PATIENT INFORMATION
Patient FAQs
Quick answers about visiting, insurance, and billing at The Heights Emergency Room. For anything not covered here, call (281) 560-4373.
YOUR VISIT
Visiting The Heights Emergency Room
Do I need to make an appointment?
No. Because we are an emergency room, we are strictly walk-in, and there is no appointment to make. You are welcome to call ahead with questions, but you do not need to schedule a visit.
Will I see a physician or a mid-level practitioner?
You will be seen by a board-certified, specially trained emergency room physician, on site 24 hours a day. The physician performs a medical screening, discusses your health history, and recommends your treatment options.
What is considered a medical emergency?
Visit an emergency room such as The Heights ER for a potentially serious medical condition, for example a heart attack, stroke, seizure, fracture, head injury, or anaphylactic shock. Emergency rooms also treat mild to serious symptoms that come up on a weekend or at night when your doctor is not available, such as strep throat, fever, bronchitis, pneumonia, animal bites, severe headaches, or broken bones. For symptoms that could be life-threatening, call 911.
Do you treat children?
Yes. We are equipped to treat patients of all ages, including infants and children, and we have a patient room dedicated to pediatric patients.
What if I need to stay in the hospital or need emergency surgery?
If you need to be transferred to a hospital for admission or surgery, our staff arranges ambulance transport to the hospital of your choice. We coordinate the arrangements with the receiving hospital so they are prepared for your admission.
FREESTANDING ERS
What Is a Freestanding Emergency Room?
What is a freestanding emergency room?
A freestanding emergency center is a facility licensed by the state to provide 24-hour emergency services to patients at the same level as a hospital-based emergency room. (From the TAFEC website)
What is the difference between The Heights Emergency Room, a freestanding emergency room, and an urgent care center?
Freestanding emergency centers are required to provide the same level of access and services as hospital-based emergency rooms, with the exception of trauma care. Unlike urgent-care centers, freestanding emergency centers are required to operate 24/7 – they must be open 24 hours, have ER physicians on-site at all times, provide round-the-clock lab and imaging services, and stock medications not required for urgent-care centers. As state-licensed facilities, freestanding emergency centers must also fulfill architectural and equipment requirements, as well as train their staffs at a level not required of urgent-care centers. (From the TAFEC website)
INSURANCE AND BILLING
Insurance, Self-Pay, and Billing
Do you accept Medicare or Medicaid?
No. We are unable to accept Medicare, Medicaid, CHIP, or TRICARE at this time.
What insurance plans do you accept?
The Heights Emergency Room bills out of network for all insurances. We also accept workers’ compensation insurance and auto insurance for motor vehicle accidents (MVA), and we offer a special finance option for self-pay. For questions about your plan’s coverage, call the facility and speak with a representative. See our Insurance Information page.
How much does a visit cost?
As an emergency room, we bill your emergency room benefits on your insurance plan. The amount you are responsible for when you arrive is the co-pay for an ER visit under your plan, which can usually be found on your insurance card. Our standard facility fees are listed by level of service.
I don’t have insurance. Can I still be seen?
Yes. When you visit without a traditional insurance plan, you receive a medical screening. If the screening shows a life-threatening emergency, we treat you promptly. If it shows a non-emergent condition, you can choose to self-pay or to be referred to another facility or physician. Self-pay is for patients without private insurance who wish to pay by cash, check, or credit card. An initial payment is due on arrival, and the remaining balance is billed to you later, usually within 2–3 weeks.
Who do I contact with questions about my bill?
Call us at (281) 560-4373 and we will help with any concerns. You can also contact our billing company, Simplex Med Billing, at (713) 457-4600, if you have questions or difficulty paying your bill. Our billing information page explains how claims work.
Required Texas Notices
Texas House Bill No. 2041 Notice
This facility is a freestanding emergency medical care facility. This facility charges rates comparable to a hospital emergency room and may charge a facility fee for medical treatment. Either the facility or a physician providing services at the facility may be out-of-network provider for the patient’s health benefit plan provider network. The physician providing medical care at this facility may bill separately from this facility for the medical care provided to a patient. This facility is out-of-network for all benefit plans at this time.
Texas Senate Bill 425
Senate Bill 425, passed by the Texas Legislature during the 84th Regular Session, requires all FECs to post notice of the following:
This is a Freestanding Emergency Medical Care Facility
This facility charges rates comparable to a hospital Emergency Room and may charge a facility fee
This facility or physician providing medical care at this facility may not be a participating provider in your
Health Benefit Plan provider network
A physician providing medical care at this facility may bill separately from the facility for the medical care provided to you
Facility Fees and Charges
These tables list our facility fees, the range of possible facility fees, physician fees, and our charge description master (CDM). A separate page lists our standard observation and facility fees.
Facility Fees/TARIFAS:
| Service Description | Charge Amount | |
| Average Billing for Regular ER (Facility Visit) | $3,200.00 | |
| Average Billing for Observation | $7,000.00 | |
| LEVEL OF SERVICE/NIVEL DE SERVICIO | FACILITY FEE/TARIFA | ||
