort cohort
27645 RADICAL RESECTION OF TUMOR; TIBIA cohort cohort
27646 RADICAL RESECTION OF TUMOR; FIBULA statewide
27647 RADICAL RESECTION OF TUMOR; TALUS OR CALCANEUS statewide
27648 INJECTION PROCEDURE FOR ANKLE ARTHROGRAPHY statewide
27650 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLESTENDON; cohort cohort cohort cohort cohort cohort
27652 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLESTENDON; WITH GRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort cohort
27654 REPAIR, SECONDARY, ACHILLES TENDON, WITH OR WITHOUT GRAFT cohort cohort cohort cohort cohort
27658 REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACHTENDON cohort cohort cohort cohort cohort cohort
27659 REPAIR, FLEXOR TENDON, LEG; SECONDARY, WITH OR WITHOUTGRAFT, EACH TENDON cohort cohort cohort cohort cohort
27664 REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACHTENDON cohort cohort cohort cohort cohort
27665 REPAIR, EXTENSOR TENDON, LEG; SECONDARY, WITH OR WITHOUTGRAFT, EACH TENDON cohort cohort
27675 REPAIR, DISLOCATING PERONEAL TENDONS; WITHOUT FIBULAROSTEOTOMY cohort cohort cohort cohort
27676 REPAIR, DISLOCATING PERONEAL TENDONS; WITH FIBULAROSTEOTOMY cohort cohort cohort cohort
27680 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE;SINGLE, EACH TENDON cohort cohort cohort
27681 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE;MULTIPLE TENDONS (THROUGH SEPARATE INCISION(S)) cohort cohort
27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE;SINGLETENDON (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
27686 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE;MULTIPLE TENDONS (THROUGH SAME INCISION), EACH statewide
27687 GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE) cohort cohort cohort cohort cohort
60
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
27690
TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLEREDIRECTION OR REROUTING); SUPERFICIAL (EG, ANTERIOR TIBIAL EXTENSORS INTO MIDFOOT) cohort cohort cohort
27691
TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLEREDIRECTION OR REROUTING); DEEP (EG, ANTERIOR TIBIAL OR POSTERIOR TIBIAL THROUGH INTEROSSEOUS SPACE, FLEXOR cohort cohort cohort cohort cohort cohort
27692
TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLEREDIRECTION OR REROUTING); EACH ADDITIONAL TENDON (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
27695 REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL cohort cohort cohort cohort cohort cohort
27696 REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS cohort cohort cohort cohort
27698 REPAIR, SECONDARY DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG,WATSON-JONES PROCEDURE) cohort cohort cohort cohort cohort
27700 ARTHROPLASTY, ANKLE; cohort cohort cohort
27702 Arthroplasty, ankle, with implant (total ankle) cohort cohort
27705 OSTEOTOMY; TIBIA cohort cohort cohort cohort cohort
27707 OSTEOTOMY; FIBULA cohort cohort
27709 OSTEOTOMY; TIBIA AND FIBULA statewide
27720 REPAIR OF NONUNION OR MALUNION, TIBIA; WITHOUT GRAFT, (EG,COMPRESSION TECHNIQUE) cohort cohort cohort cohort cohort
27722 REPAIR OF NONUNION OR MALUNION, TIBIA; WITH SLIDING GRAFT statewide
27724 REPAIR OF NONUNION OR MALUNION, TIBIA; WITH ILIAC OR OTHERAUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort cohort cohort
27726 Repair of fibula nonunion and/or malunion with internal fixation cohort cohort
27730 ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD; DISTALTIBIA statewide
27732 ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD; DISTALFIBULA statewide
27734 ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD; DISTALTIBIA AND FIBULA cohort cohort
27745 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING)WITH OR WITHOUT METHYLMETHACRYLATE, TIBIA statewide
27750
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH ORWITHOUTFIBULAR FRACTURE); WITHOUT MANIPULATION C LOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT cohort cohort cohort cohort
27752
CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH ORWITHOUTFIBULAR FRACTURE); WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION cohort cohort cohort cohort
27756
PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE(WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS) PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE cohort cohort
27758
OPEN TREATMENT OF TIBIAL SHAFT FRACTURE, (WITH OR WITHOUTFIBULAR FRACTURE) WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE cohort cohort cohort cohort cohort
27759
OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUTFIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT,WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCL AGE cohort cohort cohort cohort
27760
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHOUT statewide
27762
CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHMANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH cohort cohort cohort cohort cohort
27766 Open treatment of medial malleolus fracture, includes internal fixation when performed cohort cohort cohort cohort cohort cohort
61
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
27767 Closed treatment of posterior malleolus fracture; without manipulation statewide
27768 Closed treatment of posterior malleolus fracture; with manipulation cohort cohort cohort
27769 Open treatment of posterior malleolus fracture, includes internal fixation when performed cohort cohort cohort
27780
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE;WITHOUT MANIPULATION CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; cohort cohort
27781
CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH MANIPULATION CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH cohort cohort
27784 Open treatment of proximal fibula or shaft fracture, includes internal fixation when performed cohort cohort cohort cohort
27786
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERALMALLEOLUS); WITHOUT MANIPULATION CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL cohort cohort cohort cohort
27788
CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERALMALLEOLUS); WITH MANIPULATION CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL cohort cohort cohort cohort cohort
27792 Open treatment of distal fibular fracture (lateralmalleolus), includes internal fixation when perfo rmed cohort cohort cohort cohort cohort cohort
27808
Closed treatment of bimalleolar ankle fracture, e.g., lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation cohort cohort cohort cohort
27810
Closed treatment of bimalleolar ankle fracture, e.g., lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation cohort cohort cohort cohort cohort
27814
Open treatment of bimalleolar ankle fracture (e.g., lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli),includes internal fixation when performed cohort cohort cohort cohort cohort cohort
27816
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUTMANIPULATION CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUT statewide
27818
CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHMANIPULATION CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITH cohort cohort cohort cohort cohort
27822
Open treatment of trimalleolar ankle fracture, includes internal fixation when performed, medial and/or lateral malleolus; without fixation of posterior lip cohort cohort cohort cohort cohort cohort
27823
Open treatment of trimalleolar ankle fracture, includes internal fixation when performed, medial and/or lateral malleolus; with fixation of posterior lip cohort cohort cohort cohort
27824
CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULARPORTION OF DISTAL TIBIA (EG, PILON OR TIBIALPLAFOND), WITH OR WITHOUT ANESTHESIA; WITHOUT MANIPULATION cohort cohort
27825
CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULARPORTION OF DISTAL TIBIA (EG, PILON OR TIBIALPLAFOND), WITH OR WITHOUT ANESTHESIA; WITH SKE LETAL TRACTION AND/OR cohort cohort cohort cohort cohort
27827
Open treatment of fracture of weight bearing articular surface/portion of distal tibia (e.g., pilon or tibial plafond), with internal fixation when performed; of tibia only cohort cohort cohort cohort cohort cohort
27828
Open treatment of fracture of weight bearing articular surface/portion of distal tibia (e.g., pilon or tibial plafond), with internal fixation when performed; of both tibia and fibula cohort cohort cohort cohort cohort
27829 Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation when performed cohort cohort cohort cohort cohort cohort
27831 CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION;REQUIRING ANESTHESIA statewide
27840
CLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIACLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA cohort cohort cohort cohort
27842
CLOSED TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHESIA,WITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION CLOSED TREATMENT OF ANKLE DISLOCATION; cohort cohort
62
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
REQUIRING ANESTHESIA,
27870 ARTHRODESIS, ANKLE, ANY METHOD cohort cohort cohort cohort cohort
27871 ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL statewide
27886 AMPUTATION LEG, THROUGH TIBIA AND FIBULA; RE-AMPUTATION statewide
27899 UNLISTED PROCEDURE, LEG OR ANKLE cohort cohort cohort cohort cohort cohort
28002 *INCISION AND DRAINAGE BELOW FASCIA, WITH OR WITHOUT TENDON SHEATH INVOLVEMENT, FOOT; SINGLE BURSAL SPACE statewide
28005 INCISION, BONE CORTEX (EG, OSTEOMYELITIS OR BONE ABSCESS),FOOT cohort cohort
28008 FASCIOTOMY, FOOT AND/OR TOE cohort cohort cohort cohort cohort
28010 TENOTOMY, PERCUTANEOUS, TOE; SINGLE TENDON cohort cohort cohort
28011 TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS cohort cohort cohort cohort cohort
28020
ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OFLOOSE OR FOREIGN BODY; INTERTARSAL OR TARSOMETATARSAL JOINT ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF cohort cohort cohort cohort
28022
ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OFLOOSE OR FOREIGN BODY; METATARSOPHALANGEALJOINT ARTHROTOMY, INCLUDING EXPLORATION, DRAINAG E, OR REMOVAL OF cohort cohort cohort cohort
28024
ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OFLOOSE OR FOREIGN BODY; INTERPHALANGEAL JOINT ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF cohort cohort
28035 RELEASE, TARSAL TUNNEL (POSTERIOR TIBIAL NERVEDECOMPRESSION) cohort cohort cohort cohort cohort
28039 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANEOUS; 1.5 CM OR GREATER cohort cohort cohort cohort cohort
28041 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBFASCIAL (EG, INTRAMUSCULAR); 1.5 CM OR GREATER cohort cohort cohort cohort
28043 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBCUTANEOUS; LESS THAN 1.5 CM cohort cohort cohort
28045 EXCISION, TUMOR, SOFT TISSUE OF FOOT OR TOE, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM cohort cohort
28047 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOOT OR TOE; 3 CM OR GREATER statewide
28060 FASCIECTOMY, PLANTAR FASCIA; PARTIAL (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
28062 FASCIECTOMY, PLANTAR FASCIA; RADICAL (SEPARATE PROCEDURE) cohort cohort
28070
SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT,EACHSYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL J OINT, EACH cohort cohort cohort
28072 SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACHSYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH cohort cohort cohort
28080 EXCISION, INTERDIGITAL (MORTON) NEUROMA, SINGLE, EACH cohort cohort cohort cohort cohort cohort
28086 SYNOVECTOMY, TENDON SHEATH, FOOT; FLEXORSYNOVECTOMY, TENDON SHEATH, FOOT; FLEXOR cohort cohort
28088 SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSORSYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR statewide
28090
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE(INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION);FOOT EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE cohort cohort cohort cohort cohort cohort
28092
EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE(INCLUDING SYNOVECTOMY) (EG, CYST OR GANGLION);TOE(S), EACH EXCISION OF LESION, TENDON, TENDON SHEATH, OR CAPSULE cohort cohort cohort cohort cohort
28100 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS ORCALCANEUS; cohort cohort cohort cohort
28103 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, statewide
63
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
TALUS ORCALCANEUS; WITH ALLOGRAFT
28104
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSALOR METATARSAL BONES, EXCEPT TALUS OR CALCANEUS; cohort cohort cohort cohort cohort
28107
EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSALOR METATARSAL BONES, EXCEPT TALUS OR CALCANEUS; WITH ALLOGRAFT statewide
28108 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,PHALANGES OF FOOT cohort cohort cohort cohort cohort
28110 OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD(BUNIONETTE) (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
28111 OSTECTOMY, COMPLETE EXCISION; FIRST METATARSAL HEAD cohort cohort
28112 OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD (SECOND,THIRD OR FOURTH) cohort cohort cohort cohort
28113 OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD cohort cohort cohort cohort cohort
28114
OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, WITHPARTIAL PROXIMAL PHALANGECTOMY, EXCLUDING FIRST METATARSAL (EG, CLAYTON TYPE PROCEDURE) cohort cohort
28116 OSTECTOMY, EXCISION OF TARSAL COALITION cohort cohort cohort cohort
28118 OSTECTOMY, CALCANEUS; cohort cohort cohort cohort
28119 OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTARFASCIAL RELEASE cohort cohort cohort cohort cohort cohort
28120
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION,SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS cohort cohort cohort cohort cohort
28122
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION,SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR cohort cohort cohort cohort
28124
PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION,SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); PHALANX OF TOE cohort cohort cohort cohort
28126 RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, EACH TOE cohort cohort
28140 METATARSECTOMY cohort cohort
28150 PHALANGECTOMY, TOE, EACH TOE statewide
28153 RESECTION, CONDYLE(S), DISTAL END OF PHALANX, EACHTOE cohort cohort cohort
28160 HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE,PROXIMAL END OF PHALANX, EACH cohort cohort cohort cohort
28173 RADICAL RESECTION OF TUMOR; METATARSAL cohort cohort
28175 RADICAL RESECTION OF TUMOR; PHALANX OF TOE statewide
28190
*REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANEOUS*REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANEOUS cohort cohort cohort cohort cohort
28192 REMOVAL OF FOREIGN BODY, FOOT; DEEPREMOVAL OF FOREIGN BODY, FOOT; DEEP cohort cohort cohort cohort cohort cohort
28193 REMOVAL OF FOREIGN BODY, FOOT; COMPLICATEDREMOVAL OF FOREIGN BODY, FOOT; COMPLICATED statewide
28200 REPAIR, TENDON, FLEXOR, FOOT; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT, EACH TENDON cohort cohort cohort cohort cohort
28202 REPAIR, TENDON, FLEXOR, FOOT; SECONDARY WITH FREE GRAFT,EACH TENDON (INCLUDES OBTAINING GRAFT) cohort cohort cohort
28208 REPAIR, TENDON, EXTENSOR, FOOT; PRIMARY OR SECONDARY, EACHTENDON cohort cohort cohort cohort
28220 TENOLYSIS, FLEXOR, FOOT; SINGLE TENDON statewide
28225 TENOLYSIS, EXTENSOR, FOOT; SINGLE TENDON statewide
28230 TENOTOMY, OPEN, TENDON FLEXOR; FOOT, SINGLE OR MULTIPLETENDON(S) (SEPARATE PROCEDURE) statewide
28232 TENOTOMY, OPEN, TENDON FLEXOR; TOE, SINGLE TENDON (SEPARATE PROCEDURE) cohort cohort cohort cohort
64
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
28234 TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE, EACH TENDON cohort cohort cohort cohort
28238
RECONSTRUCTION (ADVANCEMENT), POSTERIOR TIBIAL TENDON WITHEXCISION OF ACCESSORY NAVICULAR BONE (EG, KIDNER TYPE PROCEDURE) cohort cohort cohort cohort cohort
28240 TENOTOMY, LENGTHENING, OR RELEASE, ABDUCTOR HALLUCIS MUSCLE statewide
28250 DIVISION OF PLANTAR FASCIA AND MUSCLE (EG, STEINDLERSTRIPPING) (SEPARATE PROCEDURE) cohort cohort cohort
28260 CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY (SEPARATEPROCEDURE) cohort cohort
28261 CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING statewide
28262
CAPSULOTOMY, MIDFOOT; EXTENSIVE, INCLUDING POSTERIORTALOTIBIAL CAPSULOTOMY AND TENDON(S) LENGTHENING(EG, RESISTANT CLUBFOOT DEFORMITY) cohort cohort cohort
28270 CAPSULOTOMY; METATARSOPHALANGEAL JOINT, WITH OR WITHOUTTENORRHAPHY, EACH JOINT (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
28272 CAPSULOTOMY; INTERPHALANGEAL JOINT, EACH JOINT (SEPARATEPROCEDURE) cohort cohort cohort cohort
28280 SYNDACTYLIZATION, TOES (EG, WEBBING OR KELIKIAN TYPEPROCEDURE) cohort cohort
28285 CORRECTION, HAMMERTOE (EG, INTERPHALANGEAL FUSION,PARTIALOR TOTAL PHALANGECTOMY) cohort cohort cohort cohort cohort cohort
28286 CORRECTION, COCK-UP FIFTH TOE, WITH PLASTIC SKIN CLOSURE(EG, RUIZ-MORA TYPE PROCEDURE) statewide
28288 OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD cohort cohort cohort cohort
28289
HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY, DEBRIDEMENT AND CAPSULAR RELEASE OF THE FIRST METATARSOPHALANGEAL JOINT cohort cohort cohort cohort cohort cohort
28290
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; SIMPLE EXOSTECTOMY (EG, SILVER TYPE PROCEDURE) cohort cohort cohort cohort
28292
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; KELLER, MCBRIDE, OR MAYO TYPE PROCEDURE cohort cohort cohort cohort cohort cohort
28293
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; RESECTION OF JOINT WITH IMPLANT cohort cohort cohort cohort
28296
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; WITH METATARSAL OSTEOTOMY (EG, MITCHELL, CHEVRON, OR CONCENTRIC TYPE PROCEDURES) cohort cohort cohort cohort cohort cohort
28297 CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; LAPIDUS TYPE PROCEDURE cohort cohort cohort cohort cohort cohort
28298 CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; BY PHALANX OSTEOTOMY cohort cohort cohort cohort cohort cohort
28299
CORRECTION, HALLUX VALGUS (BUNION), WITH OR WITHOUTSESAMOIDECTOMY; BY OTHER METHODS (EG, DOUBLE OSTEOTOMY) cohort cohort cohort cohort cohort cohort
28300 OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE),WITH OR WITHOUT INTERNAL FIXATION cohort cohort cohort cohort cohort cohort
28302 OSTEOTOMY; TALUS cohort cohort cohort
28304 OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS; cohort cohort cohort cohort cohort
28305
OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS; WITHAUTOGRAFT (INCLUDES OBTAINING GRAFT) (EG, FOWLER TYPE) cohort cohort
28306
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENINGORANGULAR CORRECTION, METATARSAL; FIRST METATARSA L cohort cohort cohort cohort cohort
28307
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENINGORANGULAR CORRECTION, METATARSAL; FIRST METATARSA L WITH AUTOGRAFT (OTHER THAN FIRST TOE) statewide
65
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
28308
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENINGORANGULAR CORRECTION, METATARSAL; OTHER THAN FIRS T METATARSAL, EACH cohort cohort cohort cohort cohort cohort
28309
OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENINGORANGULAR CORRECTION, METATARSAL; MULTIPLE (EG, S WANSON TYPE CAVUS FOOT PROCEDURE) cohort cohort cohort
28310
OSTEOTOMY, SHORTENING, ANGULAR OR ROTATIONAL CORRECTION;PROXIMAL PHALANX, FIRST TOE (SEPARATE PROCEDURE) cohort cohort cohort
28312 OSTEOTOMY, SHORTENING, ANGULAR OR ROTATIONAL CORRECTION;OTHER PHALANGES, ANY TOE cohort cohort
28313
RECONSTRUCTION, ANGULAR DEFORMITY OF TOE, SOFT TISSUEPROCEDURES ONLY (EG, OVERLAPPING SECOND TOE, FIFTH TOE, CURLY TOES) cohort cohort cohort cohort cohort
28315 SESAMOIDECTOMY, FIRST TOE (SEPARATE PROCEDURE) cohort cohort cohort cohort
28320 REPAIR, NONUNION OR MALUNION; TARSAL BONES cohort cohort cohort
28322 REPAIR, NONUNION OR MALUNION; METATARSAL, WITH OR WITHOUTBONE GRAFT (INCLUDES OBTAINING GRAFT) cohort cohort cohort cohort cohort cohort
28341 RECONSTRUCTION, TOE, MACRODACTYLY; REQUIRING BONE RESECTION statewide
28344 RECONSTRUCTION, TOE(S); POLYDACTYLY statewide
28345 RECONSTRUCTION, TOE(S); SYNDACTYLY, WITH OR WITHOUT SKINGRAFT(S), EACH WEB cohort cohort cohort cohort
28360 RECONSTRUCTION, CLEFT FOOT statewide
28400
CLOSED TREATMENT OF CALCANEAL FRACTURE; WITHOUT MANIPULATIONCLOSED TREATMENT OF CALCANEAL FRACTURE; WITHOUT MANIPULATION cohort cohort cohort cohort
28415 Open treatment of calcaneal fracture, includes internal fixation when performed; cohort cohort cohort cohort
28420
Open treatment of calcaneal fracture, includes internal fixation when performed; with primary iliac or other autogenous bone graft (includes obtaininggraft) statewide
28435
CLOSED TREATMENT OF TALUS FRACTURE; WITH MANIPULATIONCLOSED TREATMENT OF TALUS FRACTURE; WITH MANIPULATION cohort cohort cohort cohort
28445 Open treatment of talus fracture, includes internal fixation when performed cohort cohort cohort cohort
28465 Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation whenperformed, each cohort cohort cohort
28470
CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUTMANIPULATION, EACH CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT cohort cohort cohort cohort
28475
CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, EACH CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, cohort cohort cohort cohort cohort
28476
PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH cohort cohort cohort
28485 Open treatment of metatarsal fracture, includes internal fixation when performed, each cohort cohort cohort cohort cohort cohort
28490
CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX ORPHALANGES; WITHOUT MANIPULATION CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR cohort cohort cohort
28495
CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX ORPHALANGES; WITH MANIPULATION CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR cohort cohort cohort
28496
PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE,PHALANX OR PHALANGES, WITH MANIPULATION PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, cohort cohort
28505 Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation when performed cohort cohort cohort
28510 CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, cohort cohort
66
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OTHERTHAN GREAT TOE; WITHOUT MANIPULATION, EACH CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGE S, OTHER
28515
CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHERTHAN GREAT TOE; WITH MANIPULATION, EACH CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER cohort cohort cohort cohort
28525 Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation when performed, each cohort cohort cohort
28530 CLOSED TREATMENT OF SESAMOID FRACTURECLOSED TREATMENT OF SESAMOID FRACTURE statewide
28531
OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHOUTINTERNAL FIXATION OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHOUT statewide
28540
CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHERTHANTALOTARSAL; WITHOUT ANESTHESIA CLOSED TREATM ENT OF TARSAL BONE DISLOCATION, OTHER THAN statewide
28545
CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHERTHANTALOTARSAL; REQUIRING ANESTHESIA CLOSED TREA TMENT OF TARSAL BONE DISLOCATION, OTHER THAN statewide
28555 Open treatment of tarsal bone dislocation, includes internal fixation when performed statewide
28585 Open treatment of talotarsal joint dislocation, includes internal fixation when performed cohort cohort
28605
CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION;REQUIRING ANESTHESIA CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION; statewide
28606
PERCUTANEOUS SKELETAL FIXATION OF TARSOMETATARSAL JOINTDISLOCATION, WITH MANIPULATION PERCUTANEOUS SKELETAL FIXATION OF TARSOMETATARSAL JOINT statewide
28615 Open treatment of tarsometatarsal joint dislocation, includes internal fixation when performed cohort cohort cohort cohort cohort
28630
*CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA *CLOSED TREATMENT OFMETATARSOPHALANGEAL JOINT DISLOCATION; cohort cohort cohort cohort
28635
*CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; REQUIRING ANESTHESIA *CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; statewide
28636
PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANGEAL JOINT DISLOCATION, WITH MANIPULATION PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANGEAL JOINT cohort cohort
28645 Open treatment of metatarsophalangeal joint dislocation includes internal fixation when performed cohort cohort
28660
*CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION;WITHOUT ANESTHESIA *CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; cohort cohort cohort cohort cohort
28665
*CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION;REQUIRING ANESTHESIA *CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; statewide
28715 ARTHRODESIS; TRIPLEARTHRODESIS; TRIPLE cohort cohort cohort cohort cohort
28725 ARTHRODESIS; SUBTALARARTHRODESIS; SUBTALAR cohort cohort cohort cohort cohort cohort
28730 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE ORTRANSVERSE; cohort cohort cohort cohort cohort
28735
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE ORTRANSVERSE; WITH OSTEOTOMY (EG, FLATFOOT CORRECTION) cohort cohort cohort cohort cohort
28737
ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT,MIDTARSAL NAVICULAR-CUNEIFORM (EG, MILLER TYPE PROCEDURE) cohort cohort
28740 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT cohort cohort cohort cohort cohort cohort
28750 ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT cohort cohort cohort cohort cohort
28755 ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT cohort cohort cohort cohort cohort
67
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
28760
ARTHRODESIS, WITH EXTENSOR HALLUCIS LONGUS TRANSFER TO FIRSTMETATARSAL NECK, GREAT TOE, INTERPHALANGEAL JOINT (EG, JONES TYPE PROCEDURE) cohort cohort cohort
28800 AMPUTATION, FOOT; MIDTARSAL (EG, CHOPART TYPE PROCEDURE) statewide
28805 AMPUTATION, FOOT; TRANSMETATARSAL cohort cohort cohort
28810 AMPUTATION, METATARSAL, WITH TOE, SINGLE cohort cohort cohort cohort cohort
28820 AMPUTATION, TOE; METATARSOPHALANGEAL JOINT cohort cohort cohort cohort cohort
28825 AMPUTATION, TOE; INTERPHALANGEAL JOINT cohort cohort cohort cohort cohort
28899 UNLISTED PROCEDURE, FOOT OR TOES cohort cohort cohort cohort cohort
29010 APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLYAPPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLY statewide
29065 APPLICATION; SHOULDER TO HAND (LONG ARM)APPLICATION; SHOULDER TO HAND (LONG ARM) cohort cohort
29075 APPLICATION; ELBOW TO FINGER (SHORT ARM)APPLICATION; ELBOW TO FINGER (SHORT ARM) cohort cohort cohort cohort
29085
APPLICATION; HAND AND LOWER FOREARM (GAUNTLET)APPLICATION; HAND AND LOWER FOREARM (GAUNTLET) cohort cohort cohort
29086 APPLICATION, CAST; FINGER (CONTRACTURE) statewide
29105
APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND)APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND) cohort cohort cohort cohort cohort cohort
29125
APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND);STATICAPPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STATIC cohort cohort cohort cohort cohort cohort
29126
APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND);DYNAMICAPPLICATION OF SHORT ARM SPLINT (FOREARM T O HAND); DYNAMIC cohort cohort cohort cohort
29130 APPLICATION OF FINGER SPLINT; STATICAPPLICATION OFFINGER SPLINT; STATIC cohort cohort cohort cohort cohort
29131 APPLICATION OF FINGER SPLINT; DYNAMICAPPLICATION OF FINGER SPLINT; DYNAMIC cohort cohort cohort
29200 STRAPPING; THORAX statewide
29240 STRAPPING; SHOULDER (EG, VELPEAU) cohort cohort cohort cohort cohort
29260 STRAPPING; ELBOW OR WRIST cohort cohort cohort cohort cohort
29280 STRAPPING; HAND OR FINGER cohort cohort cohort cohort cohort
29305 APPLICATION OF HIP SPICA CAST; 1 LEG statewide
29325 APPLICATION OF HIP SPICA CAST; 1 AND ONE-HALF SPICA OR BOTH LEGS cohort cohort
29345 APPLICATION OF LONG LEG CAST (THIGH TO TOES);APPLICATION OF LONG LEG CAST (THIGH TO TOES); cohort cohort
29355
APPLICATION OF LONG LEG CAST (THIGH TO TOES); WALKER ORAMBULATORY TYPE APPLICATION OF LONG LEG CAST(THIGH TO TOES); WALKER OR statewide
29405
APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES);APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES); cohort cohort cohort cohort
29425
APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES); WALKING OR AMBULATORY TYPE APPLICATION OF SHORTLEG CAST (BELOW KNEE TO TOES); WALKING cohort cohort cohort cohort
29440 ADDING WALKER TO PREVIOUSLY APPLIED CASTADDING WALKER TO PREVIOUSLY APPLIED CAST statewide
29445 APPLICATION OF RIGID TOTAL CONTACT LEG CASTAPPLICATION OF RIGID TOTAL CONTACT LEG CAST cohort cohort cohort cohort cohort cohort
29450
APPLICATION OF CLUBFOOT CAST WITH MOLDING OR MANIPULATION,LONG OR SHORT LEG APPLICATION OF CLUBFOOTCAST WITH MOLDING OR MANIPULATION, statewide
29505
APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES)APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR TOES) cohort cohort cohort cohort cohort cohort
68
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT) cohort cohort cohort cohort cohort cohort
29520 STRAPPING; HIP statewide
29530 STRAPPING; KNEE cohort cohort cohort cohort cohort
29540 STRAPPING; ANKLE cohort cohort cohort cohort cohort
29550 STRAPPING; TOES cohort cohort cohort cohort
29580 STRAPPING; UNNA BOOT cohort cohort cohort cohort
29581 APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG(BELOW KNEE), INCLUDING ANKLE AND FOOT cohort cohort cohort cohort cohort cohort
29582 APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; THIGH AND LEG, INCLUDING ANKLE AND FOOT, WHEN PERFORMED statewide
29584 APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; UPPER ARM, FOREARM, HAND, AND FINGERS statewide
29705 REMOVAL OR BIVALVING; FULL ARM OR FULL LEG CASTREMOVAL OR BIVALVING; FULL ARM OR FULL LEG CAST cohort cohort cohort
29740 WEDGING OF CAST (EXCEPT CLUBFOOT CASTS)WEDGING OF CAST (EXCEPT CLUBFOOT CASTS) statewide
29799 UNLISTED PROCEDURE, CASTING OR STRAPPINGUNLISTED PROCEDURE, CASTING OR STRAPPING cohort cohort cohort cohort cohort
29804
ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICALARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL statewide
29805 ARTHROSCOPY, SHOULDER, DX, W/WO SYNOVIAL BIOPSY (SEP PROC) cohort cohort cohort cohort cohort
29806 ARTHROSCOPY, SHOULDER, SURGICAL; CAPSULORRHAPY cohort cohort cohort cohort cohort cohort
29807 REPAIR, SLAP LESION cohort cohort cohort cohort cohort cohort
29819
ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY cohort cohort cohort cohort cohort cohort
29820 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL cohort cohort cohort cohort cohort
29821 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE cohort cohort cohort cohort
29822 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED cohort cohort cohort cohort cohort cohort
29823 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, EXTENSIVE cohort cohort cohort cohort cohort cohort
29824 ARTHROSCOPY, SHOULDER, SURGICAL; DISTAL CLAVICULECTOMY W/ARTICULAR SURFACE cohort cohort cohort cohort cohort cohort
29825 ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECTION OFADHESIONS, WITH OR WITHOUT MANIPULATION cohort cohort cohort cohort cohort cohort
29826
ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY, WITHCORACOACROMIAL LIGAMENT (IE, ARCH) RELEASE, WHEN PERFORMED (LIST SEPARATELY IN ADDITION TO CODE FOR cohort cohort cohort cohort cohort cohort
29827 ARTHROSCOPY, SHOULDER, SURGICAL; W/ROTATOR CUFF REPAIR cohort cohort cohort cohort cohort cohort
29828 Arthroscopy, shoulder, surgical; biceps tenodesis cohort cohort cohort cohort cohort cohort
29834
ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR cohort cohort cohort cohort cohort cohort
29835 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL cohort cohort cohort cohort cohort
29836 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE cohort cohort
29837 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED cohort cohort cohort
29838 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE cohort cohort cohort cohort cohort
29840 ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SYNOVIALBIOPSY (SEPARATE PROCEDURE) cohort cohort
29844 ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL cohort cohort cohort cohort cohort
29845 ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, COMPLETE cohort cohort
29846 ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR cohort cohort cohort cohort cohort cohort
69
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OFTRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT
29847 ARTHROSCOPY, WRIST, SURGICAL; INTERNAL FIXATION FOR FRACTUREOR INSTABILITY statewide
29848 ENDOSCOPY, WRIST, SURGICAL, WITH RELEASE OF TRANSVERSECARPAL LIGAMENT cohort cohort cohort cohort cohort cohort
29851
ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S)AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE,WITH OR WITHOUT MANIPULATION; WITH INTERNAL OR E XTERNAL FIXATION (INCLUDES cohort cohort cohort cohort cohort
29855
Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation when performed (includes arthroscopy) cohort cohort
29860 ARTHROSCOPY, HIP, DIAGNOSTIC WITH OR WITHOUT SYNOVIAL BIOPSY(SEPARATE PROCEDURE) statewide
29861
ARTHROSCOPY, HIP, SURGICAL; WITH REMOVAL OF LOOSE BODY ORFOREIGN BODY ARTHROSCOPY, HIP, SURGICAL; WITH REMOVAL OF LOOSE BODY OR cohort cohort cohort
29862
ARTHROSCOPY, HIP, SURGICAL; WITH DEBRIDEMENT/SHAVING OFARTICULAR CARTILAGE (CHONDROPLASTY), ABRASIONARTHROPLASTY, AND/OR RESECTION OF LABRUM cohort cohort cohort cohort cohort cohort
29863 ARTHROSCOPY, HIP, SURGICAL; WITH SYNOVECTOMY cohort cohort cohort cohort
29866 Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty) (includes harvesting ofthe autograft[s]) cohort cohort
29867 ARTHROSCOPY, KNEE, SURGICAL;OSTEOCHONDRAL ALLOGRAFT IMPLANT W/SCOPE statewide
29868 ARTHROSCOPY, KNEE, SURGICAL; MENISCAL TRANSPLANTION, MEDIAL OR LATERAL W/SCOPE cohort cohort
29870 ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIALBIOPSY (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
29871 ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGEANDDRAINAGE cohort cohort cohort
29873 ARTHROSCOPY, KNEE, SURGICAL; W/LATERAL RELEASE cohort cohort cohort cohort cohort cohort
29874
ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY ORFOREIGN BODY (EG, OSTEOCHONDRITIS DISSECANSFRAGMENTATION, CHONDRAL FRAGMENTATION) cohort cohort cohort cohort cohort cohort
29875 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICAOR SHELF RESECTION) (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
29876 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, MAJOR, 2OR MORE COMPARTMENTS (EG, MEDIAL OR LATERAL) cohort cohort cohort cohort cohort cohort
29877 ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OFARTICULAR CARTILAGE (CHONDROPLASTY) cohort cohort cohort cohort cohort cohort
29879
ARTHROSCOPY, KNEE, SURGICAL; ABRASION ARTHROPLASTY(INCLUDESCHONDROPLASTY WHERE NECESSARY) OR MULTIP LE DRILLING cohort cohort cohort cohort cohort cohort
29880
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S cohort cohort cohort cohort cohort cohort
29881
ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING) INCLUDING DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY), SAME OR SEPARATE COMPARTMENT(S) cohort cohort cohort cohort cohort cohort
29882 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL ORLATERAL) cohort cohort cohort cohort cohort
29883 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIALAND LATERAL) cohort cohort cohort cohort cohort
29884 ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITHOR WITHOUT MANIPULATION (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
29886 ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACTOSTEOCHONDRITIS DISSECANS LESION cohort cohort cohort cohort
29887
ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACTOSTEOCHONDRITIS DISSECANS LESION WITH INTERNAL FIXATION cohort cohort cohort cohort
70
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENTREPAIR/AUGMENTATION OR RECONSTRUCTION cohort cohort cohort cohort cohort cohort
29889 ARTHROSCOPICALLY AIDED POSTERIOR CRUCIATE LIGAMENTREPAIR/AUGMENTATION OR RECONSTRUCTION cohort cohort cohort cohort
29891
ARTHROSCOPY, ANKLE, SURGICAL; EXCISION OF OSTEOCHONDRALDEFECT OF TALUS AND/OR TIBIA, INCLUDING DRILLING OF THE DEFECT cohort cohort cohort cohort cohort
29892
ARTHROSCOPICALLY AIDED REPAIR OF LARGE OSTEOCHONDRITISDISSECANS LESION, TALAR DOME FRACTURE, OR TIBIAL PLAFOND FRACTURE, WITH OR WITHOUT INTERNAL FIXATION (INCLUDES cohort cohort cohort cohort
29893 ENDOSCOPIC PLANTAR FASCIOTOMY cohort cohort cohort cohort
29894
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), cohort cohort cohort cohort
29895
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),SURGICAL; SYNOVECTOMY, PARTIAL ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), cohort cohort cohort cohort cohort
29897
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),SURGICAL; DEBRIDEMENT, LIMITED ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), cohort cohort cohort cohort cohort
29898
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),SURGICAL; DEBRIDEMENT, EXTENSIVE ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), cohort cohort cohort cohort cohort cohort
29899 ARTHROSCOPY, ANKLE, SURGICAL; W/ANKLE ARTHRODESIS cohort cohort cohort cohort
29906 Arthroscopy, subtalar joint, surgical; with debridement statewide
29907 Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis statewide
29914 Arthroscopy, hip, surgical; with femoroplasty (ie,treatment of cam lesion) cohort cohort cohort cohort cohort
29915 Arthroscopy, subtalar joint, surgical; with acetabuloplasty (ie, treatment of pincer lesion) cohort cohort cohort cohort cohort
29916 Arthroscopy, subtalar joint, surgical; with labralrepair cohort cohort cohort cohort cohort cohort
29999 UNLISTED PROC, ARTHROSCOPY cohort cohort cohort cohort cohort cohort
30000 *DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPROACH cohort cohort
30020 *DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM statewide
30100 BIOPSY, INTRANASAL cohort cohort cohort
30110 EXCISION, NASAL POLYP(S), SIMPLEEXCISION, NASAL POLYP(S), SIMPLE statewide
30115 EXCISION, NASAL POLYP(S), EXTENSIVEEXCISION, NASALPOLYP(S), EXTENSIVE cohort cohort cohort
30117 EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER),INTRANASAL LESION; INTERNAL APPROACH cohort cohort cohort cohort
30118
EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER),INTRANASAL LESION; EXTERNAL APPROACH (LATERAL RHINOTOMY) cohort cohort
30125 EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE ORCARTILAGE cohort cohort
30130 EXCISION TURBINATE, PARTIAL OR COMPLETE, ANY METHOD cohort cohort cohort cohort cohort cohort
30140 SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE, ANYMETHOD cohort cohort cohort cohort cohort cohort
30150 RHINECTOMY; PARTIAL statewide
30300
*REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE*REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE cohort cohort cohort cohort cohort
30310
REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERALANESTHESIA REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERAL cohort cohort cohort
30400 RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES AND/ORELEVATION OF NASAL TIP statewide
30420 RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAIR cohort cohort
71
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
30430 RHINOPLASTY, SECONDARY; MINOR REVISION (SMALL AMOUNT OFNASAL TIP WORK) statewide
30450 RHINOPLASTY, SECONDARY; MAJOR REVISION (NASAL TIP WORK ANDOSTEOTOMIES) statewide
30460
RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITALCLEFT LIP AND/OR PALATE, INCLUDING COLUMELLARLENGTHENING; TIP ONLY cohort cohort
30462
RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITALCLEFT LIP AND/OR PALATE, INCLUDING COLUMELLARLENGTHENING; TIP, SEPTUM, OSTEOTOMIES cohort cohort
30465 REPAIR OF NASAL VESTIBULAR STENOSIS (EG, SPREADER GRAFTING, LATERAL NASAL WALL RECONSTRUCTION) cohort cohort cohort cohort cohort
30520
SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUTCARTILAGE SCORING, CONTOURING OR REPLACEMENT WITHGRAFT cohort cohort cohort cohort cohort cohort
30540 REPAIR CHOANAL ATRESIA; INTRANASAL statewide
30545 REPAIR CHOANAL ATRESIA; TRANSPALATINE statewide
30560 *LYSIS INTRANASAL SYNECHIA cohort cohort cohort cohort
30580 REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IFANTROTOMY IS INCLUDED) cohort cohort
30600 REPAIR FISTULA; ORONASAL cohort cohort
30620 SEPTAL OR OTHER INTRANASAL DERMATOPLASTY (DOES NOTINCLUDEOBTAINING GRAFT) statewide
30630 REPAIR NASAL SEPTAL PERFORATIONS cohort cohort cohort cohort
30801
ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); SUPERFICIAL cohort cohort cohort cohort cohort
30802
ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); INTRAMURAL (IE, SUBMUCOSAL) cohort cohort cohort cohort cohort
30901 *CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERYAND/OR PACKING) ANY METHOD cohort cohort cohort cohort cohort cohort
30903 *CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX (EXTENSIVECAUTERY AND/OR PACKING) ANY METHOD cohort cohort cohort
30905
*CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASALPACKS AND/OR CAUTERIZATION, ANY METHOD; INITIAL cohort cohort cohort cohort cohort
30915 LIGATION ARTERIES; ETHMOIDAL statewide
30920 LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRANSANTRAL statewide
30930 FRACTURE NASAL TURBINATE(S), THERAPEUTIC cohort cohort cohort cohort cohort cohort
30999 UNLISTED PROCEDURE, NOSE cohort cohort cohort cohort cohort
31000 *LAVAGE BY CANNULATION; MAXILLARY SINUS (ANTRUM PUNCTURE OR NATURAL OSTIUM) cohort cohort cohort
31002 *LAVAGE BY CANNULATION; SPHENOID SINUS statewide
31020
SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASALSINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL cohort cohort cohort cohort cohort
31030
SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC)WITHOUT REMOVAL OF ANTROCHOANAL POLYPS SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) cohort cohort cohort
31032
SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC)WITH REMOVAL OF ANTROCHOANAL POLYPS SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) cohort cohort
31040 PTERYGOMAXILLARY FOSSA SURGERY, ANY APPROACH statewide
31050 SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY;SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; cohort cohort
31051 SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; WITHMUCOSALSTRIPPING OR REMOVAL OF POLYP(S) statewide
72
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
31070
SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE (TREPHINE OPERATION)SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE (TREPHINE OPERATION) statewide
31080
SINUSOTOMY FRONTAL; OBLITERATIVE WITHOUT OSTEOPLASTIC FLAP, BROW INCISION (INCLUDES ABLATION) SINUSOTOMY FRONTAL; OBLITERATIVE WITHOUT OSTEOPLASTIC FLAP, statewide
31085
SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP,CORONAL INCISION SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP, statewide
31200 ETHMOIDECTOMY; INTRANASAL, ANTERIOR cohort cohort cohort cohort
31201 ETHMOIDECTOMY; INTRANASAL, TOTAL statewide
31205 ETHMOIDECTOMY; EXTRANASAL, TOTAL statewide
3120F 12-Lead ECG Performed (EM) statewide
31225 MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION cohort cohort
31231 NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL(SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
31233
NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY SINUSOSCOPY(VIA INFERIOR MEATUS OR CANINE FOSSA PUNCTURE) statewide
31235
NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE OR CANNULATION OF OSTIUM) statewide
31237 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH BIOPSY, POLYPECTOMY ORDEBRIDEMENT (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
31238 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF EPISTAXIS cohort cohort cohort cohort
31239 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH DACRYOCYSTORHINOSTOMY cohort cohort cohort
31240 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSARESECTION cohort cohort cohort cohort cohort
31254 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, PARTIAL(ANTERIOR) cohort cohort cohort cohort cohort cohort
31255 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, TOTAL(ANTERIOR AND POSTERIOR) cohort cohort cohort cohort cohort cohort
31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; cohort cohort cohort cohort cohort cohort
31267
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SINUS cohort cohort cohort cohort cohort cohort
31276 NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUSEXPLORATION, WITH OR SINUS cohort cohort cohort cohort cohort cohort
31287 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; cohort cohort cohort cohort cohort cohort
31288 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; WITHREMOVAL OF TISSUE FROM THE SPHENOID SINUS cohort cohort cohort cohort cohort
31290 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OFCEREBROSPINAL FLUID LEAK; ETHMOID REGION cohort cohort
31291 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OFCEREBROSPINAL FLUID LEAK; SPHENOID REGION statewide
31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa statewide
31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation) cohort cohort
31297 Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation) statewide
31299 UNLISTED PROCEDURE, ACCESSORY SINUSES statewide
31300 LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMOVAL OFTUMOR OR LARYNGOCELE, CORDECTOMY cohort cohort
31500 INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE cohort cohort cohort cohort cohort
31502 TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF FISTULATRACT cohort cohort
73
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
31505 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); DIAGNOSTIC cohort cohort
31511
LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OFFOREIGN BODY LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OF statewide
31525 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY;DIAGNOSTIC, EXCEPT NEWBORN cohort cohort cohort cohort cohort
31526 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY;DIAGNOSTIC, WITH OPERATING MICROSCOPE cohort cohort cohort cohort
31528
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY;WITHDILATATION, INITIAL LARYNGOSCOPY DIRECT, WIT H OR WITHOUT TRACHEOSCOPY; WITH cohort cohort cohort cohort
31529
LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY;WITHDILATATION, SUBSEQUENT LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH cohort cohort cohort
31530
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODYREMOVAL; LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FO REIGN BODY REMOVAL; cohort cohort cohort cohort
31531
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODYREMOVAL; WITH OPERATING MICROSCOPE LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; statewide
31535 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; cohort cohort cohort cohort cohort cohort
31536 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITHOPERATINGMICROSCOPE cohort cohort cohort cohort cohort
31540 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMORAND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; cohort cohort cohort cohort cohort cohort
31541
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMORAND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE cohort cohort cohort cohort
31545
LARNGOSCOPY, DIRECT, OPERATIVE, W/OPERATING MICRO-SCOPE OR TELESCOPE, W/SUBMUCOSAL REMOVAL OF NON- NEOPLASTIC LESION(S) OF VOCAL CORD; RECONSTRUCTIONW/LOCAL TISSUE FLAPS(S) cohort cohort cohort
31560 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; statewide
31561 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; WITH OPERATING MICROSCOPE statewide
31570 LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S),THERAPEUTIC; cohort cohort cohort cohort
31571 LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S),THERAPEUTIC; WITH OPERATING MICROSCOPE cohort cohort cohort cohort
31575 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC cohort cohort cohort cohort cohort
31576 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH BIOPSY cohort cohort cohort
31577
LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OFFOREIGNBODY LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; W ITH REMOVAL OF FOREIGN statewide
31578 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OFLESION cohort cohort
31579 LARYNGOSCOPY, FLEXIBLE OR RIGID FIBEROPTIC, WITH STROBOSCOPY cohort cohort
31588 LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BURNS,RECONSTRUCTION AFTER PARTIAL LARYNGECTOMY) cohort cohort cohort
31599 UNLISTED PROCEDURE, LARYNX cohort cohort cohort
31611
CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBSEQUENTINSERTION OF AN ALARYNGEAL SPEECH PROSTHESIS(EG, VOICE BUTTON, BLOM-SINGER PROSTHESIS) statewide
31612 TRACHEAL PUNCTURE, PERCUTANEOUS WITH TRANSTRACHEALASPIRATION AND/OR INJECTION statewide
31613 TRACHEOSTOMA REVISION; SIMPLE, WITHOUT FLAP ROTATION statewide
31615 TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED TRACHEOSTOMYINCISION statewide
74
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
31620
ENDOBRONCHIAL ULTRASOUND (EBUS) DURING BRONCHOSCOPIC DIAGNOSTIC OR THERAPEUTIC INTERVENTION(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE(S)) cohort cohort cohort cohort
31622
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; DIAGNOSTIC, WITH CELL WASHING, WHEN PERFORMED (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
31623
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BRUSHING OR PROTECTED BRUSHINGS cohort cohort cohort cohort cohort
31624
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BRONCHIAL ALVEOLAR LAVAGE cohort cohort cohort cohort cohort
31625
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BRONCHIAL OR ENDOBRONCHIAL BIOPSY(S), SINGLE OR MULTIPLE SITES cohort cohort cohort cohort cohort
31627
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH COMPUTER-ASSISTED, IMAGE-GUIDED NAVIGATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE[S]) statewide
31628
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL LUNG BIOPSY(S), SINGLE LOBE cohort cohort cohort cohort cohort
31629
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), TRACHEA, MAIN STEM AND/OR LOBAR BRONCHUS(I) cohort cohort cohort cohort cohort
31630
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRACHEAL/BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE cohort cohort
31631
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF TRACHEAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED) statewide
31632
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL LUNG BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
31633
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY cohort cohort cohort
31635
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH REMOVAL OF FOREIGN BODY cohort cohort cohort
31636
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF BRONCHIAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED), INITIAL BRONCHUS cohort cohort
31640
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH EXCISION OF TUMOR cohort cohort
31641
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH DESTRUCTION OF TUMOR OR RELIEF OF STENOSIS BY ANY METHOD OTHER THAN EXCISION (EG, LASER THERAPY, CRYOTHERAPY) statewide
31645
BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, cohort cohort cohort
75
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
INITIAL (EG, DRAINAGE OF LUNG ABSCESS)
31720 CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRACHEAL cohort cohort cohort cohort cohort
31800 SUTURE OF TRACHEAL WOUND OR INJURY; CERVICAL statewide
31820 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT PLASTICREPAIR statewide
31825 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTICREPAIR statewide
31830 REVISION OF TRACHEOSTOMY SCAR statewide
31899 UNLISTED PROCEDURE, TRACHEA, BRONCHI cohort cohort
32400 *BIOPSY, PLEURA; PERCUTANEOUS NEEDLE cohort cohort cohort
32405 BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE cohort cohort cohort cohort cohort
32550 Insertion of indwelling tunneled pleural catheter with cuff cohort cohort cohort cohort cohort
32551
TUBE THORACOSTOMY, INCLUDES CONNECTION TO DRAINAGESYSTEM (EG, WATER SEAL), WHEN PERFORMED, OPEN (SE PARATE PROCEDURE) cohort cohort cohort cohort cohort
32552 REMOVAL OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF cohort cohort
32553
PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PERCUTANEOUS, INTRA-THORACIC, SINGLE OR MULTIPLE cohort cohort
32554 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITHOUT IMAGING GUIDANCE cohort cohort cohort cohort cohort
32555 THORACENTESIS, NEEDLE OR CATHETER, ASPIRATION OF THE PLEURAL SPACE; WITH IMAGING GUIDANCE cohort cohort cohort cohort cohort
32556 PLEURAL DRAINAGE, PERCUTANEOUS, WITH INSERTION OF INDWELLING CATHETER; WITHOUT IMAGING GUIDANCE cohort cohort
32557 PLEURAL DRAINAGE, PERCUTANEOUS, WITH INSERTION OF INDWELLING CATHETER; WITH IMAGING GUIDANCE cohort cohort cohort
32561
INSTILLATION(S), VIA CHEST TUBE/CATHETER, AGENT FOR FIBRINOLYSIS (EG, FIBRINOLYTIC AGENT FOR BREAK UP OF MULTILOCULATED EFFUSION); INITIAL DAY statewide
32562
INSTILLATION(S), VIA CHEST TUBE/CATHETER, AGENT FOR FIBRINOLYSIS (EG, FIBRINOLYTIC AGENT FOR BREAK UP OF MULTILOCULATED EFFUSION); SUBSEQUENT DAY statewide
32606 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); MEDIASTINALSPACE, WITH BIOPSY statewide
32609 THORACOSCOPY; WITH BIOPSY(IES) OF PLEURA cohort cohort
32655
THORACOSCOPY, SURGICAL; WITH RESECTION-PLICATION OF BULLAE, INCLUDES ANY PLEURAL PROCEDURE WHEN PERFORMED statewide
32663 THORACOSCOPY, SURGICAL; WITH LOBECTOMY (SINGLE LOBE) statewide
32664
THORACOSCOPY, SURGICAL; WITH THORACIC SYMPATHECTOMYTHORACOSCOPY, SURGICAL; WITH THORACIC SYMPATHECTOMY cohort cohort cohort
32666 THORACOSCOPY, SURGICAL; WITH THERAPEUTIC WEDGE RESECTION (EG, MASS, NODULE), INITIAL UNILATERAL statewide
32997 TOTAL LUNG LAVAGE (UNILATERAL) statewide
32998
ABLATION THERAPY FOR REDUCTION OR ERADICATION OF 1OR MORE PULMONARY TUMOR(S) INCLUDING PLEURA OR CH EST WALL WHEN INVOLVED BY TUMOR EXTENSION, PERCUTANEOUS, RADIOFREQUENCY, UNILATERAL statewide
32999 UNLISTED PROCEDURE, LUNGS AND PLEURA statewide
33010 *PERICARDIOCENTESIS; INITIAL statewide
33202
INSERTION OF EPICARDIAL ELECTRODE(S); OPEN INCISION (EG, THORACOTOMY, MEDIAN STERNOTOMY, SUBXIPHOID APPROACH) statewide
33206 INSERTION OF NEW OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); ATRIAL statewide
33207 INSERTION OF NEW OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); cohort cohort cohort
76
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
VENTRICULAR
33208
INSERTION OF NEW OR REPLACEMENT OF PERMANENT PACEMAKER WITH TRANSVENOUS ELECTRODE(S); ATRIAL AND VENTRICULAR cohort cohort cohort cohort
33210
INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS SINGLECHAMBER CARDIAC ELECTRODE OR PACEMAKER CATHETER (SEPARATE PROCEDURE) cohort cohort cohort cohort
33213 INSERTION OF PACEMAKER PULSE GENERATOR ONLY; WITH EXISTING DUAL LEADS cohort cohort
33215 REPOSITIONING, PREVIOUSLY IMPLANTED TRANSVENOUS ELECTRODE/PACING CARDIOVERT-DEFIB ELECTRODE cohort cohort
33216 INSERTION OF A SINGLE TRANSVENOUS ELECTRODE, PERMANENT PACEMAKER OR CARDIOVERTER-DEFIBRILLATOR statewide
33217 INSERTION OF 2 TRANSVENOUS ELECTRODES, PERMANENT PACEMAKER OR CARDIOVERTER-DEFIBRILLATOR statewide
33218 REPAIR OF SINGLE TRANSVENOUS ELECTRODE, PERMANENT PACEMAKER OR PACING CARDIOVERTER-DEFIBRILLATOR statewide
33222 REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKER statewide
33223 REVISION OF SKIN POCKET FOR CARDIOVERTER-DEFIBRILLATOR cohort cohort
33224
INSERTION OF PACING ELECTRODE, CARDIAC VENOUS SYSTEM, FOR LEFT VENTRICULAR PACING, WITH ATTACHMENT TO PREVIOUSLY PLACED PACEMAKER OR PACING CARDIOVERTER-DEFIBRILLATOR PULSE GENERATOR (INCLUDING REVISI statewide
33225
INSERTION OF PACING ELECTRODE, CARDIAC VENOUS SYSTEM, FOR LEFT VENTRICULAR PACING, AT TIME OF INSERTION OF PACING CARDIOVERTER-DEFIBRILLATOR OR PACEMAKER PULSE GENERATOR (EG, FOR UPGRADE TO DUAL CHAMB cohort cohort cohort cohort
33227
REMOVAL OF PERMANENT PACEMAKER PULSE GENERATOR WITH REPLACEMENT OF PACEMAKER PULSE GENERATOR; SINGLELEAD SYSTEM statewide
33228
REMOVAL OF PERMANENT PACEMAKER PULSE GENERATOR WITH REPLACEMENT OF PACEMAKER PULSE GENERATOR; DUAL LEAD SYSTEM cohort cohort cohort cohort
33229
REMOVAL OF PERMANENT PACEMAKER PULSE GENERATOR WITH REPLACEMENT OF PACEMAKER PULSE GENERATOR; MULTIPLE LEAD SYSTEM statewide
33233 REMOVAL OF PERMANENT PACEMAKER PULSE GENERATOR ONLY cohort cohort
33235 REMOVAL OF TRANSVENOUS PACEMAKER ELECTRODE(S); DUAL LEADSYSTEM cohort cohort
33241 REMOVAL OF PACING CARDIOVERTER-DEFIBRILLATOR PULSEGENERATOR ONLY cohort cohort
33244
REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PULSEGENERATOR AND/OR LEAD SYSTEM; BY OTHER THAN THORACOTOMY REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PULSE cohort cohort
33249
INSERTION OR REPLACEMENT OF PERMANENT PACING CARDIOVERTER-DEFIBRILLATOR SYSTEM WITH TRANSVENOUS LEAD(S), SINGLE OR DUAL CHAMBER cohort cohort cohort cohort
33262
REMOVAL OF PACING CARDIOVERTER-DEFIBRILLATOR PULSEGENERATOR WITH REPLACEMENT OF PACING CARDIOVERTER -DEFIBRILLATOR PULSE GENERATOR; SINGLE LEAD SYSTEM cohort cohort cohort
33263
REMOVAL OF PACING CARDIOVERTER-DEFIBRILLATOR PULSEGENERATOR WITH REPLACEMENT OF PACING CARDIOVERTER -DEFIBRILLATOR PULSE GENERATOR; DUAL LEAD SYSTEM cohort cohort cohort cohort
33264
REMOVAL OF PACING CARDIOVERTER-DEFIBRILLATOR PULSEGENERATOR WITH REPLACEMENT OF PACING CARDIOVERTER -DEFIBRILLATOR PULSE GENERATOR; MULTIPLE LEAD SYSTEM cohort cohort cohort cohort
33282 IMPLANTATION OF PATIENT-ACTIVATED CARDIAC EVENT RECORDER cohort cohort cohort cohort
77
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
33284 REMOVAL OF AN IMPLANTABLE, PATIENT-ACTIVATED CARDIAC EVENT RECORDER cohort cohort cohort
34111
EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER;RADIAL OR ULNAR ARTERY, BY ARM INCISION EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHETER; cohort cohort
34520 CROSS-OVER VEIN GRAFT TO VENOUS SYSTEM statewide
35045
DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION(PARTIAL OR TOTAL) AND GRAFT INSERTION, WITH OR WITHOUT PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED statewide
35190 REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA;EXTREMITIES statewide
35201 REPAIR BLOOD VESSEL, DIRECT; NECK cohort cohort
35206 REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY cohort cohort
35207 REPAIR BLOOD VESSEL, DIRECT; HAND, FINGER cohort cohort cohort cohort
35221 REPAIR BLOOD VESSEL, DIRECT; INTRA-ABDOMINAL statewide
35226 REPAIR BLOOD VESSEL, DIRECT; LOWER EXTREMITY cohort cohort cohort cohort
35301 Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision cohort cohort
35302 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; SUPERFICIAL FEMORAL ARTERY statewide
35390
REOPERATION, CAROTID, THROMBOENDARTERECTOMY, MORE THAN 1 MONTH AFTER ORIGINAL OPERATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
35471 Transluminal balloon angioplasty, percutaneous; renal or visceral artery cohort cohort cohort
35472 TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; AORTIC cohort cohort
35475
TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL cohort cohort cohort cohort cohort
35476 TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; VENOUS cohort cohort cohort cohort cohort
35761 EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), WITH ORWITHOUT LYSIS OF ARTERY; OTHER VESSELS cohort cohort
35800 EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS ORINFECTION; NECK cohort cohort
35876
THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT (OTHER THANHEMODIALYSIS GRAFT OR FISTULA); WITH REVISION OFARTERIAL OR VENOUS GRAFT statewide
35903 EXCISION OF INFECTED GRAFT; EXTREMITY statewide
36000 *INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN cohort cohort cohort cohort cohort
36002 INJECTION (THROMBIN) PERCUTANEOUS TREATMENT EXTREMITY PSEUDOANEURYSM cohort cohort
36005 INJECTION PROCEDURE FOR CONTRAST VENOGRAPHY (INCLUDINGINTRODUCTION OF NEEDLE OR INTRACATHETER) cohort cohort cohort cohort cohort
36010 INTRODUCTION OF CATHETER, SUPERIOR OR INFERIOR VENA CAVA cohort cohort cohort cohort
36011 Selective Catheter placement cohort cohort cohort cohort
36012
SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; SECOND ORDER,OR MORE SELECTIVE, BRANCH (EG, LEFT ADRENAL VEIN, PETROSAL SINUS) cohort cohort
36014 SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMONARY ARTERY statewide
36015 SELECTIVE CATHETER PLACEMENT, SEGMENTAL OR SUBSEGMENTALPULMONARY ARTERY cohort cohort
36140 INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITYARTERY cohort cohort cohort cohort
36147
INTRODUCTION OF NEEDLE AND/OR CATHETER, ARTERIOVENOUS SHUNT CREATED FOR DIALYSIS (GRAFT/FISTULA); INITIAL ACCESS WITH COMPLETE cohort cohort cohort cohort cohort
78
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
RADIOLOGICAL EVALUATIONOF DIALYSIS ACCESS, INCLUDING FLUOROSCOPY, IMAGE
36148
INTRODUCTION OF NEEDLE AND/OR CATHETER, ARTERIOVENOUS SHUNT CREATED FOR DIALYSIS (GRAFT/FISTULA); ADDITIONAL ACCESS FOR THERAPEUTIC INTERVENTION (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED cohort cohort cohort cohort cohort
36200 INTRODUCTION OF CATHETER, AORTA cohort cohort cohort cohort
36215
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRSTORDER THORACIC OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort cohort
36216
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIALSECOND ORDER THORACIC OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort
36217
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRDORDER OR MORE SELECTIVE THORACIC OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort cohort
36218
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADDITIONALSECOND ORDER, THIRD ORDER, AND BEYOND, THORACIC OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULARFAMILY (LIST IN cohort cohort
36221
NON-SELECTIVE CATHETER PLACEMENT, THORACIC AORTA, WITH ANGIOGRAPHY OF THE EXTRACRANIAL CAROTID, VERTEBRAL, AND/OR INTRACRANIAL VESSELS, UNILATERAL OR BILATERAL, AND ALL ASSOCIATED RADIOLOGICAL SUPERVI cohort cohort cohort
36222
SELECTIVE CATHETER PLACEMENT, COMMON CAROTID OR INNOMINATE ARTERY, UNILATERAL, ANY APPROACH, WITH ANGIOGRAPHY OF THE IPSILATERAL EXTRACRANIAL CAROTID CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SUPERV cohort cohort cohort cohort
36223
SELECTIVE CATHETER PLACEMENT, COMMON CAROTID OR INNOMINATE ARTERY, UNILATERAL, ANY APPROACH, WITH ANGIOGRAPHY OF THE IPSILATERAL INTRACRANIAL CAROTID CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SUPERV cohort cohort cohort cohort
36224
SELECTIVE CATHETER PLACEMENT, INTERNAL CAROTID ARTERY, UNILATERAL, WITH ANGIOGRAPHY OF THE IPSILATERAL INTRACRANIAL CAROTID CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SUPERVISION AND INTERPRETATION, cohort cohort cohort
