LOCATION HCPCS DESC MOD NFAC FAC ALABAMA 0073T DELIVERY, COMP IMRT $583.05 $583.05 ALABAMA 10021 FNA W/O IMAGE $120.23 $68.29 ALABAMA 10022 FNA W/IMAGE $132.17 $63.88 ALABAMA 10040 ACNE SURGERY $78.53 $71.47 ALABAMA 10060 DRAINAGE OF SKIN ABSCESS $86.55 $77.58 ALABAMA 10061 DRAINAGE OF SKIN ABSCESS $157.04 $146.46 ALABAMA 10080 DRAINAGE OF PILONIDAL CYST $147.19 $83.06 ALABAMA 10081 DRAINAGE OF PILONIDAL CYST $230.50 $147.78 ALABAMA 10120 REMOVE FOREIGN BODY $119.55 $80.75 ALABAMA 10121 REMOVE FOREIGN BODY $224.20 $168.74 ALABAMA 10140 DRAINAGE OF HEMATOMA/FLUID $120.47 $104.76 ALABAMA 10160 PUNCTURE DRAINAGE OF LESION $100.76 $84.09 ALABAMA 10180 COMPLEX DRAINAGE, WOUND $191.11 $159.05 ALABAMA 11000 DEBRIDE INFECTED SKIN $43.33 $31.79 ALABAMA 11001 DEBRIDE INFECTED SKIN ADD-ON $19.88 $16.04 ALABAMA 11004 DEBRIDE GENITALIA & PERINEUM $535.18 $535.18 ALABAMA 11005 DEBRIDE ABDOM WALL $727.35 $727.35 ALABAMA 11006 DEBRIDE GENIT/PER/ABDOM WALL $670.18 $670.18 ALABAMA 11008 REMOVE MESH FROM ABD WALL $271.96 $271.96 ALABAMA 11010 DEBRIDE SKIN, FX $398.50 $261.92 ALABAMA 11011 DEBRIDE SKIN/MUSCLE, FX $470.56 $283.65 ALABAMA 11012 DEBRIDE SKIN/MUSCLE/BONE, FX $682.64 $416.85 ALABAMA 11040 DEBRIDE SKIN, PARTIAL $37.33 $27.39 ALABAMA 11041 DEBRIDE SKIN, FULL $55.09 $44.51 ALABAMA 11042 DEBRIDE SKIN/TISSUE $77.25 $60.26 ALABAMA 11043 DEBRIDE TISSUE/MUSCLE $208.00 $182.68 ALABAMA 11044 DEBRIDE TISSUE/MUSCLE/BONE $271.21 $248.77 ALABAMA 11055 TRIM SKIN LESION $35.68 $23.17 ALABAMA 11056 TRIM SKIN LESIONS, 2 TO 4 $45.63 $32.49 ALABAMA 11057 TRIM SKIN LESIONS, OVER 4 $56.51 $42.41 ALABAMA 11100 BIOPSY, SKIN LESION $71.63 $43.41 ALABAMA 11101 BIOPSY, SKIN ADD-ON $26.69 $22.20 ALABAMA 11200 REMOVAL OF SKIN TAGS $63.66 $54.69 ALABAMA 11201 REMOVE SKIN TAGS ADD-ON $16.69 $15.41 ALABAMA 11300 SHAVE SKIN LESION $51.92 $26.92 ALABAMA 11301 SHAVE SKIN LESION $68.94 $45.54 ALABAMA 11302 SHAVE SKIN LESION $82.90 $55.97 ALABAMA 11303 SHAVE SKIN LESION $99.64 $65.66 ALABAMA 11305 SHAVE SKIN LESION $54.64 $36.04 ALABAMA 11306 SHAVE SKIN LESION $74.78 $52.98 ALABAMA 11307 SHAVE SKIN LESION $86.56 $60.91 ALABAMA 11308 SHAVE SKIN LESION $103.63 $76.06 ALABAMA 11310 SHAVE SKIN LESION $64.39 $39.06 ALABAMA 11311 SHAVE SKIN LESION $80.65 $56.93 ALABAMA 11312 SHAVE SKIN LESION $92.71 $64.82 ALABAMA 11313 SHAVE SKIN LESION $122.27 $87.33 ... VENTURA, CA 78445 VASCULAR FLOW IMAGING TC $86.66 $86.66 VENTURA, CA 78456 ACUTE VENOUS THROMBUS IMAGE $241.73 $241.73 VENTURA, CA 78456 ACUTE VENOUS THROMBUS IMAGE 26 $55.28 $55.28 VENTURA, CA 78456 ACUTE VENOUS THROMBUS IMAGE TC $186.45 $186.45 VENTURA, CA 78457 VENOUS THROMBOSIS IMAGING $165.71 $165.71 VENTURA, CA 78457 VENOUS THROMBOSIS IMAGING 26 $42.46 $42.46 VENTURA, CA 78457 VENOUS THROMBOSIS IMAGING TC $123.25 $123.25 VENTURA, CA 78458 VEN THROMBOSIS IMAGES, BILAT $236.47 $236.47 VENTURA, CA 78458 VEN THROMBOSIS IMAGES, BILAT 26 $50.49 $50.49 VENTURA, CA 78458 VEN THROMBOSIS IMAGES, BILAT TC $185.99 $185.99 VENTURA, CA 78459 HEART MUSCLE IMAGING (PET) 26 $85.32 $85.32 VENTURA, CA 78460 HEART MUSCLE BLOOD, SINGLE $157.15 $157.15 VENTURA, CA 78460 HEART MUSCLE BLOOD, SINGLE 26 $47.59 $47.59 VENTURA, CA 78460 HEART MUSCLE BLOOD, SINGLE TC $109.56 $109.56 VENTURA, CA 78461 HEART MUSCLE BLOOD, MULTIPLE $286.93 $286.93 VENTURA, CA 78461 HEART MUSCLE BLOOD, MULTIPLE 26 $68.54 $68.54 VENTURA, CA 78461 HEART MUSCLE BLOOD, MULTIPLE TC $218.39 $218.39 VENTURA, CA 78464 HEART IMAGE (3D), SINGLE $387.79 $387.79 VENTURA, CA 78464 HEART IMAGE (3D), SINGLE 26 $60.57 $60.57 VENTURA, CA 78464 HEART IMAGE (3D), SINGLE TC $327.22 $327.22 VENTURA, CA 78465 HEART IMAGE (3D), MULTIPLE $627.14 $627.14 VENTURA, CA 78465 HEART IMAGE (3D), MULTIPLE 26 $81.52 $81.52 VENTURA, CA 78465 HEART IMAGE (3D), MULTIPLE TC $545.61 $545.61 VENTURA, CA 78466 HEART INFARCT IMAGE $159.91 $159.91 VENTURA, CA 78466 HEART INFARCT IMAGE 26 $38.45 $38.45 VENTURA, CA 78466 HEART INFARCT IMAGE TC $121.46 $121.46 VENTURA, CA 78468 HEART INFARCT IMAGE (EF) $213.41 $213.41 VENTURA, CA 78468 HEART INFARCT IMAGE (EF) 26 $44.08 $44.08 VENTURA, CA 78468 HEART INFARCT IMAGE (EF) TC $169.34 $169.34 VENTURA, CA 78469 HEART INFARCT IMAGE (3D) $292.56 $292.56 VENTURA, CA 78469 HEART INFARCT IMAGE (3D) 26 $50.54 $50.54 VENTURA, CA 78469 HEART INFARCT IMAGE (3D) TC $242.02 $242.02 ... WYOMING G0283 ELEC STIM OTHER THAN WOUND $10.73 $10.73 WYOMING G0288 RECON, CTA FOR SURG PLAN $350.33 $350.33 WYOMING G0289 ARTHRO, LOOSE BODY + CHONDRO $91.16 $91.16 WYOMING G0308 ESRD RELATED SVC 4+MO < 2YRS $774.41 $774.41 WYOMING G0309 ESRD RELATED SVC 2-3MO <2YRS $645.01 $645.01 WYOMING G0310 ESRD RELATED SVC 1 VST <2YRS $515.93 $515.93 WYOMING G0311 ESRD RELATED SVS 4+MO 2-11YR $533.69 $533.69 WYOMING G0312 ESRD RELATE SVS 2-3 MO 2-11Y $444.67 $444.67 WYOMING G0313 ESRD RELATED SVS 1 MON 2-11Y $355.58 $355.58 WYOMING G0314 ESRD RELATED SVS 4+ MO 12-19 $466.57 $466.57 WYOMING G0315 ESRD RELATED SVS 2-3MO/12-19 $388.60 $388.60 WYOMING G0316 ESRD RELATED SVS 1VIS/12-19Y $310.58 $310.58 WYOMING G0317 ESRD RELATED SVS 4+MO 20+YRS $291.70 $291.70 WYOMING G0318 ESRD RELATED SVS 2-3 MO 20+Y $242.91 $242.91 WYOMING G0319 ESRD RELATED SVS 1VISIT 20+Y $194.11 $194.11 WYOMING G0320 ESD RELATED SVS HOME UNDR 2 $645.01 $645.01 WYOMING G0321 ESRDRELATEDSVS HOME MO 2-11Y $444.67 $444.67 WYOMING G0322 ESRD RELATED SVS HOM MO12-19 $388.60 $388.60 WYOMING G0323 ESRD RELATED SVS HOME MO 20+ $242.91 $242.91 WYOMING G0324 ESRD RELATE SVS HOME/DY <2YR $21.38 $21.38 WYOMING G0325 ESRD RELATE HOME/DAY/ 2-11YR $12.95 $12.95 WYOMING G0326 ESRD RELATE HOME/DY 12-19YR $14.79 $14.79 WYOMING G0327 ESRD RELATE HOME/DY 20+YRS $8.25 $8.25 WYOMING G0329 ELECTROMAGNTIC TX FOR ULCERS $7.15 $3.27 WYOMING G0332 PREADMIN IV IMMUNOGLOBULIN $61.74 $61.74 WYOMING G0341 PERCUTANEOUS ISLET CELLTRANS $467.41 $365.58 WYOMING G0342 LAPAROSCOPY ISLET CELL TRANS $675.13 $675.13 WYOMING G0343 LAPAROTOMY ISLET CELL TRANSP $1109.09 $1109.09 WYOMING G0344 INITIAL PREVENTIVE EXAM $90.86 $69.84 WYOMING G0364 BONE MARROW ASPIRATE &BIOPSY $12.01 $9.42 WYOMING G0365 VESSEL MAPPING HEMO ACCESS $147.64 $147.64 WYOMING G0365 VESSEL MAPPING HEMO ACCESS 26 $13.09 $13.09 WYOMING G0365 VESSEL MAPPING HEMO ACCESS TC $134.55 $134.55 WYOMING G0366 EKG FOR INITIAL PREVENT EXAM $23.99 $23.99 WYOMING G0367 EKG TRACING FOR INITIAL PREV $15.26 $15.26 WYOMING G0368 EKG INTERPRET & REPORT PREVE $8.74 $8.74 WYOMING G0372 MD SERVICE REQUIRED FOR PMD $19.40 $8.74 WYOMING G0375 SMOKE/TOBACCO COUNSELNG 3-10 $12.36 $12.36 WYOMING G0376 SMOKE/TOBACCO COUNSELING >10 $24.36 $24.04 WYOMING M0064 VISIT FOR DRUG MONITORING $25.37 $18.26 WYOMING P3001 SCREENING PAP SMEAR BY PHYS $21.47 $21.47 WYOMING Q0035 CARDIOKYMOGRAPHY $22.05 $22.05 WYOMING Q0035 CARDIOKYMOGRAPHY 26 $8.74 $8.74 WYOMING Q0035 CARDIOKYMOGRAPHY TC $13.32 $13.32 WYOMING Q0091 OBTAINING SCREEN PAP SMEAR $36.39 $19.26 WYOMING Q0092 SET UP PORT XRAY EQUIPMENT $10.70 $10.70