| EMERGENCY DEPT VISIT- LEVEL 1 VISITA DE EMERGENCIA- NIVEL 1 | $394.90 | ||
| EMERGENCY DEPT VISIT- LEVEL 2 VISITA DE EMERGENCIA – NIVEL 2 | $954.49 | ||
| EMERGENCY DEPT VISIT- LEVEL 3 VISITA DE EMERGENCIA – NIVEL 3 | $1,763.85 | ||
| EMERGENCY DEPT VISIT- LEVEL 4 VISITA DE EMERGENCIA – NIVEL 4 | $3,232.38 | ||
| EMERGENCY DEPT VISIT – LEVEL 5 VISITA DE EMERGENCIA – NIVEL 5 | $4,070.86 | ||
LEVEL OF SERVICE/NIVEL DE SERVICO | RANGE OF POSSIBLE FACILITY FEES FOR SERVICE/RANGO DE POSIBLES CUOTAS POR EL SERVICIO | |||
EMERGENCY DEPT VISIT- LEVEL 1 VISITA DE EMERGENCIA- NIVEL 1 | LESS THAN $650 | |||
EMERGENCY DEPT VISIT- LEVEL 2 VISITA DE EMERGENCIA – NIVEL 2 | $650 | -$2,500 | ||
EMERGENCY DEPT VISIT- LEVEL 3 VISITA DE EMERGENCIA – NIVEL 3 | $2,500 | -$13,000 | ||
EMERGENCY DEPT VISIT- LEVEL 4 VISITA DE EMERGENCIA- NIVEL 4 | $4,500 | -$35,00 | ||
EMERGENCY DEPT VISIT- LEVEL 5 VISITA DE EMERGENCIA- NIVEL 5 | $5,000 | -$65,000 | ||
Physician Fees/Cargos del Medico:
LEVEL OF CARE/NIVEL DE CUIDADO MEDICO | PHYSICIAN FEE/ CARGOS DE MEDICO |
EMERGENCY DEPT VISIT- LEVEL 1 VISITA DE EMERGENCIA- NIVEL 1 | $220.00 |
EMERGENCY DEPT VISIT- LEVEL 2 VISITA DE EMERGENCIA- NIVEL 2 | $310.04 |
EMERGENCY DEPT VISIT- LEVEL 3 VISITA DE EMERGENCIA-NIVEL 3 | $590.40 |
EMERGENCY DEPT VISIT – LEVEL 4 VISITA DE EMERGENCIA- NIVEL 4 | $820.40 |
EMERGENCY DEPT VISIT- LEVEL 5 VISITA DE EMERGENCIA – NIVEL 5 | $1,020.60 |
INITIAL OBSERVATION CARE – LEVEL 1 CUIDADO DE OBSERVACION INICIAL- NIVEL 1 | $866.80 |
INITIAL OBSERVATION CARE – LEVEL 2 CUIDADO DE OBSERVACION INICIAL- NIVEL 2 | $898 70 |
INITIAL OBSERVATION CARE – LEVEL 3 CUIDADO DE OBSERVACION INICIAL – NIVEL 3 | $917.40 |
OBSERVATION CARE DISCHARGE ALTA DE OBSERVACION | $1,145.36 |
OBSERVATION ADMIT/DISCHARGE – LEVEL 1 ADMISION DE OBSERVACION/DISCARGA – NIVEL 1 | $1,169.17 |
OBSERVATION ADMIT/DISCHARGE – LEVEL 2 ADMISION DE OBSERVACION/DISCARGA – NIVEL 2 | $1,190.39 |
OBSERVATION ADMIT/DISCHARGE – LEVEL 3 ADMISION DE OBSERVACION/DISCARGA – NIVEL 3 | $1,198.28 |
View the full charge description master (CDM)
| Code | Service Description | Charge Amount |
| 0202U | Infectious disease, pathogen-specific nucleic acid, 22 targets including (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected | $ 2,988.00 |
| 0240U | Infectious disease (viral respiratory tract infection) | $ 1,516.19 |
| 0241U | Infectious disease (viral respiratory tract infection), pat… | $ 2,028.59 |
| 10021 | FINE NEED | $ 1,800.26 |
| 10060 | Incision and drainage of abscess, simple or single | $ 1,892.75 |
| 10061 | Incision and drainage of abscess, complicated or multiple | $ 3,117.22 |
| 10080 | INCISION & DRAINAGE PILONIDAL CYST SIMPLE | $ 3,043.20 |
| 10081 | INCISION & DRAINAGE PILONIDAL CYST COMPLICATED | $ 3,449.24 |
| 10120 | Incision and removal of foreign body, subcutaneous tissues; simple | $ 1,803.60 |
| 10121 | INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP | $ 3,237.60 |
| 10180 | incision and drainage, complex, postoperative wound infection | $ 2,160.00 |
| 11042 | debridement, subcutaneous tissue | $ 3,043.20 |
| 11056 | TRIM SKIN LESIONS 2 TO 4 | $ 45.00 |
| 11106 | Incisional biopsies | $ 1,892.75 |
| 11200 | Removal of Skin Tags Procedures | $ 532.49 |
| 11719 | Trimming of nondystrophic nails, any number | $ 2,268.55 |
| 11730 | Avulsion of nail plate, partial or complete, simple; single | $ 1,150.00 |
| 11740 | Evacuation of subungual hematoma | $ 1,380.00 |
| 11750 | Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal | $ 3,043.20 |
| 11900 | Injection, intralesional; up to and including 7 lesions | $ 376.80 |
| 11982 | Removal, non-biodegradable drug delivery implant. | $ 1,380.00 |
| 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 | $ 1,524.20 |
| 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 | $ 1,841.26 |
| 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 | $ 2,250.00 |
| 12005 | simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 12.6 to 20 cm in size. | $ 2,604.00 |
| 12011 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less | $ 1,838.32 |
| 12013 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm | $ 2,361.78 |
| 12014 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm | $ 2,452.15 |
| 12015 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm | $ 3,062.90 |
| 12016 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm | $ 4,243.88 |
| 12018 | RPR F/E/E/N/L/M >30.0 CM | $ 2,133.66 |
| 12020 | Treatment of superficial wound dehiscence; simple closure | $ 3,109.54 |
| 12031 | INTMD RPR S/A/T/EXT 2.5 CM/< | $ 1,689.63 |
| 12032 | intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size. | $ 2,160.00 |
| 12034 | $ 2,659.20 | |
| 12035 | $ 3,408.94 | |
| 12041 | $ 1,915.20 | |
| 12042 | REPAIR (LACERATION)INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM | $ 2,186.40 |
| 12045 | $ 2,720.40 | |
| 12051 | $ 1,665.00 | |
| 12052 | $ 1,684.80 | |
| 12054 | $ 2,985.60 | |
| 13120 | $ 1,422.00 | |
| 13121 | $ 3,371.27 | |
| 13132 | $ 4,136.40 | |
| 13151 | $ 1,428.00 | |
| 13152 | $ 2,996.80 | |
| 13153 | CMPLX RPR E/N/E/L ADDL 5CM/< | $ 898.50 |
| 15850 | $ 1,074.00 | |
| 15853 | $ 82.80 | |
| 16000 | $ 1,244.35 | |
| 16020 | $ 1,428.00 | |
| 16025 | $ 2,361.78 | |
| 16030 | Dressings and/or debridement of partial-thickness burns, initial or subsequent | $ 3,802.85 |
| 17250 | $ 1,119.60 | |
| 19000 | $ 3,120.00 | |
| 20520 | Removal of foreign body in muscle or tendon sheath; simple | $ 5,029.91 |
| 20552 | Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | $ 1,220.71 |
| 20600 | $ 1,220.71 | |
| 20605 | Arthrocentesis, aspiration (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance. | $ 1,100.00 |
| 20610 | Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance | $ 1,532.16 |
| 20611 | Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting | $ 1,120.00 |
| 20612 | Aspiration and/or injection of ganglion cyst(s) any location | $ 1,236.14 |
| 21320 | $ 5,182.67 | |
| 21480 | Closed treatment of temporomandibular dislocation; initial or subsequent | $ 3,375.77 |
| 23650 | Closed treatment of shoulder dislocation, with manipulation; without anesthesia | $ 2,988.00 |