36225
SELECTIVE CATHETER PLACEMENT, SUBCLAVIAN OR INNOMINATE ARTERY, UNILATERAL, WITH ANGIOGRAPHY OF THE IPSILATERAL VERTEBRAL CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SUPERVISION AND INTERPRETATION, INC cohort cohort cohort
36226
SELECTIVE CATHETER PLACEMENT, VERTEBRAL ARTERY, UNILATERAL, WITH ANGIOGRAPHY OF THE IPSILATERAL VERTEBRAL CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SUPERVISION AND INTERPRETATION, INCLUDES ANGIOGRAP cohort cohort cohort cohort
36227
SELECTIVE CATHETER PLACEMENT, EXTERNAL CAROTID ARTERY, UNILATERAL, WITH ANGIOGRAPHY OF THE IPSILATERAL EXTERNAL CAROTID CIRCULATION AND ALL ASSOCIATEDRADIOLOGICAL SUPERVISION AND INTERPRETATION (LIST cohort cohort cohort cohort
36228
SELECTIVE CATHETER PLACEMENT, EACH INTRACRANIAL BRANCH OF THE INTERNAL CAROTID OR VERTEBRAL ARTERIES, UNILATERAL, WITH ANGIOGRAPHY OF THE SELECTED VESSEL CIRCULATION AND ALL ASSOCIATED RADIOLOGICAL SU cohort cohort
36245
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER ABDOMINAL, PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort cohort
36246
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER ABDOMINAL, PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort cohort
36247
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE ABDOMINAL, PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY cohort cohort cohort cohort
79
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
36248
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADDITIONAL SECOND ORDER, THIRD ORDER, AND BEYOND, ABDOMINAL, PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY (LIST IN ADDITION TO CODE cohort cohort cohort
36251
SELECTIVE CATHETER PLACEMENT (FIRST-ORDER), MAIN RENAL ARTERY AND ANY ACCESSORY RENAL ARTERY(S) FOR RENAL ANGIOGRAPHY, INCLUDING ARTERIAL PUNCTURE ANDCATHETER PLACEMENT(S), FLUOROSCOPY, CONTRAST INJE cohort cohort cohort cohort
36252
SELECTIVE CATHETER PLACEMENT (FIRST-ORDER), MAIN RENAL ARTERY AND ANY ACCESSORY RENAL ARTERY(S) FOR RENAL ANGIOGRAPHY, INCLUDING ARTERIAL PUNCTURE ANDCATHETER PLACEMENT(S), FLUOROSCOPY, CONTRAST INJE cohort cohort cohort cohort
36253
SUPERSELECTIVE CATHETER PLACEMENT (ONE OR MORE SECOND ORDER OR HIGHER RENAL ARTERY BRANCHES) RENAL ARTERY AND ANY ACCESSORY RENAL ARTERY(S) FOR RENAL ANGIOGRAPHY, INCLUDING ARTERIAL PUNCTURE, CATHETER cohort cohort cohort
36254
SUPERSELECTIVE CATHETER PLACEMENT (ONE OR MORE SECOND ORDER OR HIGHER RENAL ARTERY BRANCHES) RENAL ARTERY AND ANY ACCESSORY RENAL ARTERY(S) FOR RENAL ANGIOGRAPHY, INCLUDING ARTERIAL PUNCTURE, CATHETER statewide
36262 REMOVAL OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP statewide
36299 UNLISTED PROCEDURE, VASCULAR INJECTION statewide
36406
VENIPUNCTURE, YOUNGER THAN AGE 3 YEARS, NECESSITATING THE SKILL OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, NOT TO BE USED FOR ROUTINEVENIPUNCTURE; OTHER VEIN statewide
36410
VENIPUNCTURE, AGE 3 YEARS OR OLDER, NECESSITATING THE SKILL OF A PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROFESSIONAL (SEPARATE PROCEDURE), FOR DIAGN OSTIC OR THERAPEUTIC PURPOSES (NOT TO BE USED FOR cohort cohort cohort cohort
36415
*ROUTINE VENIPUNCTURE OR FINGER/HEEL/EAR STICK FORCOLLECTION OF SPECIMEN(S) *ROUTINE VENIPUNCTURE OR FINGER/HEEL/EAR STICK FOR cohort cohort cohort cohort cohort
36416 COLLECTION OF CAPILLARY BLOOD SPECIMEN (EG, FINGER, HEEL, EAR STICK) cohort cohort cohort cohort
36430 TRANSFUSION, BLOOD OR BLOOD COMPONENTSTRANSFUSION,BLOOD OR BLOOD COMPONENTS cohort cohort cohort cohort cohort
36470 *INJECTION OF SCLEROSING SOLUTION; SINGLE VEIN statewide
36471 *INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS,SAME LEG cohort cohort
36475
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE AND MONITORING, PERCUTANEOUS, RADIOFREQUENCY; FIRST VEIN TREATED cohort cohort
36478
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE & MONITORING, PERCUTANEOUS, LASER; FIRST VEIN TREATED cohort cohort cohort cohort
36479
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCLUSIVE OF ALL IMAGING GUIDANCE & MONITORING, PERCUTANEOUS, LASER;2ND & SEBSEQUENT VEINS TREATED IN A SINGLE EXTREMITY, EACH SEPARATE SIT statewide
36481 PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY METHOD statewide
36500 VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD SAMPLING cohort cohort
36511 THERAPEUTIC APHERESIS; WHITE BLOOD CELLS statewide
36512 THERAPEUTIC APHERESIS; RED BLOOD CELLS statewide
36513 THERAPEUTIC APHERESIS; PLATELETS cohort cohort
36514 THERAPEUTIC APHERESIS; PLASMA PHERESIS cohort cohort
36516 THERAPEUTIC APHERESIS, W/EXTRACOPPRL SELECTVE FILTRATION & PLASMA REINFUSION statewide
36522 PHOTOPHERESIS, EXTRACORPOREAL statewide
36555 INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL statewide
80
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
VENOUS CATHETER; UNDER 5 YEARS OF AGE
36556 INSERTION OF NON-TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER; AGE 5 YEARS OR OLDER cohort cohort cohort cohort cohort
36557
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP;UNDER 5 YEARS OF AGE statewide
36558
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP;AGE 5 YEARS OR OLDER cohort cohort cohort cohort cohort cohort
36560
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT; UNDER 5 YEARS OF AGE statewide
36561
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT; AGE 5 YEARS OR OLDER cohort cohort cohort cohort cohort cohort
36563 INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE WITH SUBCUTANEOUS PUMP cohort cohort
36568
INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITHOUT SUBCUTANEOUS PORT OR PUMP; UNDER 5 YEARS OF AGE cohort cohort
36569
INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITHOUT SUBCUTANEOUS PORT OR PUMP; AGE 5 YEARS OR OLDER cohort cohort cohort cohort cohort cohort
36571
INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT; AGE 5 YEARSOR OLDER cohort cohort cohort cohort cohort cohort
36575
REPAIR OF TUNNELED OR NON-TUNNELED CENTRAL VENOUS ACCESS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION SITE statewide
36576
REPAIR OF CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION SITE cohort cohort
36578
REPLACEMENT, CATHETER ONLY, OF CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRALOR PERIPHERAL INSERTION SITE cohort cohort cohort
36580
REPLACEMENT, COMPLETE, OF A NON-TUNNELED CENTRALLYINSERTED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTA NEOUS PORT OR PUMP, THROUGH SAME VENOUS ACCESS cohort cohort
36581
REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHETER, WITHOUT SUBCUTANEOUS PORT OR PUMP, THROUGH SAME VENOUS ACCESS cohort cohort cohort cohort cohort
36582
REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT, THROUGH SAME VENOUS ACCESS cohort cohort cohort
36584
REPLACEMENT COMPLETE OF A PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC) WITHOUT SUBCUTANEOUS PORT OR PUMP THROUGH SAME VENOUS ACCESS cohort cohort cohort cohort cohort
36585
REPLACEMENT COMPLETE OF A PERIPHERALLY INSERTED CENTRAL VENOUS ACCESS DEVICE WITH SUBCUTANEOUS PORT THROUGH SAME VENOUS ACCESS statewide
36589 REMOVAL OF TUNNELED CENTRAL VENOUS CATHETER WITHOUT SUBCUTANEOUS PORT OR PUMP cohort cohort cohort cohort cohort cohort
36590
REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE WITH SUBCUTANEOUS PORT OR PUMP CENTRAL OR PERIPHERAL INSERTION cohort cohort cohort cohort cohort cohort
36591 Collection of blood specimen from a completely implantable venous access device cohort cohort cohort cohort cohort
36592 Collection of blood specimen using established central or peripheral catheter, venous, not otherwisespecified cohort cohort cohort cohort
36593 Declotting by thrombolytic agent of implanted vascular access device or catheter cohort cohort cohort cohort cohort
36595 MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL (EG FIBRIN SHEATH) FROM CENTRAL VENOUS DEVICE cohort cohort cohort
81
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
VIA SEPARATE VENOUS ACCESS
36596
MECHANICAL REMOVAL OF INTRALUMINAL (INTRACATHETER)OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN statewide
36597 REPOSITIONING OF PREVIOUSLY PLACED CENTRAL VENOUS CATHETER UNDER FLUOROSCOPIC GUIDANCE statewide
36598
CONTRAST INJECTION(S) FOR RADIOLOGIC EVALUATION OFEXISTING CENTRAL VENOUS ACCESS DEVICE, INCLUDING FLUOROSCOPY, IMAGE DOCUMENTATION AND REPORT cohort cohort cohort cohort cohort
36600 *ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD FOR DIAGNOSIS cohort cohort cohort cohort cohort
36620
ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING,MONITORING OR TRANSFUSION (SEPARATE PROCEDURE);PERCUTANEOUS ARTERIAL CATHETERIZATION OR CANNULA TION FOR SAMPLING, cohort cohort cohort cohort
36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION cohort cohort cohort cohort
36815
INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE(SEPARATE PROCEDURE); ARTERIOVENOUS, EXTERNAL REVISION, OR CLOSURE statewide
36818 ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION cohort cohort cohort cohort cohort
36819 ARTERIOVENOUS ANASTOMOSIS, OPEN; BY BASILIC VEIN TRANSPOSITION cohort cohort cohort
36820 ARTERIOVENOUS ANASTOMOSIS, OPEN; FOREARM VEIN TRANSPOSITION cohort cohort
36821
ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE (EG, CIMINOTYPE) (SEPARATE ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE (EG, CIMINO cohort cohort cohort cohort cohort
36825
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECTARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); AUTOGENOUS GRAFT cohort cohort
36830
CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECTARTERIOVENOUS ANASTOMOSIS (SEPARATE PROCEDURE); NONAUTOGENOUS GRAFT cohort cohort cohort cohort cohort
36831
THROMBECTOMY, ARTERIOVENOUS FISTULA WITHOUT REVISION,AUTOGENOUS OR NONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE) statewide
36832
REVISION, ARTERIOVENOUS FISTULA; WITHOUT THROMBECTOMY,AUTOGENOUS OR NONAUTOGENOUS, DIALYSIS GRAFT (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
36833
REVISION, ARTERIOVENOUS FISTULA; WITH THROMBECTOMY,AUTOGENOUS OR NONAUTOGENOUS DIALYSIS GRAFT (SEPARATE PROCEDURE) cohort cohort cohort
36838 DISTAL REVASCULARIZATION AND INTERVAL LIGATION (DRIL) UPPER EXTREMITY HEMODIALYSIS ACCESS (STEAL SYNDROME) cohort cohort cohort
36860
EXTERNAL CANNULA DECLOTTING (SEPARATE PROCEDURE); WITHOUTBALLOON CATHETER EXTERNAL CANNULA DECLOTTING (SEPARATE PROCEDURE); WITHOUT statewide
36870
THROMBECTOMY, PERCUTANOUS, ARTERIOVENOUS FISTULA, AUTOGENOUS OR NONAUTOGENOUS GRAFT (INCLUDES MECHANICAL THROMBUS EXTRACTION AND INTRA-GRAFT THROMBOLYSIS) cohort cohort cohort cohort cohort
37182 INSERTION, TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) statewide
37183 REVISION, TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) statewide
37184
PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCORONARY, ARTERIAL OR ARTERIAL BYPASS GRAFT, INCLUDING FLUOROSCOPIC GUIDANCE AND INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S) statewide
37186
SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY (EG, NONPRIMARY MECHANICAL, SNARE BASKET, SUCTION TECHNIQUE), NONCORONARY, ARTERIAL OR ARTERIAL BYPASS cohort cohort cohort
82
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
GRAFT, INCLUDING FLUOROSCOPIC GUIDANCE AND INTRA
37187
PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY,VEIN(S), INCLUDING INTRAPROCEDURAL PHARMACOLOGICA L THROMBOLYTIC INJECTIONS AND FLUOROSCOPIC GUIDANCE cohort cohort
37191
INSERTION OF INTRAVASCULAR VENA CAVA FILTER, ENDOVASCULAR APPROACH INCLUDING VASCULAR ACCESS, VESSELSELECTION, AND RADIOLOGICAL SUPERVISION AND INTER PRETATION, INTRAPROCEDURAL ROADMAPPING, AND IMAGIN cohort cohort cohort cohort
37193
RETRIEVAL (REMOVAL) OF INTRAVASCULAR VENA CAVA FILTER, ENDOVASCULAR APPROACH INCLUDING VASCULAR ACCESS, VESSEL SELECTION, AND RADIOLOGICAL SUPERVISIONAND INTERPRETATION, INTRAPROCEDURAL ROADMAPPING, cohort cohort cohort cohort
37195 THROMBOLYSIS, CEREBRAL, BY INTRAVENOUS INFUSION statewide
37197
TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETER), INCLUDES RADIOLOGICAL SUPERVISION AND INTERPRETATION, AND IMAGING GUIDANCE (ULTRASOUND cohort cohort cohort
37200 TRANSCATHETER BIOPSY cohort cohort cohort
37202
TRANSCATHETER THERAPY, INFUSION OTHER THAN FOR THROMBOLYSIS,ANY TYPE (EG, SPASMOLYTIC, VASOCONSTRICTIVE) statewide
37204
TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR TUMORDESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDEA VASCULAR MALFORMATION), PERCUTANEOUS, ANY METH OD, NON-CENTRAL NERVOUS cohort cohort cohort
37205
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity arteries), percutaneous; initialvessel cohort cohort cohort cohort
37206
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity arteries), percutaneous; each additional vessel (List separately in addition to co cohort cohort cohort
37210
UTERINE FIBROID EMBOLIZATION (UFE, EMBOLIZATION OFTHE UTERINE ARTERIES TO TREAT UTERINE FIBROIDS, L EIOMYOMATA), PERCUTANEOUS APPROACH INCLUSIVE OF VASCULAR ACCESS, VESSEL SELECTION, EMBOLIZATION, AND cohort cohort cohort cohort cohort
37215 Transcatheter placement of intravascular stent(s),cervical carotid artery, percutaneous with distal embolic protection statewide
37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty cohort cohort cohort cohort
37221
Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed cohort cohort cohort cohort cohort
37222
Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure) statewide
37223
Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when p cohort cohort cohort cohort
37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty cohort cohort cohort cohort cohort
37225
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed cohort cohort cohort cohort
37226
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed cohort cohort cohort cohort cohort
37227
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy,includes angioplasty within the same vessel, when cohort cohort cohort cohort
37228 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty cohort cohort cohort cohort
37229 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes angioplasty cohort cohort
83
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
within the same vessel, when performed
37230
Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when perf statewide
37232
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal angioplasty (Listseparately in addition to code for primary proced cohort cohort
37233
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy, includes angioplasty within the same vessel, when performed (List s statewide
37250
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL) DURINGTHERAPEUTIC INTERVENTION; INITIAL VESSEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
37607 LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA cohort cohort cohort cohort cohort
37609 LIGATION OR BIOPSY, TEMPORAL ARTERY cohort cohort cohort cohort
37617 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE);ABDOMEN cohort cohort
37618 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE);EXTREMITY statewide
37700
LIGATION AND DIVISION OF LONG SAPHENOUS VEIN ATSAPHENOFEMORAL JUNCTION, OR DISTAL INTERRUPTIONS LIGATION AND DIVISION OF LONG SAPHENOUS VEIN AT cohort cohort
37718 LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUSVEIN cohort cohort
37722
LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS FROM SAPHENOFEMORAL JUNCTION TO KNEE OR BELOW cohort cohort
37761 LIGATION OF PERFORATOR VEIN(S), SUBFASCIAL, OPEN, INCLUDING ULTRASOUND GUIDANCE, WHEN PERFORMED, 1 LEG statewide
37765 STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; 10-20 STAB INCISIONS cohort cohort cohort
37766 STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; MORE THAN 20 INCISIONS cohort cohort cohort
37785 LIGATION, DIVISION, AND/OR EXCISION OF VARICOSE VEIN COHORT(S), 1 LEG statewide
37790 PENILE VENOUS OCCLUSIVE PROCEDURE statewide
37799 UNLISTED PROCEDURE, VASCULAR SURGERYUNLISTED PROCEDURE, VASCULAR SURGERY cohort cohort cohort cohort cohort
38100 SPLENECTOMY; TOTAL (SEPARATE PROCEDURE) cohort cohort
38101 SPLENECTOMY; PARTIAL statewide
38115 REPAIR OF RUPTURED SPLEEN (SPLENORRHAPHY) WITH OR WITHOUTPARTIAL SPLENECTOMY statewide
38120 LAPAROSCOPY, SURGICAL, SPLENECTOMY cohort cohort cohort
38129 UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN statewide
38205
BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL HARVESTING FOR TRANSPLANTATION, PER COLLECTION; ALLOGENEIC statewide
38206 BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL HARVESTING, TRANSPLANTATION/COLLECTION; AUTOLOGOUS statewide
38207 TRANSPLANT PREPARATION, HEMATOPIETIC PROGENITOR CELLS, CRYOPRESERVATION AND STORAGE statewide
38208
TRANSPLANT PREPARATION OF HEMATOPOIETIC PROGENITORCELLS; THAWING OF PREVIOUSLY FROZEN HARVEST, WITH OUT WASHING, PER DONOR statewide
38214 TRANSPLANT PREPARATION, HEMATOPIETIC PROGENITOR CELLS, PLASMA VOLUME DEPLETION statewide
38215 TRANSPLANT PREPARATION, HEMATOPIETIC PROGENITOR CELLS, CELL CONC, PLASMA/MONONUCLEAR/ BUFFY COAT statewide
38220 BONE MARROW ASPIRATION cohort cohort cohort cohort cohort cohort
38221 BONE MARROW BX. NEEDLE/TROCAR cohort cohort cohort cohort cohort
38232 BONE MARROW HARVESTING FOR TRANSPLANTATION; cohort cohort
84
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
AUTOLOGOUS
38241 HEMATOPOIETIC PROGENITOR CELL (HPC); AUTOLOGOUS TRANSPLANTATION statewide
38242 ALLOGENEIC LYMPHOCYTE INFUSIONS statewide
38500 BIOPSY OR EXCISION OF LYMPH NODE(S); SUPERFICIAL (SEPARATEPROCEDURE) cohort cohort cohort cohort cohort cohort
38505 BIOPSY OR EXCISION OF LYMPH NODE(S); BY NEEDLE, SUPERFICIAL (EG, CERVICAL, INGUINAL, AXILLARY) cohort cohort cohort cohort cohort
38510 BIOPSY OR EXCISION OF LYMPH NODE(S); DEEP CERVICALNODE(S) cohort cohort cohort cohort cohort cohort
38520 BIOPSY OR EXCISION OF LYMPH NODE(S); DEEP CERVICALNODE(S)WITH EXCISION SCALENE FAT PAD statewide
38525 BIOPSY OR EXCISION OF LYMPH NODE(S); DEEP AXILLARYNODE(S) cohort cohort cohort cohort cohort cohort
38530 BIOPSY OR EXCISION OF LYMPH NODE(S); INTERNAL MAMMARYNODE(S) statewide
38542 DISSECTION, DEEP JUGULAR NODE(S) statewide
38562 LIMITED LYMPHADENECTOMY FOR STAGING (SEPARATE PROCEDURE);PELVIC AND PARA-AORTIC cohort cohort cohort
38570 LAPAROSCOPY, SURGICAL;WITH RETROPERITONEAL LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE cohort cohort cohort cohort
38571 LAPAROSCOPY, SURGICAL;WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY cohort cohort cohort
38572
LAPAROSCOPY, SURGICAL;WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PERI-AORTIC LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE cohort cohort cohort
38589 UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM cohort cohort
38700 SUPRAHYOID LYMPHADENECTOMYSUPRAHYOID LYMPHADENECTOMY cohort cohort
38720 CERVICAL LYMPHADENECTOMY (COMPLETE)CERVICAL LYMPHADENECTOMY (COMPLETE) cohort cohort
38724
CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK DISSECTION) CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK DISSECTION) cohort cohort cohort cohort
38740 AXILLARY LYMPHADENECTOMY; SUPERFICIALAXILLARY LYMPHADENECTOMY; SUPERFICIAL statewide
38745 AXILLARY LYMPHADENECTOMY; COMPLETEAXILLARY LYMPHADENECTOMY; COMPLETE cohort cohort cohort cohort
38760
INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLUDINGCLOQUET'S NODE (SEPARATE PROCEDURE) INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLUDING cohort cohort cohort
38770
PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC,HYPOGASTRIC, AND OBTURATOR NODES (SEPARATE PROCEDURE) PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, cohort cohort
38790 INJECTION PROCEDURE; LYMPHANGIOGRAPHY statewide
38792 INJECTION PROCEDURE; RADIOACTIVE TRACER FOR IDENTIFICATION OF SENTINEL NODE cohort cohort cohort cohort cohort
38900
Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure) cohort cohort cohort cohort cohort
38999 UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM cohort cohort cohort cohort
39010
MEDIASTINOTOMY WITH EXPLORATION, DRAINAGE, REMOVALOFFOREIGN BODY, OR BIOPSY; TRANSTHORACIC APPROACH , INCLUDING EITHER TRANSTHORACIC OR MEDIAN STERNOTOMY statewide
39220 RESECTION OF MEDIASTINAL TUMOR cohort cohort
39400 MEDIASTINOSCOPY, INCLUDES BIOPSY(IES), WHEN PERFORMED cohort cohort cohort cohort cohort
39599 UNLISTED PROCEDURE, DIAPHRAGM statewide
4048F Documentation that administration of prophylactic parenteral antibiotic was initiated within one hour (if fluoroquinolone or vancomycin, two statewide
85
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
hours) prior to surgical incision (or start of procedure wh
40490 BIOPSY OF LIP statewide
40510 EXCISION OF LIP; TRANSVERSE WEDGE EXCISION WITH PRIMARYCLOSURE cohort cohort
40525 EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH LOCALFLAP (EG, ESTLANDER OR FAN) statewide
40530 RESECTION OF LIP, MORE THAN ONE-FOURTH, WITHOUTRECONSTRUCTION statewide
40650 REPAIR LIP, FULL THICKNESS; VERMILION ONLY cohort cohort cohort cohort
40652 REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HEIGHT statewide
40654 REPAIR LIP, FULL THICKNESS; OVER ONE-HALF VERTICALHEIGHT,OR COMPLEX statewide
40700 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY,PARTIAL OR COMPLETE, UNILATERAL cohort cohort
40701 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY BILATERAL, 1-STAGE PROCEDURE statewide
40720 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; SECONDARY, BYRECREATION OF DEFECT AND RECLOSURE cohort cohort cohort
40799 UNLISTED PROCEDURE, LIPS cohort cohort cohort
40800
*DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OFMOUTH;SIMPLE *DRAINAGE OF ABSCESS, CYST, HEMATOM A, VESTIBULE OF MOUTH; cohort cohort cohort cohort
40801
DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH;COMPLICATED DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; statewide
40804
*REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH;SIMPLE *REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH; statewide
40806 INCISION OF LABIAL FRENUM (FRENOTOMY) cohort cohort cohort
40810 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OFMOUTH; WITHOUT REPAIR cohort cohort
40812 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OFMOUTH; WITH SIMPLE REPAIR cohort cohort cohort cohort
40814 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OFMOUTH; WITH COMPLEX REPAIR cohort cohort
40819 EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY,FRENULECTOMY, FRENECTOMY) cohort cohort
40820
DESTRUCTION OF LESION OR SCAR OF VESTIBULE OF MOUTH BYPHYSICAL METHODS (EG, LASER, THERMAL, CRYO, CHEMICAL) cohort cohort
40830
CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESSCLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS cohort cohort cohort
40831
CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM ORCOMPLEX CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR cohort cohort
40840 VESTIBULOPLASTY; ANTERIORVESTIBULOPLASTY; ANTERIOR statewide
41008
INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, ORHEMATOMA OF TONGUE INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR statewide
41010 INCISION OF LINGUAL FRENUM (FRENOTOMY) cohort cohort cohort cohort
41016
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, ORHEMATOMA OF FLOOR OF MOUTH; SUBMENTAL EXTRAORALINCISION AND DRAINAGE OF ABSCESS, CYST, OR statewide
41017
EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, ORHEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULAR EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR statewide
41100 BIOPSY OF TONGUE; ANTERIOR TWO-THIRDSBIOPSY OF TONGUE; ANTERIOR TWO-THIRDS cohort cohort cohort
41105 BIOPSY OF TONGUE; POSTERIOR ONE-THIRDBIOPSY OF TONGUE; POSTERIOR ONE-THIRD cohort cohort
86
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
41108 BIOPSY OF FLOOR OF MOUTHBIOPSY OF FLOOR OF MOUTH statewide
41110 EXCISION OF LESION OF TONGUE WITHOUT CLOSURE cohort cohort
41112 EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIORTWO-THIRDS cohort cohort cohort cohort
41113 EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERIORONE-THIRD cohort cohort
41114 EXCISION OF LESION OF TONGUE WITH CLOSURE; WITH LOCAL TONGUEFLAP statewide
41115 EXCISION OF LINGUAL FRENUM (FRENECTOMY) cohort cohort cohort
41116 EXCISION, LESION OF FLOOR OF MOUTH cohort cohort cohort
41120 GLOSSECTOMY; LESS THAN ONE-HALF TONGUE cohort cohort cohort
41135 GLOSSECTOMY; PARTIAL, WITH UNILATERAL RADICAL NECKDISSECTION cohort cohort
41250
*REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO-THIRDS OF TONGUE *REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR cohort cohort cohort cohort
41251 *REPAIR OF LACERATION 2.5 CM OR LESS; POSTERIOR ONE-THIRD OFTONGUE statewide
41252
*REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CMOR COMPLEX *REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM statewide
41512 Tongue base suspension, permanent suture technique statewide
41520 FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITHZ-PLASTY) cohort cohort cohort cohort cohort
41599 UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH cohort cohort cohort
41800 *DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLARSTRUCTURES cohort cohort cohort cohort cohort
41820 GINGIVECTOMY, EXCISION GINGIVA, EACH QUADRANT statewide
41821 OPERCULECTOMY, EXCISION PERICORONAL TISSUES statewide
41825 EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE),DENTOALVEOLAR STRUCTURES; WITHOUT REPAIR statewide
41826 EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE),DENTOALVEOLAR STRUCTURES; WITH SIMPLE REPAIR cohort cohort cohort
41827
EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE),DENTOALVEOLAR STRUCTURES; WITH COMPLEX REPAIR statewide
41874 ALVEOLOPLASTY, EACH QUADRANT (SPECIFY) cohort cohort cohort
41899 UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES cohort cohort cohort cohort cohort cohort
42000 *DRAINAGE OF ABSCESS OF PALATE, UVULA statewide
42100 BIOPSY OF PALATE, UVULA statewide
42104 EXCISION, LESION OF PALATE, UVULA; WITHOUT CLOSURE cohort cohort cohort cohort
42106 EXCISION, LESION OF PALATE, UVULA; WITH SIMPLE PRIMARYCLOSURE cohort cohort cohort
42107 EXCISION, LESION OF PALATE, UVULA; WITH LOCAL FLAPCLOSURE statewide
42120 RESECTION OF PALATE OR EXTENSIVE RESECTION OF LESION statewide
42140 UVULECTOMY, EXCISION OF UVULA cohort cohort cohort cohort cohort
42145 PALATOPHARYNGOPLASTY (EG, UVULOPALATOPHARYNGOPLASTY,UVULOPHARYNGOPLASTY) cohort cohort cohort cohort
42160 DESTRUCTION OF LESION, PALATE OR UVULA (THERMAL, CRYO ORCHEMICAL) statewide
42180 REPAIR, LACERATION OF PALATE; UP TO 2 CMREPAIR, LACERATION OF PALATE; UP TO 2 CM statewide
42182
REPAIR, LACERATION OF PALATE; OVER 2 CM OR COMPLEXREPAIR, LACERATION OF PALATE; OVER 2 CM OR COMPLEX cohort cohort
42200 PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PALATE ONLY statewide
42205 PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF statewide
87
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ALVEOLARRIDGE; SOFT TISSUE ONLY
42210
PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALVEOLARRIDGE; WITH BONE GRAFT TO ALVEOLAR RIDGE (INCLUDES OBTAINING GRAFT) statewide
42220 PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENINGPROCEDURE statewide
42225 PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGEAL FLAP statewide
42226 LENGTHENING OF PALATE, AND PHARYNGEAL FLAP statewide
42235 REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP statewide
42299 UNLISTED PROCEDURE, PALATE, UVULA statewide
42300 *DRAINAGE OF ABSCESS; PAROTID, SIMPLE statewide
42330
SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR cohort cohort cohort cohort
42335
SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), COMPLICATED,INTRAORAL SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), COMPLICATED, statewide
42400 *BIOPSY OF SALIVARY GLAND; NEEDLE statewide
42405 BIOPSY OF SALIVARY GLAND; INCISIONAL cohort cohort
42408 EXCISION OF SUBLINGUAL SALIVARY CYST (RANULA) statewide
42409 MARSUPIALIZATION OF SUBLINGUAL SALIVARY CYST (RANULA) statewide
42410 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE,WITHOUT NERVE DISSECTION cohort cohort cohort cohort
42415 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE,WITH DISSECTION AND PRESERVATION OF FACIAL NERVE cohort cohort cohort cohort
42420 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL,WITHDISSECTION AND PRESERVATION OF FACIAL NERVE cohort cohort cohort cohort
42440 EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND cohort cohort cohort cohort cohort
42450 EXCISION OF SUBLINGUAL GLAND cohort cohort
42500
PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY;PRIMARYOR SIMPLE PLASTIC REPAIR OF SALIVARY DUCT , SIALODOCHOPLASTY; PRIMARY cohort cohort
42505
PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY;SECONDARYOR COMPLICATED PLASTIC REPAIR OF SALIVA RY DUCT, SIALODOCHOPLASTY; SECONDARY statewide
42550 INJECTION PROCEDURE FOR SIALOGRAPHY statewide
42650 *DILATION SALIVARY DUCT*DILATION SALIVARY DUCT cohort cohort
42699 UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS cohort cohort cohort
42700 *INCISION AND DRAINAGE ABSCESS; PERITONSILLAR cohort cohort cohort cohort cohort
42720 INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL ORPARAPHARYNGEAL, INTRAORAL APPROACH cohort cohort
42800 BIOPSY; OROPHARYNX cohort cohort cohort cohort
42804 BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE statewide
42806 BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LESION cohort cohort
42808 EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD cohort cohort cohort
42809 REMOVAL OF FOREIGN BODY FROM PHARYNX cohort cohort cohort
42810 EXCISION BRANCHIAL CLEFT CYST OR VESTIGE, CONFINEDTO SKINAND SUBCUTANEOUS TISSUES cohort cohort cohort cohort cohort
42815
EXCISION BRANCHIAL CLEFT CYST, VESTIGE, OR FISTULA,EXTENDING BENEATH SUBCUTANEOUS TISSUES AND/OR INTO PHARYNX cohort cohort cohort cohort
42820 TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12 cohort cohort cohort cohort cohort cohort
42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER cohort cohort cohort cohort cohort cohort
42825 TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12 cohort cohort cohort cohort cohort cohort
88
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER cohort cohort cohort cohort cohort cohort
42830 ADENOIDECTOMY, PRIMARY; UNDER AGE 12 cohort cohort cohort cohort cohort cohort
42831 ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER cohort cohort cohort cohort cohort
42835 ADENOIDECTOMY, SECONDARY; UNDER AGE 12 cohort cohort cohort
42836 ADENOIDECTOMY, SECONDARY; AGE 12 OR OVER cohort cohort
42842 RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/ORRETROMOLAR TRIGONE; WITHOUT CLOSURE statewide
42860 EXCISION OF TONSIL TAGS statewide
42870 EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD(SEPARATEPROCEDURE) cohort cohort
42892
RESECTION OF LATERAL PHARYNGEAL WALL OR PYRIFORM SINUS,DIRECT CLOSURE BY ADVANCEMENT OF LATERAL AND POSTERIOR PHARYNGEAL WALLS statewide
42950 PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATION ONPHARYNX) cohort cohort cohort
42960
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); SIMPLE CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, cohort cohort cohort cohort
42961
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); COMPLICATED, REQUIRING HOSPITALIZATION CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, cohort cohort cohort
42962
CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTTONSILLECTOMY); WITH SECONDARY SURGICAL INTERVENTION CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, cohort cohort cohort cohort
42970
CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY(EG, POSTADENOIDECTOMY); SIMPLE, WITH POSTERIOR NASAL PACKS, WITH OR WITHOUT ANTERIOR PACKSAND/OR CAUTERIZATION cohort cohort
42971
CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY(EG, POSTADENOIDECTOMY); COMPLICATED, REQUIRING HOSPITALIZATION statewide
42999 UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS cohort cohort cohort cohort cohort
43030 CRICOPHARYNGEAL MYOTOMYCRICOPHARYNGEAL MYOTOMY statewide
43130 DIVERTICULECTOMY OF HYPOPHARYNX OR ESOPHAGUS, WITHORWITHOUT MYOTOMY; CERVICAL APPROACH statewide
43200
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; DIAGNOSTIC, WITHORWITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING O R WASHING (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
43201 ESOPHAGOSCOPY, RIGID/FLEXIBLE; W/DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE cohort cohort cohort
43202 ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BIOPSY, SINGLE ORMULTIPLE cohort cohort cohort cohort
43204 ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INJECTION SCLEROSISOF ESOPHAGEAL VARICES statewide
43215
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH REMOVAL OF FOREIGNBODY ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH REMOVAL OF FOREIGN cohort cohort cohort cohort cohort
43219 ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF PLASTIC TUBE OR STENT statewide
43220
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BALLOON DILATION(LESS THAN 30 MM DIAMETER) ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BALLOON DILATION cohort cohort cohort
43226
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF GUIDEWIRE FOLLOWED BY DILATION OVER GUIDE WIRE ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF GUIDE cohort cohort
43228
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH ABLATION OFTUMOR(S),POLYP(S), OR OTHER LESION(S), NOT AMENAB LE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE cohort cohort cohort
89
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
43231
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; DIAGNOSTIC WITH OR WITHOUT COLLECTION OF SPECIMENS BY BRUSHING OR WASHING (SEPARATE PROCEDURE) WITH ENDOSCOPIC ULTRASOUND EXAMINATION. cohort cohort cohort
43232
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND-GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S) cohort cohort
43235
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; DIAGNOSTIC, WITH OR WITHOUT COLL ECTION OF cohort cohort cohort cohort cohort
43236 UPPER GI ENDOSCOPY; W/DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE cohort cohort cohort cohort cohort
43237
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS STOMACH AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH ENDOSCOPIC ULTRASOUND EXAM LIMITED TO THE ESOPHAGUS cohort cohort
43238
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS STOMACH AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH TRANSENDOSCOPIC ULTRASOUND-GUIDED INTRAMURAL OR FINE NEEDLE ASPIRATION BIOPSY statewide
43239
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH BIOPSY, SINGLE OR MULTIPLE cohort cohort cohort cohort cohort cohort
43240
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH TRANSMURAL DRAINAGE OF PSEU DOCYST. cohort cohort
43242
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH TRANSENDOSCOPIC ULTRASOUND- GUIDED INTRAMURAL FINE NEEDLE ASPIRATION/BIOPSY(S) cohort cohort cohort
43243
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH INJECTION SCLEROSIS OF ESOP HAGEAL AND/OR cohort cohort cohort
43244
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH BAND LIGATION OF ESOPHAGEAL AND/OR GASTRIC cohort cohort cohort cohort cohort
43245
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH DILATION OF GASTRIC OUTLET FOR cohort cohort cohort cohort cohort
43246
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH DIRECTED PLACEMENT OF PERCU TANEOUS cohort cohort cohort cohort cohort
43247
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH REMOVAL OF FOREIGN BODY cohort cohort cohort cohort cohort
43248
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH INSERTION OF GUIDE WIRE FOL LOWED BY cohort cohort cohort cohort cohort
43249
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH BALLOON DILATION OF ESOPHAG US (LESS THAN cohort cohort cohort cohort cohort
43250
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH REMOVAL OF TUMOR(S), POLYP( S), OR OTHER cohort cohort cohort cohort cohort
43251 UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR cohort cohort cohort cohort cohort
90
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
JEJUNUMAS APPROPRIATE; WITH REMOVAL OF TUMOR(S), POLYP( S), OR OTHER
43255
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH CONTROL OF BLEEDING, ANY ME THOD cohort cohort cohort cohort cohort
43256
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH TRANSENDOSCOPIC STENT PLACE MENT (INCLUDES PREDILATION) statewide
43257
UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS, STOMACH, & EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; WITH DELIVERY OF THERMAL ENERGY TO THE MUSCLE OF LOWER ESOPHAGEAL SPHINCTER / GASTRIC statewide
43258
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH ABLATION OF TUMOR(S), POLYP (S), OR OTHER cohort cohort cohort cohort cohort
43259
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUMAS APPROPRIATE; WITH ENDOSCOPIC ULTRASOUND EXAMI NATION cohort cohort cohort cohort
43260
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP);DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S), BY BRUSHING OR WASHING (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
43261 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH BIOPSY, SINGLE OR MULTIPLE cohort cohort cohort cohort cohort
43262 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH SPHINCTEROTOMY/PAPILLOTOMY cohort cohort cohort cohort
43263
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH PRESSURE MEASUREMENT OF SPHINCTER OF ODDI (PANCREATIC DUCT OR COMMON BILE DUCT) statewide
43264
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE REMOVAL OF STONE(S) FROM BILIARY AND/OR PANCREATIC DUCTS cohort cohort cohort cohort cohort
43265
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE DESTRUCTION, LITHOTRIPSY OF STONE(S), ANY METHOD cohort cohort cohort
43267
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE INSERTION OF NASOBILIARY OR NASOPANCREATIC DRAINAGE TUBE statewide
43268
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE INSERTION OF TUBE OR STENT INTO BILE OR PANCREATIC DUCT cohort cohort cohort cohort
43269
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE REMOVAL OF FOREIGNBODY AND/OR CHANGE cohort cohort cohort cohort cohort
43271
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE BALLOON DILATION OF AMPULLA, BILIARY AND/OR PANCREATIC DUCT(S) cohort cohort cohort cohort
43272
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHERLESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY statewide
43273
Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreaticduct(s) (List separately in addition to code(s) f or primary procedure) cohort cohort cohort cohort cohort
43279 Laparoscopy, surgical esophagomyotomy (Heller type), with fundoplasty, when performed cohort cohort cohort cohort
43280 LAPAROSCOPY, SURGICAL, ESOPHAGOGASTRIC FUNDOPLASTY(EG, NISSEN, TOUPET PROCEDURES) cohort cohort cohort cohort cohort
43281
LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITHOUT IMPLANTATION OF MESH cohort cohort cohort cohort cohort
91
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
43282
LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH cohort cohort cohort cohort cohort
43283
Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure) statewide
43333
Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis statewide
43450
*DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES *DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE cohort cohort cohort cohort cohort
43453 DILATION OF ESOPHAGUS, OVER GUIDE WIREDILATION OF ESOPHAGUS, OVER GUIDE WIRE statewide
43456
DILATION OF ESOPHAGUS, BY BALLOON OR DILATOR, RETROGRADEDILATION OF ESOPHAGUS, BY BALLOON OR DILATOR, RETROGRADE cohort cohort cohort
43458
DILATION OF ESOPHAGUS WITH BALLOON (30 MM DIAMETERORLARGER) FOR ACHALASIA DILATION OF ESOPHAGUS WI TH BALLOON (30 MM DIAMETER OR cohort cohort cohort
43499 UNLISTED PROCEDURE, ESOPHAGUS cohort cohort cohort cohort
43520 PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-RAMSTEDTTYPE OPERATION) statewide
43631 GASTRECTOMY, PARTIAL, DISTAL; WITH GASTRODUODENOSTOMY statewide
43644
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCED-URE; WITH GASTRIC BYPASS AND ROUX-EN-Y GASTROENTEROSTOMY (RUOX LIMB 150 CM OR LESS) cohort cohort
43653
LAPAROSCOPY, SURGICAL;GASTOSTOMY, WITHOUT CONSTRUCTION OF GASTRIC TUBE (EG. STAMM PROCEDURE (SEPARATE PROCEDURE) cohort cohort
43659 LAPAROSCOPY, SURGICAL;UNLISTED LAPAROSCOPY PROCEDURE , STOMACH cohort cohort cohort
43752 Naso or oro gastric tube placement, necessitating physician's skill cohort cohort
43753
Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed cohort cohort cohort cohort cohort
43760 Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance cohort cohort cohort cohort cohort
43761 REPOSITIONING OF A NASO- OR ORO-GASTRIC FEEDING TUBE, THROUGH THE DUODENUM FOR ENTERIC NUTRITION cohort cohort
43770
Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (e.g., gastric band and subcutaneous port components) cohort cohort cohort cohort
43771 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only cohort cohort cohort cohort cohort
43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only statewide
43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only cohort cohort cohort
43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components cohort cohort cohort cohort
43775
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE; LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY) cohort cohort cohort
43800 PYLOROPLASTY statewide
43830 GASTROSTOMY, TEMPORARY (TUBE, RUBBER OR PLASTIC) (SEPARATEPROCEDURE); statewide
43870 CLOSURE OF GASTROSTOMY, SURGICAL cohort cohort cohort
43880 CLOSURE OF GASTROCOLIC FISTULA statewide
43886 GASTRIC RESTRICTIVE PROCEDURE, OPEN; REVISION OF SUBCUTANEOUS PORT COMPONENT ONLY cohort cohort
92
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
43887 GASTRIC RESTRICTIVE PROCEDURE, OPEN; REMOVAL OF SUBCUTANEOUS PORT COMPONENT ONLY statewide
43888 GASTRIC RESTRICTIVE PROCEDURE, OPEN; REMOVAL AND REPLACEMENT OF SUBCUTANEOUS PORT COMPONENT ONLY cohort cohort
43999 UNLISTED PROCEDURE, STOMACH cohort cohort cohort
44005 ENTEROLYSIS (FREEING OF INTESTINAL ADHESION) (SEPARATEPROCEDURE) cohort cohort cohort
44055
CORRECTION OF MALROTATION BY LYSIS OF DUODENAL BANDS AND/OR REDUCTION OF MIDGUT VOLVULUS (EG, LADD PROCEDURE) statewide
44120 ENTERECTOMY, RESECTION OF SMALL INTESTINE; SINGLE RESECTION AND ANASTOMOSIS statewide
44140 COLECTOMY, PARTIAL; WITH ANASTOMOSIS statewide
44180 LAPAROSCOPY, SURGICAL, ENTEROLYSIS (FREEING OF INTESTINAL ADHESION) (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
44186 LAPAROSCOPY, SURGICAL; JEJUNOSTOMY (EG, FOR DECOMPRESSION OR FEEDING) statewide
44187 LAPAROSCOPY, SURGICAL; ILEOSTOMY OR JEJUNOSTOMY, NON-TUBE cohort cohort
44188 LAPAROSCOPY, SURGICAL, COLOSTOMY OR SKIN LEVEL CECOSTOMY statewide
44202 LAPAROSCOPY, SURGICAL; INTESTINAL RESECTION, WITH ANASTOMOSIS (INTRA OR EXTRACORPOREAL) cohort cohort
44204 LAPAROSCOPY, SURGICAL;COLECTOMY, PARTIAL, W/ ANASTOMOSIS cohort cohort cohort
44205 LAPAROSCOPY, SURGICAL;COLECTOMY, PARTIAL, W/ REMOVAL TERMINAL ILEUM W/ ILEOCOLOSTOMY cohort cohort
44213
LAPAROSCOPY, SURGICAL, MOBILIZATION (TAKE-DOWN) OFSPLENIC FLEXURE PERFORMED IN CONJUNCTION WITH PAR TIAL COLECTOMY (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE) statewide
44238 UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM) cohort cohort cohort cohort
44300 Placement, enterostomy or cecostomy, tube open (e.g., for feeding or decompression) (separate procedure) statewide
44310 ILEOSTOMY OR JEJUNOSTOMY, NON-TUBE (SEPARATE PROCEDURE) statewide
44312 REVISION OF ILEOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE) statewide
44346 REVISION OF COLOSTOMY; WITH REPAIR OF PARACOLOSTOMY HERNIA(SEPARATE PROCEDURE) statewide
44360
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, NOT INCLUDING ILEUM; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING cohort cohort cohort cohort
44361
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE cohort cohort cohort
44366
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH CONTROL OF BLEEDING, ANY METHOD cohort cohort
44369
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO cohort cohort cohort
44372
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH PLACEMENT OF PERCUTANEOUS JEJUNOSTOMY TUBE statewide
44376
SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, INCLUDING ILEUM; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING cohort cohort cohort cohort cohort
44377 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECONDPORTION OF DUODENUM, INCLUDING ILEUM; WITH statewide
93
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
BIOPSY, SINGLE OR MULTIPLE
44380
ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUTCOLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) statewide
44382 ILEOSCOPY, THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE statewide
44385
ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL ORPELVIC) POUCH; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING(SEPARATE PROCEDURE) cohort cohort
44386 ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL ORPELVIC) POUCH; WITH BIOPSY, SINGLE OR MULTIPLE statewide
44388
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUTCOLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) cohort cohort cohort cohort
44389
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLECOLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE cohort cohort
44392
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S),POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY statewide
44394
COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S),POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR( S), statewide
44500 INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG,MILLER-ABBOTT) (SEPARATE PROCEDURE) cohort cohort cohort
44602
SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATEDULCER, DIVERTICULUM, WOUND, INJURY OR RUPTURE; SINGLE PERFORATION cohort cohort
44604
SUTURE OF LARGE INTESTINE (COLORRHAPHY) FOR PERFORATEDULCER, DIVERTICULUM, WOUND, INJURY OR RUPTURE (SINGLE OR MULTIPLE PERFORATIONS); WITHOUT COLOSTOMY cohort cohort cohort
44615
INTESTINAL STRICTUROPLASTY (ENTEROTOMY AND ENTERORRHAPHY)WITH OR WITHOUT DILATION, FOR INTESTINAL OBSTRUCTION statewide
44620 CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; statewide
44680 INTESTINAL PLICATION (SEPARATE PROCEDURE) statewide
44705 PREPARATION OF FECAL MICROBIOTA FOR INSTILLATION, INCLUDING ASSESSMENT OF DONOR SPECIMEN statewide
44799 UNLISTED PROCEDURE, INTESTINE cohort cohort cohort cohort
44800 EXCISION OF MECKEL'S DIVERTICULUM (DIVERTICULECTOMY) OROMPHALOMESENTERIC DUCT cohort cohort cohort
44899 UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY cohort cohort cohort
44950 APPENDECTOMY; cohort cohort cohort cohort
44955
APPENDECTOMY; WHEN DONE FOR INDICATED PURPOSE AT TIME OFOTHER MAJOR PROCEDURE (NOT AS SEPARATE PROCEDURE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
44960 APPENDECTOMY; FOR RUPTURED APPENDIX WITH ABSCESS ORGENERALIZED PERITONITIS statewide
44970 LAPAROSCOPY, SURGICAL; APPENDECTOMY cohort cohort cohort cohort cohort
44979 UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX cohort cohort cohort cohort
45005 INCISION AND DRAINAGE OF SUBMUCOSAL ABSCESS, RECTUM cohort cohort cohort
45100 BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITALMEGACOLON) cohort cohort cohort cohort cohort
45120
PROCTECTOMY, COMPLETE (FOR CONGENITAL MEGACOLON), ABDOMINAL AND PERINEAL APPROACH; WITH PULL-THROUGHPROCEDURE AND ANASTOMOSIS (EG, SWENSON, DUHAMEL, OR SOAVE TYPE OPERATION) statewide
94
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
45123 PROCTECTOMY, PARTIAL, WITHOUT ANASTOMOSIS, PERINEAL APPROACH statewide
45130 EXCISION OF RECTAL PROCIDENTIA, WITH ANASTOMOSIS; PERINEALAPPROACH statewide
45171 EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PARTIAL THICKNESS) cohort cohort cohort cohort cohort
45172 EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS) cohort cohort cohort
45190 DESTRUCTION OF RECTAL TUMOR, ANY METHOD (EG,ELECTRODESICCATION) TRANSANAL APPROACH cohort cohort cohort
45300
PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, WITH OR WITHOUTCOLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) cohort cohort cohort cohort
45303 PROCTOSIGMOIDOSCOPY, RIGID; WITH DILATION, ANY METHOD statewide
45305 PROCTOSIGMOIDOSCOPY, RIGID; WITH BIOPSY, SINGLE ORMULTIPLE cohort cohort cohort cohort
45307 PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF FOREIGN BODY statewide
45308
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLETUMOR,POLYP, OR OTHER LESION BY HOT BIOPSY FORCEP S OR BIPOLAR CAUTERY statewide
45309
PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLETUMOR,POLYP, OR OTHER LESION BY SNARE TECHNIQUE PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLETUMOR, cohort cohort
45317 PROCTOSIGMOIDOSCOPY, RIGID; WITH CONTROL OF BLEEDING, ANYMETHOD statewide
45320
PROCTOSIGMOIDOSCOPY, RIGID; WITH ABLATION OF TUMOR(S),POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE(EG, cohort cohort cohort
45330
SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUTCOLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING(SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
45331
SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLESIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLEOR MULTIPLE cohort cohort cohort cohort cohort
45332
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODYSIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY cohort cohort cohort
45333
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S),POLYP(S),OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY SIGMOIDOSCOPY, FLEXIBLE; WIT H REMOVAL OF TUMOR(S), POLYP(S), cohort cohort
45334
SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING,ANYMETHOD SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY cohort cohort cohort cohort
45335 SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE cohort cohort cohort cohort
45338
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S),POLYP(S),OR OTHER LESION(S) BY SNARE TECHNIQUE S IGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), cohort cohort cohort
45339
SIGMOIDOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S),POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE cohort cohort cohort cohort cohort
45340 SIGMOIDSCOPY, FLEXIBLE; W/DILATION, BALLOON, 1/>STRJUCTURES cohort cohort cohort cohort
45341
SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR W/OUTCOLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) WITH ENDOSCOPIC ULTRASOUND EXAMINATION. cohort cohort cohort cohort cohort
45342 SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE cohort cohort cohort
95
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
NEEDLEASPIRATION/BIOPSY(S)
45378
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE;DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WITH OR WITHOUT COLON DECOMPRESSION cohort cohort cohort cohort cohort cohort
45379
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHREMOVAL OF FOREIGN BODY COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH cohort cohort
45380
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHBIOPSY, SINGLE OR MULTIPLE COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH cohort cohort cohort cohort cohort
45381 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/DIRECTED SUBMUCOSA INJECTION(S), ANY SUBSTANCE cohort cohort cohort cohort cohort
45382
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHCONTROL OF BLEEDING, ANY METHOD COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH cohort cohort cohort cohort cohort
45383
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY cohort cohort cohort cohort cohort
45384
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHREMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY cohort cohort cohort cohort cohort
45385
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITHREMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE cohort cohort cohort cohort cohort
45386 COLONOSCPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE;W/DILATION, BALLOON, 1/>STRICTURES cohort cohort cohort cohort
45387
COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION) statewide
45391 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXUREWITH ENDOSCOPIC ULTRASOUND EXAMINATION cohort cohort cohort cohort
45392
COLONOSPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRASMURAL FINE NEEDLE ASPIRATION/BIOSPY(S) cohort cohort
45400 LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE) statewide
45499 UNLISTED LAPAROSCOPY PROCEDURE, RECTUM statewide
45505 PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE cohort cohort
45541 PROCTOPEXY FOR PROLAPSE; PERINEAL APPROACH statewide
45560 REPAIR OF RECTOCELE (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
45905 *DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE) UNDERANESTHESIA OTHER THAN LOCAL cohort cohort cohort cohort
45910 DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) UNDERANESTHESIA OTHER THAN LOCAL cohort cohort
45915 *REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATEPROCEDURE) UNDER ANESTHESIA cohort cohort cohort cohort
45990 ANORECTAL EXAM, SURGICAL, REQUIRING ANESTHESIA (GENERAL, SPINAL, OR EPIDURAL), DIAGNOSTIC cohort cohort cohort cohort
45999 UNLISTED PROCEDURE, RECTUM cohort cohort cohort cohort
46020 PLACEMENT, SETON cohort cohort cohort cohort cohort cohort
46030 *REMOVAL OF ANAL SETON, OTHER MARKER cohort cohort cohort cohort cohort
46040 INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTALABSCESS (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
46045
INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULARORSUBMUCOSAL ABSCESS, TRANSANAL, UNDER ANESTHESIA cohort cohort
46050 *INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL cohort cohort cohort cohort cohort
46060
INCISION AND DRAINAGE OF ISCHIORECTAL OR INTRAMURAL ABSCESS,WITH FISTULECTOMY OR FISTULOTOMY, SUBMUSCULAR, WITH OR WITHOUT PLACEMENT OF SETON cohort cohort cohort
46080 *SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER cohort cohort cohort cohort cohort
96
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(SEPARATEPROCEDURE)
46083 INCISION OF THROMBOSED HEMORRHOID, EXTERNAL cohort cohort cohort cohort cohort
46200 FISSURECTOMY, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED cohort cohort cohort cohort cohort
46220 EXCISION OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS cohort cohort cohort cohort cohort
46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S) cohort cohort cohort cohort cohort
46230 EXCISION OF MULTIPLE EXTERNAL PAPILLAE OR TAGS, ANUS cohort cohort cohort cohort cohort
46250 HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS cohort cohort cohort cohort
46255 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; cohort cohort cohort cohort cohort
46257 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; WITH FISSURECTOMY cohort cohort cohort cohort
46258
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; WITH FISTULECTOMY, INCLUDING FISSURECTOMY, WHEN PERFORMED cohort cohort cohort cohort
46260 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORECOLUMNS/GROUPS; cohort cohort cohort cohort cohort
46261 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORECOLUMNS/GROUPS; WITH FISSURECTOMY cohort cohort cohort
46262
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORECOLUMNS/GROUPS; WITH FISTULECTOMY, INCLUDING FISS URECTOMY, WHEN PERFORMED cohort cohort
46270 SURGICAL TREATMENT OF ANAL FISTULA(FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS cohort cohort cohort cohort cohort cohort
46275 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); INTERSPHINCTERIC cohort cohort cohort cohort cohort
46280
SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED cohort cohort cohort cohort cohort
46285 SURGICAL TREATMENT OF ANAL FISTULA(FISTULECTOMY/FISTULOTOMY); SECOND STAGE cohort cohort cohort
46288 CLOSURE OF ANAL FISTULA WITH RECTAL ADVANCEMENT FLAP cohort cohort cohort cohort
46320 EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL cohort cohort cohort cohort
46500 *INJECTION OF SCLEROSING SOLUTION, HEMORRHOIDS cohort cohort cohort
46505 CHEMODENERVATION OF INTERNAL ANAL SPHINCTER cohort cohort cohort
46600
ANOSCOPY; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OFSPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
46604 ANOSCOPY; WITH DILATION, ANY METHOD cohort cohort cohort
46606 ANOSCOPY; WITH BIOPSY, SINGLE OR MULTIPLE cohort cohort cohort
46608 ANOSCOPY; WITH REMOVAL OF FOREIGN BODY statewide
46610 ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHERLESION BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY cohort cohort
46612 ANOSCOPY; WITH REMOVAL OF MULTIPLE TUMORS, POLYPS,OR OTHER LESIONS BY HOT BIOPSY TECHNIQUE cohort cohort cohort
46614 ANOSCOPY; WITH CONTROL OF BLEEDING, ANY METHOD cohort cohort
46615
ANOSCOPY; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHERLESION(S) NOT AMENABLE TO BIPOLAR CAUTERY ORSNARE TECHNIQUE cohort cohort cohort
46700 ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; ADULT cohort cohort cohort
46706 REPAIR OF ANAL FISTULA W/FIBRIN GLUE cohort cohort
46750 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; ADULT cohort cohort cohort
46761
SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATORMUSCLE IMBRICATION (PARK POSTERIOR ANAL REPAIR) statewide
46910 *DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, cohort cohort cohort cohort cohort
97
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; ELECTRODESICCATION
46917
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; LASER SURGERY cohort cohort
46922
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION cohort cohort cohort cohort cohort cohort
46924
DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), EXTENSIVE, ANY METHOD cohort cohort cohort cohort
46930 Destruction of internal hemorrhoid(s) by thermal energy (e.g., infrared coagulation, cautery, radiofrequency) cohort cohort cohort
46940
CURETTAGE OR CAUTERIZATION OF ANAL FISSURE, INCLUDINGDILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE); INITIAL cohort cohort
46945 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THANRUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP cohort cohort cohort
46946
HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THANRUBBER BAND; 2 OR MORE HEMORRHOID COLUMNS/GROUPS cohort cohort cohort cohort
46947 HEMORRHOIDOPEXY (EG,FOR PROLAPSING INTERNAL HEMORRHOIDS) BY STAPLING cohort cohort cohort cohort cohort
46999 UNLISTED PROCEDURE, ANUS cohort cohort cohort cohort cohort cohort
47000 *BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS cohort cohort cohort cohort cohort
47001
BIOPSY OF LIVER, NEEDLE; WHEN DONE FOR INDICATED PURPOSE AT TIME OF OTHER MAJOR PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
47011 HEPATOTOMY; FOR PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST, 1 OR 2 STAGES cohort cohort
47100 BIOPSY OF LIVER, WEDGE cohort cohort cohort
47120 HEPATECTOMY, RESECTION OF LIVER; PARTIAL LOBECTOMY statewide
47300 MARSUPIALIZATION OF CYST OR ABSCESS OF LIVER statewide
47350 MANAGEMENT OF LIVER HEMORRHAGE; SIMPLE SUTURE OF LIVER WOUNDOR INJURY statewide
47379 UNLISTED LAPAROSCOPIC PROCEDURE, LIVER cohort cohort cohort cohort cohort
47382 ABLATION, 1 OR MORE LIVER TUMOR(S), PERCUTANEOUS, RADIOFREQUENCY cohort cohort
47399 UNLISTED PROCEDURE, LIVER cohort cohort
47490
Cholecystostomy, percutaneous, complete procedure,including imaging guidance, catheter placement, c holecystogram when performed, and radiological supervision and interpretation statewide
47500
INJECTION PROCEDURE FOR PERCUTANEOUS TRANSHEPATICCHOLANGIOGRAPHY INJECTION PROCEDURE FOR PERCUTANEOUS TRANSHEPATIC cohort cohort
47505
INJECTION PROCEDURE FOR CHOLANGIOGRAPHY THROUGH ANEXISTING CATHETER (EG, PERCUTANEOUS TRANSHEPATIC OR T-TUBE) INJECTION PROCEDURE FOR CHOLANGIOGRAPHY THROUGH AN EXISTING cohort cohort cohort cohort cohort
47510 INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC CATHETERFORBILIARY DRAINAGE statewide
47511 INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC STENT FOR INTERNALAND EXTERNAL BILIARY DRAINAGE statewide
47525 CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER cohort cohort cohort
47550
BILIARY ENDOSCOPY, INTRAOPERATIVE (CHOLEDOCHOSCOPY) (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
47553 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT;WITH BIOPSY, SINGLE OR MULTIPLE statewide
47554 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT;WITH REMOVAL OF STONE(S) statewide
47555 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER cohort cohort
98
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
TRACT;WITH DILATION OF BILIARY DUCT STRICTURE(S)WITHOUT STENT BILIARY ENDOSCOPY, PERCUTANEOUS VI A T-TUBE OR OTHER TRACT;
47556
BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT;WITH DILATION OF BILIARY DUCT STRICTURE(S)WITH STENT BILIARY ENDOSCOPY, PERCUTANEOUS VIA T -TUBE OR OTHER TRACT; statewide
47562 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY cohort cohort cohort cohort cohort cohort
47563 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY cohort cohort cohort cohort cohort
47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT cohort cohort cohort cohort
47579 UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT cohort cohort cohort
47600 CHOLECYSTECTOMY; cohort cohort cohort cohort
47605 CHOLECYSTECTOMY; WITH CHOLANGIOGRAPHY cohort cohort
47610 CHOLECYSTECTOMY WITH EXPLORATION OF COMMON DUCT; statewide
47630 BILIARY DUCT STONE EXTRACTION, PERCUTANEOUS VIA T-TUBETRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQUE) statewide
47765 ANASTOMOSIS, OF INTRAHEPATIC DUCTS AND GASTROINTESTINALTRACT statewide
47801 PLACEMENT OF CHOLEDOCHAL STENT statewide
47999 UNLISTED PROCEDURE, BILIARY TRACT cohort cohort
48102 *BIOPSY OF PANCREAS, PERCUTANEOUS NEEDLE cohort cohort cohort cohort
48999 UNLISTED PROCEDURE, PANCREAS cohort cohort cohort
49000
EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITHORWITHOUT BIOPSY(S) (SEPARATE PROCEDURE) EXPLORA TORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITH OR cohort cohort cohort cohort
49002 REOPENING OF RECENT LAPAROTOMY cohort cohort
49010
EXPLORATION, RETROPERITONEAL AREA WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE) EXPLORATION, RETROPERITONEAL AREA WITH OR WITHOUT BIOPSY(S) statewide
49020 DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS,EXCLUSIVE OF APPENDICEAL ABSCESS; OPEN cohort cohort
49021
DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS,EXCLUSIVE OF APPENDICEAL ABSCESS; PERCUTANEOUS cohort cohort cohort cohort
49061 DRAINAGE OF RETROPERITONEAL ABSCESS; PERCUTANEOUS cohort cohort cohort cohort
49082 ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE cohort cohort cohort cohort cohort
49083 ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITH IMAGING GUIDANCE cohort cohort cohort cohort cohort
49084 PERITONEAL LAVAGE, INCLUDING IMAGING GUIDANCE, WHEN PERFORMED cohort cohort cohort
49180 *BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUSNEEDLE cohort cohort cohort cohort cohort
49203
