15 October Pricelist With Selfpay and ADNIC, ALICO and HILAL

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95010
95012
95015
95024
95027
95028
95044
95052
95056
95060
95065
95070
95071
95075
95115
95117
95120
95125
95130
95131
95132
95133
95134
95144
95145
95146
95147
95148
95149
95165
95170
95180
95199
95250
95251
95800
95801
95803
95805
95806
95807
95808
95810
95811
95812
95813
95816
95819
95822
95824
95827
95829
95830
95831
95832
95833
95834
95851
95852
95857
95860
95861
95863
95864
95865
95866
95867
95868
95869
95870
95872
95873
95874
95875
95900
95903
95904
95905
95920
95921
95922
95923
95925
95926
95927
95928
95929
95930
95933
95934
95936
95937
95950
95951
95953
95954
95955
95956
95957
95958
95961
95962
95965
95966
95967
95970
95971
95972
95973
95974
95975
95978
95979
95980
95981
95982
95990
95991
95992
96000
96001
96002
96003
96004
96020
96040
96101
96102
96103
96105
96110
96111
96116
96118
96119
96120
96125
96150
96151
96152
96153
96154
96155
96360
96361
96365
96366
96367
96368
96369
96370
96371
96372
96373
96374
96375
96376
96379
96401
96402
96405
96406
96409
96411
96413
96415
96416
96417
96420
96422
96423
96425
96440
96446
96450
96521
96522
96523
96542
96549
96567
96570
96571
96900
96902
96904
96910
96912
96913
96920
96921
97001
97002
97003
97004
97005
97006
97010
97012
97014
97016
97018
97022
97024
97026
97028
97032
97033
97034
97035
97036
97039
97110
97112
97113
97116
97124
97139
97140
97150
97530
97532
97533
97535
97537
97542
97545
97546
97597
97598
97602
97605
97606
97750
97755
97760
97761
97762
97802
97803
97804
97810
97811
97813
97814
98925
98926
98927
98928
98929
98940
98941
98942
98943
98960
98961
98962
98966
98967
98968
98969
99000
99001
99002
99024
99026
99027
99050
99051
99053
99056
99058
99060
99070
99071
99075
99078
99080
99082
99090
99091
99100
99116
99135
99140
99143
99144
99145
99148
99149
99150
99170
99172
99173
99174
99175
99183
99190
99191
99192
99195
99199
43659
43659
43999
47379
49659
49999
49999
55899
58999
58999
58999
59899
59899
59899
60699
64999
66999
69799
76497
78399
94799
95999
96999
97799
99600
Code Description
Fine needle aspiration; without imaging guidance

Fine needle aspiration; with imaging guidance
Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or pa
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or pa
Incision and drainage of pilonidal cyst; simple
Incision and drainage of pilonidal cyst; complicated
Incision and removal of foreign body, subcutaneous tissues; simple
Incision and removal of foreign body, subcutaneous tissues; complicated
Incision and drainage of hematoma, seroma or fluid collection
Puncture aspiration of abscess, hematoma, bulla, or cyst
Incision and drainage, complex, postoperative wound infection
Debridement of extensive eczematous or infected skin; up to 10% of body surface
Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in
Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum
Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without f
Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and
Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing so
Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debrid
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List se
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm,
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions
Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; single lesion
Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed; each separate/a
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions
Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition
Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less
Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm
Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm
Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm
Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm
Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or le
Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm
Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 c
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diam
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous me
Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair
Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair
Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair
Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair
Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair
Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm
Trimming of nondystrophic nails, any number
Debridement of nail(s) by any method(s); 1 to 5

Debridement of nail(s) by any method(s); 6 or more
Avulsion of nail plate, partial or complete, simple; single
Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedu
Evacuation of subungual hematoma
Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal;
Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal; with amputation of tuf
Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)
Repair of nail bed
Reconstruction of nail bed with graft
Wedge excision of skin of nail fold (eg, for ingrown toenail)
Excision of pilonidal cyst or sinus; simple
Excision of pilonidal cyst or sinus; extensive
Excision of pilonidal cyst or sinus; complicated
Injection, intralesional; up to and including 7 lesions
Injection, intralesional; more than 7 lesions
Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0
Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1
Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; ea
Subcutaneous injection of filling material (eg, collagen); 1 cc or less
Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc
Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc
Subcutaneous injection of filling material (eg, collagen); over 10.0 cc
Insertion of tissue expander(s) for other than breast, including subsequent expansion
Replacement of tissue expander with permanent prosthesis
Removal of tissue expander(s) without insertion of prosthesis
Insertion, implantable contraceptive capsules
Removal, implantable contraceptive capsules
Removal with reinsertion, implantable contraceptive capsules
Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)
Insertion, non-biodegradable drug delivery implant
Removal, non-biodegradable drug delivery implant

Removal with reinsertion, non-biodegradable drug delivery implant
Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2
Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); o
Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
Treatment of superficial wound dehiscence; simple closure
Treatment of superficial wound dehiscence; with packing
Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less
Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm
Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm
Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less
Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm
Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm
Repair, complex, trunk; 1.1 cm to 2.5 cm
Repair, complex, trunk; 2.6 cm to 7.5 cm
Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure)
Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm
Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm
Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separa
Repair, complex, eyelids, nose, ears and/or lips; 1.0 cm or less
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm
Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (List separately in addition to code for primary proced
Secondary closure of surgical wound or dehiscence, extensive or complicated
Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less
Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm
Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less
Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 s
Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less
Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm
Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code
Filleted finger or toe flap, including preparation of recipient site
Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues)
Harvest of skin for tissue cultured skin autograft, 100 sq cm or less
Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm
Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, o
Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or pa
Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or l
Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 10
Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm
Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additiona
Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part t
Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less
Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 s
Tissue cultured epidermal autograft, trunk, arms, legs; first 25 sq cm or less
Tissue cultured epidermal autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (List separately in addition to code for prima
Tissue cultured epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and
Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; firs
Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; ad
Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; ea
Acellular dermal replacement, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Acellular dermal replacement, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and child
Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100
Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each add
Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less
Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (List separately in a
Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less
Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (L
Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/o
Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/o
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part the
Allograft skin for temporary wound closure, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Allograft skin for temporary wound closure, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infa
Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple di
Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple di
Acellular dermal allograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Acellular dermal allograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children,
Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm
Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each addition
Tissue cultured allogeneic skin substitute; first 25 sq cm or less
Tissue cultured allogeneic skin substitute; each additional 25 sq cm, or part thereof (List separately in addition to code for primary
Tissue cultured allogeneic dermal substitute, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
Tissue cultured allogeneic dermal substitute, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of in
Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple d
Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple d
Xenograft, skin (dermal), for temporary wound closure, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and
Xenograft, skin (dermal), for temporary wound closure, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body
Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or
Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or
Acellular xenograft implant; first 100 sq cm or less, or 1% of body area of infants and children
Acellular xenograft implant; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (
Formation of direct or tubed pedicle, with or without transfer; trunk
Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs
Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet
Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral
Delay of flap or sectioning of flap (division and inset); at trunk
Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs
Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet
Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips
Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location
Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)
Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator sca
Muscle, myocutaneous, or fasciocutaneous flap; trunk
Muscle, myocutaneous, or fasciocutaneous flap; upper extremity
Muscle, myocutaneous, or fasciocutaneous flap; lower extremity
Flap; island pedicle
Flap; neurovascular pedicle
Free muscle or myocutaneous flap with microvascular anastomosis
Free skin flap with microvascular anastomosis
Free fascial flap with microvascular anastomosis
Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area
Graft; derma-fat-fascia
Punch graft for hair transplant; 1 to 15 punch grafts
Punch graft for hair transplant; more than 15 punch grafts
Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)
Dermabrasion; segmental, face
Dermabrasion; regional, other than face
Dermabrasion; superficial, any site (eg, tattoo removal)
Abrasion; single lesion (eg, keratosis, scar)
Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure)
Chemical peel, facial; epidermal
Chemical peel, facial; dermal
Chemical peel, nonfacial; epidermal
Chemical peel, nonfacial; dermal
Cervicoplasty
Blepharoplasty, lower eyelid;
Blepharoplasty, lower eyelid; with extensive herniated fat pad
Blepharoplasty, upper eyelid;
Blepharoplasty, upper eyelid; with excessive skin weighting down lid
Rhytidectomy; forehead
Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)
Rhytidectomy; glabellar frown lines
Rhytidectomy; cheek, chin, and neck
Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap
Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh
Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg
Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip
Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock
Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm
Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand
Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad
Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area
Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)
Graft for facial nerve paralysis; free muscle graft (including obtaining graft)
Graft for facial nerve paralysis; free muscle flap by microsurgical technique
Graft for facial nerve paralysis; regional muscle transfer
Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposi
Removal of sutures under anesthesia (other than local), same surgeon
Removal of sutures under anesthesia (other than local), other surgeon
Dressing change (for other than burns) under anesthesia (other than local)
Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft
Suction assisted lipectomy; head and neck
Suction assisted lipectomy; trunk
Suction assisted lipectomy; upper extremity
Suction assisted lipectomy; lower extremity
Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture
Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure
Excision, sacral pressure ulcer, with primary suture;
Excision, sacral pressure ulcer, with primary suture; with ostectomy
Excision, sacral pressure ulcer, with skin flap closure;

Excision, sacral pressure ulcer, with skin flap closure; with ostectomy
Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;
Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy
Excision, ischial pressure ulcer, with primary suture;
Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)
Excision, ischial pressure ulcer, with skin flap closure;
Excision, ischial pressure ulcer, with skin flap closure; with ostectomy
Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure
Excision, trochanteric pressure ulcer, with primary suture;
Excision, trochanteric pressure ulcer, with primary suture; with ostectomy
Excision, trochanteric pressure ulcer, with skin flap closure;
Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy
Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;
Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy
Unlisted procedure, excision pressure ulcer
Initial treatment, first degree burn, when no more than local treatment is required
Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)
Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5%
Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10
Escharotomy; initial incision
Escharotomy; each additional incision (List separately in addition to code for primary procedure)
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin
Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)
Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or l
Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, han
Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyel
Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of
Cryotherapy (CO2 slush, liquid N2) for acne
Chemical exfoliation for acne (eg, acne paste, acid)
Electrolysis epilation, each 30 minutes
Unlisted procedure, skin, mucous membrane and subcutaneous tissue
Puncture aspiration of cyst of breast;
Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure)
Mastotomy with exploration or drainage of abscess, deep
Injection procedure only for mammary ductogram or galactogram
Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)
Biopsy of breast; open, incisional
Biopsy of breast; percutaneous, needle core, using imaging guidance
Biopsy of breast; percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance
Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma
Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct
Excision of lactiferous duct fistula
Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (ex
Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion
Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately ident
Excision of chest wall tumor including ribs
Excision of chest wall tumor involving ribs, with plastic reconstruction; without mediastinal lymphadenectomy
Excision of chest wall tumor involving ribs, with plastic reconstruction; with mediastinal lymphadenectomy
Preoperative placement of needle localization wire, breast;
Preoperative placement of needle localization wire, breast; each additional lesion (List separately in addition to code for primary p
Image guided placement, metallic localization clip, percutaneous, during breast biopsy/aspiration (List separately in addition to cod
Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement a
Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement a
Placement of radiotherapy afterloading brachytherapy catheters (multiple tube and button type) into the breast for interstitial rad
Mastectomy for gynecomastia
Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy
Mastectomy, simple, complete
Mastectomy, subcutaneous
Mastectomy, radical, including pectoral muscles, axillary lymph nodes
Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type operation)
Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis ma
Mastopexy
Reduction mammaplasty
Mammaplasty, augmentation; without prosthetic implant
Mammaplasty, augmentation; with prosthetic implant
Removal of intact mammary implant

Removal of mammary implant material
Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
Nipple/areola reconstruction
Correction of inverted nipples
Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion
Breast reconstruction with latissimus dorsi flap, without prosthetic implant
Breast reconstruction with free flap
Breast reconstruction with other technique
Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site;
Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site;
Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site
Open periprosthetic capsulotomy, breast
Periprosthetic capsulectomy, breast
Revision of reconstructed breast
Preparation of moulage for custom breast implant
Unlisted procedure, breast
Incision and drainage of soft tissue abscess, subfascial (ie, involves the soft tissue below the deep fascia)
Exploration of penetrating wound (separate procedure); neck
Exploration of penetrating wound (separate procedure); chest
Exploration of penetrating wound (separate procedure); abdomen/flank/back
Exploration of penetrating wound (separate procedure); extremity
Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision
Biopsy, muscle; superficial
Biopsy, muscle; deep
Biopsy, muscle, percutaneous needle
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)
Biopsy, bone, open; deep (eg, humerus, ischium, femur)
Biopsy, vertebral body, open; thoracic

Biopsy, vertebral body, open; lumbar or cervical
Injection of sinus tract; therapeutic (separate procedure)
Injection of sinus tract; diagnostic (sinogram)
Removal of foreign body in muscle or tendon sheath; simple
Removal of foreign body in muscle or tendon sheath; deep or complicated
Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel
Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia")
Injection(s); single tendon origin/insertion
Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)
Injection(s); single or multiple trigger point(s), 3 or more muscle(s)
Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time o
Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)
Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
Aspiration and/or injection of ganglion cyst(s) any location
Aspiration and injection for treatment of bone cyst
Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)
Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)
Application of halo, including removal; cranial
Application of halo, including removal; pelvic
Application of halo, including removal; femoral
Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus
Removal of tongs or halo applied by another physician
Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)
Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system
Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type)
Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])
Removal, under anesthesia, of external fixation system
Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adju
Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adju
Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation
Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation
Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation
Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputa
Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation
Replantation, thumb (includes carpometacarpal joint to MP joint), complete amputation
Replantation, thumb (includes distal tip to MP joint), complete amputation
Replantation, foot, complete amputation
Bone graft, any donor area; minor or small (eg, dowel or button)
Bone graft, any donor area; major or large
Cartilage graft; costochondral
Cartilage graft; nasal septum
Fascia lata graft; by stripper
Fascia lata graft; by incision and area exposure, complex or sheet
Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)
Tissue grafts, other (eg, paratenon, fat, dermis)
Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for prima
Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure)
Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from
Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separatel
Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial i
Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in
Bone graft with microvascular anastomosis; fibula
Bone graft with microvascular anastomosis; iliac crest
Bone graft with microvascular anastomosis; metatarsal
Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal
Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe
Free osteocutaneous flap with microvascular anastomosis; iliac crest
Free osteocutaneous flap with microvascular anastomosis; metatarsal
Free osteocutaneous flap with microvascular anastomosis; great toe with web space
Electrical stimulation to aid bone healing; noninvasive (nonoperative)

Electrical stimulation to aid bone healing; invasive (operative)
Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)
Ablation, bone tumor(s) (eg, osteoid osteoma, metastasis) radiofrequency, percutaneous, including computed tomographic guidan
Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code
Unlisted procedure, musculoskeletal system, general
Arthrotomy, temporomandibular joint
Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm
Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater
Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm
Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater
Radical resection of tumor (eg, malignant neoplasm), soft tissue of face or scalp; less than 2 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of face or scalp; 2 cm or greater
Excision of bone (eg, for osteomyelitis or bone abscess); mandible
Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)
Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)
Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage
Excision of torus mandibularis
Excision of maxillary torus palatinus
Excision of malignant tumor of maxilla or zygoma
Excision of benign tumor or cyst of mandible, by enucleation and/or curettage
Excision of malignant tumor of mandible;
Excision of malignant tumor of mandible; radical resection
Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion(s))
Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or
Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion(s))
Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destr
Condylectomy, temporomandibular joint (separate procedure)
Meniscectomy, partial or complete, temporomandibular joint (separate procedure)
Coronoidectomy (separate procedure)
Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthes
Impression and custom preparation; surgical obturator prosthesis

Impression and custom preparation; orbital prosthesis
Impression and custom preparation; interim obturator prosthesis
Impression and custom preparation; definitive obturator prosthesis
Impression and custom preparation; mandibular resection prosthesis
Impression and custom preparation; palatal augmentation prosthesis
Impression and custom preparation; palatal lift prosthesis
Impression and custom preparation; speech aid prosthesis
Impression and custom preparation; oral surgical splint
Impression and custom preparation; auricular prosthesis
Impression and custom preparation; nasal prosthesis
Impression and custom preparation; facial prosthesis
Unlisted maxillofacial prosthetic procedure
Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)
Application of interdental fixation device for conditions other than fracture or dislocation, includes removal
Injection procedure for temporomandibular joint arthrography
Genioplasty; augmentation (autograft, allograft, prosthetic material)
Genioplasty; sliding osteotomy, single piece
Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)
Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)
Augmentation, mandibular body or angle; prosthetic material
Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)
Reduction forehead; contouring only
Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)
Reduction forehead; contouring and setback of anterior frontal sinus wall
Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone gra
Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft
Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft
Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autog
Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autograf
Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining
Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)

Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)
Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I
Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I
Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (inclu
Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (inclu
Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaini
Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonoce
Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)
Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)
Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial
Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of
Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft
Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)
Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation
Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation
Osteotomy, mandible, segmental;
Osteotomy, mandible, segmental; with genioglossus advancement
Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)
Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)
Osteoplasty, facial bones; reduction
Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
Graft, bone; mandible (includes obtaining graft)
Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)
Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)
Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)
Arthroplasty, temporomandibular joint, with allograft
Arthroplasty, temporomandibular joint, with prosthetic joint replacement
Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)
Reconstruction of mandible or maxilla, subperiosteal implant; partial
Reconstruction of mandible or maxilla, subperiosteal implant; complete
Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia
Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete
Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)
Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia
Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach
Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach
Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement
Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach
Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach
Malar augmentation, prosthetic material
Secondary revision of orbitocraniofacial reconstruction
Medial canthopexy (separate procedure)
Lateral canthopexy
Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach
Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach
Unlisted craniofacial and maxillofacial procedure
Closed treatment of nasal bone fracture without manipulation
Closed treatment of nasal bone fracture; without stabilization
Closed treatment of nasal bone fracture; with stabilization
Open treatment of nasal fracture; uncomplicated
Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation
Open treatment of nasal fracture; with concomitant open treatment of fractured septum
Open treatment of nasal septal fracture, with or without stabilization
Closed treatment of nasal septal fracture, with or without stabilization
Open treatment of nasoethmoid fracture; without external fixation
Open treatment of nasoethmoid fracture; with external fixation
Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligame
Open treatment of depressed frontal sinus fracture
Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approac
Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint
Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and/or local fixation
Open treatment of nasomaxillary complex fracture (LeFort II type); requiring multiple open approaches
Open treatment of nasomaxillary complex fracture (LeFort II type); with bone grafting (includes obtaining graft)
Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation
Open treatment of depressed zygomatic arch fracture (eg, Gillies approach)
Open treatment of depressed malar fracture, including zygomatic arch and malar tripod
Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomati
Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomati
Open treatment of orbital floor blowout fracture; transantral approach (Caldwell-Luc type operation)
Open treatment of orbital floor blowout fracture; periorbital approach
Open treatment of orbital floor blowout fracture; combined approach
Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant
Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)
Closed treatment of fracture of orbit, except blowout; without manipulation
Closed treatment of fracture of orbit, except blowout; with manipulation
Open treatment of fracture of orbit, except blowout; without implant
Open treatment of fracture of orbit, except blowout; with implant
Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)
Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint
Open treatment of palatal or maxillary fracture (LeFort I type);
Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), mul
Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint
Open treatment of craniofacial separation (LeFort III type); with wiring and/or internal fixation
Open treatment of craniofacial separation (LeFort III type); complicated (eg, comminuted or involving cranial nerve foramina), mul
Open treatment of craniofacial separation (LeFort III type); complicated, utilizing internal and/or external fixation techniques (eg, h
Open treatment of craniofacial separation (LeFort III type); complicated, multiple surgical approaches, internal fixation, with bone
Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)
Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)
Closed treatment of mandibular fracture; without manipulation

Closed treatment of mandibular fracture; with manipulation
Percutaneous treatment of mandibular fracture, with external fixation
Closed treatment of mandibular fracture with interdental fixation
Open treatment of mandibular fracture with external fixation
Open treatment of mandibular fracture; without interdental fixation
Open treatment of mandibular fracture; with interdental fixation
Open treatment of mandibular condylar fracture
Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation
Closed treatment of temporomandibular dislocation; initial or subsequent
Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initia
Open treatment of temporomandibular dislocation
Open treatment of hyoid fracture
Interdental wiring, for condition other than fracture
Unlisted musculoskeletal procedure, head
Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;
Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy
Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax
Biopsy, soft tissue of neck or thorax
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of neck or anterior thorax; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of neck or anterior thorax; 5 cm or greater
Excision of rib, partial
Costotransversectomy (separate procedure)
Excision first and/or cervical rib;
Excision first and/or cervical rib; with sympathectomy
Ostectomy of sternum, partial
Sternal debridement
Radical resection of sternum;

Radical resection of sternum; with mediastinal lymphadenectomy
Hyoid myotomy and suspension
Division of scalenus anticus; without resection of cervical rib
Division of scalenus anticus; with resection of cervical rib
Division of sternocleidomastoid for torticollis, open operation; without cast application
Division of sternocleidomastoid for torticollis, open operation; with cast application
Reconstructive repair of pectus excavatum or carinatum; open
Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), without thoracoscopy
Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopy
Closure of median sternotomy separation with or without debridement (separate procedure)
Closed treatment of rib fracture, uncomplicated, each
Open treatment of rib fracture without fixation, each
Treatment of rib fracture requiring external fixation (flail chest)
Closed treatment of sternum fracture
Open treatment of sternum fracture with or without skeletal fixation
Unlisted procedure, neck or thorax
Biopsy, soft tissue of back or flank; superficial
Biopsy, soft tissue of back or flank; deep
Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm
Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater
Radical resection of tumor (eg, malignant neoplasm), soft tissue of back or flank; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of back or flank; 5 cm or greater
Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic
Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral
Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral se
Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral s
Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction)
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (List separately
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List sep
Closed treatment of vertebral process fracture(s)
Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing
Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracin
Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, incl
Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, incl
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or disloca
Manipulation of spine requiring anesthesia, any region
Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral injection; thoracic
Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral injection; lumbar
Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral injection; each additional thoracic or lumbar vertebral body (
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) us
Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level
Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional l
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); t
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); l
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); t
Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); ce
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); th
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lum
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); ea
Arthrodesis, posterior technique, craniocervical (occiput-C2)
Arthrodesis, posterior technique, atlas-axis (C1-C2)
Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 segment
Arthrodesis, posterior or posterolateral technique, single level; thoracic (with or without lateral transverse technique)
Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or without lateral transverse technique)
Arthrodesis, posterior or posterolateral technique, single level; each additional vertebral segment (List separately in addition to co
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decom
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decom
Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments
Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments
Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments
Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments
Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments
Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments
Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); sing
Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 o
Exploration of spinal fusion
Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transartic
Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral seg
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral se
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebr
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)
Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in additio
Reinsertion of spinal fixation device
Removal of posterior nonsegmental instrumentation (eg, Harrington rod)
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) to vertebral defect or interspace
Removal of posterior segmental instrumentation
Removal of anterior instrumentation
Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytecto
Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompressio
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar
Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical
Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar
Unlisted procedure, spine
Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm
Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater
Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater
Radical resection of tumor (eg, malignant neoplasm), soft tissue of abdominal wall; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of abdominal wall; 5 cm or greater
Unlisted procedure, abdomen, musculoskeletal system
Removal of subdeltoid calcareous deposits, open
Capsular contracture release (eg, Sever type procedure)
Incision and drainage, shoulder area; deep abscess or hematoma
Incision and drainage, shoulder area; infected bursa
Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area
Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body

Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body
Biopsy, soft tissue of shoulder area; superficial
Biopsy, soft tissue of shoulder area; deep
Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of shoulder area; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of shoulder area; 5 cm or greater
Arthrotomy, glenohumeral joint, including biopsy
Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage
Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy
Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy
Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body
Claviculectomy; partial
Claviculectomy; total
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release
Excision or curettage of bone cyst or benign tumor of clavicle or scapula;
Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft
Excision or curettage of bone cyst or benign tumor of proximal humerus;
Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft
Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle
Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula
Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus
Ostectomy of scapula, partial (eg, superior medial angle)
Resection, humeral head

Radical resection of tumor; clavicle
Radical resection of tumor; scapula
Radical resection of tumor, proximal humerus
Removal of foreign body, shoulder; subcutaneous
Removal of foreign body, shoulder; deep (eg, Neer hemiarthroplasty removal)
Removal of foreign body, shoulder; complicated (eg, total shoulder)
Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography
Muscle transfer, any type, shoulder or upper arm; single
Muscle transfer, any type, shoulder or upper arm; multiple
Scapulopexy (eg, Sprengels deformity or for paralysis)
Tenotomy, shoulder area; single tendon
Tenotomy, shoulder area; multiple tendons through same incision
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic
Coracoacromial ligament release, with or without acromioplasty
Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)
Tenodesis of long tendon of biceps
Resection or transplantation of long tendon of biceps
Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation
Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure)
Capsulorrhaphy, anterior, any type; with bone block
Capsulorrhaphy, anterior, any type; with coracoid process transfer
Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block
Capsulorrhaphy, glenohumeral joint, any type multi-directional instability
Arthroplasty, glenohumeral joint; hemiarthroplasty
Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))
Osteotomy, clavicle, with or without internal fixation;
Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or ne
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus
Closed treatment of clavicular fracture; without manipulation

Closed treatment of clavicular fracture; with manipulation
Open treatment of clavicular fracture, includes internal fixation, when performed
Closed treatment of sternoclavicular dislocation; without manipulation
Closed treatment of sternoclavicular dislocation; with manipulation
Open treatment of sternoclavicular dislocation, acute or chronic;
Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)
Closed treatment of acromioclavicular dislocation; without manipulation
Closed treatment of acromioclavicular dislocation; with manipulation
Open treatment of acromioclavicular dislocation, acute or chronic;
Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)
Closed treatment of scapular fracture; without manipulation
Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvem
Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed
Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation
Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes re
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes re
Closed treatment of greater humeral tuberosity fracture; without manipulation
Closed treatment of greater humeral tuberosity fracture; with manipulation
Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed
Closed treatment of shoulder dislocation, with manipulation; without anesthesia
Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia
Open treatment of acute shoulder dislocation
Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation
Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed
Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation
Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed
Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)
Arthrodesis, glenohumeral joint;
Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)
Interthoracoscapular amputation (forequarter)

Disarticulation of shoulder;
Disarticulation of shoulder; secondary closure or scar revision
Unlisted procedure, shoulder
Incision and drainage, upper arm or elbow area; deep abscess or hematoma
Incision and drainage, upper arm or elbow area; bursa
Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow
Arthrotomy, elbow, including exploration, drainage, or removal of foreign body
Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)
Biopsy, soft tissue of upper arm or elbow area; superficial
Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)
Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater
Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper arm or elbow area; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper arm or elbow area; 5 cm or greater
Arthrotomy, elbow; with synovial biopsy only
Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body
Arthrotomy, elbow; with synovectomy
Excision, olecranon bursa
Excision or curettage of bone cyst or benign tumor, humerus;
Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor, humerus; with allograft
Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;
Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaini
Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft
Excision, radial head
Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus
Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck
Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus

Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process
Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)
Radical resection of tumor, shaft or distal humerus
Radical resection of tumor, radial head or neck
Resection of elbow joint (arthrectomy)
Implant removal; elbow joint
Implant removal; radial head
Removal of foreign body, upper arm or elbow area; subcutaneous
Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)
Injection procedure for elbow arthrography
Manipulation, elbow, under anesthesia
Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)
Tendon lengthening, upper arm or elbow, each tendon
Tenotomy, open, elbow to shoulder, each tendon
Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (Seddon-Brookes type procedure)
Flexor-plasty, elbow (eg, Steindler type advancement);
Flexor-plasty, elbow (eg, Steindler type advancement); with extensor advancement
Tenolysis, triceps
Tenodesis of biceps tendon at elbow (separate procedure)
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)
Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft
Repair lateral collateral ligament, elbow, with local tissue
Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)
Repair medial collateral ligament, elbow, with local tissue
Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)
Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); percutaneous
Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open
Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open wi
Arthroplasty, elbow; with membrane (eg, fascial)
Arthroplasty, elbow; with distal humeral prosthetic replacement

Arthroplasty, elbow; with implant and fascia lata ligament reconstruction
Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)
Arthroplasty, radial head;
Arthroplasty, radial head; with implant
Osteotomy, humerus, with or without internal fixation
Multiple osteotomies with realignment on intramedullary rod, humeral shaft (Sofield type procedure)
Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)
Repair of nonunion or malunion, humerus; without graft (eg, compression technique)
Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)
Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)
Decompression fasciotomy, forearm, with brachial artery exploration
Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft
Closed treatment of humeral shaft fracture; without manipulation
Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction
Open treatment of humeral shaft fracture with plate/screws, with or without cerclage
Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws
Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulat
Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation,
Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercon
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondyla
Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation
Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation
Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation
Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation
Closed treatment of humeral condylar fracture, medial or lateral; with manipulation
Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed
Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation
Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proxim
Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proxim
Treatment of closed elbow dislocation; without anesthesia
Treatment of closed elbow dislocation; requiring anesthesia
Open treatment of acute or chronic elbow dislocation
Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head)
Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head),
Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation
Closed treatment of radial head or neck fracture; without manipulation
Closed treatment of radial head or neck fracture; with manipulation
Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;
Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial hea
Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation
Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation
Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed
Arthrodesis, elbow joint; local
Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)
Amputation, arm through humerus; with primary closure
Amputation, arm through humerus; open, circular (guillotine)
Amputation, arm through humerus; secondary closure or scar revision
Amputation, arm through humerus; re-amputation
Amputation, arm through humerus; with implant
Stump elongation, upper extremity
Cineplasty, upper extremity, complete procedure
Unlisted procedure, humerus or elbow
Incision, extensor tendon sheath, wrist (eg, deQuervains disease)
Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)
Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; without debridement of nonviable muscle and
Decompression fasciotomy, forearm and/or wrist, flexor OR extensor compartment; with debridement of nonviable muscle and/or
Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle an
Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; with debridement of nonviable muscle and/
Incision and drainage, forearm and/or wrist; deep abscess or hematoma
Incision and drainage, forearm and/or wrist; bursa

Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)
Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body
Biopsy, soft tissue of forearm and/or wrist; superficial
Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)
Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater
Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm and/or wrist area; less than 3 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm and/or wrist area; 3 cm or greater
Capsulotomy, wrist (eg, contracture)
Arthrotomy, wrist joint; with biopsy
Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body
Arthrotomy, wrist joint; with synovectomy
Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex
Excision of tendon, forearm and/or wrist, flexor or extensor, each
Excision, lesion of tendon sheath, forearm and/or wrist
Excision of ganglion, wrist (dorsal or volar); primary
Excision of ganglion, wrist (dorsal or volar); recurrent
Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheuma
Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheuma
Synovectomy, extensor tendon sheath, wrist, single compartment;
Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna
Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);
Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with
Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with
Excision or curettage of bone cyst or benign tumor of carpal bones;
Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft
Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius
Radical resection of tumor, radius or ulna
Carpectomy; 1 bone
Carpectomy; all bones of proximal row
Radial styloidectomy (separate procedure)
Excision distal ulna partial or complete (eg, Darrach type or matched resection)
Injection procedure for wrist arthrography
Exploration with removal of deep foreign body, forearm or wrist
Removal of wrist prosthesis; (separate procedure)
Removal of wrist prosthesis; complicated, including total wrist
Manipulation, wrist, under anesthesia
Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle
Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle
Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle
Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle
Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle
Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or mu
Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subl
Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon
Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon
Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon
Tenodesis at wrist; flexors of fingers
Tenodesis at wrist; extensors of fingers
Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon
Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft),
Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist;
Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist; with tendon(s) transfer
Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy,
Arthroplasty, wrist, with or without interposition, with or without external or internal fixation
Centralization of wrist on ulna (eg, radial club hand)
Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon tr
Osteotomy, radius; distal third
Osteotomy, radius; middle or proximal third
Osteotomy; ulna
Osteotomy; radius AND ulna
Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius OR ulna
Multiple osteotomies, with realignment on intramedullary rod (Sofield type procedure); radius AND ulna
Osteoplasty, radius OR ulna; shortening
Osteoplasty, radius OR ulna; lengthening with autograft
Osteoplasty, radius AND ulna; shortening (excluding 64876)
Osteoplasty, radius AND ulna; lengthening with autograft
Osteoplasty, carpal bone, shortening
Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique)
Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft)
Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique)
Repair of nonunion or malunion, radius AND ulna; with autograft (includes obtaining graft)
Repair of defect with autograft; radius OR ulna
Repair of defect with autograft; radius AND ulna
Insertion of vascular pedicle into carpal bone (eg, Hori procedure)
Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bo
Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary
Arthroplasty with prosthetic replacement; distal radius
Arthroplasty with prosthetic replacement; distal ulna
Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)
Arthroplasty with prosthetic replacement; lunate
Arthroplasty with prosthetic replacement; trapezium
Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)
Arthroplasty, interposition, intercarpal or carpometacarpal joints
Revision of arthroplasty, including removal of implant, wrist joint
Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna
Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius AND ulna
Closed treatment of radial shaft fracture; without manipulation
Closed treatment of radial shaft fracture; with manipulation
Open treatment of radial shaft fracture, includes internal fixation, when performed
Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation
Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint
Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint d
Closed treatment of ulnar shaft fracture; without manipulation
Closed treatment of ulnar shaft fracture; with manipulation
Open treatment of ulnar shaft fracture, includes internal fixation, when performed
Closed treatment of radial and ulnar shaft fractures; without manipulation
Closed treatment of radial and ulnar shaft fractures; with manipulation
Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius OR ulna
Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND ulna
Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture
Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture
Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation
Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation
Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments
Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments
Closed treatment of carpal scaphoid (navicular) fracture; without manipulation
Closed treatment of carpal scaphoid (navicular) fracture; with manipulation
Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed
Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone
Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone
Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone
Closed treatment of ulnar styloid fracture
Percutaneous skeletal fixation of ulnar styloid fracture
Open treatment of ulnar styloid fracture
Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation

Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones
Percutaneous skeletal fixation of distal radioulnar dislocation
Closed treatment of distal radioulnar dislocation with manipulation
Open treatment of distal radioulnar dislocation, acute or chronic
Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation
Open treatment of trans-scaphoperilunar type of fracture dislocation
Closed treatment of lunate dislocation, with manipulation
Open treatment of lunate dislocation
Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)
Arthrodesis, wrist; with sliding graft
Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)
Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)
Arthrodesis, wrist; with autograft (includes obtaining graft)
Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, Sauve-Kapandji procedure)
Amputation, forearm, through radius and ulna;
Amputation, forearm, through radius and ulna; open, circular (guillotine)
Amputation, forearm, through radius and ulna; secondary closure or scar revision
Amputation, forearm, through radius and ulna; re-amputation
Krukenberg procedure
Disarticulation through wrist;
Disarticulation through wrist; secondary closure or scar revision
Disarticulation through wrist; re-amputation
Transmetacarpal amputation;
Transmetacarpal amputation; secondary closure or scar revision
Transmetacarpal amputation; re-amputation
Unlisted procedure, forearm or wrist
Drainage of finger abscess; simple
Drainage of finger abscess; complicated (eg, felon)
Drainage of tendon sheath, digit and/or palm, each
Drainage of palmar bursa; single, bursa
Drainage of palmar bursa; multiple bursa

Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)
Decompression fingers and/or hand, injection injury (eg, grease gun)
Decompressive fasciotomy, hand (excludes 26035)
Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous
Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial
Tendon sheath incision (eg, for trigger finger)
Tenotomy, percutaneous, single, each digit
Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint
Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each
Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each
Arthrotomy with biopsy; carpometacarpal joint, each
Arthrotomy with biopsy; metacarpophalangeal joint, each
Arthrotomy with biopsy; interphalangeal joint, each
Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater
Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater
Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm
Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of hand or finger; less than 3 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of hand or finger; 3 cm or greater
Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)
Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other loca
Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other loca
Synovectomy, carpometacarpal joint
Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit
Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint
Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger
Excision of tendon, palm, flexor or extensor, single, each tendon
Excision of tendon, finger, flexor or extensor, each tendon
Sesamoidectomy, thumb or finger (separate procedure)
Excision or curettage of bone cyst or benign tumor of metacarpal;

Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;
Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtainin
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger
Radical resection of tumor, metacarpal
Radical resection of tumor, proximal or middle phalanx of finger
Radical resection of tumor, distal phalanx of finger
Removal of implant from finger or hand
Manipulation, finger joint, under anesthesia, each joint
Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary withou
Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); secondary with free graft (inc
Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each
Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, without free graft, eac
Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); secondary, with free graft (includ
Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon
Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), e
Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon
Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod
Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod
Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon
Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon
Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod
Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod
Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon
Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon
Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each
Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finge
Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)
Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)
Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft)
Realignment of extensor tendon, hand, each tendon
Tenolysis, flexor tendon; palm OR finger, each tendon
Tenolysis, flexor tendon; palm AND finger, each tendon
Tenolysis, extensor tendon, hand OR finger, each tendon
Tenolysis, complex, extensor tendon, finger, including forearm, each tendon
Tenotomy, flexor, palm, open, each tendon
Tenotomy, flexor, finger, open, each tendon
Tenotomy, extensor, hand or finger, open, each tendon
Tenodesis; of proximal interphalangeal joint, each joint
Tenodesis; of distal joint, each joint
Lengthening of tendon, extensor, hand or finger, each tendon
Shortening of tendon, extensor, hand or finger, each tendon
Lengthening of tendon, flexor, hand or finger, each tendon
Shortening of tendon, flexor, hand or finger, each tendon
Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon
Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each
Transfer or transplant of tendon, palmar; without free tendon graft, each tendon
Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon
Opponensplasty; superficialis tendon transfer type, each tendon
Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon
Opponensplasty; hypothenar muscle transfer
Opponensplasty; other methods
Transfer of tendon to restore intrinsic function; ring and small finger
Transfer of tendon to restore intrinsic function; all 4 fingers
Correction claw finger, other methods
Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)
Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)
Release of thenar muscle(s) (eg, thumb contracture)
Cross intrinsic transfer, each tendon
Capsulodesis, metacarpophalangeal joint; single digit

Capsulodesis, metacarpophalangeal joint; 2 digits
Capsulodesis, metacarpophalangeal joint; 3 or 4 digits
Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint
Capsulectomy or capsulotomy; interphalangeal joint, each joint
Arthroplasty, metacarpophalangeal joint; each joint
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint
Arthroplasty, interphalangeal joint; each joint
Arthroplasty, interphalangeal joint; with prosthetic implant, each joint
Repair of collateral ligament, metacarpophalangeal or interphalangeal joint
Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)
Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)
Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint
Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)
Repair and reconstruction, finger, volar plate, interphalangeal joint
Pollicization of a digit
Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft
Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single
Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double
Transfer, finger to another position without microvascular anastomosis
Transfer, free toe joint, with microvascular anastomosis
Repair of syndactyly (web finger) each web space; with skin flaps
Repair of syndactyly (web finger) each web space; with skin flaps and grafts
Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)
Osteotomy; metacarpal, each
Osteotomy; phalanx of finger, each
Osteoplasty, lengthening, metacarpal or phalanx
Repair cleft hand
Reconstruction of polydactylous digit, soft tissue and bone
Repair macrodactylia, each digit
Repair, intrinsic muscles of hand, each muscle
Release, intrinsic muscles of hand, each muscle

Excision of constricting ring of finger, with multiple Z-plasties
Closed treatment of metacarpal fracture, single; without manipulation, each bone
Closed treatment of metacarpal fracture, single; with manipulation, each bone
Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone
Percutaneous skeletal fixation of metacarpal fracture, each bone
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
Closed treatment of carpometacarpal dislocation, thumb, with manipulation
Closed treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation
Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation
Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed
Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia
Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia
Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint
Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint
Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction
Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia
Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia
Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation
Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed
Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each
Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without ski
Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulatio
Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when perform
Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each
Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each
Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when perf
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each
Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each
Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia
Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia
Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation
Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single
Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;
Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, digit, other than thumb, each;
Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)
Arthrodesis, metacarpophalangeal joint, with or without internal fixation;
Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)
Arthrodesis, interphalangeal joint, with or without internal fixation;
Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (List separately in additio
Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)
Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (
Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement f
Unlisted procedure, hands or fingers
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
Incision and drainage, pelvis or hip joint area; infected bursa
Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)
Tenotomy, adductor of hip, percutaneous (separate procedure)
Tenotomy, adductor of hip, open
Tenotomy, adductor, subcutaneous, open, with obturator neurectomy
Tenotomy, hip flexor(s), open (separate procedure)
Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)
Fasciotomy, hip or thigh, any type
Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or
Arthrotomy, hip, with drainage (eg, infection)
Arthrotomy, hip, including exploration or removal of loose or foreign body
Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves
Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus me
Biopsy, soft tissue of pelvis and hip area; superficial
Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular
Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater
Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of pelvis and hip area; less than 5 cm
Arthrotomy, with biopsy; sacroiliac joint
Arthrotomy, with biopsy; hip joint
Arthrotomy with synovectomy, hip joint
Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or
Radical resection of tumor (eg, malignant neoplasm), soft tissue of pelvis and hip area; 5 cm or greater
Excision; ischial bursa
Excision; trochanteric bursa or calcification
Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autogra
Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes a
Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring sep
Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or b
Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or b
Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis
Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum
Radical resection of tumor; innominate bone, total
Radical resection of tumor; ischial tuberosity and greater trochanter of femur
Coccygectomy, primary
Removal of foreign body, pelvis or hip; subcutaneous tissue
Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)
Removal of hip prosthesis; (separate procedure)
Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer
Injection procedure for hip arthrography; without anesthesia
Injection procedure for hip arthrography; with anesthesia

Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid
Release or recession, hamstring, proximal
Transfer, adductor to ischium
Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)
Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)
Transfer iliopsoas; to greater trochanter of femur
Transfer iliopsoas; to femoral neck
Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type)
Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure)
Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)
Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allogra
Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
Revision of total hip arthroplasty; both components, with or without autograft or allograft
Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
Revision of total hip arthroplasty; femoral component only, with or without allograft
Osteotomy and transfer of greater trochanter of femur (separate procedure)
Osteotomy, iliac, acetabular or innominate bone;
Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip
Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy
Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip
Osteotomy, pelvis, bilateral (eg, congenital malformation)
Osteotomy, femoral neck (separate procedure)
Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast
Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)
Treatment of slipped femoral epiphysis; by traction, without reduction
Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ
Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)
Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning
Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (Heyman type procedure)
Open treatment of slipped femoral epiphysis; osteotomy and internal fixation
Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur

Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur
Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation
Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; with manipulation, requiring more than local anesthe
Closed treatment of coccygeal fracture
Open treatment of coccygeal fracture
Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do n
Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring
Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, incl
Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, in
Closed treatment of acetabulum (hip socket) fracture(s); without manipulation
Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction
Open treatment of posterior or anterior acetabular wall fracture, with internal fixation
Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the
Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column frac
Closed treatment of femoral fracture, proximal end, neck; without manipulation
Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction
Percutaneous skeletal fixation of femoral fracture, proximal end, neck
Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without sk
Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or witho
Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without
Closed treatment of greater trochanteric fracture, without manipulation
Open treatment of greater trochanteric fracture, includes internal fixation, when performed
Closed treatment of hip dislocation, traumatic; without anesthesia
Closed treatment of hip dislocation, traumatic; requiring anesthesia
Open treatment of hip dislocation, traumatic, without internal fixation
Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external
Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; w
Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; w
Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral hea
Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral hea
Closed treatment of post hip arthroplasty dislocation; without anesthesia
Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia
Closed treatment of femoral fracture, proximal end, head; without manipulation
Closed treatment of femoral fracture, proximal end, head; with manipulation
Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed
Manipulation, hip joint, requiring general anesthesia
Arthrodesis, sacroiliac joint (including obtaining graft)
Arthrodesis, symphysis pubis (including obtaining graft)
Arthrodesis, hip joint (including obtaining graft);
Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy
Interpelviabdominal amputation (hindquarter amputation)
Disarticulation of hip
Unlisted procedure, pelvis or hip joint
Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region
Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)
Fasciotomy, iliotibial (tenotomy), open
Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)
Tenotomy, percutaneous, adductor or hamstring; multiple tendons
Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)
Biopsy, soft tissue of thigh or knee area; superficial
Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)
Neurectomy, hamstring muscle
Neurectomy, popliteal (gastrocnemius)
Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of thigh or knee area; less than 5 cm
Arthrotomy, knee; with synovial biopsy only
Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies
Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral
Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial AND lateral
Arthrotomy, with synovectomy, knee; anterior OR posterior
Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area
Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater
Excision, prepatellar bursa
Excision of synovial cyst of popliteal space (eg, Baker's cyst)
Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee
Patellectomy or hemipatellectomy
Excision or curettage of bone cyst or benign tumor of femur;
Excision or curettage of bone cyst or benign tumor of femur; with allograft
Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (List in addition to code for primary procedure)
Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone
Radical resection of tumor (eg, malignant neoplasm), soft tissue of thigh or knee area; 5 cm or greater
Radical resection of tumor, femur or knee
Injection procedure for knee arthrography
Removal of foreign body, deep, thigh region or knee area
Suture of infrapatellar tendon; primary
Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft
Suture of quadriceps or hamstring muscle rupture; primary
Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft
Tenotomy, open, hamstring, knee to hip; single tendon
Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg
Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral
Lengthening of hamstring tendon; single tendon
Lengthening of hamstring tendon; multiple tendons, 1 leg
Lengthening of hamstring tendon; multiple tendons, bilateral
Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon
Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons
Transfer, tendon or muscle, hamstrings to femur (eg, Egger's type procedure)
Arthrotomy with meniscus repair, knee

Repair, primary, torn ligament and/or capsule, knee; collateral
Repair, primary, torn ligament and/or capsule, knee; cruciate
Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments
Autologous chondrocyte implantation, knee
Osteochondral allograft, knee, open
Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])
Anterior tibial tubercleplasty (eg, Maquet type procedure)
Reconstruction of dislocating patella; (eg, Hauser type procedure)
Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite
Reconstruction of dislocating patella; with patellectomy
Lateral retinacular release, open
Ligamentous reconstruction (augmentation), knee; extra-articular
Ligamentous reconstruction (augmentation), knee; intra-articular (open)
Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular
Quadricepsplasty (eg, Bennett or Thompson type)
Capsulotomy, posterior capsular release, knee
Arthroplasty, patella; without prosthesis
Arthroplasty, patella; with prosthesis
Arthroplasty, knee, tibial plateau;
Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy
Arthroplasty, femoral condyles or tibial plateau(s), knee;
Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy
Arthroplasty, knee, hinge prosthesis (eg, Walldius type)
Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthrop
Osteotomy, femur, shaft or supracondylar; without fixation
Osteotomy, femur, shaft or supracondylar; with fixation
Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, Sofield type procedure)
Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knoc
Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knoc
Osteoplasty, femur; shortening (excluding 64876)

Osteoplasty, femur; lengthening
Osteoplasty, femur; combined, lengthening and shortening with femoral segment transfer
Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)
Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)
Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur
Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal
Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula
Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)
Revision of total knee arthroplasty, with or without allograft; 1 component
Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee
Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur
Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);
Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable mu
Decompression fasciotomy, thigh and/or knee, multiple compartments;
Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve
Closed treatment of femoral shaft fracture, without manipulation
Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulatio
Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction
Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, w
Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or witho
Open treatment of femoral shaft fracture with plate/screws, with or without cerclage
Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation
Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or
Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation
Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, wh
Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when p
Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed
Closed treatment of distal femoral epiphyseal separation; without manipulation
Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction
Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed
Closed treatment of patellar fracture, without manipulation
Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair
Closed treatment of tibial fracture, proximal (plateau); without manipulation
Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction
Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed
Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation
Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation
Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed
Closed treatment of knee dislocation; without anesthesia
Closed treatment of knee dislocation; requiring anesthesia
Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentat
Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair
Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentat
Closed treatment of patellar dislocation; without anesthesia
Closed treatment of patellar dislocation; requiring anesthesia
Open treatment of patellar dislocation, with or without partial or total patellectomy
Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)
Arthrodesis, knee, any technique
Amputation, thigh, through femur, any level;
Amputation, thigh, through femur, any level; immediate fitting technique including first cast
Amputation, thigh, through femur, any level; open, circular (guillotine)
Amputation, thigh, through femur, any level; secondary closure or scar revision
Amputation, thigh, through femur, any level; re-amputation
Disarticulation at knee
Unlisted procedure, femur or knee
Decompression fasciotomy, leg; anterior and/or lateral compartments only
Decompression fasciotomy, leg; posterior compartment(s) only
Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)
Incision and drainage, leg or ankle; deep abscess or hematoma
Incision and drainage, leg or ankle; infected bursa
Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia

Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
Incision (eg, osteomyelitis or bone abscess), leg or ankle
Arthrotomy, ankle, including exploration, drainage, or removal of foreign body
Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening
Biopsy, soft tissue of leg or ankle area; superficial
Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)
Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or ankle area; less than 5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or ankle area; 5 cm or greater
Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm
Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm
Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body
Arthrotomy, with synovectomy, ankle;
Arthrotomy, with synovectomy, ankle; including tenosynovectomy
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater
Excision or curettage of bone cyst or benign tumor, tibia or fibula;
Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft
Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia
Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula
Radical resection of tumor; tibia
Radical resection of tumor; fibula
Radical resection of tumor; talus or calcaneus
Injection procedure for ankle arthrography
Repair, primary, open or percutaneous, ruptured Achilles tendon;
Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft)
Repair, secondary, Achilles tendon, with or without graft
Repair, fascial defect of leg
Repair, flexor tendon, leg; primary, without graft, each tendon
Repair, flexor tendon, leg; secondary, with or without graft, each tendon
Repair, extensor tendon, leg; primary, without graft, each tendon
Repair, extensor tendon, leg; secondary, with or without graft, each tendon
Repair, dislocating peroneal tendons; without fibular osteotomy
Repair, dislocating peroneal tendons; with fibular osteotomy
Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon
Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision(s))
Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)
Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each
Gastrocnemius recession (eg, Strayer procedure)
Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot
Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through in
Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (List separately in addition to
Repair, primary, disrupted ligament, ankle; collateral
Repair, primary, disrupted ligament, ankle; both collateral ligaments
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
Arthroplasty, ankle;
Arthroplasty, ankle; with implant (total ankle)
Arthroplasty, ankle; revision, total ankle
Removal of ankle implant
Osteotomy; tibia
Osteotomy; fibula
Osteotomy; tibia and fibula
Osteotomy; multiple, with realignment on intramedullary rod (eg, Sofield type procedure)
Osteoplasty, tibia and fibula, lengthening or shortening
Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)
Repair of nonunion or malunion, tibia; with sliding graft
Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method
Repair of fibula nonunion and/or malunion with internal fixation
Repair of congenital pseudarthrosis, tibia
Arrest, epiphyseal (epiphysiodesis), open; distal tibia

Arrest, epiphyseal (epiphysiodesis), open; distal fibula
Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula
Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;
Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia
Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation
Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction
Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)
Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage
Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws a
Closed treatment of medial malleolus fracture; without manipulation
Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction
Open treatment of medial malleolus fracture, includes internal fixation, when performed
Closed treatment of posterior malleolus fracture; without manipulation
Closed treatment of posterior malleolus fracture; with manipulation
Open treatment of posterior malleolus fracture, includes internal fixation, when performed
Closed treatment of proximal fibula or shaft fracture; without manipulation
Closed treatment of proximal fibula or shaft fracture; with manipulation
Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation
Closed treatment of distal fibular fracture (lateral malleolus); with manipulation
Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed
Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and poste
Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and poste
Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and poste
Closed treatment of trimalleolar ankle fracture; without manipulation
Closed treatment of trimalleolar ankle fracture; with manipulation
Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; withou
Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; with fix
Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthes
Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthes
Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixat
Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed
Closed treatment of proximal tibiofibular joint dislocation; without anesthesia
Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia
Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when performed, or with excision of proximal f
Closed treatment of ankle dislocation; without anesthesia
Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation
Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation
Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation
Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)
Arthrodesis, ankle, open
Arthrodesis, tibiofibular joint, proximal or distal
Amputation, leg, through tibia and fibula;
Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast
Amputation, leg, through tibia and fibula; open, circular (guillotine)
Amputation, leg, through tibia and fibula; secondary closure or scar revision
Amputation, leg, through tibia and fibula; re-amputation
Amputation, ankle, through malleoli of tibia and fibula (eg, Syme, Pirogoff type procedures), with plastic closure and resection of n
Ankle disarticulation
Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve
Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve
Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and
Unlisted procedure, leg or ankle
Incision and drainage, bursa, foot
Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space
Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas
Incision, bone cortex (eg, osteomyelitis or bone abscess), foot
Fasciotomy, foot and/or toe
Tenotomy, percutaneous, toe; single tendon

Tenotomy, percutaneous, toe; multiple tendons
Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint
Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint
Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint
Release, tarsal tunnel (posterior tibial nerve decompression)
Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater
Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater
Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm
Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot or toe; less than 3 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot or toe; 3 cm or greater
Arthrotomy with biopsy; intertarsal or tarsometatarsal joint
Arthrotomy with biopsy; metatarsophalangeal joint
Arthrotomy with biopsy; interphalangeal joint
Neurectomy, intrinsic musculature of foot
Fasciectomy, plantar fascia; partial (separate procedure)
Fasciectomy, plantar fascia; radical (separate procedure)
Synovectomy; intertarsal or tarsometatarsal joint, each
Synovectomy; metatarsophalangeal joint, each
Excision, interdigital (Morton) neuroma, single, each
Synovectomy, tendon sheath, foot; flexor
Synovectomy, tendon sheath, foot; extensor
Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot
Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each
Excision or curettage of bone cyst or benign tumor, talus or calcaneus;
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft
Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;
Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (inc
Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft
Excision or curettage of bone cyst or benign tumor, phalanges of foot

Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)
Ostectomy, complete excision; first metatarsal head
Ostectomy, complete excision; other metatarsal head (second, third or fourth)
Ostectomy, complete excision; fifth metatarsal head
Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, Clayton ty
Ostectomy, excision of tarsal coalition
Ostectomy, calcaneus;
Ostectomy, calcaneus; for spur, with or without plantar fascial release
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calca
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or meta
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of to
Resection, partial or complete, phalangeal base, each toe
Talectomy (astragalectomy)
Metatarsectomy
Phalangectomy, toe, each toe
Resection, condyle(s), distal end of phalanx, each toe
Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each
Radical resection of tumor; tarsal (except talus or calcaneus)
Radical resection of tumor; metatarsal
Radical resection of tumor; phalanx of toe
Removal of foreign body, foot; subcutaneous
Removal of foreign body, foot; deep
Removal of foreign body, foot; complicated
Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon
Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)
Repair, tendon, extensor, foot; primary or secondary, each tendon
Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)
Tenolysis, flexor, foot; single tendon
Tenolysis, flexor, foot; multiple tendons
Tenolysis, extensor, foot; single tendon
Tenolysis, extensor, foot; multiple tendons

Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)
Tenotomy, open, extensor, foot or toe, each tendon
Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure)
Tenotomy, lengthening, or release, abductor hallucis muscle
Division of plantar fascia and muscle (eg, Steindler stripping) (separate procedure)
Capsulotomy, midfoot; medial release only (separate procedure)
Capsulotomy, midfoot; with tendon lengthening
Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot defo
Capsulotomy, midtarsal (eg, Heyman type procedure)
Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)
Capsulotomy; interphalangeal joint, each joint (separate procedure)
Syndactylization, toes (eg, webbing or Kelikian type procedure)
Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type procedure)
Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head
Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint
Correction, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy (eg, Silver type procedure)
Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, McBride, or Mayo type procedure
Correction, hallux valgus (bunion), with or without sesamoidectomy; resection of joint with implant
Correction, hallux valgus (bunion), with or without sesamoidectomy; with tendon transplants (eg, Joplin type procedure)
Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (eg, Mitchell, Chevron, or concent
Correction, hallux valgus (bunion), with or without sesamoidectomy; Lapidus-type procedure
Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx osteotomy
Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy
Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation
Osteotomy; talus
Osteotomy, tarsal bones, other than calcaneus or talus;
Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, Fowler type)
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than f
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, Swanson type cavus foot proc
Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)
Osteotomy, shortening, angular or rotational correction; other phalanges, any toe
Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)
Sesamoidectomy, first toe (separate procedure)
Repair, nonunion or malunion; tarsal bones
Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)
Reconstruction, toe, macrodactyly; soft tissue resection
Reconstruction, toe, macrodactyly; requiring bone resection
Reconstruction, toe(s); polydactyly
Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web
Reconstruction, cleft foot
Closed treatment of calcaneal fracture; without manipulation
Closed treatment of calcaneal fracture; with manipulation
Percutaneous skeletal fixation of calcaneal fracture, with manipulation
Open treatment of calcaneal fracture, includes internal fixation, when performed;
Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone gra
Closed treatment of talus fracture; without manipulation
Closed treatment of talus fracture; with manipulation
Percutaneous skeletal fixation of talus fracture, with manipulation
Open treatment of talus fracture, includes internal fixation, when performed
Open osteochondral autograft, talus (includes obtaining graft[s])
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each
Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each
Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each
Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each
Closed treatment of metatarsal fracture; without manipulation, each
Closed treatment of metatarsal fracture; with manipulation, each
Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
Closed treatment of fracture great toe, phalanx or phalanges; without manipulation
Closed treatment of fracture great toe, phalanx or phalanges; with manipulation
Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation
Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed
Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each
Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each
Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each
Closed treatment of sesamoid fracture
Open treatment of sesamoid fracture, with or without internal fixation
Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia
Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia
Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation
Open treatment of tarsal bone dislocation, includes internal fixation, when performed
Closed treatment of talotarsal joint dislocation; without anesthesia
Closed treatment of talotarsal joint dislocation; requiring anesthesia
Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation
Open treatment of talotarsal joint dislocation, includes internal fixation, when performed
Closed treatment of tarsometatarsal joint dislocation; without anesthesia
Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia
Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation
Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed
Closed treatment of metatarsophalangeal joint dislocation; without anesthesia
Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia
Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation
Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed
Closed treatment of interphalangeal joint dislocation; without anesthesia
Closed treatment of interphalangeal joint dislocation; requiring anesthesia
Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation
Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed
Arthrodesis; pantalar
Arthrodesis; triple
Arthrodesis; subtalar
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)
Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure)
Arthrodesis, midtarsal or tarsometatarsal, single joint
Arthrodesis, great toe; metatarsophalangeal joint
Arthrodesis, great toe; interphalangeal joint
Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, Jones type procedu
Amputation, foot; midtarsal (eg, Chopart type procedure)
Amputation, foot; transmetatarsal
Amputation, metatarsal, with toe, single
Amputation, toe; metatarsophalangeal joint
Amputation, toe; interphalangeal joint
Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, including ultrasound guid
Unlisted procedure, foot or toes
Application of halo type body cast (see 20661-20663 for insertion)
Application of Risser jacket, localizer, body; only
Application of Risser jacket, localizer, body; including head
Application of turnbuckle jacket, body; only
Application of turnbuckle jacket, body; including head
Application of body cast, shoulder to hips;
Application of body cast, shoulder to hips; including head, Minerva type
Application of body cast, shoulder to hips; including 1 thigh
Application of body cast, shoulder to hips; including both thighs
Application, cast; figure-of-eight
Application, cast; shoulder spica
Application, cast; plaster Velpeau
Application, cast; shoulder to hand (long arm)
Application, cast; elbow to finger (short arm)
Application, cast; hand and lower forearm (gauntlet)
Application, cast; finger (eg, contracture)

Application of long arm splint (shoulder to hand)
Application of short arm splint (forearm to hand); static
Application of short arm splint (forearm to hand); dynamic
Application of finger splint; static
Application of finger splint; dynamic
Strapping; thorax
Strapping; shoulder (eg, Velpeau)
Strapping; elbow or wrist
Strapping; hand or finger
Application of hip spica cast; 1 leg
Application of hip spica cast; 1 and one-half spica or both legs
Application of long leg cast (thigh to toes);
Application of long leg cast (thigh to toes); walker or ambulatory type
Application of long leg cast brace
Application of cylinder cast (thigh to ankle)
Application of short leg cast (below knee to toes);
Application of short leg cast (below knee to toes); walking or ambulatory type
Application of patellar tendon bearing (PTB) cast
Adding walker to previously applied cast
Application of rigid total contact leg cast
Application of clubfoot cast with molding or manipulation, long or short leg
Application of long leg splint (thigh to ankle or toes)
Application of short leg splint (calf to foot)
Strapping; hip
Strapping; knee
Strapping; ankle and/or foot
Strapping; toes
Strapping; Unna boot
Application of multi-layer venous wound compression system, below knee
Denis-Browne splint strapping
Removal or bivalving; gauntlet, boot or body cast

Removal or bivalving; full arm or full leg cast
Removal or bivalving; shoulder or hip spica, Minerva, or Risser jacket, etc.
Removal or bivalving; turnbuckle jacket
Repair of spica, body cast or jacket
Windowing of cast
Wedging of cast (except clubfoot casts)
Wedging of clubfoot cast
Unlisted procedure, casting or strapping
Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, temporomandibular joint, surgical
Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, shoulder, surgical; capsulorrhaphy
Arthroscopy, shoulder, surgical; repair of SLAP lesion
Arthroscopy, shoulder, surgical; with removal of loose body or foreign body
Arthroscopy, shoulder, surgical; synovectomy, partial
Arthroscopy, shoulder, surgical; synovectomy, complete
Arthroscopy, shoulder, surgical; debridement, limited
Arthroscopy, shoulder, surgical; debridement, extensive
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)
Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial re
Arthroscopy, shoulder, surgical; with rotator cuff repair
Arthroscopy, shoulder, surgical; biceps tenodesis
Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, elbow, surgical; with removal of loose body or foreign body
Arthroscopy, elbow, surgical; synovectomy, partial
Arthroscopy, elbow, surgical; synovectomy, complete
Arthroscopy, elbow, surgical; debridement, limited
Arthroscopy, elbow, surgical; debridement, extensive
Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, wrist, surgical; for infection, lavage and drainage

Arthroscopy, wrist, surgical; synovectomy, partial
Arthroscopy, wrist, surgical; synovectomy, complete
Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement
Arthroscopy, wrist, surgical; internal fixation for fracture or instability
Endoscopy, wrist, surgical, with release of transverse carpal ligament
Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation;
Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation;
Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (inc
Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (inclu
Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)
Arthroscopy, hip, surgical; with removal of loose body or foreign body
Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection
Arthroscopy, hip, surgical; with synovectomy
Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])
Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)
Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral
Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, knee, surgical; for infection, lavage and drainage
Arthroscopy, knee, surgical; with lateral release
Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragm
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)
Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)
Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)
Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including de
Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion

Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect
Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or witho
Endoscopic plantar fasciotomy
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis
Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy
Arthroscopy, metacarpophalangeal joint, surgical; with debridement
Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, Stenar lesion)
Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body
Arthroscopy, subtalar joint, surgical; with synovectomy
Arthroscopy, subtalar joint, surgical; with debridement
Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis
Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)
Arthroscopy, subtalar joint, surgical; with acetabuloplasty (ie, treatment of pincer lesion)
Arthroscopy, subtalar joint, surgical; with labral repair
Unlisted procedure, arthroscopy
Drainage abscess or hematoma, nasal, internal approach
Drainage abscess or hematoma, nasal septum
Biopsy, intranasal
Excision, nasal polyp(s), simple
Excision, nasal polyp(s), extensive
Excision or destruction (eg, laser), intranasal lesion; internal approach
Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)
Excision or surgical planing of skin of nose for rhinophyma
Excision dermoid cyst, nose; simple, skin, subcutaneous

Excision dermoid cyst, nose; complex, under bone or cartilage
Excision inferior turbinate, partial or complete, any method
Submucous resection inferior turbinate, partial or complete, any method
Rhinectomy; partial
Rhinectomy; total
Injection into turbinate(s), therapeutic
Displacement therapy (Proetz type)
Insertion, nasal septal prosthesis (button)
Removal foreign body, intranasal; office type procedure
Removal foreign body, intranasal; requiring general anesthesia
Removal foreign body, intranasal; by lateral rhinotomy
Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip
Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
Rhinoplasty, primary; including major septal repair
Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)
Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)
Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only
Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteo
Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)
Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
Repair choanal atresia; intranasal
Repair choanal atresia; transpalatine
Lysis intranasal synechia
Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)
Repair fistula; oronasal
Septal or other intranasal dermatoplasty (does not include obtaining graft)
Repair nasal septal perforations
Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue
Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue
Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method
Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method
Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial
Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent
Ligation arteries; ethmoidal
Ligation arteries; internal maxillary artery, transantral
Fracture nasal inferior turbinate(s), therapeutic
Unlisted procedure, nose
Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)
Lavage by cannulation; sphenoid sinus
Sinusotomy, maxillary (antrotomy); intranasal
Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps
Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps
Pterygomaxillary fossa surgery, any approach
Sinusotomy, sphenoid, with or without biopsy;
Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)
Sinusotomy frontal; external, simple (trephine operation)
Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type)
Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)
Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)
Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision
Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision
Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision
Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision
Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)
Ethmoidectomy; intranasal, anterior
Ethmoidectomy; intranasal, total
Ethmoidectomy; extranasal, total
Maxillectomy; without orbital exenteration
Maxillectomy; with orbital exenteration (en bloc)
Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)
Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage
Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy
Nasal/sinus endoscopy, surgical; with concha bullosa resection
Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior)
Nasal/sinus endoscopy, surgical, with maxillary antrostomy;
Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus
Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus
Nasal/sinus endoscopy, surgical, with sphenoidotomy;
Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus
Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region
Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region
Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall decompression
Nasal/sinus endoscopy, surgical; with medial orbital wall and inferior orbital wall decompression
Nasal/sinus endoscopy, surgical; with optic nerve decompression
Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa
Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)
Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)
Unlisted procedure, accessory sinuses
Laryngotomy (thyrotomy, laryngofissure); with removal of tumor or laryngocele, cordectomy
Laryngotomy (thyrotomy, laryngofissure); diagnostic
Laryngectomy; total, without radical neck dissection
Laryngectomy; total, with radical neck dissection
Laryngectomy; subtotal supraglottic, without radical neck dissection
Laryngectomy; subtotal supraglottic, with radical neck dissection
Partial laryngectomy (hemilaryngectomy); horizontal
Partial laryngectomy (hemilaryngectomy); laterovertical
Partial laryngectomy (hemilaryngectomy); anterovertical
Partial laryngectomy (hemilaryngectomy); antero-latero-vertical

Pharyngolaryngectomy, with radical neck dissection; without reconstruction
Pharyngolaryngectomy, with radical neck dissection; with reconstruction
Arytenoidectomy or arytenoidopexy, external approach
Epiglottidectomy
Intubation, endotracheal, emergency procedure
Tracheotomy tube change prior to establishment of fistula tract
Laryngoscopy, indirect; diagnostic (separate procedure)
Laryngoscopy, indirect; with biopsy
Laryngoscopy, indirect; with removal of foreign body
Laryngoscopy, indirect; with removal of lesion
Laryngoscopy, indirect; with vocal cord injection
Laryngoscopy direct, with or without tracheoscopy; for aspiration
Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn
Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn
Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope
Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator
Laryngoscopy direct, with or without tracheoscopy; with dilation, initial
Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent
Laryngoscopy, direct, operative, with foreign body removal;
Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope
Laryngoscopy, direct, operative, with biopsy;
Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or t
Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of v
Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of v
Laryngoscopy, direct, operative, with arytenoidectomy;
Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope
Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;
Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope
Laryngoscopy, flexible fiberoptic; diagnostic

Laryngoscopy, flexible fiberoptic; with biopsy
Laryngoscopy, flexible fiberoptic; with removal of foreign body
Laryngoscopy, flexible fiberoptic; with removal of lesion
Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy
Laryngoplasty; for laryngeal web, 2-stage, with keel insertion and removal
Laryngoplasty; for laryngeal stenosis, with graft or core mold, including tracheotomy
Laryngoplasty; with open reduction of fracture
Laryngoplasty, cricoid split
Laryngoplasty, not otherwise specified (eg, for burns, reconstruction after partial laryngectomy)
Laryngeal reinnervation by neuromuscular pedicle
Section recurrent laryngeal nerve, therapeutic (separate procedure), unilateral
Unlisted procedure, larynx
Tracheostomy, planned (separate procedure);
Tracheostomy, planned (separate procedure); younger than 2 years
Tracheostomy, emergency procedure; transtracheal
Tracheostomy, emergency procedure; cricothyroid membrane
Tracheostomy, fenestration procedure with skin flaps
Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, Blom-Sin
Tracheal puncture, percutaneous with transtracheal aspiration and/or injection
Tracheostoma revision; simple, without flap rotation
Tracheostoma revision; complex, with flap rotation
Tracheobronchoscopy through established tracheostomy incision
Endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) (List separately in addition to cod
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or mu
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigatio
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s),
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduct
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tra
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each addition
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s),
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air le
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tr
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (List sep
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inser
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary ra
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with injection of contrast material for segmenta
Transtracheal injection for bronchography
Catheterization with bronchial brush biopsy
Catheter aspiration (separate procedure); nasotracheal
Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside
Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy
Tracheoplasty; cervical
Tracheoplasty; tracheopharyngeal fistulization, each stage
Tracheoplasty; intrathoracic
Carinal reconstruction
Bronchoplasty; graft repair
Bronchoplasty; excision stenosis and anastomosis
Excision tracheal stenosis and anastomosis; cervical
Excision tracheal stenosis and anastomosis; cervicothoracic
Excision of tracheal tumor or carcinoma; cervical
Excision of tracheal tumor or carcinoma; thoracic
Suture of tracheal wound or injury; cervical

Suture of tracheal wound or injury; intrathoracic
Surgical closure tracheostomy or fistula; without plastic repair
Surgical closure tracheostomy or fistula; with plastic repair
Revision of tracheostomy scar
Unlisted procedure, trachea, bronchi
Thoracostomy; with rib resection for empyema
Thoracostomy; with open flap drainage for empyema
Thoracotomy, limited, for biopsy of lung or pleura
Thoracotomy, major; with exploration and biopsy
Thoracotomy, major; with control of traumatic hemorrhage and/or repair of lung tear
Thoracotomy, major; for postoperative complications
Thoracotomy, major; with open intrapleural pneumonolysis
Thoracotomy, major; with cyst(s) removal, with or without a pleural procedure
Thoracotomy, major; with excision-plication of bullae, with or without any pleural procedure
Thoracotomy, major; with removal of intrapleural foreign body or fibrin deposit
Thoracotomy, major; with removal of intrapulmonary foreign body
Thoracotomy, major; with cardiac massage
Pneumonostomy; with open drainage of abscess or cyst
Pneumonostomy; with percutaneous drainage of abscess or cyst
Pleural scarification for repeat pneumothorax
Decortication, pulmonary (separate procedure); total
Decortication, pulmonary (separate procedure); partial
Pleurectomy, parietal (separate procedure)
Decortication and parietal pleurectomy
Biopsy, pleura; percutaneous needle
Biopsy, pleura; open
Biopsy, lung or mediastinum, percutaneous needle
Pneumocentesis, puncture of lung for aspiration
Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent
Thoracentesis with insertion of tube, includes water seal (eg, for pneumothorax), when performed (separate procedure)
Removal of lung, total pneumonectomy;
Removal of lung, total pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve p
Removal of lung, total pneumonectomy; extrapleural
Removal of lung, other than total pneumonectomy; single lobe (lobectomy)
Removal of lung, other than total pneumonectomy; 2 lobes (bilobectomy)
Removal of lung, other than total pneumonectomy; single segment (segmentectomy)
Removal of lung, other than total pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-br
Removal of lung, other than total pneumonectomy; all remaining lung following previous removal of a portion of lung (completion
Removal of lung, other than total pneumonectomy; excision-plication of emphysematous lung(s) (bullous or non-bullous) for lung v
Removal of lung, other than total pneumonectomy; wedge resection, single or multiple
Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separa
Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, wh
Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, wh
Extrapleural enucleation of empyema (empyemectomy)
Insertion of indwelling tunneled pleural catheter with cuff
Tube thoracostomy, includes water seal (eg, for abscess, hemothorax, empyema), when performed (separate procedure)
Removal of indwelling tunneled pleural catheter with cuff
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, sin
Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax)
Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial da
Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequ
Thoracoscopy, diagnostic (separate procedure); lungs and pleural space, without biopsy
Thoracoscopy, diagnostic (separate procedure); lungs and pleural space, with biopsy
Thoracoscopy, diagnostic (separate procedure); pericardial sac, without biopsy
Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy
Thoracoscopy, diagnostic (separate procedure); mediastinal space, without biopsy
Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy
Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)
Thoracoscopy, surgical; with partial pulmonary decortication
Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis
Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit
Thoracoscopy, surgical; with control of traumatic hemorrhage

Thoracoscopy, surgical; with excision-plication of bullae, including any pleural procedure
Thoracoscopy, surgical; with parietal pleurectomy
Thoracoscopy, surgical; with wedge resection of lung, single or multiple
Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac
Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage
Thoracoscopy, surgical; with total pericardiectomy
Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass
Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass
Thoracoscopy, surgical; with lobectomy, total or segmental
Thoracoscopy, surgical; with thoracic sympathectomy
Thoracoscopy, surgical; with esophagomyotomy (Heller type)
Repair lung hernia through chest wall
Closure of chest wall following open flap drainage for empyema (Clagett type procedure)
Open closure of major bronchial fistula
Major reconstruction, chest wall (posttraumatic)
Donor pneumonectomy(s) (including cold preservation), from cadaver donor
Lung transplant, single; without cardiopulmonary bypass
Lung transplant, single; with cardiopulmonary bypass
Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass
Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass
Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surr
Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surr
Resection of ribs, extrapleural, all stages
Thoracoplasty, Schede type or extrapleural (all stages);
Thoracoplasty, Schede type or extrapleural (all stages); with closure of bronchopleural fistula
Pneumonolysis, extraperiosteal, including filling or packing procedures
Pneumothorax, therapeutic, intrapleural injection of air
Total lung lavage (unilateral)
Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tum
Unlisted procedure, lungs and pleura
Pericardiocentesis; initial
Pericardiocentesis; subsequent
Tube pericardiostomy
Pericardiotomy for removal of clot or foreign body (primary procedure)
Creation of pericardial window or partial resection for drainage
Pericardiectomy, subtotal or complete; without cardiopulmonary bypass
Pericardiectomy, subtotal or complete; with cardiopulmonary bypass
Excision of pericardial cyst or tumor
Excision of intracardiac tumor, resection with cardiopulmonary bypass
Resection of external cardiac tumor
Transmyocardial laser revascularization, by thoracotomy; (separate procedure)
Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separatel
Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)
Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)
Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial
Insertion or replacement of permanent pacemaker with transvenous electrode(s); ventricular
Insertion or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular
Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)
Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)
Insertion or replacement of pacemaker pulse generator only; single chamber, atrial or ventricular
Insertion or replacement of pacemaker pulse generator only; dual chamber
Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previ
Repositioning of previously implanted transvenous pacemaker or pacing cardioverter-defibrillator (right atrial or right ventricular) e
Insertion of a single transvenous electrode, permanent pacemaker or cardioverter-defibrillator
Insertion of 2 transvenous electrodes, permanent pacemaker or cardioverter-defibrillator
Repair of single transvenous electrode for a single chamber, permanent pacemaker or single chamber pacing cardioverter-defibrill
Repair of 2 transvenous electrodes for a dual chamber permanent pacemaker or dual chamber pacing cardioverter-defibrillator
Revision or relocation of skin pocket for pacemaker
Revision of skin pocket for cardioverter-defibrillator
Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker o
Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of pacing cardioverter-defibrill
Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or repla
Removal of permanent pacemaker pulse generator
Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular
Removal of transvenous pacemaker electrode(s); dual lead system
Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular
Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system
Removal of permanent transvenous electrode(s) by thoracotomy
Insertion of single or dual chamber pacing cardioverter-defibrillator pulse generator
Subcutaneous removal of single or dual chamber pacing cardioverter-defibrillator pulse generator
Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s); by thoracotomy
Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s); by transvenous extraction
Insertion or repositioning of electrode lead(s) for single or dual chamber pacing cardioverter-defibrillator and insertion of pulse gen
Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entr
Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entr
Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)
Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass
Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass
Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified m
Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze pro
Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze pro
Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass
Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopu
Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmona
Implantation of patient-activated cardiac event recorder
Removal of an implantable, patient-activated cardiac event recorder
Repair of cardiac wound; without bypass
Repair of cardiac wound; with cardiopulmonary bypass
Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass
Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass
Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass
Suture repair of aorta or great vessels; with shunt bypass
Suture repair of aorta or great vessels; with cardiopulmonary bypass

Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass
Insertion of graft, aorta or great vessels; with shunt bypass
Insertion of graft, aorta or great vessels; with cardiopulmonary bypass
Valvuloplasty, aortic valve; open, with cardiopulmonary bypass
Valvuloplasty, aortic valve; open, with inflow occlusion
Valvuloplasty, aortic valve; using transventricular dilation, with cardiopulmonary bypass
Construction of apical-aortic conduit
Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
Replacement, aortic valve, with cardiopulmonary bypass; with allograft valve (freehand)
Replacement, aortic valve, with cardiopulmonary bypass; with stentless tissue valve
Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus
Replacement, aortic valve; with transventricular aortic annulus enlargement (Konno procedure)
Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (Ross pr
Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract
Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis
Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)
Aortoplasty (gusset) for supravalvular stenosis
Valvotomy, mitral valve; closed heart
Valvotomy, mitral valve; open heart, with cardiopulmonary bypass
Valvuloplasty, mitral valve, with cardiopulmonary bypass;
Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring
Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring
Replacement, mitral valve, with cardiopulmonary bypass
Valvectomy, tricuspid valve, with cardiopulmonary bypass
Valvuloplasty, tricuspid valve; without ring insertion
Valvuloplasty, tricuspid valve; with ring insertion
Replacement, tricuspid valve, with cardiopulmonary bypass
Tricuspid valve repositioning and plication for Ebstein anomaly
Valvotomy, pulmonary valve, closed heart; transventricular
Valvotomy, pulmonary valve, closed heart; via pulmonary artery
Valvotomy, pulmonary valve, open heart; with inflow occlusion

Valvotomy, pulmonary valve, open heart; with cardiopulmonary bypass
Replacement, pulmonary valve
Right ventricular resection for infundibular stenosis, with or without commissurotomy
Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection
Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)
Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass
Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass
Repair of anomalous coronary artery from pulmonary artery origin; by ligation
Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass
Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass
Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (Takeuchi pr
Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta
Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation
Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to
Coronary artery bypass, vein only; single coronary venous graft
Coronary artery bypass, vein only; 2 coronary venous grafts
Coronary artery bypass, vein only; 6 or more coronary venous grafts
Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (List separately in addition to code for primary p
Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (List separately in addition to code for primary p
Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (List separately in addition to code for p
Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (List separately in a
Coronary artery bypass, using arterial graft(s); single arterial graft
Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts
Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts
Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts
Myocardial resection (eg, ventricular aneurysmectomy)
Repair of postinfarction ventricular septal defect, with or without myocardial resection
Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, Do
Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjun
Closure of atrioventricular valve (mitral or tricuspid) by suture or patch
Closure of semilunar valve (aortic or pulmonary) by suture or patch
Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure)
Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of
Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal d
Repair of double outlet right ventricle with intraventricular tunnel repair;
Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction
Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava t
Repair of complex cardiac anomalies (eg, single ventricle) by modified Fontan procedure
Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, Norwoo
Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)
Transthoracic insertion of catheter for stent placement with catheter removal and closure (eg, hybrid approach stage 1)
Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aor
Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch
Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage
Repair of atrial septal defect and ventricular septal defect, with direct or patch closure
Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve re
Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair
Repair of complete atrioventricular canal, with or without prosthetic valve
Closure of multiple ventricular septal defects;
Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)
Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset
Closure of single ventricular septal defect, with or without patch;
Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)
Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset
Banding of pulmonary artery
Complete repair tetralogy of Fallot without pulmonary atresia;

Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch
Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary arte
Repair sinus of Valsalva fistula, with cardiopulmonary bypass;
Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect
Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass
Closure of aortico-left ventricular tunnel
Repair of isolated partial anomalous pulmonary venous return (eg, Scimitar Syndrome)
Repair of pulmonary venous stenosis
Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)
Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane
Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation)
Atrial septectomy or septostomy; open heart with cardiopulmonary bypass
Atrial septectomy or septostomy; open heart, with inflow occlusion
Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation)
Shunt; ascending aorta to pulmonary artery (Waterston type operation)
Shunt; descending aorta to pulmonary artery (Potts-Smith type operation)
Shunt; central, with prosthetic graft
Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn procedure)
Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional Glenn procedure)
Anastomosis, cavopulmonary, second superior vena cava (List separately in addition to primary procedure)
Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargemen
Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement o
Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass;
Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; w
Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type);
Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with removal of pulmonary b
Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with closure of ventricular se
Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, Jatene type); with repair of subpulmonic o
Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary o
Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation
Total repair, truncus arteriosus (Rastelli type operation)
Reimplantation of an anomalous pulmonary artery
Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)
Division of aberrant vessel (vascular ring);
Division of aberrant vessel (vascular ring); with reanastomosis
Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass
Obliteration of aortopulmonary septal defect; with cardiopulmonary bypass
Repair of patent ductus arteriosus; by ligation
Repair of patent ductus arteriosus; by division, younger than 18 years
Repair of patent ductus arteriosus; by division, 18 years and older
Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis
Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft
Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or pr
Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass
Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass
Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed
Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstructio
Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic r
Transverse arch graft, with cardiopulmonary bypass
Descending thoracic aorta graft, with or without bypass
Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass
Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hemat
Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm,
Placement of distal extension prosthesis(s) delayed after endovascular repair of descending thoracic aorta
Open subclavian to carotid artery transposition performed in conjunction with endovascular repair of descending thoracic aorta, b
Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, performed in conjunction with endovascular repa
Pulmonary artery embolectomy; with cardiopulmonary bypass
Pulmonary artery embolectomy; without cardiopulmonary bypass

Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass
Repair of pulmonary artery stenosis by reconstruction with patch or graft
Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to
Transection of pulmonary artery with cardiopulmonary bypass
Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List
Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass
Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass
Donor cardiectomy-pneumonectomy (including cold preservation)
Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft fro
Heart-lung transplant with recipient cardiectomy-pneumonectomy
Donor cardiectomy (including cold preservation)
Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from sur
Heart transplant, with or without recipient cardiectomy
Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial 24 hours
Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each additional 24 hours (List separately in addition to cod
Insertion of intra-aortic balloon assist device, percutaneous
Removal of intra-aortic balloon assist device, percutaneous
Insertion of intra-aortic balloon assist device through the femoral artery, open approach
Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft
Insertion of intra-aortic balloon assist device through the ascending aorta
Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without gra
Insertion of ventricular assist device; extracorporeal, single ventricle
Insertion of ventricular assist device; extracorporeal, biventricular
Removal of ventricular assist device; extracorporeal, single ventricle
Removal of ventricular assist device; extracorporeal, biventricular
Insertion of ventricular assist device, implantable intracorporeal, single ventricle
Removal of ventricular assist device, implantable intracorporeal, single ventricle
Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump
Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass
Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass
Unlisted procedure, cardiac surgery

Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision
Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision
Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision
Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision
Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision
Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision
Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision
Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision
Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision
Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision
Thrombectomy, direct or with catheter; subclavian vein, by neck incision
Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision
Valvuloplasty, femoral vein
Reconstruction of vena cava, any method
Venous valve transposition, any vein donor
Cross-over vein graft to venous system
Saphenopopliteal vein anastomosis
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using aorto-aortic tube prosthesis
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (1 docking limb)
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using modular bifurcated prosthesis (2 docking limbs)
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using unibody bifurcated prosthesis
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using aorto-uniiliac or aorto-unifemoral prosthesis
Transcatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological superv
Endovascular placement of iliac artery occlusion device (List separately in addition to code for primary procedure)
Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral
Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (List separately in addition to code for p
Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or r
Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false
Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false
Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascu
Open iliac artery exposure with creation of conduit for delivery of aortic or iliac endovascular prosthesis, by abdominal or retroper
Open brachial artery exposure to assist in the deployment of aortic or iliac endovascular prosthesis by arm incision, unilateral
Endovascular repair of iliac artery (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using ilio-iliac tube endo
Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneur
Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptur
Repair, congenital arteriovenous fistula; head and neck
Repair, congenital arteriovenous fistula; thorax and abdomen
Repair, congenital arteriovenous fistula; extremities

Repair, acquired or traumatic arteriovenous fistula; head and neck
Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen
Repair, acquired or traumatic arteriovenous fistula; extremities
Repair blood vessel, direct; neck
Repair blood vessel, direct; upper extremity
Repair blood vessel, direct; hand, finger
Repair blood vessel, direct; intrathoracic, with bypass
Repair blood vessel, direct; intrathoracic, without bypass
Repair blood vessel, direct; intra-abdominal
Repair blood vessel, direct; lower extremity
Repair blood vessel with vein graft; neck
Repair blood vessel with vein graft; upper extremity
Repair blood vessel with vein graft; intrathoracic, with bypass
Repair blood vessel with vein graft; intrathoracic, without bypass
Repair blood vessel with vein graft; intra-abdominal
Repair blood vessel with vein graft; lower extremity
Repair blood vessel with graft other than vein; neck
Repair blood vessel with graft other than vein; upper extremity
Repair blood vessel with graft other than vein; intrathoracic, with bypass
Repair blood vessel with graft other than vein; intrathoracic, without bypass
Repair blood vessel with graft other than vein; intra-abdominal
Repair blood vessel with graft other than vein; lower extremity
Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision
Thromboendarterectomy, including patch graft, if performed; superficial femoral artery
Thromboendarterectomy, including patch graft, if performed; popliteal artery
Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery
Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel
Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition t
Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision
Thromboendarterectomy, including patch graft, if performed; axillary-brachial
Thromboendarterectomy, including patch graft, if performed; abdominal aorta

Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal
Thromboendarterectomy, including patch graft, if performed; iliac
Thromboendarterectomy, including patch graft, if performed; iliofemoral
Thromboendarterectomy, including patch graft, if performed; combined aortoiliac
Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral
Thromboendarterectomy, including patch graft, if performed; common femoral
Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral
Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (List separately in addition to code for
Angioscopy (non-coronary vessels or grafts) during therapeutic intervention (List separately in addition to code for primary proced
Transluminal balloon angioplasty, open; renal or other visceral artery
Transluminal balloon angioplasty, open; aortic
Transluminal balloon angioplasty, open; brachiocephalic trunk or branches, each vessel
Transluminal balloon angioplasty, open; venous
Transluminal balloon angioplasty, percutaneous; renal or visceral artery
Transluminal balloon angioplasty, percutaneous; aortic
Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel
Transluminal balloon angioplasty, percutaneous; venous
Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (List separately in addition to
Bypass graft, with vein; common carotid-ipsilateral internal carotid
Bypass graft, with vein; carotid-subclavian or subclavian-carotid
Bypass graft, with vein; carotid-vertebral
Bypass graft, with vein; carotid-contralateral carotid
Bypass graft, with vein; carotid-brachial
Bypass graft, with vein; subclavian-subclavian
Bypass graft, with vein; subclavian-brachial
Bypass graft, with vein; subclavian-vertebral
Bypass graft, with vein; subclavian-axillary
Bypass graft, with vein; axillary-axillary
Bypass graft, with vein; axillary-femoral
Bypass graft, with vein; axillary-brachial
Bypass graft, with vein; brachial-ulnar or -radial

Bypass graft, with vein; brachial-brachial
Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid
Bypass graft, with vein; aortoceliac or aortomesenteric
Bypass graft, with vein; axillary-femoral-femoral
Bypass graft, with vein; hepatorenal
Bypass graft, with vein; splenorenal
Bypass graft, with vein; aortoiliac
Bypass graft, with vein; aortobi-iliac
Bypass graft, with vein; aortofemoral
Bypass graft, with vein; aortobifemoral
Bypass graft, with vein; aortoiliofemoral, unilateral
Bypass graft, with vein; aortoiliofemoral, bilateral
Bypass graft, with vein; aortofemoral-popliteal
Bypass graft, with vein; femoral-popliteal
Bypass graft, with vein; femoral-femoral
Bypass graft, with vein; aortorenal
Bypass graft, with vein; ilioiliac
Bypass graft, with vein; iliofemoral
Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels
Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial
Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels
Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral arte
In-situ vein bypass; femoral-popliteal
In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery
In-situ vein bypass; popliteal-tibial, peroneal
Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure (List separately in addition to code for primary
Bypass graft, with other than vein; common carotid-ipsilateral internal carotid
Bypass graft, with other than vein; carotid-subclavian
Bypass graft, with other than vein; subclavian-subclavian
Bypass graft, with other than vein; subclavian-axillary
Bypass graft, with other than vein; axillary-femoral

Bypass graft, with other than vein; axillary-popliteal or -tibial
Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid
Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal
Bypass graft, with other than vein; ilio-celiac
Bypass graft, with other than vein; ilio-mesenteric
Bypass graft, with other than vein; iliorenal
Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)
Bypass graft, with other than vein; aortoiliac
Bypass graft, with other than vein; aortobi-iliac
Bypass graft, with other than vein; carotid-vertebral
Bypass graft, with other than vein; subclavian-vertebral
Bypass graft, with other than vein; aortobifemoral
Bypass graft, with other than vein; aortofemoral
Bypass graft, with other than vein; axillary-axillary
Bypass graft, with other than vein; aortofemoral-popliteal
Bypass graft, with other than vein; axillary-femoral-femoral
Bypass graft, with other than vein; femoral-popliteal
Bypass graft, with other than vein; femoral-femoral
Bypass graft, with other than vein; ilioiliac
Bypass graft, with other than vein; iliofemoral
Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery
Bypass graft, with other than vein; popliteal-tibial or -peroneal artery
Bypass graft; composite, prosthetic and vein (List separately in addition to code for primary procedure)
Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedur
Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (List separately in addition to code for p
Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (List separately in addition to code for prim
Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (List separately in addition to cod
Transposition and/or reimplantation; vertebral to carotid artery
Transposition and/or reimplantation; vertebral to subclavian artery
Transposition and/or reimplantation; subclavian to carotid artery
Transposition and/or reimplantation; carotid to subclavian artery
Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List separately in addition to code for primary procedure
Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more t
Exploration (not followed by surgical repair), with or without lysis of artery; carotid artery
Exploration (not followed by surgical repair), with or without lysis of artery; femoral artery
Exploration (not followed by surgical repair), with or without lysis of artery; popliteal artery
Exploration (not followed by surgical repair), with or without lysis of artery; other vessels
Exploration for postoperative hemorrhage, thrombosis or infection; neck
Exploration for postoperative hemorrhage, thrombosis or infection; chest
Exploration for postoperative hemorrhage, thrombosis or infection; abdomen
Exploration for postoperative hemorrhage, thrombosis or infection; extremity
Repair of graft-enteric fistula
Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);
Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft
Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty
Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition
Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, Dacron, ePTFE
Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft
Excision of infected graft; neck
Excision of infected graft; extremity
Excision of infected graft; thorax
Excision of infected graft; abdomen
Introduction of needle or intracatheter, vein
Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm
Injection procedure for extremity venography (including introduction of needle or intracatheter)
Introduction of catheter, superior or inferior vena cava
Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)
Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)
Introduction of catheter, right heart or main pulmonary artery
Selective catheter placement, left or right pulmonary artery
Selective catheter placement, segmental or subsegmental pulmonary artery
Introduction of needle or intracatheter, carotid or vertebral artery

Introduction of needle or intracatheter; retrograde brachial artery
Introduction of needle or intracatheter; extremity artery
Introduction of needle and/or catheter, arteriovenous shunt created for dialysis (graft/fistula); initial access with complete radiolog
Introduction of needle and/or catheter, arteriovenous shunt created for dialysis (graft/fistula); additional access for therapeutic int
Introduction of needle or intracatheter, aortic, translumbar
Introduction of catheter, aorta
Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family
Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family
Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vasc
Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch
Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascula
Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vas
Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery bran
Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extrem
Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)
Revision of implanted intra-arterial infusion pump
Removal of implanted intra-arterial infusion pump
Unlisted procedure, vascular injection
Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; femoral or jugular
Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; scalp vein
Venipuncture, younger than age 3 years, necessitating physician's skill, not to be used for routine venipuncture; other vein
Venipuncture, age 3 years or older, necessitating physician's skill (separate procedure), for diagnostic or therapeutic purposes (not
Collection of venous blood by venipuncture
Collection of capillary blood specimen (eg, finger, heel, ear stick)
Venipuncture, cutdown; younger than age 1 year
Venipuncture, cutdown; age 1 or over
Transfusion, blood or blood components
Push transfusion, blood, 2 years or younger
Exchange transfusion, blood; newborn
Exchange transfusion, blood; other than newborn
Transfusion, intrauterine, fetal

Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk
Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); face
Injection of sclerosing solution; single vein
Injection of sclerosing solution; multiple veins, same leg
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radi
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radi
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, lase
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, lase
Percutaneous portal vein catheterization by any method
Venous catheterization for selective organ blood sampling
Catheterization of umbilical vein for diagnosis or therapy, newborn
Therapeutic apheresis; for white blood cells
Therapeutic apheresis; for red blood cells
Therapeutic apheresis; for platelets
Therapeutic apheresis; for plasma pheresis
Therapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion
Therapeutic apheresis; with extracorporeal selective adsorption or selective filtration and plasma reinfusion
Photopheresis, extracorporeal
Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age
Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older
Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age
Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older
Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age
Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older
Insertion of tunneled centrally inserted central venous access device with subcutaneous pump
Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with
Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with
Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; younger than 5 years of age
Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older
Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age
Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older
Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral inse
Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site
Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site
Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, throug
Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through sa
Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same veno
Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same ve
Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through sa
Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous ac
Removal of tunneled central venous catheter, without subcutaneous port or pump
Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion
Collection of blood specimen from a completely implantable venous access device
Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified
Declotting by thrombolytic agent of implanted vascular access device or catheter
Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access
Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen
Repositioning of previously placed central venous catheter under fluoroscopic guidance
Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation
Arterial puncture, withdrawal of blood for diagnosis
Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous
Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown
Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown
Catheterization, umbilical artery, newborn, for diagnosis or therapy
Placement of needle for intraosseous infusion
Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein
Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type)
Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure
Arteriovenous anastomosis, open; by upper arm cephalic vein transposition
Arteriovenous anastomosis, open; by upper arm basilic vein transposition
Arteriovenous anastomosis, open; by forearm vein transposition
Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate procedure)
Insertion of cannula(s) for prolonged extracorporeal circulation for cardiopulmonary insufficiency (ECMO) (separate procedure)
Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an
Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft
Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, b
Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)
Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
Insertion of Thomas shunt (separate procedure)
Distal revascularization and interval ligation (DRIL), upper extremity hemodialysis access (steal syndrome)
External cannula declotting (separate procedure); without balloon catheter
External cannula declotting (separate procedure); with balloon catheter
Thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft (includes mechanical thrombus extractio
Venous anastomosis, open; portocaval
Venous anastomosis, open; renoportal
Venous anastomosis, open; caval-mesenteric
Venous anastomosis, open; splenorenal, proximal
Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)
Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization
Revision of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization
Primary percutaneous transluminal mechanical thrombectomy, noncoronary, arterial or arterial bypass graft, including fluoroscopi
Primary percutaneous transluminal mechanical thrombectomy, noncoronary, arterial or arterial bypass graft, including fluoroscopi
Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary,
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections a
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections a
Thrombolysis, cerebral, by intravenous infusion
Transcatheter biopsy
Transcatheter therapy, infusion for thrombolysis other than coronary
Transcatheter therapy, infusion other than for thrombolysis, any type (eg, spasmolytic, vasoconstrictive)
Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter)
Transcatheter occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), pe
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity arteries), percu
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity arteries), percu
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac and lower extremity arteries), open;
Transcatheter placement of an intravascular stent(s) (except coronary, carotid, vertebral, iliac and lower extremity arteries), open;
Exchange of a previously placed intravascular catheter during thrombolytic therapy
Uterine fibroid embolization (UFE, embolization of the uterine arteries to treat uterine fibroids, leiomyomata), percutaneous appro
Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection
Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; without distal embolic protection
Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty
Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s),
Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angiop
Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent p
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angiopl
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(
Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplas
Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with atherectomy, includes
Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent pla
Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent pla
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with atherectomy
Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; initial vessel (List sepa
Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation and/or therapeutic intervention; each additional vesse
Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS)
Unlisted vascular endoscopy procedure
Ligation, internal jugular vein
Ligation; external carotid artery
Ligation; internal or common carotid artery
Ligation; internal or common carotid artery, with gradual occlusion, as with Selverstone or Crutchfield clamp
Ligation or banding of angioaccess arteriovenous fistula
Ligation or biopsy, temporal artery
Ligation, major artery (eg, post-traumatic, rupture); neck
Ligation, major artery (eg, post-traumatic, rupture); chest
Ligation, major artery (eg, post-traumatic, rupture); abdomen
Ligation, major artery (eg, post-traumatic, rupture); extremity
Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular (umbrella dev
Ligation of femoral vein
Ligation of common iliac vein
Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions
Ligation, division, and stripping, short saphenous vein
Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below
Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or in
Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg
Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg
Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions
Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions
Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)
Ligation, division, and/or excision of varicose vein cluster(s), 1 leg
Penile revascularization, artery, with or without vein graft
Penile venous occlusive procedure
Unlisted procedure, vascular surgery
Splenectomy; total (separate procedure)
Splenectomy; partial (separate procedure)
Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedu
Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy
Laparoscopy, surgical, splenectomy
Unlisted laparoscopy procedure, spleen
Injection procedure for splenoportography
Management of recipient hematopoietic progenitor cell donor search and cell acquisition
Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogenic
Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous
Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage
Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing
Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing
Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion
Transplant preparation of hematopoietic progenitor cells; tumor cell depletion
Transplant preparation of hematopoietic progenitor cells; red blood cell removal
Transplant preparation of hematopoietic progenitor cells; platelet depletion
Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion
Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer
Bone marrow; aspiration only
Bone marrow; biopsy, needle or trocar
Bone marrow harvesting for transplantation
Bone marrow or blood-derived peripheral stem cell transplantation; allogenic
Bone marrow or blood-derived peripheral stem cell transplantation; autologous
Bone marrow or blood-derived peripheral stem cell transplantation; allogeneic donor lymphocyte infusions
Drainage of lymph node abscess or lymphadenitis; simple
Drainage of lymph node abscess or lymphadenitis; extensive
Lymphangiotomy or other operations on lymphatic channels
Suture and/or ligation of thoracic duct; cervical approach
Suture and/or ligation of thoracic duct; thoracic approach
Suture and/or ligation of thoracic duct; abdominal approach
Biopsy or excision of lymph node(s); open, superficial
Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)
Biopsy or excision of lymph node(s); open, deep cervical node(s)
Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
Biopsy or excision of lymph node(s); open, deep axillary node(s)
Biopsy or excision of lymph node(s); open, internal mammary node(s)
Dissection, deep jugular node(s)
Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection
Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection

Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic
Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)
Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple
Unlisted laparoscopy procedure, lymphatic system
Suprahyoid lymphadenectomy
Cervical lymphadenectomy (complete)
Cervical lymphadenectomy (modified radical neck dissection)
Axillary lymphadenectomy; superficial
Axillary lymphadenectomy; complete
Thoracic lymphadenectomy, regional, including mediastinal and peritracheal nodes (List separately in addition to code for primary
Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval
Inguinofemoral lymphadenectomy, superficial, including Cloquets node (separate procedure)
Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, an
Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)
Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)
Injection procedure; lymphangiography
Injection procedure; for identification of sentinel node
Cannulation, thoracic duct
Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (L
Unlisted procedure, hemic or lymphatic system
Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach
Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthor
Excision of mediastinal cyst
Excision of mediastinal tumor
Mediastinoscopy, with or without biopsy
Unlisted procedure, mediastinum
Repair, laceration of diaphragm, any approach
Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia
Repair, diaphragmatic hernia (other than neonatal), traumatic; acute

Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic
Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic
Resection, diaphragm; with simple repair (eg, primary suture)
Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)
Unlisted procedure, diaphragm
Biopsy of lip
Vermilionectomy (lip shave), with mucosal advancement
Excision of lip; transverse wedge excision with primary closure
Excision of lip; V-excision with primary direct linear closure
Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan)
Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander)
Resection of lip, more than one-fourth, without reconstruction
Repair lip, full thickness; vermilion only
Repair lip, full thickness; up to half vertical height
Repair lip, full thickness; over one-half vertical height, or complex
Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral
Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure
Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages
Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure
Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of ped
Unlisted procedure, lips
Drainage of abscess, cyst, hematoma, vestibule of mouth; simple
Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated
Removal of embedded foreign body, vestibule of mouth; simple
Removal of embedded foreign body, vestibule of mouth; complicated
Incision of labial frenum (frenotomy)
Biopsy, vestibule of mouth
Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair
Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle
Excision of mucosa of vestibule of mouth as donor graft
Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)
Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)
Closure of laceration, vestibule of mouth; 2.5 cm or less
Closure of laceration, vestibule of mouth; over 2.5 cm or complex
Vestibuloplasty; anterior
Vestibuloplasty; posterior, unilateral
Vestibuloplasty; posterior, bilateral
Vestibuloplasty; entire arch
Vestibuloplasty; complex (including ridge extension, muscle repositioning)
Unlisted procedure, vestibule of mouth
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space
Incision of lingual frenum (frenotomy)
Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual
Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental
Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular
Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space
Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for su
Biopsy of tongue; anterior two-thirds
Biopsy of tongue; posterior one-third
Biopsy of floor of mouth
Excision of lesion of tongue without closure
Excision of lesion of tongue with closure; anterior two-thirds
Excision of lesion of tongue with closure; posterior one-third
Excision of lesion of tongue with closure; with local tongue flap
Excision of lingual frenum (frenectomy)

Excision, lesion of floor of mouth
Glossectomy; less than one-half tongue
Glossectomy; hemiglossectomy
Glossectomy; partial, with unilateral radical neck dissection
Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection
Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection
Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection
Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection
Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando t
Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue
Repair of laceration 2.5 cm or less; posterior one-third of tongue
Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex
Fixation of tongue, mechanical, other than suture (eg, K-wire)
Suture of tongue to lip for micrognathia (Douglas type procedure)
Tongue base suspension, permanent suture technique
Frenoplasty (surgical revision of frenum, eg, with Z-plasty)
Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session
Unlisted procedure, tongue, floor of mouth
Drainage of abscess, cyst, hematoma from dentoalveolar structures
Removal of embedded foreign body from dentoalveolar structures; soft tissues
Removal of embedded foreign body from dentoalveolar structures; bone
Gingivectomy, excision gingiva, each quadrant
Operculectomy, excision pericoronal tissues
Excision of fibrous tuberosities, dentoalveolar structures
Excision of osseous tuberosities, dentoalveolar structures
Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair
Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair
Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair
Excision of hyperplastic alveolar mucosa, each quadrant (specify)
Alveolectomy, including curettage of osteitis or sequestrectomy
Destruction of lesion (except excision), dentoalveolar structures

Periodontal mucosal grafting
Gingivoplasty, each quadrant (specify)
Alveoloplasty, each quadrant (specify)
Unlisted procedure, dentoalveolar structures
Drainage of abscess of palate, uvula
Biopsy of palate, uvula
Excision, lesion of palate, uvula; without closure
Excision, lesion of palate, uvula; with simple primary closure
Excision, lesion of palate, uvula; with local flap closure
Resection of palate or extensive resection of lesion
Uvulectomy, excision of uvula
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)
Destruction of lesion, palate or uvula (thermal, cryo or chemical)
Repair, laceration of palate; up to 2 cm
Repair, laceration of palate; over 2 cm or complex
Palatoplasty for cleft palate, soft and/or hard palate only
Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only
Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)
Palatoplasty for cleft palate; major revision
Palatoplasty for cleft palate; secondary lengthening procedure
Palatoplasty for cleft palate; attachment pharyngeal flap
Lengthening of palate, and pharyngeal flap
Lengthening of palate, with island flap
Repair of anterior palate, including vomer flap
Repair of nasolabial fistula
Maxillary impression for palatal prosthesis
Insertion of pin-retained palatal prosthesis
Unlisted procedure, palate, uvula
Drainage of abscess; parotid, simple
Drainage of abscess; parotid, complicated
Drainage of abscess; submaxillary or sublingual, intraoral

Drainage of abscess; submaxillary, external
Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral
Sialolithotomy; submandibular (submaxillary), complicated, intraoral
Sialolithotomy; parotid, extraoral or complicated intraoral
Biopsy of salivary gland; needle
Biopsy of salivary gland; incisional
Excision of sublingual salivary cyst (ranula)
Marsupialization of sublingual salivary cyst (ranula)
Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve
Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve
Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve
Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection
Excision of submandibular (submaxillary) gland
Excision of sublingual gland
Plastic repair of salivary duct, sialodochoplasty; primary or simple
Plastic repair of salivary duct, sialodochoplasty; secondary or complicated
Parotid duct diversion, bilateral (Wilke type procedure);
Parotid duct diversion, bilateral (Wilke type procedure); with excision of 1 submandibular gland
Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands
Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts
Injection procedure for sialography
Closure salivary fistula
Dilation salivary duct
Dilation and catheterization of salivary duct, with or without injection
Ligation salivary duct, intraoral
Unlisted procedure, salivary glands or ducts
Incision and drainage abscess; peritonsillar
Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach
Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach
Biopsy; oropharynx
Biopsy; hypopharynx
Biopsy; nasopharynx, visible lesion, simple
Biopsy; nasopharynx, survey for unknown primary lesion
Excision or destruction of lesion of pharynx, any method
Removal of foreign body from pharynx
Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx
Tonsillectomy and adenoidectomy; younger than age 12
Tonsillectomy and adenoidectomy; age 12 or over
Tonsillectomy, primary or secondary; younger than age 12
Tonsillectomy, primary or secondary; age 12 or over
Adenoidectomy, primary; younger than age 12
Adenoidectomy, primary; age 12 or over
Adenoidectomy, secondary; younger than age 12
Adenoidectomy, secondary; age 12 or over
Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure
Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)
Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap
Excision of tonsil tags
Excision or destruction lingual tonsil, any method (separate procedure)
Limited pharyngectomy
Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls
Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with
Suture pharynx for wound or injury
Pharyngoplasty (plastic or reconstructive operation on pharynx)
Pharyngoesophageal repair
Pharyngostomy (fistulization of pharynx, external for feeding)
Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple
Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization
Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention
Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or
Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization
Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention
Unlisted procedure, pharynx, adenoids, or tonsils
Esophagotomy, cervical approach, with removal of foreign body
Cricopharyngeal myotomy
Esophagotomy, thoracic approach, with removal of foreign body
Excision of lesion, esophagus, with primary repair; cervical approach
Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach
Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or wit
Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intes
Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or withou
Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestin
Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal r
Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectom
Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectom
Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagoga
Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrosto
Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition
Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy
Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach
Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach
Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Esophagoscopy, rigid or flexible; with directed submucosal injection(s), any substance
Esophagoscopy, rigid or flexible; with biopsy, single or multiple
Esophagoscopy, rigid or flexible; with injection sclerosis of esophageal varices
Esophagoscopy, rigid or flexible; with band ligation of esophageal varices
Esophagoscopy, rigid or flexible; with removal of foreign body
Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Esophagoscopy, rigid or flexible; with insertion of plastic tube or stent
Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm diameter)

