Office Visit / Minimal / no physician

99211

$      9.49

Office Visit / Problem focused History / exam 

99212

$    26.04

Preventive Visit

99395 / 99396 / 99397

$    26.04

Office Visit / Detailed History/ Detailed Exam

99213 /99214 / 99215

$    50.96

Office Visit / Problem focused History / exam

99201

$    26.77

Office Visit / Expanded problem focused history/ exam

99202

$    50.67

Preventive Visit

99385 / 99386 /  99387  

$    50.67

Office Visit / Detailed History/ Detailed Exam

99203 / 99204 / 99205

$    77.44

Colposcopy of the cervix

57452

$    95.91

Colposcopy with biopsy and endocervical curettage

57454

$   142.81

Colposcopy with biopsy(s) of the cervix

57455

$   116.50

Colposcopy of the cervix with endocervical curettage (biopsy)

57456

$   108.75

Colposcopy of the cervix with loop electrode biopsy(s) of the cervix

57460 ²

$   171.76

Colposcopy of the cervix with loop electrode biopsy(s) of the cervix – Facility Fee

57460TC ²

$ 1,400.00

Colposcopy with loop electrode conization of the cervix

57461 ²

$   198.34

Colposcopy with loop electrode conization of the cervix – Facility Fee

57461TC ²

$ 1,400.00

Biopsy, single/multiple/ local ex. of lesion, with/without fulguration- sep procedure

57500

$   79.35

Endoscopy with biopsy (s) of the cervix and endocervical curettage

57505

$   96.47

Conization of cervix, with/without fulguration, with/without dilation and curettage, with/without repair; cold knife or laser

57520 ²

$  286.25

Conization of cervix – Facility Fee

57520TC ²

$ 1,500.00

Loop electrode excision

57522 ²

$   256.13

Loop electrode excision – Facility Fee

57522TC ²

$ 1,500.00

Paracervical (uterine) nerve – Anesthetic Agent

64435

$   86.90

Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without Cervical dialation, any method (separate procedure)

58100 ³

$   92.22

Endometrial sampling (biopsy) performed in conjunction with colposcopy

58110 ³

$   43.00

Unilateral Mammogram (Global Procedure)

77055

$   91.49

                Technical Component

77055TC

$   55.32

                Professional Component

7705526

$   36.17

Unilateral, diagnostic mammogram- direct digital image, all views Global Procedure

G0206

$   91.49

                Technical Component

G0206TC

$   55.32

                Professional Component

G020626

$   36.17

Bilateral Mammogram (Global Procedure)

77056

$  117.01

                Technical Component

77056TC

$   72.06

                Professional Component

7705626

$   44.95

Bilateral, diagnostic mammography- direct digital image, all views Global Procedure

G0204

$  117.01

                Technical Component

G0204TC

$   72.06

                Professional Component

G020426

$   44.95

Screening Mammogram (Global Procedure)

77057

$   85.67

                Technical Component²

77057TC

$   49.49

                Professional Component

7705726

$   36.17

Screening mammography, direct digital image, bilateral, all views Global Procedure

G0202

$   85.67

                Technical Component

G0202TC

$   49.49

                Professional Component

G020226

$   36.17

Consultation on x-ray examination made elsewhere, written report

7614026

$   20.00

Breast Ultrasound (Global Procedure)

76645

$   94.71

                Technical Component

76645TC

$   66.60

                Professional Component

7664526

$   28.11

Fine Needle Aspirate – without imaging (Global Procedure)

10021 ²

$   73.04

Fine Needle Aspirate – with imaging guidance (Global Procedure)

10022 ²

$   67.90

Papillomavirus, human, amplified probe technique

87621

$  49.39

Evaluation of Aspirate

88172

$  53.09

       Technical component

88172TC

$  22.20

       Professional component

8817226

$  30.89

Cytopathology, smears, any other source; screening & interpretation

88160

$  57.28

         Technical component

88160TC

$  32.03

         Professional component

8816026

$  25.25

Cytopathology, smears, any other source; prep., screening & interpretation

88161

$  57.28

         Technical component

88161TC

$  32.76

         Professional component

8816126

$  24.53

Interpretation and Report of Aspirate

88173

$144.76

       Technical component

88173TC

$  74.24

        Professional component

8817326

$  70.52

Screening Pap Smear Cytology

88164 / 88165

$  14.87

Screening Pap Cytology – Thin Prep – Must be reimbursed @ conventional Pap smear rate

88142 / 88143

$  27.87

Abnormal Smear (read by pathologist)                  

88141

$  30.15

Screening by automated system and manual rescreening under physician Supervision

88175

$  34.41

Pathology, Cervical/Breast Biopsy

88305

$ 112.12

          Technical component

88305TC

$  74.60

           Professional component

8830526

$  37.52

Pathology, breast, excision of lesion – surgical pathology (Global Procedure)

88307

$239.35

          Technical component

88307TC

$157.21

           Professional component

8830726

$  82.15

Surgical pathology, first tissue block, with frozen section (s), single specimen

88331

$  95.63

           Technical component

88331TC

$  34.21

           Professional component

8833126

$  61.42

Each additional tissue block with frozen section (s)

88332

$  42.19

           Technical component

88332TC

$  12.01

           Professional component

8833226

$  30.18

Immunohistochemistry (including tissue immunoperoxidase, each antibody

88342

$  109.76

           Technical component

88342TC

$  67.33

           Professional component

8834226

$  42.43

Stereotactic location for breast biopsy, each lesion, radiological supervision and interpretation (Global Procedure)

77031

$  170.26

                Technical component

77031TC

$   87.34

                Professional component

7703126

$   82.93

Preoperative placement of needle location wire breast; radiological supervision and interpretation (Global Procedure)

77032

$   59.00

                Technical component

77032TC

$   30.21

                Professional component

7703226

$  28.79

Radiological examinations; surgical specimen (Global Procedure)

76098

$  20.45

                Technical component

76098TC

$  12.01

                Professional component

7609826

$   8.43

Ultrasonic guidance for needle placement (eg, biopsy aspiration, injection, localization device), imaging supervision and interpretation (Global Procedure)

76942

$  210.96

                Technical component

76942TC

$  176.13

                Professional component

7694226

$   34.77

Puncture aspiration of cyst of breast

19000 ²

$   45.77

Each additional cyst (list separately in addition to code for primary procedure)

19001²

$   22.52

Biopsy of breast; needle core (Surgical Procedure Only)

19100 ²

$   71.61

Incisional biopsy of breast (Global Procedure)

19101 ²

$  224.60

Percutaneous, needle core, using imaging guidance

19102 ²

$ 106.95

Percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance

19103 ²

$ 199.96

Excision of cyst, fibroadenoma or other benign or malignant tumor, aberrant breast tissue, duct lesion or nipple lesion (Global Procedure)

19120 ²

$ 415.61

Excision of breast lesion identified by preoperative placement of radiological marker-single lesion

19125 ²

$ 461.92

Excision of breast lesion identified by preoperative placement of radiological marker-each additional lesion

19126 ²

$ 166.57

Preoperative placement of needle localization wire, breast

19290 ²

$ 67.52

Image guided placement, metallic localization clip, percutaneous, during breast biopsy

19295 ²

$  96.80