general hospital hospital images...93041 rhythm ecg tracing 23 $30 $153 0 -80.37% 93307 tte w/o...

CPT®

Description

Hosp

Units

Hospital

Chgs

/Unit

EstimatedM

kt Avg

Chgs/Unit

Rel.

Drive

Factor

% Devtn

From

Mkt Chg

Cardiovascular

93005 Electrocardiogram tracing 8378 $129 $295 -0.76 -56.32%

93798 Cardiac rehab/monitor 2376 $207 $274 -0.09 -24.45%

93325 Doppler color flow add-on 768 $750 $678 0.03 10.63%

93320 Doppler echo exam heart 764 $1,081 $794 0.12 36.09%

93017 Cardiovascular stress test 674 $1,629 $1,170 0.17 39.19%

93280 Pm device progr eval dual 380 $25 $201 -0.04 -87.58%

93312 Echo transesophageal 339 $2,345 $2,787 -0.08 -15.83%

93454 Coronary artery angio s&i 334 $14,746 $11,137 0.66 32.4%

93225 Ecg monit/reprt up to 48 hrs 242 $910 $577 0.04 57.86%

93226 Ecg monit/reprt up to 48 hrs 242 $1,315 $702 0.08 87.45%

92960 Cardioversion electric ext 125 $3,050 $1,959 0.07 55.7%

G0297 Ldct for lung ca screen 125 $1,632 $834 0.05 95.68%

93613 Electrophys map 3d add-on 112 $9,079 $9,330 -0.02 -2.69%

93662 Intracardiac ecg (ice) 71 $6,445 $5,962 0.02 8.09%

93621 Electrophysiology evaluation 61 $9,802 $9,095 0.02 7.77%

93653 Ep & ablate supravent arrhyt 60 $35,974 $30,928 0.16 16.31%

93455 Coronary art/grft angio s&i 59 $16,272 $12,138 0.13 34.05%

93656 Tx atrial fib pulm vein isol 53 $41,180 $36,887 0.12 11.63%

93655 Ablate arrhythmia add on 37 $9,034 $13,033 -0.08 -30.68%

93641 Electrophysiology evaluation 36 $3,106 $3,764 -0.01 -17.46%

93458 L hrt artery/ventricle angio 28 $19,140 $15,117 0.06 26.61%

93456 R hrt coronary artery angio 25 $22,546 $14,193 0.11 58.84%

93041 Rhythm ecg tracing 23 $30 $153 0 -80.37%

93307 Tte w/o doppler complete 17 $974 $1,651 -0.01 -41.0%

93271 Ecg/monitoring and analysis 16 $1,181 $768 0 53.69%

93270 Remote 30 day ecg rev/report 15 $877 $408 0 115.08%

92950 Heart/lung resuscitation cpr 15 $919 $1,130 0 -18.64%

93623 Stimulation pacing heart 15 $6,743 $6,693 0 0.75%

93308 Tte f-up or lmtd 12 $864 $916 0 -5.61%

92978 Endoluminl ivus oct c 1st 11 $9,815 $5,634 0.03 74.2%

93657 Tx l/r atrial fib addl * * * -0.02 -25.79%

93457 R hrt art/grft angio * * * 0.03 56.41%

93460 R&l hrt art/ventricle angio * * * 0.01 9.76%

93650 Ablate heart dysrhythm focus * * * 0.01 19.04%

93459 L hrt art/grft angio * * * 0.01 20.52%

93620 Electrophysiology evaluation * * * 0.01 13.72%

92920 Prq cardiac angioplast 1 art * * * 0.07 221.11%

93321 Doppler echo exam heart * * * 0 2.55%

General Hospital

Service Pricing Analysis Detail

CMS Outpatient Standard Analytical File - Medicare Patients - Non-Surgical - Calendar Year 2017

© PMMC. CPT © American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA

does not directly or indirectly practice medicine or dispense medical services. AMA