Esophagoscopy, rigid or flexible; with insertion of guide wire followed by dilation over guide wire
Esophagoscopy, rigid or flexible; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapl
Esophagoscopy, rigid or flexible; with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forc
Esophagoscopy, rigid or flexible; with endoscopic ultrasound examination
Esophagoscopy, rigid or flexible; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)
Upper gastrointestinal endoscopy, simple primary examination (eg, with small diameter flexible endoscope) (separate procedure)
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagno
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with d
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with en
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with tr
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with b
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with in
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with re
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with in
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with co
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ab
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with en
Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or was
Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple
Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy
Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Oddi (pancreatic duct or com
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of calculus/calculi from biliary and/
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde destruction, lithotripsy of calculus/calculi, an
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde insertion of nasobiliary or nasopancreatic dr
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde insertion of tube or stent into bile or pancre
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of foreign body and/or change of tu
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde balloon dilation of ampulla, biliary and/or pa
Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to re
Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreatic duct(s) (List separately in addi
Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed
Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures)
Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh
Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh
Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition
Unlisted laparoscopy procedure, esophagus
Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula
Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula
Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula
Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula
Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoeso
Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesopha
Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach
Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure)
Esophagogastric fundoplasty partial or complete; laparotomy
Esophagogastric fundoplasty partial or complete; thoracotomy
Esophagomyotomy (Heller type); abdominal approach
Esophagomyotomy (Heller type); thoracic approach
Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or
Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or oth
Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh o
Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or ot
Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implanta
Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation
Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary pr
Esophagojejunostomy (without total gastrectomy); abdominal approach
Esophagojejunostomy (without total gastrectomy); thoracic approach
Esophagostomy, fistulization of esophagus, external; abdominal approach
Esophagostomy, fistulization of esophagus, external; thoracic approach
Esophagostomy, fistulization of esophagus, external; cervical approach
Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophage
Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophage
Ligation, direct, esophageal varices
Transection of esophagus with repair, for esophageal varices
Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation
Suture of esophageal wound or injury; cervical approach
Suture of esophageal wound or injury; transthoracic or transabdominal approach
Closure of esophagostomy or fistula; cervical approach
Closure of esophagostomy or fistula; transthoracic or transabdominal approach
Dilation of esophagus, by unguided sound or bougie, single or multiple passes
Dilation of esophagus, over guide wire
Dilation of esophagus, by balloon or dilator, retrograde
Dilation of esophagus with balloon (30 mm diameter or larger) for achalasia
Esophagogastric tamponade, with balloon (Sengstaken type)
Free jejunum transfer with microvascular anastomosis
Unlisted procedure, esophagus
Gastrotomy; with exploration or foreign body removal
Gastrotomy; with suture repair of bleeding ulcer
Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss)
Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, Celestin or Mousseaux-Barbin)
Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation)
Biopsy of stomach, by laparotomy
Excision, local; ulcer or benign tumor of stomach

Excision, local; malignant tumor of stomach
Gastrectomy, total; with esophagoenterostomy
Gastrectomy, total; with Roux-en-Y reconstruction
Gastrectomy, total; with formation of intestinal pouch, any type
Gastrectomy, partial, distal; with gastroduodenostomy
Gastrectomy, partial, distal; with gastrojejunostomy
Gastrectomy, partial, distal; with Roux-en-Y reconstruction
Gastrectomy, partial, distal; with formation of intestinal pouch
Vagotomy when performed with partial distal gastrectomy (List separately in addition to code[s] for primary procedure)
Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective
Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)
Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or les
Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption
Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum
Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum
Laparoscopy, surgical; transection of vagus nerves, truncal
Laparoscopy, surgical; transection of vagus nerves, selective or highly selective
Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, Stamm procedure) (separate procedure)
Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documenta
Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavag
Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)
Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double l
Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loo
Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreat
Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance
Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition
Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcuta
Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only
Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only
Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component on
Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port compon
Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)
Pyloroplasty
Gastroduodenostomy
Gastrojejunostomy; without vagotomy
Gastrojejunostomy; with vagotomy, any type
Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) (separate procedure)
Gastrostomy, open; neonatal, for feeding
Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure)
Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury
Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty
Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty
Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm com
Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy
Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption
Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate proced
Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without vagotomy
Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; with vagotomy
Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine res
Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine res
Closure of gastrostomy, surgical
Closure of gastrocolic fistula
Implantation or replacement of gastric neurostimulator electrodes, antrum, open
Revision or removal of gastric neurostimulator electrodes, antrum, open
Gastric restrictive procedure, open; revision of subcutaneous port component only
Gastric restrictive procedure, open; removal of subcutaneous port component only
Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only
Enterolysis (freeing of intestinal adhesion) (separate procedure)
Duodenotomy, for exploration, biopsy(s), or foreign body removal
Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary p
Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal
Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube)
Colotomy, for exploration, biopsy(s), or foreign body removal
Reduction of volvulus, intussusception, internal hernia, by laparotomy
Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure)
Biopsy of intestine by capsule, tube, peroral (1 or more specimens)
Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotom
Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enteroto
Enterectomy, resection of small intestine; single resection and anastomosis
Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primar
Enterectomy, resection of small intestine; with enterostomy
Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine
Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)
Donor enterectomy (including cold preservation), open; from cadaver donor
Donor enterectomy (including cold preservation), open; partial, from living donor
Intestinal allotransplantation; from cadaver donor
Intestinal allotransplantation; from living donor
Removal of transplanted intestinal allograft, complete
Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary
Colectomy, partial; with anastomosis
Colectomy, partial; with skin level cecostomy or colostomy
Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure)
Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula
Colectomy, partial; with coloproctostomy (low pelvic anastomosis)
Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy
Colectomy, partial; abdominal and transanal approach
Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy
Colectomy, total, abdominal, without proctectomy; with continent ileostomy
Colectomy, total, abdominal, with proctectomy; with ileostomy
Colectomy, total, abdominal, with proctectomy; with continent ileostomy
Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, whe
Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), includes loop ileostom
Colectomy, partial, with removal of terminal ileum with ileocolostomy
Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)
Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)
Laparoscopy, surgical; ileostomy or jejunostomy, non-tube
Laparoscopy, surgical, colostomy or skin level cecostomy
Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis
Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately in addition to code for primary pro
Laparoscopy, surgical; colectomy, partial, with anastomosis
Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy
Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)
Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy
Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J),
Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy
Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately
Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis
Unlisted laparoscopy procedure, intestine (except rectum)
Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)
Ileostomy or jejunostomy, non-tube
Revision of ileostomy; simple (release of superficial scar) (separate procedure)
Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)
Continent ileostomy (Kock procedure) (separate procedure)
Colostomy or skin level cecostomy;
Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)
Revision of colostomy; simple (release of superficial scar) (separate procedure)
Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)
Revision of colostomy; with repair of paracolostomy hernia (separate procedure)
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, with or without col
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), poly
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), poly
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, in
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), poly
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent pla
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneou
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneo
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collecti
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, inject
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placem
Ileoscopy, through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Ileoscopy, through stoma; with biopsy, single or multiple
Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)
Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; diagnostic, with or without collection of specimen(s) by brus
Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; with biopsy, single or multiple
Colonoscopy through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Colonoscopy through stoma; with biopsy, single or multiple
Colonoscopy through stoma; with removal of foreign body
Colonoscopy through stoma; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler,
Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps,
Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure)
Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation
Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations
Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations)
Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations)
Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction
Closure of enterostomy, large or small intestine;
Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal
Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedu
Closure of intestinal cutaneous fistula
Closure of enteroenteric or enterocolic fistula
Closure of enterovesical fistula; without intestinal or bladder resection
Closure of enterovesical fistula; with intestine and/or bladder resection
Intestinal plication (separate procedure)
Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)
Intraoperative colonic lavage (List separately in addition to code for primary procedure)
Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fa
Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each
Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each
Unlisted procedure, intestine
Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct
Excision of lesion of mesentery (separate procedure)
Suture of mesentery (separate procedure)
Unlisted procedure, Meckel's diverticulum and the mesentery
Incision and drainage of appendiceal abscess; open
Incision and drainage of appendiceal abscess; percutaneous
Appendectomy;
Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in
Appendectomy; for ruptured appendix with abscess or generalized peritonitis
Laparoscopy, surgical, appendectomy
Unlisted laparoscopy procedure, appendix
Transrectal drainage of pelvic abscess
Incision and drainage of submucosal abscess, rectum
Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess
Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
Anorectal myomectomy
Proctectomy; complete, combined abdominoperineal, with colostomy

Proctectomy; partial resection of rectum, transabdominal approach
Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)
Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileost
Proctectomy, partial, with anastomosis; abdominal and transsacral approach
Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type)
Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (
Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomo
Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multi
Proctectomy, partial, without anastomosis, perineal approach
Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and uretera
Excision of rectal procidentia, with anastomosis; perineal approach
Excision of rectal procidentia, with anastomosis; abdominal and perineal approach
Excision of ileoanal reservoir with ileostomy
Division of stricture of rectum
Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach
Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)
Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)
Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach
Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)
Proctosigmoidoscopy, rigid; with biopsy, single or multiple
Proctosigmoidoscopy, rigid; with removal of foreign body
Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery
Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique
Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or sna
Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, p
Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, b
Proctosigmoidoscopy, rigid; with decompression of volvulus
Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)
Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Sigmoidoscopy, flexible; with biopsy, single or multiple

Sigmoidoscopy, flexible; with removal of foreign body
Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
Sigmoidoscopy, flexible; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasm
Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance
Sigmoidoscopy, flexible; with decompression of volvulus, any method
Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipo
Sigmoidoscopy, flexible; with dilation by balloon, 1 or more strictures
Sigmoidoscopy, flexible; with endoscopic ultrasound examination
Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)
Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)
Colonoscopy, rigid or flexible, transabdominal via colotomy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, wit
Colonoscopy, flexible, proximal to splenic flexure; with removal of foreign body
Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), any substance
Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, he
Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal b
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bip
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Colonoscopy, flexible, proximal to splenic flexure; with dilation by balloon, 1 or more strictures
Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)
Colonoscopy, flexible, proximal to splenic flexure; with endoscopic ultrasound examination
Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic ultrasound guided intramural or transmural fine needle as
Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy
Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creatio
Laparoscopy, surgical; proctopexy (for prolapse)
Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection
Unlisted laparoscopy procedure, rectum
Proctoplasty; for stenosis
Proctoplasty; for prolapse of mucous membrane

Perirectal injection of sclerosing solution for prolapse
Proctopexy (eg, for prolapse); abdominal approach
Proctopexy (eg, for prolapse); perineal approach
Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach
Repair of rectocele (separate procedure)
Exploration, repair, and presacral drainage for rectal injury;
Exploration, repair, and presacral drainage for rectal injury; with colostomy
Closure of rectovesical fistula;
Closure of rectovesical fistula; with colostomy
Closure of rectourethral fistula;
Closure of rectourethral fistula; with colostomy
Reduction of procidentia (separate procedure) under anesthesia
Dilation of anal sphincter (separate procedure) under anesthesia other than local
Dilation of rectal stricture (separate procedure) under anesthesia other than local
Removal of fecal impaction or foreign body (separate procedure) under anesthesia
Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic
Unlisted procedure, rectum
Placement of seton
Removal of anal seton, other marker
Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)
Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia
Incision and drainage, perianal abscess, superficial
Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placeme
Incision, anal septum (infant)
Sphincterotomy, anal, division of sphincter (separate procedure)
Incision of thrombosed hemorrhoid, external
Fissurectomy, including sphincterotomy, when performed
Excision of single external papilla or tag, anus
Hemorrhoidectomy, internal, by rubber band ligation(s)
Excision of multiple external papillae or tags, anus
Hemorrhoidectomy, external, 2 or more columns/groups

Hemorrhoidectomy, internal and external, single column/group;
Hemorrhoidectomy, internal and external, single column/group; with fissurectomy
Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed
Hemorrhoidectomy, internal and external, 2 or more columns/groups;
Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy
Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed
Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous
Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric
Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, includ
Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage
Closure of anal fistula with rectal advancement flap
Excision of thrombosed hemorrhoid, external
Injection of sclerosing solution, hemorrhoids
Chemodenervation of internal anal sphincter
Anoscopy; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
Anoscopy; with dilation (eg, balloon, guide wire, bougie)
Anoscopy; with biopsy, single or multiple
Anoscopy; with removal of foreign body
Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery
Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique
Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique
Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator
Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or
Anoplasty, plastic operation for stricture; adult
Anoplasty, plastic operation for stricture; infant
Repair of anal fistula with fibrin glue
Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [SIS])
Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach
Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal a
Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)
Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula

Repair of high imperforate anus without fistula; perineal or sacroperineal approach
Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches
Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach
Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approache
Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach
Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;
Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vagi
Sphincteroplasty, anal, for incontinence or prolapse; adult
Sphincteroplasty, anal, for incontinence or prolapse; child
Graft (Thiersch operation) for rectal incontinence and/or prolapse
Removal of Thiersch wire or suture, anal canal
Sphincteroplasty, anal, for incontinence, adult; muscle transplant
Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park posterior anal repair)
Sphincteroplasty, anal, for incontinence, adult; implantation artificial sphincter
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, el
Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)
Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial
Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent
Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group
Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups
Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling
Unlisted procedure, anus
Biopsy of liver, needle; percutaneous
Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for p
Hepatotomy; for open drainage of abscess or cyst, 1 or 2 stages
Hepatotomy; for percutaneous drainage of abscess or cyst, 1 or 2 stages

Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)
Biopsy of liver, wedge
Hepatectomy, resection of liver; partial lobectomy
Hepatectomy, resection of liver; trisegmentectomy
Hepatectomy, resection of liver; total left lobectomy
Hepatectomy, resection of liver; total right lobectomy
Donor hepatectomy (including cold preservation), from cadaver donor
Liver allotransplantation; orthotopic, partial or whole, from cadaver or living donor, any age
Liver allotransplantation; heterotopic, partial or whole, from cadaver or living donor, any age
Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III)
Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV)
Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII)
Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if nece
Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each
Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each
Marsupialization of cyst or abscess of liver
Management of liver hemorrhage; simple suture of liver wound or injury
Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation
Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or witho
Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing
Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency
Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical
Ablation, open, of 1 or more liver tumor(s); radiofrequency
Ablation, open, of 1 or more liver tumor(s); cryosurgical
Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency
Unlisted procedure, liver
Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus
Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without
Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with tra
Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)
Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)
Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when perf
Injection procedure for percutaneous transhepatic cholangiography
Injection procedure for cholangiography through an existing catheter (eg, percutaneous transhepatic or T-tube)
Introduction of percutaneous transhepatic catheter for biliary drainage
Introduction of percutaneous transhepatic stent for internal and external biliary drainage
Change of percutaneous biliary drainage catheter
Revision and/or reinsertion of transhepatic tube
Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure)
Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with or without collection of specimen(s) by brushing and/or
Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or multiple
Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi
Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent
Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent
Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy
Laparoscopy, surgical; with guided transhepatic cholangiography with biopsy
Laparoscopy, surgical; cholecystectomy
Laparoscopy, surgical; cholecystectomy with cholangiography
Laparoscopy, surgical; cholecystectomy with exploration of common duct
Laparoscopy, surgical; cholecystoenterostomy
Unlisted laparoscopy procedure, biliary tract
Cholecystectomy;
Cholecystectomy; with cholangiography
Cholecystectomy with exploration of common duct;
Cholecystectomy with exploration of common duct; with choledochoenterostomy
Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without chola
Biliary duct stone extraction, percutaneous via T-tube tract, basket, or snare (eg, Burhenne technique)
Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography
Portoenterostomy (eg, Kasai procedure)
Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic
Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic
Excision of choledochal cyst
Cholecystoenterostomy; direct
Cholecystoenterostomy; with gastroenterostomy
Cholecystoenterostomy; Roux-en-Y
Cholecystoenterostomy; Roux-en-Y with gastroenterostomy
Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract
Anastomosis, of intrahepatic ducts and gastrointestinal tract
Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract
Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract
Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis
Placement of choledochal stent
U-tube hepaticoenterostomy
Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)
Unlisted procedure, biliary tract
Placement of drains, peripancreatic, for acute pancreatitis;
Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy
Removal of pancreatic calculus
Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)
Biopsy of pancreas, percutaneous needle
Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis
Excision of lesion of pancreas (eg, cyst, adenoma)
Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy
Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy
Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure)
Excision of ampulla of Vater
Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy
Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy
Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sp
Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sp
Pancreatectomy, total
Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or pancreatic islet cells
Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure)
Marsupialization of pancreatic cyst
External drainage, pseudocyst of pancreas; open
External drainage, pseudocyst of pancreas; percutaneous
Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct
Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y
Pancreatorrhaphy for injury
Duodenal exclusion with gastrojejunostomy for pancreatic injury
Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation)
Donor pancreatectomy (including cold preservation), with or without duodenal segment for transplantation
Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from
Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each
Transplantation of pancreatic allograft
Removal of transplanted pancreatic allograft
Unlisted procedure, pancreas
Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
Reopening of recent laparotomy
Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)
Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; open
Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous
Drainage of subdiaphragmatic or subphrenic abscess; open
Drainage of subdiaphragmatic or subphrenic abscess; percutaneous
Drainage of retroperitoneal abscess; open
Drainage of retroperitoneal abscess; percutaneous
Drainage of extraperitoneal lymphocele to peritoneal cavity, open
Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); initial
Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); subsequent
Biopsy, abdominal or retroperitoneal mass, percutaneous needle
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitone
Excision of presacral or sacrococcygeal tumor
Staging laparotomy for Hodgkins disease or lymphoma (includes splenectomy, needle or open biopsies of both liver lobes, possibly
Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)
Omentectomy, epiploectomy, resection of omentum (separate procedure)
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (
Laparoscopy, surgical; with biopsy (single or multiple)
Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)
Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity
Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter
Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstruct
Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure)
Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra
Unlisted laparoscopy procedure, abdomen, peritoneum and omentum
Injection of air or contrast into peritoneal cavity (separate procedure)
Removal of peritoneal foreign body from peritoneal cavity
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal,
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelv
Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), com
Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)
Insertion of tunneled intraperitoneal catheter for dialysis, open
Removal of tunneled intraperitoneal catheter
Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)
Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)
Insertion of peritoneal-venous shunt
Revision of peritoneal-venous shunt
Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt
Ligation of peritoneal-venous shunt
Removal of peritoneal-venous shunt
Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition t
Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter
Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation an
Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image
Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image doc
Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injectio
Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast i
Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), im
Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image docum
Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or
Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecos
Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks pos
Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks pos
Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception a
Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception a
Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible
Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated
Repair initial inguinal hernia, age 5 years or older; reducible
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated
Repair recurrent inguinal hernia, any age; reducible
Repair recurrent inguinal hernia, any age; incarcerated or strangulated
Repair inguinal hernia, sliding, any age
Repair lumbar hernia
Repair initial femoral hernia, any age; reducible
Repair initial femoral hernia, any age; incarcerated or strangulated
Repair recurrent femoral hernia; reducible
Repair recurrent femoral hernia; incarcerated or strangulated
Repair initial incisional or ventral hernia; reducible
Repair initial incisional or ventral hernia; incarcerated or strangulated
Repair recurrent incisional or ventral hernia; reducible
Repair recurrent incisional or ventral hernia; incarcerated or strangulated
Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrot
Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure)

Repair epigastric hernia (eg, preperitoneal fat); incarcerated or strangulated
Repair umbilical hernia, younger than age 5 years; reducible
Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated
Repair umbilical hernia, age 5 years or older; reducible
Repair umbilical hernia, age 5 years or older; incarcerated or strangulated
Repair spigelian hernia
Repair of small omphalocele, with primary closure
Repair of large omphalocele or gastroschisis; with or without prosthesis
Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room
Repair of omphalocele (Gross type operation); first stage
Repair of omphalocele (Gross type operation); second stage
Laparoscopy, surgical; repair initial inguinal hernia
Laparoscopy, surgical; repair recurrent inguinal hernia
Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible
Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcera
Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible
Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated
Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible
Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated
Suture, secondary, of abdominal wall for evisceration or dehiscence
Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)
Omental flap, intra-abdominal (List separately in addition to code for primary procedure)
Free omental flap with microvascular anastomosis
Renal exploration, not necessitating other specific procedures
Drainage of perirenal or renal abscess; open
Drainage of perirenal or renal abscess; percutaneous
Nephrostomy, nephrotomy with drainage
Nephrotomy, with exploration
Nephrolithotomy; removal of calculus
Nephrolithotomy; secondary surgical operation for calculus
Nephrolithotomy; complicated by congenital kidney abnormality

Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)
Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extrac
Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extrac
Transection or repositioning of aberrant renal vessels (separate procedure)
Pyelotomy; with exploration
Pyelotomy; with drainage, pyelostomy
Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)
Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality)
Renal biopsy; percutaneous, by trocar or needle
Renal biopsy; by surgical exposure of kidney
Nephrectomy, including partial ureterectomy, any open approach including rib resection;
Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery
Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy
Nephrectomy with total ureterectomy and bladder cuff; through same incision
Nephrectomy with total ureterectomy and bladder cuff; through separate incision
Nephrectomy, partial
Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if perfor
Excision or unroofing of cyst(s) of kidney
Excision of perinephric cyst
Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral
Donor nephrectomy (including cold preservation); open, from living donor
Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perin
Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection
Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each
Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each
Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each
Recipient nephrectomy (separate procedure)
Renal allotransplantation, implantation of graft; without recipient nephrectomy
Renal allotransplantation, implantation of graft; with recipient nephrectomy
Removal of transplanted renal allograft
Renal autotransplantation, reimplantation of kidney
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiologic
Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cysto
Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including r
Removal and replacement of externally accessible transnephric ureteral stent (eg, external/internal stent) requiring fluoroscopic gu
Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)
Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous
Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy t
Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous
Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous
Injection procedure for pyelography (as nephrostogram, pyelostogram, antegrade pyeloureterograms) through nephrostomy or py
Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract, percutaneous
Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter
Change of nephrostomy or pyelostomy tube
Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephr
Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephr
Nephrorrhaphy, suture of kidney wound or injury
Closure of nephrocutaneous or pyelocutaneous fistula
Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach
Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach
Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operatio
Laparoscopy, surgical; ablation of renal cysts
Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when perform
Laparoscopy, surgical; partial nephrectomy
Laparoscopy, surgical; pyeloplasty
Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional ly
Laparoscopy, surgical; nephrectomy, including partial ureterectomy
Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor
Laparoscopy, surgical; nephrectomy with total ureterectomy
Unlisted laparoscopy procedure, renal
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, e
Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of rad
Lithotripsy, extracorporeal shock wave
Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency
Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy
Ureterotomy with exploration or drainage (separate procedure)
Ureterotomy for insertion of indwelling stent, all types
Ureterolithotomy; upper one-third of ureter
Ureterolithotomy; middle one-third of ureter
Ureterolithotomy; lower one-third of ureter
Ureterectomy, with bladder cuff (separate procedure)
Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach
Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter
Manometric studies through ureterostomy or indwelling ureteral catheter
Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit
Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service
Ureteroplasty, plastic operation on ureter (eg, stricture)
Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis
Ureterolysis for ovarian vein syndrome
Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava
Revision of urinary-cutaneous anastomosis (any type urostomy);
Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia
Ureteropyelostomy, anastomosis of ureter and renal pelvis
Ureterocalycostomy, anastomosis of ureter to renal calyx
Ureteroureterostomy
Transureteroureterostomy, anastomosis of ureter to contralateral ureter
Ureteroneocystostomy; anastomosis of single ureter to bladder
Ureteroneocystostomy; anastomosis of duplicated ureter to bladder
Ureteroneocystostomy; with extensive ureteral tailoring
Ureteroneocystostomy; with vesico-psoas hitch or bladder flap
Ureteroenterostomy, direct anastomosis of ureter to intestine
Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestin
Ureterocolon conduit, including intestine anastomosis
Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation)
Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey ente
Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterost
Replacement of all or part of ureter by intestine segment, including intestine anastomosis
Cutaneous appendico-vesicostomy
Ureterostomy, transplantation of ureter to skin
Ureterorrhaphy, suture of ureter (separate procedure)
Closure of ureterocutaneous fistula
Closure of ureterovisceral fistula (including visceral repair)
Deligation of ureter
Laparoscopy, surgical; ureterolithotomy
Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement
Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement
Unlisted laparoscopy procedure, ureter
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of r
Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic ser
Cystotomy or cystostomy; with fulguration and/or insertion of radioactive material
Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion
Cystostomy, cystotomy with drainage
Cystotomy, with insertion of ureteral catheter or stent (separate procedure)
Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection
Transvesical ureterolithotomy
Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus
Drainage of perivesical or prevesical space abscess
Aspiration of bladder; by needle
Aspiration of bladder; by trocar or intracatheter
Aspiration of bladder; with insertion of suprapubic catheter
Excision of urachal cyst or sinus, with or without umbilical hernia repair
Cystotomy; for simple excision of vesical neck (separate procedure)
Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)
Cystotomy; for excision of bladder tumor
Cystotomy for excision, incision, or repair of ureterocele
Cystectomy, partial; simple
Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)
Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)
Cystectomy, complete; (separate procedure)
Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes
Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;
Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy,
Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;
Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphad
Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to constru
Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations,
Injection procedure for cystography or voiding urethrocystography
Injection procedure and placement of chain for contrast and/or chain urethrocystography
Injection procedure for retrograde urethrocystography
Bladder irrigation, simple, lavage and/or instillation
Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)
Insertion of temporary indwelling bladder catheter; simple (eg, Foley)
Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)
Change of cystostomy tube; simple
Change of cystostomy tube; complicated
Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck
Bladder instillation of anticarcinogenic agent (including retention time)
Simple cystometrogram (CMG) (eg, spinal manometer)
Complex cystometrogram (ie, calibrated electronic equipment);
Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure
Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any te
Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and ur
Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter)
Complex uroflowmetry (eg, calibrated electronic equipment)
Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique
Needle electromyography studies (EMG) of anal or urethral sphincter, any technique
Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)
Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary proced
Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging
Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), an
Cystourethroplasty with unilateral or bilateral ureteroneocystostomy
Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple
Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair)
Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra)
Cystorrhaphy, suture of bladder wound, injury or rupture; simple
Cystorrhaphy, suture of bladder wound, injury or rupture; complicated
Closure of cystostomy (separate procedure)

Closure of vesicovaginal fistula, abdominal approach
Closure of vesicouterine fistula;
Closure of vesicouterine fistula; with hysterectomy
Closure, exstrophy of bladder
Enterocystoplasty, including intestinal anastomosis
Cutaneous vesicostomy
Laparoscopy, surgical; urethral suspension for stress incontinence
Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)
Unlisted laparoscopy procedure, bladder
Cystourethroscopy (separate procedure)
Cystourethroscopy with irrigation and evacuation of multiple obstructing clots
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiolo
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiolo
Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of r
Cystourethroscopy, with biopsy(s)
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or pe
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) wit
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s)
Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration
Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia
Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia
Cystourethroscopy, with internal urethrotomy; female
Cystourethroscopy, with internal urethrotomy; male
Cystourethroscopy with direct vision internal urethrotomy
Cystourethroscopy, with resection of external sphincter (sphincterotomy)
Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without in
Cystourethroscopy, with insertion of permanent urethral stent
Cystourethroscopy, with steroid injection into stricture
Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral di
Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral
Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral
Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral
Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complic
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2
Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic
Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material
Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde
Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)
Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)
Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery
Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incisio
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is inc
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor
Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertr
Cystourethroscopy with transurethral resection or incision of ejaculatory ducts
Transurethral incision of prostate
Transurethral resection of bladder neck (separate procedure)
Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy
Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (
Transurethral resection; of postoperative bladder neck contracture
Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, u
Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy,
Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotom
Transurethral drainage of prostatic abscess
Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra
Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external
Meatotomy, cutting of meatus (separate procedure); except infant
Meatotomy, cutting of meatus (separate procedure); infant
Drainage of deep periurethral abscess
Drainage of Skene's gland abscess or cyst
Drainage of perineal urinary extravasation; uncomplicated (separate procedure)
Drainage of perineal urinary extravasation; complicated
Biopsy of urethra
Urethrectomy, total, including cystostomy; female
Urethrectomy, total, including cystostomy; male
Excision or fulguration of carcinoma of urethra
Excision of urethral diverticulum (separate procedure); female
Excision of urethral diverticulum (separate procedure); male
Marsupialization of urethral diverticulum, male or female
Excision of bulbourethral gland (Cowper's gland)
Excision or fulguration; urethral polyp(s), distal urethra
Excision or fulguration; urethral caruncle
Excision or fulguration; Skene's glands
Excision or fulguration; urethral prolapse
Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type)
Urethroplasty; second stage (formation of urethra), including urinary diversion
Urethroplasty, 1-stage reconstruction of male anterior urethra
Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra
Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage
Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage

Urethroplasty, reconstruction of female urethra
Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure)
Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)
Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)
Insertion of tandem cuff (dual cuff)
Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff
Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff
Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative s
Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected fie
Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff
Urethromeatoplasty, with mucosal advancement
Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure)
Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)
Urethrorrhaphy, suture of urethral wound or injury, female
Urethrorrhaphy, suture of urethral wound or injury; penile
Urethrorrhaphy, suture of urethral wound or injury; perineal
Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous
Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)
Dilation of urethral stricture by passage of sound or urethral dilator, male; initial
Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent
Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia
Dilation of urethral stricture by passage of filiform and follower, male; initial
Dilation of urethral stricture by passage of filiform and follower, male; subsequent
Dilation of female urethra including suppository and/or instillation; initial
Dilation of female urethra including suppository and/or instillation; subsequent
Dilation of female urethra, general or conduction (spinal) anesthesia
Transurethral destruction of prostate tissue; by microwave thermotherapy
Transurethral destruction of prostate tissue; by radiofrequency thermotherapy
Insertion of a temporary prostatic urethral stent, including urethral measurement
Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence
Unlisted procedure, urinary system

Slitting of prepuce, dorsal or lateral (separate procedure); newborn
Slitting of prepuce, dorsal or lateral (separate procedure); except newborn
Incision and drainage of penis, deep
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, e
Biopsy of penis; (separate procedure)
Biopsy of penis; deep structures
Excision of penile plaque (Peyronie disease);
Excision of penile plaque (Peyronie disease); with graft to 5 cm in length
Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length
Removal foreign body from deep penile tissue (eg, plastic implant)
Amputation of penis; partial
Amputation of penis; complete
Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy
Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturat
Circumcision, using clamp or other device with regional dorsal penile or ring block
Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)
Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age
Lysis or excision of penile post-circumcision adhesions
Repair incomplete circumcision
Frenulotomy of penis
Injection procedure for Peyronie disease;
Injection procedure for Peyronie disease; with surgical exposure of plaque
Irrigation of corpora cavernosa for priapism
Injection procedure for corpora cavernosography
Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)
Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)

Penile plethysmography
Nocturnal penile tumescence and/or rigidity test
Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra
Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce
Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm
Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm
Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than g
Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair)
1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap)
1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prep
1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization
1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and ureth
1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by u
1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube an
Repair of hypospadias complications (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple
Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with fla
Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring extensive dissection and urethroplasty with flap, p
Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release
Plastic operation on penis to correct angulation
Plastic operation on penis for epispadias distal to external sphincter;
Plastic operation on penis for epispadias distal to external sphincter; with incontinence
Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder
Insertion of penile prosthesis; non-inflatable (semi-rigid)
Insertion of penile prosthesis; inflatable (self-contained)
Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir
Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis
Repair of component(s) of a multi-component, inflatable penile prosthesis
Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session
Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the sam
Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis
Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative sessio
Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at
Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral
Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral
Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism
Plastic operation of penis for injury
Foreskin manipulation including lysis of preputial adhesions and stretching
Biopsy of testis, needle (separate procedure)
Biopsy of testis, incisional (separate procedure)
Excision of extraparenchymal lesion of testis
Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach
Orchiectomy, partial
Orchiectomy, radical, for tumor; inguinal approach
Orchiectomy, radical, for tumor; with abdominal exploration
Exploration for undescended testis (inguinal or scrotal area)
Exploration for undescended testis with abdominal exploration
Reduction of torsion of testis, surgical, with or without fixation of contralateral testis
Fixation of contralateral testis (separate procedure)
Orchiopexy, inguinal approach, with or without hernia repair
Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens)
Insertion of testicular prosthesis (separate procedure)
Suture or repair of testicular injury
Transplantation of testis(es) to thigh (because of scrotal destruction)
Laparoscopy, surgical; orchiectomy
Laparoscopy, surgical; orchiopexy for intra-abdominal testis
Unlisted laparoscopy procedure, testis
Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)
Biopsy of epididymis, needle
Excision of local lesion of epididymis
Excision of spermatocele, with or without epididymectomy
Epididymectomy; unilateral
Epididymectomy; bilateral
Exploration of epididymis, with or without biopsy
Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral
Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral
Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication
Excision of hydrocele; unilateral
Excision of hydrocele; bilateral
Repair of tunica vaginalis hydrocele (Bottle type)
Drainage of scrotal wall abscess
Scrotal exploration
Removal of foreign body in scrotum
Resection of scrotum
Scrotoplasty; simple
Scrotoplasty; complicated
Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)
Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)
Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral
Vasovasostomy, vasovasorrhaphy
Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure)
Excision of hydrocele of spermatic cord, unilateral (separate procedure)
Excision of lesion of spermatic cord (separate procedure)
Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)
Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach
Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair
Laparoscopy, surgical, with ligation of spermatic veins for varicocele
Unlisted laparoscopy procedure, spermatic cord
Vesiculotomy;
Vesiculotomy; complicated
Vesiculectomy, any approach
Excision of Mullerian duct cyst
Biopsy, prostate; needle or punch, single or multiple, any approach
Biopsy, prostate; incisional, any approach

Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance
Prostatotomy, external drainage of prostatic abscess, any approach; simple
Prostatotomy, external drainage of prostatic abscess, any approach; complicated
Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or
Prostatectomy, perineal radical;
Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes
Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and inter
Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and inter
Prostatectomy, retropubic radical, with or without nerve sparing;
Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)
Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, h
Exposure of prostate, any approach, for insertion of radioactive substance;
Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenec
Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including exter
Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed
Electroejaculation
Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)
Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approa
Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement ap
Intersex surgery; male to female
Intersex surgery; female to male
Incision and drainage of vulva or perineal abscess
Incision and drainage of Bartholin's gland abscess
Marsupialization of Bartholin's gland cyst
Lysis of labial adhesions
Hymenotomy, simple incision
Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Biopsy of vulva or perineum (separate procedure); 1 lesion
Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary p
Vulvectomy simple; partial
Vulvectomy simple; complete
Vulvectomy, radical, partial;
Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy
Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy
Vulvectomy, radical, complete;
Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy
Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy
Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy
Partial hymenectomy or revision of hymenal ring
Excision of Bartholin's gland or cyst
Plastic repair of introitus
Clitoroplasty for intersex state
Perineoplasty, repair of perineum, nonobstetrical (separate procedure)
Colposcopy of the vulva;
Colposcopy of the vulva; with biopsy(s)
Colpotomy; with exploration
Colpotomy; with drainage of pelvic abscess
Colpocentesis (separate procedure)
Incision and drainage of vaginal hematoma; obstetrical/postpartum
Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)
Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Biopsy of vaginal mucosa; simple (separate procedure)
Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)
Vaginectomy, partial removal of vaginal wall;
Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lym
Vaginectomy, complete removal of vaginal wall;
Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic
Colpocleisis (Le Fort type)
Excision of vaginal septum
Excision of vaginal cyst or tumor
Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease
Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy
Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy
Fitting and insertion of pessary or other intravaginal support device
Diaphragm or cervical cap fitting with instructions
Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedur
Colporrhaphy, suture of injury of vagina (nonobstetrical)
Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)
Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication)
Plastic repair of urethrocele
Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
Combined anteroposterior colporrhaphy;
Combined anteroposterior colporrhaphy; with enterocele repair
Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approac
Repair of enterocele, vaginal approach (separate procedure)
Repair of enterocele, abdominal approach (separate procedure)
Colpopexy, abdominal approach
Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)
Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)
Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach
Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach
Removal or revision of sling for stress incontinence (eg, fascia or synthetic)
Sling operation for stress incontinence (eg, fascia or synthetic)
Pereyra procedure, including anterior colporrhaphy
Construction of artificial vagina; without graft
Construction of artificial vagina; with graft

Revision (including removal) of prosthetic vaginal graft; vaginal approach
Revision (including removal) of prosthetic vaginal graft; open abdominal approach
Closure of rectovaginal fistula; vaginal or transanal approach
Closure of rectovaginal fistula; abdominal approach
Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy
Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication
Closure of urethrovaginal fistula;
Closure of urethrovaginal fistula; with bulbocavernosus transplant
Closure of vesicovaginal fistula; vaginal approach
Closure of vesicovaginal fistula; transvesical and vaginal approach
Vaginoplasty for intersex state
Dilation of vagina under anesthesia (other than local)
Pelvic examination under anesthesia (other than local)
Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)
Colposcopy of the entire vagina, with cervix if present;
Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix
Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach
Laparoscopy, surgical, colpopexy (suspension of vaginal apex)
Revision (including removal) of prosthetic vaginal graft, laparoscopic approach
Colposcopy of the cervix including upper/adjacent vagina;
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix
Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage
Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix
Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix
Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)
Endocervical curettage (not done as part of a dilation and curettage)
Cautery of cervix; electro or thermal
Cautery of cervix; cryocautery, initial or repeat
Cautery of cervix; laser ablation
Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser
Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode exc
Trachelectomy (cervicectomy), amputation of cervix (separate procedure)
Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without r
Excision of cervical stump, abdominal approach;
Excision of cervical stump, abdominal approach; with pelvic floor repair
Excision of cervical stump, vaginal approach;
Excision of cervical stump, vaginal approach; with anterior and/or posterior repair
Excision of cervical stump, vaginal approach; with repair of enterocele
Dilation and curettage of cervical stump
Cerclage of uterine cervix, nonobstetrical
Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach
Dilation of cervical canal, instrumental (separate procedure)
Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate pro
Endometrial sampling (biopsy) performed in conjunction with colposcopy (List separately in addition to code for primary procedure
Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)
Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal
Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal
Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight gr
Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with co
Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ov
Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without re
Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with
Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tu
Vaginal hysterectomy, for uterus 250 g or less;
Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)
Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele
Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with o
Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele
Vaginal hysterectomy, with total or partial vaginectomy;
Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele

Vaginal hysterectomy, radical (Schauta type operation)
Vaginal hysterectomy, for uterus greater than 250 g;
Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele
Vaginal hysterectomy, for uterus greater than 250 g; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) w
Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele
Insertion of intrauterine device (IUD)
Removal of intrauterine device (IUD)
Artificial insemination; intra-cervical
Artificial insemination; intra-uterine
Sperm washing for artificial insemination
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingograph
Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hy
Insertion of Heyman capsules for clinical brachytherapy
Chromotubation of oviduct, including materials
Endometrial ablation, thermal, without hysteroscopic guidance
Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed
Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separat
Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with pre
Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)
Hysteroplasty, repair of uterine anomaly (Strassman type)
Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;
Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surfa
Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater
Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node samplin
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;
Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
Hysteroscopy, diagnostic (separate procedure)
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)
Hysteroscopy, surgical; with removal of leiomyomata
Hysteroscopy, surgical; with removal of impacted foreign body
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;
Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)
Unlisted laparoscopy procedure, uterus
Unlisted hysteroscopy procedure, uterus
Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral
Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospita
Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate p
Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or Falope ring)
Laparoscopy, surgical; with fimbrioplasty
Laparoscopy, surgical; with salpingostomy (salpingoneostomy)
Unlisted laparoscopy procedure, oviduct, ovary
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
Lysis of adhesions (salpingolysis, ovariolysis)
Tubotubal anastomosis
Tubouterine implantation
Fimbrioplasty
Salpingostomy (salpingoneostomy)
Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach
Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach
Drainage of ovarian abscess; vaginal approach, open
Drainage of ovarian abscess; abdominal approach
Drainage of pelvic abscess, transvaginal or transrectal approach, percutaneous (eg, ovarian, pericolic)
Transposition, ovary(s)
Biopsy of ovary, unilateral or bilateral (separate procedure)
Wedge resection or bisection of ovary, unilateral or bilateral
Ovarian cystectomy, unilateral or bilateral
Oophorectomy, partial or total, unilateral or bilateral;
Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pel
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with
Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;
Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelv
Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy
Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal
Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal
Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectom
Follicle puncture for oocyte retrieval, any method
Embryo transfer, intrauterine
Gamete, zygote, or embryo intrafallopian transfer, any method
Amniocentesis; diagnostic
Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)
Cordocentesis (intrauterine), any method
Chorionic villus sampling, any method
Fetal contraction stress test

Fetal non-stress test
Fetal scalp blood sampling
Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretat
Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only
Transabdominal amnioinfusion, including ultrasound guidance
Fetal umbilical cord occlusion, including ultrasound guidance
Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance
Fetal shunt placement, including ultrasound guidance
Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)
Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal ap
Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy
Surgical treatment of ectopic pregnancy; abdominal pregnancy
Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy requiring total hysterectomy
Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus
Surgical treatment of ectopic pregnancy; cervical, with evacuation
Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy
Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy
Curettage, postpartum
Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)
Episiotomy or vaginal repair, by other than attending physician
Cerclage of cervix, during pregnancy; vaginal
Cerclage of cervix, during pregnancy; abdominal
Hysterorrhaphy of ruptured uterus
Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum ca
Vaginal delivery only (with or without episiotomy and/or forceps);
Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care
External cephalic version, with or without tocolysis
Delivery of placenta (separate procedure)
Antepartum care only; 4-6 visits
Antepartum care only; 7 or more visits
Postpartum care only (separate procedure)

Routine obstetric care including antepartum care, cesarean delivery, and postpartum care
Cesarean delivery only;
Cesarean delivery only; including postpartum care
Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary procedure)
Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum ca
Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);
Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care
Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery af
Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;
Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care
Treatment of incomplete abortion, any trimester, completed surgically
Treatment of missed abortion, completed surgically; first trimester
Treatment of missed abortion, completed surgically; second trimester
Treatment of septic abortion, completed surgically
Induced abortion, by dilation and curettage
Induced abortion, by dilation and evacuation
Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, deliver
Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including
Multifetal pregnancy reduction(s) (MPR)
Uterine evacuation and curettage for hydatidiform mole
Removal of cerclage suture under anesthesia (other than local)
Unlisted fetal invasive procedure, including ultrasound guidance, when performed
Unlisted laparoscopy procedure, maternity care and delivery
Incision and drainage of thyroglossal duct cyst, infected
Biopsy thyroid, percutaneous core needle
Excision of cyst or adenoma of thyroid, or transection of isthmus
Partial thyroid lobectomy, unilateral; with or without isthmusectomy

Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
Total thyroid lobectomy, unilateral; with or without isthmusectomy
Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy
Thyroidectomy, total or complete
Thyroidectomy, total or subtotal for malignancy; with limited neck dissection
Thyroidectomy, total or subtotal for malignancy; with radical neck dissection
Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid
Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach
Thyroidectomy, including substernal thyroid; cervical approach
Excision of thyroglossal duct cyst or sinus;
Excision of thyroglossal duct cyst or sinus; recurrent
Aspiration and/or injection, thyroid cyst
Parathyroidectomy or exploration of parathyroid(s);
Parathyroidectomy or exploration of parathyroid(s); re-exploration
Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach
Parathyroid autotransplantation (List separately in addition to code for primary procedure)
Thymectomy, partial or total; transcervical approach (separate procedure)
Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)
Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)
Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (sep
Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (sep
Excision of carotid body tumor; without excision of carotid artery
Excision of carotid body tumor; with excision of carotid artery
Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdom
Unlisted laparoscopy procedure, endocrine system
Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial
Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps
Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection
Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of m
Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure)
Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or other substance for diagnosis or treatment (eg, C1-C2
Puncture of shunt tubing or reservoir for aspiration or injection procedure
Twist drill hole for subdural or ventricular puncture
Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device
Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma
Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)
Burr hole(s) or trephine; with biopsy of brain or intracranial lesion
Burr hole(s) or trephine; with drainage of brain abscess or cyst
Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst
Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural
Burr hole(s); with aspiration of hematoma or cyst, intracerebral
Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitorin
Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter
Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery
Burr hole(s) or trephine, infratentorial, unilateral or bilateral
Craniectomy or craniotomy, exploratory; supratentorial
Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)
Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural
Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral
Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural
Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar
Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure)
Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial
Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial
Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacu
Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacu
Decompression of orbit only, transcranial approach
Exploration of orbit (transcranial approach); with biopsy
Exploration of orbit (transcranial approach); with removal of lesion
Exploration of orbit (transcranial approach); with removal of foreign body
Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)
Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg
Other cranial decompression, posterior fossa
Craniotomy for section of tentorium cerebelli (separate procedure)
Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion
Craniectomy, suboccipital; for exploration or decompression of cranial nerves
Craniectomy, suboccipital; for section of 1 or more cranial nerves
Craniectomy, suboccipital; for medullary tractotomy
Craniectomy, suboccipital; for mesencephalic tractotomy or pedunculotomy
Craniotomy for lobotomy, including cingulotomy
Craniectomy; with excision of tumor or other bone lesion of skull
Craniectomy; for osteomyelitis
Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma
Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial
Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial
Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial
Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure)
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or m
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor
Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull
Craniectomy, infratentorial or posterior fossa; for excision of brain abscess
Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst
Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;
Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/
Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring
Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring
Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery
Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (se
Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (incl
Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery
Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery
Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during
Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography du
Craniotomy with elevation of bone flap; for transection of corpus callosum
Craniotomy with elevation of bone flap; for total hemispherectomy
Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy
Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus
Craniotomy with elevation of bone flap; for excision of craniopharyngioma
Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach
Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
Craniectomy for craniosynostosis; single cranial suture
Craniectomy for craniosynostosis; multiple cranial sutures
Craniotomy for craniosynostosis; frontal or parietal bone flap
Craniotomy for craniosynostosis; bifrontal bone flap
Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts
Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies an
Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression
Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression
Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy
Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery
Craniectomy or craniotomy; with excision of foreign body from brain
Craniectomy or craniotomy; with treatment of penetrating wound of brain
Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;
Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting
Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without
Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphen
Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s),
Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of fro
Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or
Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or
Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without b
Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopha
Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus
Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex)
Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression
Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression
Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylecto
Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or s
Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural
Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair,
Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extrad
Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intrad
Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; ext
Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; int
Transection or ligation, carotid artery in cavernous sinus; without repair (List separately in addition to code for primary procedure)
Transection or ligation, carotid artery in cavernous sinus; with repair by anastomosis or graft (List separately in addition to code for
Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure)
Transection or ligation, carotid artery in petrous canal; with repair by anastomosis or graft (List separately in addition to code for p
Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus
Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnu
Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnu
Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base;
Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base;
Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of ve
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malfo
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malfo
Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous
Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if perfor
Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel
Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular family (List separately in additio
Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular family (List separately in ad
Surgery of intracranial arteriovenous malformation; supratentorial, simple
Surgery of intracranial arteriovenous malformation; supratentorial, complex
Surgery of intracranial arteriovenous malformation; infratentorial, simple

Surgery of intracranial arteriovenous malformation; infratentorial, complex
Surgery of intracranial arteriovenous malformation; dural, simple
Surgery of intracranial arteriovenous malformation; dural, complex
Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation
Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation
Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation
Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation
Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutch
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or bal
Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries
Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages;
Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages;
Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;
Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magne
Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring
Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source
Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List separately in addition to code for primary procedu
Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List separately in addition to code for primary proced
Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure)
Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gas
Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trig
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (List separately in
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (List separately
Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure)
Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical
Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical
Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical s
Craniectomy for implantation of neurostimulator electrodes, cerebellar; cortical
Craniectomy for implantation of neurostimulator electrodes, cerebellar; subcortical
Revision or removal of intracranial neurostimulator electrodes
Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a
Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2
Revision or removal of cranial neurostimulator pulse generator or receiver
Elevation of depressed skull fracture; simple, extradural
Elevation of depressed skull fracture; compound or comminuted, extradural
Elevation of depressed skull fracture; with repair of dura and/or debridement of brain
Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea
Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty
Reduction of craniomegalic skull (eg, treated hydrocephalus); with simple cranioplasty
Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft
Repair of encephalocele, skull vault, including cranioplasty
Craniotomy for repair of encephalocele, skull base
Cranioplasty for skull defect; up to 5 cm diameter
Cranioplasty for skull defect; larger than 5 cm diameter
Removal of bone flap or prosthetic plate of skull
Replacement of bone flap or prosthetic plate of skull
Cranioplasty for skull defect with reparative brain surgery
Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter
Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter
Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure
Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external d
Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including
Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for
Neuroendoscopy, intracranial; with retrieval of foreign body
Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage
Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach
Ventriculocisternostomy (Torkildsen type operation)
Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular
Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus
Replacement or irrigation, subarachnoid/subdural catheter
Ventriculocisternostomy, third ventricle;
Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method
Creation of shunt; ventriculo-atrial, -jugular, -auricular
Creation of shunt; ventriculo-peritoneal, -pleural, other terminus
Replacement or irrigation, ventricular catheter
Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system
Reprogramming of programmable cerebrospinal shunt
Removal of complete cerebrospinal fluid shunt system; without replacement
Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation
Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, cathete
Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, cathete
Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes
Percutaneous aspiration, spinal cord cyst or syrinx
Biopsy of spinal cord, percutaneous needle
Spinal puncture, lumbar, diagnostic
Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter)
Injection, epidural, of blood or clot patch
Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance;
Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa)
Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar
Injection procedure for discography, each level; lumbar
Injection procedure for discography, each level; cervical or thoracic
Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar
Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal
Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization o
Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization o
Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or wit
Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or wit
Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an
Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an
Removal of previously implanted intrathecal or epidural catheter
Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir
Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump
Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pum
Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir sta
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir sta
Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or
Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots fo
Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excisio
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerv
Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;
Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior
Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single
Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single seg
Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each addi
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspa
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additiona
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspa
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additiona
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or
Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord an
Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord an
Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of s
Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of s
Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompres
Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompres
Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal
Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar
Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space
Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space
Laminectomy and section of dentate ligaments, with or without dural graft, cervical; 1 or 2 segments
Laminectomy and section of dentate ligaments, with or without dural graft, cervical; more than 2 segments
Laminectomy with rhizotomy; 1 or 2 segments
Laminectomy with rhizotomy; more than 2 segments
Laminectomy with section of spinal accessory nerve

Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; cervical
Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; thoracic
Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; cervical
Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; thoracic
Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; cervical
Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages within 14 days; thoracic
Laminectomy, with release of tethered spinal cord, lumbar
Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical
Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic
Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar
Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical
Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic
Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar
Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral
Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical
Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic
Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar
Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral
Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical
Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic
Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar
Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic
Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar
Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level
Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code f
Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural,
Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural,
Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additi
Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)
Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery
Stereotactic biopsy, aspiration, or excision of lesion, spinal cord
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition
Percutaneous implantation of neurostimulator electrode array, epidural
Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural
Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when p
Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy
Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or lam
Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
Revision or removal of implanted spinal neurostimulator pulse generator or receiver
Repair of meningocele; less than 5 cm diameter
Repair of meningocele; larger than 5 cm diameter
Repair of myelomeningocele; less than 5 cm diameter
Repair of myelomeningocele; larger than 5 cm diameter
Repair of dural/cerebrospinal fluid leak, not requiring laminectomy
Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy
Dural graft, spinal
Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy
Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy
Replacement, irrigation or revision of lumbosubarachnoid shunt
Removal of entire lumbosubarachnoid shunt system without replacement
Injection, anesthetic agent; trigeminal nerve, any division or branch
Injection, anesthetic agent; facial nerve
Injection, anesthetic agent; greater occipital nerve
Injection, anesthetic agent; vagus nerve
Injection, anesthetic agent; phrenic nerve
Injection, anesthetic agent; spinal accessory nerve
Injection, anesthetic agent; cervical plexus
Injection, anesthetic agent; brachial plexus, single
Injection, anesthetic agent; brachial plexus, continuous infusion by catheter (including catheter placement)
Injection, anesthetic agent; axillary nerve
Injection, anesthetic agent; suprascapular nerve
Injection, anesthetic agent; intercostal nerve, single
Injection, anesthetic agent; intercostal nerves, multiple, regional block
Injection, anesthetic agent; ilioinguinal, iliohypogastric nerves
Injection, anesthetic agent; pudendal nerve
Injection, anesthetic agent; paracervical (uterine) nerve
Injection, anesthetic agent; sciatic nerve, single
Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter (including catheter placement)
Injection, anesthetic agent; femoral nerve, single
Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement)
Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)
Injection, anesthetic agent; other peripheral nerve or branch
Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma)
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thorac
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thorac
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral,
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral,
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image
Injection, anesthetic agent; sphenopalatine ganglion
Injection, anesthetic agent; carotid sinus (separate procedure)
Injection, anesthetic agent; stellate ganglion (cervical sympathetic)
Injection, anesthetic agent; superior hypogastric plexus
Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)
Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring
Application of surface (transcutaneous) neurostimulator
Percutaneous implantation of neurostimulator electrodes; cranial nerve
Percutaneous implantation of neurostimulator electrodes; peripheral nerve (excludes sacral nerve)
Percutaneous implantation of neurostimulator electrodes; autonomic nerve
Percutaneous implantation of neurostimulator electrodes; sacral nerve (transforaminal placement)
Percutaneous implantation of neurostimulator electrodes; neuromuscular
Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming
Incision for implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator
Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse
Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator
Incision for implantation of neurostimulator electrodes; peripheral nerve (excludes sacral nerve)
Incision for implantation of neurostimulator electrodes; autonomic nerve
Incision for implantation of neurostimulator electrodes; neuromuscular
Incision for implantation of neurostimulator electrodes; sacral nerve (transforaminal placement)
Revision or removal of peripheral neurostimulator electrodes
Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling
Revision or removal of peripheral or gastric neurostimulator pulse generator or receiver
Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch
Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale
Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitorin
Chemodenervation of parotid and submandibular salivary glands, bilateral

Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for blepharospasm, hemifacial spasm)
Chemodenervation of muscle(s); neck muscle(s) (eg, for spasmodic torticollis, spasmodic dysphonia)
Chemodenervation of muscle(s); extremity(s) and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis)
Destruction by neurolytic agent, intercostal nerve
Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, single level
Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or sacral, each additional level (List separately in addition t
Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level
Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, each additional level (List separately in additio
Destruction by neurolytic agent; pudendal nerve
Destruction by neurolytic agent; plantar common digital nerve
Destruction by neurolytic agent; other peripheral nerve or branch
Chemodenervation of eccrine glands; both axillae
Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day
Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus
Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus
Neuroplasty; digital, 1 or both, same digit
Neuroplasty; nerve of hand or foot
Neuroplasty, major peripheral nerve, arm or leg, open; other than specified
Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve
Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus
Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus
Neuroplasty and/or transposition; cranial nerve (specify)
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at wrist
Neuroplasty and/or transposition; median nerve at carpal tunnel
Decompression; unspecified nerve(s) (specify)
Decompression; plantar digital nerve
Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty include
Transection or avulsion of; supraorbital nerve
Transection or avulsion of; infraorbital nerve
Transection or avulsion of; mental nerve

Transection or avulsion of; inferior alveolar nerve by osteotomy
Transection or avulsion of; lingual nerve
Transection or avulsion of; facial nerve, differential or complete
Transection or avulsion of; greater occipital nerve
Transection or avulsion of; phrenic nerve
Transection or avulsion of; vagus nerve (vagotomy), transthoracic
Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, par
Transection or avulsion of; vagus nerve (vagotomy), abdominal
Transection or avulsion of; pudendal nerve
Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy
Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy
Transection or avulsion of other cranial nerve, extradural
Transection or avulsion of other spinal nerve, extradural
Excision of neuroma; cutaneous nerve, surgically identifiable
Excision of neuroma; digital nerve, 1 or both, same digit
Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure)
Excision of neuroma; hand or foot, except digital nerve
Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedu
Excision of neuroma; major peripheral nerve, except sciatic
Excision of neuroma; sciatic nerve
Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision)
Excision of neurofibroma or neurolemmoma; cutaneous nerve
Excision of neurofibroma or neurolemmoma; major peripheral nerve
Excision of neurofibroma or neurolemmoma; extensive (including malignant type)
Biopsy of nerve
Sympathectomy, cervical
Sympathectomy, cervicothoracic
Sympathectomy, thoracolumbar
Sympathectomy, lumbar
Sympathectomy; digital arteries, each digit
Sympathectomy; radial artery

Sympathectomy; ulnar artery
Sympathectomy; superficial palmar arch
Suture of digital nerve, hand or foot; 1 nerve
Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure)
Suture of 1 nerve; hand or foot, common sensory nerve
Suture of 1 nerve; median motor thenar
Suture of 1 nerve; ulnar motor
Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure)
Suture of posterior tibial nerve
Suture of major peripheral nerve, arm or leg, except sciatic; including transposition
Suture of major peripheral nerve, arm or leg, except sciatic; without transposition
Suture of sciatic nerve
Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure)
Suture of; brachial plexus
Suture of; lumbar plexus
Suture of facial nerve; extracranial
Suture of facial nerve; infratemporal, with or without grafting
Anastomosis; facial-spinal accessory
Anastomosis; facial-hypoglossal
Anastomosis; facial-phrenic
Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy)
Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture)
Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture)
Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length
Nerve graft (includes obtaining graft), head or neck; more than 4 cm length
Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length
Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length
Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length
Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length
Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length
Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length
Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length
Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length
Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)
Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure)
Nerve pedicle transfer; first stage
Nerve pedicle transfer; second stage
Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve
Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve
Evisceration of ocular contents; without implant
Evisceration of ocular contents; with implant
Enucleation of eye; without implant
Enucleation of eye; with implant, muscles not attached to implant
Enucleation of eye; with implant, muscles attached to implant
Exenteration of orbit (does not include skin graft), removal of orbital contents; only
Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone
Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap
Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate
Insertion of ocular implant secondary; after evisceration, in scleral shell
Insertion of ocular implant secondary; after enucleation, muscles not attached to implant
Insertion of ocular implant secondary; after enucleation, muscles attached to implant
Reinsertion of ocular implant; with or without conjunctival graft
Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant
Removal of ocular implant
Removal of foreign body, external eye; conjunctival superficial
Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating
Removal of foreign body, external eye; corneal, without slit lamp
Removal of foreign body, external eye; corneal, with slit lamp
Removal of foreign body, intraocular; from anterior chamber of eye or lens
Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route
Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction
Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure
Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization
Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization
Repair of laceration; cornea, nonperforating, with or without removal foreign body
Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue
Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue
Repair of laceration; application of tissue glue, wounds of cornea and/or sclera
Repair of wound, extraocular muscle, tendon and/or Tenon's capsule
Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium
Biopsy of cornea
Excision or transposition of pterygium; without graft
Excision or transposition of pterygium; with graft
Scraping of cornea, diagnostic, for smear and/or culture
Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)
Removal of corneal epithelium; with application of chelating agent (eg, EDTA)
Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization
Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)
Keratoplasty (corneal transplant); anterior lamellar
Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)
Keratoplasty (corneal transplant); penetrating (in aphakia)
Keratoplasty (corneal transplant); penetrating (in pseudophakia)
Keratoplasty (corneal transplant); endothelial
Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary proc
Keratomileusis
Keratophakia
Epikeratoplasty
Keratoprosthesis
Radial keratotomy
Corneal relaxing incision for correction of surgically induced astigmatism
Corneal wedge resection for correction of surgically induced astigmatism
Placement of amniotic membrane on the ocular surface for wound healing; self-retaining
Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured
Ocular surface reconstruction; amniotic membrane transplantation, multiple layers
Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)
Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)
Paracentesis of anterior chamber of eye (separate procedure); with diagnostic aspiration of aqueous
Paracentesis of anterior chamber of eye (separate procedure); with therapeutic release of aqueous
Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid memb
Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection
Goniotomy
Trabeculotomy ab externo
Trabeculoplasty by laser surgery, 1 or more sessions (defined treatment series)
Severing adhesions of anterior segment, laser technique (separate procedure)
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure)
Removal of epithelial downgrowth, anterior chamber of eye
Removal of implanted material, anterior segment of eye
Removal of blood clot, anterior segment of eye
Injection, anterior chamber of eye (separate procedure); air or liquid
Injection, anterior chamber of eye (separate procedure); medication
Excision of lesion, sclera
Fistulization of sclera for glaucoma; trephination with iridectomy
Fistulization of sclera for glaucoma; thermocauterization with iridectomy
Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy
Fistulization of sclera for glaucoma; iridencleisis or iridotasis
Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes inje
Transluminal dilation of aqueous outflow canal; without retention of device or stent
Transluminal dilation of aqueous outflow canal; with retention of device or stent
Aqueous shunt to extraocular reservoir (eg, Molteno, Schocket, Denver-Krupin)
Revision of aqueous shunt to extraocular reservoir

Repair of scleral staphyloma; without graft
Repair of scleral staphyloma; with graft
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Iridotomy by stab incision (separate procedure); except transfixion
Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe
Iridectomy, with corneoscleral or corneal section; for removal of lesion
Iridectomy, with corneoscleral or corneal section; with cyclectomy
Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)
Iridectomy, with corneoscleral or corneal section; optical (separate procedure)
Repair of iris, ciliary body (as for iridodialysis)
Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture)
Ciliary body destruction; diathermy
Ciliary body destruction; cyclophotocoagulation, transscleral
Ciliary body destruction; cyclophotocoagulation, endoscopic
Ciliary body destruction; cryotherapy
Ciliary body destruction; cyclodialysis
Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)
Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)
Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)
Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Zi
Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, YAG lase
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section,
Removal of lens material; aspiration technique, 1 or more stages
Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration
Removal of lens material; pars plana approach, with or without vitrectomy
Removal of lens material; intracapsular
Removal of lens material; intracapsular, for dislocated lens
Removal of lens material; extracapsular (other than 66840, 66850, 66852)
Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (
Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)
Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (
Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal
Exchange of intraocular lens
Use of ophthalmic endoscope (List separately in addition to code for primary procedure)
Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal
Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy
Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)
Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure
Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous
Intravitreal injection of a pharmacologic agent (separate procedure)
Discission of vitreous strands (without removal), pars plana approach
Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)
Vitrectomy, mechanical, pars plana approach;
Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)
Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole,
Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if
Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, with or without drainage of subretinal fluid
Repair of retinal detachment, 1 or more sessions; photocoagulation, with or without drainage of subretinal fluid
Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), with or with
Repair of retinal detachment; with vitrectomy, any method, with or without air or gas tamponade, focal endolaser photocoagulatio
Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)
Repair of retinal detachment; by scleral buckling or vitrectomy, on patient having previous ipsilateral retinal detachment repair(s) u
Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachmen
Release of encircling material (posterior segment)
Removal of implanted material, posterior segment; extraocular
Removal of implanted material, posterior segment; intraocular
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, 1 or more sessions; cryotherapy, diath
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, 1 or more sessions; photocoagulation
Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy
Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation
Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (inclu
Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions
Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)
Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (
Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), 1 or more sessions, cryotherapy, diathermy
Treatment of extensive or progressive retinopathy, 1 or more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, 1 or more sessions; preterm infant (less than 37 weeks gestation at birth), perf
Scleral reinforcement (separate procedure); without graft
Scleral reinforcement (separate procedure); with graft
Unlisted procedure, posterior segment
Strabismus surgery, recession or resection procedure; 1 horizontal muscle
Strabismus surgery, recession or resection procedure; 2 horizontal muscles
Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)
Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)
Strabismus surgery, any procedure, superior oblique muscle
Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (List separately in addition to code fo
Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in ad
Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surger
Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for
Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (List separately in a
Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (List separately in addition to code for pr
Release of extensive scar tissue without detaching extraocular muscle (separate procedure)
Chemodenervation of extraocular muscle
Biopsy of extraocular muscle
Unlisted procedure, ocular muscle
Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy
Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression
Fine needle aspiration of orbital contents
Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of lesion
Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of foreign body
Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with drainage
Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with removal of bone for decompression
Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for exploration, with or without biopsy
Retrobulbar injection; medication (separate procedure, does not include supply of medication)
Retrobulbar injection; alcohol
Injection of medication or other substance into Tenon's capsule
Orbital implant (implant outside muscle cone); insertion
Orbital implant (implant outside muscle cone); removal or revision
Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)
Unlisted procedure, orbit
Blepharotomy, drainage of abscess, eyelid
Severing of tarsorrhaphy
Canthotomy (separate procedure)
Excision of chalazion; single
Excision of chalazion; multiple, same lid
Excision of chalazion; multiple, different lids
Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple
Biopsy of eyelid
Correction of trichiasis; epilation, by forceps only
Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)
Correction of trichiasis; incision of lid margin
Correction of trichiasis; incision of lid margin, with free mucous membrane graft
Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure
Destruction of lesion of lid margin (up to 1 cm)
Temporary closure of eyelids by suture (eg, Frost suture)
Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;
Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate
Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)
Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)
Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach
Repair of blepharoptosis; (tarso) levator resection or advancement, external approach
Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)
Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type)
Reduction of overcorrection of ptosis
Correction of lid retraction
Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)
Repair of ectropion; suture
Repair of ectropion; thermocauterization
Repair of ectropion; excision tarsal wedge
Repair of ectropion; extensive (eg, tarsal strip operations)
Repair of entropion; suture
Repair of entropion; thermocauterization
Repair of entropion; excision tarsal wedge
Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)
Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness
Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness
Removal of embedded foreign body, eyelid
Canthoplasty (reconstruction of canthus)
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin gr
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin gr
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stag
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or firs
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or firs
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage
Unlisted procedure, eyelids
Incision of conjunctiva, drainage of cyst
Expression of conjunctival follicles (eg, for trachoma)

Biopsy of conjunctiva
Excision of lesion, conjunctiva; up to 1 cm
Excision of lesion, conjunctiva; over 1 cm
Excision of lesion, conjunctiva; with adjacent sclera
Destruction of lesion, conjunctiva
Subconjunctival injection
Conjunctivoplasty; with conjunctival graft or extensive rearrangement
Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)
Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement
Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)
Repair of symblepharon; conjunctivoplasty, without graft
Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)
Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens
Conjunctival flap; bridge or partial (separate procedure)
Conjunctival flap; total (such as Gunderson thin flap or purse string flap)
Harvesting conjunctival allograft, living donor
Unlisted procedure, conjunctiva
Incision, drainage of lacrimal gland
Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)
Snip incision of lacrimal punctum
Excision of lacrimal gland (dacryoadenectomy), except for tumor; total
Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial
Biopsy of lacrimal gland
Excision of lacrimal sac (dacryocystectomy)
Biopsy of lacrimal sac
Removal of foreign body or dacryolith, lacrimal passages
Excision of lacrimal gland tumor; frontal approach
Excision of lacrimal gland tumor; involving osteotomy
Plastic repair of canaliculi
Correction of everted punctum, cautery
Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)

Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube
Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent
Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery
Closure of the lacrimal punctum; by plug, each
Closure of lacrimal fistula (separate procedure)
Dilation of lacrimal punctum, with or without irrigation
Probing of nasolacrimal duct, with or without irrigation;
Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia
Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent
Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation
Probing of lacrimal canaliculi, with or without irrigation
Injection of contrast medium for dacryocystography
Unlisted procedure, lacrimal system
Drainage external ear, abscess or hematoma; simple
Drainage external ear, abscess or hematoma; complicated
Drainage external auditory canal, abscess
Ear piercing
Biopsy external ear
Biopsy external auditory canal
Excision external ear; partial, simple repair
Excision external ear; complete amputation
Excision exostosis(es), external auditory canal
Excision soft tissue lesion, external auditory canal
Radical excision external auditory canal lesion; without neck dissection
Radical excision external auditory canal lesion; with neck dissection
Removal foreign body from external auditory canal; without general anesthesia
Removal foreign body from external auditory canal; with general anesthesia
Removal impacted cerumen (separate procedure), 1 or both ears
Debridement, mastoidectomy cavity, simple (eg, routine cleaning)
Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)
Otoplasty, protruding ear, with or without size reduction

Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)
Reconstruction external auditory canal for congenital atresia, single stage
Unlisted procedure, external ear
Eustachian tube inflation, transnasal; with catheterization
Eustachian tube inflation, transnasal; without catheterization
Eustachian tube catheterization, transtympanic
Myringotomy including aspiration and/or eustachian tube inflation
Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia
Ventilating tube removal requiring general anesthesia
Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
Middle ear exploration through postauricular or ear canal incision
Tympanolysis, transcanal
Transmastoid antrotomy (simple mastoidectomy)
Mastoidectomy; complete
Mastoidectomy; modified radical
Mastoidectomy; radical
Petrous apicectomy including radical mastoidectomy
Resection temporal bone, external approach
Excision aural polyp
Excision aural glomus tumor; transcanal
Excision aural glomus tumor; transmastoid
Excision aural glomus tumor; extended (extratemporal)
Revision mastoidectomy; resulting in complete mastoidectomy
Revision mastoidectomy; resulting in modified radical mastoidectomy
Revision mastoidectomy; resulting in radical mastoidectomy
Revision mastoidectomy; resulting in tympanoplasty
Revision mastoidectomy; with apicectomy
Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch
Myringoplasty (surgery confined to drumhead and donor area)
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without o
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossic
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membra
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular cha
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain re
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconst
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconst
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, w
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, w
Stapes mobilization
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate
Revision of stapedectomy or stapedotomy
Repair oval window fistula
Repair round window fistula
Mastoid obliteration (separate procedure)
Tympanic neurectomy
Closure postauricular fistula, mastoid (separate procedure)
Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone
Removal or repair of electromagnetic bone conduction hearing device in temporal bone
Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stim
Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stim
Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to ex
Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to ex
Decompression facial nerve, intratemporal; lateral to geniculate ganglion
Decompression facial nerve, intratemporal; including medial to geniculate ganglion
Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion
Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion
Labyrinthotomy, with perfusion of vestibuloactive drug(s); transcanal

Labyrinthotomy, with perfusion of vestibuloactive drug(s); with mastoidectomy
Endolymphatic sac operation; without shunt
Endolymphatic sac operation; with shunt
Fenestration semicircular canal
Revision fenestration operation
Labyrinthectomy; transcanal
Labyrinthectomy; with mastoidectomy
Vestibular nerve section, translabyrinthine approach
Cochlear device implantation, with or without mastoidectomy
Unlisted procedure, inner ear
Vestibular nerve section, transcranial approach
Total facial nerve decompression and/or repair (may include graft)
Decompression internal auditory canal
Removal of tumor, temporal bone
Unlisted procedure, temporal bone, middle fossa approach
Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)
Myelography, posterior fossa, radiological supervision and interpretation
Cisternography, positive contrast, radiological supervision and interpretation
Radiologic examination, eye, for detection of foreign body
Radiologic examination, mandible; partial, less than 4 views
Radiologic examination, mandible; complete, minimum of 4 views
Radiologic examination, mastoids; less than 3 views per side
Radiologic examination, mastoids; complete, minimum of 3 views per side
Radiologic examination, internal auditory meati, complete
Radiologic examination, facial bones; less than 3 views
Radiologic examination, facial bones; complete, minimum of 3 views
Radiologic examination, nasal bones, complete, minimum of 3 views
Dacryocystography, nasolacrimal duct, radiological supervision and interpretation
Radiologic examination; optic foramina
Radiologic examination; orbits, complete, minimum of 4 views
Radiologic examination, sinuses, paranasal, less than 3 views

Radiologic examination, sinuses, paranasal, complete, minimum of 3 views
Radiologic examination, sella turcica
Radiologic examination, skull; less than 4 views
Radiologic examination, skull; complete, minimum of 4 views
Radiologic examination, teeth; single view
Radiologic examination, teeth; partial examination, less than full mouth
Radiologic examination, teeth; complete, full mouth
Radiologic examination, temporomandibular joint, open and closed mouth; unilateral
Radiologic examination, temporomandibular joint, open and closed mouth; bilateral
Temporomandibular joint arthrography, radiological supervision and interpretation
Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)
Cephalogram, orthodontic
Orthopantogram
Radiologic examination; neck, soft tissue
Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique
Complex dynamic pharyngeal and speech evaluation by cine or video recording
Laryngography, contrast, radiological supervision and interpretation
Radiologic examination, salivary gland for calculus
Sialography, radiological supervision and interpretation
Computed tomography, head or brain; without contrast material
Computed tomography, head or brain; with contrast material(s)
Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contra
Computed tomography, maxillofacial area; without contrast material
Computed tomography, maxillofacial area; with contrast material(s)
Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections
Computed tomography, soft tissue neck; without contrast material
Computed tomography, soft tissue neck; with contrast material(s)
Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postp
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postp
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) an
Magnetic resonance angiography, head; without contrast material(s)
Magnetic resonance angiography, head; with contrast material(s)
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance angiography, neck; without contrast material(s)
Magnetic resonance angiography, neck; with contrast material(s)
Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material
Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s)
Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement a
Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional te
Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to as
Radiologic examination, chest; single view, frontal
Radiologic examination, chest; stereo, frontal
Radiologic examination, chest, 2 views, frontal and lateral;
Radiologic examination, chest, 2 views, frontal and lateral; with apical lordotic procedure
Radiologic examination, chest, 2 views, frontal and lateral; with oblique projections
Radiologic examination, chest, 2 views, frontal and lateral; with fluoroscopy
Radiologic examination, chest, complete, minimum of 4 views;
Radiologic examination, chest, complete, minimum of 4 views; with fluoroscopy
Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies)
Bronchography, unilateral, radiological supervision and interpretation
Bronchography, bilateral, radiological supervision and interpretation
Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation

Radiologic examination, ribs, unilateral; 2 views
Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views
Radiologic examination, ribs, bilateral; 3 views
Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views
Radiologic examination; sternum, minimum of 2 views
Radiologic examination; sternoclavicular joint or joints, minimum of 3 views
Computed tomography, thorax; without contrast material
Computed tomography, thorax; with contrast material(s)
Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, a
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast m
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast mate
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast m
Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)
Radiologic examination, spine, entire, survey study, anteroposterior and lateral
Radiologic examination, spine, single view, specify level
Radiologic examination, spine, cervical; 2 or 3 views
Radiologic examination, spine, cervical; minimum of 4 views
Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension studies
Radiologic examination, spine, thoracolumbar, standing (scoliosis)
Radiologic examination, spine; thoracic, 2 views
Radiologic examination, spine; thoracic, 3 views
Radiologic examination, spine; thoracic, minimum of 4 views
Radiologic examination, spine; thoracolumbar, 2 views
Radiologic examination, spine; scoliosis study, including supine and erect studies
Radiologic examination, spine, lumbosacral; 2 or 3 views
Radiologic examination, spine, lumbosacral; minimum of 4 views
Radiologic examination, spine, lumbosacral; complete, including bending views
Radiologic examination, spine, lumbosacral, bending views only, minimum of 4 views
Computed tomography, cervical spine; without contrast material
Computed tomography, cervical spine; with contrast material

Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections
Computed tomography, thoracic spine; without contrast material
Computed tomography, thoracic spine; with contrast material
Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections
Computed tomography, lumbar spine; without contrast material
Computed tomography, lumbar spine; with contrast material
Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) an
Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)
Radiologic examination, pelvis; 1 or 2 views
Radiologic examination, pelvis; complete, minimum of 3 views
Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image post
Computed tomography, pelvis; without contrast material
Computed tomography, pelvis; with contrast material(s)
Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)
Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequen
Magnetic resonance angiography, pelvis, with or without contrast material(s)
Radiologic examination, sacroiliac joints; less than 3 views
Radiologic examination, sacroiliac joints; 3 or more views
Radiologic examination, sacrum and coccyx, minimum of 2 views
Myelography, cervical, radiological supervision and interpretation

Myelography, thoracic, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological su

Epidurography, radiological supervision and interpretation
Discography, cervical or thoracic, radiological supervision and interpretation
Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacrop
Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacrop
Discography, lumbar, radiological supervision and interpretation
Radiologic examination; clavicle, complete
Radiologic examination; scapula, complete
Radiologic examination, shoulder; 1 view
Radiologic examination, shoulder; complete, minimum of 2 views
Radiologic examination, shoulder, arthrography, radiological supervision and interpretation
Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction
Radiologic examination; humerus, minimum of 2 views
Radiologic examination, elbow; 2 views
Radiologic examination, elbow; complete, minimum of 3 views
Radiologic examination, elbow, arthrography, radiological supervision and interpretation
Radiologic examination; forearm, 2 views
Radiologic examination; upper extremity, infant, minimum of 2 views
Radiologic examination, wrist; 2 views
Radiologic examination, wrist; complete, minimum of 3 views
Radiologic examination, wrist, arthrography, radiological supervision and interpretation
Radiologic examination, hand; 2 views
Radiologic examination, hand; minimum of 3 views
Radiologic examination, finger(s), minimum of 2 views
Computed tomography, upper extremity; without contrast material
Computed tomography, upper extremity; with contrast material(s)
Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections
Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and i
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast ma
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)
Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material
Magnetic resonance angiography, upper extremity, with or without contrast material(s)
Radiologic examination, hip, unilateral; 1 view
Radiologic examination, hip, unilateral; complete, minimum of 2 views
Radiologic examination, hips, bilateral, minimum of 2 views of each hip, including anteroposterior view of pelvis
Radiologic examination, hip, arthrography, radiological supervision and interpretation
Radiologic examination, hip, during operative procedure
Radiologic examination, pelvis and hips, infant or child, minimum of 2 views
Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation
Radiologic examination, femur, 2 views
Radiologic examination, knee; 1 or 2 views
Radiologic examination, knee; 3 views
Radiologic examination, knee; complete, 4 or more views
Radiologic examination, knee; both knees, standing, anteroposterior
Radiologic examination, knee, arthrography, radiological supervision and interpretation
Radiologic examination; tibia and fibula, 2 views
Radiologic examination; lower extremity, infant, minimum of 2 views
Radiologic examination, ankle; 2 views
Radiologic examination, ankle; complete, minimum of 3 views
Radiologic examination, ankle, arthrography, radiological supervision and interpretation
Radiologic examination, foot; 2 views
Radiologic examination, foot; complete, minimum of 3 views
Radiologic examination; calcaneus, minimum of 2 views
Radiologic examination; toe(s), minimum of 2 views
Computed tomography, lower extremity; without contrast material
Computed tomography, lower extremity; with contrast material(s)
Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and i
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast mat
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material
Magnetic resonance angiography, lower extremity, with or without contrast material(s)
Radiologic examination, abdomen; single anteroposterior view
Radiologic examination, abdomen; anteroposterior and additional oblique and cone views
Radiologic examination, abdomen; complete, including decubitus and/or erect views
Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view ch
Computed tomography, abdomen; without contrast material
Computed tomography, abdomen; with contrast material(s)
Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image p
Computed tomography, abdomen and pelvis; without contrast material
Computed tomography, abdomen and pelvis; with contrast material(s)
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)
Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and furthe
Magnetic resonance angiography, abdomen, with or without contrast material(s)
Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation
Radiologic examination; pharynx and/or cervical esophagus
Radiologic examination; esophagus
Swallowing function, with cineradiography/videoradiography
Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation
Radiologic examination, gastrointestinal tract, upper; with or without delayed films, without KUB
Radiologic examination, gastrointestinal tract, upper; with or without delayed films, with KUB
Radiologic examination, gastrointestinal tract, upper; with small intestine, includes multiple serial films
Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or w
Radiologic examination, small intestine, includes multiple serial films;
Radiologic examination, small intestine, includes multiple serial films; via enteroclysis tube
Duodenography, hypotonic
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material
Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-con
Computed tomographic (CT) colonography, screening, including image postprocessing
Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB
Radiologic examination, colon; air contrast with specific high density barium, with or without glucagon
Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)
Cholecystography, oral contrast;
Cholecystography, oral contrast; additional or repeat examination or multiple day examination
Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation
Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (List separately
Cholangiography and/or pancreatography; through existing catheter, radiological supervision and interpretation
Cholangiography, percutaneous, transhepatic, radiological supervision and interpretation
Postoperative biliary duct calculus removal, percutaneous via T-tube tract, basket, or snare (eg, Burhenne technique), radiological
Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation
Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation
Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation
Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and films, radiological supervision an
Percutaneous placement of enteroclysis tube, radiological supervision and interpretation
Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation
Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpr
Urography (pyelography), intravenous, with or without KUB, with or without tomography
Urography, infusion, drip technique and/or bolus technique;
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
Urography, retrograde, with or without KUB
Urography, antegrade (pyelostogram, nephrostogram, loopogram), radiological supervision and interpretation

Cystography, minimum of 3 views, radiological supervision and interpretation
Vasography, vesiculography, or epididymography, radiological supervision and interpretation
Corpora cavernosography, radiological supervision and interpretation
Urethrocystography, retrograde, radiological supervision and interpretation
Urethrocystography, voiding, radiological supervision and interpretation
Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation
Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous, radiological supervision and
Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous, radiological
Dilation of nephrostomy, ureters, or urethra, radiological supervision and interpretation
Pelvimetry, with or without placental localization
Hysterosalpingography, radiological supervision and interpretation
Transcervical catheterization of fallopian tube, radiological supervision and interpretation
Perineogram (eg, vaginogram, for sex determination or extent of anomalies)
Cardiac magnetic resonance imaging for morphology and function without contrast material;
Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) an
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) an
Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure)
Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3D image post
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congeni
Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3
Aortography, thoracic, without serialography, radiological supervision and interpretation
Aortography, thoracic, by serialography, radiological supervision and interpretation
Aortography, abdominal, by serialography, radiological supervision and interpretation
Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpre
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), in
Angiography, cervicocerebral, catheter, including vessel origin, radiological supervision and interpretation
Angiography, brachial, retrograde, radiological supervision and interpretation
Angiography, external carotid, unilateral, selective, radiological supervision and interpretation
Angiography, external carotid, bilateral, selective, radiological supervision and interpretation

Angiography, carotid, cerebral, unilateral, radiological supervision and interpretation
Angiography, carotid, cerebral, bilateral, radiological supervision and interpretation
Angiography, carotid, cervical, unilateral, radiological supervision and interpretation
Angiography, carotid, cervical, bilateral, radiological supervision and interpretation
Angiography, vertebral, cervical, and/or intracranial, radiological supervision and interpretation
Angiography, spinal, selective, radiological supervision and interpretation
Angiography, extremity, unilateral, radiological supervision and interpretation
Angiography, extremity, bilateral, radiological supervision and interpretation
Angiography, renal, unilateral, selective (including flush aortogram), radiological supervision and interpretation
Angiography, renal, bilateral, selective (including flush aortogram), radiological supervision and interpretation
Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation
Angiography, adrenal, unilateral, selective, radiological supervision and interpretation
Angiography, adrenal, bilateral, selective, radiological supervision and interpretation
Angiography, pelvic, selective or supraselective, radiological supervision and interpretation
Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation
Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation
Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation
Angiography, internal mammary, radiological supervision and interpretation
Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (List sep
Angiography, arteriovenous shunt (eg, dialysis patient fistula/graft), complete evaluation of dialysis access, including fluoroscopy, i
Lymphangiography, extremity only, unilateral, radiological supervision and interpretation
Lymphangiography, extremity only, bilateral, radiological supervision and interpretation
Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation
Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation
Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, ind
Splenoportography, radiological supervision and interpretation
Venography, extremity, unilateral, radiological supervision and interpretation
Venography, extremity, bilateral, radiological supervision and interpretation
Venography, caval, inferior, with serialography, radiological supervision and interpretation
Venography, caval, superior, with serialography, radiological supervision and interpretation
Venography, renal, unilateral, selective, radiological supervision and interpretation

Venography, renal, bilateral, selective, radiological supervision and interpretation
Venography, adrenal, unilateral, selective, radiological supervision and interpretation
Venography, adrenal, bilateral, selective, radiological supervision and interpretation
Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation
Venography, superior sagittal sinus, radiological supervision and interpretation
Venography, epidural, radiological supervision and interpretation
Venography, orbital, radiological supervision and interpretation
Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation
Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation
Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation
Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation
Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and
Transcatheter therapy, embolization, any method, radiological supervision and interpretation
Transcatheter therapy, infusion, any method (eg, thrombolysis other than coronary), radiological supervision and interpretation
Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion
Exchange of a previously placed intravascular catheter during thrombolytic therapy with contrast monitoring, radiological supervis
Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access
Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiolog
Percutaneous placement of IVC filter, radiological supervision and interpretation
Intravascular ultrasound (non-coronary vessel), radiological supervision and interpretation; initial vessel
Intravascular ultrasound (non-coronary vessel), radiological supervision and interpretation; each additional non-coronary vessel (Li
Endovascular repair of infrarenal abdominal aortic aneurysm or dissection, radiological supervision and interpretation
Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal aortic or iliac artery aneurysm, pseudoan
Endovascular repair of iliac artery aneurysm, pseudoaneurysm, arteriovenous malformation, or trauma, using ilio-iliac tube endopr
Placement of distal extension prosthesis(s) (delayed) after endovascular repair of descending thoracic aorta, as needed, to level of
Transcatheter introduction of intravascular stent(s) (except coronary, carotid, vertebral, iliac, and lower extremity artery), percutan
Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), radiological superv
Transluminal balloon angioplasty, peripheral artery other than cervical carotid, renal or other visceral artery, iliac or lower extremit
Transluminal balloon angioplasty, each additional peripheral artery other than cervical carotid, renal or other visceral artery, iliac a
Transluminal balloon angioplasty, renal or other visceral artery, radiological supervision and interpretation
Transluminal balloon angioplasty, each additional visceral artery, radiological supervision and interpretation (List separately in add
Transcatheter biopsy, radiological supervision and interpretation
Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation
Percutaneous transhepatic biliary drainage with contrast monitoring, radiological supervision and interpretation
Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for interna
Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological super
Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen c
Fluoroscopy (separate procedure), up to 1 hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy)
Fluoroscopy, physician time more than 1 hour, assisting a nonradiologic physician (eg, nephrostolithotomy, ERCP, bronchoscopy, tr
Radiologic examination from nose to rectum for foreign body, single view, child
Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation
Radiological examination, surgical specimen
Radiologic examination, single plane body section (eg, tomography), other than with urography
Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urograph
Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urograph
Cineradiography/videoradiography, except where specifically included
Cineradiography/videoradiography to complement routine examination (List separately in addition to code for primary procedure)
Consultation on X-ray examination made elsewhere, written report
3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomo
3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomo
Computed tomography, limited or localized follow-up study
Magnetic resonance spectroscopy
Unlisted fluoroscopic procedure (eg, diagnostic, interventional)
Unlisted magnetic resonance procedure (eg, diagnostic, interventional)
Unlisted diagnostic radiographic procedure
Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cereb
Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter
Ophthalmic ultrasound, diagnostic; quantitative A-scan only
Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan)

Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy
Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)
Ophthalmic biometry by ultrasound echography, A-scan;
Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation
Ophthalmic ultrasonic foreign body localization
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation
Ultrasound, chest (includes mediastinum), real time with image documentation
Ultrasound, breast(s) (unilateral or bilateral), real time with image documentation
Ultrasound, abdominal, real time with image documentation; complete
Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited
Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation
Ultrasound, spinal canal and contents
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 day
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 day
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 we
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 we
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic exam
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic exam
Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transab
Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transab
Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position an
Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard
Ultrasound, pregnant uterus, real time with image documentation, transvaginal
Fetal biophysical profile; with non-stress testing
Fetal biophysical profile; without non-stress testing
Doppler velocimetry, fetal; umbilical artery
Doppler velocimetry, fetal; middle cerebral artery
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording;
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follo
Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete
Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study
Ultrasound, transvaginal
Saline infusion sonohysterography (SIS), including color flow Doppler, when performed
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete
Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)
Ultrasound, scrotum and contents
Ultrasound, transrectal;
Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)
Ultrasound, extremity, nonvascular, real-time with image documentation; complete
Ultrasound, extremity, nonvascular, real-time with image documentation; limited, anatomic specific
Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician manipulation)
Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician manipulation)
Ultrasonic guidance for pericardiocentesis, imaging supervision and interpretation
Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation
Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evalua
Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vesse
Ultrasound guidance for, and monitoring of, parenchymal tissue ablation
Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation
Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpreta
Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation
Ultrasonic guidance for amniocentesis, imaging supervision and interpretation
Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation
Ultrasonic guidance for placement of radiation therapy fields
Ultrasonic guidance for interstitial radioelement application
Ultrasound study follow-up (specify)
Gastrointestinal endoscopic ultrasound, supervision and interpretation
Ultrasound bone density measurement and interpretation, peripheral site(s), any method
Ultrasonic guidance, intraoperative
Unlisted ultrasound procedure (eg, diagnostic, interventional)
Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes
Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)
Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection proced
Computed tomography guidance for stereotactic localization
Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervisio
Computed tomography guidance for, and monitoring of, parenchymal tissue ablation
Computed tomography guidance for placement of radiation therapy fields
Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization devic
Magnetic resonance guidance for, and monitoring of, parenchymal tissue ablation
Stereotactic localization guidance for breast biopsy or needle placement (eg, for wire localization or for injection), each lesion, radi
Mammographic guidance for needle placement, breast (eg, for wire localization or for injection), each lesion, radiological supervisi
Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review fo
Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review fo
Mammary ductogram or galactogram, single duct, radiological supervision and interpretation
Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation
Mammography; unilateral
Mammography; bilateral
Screening mammography, bilateral (2-view film study of each breast)
Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral
Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral
Manual application of stress performed by physician for joint radiography, including contralateral joint if indicated
Bone age studies
Bone length studies (orthoroentgenogram, scanogram)
Radiologic examination, osseous survey; limited (eg, for metastases)
Radiologic examination, osseous survey; complete (axial and appendicular skeleton)
Radiologic examination, osseous survey, infant
Joint survey, single view, 2 or more joints (specify)
Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist,
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; vertebral fracture assessment
Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites
Magnetic resonance (eg, proton) imaging, bone marrow blood supply
Therapeutic radiology treatment planning; simple
Therapeutic radiology treatment planning; intermediate
Therapeutic radiology treatment planning; complex
Therapeutic radiology simulation-aided field setting; simple
Therapeutic radiology simulation-aided field setting; intermediate
Therapeutic radiology simulation-aided field setting; complex
Therapeutic radiology simulation-aided field setting; 3-dimensional
Unlisted procedure, therapeutic radiology clinical treatment planning
Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, NSD, gap calculation, off axis factor, tissue inhomog
Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specific
Teletherapy, isodose plan (whether hand or computer calculated); simple (1 or 2 parallel opposed unmodified ports directed to a s
Teletherapy, isodose plan (whether hand or computer calculated); intermediate (3 or more treatment ports directed to a single are
Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted Y, tangential ports, the use of wed
Special teletherapy port plan, particles, hemibody, total body
Brachytherapy isodose plan; simple (calculation made from single plane, 1 to 4 sources/ribbon application, remote afterloading bra
Brachytherapy isodose plan; intermediate (multiplane dosage calculations, application involving 5 to 10 sources/ribbons, remote a
Brachytherapy isodose plan; complex (multiplane isodose plan, volume implant calculations, over 10 sources/ribbons used, special
Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by the treating physician
Treatment devices, design and construction; simple (simple block, simple bolus)
Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)
Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)
Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and re
Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy (IMRT), design and construction per IMRT plan
Special medical radiation physics consultation
Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 sess
Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s) consisting of 1 sess
Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course
Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
Radiation treatment delivery, superficial and/or ortho voltage

Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; up to 5 MeV
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 6-10 MeV
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 11-19 MeV
Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks; 20 MeV or gr
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; up to
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 6-10
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 11-19
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 20 M
Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, com
Therapeutic radiology port film(s)
Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams, binar
Stereoscopic X-ray guidance for localization of target volume for the delivery of radiation therapy
High energy neutron radiation treatment delivery; single treatment area using a single port or parallel-opposed ports with no block
High energy neutron radiation treatment delivery; 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking an
Radiation treatment management, 5 treatments
Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only
Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)
Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance
Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral, endocavitary or intraoperative cone irradiati
Unlisted procedure, therapeutic radiology treatment management
Proton treatment delivery; simple, without compensation
Proton treatment delivery; simple, with compensation
Proton treatment delivery; intermediate
Proton treatment delivery; complex
Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)
Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)
Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators
Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators

Hyperthermia generated by intracavitary probe(s)
Infusion or instillation of radioelement solution (includes 3-month follow-up care)
Intracavitary radiation source application; simple
Intracavitary radiation source application; intermediate
Intracavitary radiation source application; complex
Interstitial radiation source application; simple
Interstitial radiation source application; intermediate
Interstitial radiation source application; complex
Remote afterloading high dose rate radionuclide brachytherapy; 1 channel
Remote afterloading high dose rate radionuclide brachytherapy; 2-12 channels
Remote afterloading high dose rate radionuclide brachytherapy; over 12 channels
Surface application of radiation source
Supervision, handling, loading of radiation source
Unlisted procedure, clinical brachytherapy
Thyroid uptake; single determination
Thyroid uptake; multiple determinations
Thyroid uptake; stimulation, suppression or discharge (not including initial uptake studies)
Thyroid imaging, with uptake; single determination
Thyroid imaging, with uptake; multiple determinations
Thyroid imaging; only
Thyroid imaging; with vascular flow
Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)
Thyroid carcinoma metastases imaging; whole body
Thyroid carcinoma metastases uptake (List separately in addition to code for primary procedure)
Parathyroid imaging
Adrenal imaging, cortex and/or medulla
Unlisted endocrine procedure, diagnostic nuclear medicine
Bone marrow imaging; limited area
Bone marrow imaging; multiple areas
Bone marrow imaging; whole body

Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings
Red cell volume determination (separate procedure); single sampling
Red cell volume determination (separate procedure); multiple samplings
Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical
Red cell survival study;
Red cell survival study; differential organ/tissue kinetics (eg, splenic and/or hepatic sequestration)
Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)
Spleen imaging only, with or without vascular flow
Kinetics, study of platelet survival, with or without differential organ/tissue localization
Platelet survival study
Lymphatics and lymph nodes imaging
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine
Liver imaging; static only
Liver imaging; with vascular flow
Liver imaging (SPECT);
Liver imaging (SPECT); with vascular flow
Liver and spleen imaging; static only
Liver and spleen imaging; with vascular flow
Liver function study with hepatobiliary agents, with serial images
Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitati
Salivary gland imaging;
Salivary gland imaging; with serial images
Salivary gland function study
Esophageal motility
Gastric mucosa imaging
Gastroesophageal reflux study
Gastric emptying study
Urea breath test, C-14 (isotopic); acquisition for analysis
Urea breath test, C-14 (isotopic); analysis
Vitamin B-12 absorption study (eg, Schilling test); without intrinsic factor
Vitamin B-12 absorption study (eg, Schilling test); with intrinsic factor
Vitamin B-12 absorption studies combined, with and without intrinsic factor
Acute gastrointestinal blood loss imaging
Gastrointestinal protein loss
Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus)
Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt)
Unlisted gastrointestinal procedure, diagnostic nuclear medicine
Bone and/or joint imaging; limited area
Bone and/or joint imaging; multiple areas
Bone and/or joint imaging; whole body
Bone and/or joint imaging; 3 phase study
Bone and/or joint imaging; tomographic (SPECT)
Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry
Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites
Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacol
Cardiac shunt detection
Non-cardiac vascular flow imaging (ie, angiography, venography)
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejec
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejec
Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated tech
Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated tech
Acute venous thrombosis imaging, peptide
Venous thrombosis imaging, venogram; unilateral
Venous thrombosis imaging, venogram; bilateral
Myocardial imaging, positron emission tomography (PET), metabolic evaluation
Myocardial imaging, infarct avid, planar; qualitative or quantitative
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique
Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification
Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion s
Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercis
Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall m
Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic),
Myocardial imaging, positron emission tomography (PET), perfusion; single study at rest or stress
Myocardial imaging, positron emission tomography (PET), perfusion; multiple studies at rest and/or stress
Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative
Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (
Unlisted cardiovascular procedure, diagnostic nuclear medicine
Pulmonary perfusion imaging, particulate
Pulmonary perfusion imaging, particulate, with ventilation; single breath
Pulmonary perfusion imaging, particulate, with ventilation; rebreathing and washout, with or without single breath
Pulmonary ventilation imaging, aerosol; single projection
Pulmonary ventilation imaging, aerosol; multiple projections (eg, anterior, posterior, lateral views)
Pulmonary perfusion imaging, particulate, with ventilation imaging, aerosol, 1 or multiple projections
Pulmonary ventilation imaging, gaseous, single breath, single projection
Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or without single breath; single projection
Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or without single breath; multiple projections (eg, ant
Pulmonary quantitative differential function (ventilation/perfusion) study
Unlisted respiratory procedure, diagnostic nuclear medicine
Brain imaging, less than 4 static views;
Brain imaging, less than 4 static views; with vascular flow
Brain imaging, minimum 4 static views;
Brain imaging, minimum 4 static views; with vascular flow
Brain imaging, tomographic (SPECT)
Brain imaging, positron emission tomography (PET); metabolic evaluation
Brain imaging, positron emission tomography (PET); perfusion evaluation
Brain imaging, vascular flow only
Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography
Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation
Cerebrospinal fluid flow, imaging (not including introduction of material); tomographic (SPECT)
Cerebrospinal fluid leakage detection and localization
Radiopharmaceutical dacryocystography
Unlisted nervous system procedure, diagnostic nuclear medicine
Kidney imaging morphology;
Kidney imaging morphology; with vascular flow
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin conv
Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg,
Kidney imaging morphology; tomographic (SPECT)
Kidney function study, non-imaging radioisotopic study
Urinary bladder residual study (List separately in addition to code for primary procedure)
Ureteral reflux study (radiopharmaceutical voiding cystogram)
Testicular imaging with vascular flow
Unlisted genitourinary procedure, diagnostic nuclear medicine
Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); limited area
Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); multiple areas
Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, single day imaging
Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); tomographic (SPECT)
Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, requiring 2 or more days im
Radiopharmaceutical localization of inflammatory process; limited area
Radiopharmaceutical localization of inflammatory process; whole body
Radiopharmaceutical localization of inflammatory process; tomographic (SPECT)
Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)
Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck)
Positron emission tomography (PET) imaging; skull base to mid-thigh
Positron emission tomography (PET) imaging; whole body
Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatom
Unlisted miscellaneous procedure, diagnostic nuclear medicine
Radiopharmaceutical therapy, by oral administration
Radiopharmaceutical therapy, by intravenous administration
Radiopharmaceutical therapy, by intracavitary administration

Radiopharmaceutical therapy, by interstitial radioactive colloid administration
Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion
Radiopharmaceutical therapy, by intra-articular administration
Radiopharmaceutical therapy, by intra-arterial particulate administration
Radiopharmaceutical therapy, unlisted procedure
Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330), Carbon dioxide (82374), C
Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310), Carbon dioxide (82374), Chlori
General health panel This panel must include the following: Comprehensive metabolic panel (80053), Blood count, complete (CBC)
Electrolyte panel This panel must include the following: Carbon dioxide (82374), Chloride (82435), Potassium (84132), Sodium (842
Comprehensive metabolic panel This panel must include the following: Albumin (82040), Bilirubin, total (82247), Calcium, total (82
Obstetric panel This panel must include the following: Blood count, complete (CBC), automated and automated differential WBC c
Lipid panel This panel must include the following: Cholesterol, serum, total (82465), Lipoprotein, direct measurement, high density
Renal function panel This panel must include the following: Albumin (82040), Calcium, total (82310), Carbon dioxide (bicarbonate)
Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709), Hepatitis B core an
Hepatic function panel This panel must include the following: Albumin (82040), Bilirubin, total (82247), Bilirubin, direct (82248), Ph
Drug screen, qualitative; multiple drug classes chromatographic method, each procedure
Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class
Drug confirmation, each procedure
Tissue preparation for drug analysis
Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure
Amikacin
Amitriptyline
Benzodiazepines
Carbamazepine; total
Carbamazepine; free
Cyclosporine
Desipramine
Digoxin
Dipropylacetic acid (valproic acid)
Doxepin
Ethosuximide
Gentamicin
Gold
Haloperidol
Imipramine
Lidocaine
Lithium
Nortriptyline
Phenobarbital
Phenytoin; total
Phenytoin; free
Primidone
Procainamide;
Procainamide; with metabolites (eg, n-acetyl procainamide)
Quinidine
Sirolimus
Salicylate
Tacrolimus
Theophylline
Tobramycin
Topiramate
Vancomycin
Quantitation of drug, not elsewhere specified
ACTH stimulation panel; for adrenal insufficiency This panel must include the following: Cortisol (82533 x 2)
ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include the following: Cortisol (82533 x 2), 17 hydroxyproge
ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol (82533 x 2), 1
Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2), Ren
Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3)
Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6), Adrenocortico
Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone (84403 x 2 o
Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol (82670 x 2 on 3 pool
Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6)
Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2)
Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone (ACTH) (82
Dexamethasone suppression panel, 48 hour This panel must include the following: Free cortisol, urine (82530 x 2), Cortisol (82533
Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3), Insulin (83525 x 3)
Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated (82384 x 2
Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone (FSH) (8300
Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human gro
Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3), Human gr
Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525), C-peptide (84681 x 5), Glucose
Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5), Glucose (82947 x 5)
Insulin tolerance panel; for growth hormone deficiency This panel must include the following: Glucose (82947 x 5), Human growth
Metyrapone panel This panel must include the following: Cortisol (82533 x 2), 11 deoxycortisol (82634 x 2)
Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must include the following: Thyroid stimulating hormone
Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid stimulating hormone
Thyrotropin releasing hormone (TRH) stimulation panel; for hyperprolactinemia This panel must include the following: Prolactin (8
Clinical pathology consultation; limited, without review of patient's history and medical records
Clinical pathology consultation; comprehensive, for a complex diagnostic problem, with review of patient's history and medical rec
Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity
Urinalysis; qualitative or semiquantitative, except immunoassays
Urinalysis; bacteriuria screen, except by culture or dipstick
Urinalysis; microscopic only
Urinalysis; 2 or 3 glass test
Urine pregnancy test, by visual color comparison methods
Volume measurement for timed collection, each
Unlisted urinalysis procedure
Acetaldehyde, blood
Acetaminophen
Acetone or other ketone bodies, serum; qualitative

Acetone or other ketone bodies, serum; quantitative
Acetylcholinesterase
Acylcarnitines; qualitative, each specimen
Acylcarnitines; quantitative, each specimen
Adrenocorticotropic hormone (ACTH)
Adenosine, 5-monophosphate, cyclic (cyclic AMP)
Albumin; serum, plasma or whole blood
Albumin; urine or other source, quantitative, each specimen
Albumin; urine, microalbumin, quantitative
Albumin; urine, microalbumin, semiquantitative (eg, reagent strip assay)
Albumin; ischemia modified
Alcohol (ethanol); any specimen except breath
Alcohol (ethanol); breath
Aldolase
Aldosterone
Alkaloids, urine, quantitative
Alpha-1-antitrypsin; total
Alpha-1-antitrypsin; phenotype
Alpha-fetoprotein (AFP); serum
Alpha-fetoprotein (AFP); amniotic fluid
Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio)
Aluminum
Amines, vaginal fluid, qualitative
Amino acids; single, qualitative, each specimen
Amino acids; multiple, qualitative, each specimen
Amino acids; single, quantitative, each specimen
Aminolevulinic acid, delta (ALA)
Amino acids, 2 to 5 amino acids, quantitative, each specimen
Amino acids, 6 or more amino acids, quantitative, each specimen
Ammonia
Amniotic fluid scan (spectrophotometric)

Amphetamine or methamphetamine
Amylase
Androstanediol glucuronide
Androstenedione
Androsterone
Angiotensin II
Angiotensin I - converting enzyme (ACE)
Apolipoprotein, each
Arsenic
Ascorbic acid (Vitamin C), blood
Atomic absorption spectroscopy, each analyte
Barbiturates, not elsewhere specified
Beta-2 microglobulin
Bile acids; total
Bile acids; cholylglycine
Bilirubin; total
Bilirubin; direct
Bilirubin; feces, qualitative
Biotinidase, each specimen
Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for
Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources
Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than col
Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations
Bradykinin
Cadmium
Vitamin D; 25 hydroxy, includes fraction(s), if performed
Calcitonin
Calcium; total
Calcium; ionized
Calcium; after calcium infusion test
Calcium; urine quantitative, timed specimen