| 23655 | Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia | $ 1,428.00 |
| 23700 | $ 1,068.90 | |
| 23931 | $ 2,771.03 | |
| 24640 | Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation | $ 1,643.81 |
| 25560 | $ 4,940.83 | |
| 25605 | $ 3,323.33 | |
| 26605 | $ 4,967.57 | |
| 26641 | Closed treatment of carpometacarpal dislocation, thumb, with manipulation | $ 1,164.00 |
| 26700 | $ 2,828.27 | |
| 26720 | TREAT FINGER FRACTURE EACH | $ 4,857.31 |
| 26735 | $ 7,035.95 | |
| 26750 | $ 942.36 | |
| 26770 | $ 2,988.00 | |
| 26775 | $ 3,371.27 | |
| 27372 | Removal of foreign body, deep, thigh region or knee area | $ 1,128.67 |
| 27750 | TREATMENT OF TIBIA FRACTURE | $ 4,365.19 |
| 28160 | $ 1,092.36 | |
| 28190 | REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS | $ 1,694.40 |
| 28193 | $ 5,268.14 | |
| 28490 | $ 1,157.24 | |
| 28510 | TREATMENT OF TOE FRACTURE | $ 2,400.84 |
| 28515 | Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each | $ 2,988.30 |
| 29105 | Application of long arm splint (shoulder to hand) | $ 1,688.57 |
| 29125 | Application of short arm splint (forearm to hand); static | $ 1,463.46 |
| 29126 | SHORT ARM SPLINT DYNAMIC | $ 1,301.12 |
| 29130 | Application of finger splint; static | $ 910.12 |
| 29131 | Application of finger splint; dynamic | $ 1,432.66 |
| 29505 | LONG LEG SPLINT THIGH ANKLE/TOES | $ 1,744.67 |
| 29515 | Application of short leg splint (calf to foot) | $ 1,463.39 |
| 29550 | $ 367.08 | |
| 30300 | Removal foreign body, intranasal; office type procedure | $ 3,953.88 |
| 30901 | Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method | $ 1,694.40 |
| 30903 | Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method | $ 1,252.30 |
| 36000 | $ 120.00 | |
| 36415 | Vein Puncturing | $ 83.00 |
| 36416 | $ 94.00 | |
| 36556 | $ 2,107.67 | |
| 36573 | Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation; age 5 years or older | $ 5,689.45 |
| 36585 | $ 3,218.03 | |
| 36589 | Removal of tunneled central venous catheter, without subcutaneous port or pump | $ 1,308.53 |
| 40804 | Removal of embedded foreign body, vestibule of mouth; simple | $ 3,624.82 |
| 42809 | Removal of foreign body from pharynx | $ 612.00 |
| 43752 | Naso- or oro-gastric tube placement, requiring physician’s skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) | $ 766.27 |
| 43753 | $ 1,055.56 | |
| 43830 | Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) | $ 1,668.00 |
| 46050 | $ 5,816.05 | |
| 51700 | Bladder irrigation, simple, lavage and/or instillation | $ 896.36 |
| 51701 | $ 456.00 | |
| 51702 | Insertion of temporary indwelling bladder catheter; simple (eg, Foley) | $ 1,453.50 |
| 54060 | Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision | $ 2,196.59 |
| 54220 | $ 5,244.00 | |
| 54520 | $ 2,027.46 | |
| 55899 | Unlisted procedure, male genital system | $ 3,000.00 |
| 56405 | Incision and drainage of vulva or perineal abscess | $ 811.20 |
| 56420 | $ 2,412.42 | |
| 62270 | $ 1,220.40 | |
| 64400 | N BLOCK INJ TRIGEMINAL | $ 2,202.74 |
| 64450 | Injection(s), anesthetic agent(s) and/or steroid; other per… | $ 634.93 |
| 64451 | Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography) | $ 1,530.87 |
| 65205 | Removal of foreign body, external eye; conjunctiva superficial | $ 952.78 |
| 65210 | Removal foreign body external eye conjunctiva embedded | $ 1,143.88 |
| 65220 | Removal of foreign body, external eye; corneal, without sli… | $ 1,428.00 |
| 65222 | Removal of foreign body, external eye; corneal, with slit lamp | $ 1,188.00 |
| 69200 | REMOVAL OF FOREIGN BODY OF EAR XTRNL AUD CANAL W/O ANES | $ 2,311.93 |
| 69205 | Removal foreign body from external auditory canal; with general anesthesia | $ 2,232.76 |
| 69209 | Removal impacted cerumen using irrigation/lavage, unilateral | $ 1,694.91 |
| 69210 | Removal impacted cerumen requiring instrumentation, unilateral | $ 2,311.93 |
| 69399 | $ 252.00 | |
| 70100 | Radiologic examination, mandible; partial, less than 4 views | $ 2,627.56 |
| 70110 | Radiologic examination, mandible 4 views | $ 1,231.16 |
| 70140 | Radiologic examination, facial bones; less than 3 views | $ 2,268.58 |
| 70150 | Radiologic examination, facial bones; less than 3 views | $ 2,460.00 |
| 70160 | Radiologic examination, nasal bones, complete, minimum of 3 views | $ 3,168.00 |
| 70210 | RADEX SINUSES PARANSL < 3 VIEWS | $ 461.74 |
| 70220 | Radiologic examination, sinuses, paranasal, complete, minimum of 3 views | $ 2,264.40 |
| 70250 | $ 1,365.54 | |
| 70260 | RADEX SKL COMPL MINIMUM 4 VIEWS | $ 2,760.00 |
| 70330 | X-RAY EXAM OF JAW JOINTS | $ 743.59 |
| 70360 | Radiologic examination; neck, soft tissue | $ 3,000.00 |
| 70450 | Computed tomography, head or brain; without contrast material | $ 5,760.00 |
| 70460 | CT HEAD/BRN C+ MATRL | $ 4,987.14 |
| 70470 | CT HEAD/BRN C-/C+ | $ 5,868.56 |
| 70480 | CT ORBIT SELLA/POST FOSSA/EAR C-MATRL | $ 5,520.00 |
| 70481 | CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL | $ 6,193.20 |
| 70482 | Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections | $ 7,800.70 |
| 70486 | Computed tomography, maxillofacial area; without contrast material | $ 6,720.82 |
| 70487 | CT MAXLFCL AREA C+ MATRL | $ 7,920.70 |
| 70488 | Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections | $ 6,481.07 |
| 70490 | Computed tomography, soft tissue neck; without contrast material | $ 6,240.00 |
| 70491 | CT SOFT TISS NCK C+ MATRL | $ 6,600.71 |
| 70492 | Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections | $10,201.13 |
| 70496 | Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $ 7,633.15 |
| 70498 | Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $ 7,315.73 |
| 71045 | Radiologic examination, chest; single view | $ 2,460.00 |
| 71046 | Chest X-Ray 2 Views | $ 2,700.00 |
| 71047 | Radiologic examination, chest; 3 views | $ 1,668.13 |
| 71048 | Radiologic examination, chest; 4 or more views | $ 1,765.19 |
| 71100 | RADEX RIBS UNI 2 VIEWS | $ 1,548.53 |
| 71101 | Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views | $ 2,760.00 |
| 71110 | Radiologic examination, ribs, bilateral; 3 views | $ 3,000.00 |
| 71111 | Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views | $ 3,024.00 |