93654 Ep & ablate ventric tachy * * * 0.02 27.03%

0387T Leadless c pm ins/rpl ventr * * * 0.02 35.23%

92921 Prq cardiac angio addl art * * * 0.03 170.36%

93463 Drug admin & hemodynmic meas * * * 0 -58.69%

93609 Map tachycardia add-on * * * 0 43.29%

93642 Electrophysiology evaluation * * * 0 161.37%

93461 R&l hrt art/ventricle angio * * * 0 12.01%

92928 Prq card stent w/angio 1 vsl * * * 0 -10.32%

92953 Temporary external pacing * * * 0 -48.59%

92979 Endoluminl ivus oct c ea * * * 0 25.47%

93750 Interrogation vad in person * * * 0 -58.65%

93797 Cardiac rehab * * * 0 -24.07%

Cardiovascular Totals: * $1,382 $1,263

5.81% 109.4%

Cath's - Cardiac

93462 L hrt cath trnsptl puncture 13 $5,913 $8,787 -0.48 -32.7%

93451 Right heart cath 12 $5,758 $9,633 -0.59 -40.22%

93453 R&l hrt cath w/ventriclgrphy * * * 0.07 41.6%

Cath's - Cardiac Totals: * $6,339 $9,352

0.01% 67.78%

Diagnostic Procedures

G0202 Screeningmammographydigital 1877 $624 $425 0.24 46.67%

93288 Pm device eval in person 766 $25 $164 -0.07 -84.79%

G0103 Psa screening 750 $157 $137 0.01 14.94%

93971 Extremity study 385 $592 $988 -0.1 -40.03%

93880 Extracranial bilat study 384 $984 $1,306 -0.08 -24.7%

93351 Stress tte complete 353 $4,510 $2,212 0.52 103.87%

0296T Ext ecg recording 283 $1,548 $534 0.18 189.92%

95810 Polysom 6/> yrs 4/> param 240 $5,843 $4,446 0.21 31.41%

95811 Polysom 6/>yrs cpap 4/> parm 209 $5,956 $4,855 0.15 22.66%

G0206 Diagnosticmammographydigital 201 $605 $426 0.02 41.97%

93970 Extremity study 131 $981 $1,499 -0.04 -34.59%

93282 Prgrmg eval implantable dfb 122 $45 $231 -0.01 -80.5%

93279 Pm device progr eval sngl 85 $25 $173 -0.01 -85.56%


93923 Upr/lxtr art stdy 3+ lvls 71 $533 $939 -0.02 -43.2%


G0204 Diagnosticmammographydigital 53 $642 $555 0 15.74%

G0279 Tomosynthesis mammo 43 $51 $118 0 -56.98%

G0121 Colon ca scrn not hi rsk ind 37 $2,811 $2,615 0 7.52%

93998 Noninvas vasc dx study proc 26 $655 $740 0 -11.52%

93926 Lower extremity study 24 $602 $900 0 -33.14%

G0105 Colorectal scrn hi risk ind 21 $2,810 $2,629 0 6.88%

95816 Eeg awake and drowsy 19 $1,221 $1,090 0 12.05%

93281 Pm device progr eval multi 16 $35 $214 0 -83.67%



0297T Ext ecg scan w/report 14 $2,248 $639 0.01 251.94%

93976 Vascular study 11 $994 $917 0 8.37%

G0102 Prostate ca screening dre * * * 0 -42.8%

93925 Lower extremity study * * * 0 -26.97%

93286 Peri-px pacemaker device evl * * * 0 -80.77%

G0101 Ca screenpelvic/breast exam * * * 0 -75.74%

93990 Doppler flow testing * * * 0 -22.41%

95819 Eeg awake and asleep * * * 0 -8.81%

95805 Multiple sleep latency test * * * 0 26.06%

93287 Peri-px device eval & prgr * * * 0 -76.86%

93931 Upper extremity study * * * 0 -27.39%

95886 Musc test done w/n test comp * * * 0 -63.63%

95953 Eeg monitoring/computer * * * 0 20.02%

G0104 Ca screenflexi sigmoidscope * * * 0 -27.11%

95885 Musc tst done w/nerv tst lim * * * 0 -70.1%

93930 Upper extremity study * * * 0 -24.67%

93924 Lwr xtr vasc stdy bilat * * * 0 -41.88%

93882 Extracranial uni/ltd study * * * 0 -12.11%

93922 Upr/l xtremity art 2 levels * * * 0 -12.6%

Diagnostic Procedures Totals: * $1,144 $897

2.38% 127.46%

Ear, Nose, & Throat

92611 Motion fluoroscopy/swallow 49 $378 $562 -2.33 -32.67%

91010 Esophagus motility study 19 $2,195 $1,871 1.59 17.3%

92610 Evaluate swallowing function 17 $433 $220 0.94 97.11%

91037 Esoph imped function test * * * -1.12 -40.47%

92553 Audiometry air & bone * * * -0.08 -69.27%

Ear, Nose, & Throat Totals: * $772 $812

0.04% 95.05%

Emergency Dept

99285 Emergency dept visit 3036 $2,299 $2,129 0.83 7.98%

99284 Emergency dept visit 1458 $1,632 $1,465 0.39 11.38%

99283 Emergency dept visit 1003 $747 $875 -0.21 -14.66%

99282 Emergency dept visit 149 $432 $507 -0.02 -14.66%

99281 Emergency dept visit 41 $205 $210 0 -2.06%

Emergency Dept Totals: 5687 $1,790 $1,682

2.14% 106.48%

Gastrointestinal

91200 Liver elastography * * * -1 -46.52%

Gastrointestinal Totals: * $269 $503

0.0% 53.48%

Integumentary Surgery

Q4101 Apligraf 88 $203 $138 0.38 47.38%

Q4116 Alloderm 72 $257 $159 0.47 61.46%

Q4100 Skin substitute nos * * * 0.15 341.02%



Integumentary Surgery Totals: * $239 $148

0.06% 162.0%

Male Reproductive

G0416 Prostate biopsy any mthd * * * 1 151.6%

Male Reproductive Totals: * $4,932 $1,960

0.0% 251.61%

Medicine

G0378 Hospital observation per hr 18228 $58 $116 -0.7 -50.0%

G0008 Admin influenza virus vac 2794 $52 $54 0 -4.62%

90662 Iiv no prsv increased ag im 2444 $45 $94 -0.08 -52.25%

G0009 Admin pneumococcal vaccine 1083 $49 $64 -0.01 -23.58%

G0283 Elec stim other than wound 669 $112 $65 0.02 73.88%

90670 Pcv13 vaccine im 626 $195 $436 -0.1 -55.22%

90732 Ppsv23 vacc 2 yrs+ subq/im 457 $88 $237 -0.05 -62.79%

90834 Psytx w pt 45 minutes 397 $81 $227 -0.04 -64.28%

90471 Immunization admin 355 $70 $95 -0.01 -26.36%

90686 Iiv4 vacc no prsv 0.5 ml im 348 $18 $55 -0.01 -66.74%

G0109 Diab manage trn ind/group 327 $87 $74 0 18.61%

90715 Tdap vaccine 7 yrs/> im 307 $48 $168 -0.02 -71.49%

G0108 Diab manage trn per indiv 292 $152 $129 0 17.77%

G0328 Fecal blood scrn immunoassay 280 $125 $76 0.01 63.04%

92507 Speech/hearing therapy 106 $270 $156 0.01 73.73%

90472 Immunization admin each add 99 $23 $46 0 -49.78%

90714 Td vacc no presv 7 yrs+ im 79 $43 $137 0 -68.77%

90746 Hepb vaccine 3 dose adult im 55 $93 $167 0 -44.41%

G0010 Admin hepatitis b vaccine 54 $44 $105 0 -58.12%

90736 Hzv vaccine live subq 44 $177 $409 -0.01 -56.76%

99406 Behav chng smoking 3-10 min 41 $6 $45 0 -86.8%

90792 Psych diag eval w/med srvcs 40 $89 $364 -0.01 -75.47%

90832 Psytx w pt 30 minutes 36 $52 $195 0 -73.52%

92526 Oral function therapy 31 $260 $123 0 110.58%

G0257 Unsched dialysis esrd pt hos 30 $1,604 $1,906 -0.01 -15.85%

90791 Psych diagnostic evaluation 29 $82 $359 -0.01 -77.21%

90632 Hepa vaccine adult im 24 $83 $154 0 -46.14%

99001 Specimen handling pt-lab 12 $41 $38 0 7.95%

95250 Cont gluc mntr phys/qhp eqp 11 $483 $440 0 9.77%

90853 Group psychotherapy * * * 0 102.31%

99407 Behav chng smoking > 10 min * * * 0 -60.41%

90673 Riv3 vaccine no preserv im * * * 0 -23.4%

90675 Rabies vaccine im * * * 0 55.04%

G0260 Inj for sacroiliac jt anesth * * * 0 85.36%

90837 Psytx w pt 60 minutes * * * 0 -68.17%

96105 Assessment of aphasia * * * 0 -5.67%

90734 Mcv4 menacwy vaccine im * * * 0 -64.18%

90707 Mmr vaccine sc * * * 0 -69.01%



90375 Rabies ig im/sc * * * 0.01 559.29%

G0365 Vessel mapping hemo access * * * 0 -13.37%

G0379 Direct refer hospital observ * * * 0 -88.72%

Medicine Totals: * $66 $117

11.01% 56.24%

Neurological

C1820 Generator neuro rechg bat sy * * * -0.89 -5.81%

95910 Nrv cndj test 7-8 studies * * * -0.05 -66.93%

95911 Nrv cndj test 9-10 studies * * * -0.03 -65.88%

95909 Nrv cndj tst 5-6 studies * * * -0.02 -65.74%

Neurological Totals: * $35,219 $37,643

0.0% 93.56%

Oral Surgery/Dental

C9728 Place device/marker non pro * * * 1 82.12%