Calculus; qualitative analysis
Calculus; quantitative analysis, chemical
Calculus; infrared spectroscopy
Calculus; X-ray diffraction
Carbohydrate deficient transferrin
Carbon dioxide (bicarbonate)
Carboxyhemoglobin; quantitative
Carboxyhemoglobin; qualitative
Carcinoembryonic antigen (CEA)
Carnitine (total and free), quantitative, each specimen
Carotene
Catecholamines; total urine
Catecholamines; blood
Catecholamines; fractionated
Cathepsin-D
Ceruloplasmin
Chemiluminescent assay
Chloramphenicol
Chloride; blood
Chloride; urine
Chloride; other source
Chlorinated hydrocarbons, screen
Cholesterol, serum or whole blood, total
Cholinesterase; serum
Cholinesterase; RBC
Chondroitin B sulfate, quantitative
Chromatography, qualitative; column (eg, gas liquid or HPLC), analyte not elsewhere specified
Chromatography, qualitative; paper, 1-dimensional, analyte not elsewhere specified
Chromatography, qualitative; paper, 2-dimensional, analyte not elsewhere specified
Chromatography, qualitative; thin layer, analyte not elsewhere specified
Chromatography, quantitative, column (eg, gas liquid or HPLC); single analyte not elsewhere specified, single stationary and mobile
Chromatography, quantitative, column (eg, gas liquid or HPLC); multiple analytes, single stationary and mobile phase
Chromium
Citrate
Cocaine or metabolite
Collagen cross links, any method
Copper
Corticosterone
Cortisol; free
Cortisol; total
Creatine
Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte not elsewhere specified; qualitative, single station
Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte not elsewhere specified; quantitative, single statio
Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte not elsewhere specified; stable isotope dilution, si
Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte not elsewhere specified; stable isotope dilution, m
Creatine kinase (CK), (CPK); total
Creatine kinase (CK), (CPK); isoenzymes
Creatine kinase (CK), (CPK); MB fraction only
Creatine kinase (CK), (CPK); isoforms
Creatinine; blood
Creatinine; other source
Creatinine; clearance
Cryofibrinogen
Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)
Cyanide
Cyanocobalamin (Vitamin B-12);
Cyanocobalamin (Vitamin B-12); unsaturated binding capacity
Cystatin C
Cystine and homocystine, urine, qualitative
Dehydroepiandrosterone (DHEA)
Dehydroepiandrosterone-sulfate (DHEA-S)
Desoxycorticosterone, 11Deoxycortisol, 11Dibucaine number

Dihydrocodeinone
Dihydromorphinone
Dihydrotestosterone (DHT)
Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed
Dimethadione
Elastase, pancreatic (EL-1), fecal, qualitative or semi-quantitative
Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen
Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen
Electrophoretic technique, not elsewhere specified
Epiandrosterone
Erythropoietin
Estradiol
Estrogens; fractionated
Estrogens; total
Estriol
Estrone
Ethchlorvynol
Ethylene glycol
Etiocholanolone
Fat or lipids, feces; qualitative
Fat or lipids, feces; quantitative
Fat differential, feces, quantitative
Fatty acids, nonesterified
Very long chain fatty acids
Ferritin
Fetal fibronectin, cervicovaginal secretions, semi-quantitative
Fluoride
Flurazepam
Folic acid; serum

Folic acid; RBC
Fructose, semen
Galactokinase, RBC
Galactose
Galactose-1-phosphate uridyl transferase; quantitative
Galactose-1-phosphate uridyl transferase; screen
Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each
Gammaglobulin (immunoglobulin); IgE
Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 4), each
Gases, blood, pH only
Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation);
Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct me
Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry
Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen)
Gastric acid analysis, includes pH if performed, each specimen
Gastrin after secretin stimulation
Gastrin
Glucagon
Glucose, body fluid, other than blood
Glucagon tolerance test
Glucose; quantitative, blood (except reagent strip)
Glucose; blood, reagent strip
Glucose; post glucose dose (includes glucose)
Glucose; tolerance test (GTT), 3 specimens (includes glucose)
Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure)
Glucose; tolbutamide tolerance test
Glucose-6-phosphate dehydrogenase (G6PD); quantitative
Glucose-6-phosphate dehydrogenase (G6PD); screen
Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
Glucosidase, beta
Glutamate dehydrogenase
Glutamine (glutamic acid amide)
Glutamyltransferase, gamma (GGT)
Glutathione
Glutathione reductase, RBC
Glutethimide
Glycated protein
Gonadotropin; follicle stimulating hormone (FSH)
Gonadotropin; luteinizing hormone (LH)
Growth hormone, human (HGH) (somatotropin)
Guanosine monophosphate (GMP), cyclic
Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13)
Haptoglobin; quantitative
Haptoglobin; phenotypes
Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13)
Helicobacter pylori; drug administration
Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); screen
Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); quantitative, each
Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or F)
Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or F)
Hemoglobin; by copper sulfate method, non-automated
Hemoglobin; F (fetal), chemical
Hemoglobin; F (fetal), qualitative
Hemoglobin; glycosylated (A1C)
Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use
Hemoglobin; methemoglobin, qualitative
Hemoglobin; methemoglobin, quantitative
Hemoglobin; plasma
Hemoglobin; sulfhemoglobin, qualitative
Hemoglobin; sulfhemoglobin, quantitative
Hemoglobin; thermolabile
Hemoglobin; unstable, screen

Hemoglobin; urine
Hemosiderin; qualitative
Hemosiderin; quantitative
b-Hexosaminidase, each assay
Histamine
Homocysteine
Homovanillic acid (HVA)
Hydroxycorticosteroids, 17- (17-OHCS)
Hydroxyindolacetic acid, 5-(HIAA)
Hydroxyprogesterone, 17-d
Hydroxyprogesterone, 20Hydroxyproline; free
Hydroxyproline; total
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multipl
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single s
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified
Insulin; total
Insulin; free
Intrinsic factor
Iron
Iron binding capacity
Isocitric dehydrogenase (IDH)
Ketogenic steroids, fractionation
Ketosteroids, 17- (17-KS); total
Ketosteroids, 17- (17-KS); fractionation
Lactate (lactic acid)
Lactate dehydrogenase (LD), (LDH);
Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation
Lactoferrin, fecal; qualitative
Lactoferrin, fecal; quantitative

Lactogen, human placental (HPL) human chorionic somatomammotropin
Lactose, urine; qualitative
Lactose, urine; quantitative
Lead
Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio
Fetal lung maturity assessment; foam stability test
Fetal lung maturity assessment; fluorescence polarization
Fetal lung maturity assessment; lamellar body density
Leucine aminopeptidase (LAP)
Lipase
Lipoprotein (a)
Lipoprotein-associated phospholipase A2 (Lp-PLA2)
Lipoprotein, blood; electrophoretic separation and quantitation
Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed
Lipoprotein, blood; quantitation of lipoprotein particle numbers and lipoprotein particle subclasses (eg, by nuclear magnetic reson
Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)
Lipoprotein, direct measurement; VLDL cholesterol
Lipoprotein, direct measurement; LDL cholesterol
Luteinizing releasing factor (LRH)
Magnesium
Malate dehydrogenase
Manganese
Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; qualitative, each specimen
Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; quantitative, each specimen
Meprobamate
Mercury, quantitative
Metanephrines
Methadone
Methemalbumin
Methsuximide
Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity
Mucopolysaccharides, acid; quantitative
Mucopolysaccharides, acid; screen
Mucin, synovial fluid (Ropes test)
Myelin basic protein, cerebrospinal fluid
Myoglobin
Myeloperoxidase (MPO)
Natriuretic peptide
Nephelometry, each analyte not elsewhere specified
Nickel
Nicotine
Molecular diagnostics; molecular isolation or extraction, each nucleic acid type (ie, DNA or RNA)
Molecular diagnostics; isolation or extraction of highly purified nucleic acid, each nucleic acid type (ie, DNA or RNA)
Molecular diagnostics; enzymatic digestion, each enzyme treatment
Molecular diagnostics; dot/slot blot production, each nucleic acid preparation
Molecular diagnostics; separation by gel electrophoresis (eg, agarose, polyacrylamide), each nucleic acid preparation
Molecular diagnostics; nucleic acid probe, each
Molecular diagnostics; nucleic acid transfer (eg, Southern, Northern), each nucleic acid preparation
Molecular diagnostics; amplification, target, each nucleic acid sequence
Molecular diagnostics; amplification, target, multiplex, first 2 nucleic acid sequences
Molecular diagnostics; amplification, target, multiplex, each additional nucleic acid sequence beyond 2 (List separately in addition
Molecular diagnostics; reverse transcription
Molecular diagnostics; mutation scanning, by physical properties (eg, single strand conformational polymorphisms [SSCP], heterod
Molecular diagnostics; mutation identification by sequencing, single segment, each segment
Molecular diagnostics; mutation identification by allele specific transcription, single segment, each segment
Molecular diagnostics; mutation identification by allele specific translation, single segment, each segment
Molecular diagnostics; lysis of cells prior to nucleic acid extraction (eg, stool specimens, paraffin embedded tissue), each specimen
Molecular diagnostics; amplification, signal, each nucleic acid sequence
Molecular diagnostics; separation and identification by high resolution technique (eg, capillary electrophoresis), each nucleic acid p
Molecular diagnostics; interpretation and report
Molecular diagnostics; RNA stabilization
Mutation identification by enzymatic ligation or primer extension, single segment, each segment (eg, oligonucleotide ligation assay
Nucleotidase 5'Oligoclonal immune (oligoclonal bands)
Organic acids; total, quantitative, each specimen
Organic acids; qualitative, each specimen
Organic acid, single, quantitative
Opiate(s), drug and metabolites, each procedure
Osmolality; blood
Osmolality; urine
Osteocalcin (bone g1a protein)
Oxalate
Oncoprotein; HER-2/neu
Oncoprotein; des-gamma-carboxy-prothrombin (DCP)
Parathormone (parathyroid hormone)
pH; body fluid, not otherwise specified
pH; exhaled breath condensate
Phencyclidine (PCP)
Calprotectin, fecal
Phenothiazine
Phenylalanine (PKU), blood
Phenylketones, qualitative
Phosphatase, acid; total
Phosphatase, acid; forensic examination
Phosphatase, acid; prostatic
Phosphatase, alkaline;
Phosphatase, alkaline; heat stable (total not included)
Phosphatase, alkaline; isoenzymes
Phosphatidylglycerol
Phosphogluconate, 6-, dehydrogenase, RBC
Phosphohexose isomerase
Phosphorus inorganic (phosphate);
Phosphorus inorganic (phosphate); urine

Porphobilinogen, urine; qualitative
Porphobilinogen, urine; quantitative
Placental alpha microglobulin-1 (PAMG-1), cervicovaginal secretion, qualitative
Porphyrins, urine; qualitative
Porphyrins, urine; quantitation and fractionation
Porphyrins, feces; quantitative
Porphyrins, feces; qualitative
Potassium; serum, plasma or whole blood
Potassium; urine
Prealbumin
Pregnanediol
Pregnanetriol
Pregnenolone
17-hydroxypregnenolone
Progesterone
Procalcitonin (PCT)
Prolactin
Prostaglandin, each
Prostate specific antigen (PSA); complexed (direct measurement)
Prostate specific antigen (PSA); total
Prostate specific antigen (PSA); free
Protein, total, except by refractometry; serum, plasma or whole blood
Protein, total, except by refractometry; urine
Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)
Protein, total, by refractometry, any source
Pregnancy-associated plasma protein-A (PAPP-A)
Protein; electrophoretic fractionation and quantitation, serum
Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)
Protein; Western Blot, with interpretation and report, blood or other body fluid
Protein; Western Blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each
Protoporphyrin, RBC; quantitative

Protoporphyrin, RBC; screen
Proinsulin
Pyridoxal phosphate (Vitamin B-6)
Pyruvate
Pyruvate kinase
Quinine
Receptor assay; estrogen
Receptor assay; progesterone
Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)
Receptor assay; non-endocrine (specify receptor)
Renin
Riboflavin (Vitamin B-2)
Selenium
Serotonin
Sex hormone binding globulin (SHBG)
Sialic acid
Silica
Sodium; serum, plasma or whole blood
Sodium; urine
Sodium; other source
Somatomedin
Somatostatin
Spectrophotometry, analyte not elsewhere specified
Specific gravity (except urine)
Sugars, chromatographic, TLC or paper chromatography
Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen
Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen
Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen
Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen
Sulfate, urine
Testosterone; free
Testosterone; total
Thiamine (Vitamin B-1)
Thiocyanate
Thromboxane metabolite(s), including thromboxane if performed, urine
Thyroglobulin
Thyroxine; total
Thyroxine; requiring elution (eg, neonatal)
Thyroxine; free
Thyroxine binding globulin (TBG)
Thyroid stimulating hormone (TSH)
Thyroid stimulating immune globulins (TSI)
Tocopherol alpha (Vitamin E)
Transcortin (cortisol binding globulin)
Transferase; aspartate amino (AST) (SGOT)
Transferase; alanine amino (ALT) (SGPT)
Transferrin
Triglycerides
Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)
Triiodothyronine T3; total (TT-3)
Triiodothyronine T3; free
Triiodothyronine T3; reverse
Troponin, quantitative
Trypsin; duodenal fluid
Trypsin; feces, qualitative
Trypsin; feces, quantitative, 24-hour collection
Tyrosine
Troponin, qualitative
Urea nitrogen; quantitative
Urea nitrogen; semiquantitative (eg, reagent strip test)
Urea nitrogen, urine
Urea nitrogen, clearance

Uric acid; blood
Uric acid; other source
Urobilinogen, feces, quantitative
Urobilinogen, urine; qualitative
Urobilinogen, urine; quantitative, timed specimen
Urobilinogen, urine; semiquantitative
Vanillylmandelic acid (VMA), urine
Vasoactive intestinal peptide (VIP)
Vasopressin (antidiuretic hormone, ADH)
Vitamin A
Vitamin, not otherwise specified
Vitamin K
Volatiles (eg, acetic anhydride, carbon tetrachloride, dichloroethane, dichloromethane, diethylether, isopropyl alcohol, methanol)
Xylose absorption test, blood and/or urine
Zinc
C-peptide
Gonadotropin, chorionic (hCG); quantitative
Gonadotropin, chorionic (hCG); qualitative
Gonadotropin, chorionic (hCG); free beta chain
Ovulation tests, by visual color comparison methods for human luteinizing hormone
Unlisted chemistry procedure
Bleeding time
Blood count; automated differential WBC count
Blood count; blood smear, microscopic examination with manual differential WBC count
Blood count; blood smear, microscopic examination without manual differential WBC count
Blood count; manual differential WBC count, buffy coat
Blood count; spun microhematocrit
Blood count; hematocrit (Hct)
Blood count; hemoglobin (Hgb)
Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count
Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)
Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each
Blood count; red blood cell (RBC), automated
Blood count; reticulocyte, manual
Blood count; reticulocyte, automated
Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [CHr], immat
Blood count; leukocyte (WBC), automated
Blood count; platelet, automated
Reticulated platelet assay
Blood smear, peripheral, interpretation by physician with written report
Bone marrow, smear interpretation
Chromogenic substrate assay
Clot retraction
Clot lysis time, whole blood dilution
Clotting; factor II, prothrombin, specific
Clotting; factor V (AcG or proaccelerin), labile factor
Clotting; factor VII (proconvertin, stable factor)
Clotting; factor VIII (AHG), 1-stage
Clotting; factor VIII related antigen
Clotting; factor VIII, VW factor, ristocetin cofactor
Clotting; factor VIII, VW factor antigen
Clotting; factor VIII, von Willebrand factor, multimetric analysis
Clotting; factor IX (PTC or Christmas)
Clotting; factor X (Stuart-Prower)
Clotting; factor XI (PTA)
Clotting; factor XII (Hageman)
Clotting; factor XIII (fibrin stabilizing)
Clotting; factor XIII (fibrin stabilizing), screen solubility
Clotting; prekallikrein assay (Fletcher factor assay)
Clotting; high molecular weight kininogen assay (Fitzgerald factor assay)
Clotting inhibitors or anticoagulants; antithrombin III, activity
Clotting inhibitors or anticoagulants; antithrombin III, antigen assay

Clotting inhibitors or anticoagulants; protein C, antigen
Clotting inhibitors or anticoagulants; protein C, activity
Clotting inhibitors or anticoagulants; protein S, total
Clotting inhibitors or anticoagulants; protein S, free
Activated Protein C (APC) resistance assay
Factor inhibitor test
Thrombomodulin
Coagulation time; Lee and White
Coagulation time; activated
Coagulation time; other methods
Euglobulin lysis
Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, semiquantitative
Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation
Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative
Fibrin degradation products, D-dimer; qualitative or semiquantitative
Fibrin degradation products, D-dimer; quantitative
Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantita
Fibrinogen; activity
Fibrinogen; antigen
Fibrinolysins or coagulopathy screen, interpretation and report
Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as ind
Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, ADAMTS-13), each analyte
Fibrinolytic factors and inhibitors; plasmin
Fibrinolytic factors and inhibitors; alpha-2 antiplasmin
Fibrinolytic factors and inhibitors; plasminogen activator
Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay
Fibrinolytic factors and inhibitors; plasminogen, antigenic assay
Heinz bodies; direct
Heinz bodies; induced, acetyl phenylhydrazine
Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis (Kleihauer-Betke)
Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette

Hemolysin, acid
Heparin assay
Heparin neutralization
Heparin-protamine tolerance test
Iron stain, peripheral blood
Leukocyte alkaline phosphatase with count
Mechanical fragility, RBC
Muramidase
Osmotic fragility, RBC; unincubated
Osmotic fragility, RBC; incubated
Platelet, aggregation (in vitro), each agent
Phospholipid neutralization; platelet
Phospholipid neutralization; hexagonal phospholipid
Prothrombin time;
Prothrombin time; substitution, plasma fractions, each
Russell viper venom time (includes venom); undiluted
Russell viper venom time (includes venom); diluted
Reptilase test
Sedimentation rate, erythrocyte; non-automated
Sedimentation rate, erythrocyte; automated
Sickling of RBC, reduction
Thrombin time; plasma
Thrombin time; titer
Thromboplastin inhibition, tissue
Thromboplastin time, partial (PTT); plasma or whole blood
Thromboplastin time, partial (PTT); substitution, plasma fractions, each
Viscosity
Unlisted hematology and coagulation procedure
Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen
Allergen specific IgG quantitative or semiquantitative, each allergen
Allergen specific IgE; quantitative or semiquantitative, each allergen

Allergen specific IgE; qualitative, multiallergen screen (dipstick, paddle, or disk)
Antibody identification; leukocyte antibodies
Antibody identification; platelet antibodies
Antibody identification; platelet associated immunoglobulin assay
Antinuclear antibodies (ANA);
Antinuclear antibodies (ANA); titer
Antistreptolysin 0; titer
Antistreptolysin 0; screen
Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report
Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and
Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, tra
C-reactive protein;
C-reactive protein; high sensitivity (hsCRP)
Beta 2 Glycoprotein I antibody, each
Cardiolipin (phospholipid) antibody, each Ig class
Anti-phosphatidylserine (phospholipid) antibody
Chemotaxis assay, specify method
Cold agglutinin; screen
Cold agglutinin; titer
Complement; antigen, each component
Complement; functional activity, each component
Complement; total hemolytic (CH50)
Complement fixation tests, each antigen
Counterimmunoelectrophoresis, each antigen
Cyclic citrullinated peptide (CCP), antibody
Deoxyribonuclease, antibody
Deoxyribonucleic acid (DNA) antibody; native or double stranded
Deoxyribonucleic acid (DNA) antibody; single stranded
Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, RNP, Sc170, J01), each antibody
Fc receptor
Fluorescent noninfectious agent antibody; screen, each antibody

Fluorescent noninfectious agent antibody; titer, each antibody
Growth hormone, human (HGH), antibody
Hemagglutination inhibition test (HAI)
Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)
Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29)
Immunoassay for tumor antigen, quantitative; CA 19-9
Immunoassay for tumor antigen, quantitative; CA 125
Human epididymis protein 4 (HE4)
Heterophile antibodies; screening
Heterophile antibodies; titer
Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney
Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each
Immunoassay for infectious agent antibody, quantitative, not otherwise specified
Immunoassay for infectious agent antibody, qualitative or semiquantitative, single step method (eg, reagent strip)
Immunoelectrophoresis; serum
Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration
Immunoelectrophoresis; crossed (2-dimensional assay)
Immunodiffusion; not elsewhere specified
Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or antibody
Immune complex assay
Immunofixation electrophoresis; serum
Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF)
Inhibin A
Insulin antibodies
Intrinsic factor antibodies
Islet cell antibody
Leukocyte histamine release test (LHR)
Leukocyte phagocytosis
Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, ATP)
Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis
B cells, total count

Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen
Natural killer (NK) cells, total count
T cells; total count
T cells; absolute CD4 and CD8 count, including ratio
T cells; absolute CD4 count
Stem cells (ie, CD34), total count
Microsomal antibodies (eg, thyroid or liver-kidney), each
Migration inhibitory factor test (MIF)
Neutralization test, viral
Nitroblue tetrazolium dye test (NTD)
Particle agglutination; screen, each antibody
Particle agglutination; titer, each antibody
Rheumatoid factor; qualitative
Rheumatoid factor; quantitative
Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon
Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing T-cells in
Skin test; candida
Skin test; unlisted antigen, each
Skin test; coccidioidomycosis
Skin test; histoplasmosis
Skin test; tuberculosis, intradermal
Streptokinase, antibody
Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)
Syphilis test, non-treponemal antibody; quantitative
Antibody; actinomyces
Antibody; adenovirus
Antibody; Aspergillus
Antibody; bacterium, not elsewhere specified
Antibody; Bartonella
Antibody; Blastomyces
Antibody; Bordetella
Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot)
Antibody; Borrelia burgdorferi (Lyme disease)
Antibody; Borrelia (relapsing fever)
Antibody; Brucella
Antibody; Campylobacter
Antibody; Candida
Antibody; Chlamydia
Antibody; Chlamydia, IgM
Antibody; Coccidioides
Antibody; Coxiella burnetii (Q fever)
Antibody; Cryptococcus
Antibody; cytomegalovirus (CMV)
Antibody; cytomegalovirus (CMV), IgM
Antibody; Diphtheria
Antibody; encephalitis, California (La Crosse)
Antibody; encephalitis, Eastern equine
Antibody; encephalitis, St. Louis
Antibody; encephalitis, Western equine
Antibody; enterovirus (eg, coxsackie, echo, polio)
Antibody; Epstein-Barr (EB) virus, early antigen (EA)
Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)
Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)
Antibody; Ehrlichia
Antibody; Francisella tularensis
Antibody; fungus, not elsewhere specified
Antibody; Giardia lamblia
Antibody; Helicobacter pylori
Antibody; helminth, not elsewhere specified
Antibody; Haemophilus influenza
Antibody; HTLV-I
Antibody; HTLV-II
Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot)
Antibody; hepatitis, delta agent
Antibody; herpes simplex, non-specific type test
Antibody; herpes simplex, type 1
Antibody; herpes simplex, type 2
Antibody; histoplasma
Antibody; HIV-1
Antibody; HIV-2
Antibody; HIV-1 and HIV-2, single assay
Hepatitis B core antibody (HBcAb); total
Hepatitis B core antibody (HBcAb); IgM antibody
Hepatitis B surface antibody (HBsAb)
Hepatitis Be antibody (HBeAb)
Hepatitis A antibody (HAAb); total
Hepatitis A antibody (HAAb); IgM antibody
Antibody; influenza virus
Antibody; Legionella
Antibody; Leishmania
Antibody; Leptospira
Antibody; Listeria monocytogenes
Antibody; lymphocytic choriomeningitis
Antibody; lymphogranuloma venereum
Antibody; mucormycosis
Antibody; mumps
Antibody; mycoplasma
Antibody; Neisseria meningitidis
Antibody; Nocardia
Antibody; parvovirus
Antibody; Plasmodium (malaria)
Antibody; protozoa, not elsewhere specified
Antibody; respiratory syncytial virus

Antibody; Rickettsia
Antibody; rotavirus
Antibody; rubella
Antibody; rubeola
Antibody; Salmonella
Antibody; Shigella
Antibody; tetanus
Antibody; Toxoplasma
Antibody; Toxoplasma, IgM
Antibody; Treponema pallidum
Antibody; Trichinella
Antibody; varicella-zoster
Antibody; West Nile virus, IgM
Antibody; West Nile virus
Antibody; virus, not elsewhere specified
Antibody; Yersinia
Thyroglobulin antibody
Hepatitis C antibody;
Hepatitis C antibody; confirmatory test (eg, immunoblot)
Lymphocytotoxicity assay, visual crossmatch; with titration
Lymphocytotoxicity assay, visual crossmatch; without titration
Serum screening for cytotoxic percent reactive antibody (PRA); standard method
Serum screening for cytotoxic percent reactive antibody (PRA); quick method
HLA typing; A, B, or C (eg, A10, B7, B27), single antigen
HLA typing; A, B, or C, multiple antigens
HLA typing; DR/DQ, single antigen
HLA typing; DR/DQ, multiple antigens
HLA typing; lymphocyte culture, mixed (MLC)
HLA typing; lymphocyte culture, primed (PLC)
Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution
Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilu
Unlisted immunology procedure
Antibody screen, RBC, each serum technique
Antibody elution (RBC), each elution
Antibody identification, RBC antibodies, each panel for each serum technique
Antihuman globulin test (Coombs test); direct, each antiserum
Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red cell
Antihuman globulin test (Coombs test); indirect, each antibody titer
Autologous blood or component, collection processing and storage; predeposited
Autologous blood or component, collection processing and storage; intra- or postoperative salvage
Blood typing; ABO
Blood typing; Rh (D)
Blood typing; antigen testing of donor blood using reagent serum, each antigen test
Blood typing; antigen screening for compatible unit using patient serum, per unit screened
Blood typing; RBC antigens, other than ABO or Rh (D), each
Blood typing; Rh phenotyping, complete
Blood typing, for paternity testing, per individual; ABO, Rh and MN
Blood typing, for paternity testing, per individual; each additional antigen system
Compatibility test each unit; immediate spin technique
Compatibility test each unit; incubation technique
Compatibility test each unit; antiglobulin technique
Compatibility test each unit; electronic
Fresh frozen plasma, thawing, each unit
Frozen blood, each unit; freezing (includes preparation)
Frozen blood, each unit; thawing
Frozen blood, each unit; freezing (includes preparation) and thawing
Hemolysins and agglutinins; auto, screen, each
Hemolysins and agglutinins; incubated
Irradiation of blood product, each unit
Leukocyte transfusion
Volume reduction of blood or blood product (eg, red blood cells or platelets), each unit
Pooling of platelets or other blood products
Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with chemical agen
Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; incubation with enzymes, eac
Pretreatment of RBCs for use in RBC antibody detection, identification, and/or compatibility testing; by density gradient separation
Pretreatment of serum for use in RBC antibody identification; incubation with drugs, each
Pretreatment of serum for use in RBC antibody identification; by dilution
Pretreatment of serum for use in RBC antibody identification; incubation with inhibitors, each
Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or RBCs of know
Splitting of blood or blood products, each unit
Unlisted transfusion medicine procedure
Animal inoculation, small animal; with observation
Animal inoculation, small animal; with observation and dissection
Concentration (any type), for infectious agents
Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropria
Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species
Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate
Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates
Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or
Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood
Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates
Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate
Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate
Culture, presumptive, pathogenic organisms, screening only;
Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart
Culture, bacterial; quantitative colony count, urine
Culture, bacterial; with isolation and presumptive identification of each isolate, urine
Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail
Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)
Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood
Culture, fungi, definitive identification, each organism; yeast
Culture, fungi, definitive identification, each organism; mold
Culture, mycoplasma, any source

Culture, chlamydia, any source
Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of i
Culture, mycobacterial, definitive identification, each isolate
Culture, typing; immunofluorescent method, each antiserum
Culture, typing; gas liquid chromatography (GLC) or high pressure liquid chromatography (HPLC) method
Culture, typing; immunologic method, other than immunofluoresence (eg, agglutination grouping), per antiserum
Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe technique, per culture or isolate, each organism pro
Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified probe technique, per culture or isolate, each organism
Culture, typing; identification by pulse field gel typing
Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16S rRNA gene)
Culture, typing; other methods
Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection
Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection
Macroscopic examination; arthropod
Macroscopic examination; parasite
Pinworm exam (eg, cellophane tape prep)
Homogenization, tissue, for culture
Ova and parasites, direct smears, concentration and identification
Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)
Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)
Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme
Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), e
Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List sep
Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent
Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent
Serum bactericidal titer (Schlicter test)
Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types
Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types
Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypa
Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites
Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps)
Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)
Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin)
Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection
Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect
Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluoresence
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic a
Infectious agent antigen detection by immunofluorescent technique; adenovirus
Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis
Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA)
Infectious agent antigen detection by immunofluorescent technique; giardia
Infectious agent antigen detection by immunofluorescent technique; Chlamydia trachomatis
Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA)
Infectious agent antigen detection by immunofluorescent technique; cryptosporidium
Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2
Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
Infectious agent antigen detection by immunofluorescent technique; Legionella micdadei
Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii
Infectious agent antigen detection by immunofluorescent technique; Rubeola
Infectious agent antigen detection by immunofluorescent technique; Treponema pallidum
Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus
Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism
Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; ade
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Asp
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Chla
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Clos
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Cry
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; cryp
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; giar
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; cyto
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Esc
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Ent
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Ent
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Hel
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Hel
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; hep
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Hist
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; HIV
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; HIV
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Infl
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; resp
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; rota
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Shig
Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Stre
Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, not o
Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; single step method, not oth
Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, poly
Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification
Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance (eg, enterococcus species van A, van B), amplified
Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, reverse transcription and amplified probe technique, each
Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, reverse transcription and
Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, multiplex reverse transcrip
Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, quantification
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification
Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, quantification
Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification
Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, amplified probe technique
Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, direct probe technique
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism
Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique
Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique
Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B
Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A
Infectious agent antigen detection by immunoassay with direct optical observation; Influenza
Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus
Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis
Infectious agent antigen detection by immunoassay with direct optical observation; adenovirus
Infectious agent antigen detection by immunoassay with direct optical observation; Chlamydia trachomatis
Infectious agent antigen detection by immunoassay with direct optical observation; Neisseria gonorrhoeae
Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A
Infectious agent antigen detection by immunoassay with direct optical observation; not otherwise specified
Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics
Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse transcriptase and protease regions
Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C virus
Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 1
Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; each additiona
Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)
Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other region (eg, integrase, fusion)
Unlisted microbiology procedure

Necropsy (autopsy), gross examination only; without CNS
Necropsy (autopsy), gross examination only; with brain
Necropsy (autopsy), gross examination only; with brain and spinal cord
Necropsy (autopsy), gross examination only; infant with brain
Necropsy (autopsy), gross examination only; stillborn or newborn with brain
Necropsy (autopsy), gross examination only; macerated stillborn
Necropsy (autopsy), gross and microscopic; without CNS
Necropsy (autopsy), gross and microscopic; with brain
Necropsy (autopsy), gross and microscopic; with brain and spinal cord
Necropsy (autopsy), gross and microscopic; infant with brain
Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain
Necropsy (autopsy), limited, gross and/or microscopic; regional
Necropsy (autopsy), limited, gross and/or microscopic; single organ
Necropsy (autopsy); forensic examination
Necropsy (autopsy); coroner's call
Unlisted necropsy (autopsy) procedure
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation
Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and simple filter preparation with interpretation
Cytopathology, concentration technique, smears and interpretation (eg, Saccomanno technique)
Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except c
Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each spe
Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each spe
Cytopathology, forensic (eg, sperm)
Sex chromatin identification; Barr bodies
Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks
Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manua
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with m
Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision
Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision
Cytopathology, slides, cervical or vaginal; manual screening under physician supervision
Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision
Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision
Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening using cell selection and review
Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic ind
Cytopathology, smears, any other source; screening and interpretation
Cytopathology, smears, any other source; preparation, screening and interpretation
Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains
Cytopathology, slides, cervical or vaginal (the Bethesda System); manual screening under physician supervision
Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician supervisio
Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening under
Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted rescreening using c
Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evalu
Cytopathology, evaluation of fine needle aspirate; interpretation and report
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screeni
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with sc
Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each sepa
Flow cytometry, cell cycle or DNA analysis
Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker
Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (List separately in
Flow cytometry, interpretation; 2 to 8 markers
Flow cytometry, interpretation; 9 to 15 markers
Flow cytometry, interpretation; 16 or more markers
Unlisted cytopathology procedure
Tissue culture for non-neoplastic disorders; lymphocyte
Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy
Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells
Tissue culture for neoplastic disorders; bone marrow, blood cells
Tissue culture for neoplastic disorders; solid tumor
Cryopreservation, freezing and storage of cells, each cell line
Thawing and expansion of frozen cells, each aliquot

Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells
Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia te
Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin C, ionizing radiatio
Chromosome analysis; count 5 cells, 1 karyotype, with banding
Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding
Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding
Chromosome analysis; analyze 20-25 cells
Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding
Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding
Molecular cytogenetics; DNA probe, each (eg, FISH)
Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)
Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)
Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells
Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells
Chromosome analysis; additional karyotypes, each study
Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding)
Chromosome analysis; additional cells counted, each study
Chromosome analysis; additional high resolution study
Cytogenetics and molecular cytogenetics, interpretation and report
Unlisted cytogenetic study
Level I - Surgical pathology, gross examination only
Level II - Surgical pathology, gross and microscopic examination Appendix, incidental, Fallopian tube, sterilization, Fingers/toes, am
Level III - Surgical pathology, gross and microscopic examination Abortion, induced, Abscess, Aneurysm - arterial/ventricular, Anus
Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed, Artery, biopsy, Bone marrow, bio
Level V - Surgical pathology, gross and microscopic examination Adrenal, resection, Bone - biopsy/curettings, Bone fragment(s), pa
Level VI - Surgical pathology, gross and microscopic examination Bone resection, Breast, mastectomy - with regional lymph nodes,
Decalcification procedure (List separately in addition to code for surgical pathology examination)
Special stains; Group I for microorganisms (eg, Gridley, acid fast, methenamine silver), including interpretation and report, each
Special stains; Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interp
Special stains; histochemical staining with frozen section(s), including interpretation and report (List separately in addition to code
Determinative histochemistry to identify chemical components (eg, copper, zinc)

Determinative histochemistry or cytochemistry to identify enzyme constituents, each
Consultation and report on referred slides prepared elsewhere
Consultation and report on referred material requiring preparation of slides
Consultation, comprehensive, with review of records and specimens, with report on referred material
Pathology consultation during surgery;
Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen
Pathology consultation during surgery; each additional tissue block with frozen section(s) (List separately in addition to code for pr
Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site
Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (List separately in
Immunohistochemistry (including tissue immunoperoxidase), each antibody
Immunofluorescent study, each antibody; direct method
Immunofluorescent study, each antibody; indirect method
Electron microscopy; diagnostic
Electron microscopy; scanning
Morphometric analysis; skeletal muscle
Morphometric analysis; nerve
Morphometric analysis; tumor (eg, DNA ploidy)
Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or s
Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or s
Nerve teasing preparations
Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, KRAS mutational ana
In situ hybridization (eg, FISH), each probe
Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) each probe; using computer-assisted technology
Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) each probe; manual
Protein analysis of tissue by Western Blot, with interpretation and report;
Protein analysis of tissue by Western Blot, with interpretation and report; immunological probe for band identification, each
Microdissection (ie, sample preparation of microscopically identified target); laser capture
Microdissection (ie, sample preparation of microscopically identified target); manual
Array-based evaluation of multiple molecular probes; 11 through 50 probes
Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based mole
Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based mole
Unlisted surgical pathology procedure
Bilirubin, total, transcutaneous
Hemoglobin (Hgb), quantitative, transcutaneous
Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin
Hemoglobin, quantitative, transcutaneous, per day; methemoglobin
Unlisted in vivo (eg, transcutaneous) laboratory service
Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and report
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count
Leukocyte assessment, fecal, qualitative or semiquantitative
Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)
Fat stain, feces, urine, or respiratory secretions
Meat fibers, feces
Nasal smear for eosinophils
Sputum, obtaining specimen, aerosol induced technique (separate procedure)
Sweat collection by iontophoresis
Unlisted miscellaneous pathology test
Culture of oocyte(s)/embryo(s), less than 4 days;
Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of oocyte(s)/embryos
Assisted embryo hatching, microtechniques (any method)
Oocyte identification from follicular fluid
Preparation of embryo for transfer (any method)
Sperm identification from aspiration (other than seminal fluid)
Cryopreservation; embryo(s)
Cryopreservation; sperm
Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis
Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis
Sperm identification from testis tissue, fresh or cryopreserved
Insemination of oocytes
Extended culture of oocyte(s)/embryo(s), 4-7 days
Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes
Assisted oocyte fertilization, microtechnique; greater than 10 oocytes
Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 e
Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos
Semen analysis; presence and/or motility of sperm including Huhner test (post coital)
Semen analysis; motility and count (not including Huhner test)
Semen analysis; volume, count, motility, and differential
Semen analysis; sperm presence and motility of sperm, if performed
Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, Kruger)
Sperm antibodies
Sperm evaluation; hamster penetration test
Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test
Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)
Cryopreservation, reproductive tissue, testicular
Storage (per year); embryo(s)
Storage (per year); sperm/semen
Storage (per year); reproductive tissue, testicular/ovarian
Storage (per year); oocyte(s)
Thawing of cryopreserved; embryo(s)
Thawing of cryopreserved; sperm/semen, each aliquot
Thawing of cryopreserved; reproductive tissue, testicular/ovarian
Thawing of cryopreserved; oocytes, each aliquot
Unlisted reproductive medicine laboratory procedure
Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualifie
Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualifie
H1N1 immunization administration (intramuscular, intranasal), including counseling when performed
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vac
Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)
Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (List separa
Psychiatric diagnostic interview examination
Interactive psychiatric diagnostic interview examination using play equipment, physical devices, language interpreter, or other me
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-v
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or reside
Psychoanalysis
Family psychotherapy (without the patient present)
Family psychotherapy (conjoint psychotherapy) (with patient present)
Multiple-family group psychotherapy
Group psychotherapy (other than of a multiple-family group)

Interactive group psychotherapy
Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychother
Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (Amytal) interview)
Therapeutic repetitive transcranial magnetic stimulation treatment; planning
Therapeutic repetitive transcranial magnetic stimulation treatment; delivery and management, per session
Electroconvulsive therapy (includes necessary monitoring)
Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psy
Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psy
Hypnotherapy
Environmental intervention for medical management purposes on a psychiatric patient's behalf with agencies, employers, or instit
Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated d
Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to f
Preparation of report of patient's psychiatric status, history, treatment, or progress (other than for legal or consultative purposes)
Unlisted psychiatric service or procedure
Biofeedback training by any modality
Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry
Hemodialysis procedure with single physician evaluation
Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription
Hemodialysis access flow study to determine blood flow in grafts and arteriovenous fistulae by an indicator method
Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapie
Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapie
End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the ade
End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of n
End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of
End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face physic
End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face physician visi
End-stage renal disease (ESRD) related services monthly, for patients 20 years of age and older; with 1 face-to-face physician visit p
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients younger than 2 years of age to include
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 2-11 years of age to include monitorin
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 12-19 years of age to include monitor
End-stage renal disease (ESRD) related services for home dialysis per full month, for patients 20 years of age and older
End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients younger than 2 ye
End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age
End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age
End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients 20 years of age an
Dialysis training, patient, including helper where applicable, any mode, completed course
Dialysis training, patient, including helper where applicable, any mode, course not completed, per training session
Hemoperfusion (eg, with activated charcoal or resin)
Unlisted dialysis procedure, inpatient or outpatient
Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;
Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;
Gastric motility (manometric) studies
Duodenal motility (manometric) study
Esophagus, acid perfusion (Bernstein) test for esophagitis
Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) placement, recording, analysis and interpretation
Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, recording, analysis and interpr
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recordi
Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recordi
Esophageal balloon distension provocation study
Breath hydrogen test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestin
Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with physician interpretation and re
Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with physician interpretation and report
Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic ball
Rectal sensation, tone, and compliance test (ie, response to graded balloon distention)
Anorectal manometry
Electrogastrography, diagnostic, transcutaneous;

Electrogastrography, diagnostic, transcutaneous; with provocative testing
Unlisted diagnostic gastroenterology procedure
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate,
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensiv
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment progra
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment progra
Determination of refractive state
Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range o
Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range o
Gonioscopy (separate procedure)
Computerized corneal topography, unilateral or bilateral, with interpretation and report
Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with int
Orthoptic and/or pleoptic training, with continuing medical direction and evaluation
Fitting of contact lens for treatment of disease, including supply of lens
Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, Autoplot, a
Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on
Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann visual fields w
Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with inte
Tonography with interpretation and report, recording indentation tonometer method or perilimbal suction method
Tonography with water provocation
Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral or bilateral
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; o
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; re
Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation
Provocative tests for glaucoma, with interpretation and report, without tonography
Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; initial
Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, melanoma), with interpretation and report; subsequ
Remote imaging for detection of retinal disease (eg, retinopathy in a patient with diabetes) with analysis and report under physicia
Remote imaging for monitoring and management of active retinal disease (eg, diabetic retinopathy) with physician review, interpre
Fluorescein angioscopy with interpretation and report
Fluorescein angiography (includes multiframe imaging) with interpretation and report

Indocyanine-green angiography (includes multiframe imaging) with interpretation and report
Fundus photography with interpretation and report
Ophthalmodynamometry
Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report
Electro-oculography with interpretation and report
Electroretinography with interpretation and report
Color vision examination, extended, eg, anomaloscope or equivalent
Dark adaptation examination with interpretation and report
External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit
Special anterior segment photography with interpretation and report; with specular endothelial microscopy and cell count
Special anterior segment photography with interpretation and report; with fluorescein angiography
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal len
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscle
Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by
Modification of contact lens (separate procedure), with medical supervision of adaptation
Replacement of contact lens
Fitting of spectacles, except for aphakia; monofocal
Fitting of spectacles, except for aphakia; bifocal
Fitting of spectacles, except for aphakia; multifocal, other than bifocal
Fitting of spectacle prosthesis for aphakia; monofocal
Fitting of spectacle prosthesis for aphakia; multifocal
Fitting of spectacle mounted low vision aid; single element system
Fitting of spectacle mounted low vision aid; telescopic or other compound lens system
Prosthesis service for aphakia, temporary (disposable or loan, including materials)
Repair and refitting spectacles; except for aphakia
Repair and refitting spectacles; spectacle prosthesis for aphakia

Unlisted ophthalmological service or procedure
Otolaryngologic examination under general anesthesia
Binocular microscopy (separate diagnostic procedure)
Evaluation of speech, language, voice, communication, and/or auditory processing
Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual
Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals
Nasopharyngoscopy with endoscope (separate procedure)
Nasal function studies (eg, rhinomanometry)
Facial nerve function studies (eg, electroneuronography)
Laryngeal function studies (ie, aerodynamic testing and acoustic testing)
Treatment of swallowing dysfunction and/or oral function for feeding
Spontaneous nystagmus, including gaze
Positional nystagmus test
Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)
Optokinetic nystagmus test
Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positiona
Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
Positional nystagmus test, minimum of 4 positions, with recording
Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests), with recording
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
Oscillating tracking test, with recording
Sinusoidal vertical axis rotational testing
Use of vertical electrodes (List separately in addition to code for primary procedure)
Computerized dynamic posturography
Tympanometry and reflex threshold measurements
Screening test, pure tone, air only
Pure tone audiometry (threshold); air only
Pure tone audiometry (threshold); air and bone
Speech audiometry threshold;
Speech audiometry threshold; with speech recognition
Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)
Audiometric testing of groups
Bekesy audiometry; screening
Bekesy audiometry; diagnostic
Loudness balance test, alternate binaural or monaural
Tone decay test
Short increment sensitivity index (SISI)
Stenger test, pure tone
Tympanometry (impedance testing)
Acoustic reflex testing, threshold
Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex dec
Filtered speech test
Staggered spondaic word test
Sensorineural acuity level test
Synthetic sentence identification test
Stenger test, speech
Visual reinforcement audiometry (VRA)
Conditioning play audiometry
Select picture audiometry
Electrocochleography
Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive
Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited
Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products)
Evoked otoacoustic emissions; comprehensive or diagnostic evaluation (comparison of transient and/or distortion product otoacou
Hearing aid examination and selection; monaural
Hearing aid examination and selection; binaural
Hearing aid check; monaural
Hearing aid check; binaural
Electroacoustic evaluation for hearing aid; monaural
Electroacoustic evaluation for hearing aid; binaural
Ear protector attenuation measurements
Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech
Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming
Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming
Diagnostic analysis of cochlear implant, age 7 years or older; with programming
Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming
Evaluation for prescription of non-speech-generating augmentative and alternative communication device
Therapeutic service(s) for the use of non-speech-generating device, including programming and modification
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patie
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patie
Therapeutic services for the use of speech-generating device, including programming and modification
Evaluation of oral and pharyngeal swallowing function
Motion fluoroscopic evaluation of swallowing function by cine or video recording
Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording;
Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording; physician interpretation and report only
Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording;
Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording; physician interpretation and report
Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;
Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; physician interpre
Evaluation of central auditory function, with report; initial 60 minutes
Evaluation of central auditory function, with report; each additional 15 minutes
Assessment of tinnitus (includes pitch, loudness matching, and masking)
Evaluation of auditory rehabilitation status; first hour
Evaluation of auditory rehabilitation status; each additional 15 minutes (List separately in addition to code for primary procedure)
Auditory rehabilitation; prelingual hearing loss
Auditory rehabilitation; postlingual hearing loss
Diagnostic analysis with programming of auditory brainstem implant, per hour
Unlisted otorhinolaryngological service or procedure
Cardiopulmonary resuscitation (eg, in cardiac arrest)
Temporary transcutaneous pacing
Cardioversion, elective, electrical conversion of arrhythmia; external
Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)
Cardioassist-method of circulatory assist; internal

Cardioassist-method of circulatory assist; external
Percutaneous transluminal coronary thrombectomy (List separately in addition to code for primary procedure)
Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addit
Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography
Thrombolysis, coronary; by intravenous infusion
Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation and/or therapeutic intervention including imaging s
Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation and/or therapeutic intervention including imaging s
Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method;
Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method;
Percutaneous transluminal coronary balloon angioplasty; single vessel
Percutaneous transluminal coronary balloon angioplasty; each additional vessel (List separately in addition to code for primary pro
Percutaneous balloon valvuloplasty; aortic valve
Percutaneous balloon valvuloplasty; mitral valve
Percutaneous balloon valvuloplasty; pulmonary valve
Atrial septectomy or septostomy; transvenous method, balloon (eg, Rashkind type) (includes cardiac catheterization)
Atrial septectomy or septostomy; blade method (Park septostomy) (includes cardiac catheterization)
Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; single vess
Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; each addit
Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel
Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for prim
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring,
Ergonovine provocation test
Microvolt T-wave alternans for assessment of ventricular arrhythmias
Rhythm ECG, 1-3 leads; with interpretation and report
Rhythm ECG, 1-3 leads; tracing only without interpretation and report
Rhythm ECG, 1-3 leads; interpretation and report only
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning a
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connectio
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; physician review and interpre
External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and
External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and
External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related
Signal-averaged electrocardiography (SAECG), with or without ECG
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device a
Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure,
Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure,
Interrogation device evaluation (in person) with physician analysis, review and report, includes connection, recording and disconne
Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim physician a
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable cardioverter-defibrillator syste
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system or implantable cardiove
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular monitor system, including analysis of 1 or m
Interrogation device evaluation(s), (remote) up to 30 days; implantable loop recorder system, including analysis of recorded heart
Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular monitor system or implantable loop recorde
Transthoracic echocardiography for congenital cardiac anomalies; complete
Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, comple
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, comple
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-
Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including prob
Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of
Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); image acquisi
Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation
Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only
Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only
Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acqu
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echo
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echo
Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography)
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during
Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure
Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed
Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, w
Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision a
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography
Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (List separately in addition to c
Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or othe
Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List se
Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes
Endomyocardial biopsy
Right heart catheterization, for congenital cardiac anomalies
Combined right heart catheterization and retrograde left heart catheterization, for congenital cardiac anomalies
Combined right heart catheterization and transseptal left heart catheterization through intact septum with or without retrograde l
Combined right heart catheterization and transseptal left heart catheterization through existing septal opening, with or without re
Indicator dilution studies such as dye or thermal dilution, including arterial and/or venous catheterization; with cardiac output mea
Indicator dilution studies such as dye or thermal dilution, including arterial and/or venous catheterization; subsequent measureme
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacifica
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventr
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ven
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aort
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for pulmonary angiog
Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coron
Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coron
Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with imp
Percutaneous transcatheter closure of a congenital ventricular septal defect with implant
Bundle of His recording
Intra-atrial recording
Right ventricular recording
Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to ident
Intra-atrial pacing
Intraventricular pacing
Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure)
Esophageal recording of atrial electrogram with or without ventricular electrogram(s);
Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing
Induction of arrhythmia by electrical pacing
Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bun
Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction o
Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure)
Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted ind
Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for su
Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold eva
Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold eva
Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator (includes defibrillation threshold evaluatio
Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, w
Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow at
Intracardiac catheter ablation of arrhythmogenic focus; for treatment of ventricular tachycardia
Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure m
Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List se
Peripheral arterial disease (PAD) rehabilitation, per session
Bioimpedance-derived physiologic cardiovascular analysis
Plethysmography, total body; with interpretation and report
Plethysmography, total body; tracing only, without interpretation and report
Plethysmography, total body; interpretation and report only
Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, inductio
Temperature gradient studies
Initial set-up and programming by a physician of wearable cardioverter-defibrillator includes initial programming of system, establi
Interrogation of ventricular assist device (VAD), in person, with physician analysis of device parameters (eg, drivelines, alarms, pow
Determination of venous pressure
Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; incl
Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; reco
Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; scan
Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; phy
Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session)
Unlisted cardiovascular service or procedure
Noninvasive physiologic studies of extracranial arteries, complete bilateral study (eg, periorbital flow direction with arterial compre
Duplex scan of extracranial arteries; complete bilateral study
Duplex scan of extracranial arteries; unilateral or limited study
Transcranial Doppler study of the intracranial arteries; complete study
Transcranial Doppler study of the intracranial arteries; limited study
Transcranial Doppler study of the intracranial arteries; vasoreactivity study
Transcranial Doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection
Transcranial Doppler study of the intracranial arteries; emboli detection with intravenous microbubble injection
Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indic
Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: a
Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional Doppler
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study
Noninvasive physiologic studies of extremity veins, complete bilateral study (eg, Doppler waveform analysis with responses to com
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete s
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited stu
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study
Duplex scan of arterial inflow and venous outflow of penile vessels; complete study
Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study
Noninvasive physiologic study of implanted wireless pressure sensor in aneurysmal sac following endovascular repair, complete stu
Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)
Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospita
Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospita
Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing
Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal
Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age
Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age
Measurement of lung volumes (ie, functional residual capacity [FRC], forced vital capacity [FVC], and expiratory reserve volume [ER
Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracin
Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmis
Patient-initiated spirometric recording per 30-day period of time; physician review and interpretation only
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration
Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s],
Vital capacity, total (separate procedure)
Maximum breathing capacity, maximal voluntary ventilation
Functional residual capacity or residual volume: helium method, nitrogen open circuit method, or other method
Expired gas collection, quantitative, single procedure (separate procedure)
Thoracic gas volume
Determination of maldistribution of inspired gas: multiple breath nitrogen washout curve including alveolar nitrogen or helium equ
Determination of resistance to airflow, oscillatory or plethysmographic methods
Determination of airway closing volume, single breath tests
Respiratory flow volume loop
Breathing response to CO2 (CO2 response curve)
Breathing response to hypoxia (hypoxia response curve)
High altitude simulation test (HAST), with physician interpretation and report;
High altitude simulation test (HAST), with physician interpretation and report; with supplemental oxygen titration
Intrapulmonary surfactant administration by a physician through endotracheal tube
Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry
Pulmonary stress testing; complex (including measurements of CO2 production, O2 uptake, and electrocardiographic recordings)
Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (e
Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour
Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in add
Continuous positive airway pressure ventilation (CPAP), initiation and management
Continuous negative pressure ventilation (CNP), initiation and management

Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluat
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent
Oxygen uptake, expired gas analysis; rest and exercise, direct, simple
Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen extracted
Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)
Carbon monoxide diffusing capacity (eg, single breath, steady state)
Membrane diffusion capacity
Pulmonary compliance study (eg, plethysmography, volume and pressure measurements)
Noninvasive ear or pulse oximetry for oxygen saturation; single determination
Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)
Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)
Carbon dioxide, expired gas determination by infrared analyzer
Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant
Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; incl
Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; mon
Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; mon
Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; phy
Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and re
Percutaneous tests (scratch, puncture, prick) sequential and incremental, with drugs, biologicals or venoms, immediate type reacti
Nitric oxide expired gas determination
Intracutaneous (intradermal) tests, sequential and incremental, with drugs, biologicals, or venoms, immediate type reaction, includ
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a p
Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type rea
Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests
Patch or application test(s) (specify number of tests)
Photo patch test(s) (specify number of tests)
Photo tests
Ophthalmic mucous membrane tests
Direct nasal mucous membrane test
Inhalation bronchial challenge testing (not including necessary pulmonary function tests); with histamine, methacholine, or similar
Inhalation bronchial challenge testing (not including necessary pulmonary function tests); with antigens or gases, specify
Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance such as metabisulfit
Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection
Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections
Professional services for allergen immunotherapy in prescribing physicians office or institution, including provision of allergenic ext
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (s
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of d
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple an
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract
Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)
Unlisted allergy/clinical immunologic service or procedure
Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor
Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; interpr
Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral a
Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflo
Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurement
Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, t
Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a tech
Polysomnography; sleep staging with 1-3 additional parameters of sleep, attended by a technologist
Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist
Polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressu
Electroencephalogram (EEG) extended monitoring; 41-60 minutes
Electroencephalogram (EEG) extended monitoring; greater than 1 hour
Electroencephalogram (EEG); including recording awake and drowsy
Electroencephalogram (EEG); including recording awake and asleep
Electroencephalogram (EEG); recording in coma or sleep only
Electroencephalogram (EEG); cerebral death evaluation only
Electroencephalogram (EEG); all night recording
Electrocorticogram at surgery (separate procedure)
Insertion by physician of sphenoidal electrodes for electroencephalographic (EEG) recording
Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk
Muscle testing, manual (separate procedure) with report; hand, with or without comparison with normal side
Muscle testing, manual (separate procedure) with report; total evaluation of body, excluding hands
Muscle testing, manual (separate procedure) with report; total evaluation of body, including hands
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)
Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side
Cholinesterase inhibitor challenge test for myasthenia gravis
Needle electromyography; 1 extremity with or without related paraspinal areas
Needle electromyography; 2 extremities with or without related paraspinal areas
Needle electromyography; larynx
Needle electromyography; hemidiaphragm
Needle electromyography; cranial nerve supplied muscle(s), unilateral
Needle electromyography; cranial nerve supplied muscles, bilateral
Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12)
Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than th
Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/
Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure
Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary proc
Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)
Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study
Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study
Nerve conduction, amplitude and latency/velocity study, each nerve; sensory
Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, i
Intraoperative neurophysiology testing, per hour (List separately in addition to code for primary procedure)
Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the follo
Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including bea
Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon refle
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the cent
Central motor evoked potential study (transcranial motor stimulation); upper limbs
Central motor evoked potential study (transcranial motor stimulation); lower limbs
Visual evoked potential (VEP) testing central nervous system, checkerboard or flash
Orbicularis oculi (blink) reflex, by electrodiagnostic testing
H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle
H-reflex, amplitude and latency study; record muscle other than gastrocnemius/soleus muscle
Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method
Monitoring for identification and lateralization of cerebral seizure focus, electroencephalographic (eg, 8 channel EEG) recording an
Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalog
Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic (E
Pharmacological or physical activation requiring physician attendance during EEG recording of activation phase (eg, thiopental acti
Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery)
Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG
Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis)
Wada activation test for hemispheric function, including electroencephalographic (EEG) monitoring
Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes,
Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes,
Magnetoencephalography (MEG), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex loc
Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language
Magnetoencephalography (MEG), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of w
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, el
Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, battery status, el
Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricula
Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricula
Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day
Comprehensive computer-based motion analysis by video-taping and 3D kinematics;
Comprehensive computer-based motion analysis by video-taping and 3D kinematics; with dynamic plantar pressure measurement
Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles
Dynamic fine wire electromyography, during walking or other functional activities, 1 muscle
Physician review and interpretation of comprehensive computer-based motion analysis, dynamic plantar pressure measurements,
Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered
Medical genetics and genetic counseling services, each 30 minutes face-to-face with patient/family
Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology
Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension,
Developmental testing; limited (eg, Developmental Screening Test II, Early Language Milestone Screen), with interpretation and re
Developmental testing; extended (includes assessment of motor, language, social, adaptive and/or cognitive functioning by standa
Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, languag
Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting
Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting
Neuropsychological testing (eg, Wisconsin Card Sorting Test), administered by a computer, with qualified health care professional
Standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care profe
Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, h
Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, h
Health and behavior intervention, each 15 minutes, face-to-face; individual
Health and behavior intervention, each 15 minutes, face-to-face; group (2 or more patients)
Health and behavior intervention, each 15 minutes, face-to-face; family (with the patient present)
Health and behavior intervention, each 15 minutes, face-to-face; family (without the patient present)
Intravenous infusion, hydration; initial, 31 minutes to 1 hour
Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)
Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in add
Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion, up to 1 hour
Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addit
Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and estab
Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to co
Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new su
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the sa
Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion
Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
Chemotherapy administration; intralesional, up to and including 7 lesions
Chemotherapy administration; intralesional, more than 7 lesions
Chemotherapy administration; intravenous, push technique, single or initial substance/drug
Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code fo
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary
Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours)
Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up t
Chemotherapy administration, intra-arterial; push technique
Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour
Chemotherapy administration, intra-arterial; infusion technique, each additional hour (List separately in addition to code for prima
Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the
Chemotherapy administration into pleural cavity, requiring and including thoracentesis
Chemotherapy administration into the peritoneal cavity via indwelling port or catheter
Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture
Refilling and maintenance of portable pump
Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)
Irrigation of implanted venous access device for drug delivery systems
Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents
Unlisted chemotherapy procedure
Photodynamic therapy by external application of light to destroy premalignant and/or malignant lesions of the skin and adjacent m
Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30
Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each ad
Actinotherapy (ultraviolet light)
Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen
Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dyspla
Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B
Photochemotherapy; psoralens and ultraviolet A (PUVA)
Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive dermatoses requiring at least 4-8 hours of care unde
Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm
Laser treatment for inflammatory skin disease (psoriasis); 250 sq cm to 500 sq cm
Physical therapy evaluation
Physical therapy re-evaluation
Occupational therapy evaluation
Occupational therapy re-evaluation
Athletic training evaluation
Athletic training re-evaluation
Application of a modality to 1 or more areas; hot or cold packs

Application of a modality to 1 or more areas; traction, mechanical
Application of a modality to 1 or more areas; electrical stimulation (unattended)
Application of a modality to 1 or more areas; vasopneumatic devices
Application of a modality to 1 or more areas; paraffin bath
Application of a modality to 1 or more areas; whirlpool
Application of a modality to 1 or more areas; diathermy (eg, microwave)
Application of a modality to 1 or more areas; infrared
Application of a modality to 1 or more areas; ultraviolet
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes
Application of a modality to 1 or more areas; contrast baths, each 15 minutes
Application of a modality to 1 or more areas; ultrasound, each 15 minutes
Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes
Unlisted modality (specify type and time if constant attendance)
Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of mot
Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinest
Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises
Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking,
Unlisted therapeutic procedure (specify)
Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each
Therapeutic procedure(s), group (2 or more individuals)
Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional perform
Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-o
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety proce
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work env
Wheelchair management (eg, assessment, fitting, training), each 15 minutes
Work hardening/conditioning; initial 2 hours
Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure)
Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), op
Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), op
Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymat
Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, an
Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, an
Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes
Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or ma
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower ex
Prosthetic training, upper and/or lower extremity(s), each 15 minutes
Checkout for orthotic/prosthetic use, established patient, each 15 minutes
Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with th
Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient
Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the p
Osteopathic manipulative treatment (OMT); 1-2 body regions involved
Chiropractic manipulative treatment (CMT); spinal, 1-2 regions
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions
Chiropractic manipulative treatment (CMT); spinal, 5 regions
Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions
Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curr
Telephone assessment and management service provided by a qualified nonphysician health care professional to an established pa
Online assessment and management service provided by a qualified nonphysician health care professional to an established patien
Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory
Handling and/or conveyance of specimen for transfer from the patient in other than a physician's office to a laboratory (distance m
Handling, conveyance, and/or any other service in connection with the implementation of an order involving devices (eg, designing
Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service wa
Hospital mandated on call service; in-hospital, each hour
Hospital mandated on call service; out-of-hospital, each hour
Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg,
Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service
Service(s) provided between 10:00 PM and 8:00 AM at 24-hour facility, in addition to basic service
Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service
Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service
Service(s) provided on an emergency basis, out of the office, which disrupts other scheduled office services, in addition to basic se
Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or
Educational supplies, such as books, tapes, and pamphlets, provided by the physician for the patient's education at cost to physicia
Medical testimony
Physician educational services rendered to patients in a group setting (eg, prenatal, obesity, or diabetic instructions)
Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard re
Unusual travel (eg, transportation and escort of patient)
Analysis of clinical data stored in computers (eg, ECGs, blood pressures, hematologic data)
Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted
Anesthesia for patient of extreme age, younger than 1 year and older than 70 (List separately in addition to code for primary anest
Anesthesia complicated by utilization of total body hypothermia (List separately in addition to code for primary anesthesia procedu
Anesthesia complicated by utilization of controlled hypotension (List separately in addition to code for primary anesthesia procedu
Anesthesia complicated by emergency conditions (specify) (List separately in addition to code for primary anesthesia procedure)
Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician performi
Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician other than the h
Anogenital examination with colposcopic magnification in childhood for suspected trauma
Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, co
Screening test of visual acuity, quantitative, bilateral
Ocular photoscreening with interpretation and report, bilateral
Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison
Physician attendance and supervision of hyperbaric oxygen therapy, per session
Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); each hour
Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 45 minute
Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 30 minute
Phlebotomy, therapeutic (separate procedure)
Unlisted special service, procedure or report
Lapgastricsleeve
Laparoscopicgastropexy
Repairparaesophagealhernia/anteriorgastorpexy
Excisionbiopsyofliver(Laparascopic)
LaparascopicUmbilicalherniorraphy
Openbiopsyintraabdominalmass
Openbiopsy,omentum
PESA(PercutaneousSpermAspiration)
Aspirationofovariancyst
Gentilesurgeryprocedure(operationsonclitoris)
Removalofintraabdominalandpelvicpacks
Insertionblynchsutureuterus
Removalcerclage(withoutanesthesia)
InsertionofBakriBalloonforPostPartumHemorrhage
Vatsthymectomy
Neurolysisofspinalcord/nerveroot
Eyesurgeryprocedure(cornealsurgery)
Excisioncholesteatoma
Ctkidney
Scan(nm)wholebody
Oxygenenrichmenttherapy
Icpmonitoring
Newbornphototheraphy
PhysiotherapyHomevisit
Nursing/Dietician/SpeechTherapy/OTHomeVisit
MANDATORY
TARIFF
GROSS CHARGES
SELF PAY RATES ACROSS