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal,mesenteric, or retroperitoneal primary or seconda ry tumors; largest tumor 5 cm diameter or less cohort cohort cohort
49204
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal,mesenteric, or retroperitoneal primary or seconda ry tumors; largest tumor 5.1-10.0 cm diameter cohort cohort cohort
49205
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal,mesenteric, or retroperitoneal primary or seconda ry tumors; largest tumor greater than 10.0 diamete cohort cohort cohort
49215 EXCISION OF PRESACRAL OR SACROCOCCYGEAL TUMOR statewide
49250 UMBILECTOMY, OMPHALECTOMY, EXCISION OF UMBILICUS (SEPARATEPROCEDURE) cohort cohort cohort cohort
49255 OMENTECTOMY, EPIPLOECTOMY, RESECTION OF OMENTUM (SEPARATEPROCEDURE) cohort cohort cohort cohort
49320 LAPAROSCOPY, SURGICAL, ABDOMEN, PERITONEUM, AND cohort cohort cohort cohort cohort
99
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OMENTUM; DIAGNOSTIC , WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)
49321 LAPAROSCOPY, SURGICAL, ABDOMEN, PERITONEUM, AND OMENTUM; WITH BIOPSY (SINGLE OR MULTIPLE) cohort cohort cohort cohort cohort
49322
LAPAROSCOPY, SURGICAL, ABDOMEN, PERITONEUM, AND OMENTUM; WITH ASPIRATION OF CAVITY OR CYST (EG, OVARIAN CYST) (SINGLE OR MULTIPLE) cohort cohort cohort cohort cohort
49324 Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter cohort cohort cohort cohort cohort
49325
LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLYPLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED cohort cohort cohort cohort
49326
LAPAROSCOPY, SURGICAL; WITH OMENTOPEXY (OMENTAL TACKING PROCEDURE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
49329
LAPAROSCOPY, SURGICAL, ABDOMEN, PERITONEUM, AND OMENTUM; UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM cohort cohort cohort cohort cohort cohort
49402 REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEALCAVITY cohort cohort cohort
49411
PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PERCUTANEOUS, INTRA-ABDOMINAL, INTRA-PELVIC (EXCEPT PROSTATE), AND/OR RETROPERITONEUM, SINGLE OR M cohort cohort
49418
Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, con cohort cohort cohort cohort
49419 Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable) cohort cohort
49421 Insertion of tunneled intraperitoneal catheter fordialysis, open cohort cohort cohort
49422 Removal of tunneled intraperitoneal catheter cohort cohort cohort cohort cohort
49423
EXCHANGE OF PREVIOUSLY PLACED ABSCESS OR CYST DRAINAGECATHETER UNDER RADIOLOGICAL GUIDANCE (SEPARATEPROCEDURE) cohort cohort cohort cohort
49424 CONTRAST INJECTION FOR ASSESSMENT OF ABSCESS OR CYST VIAPREVIOUSLY PLACED CATHETER (SEPARATE PROCEDURE) cohort cohort cohort cohort
49425 INSERTION OF PERITONEAL-VENOUS SHUNT statewide
49426 REVISION OF PERITONEAL-VENOUS SHUNT statewide
49427
INJECTION PROCEDURE (EG, CONTRAST MEDIA) FOR EVALUATION OFPREVIOUSLY PLACED PERITONEAL-VENOUS SHUNT statewide
49435
INSERTION OF SUBCUTANEOUS EXTENSION TO INTRAPERITONEAL CANNULA OR CATHETER WITH REMOTE CHEST EXIT SITE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
49440
Insertion of gastrostomy tube, percutaneous, underfluoroscopic guidance including contrast injectio n(s), image documentation and report cohort cohort cohort cohort
49441
Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report statewide
49446
Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidanceincluding contrast injection(s), image documentat ion and report cohort cohort
49450
Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report cohort cohort
49451
Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance includingcontrast injection(s), image documentation and re port cohort cohort cohort
49452 Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrastinjection(s), image cohort cohort
100
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
documentation and report
49460
Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic ) tube, anymethod, under fluoroscopic guidance including con statewide
49465
Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including i cohort cohort cohort cohort cohort
49491 REPAIR INIT INGUINAL HERNIA, PRETERM INFANT (BIRTH50 WKS POSTCONCEPT)W/WO HYDROCELECT; REDUCIBLE cohort cohort
49495 REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, WITH OR WITHOUT HYDROCELECTOMY; REDUCIBLE cohort cohort cohort
49496
REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, WITH OR WITHOUT HYDROCELECTOMY; INCARCERATED OR STRANGULATED statewide
49500 REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5YEARS, WITH OR WITHOUT HYDROCELECTOMY; REDUCIBLE cohort cohort cohort cohort
49501
REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5YEARS, WITH OR WITHOUT HYDROCELECTOMY; INCARCERATED OR STRANGULATED cohort cohort cohort
49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER;REDUCIBLE cohort cohort cohort cohort cohort cohort
49507 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER;INCARCERATED OR STRANGULATED cohort cohort cohort cohort cohort cohort
49520 REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE cohort cohort cohort cohort cohort cohort
49521 REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED ORSTRANGULATED cohort cohort cohort cohort cohort
49525 REPAIR INGUINAL HERNIA, SLIDING, ANY AGE cohort cohort cohort cohort cohort
49540 REPAIR LUMBAR HERNIA statewide
49550 REPAIR INITIAL FEMORAL HERNIA, ANY AGE, REDUCIBLE; cohort cohort cohort cohort cohort cohort
49553 REPAIR INITIAL FEMORAL HERNIA, ANY AGE; INCARCERATED ORSTRANGULATED cohort cohort
49560 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE cohort cohort cohort cohort cohort cohort
49561 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED ORSTRANGULATED cohort cohort cohort cohort cohort cohort
49565 REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE cohort cohort cohort cohort cohort
49566 REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED cohort cohort cohort cohort
49568
Implantation of mesh or other prosthesis for open incisional or ventral hernia repari or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for cohort cohort cohort cohort cohort cohort
49570 REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
49572 REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT);INCARCERATED OR STRANGULATED cohort cohort cohort cohort cohort
49580 REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; REDUCIBLE cohort cohort cohort cohort
49582 REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; INCARCERATED OR STRANGULATED statewide
49585 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE cohort cohort cohort cohort cohort cohort
49587 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; INCARCERATEDOR STRANGULATED cohort cohort cohort cohort cohort cohort
49590 REPAIR SPIGELIAN HERNIA cohort cohort
49650 LAPAROSCOPY, SURGICAL; REPAIR INTIAL INQUINAL HERNIA cohort cohort cohort cohort cohort
49651 LAPAROSCOPY, SURGICAL; REPAIR RECURRENT INQUINAL HERNIA cohort cohort cohort cohort cohort cohort
49652 Laparoscopy, surgical repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible cohort cohort cohort cohort cohort cohort
49653
Laparoscopy, surgical repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated cohort cohort cohort cohort cohort cohort
101
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible cohort cohort cohort cohort
49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated cohort cohort cohort cohort cohort cohort
49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible cohort cohort cohort cohort
49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated cohort cohort cohort cohort cohort
49659 UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY cohort cohort cohort cohort cohort
49999 UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM cohort cohort cohort cohort cohort cohort
50021 DRAINAGE OF PERIRENAL OR RENAL ABSCESS; PERCUTANEOUS cohort cohort
50040 NEPHROSTOMY, NEPHROTOMY WITH DRAINAGE cohort cohort
50060 NEPHROLITHOTOMY; REMOVAL OF CALCULUS cohort cohort
50075
NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FILLING RENAL PELVIS AND CALYCES (INCLUDING ANATROPHIC PYELOLITHOTOMY) statewide
50080
PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, WITHOR WITHOUT DILATION, ENDOSCOPY, LITHOTRIPSY, STENTING OR BASKET EXTRACTION; UP TO 2 CM cohort cohort cohort cohort
50081
PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, WITHOR WITHOUT DILATION, ENDOSCOPY, LITHOTRIPSY, STENTING OR BASKET EXTRACTION; OVER 2 CM cohort cohort cohort cohort cohort
50200 *RENAL BIOPSY; PERCUTANEOUS, BY TROCAR OR NEEDLE cohort cohort cohort cohort cohort
50220 NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY APPROACHINCLUDING RIB RESECTION; statewide
50225
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY APPROACHINCLUDING RIB RESECTION; COMPLICATED BECAUSE OF PREVIOUS SURGERY ON SAME KIDNEY statewide
50230
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY APPROACHINCLUDING RIB RESECTION; RADICAL, WITH REGIONAL LYMPHADENECTOMY AND/OR VENA CAVAL THROMBECTOMY statewide
50240 NEPHRECTOMY, PARTIAL statewide
50382
REMOVAL (VIA SNARE/CAPTURE) AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
50384
REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLINGURETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDI NG RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
50385
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation cohort cohort cohort
50386
Removal (via snare/capture) of internally dwellingureteral stent via transurethral approach, withou t use of cystoscopy, including radiological supervision and interpretation cohort cohort
50387
REMOVAL AND REPLACEMENT OF EXTERNALLY ACCESSIBLE TRANSNEPHRIC URETERAL STENT (EG, EXTERNAL/INTERNAL STENT) REQUIRING FLUOROSCOPIC GUIDANCE, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
50389
REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT) cohort cohort cohort
50390 *ASPIRATION AND/OR INJECTION OF RENAL CYST OR PELVIS BYNEEDLE, PERCUTANEOUS cohort cohort cohort cohort
50392 INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS cohort cohort cohort cohort cohort
102
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
50393
INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETERTHROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS cohort cohort cohort cohort cohort
50394
INJECTION PROCEDURE FOR PYELOGRAPHY (AS NEPHROSTOGRAM,PYELOSTOGRAM, ANTEGRADE PYELOURETEROGRAMS) THROUGH NEPHROSTOMY OR PYELOSTOMY TUBE, OR INDWELLING URETERAL cohort cohort cohort cohort
50395
INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITHDILATION TO ESTABLISH NEPHROSTOMY TRACT, PERCUTANEOUS INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH cohort cohort cohort cohort
50398 *CHANGE OF NEPHROSTOMY OR PYELOSTOMY TUBE cohort cohort cohort cohort cohort
50400
PYELOPLASTY (FOLEY Y-PYELOPLASTY), PLASTIC OPERATION ONRENAL PELVIS, WITH OR WITHOUT PLASTIC OPERATION ON URETER, NEPHROPEXY, NEPHROSTOMY, PYELOSTOMY, OR URETERAL SPLINTING; cohort cohort
50542 Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed cohort cohort
50543 LAPAROSCOPY, SURGICAL; PARTIAL NEPHRECTOMY cohort cohort cohort
50544 LAPAROSCOPY, SURGICAL; PYELOPLASTY statewide
50546 LAPAROSCOPY, SURGICAL; NEPHRECTOMY statewide
50548 LAPAROSCOPICALLY ASSISTED NEPHROURETERECTOMY statewide
50549 UNLISTED LAPAROSCOPY PROCEDURE, RENAL statewide
50551
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY ORPYELOSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; statewide
50561
RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY ORPYELOSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH statewide
50570
RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, WITH ORWITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; statewide
50590 LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE cohort cohort cohort cohort cohort
50592 Ablation, one or more renal tumor(s), percutaneous, unilateral, radiofrequency cohort cohort cohort
50593 Ablation, renal tumor(s) unilateral, percutaneous,cryotherapy cohort cohort
50600 URETEROTOMY WITH EXPLORATION OR DRAINAGE (SEPARATEPROCEDURE) cohort cohort
50605 URETEROTOMY FOR INSERTION OF INDWELLING STENT, ALLTYPES statewide
50610 URETEROLITHOTOMY; UPPER ONE-THIRD OF URETER statewide
50684
INJECTION PROCEDURE FOR URETEROGRAPHY OR URETEROPYELOGRAPHY THROUGH URETEROSTOMY OR INDWELLING URETERAL CATHETER statewide
50688 *CHANGE OF URETEROSTOMY TUBE cohort cohort
50690
INJECTION PROCEDURE FOR VISUALIZATION OF ILEAL CONDUITAND/OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE cohort cohort cohort cohort
50700 URETEROPLASTY, PLASTIC OPERATION ON URETER (EG, STRICTURE) statewide
50715 URETEROLYSIS, WITH OR WITHOUT REPOSITIONING OF URETER FORRETROPERITONEAL FIBROSIS cohort cohort
50727 REVISION OF URINARY-CUTANEOUS ANASTOMOSIS (ANY TYPEUROSTOMY); statewide
50780 URETERONEOCYSTOSTOMY; ANASTOMOSIS OF SINGLE URETERTOBLADDER cohort cohort cohort
50782 URETERONEOCYSTOSTOMY; ANASTOMOSIS OF DUPLICATED URETER TOBLADDER cohort cohort
50900 URETERORRHAPHY, SUTURE OF URETER (SEPARATE PROCEDURE) statewide
103
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
50949 UNLISTED LAPAROSCOPY PROCEDURE, URETER cohort cohort cohort cohort cohort
50951
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH ORWITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; statewide
50961
URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH ORWITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;WITH REMOVAL OF FOREIGN cohort cohort cohort
51040 CYSTOSTOMY, CYSTOTOMY WITH DRAINAGE cohort cohort cohort cohort cohort
51050 CYSTOLITHOTOMY, CYSTOTOMY WITH REMOVAL OF CALCULUS, WITHOUT VESICAL NECK RESECTION cohort cohort cohort cohort cohort
51102 Aspiration of bladder; with insertion of suprapubic catheter cohort cohort cohort cohort
51520 CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK (SEPARATEPROCEDURE) statewide
51525 CYSTOTOMY; FOR EXCISION OF BLADDER DIVERTICULUM, SINGLE ORMULTIPLE (SEPARATE PROCEDURE) statewide
51550 CYSTECTOMY, PARTIAL; SIMPLE cohort cohort
51570 CYSTECTOMY, COMPLETE; (SEPARATE PROCEDURE) statewide
51600 *INJECTION PROCEDURE FOR CYSTOGRAPHY OR VOIDINGURETHROCYSTOGRAPHY cohort cohort cohort cohort cohort
51605 INJECTION PROCEDURE AND PLACEMENT OF CHAIN FOR CONTRAST AND/OR CHAIN URETHROCYSTOGRAPHY statewide
51610 INJECTION PROCEDURE FOR RETROGRADE URETHROCYSTOGRAPHY cohort cohort cohort cohort cohort
51700 *BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION cohort cohort cohort cohort cohort
51701 INSERTION, NON-INDWELLING BLADDER CATHETER cohort cohort cohort cohort cohort
51702 INSERTION, TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE cohort cohort cohort cohort cohort
51703 INSERTION, TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED cohort cohort cohort cohort cohort
51705 *CHANGE OF CYSTOSTOMY TUBE; SIMPLE statewide
51710 *CHANGE OF CYSTOSTOMY TUBE; COMPLICATED statewide
51715
ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSALTISSUES OF THE URETHRA AND/OR BLADDER NECK ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL cohort cohort cohort cohort
51720 Bladder instillation of anticarcinogenic agent (including retention time) cohort cohort cohort cohort cohort
51726 COMPLEX CYSTOMETROGRAM (IE, CALIBRATED ELECTRONIC EQUIPMENT); cohort cohort
51727
COMPLEX CYSTOMETROGRAM (IE, CALIBRATED ELECTRONIC EQUIPMENT); WITH URETHRAL PRESSURE PROFILE STUDIES(IE, URETHRAL CLOSURE PRESSURE PROFILE), ANY TECH NIQUE cohort cohort
51728
COMPLEX CYSTOMETROGRAM (IE, CALIBRATED ELECTRONIC EQUIPMENT); WITH VOIDING PRESSURE STUDIES (IE, BLADDER VOIDING PRESSURE), ANY TECHNIQUE cohort cohort
51729
COMPLEX CYSTOMETROGRAM (IE, CALIBRATED ELECTRONIC EQUIPMENT); WITH VOIDING PRESSURE STUDIES (IE, BLADDER VOIDING PRESSURE) AND URETHRAL PRESSURE PROFILE STUDIES (IE, URETHRAL CLOSURE PRESSURE PROFILE) cohort cohort
51736 SIMPLE UROFLOWMETRY (UFR) (EG, STOP-WATCH FLOW RATE,MECHANICAL UROFLOWMETER) statewide
51741 COMPLEX UROFLOWMETRY (EG, CALIBRATED ELECTRONIC EQUIPMENT) cohort cohort cohort
51784 ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRALSPHINCTER, OTHER THAN NEEDLE, ANY TECHNIQUE cohort cohort
51785 NEEDLE ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRALSPHINCTER, ANY TECHNIQUE statewide
51797
VOIDING PRESSURE STUDIES, INTRA-ABDOMINAL (IE, RECTAL, GASTRIC, INTRAPERITONEAL) (LIST SEPARATELY INADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
104
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
51798 MEASUREMENT, POST-VOIDING RESIDUAL URINE &/OR BLADDER CAPACITY, US, NON-IMAGING cohort cohort cohort cohort cohort
51840
ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (EG,MARSHALL-MARCHETTI- KRANTZ, BURCH); SIMPLE ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (EG, cohort cohort cohort cohort
51841
ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (EG,MARSHALL-MARCHETTI-KRANTZ, BURCH); COMPLICATED (EG, SECONDARY REPAIR) statewide
51845
ABDOMINO-VAGINAL VESICAL NECK SUSPENSION, WITH OR WITHOUTENDOSCOPIC CONTROL (EG, STAMEY, RAZ, MODIFIED PEREYRA) cohort cohort
51860 CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE;SIMPLE cohort cohort cohort cohort
51865 CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE;COMPLICATED cohort cohort
51980 CUTANEOUS VESICOSTOMY statewide
51990 LAPAROSCOPY, SURGICAL; URETHRAL SUSPENSION FOR STRESS INCONTINENCE statewide
51992 LAPAROSCOPY, SURGICAL; SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC) cohort cohort cohort cohort cohort
51999 UNLISTED LAPAROSCOPY PROCEDURE, BLADDER cohort cohort
52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE)CYSTOURETHROSCOPY (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
52001 CYSTOURETHROSCOPY W/IRRIGATON & EVACUATON CLOTS cohort cohort cohort
52005
CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, WITH ORWITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; cohort cohort cohort cohort cohort
52007
CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, WITH ORWITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH BRUSH BIOPSY OF URETER cohort cohort
52204 Cystourethroscopy, with biopsy(s) cohort cohort cohort cohort cohort
52214
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERYOR LASER SURGERY) OF TRIGONE, BLADDER NECK, PROSTATIC FOSSA, URETHRA, OR PERIURETHRAL GLANDS cohort cohort cohort cohort
52224
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERYOR LASER SURGERY) OR TREATMENT OF MINOR (LESS THAN 0.5 CM) LESION(S) WITH OR WITHOUT BIOPSY cohort cohort cohort cohort cohort
52234
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERYOR LASER SURGERY) AND/OR RESECTION OF; SMALL BLADDER TUMOR(S) (0.5 TO 2.0 CM) cohort cohort cohort cohort cohort
52235
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERYOR LASER SURGERY) AND/OR RESECTION OF; MEDIUM BLADDER TUMOR(S) (2.0 TO 5.0 CM) cohort cohort cohort cohort cohort
52240
CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERYOR LASER SURGERY) AND/OR RESECTION OF; LARGE BLADDER TUMOR(S) cohort cohort cohort cohort
52250
CYSTOURETHROSCOPY WITH INSERTION OF RADIOACTIVE SUBSTANCE,WITH OR WITHOUT BIOPSY OR FULGURATION CYSTOURETHROSCOPY WITH INSERTION OF RADIOACTIVE SUBSTANCE, cohort cohort
52260
CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIALCYSTITIS; GENERAL OR CONDUCTION (SPINAL)ANESTHESIA CYSTOURETHROSCOPY, WITH DILATION OF B LADDER FOR INTERSTITIAL cohort cohort cohort cohort cohort
52265
CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIALCYSTITIS; LOCAL ANESTHESIA CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL cohort cohort
52270
CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; FEMALECYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; FEMALE statewide
52275 CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; cohort cohort cohort
105
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MALECYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE
52276
CYSTOURETHROSCOPY WITH DIRECT VISION INTERNAL URETHROTOMYCYSTOURETHROSCOPY WITH DIRECT VISION INTERNAL URETHROTOMY cohort cohort cohort cohort cohort
52281
CYSTOURETHROSCOPY, WITH CALIBRATION AND/OR DILATION OFURETHRAL STRICTURE OR STENOSIS, WITH OR WITHOUT MEATOTOMY, WITH OR WITHOUT INJECTION PROCEDURE FOR CYSTOGRAPHY, MALE OR cohort cohort cohort cohort cohort
52282 CYSTOURETHROSCOPY, WITH INSERTION OF PERMANENT URETHRAL STENT cohort cohort cohort cohort
52283
CYSTOURETHROSCOPY, WITH STEROID INJECTION INTO STRICTURECYSTOURETHROSCOPY, WITH STEROID INJECTION INTO STRICTURE statewide
52287 CYSTOURETHROSCOPY, WITH INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER cohort cohort cohort cohort
52290
CYSTOURETHROSCOPY; WITH URETERAL MEATOTOMY, UNILATERAL ORBILATERAL CYSTOURETHROSCOPY; WITH URETERALMEATOTOMY, UNILATERAL OR cohort cohort cohort
52300
CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OFORTHOTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF statewide
52301
CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ECTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ECTOPIC cohort cohort
52305 CYSTOURETHROSCOPY; WITH INCISION OR RESECTION OF ORIFICE OF BLADDER DIVERTICULUM, SINGLE OR MULTIPLE statewide
52310
CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS,OR URETERAL STENT FROM URETHRA OR BLADDER (SEPARATE PROCEDURE); SIMPLE cohort cohort cohort cohort cohort
52315
CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS,OR URETERAL STENT FROM URETHRA OR BLADDER (SEPARATE PROCEDURE); COMPLICATED cohort cohort cohort cohort
52317
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUSBY ANYMEANS IN BLADDER AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM) cohort cohort cohort cohort cohort
52318
LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUSBY ANYMEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM) cohort cohort cohort cohort
52320
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITHREMOVAL OF URETERAL CALCULUS CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH cohort cohort cohort cohort cohort
52325
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITHFRAGMENTATION OF URETERAL CALCULUS (EG, ULTRASONIC OR ELECTRO-HYDRAULIC TECHNIQUE) cohort cohort cohort cohort
52327
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITHSUBURETERIC INJECTION OF IMPLANT MATERIAL CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH cohort cohort cohort cohort
52330
CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITHMANIPULATION, WITHOUT REMOVAL OF URETERAL CALCULUS CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH cohort cohort cohort cohort cohort
52332
CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERALSTENT (EG, GIBBONS OR DOUBLE-J TYPE) CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERAL cohort cohort cohort cohort cohort
52334
CYSTOURETHROSCOPY WITH INSERTION OF URETERAL GUIDEWIRETHROUGH KIDNEY TO ESTABLISH A PERCUTANEOUS NE PHROSTOMY, RETROGRADE statewide
52341 CYSTOURETHROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILATION, LASER, cohort cohort cohort cohort cohort
106
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ELECTROCAUTERY, AND INCISION)
52342
CYSTOURETHROSCOPY; WITH TREATMENT OF URETEROPELVICJUNCTION STRICTURE (EG, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION) cohort cohort
52344
CYSTOURETHROSCOPY WITH URETEROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILATION, LASER ELECTROCAUTERY, AND INCISION) cohort cohort cohort cohort cohort
52345
CYSTOURETHROSCOPY WITH URETEROSCOPY; WITH TREATMENT OF URETEROPELVIC JUNCTURE STRICTURE (EG, BALLOONDILATER ELECTROCAUTERY, AND INCISION) cohort cohort cohort cohort
52351 CYSTOURETHROSCOPY WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC cohort cohort cohort cohort cohort
52352
CYSTOURETHROSCOPY WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH REMOVAL OR MANIPULATION OR CALCULUS (URETERAL CATHETERIZATION IS INCLUDED) cohort cohort cohort cohort cohort
52353
CYSTOURETHROSCOPY WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH LITHROTIPSY (URETERAL CATHETERIZATION ISINCLUDED) cohort cohort cohort cohort cohort
52354 CYSTOURETHROSCOPY WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH BIOPSY AND/OR FULGURATION OF LESION cohort cohort cohort cohort
52450 TRANSURETHRAL INCISION OF PROSTATETRANSURETHRAL INCISION OF PROSTATE cohort cohort cohort
52500
TRANSURETHRAL RESECTION OF BLADDER NECK (SEPARATE PROCEDURE)TRANSURETHRAL RESECTION OF BLADDER NECK (SEPARATE PROCEDURE) cohort cohort cohort cohort
52601
TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE,INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL cohort cohort cohort cohort cohort
52630
Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/o cohort cohort cohort cohort
52640
TRANSURETHRAL RESECTION; OF POSTOPERATIVE BLADDER NECKCONTRACTURE TRANSURETHRAL RESECTION; OF POSTOPERATIVE BLADDER NECK cohort cohort cohort cohort
52648
CONTACT LASER VAPORIZATION WITH OR WITHOUT TRANSURETHRALRESECTION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, cohort cohort cohort cohort cohort
52649
Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal uret cohort cohort cohort
53010 URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE PROCEDURE); PERINEAL URETHRA, EXTERNAL statewide
53020 MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE);EXCEPTINFANT cohort cohort cohort
53060 DRAINAGE OF SKENE'S GLAND ABSCESS OR CYST statewide
53200 BIOPSY OF URETHRA cohort cohort
53210 URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; FEMALE statewide
53230 EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE);FEMALE cohort cohort cohort cohort
53260 EXCISION OR FULGURATION; URETHRAL POLYP(S), DISTALURETHRA statewide
53265 EXCISION OR FULGURATION; URETHRAL CARUNCLE statewide
53270 EXCISION OR FULGURATION; SKENE'S GLANDS statewide
53400 URETHROPLASTY; FIRST STAGE, FOR FISTULA, DIVERTICULUM, ORSTRICTURE (EG, JOHANNSEN TYPE) statewide
53410 URETHROPLASTY, ONE-STAGE RECONSTRUCTION OF MALE ANTERIORURETHRA cohort cohort cohort
53420 URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OFPROSTATIC OR MEMBRANOUS URETHRA; FIRST STAGE statewide
53430 URETHROPLASTY, RECONSTRUCTION OF FEMALE URETHRA cohort cohort
107
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
53440
OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE, WITH OR WITHOUT INTRODUCTION OF PROSTHESIS OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE, WITH cohort cohort cohort cohort cohort
53445
OPERATION FOR CORRECTION OF URINARY INCONTINENCE WITHPLACEMENT OF INFLATABLE URETHRAL OR BLADDER NECK SPHINCTER, INCLUDING PLACEMENT OF PUMP AND/OR RESERVOIR cohort cohort cohort
53446 REMOVAL, INFLATABLE URETHRAL/BLADDER NECK SPHINCTER W/PUMP/RESERVOIR/CUFF cohort cohort
53447
REMOVAL, REPAIR OR REPLACEMENT OF INFLATABLE SPHINCTERINCLUDING PUMP AND/OR RESERVOIR AND/OR CUFF REMOVAL, REPAIR OR REPLACEMENT OF INFLATABLE SPHINCTER cohort cohort
53450 URETHROMEATOPLASTY, WITH MUCOSAL ADVANCEMENT cohort cohort cohort
53460 URETHROMEATOPLASTY, WITH PARTIAL EXCISION OF DISTAL URETHRALSEGMENT (RICHARDSON TYPE PROCEDURE) cohort cohort
53500
URETHROLYSIS TRANSVAGINAL SECONDARY OPEN INCLUDINGCYSTOURETHROSCOPY (EG POSTSURGICAL OBSTRUCTION SCARRING) cohort cohort cohort cohort cohort
53502 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY, FEMALE statewide
53505 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PENILE statewide
53520 CLOSURE OF URETHROSTOMY OR URETHROCUTANEOUS FISTULA, MALE(SEPARATE PROCEDURE) cohort cohort cohort
53600
*DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND ORURETHRAL DILATOR, MALE; INITIAL *DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR cohort cohort
53605
DILATION OF URETHRAL STRICTURE OR VESICAL NECK BY PASSAGE OFSOUND OR URETHRAL DILATOR, MALE, GENERALOR CONDUCTION (SPINAL) ANESTHESIA statewide
53620
*DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM ANDFOLLOWER, MALE; INITIAL *DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM AND statewide
53665
DILATION OF FEMALE URETHRA, GENERAL OR CONDUCTION (SPINAL)ANESTHESIA DILATION OF FEMALE URETHRA, GENERAL OR CONDUCTION (SPINAL) statewide
53855 INSERTION OF A TEMPORARY PROSTATIC URETHRAL STENT,INCLUDING URETHRAL MEASUREMENT statewide
53899 UNLISTED PROCEDURE, URINARY SYSTEMUNLISTED PROCEDURE, URINARY SYSTEM cohort cohort cohort cohort cohort
54000 SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE);NEWBORN statewide
54001 SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE);EXCEPT NEWBORN cohort cohort
54050
*DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; CHEMICAL *DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, statewide
54055
*DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; ELECTRODESICCATION statewide
54057
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; LASER SURGERY cohort cohort cohort cohort
54060
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION cohort cohort
54065
DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA,MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), EXTENSIVE, ANY METHOD cohort cohort cohort
54100 BIOPSY OF PENIS; CUTANEOUS (SEPARATE PROCEDURE) cohort cohort cohort
54111 EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITHGRAFT statewide
108
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
TO 5 CM IN LENGTH EXCISION OF PENILE PLAQU E (PEYRONIE DISEASE); WITH GRAFT TO
54112
EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITHGRAFTGREATER THAN 5 CM IN LENGTH EXCISION OF PEN ILE PLAQUE (PEYRONIE DISEASE); WITH GRAFT statewide
54120 AMPUTATION OF PENIS; PARTIAL statewide
54125 AMPUTATION OF PENIS; COMPLETE statewide
54150 Circumcision, using clamp or other device with regional dorsal penile or ring block cohort cohort cohort cohort
54160 Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days or less) cohort cohort
54161 CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; OLDER THAN 28 DAYS OF AGE cohort cohort cohort cohort cohort
54162 LYSIS/EXCISION, PENILE POSTCIRCUMCISION ADHESIONS cohort cohort cohort cohort cohort
54163 REPAIR, INCOMPLETE CIRCUMCISION cohort cohort cohort cohort cohort
54164 FRENULOTOMY, PENIS cohort cohort
54200 *INJECTION PROCEDURE FOR PEYRONIE DISEASE; cohort cohort
54220 IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM cohort cohort cohort cohort
54235 INJECTION OF CORPORA CAVERNOSA WITH PHARMACOLOGIC AGENT(S)(EG, PAPAVERINE, PHENTOLAMINE) cohort cohort
54300
PLASTIC OPERATION OF PENIS FOR STRAIGHTENING OF CHORDEE (EG,HYPOSPADIAS), WITH OR WITHOUT MOBILIZATION OF URETHRA cohort cohort cohort
54304
PLASTIC OPERATION ON PENIS FOR CORRECTION OF CHORDEE OR FOR FIRST STAGE HYPOSPADIAS REPAIR WITH OR WITHOUT TRANSPLANTATION OF PREPUCE AND/OR SKIN FLAPS cohort cohort cohort
54308 URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDINGURINARY DIVERSION); LESS THAN 3 CM statewide
54312 URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDINGURINARY DIVERSION); GREATER THAN 3 CM statewide
54322
1-STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUTCHORDEE OR CIRCUMCISION); WITH SIMPLE MEATAL ADVA NCEMENT (EG, MAGPI, V-FLAP) cohort cohort cohort
54324
1-STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUTCHORDEE OR CIRCUMCISION); WITH URETHROPLASTY BY L OCAL SKIN FLAPS (EG, FLIP-FLAP, PREPUCIAL FLAP) cohort cohort cohort
54326
1-STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUTCHORDEE OR CIRCUMCISION); WITH URETHROPLASTY BY L OCAL SKIN FLAPS AND MOBILIZATION OF URETHRA statewide
54328
1-STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUTCHORDEE OR CIRCUMCISION); WITH EXTENSIVE DISSECTI ON TO CORRECT CHORDEE AND URETHROPLASTY WITH LOCALSKIN FLAPS, SKIN GRAFT PATCH, AND/OR ISLAND FLAP cohort cohort
54332
1-STAGE PROXIMAL PENILE OR PENOSCROTAL HYPOSPADIASREPAIR REQUIRING EXTENSIVE DISSECTION TO CORRECT CHORDEE AND URETHROPLASTY BY USE OF SKIN GRAFT TUBE AND/OR ISLAND FLAP cohort cohort cohort
54340
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE,DIVERTICULA); BY CLOSURE, INCISION, OR EXCISION, SIMPLE statewide
54344
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE,DIVERTICULA); REQUIRING MOBILIZATION OF SKIN FLAPS AND URETHROPLASTY WITH FLAP OR PATCH GRAFT statewide
54348
REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE,DIVERTICULA); REQUIRING EXTENSIVE DISSECTION AND URETHROPLASTY WITH FLAP, PATCH OR TUBED GRAFT (INCLUDES statewide
54360 PLASTIC OPERATION ON PENIS TO CORRECT ANGULATION cohort cohort
54380 PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNALSPHINCTER; statewide
54401 INSERTION OF PENILE PROSTHESIS; INFLATABLE (SELF- cohort cohort cohort cohort cohort
109
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
CONTAINED)
54405
INSERTION OF INFLATABLE (MULTI-COMPONENT) PENILE PROSTHESIS,INCLUDING PLACEMENT OF PUMP, CYLINDERS, AND/OR RESERVOIR cohort cohort cohort cohort
54408 REPAIR COMPONENTS(S) MULTICOMPONENT, INFLATABLE PENILE PROSTHESIS statewide
54410 REMOVAL & REPLACEMENT, MULTICOMPONENT INFLATABLE PENILE PROSTHESIS, SAME SESSION statewide
54411 REMOVAL & REPLACEMENT, MULTICOMPONENT INFLATABLE PENILE PROSTHESIS, INFECTED, W/IRRIG & DEBRIDE cohort cohort
54416 REMOVAL & REPLACEMENT, NONINFLATABLE (SEMI-RIGID)/INFLATABLE (SELF-CONTAINED) PENILE PROSTHESIS statewide
54440 PLASTIC OPERATION OF PENIS FOR INJURY cohort cohort
54450 FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIALADHESIONSAND STRETCHING cohort cohort cohort
54500 BIOPSY OF TESTIS, NEEDLE (SEPARATE PROCEDURE) statewide
54505 BIOPSY OF TESTIS, INCISIONAL (SEPARATE PROCEDURE) cohort cohort cohort
54512 EXCISION OF EXTRAPARENCHYMAL LESION OF TESTIS cohort cohort cohort cohort
54520
ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), WITH OR WITHOUTTESTICULAR PROSTHESIS, SCROTAL OR INGUINAL APPROACH cohort cohort cohort cohort cohort
54522 ORCHIECTOMY, PARTIAL cohort cohort
54530 ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH cohort cohort cohort cohort cohort
54550 EXPLORATION FOR UNDESCENDED TESTIS (INGUINAL OR SCROTALAREA) statewide
54600 REDUCTION OF TORSION OF TESTIS, SURGICAL, WITH OR WITHOUTFIXATION OF CONTRALATERAL TESTIS cohort cohort cohort cohort cohort
54620 FIXATION OF CONTRALATERAL TESTIS (SEPARATE PROCEDURE) cohort cohort cohort
54640 ORCHIOPEXY, INGUINAL APPROACH, WITH OR WITHOUT HERNIA REPAIR cohort cohort cohort cohort cohort
54650 ORCHIOPEXY, ABDOMINAL APPROACH, FOR INTRA-ABDOMINAL TESTIS(EG, FOWLER-STEPHENS) statewide
54660 INSERTION OF TESTICULAR PROSTHESIS (SEPARATE PROCEDURE) statewide
54670 SUTURE OR REPAIR OF TESTICULAR INJURY cohort cohort cohort
54690 LAPAROSCOPY, SURGICAL;ORCHIECTOMY cohort cohort
54692 LAPAROSCOPY, SURGICAL;ORCHIOPEXY FOR INTRA- ABDOMINAL TESTIS statewide
54700 INCISION AND DRAINAGE OF EPIDIDYMIS, TESTIS AND/ORSCROTALSPACE (EG, ABSCESS OR HEMATOMA) cohort cohort cohort cohort cohort
54830 EXCISION OF LOCAL LESION OF EPIDIDYMIS cohort cohort cohort cohort cohort
54840 EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY cohort cohort cohort cohort cohort
54860 EPIDIDYMECTOMY; UNILATERAL cohort cohort cohort cohort
55000 *PUNCTURE ASPIRATION OF HYDROCELE, TUNICA VAGINALIS, WITH ORWITHOUT INJECTION OF MEDICATION cohort cohort cohort cohort
55040 EXCISION OF HYDROCELE; UNILATERAL cohort cohort cohort cohort cohort
55041 EXCISION OF HYDROCELE; BILATERAL cohort cohort cohort cohort
55060 REPAIR OF TUNICA VAGINALIS HYDROCELE (BOTTLE TYPE) cohort cohort cohort cohort
55100 *DRAINAGE OF SCROTAL WALL ABSCESS cohort cohort cohort cohort
55110 SCROTAL EXPLORATION statewide
55120 REMOVAL OF FOREIGN BODY IN SCROTUM statewide
55150 RESECTION OF SCROTUM cohort cohort
55175 SCROTOPLASTY; SIMPLE cohort cohort cohort cohort
55180 SCROTOPLASTY; COMPLICATED cohort cohort
55250
VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE),INCLUDING POSTOPERATIVE SEMEN EXAMINATION(S) cohort cohort cohort cohort cohort
110
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
55400 VASOVASOSTOMY, VASOVASORRHAPHY statewide
55500 EXCISION OF HYDROCELE OF SPERMATIC CORD, UNILATERAL(SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
55520 EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort cohort
55530 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FORVARICOCELE; (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
55535 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FORVARICOCELE; ABDOMINAL APPROACH cohort cohort cohort cohort
55540 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FORVARICOCELE; WITH HERNIA REPAIR statewide
55550 LAPAROSCOPY, SURGICAL, WITH LIGATION OF SPERMATIC VEINS FOR VARICOCELE cohort cohort cohort cohort
55559 UNLISTED LAPAROSCOPY PROCEDURE, SPERMATIC CORD cohort cohort cohort
55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANYAPPROACH cohort cohort cohort cohort cohort
55706 Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance statewide
55840 PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUTNERVESPARING; statewide
55842
PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUTNERVESPARING; WITH LYMPH NODE BIOPSY(S) (LIMITED PELVIC LYMPHADENECTOMY) cohort cohort
55845
PROSTATECTOMY, RETROPUBIC RADICAL, WITH OR WITHOUTNERVESPARING; WITH BILATERAL PELVIC LYMPHADENECTO MY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC AND OBTURATOR NODES cohort cohort
55866 Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed cohort cohort cohort cohort
55873 CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING) cohort cohort cohort
55875
TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY cohort cohort cohort cohort
55876
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple cohort cohort cohort cohort
55899 UNLISTED PROCEDURE, MALE GENITAL SYSTEM cohort cohort cohort cohort
55920 Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application statewide
56405 *INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS cohort cohort cohort cohort cohort
56420 *INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS cohort cohort cohort cohort cohort
56440 MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST cohort cohort cohort cohort
56441 LYSIS OF LABIAL ADHESIONS cohort cohort cohort
56442 HYMENOTOMY, SIMPLE INCISION statewide
56501
DESTRUCTION OF LESION(S), VULVA; SIMPLE, ANY METHODDESTRUCTION OF LESION(S), VULVA; SIMPLE, ANY METHOD cohort cohort cohort cohort
56515
DESTRUCTION OF LESION(S), VULVA; EXTENSIVE, ANY METHODDESTRUCTION OF LESION(S), VULVA; EXTENSIVE, ANY METHOD cohort cohort cohort cohort
56605 BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION cohort cohort cohort cohort cohort
56606
*BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE);EACHSEPARATE ADDITIONAL LESION (LIST SEPARATELY I N ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
56620 VULVECTOMY SIMPLE; PARTIAL cohort cohort cohort cohort cohort
56625 VULVECTOMY SIMPLE; COMPLETE cohort cohort cohort
56630 VULVECTOMY, RADICAL, PARTIAL; cohort cohort
56700 PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING cohort cohort cohort cohort
111
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
56740 EXCISION OF BARTHOLIN'S GLAND OR CYST cohort cohort cohort cohort
56800 PLASTIC REPAIR OF INTROITUS cohort cohort cohort
56810 PERINEOPLASTY, REPAIR OF PERINEUM, NON-OBSTETRICAL(SEPARATEPROCEDURE) cohort cohort cohort cohort
56820 COLPOSCOPY, VULVA cohort cohort cohort
56821 COLPOSCOPY, VULVA; W/BIOPSY(S) cohort cohort cohort
57000 COLPOTOMY; WITH EXPLORATION cohort cohort cohort cohort cohort
57010 COLPOTOMY; WITH DRAINAGE OF PELVIC ABSCESS statewide
57023 INCISION AND DRAINAGE OF VAGINAL HEMATOMA; NON-OBSTETRICAL (EG, POST-TRAUMA, SPONTANEOUS BLEEDING) cohort cohort
57061
DESTRUCTION OF VAGINAL LESION(S); SIMPLE, ANY METHODDESTRUCTION OF VAGINAL LESION(S); SIMPLE, ANY METHOD cohort cohort cohort cohort cohort
57065
DESTRUCTION OF VAGINAL LESION(S); EXTENSIVE, ANY METHODDESTRUCTION OF VAGINAL LESION(S); EXTENSIVE, ANY METHOD cohort cohort cohort cohort
57100 *BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE) cohort cohort cohort cohort
57105 BIOPSY OF VAGINAL MUCOSA; EXTENSIVE, REQUIRING SUTURE(INCLUDING CYSTS) statewide
57106 VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL; cohort cohort cohort
57120 COLPOCLEISIS (LE FORT TYPE) cohort cohort
57130 EXCISION OF VAGINAL SEPTUM cohort cohort cohort
57135 EXCISION OF VAGINAL CYST OR TUMOR cohort cohort cohort cohort cohort
57155 Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy cohort cohort
57156 Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy cohort cohort
57160 *FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGINALSUPPORT DEVICE cohort cohort
57180
INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUSOR TRAUMATIC NONOBSTETRICAL VAGINAL HEMORRHAGE (SEPARATE PROCEDURE) statewide
57200
COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL)COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL) cohort cohort cohort cohort cohort
57210
COLPOPERINEORRHAPHY, SUTURE OF INJURY OF VAGINA AND/ORPERINEUM (NONOBSTETRICAL) COLPOPERINEORRHAPHY, SUTURE OF INJURY OF VAGINA AND/OR cohort cohort cohort
57220
PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH(EG, KELLY URETHRAL PLICATION) PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH cohort cohort
57240
ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCELE WITH ORWITHOUTREPAIR OF URETHROCELE ANTERIOR COLPORRHAP HY, REPAIR OF CYSTOCELE WITH OR WITHOUT cohort cohort cohort cohort cohort
57250
POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE WITH OR WITHOUT PERINEORRHAPHY POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE WITH OR WITHOUT cohort cohort cohort cohort cohort
57260 COMBINED ANTEROPOSTERIOR COLPORRHAPHY;COMBINED ANTEROPOSTERIOR COLPORRHAPHY; cohort cohort cohort cohort cohort
57265
COMBINED ANTEROPOSTERIOR COLPORRHAPHY; WITH ENTEROCELEREPAIR COMBINED ANTEROPOSTERIOR COLPORRHAPHY;WITH ENTEROCELE cohort cohort cohort cohort
57267 INSERT MESH/PELVIC FLR ADDON cohort cohort cohort cohort cohort
57268 REPAIR OF ENTEROCELE, VAGINAL APPROACH (SEPARATE PROCEDURE) cohort cohort cohort cohort
57270 REPAIR OF ENTEROCELE, ABDOMINAL APPROACH (SEPARATEPROCEDURE) cohort cohort
57280 COLPOPEXY, ABDOMINAL APPROACHCOLPOPEXY, ABDOMINAL APPROACH cohort cohort cohort
112
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
57282 SACROSPINOUS LIGAMENT FIXATION FOR PROLAPSE OF VAGINA cohort cohort cohort cohort cohort
57283 COLPOPEXY, INTRAPERITONEAL cohort cohort cohort cohort cohort
57284 Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach statewide
57285 Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach cohort cohort cohort
57287 REMOVAL OR REVISION OF SLING FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC) cohort cohort cohort cohort cohort
57288
SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA ORSYNTHETIC) SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR cohort cohort cohort cohort cohort
57289
PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHYPEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY statewide
57295 REVISION (INCLUDING REMOVAL) OF PROSTHETIC VAGINALGRAFT, VAGINAL APPROACH cohort cohort cohort cohort cohort
57300 CLOSURE OF RECTOVAGINAL FISTULA; VAGINAL OR TRANSANALAPPROACH cohort cohort cohort cohort cohort
57308
CLOSURE OF RECTOVAGINAL FISTULA; TRANSPERINEAL APPROACH,WITH PERINEAL BODY RECONSTRUCTION, WITH OR WITHOUT LEVATOR PLICATION statewide
57310 CLOSURE OF URETHROVAGINAL FISTULA; statewide
57320 CLOSURE OF VESICOVAGINAL FISTULA; VAGINAL APPROACH cohort cohort
57330 CLOSURE OF VESICOVAGINAL FISTULA; TRANSVESICAL ANDVAGINALAPPROACH statewide
57400 Dilation of vagina under anesthesia (other than local) cohort cohort
57410 Pelvic examination under anesthesia (other than local) cohort cohort cohort cohort
57415 Removal of impacted vaginal foreign body (separateprocedure) under anesthesia (other than local) cohort cohort cohort
57420 COLPOSCOPY ENTIRE VAGINA, W/CERVIX IF PRESENT cohort cohort cohort
57421 COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT; W/BIOPSY (S) cohort cohort cohort cohort
57425 LAPAROSCOPY SURGICAL COLPOPEXY (SUSPENSION OF VAGINAL APEX) cohort cohort cohort cohort cohort
57426 REVISION (INCLUDING REMOVAL) OF PROSTHETIC VAGINALGRAFT, LAPAROSCOPIC APPROACH statewide
57452 *COLPOSCOPY (VAGINOSCOPY); (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
57454 *COLPOSCOPY (VAGINOSCOPY); WITH BIOPSY(S) OF THE CERVIXAND/OR ENDOCERVICAL CURETTAGE cohort cohort cohort cohort cohort
57455 COLPOSCOPY, CERVIX W/UPPER ADJACENT VAGINA; W/BIOPSY (S), CERVIX cohort cohort cohort
57456 COLPOSCOPY, CERVIX W/UPPER ADJACENT VAGINA; W/ENDOCERVICAL CURETTAGE cohort cohort cohort cohort
57460 COLPOSCOPY (VAGINOSCOPY); WITH LOOP ELECTRODE EXCISIONPROCEDURE OF THE CERVIX cohort cohort cohort cohort cohort
57461 COLPOSCOPY CERVIX W/UPPER ADJACENT VAGINA; W/LOOP ELECTRODE CONIZATION CERVIX cohort cohort cohort cohort cohort
57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) cohort cohort cohort cohort cohort
57505 ENDOCERVICAL CURETTAGE (NOT DONE AS PART OF A DILATION ANDCURETTAGE) cohort cohort cohort cohort cohort
57510 CAUTERIZATION OF CERVIX; ELECTRO OR THERMAL cohort cohort
57511 *CAUTERIZATION OF CERVIX; CRYOCAUTERY, INITIAL OR REPEAT statewide
57513 CAUTERIZATION OF CERVIX; LASER ABLATION cohort cohort cohort
57520
CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION,WITH ORWITHOUT DILATION AND CURETTAGE, WITH OR WI THOUT REPAIR; COLD KNIFE OR LASER cohort cohort cohort cohort
57522 CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION,WITH ORWITHOUT DILATION AND CURETTAGE, WITH OR WI THOUT cohort cohort cohort cohort
113
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
REPAIR; LOOP ELECTRODE EXCISION
57530 TRACHELECTOMY (CERVICECTOMY), AMPUTATION OF CERVIX(SEPARATEPROCEDURE) cohort cohort cohort cohort
57531
RADICAL TRACHELECTOMY, WITH BILATERAL TOTAL PELVICLYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING BIOPSY, WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL statewide
57550 EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; statewide
57556 EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITHREPAIR OFENTEROCELE statewide
57700 CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL cohort cohort
57720 TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX,VAGINALAPPROACH cohort cohort cohort cohort
57800 *DILATION OF CERVICAL CANAL, INSTRUMENTAL (SEPARATEPROCEDURE) cohort cohort cohort cohort
58100
*ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT CERVICAL DILATION, ANY METHOD (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
58110
ENDOMETRIAL SAMPLING (BIOPSY) PERFORMED IN CONJUNCTION WITH COLPOSCOPY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
58120 DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC(NONOBSTETRICAL) cohort cohort cohort cohort cohort
58140
MYOMECTOMY, EXCISION OF FIBROID TUMOR OF UTERUS, SINGLE ORMULTIPLE (SEPARATE PROCEDURE); ABDOMINAL APPROACH cohort cohort cohort cohort cohort
58145
MYOMECTOMY, EXCISION OF FIBROID TUMOR OF UTERUS, SINGLE ORMULTIPLE (SEPARATE PROCEDURE); VAGINAL APPROACH cohort cohort cohort cohort
58146 MYOMECTOMY 5/>INTRAMURAL MYOMAS &/OR TOTAL WT>250 GMS,ABDOMINAL APPROACH cohort cohort cohort cohort
58150
TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND CERVIX), WITH ORWITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUTREMOVAL OF OVARY(S); cohort cohort cohort cohort
58180
SUPRACERVICAL ABDOMINAL HYSTERECTOMY (SUBTOTALHYSTERECTOMY), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR WITHOUT REMOVAL OF OVARY(S) cohort cohort cohort
58200
TOTAL ABDOMINAL HYSTERECTOMY, INCLUDING PARTIAL VAGINECTOMY,WITH PARA-AORTIC AND PELVIC LYMPH NODE SAMPLING, WITH OR WITHOUT REMOVAL OF TUBE(S), WITHOR WITHOUT REMOVAL OF statewide
58210
RADICAL ABDOMINAL HYSTERECTOMY, WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY), WITH OR WITHOUT REMOVAL OF TUBE(S), WITH OR statewide
58260 VAGINAL HYSTERECTOMY; cohort cohort cohort cohort cohort
58262 VAGINAL HYSTERECTOMY; WITH REMOVAL OF TUBE(S), AND/OROVARY(S) cohort cohort cohort cohort cohort
58263 VAGINAL HYSTERECTOMY; WITH REMOVAL OF TUBE(S), AND/OROVARY(S), WITH REPAIR OF ENTEROCELE cohort cohort cohort cohort
58267
VAGINAL HYSTERECTOMY; WITH COLPO-URETHROCYSTOPEXY(MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE, WITHOR WITHOUT ENDOSCOPIC CONTROL) cohort cohort
58270 VAGINAL HYSTERECTOMY; WITH REPAIR OF ENTEROCELE cohort cohort cohort cohort
58275 VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL COLPECTOMY; statewide
58280 VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL COLPECTOMY; WITHREPAIR OF ENTEROCELE cohort cohort
58290 VAGINAL HYSTERECTOMY, UTERUS >250GMS; cohort cohort cohort cohort
58291 VAGINAL HYSTERECTOMY UTERUS >250 GMS; W/REMOVAL, TUBE(S) &/OR OVARY(S) cohort cohort cohort
58292 VAGINAL HYSTERECTOMY UTERUS >250GMS; W/REMOVAL, TUBE(S) &/OR OVARY(S) W/REPAIR OF ENTEROCELE statewide
114
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
58294 VAGINAL HYSTERECTOMY UTERUS >250 GMS; W/REPAIR OF ENTEROCELE cohort cohort cohort
58300 *INSERTION OF INTRAUTERINE DEVICE (IUD)*INSERTION OF INTRAUTERINE DEVICE (IUD) cohort cohort cohort cohort
58301 REMOVAL OF INTRAUTERINE DEVICE (IUD)REMOVAL OF INTRAUTERINE DEVICE (IUD) cohort cohort cohort cohort cohort
58340
*CATHETERIZATION AND INTRODUCTION OF SALINE OR CONTRASTMATERIAL FOR HYSTEROSONOGRAPHY OR HYSTEROSALPINGOGRAPHY cohort cohort cohort cohort cohort
58345
TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FORDIAGNOSIS AND/OR RE-ESTABLISHING PATENCY (ANY METHOD), WITH OR WITHOUT HYSTEROSALPINGOGRAPHY cohort cohort
58350 *CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS cohort cohort cohort cohort
58353 ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE. cohort cohort cohort cohort
58356 ENDOMETRIAL CRYOABLATION statewide
58400 UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUNDLIGAMENTS, WITH LIGAMENTS; (SEPARATE PROCEDURE) cohort cohort
58520 HYSTERORRHAPHY, REPAIR OF RUPTURED UTERUS (NONOBSTETRICAL) cohort cohort
58540 HYSTEROPLASTY, REPAIR OF UTERINE ANOMALY (STRASSMAN TYPE) statewide
58541 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY,FOR UTERUS 250 G OR LESS; cohort cohort cohort cohort cohort
58542
LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY,FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S) cohort cohort cohort cohort cohort
58543 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY,FOR UTERUS GREATER THAN 250 G; cohort cohort cohort cohort cohort
58544
LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY,FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TU BE(S) AND/OR OVARY(S) cohort cohort cohort cohort cohort
58545 LAPAROSCOPY, SURG, MYOMECTOMY; 1-4 INTRAMURAL MYOMAS, TOTAL WT 250 GMS, &/OR REMOVE SURFACE MYOMAS cohort cohort cohort cohort cohort
58546 LAPARPSCOPY, SURG, MYOMECTOMY; 5/> INTRAMURAL MYOMAS &/OR TOTAL WT>250 GMS cohort cohort cohort cohort
58548
LAPAROSCOPY, SURGICAL, WITH RADICAL HYSTERECTOMY, WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY), WITH REMOVAL OF TUBE(S) AND OVARY(S), IF PERFORMED cohort cohort cohort
58550
LAPAROSCOPY, SURGICAL; WITH VAGINAL HYSTERECTOMY WITH OR WITHOUT REMOVAL OF TUBE(S),WITH OR WITHOUTREMOVAL OF OVARY(S) (LAPAROSCOPIC ASSISTED VAGINALHYSTERECTOMY) cohort cohort cohort cohort cohort
58552 LAPAROSCOPY, SURG, W/VAGINAL HYSTERECTOMY, UTERUS 250 GMS/<; W/REMOVAL TUBE(S) &/OR OVARY(S) cohort cohort cohort cohort cohort
58553 LAPAROSCOPY, SURG, W/VAGINAL HYSTERECTOMY, UTERUS >250 GMS cohort cohort cohort cohort
58554 LAPAROSCOPY SURG W/VAGINAL HYSTERECTOMY, UTERUS >250 GMS; W/REMOVE TUBE(S) &/OR OVARY(S) cohort cohort cohort cohort
58555 HYSTEROSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
58558
HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D & C cohort cohort cohort cohort cohort
58559 HYSTEROSCOPY, SURGICAL; WITH LYSIS OF INTRAUTERINEADHESIONS (ANY METHOD) cohort cohort cohort cohort
58560 HYSTEROSCOPY, SURGICAL; WITH DIVISION OR RESECTIONOF INTRAUTERINE SEPTUM (ANY METHOD) cohort cohort
58561 HYSTEROSCOPY, SURGICAL;WITH REMOVAL OF LEIOMYOMATA cohort cohort cohort cohort
58562 HYSTEROSCOPY, SURGICAL;WITH REMOVAL OF IMPACTED FOREIGN BODY cohort cohort cohort cohort
58563 HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION cohort cohort cohort cohort cohort
115
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
(ANY METHOD)
58565 HYSTEROSCOPY, STERILIZATION cohort cohort cohort cohort
58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; cohort cohort cohort cohort cohort
58571 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) cohort cohort cohort cohort cohort
58572 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; cohort cohort cohort cohort
58573 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) cohort cohort cohort cohort cohort
58578 UNLISTED LAPAROSCOPY PROCEDURE, UTERUS cohort cohort cohort cohort
58579 UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS cohort cohort cohort cohort
58600
LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL ORVAGINAL APPROACH, UNILATERAL OR BILATERAL cohort cohort cohort
58615
OCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE (EG, BAND, CLIP,FALOPE RING) VAGINAL OR SUPRAPUBIC APPROACHOCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE (EG, BA ND, CLIP, cohort cohort cohort cohort
58660 LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEPARATE PROCEDURE) cohort cohort cohort cohort
58661
LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPHORECTOMY AND/OR SALPINGECTOMY) cohort cohort cohort cohort cohort
58662
LAPAROSCOPY, SURGICAL;WITH FULGURATION OR EXCISIONOF LESIONS OF THE OVARY, PELVIC VISCERA, OR PERITONEAL SURFACE BY ANY METHOD cohort cohort cohort cohort cohort
58670 LAPAROSCOPY, SURGICAL;WITH FULGURATION OF OVIDUCTS(WITH OR WITHOUT TRANSECTION) cohort cohort cohort cohort cohort
58671 LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG. BAND, CLIP, OR FALOPE RING) cohort cohort cohort cohort cohort
58672 LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY statewide
58673 LAPAROSCOPY, SURGICAL; WITH SALPINGOSTOMY (SALPINGONEOSTOMY) cohort cohort
58679 UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY (SALPINGONEOSTOMY) cohort cohort cohort cohort
58700 SALPINGECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE) cohort cohort cohort cohort
58720 SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL, UNILATERAL ORBILATERAL (SEPARATE PROCEDURE) cohort cohort cohort cohort
58740 LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) cohort cohort
58750 TUBOTUBAL ANASTOMOSIS statewide
58770 SALPINGOSTOMY (SALPINGONEOSTOMY) statewide
58800 DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL,(SEPARATE PROCEDURE); VAGINAL APPROACH cohort cohort cohort
58805 DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL,(SEPARATE PROCEDURE); ABDOMINAL APPROACH statewide
58823
DRAINAGE OF PELVIC ABSCESS, TRANSVAGINAL OR TRANSRECTALAPPROACH, PERCUTANEOUS (EG, OVARIAN, PERICOLIC) statewide
58900 BIOPSY OF OVARY, UNILATERAL OR BILATERAL (SEPARATEPROCEDURE) statewide
58925 OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL cohort cohort cohort cohort
58940 OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR BILATERAL; cohort cohort
58950 Resection (initial) of ovarian, tubal or primary preitoneal malignancy with bilateral salpingo-oophorectomy and omentectomy statewide
58970 FOLLICLE PUNCTURE FOR OOCYTE RETRIEVAL, ANY METHOD statewide
58999 Unlisted procedure, female genital system (nonobstetrical) cohort cohort cohort cohort
59000 *AMNIOCENTESIS, ANY METHOD cohort cohort cohort cohort
59001 AMNIOCENTESIS; THERAPEUTIC AMNIOTIC FLUID statewide
116
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
REDUCTIOW/US
59015 CHORIONIC VILLUS SAMPLING, ANY METHOD cohort cohort
59020 *FETAL CONTRACTION STRESS TEST cohort cohort cohort
59025 FETAL NON-STRESS TESTFETAL NON-STRESS TEST cohort cohort cohort cohort cohort
59050
FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (IE,NON-ATTENDING PHYSICIAN) WITH WRITTEN REPORT; SUPERVISION AND INTERPRETATION statewide
59074
FETAL FLUID DRAINAGE (EG VESICOCENTESIS THORACOCENTESIS PARACENTESIS) INCLUDING ULTRA- SOUND GUIDANCE statewide
59076 FETAL SHUNT PLACEMENT INCLUDING ULTRASOUND GUIDANCE statewide
59120
SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN,REQUIRING SALPINGECTOMY AND/OR OOPHORECTOMY, ABDOMINAL OR VAGINAL APPROACH cohort cohort cohort
59121 SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN,WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY statewide
59150 LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUTSALPINGECTOMY AND/OR OOPHORECTOMY cohort cohort cohort cohort
59151 LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHSALPINGECTOMY AND/OR OOPHORECTOMY cohort cohort cohort cohort
59160 CURETTAGE, POSTPARTUM cohort cohort cohort cohort
59200 INSERTION OF CERVICAL DILATOR (EG, LAMINARIA, PROSTAGLANDIN)(SEPARATE PROCEDURE) cohort cohort
59300 EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING cohort cohort cohort
59320 CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL cohort cohort cohort cohort
59325 CERCLAGE OF CERVIX, DURING PREGNANCY; ABDOMINAL statewide
59409 VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/ORFORCEPS); statewide
59412 EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS (LISTIN ADDITION TO CODE(S) FOR DELIVERY) cohort cohort cohort cohort
59414 DELIVERY OF PLACENTA (SEPARATE PROCEDURE) statewide
59514 CESAREAN DELIVERY ONLY; statewide
59812 TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER, COMPLETEDSURGICALLY cohort cohort cohort cohort cohort
59820
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRSTTRIMESTER TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST cohort cohort cohort cohort
59821
TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECONDTRIMESTER TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND cohort cohort cohort cohort
59840 INDUCED ABORTION, BY DILATION AND CURETTAGE cohort cohort
59841 INDUCED ABORTION, BY DILATION AND EVACUATION cohort cohort
59856
INDUCED ABORTION, BY 1 OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) WITH OR WITHOUT CERVICAL DILATION (EG, LAMINARIA), INCLUDING HOSPITAL ADMISSION AND VISITS, DELIVERY OF FETUS AND SECUNDINES; W cohort cohort
59866 MULTIFETAL PREGNANCY REDUCTION(S) (MPR) statewide
59870 UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE cohort cohort cohort cohort
59871 REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHERTHANLOCAL) statewide
59899 UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY cohort cohort cohort
60000 *INCISION AND DRAINAGE OF THYROGLOSSAL CYST, INFECTED statewide
60100 *BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE cohort cohort cohort cohort cohort
60200 EXCISION OF CYST OR ADENOMA OF THYROID, OR TRANSECTION OFISTHMUS cohort cohort cohort cohort
60210 PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUTISTHMUSECTOMY cohort cohort cohort cohort cohort cohort
60212 PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERALSUBTOTAL LOBECTOMY, INCLUDING cohort cohort cohort
117
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ISTHMUSECTOMY
60220 TOTAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUTISTHMUSECTOMY cohort cohort cohort cohort cohort cohort
60225
TOTAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERALSUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY cohort cohort cohort cohort cohort cohort
60240 THYROIDECTOMY, TOTAL OR COMPLETE cohort cohort cohort cohort cohort
60252 THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITHLIMITED NECK DISSECTION cohort cohort cohort cohort
60254 THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITHRADICAL NECK DISSECTION cohort cohort
60260
THYROIDECTOMY, REMOVAL OF ALL REMAINING THYROID TISSUEFOLLOWING PREVIOUS REMOVAL OF A PORTION OF THYROID cohort cohort cohort cohort
60271 THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID GLAND;CERVICAL APPROACH cohort cohort cohort
60280 EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; cohort cohort cohort cohort
60281 EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; RECURRENT statewide
60300 Aspiration and/or injection, thyroid cyst cohort cohort cohort
60500 PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); cohort cohort cohort cohort
60502 PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S);RE-EXPLORATION cohort cohort
60505
PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); WITHMEDIASTINAL EXPLORATION, STERNAL SPLIT OR TRANSTHORACIC APPROACH cohort cohort
60512 PARATHYROID AUTOTRANSPLANTATION (LIST SEPARATELY IN ADDITIONTO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
60520 THYMECTOMY, PARTIAL OR TOTAL; TRANSCERVICAL APPROACH(SEPARATE PROCEDURE) cohort cohort cohort
60521
THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACICAPPROACH, WITHOUT RADICAL MEDIASTINAL DISSECTION (SEPARATE PROCEDURE) cohort cohort
60600 EXCISION OF CAROTID BODY TUMOR; WITHOUT EXCISION OF CAROTID ARTERY statewide
60650
LAPAROSCOPY, SURGICAL, WITH ADRENALECTOMY, PARTIALOR COMPLETE, OR EXPLORATION OF ADRENAL GLAND WITH OR WITHOUT BIOPSY, TRANSABDOMINAL, LUMBAR OR DORSAL cohort cohort cohort cohort
61055
*CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE; WITHINJECTION OF DRUG OR OTHER SUBSTANCE FOR DIAGNOSIS OR TREATMENT (EG, C1-C2) cohort cohort
61070
*PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION ORINJECTION PROCEDURE *PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION OR cohort cohort
61210
Burr hole(s); for implanting ventricular catheter,reservoir, EEG electrode(s), pressure recording d evice, or other cerebral monitoring device (separate procedure) statewide
61304
CRANIECTOMY OR CRANIOTOMY, EXPLORATORY; SUPRATENTORIALCRANIECTOMY OR CRANIOTOMY, EXPLORATORY; SUPRATENTORIAL statewide
61343
CRANIECTOMY, SUBOCCIPITAL WITH CERVICAL LAMINECTOMY FORDECOMPRESSION OF MEDULLA AND SPINAL CORD, WITH OR WITHOUT DURAL GRAFT (EG, ARNOLD-CHIARI MALFORMATION) statewide
61500
CRANIECTOMY; WITH EXCISION OF TUMOR OR OTHER BONE LESION OF SKULL CRANIECTOMY; WITH EXCISION OF TUMOR OR OTHER BONE LESION OF cohort cohort cohort
61544
CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION ORCOAGULATION OF CHOROID PLEXUS CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR EXCISION OR statewide
61550 CRANIECTOMY FOR CRANIOSYNOSTOSIS; SINGLE CRANIAL SUTURE statewide
61563 EXCISION, INTRA AND EXTRACRANIAL, BENIGN TUMOR OF cohort cohort
118
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
CRANIALBONE (EG, FIBROUS DYSPLASIA); WITHOUT OPTICNERVE DECOMPRESSION
61591
INFRATEMPORAL POST-AURICULAR APPROACH TO MIDDLE CRANIALFOSSA (INTERNAL AUDITORY MEATUS, PETROUS APEX, TENTORIUM, CAVERNOUS SINUS, PARASELLAR AREA, INFRATEMPORAL FOSSA) statewide
61605
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPORAL FOSSA, PARAPHARYNGEAL SPACE, PETROUS APEX; EXTRADURAL statewide
61607
RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR AREA, CAVERNOUS SINUS, CLIVUS OR MIDLINE SKULL BASE; EXTRADURAL statewide
61613
OBLITERATION OF CAROTID ANEURYSM, ARTERIOVENOUSMALFORMATION, OR CAROTID-CAVERNOUS FISTULA BY DISSECTION WITHIN CAVERNOUS SINUS statewide
61623 ENDOVASC TEMP OCCLUSION HEAD/NCK W/VESSEL CATH BALLOON POSITIONING/INFLATION NEUR MONIT, S&I statewide
61624
TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR TUMORDESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDEA VASCULAR MALFORMATION), PERCUTANEOUS, ANY METH OD; CENTRAL NERVOUS cohort cohort
61626
TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR TUMORDESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDEA VASCULAR MALFORMATION), PERCUTANEOUS, ANY METH OD; NON-CENTRAL NERVOUS cohort cohort