Oral Surgery/Dental Totals: * $4,828 $2,651

0.0% 182.12%

Orthotic and Prosthetics

L1830 Ko immob canvas long pre ots 35 $105 $158 -0.11 -33.87%

L4350 Ankle control ortho pre ots 18 $76 $148 -0.07 -48.79%

L3807 Whfo w/o joints pre cst 12 $96 $194 -0.07 -50.44%

L3908 Who cock-up nonmolde pre ots * * * -0.03 -55.51%

L0625 Lo flex l1-below l5 pre ots * * * -0.02 -35.73%

L3670 So acro/clav can web pre ots * * * -0.04 -53.12%

L0172 Cerv col sr foam 2pc pre ots * * * -0.04 -32.2%

L8699 Prosthetic implant nos * * * -0.24 -15.36%

L4360 Pneumat walking boot pre cst * * * -0.02 -12.57%

L0174 Cerv sr 2pc thor ext pre ots * * * -0.09 -43.83%

L0120 Cerv flex n/adj foam pre ots * * * -0.01 -75.47%

L3809 Whfo w/o joints pre ots * * * -0.02 -68.19%

L8000 Mastectomy bra * * * 0.17 1,455.34%

L3650 So 8 abd restraint pre ots * * * 0 -10.13%

L8680 Implt neurostim elctr each * * * 1.58 664.5%

Orthotic and Prosthetics Totals: * $526 $398

0.05% 132.42%

Pathology & Laboratory

80053 Comprehen metabolic panel 13923 $84 $231 -0.42 -63.8%

85610 Prothrombin time 13046 $24 $66 -0.11 -63.6%

85025 Complete cbc w/auto diff wbc 11272 $75 $108 -0.08 -30.24%

80061 Lipid panel 7586 $124 $144 -0.03 -13.7%

80048 Metabolic panel total ca 6735 $66 $168 -0.14 -60.46%

84443 Assay thyroid stim hormone 5298 $151 $153 0 -1.09%

83036 Glycosylated hemoglobin test 5221 $71 $97 -0.03 -27.29%

85027 Complete cbc automated 3982 $52 $109 -0.05 -52.76%

84484 Assay of troponin quant 3871 $78 $208 -0.1 -62.67%

87086 Urine culture/colony count 2384 $50 $116 -0.03 -57.08%



88305 Tissue exam by pathologist 2320 $413 $325 0.04 27.31%

81003 Urinalysis auto w/o scope 2184 $38 $58 -0.01 -35.14%

81001 Urinalysis auto w/scope 1874 $65 $81 -0.01 -19.4%

82306 Vitamin d 25 hydroxy 1654 $211 $199 0 5.76%

82043 Ur albumin quantitative 1652 $78 $79 0 -1.47%

86850 Rbc antibody screen 1609 $193 $150 0.01 28.59%

84439 Assay of free thyroxine 1398 $87 $117 -0.01 -25.13%

82728 Assay of ferritin 1313 $126 $180 -0.01 -29.72%

87077 Culture aerobic identify 1299 $66 $86 -0.01 -23.69%

83735 Assay of magnesium 1254 $76 $100 -0.01 -23.6%

87186 Microbe susceptible mic 1248 $125 $113 0 11.38%

82607 Vitamin b-12 1212 $131 $139 0 -5.86%

83540 Assay of iron 1074 $93 $101 0 -7.94%

83550 Iron binding test 964 $84 $136 -0.01 -38.11%

86900 Blood typing serologic abo 935 $95 $94 0 1.09%

86901 Blood typing serologic rh(d) 935 $101 $86 0 17.38%

85652 Rbc sed rate automated 876 $103 $54 0.01 89.65%

88341 Immunohisto antb addl slide 843 $196 $262 -0.01 -25.16%

83880 Assay of natriuretic peptide 829 $309 $269 0.01 14.73%

85347 Coagulation time activated 742 $87 $105 0 -17.38%

83690 Assay of lipase 709 $97 $141 -0.01 -31.3%

86140 C-reactive protein 705 $74 $86 0 -13.89%

82784 Assay iga/igd/igg/igm each 681 $154 $101 0.01 51.98%

83970 Assay of parathormone 678 $308 $560 -0.03 -45.06%

85730 Thromboplastin time partial 642 $57 $122 -0.01 -53.3%

80076 Hepatic function panel 639 $67 $174 -0.01 -61.58%

84153 Assay of psa total 629 $117 $150 0 -21.72%

82746 Assay of folic acid serum 623 $117 $148 0 -20.67%

G0480 Drug test def 1-7 classes 616 $243 $287 -0.01 -15.18%

84460 Alanine amino (alt) (sgpt) 614 $67 $63 0 5.74%

82550 Assay of ck (cpk) 612 $62 $114 -0.01 -45.39%

80307 Drug test prsmv chem anlyzr 586 $233 $391 -0.02 -40.45%

84450 Transferase (ast) (sgot) 576 $66 $60 0 8.84%

82565 Assay of creatinine 570 $69 $71 0 -2.78%

87070 Culture othr specimn aerobic 553 $126 $164 0 -23.24%

84100 Assay of phosphorus 532 $45 $82 0 -45.14%

85018 Hemoglobin 515 $67 $61 0 9.57%

88185 Flowcytometry/tc add-on 500 $201 $145 0.01 39.03%

83883 Assay nephelometry not spec 484 $169 $128 0 31.72%

87205 Smear gram stain 463 $50 $77 0 -34.08%

87040 Blood culture for bacteria 461 $101 $232 -0.01 -56.3%

83615 Lactate (ld) (ldh) enzyme 437 $86 $77 0 11.9%

85014 Hematocrit 435 $61 $49 0 26.34%

86003 Allg spec ige crude xtrc ea 433 $88 $40 0 123.58%

86803 Hepatitis c ab test 374 $106 $138 0 -23.38%



84155 Assay of protein serum 361 $48 $69 0 -30.66%

84165 Protein e-phoresis serum 348 $187 $134 0 39.11%

84550 Assay of blood/uric acid 348 $63 $62 0 1.34%

80069 Renal function panel 343 $70 $353 -0.02 -80.17%

85046 Reticyte/hgb concentrate 328 $44 $86 0 -48.48%

82947 Assay glucose blood quant 326 $45 $51 0 -12.0%

84132 Assay of serum potassium 324 $62 $74 0 -17.29%

85007 Bl smear w/diff wbc count 323 $44 $55 0 -20.2%

88312 Special stains group 1 303 $319 $213 0.01 50.01%

86618 Lyme disease antibody 293 $137 $140 0 -2.22%

88342 Immunohisto antb 1st stain 292 $262 $337 0 -22.01%

84703 Chorionic gonadotropin assay 291 $93 $156 0 -40.06%

83605 Assay of lactic acid 269 $78 $154 0 -49.09%

86923 Compatibility test electric 267 $228 $180 0 26.94%

85379 Fibrin degradation quant 263 $165 $178 0 -7.65%

86038 Antinuclear antibodies 249 $166 $121 0 36.82%

87015 Specimen infect agnt concntj 235 $119 $68 0 75.74%

P9016 Rbc leukocytes reduced 231 $946 $647 0.01 46.24%

84520 Assay of urea nitrogen 227 $52 $71 0 -26.04%

82378 Carcinoembryonic antigen 227 $174 $202 0 -14.01%

87493 C diff amplified probe 224 $402 $208 0.01 93.1%

87075 Cultr bacteria except blood 202 $138 $199 0 -30.43%

82040 Assay of serum albumin 199 $68 $89 0 -23.45%

P9612 Catheterize for urine spec 182 $18 $103 0 -82.45%

86235 Nuclear antigen antibody 164 $193 $116 0 66.17%

83921 Organic acid single quant 164 $189 $169 0 12.25%

82570 Assay of urine creatinine 163 $49 $64 0 -22.99%

86431 Rheumatoid factor quant 162 $49 $75 0 -33.94%

81015 Microscopic exam of urine 158 $25 $44 0 -43.72%

83516 Immunoassay nonantibody 157 $190 $114 0 67.31%

87340 Hepatitis b surface ag ia 153 $98 $175 0 -43.87%

88313 Special stains group 2 152 $262 $212 0 23.9%

87899 Agent nos assay w/optic 145 $112 $86 0 30.04%

86376 Microsomal antibody each 136 $240 $117 0 105.99%

84156 Assay of protein urine 135 $50 $70 0 -28.31%

84481 Free assay (ft-3) 134 $280 $150 0 86.68%

87046 Stool cultr aerobic bact ea 133 $86 $68 0 26.83%

86780 Treponema pallidum 133 $159 $90 0 76.81%

87045 Feces culture aerobic bact 132 $130 $145 0 -10.03%

87880 Strep a assay w/optic 129 $76 $97 0 -22.05%

G0498 Chemo extend iv infus w/pump 129 $2,678 $917 0.05 192.14%

88307 Tissue exam by pathologist 126 $573 $619 0 -7.34%

86617 Lyme disease antibody 126 $257 $151 0 70.46%

88112 Cytopath cell enhance tech 122 $285 $240 0 19.15%

87329 Giardia ag ia 117 $112 $101 0 10.38%



88304 Tissue exam by pathologist 116 $216 $268 0 -19.3%

87328 Cryptosporidium ag ia 113 $155 $96 0 60.76%

83721 Assay of blood lipoprotein 113 $73 $77 0 -4.92%

87502 Influenza dna amp probe 112 $411 $316 0 30.08%

87389 Hiv-1 ag w/hiv-1 & hiv-2 ab 110 $179 $135 0 32.15%

87491 Chylmd trach dna amp probe 109 $291 $186 0 56.8%

88175 Cytopath c/v auto fluid redo 109 $275 $150 0 83.86%

80164 Assay dipropylacetic acd tot 108 $107 $149 0 -28.22%