ALL FACILITIES
ADNIC
312.00
936.00
811.20
811.20
308.00
924.00
800.80
800.80
325.00
975.00
845.00
845.00
341.00
1023.00
886.60
886.60
582.00
1746.00
1513.20
1513.20
365.00
1095.00
949.00
949.00
619.00
1857.00
1609.40
1609.40
334.00
1002.00
868.40
868.40
671.00
2013.00
1744.60
1744.60
423.00
1269.00
1099.80
1099.80
342.00
1026.00
889.20
889.20
642.00
1926.00
1669.20
1669.20
122.00
366.00
317.20
317.20
52.00
156.00
135.20
135.20
2118.00
6354.00
5506.80
5506.80
2864.00
8592.00
7446.40
7446.40
2589.00
7767.00
6731.40
6731.40
1005.00
3015.00
2613.00
2613.00
1027.00
3081.00
2670.20
2670.20
1121.00
3363.00
2914.60
2914.60
1564.00
4692.00
4066.40
4066.40
184.00
552.00
478.40
478.40
605.00
1815.00
1573.00
1573.00
826.00
2478.00
2147.60
2147.60
65.00
195.00
169.00
169.00
136.00
408.00
353.60
353.60
238.00
714.00
618.80
618.80
111.00
333.00
288.60
288.60
137.00
411.00
356.20
356.20
165.00
495.00
429.00
429.00
239.00
717.00
621.40
621.40
93.00
279.00
241.80
241.80
261.00
783.00
678.60
678.60
62.00
186.00
161.20
161.20
152.00
456.00
395.20
395.20
211.00
633.00
548.60
548.60
251.00
753.00
652.60
652.60
294.00
882.00
764.40
764.40
159.00
477.00
413.40
413.40
219.00
657.00
569.40
569.40
256.00
768.00
665.60
665.60
286.00
858.00
743.60
743.60
189.00
567.00
491.40
491.40
241.00
723.00
626.60
626.60
280.00
840.00
728.00
728.00
365.00
1095.00
949.00
949.00
284.00
852.00
738.40
738.40
375.00
1125.00
975.00
975.00
413.00
1239.00
1073.80
1073.80
530.00
1590.00
1378.00
1378.00
585.00
1755.00
1521.00
1521.00
887.00
2661.00
2306.20
2306.20
294.00
882.00
764.40
764.40
402.00
1206.00
1045.20
1045.20
490.00
1470.00
1274.00
1274.00
570.00
1710.00
1482.00
1482.00
650.00
1950.00
1690.00
1690.00
994.00
2982.00
2584.40
2584.40
368.00
1104.00
956.80
956.80
475.00
1425.00
1235.00
1235.00
529.00
1587.00
1375.40
1375.40
649.00
1947.00
1687.40
1687.40
831.00
2493.00
2160.60
2160.60
1192.00
3576.00
3099.20
3099.20
900.00
2700.00
2340.00
2340.00
1156.00
3468.00
3005.60
3005.60
861.00
2583.00
2238.60
2238.60
1172.00
3516.00
3047.20
3047.20
1017.00
3051.00
2644.20
2644.20
1253.00
3759.00
3257.80
3257.80
435.00
1305.00
1131.00
1131.00
547.00
1641.00
1422.20
1422.20
603.00
1809.00
1567.80
1567.80
720.00
2160.00
1872.00
1872.00
792.00
2376.00
2059.20
2059.20
1177.00
3531.00
3060.20
3060.20
442.00
1326.00
1149.20
1149.20
552.00
1656.00
1435.20
1435.20
635.00
1905.00
1651.00
1651.00
786.00
2358.00
2043.60
2043.60
888.00
2664.00
2308.80
2308.80
1090.00
3270.00
2834.00
2834.00
458.00
1374.00
1190.80
1190.80
579.00
1737.00
1505.40
1505.40
682.00
2046.00
1773.20
1773.20
856.00
2568.00
2225.60
2225.60
1061.00
3183.00
2758.60
2758.60
1475.00
4425.00
3835.00
3835.00
43.00
129.00
111.80
111.80
73.00
219.00
189.80
189.80
102.00
306.00
265.20
265.20
226.00
678.00
587.60
587.60
104.00
312.00
270.40
270.40
114.00
342.00
296.40
296.40
620.00
1860.00
1612.00
1612.00
939.00
2817.00
2441.40
2441.40
307.00
921.00
798.20
798.20
477.00
1431.00
1240.20
1240.20
666.00
1998.00
1731.60
1731.60
305.00
915.00
793.00
793.00
661.00
1983.00
1718.60
1718.60
1557.00
4671.00
4048.20
4048.20
2024.00
6072.00
5262.40
5262.40
128.00
384.00
332.80
332.80
183.00
549.00
475.80
475.80
426.00
1278.00
1107.60
1107.60
504.00
1512.00
1310.40
1310.40
130.00
390.00
338.00
338.00
173.00
519.00
449.80
449.80
264.00
792.00
686.40
686.40
333.00
999.00
865.80
865.80
436.00
1308.00
1133.60
1133.60
3206.00
9618.00
8335.60
8335.60
2264.00
6792.00
5886.40
5886.40
1145.00
3435.00
2977.00
2977.00
281.00
843.00
730.60
730.60
354.00
1062.00
920.40
920.40
608.00
1824.00
1580.80
1580.80
297.00
891.00
772.20
772.20
308.00
924.00
800.80
800.80
349.00
1047.00
907.40
907.40
609.00
1827.00
1583.40
1583.40
253.00
759.00
657.80
657.80
336.00
1008.00
873.60
873.60
400.00
1200.00
1040.00
1040.00
499.00
1497.00
1297.40
1297.40
624.00
1872.00
1622.40
1622.40
699.00
2097.00
1817.40
1817.40
317.00
951.00
824.20
824.20
353.00
1059.00
917.80
917.80
440.00
1320.00
1144.00
1144.00
554.00
1662.00
1440.40
1440.40
659.00
1977.00
1713.40
1713.40
591.00
1773.00
1536.60
1536.60
713.00
2139.00
1853.80
1853.80
676.00
2028.00
1757.60
1757.60
503.00
1509.00
1307.80
1307.80
603.00
1809.00
1567.80
1567.80
715.00
2145.00
1859.00
1859.00
753.00
2259.00
1957.80
1957.80
862.00
2586.00
2241.20
2241.20
988.00
2964.00
2568.80
2568.80
1142.00
3426.00
2969.20
2969.20
639.00
1917.00
1661.40
1661.40
737.00
2211.00
1916.20
1916.20
781.00
2343.00
2030.60
2030.60
879.00
2637.00
2285.40
2285.40
1045.00
3135.00
2717.00
2717.00
1108.00
3324.00
2880.80
2880.80
674.00
2022.00
1752.40
1752.40
808.00
2424.00
2100.80
2100.80
798.00
2394.00
2074.80
2074.80
834.00
2502.00
2168.40
2168.40
995.00
2985.00
2587.00
2587.00
1315.00
3945.00
3419.00
3419.00
1404.00
4212.00
3650.40
3650.40
856.00
2568.00
2225.60
2225.60
1047.00
3141.00
2722.20
2722.20
280.00
840.00
728.00
728.00
901.00
2703.00
2342.60
2342.60
1206.00
3618.00
3135.60
3135.60
320.00
960.00
832.00
832.00
1013.00
3039.00
2633.80
2633.80
1734.00
5202.00
4508.40
4508.40
495.00
1485.00
1287.00
1287.00
1011.00
3033.00
2628.60
2628.60
1168.00
3504.00
3036.80
3036.80
1568.00
4704.00
4076.80
4076.80
533.00
1599.00
1385.80
1385.80
2956.00
8868.00
7685.60
7685.60
1854.00
5562.00
4820.40
4820.40
2425.00
7275.00
6305.00
6305.00
2102.00
6306.00
5465.20
5465.20
2674.00
8022.00
6952.40
6952.40
2359.00
7077.00
6133.40
6133.40
2904.00
8712.00
7550.40
7550.40
2505.00
7515.00
6513.00
6513.00
3100.00
9300.00
8060.00
8060.00
3293.00
9879.00
8561.80
8561.80
1294.00
3882.00
3364.40
3364.40
2591.00
7773.00
6736.60
6736.60
839.00
2517.00
2181.40
2181.40
168.00
504.00
436.80
436.80
1002.00
3006.00
2605.20
2605.20
336.00
1008.00
873.60
873.60
544.00
1632.00
1414.40
1414.40
1652.00
4956.00
4295.20
4295.20
2632.00
7896.00
6843.20
6843.20
407.00
1221.00
1058.20
1058.20
2704.00
8112.00
7030.40
7030.40
381.00
1143.00
990.60
990.60
2797.00
8391.00
7272.20
7272.20
583.00
1749.00
1515.80
1515.80
2920.00
8760.00
7592.00
7592.00
631.00
1893.00
1640.60
1640.60
2072.00
6216.00
5387.20
5387.20
352.00
1056.00
915.20
915.20
2823.00
8469.00
7339.80
7339.80
317.00
951.00
824.20
824.20
2274.00
6822.00
5912.40
5912.40
465.00
1395.00
1209.00
1209.00
501.00
1503.00
1302.60
1302.60
2002.00
6006.00
5205.20
5205.20
553.00
1659.00
1437.80
1437.80
501.00
1503.00
1302.60
1302.60
1381.00
4143.00
3590.60
3590.60
325.00
975.00
845.00
845.00
1650.00
4950.00
4290.00
4290.00
499.00
1497.00
1297.40
1297.40
2481.00
7443.00
6450.60
6450.60
311.00
933.00
808.60
808.60
2281.00
6843.00
5930.60
5930.60
295.00
885.00
767.00
767.00
2967.00
8901.00
7714.20
7714.20
424.00
1272.00
1102.40
1102.40
3196.00
9588.00
8309.60
8309.60
532.00
1596.00
1383.20
1383.20
1079.00
3237.00
2805.40
2805.40
208.00
624.00
540.80
540.80
1127.00
3381.00
2930.20
2930.20
318.00
954.00
826.80
826.80
988.00
2964.00
2568.80
2568.80
218.00
654.00
566.80
566.80
948.00
2844.00
2464.80
2464.80
312.00
936.00
811.20
811.20
962.00
2886.00
2501.20
2501.20
106.00
318.00
275.60
275.60
1090.00
3270.00
2834.00
2834.00
206.00
618.00
535.60
535.60
1049.00
3147.00
2727.40
2727.40
261.00
783.00
678.60
678.60
1298.00
3894.00
3374.80
3374.80
211.00
633.00
548.60
548.60
1392.00
4176.00
3619.20
3619.20
319.00
957.00
829.40
829.40
1894.00
5682.00
4924.40
4924.40
755.00
2265.00
1963.00
1963.00
2669.00
8007.00
6939.40
6939.40
2745.00
8235.00
7137.00
7137.00
2845.00
8535.00
7397.00
7397.00
2502.00
7506.00
6505.20
6505.20
749.00
2247.00
1947.40
1947.40
877.00
2631.00
2280.20
2280.20
1188.00
3564.00
3088.80
3088.80
1276.00
3828.00
3317.60
3317.60
1413.00
4239.00
3673.80
3673.80
3797.00
11391.00
9872.20
9872.20
4985.00
14955.00
12961.00
12961.00
4955.00
14865.00
12883.00
12883.00
4295.00
12885.00
11167.00
11167.00
4633.00
13899.00
12045.80
12045.80
3208.00
9624.00
8340.80
8340.80
3376.00
10128.00
8777.60
8777.60
8793.00
26379.00
22861.80
22861.80
8698.00
26094.00
22614.80
22614.80
8645.00
25935.00
22477.00
22477.00
2643.00
7929.00
6871.80
6871.80
2481.00
7443.00
6450.60
6450.60
759.00
2277.00
1973.40
1973.40
1129.00
3387.00
2935.40
2935.40
2256.00
6768.00
5865.60
5865.60
1577.00
4731.00
4100.20
4100.20
1393.00
4179.00
3621.80
3621.80
1380.00
4140.00
3588.00
3588.00
533.00
1599.00
1385.80
1385.80
99.00
297.00
257.40
257.40
1028.00
3084.00
2672.80
2672.80
1547.00
4641.00
4022.20
4022.20
966.00
2898.00
2511.60
2511.60
1341.00
4023.00
3486.60
3486.60
2476.00
7428.00
6437.60
6437.60
1887.00
5661.00
4906.20
4906.20
2015.00
6045.00
5239.00
5239.00
1429.00
4287.00
3715.40
3715.40
2013.00
6039.00
5233.80
5233.80
3441.00
10323.00
8946.60
8946.60
3871.00
11613.00
10064.60
10064.60
2795.00
8385.00
7267.00
7267.00
7312.00
21936.00
19011.20
19011.20
8172.00
24516.00
21247.20
21247.20
4332.00
12996.00
11263.20
11263.20
3488.00
10464.00
9068.80
9068.80
3261.00
9783.00
8478.60
8478.60
3325.00
9975.00
8645.00
8645.00
3514.00
10542.00
9136.40
9136.40
2581.00
7743.00
6710.60
6710.60
2626.00
7878.00
6827.60
6827.60
2128.00
6384.00
5532.80
5532.80
2670.00
8010.00
6942.00
6942.00
3800.00
11400.00
9880.00
9880.00
6352.00
19056.00
16515.20
16515.20
9203.00
27609.00
23927.80
23927.80
3694.00
11082.00
9604.40
9604.40
1506.00
4518.00
3915.60
3915.60
179.00
537.00
465.40
465.40
198.00
594.00
514.80
514.80
172.00
516.00
447.20
447.20
393.00
1179.00
1021.80
1021.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2216.00
6648.00
5761.60
5761.60
2913.00
8739.00
7573.80
7573.80
2458.00
7374.00
6390.80
6390.80
3054.00
9162.00
7940.40
7940.40
3407.00
10221.00
8858.20
8858.20
4006.00
12018.00
10415.60
10415.60
3280.00
9840.00
8528.00
8528.00
3842.00
11526.00
9989.20
9989.20
2546.00
7638.00
6619.60
6619.60
3284.00
9852.00
8538.40
8538.40
3297.00
9891.00
8572.20
8572.20
3661.00
10983.00
9518.60
9518.60
6066.00
18198.00
15771.60
15771.60
2071.00
6213.00
5384.60
5384.60
3275.00
9825.00
8515.00
8515.00
2979.00
8937.00
7745.40
7745.40
3251.00
9753.00
8452.60
8452.60
4272.00
12816.00
11107.20
11107.20
4359.00
13077.00
11333.40
11333.40
0.00
0.00
0.00
0.00
171.00
513.00
444.60
444.60
211.00
633.00
548.60
548.60
425.00
1275.00
1105.00
1105.00
484.00
1452.00
1258.40
1258.40
723.00
2169.00
1879.80
1879.80
297.00
891.00
772.20
772.20
203.00
609.00
527.80
527.80
16.00
48.00
41.60
41.60
484.00
1452.00
1258.40
1258.40
1004.00
3012.00
2610.40
2610.40
1480.00
4440.00
3848.00
3848.00
1994.00
5982.00
5184.40
5184.40
251.00
753.00
652.60
652.60
311.00
933.00
808.60
808.60
165.00
495.00
429.00
429.00
250.00
750.00
650.00
650.00
339.00
1017.00
881.40
881.40
432.00
1296.00
1123.20
1123.20
479.00
1437.00
1245.40
1245.40
510.00
1530.00
1326.00
1326.00
597.00
1791.00
1552.20
1552.20
369.00
1107.00
959.40
959.40
413.00
1239.00
1073.80
1073.80
476.00
1428.00
1237.60
1237.60
538.00
1614.00
1398.80
1398.80
654.00
1962.00
1700.40
1700.40
786.00
2358.00
2043.60
2043.60
336.00
1008.00
873.60
873.60
464.00
1392.00
1206.40
1206.40
537.00
1611.00
1396.20
1396.20
670.00
2010.00
1742.00
1742.00
793.00
2379.00
2061.80
2061.80
1061.00
3183.00
2758.60
2758.60
1511.00
4533.00
3928.60
3928.60
909.00
2727.00
2363.40
2363.40
1380.00
4140.00
3588.00
3588.00
841.00
2523.00
2186.60
2186.60
199.00
597.00
517.40
517.40
178.00
534.00
462.80
462.80
373.00
1119.00
969.80
969.80
245.00
735.00
637.00
637.00
0.00
0.00
0.00
0.00
240.00
720.00
624.00
624.00
77.00
231.00
200.20
200.20
1085.00
3255.00
2821.00
2821.00
377.00
1131.00
980.20
980.20
309.00
927.00
803.40
803.40
793.00
2379.00
2061.80
2061.80
494.00
1482.00
1284.40
1284.40
1050.00
3150.00
2730.00
2730.00
1067.00
3201.00
2774.20
2774.20
1224.00
3672.00
3182.40
3182.40
1110.00
3330.00
2886.00
2886.00
1477.00
4431.00
3840.20
3840.20
1644.00
4932.00
4274.40
4274.40
588.00
1764.00
1528.80
1528.80
4371.00
13113.00
11364.60
11364.60
5862.00
17586.00
15241.20
15241.20
6472.00
19416.00
16827.20
16827.20
351.00
1053.00
912.60
912.60
159.00
477.00
413.40
413.40
298.00
894.00
774.80
774.80
1172.00
3516.00
3047.20
3047.20
343.00
1029.00
891.80
891.80
1798.00
5394.00
4674.80
4674.80
1458.00
4374.00
3790.80
3790.80
2350.00
7050.00
6110.00
6110.00
3202.00
9606.00
8325.20
8325.20
3641.00
10923.00
9466.60
9466.60
2062.00
6186.00
5361.20
5361.20
4077.00
12231.00
10600.20
10600.20
4314.00
12942.00
11216.40
11216.40
4302.00
12906.00
11185.20
11185.20
2856.00
8568.00
7425.60
7425.60
4145.00
12435.00
10777.00
10777.00
1754.00
5262.00
4560.40
4560.40
2404.00
7212.00
6250.40
6250.40
1836.00
5508.00
4773.60
4773.60
2346.00
7038.00
6099.60
6099.60
1875.00
5625.00
4875.00
4875.00
3447.00
10341.00
8962.20
8962.20
2505.00
7515.00
6513.00
6513.00
2050.00
6150.00
5330.00
5330.00
5580.00
16740.00
14508.00
14508.00
6369.00
19107.00
16559.40
16559.40
10383.00
31149.00
26995.80
26995.80
5111.00
15333.00
13288.60
13288.60
6731.00
20193.00
17500.60
17500.60
8353.00
25059.00
21717.80
21717.80
7746.00
23238.00
20139.60
20139.60
2554.00
7662.00
6640.40
6640.40
2926.00
8778.00
7607.60
7607.60
2876.00
8628.00
7477.60
7477.60
617.00
1851.00
1604.20
1604.20
0.00
0.00
0.00
0.00
831.00
2493.00
2160.60
2160.60
2201.00
6603.00
5722.60
5722.60
904.00
2712.00
2350.40
2350.40
1003.00
3009.00
2607.80
2607.80
1274.00
3822.00
3312.40
3312.40
3680.00
11040.00
9568.00
9568.00
421.00
1263.00
1094.60
1094.60
573.00
1719.00
1489.80
1489.80
323.00
969.00
839.80
839.80
358.00
1074.00
930.80
930.80
608.00
1824.00
1580.80
1580.80
809.00
2427.00
2103.40
2103.40
2302.00
6906.00
5985.20
5985.20
1385.00
4155.00
3601.00
3601.00
1498.00
4494.00
3894.80
3894.80
305.00
915.00
793.00
793.00
208.00
624.00
540.80
540.80
523.00
1569.00
1359.80
1359.80
980.00
2940.00
2548.00
2548.00
207.00
621.00
538.20
538.20
150.00
450.00
390.00
390.00
155.00
465.00
403.00
403.00
138.00
414.00
358.80
358.80
155.00
465.00
403.00
403.00
1178.00
3534.00
3062.80
3062.80
140.00
420.00
364.00
364.00
147.00
441.00
382.20
382.20
181.00
543.00
470.60
470.60
151.00
453.00
392.60
392.60
571.00
1713.00
1484.60
1484.60
551.00
1653.00
1432.60
1432.60
892.00
2676.00
2319.20
2319.20
1784.00
5352.00
4638.40
4638.40
1426.00
4278.00
3707.60
3707.60
1686.00
5058.00
4383.60
4383.60
2954.00
8862.00
7680.40
7680.40
320.00
960.00
832.00
832.00
764.00
2292.00
1986.40
1986.40
1552.00
4656.00
4035.20
4035.20
2149.00
6447.00
5587.40
5587.40
4067.00
12201.00
10574.20
10574.20
1644.00
4932.00
4274.40
4274.40
1222.00
3666.00
3177.20
3177.20
4172.00
12516.00
10847.20
10847.20
7036.00
21108.00
18293.60
18293.60
8364.00
25092.00
21746.40
21746.40
9693.00
29079.00
25201.80
25201.80
15302.00
45906.00
39785.20
39785.20
7645.00
22935.00
19877.00
19877.00
6811.00
20433.00
17708.60
17708.60
7586.00
22758.00
19723.60
19723.60
7002.00
21006.00
18205.20
18205.20
8448.00
25344.00
21964.80
21964.80
1185.00
3555.00
3081.00
3081.00
1344.00
4032.00
3494.40
3494.40
1525.00
4575.00
3965.00
3965.00
1795.00
5385.00
4667.00
4667.00
1469.00
4407.00
3819.40
3819.40
1754.00
5262.00
4560.40
4560.40
1834.00
5502.00
4768.40
4768.40
1574.00
4722.00
4092.40
4092.40
406.00
1218.00
1055.60
1055.60
413.00
1239.00
1073.80
1073.80
433.00
1299.00
1125.80
1125.80
620.00
1860.00
1612.00
1612.00
681.00
2043.00
1770.60
1770.60
501.00
1503.00
1302.60
1302.60
9470.00
28410.00
24622.00
24622.00
9723.00
29169.00
25279.80
25279.80
9687.00
29061.00
25186.20
25186.20
9743.00
29229.00
25331.80
25331.80
10444.00
31332.00
27154.40
27154.40
10309.00
30927.00
26803.40
26803.40
7991.00
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1742.00
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6666.40
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2613.00
7839.00
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3287.00
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3677.00
11031.00
9560.20
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5066.00
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5212.00
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5507.00
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14318.20
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5599.00
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14557.40
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6024.00
18072.00
15662.40
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5999.00
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15597.40
15597.40
6145.00
18435.00
15977.00
15977.00
6966.00
20898.00
18111.60
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8098.00
24294.00
21054.80
21054.80
8066.00
24198.00
20971.60
20971.60
10766.00
32298.00
27991.60
27991.60
9656.00
28968.00
25105.60
25105.60
6782.00
20346.00
17633.20
17633.20
8476.00
25428.00
22037.60
22037.60
5750.00
17250.00
14950.00
14950.00
6233.00
18699.00
16205.80
16205.80
2695.00
8085.00
7007.00
7007.00
7229.00
21687.00
18795.40
18795.40
8178.00
24534.00
21262.80
21262.80
9344.00
28032.00
24294.40
24294.40
5877.00
17631.00
15280.20
15280.20
4969.00
14907.00
12919.40
12919.40
5130.00
15390.00
13338.00
13338.00
4986.00
14958.00
12963.60
12963.60
5507.00
16521.00
14318.20
14318.20
4315.00
12945.00
11219.00
11219.00
3794.00
11382.00
9864.40
9864.40
4512.00
13536.00
11731.20
11731.20
4002.00
12006.00
10405.20
10405.20
2437.00
7311.00
6336.20
6336.20
4877.00
14631.00
12680.20
12680.20
5196.00
15588.00
13509.60
13509.60
2870.00
8610.00
7462.00
7462.00
2113.00
6339.00
5493.80
5493.80
4101.00
12303.00
10662.60
10662.60
3736.00
11208.00
9713.60
9713.60
6195.00
18585.00
16107.00
16107.00
3932.00
11796.00
10223.20
10223.20
3321.00
9963.00
8634.60
8634.60
3083.00
9249.00
8015.80
8015.80
5951.00
17853.00
15472.60
15472.60
3317.00
9951.00
8624.20
8624.20
4751.00
14253.00
12352.60
12352.60
4935.00
14805.00
12831.00
12831.00
4436.00
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11533.60
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4978.00
14934.00
12942.80
12942.80
7838.00
23514.00
20378.80
20378.80
6751.00
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17552.60
17552.60
5944.00
17832.00
15454.40
15454.40
6444.00
19332.00
16754.40
16754.40
2766.00
8298.00
7191.60
7191.60
3149.00
9447.00
8187.40
8187.40
2118.00
6354.00
5506.80
5506.80
1387.00
4161.00
3606.20
3606.20
628.00
1884.00
1632.80
1632.80
1376.00
4128.00
3577.60
3577.60
0.00
0.00
0.00
0.00
158.00
474.00
410.80
410.80
585.00
1755.00
1521.00
1521.00
559.00
1677.00
1453.40
1453.40
1700.00
5100.00
4420.00
4420.00
2072.00
6216.00
5387.20
5387.20
2686.00
8058.00
6983.60
6983.60
2381.00
7143.00
6190.60
6190.60
1084.00
3252.00
2818.40
2818.40
2733.00
8199.00
7105.80
7105.80
2865.00
8595.00
7449.00
7449.00
2810.00
8430.00
7306.00
7306.00
4166.00
12498.00
10831.60
10831.60
6031.00
18093.00
15680.60
15680.60
2308.00
6924.00
6000.80
6000.80
3371.00
10113.00
8764.60
8764.60
4096.00
12288.00
10649.60
10649.60
4418.00
13254.00
11486.80
11486.80
1236.00
3708.00
3213.60
3213.60
1385.00
4155.00
3601.00
3601.00
1976.00
5928.00
5137.60
5137.60
4162.00
12486.00
10821.20
10821.20
4818.00
14454.00
12526.80
12526.80
2549.00
7647.00
6627.40
6627.40
2423.00
7269.00
6299.80
6299.80
2744.00
8232.00
7134.40
7134.40
2969.00
8907.00
7719.40
7719.40
3686.00
11058.00
9583.60
9583.60
554.00
1662.00
1440.40
1440.40
1095.00
3285.00
2847.00
2847.00
2078.00
6234.00
5402.80
5402.80
2410.00
7230.00
6266.00
6266.00
3392.00
10176.00
8819.20
8819.20
2330.00
6990.00
6058.00
6058.00
2449.00
7347.00
6367.40
6367.40
3086.00
9258.00
8023.60
8023.60
2671.00
8013.00
6944.60
6944.60
2658.00
7974.00
6910.80
6910.80
6133.00
18399.00
15945.80
15945.80
4750.00
14250.00
12350.00
12350.00
7569.00
22707.00
19679.40
19679.40
1664.00
4992.00
4326.40
4326.40
2259.00
6777.00
5873.40
5873.40
1737.00
5211.00
4516.20
4516.20
2319.00
6957.00
6029.40
6029.40
1286.00
3858.00
3343.60
3343.60
2817.00
8451.00
7324.20
7324.20
2072.00
6216.00
5387.20
5387.20
4562.00
13686.00
11861.20
11861.20
4851.00
14553.00
12612.60
12612.60
3582.00
10746.00
9313.20
9313.20
4515.00
13545.00
11739.00
11739.00
182.00
546.00
473.20
473.20
2106.00
6318.00
5475.60
5475.60
3453.00
10359.00
8977.80
8977.80
2609.00
7827.00
6783.40
6783.40
2095.00
6285.00
5447.00
5447.00
0.00
0.00
0.00
0.00
1168.00
3504.00
3036.80
3036.80
1811.00
5433.00
4708.60
4708.60
1703.00
5109.00
4427.80
4427.80
581.00
1743.00
1510.60
1510.60
1630.00
4890.00
4238.00
4238.00
2675.00
8025.00
6955.00
6955.00
1108.00
3324.00
2880.80
2880.80
1704.00
5112.00
4430.40
4430.40
2373.00
7119.00
6169.80
6169.80
4974.00
14922.00
12932.40
12932.40
2060.00
6180.00
5356.00
5356.00
4341.00
13023.00
11286.60
11286.60
2363.00
7089.00
6143.80
6143.80
2759.00
8277.00
7173.40
7173.40
1901.00
5703.00
4942.60
4942.60
1983.00
5949.00
5155.80
5155.80
4636.00
13908.00
12053.60
12053.60
4559.00
13677.00
11853.40
11853.40
3739.00
11217.00
9721.40
9721.40
1523.00
4569.00
3959.80
3959.80
2067.00
6201.00
5374.20
5374.20
1670.00
5010.00
4342.00
4342.00
1952.00
5856.00
5075.20
5075.20
3698.00
11094.00
9614.80
9614.80
3236.00
9708.00
8413.60
8413.60
4291.00
12873.00
11156.60
11156.60
2529.00
7587.00
6575.40
6575.40
389.00
1167.00
1011.40
1011.40
945.00
2835.00
2457.00
2457.00
1935.00
5805.00
5031.00
5031.00
512.00
1536.00
1331.20
1331.20
2032.00
6096.00
5283.20
5283.20
0.00
0.00
0.00
0.00
592.00
1776.00
1539.20
1539.20
1264.00
3792.00
3286.40
3286.40
1306.00
3918.00
3395.60
3395.60
1703.00
5109.00
4427.80
4427.80
2430.00
7290.00
6318.00
6318.00
2677.00
8031.00
6960.20
6960.20
3727.00
11181.00
9690.20
9690.20
5186.00
15558.00
13483.60
13483.60
3412.00
10236.00
8871.20
8871.20
3345.00
10035.00
8697.00
8697.00
3196.00
9588.00
8309.60
8309.60
3054.00
9162.00
7940.40
7940.40
2980.00
8940.00
7748.00
7748.00
529.00
1587.00
1375.40
1375.40
3909.00
11727.00
10163.40
10163.40
3898.00
11694.00
10134.80
10134.80
3605.00
10815.00
9373.00
9373.00
516.00
1548.00
1341.60
1341.60
8626.00
25878.00
22427.60
22427.60
8757.00
26271.00
22768.20
22768.20
2174.00
6522.00
5652.40
5652.40
6430.00
19290.00
16718.00
16718.00
5347.00
16041.00
13902.20
13902.20
5364.00
16092.00
13946.40
13946.40
1345.00
4035.00
3497.00
3497.00
5885.00
17655.00
15301.00
15301.00
5712.00
17136.00
14851.20
14851.20
5757.00
17271.00
14968.20
14968.20
1350.00
4050.00
3510.00
3510.00
625.00
1875.00
1625.00
1625.00
1019.00
3057.00
2649.40
2649.40
2811.00
8433.00
7308.60
7308.60
5919.00
17757.00
15389.40
15389.40
6634.00
19902.00
17248.40
17248.40
5195.00
15585.00
13507.00
13507.00
5387.00
16161.00
14006.20
14006.20
5384.00
16152.00
13998.40
13998.40
1044.00
3132.00
2714.40
2714.40
436.00
1308.00
1133.60
1133.60
2824.00
8472.00
7342.40
7342.40
2672.00
8016.00
6947.20
6947.20
818.00
2454.00
2126.80
2126.80
2094.00
6282.00
5444.40
5444.40
2015.00
6045.00
5239.00
5239.00
943.00
2829.00
2451.80
2451.80
1898.00
5694.00
4934.80
4934.80
863.00
2589.00
2243.80
2243.80
6502.00
19506.00
16905.20
16905.20
6129.00
18387.00
15935.40
15935.40
1339.00
4017.00
3481.40
3481.40
7125.00
21375.00
18525.00
18525.00
6229.00
18687.00
16195.40
16195.40
1452.00
4356.00
3775.20
3775.20
4604.00
13812.00
11970.40
11970.40
6077.00
18231.00
15800.20
15800.20
5636.00
16908.00
14653.60
14653.60
1242.00
3726.00
3229.20
3229.20
5723.00
17169.00
14879.80
14879.80
5443.00
16329.00
14151.80
14151.80
4652.00
13956.00
12095.20
12095.20
4558.00
13674.00
11850.80
11850.80
5814.00
17442.00
15116.40
15116.40
1446.00
4338.00
3759.60
3759.60
5598.00
16794.00
14554.80
14554.80
1180.00
3540.00
3068.00
3068.00
4920.00
14760.00
12792.00
12792.00
7694.00
23082.00
20004.40
20004.40
8871.00
26613.00
23064.60
23064.60
6688.00
20064.00
17388.80
17388.80
7436.00
22308.00
19333.60
19333.60
8128.00
24384.00
21132.80
21132.80
8018.00
24054.00
20846.80
20846.80
10002.00
30006.00
26005.20
26005.20
2932.00
8796.00
7623.20
7623.20
2818.00
8454.00
7326.80
7326.80
1327.00
3981.00
3450.20
3450.20
2823.00
8469.00
7339.80
7339.80
3006.00
9018.00
7815.60
7815.60
3616.00
10848.00
9401.60
9401.60
2720.00
8160.00
7072.00
7072.00
2821.00
8463.00
7334.60
7334.60
3217.00
9651.00
8364.20
8364.20
1325.00
3975.00
3445.00
3445.00
4738.00
14214.00
12318.80
12318.80
2605.00
7815.00
6773.00
6773.00
1510.00
4530.00
3926.00
3926.00
2493.00
7479.00
6481.80
6481.80
4062.00
12186.00
10561.20
10561.20
6018.00
18054.00
15646.80
15646.80
5972.00
17916.00
15527.20
15527.20
7289.00
21867.00
18951.40
18951.40
6891.00
20673.00
17916.60
17916.60
7200.00
21600.00
18720.00
18720.00
7195.00
21585.00
18707.00
18707.00
0.00
0.00
0.00
0.00
1708.00
5124.00
4440.80
4440.80
2384.00
7152.00
6198.40
6198.40
1225.00
3675.00
3185.00
3185.00
1600.00
4800.00
4160.00
4160.00
3727.00
11181.00
9690.20
9690.20
4848.00
14544.00
12604.80
12604.80
0.00
0.00
0.00
0.00
1328.00
3984.00
3452.80
3452.80
2481.00
7443.00
6450.60
6450.60
926.00
2778.00
2407.60
2407.60
858.00
2574.00
2230.80
2230.80
2452.00
7356.00
6375.20
6375.20
2602.00
7806.00
6765.20
6765.20
2056.00
6168.00
5345.60
5345.60
613.00
1839.00
1593.80
1593.80
1251.00
3753.00
3252.60
3252.60
1518.00
4554.00
3946.80
3946.80
2514.00
7542.00
6536.40
6536.40
1054.00
3162.00
2740.40
2740.40
1938.00
5814.00
5038.80
5038.80
4184.00
12552.00
10878.40
10878.40
5044.00
15132.00
13114.40
13114.40
1798.00
5394.00
4674.80
4674.80
1616.00
4848.00
4201.60
4201.60
2300.00
6900.00
5980.00
5980.00
1783.00
5349.00
4635.80
4635.80
2384.00
7152.00
6198.40
6198.40
2102.00
6306.00
5465.20
5465.20
2565.00
7695.00
6669.00
6669.00
2194.00
6582.00
5704.40
5704.40
1890.00
5670.00
4914.00
4914.00
2514.00
7542.00
6536.40
6536.40
2239.00
6717.00
5821.40
5821.40
2374.00
7122.00
6172.40
6172.40
2873.00
8619.00
7469.80
7469.80
2452.00
7356.00
6375.20
6375.20
2018.00
6054.00
5246.80
5246.80
2043.00
6129.00
5311.80
5311.80
2739.00
8217.00
7121.40
7121.40
2423.00
7269.00
6299.80
6299.80
2395.00
7185.00
6227.00
6227.00
2650.00
7950.00
6890.00
6890.00
2063.00
6189.00
5363.80
5363.80
2736.00
8208.00
7113.60
7113.60
3558.00
10674.00
9250.80
9250.80
3764.00
11292.00
9786.40
9786.40
4417.00
13251.00
11484.20
11484.20
538.00
1614.00
1398.80
1398.80
2130.00
6390.00
5538.00
5538.00
3196.00
9588.00
8309.60
8309.60
281.00
843.00
730.60
730.60
4672.00
14016.00
12147.20
12147.20
4162.00
12486.00
10821.20
10821.20
3531.00
10593.00
9180.60
9180.60
2262.00
6786.00
5881.20
5881.20
2818.00
8454.00
7326.80
7326.80
2976.00
8928.00
7737.60
7737.60
3091.00
9273.00
8036.60
8036.60
2514.00
7542.00
6536.40
6536.40
3516.00
10548.00
9141.60
9141.60
2700.00
8100.00
7020.00
7020.00
2736.00
8208.00
7113.60
7113.60
3445.00
10335.00
8957.00
8957.00
3654.00
10962.00
9500.40
9500.40
3971.00
11913.00
10324.60
10324.60
3911.00
11733.00
10168.60
10168.60
4064.00
12192.00
10566.40
10566.40
4064.00
12192.00
10566.40
10566.40
4403.00
13209.00
11447.80
11447.80
5460.00
16380.00
14196.00
14196.00
2979.00
8937.00
7745.40
7745.40
3487.00
10461.00
9066.20
9066.20
3246.00
9738.00
8439.60
8439.60
3684.00
11052.00
9578.40
9578.40
776.00
2328.00
2017.60
2017.60
1178.00
3534.00
3062.80
3062.80
2635.00
7905.00
6851.00
6851.00
827.00
2481.00
2150.20
2150.20
1261.00
3783.00
3278.60
3278.60
2065.00
6195.00
5369.00
5369.00
2251.00
6753.00
5852.60
5852.60
790.00
2370.00
2054.00
2054.00
1049.00
3147.00
2727.40
2727.40
2060.00
6180.00
5356.00
5356.00
2378.00
7134.00
6182.80
6182.80
838.00
2514.00
2178.80
2178.80
1337.00
4011.00
3476.20
3476.20
3574.00
10722.00
9292.40
9292.40
1072.00
3216.00
2787.20
2787.20
1525.00
4575.00
3965.00
3965.00
3212.00
9636.00
8351.20
8351.20
4531.00
13593.00
11780.60
11780.60
904.00
2712.00
2350.40
2350.40
1262.00
3786.00
3281.20
3281.20
2834.00
8502.00
7368.40
7368.40
982.00
2946.00
2553.20
2553.20
1415.00
4245.00
3679.00
3679.00
2105.00
6315.00
5473.00
5473.00
1408.00
4224.00
3660.80
3660.80
3177.00
9531.00
8260.20
8260.20
1799.00
5397.00
4677.40
4677.40
3371.00
10113.00
8764.60
8764.60
700.00
2100.00
1820.00
1820.00
3734.00
11202.00
9708.40
9708.40
4673.00
14019.00
12149.80
12149.80
5073.00
15219.00
13189.80
13189.80
4105.00
12315.00
10673.00
10673.00
1708.00
5124.00
4440.80
4440.80
0.00
0.00
0.00
0.00
782.00
2346.00
2033.20
2033.20
571.00
1713.00
1484.60
1484.60
1829.00
5487.00
4755.40
4755.40
1721.00
5163.00
4474.60
4474.60
2580.00
7740.00
6708.00
6708.00
613.00
1839.00
1593.80
1593.80
1480.00
4440.00
3848.00
3848.00
1480.00
4440.00
3848.00
3848.00
2522.00
7566.00
6557.20
6557.20
1184.00
3552.00
3078.40
3078.40
1946.00
5838.00
5059.60
5059.60
3361.00
10083.00
8738.60
8738.60
4652.00
13956.00
12095.20
12095.20
1499.00
4497.00
3897.40
3897.40
1801.00
5403.00
4682.60
4682.60
2223.00
6669.00
5779.80
5779.80
1247.00
3741.00
3242.20
3242.20
2117.00
6351.00
5504.20
5504.20
2617.00
7851.00
6804.20
6804.20
3131.00
9393.00
8140.60
8140.60
1905.00
5715.00
4953.00
4953.00
2237.00
6711.00
5816.20
5816.20
2342.00
7026.00
6089.20
6089.20
1825.00
5475.00
4745.00
4745.00
2705.00
8115.00
7033.00
7033.00
2278.00
6834.00
5922.80
5922.80
2426.00
7278.00
6307.60
6307.60
2548.00
7644.00
6624.80
6624.80
2136.00
6408.00
5553.60
5553.60
2246.00
6738.00
5839.60
5839.60
4270.00
12810.00
11102.00
11102.00
4013.00
12039.00
10433.80
10433.80
2926.00
8778.00
7607.60
7607.60
3100.00
9300.00
8060.00
8060.00
2194.00
6582.00
5704.40
5704.40
1793.00
5379.00
4661.80
4661.80
504.00
1512.00
1310.40
1310.40
1318.00
3954.00
3426.80
3426.80
356.00
1068.00
925.60
925.60
1457.00
4371.00
3788.20
3788.20
2717.00
8151.00
7064.20
7064.20
2096.00
6288.00
5449.60
5449.60
1719.00
5157.00
4469.40
4469.40
2832.00
8496.00
7363.20
7363.20
2597.00
7791.00
6752.20
6752.20
2962.00
8886.00
7701.20
7701.20
2207.00
6621.00
5738.20
5738.20
2216.00
6648.00
5761.60
5761.60
2694.00
8082.00
7004.40
7004.40
2822.00
8466.00
7337.20
7337.20
2543.00
7629.00
6611.80
6611.80
3987.00
11961.00
10366.20
10366.20
2531.00
7593.00
6580.60
6580.60
3987.00
11961.00
10366.20
10366.20
1603.00
4809.00
4167.80
4167.80
1892.00
5676.00
4919.20
4919.20
2395.00
7185.00
6227.00
6227.00
3264.00
9792.00
8486.40
8486.40
3659.00
10977.00
9513.40
9513.40
3849.00
11547.00
10007.40
10007.40
5477.00
16431.00
14240.20
14240.20
2309.00
6927.00
6003.40
6003.40
2471.00
7413.00
6424.60
6424.60
2966.00
8898.00
7711.60
7711.60
3846.00
11538.00
9999.60
9999.60
3596.00
10788.00
9349.60
9349.60
3857.00
11571.00
10028.20
10028.20
3921.00
11763.00
10194.60
10194.60
2425.00
7275.00
6305.00
6305.00
2345.00
7035.00
6097.00
6097.00
3147.00
9441.00
8182.20
8182.20
1144.00
3432.00
2974.40
2974.40
1619.00
4857.00
4209.40
4209.40
3177.00
9531.00
8260.20
8260.20
3124.00
9372.00
8122.40
8122.40
1219.00
3657.00
3169.40
3169.40
2044.00
6132.00
5314.40
5314.40
2684.00
8052.00
6978.40
6978.40
3380.00
10140.00
8788.00
8788.00
3786.00
11358.00
9843.60
9843.60
1011.00
3033.00
2628.60
2628.60
1749.00
5247.00
4547.40
4547.40
2583.00
7749.00
6715.80
6715.80
2648.00
7944.00
6884.80
6884.80
1079.00
3237.00
2805.40
2805.40
1799.00
5397.00
4677.40
4677.40
3027.00
9081.00
7870.20
7870.20
2909.00
8727.00
7563.40
7563.40
3955.00
11865.00
10283.00
10283.00
3959.00
11877.00
10293.40
10293.40
1168.00
3504.00
3036.80
3036.80
1675.00
5025.00
4355.00
4355.00
2579.00
7737.00
6705.40
6705.40
1990.00
5970.00
5174.00
5174.00
2429.00
7287.00
6315.40
6315.40
324.00
972.00
842.40
842.40
842.00
2526.00
2189.20
2189.20
1408.00
4224.00
3660.80
3660.80
2353.00
7059.00
6117.80
6117.80
2650.00
7950.00
6890.00
6890.00
924.00
2772.00
2402.40
2402.40
1488.00
4464.00
3868.80
3868.80
2357.00
7071.00
6128.20
6128.20
3006.00
9018.00
7815.60
7815.60
3642.00
10926.00
9469.20
9469.20
2653.00
7959.00
6897.80
6897.80
2654.00
7962.00
6900.40
6900.40
2038.00
6114.00
5298.80
5298.80
2809.00
8427.00
7303.40
7303.40
2773.00
8319.00
7209.80
7209.80
3318.00
9954.00
8626.80
8626.80
3397.00
10191.00
8832.20
8832.20
0.00
0.00
0.00
0.00
1199.00
3597.00
3117.40
3117.40
1234.00
3702.00
3208.40
3208.40
2067.00
6201.00
5374.20
5374.20
3985.00
11955.00
10361.00
10361.00
2818.00
8454.00
7326.80
7326.80
4469.00
13407.00
11619.40
11619.40
1851.00
5553.00
4812.60
4812.60
1244.00
3732.00
3234.40
3234.40
2106.00
6318.00
5475.60
5475.60
2030.00
6090.00
5278.00
5278.00
602.00
1806.00
1565.20
1565.20
1283.00
3849.00
3335.80
3335.80
1555.00
4665.00
4043.00
4043.00
1944.00
5832.00
5054.40
5054.40
1140.00
3420.00
2964.00
2964.00
1607.00
4821.00
4178.20
4178.20
2863.00
8589.00
7443.80
7443.80
4068.00
12204.00
10576.80
10576.80
1624.00
4872.00
4222.40
4222.40
1235.00
3705.00
3211.00
3211.00
1451.00
4353.00
3772.60
3772.60
1738.00
5214.00
4518.80
4518.80
2228.00
6684.00
5792.80
5792.80
1946.00
5838.00
5059.60
5059.60
1217.00
3651.00
3164.20
3164.20
1141.00
3423.00
2966.60
2966.60
1387.00
4161.00
3606.20
3606.20
2761.00
8283.00
7178.60
7178.60
2168.00
6504.00
5636.80
5636.80
1371.00
4113.00
3564.60
3564.60
1789.00
5367.00
4651.40
4651.40
1794.00
5382.00
4664.40
4664.40
2136.00
6408.00
5553.60
5553.60
2151.00
6453.00
5592.60
5592.60
1616.00
4848.00
4201.60
4201.60
2006.00
6018.00
5215.60
5215.60
1771.00
5313.00
4604.60
4604.60
1857.00
5571.00
4828.20
4828.20
2039.00
6117.00
5301.40
5301.40
2111.00
6333.00
5488.60
5488.60
3353.00
10059.00
8717.80
8717.80
1765.00
5295.00
4589.00
4589.00
2237.00
6711.00
5816.20
5816.20
1554.00
4662.00
4040.40
4040.40
1541.00
4623.00
4006.60
4006.60
376.00
1128.00
977.60
977.60
1480.00
4440.00
3848.00
3848.00
1905.00
5715.00
4953.00
4953.00
2603.00
7809.00
6767.80
6767.80
1466.00
4398.00
3811.60
3811.60
2281.00
6843.00
5930.60
5930.60
2258.00
6774.00
5870.80
5870.80
2704.00
8112.00
7030.40
7030.40
1777.00
5331.00
4620.20
4620.20
2001.00
6003.00
5202.60
5202.60
2414.00
7242.00
6276.40
6276.40
2437.00
7311.00
6336.20
6336.20
2038.00
6114.00
5298.80
5298.80
1572.00
4716.00
4087.20
4087.20
1890.00
5670.00
4914.00
4914.00
2470.00
7410.00
6422.00
6422.00
2330.00
6990.00
6058.00
6058.00
2237.00
6711.00
5816.20
5816.20
2607.00
7821.00
6778.20
6778.20
2792.00
8376.00
7259.20
7259.20
3205.00
9615.00
8333.00
8333.00
3582.00
10746.00
9313.20
9313.20
3072.00
9216.00
7987.20
7987.20
2792.00
8376.00
7259.20
7259.20
3228.00
9684.00
8392.80
8392.80
2437.00
7311.00
6336.20
6336.20
2773.00
8319.00
7209.80
7209.80
2362.00
7086.00
6141.20
6141.20
3321.00
9963.00
8634.60
8634.60
3652.00
10956.00
9495.20
9495.20
3251.00
9753.00
8452.60
8452.60
2795.00
8385.00
7267.00
7267.00
3622.00
10866.00
9417.20
9417.20
3688.00
11064.00
9588.80
9588.80
4295.00
12885.00
11167.00
11167.00
2839.00
8517.00
7381.40
7381.40
2918.00
8754.00
7586.80
7586.80
3770.00
11310.00
9802.00
9802.00
3576.00
10728.00
9297.60
9297.60
4256.00
12768.00
11065.60
11065.60
3498.00
10494.00
9094.80
9094.80
4094.00
12282.00
10644.40
10644.40
2555.00
7665.00
6643.00
6643.00
2859.00
8577.00
7433.40
7433.40
2781.00
8343.00
7230.60
7230.60
3419.00
10257.00
8889.40
8889.40
2868.00
8604.00
7456.80
7456.80
2827.00
8481.00
7350.20
7350.20
2928.00
8784.00
7612.80
7612.80
2614.00
7842.00
6796.40
6796.40
4279.00
12837.00
11125.40
11125.40
3001.00
9003.00
7802.60
7802.60
3817.00
11451.00
9924.20
9924.20
1909.00
5727.00
4963.40
4963.40
2114.00
6342.00
5496.40
5496.40
2409.00
7227.00
6263.40
6263.40
2677.00
8031.00
6960.20
6960.20
3278.00
9834.00
8522.80
8522.80
875.00
2625.00
2275.00
2275.00
1639.00
4917.00
4261.40
4261.40
2412.00
7236.00
6271.20
6271.20
1927.00
5781.00
5010.20
5010.20
2836.00
8508.00
7373.60
7373.60
3460.00
10380.00
8996.00
8996.00
831.00
2493.00
2160.60
2160.60
1619.00
4857.00
4209.40
4209.40
2242.00
6726.00
5829.20
5829.20
875.00
2625.00
2275.00
2275.00
1692.00
5076.00
4399.20
4399.20
2425.00
7275.00
6305.00
6305.00
3253.00
9759.00
8457.80
8457.80
943.00
2829.00
2451.80
2451.80
2105.00
6315.00
5473.00
5473.00
2385.00
7155.00
6201.00
6201.00
2654.00
7962.00
6900.40
6900.40
2979.00
8937.00
7745.40
7745.40
3801.00
11403.00
9882.60
9882.60
977.00
2931.00
2540.20
2540.20
1488.00
4464.00
3868.80
3868.80
2605.00
7815.00
6773.00
6773.00
993.00
2979.00
2581.80
2581.80
1479.00
4437.00
3845.40
3845.40
2051.00
6153.00
5332.60
5332.60
1065.00
3195.00
2769.00
2769.00
1747.00
5241.00
4542.20
4542.20
2248.00
6744.00
5844.80
5844.80
1435.00
4305.00
3731.00
3731.00
2179.00
6537.00
5665.40
5665.40
1912.00
5736.00
4971.20
4971.20
1409.00
4227.00
3663.40
3663.40
2281.00
6843.00
5930.60
5930.60
1663.00
4989.00
4323.80
4323.80
2661.00
7983.00
6918.60
6918.60
1721.00
5163.00
4474.60
4474.60
2286.00
6858.00
5943.60
5943.60
2654.00
7962.00
6900.40
6900.40
3061.00
9183.00
7958.60
7958.60
3153.00
9459.00
8197.80
8197.80
2213.00
6639.00
5753.80
5753.80
2736.00
8208.00
7113.60
7113.60
3407.00
10221.00
8858.20
8858.20
2576.00
7728.00
6697.60
6697.60
2538.00
7614.00
6598.80
6598.80
2211.00
6633.00
5748.60
5748.60
2477.00
7431.00
6440.20
6440.20
3745.00
11235.00
9737.00
9737.00
2510.00
7530.00
6526.00
6526.00
1751.00
5253.00
4552.60
4552.60
2211.00
6633.00
5748.60
5748.60
2893.00
8679.00
7521.80
7521.80
2224.00
6672.00
5782.40
5782.40
2399.00
7197.00
6237.40
6237.40
0.00
0.00
0.00
0.00
511.00
1533.00
1328.60
1328.60
774.00
2322.00
2012.40
2012.40
1563.00
4689.00
4063.80
4063.80
1515.00
4545.00
3939.00
3939.00
1782.00
5346.00
4633.20
4633.20
1934.00
5802.00
5028.40
5028.40
3096.00
9288.00
8049.60
8049.60
2072.00
6216.00
5387.20
5387.20
1116.00
3348.00
2901.60
2901.60
1680.00
5040.00
4368.00
4368.00
1104.00
3312.00
2870.40
2870.40
960.00
2880.00
2496.00
2496.00
1111.00
3333.00
2888.60
2888.60
1158.00
3474.00
3010.80
3010.80
1397.00
4191.00
3632.20
3632.20
1192.00
3576.00
3099.20
3099.20
1202.00
3606.00
3125.20
3125.20
1153.00
3459.00
2997.80
2997.80
1519.00
4557.00
3949.40
3949.40
1990.00
5970.00
5174.00
5174.00
1264.00
3792.00
3286.40
3286.40
1907.00
5721.00
4958.20
4958.20
2629.00
7887.00
6835.40
6835.40
3894.00
11682.00
10124.40
10124.40
2162.00
6486.00
5621.20
5621.20
3023.00
9069.00
7859.80
7859.80
1018.00
3054.00
2646.80
2646.80
1665.00
4995.00
4329.00
4329.00
1994.00
5982.00
5184.40
5184.40
1823.00
5469.00
4739.80
4739.80
1850.00
5550.00
4810.00
4810.00
1194.00
3582.00
3104.40
3104.40
1463.00
4389.00
3803.80
3803.80
1583.00
4749.00
4115.80
4115.80
1971.00
5913.00
5124.60
5124.60
1624.00
4872.00
4222.40
4222.40
2172.00
6516.00
5647.20
5647.20
1592.00
4776.00
4139.20
4139.20
2027.00
6081.00
5270.20
5270.20
1803.00
5409.00
4687.80
4687.80
1789.00
5367.00
4651.40
4651.40
1589.00
4767.00
4131.40
4131.40
2356.00
7068.00
6125.60
6125.60
2220.00
6660.00
5772.00
5772.00
1856.00
5568.00
4825.60
4825.60
1250.00
3750.00
3250.00
3250.00
1184.00
3552.00
3078.40
3078.40
2486.00
7458.00
6463.60
6463.60
2855.00
8565.00
7423.00
7423.00
3856.00
11568.00
10025.60
10025.60
3049.00
9147.00
7927.40
7927.40
3283.00
9849.00
8535.80
8535.80
2678.00
8034.00
6962.80
6962.80
3105.00
9315.00
8073.00
8073.00
2972.00
8916.00
7727.20
7727.20
2954.00
8862.00
7680.40
7680.40
3430.00
10290.00
8918.00
8918.00
1970.00
5910.00
5122.00
5122.00
2401.00
7203.00
6242.60
6242.60
2425.00
7275.00
6305.00
6305.00
3136.00
9408.00
8153.60
8153.60
2005.00
6015.00
5213.00
5213.00
2479.00
7437.00
6445.40
6445.40
1809.00
5427.00
4703.40
4703.40
2648.00
7944.00
6884.80
6884.80
1736.00
5208.00
4513.60
4513.60
1855.00
5565.00
4823.00
4823.00
2262.00
6786.00
5881.20
5881.20
2184.00
6552.00
5678.40
5678.40
2161.00
6483.00
5618.60
5618.60
3408.00
10224.00
8860.80
8860.80
2007.00
6021.00
5218.20
5218.20
2525.00
7575.00
6565.00
6565.00
1420.00
4260.00
3692.00
3692.00
1419.00
4257.00
3689.40
3689.40
1382.00
4146.00
3593.20
3593.20
2163.00
6489.00
5623.80
5623.80
2119.00
6357.00
5509.40
5509.40
2088.00
6264.00
5428.80
5428.80
2046.00
6138.00
5319.60
5319.60
2183.00
6549.00
5675.80
5675.80
2185.00
6555.00
5681.00
5681.00
2636.00
7908.00
6853.60
6853.60
2962.00
8886.00
7701.20
7701.20
2836.00
8508.00
7373.60
7373.60
3287.00
9861.00
8546.20
8546.20
2820.00
8460.00
7332.00
7332.00
3112.00
9336.00
8091.20
8091.20
2814.00
8442.00
7316.40
7316.40
3038.00
9114.00
7898.80
7898.80
3055.00
9165.00
7943.00
7943.00
4068.00
12204.00
10576.80
10576.80
2927.00
8781.00
7610.20
7610.20
2209.00
6627.00
5743.40
5743.40
2541.00
7623.00
6606.60
6606.60
2229.00
6687.00
5795.40
5795.40
2084.00
6252.00
5418.40
5418.40
2466.00
7398.00
6411.60
6411.60
2909.00
8727.00
7563.40
7563.40
2976.00
8928.00
7737.60
7737.60
2275.00
6825.00
5915.00
5915.00
2274.00
6822.00
5912.40
5912.40
1938.00
5814.00
5038.80
5038.80
2258.00
6774.00
5870.80
5870.80
1497.00
4491.00
3892.20
3892.20
2505.00
7515.00
6513.00
6513.00
2315.00
6945.00
6019.00
6019.00
2814.00
8442.00
7316.40
7316.40
2399.00
7197.00
6237.40
6237.40
2462.00
7386.00
6401.20
6401.20
3507.00
10521.00
9118.20
9118.20
2704.00
8112.00
7030.40
7030.40
5890.00
17670.00
15314.00
15314.00
10571.00
31713.00
27484.60
27484.60
11716.00
35148.00
30461.60
30461.60
11435.00
34305.00
29731.00
29731.00
4889.00
14667.00
12711.40
12711.40
10488.00
31464.00
27268.80
27268.80
2089.00
6267.00
5431.40
5431.40
3460.00
10380.00
8996.00
8996.00
4485.00
13455.00
11661.00
11661.00
2390.00
7170.00
6214.00
6214.00
2390.00
7170.00
6214.00
6214.00
3159.00
9477.00
8213.40
8213.40
4725.00
14175.00
12285.00
12285.00
3912.00
11736.00
10171.20
10171.20
4565.00
13695.00
11869.00
11869.00
1515.00
4545.00
3939.00
3939.00
2101.00
6303.00
5462.60
5462.60
2709.00
8127.00
7043.40
7043.40
971.00
2913.00
2524.60
2524.60
1038.00
3114.00
2698.80
2698.80
1641.00
4923.00
4266.60
4266.60
1711.00
5133.00
4448.60
4448.60
2079.00
6237.00
5405.40
5405.40
1156.00
3468.00
3005.60
3005.60
1398.00
4194.00
3634.80
3634.80
1711.00
5133.00
4448.60
4448.60
2262.00
6786.00
5881.20
5881.20
1066.00
3198.00
2771.60
2771.60
1491.00
4473.00
3876.60
3876.60
1789.00
5367.00
4651.40
4651.40
2080.00
6240.00
5408.00
5408.00
2247.00
6741.00
5842.20
5842.20
1054.00
3162.00
2740.40
2740.40
1369.00
4107.00
3559.40
3559.40
1587.00
4761.00
4126.20
4126.20
2062.00
6186.00
5361.20
5361.20
643.00
1929.00
1671.80
1671.80
1085.00
3255.00
2821.00
2821.00
1686.00
5058.00
4383.60
4383.60
2155.00
6465.00
5603.00
5603.00
759.00
2277.00
1973.40
1973.40
1180.00
3540.00
3068.00
3068.00
2689.00
8067.00
6991.40
6991.40
639.00
1917.00
1661.40
1661.40
966.00
2898.00
2511.60
2511.60
1494.00
4482.00
3884.40
3884.40
1806.00
5418.00
4695.60
4695.60
885.00
2655.00
2301.00
2301.00
1225.00
3675.00
3185.00
3185.00
1583.00
4749.00
4115.80
4115.80
1972.00
5916.00
5127.20
5127.20
2769.00
8307.00
7199.40
7199.40
2565.00
7695.00
6669.00
6669.00
2779.00
8337.00
7225.40
7225.40
2593.00
7779.00
6741.80
6741.80
2887.00
8661.00
7506.20
7506.20
2440.00
7320.00
6344.00
6344.00
2811.00
8433.00
7308.60
7308.60
1970.00
5910.00
5122.00
5122.00
384.00
1152.00
998.40
998.40
2560.00
7680.00
6656.00
6656.00
848.00
2544.00
2204.80
2204.80
2537.00
7611.00
6596.20
6596.20
2290.00
6870.00
5954.00
5954.00
2280.00
6840.00
5928.00
5928.00
0.00
0.00
0.00
0.00
2246.00
6738.00
5839.60
5839.60
1900.00
5700.00
4940.00
4940.00
3487.00
10461.00
9066.20
9066.20
1566.00
4698.00
4071.60
4071.60
1950.00
5850.00
5070.00
5070.00
2150.00
6450.00
5590.00
5590.00
2632.00
7896.00
6843.20
6843.20
2671.00
8013.00
6944.60
6944.60
3317.00
9951.00
8624.20
8624.20
3088.00
9264.00
8028.80
8028.80
3391.00
10173.00
8816.60
8816.60
3542.00
10626.00
9209.20
9209.20
4296.00
12888.00
11169.60
11169.60
3658.00
10974.00
9510.80
9510.80
736.00
2208.00
1913.60
1913.60
2430.00
7290.00
6318.00
6318.00
1703.00
5109.00
4427.80
4427.80
2702.00
8106.00
7025.20
7025.20
1371.00
4113.00
3564.60
3564.60
1958.00
5874.00
5090.80
5090.80
4163.00
12489.00
10823.80
10823.80
1351.00
4053.00
3512.60
3512.60
2075.00
6225.00
5395.00
5395.00
2475.00
7425.00
6435.00
6435.00
3470.00
10410.00
9022.00
9022.00
6614.00
19842.00
17196.40
17196.40
1674.00
5022.00
4352.40
4352.40
1644.00
4932.00
4274.40
4274.40
1820.00
5460.00
4732.00
4732.00
2943.00
8829.00
7651.80
7651.80
3761.00
11283.00
9778.60
9778.60
3082.00
9246.00
8013.20
8013.20
3296.00
9888.00
8569.60
8569.60
7593.00
22779.00
19741.80
19741.80
6674.00
20022.00
17352.40
17352.40
10446.00
31338.00
27159.60
27159.60
4187.00
12561.00
10886.20
10886.20
1844.00
5532.00
4794.40
4794.40
530.00
1590.00
1378.00
1378.00
2269.00
6807.00
5899.40
5899.40
3012.00
9036.00
7831.20
7831.20
5850.00
17550.00
15210.00
15210.00
394.00
1182.00
1024.40
1024.40
461.00
1383.00
1198.60
1198.60
352.00
1056.00
915.20
915.20
2466.00
7398.00
6411.60
6411.60
2464.00
7392.00
6406.40
6406.40
2991.00
8973.00
7776.60
7776.60
3140.00
9420.00
8164.00
8164.00
3521.00
10563.00
9154.60
9154.60
3263.00
9789.00
8483.80
8483.80
4748.00
14244.00
12344.80
12344.80
4013.00
12039.00
10433.80
10433.80
4134.00
12402.00
10748.40
10748.40
5270.00
15810.00
13702.00
13702.00
6144.00
18432.00
15974.40
15974.40
7047.00
21141.00
18322.20
18322.20
5403.00
16209.00
14047.80
14047.80
5622.00
16866.00
14617.20
14617.20
3246.00
9738.00
8439.60
8439.60
4692.00
14076.00
12199.20
12199.20
5377.00
16131.00
13980.20
13980.20
5827.00
17481.00
15150.20
15150.20
6286.00
18858.00
16343.60
16343.60
5127.00
15381.00
13330.20
13330.20
4426.00
13278.00
11507.60
11507.60
5018.00
15054.00
13046.80
13046.80
4300.00
12900.00
11180.00
11180.00
2421.00
7263.00
6294.60
6294.60
3337.00
10011.00
8676.20
8676.20
4058.00
12174.00
10550.80
10550.80
3337.00
10011.00
8676.20
8676.20
3550.00
10650.00
9230.00
9230.00
4094.00
12282.00
10644.40
10644.40
2102.00
6306.00
5465.20
5465.20
3604.00
10812.00
9370.40
9370.40
1719.00
5157.00
4469.40
4469.40
2482.00
7446.00
6453.20
6453.20
661.00
1983.00
1718.60
1718.60
2021.00
6063.00
5254.60
5254.60
2160.00
6480.00
5616.00
5616.00
3208.00
9624.00
8340.80
8340.80
3010.00
9030.00
7826.00
7826.00
4164.00
12492.00
10826.40
10826.40
1894.00
5682.00
4924.40
4924.40
3543.00
10629.00
9211.80
9211.80
3871.00
11613.00
10064.60
10064.60
6097.00
18291.00
15852.20
15852.20
6946.00
20838.00
18059.60
18059.60
1688.00
5064.00
4388.80
4388.80
2779.00
8337.00
7225.40
7225.40
3312.00
9936.00
8611.20
8611.20
4368.00
13104.00
11356.80
11356.80
1646.00
4938.00
4279.60
4279.60
3471.00
10413.00
9024.60
9024.60
4494.00
13482.00
11684.40
11684.40
4497.00
13491.00
11692.20
11692.20
1386.00
4158.00
3603.60
3603.60
2704.00
8112.00
7030.40
7030.40
1026.00
3078.00
2667.60
2667.60
2741.00
8223.00
7126.60
7126.60
3425.00
10275.00
8905.00
8905.00
4620.00
13860.00
12012.00
12012.00
829.00
2487.00
2155.40
2155.40
1209.00
3627.00
3143.40
3143.40
4049.00
12147.00
10527.40
10527.40
5677.00
17031.00
14760.20
14760.20
1395.00
4185.00
3627.00
3627.00
2101.00
6303.00
5462.60
5462.60
1561.00
4683.00
4058.60
4058.60
1944.00
5832.00
5054.40
5054.40
4521.00
13563.00
11754.60
11754.60
638.00
1914.00
1658.80
1658.80
3743.00
11229.00
9731.80
9731.80
3099.00
9297.00
8057.40
8057.40
5941.00
17823.00
15446.60
15446.60
6057.00
18171.00
15748.20
15748.20
5947.00
17841.00
15462.20
15462.20
4639.00
13917.00
12061.40
12061.40
0.00
0.00
0.00
0.00
1810.00
5430.00
4706.00
4706.00
2312.00
6936.00
6011.20
6011.20
1726.00
5178.00
4487.60
4487.60
1342.00
4026.00
3489.20
3489.20
1727.00
5181.00
4490.20
4490.20
2648.00
7944.00
6884.80
6884.80
649.00
1947.00
1687.40
1687.40
1414.00
4242.00
3676.40
3676.40
2007.00
6021.00
5218.20
5218.20
1848.00
5544.00
4804.80
4804.80
1118.00
3354.00
2906.80
2906.80
1723.00
5169.00
4479.80
4479.80
3795.00
11385.00
9867.00
9867.00
1482.00
4446.00
3853.20
3853.20
1711.00
5133.00
4448.60
4448.60
2313.00
6939.00
6013.80
6013.80
2112.00
6336.00
5491.20
5491.20
2474.00
7422.00
6432.40
6432.40
2765.00
8295.00
7189.00
7189.00
1523.00
4569.00
3959.80
3959.80
2738.00
8214.00
7118.80
7118.80
1330.00
3990.00
3458.00
3458.00
1730.00
5190.00
4498.00
4498.00
1903.00
5709.00
4947.80
4947.80
2354.00
7062.00
6120.40
6120.40
2175.00
6525.00
5655.00
5655.00
2664.00
7992.00
6926.40
6926.40
2950.00
8850.00
7670.00
7670.00
1030.00
3090.00
2678.00
2678.00
3079.00
9237.00
8005.40
8005.40
5687.00
17061.00
14786.20
14786.20
5096.00
15288.00
13249.60
13249.60
298.00
894.00
774.80
774.80
1463.00
4389.00
3803.80
3803.80
2132.00
6396.00
5543.20
5543.20
2883.00
8649.00
7495.80
7495.80
2278.00
6834.00
5922.80
5922.80
3004.00
9012.00
7810.40
7810.40
1610.00
4830.00
4186.00
4186.00
2079.00
6237.00
5405.40
5405.40
2576.00
7728.00
6697.60
6697.60
1820.00
5460.00
4732.00
4732.00
2341.00
7023.00
6086.60
6086.60
3186.00
9558.00
8283.60
8283.60
2223.00
6669.00
5779.80
5779.80
3321.00
9963.00
8634.60
8634.60
2512.00
7536.00
6531.20
6531.20
2313.00
6939.00
6013.80
6013.80
2447.00
7341.00
6362.20
6362.20
2870.00
8610.00
7462.00
7462.00
3509.00
10527.00
9123.40
9123.40
6029.00
18087.00
15675.40
15675.40
5012.00
15036.00
13031.20
13031.20
3570.00
10710.00
9282.00
9282.00
3012.00
9036.00
7831.20
7831.20
2700.00
8100.00
7020.00
7020.00
2689.00
8067.00
6991.40
6991.40
2687.00
8061.00
6986.20
6986.20
1607.00
4821.00
4178.20
4178.20
2596.00
7788.00
6749.60
6749.60
4044.00
12132.00
10514.40
10514.40
4515.00
13545.00
11739.00
11739.00
2678.00
8034.00
6962.80
6962.80
2917.00
8751.00
7584.20
7584.20
2392.00
7176.00
6219.20
6219.20
3051.00
9153.00
7932.60
7932.60
2894.00
8682.00
7524.40
7524.40
2991.00
8973.00
7776.60
7776.60
3159.00
9477.00
8213.40
8213.40
2965.00
8895.00
7709.00
7709.00
4574.00
13722.00
11892.40
11892.40
4030.00
12090.00
10478.00
10478.00
5626.00
16878.00
14627.60
14627.60
2972.00
8916.00
7727.20
7727.20
3686.00
11058.00
9583.60
9583.60
4745.00
14235.00
12337.00
12337.00
3425.00
10275.00
8905.00
8905.00
3508.00
10524.00
9120.80
9120.80
4581.00
13743.00
11910.60
11910.60
4284.00
12852.00
11138.40
11138.40
4905.00
14715.00
12753.00
12753.00
4297.00
12891.00
11172.20
11172.20
4613.00
13839.00
11993.80
11993.80
2072.00
6216.00
5387.20
5387.20
2656.00
7968.00
6905.60
6905.60
3145.00
9435.00
8177.00
8177.00
2429.00
7287.00
6315.40
6315.40
5146.00
15438.00
13379.60
13379.60
6449.00
19347.00
16767.40
16767.40
4381.00
13143.00
11390.60
11390.60
4111.00
12333.00
10688.60
10688.60
1954.00
5862.00
5080.40
5080.40
2105.00
6315.00
5473.00
5473.00
2363.00
7089.00
6143.80
6143.80
2533.00
7599.00
6585.80
6585.80
1728.00
5184.00
4492.80
4492.80
1800.00
5400.00
4680.00
4680.00
2826.00
8478.00
7347.60
7347.60
2918.00
8754.00
7586.80
7586.80
4885.00
14655.00
12701.00
12701.00
3555.00
10665.00
9243.00
9243.00
1771.00
5313.00
4604.60
4604.60
2326.00
6978.00
6047.60
6047.60
2494.00
7482.00
6484.40
6484.40
3653.00
10959.00
9497.80
9497.80
4555.00
13665.00
11843.00
11843.00
3538.00
10614.00
9198.80
9198.80
1706.00
5118.00
4435.60
4435.60
2479.00
7437.00
6445.40
6445.40
3256.00
9768.00
8465.60
8465.60
1044.00
3132.00
2714.40
2714.40
2728.00
8184.00
7092.80
7092.80
1322.00
3966.00
3437.20
3437.20
2090.00
6270.00
5434.00
5434.00
3280.00
9840.00
8528.00
8528.00
4348.00
13044.00
11304.80
11304.80
1582.00
4746.00
4113.20
4113.20
2952.00
8856.00
7675.20
7675.20
1649.00
4947.00
4287.40
4287.40
2263.00
6789.00
5883.80
5883.80
3202.00
9606.00
8325.20
8325.20
3835.00
11505.00
9971.00
9971.00
4377.00
13131.00
11380.20
11380.20
1263.00
3789.00
3283.80
3283.80
1737.00
5211.00
4516.20
4516.20
3236.00
9708.00
8413.60
8413.60
540.00
1620.00
1404.00
1404.00
5247.00
15741.00
13642.20
13642.20
3024.00
9072.00
7862.40
7862.40
3286.00
9858.00
8543.60
8543.60
2571.00
7713.00
6684.60
6684.60
1859.00
5577.00
4833.40
4833.40
2682.00
8046.00
6973.20
6973.20
2725.00
8175.00
7085.00
7085.00
0.00
0.00
0.00
0.00
1513.00
4539.00
3933.80
3933.80
1620.00
4860.00
4212.00
4212.00
1854.00
5562.00
4820.40
4820.40
1431.00
4293.00
3720.60
3720.60
1224.00
3672.00
3182.40
3182.40
745.00
2235.00
1937.00
1937.00
1043.00
3129.00
2711.80
2711.80
2230.00
6690.00
5798.00
5798.00
2371.00
7113.00
6164.60
6164.60
2028.00
6084.00
5272.80
5272.80
598.00
1794.00
1554.80
1554.80
1475.00
4425.00
3835.00
3835.00
3608.00
10824.00
9380.80
9380.80
4645.00
13935.00
12077.00
12077.00
1105.00
3315.00
2873.00
2873.00
1759.00
5277.00
4573.40
4573.40
1658.00
4974.00
4310.80
4310.80
2079.00
6237.00
5405.40
5405.40
2279.00
6837.00
5925.40
5925.40
1325.00
3975.00
3445.00
3445.00
1507.00
4521.00
3918.20
3918.20
2443.00
7329.00
6351.80
6351.80
2151.00
6453.00
5592.60
5592.60
2764.00
8292.00
7186.40
7186.40
2806.00
8418.00
7295.60
7295.60
3061.00
9183.00
7958.60
7958.60
2431.00
7293.00
6320.60
6320.60
4245.00
12735.00
11037.00
11037.00
3748.00
11244.00
9744.80
9744.80
3461.00
10383.00
8998.60
8998.60
294.00
882.00
764.40
764.40
2420.00
7260.00
6292.00
6292.00
2541.00
7623.00
6606.60
6606.60
2581.00
7743.00
6710.60
6710.60
1420.00
4260.00
3692.00
3692.00
1362.00
4086.00
3541.20
3541.20
1767.00
5301.00
4594.20
4594.20
1322.00
3966.00
3437.20
3437.20
1481.00
4443.00
3850.60
3850.60
1770.00
5310.00
4602.00
4602.00
2257.00
6771.00
5868.20
5868.20
1571.00
4713.00
4084.60
4084.60
1971.00
5913.00
5124.60
5124.60
1684.00
5052.00
4378.40
4378.40
2010.00
6030.00
5226.00
5226.00
1655.00
4965.00
4303.00
4303.00
2315.00
6945.00
6019.00
6019.00
2736.00
8208.00
7113.60
7113.60
397.00
1191.00
1032.20
1032.20
1738.00
5214.00
4518.80
4518.80
2039.00
6117.00
5301.40
5301.40
2339.00
7017.00
6081.40
6081.40
2149.00
6447.00
5587.40
5587.40
3557.00
10671.00
9248.20
9248.20
4122.00
12366.00
10717.20
10717.20
2095.00
6285.00
5447.00
5447.00
2775.00
8325.00
7215.00
7215.00
1463.00
4389.00
3803.80
3803.80
4319.00
12957.00
11229.40
11229.40
4027.00
12081.00
10470.20
10470.20
3844.00
11532.00
9994.40
9994.40
3183.00
9549.00
8275.80
8275.80
3231.00
9693.00
8400.60
8400.60
4649.00
13947.00
12087.40
12087.40
4443.00
13329.00
11551.80
11551.80
3557.00
10671.00
9248.20
9248.20
3775.00
11325.00
9815.00
9815.00
2116.00
6348.00
5501.60
5501.60
1607.00
4821.00
4178.20
4178.20
2237.00
6711.00
5816.20
5816.20
2220.00
6660.00
5772.00
5772.00
2642.00
7926.00
6869.20
6869.20
2731.00
8193.00
7100.60
7100.60
1125.00
3375.00
2925.00
2925.00
1790.00
5370.00
4654.00
4654.00
2074.00
6222.00
5392.40
5392.40
3240.00
9720.00
8424.00
8424.00
3641.00
10923.00
9466.60
9466.60
1080.00
3240.00
2808.00
2808.00
1575.00
4725.00
4095.00
4095.00
2209.00
6627.00
5743.40
5743.40
1004.00
3012.00
2610.40
2610.40
1576.00
4728.00
4097.60
4097.60
2672.00
8016.00
6947.20
6947.20
982.00
2946.00
2553.20
2553.20
1409.00
4227.00
3663.40
3663.40
2605.00
7815.00
6773.00
6773.00
1015.00
3045.00
2639.00
2639.00
1382.00
4146.00
3593.20
3593.20
2594.00
7782.00
6744.40
6744.40
1061.00
3183.00
2758.60
2758.60
1533.00
4599.00
3985.80
3985.80
2807.00
8421.00
7298.20
7298.20
1012.00
3036.00
2631.20
2631.20
1552.00
4656.00
4035.20
4035.20
3055.00
9165.00
7943.00
7943.00
3480.00
10440.00
9048.00
9048.00
1078.00
3234.00
2802.80
2802.80
1793.00
5379.00
4661.80
4661.80
3040.00
9120.00
7904.00
7904.00
3943.00
11829.00
10251.80
10251.80
4728.00
14184.00
12292.80
12292.80
2476.00
7428.00
6437.60
6437.60
1263.00
3789.00
3283.80
3283.80
1430.00
4290.00
3718.00
3718.00
2737.00
8211.00
7116.20
7116.20
1284.00
3852.00
3338.40
3338.40
1792.00
5376.00
4659.20
4659.20
2663.00
7989.00
6923.80
6923.80
2976.00
8928.00
7737.60
7737.60
626.00
1878.00
1627.60
1627.60
3792.00
11376.00
9859.20
9859.20
2515.00
7545.00
6539.00
6539.00
3434.00
10302.00
8928.40
8928.40
3229.00
9687.00
8395.40
8395.40
2268.00
6804.00
5896.80
5896.80
2146.00
6438.00
5579.60
5579.60
2443.00
7329.00
6351.80
6351.80
2491.00
7473.00
6476.60
6476.60
2474.00
7422.00
6432.40
6432.40
2018.00
6054.00
5246.80
5246.80
2213.00
6639.00
5753.80
5753.80
3140.00
9420.00
8164.00
8164.00
0.00
0.00
0.00
0.00
624.00
1872.00
1622.40
1622.40
1361.00
4083.00
3538.60
3538.60
1933.00
5799.00
5025.80
5025.80
2140.00
6420.00
5564.00
5564.00
1056.00
3168.00
2745.60
2745.60
756.00
2268.00
1965.60
1965.60
1073.00
3219.00
2789.80
2789.80
1297.00
3891.00
3372.20
3372.20
1153.00
3459.00
2997.80
2997.80
1078.00
3234.00
2802.80
2802.80
1280.00
3840.00
3328.00
3328.00
1218.00
3654.00
3166.80
3166.80
1599.00
4797.00
4157.40
4157.40
959.00
2877.00
2493.40
2493.40
1284.00
3852.00
3338.40
3338.40
2748.00
8244.00
7144.80
7144.80
3325.00
9975.00
8645.00
8645.00
1044.00
3132.00
2714.40
2714.40
1000.00
3000.00
2600.00
2600.00
898.00
2694.00
2334.80
2334.80
1367.00
4101.00
3554.20
3554.20
1281.00
3843.00
3330.60
3330.60
1473.00
4419.00
3829.80
3829.80
1287.00
3861.00
3346.20
3346.20
1222.00
3666.00
3177.20
3177.20
1306.00
3918.00
3395.60
3395.60
1297.00
3891.00
3372.20
3372.20
1106.00
3318.00
2875.60
2875.60
1110.00
3330.00
2886.00
2886.00
977.00
2931.00
2540.20
2540.20
1462.00
4386.00
3801.20
3801.20
2074.00
6222.00
5392.40
5392.40
1414.00
4242.00
3676.40
3676.40
1241.00
3723.00
3226.60
3226.60
1549.00
4647.00
4027.40
4027.40
1256.00
3768.00
3265.60
3265.60
1030.00
3090.00
2678.00
2678.00
1038.00
3114.00
2698.80
2698.80
1209.00
3627.00
3143.40
3143.40
1139.00
3417.00
2961.40
2961.40
1544.00
4632.00
4014.40
4014.40
3033.00
9099.00
7885.80
7885.80
2065.00
6195.00
5369.00
5369.00
1487.00
4461.00
3866.20
3866.20
1297.00
3891.00
3372.20
3372.20
1991.00
5973.00
5176.60
5176.60
1787.00
5361.00
4646.20
4646.20
1188.00
3564.00
3088.80
3088.80
893.00
2679.00
2321.80
2321.80
2632.00
7896.00
6843.20
6843.20
1615.00
4845.00
4199.00
4199.00
1028.00
3084.00
2672.80
2672.80
957.00
2871.00
2488.20
2488.20
976.00
2928.00
2537.60
2537.60
2690.00
8070.00
6994.00
6994.00
2823.00
8469.00
7339.80
7339.80
1784.00
5352.00
4638.40
4638.40
547.00
1641.00
1422.20
1422.20
1139.00
3417.00
2961.40
2961.40
1339.00
4017.00
3481.40
3481.40
1130.00
3390.00
2938.00
2938.00
1515.00
4545.00
3939.00
3939.00
1114.00
3342.00
2896.40
2896.40
1470.00
4410.00
3822.00
3822.00
1084.00
3252.00
2818.40
2818.40
1272.00
3816.00
3307.20
3307.20
914.00
2742.00
2376.40
2376.40
1122.00
3366.00
2917.20
2917.20
1013.00
3039.00
2633.80
2633.80
884.00
2652.00
2298.40
2298.40
957.00
2871.00
2488.20
2488.20
1778.00
5334.00
4622.80
4622.80
1044.00
3132.00
2714.40
2714.40
1456.00
4368.00
3785.60
3785.60
1893.00
5679.00
4921.80
4921.80
2770.00
8310.00
7202.00
7202.00
4103.00
12309.00
10667.80
10667.80
2636.00
7908.00
6853.60
6853.60
1208.00
3624.00
3140.80
3140.80
914.00
2742.00
2376.40
2376.40
1270.00
3810.00
3302.00
3302.00
1158.00
3474.00
3010.80
3010.80
1089.00
3267.00
2831.40
2831.40
1569.00
4707.00
4079.40
4079.40
1995.00
5985.00
5187.00
5187.00
1431.00
4293.00
3720.60
3720.60
2175.00
6525.00
5655.00
5655.00
2565.00
7695.00
6669.00
6669.00
1882.00
5646.00
4893.20
4893.20
1883.00
5649.00
4895.80
4895.80
2138.00
6414.00
5558.80
5558.80
1831.00
5493.00
4760.60
4760.60
2452.00
7356.00
6375.20
6375.20
2407.00
7221.00
6258.20
6258.20
2593.00
7779.00
6741.80
6741.80
2162.00
6486.00
5621.20
5621.20
2342.00
7026.00
6089.20
6089.20
1479.00
4437.00
3845.40
3845.40
1669.00
5007.00
4339.40
4339.40
1354.00
4062.00
3520.40
3520.40
3267.00
9801.00
8494.20
8494.20
1283.00
3849.00
3335.80
3335.80
1142.00
3426.00
2969.20
2969.20
1306.00
3918.00
3395.60
3395.60
1163.00
3489.00
3023.80
3023.80
2220.00
6660.00
5772.00
5772.00
2100.00
6300.00
5460.00
5460.00
1494.00
4482.00
3884.40
3884.40
1783.00
5349.00
4635.80
4635.80
1019.00
3057.00
2649.40
2649.40
1317.00
3951.00
3424.20
3424.20
3814.00
11442.00
9916.40
9916.40
806.00
2418.00
2095.60
2095.60
1286.00
3858.00
3343.60
3343.60
1893.00
5679.00
4921.80
4921.80
4067.00
12201.00
10574.20
10574.20
4560.00
13680.00
11856.00
11856.00
743.00
2229.00
1931.80
1931.80
1150.00
3450.00
2990.00
2990.00
1605.00
4815.00
4173.00
4173.00
3851.00
11553.00
10012.60
10012.60
4465.00
13395.00
11609.00
11609.00
682.00
2046.00
1773.20
1773.20
951.00
2853.00
2472.60
2472.60
1132.00
3396.00
2943.20
2943.20
2206.00
6618.00
5735.60
5735.60
680.00
2040.00
1768.00
1768.00
816.00
2448.00
2121.60
2121.60
1239.00
3717.00
3221.40
3221.40
1923.00
5769.00
4999.80
4999.80
437.00
1311.00
1136.20
1136.20
535.00
1605.00
1391.00
1391.00
896.00
2688.00
2329.60
2329.60
1812.00
5436.00
4711.20
4711.20
421.00
1263.00
1094.60
1094.60
503.00
1509.00
1307.80
1307.80
1449.00
4347.00
3767.40
3767.40
367.00
1101.00
954.20
954.20
828.00
2484.00
2152.80
2152.80
653.00
1959.00
1697.80
1697.80
931.00
2793.00
2420.60
2420.60
1208.00
3624.00
3140.80
3140.80
2425.00
7275.00
6305.00
6305.00
496.00
1488.00
1289.60
1289.60
1175.00
3525.00
3055.00
3055.00
1418.00
4254.00
3686.80
3686.80
2620.00
7860.00
6812.00
6812.00
676.00
2028.00
1757.60
1757.60
931.00
2793.00
2420.60
2420.60
1417.00
4251.00
3684.20
3684.20
2862.00
8586.00
7441.20
7441.20
395.00
1185.00
1027.00
1027.00
487.00
1461.00
1266.20
1266.20
669.00
2007.00
1739.40
1739.40
1732.00
5196.00
4503.20
4503.20
315.00
945.00
819.00
819.00
480.00
1440.00
1248.00
1248.00
762.00
2286.00
1981.20
1981.20
1479.00
4437.00
3845.40
3845.40
4712.00
14136.00
12251.20
12251.20
3537.00
10611.00
9196.20
9196.20
2878.00
8634.00
7482.80
7482.80
3069.00
9207.00
7979.40
7979.40
2888.00
8664.00
7508.80
7508.80
2443.00
7329.00
6351.80
6351.80
2292.00
6876.00
5959.20
5959.20
2183.00
6549.00
5675.80
5675.80
1184.00
3552.00
3078.40
3078.40
2116.00
6348.00
5501.60
5501.60
2028.00
6084.00
5272.80
5272.80
2759.00
8277.00
7173.40
7173.40
1605.00
4815.00
4173.00
4173.00
1253.00
3759.00
3257.80
3257.80
1484.00
4452.00
3858.40
3858.40
831.00
2493.00
2160.60
2160.60
0.00
0.00
0.00
0.00
632.00
1896.00
1643.20
1643.20
621.00
1863.00
1614.60
1614.60
576.00
1728.00
1497.60
1497.60
546.00
1638.00
1419.60
1419.60
606.00
1818.00
1575.60
1575.60
519.00
1557.00
1349.40
1349.40
563.00
1689.00
1463.80
1463.80
607.00
1821.00
1578.20
1578.20
645.00
1935.00
1677.00
1677.00
253.00
759.00
657.80
657.80
502.00
1506.00
1305.20
1305.20
284.00
852.00
738.40
738.40
246.00
738.00
639.60
639.60
224.00
672.00
582.40
582.40
242.00
726.00
629.20
629.20
184.00
552.00
478.40
478.40
214.00
642.00
556.40
556.40
157.00
471.00
408.20
408.20
192.00
576.00
499.20
499.20
104.00
312.00
270.40
270.40
122.00
366.00
317.20
317.20
145.00
435.00
377.00
377.00
155.00
465.00
403.00
403.00
135.00
405.00
351.00
351.00
130.00
390.00
338.00
338.00
575.00
1725.00
1495.00
1495.00
647.00
1941.00
1682.20
1682.20
367.00
1101.00
954.20
954.20
390.00
1170.00
1014.00
1014.00
379.00
1137.00
985.40
985.40
319.00
957.00
829.40
829.40
228.00
684.00
592.80
592.80
245.00
735.00
637.00
637.00
307.00
921.00
798.20
798.20
113.00
339.00
293.80
293.80
391.00
1173.00
1016.60
1016.60
409.00
1227.00
1063.40
1063.40
174.00
522.00
452.40
452.40
178.00
534.00
462.80
462.80
128.00
384.00
332.80
332.80
136.00
408.00
353.60
353.60
98.00
294.00
254.80
254.80
81.00
243.00
210.60
210.60
129.00
387.00
335.40
335.40
114.00
342.00
296.40
296.40
136.00
408.00
353.60
353.60
141.00
423.00
366.60
366.60
172.00
516.00
447.20
447.20
308.00
924.00
800.80
800.80
196.00
588.00
509.60
509.60
173.00
519.00
449.80
449.80
164.00
492.00
426.40
426.40
230.00
690.00
598.00
598.00
280.00
840.00
728.00
728.00
0.00
0.00
0.00
0.00
1903.00
5709.00
4947.80
4947.80
2406.00
7218.00
6255.60
6255.60
1703.00
5109.00
4427.80
4427.80
3857.00
11571.00
10028.20
10028.20
3771.00
11313.00
9804.60
9804.60
2124.00
6372.00
5522.40
5522.40
1952.00
5856.00
5075.20
5075.20
2139.00
6417.00
5561.40
5561.40
2078.00
6234.00
5402.80
5402.80
2267.00
6801.00
5894.20
5894.20
2443.00
7329.00
6351.80
6351.80
2117.00
6351.00
5504.20
5504.20
2415.00
7245.00
6279.00
6279.00
3918.00
11754.00
10186.80
10186.80
3357.00
10071.00
8728.20
8728.20
1644.00
4932.00
4274.40
4274.40
1781.00
5343.00
4630.60
4630.60
1833.00
5499.00
4765.80
4765.80
2111.00
6333.00
5488.60
5488.60
1916.00
5748.00
4981.60
4981.60
2145.00
6435.00
5577.00
5577.00
1631.00
4893.00
4240.60
4240.60
1745.00
5235.00
4537.00
4537.00
1810.00
5430.00
4706.00
4706.00
2095.00
6285.00
5447.00
5447.00
1894.00
5682.00
4924.40
4924.40
1965.00
5895.00
5109.00
5109.00
1851.00
5553.00
4812.60
4812.60
2257.00
6771.00
5868.20
5868.20
3393.00
10179.00
8821.80
8821.80
2853.00
8559.00
7417.80
7417.80
3632.00
10896.00
9443.20
9443.20
2418.00
7254.00
6286.80
6286.80
2655.00
7965.00
6903.00
6903.00
2972.00
8916.00
7727.20
7727.20
2966.00
8898.00
7711.60
7711.60
3817.00
11451.00
9924.20
9924.20
4661.00
13983.00
12118.60
12118.60
6128.00
18384.00
15932.80
15932.80
1490.00
4470.00
3874.00
3874.00
1860.00
5580.00
4836.00
4836.00
1885.00
5655.00
4901.00
4901.00
1954.00
5862.00
5080.40
5080.40
1794.00
5382.00
4664.40
4664.40
2385.00
7155.00
6201.00
6201.00
2259.00
6777.00
5873.40
5873.40
2409.00
7227.00
6263.40
6263.40
2510.00
7530.00
6526.00
6526.00
2348.00
7044.00
6104.80
6104.80
2541.00
7623.00
6606.60
6606.60
3050.00
9150.00
7930.00
7930.00
2253.00
6759.00
5857.80
5857.80
2730.00
8190.00
7098.00
7098.00
2304.00
6912.00
5990.40
5990.40
2711.00
8133.00
7048.60
7048.60
3602.00
10806.00
9365.20
9365.20
4438.00
13314.00
11538.80
11538.80
2502.00
7506.00
6505.20
6505.20
2245.00
6735.00
5837.00
5837.00
1533.00
4599.00
3985.80
3985.80
1879.00
5637.00
4885.40
4885.40
1784.00
5352.00
4638.40
4638.40
1861.00
5583.00
4838.60
4838.60
2073.00
6219.00
5389.80
5389.80
3801.00
11403.00
9882.60
9882.60
1687.00
5061.00
4386.20
4386.20
1918.00
5754.00
4986.80
4986.80
1884.00
5652.00
4898.40
4898.40
2312.00
6936.00
6011.20
6011.20
2501.00
7503.00
6502.60
6502.60
2631.00
7893.00
6840.60
6840.60
3185.00
9555.00
8281.00
8281.00
3693.00
11079.00
9601.80
9601.80
3762.00
11286.00
9781.20
9781.20
3762.00
11286.00
9781.20
9781.20
0.00
0.00
0.00
0.00
492.00
1476.00
1279.20
1279.20
505.00
1515.00
1313.00
1313.00
316.00
948.00
821.60
821.60
501.00
1503.00
1302.60
1302.60
1580.00
4740.00
4108.00
4108.00
1899.00
5697.00
4937.40
4937.40
2828.00
8484.00
7352.80
7352.80
1610.00
4830.00
4186.00
4186.00
1007.00
3021.00
2618.20
2618.20
2242.00
6726.00
5829.20
5829.20
1385.00
4155.00
3601.00
3601.00
1600.00
4800.00
4160.00
4160.00
2836.00
8508.00
7373.60
7373.60
2861.00
8583.00
7438.60
7438.60
251.00
753.00
652.60
652.60
367.00
1101.00
954.20
954.20
661.00
1983.00
1718.60
1718.60
479.00
1437.00
1245.40
1245.40
750.00
2250.00
1950.00
1950.00
1656.00
4968.00
4305.60
4305.60
3700.00
11100.00
9620.00
9620.00
4358.00
13074.00
11330.80
11330.80
5051.00
15153.00
13132.60
13132.60
3223.00
9669.00
8379.80
8379.80
4451.00
13353.00
11572.60
11572.60
5539.00
16617.00
14401.40
14401.40
2792.00
8376.00
7259.20
7259.20
5807.00
17421.00
15098.20
15098.20
3625.00
10875.00
9425.00
9425.00
2296.00
6888.00
5969.60
5969.60
2531.00
7593.00
6580.60
6580.60
3006.00
9018.00
7815.60
7815.60
587.00
1761.00
1526.20
1526.20
1862.00
5586.00
4841.20
4841.20
1594.00
4782.00
4144.40
4144.40
2269.00
6807.00
5899.40
5899.40
2302.00
6906.00
5985.20
5985.20
496.00
1488.00
1289.60
1289.60
699.00
2097.00
1817.40
1817.40
228.00
684.00
592.80
592.80
436.00
1308.00
1133.60
1133.60
536.00
1608.00
1393.60
1393.60
611.00
1833.00
1588.60
1588.60
2132.00
6396.00
5543.20
5543.20
3088.00
9264.00
8028.80
8028.80
454.00
1362.00
1180.40
1180.40
0.00
0.00
0.00
0.00
394.00
1182.00
1024.40
1024.40
728.00
2184.00
1892.80
1892.80
1295.00
3885.00
3367.00
3367.00
1915.00
5745.00
4979.00
4979.00
2101.00
6303.00
5462.60
5462.60
2760.00
8280.00
7176.00
7176.00
1778.00
5334.00
4622.80
4622.80
2369.00
7107.00
6159.40
6159.40
1608.00
4824.00
4180.80
4180.80
2881.00
8643.00
7490.60
7490.60
3800.00
11400.00
9880.00
9880.00
5209.00
15627.00
13543.40
13543.40
4263.00
12789.00
11083.80
11083.80
4846.00
14538.00
12599.60
12599.60
4140.00
12420.00
10764.00
10764.00
4002.00
12006.00
10405.20
10405.20
3755.00
11265.00
9763.00
9763.00
2002.00
6006.00
5205.20
5205.20
2708.00
8124.00
7040.80
7040.80
3254.00
9762.00
8460.40
8460.40
6933.00
20799.00
18025.80
18025.80
7734.00
23202.00
20108.40
20108.40
421.00
1263.00
1094.60
1094.60
586.00
1758.00
1523.60
1523.60
665.00
1995.00
1729.00
1729.00
719.00
2157.00
1869.40
1869.40
738.00
2214.00
1918.80
1918.80
2514.00
7542.00
6536.40
6536.40
604.00
1812.00
1570.40
1570.40
1029.00
3087.00
2675.40
2675.40
1509.00
4527.00
3923.40
3923.40
744.00
2232.00
1934.40
1934.40
1196.00
3588.00
3109.60
3109.60
1905.00
5715.00
4953.00
4953.00
875.00
2625.00
2275.00
2275.00
1016.00
3048.00
2641.60
2641.60
4341.00
13023.00
11286.60
11286.60
4604.00
13812.00
11970.40
11970.40
3737.00
11211.00
9716.20
9716.20
4072.00
12216.00
10587.20
10587.20
4667.00
14001.00
12134.20
12134.20
628.00
1884.00
1632.80
1632.80
750.00
2250.00
1950.00
1950.00
615.00
1845.00
1599.00
1599.00
0.00
0.00
0.00
0.00
4678.00
14034.00
12162.80
12162.80
2395.00
7185.00
6227.00
6227.00
7742.00
23226.00
20129.20
20129.20
9598.00
28794.00
24954.80
24954.80
8193.00
24579.00
21301.80
21301.80
9083.00
27249.00
23615.80
23615.80
7681.00
23043.00
19970.60
19970.60
7291.00
21873.00
18956.60
18956.60
7186.00
21558.00
18683.60
18683.60
7893.00
23679.00
20521.80
20521.80
10612.00
31836.00
27591.20
27591.20
11201.00
33603.00
29122.60
29122.60
3678.00
11034.00
9562.80
9562.80
3103.00
9309.00
8067.80
8067.80
400.00
1200.00
1040.00
1040.00
129.00
387.00
335.40
335.40
184.00
552.00
478.40
478.40
468.00
1404.00
1216.80
1216.80
473.00
1419.00
1229.80
1229.80
492.00
1476.00
1279.20
1279.20
497.00
1491.00
1292.20
1292.20
452.00
1356.00
1175.20
1175.20
593.00
1779.00
1541.80
1541.80
598.00
1794.00
1554.80
1554.80
594.00
1782.00
1544.40
1544.40
741.00
2223.00
1926.60
1926.60
547.00
1641.00
1422.20
1422.20
610.00
1830.00
1586.00
1586.00
748.00
2244.00
1944.80
1944.80
801.00
2403.00
2082.60
2082.60
717.00
2151.00
1864.20
1864.20
799.00
2397.00
2077.40
2077.40
918.00
2754.00
2386.80
2386.80
1004.00
3012.00
2610.40
2610.40
1376.00
4128.00
3577.60
3577.60
2096.00
6288.00
5449.60
5449.60
1191.00
3573.00
3096.60
3096.60
1302.00
3906.00
3385.20
3385.20
865.00
2595.00
2249.00
2249.00
946.00
2838.00
2459.60
2459.60
284.00
852.00
738.40
738.40
496.00
1488.00
1289.60
1289.60
557.00
1671.00
1448.20
1448.20
650.00
1950.00
1690.00
1690.00
531.00
1593.00
1380.60
1380.60
4514.00
13542.00
11736.40
11736.40
7007.00
21021.00
18218.20
18218.20
5604.00
16812.00
14570.40
14570.40
3748.00
11244.00
9744.80
9744.80
4236.00
12708.00
11013.60
11013.60
3254.00
9762.00
8460.40
8460.40
2818.00
8454.00
7326.80
7326.80
0.00
0.00
0.00
0.00
1471.00
4413.00
3824.60
3824.60
979.00
2937.00
2545.40
2545.40
833.00
2499.00
2165.80
2165.80
675.00
2025.00
1755.00
1755.00
2635.00
7905.00
6851.00
6851.00
1987.00
5961.00
5166.20
5166.20
183.00
549.00
475.80
475.80
1650.00
4950.00
4290.00
4290.00
2783.00
8349.00
7235.80
7235.80
479.00
1437.00
1245.40
1245.40
379.00
1137.00
985.40
985.40
722.00
2166.00
1877.20
1877.20
792.00
2376.00
2059.20
2059.20
736.00
2208.00
1913.60
1913.60
795.00
2385.00
2067.00
2067.00
754.00
2262.00
1960.40
1960.40
368.00
1104.00
956.80
956.80
964.00
2892.00
2506.40
2506.40
1146.00
3438.00
2979.60
2979.60
738.00
2214.00
1918.80
1918.80
844.00
2532.00
2194.40
2194.40
182.00
546.00
473.20
473.20
230.00
690.00
598.00
598.00
741.00
2223.00
1926.60
1926.60
802.00
2406.00
2085.20
2085.20
814.00
2442.00
2116.40
2116.40
280.00
840.00
728.00
728.00
934.00
2802.00
2428.40
2428.40
942.00
2826.00
2449.20
2449.20
948.00
2844.00
2464.80
2464.80
636.00
1908.00
1653.60
1653.60
708.00
2124.00
1840.80
1840.80
641.00
1923.00
1666.60
1666.60
611.00
1833.00
1588.60
1588.60
190.00
570.00
494.00
494.00
621.00
1863.00
1614.60
1614.60
189.00
567.00
491.40
491.40
352.00
1056.00
915.20
915.20
842.00
2526.00
2189.20
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13455.00
11661.00
11661.00
4443.00
13329.00
11551.80
11551.80
4974.00
14922.00
12932.40
12932.40
8933.00
26799.00
23225.80
23225.80
13477.00
40431.00
35040.20
35040.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3747.00
11241.00
9742.20
9742.20
3692.00
11076.00
9599.20
9599.20
2319.00
6957.00
6029.40
6029.40
2319.00
6957.00
6029.40
6029.40
5388.00
16164.00
14008.80
14008.80
3987.00
11961.00
10366.20
10366.20
3703.00
11109.00
9627.80
9627.80
5689.00
17067.00
14791.40
14791.40
2822.00
8466.00
7337.20
7337.20
5557.00
16671.00
14448.20
14448.20
4603.00
13809.00
11967.80
11967.80
2358.00
7074.00
6130.80
6130.80
3451.00
10353.00
8972.60
8972.60
5733.00
17199.00
14905.80
14905.80
4363.00
13089.00
11343.80
11343.80
3823.00
11469.00
9939.80
9939.80
3574.00
10722.00
9292.40
9292.40
4279.00
12837.00
11125.40
11125.40
4747.00
14241.00
12342.20
12342.20
4913.00
14739.00
12773.80
12773.80
4750.00
14250.00
12350.00
12350.00
4542.00
13626.00
11809.20
11809.20
390.00
1170.00
1014.00
1014.00
784.00
2352.00
2038.40
2038.40
1294.00
3882.00
3364.40
3364.40
914.00
2742.00
2376.40
2376.40
1857.00
5571.00
4828.20
4828.20
2655.00
7965.00
6903.00
6903.00
783.00
2349.00
2035.80
2035.80
6820.00
20460.00
17732.00
17732.00
7335.00
22005.00
19071.00
19071.00
7335.00
22005.00
19071.00
19071.00
2332.00
6996.00
6063.20
6063.20
1051.00
3153.00
2732.60
2732.60
3414.00
10242.00
8876.40
8876.40
4302.00
12906.00
11185.20
11185.20
4325.00
12975.00
11245.00
11245.00
4309.00
12927.00
11203.40
11203.40
3832.00
11496.00
9963.20
9963.20
4824.00
14472.00
12542.40
12542.40
4398.00
13194.00
11434.80
11434.80
5337.00
16011.00
13876.20
13876.20
3795.00
11385.00
9867.00
9867.00
6782.00
20346.00
17633.20
17633.20
8454.00
25362.00
21980.40
21980.40
6927.00
20781.00
18010.20
18010.20
10035.00
30105.00
26091.00
26091.00
7307.00
21921.00
18998.20
18998.20
8634.00
25902.00
22448.40
22448.40
5642.00
16926.00
14669.20
14669.20
6922.00
20766.00
17997.20
17997.20
6376.00
19128.00
16577.60
16577.60
7206.00
21618.00
18735.60
18735.60
5364.00
16092.00
13946.40
13946.40
6287.00
18861.00
16346.20
16346.20
4268.00
12804.00
11096.80
11096.80
5103.00
15309.00
13267.80
13267.80
4816.00
14448.00
12521.60
12521.60
5405.00
16215.00
14053.00
14053.00
3644.00
10932.00
9474.40
9474.40
6480.00
19440.00
16848.00
16848.00
3912.00
11736.00
10171.20
10171.20
3024.00
9072.00
7862.40
7862.40
6537.00
19611.00
16996.20
16996.20
2873.00
8619.00
7469.80
7469.80
3587.00
10761.00
9326.20
9326.20
2956.00
8868.00
7685.60
7685.60
2767.00
8301.00
7194.20
7194.20
5175.00
15525.00
13455.00
13455.00
7687.00
23061.00
19986.20
19986.20
5441.00
16323.00
14146.60
14146.60
3189.00
9567.00
8291.40
8291.40
4481.00
13443.00
11650.60
11650.60
3739.00
11217.00
9721.40
9721.40
5493.00
16479.00
14281.80
14281.80
5526.00
16578.00
14367.60
14367.60
6435.00
19305.00
16731.00
16731.00
3899.00
11697.00
10137.40
10137.40
4033.00
12099.00
10485.80
10485.80
3309.00
9927.00
8603.40
8603.40
5205.00
15615.00
13533.00
13533.00
5410.00
16230.00
14066.00
14066.00
6155.00
18465.00
16003.00
16003.00
3598.00
10794.00
9354.80
9354.80
4044.00
12132.00
10514.40
10514.40
4343.00
13029.00
11291.80
11291.80
4803.00
14409.00
12487.80
12487.80
4958.00
14874.00
12890.80
12890.80
4787.00
14361.00
12446.20
12446.20
1883.00
5649.00
4895.80
4895.80
5788.00
17364.00
15048.80
15048.80
3434.00
10302.00
8928.40
8928.40
5637.00
16911.00
14656.20
14656.20
5257.00
15771.00
13668.20
13668.20
4963.00
14889.00
12903.80
12903.80
4015.00
12045.00
10439.00
10439.00
5889.00
17667.00
15311.40
15311.40
6599.00
19797.00
17157.40
17157.40
3175.00
9525.00
8255.00
8255.00
3788.00
11364.00
9848.80
9848.80
613.00
1839.00
1593.80
1593.80
571.00
1713.00
1484.60
1484.60
1961.00
5883.00
5098.60
5098.60
1371.00
4113.00
3564.60
3564.60
1876.00
5628.00
4877.60
4877.60
1203.00
3609.00
3127.80
3127.80
3002.00
9006.00
7805.20
7805.20
2085.00
6255.00
5421.00
5421.00
2768.00
8304.00
7196.80
7196.80
1757.00
5271.00
4568.20
4568.20
1236.00
3708.00
3213.60
3213.60
6091.00
18273.00
15836.60
15836.60
5120.00
15360.00
13312.00
13312.00
5468.00
16404.00
14216.80
14216.80
5693.00
17079.00
14801.80
14801.80
4761.00
14283.00
12378.60
12378.60
4921.00
14763.00
12794.60
12794.60
4670.00
14010.00
12142.00
12142.00
5141.00
15423.00
13366.60
13366.60
4723.00
14169.00
12279.80
12279.80
4421.00
13263.00
11494.60
11494.60
5300.00
15900.00
13780.00
13780.00
4722.00
14166.00
12277.20
12277.20
4926.00
14778.00
12807.60
12807.60
4419.00
13257.00
11489.40
11489.40
6185.00
18555.00
16081.00
16081.00
7818.00
23454.00
20326.80
20326.80
6477.00
19431.00
16840.20
16840.20
6595.00
19785.00
17147.00
17147.00
6542.00
19626.00
17009.20
17009.20
8929.00
26787.00
23215.40
23215.40
9984.00
29952.00
25958.40
25958.40
8491.00
25473.00
22076.60
22076.60
9936.00
29808.00
25833.60
25833.60
4475.00
13425.00
11635.00
11635.00
5569.00
16707.00
14479.40
14479.40
5971.00
17913.00
15524.60
15524.60
5423.00
16269.00
14099.80
14099.80
4783.00
14349.00
12435.80
12435.80
6597.00
19791.00
17152.20
17152.20
5117.00
15351.00
13304.20
13304.20
5101.00
15303.00
13262.60
13262.60
6493.00
19479.00
16881.80
16881.80
5111.00
15333.00
13288.60
13288.60
5156.00
15468.00
13405.60
13405.60
1324.00
3972.00
3442.40
3442.40
5615.00
16845.00
14599.00
14599.00
6519.00
19557.00
16949.40
16949.40
5348.00
16044.00
13904.80
13904.80
972.00
2916.00
2527.20
2527.20
5682.00
17046.00
14773.20
14773.20
4543.00
13629.00
11811.80
11811.80
3380.00
10140.00
8788.00
8788.00
4686.00
14058.00
12183.60
12183.60
4259.00
12777.00
11073.40
11073.40
5661.00
16983.00
14718.60
14718.60
5965.00
17895.00
15509.00
15509.00
7131.00
21393.00
18540.60
18540.60
6263.00
18789.00
16283.80
16283.80
6930.00
20790.00
18018.00
18018.00
6256.00
18768.00
16265.60
16265.60
6851.00
20553.00
17812.60
17812.60
6660.00
19980.00
17316.00
17316.00
6804.00
20412.00
17690.40
17690.40
4302.00
12906.00
11185.20
11185.20
4130.00
12390.00
10738.00
10738.00
6631.00
19893.00
17240.60
17240.60
6034.00
18102.00
15688.40
15688.40
4142.00
12426.00
10769.20
10769.20
5035.00
15105.00
13091.00
13091.00
5318.00
15954.00
13826.80
13826.80
4191.00
12573.00
10896.60
10896.60
4206.00
12618.00
10935.60
10935.60
4827.00
14481.00
12550.20
12550.20
4542.00
13626.00
11809.20
11809.20
4913.00
14739.00
12773.80
12773.80
4325.00
12975.00
11245.00
11245.00
308.00
924.00
800.80
800.80
1367.00
4101.00
3554.20
3554.20
1585.00
4755.00
4121.00
4121.00
772.00
2316.00
2007.20
2007.20
636.00
1908.00
1653.60
1653.60
3655.00
10965.00
9503.00
9503.00
3225.00
9675.00
8385.00
8385.00
3943.00
11829.00
10251.80
10251.80
3963.00
11889.00
10303.80
10303.80
574.00
1722.00
1492.40
1492.40
591.00
1773.00
1536.60
1536.60
2135.00
6405.00
5551.00
5551.00
1727.00
5181.00
4490.20
4490.20
1939.00
5817.00
5041.40
5041.40
1465.00
4395.00
3809.00
3809.00
1868.00
5604.00
4856.80
4856.80
7513.00
22539.00
19533.80
19533.80
2443.00
7329.00
6351.80
6351.80
1557.00
4671.00
4048.20
4048.20
5371.00
16113.00
13964.60
13964.60
2298.00
6894.00
5974.80
5974.80
3654.00
10962.00
9500.40
9500.40
3588.00
10764.00
9328.80
9328.80
3957.00
11871.00
10288.20
10288.20
4687.00
14061.00
12186.20
12186.20
4801.00
14403.00
12482.60
12482.60
1934.00
5802.00
5028.40
5028.40
2170.00
6510.00
5642.00
5642.00
6502.00
19506.00
16905.20
16905.20
7435.00
22305.00
19331.00
19331.00
54.00
162.00
140.40
140.40
391.00
1173.00
1016.60
1016.60
270.00
810.00
702.00
702.00
686.00
2058.00
1783.60
1783.60
891.00
2673.00
2316.60
2316.60
998.00
2994.00
2594.80
2594.80
733.00
2199.00
1905.80
1905.80
838.00
2514.00
2178.80
2178.80
969.00
2907.00
2519.40
2519.40
904.00
2712.00
2350.40
2350.40
572.00
1716.00
1487.20
1487.20
587.00
1761.00
1526.20
1526.20
688.00
2064.00
1788.80
1788.80
279.00
837.00
725.40
725.40
713.00
2139.00
1853.80
1853.80
878.00
2634.00
2282.80
2282.80
1367.00
4101.00
3554.20
3554.20
1553.00
4659.00
4037.80
4037.80
1853.00
5559.00
4817.80
4817.80
294.00
882.00
764.40
764.40
1373.00
4119.00
3569.80
3569.80
1534.00
4602.00
3988.40
3988.40
1828.00
5484.00
4752.80
4752.80
287.00
861.00
746.20
746.20
2339.00
7017.00
6081.40
6081.40
1456.00
4368.00
3785.60
3785.60
1100.00
3300.00
2860.00
2860.00
0.00
0.00
0.00
0.00
62.00
186.00
161.20
161.20
60.00
180.00
156.00
156.00
39.00
117.00
101.40
101.40
45.00
135.00
117.00
117.00
11.00
33.00
28.60
28.60
15.00
45.00
39.00
39.00
166.00
498.00
431.60
431.60
147.00
441.00
382.20
382.20
111.00
333.00
288.60
288.60
216.00
648.00
561.60
561.60
418.00
1254.00
1086.80
1086.80
417.00
1251.00
1084.20
1084.20
1345.00
4035.00
3497.00
3497.00
750.00
2250.00
1950.00
1950.00
750.00
2250.00
1950.00
1950.00
319.00
957.00
829.40
829.40
383.00
1149.00
995.80
995.80
2046.00
6138.00
5319.60
5319.60
854.00
2562.00
2220.40
2220.40
2018.00
6054.00
5246.80
5246.80
874.00
2622.00
2272.40
2272.40
1323.00
3969.00
3439.80
3439.80
657.00
1971.00
1708.20
1708.20
227.00
681.00
590.20
590.20
353.00
1059.00
917.80
917.80
337.00
1011.00
876.20
876.20
373.00
1119.00
969.80
969.80
527.00
1581.00
1370.20
1370.20
536.00
1608.00
1393.60
1393.60
399.00
1197.00
1037.40
1037.40
568.00
1704.00
1476.80
1476.80
581.00
1743.00
1510.60
1510.60
489.00
1467.00
1271.40
1271.40
1831.00
5493.00
4760.60
4760.60
1568.00
4704.00
4076.80
4076.80
2059.00
6177.00
5353.40
5353.40
2012.00
6036.00
5231.20
5231.20
2141.00
6423.00
5566.60
5566.60
1999.00
5997.00
5197.40
5197.40
2158.00
6474.00
5610.80
5610.80
534.00
1602.00
1388.40
1388.40
512.00
1536.00
1331.20
1331.20
1656.00
4968.00
4305.60
4305.60
1819.00
5457.00
4729.40
4729.40
201.00
603.00
522.60
522.60
820.00
2460.00
2132.00
2132.00
1135.00
3405.00
2951.00
2951.00
377.00
1131.00
980.20
980.20
1103.00
3309.00
2867.80
2867.80
1731.00
5193.00
4500.60
4500.60
1892.00
5676.00
4919.20
4919.20
369.00
1107.00
959.40
959.40
1569.00
4707.00
4079.40
4079.40
510.00
1530.00
1326.00
1326.00
755.00
2265.00
1963.00
1963.00
76.00
228.00
197.60
197.60
85.00
255.00
221.00
221.00
104.00
312.00
270.40
270.40
1031.00
3093.00
2680.60
2680.60
249.00
747.00
647.40
647.40
292.00
876.00
759.20
759.20
203.00
609.00
527.80
527.80
74.00
222.00
192.40
192.40
188.00
564.00
488.80
488.80
395.00
1185.00
1027.00
1027.00
477.00
1431.00
1240.20
1240.20
295.00
885.00
767.00
767.00
214.00
642.00
556.40
556.40
592.00
1776.00
1539.20
1539.20
790.00
2370.00
2054.00
2054.00
565.00
1695.00
1469.00
1469.00
2543.00
7629.00
6611.80
6611.80
3035.00
9105.00
7891.00
7891.00
3069.00
9207.00
7979.40
7979.40
2343.00
7029.00
6091.80
6091.80
1407.00
4221.00
3658.20
3658.20
4921.00
14763.00
12794.60
12794.60
2549.00
7647.00
6627.40
6627.40
2499.00
7497.00
6497.40
6497.40
1738.00
5214.00
4518.80
4518.80
2208.00
6624.00
5740.80
5740.80
2497.00
7491.00
6492.20
6492.20
1853.00
5559.00
4817.80
4817.80
4393.00
13179.00
11421.80
11421.80
482.00
1446.00
1253.20
1253.20
561.00
1683.00
1458.60
1458.60
1684.00
5052.00
4378.40
4378.40
5447.00
16341.00
14162.20
14162.20
5653.00
16959.00
14697.80
14697.80
5049.00
15147.00
13127.40
13127.40
5652.00
16956.00
14695.20
14695.20
6075.00
18225.00
15795.00
15795.00
3033.00
9099.00
7885.80
7885.80
1426.00
4278.00
3707.60
3707.60
2573.00
7719.00
6689.80
6689.80
954.00
2862.00
2480.40
2480.40
1438.00
4314.00
3738.80
3738.80
2314.00
6942.00
6016.40
6016.40
1646.00
4938.00
4279.60
4279.60
1033.00
3099.00
2685.80
2685.80
804.00
2412.00
2090.40
2090.40
1002.00
3006.00
2605.20
2605.20
1195.00
3585.00
3107.00
3107.00
1459.00
4377.00
3793.40
3793.40
3268.00
9804.00
8496.80
8496.80
2415.00
7245.00
6279.00
6279.00
1204.00
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3130.40
1626.00
4878.00
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414.00
1242.00
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2927.00
8781.00
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3993.00
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806.00
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4477.20
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6960.00
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5733.00
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2803.00
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2105.00
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761.00
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1978.60
1978.60
1251.00
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1480.00
4440.00
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4752.80
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2542.80
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538.00
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1398.80
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956.80
956.80
290.00
870.00
754.00
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44.00
132.00
114.40
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287.00
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261.00
783.00
678.60
678.60
171.00
513.00
444.60
444.60
44.00
132.00
114.40
114.40
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441.00
382.20
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444.60
335.00
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871.00
871.00
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967.20
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3286.40
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348.00
1044.00
904.80
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665.00
1995.00
1729.00
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1667.00
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4905.00
4251.00
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145.00
435.00
377.00
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4427.80
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828.00
2484.00
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579.00
1737.00
1505.40
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381.00
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990.60
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1150.00
3450.00
2990.00
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429.00
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682.00
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625.00
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1266.00
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3291.60
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1514.00
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1687.00
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4950.40
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1399.00
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1678.00
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1475.00
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3835.00
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1042.60
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476.00
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1237.60
1237.60
862.00
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173.00
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449.80
449.80
368.00
1104.00
956.80
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1115.40
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450.00
1350.00
1170.00
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454.00
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354.00
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920.40
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529.00
1587.00
1375.40
1375.40
275.00
825.00
715.00
715.00
341.00
1023.00
886.60
886.60
2359.00
7077.00
6133.40
6133.40
1723.00
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4479.80
4479.80
602.00
1806.00
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3940.00
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6334.00
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2767.00
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2170.00
6510.00
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5501.60
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3949.00
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3393.00
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8821.80
8821.80
3335.00
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1370.20
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744.00
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1934.40
1934.40
550.00
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801.00
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532.00
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477.00
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792.00
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797.00
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1379.00
4137.00
3585.40
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0.00
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0.00
0.00
533.00
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1385.80
1385.80
378.00
1134.00
982.80
982.80
4324.00
12972.00
11242.40
11242.40
657.00
1971.00
1708.20
1708.20
4208.00
12624.00
10940.80
10940.80
3050.00
9150.00
7930.00
7930.00
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25341.00
21962.20
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12460.00
37380.00
32396.00
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11159.00
33477.00
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11969.00
35907.00
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0.00
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17789.00
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15014.00
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39036.40
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12957.00
38871.00
33688.20
33688.20
13996.00
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36389.60
36389.60
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1205.00
3615.00
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1404.00
4212.00
3650.40
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4976.00
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12937.60
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6816.00
20448.00
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10951.00
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28472.60
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5247.00
15741.00
13642.20
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4494.00
13482.00
11684.40
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4560.00
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13564.20
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5055.00
15165.00
13143.00
13143.00
2788.00
8364.00
7248.80
7248.80
0.00
0.00
0.00
0.00
7829.00
23487.00
20355.40
20355.40
4870.00
14610.00
12662.00
12662.00
4957.00
14871.00
12888.20
12888.20
4597.00
13791.00
11952.20
11952.20
3150.00
9450.00
8190.00
8190.00
1214.00
3642.00
3156.40
3156.40
350.00
1050.00
910.00
910.00
135.00
405.00
351.00
351.00
1667.00
5001.00
4334.20
4334.20
2062.00
6186.00
5361.20
5361.20
467.00
1401.00
1214.20
1214.20
1931.00
5793.00
5020.60
5020.60
604.00
1812.00
1570.40
1570.40
1127.00
3381.00
2930.20
2930.20
1133.00
3399.00
2945.80
2945.80
1779.00
5337.00
4625.40
4625.40
1335.00
4005.00
3471.00
3471.00
1515.00
4545.00
3939.00
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980.00
2940.00
2548.00
2548.00
1073.00
3219.00
2789.80
2789.80
2715.00
8145.00
7059.00
7059.00
2742.00
8226.00
7129.20
7129.20
3135.00
9405.00
8151.00
8151.00
2809.00
8427.00
7303.40
7303.40
0.00
0.00
0.00
0.00
3932.00
11796.00
10223.20
10223.20
3564.00
10692.00
9266.40
9266.40
4555.00
13665.00
11843.00
11843.00
4605.00
13815.00
11973.00
11973.00
5010.00
15030.00
13026.00
13026.00
1962.00
5886.00
5101.20
5101.20
3807.00
11421.00
9898.20
9898.20
6295.00
18885.00
16367.00
16367.00
5662.00
16986.00
14721.20
14721.20
7267.00
21801.00
18894.20
18894.20
4823.00
14469.00
12539.80
12539.80
4152.00
12456.00
10795.20
10795.20
4912.00
14736.00
12771.20
12771.20
4758.00
14274.00
12370.80
12370.80
5357.00
16071.00
13928.20
13928.20
8202.00
24606.00
21325.20
21325.20
11061.00
33183.00
28758.60
28758.60
8994.00
26982.00
23384.40
23384.40
11812.00
35436.00
30711.20
30711.20
5748.00
17244.00
14944.80
14944.80
3654.00
10962.00
9500.40
9500.40
5537.00
16611.00
14396.20
14396.20
4945.00
14835.00
12857.00
12857.00
0.00
0.00
0.00
0.00
6704.00
20112.00
17430.40
17430.40
8405.00
25215.00
21853.00
21853.00
4269.00
12807.00
11099.40
11099.40
3218.00
9654.00
8366.80
8366.80
1285.00
3855.00
3341.00
3341.00
10390.00
31170.00
27014.00
27014.00
4021.00
12063.00
10454.60
10454.60
5677.00
17031.00
14760.20
14760.20
5933.00
17799.00
15425.80
15425.80
6816.00
20448.00
17721.60
17721.60
4529.00
13587.00
11775.40
11775.40
11265.00
33795.00
29289.00
29289.00
10493.00
31479.00
27281.80
27281.80
11253.00
33759.00
29257.80
29257.80
10539.00
31617.00
27401.40
27401.40
6576.00
19728.00
17097.60
17097.60
9777.00
29331.00
25420.20
25420.20
376.00
1128.00
977.60
977.60
4167.00
12501.00
10834.20
10834.20
3934.00
11802.00
10228.40
10228.40
1095.00
3285.00
2847.00
2847.00
3969.00
11907.00
10319.40
10319.40
4693.00
14079.00
12201.80
12201.80
4885.00
14655.00
12701.00
12701.00
6518.00
19554.00
16946.80
16946.80
6046.00
18138.00
15719.60
15719.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
861.00
2583.00
2238.60
2238.60
9223.00
27669.00
23979.80
23979.80
4591.00
13773.00
11936.60
11936.60
0.00
0.00
0.00
0.00
2792.00
8376.00
7259.20
7259.20
3801.00
11403.00
9882.60
9882.60
3425.00
10275.00
8905.00
8905.00
5778.00
17334.00
15022.80
15022.80
923.00
2769.00
2399.80
2399.80
3636.00
10908.00
9453.60
9453.60
1093.00
3279.00
2841.80
2841.80
3990.00
11970.00
10374.00
10374.00
1009.00
3027.00
2623.40
2623.40
2698.00
8094.00
7014.80
7014.80
366.00
1098.00
951.60
951.60
373.00
1119.00
969.80
969.80
379.00
1137.00
985.40
985.40
4336.00
13008.00
11273.60
11273.60
5524.00
16572.00
14362.40
14362.40
6341.00
19023.00
16486.60
16486.60
8045.00
24135.00
20917.00
20917.00
3521.00
10563.00
9154.60
9154.60
2113.00
6339.00
5493.80
5493.80
2857.00
8571.00
7428.20
7428.20
1184.00
3552.00
3078.40
3078.40
1257.00
3771.00
3268.20
3268.20
1345.00
4035.00
3497.00
3497.00
2345.00
7035.00
6097.00
6097.00
1432.00
4296.00
3723.20
3723.20
1535.00
4605.00
3991.00
3991.00
693.00
2079.00
1801.80
1801.80
474.00
1422.00
1232.40
1232.40
0.00
0.00
0.00
0.00
396.00
1188.00
1029.60
1029.60
3108.00
9324.00
8080.80
8080.80
709.00
2127.00
1843.40
1843.40
296.00
888.00
769.60
769.60
842.00
2526.00
2189.20
2189.20
1593.00
4779.00
4141.80
4141.80
857.00
2571.00
2228.20
2228.20
1390.00
4170.00
3614.00
3614.00
401.00
1203.00
1042.60
1042.60
214.00
642.00
556.40
556.40
2732.00
8196.00
7103.20
7103.20
2304.00
6912.00
5990.40
5990.40
162.00
486.00
421.20
421.20
1565.00
4695.00
4069.00
4069.00
1664.00
4992.00
4326.40
4326.40
437.00
1311.00
1136.20
1136.20
672.00
2016.00
1747.20
1747.20
1249.00
3747.00
3247.40
3247.40
1425.00
4275.00
3705.00
3705.00
1196.00
3588.00
3109.60
3109.60
908.00
2724.00
2360.80
2360.80
373.00
1119.00
969.80
969.80
512.00
1536.00
1331.20
1331.20
786.00
2358.00
2043.60
2043.60
270.00
810.00
702.00
702.00
169.00
507.00
439.40
439.40
2870.00
8610.00
7462.00
7462.00
3463.00
10389.00
9003.80
9003.80
1479.00
4437.00
3845.40
3845.40
2240.00
6720.00
5824.00
5824.00
1342.00
4026.00
3489.20
3489.20
2185.00
6555.00
5681.00
5681.00
1878.00
5634.00
4882.80
4882.80
2307.00
6921.00
5998.20
5998.20
2285.00
6855.00
5941.00
5941.00
2771.00
8313.00
7204.60
7204.60
2069.00
6207.00
5379.40
5379.40
2453.00
7359.00
6377.80
6377.80
2083.00
6249.00
5415.80
5415.80
2284.00
6852.00
5938.40
5938.40
2161.00
6483.00
5618.60
5618.60
2622.00
7866.00
6817.20
6817.20
2671.00
8013.00
6944.60
6944.60
3376.00
10128.00
8777.60
8777.60
2786.00
8358.00
7243.60
7243.60
3413.00
10239.00
8873.80
8873.80
978.00
2934.00
2542.80
2542.80
1497.00
4491.00
3892.20
3892.20
1861.00
5583.00
4838.60
4838.60
1192.00
3576.00
3099.20
3099.20
1738.00
5214.00
4518.80
4518.80
1600.00
4800.00
4160.00
4160.00
1893.00
5679.00
4921.80
4921.80
2069.00
6207.00
5379.40
5379.40
2641.00
7923.00
6866.60
6866.60
17990.00
53970.00
46774.00
46774.00
4112.00
12336.00
10691.20
10691.20
2485.00
7455.00
6461.00
6461.00
1949.00
5847.00
5067.40
5067.40
1542.00
4626.00
4009.20
4009.20
2011.00
6033.00
5228.60
5228.60
2666.00
7998.00
6931.60
6931.60
3343.00
10029.00
8691.80
8691.80
3064.00
9192.00
7966.40
7966.40
3688.00
11064.00
9588.80
9588.80
3078.00
9234.00
8002.80
8002.80
4425.00
13275.00
11505.00
11505.00
2950.00
8850.00
7670.00
7670.00
5225.00
15675.00
13585.00
13585.00
1289.00
3867.00
3351.40
3351.40
0.00
0.00
0.00
0.00
2659.00
7977.00
6913.40
6913.40
3806.00
11418.00
9895.60
9895.60
921.00
2763.00
2394.60
2394.60
3304.00
9912.00
8590.40
8590.40
3326.00
9978.00
8647.60
8647.60
4074.00
12222.00
10592.40
10592.40
4324.00
12972.00
11242.40
11242.40
4240.00
12720.00
11024.00
11024.00
5217.00
15651.00
13564.20
13564.20
3107.00
9321.00
8078.20
8078.20
4571.00
13713.00
11884.60
11884.60
3460.00
10380.00
8996.00
8996.00
3390.00
10170.00
8814.00
8814.00
3726.00
11178.00
9687.60
9687.60
3697.00
11091.00
9612.20
9612.20
4011.00
12033.00
10428.60
10428.60
515.00
1545.00
1339.00
1339.00
2716.00
8148.00
7061.60
7061.60
3747.00
11241.00
9742.20
9742.20
4296.00
12888.00
11169.60
11169.60
4593.00
13779.00
11941.80
11941.80
4664.00
13992.00
12126.40
12126.40
5243.00
15729.00
13631.80
13631.80
4739.00
14217.00
12321.40
12321.40
4352.00
13056.00
11315.20
11315.20
3427.00
10281.00
8910.20
8910.20
3418.00
10254.00
8886.80
8886.80
0.00
0.00
0.00
0.00
5083.00
15249.00
13215.80
13215.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
788.00
2364.00
2048.80
2048.80
688.00
2064.00
1788.80
1788.80
632.00
1896.00
1643.20
1643.20
3418.00
10254.00
8886.80
8886.80
9293.00
27879.00
24161.80
24161.80
10433.00
31299.00
27125.80
27125.80
4335.00
13005.00
11271.00
11271.00
7220.00
21660.00
18772.00
18772.00
1517.00
4551.00
3944.20
3944.20
1374.00
4122.00
3572.40
3572.40
1281.00
3843.00
3330.60
3330.60
968.00
2904.00
2516.80
2516.80
548.00
1644.00
1424.80
1424.80
302.00
906.00
785.20
785.20
347.00
1041.00
902.20
902.20
359.00
1077.00
933.40
933.40
637.00
1911.00
1656.20
1656.20
775.00
2325.00
2015.00
2015.00
236.00
708.00
613.60
613.60
643.00
1929.00
1671.80
1671.80
412.00
1236.00
1071.20
1071.20
403.00
1209.00
1047.80
1047.80
4146.00
12438.00
10779.60
10779.60
4993.00
14979.00
12981.80
12981.80
4596.00
13788.00
11949.60
11949.60
3703.00
11109.00
9627.80
9627.80
5328.00
15984.00
13852.80
13852.80
5158.00
15474.00
13410.80
13410.80
4102.00
12306.00
10665.20
10665.20
3297.00
9891.00
8572.20
8572.20
4180.00
12540.00
10868.00
10868.00
5332.00
15996.00
13863.20
13863.20
4471.00
13413.00
11624.60
11624.60
4816.00
14448.00
12521.60
12521.60
4304.00
12912.00
11190.40
11190.40
5786.00
17358.00
15043.60
15043.60
4835.00
14505.00
12571.00
12571.00
0.00
0.00
0.00
0.00
1058.00
3174.00
2750.80
2750.80
1134.00
3402.00
2948.40
2948.40
1228.00
3684.00
3192.80
3192.80
1244.00
3732.00
3234.40
3234.40
1421.00
4263.00
3694.60
3694.60
2084.00
6252.00
5418.40
5418.40
1766.00
5298.00
4591.60
4591.60
1915.00
5745.00
4979.00
4979.00
2036.00
6108.00
5293.60
5293.60
2572.00
7716.00
6687.20
6687.20
2029.00
6087.00
5275.40
5275.40
2189.00
6567.00
5691.40
5691.40
2413.00
7239.00
6273.80
6273.80
1986.00
5958.00
5163.60
5163.60
2663.00
7989.00
6923.80
6923.80
3356.00
10068.00
8725.60
8725.60
3509.00
10527.00
9123.40
9123.40
3378.00
10134.00
8782.80
8782.80
3230.00
9690.00
8398.00
8398.00
3190.00
9570.00
8294.00
8294.00
3706.00
11118.00
9635.60
9635.60
4089.00
12267.00
10631.40
10631.40
272.00
816.00
707.20
707.20
345.00
1035.00
897.00
897.00
280.00
840.00
728.00
728.00
246.00
738.00
639.60
639.60
3304.00
9912.00
8590.40
8590.40
4291.00
12873.00
11156.60
11156.60
3837.00
11511.00
9976.20
9976.20
4172.00
12516.00
10847.20
10847.20
1799.00
5397.00
4677.40
4677.40
2487.00
7461.00
6466.20
6466.20
4356.00
13068.00
11325.60
11325.60
4123.00
12369.00
10719.80
10719.80
4057.00
12171.00
10548.20
10548.20
4123.00
12369.00
10719.80
10719.80
3968.00
11904.00
10316.80
10316.80
4120.00
12360.00
10712.00
10712.00
4265.00
12795.00
11089.00
11089.00
4339.00
13017.00
11281.40
11281.40
3315.00
9945.00
8619.00
8619.00
4781.00
14343.00
12430.60
12430.60
4369.00
13107.00
11359.40
11359.40
4738.00
14214.00
12318.80
12318.80
5946.00
17838.00
15459.60
15459.60
6457.00
19371.00
16788.20
16788.20
4393.00
13179.00
11421.80
11421.80
4459.00
13377.00
11593.40
11593.40
3374.00
10122.00
8772.40
8772.40
3043.00
9129.00
7911.80
7911.80
3146.00
9438.00
8179.60
8179.60
4224.00
12672.00
10982.40
10982.40
3167.00
9501.00
8234.20
8234.20
3482.00
10446.00
9053.20
9053.20
4952.00
14856.00
12875.20
12875.20
4565.00
13695.00
11869.00
11869.00
0.00
0.00
0.00
0.00
1102.00
3306.00
2865.20
2865.20
1216.00
3648.00
3161.60
3161.60
1308.00
3924.00
3400.80
3400.80
1273.00
3819.00
3309.80
3309.80
1140.00
3420.00
2964.00
2964.00
1332.00
3996.00
3463.20
3463.20
1289.00
3867.00
3351.40
3351.40
1700.00
5100.00
4420.00
4420.00
1677.00
5031.00
4360.20
4360.20
1279.00
3837.00
3325.40
3325.40
1664.00
4992.00
4326.40
4326.40
1669.00
5007.00
4339.40
4339.40
1022.00
3066.00
2657.20
2657.20
1758.00
5274.00
4570.80
4570.80
1680.00
5040.00
4368.00
4368.00
2068.00
6204.00
5376.80
5376.80
2058.00
6174.00
5350.80
5350.80
1448.00
4344.00
3764.80
3764.80
154.00
462.00
400.40
400.40
296.00
888.00
769.60
769.60
806.00
2418.00
2095.60
2095.60
2442.00
7326.00
6349.20
6349.20
2113.00
6339.00
5493.80
5493.80
3072.00
9216.00
7987.20
7987.20
2842.00
8526.00
7389.20
7389.20
2778.00
8334.00
7222.80
7222.80
3477.00
10431.00
9040.20
9040.20
4563.00
13689.00
11863.80
11863.80
4647.00
13941.00
12082.20
12082.20
5326.00
15978.00
13847.60
13847.60
6528.00
19584.00
16972.80
16972.80
6789.00
20367.00
17651.40
17651.40
7563.00
22689.00
19663.80
19663.80
6934.00
20802.00
18028.40
18028.40
7859.00
23577.00
20433.40
20433.40
8437.00
25311.00
21936.20
21936.20
8248.00
24744.00
21444.80
21444.80
244.00
732.00
634.40
634.40
135.00
405.00
351.00
351.00
267.00
801.00
694.20
694.20
215.00
645.00
559.00
559.00
139.00
417.00
361.40
361.40
165.00
495.00
429.00
429.00
337.00
1011.00
876.20
876.20
274.00
822.00
712.40
712.40
382.00
1146.00
993.20
993.20
743.00
2229.00
1931.80
1931.80
287.00
861.00
746.20
746.20
641.00
1923.00
1666.60
1666.60
922.00
2766.00
2397.20
2397.20
1099.00
3297.00
2857.40
2857.40
1088.00
3264.00
2828.80
2828.80
1351.00
4053.00
3512.60
3512.60
141.00
423.00
366.60
366.60
176.00
528.00
457.60
457.60
677.00
2031.00
1760.20
1760.20
750.00
2250.00
1950.00
1950.00
752.00
2256.00
1955.20
1955.20
381.00
1143.00
990.60
990.60
62.00
186.00
161.20
161.20
3743.00
11229.00
9731.80
9731.80
3867.00
11601.00
10054.20
10054.20
2392.00
7176.00
6219.20
6219.20
2855.00
8565.00
7423.00
7423.00
2119.00
6357.00
5509.40
5509.40
2695.00
8085.00
7007.00
7007.00
3219.00
9657.00
8369.40
8369.40
1684.00
5052.00
4378.40
4378.40
2971.00
8913.00
7724.60
7724.60
2717.00
8151.00
7064.20
7064.20
3916.00
11748.00
10181.60
10181.60
5878.00
17634.00
15282.80
15282.80
4979.00
14937.00
12945.40
12945.40
2541.00
7623.00
6606.60
6606.60
2748.00
8244.00
7144.80
7144.80
3119.00
9357.00
8109.40
8109.40
0.00
0.00
0.00
0.00
531.00
1593.00
1380.60
1380.60
1033.00
3099.00
2685.80
2685.80
728.00
2184.00
1892.80
1892.80
913.00
2739.00
2373.80
2373.80
913.00
2739.00
2373.80
2373.80
782.00
2346.00
2033.20
2033.20
1088.00
3264.00
2828.80
2828.80
934.00
2802.00
2428.40
2428.40
882.00
2646.00
2293.20
2293.20
1035.00
3105.00
2691.00
2691.00
1810.00
5430.00
4706.00
4706.00
872.00
2616.00
2267.20
2267.20
755.00
2265.00
1963.00
1963.00
911.00
2733.00
2368.60
2368.60
935.00
2805.00
2431.00
2431.00
1261.00
3783.00
3278.60
3278.60
954.00
2862.00
2480.40
2480.40
1172.00
3516.00
3047.20
3047.20
730.00
2190.00
1898.00
1898.00
1213.00
3639.00
3153.80
3153.80
725.00
2175.00
1885.00
1885.00
721.00
2163.00
1874.60
1874.60
876.00
2628.00
2277.60
2277.60
1023.00
3069.00
2659.80
2659.80
1050.00
3150.00
2730.00
2730.00
1002.00
3006.00
2605.20
2605.20
617.00
1851.00
1604.20
1604.20
1075.00
3225.00
2795.00
2795.00
1922.00
5766.00
4997.20
4997.20
1703.00
5109.00
4427.80
4427.80
885.00
2655.00
2301.00
2301.00
1152.00
3456.00
2995.20
2995.20
944.00
2832.00
2454.40
2454.40
1459.00
4377.00
3793.40
3793.40
797.00
2391.00
2072.20
2072.20
921.00
2763.00
2394.60
2394.60
1035.00
3105.00
2691.00
2691.00
1124.00
3372.00
2922.40
2922.40
1253.00
3759.00
3257.80
3257.80
1361.00
4083.00
3538.60
3538.60
1451.00
4353.00
3772.60
3772.60
1637.00
4911.00
4256.20
4256.20
1125.00
3375.00
2925.00
2925.00
1322.00
3966.00
3437.20
3437.20
1518.00
4554.00
3946.80
3946.80
1406.00
4218.00
3655.60
3655.60
1675.00
5025.00
4355.00
4355.00
1708.00
5124.00
4440.80
4440.80
960.00
2880.00
2496.00
2496.00
1667.00
5001.00
4334.20
4334.20
1732.00
5196.00
4503.20
4503.20
3021.00
9063.00
7854.60
7854.60
1585.00
4755.00
4121.00
4121.00
1041.00
3123.00
2706.60
2706.60
3549.00
10647.00
9227.40
9227.40
3789.00
11367.00
9851.40
9851.40
3395.00
10185.00
8827.00
8827.00
1566.00
4698.00
4071.60
4071.60
525.00
1575.00
1365.00
1365.00
1038.00
3114.00
2698.80
2698.80
348.00
1044.00
904.80
904.80
247.00
741.00
642.20
642.20
1395.00
4185.00
3627.00
3627.00
610.00
1830.00
1586.00
1586.00
1490.00
4470.00
3874.00
3874.00
2354.00
7062.00
6120.40
6120.40
509.00
1527.00
1323.40
1323.40
2767.00
8301.00
7194.20
7194.20
3315.00
9945.00
8619.00
8619.00
1619.00
4857.00
4209.40
4209.40
2179.00
6537.00
5665.40
5665.40
2252.00
6756.00
5855.20
5855.20
1507.00
4521.00
3918.20
3918.20
1554.00
4662.00
4040.40
4040.40
648.00
1944.00
1684.80
1684.80
666.00
1998.00
1731.60
1731.60
704.00
2112.00
1830.40
1830.40
934.00
2802.00
2428.40
2428.40
2866.00
8598.00
7451.60
7451.60
3117.00
9351.00
8104.20
8104.20
3499.00
10497.00
9097.40
9097.40
4041.00
12123.00
10506.60
10506.60
3004.00
9012.00
7810.40
7810.40
3346.00
10038.00
8699.60
8699.60
3482.00
10446.00
9053.20
9053.20
4125.00
12375.00
10725.00
10725.00
3152.00
9456.00
8195.20
8195.20
2788.00
8364.00
7248.80
7248.80
2831.00
8493.00
7360.60
7360.60
3127.00
9381.00
8130.20
8130.20
2287.00
6861.00
5946.20
5946.20
2885.00
8655.00
7501.00
7501.00
4575.00
13725.00
11895.00
11895.00
2180.00
6540.00
5668.00
5668.00
1448.00
4344.00
3764.80
3764.80
1624.00
4872.00
4222.40
4222.40
2691.00
8073.00
6996.60
6996.60
1730.00
5190.00
4498.00
4498.00
1727.00
5181.00
4490.20
4490.20
2246.00
6738.00
5839.60
5839.60
2837.00
8511.00
7376.20
7376.20
1977.00
5931.00
5140.20
5140.20
228.00
684.00
592.80
592.80
212.00
636.00
551.20
551.20
231.00
693.00
600.60
600.60
313.00
939.00
813.80
813.80
287.00
861.00
746.20
746.20
183.00
549.00
475.80
475.80
181.00
543.00
470.60
470.60
140.00
420.00
364.00
364.00
3122.00
9366.00
8117.20
8117.20
3413.00
10239.00
8873.80
8873.80
297.00
891.00
772.20
772.20
838.00
2514.00
2178.80
2178.80
0.00
0.00
0.00
0.00
385.00
1155.00
1001.00
1001.00
493.00
1479.00
1281.80
1281.80
1096.00
3288.00
2849.60
2849.60
379.00
1137.00
985.40
985.40
329.00
987.00
855.40
855.40
406.00
1218.00
1055.60
1055.60
350.00
1050.00
910.00
910.00
464.00
1392.00
1206.40
1206.40
627.00
1881.00
1630.20
1630.20
471.00
1413.00
1224.60
1224.60
758.00
2274.00
1970.80
1970.80
2223.00
6669.00
5779.80
5779.80
2857.00
8571.00
7428.20
7428.20
3347.00
10041.00
8702.20
8702.20
1503.00
4509.00
3907.80
3907.80
2252.00
6756.00
5855.20
5855.20
2907.00
8721.00
7558.20
7558.20
4265.00
12795.00
11089.00
11089.00
5414.00
16242.00
14076.40
14076.40
393.00
1179.00
1021.80
1021.80
571.00
1713.00
1484.60
1484.60
700.00
2100.00
1820.00
1820.00
709.00
2127.00
1843.40
1843.40
775.00
2325.00
2015.00
2015.00
681.00
2043.00
1770.60
1770.60
294.00
882.00
764.40
764.40
1890.00
5670.00
4914.00
4914.00
520.00
1560.00
1352.00
1352.00
283.00
849.00
735.80
735.80
415.00
1245.00
1079.00
1079.00
261.00
783.00
678.60
678.60
345.00
1035.00
897.00
897.00
429.00
1287.00
1115.40
1115.40
2287.00
6861.00
5946.20
5946.20
2674.00
8022.00
6952.40
6952.40
2643.00
7929.00
6871.80
6871.80
3024.00
9072.00
7862.40
7862.40
3691.00
11073.00
9596.60
9596.60
2586.00
7758.00
6723.60
6723.60
2787.00
8361.00
7246.20
7246.20
3459.00
10377.00
8993.40
8993.40
3378.00
10134.00
8782.80
8782.80
3353.00
10059.00
8717.80
8717.80
3622.00
10866.00
9417.20
9417.20
4402.00
13206.00
11445.20
11445.20
2024.00
6072.00
5262.40
5262.40
3505.00
10515.00
9113.00
9113.00
4429.00
13287.00
11515.40
11515.40
6262.00
18786.00
16281.20
16281.20
2570.00
7710.00
6682.00
6682.00
2849.00
8547.00
7407.40
7407.40
3410.00
10230.00
8866.00
8866.00
4592.00
13776.00
11939.20
11939.20
1884.00
5652.00
4898.40
4898.40
2322.00
6966.00
6037.20
6037.20
2890.00
8670.00
7514.00
7514.00
2604.00
7812.00
6770.40
6770.40
2821.00
8463.00
7334.60
7334.60
3067.00
9201.00
7974.20
7974.20
3665.00
10995.00
9529.00
9529.00
1876.00
5628.00
4877.60
4877.60
2527.00
7581.00
6570.20
6570.20
3208.00
9624.00
8340.80
8340.80
2513.00
7539.00
6533.80
6533.80
2279.00
6837.00
5925.40
5925.40
1476.00
4428.00
3837.60
3837.60
1961.00
5883.00
5098.60
5098.60
206.00
618.00
535.60
535.60
266.00
798.00
691.60
691.60
745.00
2235.00
1937.00
1937.00
1918.00
5754.00
4986.80
4986.80
1166.00
3498.00
3031.60
3031.60
2102.00
6306.00
5465.20
5465.20
1798.00
5394.00
4674.80
4674.80
2654.00
7962.00
6900.40
6900.40
1750.00
5250.00
4550.00
4550.00
2448.00
7344.00
6364.80
6364.80
1609.00
4827.00
4183.40
4183.40
1067.00
3201.00
2774.20
2774.20
1711.00
5133.00
4448.60
4448.60
2535.00
7605.00
6591.00
6591.00
1263.00
3789.00
3283.80
3283.80
1436.00
4308.00
3733.60
3733.60
2807.00
8421.00
7298.20
7298.20
2509.00
7527.00
6523.40
6523.40
2710.00
8130.00
7046.00
7046.00
0.00
0.00
0.00
0.00
761.00
2283.00
1978.60
1978.60
575.00
1725.00
1495.00
1495.00
1325.00
3975.00
3445.00
3445.00
1140.00
3420.00
2964.00
2964.00
1487.00
4461.00
3866.20
3866.20
2012.00
6036.00
5231.20
5231.20
1270.00
3810.00
3302.00
3302.00
2810.00
8430.00
7306.00
7306.00
3848.00
11544.00
10004.80
10004.80
302.00
906.00
785.20
785.20
1205.00
3615.00
3133.00
3133.00
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4726.80
1356.00
4068.00
3525.60
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592.00
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3888.00
3369.60
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2479.00
7437.00
6445.40
6445.40
1131.00
3393.00
2940.60
2940.60
1004.00
3012.00
2610.40
2610.40
671.00
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1744.60
1744.60
1773.00
5319.00
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4609.80
915.00
2745.00
2379.00
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1431.00
4293.00
3720.60
3720.60
1630.00
4890.00
4238.00
4238.00
1259.00
3777.00
3273.40
3273.40
1527.00
4581.00
3970.20
3970.20
1954.00
5862.00
5080.40
5080.40
1521.00
4563.00
3954.60
3954.60
0.00
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0.00
1497.00
4491.00
3892.20
3892.20
1922.00
5766.00
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2557.00
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6648.20
6648.20
1227.00
3681.00
3190.20
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564.00
1692.00
1466.40
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2850.00
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1304.00
3912.00
3390.40
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1605.00
4815.00
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6330.00
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3906.00
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17283.00
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6315.00
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16419.00
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3125.00
9375.00
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3380.00
10140.00
8788.00
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4789.00
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5128.00
15384.00
13332.80
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5867.00
17601.00
15254.20
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3122.00
9366.00
8117.20
8117.20
3920.00
11760.00
10192.00
10192.00
4772.00
14316.00
12407.20
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6229.00
18687.00
16195.40
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509.00
1527.00
1323.40
1323.40
2900.00
8700.00
7540.00
7540.00
2719.00
8157.00
7069.40
7069.40
359.00
1077.00
933.40
933.40
1603.00
4809.00
4167.80
4167.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
392.00
1176.00
1019.20
1019.20
333.00
999.00
865.80
865.80
669.00
2007.00
1739.40
1739.40
497.00
1491.00
1292.20
1292.20
173.00
519.00
449.80
449.80
415.00
1245.00
1079.00
1079.00
731.00
2193.00
1900.60
1900.60
224.00
672.00
582.40
582.40
108.00
324.00
280.80
280.80
1834.00
5502.00
4768.40
4768.40
2208.00
6624.00
5740.80
5740.80
3263.00
9789.00
8483.80
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4133.00
12399.00
10745.80
10745.80
4823.00
14469.00
12539.80
12539.80
4245.00
12735.00
11037.00
11037.00
4493.00
13479.00
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5281.00
15843.00
13730.60
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5190.00
15570.00
13494.00
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682.00
2046.00
1773.20
1773.20
1093.00
3279.00
2841.80
2841.80
881.00
2643.00
2290.60
2290.60
4209.00
12627.00
10943.40
10943.40
951.00
2853.00
2472.60
2472.60
314.00
942.00
816.40
816.40
423.00
1269.00
1099.80
1099.80
692.00
2076.00
1799.20
1799.20
1589.00
4767.00
4131.40
4131.40
303.00
909.00
787.80
787.80
616.00
1848.00
1601.60
1601.60
1142.00
3426.00
2969.20
2969.20
353.00
1059.00
917.80
917.80
624.00
1872.00
1622.40
1622.40
244.00
732.00
634.40
634.40
449.00
1347.00
1167.40
1167.40
1756.00
5268.00
4565.60
4565.60
5185.00
15555.00
13481.00
13481.00
5938.00
17814.00
15438.80
15438.80
3307.00
9921.00
8598.20
8598.20
5938.00
17814.00
15438.80
15438.80
5180.00
15540.00
13468.00
13468.00
1868.00
5604.00
4856.80
4856.80
581.00
1743.00
1510.60
1510.60
628.00
1884.00
1632.80
1632.80
107.00
321.00
278.20
278.20
944.00
2832.00
2454.40
2454.40
368.00
1104.00
956.80
956.80
179.00
537.00
465.40
465.40
178.00
534.00
462.80
462.80
384.00
1152.00
998.40
998.40
1083.00
3249.00
2815.80
2815.80
1331.00
3993.00
3460.60
3460.60
1164.00
3492.00
3026.40
3026.40
1447.00
4341.00
3762.20
3762.20
2437.00
7311.00
6336.20
6336.20
2486.00
7458.00
6463.60
6463.60
3066.00
9198.00
7971.60
7971.60
3357.00
10071.00
8728.20
8728.20
946.00
2838.00
2459.60
2459.60
1758.00
5274.00
4570.80
4570.80
2935.00
8805.00
7631.00
7631.00
3499.00
10497.00
9097.40
9097.40
1825.00
5475.00
4745.00
4745.00
2535.00
7605.00
6591.00
6591.00
2987.00
8961.00
7766.20
7766.20
2476.00
7428.00
6437.60
6437.60
2451.00
7353.00
6372.60
6372.60
2542.00
7626.00
6609.20
6609.20
2597.00
7791.00
6752.20
6752.20
2336.00
7008.00
6073.60
6073.60
3011.00
9033.00
7828.60
7828.60
1744.00
5232.00
4534.40
4534.40
3507.00
10521.00
9118.20
9118.20
2035.00
6105.00
5291.00
5291.00
3401.00
10203.00
8842.60
8842.60
3877.00
11631.00
10080.20
10080.20
2410.00
7230.00
6266.00
6266.00
1632.00
4896.00
4243.20
4243.20
1861.00
5583.00
4838.60
4838.60
1911.00
5733.00
4968.60
4968.60
2636.00
7908.00
6853.60
6853.60
4272.00
12816.00
11107.20
11107.20
488.00
1464.00
1268.80
1268.80
392.00
1176.00
1019.20
1019.20
579.00
1737.00
1505.40
1505.40
333.00
999.00
865.80
865.80
453.00
1359.00
1177.80
1177.80
3376.00
10128.00
8777.60
8777.60
3571.00
10713.00
9284.60
9284.60
3049.00
9147.00
7927.40
7927.40
336.00
1008.00
873.60
873.60
501.00
1503.00
1302.60
1302.60
409.00
1227.00
1063.40
1063.40
382.00
1146.00
993.20
993.20
656.00
1968.00
1705.60
1705.60
741.00
2223.00
1926.60
1926.60
294.00
882.00
764.40
764.40
330.00
990.00
858.00
858.00
424.00
1272.00
1102.40
1102.40
481.00
1443.00
1250.60
1250.60
481.00
1443.00
1250.60
1250.60
989.00
2967.00
2571.40
2571.40
885.00
2655.00
2301.00
2301.00
1253.00
3759.00
3257.80
3257.80
6359.00
19077.00
16533.40
16533.40
2871.00
8613.00
7464.60
7464.60
3029.00
9087.00
7875.40
7875.40
1491.00
4473.00
3876.60
3876.60
2207.00
6621.00
5738.20
5738.20
2063.00
6189.00
5363.80
5363.80
414.00
1242.00
1076.40
1076.40
1124.00
3372.00
2922.40
2922.40
1118.00
3354.00
2906.80
2906.80
177.00
531.00
460.20
460.20
324.00
972.00
842.40
842.40
152.00
456.00
395.20
395.20
799.00
2397.00
2077.40
2077.40
3390.00
10170.00
8814.00
8814.00
1995.00
5985.00
5187.00
5187.00
4267.00
12801.00
11094.20
11094.20
3676.00
11028.00
9557.60
9557.60
4603.00
13809.00
11967.80
11967.80
3527.00
10581.00
9170.20
9170.20
4854.00
14562.00
12620.40
12620.40
6496.00
19488.00
16889.60
16889.60
10292.00
30876.00
26759.20
26759.20
3047.00
9141.00
7922.20
7922.20
3402.00
10206.00
8845.20
8845.20
3659.00
10977.00
9513.40
9513.40
3894.00
11682.00
10124.40
10124.40
3251.00
9753.00
8452.60
8452.60
3627.00
10881.00
9430.20
9430.20
3887.00
11661.00
10106.20
10106.20
4851.00
14553.00
12612.60
12612.60
4253.00
12759.00
11057.80
11057.80
4609.00
13827.00
11983.40
11983.40
4862.00
14586.00
12641.20
12641.20
5060.00
15180.00
13156.00
13156.00
4509.00
13527.00
11723.40
11723.40
185.00
555.00
481.00
481.00
253.00
759.00
657.80
657.80
172.00
516.00
447.20
447.20
218.00
654.00
566.80
566.80
46.00
138.00
119.60
119.60
274.00
822.00
712.40
712.40
1026.00
3078.00
2667.60
2667.60
1570.00
4710.00
4082.00
4082.00
284.00
852.00
738.40
738.40
1239.00
3717.00
3221.40
3221.40
1978.00
5934.00
5142.80
5142.80
1602.00
4806.00
4165.20
4165.20
2963.00
8889.00
7703.80
7703.80
2978.00
8934.00
7742.80
7742.80
3353.00
10059.00
8717.80
8717.80
3183.00
9549.00
8275.80
8275.80
3557.00
10671.00
9248.20
9248.20
3621.00
10863.00
9414.60
9414.60
3918.00
11754.00
10186.80
10186.80
3302.00
9906.00
8585.20
8585.20
4167.00
12501.00
10834.20
10834.20
6669.00
20007.00
17339.40
17339.40
3253.00
9759.00
8457.80
8457.80
3611.00
10833.00
9388.60
9388.60
4196.00
12588.00
10909.60
10909.60
4857.00
14571.00
12628.20
12628.20
702.00
2106.00
1825.20
1825.20
985.00
2955.00
2561.00
2561.00
1269.00
3807.00
3299.40
3299.40
1434.00
4302.00
3728.40
3728.40
2028.00
6084.00
5272.80
5272.80
1072.00
3216.00
2787.20
2787.20
1954.00
5862.00
5080.40
5080.40
2451.00
7353.00
6372.60
6372.60
3425.00
10275.00
8905.00
8905.00
3807.00
11421.00
9898.20
9898.20
4268.00
12804.00
11096.80
11096.80
4884.00
14652.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1339.00
4017.00
3481.40
3481.40
1206.00
3618.00
3135.60
3135.60
287.00
861.00
746.20
746.20
894.00
2682.00
2324.40
2324.40
2480.00
7440.00
6448.00
6448.00
2374.00
7122.00
6172.40
6172.40
2597.00
7791.00
6752.20
6752.20
1341.00
4023.00
3486.60
3486.60
1340.00
4020.00
3484.00
3484.00
2719.00
8157.00
7069.40
7069.40
2952.00
8856.00
7675.20
7675.20
0.00
0.00
0.00
0.00
2856.00
8568.00
7425.60
7425.60
2656.00
7968.00
6905.60
6905.60
3220.00
9660.00
8372.00
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3328.00
9984.00
8652.80
8652.80
3112.00
9336.00
8091.20
8091.20
2985.00
8955.00
7761.00
7761.00
3145.00
9435.00
8177.00
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1088.00
3264.00
2828.80
2828.80
1465.00
4395.00
3809.00
3809.00
1228.00
3684.00
3192.80
3192.80
2642.00
7926.00
6869.20
6869.20
939.00
2817.00
2441.40
2441.40
2594.00
7782.00
6744.40
6744.40
1633.00
4899.00
4245.80
4245.80
2579.00
7737.00
6705.40
6705.40
2725.00
8175.00
7085.00
7085.00
1901.00
5703.00
4942.60
4942.60
4169.00
12507.00
10839.40
10839.40
3983.00
11949.00
10355.80
10355.80
5125.00
15375.00
13325.00
13325.00
5784.00
17352.00
15038.40
15038.40
7158.00
21474.00
18610.80
18610.80
7756.00
23268.00
20165.60
20165.60
4882.00
14646.00
12693.20
12693.20
5604.00
16812.00
14570.40
14570.40
6152.00
18456.00
15995.20
15995.20
3416.00
10248.00
8881.60
8881.60
702.00
2106.00
1825.20
1825.20
483.00
1449.00
1255.80
1255.80
750.00
2250.00
1950.00
1950.00
300.00
900.00
780.00
780.00
670.00
2010.00
1742.00
1742.00
758.00
2274.00
1970.80
1970.80
492.00
1476.00
1279.20
1279.20
250.00
750.00
650.00
650.00
172.00
516.00
447.20
447.20
363.00
1089.00
943.80
943.80
190.00
570.00
494.00
494.00
158.00
474.00
410.80
410.80
1151.00
3453.00
2992.60
2992.60
1888.00
5664.00
4908.80
4908.80
1188.00
3564.00
3088.80
3088.80
1888.00
5664.00
4908.80
4908.80
3093.00
9279.00
8041.80
8041.80
2945.00
8835.00
7657.00
7657.00
2948.00
8844.00
7664.80
7664.80
3050.00
9150.00
7930.00
7930.00
2996.00
8988.00
7789.60
7789.60
3262.00
9786.00
8481.20
8481.20
1317.00
3951.00
3424.20
3424.20
2853.00
8559.00
7417.80
7417.80
2778.00
8334.00
7222.80
7222.80
642.00
1926.00
1669.20
1669.20
169.00
507.00
439.40
439.40
552.00
1656.00
1435.20
1435.20
565.00
1695.00
1469.00
1469.00
798.00
2394.00
2074.80
2074.80
1054.00
3162.00
2740.40
2740.40
6974.00
20922.00
18132.40
18132.40
2725.00
8175.00
7085.00
7085.00
3473.00
10419.00
9029.80
9029.80
347.00
1041.00
902.20
902.20
307.00
921.00
798.20
798.20
1192.00
3576.00
3099.20
3099.20
2102.00
6306.00
5465.20
5465.20
465.00
1395.00
1209.00
1209.00
7727.00
23181.00
20090.20
20090.20
3071.00
9213.00
7984.60
7984.60
4214.00
12642.00
10956.40
10956.40
1818.00
5454.00
4726.80
4726.80
7325.00
21975.00
19045.00
19045.00
3062.00
9186.00
7961.20
7961.20
3809.00
11427.00
9903.40
9903.40
7828.00
23484.00
20352.80
20352.80
3170.00
9510.00
8242.00
8242.00
4330.00
12990.00
11258.00
11258.00
1088.00
3264.00
2828.80
2828.80
1301.00
3903.00
3382.60
3382.60
1309.00
3927.00
3403.40
3403.40
1608.00
4824.00
4180.80
4180.80
758.00
2274.00
1970.80
1970.80
1334.00
4002.00
3468.40
3468.40
1248.00
3744.00
3244.80
3244.80
1465.00
4395.00
3809.00
3809.00
1804.00
5412.00
4690.40
4690.40
1533.00
4599.00
3985.80
3985.80
1805.00
5415.00
4693.00
4693.00
1876.00
5628.00
4877.60
4877.60
783.00
2349.00
2035.80
2035.80
1726.00
5178.00
4487.60
4487.60
497.00
1491.00
1292.20
1292.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
537.00
1611.00
1396.20
1396.20
284.00
852.00
738.40
738.40
2429.00
7287.00
6315.40
6315.40
2607.00
7821.00
6778.20
6778.20
3758.00
11274.00
9770.80
9770.80
2849.00
8547.00
7407.40
7407.40
3423.00
10269.00
8899.80
8899.80
3586.00
10758.00
9323.60
9323.60
4868.00
14604.00
12656.80
12656.80
6247.00
18741.00
16242.20
16242.20
4051.00
12153.00
10532.60
10532.60
5062.00
15186.00
13161.20
13161.20
3899.00
11697.00
10137.40
10137.40
1644.00
4932.00
4274.40
4274.40
2209.00
6627.00
5743.40
5743.40
263.00
789.00
683.80
683.80
3751.00
11253.00
9752.60
9752.60
4709.00
14127.00
12243.40
12243.40
5124.00
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906.00
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4546.00
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4870.00
14610.00
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6481.80
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5400.20
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3350.00
10050.00
8710.00
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1797.00
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797.00
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101.00
303.00
262.60
262.60
2016.00
6048.00
5241.60
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3882.00
11646.00
10093.20
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4022.00
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10457.20
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2854.00
8562.00
7420.40
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3082.00
9246.00
8013.20
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2202.00
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5725.20
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2634.00
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2475.00
7425.00
6435.00
6435.00
2968.00
8904.00
7716.80
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2487.00
7461.00
6466.20
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1162.00
3486.00
3021.20
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1161.00
3483.00
3018.60
3018.60
1264.00
3792.00
3286.40
3286.40
1089.00
3267.00
2831.40
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564.00
1692.00
1466.40
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1295.00
3885.00
3367.00
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2408.00
7224.00
6260.80
6260.80
820.00
2460.00
2132.00
2132.00
759.00
2277.00
1973.40
1973.40
0.00
0.00
0.00
0.00
3414.00
10242.00
8876.40
8876.40
2834.00
8502.00
7368.40
7368.40
3118.00
9354.00
8106.80
8106.80
3146.00
9438.00
8179.60
8179.60
4809.00
14427.00
12503.40
12503.40
395.00
1185.00
1027.00
1027.00
6052.00
18156.00
15735.20
15735.20
4374.00
13122.00
11372.40
11372.40
4335.00
13005.00
11271.00
11271.00
5235.00
15705.00
13611.00
13611.00
4505.00
13515.00
11713.00
11713.00
274.00
822.00
712.40
712.40
313.00
939.00
813.80
813.80
340.00
1020.00
884.00
884.00
3563.00
10689.00
9263.80
9263.80
3563.00
10689.00
9263.80
9263.80
4238.00
12714.00
11018.80
11018.80
0.00
0.00
0.00
0.00
506.00
1518.00
1315.60
1315.60
421.00
1263.00
1094.60
1094.60
452.00
1356.00
1175.20
1175.20
384.00
1152.00
998.40
998.40
503.00
1509.00
1307.80
1307.80
619.00
1857.00
1609.40
1609.40
1352.00
4056.00
3515.20
3515.20
482.00
1446.00
1253.20
1253.20
192.00
576.00
499.20
499.20
446.00
1338.00
1159.60
1159.60
513.00
1539.00
1333.80
1333.80
1637.00
4911.00
4256.20
4256.20
583.00
1749.00
1515.80
1515.80
497.00
1491.00
1292.20
1292.20
362.00
1086.00
941.20
941.20
1357.00
4071.00
3528.20
3528.20
1756.00
5268.00
4565.60
4565.60
1890.00
5670.00
4914.00
4914.00
2151.00
6453.00
5592.60
5592.60
2715.00
8145.00
7059.00
7059.00
1811.00
5433.00
4708.60
4708.60
2229.00
6687.00
5795.40
5795.40
1800.00
5400.00
4680.00
4680.00
1576.00
4728.00
4097.60
4097.60
1627.00
4881.00
4230.20
4230.20
2084.00
6252.00
5418.40
5418.40
1794.00
5382.00
4664.40
4664.40
1067.00
3201.00
2774.20
2774.20
920.00
2760.00
2392.00
2392.00
1589.00
4767.00
4131.40
4131.40
1764.00
5292.00
4586.40
4586.40
1009.00
3027.00
2623.40
2623.40
883.00
2649.00
2295.80
2295.80
1730.00
5190.00
4498.00
4498.00
1671.00
5013.00
4344.60
4344.60
914.00
2742.00
2376.40
2376.40
1671.00
5013.00
4344.60
4344.60
461.00
1383.00
1198.60
1198.60
1717.00
5151.00
4464.20
4464.20
1688.00
5064.00
4388.80
4388.80
2459.00
7377.00
6393.40
6393.40
2712.00
8136.00
7051.20
7051.20
3505.00
10515.00
9113.00
9113.00
3496.00
10488.00
9089.60
9089.60
2560.00
7680.00
6656.00
6656.00
0.00
0.00
0.00
0.00
402.00
1206.00
1045.20
1045.20
202.00
606.00
525.20
525.20
359.00
1077.00
933.40
933.40
549.00
1647.00
1427.40
1427.40
666.00
1998.00
1731.60
1731.60
1448.00
4344.00
3764.80
3764.80
546.00
1638.00
1419.60
1419.60
129.00
387.00
335.40
335.40
1996.00
5988.00
5189.60
5189.60
2449.00
7347.00
6367.40
6367.40
2370.00
7110.00
6162.00
6162.00
2646.00
7938.00
6879.60
6879.60
1713.00
5139.00
4453.80
4453.80
2379.00
7137.00
6185.40
6185.40
1482.00
4446.00
3853.20
3853.20
1524.00
4572.00
3962.40
3962.40
2412.00
7236.00
6271.20
6271.20
1451.00
4353.00
3772.60
3772.60
0.00
0.00
0.00
0.00
547.00
1641.00
1422.20
1422.20
618.00
1854.00
1606.80
1606.80
359.00
1077.00
933.40
933.40
3692.00
11076.00
9599.20
9599.20
3578.00
10734.00
9302.80
9302.80
1119.00
3357.00
2909.40
2909.40
2481.00
7443.00
6450.60
6450.60
1015.00
3045.00
2639.00
2639.00
971.00
2913.00
2524.60
2524.60
3367.00
10101.00
8754.20
8754.20
4130.00
12390.00
10738.00
10738.00
2217.00
6651.00
5764.20
5764.20
618.00
1854.00
1606.80
1606.80
2788.00
8364.00
7248.80
7248.80
2813.00
8439.00
7313.80
7313.80
2900.00
8700.00
7540.00
7540.00
538.00
1614.00
1398.80
1398.80
431.00
1293.00
1120.60
1120.60
2322.00
6966.00
6037.20
6037.20
384.00
1152.00
998.40
998.40
683.00
2049.00
1775.80
1775.80
759.00
2277.00
1973.40
1973.40
951.00
2853.00
2472.60
2472.60
1401.00
4203.00
3642.60
3642.60
425.00
1275.00
1105.00
1105.00
191.00
573.00
496.60
496.60
0.00
0.00
0.00
0.00
440.00
1320.00
1144.00
1144.00
583.00
1749.00
1515.80
1515.80
526.00
1578.00
1367.60
1367.60
98.00
294.00
254.80
254.80
237.00
711.00
616.20
616.20
314.00
942.00
816.40
816.40
1197.00
3591.00
3112.20
3112.20
1490.00
4470.00
3874.00
3874.00
3222.00
9666.00
8377.20
8377.20
924.00
2772.00
2402.40
2402.40
3862.00
11586.00
10041.20
10041.20
6239.00
18717.00
16221.40
16221.40
263.00
789.00
683.80
683.80
376.00
1128.00
977.60
977.60
122.00
366.00
317.20
317.20
305.00
915.00
793.00
793.00
507.00
1521.00
1318.20
1318.20
1779.00
5337.00
4625.40
4625.40
4006.00
12018.00
10415.60
10415.60
5661.00
16983.00
14718.60
14718.60
0.00
0.00
0.00
0.00
328.00
984.00
852.80
852.80
195.00
585.00
507.00
507.00
720.00
2160.00
1872.00
1872.00
448.00
1344.00
1164.80
1164.80
555.00
1665.00
1443.00
1443.00
287.00
861.00
746.20
746.20
486.00
1458.00
1263.60
1263.60
599.00
1797.00
1557.40
1557.40
2560.00
7680.00
6656.00
6656.00
2018.00
6054.00
5246.80
5246.80
2730.00
8190.00
7098.00
7098.00
3625.00
10875.00
9425.00
9425.00
4457.00
13371.00
11588.20
11588.20
4568.00
13704.00
11876.80
11876.80
6146.00
18438.00
15979.60
15979.60
9990.00
29970.00
25974.00
25974.00
470.00
1410.00
1222.00
1222.00
3853.00
11559.00
10017.80
10017.80
5844.00
17532.00
15194.40
15194.40
9442.00
28326.00
24549.20
24549.20
3905.00
11715.00
10153.00
10153.00
4062.00
12186.00
10561.20
10561.20
4671.00
14013.00
12144.60
12144.60
4153.00
12459.00
10797.80
10797.80
5794.00
17382.00
15064.40
15064.40
1096.00
3288.00
2849.60
2849.60
1812.00
5436.00
4711.20
4711.20
3286.00
9858.00
8543.60
8543.60
4015.00
12045.00
10439.00
10439.00
3874.00
11622.00
10072.40
10072.40
4529.00
13587.00
11775.40
11775.40
5112.00
15336.00
13291.20
13291.20
5099.00
15297.00
13257.40
13257.40
3877.00
11631.00
10080.20
10080.20
4990.00
14970.00
12974.00
12974.00
4563.00
13689.00
11863.80
11863.80
5481.00
16443.00
14250.60
14250.60
5385.00
16155.00
14001.00
14001.00
5720.00
17160.00
14872.00
14872.00
2995.00
8985.00
7787.00
7787.00
3462.00
10386.00
9001.20
9001.20
4508.00
13524.00
11720.80
11720.80
4320.00
12960.00
11232.00
11232.00
3015.00
9045.00
7839.00
7839.00
3013.00
9039.00
7833.80
7833.80
3520.00
10560.00
9152.00
9152.00
3093.00
9279.00
8041.80
8041.80
2555.00
7665.00
6643.00
6643.00
0.00
0.00
0.00
0.00
3216.00
9648.00
8361.60
8361.60
4019.00
12057.00
10449.40
10449.40
4983.00
14949.00
12955.80
12955.80
4226.00
12678.00
10987.60
10987.60
5035.00
15105.00
13091.00
13091.00
4381.00
13143.00
11390.60
11390.60
7064.00
21192.00
18366.40
18366.40
4373.00
13119.00
11369.80
11369.80
4580.00
13740.00
11908.00
11908.00
731.00
2193.00
1900.60
1900.60
3887.00
11661.00
10106.20
10106.20
3951.00
11853.00
10272.60
10272.60
3531.00
10593.00
9180.60
9180.60
3196.00
9588.00
8309.60
8309.60
2905.00
8715.00
7553.00
7553.00
3423.00
10269.00
8899.80
8899.80
3810.00
11430.00
9906.00
9906.00
5786.00
17358.00
15043.60
15043.60
4586.00
13758.00
11923.60
11923.60
0.00
0.00
0.00
0.00
7298.00
21894.00
18974.80
18974.80
7438.00
22314.00
19338.80
19338.80
7245.00
21735.00
18837.00
18837.00
8061.00
24183.00
20958.60
20958.60
0.00
0.00
0.00
0.00
798.00
2394.00
2074.80
2074.80
207.00
621.00
538.20
538.20
309.00
927.00
803.40
803.40
59.00
177.00
153.40
153.40
72.00
216.00
187.20
187.20
81.00
243.00
210.60
210.60
75.00
225.00
195.00
195.00
118.00
354.00
306.80
306.80
94.00
282.00
244.40
244.40
63.00
189.00
163.80
163.80
88.00
264.00
228.80
228.80
68.00
204.00
176.80
176.80
99.00
297.00
257.40
257.40
74.00
222.00
192.40
192.40
89.00
267.00
231.40
231.40
65.00
195.00
169.00
169.00
81.00
243.00
210.60
210.60
61.00
183.00
158.60
158.60
77.00
231.00
200.20
200.20
97.00
291.00
252.20
252.20
31.00
93.00
80.60
80.60
83.00
249.00
215.80
215.80
107.00
321.00
278.20
278.20
64.00
192.00
166.40
166.40
99.00
297.00
257.40
257.40
177.00
531.00
460.20
460.20
756.00
2268.00
1965.60
1965.60
45.00
135.00
117.00
117.00
44.00
132.00
114.40
114.40
57.00
171.00
148.20
148.20
179.00
537.00
465.40
465.40
190.00
570.00
494.00
494.00
172.00
516.00
447.20
447.20
86.00
258.00
223.60
223.60
208.00
624.00
540.80
540.80
342.00
1026.00
889.20
889.20
449.00
1347.00
1167.40
1167.40
541.00
1623.00
1406.60
1406.60
576.00
1728.00
1497.60
1497.60
665.00
1995.00
1729.00
1729.00
737.00
2211.00
1916.20
1916.20
474.00
1422.00
1232.40
1232.40
568.00
1704.00
1476.80
1476.80
686.00
2058.00
1783.60
1783.60
461.00
1383.00
1198.60
1198.60
556.00
1668.00
1445.60
1445.60
663.00
1989.00
1723.80
1723.80
1038.00
3114.00
2698.80
2698.80
1074.00
3222.00
2792.40
2792.40
847.00
2541.00
2202.20
2202.20
960.00
2880.00
2496.00
2496.00
1166.00
3498.00
3031.60
3031.60
952.00
2856.00
2475.20
2475.20
943.00
2829.00
2451.80
2451.80
1440.00
4320.00
3744.00
3744.00
951.00
2853.00
2472.60
2472.60
1009.00
3027.00
2623.40
2623.40
1440.00
4320.00
3744.00
3744.00
891.00
2673.00
2316.60
2316.60
996.00
2988.00
2589.60
2589.60
1167.00
3501.00
3034.20
3034.20
1027.00
3081.00
2670.20
2670.20
1459.00
4377.00
3793.40
3793.40
2580.00
7740.00
6708.00
6708.00
2840.00
8520.00
7384.00
7384.00
2865.00
8595.00
7449.00
7449.00
48.00
144.00
124.80
124.80
61.00
183.00
158.60
158.60
62.00
186.00
161.20
161.20
78.00
234.00
202.80
202.80
96.00
288.00
249.60
249.60
144.00
432.00
374.40
374.40
93.00
279.00
241.80
241.80
172.00
516.00
447.20
447.20
73.00
219.00
189.80
189.80
198.00
594.00
514.80
514.80
289.00
867.00
751.40
751.40
187.00
561.00
486.20
486.20
66.00
198.00
171.60
171.60
81.00
243.00
210.60
210.60
84.00
252.00
218.40
218.40
109.00
327.00
283.40
283.40
64.00
192.00
166.40
166.40
76.00
228.00
197.60
197.60
433.00
1299.00
1125.80
1125.80
543.00
1629.00
1411.80
1411.80
660.00
1980.00
1716.00
1716.00
826.00
2478.00
2147.60
2147.60
975.00
2925.00
2535.00
2535.00
1108.00
3324.00
2880.80
2880.80
1371.00
4113.00
3564.60
3564.60
970.00
2910.00
2522.00
2522.00
162.00
486.00
421.20
421.20
48.00
144.00
124.80
124.80
83.00
249.00
215.80
215.80
109.00
327.00
283.40
283.40
140.00
420.00
364.00
364.00
80.00
240.00
208.00
208.00
69.00
207.00
179.40
179.40
76.00
228.00
197.60
197.60
90.00
270.00
234.00
234.00
76.00
228.00
197.60
197.60
106.00
318.00
275.60
275.60
87.00
261.00
226.20
226.20
115.00
345.00
299.00
299.00
157.00
471.00
408.20
408.20
111.00
333.00
288.60
288.60
436.00
1308.00
1133.60
1133.60
542.00
1626.00
1409.20
1409.20
650.00
1950.00
1690.00
1690.00
435.00
1305.00
1131.00
1131.00
544.00
1632.00
1414.40
1414.40
650.00
1950.00
1690.00
1690.00
435.00
1305.00
1131.00
1131.00
542.00
1626.00
1409.20
1409.20
649.00
1947.00
1687.40
1687.40
795.00
2385.00
2067.00
2067.00
1014.00
3042.00
2636.40
2636.40
796.00
2388.00
2069.60
2069.60
903.00
2709.00
2347.80
2347.80
782.00
2346.00
2033.20
2033.20
988.00
2964.00
2568.80
2568.80
1169.00
3507.00
3039.40
3039.40
1089.00
3267.00
2831.40
2831.40
1145.00
3435.00
2977.00
2977.00
1118.00
3354.00
2906.80
2906.80
56.00
168.00
145.60
145.60
89.00
267.00
231.40
231.40
784.00
2352.00
2038.40
2038.40
421.00
1263.00
1094.60
1094.60
513.00
1539.00
1333.80
1333.80
655.00
1965.00
1703.00
1703.00
883.00
2649.00
2295.80
2295.80
981.00
2943.00
2550.60
2550.60
1194.00
3582.00
3104.40
3104.40
968.00
2904.00
2516.80
2516.80
61.00
183.00
158.60
158.60
70.00
210.00
182.00
182.00
59.00
177.00
153.40
153.40
267.00
801.00
694.20
694.20
260.00
780.00
676.00
676.00
262.00
786.00
681.20
681.20
407.00
1221.00
1058.20
1058.20
247.00
741.00
642.20
642.20
251.00
753.00
652.60
652.60
571.00
1713.00
1484.60
1484.60
589.00
1767.00
1531.40
1531.40
216.00
648.00
561.60
561.60
61.00
183.00
158.60
158.60
66.00
198.00
171.60
171.60
50.00
150.00
130.00
130.00
65.00
195.00
169.00
169.00
220.00
660.00
572.00
572.00
83.00
249.00
215.80
215.80
61.00
183.00
158.60
158.60
59.00
177.00
153.40
153.40
69.00
207.00
179.40
179.40
201.00
603.00
522.60
522.60
58.00
174.00
150.80
150.80
68.00
204.00
176.80
176.80
67.00
201.00
174.20
174.20
78.00
234.00
202.80
202.80
234.00
702.00
608.40
608.40
58.00
174.00
150.80
150.80
68.00
204.00
176.80
176.80
69.00
207.00
179.40
179.40
433.00
1299.00
1125.80
1125.80
533.00
1599.00
1385.80
1385.80
677.00
2031.00
1760.20
1760.20
748.00
2244.00
1944.80
1944.80
891.00
2673.00
2316.60
2316.60
949.00
2847.00
2467.40
2467.40
1189.00
3567.00
3091.40
3091.40
835.00
2505.00
2171.00
2171.00
900.00
2700.00
2340.00
2340.00
1120.00
3360.00
2912.00
2912.00
1111.00
3333.00
2888.60
2888.60
57.00
171.00
148.20
148.20
82.00
246.00
213.20
213.20
86.00
258.00
223.60
223.60
213.00
639.00
553.80
553.80
65.00
195.00
169.00
169.00
92.00
276.00
239.20
239.20
168.00
504.00
436.80
436.80
60.00
180.00
156.00
156.00
65.00
195.00
169.00
169.00
79.00
237.00
205.40
205.40
91.00
273.00
236.60
236.60
75.00
225.00
195.00
195.00
290.00
870.00
754.00
754.00
57.00
171.00
148.20
148.20
68.00
204.00
176.80
176.80
60.00
180.00
156.00
156.00
70.00
210.00
182.00
182.00
224.00
672.00
582.40
582.40
58.00
174.00
150.80
150.80
66.00
198.00
171.60
171.60
60.00
180.00
156.00
156.00
63.00
189.00
163.80
163.80
434.00
1302.00
1128.40
1128.40
539.00
1617.00
1401.40
1401.40
682.00
2046.00
1773.20
1773.20
833.00
2499.00
2165.80
2165.80
871.00
2613.00
2264.60
2264.60
957.00
2871.00
2488.20
2488.20
1193.00
3579.00
3101.80
3101.80
854.00
2562.00
2220.40
2220.40
924.00
2772.00
2402.40
2402.40
1119.00
3357.00
2909.40
2909.40
973.00
2919.00
2529.80
2529.80
50.00
150.00
130.00
130.00
79.00
237.00
205.40
205.40
82.00
246.00
213.20
213.20
98.00
294.00
254.80
254.80
431.00
1293.00
1120.60
1120.60
590.00
1770.00
1534.00
1534.00
782.00
2346.00
2033.20
2033.20
836.00
2508.00
2173.60
2173.60
459.00
1377.00
1193.40
1193.40
722.00
2166.00
1877.20
1877.20
914.00
2742.00
2376.40
2376.40
782.00
2346.00
2033.20
2033.20
1079.00
3237.00
2805.40
2805.40
1198.00
3594.00
3114.80
3114.80
968.00
2904.00
2516.80
2516.80
144.00
432.00
374.40
374.40
160.00
480.00
416.00
416.00
187.00
561.00
486.20
486.20
188.00
564.00
488.80
488.80
334.00
1002.00
868.40
868.40
235.00
705.00
611.00
611.00
247.00
741.00
642.20
642.20
366.00
1098.00
951.60
951.60
263.00
789.00
683.80
683.80
295.00
885.00
767.00
767.00
396.00
1188.00
1029.60
1029.60
224.00
672.00
582.40
582.40
815.00
2445.00
2119.00
2119.00
668.00
2004.00
1736.80
1736.80
1098.00
3294.00
2854.80
2854.80
1220.00
3660.00
3172.00
3172.00
1622.00
4866.00
4217.20
4217.20
322.00
966.00
837.20
837.20
447.00
1341.00
1162.20
1162.20
420.00
1260.00
1092.00
1092.00
144.00
432.00
374.40
374.40
143.00
429.00
371.80
371.80
100.00
300.00
260.00
260.00
58.00
174.00
150.80
150.80
101.00
303.00
262.60
262.60
204.00
612.00
530.40
530.40
288.00
864.00
748.80
748.80
311.00
933.00
808.60
808.60
196.00
588.00
509.60
509.60
324.00
972.00
842.40
842.40
250.00
750.00
650.00
650.00
272.00
816.00
707.20
707.20
299.00
897.00
777.40
777.40
244.00
732.00
634.40
634.40
229.00
687.00
595.40
595.40
229.00
687.00
595.40
595.40
279.00
837.00
725.40
725.40
238.00
714.00
618.80
618.80
132.00
396.00
343.20
343.20
114.00
342.00
296.40
296.40
176.00
528.00
457.60
457.60
198.00
594.00
514.80
514.80
143.00
429.00
371.80
371.80
177.00
531.00
460.20
460.20
144.00
432.00
374.40
374.40
203.00
609.00
527.80
527.80
203.00
609.00
527.80
527.80
205.00
615.00
533.00
533.00
75.00
225.00
195.00
195.00
162.00
486.00
421.20
421.20
168.00
504.00
436.80
436.80
0.00
0.00
0.00
0.00
762.00
2286.00
1981.20
1981.20
1061.00
3183.00
2758.60
2758.60
1015.00
3045.00
2639.00
2639.00
1202.00
3606.00
3125.20
3125.20
158.00
474.00
410.80
410.80
227.00
681.00
590.20
590.20
622.00
1866.00
1617.20
1617.20
846.00
2538.00
2199.60
2199.60
946.00
2838.00
2459.60
2459.60
430.00
1290.00
1118.00
1118.00
317.00
951.00
824.20
824.20
326.00
978.00
847.60
847.60
390.00
1170.00
1014.00
1014.00
916.00
2748.00
2381.60
2381.60
363.00
1089.00
943.80
943.80
393.00
1179.00
1021.80
1021.80
398.00
1194.00
1034.80
1034.80
491.00
1473.00
1276.60
1276.60
420.00
1260.00
1092.00
1092.00
507.00
1521.00
1318.20
1318.20
394.00
1182.00
1024.40
1024.40
456.00
1368.00
1185.60
1185.60
398.00
1194.00
1034.80
1034.80
483.00
1449.00
1255.80
1255.80
369.00
1107.00
959.40
959.40
443.00
1329.00
1151.80
1151.80
343.00
1029.00
891.80
891.80
417.00
1251.00
1084.20
1084.20
366.00
1098.00
951.60
951.60
361.00
1083.00
938.60
938.60
420.00
1260.00
1092.00
1092.00
358.00
1074.00
930.80
930.80
336.00
1008.00
873.60
873.60
390.00
1170.00
1014.00
1014.00
349.00
1047.00
907.40
907.40
373.00
1119.00
969.80
969.80
209.00
627.00
543.40
543.40
460.00
1380.00
1196.00
1196.00
469.00
1407.00
1219.40
1219.40
512.00
1536.00
1331.20
1331.20
526.00
1578.00
1367.60
1367.60
563.00
1689.00
1463.80
1463.80
216.00
648.00
561.60
561.60
998.00
2994.00
2594.80
2594.80
262.00
786.00
681.20
681.20
324.00
972.00
842.40
842.40
312.00
936.00
811.20
811.20
324.00
972.00
842.40
842.40
331.00
993.00
860.60
860.60
390.00
1170.00
1014.00
1014.00
320.00
960.00
832.00
832.00
388.00
1164.00
1008.80
1008.80
318.00
954.00
826.80
826.80
315.00
945.00
819.00
819.00
537.00
1611.00
1396.20
1396.20
359.00
1077.00
933.40
933.40
348.00
1044.00
904.80
904.80
352.00
1056.00
915.20
915.20
319.00
957.00
829.40
829.40
319.00
957.00
829.40
829.40
252.00
756.00
655.20
655.20
1827.00
5481.00
4750.20
4750.20
1607.00
4821.00
4178.20
4178.20
241.00
723.00
626.60
626.60
317.00
951.00
824.20
824.20
367.00
1101.00
954.20
954.20
159.00
477.00
413.40
413.40
1062.00
3186.00
2761.20
2761.20
368.00
1104.00
956.80
956.80
368.00
1104.00
956.80
956.80
441.00
1323.00
1146.60
1146.60
133.00
399.00
345.80
345.80
217.00
651.00
564.20
564.20
697.00
2091.00
1812.20
1812.20
598.00
1794.00
1554.80
1554.80
398.00
1194.00
1034.80
1034.80
348.00
1044.00
904.80
904.80
257.00
771.00
668.20
668.20
669.00
2007.00
1739.40
1739.40
290.00
870.00
754.00
754.00
198.00
594.00
514.80
514.80
367.00
1101.00
954.20
954.20
186.00
558.00
483.60
483.60
901.00
2703.00
2342.60
2342.60
303.00
909.00
787.80
787.80
537.00
1611.00
1396.20
1396.20
609.00
1827.00
1583.40
1583.40
232.00
696.00
603.20
603.20
261.00
783.00
678.60
678.60
146.00
438.00
379.60
379.60
266.00
798.00
691.60
691.60
55.00
165.00
143.00
143.00
125.00
375.00
325.00
325.00
37.00
111.00
96.20
96.20
214.00
642.00
556.40
556.40
317.00
951.00
824.20
824.20
424.00
1272.00
1102.40
1102.40
155.00
465.00
403.00
403.00
0.00
0.00
0.00
0.00
50.00
150.00
130.00
130.00
120.00
360.00
312.00
312.00
163.00
489.00
423.80
423.80
341.00
1023.00
886.60
886.60
963.00
2889.00
2503.80
2503.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
252.00
756.00
655.20
655.20
350.00
1050.00
910.00
910.00
209.00
627.00
543.40
543.40
193.00
579.00
501.80
501.80
189.00
567.00
491.40
491.40
31.00
93.00
80.60
80.60
156.00
468.00
405.60
405.60
169.00
507.00
439.40
439.40
162.00
486.00
421.20
421.20
251.00
753.00
652.60
652.60
180.00
540.00
468.00
468.00
201.00
603.00
522.60
522.60
290.00
870.00
754.00
754.00
221.00
663.00
574.60
574.60
273.00
819.00
709.80
709.80
221.00
663.00
574.60
574.60
314.00
942.00
816.40
816.40
295.00
885.00
767.00
767.00
263.00
789.00
683.80
683.80
141.00
423.00
366.60
366.60
307.00
921.00
798.20
798.20
203.00
609.00
527.80
527.80
388.00
1164.00
1008.80
1008.80
444.00
1332.00
1154.40
1154.40
262.00
786.00
681.20
681.20
171.00
513.00
444.60
444.60
187.00
561.00
486.20
486.20
248.00
744.00
644.80
644.80
212.00
636.00
551.20
551.20
255.00
765.00
663.00
663.00
185.00
555.00
481.00
481.00
85.00
255.00
221.00
221.00
199.00
597.00
517.40
517.40
459.00
1377.00
1193.40
1193.40
272.00
816.00
707.20
707.20
128.00
384.00
332.80
332.80
94.00
282.00
244.40
244.40
260.00
780.00
676.00
676.00
263.00
789.00
683.80
683.80
258.00
774.00
670.80
670.80
198.00
594.00
514.80
514.80
255.00
765.00
663.00
663.00
273.00
819.00
709.80
709.80
363.00
1089.00
943.80
943.80
244.00
732.00
634.40
634.40
64.00
192.00
166.40
166.40
309.00
927.00
803.40
803.40
265.00
795.00
689.00
689.00
167.00
501.00
434.20
434.20
187.00
561.00
486.20
486.20
612.00
1836.00
1591.20
1591.20
73.00
219.00
189.80
189.80
333.00
999.00
865.80
865.80
238.00
714.00
618.80
618.80
410.00
1230.00
1066.00
1066.00
177.00
531.00
460.20
460.20
66.00
198.00
171.60
171.60
68.00
204.00
176.80
176.80
136.00
408.00
353.60
353.60
188.00
564.00
488.80
488.80
217.00
651.00
564.20
564.20
194.00
582.00
504.40
504.40
15.00
45.00
39.00
39.00
120.00
360.00
312.00
312.00
0.00
0.00
0.00
0.00
246.00
738.00
639.60
639.60
161.00
483.00
418.60
418.60
130.00
390.00
338.00
338.00
1064.00
3192.00
2766.40
2766.40
265.00
795.00
689.00
689.00
1074.00
3222.00
2792.40
2792.40
390.00
1170.00
1014.00
1014.00
823.00
2469.00
2139.80
2139.80
1337.00
4011.00
3476.20
3476.20
270.00
810.00
702.00
702.00
106.00
318.00
275.60
275.60
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
118.00
354.00
306.80
306.80
161.00
483.00
418.60
418.60
177.00
531.00
460.20
460.20
227.00
681.00
590.20
590.20
162.00
486.00
421.20
421.20
1281.00
3843.00
3330.60
3330.60
1274.00
3822.00
3312.40
3312.40
109.00
327.00
283.40
283.40
48.00
144.00
124.80
124.80
81.00
243.00
210.60
210.60
142.00
426.00
369.20
369.20
211.00
633.00
548.60
548.60
216.00
648.00
561.60
561.60
85.00
255.00
221.00
221.00
275.00
825.00
715.00
715.00
84.00
252.00
218.40
218.40
133.00
399.00
345.80
345.80
61.00
183.00
158.60
158.60
59.00
177.00
153.40
153.40
50.00
150.00
130.00
130.00
915.00
2745.00
2379.00
2379.00
155.00
465.00
403.00
403.00
232.00
696.00
603.20
603.20
345.00
1035.00
897.00
897.00
380.00
1140.00
988.00
988.00
673.00
2019.00
1749.80
1749.80
1105.00
3315.00
2873.00
2873.00
920.00
2760.00
2392.00
2392.00
0.00
0.00
0.00
0.00
138.00
414.00
358.80
358.80
3855.00
11565.00
10023.00
10023.00
124.00
372.00
322.40
322.40
179.00
537.00
465.40
465.40
281.00
843.00
730.60
730.60
189.00
567.00
491.40
491.40
294.00
882.00
764.40
764.40
412.00
1236.00
1071.20
1071.20
553.00
1659.00
1437.80
1437.80
131.00
393.00
340.60
340.60
159.00
477.00
413.40
413.40
108.00
324.00
280.80
280.80
301.00
903.00
782.60
782.60
82.00
246.00
213.20
213.20
1017.00
3051.00
2644.20
2644.20
220.00
660.00
572.00
572.00
2093.00
6279.00
5441.80
5441.80
1650.00
4950.00
4290.00
4290.00
3102.00
9306.00
8065.20
8065.20
0.00
0.00
0.00
0.00
39.00
117.00
101.40
101.40
400.00
1200.00
1040.00
1040.00
274.00
822.00
712.40
712.40
306.00
918.00
795.60
795.60
309.00
927.00
803.40
803.40
530.00
1590.00
1378.00
1378.00
376.00
1128.00
977.60
977.60
422.00
1266.00
1097.20
1097.20
420.00
1260.00
1092.00
1092.00
495.00
1485.00
1287.00
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498.00
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1294.80
1294.80
562.00
1686.00
1461.20
1461.20
565.00
1695.00
1469.00
1469.00
27.00
81.00
70.20
70.20
957.00
2871.00
2488.20
2488.20
205.00
615.00
533.00
533.00
383.00
1149.00
995.80
995.80
541.00
1623.00
1406.60
1406.60
384.00
1152.00
998.40
998.40
211.00
633.00
548.60
548.60
871.00
2613.00
2264.60
2264.60
1438.00
4314.00
3738.80
3738.80
314.00
942.00
816.40
816.40
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
0.00
867.00
2601.00
2254.20
2254.20
1884.00
5652.00
4898.40
4898.40
1776.00
5328.00
4617.60
4617.60
2053.00
6159.00
5337.80
5337.80
1117.00
3351.00
2904.20
2904.20
749.00
2247.00
1947.40
1947.40
774.00
2322.00
2012.40
2012.40
1035.00
3105.00
2691.00
2691.00
1470.00
4410.00
3822.00
3822.00
875.00
2625.00
2275.00
2275.00
1211.00
3633.00
3148.60
3148.60
1764.00
5292.00
4586.40
4586.40
510.00
1530.00
1326.00
1326.00
2476.00
7428.00
6437.60
6437.60
2530.00
7590.00
6578.00
6578.00
238.00
714.00
618.80
618.80
193.00
579.00
501.80
501.80
0.00
0.00
0.00
0.00
144.00
432.00
374.40
374.40
188.00
564.00
488.80
488.80
164.00
492.00
426.40
426.40
494.00
1482.00
1284.40
1284.40
334.00
1002.00
868.40
868.40
342.00
1026.00
889.20
889.20
364.00
1092.00
946.40
946.40
443.00
1329.00
1151.80
1151.80
576.00
1728.00
1497.60
1497.60
636.00
1908.00
1653.60
1653.60
166.00
498.00
431.60
431.60
309.00
927.00
803.40
803.40
864.00
2592.00
2246.40
2246.40
0.00
0.00
0.00
0.00
337.00
1011.00
876.20
876.20
437.00
1311.00
1136.20
1136.20
492.00
1476.00
1279.20
1279.20
173.00
519.00
449.80
449.80
149.00
447.00
387.40
387.40
173.00
519.00
449.80
449.80
187.00
561.00
486.20
486.20
185.00
555.00
481.00
481.00
307.00
921.00
798.20
798.20
718.00
2154.00
1866.80
1866.80
257.00
771.00
668.20
668.20
420.00
1260.00
1092.00
1092.00
770.00
2310.00
2002.00
2002.00
309.00
927.00
803.40
803.40
730.00
2190.00
1898.00
1898.00
0.00
0.00
0.00
0.00
390.00
1170.00
1014.00
1014.00
402.00
1206.00
1045.20
1045.20
428.00
1284.00
1112.80
1112.80
700.00
2100.00
1820.00
1820.00
390.00
1170.00
1014.00
1014.00
242.00
726.00
629.20
629.20
255.00
765.00
663.00
663.00
693.00
2079.00
1801.80
1801.80
345.00
1035.00
897.00
897.00
246.00
738.00
639.60
639.60
192.00
576.00
499.20
499.20
466.00
1398.00
1211.60
1211.60
508.00
1524.00
1320.80
1320.80
497.00
1491.00
1292.20
1292.20
584.00
1752.00
1518.40
1518.40
40.00
120.00
104.00
104.00
346.00
1038.00
899.60
899.60
165.00
495.00
429.00
429.00
181.00
543.00
470.60
470.60
180.00
540.00
468.00
468.00
708.00
2124.00
1840.80
1840.80
148.00
444.00
384.80
384.80
678.00
2034.00
1762.80
1762.80
521.00
1563.00
1354.60
1354.60
0.00
0.00
0.00
0.00
363.00
1089.00
943.80
943.80
477.00
1431.00
1240.20
1240.20
508.00
1524.00
1320.80
1320.80
707.00
2121.00
1838.20
1838.20
463.00
1389.00
1203.80
1203.80
66.00
198.00
171.60
171.60
32.00
96.00
83.20
83.20
149.00
447.00
387.40
387.40
376.00
1128.00
977.60
977.60
348.00
1044.00
904.80
904.80
662.00
1986.00
1721.20
1721.20
1014.00
3042.00
2636.40
2636.40
511.00
1533.00
1328.60
1328.60
503.00
1509.00
1307.80
1307.80
707.00
2121.00
1838.20
1838.20
397.00
1191.00
1032.20
1032.20
364.00
1092.00
946.40
946.40
2127.00
6381.00
5530.20
5530.20
355.00
1065.00
923.00
923.00
412.00
1236.00
1071.20
1071.20
508.00
1524.00
1320.80
1320.80
475.00
1425.00
1235.00
1235.00
606.00
1818.00
1575.60
1575.60
376.00
1128.00
977.60
977.60
510.00
1530.00
1326.00
1326.00
2166.00
6498.00
5631.60
5631.60
2700.00
8100.00
7020.00
7020.00
492.00
1476.00
1279.20
1279.20
91.00
273.00
236.60
236.60
0.00
0.00
0.00
0.00
427.00
1281.00
1110.20
1110.20
294.00
882.00
764.40
764.40
715.00
2145.00
1859.00
1859.00
342.00
1026.00
889.20
889.20
424.00
1272.00
1102.40
1102.40
720.00
2160.00
1872.00
1872.00
345.00
1035.00
897.00
897.00
396.00
1188.00
1029.60
1029.60
413.00
1239.00
1073.80
1073.80
745.00
2235.00
1937.00
1937.00
0.00
0.00
0.00
0.00
364.00
1092.00
946.40
946.40
432.00
1296.00
1123.20
1123.20
395.00
1185.00
1027.00
1027.00
677.00
2031.00
1760.20
1760.20
719.00
2157.00
1869.40
1869.40
3929.00
11787.00
10215.40
10215.40
3446.00
10338.00
8959.60
8959.60
347.00
1041.00
902.20
902.20
690.00
2070.00
1794.00
1794.00
684.00
2052.00
1778.40
1778.40
658.00
1974.00
1710.80
1710.80
702.00
2106.00
1825.20
1825.20
676.00
2028.00
1757.60
1757.60
376.00
1128.00
977.60
977.60
0.00
0.00
0.00
0.00
353.00
1059.00
917.80
917.80
430.00
1290.00
1118.00
1118.00
467.00
1401.00
1214.20
1214.20
335.00
1005.00
871.00
871.00
752.00
2256.00
1955.20
1955.20
413.00
1239.00
1073.80
1073.80
209.00
627.00
543.40
543.40
142.00
426.00
369.20
369.20
466.00
1398.00
1211.60
1211.60
434.00
1302.00
1128.40
1128.40
0.00
0.00
0.00
0.00
378.00
1134.00
982.80
982.80
514.00
1542.00
1336.40
1336.40
653.00
1959.00
1697.80
1697.80
686.00
2058.00
1783.60
1783.60
1151.00
3453.00
2992.60
2992.60
367.00
1101.00
954.20
954.20
669.00
2007.00
1739.40
1739.40
684.00
2052.00
1778.40
1778.40
79.00
237.00
205.40
205.40
2971.00
8913.00
7724.60
7724.60
3668.00
11004.00
9536.80
9536.80
3817.00
11451.00
9924.20
9924.20
4170.00
12510.00
10842.00
10842.00
4609.00
13827.00
11983.40
11983.40
4734.00
14202.00
12308.40
12308.40
0.00
0.00
0.00
0.00
273.00
819.00
709.80
709.80
309.00
927.00
803.40
803.40
327.00
981.00
850.20
850.20
266.00
798.00
691.60
691.60
379.00
1137.00
985.40
985.40
319.00
957.00
829.40
829.40
426.00
1278.00
1107.60
1107.60
0.00
0.00
0.00
0.00
105.00
315.00
273.00
273.00
250.00
750.00
650.00
650.00
143.00
429.00
371.80
371.80
36.00
108.00
93.60
93.60
193.00
579.00
501.80
501.80
209.00
627.00
543.40
543.40
67.00
201.00
174.20
174.20
207.00
621.00
538.20
538.20
239.00
717.00
621.40
621.40
172.00
516.00
447.20
447.20
75.00
225.00
195.00
195.00
71.00
213.00
184.60
184.60
68.00
204.00
176.80
176.80
78.00
234.00
202.80
202.80
0.00
0.00
0.00
0.00
77.00
231.00
200.20
200.20
92.00
276.00
239.20
239.20
95.00
285.00
247.00
247.00
75.00
225.00
195.00
195.00
68.00
204.00
176.80
176.80
93.00
279.00
241.80
241.80
88.00
264.00
228.80
228.80
68.00
204.00
176.80
176.80
70.00
210.00
182.00
182.00
80.00
240.00
208.00
208.00
84.00
252.00
218.40
218.40
84.00
252.00
218.40
218.40
84.00
252.00
218.40
218.40
75.00
225.00
195.00
195.00
88.00
264.00
228.80
228.80
75.00
225.00
195.00
195.00
34.00
102.00
88.40
88.40
70.00
210.00
182.00
182.00
59.00
177.00
153.40
153.40
68.00
204.00
176.80
176.80
71.00
213.00
184.60
184.60
85.00
255.00
221.00
221.00
86.00
258.00
223.60
223.60
86.00
258.00
223.60
223.60
75.00
225.00
195.00
195.00
70.00
210.00
182.00
182.00
36.00
108.00
93.60
93.60
70.00
210.00
182.00
182.00
73.00
219.00
189.80
189.80
83.00
249.00
215.80
215.80
61.00
183.00
158.60
158.60
70.00
210.00
182.00
182.00
70.00
210.00
182.00
182.00
116.00
348.00
301.60
301.60
307.00
921.00
798.20
798.20
267.00
801.00
694.20
694.20
447.00
1341.00
1162.20
1162.20
281.00
843.00
730.60
730.60
1167.00
3501.00
3034.20
3034.20
183.00
549.00
475.80
475.80
198.00
594.00
514.80
514.80
471.00
1413.00
1224.60
1224.60
157.00
471.00
408.20
408.20
2064.00
6192.00
5366.40
5366.40
256.00
768.00
665.60
665.60
164.00
492.00
426.40
426.40
176.00
528.00
457.60
457.60
529.00
1587.00
1375.40
1375.40
238.00
714.00
618.80
618.80
280.00
840.00
728.00
728.00
463.00
1389.00
1203.80
1203.80
360.00
1080.00
936.00
936.00
368.00
1104.00
956.80
956.80
319.00
957.00
829.40
829.40
180.00
540.00
468.00
468.00
241.00
723.00
626.60
626.60
209.00
627.00
543.40
543.40
73.00
219.00
189.80
189.80
211.00
633.00
548.60
548.60
11.00
33.00
28.60
28.60
11.00
33.00
28.60
28.60
9.00
27.00
23.40
23.40
8.00
24.00
20.80
20.80
8.00
24.00
20.80
20.80
9.00
27.00
23.40
23.40
11.00
33.00
28.60
28.60
13.00
39.00
33.80
33.80
23.00
69.00
59.80
59.80
11.00
33.00
28.60
28.60
0.00
0.00
0.00
0.00
45.00
135.00
117.00
117.00
73.00
219.00
189.80
189.80
16.00
48.00
41.60
41.60
29.00
87.00
75.40
75.40
40.00
120.00
104.00
104.00
50.00
150.00
130.00
130.00
61.00
183.00
158.60
158.60
139.00
417.00
361.40
361.40
92.00
276.00
239.20
239.20
18.00
54.00
46.80
46.80
19.00
57.00
49.40
49.40
21.00
63.00
54.60
54.60
17.00
51.00
44.20
44.20
122.00
366.00
317.20
317.20
39.00
117.00
101.40
101.40
43.00
129.00
111.80
111.80
35.00
105.00
91.00
91.00
146.00
438.00
379.60
379.60
108.00
324.00
280.80
280.80
48.00
144.00
124.80
124.80
52.00
156.00
135.20
135.20
60.00
180.00
156.00
156.00
60.00
180.00
156.00
156.00
231.00
693.00
600.60
600.60
92.00
276.00
239.20
239.20
13.00
39.00
33.80
33.80
50.00
150.00
130.00
130.00
50.00
150.00
130.00
130.00
61.00
183.00
158.60
158.60
60.00
180.00
156.00
156.00
61.00
183.00
158.60
158.60
61.00
183.00
158.60
158.60
53.00
159.00
137.80
137.80
25.00
75.00
65.00
65.00
56.00
168.00
145.60
145.60
23.00
69.00
59.80
59.80
104.00
312.00
270.40
270.40
105.00
315.00
273.00
273.00
90.00
270.00
234.00
234.00
74.00
222.00
192.40
192.40
53.00
159.00
137.80
137.80
56.00
168.00
145.60
145.60
68.00
204.00
176.80
176.80
68.00
204.00
176.80
176.80
54.00
162.00
140.40
140.40
41.00
123.00
106.60
106.60
58.00
174.00
150.80
150.80
62.00
186.00
161.20
161.20
95.00
285.00
247.00
247.00
18.00
54.00
46.80
46.80
18.00
54.00
46.80
46.80
16.00
48.00
41.60
41.60
61.00
183.00
158.60
158.60
12.00
36.00
31.20
31.20
12.00
36.00
31.20
31.20
12.00
36.00
31.20
31.20
57.00
171.00
148.20
148.20
25.00
75.00
65.00
65.00
83.00
249.00
215.80
215.80
106.00
318.00
275.60
275.60
96.00
288.00
249.60
249.60
18.00
54.00
46.80
46.80
49.00
147.00
127.40
127.40
19.00
57.00
49.40
49.40
22.00
66.00
57.20
57.20
41.00
123.00
106.60
106.60
46.00
138.00
119.60
119.60
46.00
138.00
119.60
119.60
45.00
135.00
117.00
117.00
65.00
195.00
169.00
169.00
18.00
54.00
46.80
46.80
44.00
132.00
114.40
114.40
22.00
66.00
57.20
57.20
68.00
204.00
176.80
176.80
61.00
183.00
158.60
158.60
33.00
99.00
85.80
85.80
62.00
186.00
161.20
161.20
90.00
270.00
234.00
234.00
91.00
273.00
236.60
236.60
75.00
225.00
195.00
195.00
39.00
117.00
101.40
101.40
51.00
153.00
132.60
132.60
46.00
138.00
119.60
119.60
17.00
51.00
44.20
44.20
18.00
54.00
46.80
46.80
18.00
54.00
46.80
46.80
22.00
66.00
57.20
57.20
15.00
45.00
39.00
39.00
28.00
84.00
72.80
72.80
27.00
81.00
70.20
70.20
74.00
222.00
192.40
192.40
65.00
195.00
169.00
169.00
57.00
171.00
148.20
148.20
77.00
231.00
200.20
200.20
67.00
201.00
174.20
174.20
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
73.00
219.00
189.80
189.80
100.00
300.00
260.00
260.00
55.00
165.00
143.00
143.00
67.00
201.00
174.20
174.20
45.00
135.00
117.00
117.00
81.00
243.00
210.60
210.60
60.00
180.00
156.00
156.00
59.00
177.00
153.40
153.40
17.00
51.00
44.20
44.20
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
23.00
69.00
59.80
59.80
48.00
144.00
124.80
124.80
41.00
123.00
106.60
106.60
43.00
129.00
111.80
111.80
18.00
54.00
46.80
46.80
19.00
57.00
49.40
49.40
34.00
102.00
88.40
88.40
31.00
93.00
80.60
80.60
23.00
69.00
59.80
59.80
70.00
210.00
182.00
182.00
54.00
162.00
140.40
140.40
52.00
156.00
135.20
135.20
49.00
147.00
127.40
127.40
29.00
87.00
75.40
75.40
91.00
273.00
236.60
236.60
80.00
240.00
208.00
208.00
111.00
333.00
288.60
288.60
105.00
315.00
273.00
273.00
44.00
132.00
114.40
114.40
74.00
222.00
192.40
192.40
92.00
276.00
239.20
239.20
92.00
276.00
239.20
239.20
139.00
417.00
361.40
361.40
50.00
150.00
130.00
130.00
41.00
123.00
106.60
106.60
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
123.00
369.00
319.80
319.80
77.00
231.00
200.20
200.20
67.00
201.00
174.20
174.20
100.00
300.00
260.00
260.00
116.00
348.00
301.60
301.60
78.00
234.00
202.80
202.80
87.00
261.00
226.20
226.20
90.00
270.00
234.00
234.00
62.00
186.00
161.20
161.20
54.00
162.00
140.40
140.40
85.00
255.00
221.00
221.00
18.00
54.00
46.80
46.80
60.00
180.00
156.00
156.00
62.00
186.00
161.20
161.20
48.00
144.00
124.80
124.80
65.00
195.00
169.00
169.00
49.00
147.00
127.40
127.40
231.00
693.00
600.60
600.60
67.00
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174.20
174.20
71.00
213.00
184.60
184.60
53.00
159.00
137.80
137.80
62.00
186.00
161.20
161.20
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161.20
161.20
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200.20
200.20
40.00
120.00
104.00
104.00
76.00
228.00
197.60
197.60
30.00
90.00
78.00
78.00
34.00
102.00
88.40
88.40
60.00
180.00
156.00
156.00
29.00
87.00
75.40
75.40
30.00
90.00
78.00
78.00
69.00
207.00
179.40
179.40
102.00
306.00
265.20
265.20
32.00
96.00
83.20
83.20
36.00
108.00
93.60
93.60
14.00
42.00
36.40
36.40
64.00
192.00
166.40
166.40
64.00
192.00
166.40
166.40
51.00
153.00
132.60
132.60
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42.00
36.40
36.40
54.00
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140.40
140.40
14.00
42.00
36.40
36.40
11.00
33.00
28.60
28.60
17.00
51.00
44.20
44.20
46.00
138.00
119.60
119.60
14.00
42.00
36.40
36.40
55.00
165.00
143.00
143.00
35.00
105.00
91.00
91.00
22.00
66.00
57.20
57.20
8.00
24.00
20.80
20.80
77.00
231.00
200.20
200.20
28.00
84.00
72.80
72.80
57.00
171.00
148.20
148.20
26.00
78.00
67.60
67.60
51.00
153.00
132.60
132.60
25.00
75.00
65.00
65.00
66.00
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171.60
171.60
54.00
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140.40
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174.20
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201.00
174.20
174.20
60.00
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156.00
156.00
60.00
180.00
156.00
156.00
242.00
726.00
629.20
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46.00
138.00
119.60
119.60
62.00
186.00
161.20
161.20
242.00
726.00
629.20
629.20
28.00
84.00
72.80
72.80
68.00
204.00
176.80
176.80
79.00
237.00
205.40
205.40
46.00
138.00
119.60
119.60
65.00
195.00
169.00
169.00
8.00
24.00
20.80
20.80
29.00
87.00
75.40
75.40
22.00
66.00
57.20
57.20
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35.00
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91.00
18.00
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46.80
46.80
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70.20
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46.80
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75.40
75.40
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65.00
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30.00
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78.00
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14.00
42.00
36.40
36.40
17.00
51.00
44.20
44.20
25.00
75.00
65.00
65.00
61.00
183.00
158.60
158.60
106.00
318.00
275.60
275.60
61.00
183.00
158.60
158.60
69.00
207.00
179.40
179.40
63.00
189.00
163.80
163.80
46.00
138.00
119.60
119.60
97.00
291.00
252.20
252.20
90.00
270.00
234.00
234.00
81.00
243.00
210.60
210.60
88.00
264.00
228.80
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41.00
123.00
106.60
106.60
31.00
93.00
80.60
80.60
48.00
144.00
124.80
124.80
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119.60
119.60
41.00
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106.60
106.60
46.00
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119.60
119.60
57.00
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148.20
148.20
23.00
69.00
59.80
59.80
32.00
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83.20
83.20
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83.20
83.20
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254.80
254.80
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119.60
119.60
95.00
285.00
247.00
247.00
39.00
117.00
101.40
101.40
22.00
66.00
57.20
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119.60
119.60
71.00
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184.60
184.60
73.00
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189.80
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20.00
60.00
52.00
52.00
41.00
123.00
106.60
106.60
43.00
129.00
111.80
111.80
79.00
237.00
205.40
205.40
68.00
204.00
176.80
176.80
68.00
204.00
176.80
176.80
68.00
204.00
176.80
176.80
33.00
99.00
85.80
85.80
25.00
75.00
65.00
65.00
46.00
138.00
119.60
119.60
122.00
366.00
317.20
317.20
41.00
123.00
106.60
106.60
89.00
267.00
231.40
231.40
113.00
339.00
293.80
293.80
29.00
87.00
75.40
75.40
42.00
126.00
109.20
109.20
34.00
102.00
88.40
88.40
62.00
186.00
161.20
161.20
24.00
72.00
62.40
62.40
26.00
78.00
67.60
67.60
88.00
264.00
228.80
228.80
65.00
195.00
169.00
169.00
65.00
195.00
169.00
169.00
63.00
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163.80
163.80
58.00
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150.80
150.80
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158.60
158.60
59.00
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153.40
153.40
39.00
117.00
101.40
101.40
53.00
159.00
137.80
137.80
43.00
129.00
111.80
111.80
71.00
213.00
184.60
184.60
36.00
108.00
93.60
93.60
21.00
63.00
54.60
54.60
62.00
186.00
161.20
161.20
46.00
138.00
119.60
119.60
88.00
264.00
228.80
228.80
122.00
366.00
317.20
317.20
49.00
147.00
127.40
127.40
88.00
264.00
228.80
228.80
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255.00
221.00
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156.00
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51.00
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132.60
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40.00
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104.00
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72.00
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62.40
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65.00
65.00
107.00
321.00
278.20
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119.60
119.60
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600.60
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431.60
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384.80
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39.00
33.80
33.80
41.00
123.00
106.60
106.60
53.00
159.00
137.80
137.80
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145.60
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39.00
33.80
33.80
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81.00
70.20
70.20
29.00
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75.40
75.40
35.00
105.00
91.00
91.00
19.00
57.00
49.40
49.40
27.00
81.00
70.20
70.20
53.00
159.00
137.80
137.80
60.00
180.00
156.00
156.00
25.00
75.00
65.00
65.00
37.00
111.00
96.20
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51.00
44.20
44.20
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57.00
49.40
49.40
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45.00
39.00
39.00
30.00
90.00
78.00
78.00
166.00
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431.60
431.60
31.00
93.00
80.60
80.60
102.00
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265.20
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239.20
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44.20
44.20
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39.00
39.00
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69.00
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66.00
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171.60
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33.80
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33.80
33.80
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33.80
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49.40
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140.40
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39.00
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101.40
101.40
64.00
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166.40
166.40
61.00
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158.60
158.60
64.00
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166.40
166.40
52.00
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135.20
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31.00
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80.60
80.60
64.00
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166.40
166.40
101.00
303.00
262.60
262.60
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101.40
101.40
34.00
102.00
88.40
88.40
42.00
126.00
109.20
109.20
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693.00
600.60
600.60
233.00
699.00
605.80
605.80
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564.00
488.80
488.80
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396.00
343.20
343.20
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237.00
205.40
205.40
73.00
219.00
189.80
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239.20
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333.00
288.60
288.60
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202.80
202.80
48.00
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124.80
124.80
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221.00
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46.80
46.80
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197.60
197.60
66.00
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171.60
171.60
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75.00
65.00
65.00
9.00
27.00
23.40
23.40
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184.60
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60.00
52.00
52.00
20.00
60.00
52.00
52.00
41.00
123.00
106.60
106.60
41.00
123.00
106.60
106.60
17.00
51.00
44.20
44.20
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239.20
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156.00
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549.00
475.80
475.80
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132.60
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49.40
49.40
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49.40
49.40
46.00
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119.60
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54.60
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59.80
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158.60
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148.20
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36.00
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70.20
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37.00
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96.20
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72.80
72.80
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42.00
36.40
36.40
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39.00
33.80
33.80
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51.00
44.20
44.20
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62.40
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41.60
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44.20
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117.00
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36.00
31.20
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25.00
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65.00
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18.00
54.00
46.80
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145.60
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330.20
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366.00
317.20
317.20
42.00
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109.20
109.20
42.00
126.00
109.20
109.20
49.00
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127.40
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111.80
111.80
41.00
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106.60
106.60
75.00
225.00
195.00
195.00
54.00
162.00
140.40
140.40
27.00
81.00
70.20
70.20
54.00
162.00
140.40
140.40
36.00
108.00
93.60
93.60
0.00
0.00
0.00
0.00
16.00
48.00
41.60
41.60
23.00
69.00
59.80
59.80
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39.00
33.80
33.80
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33.80
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20.80
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84.00
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39.00
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39.00
39.00
20.00
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52.00
52.00
9.00
27.00
23.40
23.40
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48.00
41.60
41.60
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249.60
249.60
76.00
228.00
197.60
197.60
280.00
840.00
728.00
728.00
43.00
129.00
111.80
111.80
13.00
39.00
33.80
33.80
16.00
48.00
41.60
41.60
47.00
141.00
122.20
122.20
64.00
192.00
166.40
166.40
64.00
192.00
166.40
166.40
64.00
192.00
166.40
166.40
74.00
222.00
192.40
192.40
83.00
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215.80
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215.80
215.80
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64.00
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166.40
64.00
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166.40
166.40
69.00
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179.40
179.40
59.00
177.00
153.40
153.40
32.00
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83.20
83.20
68.00
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176.80
176.80
68.00
204.00
176.80
176.80
43.00
129.00
111.80
111.80
39.00
117.00
101.40
101.40
43.00
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111.80
111.80
50.00
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130.00
130.00
42.00
126.00
109.20
109.20
55.00
165.00
143.00
143.00
55.00
165.00
143.00
143.00
46.00
138.00
119.60
119.60
38.00
114.00
98.80
98.80
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45.00
39.00
39.00
15.00
45.00
39.00
39.00
13.00
39.00
33.80
33.80
30.00
90.00
78.00
78.00
25.00
75.00
65.00
65.00
31.00
93.00
80.60
80.60
41.00
123.00
106.60
106.60
26.00
78.00
67.60
67.60
36.00
108.00
93.60
93.60
36.00
108.00
93.60
93.60
31.00
93.00
80.60
80.60
31.00
93.00
80.60
80.60
19.00
57.00
49.40
49.40
64.00
192.00
166.40
166.40
59.00
177.00
153.40
153.40
32.00
96.00
83.20
83.20
28.00
84.00
72.80
72.80
62.00
186.00
161.20
161.20
24.00
72.00
62.40
62.40
36.00
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93.60
93.60
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45.00
39.00
39.00
25.00
75.00
65.00
65.00
28.00
84.00
72.80
72.80
24.00
72.00
62.40
62.40
32.00
96.00
83.20
83.20
47.00
141.00
122.20
122.20
43.00
129.00
111.80
111.80
51.00
153.00
132.60
132.60
23.00
69.00
59.80
59.80
31.00
93.00
80.60
80.60
31.00
93.00
80.60
80.60
67.00
201.00
174.20
174.20
24.00
72.00
62.40
62.40
48.00
144.00
124.80
124.80
77.00
231.00
200.20
200.20
64.00
192.00
166.40
166.40
46.00
138.00
119.60
119.60
14.00
42.00
36.40
36.40
14.00
42.00
36.40
36.40
34.00
102.00
88.40
88.40
34.00
102.00
88.40
88.40
36.00
108.00
93.60
93.60
13.00
39.00
33.80
33.80
10.00
30.00
26.00
26.00
20.00
60.00
52.00
52.00
21.00
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187.20
126.00
378.00
327.60
327.60
154.00
462.00
400.40
400.40
72.00
216.00
187.20
187.20
126.00
378.00
327.60
327.60
150.00
450.00
390.00
390.00
126.00
378.00
327.60
327.60
126.00
378.00
327.60
327.60
72.00
216.00
187.20
187.20
126.00
378.00
327.60
327.60
150.00
450.00
390.00
390.00
126.00
378.00
327.60
327.60
72.00
216.00
187.20
187.20
72.00
216.00
187.20
187.20
126.00
378.00
327.60
327.60
154.00
462.00
400.40
400.40
144.00
432.00
374.40
374.40
252.00
756.00
655.20
655.20
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
468.00
1404.00
1216.80
1216.80
925.00
2775.00
2405.00
2405.00
925.00
2775.00
2405.00
2405.00
1755.00
5265.00
4563.00
4563.00
94.00
282.00
244.40
244.40
32.00
96.00
83.20
83.20
333.00
999.00
865.80
865.80
0.00
0.00
0.00
0.00
674.00
2022.00
1752.40
1752.40
775.00
2325.00
2015.00
2015.00
843.00
2529.00
2191.80
2191.80
606.00
1818.00
1575.60
1575.60
606.00
1818.00
1575.60
1575.60
775.00
2325.00
2015.00
2015.00
1045.00
3135.00
2717.00
2717.00
1146.00
3438.00
2979.60
2979.60
1248.00
3744.00
3244.80
3244.80
606.00
1818.00
1575.60
1575.60
606.00
1818.00
1575.60
1575.60
337.00
1011.00
876.20
876.20
269.00
807.00
699.40
699.40
1686.00
5058.00
4383.60
4383.60
169.00
507.00
439.40
439.40
0.00
0.00
0.00
0.00
225.00
675.00
585.00
585.00
266.00
798.00
691.60
691.60
353.00
1059.00
917.80
917.80
260.00
780.00
676.00
676.00
338.00
1014.00
878.80
878.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
61.00
183.00
158.60
158.60
54.00
162.00
140.40
140.40
29.00
87.00
75.40
75.40
103.00
309.00
267.80
267.80
73.00
219.00
189.80
189.80
73.00
219.00
189.80
189.80
41.00
123.00
106.60
106.60
55.00
165.00
143.00
143.00
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
22.00
66.00
57.20
57.20
182.00
546.00
473.20
473.20
201.00
603.00
522.60
522.60
300.00
900.00
780.00
780.00
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
38.00
114.00
98.80
98.80
182.00
546.00
473.20
473.20
161.00
483.00
418.60
418.60
77.00
231.00
200.20
200.20
95.00
285.00
247.00
247.00
0.00
0.00
0.00
0.00
359.00
1077.00
933.40
933.40
313.00
939.00
813.80
813.80
191.00
573.00
496.60
496.60
222.00
666.00
577.20
577.20
269.00
807.00
699.40
699.40
341.00
1023.00
886.60
886.60
0.00
0.00
0.00
0.00
419.00
1257.00
1089.40
1089.40
505.00
1515.00
1313.00
1313.00
529.00
1587.00
1375.40
1375.40
454.00
1362.00
1180.40
1180.40
530.00
1590.00
1378.00
1378.00
36.00
108.00
93.60
93.60
36.00
108.00
93.60
93.60
535.00
1605.00
1391.00
1391.00
622.00
1866.00
1617.20
1617.20
622.00
1866.00
1617.20
1617.20
635.00
1905.00
1651.00
1651.00
447.00
1341.00
1162.20
1162.20
540.00
1620.00
1404.00
1404.00
447.00
1341.00
1162.20
1162.20
645.00
1935.00
1677.00
1677.00
597.00
1791.00
1552.20
1552.20
77.00
231.00
200.20
200.20
96.00
288.00
249.60
249.60
116.00
348.00
301.60
301.60
125.00
375.00
325.00
325.00
144.00
432.00
374.40
374.40
90.00
270.00
234.00
234.00
246.00
738.00
639.60
639.60
69.00
207.00
179.40
179.40
124.00
372.00
322.40
322.40
101.00
303.00
262.60
262.60
0.00
0.00
0.00
0.00
83.00
249.00
215.80
215.80
182.00
546.00
473.20
473.20
217.00
651.00
564.20
564.20
361.00
1083.00
938.60
938.60
770.00
2310.00
2002.00
2002.00
1146.00
3438.00
2979.60
2979.60
62.00
186.00
161.20
161.20
361.00
1083.00
938.60
938.60
278.00
834.00
722.80
722.80
308.00
924.00
800.80
800.80
427.00
1281.00
1110.20
1110.20
478.00
1434.00
1242.80
1242.80
300.00
900.00
780.00
780.00
517.00
1551.00
1344.20
1344.20
625.00
1875.00
1625.00
1625.00
59.00
177.00
153.40
153.40
312.00
936.00
811.20
811.20
139.00
417.00
361.40
361.40
327.00
981.00
850.20
850.20
195.00
585.00
507.00
507.00
365.00
1095.00
949.00
949.00
354.00
1062.00
920.40
920.40
279.00
837.00
725.40
725.40
2504.00
7512.00
6510.40
6510.40
1290.00
3870.00
3354.00
3354.00
654.00
1962.00
1700.40
1700.40
1078.00
3234.00
2802.80
2802.80
279.00
837.00
725.40
725.40
427.00
1281.00
1110.20
1110.20
522.00
1566.00
1357.20
1357.20
921.00
2763.00
2394.60
2394.60
0.00
0.00
0.00
0.00
577.00
1731.00
1500.20
1500.20
828.00
2484.00
2152.80
2152.80
816.00
2448.00
2121.60
2121.60
80.00
240.00
208.00
208.00
82.00
246.00
213.20
213.20
548.00
1644.00
1424.80
1424.80
721.00
2163.00
1874.60
1874.60
1196.00
3588.00
3109.60
3109.60
2161.00
6483.00
5618.60
5618.60
2202.00
6606.00
5725.20
5725.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
18.00
54.00
46.80
46.80
13.00
39.00
33.80
33.80
13.00
39.00
33.80
33.80
13.00
39.00
33.80
33.80
0.00
0.00
0.00
0.00
631.00
1893.00
1640.60
1640.60
17.00
51.00
44.20
44.20
20.00
60.00
52.00
52.00
15.00
45.00
39.00
39.00
26.00
78.00
67.60
67.60
15.00
45.00
39.00
39.00
13.00
39.00
33.80
33.80
17.00
51.00
44.20
44.20
49.00
147.00
127.40
127.40
11.00
33.00
28.60
28.60
0.00
0.00
0.00
0.00
5876.00
17628.00
15277.60
15277.60
6111.00
18333.00
15888.60
15888.60
0.00
0.00
0.00
0.00
634.62
1903.85
1650.00
1650.00
711.54
2134.62
1850.00
1850.00
365.38
1096.15
950.00
950.00
384.62
1153.85
1000.00
1000.00
1300.00
3900.00
3380.00
3380.00
20.00
60.00
52.00
52.00
211.54
634.62
550.00
550.00
711.54
2134.62
1850.00
1850.00
0.00
0.00
0.00
0.00
300.00
900.00
780.00
780.00
10400.00
31200.00
27040.00
27040.00
10400.00
31200.00
27040.00
27040.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
32.00
96.00
83.20
83.20
31.00
93.00
80.60
80.60
43.00
129.00
111.80
111.80
43.00
129.00
111.80
111.80
56.00
168.00
145.60
145.60
39.00
117.00
101.40
101.40
76.00
228.00
197.60
197.60
36.00
108.00
93.60
93.60
71.00
213.00
184.60
184.60
0.00
0.00
0.00
0.00
192.31
576.92
500.00
500.00
650.00
1950.00
1690.00
1690.00
192.31
576.92
500.00
500.00
192.31
576.92
500.00
500.00
288.46
865.38
750.00
750.00
192.31
576.92
500.00
500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
28.00
84.00
72.80
72.80
13.00
39.00
33.80
33.80
0.00
0.00
0.00
0.00
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
11.00
33.00
28.60
28.60
11.00
33.00
28.60
28.60
568.00
1704.00
1476.80
1476.80
631.00
1893.00
1640.60
1640.60
231.00
693.00
600.60
600.60
270.00
810.00
702.00
702.00
304.00
912.00
790.40
790.40
373.00
1119.00
969.80
969.80
448.00
1344.00
1164.80
1164.80
521.00
1563.00
1354.60
1354.60
234.00
702.00
608.40
608.40
307.00
921.00
798.20
798.20
333.00
999.00
865.80
865.80
405.00
1215.00
1053.00
1053.00
476.00
1428.00
1237.60
1237.60
580.00
1740.00
1508.00
1508.00
197.00
591.00
512.20
512.20
238.00
714.00
618.80
618.80
293.00
879.00
761.80
761.80
341.00
1023.00
886.60
886.60
434.00
1302.00
1128.40
1128.40
490.00
1470.00
1274.00
1274.00
215.00
645.00
559.00
559.00
257.00
771.00
668.20
668.20
313.00
939.00
813.80
813.80
357.00
1071.00
928.20
928.20
452.00
1356.00
1175.20
1175.20
506.00
1518.00
1315.60
1315.60
292.00
876.00
759.20
759.20
304.00
912.00
790.40
790.40
381.00
1143.00
990.60
990.60
127.00
381.00
330.20
330.20
120.00
360.00
312.00
312.00
140.00
420.00
364.00
364.00
219.00
657.00
569.40
569.40
600.00
1800.00
1560.00
1560.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
628.00
1884.00
1632.80
1632.80
269.00
807.00
699.40
699.40
400.00
1200.00
1040.00
1040.00
355.00
1065.00
923.00
923.00
316.00
948.00
821.60
821.60
187.00
561.00
486.20
486.20
326.00
978.00
847.60
847.60
50.00
150.00
130.00
130.00
0.00
0.00
0.00
0.00
71.00
213.00
184.60
184.60
155.00
465.00
403.00
403.00
271.00
813.00
704.60
704.60
387.00
1161.00
1006.20
1006.20
211.00
633.00
548.60
548.60
306.00
918.00
795.60
795.60
464.00
1392.00
1206.40
1206.40
3501.00
10503.00
9102.60
9102.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3032.00
9096.00
7883.20
7883.20
1701.00
5103.00
4422.60
4422.60
1180.00
3540.00
3068.00
3068.00
2400.00
7200.00
6240.00
6240.00
1629.00
4887.00
4235.40
4235.40
1101.00
3303.00
2862.60
2862.60
1055.00
3165.00
2743.00
2743.00
887.00
2661.00
2306.20
2306.20
683.00
2049.00
1775.80
1775.80
2028.00
6084.00
5272.80
5272.80
1767.00
5301.00
4594.20
4594.20
1684.00
5052.00
4378.40
4378.40
885.00
2655.00
2301.00
2301.00
98.00
294.00
254.80
254.80
84.00
252.00
218.40
218.40
83.00
249.00
215.80
215.80
43.00
129.00
111.80
111.80
506.00
1518.00
1315.60
1315.60
249.00
747.00
647.40
647.40
334.00
1002.00
868.40
868.40
0.00
0.00
0.00
0.00
647.00
1941.00
1682.20
1682.20
87.00
261.00
226.20
226.20
859.00
2577.00
2233.40
2233.40
631.00
1893.00
1640.60
1640.60
506.00
1518.00
1315.60
1315.60
687.00
2061.00
1786.20
1786.20
1738.00
5214.00
4518.80
4518.80
590.00
1770.00
1534.00
1534.00
835.00
2505.00
2171.00
2171.00
1028.00
3084.00
2672.80
2672.80
256.00
768.00
665.60
665.60
3227.00
9681.00
8390.20
8390.20
2602.00
7806.00
6765.20
6765.20
534.00
1602.00
1388.40
1388.40
1289.00
3867.00
3351.40
3351.40
804.00
2412.00
2090.40
2090.40
264.00
792.00
686.40
686.40
324.00
972.00
842.40
842.40
0.00
0.00
0.00
0.00
105.00
315.00
273.00
273.00
196.00
588.00
509.60
509.60
112.00
336.00
291.20
291.20
163.00
489.00
423.80
423.80
38.00
114.00
98.80
98.80
549.00
1647.00
1427.40
1427.40
261.00
783.00
678.60
678.60
51.00
153.00
132.60
132.60
138.00
414.00
358.80
358.80
237.00
711.00
616.20
616.20
194.00
582.00
504.40
504.40
259.00
777.00
673.40
673.40
173.00
519.00
449.80
449.80
248.00
744.00
644.80
644.80
330.00
990.00
858.00
858.00
354.00
1062.00
920.40
920.40
288.00
864.00
748.80
748.80
320.00
960.00
832.00
832.00
136.00
408.00
353.60
353.60
167.00
501.00
434.20
434.20
167.00
501.00
434.20
434.20
320.00
960.00
832.00
832.00
228.00
684.00
592.80
592.80
51.00
153.00
132.60
132.60
46.00
138.00
119.60
119.60
43.00
129.00
111.80
111.80
112.00
336.00
291.20
291.20
210.00
630.00
546.00
546.00
502.00
1506.00
1305.20
1305.20
891.00
2673.00
2316.60
2316.60
279.00
837.00
725.40
725.40
34.00
102.00
88.40
88.40
306.00
918.00
795.60
795.60
329.00
987.00
855.40
855.40
566.00
1698.00
1471.60
1471.60
191.00
573.00
496.60
496.60
211.00
633.00
548.60
548.60
90.00
270.00
234.00
234.00
443.00
1329.00
1151.80
1151.80
446.00
1338.00
1159.60
1159.60
175.00
525.00
455.00
455.00
189.00
567.00
491.40
491.40
217.00
651.00
564.20
564.20
189.00
567.00
491.40
491.40
143.00
429.00
371.80
371.80
139.00
417.00
361.40
361.40
193.00
579.00
501.80
501.80
136.00
408.00
353.60
353.60
138.00
414.00
358.80
358.80
59.00
177.00
153.40
153.40
64.00
192.00
166.40
166.40
73.00
219.00
189.80
189.80
79.00
237.00
205.40
205.40
73.00
219.00
189.80
189.80
85.00
255.00
221.00
221.00
22.00
66.00
57.20
57.20
36.00
108.00
93.60
93.60
38.00
114.00
98.80
98.80
56.00
168.00
145.60
145.60
39.00
117.00
101.40
101.40
0.00
0.00
0.00
0.00
375.00
1125.00
975.00
975.00
57.00
171.00
148.20
148.20
319.00
957.00
829.40
829.40
131.00
393.00
340.60
340.60
48.00
144.00
124.80
124.80
299.00
897.00
777.40
777.40
115.00
345.00
299.00
299.00
131.00
393.00
340.60
340.60
275.00
825.00
715.00
715.00
133.00
399.00
345.80
345.80
98.00
294.00
254.80
254.80
88.00
264.00
228.80
228.80
141.00
423.00
366.60
366.60
75.00
225.00
195.00
195.00
364.00
1092.00
946.40
946.40
140.00
420.00
364.00
364.00
144.00
432.00
374.40
374.40
67.00
201.00
174.20
174.20
116.00
348.00
301.60
301.60
111.00
333.00
288.60
288.60
348.00
1044.00
904.80
904.80
20.00
60.00
52.00
52.00
384.00
1152.00
998.40
998.40
78.00
234.00
202.80
202.80
41.00
123.00
106.60
106.60
104.00
312.00
270.40
270.40
126.00
378.00
327.60
327.60
73.00
219.00
189.80
189.80
59.00
177.00
153.40
153.40
139.00
417.00
361.40
361.40
91.00
273.00
236.60
236.60
54.00
162.00
140.40
140.40
124.00
372.00
322.40
322.40
108.00
324.00
280.80
280.80
96.00
288.00
249.60
249.60
86.00
258.00
223.60
223.60
47.00
141.00
122.20
122.20
52.00
156.00
135.20
135.20
29.00
87.00
75.40
75.40
60.00
180.00
156.00
156.00
78.00
234.00
202.80
202.80
98.00
294.00
254.80
254.80
191.00
573.00
496.60
496.60
57.00
171.00
148.20
148.20
53.00
159.00
137.80
137.80
164.00
492.00
426.40
426.40
200.00
600.00
520.00
520.00
131.00
393.00
340.60
340.60
241.00
723.00
626.60
626.60
452.00
1356.00
1175.20
1175.20
254.00
762.00
660.40
660.40
130.00
390.00
338.00
338.00
255.00
765.00
663.00
663.00
165.00
495.00
429.00
429.00
210.00
630.00
546.00
546.00
65.00
195.00
169.00
169.00
108.00
324.00
280.80
280.80
63.00
189.00
163.80
163.80
135.00
405.00
351.00
351.00
158.00
474.00
410.80
410.80
169.00
507.00
439.40
439.40
499.00
1497.00
1297.40
1297.40
304.00
912.00
790.40
790.40
538.00
1614.00
1398.80
1398.80
320.00
960.00
832.00
832.00
0.00
0.00
0.00
0.00
306.00
918.00
795.60
795.60
276.00
828.00
717.60
717.60
152.00
456.00
395.20
395.20
331.00
993.00
860.60
860.60
292.00
876.00
759.20
759.20
320.00
960.00
832.00
832.00
629.00
1887.00
1635.40
1635.40
145.00
435.00
377.00
377.00
564.00
1692.00
1466.40
1466.40
131.00
393.00
340.60
340.60
757.00
2271.00
1968.20
1968.20
162.00
486.00
421.20
421.20
325.00
975.00
845.00
845.00
82.00
246.00
213.20
213.20
259.00
777.00
673.40
673.40
329.00
987.00
855.40
855.40
40.00
120.00
104.00
104.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
220.00
660.00
572.00
572.00
0.00
0.00
0.00
0.00
1054.00
3162.00
2740.40
2740.40
39.00
117.00
101.40
101.40
767.00
2301.00
1994.20
1994.20
899.00
2697.00
2337.40
2337.40
651.00
1953.00
1692.60
1692.60
344.00
1032.00
894.40
894.40
671.00
2013.00
1744.60
1744.60
614.00
1842.00
1596.40
1596.40
1489.00
4467.00
3871.40
3871.40
193.00
579.00
501.80
501.80
340.00
1020.00
884.00
884.00
208.00
624.00
540.80
540.80
3060.00
9180.00
7956.00
7956.00
851.00
2553.00
2212.60
2212.60
2268.00
6804.00
5896.80
5896.80
608.00
1824.00
1580.80
1580.80
5034.00
15102.00
13088.40
13088.40
5183.00
15549.00
13475.80
13475.80
4074.00
12222.00
10592.40
10592.40
1220.00
3660.00
3172.00
3172.00
965.00
2895.00
2509.00
2509.00
2496.00
7488.00
6489.60
6489.60
669.00
2007.00
1739.40
1739.40
2472.00
7416.00
6427.20
6427.20
1226.00
3678.00
3187.60
3187.60
65.00
195.00
169.00
169.00
33.00
99.00
85.80
85.80
32.00
96.00
83.20
83.20
301.00
903.00
782.60
782.60
82.00
246.00
213.20
213.20
164.00
492.00
426.40
426.40
55.00
165.00
143.00
143.00
397.00
1191.00
1032.20
1032.20
569.00
1707.00
1479.40
1479.40
46.00
138.00
119.60
119.60
19.00
57.00
49.40
49.40
27.00
81.00
70.20
70.20
322.00
966.00
837.20
837.20
93.00
279.00
241.80
241.80
131.00
393.00
340.60
340.60
98.00
294.00
254.80
254.80
97.00
291.00
252.20
252.20
2554.00
7662.00
6640.40
6640.40
792.00
2376.00
2059.20
2059.20
32.00
96.00
83.20
83.20
668.00
2004.00
1736.80
1736.80
93.00
279.00
241.80
241.80
112.00
336.00
291.20
291.20
178.00
534.00
462.80
462.80
205.00
615.00
533.00
533.00
240.00
720.00
624.00
624.00
222.00
666.00
577.20
577.20
287.00
861.00
746.20
746.20
315.00
945.00
819.00
819.00
145.00
435.00
377.00
377.00
93.00
279.00
241.80
241.80
124.00
372.00
322.40
322.40
131.00
393.00
340.60
340.60
232.00
696.00
603.20
603.20
110.00
330.00
286.00
286.00
126.00
378.00
327.60
327.60
115.00
345.00
299.00
299.00
202.00
606.00
525.20
525.20
176.00
528.00
457.60
457.60
351.00
1053.00
912.60
912.60
89.00
267.00
231.40
231.40
96.00
288.00
249.60
249.60
104.00
312.00
270.40
270.40
0.00
0.00
0.00
0.00
711.00
2133.00
1848.60
1848.60
465.00
1395.00
1209.00
1209.00
683.00
2049.00
1775.80
1775.80
433.00
1299.00
1125.80
1125.80
345.00
1035.00
897.00
897.00
1130.00
3390.00
2938.00
2938.00
159.00
477.00
413.40
413.40
1008.00
3024.00
2620.80
2620.80
1014.00
3042.00
2636.40
2636.40
166.00
498.00
431.60
431.60
634.00
1902.00
1648.40
1648.40
757.00
2271.00
1968.20
1968.20
192.00
576.00
499.20
499.20
87.00
261.00
226.20
226.20
83.00
249.00
215.80
215.80
726.00
2178.00
1887.60
1887.60
837.00
2511.00
2176.20
2176.20
116.00
348.00
301.60
301.60
2863.00
8589.00
7443.80
7443.80
3179.00
9537.00
8265.40
8265.40
4160.00
12480.00
10816.00
10816.00
3278.00
9834.00
8522.80
8522.80
3825.00
11475.00
9945.00
9945.00
4102.00
12306.00
10665.20
10665.20
4649.00
13947.00
12087.40
12087.40
3956.00
11868.00
10285.60
10285.60
4369.00
13107.00
11359.40
11359.40
4676.00
14028.00
12157.60
12157.60
5357.00
16071.00
13928.20
13928.20
764.00
2292.00
1986.40
1986.40
405.00
1215.00
1053.00
1053.00
945.00
2835.00
2457.00
2457.00
503.00
1509.00
1307.80
1307.80
2878.00
8634.00
7482.80
7482.80
1084.00
3252.00
2818.40
2818.40
2752.00
8256.00
7155.20
7155.20
2801.00
8403.00
7282.60
7282.60
2791.00
8373.00
7256.60
7256.60
156.00
468.00
405.60
405.60
24.00
72.00
62.40
62.40
210.00
630.00
546.00
546.00
214.00
642.00
556.40
556.40
162.00
486.00
421.20
421.20
634.00
1902.00
1648.40
1648.40
524.00
1572.00
1362.40
1362.40
573.00
1719.00
1489.80
1489.80
964.00
2892.00
2506.40
2506.40
562.00
1686.00
1461.20
1461.20
3729.00
11187.00
9695.40
9695.40
5032.00
15096.00
13083.20
13083.20
679.00
2037.00
1765.40
1765.40
197.00
591.00
512.20
512.20
643.00
1929.00
1671.80
1671.80
133.00
399.00
345.80
345.80
766.00
2298.00
1991.60
1991.60
796.00
2388.00
2069.60
2069.60
1432.00
4296.00
3723.20
3723.20
226.00
678.00
587.60
587.60
323.00
969.00
839.80
839.80
1367.00
4101.00
3554.20
3554.20
2505.00
7515.00
6513.00
6513.00
2990.00
8970.00
7774.00
7774.00
538.00
1614.00
1398.80
1398.80
790.00
2370.00
2054.00
2054.00
730.00
2190.00
1898.00
1898.00
1214.00
3642.00
3156.40
3156.40
1898.00
5694.00
4934.80
4934.80
1679.00
5037.00
4365.40
4365.40
2146.00
6438.00
5579.60
5579.60
1373.00
4119.00
3569.80
3569.80
2182.00
6546.00
5673.20
5673.20
3326.00
9978.00
8647.60
8647.60
3621.00
10863.00
9414.60
9414.60
552.00
1656.00
1435.20
1435.20
701.00
2103.00
1822.60
1822.60
33.00
99.00
85.80
85.80
84.00
252.00
218.40
218.40
180.00
540.00
468.00
468.00
149.00
447.00
387.40
387.40
31.00
93.00
80.60
80.60
985.00
2955.00
2561.00
2561.00
33.00
99.00
85.80
85.80
0.00
0.00
0.00
0.00
192.00
576.00
499.20
499.20
33.00
99.00
85.80
85.80
195.00
585.00
507.00
507.00
106.00
318.00
275.60
275.60
28.00
84.00
72.80
72.80
70.00
210.00
182.00
182.00
30.00
90.00
78.00
78.00
43.00
129.00
111.80
111.80
0.00
0.00
0.00
0.00
378.00
1134.00
982.80
982.80
877.00
2631.00
2280.20
2280.20
640.00
1920.00
1664.00
1664.00
1285.00
3855.00
3341.00
3341.00
768.00
2304.00
1996.80
1996.80
992.00
2976.00
2579.20
2579.20
1251.00
3753.00
3252.60
3252.60
1358.00
4074.00
3530.80
3530.80
338.00
1014.00
878.80
878.80
526.00
1578.00
1367.60
1367.60
669.00
2007.00
1739.40
1739.40
1112.00
3336.00
2891.20
2891.20
738.00
2214.00
1918.80
1918.80
888.00
2664.00
2308.80
2308.80
591.00
1773.00
1536.60
1536.60
446.00
1338.00
1159.60
1159.60
600.00
1800.00
1560.00
1560.00
432.00
1296.00
1123.20
1123.20
1336.00
4008.00
3473.60
3473.60
767.00
2301.00
1994.20
1994.20
865.00
2595.00
2249.00
2249.00
599.00
1797.00
1557.40
1557.40
617.00
1851.00
1604.20
1604.20
404.00
1212.00
1050.40
1050.40
155.00
465.00
403.00
403.00
786.00
2358.00
2043.60
2043.60
350.00
1050.00
910.00
910.00
250.00
750.00
650.00
650.00
182.00
546.00
473.20
473.20
343.00
1029.00
891.80
891.80
130.00
390.00
338.00
338.00
371.00
1113.00
964.60
964.60
572.00
1716.00
1487.20
1487.20
117.00
351.00
304.20
304.20
175.00
525.00
455.00
455.00
83.00
249.00
215.80
215.80
92.00
276.00
239.20
239.20
224.00
672.00
582.40
582.40
222.00
666.00
577.20
577.20
45.00
135.00
117.00
117.00
89.00
267.00
231.40
231.40
145.00
435.00
377.00
377.00
45.00
135.00
117.00
117.00
118.00
354.00
306.80
306.80
124.00
372.00
322.40
322.40
162.00
486.00
421.20
421.20
124.00
372.00
322.40
322.40
141.00
423.00
366.60
366.60
197.00
591.00
512.20
512.20
237.00
711.00
616.20
616.20
206.00
618.00
535.60
535.60
279.00
837.00
725.40
725.40
228.00
684.00
592.80
592.80
199.00
597.00
517.40
517.40
585.00
1755.00
1521.00
1521.00
32.00
96.00
83.20
83.20
146.00
438.00
379.60
379.60
155.00
465.00
403.00
403.00
52.00
156.00
135.20
135.20
225.00
675.00
585.00
585.00
136.00
408.00
353.60
353.60
31.00
93.00
80.60
80.60
43.00
129.00
111.80
111.80
83.00
249.00
215.80
215.80
208.00
624.00
540.80
540.80
181.00
543.00
470.60
470.60
178.00
534.00
462.80
462.80
186.00
558.00
483.60
483.60
183.00
549.00
475.80
475.80
292.00
876.00
759.20
759.20
11.00
33.00
28.60
28.60
17.00
51.00
44.20
44.20
56.00
168.00
145.60
145.60
47.00
141.00
122.20
122.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
24.00
72.00
62.40
62.40
34.00
102.00
88.40
88.40
71.00
213.00
184.60
184.60
57.00
171.00
148.20
148.20
27.00
81.00
70.20
70.20
17.00
51.00
44.20
44.20
24.00
72.00
62.40
62.40
20.00
60.00
52.00
52.00
23.00
69.00
59.80
59.80
158.00
474.00
410.80
410.80
116.00
348.00
301.60
301.60
42.00
126.00
109.20
109.20
103.00
309.00
267.80
267.80
158.00
474.00
410.80
410.80
241.00
723.00
626.60
626.60
34.00
102.00
88.40
88.40
20.00
60.00
52.00
52.00
53.00
159.00
137.80
137.80
22.00
66.00
57.20
57.20
88.00
264.00
228.80
228.80
112.00
336.00
291.20
291.20
135.00
405.00
351.00
351.00
164.00
492.00
426.40
426.40
196.00
588.00
509.60
509.60
24.00
72.00
62.40
62.40
39.00
117.00
101.40
101.40
72.00
216.00
187.20
187.20
65.00
195.00
169.00
169.00
97.00
291.00
252.20
252.20
130.00
390.00
338.00
338.00
24.00
72.00
62.40
62.40
18.00
54.00
46.80
46.80
512.00
1536.00
1331.20
1331.20
0.00
0.00
0.00
0.00
555.00
1665.00
1443.00
1443.00
163.00
489.00
423.80
423.80
771.00
2313.00
2004.60
2004.60
363.00
1089.00
943.80
943.80
609.00
1827.00
1583.40
1583.40
1454.00
4362.00
3780.40
3780.40
614.00
1842.00
1596.40
1596.40
1553.00
4659.00
4037.80
4037.80
2340.00
7020.00
6084.00
6084.00
2198.00
6594.00
5714.80
5714.80
2306.00
6918.00
5995.60
5995.60
1169.00
3507.00
3039.40
3039.40
1382.00
4146.00
3593.20
3593.20
1066.00
3198.00
2771.60
2771.60
739.00
2217.00
1921.40
1921.40
1110.00
3330.00
2886.00
2886.00
336.00
1008.00
873.60
873.60
2096.00
6288.00
5449.60
5449.60
5149.00
15447.00
13387.40
13387.40
362.00
1086.00
941.20
941.20
112.00
336.00
291.20
291.20
111.00
333.00
288.60
288.60
69.00
207.00
179.40
179.40
183.00
549.00
475.80
475.80
32.00
96.00
83.20
83.20
29.00
87.00
75.40
75.40
185.00
555.00
481.00
481.00
358.00
1074.00
930.80
930.80
533.00
1599.00
1385.80
1385.80
644.00
1932.00
1674.40
1674.40
689.00
2067.00
1791.40
1791.40
469.00
1407.00
1219.40
1219.40
423.00
1269.00
1099.80
1099.80
326.00
978.00
847.60
847.60
443.00
1329.00
1151.80
1151.80
235.00
705.00
611.00
611.00
229.00
687.00
595.40
595.40
711.00
2133.00
1848.60
1848.60
233.00
699.00
605.80
605.80
222.00
666.00
577.20
577.20
429.00
1287.00
1115.40
1115.40
225.00
675.00
585.00
585.00
269.00
807.00
699.40
699.40
199.00
597.00
517.40
517.40
316.00
948.00
821.60
821.60
623.00
1869.00
1619.80
1619.80
315.00
945.00
819.00
819.00
394.00
1182.00
1024.40
1024.40
540.00
1620.00
1404.00
1404.00
606.00
1818.00
1575.60
1575.60
593.00
1779.00
1541.80
1541.80
587.00
1761.00
1526.20
1526.20
905.00
2715.00
2353.00
2353.00
957.00
2871.00
2488.20
2488.20
494.00
1482.00
1284.40
1284.40
294.00
882.00
764.40
764.40
229.00
687.00
595.40
595.40
187.00
561.00
486.20
486.20
266.00
798.00
691.60
691.60
1111.00
3333.00
2888.60
2888.60
928.00
2784.00
2412.80
2412.80
1563.00
4689.00
4063.80
4063.80
1148.00
3444.00
2984.80
2984.80
653.00
1959.00
1697.80
1697.80
3267.00
9801.00
8494.20
8494.20
1318.00
3954.00
3426.80
3426.80
1845.00
5535.00
4797.00
4797.00
1031.00
3093.00
2680.60
2680.60
907.00
2721.00
2358.20
2358.20
2501.00
7503.00
6502.60
6502.60
1239.00
3717.00
3221.40
3221.40
1043.00
3129.00
2711.80
2711.80
120.00
360.00
312.00
312.00
213.00
639.00
553.80
553.80
406.00
1218.00
1055.60
1055.60
237.00
711.00
616.20
616.20
733.00
2199.00
1905.80
1905.80
395.00
1185.00
1027.00
1027.00
889.00
2667.00
2311.40
2311.40
385.00
1155.00
1001.00
1001.00
178.00
534.00
462.80
462.80
118.00
354.00
306.80
306.80
191.00
573.00
496.60
496.60
274.00
822.00
712.40
712.40
220.00
660.00
572.00
572.00
161.00
483.00
418.60
418.60
362.00
1086.00
941.20
941.20
372.00
1116.00
967.20
967.20
82.00
246.00
213.20
213.20
74.00
222.00
192.40
192.40
422.00
1266.00
1097.20
1097.20
587.00
1761.00
1526.20
1526.20
161.00
483.00
418.60
418.60
307.00
921.00
798.20
798.20
263.00
789.00
683.80
683.80
234.00
702.00
608.40
608.40
300.00
900.00
780.00
780.00
32.00
96.00
83.20
83.20
459.00
1377.00
1193.40
1193.40
339.00
1017.00
881.40
881.40
334.00
1002.00
868.40
868.40
248.00
744.00
644.80
644.80
333.00
999.00
865.80
865.80
358.00
1074.00
930.80
930.80
74.00
222.00
192.40
192.40
73.00
219.00
189.80
189.80
69.00
207.00
179.40
179.40
17.00
51.00
44.20
44.20
68.00
204.00
176.80
176.80
84.00
252.00
218.40
218.40
71.00
213.00
184.60
184.60
20.00
60.00
52.00
52.00
86.00
258.00
223.60
223.60
27.00
81.00
70.20
70.20
41.00
123.00
106.60
106.60
24.00
72.00
62.40
62.40
190.00
570.00
494.00
494.00
20.00
60.00
52.00
52.00
85.00
255.00
221.00
221.00
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
20.00
60.00
52.00
52.00
0.00
0.00
0.00
0.00
256.00
768.00
665.60
665.60
111.00
333.00
288.60
288.60
249.00
747.00
647.40
647.40
262.00
786.00
681.20
681.20
373.00
1119.00
969.80
969.80
210.00
630.00
546.00
546.00
478.00
1434.00
1242.80
1242.80
104.00
312.00
270.40
270.40
526.00
1578.00
1367.60
1367.60
238.00
714.00
618.80
618.80
359.00
1077.00
933.40
933.40
573.00
1719.00
1489.80
1489.80
268.00
804.00
696.80
696.80
614.00
1842.00
1596.40
1596.40
1325.00
3975.00
3445.00
3445.00
664.00
1992.00
1726.40
1726.40
389.00
1167.00
1011.40
1011.40
460.00
1380.00
1196.00
1196.00
377.00
1131.00
980.20
980.20
40.00
120.00
104.00
104.00
258.00
774.00
670.80
670.80
0.00
0.00
0.00
0.00
480.00
1440.00
1248.00
1248.00
219.00
657.00
569.40
569.40
99.00
297.00
257.40
257.40
35.00
105.00
91.00
91.00
82.00
246.00
213.20
213.20
233.00
699.00
605.80
605.80
254.00
762.00
660.40
660.40
326.00
978.00
847.60
847.60
459.00
1377.00
1193.40
1193.40
319.00
957.00
829.40
829.40
656.00
1968.00
1705.60
1705.60
138.00
414.00
358.80
358.80
77.00
231.00
200.20
200.20
158.00
474.00
410.80
410.80
190.00
570.00
494.00
494.00
199.00
597.00
517.40
517.40
99.00
297.00
257.40
257.40
22.00
66.00
57.20
57.20
29.00
87.00
75.40
75.40
29.00
87.00
75.40
75.40
34.00
102.00
88.40
88.40
19.00
57.00
49.40
49.40
41.00
123.00
106.60
106.60
23.00
69.00
59.80
59.80
22.00
66.00
57.20
57.20
27.00
81.00
70.20
70.20
34.00
102.00
88.40
88.40
57.00
171.00
148.20
148.20
32.00
96.00
83.20
83.20
23.00
69.00
59.80
59.80
59.00
177.00
153.40
153.40
0.00
0.00
0.00
0.00
58.00
174.00
150.80
150.80
61.00
183.00
158.60
158.60
77.00
231.00
200.20
200.20
51.00
153.00
132.60
132.60
47.00
141.00
122.20
122.20
0.00
0.00
0.00
0.00
54.00
162.00
140.40
140.40
38.00
114.00
98.80
98.80
63.00
189.00
163.80
163.80
48.00
144.00
124.80
124.80
53.00
159.00
137.80
137.80
126.00
378.00
327.60
327.60
55.00
165.00
143.00
143.00
55.00
165.00
143.00
143.00
401.00
1203.00
1042.60
1042.60
56.00
168.00
145.60
145.60
135.00
405.00
351.00
351.00
90.00
270.00
234.00
234.00
42.00
126.00
109.20
109.20
76.00
228.00
197.60
197.60
82.00
246.00
213.20
213.20
61.00
183.00
158.60
158.60
132.00
396.00
343.20
343.20
138.00
414.00
358.80
358.80
60.00
180.00
156.00
156.00
83.00
249.00
215.80
215.80
45.00
135.00
117.00
117.00
39.00
117.00
101.40
101.40
20.00
60.00
52.00
52.00
67.00
201.00
174.20
174.20
51.00
153.00
132.60
132.60
143.00
429.00
371.80
371.80
58.00
174.00
150.80
150.80
59.00
177.00
153.40
153.40
79.00
237.00
205.40
205.40
103.00
309.00
267.80
267.80
119.00
357.00
309.40
309.40
139.00
417.00
361.40
361.40
48.00
144.00
124.80
124.80
68.00
204.00
176.80
176.80
87.00
261.00
226.20
226.20
45.00
135.00
117.00
117.00
47.00
141.00
122.20
122.20
46.00
138.00
119.60
119.60
33.00
99.00
85.80
85.80
19.00
57.00
49.40
49.40
36.00
108.00
93.60
93.60
53.00
159.00
137.80
137.80
38.00
114.00
98.80
98.80
2.45
7.35
6.37
6.37
2.8
8.40
7.28
7.28
3.15
9.45
8.19
8.19
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
24.00
72.00
62.40
62.40
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
28.00
84.00
72.80
72.80
32.00
96.00
83.20
83.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
50.00
150.00
130.00
130.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
210.00
630.00
546.00
546.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
315.00
945.00
819.00
819.00
263.00
789.00
683.80
683.80
105.00
315.00
273.00
273.00
289.00
867.00
751.40
751.40
236.00
708.00
613.60
613.60
105.00
315.00
273.00
273.00
516.00
1548.00
1341.60
1341.60
63.00
189.00
163.80
163.80
11.00
33.00
28.60
28.60
63.00
189.00
163.80
163.80
43.00
129.00
111.80
111.80
399.00
1197.00
1037.40
1037.40
564.00
1692.00
1466.40
1466.40
395.00
1185.00
1027.00
1027.00
282.00
846.00
733.20
733.20
169.00
507.00
439.40
439.40
0.00
0.00
0.00
0.00
3825.00
11475.00
9945.00
9945.00
3825.00
11475.00
9945.00
9945.00
4066.00
12198.00
10571.60
10571.60
4342.50
13027.50
11290.50
11290.50
1694.50
5083.50
4405.70
4405.70
2553.00
7659.00
6637.80
6637.80
2553.00
7659.00
6637.80
6637.80
300.00
900.00
780.00
780.00
2440.50
7321.50
6345.30
6345.30
2440.50
7321.50
6345.30
6345.30
2440.50
7321.50
6345.30
6345.30
2044.00
6132.00
5314.40
5314.40
2044.00
6132.00
5314.40
5314.40
2044.00
6132.00
5314.40
5314.40
3449.00
10347.00
8967.40
8967.40
4175.50
12526.50
10856.30
10856.30
2053.50
6160.50
5339.10
5339.10
3575.50
10726.50
9296.30
9296.30
508.00
1524.00
1320.80
1320.80
438.00
1314.00
1138.80
1138.80
173.50
520.50
451.10
451.10
721.50
2164.50
1875.90
1875.90
424.50
1273.50
1103.70
1103.70
108.50
325.50
282.10
282.10
150.00
450.00
390.00
390.00
ALICO
HILAL Enhanced
811.20
873.60
800.80
862.40
845.00
910.00
886.60
954.80
1513.20
1629.60
949.00
1022.00
1609.40
1733.20
868.40
935.20
1744.60
1878.80
1099.80
1184.40
889.20
957.60
1669.20
1797.60
317.20
341.60
135.20
145.60
5506.80
5930.40
7446.40
8019.20
6731.40
7249.20
2613.00
2814.00
2670.20
2875.60
2914.60
3138.80
4066.40
4379.20
478.40
515.20
1573.00
1694.00
2147.60
2312.80
169.00
182.00
353.60
380.80
618.80
666.40
288.60
310.80
356.20
383.60
429.00
462.00
621.40
669.20
241.80
260.40
678.60
730.80
161.20
173.60
395.20
425.60
548.60
590.80
652.60
702.80
764.40
823.20
413.40
445.20
569.40
613.20
665.60
716.80
743.60
800.80
491.40
529.20
626.60
674.80
728.00
784.00
949.00
1022.00
738.40
795.20
975.00
1050.00
1073.80
1156.40
1378.00
1484.00
1521.00
1638.00
2306.20
2483.60
764.40
823.20
1045.20
1125.60
1274.00
1372.00
1482.00
1596.00
1690.00
1820.00
2584.40
2783.20
956.80
1030.40
1235.00
1330.00
1375.40
1481.20
1687.40
1817.20
2160.60
2326.80
3099.20
3337.60
2340.00
2520.00
3005.60
3236.80
2238.60
2410.80
3047.20
3281.60
2644.20
2847.60
3257.80
3508.40
1131.00
1218.00
1422.20
1531.60
1567.80
1688.40
1872.00
2016.00
2059.20
2217.60
3060.20
3295.60
1149.20
1237.60
1435.20
1545.60
1651.00
1778.00
2043.60
2200.80
2308.80
2486.40
2834.00
3052.00
1190.80
1282.40
1505.40
1621.20
1773.20
1909.60
2225.60
2396.80
2758.60
2970.80
3835.00
4130.00
111.80
120.40
189.80
204.40
265.20
285.60
587.60
632.80
270.40
291.20
296.40
319.20
1612.00
1736.00
2441.40
2629.20
798.20
859.60
1240.20
1335.60
1731.60
1864.80
793.00
854.00
1718.60
1850.80
4048.20
4359.60
5262.40
5667.20
332.80
358.40
475.80
512.40
1107.60
1192.80
1310.40
1411.20
338.00
364.00
449.80
484.40
686.40
739.20
865.80
932.40
1133.60
1220.80
8335.60
8976.80
5886.40
6339.20
2977.00
3206.00
730.60
786.80
920.40
991.20
1580.80
1702.40
772.20
831.60
800.80
862.40
907.40
977.20
1583.40
1705.20
657.80
708.40
873.60
940.80
1040.00
1120.00
1297.40
1397.20
1622.40
1747.20
1817.40
1957.20
824.20
887.60
917.80
988.40
1144.00
1232.00
1440.40
1551.20
1713.40
1845.20
1536.60
1654.80
1853.80
1996.40
1757.60
1892.80
1307.80
1408.40
1567.80
1688.40
1859.00
2002.00
1957.80
2108.40
2241.20
2413.60
2568.80
2766.40
2969.20
3197.60
1661.40
1789.20
1916.20
2063.60
2030.60
2186.80
2285.40
2461.20
2717.00
2926.00
2880.80
3102.40
1752.40
1887.20
2100.80
2262.40
2074.80
2234.40
2168.40
2335.20
2587.00
2786.00
3419.00
3682.00
3650.40
3931.20
2225.60
2396.80
2722.20
2931.60
728.00
784.00
2342.60
2522.80
3135.60
3376.80
832.00
896.00
2633.80
2836.40
4508.40
4855.20
1287.00
1386.00
2628.60
2830.80
3036.80
3270.40
4076.80
4390.40
1385.80
1492.40
7685.60
8276.80
4820.40
5191.20
6305.00
6790.00
5465.20
5885.60
6952.40
7487.20
6133.40
6605.20
7550.40
8131.20
6513.00
7014.00
8060.00
8680.00
8561.80
9220.40
3364.40
3623.20
6736.60
7254.80
2181.40
2349.20
436.80
470.40
2605.20
2805.60
873.60
940.80
1414.40
1523.20
4295.20
4625.60
6843.20
7369.60
1058.20
1139.60
7030.40
7571.20
990.60
1066.80
7272.20
7831.60
1515.80
1632.40
7592.00
8176.00
1640.60
1766.80
5387.20
5801.60
915.20
985.60
7339.80
7904.40
824.20
887.60
5912.40
6367.20
1209.00
1302.00
1302.60
1402.80
5205.20
5605.60
1437.80
1548.40
1302.60
1402.80
3590.60
3866.80
845.00
910.00
4290.00
4620.00
1297.40
1397.20
6450.60
6946.80
808.60
870.80
5930.60
6386.80
767.00
826.00
7714.20
8307.60
1102.40
1187.20
8309.60
8948.80
1383.20
1489.60
2805.40
3021.20
540.80
582.40
2930.20
3155.60
826.80
890.40
2568.80
2766.40
566.80
610.40
2464.80
2654.40
811.20
873.60
2501.20
2693.60
275.60
296.80
2834.00
3052.00
535.60
576.80
2727.40
2937.20
678.60
730.80
3374.80
3634.40
548.60
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4006.80
3182.40
3427.20
1937.00
2086.00
2711.80
2920.40
5798.00
6244.00
6164.60
6638.80
5272.80
5678.40
1554.80
1674.40
3835.00
4130.00
9380.80
10102.40
12077.00
13006.00
2873.00
3094.00
4573.40
4925.20
4310.80
4642.40
5405.40
5821.20
5925.40
6381.20
3445.00
3710.00
3918.20
4219.60
6351.80
6840.40
5592.60
6022.80
7186.40
7739.20
7295.60
7856.80
7958.60
8570.80
6320.60
6806.80
11037.00
11886.00
9744.80
10494.40
8998.60
9690.80
764.40
823.20
6292.00
6776.00
6606.60
7114.80
6710.60
7226.80
3692.00
3976.00
3541.20
3813.60
4594.20
4947.60
3437.20
3701.60
3850.60
4146.80
4602.00
4956.00
5868.20
6319.60
4084.60
4398.80
5124.60
5518.80
4378.40
4715.20
5226.00
5628.00
4303.00
4634.00
6019.00
6482.00
7113.60
7660.80
1032.20
1111.60
4518.80
4866.40
5301.40
5709.20
6081.40
6549.20
5587.40
6017.20
9248.20
9959.60
10717.20
11541.60
5447.00
5866.00
7215.00
7770.00
3803.80
4096.40
11229.40
12093.20
10470.20
11275.60
9994.40
10763.20
8275.80
8912.40
8400.60
9046.80
12087.40
13017.20
11551.80
12440.40
9248.20
9959.60
9815.00
10570.00
5501.60
5924.80
4178.20
4499.60
5816.20
6263.60
5772.00
6216.00
6869.20
7397.60
7100.60
7646.80
2925.00
3150.00
4654.00
5012.00
5392.40
5807.20
8424.00
9072.00
9466.60
10194.80
2808.00
3024.00
4095.00
4410.00
5743.40
6185.20
2610.40
2811.20
4097.60
4412.80
6947.20
7481.60
2553.20
2749.60
3663.40
3945.20
6773.00
7294.00
2639.00
2842.00
3593.20
3869.60
6744.40
7263.20
2758.60
2970.80
3985.80
4292.40
7298.20
7859.60
2631.20
2833.60
4035.20
4345.60
7943.00
8554.00
9048.00
9744.00
2802.80
3018.40
4661.80
5020.40
7904.00
8512.00
10251.80
11040.40
12292.80
13238.40
6437.60
6932.80
3283.80
3536.40
3718.00
4004.00
7116.20
7663.60
3338.40
3595.20
4659.20
5017.60
6923.80
7456.40
7737.60
8332.80
1627.60
1752.80
9859.20
10617.60
6539.00
7042.00
8928.40
9615.20
8395.40
9041.20
5896.80
6350.40
5579.60
6008.80
6351.80
6840.40
6476.60
6974.80
6432.40
6927.20
5246.80
5650.40
5753.80
6196.40
8164.00
8792.00
0.00
0.00
1622.40
1747.20
3538.60
3810.80
5025.80
5412.40
5564.00
5992.00
2745.60
2956.80
1965.60
2116.80
2789.80
3004.40
3372.20
3631.60
2997.80
3228.40
2802.80
3018.40
3328.00
3584.00
3166.80
3410.40
4157.40
4477.20
2493.40
2685.20
3338.40
3595.20
7144.80
7694.40
8645.00
9310.00
2714.40
2923.20
2600.00
2800.00
2334.80
2514.40
3554.20
3827.60
3330.60
3586.80
3829.80
4124.40
3346.20
3603.60
3177.20
3421.60
3395.60
3656.80
3372.20
3631.60
2875.60
3096.80
2886.00
3108.00
2540.20
2735.60
3801.20
4093.60
5392.40
5807.20
3676.40
3959.20
3226.60
3474.80
4027.40
4337.20
3265.60
3516.80
2678.00
2884.00
2698.80
2906.40
3143.40
3385.20
2961.40
3189.20
4014.40
4323.20
7885.80
8492.40
5369.00
5782.00
3866.20
4163.60
3372.20
3631.60
5176.60
5574.80
4646.20
5003.60
3088.80
3326.40
2321.80
2500.40
6843.20
7369.60
4199.00
4522.00
2672.80
2878.40
2488.20
2679.60
2537.60
2732.80
6994.00
7532.00
7339.80
7904.40
4638.40
4995.20
1422.20
1531.60
2961.40
3189.20
3481.40
3749.20
2938.00
3164.00
3939.00
4242.00
2896.40
3119.20
3822.00
4116.00
2818.40
3035.20
3307.20
3561.60
2376.40
2559.20
2917.20
3141.60
2633.80
2836.40
2298.40
2475.20
2488.20
2679.60
4622.80
4978.40
2714.40
2923.20
3785.60
4076.80
4921.80
5300.40
7202.00
7756.00
10667.80
11488.40
6853.60
7380.80
3140.80
3382.40
2376.40
2559.20
3302.00
3556.00
3010.80
3242.40
2831.40
3049.20
4079.40
4393.20
5187.00
5586.00
3720.60
4006.80
5655.00
6090.00
6669.00
7182.00
4893.20
5269.60
4895.80
5272.40
5558.80
5986.40
4760.60
5126.80
6375.20
6865.60
6258.20
6739.60
6741.80
7260.40
5621.20
6053.60
6089.20
6557.60
3845.40
4141.20
4339.40
4673.20
3520.40
3791.20
8494.20
9147.60
3335.80
3592.40
2969.20
3197.60
3395.60
3656.80
3023.80
3256.40
5772.00
6216.00
5460.00
5880.00
3884.40
4183.20
4635.80
4992.40
2649.40
2853.20
3424.20
3687.60
9916.40
10679.20
2095.60
2256.80
3343.60
3600.80
4921.80
5300.40
10574.20
11387.60
11856.00
12768.00
1931.80
2080.40
2990.00
3220.00
4173.00
4494.00
10012.60
10782.80
11609.00
12502.00
1773.20
1909.60
2472.60
2662.80
2943.20
3169.60
5735.60
6176.80
1768.00
1904.00
2121.60
2284.80
3221.40
3469.20
4999.80
5384.40
1136.20
1223.60
1391.00
1498.00
2329.60
2508.80
4711.20
5073.60
1094.60
1178.80
1307.80
1408.40
3767.40
4057.20
954.20
1027.60
2152.80
2318.40
1697.80
1828.40
2420.60
2606.80
3140.80
3382.40
6305.00
6790.00
1289.60
1388.80
3055.00
3290.00
3686.80
3970.40
6812.00
7336.00
1757.60
1892.80
2420.60
2606.80
3684.20
3967.60
7441.20
8013.60
1027.00
1106.00
1266.20
1363.60
1739.40
1873.20
4503.20
4849.60
819.00
882.00
1248.00
1344.00
1981.20
2133.60
3845.40
4141.20
12251.20
13193.60
9196.20
9903.60
7482.80
8058.40
7979.40
8593.20
7508.80
8086.40
6351.80
6840.40
5959.20
6417.60
5675.80
6112.40
3078.40
3315.20
5501.60
5924.80
5272.80
5678.40
7173.40
7725.20
4173.00
4494.00
3257.80
3508.40
3858.40
4155.20
2160.60
2326.80
0.00
0.00
1643.20
1769.60
1614.60
1738.80
1497.60
1612.80
1419.60
1528.80
1575.60
1696.80
1349.40
1453.20
1463.80
1576.40
1578.20
1699.60
1677.00
1806.00
657.80
708.40
1305.20
1405.60
738.40
795.20
639.60
688.80
582.40
627.20
629.20
677.60
478.40
515.20
556.40
599.20
408.20
439.60
499.20
537.60
270.40
291.20
317.20
341.60
377.00
406.00
403.00
434.00
351.00
378.00
338.00
364.00
1495.00
1610.00
1682.20
1811.60
954.20
1027.60
1014.00
1092.00
985.40
1061.20
829.40
893.20
592.80
638.40
637.00
686.00
798.20
859.60
293.80
316.40
1016.60
1094.80
1063.40
1145.20
452.40
487.20
462.80
498.40
332.80
358.40
353.60
380.80
254.80
274.40
210.60
226.80
335.40
361.20
296.40
319.20
353.60
380.80
366.60
394.80
447.20
481.60
800.80
862.40
509.60
548.80
449.80
484.40
426.40
459.20
598.00
644.00
728.00
784.00
0.00
0.00
4947.80
5328.40
6255.60
6736.80
4427.80
4768.40
10028.20
10799.60
9804.60
10558.80
5522.40
5947.20
5075.20
5465.60
5561.40
5989.20
5402.80
5818.40
5894.20
6347.60
6351.80
6840.40
5504.20
5927.60
6279.00
6762.00
10186.80
10970.40
8728.20
9399.60
4274.40
4603.20
4630.60
4986.80
4765.80
5132.40
5488.60
5910.80
4981.60
5364.80
5577.00
6006.00
4240.60
4566.80
4537.00
4886.00
4706.00
5068.00
5447.00
5866.00
4924.40
5303.20
5109.00
5502.00
4812.60
5182.80
5868.20
6319.60
8821.80
9500.40
7417.80
7988.40
9443.20
10169.60
6286.80
6770.40
6903.00
7434.00
7727.20
8321.60
7711.60
8304.80
9924.20
10687.60
12118.60
13050.80
15932.80
17158.40
3874.00
4172.00
4836.00
5208.00
4901.00
5278.00
5080.40
5471.20
4664.40
5023.20
6201.00
6678.00
5873.40
6325.20
6263.40
6745.20
6526.00
7028.00
6104.80
6574.40
6606.60
7114.80
7930.00
8540.00
5857.80
6308.40
7098.00
7644.00
5990.40
6451.20
7048.60
7590.80
9365.20
10085.60
11538.80
12426.40
6505.20
7005.60
5837.00
6286.00
3985.80
4292.40
4885.40
5261.20
4638.40
4995.20
4838.60
5210.80
5389.80
5804.40
9882.60
10642.80
4386.20
4723.60
4986.80
5370.40
4898.40
5275.20
6011.20
6473.60
6502.60
7002.80
6840.60
7366.80
8281.00
8918.00
9601.80
10340.40
9781.20
10533.60
9781.20
10533.60
0.00
0.00
1279.20
1377.60
1313.00
1414.00
821.60
884.80
1302.60
1402.80
4108.00
4424.00
4937.40
5317.20
7352.80
7918.40
4186.00
4508.00
2618.20
2819.60
5829.20
6277.60
3601.00
3878.00
4160.00
4480.00
7373.60
7940.80
7438.60
8010.80
652.60
702.80
954.20
1027.60
1718.60
1850.80
1245.40
1341.20
1950.00
2100.00
4305.60
4636.80
9620.00
10360.00
11330.80
12202.40
13132.60
14142.80
8379.80
9024.40
11572.60
12462.80
14401.40
15509.20
7259.20
7817.60
15098.20
16259.60
9425.00
10150.00
5969.60
6428.80
6580.60
7086.80
7815.60
8416.80
1526.20
1643.60
4841.20
5213.60
4144.40
4463.20
5899.40
6353.20
5985.20
6445.60
1289.60
1388.80
1817.40
1957.20
592.80
638.40
1133.60
1220.80
1393.60
1500.80
1588.60
1710.80
5543.20
5969.60
8028.80
8646.40
1180.40
1271.20
0.00
0.00
1024.40
1103.20
1892.80
2038.40
3367.00
3626.00
4979.00
5362.00
5462.60
5882.80
7176.00
7728.00
4622.80
4978.40
6159.40
6633.20
4180.80
4502.40
7490.60
8066.80
9880.00
10640.00
13543.40
14585.20
11083.80
11936.40
12599.60
13568.80
10764.00
11592.00
10405.20
11205.60
9763.00
10514.00
5205.20
5605.60
7040.80
7582.40
8460.40
9111.20
18025.80
19412.40
20108.40
21655.20
1094.60
1178.80
1523.60
1640.80
1729.00
1862.00
1869.40
2013.20
1918.80
2066.40
6536.40
7039.20
1570.40
1691.20
2675.40
2881.20
3923.40
4225.20
1934.40
2083.20
3109.60
3348.80
4953.00
5334.00
2275.00
2450.00
2641.60
2844.80
11286.60
12154.80
11970.40
12891.20
9716.20
10463.60
10587.20
11401.60
12134.20
13067.60
1632.80
1758.40
1950.00
2100.00
1599.00
1722.00
0.00
0.00
12162.80
13098.40
6227.00
6706.00
20129.20
21677.60
24954.80
26874.40
21301.80
22940.40
23615.80
25432.40
19970.60
21506.80
18956.60
20414.80
18683.60
20120.80
20521.80
22100.40
27591.20
29713.60
29122.60
31362.80
9562.80
10298.40
8067.80
8688.40
1040.00
1120.00
335.40
361.20
478.40
515.20
1216.80
1310.40
1229.80
1324.40
1279.20
1377.60
1292.20
1391.60
1175.20
1265.60
1541.80
1660.40
1554.80
1674.40
1544.40
1663.20
1926.60
2074.80
1422.20
1531.60
1586.00
1708.00
1944.80
2094.40
2082.60
2242.80
1864.20
2007.60
2077.40
2237.20
2386.80
2570.40
2610.40
2811.20
3577.60
3852.80
5449.60
5868.80
3096.60
3334.80
3385.20
3645.60
2249.00
2422.00
2459.60
2648.80
738.40
795.20
1289.60
1388.80
1448.20
1559.60
1690.00
1820.00
1380.60
1486.80
11736.40
12639.20
18218.20
19619.60
14570.40
15691.20
9744.80
10494.40
11013.60
11860.80
8460.40
9111.20
7326.80
7890.40
0.00
0.00
3824.60
4118.80
2545.40
2741.20
2165.80
2332.40
1755.00
1890.00
6851.00
7378.00
5166.20
5563.60
475.80
512.40
4290.00
4620.00
7235.80
7792.40
1245.40
1341.20
985.40
1061.20
1877.20
2021.60
2059.20
2217.60
1913.60
2060.80
2067.00
2226.00
1960.40
2111.20
956.80
1030.40
2506.40
2699.20
2979.60
3208.80
1918.80
2066.40
2194.40
2363.20
473.20
509.60
598.00
644.00
1926.60
2074.80
2085.20
2245.60
2116.40
2279.20
728.00
784.00
2428.40
2615.20
2449.20
2637.60
2464.80
2654.40
1653.60
1780.80
1840.80
1982.40
1666.60
1794.80
1588.60
1710.80
494.00
532.00
1614.60
1738.80
491.40
529.20
915.20
985.60
2189.20
2357.60
13072.80
14078.40
16478.80
17746.40
13072.80
14078.40
16998.80
18306.40
12727.00
13706.00
12919.40
13913.20
11572.60
12462.80
13244.40
14263.20
10478.00
11284.00
13782.60
14842.80
6715.80
7232.40
7755.80
8352.40
3182.40
3427.20
4672.20
5031.60
3307.20
3561.60
0.00
0.00
6913.40
7445.20
7423.00
7994.00
6032.00
6496.00
9146.80
9850.40
14019.20
15097.60
8361.60
9004.80
8902.40
9587.20
9466.60
10194.80
14739.40
15873.20
9599.20
10337.60
9599.20
10337.60
7469.80
8044.40
10886.20
11723.60
2852.20
3071.60
7641.40
8229.20
15236.00
16408.00
9547.20
10281.60
8769.80
9444.40
15350.40
16531.20
917.80
988.40
5392.40
5807.20
891.80
960.40
1027.00
1106.00
923.00
994.00
1188.20
1279.60
15033.20
16189.60
26551.20
28593.60
33852.00
36456.00
14248.00
15344.00
15238.60
16410.80
13816.40
14879.20
22677.20
24421.60
23080.20
24855.60
14123.20
15209.60
13795.60
14856.80
2366.00
2548.00
17349.80
18684.40
19593.60
21100.80
16543.80
17816.40
3270.80
3522.40
1614.60
1738.80
1544.40
1663.20
1965.60
2116.80
1159.60
1248.80
678.60
730.80
611.00
658.00
2961.40
3189.20
3208.40
3455.20
4170.40
4491.20
4615.00
4970.00
3689.40
3973.20
4443.40
4785.20
6362.20
6851.60
10501.40
11309.20
15904.20
17127.60
10095.80
10872.40
11271.00
12138.00
9165.00
9870.00
7623.20
8209.60
7521.80
8100.40
6793.80
7316.40
6991.40
7529.20
9984.00
10752.00
7607.60
8192.80
8543.60
9200.80
13410.80
14442.40
8088.60
8710.80
11640.20
12535.60
8988.20
9679.60
8585.20
9245.60
26962.00
29036.00
12690.60
13666.80
0.00
0.00
24577.80
26468.40
27118.00
29204.00
29224.00
31472.00
31964.40
34423.20
0.00
0.00
0.00
0.00
13413.40
14445.20
12768.60
13750.80
15795.00
17010.00
11824.80
12734.40
977.60
1052.80
3369.60
3628.80
4139.20
4457.60
0.00
0.00
1118.00
1204.00
1138.80
1226.40
4739.80
5104.40
8437.00
9086.00
7688.20
8279.60
12435.80
13392.40
13798.20
14859.60
9677.20
10421.60
14973.40
16125.20
13335.40
14361.20
15337.40
16517.20
1292.20
1391.60
7423.00
7994.00
7670.00
8260.00
4227.60
4552.80
4500.60
4846.80
4862.00
5236.00
1674.40
1803.20
1723.80
1856.40
3133.00
3374.00
3559.40
3833.20
4472.00
4816.00
2813.20
3029.60
3447.60
3712.80
3442.40
3707.20
3616.60
3894.80
3645.20
3925.60
3190.20
3435.60
3803.80
4096.40
4716.40
5079.20
4243.20
4569.60
4542.20
4891.60
2165.80
2332.40
4490.20
4835.60
5865.60
6316.80
7527.00
8106.00
7810.40
8411.20
9003.80
9696.40
4245.80
4572.40
2033.20
2189.60
13049.40
14053.20
7872.80
8478.40
8361.60
9004.80
14209.00
15302.00
15847.00
17066.00
13249.60
14268.80
15917.20
17141.60
18917.60
20372.80
5623.80
6056.40
6323.20
6809.60
8164.00
8792.00
15701.40
16909.20
13046.80
14050.40
17812.60
19182.80
2938.00
3164.00
2093.00
2254.00
23712.00
25536.00
39850.20
42915.60
11169.60
12028.80
14297.40
15397.20
10246.60
11034.80
11473.80
12356.40
13475.80
14512.40
13868.40
14935.20
13436.80
14470.40
18262.40
19667.20
22133.80
23836.40
13408.20
14439.60
14326.00
15428.00
16910.40
18211.20
22191.00
23898.00
27900.60
30046.80
24762.40
26667.20
32700.20
35215.60
23774.40
25603.20
31309.20
33717.60
20945.60
22556.80
19658.60
21170.80
19773.00
21294.00
16127.80
17368.40
14263.60
15360.80
16322.80
17578.40
26564.20
28607.60
23212.80
24998.40
23784.80
25614.40
27313.00
29414.00
23498.80
25306.40
30095.00
32410.00
23862.80
25698.40
26845.00
28910.00
17804.80
19174.40
12363.00
13314.00
11910.60
12826.80
11315.20
12185.60
20862.40
22467.20
22708.40
24455.20
14718.60
15850.80
15168.40
16335.20
16140.80
17382.40
15243.80
16416.40
10852.40
11687.20
12287.60
13232.80
12342.20
13291.60
14125.80
15212.40
20051.20
21593.60
22032.40
23727.20
16520.40
17791.20
156.00
168.00
18881.20
20333.60
20703.80
22296.40
23532.60
25342.80
24206.00
26068.00
25524.20
27487.60
26559.00
28602.00
1830.40
1971.20
4032.60
4342.80
5330.00
5740.00
6409.00
6902.00
7202.00
7756.00
8164.00
8792.00
5140.20
5535.60
18205.20
19605.60
21421.40
23069.20
23894.00
25732.00
25799.80
27784.40
25623.00
27594.00
30053.40
32365.20
28883.40
31105.20
2256.80
2430.40
16476.20
17743.60
15795.00
17010.00
17487.60
18832.80
17269.20
18597.60
16978.00
18284.00
18946.20
20403.60
19029.40
20493.20
19162.00
20636.00
20784.40
22383.20
27203.80
29296.40
16120.00
17360.00
8655.40
9321.20
33943.00
36554.00
15979.60
17208.80
15298.40
16475.20
16237.00
17486.00
18946.20
20403.60
18590.00
20020.00
19185.40
20661.20
19097.00
20566.00
18410.60
19826.80
17274.40
18603.20
17825.60
19196.80
18337.80
19748.40
18262.40
19667.20
12139.40
13073.20
15844.40
17063.20
18894.20
20347.60
19671.60
21184.80
14965.60
16116.80
16372.20
17631.60
14794.00
15932.00
16385.20
17645.60
14762.80
15898.40
20805.20
22405.60
19393.40
20885.20
15948.40
17175.20
12487.80
13448.40
13551.20
14593.60
12396.80
13350.40
12571.00
13538.00
12495.60
13456.80
11577.80
12468.40
12854.40
13843.20
12620.40
13591.20
13780.00
14840.00
3822.00
4116.00
20321.60
21884.80
19890.00
21420.00
17368.00
18704.00
16762.20
18051.60
17708.60
19070.80
15483.00
16674.00
21348.60
22990.80
21223.80
22856.40
21600.80
23262.40
21125.00
22750.00
31090.80
33482.40
33602.40
36187.20
19671.60
21184.80
13249.60
14268.80
9523.80
10256.40
11060.40
11911.20
11107.20
11961.60
12256.40
13199.20
14690.00
15820.00
9367.80
10088.40
9198.80
9906.40
11645.40
12541.20
12643.80
13616.40
12846.60
13834.80
14424.80
15534.40
13390.00
14420.00
17703.40
19065.20
31257.20
33661.60
30648.80
33006.40
31262.40
33667.20
24406.20
26283.60
19461.00
20958.00
35443.20
38169.60
17698.20
19059.60
15243.80
16416.40
11055.20
11905.60
4053.40
4365.20
9604.40
10343.20
7966.40
8579.20
9718.80
10466.40
16273.40
17525.20
13137.80
14148.40
15446.60
16634.80
13962.00
15036.00
17550.00
18900.00
13395.20
14425.60
2748.20
2959.60
16517.80
17788.40
26166.40
28179.20
0.00
0.00
0.00
0.00
33376.20
35943.60
0.00
0.00
0.00
0.00
46924.80
50534.40
9578.40
10315.20
5246.80
5650.40
2467.40
2657.20
325.00
350.00
3419.00
3682.00
6804.20
7327.60
4958.20
5339.60
8452.60
9102.80
10634.00
11452.00
11661.00
12558.00
11551.80
12440.40
12932.40
13927.20
23225.80
25012.40
35040.20
37735.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
9742.20
10491.60
9599.20
10337.60
6029.40
6493.20
6029.40
6493.20
14008.80
15086.40
10366.20
11163.60
9627.80
10368.40
14791.40
15929.20
7337.20
7901.60
14448.20
15559.60
11967.80
12888.40
6130.80
6602.40
8972.60
9662.80
14905.80
16052.40
11343.80
12216.40
9939.80
10704.40
9292.40
10007.20
11125.40
11981.20
12342.20
13291.60
12773.80
13756.40
12350.00
13300.00
11809.20
12717.60
1014.00
1092.00
2038.40
2195.20
3364.40
3623.20
2376.40
2559.20
4828.20
5199.60
6903.00
7434.00
2035.80
2192.40
17732.00
19096.00
19071.00
20538.00
19071.00
20538.00
6063.20
6529.60
2732.60
2942.80
8876.40
9559.20
11185.20
12045.60
11245.00
12110.00
11203.40
12065.20
9963.20
10729.60
12542.40
13507.20
11434.80
12314.40
13876.20
14943.60
9867.00
10626.00
17633.20
18989.60
21980.40
23671.20
18010.20
19395.60
26091.00
28098.00
18998.20
20459.60
22448.40
24175.20
14669.20
15797.60
17997.20
19381.60
16577.60
17852.80
18735.60
20176.80
13946.40
15019.20
16346.20
17603.60
11096.80
11950.40
13267.80
14288.40
12521.60
13484.80
14053.00
15134.00
9474.40
10203.20
16848.00
18144.00
10171.20
10953.60
7862.40
8467.20
16996.20
18303.60
7469.80
8044.40
9326.20
10043.60
7685.60
8276.80
7194.20
7747.60
13455.00
14490.00
19986.20
21523.60
14146.60
15234.80
8291.40
8929.20
11650.60
12546.80
9721.40
10469.20
14281.80
15380.40
14367.60
15472.80
16731.00
18018.00
10137.40
10917.20
10485.80
11292.40
8603.40
9265.20
13533.00
14574.00
14066.00
15148.00
16003.00
17234.00
9354.80
10074.40
10514.40
11323.20
11291.80
12160.40
12487.80
13448.40
12890.80
13882.40
12446.20
13403.60
4895.80
5272.40
15048.80
16206.40
8928.40
9615.20
14656.20
15783.60
13668.20
14719.60
12903.80
13896.40
10439.00
11242.00
15311.40
16489.20
17157.40
18477.20
8255.00
8890.00
9848.80
10606.40
1593.80
1716.40
1484.60
1598.80
5098.60
5490.80
3564.60
3838.80
4877.60
5252.80
3127.80
3368.40
7805.20
8405.60
5421.00
5838.00
7196.80
7750.40
4568.20
4919.60
3213.60
3460.80
15836.60
17054.80
13312.00
14336.00
14216.80
15310.40
14801.80
15940.40
12378.60
13330.80
12794.60
13778.80
12142.00
13076.00
13366.60
14394.80
12279.80
13224.40
11494.60
12378.80
13780.00
14840.00
12277.20
13221.60
12807.60
13792.80
11489.40
12373.20
16081.00
17318.00
20326.80
21890.40
16840.20
18135.60
17147.00
18466.00
17009.20
18317.60
23215.40
25001.20
25958.40
27955.20
22076.60
23774.80
25833.60
27820.80
11635.00
12530.00
14479.40
15593.20
15524.60
16718.80
14099.80
15184.40
12435.80
13392.40
17152.20
18471.60
13304.20
14327.60
13262.60
14282.80
16881.80
18180.40
13288.60
14310.80
13405.60
14436.80
3442.40
3707.20
14599.00
15722.00
16949.40
18253.20
13904.80
14974.40
2527.20
2721.60
14773.20
15909.60
11811.80
12720.40
8788.00
9464.00
12183.60
13120.80
11073.40
11925.20
14718.60
15850.80
15509.00
16702.00
18540.60
19966.80
16283.80
17536.40
18018.00
19404.00
16265.60
17516.80
17812.60
19182.80
17316.00
18648.00
17690.40
19051.20
11185.20
12045.60
10738.00
11564.00
17240.60
18566.80
15688.40
16895.20
10769.20
11597.60
13091.00
14098.00
13826.80
14890.40
10896.60
11734.80
10935.60
11776.80
12550.20
13515.60
11809.20
12717.60
12773.80
13756.40
11245.00
12110.00
800.80
862.40
3554.20
3827.60
4121.00
4438.00
2007.20
2161.60
1653.60
1780.80
9503.00
10234.00
8385.00
9030.00
10251.80
11040.40
10303.80
11096.40
1492.40
1607.20
1536.60
1654.80
5551.00
5978.00
4490.20
4835.60
5041.40
5429.20
3809.00
4102.00
4856.80
5230.40
19533.80
21036.40
6351.80
6840.40
4048.20
4359.60
13964.60
15038.80
5974.80
6434.40
9500.40
10231.20
9328.80
10046.40
10288.20
11079.60
12186.20
13123.60
12482.60
13442.80
5028.40
5415.20
5642.00
6076.00
16905.20
18205.60
19331.00
20818.00
140.40
151.20
1016.60
1094.80
702.00
756.00
1783.60
1920.80
2316.60
2494.80
2594.80
2794.40
1905.80
2052.40
2178.80
2346.40
2519.40
2713.20
2350.40
2531.20
1487.20
1601.60
1526.20
1643.60
1788.80
1926.40
725.40
781.20
1853.80
1996.40
2282.80
2458.40
3554.20
3827.60
4037.80
4348.40
4817.80
5188.40
764.40
823.20
3569.80
3844.40
3988.40
4295.20
4752.80
5118.40
746.20
803.60
6081.40
6549.20
3785.60
4076.80
2860.00
3080.00
0.00
0.00
161.20
173.60
156.00
168.00
101.40
109.20
117.00
126.00
28.60
30.80
39.00
42.00
431.60
464.80
382.20
411.60
288.60
310.80
561.60
604.80
1086.80
1170.40
1084.20
1167.60
3497.00
3766.00
1950.00
2100.00
1950.00
2100.00
829.40
893.20
995.80
1072.40
5319.60
5728.80
2220.40
2391.20
5246.80
5650.40
2272.40
2447.20
3439.80
3704.40
1708.20
1839.60
590.20
635.60
917.80
988.40
876.20
943.60
969.80
1044.40
1370.20
1475.60
1393.60
1500.80
1037.40
1117.20
1476.80
1590.40
1510.60
1626.80
1271.40
1369.20
4760.60
5126.80
4076.80
4390.40
5353.40
5765.20
5231.20
5633.60
5566.60
5994.80
5197.40
5597.20
5610.80
6042.40
1388.40
1495.20
1331.20
1433.60
4305.60
4636.80
4729.40
5093.20
522.60
562.80
2132.00
2296.00
2951.00
3178.00
980.20
1055.60
2867.80
3088.40
4500.60
4846.80
4919.20
5297.60
959.40
1033.20
4079.40
4393.20
1326.00
1428.00
1963.00
2114.00
197.60
212.80
221.00
238.00
270.40
291.20
2680.60
2886.80
647.40
697.20
759.20
817.60
527.80
568.40
192.40
207.20
488.80
526.40
1027.00
1106.00
1240.20
1335.60
767.00
826.00
556.40
599.20
1539.20
1657.60
2054.00
2212.00
1469.00
1582.00
6611.80
7120.40
7891.00
8498.00
7979.40
8593.20
6091.80
6560.40
3658.20
3939.60
12794.60
13778.80
6627.40
7137.20
6497.40
6997.20
4518.80
4866.40
5740.80
6182.40
6492.20
6991.60
4817.80
5188.40
11421.80
12300.40
1253.20
1349.60
1458.60
1570.80
4378.40
4715.20
14162.20
15251.60
14697.80
15828.40
13127.40
14137.20
14695.20
15825.60
15795.00
17010.00
7885.80
8492.40
3707.60
3992.80
6689.80
7204.40
2480.40
2671.20
3738.80
4026.40
6016.40
6479.20
4279.60
4608.80
2685.80
2892.40
2090.40
2251.20
2605.20
2805.60
3107.00
3346.00
3793.40
4085.20
8496.80
9150.40
6279.00
6762.00
3130.40
3371.20
4227.60
4552.80
2046.20
2203.60
1076.40
1159.20
7610.20
8195.60
10381.80
11180.40
9607.00
10346.00
4066.40
4379.20
4947.80
5328.40
1846.00
1988.00
2095.60
2256.80
4477.20
4821.60
6032.00
6496.00
4968.60
5350.80
7287.80
7848.40
5473.00
5894.00
7064.20
7607.60
6814.60
7338.80
7407.40
7977.20
1978.60
2130.80
3252.60
3502.80
2711.80
2920.40
3848.00
4144.00
1042.60
1122.80
785.20
845.60
6783.40
7305.20
0.00
0.00
7046.00
7588.00
6988.80
7526.40
7974.20
8587.60
4752.80
5118.40
3707.60
3992.80
2009.80
2164.40
5194.80
5594.40
10574.20
11387.60
12828.40
13815.20
3751.80
4040.40
6099.60
6568.80
4573.40
4925.20
12422.80
13378.40
2470.00
2660.00
4287.40
4617.20
4776.20
5143.60
6156.80
6630.40
6494.80
6994.40
5467.80
5888.40
4414.80
4754.40
5413.20
5829.60
2542.80
2738.40
2548.00
2744.00
13018.20
14019.60
4508.40
4855.20
0.00
0.00
10883.60
11720.80
10998.00
11844.00
2488.20
2679.60
12017.20
12941.60
9937.20
10701.60
0.00
0.00
1398.80
1506.40
956.80
1030.40
754.00
812.00
767.00
826.00
421.20
453.60
270.40
291.20
114.40
123.20
746.20
803.60
678.60
730.80
444.60
478.80
114.40
123.20
382.20
411.60
444.60
478.80
871.00
938.00
967.20
1041.60
3286.40
3539.20
1188.20
1279.60
1175.20
1265.60
904.80
974.40
1729.00
1862.00
4334.20
4667.60
4251.00
4578.00
5574.40
6003.20
7646.60
8234.80
6320.60
6806.80
2386.80
2570.40
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823.20
4032.60
4342.80
4417.40
4757.20
4082.00
4396.00
5197.40
5597.20
4529.20
4877.60
4747.60
5112.80
9503.00
10234.00
6539.00
7042.00
6635.20
7145.60
5012.80
5398.40
7373.60
7940.80
8936.20
9623.60
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0.00
7826.00
8428.00
13049.40
14053.20
14209.00
15302.00
6484.40
6983.20
8242.00
8876.00
2472.60
2662.80
2532.40
2727.20
7950.80
8562.40
12170.60
13106.80
7493.20
8069.60
9651.20
10393.60
787.80
848.40
377.00
406.00
2678.00
2884.00
1279.20
1377.60
0.00
0.00
4755.40
5121.20
7571.20
8153.60
8429.20
9077.60
10907.00
11746.00
4828.20
5199.60
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0.00
8034.00
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58299.80
62784.40
8262.80
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8977.80
9668.40
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7506.20
8083.60
11827.40
12737.20
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767.00
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3515.20
3785.60
3455.40
3721.20
3484.00
3752.00
5363.80
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6060.60
6526.80
3923.40
4225.20
2769.00
2982.00
3385.20
3645.60
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4410.00
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10337.60
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1248.00
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2134.60
2298.80
1253.20
1349.60
2168.40
2335.20
423.80
456.40
1073.80
1156.40
1232.40
1327.20
1900.60
2046.80
2938.00
3164.00
3068.00
3304.00
2553.20
2749.60
2249.00
2422.00
1632.80
1758.40
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6396.00
6888.00
6255.60
6736.80
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8635.20
11434.80
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1079.00
1162.00
1313.00
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2558.40
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2818.40
3035.20
1157.00
1246.00
3328.00
3584.00
3369.60
3628.80
3380.00
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3866.20
4163.60
4360.20
4695.60
1055.60
1136.80
1089.40
1173.20
876.20
943.60
1287.00
1386.00
2441.40
2629.20
2701.40
2909.20
6203.60
6680.80
1463.80
1576.40
2134.60
2298.80
10090.60
10866.80
12594.40
13563.20
20909.20
22517.60
21192.60
22822.80
26829.40
28893.20
21169.20
22797.60
23098.40
24875.20
29034.20
31267.60
1437.80
1548.40
1627.60
1752.80
2059.20
2217.60
4323.80
4656.40
3335.80
3592.40
6032.00
6496.00
2454.40
2643.20
3926.00
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0.00
0.00
1404.00
1512.00
1609.40
1733.20
2568.80
2766.40
2048.80
2206.40
460.20
495.60
1770.60
1906.80
3109.60
3348.80
1188.20
1279.60
2035.80
2192.40
2969.20
3197.60
2077.40
2237.20
2732.60
2942.80
1024.40
1103.20
2558.40
2755.20
2571.40
2769.20
2454.40
2643.20
0.00
0.00
1011.40
1089.20
1060.80
1142.40
1354.60
1458.80
1726.40
1859.20
3356.60
3614.80
9630.40
10371.20
1513.20
1629.60
6895.20
7425.60
1432.60
1542.80
1666.60
1794.80
2516.80
2710.40
8343.40
8985.20
9445.80
10172.40
10038.60
10810.80
7043.40
7585.20
5064.80
5454.40
8517.60
9172.80
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9343.60
8145.80
8772.40
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7666.40
6489.60
6988.80
1107.60
1192.80
1476.80
1590.40
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0.00
1492.40
1607.20
4193.80
4516.40
1222.00
1316.00
1723.80
1856.40
1614.60
1738.80
2514.20
2707.60
3291.60
3544.80
650.00
700.00
2191.80
2360.40
3221.40
3469.20
2176.20
2343.60
6073.60
6540.80
10870.60
11706.80
12459.20
13417.60
8192.60
8822.80
13262.60
14282.80
4565.60
4916.80
3502.20
3771.60
3335.80
3592.40
4425.20
4765.60
4999.80
5384.40
6723.60
7240.80
7659.60
8248.80
6143.80
6616.40
824.20
887.60
3416.40
3679.20
572.00
616.00
759.20
817.60
2022.80
2178.40
0.00
0.00
1320.80
1422.40
3858.40
4155.20
7943.00
8554.00
1099.80
1184.40
1331.20
1433.60
1133.60
1220.80
1292.20
1391.60
1588.60
1710.80
1276.60
1374.80
2818.40
3035.20
5431.40
5849.20
2844.40
3063.20
2958.80
3186.40
2558.40
2755.20
2459.60
2648.80
2028.00
2184.00
2178.80
2346.40
1666.60
1794.80
2353.00
2534.00
9677.20
10421.60
13309.40
14333.20
21697.00
23366.00
1835.60
1976.80
5587.40
6017.20
13774.80
14834.40
18288.40
19695.20
23069.80
24844.40
3335.80
3592.40
7644.00
8232.00
9165.00
9870.00
7280.00
7840.00
1653.60
1780.80
4113.20
4429.60
5067.40
5457.20
3868.80
4166.40
4485.00
4830.00
5028.40
5415.20
0.00
0.00
5301.40
5709.20
5075.20
5465.60
12409.80
13364.40
6159.40
6633.20
9601.80
10340.40
24299.60
26168.80
44564.00
47992.00
25604.80
27574.40
43534.40
46883.20
51695.80
55672.40
23545.60
25356.80
36316.80
39110.40
27409.20
29517.60
24216.40
26079.20
45123.00
48594.00
38539.80
41504.40
7644.00
8232.00
14346.80
15450.40
1248.00
1344.00
1801.80
1940.40
1651.00
1778.00
2100.80
2262.40
2134.60
2298.80
1482.00
1596.00
1375.40
1481.20
2230.80
2402.40
1630.20
1755.60
1219.40
1313.20
1349.40
1453.20
2009.80
2164.40
2132.00
2296.00
1814.80
1954.40
2498.60
2690.80
1640.60
1766.80
1801.80
1940.40
2254.20
2427.60
2238.60
2410.80
2787.20
3001.60
2095.60
2256.80
3785.60
4076.80
1484.60
1598.80
4035.20
4345.60
2545.40
2741.20
2813.20
3029.60
1799.20
1937.60
2402.40
2587.20
1913.60
2060.80
1791.40
1929.20
1653.60
1780.80
1807.00
1946.00
2080.00
2240.00
2688.40
2895.20
2423.20
2609.60
3088.80
3326.40
2542.80
2738.40
2891.20
3113.60
3299.40
3553.20
3468.40
3735.20
4076.80
4390.40
3998.80
4306.40
4890.60
5266.80
5486.00
5908.00
4058.60
4370.80
4126.20
4443.60
4516.20
4863.60
4071.60
4384.80
4084.60
4398.80
1206.40
1299.20
12292.80
13238.40
10244.00
11032.00
14682.20
15811.60
16497.00
17766.00
1528.80
1646.40
0.00
0.00
6045.00
6510.00
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11580.80
14201.20
15293.60
15327.00
16506.00
27170.00
29260.00
26423.80
28456.40
13189.80
14204.40
12597.00
13566.00
7698.60
8290.80
11307.40
12177.20
12469.60
13428.80
12896.00
13888.00
11026.60
11874.80
11973.00
12894.00
12103.00
13034.00
13041.60
14044.80
14289.60
15388.80
15597.40
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1268.80
1366.40
13018.20
14019.60
14159.60
15248.80
12053.60
12980.80
12404.60
13358.80
10171.20
10953.60
21603.40
23265.20
24055.20
25905.60
13845.00
14910.00
14136.20
15223.60
14531.40
15649.20
10017.80
10788.40
16403.40
17665.20
10028.20
10799.60
14422.20
15531.60
954.20
1027.60
1404.00
1512.00
2277.60
2452.80
2342.60
2522.80
2139.80
2304.40
0.00
0.00
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7412.60
7982.80
12711.40
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14409.20
15517.60
9092.20
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6520.80
7022.40
7987.20
8601.60
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9984.80
11533.60
12420.80
18634.20
20067.60
21470.80
23122.40
21806.20
23483.60
13717.60
14772.80
19224.40
20703.20
18192.20
19591.60
20124.00
21672.00
1063.40
1145.20
11146.20
12003.60
11341.20
12213.60
16385.20
17645.60
17524.00
18872.00
0.00
0.00
0.00
0.00
6154.20
6627.60
7199.40
7753.20
5358.60
5770.80
382.20
411.60
192.40
207.20
293.80
316.40
538.20
579.60
483.60
520.80
699.40
753.20
707.20
761.60
975.00
1050.00
10548.20
11359.60
12025.00
12950.00
9035.00
9730.00
12017.20
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9055.80
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13042.40
8777.60
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9599.20
10337.60
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13652.80
12370.80
13322.40
6575.40
7081.20
5569.20
5997.60
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10670.80
12838.80
13826.40
10813.40
11645.20
12087.40
13017.20
18577.00
20006.00
15428.40
16615.20
17030.00
18340.00
18275.40
19681.20
15397.20
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16164.20
17407.60
6710.60
7226.80
15093.00
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0.00
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0.00
0.00
3380.00
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3049.80
3284.40
4305.60
4636.80
10342.80
11138.40
8187.40
8817.20
1354.60
1458.80
9198.80
9906.40
9279.40
9993.20
9341.80
10060.40
8832.20
9511.60
14149.20
15237.60
1076.40
1159.20
8018.40
8635.20
9313.20
10029.60
11572.60
12462.80
2298.40
2475.20
11180.00
12040.00
23335.00
25130.00
26995.80
29072.40
2311.40
2489.20
12425.40
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0.00
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0.00
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0.00
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1151.80
1240.40
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17256.20
18583.60
15758.60
16970.80
16767.40
18057.20
15732.60
16942.80
20048.60
21590.80
18423.60
19840.80
17690.40
19051.20
20259.20
21817.60
19710.60
21226.80
21832.20
23511.60
20594.60
22178.80
21065.20
22685.60
11757.20
12661.60
8697.00
9366.00
6149.00
6622.00
10433.80
11236.40
11575.20
12465.60
13132.60
14142.80
2306.20
2483.60
14612.00
15736.00
12716.60
13694.80
16671.20
17953.60
17383.60
18720.80
18894.20
20347.60
17030.00
18340.00
21330.40
22971.20
19523.40
21025.20
1801.80
1940.40
15847.00
17066.00
0.00
0.00
7961.20
8573.60
9882.60
10642.80
5566.60
5994.80
9526.40
10259.20
13358.80
14386.40
11364.60
12238.80
9352.20
10071.60
5863.00
6314.00
9963.20
10729.60
11200.80
12062.40
1495.00
1610.00
1643.20
1769.60
1976.00
2128.00
2103.40
2265.20
1879.80
2024.40
2472.60
2662.80
2529.80
2724.40
2740.40
2951.20
2444.00
2632.00
1955.20
2105.60
2901.60
3124.80
3060.20
3295.60
3936.40
4239.20
4186.00
4508.00
642.20
691.60
782.60
842.80
1544.40
1663.20
1554.80
1674.40
1866.80
2010.40
2108.60
2270.80
2405.00
2590.00
2857.40
3077.20
3112.20
3351.60
2639.00
2842.00
3042.00
3276.00
3049.80
3284.40
2631.20
2833.60
228.80
246.40
13369.20
14397.60
15342.60
16522.80
10010.00
10780.00
12391.60
13344.80
10199.80
10984.40
8213.40
8845.20
9674.60
10418.80
15233.40
16405.20
13304.20
14327.60
13730.60
14786.80
12623.00
13594.00
14684.80
15814.40
10140.00
10920.00
9646.00
10388.00
1588.60
1710.80
0.00
0.00
2381.60
2564.80
3663.40
3945.20
0.00
0.00
7189.00
7742.00
7922.20
8531.60
7079.80
7624.40
0.00
0.00
7308.60
7870.80
2423.20
2609.60
6063.20
6529.60
795.60
856.80
8262.80
8898.40
5649.80
6084.40
0.00
0.00
3962.40
4267.20
1469.00
1582.00
5335.20
5745.60
2792.40
3007.20
3447.60
3712.80
17544.80
18894.40
10329.80
11124.40
17927.00
19306.00
18751.20
20193.60
17186.00
18508.00
14960.40
16111.20
18551.00
19978.00
15022.80
16178.40
16416.40
17679.20
10602.80
11418.40
27292.20
29391.60
10342.80
11138.40
12987.00
13986.00
17160.00
18480.00
3744.00
4032.00
9523.80
10256.40
5595.20
6025.60
7638.80
8226.40
6494.80
6994.40
639.60
688.80
1341.60
1444.80
1040.00
1120.00
1157.00
1246.00
1120.60
1206.80
1201.20
1293.60
1320.80
1422.40
1263.60
1360.80
1222.00
1316.00
1027.00
1106.00
1222.00
1316.00
816.40
879.20
1034.80
1114.40
1627.60
1752.80
1619.80
1744.40
1557.40
1677.20
1349.40
1453.20
1362.40
1467.20
1931.80
2080.40
2090.40
2251.20
1700.40
1831.20
1495.00
1610.00
2282.80
2458.40
1661.40
1789.20
1960.40
2111.20
2376.40
2559.20
3013.40
3245.20
2873.00
3094.00
2800.20
3015.60
3767.40
4057.20
3413.80
3676.40
2810.60
3026.80
3229.20
3477.60
3910.40
4211.20
3294.20
3547.60
2821.00
3038.00
3627.00
3906.00
18868.20
20319.60
20412.60
21982.80
10927.80
11768.40
14539.20
15657.60
0.00
0.00
4921.80
5300.40
5532.80
5958.40
579.80
624.40
10017.80
10788.40
8775.00
9450.00
13897.00
14966.00
6593.60
7100.80
10514.40
11323.20
15514.20
16707.60
11273.60
12140.80
13761.80
14820.40
11008.40
11855.20
13655.20
14705.60
1892.80
2038.40
1578.20
1699.60
1827.80
1968.40
2103.40
2265.20
1014.00
1092.00
0.00
0.00
2184.00
2352.00
847.60
912.80
3840.20
4135.60
4035.20
4345.60
1040.00
1120.00
4427.80
4768.40
2152.80
2318.40
1505.40
1621.20
990.60
1066.80
2990.00
3220.00
1115.40
1201.20
1773.20
1909.60
1625.00
1750.00
2930.20
3155.60
3291.60
3544.80
3936.40
4239.20
4386.20
4723.60
4430.40
4771.20
4950.40
5331.20
5171.40
5569.20
3637.40
3917.20
3845.40
4141.20
4362.80
4698.40
3835.00
4130.00
5114.20
5507.60
1042.60
1122.80
1237.60
1332.80
2241.20
2413.60
449.80
484.40
956.80
1030.40
1115.40
1201.20
1170.00
1260.00
1180.40
1271.20
920.40
991.20
1375.40
1481.20
715.00
770.00
886.60
954.80
6133.40
6605.20
4479.80
4824.40
1565.20
1685.60
4368.00
4704.00
10244.00
11032.00
19364.80
20854.40
4591.60
4944.80
10298.60
11090.80
16468.40
17735.20
19089.20
20557.60
20150.00
21700.00
23376.60
25174.80
32487.00
34986.00
33134.40
35683.20
34793.20
37469.60
7194.20
7747.60
5642.00
6076.00
5501.60
5924.80
2160.60
2326.80
10267.40
11057.20
8821.80
9500.40
8671.00
9338.00
1313.00
1414.00
1362.40
1467.20
1370.20
1475.60
1934.40
2083.20
1430.00
1540.00
2680.60
2886.80
2082.60
2242.80
1383.20
1489.60
1240.20
1335.60
2059.20
2217.60
2072.20
2231.60
3585.40
3861.20
0.00
0.00
1385.80
1492.40
982.80
1058.40
11242.40
12107.20
1708.20
1839.60
10940.80
11782.40
7930.00
8540.00
21962.20
23651.60
32396.00
34888.00
29013.40
31245.20
31119.40
33513.20
0.00
0.00
46251.40
49809.20
39036.40
42039.20
33688.20
36279.60
36389.60
39188.80
44418.40
47835.20
0.00
0.00
0.00
0.00
0.00
0.00
3133.00
3374.00
3650.40
3931.20
10701.60
11524.80
12937.60
13932.80
17721.60
19084.80
28472.60
30662.80
13642.20
14691.60
11684.40
12583.20
11856.00
12768.00
13564.20
14607.60
13143.00
14154.00
7248.80
7806.40
0.00
0.00
20355.40
21921.20
12662.00
13636.00
12888.20
13879.60
11952.20
12871.60
8190.00
8820.00
3156.40
3399.20
910.00
980.00
351.00
378.00
4334.20
4667.60
5361.20
5773.60
1214.20
1307.60
5020.60
5406.80
1570.40
1691.20
2930.20
3155.60
2945.80
3172.40
4625.40
4981.20
3471.00
3738.00
3939.00
4242.00
2548.00
2744.00
2789.80
3004.40
7059.00
7602.00
7129.20
7677.60
8151.00
8778.00
7303.40
7865.20
0.00
0.00
10223.20
11009.60
9266.40
9979.20
11843.00
12754.00
11973.00
12894.00
13026.00
14028.00
5101.20
5493.60
9898.20
10659.60
16367.00
17626.00
14721.20
15853.60
18894.20
20347.60
12539.80
13504.40
10795.20
11625.60
12771.20
13753.60
12370.80
13322.40
13928.20
14999.60
21325.20
22965.60
28758.60
30970.80
23384.40
25183.20
30711.20
33073.60
14944.80
16094.40
9500.40
10231.20
14396.20
15503.60
12857.00
13846.00
0.00
0.00
17430.40
18771.20
21853.00
23534.00
11099.40
11953.20
8366.80
9010.40
3341.00
3598.00
27014.00
29092.00
10454.60
11258.80
14760.20
15895.60
15425.80
16612.40
17721.60
19084.80
11775.40
12681.20
29289.00
31542.00
27281.80
29380.40
29257.80
31508.40
27401.40
29509.20
17097.60
18412.80
25420.20
27375.60
977.60
1052.80
10834.20
11667.60
10228.40
11015.20
2847.00
3066.00
10319.40
11113.20
12201.80
13140.40
12701.00
13678.00
16946.80
18250.40
15719.60
16928.80
0.00
0.00
0.00
0.00
2238.60
2410.80
23979.80
25824.40
11936.60
12854.80
0.00
0.00
7259.20
7817.60
9882.60
10642.80
8905.00
9590.00
15022.80
16178.40
2399.80
2584.40
9453.60
10180.80
2841.80
3060.40
10374.00
11172.00
2623.40
2825.20
7014.80
7554.40
951.60
1024.80
969.80
1044.40
985.40
1061.20
11273.60
12140.80
14362.40
15467.20
16486.60
17754.80
20917.00
22526.00
9154.60
9858.80
5493.80
5916.40
7428.20
7999.60
3078.40
3315.20
3268.20
3519.60
3497.00
3766.00
6097.00
6566.00
3723.20
4009.60
3991.00
4298.00
1801.80
1940.40
1232.40
1327.20
0.00
0.00
1029.60
1108.80
8080.80
8702.40
1843.40
1985.20
769.60
828.80
2189.20
2357.60
4141.80
4460.40
2228.20
2399.60
3614.00
3892.00
1042.60
1122.80
556.40
599.20
7103.20
7649.60
5990.40
6451.20
421.20
453.60
4069.00
4382.00
4326.40
4659.20
1136.20
1223.60
1747.20
1881.60
3247.40
3497.20
3705.00
3990.00
3109.60
3348.80
2360.80
2542.40
969.80
1044.40
1331.20
1433.60
2043.60
2200.80
702.00
756.00
439.40
473.20
7462.00
8036.00
9003.80
9696.40
3845.40
4141.20
5824.00
6272.00
3489.20
3757.60
5681.00
6118.00
4882.80
5258.40
5998.20
6459.60
5941.00
6398.00
7204.60
7758.80
5379.40
5793.20
6377.80
6868.40
5415.80
5832.40
5938.40
6395.20
5618.60
6050.80
6817.20
7341.60
6944.60
7478.80
8777.60
9452.80
7243.60
7800.80
8873.80
9556.40
2542.80
2738.40
3892.20
4191.60
4838.60
5210.80
3099.20
3337.60
4518.80
4866.40
4160.00
4480.00
4921.80
5300.40
5379.40
5793.20
6866.60
7394.80
46774.00
50372.00
10691.20
11513.60
6461.00
6958.00
5067.40
5457.20
4009.20
4317.60
5228.60
5630.80
6931.60
7464.80
8691.80
9360.40
7966.40
8579.20
9588.80
10326.40
8002.80
8618.40
11505.00
12390.00
7670.00
8260.00
13585.00
14630.00
3351.40
3609.20
0.00
0.00
6913.40
7445.20
9895.60
10656.80
2394.60
2578.80
8590.40
9251.20
8647.60
9312.80
10592.40
11407.20
11242.40
12107.20
11024.00
11872.00
13564.20
14607.60
8078.20
8699.60
11884.60
12798.80
8996.00
9688.00
8814.00
9492.00
9687.60
10432.80
9612.20
10351.60
10428.60
11230.80
1339.00
1442.00
7061.60
7604.80
9742.20
10491.60
11169.60
12028.80
11941.80
12860.40
12126.40
13059.20
13631.80
14680.40
12321.40
13269.20
11315.20
12185.60
8910.20
9595.60
8886.80
9570.40
0.00
0.00
13215.80
14232.40
0.00
0.00
0.00
0.00
2048.80
2206.40
1788.80
1926.40
1643.20
1769.60
8886.80
9570.40
24161.80
26020.40
27125.80
29212.40
11271.00
12138.00
18772.00
20216.00
3944.20
4247.60
3572.40
3847.20
3330.60
3586.80
2516.80
2710.40
1424.80
1534.40
785.20
845.60
902.20
971.60
933.40
1005.20
1656.20
1783.60
2015.00
2170.00
613.60
660.80
1671.80
1800.40
1071.20
1153.60
1047.80
1128.40
10779.60
11608.80
12981.80
13980.40
11949.60
12868.80
9627.80
10368.40
13852.80
14918.40
13410.80
14442.40
10665.20
11485.60
8572.20
9231.60
10868.00
11704.00
13863.20
14929.60
11624.60
12518.80
12521.60
13484.80
11190.40
12051.20
15043.60
16200.80
12571.00
13538.00
0.00
0.00
2750.80
2962.40
2948.40
3175.20
3192.80
3438.40
3234.40
3483.20
3694.60
3978.80
5418.40
5835.20
4591.60
4944.80
4979.00
5362.00
5293.60
5700.80
6687.20
7201.60
5275.40
5681.20
5691.40
6129.20
6273.80
6756.40
5163.60
5560.80
6923.80
7456.40
8725.60
9396.80
9123.40
9825.20
8782.80
9458.40
8398.00
9044.00
8294.00
8932.00
9635.60
10376.80
10631.40
11449.20
707.20
761.60
897.00
966.00
728.00
784.00
639.60
688.80
8590.40
9251.20
11156.60
12014.80
9976.20
10743.60
10847.20
11681.60
4677.40
5037.20
6466.20
6963.60
11325.60
12196.80
10719.80
11544.40
10548.20
11359.60
10719.80
11544.40
10316.80
11110.40
10712.00
11536.00
11089.00
11942.00
11281.40
12149.20
8619.00
9282.00
12430.60
13386.80
11359.40
12233.20
12318.80
13266.40
15459.60
16648.80
16788.20
18079.60
11421.80
12300.40
11593.40
12485.20
8772.40
9447.20
7911.80
8520.40
8179.60
8808.80
10982.40
11827.20
8234.20
8867.60
9053.20
9749.60
12875.20
13865.60
11869.00
12782.00
0.00
0.00
2865.20
3085.60
3161.60
3404.80
3400.80
3662.40
3309.80
3564.40
2964.00
3192.00
3463.20
3729.60
3351.40
3609.20
4420.00
4760.00
4360.20
4695.60
3325.40
3581.20
4326.40
4659.20
4339.40
4673.20
2657.20
2861.60
4570.80
4922.40
4368.00
4704.00
5376.80
5790.40
5350.80
5762.40
3764.80
4054.40
400.40
431.20
769.60
828.80
2095.60
2256.80
6349.20
6837.60
5493.80
5916.40
7987.20
8601.60
7389.20
7957.60
7222.80
7778.40
9040.20
9735.60
11863.80
12776.40
12082.20
13011.60
13847.60
14912.80
16972.80
18278.40
17651.40
19009.20
19663.80
21176.40
18028.40
19415.20
20433.40
22005.20
21936.20
23623.60
21444.80
23094.40
634.40
683.20
351.00
378.00
694.20
747.60
559.00
602.00
361.40
389.20
429.00
462.00
876.20
943.60
712.40
767.20
993.20
1069.60
1931.80
2080.40
746.20
803.60
1666.60
1794.80
2397.20
2581.60
2857.40
3077.20
2828.80
3046.40
3512.60
3782.80
366.60
394.80
457.60
492.80
1760.20
1895.60
1950.00
2100.00
1955.20
2105.60
990.60
1066.80
161.20
173.60
9731.80
10480.40
10054.20
10827.60
6219.20
6697.60
7423.00
7994.00
5509.40
5933.20
7007.00
7546.00
8369.40
9013.20
4378.40
4715.20
7724.60
8318.80
7064.20
7607.60
10181.60
10964.80
15282.80
16458.40
12945.40
13941.20
6606.60
7114.80
7144.80
7694.40
8109.40
8733.20
0.00
0.00
1380.60
1486.80
2685.80
2892.40
1892.80
2038.40
2373.80
2556.40
2373.80
2556.40
2033.20
2189.60
2828.80
3046.40
2428.40
2615.20
2293.20
2469.60
2691.00
2898.00
4706.00
5068.00
2267.20
2441.60
1963.00
2114.00
2368.60
2550.80
2431.00
2618.00
3278.60
3530.80
2480.40
2671.20
3047.20
3281.60
1898.00
2044.00
3153.80
3396.40
1885.00
2030.00
1874.60
2018.80
2277.60
2452.80
2659.80
2864.40
2730.00
2940.00
2605.20
2805.60
1604.20
1727.60
2795.00
3010.00
4997.20
5381.60
4427.80
4768.40
2301.00
2478.00
2995.20
3225.60
2454.40
2643.20
3793.40
4085.20
2072.20
2231.60
2394.60
2578.80
2691.00
2898.00
2922.40
3147.20
3257.80
3508.40
3538.60
3810.80
3772.60
4062.80
4256.20
4583.60
2925.00
3150.00
3437.20
3701.60
3946.80
4250.40
3655.60
3936.80
4355.00
4690.00
4440.80
4782.40
2496.00
2688.00
4334.20
4667.60
4503.20
4849.60
7854.60
8458.80
4121.00
4438.00
2706.60
2914.80
9227.40
9937.20
9851.40
10609.20
8827.00
9506.00
4071.60
4384.80
1365.00
1470.00
2698.80
2906.40
904.80
974.40
642.20
691.60
3627.00
3906.00
1586.00
1708.00
3874.00
4172.00
6120.40
6591.20
1323.40
1425.20
7194.20
7747.60
8619.00
9282.00
4209.40
4533.20
5665.40
6101.20
5855.20
6305.60
3918.20
4219.60
4040.40
4351.20
1684.80
1814.40
1731.60
1864.80
1830.40
1971.20
2428.40
2615.20
7451.60
8024.80
8104.20
8727.60
9097.40
9797.20
10506.60
11314.80
7810.40
8411.20
8699.60
9368.80
9053.20
9749.60
10725.00
11550.00
8195.20
8825.60
7248.80
7806.40
7360.60
7926.80
8130.20
8755.60
5946.20
6403.60
7501.00
8078.00
11895.00
12810.00
5668.00
6104.00
3764.80
4054.40
4222.40
4547.20
6996.60
7534.80
4498.00
4844.00
4490.20
4835.60
5839.60
6288.80
7376.20
7943.60
5140.20
5535.60
592.80
638.40
551.20
593.60
600.60
646.80
813.80
876.40
746.20
803.60
475.80
512.40
470.60
506.80
364.00
392.00
8117.20
8741.60
8873.80
9556.40
772.20
831.60
2178.80
2346.40
0.00
0.00
1001.00
1078.00
1281.80
1380.40
2849.60
3068.80
985.40
1061.20
855.40
921.20
1055.60
1136.80
910.00
980.00
1206.40
1299.20
1630.20
1755.60
1224.60
1318.80
1970.80
2122.40
5779.80
6224.40
7428.20
7999.60
8702.20
9371.60
3907.80
4208.40
5855.20
6305.60
7558.20
8139.60
11089.00
11942.00
14076.40
15159.20
1021.80
1100.40
1484.60
1598.80
1820.00
1960.00
1843.40
1985.20
2015.00
2170.00
1770.60
1906.80
764.40
823.20
4914.00
5292.00
1352.00
1456.00
735.80
792.40
1079.00
1162.00
678.60
730.80
897.00
966.00
1115.40
1201.20
5946.20
6403.60
6952.40
7487.20
6871.80
7400.40
7862.40
8467.20
9596.60
10334.80
6723.60
7240.80
7246.20
7803.60
8993.40
9685.20
8782.80
9458.40
8717.80
9388.40
9417.20
10141.60
11445.20
12325.60
5262.40
5667.20
9113.00
9814.00
11515.40
12401.20
16281.20
17533.60
6682.00
7196.00
7407.40
7977.20
8866.00
9548.00
11939.20
12857.60
4898.40
5275.20
6037.20
6501.60
7514.00
8092.00
6770.40
7291.20
7334.60
7898.80
7974.20
8587.60
9529.00
10262.00
4877.60
5252.80
6570.20
7075.60
8340.80
8982.40
6533.80
7036.40
5925.40
6381.20
3837.60
4132.80
5098.60
5490.80
535.60
576.80
691.60
744.80
1937.00
2086.00
4986.80
5370.40
3031.60
3264.80
5465.20
5885.60
4674.80
5034.40
6900.40
7431.20
4550.00
4900.00
6364.80
6854.40
4183.40
4505.20
2774.20
2987.60
4448.60
4790.80
6591.00
7098.00
3283.80
3536.40
3733.60
4020.80
7298.20
7859.60
6523.40
7025.20
7046.00
7588.00
0.00
0.00
1978.60
2130.80
1495.00
1610.00
3445.00
3710.00
2964.00
3192.00
3866.20
4163.60
5231.20
5633.60
3302.00
3556.00
7306.00
7868.00
10004.80
10774.40
785.20
845.60
3133.00
3374.00
4726.80
5090.40
3525.60
3796.80
1539.20
1657.60
3603.60
3880.80
3296.80
3550.40
4552.60
4902.80
3369.60
3628.80
6445.40
6941.20
2940.60
3166.80
2610.40
2811.20
1744.60
1878.80
4609.80
4964.40
2379.00
2562.00
3720.60
4006.80
4238.00
4564.00
3273.40
3525.20
3970.20
4275.60
5080.40
5471.20
3954.60
4258.80
0.00
0.00
3892.20
4191.60
4997.20
5381.60
6648.20
7159.60
3190.20
3435.60
1466.40
1579.20
2470.00
2660.00
3390.40
3651.20
4173.00
4494.00
5486.00
5908.00
10155.60
10936.80
12277.20
13221.60
14978.60
16130.80
16419.00
17682.00
8125.00
8750.00
8788.00
9464.00
12451.40
13409.20
13332.80
14358.40
15254.20
16427.60
8117.20
8741.60
10192.00
10976.00
12407.20
13361.60
16195.40
17441.20
1323.40
1425.20
7540.00
8120.00
7069.40
7613.20
933.40
1005.20
4167.80
4488.40
0.00
0.00
0.00
0.00
1019.20
1097.60
865.80
932.40
1739.40
1873.20
1292.20
1391.60
449.80
484.40
1079.00
1162.00
1900.60
2046.80
582.40
627.20
280.80
302.40
4768.40
5135.20
5740.80
6182.40
8483.80
9136.40
10745.80
11572.40
12539.80
13504.40
11037.00
11886.00
11681.80
12580.40
13730.60
14786.80
13494.00
14532.00
1773.20
1909.60
2841.80
3060.40
2290.60
2466.80
10943.40
11785.20
2472.60
2662.80
816.40
879.20
1099.80
1184.40
1799.20
1937.60
4131.40
4449.20
787.80
848.40
1601.60
1724.80
2969.20
3197.60
917.80
988.40
1622.40
1747.20
634.40
683.20
1167.40
1257.20
4565.60
4916.80
13481.00
14518.00
15438.80
16626.40
8598.20
9259.60
15438.80
16626.40
13468.00
14504.00
4856.80
5230.40
1510.60
1626.80
1632.80
1758.40
278.20
299.60
2454.40
2643.20
956.80
1030.40
465.40
501.20
462.80
498.40
998.40
1075.20
2815.80
3032.40
3460.60
3726.80
3026.40
3259.20
3762.20
4051.60
6336.20
6823.60
6463.60
6960.80
7971.60
8584.80
8728.20
9399.60
2459.60
2648.80
4570.80
4922.40
7631.00
8218.00
9097.40
9797.20
4745.00
5110.00
6591.00
7098.00
7766.20
8363.60
6437.60
6932.80
6372.60
6862.80
6609.20
7117.60
6752.20
7271.60
6073.60
6540.80
7828.60
8430.80
4534.40
4883.20
9118.20
9819.60
5291.00
5698.00
8842.60
9522.80
10080.20
10855.60
6266.00
6748.00
4243.20
4569.60
4838.60
5210.80
4968.60
5350.80
6853.60
7380.80
11107.20
11961.60
1268.80
1366.40
1019.20
1097.60
1505.40
1621.20
865.80
932.40
1177.80
1268.40
8777.60
9452.80
9284.60
9998.80
7927.40
8537.20
873.60
940.80
1302.60
1402.80
1063.40
1145.20
993.20
1069.60
1705.60
1836.80
1926.60
2074.80
764.40
823.20
858.00
924.00
1102.40
1187.20
1250.60
1346.80
1250.60
1346.80
2571.40
2769.20
2301.00
2478.00
3257.80
3508.40
16533.40
17805.20
7464.60
8038.80
7875.40
8481.20
3876.60
4174.80
5738.20
6179.60
5363.80
5776.40
1076.40
1159.20
2922.40
3147.20
2906.80
3130.40
460.20
495.60
842.40
907.20
395.20
425.60
2077.40
2237.20
8814.00
9492.00
5187.00
5586.00
11094.20
11947.60
9557.60
10292.80
11967.80
12888.40
9170.20
9875.60
12620.40
13591.20
16889.60
18188.80
26759.20
28817.60
7922.20
8531.60
8845.20
9525.60
9513.40
10245.20
10124.40
10903.20
8452.60
9102.80
9430.20
10155.60
10106.20
10883.60
12612.60
13582.80
11057.80
11908.40
11983.40
12905.20
12641.20
13613.60
13156.00
14168.00
11723.40
12625.20
481.00
518.00
657.80
708.40
447.20
481.60
566.80
610.40
119.60
128.80
712.40
767.20
2667.60
2872.80
4082.00
4396.00
738.40
795.20
3221.40
3469.20
5142.80
5538.40
4165.20
4485.60
7703.80
8296.40
7742.80
8338.40
8717.80
9388.40
8275.80
8912.40
9248.20
9959.60
9414.60
10138.80
10186.80
10970.40
8585.20
9245.60
10834.20
11667.60
17339.40
18673.20
8457.80
9108.40
9388.60
10110.80
10909.60
11748.80
12628.20
13599.60
1825.20
1965.60
2561.00
2758.00
3299.40
3553.20
3728.40
4015.20
5272.80
5678.40
2787.20
3001.60
5080.40
5471.20
6372.60
6862.80
8905.00
9590.00
9898.20
10659.60
11096.80
11950.40
12698.40
13675.20
0.00
0.00
0.00
0.00
3481.40
3749.20
3135.60
3376.80
746.20
803.60
2324.40
2503.20
6448.00
6944.00
6172.40
6647.20
6752.20
7271.60
3486.60
3754.80
3484.00
3752.00
7069.40
7613.20
7675.20
8265.60
0.00
0.00
7425.60
7996.80
6905.60
7436.80
8372.00
9016.00
8652.80
9318.40
8091.20
8713.60
7761.00
8358.00
8177.00
8806.00
2828.80
3046.40
3809.00
4102.00
3192.80
3438.40
6869.20
7397.60
2441.40
2629.20
6744.40
7263.20
4245.80
4572.40
6705.40
7221.20
7085.00
7630.00
4942.60
5322.80
10839.40
11673.20
10355.80
11152.40
13325.00
14350.00
15038.40
16195.20
18610.80
20042.40
20165.60
21716.80
12693.20
13669.60
14570.40
15691.20
15995.20
17225.60
8881.60
9564.80
1825.20
1965.60
1255.80
1352.40
1950.00
2100.00
780.00
840.00
1742.00
1876.00
1970.80
2122.40
1279.20
1377.60
650.00
700.00
447.20
481.60
943.80
1016.40
494.00
532.00
410.80
442.40
2992.60
3222.80
4908.80
5286.40
3088.80
3326.40
4908.80
5286.40
8041.80
8660.40
7657.00
8246.00
7664.80
8254.40
7930.00
8540.00
7789.60
8388.80
8481.20
9133.60
3424.20
3687.60
7417.80
7988.40
7222.80
7778.40
1669.20
1797.60
439.40
473.20
1435.20
1545.60
1469.00
1582.00
2074.80
2234.40
2740.40
2951.20
18132.40
19527.20
7085.00
7630.00
9029.80
9724.40
902.20
971.60
798.20
859.60
3099.20
3337.60
5465.20
5885.60
1209.00
1302.00
20090.20
21635.60
7984.60
8598.80
10956.40
11799.20
4726.80
5090.40
19045.00
20510.00
7961.20
8573.60
9903.40
10665.20
20352.80
21918.40
8242.00
8876.00
11258.00
12124.00
2828.80
3046.40
3382.60
3642.80
3403.40
3665.20
4180.80
4502.40
1970.80
2122.40
3468.40
3735.20
3244.80
3494.40
3809.00
4102.00
4690.40
5051.20
3985.80
4292.40
4693.00
5054.00
4877.60
5252.80
2035.80
2192.40
4487.60
4832.80
1292.20
1391.60
0.00
0.00
0.00
0.00
1396.20
1503.60
738.40
795.20
6315.40
6801.20
6778.20
7299.60
9770.80
10522.40
7407.40
7977.20
8899.80
9584.40
9323.60
10040.80
12656.80
13630.40
16242.20
17491.60
10532.60
11342.80
13161.20
14173.60
10137.40
10917.20
4274.40
4603.20
5743.40
6185.20
683.80
736.40
9752.60
10502.80
12243.40
13185.20
13322.40
14347.20
2329.60
2508.80
9854.00
10612.00
10792.60
11622.80
13114.40
14123.20
9893.00
10654.00
11458.20
12339.60
13702.00
14756.00
17347.20
18681.60
11260.60
12126.80
0.00
0.00
1029.60
1108.80
1058.20
1139.60
1294.80
1394.40
1190.80
1282.40
949.00
1022.00
1248.00
1344.00
785.20
845.60
4329.00
4662.00
3018.60
3250.80
8535.80
9192.40
7035.60
7576.80
11876.80
12790.40
12825.80
13812.40
9396.40
10119.20
11957.40
12877.20
11765.00
12670.00
3525.60
3796.80
4716.40
5079.20
8179.60
8808.80
8018.40
8635.20
15542.80
16738.40
19055.40
20521.20
19708.00
21224.00
18764.20
20207.60
17300.40
18631.20
19591.00
21098.00
839.80
904.40
17997.20
19381.60
20204.60
21758.80
22500.40
24231.20
22718.80
24466.40
16598.40
17875.20
18831.80
20280.40
19557.20
21061.60
12877.80
13868.40
13686.40
14739.20
20815.60
22416.80
19349.20
20837.60
19000.80
20462.40
18244.20
19647.60
19016.40
20479.20
19960.20
21495.60
18200.00
19600.00
14071.20
15153.60
17966.00
19348.00
12737.40
13717.20
10979.80
11824.40
20644.00
22232.00
24172.20
26031.60
17971.20
19353.60
17534.40
18883.20
832.00
896.00
26132.60
28142.80
27994.20
30147.60
35716.20
38463.60
30269.20
32597.60
20748.00
22344.00
19752.20
21271.60
34707.40
37377.20
29260.40
31511.20
11536.20
12423.60
14435.20
15545.60
15574.00
16772.00
9422.40
10147.20
24502.40
26387.20
23428.60
25230.80
25383.80
27336.40
22412.00
24136.00
20714.20
22307.60
20386.60
21954.80
20727.20
22321.60
20610.20
22195.60
18046.60
19434.80
30243.20
32569.60
21897.20
23581.60
14833.00
15974.00
8613.80
9276.40
10530.00
11340.00
15381.60
16564.80
15904.20
17127.60
15904.20
17127.60
19562.40
21067.20
18782.40
20227.20
22830.60
24586.80
21330.40
22971.20
24328.20
26199.60
17695.60
19056.80
18855.20
20305.60
23795.20
25625.60
33537.40
36117.20
23636.60
25454.80
26143.00
28154.00
28558.40
30755.20
27313.00
29414.00
26886.60
28954.80
30560.40
32911.20
22903.40
24665.20
29731.00
32018.00
29978.00
32284.00
29884.40
32183.20
22646.00
24388.00
24042.20
25891.60
27422.20
29531.60
26702.00
28756.00
20568.60
22150.80
22500.40
24231.20
21252.40
22887.20
28303.60
30480.80
27690.00
29820.00
30656.60
33014.80
5623.80
6056.40
17979.00
19362.00
3541.20
3813.60
13301.60
14324.80
31046.60
33434.80
22107.80
23808.40
31447.00
33866.00
12386.40
13339.20
14245.40
15341.20
5148.00
5544.00
10337.60
11132.80
7966.40
8579.20
11853.40
12765.20
12807.60
13792.80
5886.40
6339.20
2072.20
2231.60
4136.60
4454.80
21424.00
23072.00
39834.60
42898.80
27021.80
29100.40
42853.20
46149.60
20735.00
22330.00
34840.00
37520.00
40193.40
43285.20
44142.80
47538.40
32481.80
34980.40
38321.40
41269.20
12851.80
13840.40
24733.80
26636.40
19877.00
21406.00
17063.80
18376.40
24785.80
26692.40
11996.40
12919.20
14352.00
15456.00
13306.80
14330.40
12984.40
13983.20
14973.40
16125.20
15353.00
16534.00
2256.80
2430.40
1853.80
1996.40
2256.80
2430.40
8255.00
8890.00
10519.60
11328.80
9474.40
10203.20
2080.00
2240.00
13010.40
14011.20
2870.40
3091.20
1443.00
1554.00
8338.20
8979.60
14830.40
15971.20
14164.80
15254.40
2722.20
2931.60
21658.00
23324.00
4794.40
5163.20
11190.40
12051.20
9763.00
10514.00
5327.40
5737.20
4849.00
5222.00
7917.00
8526.00
3673.80
3956.40
9573.20
10309.60
12022.40
12947.20
14495.00
15610.00
15256.80
16430.40
11863.80
12776.40
16796.00
18088.00
16559.40
17833.20
16268.20
17519.60
16086.20
17323.60
9874.80
10634.40
10823.80
11656.40
8369.40
9013.20
9804.60
10558.80
13379.60
14408.80
11811.80
12720.40
13860.60
14926.80
1209.00
1302.00
1817.40
1957.20
14354.60
15458.80
17908.80
19286.40
11554.40
12443.20
19793.80
21316.40
14843.40
15985.20
15163.20
16329.60
8710.00
9380.00
9222.20
9931.60
4040.40
4351.20
13031.20
14033.60
11349.00
12222.00
9625.20
10365.60
9924.20
10687.60
4875.00
5250.00
7932.60
8542.80
764.40
823.20
5623.80
6056.40
10592.40
11407.20
4056.00
4368.00
2363.40
2545.20
1479.40
1593.20
2714.40
2923.20
2662.40
2867.20
881.40
949.20
1066.00
1148.00
1086.80
1170.40
1731.60
1864.80
1586.00
1708.00
1508.00
1624.00
1229.80
1324.40
5293.60
5700.80
1768.00
1904.00
1695.20
1825.60
5454.80
5874.40
5857.80
6308.40
1151.80
1240.40
980.20
1055.60
1201.20
1293.60
1094.60
1178.80
3809.00
4102.00
8197.80
8828.40
2878.20
3099.60
2964.00
3192.00
3699.80
3984.40
3926.00
4228.00
3148.60
3390.80
241.80
260.40
377.00
406.00
11702.60
12602.80
11746.80
12650.40
11138.40
11995.20
10332.40
11127.20
11216.40
12079.20
14019.20
15097.60
14375.40
15481.20
11793.60
12700.80
11026.60
11874.80
9149.40
9853.20
1843.40
1985.20
13293.80
14316.40
12308.40
13255.20
4890.60
5266.80
4643.60
5000.80
12022.40
12947.20
11450.40
12331.20
10392.20
11191.60
2043.60
2200.80
14965.60
16116.80
16294.20
17547.60
15415.40
16601.20
14034.80
15114.40
3088.80
3326.40
16790.80
18082.40
1978.60
2130.80
13000.00
14000.00
2397.20
2581.60
14245.40
15341.20
1864.20
2007.60
16811.60
18104.80
2576.60
2774.80
17999.80
19384.40
1827.80
1968.40
22690.20
24435.60
2485.60
2676.80
18730.40
20171.20
1710.80
1842.40
22042.80
23738.40
21286.20
22923.60
2802.80
3018.40
15077.40
16237.20
13332.80
14358.40
16356.60
17614.80
14050.40
15131.20
14970.80
16122.40
11304.80
12174.40
12040.60
12966.80
12061.40
12989.20
12989.60
13988.80
14557.40
15677.20
12825.80
13812.40
15657.20
16861.60
15106.00
16268.00
15852.20
17071.60
14424.80
15534.40
28228.20
30399.60
28847.00
31066.00
28839.20
31057.60
15792.40
17007.20
16281.20
17533.60
13005.20
14005.60
13761.80
14820.40
19697.60
21212.80
19630.00
21140.00
18025.80
19412.40
17674.80
19034.40
17011.80
18320.40
16918.20
18219.60
14705.60
15836.80
15038.40
16195.20
20004.40
21543.20
19843.20
21369.60
18678.40
20115.20
17994.60
19378.80
24757.20
26661.60
24377.60
26252.80
26080.60
28086.80
26397.80
28428.40
3182.40
3427.20
17375.80
18712.40
20917.00
22526.00
20654.40
22243.20
21964.80
23654.40
22295.00
24010.00
23719.80
25544.40
20319.00
21882.00
22854.00
24612.00
3075.80
3312.40
8595.60
9256.80
5389.80
5804.40
11710.40
12611.20
10428.60
11230.80
3681.60
3964.80
4144.40
4463.20
8195.20
8825.60
3078.40
3315.20
6679.40
7193.20
4469.40
4813.20
4708.60
5070.80
3876.60
4174.80
3497.00
3766.00
12251.20
13193.60
13434.20
14467.60
15574.00
16772.00
17357.60
18692.80
8603.40
9265.20
10397.40
11197.20
10444.20
11247.60
8821.80
9500.40
5980.00
6440.00
6351.80
6840.40
5626.40
6059.20
655.20
705.60
699.40
753.20
785.20
845.60
889.20
957.60
795.60
856.80
774.80
834.40
769.60
828.80
683.80
736.40
1058.20
1139.60
683.80
736.40
748.80
806.40
837.20
901.60
1222.00
1316.00
917.80
988.40
904.80
974.40
826.80
890.40
735.80
792.40
980.20
1055.60
624.00
672.00
899.60
968.80
871.00
938.00
650.00
700.00
338.00
364.00
1391.00
1498.00
730.60
786.80
1333.80
1436.40
694.20
747.60
1040.00
1120.00
585.00
630.00
595.40
641.20
873.60
940.80
496.60
534.80
504.40
543.20
782.60
842.80
738.40
795.20
730.60
786.80
1180.40
1271.20
915.20
985.60
1021.80
1100.40
88.40
95.20
1500.20
1615.60
1359.80
1464.40
1601.60
1724.80
5748.60
6190.80
1219.40
1313.20
278.20
299.60
5982.60
6442.80
5907.20
6361.60
5200.00
5600.00
2865.20
3085.60
2880.80
3102.40
2844.40
3063.20
6263.40
6745.20
1877.20
2021.60
2067.00
2226.00
1799.20
1937.60
2160.60
2326.80
3455.40
3721.20
4620.20
4975.60
845.00
910.00
1534.00
1652.00
1432.60
1542.80
1487.20
1601.60
1679.60
1808.80
1840.80
1982.40
624.00
672.00
2503.80
2696.40
824.20
887.60
1757.60
1892.80
650.00
700.00
1578.20
1699.60
390.00
420.00
504.40
543.20
1617.20
1741.60
2033.20
2189.60
4693.00
5054.00
3023.80
3256.40
4620.20
4975.60
5262.40
5667.20
7204.60
7758.80
6614.40
7123.20
5085.60
5476.80
5577.00
6006.00
3757.00
4046.00
3985.80
4292.40
3312.40
3567.20
2600.00
2800.00
1770.60
1906.80
4019.60
4328.80
4238.00
4564.00
3985.80
4292.40
5101.20
5493.60
4433.00
4774.00
4682.60
5042.80
4599.40
4953.20
4071.60
4384.80
4919.20
5297.60
8658.00
9324.00
4810.00
5180.00
4261.40
4589.20
4765.80
5132.40
5519.80
5944.40
5291.00
5698.00
5475.60
5896.80
3946.80
4250.40
3707.60
3992.80
1887.60
2032.80
4279.60
4608.80
2132.00
2296.00
6988.80
7526.40
10283.00
11074.00
2293.20
2469.60
3790.80
4082.40
7958.60
8570.80
10675.60
11496.80
1890.20
2035.60
6333.60
6820.80
7527.00
8106.00
8439.60
9088.80
6380.40
6871.20
7321.60
7884.80
6520.80
7022.40
6520.80
7022.40
7433.40
8005.20
6507.80
7008.40
3281.20
3533.60
7100.60
7646.80
7711.60
8304.80
7711.60
8304.80
3400.80
3662.40
8320.00
8960.00
9705.80
10452.40
10082.80
10858.40
11775.40
12681.20
2576.60
2774.80
11850.80
12762.40
14385.80
15492.40
8294.00
8932.00
10821.20
11653.60
10652.20
11471.60
9919.00
10682.00
10519.60
11328.80
1089.40
1173.20
1716.00
1848.00
1869.40
2013.20
10665.20
11485.60
12433.20
13389.60
10275.20
11065.60
11492.00
12376.00
9997.00
10766.00
10870.60
11706.80
13332.80
14358.40
14482.00
15596.00
12259.00
13202.00
13104.00
14112.00
6188.00
6664.00
7163.00
7714.00
9838.40
10595.20
10267.40
11057.20
7490.60
8066.80
9118.20
9819.60
6029.40
6493.20
5959.20
6417.60
6981.00
7518.00
7287.80
7848.40
8034.00
8652.00
11398.40
12275.20
13306.80
14330.40
13975.00
15050.00
2763.80
2976.40
6913.40
7445.20
7017.40
7557.20
7508.80
8086.40
5220.80
5622.40
8091.20
8713.60
6097.00
6566.00
418.60
450.80
517.40
557.20
403.00
434.00
564.20
607.60
6700.20
7215.60
8785.40
9461.20
10322.00
11116.00
1333.80
1436.40
3226.60
3474.80
3510.00
3780.00
4388.80
4726.40
6414.20
6907.60
9978.80
10746.40
4693.00
5054.00
4716.40
5079.20
5670.60
6106.80
1027.00
1106.00
3510.00
3780.00
4508.40
4855.20
990.60
1066.80
670.80
722.40
3564.60
3838.80
2987.40
3217.20
3244.80
3494.40
10465.00
11270.00
11627.20
12521.60
11676.60
12574.80
11661.00
12558.00
10940.80
11782.40
0.00
0.00
11044.80
11894.40
12815.40
13801.20
11931.40
12849.20
13585.00
14630.00
6492.20
6991.60
3809.00
4102.00
5051.80
5440.40
699.40
753.20
2706.60
2914.80
8309.60
8948.80
12279.80
13224.40
10972.00
11816.00
1248.00
1344.00
1276.60
1374.80
4461.60
4804.80
4570.80
4922.40
6814.60
7338.80
8101.60
8724.80
2847.00
3066.00
2675.40
2881.20
4305.60
4636.80
5623.80
6056.40
5925.40
6381.20
6068.40
6535.20
8837.40
9517.20
7399.60
7968.80
6117.80
6588.40
1201.20
1293.60
1040.00
1120.00
5592.60
6022.80
7989.80
8604.40
7984.60
8598.80
9037.60
9732.80
7831.20
8433.60
11258.00
12124.00
14201.20
15293.60
9154.60
9858.80
10381.80
11180.40
11052.60
11902.80
7142.20
7691.60
6996.60
7534.80
8949.20
9637.60
5387.20
5801.60
3198.00
3444.00
3510.00
3780.00
7607.60
8192.80
9724.00
10472.00
4032.60
4342.80
5421.00
5838.00
5267.60
5672.80
4921.80
5300.40
6026.80
6490.40
3647.80
3928.40
3816.80
4110.40
5881.20
6333.60
3941.60
4244.80
3603.60
3880.80
2311.40
2489.20
3996.20
4303.60
4417.40
4757.20
3660.80
3942.40
2906.80
3130.40
7079.80
7624.40
6554.60
7058.80
6661.20
7173.60
7511.40
8089.20
8101.60
8724.80
6934.20
7467.60
7885.80
8492.40
7472.40
8047.20
10129.60
10908.80
6845.80
7372.40
7277.40
7837.20
7251.40
7809.20
8580.00
9240.00
845.00
910.00
4516.20
4863.60
5124.60
5518.80
5449.60
5868.80
6071.00
6538.00
8205.60
8836.80
1094.60
1178.80
4833.40
5205.20
3351.40
3609.20
9120.80
9822.40
11819.60
12728.80
13496.60
14534.80
12662.00
13636.00
14487.20
15601.60
15454.40
16643.20
6481.80
6980.40
6097.00
6566.00
11668.80
12566.40
15308.80
16486.40
7306.00
7868.00
12633.40
13605.20
16673.80
17956.40
4672.20
5031.60
5400.20
5815.60
8710.00
9380.00
4672.20
5031.60
4690.40
5051.20
5304.00
5712.00
6383.00
6874.00
12812.80
13798.40
9809.80
10564.40
2072.20
2231.60
262.60
282.80
5241.60
5644.80
10093.20
10869.60
10457.20
11261.60
7420.40
7991.20
8013.20
8629.60
0.00
0.00
5725.20
6165.60
6848.40
7375.20
6435.00
6930.00
7716.80
8310.40
6466.20
6963.60
3021.20
3253.60
3018.60
3250.80
3286.40
3539.20
2831.40
3049.20
1466.40
1579.20
3367.00
3626.00
6260.80
6742.40
2132.00
2296.00
1973.40
2125.20
0.00
0.00
8876.40
9559.20
7368.40
7935.20
8106.80
8730.40
8179.60
8808.80
12503.40
13465.20
1027.00
1106.00
15735.20
16945.60
11372.40
12247.20
11271.00
12138.00
13611.00
14658.00
11713.00
12614.00
712.40
767.20
813.80
876.40
884.00
952.00
9263.80
9976.40
9263.80
9976.40
11018.80
11866.40
0.00
0.00
1315.60
1416.80
1094.60
1178.80
1175.20
1265.60
998.40
1075.20
1307.80
1408.40
1609.40
1733.20
3515.20
3785.60
1253.20
1349.60
499.20
537.60
1159.60
1248.80
1333.80
1436.40
4256.20
4583.60
1515.80
1632.40
1292.20
1391.60
941.20
1013.60
3528.20
3799.60
4565.60
4916.80
4914.00
5292.00
5592.60
6022.80
7059.00
7602.00
4708.60
5070.80
5795.40
6241.20
4680.00
5040.00
4097.60
4412.80
4230.20
4555.60
5418.40
5835.20
4664.40
5023.20
2774.20
2987.60
2392.00
2576.00
4131.40
4449.20
4586.40
4939.20
2623.40
2825.20
2295.80
2472.40
4498.00
4844.00
4344.60
4678.80
2376.40
2559.20
4344.60
4678.80
1198.60
1290.80
4464.20
4807.60
4388.80
4726.40
6393.40
6885.20
7051.20
7593.60
9113.00
9814.00
9089.60
9788.80
6656.00
7168.00
0.00
0.00
1045.20
1125.60
525.20
565.60
933.40
1005.20
1427.40
1537.20
1731.60
1864.80
3764.80
4054.40
1419.60
1528.80
335.40
361.20
5189.60
5588.80
6367.40
6857.20
6162.00
6636.00
6879.60
7408.80
4453.80
4796.40
6185.40
6661.20
3853.20
4149.60
3962.40
4267.20
6271.20
6753.60
3772.60
4062.80
0.00
0.00
1422.20
1531.60
1606.80
1730.40
933.40
1005.20
9599.20
10337.60
9302.80
10018.40
2909.40
3133.20
6450.60
6946.80
2639.00
2842.00
2524.60
2718.80
8754.20
9427.60
10738.00
11564.00
5764.20
6207.60
1606.80
1730.40
7248.80
7806.40
7313.80
7876.40
7540.00
8120.00
1398.80
1506.40
1120.60
1206.80
6037.20
6501.60
998.40
1075.20
1775.80
1912.40
1973.40
2125.20
2472.60
2662.80
3642.60
3922.80
1105.00
1190.00
496.60
534.80
0.00
0.00
1144.00
1232.00
1515.80
1632.40
1367.60
1472.80
254.80
274.40
616.20
663.60
816.40
879.20
3112.20
3351.60
3874.00
4172.00
8377.20
9021.60
2402.40
2587.20
10041.20
10813.60
16221.40
17469.20
683.80
736.40
977.60
1052.80
317.20
341.60
793.00
854.00
1318.20
1419.60
4625.40
4981.20
10415.60
11216.80
14718.60
15850.80
0.00
0.00
852.80
918.40
507.00
546.00
1872.00
2016.00
1164.80
1254.40
1443.00
1554.00
746.20
803.60
1263.60
1360.80
1557.40
1677.20
6656.00
7168.00
5246.80
5650.40
7098.00
7644.00
9425.00
10150.00
11588.20
12479.60
11876.80
12790.40
15979.60
17208.80
25974.00
27972.00
1222.00
1316.00
10017.80
10788.40
15194.40
16363.20
24549.20
26437.60
10153.00
10934.00
10561.20
11373.60
12144.60
13078.80
10797.80
11628.40
15064.40
16223.20
2849.60
3068.80
4711.20
5073.60
8543.60
9200.80
10439.00
11242.00
10072.40
10847.20
11775.40
12681.20
13291.20
14313.60
13257.40
14277.20
10080.20
10855.60
12974.00
13972.00
11863.80
12776.40
14250.60
15346.80
14001.00
15078.00
14872.00
16016.00
7787.00
8386.00
9001.20
9693.60
11720.80
12622.40
11232.00
12096.00
7839.00
8442.00
7833.80
8436.40
9152.00
9856.00
8041.80
8660.40
6643.00
7154.00
0.00
0.00
8361.60
9004.80
10449.40
11253.20
12955.80
13952.40
10987.60
11832.80
13091.00
14098.00
11390.60
12266.80
18366.40
19779.20
11369.80
12244.40
11908.00
12824.00
1900.60
2046.80
10106.20
10883.60
10272.60
11062.80
9180.60
9886.80
8309.60
8948.80
7553.00
8134.00
8899.80
9584.40
9906.00
10668.00
15043.60
16200.80
11923.60
12840.80
0.00
0.00
18974.80
20434.40
19338.80
20826.40
18837.00
20286.00
20958.60
22570.80
0.00
0.00
2074.80
2234.40
538.20
579.60
803.40
865.20
153.40
165.20
187.20
201.60
210.60
226.80
195.00
210.00
306.80
330.40
244.40
263.20
163.80
176.40
228.80
246.40
176.80
190.40
257.40
277.20
192.40
207.20
231.40
249.20
169.00
182.00
210.60
226.80
158.60
170.80
200.20
215.60
252.20
271.60
80.60
86.80
215.80
232.40
278.20
299.60
166.40
179.20
257.40
277.20
460.20
495.60
1965.60
2116.80
117.00
126.00
114.40
123.20
148.20
159.60
465.40
501.20
494.00
532.00
447.20
481.60
223.60
240.80
540.80
582.40
889.20
957.60
1167.40
1257.20
1406.60
1514.80
1497.60
1612.80
1729.00
1862.00
1916.20
2063.60
1232.40
1327.20
1476.80
1590.40
1783.60
1920.80
1198.60
1290.80
1445.60
1556.80
1723.80
1856.40
2698.80
2906.40
2792.40
3007.20
2202.20
2371.60
2496.00
2688.00
3031.60
3264.80
2475.20
2665.60
2451.80
2640.40
3744.00
4032.00
2472.60
2662.80
2623.40
2825.20
3744.00
4032.00
2316.60
2494.80
2589.60
2788.80
3034.20
3267.60
2670.20
2875.60
3793.40
4085.20
6708.00
7224.00
7384.00
7952.00
7449.00
8022.00
124.80
134.40
158.60
170.80
161.20
173.60
202.80
218.40
249.60
268.80
374.40
403.20
241.80
260.40
447.20
481.60
189.80
204.40
514.80
554.40
751.40
809.20
486.20
523.60
171.60
184.80
210.60
226.80
218.40
235.20
283.40
305.20
166.40
179.20
197.60
212.80
1125.80
1212.40
1411.80
1520.40
1716.00
1848.00
2147.60
2312.80
2535.00
2730.00
2880.80
3102.40
3564.60
3838.80
2522.00
2716.00
421.20
453.60
124.80
134.40
215.80
232.40
283.40
305.20
364.00
392.00
208.00
224.00
179.40
193.20
197.60
212.80
234.00
252.00
197.60
212.80
275.60
296.80
226.20
243.60
299.00
322.00
408.20
439.60
288.60
310.80
1133.60
1220.80
1409.20
1517.60
1690.00
1820.00
1131.00
1218.00
1414.40
1523.20
1690.00
1820.00
1131.00
1218.00
1409.20
1517.60
1687.40
1817.20
2067.00
2226.00
2636.40
2839.20
2069.60
2228.80
2347.80
2528.40
2033.20
2189.60
2568.80
2766.40
3039.40
3273.20
2831.40
3049.20
2977.00
3206.00
2906.80
3130.40
145.60
156.80
231.40
249.20
2038.40
2195.20
1094.60
1178.80
1333.80
1436.40
1703.00
1834.00
2295.80
2472.40
2550.60
2746.80
3104.40
3343.20
2516.80
2710.40
158.60
170.80
182.00
196.00
153.40
165.20
694.20
747.60
676.00
728.00
681.20
733.60
1058.20
1139.60
642.20
691.60
652.60
702.80
1484.60
1598.80
1531.40
1649.20
561.60
604.80
158.60
170.80
171.60
184.80
130.00
140.00
169.00
182.00
572.00
616.00
215.80
232.40
158.60
170.80
153.40
165.20
179.40
193.20
522.60
562.80
150.80
162.40
176.80
190.40
174.20
187.60
202.80
218.40
608.40
655.20
150.80
162.40
176.80
190.40
179.40
193.20
1125.80
1212.40
1385.80
1492.40
1760.20
1895.60
1944.80
2094.40
2316.60
2494.80
2467.40
2657.20
3091.40
3329.20
2171.00
2338.00
2340.00
2520.00
2912.00
3136.00
2888.60
3110.80
148.20
159.60
213.20
229.60
223.60
240.80
553.80
596.40
169.00
182.00
239.20
257.60
436.80
470.40
156.00
168.00
169.00
182.00
205.40
221.20
236.60
254.80
195.00
210.00
754.00
812.00
148.20
159.60
176.80
190.40
156.00
168.00
182.00
196.00
582.40
627.20
150.80
162.40
171.60
184.80
156.00
168.00
163.80
176.40
1128.40
1215.20
1401.40
1509.20
1773.20
1909.60
2165.80
2332.40
2264.60
2438.80
2488.20
2679.60
3101.80
3340.40
2220.40
2391.20
2402.40
2587.20
2909.40
3133.20
2529.80
2724.40
130.00
140.00
205.40
221.20
213.20
229.60
254.80
274.40
1120.60
1206.80
1534.00
1652.00
2033.20
2189.60
2173.60
2340.80
1193.40
1285.20
1877.20
2021.60
2376.40
2559.20
2033.20
2189.60
2805.40
3021.20
3114.80
3354.40
2516.80
2710.40
374.40
403.20
416.00
448.00
486.20
523.60
488.80
526.40
868.40
935.20
611.00
658.00
642.20
691.60
951.60
1024.80
683.80
736.40
767.00
826.00
1029.60
1108.80
582.40
627.20
2119.00
2282.00
1736.80
1870.40
2854.80
3074.40
3172.00
3416.00
4217.20
4541.60
837.20
901.60
1162.20
1251.60
1092.00
1176.00
374.40
403.20
371.80
400.40
260.00
280.00
150.80
162.40
262.60
282.80
530.40
571.20
748.80
806.40
808.60
870.80
509.60
548.80
842.40
907.20
650.00
700.00
707.20
761.60
777.40
837.20
634.40
683.20
595.40
641.20
595.40
641.20
725.40
781.20
618.80
666.40
343.20
369.60
296.40
319.20
457.60
492.80
514.80
554.40
371.80
400.40
460.20
495.60
374.40
403.20
527.80
568.40
527.80
568.40
533.00
574.00
195.00
210.00
421.20
453.60
436.80
470.40
0.00
0.00
1981.20
2133.60
2758.60
2970.80
2639.00
2842.00
3125.20
3365.60
410.80
442.40
590.20
635.60
1617.20
1741.60
2199.60
2368.80
2459.60
2648.80
1118.00
1204.00
824.20
887.60
847.60
912.80
1014.00
1092.00
2381.60
2564.80
943.80
1016.40
1021.80
1100.40
1034.80
1114.40
1276.60
1374.80
1092.00
1176.00
1318.20
1419.60
1024.40
1103.20
1185.60
1276.80
1034.80
1114.40
1255.80
1352.40
959.40
1033.20
1151.80
1240.40
891.80
960.40
1084.20
1167.60
951.60
1024.80
938.60
1010.80
1092.00
1176.00
930.80
1002.40
873.60
940.80
1014.00
1092.00
907.40
977.20
969.80
1044.40
543.40
585.20
1196.00
1288.00
1219.40
1313.20
1331.20
1433.60
1367.60
1472.80
1463.80
1576.40
561.60
604.80
2594.80
2794.40
681.20
733.60
842.40
907.20
811.20
873.60
842.40
907.20
860.60
926.80
1014.00
1092.00
832.00
896.00
1008.80
1086.40
826.80
890.40
819.00
882.00
1396.20
1503.60
933.40
1005.20
904.80
974.40
915.20
985.60
829.40
893.20
829.40
893.20
655.20
705.60
4750.20
5115.60
4178.20
4499.60
626.60
674.80
824.20
887.60
954.20
1027.60
413.40
445.20
2761.20
2973.60
956.80
1030.40
956.80
1030.40
1146.60
1234.80
345.80
372.40
564.20
607.60
1812.20
1951.60
1554.80
1674.40
1034.80
1114.40
904.80
974.40
668.20
719.60
1739.40
1873.20
754.00
812.00
514.80
554.40
954.20
1027.60
483.60
520.80
2342.60
2522.80
787.80
848.40
1396.20
1503.60
1583.40
1705.20
603.20
649.60
678.60
730.80
379.60
408.80
691.60
744.80
143.00
154.00
325.00
350.00
96.20
103.60
556.40
599.20
824.20
887.60
1102.40
1187.20
403.00
434.00
0.00
0.00
130.00
140.00
312.00
336.00
423.80
456.40
886.60
954.80
2503.80
2696.40
0.00
0.00
0.00
0.00
0.00
0.00
655.20
705.60
910.00
980.00
543.40
585.20
501.80
540.40
491.40
529.20
80.60
86.80
405.60
436.80
439.40
473.20
421.20
453.60
652.60
702.80
468.00
504.00
522.60
562.80
754.00
812.00
574.60
618.80
709.80
764.40
574.60
618.80
816.40
879.20
767.00
826.00
683.80
736.40
366.60
394.80
798.20
859.60
527.80
568.40
1008.80
1086.40
1154.40
1243.20
681.20
733.60
444.60
478.80
486.20
523.60
644.80
694.40
551.20
593.60
663.00
714.00
481.00
518.00
221.00
238.00
517.40
557.20
1193.40
1285.20
707.20
761.60
332.80
358.40
244.40
263.20
676.00
728.00
683.80
736.40
670.80
722.40
514.80
554.40
663.00
714.00
709.80
764.40
943.80
1016.40
634.40
683.20
166.40
179.20
803.40
865.20
689.00
742.00
434.20
467.60
486.20
523.60
1591.20
1713.60
189.80
204.40
865.80
932.40
618.80
666.40
1066.00
1148.00
460.20
495.60
171.60
184.80
176.80
190.40
353.60
380.80
488.80
526.40
564.20
607.60
504.40
543.20
39.00
42.00
312.00
336.00
0.00
0.00
639.60
688.80
418.60
450.80
338.00
364.00
2766.40
2979.20
689.00
742.00
2792.40
3007.20
1014.00
1092.00
2139.80
2304.40
3476.20
3743.60
702.00
756.00
275.60
296.80
52.00
56.00
52.00
56.00
306.80
330.40
418.60
450.80
460.20
495.60
590.20
635.60
421.20
453.60
3330.60
3586.80
3312.40
3567.20
283.40
305.20
124.80
134.40
210.60
226.80
369.20
397.60
548.60
590.80
561.60
604.80
221.00
238.00
715.00
770.00
218.40
235.20
345.80
372.40
158.60
170.80
153.40
165.20
130.00
140.00
2379.00
2562.00
403.00
434.00
603.20
649.60
897.00
966.00
988.00
1064.00
1749.80
1884.40
2873.00
3094.00
2392.00
2576.00
0.00
0.00
358.80
386.40
10023.00
10794.00
322.40
347.20
465.40
501.20
730.60
786.80
491.40
529.20
764.40
823.20
1071.20
1153.60
1437.80
1548.40
340.60
366.80
413.40
445.20
280.80
302.40
782.60
842.80
213.20
229.60
2644.20
2847.60
572.00
616.00
5441.80
5860.40
4290.00
4620.00
8065.20
8685.60
0.00
0.00
101.40
109.20
1040.00
1120.00
712.40
767.20
795.60
856.80
803.40
865.20
1378.00
1484.00
977.60
1052.80
1097.20
1181.60
1092.00
1176.00
1287.00
1386.00
1294.80
1394.40
1461.20
1573.60
1469.00
1582.00
70.20
75.60
2488.20
2679.60
533.00
574.00
995.80
1072.40
1406.60
1514.80
998.40
1075.20
548.60
590.80
2264.60
2438.80
3738.80
4026.40
816.40
879.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2254.20
2427.60
4898.40
5275.20
4617.60
4972.80
5337.80
5748.40
2904.20
3127.60
1947.40
2097.20
2012.40
2167.20
2691.00
2898.00
3822.00
4116.00
2275.00
2450.00
3148.60
3390.80
4586.40
4939.20
1326.00
1428.00
6437.60
6932.80
6578.00
7084.00
618.80
666.40
501.80
540.40
0.00
0.00
374.40
403.20
488.80
526.40
426.40
459.20
1284.40
1383.20
868.40
935.20
889.20
957.60
946.40
1019.20
1151.80
1240.40
1497.60
1612.80
1653.60
1780.80
431.60
464.80
803.40
865.20
2246.40
2419.20
0.00
0.00
876.20
943.60
1136.20
1223.60
1279.20
1377.60
449.80
484.40
387.40
417.20
449.80
484.40
486.20
523.60
481.00
518.00
798.20
859.60
1866.80
2010.40
668.20
719.60
1092.00
1176.00
2002.00
2156.00
803.40
865.20
1898.00
2044.00
0.00
0.00
1014.00
1092.00
1045.20
1125.60
1112.80
1198.40
1820.00
1960.00
1014.00
1092.00
629.20
677.60
663.00
714.00
1801.80
1940.40
897.00
966.00
639.60
688.80
499.20
537.60
1211.60
1304.80
1320.80
1422.40
1292.20
1391.60
1518.40
1635.20
104.00
112.00
899.60
968.80
429.00
462.00
470.60
506.80
468.00
504.00
1840.80
1982.40
384.80
414.40
1762.80
1898.40
1354.60
1458.80
0.00
0.00
943.80
1016.40
1240.20
1335.60
1320.80
1422.40
1838.20
1979.60
1203.80
1296.40
171.60
184.80
83.20
89.60
387.40
417.20
977.60
1052.80
904.80
974.40
1721.20
1853.60
2636.40
2839.20
1328.60
1430.80
1307.80
1408.40
1838.20
1979.60
1032.20
1111.60
946.40
1019.20
5530.20
5955.60
923.00
994.00
1071.20
1153.60
1320.80
1422.40
1235.00
1330.00
1575.60
1696.80
977.60
1052.80
1326.00
1428.00
5631.60
6064.80
7020.00
7560.00
1279.20
1377.60
236.60
254.80
0.00
0.00
1110.20
1195.60
764.40
823.20
1859.00
2002.00
889.20
957.60
1102.40
1187.20
1872.00
2016.00
897.00
966.00
1029.60
1108.80
1073.80
1156.40
1937.00
2086.00
0.00
0.00
946.40
1019.20
1123.20
1209.60
1027.00
1106.00
1760.20
1895.60
1869.40
2013.20
10215.40
11001.20
8959.60
9648.80
902.20
971.60
1794.00
1932.00
1778.40
1915.20
1710.80
1842.40
1825.20
1965.60
1757.60
1892.80
977.60
1052.80
0.00
0.00
917.80
988.40
1118.00
1204.00
1214.20
1307.60
871.00
938.00
1955.20
2105.60
1073.80
1156.40
543.40
585.20
369.20
397.60
1211.60
1304.80
1128.40
1215.20
0.00
0.00
982.80
1058.40
1336.40
1439.20
1697.80
1828.40
1783.60
1920.80
2992.60
3222.80
954.20
1027.60
1739.40
1873.20
1778.40
1915.20
205.40
221.20
7724.60
8318.80
9536.80
10270.40
9924.20
10687.60
10842.00
11676.00
11983.40
12905.20
12308.40
13255.20
0.00
0.00
709.80
764.40
803.40
865.20
850.20
915.60
691.60
744.80
985.40
1061.20
829.40
893.20
1107.60
1192.80
0.00
0.00
273.00
294.00
650.00
700.00
371.80
400.40
93.60
100.80
501.80
540.40
543.40
585.20
174.20
187.60
538.20
579.60
621.40
669.20
447.20
481.60
195.00
210.00
184.60
198.80
176.80
190.40
202.80
218.40
0.00
0.00
200.20
215.60
239.20
257.60
247.00
266.00
195.00
210.00
176.80
190.40
241.80
260.40
228.80
246.40
176.80
190.40
182.00
196.00
208.00
224.00
218.40
235.20
218.40
235.20
218.40
235.20
195.00
210.00
228.80
246.40
195.00
210.00
88.40
95.20
182.00
196.00
153.40
165.20
176.80
190.40
184.60
198.80
221.00
238.00
223.60
240.80
223.60
240.80
195.00
210.00
182.00
196.00
93.60
100.80
182.00
196.00
189.80
204.40
215.80
232.40
158.60
170.80
182.00
196.00
182.00
196.00
301.60
324.80
798.20
859.60
694.20
747.60
1162.20
1251.60
730.60
786.80
3034.20
3267.60
475.80
512.40
514.80
554.40
1224.60
1318.80
408.20
439.60
5366.40
5779.20
665.60
716.80
426.40
459.20
457.60
492.80
1375.40
1481.20
618.80
666.40
728.00
784.00
1203.80
1296.40
936.00
1008.00
956.80
1030.40
829.40
893.20
468.00
504.00
626.60
674.80
543.40
585.20
189.80
204.40
548.60
590.80
28.60
30.80
28.60
30.80
23.40
25.20
20.80
22.40
20.80
22.40
23.40
25.20
28.60
30.80
33.80
36.40
59.80
64.40
28.60
30.80
0.00
0.00
117.00
126.00
189.80
204.40
41.60
44.80
75.40
81.20
104.00
112.00
130.00
140.00
158.60
170.80
361.40
389.20
239.20
257.60
46.80
50.40
49.40
53.20
54.60
58.80
44.20
47.60
317.20
341.60
101.40
109.20
111.80
120.40
91.00
98.00
379.60
408.80
280.80
302.40
124.80
134.40
135.20
145.60
156.00
168.00
156.00
168.00
600.60
646.80
239.20
257.60
33.80
36.40
130.00
140.00
130.00
140.00
158.60
170.80
156.00
168.00
158.60
170.80
158.60
170.80
137.80
148.40
65.00
70.00
145.60
156.80
59.80
64.40
270.40
291.20
273.00
294.00
234.00
252.00
192.40
207.20
137.80
148.40
145.60
156.80
176.80
190.40
176.80
190.40
140.40
151.20
106.60
114.80
150.80
162.40
161.20
173.60
247.00
266.00
46.80
50.40
46.80
50.40
41.60
44.80
158.60
170.80
31.20
33.60
31.20
33.60
31.20
33.60
148.20
159.60
65.00
70.00
215.80
232.40
275.60
296.80
249.60
268.80
46.80
50.40
127.40
137.20
49.40
53.20
57.20
61.60
106.60
114.80
119.60
128.80
119.60
128.80
117.00
126.00
169.00
182.00
46.80
50.40
114.40
123.20
57.20
61.60
176.80
190.40
158.60
170.80
85.80
92.40
161.20
173.60
234.00
252.00
236.60
254.80
195.00
210.00
101.40
109.20
132.60
142.80
119.60
128.80
44.20
47.60
46.80
50.40
46.80
50.40
57.20
61.60
39.00
42.00
72.80
78.40
70.20
75.60
192.40
207.20
169.00
182.00
148.20
159.60
200.20
215.60
174.20
187.60
169.00
182.00
169.00
182.00
189.80
204.40
260.00
280.00
143.00
154.00
174.20
187.60
117.00
126.00
210.60
226.80
156.00
168.00
153.40
165.20
44.20
47.60
169.00
182.00
169.00
182.00
169.00
182.00
169.00
182.00
59.80
64.40
124.80
134.40
106.60
114.80
111.80
120.40
46.80
50.40
49.40
53.20
88.40
95.20
80.60
86.80
59.80
64.40
182.00
196.00
140.40
151.20
135.20
145.60
127.40
137.20
75.40
81.20
236.60
254.80
208.00
224.00
288.60
310.80
273.00
294.00
114.40
123.20
192.40
207.20
239.20
257.60
239.20
257.60
361.40
389.20
130.00
140.00
106.60
114.80
169.00
182.00
169.00
182.00
319.80
344.40
200.20
215.60
174.20
187.60
260.00
280.00
301.60
324.80
202.80
218.40
226.20
243.60
234.00
252.00
161.20
173.60
140.40
151.20
221.00
238.00
46.80
50.40
156.00
168.00
161.20
173.60
124.80
134.40
169.00
182.00
127.40
137.20
600.60
646.80
174.20
187.60
184.60
198.80
137.80
148.40
161.20
173.60
161.20
173.60
200.20
215.60
104.00
112.00
197.60
212.80
78.00
84.00
88.40
95.20
156.00
168.00
75.40
81.20
78.00
84.00
179.40
193.20
265.20
285.60
83.20
89.60
93.60
100.80
36.40
39.20
166.40
179.20
166.40
179.20
132.60
142.80
36.40
39.20
140.40
151.20
36.40
39.20
28.60
30.80
44.20
47.60
119.60
128.80
36.40
39.20
143.00
154.00
91.00
98.00
57.20
61.60
20.80
22.40
200.20
215.60
72.80
78.40
148.20
159.60
67.60
72.80
132.60
142.80
65.00
70.00
171.60
184.80
140.40
151.20
174.20
187.60
174.20
187.60
156.00
168.00
156.00
168.00
629.20
677.60
119.60
128.80
161.20
173.60
629.20
677.60
72.80
78.40
176.80
190.40
205.40
221.20
119.60
128.80
169.00
182.00
20.80
22.40
75.40
81.20
57.20
61.60
91.00
98.00
91.00
98.00
46.80
50.40
70.20
75.60
70.20
75.60
46.80
50.40
75.40
81.20
65.00
70.00
78.00
84.00
36.40
39.20
44.20
47.60
65.00
70.00
158.60
170.80
275.60
296.80
158.60
170.80
179.40
193.20
163.80
176.40
119.60
128.80
252.20
271.60
234.00
252.00
210.60
226.80
228.80
246.40
106.60
114.80
80.60
86.80
124.80
134.40
119.60
128.80
106.60
114.80
119.60
128.80
148.20
159.60
59.80
64.40
83.20
89.60
83.20
89.60
254.80
274.40
119.60
128.80
247.00
266.00
101.40
109.20
57.20
61.60
119.60
128.80
184.60
198.80
184.60
198.80
189.80
204.40
52.00
56.00
106.60
114.80
111.80
120.40
205.40
221.20
176.80
190.40
176.80
190.40
176.80
190.40
85.80
92.40
65.00
70.00
119.60
128.80
317.20
341.60
106.60
114.80
231.40
249.20
293.80
316.40
75.40
81.20
109.20
117.60
88.40
95.20
161.20
173.60
62.40
67.20
67.60
72.80
228.80
246.40
169.00
182.00
169.00
182.00
163.80
176.40
150.80
162.40
158.60
170.80
153.40
165.20
101.40
109.20
137.80
148.40
111.80
120.40
184.60
198.80
93.60
100.80
54.60
58.80
161.20
173.60
119.60
128.80
228.80
246.40
317.20
341.60
127.40
137.20
228.80
246.40
221.00
238.00
39.00
42.00
39.00
42.00
39.00
42.00
39.00
42.00
39.00
42.00
39.00
42.00
39.00
42.00
156.00
168.00
312.00
336.00
156.00
168.00
132.60
142.80
156.00
168.00
156.00
168.00
156.00
168.00
156.00
168.00
124.80
134.40
156.00
168.00
156.00
168.00
39.00
42.00
124.80
134.40
156.00
168.00
104.00
112.00
187.20
201.60
156.00
168.00
156.00
168.00
156.00
168.00
182.00
196.00
62.40
67.20
65.00
70.00
278.20
299.60
119.60
128.80
600.60
646.80
431.60
464.80
384.80
414.40
33.80
36.40
106.60
114.80
137.80
148.40
184.60
198.80
145.60
156.80
52.00
56.00
33.80
36.40
70.20
75.60
75.40
81.20
91.00
98.00
49.40
53.20
70.20
75.60
137.80
148.40
156.00
168.00
65.00
70.00
96.20
103.60
44.20
47.60
49.40
53.20
39.00
42.00
78.00
84.00
431.60
464.80
80.60
86.80
265.20
285.60
239.20
257.60
109.20
117.60
44.20
47.60
39.00
42.00
137.80
148.40
179.40
193.20
176.80
190.40
192.40
207.20
213.20
229.60
195.00
210.00
179.40
193.20
179.40
193.20
234.00
252.00
171.60
184.80
171.60
184.80
171.60
184.80
33.80
36.40
33.80
36.40
33.80
36.40
49.40
53.20
140.40
151.20
101.40
109.20
166.40
179.20
158.60
170.80
166.40
179.20
135.20
145.60
80.60
86.80
166.40
179.20
262.60
282.80
101.40
109.20
88.40
95.20
109.20
117.60
600.60
646.80
605.80
652.40
488.80
526.40
343.20
369.60
205.40
221.20
189.80
204.40
239.20
257.60
288.60
310.80
202.80
218.40
124.80
134.40
221.00
238.00
46.80
50.40
46.80
50.40
46.80
50.40
197.60
212.80
171.60
184.80
65.00
70.00
23.40
25.20
184.60
198.80
52.00
56.00
52.00
56.00
106.60
114.80
106.60
114.80
44.20
47.60
239.20
257.60
241.80
260.40
197.60
212.80
109.20
117.60
111.80
120.40
148.20
159.60
65.00
70.00
59.80
64.40
83.20
89.60
137.80
148.40
156.00
168.00
475.80
512.40
132.60
142.80
166.40
179.20
49.40
53.20
49.40
53.20
119.60
128.80
54.60
58.80
59.80
64.40
132.60
142.80
158.60
170.80
148.20
159.60
93.60
100.80
70.20
75.60
70.20
75.60
70.20
75.60
96.20
103.60
72.80
78.40
36.40
39.20
33.80
36.40
44.20
47.60
62.40
67.20
41.60
44.80
44.20
47.60
117.00
126.00
31.20
33.60
65.00
70.00
46.80
50.40
145.60
156.80
330.20
355.60
317.20
341.60
109.20
117.60
109.20
117.60
127.40
137.20
148.20
159.60
111.80
120.40
106.60
114.80
195.00
210.00
140.40
151.20
70.20
75.60
140.40
151.20
93.60
100.80
0.00
0.00
41.60
44.80
59.80
64.40
33.80
36.40
33.80
36.40
33.80
36.40
20.80
22.40
20.80
22.40
20.80
22.40
72.80
78.40
59.80
64.40
39.00
42.00
28.60
30.80
39.00
42.00
39.00
42.00
52.00
56.00
23.40
25.20
41.60
44.80
249.60
268.80
197.60
212.80
728.00
784.00
111.80
120.40
33.80
36.40
41.60
44.80
122.20
131.60
166.40
179.20
166.40
179.20
166.40
179.20
192.40
207.20
215.80
232.40
215.80
232.40
215.80
232.40
179.40
193.20
166.40
179.20
166.40
179.20
179.40
193.20
153.40
165.20
83.20
89.60
176.80
190.40
176.80
190.40
111.80
120.40
101.40
109.20
111.80
120.40
130.00
140.00
109.20
117.60
143.00
154.00
143.00
154.00
119.60
128.80
98.80
106.40
39.00
42.00
39.00
42.00
33.80
36.40
78.00
84.00
65.00
70.00
80.60
86.80
106.60
114.80
67.60
72.80
93.60
100.80
93.60
100.80
80.60
86.80
80.60
86.80
49.40
53.20
166.40
179.20
153.40
165.20
83.20
89.60
72.80
78.40
161.20
173.60
62.40
67.20
93.60
100.80
39.00
42.00
65.00
70.00
72.80
78.40
62.40
67.20
83.20
89.60
122.20
131.60
111.80
120.40
132.60
142.80
59.80
64.40
80.60
86.80
80.60
86.80
174.20
187.60
62.40
67.20
124.80
134.40
200.20
215.60
166.40
179.20
119.60
128.80
36.40
39.20
36.40
39.20
88.40
95.20
88.40
95.20
93.60
100.80
33.80
36.40
26.00
28.00
52.00
56.00
54.60
58.80
65.00
70.00
88.40
95.20
57.20
61.60
59.80
64.40
109.20
117.60
0.00
0.00
65.00
70.00
49.40
53.20
49.40
53.20
75.40
81.20
140.40
151.20
330.20
355.60
117.00
126.00
111.80
120.40
104.00
112.00
70.20
75.60
54.60
58.80
195.00
210.00
195.00
210.00
195.00
210.00
49.40
53.20
119.60
128.80
239.20
257.60
239.20
257.60
148.20
159.60
148.20
159.60
62.40
67.20
75.40
81.20
111.80
120.40
111.80
120.40
189.80
204.40
93.60
100.80
83.20
89.60
119.60
128.80
124.80
134.40
130.00
140.00
111.80
120.40
166.40
179.20
192.40
207.20
111.80
120.40
111.80
120.40
148.20
159.60
75.40
81.20
184.60
198.80
195.00
210.00
195.00
210.00
195.00
210.00
140.40
151.20
49.40
53.20
59.80
64.40
70.20
75.60
195.00
210.00
140.40
151.20
119.60
128.80
210.60
226.80
210.60
226.80
210.60
226.80
130.00
140.00
111.80
120.40
228.80
246.40
210.60
226.80
275.60
296.80
145.60
156.80
200.20
215.60
140.40
151.20
184.60
198.80
117.00
126.00
143.00
154.00
912.60
982.80
457.60
492.80
353.60
380.80
249.60
268.80
353.60
380.80
353.60
380.80
439.40
473.20
249.60
268.80
353.60
380.80
137.80
148.40
184.60
198.80
158.60
170.80
205.40
221.20
93.60
100.80
101.40
109.20
52.00
56.00
52.00
56.00
579.80
624.40
416.00
448.00
114.40
123.20
46.80
50.40
46.80
50.40
46.80
50.40
57.20
61.60
104.00
112.00
39.00
42.00
41.60
44.80
93.60
100.80
119.60
128.80
140.40
151.20
119.60
128.80
93.60
100.80
119.60
128.80
124.80
134.40
145.60
156.80
158.60
170.80
124.80
134.40
83.20
89.60
122.20
131.60
215.80
232.40
111.80
120.40
119.60
128.80
106.60
114.80
111.80
120.40
135.20
145.60
130.00
140.00
156.00
168.00
143.00
154.00
124.80
134.40
124.80
134.40
124.80
134.40
124.80
134.40
122.20
131.60
122.20
131.60
143.00
154.00
169.00
182.00
182.00
196.00
96.20
103.60
114.40
123.20
137.80
148.40
137.80
148.40
122.20
131.60
148.20
159.60
78.00
84.00
130.00
140.00
179.40
193.20
161.20
173.60
135.20
145.60
124.80
134.40
179.40
193.20
117.00
126.00
83.20
89.60
124.80
134.40
114.40
123.20
111.80
120.40
109.20
117.60
101.40
109.20
106.60
114.80
117.00
126.00
106.60
114.80
127.40
137.20
275.60
296.80
114.40
123.20
124.80
134.40
124.80
134.40
119.60
128.80
111.80
120.40
124.80
134.40
122.20
131.60
124.80
134.40
124.80
134.40
124.80
134.40
140.40
151.20
124.80
134.40
117.00
126.00
119.60
128.80
179.40
193.20
124.80
134.40
135.20
145.60
119.60
128.80
124.80
134.40
124.80
134.40
137.80
148.40
135.20
145.60
135.20
145.60
88.40
95.20
117.00
126.00
119.60
128.80
156.00
168.00
135.20
145.60
119.60
128.80
124.80
134.40
148.20
159.60
119.60
128.80
145.60
156.80
488.80
526.40
444.60
478.80
369.20
397.60
275.60
296.80
239.20
257.60
543.40
585.20
260.00
280.00
600.60
646.80
527.80
568.40
343.20
369.60
540.80
582.40
179.40
193.20
0.00
0.00
140.40
151.20
169.00
182.00
262.60
282.80
52.00
56.00
52.00
56.00
49.40
53.20
566.80
610.40
884.00
952.00
28.60
30.80
28.60
30.80
26.00
28.00
88.40
95.20
36.40
39.20
72.80
78.40
156.00
168.00
135.20
145.60
231.40
249.20
189.80
204.40
213.20
229.60
169.00
182.00
91.00
98.00
707.20
761.60
530.40
571.20
707.20
761.60
75.40
81.20
111.80
120.40
195.00
210.00
439.40
473.20
195.00
210.00
176.80
190.40
140.40
151.20
140.40
151.20
226.20
243.60
189.80
204.40
213.20
229.60
189.80
204.40
189.80
204.40
140.40
151.20
0.00
0.00
124.80
134.40
156.00
168.00
62.40
67.20
96.20
103.60
88.40
95.20
88.40
95.20
80.60
86.80
88.40
95.20
88.40
95.20
88.40
95.20
75.40
81.20
75.40
81.20
62.40
67.20
80.60
86.80
75.40
81.20
75.40
81.20
72.80
78.40
78.00
84.00
83.20
89.60
96.20
103.60
96.20
103.60
143.00
154.00
184.60
198.80
101.40
109.20
101.40
109.20
52.00
56.00
117.00
126.00
49.40
53.20
187.20
201.60
236.60
254.80
49.40
53.20
774.80
834.40
49.40
53.20
101.40
109.20
106.60
114.80
39.00
42.00
39.00
42.00
39.00
42.00
54.60
58.80
83.20
89.60
44.20
47.60
65.00
70.00
44.20
47.60
80.60
86.80
96.20
103.60
62.40
67.20
52.00
56.00
140.40
151.20
39.00
42.00
52.00
56.00
57.20
61.60
166.40
179.20
39.00
42.00
78.00
84.00
184.60
198.80
182.00
196.00
244.40
263.20
189.80
204.40
182.00
196.00
317.20
341.60
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
135.20
145.60
111.80
120.40
88.40
95.20
96.20
103.60
106.60
114.80
153.40
165.20
111.80
120.40
166.40
179.20
166.40
179.20
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
88.40
95.20
88.40
95.20
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
325.00
350.00
236.60
254.80
187.20
201.60
327.60
352.80
400.40
431.20
327.60
352.80
327.60
352.80
345.80
372.40
572.00
616.00
140.40
151.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
795.60
856.80
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
187.20
201.60
327.60
352.80
400.40
431.20
187.20
201.60
327.60
352.80
390.00
420.00
327.60
352.80
327.60
352.80
187.20
201.60
327.60
352.80
390.00
420.00
327.60
352.80
187.20
201.60
187.20
201.60
327.60
352.80
400.40
431.20
374.40
403.20
655.20
705.60
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
111.80
120.40
1216.80
1310.40
2405.00
2590.00
2405.00
2590.00
4563.00
4914.00
244.40
263.20
83.20
89.60
865.80
932.40
0.00
0.00
1752.40
1887.20
2015.00
2170.00
2191.80
2360.40
1575.60
1696.80
1575.60
1696.80
2015.00
2170.00
2717.00
2926.00
2979.60
3208.80
3244.80
3494.40
1575.60
1696.80
1575.60
1696.80
876.20
943.60
699.40
753.20
4383.60
4720.80
439.40
473.20
0.00
0.00
585.00
630.00
691.60
744.80
917.80
988.40
676.00
728.00
878.80
946.40
0.00
0.00
0.00
0.00
158.60
170.80
140.40
151.20
75.40
81.20
267.80
288.40
189.80
204.40
189.80
204.40
106.60
114.80
143.00
154.00
98.80
106.40
98.80
106.40
98.80
106.40
98.80
106.40
57.20
61.60
473.20
509.60
522.60
562.80
780.00
840.00
98.80
106.40
98.80
106.40
98.80
106.40
98.80
106.40
473.20
509.60
418.60
450.80
200.20
215.60
247.00
266.00
0.00
0.00
933.40
1005.20
813.80
876.40
496.60
534.80
577.20
621.60
699.40
753.20
886.60
954.80
0.00
0.00
1089.40
1173.20
1313.00
1414.00
1375.40
1481.20
1180.40
1271.20
1378.00
1484.00
93.60
100.80
93.60
100.80
1391.00
1498.00
1617.20
1741.60
1617.20
1741.60
1651.00
1778.00
1162.20
1251.60
1404.00
1512.00
1162.20
1251.60
1677.00
1806.00
1552.20
1671.60
200.20
215.60
249.60
268.80
301.60
324.80
325.00
350.00
374.40
403.20
234.00
252.00
639.60
688.80
179.40
193.20
322.40
347.20
262.60
282.80
0.00
0.00
215.80
232.40
473.20
509.60
564.20
607.60
938.60
1010.80
2002.00
2156.00
2979.60
3208.80
161.20
173.60
938.60
1010.80
722.80
778.40
800.80
862.40
1110.20
1195.60
1242.80
1338.40
780.00
840.00
1344.20
1447.60
1625.00
1750.00
153.40
165.20
811.20
873.60
361.40
389.20
850.20
915.60
507.00
546.00
949.00
1022.00
920.40
991.20
725.40
781.20
6510.40
7011.20
3354.00
3612.00
1700.40
1831.20
2802.80
3018.40
725.40
781.20
1110.20
1195.60
1357.20
1461.60
2394.60
2578.80
0.00
0.00
1500.20
1615.60
2152.80
2318.40
2121.60
2284.80
208.00
224.00
213.20
229.60
1424.80
1534.40
1874.60
2018.80
3109.60
3348.80
5618.60
6050.80
5725.20
6165.60
0.00
0.00
0.00
0.00
0.00
0.00
46.80
50.40
33.80
36.40
33.80
36.40
33.80
36.40
0.00
0.00
1640.60
1766.80
44.20
47.60
52.00
56.00
39.00
42.00
67.60
72.80
39.00
42.00
33.80
36.40
44.20
47.60
127.40
137.20
28.60
30.80
0.00
0.00
15277.60
16452.80
15888.60
17110.80
0.00
0.00
1650.00
1776.92
1850.00
1992.31
950.00
1023.08
1000.00
1076.92
3380.00
3640.00
52.00
56.00
550.00
592.31
1850.00
1992.31
0.00
0.00
780.00
840.00
27040.00
29120.00
27040.00
29120.00
0.00
0.00
0.00
0.00
83.20
89.60
80.60
86.80
111.80
120.40
111.80
120.40
145.60
156.80
101.40
109.20
197.60
212.80
93.60
100.80
184.60
198.80
0.00
0.00
500.00
538.46
1690.00
1820.00
500.00
538.46
500.00
538.46
750.00
807.69
500.00
538.46
0.00
0.00
0.00
0.00
0.00
0.00
72.80
78.40
33.80
36.40
0.00
0.00
52.00
56.00
52.00
56.00
28.60
30.80
28.60
30.80
1476.80
1590.40
1640.60
1766.80
600.60
646.80
702.00
756.00
790.40
851.20
969.80
1044.40
1164.80
1254.40
1354.60
1458.80
608.40
655.20
798.20
859.60
865.80
932.40
1053.00
1134.00
1237.60
1332.80
1508.00
1624.00
512.20
551.60
618.80
666.40
761.80
820.40
886.60
954.80
1128.40
1215.20
1274.00
1372.00
559.00
602.00
668.20
719.60
813.80
876.40
928.20
999.60
1175.20
1265.60
1315.60
1416.80
759.20
817.60
790.40
851.20
990.60
1066.80
330.20
355.60
312.00
336.00
364.00
392.00
569.40
613.20
1560.00
1680.00
0.00
0.00
0.00
0.00
1632.80
1758.40
699.40
753.20
1040.00
1120.00
923.00
994.00
821.60
884.80
486.20
523.60
847.60
912.80
130.00
140.00
0.00
0.00
184.60
198.80
403.00
434.00
704.60
758.80
1006.20
1083.60
548.60
590.80
795.60
856.80
1206.40
1299.20
9102.60
9802.80
0.00
0.00
0.00
0.00
7883.20
8489.60
4422.60
4762.80
3068.00
3304.00
6240.00
6720.00
4235.40
4561.20
2862.60
3082.80
2743.00
2954.00
2306.20
2483.60
1775.80
1912.40
5272.80
5678.40
4594.20
4947.60
4378.40
4715.20
2301.00
2478.00
254.80
274.40
218.40
235.20
215.80
232.40
111.80
120.40
1315.60
1416.80
647.40
697.20
868.40
935.20
0.00
0.00
1682.20
1811.60
226.20
243.60
2233.40
2405.20
1640.60
1766.80
1315.60
1416.80
1786.20
1923.60
4518.80
4866.40
1534.00
1652.00
2171.00
2338.00
2672.80
2878.40
665.60
716.80
8390.20
9035.60
6765.20
7285.60
1388.40
1495.20
3351.40
3609.20
2090.40
2251.20
686.40
739.20
842.40
907.20
0.00
0.00
273.00
294.00
509.60
548.80
291.20
313.60
423.80
456.40
98.80
106.40
1427.40
1537.20
678.60
730.80
132.60
142.80
358.80
386.40
616.20
663.60
504.40
543.20
673.40
725.20
449.80
484.40
644.80
694.40
858.00
924.00
920.40
991.20
748.80
806.40
832.00
896.00
353.60
380.80
434.20
467.60
434.20
467.60
832.00
896.00
592.80
638.40
132.60
142.80
119.60
128.80
111.80
120.40
291.20
313.60
546.00
588.00
1305.20
1405.60
2316.60
2494.80
725.40
781.20
88.40
95.20
795.60
856.80
855.40
921.20
1471.60
1584.80
496.60
534.80
548.60
590.80
234.00
252.00
1151.80
1240.40
1159.60
1248.80
455.00
490.00
491.40
529.20
564.20
607.60
491.40
529.20
371.80
400.40
361.40
389.20
501.80
540.40
353.60
380.80
358.80
386.40
153.40
165.20
166.40
179.20
189.80
204.40
205.40
221.20
189.80
204.40
221.00
238.00
57.20
61.60
93.60
100.80
98.80
106.40
145.60
156.80
101.40
109.20
0.00
0.00
975.00
1050.00
148.20
159.60
829.40
893.20
340.60
366.80
124.80
134.40
777.40
837.20
299.00
322.00
340.60
366.80
715.00
770.00
345.80
372.40
254.80
274.40
228.80
246.40
366.60
394.80
195.00
210.00
946.40
1019.20
364.00
392.00
374.40
403.20
174.20
187.60
301.60
324.80
288.60
310.80
904.80
974.40
52.00
56.00
998.40
1075.20
202.80
218.40
106.60
114.80
270.40
291.20
327.60
352.80
189.80
204.40
153.40
165.20
361.40
389.20
236.60
254.80
140.40
151.20
322.40
347.20
280.80
302.40
249.60
268.80
223.60
240.80
122.20
131.60
135.20
145.60
75.40
81.20
156.00
168.00
202.80
218.40
254.80
274.40
496.60
534.80
148.20
159.60
137.80
148.40
426.40
459.20
520.00
560.00
340.60
366.80
626.60
674.80
1175.20
1265.60
660.40
711.20
338.00
364.00
663.00
714.00
429.00
462.00
546.00
588.00
169.00
182.00
280.80
302.40
163.80
176.40
351.00
378.00
410.80
442.40
439.40
473.20
1297.40
1397.20
790.40
851.20
1398.80
1506.40
832.00
896.00
0.00
0.00
795.60
856.80
717.60
772.80
395.20
425.60
860.60
926.80
759.20
817.60
832.00
896.00
1635.40
1761.20
377.00
406.00
1466.40
1579.20
340.60
366.80
1968.20
2119.60
421.20
453.60
845.00
910.00
213.20
229.60
673.40
725.20
855.40
921.20
104.00
112.00
0.00
0.00
0.00
0.00
572.00
616.00
0.00
0.00
2740.40
2951.20
101.40
109.20
1994.20
2147.60
2337.40
2517.20
1692.60
1822.80
894.40
963.20
1744.60
1878.80
1596.40
1719.20
3871.40
4169.20
501.80
540.40
884.00
952.00
540.80
582.40
7956.00
8568.00
2212.60
2382.80
5896.80
6350.40
1580.80
1702.40
13088.40
14095.20
13475.80
14512.40
10592.40
11407.20
3172.00
3416.00
2509.00
2702.00
6489.60
6988.80
1739.40
1873.20
6427.20
6921.60
3187.60
3432.80
169.00
182.00
85.80
92.40
83.20
89.60
782.60
842.80
213.20
229.60
426.40
459.20
143.00
154.00
1032.20
1111.60
1479.40
1593.20
119.60
128.80
49.40
53.20
70.20
75.60
837.20
901.60
241.80
260.40
340.60
366.80
254.80
274.40
252.20
271.60
6640.40
7151.20
2059.20
2217.60
83.20
89.60
1736.80
1870.40
241.80
260.40
291.20
313.60
462.80
498.40
533.00
574.00
624.00
672.00
577.20
621.60
746.20
803.60
819.00
882.00
377.00
406.00
241.80
260.40
322.40
347.20
340.60
366.80
603.20
649.60
286.00
308.00
327.60
352.80
299.00
322.00
525.20
565.60
457.60
492.80
912.60
982.80
231.40
249.20
249.60
268.80
270.40
291.20
0.00
0.00
1848.60
1990.80
1209.00
1302.00
1775.80
1912.40
1125.80
1212.40
897.00
966.00
2938.00
3164.00
413.40
445.20
2620.80
2822.40
2636.40
2839.20
431.60
464.80
1648.40
1775.20
1968.20
2119.60
499.20
537.60
226.20
243.60
215.80
232.40
1887.60
2032.80
2176.20
2343.60
301.60
324.80
7443.80
8016.40
8265.40
8901.20
10816.00
11648.00
8522.80
9178.40
9945.00
10710.00
10665.20
11485.60
12087.40
13017.20
10285.60
11076.80
11359.40
12233.20
12157.60
13092.80
13928.20
14999.60
1986.40
2139.20
1053.00
1134.00
2457.00
2646.00
1307.80
1408.40
7482.80
8058.40
2818.40
3035.20
7155.20
7705.60
7282.60
7842.80
7256.60
7814.80
405.60
436.80
62.40
67.20
546.00
588.00
556.40
599.20
421.20
453.60
1648.40
1775.20
1362.40
1467.20
1489.80
1604.40
2506.40
2699.20
1461.20
1573.60
9695.40
10441.20
13083.20
14089.60
1765.40
1901.20
512.20
551.60
1671.80
1800.40
345.80
372.40
1991.60
2144.80
2069.60
2228.80
3723.20
4009.60
587.60
632.80
839.80
904.40
3554.20
3827.60
6513.00
7014.00
7774.00
8372.00
1398.80
1506.40
2054.00
2212.00
1898.00
2044.00
3156.40
3399.20
4934.80
5314.40
4365.40
4701.20
5579.60
6008.80
3569.80
3844.40
5673.20
6109.60
8647.60
9312.80
9414.60
10138.80
1435.20
1545.60
1822.60
1962.80
85.80
92.40
218.40
235.20
468.00
504.00
387.40
417.20
80.60
86.80
2561.00
2758.00
85.80
92.40
0.00
0.00
499.20
537.60
85.80
92.40
507.00
546.00
275.60
296.80
72.80
78.40
182.00
196.00
78.00
84.00
111.80
120.40
0.00
0.00
982.80
1058.40
2280.20
2455.60
1664.00
1792.00
3341.00
3598.00
1996.80
2150.40
2579.20
2777.60
3252.60
3502.80
3530.80
3802.40
878.80
946.40
1367.60
1472.80
1739.40
1873.20
2891.20
3113.60
1918.80
2066.40
2308.80
2486.40
1536.60
1654.80
1159.60
1248.80
1560.00
1680.00
1123.20
1209.60
3473.60
3740.80
1994.20
2147.60
2249.00
2422.00
1557.40
1677.20
1604.20
1727.60
1050.40
1131.20
403.00
434.00
2043.60
2200.80
910.00
980.00
650.00
700.00
473.20
509.60
891.80
960.40
338.00
364.00
964.60
1038.80
1487.20
1601.60
304.20
327.60
455.00
490.00
215.80
232.40
239.20
257.60
582.40
627.20
577.20
621.60
117.00
126.00
231.40
249.20
377.00
406.00
117.00
126.00
306.80
330.40
322.40
347.20
421.20
453.60
322.40
347.20
366.60
394.80
512.20
551.60
616.20
663.60
535.60
576.80
725.40
781.20
592.80
638.40
517.40
557.20
1521.00
1638.00
83.20
89.60
379.60
408.80
403.00
434.00
135.20
145.60
585.00
630.00
353.60
380.80
80.60
86.80
111.80
120.40
215.80
232.40
540.80
582.40
470.60
506.80
462.80
498.40
483.60
520.80
475.80
512.40
759.20
817.60
28.60
30.80
44.20
47.60
145.60
156.80
122.20
131.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
62.40
67.20
88.40
95.20
184.60
198.80
148.20
159.60
70.20
75.60
44.20
47.60
62.40
67.20
52.00
56.00
59.80
64.40
410.80
442.40
301.60
324.80
109.20
117.60
267.80
288.40
410.80
442.40
626.60
674.80
88.40
95.20
52.00
56.00
137.80
148.40
57.20
61.60
228.80
246.40
291.20
313.60
351.00
378.00
426.40
459.20
509.60
548.80
62.40
67.20
101.40
109.20
187.20
201.60
169.00
182.00
252.20
271.60
338.00
364.00
62.40
67.20
46.80
50.40
1331.20
1433.60
0.00
0.00
1443.00
1554.00
423.80
456.40
2004.60
2158.80
943.80
1016.40
1583.40
1705.20
3780.40
4071.20
1596.40
1719.20
4037.80
4348.40
6084.00
6552.00
5714.80
6154.40
5995.60
6456.80
3039.40
3273.20
3593.20
3869.60
2771.60
2984.80
1921.40
2069.20
2886.00
3108.00
873.60
940.80
5449.60
5868.80
13387.40
14417.20
941.20
1013.60
291.20
313.60
288.60
310.80
179.40
193.20
475.80
512.40
83.20
89.60
75.40
81.20
481.00
518.00
930.80
1002.40
1385.80
1492.40
1674.40
1803.20
1791.40
1929.20
1219.40
1313.20
1099.80
1184.40
847.60
912.80
1151.80
1240.40
611.00
658.00
595.40
641.20
1848.60
1990.80
605.80
652.40
577.20
621.60
1115.40
1201.20
585.00
630.00
699.40
753.20
517.40
557.20
821.60
884.80
1619.80
1744.40
819.00
882.00
1024.40
1103.20
1404.00
1512.00
1575.60
1696.80
1541.80
1660.40
1526.20
1643.60
2353.00
2534.00
2488.20
2679.60
1284.40
1383.20
764.40
823.20
595.40
641.20
486.20
523.60
691.60
744.80
2888.60
3110.80
2412.80
2598.40
4063.80
4376.40
2984.80
3214.40
1697.80
1828.40
8494.20
9147.60
3426.80
3690.40
4797.00
5166.00
2680.60
2886.80
2358.20
2539.60
6502.60
7002.80
3221.40
3469.20
2711.80
2920.40
312.00
336.00
553.80
596.40
1055.60
1136.80
616.20
663.60
1905.80
2052.40
1027.00
1106.00
2311.40
2489.20
1001.00
1078.00
462.80
498.40
306.80
330.40
496.60
534.80
712.40
767.20
572.00
616.00
418.60
450.80
941.20
1013.60
967.20
1041.60
213.20
229.60
192.40
207.20
1097.20
1181.60
1526.20
1643.60
418.60
450.80
798.20
859.60
683.80
736.40
608.40
655.20
780.00
840.00
83.20
89.60
1193.40
1285.20
881.40
949.20
868.40
935.20
644.80
694.40
865.80
932.40
930.80
1002.40
192.40
207.20
189.80
204.40
179.40
193.20
44.20
47.60
176.80
190.40
218.40
235.20
184.60
198.80
52.00
56.00
223.60
240.80
70.20
75.60
106.60
114.80
62.40
67.20
494.00
532.00
52.00
56.00
221.00
238.00
52.00
56.00
52.00
56.00
52.00
56.00
52.00
56.00
52.00
56.00
0.00
0.00
665.60
716.80
288.60
310.80
647.40
697.20
681.20
733.60
969.80
1044.40
546.00
588.00
1242.80
1338.40
270.40
291.20
1367.60
1472.80
618.80
666.40
933.40
1005.20
1489.80
1604.40
696.80
750.40
1596.40
1719.20
3445.00
3710.00
1726.40
1859.20
1011.40
1089.20
1196.00
1288.00
980.20
1055.60
104.00
112.00
670.80
722.40
0.00
0.00
1248.00
1344.00
569.40
613.20
257.40
277.20
91.00
98.00
213.20
229.60
605.80
652.40
660.40
711.20
847.60
912.80
1193.40
1285.20
829.40
893.20
1705.60
1836.80
358.80
386.40
200.20
215.60
410.80
442.40
494.00
532.00
517.40
557.20
257.40
277.20
57.20
61.60
75.40
81.20
75.40
81.20
88.40
95.20
49.40
53.20
106.60
114.80
59.80
64.40
57.20
61.60
70.20
75.60
88.40
95.20
148.20
159.60
83.20
89.60
59.80
64.40
153.40
165.20
0.00
0.00
150.80
162.40
158.60
170.80
200.20
215.60
132.60
142.80
122.20
131.60
0.00
0.00
140.40
151.20
98.80
106.40
163.80
176.40
124.80
134.40
137.80
148.40
327.60
352.80
143.00
154.00
143.00
154.00
1042.60
1122.80
145.60
156.80
351.00
378.00
234.00
252.00
109.20
117.60
197.60
212.80
213.20
229.60
158.60
170.80
343.20
369.60
358.80
386.40
156.00
168.00
215.80
232.40
117.00
126.00
101.40
109.20
52.00
56.00
174.20
187.60
132.60
142.80
371.80
400.40
150.80
162.40
153.40
165.20
205.40
221.20
267.80
288.40
309.40
333.20
361.40
389.20
124.80
134.40
176.80
190.40
226.20
243.60
117.00
126.00
122.20
131.60
119.60
128.80
85.80
92.40
49.40
53.20
93.60
100.80
137.80
148.40
98.80
106.40
6.37
6.86
7.28
7.84
8.19
8.82
0.00
0.00
0.00
0.00
0.00
0.00
62.40
67.20
0.00
0.00
0.00
0.00
0.00
0.00
72.80
78.40
83.20
89.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
130.00
140.00
0.00
0.00
0.00
0.00
546.00
588.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
819.00
882.00
683.80
736.40
273.00
294.00
751.40
809.20
613.60
660.80
273.00
294.00
1341.60
1444.80
163.80
176.40
28.60
30.80
163.80
176.40
111.80
120.40
1037.40
1117.20
1466.40
1579.20
1027.00
1106.00
733.20
789.60
439.40
473.20
0.00
0.00
9945.00
10710.00
9945.00
10710.00
10571.60
11384.80
11290.50
12159.00
4405.70
4744.60
6637.80
7148.40
6637.80
7148.40
780.00
840.00
6345.30
6833.40
6345.30
6833.40
6345.30
6833.40
5314.40
5723.20
5314.40
5723.20
5314.40
5723.20
8967.40
9657.20
10856.30
11691.40
5339.10
5749.80
9296.30
10011.40
1320.80
1422.40
1138.80
1226.40
451.10
485.80
1875.90
2020.20
1103.70
1188.60
282.10
303.80
390.00
420.00
Code
0001F
0005F
0012F
0500F
0501F
0502F
0503F
0505F
0507F
0509F
1000F
1002F
1003F
1004F
1005F
1006F
1007F
1008F
1015F
1018F
1019F
1022F
1026F
1030F
1034F
1035F
1036F
1038F
1039F
1040F
1050F
1055F
1060F
1061F
1065F
1066F
1070F
1071F
1090F
1091F
1100F
1101F
1110F
1111F
Code Description
MANDATORY TARIFF
Heart failure assessed (includes assessment of all the following components) (CAD, HF): Blood pressure
0.00
measured
Osteoarthritis assessed (OA) Includes assessment of all the following components: Osteoarthritis
0.00
symptoms and f
Community-acquired bacterial pneumonia assessment (includes all of the following components)
0.00
(CAP): Co-morbi
Initial prenatal care visit (report at first prenatal encounter with health care professional providing
0.00obstetrical care
Prenatal flow sheet documented in medical record by first prenatal visit (documentation includes
0.00at minimum blo
Subsequent prenatal care visit (Prenatal) [Excludes: patients who are seen for a condition unrelated
0.00 to pregnancy
Postpartum care visit (Prenatal)
0.00
Hemodialysis plan of care documented (ESRD)
0.00
Peritoneal dialysis plan of care documented (ESRD)
0.00
Urinary incontinence plan of care documented (GER)
0.00
Tobacco use assessed (CAD, CAP, COPD, PV) (DM)
0.00
Anginal symptoms and level of activity assessed (CAD)
0.00
Level of activity assessed (HF)
0.00
Clinical symptoms of volume overload (excess) assessed (HF)
0.00
Asthma symptoms evaluated (includes physician documentation of numeric frequency of symptoms
0.00 or patient co
Osteoarthritis symptoms and functional status assessed (may include the use of a standardized0.00
scale or the comp
Use of anti-inflammatory or analgesic over-the-counter (OTC) medications for symptom relief assessed
0.00
(OA)
Gastrointestinal and renal risk factors assessed for patients on prescribed or OTC non-steroidal0.00
anti-inflammatory
Chronic obstructive pulmonary disease (COPD) symptoms assessed (Includes assessment of at 0.00
least one of the fol
Dyspnea assessed, not present (COPD)
0.00
Dyspnea assessed, present (COPD)
0.00
Pneumococcus immunization status assessed (CAP, COPD)
0.00
Co-morbid conditions assessed (eg, includes assessment for presence or absence of: malignancy,
0.00liver disease, co
Influenza immunization status assessed (CAP)
0.00
Current tobacco smoker (CAD, CAP, COPD, PV) (DM)
0.00
Current smokeless tobacco user (eg, chew, snuff) (PV)
0.00
Current tobacco non-user (CAD, CAP, COPD, PV) (DM)
0.00
Persistent asthma (mild, moderate or severe) (Asthma)
0.00
Intermittent asthma (Asthma)
0.00
DSM-IV criteria for major depressive disorder documented (MDD)
0.00
History obtained regarding new or changing moles (ML)
0.00
Visual functional status assessed (EC)
0.00
Documentation of permanent OR persistent OR paroxysmal atrial fibrillation (STR)
0.00
Documentation of absence of permanent AND persistent AND paroxysmal atrial fibrillation (STR)
0.00
Ischemic stroke symptom onset of less than 3 hours prior to arrival (STR)
0.00
Ischemic stroke symptom onset greater than or equal to 3 hours prior to arrival (STR)
0.00
Alarm symptoms (involuntary weight loss, dysphagia, or gastrointestinal bleeding) assessed; none
0.00present (GERD)
Alarm symptoms (involuntary weight loss, dysphagia, or gastrointestinal bleeding) assessed; one
0.00
or more present
Presence or absence of urinary incontinence assessed (GER)
0.00
Urinary incontinence characterized (eg frequency, volume, timing, type of symptoms, how bothersome)
0.00
(GER)
Patient screened for future fall risk; documentation of two or more falls in the past year or any0.00
fall with injury in t
Patient screened for future fall risk; documentation of no falls in the past year or only one fall without
0.00 injury in th
Patient discharged from an inpatient facility (eg hospital, skilled nursing facility, or rehabilitation
0.00
facility) within th
Discharge medications reconciled with the current medication list in outpatient medical record0.00
(GER)
2000F
2001F
2002F
2004F
2010F
2014F
2018F
2019F
2020F
2021F
2022F
2024F
2026F
2027F
2028F
2029F
2030F
2031F
3006F
3011F
3014F
3017F
3020F
3021F
3022F
3023F
3025F
3027F
3028F
3035F
3037F
3040F
3042F
3044F
3045F
3046F
3048F
3049F
3050F
3060F
3061F
3062F
3066F
3072F
3073F
3074F
3075F
Blood pressure measured (CAD, HF, HTN)