61750 STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION, INCLUDING BURRHOLE(S), FOR INTRACRANIAL LESION; cohort cohort
61751
STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION, INCLUDING BURRHOLE(S), FOR INTRACRANIAL LESION; WITH COMPUTERIZED AXIAL TOMOGRAPHY statewide
61781 Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedure) cohort cohort
61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary procedure) cohort cohort cohort cohort
61867
TWIST DRILL, BURR HOLE, CRANIOTOMY, OR CRANIECTOMYWITH STEREOTACTIC IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY IN SUBCORTICAL SITE (EG, THALAMUS , GLOBUS PALLIDUS, SUBTHALAMIC NUCLEUS, PERIVENTRI statewide
61885
INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIALNEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT ORINDUCTIVE COUPLING cohort cohort
61886
INSERTION OR REPLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT OR INDUCTIVECOUPLING; WITH CONNECTION TO 2 OR MORE ELECTRODE ARRAYS cohort cohort
61888 REVISION OR REMOVAL OF CRANIAL NEUROSTIMULATOR PULSEGENERATOR OR RECEIVER cohort cohort
62000
ELEVATION OF DEPRESSED SKULL FRACTURE; SIMPLE, EXTRADURALELEVATION OF DEPRESSED SKULL FRACTURE; SIMPLE, EXTRADURAL statewide
62140 CRANIOPLASTY FOR SKULL DEFECT; UP TO 5 CM DIAMETER statewide
62142 REMOVAL OF BONE FLAP OR PROSTHETIC PLATE OF SKULL statewide
62145 CRANIOPLASTY FOR SKULL DEFECT WITH REPARATIVE BRAIN SURGERY statewide
62146 CRANIOPLASTY WITH AUTOGRAFT (INCLUDES OBTAINING BONEGRAFTS); UP TO 5 CM DIAMETER statewide
62148 INCISION & RETRIEVAL SUBQ CRANIAL BONE GRAFT FOR CRANIOPLASTY statewide
62160 NEUROENDOSCOPY, INTRACRANIAL PLACE/REPLACE VENTRICULAR CATH, SHUNT SYS/ENT DRAINAGE statewide
62201
VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE; STEREOTACTICMETHOD VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE; STEREOTACTIC statewide
119
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
62220
CREATION OF SHUNT; VENTRICULO-ATRIAL, -JUGULAR, -AURICULARCREATION OF SHUNT; VENTRICULO-ATRIAL, -JUGULAR, -AURICULAR statewide
62223
CREATION OF SHUNT; VENTRICULO-PERITONEAL, -PLEURAL, OTHERTERMINUS CREATION OF SHUNT; VENTRICULO-PERITONEAL, -PLEURAL, OTHER statewide
62225
REPLACEMENT OR IRRIGATION, VENTRICULAR CATHETERREPLACEMENT OR IRRIGATION, VENTRICULAR CATHETER statewide
62230
REPLACEMENT OR REVISION OF CSF SHUNT, OBSTRUCTED VALVE, ORDISTAL CATHETER IN SHUNT SYSTEM REPLACEMENT OR REVISION OF CSF SHUNT, OBSTRUCTED VALVE, OR statewide
62252 REPROGRAMMING OF PROGRAMMABLE CSF SHUNT. statewide
62256
REMOVAL OF COMPLETE CSF SHUNT SYSTEM; WITHOUT REPLACEMENTREMOVAL OF COMPLETE CSF SHUNT SYSTEM; WITHOUT REPLACEMENT statewide
62258
REMOVAL OF COMPLETE CSF SHUNT SYSTEM; WITH REPLACEMENT BYSIMILAR OR OTHER SHUNT AT SAME OPERATION REMOVAL OF COMPLETE CSF SHUNT SYSTEM; WITH REPLACEMENT BY statewide
62264 LYSIS PERQ EPIDURAL ADHESIONS SOLUTION INJECTION/ MECHANICAL W/RADIOLOGIC LOCALIZATION; 1 DAY statewide
62267 Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes statewide
62268 *PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRINX cohort cohort
62269 *BIOPSY OF SPINAL CORD, PERCUTANEOUS NEEDLE cohort cohort
62270 *SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC cohort cohort cohort cohort cohort
62272 *SPINAL PUNCTURE, THERAPEUTIC, FOR DRAINAGE OF SPINAL FLUID (BY NEEDLE OR CATHETER) cohort cohort cohort cohort
62273
*INJECTION, LUMBAR EPIDURAL, OF BLOOD OR CLOT PATCH*INJECTION, LUMBAR EPIDURAL, OF BLOOD OR CLOT PATCH cohort cohort cohort cohort cohort cohort
62281
*INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL,ICED SALINE SOLUTIONS); EPIDURAL, CERVICAL OR THORACIC *INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, statewide
62282
*INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL,ICED SALINE SOLUTIONS); EPIDURAL, LUMBAR OR CAUDAL *INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, statewide
62284 Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa) cohort cohort cohort cohort cohort
62287
DECOMPRESSION PROCEDURE, PERCUTANEOUS, OF NUCLEUS PULPOSUS OF INTERVERTEBRAL DISC, ANY METHOD UTILIZING NEEDLE BASED TECHNIQUE TO REMOVE DISC MATERIALUNDER FLUOROSCOPIC IMAGING OR OTHER FORM OF INDIR statewide
62290 *INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; LUMBAR cohort cohort cohort cohort cohort
62291 *INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; CERVICAL cohort cohort
62310
INJECTION(S), OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (INCLUDING ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER SOLUTION), NOT INCLUDING NEUROLYTIC SUBSTANCES, INCLUDING NEEDLE OR CATHETER PLACEM cohort cohort cohort cohort cohort cohort
62311
INJECTION(S), OF DIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (INCLUDING ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER SOLUTION), NOT INCLUDING NEUROLYTIC SUBSTANCES, INCLUDING NEEDLE OR CATHETER PLACEM cohort cohort cohort cohort cohort cohort
62318
INJECTION(S), INCLUDING INDWELLING CATHETER PLACEMENT, CONTINUOUS INFUSION OR INTERMITTENT BOLUS, OFDIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (INCLUDING ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER cohort cohort
62319
INJECTION(S), INCLUDING INDWELLING CATHETER PLACEMENT, CONTINUOUS INFUSION OR INTERMITTENT BOLUS, OFDIAGNOSTIC OR THERAPEUTIC SUBSTANCE(S) (INCLUDING cohort cohort cohort
120
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ANESTHETIC, ANTISPASMODIC, OPIOID, STEROID, OTHER
62350
IMPLANTATION, REVISION OR REPOSITIONING OF INTRATHECAL OREPIDURAL CATHETER, FOR IMPLANTABLE RESERVOIR OR IMPLANTABLE INFUSION PUMP; WITHOUT LAMINECTOMY cohort cohort cohort cohort
62362
IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OREPIDURAL DRUG INFUSION; PROGRAMMABLE PUMP, INCLUDING PREPARATION OF PUMP, WITH OR WITHOUT PROGRAMMING cohort cohort cohort cohort
62367
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION (INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION STATUS); WITHOUT REPROGRAMMING O statewide
62368
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FORINTRATHECAL OR EPIDURAL DRUG INFUSION (INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION cohort cohort cohort cohort
62369
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION (INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION STATUS); WITH REPROGRAMMING AND cohort cohort cohort cohort cohort
62370
ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION (INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION STATUS); WITH REPROGRAMMING AND cohort cohort
63001
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (EG, SPINAL STENOSIS), ONE OR TWO VERTEBRAL statewide
63005
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (EG, SPINAL STENOSIS), ONE OR TWO VERTEBRAL cohort cohort cohort
63012
LAMINECTOMY WITH REMOVAL OF ABNORMAL FACETS AND/ORPARSINTER-ARTICULARIS WITH DECOMPRESSION OF CAUDA EQUINA AND NERVE ROOTS FOR SPONDYLOLISTHESIS, LU MBAR (GILL TYPE statewide
63015
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (EG, SPINAL STENOSIS), MORE THAN 2 VERTEBRAL statewide
63017
LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (EG, SPINAL STENOSIS), MORE THAN 2 VERTEBRAL cohort cohort
63020
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, CERVICAL cohort cohort cohort
63030
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, LUMBAR cohort cohort cohort cohort cohort cohort
63035
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; EACH ADDITIONAL INTERSPACE, CERVICAL OR cohort cohort cohort cohort cohort
63040
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVEROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISK, RE-EXPLORATION; statewide
63042
LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVEROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISK, RE-EXPLORATION; cohort cohort cohort cohort
63044 LAMINOTOMY (HEMILAMINECTOMY),WITH DECOMPRESSION OFNERVEROOT(S),INCLUDING PARTIAL statewide
121
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
FACETECTOMY,FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISK,RE-EXPLORATION;EACH ADDT'L LUMBAR INTERSPACE
63045
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL ORBILATERAL WITH DECOMPRESSION OF SPINAL CORD,CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL O R LATERAL RECESS cohort cohort cohort
63046
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL ORBILATERAL WITH DECOMPRESSION OF SPINAL CORD,CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL O R LATERAL RECESS cohort cohort
63047
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL ORBILATERAL WITH DECOMPRESSION OF SPINAL CORD,CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL O R LATERAL RECESS cohort cohort cohort cohort cohort cohort
63048
LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL ORBILATERAL WITH DECOMPRESSION OF SPINAL CORD,CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL O R LATERAL RECESS cohort cohort cohort cohort cohort cohort
63051
LAMINOPLASTY, CERVICAL, WITH DECOMPRESSION OF THE SPINAL CORD, 2 OR MORE VERTEBRAL SEGMENTS; WITH RECONSTRUCTION OF THE POSTERIOR BONY ELEMENTS (INCLUDING THE APPLICATION OF BRIDGING BONE GRAFT AND NO statewide
63055
TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD,EQUINA AND/OR NERVE ROOT(S) (EG, HERNIATEDINTERVERTEBRAL DISK), SINGLE SEGMENT; THORACIC statewide
63056
TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD,EQUINA AND/OR NERVE ROOT(S) (EG, HERNIATEDINTERVERTEBRAL DISK), SINGLE SEGMENT; LUMBAR cohort cohort cohort cohort
63057
TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD,EQUINA AND/OR NERVE ROOT(S) (EG, HERNIATEDINTERVERTEBRAL DISK), SINGLE SEGMENT; EACH ADDIT IONAL SEGMENT, THORACIC OR cohort cohort cohort
63075
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINALCORD AND/OR NERVE ROOT(S), INCLUDING OSTEOPHYTECT OMY; CERVICAL, SINGLE INTERSPACE cohort cohort cohort
63076
DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINALCORD AND/OR NERVE ROOT(S), INCLUDING OSTEOPHYTECT OMY; CERVICAL, EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE cohort cohort
63081
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, SINGLE SEGMENT cohort cohort cohort cohort
63082
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, EACH ADDITIONAL SEGMENT cohort cohort cohort cohort
63200 LAMINECTOMY, WITH RELEASE OF TETHERED SPINAL CORD,LUMBAR statewide
63225 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
63252
LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUSMALFORMATION OF SPINAL CORD; THORACOLUMBAR LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS statewide
63267 LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESIONOTHER THAN NEOPLASM, EXTRADURAL; LUMBAR cohort cohort cohort cohort
63273 LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER THANNEOPLASM, INTRADURAL; SACRAL statewide
63276 LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM;EXTRADURAL, THORACIC statewide
63277 LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL NEOPLASM;EXTRADURAL, LUMBAR statewide
63281 LAMINECTOMY FOR BIOPSY/EXCISION OF INTRASPINAL statewide
122
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
NEOPLASM;INTRADURAL, EXTRAMEDULLARY, THORACIC
63302
VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EXTRADURAL, THORACIC BY THORACOLUMBAR APPROACH statewide
63650
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODEARRAY, EPIDURAL PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE cohort cohort cohort cohort cohort
63655
LAMINECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, PLATE/PADDLE, EPIDURAL LAMINECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, cohort cohort cohort cohort
63661
REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S), INCLUDING FLUOROSCOPY, WHEN PERFORMED cohort cohort
63662
REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PLATE/PADDLE(S) PLACED VIA LAMINOTOMY OR LAMINECTOMY, INCLUDING FLUOROSCOPY, WHEN PERFORMED cohort cohort cohort cohort
63663
REVISION INCLUDING REPLACEMENT, WHEN PERFORMED, OFSPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARR AY(S), INCLUDING FLUOROSCOPY, WHEN PERFORMED cohort cohort cohort cohort
63685
INCISION AND SUBCUTANEOUS PLACEMENT OF SPINALNEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT OR INDUCTIVE COUPLING cohort cohort cohort cohort cohort
63688 REVISION OR REMOVAL OF IMPLANTED SPINAL NEUROSTIMULATORPULSE GENERATOR cohort cohort cohort cohort cohort cohort
63707 REPAIR OF DURAL/CSF LEAK, NOT REQUIRING LAMINECTOMY statewide
63709 REPAIR OF DURAL/CSF LEAK OR PSEUDOMENINGOCELE, WITHLAMINECTOMY statewide
63710 DURAL GRAFT, SPINAL statewide
63740 CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL,-PLEURAL, OR OTHER; INCLUDING LAMINECTOMY statewide
63741
CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL,-PLEURAL, OR OTHER; PERCUTANEOUS, NOT REQUIRING LAMINECTOMY statewide
63744 REPLACEMENT, IRRIGATION OR REVISION OF LUMBOSUBARACHNOIDSHUNT statewide
64400 *INJECTION, ANESTHETIC AGENT; TRIGEMINAL NERVE, ANY DIVISIONOR BRANCH cohort cohort cohort cohort cohort
64402 *INJECTION, ANESTHETIC AGENT; FACIAL NERVE cohort cohort cohort cohort cohort
64405 *INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVE cohort cohort cohort cohort cohort
64410 *INJECTION, ANESTHETIC AGENT; PHRENIC NERVE statewide
64412 *INJECTION, ANESTHETIC AGENT; SPINAL ACCESSORY NERVE statewide
64413 *INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS cohort cohort cohort cohort
64415 *INJECTION, ANESTHETIC AGENT; BRACHIAL PLEXUS cohort cohort cohort cohort cohort
64416 Injection, anesthetic agent; brachialplexus, continuous infusion by catheter (including catheter placement) cohort cohort cohort cohort cohort
64417 *INJECTION, ANESTHETIC AGENT; AXILLARY NERVE cohort cohort cohort cohort cohort
64418 *INJECTION, ANESTHETIC AGENT; SUPRASCAPULAR NERVE cohort cohort cohort cohort
64420 *INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVE, SINGLE cohort cohort cohort cohort
64421
*INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVES, MULTIPLE, REGIONAL BLOCK *INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVES, MULTIPLE, cohort cohort cohort cohort
64425 *INJECTION, ANESTHETIC AGENT; ILIOINGUINAL, ILIOHYPOGASTRIC NERVES cohort cohort cohort cohort cohort
64430 *INJECTION, ANESTHETIC AGENT; PUDENDAL NERVE cohort cohort
64435 *INJECTION, ANESTHETIC AGENT; PARACERVICAL (UTERINE) NERVE cohort cohort
64445 *INJECTION, ANESTHETIC AGENT; SCIATIC NERVE cohort cohort cohort cohort cohort
64446 Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter (including catheter placement) cohort cohort
123
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
64447 INJECTION ANESTHETIC AGENT; FEMORAL NERVE SINGLE cohort cohort cohort cohort cohort
64448 Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement) cohort cohort cohort cohort
64449 Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement) cohort cohort
64450 *INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE ORBRANCH cohort cohort cohort cohort cohort
64455 Injection(s), anesthetic agent and/or steriod, plantar common digital nerve(s) (e.g., Morton's neuroma) cohort cohort
64479
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level cohort cohort cohort cohort cohort cohort
64480
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional level (List separately in addition to code for cohort cohort cohort cohort cohort
64483 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level cohort cohort cohort cohort cohort cohort
64484
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for prim cohort cohort cohort cohort cohort cohort
64490
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), CERVICAL OR THORACIC; SINGLE LEVEL cohort cohort cohort cohort cohort cohort
64491
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), CERVICAL OR THORACIC; SECOND LEVEL cohort cohort cohort cohort cohort cohort
64492
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), CERVICAL OR THORACIC; THIRD AND ANY cohort cohort cohort cohort cohort cohort
64493
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL; SINGLE LEVEL cohort cohort cohort cohort cohort cohort
64494
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL; SECOND LEVEL (LIS cohort cohort cohort cohort cohort cohort
64495
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET (ZYGAPOPHYSEAL) JOINT (OR NERVES INNERVATING THAT JOINT) WITH IMAGE GUIDANCE (FLUOROSCOPY OR CT), LUMBAR OR SACRAL; THIRD AND ANY ADD cohort cohort cohort cohort cohort cohort
64505 *INJECTION, ANESTHETIC AGENT; SPHENOPALATINE GANGLION cohort cohort
64510 *INJECTION, ANESTHETIC AGENT; STELLATE GANGLION (CERVICALSYMPATHETIC) cohort cohort cohort cohort cohort cohort
64517 INJECTION, ANESTHETIC AGENT; SUPERIOR HYPOGASTRIC PLEXUS cohort cohort cohort
64520 *INJECTION, ANESTHETIC AGENT; LUMBAR OR THORACIC(PARAVERTEBRAL SYMPATHETIC) cohort cohort cohort cohort cohort cohort
64530 *INJECTION, ANESTHETIC AGENT; CELIAC PLEXUS, WITH OR WITHOUTRADIOLOGIC MONITORING cohort cohort cohort cohort
64555
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; PERIPHERAL NERVE (EXCLUDES SACRAL NERVE) cohort cohort
64561
PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; SACRAL NERVE (TRANSFORAMINAL PLACEMENT) INCLUDING IMAGE GUIDANCE, IF PERFORMED cohort cohort cohort cohort
64568 Incision for implantation of cranial nerve (eg, vagus nerve) cohort cohort cohort
124
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
neurostimulator electrode array and pulse generator
64570 Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator statewide
64581
INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; SACRAL NERVE (TRANSFORAMINAL PLACEMENT) cohort cohort cohort cohort cohort
64585 REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR ELECTRODE ARRAY cohort cohort cohort cohort cohort
64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling cohort cohort cohort cohort cohort
64595 Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver cohort cohort cohort cohort cohort
64600
DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE;SUPRAORBITAL, INFRAORBITAL, MENTAL, OR INFERIOR ALVEOLAR BRANCH cohort cohort
64605
DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE;SECONDAND THIRD DIVISION BRANCHES AT FORAMEN OVAL E statewide
64611 Chemodenervation of parotid and submandibular salivary glands, bilateral statewide
64612
CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL NERVE, UNILATERAL (EG, FOR BLEPHAROSPASM, HEMIFACIAL SPASM) cohort cohort cohort
64613
DESTRUCTION BY NEUROLYTIC AGENT (CHEMODENERVATION OF MUSCLE ENDPLATE); CERVICAL SPINAL MUSCLES (EG, FOR SPASMODIC TORTICOLLIS) cohort cohort cohort cohort
64614
CHEMODENERVATION OF MUSCLE(S); EXTREMITY AND/OR TRUNK MUSCLE(S) (EG, FOR DYSTONIA, CEREBRAL PALSY, MULTIPLE SCLEROSIS) cohort cohort cohort
64615
CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL, TRIGEMINAL, CERVICAL SPINAL AND ACCESSORY NERVES, BILATERAL (EG, FOR CHRONIC MIGRAINE) cohort cohort
64620 DESTRUCTION BY NEUROLYTIC AGENT; INTERCOSTAL NERVE cohort cohort cohort
64630 DESTRUCTION BY NEUROLYTIC AGENT; PUDENDAL NERVE statewide
64633
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); CERVICAL OR THORACIC, SINGLE FACET JOINT cohort cohort cohort cohort cohort
64634
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); CERVICAL OR THORACIC, EACH ADDITIONAL FACET JOINT (LIST SEPARATELY IN ADDITION TO CODE F cohort cohort cohort cohort cohort
64635
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); LUMBAR OR SACRAL, SINGLE FACET JOINT cohort cohort cohort cohort cohort cohort
64636
DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT); LUMBAR OR SACRAL, EACH ADDITIONAL FACET JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR P cohort cohort cohort cohort cohort cohort
64640 DESTRUCTION BY NEUROLYTIC AGENT; OTHER PERIPHERAL NERVE ORBRANCH cohort cohort cohort cohort cohort
64680 DESTRUCTION BY NEUROLYTIC AGENT, CELIAC PLEXUS, WITH ORWITHOUT RADIOLOGIC MONITORING cohort cohort cohort cohort cohort
64681 DESTRUCTION BY NEUROLYTIC AGENT, WITH OR WITHOUT RADIOLOGIC MONITORING; SUPERIOR HYPOGASTRIC PLEXUS statewide
64702 NEUROPLASTY; DIGITAL, ONE OR BOTH, SAME DIGIT cohort cohort cohort cohort
64704 NEUROPLASTY; NERVE OF HAND OR FOOT cohort cohort cohort cohort
64708 Neuroplasty, major peripheral nerve, arm or leg, open; other than specified cohort cohort cohort cohort cohort cohort
64713 Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus cohort cohort
125
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
64716 NEUROPLASTY AND/OR TRANSPOSITION; CRANIAL NERVE (SPECIFY) statewide
64718
NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOWNEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW cohort cohort cohort cohort cohort cohort
64719
NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT WRISTNEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT WRIST cohort cohort cohort cohort cohort cohort
64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPALTUNNEL cohort cohort cohort cohort cohort cohort
64722 DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY) cohort cohort cohort
64727
INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE(LIST SEPARATELY IN ADDITION TO CODE FOR NEUROPLASTY) (NEUROPLASTY INCLUDES EXTERNAL NEUROLYSIS) cohort cohort cohort cohort cohort
64732 TRANSECTION OR AVULSION OF; SUPRAORBITAL NERVE statewide
64771 TRANSECTION OR AVULSION OF OTHER CRANIAL NERVE, EXTRADURAL cohort cohort
64772 TRANSECTION OR AVULSION OF OTHER SPINAL NERVE, EXTRADURAL cohort cohort cohort
64774 EXCISION OF NEUROMA; CUTANEOUS NERVE, SURGICALLYIDENTIFIABLE cohort cohort cohort
64776 EXCISION OF NEUROMA; DIGITAL NERVE, ONE OR BOTH, SAME DIGIT cohort cohort
64782 EXCISION OF NEUROMA; HAND OR FOOT, EXCEPT DIGITAL NERVE cohort cohort cohort
64783
EXCISION OF NEUROMA; HAND OR FOOT, EACH ADDITIONALNERVE,EXCEPT SAME DIGIT (LIST SEPARATELY IN ADDIT ION TO CODE FOR PRIMARY PROCEDURE) statewide
64784 EXCISION OF NEUROMA; MAJOR PERIPHERAL NERVE, EXCEPT SCIATIC cohort cohort
64788
EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVEEXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVE cohort cohort
64790
EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERALNERVE EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL statewide
64795 BIOPSY OF NERVE cohort cohort cohort cohort
64820 SYMPATHECTOMY, DIGITAL ARTERIES, WITH MAGNIFICATION, EACHDIGIT cohort cohort
64821 SYMPATHECTOMY; RADIAL ARTERY statewide
64822 SYMPATHECTOMY; ULNAR ARTERY statewide
64823 SYMPATHECTOMY; SUPERFICIAL PALMAR ARCH cohort cohort
64831 SUTURE OF DIGITAL NERVE, HAND OR FOOT; ONE NERVE cohort cohort cohort cohort cohort
64832
SUTURE OF DIGITAL NERVE, HAND OR FOOT; EACH ADDITIONALDIGITAL NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
64834 SUTURE OF 1 NERVE; HAND OR FOOT, COMMON SENSORY NERVE cohort cohort
64835 SUTURE OF 1 NERVE; MEDIAN MOTOR THENAR cohort cohort cohort
64836 SUTURE OF 1 NERVE; ULNAR MOTOR cohort cohort
64837
SUTURE OF EACH ADDITIONAL NERVE, HAND OR FOOT (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
64856 SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPTSCIATIC; INCLUDING TRANSPOSITION statewide
64857 SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPTSCIATIC; WITHOUT TRANSPOSITION cohort cohort
64859
SUTURE OF EACH ADDITIONAL MAJOR PERIPHERAL NERVE (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
126
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
64864 SUTURE OF FACIAL NERVE; EXTRACRANIAL statewide
64868 ANASTOMOSIS; FACIAL-HYPOGLOSSAL statewide
64885
NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; UP TO 4 CM IN LENGTH NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; UP TO statewide
64886
NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; MORETHAN 4 CM LENGTH NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; MORE statewide
64892
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARMOR LEG; UP TO 4 CM LENGTH NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM statewide
64893
NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARMOR LEG; MORE THAN 4 CM LENGTH NERVE GRAFT(INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM statewide
64897 NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS(CABLE), ARM OR LEG; UP TO 4 CM LENGTH statewide
64902
NERVE GRAFT, EACH ADDITIONAL NERVE; MULTIPLE STRANDS (CABLE)(LIST SEPARATELY IN ADDITION TO CODE FORPRIMARY PROCEDURE) statewide
64905 NERVE PEDICLE TRANSFER; FIRST STAGENERVE PEDICLE TRANSFER; FIRST STAGE statewide
64910 NERVE REPAIR; WITH SYNTHETIC CONDUIT OR VEIN ALLOGRAFT (EG, NERVE TUBE), EACH NERVE cohort cohort cohort cohort
64911 NERVE REPAIR; WITH AUTOGENOUS VEIN GRAFT (INCLUDESHARVEST OF VEIN GRAFT), EACH NERVE cohort cohort cohort
64999 UNLISTED PROCEDURE, NERVOUS SYSTEM cohort cohort cohort cohort cohort
65091 EVISCERATION OF OCULAR CONTENTS; WITHOUT IMPLANT statewide
65105 ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES ATTACHEDTOIMPLANT cohort cohort cohort
65140
INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION,MUSCLES ATTACHED TO IMPLANT INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION, statewide
65205
*REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVALSUPERFICIAL *REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL cohort cohort cohort cohort cohort
65210
*REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVALEMBEDDED (INCLUDES CONCRETIONS), SUBCONJUNCTIVAL, OR SCLERAL NONPERFORATING cohort cohort cohort cohort
65220
*REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUTSLIT LAMP *REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUT cohort cohort cohort cohort cohort cohort
65222
*REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLITLAMP *REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT cohort cohort cohort cohort cohort
65235
REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM ANTERIOR CHAMBER OR LENS REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM ANTERIOR CHAMBER cohort cohort
65270
*REPAIR OF LACERATION; CONJUNCTIVA, WITH OR WITHOUTNONPERFORATING LACERATION SCLERA, DIRECT CLOSURE cohort cohort
65275 REPAIR OF LACERATION; CORNEA, NONPERFORATING, WITHORWITHOUT REMOVAL FOREIGN BODY cohort cohort
65280 REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, NOTINVOLVING UVEAL TISSUE cohort cohort
65285
REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING,WITH REPOSITION OR RESECTION OF UVEAL TISSUE cohort cohort
65400 EXCISION OF LESION, CORNEA (KERATECTOMY, LAMELLAR,PARTIAL),EXCEPT PTERYGIUM cohort cohort cohort
65420 EXCISION OR TRANSPOSITION OF PTERYGIUM; WITHOUT GRAFT cohort cohort
65426 EXCISION OR TRANSPOSITION OF PTERYGIUM; WITH GRAFT cohort cohort cohort cohort cohort
65435 *REMOVAL OF CORNEAL EPITHELIUM; WITH OR WITHOUTCHEMOCAUTERIZATION (ABRASION, CURETTAGE) statewide
127
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
65436 REMOVAL OF CORNEAL EPITHELIUM; WITH APPLICATION OFCHELATINGAGENT (EG, EDTA) statewide
65450
DESTRUCTION OF LESION OF CORNEA BY CRYOTHERAPY,PHOTOCOAGULATION OR THERMOCAUTERIZATION statewide
65710 Keratoplasty (corneal transplant); anterior lamellar statewide
65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) cohort cohort cohort cohort
65750 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (INAPHAKIA) statewide
65755 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (INPSEUDOPHAKIA) statewide
65756 Keratoplasty (corneal transplant); endothelial cohort cohort cohort cohort cohort cohort
65757
Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure) cohort cohort cohort
65771 RADIAL KERATOTOMY statewide
65772 CORNEAL RELAXING INCISION FOR CORRECTION OF SURGICALLYINDUCED ASTIGMATISM cohort cohort cohort
65775 CORNEAL WEDGE RESECTION FOR CORRECTION OF SURGICALLY INDUCEDASTIGMATISM statewide
65778 Placement of amniotic membrane on the ocular surface for wound healing; self-retaining statewide
65779 Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured statewide
65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers cohort cohort
65782 OCULAR SURFACE RECONSTRUCTION; LIMBAL CONJUNCTIVALAUTOGRAFT (INCLUDES OBTAINING GRAFT) cohort cohort
65800 PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH REMOVAL OF AQUEOUS statewide
65815
PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATEPROCEDURE); WITH REMOVAL OF BLOOD, WITH OR WITHOUT IRRIGATION AND/OR AIR INJECTION statewide
65850 TRABECULOTOMY AB EXTERNO cohort cohort
65855 TRABECULOPLASTY BY LASER SURGERY, ONE OR MORE SESSIONS(DEFINED TREATMENT SERIES) cohort cohort cohort cohort
65865
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONALTECHNIQUE (WITH OR WITHOUT INJECTION OF AIROR LIQUID) (SEPARATE PROCEDURE); GONIOSYNECHIAE statewide
65870
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONALTECHNIQUE (WITH OR WITHOUT INJECTION OF AIROR LIQUID) (SEPARATE PROCEDURE); ANTERIOR SYNECH IAE, EXCEPT cohort cohort
65875
SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONALTECHNIQUE (WITH OR WITHOUT INJECTION OF AIROR LIQUID) (SEPARATE PROCEDURE); POSTERIOR SYNEC HIAE cohort cohort
65920
REMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT EYEREMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT EYE cohort cohort cohort cohort
66020 INJECTION, ANTERIOR CHAMBER (SEPARATE PROCEDURE); AIR ORLIQUID statewide
66030 *INJECTION, ANTERIOR CHAMBER (SEPARATE PROCEDURE);MEDICATION cohort cohort
66130 EXCISION OF LESION, SCLERA statewide
66170 FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY ABEXTERNO IN ABSENCE OF PREVIOUS SURGERY cohort cohort cohort cohort cohort
66172
FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY ABEXTERNO WITH SCARRING FROM PREVIOUS OCULAR SURGERY OR TRAUMA (INCLUDES INJECTION OF ANTIFIBROTIC AGENTS) cohort cohort
128
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
66175 Transluminal dilation of aqueous outflow canal; with retention of device or stent statewide
66180 AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR, (EG, MOLTENO,SCHOCKET, DENVER-KRUPIN) cohort cohort cohort cohort
66185 REVISION OF AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR cohort cohort
66250
REVISION OR REPAIR OF OPERATIVE WOUND OF ANTERIOR SEGMENT,ANY TYPE, EARLY OR LATE, MAJOR OR MINOR PROCEDURE cohort cohort cohort cohort
66500 IRIDOTOMY BY STAB INCISION (SEPARATE PROCEDURE); EXCEPTTRANSFIXION statewide
66600 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION;FORREMOVAL OF LESION statewide
66625
IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION;PERIPHERAL FOR GLAUCOMA (SEPARATE PROCEDURE) cohort cohort
66680 REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS) statewide
66682
SUTURE OF IRIS, CILIARY BODY (SEPARATE PROCEDURE) WITHRETRIEVAL OF SUTURE THROUGH SMALL INCISION (EG, MCCANNEL SUTURE) cohort cohort cohort cohort
66710 CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION cohort cohort cohort
66711 CILIARY ENDOSCOPIC ABLATION cohort cohort
66761 Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) cohort cohort cohort cohort cohort
66762
IRIDOPLASTY BY PHOTOCOAGULATION (ONE OR MORE SESSIONS) (EG, FOR IMPROVEMENT OF VISION, FOR WIDENING OF ANTERIOR CHAMBER ANGLE) cohort cohort
66820
DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIEDPOSTERIOR LENS CAPSULE AND/OR ANTERIOR HYALOID); STAB INCISION TECHNIQUE (ZIEGLER OR WHEELER KNIFE) statewide
66821
DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIEDPOSTERIOR LENS CAPSULE AND/OR ANTERIOR HYALOID); LASER SURGERY (EG, YAG LASER) (ONE OR MORE STAGES) cohort cohort cohort cohort
66825 REPOSITIONING OF INTRAOCULAR LENS PROSTHESIS, REQUIRING ANINCISION (SEPARATE PROCEDURE) cohort cohort cohort
66840 REMOVAL OF LENS MATERIAL; ASPIRATION TECHNIQUE, ONE OR MORE STAGES statewide
66850
REMOVAL OF LENS MATERIAL; PHACOFRAGMENTATION TECHNIQUE(MECHANICAL OR ULTRASONIC) (EG, PHACOEMULSIFICATION), WITH ASPIRATION cohort cohort cohort cohort cohort
66852 REMOVAL OF LENS MATERIAL; PARS PLANA APPROACH, WITH ORWITHOUT VITRECTOMY cohort cohort cohort cohort
66920 REMOVAL OF LENS MATERIAL; INTRACAPSULAR cohort cohort
66930 REMOVAL OF LENS MATERIAL; INTRACAPSULAR, FOR DISLOCATED LENS statewide
66940 REMOVAL OF LENS MATERIAL; EXTRACAPSULAR (OTHER THAN 66840,66850, 66852) cohort cohort
66982
EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (1-STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION), COMPLEX, REQUIR cohort cohort cohort cohort cohort cohort
66983 INTRACAPSULAR CATARACT EXTRACTION WITH INSERTION OFINTRAOCULAR LENS PROSTHESIS (ONE STAGE PROCEDURE) statewide
66984
EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULARLENS PROSTHESIS (ONE STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR cohort cohort cohort cohort cohort cohort
66985
INSERTION OF INTRAOCULAR LENS PROSTHESIS (SECONDARYIMPLANT), NOT ASSOCIATED WITH CONCURRENT CATARACTREMOVAL cohort cohort cohort cohort cohort
66986 EXCHANGE OF INTRAOCULAR LENS cohort cohort cohort cohort
66990 OPHTHALMIC ENDOSCOPE USE cohort cohort cohort
129
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
66999 UNLISTED PROCEDURE, ANTERIOR SEGMENT OF EYE cohort cohort cohort
67005 REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUEOR LIMBAL INCISION); PARTIAL REMOVAL cohort cohort cohort
67010
REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUEOR LIMBAL INCISION); SUBTOTAL REMOVAL WITHMECHANICAL VITRECTOMY cohort cohort cohort
67015
ASPIRATION OR RELEASE OF VITREOUS, SUBRETINAL OR CHOROIDALFLUID, PARS PLANA APPROACH (POSTERIOR SCLEROTOMY) cohort cohort
67025
INJECTION OF VITREOUS SUBSTITUTE, PARS PLANA OR LIMBALAPPROACH, (FLUID-GAS EXCHANGE), WITH OR WITHOUT ASPIRATION (SEPARATE PROCEDURE) cohort cohort cohort cohort
67027
IMPLANTATION OF INTRAVITREAL DRUG DELIVERY SYSTEM (EG,GANCICLOVIR IMPLANT), INCLUDES CONCOMITANT REMOVAL OF VITREOUS statewide
67028 INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT (SEPARATEPROCEDURE) cohort cohort cohort
67036 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; cohort cohort cohort cohort cohort
67039 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH FOCALENDOLASER PHOTOCOAGULATION cohort cohort cohort
67040 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH ENDOLASER PANRETINAL PHOTOCOAGULATION cohort cohort cohort cohort
67041 Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (e.g., macular pucker) cohort cohort cohort cohort cohort cohort
67042
Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (e.g., for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tampon cohort cohort cohort cohort cohort cohort
67043
Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (e.g., choroidal neovascularization), includes, if performed, intraocular tamponade i.e., air, gas or silicone oil) and cohort cohort cohort
67101
REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS;CRYOTHERAPY OR DIATHERMY, WITH OR WITHOUT DRAINAGE OF SUBRETINAL FLUID cohort cohort cohort
67105
REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS;PHOTOCOAGULATION, WITH OR WITHOUT DRAINAGE OF SUBRETINAL FLUID cohort cohort cohort cohort
67107
REPAIR OF RETINAL DETACHMENT; SCLERAL BUCKLING (SUCH ASLAMELLAR SCLERAL DISSECTION, IMBRICATION OR ENCIRCLING PROCEDURE), WITH OR WITHOUT IMPLANT, WITH OR WITHOUT cohort cohort cohort cohort cohort
67108
REPAIR OF RETINAL DETACHMENT; WITH VITRECTOMY, ANYMETHOD,WITH OR WITHOUT AIR OR GAS TAMPONADE, FOCA L ENDOLASER PHOTOCOAGULATION, CRYOTHERAPY, DRAINAGE OF SUBRETINAL FLUID, cohort cohort cohort cohort cohort cohort
67110 REPAIR OF RETINAL DETACHMENT; BY INJECTION OF AIR OR OTHERGAS (EG, PNEUMATIC RETINOPEXY) cohort cohort
67112
REPAIR OF RETINAL DETACHMENT; BY SCLERAL BUCKLING ORVITRECTOMY, ON PATIENT HAVING PREVIOUS IPSILATERAL RETINAL DETACHMENT REPAIR(S) USING SCLERAL BUCKLING OR VITRECTOMY cohort cohort cohort
67113
Repair of complex retinal detachment (e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 deg cohort cohort cohort cohort cohort cohort
67120
REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT;EXTRAOCULAR REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; cohort cohort
67121
REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT;INTRAOCULAR REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; cohort cohort cohort
67141
PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK,LATTICE DEGENERATION) WITHOUT DRAINAGE, ONE OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY statewide
67145 PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK,LATTICE DEGENERATION) WITHOUT DRAINAGE, ONE OR cohort cohort cohort cohort
130
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)
67208
DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULAREDEMA, TUMORS), ONE OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY cohort cohort
67210
DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULAREDEMA, TUMORS), ONE OR MORE SESSIONS; PHOTOCOAGULATION cohort cohort
67220
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDALNEOVASCULARIZATION), ONE OR MORE SESSION, PHOTOCOAGULATION (LASER) statewide
67221
DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDALNEOVASCULARIZATION);PHOTODYNAMIC THERAPY (INCLUDES INTRAVENOUS INFUSION) statewide
67227 Destruction of extensive or progressive retinopathy (e.g., diabetic retinopathy), one or more sessions, cryotherapy, diathermy cohort cohort
67228 Treatment of extensive or progressive retinopathy,one or more sessions; (e.g., diabetic retinopathy ), photocoagulation cohort cohort cohort cohort
67250 SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITHOUT GRAFT statewide
67255 SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITH GRAFT cohort cohort cohort cohort
67311 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE; ONEHORIZONTAL MUSCLE cohort cohort cohort cohort cohort
67312 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE; TWOHORIZONTAL MUSCLES cohort cohort cohort
67314
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE; ONEVERTICAL MUSCLE (EXCLUDING SUPERIOR OBLIQUE) cohort cohort cohort cohort
67316
STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE; TWO ORMORE VERTICAL MUSCLES (EXCLUDING SUPERIOR OBLIQUE) statewide
67318 STRABISMUS SURGERY, ANY PROCEDURE, SUPERIOR OBLIQUE MUSCLE cohort cohort cohort
67320
TRANSPOSITION PROCEDURE (EG, FOR PARETIC EXTRAOCULARMUSCLE), ANY EXTRAOCULAR MUSCLE (SPECIFY) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
67331
STRABISMUS SURGERY ON PATIENT WITH PREVIOUS EYE SURGERY ORINJURY THAT DID NOT INVOLVE THE EXTRAOCULAR MUSCLES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
67332
STRABISMUS SURGERY ON PATIENT WITH SCARRING OF EXTRAOCULARMUSCLES (EG, PRIOR OCULAR INJURY, STRABISMUS OR RETINAL DETACHMENT SURGERY) OR RESTRICTIVE MYOPATHY (EG, DYSTHYROID cohort cohort
67334
STRABISMUS SURGERY BY POSTERIOR FIXATION SUTURE TECHNIQUE,WITH OR WITHOUT MUSCLE RECESSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
67335
PLACEMENT OF ADJUSTABLE SUTURE(S) DURING STRABISMUS SURGERY,INCLUDING POSTOPERATIVE ADJUSTMENT(S) OFSUTURE(S) (LIST SEPARATELY IN ADDITION TO CODE F OR SPECIFIC STRABISMUS cohort cohort
67340
STRABISMUS SURGERY INVOLVING EXPLORATION AND/OR REPAIR OFDETACHED EXTRAOCULAR MUSCLE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
67346 BIOPSY OF EXTRAOCULAR MUSCLE statewide
67400
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVALAPPROACH); FOR EXPLORATION, WITH OR WITHOUT BIOPSY cohort cohort cohort
67405 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVALAPPROACH); WITH DRAINAGE ONLY cohort cohort
67412 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVALAPPROACH); WITH REMOVAL OF LESION cohort cohort cohort cohort
131
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
67413
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVALAPPROACH); WITH REMOVAL OF FOREIGN BODY ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL statewide
67414
ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVALAPPROACH); WITH REMOVAL OF BONE FOR DECOMPRESSION statewide
67420 ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG,KROENLEIN); WITH REMOVAL OF LESION cohort cohort
67500 *RETROBULBAR INJECTION; MEDICATION (SEPARATE PROCEDURE, DOESNOT INCLUDE SUPPLY OF MEDICATION) statewide
67515 *INJECTION OF THERAPEUTIC AGENT INTO TENON'S CAPSULE statewide
67550 ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION statewide
67560 ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL ORREVISION statewide
67570 OPTIC NERVE DECOMPRESSION (EG, INCISION OR FENESTRATION OFOPTIC NERVE SHEATH) cohort cohort
67599 UNLISTED PROCEDURE, ORBIT statewide
67700 *BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID cohort cohort cohort
67710 *SEVERING OF TARSORRHAPHY statewide
67715 *CANTHOTOMY (SEPARATE PROCEDURE) statewide
67800 EXCISION OF CHALAZION; SINGLE cohort cohort cohort cohort
67801 EXCISION OF CHALAZION; MULTIPLE, SAME LIDEXCISION OF CHALAZION; MULTIPLE, SAME LID statewide
67805 EXCISION OF CHALAZION; MULTIPLE, DIFFERENT LIDSEXCISION OF CHALAZION; MULTIPLE, DIFFERENT LIDS cohort cohort
67808
EXCISION OF CHALAZION; UNDER GENERAL ANESTHESIA AND/ORREQUIRING HOSPITALIZATION, SINGLE OR MULTIPLE EXCISION OF CHALAZION; UNDER GENERAL ANESTHESIA A ND/OR cohort cohort cohort
67825
*CORRECTION OF TRICHIASIS; EPILATION BY OTHER THANFORCEPS(EG, BY ELECTROSURGERY, CRYOTHERAPY, LASER SURGERY) cohort cohort
67840 *EXCISION OF LESION OF EYELID (EXCEPT CHALAZION) WITHOUTCLOSURE OR WITH SIMPLE DIRECT CLOSURE cohort cohort cohort cohort
67850 *DESTRUCTION OF LESION OF LID MARGIN (UP TO 1 CM) statewide
67875 TEMPORARY CLOSURE OF EYELIDS BY SUTURE (EG, FROST SUTURE) cohort cohort cohort cohort
67880 CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIANTARSORRHAPHY, OR CANTHORRHAPHY; cohort cohort cohort
67882
CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIANTARSORRHAPHY, OR CANTHORRHAPHY; WITH TRANSPOSITION OFTARSAL PLATE statewide
67900 REPAIR OF BROW PTOSIS (SUPRACILIARY, MID-FOREHEAD OR CORONALAPPROACH) cohort cohort cohort cohort
67901 REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITHSUTURE OR OTHER MATERIAL cohort cohort cohort
67902 REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITHFASCIAL SLING (INCLUDES OBTAINING FASCIA) cohort cohort
67903 REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTIONORADVANCEMENT, INTERNAL APPROACH statewide
67904 REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTIONORADVANCEMENT, EXTERNAL APPROACH cohort cohort cohort cohort cohort cohort
67908
REPAIR OF BLEPHAROPTOSIS; CONJUNCTIVO-TARSO-MULLER'SMUSCLE-LEVATOR RESECTION (EG, FASANELLA-SERVAT TYPE) cohort cohort
67911 CORRECTION OF LID RETRACTION cohort cohort cohort
67912 CORRECTION OF LAGOPHTHALMOS, WITH IMPLANTATION OF UPPER EYELID LID LOAD (EG, GOLD WEIGHT) cohort cohort
67914 REPAIR OF ECTROPION; SUTURE statewide
132
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
67917 REPAIR OF ECTROPION; BLEPHAROPLASTY, EXTENSIVE (EG,KUHNT-SZYMANOWSKI OR TARSAL STRIP OPERATIONS) cohort cohort cohort
67921 REPAIR OF ENTROPION; SUTURE statewide
67923 REPAIR OF ENTROPION; EXCISION TARSAL WEDGE statewide
67924 REPAIR OF ENTROPION; BLEPHAROPLASTY, EXTENSIVE (EG, WHEELER OPERATION) statewide
67930
SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN,TARSUS, AND/OR PALPEBRAL CONJUNCTIVA DIRECT CLOSURE; PARTIAL THICKNESS statewide
67935
SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN,TARSUS, AND/OR PALPEBRAL CONJUNCTIVA) DIRECT CLOSURE; FULL THICKNESS cohort cohort cohort cohort
67938 REMOVAL OF EMBEDDED FOREIGN BODY, EYELID cohort cohort cohort
67950 CANTHOPLASTY (RECONSTRUCTION OF CANTHUS) cohort cohort cohort
67961
EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS,CONJUNCTIVA, CANTHUS, OR FULL THICKNESS,MAY INCLUDE PREPARATION FOR SKIN GRAFT OR PEDICL E FLAP WITH ADJACENT cohort cohort cohort cohort
67966
EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS,CONJUNCTIVA, CANTHUS, OR FULL THICKNESS,MAY INCLUDE PREPARATION FOR SKIN GRAFT OR PEDICL E FLAP WITH ADJACENT cohort cohort cohort cohort cohort
67971
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OFTARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; UP TO TWO-THIRDS OF EYELID, ONE STAGE OR FIRST STAGE cohort cohort
67973
RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OFTARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; TOTAL EYELID, LOWER, ONE STAGE OR FIRST STAGE statewide
67999 UNLISTED PROCEDURE, EYELIDS cohort cohort
68100 BIOPSY OF CONJUNCTIVA statewide
68110 EXCISION OF LESION, CONJUNCTIVA; UP TO 1 CM cohort cohort cohort cohort
68115 EXCISION OF LESION, CONJUNCTIVA; OVER 1 CM cohort cohort cohort cohort cohort
68130 EXCISION OF LESION, CONJUNCTIVA; WITH ADJACENT SCLERA statewide
68135 *DESTRUCTION OF LESION, CONJUNCTIVA statewide
68200 *SUBCONJUNCTIVAL INJECTION cohort cohort
68320 CONJUNCTIVOPLASTY; WITH CONJUNCTIVAL GRAFT OR EXTENSIVEREARRANGEMENT cohort cohort
68325 CONJUNCTIVOPLASTY; WITH BUCCAL MUCOUS MEMBRANE GRAFT(INCLUDES OBTAINING GRAFT) statewide
68335 REPAIR OF SYMBLEPHARON; WITH FREE GRAFT CONJUNCTIVA ORBUCCAL MUCOUS MEMBRANE (INCLUDES OBTAINING GRAFT) statewide
68360 CONJUNCTIVAL FLAP; BRIDGE OR PARTIAL (SEPARATE PROCEDURE) cohort cohort
68399 UNLISTED PROCEDURE, CONJUNCTIVA statewide
68440 *SNIP INCISION OF LACRIMAL PUNCTUM cohort cohort
68510 BIOPSY OF LACRIMAL GLAND cohort cohort
68530 REMOVAL OF FOREIGN BODY OR DACRYOLITH, LACRIMAL PASSAGES statewide
68700 PLASTIC REPAIR OF CANALICULI cohort cohort
68720 DACRYOCYSTORHINOSTOMY (FISTULIZATION OF LACRIMAL SAC TONASAL CAVITY) cohort cohort cohort cohort cohort
68750 CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASALCAVITY); WITH INSERTION OF TUBE OR STENT statewide
68760 CLOSURE OF THE LACRIMAL PUNCTUM; BY THERMOCAUTERIZATION,LIGATION, OR LASER SURGERY statewide
68801 *DILATION OF LACRIMAL PUNCTUM, WITH OR WITHOUT IRRIGATION statewide
68810 *PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION; cohort cohort
68811 PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT cohort cohort cohort cohort cohort
133
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
IRRIGATION;REQUIRING GENERAL ANESTHESIA
68815 PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION;WITH INSERTION OF TUBE OR STENT cohort cohort cohort cohort cohort
68816 Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation cohort cohort cohort cohort cohort
68840 *PROBING OF LACRIMAL CANALICULI, WITH OR WITHOUT IRRIGATION cohort cohort
68850 *INJECTION OF CONTRAST MEDIUM FOR DACRYOCYSTOGRAPHY statewide
68899 UNLISTED PROCEDURE, LACRIMAL SYSTEM statewide
69000 *DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; SIMPLE cohort cohort cohort cohort cohort
69005 DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED statewide
69020 *DRAINAGE EXTERNAL AUDITORY CANAL, ABSCESS cohort cohort
69100 BIOPSY EXTERNAL EAR cohort cohort cohort
69110 EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR cohort cohort cohort
69120 EXCISION EXTERNAL EAR; COMPLETE AMPUTATION statewide
69145 EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL cohort cohort cohort cohort cohort cohort
69200 REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL;WITHOUTGENERAL ANESTHESIA cohort cohort cohort cohort cohort
69205 REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL;WITHGENERAL ANESTHESIA cohort cohort cohort cohort cohort
69210 REMOVAL IMPACTED CERUMEN (SEPARATE PROCEDURE), ONEOR BOTHEARS cohort cohort cohort cohort cohort cohort
69220 DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE (EG, ROUTINECLEANING) cohort cohort
69300 OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCTION statewide
69310
RECONSTRUCTION OF EXTERNAL AUDITORY CANAL (MEATOPLASTY) (EG,FOR STENOSIS DUE TO TRAUMA, INFECTION), (SEPARATE PROCEDURE) cohort cohort cohort
69399 UNLISTED PROCEDURE, EXTERNAL EAR cohort cohort
69420 *MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBEINFLATION cohort cohort cohort cohort
69421 *MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBEINFLATION REQUIRING GENERAL ANESTHESIA cohort cohort cohort cohort cohort
69424 VENTILATING TUBE REMOVAL WHEN ORIGINALLY INSERTED BY ANOTHERPHYSICIAN cohort cohort cohort cohort cohort cohort
69433 *TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE),LOCAL OR TOPICAL ANESTHESIA cohort cohort cohort
69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE),GENERAL ANESTHESIA cohort cohort cohort cohort cohort cohort
69450 TYMPANOLYSIS, TRANSCANAL cohort cohort
69501 TRANSMASTOID ANTROTOMY ("SIMPLE" MASTOIDECTOMY) statewide
69502 MASTOIDECTOMY; COMPLETE statewide
69511 MASTOIDECTOMY; RADICAL statewide
69535 RESECTION TEMPORAL BONE, EXTERNAL APPROACH statewide
69540 EXCISION AURAL POLYP statewide
69552 EXCISION AURAL GLOMUS TUMOR; TRANSMASTOID statewide
69601 REVISION MASTOIDECTOMY; RESULTING IN COMPLETE MASTOIDECTOMY statewide
69603 REVISION MASTOIDECTOMY; RESULTING IN RADICAL MASTOIDECTOMY statewide
69604 REVISION MASTOIDECTOMY; RESULTING IN TYMPANOPLASTY statewide
69610
TYMPANIC MEMBRANE REPAIR, WITH OR WITHOUT SITE PREPARATIONOR PERFORATION FOR CLOSURE, WITH OR WITHOUT PATCH cohort cohort cohort cohort cohort cohort
69620 MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND cohort cohort cohort cohort cohort
134
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
DONOR AREA)
69631
TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITIAL OR REVISION; WITHOUT OSSICULAR CHAIN RECONSTRUCTION cohort cohort cohort cohort cohort
69632
TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITIAL OR REVISION; WITH OSSICULAR CHAIN RECONSTRUCTION (EG, POSTFENESTRATION) cohort cohort cohort cohort
69633
TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR SURGERY), INITIAL OR REVISION; WITH OSSICULAR CHAIN RECONSTRUCTION AND SYNTHETIC PROSTHESIS cohort cohort cohort cohort cohort
69635
TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDINGCANALPLASTY, ATTICOTOMY, MIDDLE EAR SURGERY, AND/OR TYMPANIC MEMBRANE REPAIR); WITHOUT OSSICULAR CHAIN RECONSTRUCTION statewide
69637
TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDINGCANALPLASTY, ATTICOTOMY, MIDDLE EAR SURGERY, AND/OR TYMPANIC MEMBRANE REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION AND cohort cohort
69641
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); WITHOUT OSSICULAR CHAIN RECONSTRUCTION cohort cohort cohort cohort
69642
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION cohort cohort cohort
69643
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); WITH INTACT OR RECONSTRUCTED WALL, WITHOUT OSSICULAR CHAIN cohort cohort cohort
69644
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); WITH INTACT OR RECONSTRUCTED CANAL WALL, WITH OSSICULAR CHAIN cohort cohort cohort cohort
69645
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); RADICAL OR COMPLETE, WITHOUT OSSICULAR CHAIN RECONSTRUCTION cohort cohort
69646
TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY,MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); RADICAL OR COMPLETE, WITH OSSICULAR CHAIN RECONSTRUCTION statewide
69650 STAPES MOBILIZATION statewide
69660
STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OFOSSICULAR CONTINUITY, WITH OR WITHOUT USE OF FOREIGN MATERIAL; cohort cohort cohort cohort
69661
STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OFOSSICULAR CONTINUITY, WITH OR WITHOUT USE OF FOREIGN MATERIAL; WITH FOOTPLATE DRILL OUT cohort cohort
69662 REVISION OF STAPEDECTOMY OR STAPEDOTOMY cohort cohort cohort
69700 CLOSURE POSTAURICULAR FISTULA, MASTOID (SEPARATE PROCEDURE) statewide
69710 IMPLANTATION OR REPLACEMENT OF ELECTROMAGNETIC BONECONDUCTION HEARING DEVICE IN TEMPORAL BONE cohort cohort cohort
69711 REMOVAL OR REPAIR OF ELECTROMAGNETIC BONE CONDUCTION HEARINGDEVICE IN TEMPORAL BONE statewide
69714
IMPLANTATION OSSEOINTEGRATED IMPLANT TEMPORAL BONEW/ PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR, WITHOUT MASTIODECTOMY cohort cohort cohort
69717
REPLACEMENT (INCLUDING REMOVAL OF EXISTING DEVICE)OSSEOINTERGRATED IMPLANT, TEMPORAL BONE W/ PERCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR/COCHLEAR STIMULATOR W/OUT MASTOIDECTOMY statewide
135
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
69720 DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; LATERALTOGENICULATE GANGLION statewide
69799 UNLISTED PROCEDURE, MIDDLE EAR cohort cohort cohort cohort cohort
69801 Labyrinthotomy, with perfusion of vestibuloactive drug(s); transcanal cohort cohort cohort
69805 ENDOLYMPHATIC SAC OPERATION; WITHOUT SHUNT cohort cohort
69806 ENDOLYMPHATIC SAC OPERATION; WITH SHUNT cohort cohort
69820 FENESTRATION SEMICIRCULAR CANAL statewide
69930 COCHLEAR DEVICE IMPLANTATION, WITH OR WITHOUT MASTOIDECTOMY cohort cohort cohort
69949 UNLISTED PROCEDURE, INNER EAR cohort cohort
69990 USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
70015 CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
70030 RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY cohort cohort cohort cohort cohort cohort
70100 RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOURVIEWS cohort cohort cohort cohort cohort cohort
70110 RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS cohort cohort cohort cohort cohort
70140
RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS cohort cohort cohort cohort
70150
RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OFTHREE VIEWS RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF cohort cohort cohort cohort cohort
70160 RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF 3 VIEWS cohort cohort cohort cohort cohort
70170 DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICALSUPERVISION AND INTERPRETATION statewide
70200 RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOURVIEWS cohort cohort cohort cohort cohort
70210 RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS cohort cohort cohort cohort
70220 RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE,MINIMUM OF THREE VIEWS cohort cohort cohort cohort cohort
70250
RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH ORWITHOUT STEREO RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR cohort cohort cohort cohort cohort
70260
RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOURVIEWS, WITH OR WITHOUT STEREO RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR cohort cohort cohort cohort cohort
70300 RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEWRADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW statewide
70310
RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESSTHAN FULL MOUTH RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS cohort cohort
70320
RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTHRADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH cohort cohort
70328
RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN ANDCLOSED MOUTH; UNILATERAL RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND statewide
70330
RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN ANDCLOSED MOUTH; BILATERAL RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND cohort cohort cohort cohort cohort
70336 MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULARJOINT cohort cohort cohort cohort cohort
70355 ORTHOPANTOGRAM (EG, PANORAMIC X-RAY) cohort cohort cohort cohort
70360 RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE cohort cohort cohort cohort cohort
70371 COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY cohort cohort cohort
136
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
CINE OR VIDEO RECORDING
70390 SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
70450 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
70460 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
70470
COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort cohort
70480
COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIORFOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort
70481
COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIORFOSSA OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
70482
COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIORFOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER cohort cohort cohort cohort cohort
70486 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA;WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
70487 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA;WITHCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
70488
COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA;WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MA TERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort
70490 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort
70491 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort cohort
70492
COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUTCONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort
70496 Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed and image postprocessing cohort cohort cohort cohort cohort
70498 Computed tomographic angiography, neck, with contrast material(s), including noncontrast image, if performed, and image postprocessing cohort cohort cohort cohort cohort
70540 Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) cohort cohort cohort cohort cohort
70542 MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK; WITH CONTRAST MATERIAL(S) cohort cohort
70543
MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
70544 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CON-TRAST MATERIAL(S) cohort cohort cohort cohort cohort
70545 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CON- TRAST MATERIAL(S) statewide
70546
MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CON-TRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
70547 MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CON-TRAST MATERIAL(S) cohort cohort cohort cohort cohort
70548 MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITH CON- TRAST MATERIAL(S) cohort cohort cohort cohort
70549
MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CON-TRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
70551 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDINGBRAIN STEM); WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
70552 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDINGBRAIN STEM); WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
137
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
70553
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDINGBRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort cohort
70554
MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTIONAL MRI;INCLUDING TEST SELECTION AND ADMINISTRATION OF RE PETITIVE BODY PART MOVEMENT AND/OR VISUAL STIMULATION, NOT REQUIRING PHYSICIAN OR PSYCHOLOGIST ADMIN statewide
70555
MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTIONAL MRI;REQUIRING PHYSICIAN OR PSYCHOLOGIST ADMINISTRATIO N OF ENTIRE NEUROFUNCTIONAL TESTING statewide
71010 RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL cohort cohort cohort cohort cohort cohort
71020 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL ANDLATERAL; cohort cohort cohort cohort cohort cohort
71021 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL ANDLATERAL; WITH APICAL LORDOTIC PROCEDURE cohort cohort cohort cohort cohort
71022 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL ANDLATERAL; WITH OBLIQUE PROJECTIONS cohort cohort cohort cohort
71023 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL ANDLATERAL; WITH FLUOROSCOPY cohort cohort cohort cohort
71030 RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOURVIEWS; cohort cohort cohort cohort
71035 RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERALDECUBITUS, BUCKY STUDIES) cohort cohort cohort cohort
71100 RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS cohort cohort cohort cohort cohort cohort
71101
RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDINGPOSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS cohort cohort cohort cohort cohort cohort
71110 RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS cohort cohort cohort cohort cohort
71111
RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDINGPOSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS cohort cohort cohort cohort cohort
71120 RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort cohort
71130 RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS,MINIMUM OF THREE VIEWS cohort cohort cohort cohort
71250 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRASTMATERIAL cohort cohort cohort cohort cohort cohort
71260 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRASTMATERIAL(S) cohort cohort cohort cohort cohort cohort
71270
COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRASTMATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort
71275
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing cohort cohort cohort cohort cohort cohort
71550
MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOREVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY) cohort cohort cohort cohort
71552
MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL LYMPHA- DENOPATHY); WITHOUT CONTRAST MATERIAL(S) FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
71555
MAGNETIC RESONANCE ANGIOGRAPHY, CHEST (EXCLUDINGMYOCARDIUM), WITH OR WITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort
72010 RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY,ANTEROPOSTERIOR AND LATERAL cohort cohort
72020 RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL cohort cohort cohort cohort cohort cohort
72040 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 3 VIEWS OR LESS cohort cohort cohort cohort cohort cohort
72050 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS cohort cohort cohort cohort cohort cohort
72052 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 6 OR MOREVIEWS cohort cohort cohort cohort cohort cohort
138
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
72069 RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING(SCOLIOSIS) cohort cohort cohort cohort cohort
72070 RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR ANDLATERAL cohort cohort cohort cohort cohort cohort
72072
RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR ANDLATERAL, INCLUDING SWIMMER'S VIEW OF THECERVICOTHORACIC JUNCTION cohort cohort cohort cohort cohort cohort
72074 RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE,INCLUDINGOBLIQUES, MINIMUM OF FOUR VIEWS cohort cohort cohort cohort cohort
72080 RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR,ANTEROPOSTERIOR AND LATERAL cohort cohort cohort cohort cohort
72090 RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDINGSUPINE AND ERECT STUDIES cohort cohort cohort cohort cohort
72100 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL cohort cohort cohort cohort cohort cohort
72110 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITHOBLIQUE VIEWS cohort cohort cohort cohort cohort cohort
72114 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS, MINIMUM OF 6 VIEWS cohort cohort cohort cohort cohort
72120 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; BENDING VIEWS ONLY, 2 OR 3 VIEWS cohort cohort cohort cohort cohort
72125 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
72126 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRASTMATERIAL cohort cohort cohort cohort cohort
72127
COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort
72128 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort
72129 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRASTMATERIAL cohort cohort cohort cohort cohort
72130
COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort
72131 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort
72132 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRASTMATERIAL cohort cohort cohort cohort cohort cohort
72133
COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort
72141 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
72142 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
72146 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort
72147 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, THORACIC; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
72148 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
72149 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
72156
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; CERVICAL cohort cohort cohort cohort cohort
72157
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; THORACIC cohort cohort cohort cohort cohort
72158
MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL ANDCONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; LUMBAR cohort cohort cohort cohort cohort cohort
139
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
72170 RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY cohort cohort cohort cohort cohort cohort
72190 RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREEVIEWS cohort cohort cohort cohort cohort
72191 Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing cohort cohort cohort cohort cohort
72192 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRASTMATERIAL cohort cohort cohort cohort cohort cohort
72193 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRASTMATERIAL(S) cohort cohort cohort cohort cohort
72194
COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRASTMATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort cohort cohort
72195 MAGNETIC RESONANCE (EG, PROTON) IMAGING; PELVIS; WITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
72196 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS cohort cohort cohort
72197
MAGNETIC RESONANCE (EG, PROTON) IMAGING; PELVIS; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRASTMATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
72198 MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUTCONTRAST MATERIAL(S) cohort cohort cohort
72200 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREEVIEWS cohort cohort cohort cohort
72202 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MOREVIEWS cohort cohort cohort cohort cohort
72220 RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUMOF TWOVIEWS cohort cohort cohort cohort cohort cohort
72240 MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort cohort
72255 MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort
72265 MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISIONANDINTERPRETATION cohort cohort cohort cohort cohort cohort
72270 MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISIONAND INTERPRETATION cohort cohort cohort cohort cohort
72275 EPIDUROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
72291
RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, VERTEBRAL AUGMENTATION, ORSACRAL AUGMENTATION (SACROPLASTY), INCLUDING CAVI TY CREATION, PER VERTEBRAL BODY OR SACRUM; UNDER F cohort cohort cohort
72292
RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY, VERTEBRAL AUGMENTATION, ORSACRAL AUGMENTATION (SACROPLASTY), INCLUDING CAVI TY CREATION, PER VERTEBRAL BODY OR SACRUM; UNDER C statewide
72295 DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort
73000 RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE cohort cohort cohort cohort cohort cohort
73010 RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE cohort cohort cohort cohort cohort cohort
73020 RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW cohort cohort cohort cohort cohort
73030 RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWOVIEWS cohort cohort cohort cohort cohort cohort
73040 RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
73050 RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL,WITH OR WITHOUT WEIGHTED DISTRACTION cohort cohort cohort cohort cohort
73060 RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort cohort
73070 RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR ANDLATERALVIEWS cohort cohort cohort cohort cohort
73080 RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREEVIEWS cohort cohort cohort cohort cohort cohort
140
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
73085 RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort
73090
RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERALVIEWS RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL cohort cohort cohort cohort cohort cohort
73092 RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort
73100 RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR ANDLATERALVIEWS cohort cohort cohort cohort cohort cohort
73110 RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREEVIEWS cohort cohort cohort cohort cohort cohort
73115 RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
73120 RADIOLOGIC EXAMINATION, HAND; TWO VIEWS cohort cohort cohort cohort cohort
73130 RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS cohort cohort cohort cohort cohort cohort
73140 RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort cohort
73200 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
73201 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
73202
COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort
73206
Computed tomographic angiography, upper extremity,with contrast material(s), including noncontrast images, if performed, and image postprocessing cohort cohort cohort cohort
73218
MAGNETIC RESONANCE (EG, PROTON) IMAGING; UPPER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
73219 MAGNETIC RESONANCE (EG, PROTON) IMAGING; UPPER EXTREMITY, OTHER THAN JOINT; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort
73220 MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY,OTHER THAN JOINT cohort cohort cohort cohort
73221 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF UPPER EXTREMITY cohort cohort cohort cohort cohort cohort
73222 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF UPPER EXTREMITY; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort cohort
73223
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
73225 MAGNETIC RESONANCE ANGIOGRAPHY, UPPER EXTREMITY, WITH ORWITHOUT CONTRAST MATERIAL(S) cohort cohort cohort
73500 RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW cohort cohort cohort cohort cohort
73510 RADIOLOGIC EXAMINATION, HIP, UNILATERAL; COMPLETE,MINIMUMOF TWO VIEWS cohort cohort cohort cohort cohort cohort
73520
RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWOVIEWS OF EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF PELVIS cohort cohort cohort cohort cohort cohort
73525 RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort cohort
73530 RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE cohort cohort cohort cohort
73540 RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT ORCHILD,MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort
73550 RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR ANDLATERALVIEWS cohort cohort cohort cohort cohort cohort
73560 RADIOLOGIC EXAMINATION, KNEE; ONE OR TWO VIEWS cohort cohort cohort cohort cohort cohort
73562 RADIOLOGIC EXAMINATION, KNEE; THREE VIEWS cohort cohort cohort cohort cohort
73564 RADIOLOGIC EXAMINATION, KNEE; COMPLETE, FOUR OR MORE VIEWS cohort cohort cohort cohort cohort cohort
141
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
73565 RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING,ANTEROPOSTERIOR cohort cohort cohort cohort cohort
73580 RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort
73590 RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIORAND LATERAL VIEWS cohort cohort cohort cohort cohort cohort
73592 RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort
73600 RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR ANDLATERALVIEWS cohort cohort cohort cohort cohort cohort
73610 RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREEVIEWS cohort cohort cohort cohort cohort cohort
73615 RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort
73620 RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERALVIEWS cohort cohort cohort cohort cohort cohort
73630 RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OFTHREEVIEWS cohort cohort cohort cohort cohort cohort
73650 RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort
73660 RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF TWO VIEWS cohort cohort cohort cohort cohort cohort
73700 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUTCONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
73701 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
73702
COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUTCONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS cohort cohort cohort
73706
Computed tomographic angiography, lower extremity,with contrast material(s), including noncontrast images, if performed, and image postprocessing cohort cohort cohort cohort cohort
73718
MAGNETIC RESONANCE (EG, PROTON) IMAGING; LOWER EXTREMITY, OTHER THAN JOINT; WITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort cohort
73719 MAGNETIC RESONANCE (EG, PROTON) IMAGING; LOWER EXTREMITY, OTHER THAN JOINT; WITH CONTRAST MATERIAL(S) cohort cohort cohort
73720 MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY,OTHER THAN JOINT cohort cohort cohort cohort cohort
73721 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL cohort cohort cohort cohort cohort cohort
73722 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF LOWER EXTREMITY; WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
73723
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINTOF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
73725 MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH ORWITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort
74000 RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW cohort cohort cohort cohort cohort cohort
74010 RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR ANDADDITIONAL OBLIQUE AND CONE VIEWS cohort cohort cohort cohort cohort
74020 RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDINGDECUBITUS AND/OR ERECT VIEWS cohort cohort cohort cohort cohort cohort
74022
RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMENSERIES, INCLUDING SUPINE, ERECT, AND/OR DECUBITUS VIEWS, UPRIGHT PA CHEST cohort cohort cohort cohort cohort cohort
74150 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRASTMATERIAL cohort cohort cohort cohort cohort
74160 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRASTMATERIAL(S) cohort cohort cohort cohort cohort cohort
74170 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRASTMATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
142
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
AND FURTHER SECTIONS
74174
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES, IF PERFORMED, AND IMAGE POSTPROCESSING cohort cohort cohort cohort cohort
74175
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing cohort cohort cohort cohort cohort
74176 Computed tomography, abdomen and pelvis; without contrast material cohort cohort cohort cohort cohort cohort
74177 Computed tomography, abdomen and pelvis; with contrast material(s) cohort cohort cohort cohort cohort cohort
74178
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions cohort cohort cohort cohort cohort cohort
74181 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN WITHOUT CONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
74182 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN WITH CONTRAST MATERIAL(S) cohort cohort cohort cohort
74183
MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SEQUENCES cohort cohort cohort cohort cohort
74185 MAGNETIC RESONANCE ANGIOGRAPHY, ABDOMEN, WITH OR WITHOUTCONTRAST MATERIAL(S) cohort cohort cohort cohort cohort
74210 RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS cohort cohort cohort
74220 RADIOLOGIC EXAMINATION; ESOPHAGUS cohort cohort cohort cohort cohort cohort
74230 SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITHCINERADIOGRAPHY AND/OR VIDEO cohort cohort cohort cohort cohort
74240 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB cohort cohort cohort cohort cohort
74241 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB cohort cohort cohort cohort cohort
74245 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS cohort cohort cohort cohort cohort
74246
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIRCONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH OR WITHOUT DELAYED cohort cohort cohort cohort cohort cohort
74247
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIRCONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH OR WITHOUT DELAYED cohort cohort cohort cohort cohort
74249
RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIRCONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH SMALL BOWEL cohort cohort cohort cohort cohort
74250 RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLESERIAL FILMS cohort cohort cohort cohort cohort
74251 RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLESERIAL FILMS; VIA ENTEROCLYSIS TUBE statewide
74261
COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING IMAGE POSTPROCESSING; WITHOUT CONTRASTMATERIAL cohort cohort cohort cohort cohort
74263 COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, SCREENING,INCLUDING IMAGE POSTPROCESSING cohort cohort cohort
74270 Radiologic examination, colon; contrast (e.g., barium) enema, with or without KUB cohort cohort cohort cohort cohort
74280 RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFICHIGH DENSITY BARIUM, WITH OR WITHOUT GLUCAGON cohort cohort cohort cohort cohort
74283
THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OFINTUSSUSCEPTION OR OTHER INTRALUMINAL OBSTRUCTION (EG, MECONIUM ILEUS) cohort cohort cohort
74290 CHOLECYSTOGRAPHY, ORAL CONTRAST; statewide
74300 CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; cohort cohort cohort cohort cohort
143
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
INTRAOPERATIVE,RADIOLOGICAL SUPERVISION AND INTERPRETATION
74301
CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONALSETINTRAOPERATIVE, RADIOLOGICAL SUPERVISION AND I NTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
74305
CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
74320 CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort
74327
POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIAT-TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQUE), RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
74328
ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM,RADIOLOGICAL SUPERVISION AND INTERPRETATION ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, cohort cohort cohort cohort cohort
74329
ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, cohort cohort cohort
74330
COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARYANDPANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERV ISION AND INTERPRETATION cohort cohort cohort cohort cohort
74340
INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG,MILLER-ABBOTT), INCLUDING MULTIPLE FLUOROSCOPIES AND FILMS, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
74360
INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG,ESOPHAGUS), RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort
74363
PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCTSTRICTURE WITH OR WITHOUT PLACEMENT OF STENT, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
74400
UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB,WITH OR WITHOUT TOMOGRAPHY; UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, cohort cohort cohort cohort cohort
74410
UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; cohort cohort cohort
74415
UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; cohort cohort cohort cohort
74420 UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB cohort cohort cohort cohort cohort
74425
UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
74430 CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
74450 URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort cohort
74455 URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort cohort
74475
INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
74480
INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETERTHROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
74485 DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort
74710 PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION statewide
144
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
74740 HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort cohort cohort
74742 TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
74775 PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATIONOR EXTENTOF ANOMALIES) statewide
75557 Cardiac magnetic resonance imaging for morphology and function without contrast material; cohort cohort cohort
75561
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; cohort cohort cohort
75563
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging statewide
75565
CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
75571
COMPUTED TOMOGRAPHY, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM cohort cohort cohort cohort
75572
COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL, FOR EVALUATION OF CARDIAC STRUCTURE AND MORPHOLOGY (INCLUDING 3D IMAGE POSTPROCESSING, ASSESSMENT OF CARDIAC FUNCTION, AND EVALUATION OF VENOUS STRU cohort cohort cohort
75573
COMPUTED TOMOGRAPHY, HEART, WITH CONTRAST MATERIAL, FOR EVALUATION OF CARDIAC STRUCTURE AND MORPHOLOGY IN THE SETTING OF CONGENITAL HEART DISEASE (INCLUDING 3D IMAGE POSTPROCESSING, ASSESSMENT OF LV C cohort cohort
75574
COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEART, CORONARY ARTERIES AND BYPASS GRAFTS (WHEN PRESENT), WITH CONTRAST MATERIAL, INCLUDING 3D IMAGE POSTPROCESSING(INCLUDING EVALUATION OF CARDIAC STRUCTURE AND MO cohort cohort cohort cohort cohort
75600 AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort
75605 AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75625 AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
75630
AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWEREXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75635
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing. cohort cohort cohort cohort cohort
75705 ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION ANDINTERPRETATION statewide
75710 ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISIONAND INTERPRETATION cohort cohort cohort cohort cohort
75716 ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
75726
ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH ORWITHOUT FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
75733 ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICALSUPERVISION AND INTERPRETATION statewide
75736
ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
75741 ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION cohort cohort
75743 ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICALSUPERVISION AND INTERPRETATION statewide
75756 ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL statewide
145
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
SUPERVISION AND INTERPRETATION
75774
ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTERBASIC EXAMINATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR cohort cohort cohort cohort
75791
ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT FISTULA/GRAFT), COMPLETE EVALUATION OF DIALYSIS ACCESS, INCLUDING FLUOROSCOPY, IMAGE DOCUMENTATION AND REPORT (INCLUDES INJECTIONS OF CONTRAST AN statewide
75809
SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLINGNONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPERITONEAL SHUNT), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
75820 VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75822 VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISIONAND INTERPRETATION cohort cohort cohort cohort
75825
VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75827
VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75831 VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort
75833 VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort
75860 VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICALSUPERVISION AND INTERPRETATION statewide
75870 VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort
75885
PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMICEVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
75887
PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMICEVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
75889
HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMICEVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
75891
HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMICEVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
75893
VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUTANGIOGRAPHY (EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
75894 TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort
75896
TRANSCATHETER THERAPY, INFUSION, OTHER THAN FOR THROMBOLYSIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
75898
ANGIOGRAPHY THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION ORINFUSION, OTHER THAN FOR THROMBOLYSIS cohort cohort cohort
75901 MECHANICAL REMOVE, PERICATHETER OBSTRUCTIVE MATL FROM CVA DEVICE VIA SEP VENOUS ACCESS S&I cohort cohort cohort
75945
INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICALSUPERVISION AND INTERPRETATION; INITIAL VESSEL statewide
75960
Transcatheter introduction of intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity artery), percutaneous and/or open, radiological supervision and interpretation, ea cohort cohort cohort cohort cohort
75962
TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY OTHER THAN RENAL, OR OTHER VISCERAL ARTERY, ILIAC OR LOWER EXTREMITY, RADIOLOGICAL SUPERVISION cohort cohort cohort cohort cohort
146
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ANDINTERPRETATION
75966
TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERALARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
75968
TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERALARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
75970 TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION ANDINTERPRETATION cohort cohort cohort
75978
TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIANSTENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
75982
PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINEDINTERNAL AND EXTERNAL BILIARY DRAINAGE OR OFA DRAINAGE STENT FOR INTERNAL BILIARY DRAINAGE I N PATIENTS WITH AN cohort cohort
75984
Change of percutaneous tube or drainage catheter with contrast monitoring (e.g., genitourinary system, abscess), radiological supervision and interpretation cohort cohort cohort cohort cohort
75989
RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OFABSCESS, OR SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUND, OR COMPUTED TOMOGRAPHY), WITH PLACEM ENT OF INDWELLING CATHETER, cohort cohort cohort cohort
76000
FLUOROSCOPY (SEPARATE PROCEDURE), UP TO 1 HOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONALTIME, OTHER THAN 71023 OR 71034 (EG, CARDIAC FLUO ROSCOPY) cohort cohort cohort cohort cohort cohort
76001
FLUOROSCOPY, PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL TIME MORE THAN 1 HOUR, ASSISTING A NONRADIOLOGIC PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (EG, NEPHROSTOLITHOTOMY, ERCP, cohort cohort cohort cohort cohort cohort
76010 RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY,SINGLE FILM, CHILD cohort cohort cohort cohort
76080
RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACTSTUDY, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
76098 RADIOLOGICAL EXAMINATION, SURGICAL SPECIMEN cohort cohort cohort cohort cohort
76100 RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG,TOMOGRAPHY), OTHER THAN WITH UROGRAPHY cohort cohort
76120 CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED statewide
76125
CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
76140 CONSULTATION ON X-RAY EXAMINATION MADE ELSEWHERE, WRITTENREPORT statewide
76365
COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION,RADIOLOGICAL SUPERVISION AND INTERPRETATION statewide
76376
3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER TOMOGRAPHIC MODALITY WITH IMAGE POSTPROCESSING UNDER CONCURRENT SUPERVISION; NOT cohort cohort cohort cohort
76377
3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER TOMOGRAPHIC MODALITY WITH IMAGE POSTPROCESSING UNDER CONCURRENT SUPERVISION; REQ cohort cohort cohort cohort cohort
76380 COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UPSTUDY cohort cohort cohort cohort cohort
76390 MAGNETIC RESONANCE SPECTROSCOPY statewide
76496 UNLISTED FLUOROSCOPIC PROCEDURE cohort cohort
76497 UNLISTED COMPUTED TOMOGRAPHY PROCEDURE cohort cohort
147
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
76498 UNLISTED MAGNETIC RESONANCE PROCEDURE cohort cohort
76499 UNLISTED DIAGNOSTIC RADIOLOGIC PROCEDUREUNLISTED DIAGNOSTIC RADIOLOGIC PROCEDURE cohort cohort cohort
76506
Echoencephalography, real time with image documentation (gray sale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnorm cohort cohort cohort cohort
76512 OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACTB-SCAN (WITH OR WITHOUT SIMULTANEOUS A-SCAN) statewide
76513 OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; IMMERSION(WATER BATH) B-SCAN statewide
76514
OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL (DETERMINATION OF CORNEAL THICKNESS) statewide
76519 OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITHINTRAOCULAR LENS POWER CALCULATION statewide
76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid) real time with image documentation cohort cohort cohort cohort cohort cohort
76604 Ultrasound, chest (includes mediastinum), real time with image documentation cohort cohort cohort cohort cohort
76645 Ultrasound, breast(s) (unilateral or bilateral), real time with image documentation cohort cohort cohort cohort cohort cohort
76700 Ultrasound, abdominal, real time with image documentation; complete cohort cohort cohort cohort cohort cohort
76705
ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGEDOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP) cohort cohort cohort cohort cohort cohort
76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete cohort cohort cohort cohort cohort cohort
76775
ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES),B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED cohort cohort cohort cohort cohort
76776 ULTRASOUND, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER WITH IMAGE DOCUMENTATION cohort cohort cohort cohort
76800 ECHOGRAPHY, SPINAL CANAL AND CONTENTS cohort cohort cohort cohort cohort
76801 US,PREG UTER, REAL TIME W/IMAGE DOCUMENT, FETAL & MATERNAL, 1ST TRIMEST, TRANSABDOM SINGL/1ST GEST cohort cohort cohort cohort cohort
76802 US,PREG UTER, REAL TIME W/IMAGE DOCUMENT, FETAL & MATERNAL, 1ST TRIMEST, TRANSABDOM;EA ADD'L GEST cohort cohort cohort
76805
ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITHIMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MATERNAL EVALUATION) cohort cohort cohort cohort cohort
76810
ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITHIMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MATERNAL EVALUATION), MULTIPLE GESTATION, AFTER THE FIRST TRIMESTER cohort cohort cohort cohort cohort
76811 US,PREG UTER, REAL TIME W/IMAGE DOC FETL & MATRNL + DETL FETL EXM, TRANSABD; SINGL/1ST ADD'L GEST cohort cohort cohort cohort
76812 US,PREG UTER, REAL TIME W/IMAGE DOC FETAL & MATERNAL,+ DETAIL FETAL EXAM TRANSABD; EA ADD'L GEST cohort cohort cohort cohort
76813
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY MEASUREMENT, TRANSABDOMINAL OR TRANSVAGINALAPPROACH; SINGLE OR FIRST GESTATION cohort cohort cohort cohort
76814
ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY MEASUREMENT, TRANSABDOMINAL OR TRANSVAGINALAPPROACH; EACH ADDITIONAL GESTATION (LIST SEPARAT cohort cohort cohort cohort
76815
ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITHIMAGE DOCUMENTATION; LIMITED (FETAL SIZE, HEART BEAT, PLACENTAL LOCATION, FETAL POSITION, OREMERGENCY IN THE cohort cohort cohort cohort cohort
76816 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITHIMAGE DOCUMENTATION; FOLLOW-UP OR REPEAT cohort cohort cohort cohort cohort
148
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
76817 US,PREGNANT UTERUS,REAL TIME W/IMAGE DOCUMENT TRANSVAGINAL cohort cohort cohort cohort cohort
76818 FETAL BIOPHYSICAL PROFILE cohort cohort cohort cohort
76819 FETAL BIOPHYSICAL PROFILE : WITH NON-STRESS TESTING cohort cohort cohort cohort
76820 UMBILICAL ARTERY ECHO cohort cohort cohort
76821 MIDDLE CEREBRAL ARTERY ECHO cohort cohort cohort
76825
ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIMEWITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; cohort cohort
76826
ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIMEWITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; FOLLOW-UP OR REPEAT STUDY cohort cohort
76827
DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM,PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; COMPLETE cohort cohort cohort
76828
DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM,PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY; FOLLOW-UP OR REPEAT STUDY cohort cohort
76830 ECHOGRAPHY, TRANSVAGINAL cohort cohort cohort cohort cohort cohort
76831 HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER cohort cohort cohort
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete cohort cohort cohort cohort cohort cohort
76857
ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIMEWITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES) cohort cohort cohort cohort cohort
76870 ECHOGRAPHY, SCROTUM AND CONTENTS cohort cohort cohort cohort cohort cohort
76872 ECHOGRAPHY, TRANSRECTAL cohort cohort cohort cohort cohort
76873
ECHOGRAPHY, PROSTATE VOLUME STUDAY FOR BRACHYTHERAPY TREATMENT PLANNIN (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
76881 Ultrasound, extremity, nonvascular, real-time withimage documentation; complete cohort cohort cohort cohort cohort cohort
76882 Ultrasound, extremity, nonvascular, real-time withimage documentation; limited, anatomic specific cohort cohort cohort cohort cohort
76885
ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC (REQUIRING PHYSICIAN OR OTHERQUALIFIED HEALTH CARE PROFESSIONAL MANIPULATION) cohort cohort cohort cohort
76886
ULTRASOUND, INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; LIMITED, STATIC (NOT REQUIRING PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL MANIPULATION) cohort cohort cohort cohort
76932 ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL SUPERVISION statewide
76936
ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIALPSEUDO-ANEURYSM OR ARTERIOVENOUS FISTULAE (INCLUDES DIAGNOSTIC ULTRASOUND EVALUATION, COMPRESSION OF LESION AND cohort cohort cohort
76937
ULTRASOUND GUIDANCE FOR VASCULAR ACCESS REQUIRING ULTRASOUND EVALUATION OF POTENTIAL ACCESS SITES, DOCUMENTATION OF SELECTED VESSEL PATENCY, CONCURRENT REALTIME ULTRASOUND VISUALIZATION OF VASCULAR NE cohort cohort cohort cohort cohort cohort
76940 Ultrasound guidance for, and monitoring of, parenchymal tissue ablation statewide
76941
ULTRASONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION ORCORDOCENTESIS, RADIOLOGICAL SUPERVISION ANDINTERPRETATION statewide
76942
ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT(EG,BIOPSYASPIRATION, INJECTION,LOCALIZATION DEVICE) IMAGINGSUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort cohort
76945 ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING,RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
149
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
76946 ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICALSUPERVISION AND INTERPRETATION cohort cohort cohort cohort
76950 ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN statewide
76965
ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENTAPPLICATION ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT cohort cohort cohort cohort
76970 ULTRASOUND STUDY FOLLOW-UP (SPECIFY) cohort cohort
76998 ULTRASONIC GUIDANCE, INTRAOPERATIVE cohort cohort cohort cohort cohort
76999 UNLISTED ULTRASOUND PROCEDURE cohort cohort cohort cohort cohort
77001
FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT, REPLACEMENT (CATHETER ONLY OR COMPLETE), OR REMOVAL (INCLUDES FLUOROSCOPIC GUIDANCE FOR VASCULAR ACCESS AND CATHETER MANIPULATION, ANY cohort cohort cohort cohort cohort cohort
77002 FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE) cohort cohort cohort cohort cohort cohort
77003
FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP FOR SPINE OR PARASPINOUS DIAGNOSTICOR THERAPEUTIC INJECTION PROCEDURES (EPIDURAL OR SUBARACHNOID) cohort cohort cohort cohort cohort cohort
77011 COMPUTED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION cohort cohort
77012
COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT (EG, BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
77013 COMPUTERIZED TOMOGRAPHY GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION cohort cohort cohort
77014 COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS cohort cohort cohort cohort cohort
77021
MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT (EG, FOR BIOPSY, NEEDLE ASPIRATION, INJECTION, OR PLACEMENT OF LOCALIZATION DEVICE) RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
77031
STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT (EG, FOR WIRE LOCALIZATION OR FOR INJECTION), EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
77032
MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST(EG, FOR WIRE LOCALIZATION OR FOR INJECTION), EAC H LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort cohort
77051
COMPUTER-AIDED DETECTION (COMPUTER ALGORITHM ANALYSIS OF DIGITAL IMAGE DATA FOR LESION DETECTION) WITH FURTHER REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION OF FILM RADIOGRAPHIC IMAGES; DIAG cohort cohort cohort cohort cohort
77052
COMPUTER-AIDED DETECTION (COMPUTER ALGORITHM ANALYSIS OF DIGITAL IMAGE DATA FOR LESION DETECTION) WITH FURTHER REVIEW FOR INTERPRETATION, WITH OR WITHOUT DIGITIZATION OF FILM RADIOGRAPHIC IMAGES; SCRE cohort cohort cohort cohort cohort
77053 MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort cohort cohort
77054 MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION cohort cohort
77055 MAMMOGRAPHY; UNILATERAL cohort cohort cohort cohort cohort
77056 MAMMOGRAPHY; BILATERAL cohort cohort cohort cohort cohort
77057 SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW FILM STUDY OF EACH BREAST) cohort cohort cohort cohort cohort
77058 MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/ORWITH CONTRAST MATERIAL(S); UNILATERAL cohort cohort cohort cohort
77059 MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/ORWITH CONTRAST MATERIAL(S); BILATERAL cohort cohort cohort cohort cohort
77072 BONE AGE STUDIES cohort cohort cohort cohort cohort
77073 BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, cohort cohort cohort cohort
150
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
SCANOGRAM)
77074 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES) cohort cohort cohort cohort
77075 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON) cohort cohort cohort cohort cohort
77076 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY, INFANT cohort cohort
77077 JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS (SPECIFY) cohort cohort cohort cohort
77078 COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE) cohort cohort
77080
DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE) cohort cohort cohort cohort cohort cohort
77081
DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL) cohort cohort cohort cohort
77082
DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; VERTEBRAL FRACTURE ASSESSMENT cohort cohort
77280 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE cohort cohort cohort cohort cohort
77285 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING;INTERMEDIATE cohort cohort cohort
77290 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING;COMPLEX cohort cohort cohort cohort cohort
77295 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING;THREE-DIMENSIONAL cohort cohort cohort cohort cohort
77300
BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTHDOSE, TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TISSUE INHOMOGENEITY FACTORS, AS REQUIREDDURING COURSE OF cohort cohort cohort cohort cohort
77301 INTENSITY MODULATED RADIOTHERAPY PLAN W/DOSE VOLUME HISTOGRAMS cohort cohort cohort cohort cohort
77305
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTERCALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIED PORTS DIRECTED TO A SINGLE AREA OF INTEREST) cohort cohort cohort cohort
77310
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTERCALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS DIRECTED TO A SINGLE AREA OF INTEREST) cohort cohort cohort
77315
TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTERCALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL PORTS, THE USE OF WEDGES, COMPENSATORS, COMPLEX BLOCKING, cohort cohort cohort cohort cohort
77321 SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTALBODY cohort cohort cohort cohort cohort
77326
BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR SOURCES/RIBBON APPLICATION, REMOTE AFTERLOADING BRACHYTHERAPY, 1 TO 8 SOURCES) cohort cohort cohort
77327
BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION INVOLVING 5 TO 10 SOURCES/RIBBONS, REMOTE AFTERLOADING BRACHYTHERAPY, 9 TO 12 cohort cohort
77328
BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANEISODOSE PLAN, VOLUME IMPLANT CALCULATIONS, OVER 10 SOURCES/RIBBONS USED, SPECIAL SPATIAL RECONSTRUCTION, REMOTE cohort cohort cohort cohort
77331
SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING PHYSICIAN SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY cohort cohort cohort cohort cohort
77332 TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE(SIMPLEBLOCK, SIMPLE BOLUS) cohort cohort cohort cohort cohort
151
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
77333
TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE(MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS) cohort cohort cohort cohort cohort
77334
TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX(IRREGULAR BLOCKS, SPECIAL SHIELDS, COMPENSATORS,WEDGES, MOLDS OR CASTS) cohort cohort cohort cohort cohort
77336
CONTINUING MEDICAL PHYSICS CONSULTATION, INCLUDINGASSESSMENT OF TREATMENT PARAMETERS, QUALITY ASSURANCE OF DOSE DELIVERY, AND REVIEW OF PATIENT TREATMENT DOCUMENTATION cohort cohort cohort cohort cohort
77338
MULTI-LEAF COLLIMATOR(MLC) DEVICE(S) FOR INTENSITYMODULATED RADIATION THERAPY (IMRT),DESIGN AND CONSTRUCTION PER IMRT PLAN cohort cohort cohort cohort cohort
77370 SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION cohort cohort cohort cohort cohort
77371
Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-sourceCobalt 60 based statewide
77373
STEREOTACTIC BODY RADIATION THERAPY, TREATMENT DELIVERY, PER FRACTION TO 1 OR MORE LESIONS, INCLUDING IMAGE GUIDANCE, ENTIRE COURSE NOT TO EXCEED 5 FRACTIONS statewide
77399 UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY ANDTREATMENT DEVICES, AND SPECIAL SERVICES cohort cohort cohort
77401 RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHOVOLTAGE statewide
77402
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR NO BLOCKS; UP TO 5 MEV statewide
77403
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR NO BLOCKS; 6-10 MEV cohort cohort cohort cohort
77404
RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR NO BLOCKS; 11-19 MEV cohort cohort cohort cohort
77408
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, USE OF MULTIPLE BLOCKS; 6-10 MEV cohort cohort
77409
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, USE OF MULTIPLE BLOCKS; 11-19 MEV cohort cohort cohort cohort
77411
RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, USE OF MULTIPLE BLOCKS; 20 MEV OR GREATER statewide
77412
RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATETREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, cohort cohort cohort
77413
RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATETREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, cohort cohort cohort cohort cohort
77414
RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATETREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, cohort cohort cohort cohort cohort
77416
RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATETREATMENT AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, cohort cohort cohort
77417 THERAPEUTIC RADIOLOGY PORT FILM(S) cohort cohort cohort cohort cohort
77418 INTENSITY MODULATED RADIOTHERAPY PLAN, SINGLE/ MULTIPLE FIELDS/ARCS, PER SESSION cohort cohort cohort cohort cohort
77421 STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR THE DELIVERY OF RADIATION THERAPY cohort cohort cohort cohort cohort
77470 SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY cohort cohort cohort cohort cohort
152
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
IRRADIATION, HEMIBODY RADIATION, PER ORAL OR ENDOCAVITARY IRRADIATION)
77750 INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION statewide
77761 INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE statewide
77762 INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE statewide
77763 INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX statewide
77777
INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATEINTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE cohort cohort
77778
INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEXINTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX cohort cohort cohort cohort
77785 Remote afterloading high dose rate radionuclide brachytherapy; 1 channel cohort cohort cohort
77786 Remote afterloading high dose rate radionuclide brachytherapy; 2-12 channels cohort cohort cohort
77787 Remote afterloading high dose rate radionuclide brachytherapy; over 12 channels cohort cohort
77790 SUPERVISION, HANDLING, LOADING OF RADIOELEMENT cohort cohort cohort cohort
77799 UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY cohort cohort
78012
THYROID UPTAKE, SINGLE OR MULTIPLE QUANTITATIVE MEASUREMENT(S) (INCLUDING STIMULATION, SUPPRESSION, OR DISCHARGE, WHEN PERFORMED) cohort cohort cohort cohort cohort
78013 THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED); cohort cohort cohort cohort cohort
78014
THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED); WITH SINGLE OR MULTIPLE UPTAKE(S) QUANTITATIVE MEASUREMENT(S) (INCLUDING STIMULATION, SUPPRESSION, OR DISCHARGE, WHEN PERFORMED) cohort cohort cohort cohort cohort
78015 THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA(EG, NECKAND CHEST ONLY) cohort cohort
78018 THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY cohort cohort cohort cohort
78020 THYROID CARCINOMA METASTASES UPTAKE (LIST SEPARATELY INADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
78070 PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION,WHEN PERFORMED); cohort cohort cohort cohort cohort
78071
PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION,WHEN PERFORMED); WITH TOMOGRAPHIC (SPECT) cohort cohort cohort cohort
78072
PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION,WHEN PERFORMED); WITH TOMOGRAPHIC (SPECT), AND CO NCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ANATOMICAL LOCALIZATION cohort cohort cohort
78075 ADRENAL IMAGING, CORTEX AND/OR MEDULLA statewide
78102 BONE MARROW IMAGING; LIMITED AREA statewide
78104 BONE MARROW IMAGING; WHOLE BODY statewide
78122
WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATEMEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME(RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE) statewide
78195 LYMPHATICS AND LYMPH GLANDS IMAGING cohort cohort cohort cohort
78201 LIVER IMAGING; STATIC ONLY statewide
78202 LIVER IMAGING; WITH VASCULAR FLOW statewide
78205 LIVER IMAGING (SPECT) cohort cohort cohort cohort
78215 LIVER AND SPLEEN IMAGING; STATIC ONLY cohort cohort cohort cohort cohort
78216 LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW cohort cohort
78226 HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; cohort cohort cohort cohort cohort
78227 HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; WITH PHARMACOLOGIC INTERVENTION, cohort cohort cohort cohort cohort cohort
153
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
INCLUDING QUANTITATIVE MEASUREMENT(S) WHEN PERFORMED
78264 GASTRIC EMPTYING STUDY cohort cohort cohort cohort cohort
78267 UREA BREATH TEST, C-14; ACQUISITION FOR ANALYSIS cohort cohort
78268 UREA BREATH TEST, C-14; ANALYSIS statewide
78278 ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING cohort cohort cohort cohort
78290 BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL'SLOCALIZATION, VOLVULUS) cohort cohort cohort cohort
78300 BONE AND/OR JOINT IMAGING; LIMITED AREA cohort cohort cohort cohort cohort
78305 BONE AND/OR JOINT IMAGING; MULTIPLE AREAS cohort cohort cohort
78306 BONE AND/OR JOINT IMAGING; WHOLE BODY cohort cohort cohort cohort cohort cohort
78315 BONE AND/OR JOINT IMAGING; THREE PHASE STUDY cohort cohort cohort cohort cohort cohort
78320 BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT) cohort cohort cohort cohort cohort cohort
78428 CARDIAC SHUNT DETECTION statewide
78445 NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY,VENOGRAPHY) statewide
78451
MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT) (INCLUDING ATTENUATION CORRECTION, QUALITATIVE OR QUANTITATIVE WALL MOTION, EJECTION FRACTION BY FIRST PASS OR GATED TECHNIQUE, ADDITIONAL QUANTIFICAT cohort cohort cohort cohort cohort
78452
MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT) (INCLUDING ATTENUATION CORRECTION, QUALITATIVE OR QUANTITATIVE WALL MOTION, EJECTION FRACTION BY FIRST PASS OR GATED TECHNIQUE, ADDITIONAL QUANTIFICAT cohort cohort cohort cohort cohort
78454
MYOCARDIAL PERFUSION IMAGING, PLANAR (INCLUDING QUALITATIVE OR QUANTITATIVE WALL MOTION, EJECTION FRACTION BY FIRST PASS OR GATED TECHNIQUE, ADDITIONAL QUANTIFICATION, WHEN PERFORMED); MULTIPLE STUDIE statewide
78459 MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET),METABOLIC EVALUATION statewide
78472
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; PLANAR,SINGLE STUDY AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOGIC), WALL MOTION STUDY PLUS EJECTIONFRACTION, cohort cohort cohort cohort cohort
78473
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLESTUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, AT REST AND STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH OR WITHOUT cohort cohort
78492
MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET),PERFUSION; MULTIPLE STUDIES AT REST AND/OR STRESS MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), statewide
78494
CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, ATREST, WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT QUANTITATIVE PROCESSING cohort cohort
78579 PULMONARY VENTILATION IMAGING (EG, AEROSOL OR GAS) cohort cohort cohort cohort
78580 PULMONARY PERFUSION IMAGING (EG, PARTICULATE) cohort cohort cohort cohort
78582 PULMONARY VENTILATION (EG, AEROSOL OR GAS) AND PERFUSION IMAGING cohort cohort cohort cohort cohort
78597 QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING WHEN PERFORMED cohort cohort cohort cohort
78598
QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION AND VENTILATION (EG, AEROSOL OR GAS), INCLUDING IMAGING WHEN PERFORMED cohort cohort cohort
78606 Brain imaging, minimum 4 static views; with vascular flow statewide
78607 Brain imaging, tomographic (SPECT) cohort cohort
78608
BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET);METABOLICEVALUATION BRAIN IMAGING, POSITRON EMIS SION TOMOGRAPHY (PET); METABOLIC cohort cohort cohort
78630 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDINGINTRODUCTION OF MATERIAL); CISTERNOGRAPHY cohort cohort
154
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
78645 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDINGINTRODUCTION OF MATERIAL); SHUNT EVALUATION cohort cohort
78650 CSF LEAKAGE DETECTION AND LOCALIZATION statewide
78660
RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHYRADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY cohort cohort
78700 Kidney imaging morphology cohort cohort cohort
78701 KIDNEY IMAGING; WITH VASCULAR FLOW cohort cohort
78707 with vascular flow and function, single study without pharmocological intervention cohort cohort cohort cohort cohort
78708
with vascular flow and function, single study, with pharmacological intervention (eg, angiotension converting enzyme inhibitor and/or diuretic) cohort cohort cohort cohort cohort
78709
with vascular flow and function, multiple studies,with and without pharmacological intervention (eg , angiotension converting enzyme inhibitor and/or diuretic) cohort cohort cohort
78710 Tomographic (SPECT) cohort cohort
78725 KIDNEY FUNCTION STUDY, NON-IMAGING RADIOISOTOPIC STUDY statewide
78740
URETERAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDINGCYSTOGRAM) URETERAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING cohort cohort cohort
78800
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; LIMITEDAREARADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; LI MITED AREA cohort cohort cohort cohort
78801 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; MULTIPLE AREAS cohort cohort
78802 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; WHOLE BODY cohort cohort cohort
78803 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; TOMOGRAPHIC(SPECT) cohort cohort cohort cohort
78804
RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRIBUTION OF RADIOPHARMACEUTICAL AGENT(S); WHOLE BODY, REQUIRING TWO OR MORE DAYS IMAGING cohort cohort cohort cohort
78805
RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; LIMITED AREARADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; LIMITED AREA cohort cohort cohort cohort
78806 RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; WHOLEBODY cohort cohort cohort cohort
78807 RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; TOMOGRAPHIC(SPECT) statewide
78808 Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (e.g., parathyroid adenoma) cohort cohort
78812 Positron emission tomography (PET) imaging; skull base to mid-thigh statewide
78813 Positron emission tomography (PET) imaging; whole body statewide
78814
Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging;limited area (e.g., chest, head/neck) cohort cohort
78815
Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging;skull base to mid-thigh cohort cohort cohort cohort cohort
78816
Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging;whole body cohort cohort cohort cohort cohort
78999 UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEARMEDICINE statewide
79005 NUCLEAR RX, ORAL ADMIN cohort cohort cohort cohort
79101 NUCLEAR RX, IV ADMIN cohort cohort cohort
79403 RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONAL ANTIBODY BY INTRAVENOUS INFUSION cohort cohort
79440 INTRA-ARTICULAR RADIOPHARMACEUTICAL THERAPYINTRA-ARTICULAR RADIOPHARMACEUTICAL THERAPY statewide
155
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
79445 NUCLEAR RX, INTRA-ARTERIAL statewide
80047
Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330), Carbon dioxide (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Potassium (8413 statewide
80048
Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310), Carbon dioxide (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Potassium (84132), cohort cohort
80050
General health panel This panel must include the following: Comprehensive metabolic panel (80053), Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004 statewide
80053
Comprehensive metabolic panel This panel must include the following: Albumin (82040), Bilirubin, total (82247), Calcium, total (82310), Carbon dioxide(bicarbonate) (82374), Chloride (82435), Creatini cohort cohort cohort cohort
80061
Lipid panel This panel must include the following:Cholesterol, serum, total (82465), Lipoprotein, d irect measurement, high density cholesterol (HDL cholesterol) (83718), Triglycerides (84478) cohort cohort
80069
Renal function panel This panel must include the following: Albumin (82040), Calcium, total (82310),Carbon dioxide (bicarbonate) (82374), Chloride (8 2435), Creatinine (82565), Glucose (82947), Phosph statewide
80074
Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709), Hepatitis B core antibody (HBcAb), IgMantibody (86705), Hepatitis B surface antigen (HB cohort cohort
80076
Hepatic function panel This panel must include thefollowing: Albumin (82040), Bilirubin, total (822 47), Bilirubin, direct (82248), Phosphatase, alkaline (84075), Protein, total (84155), Transferase, statewide
80104 Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure statewide
80156 CARBAMAZEPINE(CLOSEST CLINICALLY EQUIVALENT CODE(S) DELETED IN 1993: 82372) statewide
80202 VANCOMYCIN statewide
80299 QUANTITATION OF DRUG, NOT ELSEWHERE SPECIFIED statewide
81000
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN,GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE cohort cohort cohort cohort
81001
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN,GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE cohort cohort cohort cohort cohort cohort
81002
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN,GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE cohort cohort cohort cohort cohort
81003
URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN,GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE cohort cohort cohort cohort cohort cohort
81005
URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPTIMMUNOASSAYS URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPT cohort cohort cohort cohort
81015 URINALYSIS; MICROSCOPIC ONLYURINALYSIS; MICROSCOPIC ONLY cohort cohort cohort cohort cohort
81025
URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODSURINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS cohort cohort cohort cohort cohort cohort
81050 VOLUME MEASUREMENT FOR TIMED COLLECTION, EACHVOLUME MEASUREMENT FOR TIMED COLLECTION, EACH cohort cohort cohort cohort cohort
81201 APC (adenomatous polyposis coli) (e.g., familial adenomatosis polyposis [FAP], attenuated FAP) gene analysis; full gene sequence statewide
81205
BCKDHB (BRANCHED-CHAIN KETO ACID DEHYDROGENASE E1,BETA POLYPEPTIDE) (EG, MAPLE SYRUP URINE DISEASE) GENE ANALYSIS, COMMON VARIANTS (EG, R183P, G278S, E422X) statewide
81206 BCR/ABL1 (T(9;22)) (EG, CHRONIC MYELOGENOUS LEUKEMIA) TRANSLOCATION ANALYSIS; MAJOR BREAKPOINT, QUALITATIVE statewide
156
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OR QUANTITATIVE
81207
BCR/ABL1 (T(9;22)) (EG, CHRONIC MYELOGENOUS LEUKEMIA) TRANSLOCATION ANALYSIS; MINOR BREAKPOINT, QUALITATIVE OR QUANTITATIVE statewide
81210 BRAF (V-RAF MURINE SARCOMA VIRAL ONCOGENE HOMOLOG B1) (EG, COLON CANCER), GENE ANALYSIS, V600E VARIANT statewide
81220
CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR) (EG, CYSTIC FIBROSIS) GENE ANALYSIS; COMMON VARIANTS (EG, ACMG/ACOG GUIDELINES) statewide
81223
CFTR (CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR) (EG, CYSTIC FIBROSIS) GENE ANALYSIS; FULLGENE SEQUENCE statewide
81225
CYP2C19 (CYTOCHROME P450, FAMILY 2, SUBFAMILY C, POLYPEPTIDE 19) (EG, DRUG METABOLISM), GENE ANALYSIS, COMMON VARIANTS (EG, *2, *3, *4, *8, *17) statewide
81229
CYTOGENOMIC CONSTITUTIONAL (GENOME-WIDE) MICROARRAY ANALYSIS; INTERROGATION OF GENOMIC REGIONS FOR COPY NUMBER AND SINGLE NUCLEOTIDE POLYMORPHISM (SNP) VARIANTS FOR CHROMOSOMAL ABNORMALITIES statewide
81240 F2 (PROTHROMBIN, COAGULATION FACTOR II) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, 20210G>A VARIANT statewide
81241 F5 (COAGULATION FACTOR V) (EG, HEREDITARY HYPERCOAGULABILITY) GENE ANALYSIS, LEIDEN VARIANT statewide
81243
FMR1 (FRAGILE X MENTAL RETARDATION 1) (EG, FRAGILEX MENTAL RETARDATION) GENE ANALYSIS; EVALUATION T O DETECT ABNORMAL (EG, EXPANDED) ALLELES statewide
81264
IGK@ (IMMUNOGLOBULIN KAPPA LIGHT CHAIN LOCUS) (EG,LEUKEMIA AND LYMPHOMA, B-CELL), GENE REARRANGEMEN T ANALYSIS, EVALUATION TO DETECT ABNORMAL CLONAL POPULATION(S) statewide
81265
COMPARATIVE ANALYSIS USING SHORT TANDEM REPEAT (STR) MARKERS; PATIENT AND COMPARATIVE SPECIMEN (EG, PRE-TRANSPLANT RECIPIENT AND DONOR GERMLINE TESTING, POST-TRANSPLANT NON-HEMATOPOIETIC RECIPIENT GER statewide
81267
CHIMERISM (ENGRAFTMENT) ANALYSIS, POST TRANSPLANTATION SPECIMEN (EG, HEMATOPOIETIC STEM CELL), INCLUDES COMPARISON TO PREVIOUSLY PERFORMED BASELINE ANALYSES; WITHOUT CELL SELECTION statewide
81268
CHIMERISM (ENGRAFTMENT) ANALYSIS, POST TRANSPLANTATION SPECIMEN (EG, HEMATOPOIETIC STEM CELL), INCLUDES COMPARISON TO PREVIOUSLY PERFORMED BASELINE ANALYSES; WITH CELL SELECTION (EG, CD3, CD33), EACH statewide
81270 JAK2 (JANUS KINASE 2) (EG, MYELOPROLIFERATIVE DISORDER) GENE ANALYSIS, P.VAL617PHE (V617F) VARIANT statewide
81275
KRAS (V-KI-RAS2 KIRSTEN RAT SARCOMA VIRAL ONCOGENE) (EG, CARCINOMA) GENE ANALYSIS, VARIANTS IN CODONS 12 AND 13 statewide
81331
SNRPN/UBE3A (SMALL NUCLEAR RIBONUCLEOPROTEIN POLYPEPTIDE N AND UBIQUITIN PROTEIN LIGASE E3A) (EG, PRADER-WILLI SYNDROME AND/OR ANGELMAN SYNDROME), METHYLATION ANALYSIS statewide
81370 HLA CLASS I AND II TYPING, LOW RESOLUTION (EG, ANTIGEN EQUIVALENTS); HLA-A, -B, -C, -DRB1/3/4/5, AND-DQB1 statewide
81376
HLA CLASS II TYPING, LOW RESOLUTION (EG, ANTIGEN EQUIVALENTS); ONE LOCUS (EG, HLA-DRB1/3/4/5, -DQB1,-DQA1, -DPB1, OR -DPA1), EACH statewide
81378 HLA CLASS I AND II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS), HLA-A, -B, -C, AND -DRB1 statewide
81379 HLA CLASS I TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); COMPLETE (IE, HLA-A, -B, AND -C) statewide
81382
HLA CLASS II TYPING, HIGH RESOLUTION (IE, ALLELES OR ALLELE GROUPS); ONE LOCUS (EG, HLA-DRB1, -DRB3,-DRB4, -DRB5, -DQB1, -DQA1, -DPB1, OR -DPA1), EAC H statewide
81401 MOLECULAR PATHOLOGY PROCEDURE, LEVEL 2 (EG, 2-10 SNPS, statewide
157
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
1 METHYLATED VARIANT, OR 1 SOMATIC VARIANT [TYPICALLY USING NONSEQUENCING TARGET VARIANT ANALYSIS], OR DETECTION OF A DYNAMIC MUTATION DISORDER/T
81404
MOLECULAR PATHOLOGY PROCEDURE, LEVEL 5 (EG, ANALYSIS OF 2-5 EXONS BY DNA SEQUENCE ANALYSIS, MUTATIONSCANNING OR DUPLICATION/DELETION VARIANTS OF 6-10 EXONS, OR CHARACTERIZATION OF A DYNAMIC MUTATION statewide
81408
MOLECULAR PATHOLOGY PROCEDURE, LEVEL 9 (EG, ANALYSIS OF >50 EXONS IN A SINGLE GENE BY DNA SEQUENCE ANALYSIS) ATM (ATAXIA TELANGIECTASIA MUTATED) (EG, ATAXIA TELANGIECTASIA), FULL GENE SEQUENCE CDH23 ( statewide
81479 UNLISTED MOLECULAR PATHOLOGY PROCEDURE statewide
82003 ACETAMINOPHEN statewide
82010 KETONE BODY(S) (EG, ACETONE, ACETOACETIC ACID, BETA-HYDROXYBUTYRATE); QUANTITATIVE statewide
82017 ACYLCARNITINES; QUANTITATIVE, EACH SPECIMEN (FOR CARNITINE, SEE 82379) statewide
82040 Albumin serum, plasma or whole blood cohort cohort
82043 ALBUMIN; URINE, MICROALBUMIN, QUANTITATIVE statewide
82055 ALCOHOL (ETHANOL); ANY SPECIMEN EXCEPT BREATH statewide
82103 ALPHA-1-ANTITRYPSIN; TOTAL(CLOSEST CLINICALLY EQUIVALENT CODE(S), DELETED IN 1993: 86064, 86067) statewide
82120 AMINES, VAGINAL FLUID, QUALITATIVE statewide
82136 AMINO ACIDS, 2 TO 5 AMINO ACIDS, QUANTITATIVE, EACH SPECIMEN statewide
82139 AMINO ACIDS, 6 OR MORE AMINO ACIDS, QUANTITATIVE, EACHSPECIMEN statewide
82140 AMMONIA statewide
82150 AMYLASE cohort cohort
82157 ANDROSTENEDIONE statewide
82172 APOLIPOPROTEIN, EACH statewide
82247 BILIRUBIN; TOTAL statewide
82248 BILIRUBIN; DIRECT statewide
82270 BLOOD, OCCULT; FECES, 1-3 SIMULTANEOUS DETERMINATIONS cohort cohort cohort
82271 BLOOD, OCCULT, BY PEROXIDASE ACTIVITY (EG, GUAIAC), QUALITATIVE; OTHER SOURCES statewide
82272
Blood, occult, by peroxidase activity (e.g., guiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasmscreening cohort cohort
82300 CADMIUM cohort cohort
82310 CALCIUM; TOTALCALCIUM; TOTAL statewide
82360 CALCULUS (STONE); QUANTITATIVE ANALYSIS, CHEMICAL statewide
82373 CARBOHYDRATE DEFICIENT TRANSFERRIN statewide
82379 CARNITINE (TOTAL AND FREE), QUANTITATIVE, EACH SPECIMEN statewide
82380 CAROTENE statewide
82390 CERULOPLASMIN statewide
82397 CHEMILUMINESCENT ASSAY statewide
82438 CHLORIDE; OTHER SOURCE statewide
82465 CHOLESTEROL, SERUM, TOTALCHOLESTEROL, SERUM, TOTAL statewide
82491
CHROMATOGRAPHY, QUANTITATIVE, COLUMN (EG, GAS LIQUID ORHPLC); SINGLE ANALYTE NOT ELSEWHERE SPECIFIED, SINGLE STATIONARY AND MOBILE PHASE statewide
82492
CHROMATOGRAPHY, QUANTITATIVE, COLUMN (EG, GAS LIQUID ORHPLC); MULTIPLE ANALYTES, SINGLE STATIONARY AND MOBILE PHASE cohort cohort
82495 CHROMIUM statewide
82533 CORTISOL; TOTAL statewide
158
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
82544
COLUMN CHROMATOGRAPHY/MASS SPECTOMETRY (EG, GC/MS,ORHPLC/MS), ANALYTE NOT ELSEWHERE SPECIFIED; STAB LE ISOTOPE DILUTION, MULTIPLE ANALYTES, QUANTITATIVE, SINGLE STATIONARY statewide
82550 CREATINE KINASE (CK), (CPK); TOTAL statewide
82565 CREATININE; BLOOD statewide
82570 CREATININE; OTHER SOURCE statewide
82607 CYANOCOBALAMIN (VITAMIN B-12);CYANOCOBALAMIN (VITAMIN B-12); statewide
82626 DEHYDROEPIANDROSTERONE (DHEA) statewide
82633 DESOXYCORTICOSTERONE, 11- statewide
82634 DEOXYCORTISOL, 11- statewide
82651 DIHYDROTESTOSTERONE (DHT) cohort cohort
82652 VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED statewide
82656 PANCREATIC ELASTASE, FECAL statewide
82657
ENZYME ACTIVITY IN BLOOD CELLS, CULTURED CELLS, ORTISSUE,NOT ELSEWHERE SPECIFIED; NONRADIOACTIVE SU BSTRATE, EACH SPECIMEN statewide
82658
ENZYME ACTIVITY IN BLOOD CELLS, CULTURED CELLS, ORTISSUE,NOT ELSEWHERE SPECIFIED; RADIOACTIVE SUBST RATE, EACH SPECIMEN statewide
82670 ESTRADIOL statewide
82705 FAT OR LIPIDS, FECES; QUALITATIVE statewide
82728 FERRITIN statewide
82731 FETAL FIBRONECTIN, CERVICOVAGINAL SECRETIONS,SEMI-QUANTITATIVE statewide
82746 FOLIC ACID; SERUM statewide
82784 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGA, IGD, IGG, IGM, EACH statewide
82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE statewide
82787 GAMMAGLOBULIN (IMMUNOGLOBULIN); IMMUNOGLOBULIN SUBCLASSES (EG, IGG1, 2, 3, OR 4), EACH statewide
82800 GASES, BLOOD, PH ONLYGASES, BLOOD, PH ONLY statewide
82947 GLUCOSE; QUANTITATIVEGLUCOSE; QUANTITATIVE cohort cohort
82948 GLUCOSE; BLOOD, REAGENT STRIPGLUCOSE; BLOOD, REAGENT STRIP statewide
82955 GLUCOSE-6-PHOSPHATE DEHYDROGENASE (G6PD); QUANTITATIVE statewide
82962
GLUCOSE, BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BYTHE FDA SPECIFICALLY FOR HOME USE GLUCOSE,BLOOD BY GLUCOSE MONITORING DEVICE(S) CLEARED BY cohort cohort
82977 GLUTAMYLTRANSFERASE, GAMMA (GGT) statewide
82978 GLUTATHIONE statewide
83001 GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH) statewide
83002 GONADOTROPIN; LUTEINIZING HORMONE (LH) statewide
83005 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
83010 HAPTOGLOBIN; QUANTITATIVE statewide
83021 HEMOGLOBIN FRACTIONATION AND QUANTITATION; CHROMATOGRAPHY(EG, A2, S, C, AND/OR F) statewide