87591 N.gonorrhoeae dna amp prob 107 $290 $181 0 60.24%

86706 Hep b surface antibody 103 $103 $175 0 -41.3%

86200 Ccp antibody 103 $165 $114 0 44.12%

83010 Assay of haptoglobin quant 100 $140 $127 0 10.12%

86403 Particle agglut antbdy scrn 98 $80 $116 0 -31.06%

80178 Assay of lithium 98 $67 $90 0 -25.82%

82330 Assay of calcium 92 $113 $142 0 -20.23%

82248 Bilirubin direct 87 $69 $63 0 9.64%

85049 Automated platelet count 87 $49 $68 0 -27.94%

86141 C-reactive protein hs 84 $123 $120 0 2.57%

86666 Ehrlichia antibody 82 $161 $116 0 38.53%

89051 Body fluid cell count 82 $59 $141 0 -58.25%

80074 Acute hepatitis panel 76 $420 $406 0 3.58%

82310 Assay of calcium 75 $48 $95 0 -49.24%

86301 Immunoassay tumor ca 19-9 75 $235 $170 0 37.95%

87624 Hpv high-risk types 75 $349 $178 0 96.16%

82977 Assay of ggt 74 $67 $85 0 -21.24%

84436 Assay of total thyroxine 72 $81 $96 0 -15.49%

82803 Blood gases any combination 71 $159 $292 0 -45.61%

84480 Assay triiodothyronine (t3) 70 $131 $138 0 -4.73%

87076 Culture anaerobe ident each 70 $78 $124 0 -37.13%

82274 Assay test for blood fecal 70 $125 $88 0 41.18%

82553 Creatine mb fraction 65 $73 $195 0 -62.39%

84075 Assay alkaline phosphatase 65 $69 $85 0 -18.76%

80162 Assay of digoxin total 64 $106 $141 0 -24.99%

87210 Smear wet mount saline/ink 63 $39 $74 0 -47.38%

86300 Immunoassay tumor ca 15-3 63 $227 $172 0 32.13%

87081 Culture screen only 62 $58 $111 0 -47.31%

87804 Influenza assay w/optic 62 $27 $116 0 -76.82%

84295 Assay of serum sodium 61 $50 $58 0 -13.11%

86147 Cardiolipin antibody ea ig 60 $153 $146 0 4.96%

86039 Antinuclear antibodies (ana) 58 $188 $106 0 76.48%

88271 Cytogenetics dna probe 58 $332 $230 0 43.97%

86021 Wbc antibody identification 57 $154 $181 0 -15.13%

84134 Assay of prealbumin 57 $116 $133 0 -12.83%

86304 Immunoassay tumor ca 125 55 $165 $198 0 -16.97%

86255 Fluorescent antibody screen 54 $164 $157 0 4.53%



82962 Glucose blood test 54 $16 $44 0 -63.63%

80156 Assay carbamazepine total 53 $115 $158 0 -27.21%

82533 Total cortisol 53 $130 $166 0 -21.63%

80299 Quantitative assay drug 52 $196 $172 0 13.76%

86334 Immunofix e-phoresis serum 52 $254 $220 0 15.63%

87116 Mycobacteria culture 50 $181 $179 0 1.09%

87206 Smear fluorescent/acid stai 50 $93 $94 0 -1.07%

87338 Hpylori stool ia 50 $140 $155 0 -9.4%

86920 Compatibility test spin 50 $126 $210 0 -40.31%

80185 Assay of phenytoin total 50 $102 $152 0 -32.83%

80197 Assay of tacrolimus 49 $127 $232 0 -45.22%

87185 Microbe susceptible enzyme 49 $42 $47 0 -11.41%

86800 Thyroglobulin antibody 47 $230 $117 0 96.77%

86225 Dna antibody native 47 $154 $134 0 15.18%

82140 Assay of ammonia 47 $112 $170 0 -34.34%

87522 Hepatitis c revrs trnscrpj 47 $394 $388 0 1.55%

86870 Rbc antibody identification 46 $319 $308 0 3.29%

87102 Fungus isolation culture 45 $119 $171 0 -30.0%

83519 Ria nonantibody 44 $242 $218 0 11.21%

83520 Immunoassay quant nos nonab 43 $214 $111 0 92.54%

84402 Assay of free testosterone 43 $327 $156 0 109.05%

82105 Alpha-fetoprotein serum 42 $186 $165 0 12.32%

82668 Assay of erythropoietin 42 $211 $153 0 37.76%

88173 Cytopath eval fna report 42 $289 $254 0 13.73%

P9040 Rbc leukoreduced irradiated 42 $1,162 $835 0 39.18%

83993 Assay for calprotectin fecal 41 $175 $257 0 -32.0%

82247 Bilirubin total 40 $139 $58 0 137.26%

80177 Drug scrn quan levetiracetam 39 $192 $143 0 34.62%

88311 Decalcify tissue 39 $100 $89 0 12.5%

82365 Calculus spectroscopy 38 $141 $114 0 23.29%

82525 Assay of copper 37 $191 $100 0 91.64%

86704 Hep b core antibody total 37 $103 $128 0 -19.63%

89055 Leukocyte assessment fecal 37 $41 $68 0 -39.36%

86480 Tb test cell immun measure 36 $560 $270 0 107.35%

82523 Collagen crosslinks 36 $212 $144 0 47.79%

82164 Angiotensin i enzyme test 36 $238 $131 0 81.92%

80051 Electrolyte panel 36 $95 $158 0 -39.52%

82010 Acetone assay 35 $68 $100 0 -32.2%

84166 Protein e-phoresis/urine/csf 35 $303 $148 0 105.05%

87106 Fungi identification yeast 34 $81 $107 0 -23.88%

84403 Assay of total testosterone 33 $234 $178 0 31.28%

84425 Assay of vitamin b-1 32 $355 $145 0 144.42%

82232 Assay of beta-2 protein 32 $271 $146 0 85.86%

88331 Path consult intraop 1 bloc 32 $189 $318 0 -40.64%

88184 Flowcytometry/ tc 1 marker 31 $334 $274 0 22.02%



82787 Igg 1 2 3 or 4 each 31 $44 $92 0 -52.13%

82272 Occult bld feces 1-3 tests 30 $35 $52 0 -32.87%

84154 Assay of psa free 29 $116 $134 0 -13.44%

99195 Phlebotomy 29 $228 $289 0 -21.23%

84702 Chorionic gonadotropin test 28 $142 $220 0 -35.44%

86880 Coombs test direct 28 $128 $97 0 31.03%

82103 Alpha-1-antitrypsin total 28 $232 $119 0 95.15%

88172 Cytp dx eval fna 1st ea site 27 $155 $253 0 -38.79%

82785 Assay of ige 26 $270 $124 0 118.03%

86160 Complement antigen 25 $170 $127 0 33.27%

87798 Detect agent nos dna amp 25 $359 $209 0 71.73%

P9037 Plate pheres leukoredu irrad 25 $3,289 $2,075 0.01 58.52%

88361 Tumor immunohistochem/comput 24 $398 $368 0 8.13%

86317 Immunoassay infectious agent 24 $146 $90 0 62.5%

87254 Virus inoculation shell via 24 $332 $124 0 166.67%

82945 Glucose other fluid 24 $40 $86 0 -53.63%

83090 Assay of homocystine 24 $279 $176 0 59.06%

84300 Assay of urine sodium 24 $48 $72 0 -33.62%

84157 Assay of protein other 24 $33 $94 0 -64.81%

82085 Assay of aldolase 24 $110 $90 0 21.63%

82390 Assay of ceruloplasmin 23 $177 $108 0 64.72%

84080 Assay alkaline phosphatases 23 $167 $125 0 33.38%

86677 Helicobacter pylori antibody 23 $173 $153 0 12.83%

88189 Flowcytometry/read 16 & > 23 $415 $205 0 101.9%

89060 Exam synovial fluid crystals 21 $79 $93 0 -15.06%

83789 Mass spectrometry qual/quan 21 $154 $148 0 4.11%

82652 Vit d 1 25-dihydroxy 21 $511 $255 0 100.13%

80202 Assay of vancomycin 20 $102 $188 0 -45.6%

80184 Assay of phenobarbital 20 $92 $137 0 -33.05%

83051 Assay of plasma hemoglobin 20 $49 $94 0 -48.48%

P9045 Albumin (human) 5% 250 ml 20 $634 $323 0 96.37%

86905 Blood typing rbc antigens 19 $98 $144 0 -31.84%

86753 Protozoa antibody nos 18 $114 $104 0 9.01%

87400 Influenza a/b ag ia 18 $161 $123 0 30.25%

88360 Tumor immunohistochem/manual 17 $396 $395 0 0.48%

86708 Hepatitis a antibody 17 $121 $80 0 51.45%

86705 Hep b core antibody igm 17 $106 $146 0 -27.34%

86606 Aspergillus antibody 17 $166 $84 0 98.07%

86580 Tb intradermal test 16 $30 $38 0 -21.4%

84146 Assay of prolactin 16 $175 $184 0 -4.74%

85384 Fibrinogen activity 16 $89 $141 0 -37.21%

82340 Assay of calcium in urine 16 $48 $66 0 -27.19%

82150 Assay of amylase 16 $89 $121 0 -25.94%

88333 Intraop cyto path consult 1 16 $150 $252 0 -40.54%

88275 Cytogenetics 100-300 16 $340 $320 0 6.18%



88381 Microdissection manual 15 $515 $393 0 31.01%

86609 Bacterium antibody 15 $110 $71 0 54.54%

86812 Hla typing a b or c 15 $234 $189 0 23.64%

85303 Clot inhibit prot c activity 14 $226 $217 0 4.29%

84482 T3 reverse 14 $253 $134 0 89.68%

83525 Assay of insulin 14 $89 $101 0 -11.32%