0.00
Weight recorded (HF, PAG)
0.00
Clinical signs of volume overload (excess) assessed (HF)
0.00
Initial examination of the involved joint(s) (includes visual inspection, palpation, range of motion)
0.00(OA) [Instruction
Vital signs (temperature, pulse, respiratory rate, and blood pressure) documented and reviewed
0.00
(CAP) (EM)
Mental status assessed (CAP) (EM)
0.00
Hydration status assessed (normal/mildly dehydrated/severely dehydrated) (CAP)
0.00
Dilated macular exam performed, including documentation of the presence or absence of macular
0.00thickening or h
Dilated fundus evaluation performed within six months prior to cataract surgery (EC)
0.00
Dilated macular or fundus exam performed, including documentation of the presence or absence
0.00of macular edem
Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented0.00
and reviewed (DM
Seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist
0.00 documented a
Eye imaging validated to match diagnosis from seven standard field stereoscopic photos results0.00
documented and
Optic nerve head evaluation performed (EC)
0.00
Foot examination performed (includes examination through visual inspection, sensory exam with
0.00monofilament, a
Complete physical skin exam performed (ML)
0.00
Hydration status documented, normally hydrated (PAG)
0.00
Hydration status documented, dehydrated (PAG)
0.00
Chest X-ray results documented and reviewed (CAP)
0.00
Lipid panel results documented and reviewed (must include total cholesterol, HDL-C, triglycerides
0.00and calculated L
Screening mammography results documented and reviewed (PV)
0.00
Colorectal cancer screening results documented and reviewed (PV) (Includes: fecal occult blood
0.00
testing annually,
Left ventricular function (LVF) assessment (eg, echocardiography, nuclear test, or ventriculography)
0.00 documented
Left ventricular ejection fraction (LVEF) <40% or documentation of moderately or severely depressed
0.00 left ventricu
Left ventricular ejection fraction (LVEF) >=40% or documentation as normal or mildly depressed0.00
left ventricular sy
Spirometry results documented and reviewed (COPD)
0.00
Spirometry test results demonstrate FEV1/FVC<70% with COPD symptoms (eg, dyspnea, cough/sputum,
0.00
wheezing
Spirometry test results demonstrate FEV1/FVC>=70% or patient does not have COPD symptoms
0.00
(COPD)
Oxygen saturation results documented and reviewed (includes assessment through pulse oximetry
0.00 or arterial bloo
Oxygen saturation <= 88 % or a Pa02 <= 55 mm Hg (COPD)
0.00
Oxygen saturation > 88% or PaO2 > 55 mmHg (COPD)
0.00
Functional expiratory volume (FEV1) < 40% of predicted value (COPD)
0.00
Functional expiratory volume (FEV1) >= 40% of predicted value (COPD)
0.00
Most recent hemoglobin A1c (HbA1c) level < 7.0% (DM)
0.00
Most recent hemoglobin A1c (HbA1c) level 7.0 9.0 % (DM)
0.00
Most recent hemoglobin A1c level > 9.0% (DM)
0.00
Most recent LDL-C < 100 mg/dL (DM)
0.00
Most recent LDL-C 100-129 mg/dL (DM)
0.00
Most recent LDL-C >= 130 mg/dL (DM)
0.00
Positive microalbuminuria test result documented and reviewed (DM)
0.00
Negative microalbuminuria test result documented and reviewed (DM)
0.00
Positive macroalbuminuria test result documented and reviewed (DM)
0.00
Documentation of treatment for nephropathy (eg, patient receiving dialysis, patient being treated
0.00for ESRD, CRF,
Low risk for retinopathy (no evidence of retinopathy in the prior year) (DM)
0.00
Pre-surgical (cataract) axial length, corneal power measurement and method of intraocular lens0.00
power calculation
Most recent systolic blood pressure < 130 mm Hg (DM) (HTN)
0.00
Most recent systolic blood pressure 130 - 139 mm Hg (DM) (HTN)
0.00
3077F
3078F
3079F
3080F
3082F
3083F
3084F
3085F
3088F
3089F
3090F
3091F
3092F
3093F
3095F
3096F
3100F
3110F
3111F
3112F
3120F
3130F
3132F
3140F
3141F
3142F
3150F
3155F
3160F
3170F
3200F
3210F
4000F
4001F
4002F
4003F
4005F
4006F
4009F
4011F
4012F
4014F
4015F
4016F
4017F
4018F
4019F
Most recent systolic blood pressure >= 140 mm Hg (HTN) (DM)