| 71120 | Radiologic examination; sternum, minimum of 2 views | $ 2,220.00 |
| 71250 | Computed tomography, thorax, diagnostic; without contrast material | $ 5,640.00 |
| 71260 | CT SCAN chest (thorax); with contrast material(s) | $ 5,880.00 |
| 71275 | Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing | $ 5,760.00 |
| 72040 | Radiologic examination, spine, cervical; 2 or 3 views | $ 2,760.00 |
| 72050 | Radiologic examination, spine, cervical; 4 or 5 views | $ 2,861.44 |
| 72052 | RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | $ 3,684.06 |
| 72070 | Radiologic examination, spine; thoracic, 2 views | $ 2,640.00 |
| 72072 | RADEX SPI THRC 3 VIEWS | $ 2,481.76 |
| 72074 | Radiologic examination, spine; thoracic, minimum of 4 views | $ 798.78 |
| 72082 | Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views | $ 1,920.00 |
| 72100 | Radiologic examination, spine, lumbosacral; 2 or 3 views | $ 3,000.00 |
| 72110 | Radiologic examination, spine, lumbosacral; minimum of 4 views | $ 3,348.53 |
| 72114 | $ 2,481.76 | |
| 72120 | RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | $ 1,774.43 |
| 72125 | Computed tomography, cervical spine; without contrast material | $ 7,428.53 |
| 72126 | CT CRV SPI C+ MATRL | $ 9,227.58 |
| 72127 | CT CRV SPI C-/C+ | $ 7,932.64 |
| 72128 | Computed tomography, thoracic spine; without contrast material | $ 6,420.00 |
| 72129 | Computed tomography, thoracic spine; with contrast material | $ 6,804.00 |
| 72130 | Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections | $ 7,187.64 |
| 72131 | Computed tomography, lumbar spine; without contrast material | $ 6,804.00 |
| 72132 | CT LMBR SPI C+ MATRL | $ 8,486.54 |
| 72133 | Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections | $ 8,298.38 |
| 72170 | RADEX PELVIS 1/2 VIEWS | $ 1,860.00 |
| 72190 | Radiologic examination, pelvis; complete, minimum of 3 views | $ 3,108.90 |
| 72192 | Computed tomography, pelvis; without contrast material | $ 6,120.00 |
| 72193 | CT PELVIS C+ MATRL | $ 6,240.00 |
| 72194 | CT PELVIS C-/C+ | $ 7,312.01 |
| 72220 | Radiologic examination, sacrum and coccyx, minimum of 2 views | $ 2,208.00 |
| 73000 | Radiologic examination; clavicle, complete | $ 2,592.00 |
| 73010 | Radiologic examination; scapula, complete | $ 1,188.00 |
| 73020 | Radiologic examination, shoulder; 1 view | $ 2,988.26 |
| 73030 | Radiologic examination, shoulder; complete, minimum of 2 views | $ 3,120.00 |
| 73060 | Radiologic examination; humerus, minimum of 2 views | $ 2,700.52 |
| 73070 | Radiologic examination, elbow; 2 views | $ 2,268.50 |
| 73080 | Radiologic examination, elbow; complete, minimum of 3 views | $ 3,024.00 |
| 73090 | Radiologic examination; forearm, 2 views | $ 3,024.00 |
| 73100 | $ 2,147.36 | |
| 73110 | Radiologic examination, wrist; complete, minimum of 3 views | $ 3,024.00 |
| 73120 | $ 2,628.53 | |
| 73130 | Radiologic examination, hand; minimum of 3 views | $ 2,988.90 |
| 73140 | Radiologic examination, finger(s), minimum of 2 views | $ 2,988.26 |
| 73200 | CT UXTR C-MATRL | $10,211.56 |
| 73201 | Computed tomography, upper extremity; with contrast material(s) | $ 9,690.50 |
| 73501 | $ 1,860.00 | |
| 73502 | Hip, unilateral, with pelvis when performed; 2-3 views | $ 3,024.00 |
| 73503 | $ 3,024.00 | |
| 73521 | Radiologic examination, hips, bilateral, with pelvis when performed; 2 views | $ 2,279.33 |
| 73522 | Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views | $ 2,370.00 |
| 73523 | Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views | $ 2,352.14 |
| 73552 | Radiologic examination, femur; minimum 2 views | $ 2,090.54 |
| 73560 | Radiologic examination, knee; 1 or 2 views | $ 1,920.00 |
| 73562 | Radiologic examination, knee; 3 views | $ 3,024.00 |
| 73564 | Radiologic examination, knee; complete, 4 or more views | $ 3,908.27 |
| 73565 | Radiologic examination, knee; both knees, standing, anteroposterior | $ 533.72 |
| 73590 | Radiologic examination; tibia and fibula, 2 views | $ 3,024.00 |
| 73600 | RADEX ANKLE 2 VIEWS | $ 2,232.29 |
| 73610 | Radiologic examination, ankle; complete, minimum of 3 views | $ 3,428.27 |
| 73620 | RADEX FOOT 2 VIEWS | $ 2,189.33 |
| 73630 | Radiologic examination, foot; complete, minimum of 3 views | $ 3,132.84 |
| 73650 | Radiologic examination; calcaneus, minimum of 2 views | $ 3,024.00 |
| 73660 | XR RT TOE(S) 2 OR MORE VIEWS | $ 1,800.00 |
| 73700 | Computed tomography, lower extremity; without contrast material | $ 5,424.72 |
| 73701 | Computed tomography, lower extremity; with contrast material(s) [Toggle Dictionary Definitions] | $ 7,770.00 |
| 73721 | $ 8,412.53 | |
| 74018 | Radiologic examination, abdomen; 1 view | $ 1,800.00 |
| 74019 | Radiologic examination, abdomen; 2 views | $ 1,800.53 |
| 74021 | Radiologic examination, abdomen; 3 or more views | $ 2,268.56 |
| 74022 | Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest | $ 2,268.52 |
| 74150 | “Computed tomography, abdomen; without contrast material “ | $ 8,060.12 |
| 74160 | “Computed tomography, abdomen; with contrast material(s) “ | $ 8,179.73 |
| 74170 | CT ABD C-/C+ | $10,188.54 |
| 74174 | Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $ 8,528.40 |
| 74175 | Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $10,908.53 |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | $ 9,850.69 |
| 74177 | CT Scan , abdomen and pelvis; with contrast material(s) | $ 9,850.69 |
| 74178 | CT ABD & PELVIS W/O CONTRST 1+ BODY REGNS | $ 9,708.53 |
| 75635 | $ 7,622.88 | |
| 76010 | Radiologic examination from nose to rectum for foreign body, single view, child | $ 639.29 |
| 76380 | Other Diagnostic Radiology (Diagnostic Imaging) Related Procedures | $ 3,152.33 |
| 76536 | Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation | $ 2,227.69 |
| 76641 | Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete | $ 1,068.00 |
| 76642 | Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited | $ 1,643.33 |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | $ 1,642.80 |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) | $ 3,660.26 |
| 76770 | Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete | $ 3,253.09 |
| 76775 | Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited | $ 1,236.13 |
| 76801 | Ultrasound, pregnant uterus, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation | $ 2,724.00 |
| 76805 | US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION | $ 3,664.42 |
| 76810 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal | $ 1,706.20 |
| 76815 | ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTAT… | $ 517.01 |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters | $ 1,974.24 |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | $ 2,856.53 |
| 76830 | Ultrasound, transvaginal | $ 3,221.30 |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $ 4,247.53 |
| 76857 | Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) | $ 2,352.29 |
| 76870 | Ultrasound, scrotum and contents | $ 3,414.24 |
| 76882 | Ultrasound, limited, joint or other nonvascular extremity structure (eg muscle, nerve, other soft-tissue structure, or soft-tissue mass, real-time with image documentation | $ 1,188.00 |
| 76937 | $ 911.77 | |
| 76999 | $ 1,595.56 | |
| 80047 | METABOLIC PANEL IONIZED CA | $ 13.73 |
| 80048 | BASIC METABOLIC PANEL CALCIUM TOTAL | $ 2,022.24 |
| 80050 | GENERAL HEALTH PANEL | $10,000.00 |
| 80051 | ELECTROLYTE PANEL | $ 540.00 |
| 80053 | COMPREHENSIVE METABOLIC PANNEL | $ 1,404.20 |
| 80061 | Lipid panel | $ 172.67 |
| 80069 | $ 147.94 | |
| 80074 | $ 648.00 | |
| 80076 | LFT ; Hepatic function panel | $ 780.00 |
| 80143 | $ 409.82 | |
| 80162 | $ 561.46 | |
| 80178 | $ 252.00 | |
| 80179 | Salicylate | $ 431.56 |
| 80183 | Oxcarbazepine | $ 186.63 |
| 80305 | Drug test(s) | $ 582.00 |
| 80306 | Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); (eg, dipsticks, cups, cards, cartridges), | $ 360.36 |
| 80307 | $ 360.36 | |
| 80320 | $ 654.00 | |
| 80329 | $ 588.00 | |
| 81000 | Urinalysis , by dip stick or tablet reagent | $ 420.00 |
| 81001 | $ 330.00 | |
| 81002 | $ 252.00 | |
| 81003 | Urinalysis, by dip stick or tablet reagent for bilirubin, g. | $ 54.00 |
| 81007 | $ 101.24 | |
| 81025 | Urine pregnancy test, by visual color comparison methods | $ 504.00 |
| 82010 | $ 65.56 | |
| 82040 | Albumin; serum, plasma or whole blood | $ 180.00 |
| 82077 | $ 393.76 | |
| 82135 | $ 138.00 | |
| 82140 | $ 360.00 | |
| 82150 | Amylase | $ 516.00 |
| 82247 | $ 164.40 | |
| 82248 | Bilirubin; direct | $ 232.14 |
| 82270 | BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER | $ 660.00 |
| 82272 | $ 38.40 | |
| 82274 | $ 498.96 | |
| 82310 | $ 468.00 | |
| 82533 | $ 138.00 | |
| 82550 | Creatine kinase (CK), (CPK); total | $ 468.52 |
| 82553 | CKMB – CREATINE KINASE MB FXJ ONLY | $ 468.00 |
| 82565 | Creatinine; blood | $ 360.00 |
| 82570 | $ 102.00 | |
| 82607 | Cyanocobalamin (Vitamin B-12) | $ 220.19 |
| 82627 | $ 204.28 | |
| 82670 | $ 324.48 | |
| 82728 | Ferritin | $ 179.56 |
| 82746 | $ 259.56 | |
| 82747 | Folic acid; RBC | $ 211.02 |
| 82803 | $ 612.00 | |
| 82945 | $ 59.92 | |
| 82947 | Glucose; quantitative, blood (except reagent strip) | $ 468.52 |
| 82962 | Blood Sugar Test | $ 144.00 |
| 82977 | Glutamyltransferase, gamma (GGT) | $ 300.00 |
| 83001 | $ 660.64 | |
| 83002 | $ 660.00 | |
| 83010 | $ 54.00 | |
| 83020 | $ 179.56 | |
| 83036 | Hemoglobin; glycosylated (A1C) | $ 220.80 |
| 83520 | $ 393.76 | |
| 83540 | $ 300.00 | |
| 83550 | $ 881.47 | |
| 83605 | LACTATE | $ 174.98 |
| 83690 | Lipase | $ 1,156.20 |
| 83735 | Magnesium | $ 600.00 |
| 83874 | MYOGLOBIN | $ 594.00 |
| 83880 | BNP – B TYPE NATRIURETIC PEPTIDE | $ 746.78 |
| 83921 | $ 324.00 | |
| 83970 | $ 459.60 | |
| 84075 | Phosphatase, alkaline | $ 610.20 |
| 84100 | Phosphorus inorganic (phosphate) | $ 240.00 |
| 84146 | $ 150.00 | |
| 84155 | $ 31.20 | |
| 84403 | $ 144.00 | |
| 84425 | $ 976.31 | |
| 84436 | $ 1,188.00 | |
| 84439 | Thyroxine; free | $ 420.00 |
| 84443 | Thyroid stimulating hormone (TSH) | $ 1,188.00 |
| 84450 | $ 120.00 | |
| 84460 | $ 127.82 | |
| 84466 | Transferrin | $ 162.52 |
| 84479 | $ 336.00 | |
| 84481 | $ 474.00 | |
| 84484 | TROPONIN QUAN | $ 918.00 |
| 84520 | Urea nitrogen; quantitative | $ 468.52 |
| 84550 | URIC ACID BLOOD | $ 218.03 |
| 84600 | $ 428.40 | |
| 84702 | Gonadotropin, chorionic (hCG); quantitative | $ 960.00 |
| 84703 | Human Chorionic Gonadotropin , pregnancy test | $ 139.24 |
| 85025 | complete blood count | $ 1,212.00 |
| 85060 | $ 503.56 | |
| 85379 | Fibrin degradation products, D-dimer; quantitative | $ 966.00 |
| 85610 | PT – PROTHROMBIN TIME | $ 852.00 |
| 85652 | Sedimentation rate, erythrocyte; automated | $ 504.00 |
| 85730 | $ 108.00 | |
| 86038 | $ 300.00 | |
| 86039 | $ 254.45 | |
| 86140 | C-reactive protein | $ 588.52 |
| 86141 | $ 960.00 | |
| 86308 | Heterophile antibodies; screening | $ 660.00 |
| 86328 | Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus | $ 468.00 |
| 86431 | Rheumatoid factor; quantitative | $ 175.00 |
| 86592 | $ 97.56 | |
| 86593 | $ 96.00 | |
| 86677 | Antibody; Helicobacter pylori | $ 360.53 |
| 86694 | $ 128.27 | |
| 86695 | $ 128.27 | |
| 86696 | $ 202.80 | |
| 86701 | $ 468.52 | |
| 86703 | $ 270.54 | |
| 86704 | $ 274.74 | |
| 86706 | $ 244.87 | |
| 86708 | $ 282.49 | |
| 86709 | $ 121.61 | |
| 86735 | $ 588.76 | |
| 86757 | $ 1,075.73 | |
| 86769 | SARS-COV-2 COVID-19 ANTIBODY | $ 260.10 |
| 86780 | $ 156.00 | |
| 86803 | $ 325.36 | |
| 86850 | $ 138.76 | |
| 86900 | Blood typing, serologic; ABO | $ 504.00 |
| 86901 | Blood typing, serologic; Rh (D) | $ 468.15 |
| 87040 | Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) | $ 1,500.00 |
| 87045 | Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species | $ 648.30 |
| 87046 | Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate | $ 648.30 |
| 87070 | Culture, bacterial; any other source except urine, blood or… | $ 739.94 |
| 87077 | Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate | $ 385.40 |
| 87086 | CUL BACT QUAN COLONY CNT URINE | $ 348.00 |
| 87088 | $ 108.00 | |
| 87102 | $ 191.75 | |
| 87150 | $ 204.00 | |
| 87177 | $ 214.06 | |
| 87187 | Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate. | $ 355.36 |
| 87205 | Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types | $ 300.00 |
| 87206 | $ 48.00 | |
| 87209 | $ 648.30 | |
| 87210 | Smear, primary source with interpretation; wet mount for in… | $ 167.18 |
| 87255 | GENET VIRUS ISOLATE HSV | $ 790.80 |
| 87301 | Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay , enzyme-linked immunosorbent assay or semiquantitative; adenovirus enteric types | $ 588.00 |
| 87338 | H-pylori blood test | $ 1,527.73 |
| 87340 | $ 111.56 | |
| 87341 | $ 378.76 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, qualitative or semiquantitative; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result | $ 348.53 |
| 87420 | Infectious agent antigen detection by enzyme immunoassay techniqu | $ 360.35 |
| 87426 | Infectious agent antigen detection by immunoassay technique… | $ 816.53 |
| 87427 | $ 648.30 | |
| 87428 | Infectious agent antigen detection by immunoassay technique, severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B | $ 1,584.52 |
| 87480 | $ 467.56 | |
| 87486 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique | $ 780.52 |
| 87491 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique | $ 588.00 |
| 87493 | $ 661.20 | |
| 87505 | $ 2,925.01 | |
| 87507 | $ 3,468.00 | |
| 87510 | $ 457.69 | |
| 87521 | $ 800.05 | |
| 87522 | $ 462.67 | |
| 87529 | Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique | $ 2,268.55 |
| 87541 | $ 204.00 | |
| 87581 | Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique | $ 780.52 |
| 87591 | Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique | $ 588.00 |
| 87631 | Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus, includes multiplex reverse transcription,, technique, multiple types or subtypes, 3-5 targets | $ 1,689.10 |
| 87633 | Infectious agent detection by nucleic acid,includes multiplex reverse transcription,when performed,and multiplex amplified probe technique,multiple types or sub types,12-25 targets | $ 2,988.00 |
| 87635 | Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique | $ 708.00 |
| 87651 | Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique | $ 319.70 |
| 87660 | $ 463.73 | |
| 87661 | $ 428.40 | |
| 87798 | Infectious agent detection by nucleic acid (DNA or RNA), no… | $ 660.52 |
| 87801 | Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique | $ 1,351.94 |
| 87804 | Infectious agent antigen detection by immunoassay with dire… | $ 427.39 |
| 87807 | Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus | $ 600.23 |
| 87880 | Rapid strep test | $ 984.00 |
| 87905 | $ 349.19 | |
| 89051 | $ 660.00 | |
| 89055 | $ 457.69 | |
| 89060 | $ 347.56 | |
| 90471 | IMADM PRQ ID SUBQ/IM NJXS 1 VACC | $ 433.20 |
| 90714 | Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | $ 696.00 |
| 90715 | Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use | $ 588.52 |
| 91301 | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use | $ 21.61 |
| 93000 | ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $ 294.49 |
| 93005 | Electrocardiogram (ECG or EKG) | $ 294.49 |
| 93010 | ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY EKG | $ 251.51 |
| 93040 | Rhythm ECG, 1-3 leads; with interpretation and report | $ 123.60 |
| 93041 | RHYTHM ECG 1-3 LDS TRCG ONLY W/O I&R | $ 180.00 |
| 93042 | Rhythm ECG, 1-3 leads; interpretation and report only | $ 180.00 |
| 93227 | ECG MONIT/REPRT UP TO 48 HRS | $ 308.45 |
| 93306 | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography | $ 4,153.81 |
| 93308 | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study | $ 4,241.51 |
| 93880 | Duplex scan of extracranial arteries; complete bilateral study | $ 8,364.62 |
| 93925 | Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study | $ 3,564.53 |
| 93926 | Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study | $ 3,570.40 |
| 93931 | $ 3,060.00 | |
| 93970 | Duplex scan of extremity veins including responses to compr… | $ 3,228.52 |
| 93971 | Duplex scan of extremity veins including responses to compr… | $ 4,382.58 |
| 93975 | Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study | $ 8,376.88 |
| 93976 | Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study | $ 2,268.30 |
| 94010 | $ 631.10 | |
| 94640 | Pressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, | $ 348.52 |
| 94760 | Noninvasive ear or pulse oximetry for oxygen saturation; single determination | $ 69.63 |
| 94761 | Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise) | $ 88.80 |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | 725.25 |
| 96361 | Intravenous infusion, hydration; each additional hour | 449 |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour | 711 |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour | 700 |
| 96367 | Intravenous infusion, Sequential to 1 hr | 990 |
| 96368 | THER/DIAG CONCURRENT INF | 353.39 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular | 164.05 |
| 96374 | IV PUSH THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG | 357 |
| 96375 | IV PUSH ADD DRUG THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG | 374 |
| 96376 | Sequential intravenous push of the same substance/drug | 289 |
| 97597 | DEBRIDEMENT OPEN WOUND 20 SQ CM OR LESS | 2512.03 |
| 97605 | Pressure wound therapy | 168 |
| 99000 | Specimen handling | 95.82 |
| 99001 | 127.82 | |
| 99024 | 587.56 | |
| 99053 | Service(s) provided between 10:00 PM and 8:00 AM at 24-hour facility, in addition to basic service | 491.56 |
| 99070 | SUPPLIES&MATERIALS PRV BY PHYS >&ABOVE | 73.45 |
| 99072 | Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s) | 198.53 |
| 99217 | Observation Care Discharge | 1800 |
| 99218 | Initial Hospital Observation Care Services | 2988.26 |
| 99219 | initial observation care that involves high-level services provided on a daily basis | 2219.62 |
| 99220 | Initial Observation Care | 3228.14 |
| 99221 | Initial hospital inpat or obs care, per day, for E&M of a pat, which requires an examination and moder level of MDM on the date of the encounter for code selection, 40 mins must be met or exceeded. | 1911.32 |
| 99222 | Initial hospital inpat or obs care, per day, for E&M of a pat, which requires an examination and moder level of MDM on the date of the encounter for code selection, 55 mins must be met or exceeded. | 2974.73 |
| 99223 | Initial hospital inpat or obs care, per day, for E&M of a pat, which requires an examination and moder level of MDM on the date of the encounter for code selection, 75 mins must be met or exceeded | 3974.27 |
| 99231 | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient 25 minutes must be met or exceeded. | 1135.67 |
| 99232 | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient 35 minutes must be met or exceeded. | 1808.04 |
| 99233 | Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient 35 minutes must be met or exceeded. | 2719.58 |
| 99234 | OBSERVATION ADMIT/DISCHARGE – Level 1 | 2436.54 |
| 99235 | OBSERVATION ADMIT/DISCHARGE – Level 2 | 2508.14 |
| 99236 | OBSERVATION ADMIT/DISCHARGE – Same Day Greater than 8 hours | 2239.76 |
| 99238 | Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | 1846.57 |
| 99239 | Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter | 2619.26 |
| 99281 | EMER DEPT SELF LIMITED/MINOR | 708.13 |
| 99282 | MODERATE SEVERITY | 1176.91 |
| 99283 | Emergency department visit for the evaluation and management , the presenting problem(s) are of moderate severity. | 2988 |
| 99284 | Emergency department visit for the evaluation and management of a patient,presenting problem(s) are of high severity, and require urgent evaluation | 4334.4 |
| 99285 | EMERGENCY DEPT VISIT HI MDM | 5520 |
| 99291 | CRITICAL CARE (30-74 MIN) | 7602 |
| 99292 | CRITICAL CARE (EACH ADDITIONAL 30 MIN) | 3712.97 |
| 99356 | Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; first hour | 2377.02 |
| 99357 | Prolonged service in the inpatient or observation setting, requiring unit/floor time beyond the usual service; each additional 30 minutes | 130.93 |
| 99406 | Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes | 291.95 |
| 99407 | Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes | 393.61 |
| 99418 | PROLNG IP/OBS E/M EA 15 MIN | 118.02 |
| A4208 | IM MEDS-BUNDLE | 18 |
| A4209 | 5+ CC STERILE SYRINGE&NEEDLE | 19 |
| A4215 | Needle any size | 56 |
| A4216 | STERILE WATER/SALINE, 10 ML | 11 |
| A4217 | STERILE WATER/SALINE, 500 ML | 120.3 |
| A4222 | INFUSION SUPPLIES WITH PUMP | 73.48 |
| A4244 | ALCOHOL OR PEROXIDE PER PINT | 131.04 |
| A4245 | 11.63 | |
| A4246 | Betadine or pHisoHex solution, per pint | 201.6 |
| A4247 | BETADINE/IODINE SWABS/WIPES | 60.76 |
| A4314 | 123.6 | |
| A4320 | IRRIGATION TRAY | 118.36 |
| A4327 | FEM URINARY COLLECT DEV CUP | 116.52 |
| A4334 | FOLEY CATHETER LEG STRAP | 26.22 |
| A4340 | FOLEY CATH 2-WAY W/ 5CC BALLOON 20 FR ( IF foley catheter insert) | 89.42 |
| A4364 | Adhesive, liquid or equal, any type, per oz | 102.8 |
| A4450 | LACERATION TRAY | 17 |
| A4452 | Tape, waterproof, per 18 square inches | 15.61 |
| A4467 | straps | 32 |
| A4550 | 150 | |
| A4556 | ELECTRODES, PAIR | 55 |
| A4565 | SLINGS | 48 |
| A4570 | 150 | |
| A4590 | 648.3 | |
| A4606 | OXYGEN PROBE USED W OXIMETER | 106.8 |
| A4615 | CANNULA NASAL | 111.6 |
| A4620 | VARIABLE CONCENTRATION MASK | 106.8 |
| A4649 | Suture | 39 |
| A4770 | BLOOD COLLECTION TUBE/VACUUM | 60.11 |
| A4930 | STERILE, GLOVES PER PAIR | 95.82 |
| A6216 | 0.17 | |
| A6219 | GAUZE <= 16 SQ IN W/BORDER | 143.56 |
| A6250 | SKIN SEAL PROTECT MOISTURIZR | 52 |
| A6260 | WOUND CLEANSERS ANY TYPE ANY SIZE | 5 |
| A6266 | 10.8 | |
| A6402 | Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing | 15 |
| A6413 | ADHESIVE BANDAGE FIRSTAID TYPE EA | 12 |
| A6448 | Ace wrap | 15 |
| A6449 | Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard | 118.36 |
| A6450 | LT COMPRES BAND >=5/YD | 26.14 |
| A6454 | 27.6 | |
| A7000 | DISPOSABLE CANISTER FOR PUMP | 75.74 |
| A7003 | NEBULIZER ADMINISTRATION SET | 95.82 |
| A7015 | AEROSOL MASK USED W NEBULIZE | 59.63 |
| A9150 | Administrative, Miscellaneous and Investigational | 37.2 |
| A9273 | 47.59 | |
| A9284 | 458.4 | |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 251.56 |
| E0114 | CRUTCH UNDERARM PAIR NO WOOD | 200.4 |
| E0116 | CRUTCH UNDERARM EACH NO WOOD | 77 |
| E0325 | URINAL MALE JUG-TYPE | 9.59 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | 95 |
| G0168 | 360 | |
| G0316 | Prolonged hospital inpatient or observation care evaluation and management service(s) each additional 15 minutes by the physician | 118.02 |
| G0378 | Observation initial 1 hour | 2268 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 300.16 |
| G6039 | ACETAMINOPHEN | 162.22 |
| J0131 | Injection, acetaminophen, 10 mg | 42.79 |
| J0132 | 36 | |
| J0153 | ADENOSINE INJ 1MG | 349.12 |
| J0171 | Injection, Adrenalin, epinephrine, 0.1 mg | 57.6 |
| J0282 | Injection, amiodarone hydrochloride, 30 mg | 46.8 |
| J0290 | 60.72 | |
| J0295 | 60 | |
| J0360 | Injection, hydralazine hcl, up to 20 mg | 253.12 |
| J0456 | Injection, azithromycin, 500 mg | 119.92 |
| J0461 | Injection, atropine sulfate, 0.01 mg | 35.59 |
| J0500 | Injection, dicyclomine hcl, up to 20 mg | 385.21 |
| J0558 | 61.12 | |
| J0561 | Injection, penicillin G benzathine, 100, 000 units | 107.56 |
| J0610 | Injection, calcium gluconate, per 10 ml | 50.03 |
| J0612 | 55.2 | |
| J0613 | 54.12 | |
| J0665 | INJ, BUPIVACAINE, NOS, 0.5MG | 15.3 |
| J0690 | Injection, cefazolin sodium, 500 mg | 84 |
| J0692 | Injection, cefepime hydrochloride, 500 mg | 119.33 |
| J0694 | 147.6 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 106.8 |
| J0697 | 59.33 | |
| J0735 | 154.8 | |
| J0736 | Injection, clindamycin phosphate, 300 mg | 41.51 |
| J0744 | Injection, ciprofloxacin for intravenous infusion, 200 mg | 235.58 |
| J0780 | Injection, prochlorperazine, up to 10 mg | 95.82 |
| J0840 | 46.19 | |
| J1020 | 47.56 | |
| J1030 | METHYLPREDNISOLONE 40 MG INJ | 83.82 |
| J1040 | METHYLPREDNISOLONE 80 MG INJ | 115.82 |
| J1094 | 348.52 | |
| J1100 | DEXAMETHASONE 1mg | 44.35 |
| J1110 | 204 | |
| J1160 | DIGOXIN INJECTION | 82.75 |
| J1165 | 123.91 | |
| J1170 | Injection, hydromorphone, up to 4 mg | 181.12 |
| J1200 | Injection, diphenhydramine HCl, up to 50 mg | 71.56 |
| J1265 | 46.19 | |
| J1335 | 159.42 | |
| J1450 | 59.56 | |