83036 HEMOGLOBIN; GLYCATEDHEMOGLOBIN; GLYCATED statewide
83090 HOMOCYSTINE statewide
83498 HYDROXYPROGESTERONE, 17-D statewide
83516
IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD statewide
83519 IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, BY statewide
159
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
RADIOIMMUNOASSAY (EG, RIA)
83520
IMMUNOASSAY FOR ANALYTE OTHER THAN INFECTIOUS AGENT ANTIBODY OR INFECTIOUS AGENT ANTIGEN; QUANTITATIVE, NOT OTHERWISE SPECIFIED statewide
83525 INSULIN; TOTALINSULIN; TOTAL statewide
83540 IRON statewide
83615 LACTATE DEHYDROGENASE (LD), (LDH); statewide
83655 LEADLEAD cohort cohort
83690 LIPASE cohort cohort
83718
LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL(HDL CHOLESTEROL) LIPOPROTEIN, DIRECT MEASUREMENT; HIGH DENSITY CHOLESTEROL statewide
83721
LIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROLLIPOPROTEIN, DIRECT MEASUREMENT; LDL CHOLESTEROL statewide
83735 MAGNESIUM cohort cohort
83789
MASS SPECTROMETRY AND TANDEM MASS SPECTROMETRY (MS, MS/MS), ANALYTE NOT ELSEWHERE SPECIFIED; QUANTITATIVE, EACH SPECIMEN statewide
83840 METHADONE statewide
83880 NATRIURETIC PEPTIDE cohort cohort
83883 NEPHELOMETRY, EACH ANALYTE NOT ELSEWHERE SPECIFIED statewide
83919 ORGANIC ACIDS; QUALITATIVE, EACH SPECIMEN statewide
83921 ORGANIC ACID, SINGLE, QUANTITATIVE statewide
83970 PARATHORMONE (PARATHYROID HORMONE) statewide
83986 PH; BODY FLUID, NOT OTHERWISE SPECIFIED statewide
83993 Calprotectin, fecal statewide
84075 PHOSPHATASE, ALKALINE; statewide
84087 PHOSPHOHEXOSE ISOMERASE statewide
84100 PHOSPHORUS INORGANIC (PHOSPHATE); cohort cohort
84132 Potassium; serum, plasma or whole blood statewide
84143 17-HYDROXYPREGNENOLONE statewide
84144 PROGESTERONE statewide
84146 PROLACTIN statewide
84153 PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL (CLOSEST CLINICALLYEQUIVALENT CODE(S), DELETED IN 1993: 80080) statewide
84155 Protein, total, except by refractometry; serum, plasma or whole blood statewide
84156 PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE cohort cohort
84165 PROTEIN; ELECTROPHORETIC FRACTIONATION AND QUANTITATION statewide
84166 PROTEIN E-PHORESIS/URINE/CSF statewide
84176 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
84207 PYRIDOXAL PHOSPHATE (VITAMIN B-6) statewide
84220 PYRUVATE KINASE statewide
84244 RENIN statewide
84295 Sodium; serum, plasma or whole blood statewide
84376 SUGARS (MONO, DI, AND OLIGOSACCHARIDES); SINGLE QUALITATIVE,EACH SPECIMEN cohort cohort
84378 SUGARS (MONO, DI, AND OLIGOSACCHARIDES); SINGLEQUANTITATIVE, EACH SPECIMEN statewide
84403 TESTOSTERONE; TOTALTESTOSTERONE; TOTAL statewide
84425 THIAMINE (VITAMIN B-1) statewide
84432 THYROGLOBULIN statewide
84436 THYROXINE; TOTALTHYROXINE; TOTAL statewide
84439 THYROXINE; FREETHYROXINE; FREE statewide
160
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
84443 THYROID STIMULATING HORMONE (TSH) cohort cohort
84446 TOCOPHEROL ALPHA (VITAMIN E) statewide
84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT) statewide
84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT) statewide
84466 TRANSFERRIN statewide
84478 TRIGLYCERIDES statewide
84480 TRIIODOTHYRONINE (T-3); TOTAL (TT-3) statewide
84484 TROPONIN, QUANTITATIVE cohort cohort cohort cohort
84550 URIC ACID; BLOOD statewide
84590 VITAMIN A statewide
84681 C-PEPTIDE statewide
84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE statewide
84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE statewide
85007 BLOOD COUNT; MANUAL DIFFERENTIAL WBC COUNT (INCLUDES RBCMORPHOLOGY AND PLATELET ESTIMATION) cohort cohort
85014 BLOOD COUNT; OTHER THAN SPUN HEMATOCRIT cohort cohort
85018 BLOOD COUNT; HEMOGLOBINBLOOD COUNT; HEMOGLOBIN statewide
85025
BLOOD COUNT; HEMOGRAM AND PLATELET COUNT, AUTOMATED, ANDAUTOMATED COMPLETE DIFFERENTIAL WBC COUNT (CBC) cohort cohort cohort
85027 BLOOD COUNT; HEMOGRAM AND PLATELET COUNT, AUTOMATED cohort cohort cohort cohort cohort
85097 BONE MARROW; SMEAR INTERPRETATION ONLY, WITH OR WITHOUTDIFFERENTIAL CELL COUNT statewide
85210 CLOTTING; FACTOR II, PROTHROMBIN, SPECIFIC statewide
85260 CLOTTING; FACTOR X (STUART-PROWER) statewide
85280 CLOTTING; FACTOR XII (HAGEMAN) statewide
85300 CLOTTING INHIBITORS OR ANTICOAGULANTS; ANTITHROMBIN III,ACTIVITY statewide
85303 CLOTTING INHIBITORS OR ANTICOAGULANTS; PROTEIN C, ACTIVITY statewide
85347 COAGULATION TIME; ACTIVATED statewide
85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE cohort cohort
85598 Phospholipid neutralization; hexagonal phospholipid statewide
85610 PROTHROMBIN TIME; cohort cohort cohort cohort
85613 RUSSELL VIPER VENOM TIME (INCLUDES VENOM); DILUTED statewide
85651 SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED statewide
85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED statewide
85660 SICKLING OF RBC, REDUCTIONSICKLING OF RBC, REDUCTION cohort cohort
85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD cohort cohort cohort
86000
AGGLUTININS, FEBRILE (EG, BRUCELLA, FRANCISELLA, MURINETYPHUS, Q FEVER, ROCKY MOUNTAIN SPOTTED FEVER, SCRUB TYPHUS), EACH ANTIGEN statewide
86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE,EACH ALLERGEN statewide
86038 ANTINUCLEAR ANTIBODIES (ANA);ANTINUCLEAR ANTIBODIES (ANA); statewide
86039 ANTINUCLEAR ANTIBODIES (ANA); TITERANTINUCLEAR ANTIBODIES (ANA); TITER statewide
86060 ANTISTREPTOLYSIN 0; TITERANTISTREPTOLYSIN 0; TITER cohort cohort
86063 ANTISTREPTOLYSIN 0; SCREENANTISTREPTOLYSIN 0; SCREEN statewide
86140 C-REACTIVE PROTEIN cohort cohort
86146 BETA 2 GLYCOPROTEIN I ANTIBODY, EACH statewide
86147 CARDIOLIPIN (PHOSPHOLIPID) ANTIBODYCARDIOLIPIN (PHOSPHOLIPID) ANTIBODY statewide
161
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
86160
COMPLEMENT; ANTIGEN, EACH COMPONENT (CLOSEST CLINICALLYEQUIVALENT CODE(S), DELETED IN 1993: 86159, 86163, 86164) statewide
86225
DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLESTRANDED DEOXYRIBONUCLEIC ACID (DNA) ANTIBODY; NATIVE OR DOUBLE statewide
86235 EXTRACTABLE NUCLEAR ANTIGEN, ANTIBODY TO, ANY METHOD (EG,NRNP, SS-A, SS-B, SM, RNP, SC170, J01), EACH ANTIBODY cohort cohort
86255
FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACHANTIBODY FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH statewide
86256
FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACHANTIBODY FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH statewide
86317 IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE, NOTOTHERWISE SPECIFIED statewide
86331 IMMUNODIFFUSION; GEL DIFFUSION, QUALITATIVE (OUCHTERLONY),EACH ANTIGEN OR ANTIBODY statewide
86334 IMMUNOFIXATION ELECTROPHORESIS statewide
86335 IMMUNFIX E-PHORSIS/URINE/CSF statewide
86341 ISLET CELL ANTIBODY statewide
86355 B CELLS, TOTAL COUNT statewide
86356 Mononuclear cell antigen, quantitative (e.g., flowcytometry), not otherwise specified, each antigen statewide
86357 NATURAL KILLER (NK) CELLS, TOTAL COUNT statewide
86359 T CELLS; TOTAL COUNT statewide
86361 T CELLS; ABSOLUTE CD4 COUNT statewide
86403 PARTICLE AGGLUTINATION; SCREEN, EACH ANTIBODY cohort cohort cohort
86431 RHEUMATOID FACTOR; QUANTITATIVE statewide
86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon cohort cohort
86580 SKIN TEST; TUBERCULOSIS, INTRADERMAL statewide
86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART) cohort cohort
86618 ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE) cohort cohort
86619 ANTIBODY; BORRELIA (RELAPSING FEVER) statewide
86644 ANTIBODY; CYTOMEGALOVIRUS (CMV)ANTIBODY; CYTOMEGALOVIRUS (CMV) statewide
86645 ANTIBODY; CYTOMEGALOVIRUS (CMV), IGMANTIBODY; CYTOMEGALOVIRUS (CMV), IGM statewide
86663 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, EARLY ANTIGEN (EA)ANTIBODY; EPSTEIN-BARR (EB) VIRUS, EARLY ANTIGEN (EA) statewide
86664
ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN(EBNA)ANTIBODY; EPSTEIN-BARR (EB) VIRUS, NUCLEAR ANTIGEN (EBNA) statewide
86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA)ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID(VCA) statewide
86666 ANTIBODY; EHRLICHIA statewide
86682 ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED statewide
86684 ANTIBODY; HEMOPHILUS INFLUENZA statewide
86687 ANTIBODY; HTLV I statewide
86692 ANTIBODY; HEPATITIS, DELTA AGENTANTIBODY; HEPATITIS, DELTA AGENT statewide
86694 ANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TESTANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TEST statewide
86695 ANTIBODY; HERPES SIMPLEX, TYPE 1 cohort cohort cohort
86696 ANTIBODY; HERPES SIMPLEX, TYPE 2 cohort cohort cohort cohort
86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE RESULT cohort cohort cohort
162
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
86704 HEPATITIS B CORE ANTIBODY (HBCAB); IGG AND IGMHEPATITIS B CORE ANTIBODY (HBCAB); IGG AND IGM statewide
86706 HEPATITIS B SURFACE ANTIBODY (HBSAB)HEPATITIS B SURFACE ANTIBODY (HBSAB) cohort cohort
86708 HEPATITIS A ANTIBODY (HAAB); IGG AND IGMHEPATITIS A ANTIBODY (HAAB); IGG AND IGM statewide
86709 HEPATITIS A ANTIBODY (HAAB); IGM ANTIBODYHEPATITISA ANTIBODY (HAAB); IGM ANTIBODY statewide
86735 ANTIBODY; MUMPS (CLOSEST CLINICALLY EQUIVALENT CODE(S),DELETED IN 1993: 86540) statewide
86747 ANTIBODY; PARVOVIRUS statewide
86753 ANTIBODY; PROTOZOA, NOT ELSEWHERE SPECIFIED statewide
86757 RICKETTSIA statewide
86762 ANTIBODY; RUBELLA statewide
86765 ANTIBODY; RUBEOLA statewide
86777 ANTIBODY; TOXOPLASMAANTIBODY; TOXOPLASMA statewide
86778 ANTIBODY; TOXOPLASMA, IGMANTIBODY; TOXOPLASMA, IGM statewide
86780 ANTIBODY; TREPONEMA PALLIDUM statewide
86787 ANTIBODY; VARICELLA-ZOSTER cohort cohort
86790 ANTIBODY; VIRUS, NOT ELSEWHERE SPECIFIED statewide
86800 THYROGLOBULIN ANTIBODY statewide
86803 HEPATITIS C ANTIBODY;HEPATITIS C ANTIBODY; cohort cohort
86825
HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH, NON-CYTOTOXIC (EG, USING FLOW CYTOMETRY); FIRST SERUM SAMPLE OR DILUTION statewide
86829
ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA), SOLID PHASE ASSAYS (EG, MICROSPHERES OR BEADS, ELISA, FLOW CYTOMETRY); QUALITATIVE ASSESSMENT OF THE PRESENCE OR ABSENCE OF ANTIBODY(IES) TO HLA CLASS I OR statewide
86832
ANTIBODY TO HUMAN LEUKOCYTE ANTIGENS (HLA), SOLID PHASE ASSAYS (EG, MICROSPHERES OR BEADS, ELISA, FLOW CYTOMETRY); HIGH DEFINITION QUALITATIVE PANEL FOR IDENTIFICATION OF ANTIBODY SPECIFICITIES (EG, I statewide
86850
ANTIBODY SCREEN, RBC, EACH SERUM TECHNIQUE (CLOSESTCLINICALLY EQUIVALENT CODE(S), DELETED IN 1993: 86016, 86031, 86083) cohort cohort
86885 Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell statewide
86900 BLOOD TYPING; ABO (CLOSEST CLINICALLY EQUIVALENT CODE(S),DELETED IN 1993: 86080, 86082) cohort cohort
86901 BLOOD TYPING; RH (D)(CLOSEST CLINICALLY EQUIVALENTCODE(S), DELETED IN 1993: 86082, 86083, 86100) cohort cohort
87015 CONCENTRATION (ANY TYPE), FOR PARASITES, OVA, OR TUBERCLEBACILLUS (TB, AFB) cohort cohort cohort cohort cohort
87040 CULTURE, BACTERIAL, DEFINITIVE; BLOOD (INCLUDES ANAEROBICSCREEN) cohort cohort cohort cohort cohort cohort
87045 CULTURE, BACTERIAL, DEFINITIVE; STOOL cohort cohort cohort cohort cohort cohort
87046
CULTURE, BACTERIAL; STOOL, ADDITIONAL PATHOGENS, ISOLATION AND PRELIMINARY EXAMINATION (EG, CAMPYLOBACTER, YERSINIA, VIBRO, E. COLI O157),EACH PLATE cohort cohort cohort cohort cohort
87070 CULTURE, BACTERIAL, DEFINITIVE; ANY OTHER SOURCE cohort cohort cohort cohort cohort cohort
87071
CULTURE, BACTERIAL; QUANTITATIVE, AEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, ANY SOURCE EXCEPT URINE, BLOOD OR STOOL cohort cohort cohort cohort cohort
87073
CULTURE, BACTERIAL; QUANTITATIVE, ANAEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES, ANY SOURCE EXCEPT URINE, BLOOD OR STOOL statewide
87075 CULTURE, BACTERIAL, ANY SOURCE; ANAEROBIC (ISOLATION) cohort cohort cohort cohort cohort cohort
87076 CULTURE, BACTERIAL, ANY SOURCE; DEFINITIVE IDENTIFICATION,EACH ANAEROBIC ORGANISM, INCLUDING GAS cohort cohort cohort cohort cohort
163
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
CHROMATOGRAPHY
87077
CULTURE, BACTERIAL, ANY SOURCE; AEROBIC ISOLATE, ADDITIONAL METHODS REQUIRED FOR DEFINITIVE IDENTI FICATION, EACH ISOLATE cohort cohort cohort cohort cohort cohort
87081 CULTURE, BACTERIAL, SCREENING ONLY, FOR SINGLE ORGANISMS cohort cohort cohort cohort cohort
87085
CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY, BY COMMERCIAL KIT (SPECIFY TYPE); WITH COLONY COUNT CULTURE, PRESUMPTIVE, PATHOGENIC ORGANISMS, SCREENING ONLY, statewide
87086 CULTURE, BACTERIAL, URINE; QUANTITATIVE, COLONY COUNT cohort cohort cohort cohort cohort cohort
87088
CULTURE, BACTERIAL, URINE; IDENTIFICATION, IN ADDITION TOQUANTITATIVE OR COMMERCIAL KIT CULTURE, BACTERIAL, URINE; IDENTIFICATION, IN ADDITION TO cohort cohort cohort cohort cohort cohort
87101 CULTURE, FUNGI, ISOLATION (WITH OR WITHOUT PRESUMPTIVEIDENTIFICATION); SKIN cohort cohort cohort cohort
87102
CULTURE, FUNGI, ISOLATION (WITH OR WITHOUT PRESUMPTIVEIDENTIFICATION); OTHER SOURCE (EXCEPT BLOOD) cohort cohort cohort cohort cohort
87103 CULTURE, FUNGI, ISOLATION (WITH OR WITHOUT PRESUMPTIVEIDENTIFICATION); BLOOD cohort cohort cohort
87106
CULTURE, FUNGI, DEFINITIVE IDENTIFICATION,EACH ORGANISM; YEAST (USE 87106 IN ADDITIONAL TO CODES 87101, 87102, OR 87103 WHEN APPROPRIATE) cohort cohort cohort cohort
87107
CULTURE, FUNGI, DEFINITIVE IDENTIFICATION,EACH ORGANISM; MOLD (USE 87106 IN ADDITIONAL TO CODES 87101, 87102, OR 87103 WHEN APPROPRIATE) cohort cohort cohort cohort
87109 CULTURE, MYCOPLASMA, ANY SOURCE cohort cohort cohort cohort
87110 CULTURE, CHLAMYDIA cohort cohort cohort
87116 CULTURE, TUBERCLE OR OTHER ACID-FAST BACILLI (EG, TB, AFB,MYCOBACTERIA); ANY SOURCE, ISOLATION ONLY cohort cohort cohort cohort cohort
87118 CULTURE, MYCOBACTERIA, DEFINITIVE IDENTIFICATION OF EACHORGANISM cohort cohort
87140 CULTURE, TYPING; FLUORESCENT METHOD, EACH ANTISERUM cohort cohort cohort cohort
87147 CULTURE, TYPING; SEROLOGIC METHOD, AGGLUTINATION GROUPING,PER ANTISERUM cohort cohort cohort cohort cohort
87149
CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID (DNA OR RNA) PROBE, DIRECT PROBE TECHNIQUE, PER CULTURE OR ISOLATE, EACH ORGANISM PROBED cohort cohort cohort
87153
CULTURE, TYPING; IDENTIFICATION BY NUCLEIC ACID SEQUENCING METHOD, EACH ISOLATE (EG, SEQUENCING OF THE 16S RRNA GENE) statewide
87168 MACROSCOPIC EXAMINATION; ARTHROPOD cohort cohort
87169 MACROSCOPIC EXAMINATION; PARASITE statewide
87172 PINWORM EXAM (EG, CELLOPHANE TAPE PREP) cohort cohort
87176 ENDOTOXIN, BACTERIAL (PYROGENS); HOMOGENIZATION, TISSUE, FORCULTURE cohort cohort cohort cohort cohort
87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION ANDIDENTIFICATION cohort cohort cohort cohort cohort cohort
87181 SENSITIVITY STUDIES, ANTIBIOTIC; AGAR DIFFUSION METHOD, PER ANTIBIOTIC cohort cohort cohort cohort cohort
87184 SENSITIVITY STUDIES, ANTIBIOTIC; DISK METHOD, PER PLATE (12 OR FEWER DISKS) cohort cohort cohort cohort cohort
87185 SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; ENZYME DETECTION (EG, BETA LACTAMASE), PER ENZYME cohort cohort cohort cohort cohort
87186
SENSITIVITY STUDIES, ANTIBIOTIC; MICROTITER, MINIMUMINHIBITORY CONCENTRATION (MIC), ANY NUMBER OF ANTIBIOTICS cohort cohort cohort cohort cohort cohort
87188 SENSITIVITY STUDIES, ANTIBIOTIC; MACROTUBE DILUTION METHOD, EACH ANTIBIOTIC statewide
87190 SENSITIVITY STUDIES, ANTIBIOTIC; TUBERCLE BACILLUS(TB,AFB), EACH DRUG statewide
164
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
87205 SMEAR, PRIMARY SOURCE, WITH INTERPRETATION; ROUTINE STAINFOR BACTERIA, FUNGI, OR CELL TYPES cohort cohort cohort cohort cohort cohort
87206
SMEAR, PRIMARY SOURCE, WITH INTERPRETATION; FLUORESCENTAND/OR ACID FAST STAIN FOR BACTERIA, FUNGI, OR CELL TYPES cohort cohort cohort cohort cohort
87207
SMEAR, PRIMARY SOURCE, WITH INTERPRETATION; SPECIAL STAINFOR INCLUSION BODIES OR INTRACELLULAR PARASITES (EG, MALARIA, KALA AZAR, HERPES) cohort cohort cohort cohort cohort
87209
SMEAR, PRIMARY SOURCE WITH INTERPRETATION; COMPLEXSPECIAL STAIN (EG, TRICHROME, IRON HEMOTOXYLIN) F OR OVA AND PARASITES cohort cohort cohort cohort cohort
87210
SMEAR, PRIMARY SOURCE, WITH INTERPRETATION; WET MOUNT WITHSIMPLE STAIN, FOR BACTERIA, FUNGI, OVA, AND/OR PARASITES SMEAR, PRIMARY SOURCE, WITH INTERPRETATION; WET MOUNT WITH cohort cohort cohort cohort cohort
87220 TISSUE EXAMINATION FOR FUNGI (EG, KOH SLIDE)TISSUEEXAMINATION FOR FUNGI (EG, KOH SLIDE) cohort cohort cohort
87230 TOXIN OR ANTITOXIN ASSAY, TISSUE CULTURE (EG, CLOSTRIDIUMDIFFICILE TOXIN) cohort cohort cohort
87252 VIRUS IDENTIFICATION; TISSUE CULTURE INOCULATION ANDOBSERVATION cohort cohort cohort cohort cohort
87253
VIRUS IDENTIFICATION; TISSUE CULTURE, ADDITIONAL STUDIES(EG, HEMABSORPTION, NEUTRALIZATION) EACH ISOLATE cohort cohort
87254 VIRUS ISOLATION; SHELL VIAL, INCLUDES IDENTIFICATION WITH IMMUNOFLUORESCENCE STAIN, EACH VIRUS cohort cohort cohort cohort
87255 VIRUS ISOLATION; ID, NON-IMMUNOLOGIC METHOD, OTHER THAN CYTOPATHIC EFFECT cohort cohort cohort cohort
87260
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; ADENOVIRUS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT statewide
87265
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; BORDETELLA PERTUSSIS/PARAPERTUSSIS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT cohort cohort
87269 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; GIARDIA statewide
87272
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT ANTIBODY TECHNIQUE; CRYPTOSPORIDIUM/GIARDIA cohort cohort cohort
87273
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; HERPES SIMPLEX VIRUS TYPE 2 statewide
87274
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; HERPES SIMPLEX VIRUS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT cohort cohort
87275 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS cohort cohort
87276
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; INFLUENZA A VIRUS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT cohort cohort cohort
87278
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; LEGIONELLA PNEUMOPHILA INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT statewide
87279
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PARAINFLUENZA VIRUS, EACH TYPE statewide
87280
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; RESPIRATORY SYNCYTIAL VIRUS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT cohort cohort
165
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
87281 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PNEUMOCYSTIS CARINII cohort cohort
87290
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE; VARICELLA ZOSTER VIRUS INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT statewide
87299
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENTANTIBODY TECHNIQUE, NOT OTHERWISE SPECIFIED INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUO RESCENT statewide
87300
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE, POLYVALENT FOR MULTIPLE ORGANISMS, EACH POLYVALENT ANTISERUM cohort cohort cohort
87305
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE-STEP METHOD; ASPERGILLUS cohort cohort
87320
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CHLAMYDIA TRACHOMATIS statewide
87324
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CLOSTRIDIUM DIFFICILE TOXINA cohort cohort cohort cohort cohort cohort
87327
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; CRYPTOCOCCUS NEOFORMANS statewide
87328
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; CRYPTOSPORIDIUM/GIARDIA cohort cohort cohort cohort cohort
87329
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; GIARDIA cohort cohort cohort cohort cohort cohort
87336
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; ENTAMOEBA HISTOLYTICA DISPAR GROUP cohort cohort
87337
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; ENTAMOEBA HISTOLYTICA GROUP statewide
87338
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMI- QUANTITATIVE, MULTIPLE STEP METHOD; HELICOBACTER PYLORI, STOOL cohort cohort cohort cohort cohort
87339 HELICOBACTER PYLORI cohort cohort
87340
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS B SURFACE ANTIGEN(HBSAG) cohort cohort cohort cohort cohort cohort
87341
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; HEPATITIS B SURFACE ANTIGEN(HBSAG) NEUTRALIZATION cohort cohort cohort cohort
87350
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS BE ANTIGEN (HBEAG) cohort cohort cohort cohort cohort
87385
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HISTOPLASMA CAPSULATUM cohort cohort cohort
87389
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE-STEP METHOD; HIV-1 ANTIGEN(S), cohort cohort cohort cohort cohort
166
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
WITH HIV- 1 AND HIV-2 ANTIBODIES, SINGLE RESULT
87390
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HIV-1 statewide
87400
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; INFLUENZA, A OR B, EACH cohort cohort cohort cohort
87420
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; RESPIRATORY SYNCYTIAL VIRUS cohort cohort cohort cohort
87425
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; ROTAVIRUS cohort cohort cohort cohort
87427
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE,MULTIPLE STEP METHOD; SHIGA-LIKE TOXIN cohort cohort cohort cohort
87430
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; STREPTOCOCCUS, GROUP A cohort cohort cohort cohort cohort
87449
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE STEP METHOD, NOT OTHERWISE SPECIFIED cohort cohort cohort cohort cohort
87450
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAYTECHNIQUE QUALITATIVE OR SEMIQUANTITATIVE; SINGLE STEP METHOD, NOT OTHERWISE SPECIFIED cohort cohort
87451
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE QUALITATIVE OR SEMIQUANTITATIVE; MULTIPLE STEP METHOD,EACH POLYVALENT ANTISERUM statewide
87471
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);BARTONELLA HENSELAE AND BARTONELLA QUINTANA, AMPLIFIED PROBE TECHNIQUE statewide
87476
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNI QUE cohort cohort cohort cohort
87481 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE statewide
87486
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHNI QUE statewide
87490
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CHLAMYDIA TRACHOMATIS, DIRECT PROBE TECHNIQU E INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNAOR RNA); cohort cohort cohort cohort
87491
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHN IQUE cohort cohort cohort cohort cohort
87493
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); CLOSTRIDIUM DIFFICILE, TOXIN GENE(S), AMPLI FIED PROBE TECHNIQUE cohort cohort cohort cohort cohort
87496
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CYTOMEGALOVIRUS, AMPLIFIED PROBE TECHNIQUE INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); cohort cohort cohort cohort
87497
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);CYTOMEGALOVIRUS, QUANTIFICATION INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); cohort cohort cohort cohort
87498
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); ENTEROVIRUS, REVERSE TRANSCRIPTION AND AMPL IFIED PROBE TECHNIQUE cohort cohort cohort
87500 Infectious agent detection by nucleic acid (DNA orRNA); vancomycin statewide
167
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
resistance (e.g., enterococcus s pecies van A, van B), amplified probe technique
87501
Infectious agent detection by nucleic acid (DNA orRNA); influenza virus, reverse transcription and amplified probe technique, each type or subtype statewide
87502
Infectious agent detection by nucleic acid (DNA orRNA); influenza virus, for multiple types or sub- types, reverse transcription and amplified probe technique, first 2 types or sub-types cohort cohort cohort
87503
Infectious agent detection by nucleic acid (DNA orRNA); influenza virus, for multiple types or sub- types, multiplex reverse transcription and amplified probe technique, each additional influenza viru cohort cohort cohort
87516
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);HEPATITIS B VIRUS, AMPLIFIED PROBE TECHNIQUE INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); statewide
87517
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);HEPATITIS B VIRUS, QUANTIFICATION INFECTIOU S AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); cohort cohort cohort cohort cohort
87521
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); HEPATITIS C, REVERSE TRANSCRIPTION AND AMPL IFIED PROBE TECHNIQUE cohort cohort cohort
87522
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); HEPATITIS C, REVERSE TRANSCRIPTION AND QUAN TIFICATION cohort cohort cohort cohort cohort cohort
87529
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHNI QUE cohort cohort cohort cohort cohort
87532 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);HERPES VIRUS-6, AMPLIFIED PROBE TECHNIQUE statewide
87533
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);HERPES VIRUS-6, QUANTIFICATION INFECTIOUS A GENT DETECTION BY NUCLEIC ACID (DNA OR RNA); statewide
87535
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); HIV-1, REVERSE TRANSCRIPTION AND AMPLIFIED PROBE TECHNIQUE cohort cohort
87536
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); HIV-1, REVERSE TRANSCRIPTION AND QUANTIFICA TION cohort cohort cohort cohort cohort
87556
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);MYCOBACTERIA TUBERCULOSIS, AMPLIFIED PROBE T ECHNIQUE cohort cohort
87581
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECHN IQUE statewide
87590
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);NEISSERIA GONORRHOEAE, DIRECT PROBE TECHNIQU E INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNAOR RNA); cohort cohort cohort
87591
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHN IQUE cohort cohort cohort cohort cohort
87621
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA);PAPILLOMAVIRUS, HUMAN, AMPLIFIED PROBE TECHN IQUE cohort cohort cohort cohort
87631
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ A VIRUS, CORONAVIRUS, METAPNEUMOVIRUS, PARAINFLUENZA VIRUS, RESPIRATORY SYNCYTIAL VIRUS, RHINOVIRUS) cohort cohort
87632
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ A VIRUS, CORONAVIRUS, METAPNEUMOVIRUS, PARAINFLUENZA VIRUS, RESPIRATORY SYNCYTIAL VIRUS, RHINOVIRUS) cohort cohort
87633
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); RESPIRATORY VIRUS (EG, ADENOVIRUS, INFLUENZ A VIRUS, CORONAVIRUS, METAPNEUMOVIRUS, PARAINFLUENZA VIRUS, RESPIRATORY SYNCYTIAL VIRUS, RHINOVIRUS) cohort cohort
168
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
87640
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); STAPHYLOCOCCUS AUREUS, AMPLIFIED PROBE TECH NIQUE statewide
87641
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); STAPHYLOCOCCUS AUREUS, METHICILLIN RESISTAN T, AMPLIFIED PROBE TECHNIQUE cohort cohort cohort cohort cohort
87653
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); STREPTOCOCCUS, GROUP B, AMPLIFIED PROBE TEC HNIQUE cohort cohort
87798
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); NOTOTHERWISE SPECIFIED, AMPLIFIED PROBE TEC HNIQUE INFECTIOUS AGENT DETECTION BY NUCLEIC ACID(DNA OR RNA); NOT cohort cohort cohort cohort cohort
87799
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA); NOTOTHERWISE SPECIFIED, QUANTIFICATION INF ECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NOT cohort cohort cohort cohort
87800 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA),MULTIPLE ORGANISMS; DIRECT PROBE(S) TECHNIQUE statewide
87801
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA ORRNA),MULTIPLE ORGANISMS; AMPLIFIED PROBE(S) TECHNIQUE cohort cohort cohort cohort cohort
87802 INFECTIOUS AGENT, IMMUNOASSAY, DIRECT OBSERVATION;STREPTOCOCCUC GROUP B cohort cohort cohort
87803 INFECTIOUS AGENT, IMMUNOASSAY, DIRECT OBSERVATION;CLOSTRIDIUM DIFFICILE TOXIN A statewide
87804 INFECTIOUS AGENT, IMMUNOASSAY, DIRECT OBSERVATION;INFLUENZA cohort cohort cohort cohort cohort
87807 RSV ASSAY W/OPTIC cohort cohort cohort cohort cohort
87808
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; TRICHOMONAS VAGINALIS statewide
87810 Chlamydia trachomatis statewide
87880
INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECTOPTICAL OBSERVATION; STREPTOCOCCUS, GROUP A INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT cohort cohort cohort cohort cohort cohort
87899
INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECTOPTICAL OBSERVATION; NOT OTHERWISE SPECIFIED INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT cohort cohort cohort cohort
87900
INFECTIOUS AGENT DRUG SUSCEPTIBILITY PHENOTYPE PREDICTION USING REGULARLY UPDATED GENOTYPIC BIOINFORMATICS statewide
87901 Infectious agent genotype analysis by nucleic acid(DNA or RNA); HIV-1, reverse transcriptase and pr otease regions cohort cohort
87902 INFECTIOUS AGENT, GENOTYPE ANALYSIS, NUCLEIC ACID (DNA/RNA); HEPATITIS C VIRUS cohort cohort cohort cohort
87903
INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NUCLEIC ACID (DNA OR RNA) WITH DRUG RESISTANCE TISSUE CULTURE ANALYSIS, HIV 1; UP TO 10 DRUGS statewide
87904
INFECTIOUS AGENT PHENOTYPE ANALYSIS BY NUCLEIC ACID(DNA OR RNA)WITH DRUG RESISTANCE TISSUE CULTURE ANALYSIS,HIV1;EACH ADDITIONAL DRUG, UP TO 5 DRUGS(LIST SEPARATELY IN ADDITION TO CODE PRIM PROCDUR statewide
87999 UNLISTED MICROBIOLOGY PROCEDURE statewide
88112
CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE WITH INTERPRETATION (EG, LIQUID BASED SLIDE PREPARATION METHOD), EXCEPT CERVICAL OR VAGINAL statewide
88142
CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM),COLLECTED IN PRESERVATIVE FLUID, AUTOMATEDTHIN LAYER PREPARATION; MANUAL SCREENING UNDER P HYSICIAN SUPERVISION cohort cohort cohort cohort
88173 EVALUATION OF FINE NEEDLE ASPIRATE WITH OR WITHOUTPREPARATION OF SMEARS; INTERPRETATION AND cohort cohort
169
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
REPORT
88174 CYTOPATHOLOGY, CERVICAL/VAGINAL, AUTO THIN LAYER PREP; AUTO SCREEN, WITH PHYSICIAN SUPERVISION statewide
88175
CYTOPATHOLOGY, CERVICAL/VAGINAL,AUTO THIN LAYER PREP; AUTO SCREEN & MANUAL RESCREEN, WITH PHYSICIAN INTERPRETATION cohort cohort
88184 FLOWCYTOMETRY/ TC, 1 MARKER statewide
88185 FLOWCYTOMETRY/TC, ADD-ON statewide
88230 TISSUE CULTURE FOR NON-NEOPLASTIC DISORDERS; LYMPHOCYTE statewide
88237 TISSUE CULTURE FOR NEOPLASTIC DISORDERS; BONE MARROW, BLOOD CELLS statewide
88261 CHROMOSOME ANALYSIS; COUNT 5 CELLS, 1 KARYOTYPE, WITHBANDING statewide
88262 CHROMOSOME ANALYSIS; COUNT 15-20 CELLS, 2 KARYOTYPES, WITHBANDING statewide
88264 CHROMOSOME ANALYSIS; ANALYZE 20-25 CELLS statewide
88271 MOLECULAR CYTOGENETICS; DNA PROBE, EACH (EG, FISH) statewide
88275 MOLECULAR CYTOGENETICS; INTERPHASE IN SITU HYBRIDIZATION,ANALYZE 100-300 CELLS statewide
88280 CHROMOSOME ANALYSIS; ADDITIONAL KARYOTYPES, EACH STUDY statewide
88283 CHROMOSOME ANALYSIS; ADDITIONAL SPECIALIZED BANDINGTECHNIQUE (EG, NOR, C-BANDING) statewide
88285 CHROMOSOME ANALYSIS; ADDITIONAL CELLS COUNTED, EACH STUDY statewide
88304 LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION statewide statewide
88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION cohort cohort cohort
88307 LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION cohort cohort cohort
88311 DECALCIFICATION PROCEDURE (LIST SEPARATELY IN ADDITION TOCODE FOR SURGICAL PATHOLOGY EXAMINATION) cohort cohort
88312
SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT;GROUP I FOR MICROORGANISMS (EG, ACID FAST, METHEN AMINE SILVER) statewide
88313
SPECIAL STAIN INCLUDING INTERPRETATION AND REPORT;GROUP II, ALL OTHER (EG, IRON, TRICHROME), EXCEPT STAIN FOR MICROORGANISMS, STAINS FOR ENZYME CONST ITUENTS, OR IMMUNOCYTOCHEMISTRY AND IMMUNOHISTOCHE cohort cohort cohort
88331 PATHOLOGY CONSULTATION DURING SURGERY; WITH FROZENSECTION(S), SINGLE SPECIMEN statewide
88334
Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in addition to code for primary procedure) cohort cohort
88342 IMMUNOCYTOCHEMISTRY (INCLUDING TISSUE IMMUNOPEROXIDASE),EACH ANTIBODY cohort cohort cohort cohort
88346 IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; DIRECT METHOD statewide
88347 IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; INDIRECT METHOD statewide
88348 ELECTRON MICROSCOPY; DIAGNOSTIC statewide
88361
MORPHOMETRIC ANALYSIS; TUMOR IMMUNOHISTOCHEMISTRY (EG, HER-2/NEU, ESTROGEN RECEPTOR/PROGESTERONE RECEPTOR), QUANTITATIVE OR SEMIQUANTITATIVE statewide
89051 CELL COUNT, MISCELLANEOUS BODY FLUIDS (EG, CSF, JOINTFLUID), EXCEPT BLOOD; WITH DIFFERENTIAL COUNT statewide
89055 LEUKOCYTE COUNT, FECAL cohort cohort
89060 Crystal identification by light microscopy with orwithout polarizing lens analysis, tissue or any b ody fluid (except urine) statewide
170
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
89220 SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE (SEPARATE PROCEDURE) statewide
89230 SWEAT COLLECTION BY IONTOPHORESIS statewide
90287 Botulinum antitoxin, equine, any route statewide
90371 Hepatitis B immune globulin (HBIg), human, for intramuscular use statewide
90375 Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous use cohort cohort cohort cohort cohort
90376 Rabies immune globulin, heat-treated (Rig-HT), human, for intramuscular and/or subcutaneous use statewide
90460
IMMUNIZATION ADMINISTRATION THROUGH 18 YEARS OF AGE VIA ANY ROUTE OF ADMINISTRATION, WITH COUNSELINGBY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFE SSIONAL; FIRST OR ONLY COMPONENT OF EACH VACCINE O cohort cohort
90461
IMMUNIZATION ADMINISTRATION THROUGH 18 YEARS OF AGE VIA ANY ROUTE OF ADMINISTRATION, WITH COUNSELINGBY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFE SSIONAL; EACH ADDITIONAL VACCINE OR TOXOID COMPONE cohort cohort
90471
IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS, INTRADERMAL, SUBCUTANEOUS, OR INTRAMUSCULAR INJECTIONS); 1 VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) cohort cohort cohort cohort cohort cohort
90472
IMMUNIZATION ADMINISTRATION (INCLUDES PERCUTANEOUS,INTRADERMAL, SUBCUTANEOUS, INTRAMUSCULAR AND JET INJECTIONS AND/OR INTRANASAL OR ORAL ADMINISTRATION); TWO OR MORE cohort cohort cohort cohort cohort
90473 IMMUNIZATION ADMINISTRATION BY INTRANASAL OR ORAL ROUTE; 1 VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) statewide
90474 IMMUNIZATION ADMINISTRATION,INTRANASAL/ORAL; EA ADD'L SINGLE/COMBINATION VACCINE/TOXOID cohort cohort
90585 Bacillus Calmette-Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use statewide
90586 Bacillus Calmette-Guerin vaccine (BCG) for bladdercancer, live, for intravesical use statewide
90632 Hepatitis A vaccine, adult dosage, for intramuscular use statewide
90633 Hepatitis A vaccine, pediatric/adolescent dosage-2dose schedule, for intramuscular use cohort cohort
90636 Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use statewide
90645 Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use cohort cohort
90646 Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use statewide
90647 Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use statewide
90648 Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for intramuscular use statewide
90649 Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent), 3 dose schedule, for intramuscular use cohort cohort
90655 Influenza virus vaccine, trivalent, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use cohort cohort
90656 Influenza virus vaccine, trivalent, split virus, preservative free, when administered to individuals3 years and older, for intramuscular use cohort cohort cohort cohort
90657 Influenza virus vaccine, trivalent, split virus, when administered to children 6-35 months of age, for intramuscular use statewide
90658 Influenza virus vaccine, trivalent, split virus, when administered to individuals 3 years of age andolder, for intramuscular use cohort cohort cohort
90660 Influenza virus vaccine, trivalent, live, for intranasal use statewide
90662 Influenza virus vaccine, split virus, preservationfree, enhanced immunogenicity via increased antig en content, for intramuscular use cohort cohort
90669 PNEUMOCOCCAL CONJUGATE VACCINE, 7 VALENT, FOR INTRAMUSCULAR USE statewide
90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular use cohort cohort
171
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
90675 Rabies vaccine, for intramuscular use cohort cohort cohort cohort cohort
90680 Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use statewide
90681 Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use statewide
90686
Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use statewide
90696
Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 years through6 years of age, for intramuscular use cohort cohort cohort
90700
Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use cohort cohort
90702 Diphtheria and tetanus toxoids (DT) absorbed when administered to individuals younger than 7 years, for intramuscular use statewide
90703 Tetanus toxoid absorbed, for intramuscular use cohort cohort
90707 MEASLES, MUMPS AND RUBELLA VIRUS VACCINE (MMR), LIVE, FORSUBCUTANEOUS USE statewide
90710 Measles, mumps, rubella, and varicella vaccine (MMRV), live for subcutaneous use cohort cohort
90713 POLIOVIRUS VACCINE, INACTIVATED, (IPV), FOR SUBCUTANEOUS OR INTRAVMUSCULAR USE cohort cohort
90714 Tetanus and diphtheria toxoids (Td) absorbed, preservative free, when administered to individuals 7years or older, for intramuscular use cohort cohort cohort cohort
90715 Tetanus diphtheria toxoids and acellular pertussisvaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use cohort cohort cohort cohort cohort
90716 Varicella virus vaccine, live, for subcutaneous use statewide
90723 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and poliovirus vaccine, inactivated (DtaP-HepB-IPV), for intramuscular use cohort cohort cohort
90732
Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use cohort cohort cohort cohort
90733 Meningococcal polysaccharide vaccine (any group(s)), for subcutaneous use cohort cohort cohort
90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for intramuscular use cohort cohort
90736 Zoster (shingles) vaccine, live, for subcutaneous injection cohort cohort
90740 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use cohort cohort
90741 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
90743 Hepatitis B vaccine, adolescent (2 dose schedule),for intramuscular use statewide
90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use cohort cohort
90746 Hepatitis B vaccine, adult dosage (3 dose schedule), for intramuscular use cohort cohort
90791 PSYCHIATRIC DIAGNOSTIC EVALUATION cohort cohort cohort cohort
90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES statewide
90832 PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER cohort cohort cohort
90833
PSYCHOTHERAPY, 30 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE) statewide
90834 PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEMBER cohort cohort
90836
PSYCHOTHERAPY, 45 MINUTES WITH PATIENT AND/OR FAMILY MEMBER WHEN PERFORMED WITH AN EVALUATION AND MANAGEMENT SERVICE (LIST SEPARATELY IN ADDITION TO THE CODE FOR PRIMARY PROCEDURE) statewide
90837 PSYCHOTHERAPY, 60 MINUTES WITH PATIENT AND/OR FAMILY cohort cohort
172
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MEMBER
90839 PSYCHOTHERAPY FOR CRISIS; FIRST 60 MINUTES statewide
90847
FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT) FAMILY PSYCHOTHERAPY (CONJOINTPSYCHOTHERAPY) (WITH PATIENT statewide
90853
GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP) GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP) cohort cohort cohort
90870
ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING);SINGLE SEIZURE ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING); cohort cohort cohort cohort cohort
90901 BIOFEEDBACK TRAINING BY ANY MODALITY statewide
90911
BIOFEEDBACK TRAINING, PERINEAL MUSCLES, ANORECTAL ORURETHRAL SPHINCTER, INCLUDING EMG AND/OR MANOMETRY statewide
90935
HEMODIALYSIS PROCEDURE WITH SINGLE EVALUATION BY APHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSI ONAL cohort cohort
90945
DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (EG, PERITONEAL DIALYSIS, HEMOFILTRATION, OR OTHER CONTINUOUS RENAL REPLACEMENT THERAPIES), WITH SINGLE EVALUATION BY A PHYSICIAN OR OTHER QUALIFIED HEALTH C statewide
90947
DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (EG, PERITONEAL DIALYSIS, HEMOFILTRATION, OR OTHER CONTINUOUS RENAL REPLACEMENT THERAPIES) REQUIRING REPEATED EVALUATION BY A PHYSICIAN OR OTHER QUALIFIED HE statewide
90999
UNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENTUNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENT cohort
91010
ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY WITH INTERPRETATION AND REPORT; cohort cohort cohort cohort cohort
91020 GASTRIC MOTILITY (MANOMETRIC) STUDIES statewide
91034 GASTROESOPHAGEAL REFLUX TEST cohort cohort cohort cohort
91035 ESOPHAGUS, GASTROESOPHAGEAL REFLUX TEST, WITH ELECTRODE cohort cohort cohort cohort cohort
91037
ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST WITH NASAL CATHETER INTRALUMINAL IMPEDANCE ELECTRODE(S) PLACEMENT, RECORDING, ANALYSIS AND INTERPRETATION cohort cohort cohort
91038 ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST WITH NASAL CATHETER INTRALUMINAL, > 1 HR cohort cohort cohort
91065 BREATH HYDROGEN TEST (EG, FOR DETECTION OF LACTASEDEFICIENCY) cohort cohort cohort
91110
GASTROINTESTINAL TRACT IMAGING, INTRALUMINAL (EG, CAPSULE ENDOSCOPY), ESOPHAGUS THROUGH ILEUM, WITH INTERPRETATION AND REPORT cohort cohort cohort cohort
91112
GASTROINTESTINAL TRANSIT AND PRESSURE MEASUREMENT,STOMACH THROUGH COLON, WIRELESS CAPSULE, WITH INT ERPRETATION AND REPORT statewide
91117
Colon motility (manometric) study, minimum 6 hourscontinuous recording (including provocation tests , eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretatio statewide
91120 RECTAL SENSATION TEST statewide
91122 ANORECTAL MANOMETRY cohort cohort
91299 UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE cohort cohort
92015 DETERMINATION OF REFRACTIVE STATEDETERMINATION OF REFRACTIVE STATE statewide
92018
OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDERGENERALANESTHESIA, WITH OR WITHOUT MANIPULATION O F GLOBE FOR PASSIVE RANGE OF MOTION OR OTHER MANIPULATION TO FACILITATE cohort cohort
173
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
92019
OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDERGENERALANESTHESIA, WITH OR WITHOUT MANIPULATION O F GLOBE FOR PASSIVE RANGE OF MOTION OR OTHER MANIPULATION TO FACILITATE statewide
92025 COMPUTERIZED CORNEAL TOPOGRAPHY, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT statewide
92081
VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL,WITHINTERPRETATION AND REPORT; LIMITED EXAMINATIO N (EG, TANGENT SCREEN, AUTOPLOT, ARC PERIMETER, OR SINGLE STIMULUS LEVEL statewide
92082
VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL,WITHINTERPRETATION AND REPORT; INTERMEDIATE EXAMI NATION (EG, AT LEAST 2 ISOPTERS ON GOLDMANN PERIMETER, OR SEMIQUANTITATIVE, statewide
92083
Visual field examination, unilateral or bilateral,with interpretation and report; extended examinat ion (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the statewide
92133
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve statewide
92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina statewide
92136 OPTHALMIC BIOMETRY BY PARTIAL COHERENCE INTERFEROMETRY W/ INTRAOCULAR LENS CALCULATION statewide
92140
PROVOCATIVE TESTS FOR GLAUCOMA, WITH INTERPRETATION ANDREPORT, WITHOUT TONOGRAPHY PROVOCATIVE TESTSFOR GLAUCOMA, WITH INTERPRETATION AND statewide
92235
FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITHINTERPRETATION AND REPORT FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH statewide
92240 INDOCYANINE-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAMEIMAGING) WITH INTERPRETATION AND REPORT statewide
92250
FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORTFUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT statewide
92270
ELECTRO-OCULOGRAPHY WITH INTERPRETATION AND REPORTELECTRO-OCULOGRAPHY WITH INTERPRETATION AND REPORT cohort cohort
92275
ELECTRORETINOGRAPHY WITH INTERPRETATION AND REPORTELECTRORETINOGRAPHY WITH INTERPRETATION AND REPORT statewide
92285
EXTERNAL OCULAR PHOTOGRAPHY WITH INTERPRETATION AND REPORTFOR DOCUMENTATION OF MEDICAL PROGRESS (EG,CLOSE-UP PHOTOGRAPHY, SLIT LAMP PHOTOGRAPHY, GON IOPHOTOGRAPHY, cohort cohort
92499
UNLISTED OPHTHALMOLOGICAL SERVICE OR PROCEDUREUNLISTED OPHTHALMOLOGICAL SERVICE OR PROCEDURE cohort cohort
92502 OTOLARYNGOLOGIC EXAMINATION UNDER GENERAL ANESTHESIA cohort cohort
92504 BINOCULAR MICROSCOPY (SEPARATE DIAGNOSTIC PROCEDURE) statewide
92506
EVALUATION OF SPEECH, LANGUAGE, VOICE, COMMUNICATION,AUDITORY PROCESSING, AND/OR AURAL REHABILITATION STATUS statewide
92511 NASOPHARYNGOSCOPY WITH ENDOSCOPE (SEPARATE PROCEDURE) cohort cohort cohort cohort
92540
BASIC VESTIBULAR EVALUATION, INCLUDES SPONTANEOUS NYSTAGMUS TEST WITH ECCENTRIC GAZE FIXATION NYSTAGMUS, WITH RECORDING, POSITIONAL NYSTAGMUS TEST, MINIMUM OF 4 POSITIONS, WITH RECORDING, OPTOKINETIC cohort cohort cohort
92542
POSITIONAL NYSTAGMUS TEST, MINIMUM OF 4 POSITIONS,WITHRECORDING POSITIONAL NYSTAGMUS TEST, MINIMUM OF 4 POSITIONS, WITH statewide
174
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
92543
CALORIC VESTIBULAR TEST, EACH IRRIGATION (BINAURAL, BITHERMAL STIMULATION CONSTITUTES 4 TESTS), WITHRECORDING cohort cohort cohort
92546 SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTINGSINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING statewide
92547
USE OF VERTICAL ELECTRODES (LIST SEPARATELY IN ADDITION TOCODE FOR PRIMARY PROCEDURE) USE OF VERTICAL ELECTRODES (LIST SEPARATELY IN ADDITION TO statewide
92550 TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS cohort cohort cohort cohort
92551 SCREENING TEST, PURE TONE, AIR ONLY cohort cohort cohort cohort
92552 PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY cohort cohort cohort cohort
92553 PURE TONE AUDIOMETRY (THRESHOLD); AIR AND BONE cohort cohort
92555 SPEECH AUDIOMETRY THRESHOLD; cohort cohort cohort cohort
92556 SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION cohort cohort cohort cohort
92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECHRECOGNITION (92553 AND 92556 COMBINED) cohort cohort cohort cohort
92558
EVOKED OTOACOUSTIC EMISSIONS, SCREENING (QUALITATIVE MEASUREMENT OF DISTORTION PRODUCT OR TRANSIENT EVOKED OTOACOUSTIC EMISSIONS), AUTOMATED ANALYSIS cohort cohort
92563 TONE DECAY TEST statewide
92565 STENGER TEST, PURE TONE cohort cohort
92567 TYMPANOMETRY (IMPEDANCE TESTING) cohort cohort cohort cohort
92568 ACOUSTIC REFLEX TESTING, THRESHOLD cohort cohort cohort cohort
92570
ACOUSTIC IMMITTANCE TESTING, INCLUDES TYMPANOMETRY(IMPEDANCE TESTING), ACOUSTIC REFLEX THRESHOLD TE STING, AND ACOUSTIC REFLEX DECAY TESTING cohort cohort cohort
92572 STAGGERED SPONDAIC WORD TEST statewide
92577 STENGER TEST, SPEECH statewide
92579 VISUAL REINFORCEMENT AUDIOMETRY (VRA) cohort cohort cohort cohort
92582 CONDITIONING PLAY AUDIOMETRY cohort cohort cohort
92583 SELECT PICTURE AUDIOMETRY statewide
92584 ELECTROCOCHLEOGRAPHY cohort cohort
92585
AUDITORY EVOKED POTENTIALS FOR EVOKED RESPONSE AUDIOMETRYAND/OR TESTING OF THE CENTRAL NERVOUS SYSTEM cohort cohort cohort cohort
92586
AUDITORY EVOKED POTENTIALS FOR EVOKED RESPONSE AUDIOMETRY AND/OR TESTING OF THE CENTRAL NERVOUS SYSTEM; LIMITED cohort cohort cohort cohort
92587
DISTORTION PRODUCT EVOKED OTOACOUSTIC EMISSIONS; LIMITED EVALUATION (TO CONFIRM THE PRESENCE OR ABSENCE OF HEARING DISORDER, 3-6 FREQUENCIES) OR TRANSIENT EVOKED OTOACOUSTIC EMISSIONS, WITH INTERPRETA cohort cohort cohort cohort
92588
DISTORTION PRODUCT EVOKED OTOACOUSTIC EMISSIONS; COMPREHENSIVE DIAGNOSTIC EVALUATION (QUANTITATIVE ANALYSIS OF OUTER HAIR CELL FUNCTION BY COCHLEAR MAPPING, MINIMUM OF 12 FREQUENCIES), WITH INTERPRETA cohort cohort cohort cohort
92590 HEARING AID EXAMINATION AND SELECTION; MONAURAL statewide
92591 HEARING AID EXAMINATION AND SELECTION; BINAURAL statewide
92592 HEARING AID CHECK; MONAURALHEARING AID CHECK; MONAURAL cohort cohort
92593 HEARING AID CHECK; BINAURALHEARING AID CHECK; BINAURAL cohort cohort
92594 ELECTROACOUSTIC EVALUATION FOR HEARING AID; MONAURAL cohort cohort
92595 ELECTROACOUSTIC EVALUATION FOR HEARING AID; BINAURAL cohort cohort
92601 DX ANALYSIS COCHLEAR IMPLANT, PATIENT <7 YRS. W/PROGRAMMING statewide
92602 DX ANALYSIS COCHLEAR IMPLANT, PATIENT <7 YRS. REPROGRAMMING statewide
175
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
92603 DX ANALYSIS COCHLEAR IMPLANT, PATIENT >7 YRS. W/PROGRAMMING statewide
92604 DX ANALYSIS COCHLEAR IMPLANT, PATIENT >7 YRS. REPROGRAMMING statewide
92610 EVAL ORAL & PHARYNGEAL SWALLOW FUNCTION statewide
92611 MOTION FLUOROSCOPIC EVAL SWALLOW FUNCTION CINE/ VIDEO RECORD statewide
92612 FLEXIBLE FIBEROPTIC ENDOSCOPIC EVAL SWALLOW CINE/ VIDEO RECORD statewide
92620 AUDITORY FUNCTION, 60 MIN cohort cohort cohort cohort
92621
EVALUATION OF CENTRAL AUDITORY FUNCTION, WITH REPORT; EACH ADDITIONAL 15 MINUTES (LIST SEPARATELY INADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
92625 TINNITUS ASSESSMENT statewide
92626 EVALUATION OF AUDITORY REHABILITATION STATUS; FIRST HOUR cohort cohort
92627
EVALUATION OF AUDITORY REHABILITATION STATUS; EACHADDITIONAL 15 MINUTES (LIST SEPARATELY IN ADDITIO N TO CODE FOR PRIMARY PROCEDURE) statewide
92700 UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE statewide
92920 PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY; SINGLE MAJOR CORONARY ARTERY OR BRANCH cohort cohort cohort cohort cohort
92921
PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
92924
PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH statewide
92928
PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH cohort cohort cohort cohort
92929
PERCUTANEOUS TRANSCATHETER PLACEMENT OF INTRACORONARY STENT(S), WITH CORONARY ANGIOPLASTY WHEN PERFORMED; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO CODE FOR PRI cohort cohort cohort cohort
92933
PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, WITH INTRACORONARY STENT, WITH CORONARY ANGIOPLASTY WHEN PERFORMED; SINGLE MAJOR CORONARY ARTERY OR BRANCH cohort cohort cohort
92937
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF INTRACORONARY STENT, ATHERECTOMY AND ANGIOPLASTY, I cohort cohort cohort
92938
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF INTRACORONARY STENT, ATHERECTOMY AND ANGIOPLASTY, I statewide
92941
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF ACUTE TOTAL/SUBTOTAL OCCLUSION DURING ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF INTRACORONARY STEN cohort cohort
92943
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF INTRACORONARY STENT, ATHERECTOMY AN cohort cohort cohort cohort
92944
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF CHRONIC TOTAL OCCLUSION, CORONARY ARTERY, CORONARY ARTERY BRANCH, OR CORONARY ARTERY BYPASS GRAFT, ANY COMBINATION OF INTRACORONARY STENT, ATHERECTOMY AN statewide
92950 CARDIOPULMONARY RESUSCITATION (EG, IN CARDIAC ARREST) cohort cohort cohort cohort cohort
176
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
92953 TEMPORARY TRANSCUTANEOUS PACING cohort cohort
92960 CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OFARRHYTHMIA, EXTERNAL cohort cohort cohort cohort cohort
92961 CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; INTERNAL (SEPARATE PROCEDURE) statewide
92971 Cardioassist-method of circulatory assist; external statewide
92973
PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY MECHANICAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
92974 TRANSCATHETER PLACEMENT, RADIATION DELIVERY DEVICECORONARY INTRAVASCULAR BRACHYTHERAPY statewide
92977 THROMBOLYSIS, CORONARY; BY INTRAVENOUS INFUSION cohort cohort
92978
INTRAVASCULAR ULTRASOUND (CORONARY VESSEL OR GRAFT) DURINGTHERAPEUTIC INTERVENTION INCLUDING IMAGINGSUPERVISION, INTERPRETATION AND REPORT; INITIAL VESSEL (LIST SEPARATELY cohort cohort cohort cohort cohort
92979
INTRAVASCULAR ULTRASOUND (CORONARY VESSEL OR GRAFT) DURINGTHERAPEUTIC INTERVENTION INCLUDING IMAGINGSUPERVISION, INTERPRETATION AND REPORT; EACH ADD ITIONAL VESSEL (LIST cohort cohort cohort
92986 PERCUTANEOUS BALLOON VALVULOPLASTY; AORTIC VALVE statewide
92987 PERCUTANEOUS BALLOON VALVULOPLASTY; MITRAL VALVE statewide
92990 PERCUTANEOUS BALLOON VALVULOPLASTY; PULMONARY VALVE statewide
92997 PERCUTANEOUS TRANSLUMINAL PULMONARY ARTERY BALLOONANGIOPLASTY; SINGLE VESSEL statewide
92998
PERCUTANEOUS TRANSLUMINAL PULMONARY ARTERY BALLOONANGIOPLASTY; EACH ADDITIONAL VESSEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) statewide
93000
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH cohort cohort cohort cohort cohort
93005
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS;TRACING ONLY, WITHOUT INTERPRETATION AND REPORT ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12LEADS; cohort cohort cohort cohort cohort cohort
93010
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS;INTERPRETATION AND REPORT ONLY ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; cohort cohort cohort
93015
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINUOUS ELECTROCARDIOGRAPHIC MONITORING, AND/OR PHARMACOLOGICAL STRESS; WITH SUPERVISION, INTERPRETATION AND RE statewide
93017
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMALTREADMILL OR BICYCLE EXERCISE, CONTINOUS ELECTROCARDIOGRAPHIC MONITORING, AND/OR PHARMACOLOGICAL cohort cohort cohort cohort cohort
93018
CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMALTREADMILL OR BICYCLE EXERCISE, CONTINOUS ELECTROCARDIOGRAPHIC MONITORING, AND/OR PHARMACOLOGICAL statewide
93040 RHYTHM ECG, ONE TO THREE LEADS; WITH INTERPRETATION ANDREPORT statewide
93041 RHYTHM ECG, ONE TO THREE LEADS; TRACING ONLY WITHOUTINTERPRETATION AND REPORT cohort cohort cohort cohort cohort
93225
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection) cohort cohort cohort cohort cohort cohort
93226 External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report cohort cohort cohort cohort cohort
93229 EXTERNAL MOBILE CARDIOVASCULAR TELEMETRY WITH cohort cohort
177
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
ELECTROCARDIOGRAPHIC RECORDING, CONCURRENT COMPUTERIZED REAL TIME DATA ANALYSIS AND GREATER THAN 24 HOURS OF ACCESSIBLE ECG DATA STORAGE (RETRIEVABLE WITH
93270
External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende cohort cohort cohort cohort cohort
93271
External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attende cohort cohort cohort cohort
93272
EXTERNAL PATIENT AND, WHEN PERFORMED, AUTO ACTIVATED ELECTROCARDIOGRAPHIC RHYTHM DERIVED EVENT RECORDING WITH SYMPTOM-RELATED MEMORY LOOP WITH REMOTE DOWNLOAD CAPABILITY UP TO 30 DAYS, 24-HOUR ATTENDE statewide
93278 SIGNAL-AVERAGED ELECTROCARDIOGRAPHY (SAECG), WITH OR WITHOUTECG statewide
93279
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN cohort cohort
93280
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN cohort cohort cohort
93281
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN statewide
93282
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN statewide
93283
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN cohort cohort cohort
93284
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN cohort cohort
93285
PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH ITERATIVE ADJUSTMENT OF THE IMPLANTABLE DEVICE TO TEST THE FUNCTION OF THE DEVICE AND SELECT OPTIMAL PERMANENT PROGRAMMED VALUES WITH ANALYSIS, REVIEW AN statewide
93286
PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) AND PROGRAMMING OF DEVICE SYSTEM PARAMETERS BEFORE OR AFTER A SURGERY, PROCEDURE, OR TEST WITH ANALYSIS,REVIEW AND REPORT BY A PHYSICIAN OR OTHER QUALIFI statewide
93287
PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) AND PROGRAMMING OF DEVICE SYSTEM PARAMETERS BEFORE OR AFTER A SURGERY, PROCEDURE, OR TEST WITH ANALYSIS,REVIEW AND REPORT BY A PHYSICIAN OR OTHER QUALIFI statewide
93288
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHERQUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONN ECTION, RECORDING AND DISCONNECTION PER PATIENT cohort cohort cohort
178
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
EN
93289
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHERQUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONN ECTION, RECORDING AND DISCONNECTION PER PATIENT EN cohort cohort cohort
93290
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHERQUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONN ECTION, RECORDING AND DISCONNECTION PER PATIENT EN statewide
93291
INTERROGATION DEVICE EVALUATION (IN PERSON) WITH ANALYSIS, REVIEW AND REPORT BY A PHYSICIAN OR OTHERQUALIFIED HEALTH CARE PROFESSIONAL, INCLUDES CONN ECTION, RECORDING AND DISCONNECTION PER PATIENT EN cohort cohort
93293
TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVALUATION(S) SINGLE, DUAL, OR MULTIPLE LEAD PACEMAKER SYSTEM, INCLUDES RECORDING WITH AND WITHOUT MAGNET APPLICATION WITH ANALYSIS, REVIEW AND REPORT(S) BY A PH cohort cohort cohort
93296
Interrogation device evaluation(s) (remote), up to90 days; single, dual, or multiple lead pacemaker system or implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of tra cohort cohort cohort
93299
Interrogation device evaluation(s), (remote) up to30 days; implantable cardiovascular monitor syste m or implantable loop recorded system, remote dataacquisition(s), receipt of transmissions and tech statewide
93303 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIACANOMALIES; COMPLETE cohort cohort cohort cohort
93304 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIACANOMALIES; FOLLOW-UP OR LIMITED STUDY cohort cohort
93305 ADDED DURING FEE SCHEDULE LOAD PROCESS cohort cohort cohort cohort
93306
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording,when performed, complete with spectral Doppler ec hocardiography, and with color flow Doppler echoca cohort cohort cohort cohort cohort cohort
93307
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording,when performed, complete, without spectral or col or Doppler echocardiography cohort cohort cohort cohort cohort
93308
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording,when performed, follow-up or limited study cohort cohort cohort cohort cohort
93312
ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL TIME WITH IMAGEDOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION cohort cohort cohort cohort cohort
93313
ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL TIME WITH IMAGEDOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY cohort cohort
93315
TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENITAL CARDIACANOMALIES; INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION AND REPORT statewide
93318
ECHOCARDIOGRAPHY, TEE FOR MONITORING PURPOSES, INCLUDING PROBE PLACEMENT, REAT TIME 2 DIMENSIONALIMAGE ACQUISITION AND INTERPRETATION LEADING TO ONGOING ASSESSMENT OF CARDIAC PUMPING FUNCTION cohort cohort cohort
93320
DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVEWITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); COMPLETE cohort cohort cohort cohort cohort
93321
DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVEWITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); FOLLOW-UP OR LIMITED STUDY cohort cohort cohort cohort cohort
93325 DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY cohort cohort cohort cohort cohort
179
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MAPPING (LISTSEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHY)
93350
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording,when performed, during rest and cardiovascular st ress test using treadmill, bicycle exercise and/or cohort cohort cohort cohort cohort
93351
ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING,WHEN PERFORMED, DURING REST AND CARDIOVASCULAR ST RESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR cohort cohort cohort cohort cohort
93352
Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure) cohort cohort
93451 Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed cohort cohort cohort cohort
93452
Left heart catheterization including intraprocedural injection(s) for left ventriculography, imagingsupervision and interpretation, when performed cohort cohort cohort cohort
93453
Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed cohort cohort cohort
93454
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; cohort cohort cohort cohort
93455
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i cohort cohort cohort cohort
93456
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheteriza cohort cohort cohort cohort
93457
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) i cohort cohort
93458
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat cohort cohort cohort cohort cohort
93459
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterizat cohort cohort cohort cohort cohort
93460
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca cohort cohort cohort cohort cohort
93461
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca cohort cohort cohort cohort cohort
93462
Left heart catheterization by transseptal puncturethrough intact septum or by transapical puncture (List separately in addition to code for primary procedure) cohort cohort cohort
93463
Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside,dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, cohort cohort cohort
93464
Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure) cohort cohort cohort
93503 INSERTION AND PLACEMENT OF FLOW DIRECTED CATHETER (EG,SWAN-GANZ) FOR MONITORING PURPOSES statewide
93505 Endomyocardial biopsy statewide
93530 Right heart catheterization, for congenital cardiac anomalies statewide
93531 Combined right heart catheterization and retrograde left heart catheterization, for congenital cardiac anomalies cohort cohort cohort
93533
Combined right heart catheterization and transseptal left heart catheterization through existing septal opening, with or without retrograde left heartcatheterization, for congenital cardiac anomalies statewide
93563 Injection procedure during cardiac catheterizationincluding imaging supervision, interpretation, an d report; for selective coronary cohort cohort
180
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
angiography during congenital heart catheterization (List separatel
93565
Injection procedure during cardiac catheterizationincluding imaging supervision, interpretation, an d report; for selective left ventricular or left atrial angiography (List separately in addition to cohort cohort
93566
Injection procedure during cardiac catheterizationincluding imaging supervision, interpretation, an d report; for selective right ventricular or rightatrial angiography (List separately in addition t cohort cohort
93567
Injection procedure during cardiac catheterizationincluding imaging supervision, interpretation, an d report; for supravalvular aortography (List separately in addition to code for primary procedure) cohort cohort cohort cohort
93568
Injection procedure during cardiac catheterizationincluding imaging supervision, interpretation, an d report; for pulmonary angiography (List separately in addition to code for primary procedure) statewide
93571
INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVEDCORONARY FLOW RESERVE MEASUREMENT (CORONARY VESSEL OR GRAFT) DURING CORONARY ANGIOGRAPHY INCLUDING PHARMACOLOGICALLY cohort cohort cohort cohort cohort