83001 Assay of gonadotropin (fsh) 14 $168 $164 0 2.57%

81332 Serpina1 gene 14 $286 $338 0 -15.22%

82575 Creatinine clearance test 14 $73 $152 0 -51.91%

81235 Egfr gene com variants 13 $561 $1,278 0 -56.09%

81241 F5 gene 13 $184 $356 0 -48.36%

80159 Drug assay clozapine 13 $198 $113 0 74.65%

83002 Assay of gonadotropin (lh) 13 $166 $168 0 -1.01%

85306 Clot inhibit prot s free 13 $253 $214 0 18.18%

85300 Antithrombin iii activity 13 $208 $186 0 11.82%

87181 Microbe susceptible diffuse 13 $26 $65 0 -59.61%

86316 Immunoassay tumor other 13 $321 $171 0 87.97%

85613 Russell viper venom diluted 13 $104 $117 0 -11.37%

88274 Cytogenetics 25-99 13 $262 $333 0 -21.11%

85670 Thrombin time plasma 12 $60 $94 0 -35.67%

86709 Hepatitis a igm antibody 12 $97 $65 0 48.84%

83655 Assay of lead 12 $133 $79 0 67.54%

83935 Assay of urine osmolality 12 $66 $96 0 -31.08%

81240 F2 gene 12 $222 $374 0 -40.48%

83930 Assay of blood osmolality 11 $66 $99 0 -32.95%

83630 Lactoferrin fecal (qual) 11 $275 $113 0 142.91%

83986 Assay ph body fluid nos 11 $30 $54 0 -43.43%

84466 Assay of transferrin 11 $123 $168 0 -26.7%

86922 Compatibility test antiglob 11 $259 $208 0 24.63%

86308 Heterophile antibody screen 11 $76 $97 0 -21.22%

89050 Body fluid cell count 11 $49 $121 0 -59.24%

88365 Insitu hybridization (fish) 11 $422 $428 0 -1.41%

87902 Genotype dna/rna hep c 11 $610 $980 0 -37.8%

P9059 Plasma frz between 8-24hour 11 $416 $240 0 73.59%

86762 Rubella antibody * * * 0 122.52%

87176 Tissue homogenization cultr * * * 0 -27.23%

84207 Assay of vitamin b-6 * * * 0 122.07%

84078 Assay alkaline phosphatase * * * 0 -30.47%

80195 Assay of sirolimus * * * 0 -57.16%

81275 Kras gene variants exon 2 * * * 0 -90.62%

81276 Kras gene addl variants * * * 0 53.18%

80203 Drug screen quant zonisamide * * * 0 27.81%

84145 Procalcitonin (pct) * * * 0 70.69%

84478 Assay of triglycerides * * * 0 -26.74%

84681 Assay of c-peptide * * * 0 141.23%



87149 Dna/rna direct probe * * * 0 28.65%

87300 Ag detection polyval if * * * 0 6.13%

86902 Blood type antigen donor ea * * * 0 115.45%

P9047 Albumin (human) 25% 50ml * * * 0 73.82%

88309 Tissue exam by pathologist * * * 0 -0.53%

P9035 Platelet pheres leukoreduced * * * 0 46.95%

87801 Detect agnt mult dna ampli * * * 0 62.37%

87529 Hsv dna amp probe * * * 0 39.3%

87536 Hiv-1 quant&revrse trnscrpj * * * 0 4.62%

88374 M/phmtrc alys ishquant/semiq * * * 0 90.01%

86711 John cunningham antibody * * * 0 -85.58%

87301 Adenovirus ag ia * * * 0 8.59%

87252 Virus inoculation tissue * * * 0 31.3%

86695 Herpes simplex type 1 test * * * 0 105.2%

86696 Herpes simplex type 2 test * * * 0 166.37%

86146 Beta-2 glycoprotein antibody * * * 0 89.95%

87177 Ova and parasites smears * * * 0 0.25%

84238 Assay nonendocrine receptor * * * 0 111.08%

84181 Western blot test * * * 0 -35.06%

83825 Assay of mercury * * * 0 147.14%

82950 Glucose test * * * 0 14.01%

80170 Assay of gentamicin * * * 0 -31.66%

81256 Hfe gene * * * 0 -56.88%

82172 Assay of apolipoprotein * * * 0 144.49%

82175 Assay of arsenic * * * 0 166.08%

82595 Assay of cryoglobulin * * * 0 -6.6%

82670 Assay of estradiol * * * 0 28.32%

88302 Tissue exam by pathologist * * * 0 7.59%

88346 Immunofluor antb 1st stain * * * 0 -24.6%

87350 Hepatitis be ag ia * * * 0 1.08%

88120 Cytp urne 3-5 probes ea spec * * * 0 103.07%

88237 Tissue culture bone marrow * * * 0 -53.9%

82384 Assay three catecholamines * * * 0 79.78%

82300 Assay of cadmium * * * 0 113.05%

83915 Assay of nucleotidase * * * 0 -21.04%

84133 Assay of urine potassium * * * 0 -31.44%

84244 Assay of renin * * * 0 58.33%

84630 Assay of zinc * * * 0 118.71%

87107 Fungi identification mold * * * 0 18.81%

87209 Smear complex stain * * * 0 79.02%

86787 Varicella-zoster antibody * * * 0 46.62%

86860 Rbc antibody elution * * * 0 -7.06%

86921 Compatibility test incubate * * * 0 36.34%

86148 Anti-phospholipid antibody * * * 0 64.2%

86335 Immunfix e-phorsis/urine/csf * * * 0 18.15%



86162 Complement total (ch50) * * * 0 44.19%

86665 Epstein-barr capsid vca * * * 0 66.95%

86682 Helminth antibody * * * 0 -20.94%

86611 Bartonella antibody * * * 0 89.62%

86331 Immunodiffusion ouchterlony * * * 0 110.56%

86707 Hepatitis be antibody * * * 0 11.37%

86744 Nocardia antibody * * * 0 35.06%

84540 Assay of urine/urea-n * * * 0 -39.25%

85004 Automated diff wbc count * * * 0 44.23%

85048 Automated leukocyte count * * * 0 75.87%

85097 Bone marrow interpretation * * * 0 15.76%

84270 Assay of sex hormone globul * * * 0 228.32%

84311 Spectrophotometry * * * 0 -38.64%

82985 Assay of glycated protein * * * 0 80.06%

82024 Assay of acth * * * 0 21.35%

82088 Assay of aldosterone * * * 0 120.46%

82542 Col chromotography qual/quan * * * 0 -24.08%

82436 Assay of urine chloride * * * 0 -25.57%

81025 Urine pregnancy test * * * 0 -81.9%

80201 Assay of topiramate * * * 0 25.69%

88264 Chromosome analysis 20-25 * * * 0 33.92%

88348 Electron microscopy * * * 0 52.76%

88300 Surgical path gross * * * 0 -6.53%

88334 Intraop cyto path consult 2 * * * 0 -33.53%

88187 Flowcytometry/read 2-8 * * * 0 128.87%

87517 Hepatitis b dna quant * * * 0 64.84%

87631 Resp virus 3-5 targets * * * 0 35.17%

80173 Assay of haloperidol * * * 0 55.04%

80158 Drug assay cyclosporine * * * 0 -2.51%

82465 Assay bld/serum cholesterol * * * 0 -17.24%

82435 Assay of blood chloride * * * 0 17.65%

82656 Pancreatic elastase fecal * * * 0 -26.53%

82627 Dehydroepiandrosterone * * * 0 151.39%

82552 Assay of cpk in blood * * * 0 -41.04%

82042 Other source albumin quan ea * * * 0 -44.92%

81374 Hla i typing 1 antigen lr * * * 0 -17.38%

83013 H pylori (c-13) breath * * * 0 98.53%

82941 Assay of gastrin * * * 0 50.84%

83695 Assay of lipoprotein(a) * * * 0 32.82%

83835 Assay of metanephrines * * * 0 2.86%

84479 Assay of thyroid (t3 or t4) * * * 0 -9.52%

85210 Clot factor ii prothrom spec * * * 0 56.31%

85240 Clot factor viii ahg 1 stage * * * 0 35.96%

85576 Blood platelet aggregation * * * 0 143.6%

86628 Candida antibody * * * 0 144.68%



86360 T cell absolute count/ratio * * * 0 -40.85%

86361 T cell absolute count * * * 0 -23.51%

86592 Syphilis test non-trep qual * * * 0 -7.48%

86664 Epstein-barr nuclear antigen * * * 0 99.9%

86698 Histoplasma antibody * * * 0 48.0%

86336 Inhibin a * * * 0 16.37%

85651 Rbc sed rate nonautomated * * * 0 46.39%

85660 Rbc sickle cell test * * * 0 149.02%

86735 Mumps antibody * * * 0 29.94%

86765 Rubeola antibody * * * 0 9.13%

87207 Smear special stain * * * 0 -25.43%

87255 Genet virus isolate hsv * * * 0 141.42%

87281 Pneumocystis carinii ag if * * * 0 -17.62%

84590 Assay of vitamin a * * * 0 12.19%

84445 Assay of tsi globulin * * * 0 131.07%

84432 Assay of thyroglobulin * * * 0 92.7%

84144 Assay of progesterone * * * 0 25.7%

84152 Assay of psa complexed * * * 0 13.1%

83021 Hemoglobin chromotography * * * 0 73.01%

82955 Assay of g6pd enzyme * * * 0 70.05%