0.00
Most recent diastolic blood pressure < 80 mm Hg (HTN) (DM)
0.00
Most recent diastolic blood pressure 80-89 mm Hg (HTN) (DM)
0.00
Most recent diastolic blood pressure >= 90 mm Hg (HTN) (DM)
0.00
Kt/V < 1.2 (Clearance of urea (Kt)/volume (V)) (ESRD)
0.00
Kt/V equal to or greater than 1.2 and less than 1.7 (Clearance of urea (Kt)/volume (V)) (ESRD) 0.00
Kt/V >= 1.7 (Clearance of urea Kt)/volume (V)) (ESRD)
0.00
Suicide risk assessed (MDD)
0.00
Major depressive disorder, mild (MDD)
0.00
Major depressive disorder, moderate (MDD)
0.00
Major depressive disorder, severe without psychotic features (MDD)
0.00
Major depressive disorder, severe with psychotic features (MDD)
0.00
Major depressive disorder, in remission (MDD)
0.00
Documentation of new diagnosis of initial or recurrent episode of major depressive disorder (MDD)
0.00
Central Dual-energy X-Ray Absorptiometry (DXA) results documented (OP)
0.00
Central Dual-energy X-Ray Absorptiometry (DXA) ordered (OP)
0.00
Carotid imaging study report (includes direct or indirect reference to measurements of distal internal
0.00 carotid diam
Presence or absence of hemorrhage and mass lesion and acute infarction documented in final CT
0.00
or MRI report (S
CT or MRI of the brain performed within 24 hours of arrival to the hospital (STR)
0.00
CT or MRI of the brain performed greater than 24 hours after arrival to the hospital (STR)
0.00
12-Lead ECG Performed (EM)
0.00
Upper gastrointestinal endoscopy performed (GERD)
0.00
Documentation of referral for upper gastrointestinal endoscopy (GERD)
0.00
Upper gastrointestinal endoscopy report indicates suspicion of Barrett's esophagus (GERD)
0.00
Upper gastrointestinal endoscopy report indicates no suspicion of Barrett's esophagus (GERD) 0.00
Barium swallow test ordered (GERD)
0.00
Forceps esophageal biopsy performed (GERD)
0.00
Cytogenetic testing performed on bone marrow at time of diagnosis or prior to initiating treatment
0.00 (HEM)
Documentation of iron stores prior to initiating erythropoietin therapy (HEM)
0.00
Flow cytometry studies performed at time of diagnosis or prior to initiating treatment (HEM) 0.00
Barium swallow test not ordered (GERD)
0.00
Group A Strep Test Performed (PHAR)
0.00
Tobacco use cessation intervention, counseling (COPD, CAP, CAD)
0.00
Tobacco use cessation intervention, pharmacologic therapy (COPD, CAD, CAP, PV) (DM)
0.00
Statin therapy, prescribed (CAD)
0.00
Patient education, written/oral, appropriate for patients with heart failure, performed (HF) 0.00
Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed (OP)
0.00
Beta-blocker therapy, prescribed
0.00
Angiotensin converting enzyme (ACE) inhibitor or Angiotensin Receptor Blocker (ARB) therapy,0.00
prescribed (HF, CA
Oral antiplatelet therapy prescribed (eg, aspirin, clopidogrel/Plavix, or combination of aspirin and
0.00dipyridamole/A
Warfarin therapy prescribed (CHF)
0.00
Written discharge instructions provided to heart failure patients discharged home. (Instructions0.00
include all of the
Persistent asthma, preferred long term control medication or an acceptable alternative treatment,
0.00 prescribed (As
Anti-inflammatory/analgesic agent prescribed (OA) (Use for prescribed or continued medication[s],
0.00 including over
Gastrointestinal prophylaxis for NSAID use prescribed (OA)
0.00
Therapeutic exercise for the involved joint(s) instructed or physical or occupational therapy prescribed
0.00
(OA)
Documentation of receipt of counseling on exercise AND either both calcium and vitamin D use0.00
or counseling rega
4025F
4030F
4033F
4035F
4037F
4040F
4041F
4042F
4043F
4044F
4045F
4046F
4047F
4048F
4049F
4050F
4051F
4052F
4053F
4054F
4055F
4056F
4058F
4060F
4062F
4064F
4065F
4066F
4067F
4070F
4073F
4075F
4077F
4079F
4084F
4090F
4095F
4100F
4110F
4115F
4120F
4124F
5005F
5010F
5015F
6005F
6010F
Inhaled bronchodilator prescribed (COPD)