93572
INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVEDCORONARY FLOW RESERVE MEASUREMENT (CORONARY VESSEL OR GRAFT) DURING CORONARY ANGIOGRAPHY INCLUDING PHARMACOLOGICALLY cohort cohort cohort cohort
93580 PERC TRANSCATHETER CLOSURE CONGENITAL INTERATRIAL COMMUNICATION W/IMPLANT cohort cohort
93581 PERC TRANSCATHETER CLOSURE CONGENITAL VENTRICULAR SEPTAL DEFECT W/IMPLANT statewide
93603 RIGHT VENTRICULAR RECORDING statewide
93609
INTRAVENTRICULAR AND/OR INTRA-ATRIAL MAPPING OF TACHYCARDIA SITE(S) WITH CATHETER MANIPULATION TO RECORD FROM MULTIPLE SITES TO IDENTIFY ORIGIN OF TACHYCARDIA cohort cohort cohort
93612 INTRAVENTRICULAR PACING statewide
93613 INTRACARDIAC ELECTROPHYSIOLOGIC 3- DIMENSIONAL MAPPING cohort cohort cohort
93616 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH ORWITHOUTVENTRICULAR ELECTROGRAM(S); WITH PACING statewide
93618 INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING statewide
93619
Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple elec cohort cohort
93620
Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco cohort cohort cohort
93621
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH RIGHTATRIAL PACING AND RECORDING, RIGHT VENTRICULARPACING AND RECORDING, HIS BUNDLE RECORDING, INCL UDING INSERTION AND cohort cohort cohort
93622
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH RIGHTATRIAL PACING AND RECORDING, RIGHT VENTRICULARPACING AND RECORDING, HIS BUNDLE RECORDING, INCL UDING INSERTION AND cohort cohort cohort
93623
PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUGINFUSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
93624
Electrophysiologic follow-up study with pacing andrecording to test effectiveness of therapy, inclu ding induction or attempted induction of arrhythmia statewide
93631
INTRA-OPERATIVE EPICARDIAL AND ENDOCARDIAL PACING ANDMAPPING TO LOCALIZE THE SITE OF TACHYCARDIA OR ZONE OF SLOW CONDUCTION FOR SURGICAL CORRECTION statewide
93640
Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing statewide
93641 Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold cohort cohort cohort
181
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
evaluation (induction of arrhythmia, evaluation of sensing and pacing
93642
Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for a cohort cohort cohort
93650
Intracardiac catheter ablation of atrioventricularnode function, atrioventricular conduction for cr eation of complete heart block, with or without temporary pacemaker placement cohort cohort
93653
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF AN ARRHYTHMIA WITH RIGHT ATRIAL PACING AND RE cohort cohort cohort
93654
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF AN ARRHYTHMIA WITH RIGHT ATRIAL PACING AND RE cohort cohort cohort
93655
INTRACARDIAC CATHETER ABLATION OF A DISCRETE MECHANISM OF ARRHYTHMIA WHICH IS DISTINCT FROM THE PRIMARY ABLATED MECHANISM, INCLUDING REPEAT DIAGNOSTICMANEUVERS, TO TREAT A SPONTANEOUS OR INDUCED ARRH cohort cohort cohort
93656
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING TRANSSEPTAL CATHETERIZATIONS, INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF AN ARRHYTHMIA W cohort cohort cohort
93657
ADDITIONAL LINEAR OR FOCAL INTRACARDIAC CATHETER ABLATION OF THE LEFT OR RIGHT ATRIUM FOR TREATMENT OF ATRIAL FIBRILLATION REMAINING AFTER COMPLETION OF PULMONARY VEIN ISOLATION (LIST SEPARATELY IN AD cohort cohort cohort
93660
Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring andintermittent blood pressure monitoring, with or w ithout pharmacological intervention cohort cohort cohort cohort cohort
93662
INTRACARDIAC ECHOCARDIOGRAPHY DURING THERAPEUTIC/ DIAGNOSTIC INTERVENTION, INCLUDING IMAGING SUPERVISION AND INTERPRETATION (LIST SEPARATELY INADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort
93750
INTERROGATION OF VENTRICULAR ASSIST DEVICE (VAD), IN PERSON, WITH PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ANALYSIS OF DEVICE PARAMETERS (EG, DRIVELINES, ALARMS, POWER SURGES), REVIEW OF statewide
93786
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEMSUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS OR LONGER; RECORDING ONLY cohort cohort
93788
AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEMSUCH AS MAGNETIC TAPE AND/OR COMPUTER DISK, FOR 24 HOURS OR LONGER; SCANNING ANALYSIS WITH REPORT cohort cohort
93797
PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITHOUT CONTINUOUS ECG MONITORING (PER SESSION) statewide
93799 UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE cohort cohort cohort
93880 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERALSTUDY cohort cohort cohort cohort cohort cohort
93882 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; UNILATERAL OR LIMITED STUDY cohort cohort cohort
93886 TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES;COMPLETE STUDY cohort cohort cohort cohort
93888 TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES;LIMITED STUDY cohort cohort cohort
93892 TCD, EMOLIDETECT W/O INJ statewide
93893 TCD, EMOLI DETECT W/INJ statewide
93922
Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis a cohort cohort cohort cohort cohort cohort
93923 Complete bilateral noninvasive physiologic studiesof upper or lower cohort cohort cohort cohort cohort
182
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
extremity arteries, 3 or more l evels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibia
93924
Noninvasive physiologic studies of lower extremityarteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler waveform or volume plethysmography recording and analysis at res cohort cohort cohort cohort
93925 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASSGRAFTS; COMPLETE BILATERAL STUDY cohort cohort cohort cohort cohort
93926 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASSGRAFTS; UNILATERAL OR LIMITED STUDY cohort cohort cohort cohort cohort
93930 DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASSGRAFTS; COMPLETE BILATERAL STUDY cohort cohort cohort cohort cohort
93931 DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASSGRAFTS; UNILATERAL OR LIMITED STUDY cohort cohort cohort cohort
93965
NON-INVASIVE PHYSIOLOGIC STUDIES OF EXTREMITY VEINS,COMPLETE BILATERAL STUDY(EG, DOPPLER WAVEFORM ANALYSIS WITH RESPONSES TO COMPRESSION AND OTHER MANEUVERS, cohort cohort cohort
93970
DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSESTOCOMPRESSION AND OTHER MANEUVERS; COMPLETE BILAT ERAL STUDY cohort cohort cohort cohort cohort cohort
93971
DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSESTOCOMPRESSION AND OTHER MANEUVERS; UNILATERAL OR LIMITED STUDY cohort cohort cohort cohort cohort cohort
93975
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OFABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETROPERITONEAL ORGANS; COMPLETE STUDY cohort cohort cohort cohort cohort
93976
DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OFABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR RETROPERITONEAL ORGANS; LIMITED STUDY cohort cohort cohort cohort cohort
93978 DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE,OR BYPASS GRAFTS; COMPLETE STUDY cohort cohort cohort cohort cohort
93979
DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE,OR BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY cohort cohort cohort
93980 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; COMPLETE STUDY cohort cohort cohort
93981 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; FOLLOW-UP OR LIMITED STUDY statewide
93990 DUPLEX SCAN OF HEMODIALYSIS ACCESS (INCLUDING ARTERIALINFLOW, BODY OF ACCESS AND VENOUS OUTFLOW) cohort cohort cohort
93998 UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY statewide
94002
VENTILATION ASSIST AND MANAGEMENT, INITIATION OF PRESSURE OR VOLUME PRESET VENTILATORS FOR ASSISTED OR CONTROLLED BREATHING; HOSPITAL INPATIENT/OBSERVATION, INITIAL DAY cohort cohort cohort cohort cohort
94003
VENTILATION ASSIST AND MANAGEMENT, INITIATION OF PRESSURE OR VOLUME PRESET VENTILATORS FOR ASSISTED OR CONTROLLED BREATHING; HOSPITAL INPATIENT/OBSERVATION, EACH SUBSEQUENT DAY cohort cohort cohort
94010
SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREMENT(S), WITH OR WITHOUT MAXIMAL VOLUNTARY VENTILATION cohort cohort cohort cohort cohort
94011 MEASUREMENT OF SPIROMETRIC FORCED EXPIRATORY FLOWSIN AN INFANT OR CHILD THROUGH 2 YEARS OF AGE statewide
94012
MEASUREMENT OF SPIROMETRIC FORCED EXPIRATORY FLOWS, BEFORE AND AFTER BRONCHODILATOR, IN AN INFANT ORCHILD THROUGH 2 YEARS OF AGE statewide
94013
MEASUREMENT OF LUNG VOLUMES (IE, FUNCTIONAL RESIDUAL CAPACITY ¢FRC!, FORCED VITAL CAPACITY ¢FVC!, AND EXPIRATORY RESERVE VOLUME ¢ERV!) IN AN INFANT ORCHILD THROUGH 2 YEARS OF AGE statewide
94060
BRONCHOSPASM EVALUATION: SPIROMETRY AS IN 94010, BEFORE AND AFTER BRONCHODILATOR (AEROSOL OR PARENTERAL) cohort cohort cohort cohort cohort cohort
183
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
94070
PROLONGED POSTEXPOSURE EVALUATION OF BRONCHOSPASM WITHMULTIPLE SPIROMETRIC DETERMINATIONS AFTER ANTIGEN, COLD AIR, METHACHOLINE OR OTHER CHEMICAL AGENT, WITH SUBSEQUENT cohort cohort cohort cohort cohort
94150 VITAL CAPACITY, TOTAL (SEPARATE PROCEDURE) cohort cohort cohort cohort
94200 MAXIMUM BREATHING CAPACITY, MAXIMAL VOLUNTARY VENTILATION cohort cohort cohort cohort cohort
94250 EXPIRED GAS COLLECTION, QUANTITATIVE, SINGLE PROCEDURE(SEPARATE PROCEDURE) statewide
94375 RESPIRATORY FLOW VOLUME LOOP cohort cohort cohort cohort cohort
94452
HIGH ALTITUDE SIMULATION TEST (HAST), WITH INTERPRETATION AND REPORT BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL; statewide
94620
Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry cohort cohort cohort cohort cohort
94621
PULMONARY STRESS TESTING; COMPLEX (INCLUDING MEASUREMENTS OFCO2 PRODUCTION, O2 UPTAKE, AND ELECTROCARDIOGRAPHIC RECORDINGS) cohort cohort cohort cohort
94640
NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAYOBSTRUCTION NONPRESSURIZED INHALATION TREATMENTFOR ACUTE AIRWAY cohort cohort cohort cohort cohort cohort
94642
AEROSOL INHALATION OF PENTAMIDINE FOR PNEUMOCYSTISCARINIIPNEUMONIA TREATMENT OR PROPHYLAXIS cohort cohort
94644 CONTINUOUS INHALATION TREATMENT WITH AEROSOL MEDICATION FOR ACUTE AIRWAY OBSTRUCTION; FIRST HOUR cohort cohort cohort cohort cohort
94645
CONTINUOUS INHALATION TREATMENT WITH AEROSOL MEDICATION FOR ACUTE AIRWAY OBSTRUCTION; EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
94660 CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION (CPAP),INITIATION AND MANAGEMENT cohort cohort cohort cohort cohort
94664
AEROSOL OR VAPOR INHALATIONS FOR SPUTUM MOBILIZATION,BRONCHODILATION, OR SPUTUM INDUCTION FOR DIAGNOSTIC PURPOSES; INITIAL DEMONSTRATION AND/OR EVALUATION cohort cohort cohort cohort cohort
94667
MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, ANDVIBRATION TO FACILITATE LUNG FUNCTION; INITIAL DEMONSTRATION AND/OR EVALUATION cohort cohort cohort cohort cohort
94668 MANIPULATION CHEST WALL, SUCH AS CUPPING, PERCUSSING, ANDVIBRATION TO FACILITATE LUNG FUNCTION; SUBSEQUENT cohort cohort cohort cohort
94680
OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST AND EXERCISE,DIRECT, SIMPLE OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST AND EXERCISE, statewide
94690
OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST, INDIRECT(SEPARATE PROCEDURE) OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST, INDIRECT cohort cohort cohort
94726 PLETHYSMOGRAPHY FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, AIRWAY RESISTANCE cohort cohort cohort cohort cohort
94727
GAS DILUTION OR WASHOUT FOR DETERMINATION OF LUNG VOLUMES AND, WHEN PERFORMED, DISTRIBUTION OF VENTILATION AND CLOSING VOLUMES cohort cohort cohort cohort
94728 AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY cohort cohort cohort
94729
DIFFUSING CAPACITY (EG, CARBON MONOXIDE, MEMBRANE)(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
94750 PULMONARY COMPLIANCE STUDY, ANY METHOD cohort cohort cohort
94760 NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION;SINGLE DETERMINATION cohort cohort cohort cohort cohort cohort
94761
NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION;MULTIPLE DETERMINATIONS (EG, DURING EXERCISE) cohort cohort cohort cohort cohort cohort
184
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
94762
NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
94770 CARBON DIOXIDE, EXPIRED GAS DETERMINATION BY INFRAREDANALYZER cohort cohort cohort cohort cohort
94799 UNLISTED PULMONARY SERVICE OR PROCEDURE cohort cohort cohort cohort cohort
95004
PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) WITHALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, INC LUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TESTS cohort cohort
95012 NITRIC OXIDE EXPIRED GAS DETERMINATION statewide
95018
ALLERGY TESTING, ANY COMBINATION OF PERCUTANEOUS (SCRATCH, PUNCTURE, PRICK) AND INTRACUTANEOUS (INTRADERMAL), SEQUENTIAL AND INCREMENTAL, WITH DRUGS OR BIOLOGICALS, IMMEDIATE TYPE REACTION, INCLUDING statewide
95024
INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENICEXTRACTS, IMMEDIATE TYPE REACTION, INCLUDING TEST INTERPRETATION AND REPORT, SPECIFY NUMBER OF TEST S statewide
95044
PATCH OR APPLICATION TEST(S) (SPECIFY NUMBER OF TESTS)PATCH OR APPLICATION TEST(S) (SPECIFY NUMBER OF TESTS) statewide
95070
INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDINGNECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS cohort cohort cohort
95076
INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR OTHER SUBSTANCE); INITIAL 120 MINUTES OF TESTING statewide
95079
INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR OTHER SUBSTANCE); EACH ADDITIONAL 60 MINUTES OF TESTING (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY statewide
95115
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOTINCLUDING PROVISION OF ALLERGENIC EXTRACTS; SINGLE INJECTION cohort cohort cohort
95117
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOTINCLUDING PROVISION OF ALLERGENIC EXTRACTS; TWO OR MORE INJECTIONS cohort cohort cohort
95165
PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OFANTIGENS FOR ALLERGEN IMMUNOTHERAPY; SINGLE OR MULTIPLE ANTIGENS (SPECIFY NUMBER OF DOSES) statewide
95250
Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal cohort cohort cohort cohort
95782
POLYSOMNOGRAPHY; YOUNGER THAN 6 YEARS, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A TECHNOLOGIST cohort cohort
95783
POLYSOMNOGRAPHY; YOUNGER THAN 6 YEARS, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, WITH INITIATION OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY OR BI-LEVEL VENTILATION, ATTENDED BY statewide
95800
Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis(eg, by airflow or peripheral arterial tone), and sleep time statewide
95805
MULTIPLE SLEEP LATENCY OR MAINTENANCE OF WAKEFULNESSTESTING, RECORDING, ANALYSIS AND INTERPRETATION OF PHYSIOLOGICAL MEASUREMENTS OF SLEEP DURING MULTIPLE TRIALS cohort cohort cohort cohort cohort
95806
SLEEP STUDY, UNATTENDED, SIMULTANEOUS RECORDING OF, HEART RATE, OXYGEN SATURATION, RESPIRATORY AIRFLOW, AND RESPIRATORY EFFORT (EG, THORACOABDOMINAL MOVEMENT) cohort cohort cohort cohort
95807
SLEEP STUDY, SIMULTANEOUS RECORDING OF VENTILATION,RESPIRATORY EFFORT, ECG OR HEART RATE, AND OXYGENSATURATION, ATTENDED BY A TECHNOLOGIST cohort cohort
185
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
95808
POLYSOMNOGRAPHY; ANY AGE, SLEEP STAGING WITH 1-3 ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A TECHNOLOGIST statewide
95810
POLYSOMNOGRAPHY; AGE 6 YEARS OR OLDER, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A TECHNOLOGIST cohort cohort cohort cohort cohort cohort
95811
POLYSOMNOGRAPHY; AGE 6 YEARS OR OLDER, SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, WITH INITIATION OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY OR BILEVEL VENTILATION, ATTENDED BY A cohort cohort cohort cohort cohort cohort
95812 ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; UPTO ONEHOUR cohort cohort cohort cohort
95813 ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; GREATER THANONE HOUR cohort cohort cohort cohort
95816
ELECTROENCEPHALOGRAM (EEG) INCLUDING RECORDING AWAKE ANDDROWSY, WITH HYPERVENTILATION AND/OR PHOTIC STIMULATION cohort cohort cohort cohort cohort
95819
ELECTROENCEPHALOGRAM (EEG) INCLUDING RECORDING AWAKE ANDASLEEP, WITH HYPERVENTILATION AND/OR PHOTIC STIMULATION cohort cohort cohort cohort cohort
95831 MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE); EXTREMITY(EXCLUDING HAND) OR TRUNK, WITH REPORT statewide
95834 MUSCLE TESTING, MANUAL (SEPARATE PROCEDURE); TOTALEVALUATION OF BODY, INCLUDING HANDS statewide
95851
RANGE OF MOTION MEASUREMENTS AND REPORT (SEPARATEPROCEDURE); EACH EXTREMITY (EXCLUDING HAND) OR EACHTRUNK SECTION (SPINE) statewide
95860 NEEDLE ELECTROMYOGRAPHY; 1 EXTREMITY WITH OR WITHOUT RELATED PARASPINAL AREAS cohort cohort cohort cohort cohort
95861 NEEDLE ELECTROMYOGRAPHY, TWO EXTREMITIES WITH OR WITHOUTRELATED PARASPINAL AREAS cohort cohort cohort cohort
95865 NEEDLE ELECTROMYOGRAPHY; LARYNX cohort cohort
95867 NEEDLE ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES,UNILATERAL cohort cohort
95868 NEEDLE ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES,BILATERAL cohort cohort cohort cohort
95869 NEEDLE ELECTROMYOGRAPHY; THORACIC PARASPINAL MUSCLES statewide
95870
NEEDLE ELECTROMYOGRAPHY; LIMITED STUDY OF MUSCLES IN 1 EXTREMITY OR NON-LIMB (AXIAL) MUSCLES (UNILATERAL OR BILATERAL), OTHER THAN THORACIC PARASPINAL, CRANIAL NERVE SUPPLIED MUSCLES, OR SPHINCTERS cohort cohort cohort
95872
NEEDLE ELECTROMYOGRAPHY USING SINGLE FIBER ELECTRODE, WITHQUANTITATIVE MEASUREMENT OF JITTER, BLOCKING AND/OR FIBER DENSITY, ANY/ALL SITES OF EACH MUSCLE STUDIED cohort cohort
95873
ELECTRICAL STIMULATION FOR GUIDANCE IN CONJUNCTIONWITH CHEMODENERVATION (LIST SEPARATELY IN ADDITIO N TO CODE FOR PRIMARY PROCEDURE) cohort cohort
95874
NEEDLE ELECTROMYOGRAPHY FOR GUIDANCE IN CONJUNCTION WITH CHEMODENERVATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort
95875 ISCHEMIC LIMB EXERCISE WITH NEEDLE ELECTROMYOGRAPHY, WITHLACTIC ACID DETERMINATION statewide
95885
NEEDLE ELECTROMYOGRAPHY, EACH EXTREMITY, WITH RELATED PARASPINAL AREAS, WHEN PERFORMED, DONE WITH NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY; LIMITED (LIST SEPARATELY IN ADDITION TO CODE F cohort cohort cohort cohort
95886
NEEDLE ELECTROMYOGRAPHY, EACH EXTREMITY, WITH RELATED PARASPINAL AREAS, WHEN PERFORMED, DONE WITH NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY; COMPLETE, FIVE OR MORE MUSCLES STUDIED, INNERV cohort cohort cohort cohort
95887
NEEDLE ELECTROMYOGRAPHY, NON-EXTREMITY (CRANIAL NERVE SUPPLIED OR AXIAL) MUSCLE(S) DONE WITH NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY (LIST cohort cohort
186
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
SEPARATELY IN ADDITION TO CODE FOR PRIMARY PRO
95907 NERVE CONDUCTION STUDIES; 1-2 STUDIES cohort cohort cohort
95908 NERVE CONDUCTION STUDIES; 3-4 STUDIES cohort cohort cohort cohort cohort
95909 NERVE CONDUCTION STUDIES; 5-6 STUDIES cohort cohort cohort cohort cohort
95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES cohort cohort cohort cohort
95911 NERVE CONDUCTION STUDIES; 9-10 STUDIES cohort cohort cohort cohort
95912 NERVE CONDUCTION STUDIES; 11-12 STUDIES cohort cohort cohort cohort
95913 NERVE CONDUCTION STUDIES; 13 OR MORE STUDIES cohort cohort cohort
95921
TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; CARDIOVAGAL INNERVATION (PARASYMPATHETIC FUNCTION), INCLUDING 2 OR MORE OF THE FOLLOWING: HEART RATE RESPONSE TO DEEP BREATHING WITH RECORDED R-R INTERVAL statewide
95922
TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; VASOMOTORADRENERGIC INNERVATION (SYMPATHETIC ADRENERGIC FUNCTION), INCLUDING BEAT-TO-BEAT BLOOD PRESSURE AND R-R INTERVAL statewide
95923
TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; SUDOMOTOR, INCLUDING 1 OR MORE OF THE FOLLOWING: QUANTITATIVE SUDOMOTOR AXON REFLEX TEST (QSART), SILASTIC SWEAT IMPRINT, THERMOREGULATORY SWEAT TEST, AND statewide
95924
TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; COMBINED PARASYMPATHETIC AND SYMPATHETIC ADRENERGIC FUNCTION TESTING WITH AT LEAST 5 MINUTES OF PASSIVE TILT statewide
95925
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY,STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM;IN UPPER LIMBS cohort cohort cohort
95926
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY,STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM;IN LOWER LIMBS cohort cohort cohort
95927
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY,STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM;IN THE TRUNK OR statewide
95928 C MONTOR EVOKED, UPPER LIMBS statewide
95929 C MONTOR EVOKED, LOWER LIMBS cohort cohort
95930 VISUAL EVOKED POTENTIAL (VEP) TESTING CENTRAL NERVOUSSYSTEM, CHECKERBOARD OR FLASH cohort cohort cohort cohort
95933 ORBICULARIS OCULI (BLINK) REFLEX, BY ELECTRODIAGNOSTICTESTING statewide
95937 NEUROMUSCULAR JUNCTION TESTING (REPETITIVE STIMULATION, PAIRED STIMULI), EACH NERVE, ANY 1 METHOD cohort cohort
95938
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKINSITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM; IN UPPER AND LOWER LIMBS cohort cohort cohort
95939
SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR SKINSITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM; IN UPPER AND LOWER LIMBS cohort cohort cohort
95940
CONTINUOUS INTRAOPERATIVE NEUROPHYSIOLOGY MONITORING IN THE OPERATING ROOM, ONE ON ONE MONITORING REQUIRING PERSONAL ATTENDANCE, EACH 15 MINUTES (LISTSEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED cohort cohort cohort cohort cohort
95950
MONITORING FOR IDENTIFICATION AND LATERALIZATION OF CEREBRALSEIZURE FOCUS, ELECTROENCEPHALOGRAPHIC (EG, 8 CHANNEL EEG) RECORDING AND INTERPRETATION, EACH 24 HOURS cohort cohort cohort
187
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
95951
MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BYCABLE OR RADIO, 16 OR MORE CHANNEL TELEMETRY, COMBINED ELECTROENCEPHALOGRAPHIC (EEG) AND VIDEO RECORDING AND cohort cohort cohort
95953
Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic (EEG) recording and interpretation, each 24 hours, unattended cohort cohort cohort cohort cohort
95955 ELECTROENCEPHALOGRAM (EEG) DURING NONINTRACRANIAL SURGERY(EG, CAROTID SURGERY) statewide
95956
Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG) recording and interpretation, each 24 hours, attended by a technolo cohort cohort
95957 DIGITAL ANALYSIS OF ELECTROENCEPHALOGRAM (EEG) (EG, FOREPILEPTIC SPIKE ANALYSIS) cohort cohort
95958 WADA ACTIVATION TEST FOR HEMISPHERIC FUNCTION, INCLUDINGELECTROENCEPHALOGRAPHIC (EEG) MONITORING statewide
95965 MAGNETOENCEPHALOGRAPHY (MEG), RECORD & ANALYSIS; FOR SPONTANEOUS BRAIN MAGNETIC ACTIVITY statewide
95966 MAGNETOENCEPHALOGRAPHY (MEG), RECORD & ANALYSIS; FOR EVOKED MAGNETIC FIELDS, SINGLE MODALITY statewide
95967 MAGNETOENCEPHALOGRAPHY (MEG), RECORD & ANALYSIS; FOR EVOKED MAGNETIC FIELDS, EA ADD'L MODALITY statewide
95970
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPLITUDE, PULSE DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE SELECTABILITY, OUTPUT MODULATI statewide
95971
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPLITUDE, PULSE DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE SELECTABILITY, OUTPUT MODULATI cohort cohort cohort cohort cohort
95972
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPLITUDE, PULSE DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE SELECTABILITY, OUTPUT MODULATI cohort cohort cohort cohort cohort
95973
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPLITUDE, PULSE DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE SELECTABILITY, OUTPUT MODULATI statewide
95974
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (EG, RATE, PULSE AMPLITUDE, PULSE DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE SELECTABILITY, OUTPUT MODULATI cohort cohort
95978 ANALYZE NEUROSTIM BRAIN / 1 HOUR statewide
95990
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOIR FOR DRUG DELIVERY, SPINAL (INTRATHECAL, EPIDURAL) OR BRAIN (INTRAVENTRICULAR), INCLUDES ELECTRONIC ANALYSIS OF PUMP, WHEN PERFORMED; cohort cohort
95991
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOIR FOR DRUG DELIVERY, SPINAL (INTRATHECAL, EPIDURAL) OR BRAIN (INTRAVENTRICULAR), INCLUDES ELECTRONIC ANALYSIS OF PUMP, WHEN PERFORMED; REQUIRIN statewide
95999 UNLISTED NEUROLOGICAL OR NEUROMUSCULAR DIAGNOSTIC PROCEDURE statewide
96020
NEUROFUNCTIONAL TESTING SELECTION AND ADMINISTRATION DURING NONINVASIVE IMAGING FUNCTIONAL BRAIN MAPPING, WITH TEST ADMINISTERED ENTIRELY BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL (IE statewide
96101
Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities,personality and psychopathology, e.g., MMPI, Rors chach, WAIS), per hour of the psychologist's or ph cohort cohort
96102
PSYCHOLOGICAL TESTING (INCLUDES PSYCHODIAGNOSTIC ASSESSMENT OF EMOTIONALITY, INTELLECTUAL ABILITIES,PERSONALITY AND PSYCHOPATHOLOGY, EG, MMPI AND WAI S), WITH QUALIFIED HEALTH CARE PROFESSIONAL INTERP statewide
188
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
96103
PSYCHOLOGICAL TESTING (INCLUDES PSYCHODIAGNOSTIC ASSESSMENT OF EMOTIONALITY, INTELLECTUAL ABILITIES,PERSONALITY AND PSYCHOPATHOLOGY, EG, MMPI), ADMIN ISTERED BY A COMPUTER, WITH QUALIFIED HEALTH CARE statewide
96110 DEVELOPMENTAL SCREENING, WITH INTERPRETATION AND REPORT, PER STANDARDIZED INSTRUMENT FORM statewide
96111
DEVELOPMENTAL TESTING, (INCLUDES ASSESSMENT OF MOTOR, LANGUAGE, SOCIAL, ADAPTIVE, AND/OR COGNITIVE FUNCTIONING BY STANDARDIZED DEVELOPMENTAL INSTRUMENTS) WITH INTERPRETATION AND REPORT statewide
96116
NEUROBEHAVIORAL STATUS EXAM (CLINICAL ASSESSMENT OF THINKING, REASONING AND JUDGMENT, EG, ACQUIRED KNOWLEDGE, ATTENTION, LANGUAGE, MEMORY, PLANNING AND PROBLEM SOLVING, AND VISUAL SPATIAL ABILITIES), statewide
96118
Neuropsychological testing (e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scalesand Wisconsin Card Sorting Test), per hour of the psychologist's or physician's time, both face-to- statewide
96119
NEUROPSYCHOLOGICAL TESTING (EG, HALSTEAD-REITAN NEUROPSYCHOLOGICAL BATTERY, WECHSLER MEMORY SCALES AND WISCONSIN CARD SORTING TEST), WITH QUALIFIED HEALTH CARE PROFESSIONAL INTERPRETATION AND REPORT, statewide
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour cohort cohort cohort cohort cohort
96361 Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure) cohort cohort cohort cohort cohort
96365 Intravenous infusion, for therapy, prophylaxis, ordiagnosis (specify substance or drug); initial, u p to 1 hour cohort cohort cohort cohort cohort
96366
Intravenous infusion, for therapy, prophylaxis, ordiagnosis (specify substance or drug); each addit ional hour (List separately in addition to code for primary procedure) cohort cohort cohort cohort cohort
96367
INTRAVENOUS INFUSION, FOR THERAPY, PROPHYLAXIS, ORDIAGNOSIS (SPECIFY SUBSTANCE OR DRUG); ADDITIONAL SEQUENTIAL INFUSION OF A NEW DRUG/SUBSTANCE, UP T O 1 HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR cohort cohort cohort cohort cohort
96368
Intravenous infusion, for therapy, prophylaxis, ordiagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure) cohort cohort cohort cohort cohort
96372 Therapeutic, prophylactic, or diagnostic injection(specify substance or drug); subcutaneous or intr amuscular cohort cohort cohort cohort cohort
96373 Therapeutic, prophylactic, or diagnostic injection(specify substance or drug); intra-arterial cohort cohort cohort
96374 Therapeutic, prophylactic, or diagnostic injection(specify substance or drug); intravenous push, si ngle or initial substance/drug cohort cohort cohort cohort cohort
96375
Therapeutic, prophylactic, or diagnostic injection(specify substance or drug); each additional sequ ential intravenous push of a new substance/drug (List separately in addition to code for primary pro cohort cohort cohort cohort cohort
96376
Therapeutic, prophylactic, or diagnostic injection(specify substance or drug); each additional sequ ential intraveous push of the same substance/drug provided in a facility (List separately in additio cohort cohort cohort cohort cohort
96379 Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion cohort cohort cohort
96401 CHEMOTHERAPY ADMINISTRATION, SUBCUTANEOUS OR INTRAMUSCULAR; NON-HORMONAL ANTI-NEOPLASTIC cohort cohort cohort cohort cohort
96402 CHEMOTHERAPY ADMINISTRATION, SUBCUTANEOUS OR INTRAMUSCULAR; HORMONAL ANTI-NEOPLASTIC cohort cohort cohort cohort cohort
96409 CHEMOTHERAPY ADMINISTRATION; INTRAVENOUS, PUSH TECHNIQUE, SINGLE OR INITIAL SUBSTANCE/DRUG cohort cohort cohort cohort cohort
96411
CHEMOTHERAPY ADMINISTRATION; INTRAVENOUS, PUSH TECHNIQUE, EACH ADDITIONAL SUBSTANCE/DRUG (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
96413
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; UP TO 1 HOUR, SINGLE OR INITIAL SUBSTANCE/DRUG cohort cohort cohort cohort cohort
189
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
96415
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
96416
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; INITIATION OF PROLONGED CHEMOTHERAPY INFUSION (MORE THAN 8 HOURS), REQUIRING USE OF A PORTABLE OR IMPLANTABLE PUMP cohort cohort cohort cohort cohort
96417
CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS INFUSION TECHNIQUE; EACH ADDITIONAL SEQUENTIAL INFUSION (DIFFERENT SUBSTANCE/DRUG), UP TO 1 HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort cohort
96420
CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; PUSH TECHNIQUE CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; PUSH TECHNIQUE statewide
96446 Chemotherapy administration into the peritoneal cavity via indwelling port or catheter cohort cohort cohort
96450
CHEMOTHERAPY ADMINISTRATION, INTO CNS (EG, INTRATHECAL),REQUIRING AND INCLUDING LUMBAR PUNCTURE CHEMOTHERAPY ADMINISTRATION, INTO CNS (EG, INTRATHECAL), cohort cohort cohort
96521 REFILLING AND MAINTENANCE OF PORTABLE PUMP cohort cohort cohort cohort cohort
96522
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOIR FOR DRUG DELIVERY, SYSTEMIC (EG, INTRAVENOUS, INTRA-ARTERIAL) cohort cohort
96523 IRRIGATION OF IMPLANTED VENOUS ACCESS DEVICE FOR DRUG DELIVERY SYSTEMS cohort cohort cohort cohort cohort
96526 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
96542
CHEMOTHERAPY INJECTION, SUBARACHNOID OR INTRAVENTRICULAR VIASUBCUTANEOUS RESERVOIR, SINGLE OR MULTIPLE AGENTS cohort cohort
96549 UNLISTED CHEMOTHERAPY PROCEDURE cohort cohort
97001 PHYSICAL THERAPY EVALUATION statewide
97028
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ULTRAVIOLET APPLICATION OF A MODALITY TO ONE OR MOREAREAS; ULTRAVIOLET statewide
97116 THERAPEUTIC PROCEDURE, 1 OR MORE AREAS, EACH 15 MINUTES; GAIT TRAINING (INCLUDES STAIR CLIMBING) statewide
97150
THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS)THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS) cohort cohort cohort cohort cohort
97250 (CODE DELETED IN 1999. TO REPORT, SEE 97140) MYOFA statewide
97530
THERAPEUTIC ACTIVITIES, DIRECT (ONE-ON-ONE) PATIENT CONTACT (USE OF DYNAMIC ACTIVITIES TO IMPROVE FUNCTIONAL PERFORMANCE), EACH 15 MINUTES cohort cohort
97532
DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, MEMORY, PROBLEM SOLVING (INCLUDES COMPENSATORYTRAINING), DIRECT (ONE-ON-ONE) PATIENT CONTACT, E ACH 15 MINUTES statewide
97535
SELF-CARE/HOME MANAGEMENT TRAINING (EG, ACTIVITIESOF DAILY LIVING (ADL) AND COMPENSATORY TRAINING, MEAL PREPARATION, SAFETY PROCEDURES, AND INSTRUCTIONS IN USE OF ASSISTIVE TECHNOLOGY DEVICES/ADAPTIV cohort cohort
97597
Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de cohort cohort cohort cohort cohort cohort
97598
Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, de cohort cohort cohort cohort cohort
97602
REMOVAL OF DEVITALIZED TISSUE FROM WOUND;NONSELECTIVE DEBRIDEMENT, WITHOUT ANESTHESIA, WOUND ASSESS-MENT, AND INSTUCTION FOR ONGING CARE, PER SESSION cohort cohort cohort cohort cohort
97605 NEG PRESSURE WOUND THERAPY, < 50 CM cohort cohort cohort cohort
97606 NEG PRESSURE WOUND THERAPY, > 50 CM cohort cohort
190
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
97802
MEDICAL NUTRITION THERAPY; INITIAL ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE TO FACE WITH THE PATIENT, EACH 15 MINUTES statewide
97803
MEDICAL NUTRITION THERAPY; RE-ASSESSMENT AND INTERVENTION, INDIVIDUAL, FACE TO FACE WITH THE PATIENT, EACH 15 MINUTES statewide
97804 MEDICAL NUTRITION THERAPY; GROUP (2 OR MORE INDIVIDUALS),EACH 30 MINUTES statewide
98926
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); THREE TOFOUR BODYREGIONS INVOLVED OSTEOPATHIC MANIPULATI VE TREATMENT (OMT); THREE TO FOUR BODY statewide
98929
OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); NINE TO TEN BODYREGIONS INVOLVED OSTEOPATHIC MANIPULATIVETREATMENT (OMT); NINE TO TEN BODY statewide
98960
EDUCATION AND TRAINING FOR PATIENT SELF-MANAGEMENTBY A QUALIFIED, NONPHYSICIAN HEALTH CARE PROFESSI ONAL USING A STANDARDIZED CURRICULUM, FACE-TO-FACEWITH THE PATIENT (COULD INCLUDE CAREGIVER/FAMILY) statewide
99005
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION ANDMANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE THREE KEY COMPONENTS: statewide
99070
SUPPLIES AND MATERIALS (EXCEPT SPECTACLES), PROVIDED BY THE PHYSICIAN OR OTHER QUALIFIED HEALTH CAREPROFESSIONAL OVER AND ABOVE THOSE USUALLY INCLUDE D WITH THE OFFICE VISIT OR OTHER SERVICES RENDERED cohort cohort cohort
99100
ANESTHESIA FOR PATIENT OF EXTREME AGE, UNDER ONE YEAR ANDOVER SEVENTY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY ANESTHESIA PROCEDURE) statewide
99140
ANESTHESIA COMPLICATED BY EMERGENCY CONDITIONS (SPECIFY)(LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY ANESTHESIA PROCEDURE) statewide
99143
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999) PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTI cohort cohort cohort cohort cohort
99144
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999) PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTI cohort cohort cohort cohort cohort
99145
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999) PROVIDED BY THE SAME PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL PERFORMING THE DIAGNOSTIC OR THERAPEUTI cohort cohort cohort cohort cohort
99148
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999), PROVIDED BY APHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSI ONAL OTHER THAN THE HEALTH CARE PROFESSIONAL PERFO cohort cohort cohort cohort
99149
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999), PROVIDED BY APHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSI ONAL OTHER THAN THE HEALTH CARE PROFESSIONAL PERFO cohort cohort cohort cohort cohort
99150
MODERATE SEDATION SERVICES (OTHER THAN THOSE SERVICES DESCRIBED BY CODES 00100-01999), PROVIDED BY APHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSI ONAL OTHER THAN THE HEALTH CARE PROFESSIONAL PERFO cohort cohort cohort
99173 SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL statewide
99183
PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ATTENDANCE AND SUPERVISION OF HYPERBARIC OXYGEN THERAPY, PER SESSION cohort cohort cohort cohort cohort
99195 PHLEBOTOMY, THERAPEUTIC (SEPARATE PROCEDURE) cohort cohort cohort cohort cohort
99201 OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION cohort cohort cohort cohort cohort
191
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY;A PROBLEM FOCUSED EXAMINATION; STRAIGHTFORWARD ME
99202
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION cohort cohort cohort cohort cohort cohort
99203
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; MEDICAL DECISION MAKING OF LOW C cohort cohort cohort cohort cohort cohort
99204
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; ACOMPREHENSIVE EXAMINATION; MEDICAL DECISION MAKIN cohort cohort cohort cohort cohort cohort
99205
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; ACOMPREHENSIVE EXAMINATION; MEDICAL DECISION MAKIN cohort cohort cohort cohort cohort cohort
99211
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, THAT MAY NOT REQUIRE THE PRESENCE OF A PHYSICIAN. USUALLY, THE PRESENTING PROBLEM(S) ARE MINIMAL. TYPICALL cohort cohort cohort cohort cohort cohort
99212
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINAT cohort cohort cohort cohort cohort cohort
99213
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROB cohort cohort cohort cohort cohort cohort
99214
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; MEDICAL D cohort cohort cohort cohort cohort
99215
OFFICE OR OTHER OUTPATIENT VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH REQUIRES AT LEAST 2 OF THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; cohort cohort cohort cohort cohort
99217
OBSERVATION CARE DISCHARGE DAY MANAGEMENT (THIS CODE IS TO BE UTILIZED TO REPORT ALL SERVICES PROVIDED TO A PATIENT ON DISCHARGE FROM "OBSERVATION STATUS" IF THE DISCHARGE IS ON OTHER THAN THE INITIAL cohort cohort cohort cohort cohort
99218
INITIAL OBSERVATION CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED OR COMPREHENSIVE HISTORY; A DETAILED OR COMPREHENSIVE EXAMINATION; A cohort cohort cohort cohort cohort cohort
99219
INITIAL OBSERVATION CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAK cohort cohort cohort cohort
99220
INITIAL OBSERVATION CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAK statewide
99224
SUBSEQUENT OBSERVATION CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRESAT LEAST 2 OF THESE 3 KEY COMPONENTS: PROBLEM FOC USED INTERVAL HISTORY; PROBLEM FOCUSED EXAMINATION cohort cohort cohort
99231
SUBSEQUENT HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES ATLEAST 2 OF THESE 3 KEY COMPONENTS: A PROBLEM FOCU SED INTERVAL HISTORY; A PROBLEM FOCUSED EXAMINATIO statewide
99234
OBSERVATION OR INPATIENT HOSPITAL CARE, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT INCLUDING ADMISSION AND DISCHARGE ON THE SAME DATE, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED OR cohort cohort cohort
192
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
COMPREHE
99235
OBSERVATION OR INPATIENT HOSPITAL CARE, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT INCLUDING ADMISSION AND DISCHARGE ON THE SAME DATE, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTOR statewide
99241
OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINATION;AND STRAIGHTFORWARD MEDICAL DECISION MAKING. COUN cohort cohort
99242
OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND STRAIGHTFORWARD MEDICAL D statewide
99243
OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; AND MEDICAL DECISION MAKING OF LOW COMPLEXITY. COUNSELING AND/O cohort cohort
99244
OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; ANDMEDICAL DECISION MAKING OF MODERATE COMPLEXITY. C cohort cohort cohort
99245
OFFICE CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; ANDMEDICAL DECISION MAKING OF HIGH COMPLEXITY. COUNS cohort cohort
99252
INPATIENT CONSULTATION FOR A NEW OR ESTABLISHED PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY; AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND STRAIGHTFORWARD MEDICA statewide
99281
EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A PROBLEM FOCUSED HISTORY; A PROBLEMFOCUSED EXAMINATION; AND STRAIGHTFORWARD MEDICAL cohort cohort cohort cohort cohort cohort
99282
EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY;AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND MEDI cohort cohort cohort cohort cohort cohort
99283
EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: AN EXPANDED PROBLEM FOCUSED HISTORY;AN EXPANDED PROBLEM FOCUSED EXAMINATION; AND MEDI cohort cohort cohort cohort cohort cohort
99284
EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A DETAILED HISTORY; A DETAILED EXAMINATION; AND MEDICAL DECISION MAKING OF MODERATE CO cohort cohort cohort cohort cohort cohort
99285
EMERGENCY DEPARTMENT VISIT FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS WITHIN THE CONSTRAINTS IMPOSED BY THEURGENCY OF THE PATIENT'S CLINICAL CONDITION AND/O cohort cohort cohort cohort cohort cohort
99291
CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE UNSTABLECRITICALLY ILL OR UNSTABLE CRITICALLY INJURED PATIENT, REQUIRING THE CONSTANT ATTENDANCE OF THE PHYSICIAN; FIRST cohort cohort cohort cohort cohort
99292
CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE CRITICALLYILL OR CRITICALLY INJURED PATIENT, REQUIRING THE CONSTANT ATTENDANCE OF THE PHYSICIAN; EACHADDITIONAL 30 MINUTES cohort cohort cohort cohort cohort
99306
INITIAL NURSING FACILITY CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF A PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISIO cohort cohort cohort
99341 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A statewide
193
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
PROBLEM FOCUSED HISTORY; A PROBLEM FOCUSED EXAMINATION; AND STRAIGHTFORWARD MEDICAL DECISION MAK
99345
HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES THESE 3 KEY COMPONENTS: A COMPREHENSIVE HISTORY; A COMPREHENSIVE EXAMINATION; AND MEDICAL DECISION MAKING OF HIGH COMPLEXI statewide
99351 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
99366
Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care profe statewide
99374
SUPERVISION OF A PATIENT UNDER CARE OF HOME HEALTHAGENCY (PATIENT NOT PRESENT) IN HOME, DOMICILIARY OR EQUIVALENT ENVIRONMENT (EG, ALZHEIMER'S FACILI TY) REQUIRING COMPLEX AND MULTIDISCIPLINARY CARE M statewide
99395
Periodic comprehensive preventive medicine reevaluation and management of an individual including anage and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc statewide
99396
Periodic comprehensive preventive medicine reevaluation and management of an individual including anage and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduc cohort cohort
99401
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDIVIDUAL (SEPARATE PROCEDURE); APPROXIMATELY 15 MINUTES statewide
99402
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDIVIDUAL (SEPARATE PROCEDURE); APPROXIMATELY 30 MINUTES statewide
99403
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDIVIDUAL (SEPARATE PROCEDURE); APPROXIMATELY 45 MINUTES statewide
99404
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO AN INDIVIDUAL (SEPARATE PROCEDURE); APPROXIMATELY 60 MINUTES cohort cohort
99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes cohort cohort
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes statewide
99412
PREVENTIVE MEDICINE COUNSELING AND/OR RISK FACTOR REDUCTION INTERVENTION(S) PROVIDED TO INDIVIDUALS IN A GROUP SETTING (SEPARATE PROCEDURE); APPROXIMATELY 60 MINUTES statewide
99460 Initial hospital or birthing center care, per day,for evaluation and management of normal newborn i nfant statewide
A0398 ALS ROUTINE DISPOSABLE SUPPLIES statewide
A0422 AMBULANCE (ALS OR BLS) OXYGEN AND OXYGEN SUPPLIES,LIFESUSTAINING SITUATION statewide
A0425 GROUND MILEAGE , PER STATUTE MILE cohort cohort cohort cohort
A0426 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON- EMERGENCY TRANSPORT, LEVEL 1 (ALS 1) cohort cohort cohort cohort
A0427 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT LEVEL 1 cohort cohort cohort cohort
A0428 AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON- EMERGENCY TRANSPORT (BLS) cohort cohort cohort cohort
A0429 AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS- EMERGENCY cohort cohort cohort
A0430 AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING) statewide
A0431 AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING) statewide
A0433 ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2) cohort cohort cohort cohort
A0434 SPECIALTY CARE TRANSPORT (SCT) cohort cohort
A0435 FIXED WING AIR MILEAGE, PER STATUTE MILE statewide
194
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
A0436 ROTARY WING AIR MILEAGE, PER STATUTE MILE statewide
A0888 NONCOVERED AMBULANCE MILEAGE, PER MILE (E.G., FOR MILESTRAVELED BEYOND CLOSEST APPROPRIATE FACILITY) statewide
A0998 AMBULANCE RESPONSE AND TREATMENT, NO TRANSPORT statewide
A4206 Syringe with needle, sterile, 1 cc or less, each statewide
A4208 SYRINGE WITH NEEDLE, STERILE 3CC, EACH statewide
A4212 NON-CORING NEEDLE OR STYLET WITH OR WITHOUT CATHETER cohort cohort cohort
A4216 STERILE WATER, SALINE AND/OR DEXTROSE, DILUENT/FLUSH, 10 ML cohort cohort cohort cohort cohort
A4217 STERILE WATER/SALINE, 500 ML cohort cohort cohort cohort
A4218 STERILE SALINE OR WATER, METERED DOSE DISPENSER, 10 ML statewide
A4220 REFILL KIT FOR IMPLANTABLE INFUSION PUMP statewide
A4222 SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, PER CASSETTE ORBAG (LIST DRUG SEPARATELY) statewide
A4248 CHLORHEXIDINE CONTAINING ANTISEPTIC, 1 ML cohort cohort
A4264 PERMANENT IMPLANTABLE CONTRACEPTIVE INTRATUBAL OCCLUSION DEVICE(S) AND DELIVERY SYSTEM cohort cohort cohort cohort
A4270 DISPOSABLE ENDOSCOPE SHEATH, EACH cohort cohort cohort
A4300 IMPLANTABLE ACCESS CATHETER (VENOUS, ARTERIAL, EPIDURAL ORPERITONEAL), EXTERNAL ACCESS cohort cohort
A4301
IMPLANTABLE ACCESS TOTAL SYSTEM; CATHETER, PORT/RESERVOIR(VENOUS, ARTERIAL OR EPIDURAL), PERCUTANEOUS ACCESS cohort cohort
A4306 DISPOSABLE DRUG DELIVERY SYSTEM, FLOW RATE OF LESSTHAN 50 ML PER HOUR statewide
A4310 INSERTION TRAY WITHOUT DRAINAGE BAG AND WITHOUT CATHETER(ACCESSORIES ONLY) statewide
A4314
INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER,FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.) statewide
A4316
INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER,FOLEY TYPE, THREE-WAY, FOR CONTINUOUS IRRIGATION statewide
A4320 IRRIGATION TRAY WITH BULB OR PISTON SYRINGE, ANY PURPOSE statewide
A4322 IRRIGATION SYRINGE, BULB OR PISTON, EACH statewide
A4334 URINARY CATHETER ANCHORING DEVICE, LEG STRAP, EACH statewide
A4335 INCONTINENCE SUPPLY; MISCELLANEOUS statewide
A4338
INDWELLING CATHETER; FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH cohort cohort cohort
A4340 INDWELLING CATHETER; SPECIALTY TYPE, EG; COUDE, MUSHROOM,WING, ETC.), EACH cohort cohort cohort cohort
A4344 INDWELLING CATHETER, FOLEY TYPE, TWO-WAY, ALL SILICONE, EACH cohort cohort cohort cohort
A4346 INDWELLING CATHETER; FOLEY TYPE, THREE WAY FOR CONTINUOUSIRRIGATION, EACH cohort cohort
A4349 DISPOSABLE MALE EXTERNAL CATHETER statewide
A4351 INTERMITTENT URINARY CATHETER; STRAIGHT TIP, EACH statewide
A4353 INTERMITTENT URINARY CATHETER, WITH INSERTION SUPPLIES cohort cohort
A4355
IRRIGATION TUBING SET FOR CONTINUOUS BLADDER IRRIGATIONTHROUGH A THREE-WAY INDWELLING FOLEY CATHETER, EACH statewide
A4357 BEDSIDE DRAINAGE BAG, DAY OR NIGHT, WITH OR WITHOUTANTI-REFLUX DEVICE, WITH OR WITHOUT TUBE, EACH statewide
A4358 URINARY LEG BAG; VINYL, WITH OR WITHOUT TUBE, EACH cohort cohort
A4364 ADHESIVE FOR OSTOMY OR CATHETER; LIQUID (SPRAY, BRUSH,ETC.), CEMENT, POWDER OR PASTE; ANY COMPOSITION statewide
195
CPT Description
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Peer Cohort 2
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Peer Cohort 6
(E.G. SILICONE, LATEX, ETC.); PER OZ.
A4373
OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE,OR ACCORDION), STANDARD WEAR, WITH BUILT-IN CONVEXITY, ANY SIZE, EACH statewide
A4421 OSTOMY SUPPLY; MISCELLANEOUS statewide
A4463 SURGICAL DRESSING HOLDER, REUSABLE, EACH statewide
A4465 NON-ELASTIC BINDER FOR EXTREMITY statewide
A4466 GARMENT, BELT, SLEEVE OR OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE MATERIAL, ANY TYPE, EACH statewide
A4495 SURGICAL STOCKINGS THIGH LENGTH, EACH statewide
A4550 SURGICAL TRAYS statewide
A4562 PESSARY, NON RUBBER, ANY TYPE statewide
A4565 SLINGS cohort cohort cohort
A4570 SPLINT cohort cohort
A4614 PEAK EXPIRATORY FLOW RATE METER, HAND HELD statewide
A4615 CANNULA, NASAL cohort cohort cohort
A4616 TUBING (OXYGEN), PER FOOT statewide
A4628 OROPHARYNGEAL SUCTION CATHETER, EACH statewide
A4641 RADIOPHARMACEUTICAL, DIAGNOSTIC, NOT OTHERWISE CLASSIFIED cohort cohort cohort cohort
A4648 Tissue marker, implantable, any type, each cohort cohort cohort cohort cohort
A4649 SURGICAL SUPPLY; MISCELLANEOUS cohort cohort cohort cohort
A4719 "Y SET" TUBNG FOR PERITONEAL DIALYSIS statewide
A4722
DIALYSATE SOLUTION ANY CONCENTRATION OF DEXTROSE FLUID VOLUME GREATER THAN 1999CC BUT LESS THAN OR EQUAL TO 2999CC FOR PERITONEAL DIALYSIS statewide
A4725
DIALYSATE SOLUTION ANY CONCENTRATION OF DEXTROSE FLUID VOLUME GREATER THAN 4999CC BUT LESS THAN OR EQUAL TO 5999CC FOR PERITONEAL DIALYSIS statewide
A5500
FOR DIABETICS ONLY, FITTING (INCLUDING FOLLOW-UP),CUSTOMPREPARATION AND SUPPLY OF OFF-THE-SHELF DEP TH-INLAY SHOE MANUFACTURED TO ACCOMMODATE MULTI- DENSITY INSERT(S), PER statewide
A5512
FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, DIRECT FORMED, MOLDED TO FOOT AFTER EXTERNAL HEAT SOURCE OF 230 DEGREES FAHRENHEIT OR HIGHER, TOTAL CONTACT WITH PATIENT'S FOOT, INCLUDING ARCH, BASE LAYE statewide
A6021 Collagen dressing, sterile, size 16 sq. In. Or less, each cohort cohort cohort
A6022 Collagen dressing, sterile, size more than 16 sq. In. But less than or equal to 48 sq. In. , each statewide
A6196 ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ.IN. OR LESS, EACH DRESSING cohort cohort cohort cohort
A6197
ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING cohort cohort cohort cohort
A6199 ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND FILLER, STERILE, PER 6 INCHES statewide
A6207 CONTACT LAYER, STERILE, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING cohort cohort cohort
A6209 FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING cohort cohort cohort cohort
A6210
FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORETHAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DRESSING cohort cohort cohort cohort cohort
A6211
FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORETHAN 48 SQ. IN., WITHOUT ADHESIVE BORDER, EACH DR ESSING statewide
A6212 FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING cohort cohort cohort cohort
196
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
A6213
FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE MORETHAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., WITH ANY SIZE ADHESIVE BORDER, EACH DRESSING cohort cohort cohort
A6215 FOAM DRESSING, WOUND FILLER, STERILE, PER GRAM statewide
A6222
GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH cohort cohort cohort cohort
A6223
GAUZE, IMPREGNATED WITH OTHER THAN WATER, NORMAL SALINE, OR HYDROGEL, STERILE, PAD SIZE MORE THAN 16SQ INCHES, WITHOUT ADHESIVE BORDER, EACH DRESSING cohort cohort cohort
A6234
HYDROCOLLOID DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING cohort cohort cohort
A6240 HYDROCOLLOID DRESSING, WOUND FILLER, PASTE, STERILE, PER OUNCE cohort cohort cohort
A6242 HYDROGEL DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING statewide
A6248 HYDROGEL DRESSING, WOUND FILLER, GEL, PER FLUID OUNCE cohort cohort cohort cohort cohort
A6250 SKIN SEALANTS, PROTECTANTS, MOISTURIZERS, OINTMENTS, ANYTYPE, ANY SIZE cohort cohort
A6251
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING statewide
A6252
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 16 SQ. IN., BUT LESS THAN OREQUAL TO 48 SQ. IN., WITHOUT ADHESIVE BORDER, EAC H DRESSING cohort cohort
A6253
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE MORE THAN 48 SQ. IN., WITHOUT ADHESIVEBORDER, EACH DRESSING statewide
A6257 TRANSPARENT FILM, STERILE, 16 SQ. IN. OR LESS, EACH DRESSING cohort cohort
A6258 TRANSPARENT FILM, STERILE, MORE THAN 16 SQ. IN. BUT LESS THAN OR EQUAL TO 48 SQ. IN., EACH DRESSING cohort cohort cohort
A6259 TRANSPARENT FILM, STERILE, MORE THAN 48 SQ. IN., EACH DRESSING statewide
A6260 WOUND CLEANSERS, ANY TYPE, ANY SIZE statewide
A6266 GAUZE, IMPREGNATED, OTHER THAN WATER, NORMAL SALINE, OR ZINC PASTE, STERILE, ANY WIDTH, PER LINEAR YARD statewide
A6402 GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. ORLESS, WITHOUT ADHESIVE BORDER, EACH DRESSING cohort cohort cohort
A6407 PACKING STRIPS, NON-IMPREGNATED, STERILE, UP TO 2 INCHES IN WIDTH, PER LINEAR YARD statewide
A6413 Adhesive bandage, first-aid type, any size, each statewide
A6443 CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN cohort cohort
A6444 CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-STERILE, WIDTH GREATER THAN statewide
A6445 CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH LESS THAN THREE cohort cohort
A6446 CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH GREATER THAN OR cohort cohort cohort
A6447 CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, STERILE, WIDTH GREATER THAN OR statewide
A6448 LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN,WIDTH LESS THAN THREE statewide
A6449 LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN,WIDTH GREATER THAN OR EQUAL cohort cohort cohort
A6450 LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN,WIDTH GREATER THAN OR EQUAL statewide
A6451 MODERATE COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, LOAD RESISTANCE OF 1.25 statewide
A6453 SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON- cohort cohort
197
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
WOVEN, WIDTH LESS THAN THREE
A6454 SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, WIDTH GREATER THAN OR cohort cohort
A6455 SELF-ADHERENT BANDAGE, ELASTIC, NON-KNITTED/NON-WOVEN, WIDTH GREATER THAN OR statewide
A6456
ZINC PASTE IMPREGNATED BANDAGE, NON-ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARD cohort cohort cohort
A6457 TUBULAR DRESSING WITH OR WITHOUT ELASTIC, ANY WIDTH, PER LINEAR YARD statewide
A6534 GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 30-40MMHG, EACH statewide
A6535 GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 40-50MMHG, EACH statewide
A6538 GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40-50 MMHG, EACH statewide
A6550
WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES statewide
A7000 CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH cohort cohort
A7002 TUBING, USED WITH SUCTION PUMP, EACH statewide
A7003 ADMINISTRATION SET, WITH SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE statewide
A7030 FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH statewide
A7042 IMPLANTED PLEURAL CATHETER, EACH cohort cohort
A7043 VACUUM DRAINAGE BOTTLE AND TUBING FOR USE WITH IMPLANTED CATHETER cohort cohort cohort cohort
A7501 TRACHEOSTOMA VALVE, INCLUDING DIAPHRAGM, EACH statewide
A7503 FILTER HOLDER OR FILTER CAP, REUSABLE, FOR USE IN A TRACHEOSTOMA HEAT statewide
A7504 FILTER FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM, EACH statewide
A7506 ADHESIVE DISC FOR USE IN A HEAT AND MOISTURE EXCHANGE SYSTEM AND/OR WITH statewide
A7521 TRACHEOSTOMY/LARYNGECTOMY TUBE, CUFFED, POLYVINYLCHLORIDE (PVC), SILICONE OR statewide
A9150 NON-PRESCRIPTION DRUGS cohort cohort cohort cohort cohort
A9152 SINGLE VITAMIN NOS statewide
A9153 MULTI-VITAMIN NOS cohort cohort
A9270 NON-COVERED ITEM OR SERVICE cohort cohort cohort cohort cohort
A9280 ALERT OR ALARM DEVICE, NOT OTHERWISE CLASSIFIED statewide
A9500 TECHNETIUM TC-99M SESTAMIBI, DIAGNOSTIC, PER STUDYDOSE cohort cohort cohort cohort cohort
A9502 TECHNETIUM TC-99M TETROFOSMIN, DIAGNOSTIC, PER STUDY DOSE cohort cohort cohort cohort cohort
A9503 TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDYDOSE, UP TO 30 MILLICURIES cohort cohort cohort cohort cohort cohort
A9505 THALLIUM TL-201 THALLOUS CHLORIDE, DIAGNOSTIC, PERMILLICURIE cohort cohort
A9508 IODINE I-131 IOBENGUANE SULFATE, DIAGNOSTIC, PER 0.5 MILLICURIE cohort cohort
A9509 Iodine I-123 Sodium Iodide, diagnostic, per millicurie cohort cohort
A9510 TECHNETIUM TC-99M DISOFENIN, DIAGNOSTIC, PER STUDYDOSE, UP TO 15 MILLICURIES cohort cohort cohort
A9512 TECHNETIUM TC-99M PERTECHNETATE, DIAGNOSTIC, PER MILLICURIE cohort cohort cohort cohort cohort
A9516 Iodine I-123 Sodium Iodide, diagnostic, per 100 microcuries, up to 999 microcuries cohort cohort cohort cohort cohort
A9517 IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER cohort cohort cohort cohort
198
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
MILLICURIE
A9521 TECHNETIUM TC-99M EXAMETAZIME, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES cohort cohort cohort cohort
A9524 IODINE I-131 IODINATED SERUM ALBUMIN, DIAGNOSTIC, PER 5 MICROCURIES statewide
A9526 NITROGEN N-13 AMMONIA, DIAGNOSTIC, PER STUDY DOSE,UP TO 40 MILLICURIES statewide
A9527 IODINE I-125, SODIUM IODIDE SOLUTION, THERAPEUTIC,PER MILLICURIE statewide
A9528 IODINE I-131 SODIUM IODIDE CAPSULE(S), DIAGNOSTIC,PER MILLICURIE cohort cohort cohort cohort
A9529 IODINE I-131 SODIUM IODIDE SOLUTION, DIAGNOSTIC, PER MILLICURIE cohort cohort
A9530 IODINE I-131 SODIUM IODIDE SOLUTION, THERAPEUTIC, PER MILLICURIE cohort cohort
A9531 IODINE I-131 SODIUM IODIDE, DIAGNOSTIC, PER MICROCURIE (UP TO 100 MICROCURIES) cohort cohort cohort cohort cohort
A9537 TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES cohort cohort cohort cohort cohort cohort
A9538 TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES cohort cohort cohort
A9539 TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, PER STUDYDOSE, UP TO 25 MILLICURIES cohort cohort cohort cohort cohort
A9540 TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES cohort cohort cohort cohort cohort
A9541 TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, PER STUDY DOSE, UP TO 20 MILLICURIES cohort cohort cohort cohort cohort
A9543 YTTRIUM Y-90 IBRITUMOMAB TIUXETAN, THERAPEUTIC, PER TREATMENT DOSE, UP TO 40 MILLICURIES cohort cohort
A9547 INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURIE cohort cohort cohort
A9548 INDIUM IN-111 PENTETATE, DIAGNOSTIC, PER 0.5 MILLICURIE cohort cohort cohort
A9550 TECHNETIUM TC-99M SODIUM GLUCEPTATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIE statewide
A9551 TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MILLICURIES cohort cohort cohort
A9552 FLUORODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC, PER STUDYDOSE, UP TO 45 MILLICURIES cohort cohort cohort cohort cohort
A9554 IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 10 MICROCURIES statewide
A9555 RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURIES statewide
A9556 GALLIUM GA-67 CITRATE, DIAGNOSTIC, PER MILLICURIE cohort cohort
A9557 TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES statewide
A9558 XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES cohort cohort cohort cohort cohort
A9560 TECHNETIUM TC-99M LABELED RED BLOOD CELLS, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES cohort cohort cohort cohort cohort
A9561 TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES cohort cohort cohort cohort
A9562 TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES cohort cohort cohort cohort cohort
A9564 CHROMIC PHOSPHATE P-32 SUSPENSION, THERAPEUTIC, PER MILLICURIE statewide
A9567 TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES cohort cohort cohort cohort
A9569 Technetium TC-99M Exametazime labeled autologous white blood cells, diagnostic, per study dose cohort cohort
A9570 Indium IN-111 labeled autologous white blood cells, diagnostic, per study dose cohort cohort cohort cohort
A9572 Indium IN-111 Pentetreotide, diagnostic, per studydose up to 6 millicuries cohort cohort cohort cohort
199
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
A9577 Injection, Gadobenate Dimeglumine (Multihance), per ml cohort cohort
A9579 Injection, Gadolinium-based magnetic resonance contrast agent, not other wise specified (NOS), per ml cohort cohort cohort cohort
A9580 SODIUM FLUORIDE F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES cohort cohort cohort
A9581 INJECTION, GADOXETATE DISODIUM, 1 ML cohort cohort
A9582 IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES cohort cohort
A9583 INJECTION, GADOFOSVESET TRISODIUM, 1 ML statewide
A9584 IODINE 1-123 IOFLUPANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES statewide
A9585 INJECTION, GADOBUTROL, 0.1 ML cohort cohort cohort
A9604 SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TREATMENT DOSE, UP TO 150 MILLICURIES statewide
A9699 RADIOPHARMACEUTICAL, THERAPEUTIC, NOT OTHERWISE CLASSIFIED statewide
A9999 MISCELLANEOUS DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED statewide
ADJUS CLAIM WAITING REFUND statewide
B4087 Gastrostomy/jejunostomy tube, standard, any material, any type, each cohort cohort cohort
B4088 Gastrostomy/jejunostomy tube, low-profile, any material, any type, each statewide
C1204 Technetium Tc 99m tilmanocept, diagnostic, up to 0.5 millicuries statewide
C1300 C code valid for UB claims only cohort cohort cohort cohort cohort
C1713 C code valid for UB claims only cohort cohort cohort cohort cohort cohort
C1714 C code valid for UB claims only cohort cohort cohort cohort
C1715 C code valid for UB claims only cohort cohort cohort
C1717 C code valid for UB claims only cohort cohort cohort
C1721 C code valid for UB claims only cohort cohort cohort cohort cohort
C1722 C code valid for UB claims only cohort cohort cohort cohort
C1724 C code valid for UB claims only cohort cohort cohort cohort
C1725 C code valid for UB claims only cohort cohort cohort cohort cohort
C1726 C code valid for UB claims only cohort cohort cohort cohort cohort
C1727 C code valid for UB claims only cohort cohort cohort cohort cohort
C1728 C code valid for UB claims only cohort cohort
C1729 C code valid for UB claims only cohort cohort cohort cohort cohort
C1730 C code valid for UB claims only cohort cohort cohort cohort cohort
C1731 C code valid for UB claims only cohort cohort cohort
C1732 C code valid for UB claims only cohort cohort cohort
C1733 C code valid for UB claims only cohort cohort cohort cohort
C1750 C code valid for UB claims only cohort cohort cohort cohort cohort
C1751 C CODE VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C1752 C code valid for UB claims only cohort cohort cohort
C1753 C code valid for UB claims only cohort cohort cohort cohort cohort
C1755 C code valid for UB claims only cohort cohort cohort cohort cohort
C1756 C code valid for UB claims only statewide
C1757 C code valid for UB claims only cohort cohort cohort cohort cohort
C1758 C code valid for UB claims only cohort cohort cohort cohort cohort
C1759 C code valid for UB claims only cohort cohort cohort
C1760 C code valid for UB claims only cohort cohort cohort cohort cohort
C1762 C code valid for UB claims only cohort cohort cohort cohort cohort
C1763 C code valid for UB claims only cohort cohort cohort cohort
C1764 C code valid for UB claims only cohort cohort cohort cohort
C1765 C code valid for UB claims only cohort cohort cohort cohort cohort
200
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
C1766 C code valid for UB claims only cohort cohort cohort cohort
C1767 C CODE VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C1768 C code valid for UB claims only cohort cohort cohort cohort cohort
C1769 C code valid for UB claims only cohort cohort cohort cohort cohort
C1770 C code valid for UB claims only statewide
C1771 C code valid for UB claims only cohort cohort cohort cohort cohort
C1772 C code valid for UB claims only cohort cohort cohort cohort
C1773 C code valid for UB claims only cohort cohort cohort cohort cohort
C1776 C code valid for UB claims only cohort cohort cohort cohort cohort cohort
C1777 C code valid for UB claims only cohort cohort cohort
C1778 C CODE VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C1779 C code valid for UB claims only cohort cohort
C1780 LENS, INTRAOCULAR (NEW TECHNOLOGY) [C CODES FOR FACILITY CLAIMS ONLY] cohort cohort cohort cohort cohort
C1781 C code valid for UB claims only cohort cohort cohort cohort cohort cohort
C1782 C code valid for UB claims only cohort cohort cohort cohort cohort
C1783 C code valid for UB claims only cohort cohort cohort cohort
C1784 C code valid for UB claims only cohort cohort cohort cohort
C1785 C code valid for UB claims only cohort cohort cohort cohort
C1786 C code valid for UB claims only cohort cohort
C1787 C code valid for UB claims only cohort cohort cohort cohort cohort
C1788 C code valid for UB claims only cohort cohort cohort cohort cohort cohort
C1789 C code valid for UB claims only cohort cohort cohort cohort cohort
C1813 C code valid for UB claims only cohort cohort cohort cohort
C1814 C CODES VALID FOR UB ONLY cohort cohort cohort cohort
C1815 C code valid for UB claims only cohort cohort cohort cohort
C1816 C code valid for UB claims only cohort cohort
C1817 C code valid for UB claims only cohort cohort
C1818 C code valid for UB claims only statewide
C1819 C code valid for UB claims only cohort cohort
C1820 C code valid for UB claims only cohort cohort cohort cohort cohort
C1821 C code valid for UB claims only cohort cohort cohort
C1830 Powered bone marrow biopsy needle cohort cohort cohort cohort
C1874 C code valid for UB claims only cohort cohort cohort cohort cohort
C1875 C code valid for UB claims only cohort cohort
C1876 C CODE VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C1877 C code valid for UB claims only cohort cohort cohort cohort
C1878 C code valid for UB claims only statewide
C1879 C code valid for UB claims only cohort cohort cohort cohort
C1880 C code valid for UB claims only cohort cohort cohort cohort
C1881 C code valid for UB claims only cohort cohort
C1882 C code valid for UB claims only cohort cohort cohort
C1883 C code valid for UB claims only cohort cohort cohort cohort cohort
C1884 C code valid for UB claims only cohort cohort cohort cohort
C1885 C code valid for UB claims only cohort cohort
C1886 CATHETER, EXTRAVASCULAR TISSUE ABLATION, ANY MODALITY (INSERTABLE) [C codes used by facilities only] cohort cohort cohort
C1887 C CODES VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C1888 C code valid for UB claims only cohort cohort cohort
C1892 C code valid for UB claims only cohort cohort cohort cohort
C1893 C code valid for UB claims only cohort cohort cohort cohort cohort
201
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
C1894 C code valid for UB claims only cohort cohort cohort cohort cohort
C1895 C code valid for UB claims only cohort cohort cohort cohort
C1897 C code valid for UB claims only cohort cohort cohort cohort
C1898 C code valid for UB claims only cohort cohort cohort cohort
C1899 C code valid for UB claims only statewide
C1900 C code valid for UB claims only cohort cohort cohort cohort
C2615 C code valid for UB claims only cohort cohort cohort cohort cohort
C2616 C code valid for UB claims only cohort cohort
C2617 C code valid for UB claims only cohort cohort cohort cohort cohort
C2618 C CODE VALID FOR UB CLAIMS ONLY cohort cohort cohort cohort cohort
C2621 C code valid for UB claims only cohort cohort
C2625 C code valid for UB claims only cohort cohort cohort cohort
C2626 C code valid for UB claims only cohort statewide
C2627 C code valid for UB claims only cohort cohort cohort cohort
C2628 C code valid for UB claims only cohort cohort cohort cohort
C2629 C code valid for UB claims only statewide
C2630 C code valid for UB claims only cohort cohort cohort
C2631 C code valid for UB claims only cohort cohort cohort cohort
C2634 C CODE VALID FOR UB CLAIMS ONLY statewide
C2638 C code valid for UB claims only cohort cohort
C2639 C code valid for UB claims only cohort cohort cohort cohort
C2641 C code valid for UB claims only cohort cohort
C8900 C code valid for UB claims only cohort cohort
C8901 C code valid for UB claims only cohort cohort
C8902 C code valid for UB claims only cohort cohort cohort
C8905 C code valid for UB claims only cohort cohort
C8906 C code valid for UB claims only statewide
C8907 C code valid for UB claims only statewide
C8908 C code valid for UB claims only cohort cohort cohort cohort
C8909 C code valid for UB claims only statewide
C8910 C code valid for UB claims only statewide
C8911 C code valid for UB claims only cohort cohort cohort
C8912 C code valid for UB claims only cohort cohort
C8913 C code valid for UB claims only statewide
C8914 C code valid for UB claims only cohort cohort cohort
C8918 C code valid for UB claims only cohort cohort cohort cohort
C8919 C code valid for UB claims only statewide
C8920 C code valid for UB claims only cohort cohort cohort
C8922 C code valid for UB claims only statewide
C8923 C code valid for UB claims only cohort cohort cohort cohort cohort
C8924 C code valid for UB claims only cohort cohort cohort cohort
C8925 C code valid for UB claims only cohort cohort cohort
C8928 C code valid for UB claims only cohort cohort cohort cohort cohort
C8929 C Code valid for UB claims only cohort cohort cohort cohort cohort
C8930 C Code valid for UB claims only cohort cohort cohort cohort
C8936 Magnetic resonance angiography without contrast followed by with contrast, upper extremity statewide
C8957 C code valid for UB claims only statewide
C9113 C CODE VALID FOR UB CLAIMS ONLY cohort cohort
C9257 C code valid for UB claims only statewide
C9285 Lidocaine 70 mg/tetracaine 70 mg, per patch [C codes should be used statewide
202
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
by facilities only]
C9290 Injection, bupivacaine liposome, 1 mg [C codes valid with facility claims only] cohort cohort
C9292 INJECTION, PERTUZUMAB, 10 MG C CODES CAN ONLY BE USED ON UB FACILITY CLAIMS statewide
C9352 C code valid for UB claims only statewide
C9359 C codes valid for UB claims only cohort cohort cohort cohort cohort
C9362 C Code valid for UB claims only cohort cohort
C9399 C code valid for UB claims only statewide
C9600
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery orbranch [C code for facility claims only] cohort cohort cohort cohort cohort
C9601
Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to cohort cohort cohort cohort
C9602
Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronaryangioplasty when performed; single major coronary artery or branch [C code for facility claims only cohort cohort
C9604
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and a cohort cohort cohort cohort
C9606
Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intr statewide
C9607
Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, a cohort cohort cohort
C9724
Endoscopic full-thickness plication in the gastriccardia using endoscopic plication system (eps); i ncludes endoscopy [C codes used for facility claims only] statewide
C9726 C code valid for UB claims only statewide
C9728 C code valid for UB claims only cohort cohort
C9736 Laparoscopy, surgical, radiofrequency ablation of uterine fibroid(s), including intraoperative guidance and monitoring, when performed statewide
C9898 C codes valid for UB claims only cohort cohort
D0150 COMPREHENSIVE ORAL EVALUATION statewide
D0210 Intraoral - complete series of radiographic images cohort cohort
D0220 Intraoral - periapical first radiographic image cohort cohort
D0230 Intraoral - periapical each additional radiographic image cohort cohort
D0240 Intraoral - 0cclusal radiographic image statewide
D0272 Bitewings - two radiographic images statewide
D0274 Bitewings - four radiographic images statewide
D0470 DIAGNOSTIC CASTS statewide
D1110 PROPHYLAXIS-ADULT statewide
D1120 PROPHYLAXIS-CHILD cohort cohort cohort cohort
D1206 Topical application of fluoride varnish cohort cohort cohort cohort
D1208 Topical application of fluoride cohort cohort cohort
D1351 SEALANT-PER TOOTH cohort cohort cohort
D1510 SPACE MAINTAINER-FIXED UNILATERAL statewide
D2140 AMALGAM RESTORATIONS - ONE SURFACE, PERMANENT statewide
D2330 RESIN RESTORATIONS - ONE SURFACE, ANTERIOR cohort cohort
D2331 RESIN RESTORATIONS - TWO SURFACES, ANTERIOR cohort cohort
D2332 RESIN RESTORATIONS - THREE SURFACES, ANTERIOR statewide
D2335 RESIN RESTORATIONS - FOUR OR MORE SURFACES OR INVOLVINGINCISAL ANGLE (ANTERIOR) cohort cohort
D2390 RESIN-BASED COMPOSITE CROWN, ANTERIOR cohort cohort
D2391 RESIN-BASED COMPOSITE - ONE SURFACE, cohort cohort cohort
203
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
D2392 RESIN-BASED COMPOSITE - TWO SURFACES, cohort cohort
D2393 RESIN-BASED COMPOSITE - THREE SURFACES, cohort cohort
D2394 RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, statewide
D2650 INLAY RESTORATIONS, COMPOSITE/RESIN-ONE SURFACE (LABORATORY PROCESSED) statewide
D2662 ONLAY - COMPOSITE/RESIN - TWO SURFACES (LABORATORYPROCESSED statewide
D2710 CROWN RESTORATIONS-RESIN (LABORATORY) statewide
D2740 CROWN RESTORATIONS-PORCELAIN/CERAMIC SUBSTRATE statewide
D2930 PREFABRICATED STAINLESS STEEL CROWN-PRIMARY TOOTH cohort cohort cohort
D2932 PREFABRICATED RESIN CROWN statewide
D2934 PREFABRICATED ESTHETIC COATED STAINLESS STEEL statewide
D2940 PROTECTIVE RESTORATION cohort cohort
D2980 Crown repair necessitated by restorative material failure statewide
D2999 UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT statewide
D3120 PULP CAP-INDIRECT statewide
D3220 THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) cohort cohort
D3221 GROSS PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT statewide
D3230 PULPAL THERAPY (RESORBABLE FILLING)-ANTERIOR, PRIMARY TOOTH (EXCLUDING FINAL RESTORATION) cohort cohort
D3310 ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION) statewide
D3320 ENDODONTIC THERAPY, BICUSPID TOOTH (EXCLUDING FINAL RESTORATION) statewide
D3330 ENDODONTIC THERAPY, MOLAR (EXCLUDING FINAL RESTORATION) cohort cohort
D4341 PERIODONTAL SCALING AND ROOT PLANING-PER QUADRANT statewide
D7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL) cohort cohort cohort
D7241 REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY, WITH UNUSUALSURGICAL COMPLICATIONS statewide
D7250 SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE) statewide
D7310 ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEETH OR TOOTH statewide
E0105 CANE, QUAD OR THREE PRONG, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIPS statewide
E0110
CRUTCHES, FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS,ADJUSTABLE OR FIXED, PAIR, COMPLETE WITH TIPS AND HANDGRIPS cohort cohort
E0112 CRUTCHES, UNDERARM, WOOD, ADJUSTABLE OR FIXED, PAIR, WITHPADS, TIPS AND HANDGRIPS cohort cohort cohort cohort
E0114 CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED,PAIR, WITH PADS, TIPS AND HANDGRIPS cohort cohort cohort cohort cohort
E0116
CRUTCH, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, WITH PAD, TIP, HANDGRIP, WITH OR WITHOUT SHOCK ABSORBER, EACH statewide
E0117 CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACH statewide
E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT cohort cohort
E0160 SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE cohort cohort
E0218 WATER CIRCULATING COLD PAD WITH PUMP cohort cohort cohort cohort
E0603 BREAST PUMP ELECTRIC (AC AND/OR DC), ANY TYPE cohort cohort
E0607 HOME BLOOD GLUCOSE MONITOR cohort cohort
E0621 SLING OR SEAT, PATIENT LIFT, CANVAS OR NYLON statewide
E0781
AMBULATORY INFUSION PUMP, SINGLE OR MULTIPLE CHANNELS, WITH ADMINISTRATIVE EQUIPMENT, WORN BY PATIENT statewide
204
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
E0782 INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE statewide
E0870 TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION,(E.G. BUCK'S) statewide
E0910 TRAPEZE BARS, A/K/A PATIENT HELPER, ATTACHED TO BED, WITHGRAB BAR statewide
E1700 JAW MOTION REHABILITATION SYSTEM statewide
G0008 ADMINISTRATION OF INFLUENZA VIRUS VACCINE cohort cohort cohort cohort cohort
G0009 ADMINISTRATION OF PNEUMOCOCCAL VACCINE cohort cohort cohort cohort cohort
G0010 ADMINISTRATION OF HEPATITIS B VACCINE cohort cohort
G0027 SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER statewide
G0101 CERVICAL OR VAGINAL CANCER SCREENING; PELVIC AND CLINICAL BREAST EXAMINATION cohort cohort
G0102 PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAM cohort cohort
G0103 PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA) statewide
G0104 COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY cohort cohort
G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL ATHIGH RISK cohort cohort cohort cohort cohort
G0108 DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES,INDIVIDUAL, PER SESSION cohort cohort cohort
G0109 DIABETES SELF-MANAGEMENT TRAINING SERVICES, GROUP SESSION,PER INDIVIDUAL statewide
G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOTMEETING CRITERIA FOR HIGH RISK cohort cohort cohort cohort cohort
G0127 TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER cohort cohort
G0130
SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITYSTUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL) statewide
G0145
SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENING AND statewide
G0168 WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY cohort cohort cohort cohort cohort
G0173 STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION statewide
G0176
ACTIVITY THERAPY, SUCH AS MUSIC, DANCE,ART, OR PLAY THERAPY NOT FOR RECREATION RELATED TO CARE AND TREATMENT OF PATIENTS DISABLING MENTAL HEALTH PROBLEMS, PER SESSION (45 MINUTES OR MORE) statewide
G0202 SCREENING MAMOGRAPHY PRODUCING DIRECT DIGITAL IMAGE, BILATERAL ALL VIEWS. cohort cohort cohort cohort cohort cohort
G0204 DIAGNOSTIC MAMMOGRAPHY, DIRECT DIGITAL IMAGE, BILATERAL ALL VIEWS. cohort cohort cohort cohort cohort cohort
G0206 DIAGNOSTIC MAMMOGRAPHY, DIRECT DIGITAL IMAGE, UNILATERAL ALL VIEWS. cohort cohort cohort cohort cohort cohort
G0237
THERAPEUTIC PROCEDURES TO INCREASE STRENGTH OR ENDURANCE OF RESPIRATORY MUSCLES, FACE TO FACE ONE ON ONE EACH 15 MINUTES (INCLUDES MONITORING) cohort cohort cohort cohort cohort
G0238
THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN DESCRIBED BY G0237 ONE ON ONEFACE TO FACE PER 15 MINUTES (INCLUDES MONITORING) cohort cohort cohort cohort cohort
G0239
THERAPEUTIC PROCEDURES TO IMPROVE RESPIRATORY FUNCTION, OTHER THAN SERVICES DESCRIBED BY G0237 TWO OR MORE (INCLUDING MONITORING) cohort cohort cohort cohort cohort
G0251
LINEAR ACCELERATOR BASED STERIOTACTIC RADIOSURGERYDELIVERY INCLUDING COLLIMATOR CAHNGE AND CUSTOM PLUGGING FRACTIONED TREATMENT, ALL LESIONS, PER SESSION, MAX 5 SESSIONS PER COURSE statewide
G0257 UNSCHEDULED OR EMERGENCY DIALYSIS TREATMENT FOR AN ESRD PATIENT IN A HOSPITAL cohort cohort cohort cohort
205
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
G0259 INJECTION PROCEDURE FOR SACROILIAC JOINT; ARTHROGRAPY statewide
G0260 INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID cohort cohort cohort cohort cohort
G0269 PLACEMENT OF OCCLUSIVE DEVICE INTO EITHER A VENOUS OR ARTIERIAL ACCESS SITE cohort cohort cohort cohort cohort
G0275
RENAL ARTERY ANGIOGRAPHY (UNILATERAL OR BILATERAL)PERFORMED AT THE TIME OF CARDIAC CATHETERIZATION, INCLUDES CATHETER PLACEMENT, INJECTION OF DYE, cohort cohort cohort
G0278 ILIAC ARTERY ANGIOGRAPHY PERFORMED AT THE SAME TIME OF CARDIAC CATHETERIZATION cohort cohort
G0288 RECONSTRUCTION, COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF AORTA FOR SURGICAL PLANNING statewide
G0289 ARTHROSCOPY, KNEE, SURGICAL, FOR REMOVAL OF LOOSE BODY, FOREIGN BODY cohort cohort cohort cohort
G0339
IMAGE GUIDED ROBOTIC LINEAR ACCELERATOR BASE STEREOTACTIC RADIOSURGERY COMPLETE COURSE OF THERAPY INONE SESSION OR FIRST SESSION OF FRACTIONATED TREA TMENT cohort cohort
G0340
IMAGE GUIDED ROBOTIC LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING FRACTIONATED TREATMENT ALL LESIONS PER SESSION MAX 5 SESSIONS PER TREA cohort cohort
G0364 BONE MARROR ASPIRATE & BIOPSY cohort cohort cohort cohort
G0365 VESSEL MAPPING HEMO ACCESS cohort cohort cohort
G0378 HOSPITAL OBSERVATION SERVICE, PER HOUR cohort cohort cohort cohort cohort cohort
G0379 DIRECT ADMISSION OF PATIENT FOR HOSPITAL OBSERVATION CARE cohort cohort cohort cohort cohort
G0380
Level I hospital emergency department visit provided in a type B emergency department; (The ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is loc cohort cohort cohort
G0381
Level 2 hospital emergency department visit provided in a type B emergency department; (The ED must meet at least one of the following requirements: cohort cohort cohort
G0382
Level 3 hospital emergency department visit provided in a type B emergency department; (The ED must meet at least one of the following requirements: cohort cohort cohort
G0383
Level 4 hospital emergency department visit provided in a type B emergency department; (The ED must meet at least one of the following requirements: cohort cohort cohort
G0384
Level 5 hospital emergency department visit provided in a type B emergency department; (The ED must meet at least one of the following requirements: cohort cohort cohort
G0389
ULTRASOUND B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOR ABDOMINAL AORTIC ANEURYSM (AAA) SCREENING cohort cohort cohort cohort cohort
G0390 TRAUMA RESPONSE TEAM ASSOCIATED WITH HOSPITAL CRITICAL CARE SERVICE cohort cohort cohort cohort
G0399
HOME SLEEP STUDY TEST (HST) WITH TYPE III PROTABLEMONITOR, UNATTENDED; MINIMUM OF 4 CHANNELS: 2 RESPIRATORY MOVEMENT/AIR FLOW, 1 ECG/HEART RATE, AND 1 OXYGEN SATURATION statewide
G0402
INITIAL PREVENTIVE PHYSICAL EXAMINATION; FACE-TO-FACE VISIT, SERVICES LIMITED TO NEW BENEFICIARY DURING THE FIRST 12 MO OF MEDICARE ENROLLMENT statewide
G0410
GROUP PSYCHOTHERAPY OTHER THAN OF A MULTIPLE-FAMILY GROUP, IN A PARTIAL HOSPITALIZATION SETTING, APPROXIMATELY 45 TO 50 MINUTES cohort cohort
G0424 PULMONARY REHABILITATION, INCLUDING EXERCISE (INCLUDES MONITORING), ONE HOUR, PER SESSION, cohort cohort cohort cohort cohort
G0431 DRUG SCREEN, QUALITATIVE; MULTIPLE DRUG CLASSES BYHIGH COMPLEXITY TEST METHOD (E.G., IMMUNOASSAY, E statewide
206
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
NZYME ASSAY), PER PATIENT ENCOUNTER
G0435 Infectious agent antigen detection by rapid antibody test of oral mucosa transudate, HIV-1 or HIV-2,screening statewide
G0436
SMOKING AND TOBACCO CESSATION COUNSELING VISIT FORTHE ASYMPTOMATIC PATIENT; INTERMEDIATE, GREATER T HAN 3 MINUTES, UP TO 10 MINUTES statewide
G8553 PRESCRIPTION(S) GENERATED AND TRANSMITTED VIA A QUALIFIED ERX SYSTEM OR A CERTIFIED EHR SYSTEM statewide
G9019 OSELTAMIVIR PHOSPHATE, ORAL statewide
H0015 ALCOHOL AND/OR DRUG SERVICES; INTENSIVE OUTPATIENTTREATMENT PROGRAM statewide
H0035 MENTAL HEALTH PARTIAL HOSPITALIZATION, TREATMENT, LESS THAN 24 HOURS cohort cohort
H075 MAJOR CHEST PROCEDURES statewide
H181 G.I. OBSTRUCTION W/O CC statewide
H189 OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC statewide
H209 MAJ JOINT & LIMB REATTACH PROC OF LOW EXT, EXC HIPEXC FOR COMP cohort cohort
H359 UTERINE + ADNEXA PROC FOR CA IN SITU + NON-MALIGNA statewide
H373 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES statewide
H493 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E W CC statewide
H813 NONBACTERIAL GASTROENTERITIS & ABDOMINAL PAIN AGE >17 W/CC statewide
H876 CHEMO W ACUTE LEUKEMIA AS SDX OR WITH USE OF HIGH DOSE CHEMO AGENT statewide
J0110 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
J0129
INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT SUPERVISION OF A PHYSICIAN, NOT FOR USE WHEN DRUG IS SELF ADMINISTERED) statewide
J0130 INJECTION ABCIXIMAB, 10 MG statewide
J0131 INJECTION, ACETAMINOPHEN, 10 MG cohort cohort cohort cohort
J0132 INJECTION, ACETYLCYSTEINE, 100 MG statewide
J0133 INJECTION, ACYCLOVIR, 5 MG statewide
J0150
INJECTION, ADENOSINE, 6 MG (NOT TO BE USED TO REPORT ANYADENOSINE PHOSPHATE COMPOUNDS, INSTEAD USE A9270) cohort cohort cohort
J0152 INJECTION ADENOSINE 30MG (NOT TO BE USED TO REPORTANY ADENOSINE PHOSPHATE) cohort cohort cohort
J0171 INJECTION, ADRENALIN, EPINEPHRINE, 0.1 MG cohort cohort cohort cohort cohort
J0178 Injection, aflibercept, 1 mg statewide
J0180 AGALSIDASE BETA INJECTION, 1MG statewide
J0221 INJECTION, ALGLUCOSIDASE ALFA, (LUMIZYME), 10 MG statewide
J0278 INJECTION, AMIKACIN SULFATE, 100 MG cohort cohort
J0280 INJECTION, AMINOPHYLLIN, UP TO 250 MG cohort cohort cohort
J0282 INJECTION, AMIODARONE HYDROCHLORINE, 30 MG cohort cohort
J0289 INJECTION, AMPHOTERICIN B LIPOSOME, 10 MG statewide
J0290 INJECTION, AMPICILLIN SODIUM, cohort cohort cohort
J0295 INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER1.5 GM cohort cohort cohort cohort cohort
J0330 INJECTION, SUCCINYLCHOLINE CHLORIDE, UP TO 20 MG cohort cohort cohort cohort cohort
J0360 INJECTION, HYDRALAZINE HCL, UP TO 20 MG cohort cohort cohort cohort
J0456 AZITHROMYCIN- INJECTION, AZITHROMYCIN, 500 MG cohort cohort cohort
J0461 INJECTION, ATROPINE SULFATE, 0.01 MG cohort cohort cohort cohort
J0475 INJECTION, BACLOFEN, 10 MG statewide
J0490 INJECTION, BELIMUMAB, 10 MG [Benlysta] statewide
207
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J0500 INJECTION, DICYCLOMINE HCL, UP TO 20 MG cohort cohort cohort cohort
J0561 INJECTION, PENICILLIN G BENZATHINE, 100,000 UNITS cohort cohort cohort
J0583 INJECTION BIVALIRUDIN 1MG cohort cohort cohort cohort
J0585 INJECTION, ONABOTULINUMTOXINA, 1 UNIT statewide
J0595 INJECTION BUTORPHANOL TARTRATE 1 MG cohort cohort cohort
J0597 INJECTION, C-1 ESTERASE INHIBITOR (HUMAN), BERINERT, 10 UNITS statewide
J0610 INJECTION, CALCIUM GLUCONATE, PER 10 ML cohort cohort cohort
J0630 INJECTION, CALCITONIN SALMON, UP TO 400 UNITS statewide
J0640 INJECTION, LEUCOVORIN CALCIUM, PER 50 MG cohort cohort cohort cohort
J0650 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
J0670 INJECTION, MEPIVACAINE HYDROCHLORIDE, PER 10 ML cohort cohort cohort cohort
J0690 INJECTION, CEFAZOLIN SODIUM, cohort cohort cohort cohort cohort cohort
J0692 INJECTION, CEFEPIME HYDROCHLORIDE, 500MG. cohort cohort cohort
J0694 INJECTION, CEFOXITIN SODIUM, 1 GM cohort cohort cohort cohort cohort
J0696 INJECTION, CEFTRIAXONE SODIUM, PER 250 MG cohort cohort cohort cohort cohort
J0697 INJECTION, STERILE CEFUROXIME SODIUM, PER 750 MG cohort cohort cohort
J0698 CEFOTAXIME SODIUM, PER GM cohort cohort
J0702 Injection, Betamethasone Acetate 3 mg and Betamethasone Sodium Phosphate 3 mg cohort cohort cohort
J0706 NJECTION CAFFEINE CITRATE 5MG statewide
J0713 INJECTION, CEFTAZIDIME, PER 500 MG cohort cohort
J0725 INJECTION, CHORIONIC GONADOTROPIN, PER 1,000 USP UNITS statewide
J0735 INJECTION, CLONIDINE HYDROCHLORIDE, 1 MG statewide
J0740 INJECTION CIDOFOVIR, 375 MG statewide
J0743 INJECTION, CILASTATIN SODIUM; IMIPENEM, PER 250 MG statewide
J0744 INJECTION CIPROFLOXACIN FOR INTRAVENOUS INFUSION 200MG cohort cohort cohort cohort cohort
J0760 INJECTION, COLCHICINE, PER 1MG statewide
J0780 INJECTION, PROCHLORPERAZINE, UP TO 10 MG cohort cohort cohort cohort cohort
J0833 INJECTION, COSYNTROPIN, NOT OTHERWISE SPECIFIED, 0.25 MG statewide
J0834 INJECTION, COSYNTROPIN (CORTROSYN), 0.25 MG cohort cohort cohort
J0840 INJECTION, CROTALIDAE POLYVALENT IMMUNE FAB (OVINE), UP TO 1 GRAM statewide
J0850 INJECTION, CYTOMEGALOVIRUS IMMUNE GLOBULIN INTRAVENOUS(HUMAN), PER VIAL statewide
J0878 DAPTOMYCIN INJECTION 1MG statewide
J0881 INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRDUSE) cohort cohort cohort
J0882 INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (FOR ESRDON DIALYSIS) statewide
J0885 INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS cohort cohort
J0886 INJECTION, EPOETIN ALFA, 1000 UNITS (FOR ESRD ON DIALYSIS) statewide
J0894 INJECTION, DECITABINE, 1 MG statewide
J0895 INJECTION, DEFEROXAMINE MESYLATE, 500 MG PER 5 CC statewide
J0897 INJECTION, DENOSUMAB, 1 MG [Prolia] [XGEVA] cohort cohort
J1020 INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG statewide
J1030 INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG cohort cohort cohort cohort
J1040 INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG cohort cohort cohort
J1050 Injection, medroxyprogesterone acetate, 1 mg cohort cohort cohort cohort
J1070 INJECTION, TESTOSTERONE CYPIONATE, UP TO 100 MG statewide
J1080 INJECTION, TESTOSTERONE CYPIONATE, 1 CC, 200 MG statewide
J1100 INJECTION, DEXAMETHOSONE SODIUM PHOSPHATE, UP TO 4MG/ML cohort cohort cohort cohort cohort
208
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J1110 INJECTION, DIHYDROERGOTAMINE MESYLATE, PER 1 MG cohort cohort cohort
J1120 INJECTION, ACETAZOLAMIDE SODIUM, UP TO 500 MG cohort cohort cohort
J1160 INJECTION, DIGOXIN, UP TO 0.5 MG cohort cohort
J1165 INJECTION, PHENYTOIN SODIUM, PER 50 MG cohort cohort cohort
J1170 INJECTION, HYDROMORPHONE, UP TO 4 MG cohort cohort cohort cohort
J1200 INJECTION, DIPHENHYDRAMINE HCL, cohort cohort cohort cohort cohort
J1212 INJECTION, DMSO, DIMETHYL SULFOXIDE, 50%, 50 ML statewide
J1245 INJECTION, DIPYRIDAMOLE, PER 10 MG statewide
J1250 INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG cohort cohort cohort
J1260 INJECTION, DOLASETRON MESYLATE, 1 MG statewide
J1265 INJECTION, DOPAMINE HCL, 40 MG cohort cohort
J1300 Injection, Eculizumab, 10 mg statewide
J1327 EPTIFIBATIDE INJECTION, 500 MG cohort cohort cohort
J1335 INJECTION ERTAPENEM SODIUM 500MG cohort cohort cohort cohort cohort
J1364 INJECTION, ERYTHROMYCIN LACTOBIONATE, PER 500 MG statewide
J1410 INJECTION, ESTROGEN cohort cohort
J1440 INJECTION, FILGRASTIM (G-CSF), 300 MCG cohort cohort
J1441 INJECTION, FILGRASTIM (G-CSF), 480 MCG cohort cohort cohort
J1450 INJECTION FLUCONAZOLE, 200 MG cohort cohort cohort
J1453 INJECTION, FOSAPREPITANT, 1 MG cohort cohort cohort
J1455 INJECTION, FOSCARNET SODIUM, PER 1000 MG statewide
J1459 INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQUID), 500 MG statewide
J1559 INJECTION, IMMUNE GLOBULIN (HIZENTRA), 100 MG statewide
J1561 Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e. g. Liquid), 500 mg cohort cohort
J1566 Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg statewide
J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e. g. Liquid), 500 mg statewide
J1570 INJECTION, GANCICLOVIR SODIUM, 500 MG statewide
J1580 INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG cohort cohort cohort
J1610 INJECTION, GLUCAGON HYDROCHLORIDE, PER 1 MG cohort cohort cohort
J1630 INJECTION, HALOPERIDOL, UP TO 5 MG cohort cohort cohort
J1642 INJECTION, HEPARIN SODIUM, (HEPARIN LOCK FLUSH), PER 10UNITS cohort cohort cohort cohort
J1644 INJECTION, HEPARIN SODIUM, PER 1000 UNITS cohort cohort cohort cohort cohort
J1645 INJECTION, DALTEPARIN SODIUM, PER 2500 IU statewide
J1650 INJECTION, ENOXAPARIN SODIUM, 10 MG cohort cohort cohort cohort
J1652 INJECTION FONDAPARINUX SODIUM 0.5 MG. cohort cohort
J1670 INJECTION, TETANUS IMMUNE GLOBULIN, HUMAN, UP TO 250 UNITS cohort cohort
J1720 INJECTION, HYDROCORTISONE cohort cohort cohort
J1725 INJECTION, HYDROXYPROGESTERONE CAPROATE, 1 MG [Makena] statewide
J1740 INJECTION, IBANDRONATE SODIUM, 1 MG statewide
J1742 INJECTION, IBUTILIDE FUMARATE, 1 MG cohort cohort
J1745 INJECTION INFLIXIMAB, 10MG cohort cohort cohort
J1750 INJECTION, IRON DEXTRAN, 50MG cohort cohort
J1756 INJECTION IRON SUCROSE 1 MG. cohort cohort cohort
J1790 INJECTION, DROPERIDOL, UP TO 5 MG cohort cohort cohort cohort
J1800 INJECTION, PROPRANOLOL HCL, UP TO 1 MG cohort cohort cohort
J1815 INJECTION INSULIN PER 5 UNITS cohort cohort cohort cohort cohort
209
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J1817 INSULIN FOR ADMINISTRATION THROUGH DME (I.E., INSULIN PUMP) PER 50 UNITS statewide
J1885 INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG cohort cohort cohort cohort cohort
J1940 INJECTION, FUROSEMIDE, UP TO 20 MG cohort cohort cohort cohort
J1950 INJECTION, LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), PER3.75 MG cohort cohort
J1953 INJECTION, LEVETIRACETAM, 10 MG cohort cohort cohort
J1956 INJECTION, LEVOFLOXACIN, 250 MG cohort cohort cohort cohort cohort cohort
J1980 INJECTION, HYOSCYAMINE SULFATE, UP TO 0.25 MG statewide
J2001 INJECTION LIDOCAINE HCL FOR INTRAVENOUS INFUSION 10 MG cohort cohort cohort cohort cohort
J2060 INJECTION, LORAZEPAM, 2 MG cohort cohort cohort cohort cohort cohort
J2150 INJECTION, MANNITOL, 25% IN 50 ML cohort cohort cohort
J2175 INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG cohort cohort cohort cohort cohort cohort
J2185 INJECTION MEROPENEM 100MG cohort cohort cohort
J2210 INJECTION, METHYLERGONOVINE MALEATE, UP TO 0.2 MG cohort cohort cohort
J2248 INJECTION, MICAFUNGIN SODIUM, 1 MG statewide
J2250 INJECTION, MIDAZOLAM HYDROCHLORIDE, PER 1 MG cohort cohort cohort cohort cohort cohort
J2270 INJECTION, MORPHINE SULFATE, UP TO 10 MG cohort cohort cohort cohort cohort cohort
J2271 INJECTION, MORPHINE SULFATE, 100MG statewide
J2275 INJECTION, MORPHINE SULFATE (PRESERVATIVE-FREE STERILESOLUTION), PER 10 MG cohort cohort cohort
J2280 INJECTION MOXIFLOXACIN 100MG cohort cohort cohort
J2300 INJECTION, NALBUPHINE HYDROCHLORIDE, PER 10 MG cohort cohort cohort
J2310 INJECTION, NALOXONE HYDROCHLORIDE, PER 1 MG cohort cohort cohort
J2323 Injection, Natalizumab, 1 mg statewide
J2353 INJECTION OCTREOTIDE DEPOT FORM FOR INTRAMUSCULAR INJECTION 1 MG cohort cohort cohort
J2354 INJECTION OCTREOTIDE NON-DEPOT FORM FOR SUBCUTAN- EOUS OR INTRAVENOUS cohort cohort cohort cohort
J2357 OMALIZUMAB INJECTION, 5MG cohort cohort
J2360 INJECTION, ORPHENADRINE CITRATE, UP TO 60 MG statewide
J2370 INJECTION, PHENYLEPHRINE HCL, UP TO 1 ML cohort cohort cohort cohort
J2400 INJECTION, CHLOROPROCAINE HYDROCHLORIDE, PER 30 ML cohort cohort
J2405 INJECTION, ONDANSETRON HYDROCHLORIDE, PER 1 MG cohort cohort cohort cohort cohort
J2425 INJECTION, PALIFERMIN, 50 MICROGRAMS statewide
J2430 INJECTION, PAMIDRONATE DISODIUM, PER 30 MG statewide
J2440 INJECTION, PAPAVERINE HCL, UP TO 60 MG cohort cohort
J2469 PALONOSETRON HCL INJECTION, 25MCG cohort cohort cohort
J2501 INJECTION PARICALCITOL 1 MCG. statewide
J2505 INJECTION PEGFILGRASTIM 6 MG cohort cohort cohort
J2507 INJECTION, PEGLOTICASE, 1 MG [Krystexxa] statewide
J2515 INJECTION, PENTOBARBITAL SODIUM, PER 50 MG statewide
J2540 INJECTION, PENICILLIN G POTASSIUM, UP TO 600,000 UNITS cohort cohort cohort
J2543 INJECTION, PIPERACILLIN SODIUM/TAZOBACTAM SODIUM, 1 GRAM0.125 GRAMS (1.125 GRAMS) cohort cohort cohort cohort cohort
J2545
Pentamidine Isethionate, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 300 mg statewide
J2550 INJECTION, PROMETHAZINE HCL, UP TO 50 MG cohort cohort cohort cohort cohort
J2560 INJECTION, PHENOBARBITAL SODIUM, UP TO 120 MG statewide
J2562 INJECTION, PLERIXAFOR, 1 MG statewide
J2590 INJECTION, OXYTOCIN, UP TO 10 UNITS cohort cohort cohort cohort
J2597 INJECTION, DESMOPRESSIN ACETATE, PER 1 MCG cohort cohort cohort
J2690 INJECTION, PROCAINAMIDE HCL, UP TO 1 GM statewide
210
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J2710 INJECTION, NEOSTIGMINE METHYLSULFATE, UP TO 0.5 MG cohort cohort cohort cohort cohort
J2720 INJECTION, PROTAMINE SULFATE, PER 10 MG cohort cohort
J2730 INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM cohort cohort
J2765 INJECTION, METOCLOPRAMIDE HCL, UP TO 10 MG cohort cohort cohort cohort cohort cohort
J2778 Injection, Ranibizumab, 0.1 mg statewide
J2780 INJECTION, RANITIDINE HYDROCHLORIDE, 25 MG cohort cohort cohort cohort
J2785 INJECTION, REGADENOSON, 0.1 MG cohort cohort cohort cohort cohort
J2788 INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, MINIDOSE,50 MICROGRAMS (250 I.U.) cohort cohort
J2790 INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.) cohort cohort cohort cohort
J2791 Injection, RHO (D) immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 IU statewide
J2792 INJECTION, RHO D IMMUNE GLOBULIN, INTRAVENOUS, HUMAN,SOLVENT DETERGENT, 100 IU statewide
J2795 INJECTION, ROPIVACAINE HYDROCHLORIDE, 1 MG cohort cohort cohort cohort
J2800 INJECTION, METHOCARBAMOL, UP TO 10 ML cohort cohort
J2805 INJECTION, SINCALIDE, 5 MICROGRAMS cohort cohort cohort
J2916 INJECTION SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION 12.5 MG cohort cohort cohort
J2920 INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UPTO 40 MG cohort cohort cohort cohort cohort cohort
J2930 INJECTION, METHYLPREDNISOLONE SODIUM SUCCINATE, UPTO 125 MG cohort cohort cohort cohort cohort
J2997 INJECTION, ALTEPLASE RECOMBINANT, 1 MG cohort cohort cohort
J3010 INJECTION, FENTANYL CITRATE, UP TO 2 ML cohort cohort cohort cohort cohort cohort
J3030
INJECTION, SUMATRIPTAN SUCCINATE, 6 MG, ADMINISTERED UNDERDIRECT PHYSICIAN SUPERVISION, EXCLUDES SELF ADMINISTRATION cohort cohort cohort
J3101 INJECTION, TENECTEPLASE, 1 MG statewide
J3105 INJECTION, TERBUTALINE SULFATE, UP TO 1 MG. cohort cohort
J3190 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
J3230 INJECTION, CHLORPROMAZINE HCL, UP TO 50 MG statewide
J3240 INJECTION, THYROTROPIN, UP TO 10 I.U. cohort cohort cohort cohort
J3243 INJECTION, TIGECYCLINE, 1 MG statewide
J3260 INJECTION, TOBRAMYCIN SULFATE, UP TO 80 MG cohort cohort
J3262 INJECTION, TOCILIZUMAB, 1 MG statewide
J3300 INJECTION, TRIAMCINOLONE ACETONIDE, PRESERVATIVE FREE, 1MG statewide
J3301 INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISESPECIFIED, 10 MG cohort cohort cohort cohort cohort
J3303 INJECTION TRIAMCINOLONE HEXACETONIDE, PER 5MG statewide
J3315 INJECTION TRIPTORELIN PAMOATE 3.75 MG. statewide
J3360 INJECTION, DIAZEPAM, UP TO 5 MG cohort cohort cohort cohort cohort cohort
J3370 INJECTION, VANCOMYCIN HCL, UP TO 500 MG cohort cohort cohort cohort cohort
J3396 VERTEPORFIN INJECTION,0.1 MG statewide
J3410 INJECTION, HYDROXYZINE HCL, UP TO 25 MG cohort cohort cohort
J3411 INJECTION THIAMINE HCL 100MG cohort cohort cohort
J3415 INJECTION PYRIDOXINE HCL 100MG statewide
J3420 INJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000MCG cohort cohort cohort
J3430 INJECTION, PHYTONADIONE (VITAMIN K), PER 1 MG cohort cohort cohort
J3465 INJECTION VORICONAZOLE 10 MG statewide
J3470 INJECTION, HYALURONIDASE, UP TO 150 UNITS cohort cohort
J3471 INJECTION, HYALURONIDASE, OVINE, PRESERVATIVE FREE, PER 1 USP UNIT (UP TO 999 USP UNITS) cohort cohort
211
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J3473 INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT statewide
J3475 INJECTION, MAGNESIUM SULFATE, PER 500 MG cohort cohort cohort cohort cohort
J3480 INJECTION, POTASSIUM CHLORIDE, PER 2 MEQ cohort cohort cohort cohort cohort cohort
J3486 INJECTION ZIPRASIDONE MESYLATE 10MG cohort cohort
J3487 Injection, Zoledronic acid (Zometa), 1 mg cohort cohort cohort
J3488 Injection, Zoledronic Acid (Reclast), 1 mg cohort cohort cohort cohort
J3490 UNCLASSIFIED DRUGS cohort cohort cohort cohort cohort cohort
J3535 DRUG ADMINISTERED THROUGH A METERED DOSE INHALER statewide
J3590 UNCLASSIFIED BIOLOGICS cohort cohort
J7020 ADDED DURING FEE SCHEDULE LOAD PROCESS statewide
J7030 INFUSION, NORMAL SALINE SOLUTION, 1000 CC cohort cohort cohort cohort cohort cohort
J7040 INFUSION, NORMAL SALINE SOLUTION, STERILE (500 ML=1 UNIT) cohort cohort cohort cohort cohort cohort
J7042 5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT) cohort cohort cohort cohort cohort cohort
J7050 INFUSION, NORMAL SALINE SOLUTION, 250 CC cohort cohort cohort cohort cohort cohort
J7060 5% DEXTROSE/WATER (500 ML = 1 UNIT) cohort cohort cohort cohort cohort
J7070 INFUSION, D5W, 1000 CC cohort cohort cohort cohort
J7100 INFUSION, DEXTRAN 40, 500 ML statewide
J7120 RINGERS LACTATE INFUSION, UP TO 1000 CC cohort cohort cohort cohort cohort cohort
J7187 Injection, Von Willebrand factor complex (Humate-P), per IU VWF:RCO statewide
J7192 FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER I.U., NOT OTHERWISE SPECIFIED statewide
J7194 FACTOR IX, COMPLEX, PER I.U. statewide
J7195 FACTOR IX (ANTIHEMOPHILIAC FACTOR, RECOMBINANT) PER IU statewide
J7300 INTRAUTERINE COPPER CONTRACEPTIVE statewide
J7302 LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVSYSTEM 52 MG cohort cohort
J7307 Etonogestrel (contraceptive) Implant System, including implant and supplies cohort cohort cohort
J7311 FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT statewide
J7315 Mitomycin, opthalmic, 0. 2 mg statewide
J7324 Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose statewide
J7330 Autologous cultured chondrocytes, implant statewide
J7500 AZATHIOPRINE - ORAL, TAB, 50 MG, 100S EA cohort cohort cohort
J7502 CYCLOSPORINE, ORAL, 100 MG. statewide
J7506 PREDNISONE, ORAL, PER 5 MG cohort cohort cohort cohort cohort
J7507 TACROLIMUS, ORAL, PER 1 MG statewide
J7509 METHYLPREDNISOLONE ORAL, PER 4 MG cohort cohort cohort
J7510 PREDNISOLONE ORAL, PER 5 MG cohort cohort cohort cohort cohort
J7517 MYCOPHENOLATE MOFETIL, ORAL, 250 MG cohort cohort
J7518 MYCOPHENOLIC ACID, ORAL, 180 MG statewide
J7520 SIROLIMUS, ORAL, 1 MG statewide
J7525 TACROLIMUS, PARENTERAL, 5 MG statewide
J7605
Arformoterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, 15 micrograms statewide
J7607
LEVALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 0.5 MG statewide
J7608 Acetylcysteine, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per gram cohort cohort
J7609 ALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MG statewide
J7611 Albuterol, inhalation solution, FDA-approved finalproduct, non-compounded, administered through DME , concentrated form, 1 mg cohort cohort cohort cohort
212
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J7612 Levalbuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, 1 mg cohort cohort cohort cohort
J7613 Albuterol, inhalation solution, FDA-approved finalproduct, non-compounded, administered through DME , unit dose, 1 mg cohort cohort cohort cohort cohort
J7614 Levalbuterol, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose, 0.5 mg cohort cohort cohort cohort
J7620 ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG, FDA-APPROVED cohort cohort cohort cohort
J7622 BECLOMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH statewide
J7626 BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, cohort cohort cohort cohort cohort
J7627 BUDESONIDE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, statewide
J7638 DEXAMETHASONE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH statewide
J7642 GLYCOPYRROLATE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH statewide
J7644 IPRATROPIUM BROMIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, cohort cohort cohort cohort cohort
J7645
IPRATROPIUM BROMIDE, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER MILLIGRAM statewide
J7674 METHACHOLINE CHLORIDE ADM AS INHALATION SOLUTION THROUGH A NEBULIZER, PER 1MG cohort cohort
J7676 Pentamidine Isethionate, inhalation solution, compounded product, administered through DME, unit dose form, per 300 mg statewide
J7799 NOC DRUGS, OTHER THAN INHALATION DRUGS, ADMINISTERED THROUGHDME cohort cohort
J8498 ANTIEMETIC DRUG, RECTAL/SUPPOSITORY, NOT OTHERWISESPECIFIED cohort cohort
J8499 PRESCRIPTION DRUG, ORAL, NON CHEMOTHERAPEUTIC, NOS cohort cohort cohort
J8501 APREPITANT, ORAL, 5MG cohort cohort cohort
J8530 CYCLOPHOSPHAMIDE; ORAL, 25 MG statewide
J8540 DEXAMETHASONE, ORAL, 0.25 MG cohort cohort cohort
J8597 ANTIEMETIC DRUG, ORAL, NOT OTHERWISE SPECIFIED statewide
J8700 TEMOZOLMIDE, ORAL, 5 MG statewide
J8999 PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS statewide
J9000 INJECTION, DOXORUBICIN HYDROCHLORIDE, 10 MG cohort cohort cohort
J9002 Injection, Doxorubicin Hydrochloride, Liposomal, Doxil, 10 mg cohort cohort
J9010 INJECTION, ALEMTUZUMAB, 10 MG statewide
J9017 INJECTION, ARSENIC TRIOXIDE, 1 MG statewide
J9025 INJECTION, AZACITIDINE, 1 MG statewide
J9033 INJECTION, BENDAMUSTINE HCL, 1 MG cohort cohort
J9035 BEVACIZUMAB INJECTION, 10MG cohort cohort cohort
J9040 INJECTION, BLEOMYCIN SULFATE, 15 UNITS cohort cohort
J9041 BORTEZOMIB INJECTION, 0.1 MG cohort cohort cohort
J9045 INJECTION, CARBOPLATIN, 50 MG cohort cohort cohort
J9055 CETUXIMAB INJECTION, 10MG cohort cohort
J9060 INJECTION, CISPLATIN, POWDER OR S0LUTION, 10 MG cohort cohort cohort
J9070 CYCLOPHOSPHAMIDE, 100 MG cohort cohort cohort
J9098 INJECTION, CYTARABINE LIPOSOME, 10 MG statewide
J9100 INJECTION, CYTARABINE, 100 MG statewide
J9120 INJECTION, DACTINOMYCIN, 0.5 MG statewide
J9130 DACARBAZINE, 100 MG cohort cohort
J9155 INJECTION, DEGARELIX, 1 MG statewide
213
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
J9171 INJECTION, DOCETAXEL, 1 MG cohort cohort cohort
J9175 INJECTION, ELLIOTTS' B SOLUTION, 1 ML statewide
J9178 INJECTION EPIRUBICIN HCL 2MG cohort cohort
J9179 INJECTION, ERIBULIN MESYLATE, 0.1 MG statewide
J9181 INJECTION, ETOPOSIDE, 10 MG cohort cohort cohort
J9185 INJECTION, FLUDARABINE PHOSPHATE, 50 MG cohort cohort
J9190 INJECTION, FLUOROURACIL, 500 MG cohort cohort cohort
J9201 INJECTION, GEMCITABINE HYDROCHLORIDE, 200 MG cohort cohort cohort
J9202 GOSERELIN ACETATE IMPLANT, PER 3.6 MG cohort cohort
J9206 INJECTION, IRINOTECAN, 20 MG cohort cohort cohort
J9207 INJECTION, IXABEPILONE, 1 MG statewide
J9208 INJECTION, IFOSFAMIDE, 1 GRAM cohort cohort
J9209 INJECTION, MESNA, 200 MG cohort cohort
J9217 LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG cohort cohort
J9218 LEUPROLIDE ACETATE, PER 1 MG statewide
J9226 Histrelin implant (Supprelin LA), 50 mg cohort cohort
J9228 INJECTION, IPILIMUMAB, 1 MG [Yervoy] statewide
J9245 INJECTION, MELPHALAN HYDROCHLORIDE, 50 MG statewide
J9250 METHOTREXATE SODIUM, 5 MG cohort cohort
J9260 METHOTREXATE SODIUM, 50 MG statewide
J9261 INJECTION, NELARABINE, 50 MG statewide
J9263 INJECTION OXALIPLATIN 0.5 MG cohort cohort cohort
J9264 INJECTION, PACLITAXEL PROTEIN-BOUND PARTICLES, 1 MG cohort cohort
J9265 INJECTION, PACLITAXEL, 30 MG cohort cohort cohort
J9266 INJECTION, PEGASPARGASE, PER SINGLE DOSE VIAL statewide
J9270 INJECTION, PLICAMYCIN, 2.5 MG cohort cohort
J9280 Injection, mitomycin, 5 mg cohort cohort cohort
J9303 Injection, Panitumumab, 10 mg statewide
J9305 PEMETREXED INJECTION, 10MG cohort cohort
J9307 INJECTION, PRALATREXATE, 1 MG statewide
J9310 INJECTION, RITUXIMAB, 100 MG cohort cohort cohort
J9315 INJECTION, ROMIDEPSIN, 1 MG statewide
J9328 INJECTION, TEMOZOLOMIDE, 1 MG statewide
J9330 INJECTION, TEMSIROLIMUS, 1 MG statewide
J9351 INJECTION, TOPOTECAN, 0.1 MG statewide
J9355 INJECTION, TRASTUZUMAB, 10 MG cohort cohort cohort
J9360 INJECTION, VINBLASTINE SULFATE, 1 MG cohort cohort
J9370 VINCRISTINE SULFATE, 1 MG statewide
J9390 INJECTION, VINORELBINE TARTRATE, 10 MG cohort cohort
J9395 INJECTION, FULVESTRANT, 25 MG cohort cohort
J9999 NOT OTHERWISE CLASSIFIED, ANTINEOPLASTIC DRUGS statewide
L0120 CERVICAL, FLEXIBLE, NON-ADJUSTABLE (FOAM COLLAR) cohort cohort cohort cohort cohort
L0130 CERVICAL, FLEXIBLE, THERMOPLASTIC COLLAR, MOLDED TO PATIENT statewide
L0140 CERVICAL, SEMI-RIGID, ADJUSTABLE (PLASTIC COLLAR) cohort cohort cohort
L0150 CERVICAL, SEMI-RIGID, ADJUSTABLE MOLDED CHIN CUP (PLASTICCOLLAR WITH MANDIBULAR/OCCIPITAL PIECE) cohort cohort
L0172 CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE cohort cohort cohort cohort cohort
L0174 CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC EXTENSION cohort cohort
L0180 CERVICAL, MULTIPLE POST COLLAR, statewide
214
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
OCCIPITAL/MANDIBULARSUPPORTS, ADJUSTABLE
L0458
TLSO TRIPLANAR CONTROL MODULAR SEGMENTED SPINAL SYSTEM TWO RIGID PLASTIC SHELLS POSTERIOR EXTENDS FROM THE SACROCOCCYGEAL JUNCTION AND TERMINATES JUST INFERIOR TO THE SCAPULAR SPINE statewide
L0484 TLSO TRIPLANAR CONTROL TWO PIECE RIGID PLASTIC SHELL WITHOUT INTERFACE LINER statewide
L0486 TLSO TRIPLANAR CONTROL TWO PIECE RIGID PLASTIC SHELL WITH INTERFACE LINER statewide
L0625
LUMBAR ORTHOSIS, FLEXIBLE, PROVIDES LUMBAR SUPPORT, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSU cohort cohort cohort
L0627
LUMBAR ORTHOSIS, SAGITTAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR PANELS, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISC cohort cohort cohort
L0628
LUMBAR-SACRAL ORTHOSIS, FLEXIBLE, PROVIDES LUMBO-SACRAL SUPPORT, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DI cohort cohort
L0631 LUMBAR-SACRAL ORTHOSIS, SAGITTAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR cohort cohort
L0636
LUMBAR SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, LUMBAR FLEXION, RIGID POSTERIOR FRAME/PANELS, LATERAL ARTICULATING DESIGN TO FLEX THE LUMBAR SPINE, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO statewide
L0999 ADDITION TO SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED statewide
L1020 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, KYPHOSIS PAD statewide
L1030 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, LUMBAR BOLSTER PAD statewide
L1040 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, LUMBAR ORLUMBARRIB PAD statewide
L1050 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, STERNAL PAD statewide
L1060 ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, THORACIC PAD statewide
L1200 THORACIC-LUMBAR-SACRAL-ORTHOSIS (TLSO), INCLUSIVE OFFURNISHING INITIAL ORTHOSIS ONLY statewide
L1499 SPINAL ORTHOSIS, NOT OTHERWISE SPECIFIED cohort cohort cohort
L1620 HO, ABDUCTION CONTROL OF HIP JOINTS, FLEXIBLE, PAVLIKHARNESS statewide
L1652 HIP ORTHOSIS BILATERAL THIGH CUFFS WITH ADJUSTABLEABDUCTOR SPREADER BAR statewide
L1810 KO, ELASTIC WITH JOINTS cohort cohort
L1820 KO, ELASTIC WITH CONDYLAR PADS AND JOINTS statewide
L1830 KO, IMMOBILIZER, CANVAS LONGITUDINAL cohort cohort cohort cohort cohort
L1832
KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort cohort
L1845
KNEE ORTHOSIS, DOUBLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND EXTENSION JOINT (UNICENTRIC OR POLYCENTRIC), MEDIAL-LATERAL AND ROTATION CONTROL, WITH OR WITHOUT VARUS/VALGUS ADJUSTMENT, PR statewide
L1902 AFO, ANKLE GAUNTLET cohort cohort
L1930 AFO, PLASTIC cohort cohort cohort
L1940 AFO, MOLDED TO PATIENT MODEL, PLASTIC statewide
L1970 AFO, PLASTIC MOLDED TO PATIENT MODEL, WITH ANKLE JOINT statewide
L1990 AFO, DOUBLE UPRIGHT FREE PLANTAR DORSIFLEXION, SOLIDSTIRRUP, CALF BAND/CUFF (DOUBLE BAR "BK" ORTHOSIS) statewide
L2112 AFO, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SOFT statewide
L2114 AFO, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, SEMI- cohort cohort
215
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
RIGID
L2275 ADDITION TO LOWER EXTREMITY, VARUS/VALGUS CORRECTION,PLASTIC MODIFICATION, PADDED/LINED statewide
L2999 LOWER EXTREMITY ORTHOSES, NOT OTHERWISE SPECIFIED cohort cohort
L3000 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, "UCB"TYPE, BERKELEY SHELL, EACH statewide
L3010 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL,LONGITUDINAL ARCH SUPPORT, EACH statewide
L3020 FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL,LONGITUDINAL/METATARSAL SUPPORT, EACH cohort cohort
L3031 FOOT, INSERT/PLATE, REMOVABLE, ADDITION TO LOWER EXTREMITY ORTHOSIS, HIGH statewide
L3160 FOOT, ADJUSTABLE SHOE-STYLED POSITIONING DEVICE statewide
L3204 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, INFANT statewide
L3224 ORTHOPEDIC FOOTWEAR, WOMAN'S SHOE, OXFORD, USED ASANINTEGRAL PART OF A BRACE (ORTHOSIS) statewide
L3260 AMBULATORY SURGICAL BOOT, EACH cohort cohort
L3265 PLASTAZOTE SANDAL, EACH cohort cohort
L3300 LIFT, ELEVATION, HEEL, TAPERED TO METATARSALS, PERINCH statewide
L3334 LIFT, ELEVATION, HEEL, PER INCH statewide
L3610 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, CALIPERPLATE, NEW statewide
L3630 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, SOLIDSTIRRUP, NEW statewide
L3650 SHOULDER ORTHOSIS, (SO), FIGURE OF "8" DESIGN ABDUCTION RE- STRAINER cohort cohort cohort cohort cohort
L3660 SO, FIGURE OF "8" DESIGN ABDUCTION RESTRAINER, CANVAS ANDWEBBING cohort cohort cohort
L3670 SO, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE) cohort cohort cohort cohort
L3702
ELBOW ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT statewide
L3720 EO, DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, FREE MOTION cohort cohort
L3730 EO, DOUBLE UPRIGHT WITH FOREARM/ARM CUFFS, EXTENSION/FLEXION ASSIST statewide
L3763
ELBOW WRIST HAND ORTHOSIS, RIGID, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT statewide
L3764
ELBOW WRIST HAND ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINTS, ELASTIC BANDS, TURNBUCKLES, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT statewide
L3765
ELBOW WRIST HAND FINGER ORTHOSIS, RIGID, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT statewide
L3806
Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps,custom fabricated, includes fitting and adjustmen statewide
L3807 WHFO, EXTENSION ASSIST, WITH INFLATABLE PALMER AIRSUPPORT, WITH OR WITHOUT THUMB EXTENSION cohort cohort
L3808
WRIST HAND FINGER ORTHOSIS, RIGID WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE MATERIAL; STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort cohort cohort cohort
L3900
WHFO, DYNAMIC FLEXOR HINGE, RECIPROCAL WRIST EXTENSION/FLEXION, FINGER FLEXION/EXTENSION, WRIST OR FINGER DRIVEN statewide
L3905
WRIST HAND ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINTS, ELASTIC BANDS, TURNBUCKLES, MAY INCLUDESOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUD ES FITTING AND ADJUSTMENT statewide
216
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
L3906
WRIST HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDESFITTING AND ADJUSTMENT cohort cohort cohort
L3908 WHO, WRIST EXTENSION CONTROL COCK-UP, NON MOLDED cohort cohort cohort cohort cohort cohort
L3913
HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort cohort
L3919
HAND ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort
L3921
HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINTS, ELASTIC BANDS, TURNBUCKLES, MAY INCLUDE SOFT INTERFACE, STRAPS, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT statewide
L3923
HAND FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort
L3925
Finger orthosis, proximal interphalangeal (PIP)/distal interphalangeal (DIP), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, includes fitting and adju cohort cohort cohort cohort
L3929
Hand finger orthosis, includes one or more nontorsion joints(s), turnbuckles, elastic bands/springs,may include soft interface material, straps, pref abricated, includes fitting and adjustment statewide
L3933
FINGER ORTHOSIS, WITHOUT JOINTS, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING ANDADJUSTMENT cohort cohort cohort cohort cohort
L3935
FINGER ORTHOSIS, NONTORSION JOINT, MAY INCLUDE SOFT INTERFACE, CUSTOM FABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort
L3962 SEWHO, ABDUCTION POSITIONING, ERBS PALSEY DESIGN statewide
L3982 UPPER EXTREMITY FRACTURE ORTHOSIS, RADIUS/ULNAR statewide
L3984 UPPER EXTREMITY FRACTURE ORTHOSIS, WRIST statewide
L3999 UPPER LIMB ORTHOSIS, NOT OTHERWISE SPECIFIED cohort cohort
L4205 REPAIR OF ORTHOTIC DEVICE, LABOR COMPONENT, PER 15MINUTES statewide
L4210 REPAIR OF ORTHOTIC DEVICE, REPAIR OR REPLACE MINORPARTS statewide
L4350 PNEUMATIC ANKLE CONTROL SPLINT (E.G., AIRCAST) cohort cohort cohort cohort
L4360
WALKING BOOT, PNEUMATIC AND/OR VACUUM, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort
L4386 NON-PNEUMATIC WALKING SPLINT WITH OR WITHOUT JOINTS PREFABRICATED INCLUDES FITTING AND ADJUSTMENTS cohort cohort cohort cohort cohort
L4396
STATIC OR DYNAMIC ANKLE FOOT ORTHOSIS, INCLUDING SOFT INTERFACE MATERIAL, ADJUSTABLE FOR FIT, FOR POSITIONING, MAY BE USED FOR MINIMAL AMBULATION, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT cohort cohort cohort
L8000 Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type statewide
L8015 EXTERNAL BREAST PROSTHESIS GARMENT, WITH MASTECTOMY FORM,POST MASTECTOMY statewide
L8020 BREAST PROSTHESIS, MASTECTOMY FORM statewide
L8030 BREAST PROSTHESIS, SILICONE OR EQUAL, WITHOUT INTEGRAL ADHESIVE statewide
L8460 PROSTHETIC SHRINKER, ABOVE KNEE, EACH statewide
L8509 TRACHEO-ESOPHAGEAL VOICE PROSTHESIS INSERTED BY A LICENSED HEALTH CARE PROVIDER ANY TYPE statewide
L8600 IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL cohort cohort cohort cohort
L8603 COLLAGEN IMPLANT, URINARY TRACT, PER 2.5 CC SYRINGE,INCLUDES SHIPPING AND NECESSARY SUPPLIES cohort cohort cohort cohort
L8604 INJECTABLE BULKING AGENT, DEXTRANOMER/HYALURONIC ACID COPOLYMER IMPLANT, URINARY TRACT, 1 ML, INCLUDES cohort cohort cohort cohort
217
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
SHIPPING AND NECESSARY SUPPLIES
L8606 INJECTABLE BULKING AGENT, SYNTHETIC IMPLANT, URINARY TRACT, 1 ML SYRINGE cohort cohort cohort
L8610 OCULAR IMPLANT cohort cohort cohort
L8612 AQUEOUS SHUNT cohort cohort
L8613 OSSICULA IMPLANT cohort cohort cohort
L8614 COCHLEAR DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS statewide
L8627 COCHLEAR IMPLANT, EXTERNAL SPEECH PROCESSOR, COMPONENT, REPLACEMENT statewide
L8670 VASCULAR GRAFT MATERIAL, SYNTHETIC, IMPLANT statewide
L8680 IMPLANTABLE NEUROSTIMULATOR ELECTRODE (WITH ANY NUMBER OF CONTACT POINTS), EACH cohort cohort cohort
L8681
PATIENT PROGRAMMER (EXTERNAL) FOR USE WITH IMPLANTABLE PROGRAMMABLE NEUROSTIMULATOR PULSE GENERATOR,REPLACEMENT ONLY cohort cohort
L8686 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, SINGLE ARRAY, NON-RECHARGEABLE, INCLUDES EXTENSION statewide
L8687 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, DUAL ARRAY, RECHARGEABLE, INCLUDES EXTENSION cohort cohort
L8689
EXTERNAL RECHARGING SYSTEM FOR BATTERY (INTERNAL) FOR USE WITH IMPLANTABLE NEUROSTIMULATOR REPLACEMENT ONLY statewide
L8690 AUDITORY OSSEOINTEGRATED DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS cohort cohort cohort
L8693 AUDITORY OSSEOINTEGRATED DEVICE ABUTMENT, ANY LENGTH, REPLACEMENT ONLY cohort cohort
L8699 PROSTHETIC IMPLANT, NOT OTHERWISE SPECIFIED cohort cohort cohort
P9041 INFUSION, ALBUMIN (HUMAN), 5%, 50 ML statewide
P9045 INFUSION ALBUMIN (HUMAN), 5%, 250 ML. statewide
P9047 INFUSION ALBUMIN (HUMAN) 25%, 50ML. cohort cohort
P9612 CATHETERIZATION FOR COLLECTION OF SPECIMEN, SINGLEPATIENT, ALL PLACES OF SERVICE cohort cohort cohort cohort cohort
Q0081 INFUSION THERAPY, USING OTHER THAN CHEMOTHERAPEUTIC DRUGS,PER VISIT statewide
Q0091
SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARINGANDCONVEYANCE OF CERVICAL OR VAGINAL SMEAR TO LAB ORATORY cohort cohort cohort cohort
Q0092 SET-UP PORTABLE X-RAY EQUIPMENT statewide
Q0111 WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL, OR SKIN SPECIMENS cohort cohort
Q0112 ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS cohort cohort
Q0114 FERN TEST cohort cohort cohort cohort
Q0138 INJECTION, FERUMOXYTOL, FOR TREATMENT OF IRON DEFICIENCY ANEMIA, 1 MG (FOR NON-ESRD ON DIALYSIS) statewide
Q0144 AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM cohort cohort cohort cohort
Q0162
ONDANSETRON 1 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE R cohort cohort cohort cohort cohort
Q0163
DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVEDPRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETICAT TIME OF CHEMOTHERAPY cohort cohort cohort cohort
Q0164
PROCHLORPERAZINE MALEATE, 5PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY cohort cohort
Q0165 PROCHLORPERAZINE MALEATE, 10PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC cohort cohort cohort
218
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
Q0167
DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTIONANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, statewide
Q0168
DRONABINOL, 5 MG, ORAL, FDA APPROVED PRESCRIPTIONANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, statewide
Q0169
PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVEDPRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY cohort cohort
Q0170 PROMETHAZINE HYDROCHLORIDE, 25PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC cohort cohort cohort cohort
Q0171 CHLORPROMAZINE HYDROCHLORIDE, 10PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC statewide
Q0172
CHLORPROMAZINE HYDROCHLORIDE, 25 MG, ORAL, FDA APPROVEDPRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC cohort cohort cohort
Q0177
HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, cohort cohort
Q0178
HYDROXYZINE PAMOATE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, statewide
Q0496
BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY statewide
Q0498 HOLSTER FOR USE statewide
Q0499
BELT/VEST/BAG FOR USE TO CARRY EXTERNAL PERIPHERALCOMPONENTS OF ANY TYPE VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY statewide
Q0501
SHOWER COVER FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY statewide
Q0508 Miscellaneous supply or accessory for use with an implanted ventricular assist device (VAD) statewide
Q2009 INJECTION, FOSPHENYTOIN, 50 MG PHENYTOIN EQUIVALENT statewide
Q2026 Injection, Radiesse, 0.1 ml statewide
Q2035
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FORINTRAMUSCULAR USE (AFLURIA) cohort cohort cohort
Q2036
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FORINTRAMUSCULAR USE (Flulaval) statewide
Q2037
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND OLDER, FORINTRAMUSCULAR USE (FLUVIRIN) statewide
Q2038
INFLUENZA VIRUS VACCINE, SPLIT VIRUS, WHEN ADMINISTERED TO INDIVIDUALS 3 YEARS OF AGE AND ODER, FOR INTRAMUSCULAR USE (FLUZONE) statewide
Q2043
Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including leukapheresis and all other preparatory procedures, per infusion statewide
Q2050 Injection, doxorubicin Hydrochloride, Liposomal, not otherwise specified, 10 mg statewide
Q2051 Injection, Zoledronic Acid, not otherwise specified, 1 mg cohort cohort
Q3001 RADIOELEMENTS FOR BRACHYTHERAPY, ANY TYPE, EACH statewide
Q3014 TELEHEALTH ORIGINATING SITE FACILITY FEE cohort cohort
Q4021 CAST SUPPLIES SHORT ARM SPLINT ADULT (11 YEARS+) PLASTER statewide
219
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
Q4041 CAST SUPPLIES LONG LEG SPLINT ADULT (11 YEARS+) PLASTER statewide
Q4042 CAST SUPPLIES LONG LEG SPLINT ADULT (11 YEARS+) FIBERGLASS statewide
Q4045 CAST SUPPLIES SHORT LEG SPLINT ADULT (11 YEARS+) PLASTER cohort cohort
Q4046 CAST SUPPLIES SHORT LEG SPLINT ADULT (11 YEARS+) FIBERGLASS statewide
Q4049 FINGER SPLINT STATIC statewide
Q4081 INJECTION, EPOETIN ALFA, 100 UNITS (FOR ESRD ON DIALYSIS) cohort cohort cohort
Q4100 SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED statewide
Q4101 APLIGRAF, PER SQUARE CENTIMETER cohort cohort cohort cohort
Q4102 OASIS WOUND MATRIX, PER SQUARE CENTIMETER statewide
Q4112 CYMETRA, INJECTABLE, 1CC statewide
Q4116 ALLODERM, PER SQUARE CENTIMETER cohort cohort cohort cohort cohort
Q4119 Matristem wound matrix, psmx, rs, or psm, per square centimeter cohort cohort
Q9954 ORAL MAGNETIC RESONANCE CONTRAST AGENT, PER ML cohort cohort
Q9957 INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML cohort cohort cohort
Q9958 HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML IODINE CONCENTRATION PER ML cohort cohort
Q9959 HIGH OSMOLAR CONTRAST MATERIAL, 150-199 MG/ML IODINE CONCENTRATION PER ML statewide
Q9961 HIGH OSMOLAR CONTRAST MATERIAL, 250-299 MG/ML IODINE CONCENTRATION PER ML statewide
Q9962 HIGH OSMOLAR CONTRAST MATERIAL, 300-349 MG/ML IODINE CONCENTRATION PER ML statewide
Q9963 HIGH OSMOLAR CONTRAST MATERIAL, 350-399 MG/ML IODINE CONCENTRATION PER ML cohort cohort
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml cohort cohort cohort
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml cohort cohort
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml cohort cohort cohort cohort
Q9968 INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT (E.G., METHYLENE BLUE, ISOSULFAN BLUE), 1 MG cohort cohort cohort
S0020 INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 ML cohort cohort cohort cohort
S0028 INJECTION FAMOTIDINE 20 MG. cohort cohort cohort cohort
S0030 INJECTION METRONIDAZOLE, 500MG statewide
S0073 INJECTION, AZTREONAM, 500 MG statewide
S0077 INJECTON CLINDAMYCIN PHOSPHATE 300MG. cohort cohort cohort
S0106 BUPROPION HCI SUSTAINED RELEASE TABLET 150 MG PER BOTTLE OF 60 TABLETS cohort cohort
S0109 METHADONE, ORAL, 5MG cohort cohort
S0119 ONDANSETRON, ORAL, 4 MG (FOR CIRCUMSTANCES FALLINGUNDER THE MEDICARE STATUTE, USE HCPCS Q CODE) cohort cohort
S0138 FINASTERIDE, 5 MG. statewide
S0164 INJECTION, PANTOPRAZOLE SODIUM, 40 MG cohort cohort cohort
S0179 MEGESTROL ACETATE ORAL 20 MG. statewide
S0183
PROCHLORPERAZINE MALEATE ORAL 5MG. (FOR CIRCUM- STANCES FALLING UNDER THE MEDICARE STATUTE USE Q0164-Q0165 statewide
S0187 TAMOXIFEN CITRATE ORAL 10MG. cohort cohort
S0191 MISOPROSTOL, ORAL 200 MCG. statewide
S0390
ROUTINE FOOT CARE; REMOVAL AND/OR TRIMMING OF CORNS, CALLUSES AND/OR NAILS AND PREVENTATIVE MAINTENANCE PER VISIT statewide
S1015 IV TUBING EXTENSION SET statewide
220
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
S1040 CRANIAL REMOLDING ORTHOSIS, PEDIATRIC, RIGID, WITHSOFT INTERFACE MATERIAL, statewide
S1090 Mometasone Furoae sinus implant, 370 micrograms cohort cohort
S2070
CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; WITH ENDOSCOPIC LASER TREATMENT OF URETERAL CALCULI ( INCLUDES URETEREAL CATHERIZATION) cohort cohort cohort cohort
S2083 ADJUSTMENT OF GASTRIC BAND DIAMETER VIA SUBCUT- ANEOUS PORT BY INJECTION OR ASPIRATION OF SALINE cohort cohort cohort cohort
S2117 ARTHROEREISIS, SUBTALAR statewide
S2140 CORD BLOOD HARVESTING FOR TRANSPLANTATION ALLOGENIC statewide
S2325 HIP CORE DECOMPRESSION statewide
S2900
SURGICAL TECHNIQUES REQUIRING USE OF ROBOTICS SURGICAL SYSTEM (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) cohort cohort cohort cohort
S4991 NICOTINE PATCHES, NON-LEGEND cohort cohort
S5010 5% DEXTROSE AND 0.45% NORMAL SALINE 1000ML. statewide
S5011 5% DEXTROSE IN LACTATED RINGER'S 1000 ML. cohort cohort cohort
S8096 PORTABLE PEAK FLOW METER cohort cohort
S8101 HOLDING CHAMBER OR SPACER FOR USE WITH AN INHALER OR NEBULIZER; WITH MASK statewide
S9443 LACTATION CLASSES, NON-PHYSICIAN PROVIDER PER SESSION cohort cohort
S9470 NUTRITIONAL COUNSELING, DIETITIAN VISIT statewide
S9480 INTENSIVE OUTPATIENT PSYCHIATRIC SERVICES, PER DIEM cohort cohort
T001 INPATIENT MEDICAL statewide
T5001 POSITIONING SEAT FOR PERSONS WITH SPECIAL ORTHOPEDIC NEEDS statewide
T5999 SUPPLY, NOT OTHERWISE SPECIFIED statewide
V2627 SCLERAL COVER SHELL statewide
V2630 ANTERIOR CHAMBER INTRAOCULAR LENS cohort cohort
V2632 POSTERIOR CHAMBER INTRAOCULAR LENS cohort cohort cohort cohort cohort
V2785 PROCESSING, PRESERVING AND TRANSPORTING CORNEAL TISSUE cohort cohort cohort cohort cohort
V2787 Astigmatism correcting function of intraocular lens cohort cohort cohort cohort cohort
V2788 PRESBYOPIA CORRECTING FUNCTION OF INTRAOCULAR LENS cohort cohort cohort cohort cohort cohort
V2790 AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION PER PROCEDURE cohort cohort cohort cohort cohort
V2797 VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER HCPCS VISION CODE statewide
V5011 FITTING/ORIENTATION/CHECKING OF HEARING AID statewide
V5014 REPAIR/MODIFICATION OF A HEARING AID statewide
V5020 CONFORMITY EVALUATION statewide
V5050 HEARING AID, MONAURAL, IN THE EAR statewide
V5090 DISPENSING FEE, UNSPECIFIED HEARING AID cohort cohort
V5110 DISPENSING FEE, BILATERAL cohort cohort
V5130 BINAURAL, IN THE EAR statewide
V5160 DISPENSING FEE, BINAURAL statewide
V5241 DISPENSING FEE MONAURAL HEARING AID ANY TYPE cohort cohort
V5256 HEARING AID DIGITAL MONAURAL ITE statewide
V5257 HEARING AID DIGITAL MONAURAL BTE cohort cohort
V5261 HEARING AID DIGITAL BINAURAL BTE cohort cohort
V5264 EAR MOLD/INSERT NOT DISPOSABLE ANY TYPE cohort cohort
V5266 BATTERY FOR USE IN HEARING DEVICE cohort cohort
V5267 Hearing aid supplies / accessories cohort cohort
V5274 ASSISTANT LEARNING DEVICE NOT OTHERWISE SPECIFIED cohort cohort
V5275 EAR IMPRESSION EACH statewide
221
CPT Description
Peer Cohort 1
Peer Cohort 2
Peer Cohort 3
Peer Cohort 4
Peer Cohort 5
Peer Cohort 6
V5290 Assistive listening device, transmitter microphone, any type statewide
V5299 HEARING SERVICE, MISCELLANEOUS cohort cohort