82677 Assay of estriol * * * 0 78.43%

82705 Fats/lipids feces qual * * * 0 32.83%

82710 Fats/lipids feces quant * * * 0 -12.95%

80171 Drug screen quant gabapentin * * * 0 30.5%

80305 Drug test prsmv dir opt obs * * * 0 -39.1%

88344 Immunohisto antibody slide * * * 0 -18.55%

88332 Path consult intraop addl * * * 0 -55.25%

88368 Insitu hybridization manual * * * 0 50.04%

G0472 Hep c screen high risk/other * * * 0 -9.13%

88188 Flowcytometry/read 9-15 * * * 0 179.65%

80188 Assay of primidone * * * 0 17.52%

82530 Cortisol free * * * 0 30.97%

81376 Hla ii typing 1 locus lr * * * 0 110.72%

81382 Hla ii typing 1 loc hr * * * 0 -3.07%

81401 Mopath procedure level 2 * * * 0 -37.99%

82135 Assay aminolevulinic acid * * * 0 -8.8%

81220 Cftr gene com variants * * * 0 -60.11%

82747 Assay of folic acid rbc * * * 0 73.64%

84110 Assay of porphobilinogen * * * 0 0.01%

83874 Assay of myoglobin * * * 0 -42.08%

83916 Oligoclonal bands * * * 0 99.22%

84446 Assay of vitamin e * * * 0 48.35%

84302 Assay of sweat sodium * * * 0 -31.04%

84305 Assay of somatomedin * * * 0 22.56%

84255 Assay of selenium * * * 0 45.64%



84585 Assay of urine vma * * * 0 116.27%

85598 Hexagnal phosph pltlt neutrl * * * 0 -72.07%

85460 Hemoglobin fetal * * * 0 56.34%

85245 Clot factor viii vw ristoctn * * * 0 61.81%

87305 Aspergillus ag ia * * * 0 -15.84%

87168 Macroscopic exam arthropod * * * 0 -20.57%

86738 Mycoplasma antibody * * * 0 27.49%

86747 Parvovirus antibody * * * 0 39.61%

85810 Blood viscosity examination * * * 0 36.93%

85635 Reptilase test * * * 0 -34.94%

86060 Antistreptolysin o titer * * * 0 34.44%

86256 Fluorescent antibody titer * * * 0 102.29%

86645 Cmv antibody igm * * * 0 43.65%

86593 Syphilis test non-trep quant * * * 0 -45.18%

86332 Immune complex assay * * * 0 57.55%

86631 Chlamydia antibody * * * 0 173.21%

86635 Coccidioides antibody * * * 0 96.55%

86648 Diphtheria antibody * * * 0 -30.7%

86684 Hemophilus influenza antibdy * * * 0 -41.13%

86694 Herpes simplex nes antbdy * * * 0 126.24%

86226 Dna antibody single strand * * * 0 41.43%

86215 Deoxyribonuclease antibody * * * 0 10.93%

86340 Intrinsic factor antibody * * * 0 39.09%

86355 B cells total count * * * 0 -48.32%

86356 Mononuclear cell antigen * * * 0 -46.25%

86359 T cells total count * * * 0 -46.53%

86022 Platelet antibodies * * * 0 23.63%

86156 Cold agglutinin screen * * * 0 66.41%

86784 Trichinella antibody * * * 0 -30.48%

86790 Virus antibody nos * * * 0 -10.51%

86774 Tetanus antibody * * * 0 74.33%

87140 Culture type immunofluoresc * * * 0 40.66%

87184 Microbe susceptible disk * * * 0 -43.88%

87220 Tissue exam for fungi * * * 0 -53.81%

85246 Clot factor viii vw antigen * * * 0 74.75%

85247 Clot factor viii multimetric * * * 0 63.13%

85302 Clot inhibit prot c antigen * * * 0 -44.53%

84999 Clinical chemistry test * * * 0 -60.54%

84182 Protein western blot test * * * 0 16.21%

83945 Assay of oxalate * * * 0 21.92%

84112 Eval amniotic fluid protein * * * 0 46.33%

82943 Assay of glucagon * * * 0 370.4%

83018 Heavy metal quant each nes * * * 0 27.03%

83704 Lipoprotein bld quan part * * * 0 89.59%

83718 Assay of lipoprotein * * * 0 -8.0%



83497 Assay of 5-hiaa * * * 0 90.26%

82163 Assay of angiotensin ii * * * 0 -18.06%

82180 Assay of ascorbic acid * * * 0 66.62%

82104 Alpha-1-antitrypsin pheno * * * 0 -12.89%

81402 Mopath procedure level 3 * * * 0 -31.65%

81479 Unlisted molecular pathology * * * 0 143.35%

81301 Microsatellite instability * * * 0 1,266.47%

82495 Assay of chromium * * * 0 -12.01%

82438 Assay other fluid chlorides * * * 0 -56.0%

82397 Chemiluminescent assay * * * 0 -44.65%

82374 Assay blood carbon dioxide * * * 0 -12.41%

82375 Assay carboxyhb quant * * * 0 51.66%

82672 Assay of estrogen * * * 0 135.81%

80168 Assay of ethosuximide * * * 0 15.55%

80345 Drug screening barbiturates * * * 0 104.95%

81210 Braf gene * * * 0 -33.53%

81219 Calr gene com variants * * * 0 46.05%

81261 Igh gene rearrange amp meth * * * 0 28.66%

81264 Igk rearrangeabn clonal pop * * * 0 28.16%

81002 Urinalysis nonauto w/o scope * * * 0 -61.45%

88239 Tissue culture tumor * * * 0 76.34%

88108 Cytopath concentrate tech * * * 0 -8.7%

87900 Phenotype infect agent drug * * * 0 79.83%

87901 Genotype dna hiv reverse t * * * 0 -7.63%

87496 Cytomeg dna amp probe * * * 0 -52.99%

87497 Cytomeg dna quant * * * 0 6.01%

Pathology & Laboratory Totals: * $109 $146

49.19% 74.38%

Physical Medicine

97110 Therapeutic exercises 7623 $106 $85 0.61 24.0%

97140 Manual therapy 1/> regions 2830 $109 $106 0.03 2.46%

97803 Med nutrition indiv subseq 1114 $69 $71 -0.01 -3.04%

97535 Self care mngment training 543 $102 $55 0.1 84.25%

97802 Medical nutrition indiv in 536 $70 $72 0 -1.99%

97035 Ultrasound therapy 529 $106 $71 0.07 50.02%

97161 Pt eval low complex 20 min 511 $261 $246 0.03 6.01%

97113 Aquatic therapy/exercises 442 $107 $118 -0.02 -9.65%

97162 Pt eval mod complex 30 min 368 $261 $253 0.01 3.09%

97116 Gait training therapy 303 $105 $53 0.06 98.62%

97602 Wound(s) care non-selective 184 $217 $294 -0.06 -26.24%

97165 Ot eval low complex 30 min 170 $315 $213 0.07 48.01%

97530 Therapeutic activities 162 $102 $57 0.03 77.95%

97597 Rmvl devital tis 20 cm/< 123 $416 $433 -0.01 -3.92%

97166 Ot eval mod complex 45 min 121 $344 $211 0.06 63.02%

97760 Orthotic mgmt&trainj 1st enc 111 $111 $65 0.02 71.24%



97012 Mechanical traction therapy 69 $102 $96 0 6.2%

97163 Pt eval high complex 45 min 61 $261 $288 -0.01 -9.34%

97605 Neg press wound tx </=50 cm 41 $312 $346 -0.01 -10.02%

97804 Medical nutrition group 32 $76 $53 0 43.4%

97112 Neuromuscular reeducation 20 $112 $71 0 57.39%

97018 Paraffin bath therapy * * * 0 10.68%

97606 Neg press wound tx >50 cm * * * 0 50.14%

92523 Speech sound lang comprehen * * * 0 11.83%

97167 Ot eval high complex 60 min * * * 0 57.0%

92522 Evaluate speech production * * * 0 9.13%

97014 Electric stimulation therapy * * * 0 52.65%

92524 Behavral qualit analys voice * * * 0 -12.29%

97598 Rmvl devital tis addl 20cm/< * * * 0 -24.53%

97542 Wheelchair mngment training * * * 0 133.9%

97532 Cognitive skills development * * * 0 115.6%

97168 Ot re-eval est plan care * * * 0 -10.77%

97164 Pt re-eval est plan care * * * 0 1.02%

97032 Electrical stimulation * * * 0 18.05%

Physical Medicine Totals: * $120 $104

5.98% 115.42%

Physician Services

G0463 Hospital outpt clinic visit 38185 $116 $175 -1.02 -33.72%

99291 Critical care first hour 54 $3,141 $2,951 0 6.41%

99292 Critical care addl 30 min 17 $2,127 $962 0.01 120.99%

99156 Mod sed oth phys/qhp 5/>yrs 17 $803 $424 0 89.43%

96125 Cognitive test by hc pro 12 $360 $252 0 42.71%

99152 Mod sed same phys/qhp 5/>yrs * * * 0 57.21%

99155 Mod sed oth phys/qhp <5 yrs * * * 0 100.34%

99157 Mod sed other phys/qhp ea * * * 0 100.74%

93229 Remote 30 day ecg tech supp * * * 0 102.85%

Physician Services Totals: * $121 $179