0.00
Long-term oxygen therapy prescribed (more than 15 hours per day) (COPD)
0.00
Pulmonary rehabilitation exercise training recommended (COPD)
0.00
Influenza immunization recommended (COPD)
0.00
Influenza immunization ordered or administered (COPD, PV)
0.00
Pneumococcal immunization ordered or administered (COPD)
0.00
Documentation of order for cefazolin OR cefuroxime for antimicrobial prophylaxis (PERI 2)
0.00
Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical0.00
incision nor given
Documentation that an order was given to discontinue prophylactic antibiotics within 48 hours0.00
of surgical end tim
Documentation that an order was given for venous thromboembolism (VTE) prophylaxis to be 0.00
given within 24 hrs
Appropriate empiric antibiotic prescribed (CAP), (EM)
0.00
Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision0.00
or given intraoper
Documentation of order for prophylactic antibiotics to be given within one hour (if fluoroquinolone
0.00 or vancomyci
Documentation that prophylactic antibiotic was given within one hour (if fluoroquinolone or vancomycin,
0.00
two hou
Documentation that order was given to discontinue prophylactic antibiotics within 24 hours of 0.00
surgical end time,
Hypertension plan of care documented as appropriate (HTN)
0.00
Referred for an arterio-venous (AV) fistula (ESRD)
0.00
Hemodialysis via functioning arterio-venous (AV) fistula (ESRD)
0.00
Hemodialysis via functioning arterio-venous (AV) graft (ESRD)
0.00
Hemodialysis via catheter (ESRD)
0.00
Patient receiving peritoneal dialysis (ESRD)
0.00
Appropriate oral rehydration solution recommended (PAG)
0.00
Pediatric Gastroenteritis Education provided to caregiver (PAG)
0.00
Psychotherapy services provided (MDD)
0.00
Patient referral for psychotherapy documented (MDD)
0.00
Antidepressant pharmacotherapy prescribed (MDD)
0.00
Antipsychotic pharmacotherapy prescribed (MDD)
0.00
Electroconvulsive Therapy (ECT) provided (MDD)
0.00
Patient referral for electroconvulsive therapy (ECT) documented (MDD)
0.00
Deep Vein Thrombosis (DVT) prophylaxis received by end of hospital day 2 (STR)
0.00
Oral antiplatelet therapy prescribed at discharge (STR)
0.00
Anticoagulant therapy prescribed at discharge (STR)
0.00
Documentation that tissue plasminogen activator (t-PA) administration was considered (STR) 0.00
Documentation that rehabilitation services were considered (STR)
0.00
Aspirin received within 24 hours before emergency department arrival or during emergency department
0.00
stay (EM
Patient receiving erythropoietin therapy (HEM)
0.00
Patient not receiving erythropoietin therapy (HEM)
0.00
Bisphosphonate therapy, intravenous, ordered or received (HEM)
0.00
Internal mammary artery graft performed for primary, isolated coronary artery bypass graft procedure
0.00
(CABG)
Beta blocker administered within 24 hours prior to surgical incision (CABG)
0.00
Antibiotic prescribed or dispensed (URI, PHAR)
0.00
Antibiotic neither prescribed nor dispensed (URI, PHAR)
0.00
Patient counseled on self-examination for new or changing moles (ML)
0.00
Findings of dilated macular or fundus exam communicated to the physician managing the diabetes
0.00 care (EC)
Documentation of communication that a fracture occurred and that the patient was or should 0.00
be tested or treate
Rationale (eg, severity of illness and safety) for level of care (eg, home, hospital) documented (CAP)
0.00
Dysphagia screening conducted prior to order for or receipt of any foods, fluids or medication by
0.00
mouth (STR)
6015F
6020F
0014F
0015F
0513F
0514F
0516F
0517F
0518F
0519F
0520F
0521F
0525F
0526F
0528F
0529F
0535F
0540F
0545F
0575F
1116F
1118F
1119F
1121F
1123F
1124F
1125F
1126F
1130F
1134F
1135F
1136F
1137F
1150F
1151F
1152F
1153F
1157F
1158F
1159F
1160F
1170F
1180F
1200F
1205F
1220F
1400F
Patient receiving or eligible to receive foods, fluids or medication by mouth (STR)

0.00
NPO (nothing by mouth) ordered (STR)
0.00
Comprehensive preoperative assessment performed for cataract surgery with intraocular lens 0.00
(IOL) placement (in
Melanoma follow up completed (includes assessment of all of the following components) (ML):0.00
History obtained r
Elevated blood pressure plan of care documented (CKD)
0.00
Plan of care for elevated hemoglobin level documented for patient receiving Erythropoiesis-Stimulating
0.00
Agent the
Anemia plan of care documented (ESRD)
0.00
Glaucoma plan of care documented (EC)
0.00
Falls plan of care documented (GER)
0.00
Planned chemotherapy regimen, including at a minimum: drug(s) prescribed, dose, and duration,
0.00
documented pri
Radiation dose limits to normal tissues established prior to the initiation of a course of 3D conformal
0.00 radiation for
Plan of care to address pain documented (COA) (ONC)
0.00
Initial visit for episode (BkP)
0.00
Subsequent visit for episode (BkP)
0.00
Recommended follow-up interval for repeat colonoscopy of at least 10 years documented in colonoscopy
0.00
report (
Interval of 3 or more years since patient's last colonoscopy, documented (End/Polyp)
0.00
Dyspnea management plan of care, documented (Pall Cr)
0.00
Glucorticoid Management Plan Documented (RA)
0.00
Plan for follow-up care for major depressive disorder, documented (MDD ADOL)
0.00
HIV RNA control plan of care, documented (HIV)
0.00
Auricular or periauricular pain assessed (AOE)
0.00
GERD symptoms assessed after 12 months of therapy (GERD)
0.00
Initial evaluation for condition (HEP C) (EPI)
0.00
Subsequent evaluation for condition (HEP C) (EPI)
0.00
Advance Care Planning discussed and documented advance care plan or surrogate decision maker
0.00documented in
Advance Care Planning discussed and documented in the medical record, patient did not wish or
0.00
was not able to n
Pain severity quantified; pain present (COA) (ONC)
0.00
Pain severity quantified; no pain present (COA) (ONC)
0.00
Back pain and function assessed, including all of the following: Pain assessment AND functional0.00
status AND patien
Episode of back pain lasting 6 weeks or less (BkP)
0.00
Episode of back pain lasting longer than 6 weeks (BkP)
0.00
Episode of back pain lasting 12 weeks or less (BkP)
0.00
Episode of back pain lasting longer than 12 weeks (BkP)
0.00
Documentation that a patient has a substantial risk of death within 1 year (Pall Cr)
0.00
Documentation that a patient does not have a substantial risk of death within one year (Pall Cr)0.00
Documentation of advanced disease diagnosis, goals of care prioritize comfort (Pall Cr)
0.00
Documentation of advanced disease diagnosis, goals of care do not prioritize comfort (Pall Cr) 0.00
Advance care plan or similar legal document present in the medical record (COA)
0.00
Advance care planning discussion documented in the medical record (COA)
0.00
Medication list documented in medical record (COA)
0.00
Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions,
0.00 OTCs, herbal
Functional status assessed (COA) (RA)
0.00
All specified thromboembolic risk factors assessed (AFIB)
0.00
Seizure type(s) and current seizure frequency(ies) documented (EPI)
0.00
Etiology of epilepsy or epilepsy syndrome(s) reviewed and documented (EPI)
0.00
Patient screened for depression (SUD)
0.00
Parkinson's disease diagnosis reviewed (Prkns)
0.00
2035F
2040F
2044F
2050F
2060F
3008F
3015F
3016F
3018F
3038F
3215F
3216F
3218F
3220F
3230F
3250F
3260F
3265F
3266F
3268F
3269F
3270F
3271F
3272F
3273F
3274F
3278F
3279F
3280F
3281F
3284F
3285F
3288F
3290F
3291F
3292F
3293F
3294F
3300F
3301F
3315F
3316F
3317F
3318F
3319F
3320F
3321F
Tympanic membrane mobility assessed with pneumatic otoscopy or tympanometry (OME)

0.00
Physical examination on the date of the initial visit for low back pain performed, in accordance0.00
with specifications
Documentation of mental health assessment prior to intervention (back surgery or epidural steroid
0.00 injection) or fo
Wound characteristics including size AND nature of wound base tissue AND amount of drainage0.00
prior to debridem
Patient interviewed directly by evaluating clinician on or before date of diagnosis of major depressive
0.00 disorder (M
Body Mass Index (BMI), documented (PV)
0.00
Cervical cancer screening results documented and reviewed (PV)
0.00
Patient screened for unhealthy alcohol use using a systematic screening method (PV)
0.00
Pre-procedure risk assessment AND depth of insertion AND quality of the bowel prep AND complete
0.00 description o
Pulmonary function test performed within 12 months prior to surgery (Lung/Esop Cx)
0.00
Patient has documented immunity to Hepatitis A (HEP-C)
0.00
Patient has documented immunity to Hepatitis B (HEP-C)
0.00
RNA testing for Hepatitis C documented as performed within 6 months prior to initiation of antiviral
0.00 treatment fo
Hepatitis C quantitative RNA testing documented as performed at 12 weeks from initiation of antiviral
0.00
treatment
Documentation that hearing test was performed within 6 months prior to tympanostomy tube0.00
insertion (OME)
Specimen site other than anatomic location of primary tumor (PATH)
0.00
pT category (primary tumor), pN category (regional lymph nodes), and histologic grade documented
0.00 in pathology
Ribonucleic acid (RNA) testing for Hepatitis C viremia ordered or results documented (HEP C) 0.00
Hepatitis C genotype testing documented as performed prior to initiation of antiviral treatment0.00
for Hepatitis C (HE
Prostate-specific antigen (PSA), AND primary tumor (T) stage, AND Gleason score documented 0.00
prior to initiation o
Bone scan performed prior to initiation of treatment or at any time since diagnosis of prostate 0.00
cancer (PRCA)
Bone scan not performed prior to initiation of treatment nor at any time since diagnosis of prostate
0.00 cancer (PRCA
Low risk of recurrence, prostate cancer (PRCA)
0.00
Intermediate risk of recurrence, prostate cancer (PRCA)
0.00
High risk of recurrence, prostate cancer (PRCA)
0.00
Prostate cancer risk of recurrence not determined or neither low, intermediate nor high (PRCA)0.00
Serum levels of calcium, phosphorus, intact Parathyroid Hormone (PTH) and lipid profile ordered
0.00
(CKD)
Hemoglobin level greater than or equal to 13 g/dL (CKD, ESRD)
0.00
Hemoglobin level 11 g/dL to 12.9 g/dL (CKD, ESRD)
0.00
Hemoglobin level less than 11 g/dL (CKD, ESRD)
0.00
Intraocular pressure (IOP) reduced by a value of greater than or equal to 15% from the pre-intervention
0.00
level (EC)
Intraocular pressure (IOP) reduced by a value less than 15% from the pre-intervention level (EC)
0.00
Falls risk assessment documented (GER)
0.00
Patient is D (Rh) negative and unsensitized (Pre-Cr)
0.00
Patient is D (Rh) positive or sensitized (Pre-Cr)
0.00
HIV testing ordered or documented and reviewed during the first or second prenatal visit (Pre-Cr)
0.00
ABO and Rh blood typing documented as performed (Pre-Cr)
0.00
Group B Streptococcus (GBS) screening documented as performed during week 35-37 gestation0.00
(Pre-Cr)
American Joint Committee on Cancer (AJCC) stage documented and reviewed (ONC)
0.00
Cancer stage documented in medical record as metastatic and reviewed (ONC)
0.00
Estrogen receptor (ER) or progesterone receptor (PR) positive breast cancer (ONC)
0.00
Estrogen receptor (ER) and progesterone receptor (PR) negative breast cancer (ONC)
0.00
Pathology report confirming malignancy documented in the medical record and reviewed prior0.00
to the initiation of
Pathology report confirming malignancy documented in the medical record and reviewed prior0.00
to the initiation of
1 of the following diagnostic imaging studies ordered: chest x-ray, CT, Ultrasound, MRI, PET, or0.00
nuclear medicine s
None of the following diagnostic imaging studies ordered: chest X-ray, CT, Ultrasound, MRI, PET,
0.00
or nuclear medic
AJCC Cancer Stage 0 or IA Melanoma, documented (ML)
0.00
3322F
3323F
3324F
3325F
3328F
3330F
3331F
3340F
3341F
3342F
3343F
3344F
3345F
3350F
3351F
3352F
3353F
3354F
3370F
3372F
3374F
3376F
3378F
3380F
3382F
3384F
3386F
3388F
3390F
3450F
3451F
3452F
3455F
3470F
3471F
3472F
3475F
3476F
3490F
3491F
3492F
3493F
3494F
3495F
3496F
3497F
3498F
Melanoma greater than AJCC Stage 0 or IA (ML)

0.00
Clinical tumor, node and metastases (TNM) staging documented and reviewed prior to surgery0.00
(Lung/Esop Cx)
MRI or CT scan ordered, reviewed or requested (EPI)
0.00
Preoperative assessment of functional or medical indication(s) for surgery prior to the cataract0.00
surgery with intrao
Performance status documented and reviewed within 2 weeks prior to surgery (Lung/Esop Cx) 0.00
Imaging study ordered (BkP)
0.00
Imaging study not ordered (BkP)
0.00
Mammogram assessment category of "incomplete: need additional imaging evaluation", documented
0.00 (RAD)
Mammogram assessment category of "negative," documented (RAD)
0.00
Mammogram assessment category of "benign," documented (RAD)
0.00
Mammogram assessment category of "probably benign," documented (RAD)
0.00
Mammogram assessment category of "suspicious," documented (RAD)
0.00
Mammogram assessment category of "highly suggestive of malignancy," documented (RAD) 0.00
Mammogram assessment category of "known biopsy proven malignancy," documented (RAD) 0.00
Negative screen for depressive symptoms as categorized by using a standardized depression screening/assessmen
0.00
No significant depressive symptoms as categorized by using a standardized depression assessment
0.00 tool (MDD)
Mild to moderate depressive symptoms as categorized by using a standardized depression screening/assessment
0.00
Clinically significant depressive symptoms as categorized by using a standardized depression screening/assessmen
0.00
AJCC Breast Cancer Stage 0 documented (ONC)
0.00
AJCC Breast Cancer Stage I: T1mic, T1a or T1b (tumor size <= 1 cm) documented (ONC)
0.00
AJCC Breast Cancer Stage I: T1c (tumor size > 1 cm to 2 cm) documented (ONC)
0.00
AJCC Breast Cancer Stage II documented (ONC)
0.00
AJCC Breast Cancer Stage III documented (ONC)
0.00
AJCC Breast Cancer Stage IV documented (ONC)
0.00
AJCC colon cancer, Stage 0 documented (ONC)
0.00
AJCC colon cancer, Stage I documented (ONC)
0.00
AJCC colon cancer, Stage II documented (ONC)
0.00
AJCC colon cancer, Stage III documented (ONC)
0.00
AJCC colon cancer, Stage IV documented (ONC)
0.00
Dyspnea screened, no dyspnea or mild dyspnea (Pall Cr)
0.00
Dyspnea screened, moderate or severe dyspnea (Pall Cr)
0.00
Dyspnea not screened (Pall Cr)
0.00
TB screening performed and results interpreted within six months prior to initiation of first-time
0.00
biologic disease m
Rheumatoid arthritis (RA) disease activity, low (RA)
0.00
Rheumatoid arthritis (RA) disease activity, moderate (RA)
0.00
Rheumatoid arthritis (RA) disease activity, high (RA)
0.00
Disease prognosis for rheumatoid arthritis assessed, poor prognosis documented (RA)
0.00
Disease prognosis for rheumatoid arthritis assessed, good prognosis documented (RA)
0.00
History of AIDS-defining condition (HIV)
0.00
HIV indeterminate (infants of undetermined HIV status born of HIV-infected mothers) (HIV) 0.00
History of nadir CD4+ cell count <350 cells/mm (HIV)
0.00
No history of nadir CD4+ cell count <350 cells/mm AND no history of AIDS-defining condition (HIV)
0.00
CD4+ cell count <200 cells/mm (HIV)
0.00
CD4+ cell count 200 - 499 cells/mm (HIV)
0.00
CD4+ cell count >=500 cells/mm (HIV)
0.00
CD4+ cell percentage <15% (HIV)
0.00
CD4+ cell percentage >=15% (HIV)
0.00
3500F
3502F
3503F
3510F
3511F
3512F
3513F
3514F
3515F
3550F
3551F
3552F
3555F
3570F
3572F
3573F
3650F
3700F
3720F
4004F
4063F
4130F
4131F
4132F
4133F
4134F
4135F
4136F
4148F
4149F
4150F
4151F
4153F
4155F
4157F
4158F
4159F
4163F
4164F
4165F
4167F
4168F
4169F
4171F
4172F
4174F
4175F
CD4+ cell count or CD4+ cell percentage documented as performed (HIV)

0.00
HIV RNA viral load below limits of quantification (HIV)
0.00
HIV RNA viral load not below limits of quantification (HIV)
0.00
Documentation that tuberculosis (TB) screening test performed and results interpreted (HIV) 0.00
Chlamydia and gonorrhea screenings documented as performed (HIV)
0.00
Syphilis screening documented as performed (HIV)
0.00
Hepatitis B screening documented as performed (HIV)
0.00
Hepatitis C screening documented as performed (HIV)
0.00
Patient has documented immunity to Hepatitis C (HIV)
0.00
Low risk for thromboembolism (AFIB)
0.00
Intermediate risk for thromboembolism (AFIB)
0.00
High risk for thromboembolism (AFIB)
0.00
Patient had International Normalized Ratio (INR) measurement performed (AFIB)
0.00
Final report for bone scintigraphy study includes correlation with existing relevant imaging studies
0.00(eg, X-ray, MRI
Patient considered to be potentially at risk for fracture in a weight-bearing site (NUC_MED) 0.00
Patient not considered to be potentially at risk for fracture in a weight-bearing site (NUC_MED)0.00
Electroencephalogram (EEG) ordered, reviewed or requested (EPI)
0.00
Psychiatric disorders or disturbances assessed (Prkns)
0.00
Cognitive impairment or dysfunction assessed (Prkns)
0.00
Patient screened for tobacco use AND received tobacco cessation counseling, if identified as a tobacco
0.00
user (PV)
Antidepressant pharmacotherapy considered and not prescribed (MDD ADOL)
0.00
Topical preparations (including OTC) prescribed for acute otitis externa (AOE)
0.00
Systemic antimicrobial therapy prescribed (AOE)
0.00
Systemic antimicrobial therapy not prescribed (AOE)
0.00
Antihistamines or decongestants prescribed or recommended (OME)
0.00
Antihistamines or decongestants neither prescribed nor recommended (OME)
0.00
Systemic corticosteroids prescribed (OME)
0.00
Systemic corticosteroids not prescribed (OME)
0.00
Hepatitis A vaccine injection administered or previously received (HEP-C)
0.00
Hepatitis B vaccine injection administered or previously received (HEP-C)
0.00
Patient receiving antiviral treatment for Hepatitis C (HEP-C)
0.00
Patient not receiving antiviral treatment for Hepatitis C (HEP-C)
0.00
Combination peginterferon and ribavirin therapy prescribed (HEP-C)
0.00
Hepatitis A vaccine series previously received (HEP-C)
0.00
Hepatitis B vaccine series previously received (HEP-C)
0.00
Patient counseled about risks of alcohol use (HEP-C)
0.00
Counseling regarding contraception received prior to initiation of antiviral treatment (HEP-C) 0.00
Patient counseling at a minimum on all of the following treatment options for clinically localized
0.00
prostate cancer:
Adjuvant (ie, in combination with external beam radiotherapy to the prostate for prostate cancer)
0.00hormonal thera
3-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT)
0.00
received (PRCA)
Head of bed elevation (30-45 degrees) on first ventilator day ordered (CRIT)
0.00
Patient receiving care in the intensive care unit (ICU) and receiving mechanical ventilation, 24 hours
0.00 or less (CRIT)
Patient either not receiving care in the intensive care unit (ICU) OR not receiving mechanical ventilation
0.00
OR receiv
Patient receiving erythropoiesis-stimulating agents (ESA) therapy (CKD)
0.00
Patient not receiving erythropoiesis-stimulating agents (ESA) therapy (CKD)
0.00
Counseling about the potential impact of glaucoma on visual functioning and quality of life, and0.00
importance of tre
Best-corrected visual acuity of 20/40 or better (distance or near) achieved within the 90 days following
0.00
cataract su
4176F
4177F
4178F
4179F
4180F
4181F
4182F
4185F
4186F
4187F
4188F
4189F
4190F
4191F
4192F
4193F
4194F
4195F
4196F
4200F
4201F
4210F
4220F
4221F
4230F
4240F
4242F
4245F
4248F
4250F
4255F
4256F
4260F
4261F
4265F
4266F
4267F
4268F
4269F
4270F
4271F
4274F
4275F
4276F
4279F
4280F
4290F
Counseling about value of protection from UV light and lack of proven efficacy of nutritional supplements
0.00
in preve
Counseling about the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation
0.00 for prevent
Anti-D immune globulin received between 26 and 30 weeks gestation (Pre-Cr)
0.00
Tamoxifen or aromatase inhibitor (AI) prescribed (ONC)
0.00
Adjuvant chemotherapy referred, prescribed, or previously received for Stage III colon cancer (ONC)
0.00
Conformal radiation therapy received (NMA-No Measure Assoc.)
0.00
Conformal radiation therapy not received (NMA-No Measure Assoc.)
0.00
Continuous (12-months) therapy with proton pump inhibitor (PPI) or histamine H2 receptor antagonist
0.00
(H2RA) rec
No continuous (12-months) therapy with either proton pump inhibitor (PPI) or histamine H2 receptor
0.00 antagonist (
Disease modifying anti-rheumatic drug therapy prescribed or dispensed (RA)
0.00
Appropriate angiotensin converting enzyme (ACE)/angiotensin receptor blockers (ARB) therapeutic
0.00 monitoring te
Appropriate digoxin therapeutic monitoring test ordered or performed (AM)
0.00
Appropriate diuretic therapeutic monitoring test ordered or performed (AM)
0.00
Appropriate anticonvulsant therapeutic monitoring test ordered or performed (AM)
0.00
Patient not receiving glucocorticoid therapy (RA)
0.00
Patient receiving <10 mg daily prednisone (or equivalent), or RA activity is worsening, or glucocorticoid
0.00
use is for l
Patient receiving >=10 mg daily prednisone (or equivalent) for longer than 6 months, and improvement
0.00
or no chan
Patient receiving first-time biologic disease modifying anti-rheumatic drug therapy for rheumatoid
0.00arthritis (RA)
Patient not receiving first-time biologic disease modifying anti-rheumatic drug therapy for rheumatoid
0.00
arthritis (R
External beam radiotherapy as primary therapy to prostate with or without nodal irradiation (PRCA)
0.00
External beam radiotherapy with or without nodal irradiation as adjuvant or salvage therapy for
0.00
prostate cancer p
Angiotensin converting enzyme (ACE) or angiotensin receptor blockers (ARB) medication therapy
0.00
for 6 months or
Digoxin medication therapy for 6 months or more (MM)
0.00
Diuretic medication therapy for 6 months or more (MM)
0.00
Anticonvulsant medication therapy for 6 months or more (MM)
0.00
Instruction in therapeutic exercise with follow-up by the physician provided to patients during 0.00
episode of back pa
Counseling for supervised exercise program provided to patients during episode of back pain lasting
0.00 longer than 1
Patient counseled during the initial visit to maintain or resume normal activities (BkP)
0.00
Patient counseled during the initial visit for an episode of back pain against bed rest lasting 4 days
0.00or longer (BkP)
Active warming used intraoperatively for the purpose of maintaining normothermia, OR at least
0.00
1 body temperat
Duration of general or neuraxial anesthesia 60 minutes or longer, as documented in the anesthesia
0.00 record (CRIT)
Duration of general or neuraxial anesthesia less than 60 minutes, as documented in the anesthesia
0.00 record (CRIT)
Wound surface culture technique used (CWC)
0.00
Technique other than surface culture of the wound exudate used (eg, Levine/deep swab technique,
0.00 semi-quantita
Use of wet to dry dressings prescribed or recommended (CWC)
0.00
Use of wet to dry dressings neither prescribed nor recommended (CWC)
0.00
Compression therapy prescribed (CWC)
0.00
Patient education regarding the need for long term compression therapy including interval replacement
0.00
of compr
Appropriate method of offloading (pressure relief) prescribed (CWC)
0.00
Patient receiving potent antiretroviral therapy for 6 months or longer (HIV)
0.00
Patient receiving potent antiretroviral therapy for less than 6 months or not receiving potent antiretroviral
0.00
therap
Influenza immunization administered or previously received (HIV) (P-ESRD)
0.00
Hepatitis B vaccine injection administered or previously received (HIV)
0.00
Potent antiretroviral therapy prescribed (HIV)
0.00
Pneumocystis jiroveci pneumonia prophylaxis prescribed (HIV)
0.00
Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low CD4+ cell count
0.00
or percentage (H
Patient screened for injection drug use (HIV)
0.00
4293F
4300F
4301F
4305F
4306F
4320F
4324F
4325F
4326F
4328F
4330F
4340F
4400F
5020F
5050F
5060F
5062F
5100F
5200F
6030F
6040F
6045F
6070F
6080F
6090F
7010F
7020F
7025F
0019T
0030T
0042T
0048T
0050T
0051T
0052T
0053T
0054T
0055T
0058T
0059T
0071T
0072T
0073T
0075T
0076T
0078T
0079T
Patient screened for high-risk sexual behavior (HIV)

0.00
Patient receiving warfarin therapy for nonvalvular atrial fibrillation or atrial flutter (AFIB)
0.00
Patient not receiving warfarin therapy for nonvalvular atrial fibrillation or atrial flutter (AFIB) 0.00
Patient education regarding appropriate foot care AND daily inspection of the feet received (CWC)
0.00
Patient counseled regarding psychosocial AND pharmacologic treatment options for opioid addiction
0.00 (SUD)
Patient counseled regarding psychosocial AND pharmacologic treatment options for alcohol dependence
0.00
(SUD)
Patient (or caregiver) queried about Parkinson's disease medication related motor complications
0.00
(Prkns)
Medical and surgical treatment options reviewed with patient (or caregiver) (Prkns)
0.00
Patient (or caregiver) queried about symptoms of autonomic dysfunction (Prkns)
0.00
Patient (or caregiver) queried about sleep disturbances (Prkns)
0.00
Counseling about epilepsy specific safety issues provided to patient (or caregiver(s)) (EPI)
0.00
Counseling for women of childbearing potential with epilepsy (EPI)
0.00
Rehabilitative therapy options discussed with patient (or caregiver) (Prkns)
0.00
Treatment summary report communicated to physician(s) managing continuing care and to the0.00
patient within 1 m
Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis
0.00 (ML)
Findings from diagnostic mammogram communicated to practice managing patient's on-going 0.00
care within 3 busin
Findings from diagnostic mammogram communicated to the patient within 5 days of exam interpretation
0.00
(RAD)
Potential risk for fracture communicated to the referring physician within 24 hours of completion
0.00of the imaging s
Consideration of referral for a neurological evaluation of appropriateness for surgical therapy for
0.00
intractable epile
All elements of maximal sterile barrier technique followed including: cap AND mask AND sterile0.00
gown AND sterile
Use of appropriate radiation dose reduction devices OR manual techniques for appropriate moderation
0.00
of exposu
Radiation exposure or exposure time in final report for procedure using fluoroscopy, documented
0.00(RAD)
Patient queried and counseled about anti-epileptic drug (AED) side effects (EPI)
0.00
Patient (or caregiver) queried about falls (Prkns)
0.00
Patient (or caregiver) counseled about safety issues appropriate to patient's stage of disease (Prkns)
0.00
Patient information entered into a recall system that includes: target date for the next exam specified
0.00 AND a proc
Mammogram assessment category (eg, Mammography Quality Standards Act [MQSA], Breast Imaging
0.00 Reporting a
Patient information entered into a reminder system with a target due date for the next mammogram
0.00 (RAD)
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, low energy
385.00
Antiprothrombin (phospholipid cofactor) antibody, each Ig class
0.00
Cerebral perfusion analysis using computed tomography with contrast administration, including0.00
post-processing o
Implantation of a ventricular assist device, extracorporeal, percutaneous transseptal access, single
0.00or dual cannula
Removal of a ventricular assist device, extracorporeal, percutaneous transseptal access, single 0.00
or dual cannulation
Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy 0.00
Replacement or repair of thoracic unit of a total replacement heart system (artificial heart)
0.00
Replacement or repair of implantable component or components of total replacement heart system
0.00 (artificial hea
Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance
0.00 based on flu
1725.00 based on CT
Cryopreservation; reproductive tissue, ovarian
0.00
Cryopreservation; oocyte(s)
0.00
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata
0.00
volume less than
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata
0.00
volume greater o
Compensator-based beam modulation treatment delivery of inverse planned treatment using
1692.00
3 or more high reso
Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including
0.00 radiologic supe
Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including
0.00 radiologic supe
Endovascular repair using prosthesis of abdominal aortic aneurysm, pseudoaneurysm or dissection,
0.00 abdominal ao
Placement of visceral extension prosthesis for endovascular repair of abdominal aortic aneurysm
0.00
involving viscera
0080T
0081T
0085T
0092T
0095T
0098T
0099T
0100T
0101T
0102T
0103T
0106T
0107T
0108T
0109T
0110T
0111T
0123T
0124T
0126T
0141T
0142T
0143T
0155T
0156T
0157T
0158T
0159T
0163T
0164T
0165T
0166T
0167T
0168T
0169T
0171T
0172T
0173T
0174T
0175T
0178T
0179T
0180T
0181T
0182T
0183T
0184T
Endovascular repair of abdominal aortic aneurysm, pseudoaneurysm or dissection, abdominal 0.00

aorta involving visc
Placement of visceral extension prosthesis for endovascular repair of abdominal aortic aneurysm
0.00
involving viscera
Breath test for heart transplant rejection
0.00
Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation
0.00
(include
Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace,
0.00
cervical (List sepa
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each
0.00
additional intersp
Implantation of intrastromal corneal ring segments
0.00
Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation
0.00
of intra-ocular re
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, high energy
0.00
Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than
0.00 local, involvin
Holotranscobalamin, quantitative
0.00
Quantitative sensory testing (QST), testing and interpretation per extremity; using touch pressure
0.00stimuli to asses
Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli
0.00 to assess large
Quantitative sensory testing (QST), testing and interpretation per extremity; using cooling stimuli
0.00
to assess small n
Quantitative sensory testing (QST), testing and interpretation per extremity; using heat-pain stimuli
0.00 to assess sma
Quantitative sensory testing (QST), testing and interpretation per extremity; using other stimuli0.00
to assess sensatio
Long-chain (C20-22) omega-3 fatty acids in red blood cell (RBC) membranes
0.00
Fistulization of sclera for glaucoma, through ciliary body
0.00
Conjunctival incision with posterior extrascleral placement of pharmacological agent (does not0.00
include supply of m
Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or
0.00
coronary heart d
Pancreatic islet cell transplantation through portal vein, percutaneous
0.00
Pancreatic islet cell transplantation through portal vein, open
0.00
Laparoscopy, surgical, pancreatic islet cell transplantation through portal vein
0.00
Laparoscopy, surgical; implantation or replacement of gastric stimulation electrodes, lesser curvature
0.00 (ie, morbid
Laparoscopy, surgical; revision or removal of gastric stimulation electrodes, lesser curvature (ie,0.00
morbid obesity)
Laparotomy, implantation or replacement of gastric stimulation electrodes, lesser curvature (ie,
0.00
morbid obesity)
Laparotomy, revision or removal of gastric stimulation electrodes, lesser curvature (ie, morbid 0.00
obesity)
Computer-aided detection, including computer algorithm analysis of MRI image data for lesion0.00
detection/characte
Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace
0.00 (other than f
Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace,
0.00
lumbar (List sepa
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each
0.00
additional intersp
Transmyocardial transcatheter closure of ventricular septal defect, with implant; without cardiopulmonary
0.00
bypass
Transmyocardial transcatheter closure of ventricular septal defect, with implant; with cardiopulmonary
0.00
bypass
Rhinophototherapy, intranasal application of ultraviolet and visible light, bilateral
0.00
Stereotactic placement of infusion catheter(s) in the brain for delivery of therapeutic agent(s), 0.00
including computer
Insertion of posterior spinous process distraction device (including necessary removal of bone or
0.00
ligament for inse
Insertion of posterior spinous process distraction device (including necessary removal of bone or
0.00
ligament for inse
Monitoring of intraocular pressure during vitrectomy surgery (List separately in addition to code
0.00
for primary proce
Computer-aided detection (CAD) (computer algorithm analysis of digital image data for lesion detection)
0.00
with furt
Computer-aided detection (CAD) (computer algorithm analysis of digital image data for lesion detection)
0.00
with furt
Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; with interpretation
0.00 and report
Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; tracing and graphics
0.00 only, without
Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; interpretation and
0.00report only
Corneal hysteresis determination, by air impulse stimulation, bilateral, with interpretation and 0.00
report
High dose rate electronic brachytherapy, per fraction
0.00
Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed,
0.00
wound as
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis
0.00
propria (ie,
0185T
0186T
0188T
0189T
0190T
0191T
0192T
0195T
0196T
0197T
0198T
0199T
0200T
0201T
0202T
0205T
0206T
0207T
0208T
0209T
0210T
0211T
0212T
0213T
0214T
0215T
0216T
0217T
0218T
0219T
0220T
0221T
0222T
0223T
0224T
0225T
0226T
0227T
0228T
0229T
0230T
0231T
0232T
0233T
0234T
0235T
0236T
Multivariate analysis of patient-specific findings with quantifiable computer probability assessment,