| J1580 | 109.79 | |
| J1610 | Injection, glucagon hydrochloride, per 1 mg | 1512.43 |
| J1630 | Injection, haloperidol, up to 5 mg | 104.12 |
| J1631 | Injection, haloperidol decanoate, per 50 mg | 59.65 |
| J1642 | 31.81 | |
| J1644 | Injection, heparin sodium, per 1000 units | 63.6 |
| J1650 | Injection, enoxaparin sodium, 10 mg | 59.92 |
| J1741 | 35.39 | |
| J1790 | “Injection, droperidol, up to 5 mg “ | 49.96 |
| J1800 | PROPRANOLOL INJECTION | 223.4 |
| J1810 | 38.09 | |
| J1815 | Injection, insulin, per 5 units | 51.6 |
| J1817 | 35.77 | |
| J1836 | Injection, metronidazole, 10 mg | 33.19 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 59.53 |
| J1920 | 31.38 | |
| J1940 | Injection, furosemide, up to 20 mg | 52.57 |
| J1956 | Injection, levofloxacin, 250 mg | 150 |
| J1980 | 348.52 | |
| J2001 | Injection, lidocaine HCl for intravenous infusion, 10 mg | 47.75 |
| J2020 | 126.38 | |
| J2060 | Injection, lorazepam, 2 mg | 47.75 |
| J2175 | 115.62 | |
| J2180 | 47.59 | |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 63.6 |
| J2270 | MORPHINE SULFATE INJECTION | 78.76 |
| J2274 | 50.03 | |
| J2310 | Injection, naloxone hydrochloride, per 1 mg | 95.92 |
| J2358 | 70.93 | |
| J2360 | Injection, orphenadrine citrate, up to 60 mg | 52.55 |
| J2405 | ONDANSETRON HCL INJECTION | 69.17 |
| J2543 | PIPERACILLIN/TAZOBACTAM | 131.2 |
| J2550 | Injection, promethazine HCl, up to 50 mg | 71.92 |
| J2650 | PREDNISOLONE ACETATE INJ | 115.33 |
| J2704 | 45.37 | |
| J2765 | Injection, metoclopramide HCl, up to 10 mg | 40.19 |
| J2780 | 28.09 | |
| J2800 | 70.36 | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | 61.79 |
| J2930 | Injection, methylprednisolone sodium succinate, up to 125 mg | 65.33 |
| J2997 | 708.76 | |
| J3010 | FENTANYL CITRATE INJECITON 0.1MG | 95.33 |
| J3030 | SUMATRIPTAN SUCCINATE / 6 MG | 239.92 |
| J3105 | 179.56 | |
| J3260 | 65.56 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 34.93 |
| J3360 | Injection, diazepam, up to 5 mg | 46.27 |
| J3370 | VANCOMYCIN Inj – 500MG | 74.4 |
| J3410 | “Injection, hydroxyzine HCl, up to 25 mg “ | 55.87 |
| J3411 | 80.99 | |
| J3430 | 59.95 | |
| J3475 | Injection, magnesium sulfate, per 500 mg | 85.79 |
| J3480 | INJ POTASSIUM CHLORIDE | 127.07 |
| J3486 | 123.16 | |
| J3490 | DRUGS UNCLASSIFIED INJECTION | 185.92 |
| J3490G | 123.6 | |
| J7030 | Infusion, normal saline solution , 1000 cc | 78.13 |
| J7040 | Infusion, normal saline solution, sterile (500 ml=1 unit) | 48 |
| J7042 | 5% dextrose/normal saline (500 ml = 1 unit) | 56.93 |
| J7050 | Infusion, normal saline solution , 250 cc | 68.4 |
| J7060 | 5% dextrose/water (500 ml = 1 unit) | 57.52 |
| J7070 | D5W INFUSION | 59.99 |
| J7120 | RINGERS LACTATE INFUSION | 59.87 |
| J7121 | 5% dextrose in lactated ringers infusion, up to 1000 cc | 64.67 |
| J7509 | 19.63 | |
| J7510 | Prednisolone oral, per 5 mg | 6 |
| J7512 | 6 | |
| J7610 | Albuterol, inhalation solution, compounded product, administered through DME, concentrated form, 1 mg | 91.32 |
| J7612 | 27.6 | |
| J7613 | ALBUTEROL NON-COMP UNIT | 47.33 |
| J7615 | 56.59 | |
| J7620 | ALBUTEROL IPRATROP NON-COMP | 52.43 |
| J7626 | Budesonide, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, up to 0.5 mg | 51.6 |
| J7637 | 42.53 | |
| J7644 | Ipratropium bromide, inhalation solution, compounded product, administered through DME, unit dose form, per milligram | 71.56 |
| J7645 | Ipratropium bromide, inhalation solution, compounded product, administered through DME, unit dose form, per milligram | 27.61 |
| J7682 | 30 | |
| J7699 | Noc drugs, inhalation solution administered through DME | 48.59 |
| J8498 | 34.8 | |
| J8499 | “Prescription drug, oral, non chemotherapeutic, NOS “ | 31 |
| J8499AF | CEPHALEXIN 500MG | 19.93 |
| J8499AN | CYCLOBENZAPRINE HYDROCHLORIDE | 19.93 |
| J8499D | AMOXICILLIN SUSPENSION 400MG | 19.93 |
| J8499F | IBUPROFEN 600MG | 19.93 |
| J8499V | 180 | |
| J8540 | DEXAMETHASONE ORAL 0.25 MG | 11 |
| J9260 | 54.82 | |
| K0730 | Inhalation drug delivery system | 151 |
| L0120 | CERV FLEXIBLE NON-ADJUSTABLE | 1038 |
| L0172 | Collar | 689.63 |
| L0174 | 360 | |
| L1830 | Knee – KO IMMOBILIZER CANVAS LONGIT | 201 |
| L1833 | 1503.6 | |
| L3260 | 63 | |
| L3650 | Shoulder orthosis (SO), figure of eight design abduction restrainer, prefabricated, off-the-shelf | 89 |
| L3809 | 686.4 | |
| L4350 | 344.4 | |
| L4361 | 745.2 | |
| L4387 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf | 182.79 |
| L4631 | ankle boot | 357.6 |
| M0222 | 1440 | |
| M0239 | 1080 | |
| M0243 | 1440 | |
| M0245 | 1080 | |
| M0247 | 1440 | |
| Q0144 | Azithromycin dihydrate, oral, capsules/powder, 1 gram | 272 |
| Q0163 | 11 | |
| Q0169 | Promethazine hydrochloride, 12.5 mg, oral, | 106.38 |
| Q0244 | 0.01 | |
| Q4046 | 1404.2 | |
| Q4049 | 123.6 | |
| Q4051 | SPLINT SUPPLIES MISC | 288.83 |
| Q9962 | 228 | |
| Q9963 | 246.55 | |
| Q9965 | Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml | 444 |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 480 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 444 |
| S0020 | Injection, bupivacaine hydrochloride, 30 ml | 480 |
| S0028 | PEPCID – INJECTION, FAMOTIDINE, 20 MG | 64.44 |
| S0030 | Injection, metronidazole, 500 mg | 63.6 |
| S0039 | INJECTION, SULFAMETHOXAZOLE | 328.22 |
| S0077 | Injection, clindamycin phosphate, 300 mg | 59.56 |
| S0119 | Ondansetron, oral, 4 mg | 71 |
| S0164 | Injection, pantoprazole sodium, 40 mg | 58.57 |
| S0181 | ONDANESTRON HCA, ORAL 4MG | 5.1 |
| S0182 | 47.59 | |
| S0630 | REMOVAL OF SUTURES | 303.6 |
| S1015 | IV TUBING EXTENSION SET | 49.73 |
| S5000 | PRESCRIPTION DRUG, GENERIC | 16.27 |
| S5001 | NON-GENERIC DRUG | 35.53 |
| S5010 | 5% DEXTROSE AND 0.45% SALINE | 8.04 |
| S5012 | 5% DEXTROSE WITH POTASSIUM | 72 |
| S5013 | 19.2 | |
| S8100 | 49.2 | |
| S8101 | 75.6 | |
| S8430 | 67.2 | |
| S8431 | 54 | |
| S8451 | 250.8 | |
| U0002 | coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), | 792 |
| U0003 | Infectious agent detection by nucleic acid (DNA or RNA); se… | 708 |
| U0005 | INFEC AGEN DETEC AMPLI PROBE | 324 |
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