14.38% 67.81%

Radiology

71020 Chest x-ray 2721 $285 $380 -0.09 -25.19%

77063 Breast tomosynthesis bi 1762 $50 $97 -0.03 -47.81%

93306 Tte w/doppler complete 1566 $2,367 $2,445 -0.04 -3.2%

71010 Chest x-ray 1348 $266 $362 -0.04 -26.34%

70450 Ct head/brain w/o dye 1160 $1,288 $2,118 -0.32 -39.16%

77080 Dxa bone density axial 741 $406 $560 -0.04 -27.48%

74177 Ct abd & pelv w/contrast 620 $4,236 $4,499 -0.05 -5.83%

78452 Ht muscle image spect mult 523 $4,891 $4,588 0.05 6.6%

71275 Ct angiography chest 381 $2,802 $3,124 -0.04 -10.29%

73630 X-ray exam of foot 372 $284 $399 -0.01 -28.89%

72125 Ct neck spine w/o dye 362 $1,633 $2,533 -0.11 -35.51%

71250 Ct thorax w/o dye 348 $1,626 $2,058 -0.05 -20.95%



72100 X-ray exam l-s spine 2/3 vws 338 $352 $474 -0.01 -25.8%

71260 Ct thorax w/dye 322 $1,895 $2,522 -0.07 -24.87%

73502 X-ray exam hip uni 2-3 views 266 $271 $399 -0.01 -32.23%

73562 X-ray exam of knee 3 264 $272 $429 -0.01 -36.49%

74174 Ct angio abd&pelv w/o&w/dye 257 $5,134 $4,695 0.04 9.35%

74176 Ct abd & pelvis w/o contrast 253 $3,013 $3,889 -0.07 -22.53%

76705 Echo exam of abdomen 231 $562 $824 -0.02 -31.82%

73030 X-ray exam of shoulder 225 $242 $425 -0.01 -43.15%

76775 Us exam abdo back wall lim 205 $708 $775 0 -8.65%

75572 Ct hrt w/3d image 174 $2,651 $1,968 0.04 34.7%

76937 Us guide vascular access 171 $286 $673 -0.02 -57.55%

70551 Mri brain stem w/o dye 161 $3,551 $3,105 0.02 14.35%

76536 Us exam of head and neck 155 $615 $785 -0.01 -21.66%

C8929 Tte w or wo fol wcondoppler 155 $2,138 $2,616 -0.02 -18.28%

73610 X-ray exam of ankle 153 $284 $413 -0.01 -31.21%

76999 Echo examination procedure 146 $111 $521 -0.02 -78.69%

76642 Ultrasound breast limited 146 $473 $506 0 -6.5%

70553 Mri brain stem w/o & w/dye 141 $4,350 $4,435 0 -1.92%

72148 Mri lumbar spine w/o dye 136 $2,860 $3,051 -0.01 -6.27%

76700 Us exam abdom complete 126 $713 $1,109 -0.02 -35.75%

76376 3d render w/intrp postproces 123 $459 $551 0 -16.76%

73130 X-ray exam of hand 122 $238 $424 -0.01 -43.9%

78815 Pet image w/ct skull-thigh 106 $7,592 $7,046 0.02 7.74%

74020 X-ray exam of abdomen 92 $239 $420 -0.01 -43.08%

78451 Ht muscle image spect sing 88 $2,138 $3,533 -0.04 -39.49%

72040 X-ray exam neck spine 2-3 vw 85 $410 $444 0 -7.58%

73110 X-ray exam of wrist 82 $243 $412 0 -41.05%

70355 Panoramic x-ray of jaws 80 $350 $277 0 26.44%

70486 Ct maxillofacial w/o dye 79 $1,555 $2,092 -0.01 -25.66%

74183 Mri abdomen w/o & w/dye 78 $4,361 $4,514 0 -3.4%

77001 Fluoroguide for vein device 77 $1,832 $846 0.03 116.65%

78306 Bone imaging whole body 76 $2,145 $2,056 0 4.31%

72070 X-ray exam thorac spine 2vws 75 $339 $441 0 -23.11%

74420 Contrst x-ray urinary tract 72 $1,429 $1,040 0.01 37.4%

C8930 Tte w or w/o contr cont ecg 72 $4,412 $2,827 0.04 56.09%

77012 Ct scan for needle biopsy 68 $2,027 $2,270 -0.01 -10.7%

73590 X-ray exam of lower leg 67 $338 $410 0 -17.54%

75625 Contrast exam abdominl aorta 66 $7,461 $5,037 0.05 48.14%

72020 X-ray exam of spine 1 view 65 $316 $360 0 -12.11%

76856 Us exam pelvic complete 62 $543 $921 -0.01 -41.06%

76770 Us exam abdo back wall comp 60 $574 $905 -0.01 -36.54%

74000 X-ray exam of abdomen 60 $272 $350 0 -22.07%

70498 Ct angiography neck 59 $2,362 $3,034 -0.01 -22.14%

72050 X-ray exam neck spine 4/5vws 58 $430 $627 0 -31.32%

74220 Contrast x-ray esophagus 57 $504 $653 0 -22.76%



75710 Artery x-rays arm/leg 57 $3,326 $4,965 -0.03 -33.01%

71101 X-ray exam unilat ribs/chest 56 $341 $528 0 -35.49%

71100 X-ray exam ribs uni 2 views 55 $342 $413 0 -17.26%

76830 Transvaginal us non-ob 55 $537 $765 0 -29.78%

72170 X-ray exam of pelvis 54 $202 $380 0 -46.95%

74230 Cine/vid x-ray throat/esoph 51 $471 $673 0 -29.91%

74178 Ct abd & pelv 1/> regns 50 $5,157 $5,072 0 1.66%

73080 X-ray exam of elbow 49 $326 $437 0 -25.41%

72141 Mri neck spine w/o dye 48 $2,865 $2,662 0 7.62%

74022 X-ray exam series abdomen 47 $387 $599 0 -35.39%

73620 X-ray exam of foot 46 $361 $362 0 -0.08%

72131 Ct lumbar spine w/o dye 46 $1,629 $2,471 -0.01 -34.07%

76706 Us abdl aorta screen aaa 46 $685 $534 0 28.3%

76942 Echo guide for biopsy 45 $1,068 $931 0 14.73%

70544 Mr angiography head w/o dye 43 $2,836 $2,915 0 -2.72%

73090 X-ray exam of forearm 42 $240 $398 0 -39.69%

76870 Us exam scrotum 41 $642 $844 0 -23.95%

76882 Us lmtd jt/nonvasc xtr strux 41 $811 $504 0 60.95%

78264 Gastric emptying imag study 40 $1,770 $1,988 0 -10.97%

73060 X-ray exam of humerus 40 $243 $392 0 -37.86%

73120 X-ray exam of hand 40 $314 $385 0 -18.35%

72158 Mri lumbar spine w/o & w/dye 39 $4,319 $4,345 0 -0.59%

70496 Ct angiography head 37 $2,428 $3,088 -0.01 -21.35%

75635 Ct angio abdominal arteries 37 $3,140 $3,158 0 -0.57%

73523 X-ray exam hips bi 5/> views 36 $522 $721 0 -27.59%

73552 X-ray exam of femur 2/> 35 $418 $389 0 7.64%

70491 Ct soft tissue neck w/dye 35 $1,969 $2,443 -0.01 -19.38%

76857 Us exam pelvic limited 35 $493 $542 0 -8.99%

73140 X-ray exam of finger(s) 31 $238 $310 0 -23.32%

73700 Ct lower extremity w/o dye 31 $2,127 $2,017 0 5.45%

74246 Contrst x-ray uppr gi tract 31 $1,081 $883 0 22.36%

75716 Artery x-rays arms/legs 30 $10,927 $5,588 0.05 95.53%

74160 Ct abdomen w/dye 29 $2,677 $2,586 0 3.51%

70549 Mr angiograph neck w/o&w/dye 26 $4,157 $3,917 0 6.1%

72146 Mri chest spine w/o dye 25 $2,882 $3,049 0 -5.49%

74181 Mri abdomen w/o dye 24 $2,750 $3,072 0 -10.47%

73721 Mri jnt of lwr extre w/o dye 23 $2,886 $2,939 0 -1.81%

73560 X-ray exam of knee 1 or 2 23 $299 $354 0 -15.61%

72197 Mri pelvis w/o & w/dye 23 $4,355 $4,491 0 -3.02%

73650 X-ray exam of heel 21 $284 $319 0 -11.09%

75736 Artery x-rays pelvis 19 $7,654 $5,137 0.02 49.0%

73221 Mri joint upr extrem w/o dye 19 $2,588 $2,869 0 -9.77%

78582 Lung ventilat&perfus imaging 18 $3,701 $2,255 0.01 64.09%

72220 X-ray exam sacrum tailbone 17 $271 $420 0 -35.38%

73660 X-ray exam of toe(s) 17 $241 $309 0 -21.95%



72192 Ct pelvis w/o dye 15 $1,519 $2,185 0 -30.49%

76000 Fluoroscopy <1 hr phys/qhp 14 $450 $676 0 -33.42%

73564 X-ray exam knee 4 or more 13 $306 $501 0 -39.05%

73501 X-ray exam hip uni 1 view 13 $267 $321 0 -16.8%

74249 Contrst x-ray uppr gi tract 13 $1,477 $1,282 0 15.26%

72156 Mri neck spine w/o & w/dye 13 $4,378 $4,435 0 -1.28%

0346T Ultrasound elastography 13 $176 $430 0 -59.16%

78227 Hepatobil syst image w/drug 13 $2,895 $2,149 0 34.72%

76641 Ultrasound breast complete 13 $699 $701 0 -0.28%

70220 X-ray exam of sinuses 12 $347 $483 0 -28.2%

72193 Ct pelvis w/dye 12 $1,991 $2,486 0 -19.9%

72120 X-ray bend only l-s spine 12 $385 $495 0 -22.09%

72128 Ct chest spine w/o dye 11 $1,614 $2,381 0 -32.22%

73000 X-ray exam of collar bone 11 $238 $361 0 -34.01%

74170 Ct abdomen w/o & w/dye 11 $2,648 $3,106 0 -14.76%

73600 X-ray exam of ankle * * * 0 -23.16%

76098 X-ray exam surgical specimen * * * 0 -66.86%

75726 Artery x-rays abdomen * * * 0 16.68%

73200 Ct upper extremity w/o dye * * * 0 14.89%

72110 X-ray exam l-2 spine 4/>vws * * * 0 -48.25%

78607 Brain imaging (3d) * * * 0 -8.4%

C8908 Mri w/o fol w/cont breast * * * 0.01 68.19%

77074 X-rays bone survey limited * * * 0 -41.08%

76805 Ob us >/= 14 wks sngl fetus * * * 0 -15.57%

76816 Ob us follow-up per fetus * * * 0 -6.76%

72132 Ct lumbar spine w/dye * * * 0 -28.6%

71111 X-ray exam ribs/chest4/> vws * * * 0 -43.52%

73070 X-ray exam of elbow * * * 0 -8.57%

73100 X-ray exam of wrist * * * 0 -10.89%

74400 Contrst x-ray urinary tract * * * 0 -30.63%

70460 Ct head/brain w/dye * * * 0 -30.17%

74430 Contrast x-ray bladder * * * 0 -13.13%

73565 X-ray exam of knees * * * 0 9.28%

73701 Ct lower extremity w/dye * * * 0 -19.22%

73718 Mri lower extremity w/o dye * * * 0 -7.42%

74150 Ct abdomen w/o dye * * * 0 -31.87%

78071 Parathyrd planar w/wo subtrj * * * 0 -9.98%

76801 Ob us < 14 wks single fetus * * * 0 -23.84%

77002 Needle localization by xray * * * 0 71.57%

74175 Ct angio abdom w/o & w/dye * * * 0 -10.17%

74250 X-ray exam of small bowel * * * 0 34.25%

73720 Mri lwr extremity w/o&w/dye * * * 0 11.02%

72202 X-ray exam si joints 3/> vws * * * 0 -49.97%

70487 Ct maxillofacial w/dye * * * 0 -1.12%

70360 X-ray exam of neck * * * 0 -36.16%



70150 X-ray exam of facial bones * * * 0 -34.57%

71035 Chest x-ray * * * 0 -16.32%

74330 X-ray bile/panc endoscopy * * * 0 -43.84%

75984 Xray control catheter change * * * 0 33.49%

78215 Liver and spleen imaging * * * 0 6.45%

78226 Hepatobiliary system imaging * * * 0 -9.39%

78315 Bone imaging 3 phase * * * 0 -4.09%

C8902 Mra w/o fol w/cont abd * * * 0 1.56%

76998 Us guide intraop * * * 0 -35.36%

74300 X-ray bile ducts/pancreas * * * 0 -3.19%

74270 Contrast x-ray exam of colon * * * 0 -31.21%

73010 X-ray exam of shoulder blade * * * 0 -40.3%

72195 Mri pelvis w/o dye * * * 0 -0.77%

70480 Ct orbit/ear/fossa w/o dye * * * 0 -21.66%

70030 X-ray eye for foreign body * * * 0 -15.98%

72157 Mri chest spine w/o & w/dye * * * 0 -4.42%

73522 X-ray exam hips bi 3-4 views * * * 0 -22.71%

71110 X-ray exam ribs bil 3 views * * * 0 -15.13%

72114 X-ray exam l-s spine bending * * * 0 -41.24%

71552 Mri chest w/o & w/dye * * * 0 -3.91%

73723 Mri joint lwr extr w/o&w/dye * * * 0 2.51%

75827 Vein x-ray chest * * * 0 6.5%

75894 X-rays transcath therapy * * * 0 -38.16%

76604 Us exam chest * * * 0 -25.89%

76815 Ob us limited fetus(s) * * * 0 -8.43%

78708 K flow/funct image w/drug * * * 0 -31.47%

78014 Thyroid imaging w/blood flow * * * 0 18.49%

78707 K flow/funct image w/o drug * * * 0 -6.28%

78816 Pet image w/ct full body * * * 0 11.27%

79445 Nuclear rx intra-arterial * * * 0 -10.13%

C8914 Mra w/o fol w/cont lwr ext * * * 0 -38.68%

C8920 Mra w/o fol w/cont pelvis * * * 0 -11.72%

77300 Radiation therapy dose plan * * * 0 -13.59%

77790 Radiation handling * * * 0 -82.83%

76377 3d render w/intrp postproces * * * 0 -0.96%

75605 Contrast exam thoracic aorta * * * 0.01 122.67%

75820 Vein x-ray arm/leg * * * 0 72.07%

71023 Chest x-ray and fluoroscopy * * * 0 -10.33%

73551 X-ray exam of femur 1 * * * 0 3.45%

70481 Ct orbit/ear/fossa w/dye * * * 0 -7.22%

70490 Ct soft tissue neck w/o dye * * * 0 -10.6%

70160 X-ray exam of nasal bones * * * 0 -29.85%

73218 Mri upper extremity w/o dye * * * 0 -4.67%

73220 Mri uppr extremity w/o&w/dye * * * 0 7.22%

71030 Chest x-ray * * * 0 -42.17%



71120 X-ray exam breastbone 2/>vws * * * 0 -15.64%

71550 Mri chest w/o dye * * * 0 -3.45%

72126 Ct neck spine w/dye * * * 0 -19.11%

75989 Abscess drainage under x-ray * * * 0 24.91%

75571 Ct hrt w/o dye w/ca test * * * 0 -53.18%

75574 Ct angio hrt w/3d image * * * 0 104.53%

74280 Contrast x-ray exam of colon * * * 0 33.25%

74240 X-ray upper gi delay w/o kub * * * 0 -15.2%

76872 Us transrectal * * * 0 2.07%

C8911 Mra w/o fol w/cont chest * * * 0 -21.11%

79005 Nuclear rx oral admin * * * 0 -24.22%

78320 Bone imaging (3d) * * * 0 -1.85%

78472 Gated heart planar single * * * 0 2.1%

78579 Lung ventilation imaging * * * 0 -11.74%

78605 Brain image 4+ views * * * 0 -54.2%

78300 Bone imaging limited area * * * 0 21.21%

78802 Tumor imaging whole body * * * 0 -22.93%

C8925 2d tee w or w/o fol w/conin * * * 0 -5.01%

77003 Fluoroguide for spine inject * * * 0 197.46%

78012 Thyroid uptake measurement * * * 0 -23.01%

77013 Ct guide for tissue ablation * * * 0 -15.09%

76819 Fetal biophys profil w/o nst * * * 0 13.69%

76810 Ob us >/= 14 wks addl fetus * * * 0 -15.02%

76831 Echo exam uterus * * * 0 18.08%

74245 X-ray upper gi&small intest * * * 0 33.7%

74010 X-ray exam of abdomen * * * 0 -34.85%

75600 Contrast exam thoracic aorta * * * 0 69.44%

74455 X-ray urethra/bladder * * * 0 -15.55%

74425 Contrst x-ray urinary tract * * * 0 -15.88%

75901 Remove cva device obstruct * * * 0 27.47%

75825 Vein x-ray trunk * * * 0 -33.72%

75774 Artery x-ray each vessel * * * 0 -47.34%

75809 Nonvascular shunt x-ray * * * 0 -18.84%

76001 Fluoroscope exam extensive * * * 0 126.08%

72052 X-ray exam neck spine 6/>vws * * * 0 -33.29%

71130 X-ray strenoclavic jt 3/>vws * * * 0 -13.18%

71270 Ct thorax w/o & w/dye * * * 0 -30.07%

70552 Mri brain stem w/dye * * * 0 -11.64%

73206 Ct angio upr extrm w/o&w/dye * * * 0 -7.87%

73223 Mri joint upr extr w/o&w/dye * * * 0 12.48%

70470 Ct head/brain w/o & w/dye * * * 0 -25.81%

70546 Mr angiograph head w/o&w/dye * * * 0 5.86%

70547 Mr angiography neck w/o dye * * * 0 -4.78%

70110 X-ray exam of jaw 4/> views * * * 0 -38.08%

Radiology Totals: * $1,367 $1,516



7.58% 90.17%

Respiratory

94761 Measure blood oxygen level 683 $142 $144 -0.01 -1.62%

94640 Airway inhalation treatment 546 $102 $193 -0.23 -47.3%

94729 Co/membane diffuse capacity 492 $285 $397 -0.26 -28.37%

94060 Evaluation of wheezing 406 $653 $644 0.02 1.33%

94726 Pulm funct tst plethysmograp 290 $250 $491 -0.32 -49.15%

94010 Breathing capacity test 201 $341 $356 -0.01 -4.18%

94727 Pulm function test by gas 191 $243 $395 -0.13 -38.47%

94664 Evaluate pt use of inhaler 178 $122 $187 -0.05 -34.7%

94669 Mechanical chest wall oscill 44 $218 $198 0 10.26%

94760 Measure blood oxygen level 20 $69 $88 0 -21.43%

95070 Bronchial allergy tests 16 $954 $688 0.02 38.75%

94762 Measure blood oxygen level 12 $285 $410 -0.01 -30.56%

94660 Pos airway pressure cpap 11 $615 $782 -0.01 -21.41%

94690 Exhaled air analysis * * * 0 -26.77%

94150 Vital capacity test * * * 0 11.95%

94002 Vent mgmt inpat init day * * * 0 3.41%

Respiratory Totals: * $262 $331

1.17% 79.07%

Transportation

P9604 One-way allow prorated trip 526 $6 $14 -1 -56.19%

Transportation Totals: 526 $6 $14

0.2% 43.8%

Weighted Totals

Weighted Totals Totals: * $341 $369

100.0% 92.25%



General Hospital

Service Pricing Analysis Detail

CMS Outpatient Standard Analytical File - Medicare Patients - Non-Surgical - Calendar Year 2017



general hospital hospital images...93041 rhythm ecg tracing 23 $30 $153 0 -80.37% 93307 tte w/o...

Documents