0.00 including rep
Suprachoroidal delivery of pharmacologic agent (does not include supply of medication)
0.00
Remote real-time interactive video-conferenced critical care, evaluation and management of the
0.00
critically ill or cri
0.00
Placement of intraocular radiation source applicator (List separately in addition to primary procedure)
0.00
Insertion of anterior segment aqueous drainage device, without extraocular reservoir; internal 0.00
approach, into the
Insertion of anterior segment aqueous drainage device, without extraocular reservoir; external0.00
approach
Arthrodesis, pre-sacral interbody technique, including instrumentation, imaging (when performed),
0.00 and discectom
0.00 and discectom
Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy
0.00 (eg, 3D pos
Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation
0.00 and report
Physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) (including frequency
0.00
and amplitude),
Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon
0.00 or mechanic
Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon
0.00or mechanical
Posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including facetectomy,0.00
laminectomy, fora
Intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) during diagnostic
0.00evaluation and
Algorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment,
0.00
includin
Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral 0.00
Pure tone audiometry (threshold), automated; air only
0.00
Pure tone audiometry (threshold), automated; air and bone
0.00
Speech audiometry threshold, automated;
0.00
Speech audiometry threshold, automated; with speech recognition
0.00
Comprehensive audiometry threshold evaluation and speech recognition (0209T, 0211T combined),
0.00 automated
Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement
0.00
of bone gra
0.00
of bone gra
0.00
of bone gra
0.00
of bone gra
Acoustic cardiography, including automated analysis of combined acoustic and electrical intervals;
0.00single, with int
0.00multiple, includ
Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); diagnostic,
0.00 including colle
Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); with biopsy(ies)
0.00
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance,
0.00
cervical or thorac
0.00
cervical or thorac
0.00
lumbar or sacral;
0.00
lumbar or sacral;
Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation
0.00
when performed
Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy
0.00
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision0.00
and interpretation
and interpretation
and interpretation
0237T
0238T
0239T
0240T
0241T
0242T
0243T
0244T
0245T
0246T
0247T
0248T
0249T
0250T
0251T
0252T
0253T
0254T
0255T
0256T
0257T
0258T
0259T
0054T
0055T
0184T
0185T
0186T
0188T
0189T
0190T
0191T
0192T
0195T
0196T
0197T
0198T
0199T
0200T
0201T
0202T
0205T
0206T
0207T
0208T
0209T
0210T

and interpretation
and interpretation
Bioimpedance spectroscopy (BIS), measuring 100 frequencies or greater, direct measurement of
0.00
extracellular fluid
Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study
0.00with interpreta
0.00with interpreta
Gastrointestinal tract transit and pressure measurement, stomach through colon, wireless capsule,
0.00 with interpret
Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic0.00
evaluation(s), with
Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation
0.00
of noc
Open treatment of rib fracture requiring internal fixation, unilateral; 1-2 ribs
0.00
0.00
0.00
Open treatment of rib fracture requiring internal fixation, unilateral; 7 or more ribs
0.00
Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance
0.00
Airway sizing and insertion of bronchial valve(s), each lobe (List separately in addition to code for
0.00
primary procedu
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal0.00
of bronchial valve
of bronchial valve
approach, into the
Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation,
0.00
traum
0.00
traum
Implantation of catheter-delivered prosthetic aortic heart valve; endovascular approach
0.00
Implantation of catheter-delivered prosthetic aortic heart valve; open thoracic approach (eg, transapical,
0.00
transven
Transthoracic cardiac exposure (eg, sternotomy, thoracotomy, subxiphoid) for catheter-delivered
0.00aortic valve rep
0.00 based on flu
0.00 based on CT
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis
0.00
propria (ie,
Multivariate analysis of patient-specific findings with quantifiable computer probability assessment,
0.00 including rep
Suprachoroidal delivery of pharmacologic agent (does not include supply of medication)
0.00
0.00
0.00
Placement of intraocular radiation source applicator (List separately in addition to primary procedure)
0.00
approach, into the
Insertion of anterior segment aqueous drainage device, without extraocular reservoir; external0.00
approach
0.00 and discectom
0.00 and discectom
Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy
0.00 (eg, 3D pos
Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation
0.00 and report
Physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) (including frequency
0.00
and amplitude),
Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon
0.00 or mechanic
Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon
0.00or mechanical
Posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including facetectomy,0.00
laminectomy, fora
Intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) during diagnostic
0.00evaluation and
Algorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment,
0.00
includin
Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral 0.00
Pure tone audiometry (threshold), automated; air only
0.00
Pure tone audiometry (threshold), automated; air and bone
0.00
Speech audiometry threshold, automated;
0.00
0211T
0212T
0213T
0214T
0215T
0216T
0217T
0218T
0219T
0220T
0221T
0222T
0223T
0224T
0225T
0226T
0227T
0228T
0229T
0230T
0231T
0232T
0233T
0234T
0235T
0236T
0237T
0238T
0239T
0240T
0241T
0242T
0243T
0244T
0245T
0246T
0247T
0248T
0249T
0250T
0251T
0252T
0253T
0254T
0255T
0256T
0257T
Speech audiometry threshold, automated; with speech recognition

0.00
Comprehensive audiometry threshold evaluation and speech recognition (0209T, 0211T combined),
0.00 automated
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
innervating that
0.00
of bone gra
0.00
of bone gra
0.00
of bone gra
0.00
of bone gra
0.00single, with int
Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); diagnostic,
0.00 including colle
Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); with biopsy(ies)
0.00
0.00
cervical or thorac
0.00
cervical or thorac
0.00
lumbar or sacral;
0.00
lumbar or sacral;
Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation
0.00
when performed
Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy
0.00
and interpretation
and interpretation
and interpretation
and interpretation
and interpretation
Bioimpedance spectroscopy (BIS), measuring 100 frequencies or greater, direct measurement of
0.00
extracellular fluid
0.00with interpreta
0.00with interpreta
Gastrointestinal tract transit and pressure measurement, stomach through colon, wireless capsule,
0.00 with interpret
Intermittent measurement of wheeze rate for bronchodilator or bronchial-challenge diagnostic0.00
evaluation(s), with
Continuous measurement of wheeze rate during treatment assessment or during sleep for documentation
0.00
of noc
0.00
0.00
0.00
Open treatment of rib fracture requiring internal fixation, unilateral; 7 or more ribs
0.00
Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance
0.00
Airway sizing and insertion of bronchial valve(s), each lobe (List separately in addition to code for
0.00
primary procedu
of bronchial valve
of bronchial valve
approach, into the
0.00
traum
0.00
traum
Implantation of catheter-delivered prosthetic aortic heart valve; endovascular approach
0.00
Implantation of catheter-delivered prosthetic aortic heart valve; open thoracic approach (eg, transapical,
0.00
transven
0258T
0259T

GROSS
CHARGES
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
SELF PAY RATES

ACROSS ALL
FACILITIES
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
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0.00
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0.00
0.00
0.00
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0.00
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0.00
0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
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0.00
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0.00
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
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0.00
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0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1155.00
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0.00
0.00
0.00
0.00
0.00
0.00
5175.00
0.00
0.00
0.00
0.00
5076.00
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1001.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
4485.00
0.00
0.00
0.00
0.00
4399.20
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
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0.00
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
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0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
Type
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
Code
011011
011012
011013
011101
011102
011103
011111
011112
011113
011121
011122
011123
011131
011132
011133
011201
011202
011203
011301
011302
011303
014101
014102
014103
014111
014112
014113
014121
014122
014123
014131
014132
014133
014141
014142
014143
014151
014152
014153
014161
014162
014163
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
014171
014172
014173
014181
014182
014183
014191
014192
014193
014201
014202
014203
014211
014212
014213
014221
014222
014223
014231
014232
014233
014241
014242
014243
014251
014252
014253
014261
014262
014263
021201
021202
021203
021301
021302
021303
024101
024102
024103
024111
024112
024113
024121
024122
024123
031101
031102
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
031103
031111
031112
031113
031121
031122
031123
031131
031132
031133
031141
031142
031143
031151
031152
031153
031201
031202
031203
031301
031302
031303
034101
034102
034103
034111
034112
034113
034121
034122
034123
034131
034132
034133
034141
034142
034143
034151
034152
034153
041011
041012
041013
041021
041022
041023
041101
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
041102
041103
041201
041202
041203
041301
041302
041303
044101
044102
044103
044111
044112
044113
044121
044122
044123
044131
044132
044133
044141
044142
044143
044151
044152
044153
044161
044162
044163
044171
044172
044173
044181
044182
044183
044191
044192
044193
044201
044202
044203
044211
044212
044213
051011
051012
051013
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
051021
051022
051023
051031
051032
051033
051041
051042
051043
051051
051052
051053
051061
051062
051063
051071
051072
051073
051111
051112
051113
051121
051122
051123
051131
051132
051133
051141
051142
051143
051151
051152
051153
051161
051162
051163
051171
051172
051173
051201
051202
051203
051301
051302
051303
051401
051402
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
051403
054101
054102
054103
054111
054112
054113
054121
054122
054123
054131
054132
054133
054141
054142
054143
054151
054152
054153
054161
054162
054163
054171
054172
054173
054181
054182
054183
054191
054192
054193
054201
054202
054203
054211
054212
054213
054221
054222
054223
054231
054232
054233
054241
054242
054243
061101
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
061102
061103
061111
061112
061113
061121
061122
061123
061131
061132
061133
061141
061142
061143
061201
061202
061203
061301
061302
061303
061401
061402
061403
061501
061502
061503
064101
064102
064103
064111
064112
064113
064121
064122
064123
064131
064132
064133
064141
064142
064143
064151
064152
064153
064161
064162
064163
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
064171
064172
064173
064181
064182
064183
071011
071012
071013
071101
071102
071103
071111
071112
071113
071121
071122
071123
071131
071132
071133
071141
071142
071143
074101
074102
074103
074111
074112
074113
074121
074122
074123
074131
074132
074133
074141
074142
074143
081011
081012
081013
081021
081022
081023
081041
081042
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
081043
081051
081052
081053
081061
081062
081063
081071
081072
081073
081101
081102
081103
081201
081202
081203
081301
081302
081303
081401
081402
081403
081501
081502
081503
081601
081602
081603
081701
081702
081703
081801
081802
081803
084101
084102
084103
084111
084112
084113
084121
084122
084123
084131
084132
084133
084141
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
084142
084143
084151
084152
084153
084161
084162
084163
084171
084172
084173
084181
084182
084183
084191
084192
084193
084201
084202
084203
084211
084212
084213
091201
091202
091203
091301
091302
091303
091401
091402
091403
091501
091502
091503
094101
094102
094103
094111
094112
094113
094121
094122
094123
094131
094132
094133
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
094141
094142
094143
101011
101012
101013
101101
101102
101103
101201
101202
101203
104101
104102
104103
104111
104112
104113
104121
104122
104123
104131
104132
104133
111011
111012
111013
111111
111112
111113
111121
111122
111123
111201
111202
111203
111301
111302
111303
111401
111402
111403
114101
114102
114103
114111
114112
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
114113
114121
114122
114123
114131
114132
114133
114141
114142
114143
114151
114152
114153
114161
114162
114163
121101
121102
121103
121111
121112
121113
121121
121122
121123
121131
121132
121133
121141
121142
121143
121151
121152
121153
124101
124102
124103
124111
124112
124113
131011
131012
131013
131101
131102
131103
131111
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
131112
131113
131121
131122
131123
131131
131132
131133
131201
131202
131203
131301
131302
131303
134101
134102
134103
134111
134112
134113
134121
134122
134123
134131
134132
134133
134141
134142
134143
134151
134152
134153
134161
134162
134163
134171
134172
134173
146101
146102
146103
146111
146112
146113
146121
146122
146123
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
146131
146132
146133
158011
158012
158013
158021
158022
158023
158031
158032
158033
158041
158042
158043
158051
158052
158053
158061
158062
158063
158071
158072
158073
158081
158082
158083
158101
158102
158103
158111
158112
158113
158121
158122
158123
158131
158132
158133
158141
158142
158143
158151
158152
158153
158161
158162
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
158163
158171
158172
158173
161101
161102
161103
161111
161112
161113
161201
161202
161203
164101
164102
164103
164111
164112
164113
164121
164122
164123
164131
164132
164133
164141
164142
164143
174101
174102
174103
174111
174112
174113
174121
174122
174123
174131
174132
174133
174141
174142
174143
184101
184102
184103
184111
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
184112
184113
184121
184122
184123
184131
184132
184133
184141
184142
184143
184151
184152
184153
194101
194102
194103
194111
194112
194113
194121
194122
194123
194131
194132
194133
194141
194142
194143
194151
194152
194153
194161
194162
194163
194171
194172
194173
194181
194182
194183
194191
194192
194193
201101
201102
201103
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
DRG
204101
204102
204103
204111
204112
204113
204121
204122
204123
214101
214102
214103
214111
214112
214113
214121
214122
214123
214131
214132
214133
214141
214142
214143
214151
214152
214153
214161
214162
214163
214171
214172
214173
224101
224102
224103
224111
224112
224113
224121
224122
224123
Code Description
IP INTRACRANIAL VASCULAR PROCEDURES
IP INTRACRANIAL VASCULAR PROCEDURES w/CC
IP INTRACRANIAL VASCULAR PROCEDURES w/MCC
IP CRANIOTOMY
IP CRANIOTOMY w/CC
IP CRANIOTOMY w/MCC
IP VENTRICULAR SHUNT PROCEDURES
IP VENTRICULAR SHUNT PROCEDURES w/CC
IP VENTRICULAR SHUNT PROCEDURES w/MCC
IP EXTRACRANIAL VASCULAR PROCEDURES
IP EXTRACRANIAL VASCULAR PROCEDURES w/CC
IP EXTRACRANIAL VASCULAR PROCEDURES w/MCC
IP CARPAL TUNNEL RELEASE
IP CARPAL TUNNEL RELEASE w/CC
IP CARPAL TUNNEL RELEASE w/MCC
IP CRANIAL & PERIPHERAL NERVE PROCEDURES
IP CRANIAL & PERIPHERAL NERVE PROCEDURES w/CC
IP CRANIAL & PERIPHERAL NERVE PROCEDURES w/MCC
IP SPINE PROCEDURES
IP SPINE PROCEDURES w/CC
IP SPINE PROCEDURES w/MCC
IM SPINAL DISORDERS & INJURIES
IM SPINAL DISORDERS & INJURIES w/CC
IM SPINAL DISORDERS & INJURIES w/MCC
IM NERVOUS SYSTEM MALIGNANCY & DEGENERATIVE DISORDERS
IM NERVOUS SYSTEM MALIGNANCY & DEGENERATIVE DISORDERS w/CC
IM NERVOUS SYSTEM MALIGNANCY & DEGENERATIVE DISORDERS w/MCC
IM MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA
IM MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA w/CC
IM MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA w/MCC
IM NON-TRAUMATIC INTRACRANIAL HEMORRHAGE
IM NON-TRAUMATIC INTRACRANIAL HEMORRHAGE w/CC
IM NON-TRAUMATIC INTRACRANIAL HEMORRHAGE w/MCC
IM CEREBROVASCULAR ACCIDENT WITH INFARCT
IM CEREBROVASCULAR ACCIDENT WITH INFARCT w/CC
IM CEREBROVASCULAR ACCIDENT WITH INFARCT w/MCC
IM NON-SPECIFIC CVA & PRE-CEREBRAL OCCLUSION WITHOUT INFARCT
IM NON-SPECIFIC CVA & PRE-CEREBRAL OCCLUSION WITHOUT INFARCT w/CC
IM NON-SPECIFIC CVA & PRE-CEREBRAL OCCLUSION WITHOUT INFARCT w/MCC
IM TRANSIENT ISCHEMIA
IM TRANSIENT ISCHEMIA w/CC
IM TRANSIENT ISCHEMIA w/MCC
IM CRANIAL & PERIPHERAL NERVE DISORDERS

IM CRANIAL & PERIPHERAL NERVE DISORDERS w/CC
IM CRANIAL & PERIPHERAL NERVE DISORDERS w/MCC
IM BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM
IM BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM w/CC
IM BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM w/MCC
IM NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS
IM NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS w/CC
IM NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS w/MCC
IM VIRAL MENINGITIS
IM VIRAL MENINGITIS w/CC
IM VIRAL MENINGITIS w/MCC
IM NON-TRAUMATIC STUPOR & COMA
IM NON-TRAUMATIC STUPOR & COMA w/CC
IM NON-TRAUMATIC STUPOR & COMA w/MCC
IM SEIZURE
IM SEIZURE w/CC
IM SEIZURE w/MCC
IM MIGRAINE & OTHER HEADACHES
IM MIGRAINE & OTHER HEADACHES w/CC
IM MIGRAINE & OTHER HEADACHES w/MCC
IM HEAD TRAUMA
IM HEAD TRAUMA w/CC
IM HEAD TRAUMA w/MCC
IM CONCUSSION
IM CONCUSSION w/CC
IM CONCUSSION w/MCC
IM OTHER NERVOUS SYSTEM DISORDERS
IM OTHER NERVOUS SYSTEM DISORDERS w/CC
IM OTHER NERVOUS SYSTEM DISORDERS w/MCC
IP ORBITAL & EXTRAOCULAR PROCEDURES
IP ORBITAL & EXTRAOCULAR PROCEDURES w/CC
IP ORBITAL & EXTRAOCULAR PROCEDURES w/MCC
IP INTRAOCULAR & LENS PROCEDURES
IP INTRAOCULAR & LENS PROCEDURES w/CC
IP INTRAOCULAR & LENS PROCEDURES w/MCC
IM ACUTE MAJOR EYE INFECTIONS
IM ACUTE MAJOR EYE INFECTIONS w/CC
IM ACUTE MAJOR EYE INFECTIONS w/MCC
IM NEUROLOGICAL EYE DISORDERS
IM NEUROLOGICAL EYE DISORDERS w/CC
IM NEUROLOGICAL EYE DISORDERS w/MCC
IM OTHER EYE DISORDERS
IM OTHER EYE DISORDERS w/CC
IM OTHER EYE DISORDERS w/MCC
IP COMPLEX LARYNX PROCEDURES
IP COMPLEX LARYNX PROCEDURES w/CC
IP COMPLEX LARYNX PROCEDURES w/MCC

IP OTHER COMPLEX HEAD & NECK PROCEDURES
IP OTHER COMPLEX HEAD & NECK PROCEDURES w/CC
IP OTHER COMPLEX HEAD & NECK PROCEDURES w/MCC
IP SINUS & MASTOID PROCEDURES
IP SINUS & MASTOID PROCEDURES w/CC
IP SINUS & MASTOID PROCEDURES w/MCC
IP SALIVARY GLAND PROCEDURES
IP SALIVARY GLAND PROCEDURES w/CC
IP SALIVARY GLAND PROCEDURES w/MCC
IP CLEFT LIP & PALATE REPAIR
IP CLEFT LIP & PALATE REPAIR w/CC
IP CLEFT LIP & PALATE REPAIR w/MCC
IP TONSIL & ADENOID PROCEDURES
IP TONSIL & ADENOID PROCEDURES w/CC
IP TONSIL & ADENOID PROCEDURES w/MCC
IP OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES
IP OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES w/CC
IP OTHER EAR, NOSE, MOUTH & THROAT PROCEDURES w/MCC
IP MOUTH PROCEDURES
IP MOUTH PROCEDURES w/CC
IP MOUTH PROCEDURES w/MCC
IM EAR, NOSE, MOUTH & THROAT MALIGNANCY
IM EAR, NOSE, MOUTH & THROAT MALIGNANCY w/CC
IM EAR, NOSE, MOUTH & THROAT MALIGNANCY w/MCC
IM DYSEQUILIBRIUM
IM DYSEQUILIBRIUM w/CC
IM DYSEQUILIBRIUM w/MCC
IM EPISTAXIS
IM EPISTAXIS w/CC
IM EPISTAXIS w/MCC
IM EPIGLOTTITIS, OTITIS MEDIA, UPPER RESPIRATORY TRACT INFECTION & LARYNGOTRACHEITIS
IM EPIGLOTTITIS, OTITIS MEDIA, UPPER RESPIRATORY TRACT INFECTION & LARYNGOTRACHEITIS w/CC
IM EPIGLOTTITIS, OTITIS MEDIA, UPPER RESPIRATORY TRACT INFECTION & LARYNGOTRACHEITIS w/MCC
IM DENTAL & ORAL DISEASE
IM DENTAL & ORAL DISEASE w/CC
IM DENTAL & ORAL DISEASE w/MCC
IM OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES
IM OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES w/CC
IM OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES w/MCC
IP LONG TERM MECHANICAL VENTILATION WITH TRACHEOSTOMY
IP LONG TERM MECHANICAL VENTILATION WITH TRACHEOSTOMY w/CC
IP LONG TERM MECHANICAL VENTILATION WITH TRACHEOSTOMY w/MCC
IP LONG TERM MECHANICAL VENTILATION WITHOUT TRACHEOSTOMY
IP LONG TERM MECHANICAL VENTILATION WITHOUT TRACHEOSTOMY w/CC
IP LONG TERM MECHANICAL VENTILATION WITHOUT TRACHEOSTOMY w/MCC
IP COMPLEX RESPIRATORY SYSTEM PROCEDURES
IP COMPLEX RESPIRATORY SYSTEM PROCEDURES w/CC

IP COMPLEX RESPIRATORY SYSTEM PROCEDURES w/MCC
IP NON-COMPLEX RESPIRATORY SYSTEM PROCEDURES
IP NON-COMPLEX RESPIRATORY SYSTEM PROCEDURES w/CC
IP NON-COMPLEX RESPIRATORY SYSTEM PROCEDURES w/MCC
IP MODERATELY COMPLEX RESPIRATORY SYSTEM PROCEDURES
IP MODERATELY COMPLEX RESPIRATORY SYSTEM PROCEDURES w/CC
IP MODERATELY COMPLEX RESPIRATORY SYSTEM PROCEDURES w/MCC
IM CYSTIC FIBROSIS
IM CYSTIC FIBROSIS w/CC
IM CYSTIC FIBROSIS w/MCC
IM RESPIRATORY FAILURE
IM RESPIRATORY FAILURE w/CC
IM RESPIRATORY FAILURE w/MCC
IM PULMONARY EMBOLISM
IM PULMONARY EMBOLISM w/CC
IM PULMONARY EMBOLISM w/MCC
IM MAJOR CHEST TRAUMA
IM MAJOR CHEST TRAUMA w/CC
IM MAJOR CHEST TRAUMA w/MCC
IM RESPIRATORY MALIGNANCY
IM RESPIRATORY MALIGNANCY w/CC
IM RESPIRATORY MALIGNANCY w/MCC
IM RESPIRATORY INFECTIONS & INFLAMMATIONS
IM RESPIRATORY INFECTIONS & INFLAMMATIONS w/CC
IM RESPIRATORY INFECTIONS & INFLAMMATIONS w/MCC
IM SIMPLE PNEUMONIA & WHOOPING COUGH
IM SIMPLE PNEUMONIA & WHOOPING COUGH w/CC
IM SIMPLE PNEUMONIA & WHOOPING COUGH w/MCC
IM CHRONIC OBSTRUCTIVE PULMONARY DISEASE
IM CHRONIC OBSTRUCTIVE PULMONARY DISEASE w/CC
IM CHRONIC OBSTRUCTIVE PULMONARY DISEASE w/MCC
IM ASTHMA & BRONCHIOLITIS
IM ASTHMA & BRONCHIOLITIS w/CC
IM ASTHMA & BRONCHIOLITIS w/MCC
IM INTERSTITIAL LUNG DISEASE
IM INTERSTITIAL LUNG DISEASE w/CC
IM INTERSTITIAL LUNG DISEASE w/MCC
IM PNEUMOTHORAX & PLEURAL EFFUSION
IM PNEUMOTHORAX & PLEURAL EFFUSION w/CC
IM PNEUMOTHORAX & PLEURAL EFFUSION w/MCC
IM RESPIRATORY SYSTEM SIGNS, SYMPTOMS & OTHER DIAGNOSES
IM RESPIRATORY SYSTEM SIGNS, SYMPTOMS & OTHER DIAGNOSES w/CC
IM RESPIRATORY SYSTEM SIGNS, SYMPTOMS & OTHER DIAGNOSES w/MCC
IP HEART &/OR LUNG TRANSPLANTATION
IP HEART &/OR LUNG TRANSPLANTATION w/CC
IP HEART &/OR LUNG TRANSPLANTATION w/MCC
IP CARDIAC VALVE PROCEDURES WITH CARDIAC CATHETERIZATION

IP CARDIAC VALVE PROCEDURES WITH CARDIAC CATHETERIZATION w/CC
IP CARDIAC VALVE PROCEDURES WITH CARDIAC CATHETERIZATION w/MCC
IP COMPLEX CARDIOTHORACIC REPAIR OF HEART ANOMALY
IP COMPLEX CARDIOTHORACIC REPAIR OF HEART ANOMALY w/CC
IP COMPLEX CARDIOTHORACIC REPAIR OF HEART ANOMALY w/MCC
IP CARDIAC VALVE PROCEDURES WITHOUT CARDIAC CATHETERIZATION
IP CARDIAC VALVE PROCEDURES WITHOUT CARDIAC CATHETERIZATION w/CC
IP CARDIAC VALVE PROCEDURES WITHOUT CARDIAC CATHETERIZATION w/MCC
IP CORONARY BYPASS WITH CARDIAC CATHETERIZATION
IP CORONARY BYPASS WITH CARDIAC CATHETERIZATION w/CC
IP CORONARY BYPASS WITH CARDIAC CATHETERIZATION w/MCC
IP OTHER CARDIOTHORACIC PROCEDURES
IP OTHER CARDIOTHORACIC PROCEDURES w/CC
IP OTHER CARDIOTHORACIC PROCEDURES w/MCC
IP CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION
IP CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION w/CC
IP CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION w/MCC
IP CARDIAC DEFIBRILLATOR & HEART ASSIST SYSTEM INSERTION
IP CARDIAC DEFIBRILLATOR & HEART ASSIST SYSTEM INSERTION w/CC
IP CARDIAC DEFIBRILLATOR & HEART ASSIST SYSTEM INSERTION w/MCC
IP COMPLEX THORACIC VASCULAR PROCEDURES
IP COMPLEX THORACIC VASCULAR PROCEDURES w/CC
IP COMPLEX THORACIC VASCULAR PROCEDURES w/MCC
IP COMPLEX ABDOMINAL VASCULAR PROCEDURES
IP COMPLEX ABDOMINAL VASCULAR PROCEDURES w/CC
IP COMPLEX ABDOMINAL VASCULAR PROCEDURES w/MCC
IP PERMANENT CARDIAC PACEMAKER INSERTION
IP PERMANENT CARDIAC PACEMAKER INSERTION w/CC
IP PERMANENT CARDIAC PACEMAKER INSERTION w/MCC
IP CARDIAC CATHETERIZATION
IP CARDIAC CATHETERIZATION w/CC
IP CARDIAC CATHETERIZATION w/MCC
IP CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT
IP CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT w/CC
IP CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT w/MCC
IP VEIN LIGATION & STRIPPING
IP VEIN LIGATION & STRIPPING w/CC
IP VEIN LIGATION & STRIPPING w/MCC
IP OTHER CIRCULATORY SYSTEM PROCEDURES
IP OTHER CIRCULATORY SYSTEM PROCEDURES w/CC
IP OTHER CIRCULATORY SYSTEM PROCEDURES w/MCC
IP CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT
IP CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT w/CC
IP CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT w/MCC
IP PERCUTANEOUS CARDIOVASCULAR PROCEDURES
IP PERCUTANEOUS CARDIOVASCULAR PROCEDURES w/CC
IP PERCUTANEOUS CARDIOVASCULAR PROCEDURES w/MCC

IM ACUTE MYOCARDIAL INFARCTION
IM ACUTE MYOCARDIAL INFARCTION w/CC
IM ACUTE MYOCARDIAL INFARCTION w/MCC
IM ACUTE & SUBACUTE ENDOCARDITIS
IM ACUTE & SUBACUTE ENDOCARDITIS w/CC
IM ACUTE & SUBACUTE ENDOCARDITIS w/MCC
IM HEART FAILURE
IM HEART FAILURE w/CC
IM HEART FAILURE w/MCC
IM DEEP VEIN THROMBOPHLEBITIS
IM DEEP VEIN THROMBOPHLEBITIS w/CC
IM DEEP VEIN THROMBOPHLEBITIS w/MCC
IM CARDIAC ARREST, UNEXPLAINED
IM CARDIAC ARREST, UNEXPLAINED w/CC
IM CARDIAC ARREST, UNEXPLAINED w/MCC
IM PERIPHERAL & OTHER VASCULAR DISORDERS
IM PERIPHERAL & OTHER VASCULAR DISORDERS w/CC
IM PERIPHERAL & OTHER VASCULAR DISORDERS w/MCC
IM ATHEROSCLEROSIS
IM ATHEROSCLEROSIS w/CC
IM ATHEROSCLEROSIS w/MCC
IM HYPERTENSION
IM HYPERTENSION w/CC
IM HYPERTENSION w/MCC
IM CARDIAC CONGENITAL & VALVULAR DISORDERS
IM CARDIAC CONGENITAL & VALVULAR DISORDERS w/CC
IM CARDIAC CONGENITAL & VALVULAR DISORDERS w/MCC
IM CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS
IM CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS w/CC
IM CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS w/MCC
IM ANGINA PECTORIS & CHEST PAIN
IM ANGINA PECTORIS & CHEST PAIN w/CC
IM ANGINA PECTORIS & CHEST PAIN w/MCC
IM SYNCOPE & COLLAPSE
IM SYNCOPE & COLLAPSE w/CC
IM SYNCOPE & COLLAPSE w/MCC
IM CARDIOMYOPATHY
IM CARDIOMYOPATHY w/CC
IM CARDIOMYOPATHY w/MCC
IM MALFUNCTION, REACTION & COMPLICATION OF CARDIAOVASCOLAR DEVICE OR PROCEDURE
IM MALFUNCTION, REACTION & COMPLICATION OF CARDIAOVASCOLAR DEVICE OR PROCEDURE w/CC
IM MALFUNCTION, REACTION & COMPLICATION OF CARDIAOVASCOLAR DEVICE OR PROCEDURE w/MCC
IM OTHER CIRCULATORY SYSTEM DIAGNOSES
IM OTHER CIRCULATORY SYSTEM DIAGNOSES w/CC
IM OTHER CIRCULATORY SYSTEM DIAGNOSES w/MCC
IP NON-COMPLEX SMALL & LARGE BOWEL PROCEDURES
IP NON-COMPLEX SMALL & LARGE BOWEL PROCEDURES w/CC

IP NON-COMPLEX SMALL & LARGE BOWEL PROCEDURES w/MCC
IP PERITONEAL ADHESIOLYSIS
IP PERITONEAL ADHESIOLYSIS w/CC
IP PERITONEAL ADHESIOLYSIS w/MCC
IP HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL
IP HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL w/CC
IP HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL w/MCC
IP APPENDICEAL PROCEDURES
IP APPENDICEAL PROCEDURES w/CC
IP APPENDICEAL PROCEDURES w/MCC
IP INGUINAL & FEMORAL HERNIA PROCEDURES
IP INGUINAL & FEMORAL HERNIA PROCEDURES w/CC
IP INGUINAL & FEMORAL HERNIA PROCEDURES w/MCC
IP COMPLEX INTESTINAL PROCEDURES
IP COMPLEX INTESTINAL PROCEDURES w/CC
IP COMPLEX INTESTINAL PROCEDURES w/MCC
IP NON-COMPLEX STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES
IP NON-COMPLEX STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES w/CC
IP NON-COMPLEX STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES w/MCC
IP OTHER DIGESTIVE SYSTEM PROCEDURES
IP OTHER DIGESTIVE SYSTEM PROCEDURES w/CC
IP OTHER DIGESTIVE SYSTEM PROCEDURES w/MCC
IP ANAL PROCEDURES
IP ANAL PROCEDURES w/CC
IP ANAL PROCEDURES w/MCC
IM DIGESTIVE MALIGNANCY
IM DIGESTIVE MALIGNANCY w/CC
IM DIGESTIVE MALIGNANCY w/MCC
IM PEPTIC ULCER & GASTRITIS
IM PEPTIC ULCER & GASTRITIS w/CC
IM PEPTIC ULCER & GASTRITIS w/MCC
IM ESOPHAGEAL DISORDERS
IM ESOPHAGEAL DISORDERS w/CC
IM ESOPHAGEAL DISORDERS w/MCC
IM DIVERTICULITIS, DIVERTICULOSIS & INFLAMMATORY BOWEL DISEASE
IM DIVERTICULITIS, DIVERTICULOSIS & INFLAMMATORY BOWEL DISEASE w/CC
IM DIVERTICULITIS, DIVERTICULOSIS & INFLAMMATORY BOWEL DISEASE w/MCC
IM GASTROINTESTINAL VASCULAR INSUFFICIENCY
IM GASTROINTESTINAL VASCULAR INSUFFICIENCY w/CC
IM GASTROINTESTINAL VASCULAR INSUFFICIENCY w/MCC
IM GASTROINTESTINAL OBSTRUCTION
IM GASTROINTESTINAL OBSTRUCTION w/CC
IM GASTROINTESTINAL OBSTRUCTION w/MCC
IM MAJOR GASTROINTESTINAL INFECTIONS
IM MAJOR GASTROINTESTINAL INFECTIONS w/CC
IM MAJOR GASTROINTESTINAL INFECTIONS w/MCC
IM OTHER GASTROENTERITIS & ABDOMINAL PAIN

IM OTHER GASTROENTERITIS & ABDOMINAL PAIN w/CC
IM OTHER GASTROENTERITIS & ABDOMINAL PAIN w/MCC
IM OTHER DIGESTIVE SYSTEM DIAGNOSES
IM OTHER DIGESTIVE SYSTEM DIAGNOSES w/CC
IM OTHER DIGESTIVE SYSTEM DIAGNOSES w/MCC
IP LIVER TRANSPLANTATION
IP LIVER TRANSPLANTATION w/CC
IP LIVER TRANSPLANTATION w/MCC
IP PANCREAS & LIVER PROCEDURES
IP PANCREAS & LIVER PROCEDURES w/CC
IP PANCREAS & LIVER PROCEDURES w/MCC
IP COMPLEX BILIARY TRACT PROCEDURES
IP COMPLEX BILIARY TRACT PROCEDURES w/CC
IP COMPLEX BILIARY TRACT PROCEDURES w/MCC
IP CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC
IP CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC w/CC
IP CHOLECYSTECTOMY EXCEPT LAPAROSCOPIC w/MCC
IP OTHER HEPATOBILIARY & PANCREAS PROCEDURES
IP OTHER HEPATOBILIARY & PANCREAS PROCEDURES w/CC
IP OTHER HEPATOBILIARY & PANCREAS PROCEDURES w/MCC
IP LAPAROSCOPIC CHOLECYSTECTOMY
IP LAPAROSCOPIC CHOLECYSTECTOMY w/CC
IP LAPAROSCOPIC CHOLECYSTECTOMY w/MCC
IM CIRRHOSIS & ALCOHOLIC HEPATITIS
IM CIRRHOSIS & ALCOHOLIC HEPATITIS w/CC
IM CIRRHOSIS & ALCOHOLIC HEPATITIS w/MCC
IM MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS
IM MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS w/CC
IM MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS w/MCC
IM PANCREAS DISORDERS EXCEPT MALIGNANCY
IM PANCREAS DISORDERS EXCEPT MALIGNANCY w/CC
IM PANCREAS DISORDERS EXCEPT MALIGNANCY w/MCC
IM LIVER DISORDERS EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS
IM LIVER DISORDERS EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS w/CC
IM LIVER DISORDERS EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS w/MCC
IM OTHER BILIARY TRACT DISORDERS
IM OTHER BILIARY TRACT DISORDERS w/CC
IM OTHER BILIARY TRACT DISORDERS w/MCC
IP BILATERAL & MULTIPLE MAJOR LOWER EXTREMITY JOINT PROCEDURES
IP BILATERAL & MULTIPLE MAJOR LOWER EXTREMITY JOINT PROCEDURES w/CC
IP BILATERAL & MULTIPLE MAJOR LOWER EXTREMITY JOINT PROCEDURES w/MCC
IP AMPUTATION
IP AMPUTATION w/CC
IP AMPUTATION w/MCC
IP MAJOR LOWER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES
IP MAJOR LOWER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES w/CC
IP MAJOR LOWER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES w/MCC

IP MAJOR UPPER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES
IP MAJOR UPPER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES w/CC
IP MAJOR UPPER EXTREMITY JOINT & LIMB REATTACHMENT PROCEDURES w/MCC
IP SPINAL FUSION PROCEDURES FOR CURVATURE OF THE SPINE
IP SPINAL FUSION PROCEDURES FOR CURVATURE OF THE SPINE w/CC
IP SPINAL FUSION PROCEDURES FOR CURVATURE OF THE SPINE w/MCC
IP SPINAL FUSION PROCEDURES EXCEPT FOR CURVATURE OF THE SPINE
IP SPINAL FUSION PROCEDURES EXCEPT FOR CURVATURE OF THE SPINE w/CC
IP SPINAL FUSION PROCEDURES EXCEPT FOR CURVATURE OF THE SPINE w/MCC
IP CRANIAL & FACIAL BONE RECONSTRUCTIVE PROCEDURES
IP CRANIAL & FACIAL BONE RECONSTRUCTIVE PROCEDURES w/CC
IP CRANIAL & FACIAL BONE RECONSTRUCTIVE PROCEDURES w/MCC
IP HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT
IP HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT w/CC
IP HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT w/MCC
IP FOOT PROCEDURES
IP FOOT PROCEDURES w/CC
IP FOOT PROCEDURES w/MCC
IP LOCAL EXCISION & REMOVAL OF INTERNAL FIXATION DEVICE
IP LOCAL EXCISION & REMOVAL OF INTERNAL FIXATION DEVICE w/CC
IP LOCAL EXCISION & REMOVAL OF INTERNAL FIXATION DEVICE w/MCC
IP SOFT TISSUE PROCEDURES
IP SOFT TISSUE PROCEDURES w/CC
IP SOFT TISSUE PROCEDURES w/MCC
IP OTHER MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE PROCEDURES
IP OTHER MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE PROCEDURES w/CC
IP OTHER MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE PROCEDURES w/MCC
IP KNEE & LOWER LEG PROCEDURES EXCEPT FOOT
IP KNEE & LOWER LEG PROCEDURES EXCEPT FOOT w/CC
IP KNEE & LOWER LEG PROCEDURES EXCEPT FOOT w/MCC
IP UPPER EXTREMITY PROCEDURES
IP UPPER EXTREMITY PROCEDURES w/CC
IP UPPER EXTREMITY PROCEDURES w/MCC
IM FRACTURES OF FEMUR
IM FRACTURES OF FEMUR w/CC
IM FRACTURES OF FEMUR w/MCC
IM FRACTURE OF PELVIS OR DISLOCATION OF HIP
IM FRACTURE OF PELVIS OR DISLOCATION OF HIP w/CC
IM FRACTURE OF PELVIS OR DISLOCATION OF HIP w/MCC
IM FRACTURE OR DISLOCATION EXCEPT FEMUR & PELVIS
IM FRACTURE OR DISLOCATION EXCEPT FEMUR & PELVIS w/CC
IM FRACTURE OR DISLOCATION EXCEPT FEMUR & PELVIS w/MCC
IM MUSCULOSKELETAL & CONNECTIVE TISSUE MALIGNANCY & PATHOLOGICAL FRACTURES
IM MUSCULOSKELETAL & CONNECTIVE TISSUE MALIGNANCY & PATHOLOGICAL FRACTURES w/CC
IM MUSCULOSKELETAL & CONNECTIVE TISSUE MALIGNANCY & PATHOLOGICAL FRACTURES w/MCC
IM OSTEOMYELITIS
IM OSTEOMYELITIS w/CC
IM OSTEOMYELITIS w/MCC
IM SEPTIC ARTHRITIS
IM SEPTIC ARTHRITIS w/CC
IM SEPTIC ARTHRITIS w/MCC
IM CONNECTIVE TISSUE DISORDERS
IM CONNECTIVE TISSUE DISORDERS w/CC
IM CONNECTIVE TISSUE DISORDERS w/MCC
IM MEDICAL BACK PROBLEMS
IM MEDICAL BACK PROBLEMS w/CC
IM MEDICAL BACK PROBLEMS w/MCC
IM OTHER BONE & JOINT DISEASES
IM OTHER BONE & JOINT DISEASES w/CC
IM OTHER BONE & JOINT DISEASES w/MCC
IM MALFUNCTION, REACTION OR COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
IM MALFUNCTION, REACTION OR COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE w/CC
IM MALFUNCTION, REACTION OR COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE w/MCC
IM MUSCULOSKELETAL SIGNS, SYMPTOMS, SPRAINS & MINOR INFLAMMATIONS
IM MUSCULOSKELETAL SIGNS, SYMPTOMS, SPRAINS & MINOR INFLAMMATIONS w/CC
IM MUSCULOSKELETAL SIGNS, SYMPTOMS, SPRAINS & MINOR INFLAMMATIONS w/MCC
IM OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES
IM OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES w/CC
IM OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES w/MCC
IP SKIN GRAFT WITH BURNS
IP SKIN GRAFT WITH BURNS w/CC
IP SKIN GRAFT WITH BURNS w/MCC
IP SKIN GRAFT WITHOUT BURNS
IP SKIN GRAFT WITHOUT BURNS w/CC
IP SKIN GRAFT WITHOUT BURNS w/MCC
IP OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST PROCEDURES
IP OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST PROCEDURES w/CC
IP OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST PROCEDURES w/MCC
IP BREAST PROCEDURES
IP BREAST PROCEDURES w/CC
IP BREAST PROCEDURES w/MCC
IM MAJOR SKIN DISORDERS
IM MAJOR SKIN DISORDERS w/CC
IM MAJOR SKIN DISORDERS w/MCC
IM MALIGNANT BREAST DISORDERS
IM MALIGNANT BREAST DISORDERS w/CC
IM MALIGNANT BREAST DISORDERS w/MCC
IM CELLULITIS
IM CELLULITIS w/CC
IM CELLULITIS w/MCC
IM TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE & BREAST
IM TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE & BREAST w/CC
IM TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE & BREAST w/MCC
IM OTHER SKIN & BREAST DISORDERS

IM OTHER SKIN & BREAST DISORDERS w/CC
IM OTHER SKIN & BREAST DISORDERS w/MCC
IP PITUITARY & PINEAL PROCEDURES
IP PITUITARY & PINEAL PROCEDURES w/CC
IP PITUITARY & PINEAL PROCEDURES w/MCC
IP ADRENAL PROCEDURES
IP ADRENAL PROCEDURES w/CC
IP ADRENAL PROCEDURES w/MCC
IP THYROID, PARATHYROID & THYROGLOSSAL DUCT PROCEDURES
IP THYROID, PARATHYROID & THYROGLOSSAL DUCT PROCEDURES w/CC
IP THYROID, PARATHYROID & THYROGLOSSAL DUCT PROCEDURES w/MCC
IM DIABETES AND NUTRITIONAL & MISC METABOLIC DISORDERS
IM DIABETES AND NUTRITIONAL & MISC METABOLIC DISORDERS w/CC
IM DIABETES AND NUTRITIONAL & MISC METABOLIC DISORDERS w/MCC
IM HYPOVOLEMIA & ELECTROLYTE DISORDERS
IM HYPOVOLEMIA & ELECTROLYTE DISORDERS w/CC
IM HYPOVOLEMIA & ELECTROLYTE DISORDERS w/MCC
IM INBORN ERRORS OF METABOLISM
IM INBORN ERRORS OF METABOLISM w/CC
IM INBORN ERRORS OF METABOLISM w/MCC
IM OTHER ENDOCRINE DISORDERS
IM OTHER ENDOCRINE DISORDERS w/CC
IM OTHER ENDOCRINE DISORDERS w/MCC
IP KIDNEY TRANSPLANTATION
IP KIDNEY TRANSPLANTATION w/CC
IP KIDNEY TRANSPLANTATION w/MCC
IP COMPLEX BLADDER PROCEDURES
IP COMPLEX BLADDER PROCEDURES w/CC
IP COMPLEX BLADDER PROCEDURES w/MCC
IP CREATE, REVISE, REMOVE DIALYSIS DEVICE
IP CREATE, REVISE, REMOVE DIALYSIS DEVICE w/CC
IP CREATE, REVISE, REMOVE DIALYSIS DEVICE w/MCC
IP UPPER URINARY TRACT PROCEDURES
IP UPPER URINARY TRACT PROCEDURES w/CC
IP UPPER URINARY TRACT PROCEDURES w/MCC
IP BLADDER & LOWER URINARY TRACT PROCEDURES
IP BLADDER & LOWER URINARY TRACT PROCEDURES w/CC
IP BLADDER & LOWER URINARY TRACT PROCEDURES w/MCC
IP URETHRAL & TRANSURETHRAL PROCEDURES
IP URETHRAL & TRANSURETHRAL PROCEDURES w/CC
IP URETHRAL & TRANSURETHRAL PROCEDURES w/MCC
IM KIDNEY & URINARY TRACT MALIGNANCY & RENAL FAILURE
IM KIDNEY & URINARY TRACT MALIGNANCY & RENAL FAILURE w/CC
IM KIDNEY & URINARY TRACT MALIGNANCY & RENAL FAILURE w/MCC
IM NEPHRITIS
IM NEPHRITIS w/CC
IM NEPHRITIS w/MCC
IM KIDNEY & URINARY TRACT INFECTIONS
IM KIDNEY & URINARY TRACT INFECTIONS w/CC
IM KIDNEY & URINARY TRACT INFECTIONS w/MCC
IM URINARY STONES
IM URINARY STONES w/CC
IM URINARY STONES w/MCC
IM MALFUNCTION, REACTION OR COMPLICATION OF URINARY TRACT DEVICE, GRAFT OR TRANSPLANTATION
IM MALFUNCTION, REACTION OR COMPLICATION OF URINARY TRACT DEVICE, GRAFT OR TRANSPLANTATION w/CC
IM MALFUNCTION, REACTION OR COMPLICATION OF URINARY TRACT DEVICE, GRAFT OR TRANSPLANTATION w/MCC
IM KIDNEY & URINARY TRACT SIGNS & SYMPTOMS
IM KIDNEY & URINARY TRACT SIGNS & SYMPTOMS w/CC
IM KIDNEY & URINARY TRACT SIGNS & SYMPTOMS w/MCC
IM OTHER KIDNEY & URINARY TRACT DIAGNOSES
IM OTHER KIDNEY & URINARY TRACT DIAGNOSES w/CC
IM OTHER KIDNEY & URINARY TRACT DIAGNOSES w/MCC
IP COMPLEX PROSTATECTOMY PROCEDURES
IP COMPLEX PROSTATECTOMY PROCEDURES w/CC
IP COMPLEX PROSTATECTOMY PROCEDURES w/MCC
IP PENIS PROCEDURES
IP PENIS PROCEDURES w/CC
IP PENIS PROCEDURES w/MCC
IP MODERATELY COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES
IP MODERATELY COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES w/CC
IP MODERATELY COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES w/MCC
IP NON-COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES
IP NON-COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES w/CC
IP NON-COMPLEX PROSTATE & SCROTAL CONTENTS PROCEDURES w/MCC
IP TRANSURETHRAL PROSTATECTOMY
IP TRANSURETHRAL PROSTATECTOMY w/CC
IP TRANSURETHRAL PROSTATECTOMY w/MCC
IP CIRCUMCISION
IP CIRCUMCISION w/CC
IP CIRCUMCISION w/MCC
IM MALE REPRODUCTIVE SYSTEM MALIGNANCY
IM MALE REPRODUCTIVE SYSTEM MALIGNANCY w/CC
IM MALE REPRODUCTIVE SYSTEM MALIGNANCY w/MCC
IM MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY
IM MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY w/CC
IM MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY w/MCC
IP PELVIC EVISCERATION, RADICAL HYSTERECTECTOMY & RADICAL VULVECTOMY
IP PELVIC EVISCERATION, RADICAL HYSTERECTECTOMY & RADICAL VULVECTOMY w/CC
IP PELVIC EVISCERATION, RADICAL HYSTERECTECTOMY & RADICAL VULVECTOMY w/MCC
IP ABORTION PROCEDURES
IP ABORTION PROCEDURES w/CC
IP ABORTION PROCEDURES w/MCC
IP DILATION & CURETTAGE, INTRAUTERINE & CERVICAL PROCEDURES
IP DILATION & CURETTAGE, INTRAUTERINE & CERVICAL PROCEDURES w/CC

IP DILATION & CURETTAGE, INTRAUTERINE & CERVICAL PROCEDURES w/MCC
IP OPEN TUBAL INTERRUPTION
IP OPEN TUBAL INTERRUPTION w/CC
IP OPEN TUBAL INTERRUPTION w/MCC
IP ENDOSCOPIC TUBAL INTERRUPTION
IP ENDOSCOPIC TUBAL INTERRUPTION w/CC
IP ENDOSCOPIC TUBAL INTERRUPTION w/MCC
IP UTERINE & ADNEXAL PROCEDURES
IP UTERINE & ADNEXAL PROCEDURES w/CC
IP UTERINE & ADNEXAL PROCEDURES w/MCC
IP VAGINA, CERVIX & VULVA PROCEDURES
IP VAGINA, CERVIX & VULVA PROCEDURES w/CC
IP VAGINA, CERVIX & VULVA PROCEDURES w/MCC
IM FEMALE REPRODUCTIVE SYSTEM MALIGNANCY
IM FEMALE REPRODUCTIVE SYSTEM MALIGNANCY w/CC
IM FEMALE REPRODUCTIVE SYSTEM MALIGNANCY w/MCC
IM FEMALE REPRODUCTIVE SYSTEM INFECTIONS
IM FEMALE REPRODUCTIVE SYSTEM INFECTIONS w/CC
IM FEMALE REPRODUCTIVE SYSTEM INFECTIONS w/MCC
IM MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
IM MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS w/CC
IM MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS w/MCC
IM ABORTION
IM ABORTION w/CC
IM ABORTION w/MCC
IM THREATENED ABORTION
IM THREATENED ABORTION w/CC
IM THREATENED ABORTION w/MCC
IM FALSE LABOR
IM FALSE LABOR w/CC
IM FALSE LABOR w/MCC
IM ANTEPARTUM DISORDERS
IM ANTEPARTUM DISORDERS w/CC
IM ANTEPARTUM DISORDERS w/MCC
IM POSTPARTUM DISORDERS
IM POSTPARTUM DISORDERS w/CC
IM POSTPARTUM DISORDERS w/MCC
IP CESAREAN DELIVERY
IP CESAREAN DELIVERY w/CC
IP CESAREAN DELIVERY w/MCC
IP VAGINAL DELIVERY WITH STERILIZATION &/OR DILATION & CURETTAGE
IP VAGINAL DELIVERY WITH STERILIZATION &/OR DILATION & CURETTAGE w/CC
IP VAGINAL DELIVERY WITH STERILIZATION &/OR DILATION & CURETTAGE w/MCC
IP VAGINAL DELIVERY WITH PROCEDURE EXCEPT STERILIZATION &/OR DILATION & CURETTAGE
IP VAGINAL DELIVERY WITH PROCEDURE EXCEPT STERILIZATION &/OR DILATION & CURETTAGE w/CC
IP VAGINAL DELIVERY WITH PROCEDURE EXCEPT STERILIZATION &/OR DILATION & CURETTAGE w/MCC
IM VAGINAL DELIVERY
IM VAGINAL DELIVERY w/CC
IM VAGINAL DELIVERY w/MCC
IP NEONATE, W ORGAN TRANSPLANTATION OR EXTRACORPOREAL MEMBRANE OXYGENATION
IP NEONATE, W ORGAN TRANSPLANTATION OR EXTRACORPOREAL MEMBRANE OXYGENATION w/CC
IP NEONATE, W ORGAN TRANSPLANTATION OR EXTRACORPOREAL MEMBRANE OXYGENATION w/MCC
IP NEONATE, BIRTHWT <1000 GRAMS WITH MAJOR PROCEDURE
IP NEONATE, BIRTHWT <1000 GRAMS WITH MAJOR PROCEDURE w/CC
IP NEONATE, BIRTHWT <1000 GRAMS WITH MAJOR PROCEDURE w/MCC
IP NEONATE, BIRTHWT <1000 GRAMS WITHOUT MAJOR PROCEDURE
IP NEONATE, BIRTHWT <1000 GRAMS WITHOUT MAJOR PROCEDURE w/CC
IP NEONATE, BIRTHWT <1000 GRAMS WITHOUT MAJOR PROCEDURE w/MCC
IP NEONATE, BIRTHWT 1000-1499 GRAMS WITH MAJOR PROCEDURE
IP NEONATE, BIRTHWT 1000-1499 GRAMS WITH MAJOR PROCEDURE w/CC
IP NEONATE, BIRTHWT 1000-1499 GRAMS WITH MAJOR PROCEDURE w/MCC
IP NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR PROCEDURE
IP NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR PROCEDURE w/CC
IP NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR PROCEDURE w/MCC
IP NEONATE, BIRTHWT >2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME
IP NEONATE, BIRTHWT >2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME w/CC
IP NEONATE, BIRTHWT >2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME w/MCC
IM NEONATE, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY
IM NEONATE, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY w/CC
IM NEONATE, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY w/MCC
IM NEONATE, BIRTHWT 1000-1499 GRAMS WITHOUT MAJOR PROCEDURE
IM NEONATE, BIRTHWT 1000-1499 GRAMS WITHOUT MAJOR PROCEDURE w/CC
IM NEONATE, BIRTHWT 1000-1499 GRAMS WITHOUT MAJOR PROCEDURE w/MCC
IM NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR ANOMALY OR HEREDITARY CONDITION
IM NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR ANOMALY OR HEREDITARY CONDITION w/CC
IM NEONATE, BIRTHWT >2499 GRAMS WITH MAJOR ANOMALY OR HEREDITARY CONDITION w/MCC
IM NEONATE, BIRTHWT >2499 GRAMS WITH ASPIRATION SYNDROME
IM NEONATE, BIRTHWT >2499 GRAMS WITH ASPIRATION SYNDROME w/CC
IM NEONATE, BIRTHWT >2499 GRAMS WITH ASPIRATION SYNDROME w/MCC
IM NEONATE, BIRTHWT >2499 GRAMS WITH CONGENITAL/PERINATAL INFECTIONS
IM NEONATE, BIRTHWT >2499 GRAMS WITH CONGENITAL/PERINATAL INFECTIONS w/CC
IM NEONATE, BIRTHWT >2499 GRAMS WITH CONGENITAL/PERINATAL INFECTIONS w/MCC

IM NEONATE, BIRTHWT >2499 GRAMS WITHOUT MAJOR PROCEDURE
IM NEONATE, BIRTHWT >2499 GRAMS WITHOUT MAJOR PROCEDURE w/CC
IM NEONATE, BIRTHWT >2499 GRAMS WITHOUT MAJOR PROCEDURE w/MCC
IP BONE MARROW TRANSPLANTATION
IP BONE MARROW TRANSPLANTATION w/CC
IP BONE MARROW TRANSPLANTATION w/MCC
IP SPLEEN PROCEDURES
IP SPLEEN PROCEDURES w/CC
IP SPLEEN PROCEDURES w/MCC
IP OTHER PROCEDURES OF BLOOD & BLOOD FORMING ORGANS
IP OTHER PROCEDURES OF BLOOD & BLOOD FORMING ORGANS w/CC
IP OTHER PROCEDURES OF BLOOD & BLOOD FORMING ORGANS w/MCC
IM AGRANULOCYTOSIS
IM AGRANULOCYTOSIS w/CC
IM AGRANULOCYTOSIS w/MCC
IM COAGULATION DISORDERS
IM COAGULATION DISORDERS w/CC
IM COAGULATION DISORDERS w/MCC
IM SICKLE CELL ANEMIA CRISIS
IM SICKLE CELL ANEMIA CRISIS w/CC
IM SICKLE CELL ANEMIA CRISIS w/MCC
IM RED BLOOD CELL DISORDERS EXCEPT SICKLE CELL ANEMIA CRISIS
IM RED BLOOD CELL DISORDERS EXCEPT SICKLE CELL ANEMIA CRISIS w/CC
IM RED BLOOD CELL DISORDERS EXCEPT SICKLE CELL ANEMIA CRISIS w/MCC
IM OTHER BLOOD & BLOOD FORMING ORGANS DISORDERS
IM OTHER BLOOD & BLOOD FORMING ORGANS DISORDERS w/CC
IM OTHER BLOOD & BLOOD FORMING ORGANS DISORDERS w/MCC
IM ACUTE LEUKEMIA
IM ACUTE LEUKEMIA w/CC
IM ACUTE LEUKEMIA w/MCC
IM LYMPHOMA & NON-ACUTE LEUKEMIA
IM LYMPHOMA & NON-ACUTE LEUKEMIA w/CC
IM LYMPHOMA & NON-ACUTE LEUKEMIA w/MCC
IM RADIOTHERAPY
IM RADIOTHERAPY w/CC
IM RADIOTHERAPY w/MCC
IM CHEMOTHERAPY
IM CHEMOTHERAPY w/CC
IM CHEMOTHERAPY w/MCC
IM OTHER MYELOPROLIF DISORDERS & POORLY DIFFERENTIATED NEOPLASM DIAGNOSIS
IM OTHER MYELOPROLIF DISORDERS & POORLY DIFFERENTIATED NEOPLASM DIAGNOSIS w/CC
IM OTHER MYELOPROLIF DISORDERS & POORLY DIFFERENTIATED NEOPLASM DIAGNOSIS w/MCC
IM SEPTICEMIA
IM SEPTICEMIA w/CC
IM SEPTICEMIA w/MCC
IM POST-OPERATIVE & POST-TRAUMATIC INFECTIONS
IM POST-OPERATIVE & POST-TRAUMATIC INFECTIONS w/CC

IM POST-OPERATIVE & POST-TRAUMATIC INFECTIONS w/MCC
IM FEVER
IM FEVER w/CC
IM FEVER w/MCC
IM NON-BACTERIAL INFECTIONS
IM NON-BACTERIAL INFECTIONS w/CC
IM NON-BACTERIAL INFECTIONS w/MCC
IM OTHER BACTERIAL & PARASITIC DISEASES
IM OTHER BACTERIAL & PARASITIC DISEASES w/CC
IM OTHER BACTERIAL & PARASITIC DISEASES w/MCC
IM HUMAN IMMUNODEFICIENCY VIRUS INFECTION
IM HUMAN IMMUNODEFICIENCY VIRUS INFECTION w/CC
IM HUMAN IMMUNODEFICIENCY VIRUS INFECTION w/MCC
IM SCHIZOPHRENIA
IM SCHIZOPHRENIA w/CC
IM SCHIZOPHRENIA w/MCC
IM MAJOR DEPRESSION
IM MAJOR DEPRESSION w/CC
IM MAJOR DEPRESSION w/MCC
IM PERSONALITY & IMPULSE CONTROL DISORDERS
IM PERSONALITY & IMPULSE CONTROL DISORDERS w/CC
IM PERSONALITY & IMPULSE CONTROL DISORDERS w/MCC
IM BIPOLAR DISORDERS
IM BIPOLAR DISORDERS w/CC
IM BIPOLAR DISORDERS w/MCC
IM DEPRESSION
IM DEPRESSION w/CC
IM DEPRESSION w/MCC
IM NEUROSES EXCEPT DEPRESSION
IM NEUROSES EXCEPT DEPRESSION w/CC
IM NEUROSES EXCEPT DEPRESSION w/MCC
IM ORGANIC DISTURBANCES & MENTAL RETARDATION
IM ORGANIC DISTURBANCES & MENTAL RETARDATION w/CC
IM ORGANIC DISTURBANCES & MENTAL RETARDATION w/MCC
IM CHILDHOOD MENTAL DISORDERS
IM CHILDHOOD MENTAL DISORDERS w/CC
IM CHILDHOOD MENTAL DISORDERS w/MCC
IM COMPULSIVE NUTRITION DISORDERS
IM COMPULSIVE NUTRITION DISORDERS w/CC
IM COMPULSIVE NUTRITION DISORDERS w/MCC
IM OTHER MENTAL DISORDERS
IM OTHER MENTAL DISORDERS w/CC
IM OTHER MENTAL DISORDERS w/MCC
IP ALCOHOL & DRUG REHABILITATION &/OR DETOXIFICATION THERAPY
IP ALCOHOL & DRUG REHABILITATION &/OR DETOXIFICATION THERAPY w/CC
IP ALCOHOL & DRUG REHABILITATION &/OR DETOXIFICATION THERAPY w/MCC
IM DRUG & ALCOHOL ABUSE & DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
IM DRUG & ALCOHOL ABUSE & DEPENDENCE, LEFT AGAINST MEDICAL ADVICE w/CC
IM DRUG & ALCOHOL ABUSE & DEPENDENCE, LEFT AGAINST MEDICAL ADVICE w/MCC
IM ALCOHOL, OPIOID & COCAINE ABUSE & DEPENDENCE
IM ALCOHOL, OPIOID & COCAINE ABUSE & DEPENDENCE w/CC
IM ALCOHOL, OPIOID & COCAINE ABUSE & DEPENDENCE w/MCC
IM OTHER DRUG ABUSE & DEPENDENCE
IM OTHER DRUG ABUSE & DEPENDENCE w/CC
IM OTHER DRUG ABUSE & DEPENDENCE w/MCC
IM INJURIES TO UNSPECIFIED OR MULTIPLE SITES
IM INJURIES TO UNSPECIFIED OR MULTIPLE SITES w/CC
IM INJURIES TO UNSPECIFIED OR MULTIPLE SITES w/MCC
IM ALLERGIC REACTIONS
IM ALLERGIC REACTIONS w/CC
IM ALLERGIC REACTIONS w/MCC
IM POISONING & TOXIC EFFECTS OF DRUGS
IM POISONING & TOXIC EFFECTS OF DRUGS w/CC
IM POISONING & TOXIC EFFECTS OF DRUGS w/MCC
IM COMPLICATIONS OF TREATMENT
IM COMPLICATIONS OF TREATMENT w/CC
IM COMPLICATIONS OF TREATMENT w/MCC
IM CHILD OR ADULT MALTREATMENT SYNDROME
IM CHILD OR ADULT MALTREATMENT SYNDROME w/CC
IM CHILD OR ADULT MALTREATMENT SYNDROME w/MCC
IM BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY
IM BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY w/CC
IM BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY w/MCC
IM BURNS
IM BURNS w/CC
IM BURNS w/MCC
IM OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES
IM OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES w/CC
IM OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES w/MCC
IM REHABILITATION
IM REHABILITATION w/CC
IM REHABILITATION w/MCC
IM SIGNS & SYMPTOMS
IM SIGNS & SYMPTOMS w/CC
IM SIGNS & SYMPTOMS w/MCC
IM OTHER FACTORS INFLUENCING HEALTH STATUS
IM OTHER FACTORS INFLUENCING HEALTH STATUS w/CC
IM OTHER FACTORS INFLUENCING HEALTH STATUS w/MCC
DRG Weight
1.8210
4.7347
10.8881
2.6200
4.1591
6.7725
1.6022
2.2386
6.0596
2.3263
3.1299
6.8936
0.3075
0.4511
1.2766
1.0541
1.3665
3.0365
1.2677
1.5507
2.9359
1.3178
1.6293
3.2743
2.1419
2.4856
3.6419
0.6731
1.2000
2.7150
2.0936
2.4156
7.7864
0.8592
1.6762
3.7546
0.5132
1.1773
2.0064
0.5381
0.7274
0.8825
SELF PAY RATES

ACROSS ALL
FACILITIES
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
25,493.73
66,286.34
152,432.81
36,679.35
58,228.08
94,814.84
22,430.94
31,339.87
84,834.94
32,567.74
43,819.18
96,510.62
4,305.64
6,315.96
17,872.96
14,757.42
19,131.00
42,511.64
17,747.12
21,710.29
41,102.61
18,449.53
22,810.14
45,840.76
29,987.05
34,798.82
50,986.46
9,422.72
16,800.15
38,009.39
29,309.99
33,818.34
109,009.22
12,029.05
23,466.86
52,564.95
7,184.91
16,481.84
28,089.05
7,532.83
10,184.07
12,354.51
MDC
Diseases & Disorders of the Nervous System
IP
Surgical/
medical
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
0.5283
1.3274
2.3003
1.6574
2.4718
5.3275
1.2035
2.3337
4.3438
0.5702
0.8101
1.3394
0.3670
1.1856
1.9112
0.3826
0.7596
1.4706
0.3097
0.5992
1.0200
0.4866
1.4640
4.2998
0.3229
0.8538
3.2307
0.5134
1.0714
2.1210
0.3661
0.4868
0.9092
0.5844
0.9560
0.9564
0.5529
0.8628
1.5915
0.4011
0.5297
0.6263
0.3082
0.6083
1.6569
3.6764
5.4448
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
7,395.96
18,583.33
32,204.70
23,203.37
34,605.41
74,585.13
16,849.28
32,671.11
60,813.29
7,983.31
11,341.16
18,751.91
5,138.36
16,599.03
26,756.18
5,356.64
10,634.07
20,588.77
4,335.89
8,388.72
14,280.00
6,812.81
20,495.62
60,197.79
4,520.92
11,952.73
45,229.66
7,187.52
14,999.33
29,694.25
5,125.69
6,815.30
12,728.46
8,182.10
13,383.90
13,388.98
7,740.49
12,078.69
22,281.14
5,614.73
7,416.30
8,767.98
4,315.26
8,515.53
23,196.09
51,469.96
76,227.69

Diseases & Disorders of the Eye
Diseases & Disorders of the Ear, Nose, Mouth & Throat
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IP
IP
5.9398
9.9965
10.9962
11.9958
0.6592
1.2332
1.4299
0.6022
0.8355
1.9097
0.7702
0.8418
0.9705
0.3105
0.4385
0.7233
0.6424
1.2471
13.6147
0.3985
0.8734
2.9876
1.0024
2.4048
2.6002
0.3606
0.6670
0.7920
0.2632
0.3840
0.7622
0.2646
0.4130
0.5336
0.3327
0.4838
1.8836
0.3080
0.6140
1.7372
9.5014
10.1503
15.4840
3.7532
4.0207
5.9414
2.2370
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
83,157.48
139,951.58
153,946.74
167,941.90
9,228.66
17,264.63
20,017.93
8,431.07
11,696.73
26,736.47
10,782.48
11,784.99
13,587.69
4,347.00
6,139.42
10,126.20
8,994.08
17,459.56
190,605.29
5,578.64
12,227.80
41,826.89
14,033.56
33,666.72
36,402.55
5,048.73
9,338.33
11,087.82
3,684.47
5,376.34
10,671.48
3,704.01
5,781.46
7,470.98
4,657.92
6,772.63
26,370.45
4,312.11
8,595.63
24,321.36
133,019.80
142,104.57
216,776.09
52,544.95
56,289.64
83,180.05
31,317.85

Diseases & Disorders of the Respiratory System
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IP
IP
IP
IP
IP
IP
IP
2.7721
3.0241
2.0871
2.9743
4.4339
0.9334
1.2526
3.1261
1.3767
1.4166
2.8720
1.6756
2.5316
3.9631
1.1966
1.5496
2.0693
0.1026
0.5252
1.7491
1.3898
1.4006
2.0331
1.3598
1.6721
3.4084
0.4551
0.7432
1.7280
0.8529
1.0111
1.4701
0.3815
0.6534
0.6614
0.6842
1.4956
2.4743
0.6091
1.1447
2.4893
0.3641
0.7147
1.4751
12.8837
13.1672
20.7842
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
38,809.15
42,337.25
29,219.50
41,640.31
62,074.27
13,067.04
17,536.73
43,765.73
19,274.31
19,833.04
40,208.40
23,458.00
35,442.54
55,482.99
16,752.09
21,694.37
28,970.40
1,435.91
7,352.90
24,487.36
19,457.18
19,608.82
28,463.39
19,037.55
23,409.52
47,717.54
6,371.80
10,404.26
24,192.57
11,941.05
14,155.94
20,580.83
5,340.52
9,148.09
9,259.05
9,578.11
20,938.59
34,640.51
8,527.92
16,026.33
34,849.56
5,097.29
10,006.10
20,652.09
180,372.11
184,341.23
290,979.10

Diseases & Disorders of the Circulatory System
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IP
IP
IP
5.1780
7.0586
15.0182
3.4107
6.3237
8.9011
5.1573
5.6639
7.3240
4.0881
4.6292
6.7502
2.4703
3.6317
4.6302
3.8704
4.4992
6.2583
3.9389
4.3796
5.8279
2.0108
2.8655
5.2945
3.1487
4.0694
6.9341
1.7754
2.1775
3.0808
0.6120
0.7847
1.0454
1.8423
2.5804
5.5253
0.5608
0.5618
1.1150
1.4348
2.0642
2.3449
2.8231
3.1765
5.7629
2.3217
2.4504
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
72,491.78
98,820.09
210,254.13
47,750.22
88,531.64
124,615.39
72,202.79
79,294.50
102,535.54
57,233.21
64,809.46
94,502.26
34,584.44
50,844.06
64,822.17
54,185.82
62,989.23
87,616.82
55,144.32
61,314.71
81,591.17
28,150.71
40,116.76
74,123.29
44,082.05
56,972.02
97,077.95
24,856.22
30,484.61
43,131.86
8,568.25
10,985.33
14,636.18
25,792.16
36,124.92
77,354.54
7,850.83
7,864.76
15,609.39
20,087.56
28,898.36
32,828.15
39,523.05
44,471.11
80,679.95
32,504.14
34,304.92

IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
2.5374
1.3705
2.3091
3.1305
1.2668
2.0832
3.5851
0.9447
1.1144
1.8606
0.6852
0.9954
1.2256
3.3155
3.8792
6.0116
0.8306
1.6785
2.4225
0.6520
1.4156
1.9493
0.4247
0.7847
1.1611
1.2919
2.8538
4.4972
0.5264
0.8535
1.9750
0.4393
0.5718
0.9902
0.5553
0.5570
0.8091
0.5607
0.8726
1.1845
0.8700
1.0681
2.0870
0.9735
1.2566
1.9219
1.1562
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
35,524.25
19,186.43
32,326.74
43,827.05
17,735.59
29,165.23
50,191.57
13,225.74
15,601.41
26,049.08
9,592.19
13,935.37
17,157.80
46,416.86
54,308.60
84,162.45
11,628.94
23,498.71
33,914.47
9,128.32
19,818.61
27,290.62
5,946.21
10,986.01
16,255.88
18,086.63
39,953.61
62,960.78
7,370.09
11,949.40
27,650.63
6,149.70
8,005.37
13,862.14
7,774.51
7,797.34
11,327.25
7,850.39
12,215.71
16,582.76
12,180.14
14,953.47
29,217.76
13,628.38
17,592.60
26,907.02
16,187.14

Diseases & Disorders of the Digestive System
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IP
1.8219
6.1318
0.9748
1.4889
4.4680
0.6138
1.1809
1.3709
0.6087
0.8773
1.2165
0.5254
0.7390
0.8260
1.4371
1.5370
3.9708
0.9150
1.7832
4.3801
0.7530
1.3301
2.2350
0.4024
0.6159
0.8119
1.3698
1.6305
2.7536
0.3114
0.5814
1.3932
0.2321
0.6217
1.1068
0.6613
0.8626
1.9744
0.3586
1.6836
4.7900
0.4198
0.8884
2.3553
0.9957
1.5410
3.0767
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
25,506.89
85,844.52
13,647.08
20,844.38
62,551.74
8,593.27
16,532.35
19,192.58
8,521.90
12,282.24
17,030.37
7,355.09
10,345.56
11,563.99
20,119.98
21,518.06
55,591.47
12,809.50
24,964.55
61,321.12
10,542.30
18,621.90
31,290.27
5,633.29
8,622.99
11,366.07
19,176.77
22,827.48
38,550.48
4,359.35
8,139.83
19,505.31
3,250.03
8,703.89
15,495.31
9,258.80
12,076.76
27,641.88
5,020.42
23,570.17
67,059.36
5,877.68
12,437.51
32,973.86
13,939.48
21,573.52
43,073.38

IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
0.2443
0.3971
0.5703
0.3276
0.7194
1.5380
9.9312
10.9568
19.2205
1.5654
2.3495
4.2840
1.8043
4.0280
4.8690
1.2597
1.9995
2.8216
0.9488
2.9572
3.5690
0.8317
0.8450
1.1869
0.6501
0.9368
1.4140
1.1672
1.5968
2.7559
0.7185
1.0265
2.6412
0.4484
1.0652
2.0609
0.6982
0.9733
1.4310
4.8028
5.2831
5.7633
1.2567
2.0762
3.1202
2.2406
2.4450
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
3,419.77
5,559.86
7,983.96
4,586.21
10,071.77
21,531.52
139,037.11
153,395.10
269,086.57
21,915.74
32,893.66
59,976.23
25,259.65
56,391.52
68,165.49
17,635.40
27,992.78
39,501.89
13,283.81
41,400.69
49,966.10
11,643.38
11,829.77
16,616.53
9,101.10
13,115.19
19,796.35
16,340.83
22,354.70
38,582.20
10,058.39
14,371.41
36,977.43
6,276.98
14,912.19
28,851.91
9,774.39
13,626.90
20,033.38
67,238.83
73,962.71
80,686.59
17,594.41
29,066.96
43,682.89
31,368.53
34,229.84

IM
IM
IM
IM
IM
IM
Diseases & Disorders of the Hepatobiliary System & Pancreas
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
Diseases & Disorders of the Muskuloskeletal System & Connective
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
3.5944
1.4417
1.6662
2.8380
4.4271
5.3175
7.8845
3.5433
5.8462
6.1932
2.0748
3.4420
4.0980
1.8500
2.4408
3.7282
0.7593
1.2879
1.9538
0.4487
0.8847
1.0904
0.4775
1.1489
2.0127
1.2271
2.2244
3.3793
1.0664
1.8817
2.0776
0.7830
1.3980
2.1428
1.5283
2.0198
3.3974
1.0005
1.7101
2.8514
0.4087
0.7932
2.4792
0.9352
1.7454
1.8002
1.2360
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
50,321.17
20,183.52
23,326.91
39,731.69
61,979.40
74,445.00
110,383.32
49,605.60
81,847.46
86,704.95
29,047.32
48,188.51
57,371.33
25,900.47
34,171.76
52,194.81
10,629.62
18,030.04
27,353.62
6,282.02
12,386.21
15,265.50
6,685.37
16,084.33
28,178.50
17,178.88
31,141.92
47,309.54
14,929.08
26,343.89
29,085.76
10,962.40
19,571.73
29,999.05
21,395.80
28,276.71
47,563.13
14,007.44
23,942.01
39,919.46
5,721.20
11,104.45
34,708.23
13,092.29
24,435.92
25,203.27
17,304.35

IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IP
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
1.5731
7.5117
0.7320
1.3176
2.5852
0.8949
1.4567
2.5587
0.4935
1.5077
3.9777
0.8236
1.1827
1.7809
0.5205
2.3340
4.4453
0.3510
0.5381
0.7445
0.3818
0.8284
2.0765
1.9558
2.2263
4.9963
1.4688
3.0167
5.7585
0.4186
1.5968
2.8016
0.6590
0.9994
1.2535
0.8289
1.1703
2.2030
0.8553
1.5858
1.7913
0.3415
0.6279
1.2137
0.3041
0.4437
1.8042
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
22,022.76
105,163.13
10,247.57
18,446.62
36,192.13
12,528.01
20,393.76
35,822.09
6,909.33
21,107.10
55,687.63
11,530.34
16,557.51
24,932.80
7,287.22
32,675.87
62,234.56
4,914.29
7,533.39
10,423.34
5,345.31
11,597.01
29,070.59
27,381.42
31,167.69
69,947.71
20,562.59
42,233.71
80,618.98
5,860.32
22,355.45
39,221.90
9,226.25
13,991.33
17,549.11
11,604.71
16,383.76
30,842.56
11,974.26
22,201.64
25,077.91
4,780.59
8,790.19
16,991.50
4,257.79
6,212.39
25,259.47

IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
IM
Tissue
Diseases & Disorders of the Skin, Subcutaneous Tissue & IP
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Diseases & Disorders of the Skin, Subcutaneous Tissue & IM
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
Breast
0.2948
0.6483
1.9076
2.4972
3.0149
3.9158
1.4872
1.5413
3.7401
0.7443
1.0918
2.5527
0.4974
0.7343
1.3974
0.3190
0.6036
1.0049
2.2118
3.1226
3.4065
0.4910
0.8481
2.3929
5.9707
6.6034
7.0074
1.4613
3.6209
4.1012
0.3171
0.6025
1.2936
0.7336
1.0209
1.0645
0.4742
0.8235
1.0048
0.4232
0.5885
0.7312
0.6821
1.4123
2.1849
0.5775
0.9938
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
4,127.77
9,076.35
26,706.55
34,960.45
42,208.04
54,821.46
20,820.49
21,577.57
52,361.73
10,419.80
15,284.54
35,737.85
6,963.85
10,279.70
19,562.97
4,465.73
8,450.51
14,068.22
30,965.64
43,716.87
47,691.13
6,874.13
11,873.44
33,500.83
83,590.04
92,448.18
98,103.64
20,458.57
50,692.18
57,417.28
4,439.80
8,435.26
18,110.92
10,270.80
14,292.52
14,902.41
6,638.82
11,528.67
14,067.71
5,924.59
8,239.07
10,237.35
9,548.83
19,771.72
30,589.05
8,085.07
13,913.78

Breast
Breast
Breast
Diseases & Disorders of the Endocrine, Nutritional & Metabolic
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IP
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
IM
Systems
Diseases & Disorders of the Urinary Tract
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
1.3399
0.4911
0.8192
1.3796
0.3030
0.4082
0.7918
0.7297
1.1236
1.8221
0.3021
0.5426
0.8399
0.3654
0.7879
2.1056
1.6715
1.9193
2.5216
1.2144
1.3868
2.6524
0.4015
0.6436
1.5287
0.4927
0.8529
2.6206
0.8157
1.0042
1.6087
0.1438
0.3015
0.9526
0.6926
1.4893
2.5703
0.3826
0.8577
4.3751
1.6018
1.7070
3.4986
0.4076
0.7870
1.0186
0.3702
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
18,758.76
6,875.84
11,468.31
19,314.35
4,241.89
5,714.81
11,085.82
10,216.08
15,730.01
25,509.70
4,229.56
7,597.00
11,758.91
5,115.78
11,030.69
29,478.97
23,401.23
26,869.88
35,302.01
17,002.17
19,414.56
37,133.97
5,620.90
9,010.14
21,402.26
6,897.41
11,940.16
36,689.07
11,419.85
14,058.44
22,522.38
2,013.28
4,220.36
13,336.19
9,696.65
20,850.85
35,983.51
5,355.71
12,007.69
61,251.74
22,425.46
23,897.33
48,979.73
5,706.71
11,017.69
14,260.70
5,182.12

IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
Diseases & Disorders of the Male Reproductive System IP
Diseases & Disorders of the Male Reproductive System IM
Diseases & Disorders of the Female Reproductive SystemIP
0.4800
0.7999
0.6537
0.7433
0.8264
0.7048
0.7652
1.0279
0.6611
1.1774
1.3664
0.4482
0.6317
0.6832
0.8599
1.1649
1.9804
0.3636
0.5518
3.2179
0.3372
0.5290
1.3128
0.2920
0.3430
0.8737
0.3037
0.3699
0.6458
0.3577
0.3886
0.5619
0.2695
0.3494
0.6861
0.3116
0.5311
1.3882
0.8596
0.9988
1.2180
0.5801
0.6030
0.7811
0.6583
0.8201
1.1172
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
6,719.41
11,198.09
9,152.42
10,406.12
11,569.49
9,867.60
10,713.37
14,390.03
9,255.66
16,484.11
19,130.08
6,274.34
8,843.98
9,564.75
12,038.75
16,308.23
27,726.10
5,089.81
7,724.77
45,049.94
4,721.25
7,406.55
18,379.52
4,088.16
4,801.84
12,231.67
4,251.17
5,179.23
9,041.89
5,007.26
5,439.96
7,867.08
3,772.46
4,891.61
9,605.27
4,362.81
7,435.85
19,434.84
12,034.71
13,982.85
17,052.41
8,121.33
8,442.28
10,934.90
9,216.42
11,481.94
15,641.03

Diseases & Disorders of the Female Reproductive SystemIM
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
Childbirth
IP
0.5774
0.6879
0.9446
15.0050
18.5663
21.7916
24.2098
27.7711
31.7305
4.9156
22.0868
23.8999
11.9594
15.5208
22.2529
6.5032
9.2173
13.5805
3.8445
6.8280
12.7009
2.9876
4.4032
9.4613
2.9664
6.2150
9.6283
0.4247
0.6824
12.3407
8.1363
13.3752
15.0350
3.6421
7.1798
7.8555
0.6930
2.5750
6.9712
1.7187
3.9278
8.3593
0.5818
2.4317
4.6259
2.0998
2.6697
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
8,083.94
9,630.55
13,224.91
210,069.62
259,928.30
305,082.96
338,937.33
388,796.01
444,227.24
68,818.02
309,215.21
334,598.11
167,432.13
217,290.81
311,540.32
91,044.16
129,042.83
190,127.28
53,822.72
95,592.04
177,812.11
41,826.99
61,645.00
132,457.89
41,529.24
87,009.33
134,795.87
5,946.44
9,553.85
172,770.00
113,908.70
187,253.43
210,489.60
50,989.32
100,516.86
109,977.25
9,701.71
36,050.48
97,596.65
24,061.47
54,989.37
117,030.35
8,144.60
34,043.79
64,762.67
29,396.64
37,375.86
Childbirth
Childbirth
Childbirth
Newborns & Other Neonates
IM
IM
IM
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IP
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
3.9505
0.3663
0.7928
2.4610
3.6069
9.7754
13.2483
0.8174
1.3140
2.9333
0.7911
1.4352
2.4916
0.9172
1.2568
1.8942
1.2367
1.5091
1.8377
0.6327
0.8776
1.1025
0.4455
0.5937
1.1670
0.5026
0.7445
1.7296
0.5616
2.0804
5.3007
1.2018
1.6506
3.0632
0.7908
1.1871
1.3204
0.8378
1.1636
1.3424
0.8977
1.2631
3.3563
0.7394
2.0479
4.6755
0.6030
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
55,307.47
5,127.98
11,099.49
34,454.35
50,496.00
136,855.63
185,476.87
11,444.28
18,396.64
41,066.66
11,075.67
20,093.09
34,882.26
12,840.66
17,595.51
26,518.48
17,314.00
21,127.30
25,727.13
8,857.90
12,286.31
15,434.81
6,236.61
8,311.85
16,337.47
7,035.76
10,423.47
24,214.20
7,863.05
29,126.17
74,210.36
16,824.97
23,108.09
42,884.20
11,070.98
16,618.80
18,484.94
11,729.81
16,290.65
18,793.71
12,567.79
17,683.70
46,988.45
10,350.99
28,671.27
65,456.56
8,442.53

IM
IM
IM
IM
Diseases & Disorders of Blood, Blood Forming Organs, Innunological
IP
System
IP
System
IP
System
IP
System
IP
System
IP
System
IP
System
IP
System
IP
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
IM
System
Diseases & Disorders of the Myeloproliferative System & IM
Poorly Differentiated Neop
Infectious & Parasitic Diseases of Systemic or UnspecifiedIM
Sites
Sites
Sites
Sites
0.9907
2.8316
0.3262
0.4439
0.6789
0.3786
0.5230
0.8065
0.4077
0.7704
1.3829
0.9985
1.5913
2.6723
1.3904
1.5295
1.6685
1.0475
1.1523
1.2570
0.5813
1.4273
1.5430
1.3649
1.7478
1.9067
0.9851
1.0836
1.1821
0.4879
0.5791
2.2273
0.8934
1.0385
1.3863
0.4680
0.5009
0.5344
0.8127
0.8942
1.3785
0.6552
0.8390
1.0445
0.4596
0.6173
1.1230
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
13,870.25
39,642.50
4,566.27
6,214.73
9,504.31
5,300.55
7,322.53
11,291.22
5,707.59
10,786.00
19,360.97
13,979.02
22,278.58
37,411.95
19,466.19
21,412.81
23,359.43
14,665.41
16,131.95
17,598.49
8,137.68
19,982.60
21,602.35
19,108.07
24,469.35
26,693.83
13,791.60
15,170.76
16,549.92
6,830.79
8,107.68
31,182.80
12,507.68
14,539.20
19,407.71
6,552.67
7,012.86
7,481.83
11,378.29
12,519.36
19,299.32
9,172.49
11,745.81
14,623.08
6,434.85
8,641.57
15,721.84

Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Sites
Mental Diseases & Disorders
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
Alcohol/Drug Abuse & Dependence
IP
IP
IP
0.6037
0.6404
1.0023
1.0279
1.6174
2.6052
0.7100
1.0577
1.6290
0.2777
0.6571
1.2100
0.2492
0.4413
1.3071
0.2762
0.4812
0.8144
0.3379
1.2467
2.4141
0.4302
0.7807
0.9063
0.1801
0.3398
0.4401
0.5387
0.8798
1.6523
0.3109
0.9400
2.1657
1.1044
2.6859
4.0593
0.4592
1.0853
2.8702
0.6072
0.6126
2.9662
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
AED
8,451.13
8,966.00
14,031.75
14,390.12
22,643.06
36,472.70
9,939.59
14,808.01
22,805.41
3,887.21
9,199.55
16,939.71
3,488.65
6,178.72
18,298.87
3,866.52
6,736.62
11,402.08
4,730.78
17,453.24
33,797.01
6,022.62
10,929.30
12,687.77
2,520.79
4,757.70
6,162.09
7,542.28
12,317.21
23,132.38
4,352.66
13,160.37
30,320.06
15,461.04
37,602.10
56,829.63
6,428.37
15,194.47
40,183.10
8,500.96
8,576.40
41,527.09

IM
IM
IM
IM
IM
IM
IM
IM
IM
Injuries, Poisonings & Toxic Effects of Drugs
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
IM
Factors Influencing Health Status & Other Contacts with Health
IM
Services
IM
Services
IM
Services
IM
Services
IM
Services
IM
Services
IM
Services
IM
Services
IM
Services
Type
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
Code:
00100
00102
00103
00104
00120
00124
00126
00140
00142
00144
00145
00147
00148
00160
00162
00164
00170
00172
00174
00176
00190
00192
00210
00212
00214
00215
00216
00218
00220
00222
00300
00320
00322
00326
00350
00352
00400
00402
00404
00406
00410
00450
00452
00454
00470
00472
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
00474
00500
00520
00522
00524
00528
00529
00530
00532
00534
00537
00539
00540
00541
00542
00546
00548
00550
00560
00561
00562
00563
00566
00580
00600
00604
00620
00622
00625
00626
00630
00632
00634
00635
00640
00670
00700
00702
00730
00740
00750
00752
00754
00756
00770
00790
00792
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
00794
00796
00797
00800
00802
00810
00820
00830
00832
00834
00836
00840
00842
00844
00846
00848
00851
00860
00862
00864
00865
00866
00868
00870
00872
00873
00880
00882
00902
00904
00906
00908
00910
00912
00914
00916
00918
00920
00921
00922
00924
00926
00928
00930
00932
00934
00936
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
00938
00940
00942
00944
00948
00950
00952
01112
01120
01130
01140
01150
01160
01170
01173
01180
01190
01200
01202
01210
01212
01214
01215
01220
01230
01232
01234
01250
01260
01270
01272
01274
01320
01340
01360
01380
01382
01390
01392
01400
01402
01404
01420
01430
01432
01440
01442
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
01444
01462
01464
01470
01472
01474
01480
01482
01484
01486
01490
01500
01502
01520
01522
01610
01620
01622
01630
01634
01636
01638
01650
01652
01654
01656
01670
01680
01682
01710
01712
01714
01716
01730
01732
01740
01742
01744
01756
01758
01760
01770
01772
01780
01782
01810
01820
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
CPT
01829
01830
01832
01840
01842
01844
01850
01852
01860
01916
01920
01922
01924
01925
01926
01930
01931
01932
01933
01935
01936
01951
01952
01953
01958
01960
01961
01962
01963
01965
01966
01967
01968
01969
01990
01991
01992
01996
01999
Description
Anesthesia for procedures on salivary glands, including biopsy
Anesthesia for procedures involving plastic repair of cleft lip
Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)
Anesthesia for electroconvulsive therapy
Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified
Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy
Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy
Anesthesia for procedures on eye; not otherwise specified
Anesthesia for procedures on eye; lens surgery
Anesthesia for procedures on eye; corneal transplant
Anesthesia for procedures on eye; vitreoretinal surgery
Anesthesia for procedures on eye; iridectomy
Anesthesia for procedures on eye; ophthalmoscopy
Anesthesia for procedures on nose and accessory sinuses; not otherwise specified
Anesthesia for procedures on nose and accessory sinuses; radical surgery
Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue
Anesthesia for intraoral procedures, including biopsy; not otherwise specified
Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
Anesthesia for intraoral procedures, including biopsy; radical surgery
Anesthesia for procedures on facial bones or skull; not otherwise specified
Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)
Anesthesia for intracranial procedures; not otherwise specified
Anesthesia for intracranial procedures; subdural taps
Anesthesia for intracranial procedures; burr holes, including ventriculography
Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound
Anesthesia for intracranial procedures; vascular procedures
Anesthesia for intracranial procedures; procedures in sitting position
Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures
Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve
Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not other
Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, a
Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid
Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age
Anesthesia for procedures on major vessels of neck; not otherwise specified
Anesthesia for procedures on major vessels of neck; simple ligation
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise spec
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive pro
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified
Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversio
Anesthesia for procedures on clavicle and scapula; not otherwise specified
Anesthesia for procedures on clavicle and scapula; radical surgery
Anesthesia for procedures on clavicle and scapula; biopsy of clavicle
Anesthesia for partial rib resection; not otherwise specified
Anesthesia for partial rib resection; thoracoplasty (any type)
Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)
Anesthesia for all procedures on esophagus
Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified
Anesthesia for closed chest procedures; needle biopsy of pleura
Anesthesia for closed chest procedures; pneumocentesis
Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation
Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation
Anesthesia for permanent transvenous pacemaker insertion
Anesthesia for access to central venous circulation
Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator
Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation
Anesthesia for tracheobronchial reconstruction
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscop
Anesthesia for sternal debridement
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year o
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, fo
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circu
Anesthesia for direct coronary artery bypass grafting; without pump oxygenator
Anesthesia for heart transplant or heart/lung transplant
Anesthesia for procedures on cervical spine and cord; not otherwise specified
Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position
Anesthesia for procedures on thoracic spine and cord; not otherwise specified
Anesthesia for procedures on thoracic spine and cord; thoracolumbar sympathectomy
Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilati
Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation
Anesthesia for procedures in lumbar region; not otherwise specified
Anesthesia for procedures in lumbar region; lumbar sympathectomy
Anesthesia for procedures in lumbar region; chemonucleolysis
Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture
Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine
Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)
Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified
Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy
Anesthesia for procedures on upper posterior abdominal wall
Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum
Anesthesia for hernia repairs in upper abdomen; not otherwise specified
Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence
Anesthesia for hernia repairs in upper abdomen; omphalocele
Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia
Anesthesia for all procedures on major abdominal blood vessels
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of l
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, Wh
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid o
Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified
Anesthesia for procedures on lower anterior abdominal wall; panniculectomy
Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum
Anesthesia for procedures on lower posterior abdominal wall
Anesthesia for hernia repairs in lower abdomen; not otherwise specified
Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias
Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age
Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age a
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration
Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-t
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retr
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy
Anesthesia for lithotripsy, extracorporeal shock wave; with water bath
Anesthesia for lithotripsy, extracorporeal shock wave; without water bath
Anesthesia for procedures on major lower abdominal vessels; not otherwise specified
Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation
Anesthesia for; anorectal procedure
Anesthesia for; radical perineal procedure
Anesthesia for; vulvectomy
Anesthesia for; perineal prostatectomy
Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified
Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)
Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate
Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding
Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of
Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified
Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral
Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles
Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral
Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal
Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal
Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral
Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis
Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral i
Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral i
Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal app
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colpor
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalp
Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest
Anesthesia for procedures on bony pelvis
Anesthesia for body cast application or revision
Anesthesia for interpelviabdominal (hindquarter) amputation
Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation
Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint
Anesthesia for open procedures involving symphysis pubis or sacroiliac joint
Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum
Anesthesia for obturator neurectomy; extrapelvic
Anesthesia for obturator neurectomy; intrapelvic
Anesthesia for all closed procedures involving hip joint
Anesthesia for arthroscopic procedures of hip joint
Anesthesia for open procedures involving hip joint; not otherwise specified
Anesthesia for open procedures involving hip joint; hip disarticulation
Anesthesia for open procedures involving hip joint; total hip arthroplasty
Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty
Anesthesia for all closed procedures involving upper two-thirds of femur
Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified
Anesthesia for open procedures involving upper two-thirds of femur; amputation
Anesthesia for open procedures involving upper two-thirds of femur; radical resection
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg
Anesthesia for all procedures involving veins of upper leg, including exploration
Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified
Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation
Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area
Anesthesia for all closed procedures on lower one-third of femur
Anesthesia for all open procedures on lower one-third of femur
Anesthesia for all closed procedures on knee joint
Anesthesia for diagnostic arthroscopic procedures of knee joint
Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella
Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella
Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified
Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty
Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee
Anesthesia for all cast applications, removal, or repair involving knee joint
Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified
Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula
Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified
Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch g
Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneury
Anesthesia for all closed procedures on lower leg, ankle, and foot
Anesthesia for arthroscopic procedures of ankle and/or foot
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured Achilles te
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg,
Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified
Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)
Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula
Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement
Anesthesia for lower leg cast application, removal, or repair
Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified
Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter
Anesthesia for procedures on veins of lower leg; not otherwise specified
Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla
Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder j
Anesthesia for diagnostic arthroscopic procedures of shoulder joint
Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular j
Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified
Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm
Anesthesia for procedures on arteries of shoulder and axilla; bypass graft
Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft
Anesthesia for all procedures on veins of shoulder and axilla
Anesthesia for shoulder cast application, removal or repair; not otherwise specified
Anesthesia for shoulder cast application, removal or repair; shoulder spica
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shou
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to sho
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of lon
Anesthesia for all closed procedures on humerus and elbow
Anesthesia for diagnostic arthroscopic procedures of elbow joint
Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified
Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus
Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus
Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures
Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus
Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement
Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified
Anesthesia for procedures on arteries of upper arm and elbow; embolectomy
Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified
Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand
Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones
Anesthesia for diagnostic arthroscopic procedures on the wrist

Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not oth
Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total w
Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified
Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy
Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)
Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified
Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy
Anesthesia for forearm, wrist, or hand cast application, removal, or repair
Anesthesia for diagnostic arteriography/venography
Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan-Ganz cathe
Anesthesia for non-invasive imaging or radiation therapy
Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified
Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary
Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or a
Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include acce
Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic
Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic
Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body s
Anesthesia for external cephalic version procedure
Anesthesia for vaginal delivery only
Anesthesia for cesarean delivery only
Anesthesia for urgent hysterectomy following delivery
Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care
Anesthesia for incomplete or missed abortion procedures
Anesthesia for induced abortion procedures
Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement an
Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List separately in addition to code for primar
Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (List separately in addition to code for p
Physiological support for harvesting of organ(s) from brain-dead patient
Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different prov
Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different prov
Daily hospital management of epidural or subarachnoid continuous drug administration
Unlisted anesthesia procedure(s)
Base Units 15 October 2012

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11
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9
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15
13
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3
7
10
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3
5
5
13
4
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6
3
6
10
13
15
6
4
4
8
11
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10
15
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15
8
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4
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7
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5
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6
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4
6
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5
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3
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6
4
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6
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8
4
6
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3
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3
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6
8
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3
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15
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10
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4
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3
4
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6
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7
6
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4
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0
ts 15 October 2012
Code
99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99241
99242
99243
99244
99245
99281
99282
99283
99284
99285
Description
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key
components: A problem focused history; A problem focused examination; Straightforward medical decision
making.
and/orvisit
coordination
of care with
providersofora agencies
are provided
consistent
Office orCounseling
other outpatient
for the evaluation
andother
management
new patient,
which requires
thesewith
3 key
components: An expanded problem focused history; An expanded problem focused examination;
Straightforward
medical decision
Counseling
coordination
of care
withwhich
otherrequires
providers
or 3 key
Office or other outpatient
visit formaking.
the evaluation
and and/or
management
of a new
patient,
these
components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling
and/or
coordination
of carevisit
with
providers or
are provided
consistent
with the
naturethese
of the3 key
Office or
other outpatient
forother
the evaluation
andagencies
management
of a new
patient, which
requires
components: A comprehensive history; A comprehensive examination; Medical decision making of moderate
complexity.
Counseling
and/or
coordination
of care
with
other providers
or agencies
provided
consistent
Office or other
outpatient
visit for
the evaluation
and
management
of a new
patient, are
which
requires
these 3 key
components: A comprehensive history; A comprehensive examination; Medical decision making of high
complexity.
Counseling
and/or
coordination
of care
with
other providers
agencies are
provided
Office or other
outpatient
visit for
the evaluation
and
management
of an or
established
patient,
that consistent
may not
require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are
spent
or supervising
these
services. and management of an established patient, which requires at
Office performing
or other outpatient
visit for
the evaluation
least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward
medical
making. Counseling
coordination
of care with
other
providerspatient,
or agencies
provided
Office ordecision
other outpatient
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evaluation
and management
of an
established
whichare
requires
at
least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused
examination; Medical decision making of low complexity. Counseling and coordination of care with other
Office or other outpatient visit for the evaluation and management of an established patient, which requires at
least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of
moderate complexity. Counseling and/or coordination of care with other providers or agencies are provided
Office or other outpatient visit for the evaluation and management of an established patient, which requires at
least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision
making of high complexity. Counseling and/or coordination of care with other providers or agencies are provided
consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting
Office consultation for a new or established patient, which requires these 3 key components: A problem focused
history; A problem focused examination; and Straightforward medical decision making. Counseling and/or
coordination of care with other providers or agencies are provided consistent with the nature of the problem(s)
and
theconsultation
patient's and/or
family's
needs. Usually,
the which
presenting
problem(s)
limited or minor.
Physicians
Office
for a new
or established
patient,
requires
these 3 are
keyself
components:
An expanded
problem focused history; An expanded problem focused examination; and Straightforward medical decision
making. Counseling and/or coordination of care with other providers or agencies are provided consistent with
the
nature
of the problem(s)
the patient's
and/orwhich
family's
needs.these
Usually,
the
presenting problem(s)
are of
Office
consultation
for a new and
or established
patient,
requires
3 key
components:
A detailed history;
A detailed examination; and Medical decision making of low complexity. Counseling and/or coordination of care
with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's
and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Physicians typically spend 40
Office consultation for a new or established patient, which requires these 3 key components: A comprehensive
history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or
and theconsultation
patient's and/or
family's
needs. Usually,
the which
presenting
problem(s)
moderate toAhigh
severity.
Office
for a new
or established
patient,
requires
these 3 are
keyof
components:
comprehensive
history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or
Emergency department visit for the evaluation and management of a patient, which requires these 3 key
components: A problem focused history; A problem focused examination; and Straightforward medical decision
making. Counseling and/or coordination of care with other providers or agencies are provided consistent with
the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self
components: An expanded problem focused history; An expanded problem focused examination; and Medical
decision making of low complexity. Counseling and/or coordination of care with other providers or agencies are
provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the
components: An expanded problem focused history; An expanded problem focused examination; and Medical
decision making of moderate complexity. Counseling and/or coordination of care with other providers or
components: A detailed history; A detailed examination; and Medical decision making of moderate complexity.
Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature
of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high
components within the constraints imposed by the urgency of the patient's clinical condition and/or mental
status: A comprehensive history; A comprehensive examination; and Medical decision making of high
MANDATORY TARIFF
57
SELF PAY RATES ACROSS

ALL FACILITIES
159.60
0.00
0.00
0.00
0.00
25
70.00
0.00
0.00
0.00
0.00
62
173.60
0.00
0.00
0.00
0.00
28
78.40
0.00
0.00
0.00
0.00

15 October Pricelist With Selfpay and ADNIC, ALICO and HILAL

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Code

Fine needle aspiration; without imaging guidance

Debridement of nail(s) by any method(s); 1 to 5

Removal, non-biodegradable drug delivery implant

Excision, sacral pressure ulcer, with skin flap closure;

Removal of intact mammary implant

Biopsy, vertebral body, open; thoracic

Electrical stimulation to aid bone healing; noninvasive (nonoperative)

Impression and custom preparation; surgical obturator prosthesis

Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)

Open treatment of depressed frontal sinus fracture

Closed treatment of mandibular fracture; without manipulation

Radical resection of sternum;

Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body

Resection, humeral head

Closed treatment of clavicular fracture; without manipulation

Interthoracoscapular amputation (forequarter)

Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus

Arthroplasty, elbow; with distal humeral prosthetic replacement

Incision and drainage, forearm and/or wrist; bursa

Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation

Drainage of palmar bursa; multiple bursa

Excision or curettage of bone cyst or benign tumor of metacarpal;

Capsulodesis, metacarpophalangeal joint; single digit

Release, intrinsic muscles of hand, each muscle

Injection procedure for hip arthrography; with anesthesia

Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur

Arthrotomy with meniscus repair, knee

Osteoplasty, femur; shortening (excluding 64876)

Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia

Arrest, epiphyseal (epiphysiodesis), open; distal tibia

Tenotomy, percutaneous, toe; single tendon

Excision or curettage of bone cyst or benign tumor, phalanges of foot

Tenolysis, extensor, foot; multiple tendons

Application, cast; finger (eg, contracture)

Removal or bivalving; gauntlet, boot or body cast

Arthroscopy, wrist, surgical; for infection, lavage and drainage

Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion

Excision dermoid cyst, nose; simple, skin, subcutaneous

Partial laryngectomy (hemilaryngectomy); antero-latero-vertical

Laryngoscopy, flexible fiberoptic; diagnostic

Suture of tracheal wound or injury; cervical

Removal of lung, total pneumonectomy;

Thoracoscopy, surgical; with control of traumatic hemorrhage

Suture repair of aorta or great vessels; with cardiopulmonary bypass

Valvotomy, pulmonary valve, open heart; with inflow occlusion

Complete repair tetralogy of Fallot without pulmonary atresia;

Pulmonary artery embolectomy; without cardiopulmonary bypass

Unlisted procedure, cardiac surgery

Repair, congenital arteriovenous fistula; extremities

Thromboendarterectomy, including patch graft, if performed; abdominal aorta

Bypass graft, with vein; brachial-ulnar or -radial

Bypass graft, with other than vein; axillary-femoral

Transposition and/or reimplantation; carotid to subclavian artery

Introduction of needle or intracatheter, carotid or vertebral artery

Transfusion, intrauterine, fetal

Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection

Repair, diaphragmatic hernia (other than neonatal), traumatic; acute

Excision of lingual frenum (frenectomy)

Destruction of lesion (except excision), dentoalveolar structures

Drainage of abscess; submaxillary or sublingual, intraoral

Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm diameter)

Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy