AnnexA MedicalCaseRates

ICD 10 CODE DESCRIPTION GROUP Professional
Case Rate Fee
P91.3 Neonatal cerebral irritability ABNORMAL SENSORIUM IN THE NEWBORN 12,000 3,600
P91.4 Neonatal cerebral depression ABNORMAL SENSORIUM IN THE NEWBORN 12,000 3,600
P91.6 Hypoxic ischaemic encephalopathy of newborn ABNORMAL SENSORIUM IN THE NEWBORN 12,000 3,600
P91.8 Other specified disturbances of cerebral status of newborn ABNORMAL SENSORIUM IN THE NEWBORN 12,000 3,600
P91.9 Disturbance of cerebral status of newborn, unspecified ABNORMAL SENSORIUM IN THE NEWBORN 12,000 3,600
J36 Peritonsillar abscess; Abscess of tonsil; Peritonsillar ABSCESS OF RESPIRATORY TRACT 10,000 3,000
cellulitis; Quinsy
Other diseases of larynx; Abscess of larynx; Cellulitis of larynx; Disease
NOS of larynx; Necrosis of larynx; Pachyderma of larynx; Perichondritis of
J38.7 larynx; Ulcer of larynx ABSCESS OF RESPIRATORY TRACT 10,000 3,000
J39.0 Retropharyngeal and parapharyngeal abscess; ABSCESS OF RESPIRATORY TRACT 10,000 3,000
Peripharyngeal abscess
J39.1 Other abscess of pharynx; Cellulitis of pharynx; ABSCESS OF RESPIRATORY TRACT 10,000 3,000
Nasopharyngeal abscess
J39.2 Other diseases of pharynx; Cyst of pharynx or nasopharynx; ABSCESS OF RESPIRATORY TRACT 10,000 3,000
Oedema of pharynx or nasopharynx
J85.1 Abscess of lung with pneumonia ABSCESS OF RESPIRATORY TRACT 10,000 3,000
J85.2 Abscess of lung without pneumonia; Abscess of lung NOS ABSCESS OF RESPIRATORY TRACT 10,000 3,000
J85.3 Abscess of mediastinum ABSCESS OF RESPIRATORY TRACT 10,000 3,000

J86.0 Pyothorax with fistula ABSCESS OF RESPIRATORY TRACT 10,000 3,000
J86.9 Pyothorax without fistula; Abscess of pleura; Abscess of ABSCESS OF RESPIRATORY TRACT 10,000 3,000
thorax; Empyema; Pyopneumothorax
A00.0 Cholera due to Vibrio cholerae 01, biovar cholerae ACUTE GASTROENTERITIS 6,000 1,800
A00.1 Cholera due to Vibrio cholerae 01, biovar eltor ACUTE GASTROENTERITIS 6,000 1,800
A00.9 Cholera, unspecified ACUTE GASTROENTERITIS 6,000 1,800
A03.0 Shigellosis due to Shigella dysenteriae; Group A shigellosis ACUTE GASTROENTERITIS 6,000 1,800
[Shiga-Kruse dysentery]
A03.1 Shigellosis due to Shigella flexneri;Group B shigellosis ACUTE GASTROENTERITIS 6,000 1,800
A03.2 Shigellosis due to Shigella boydii; Group C shigellosis ACUTE GASTROENTERITIS 6,000 1,800
A03.3 Shigellosis due to Shigella sonnei; Group D shigellosis ACUTE GASTROENTERITIS 6,000 1,800
A03.8 Other shigellosis ACUTE GASTROENTERITIS 6,000 1,800
A03.9 Shigellosis, unspecified; ; Bacillary dysentery NOS ACUTE GASTROENTERITIS 6,000 1,800
A04.0 Enteropathogenic Escherichia coli infection ACUTE GASTROENTERITIS 6,000 1,800
A04.1 Enterotoxigenic Escherichia coli infection ACUTE GASTROENTERITIS 6,000 1,800
A04.2 Enteroinvasive Escherichia coli infection ACUTE GASTROENTERITIS 6,000 1,800
A04.3 Enterohaemorrhagic Escherichia coli infection ACUTE GASTROENTERITIS 6,000 1,800
A04.4 Other intestinal Escherichia coli infections ACUTE GASTROENTERITIS 6,000 1,800
A04.5 Campylobacter enteritis ACUTE GASTROENTERITIS 6,000 1,800
A04.6 Enteritis due to Yersinia enterocolitica ACUTE GASTROENTERITIS 6,000 1,800
Enterocolitis due to Clostridium difficile; Foodborne intoxication by
Clostridium difficile; Pseudomembranous
A04.7 colitis ACUTE GASTROENTERITIS 6,000 1,800
A04.8 Other specified bacterial intestinal infections ACUTE GASTROENTERITIS 6,000 1,800
A04.9 Bacterial intestinal infection, unspecified. Bacterial enteritis ACUTE GASTROENTERITIS 6,000 1,800
NOS
A05.0 Foodborne staphylococcal intoxication ACUTE GASTROENTERITIS 6,000 1,800

Foodborne Clostridium perfringens [Clostridium welchii] intoxication.
A05.2 Enteritis necroticans. ACUTE GASTROENTERITIS 6,000 1,800
Pig-bel
A05.3 Foodborne Vibrio parahaemolyticus intoxication ACUTE GASTROENTERITIS 6,000 1,800

A05.4 Foodborne Bacillus cereus intoxication ACUTE GASTROENTERITIS 6,000 1,800
A05.8 Other specified bacterial foodborne intoxications ACUTE GASTROENTERITIS 6,000 1,800
A05.9 Bacterial foodborne intoxication, unspecified ACUTE GASTROENTERITIS 6,000 1,800
A07.0 Balantidiasis; Balantidial dysentery ACUTE GASTROENTERITIS 6,000 1,800
A07.1 Giardiasis [lambliasis] ACUTE GASTROENTERITIS 6,000 1,800
A07.2 Cryptosporidiosis ACUTE GASTROENTERITIS 6,000 1,800
A07.3 Isosporiasis; Infection due to Isospora belli and Isospora ACUTE GASTROENTERITIS 6,000 1,800
hominis; Intestinal coccidiosis; Isosporosis
A07.8 Other specified protozoal intestinal diseases; Intestinal ACUTE GASTROENTERITIS 6,000 1,800
trichomoniasis; Sarcocystosis; Sarcosporidiosis
Protozoal intestinal disease, unspecified;Flagellate

diarrhoea; Protozoal colitis; Protozoal diarrhoea; Protozoal dysentery
A07.9 ACUTE GASTROENTERITIS 6,000 1,800
A08.0 Rotaviral enteritis ACUTE GASTROENTERITIS 6,000 1,800

A08.1 Acute gastroenteropathy due to Norovirus; Noroviral ACUTE GASTROENTERITIS 6,000 1,800
enteritis; Small round structured virus enteritis
A08.2 Adenoviral enteritis ACUTE GASTROENTERITIS 6,000 1,800

A08.3 Other viral enteritis ACUTE GASTROENTERITIS 6,000 1,800
Viral intestinal infection, unspecified; Viral enteritis NOS; Viral
gastroenteritis NOS; Viral gastroenteropathy NOS
A08.5 Other specified intestinal infections ACUTE GASTROENTERITIS 6,000 1,800

Infectious diarrhea
Infectious diarrhea with no dehydration
A09.0 Other and unspecified gastroenteritis and colitis of infectious origin ACUTE GASTROENTERITIS 6,000 1,800
Gastroenteritis and colitis of unspecified origin; Neonatal diarrhoea NOS
K52.0 Gastroenteritis and colitis due to radiation ACUTE GASTROENTERITIS 6,000 1,800
K52.1 Toxic gastroenteritis and colitis ACUTE GASTROENTERITIS 6,000 1,800
K52.2 Allergic and dietetic gastroenteritis and colitis; Food ACUTE GASTROENTERITIS 6,000 1,800
hypersensitivity gastroenteritis or colitis
K52.8 Other specified noninfective gastroenteritis and colitis; ACUTE GASTROENTERITIS 6,000 1,800
Eosinophilic gastritis or gastroenteritis
Noninfective gastroenteritis and colitis, unspecified; Diarrhoea specified as

noninfective, or NOS in countries where the conditions can be presumed
to be of noninfectious origin; Enteritis specified as noninfective, or NOS in
countries where the conditions can be presumed to be of noninfectious
origin; Ileitis specified as noninfective, or NOS in countries where the
conditions can be presumed to be noninfectious origin; Jejunitis specified
as noninfective, or NOS in countries where the conditions can be
presumed to be noninfectious origin; Sigmoiditis pecified as noninfective,
or NOS in countries where the conditions can be presumed to be
K52.9 noninfectious origin ACUTE GASTROENTERITIS 6,000 1,800
K58.0 Irritable bowel syndrome with diarrhoea ACUTE GASTROENTERITIS 6,000 1,800
Acute renal failure with tubular necrosis; Tubular necrosis NOS; Acute
N17.0 Tubular necrosis ; Renal Tubular necrosis ACUTE RENAL FAILURE 19,300 5,790
Acute renal failure with acute cortical necrosis; Cortical

necrosis NOS; Acute Cortical necrosis ; Renal Cortical necrosis
N17.1 ACUTE RENAL FAILURE 19,300 5,790
Acute renal failure with medullary necrosis; Medullary papillary necrosis,

NOS; Acute medullary papillary necrosis;
N17.2 Renal medullary papillary necrosis ACUTE RENAL FAILURE 19,300 5,790
N17.8 Other acute renal failure ACUTE RENAL FAILURE 19,300 5,790
N17.9 Acute renal failure, unspecified; ACUTE RENAL FAILURE 19,300 5,790
Renal failure following abortion and ectopic and molar pregnancy; Oliguria
Acute renal failure; Oliguria renal shutdown; Oliguria renal tubular
O08.4 necrosis; Oliguria Uraemia ACUTE RENAL FAILURE 19,300 5,790
J80 Adult respiratory distress syndrome; Adult hyaline ADULT RESPIRATORY DISTRESS SYNDROME 32,000 9,600
membrane disease
T78.1 Other adverse food reactions, not elsewhere classified ALLERGIC REACTIONS 6,200 1,860
T78.3 Angioneurotic oedema; Giant urticaria; Quinke's oedema ALLERGIC REACTIONS 6,200 1,860
T78.4 Allergy, unspecified; Allergic reaction NOS; Hypersensitivity ALLERGIC REACTIONS 6,200 1,860
NOS; Idiosyncracy NOS
T78.8 Other adverse effects, not elsewhere classified ALLERGIC REACTIONS 6,200 1,860
T78.9 Adverse effect, unspecified ALLERGIC REACTIONS 6,200 1,860
Unspecified adverse effect of drug or medicament; Adverse effect of
correct drug or medicament properly administered; Allergic reactiion to
correct drug or medicament properly administered; Hypersensitivity to
correct drug or medicament properly administered; Idiosyncracy to
correct drug or medicament properly administered; Drug: hypersensitivity
T88.7 NOS; reaction NOS ALLERGIC REACTIONS 6,200 1,860
A06.4+ K77.0* Amoebic liver abscess; Hepatic amoebiasis AMOEBIASIS, HEPATIC 10,000 3,000
A06.0 Acute amoebic dysentery; Acute amoebiasis; Intestinal AMOEBIASIS, NONHEPATIC 6,000 1,800
amoebiasis NOS
A06.1 Chronic intestinal amoebiasis AMOEBIASIS, NONHEPATIC 6,000 1,800
A06.2 Amoebic nondysenteric colitis AMOEBIASIS, NONHEPATIC 6,000 1,800
A06.3 Amoeboma of intestine; Amoeboma NOS AMOEBIASIS, NONHEPATIC 6,000 1,800
A06.7 Cutaneous amoebiasis AMOEBIASIS, NONHEPATIC 6,000 1,800
A06.8 Amoebic infection of other sites AMOEBIASIS, NONHEPATIC 6,000 1,800
Amoebic Appendicitis; Amoebic balanitis (N51.2*)
E85.8 Other amyloidosis; Localized amyloidosis AMYLOIDOSIS 11,100 3,330

T78.0 Anaphylactic shock due to adverse food reaction ANAPHYLACTIC SHOCK 7,600 2,280
T78.2 Anaphylactic shock, unspecified; Allergic shock NOS; ANAPHYLACTIC SHOCK 7,600 2,280
Anaphylactic reaction NOS; Anaphylaxis NOS
T88.6 Anaphylactic shock due to adverse effect of correct drug or ANAPHYLACTIC SHOCK 7,600 2,280
medicament properly administered
D50.0 Iron deficiency anaemia secondary to blood loss (chronic); ANEMIA 10,000 3,000
Posthaemorrhagic anaemia (chronic)
D50.1 Sideropenic dysphagia; Kelly-Paterson syndrome; Plummer- ANEMIA 10,000 3,000

Vinson syndrome
D50.8 Other iron deficiency anaemias ANEMIA 10,000 3,000
D50.9 Iron deficiency anaemia, unspecified ANEMIA 10,000 3,000
Vitamin B12 deficiency anaemia due to intrinsic factor deficiency; Addison
Anaemia; Biermer Anaemia; Congenital Pernicious Anaemia; Congenital
intrinsic factor deficiency
D51.0 Pernicious anemia ANEMIA 10,000 3,000
D51.8 Other vitamin B12 deficiency anaemias ANEMIA 10,000 3,000

D51.9 Vitamin B12 deficiency anaemia, unspecified ANEMIA 10,000 3,000
Drug-induced folate deficiency anaemia
Use additional external cause code (Chapter XX), if desired to identify drug
D52.1 ANEMIA 10,000 3,000
D52.9 Folate deficiency anaemia, unspecified; Folic acid deficiency ANEMIA 10,000 3,000
anaemia NOS
D53.0 Protein deficiency anaemia; Amino-acid deficiency ANEMIA 10,000 3,000

anaemia; Orotaciduric anaemia
D53.1 Other megaloblastic anaemias, not elsewhere classified; ANEMIA 10,000 3,000
Megaloblastic anaemia NOS
D53.2 Scorbutic anaemia ANEMIA 10,000 3,000

Other specified nutritional anaemias; Anaemia associated with deficiency
of copper; Anaemia associated with deficiency of molybdenum; Anaemia
D53.8 associated with ANEMIA 10,000 3,000
deficiency of zinc
D53.9 Nutritional anaemia, unspecified; Simple chronic anaemia ANEMIA 10,000 3,000
Anaemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency;

Favism;
D55.0 G6PD deficiency anaemia ANEMIA 10,000 3,000
Anaemia due to other disorders of glutathione metabolism; Anaemia due

to enzyme deficiencies, except G6PD, related to the hexose
monophosphate [HMP] shunt pathway; Anaemia due to haemolytic
D55.1 nonspherocytic hereditary, type I ANEMIA 10,000 3,000
Anaemia due to disorders of glycolytic enzymes; Haemolytic

nonspherocytic hereditary Anaemia, type II; Hexokinase deficiency
Anaemia; Pyruvate kinase [PK] deficiency Anaemia; Triose-phosphate
D55.2 isomerase deficiency ANEMIA 10,000 3,000
Anaemia
D55.8 Other anaemias due to enzyme disorders ANEMIA 10,000 3,000

D55.9 Anaemia due to enzyme disorder, unspecified ANEMIA 10,000 3,000
Thalassaemia, unspecified
Mediterranean anaemia; Mediterranean anaemia with other
haemoglobinopathy; Thalassaemia minor with other haemoglobinopathy;
D56.9 Thalassaemia mixed with other haemoglobinopathy; ANEMIA 10,000 3,000
D57.0 Sickle-cell anaemia with crisis; Hb-SS disease with crisis ANEMIA 10,000 3,000
D57.1 Sickle-cell anaemia without crisis; Sickle-cell anaemia NOS; ANEMIA 10,000 3,000
Sickle-cell disease NOS ; Sickle-cell disorder NOS
D57.3 Sickle-cell trait; Hb-S trait ; Heterozygous Haemoglobin S ANEMIA 10,000 3,000
D57.8 Other sickle-cell disorders ANEMIA 10,000 3,000

Hereditary spherocytosis; Acholuric (familial) jaundice; Congenital
D58.0 (spherocytic) haemolytic icterus; Minkowski- ANEMIA 10,000 3,000
Chauffard syndrome
D58.1 Hereditary elliptocytosis; Congenital Elliptocytosis; ANEMIA 10,000 3,000

Congenital Ovalocytosis; Hereditary Ovalocytosis
Other haemoglobinopathies; Abnormal haemoglobin NOS; Congenital
Heinz body anaemia; Hb-C Disease; Hb-C Disease; Hb-D Disease; Hb-E
Disease; Haemoglobinopathy NOS; Unstable haemoglobin haemolytic
D58.2 disease ANEMIA 10,000 3,000
D58.8 Other specified hereditary haemolytic anaemias; ANEMIA 10,000 3,000

Stomatocytosis
D58.9 Hereditary haemolytic anaemia, unspecified; Acquired ANEMIA 10,000 3,000

haemolytic anaemia
D59.0 Drug-induced autoimmune haemolytic anaemia ANEMIA 10,000 3,000

Other autoimmune haemolytic anaemias; Autoimmune haemolytic
disease, cold type; (Autoimmune haemolytic disease, warm type; Chronic
cold haemagglutinin disease; Cold agglutinin disease; Cold agglutinin
haemoglobinuria; Secondary symptomatic Haemolytic anaemia, cold type;
Secondary symptomatic Haemolytic anaemia, warm type;
D59.1 ANEMIA 10,000 3,000
D59.2 Drug-induced nonautoimmune haemolytic anaemia; Drug- ANEMIA 10,000 3,000

induced enzyme deficiency anaemia
Other nonautoimmune haemolytic anaemias; Mechanical Haemolytic

D59.4 anaemia; Microangiopathic Haemolytic ANEMIA 10,000 3,000
anaemia; Toxic Haemolytic anaemia
D59.5 Paroxysmal nocturnal haemoglobinuria [Marchiafava- ANEMIA 10,000 3,000

Micheli]
Haemoglobinuria due to haemolysis from other external causes;

Haemoglobinuria from exertion; Haemoglobinuria march;
D59.6 Haemoglobinuria paroxysmal cold ANEMIA 10,000 3,000
D59.8 Other acquired haemolytic anaemias ANEMIA 10,000 3,000

D59.9 Acquired haemolytic anaemia, unspecified; Chronic ANEMIA 10,000 3,000
Idiopathic haemolytic anaemia
D60.1 Transient acquired pure red cell aplasia ANEMIA 10,000 3,000
Constitutional aplastic anaemia; Congenital Pure red cell Aplasia; Pure
red cell Aplasia of infants; Primary Pure red cell Aplasia; Blackfan-
Diamond syndrome; Familial hypoplastic anaemia; Fanconi's anaemia;
D61.0 Pancytopenia with malformations ANEMIA 10,000 3,000
D61.1 Drug-induced aplastic anaemia ANEMIA 10,000 3,000

D61.2 Aplastic anaemia due to other external agents ANEMIA 10,000 3,000
D61.3 Idiopathic aplastic anaemia ANEMIA 10,000 3,000
D61.8 Other specified aplastic anaemias ANEMIA 10,000 3,000
D61.9 Aplastic anaemia, unspecified; Hypoplastic anaemia NOS; ANEMIA 10,000 3,000
Medullary hypoplasia; Panmyelophthisis
D62 Acute posthaemorrhagic anaemia ANEMIA 10,000 3,000
D63.0* Anaemia in neoplastic disease ANEMIA 10,000 3,000
D63.8* Anaemia in other chronic diseases classified elsewhere ANEMIA 10,000 3,000
D64.0 Hereditary sideroblastic anaemia; Sex-linked hypochromic ANEMIA 10,000 3,000
sideroblastic anaemia
D64.1 Secondary sideroblastic anaemia due to disease ANEMIA 10,000 3,000

D64.2 Secondary sideroblastic anaemia due to drugs and toxins ANEMIA 10,000 3,000
Other sideroblastic anaemias; Sideroblastic anaemia NOS; pyridoxine-

D64.3 responsive NEC Sideroblastic anaemia ANEMIA 10,000 3,000
D64.8 Other specified anaemias; Infantile pseudoleukaemia; ANEMIA 10,000 3,000

Leukoerythroblastic anaemia
D64.9 Anaemia, unspecified ANEMIA 10,000 3,000

Severe anemia
M00.16 Pneumococcal arthritis and polyarthritis, Lower leg ARTHRITIS INFECTIOUS 9,700 2,910
M00.19 Pneumococcal arthritis and polyarthritis, Site unspecified ARTHRITIS INFECTIOUS 9,700 2,910
M00.29 Other streptococcal arthritis and polyarthritis, Site ARTHRITIS INFECTIOUS 9,700 2,910
unspecified
M00.82 Arthritis and polyarthritis due to other specified bacterial ARTHRITIS INFECTIOUS 9,700 2,910
agents upper arm
M00.90 Pyogenic arthritis, unspecified; Infective arthritis NOS ARTHRITIS INFECTIOUS 9,700 2,910
multiple sites
shoulder region
forearm
hand
pelvic region and thigh
lower leg
ankle and foot
other sites
site unspecified
M02.39 Reiter's disease, site unspecified ARTHRITIS INFECTIOUS 9,700 2,910

M06.19 Adult-onset Still's disease, site unspecified ARTHRITIS INFECTIOUS 9,700 2,910
M08.29 Juvenile arthritis with systemic onset; Still's disease NOS ARTHRITIS INFECTIOUS 9,700 2,910
site unspecified
M02.99 Reactive arthropathy, unspecified, site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M05.99 Seropositive rheumatoid arthritis, unspecified, site ARTHRITIS NONINFECTIOUS 7,000 2,100
unspecified
M06.01 Seronegative rheumatoid arthritis, shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.09 Seronegative rheumatoid arthritis, site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.36 Rheumatoid nodule, lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.45 Inflammatory polyarthropathy, pelvic region and thigh ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.49 Inflammatory polyarthropathy, site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.81 Other specified rheumatoid arthritis, shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.86 Other specified rheumatoid arthritis, lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.87 Other specified rheumatoid arthritis, ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.89 Other specified rheumatoid arthritis, site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.90 Rheumatoid arthritis, unspecified, multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.91 Rheumatoid arthritis, unspecified, shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.93 Rheumatoid arthritis, unspecified, forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.94 Rheumatoid arthritis, unspecified, hand ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.95 Rheumatoid arthritis, unspecified, pelvic region and thigh ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.96 Rheumatoid arthritis, unspecified, lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.97 Rheumatoid arthritis, unspecified, ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.98 Rheumatoid arthritis, unspecified, other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M06.99 Rheumatoid arthritis, unspecified, site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.06 Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis ARTHRITIS NONINFECTIOUS 7,000 2,100
with or without rheumatoid factor lower leg
Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis with or

M08.07 without rheumatoid factor ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis with or
without rheumatoid factor site unspecified
M08.09 ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.19 Juvenile ankylosing spondylitis site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.86 Other juvenile arthritis lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.89 Other juvenile arthritis site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.91 Juvenile arthritis, unspecified shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.96 Juvenile arthritis, unspecified lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M08.99 Juvenile arthritis, unspecified site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.00 Idiopathic gout; Gouty bursitis; Primary gout multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.01 Idiopathic gout; Gouty bursitis; Primary gout; ARTHRITIS NONINFECTIOUS 7,000 2,100
Urate tophus of heart shoulder region
Urate tophus of heart upper arm
M10.03 Idiopathic gout; Gouty bursitis; Primary gout forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
Urate tophus of heart hand
M10.05 Idiopathic gout; Gouty bursitis; Primary gout;Urate tophus ARTHRITIS NONINFECTIOUS 7,000 2,100
of heart pelvic region and thigh
M10.06 Idiopathic gout; Gouty bursitis; Primary gout lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
Urate tophus of heart ankle and foot
Urate tophus of heart other sites
Urate tophus of heart site unspecified
M10.10 Lead-induced gout multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.29 Drug-induced gout site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.30 Gout due to impairment of renal function multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.36 Gout due to impairment of renal function lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.39 Gout due to impairment of renal function site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.40 Other secondary gout multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.49 Other secondary gout site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.90 Gout, unspecified multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.91 Gout, unspecified shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.92 Gout, unspecified upper arm ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.93 Gout, unspecified forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.94 Gout, unspecified hand ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.96 Gout, unspecified lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.97 Gout, unspecified ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.98 Gout, unspecified other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M10.99 Gout, unspecified site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M11.89 Other specified crystal arthropathies site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M11.90 Crystal arthropathy, unspecified multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M11.99 Crystal arthropathy, unspecified site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.26 Villonodular synovitis (pigmented) lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.39 Palindromic rheumatism site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.50 Traumatic arthropathy multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.52 Traumatic arthropathy upper arm ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.53 Traumatic arthropathy forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.54 Traumatic arthropathy hand ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.55 Traumatic arthropathy pelvic region and thigh ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.56 Traumatic arthropathy lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.57 Traumatic arthropathy ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.58 Traumatic arthropathy other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.59 Traumatic arthropathy site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M12.86 Other specific arthropathies, not elsewhere classified; ARTHRITIS NONINFECTIOUS 7,000 2,100
Transient arthropathy lower leg
M12.89 Other specific arthropathies, not elsewhere classified; ARTHRITIS NONINFECTIOUS 7,000 2,100
Transient arthropathy site unspecified
M13.00 Polyarthritis, unspecified multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100

M13.01 Polyarthritis, unspecified shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.02 Polyarthritis, unspecified upper arm ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.06 Polyarthritis, unspecified lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.09 Polyarthritis, unspecified site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.13 Monoarthritis, not elsewhere classified forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.16 Monoarthritis, not elsewhere classified lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.17 Monoarthritis, not elsewhere classified ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.18 Monoarthritis, not elsewhere classified other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.80 Other specified arthritis; Allergic arthritis multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.81 Other specified arthritis; Allergic arthritis shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.85 Other specified arthritis; Allergic arthritis pelvic region and ARTHRITIS NONINFECTIOUS 7,000 2,100
thigh
M13.86 Other specified arthritis; Allergic arthritis lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.87 Other specified arthritis; Allergic arthritis ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.88 Other specified arthritis; Allergic arthritis other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.89 Other specified arthritis; Allergic arthritis site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.90 Arthritis, unspecified; Arthropathy NOS multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.91 Arthritis, unspecified; Arthropathy NOS shoulder region ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.92 Arthritis, unspecified; Arthropathy NOS upper arm ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.93 Arthritis, unspecified; Arthropathy NOS forearm ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.94 Arthritis, unspecified; Arthropathy NOS hand ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.95 Arthritis, unspecified; Arthropathy NOS pelvic region and ARTHRITIS NONINFECTIOUS 7,000 2,100
thigh
M13.96 Arthritis, unspecified; Arthropathy NOS lower leg ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.97 Arthritis, unspecified; Arthropathy NOS ankle and foot ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.98 Arthritis, unspecified; Arthropathy NOS other sites ARTHRITIS NONINFECTIOUS 7,000 2,100
M13.99 Arthritis, unspecified; Arthropathy NOS site unspecified ARTHRITIS NONINFECTIOUS 7,000 2,100
A92.0 Chikungunya virus disease; Chikungunya (haemorrhagic) ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
fever
A92.1 O'nyong-nyong fever ARTHROPOD BORNE VIRAL FEVER 8,100 2,430

Venezuelan equine fever; Venezuelan equine encephalitis; Venezuelan
A92.2 encephalomyelitis virus disease ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
A92.8 Other specified mosquito-borne viral fevers ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
A93.1 Sandfly fever; Pappataci fever; Phlebotomus fever ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
Other specified arthropod-borne viral fevers; Piry virus disease; Severe
fever with thrombocytopenia syndrome [SFTS]; Vesicular stomatitis virus
A93.8 disease [Indiana fever] ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
Unspecified arthropod-borne viral fever; Unspecified arthropod-borne

viral fever; Arboviral fever NOS; Arbovirus infection NOS
A94 Acute hemorrhagic fever ARTHROPOD BORNE VIRAL FEVER 8,100 2,430
M15.0 Primary generalized (osteo)arthrosis ARTHROSIS 7,000 2,100

M15.2 Bouchard's nodes (with arthropathy) ARTHROSIS 7,000 2,100
M15.3 Secondary multiple arthrosis; Post-traumatic polyarthrosis ARTHROSIS 7,000 2,100
M15.4 Erosive (osteo)arthrosis ARTHROSIS 7,000 2,100

M15.8 Other polyarthrosis ARTHROSIS 7,000 2,100
M15.9 Polyarthrosis, unspecified; Generalized osteoarthritis NOS ARTHROSIS 7,000 2,100
M16.0 Primary coxarthrosis, bilateral ARTHROSIS 7,000 2,100

M16.1 Other primary coxarthrosis; Primary coxarthrosis NOS; ARTHROSIS 7,000 2,100
Primary coxarthrosis unilateral
M16.2 Coxarthrosis resulting from dysplasia, bilateral ARTHROSIS 7,000 2,100
M16.3 Other dysplastic coxarthrosis; Dysplastic coxarthrosis NOS; ARTHROSIS 7,000 2,100
Dysplastic coxarthrosis unilateral
M16.9 Coxarthrosis, unspecified ARTHROSIS 7,000 2,100

M17.0 Primary gonarthrosis, bilateral ARTHROSIS 7,000 2,100
M17.1 Other primary gonarthrosis; Primary gonarthrosis NOS; ARTHROSIS 7,000 2,100
Primary gonarthrosis unilateral
M17.2 Post-traumatic gonarthrosis, bilateral ARTHROSIS 7,000 2,100

Other post-traumatic gonarthrosis; Post-traumatic gonarthrosis NOS; Post-
traumatic gonarthrosis unilateral
M17.3 ARTHROSIS 7,000 2,100
M17.5 Other secondary gonarthrosis; Secondary gonarthrosis ARTHROSIS 7,000 2,100

NOS; Secondary gonarthrosis unilateral
M17.9 Gonarthrosis, unspecified ARTHROSIS 7,000 2,100

M18.0 Primary arthrosis of first carpometacarpal joints, bilateral ARTHROSIS 7,000 2,100
M18.9 Arthrosis of first carpometacarpal joint, unspecified ARTHROSIS 7,000 2,100

M19.00 Primary arthrosis of other joints; Primary arthrosis ARTHROSIS 7,000 2,100
NOSmultiple sites
NOSupper arm
NOSpelvic region and thigh
NOSlower leg
NOSother sites
M19.09 Primary arthrosis of other joints; Primary arthrosis NOSsite ARTHROSIS 7,000 2,100
unspecified
M19.10 Post-traumatic arthrosis of other joints; Post-traumatic ARTHROSIS 7,000 2,100

arthrosis NOS multiple sites

arthrosis NOS shoulder region

arthrosis NOS upper arm

arthrosis NOS site unspecified
M19.21 Other secondary arthrosis; Secondary arthrosis NOS ARTHROSIS 7,000 2,100
shoulder region
M19.29 Other secondary arthrosis; Secondary arthrosis NOS site ARTHROSIS 7,000 2,100
unspecified
M19.81 Other specified arthrosis shoulder region ARTHROSIS 7,000 2,100
M19.86 Other specified arthrosis lower leg ARTHROSIS 7,000 2,100
M19.87 Other specified arthrosis ankle and foot ARTHROSIS 7,000 2,100
M19.88 Other specified arthrosis other sites ARTHROSIS 7,000 2,100
M19.89 Other specified arthrosis site unspecified ARTHROSIS 7,000 2,100
M19.90 Arthrosis, unspecified multiple sites ARTHROSIS 7,000 2,100
M19.91 Arthrosis, unspecified shoulder region ARTHROSIS 7,000 2,100
M19.92 Arthrosis, unspecified upper arm ARTHROSIS 7,000 2,100
M19.93 Arthrosis, unspecified forearm ARTHROSIS 7,000 2,100
M19.94 Arthrosis, unspecified hand ARTHROSIS 7,000 2,100
M19.95 Arthrosis, unspecified pelvic region and thigh ARTHROSIS 7,000 2,100
M19.96 Arthrosis, unspecified lower leg ARTHROSIS 7,000 2,100
M19.97 Arthrosis, unspecified ankle and foot ARTHROSIS 7,000 2,100
M19.98 Arthrosis, unspecified other sites ARTHROSIS 7,000 2,100
M19.99 Arthrosis, unspecified site unspecified ARTHROSIS 7,000 2,100
Osteoarthritis
Predominantly allergic asthma; Allergic bronchitis NOS; Allergic rhinitis

with asthma; Atopic asthma; Extrinsic allergic asthma; Hay fever with
J45.00 asthma; in Acute Exacerbation ASTHMA IN ACUTE EXACERBATION 9,000 2,700
J45.10 Nonallergic asthma; Idiosyncratic asthma; Intrinsic ASTHMA IN ACUTE EXACERBATION 9,000 2,700
nonallergic asthma, in Acute Exacerbation
J45.80 Mixed asthma, in Acute Exacerbation ASTHMA IN ACUTE EXACERBATION 9,000 2,700
J45.90 Bronchial Asthma in Acute Exacerbation ASTHMA IN ACUTE EXACERBATION 9,000 2,700
J46 Status asthmaticus; Acute severe asthma ASTHMA IN ACUTE EXACERBATION 9,000 2,700
J98.1 Pulmonary collapse; Atelectasis; Collapse of lung; Brock's ATELECTASIS 13,800 4,140
syndrome
M54.01 Panniculitis affecting regions of neck and back occipito- BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
atlanto-axial region
M54.06 Panniculitis affecting regions of neck and back lumbar BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
region
M54.08 Panniculitis affecting regions of neck and back sacral and BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
sacrococcygeal region
Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or
radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ;
M54.10 Radiculitis NOS BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
Multiple sites in spine

occipito-atlanto-axial region

cervical region

thoracic region

M54.15 Radiculitis NOS thoracolumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920

lumbar region

lumbosacral region

sacral and sacrococcygeal region

site unspecified
M54.2 Cervicalgia BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920

M54.20 Cervicalgia Multiple sites in spine BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.22 Cervicalgia cervical region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.26 Cervicalgia lumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.3 Sciatica BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.30 Sciatica Multiple sites in spine BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.31 Sciatica occipito-atlanto-axial region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.35 Sciatica thoracolumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.36 Sciatica lumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.37 Sciatica lumbosacral region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.38 Sciatica sacral and sacrococcygeal region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.39 Sciatica site unspecified BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.4 Lumbago with sciatica BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.41 Lumbago with sciatica occipito-atlanto-axial region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.44 Lumbago with sciatica thoracic region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.46 Lumbago with sciatica lumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.48 Lumbago with sciatica sacral and sacrococcygeal region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.49 Lumbago with sciatica site unspecified BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.5 Low back pain; Loin pain; Low back strain; Lumbago NOS BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
Multiple sites in spine
occipito-atlanto-axial region
cervical region
M54.84 Other dorsalgia thoracic region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.88 Other dorsalgia sacral and sacrococcygeal region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.91 Dorsalgia, unspecified; Backache NOS occipito-atlanto-axial BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
region
M54.93 Dorsalgia, unspecified; Backache NOS cervicothoracic BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
region
M54.96 Dorsalgia, unspecified; Backache NOS lumbar region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.97 Dorsalgia, unspecified; Backache NOS lumbosacral region BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.98 Dorsalgia, unspecified; Backache NOS sacral and BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
M54.99 Dorsalgia, unspecified; Backache NOS site unspecified BACK PAIN, RADICULOPATHY, SCIATICA 6,400 1,920
N31.0 Uninhibited neuropathic bladder, not elsewhere classified BLADDER DYSFUNCTION 9,000 2,700
N31.1 Reflex neuropathic bladder, not elsewhere classified BLADDER DYSFUNCTION 9,000 2,700
Flaccid neuropathic bladder, not elsewhere classified; Atonic Motor
Neuropathic bladder; Sensory Atonic Motor Neuropathic bladder;
N31.2 Autonomous Neuropathic bladder ; Nonreflex Neuropathic bladder BLADDER DYSFUNCTION 9,000 2,700
N31.8 Other neuromuscular dysfunction of bladder BLADDER DYSFUNCTION 9,000 2,700

N31.9 Neuromuscular dysfunction of bladder, unspecified; BLADDER DYSFUNCTION 9,000 2,700
Neurogenic bladder dysfunction NOS
N32.9 Bladder disorder, unspecified BLADDER DYSFUNCTION 9,000 2,700
N39.3 Stress incontinence BLADDER DYSFUNCTION 9,000 2,700
N39.4 Other specified urinary incontinence; Overflow BLADDER DYSFUNCTION 9,000 2,700
incontinence, Reflex incontinence, Urge incontinence
R32 Unspecified urinary incontinence; Enuresis NOS BLADDER DYSFUNCTION 9,000 2,700
A05.1 Botulism; Classical foodborne intoxication due to BOTULISM 4,800 1,440
Clostridium botulinum
G93.5 Compression of brain; [compression, Herniation] of brain BRAIN HERNIATION 22,400 6,720
(stem)
Inflammatory disorders of breast; Acute abscess of non puerperal areola;
Acute abscess nonpuerperal breast; Chronic abscess of nonpuerperal
areola; Chronic abscess of nonpuerperal breast; Carbuncle of breast;
Acute mastitis nonpuerperal, NOS; Acute mastitis nonpuerperal, infective;
subacute mastitis nonpuerperal, NOS; subacute mastitis nonpuerpural,
N61 infective BREAST INFECTIONS 7,900 2,370
Infection of nipple associated with childbirth; Gestational abscess of

nipple; Puerperal abscess of nipple
O91.0 BREAST INFECTIONS 7,900 2,370
Abscess of breast associated with childbirth; Mammary abscess

gestational or puerperal; Purulent mastitis gestational or puerperal;
O91.1 Subareolar abscess gestational or BREAST INFECTIONS 7,900 2,370
puerperal
Nonpurulent mastitis associated with childbirth; Lymphangitis of breast

gestational or puerperal; Mastitis NOS gestational or puerperal; Interstitial
mastitis gestational or puerperal; Parenchymatous mastitis gestational or
O91.2 puerperal BREAST INFECTIONS 7,900 2,370
O92.0 Retracted nipple associated with childbirth BREAST INFECTIONS 7,900 2,370
O92.1 Cracked nipple associated with childbirth; Fissure of nipple, BREAST INFECTIONS 7,900 2,370
gestational or puerperal
C50.0 Malignant neoplasm of Nipple and areola, breast BREAST MALIGNANCY 11,800 3,540
C50.1 Malignant neoplasm of Central portion of breast BREAST MALIGNANCY 11,800 3,540
C50.2 Malignant neoplasm of Upper-inner quadrant of breast BREAST MALIGNANCY 11,800 3,540
C50.3 Malignant neoplasm of Lower-inner quadrant of breast BREAST MALIGNANCY 11,800 3,540
C50.4 Malignant neoplasm of Upper-outer quadrant of breast BREAST MALIGNANCY 11,800 3,540
C50.6 Malignant neoplasm of Axillary tail of breast BREAST MALIGNANCY 11,800 3,540
C50.8 Malignant neoplasm of Overlapping lesion of breast BREAST MALIGNANCY 11,800 3,540
C50.9 Malignant neoplasm of Breast, unspecified BREAST MALIGNANCY 11,800 3,540
L10.0 Pemphigus vulgaris BULLOUS DISORDERS 12,000 3,600
L10.1 Pemphigus vegetans BULLOUS DISORDERS 12,000 3,600
L10.2 Pemphigus foliaceus BULLOUS DISORDERS 12,000 3,600
L10.4 Pemphigus erythematosus; Senear-Usher syndrome BULLOUS DISORDERS 12,000 3,600
L10.8 Other pemphigus BULLOUS DISORDERS 12,000 3,600
L10.9 Pemphigus, unspecified BULLOUS DISORDERS 12,000 3,600
L11.0 Acquired keratosis follicularis BULLOUS DISORDERS 12,000 3,600
L11.1 Transient acantholytic dermatosis [Grover] BULLOUS DISORDERS 12,000 3,600
L11.9 Acantholytic disorder, unspecified BULLOUS DISORDERS 12,000 3,600
L12.0 Bullous pemphigoid BULLOUS DISORDERS 12,000 3,600
L12.1 Cicatricial pemphigoid; Benign mucous membrane BULLOUS DISORDERS 12,000 3,600
pemphigoid
L12.2 Chronic bullous disease of childhood; Juvenile dermatitis BULLOUS DISORDERS 12,000 3,600
herpetiformis
L12.3 Acquired epidermolysis bullosa BULLOUS DISORDERS 12,000 3,600

L12.8 Other pemphigoid BULLOUS DISORDERS 12,000 3,600
L13.0 Dermatitis herpetiformis; Duhring's disease BULLOUS DISORDERS 12,000 3,600
L13.1 Subcorneal pustular dermatitis; Sneddon-Wilkinson disease BULLOUS DISORDERS 12,000 3,600
L13.9 Bullous disorder, unspecified BULLOUS DISORDERS 12,000 3,600

T20.4 Corrosion of unspecified degree of head and neck BURN A 8,500 2,550
T21.0 Burn of unspecified degree of trunk BURN A 8,500 2,550
T21.2 Burn of second degree of trunk BURN A 8,500 2,550
T21.5 Corrosion of first degree of trunk BURN A 8,500 2,550
T21.6 Corrosion of second degree of trunk BURN A 8,500 2,550
T22.2 Burn of second degree of shoulder and upper limb, except BURN A 8,500 2,550
wrist and hand
T22.5 Corrosion of first degree of shoulder and upper limb, BURN A 8,500 2,550
except wrist and hand
T22.6 Corrosion of second degree of shoulder and upper limb, BURN A 8,500 2,550
except wrist and hand
T23.2 Burn of second degree of wrist and hand BURN A 8,500 2,550
T23.4 Corrosion of unspecified degree of wrist and hand BURN A 8,500 2,550
T24.2 Burn of second degree of hip and lower limb, except ankle BURN A 8,500 2,550
and foot
T24.5 Corrosion of first degree of hip and lower limb, except BURN A 8,500 2,550
ankle and foot
T24.6 Corrosion of second degree of hip and lower limb, except BURN A 8,500 2,550
ankle and foot
T25.2 Burn of second degree of ankle and foot BURN A 8,500 2,550
T25.5 Corrosion of first degree of ankle and foot BURN A 8,500 2,550
T26.0 Burn of eyelid and periocular area BURN A 8,500 2,550
T26.4 Burn of eye and adnexa, part unspecified BURN A 8,500 2,550
T26.9 Corrosion of eye and adnexa, part unspecified BURN A 8,500 2,550
T27.3 Burn of respiratory tract, part unspecified BURN A 8,500 2,550
T27.7 Corrosion of respiratory tract, part unspecified BURN A 8,500 2,550
T28.9 Corrosion of other and unspecified internal organs BURN A 8,500 2,550
T29.1 Burns of multiple regions, no more than first-degree burns BURN A 8,500 2,550
mentioned
T30.0 Burn of unspecified body region, unspecified degree; Burn BURN A 8,500 2,550
NOS
T30.2 Burn of second degree, body region unspecified; Secodn- BURN A 8,500 2,550
degree burn NOS
T30.3 Burn of third degree, body region unspecified; Third-degree BURN A 8,500 2,550
burn NOS
T30.4 Corrosion of unspecified body region, unspecified degree; BURN A 8,500 2,550
Corrosion NOS
T30.5 Corrosion of first degree, body region unspecified; First- BURN A 8,500 2,550
degree corrosion NOS
T30.6 Corrosion of second degree, body region unspecified; BURN A 8,500 2,550
Second-degree corrosion NOS
T30.7 Corrosion of third degree, body region unspecified; Thrid- BURN A 8,500 2,550
degree corrosion NOS
T31.0 Burns involving less than 10% of body surface BURN A 8,500 2,550
T31.1 Burns involving 10-19% of body surface BURN A 8,500 2,550
T32.0 Corrosions involving less than 10% of body surface BURN A 8,500 2,550
T32.1 Corrosions involving 10-19% of body surface BURN A 8,500 2,550
T34.1 Frostbite with tissue necrosis of neck BURN A 8,500 2,550
T35.0 Superficial frostbite involving multiple body regions; BURN A 8,500 2,550
Multiple superficial frosbite NOS
T35.1 Frostbite with tissue necrosis involving multiple body BURN A 8,500 2,550
regions; Multiple frosbite with tissue necrosis NOS
T20.2 Burn of second degree of head and neck BURN B 10,600 3,180
T20.3 Burn of third degree of head and neck BURN B 10,600 3,180
T20.6 Corrosion of second degree of head and neck BURN B 10,600 3,180
T22.3 Burn of third degree of shoulder and upper limb, except BURN B 10,600 3,180
wrist and hand
T23.3 Burn of third degree of wrist and hand BURN B 10,600 3,180
T23.6 Corrosion of second degree of wrist and hand BURN B 10,600 3,180
T23.7 Corrosion of third degree of wrist and hand BURN B 10,600 3,180
T24.3 Burn of third degree of hip and lower limb, except ankle BURN B 10,600 3,180
and foot
T24.7 Corrosion of third degree of hip and lower limb, except BURN B 10,600 3,180
ankle and foot
T25.3 Burn of third degree of ankle and foot BURN B 10,600 3,180
T26.1 Burn of cornea and conjunctival sac BURN B 10,600 3,180
T26.2 Burn with resulting rupture and destruction of eyeball BURN B 10,600 3,180
T26.3 Burn of other parts of eye and adnexa BURN B 10,600 3,180
T26.6 Corrosion of cornea and conjunctival sac BURN B 10,600 3,180
T27.0 Burn of larynx and trachea BURN B 10,600 3,180
T27.2 Burn of other parts of respiratory tract; Thoracic cavity BURN B 10,600 3,180
T28.0 Burn of mouth and pharynx BURN B 10,600 3,180
T28.1 Burn of oesophagus BURN B 10,600 3,180
T28.2 Burn of other parts of alimentary tract BURN B 10,600 3,180
T28.3 Burn of internal genitourinary organs BURN B 10,600 3,180
T28.5 Corrosion of mouth and pharynx BURN B 10,600 3,180
T28.6 Corrosion of oesophagus BURN B 10,600 3,180
T28.7 Corrosion of other parts of alimentary tract BURN B 10,600 3,180
T28.8 Corrosion of internal genitourinary organs BURN B 10,600 3,180
T29.2 Burns of multiple regions, no more than second-degree BURN B 10,600 3,180
burns mentioned
T29.3 Burns of multiple regions, at least one burn of third degree BURN B 10,600 3,180
mentioned
T29.6 Corrosions of multiple regions, no more than second- BURN B 10,600 3,180
degree corrosions mentioned
T31.2 Burns involving 20-29% of body surface BURN B 10,600 3,180
T32.2 Corrosions involving 20-29% of body surface BURN B 10,600 3,180
Frostbite with tissue necrosis of other and unspecified sites; Frosbite with
tissue necrosis NOS; Frosbite with tissue of leg NOS; Frosbite with tissue
T34.9 necrosis of trunk NOS BURN B 10,600 3,180
T21.3 Burn of third degree of trunk BURN C 16,100 4,830

T31.6 Burns involving 60-69% of body surface BURN C 16,100 4,830
T31.9 Burns involving 90% or more of body surface BURN C 16,100 4,830
T32.9 Corrosions involving 90% or more of body surface BURN C 16,100 4,830
I47.0 Re-entry ventricular arrhythmia CARDIAC ARRHYTHMIA 12,200 3,660
Supraventricular tachycardia; Atrial Paroxysmal tachycardia;
Atrioventricular [AV] Paroxysmal tachycardia; Junctional Paroxysmal
I47.1 tachycardia; Nodal Paroxysmal tachycardia CARDIAC ARRHYTHMIA 12,200 3,660
I47.2 Ventricular tachycardia CARDIAC ARRHYTHMIA 12,200 3,660

I47.9 Paroxysmal tachycardia, unspecified; Bouveret (-Hoffmann) CARDIAC ARRHYTHMIA 12,200 3,660
syndrome
I48 Atrial fibrillation and flutter CARDIAC ARRHYTHMIA 12,200 3,660

I49.0 Ventricular fibrillation and flutter CARDIAC ARRHYTHMIA 12,200 3,660
I49.1 Atrial premature depolarization; Atrial premature beats CARDIAC ARRHYTHMIA 12,200 3,660
I49.2 Junctional premature depolarization CARDIAC ARRHYTHMIA 12,200 3,660

I49.3 Ventricular premature depolarization CARDIAC ARRHYTHMIA 12,200 3,660
Other and unspecified premature depolarization; Ectopic beats;
I49.4 Extrasystoles; Extrasystolic arrhythmias; Premature CARDIAC ARRHYTHMIA 12,200 3,660
beats NOS; Premature contractions
I49.5 Sick sinus syndrome; Tachycardia-bradycardia syndrome CARDIAC ARRHYTHMIA 12,200 3,660
Other specified cardiac arrhythmias; Brugada syndrome; Long QT

syndrome; coronary sinus rhythm disorder; ectopic rhythm disorder;
I49.8 nodal rhythm disorder CARDIAC ARRHYTHMIA 12,200 3,660
I49.9 Cardiac arrhythmia, unspecified; Cardiac arrhythmia NOS CARDIAC ARRHYTHMIA 12,200 3,660
I42.0 Dilated cardiomyopathy; Congestive cardiomyopathy CARDIOMYOPATHY 13,400 4,020

I42.1 Obstructive hypertrophic cardiomyopathy; Hypertrophic CARDIOMYOPATHY 13,400 4,020
subaortic stenosis
I42.2 Other hypertrophic cardiomyopathy; Nonobstructive CARDIOMYOPATHY 13,400 4,020

hypertrophic cardiomyopathy
Endomyocardial (eosinophilic) disease; Endomyocardial (tropical) fibrosis;

Löffler's endocarditis
I42.3 CARDIOMYOPATHY 13,400 4,020
I42.4 Endocardial fibroelastosis; Congenital cardiomyopathy CARDIOMYOPATHY 13,400 4,020

I42.5 Other restrictive cardiomyopathy CARDIOMYOPATHY 13,400 4,020
I42.6 Alcoholic cardiomyopathy CARDIOMYOPATHY 13,400 4,020
I42.7 Cardio myopathy due to drugs and other external agents CARDIOMYOPATHY 13,400 4,020
I42.8 Other cardiomyopathies CARDIOMYOPATHY 13,400 4,020

I42.9 Cardio myopathy, unspecified; Primary cardiomyopathy CARDIOMYOPATHY 13,400 4,020
NOS; Secondary cardiomyopathy NOS
P29.0 Neonatal cardiac failure CARDIOVASCULAR COMPLICATIONS IN THE 22,700 6,810

NEWBORN
P29.1 Neonatal cardiac dysrhythmia CARDIOVASCULAR COMPLICATIONS IN THE 22,700 6,810

NEWBORN
P29.2 Neonatal hypertension CARDIOVASCULAR COMPLICATIONS IN THE 22,700 6,810

NEWBORN
P29.4 Transient myocardial ischaemia of newborn CARDIOVASCULAR COMPLICATIONS IN THE 22,700 6,810
NEWBORN
P29.8 Other cardiovascular disorders originating in the perinatal CARDIOVASCULAR COMPLICATIONS IN THE 22,700 6,810
period NEWBORN
Cauda equina syndrome; Neurogenic bladder due to cauda equina
syndrome
G83.4 Excludes: cord bladder NOS (G95.8) CAUDA EQUINA SYNDROME 8,800 2,640
A46 Erysipelas CELLULITIS 9,600 2,880

A48.0 Gas gangrene; Clostridial cellulitis; Clostridial myonecrosis CELLULITIS 9,600 2,880
L03.0 Cellulitis of finger and toe; Infection of nail; Onychia; CELLULITIS 9,600 2,880
Paronychia; Perionychia
L03.1 Cellulitis of other parts of limb, Axilla; Cellulitis of CELLULITIS 9,600 2,880
Hip;Cellulitis of Shoulder
L03.2 Cellulitis of face CELLULITIS 9,600 2,880

Cellulitis of trunk;Cellulitis of Abdominal wall;Cellulitis of
Back [any part]; Cellulitis of Chest wall;Cellulitis of Groin;Cellulitis of
L03.3 Perineum;Cellulitis of Umbilicus CELLULITIS 9,600 2,880
L03.8 Cellulitis of other sites; Cellulitis of Head [any part, except CELLULITIS 9,600 2,880
face];Cellulitis of Scalp
L03.9 Cellulitis, unspecified CELLULITIS 9,600 2,880

L98.3 Eosinophilic cellulitis [Wells] CELLULITIS 9,600 2,880
G80.0 Spastic cerebral palsy; Congenital spastic paralysis CEREBRAL PALSY 9,500 2,850
(cerebral); Spastic tetraplegic cerebral palsy
G80.1 Spastic diplegia; Spastic cerebral palsy NOS CEREBRAL PALSY 9,500 2,850
G80.2 Infantile hemiplegia CEREBRAL PALSY 9,500 2,850
Spastic hemiplegic cerebral palsy
G80.3 Dyskinetic cerebral palsy; Athetoid cerebral palsy; Dystonic CEREBRAL PALSY 9,500 2,850
cerebral palsy
G80.4 Ataxic cerebral palsy CEREBRAL PALSY 9,500 2,850

G80.8 Other infantile cerebral palsy; Mixed cerebral palsy CEREBRAL PALSY 9,500 2,850
syndromes
G80.9 Infantile cerebral palsy, unspecified; Cerebral palsy NOS CEREBRAL PALSY 9,500 2,850
K74.3 Primary biliary cirrhosis; Chronic nonsupparative CHOLANGITIS 13,200 3,960

destructive cholangitis
K80.3 Calculus of bile duct with cholangitis; Any condition listed in CHOLANGITIS 13,200 3,960
K80.5 with cholangitis
Calculus of gallbladder with acute cholecystitis; Any condition listed in

K80.0 K80.2 with acute cholecystitis CHOLECYSTITIS 11,300 3,390
Acute cholecystitis with cholelithiasis
Calculus of gallbladder with other cholecystitis; Any

K80.1 condition listed in K80.2 with chronic cholecystitis; Cholecystitis with CHOLECYSTITIS 11,300 3,390
cholelithiasis NOS
K80.4 Calculus of bile duct with cholecystitis; Any condition listed CHOLECYSTITIS 11,300 3,390
in K80.5 with cholecystitis (with cholangitis)
Acute cholecystitis; Abscess of gallbladder without calculus;

Angiocholecystitis without calculus; Acute emphysematous cholecystitis
without calculus; Gangrenous cholecystitis without calculus; Supparative
cholecystitis without calculus; Empyema of gallbladder without calculus;
K81.0 Gangrene of gallbladder without calculus CHOLECYSTITIS 11,300 3,390
K81.1 Chronic cholecystitis CHOLECYSTITIS 11,300 3,390

K81.8 Other cholecystitis CHOLECYSTITIS 11,300 3,390
Q90.0 Trisomy 21, meiotic nondisjunction CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q90.2 Trisomy 21, translocation CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q90.9 Down's syndrome, unspecified; Trisomy 21 NOS CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q91.0 Trisomy 18, meiotic nondisjunction CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q91.2 Trisomy 18, translocation CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q91.3 Edwards' syndrome, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q91.7 Patau's syndrome, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q92.9 Trisomy and partial trisomy of autosomes, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q93.1 Whole chromosome monosomy, mosaicism (mitotic CHROMOSOMAL ABNORMALITIES 12,700 3,810
nondisjunction)
Q93.2 Chromosome replaced with ring or dicentric CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q93.4 Deletion of short arm of chromosome 5; Cri-du-chat CHROMOSOMAL ABNORMALITIES 12,700 3,810
syndrome
Q93.5 Other deletions of part of a chromosome; Angelman CHROMOSOMAL ABNORMALITIES 12,700 3,810
syndrome
Q93.7 Deletions with other complex rearrangements CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q93.9 Deletion from autosomes, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q95.9 Balanced rearrangement and structural marker, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q96.9 Turner's syndrome, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810

Q97.9 Sex chromosome abnormality, female phenotype, CHROMOSOMAL ABNORMALITIES 12,700 3,810
unspecified
Q98.4 Klinefelter's syndrome, unspecified CHROMOSOMAL ABNORMALITIES 12,700 3,810

Q99.2 Fragile X chromosome; Fragile X syndrome CHROMOSOMAL ABNORMALITIES 12,700 3,810
Q99.8 Other specified chromosome abnormalities CHROMOSOMAL ABNORMALITIES 12,700 3,810
N18.0 End stage renal disease CHRONIC KIDNEY DISEASE N/A N/A
Chronic kidney disease, stage 5 Chronic uraemia
End stage kidney disease:
• in allograft failure
• NOS
• on dialysis
• without dialysis or transplant Renal retinitis+(H32.8*)
Uraemic:
• apoplexia+(I68.8*)
• dementia+(F02.8*)
N18.5 • neuropathy+(G63.8*) CHRONIC KIDNEY DISEASE 14,500 4,350
• paralysis+(G99.8*)
• pericarditis+(I32.8*)
N18.8 Other chronic renal failure CHRONIC KIDNEY DISEASE N/A N/A
N18.9 Chronic renal failure CHRONIC KIDNEY DISEASE 14,500 4,350

Chronic kidney disease, unspecified
Unspecified renal failure Unspecified kidney failure

Renal insufficiency NOS
N19 CHRONIC KIDNEY DISEASE 14,500 4,350
Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with

acute lower respiratory infection
J44.0 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12,200 3,660
Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with

acute exacerbation, unspecified
J44.1 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12,200 3,660
Chronic asthmatic (obstructive) bronchitis NOS; Chronic

J44.8 emphysematous bronchitis NOS; Chronic obstructive bronchitis NOS CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12,200 3,660
Chronic obstructive pulmonary disease, unspecified; Chronic obstructive

J44.9 airway disease NOS; Chronic CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12,200 3,660
obstructive lung disease NOS
Q35.0 Cleft hard palate, bilateral; Bilateral fissure of hard palate; CLEFT LIP AND PALATE 7,800 2,340
Bilateral palatoschisis of hard palate
Q35.1 Cleft hard palate CLEFT LIP AND PALATE 7,800 2,340
Q35.3 Cleft soft palate CLEFT LIP AND PALATE 7,800 2,340
Q35.5 Cleft hard palate with cleft soft palate CLEFT LIP AND PALATE 7,800 2,340
Q35.7 Cleft uvula CLEFT LIP AND PALATE 7,800 2,340
Q35.8 Cleft palate, unspecified, bilateral CLEFT LIP AND PALATE 7,800 2,340
Q35.9 Cleft palate, unspecified CLEFT LIP AND PALATE 7,800 2,340
Q36.0 Cleft lip, bilateral CLEFT LIP AND PALATE 7,800 2,340
Q36.1 Cleft lip, median CLEFT LIP AND PALATE 7,800 2,340
Q36.9 Cleft lip, unilateral; Cleft lip NOS CLEFT LIP AND PALATE 7,800 2,340
Q37.0 Cleft hard palate with bilateral cleft lip CLEFT LIP AND PALATE 7,800 2,340
Q37.1 Cleft hard palate with unilateral cleft lip; Cleft hard palate CLEFT LIP AND PALATE 7,800 2,340
with cleft lip NOS
Q37.2 Cleft soft palate with bilateral cleft lip CLEFT LIP AND PALATE 7,800 2,340
Q37.3 Cleft soft palate with unilateral cleft lip; Cleft soft palate CLEFT LIP AND PALATE 7,800 2,340
with cleft lip NOS
Q37.4 Cleft hard and soft palate with bilateral cleft lip CLEFT LIP AND PALATE 7,800 2,340
Q37.5 Cleft hard and soft palate with unilateral cleft lip; Cleft hard CLEFT LIP AND PALATE 7,800 2,340
and soft palate with cleft lip NOS
Q37.8 Unspecified cleft palate with bilateral cleft lip CLEFT LIP AND PALATE 7,800 2,340
Q37.9 Unspecified cleft palate with unilateral cleft lip; Cleft palate CLEFT LIP AND PALATE 7,800 2,340
with cleft lip NOS
F01.0 Vascular dementia of acute onset COGNITIVE DYSFUNCTION 8,200 2,460

R41.0 Disorientation, unspecified; Confusion NOS COGNITIVE DYSFUNCTION 8,200 2,460
R41.3 Other amnesia; Amnesia NOS COGNITIVE DYSFUNCTION 8,200 2,460
Senility; Old age without mention of psychosis; Senescence
without mention of psychosis; Senile asthenia; Senile debility
R54 COGNITIVE DYSFUNCTION 8,200 2,460
D34 Benign neoplasm of thyroid gland COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.0 Benign neoplasm of Adrenal gland COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.1 Benign neoplasm of Parathyroid gland COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.2 Benign neoplasm of Pituitary gland COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.3 Benign neoplasm of Craniopharyngeal duct COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.4 Benign neoplasm of Pineal gland COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D35.9 Benign neoplasm of Endocrine gland, unspecified COMPLICATIONS OF BENIGN NEOPLASMS OF 12,000 3,600
ENDOCRINE GLANDS
D16.0 Benign neoplasm of Scapula and long bones of upper limb COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.1 Benign neoplasm of Short bones of upper limb COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.2 Benign neoplasm ofLong bones of lower limb COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.3 Benign neoplasm of Short bones of lower limb COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
Benign neoplasm of Bones of skull and face; Benign neoplasm of Superior COMPLICATIONS OF BENIGN NEOPLASMS OF THE BONES
Maxilla; Benign neoplasm of Orbital
D16.4 bone 10,500 3,150
D16.5 Benign neoplasm of Lower jaw bone COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.6 Benign neoplasm of Vertebral column COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.7 Benign neoplasm of Ribs, sternum and clavicle COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.8 Benign neoplasm of Pelvic bones, sacrum and coccyx COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
BONES
D16.9 Benign neoplasm of Bone and articular cartilage, COMPLICATIONS OF BENIGN NEOPLASMS OF THE 10,500 3,150
unspecified BONES
D12.0 Benign neoplasm of Caecum;Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
Ileocaecal valve DIGESTIVE SYSTEM
D12.1 Benign neoplasm of Appendix COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
Benign neoplasm of Transverse colon; Benign neoplasm of Hepatic flexure; COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
D12.3 Benign neoplasm of Splenic flexure SYSTEM 8,700 2,610
D12.4 Benign neoplasm of Descending colon COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D12.5 Benign neoplasm of Sigmoid colon COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
Benign neoplasm of Colon, unspecified; Adenomatosis of colon; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
neoplasm of Large intestine NOS; Hereditary SYSTEM
D12.6 Polyposis of colon 8,700 2,610
Benign neoplasm of Rectosigmoid junction; Adenomatosis of colon; COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
Benign neoplasm of Large intestine NOS; SYSTEM
D12.7 Hereditary Polyposis of colon 8,700 2,610
D12.8 Benign neoplasm of Rectum COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D12.9 Benign neoplasm of Anus and anal canal COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D13.0 Benign neoplasm of Oesophagus COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D13.1 Benign neoplasm of Stomach COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D13.2 Benign neoplasm of Duodenum COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D13.3 Benign neoplasm of Other and unspecified parts of small COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
intestine DIGESTIVE SYSTEM
D13.4 Benign neoplasm of Liver; Benign neoplasm of Intrahepatic COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
bile ducts DIGESTIVE SYSTEM
D13.5 Benign neoplasm of Extrahepatic bile ducts COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D13.6 Benign neoplasm of Pancreas COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
Benign neoplasm of Endocrine pancreas; Benign neoplasm of Islet cell COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
D13.7 tumour; Benign neoplasm of Islets of SYSTEM 8,700 2,610
Langerhans
Benign neoplasm of Ill-defined sites within the digestive system; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
neoplasm of Digestive system NOS; Benign neoplasm of Intestine NOS; SYSTEM
D13.9 Benign neoplasm of Spleen 8,700 2,610
D17.5 Benign lipomatous neoplasm of intra-abdominal organs COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D17.6 Benign lipomatous neoplasm of spermatic cord COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
Benign lipomatous neoplasm of other sites; Benign lipomatous neoplasm COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE
of Peritoneum; Benign lipomatous SYSTEM
D17.7 neoplasm of Retroperitoneum 8,700 2,610
D20.0 Benign neoplasm of of soft tissue of Retroperitoneum COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D20.1 Benign neoplasm of of soft tissue of Peritoneum COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
DIGESTIVE SYSTEM
D21.4 Benign neoplasm of Connective and other soft tissue of COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,700 2,610
abdomen DIGESTIVE SYSTEM
D25.0 Submucous leiomyoma of uterus COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
FEMALE GENITAL TRACT
D25.1 Intramural leiomyoma of uterus COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D25.2 Subserosal leiomyoma of uterus COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D25.9 Leiomyoma of uterus, unspecified COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D26.0 Other Benign neoplasm of Cervix uteri COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D26.1 Other Benign neoplasm of Corpus uteri COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D26.7 Other Benign neoplasm of Other parts of uterus COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D26.9 Other Benign neoplasm of Uterus, unspecified COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D27 Benign neoplasm of ovary COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D28.0 Benign neoplasm of Vulva COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D28.1 Benign neoplasm of Vagina COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
Benign neoplasm of Uterine tubes and ligaments; Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE
Fallopian Tubes; Benign neoplasm of Uterine Broad Ligament; Benign GENITAL TRACT
D28.2 neoplasm of Uterine round ligament 9,600 2,880
D28.7 Benign neoplasm of Other specified female genital organs COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D28.9 Benign neoplasm of Female genital organ, unspecified COMPLICATIONS OF BENIGN NEOPLASMS OF THE 9,600 2,880
D29.0 Benign neoplasm of Penis COMPLICATIONS OF BENIGN NEOPLASMS OF THE 7,700 2,310
MALE GENITAL TRACT
D29.1 Benign neoplasm of Prostate COMPLICATIONS OF BENIGN NEOPLASMS OF THE 7,700 2,310
MALE GENITAL TRACT
D29.2 Benign neoplasm of Testis COMPLICATIONS OF BENIGN NEOPLASMS OF THE 7,700 2,310
MALE GENITAL TRACT
D29.4 Benign neoplasm of Scrotum; Benign neoplasm of Skin of COMPLICATIONS OF BENIGN NEOPLASMS OF THE 7,700 2,310
scrotum MALE GENITAL TRACT
D32.0 Benign neoplasm of Cerebral meninges COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
NERVOUS SYSTEM
D32.1 Benign neoplasm of Spinal meninges COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
NERVOUS SYSTEM
D32.9 Benign neoplasm of Meninges, unspecified; Meningioma COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
NOS NERVOUS SYSTEM
Benign neoplasm of Brain, supratentorial; Benign neoplasm of Cerebral
ventricle; Benign neoplasm of Cerebrum; Benign neoplasm of Frontal lobe;
Benign neoplasm of Occipital lobe; Benign neoplasm of Parietal lobe; COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS
D33.0 Benign neoplasm of Temporal lobe SYSTEM 14,800 4,440
Benign neoplasm of Brain, infratentorial; Benign neoplasm of Brain stem; COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS
D33.1 Benign neoplasm of Cerebellum; Benign SYSTEM 14,800 4,440
neoplasm of Fourth ventricle
D33.2 Benign neoplasm of Brain, unspecified COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
NERVOUS SYSTEM
D33.3 Benign neoplasm of Cranial nerves; Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
Olfactory bulb NERVOUS SYSTEM
D33.4 Benign neoplasm of Spinal cord COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
NERVOUS SYSTEM
D33.7 Benign neoplasm of Other specified parts of central COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
nervous system NERVOUS SYSTEM
D33.9 Benign neoplasm of Central nervous system, unspecified; COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
Central Nervous system NOS NERVOUS SYSTEM
D36.1 Benign neoplasm of Peripheral nerves and autonomic COMPLICATIONS OF BENIGN NEOPLASMS OF THE 14,800 4,440
nervous system NERVOUS SYSTEM
Benign neoplasm of Lip; Benign neoplasm of frenulum of Lip; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL
D10.0 neoplasm of Inner aspect of lip; Benign CAVITY, PHARYNX, LARYNX, SALIVARY 9,500 2,850
neoplasm of Mucosa of Lip; Vermilion border of Lip GLANDS
Benign neoplasm of Tongue;Benign neoplasm of Lingual tonsil COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL
CAVITY, PHARYNX, LARYNX, SALIVARY
D10.1 GLANDS 9,500 2,850
Benign neoplasm of Other and unspecified parts of mouth; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL
neoplasm of Minor salivary gland NOS CAVITY, PHARYNX, LARYNX, SALIVARY
D10.3 GLANDS 9,500 2,850
Benign neoplasm of Nasopharynx; Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE

Pharyngeal tonsil; Benign neoplasm of Posterior margin of septum and ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS
D10.6 choanae 9,500 2,850
COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL

D10.7 Benign neoplasm of Hypopharynx CAVITY, PHARYNX, LARYNX, SALIVARY 9,500 2,850
GLANDS
COMPLICATIONS OF BENIGN NEOPLASMS OF THE

D10.9 Benign neoplasm of Pharynx, unspecified ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS 9,500 2,850

D11.0 Benign neoplasm of Parotid gland CAVITY, PHARYNX, LARYNX, SALIVARY 9,500 2,850
GLANDS
Benign neoplasm of Other major salivary glands; sublingual; COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL
submandibular CAVITY, PHARYNX, LARYNX, SALIVARY
D11.7 GLANDS 9,500 2,850

CAVITY, PHARYNX, LARYNX, SALIVARY
D11.9 Benign neoplasm of Major salivary gland, unspecified GLANDS 9,500 2,850
Benign neoplasm of Larynx; Benign neoplasm of suprahyoid portion of COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL
D14.1 Epiglottis CAVITY, PHARYNX, LARYNX, SALIVARY 9,500 2,850
GLANDS

D14.2 Benign neoplasm of Trachea CAVITY, PHARYNX, LARYNX, SALIVARY 9,500 2,850
GLANDS
D30.0 Benign neoplasm of Kidney COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,300 2,490
URINARY SYSTEM
D30.1 Benign neoplasm of Renal pelvis COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,300 2,490
URINARY SYSTEM
Benign neoplasm of Bladder; Benign neoplasm of Urethral orifice of COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY
D30.3 bladder; Benign neoplasm of ureteric orifice of SYSTEM 8,300 2,490
bladder
D30.4 Benign neoplasm of Urethra COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,300 2,490
URINARY SYSTEM
D30.9 Benign neoplasm of Urinary organ, unspecified; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE 8,300 2,490
neoplasm of Urinary system NOS URINARY SYSTEM
Cardiac septal defect, acquired; Acquired atrial septal
I51.0 defect old; Acquired auricular septal defect old ; Acquired ventricular COMPLICATIONS OF HEART DISEASES 14,400 4,320
septal defect old
I51.1 Rupture of chordae tendineae, not elsewhere classified COMPLICATIONS OF HEART DISEASES 14,400 4,320
I51.2 Rupture of papillary muscle, not elsewhere classified COMPLICATIONS OF HEART DISEASES 14,400 4,320
Intra cardiac thrombosis, not elsewhere classified; Old Apical thrombosis;
I51.3 Old Atrial thrombosis; Old Auricular COMPLICATIONS OF HEART DISEASES 14,400 4,320
thrombosis; Old Venticular thrombosis
I51.4 Myocarditis, unspecified; Myocardial fibrosis; Myocarditis COMPLICATIONS OF HEART DISEASES 14,400 4,320
NOS; Chronic interstitial myocarditis
Myocardial degeneration; Fatty Degeneration of heart or myocardium

fatty; Senile Degeneration of heart or
I51.5 myocardium; Myocardial disease COMPLICATIONS OF HEART DISEASES 14,400 4,320
I51.8 Other ill-defined heart diseases; Acute carditis; Chronic COMPLICATIONS OF HEART DISEASES 14,400 4,320
Carditis; Acute pancarditis; Chronic pancarditis
D18.0 Haemangioma, any site; Angioma NOS COMPLICATIONS OF HEMANGIOMA AND 9,000 2,700
LYMPHANGIOMA
D18.1 Lymphangioma, any site COMPLICATIONS OF HEMANGIOMA AND 9,000 2,700

LYMPHANGIOMA
D14.3 Benign neoplasm of Bronchus and lung COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
D14.4 Benign neoplasm of Respiratory system, unspecified COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
D15.0 Benign neoplasm of Thymus COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030

NEOPLASMS
D15.1 Benign neoplasm of Heart COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
D15.2 Benign neoplasm of Mediastinum COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
D15.9 Benign neoplasm of Intrathoracic organ, unspecified COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
D17.4 Benign lipomatous neoplasm of intrathoracic organs COMPLICATIONS OF INTRATHORACIC BENIGN 10,100 3,030
NEOPLASMS
Benign neoplasm of Connective and other soft tissue of thorax; Benign

neoplasm of Connective and other soft tissue of Axilla; Benign neoplasm
of Connective and other soft tissue of Diaphragm; Benign neoplasm of
D21.3 Connective and other soft tissue of Great vessels COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS 10,100 3,030
A52.1 Late Symptomatic neurosyphilis; Tabes dorsalis COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650
DISEASES
Neurosyphilis, unspecified; Syphilitic Gumma of central nervous system COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES
NOS; Late Syphilis of central nervous system NOS; Syphiloma of central
A52.3 nervous system NOS 5,500 1,650
A52.7 Other symptomatic late syphilis COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650
DISEASES
A53.0 Latent syphilis, unspecified as early or late; Latent syphilis COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650
NOS; Positive serological reaction for syphilis DISEASES
Gonococcal infection of lower genitourinary tract with COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES
periurethral and accessory gland abscess; Gonococcal Bartholin's gland
A54.1 abscess 5,500 1,650
A54.2 Gonococcal Pelviperitonitis and other gonococcal COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650
genitourinary infections DISEASES
A54.8 Other gonococcal infections: COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650

Gonococcal septicaemia; Gonococcal skin lesions DISEASES
Chlamydial lymphogranuloma (venereum); Climatic or tropical bubo ; COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES
A55 Durand-Nicolas-Favre disease; Esthiomene; 5,500 1,650
Lymphogranuloma inguinale
A56.1 Chlamydial infection of pelviperitoneum and other COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650
genitourinary organs; DISEASES
A59 Trichomoniasis COMPLICATIONS OF SEXUALLY TRANSMITTED 5,500 1,650

DISEASES
T79.0 Air embolism (traumatic) COMPLICATIONS OF TRAUMA 9,300 2,790

T79.1 Fat embolism (traumatic) COMPLICATIONS OF TRAUMA 9,300 2,790
T79.2 Traumatic secondary and recurrent haemorrhage COMPLICATIONS OF TRAUMA 9,300 2,790
T79.3 Post-traumatic wound infection, not elsewhere classified COMPLICATIONS OF TRAUMA 9,300 2,790
T79.4 Traumatic shock; immediate shock following injury; COMPLICATIONS OF TRAUMA 9,300 2,790
Delayed shock following injury
T79.5 Traumatic anuria; Crush syndrome; Renal failure following COMPLICATIONS OF TRAUMA 9,300 2,790
crushing
T79.6 Traumatic ischaemia of muscle; Compartment syndrome; COMPLICATIONS OF TRAUMA 9,300 2,790
Volkmann's ischaemic contracture
T79.7 Traumatic subcutaneous emphysema COMPLICATIONS OF TRAUMA 9,300 2,790

T79.8 Other early complications of trauma COMPLICATIONS OF TRAUMA 9,300 2,790
Congenital adrenogenital disorders associated with enzyme deficiency;
Congenital adrenal hyperplasia; 21-Hydroxylase deficiency; Salt-losing
E25.0 congenital adrenal hyperplasia CONGENITAL ANDROGENITAL DISORDER 7,800 2,340
P61.2 Anaemia of prematurity CONGENITAL ANEMIA 15,200 4,560

P61.3 Congenital anaemia from fetal blood loss CONGENITAL ANEMIA 15,200 4,560
P61.4 Other congenital anaemias, not elsewhere classified; CONGENITAL ANEMIA 15,200 4,560
Congenital anaemia NOS
D64.4 Congenital dyserythropoietic anaemia; Congenital CONGENITAL BLOOD DISORDERS 4,000 1,200
Dyshaematopoietic anaemia
D74.0 Congenital methaemoglobinaemia CONGENITAL BLOOD DISORDERS 4,000 1,200
Q80.2 Lamellar ichthyosis; Collodion baby CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q80.9 Congenital ichthyosis, unspecified CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q81.2 Epidermolysis bullosa dystrophica CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q81.8 Other epidermolysis bullosa CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q81.9 Epidermolysis bullosa, unspecified CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q82.0 Hereditary lymphoedema CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q82.2 Mastocytosis; Urticaria pigmentosa CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q82.3 Incontinentia pigmenti CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q82.4 Ectodermal dysplasia (anhidrotic) CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Other specified congenital malformations of skin; Abnormal palmar
creases; Accessory skin tags; Benign familial pemphigus [Hailey-Hailey];
Cutis laxa (hyperelastica); Dermatoglyphic anomalies; Inherited keratosis
Q82.8 palmaris et plantaris; Keratosis follicula CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Q84.8 Other specified congenital malformations of integument; CONGENITAL DERMATOLOGIC DISEASES 11,800 3,540
Aplasia cutis congenita
Q50.1 Developmental ovarian cyst CONGENITAL DISORDERS OF THE FEMALE GENITAL 9,300 2,790
TRACT
Other congenital malformations of ovary; Accessory ovary; Congenital CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT
malformation of ovary NOS; Ovarian streak
Q50.3 9,300 2,790
Q50.4 Embryonic cyst of fallopian tube; Fimbrial cyst CONGENITAL DISORDERS OF THE FEMALE GENITAL 9,300 2,790
TRACT
Q50.5 Embryonic cyst of broad ligament; Cyst epoophoron; CONGENITAL DISORDERS OF THE FEMALE GENITAL 9,300 2,790
Gartner's duct Cyst; Parovarian Cyst TRACT
Other congenital malformations of fallopian tube and broad ligament;
Absence of fallopian tube or broad ligament; Accessory of fallopian tube
or broad ligament; Atresia of fallopian tube or broad ligament; Congenital
malformation of fallopian tube or broad ligament NOS
Q50.6 CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT 9,300 2,790
Q51.0 Agenesis and aplasia of uterus; Congenital absence of CONGENITAL DISORDERS OF THE FEMALE GENITAL 9,300 2,790
uterus TRACT
Q51.9 Congenital malformation of uterus and cervix, unspecified CONGENITAL DISORDERS OF THE FEMALE GENITAL 9,300 2,790
TRACT
Q65.6 Unstable hip; Dislocatable hip; Subluxatable hip CONGENITAL DISORDERS OF THE 5,300 1,590
MUSCULOSKELETAL SYSTEM
Q67.3 Plagiocephaly CONGENITAL DISORDERS OF THE 5,300 1,590

Other congenital deformities of skull, face and jaw; Depressions in skull; CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM
Deviation of nasal septum, congenital; Hemifacial atrophy or hypertrophy;
Q67.4 Squashed or bent nose, congenital 5,300 1,590
Q67.6 Pectus excavatum; Congenital funnel chest CONGENITAL DISORDERS OF THE 5,300 1,590
Q67.7 Pectus carinatum; Congenital pigeon chest CONGENITAL DISORDERS OF THE 5,300 1,590
Congenital deformity of sternocleidomastoid muscle; Congenital, CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM
sternomastoid torticollis; Contracture of sternocleidomastoid muscle;
Q68.0 Sternomastoid tumour, 5,300 1,590
congenital
Congenital scoliosis due to congenital bony malformation; Hemivertebra CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM
fusion or failure of segmentation with
Q76.3 scoliosis 5,300 1,590
Q78.0 Osteogenesis imperfecta; Fragilitas ossium CONGENITAL DISORDERS OF THE 5,300 1,590
Q78.2 Osteopetrosis; Albers-Schönberg syndrome CONGENITAL DISORDERS OF THE 5,300 1,590

Q78.8 Other specified osteochondrodysplasias; Osteopoikilosis CONGENITAL DISORDERS OF THE 5,300 1,590
Q78.9 Osteochondrodysplasia, unspecified; Chondrodystrophy CONGENITAL DISORDERS OF THE 5,300 1,590

NOS; Osteodystrophy NOS MUSCULOSKELETAL SYSTEM
Q87.5 Other congenital malformation syndromes with other CONGENITAL DISORDERS OF THE 5,300 1,590
skeletal changes MUSCULOSKELETAL SYSTEM
Q39.0 Atresia of oesophagus without fistula; Atresia of CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
oesophagus NOS
Atresia of oesophagus with tracheo-oesophageal fistula; Atresia of
oesophagus with broncho-oesophageal fistula
Q39.1 CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q39.2 Congenital tracheo-oesophageal fistula without atresia; CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital tracheo-oesophageal fistula NOS
Q39.6 Diverticulum of oesophagus; Oesophageal pouch CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q39.9 Congenital malformation of oesophagus, unspecified CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital hypertrophic pyloric stenosis; Congenital or infantile
constriction of pylorus; Congenital or infantile hypertrophy of pylorus;
Congenital or infantile spasm of pylorus; Congenital or infantile stenosis of
Q40.0 pylorus; CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital or infantile stricture of pylorus
Q40.1 Congenital hiatus hernia; Displacement of cardia through CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
oesophageal hiatus
Other specified congenital malformations of stomach; Congenital

displacement of stomach; Congenital diverticulum of stomach; Congenital
hourglass stomach; Duplication of stomach; Megalogastria; Microgastria
Q40.2 CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital malformation of upper alimentary tract, unspecified;

Congenital anomaly NOS of upper alimentary tract; Congenital deformity
Q40.9 NOS of upper alimentary tract CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q41.0 Congenital absence, atresia and stenosis of duodenum CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q41.1 Congenital absence, atresia and stenosis of jejunum; Apple CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
peel syndrome; Imperforate jejunum
Q41.2 Congenital absence, atresia and stenosis of ileum CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital absence, atresia and stenosis of small intestine, part
unspecified; Congenital absence, atresia and stenosis
Q41.9 of intestine NOS CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q42.0 Congenital absence, atresia and stenosis of rectum with CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
fistula
Q42.1 Congenital absence, atresia and stenosis of rectum without CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
fistula; Imperforate rectum
Q42.2 Congenital absence, atresia and stenosis of anus with fistula CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q42.3 Congenital absence, atresia and stenosis of anus without CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
fistula; Imperforate anus
Q42.9 Congenital absence, atresia and stenosis of large intestine, CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
part unspecified
Q43.0 Meckel's diverticulum; Persistent omphalomesenteric duct; CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Persistent vitelline duct
Q43.1 Hirschsprung's disease; Aganglionosis; Congenital CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
(aganglionic) megacolon
Q43.2 Other congenital functional disorders of colon; Congenital CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
dilatation of colon
Congenital malformations of intestinal fixation; Congenital anomalous
omental adhesions [bands] ; Congenital peritoneal adhesions [bands];
Jackson's membrane; Malrotation of colon; Failure of rotation of caecum
and colon; Incomplete rotation of caecum and colon; Insufficient rotation
Q43.3 of caecum and colon; Universal mesentery CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q43.4 Duplication of intestine CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390

Q43.5 Ectopic anus CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q43.6 Congenital fistula of rectum and anus CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q43.7 Persistent cloaca; Cloaca NOS CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Other specified congenital malformations of intestine; Congenital blind
loop syndrome; Congenital diverticulitis, colon; Congenital diverticulum,
intestine; Dolichocolon; Megaloappendix; Megaloduodenum;
Microcolon; Transposition of appendix; Transposition of
Q43.8 colon; Transposition of intestine CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q43.9 Congenital malformation of intestine, unspecified CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q44.0 Agenesis, aplasia and hypoplasia of gallbladder; Congenital CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
absence of gallbladder
Other congenital malformations of gallbladder; Congenital malformation

Q44.1 of gallbladder NOS; Intrahepatic gallbladder CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q44.2 Atresia of bile ducts CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390

Q44.3 Congenital stenosis and stricture of bile ducts CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q44.4 Choledochal cyst CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Other congenital malformations of bile ducts; Accessory hepatic duct;
Congenital malformation of bile duct NOS; Biliary duct Duplication; Cystic
Q44.5 duct Duplication CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q44.6 Cystic disease of liver; Fibrocystic disease of liver CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Other congenital malformations of liver; Accessory liver; Alagille's
syndrome; Congenital absence of liver; Congenital hepatomegaly;
Q44.7 Congenital malformation of liver NOS CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q45.0 Agenesis, aplasia and hypoplasia of pancreas; Congenital CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
absence of pancreas
Other specified congenital malformations of digestive system; Absence of
alimentary tract NOS, complete; Absence of alimentary tract NOS, partial;
Duplication of digestive organs NOS; Malposition, congenital of digestive
Q45.8 organs NOS CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Congenital malformation of digestive system, unspecified; Congenital

anomaly NOS of digestive system ; Congenital deformity NOS of digestive
Q45.9 system CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q79.0 Congenital diaphragmatic hernia CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390

Other congenital malformations of diaphragm; Absence of
Q79.1 diaphragm; Congenital malformation of diaphragm NOS; Eventration of CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
diaphragm
Q79.2 Exomphalos; Omphalocele CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390

Q79.3 Gastroschisis CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q79.4 Prune belly syndrome CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q79.5 Other congenital malformations of abdominal wall CONGENITAL GASTROINTESTINAL DISORDERS 11,300 3,390
Q20.0 Common arterial trunk; Persistent truncus arteriosus CONGENITAL HEART DISEASES 11,600 3,480
Q20.1 Double outlet right ventricle; Taussig-Bing syndrome CONGENITAL HEART DISEASES 11,600 3,480
Q20.2 Double outlet left ventricle CONGENITAL HEART DISEASES 11,600 3,480
Discordant ventriculoarterial connection;
Dextrotransposition of aorta; Transposition of great vessels (complete)
Q20.3 CONGENITAL HEART DISEASES 11,600 3,480
Q20.4 Double inlet ventricle; Common ventricle; Cor triloculare CONGENITAL HEART DISEASES 11,600 3,480
biatriatum; Single ventricle
Discordant atrioventricular connection; Corrected transposition;

Q20.5 Laevotransposition; Ventricular inversion CONGENITAL HEART DISEASES 11,600 3,480
Q20.9 Congenital malformation of cardiac chambers and CONGENITAL HEART DISEASES 11,600 3,480
connections, unspecified
Q21.0 Ventricular septal defect CONGENITAL HEART DISEASES 11,600 3,480
Atrial septal defect; Coronary sinus defect; Patent or persistent foramen
ovale; Patent or persistent ostium
Q21.1 secundum defect (type II); Sinus venosus defect CONGENITAL HEART DISEASES 11,600 3,480
Atrioventricular septal defect; Common atrioventricular

Q21.2 canal; Endocardial cushion defect; Ostium primum atrial septal defect CONGENITAL HEART DISEASES 11,600 3,480
(type I)
Tetralogy of Fallot; Ventricular septal defect with pulmonary stenosis or

Q21.3 atresia, dextroposition of aorta and CONGENITAL HEART DISEASES 11,600 3,480
hypertrophy of right ventricle.
Q21.4 Aortopulmonary septal defect; Aortic septal defect; CONGENITAL HEART DISEASES 11,600 3,480
Aortopulmonary window
Q21.8 Other congenital malformations of cardiac septa; CONGENITAL HEART DISEASES 11,600 3,480
Eisenmenger's defect; Pentalogy of Fallot
Q21.9 Congenital malformation of cardiac septum, unspecified; CONGENITAL HEART DISEASES 11,600 3,480
Septal (heart) defect NOS
Q22.0 Pulmonary valve atresia CONGENITAL HEART DISEASES 11,600 3,480
Q22.1 Congenital pulmonary valve stenosis CONGENITAL HEART DISEASES 11,600 3,480
Q22.2 Congenital pulmonary valve insufficiency; Congenital CONGENITAL HEART DISEASES 11,600 3,480
pulmonary valve regurgitation
Q22.4 Congenital tricuspid stenosis; Tricuspid atresia CONGENITAL HEART DISEASES 11,600 3,480
Q22.5 Ebstein's anomaly CONGENITAL HEART DISEASES 11,600 3,480
Q22.6 Hypoplastic right heart syndrome CONGENITAL HEART DISEASES 11,600 3,480
Q22.8 Other congenital malformations of tricuspid valve CONGENITAL HEART DISEASES 11,600 3,480
Q23.0 Congenital stenosis of aortic valve; Congenital aortic CONGENITAL HEART DISEASES 11,600 3,480
atresia; Congenital aortic stenosis
Q23.1 Congenital insufficiency of aortic valve; Bicuspid aortic CONGENITAL HEART DISEASES 11,600 3,480
valve; Congenital aortic insufficiency
Q23.2 Congenital mitral stenosis; Congenital mitral atresia CONGENITAL HEART DISEASES 11,600 3,480
Q23.3 Congenital mitral insufficiency CONGENITAL HEART DISEASES 11,600 3,480
Hypoplastic left heart syndrome; Atresia, or marked hypoplasia of aortic
orifice or valve, with hypoplasia of ascending aorta and defective
development of left ventricle (with mitral valve stenosis or
Q23.4 atresia). CONGENITAL HEART DISEASES 11,600 3,480
Q23.8 Other congenital malformations of aortic and mitral valves CONGENITAL HEART DISEASES 11,600 3,480
Q23.9 Congenital malformation of aortic and mitral valves, CONGENITAL HEART DISEASES 11,600 3,480
unspecified
Q24.0 Dextrocardia CONGENITAL HEART DISEASES 11,600 3,480

Q24.2 Cor triatriatum CONGENITAL HEART DISEASES 11,600 3,480
Q24.3 Pulmonary infundibular stenosis CONGENITAL HEART DISEASES 11,600 3,480
Q24.4 Congenital subaortic stenosis CONGENITAL HEART DISEASES 11,600 3,480
Q24.5 Malformation of coronary vessels; Congenital coronary CONGENITAL HEART DISEASES 11,600 3,480
(artery) aneurysm
Q24.6 Congenital heart block CONGENITAL HEART DISEASES 11,600 3,480

Other specified congenital malformations of heart; Congenital
diverticulum of left ventricle; Congenital malformation of myocardium;
Congenital malformation of pericardium; Malposition of heart; Uhl's
Q24.8 disease CONGENITAL HEART DISEASES 11,600 3,480
Congenital malformation of heart, unspecified; Congenital anomaly NOS of

Q24.9 heart; Congenital disease NOS of heart CONGENITAL HEART DISEASES 11,600 3,480
Q25.0 Patent ductus arteriosus; Patent ductus Botallo; Persistent CONGENITAL HEART DISEASES 11,600 3,480
ductus arteriosus
Q25.1 Coarctation of aorta; Preductal coarctation of aorta; CONGENITAL HEART DISEASES 11,600 3,480
Postductal coarctation of aorta
Q25.2 Atresia of aorta CONGENITAL HEART DISEASES 11,600 3,480

Q25.3 Stenosis of aorta; Supravalvular aortic stenosis CONGENITAL HEART DISEASES 11,600 3,480
Other congenital malformations of aorta; Absence of aorta; Aplasia of
aorta; Congenital aneurysm of aorta; Congenital dilatation of aorta;
Aneurysm of sinus of valsalva (rupture); Double aortic arch [vascular ring
or aorta]; Hypoplasia of aorta; Persistent convolutions of aortic arch;
Q25.4 Persistent right aortic arch CONGENITAL HEART DISEASES 11,600 3,480
Q25.5 Atresia of pulmonary artery CONGENITAL HEART DISEASES 11,600 3,480

Q25.6 Stenosis of pulmonary artery CONGENITAL HEART DISEASES 11,600 3,480
Other congenital malformations of pulmonary artery; aberrant pulmonary
artery; agenesis of pulmonary artery; aneurysm, congenital of pulmonary
artery; anomaly of pulmonary artery; hypoplasia of pulmonary artery;
Q25.7 pulmonary arteriovenous aneurysm CONGENITAL HEART DISEASES 11,600 3,480
Q25.8 Other congenital malformations of great arteries CONGENITAL HEART DISEASES 11,600 3,480
Q25.9 Congenital malformation of great arteries, unspecified CONGENITAL HEART DISEASES 11,600 3,480
Congenital stenosis of vena cava; Congenital stenosis of inferior vena cava;
Congenital stenosis of superior vena
Q26.0 cava CONGENITAL HEART DISEASES 11,600 3,480
Q26.2 Total anomalous pulmonary venous connection CONGENITAL HEART DISEASES 11,600 3,480
Q26.4 Anomalous pulmonary venous connection, unspecified CONGENITAL HEART DISEASES 11,600 3,480
Other congenital malformations of great veins; Absence of inferior vena
cava ; Absence of superior vena cava ; Azygos continuation of inferior
vena cava; Persistent left posterior cardinal vein; Scimitar syndrome
Q26.8 CONGENITAL HEART DISEASES 11,600 3,480
Congenital malformation of great vein, unspecified; Anomaly of inferior

vena cava NOS; Anomaly of superior
Q26.9 vena cava NOS CONGENITAL HEART DISEASES 11,600 3,480
E00.0 Congenital iodine-deficiency syndrome, neurological type; CONGENITAL HYPOTHYROIDISM 9,900 2,970
Endemic cretinism, neurological type
Congenital hypothyroidism with diffuse goitre; Nontoxic

congenital Goitre NOS; Nontoxic ongenital parenchymatous Goitre
E03.0 CONGENITAL HYPOTHYROIDISM 9,900 2,970
Congenital hypothyroidism without goitre; Aplasia of thyroid (with

E03.1 myxoedema); Congenital atrophy of thyroid; CONGENITAL HYPOTHYROIDISM 9,900 2,970
Congenital hypothyroidism NOS
Q00.0 Anencephaly; Acephaly; Acrania; Amyelencephaly; CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Hemicephaly; Hemicephaly BRAIN/NERVOUS SYSTEM
Q01.0 Frontal encephalocele CONGENITAL MALFORMATIONS OF THE 13,000 3,900
BRAIN/NERVOUS SYSTEM
Q01.1 Nasofrontal encephalocele CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q01.2 Occipital encephalocele CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q01.8 Encephalocele of other sites CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q02 Microcephaly; Hydromicrocephaly; Micrencephalon CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Malformations of aqueduct of Sylvius; Anomaly of aqueduct of sylvius; CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q03.0 Obstruction, congenital of aqueduct of SYSTEM 13,000 3,900
sylvius; Stenosis of aqueduct of sylvius
Q03.1 Atresia of foramina of Magendie and Luschka; Dandy- CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Walker syndrome BRAIN/NERVOUS SYSTEM
Q04.0 Congenital malformations of corpus callosum; Agenesis of CONGENITAL MALFORMATIONS OF THE 13,000 3,900
corpus callosum BRAIN/NERVOUS SYSTEM
Q04.2 Holoprosencephaly CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Other reduction deformities of brain; Absence of part of brain; Agenesis of

part of brain; Aplasia of part of brain; Hypoplasia of part of brain ; Agyria;
Hydranencephaly; Lissencephaly; Microgyria; Pachygyria CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q04.3 SYSTEM 13,000 3,900
Q04.4 Septo-optic dysplasia CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q04.6 Congenital cerebral cysts; Porencephaly; Schizencephaly CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q04.8 Other specified congenital malformations of brain; CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Macrogyria BRAIN/NERVOUS SYSTEM
Congenital malformation of brain, unspecified; Congenital anomaly NOS of

brain; Congenital deformity NOS of brain; Congenital disease of lesion NOS
of brain; Congenital multiple anomalis NOS of brain CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q04.9 SYSTEM 13,000 3,900
Thoracic spina bifida with hydrocephalus; Dorsal spina bifida with CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
hydrocephalus; Thoracolumbar spina bifida with SYSTEM
Q05.1 hydrocephalus 13,000 3,900
Q05.2 Lumbar spina bifida with hydrocephalus; Lumbosacral spina CONGENITAL MALFORMATIONS OF THE 13,000 3,900
bifida with hydrocephalus BRAIN/NERVOUS SYSTEM
Q05.4 Unspecified spina bifida with hydrocephalus CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q05.6 Thoracic spina bifida without hydrocephalus; Dorsal NOS CONGENITAL MALFORMATIONS OF THE 13,000 3,900
spina bifida; Thoracolumbar NOS spina bifida BRAIN/NERVOUS SYSTEM
Q05.7 Lumbar spina bifida without hydrocephalus; Lumbosacral CONGENITAL MALFORMATIONS OF THE 13,000 3,900
spina bifida NOS BRAIN/NERVOUS SYSTEM
Q05.8 Sacral spina bifida without hydrocephalus CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q05.9 Spina bifida, unspecified CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q06.0 Amyelia CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q06.2 Diastematomyelia CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q06.4 Hydromyelia; Hydrorachis CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q06.8 Other specified congenital malformations of spinal cord CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Congenital malformation of spinal cord, unspecified; Congenital anomaly

NOS of spinal cord or meninges; Congenital deformity NOS of spinal cord
or meninges; Congenital disease or lesion NOS of spinal cord or meninges CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q06.9 SYSTEM 13,000 3,900
Q07.0 Arnold-Chiari syndrome CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Congenital malformation of nervous system, unspecified; Congenital CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
anomaly NOS of nervous system; Congenital deformity NOS of nervous SYSTEM
Q07.9 system; Congenital disease or lesion NOS of nervous system 13,000 3,900
Q74.3 Arthrogryposis multiplex congenita CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Q75.0 Craniosynostosis; Acrocephaly; ]Imperfect fusion of skull; CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Oxycephaly; Trigonocephaly BRAIN/NERVOUS SYSTEM
Q75.1 Craniofacial dysostosis; Crouzon's disease CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q75.2 Hypertelorism CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Q75.4 Mandibulofacial dysostosis; Franceschetti Syndrome; CONGENITAL MALFORMATIONS OF THE 13,000 3,900
Treacher Collins Syndrome BRAIN/NERVOUS SYSTEM
Other specified congenital malformations of skull and face bones; Absence CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q75.8 of skull bone, congenital; Congenital SYSTEM 13,000 3,900
deformity of forehead; Platybasia
Congenital malformation of skull and face bones, unspecified; Congenital CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q75.9 anomaly of face bones NOS; SYSTEM 13,000 3,900
Congenital anomaly of skull NOS
Q76.0 Spina bifida occulta CONGENITAL MALFORMATIONS OF THE 13,000 3,900

Other congenital malformations of spine, not associated with scoliosis;

Congenital absence of vertebra unspecified or not associated with
scoliosis; Congenital fusion of spine unspecified or not associated with
scoliosis; Congenital kyphosis unspecified or not associated with scoliosis;
Congenital lordosis unspecified or not associated with scoliosis; Congenital
malformation of lumbosacral joint unspecified or not associated with
scoliosis; Congenital malformation of lumbosacral region unspecified or
not associated with scoliosis; Hemivertebra unspecified or not associated
with scoliosis; Malformation of spine unspecified or not associated with
scoliosis; Platyspondylisis unspecified or not associated with scoliosis;
Supernumerary vertebra unspecified or nor associated with scoliosis CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS
Q76.4 13,000 3,900
SYSTEM
Q32.0 Congenital tracheomalacia CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510

RESPIRATORY TRACT
Other congenital malformations of bronchus; Absence of bronchus;

Agenesis of bronchus; Atresia of bronchus; Congenital malformation NOS
of bronchus; Diverticulum of bronchus; Congenital malformations of lung] CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY
Q32.4 of bronchus 21,700 6,510
TRACT
Congenital cystic lung; Congenital honeycomb lung; Congenital cystic lung CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY
Q33.0 disease; Congenital polycystic lung TRACT 21,700 6,510
disease
Q33.2 Sequestration of lung CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510

RESPIRATORY TRACT
Q33.3 Agenesis of lung; Absence of lung, lobe CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510
RESPIRATORY TRACT
Q33.4 Congenital bronchiectasis CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510

RESPIRATORY TRACT
Q33.6 Hypoplasia and dysplasia of lung CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510
RESPIRATORY TRACT
Q34.1 Congenital cyst of mediastinum CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510
RESPIRATORY TRACT
Q34.8 Other specified congenital malformations of respiratory CONGENITAL MALFORMATIONS OF THE LOWER 21,700 6,510
system; Atresia of nasopharynx RESPIRATORY TRACT
Congenital malformation of respiratory system, unspecified; Congenital CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY
Q34.9 absence of respiratory organ ; TRACT 21,700 6,510
Congenital anomaly NOS of respiratory organ
Choanal atresia; Absence of anterior nares; Absence of posterior nares; CONGENITAL MALFORMATIONS OF THE NOSE, UPPER
Q30.0 congenital stenosis of anterior nares; RESPIRATORY TRACT 11,000 3,300
Congenital stenosis of posterior nares
Q30.1 Agenesis and underdevelopment of nose; Congenital CONGENITAL MALFORMATIONS OF THE NOSE, 11,000 3,300
absence of nose UPPER RESPIRATORY TRACT
Q30.2 Fissured, notched and cleft nose CONGENITAL MALFORMATIONS OF THE NOSE, 11,000 3,300
UPPER RESPIRATORY TRACT
Q31.3 Laryngocele CONGENITAL MALFORMATIONS OF THE NOSE, 11,000 3,300

Q31.5 Congenital laryngomalacia CONGENITAL MALFORMATIONS OF THE NOSE, 11,000 3,300

Other congenital malformations of larynx; Absence of cricoid cartilage,

epiglottis, glottis, larynx or thyroid cartilage; Agenesis of cricoid cartilage,
epiglottis, glottis, larynx or thyroid cartilage; Atresia of cricoid cartilage,
epiglottis, glottis, larynx or thyroid cartilage; Cleft thyroid cartilage;
Congenital stenosis of larynx NEC; Fissure of epiglottis; Posterior cleft of
cricoid cartilage CONGENITAL MALFORMATIONS OF THE NOSE, UPPER
Q31.8 RESPIRATORY TRACT 11,000 3,300
Q31.9 Congenital malformation of larynx, unspecified CONGENITAL MALFORMATIONS OF THE NOSE, 11,000 3,300
Q38.2 Macroglossia CONGENITAL MALFORMATIONS OF THE ORAL 4,000 1,200

CAVITY
Congenital malformations of palate, not elsewhere classified; Absence of CONGENITAL MALFORMATIONS OF THE ORAL CAVITY
Q38.5 uvula; Congenital malformation of 4,000 1,200
palate NOS; High arched palate
Q38.6 Other congenital malformations of mouth; Congenital CONGENITAL MALFORMATIONS OF THE ORAL 4,000 1,200
malformation of mouth NOS CAVITY
Q38.8 Other congenital malformations of pharynx; Congenital CONGENITAL MALFORMATIONS OF THE ORAL 4,000 1,200
malformation of pharynx NOS CAVITY
Q12.2 Coloboma of lens CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290

Q12.4 Spherophakia CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
Other congenital corneal malformations; Congenital malformation of
cornea NOS;
Q13.4 Microcornea; Peter's anomaly CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
Q14.0 Congenital malformation of vitreous humour; Congenital CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
vitreous opacity
Q14.1 Congenital malformation of retina; Congenital retinal CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
aneurysm
Q14.9 Congenital malformation of posterior segment of eye, CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
unspecified
Congenital glaucoma; Buphthalmos; Glaucoma of newborn;

Hydrophthalmos; Keratoglobus, congenital, with glaucoma; Macrocornea
with glaucoma; Macrophthalmos in congenital glaucoma; Megalocornea
Q15.0 with glaucoma CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
Q15.8 Other specified congenital malformations of eye CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
Congenital malformation of eye, unspecified; Congenital anomaly NOS of
eye; Congenital deformity NOS of eye
Q15.9 CONGENITAL OPHTHALMOLOGIC DISORDERS 4,300 1,290
P96.0 Congenital renal failure; Uraemia of newborn CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.0 Renal agenesis, unilateral CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.1 Renal agenesis, bilateral CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.2 Renal agenesis, unspecified CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.3 Renal hypoplasia, unilateral CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.5 Renal hypoplasia, unspecified CONGENITAL RENAL DISORDERS 9,100 2,730
Q60.6 Potter's syndrome CONGENITAL RENAL DISORDERS 9,100 2,730
Q61.0 Congenital single renal cyst; Congenital cyst of kidney; CONGENITAL RENAL DISORDERS 9,100 2,730
Single cyst of kidney
Q61.1 Polycystic kidney, autosomal recessive; Polycystic kidney, CONGENITAL RENAL DISORDERS 9,100 2,730
infantile type
Q61.2 Polycystic kidney, autosomal dominant; Polycystic kidney, CONGENITAL RENAL DISORDERS 9,100 2,730
adult type
Q61.3 Polycystic kidney, unspecified CONGENITAL RENAL DISORDERS 9,100 2,730

Q61.4 Renal dysplasia CONGENITAL RENAL DISORDERS 9,100 2,730
Q61.5 Medullary cystic kidney; Sponge kidney NOS CONGENITAL RENAL DISORDERS 9,100 2,730
Q61.8 Other cystic kidney diseases; Fibrocystic kidney; Fibrocystic CONGENITAL RENAL DISORDERS 9,100 2,730
renal degeneration or disease
Q61.9 Cystic kidney disease, unspecified; Meckel-Gruber CONGENITAL RENAL DISORDERS 9,100 2,730
syndrome
Q62.0 Congenital hydronephrosis CONGENITAL RENAL DISORDERS 9,100 2,730

Q62.7 Congenital vesico-uretero-renal reflux CONGENITAL RENAL DISORDERS 9,100 2,730
Q63.0 Accessory kidney CONGENITAL RENAL DISORDERS 9,100 2,730
Q63.1 Lobulated, fused and horseshoe kidney CONGENITAL RENAL DISORDERS 9,100 2,730
Q63.2 Ectopic kidney; Congenital displaced kidney; Malrotation of CONGENITAL RENAL DISORDERS 9,100 2,730
kidney
Q63.3 Hyperplastic and giant kidney CONGENITAL RENAL DISORDERS 9,100 2,730
Q63.8 Other specified congenital malformations of kidney; CONGENITAL RENAL DISORDERS 9,100 2,730
Congenital renal calculi
Early cutaneous congenital syphilis: , Early mucocutaneous congenital

syphilis, Early visceral congenital syphilis; Early congenital syphilitic
laryngitis; Early congenital syphilitic oculopathy; Early congenital
syphilitic osteochondropathy; Early congenital syphilitic pharyngitis; Early
A50.0 congenital syphilitic pneumonia; Early congenital syphilitic rhinitis CONGENITAL SYPHILIS 12,800 3,840
A50.2 Early congenital syphilis, unspecified; Congenital syphilis CONGENITAL SYPHILIS 12,800 3,840
NOS less than two years after birth.
Late congenital neurosyphilis [juvenile neurosyphilis]; Dementia paralytica

juvenilis; Juvenile general paresis ; Juvenile tabes dorsalis; Juvenile
A50.4 taboparetic neurosyphilis CONGENITAL SYPHILIS 12,800 3,840
A50.5 Other late congenital syphilis, symptomatic; Syphilitic CONGENITAL SYPHILIS 12,800 3,840
saddle nose
A50.9 Congenital syphilis, unspecified CONGENITAL SYPHILIS 12,800 3,840

Atresia and stenosis of ureter; Congenital occlusion of ureter; Congenital
occlusion of ureteropelvic junction; Congenital occlusion of ureterovesical
Q62.1 orifice; Impervious ureter CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Q62.2 Congenital megaloureter; Congenital dilatation of ureter CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Q62.3 Other obstructive defects of renal pelvis and ureter; CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Congenital ureterocele
Q62.5 Duplication of ureter; Accessory of ureter, Double of ureter CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Malposition of ureter; Deviation of ureter or ureteric orifice; Displacement

of ureter or ureteric orifice; Ectopic of ureter or ureteric orifice;
Q62.6 Implantation, anomalous of ureter or ureteric orifice CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Q64.1 Exstrophy of urinary bladder; Ectopia vesicae; Extroversion CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
of bladder
Q64.2 Congenital posterior urethral valves CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Other atresia and stenosis of urethra and bladder neck; Congenital bladder
neck obstruction; Congenital stricture of urethra; Congenital stricture of
urinary meatus; Congenital stricture of vesicourethral orifice; Impervious
Q64.3 urethra CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Q64.4 Malformation of urachus; Cyst of urachus; Patent urachus; CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Prolapse of urachus
Other congenital malformations of bladder and urethra; Accessory

bladder; Accessory urethra; Congenital hernia of bladder; Congenital
malformation of bladder or urethra NOS; Congenital prolapse of bladder
(mucosa); Congenital prolapse of urethra; Congenital prolapse of urinary
meatus; Congenital prolapse of urethrorectal fistula; Double urethra;
Q64.7 Double urinary meatus CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Q64.8 Other specified congenital malformations of urinary system CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
Congenital malformation of urinary system, unspecified;

Q64.9 Congenital anomaly NOS of urinary system; Congenital deformity NOS of CONGENITAL URINARY TRACT DISORDERS 9,100 2,730
urinary system
Q27.1 Congenital renal artery stenosis CONGENITAL VASCULAR DISEASES 12,000 3,600
Q27.3 Peripheral arteriovenous malformation; Arteriovenous CONGENITAL VASCULAR DISEASES 12,000 3,600
aneurysm
Other specified congenital malformations of peripheral vascular system;

Aberrant subclavian artery; Absence of artery or vein NEC; Atresia of
artery or vein NEC; Congenital aneurysm (peripheral); Congenital stricture,
Q27.8 artery; Congenital varix CONGENITAL VASCULAR DISEASES 12,000 3,600
Q27.9 Congenital malformation of peripheral vascular system, CONGENITAL VASCULAR DISEASES 12,000 3,600
unspecified; Anomaly of artery or vein NOS
Arteriovenous malformation of precerebral vessels; Congenital

Q28.0 arteriovenous precerebral aneurysm CONGENITAL VASCULAR DISEASES 12,000 3,600
(nonruptured)
Other malformations of precerebral vessels; Congenital malformation of

precerebral vessels NOS; Congenital
Q28.1 precerebral aneurysm (nonruptured) CONGENITAL VASCULAR DISEASES 12,000 3,600
Arteriovenous malformation of cerebral vessels; Arteriovenous

malformation of brain NOS;
Q28.2 Congenital arteriovenous cerebral aneurysm (nonruptured) CONGENITAL VASCULAR DISEASES 12,000 3,600
Other malformations of cerebral vessels; Congenital

cerebral aneurysm, nonruptured; Congenital malformation of cerebral
Q28.3 vessels NOS CONGENITAL VASCULAR DISEASES 12,000 3,600
M30.0 Polyarteritis nodosa CONNECTIVE TISSUE DISEASES 13,800 4,140

M30.1 Polyarteritis with lung involvement [Churg-Strauss]; Allergic CONNECTIVE TISSUE DISEASES 13,800 4,140
granulomatous angiitis
M30.2 Juvenile polyarteritis CONNECTIVE TISSUE DISEASES 13,800 4,140

M30.3 Mucocutaneous lymph node syndrome [Kawasaki] CONNECTIVE TISSUE DISEASES 13,800 4,140
M30.8 Other conditions related to polyarteritis nodosa; CONNECTIVE TISSUE DISEASES 13,800 4,140
Polyangiitis overlap syndrome
M31.0 Hypersensitivity angiitis; Goodpasture's syndrome CONNECTIVE TISSUE DISEASES 13,800 4,140
M31.1 Thrombotic microangiopathy; Thrombotic CONNECTIVE TISSUE DISEASES 13,800 4,140
thrombocytopenic purpura
M31.2 Lethal midline granuloma CONNECTIVE TISSUE DISEASES N/A N/A

M31.3 Wegener's granulomatosis; Necrotizing respiratory CONNECTIVE TISSUE DISEASES 13,800 4,140
granulomatosis
M31.4 Aortic arch syndrome [Takayasu] CONNECTIVE TISSUE DISEASES 13,800 4,140
M31.6 Other giant cell arteritis CONNECTIVE TISSUE DISEASES 13,800 4,140
M31.8 Other specified necrotizing vasculopathies; CONNECTIVE TISSUE DISEASES 13,800 4,140
Hypocomplementaemic vasculitis
M31.9 Necrotizing vasculopathy, unspecified CONNECTIVE TISSUE DISEASES 13,800 4,140

M33.0 Juvenile dermatomyositis CONNECTIVE TISSUE DISEASES 13,800 4,140
M33.1 Other dermatomyositis CONNECTIVE TISSUE DISEASES 13,800 4,140
M33.2 Polymyositis CONNECTIVE TISSUE DISEASES 13,800 4,140
M33.9 Dermatopolymyositis, unspecified CONNECTIVE TISSUE DISEASES 13,800 4,140
M34.0 Progressive systemic sclerosis CONNECTIVE TISSUE DISEASES 13,800 4,140
CR(E)ST syndrome; Combination of calcinosis, Raynaud's phenomenon,
M34.1 (o)esophageal dysfunction, CONNECTIVE TISSUE DISEASES 13,800 4,140
sclerodactyly, telangiectasia
M34.2 Systemic sclerosis induced by drugs and chemicals CONNECTIVE TISSUE DISEASES 13,800 4,140
M34.9 Systemic sclerosis, unspecified CONNECTIVE TISSUE DISEASES 13,800 4,140
M35.0 Sicca syndrome [SJÖGREN] CONNECTIVE TISSUE DISEASES 13,800 4,140
M35.1 Other overlap syndromes; Mixed connective tissue disease CONNECTIVE TISSUE DISEASES 13,800 4,140
M35.2 Behçet's disease CONNECTIVE TISSUE DISEASES 13,800 4,140

M35.3 Polymyalgia rheumatica CONNECTIVE TISSUE DISEASES 13,800 4,140
M35.4 Diffuse (eosinophilic) fasciitis CONNECTIVE TISSUE DISEASES 13,800 4,140
M35.8 Other specified systemic involvement of connective tissue CONNECTIVE TISSUE DISEASES 13,800 4,140
Systemic involvement of connective tissue, unspecified; Systemic

Autoimmune disease NOS; Collagen (vascular)
M35.9 disease NOS CONNECTIVE TISSUE DISEASES 13,800 4,140
G50.0 Trigeminal neuralgia; Syndrome of paroxysmal facial pain; CRANIAL NERVE DISORDER 7,400 2,220
Tic douloureux
G50.8 Other disorders of trigeminal nerve CRANIAL NERVE DISORDER 7,400 2,220
G51.0 Bell's palsy; Facial palsy CRANIAL NERVE DISORDER 7,400 2,220
G51.1 Geniculate ganglionitis CRANIAL NERVE DISORDER 7,400 2,220
G51.3 Clonic hemifacial spasm CRANIAL NERVE DISORDER 7,400 2,220
G51.4 Facial myokymia CRANIAL NERVE DISORDER 7,400 2,220
G51.8 Other disorders of facial nerve CRANIAL NERVE DISORDER 7,400 2,220
G51.9 Disorder of facial nerve, unspecified CRANIAL NERVE DISORDER 7,400 2,220
G52.0 Disorders of olfactory nerve; Disorder of 1st cranial nerve CRANIAL NERVE DISORDER 7,400 2,220
G52.1 Disorders of glossopharyngeal nerve; Disorder of 9th CRANIAL NERVE DISORDER 7,400 2,220
cranial nerve; Glossopharyngeal neuralgia
G52.2 Disorders of vagus nerve; Disorder of pneumogastric [10th] CRANIAL NERVE DISORDER 7,400 2,220
nerve
G52.7 Disorders of multiple cranial nerves; Polyneuritis cranialis CRANIAL NERVE DISORDER 7,400 2,220
G52.8 Disorders of other specified cranial nerves CRANIAL NERVE DISORDER 7,400 2,220
H46 Optic neuritis; Optic neuropathy, except ischaemic; Optic CRANIAL NERVE DISORDER 7,400 2,220
papillitis; Retrobulbar neuritis NOS
Disorders of optic nerve, not elsewhere classified;

Compression of optic nerve; Haemorrhage in optic nerve sheath;
H47.0 Ischaemic optic neuropathy CRANIAL NERVE DISORDER 7,400 2,220
J05.0 Acute obstructive laryngitis [croup]; Obstructive laryngitis CROUP 8,200 2,460
NOS
Pituitary-dependent Cushing's disease; Overproduction of pituitary ACTH;

Pituitary-dependent hyperadrenocorticism
E24.0 CUSHING'S SYNDROME 9,500 2,850
E24.1 Nelson's syndrome CUSHING'S SYNDROME 9,500 2,850

E24.2 Drug-induced Cushing's syndrome CUSHING'S SYNDROME 9,500 2,850
E24.3 Ectopic ACTH syndrome CUSHING'S SYNDROME 9,500 2,850
E24.8 Other Cushing's syndrome CUSHING'S SYNDROME 9,500 2,850
E24.9 Cushing's syndrome, unspecified CUSHING'S SYNDROME 9,500 2,850
E84.0 Cystic fibrosis with pulmonary manifestations CYSTIC FIBROSIS 7,300 2,190
E84.1 Cystic fibrosis with intestinal manifestations CYSTIC FIBROSIS 7,300 2,190
E84.8 Cystic fibrosis with other manifestations; Cystic fibrosis with CYSTIC FIBROSIS 7,300 2,190
combined manifestations
E84.9 Cystic fibrosis, unspecified CYSTIC FIBROSIS 7,300 2,190

G30.0 Alzheimer's disease with early onset DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
SYSTEM
G30.1 Alzheimer's disease with late onset DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
SYSTEM
G30.8 Other Alzheimer's disease DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
SYSTEM
G30.9+F00.9* Dementia in alzheimer's disease, unspecified DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
SYSTEM
G31.0 Circumscribed brain atrophy; Pick's disease; Progressive DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
isolated aphasia SYSTEM
G31.1 Senile degeneration of brain, not elsewhere classified DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
SYSTEM
Degeneration of nervous system due to alcohol; Alcoholic cerebellar

ataxia; Alcoholic cerebellar degeneration; Alcoholic cerebral degeneration;
Alcoholic encephalopathy; Dysfunction of autonomic nervous system due
G31.2 to alcohol DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM 10,000 3,000
Other specified degenerative diseases of nervous system; Grey-matter DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM
degeneration [Alpers]; Lewy body (ies) dementia; Lewy body (ies) disease;
G31.8 Subacute necrotizing encephalopathy [Leigh] 10,000 3,000
G32.8* Other specified degenerative disorders of nervous system DEGENERATIVE DISEASES OF CENTRAL NERVOUS 10,000 3,000
in diseases classified elsewhere SYSTEM
Multiple sclerosis; Multiple sclerosis NOS; Multiple sclerosis of brain DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM
stem; Multiple sclerosis of cord; Multiple sclerosis, disseminated; Multiple
G35 sclerosis, generalized 11,600 3,480
G36.0 Neuromyelitis optica [Devic]; Demyelination in optic DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
neuritis SYSTEM
G36.1 Acute and subacute haemorrhagic leukoencephalitis DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
[Hurst] SYSTEM
G36.8 Other specified acute disseminated demyelination DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G36.9 Acute disseminated demyelination, unspecified DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G37.0 Diffuse sclerosis; Periaxial encephalitis; Schilder's disease DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G37.1 Central demyelination of corpus callosum DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G37.2 Central pontine myelinolysis DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G37.3 Acute transverse myelitis in demyelinating disease of DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
central nervous system; Acute transverse myelitis NOS SYSTEM
G37.4 Subacute necrotizing myelitis DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
SYSTEM
G37.8 Other specified demyelinating diseases of central nervous DEMYELINATING DISEASE OF CENTRAL NERVOUS 11,600 3,480
system SYSTEM
Demyelinating disease of central nervous system, unspecified DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM
G37.9 Brain sclerosis 11,600 3,480
Dengue without warning signs: Dengue fever (DF) Dengue haemorrhagic

A97.0 fever Grades 1 and 2; Dengue haemorrhagic DENGUE FEVER 10,000 3,000
fever without warning signs
A97.1 Dengue with warning sings; Dengue haemorrhagic fever DENGUE FEVER 10,000 3,000
with warning signs
A97.2 Severe Dengue; Severe Dengue fever; Severe Dengue DENGUE, SEVERE 16,000 4,800
haemorrhagic fever
E23.2 Diabetes insipidus DIABETES INSIPIDUS 10,100 3,030
N25.1 Nephrogenic diabetes insipidus DIABETES INSIPIDUS 10,100 3,030
Insulin-dependent diabetes mellitus with coma; Brittle diabetes (mellitus)
with coma; Juvenile-onset diabetes (mellitus) withcoma ; Ketosis-prone
diabetes (mellitus) with coma; Type I diabetes (mellitus) with coma;
E10.0 DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
Insulin-dependent diabetes mellitus with acididosis/ ketoacidosis without

mention of coma; Diabetic acididosis without mention of coma; Diabetic
E10.1 ketoacidosis without DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
mention of coma;
Non-insulin-dependent diabetes mellitus with coma; Nonobese diabetes

(mellitus) With coma ; Obese diabetes mellitus With coma ; Adult-onset
diabetes mellitus With coma ; Maturity-onset diabetes mellitus With coma
; Nonketotic diabetes mellitus With coma; Stable diabetes mellitus with
coma; Type II diabetes mellitus with coma; Non-insulin-dependent
E11.0 diabetes of the young DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
Non-insulin-dependent diabetes mellitus with ketoacidosis without

mention of coma; ; Nonobese diabetes (mellitus) With ketoacidosis
without mention of coma; Obese diabetes mellitus With ketoacidosis
without mention of coma; Adult-onset diabetes mellitus without mention
of coma; Maturity-onset diabetes mellitus without mention of coma;
Nonketotic diabetes mellitus without mention of coma; Stable diabetes
mellitus without mention of coma; Type II diabetes mellitus without
E11.1 mention of coma; Non- insulin-dependent diabetes of the young DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
Malnutrition-related diabetes mellitus with coma; Insulin- dependent

malnutrition-related diabetes mellitus with coma ; Non-insulin-dependent
E12.0 malnutrition-related diabetes mellitus with coma DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
E13.0 Other specified diabetes mellitus with coma DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
E13.1 Other specified diabetes mellitus with acididosis/ DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
ketoacidosis without mention of coma
E14.0 Unspecified diabetes mellitus; diabetes NOS with coma DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
E14.1 Unspecified diabetes mellitus; diabetes NOS with DIABETES MELLITUS WITH COMA OR KETOSIS 15,800 4,740
acididosis/ ketoacidosis without mention of coma
E10.5 Insulin-dependent diabetes mellitus with Diabetic DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
gangrene/ ulcer OTHER THAN COMA AND KETOSIS
E10.6 Insulin-dependent diabetes mellitus with other specified DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
complications OTHER THAN COMA AND KETOSIS
E10.7 Insulin-dependent diabetes mellitus with multiple DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
E10.8 Insulin-dependent diabetes mellitus with unspecified DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
Non-insulin-dependent diabetes mellitus with Diabetic gangrene/ ulcer;
Nonobese diabetes (mellitus) with Diabetic gangrene/ ulcer; Obese
diabetes mellitus with Diabetic gangrene/ ulcer; Adult-onset diabetes
mellitus with Diabetic gangrene/ ulcer; Maturity -onset diabetes mellitus
with Diabetic gangrene/ulcer; Nonketotic diabetes mellitus with Diabetic
gangrene/ulcer; Stable diabetes mellitus with diabetic gangrene/ulcer;
Type II diabetes mellitus with diabetic gangrene/ulcer; Non-insulin-
E11.5 dependent diabetes of the young DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN 12,600 3,780
COMA AND KETOSIS
E11.6 Non-insulin-dependent diabetes mellitus with other DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
specified complications OTHER THAN COMA AND KETOSIS
Non-insulin-dependent diabetes mellitus with multiple complications ;

Nonobese diabetes (mellitus) With multiple complications ; Obese
diabetes mellitus With multiple complications ; Adult-onset diabetes DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E11.7 mellitus With multiple complications ; Matur COMA AND KETOSIS 12,600 3,780
Malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer;

Insulin-dependent malnutrition-related diabetes mellitus with Diabetic
gangrene/ ulcer; Non- insulin-dependent malnutrition-related diabetes DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E12.5 mellitus 12,600 3,780
COMA AND KETOSIS
with Diabetic gangrene/ ulcer
E12.6 Malnutrition-related diabetes mellitus with other specified DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
Malnutrition-related diabetes mellitus with unspecified complications;

Insulin-dependent malnutrition-related diabetes mellitus with unspecified
complications; Non- insulin-dependent malnutrition-related diabetes
mellitus with unspecified complications DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E12.8 COMA AND KETOSIS 12,600 3,780
E13.5 Other specified diabetes mellitus with Diabetic gangrene/ DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
ulcer OTHER THAN COMA AND KETOSIS
E13.6 Other specified diabetes mellitus with other specified DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
E14.5 Unspecified diabetes mellitus; diabetes NOS with Diabetic DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
gangrene/ ulcer OTHER THAN COMA AND KETOSIS
E14.6 Unspecified diabetes mellitus with other specified DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
E14.7 Unspecified diabetes mellitus; diabetes NOS with multiple DIABETES MELLITUS WITH COMPLICATIONS 12,600 3,780
A36.0 Pharyngeal diphtheria; Diphtheritic membranous angina; DIPHTHERIA 8,700 2,610

Tonsillar diphtheria
A36.3 Cutaneous diphtheria DIPHTHERIA 8,700 2,610
A36.9 Diphtheria, unspecified DIPHTHERIA 8,700 2,610
Agranulocytosis; Agranulocytic angina; Infantile genetic agranulocytosis;
Kostmann's disease;
Neutropenia NOS; Congenital Neutropenia; Cyclic Neutropenia; Drug-
induced Neutropenia; Periodic Neutropenia; Primary Splenic
D70 Neutropenia; Toxic DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12,100 3,630
Neutropenia; Neutropenic splenomegaly
Functional disorders of polymorphonuclear neutrophils; Cell membrane

receptor complex [CR3] defect; Chronic (childhood) granulomatous
disease;
D71 Congenital dysphagocytosis; Progressive septic DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12,100 3,630
granulomatosis; Other disorders of white blood cells
Genetic anomalies of leukocytes; Alder Granulation Anomaly or

Syndrome; Alder Granulocyte Anomaly or Syndrome; May-Hegglin
Granulation Anomaly or Syndrome; May-Hegglin Granulocyte Anomaly or
Syndrome; Pelger-Huët Granulocyte Anomaly or Syndrome; Hereditary
leukocytic: hypersegmentation,; hyposegmentation ; Hereditary
D72.0 leukomelanopathy DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12,100 3,630
Other specified disorders of white blood cells; Lymphocytic Leukaemoid

reaction; Monocytic Leukaemoid reaction; Myelocytic Leukaemoid
reaction; Leukocytosis; Symptomatic Lymphocytosis; Lymphopenia;
Symptomatic Monocytosis;Plasmacytosis
D72.8 DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12,100 3,630
D73.2 Chronic congestive splenomegaly DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D73.3 Abscess of spleen DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D73.4 Cyst of spleen DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D73.5 Infarction of spleen; Nontraumatic Splenic rupture; Torsion DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
of spleen ORGANS
D73.8 Other diseases of spleen; Fibrosis of spleen NOS; DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
Perisplenitis; Splenitis NOS ORGANS
D74.9 Methaemoglobinaemia, unspecified DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D75.0 Familial erythrocytosis; Benign Polycythaemia; Familial DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
Polycythaemia ORGANS
Secondary polycythaemia; Acquired Polycythaemia due to erythropoietin;

Acquired Polycythaemia due to fall in plasma volume; Acquired
Polycythaemia due to high altitude; Acquired Polycythaemia due to stress;
Emotional Polycythaemia; Hypoxaemic Polycythaemia; nephrogenous
D75.1 Polycythaemia; relative Polycythaemia DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12,100 3,630
D75.2 Essential thrombocytosis DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D75.8 Other specified diseases of blood and blood-forming organs DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
D76.0 Langerhans' cell histiocytosis, not elsewhere classified DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
Haemophagocytic lymphohistiocytosis; Eosinophilic granuloma; Hand- DISEASES OF BLOOD AND BLOOD FORMING ORGANS
D76.1 Schüller-Christian disease; Chronic 12,100 3,630
Histiocytosis X
D76.2 Haemophagocytic syndrome, infection-associated DISEASES OF BLOOD AND BLOOD FORMING 12,100 3,630
ORGANS
Other histiocytosis syndromes; Reticulohistiocytoma (giant- DISEASES OF BLOOD AND BLOOD FORMING ORGANS
cell); Sinus histiocytosis with massive lymphadenopathy;
D76.3 Xanthogranuloma 12,100 3,630
K20 Oesophagitis; Abscess of oesophagus; Oesophagitis NOS; DISEASES OF ESOPHAGUS 8,300 2,490
Chemical oesophagitis; Peptic oesophagitis
K22.0 Achalasia of cardia; Achalasia NOS; Cardiospasm DISEASES OF ESOPHAGUS 8,300 2,490
Ulcer of oesophagus; Erosion of oesophagus; Ulcer of oesophagus NOS;
Ulcer of oesophagus due to ingestion of chemicals; Ulcer of oesophagus
due to ingestion of drugs and medicaments; Fungal ulcer of oesophagus;
Peptic ulcer of oesophagus; Ulcerative oesophagitis
K22.1 DISEASES OF ESOPHAGUS 8,300 2,490
Oesophageal obstruction; Oesophageal web (acquired); Compression of

oesophagus; Constriction of oesophagus; Stenosis of oesophagus;
K22.2 Stricture of oesophagus DISEASES OF ESOPHAGUS 8,300 2,490
K22.3 Perforation of oesophagus; Rupture of oesophagus DISEASES OF ESOPHAGUS 8,300 2,490

K22.4 Dyskinesia of oesophagus; Corksrew oesophagus; Diffuse DISEASES OF ESOPHAGUS 8,300 2,490
oesophageal spasm; Spasm of oesophagus
K22.6 Gastro-oesophageal laceration-haemorrhage syndrome; DISEASES OF ESOPHAGUS 8,300 2,490
Mallory-Weiss syndrome
K22.7 Barrett's esophagus; Barret's disease; Barett's syndrome DISEASES OF ESOPHAGUS 8,300 2,490
K22.8 Other specified diseases of oesophagus; Haemorrhage of DISEASES OF ESOPHAGUS 8,300 2,490
oesophagus NOS
K22.9 Disease of oesophagus, unspecified DISEASES OF ESOPHAGUS 8,300 2,490

H60.1 Cellulitis of external ear; Cellulitis of auricle; Cellulitis of DISEASES OF EXTERNAL EAR 9,000 2,700
external auditory canal
H60.2 Malignant otitis externa DISEASES OF EXTERNAL EAR 9,000 2,700

H60.3 Other infective otitis externa; diffuse Otitis externa ; DISEASES OF EXTERNAL EAR 9,000 2,700
Haemorrhagic Otitis externa ; Swimmer's ear
H60.4 Cholesteatoma of external ear; Keratosis obturans of DISEASES OF EXTERNAL EAR 9,000 2,700
external ear (canal)
H83.0 Labyrinthitis DISEASES OF INNER EAR 6,200 1,860

H83.8 Other specified diseases of inner ear DISEASES OF INNER EAR 6,200 1,860
Obstruction of Eustachian tube; Compression of
Eustachian tube; Stenosis of Eustachian tube; Stricture of Eustachian tube
H68.1 DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H69.9 Eustachian tube disorder, unspecified DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H70.0 Acute mastoiditis; Abscess of mastoid; Empyema of DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
mastoid
H70.1 Chronic mastoiditis; Caries of mastoid; Fistula of mastoid DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H70.2 Petrositis; Acute inflammation of petrous bone; Chronic DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
inflammation of petrous bone
H70.8 Other mastoiditis and related conditions DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H70.9 Mastoiditis, unspecified DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
Cholesteatoma of middle ear; Cholesteatoma tympani; Perforation of
tympanic membrane; Persistent post- traumatic perforation of ear drum;
H71 Postinflammatory perforation of ear drum DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H73.0 Acute myringitis; Acute tympanitis; Bullous myringitis DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H73.1 Chronic myringitis; Chronic tympanitis DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H73.8 Other specified disorders of tympanic membrane DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H73.9 Disorder of tympanic membrane, unspecified DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H74.8 Other specified disorders of middle ear and mastoid DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
H74.9 Disorder of middle ear and mastoid, unspecified DISEASES OF MIDDLE EAR AND MASTOID 10,400 3,120
Developmental odontogenic cysts; Dentigerous cyst; Eruption Cyst; DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
Follicular cyst; Gingival cyst; Lateral
K09.0 periodontal cyst; Primordial cyst; Keratocyst 8,300 2,490
Developmental (nonodontogenic) cysts of oral region; Cyst of DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
globulomaxillary; Cyst of incisive canal; Cyst of median palatal; Cyst of
K09.1 nasopalatine; Cyst of palatine papilla 8,300 2,490
Other cysts of jaw; Cyst of jaw NOS; Aneurysmal cyst of jaw; Haemorrhagic DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
cyst of jaw; Traumatic cyst of jaw
K09.2 8,300 2,490
Other cysts of oral region, not elsewhere classified; Dermoid cyst of DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
mouth; Epidermoid cyst of mouth; Lymphoepithelial cyst of mouth;
K09.8 Epstein's pearl; 8,300 2,490
Nasoalveolar cyst; Nasolabial cyst
K09.9 Cyst of oral region, unspecified DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
K10.0 Developmental disorders of jaws; Latent bone cyst of jaw; DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
Stafne's cyst; Torus mandibularis; Torus palatinus AND JAW
K10.1 Giant cell granuloma, central; Giant cell granuloma NOS DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
Inflammatory conditions of jaws; Acute osteitis of jaw; Chronic osteitis of

jaw; Supparative osteitis of jaw; Acute neonatal osteomyelitis of jaw;
Chronic neonatal osteomyelitis of jaw; Supparative neonatal osteomyelitis
of jaw; Acute osteoradionecrosis of jaw; chronic osteoradionecrosis of
jaw; Suppurative osteoradionecrosis of jaw; Acute periostitis of jaw;
Chronic periortitis of jaw; Suppurative periortitis of jaw; Sequestrum, of
K10.2 jaw bone DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW 8,300 2,490
K10.3 Alveolitis of jaws; Alveolar osteitis; Dry socket DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
Other specified diseases of jaws; Cherubism of jaw; Exostosis of jaw; DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
K10.8 Fibrous dysplasia of jaw; Unilateral 8,300 2,490
condylar hyperplasia; Unilateral condylar hypoplasia
K11.2 Sialoadenitis DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490

AND JAW
K11.3 Abscess of salivary gland DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
K11.4 Fistula of salivary gland DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
K11.5 Sialolithiasis; Calculus of salivary gland or duct; Stone of DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
salivary gland or duct AND JAW
Mucocele of salivary gland; Mucous extravasation cyst of salivary gland; DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
Mucous retention cyst of salivary gland;
K11.6 Ranula 8,300 2,490
Other diseases of salivary glands; Benign lymphoepithelial lesion of DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
salivary gland; Mikulicz' disease; Necrotizing sialometaplasia; Sialectasia;
K11.8 Stenosis of salivary duct; 8,300 2,490
Stricture of salivary duct
K11.9 Disease of salivary gland, unspecified; Sialoadenopathy NOS DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
AND JAW
K12.2 Cellulitis and abscess of mouth; Cellulitis of floor of mouth; DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
Submandibular abscess AND JAW
Granuloma and granuloma-like lesions of oral mucosa; Eosinophilic DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
granuloma of oral mucosa; Granuloma pyogenicum of oral mucosa;
K13.4 Verrucous xanthoma of oral mucosa 8,300 2,490
K13.7 Other and unspecified lesions of oral mucosa; Focal oral DISEASES OF ORAL CAVITY, SALIVARY GLANDS, 8,300 2,490
mucinosis AND JAW
K31.1 Adult hypertrophic pyloric stenosis; Pyloric stenosis NOS DISEASES OF STOMACH AND DUODENUM 6,600 1,980
K31.2 Hourglass stricture and stenosis of stomach DISEASES OF STOMACH AND DUODENUM 6,600 1,980
K31.3 Pylorospasm, not elsewhere classified DISEASES OF STOMACH AND DUODENUM 6,600 1,980
K31.4 Gastric diverticulum DISEASES OF STOMACH AND DUODENUM 6,600 1,980
Obstruction of duodenum; Constriction of duodenum; Stenosis of
K31.5 duodenum; Stricture of duodenum; Chronic DISEASES OF STOMACH AND DUODENUM 6,600 1,980
duodenal ileus
K31.6 Fistula of stomach and duodenum; Gastrocolic fistula; DISEASES OF STOMACH AND DUODENUM 6,600 1,980
Gastrojejunocolic fistula
K31.7 Polyp of stomach and duodenum DISEASES OF STOMACH AND DUODENUM 6,600 1,980
Other specified diseases of stomach and duodenum;
Achlorhydria; Gastroptosis; Hourglass contraction of stomach
K31.8 DISEASES OF STOMACH AND DUODENUM 6,600 1,980
K74.4 Secondary biliary cirrhosis DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
K74.5 Biliary cirrhosis, unspecified DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
Calculus of gallbladder without cholecystitis; Cholecystolithiasis
unspecified or without cholecystitis; Cholelithiasis unspecified or without
cholecystitis; Recurrent colic of gallbladder unspecified or without
cholecystitis; Impacted gallstone of cystic duct unspecified or without
cholecystitis; impacted gallstone of gallbladder unspecified or without
K80.2 cholecystitis DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9,800 2,940
Calculus of bile duct without cholangitis or cholecystitis;

Choledocholithiasis unspecified or without cholangitis or cholecystitis;
Impacted gallstone of bile duct NOS unspecified or without cholangitis or
cholecystitis; Impacted gallstone of common duct unspecified or without
cholangitis or cholecystitis; Impacted gallstone of hepatic duct unspecified
or without cholangitis or cholecystitis; Hepatic cholelithiasis unspecified or
without cholangitisor cholecystitis; Hepatic recurrent colic unspecified or
K80.5 without cholangitis or cholecystitis DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9,800 2,940
K80.8 Other cholelithiasis DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
Obstruction of gallbladder; Occlusion of cystic duct of gallbladder without DISEASES OF THE GALLBLADDER AND BILIARY TRACT
calculus; Stenosis of cystic duct or gallbladder without calculus; Stricture
K82.0 of cystic duct or gallbladder without calculus 9,800 2,940
K82.1 Hydrops of gallbladder; Mucocele of gallbladder DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
K82.2 Perforation of gallbladder; Rupture of cystic duct or DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
gallbladder TRACT
K82.3 Fistula of gallbladder; Cholecystocolic fistula; DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
Cholecystoduodenal fistula TRACT
K82.4 Cholesterolosis of gallbladder; Strawberry gallbladder DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
Other specified diseases of gallbladder; Adhesions of cystic duct or

gallbladder; Atrophy of cystic duct or gallbladder; Cyst of cystic duct or
gallbladder; Dyskinesia of cystic duct or gallbladder; Hypertrophy of cystic
duct or gallbladder; Nonfunctioning of cystic duct or gallbladder; Ulcer of
K82.8 cystic duct or gallbladder DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9,800 2,940
Cholangitis; Cholangitis NOS; Ascending cholangitis; Primary cholangitis; DISEASES OF THE GALLBLADDER AND BILIARY TRACT
Recurrent cholangitis; Sclerosing cholangitis; Secondary cholangitis;
K83.0 Stenosing cholangitis; Suppurative cholangitis 9,800 2,940
Obstruction of bile duct; Occlusion of bile duct without calculus; Stenosis DISEASES OF THE GALLBLADDER AND BILIARY TRACT
of bile duct without calculus; Stricture of
K83.1 bile duct without calculus 9,800 2,940
K83.3 Fistula of bile duct; Choledochoduodenal fistula DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
K83.4 Spasm of sphincter of Oddi DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
K83.5 Biliary cyst DISEASES OF THE GALLBLADDER AND BILIARY 9,800 2,940
TRACT
Other specified diseases of biliary tract; Adhesions of bile DISEASES OF THE GALLBLADDER AND BILIARY TRACT
K83.8 duct; Atrophy of bile duct; Hypertrophy of bile duct; Ulcer of bile duct 9,800 2,940
Acute pancreatitis; Abscess of pancreas; Acute necrosis of pancreas;

Infective necrosis of pancreas; Pancreatitis NOS; Acute recurrent
pancreatitis; Haemorrhagic pancreatitis; Subacute pancreatitis;
K85 Supparative pancreatitis DISEASES OF THE PANCREAS 12,600 3,780
K85.0 Idiopathic acute pancreatitis DISEASES OF THE PANCREAS 12,600 3,780

K85.1 Biliary acute pancreatitis; Gallstone pancreatitis DISEASES OF THE PANCREAS 12,600 3,780
K85.2 Alcohol-induced acute pancreatitis DISEASES OF THE PANCREAS 12,600 3,780
K85.8 Other acute pancreatitis DISEASES OF THE PANCREAS 12,600 3,780
K85.9 Acute pancreatitis, unspecified; Other diseases of pancreas DISEASES OF THE PANCREAS 12,600 3,780
K86.0 Alcohol-induced chronic pancreatitis DISEASES OF THE PANCREAS 12,600 3,780

Other chronic pancreatitis; Chronic pancreatitis NOS; Infectious chronic
K86.1 pancreatitis; Recurrent chronic DISEASES OF THE PANCREAS 12,600 3,780
pancreatitis; Relapsing chronic pancreatitis
K86.2 Cyst of pancreas DISEASES OF THE PANCREAS 12,600 3,780

K86.3 Pseudocyst of pancreas DISEASES OF THE PANCREAS 12,600 3,780
Other specified diseases of pancreas; Atrophy of pancreas; Calculus of
pancreas; Cirrhosis of pancreas; Fibrosis of pancreas; Pancreatic
infantilism; Pancreatic necrosis NOS; Aseptic pancreatic necrosis; Fat
K86.8 necrosis of pancreas DISEASES OF THE PANCREAS 12,600 3,780
Other specified diseases of pulmonary vessels; Rupture of pulmonary

vessel; Stenosis of pulmonary vessel; Stricture
I28.8 of pulmonary vessel DISEASES OF VASCULAR SYSTEM 13,100 3,930
I71.0 Dissection of aorta [anypart]; Dissecting aneurysm of aorta DISEASES OF VASCULAR SYSTEM 13,100 3,930
(ruptured) [any part]
Aortic aneurysm of unspecified site without mention of rupture;
Aneurysm of aorta; Dilatation of aorta; Hyaline
I71.9 necrosis of aorta DISEASES OF VASCULAR SYSTEM 13,100 3,930
I74.0 Embolism and thrombosis of abdominal aorta; Aortic DISEASES OF VASCULAR SYSTEM 13,100 3,930
bifurcation syndrome; Leriche's syndrome
I74.1 Embolism and thrombosis of other and unspecified parts of DISEASES OF VASCULAR SYSTEM 13,100 3,930
aorta
I74.2 Embolism and thrombosis of arteries of upper extremities DISEASES OF VASCULAR SYSTEM 13,100 3,930
I74.3 Embolism and thrombosis of arteries of lower extremities DISEASES OF VASCULAR SYSTEM 13,100 3,930
I74.4 Embolism and thrombosis of arteries of extremities, DISEASES OF VASCULAR SYSTEM 13,100 3,930
unspecified; Peripheral arterial embolism
I74.5 Embolism and thrombosis of iliac artery DISEASES OF VASCULAR SYSTEM 13,100 3,930
I74.8 Embolism and thrombosis of other arteries DISEASES OF VASCULAR SYSTEM 13,100 3,930
I74.9 Embolism and thrombosis of unspecified artery DISEASES OF VASCULAR SYSTEM 13,100 3,930
I77.4 Coeliac artery compression syndrome DISEASES OF VASCULAR SYSTEM 13,100 3,930
I77.6 Arteritis, unspecified; Aortitis NOS; Endarteritis NOS DISEASES OF VASCULAR SYSTEM 13,100 3,930
I77.8 Other specified disorders of arteries and arterioles DISEASES OF VASCULAR SYSTEM 13,100 3,930
I85.0 Oesophageal varices with bleeding DISEASES OF VASCULAR SYSTEM 13,100 3,930
I87.1 Compression of vein; Stricture of vein; Inferior Vena cava DISEASES OF VASCULAR SYSTEM 13,100 3,930
syndrome; Superior vena cava syndrome
Disseminated chorioretinal inflammation; Disseminated chorioretinitis;

H30.1 Disseminated choroiditis; Disseminated DISODERS OF CHOROID AND RETINA 4,600 1,380
retinitis; Disseminated retinochoroiditis
H30.8 Other chorioretinal inflammations; Harada's disease DISODERS OF CHOROID AND RETINA 4,600 1,380
H31.3 Choroidal haemorrhage and rupture; Choroidal DISODERS OF CHOROID AND RETINA 4,600 1,380
haemorrhage NOS; Choroidal haemorrhage expulsive
M80.0 Postmenopausal osteoporosis with pathological fracture DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M80.1 Postoophorectomy osteoporosis with pathological fracture DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M80.3 Postsurgical malabsorption osteoporosis with pathological DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
fracture
M81.0 Postmenopausal osteoporosis DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.08 Postmenopausal osteoporosis Other DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.1 Postoophorectomy osteoporosis DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.4 Drug-induced osteoporosis DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.40 Drug-induced osteoporosis Multiple site DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.55 Idiopathic osteoporosis Pelvic region and thigh DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.58 Idiopathic osteoporosis Other DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.6 Localized osteoporosis [Lequesne] DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.8 Other osteoporosis; Senile osteoporosis DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.88 Other osteoporosis; Senile osteoporosis Other, head, DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
neck,ribs,skull,trunk,vertebral column
M81.89 Other osteoporosis; Senile osteoporosis Site unspecified DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.9 Osteoporosis, unspecified DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.95 Osteoporosis, Pelvic region and thigh DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M81.98 Osteoporosis, Other DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.2 Adult osteomalacia due to malabsorption; Postsurgical DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
malabsorption osteomalacia in adults
M83.4 Aluminium bone disease DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.8 Other adult osteomalacia DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.87 Other adult osteomalacia Ankle and foot DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.89 Other adult osteomalacia Site unspecified DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.9 Adult osteomalacia, unspecified DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M83.99 Adult osteomalacia, unspecified Site unspecified DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.0 Fibrous dysplasia (monostotic) DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.1 Skeletal fluorosis Multiple site DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.2 Hyperostosis of skull DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.5 Aneurysmal bone cyst DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.55 Aneurysmal bone cyst Pelvic region and thigh DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.6 Other cyst of bone DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.63 Other cyst of bone Forearm DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.65 Other cyst of bone Pelvic region and thigh DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
M85.8 Other specified disorders of bone density and structure; DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
Hyperostosis of bones, except skull
M85.88 Other specified disorders of bone density and structure; DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
Hyperostosis of bones, except skull Other
M89.38 Hypertrophy of bone Other DISORDER OF BONE DENSITY AND STRUCTURE 7,900 2,370
Other sphingolipidosis; Fabry(-Anderson) Disease; Gaucher Disease;
Krabbe Disease; Niemann-Pick Disease; Faber's syndrome; Metachromatic
E75.2 leukodystrophy; Sulfatase deficiency DISORDER OF LIPID STORAGE 8,100 2,430
Neuronal ceroid lipofuscinosis; Batten Disease; Bielschowsky-Jansky

E75.4 Disease; Kufs Disease; pielmeyer-Vogt DISORDER OF LIPID STORAGE 8,100 2,430
Disease
Other lipid storage disorders; Cerebrotendinous cholesterosis [van

E75.5 Bogaert-Scherer-Epstein]; Wolman's DISORDER OF LIPID STORAGE 8,100 2,430
disease
E75.6 Lipid storage disorder, unspecified DISORDER OF LIPID STORAGE 8,100 2,430
N95.0 Postmenopausal bleeding DISORDERS ASSOCIATED WITH MENOPAUSE 6,000 1,800
Primary hyperaldosteronism; Conn's syndrome;
Primary aldosteronism due to adrenal hyperplasia (bilateral)
E26.0 DISORDERS OF ADRENAL GLAND 9,900 2,970
E26.1 Secondary hyperaldosteronism DISORDERS OF ADRENAL GLAND 9,900 2,970

E26.8 Other hyperaldosteronism; Bartter's syndrome DISORDERS OF ADRENAL GLAND 9,900 2,970
E26.9 Hyperaldosteronism, unspecified; Other disorders of DISORDERS OF ADRENAL GLAND 9,900 2,970
adrenal gland
E27.1 Primary adrenocortical insufficiency; Addison's disease; DISORDERS OF ADRENAL GLAND 9,900 2,970
Autoimmune adrenalitis
E27.2 Addisonian crisis; Adrenal crisis; Adrenocortical crisis DISORDERS OF ADRENAL GLAND 9,900 2,970
E27.3 Drug-induced adrenocortical insufficiency DISORDERS OF ADRENAL GLAND 9,900 2,970
Other and unspecified adrenocortical insufficiency; Adrenal haemorrhage;
E27.4 Adrenal infarction; DISORDERS OF ADRENAL GLAND 9,900 2,970
Adrenocortical insufficiency NOS; Hypoaldosteronism
E27.8 Other specified disorders of adrenal gland; Abnormality of DISORDERS OF ADRENAL GLAND 9,900 2,970
cortisol-binding globulin
E70.0 Classical phenylketonuria DISORDERS OF AMINO ACID METABOLISM 10,600 3,180

E70.1 Other hyperphenylalaninaemias DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Disorders of tyrosine metabolism; Alkaptonuria; Hypertyrosinaemia;
Ochronosis; Tyrosinaemia; Tyrosinosis
E70.2 DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Albinism; OcularAlbinism; Oculocutaneous Albinism Chediak(-

Steinbrinck)-Higashi Syndrome; Cross Syndrome;
E70.3 Hermansky-Pudlak Syndrome DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Other disorders of aromatic amino-acid metabolism; Disorders of histidine

metabolism; Disorders of tryptophan
E70.8 metabolism DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
E71.0 Maple-syrup-urine disease DISORDERS OF AMINO ACID METABOLISM 10,600 3,180

Other disorders of branched-chain amino-acid metabolism; Hyperleucine-
isoleucinaemia; Hypervalinaemia; Isovaleric acidaemia;
E71.1 Methylmalonic acidaemia; Propionic acidaemia DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Disorders of fatty-acid metabolism; Adrenoleukodystrophy [Addison-

Schilder]; Muscle carnitine palmityltransferase
E71.3 deficiency DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Disorders of amino-acid transport; Cystinosis; Cystinuria;

Fanconi(-de Toni)(-Debré) syndrome; Hartnup's disease; Lowe's syndrome
E72.0 DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Disorders of urea cycle metabolism; Argininaemia; Argininosuccinic

E72.2 aciduria; Citrullinaemia; DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
Hyperammonaemia
E72.3 Disorders of lysine and hydroxylysine metabolism / Glutaric DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
aciduria; Hydroxylysinaemia; Hyperlysinaemia
Disorders of glycine metabolism; Hyperhydroxyprolinaemia;
Hyperprolinaemia (type I) , Hyperprolinaemia type II; Non-ketotic
E72.5 hyperglycinaemia; Sarcosinaemia DISORDERS OF AMINO ACID METABOLISM 10,600 3,180
E73.0 Congenital lactase deficiency DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740

Glycogen storage disease; Cardiac glycogenosis; Andersen Disease; Cori
Disease; Forbes Disease; Hers Disease; McArdle Disease; Pompe Disease;
Tauri Disease; von Gierke Disease; Liver phosphorylase deficiency
E74.0 DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740
Disorders of fructose metabolism; Essential fructosuria; Fructose-1,6-

diphosphatase deficiency; Hereditary fructose
E74.1 intolerance DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740
E74.2 Disorders of galactose metabolism; Galactokinase DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740
deficiency; Galactosaemia
E74.3 Other disorders of intestinal carbohydrate absorption; DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740
Glucose-galactose malabsorption; Sucrase deficiency
Other specified disorders of carbohydrate metabolism/Essential

pentosuria; Oxalosis; Oxaluria; Renal
E74.8 glycosuria DISORDERS OF CARBOHYDRATE METABOLISM 5,800 1,740
E77.8 Other disorders of glycoprotein metabolism DISORDERS OF GLYCOPROTEIN METABOLISM 10,600 3,180
E76.0 Mucopolysaccharidosis, type I; Hurler Syndrome; Hurler- DISORDERS OF GLYCOSAMINOGLYCAN 10,900 3,270
Scheie Syndrome; Scheie Syndrome METABOLISM
E76.1 Mucopolysaccharidosis, type II; Hunter's syndrome DISORDERS OF GLYCOSAMINOGLYCAN 10,900 3,270
METABOLISM
Other mucopolysaccharidoses; ß-Glucuronidase deficiency;

Mucopolysaccharidosis, type III; Mucopolysaccharidosis IV,
Mucopolysaccharidosis VI, Mucopolysaccharidosis VII;
Mild Maroteaux-Lamy Syndrome; Severe Maroteaux-Lamy Syndrome;
Morquio-like Syndrome; Morquio-classic syndrome; Sanfilippo type B
syndrome; Sanfilippo type C syndrome; Sanfilippo type D syndrome
E76.2 DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM 10,900 3,270
E76.3 Mucopolysaccharidosis, unspecified DISORDERS OF GLYCOSAMINOGLYCAN 10,900 3,270

METABOLISM
E76.8 Other disorders of glucosaminoglycan metabolism DISORDERS OF GLYCOSAMINOGLYCAN 10,900 3,270

METABOLISM
Pure hypercholesterolaemia; Familial hypercholesterolaemia;
Fredrickson's hyperlipoproteinaemia, type Iia;
Hyperbetalipoproteinaemia; Hyperlipidaemia, group A; Low- density-
lipoprotein-type [LDL] hyperlipoproteinaemia
E78.0 DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
Pure hyperglyceridaemia; Endogenous hyperglyceridaemia; Fredrickson's

hyperlipoproteinaemia, type IV; Hyperlipidaemia, group B;
Hyperprebetalipoproteinaemia'; Very-low-density-lipoprotein-type [VLDL]
E78.1 hyperlipoproteinaemia DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
Mixed hyperlipidaemia; Broad- or floating- betalipoproteinaemia;

Fredrickson's hyperlipoproteinaemia, type IIb; Fredrickson's
hyperlipoproteinaemia type III; Hyperbetalipoproteinaemia with
prebetalipoproteinaemia; Hypercholesterolaemia with endogenous
hyperglyceridaemia; Hyperlipidaemia, group C; Tubero-eruptive
xanthoma; Xanthoma tuberosum
E78.2 DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
Hyperchylomicronaemia; Fredrickson's hyperlipoproteinaemia, type I;

Fredrickson's hyperlipoproteinaemia, type V; Hyperlipidaemia, group D;
E78.3 Mixed hyperglyceridaemia DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
E78.4 Other hyperlipidaemia; Familial combined hyperlipidaemia DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
Lipoprotein deficiency; Abetalipoproteinaemia; High-density lipoprotein

deficiency; Hypoalphalipoproteinaemia; Familial
Hypobetalipoproteinaemia; Lecithin cholesterol acyltransferase deficiency;
E78.6 Tangier disease DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
E78.8 Other disorders of lipoprotein metabolism DISORDERS OF LIPOPROTEIN METABOLISM 6,600 1,980
E83.0 Disorders of copper metabolism; Menkes' kinky hair DISORDERS OF MINERAL METABOLISM 7,300 2,190
disease; Menkes' steely hair disease; Wilson's disease
E83.1 Disorders of iron metabolism; Haemochromatosis DISORDERS OF MINERAL METABOLISM 7,300 2,190
E83.2 Disorders of zinc metabolism; Acrodermatitis enteropathica DISORDERS OF MINERAL METABOLISM 7,300 2,190
Disorders of phosphorus metabolism; Acid phosphatase deficiency;

Familial hypophosphataemia; Hypophosphatasia; Vitamin-D-resistant
E83.3 osteomalacia; Vitamin-D-resistant rickets DISORDERS OF MINERAL METABOLISM 7,300 2,190
E83.4 Disorders of magnesium metabolism; Hypermagnesaemia; DISORDERS OF MINERAL METABOLISM 7,300 2,190
Hypomagnesaemia
E83.5 Disorders of calcium metabolism; Familial hypocalciuric DISORDERS OF MINERAL METABOLISM 7,300 2,190
hypercalcaemia; Idiopathic hypercalciuria
E83.8 Other disorders of mineral metabolism DISORDERS OF MINERAL METABOLISM 7,300 2,190
Acute inflammation of orbit; Abscess of orbit;Cellulitis of orbit;
Osteomyelitis of orbit; Periostitis of orbit, Tenonitis of
H05.0 orbit DISORDERS OF ORBIT 9,500 2,850
H05.2 Exophthalmic conditions; Displacement of globe (lateral) DISORDERS OF ORBIT 9,500 2,850
NOS; Haemorrhage of orbit; Oedema of orbit
Hereditary erythropoietic porphyria; Congenital erythropoietic porphyria; DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM
Erythropoietic protoporphyria
E80.0 9,800 2,940
E80.2 Other porphyria; Hereditary coproporphyria DISORDERS OF PORPHYRIN AND BILIRUBIN 9,800 2,940
Porphyria NOS; Acute intermittent (hepatic) Porphyria METABOLISM
E80.4 Gilbert's syndrome DISORDERS OF PORPHYRIN AND BILIRUBIN 9,800 2,940

METABOLISM
E80.5 Crigler-Najjar syndrome DISORDERS OF PORPHYRIN AND BILIRUBIN 9,800 2,940

METABOLISM
E80.6 Other disorders of bilirubin metabolism; Dubin-Johnson DISORDERS OF PORPHYRIN AND BILIRUBIN 9,800 2,940
syndrome; Rotor's syndrome METABOLISM
E79.8 Other disorders of purine and pyrimidine metabolism; DISORDERS OF PURINE AND PYRIMIDINE 7,000 2,100
Hereditary xanthinuria METABOLISM
E20.0 Idiopathic hypoparathyroidism DISORDERS OF THE PARATHYROID 9,300 2,790
E20.8 Other hypoparathyroidism DISORDERS OF THE PARATHYROID 9,300 2,790
E20.9 Hypoparathyroidism, unspecified; Parathyroid tetany DISORDERS OF THE PARATHYROID 9,300 2,790
Primary hyperparathyroidism; Hyperplasia of parathyroid; Osteitis fibrosa
cystica generalisata [von Recklinghausen's
E21.0 disease of bone] DISORDERS OF THE PARATHYROID 9,300 2,790
E21.4 Other specified disorders of parathyroid gland DISORDERS OF THE PARATHYROID 9,300 2,790
E21.5 Disorder of parathyroid gland, unspecified DISORDERS OF THE PARATHYROID 9,300 2,790
E22.2 Syndrome of inappropriate secretion of antidiuretic DISORDERS OF THE PITUITARY GLAND 11,800 3,540
hormone
Hypopituitarism; Fertile eunuch syndrome; Hypogonadotropic

hypogonadism; Idiopathic growth hormone deficiency; Isolated deficiency
of gonadotropin; Isolated deficiency of growth hormone; Isolated
deficiency of pituitary hormone; Kallmann's syndrome; Loraine-Levi short
stature; Necrosis of pituitary gland(postpartum); Panhypopituitarism;
Pituitary cachexia; Pituitary insufficiency NOS; Pituitary short stature;
Sheehan's syndrome; Simmond's disease
E23.0 DISORDERS OF THE PITUITARY GLAND 11,800 3,540
H43.0 Vitreous prolapse DISORDERS OF VITREOUS BODY AND GLOBE 10,400 3,120
H43.1 Vitreous haemorrhage DISORDERS OF VITREOUS BODY AND GLOBE 10,400 3,120
H44.0 Purulent endophthalmitis; Panophthalmitis; Vitreous DISORDERS OF VITREOUS BODY AND GLOBE 10,400 3,120
abscess
H44.1 Other endophthalmitis; Parasitic endophthalmitis NOS; DISORDERS OF VITREOUS BODY AND GLOBE 10,400 3,120
Sympathetic uveitis
H44.5 Degenerated conditions of globe; Absolute glaucoma; DISORDERS OF VITREOUS BODY AND GLOBE 10,400 3,120
Atrophy of globe; Phthisis bulbi
Disseminated intravascular coagulation [defibrination syndrome];

Acquired Afibrinogenaemia; Consumption coagulopathy; Diffuse or
disseminated intravascular coagulation [DIC] ; Acquired Fibrinolytic
D65 haemorrhage; Fibrinolytic Purpura; Purpura fulminans; DISSEMINATED INTRAVASCULAR COAGULATION 32,000 9,600
P60 Disseminated intravascular coagulation of fetus and DISSEMINATED INTRAVASCULAR COAGULATION 32,000 9,600
newborn; Defibrination syndrome of fetus or newborn
M42.1 Adult osteochondrosis of spine DORSOPATHIES 7,600 2,280
M43.02 Spondylolysis cervical region DORSOPATHIES 7,600 2,280
M43.03 Spondylolysis cervicothoracic region DORSOPATHIES 7,600 2,280
M43.04 Spondylolysis thoracic region DORSOPATHIES 7,600 2,280
M43.06 Spondylolysis lumbar region DORSOPATHIES 7,600 2,280
M43.07 Spondylolysis lumbosacral region DORSOPATHIES 7,600 2,280
M43.09 Spondylolysis site unspecified DORSOPATHIES 7,600 2,280
M43.10 Spondylolisthesis Multiple sites in spine DORSOPATHIES 7,600 2,280
M43.12 Spondylolisthesis cervical region DORSOPATHIES 7,600 2,280
M43.15 Spondylolisthesis thoracolumbar region DORSOPATHIES 7,600 2,280
M43.16 Spondylolisthesis lumbar region DORSOPATHIES 7,600 2,280
M43.17 Spondylolisthesis lumbosacral region DORSOPATHIES 7,600 2,280
M43.18 Spondylolisthesis sacral and sacrococcygeal region DORSOPATHIES 7,600 2,280
M43.19 Spondylolisthesis site unspecified DORSOPATHIES 7,600 2,280
M43.22 Other fusion of spine; Ankylosis of spinal joint cervical DORSOPATHIES 7,600 2,280
region
M43.26 Other fusion of spine; Ankylosis of spinal joint lumbar DORSOPATHIES 7,600 2,280
region
M43.27 Other fusion of spine; Ankylosis of spinal joint lumbosacral DORSOPATHIES 7,600 2,280
region
M43.29 Other fusion of spine; Ankylosis of spinal joint site DORSOPATHIES 7,600 2,280
unspecified
M43.42 Other recurrent atlantoaxial subluxation cervical region DORSOPATHIES 7,600 2,280
M43.49 Other recurrent atlantoaxial subluxation site unspecified DORSOPATHIES 7,600 2,280
M43.60 Torticollis Multiple sites in spine DORSOPATHIES 7,600 2,280

M43.62 Torticollis cervical region DORSOPATHIES 7,600 2,280
M43.64 Torticollis thoracic region DORSOPATHIES 7,600 2,280
M43.66 Torticollis lumbar region DORSOPATHIES 7,600 2,280
M43.68 Torticollis sacral and sacrococcygeal region DORSOPATHIES 7,600 2,280
M43.69 Torticollis site unspecified DORSOPATHIES 7,600 2,280
M43.8 Other specified deforming dorsopathies DORSOPATHIES 7,600 2,280
M43.82 Other specified deforming dorsopathies cervical region DORSOPATHIES 7,600 2,280
M43.85 Other specified deforming dorsopathies thoracolumbar DORSOPATHIES 7,600 2,280
region
M43.86 Other specified deforming dorsopathies lumbar region DORSOPATHIES 7,600 2,280
M43.87 Other specified deforming dorsopathies lumbosacral region DORSOPATHIES 7,600 2,280
M43.88 Other specified deforming dorsopathies sacral and DORSOPATHIES 7,600 2,280
M43.89 Other specified deforming dorsopathies site unspecified DORSOPATHIES 7,600 2,280
M43.9 Deforming dorsopathy, unspecified; Curvature of spine DORSOPATHIES 7,600 2,280

NOS

NOS thoracic region
NOS thoracolumbar region

NOS lumbar region
NOS lumbosacral region

NOS site unspecified
M53.0 Cervicocranial syndrome; Posterior cervical sympathetic DORSOPATHIES 7,600 2,280
syndrome
M53.1 Cervicobrachial syndrome DORSOPATHIES 7,600 2,280

M53.12 Cervicobrachial syndrome cervical region DORSOPATHIES 7,600 2,280
M53.19 Cervicobrachial syndrome site unspecified DORSOPATHIES 7,600 2,280
M53.2 Spinal instabilities DORSOPATHIES 7,600 2,280
M53.22 Spinal instabilities cervical region DORSOPATHIES 7,600 2,280
M53.24 Spinal instabilities thoracic region DORSOPATHIES 7,600 2,280
M53.26 Spinal instabilities lumbar region DORSOPATHIES 7,600 2,280
M53.27 Spinal instabilities lumbosacral region DORSOPATHIES 7,600 2,280
M53.28 Spinal instabilities sacral and sacrococcygeal region DORSOPATHIES 7,600 2,280
M53.29 Spinal instabilities site unspecified DORSOPATHIES 7,600 2,280
M53.3 Coccygodynia DORSOPATHIES 7,600 2,280
M53.38 Coccygodynia sacral and sacrococcygeal region DORSOPATHIES 7,600 2,280
M53.8 Other specified dorsopathies DORSOPATHIES 7,600 2,280
M53.86 Other specified dorsopathies lumbar region DORSOPATHIES 7,600 2,280
M53.87 Other specified dorsopathies lumbosacral region DORSOPATHIES 7,600 2,280
M53.89 Other specified dorsopathies site unspecified DORSOPATHIES 7,600 2,280
M53.9 Dorsopathy, unspecified DORSOPATHIES 7,600 2,280
M53.92 Dorsopathy, unspecified cervical region DORSOPATHIES 7,600 2,280
M53.95 Dorsopathy, unspecified thoracolumbar region DORSOPATHIES 7,600 2,280
M54 Dorsalgia DORSOPATHIES 7,600 2,280
T75.1 Drowning and nonfatal submersion; Immersion; Swimmer's DROWNING 7,100 2,130
cramp
O00.0 Abdominal pregnancy ECTOPIC PREGNANCY 7,800 2,340

O00.1 Tubal pregnancy; Fallopian pregnancy; Rupture of fallopian ECTOPIC PREGNANCY 7,800 2,340
tube due to pregnancy; Tubal abortion
O00.2 Ovarian pregnancy ECTOPIC PREGNANCY 7,800 2,340

Other ectopic pregnancy; Cervical pregnancy; Cornual pregnancy;
O00.8 Intraligamentous pregnancy; Mural pregnancy ECTOPIC PREGNANCY 7,800 2,340
O00.9 Ectopic pregnancy, unspecified ECTOPIC PREGNANCY 7,800 2,340

O36.7 Maternal care for viable fetus in abdominal pregnancy ECTOPIC PREGNANCY 7,800 2,340
T75.0 Effects of lightning; Shock from lightning; Struck by ELECTRICAL SHOCK 5,400 1,620
lightning NOS
T75.4 Effects of electric current; Electrocution; Shock from ELECTRICAL SHOCK 5,400 1,620
electric current
J43.0 MacLeod's syndrome; Unilateral emphysema; Unilateral EMPHYSEMA 11,400 3,420

transparency of lung
J43.1 Panlobular emphysema; Panacinar emphysema EMPHYSEMA 11,400 3,420

J43.2 Centrilobular emphysema EMPHYSEMA 11,400 3,420
J43.8 Other emphysema EMPHYSEMA 11,400 3,420
Emphysema, unspecified; Lung emphysema NOS; Pulmonary emphysema
NOS; Bullous lung emphysema; Bullous pulmonary emphysema; Vesicular
lung emphysema; Vesucular pulmonary emphysema; Emphysematous
J43.9 bleb EMPHYSEMA 11,400 3,420
J98.2 Interstitial emphysema; Mediastinal emphysema EMPHYSEMA 11,400 3,420

J98.3 Compensatory emphysema EMPHYSEMA 11,400 3,420
Human immunodeficiency virus [HIV] disease resulting in encephalopathy;
Human immunodeficiency virus [HIV]
B22.0 dementia ENCEPHALOPATHY 22,200 6,660
G92 Toxic encephalopathy ENCEPHALOPATHY 22,200 6,660

G93.1 Anoxic brain damage, not elsewhere classified ENCEPHALOPATHY 22,200 6,660
I67.4 Hypertensive encephalopathy ENCEPHALOPATHY 22,200 6,660
N80.0 Endometriosis of uterus; Adenomyosis ENDOMETRIOSIS 7,700 2,310
N80.1 Endometriosis of ovary ENDOMETRIOSIS 7,700 2,310
N80.2 Endometriosis of fallopian tube ENDOMETRIOSIS 7,700 2,310
N80.3 Endometriosis of pelvic peritoneum ENDOMETRIOSIS 7,700 2,310
N80.4 Endometriosis of rectovaginal septum and vagina ENDOMETRIOSIS 7,700 2,310
N80.5 Endometriosis of intestine ENDOMETRIOSIS 7,700 2,310
N80.8 Other endometriosis; Endometriosis of thorax ENDOMETRIOSIS 7,700 2,310
N80.9 Endometriosis, unspecified ENDOMETRIOSIS 7,700 2,310
J05.1 Acute epiglottitis; Epiglottitis NOS EPIGLOTTITIS 9,700 2,910
Localization-related focal idiopathic epilepsy and epileptic syndromes with
seizures of localized onset; Localization- related partial idiopathic epilepsy
and epileptic syndromes with seizures of localized onset; Benign
childhood epilepsy with centrotemporal EEG spikes;Childhood epilepsy
G40.0 with occipital EEG paroxysms EPILEPSY 7,800 2,340
Localization-related focal symptomatic epilepsy and epileptic syndromes

with simple partial seizures; Localization-related partial symptomatic
epilepsy and epileptic syndromes with simple partial seizures; Attacks
without alteration of consciousness ; Simple partial seizures developing
G40.1 into secondarily generalized seizures EPILEPSY 7,800 2,340
Localization-related focal symptomatic epilepsy and epileptic syndromes

with complex partial seizures; Localization-related partial symptomatic
epilepsy and epileptic syndromes with complex partial seizures; Attacks
with alteration of consciousness, often with automatisms. Complex partial
G40.2 seizures developing into secondarily generalized seizures EPILEPSY 7,800 2,340
Generalized idiopathic epilepsy and epileptic syndromes; Benign

myoclonic epilepsy in infancy; Benign familial neonatal convulsions;
Childhood absence epilepsy [pyknolepsy]; Epilepsy with grand mal
seizures on awakening; Juvenile absence epilepsy; Juvenile absence
epilepsy; Juvenile myoclonic epilepsy impulsive petit mal); Nonspecific
atonic epileptic seizures; Nonspecific clonic epileptic seizures; Nonspecific
myoclonic epileptic seizures; nonspecific tonic epileptic seizures;
G40.3 Nonspecific tonic-clonic epileptic seizures EPILEPSY 7,800 2,340
Other generalized epilepsy and epileptic syndromes; Epilepsy with
myoclonic absences; Epilepsy with myoclonic- astatic seizures; Infantile
spasms; Lennox-Gastaut syndrome; Salaam attacks; Symptomatic early
G40.4 myoclonic; Encephalopathy; West's syndrome EPILEPSY 7,800 2,340
Special epileptic syndromes; Epilepsia partialis continua [Kozhevnikof];

Epileptic seizures related to alcohol; Epileptic seizures related to drugs;
Epileptic seizures related to hormonal changes; Epileptic seizures related
to sleep deprivation; Epileptic seizures related to stress
G40.5 EPILEPSY 7,800 2,340
G40.6 Grand mal seizures, unspecified (with or without petit mal) EPILEPSY 7,800 2,340
G40.7 Petit mal, unspecified, without grand mal seizures EPILEPSY 7,800 2,340
Other epilepsy; Epilepsies and epileptic syndromes undetermined as to
whether they are focal or generalized
G40.8 EPILEPSY 7,800 2,340
G40.9 Epilepsy, unspecified; Epileptic convulsions NOS; Epileptic EPILEPSY 7,800 2,340
fits NOS; Epileptic seizures NOS
G21.0 Malignant neuroleptic syndrome EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G21.1 Other drug-induced secondary parkinsonism EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G21.8 Other secondary parkinsonism EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G21.9 Secondary parkinsonism, unspecified EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G23.0 Hallervorden-Spatz disease; Pigmentary pallidal EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
degeneration
G23.1 Progressive supranuclear ophthalmoplegia [Steele- EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
Richardson-Olszewski]
Other specified degenerative diseases of basal ganglia; Calcification of

basal ganglia; Neurogenic orthostatic
G23.8 hypotension [Shy-Drager} EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G23.9 Degenerative disease of basal ganglia, unspecified EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.0 Carcinomatous neuromyopathy in Drug-induced dystonia EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.1 Idiopathic familial dystonia; Idiopathic dystonia NOS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.3 Spasmodic torticollis EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.4 Idiopathic orofacial dystonia; Orofacial dyskinesia EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.8 Other dystonia EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G24.9 Dystonia, unspecified; Dyskinesia NOS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G25.3 Myoclonus; Drug-induced myoclonus EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
G25.5 Other chorea; Chorea NOS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
Other specified extrapyramidal and movement disorders;

G25.8 Akathisia (drug-induced) (treatment-induced) Restless legs syndrome; EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
Stiff-man syndrome
G25.9 Extrapyramidal and movement disorder, unspecified EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 8,300 2,490
R56.0 Febrile convulsions FEBRILE SEIZURES 7,000 2,100

R56.8 Other and unspecified convulsions; Fit NOS; Seizure FEBRILE SEIZURES 7,000 2,100
(convulsive) NOS
P92.1 Regurgitation and rumination in newborn FEEDING PROBLEMS NEWBORN 8,700 2,610
P92.2 Slow feeding of newborn FEEDING PROBLEMS NEWBORN 8,700 2,610
P92.4 Overfeeding of newborn FEEDING PROBLEMS NEWBORN 8,700 2,610
P92.8 Other feeding problems of newborn FEEDING PROBLEMS NEWBORN 8,700 2,610
P92.9 Feeding problem of newborn, unspecified FEEDING PROBLEMS NEWBORN 8,700 2,610
R50.9 Fever, unspecified; Hyperpyrexia NOS; Pyrexia NOS FEVER OF UNKNOWN ORIGIN 7,000 2,100
E87.0 Hyperosmolality and hypernatraemia; Sodium [Na] excess; FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
Sodium [Na] overload
E87.1 Hypo-osmolality and hyponatraemia FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
E87.2 Acidosis; Acidosis NOS; Lactic Acidosis; Metabolic Acidosis; FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
Respiratory Acidosis
E87.3 Alkalosis; Alkalosis NOS; Metabolic Alkalosis; Respiratory FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
Alkalosis
E87.4 Mixed disorder of acid-base balance FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
E87.5 Hyperkalaemia; Potassium [K] excess; Potassium [K] FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
overload
E87.6 Hypokalaemia; Potassium [K] deficiency FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
E87.7 Fluid overload FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
Other disorders of electrolyte and fluid balance, not elsewhere classified;
Electrolyte imbalance NOS; Hyperchloraemia; Hypochloraemia; Other
metabolic disorders
E87.8 Electrolyte abnormality FLUID AND ELECTROLYTE DISTURBANCES 8,500 2,550
S22.00 Fracture of thoracic vertebra; Fracture of thoracic spine FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
NOS (closed)
S22.10 Multiple fractures of thoracic spine (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.2 Fracture of sternum FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.20 Fracture of sternum (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.3 Fracture of rib FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.30 Fracture of rib (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.31 Fracture of rib (open) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.4 Multiple fractures of ribs FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.40 Multiple fractures of ribs (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.41 Multiple fractures of ribs (open) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.80 Fracture of other parts of bony thorax (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
S22.90 Fracture of bony thorax, part unspecified (closed) FRACTURES OF THE BONES OF THE THORAX 8,700 2,610
J85.0 Gangrene and necrosis of lung GANGRENE 13,200 3,960
L88 Pyoderma gangrenosum; Dermatitis gangrenosa; GANGRENE 13,200 3,960
Phagedenic pyoderma
R02 Gangrene, not elsewhere classified GANGRENE 13,200 3,960

K21.0 Gastro-oesophageal reflux disease with oesophagitis; GASTROESOPHAGEAL REFLUX DISEASE 6,100 1,830
Reflux oesophagitis
K21.9 Gastro-oesophageal reflux disease without oesophagitis; GASTROESOPHAGEAL REFLUX DISEASE 6,100 1,830
Oesophageal reflux NOS
P76.0 Meconium plug syndrome GASTROINTESTINAL DISORDERS OF THE 11,700 3,510

NEWBORN
P76.1 Transitory ileus of newborn GASTROINTESTINAL DISORDERS OF THE 11,700 3,510

NEWBORN
P76.8 Other specified intestinal obstruction of newborn GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
P76.9 Intestinal obstruction of newborn, unspecified GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
P77 Necrotizing enterocolitis of fetus and newborn GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
P78.0 Perinatal intestinal perforation; Meconium peritonitis GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
P78.2 Neonatal haematemesis and melaena due to swallowed GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
maternal blood NEWBORN
P78.3 Noninfective neonatal diarrhoea GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
P78.8 Other specified perinatal digestive system disorders; GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
Congenital cirrhosis of liver; Peptic ulcer of newborn NEWBORN
P78.9 Perinatal digestive system disorder, unspecified GASTROINTESTINAL DISORDERS OF THE 11,700 3,510
NEWBORN
H40.0 Glaucoma suspect; Ocular hypertension GLAUCOMA 6,500 1,950

Primary open-angle glaucoma; primary capsular with pseudoexfoliation of
lens glaucoma; Residual stage capsular with pseudoexfoliation of lens;
Primary chronic simple glaucoma; Residual stage chronic simple glaucoma;
Primary low-tension glaucoma; Residual low tension glaucoma; Primary
H40.1 pigmentary glaucoma; Residual pigmentary GLAUCOMA 6,500 1,950
glaucoma
Primary angle-closure glaucoma; Primary acute angle- closure glaucoma ;

Acute residual stage angle-closure glaucoma ; Primary chronic angle-
closure glaucoma ; Residual stage chronic angle-closure glaucoma; Primary
intermittent angle-cloure glaucoma; Residual intermittent angle-closure
H40.2 glaucoma GLAUCOMA 6,500 1,950
H40.3 Glaucoma secondary to eye trauma GLAUCOMA 6,500 1,950

H40.4 Glaucoma secondary to eye inflammation GLAUCOMA 6,500 1,950
H40.5 Glaucoma secondary to other eye disorders GLAUCOMA 6,500 1,950
H40.8 Other glaucoma GLAUCOMA 6,500 1,950
H40.9 Glaucoma, unspecified GLAUCOMA 6,500 1,950
Acute nephritic syndrome including Acute glomerular disease, Acute
glomerulonephritis, Acute nephritis, Acute renal disease NOS, with Minor
N00.0 glomerular abnormality GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

glomerulonephritis, Acute nephritis, Acute renal disease NOS, with Focal
and segmental glomerular lesions (with focal and segmental hyalinosis;
focal and segmental sclerosis) & Focal glomerulonephritis
N00.1 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse
N00.2 membranous glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N00.3 mesangial proliferative glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N00.4 endocapillary proliferative GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis
mesangiocapillary glomerulonephritis (Membranoproliferative
glomerulonephritis, types 1 and 3, or NOS)
N00.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N00.7 crescentic glomerulonephritis (Extracpillary glomerulonephritis) GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

glomerulonephritis, Acute nephritis, Acute renal disease NOS with Other
N00.8 (Proliferative glomerulonephritis NOS) GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N00.9 glomerulonephritis, Acute nephritis, Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
renal disease NOS, Unspecified renal biopsy
Rapidly progressive nephritic syndrome; rapidly progressive glomerular

disease; rapidly progressive glomerulonephritis; rapidly progressive
N01.0 nephritis, Minor glomerular abnormality GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N01.1 nephritis, Focal and segmental glomerular lesions GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N01.3 nephritis, Diffuse mesangial proliferative glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N01.5 nephritis, Diffuse mesangiocapillary glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N01.8 nephritis, other GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N01.9 nephritis, Unspecified GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Recurrent and persistent haematuria including Benign familial

Haematuria; Benign familial Haematuria of childhood; Haematuria with
N02.0 morphological lesion specified with Minor glomerular abnormality GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N02.1 morphological lesion specified with Focal and segmental glomerular GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
lesions

N02.2 morphological lesion specified with Diffuse membranous GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis

morphological lesion specified with Diffuse mesangiocapillary
N02.5 glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

morphological lesion specified with other (Proliferative glomerulonephritis
NOS)
N02.8 IgA Nephropathy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N02.9 morphological lesion specified with Unspecified renal biopsy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Chronic nephritic syndrome including Chronic glomerular disease,

Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS,
N03.0 with Minor glomerular abnormality GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N03.1 with Focal and segmental GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerular lesions

N03.2 withDiffuse membranous glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N03.3 with Diffuse mesangial proliferative glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N03.4 with Diffuse endocapillary proliferative glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N03.5 with Diffuse mesangiocapillary GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis

N03.7 with Diffuse crescentic glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N03.8 with Other (Proliferative glomerulonephritis NOS) GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

N03.9 with Unspecified renal biopsy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N04.0 Nephrotic syndrome: Minor glomerular abnormality; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Minimal change lesion
Nephrotic syndrome: Focal and segmental glomerular lesions; Focal and

segmental hyalinosis; Focal and
N04.1 segmental sclerosis; Focal glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N04.2 Nephrotic syndrome: Diffuse membranous GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis
N04.3 Nephrotic syndrome: Diffuse mesangial proliferative GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis
N04.4 Nephrotic syndrome: Diffuse endocapillary proliferative GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis
Nephrotic syndrome: Diffuse mesangiocapillary glomerulonephritis;

Membranoproliferative
N04.5 glomerulonephritis, types 1 and 3, or NOS GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N04.7 Nephrotic syndrome: Diffuse crescentic glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Extracapillary glomerulonephritis
N04.8 Nephrotic syndrome: Other GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N04.9 Nephrotic syndrome:Unspecified GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Unspecified nephritic syndrome including Glomerular

N05.0 disease, Glomerulonephritis, Nephritis NOS with Minor glomerular GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
abnormality, minimal change lesion
Unspecified nephritic syndrome including Glomerular disease,

Glomerulonephritis, Nephritis NOS with Focal and segmental glomerular
lesions (with focal and segmental hyalinosis; focal and segmental
N05.1 sclerosis) & Focal GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis

N05.2 Glomerulonephritis, Nephritis NOS with Diffuse GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
membranous glomerulonephritis

N05.3 Glomerulonephritis, Nephritis NOS with Diffuse GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
mesangial proliferative glomerulonephritis

Glomerulonephritis, Nephritis NOS with Diffuse
N05.4 endocapillary proliferative glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

Glomerulonephritis, Nephritis NOS with Diffuse mesangiocapillary
glomerulonephritis, Membranoproliferative glomerulonephritis, types 1
N05.5 and 3, or NOS GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

Glomerulonephritis, Nephritis NOS with Dense deposit disease
N05.6 Membranoproliferative glomerulonephritis, type 2 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

Glomerulonephritis, Nephritis NOS with Diffuse crescentic
N05.7 glomerulonephritis, Extracapillary glomerulonephritis GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

Glomerulonephritis, Nephritis NOS with Other (Proliferative
N05.8 glomerulonephritis NOS) GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000

Glomerulonephritis, Nephritis NOS with
N05.9 Unspecified renal biopsy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Isolated proteinuria with specified morphological lesion with

morphological lesion specified with Minor glomerular
N06.0 abnormality GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Isolated proteinuria with specified morphological lesion with Other

N06.8 (Proliferative glomerulonephritis NOS) GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N06.9 Isolated proteinuria with specified morphological lesion GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
with Unspecified renal biopsy
N07.0 Hereditary nephropathy, not elsewhere classified with GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Minor glomerular abnormality
Hereditary nephropathy, not elsewhere classified with Focal and

segmental glomerular lesions (with focal and segmental hyalinosis; focal
N07.1 and segmental sclerosis) & Focal GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
glomerulonephritis
Diffuse membranous glomerulonephritis
Diffuse mesangial proliferative glomerulonephritis
Hereditary nephropathy, not elsewhere classified with Diffuse

mesangiocapillary glomerulonephritis, Membranoproliferative
N07.5 glomerulonephritis, types 1 and 3, or NOS GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Unspecified renal biopsy
Acute tubulo-interstitial nephritis; pyelonephritis; Acute infectious

N10 interstitial nephritis; Acute pyelitis; Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
pyelonephritis
Chronic tubulo-interstitial nephritis, unspecified; Chronic interstitial

nephritis NOS; Chronic pyelitis NOS; Chronic
N11.9 pyelonephritis NOS GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
Tubulo-interstitial nephritis, not specified as acute or chronic; Interstitial

nephritis NOS; Pyelitis NOS;
N12 Pyelonephritis NOS GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N14.0 Analgesic nephropathy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N14.1 Nephropathy induced by other drugs, medicaments and GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
biological substances
N14.2 Nephropathy induced by unspecified drug, medicament or GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
biological substance
N14.4 Toxic nephropathy, not elsewhere classified GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N15.0 Balkan nephropathy; Balkan endemic nephropathy GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N15.8 Other specified renal tubulo-interstitial diseases GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N15.9 Renal tubulo-interstitial disease, unspecified; Infection of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
kidney NOS
N39.1 Persistent proteinuria, unspecified GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
N39.2 Orthostatic proteinuria, unspecified GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10,000 3,000
M23.20 Derangement of meniscus due to old tear or injury; Old HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
bucket-handle tear multiple sites
Derangement of meniscus due to old tear or injury; Old bucket-handle tear
M23.21 Anterior cruciate ligament or Anterior HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
horn of medial meniscus

M23.22 Posterior cruciate ligament or Posterior HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
horn of medial meniscus

Posterior horn of lateral meniscus
M23.25 HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M23.46 Loose body in knee Other and unspecified lateral meniscus HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M23.5 Chronic instability of knee HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M23.80 Other internal derangements of knee; Laxity of ligament of HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
knee; Snapping knee multiple sites
M23.9 Internal derangement of knee, unspecified HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M23.91 Internal derangement of knee, unspecified Anterior HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
cruciate ligament or Anterior horn of medial meniscus
M24.08 Loose body in joint other sites HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.1 Other articular cartilage disorders HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.2 Disorder of ligament; Instability secondary to old ligament HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
injury; Ligamentous laxity NOS
M24.4 Recurrent dislocation and subluxation of joint HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.41 Recurrent dislocation and subluxation of joint shoulder HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
region
M24.50 Contracture of joint multiple sites HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.54 Contracture of joint hand HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.56 Contracture of joint lower leg HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.6 Ankylosis of joint HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.65 Ankylosis of joint pelvic region and thigh HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.66 Ankylosis of joint lower leg HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.69 Ankylosis of joint site unspecified HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.7 Protrusio acetabuli HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
M24.88 Other specific joint derangements, not elsewhere classified; HAND, FEET AND JOINT DEFORMITIES 9,200 2,760
Irritable hip other sites
G43.0 Migraine without aura [common migraine] HEADACHE SYNDROMES 5,500 1,650
Migraine with aura [classical migraine]; Migraine aura without headache;
Migraine, basilar; Migraine equivalents; Familial hemiplegic Migraine;
Migraine with acute-onset aura; Migraine with prolonged aura; Migraine
G43.1 with typical HEADACHE SYNDROMES 5,500 1,650
aura
G43.2 Status migrainosus HEADACHE SYNDROMES 5,500 1,650

G43.3 Complicated migraine HEADACHE SYNDROMES 5,500 1,650
G43.8 Other migraine; Ophthalmoplegic migraine; Retinal HEADACHE SYNDROMES 5,500 1,650
migraine
G43.9 Migraine, unspecified HEADACHE SYNDROMES 5,500 1,650

Cluster headache syndrome; Chronic paroxysmal hemicrania; Chronic
G44.0 cluster headache; Episodic Cluster HEADACHE SYNDROMES 5,500 1,650
headache
G44.1 Vascular headache, not elsewhere classified; Vascular HEADACHE SYNDROMES 5,500 1,650
headache NOS
Tension-type headache; Chronic tension-type headache; Episodic tension

G44.2 headache; Tension headache NOS HEADACHE SYNDROMES 5,500 1,650
G44.3 Chronic post-traumatic headache HEADACHE SYNDROMES 5,500 1,650

G44.4 Drug-induced headache, not elsewhere classified HEADACHE SYNDROMES 5,500 1,650
G44.8 Other specified headache syndromes HEADACHE SYNDROMES 5,500 1,650
R51 Headache; Facial pain NOS HEADACHE SYNDROMES 5,500 1,650
I44.2 Atrioventricular block, complete; Complete heart block HEART CONDUCTION DISORDERS 12,300 3,690
NOS; Third-degree block
I44.3 Other and unspecified atrioventricular block; HEART CONDUCTION DISORDERS 12,300 3,690
Atrioventricular block NOS
I44.4 Left anterior fascicular block HEART CONDUCTION DISORDERS 12,300 3,690
I45.5 Other specified heart blockl; Sinoatrial NOS; Sinoauricular HEART CONDUCTION DISORDERS 12,300 3,690
block
Pre-excitation syndrome; Anomalous atrioventicular excitation;

Atrioventricular conduction, accelerated; Atrioventicular conduction,
accesory; Atrioventicular conduction pre-excitation; Lown-Ganong-Levine
I45.6 syndrome; Wolff-Parkinson-White syndrome HEART CONDUCTION DISORDERS 12,300 3,690
I45.8 Other specified conduction disorder; Atrioventricular [AV] HEART CONDUCTION DISORDERS 12,300 3,690
dissociation; Interference dissociation
I45.9 Heart conduction disorders, unspecified; Heart block NOS; HEART CONDUCTION DISORDERS 12,300 3,690
Stokes-Adams syndrome
I09.9 Rheumatic heart disease, unspecified; Rheumatic carditis; HEART FAILURE 15,700 4,710
Rheumatic heart failure
I50.0 Congestive heart failure; Congestive heart disease; Right HEART FAILURE 15,700 4,710
venticular failure (secondary to left heart failure)
Left ventricular failure; Acute oedema of lung with mention of heart

disease NOS or heart failure; Acute pulmonary oedema with mention of
heart disease NOS or heart failure; Cardiac asthma with mention of heart
disease NOS or heart failure; Left heart failure with mention of heart
I50.1 disease NOS or heart failure HEART FAILURE 15,700 4,710
I50.9 Heart failure, unspecified; Cardiac, heart or myocardial HEART FAILURE 15,700 4,710
failure NOS
Mitral (valve) insufficiency; Incompetence mitral valve NOS or of specified
cause, except rheumatic; Regurgitation mitral valve NOS or of specified
I34.0 cause, except rheumatic HEART VALVE DISORDERS 8,400 2,520
I34.1 Mitral (valve) prolapse; Floppy mitral valve syndrome HEART VALVE DISORDERS 8,400 2,520
I34.2 Nonrheumatic mitral (valve) stenosis HEART VALVE DISORDERS 8,400 2,520
I34.8 Other nonrheumatic mitral heart valve disorders HEART VALVE DISORDERS 8,400 2,520
I34.9 Nonrheumatic mitral valve disorder, unspecified HEART VALVE DISORDERS 8,400 2,520
I35.0 Aortic (valve) stenosis HEART VALVE DISORDERS 8,400 2,520
Aortic (valve) insufficiency; Incompetence Aortic valve NOS or of specified
cause, except rheumatic; Aortic valve regurgitation NOS or of specified
I35.1 cause, except rheumatic HEART VALVE DISORDERS 8,400 2,520
I35.2 Aortic (valve) stenosis with insufficiency HEART VALVE DISORDERS 8,400 2,520
I35.8 Other aortic heart valve disorders HEART VALVE DISORDERS 8,400 2,520
I35.9 Aortic valve disorder, unspecified HEART VALVE DISORDERS 8,400 2,520
I36.0 Nonrheumatic tricuspid (valve) stenosis HEART VALVE DISORDERS 8,400 2,520
Nonrheumatic tricuspid (valve) insufficiency; Incompetence tricuspid valve
of specified cause, except rheumatic; Tricuspid valve regurgitation of
I36.1 specified cause, except rheumatic HEART VALVE DISORDERS 8,400 2,520
I36.8 Other nonrheumatic tricuspid valve disorders HEART VALVE DISORDERS 8,400 2,520
I36.9 Nonrheumatic tricuspid valve disorder, unspecified HEART VALVE DISORDERS 8,400 2,520
I37.0 Pulmonary valve stenosis HEART VALVE DISORDERS 8,400 2,520
Pulmonary valve insufficiency; Incompetence pulmonary valve NOS or
specified cause, except rheumatic; Pulmonary valve regurgitation NOS or
I37.1 of specified cause, except rheumatic HEART VALVE DISORDERS 8,400 2,520
I37.8 Other pulmonary heart valve disorders HEART VALVE DISORDERS 8,400 2,520
I37.9 Pulmonary valve disorder, unspecified HEART VALVE DISORDERS 8,400 2,520
T67.0 Heat stroke and sunstroke; Heat apoplexy; Heat pyrexia; HEAT EXHAUSTION 6,500 1,950
Siriasis; Thermoplegia
T67.1 Heat syncope; Heat collapse HEAT EXHAUSTION 6,500 1,950

T67.2 Heat cramp HEAT EXHAUSTION 6,500 1,950
T67.3 Heat exhaustion, anhydrotic; Heat prostration due to water HEAT EXHAUSTION 6,500 1,950
depletion
T67.4 Heat exhaustion due to salt depletion; Heat prostation due HEAT EXHAUSTION 6,500 1,950
to salt (and water) depletion
T67.5 Heat exhaustion, unspecified; Heat prostration NOS HEAT EXHAUSTION 6,500 1,950
T67.9 Effect of heat and light, unspecified HEAT EXHAUSTION 6,500 1,950
M25.00 Haemarthrosis multiple sites HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.01 Haemarthrosis shoulder region HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.05 Haemarthrosis pelvic region and thigh HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.06 Haemarthrosis lower leg HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.07 Haemarthrosis ankle and foot HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.08 Haemarthrosis other sites HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.09 Haemarthrosis site unspecified HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.38 Other instability of joint other sites HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.40 Effusion of joint multiple sites HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.41 Effusion of joint shoulder region HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.46 Effusion of joint lower leg HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
M25.47 Effusion of joint ankle and foot HEMARTHROSIS/JOINT EFFUSION 7,800 2,340
D59.3 Haemolytic-uraemic syndrome HEMOLYTIC UREMIC SYNDROME 20,200 6,060
Delayed or excessive haemorrhage following abortion and ectopic and HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD
molar pregnancy; Afibrinogenaemia;
O08.1 Defibrination syndrome; Intravascular coagulation 7,000 2,100
Third-stage haemorrhage; Haemorrhage associated with retained, trapped HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD
or adherent placenta; Retained placenta
O72.0 NOS 7,000 2,100
Other immediate postpartum haemorrhage; Haemorrhage following HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD
O72.1 delivery of placenta; Postpartum atomic 7,000 2,100
haemorrhage NOS
Delayed and secondary postpartum haemorrhage; Haemorrhage HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD
associated with retained portions of placenta or membranes; Retained
O72.2 products of concepcion NOS, 7,000 2,100
following delivery
O72.3 Postpartum coagulation defects; Afibrinogenaemia HEMORRHAGE IN PREGNANCY AND POST 7,000 2,100
postpartum; Fibrinolysis postpartum PARTUM PERIOD
O73.0 Retained placenta without haemorrhage; Placenta accreta HEMORRHAGE IN PREGNANCY AND POST 7,000 2,100
without haemorrhage PARTUM PERIOD
Retained portions of placenta and membranes without haemorrhage; HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD
O73.1 Retained products of conception following 7,000 2,100
delivery, without haemorrhage
P50.0 Fetal blood loss from vasa praevia HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P50.1 Fetal blood loss from ruptured cord HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P50.2 Fetal blood loss from placenta HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P50.9 Fetal blood loss, unspecified; Fetal haemorrhage NOS HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P51.9 Umbilical haemorrhage of newborn, unspecified HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P53 Haemorrhagic disease of fetus and newborn; Vitamin K HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
deficiency of newborn THE NEWBORN
P54.0 Neonatal haematemesis HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P54.2 Neonatal rectal haemorrhage HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P54.3 Other neonatal gastrointestinal haemorrhage HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P54.4 Neonatal adrenal haemorrhage HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
Neonatal cutaneous haemorrhage; Bruising in fetus or newborn; HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE
Ecchymoses in fetus or newborn; Petechiae in fetus or newborn; NEWBORN
P54.5 Superficial haematomata in fetus or newborn 7,800 2,340
P54.6 Neonatal vaginal haemorrhage; Pseudomenses HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P54.8 Other specified neonatal haemorrhages HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P54.9 Neonatal haemorrhage, unspecified HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P55.0 Rh isoimmunization of fetus and newborn HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P55.1 ABO isoimmunization of fetus and newborn HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P55.8 Other haemolytic diseases of fetus and newborn HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P55.9 Haemolytic disease of fetus and newborn, unspecified HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
Transient neonatal thrombocytopenia; neonatal thrombocytopenia due to

exchange transfusion; Neonatal thrombocytopenia due to idiophatic
maternal thrombocytopenia; Neonatal thrombocytopenia due to HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE
P61.0 isoimmunization NEWBORN 7,800 2,340
P61.1 Polycythaemia neonatorum HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P61.5 Transient neonatal neutropenia HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P61.6 Other transient neonatal disorders of coagulation HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P61.8 Other specified perinatal haematological disorders HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
P61.9 Perinatal haematological disorder, unspecified HEMORRHAGIC AND HEMATOLOGIC DISEASES OF 7,800 2,340
THE NEWBORN
Hereditary factor VIII deficiency; Deficiency factor VIII (with functional

D66 defect); Haemophilia NOS; Haemophilia A; HEMORRHAGIC CONDITIONS 12,800 3,840
Classical Haemophilia
Hereditary factor IX deficiency; Christmas disease; Factor IX Deficiency

(with functional defect); Plasma thromboplastin component [PTC]
D67 Deficiency; Haemophilia B HEMORRHAGIC CONDITIONS 12,800 3,840
Von Willebrand's disease; Angiohaemophilia; Factor VIII deficiency with

D68.0 vascular defect; Vascular haemophilia HEMORRHAGIC CONDITIONS 12,800 3,840
D68.1 Hereditary factor XI deficiency; Haemophilia C Plasma HEMORRHAGIC CONDITIONS 12,800 3,840
thromoplastin antecedent [PTA] deficiency
Hereditary deficiency of other clotting factors; Congenital

afibrinogenaemia; AC globulin Deficiency; Proaccelerin Deficiency;
Deficiency of factor I [fibrinogen]; Deficiency of factor II [prothrombin];
Deficiency of factor V [labile]; Deficiency of factor VII [stable]; Deficiency
of factor X [Stuart-Prower]; Deficiency of XII [hageman]; XIII [fibrin-
stabilizing]; Congenital dysfibrinogenaemia; Hypoproconvertinaemia;
D68.2 Owren's disease HEMORRHAGIC CONDITIONS 12,800 3,840
Haemorrhagic disorder due to circulating anticoagulants; Haemorrhage

during long term use of anticoagulants; Hyperheparinaemia; Increase in
antithrombin; Increase in anti-VIIIa; Increase in anti-Ixa; Increase in anti-
D68.3 Xa; Increase in anti-Xia HEMORRHAGIC CONDITIONS 12,800 3,840
Acquired coagulation factor deficiency; Deficiency of coagulation factor

D68.4 due to liver disease; Deficiency of HEMORRHAGIC CONDITIONS 12,800 3,840
coagulation factor due to vitamin K deficiency
D68.8 Other specified coagulation defects; Presence of systemic HEMORRHAGIC CONDITIONS 12,800 3,840
lupus erythematosus [SLE] inhibitor
D68.9 Coagulation defect, unspecified HEMORRHAGIC CONDITIONS 12,800 3,840

Allergic purpura; Anaphylactoid Purpura; Henoch(- Schönlein) Purpura;
Nonthrombocytopenic Purpura; Haemorrhagic Purpura; Idiopathic
D69.0 Purpura; Vascular Purpura; AllergicVasculitis HEMORRHAGIC CONDITIONS 12,800 3,840
Qualitative platelet defects; Bernard-Soulier [giant platelet] syndrome;

Glanzmann's disease; Grey platelet syndrome; Haemorrhagic
D69.1 Thromboasthenia; Hereditary Thromboasthenia; Thrombocytopathy ; HEMORRHAGIC CONDITIONS 12,800 3,840
D69.2 Other nonthrombocytopenic purpura; Purpura NOS; Senile HEMORRHAGIC CONDITIONS 12,800 3,840
Purpura; Simplex Purpura
D69.3 Idiopathic thrombocytopenic purpura; Evans' syndrome HEMORRHAGIC CONDITIONS 12,800 3,840
D69.8 Other specified haemorrhagic conditions; Hereditary HEMORRHAGIC CONDITIONS 12,800 3,840
Capillary fragility; Vascular pseudohaemophilia
Alcoholic hepatic failure; Alcoholic hepatic failure NOS; Acute alcoholic

hepatic failure; Chronic alcoholic hepatic failure; Subacute alcoholic
K70.4 hepatic failure; Alcoholic hepatic HEPATIC FAILURE 20,600 6,180
failure with or without hepatic coma
K72.0 Acute and subacute hepatic failure HEPATIC FAILURE 20,600 6,180
Acute hepatitis
K72.1 Chronic hepatic failure HEPATIC FAILURE 20,600 6,180

K72.9 Hepatic failure, unspecified HEPATIC FAILURE 20,600 6,180
Liver necrosis
O01.0 Classical hydatidiform mole; Complete hydatidiform mole HYDATIDIFORM MOLE 6,600 1,980
O01.1 Incomplete and partial hydatidiform mole HYDATIDIFORM MOLE 6,600 1,980
O01.9 Hydatidiform mole, unspecified; Trophoblastic disease HYDATIDIFORM MOLE 6,600 1,980
NOS; Vesicular mole NOS
G91.0 Communicating hydrocephalus HYDROCEPHALUS 17,300 5,190

G91.1 Obstructive hydrocephalus HYDROCEPHALUS 17,300 5,190
G91.2 Normal-pressure hydrocephalus HYDROCEPHALUS 17,300 5,190
G91.3 Post-traumatic hydrocephalus, unspecified HYDROCEPHALUS 17,300 5,190
G91.8 Other hydrocephalus HYDROCEPHALUS 17,300 5,190
G91.9 Hydrocephalus, unspecified HYDROCEPHALUS 17,300 5,190
Q03.8 Other congenital hydrocephalus HYDROCEPHALUS 17,300 5,190
Q03.9 Congenital hydrocephalus, unspecified HYDROCEPHALUS 17,300 5,190
P56.0 Hydrops fetalis due to isoimmunization HYDROPS FETALIS 7,400 2,220
P56.9 Hydrops fetalis due to other and unspecified haemolytic HYDROPS FETALIS 7,400 2,220
disease
P83.2 Hydrops fetalis not due to haemolytic disease; Hydrops HYDROPS FETALIS 7,400 2,220
fetalis NOS
I10.1 Hypertension, stage 2 HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
Hypertension Essential hypertension
Malignant hypertension
I10.9 HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I11.0 Hypertensive heart disease with (congestive) heart failure; HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
Hypertensive heart failure
I11.9 Hypertensive heart disease without (congestive) heart HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
failure; Hypertensive heart disease NOS
I12.0 Hypertensive renal disease with renal failure; Hypertensive HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
renal failure
I12.9 Hypertensive renal disease without renal failure; HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
Hypertensive renal disease NOS
I13.0 Hypertensive heart and renal disease with (congestive) HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
heart failure
I13.1 Hypertensive heart and renal disease with renal failure HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I13.2 Hypertensive heart and renal disease with both HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
(congestive) heart failure and renal failure
I13.9 Hypertensive heart and renal disease, unspecified HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I15.0 Renovascular hypertension HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I15.1 Hypertension secondary to other renal disorders HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I15.2 Hypertension secondary to endocrine disorders HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I15.8 Other secondary hypertension HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
I15.9 Secondary hypertension, unspecified HYPERTENSIVE EMERGENCY/URGENCY 9,000 2,700
E05.0 Thyrotoxicosis with diffuse goitre; Exophthalmic or toxic HYPERTHYROIDISM 8,500 2,550
goitre NOS; Graves' disease; Toxic diffuse goitre
E05.1 Thyrotoxicosis with toxic single thyroid nodule; HYPERTHYROIDISM 8,500 2,550
Thyrotoxicosis with toxic uninodular goitre
Thyrotoxicosis with toxic multinodular goitre; Toxic nodular goitre NOS
Thyroid nodules with hyperthyroidism
E05.2 Toxic thyroid nodules HYPERTHYROIDISM 8,500 2,550
E05.3 Thyrotoxicosis from ectopic thyroid tissue HYPERTHYROIDISM 8,500 2,550

E05.4 Thyrotoxicosis factitia HYPERTHYROIDISM 8,500 2,550
E05.5 Thyroid crisis or storm HYPERTHYROIDISM 8,500 2,550
E05.8 Other thyrotoxicosis; Overproduction of thyroid-stimulating HYPERTHYROIDISM 8,500 2,550
hormone
E05.9 Thyrotoxicosis, unspecified; Hyperthyroidism NOS; HYPERTHYROIDISM 8,500 2,550
Thyroiditis
E01.0 Iodine-deficiency-related diffuse (endemic) goitre HYPOTHYROIDISM 8,100 2,430

E01.1 Iodine-deficiency-related multinodular (endemic) goitre; HYPOTHYROIDISM 8,100 2,430
Iodine-deficiency-related nodular goitre
E01.2 Iodine-deficiency-related (endemic) goitre, unspecified HYPOTHYROIDISM 8,100 2,430
Other iodine-deficiency-related thyroid disorders and allied conditions;
Acquired iodine-deficiency hypothyroidism NOS
E01.8 HYPOTHYROIDISM 8,100 2,430
E02 Subclinical iodine-deficiency hypothyroidism HYPOTHYROIDISM 8,100 2,430

E03.2 Hypothyroidism due to medicaments and other exogenous HYPOTHYROIDISM 8,100 2,430
substances
E03.5 Myxoedema coma HYPOTHYROIDISM 8,100 2,430
E03.8 Other specified hypothyroidism HYPOTHYROIDISM 8,100 2,430
E03.9 Hypothyroidism, unspecified; HYPOTHYROIDISM 8,100 2,430
Hereditary hypogammaglobulinaemia; Autosomal recessive
agammaglobulinaemia (Swiss type); X-linked agammaglobulinaemia
D80.0 [Bruton] (with growth hormone IMMUNODEFICIENCY 11,600 3,480
deficiency)
D80.2 Selective deficiency of immunoglobulin A [IgA] IMMUNODEFICIENCY 11,600 3,480

D80.7 Transient hypogammaglobulinaemia of infancy IMMUNODEFICIENCY 11,600 3,480
D80.8 Other immunodeficiencies with predominantly antibody IMMUNODEFICIENCY 11,600 3,480
defects; Kappa light chain deficiency
D80.9 Immunodeficiency with predominantly antibody defects, IMMUNODEFICIENCY 11,600 3,480

unspecified
D81.1 Severe combined immunodeficiency [SCID] with low T- and IMMUNODEFICIENCY 11,600 3,480
B-cell numbers
D81.6 Major histocompatibility complex class I deficiency; Bare IMMUNODEFICIENCY 11,600 3,480
lymphocyte syndrome
D81.9 Combined immunodeficiency, unspecified; Severe IMMUNODEFICIENCY 11,600 3,480

combined immunodeficiency disorder [SCID] NOS
D82.0 Wiskott-Aldrich syndrome; Immunodeficiency with IMMUNODEFICIENCY 11,600 3,480

thrombocytopenia and eczema
Di George's syndrome; Pharyngeal pouch syndrome; Thymic

D82.1 alymphoplasia; Thymic aplasia or hypoplasia with IMMUNODEFICIENCY 11,600 3,480
immunodeficiency
Immunodeficiency following hereditary defective response to Epstein-Barr

D82.3 virus; X-linked lymphoproliferative disease IMMUNODEFICIENCY 11,600 3,480
D82.4 Hyperimmunoglobulin E [IgE] syndrome IMMUNODEFICIENCY 11,600 3,480

D82.9 Immunodeficiency associated with major defect, IMMUNODEFICIENCY 11,600 3,480
unspecified
Common variable immunodeficiency with predominant abnormalities of

D83.0 B-cell numbers and function IMMUNODEFICIENCY 11,600 3,480
D83.1 Common variable immunodeficiency with predominant IMMUNODEFICIENCY 11,600 3,480

immunoregulatory T-cell disorders
D83.9 Common variable immunodeficiency, unspecified IMMUNODEFICIENCY 11,600 3,480

D84.8 Other specified immunodeficiencies IMMUNODEFICIENCY 11,600 3,480
D84.9 Immunodeficiency, unspecified IMMUNODEFICIENCY 11,600 3,480
D86.1 Sarcoidosis of lymph nodes IMMUNODEFICIENCY 11,600 3,480
D86.8 Sarcoidosis of other and combined sites; Uveoparotid fever IMMUNODEFICIENCY 11,600 3,480
[Heerfordt]
D86.9 Sarcoidosis, unspecified IMMUNODEFICIENCY 11,600 3,480

Polyclonal hypergammaglobulinaemia; Benign hypergammaglobulinaemic
D89.0 purpura; Polyclonal IMMUNODEFICIENCY 11,600 3,480
gammopathy NOS
Cryoglobulinaemia; Essential Cryoglobulinaemia; Idiopathic

Cryoglobulinaemia; Mixed Cryoglobulinaemia; Primary Cryoglobulinaemia;
Secondary Cryoglobulinaemia; Cryoglobulinaemic purpura;
D89.1 Cryoglobulinaemic vasculitis IMMUNODEFICIENCY 11,600 3,480
D89.2 Hypergammaglobulinaemia, unspecified IMMUNODEFICIENCY 11,600 3,480

D89.8 Other specified disorders involving the immune IMMUNODEFICIENCY 11,600 3,480
mechanism, not elsewhere classified
D89.9 Disorder involving the immune mechanism, unspecified; IMMUNODEFICIENCY 11,600 3,480
Immune disease NOS
N48.0 Leukoplakia of penis; Balanitis xerotica obliterans; Kraurosis INFLAMMATION/INFECTION OF THE MALE 9,000 2,700
of penis GENITAL TRACT
N48.1 Balanoposthitis; Balanitis INFLAMMATION/INFECTION OF THE MALE 9,000 2,700

GENITAL TRACT
Other inflammatory disorders of penis; Abscess of corpus cavernosum and

penis; Boil of corpus cavernosum and penis; Carbuncle of corpus
cavernosum and penis; Cellulitis of corpus cavernosum and penis;
Cavernitis (penis) of corpus cavernosum and penis
N48.2 INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT 9,000 2,700
N48.5 Ulcer of penis INFLAMMATION/INFECTION OF THE MALE 9,000 2,700

GENITAL TRACT
N48.6 Induratio penis plastica; Peyronie's disease; Plastic INFLAMMATION/INFECTION OF THE MALE 9,000 2,700
induration of penis GENITAL TRACT
N49.0 Inflammatory disorders of seminal vesicle; Vesiculitis NOS INFLAMMATION/INFECTION OF THE MALE 9,000 2,700
GENITAL TRACT
N49.1 Inflammatory disorders of spermatic cord, tunica vaginalis INFLAMMATION/INFECTION OF THE MALE 9,000 2,700
and vas deferens; Vasitis GENITAL TRACT
N49.2 Inflammatory disorders of scrotum INFLAMMATION/INFECTION OF THE MALE 9,000 2,700

GENITAL TRACT
Inflammatory disorders of other specified male genital INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT
organs; Inflammation of multiple sites in male genital organs
N49.8 9,000 2,700
Inflammatory disorder of unspecified male genital organ; Abscess of

unspecified male genital organ; Boil of unspecified male genital organ;
Carbuncle of unspecified male genital organ; Cellulitis of unspecified male
N49.9 genital INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT 9,000 2,700
organ
Crohn's disease of small intestine; Crohn's disease [regional enteritis] of

duodenum; Crohn's disease [regional enteritis] of ileum; Crohn's disease
K50.0 [regional enteritis] of jejunum; Regional ileitis; Terminal ileitis INFLAMMATORY BOWEL DISEASE 9,100 2,730
Crohn's disease of large intestine; Granulomatous colitis; Regional colitis;

Crohn's disease [regional enteritis] of colon; Crohn's disease [regional
enteritis] of large bowel; Crohn's disease [regional enteritis] of rectum
K50.1 INFLAMMATORY BOWEL DISEASE 9,100 2,730
K50.8 Other Crohn's disease; Crohn's disease of both small and INFLAMMATORY BOWEL DISEASE 9,100 2,730
large intestine
Crohn's disease [regional enteritis], unspecified; Crohn's disease NOS;
K50.9 Regional enteritis NOS; Granulomatous INFLAMMATORY BOWEL DISEASE 9,100 2,730
enteritis NOS
K51.0 Ulcerative (chronic) enterocolitis INFLAMMATORY BOWEL DISEASE 9,100 2,730

K51.1 Ulcerative (chronic) ileocolitis INFLAMMATORY BOWEL DISEASE 9,100 2,730
K51.2 Ulcerative (chronic) proctitis INFLAMMATORY BOWEL DISEASE 9,100 2,730
K51.3 Ulcerative (chronic) rectosigmoiditis INFLAMMATORY BOWEL DISEASE 9,100 2,730
K51.5 Mucosal proctocolitis INFLAMMATORY BOWEL DISEASE 9,100 2,730
K51.8 Other ulcerative colitis INFLAMMATORY BOWEL DISEASE 9,100 2,730
K51.9 Ulcerative colitis, unspecified; Ulcerative enteritis NOS INFLAMMATORY BOWEL DISEASE 9,100 2,730
G04.0 Acute disseminated encephalitis; Postimmunization INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
[Encephalitis; Postimmunization Encephalomyelitis NERVOUS SYSTEM
G04.1 Tropical spastic paraplegia INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
NERVOUS SYSTEM
G04.2 Bacterial meningoencephalitis and meningomyelitis, not INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
elsewhere classified NERVOUS SYSTEM
G04.8 Other encephalitis, myelitis and encephalomyelitis; INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
Postinfectious encephalitis and encephalomyelitis NOS NERVOUS SYSTEM
G04.9 Encephalitis, myelitis and encephalomyelitis, unspecified; INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
Ventriculitis (cerebral) NOS NERVOUS SYSTEM
G05.8* Encephalitis, myelitis and encephalomyelitis in other INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
diseases classified elsewhere NERVOUS SYSTEM
G07* Intracranial and intraspinal abscess and grauloma in INFLAMMATORY DISEASE OF THE CENTRAL 21,600 6,480
diseases classified elsewhere NERVOUS SYSTEM
Intracranial and intraspinal phlebitis and thrombophlebitis; Septic INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM
[embolism, endophlebitis, phlebitis, thrombophlebitis, thrombosis] of
G08 intracranial or intraspinal venous sinuses and veins 21,600 6,480
Measles complicated by encephalitis; Encephalitis, myelitis and INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM
B05.0+ G05.1* encephalomyelitis in viral diseases classified elsewhere 21,600 6,480
I30.0 Acute nonspecific idiopathic pericarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Infective pericarditis; Pneumococcal pericarditis; Purulent pericarditis;
Staphylococcal pericarditis; Streptococcal pericarditis; Viral pericarditis;
I30.1 Pyopericarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I30.8 Other forms of acute pericarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I30.9 Acute pericarditis, unspecified INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Chronic adhesive pericarditis; Accretio cordis; Adherent pericardium;
Adhesive mediastinopericarditis
I31.0 INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I31.1 Chronic constrictive pericarditis; Concretio cordis; INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Pericardial calcification
Acute and subacute infective endocarditis; Acute bacterial endocarditis;

Subacute bacterial endocarditis; Acute infective endocarditis NOS;
Subacute infective endocarditis NOS; Acute lenta endocarditis; Subacute
lenta endocarditis; Acute malignant endocarditis; Subacute malignant
endocarditis; Acute septic endocarditis; Subacute septic endocarditis;
Acute ulcerative endocarditis; Subacute ulcerative endocarditis
I33.0 INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Acute endocarditis, unspecified; Endocarditis, acute or subacute;

I33.9 Myoendocarditis, acute or subacute; INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Periendocarditis, acute or subacute
Endocarditis, valve unspecified; Chronic Endocarditis NOS; Valvular

incompetence of unspecified valve NOS or of specified cause, except
rheumatic or congenital; Valvular insufficiency of unspecified valve NOS or
of specified cause, except rheumatic or congenital; Valvular regurgitation
of unspecified valve NOS or of specified cause, except rheumatic or
congenital; Valvular stenosis of unspecified valve NOS or of specified
cause, except rheumatic or congenital; Chronic valvulitis of unspecified
I38 valve NOS or of specified cause, except rheumatic or congenital INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I40.0 Infective myocarditis; Septic myocarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I40.1 Isolated myocarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I40.8 Other acute myocarditis INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
I40.9 Acute myocarditis, unspecified INFLAMMATORY DISEASES OF THE HEART 14,400 4,320
Influenza due to identified zoonotic or pandemic influenza virus; Influenza
caused by influenza virus strains of special epidemiological importance
J09 with an animal-human or inter- human transimission INFLUENZA 6,600 1,980
Influenza with pneumonia, seasonal influenza virus

J10.0 identified; Influenzal (broncho)pneumonia, other influenza virus identified INFLUENZA 6,600 1,980
Influenza with other respiratory manifestations, seasonal influenza virus

identified; Influenza; Influenzal acute upper respiratory infection, seasonal
influenza virus identified; Influenzal laryngitis, seasonal influenza virus
identified; Influenzal pharyngitis, seasonal influenza virus identified;
J10.1 Influenzal pleural effusion, seasonal influenza virus identified INFLUENZA 6,600 1,980
Influenza with other manifestations, seasonal influenza virus identified;

Encephalopathy due to influenza, seasonal influenza virus identified;
Influenzal gastroenteritis, seasonal influenza virus identified; Influenzal
myocarditis (acute), seasonal influenza virus identified
J10.8 INFLUENZA 6,600 1,980
Influenza with pneumonia, virus not identified; Influenzal (broncho)

pneumonia, unspecified or specific virus not
J11.0 identified INFLUENZA 6,600 1,980
Influenza with other respiratory manifestations, virus not identified;

Influenza NOS; Influenzal Acute upper respiratory infection, unspecified
or specific virus not identified; Influenzal laryngitis, unspecified or specific
virus not identified; Influenzal pharyngitis, unspecified or specific virus not
J11.1 identified; Influenzal pleural effusion, unspecified or specific virus not INFLUENZA 6,600 1,980
identified
Influenza with other manifestations, virus not identified; Encephalopathy

due to influenza, unspecified or specific virus not identified; Influenzal
gastroentiritis, unspecified or specific virus not identified; Acute influenzal
myocarditis, unspecified or specific virus not identified
J11.8 INFLUENZA 6,600 1,980
J11.8+ I41.1* Influenzal myocarditis (acute), virus not identified INFLUENZA 6,600 1,980
T66 Unspecified effects of radiation INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
EXTERNAL FACTORS CAUSES
T67.6 Heat fatigue, transient INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
T67.8 Other effects of heat and light INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
T68 Hypothermia INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790

T69.0 Immersion hand and foot; Trench foot INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
T69.9 Effect of reduced temperature, unspecified INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
Otitic barotrauma; Aero-otitis media; Effects of change in ambient INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL
T70.0 atmospheric pressure or water pressure on ears/ FACTORS CAUSES 9,300 2,790
on sinuses
Other and unspecified effects of high altitude; Alpine sickness; Anoxia due INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL
T70.2 to high altitude; Barotrauma NOS; FACTORS CAUSES 9,300 2,790
Hypobaropathy; Mountain sickness
T70.3 Caisson disease [decompression sickness]; Compressed-air INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
disease; Diver's palsy or paralysis EXTERNAL FACTORS CAUSES
T70.4 Effects of high-pressure fluids; Traumatic jet injection INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
(industrial) EXTERNAL FACTORS CAUSES
T70.8 Other effects of air pressure and water pressure; Blast INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
injury syndrome EXTERNAL FACTORS CAUSES
T70.9 Effect of air pressure and water pressure, unspecified INJURIES DUE TO ENVIRONMENTAL AND OTHER 9,300 2,790
Effects of vibration; Pneumatic hammer syndrome; Traumatic vasospastic INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL
syndrome; Vertigo from infrasound FACTORS CAUSES
T75.2 9,300 2,790
Other specified injuries due to environmental and other external factors INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL
T75.8 causes; Effects of abnormal gravitation [G] FACTORS CAUSES 9,300 2,790
forces; Effects of weightlessness
S14.0 Concussion and oedema of cervical spinal cord INJURIES TO NEURAL STRUCTURES AND NERVES 18,400 5,520
S34.0 Concussion and oedema of lumbar spinal cord INJURIES TO NEURAL STRUCTURES AND NERVES 18,400 5,520
S16 Injury of muscle and tendon at neck level INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S39.0 Injury of muscle and tendon of abdomen, lower back and INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
pelvis JOINTS
S43.0 Dislocation of shoulder joint; Dislocation of Glenohumeral INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
joint JOINTS
Sprain and strain of shoulder joint; sprain and strain of Coracohumeral INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
(ligament); Sprain and strain of Rotator cuff
S43.4 capsule 7,200 2,160
S43.5 Sprain and strain of acromioclavicular joint; sprain and INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
strain of Acromioclavicular ligament JOINTS
Sprain and strain of other and unspecified parts of shoulder girdle; Sprain INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
S43.7 and strain of shoulder girdle NOS 7,200 2,160
S46.0 Injury of tendon of the rotator cuff of shoulder INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S46.1 Injury of muscle and tendon of long head of biceps INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S46.2 Injury of muscle and tendon of other parts of biceps INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S46.7 Injury of multiple muscles and tendons at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
upper arm level JOINTS
S46.8 Injury of other muscles and tendons at shoulder and upper INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
arm level JOINTS
S46.9 Injury of unspecified muscle and tendon at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
upper arm level JOINTS
S53.4 Sprain and strain of elbow INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S56.0 Injury of flexor muscle and tendon of thumb at forearm INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
level JOINTS
S56.1 Injury of long flexor muscle and tendon of other finger(s) at INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
forearm level JOINTS
S56.2 Injury of other flexor muscle and tendon at forearm level INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S56.3 Injury of extensor or abductor muscles and tendons of INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
thumb at forearm level JOINTS
Sprain and strain of wrist; Sprain and strain of Carpal joint; Sprain and INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
S63.5 strain of Radiocarpal joint; Sprain and strain of 7,200 2,160
Radiocarpal ligament
Sprain and strain of finger(s); Sprain and strain of Interphalangeal joint, INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
hand; Sprain and strain Metacarpophalangeal joint; Sprain and strain of
S63.6 Phalanx, hand; Sprain and strain of Thumb 7,200 2,160
S63.7 Sprain and strain of other and unspecified parts of hand INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S66.1 Injury of flexor muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
and hand level JOINTS
S66.3 Injury of extensor muscle and tendon of other finger at INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
wrist and hand level JOINTS
S66.5 Injury of intrinsic muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
and hand level JOINTS
S66.6 Injury of multiple flexor muscles and tendons at wrist and INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
hand level JOINTS
S66.8 Injury of other muscles and tendons at wrist and hand level INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S66.9 Injury of unspecified muscle and tendon at wrist and hand INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
level JOINTS
S73.1 Sprain and strain of hip INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S76.1 Injury of quadriceps muscle and tendon; injury of Patellar INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
ligament (tendon) JOINTS
S76.2 Injury of adductor muscle and tendon of thigh INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S76.3 Injury of muscle and tendon of the posterior muscle group INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
at thigh level JOINTS
S76.4 Injury of other and unspecified muscles and tendons at INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
thigh level JOINTS
Sprain and strain involving fibular collateral ligament of INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
S83.4 knee; Sprain and strain involving tibial collateral ligament of knee 7,200 2,160
Sprain and strain involving anterior cruciate ligament of knee; Sprain and INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
S83.5 strain involving posterior cruciate 7,200 2,160
ligament of knee
S83.6 Sprain and strain of other and unspecified parts of knee; INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
Tibiofibular joint and ligament, superior JOINTS
S86.8 Injury of other muscles and tendons at lower leg level INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
S86.9 Injury of unspecified muscle and tendon at lower leg level INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
Sprain and strain of ankle including Calcaneofibular (ligament), Deltoid INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
(ligament), Internal collateral (ligament), Talofibular (ligament),
S93.4 Tibiofibular , distal (ligament) 7,200 2,160
S93.5 Sprain and strain of toe(s) including Interphalangeal INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
(joint(s), metatarsophalangeal (joint(s) JOINTS
S93.6 Sprain and strain of other and unspecified parts of foot INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
including Tarsal (ligament), Tarsometatarsal (ligament) JOINTS
S96.0 Injury of muscle and tendon of long flexor muscle of toe at INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
ankle and foot level JOINTS
S96.9 Injury of unspecified muscle and tendon at ankle and foot INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
level JOINTS
T03.9 Multiple dislocations, sprains and strains, unspecified INJURIES TO THE MUSCLES AND TENDONS AND 7,200 2,160
JOINTS
J81 Pulmonary oedema; Acute oedema of lung; Passive INTERSTITIAL PULMONARY DISEASE 14,000 4,200
pulmonary congestion; Lung dropsy
Pulmonary eosinophilia, not elsewhere classified; Eosinophilic asthma;
Loffler's pneumonia; Tropical
J82 pulmonary eosinophilia NOS INTERSTITIAL PULMONARY DISEASE 14,000 4,200
J84.0 Alveolar and parietoalveolar conditions; Alveolar INTERSTITIAL PULMONARY DISEASE 14,000 4,200
proteinosis; Pulmonary alveolar microlithiasis
Other interstitial pulmonary diseases with fibrosis; Diffuse pulmonary

fibrosis; Cryptogenic fibrosing alveolitis; Hamman-Rich syndrome;
J84.1 Idiopathic pulmonary fibrosis INTERSTITIAL PULMONARY DISEASE 14,000 4,200
J84.8 Other specified interstitial pulmonary diseases INTERSTITIAL PULMONARY DISEASE 14,000 4,200
J84.9 Interstitial pulmonary disease, unspecified; Interstitial INTERSTITIAL PULMONARY DISEASE 14,000 4,200
pneumonia NOS
Acute vascular disorders of intestine; Acute fulminant ischaemic colitis;

Acute intestinal infarction; Acute small intestine ischaemia; Mesentric
artery embolism; Mesentric vein embolism; Mesentric artery infarction;
Mesentric vein infarction; Mesentric artery thrombosis; Mesenteric vein
K55.0 thrombosis; Subacute ischaemic colitis INTESTINAL DISORDERS 9,500 2,850
Chronic vascular disorders of intestine; Chronic ischaemic colitis; Chronic

ischaemic enteritis; Chronic ischaemic enterocolitis; Ischaemic stricture of
intestine; Mesentric atherosclerosis; Mesentric vascular insufficiency
K55.1 INTESTINAL DISORDERS 9,500 2,850
K55.2 Angiodysplasia of colon; Angiodysplasia of intestine NOS INTESTINAL DISORDERS 9,500 2,850
Vascular disorder of intestine, unspecified; Ischaemic colitis NOS;

K55.9 Ischaemic enteritis NOS; Ischaemic enterocolitis NOS INTESTINAL DISORDERS 9,500 2,850
Diverticular disease of small intestine with perforation and

K57.0 abscess; Diverticular disease of small intestine with peritonitis INTESTINAL DISORDERS 9,500 2,850
Diverticular disease of small intestine without perforation or abscess;

K57.1 Diverticular disease of small intestine NOS INTESTINAL DISORDERS 9,500 2,850
Diverticular disease of large intestine with perforation and

abscess; Diverticular disease/ Diverticulitis/ Diverticulosis/ Diverticulum of
K57.2 colon with peritonitis INTESTINAL DISORDERS 9,500 2,850
Diverticular disease of large intestine without perforation or abscess;
Diverticular disease of colon NOS
Diverticular disease of both small and large intestine with perforation and
K57.4 abscess; Diverticular disease of both small INTESTINAL DISORDERS 9,500 2,850
and large intestine with peritonitis
Diverticular disease of both small and large intestine

K57.5 without perforation or abscess; Diverticular disease of both small and INTESTINAL DISORDERS 9,500 2,850
large intestine NOS
Diverticular disease of intestine, part unspecified, with

perforation and abscess; Diverticular disease of intestine NOS with
K57.8 peritonitis INTESTINAL DISORDERS 9,500 2,850
Diverticular disease of intestine, part unspecified, without perforation or

abscess; Diverticular disease of intestine NOS
K59.3 Megacolon, not elsewhere classified; Dilatation of colon; INTESTINAL DISORDERS 9,500 2,850
Toxic megacolon
K59.8 Other specified functional intestinal disorders; Atony of INTESTINAL DISORDERS 9,500 2,850
colon
K59.9 Functional intestinal disorder, unspecified INTESTINAL DISORDERS 9,500 2,850

K63.0 Abscess of intestine INTESTINAL DISORDERS 9,500 2,850
K63.1 Nontraumatic perforation of intestine INTESTINAL DISORDERS 9,500 2,850
K63.2 Fistula of intestine INTESTINAL DISORDERS 9,500 2,850
K63.3 Ulcer of intestine; Primary ulcer of small intestine INTESTINAL DISORDERS 9,500 2,850
K63.4 Enteroptosis INTESTINAL DISORDERS 9,500 2,850
K63.5 Polyp of colon INTESTINAL DISORDERS 9,500 2,850
K63.8 Other specified diseases of intestine INTESTINAL DISORDERS 9,500 2,850
K63.9 Disease of intestine, unspecified INTESTINAL DISORDERS 9,500 2,850
B05.4 Measles with intestinal complications INTESTINAL DISORDERS 9,500 2,850
K90.0 Coeliac disease; Gluten-sensitive enteropathy; Idiopathic INTESTINAL MALABSORPTION 4,100 1,230
steatorrhoea; Nontropical sprue
K90.1 Tropical sprue; Sprue NOS; Tropical steatorrhoea INTESTINAL MALABSORPTION 4,100 1,230
K90.2 Blind loop syndrome, not elsewhere classified; Blind loop INTESTINAL MALABSORPTION 4,100 1,230
syndrome NOS
K90.3 Pancreatic steatorrhoea INTESTINAL MALABSORPTION 4,100 1,230
Malabsorption due to intolerance, not elsewhere classified; Malabsorption
due to intolerance to carbohydrate; Malabsorption due to intolerance to
fat; Malabsorption due to intolerance to protein; Malabsorption due to
K90.4 intolerance to starch INTESTINAL MALABSORPTION 4,100 1,230
K90.8 Other intestinal malabsorption INTESTINAL MALABSORPTION 4,100 1,230

K90.9 Intestinal malabsorption, unspecified INTESTINAL MALABSORPTION 4,100 1,230
K56.0 Paralytic ileus; Paralysis of bowel; Paralysis of colon; INTESTINAL OBSTRUCTION 10,100 3,030
Paralysis of intestine
Intussusception; Intussusception or invagination of bowel;
Intussusception or invagination of colon; Intussusception or invagination
K56.1 of intestine; Intussusception or invagination of rectum INTESTINAL OBSTRUCTION 10,100 3,030
K56.2 Volvulus; Strangulation of colon or intestine; Torsion of INTESTINAL OBSTRUCTION 10,100 3,030
colon or intestine; Twist of colon or intestine
K56.3 Gallstone ileus; Obstruction of intestine by gallstone INTESTINAL OBSTRUCTION 10,100 3,030
K56.4 Other impaction of intestine; Enterolith; Impaction of INTESTINAL OBSTRUCTION 10,100 3,030
colon; Impaction of faecal
Intestinal adhesions [bands] with obstruction; Peritoneal adhesions

K56.5 [bands] with intestinal obstruction INTESTINAL OBSTRUCTION 10,100 3,030
Other and unspecified intestinal obstruction; Enterotenosis; Obstructive

ileus NOS; Occlusion of colon or intestine; Stenosis of colon or intestine;
K56.6 Stricture of colon or intestine INTESTINAL OBSTRUCTION 10,100 3,030
K56.7 Ileus, unspecified INTESTINAL OBSTRUCTION 10,100 3,030

Intracranial abscess and granuloma; Abscess (embolic)(of) brain [any
part]; Abscess (embolic)(of) cerebellar; Abscess (embolic)(of) cerebral;
Abscess (embolic)(of) otogenic; IIntracranial abscess or granuloma,
epidural; Intracranial abscess or granuloma, extradural; Intracranial
G06.0 abscess or granuloma, subdural INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA 27,900 8,370
Intraspinal abscess and granuloma; Abscess (embolic) of spinal cord [any

part]; Intraspinal abscess or granuloma epidural; Intraspinal abscess or
granuloma extradural; Intraspinal abscess or granuloma subdural
G06.1 INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA 27,900 8,370
G06.2 Encephalitis, myelitis and encephalomyelitis in Extradural INTRACRANIAL AND INTRASPINAL ABSCESS AND 27,900 8,370
and subdural abscess, unspecified GRANULOMA
Injury of optic nerve and pathways; Injury of Optic chiasm; Injury of 2nd
cranial nerve; Injury of Visual cortex
S04.0 INTRACRANIAL INJURIES 8,800 2,640
S04.1 Injury of oculomotor nerve; injury of 3rd cranial nerve INTRACRANIAL INJURIES 8,800 2,640
S04.4 Injury of abducent nerve; injury of 6th cranial nerve INTRACRANIAL INJURIES 8,800 2,640
S04.5 Injury of facial nerve; injury of 7th cranial nerve INTRACRANIAL INJURIES 8,800 2,640
S04.6 Injury of acoustic nerve; injury of Auditory nerve; injury of INTRACRANIAL INJURIES 8,800 2,640
8th cranial nerve
Injury of other cranial nerves; injury of Glossopharyngeal [9th] nerve;
injury of Hypoglossal [12th] nerve; injury of; injury of Olfactory [1st] nerve;
S04.8 injury of Vagus [10th] nerve INTRACRANIAL INJURIES 8,800 2,640
S04.9 Injury of unspecified cranial nerve INTRACRANIAL INJURIES 8,800 2,640

S05.0 Injury of conjunctiva and corneal abrasion without mention INTRACRANIAL INJURIES 8,800 2,640
of foreign body
S06.00 Concussion; Commotio cerebri (without open intracranial INTRACRANIAL INJURIES 8,800 2,640
wound)
S06.01 Concussion; Commotio cerebri (with open intracranial INTRACRANIAL INJURIES 8,800 2,640
wound)
S06.10 Traumatic cerebral oedema (without open intracranial INTRACRANIAL INJURIES 8,800 2,640
wound)
Diffuse brain injury; Cerebral contusion NOS; Cerebral laceration NOS;

Traumatic compression of brain NOS (with
S06.20 open intracranial wound) INTRACRANIAL INJURIES 8,800 2,640
Diffuse brain injury; Cerebral contusion NOS; Cerebral

laceration NOS; Traumatic compression of brain NOS (without open
S06.21 intracranial wound) INTRACRANIAL INJURIES 8,800 2,640
Focal brain injury; Focal cerebral; Focal cerebral contusion; Focal cerebral
laceration; Focal traumatic intracerebral haemorrhage (without open
Focal brain injury; Focal cerebral; Focal cerebral contusion; Focal cerebral
laceration; Focal traumatic intracerebral haemorrhage (with open
S06.40 Epidural haemorrhage; Extradural haemorrhage, traumatic INTRACRANIAL INJURIES 8,800 2,640
(without open intracranial wound)
S06.41 Epidural haemorrhage; Extradural haemorrhage, traumatic INTRACRANIAL INJURIES 8,800 2,640
(with open intracranial wound)
S06.50 Traumatic subdural haemorrhage (without open INTRACRANIAL INJURIES 8,800 2,640
intracranial wound)
S06.51 Traumatic subdural haemorrhage (with open intracranial INTRACRANIAL INJURIES 8,800 2,640
wound)
S06.60 Traumatic subarachnoid haemorrhage (without open INTRACRANIAL INJURIES 8,800 2,640
intracranial wound)
S06.61 Traumatic subarachnoid haemorrhage (with open INTRACRANIAL INJURIES 8,800 2,640
intracranial wound)
S06.70 Intracranial injury with prolonged coma (without open INTRACRANIAL INJURIES 8,800 2,640
intracranial wound)
Other intracranial injuries; traumatic haemorrhage cerebellar; traumatic

S06.80 haemorrhage intracranial NOS INTRACRANIAL INJURIES 8,800 2,640
(without open intracranial wound)
Other intracranial injuries; traumatic haemorrhage cerebellar; traumatic

haemorrhage intracranial NOS (with
S06.81 open intracranial wound) INTRACRANIAL INJURIES 8,800 2,640
S06.90 Intracranial injury, unspecified; brain injury NOS (without INTRACRANIAL INJURIES 8,800 2,640
open intracranial wound)
S06.91 Intracranial injury, unspecified; brain injury NOS (with open INTRACRANIAL INJURIES 8,800 2,640
intracranial wound)
S09.0 Injury of blood vessels of head, not elsewhere classified INTRACRANIAL INJURIES 8,800 2,640
S09.1 Injury of muscle and tendon of head INTRACRANIAL INJURIES 8,800 2,640
S09.2 Traumatic rupture of ear drum INTRACRANIAL INJURIES 8,800 2,640
S09.7 Multiple injuries of head INTRACRANIAL INJURIES 8,800 2,640
S09.8 Other specified injuries of head INTRACRANIAL INJURIES 8,800 2,640
S09.9 Unspecified injury of head; Injury of face NOS; Injury of ear INTRACRANIAL INJURIES 8,800 2,640
NOS; Injury of nose NOS
Intraventricular (nontraumatic) haemorrhage, grade 1, of INTRAVENTRICULAR

fetus and newborn; Subependymal haemorrhage (without intraventricular HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE
P52.0 extension) NEWBORN 25,600 7,680
Intraventricular (nontraumatic) haemorrhage, grade 2, of fetus and INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL

newborn; Subependymal haemorrhage with HEMORRHAGE IN
P52.1 intraventricular extension THE NEWBORN 25,600 7,680
Unspecified intraventricular (nontraumatic) haemorrhage of fetus and INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL

P52.3 newborn HEMORRHAGE IN 25,600 7,680
THE NEWBORN
Intracerebral (nontraumatic) haemorrhage of fetus and newborn INTRAVENTRICULAR

P52.4 HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE 25,600 7,680
NEWBORN
Subarachnoid (nontraumatic) haemorrhage of fetus and newborn INTRAVENTRICULAR

P52.5 HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE 25,600 7,680
NEWBORN
Cerebellar (nontraumatic) and posterior fossa haemorrhage of fetus and INTRAVENTRICULAR

newborn HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE
P52.6 NEWBORN 25,600 7,680
Other intracranial (nontraumatic) haemorrhages of fetus and newborn INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL

HEMORRHAGE IN
P52.8 THE NEWBORN 25,600 7,680
Intracranial (nontraumatic) haemorrhage of fetus and newborn, INTRAVENTRICULAR

P52.9 unspecified HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE 25,600 7,680
NEWBORN
Acute transmural myocardial infarction of anterior wall [or duration of <4
weeks] KILLIPS stage unspecified; Acute transmural infarction of anterior
wall NOS [or duration of
<4 weeks] KILLIPS stage unspecified; Acute anteroapical; anterolateral;
I21.0 anteroseptal transmural infarction [or duration of <4 weeks] KILLIPS stage ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18,900 5,670
unspecified;
Acute transmural myocardial infarction of inferior wall [or duration of <4

weeks] KILLIPS I; Acute transmural infarction of diaphragmatic wall [or
duration of <4 weeks] KILLIPS I; Acute transmural infarction of inferior wall
NOS; inferolateral; inferoposterior [or duration of <4
I21.1 weeks]KILLIPS I; ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18,900 5,670
Acute transmural myocardial infarction of other sites [or duration of <4

weeks] KILLIPS II; Acute apical-lateral transmural infarction [or duration of
<4 weeks] KILLIPS II; Acute basal-lateral transmural infarction [or duration
of <4 weeks] KILLIPS II; high lateral; lateral wall NOS; posterior (true);
I21.2 posterobasal; posterolateral; posteroseptal; septal NOS ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18,900 5,670
I21.3 Acute transmural myocardial infarction of unspecified site; ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
Transmural myocardial infarction NOS INFARCTION
I21.4 Acute subendocardial myocardial infarction; ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
Nontransmural myocardial infarction NOS INFARCTION
Acute myocardial infarction, unspecified [or duration of <4 weeks] KILLIPS ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
I21.9 I; Acute myocardial infarction NOS [or 18,900 5,670
duration of <4 weeks] KILLIPS I
Subsequent myocardial infarction of anterior wall; Acute Subsequent

infarction of anterior wall NOS; Acute subsequent infarction of
anteroapical wall; Acute subsequent infarction of anterolateral wall; Acute
I22.0 subsequent infarction of anteroseptal wall ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18,900 5,670
Subsequent myocardial infarction of inferior wall; Acute subsequent

infarction of diaphragmatic wall; Acute subsequent infarction of inferior
wall NOS; Acute subsequent infarction of inferolateral wall; Acute
I22.1 subsequent infarction of inferoposterior wall ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18,900 5,670
Subsequent myocardial infarction of other sites; Acute myocardial ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
infarction of apical-lateral wall; Acute myocardial infarction of basal-lateral
wall; Acute myocardial infarction of high lateral wall; Acute myocardial
infarction of lateral wall NOS; posterior (true); posterobasal;
I22.8 posterolateral; posteroseptal; septal NOS 18,900 5,670
I22.9 Subsequent myocardial infarction of unspecified site ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
INFARCTION
I23.0 Haemopericardium as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
myocardial infarction INFARCTION
I23.1 Atrial septal defect as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
myocardial infarction INFARCTION
I23.2 Ventricular septal defect as current complication following ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
acute myocardial infarction INFARCTION
Rupture of cardiac wall without haemopericardium as current ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
complication following acute myocardial infarction
I23.3 18,900 5,670
I23.4 Rupture of chordae tendineae as current complication ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
following acute myocardial infarction INFARCTION
I23.5 Rupture of papillary muscle as current complication ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
following acute myocardial infarction INFARCTION
I23.8 Other current complications following acute myocardial ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
infarction INFARCTION
I24.1 Dressler's syndrome; Postmyocardial infarction syndrome ISCHEMIC HEART DISEASE WITH MYOCARDIAL 18,900 5,670
INFARCTION
Unstable angina; Angina crescendo; Angina de novo effort; ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION
I20.0 Angina worsening effort; Intermediate coronary syndrome; Preinfarction 12,000 3,600
syndrome
Angina pectoris with documented spasm; Angiospastic Angina ; Prinzmetal ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION
I20.1 Angina ; spasm-induced Angina ; 12,000 3,600
Variant Angina
I20.8 Other forms of angina pectoris; Angina of effort; ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
Stenocardia INFARCTION
I20.9 Angina pectoris, unspecified; Angina NOS; Cardiac Angina ; ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
Anginal syndrome; Ischaemic chest pain INFARCTION
Coronary thrombosis not resulting in myocardial infarction; Coronary

artery embolism not resulting in myocardial infaction; Coronary vein
embolism not resulting in myocardial infarction; Coronary artery occlusion
not resulting in myocardial infarction; Coronary artery thromboembolism
not resulting in myocardial infarction; Coronary vein thromboembolism
not resulting in myocardial infarction;
I24.0 ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION 12,000 3,600
I24.8 Other forms of acute ischaemic heart disease; Coronary ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
failure; Coronary insufficiency INFARCTION
I25.5 Ischaemic cardiomyopathy ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
INFARCTION
I25.6 Silent myocardial ischaemia ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
INFARCTION
I25.8 Other forms of chronic ischaemic heart disease ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
INFARCTION
I25.9 Chronic ischaemic heart disease, unspecified; Chronic ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL 12,000 3,600
Ischaemic heart disease NOS INFARCTION
P57.0 Kernicterus due to isoimmunization JAUNDICE IN THE NEWBORN 7,400 2,220

P57.8 Other specified kernicterus JAUNDICE IN THE NEWBORN 7,400 2,220
P57.9 Kernicterus, unspecified JAUNDICE IN THE NEWBORN 7,400 2,220
P58.1 Neonatal jaundice due to bleeding JAUNDICE IN THE NEWBORN 7,400 2,220
P58.2 Neonatal jaundice due to infection JAUNDICE IN THE NEWBORN 7,400 2,220
P58.3 Neonatal jaundice due to polycythaemia JAUNDICE IN THE NEWBORN 7,400 2,220
P58.4 Neonatal jaundice due to drugs or toxins transmitted from JAUNDICE IN THE NEWBORN 7,400 2,220
mother or given to newborn
P58.8 Neonatal jaundice due to other specified excessive JAUNDICE IN THE NEWBORN 7,400 2,220
haemolysis
P58.9 Neonatal jaundice due to excessive haemolysis, unspecified JAUNDICE IN THE NEWBORN 7,400 2,220
Neonatal jaundice associated with preterm delivery; Hyperbilirubinaemia

of prematurity; Jaundice due to
P59.0 delayed conjucation associated with preterm delivery JAUNDICE IN THE NEWBORN 7,400 2,220
P59.1 Inspissated bile syndrome JAUNDICE IN THE NEWBORN 7,400 2,220

P59.2 Neonatal jaundice from other and unspecified JAUNDICE IN THE NEWBORN 7,400 2,220
hepatocellular damage
P59.3 Neonatal jaundice from breast milk inhibitor JAUNDICE IN THE NEWBORN 7,400 2,220
P59.8 Neonatal jaundice from other specified causes JAUNDICE IN THE NEWBORN 7,400 2,220
P59.9 Neonatal jaundice, unspecified; Intense physiological JAUNDICE IN THE NEWBORN 7,400 2,220
jaundice, NOS; Prolonged physiological jaundice, NOS
A30.0 Hansen's disease: Indeterminate leprosy; I leprosy LEPROSY 8,800 2,640
A30.1 Hansen's disease : Tuberculoid leprosy; TT leprosy LEPROSY 8,800 2,640
A30.2 Hansen's disease: Borderline tuberculoid leprosy; BT LEPROSY 8,800 2,640
leprosy
A30.4 Hansen's disease: Borderline lepromatous leprosy; BL LEPROSY 8,800 2,640

leprosy
A30.5 Hansen's disease: Lepromatous leprosy; LL leprosy LEPROSY 8,800 2,640
A30.8 Other forms of leprosy LEPROSY 8,800 2,640
A30.9 Leprosy, unspecified LEPROSY 8,800 2,640
Hansen Disease
A27.0 Leptospirosis icterohaemorrhagica; Leptospirosis due to LEPTOSPIROSIS MODERATE TO SEVERE 11,000 3,300
Leptospira interrogans serovar icterohaemorrhagiae
A27.8 Other forms of leptospirosis LEPTOSPIROSIS MODERATE TO SEVERE 11,000 3,300
A27.9 Leptospirosis, unspecified LEPTOSPIROSIS MODERATE TO SEVERE 11,000 3,300
K70.0 Alcoholic fatty liver LIVER DISEASES I 11,800 3,540
K70.1 Alcoholic hepatitis LIVER DISEASES I 11,800 3,540
K70.2 Alcoholic fibrosis and sclerosis of liver LIVER DISEASES I 11,800 3,540
K70.3 Alcoholic cirrhosis of liver; Alcoholic cirrhosis NOS; LIVER DISEASES I 11,800 3,540
Laennec's cirrhosis
K70.9 Alcoholic liver disease, unspecified LIVER DISEASES I 11,800 3,540

K71.0 Toxic liver disease with cholestasis; Cholestatis with LIVER DISEASES I 11,800 3,540
hepatocyte injury; Pure cholestasis
Toxic liver disease with hepatic necrosis; Acute hepatic failure due to
drugs; Chronic hepatic failure due to drugs
K71.1 LIVER DISEASES I 11,800 3,540
K71.2 Toxic liver disease with acute hepatitis LIVER DISEASES I 11,800 3,540
K71.3 Toxic liver disease with chronic persistent hepatitis LIVER DISEASES I 11,800 3,540
K71.5 Toxic liver disease with chronic active hepatitis; Toxic liver LIVER DISEASES I 11,800 3,540
disease with lupoid hepatitis
K71.6 Toxic liver disease with hepatitis, not elsewhere classified LIVER DISEASES I 11,800 3,540
Toxic liver disease with other disorders of liver; Toxic liver disease with
focal nodular hyperplasia; Toxic liver disease with hepatic granulomas;
Toxic liver disease with peliosis hepatis; Toxic liver disease with veno-
K71.8 occlusive disease of liver LIVER DISEASES I 11,800 3,540
K71.9 Toxic liver disease, unspecified LIVER DISEASES I 11,800 3,540

K73.0 Chronic persistent hepatitis, not elsewhere classified LIVER DISEASES I 11,800 3,540
K73.2 Chronic active hepatitis, not elsewhere classified; Lupoid LIVER DISEASES I 11,800 3,540
hepatitis NEC
K73.8 Other chronic hepatitis, not elsewhere classified LIVER DISEASES I 11,800 3,540
K73.9 Chronic hepatitis, unspecified LIVER DISEASES I 11,800 3,540
K74.1 Hepatic sclerosis LIVER DISEASES I 11,800 3,540
K74.6+I98.2* Oesophageal varices in other and unspecified cirrhosis of LIVER DISEASES I 11,800 3,540
liver
Abscess of liver; Hepatic abscess NOS; Cholangitic hepatic abscess;
Haematogenic hepatic abscess; Lymphogenic hepatic abscess;
K75.0 Pylephlebitic hepatic abscess LIVER DISEASES I 11,800 3,540
K75.1 Phlebitis of portal vein; Pylephlebitis LIVER DISEASES I 11,800 3,540

K75.2 Nonspecific reactive hepatitis LIVER DISEASES I 11,800 3,540
K75.3 Granulomatous hepatitis, not elsewhere classified LIVER DISEASES I 11,800 3,540
K75.4 Autoimmune hepatitis LIVER DISEASES I 11,800 3,540
K75.8 Other specified inflammatory liver diseases LIVER DISEASES I 11,800 3,540
Non alcoholic Steatohepatitis (NASH)
K75.9 Inflammatory liver disease, unspecified; Hepatitis NOS LIVER DISEASES I 11,800 3,540
K76.0 Fatty (change of) liver, not elsewhere classified LIVER DISEASES I 11,800 3,540
K76.8 Other specified diseases of liver; Focal nodular hyperplasia LIVER DISEASES I 11,800 3,540
of liver; Hepatoptosis
K76.9 Liver disease, unspecified LIVER DISEASES I 11,800 3,540

K71.4 Toxic liver disease with chronic lobular hepatitis LIVER DISEASES II 15,100 4,530
K71.7 Toxic liver disease with fibrosis and cirrhosis of liver LIVER DISEASES II 15,100 4,530
K74.0 Hepatic fibrosis LIVER DISEASES II 15,100 4,530
K74.2 Hepatic fibrosis with hepatic sclerosis LIVER DISEASES II 15,100 4,530
Other and unspecified cirrhosis of liver; Cirrhosis of liver NOS; Cryptogenic
cirrhosis of liver; Macronodular cirrhosis of liver; Micronodular cirrhosis of
liver; Mixed type cirrhosis of liver; Portal cirrhosis of liver; Postnecrotic
K74.6 cirrhosis of LIVER DISEASES II 15,100 4,530
liver;
K76.1 Chronic passive congestion of liver; Cardiac cirrhosis (so- LIVER DISEASES II 15,100 4,530
called) of liver; Cardiac sclerosis of liver
K76.2 Central haemorrhagic necrosis of liver LIVER DISEASES II 15,100 4,530

K76.3 Infarction of liver LIVER DISEASES II 15,100 4,530
K76.4 Peliosis hepatis; Hepatic angiomatosis LIVER DISEASES II 15,100 4,530
K76.6 Portal hypertension LIVER DISEASES II 15,100 4,530
K76.7 Hepatorenal syndrome LIVER DISEASES II 15,100 4,530
Nonspecific mesenteric lymphadenitis; Acute Mesenteric lymphadenitis;
Chronic Mesenteric lymphadenitis
I88.0 LYMPHADENITIS 6,800 2,040
I89.1 Lymphangitis; Lymphangitis NOS; Chronic Lymphangitis; LYMPHATIC VESSELS DISORDER 8,900 2,670
Subacute Lymphangitis
Other specified noninfective disorders of lymphatic vessels and lymph

I89.8 nodes; Chylocele (nonfilarial); Lipomelanotic LYMPHATIC VESSELS DISORDER 8,900 2,670
reticulosis
I89.9 Noninfective disorder of lymphatic vessels and lymph LYMPHATIC VESSELS DISORDER 8,900 2,670
nodes, unspecified; Disease of lymphatic vessels NOS
C64 Malignant neoplasm of kidney, except renal pelvis & renal MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
calyces
Malignant neoplasm of renal pelvis; Malignant neoplasm of Pelviureteric

C65 junction; Malignant neoplasm of Renal calyces MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C66 Malignant neoplasm of ureter MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.0 Malignant neoplasm of Trigone of bladder MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.1 Malignant neoplasm of Dome of bladder MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.2 Malignant neoplasm of Lateral wall of bladder MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.3 Malignant neoplasm of Anterior wall of bladder MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.5 Malignant neoplasm of Bladder neck; Malignant neoplasm MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
of Internal urethral orifice
C67.6 Malignant neoplasm of Ureteric orifice MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.7 Malignant neoplasm of Urachus MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.8 Malignant neoplasm of Overlapping lesion of bladder MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C67.9 Malignant neoplasm of Bladder, unspecified MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C68.0 Malignant neoplasm of Urethra MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C68.9 Malignant neoplasm of Urinary organ, unspecified; MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
Malignant neoplasm of Urinary system NOS
C79.0 Secondary malignant neoplasm of kidney and renal pelvis MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
C79.1 Secondary malignant neoplasm of bladder and other and MALIGNANT NEOPLASM OF URINARY TRACT 14,100 4,230
unspecified urinary organs
C40.0 Malignant neoplasm of Scapula and long bones of upper MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
limb ARTICULAR CARTILAGE
C40.1 Malignant neoplasm of Short bones of upper limb MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C40.2 Malignant neoplasm of Long bones of lower limb MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C40.3 Malignant neoplasm of Short bones of lower limb MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C40.9 Malignant neoplasm of Bone and articular cartilage of limb, MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
unspecified ARTICULAR CARTILAGE
Malignant neoplasm of Bones of skull and face; Malignant neoplasm o f MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE
C41.0 Superior maxilla; Malignant neoplasm of 16,500 4,950
Orbital bone
C41.1 Malignant neoplasm of Mandible; Malignant neoplasm of MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
Lower jaw bone ARTICULAR CARTILAGE
C41.2 Malignant neoplasm of Vertebral column MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C41.3 Malignant neoplasm of Ribs, sternum and clavicle MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C41.4 Malignant neoplasm of Pelvic bones, sacrum and coccyx MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C41.8 Malignant neoplasm of Overlapping lesion of bone and MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
articular cartilage ARTICULAR CARTILAGE
C41.9 Malignant neoplasm of Bone and articular cartilage, MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
unspecified ARTICULAR CARTILAGE
C79.5 Secondary malignant neoplasm of bone and bone marrow MALIGNANT NEOPLASMS OF BONE AND 16,500 4,950
ARTICULAR CARTILAGE
C70.0 Malignant neoplasm of Cerebral meninges MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C70.1 Malignant neoplasm of Spinal meninges MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C70.9 Malignant neoplasm of Meninges, unspecified MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.0 Malignant neoplasm of Cerebrum, except lobes and MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
ventricles; Malignant neoplasm of Supratentorial NOS SYSTEM
C71.1 Malignant neoplasm of Frontal lobe MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.2 Malignant neoplasm of Temporal lobe MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.3 Malignant neoplasm of Parietal lobe MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.4 Malignant neoplasm of Occipital lobe MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.5 Malignant neoplasm of Cerebral ventricle MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.6 Malignant neoplasm of Cerebellum MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
Malignant neoplasm of Brain stem; Malignant neoplasm of Fourth MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM
C71.7 Ventricle; Malignant neoplasm of Infratentorial NOS 16,900 5,070
C71.8 Malignant neoplasm of Overlapping lesion of brain MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C71.9 Malignant neoplasm of Brain, unspecified MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C72.0 Malignant neoplasm of Spinal cord MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C72.1 Malignant neoplasm of Cauda equina MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C72.2 Malignant neoplasm of Olfactory nerve; Malignant MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
neoplasm of Olfactory bulb SYSTEM
C72.3 Malignant neoplasm of Optic nerve MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C72.4 Malignant neoplasm of Acoustic nerve MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
SYSTEM
C72.5 Malignant neoplasm of Other and unspecified cranial MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
nerves; Malignant neoplasm of Cranial nerve NOS SYSTEM
C72.8 Malignant neoplasm of Overlapping lesion of brain and MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
other parts of central nervous system SYSTEM
Malignant neoplasm of Central nervous system, unspecified; Malignant MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM
neoplasm of Nervous system NOS
C72.9 16,900 5,070
C79.3 Secondary malignant neoplasm of brain and cerebral MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
meninges SYSTEM
C79.4 Secondary malignant neoplasm of other and unspecified MALIGNANT NEOPLASMS OF CENTRAL NERVOUS 16,900 5,070
parts of nervous system SYSTEM
C15.0 Malignant neoplasm of Cervical part of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.2 Malignant neoplasm of Abdominal part of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.3 Malignant neoplasm of Upper third of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.4 Malignant neoplasm of Middle third of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.5 Malignant neoplasm of Lower third of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.8 Malignant neoplasm of Overlapping lesion of oesophagus MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C15.9 Malignant neoplasm of Oesophagus, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C16 Dermato(poly)myositis in Malignant neoplasm of stomach MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Malignant neoplasm of Cardia; Malignant neoplasm of Cardiac orifice;

Malignant neoplasm of Cardio-oesophageal junction; Malignant neoplasm
of
C16.0 Gastro-oesophageal junction; Malignant neoplasm of MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Oesophagus and stomach
C16.1 Malignant neoplasm of Fundus of stomach MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C16.2 Malignant neoplasm of Body of stomach MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C16.3 Malignant neoplasm of Pyloric antrum; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
neoplasm of Gastric antrum
C16.4 Malignant neoplasm of Pylorus; Malignant neoplasm of MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Prepylorus; Malignant neoplasm of pyloric canal
C16.5 Malignant neoplasm of Lesser curvature of stomach, MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
unspecified
C16.6 Malignant neoplasm of Greater curvature of stomach, MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
unspecified
C16.9 Malignant neoplasm of Stomach, unspecified; Gastric MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
cancer NOS
C17.0 Malignant neoplasm of Duodenum MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C17.1 Malignant neoplasm of Jejunum MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C17.2 Malignant neoplasm of Ileum MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C17.9 Malignant neoplasm of Small intestine, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.0 Malignant neoplasm of Caecum; Malignant neoplasm of MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Ileocaecal valve
C18.1 Malignant neoplasm of Appendix MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.2 Malignant neoplasm of Ascending colon MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.3 Malignant neoplasm of Hepatic flexure MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.4 Malignant neoplasm of Transverse colon MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.5 Malignant neoplasm of Splenic flexure MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.6 Malignant neoplasm of Descending colon MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.7 Malignant neoplasm of Sigmoid colon; Malignant neoplasm MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
of Sigmoid flexure
C18.8 Malignant neoplasm of Overlapping lesion of colon MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C18.9 Malignant neoplasm of Colon, unspecified; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
neoplasm of Large intestine NOS
Malignant neoplasm of rectosigmoid junction; Malignant neoplasm of

Colon with rectum; Malignant neoplasm of
C19 Rectosigmoid colon MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C20 Malignant neoplasm of rectum; Malignant neoplasm of MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Rectal ampulla
C21.0 Malignant neoplasm of Anus, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C21.1 Malignant neoplasm of Anal canal; Malignant neoplasm of MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Anal sphincter
Malignant neoplasm of Overlapping lesion of rectum, anus

and anal canal; Malignant neoplasm of Anorectal junction; Malignant
C21.8 neoplasm of Anorectum MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.0 Liver cell carcinoma; Hepatocellular carcinoma MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Hepatoma
C22.1 Intrahepatic bile duct carcinoma; Cholangiocarcinoma MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.2 Hepatoblastoma MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.3 Angiosarcoma of liver; Kupffer cell sarcoma MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.4 Other sarcomas of liver MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.7 Other specified carcinomas of liver MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C22.9 Liver, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C23 Malignant neoplasm of gallbladder MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Malignant neoplasm of Extrahepatic bile duct; Malignant neoplasm of

Biliary duct or passage NOS; Malignant neoplasm of Common bile duct;
Malignant neoplasm of Cystic duct; Malignant neoplasm of Hepatic duct
C24.0 MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C24.1 Malignant neoplasm of Ampulla of Vater MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C24.8 Malignant neoplasm of Overlapping lesion of biliary tract MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C24.9 Malignant neoplasm of Biliary tract, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.0 Malignant neoplasm of Head of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.1 Malignant neoplasm of Body of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.2 Malignant neoplasm of Tail of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.3 Malignant neoplasm of Pancreatic duct MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.4 Malignant neoplasm of Endocrine pancreas; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
neoplasm of Islets of Langerhans
C25.7 Malignant neoplasm of Other parts of pancreas; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
neoplasm of Neck of pancreas
C25.8 Malignant neoplasm of Overlapping lesion of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C25.9 Malignant neoplasm of Pancreas, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C26.0 Malignant neoplasm of Intestinal tract, part unspecified; MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Malignant neoplasm of Intestine NOS
C26.1 Malignant neoplasm of Spleen MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C26.8 Malignant neoplasm of Overlapping lesion of digestive MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
system
Malignant neoplasm of Ill-defined sites within the digestive system;
Malignant neoplasm of Alimentary canal or tract NOS; Malignant
C26.9 neoplasm of Gastrointestinal tract NOS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Mesothelioma of peritoneum; Mesothelioma of Mesentery;

Mesothelioma of Mesocolon; Mesothelioma of Omentum; Mesothelioma
C45.1 of Parietal MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
Peritoneum; Mesothelioma of Pelvic Peritoneum
Malignant neoplasm of Specified parts of peritoneum; Malignant

neoplasm of Mesentery; Malignant neoplasm of Mesocolon; Malignant
neoplasm of Omentum; Malignant neoplasm of Parietal Peritoneum;
Malignant neoplasm of Pelvic peritoneum
C48.1 MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C48.2 Malignant neoplasm of Peritoneum, unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C76.2 Malignant neoplasm of Abdomen MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C77.2 Secondary and unspecified malignant neoplasm of Intra- MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
abdominal lymph nodes
C78.4 Secondary malignant neoplasm of small intestine MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C78.5 Secondary malignant neoplasm of large intestine and MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
rectum
C78.6 Secondary malignant neoplasm of retroperitoneum and MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
peritoneum; Malignant ascites NOS
C78.7 Secondary malignant neoplasm of liver MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
C78.8 Secondary malignant neoplasm of other and unspecified MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14,200 4,260
digestive organs
Malignant neoplasm of Nasal cavity; Malignant neoplasm of Cartilage of
nose; Malignant neoplasm of nasal Concha; Malignant neoplasm of
Internal nose; Malignant neoplasm of Septum of nose; Malignant
C30.0 neoplasm of Vestibule of nose MALIGNANT NEOPLASMS OF EARS AND NOSE 10,300 3,090
Malignant neoplasm of Middle ear; Malignant neoplasm of Eustachian

tube; Malignant neoplasm of Inner ear; Malignant neoplasm of
C30.1 Mastoid air cells MALIGNANT NEOPLASMS OF EARS AND NOSE 10,300 3,090
C69.1 Malignant neoplasm of Cornea MALIGNANT NEOPLASMS OF EYE 16,900 5,070

C69.2 Malignant neoplasm of Retina MALIGNANT NEOPLASMS OF EYE 16,900 5,070
C69.3 Malignant neoplasm of Choroid MALIGNANT NEOPLASMS OF EYE 16,900 5,070
C69.4 Malignant neoplasm of Ciliary body; Malignant neoplasm MALIGNANT NEOPLASMS OF EYE 16,900 5,070
of Eyeball
Malignant neoplasm of Lacrimal gland and duct; Malignant neoplasm of

C69.5 Lacrimal sac; Malignant neoplasm of MALIGNANT NEOPLASMS OF EYE 16,900 5,070
Nasolacrimal duct
Malignant neoplasm of Orbit; Malignant neoplasm of Connective tissue

of orbit; Malignant neoplasm of Extraocular muscle; Malignant neoplasm
of Peripheral nerves of orbit; Malignant neoplasm of Retrobulbar tissue;
C69.6 Malignant neoplasm of Retro-ocular tissue MALIGNANT NEOPLASMS OF EYE 16,900 5,070
C69.9 Malignant neoplasm of Eye, unspecified MALIGNANT NEOPLASMS OF EYE 16,900 5,070
C51.0 Malignant neoplasm of Labium majus; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
of Bartholin's [greater vestibular] gland TRACT
C51.1 Malignant neoplasm of Labium minus MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C51.2 Malignant neoplasm of Clitoris MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
Malignant neoplasm of Vulva, unspecified; Malignant neoplasm of MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
External female genitalia NOS; Malignant
C51.9 neoplasm of Pudendum 11,400 3,420
C52 Malignant neoplasm of vagina MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C53.0 Malignant neoplasm of Endocervix MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C53.1 Malignant neoplasm of Exocervix MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C53.8 Malignant neoplasm of Overlapping lesion of cervix uteri MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C53.9 Malignant neoplasm of Cervix uteri, unspecified MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C54.0 Malignant neoplasm of Isthmus uteri; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
of Lower uterine segment TRACT
C54.1 Malignant neoplasm of Endometrium MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C54.2 Malignant neoplasm of Myometrium MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C54.3 Malignant neoplasm of Fundus uteri MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C54.8 Malignant neoplasm of Overlapping lesion of corpus uteri MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C54.9 Corpus uteri, unspecified MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C55 Malignant neoplasm of uterus, part unspecified MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C56 Malignant neoplasm of ovary MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
Malignant neoplasm of Fallopian tube; Malignant neoplasm of Oviduct; MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
C57.0 Malignant neoplasm of Uterine tube 11,400 3,420
C57.3 Malignant neoplasm of Parametrium; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
of Uterine ligament NOS TRACT
C57.4 Malignant neoplasm of Uterine adnexa, unspecified MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
C57.7 Malignant neoplasm of Other specified female genital MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
organs; Malignant neoplasm of Wolffian body or duct TRACT
Malignant neoplasm of Overlapping lesion of female genital MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
C57.8 organs; Malignant neoplasm of Tubo-ovarian; Malignant neoplasm of 11,400 3,420
Utero-ovarian
Malignant neoplasm of Female genital organ, unspecified; Malignant MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
neoplasm of Female genitourinary tract NOS
C57.9 11,400 3,420
C58 Malignant neoplasm of placenta; Choriocarcinoma NOS; MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
Chorionepithelioma NOS TRACT
C79.6 Secondary malignant neoplasm of ovary MALIGNANT NEOPLASMS OF FEMALE GENITAL 11,400 3,420
TRACT
Malignant neoplasm of External upper lip; Malignant neoplasm of Upper MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
lip NOS; Malignant neoplasm of Upper lip; Malignant neoplasm of lipstick
C00.0 area; Malignant neoplasm of Upper lip, vermilion border 11,500 3,450
C00.9 Malignant neoplasm of Lip, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of base of Dorsal surface of tongue ; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
neoplasm of Fixed part of tongue NOS;
C01 Malignant neoplasm of Posterior third of tongue 11,500 3,450
Malignant neoplasm of Dorsal surface of base of tongue; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
C02.0 Malignant neoplasm of Anterior two-thirds of dorsal surface of tongue 11,500 3,450
C02.1 Malignant neoplasm of Border of tongue; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
neoplasm of Tip of tongue PHARYNX
Malignant neoplasm of Ventral surface of tongue; Malignant neoplasm of MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
Anterior two-thirds of ventral surface of tongue; Malignant neoplasm of
C02.2 Frenulum linguae 11,500 3,450
Malignant neoplasm of Anterior two-thirds of tongue, part unspecified; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
Malignant neoplasm of Middle third of tongue NOS; Malignant neoplasm
C02.3 of Mobile part of tongue NOS 11,500 3,450
C02.4 Malignant neoplasm of Lingual tonsil MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C02.8 Malignant neoplasm of Overlapping lesion of tongue MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C02.9 Malignant neoplasm of Tongue, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C03.0 Malignant neoplasm of Upper gum MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C03.1 Malignant neoplasm of Lower gum MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C03.9 Malignant neoplasm of Gum, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C04.9 Malignant neoplasm of Floor of mouth, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C05.0 Malignant neoplasm of Hard palate MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C05.1 Malignant neoplasm of Soft palate MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C05.9 Malignant neoplasm of Palate, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of Cheek mucosa; Malignant neoplasm of Buccal MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
mucosa NOS; Malignant neoplasm of Internal
C06.0 cheek 11,500 3,450
Malignant neoplasm of Vestibule of mouth; Malignant neoplasm of Upper

buccal sulcus; Malignant neoplasm of Lower buccal sulcus; Malignant
neoplasm of Upper Labial sulcus; Malignant neoplasm of Lower Labial
C06.1 sulcus MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX 11,500 3,450
C06.2 Malignant neoplasm of Retromolar area MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of Mouth, unspecified; Minor Malignant neoplasm of MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
minor salivary gland, unspecified site; Malignant neoplasm of Oral cavity
C06.9 NOS 11,500 3,450
C07 Malignant neoplasm of parotid gland MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C08.0 Malignant neoplasm of Submandibular gland; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
neoplasm of Submaxillary gland PHARYNX
C08.1 Malignant neoplasm of Sublingual gland MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of Major salivary gland, unspecified; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
C08.9 neoplasm of Major Salivary gland NOS 11,500 3,450
C09.0 Malignant neoplasm of Tonsillar fossa MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of Tonsil, unspecified; Malignant neoplasm of Tonsil MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
C09.9 NOS; Malignant neoplasm of Faucial 11,500 3,450
Tonsil; Malignant neoplasm of Palatine Tonsil
C10.0 Malignant neoplasm of Vallecula MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C10.3 Malignant neoplasm of Posterior wall of oropharynx MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C10.4 Malignant neoplasm of Branchial cleft; Malignant neoplasm MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
of Branchial cyst PHARYNX
C10.9 Malignant neoplasm of Oropharynx, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C11.0 Malignant neoplasm of Superior wall of nasopharynx; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
Malignant neoplasm of Roof of nasopharynx PHARYNX
Malignant neoplasm of Posterior wall of nasopharynx; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
Malignant neoplasm of Adenoid; Malignant neoplasm of Pharyngeal tonsil
C11.1 11,500 3,450
Malignant neoplasm of Lateral wall of nasopharynx; Malignant neoplasm MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
of Fossa of Rosenmüller; Malignant neoplasm of Opening of auditory tube;
C11.2 Malignant neoplasm of Pharyngeal recess 11,500 3,450
Malignant neoplasm of Anterior wall of nasopharynx; Malignant neoplasm

of A nterior Nasopharyngeal surface of soft palate; Malignant neoplasm of
Posterior Nasopharyngeal surface of soft palate; Malignant neoplasm of
Posterior margin of nasal choana; Malignant of Posterior margin of nasal
C11.3 septum; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX 11,500 3,450
C11.9 Malignant neoplasm of Nasopharynx, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
Malignant neoplasm of Aryepiglottic fold, hypopharyngeal aspect

hypopharynx ; Malignant neoplasm of Aryepiglottic fold, hypopharynx
NOS; Malignant neoplasm of Aryepiglottic fold, marginal zone,
C13.1 hypopharynx MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX 11,500 3,450
C13.9 Malignant neoplasm of Hypopharynx, unspecified; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
Malignant neoplasm of Hypopharyngeal wall NOS PHARYNX
C14.0 Malignant neoplasm of Pharynx, unspecified MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
PHARYNX
C14.8 Malignant neoplasm of Overlapping lesion of lip, oral cavity MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, 11,500 3,450
and pharynx PHARYNX
Malignant neoplasm of Head, face and neck; Malignant neoplasm of MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
Cheek NOS; Malignant neoplasm of Nose NOS
C76.0 11,500 3,450
Secondary and unspecified malignant neoplasm of Lymph nodes of head, MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
face and neck; Malignant neoplasm of
C77.0 Supraclavicular lymph nodes 11,500 3,450
B21.1 Human immunodeficiency virus [HIV] disease resulting in MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Burkitt's lymphoma HEMATOPOIETIC AND RELATED TISSUE
B21.2 Human immunodeficiency virus [HIV] disease resulting in MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
other types of non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE
Human immunodeficiency virus [HIV] disease resulting in MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND
B21.3 other malignant neoplasms of lymphoid, haematopoietic and related RELATED TISSUE 13,900 4,170
tissue
Hodgkin's disease (Lymphocytic predominance); Hodgkin's disease MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND
(Lymphocytic-histiocytic predominance) RELATED TISSUE
C81.0 Nodular lymphocyte predominant Hodgkin lymphoma 13,900 4,170
C81.1 Hodgkin's disease( Nodular sclerosis) MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
HEMATOPOIETIC AND RELATED TISSUE
C81.9 Hodgkin's disease, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C82.0 Small cleaved cell, follicular non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Follicular lymphoma grade I HEMATOPOIETIC AND RELATED TISSUE
Mixed small cleaved non-Hodgkin's lymphoma and large cell, follicular MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND
C82.1 non-Hodgkin's lymphoma RELATED TISSUE 13,900 4,170
Follicular lymphoma grade II
C82.2 Large cell, follicular non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Follicular lymphoma grade III, unspecified HEMATOPOIETIC AND RELATED TISSUE
C82.7 Other types of follicular non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C82.9 Follicular non-Hodgkin's lymphoma, unspecified; Nodular MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
non-Hodgkin's lymphoma NOS HEMATOPOIETIC AND RELATED TISSUE
C83.0 Small cell diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Small cell B-cell lymphoma HEMATOPOIETIC AND RELATED TISSUE
C83.2 Mixed small and large cell diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A
C83.3 Large cell diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Diffuse large B-cell lymphoma HEMATOPOIETIC AND RELATED TISSUE
C83.4 Immunoblastic diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A
C83.5 Lymphoblastic diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C83.7 Burkitt's tumour MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

Burkitt"s lymphoma HEMATOPOIETIC AND RELATED TISSUE
C83.8 Other types of diffuse non-Hodgkin's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Other non-follicular lymphoma HEMATOPOIETIC AND RELATED TISSUE
C83.9 Diffuse non-Hodgkin's lymphoma, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Non-follicular lymphoma, unspecified HEMATOPOIETIC AND RELATED TISSUE
C84.0 Mycosis fungoides MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C84.1 Sézary's disease MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C84.3 Lymphoepithelioid lymphoma; Lennert's lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A
C84.4 Peripheral T-cell lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C84.5 Other and unspecified T-cell lymphomas MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C85.0 Lymphosarcoma MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A

C85.1 B-cell lymphoma, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

Other specified types of non-Hodgkin's lymphoma; Malignant MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND
C85.7 reticuloendotheliosis; Malignant reticulosis; RELATED TISSUE 13,900 4,170
Microglioma
C85.9 Non-Hodgkin's lymphoma, unspecified type; Lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
NOS HEMATOPOIETIC AND RELATED TISSUE
C90.0 Multiple myeloma; Kahler's disease; Myelomatosis MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C90.1 Plasma cell leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C90.2 Extramedullary Plasmacytoma; Malignant plasma cell MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
tumour NOS; Plasmacytoma NOS ; Solitary myeloma HEMATOPOIETIC AND RELATED TISSUE
C91.0 Acute lymphoblastic leukemia; Acute lymphocytic leukemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.1 Chronic lymphocytic leukaemia of B-cell type MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.2 Subacute lymphocytic leukaemia of B-cell type MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.3 Prolymphocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.4 Hairy-cell leukaemia; Leukaemic reticuloendotheliosis MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.5 Adult T-cell leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.7 Other lymphoid leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C91.9 Lymphoid leukaemia, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.0 Acute myeloid leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

Acute myeloblastic leukaemia HEMATOPOIETIC AND RELATED TISSUE
C92.1 Chronic myeloid leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.2 Subacute myeloid leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.3 Myeloid sarcoma; Chloroma; Granulocytic sarcoma MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C92.4 Acute promyelocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.5 Acute myelomonocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.7 Other myeloid leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C92.9 Myeloid leukaemia, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C93.0 Acute monocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C93.1 Chronic monocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

Chronic myelomonocytic leukaemia HEMATOPOIETIC AND RELATED TISSUE
C93.9 Monocytic leukaemia, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Acute erythraemia and erythroleukaemia; Acute MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND
C94.0 erythraemic myelosis; Di Guglielmo's disease Acute erythroid leukaemia RELATED TISSUE 13,900 4,170
C94.2 Acute megakaryoblastic leukaemia; Acute megakaryocytic MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Leukaemia HEMATOPOIETIC AND RELATED TISSUE
C94.4 Acute panmyelosis MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C94.5 Acute myelofibrosis MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C95.0 Acute leukaemia of unspecified cell type; Blast cell MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
leukaemia; Stem cell leukaemia HEMATOPOIETIC AND RELATED TISSUE
C95.1 Chronic leukaemia of unspecified cell type MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C95.2 Subacute leukaemia of unspecified cell type MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A
C95.7 Other leukaemia of unspecified cell type MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
C95.9 Leukaemia, unspecified MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170

C96.0 Letterer-Siwe disease; Nonlipid reticuloendotheliosis; MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Nonlipid reticulosis HEMATOPOIETIC AND RELATED TISSUE
C96.1 Malignant histiocytosis; Histiocytic medullary reticulosis MALIGNANT NEOPLASMS OF LYMPHOID, N/A N/A
C96.2 Malignant mast cell tumour; Malignant mastocytoma; MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
Malignant mastocytosis; Mast cell sarcoma HEMATOPOIETIC AND RELATED TISSUE
C96.7 Other specified malignant neoplasms of lymphoid, MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
haematopoietic and related tissue HEMATOPOIETIC AND RELATED TISSUE
C96.9 Malignant neoplasm of lymphoid, haematopoietic and MALIGNANT NEOPLASMS OF LYMPHOID, 13,900 4,170
related tissue, unspecified HEMATOPOIETIC AND RELATED TISSUE
C60.9 Malignant neoplasm of Penis, unspecified; Malignant MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
neoplasm of Skin of penis NOS TRACT
C61 Malignant neoplasm of prostate MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
TRACT
C62.0 Malignant neoplasm of Undescended testis; Ectopic testis MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
; Malignant neoplasm of Retained testis TRACT
C62.1 Malignant neoplasm of Descended testis; Malignant MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
neoplasm of Scrotal Testis TRACT
C62.9 Malignant neoplasm of Testis, unspecified MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
TRACT
C63.0 Malignant neoplasm of Epididymis MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
TRACT
C63.1 Malignant neoplasm of Spermatic cord MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
TRACT
C63.2 Malignant neoplasm of Scrotum; Malignant neoplasm of MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
Skin of scrotum TRACT
C63.7 Malignant neoplasm of Seminal vesicle; Malignant MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
neoplasm of Tunica vaginalis TRACT
C63.9 Malignant neoplasm of Male genital organ, unspecified; MALIGNANT NEOPLASMS OF MALE GENITAL 13,400 4,020
Male genitourinary tract NOS TRACT
C45.2 Mesothelioma of pericardium MALIGNANT NEOPLASMS OF MESOTHELIUM 10,600 3,180
C45.7 Mesothelioma of other sites MALIGNANT NEOPLASMS OF MESOTHELIUM 10,600 3,180
C45.9 Mesothelioma, unspecified MALIGNANT NEOPLASMS OF MESOTHELIUM 10,600 3,180
C48.0 Malignant neoplasm of Retroperitoneum MALIGNANT NEOPLASMS OF MESOTHELIUM 10,600 3,180
Malignant neoplasm of Pelvis; Malignant neoplasm of Groin NOS;
Malignant neoplasm of
C76.3 Sites overlapping systems within the pelvis, such as MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
rectovaginal (septum) & rectovesical (septum)
C76.4 Malignant neoplasm of Upper limb MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C76.5 Malignant neoplasm of Lower limb MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C76.7 Malignant neoplasm of Other ill-defined sites MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C76.8 Malignant neoplasm of Overlapping lesion of other and ill- MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
defined sites
Secondary and unspecified malignant neoplasm of Axillary and upper limb

lymph nodes; Secondary and unspecified malignant neoplasm of Pectoral
C77.3 lymph nodes MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C77.9 Secondary and unspecified malignant neoplasm of Lymph MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
node, unspecified
C79.7 Secondary malignant neoplasm of adrenal gland MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C79.8 Secondary malignant neoplasm of other specified sites MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
Malignant neoplasm without specification of site; Unspecified site
whether primary or secondary [Cancer, Carcinoma, Carcinomatosis,
Generalized cancer, Generalized malignancy, Malignancy, Multiple
cancer]; Malignant cachexia; Malignant neoplasm of Primary site unknown
C80 MALIGNANT NEOPLASMS OF OTHER SITES 16,100 4,830
C47.0 Malignant neoplasm of Peripheral nerves of head, face and MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
neck
C47.1 Malignant neoplasm of Peripheral nerves of upper limb, MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
including shoulder
C47.2 Malignant neoplasm of Peripheral nerves of lower limb, MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
including hip
C47.3 Malignant neoplasm of Peripheral nerves of thorax MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
C47.4 Malignant neoplasm of Peripheral nerves of abdomen MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
C47.5 Malignant neoplasm of Peripheral nerves of pelvis MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
C47.6 Malignant neoplasm of Peripheral nerves of trunk, MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
unspecified
C47.9 Malignant neoplasm of Peripheral nerves and autonomic MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13,300 3,990
nervous system, unspecified
Malignant neoplasm of Glottis; Malignant neoplasm of Intrinsic larynx; MALIGNANT NEOPLASMS OF RESPIRATORY AND
Malignant neoplasm of true Vocal cord NOS INTRATHORACIC ORGANS
C32.0 14,600 4,380
Malignant neoplasm of Supraglottis: Malignant neoplasm of Aryepiglottic

fold, laryngeal aspect; Malignant neoplasm of Epiglottis (suprahyoid
portion) NOS; Malignant neoplasm of Extrinsic larynx; Malignant
neoplasm of False vocal cord; Malignant neoplasm of posterior laryngeal
C32.1 surface of epiglottis; Malignant neoplasm of ventricular bands MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
INTRATHORACIC ORGANS
C32.2 Malignant neoplasm of Subglottis MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C32.3 Malignant neoplasm of Laryngeal cartilage MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C32.9 Malignant neoplasm of Larynx, unspecified MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C33 Malignant neoplasm of trachea MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
Malignant neoplasm of Main bronchus; Malignant neoplasm of Carina; MALIGNANT NEOPLASMS OF RESPIRATORY AND
C34.0 Malignant neoplasm of Hilus of lung INTRATHORACIC ORGANS 14,600 4,380
C34.1 Malignant neoplasm of Upper lobe, bronchus or lung MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C34.2 Malignant neoplasm of Middle lobe, bronchus or lung MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C34.3 Malignant neoplasm of Lower lobe, bronchus or lung MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C34.8 Malignant neoplasm of Overlapping lesion of bronchus and MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
lung INTRATHORACIC ORGANS
C34.9 Malignant neoplasm of Bronchus or lung, unspecified MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C37 Malignant neoplasm of thymus MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C38.0 Malignant neoplasm of Heart; Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
Pericardium INTRATHORACIC ORGANS
C38.1 Malignant neoplasm of Anterior mediastinum MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C38.3 Malignant neoplasm of Mediastinum, part unspecified MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C38.4 Malignant neoplasm of Pleura MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C38.8 Malignant neoplasm of Overlapping lesion of heart, MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
mediastinum and pleura INTRATHORACIC ORGANS
C39.0 Malignant neoplasm of Upper respiratory tract, part MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
unspecified INTRATHORACIC ORGANS
C39.8 Malignant neoplasm of Overlapping lesion of respiratory MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
and intrathoracic organs INTRATHORACIC ORGANS
C39.9 Malignant neoplasm of Ill-defined sites within the MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
respiratory system; Respiratory tract NOS INTRATHORACIC ORGANS
C45.0 Mesothelioma of pleura MALIGNANT NEOPLASMS OF RESPIRATORY AND 10,600 3,180

Malignant neoplasm of Thorax; Malignant neoplasm of Axilla NOS; MALIGNANT NEOPLASMS OF RESPIRATORY AND
Malignant neoplasm of Intrathoracic NOS; INTRATHORACIC ORGANS
C76.1 Malignant neoplasm of Thoracic NOS 14,600 4,380
C77.1 Secondary and unspecified malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
Intrathoracic lymph nodes INTRATHORACIC ORGANS
C78.0 Secondary malignant neoplasm of lung MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C78.1 Secondary malignant neoplasm of mediastinum MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
C78.2 Secondary malignant neoplasm of pleura; Malignant pleural MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
effusion NOS INTRATHORACIC ORGANS
C78.3 Secondary malignant neoplasm of other and unspecified MALIGNANT NEOPLASMS OF RESPIRATORY AND 14,600 4,380
respiratory organs INTRATHORACIC ORGANS
Malignant neoplasm of Maxillary sinus; Malignant neoplasm of Antrum

(Highmore); Malignant neoplasm of
C31.0 Antrum (maxillary) MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
C31.1 Malignant neoplasm of Ethmoidal sinus MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
C31.2 Malignant neoplasm of Frontal sinus MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
C31.3 Malignant neoplasm of Sphenoidal sinus MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
C31.8 Malignant neoplasm of Overlapping lesion of accessory MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
sinuses
C31.9 Malignant neoplasm of Accessory sinus, unspecified MALIGNANT NEOPLASMS OF SINUSES 11,500 3,450
B21.0 Human Immunodeficiency Virus [HIV] Disease resulting in MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
Kaposi's Sarcoma
C46.9 Kaposi's sarcoma, unspecified MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
Malignant neoplasm of Connective and soft tissue of head, face and neck;
Malignant neoplasm of Connective tissue of ear; Malignant neoplasm of
C49.0 Connective tissue of eyelid MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
C49.1 Malignant neoplasm of Connective and soft tissue of upper MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
limb, including shoulder
C49.2 Malignant neoplasm of Connective and soft tissue of lower MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
limb, including hip
Malignant neoplasm of Connective and soft tissue of thorax; Malignant

neoplasm of Connective and soft tissue of Axilla; Malignant neoplasm of
Connective and soft tissue of Diaphragm; Malignant neoplasm of
C49.3 Connective and soft tissue of Great vessels MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
Malignant neoplasm of Connective and soft tissue of abdomen; Malignant

neoplasm of Connective and soft tissue of Abdominal wall; Malignant
C49.4 neoplasm of Connective and soft tissue of Hypochondrium MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
Malignant neoplasm of Connective and soft tissue of pelvis; Malignant

neoplasm of Connective and soft tissue of Buttock; Malignant neoplasm of
Connective and soft tissue of Groin; Malignant neoplasm of Connective
C49.5 and soft tissue of Perineum MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
Malignant neoplasm of Connective and soft tissue of trunk, unspecified;

C49.6 Malignant neoplasm of Connective and soft MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
tissue of Back NOS
C49.8 Malignant neoplasm of Overlapping lesion of connective MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
and soft tissue
C49.9 Malignant neoplasm of Connective and soft tissue, MALIGNANT NEOPLASMS OF SOFT TISSUES 12,000 3,600
unspecified
C73 Malignant neoplasm of thyroid gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
OTHER ENDOCRINE GLANDS
C74.0 Malignant neoplasm of Cortex of adrenal gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C74.1 Malignant neoplasm of Medulla of adrenal gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C74.9 Malignant neoplasm of Adrenal gland, unspecified MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C75.0 Malignant neoplasm of Parathyroid gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C75.1 Malignant neoplasm of Pituitary gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C75.3 Malignant neoplasm of Pineal gland MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C75.5 Malignant neoplasm of Aortic body and other paraganglia MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
C75.9 Malignant neoplasm of Endocrine gland, unspecified MALIGNANT NEOPLASMS OF THYROID AND 11,400 3,420
E40 Kwashiorkor MALNUTRITION 11,700 3,510

E41 Nutritional marasmus; Severe malnutrition with marasmus MALNUTRITION 11,700 3,510
Marasmic kwashiorkor; Severe protein-energy malnutrition, intermediate

form; Severe protein-energy malnutrition with signs of both kwashiorkor
E42 and marasmus MALNUTRITION 11,700 3,510
E43 Unspecified severe protein-energy malnutrition MALNUTRITION 11,700 3,510

E44.0 Moderate protein-energy malnutrition MALNUTRITION 11,700 3,510
E44.1 Mild protein-energy malnutrition MALNUTRITION 11,700 3,510
Retarded development following protein-energy
malnutrition; Nutritional short stature; Nutritional stunting; Physical
E45 retardation due to malnutrition MALNUTRITION 11,700 3,510
E46 Unspecified protein-energy malnutrition; Malnutrition NOS; MALNUTRITION 11,700 3,510

Protein-energy imbalance NOS
O10.0 Pre-existing essential hypertension complicating pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
child birth and the puerperium
O10.1 Pre-existing hypertensive heart disease complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
pregnancy, childbirth and the puerperium
O10.2 Pre-existing hypertensive renal disease complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
pregnancy childbirth and the puerperium
O10.3 Pre-existing hypertensive heart and renal disease MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
complicating pregnancy, childbirth and the puerperium
O10.4 Pre-existing secondary hypertension complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O10.9 Unspecified pre-existing hypertension complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O11 Pre-existing hypertensive disorder with superimposed MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
proteinuria
O12.1 Gestational proteinuria MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O12.2 Gestational oedema with proteinuria MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Gestational [pregnancy-induced] hypertension wihtout significant
O13 proteinuria; Gestational hypertension NOS; Mild MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
pre-eclampsia
O14.0 Moderate pre-eclampsia MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O14.1 Severe pre-eclampsia MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O14.9 Pre-eclampsia, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O15.0 Eclampsia in pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O15.1 Eclampsia in labour MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O15.9 Eclampsia, unspecified as to time period; Eclampsia NOS MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O16 Unspecified maternal hypertension MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O20.0 Threatened abortion; Haemorrhage specified as due to MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
threatened abortion
O20.8 Other haemorrhage in early pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O20.9 Haemorrhage in early pregnancy, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Mild hyperemesis gravidarum; Hyperemesis gravidarum, mild or
unspecified, starting before the end of the 22nd
O21.0 week of gestation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Hyperemesis gravidarum with metabolic disturbance; Hyperemesis

gravidarum, starting before the end of the 22nd week of gestation, with
metabolic disturbance such as carbohydrate depletion, dehydration,
O21.1 elctrolyte imbalance MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O21.2 Late vomiting of pregnancy; Excessive vomiting starting MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
after 22 completed weeks of gestation
Other vomiting complicating pregnancy; Vomiting due to disease classified

elsewhere, complicating pregnancy
O21.8 MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O21.9 Vomiting of pregnancy, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O22.3 Deep phlebothrombosis in pregnancy; Deep-vein MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
thrombosis, antepartum
O22.5 Cerebral venous thrombosis in pregnancy; Cerebrovenous MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
sinus thrombosis in pregnancy
Venous complication in pregnancy, unspecified; Gestational phlebitis NOS;
O22.9 Gestational phlebopathy NOS; Gestational MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
thrombosis NOS
O23.0 Infections of kidney in pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O23.3 Infections of other parts of urinary tract in pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O24.0 Pre-existing diabetes mellitus, insulin-dependent MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O24.1 Pre-existing diabetes mellitus, non-insulin-dependent MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O24.2 Pre-existing malnutrition-related diabetes mellitus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O24.3 Pre-existing diabetes mellitus, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O24.4 Diabetes mellitus arising in pregnancy; Gestational diabetes MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
mellitus NOS
O24.9 Diabetes mellitus in pregnancy, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O26.2 Pregnancy care of habitual aborter MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O26.3 Retained in trauterine contraceptive device in pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O26.4 Herpes gestationis MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O26.5 Maternal hypotension syndrome; Supine hypotensive MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
syndrome
O26.6 Liver disorders in pregnancy, childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O26.7 Subluxation of symphysis (pubis) in pregnancy childbirth MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
and the puerperium
Other specified pregnancy-related conditions; Exhaustion and fatigue

pregnancy-related; Peripheral neuritis pregnancy-related; Renal disease
O26.8 pregnancy-related MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O26.9 Pregnancy-relatedcondition, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O28.0 Abnormal haematological finding on antenatal screening of MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
mother
O28.3 Abnormal ultrasonic finding on antenatal screening of MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
mother
O28.5 Abnormal chromosomal and genetic finding on antenatal MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
screening of mother
O28.8 Other abnormal findings on antenatal screening of mother MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O28.9 Abnormal finding on antenatal screening of mother, MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
unspecified
O29.8 Other complications of anaesthesia during pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O30.0 Twin pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O30.1 Triplet pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O30.8 Other multiple gestation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O30.9 Multiple gestation, unspecified; Multiple pregnancy NOS MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O31.0 Papyraceous fetus; Fetus compressus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O31.1 Continuing pregnancy after abortion of one fetus or more MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O31.2 Continuing pregnancy after intrauterine death of one fetus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
or more
O31.8 Other complications specific to multiple gestation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.0 Maternal care for unstable lie MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.1 Maternal care for breech presentation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.2 Maternal care for transverse and oblique lie; Oblique MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
presentation; Transverse presentation
O32.3 Maternal care for face, brow and chin presentation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.4 Maternal care for high head at term; Failure of head to MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
enter pelvic brim
O32.5 Maternal care for multiple gestation with malpresentation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
of one fetus or more
O32.6 Maternal care for compound presentation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.8 Maternal care for other malpresentation of fetus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O32.9 Maternal care for malpresentation of fetus, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion due to deformity of maternal pelvic

bones; Pelvic deformity causing
O33.0 disproportion NOS MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion due to generally contracted pelvis;

Contracted pelvis NOS causing
O33.1 disproportion MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion due to inlet contraction of pelvis; Inlet

O33.2 contraction (pelvis) causing disproportion MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion due to outlet contraction of pelvis; Mid-

cavity contraction pelvis causing disproportion; Outlet contraction pelvis
O33.3 causing disproportion MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O33.4 Maternal care for disproportion of mixed maternal and MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
fetal origin
Maternal care for disproportion due to unusually large fetus;

O33.5 Disproportion of fetal origin with normally formed MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
fetus; Fetal disproportion NOS
O33.6 Maternal care for disproportion due to hydrocephalic fetus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion due to other fetal deformities; Conjoined

twins; Fetal ascites causing disproportion; Fetal hydrops causing
disproportion; Fetal meaningomyelocele causing disproportion; Fetal
tumour causing disproportion; Sacral teratoma causing
O33.7 disproportion MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for disproportion, unspecified; Cephalopelvic disproportion

O33.9 NOS; Fetopelvic disproportion NOS MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for congenital malformation of uterus;

Maternal care for double uterus; Maternal care for Uterus bicornis
O34.1 Maternal care for tumour of corpus uteri; Maternal for MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
polyp of corpus uteri; Maternal care for uterine fibroid
O34.2 Maternal care due to uterine scar from previous surgery; MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for scar from previous
Maternal care for cervical incompetence; Maternal care for cerclage with
or without mention of cervical incompetence; Maternal care for Shirodkar
O34.3 suture with or without mention of cervical incompetence MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for other abnormalities of cervix; Maternal care for polyp of
cervix; Maternal care for previous surgery to cervix; Maternal care for
stricture or stenosis of cervix; Maternal care for tumour of cervix
Maternal care for other abnormalities of gravid uterus; Maternal care for
incarceratiion of gravid uterus; Maternal care for prolapse of gravid
O34.5 uterus; Maternal care for retroversion of gravid uterus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for abnormality of vagina; Maternal care for previous

surgery to vagina; Maternal care for septate vagina; Maternal care for
acquired stenosis of vagina; Maternal care for congenital stenosis of
O34.6 vagina; Maternal care for tumour of vagina MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for abnormality of vulva and perineum; Maternal care for
fibrosis of perineum; Maternal care for previous surgery to perineum or
vulva; Maternal care for rigid perineum; Maternal care for tumour of vulva
Maternal care for other abnormalities of pelvic organs; Maternal care for
cystocele; Maternal care for previous pelvic floor repair; Maternal care for
pendulous abdomen; Maternal care for rectocele; Maternal care for rigid
O34.8 pelvic MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
floor
O34.9 Maternal care for abnormality of pelvic organ, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for (suspected) central nervous system malformation in

fetus; Maternal care for suspected fetal anencephaly; Maternal care for
O35.0 suspected fetal spina bifida MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O35.2 Maternal care for (suspected) hereditary disease in fetus MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for (suspected) damage to fetus from viral disease in

mother; Maternal care for suspected damage to fetus from maternal
cytomegalovirus infection; Maternal care for suspected damage to fetus
O35.3 from maternal rubella MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for (suspected) damage to fetus by drugs; Maternal care for
suspected damage to fetus from drug
O35.5 addiction MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for other (suspected) fetal abnormality and damage;

Maternal care for suspected damage to fetus from maternal listeriosis;
Maternal care for suspected damage to fetus from maternal
O35.8 toxoplasmosis MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O35.9 Maternal care for (suspected) fetal abnormality and MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
damage, unspecified
O36.0 Maternal care for rhesus isoimmunization; Anti-D [Rh] MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
antibodies; Rh incompatibility (with hydrops fetalis)
Maternal care for other isoimmunization; ABO

isoimmunization; Isoimmunization NOS (with hydrops fetalis)
O36.2 Maternal care for hydrops fetalis; Hydrops fetalis NOS; MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Hydrops fetalis not associated with isoimmunization
O36.3 Maternal care for signs of fetal hypoxia MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O36.4 Maternal care for intrauterine death MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Maternal care for poor fetal growth; Maternal care for known or
suspected light-for-dates; Maternal care for known or suspected placental
O36.5 insufficiency; Maternal care MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
for known or suspected small-for-dates
O36.6 Maternal care for excessive fetal growth; Maternal care for MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
known or suspected large-for-dates
O36.8 Maternal care for other specified fetal problems MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O36.9 Maternal care for fetal problem, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O40 Polyhydramnios; Hydramnios MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O41.0 Oligohydramnios; Oligohydramnios without mention of MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
rupture of membrane
O41.1 Infection of amniotic sac and membranes; Amnionitis; MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Chorioamnionitis; Membranitis; Placentitis
O41.8 Other specified disorders of amniotic fluid and membranes MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O41.9 Disorder of amniotic fluid and membranes, unspecified; MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Premature rupture of membranes
O42.0 Premature rupture of membranes on set of labour within MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
24 hours
O42.1 Premature rupture of membranes on set of labour after 24 MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
hours
O42.2 Premature rupture of membranes, labour delayed by MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
therapy
O42.9 Premature rupture of membranes, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Placental transfusion syndromes; Fetomaternal transfusion; Maternofetal
O43.0 transfusion; Twin-to-twin transfusion MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O43.1 Malformation of placenta; Abnormal placenta NOS; MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Circumvallate placenta
O43.8 Other placental disorders; Placental dysfunction; Placental MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
infarction
O43.9 Placental disorder, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

Placenta praevia specified as without haemorrhage; Low implantation of
placenta, NOS or with haemorrhage
Placenta praevia with haemorrhage; Low implantation of placenta, NOS or

with haemorrhage; Placenta praevia, marginal NOS or with haemorrhage;
Placenta praevia, partial NOS or with haemorrhage; Placenta praevia, total
O44.1 NOS or with haemorrhage MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Premature separation of placenta with coagulation defect; Abruptio

placentae with (excessive) haemorrhage associated with
afibrinogenaemia; Abruptio placentae with (excessive) haemorrhage
associated with disseminated intravascular coagulation; Abruptio
placentae with (excessive) hemorrhage associated with
hyperfibrinogenaemia; Abruptio placentae with (excessive) haemorrhage
O45.0 associated with hypofibrinogenaemia MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O45.8 Other premature separation of placenta MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O45.9 Premature separation of placenta, unspecified; Abruptio MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
placenta NOS
Antepartum haemorrhage with coagulation defect; Antepartum

haemorrhage (excessive) associated with afibrinogenaemia; Antepartum
haemorrhage (excessive) associated with disseminated intravascular
coagulation; Antepartum haemorrhage (excessive) associated with
hyperfibrinolysis; Antepartum haemorrahge (excessive) associated with
O46.0 hypofibrinogenaemia MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O46.8 Other antepartum haemorrhage MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040

O46.9 Antepartum haemorrhage, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O47.0 False labour before 37 completed weeks of gestation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O47.1 False labour at or after 37 completed weeks of gestation MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O47.9 False labour, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O48 Prolonged pregnancy; Post-dates; Post-term MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O98.0 Tuberculosis complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
O98.1 Syphilis complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
O98.2 Gonorrhoea complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
Other infections with apredominantly sexual mode of transmission

O98.3 complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
O98.4 Viral hepatitis complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
O98.5 Other viral diseases complicating pregnancy, childbirth and MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
the puerperium
O98.6 Protozoal diseases complicating pregnancy, childbirth and MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
the puerperium
O98.8 Other maternal infectious and parasitic diseases MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O98.9 Unspecified maternal infectious or parasitic disease MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.0 Anaemia complicating pregnancy, childbirth and the MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
puerperium
Other diseases of the blood and blood-forming organs and certain

disorders involving the immune mechanism complicating pregnancy,
O99.1 childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.2 Endocrine, nutritional and metabolic diseases complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.3 Mental disorders and diseases of the nervous system MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.4 Diseases of the circulatory system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
childbirth and the puerperium
O99.5 Diseases of the respiratory system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.6 Diseases of the digestive system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.7 Diseases of the skin and subcutaneous tissue complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O99.8 Other specified diseases and conditions complicating MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
O60.0 Preterm labor, not resulting to delivery MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z34.0 Supervision of normal first pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z34.8 Supervision of other normal pregnancy MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z34.9 Supervision of normal pregnancy, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.0 Supervision of pregnancy with history of infertility MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Supervision of pregnancy with history of abortive outcome; Supervision of
pregnancy with history of hydatidiform mole; Supervision of pregnancy
Z35.1 with history of vesicular MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
mole
Supervision of pregnancy with other poor reproductive or obstetric

history; Supervision of pregnancy with history of neonatal death;
Z35.2 Supervision of pregnancy with history of stillbirth MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.4 Supervision of pregnancy with grand multiparity MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.5 Supervision of elderly primigravida MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.6 Supervision of very young primigravida MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.7 Supervision of high-risk pregnancy due to social problems MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.8 Supervision of other high-risk pregnancies MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
Z35.9 Supervision of high-risk pregnancy, unspecified MATERNAL COMORBIDITIES CONDITIONS 6,800 2,040
A87.8 Other viral meningitis MENINGITIS 25,700 7,710
A87.9 Viral meningitis, unspecified MENINGITIS 25,700 7,710
G00.0 Haemophilus meningitis; Meningitis due to Haemophilus MENINGITIS 25,700 7,710
influenzae
G00.1 Pneumococcal meningitis MENINGITIS 25,700 7,710

G00.2 Streptococcal meningitis MENINGITIS 25,700 7,710
G00.3 Staphylococcal meningitis MENINGITIS 25,700 7,710
Other bacterial meningitis; Meningitis due to Escherichia
G00.8 coli; Meningitis due to Friedländer bacillus; Meningitis due to Klebsiella MENINGITIS 25,700 7,710
Bacterial meningitis, unspecified; Meningitis purulent NOS; Meningitis

pyogenic NOS; Meningitis suppurative NOS
G00.9 MENINGITIS 25,700 7,710
G03.0 Nonpyogenic meningitis; Nonbacterial meningitis MENINGITIS 25,700 7,710

G03.1 Chronic meningitis MENINGITIS 25,700 7,710
G03.8 Meningitis due to other specified causes MENINGITIS 25,700 7,710
G03.9 Meningitis, unspecified; Arachnoiditis (spinal) NOS MENINGITIS 25,700 7,710
B05.1+ G02.0* Measles complicated by meningitis; Meningitis in viral MENINGITIS 25,700 7,710
diseases classified elsewhere
A39.2 Acute meningococcaemia MENINGOCOCCAL INFECTION 19,800 5,940
A39.3 Chronic meningococcaemia MENINGOCOCCAL INFECTION 19,800 5,940
A39.4 Meningococcaemia, unspecified; Meningococcal MENINGOCOCCAL INFECTION 19,800 5,940
bacteraemia NOS
A39.9 Meningococcal infection, unspecified; Meningococcal MENINGOCOCCAL INFECTION 19,800 5,940

disease NOS
N91.0 Primary amenorrhoea; Failure to start menstruation at MENSTRUAL IRREGULARITIES 6,600 1,980
puberty.
N91.1 Secondary amenorrhoea; Absence of menstruation in a MENSTRUAL IRREGULARITIES 6,600 1,980

woman who had previously menstruated.
N91.2 Amenorrhoea, unspecified; Absence of menstruation NOS MENSTRUAL IRREGULARITIES 6,600 1,980
N91.5 Oligomenorrhoea, unspecified; Hypomenorrhoea NOS MENSTRUAL IRREGULARITIES 6,600 1,980

Excessive and frequent menstruation with regular cycle; Heavy periods
N92.0 NOS; Menorrhagia NOS; Polymenorrhoea MENSTRUAL IRREGULARITIES 6,600 1,980
Excessive and frequent menstruation with irregular cycle; Irregular

intermenstrual bleeding; Irregular, shortened intervals between menstrual
N92.1 bleeding; Menometrorrhagia; Metrorrhagia MENSTRUAL IRREGULARITIES 6,600 1,980
Excessive menstruation at puberty; Excessive bleeding associated with

onset of menstrual periods; Pubertal
N92.2 menorrhagia; Puberty bleeding MENSTRUAL IRREGULARITIES 6,600 1,980
N92.3 Ovulation bleeding; Regular intermenstrual bleeding MENSTRUAL IRREGULARITIES 6,600 1,980
Excessive bleeding in the premenopausal period; Climateric menorrhagia
or metrorrhagia; Menopausal menorrhagia or metrorrhagia; Preclimateric
menorrhagia or metrorrhagia; Premenopausal menorrhagia or
N92.4 metrorrhagia MENSTRUAL IRREGULARITIES 6,600 1,980
N92.5 Other specified irregular menstruation MENSTRUAL IRREGULARITIES 6,600 1,980

N92.6 Irregular menstruation, unspecified; Irregular bleeding MENSTRUAL IRREGULARITIES 6,600 1,980
NOS; Irregular periods NOS
N93.0 Postcoital and contact bleeding MENSTRUAL IRREGULARITIES 6,600 1,980

Other specified abnormal uterine and vaginal bleeding; Dysfunctional or
functional uterine or vaginal bleeding NOS
N93.8 MENSTRUAL IRREGULARITIES 6,600 1,980
N93.9 Abnormal uterine and vaginal bleeding, unspecified MENSTRUAL IRREGULARITIES 6,600 1,980
Uterine hemorrhage not due to menstraution
N94.8 Other specified conditions associated with female genital MENSTRUAL IRREGULARITIES 6,600 1,980
organs and menstrual cycle
N94.9 Unspecified condition associated with female genital MENSTRUAL IRREGULARITIES 6,600 1,980
organs and menstrual cycle
F01.1 Multi-infarct dementia; Predominantly cortical dementia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F01.8 Other vascular dementia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F01.9 Vascular dementia, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Unspecified dementia; Presenile dementia NOS; Presenile psychosis NOS;
Senile dementia NOS; Senile dementia depressed or paranoid type; Senile
F03 psychosis NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Organic amnesic syndrome, not induced by alcohol and other

F04 psychoactive substances; Korsakov's psychosis or MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
syndrome, nonalcoholic
F05.0 Delirium not superimposed on dementia, so described MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F05.8 Other delirium MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F05.9 Other delirium/Delirium, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F06.0 Organic hallucinosis; Organic hallucinatory state MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
(nonalcoholic)
Organic delusional [schizophrenia-like] disorder; Paranoid and paranoid-
hallucinatory organic states; Schizophrenia-
F06.2 like psychosis in epilepsy MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F06.3 Organic mood [affective] disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F06.4 Organic anxiety disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F06.7 Mild cognitive disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Other specified mental disorders due to brain damage and
dysfunction and to physical disease; Epileptic psychosis NOS
F06.8 MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Unspecified mental disorder due to brain damage and

dysfunction and to physical disease; Organic brain syndrome NOS; Organic
F06.9 mental disorder NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Organic personality disorder; Organic pseudopsychopathic personality;

Organic pseudoretarded personality; Frontal lobe Syndrome; Limbic
epilepsy personality Syndrome ;
F07.0 Lobotomy Syndrome; Postleucotomy Syndrome MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F07.1 Postencephalitic syndrome MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340

Postconcussional syndrome; Postcontusional syndrome (encephalopathy);
Post-traumatic brain syndrome,
F07.2 nonpsychotic MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Unspecified organic personality and behavioural disorder

F07.9 due to brain disease, damage and dysfunction; Organic psychosyndrome MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F09 Unspecified organic or symptomatic mental disorder; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Organic Psychosis NOS; Symptomatic Psychosis NOS
F10.0 Mental and behavioural disorders due to use of alcohol in MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
acute intoxication
F10.1 Mental and behavioural disorders due to use of MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
alcohol:harmful use
F10.2 Mental and behavioural disorders due to use of alcohol: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
dependency syndrome
alcohol:withdrawal state
withdrawal state with delirium
psychotic disorder
amnesic syndrome
residual and late-onset psychotic disorder
other mental and behavioural disorders
unspecified mental and behavioural disorder
F11.1 Mental and behavioural disorders due to use of opioids: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
harmful use
dependence syndrome
psychotic disorder
cannabinoids: acute intoxication
cannabinoids: psychotic disorder
F13.1 Mental and behavioural disorders due to use of sedatives MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
or hypnotics: harmful use
or hypnotics: dependence syndrome
or hypnotics: withdrawal state
or hypnotics: withdrawal state with delirium
or hypnotics: psychotic disorder
Mental and behavioural disorders due to use of sedatives or hypnotics:

F13.7 residual and late-onset psychotic disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F14.0 Mental and behavioural disorders due to use of cocaine: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
acute intoxication
dependence syndrome
psychotic disorder
amnesic syndrome
F15.0 Mental and behavioural disorders due to use of other MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
stimulants, including caffeine: acute intoxication
stimulants, including caffeine: harmful use
stimulants, including caffeine: dependence syndrome
stimulants, including caffeine: withdrawal state
stimulants, including caffeine: psychotic disorder
Mental and behavioural disorders due to use of other

stimulants, including caffeine: other mental and behavioural disorders
Mental and behavioural disorders due to use of other stimulants,

F15.9 including caffeine: unspecified mental and MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
behavioural disorder
hallucinogens: acute intoxication
hallucinogens: harmful use
hallucinogens: dependence syndrome
hallucinogens: psychotic disorder
F17.2 Mental and behavioural disorders due to use of tobacco: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
dependence syndrome
F17.3 Mental and behavioural disorders due to use of tobacco: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
withdrawal state
F18.0 Mental and behavioural disorders due to use of volatile MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
solvents: acute intoxication
solvents: withdrawal state with delirium
solvents: amnesic syndrome
Mental and behavioural disorders due to multiple drug use and use of
F19.1 other psychoactive substances; misuse of drugs MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
NOS: harmful use
F19.2 other psychoactive substances; misuse of drugs MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
NOS: dependence syndrome
Mental and behavioural disorders due to multiple drug use

F19.3 and use of other psychoactive substances; misuse of drugs NOS: MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
withdrawal state
other psychoactive substances; misuse of drugs
F19.5 NOS: psychotic disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
other psychoactive substances; misuse of drugs NOS: residual and late-
F19.7 onset psychotic disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
other psychoactive substances; misuse of drugs
F19.8 NOS: other mental and behavioural disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
other psychoactive substances; misuse of drugs NOS: unspecified mental
F19.9 and behavioural disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F20.0 Paranoid schizophrenia; Paraphrenic schizophrenia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F20.1 Hebephrenic schizophrenia; Disorganized schizophrenia; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Hebephrenia
Catatonic schizophrenia; Catatonic stupor; Schizophrenic catalepsy;

Schizophrenic catatonia; Schizophrenic
F20.2 flexibilitas cerea MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F20.3 Undifferentiated schizophrenia; Atypical schizophrenia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Residual schizophrenia; Chronic undifferentiated schizophrenia;
F20.5 Restzustand (schizophrenic); Schizophrenic MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
residual state
F20.6 Simple schizophrenia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340

Other schizophrenia; Cenesthopathic schizophrenia;
F20.8 Schizophreniform disorder NOS; Schizophreniform psychosis NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F20.9 Schizophrenia, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340

Schizotypal disorder; Latent schizophrenic reaction; Schizophrenia
borderline; Schizophrenia latent; Schizophrenia prepsychotic;
Schizophrenia prodromal; Schizophrenia pseudoneurotic;
Schizophrenia pseudopsychopathic; Schizotypal personality
F21 disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Delusional disorder; Paranoia; Paranoid psychosis; Paranoid state;

Paraphrenia (late); Sensitiver Beziehungswahn
Other persistent delusional disorders; Delusional

F22.8 dysmorphophobia; Involutional paranoid state; Paranoia querulans MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Acute polymorphic psychotic disorder without symptoms of

schizophrenia; Bouffée délirante without symptoms of schizophrenia or
unspecified; Cycloid psychosis without symptoms of schizophrenia or
F23.0 unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Acute polymorphic psychotic disorder with symptoms of schizophrenia;

Bouffée délirante with symptoms of schizophrenia; Cycloid psychosis with
F23.1 symptoms of schizophrenia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Acute schizophrenia-like psychotic disorder;Acute (undifferentiated)

schizophrenia;Brief schizophreniform disorder; Brief schizophreniform
F23.2 psychosis; Oneirophrenia; Schizophrenic reaction MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Other acute predominantly delusional psychotic disorders; Paranoid

F23.3 reaction; Psychogenic paranoid psychosis MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F23.8 Other acute and transient psychotic disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F23.9 Acute and transient psychotic disorder, unspecified; Brief MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
reactive psychosis NOS; Reactive psychosis
F24 Induced delusional disorder; Folie à deux; Induced paranoid MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
disorder; Induced psychotic disorder
Schizoaffective disorder, manic type; Schizoaffective psychosis, manic
type; Schizophreniform psychosis, manic
F25.0 type MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Schizoaffective disorder, depressive type; Schizoaffective

F25.1 psychosis, depressive type; Schizophreniform psychosis, depressive type MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Schizoaffective disorder, mixed type; Cyclic schizophrenia; Mixed

F25.2 schizophrenic and affective psychosis MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F25.8 Other schizoaffective disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F25.9 Schizoaffective disorder, unspecified; Schizoaffective MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
psychosis NOS
F28 Other nonorganic psychotic disorders; Chronic MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
hallucinatory psychosis
F29 Unspecified nonorganic psychosis; Psychosis NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F30.0 Hypomania MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F30.1 Mania without psychotic symptoms MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Mania with psychotic symptoms; Mania with mood- congruent psychotic
F30.2 symptoms; Mania with mood- MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
incongruent psychotic symptoms; Manic stupor
F30.9 Manic episode, unspecified; Mania NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F31.0 Bipolar affective disorder, current episode hypomanic MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F31.1 Bipolar affective disorder, current episode manic without MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
psychotic symptoms
F31.2 Bipolar affective disorder, current episode manic with MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
psychotic symptoms
F31.3 Bipolar affective disorder, current episode mild or MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
moderate depression
F31.5 Bipolar affective disorder, current episode severe MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
depression with psychotic symptoms
F31.6 Bipolar affective disorder, current episode mixed MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F31.7 Bipolar affective disorder, currently in remission MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F31.8 Other bipolar affective disorders; Bipolar II disorder; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Recurrent manic episodes NOS
F31.9 Bipolar affective disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F32.0 Mild depressive episode MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F32.1 Moderate depressive episode MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Severe depressive episode without psychotic symptoms; [Agitated
depression, Major depression, Vital depression] single episode without
F32.2 psychotic symptoms MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Severe depressive episode with psychotic symptoms; Single episodes of

major depression with psychotic symptoms; Single episodes of
psychogenic depressive psychosis; Single episodes of psychotic
F32.3 depression; Single episodes of reactive depressive psychosis MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F32.8 Other depressive episodes; Atypical depression; Single MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
episodes of "masked" depression NOS
F32.9 Depressive episode, unspecified; Depression NOS; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Depressive disorder NOS
Recurrent depressive disorder, current episode severe without psychotic

symptoms; Endogenous depression without psychotic symptoms; Major
depression, recurrent without psychotic symptoms; Manic-depressive
psychosis, depressed type without psychotic symptoms; Vital depression,
F33.2 recurrent without psychotic symptoms MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Recurrent depressive disorder, current episode severe with psychotic

symptoms including Endogenous depression with psychotic symptoms;
Manic-depressive psychosis, depressed type with psychotic symptoms;
Recurrent severe episodes of major depression with psychotic symptoms;
Recurrent severe episodes of psychogenic depressive psychosis; Recurrent
severe episodes of psychotic depression; Recurrent severe episodes of
reactive depressive psychosis
F33.8 Other recurrent depressive disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F33.9 Recurrent depressive disorder, unspecified; Monopolar MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
depression NOS
F34.0 Cyclothymia; Affective personality disorder; Cycloid MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
personality; Cyclothymic personality
Dysthymia; Depressive neurosis; Depressive personality disorder; Neurotic

depression; Persistent anxiety
F34.1 depression MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F42.1 Predominantly compulsive acts [obsessional rituals] MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F42.2 Mixed obsessional thoughts and acts MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F42.8 Other obsessive-compulsive disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F42.9 Obsessive-compulsive disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Acute stress reaction including Acute crisis reaction; Acute reaction to
stress; Combat fatigue; Crisis state; Psychic
F43.0 shock MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F43.1 Post-traumatic stress disorder; Traumatic neurosis MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F43.2 Adjustment disorders; Culture shock; Grief reaction; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Hospitalism in children
F43.8 Other reactions to severe stress MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F44.0 Dissociative amnesia MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F44.4 Dissociative motor disorders; Psychogenic aphonia; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Psychogenic dysphonia
Other dissociative [conversion] disorders; Ganser's syndrome; Multiple

personality; Psychogenic confusion;
F44.8 Psychogenic twilight state MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F44.9 Dissociative [conversion] disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F45.0 Somatization disorder; Briquet’s disorder; Multiple MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
psychosomatic disorder
F45.1 Undifferentiated somatoform disorder; Undifferentiated MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
psychosomatic disorder
Hypochondriacal disorder; Body dysmorphic disorder;

F45.2 Dysmorphophobia (nondelusional); Hypochondriacal neurosis; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Hypochondriasis; Nosophobia
Somatoform autonomic dysfunction; Cardiac neurosis; Da Costa's

syndrome; Gastric neurosis ; Neurocirculatory asthenia
Psychogenic forms of aerophagy; Psychogenic forms of cough,
Psychogenic forms of diarrhea; Psychogenic forms of dyspepsia;
Psychogenic forms of dysuria; psychogenic forms of flatulence;
Psychogenic forms of hiccough; Psychogenic forms of hyperventilation;
Psychogenic forms of increased frequency of micturition; Psychogenic
forms of irritable bowel syndrome; Psychogenic forms of pylorospasm
Psychogenic urine retention Psychogenic polyuria
Persistent somatoform pain disorder; Psychalgia; Psychogenic backache;

F45.4 Psychogenic headache; Somatoform MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
pain disorder
Other somatoform disorders; Psychogenic dysmenorrhoea; Psychogenic

dysphagia, including "globus hystericus"; Psychogenic pruritus;
F45.8 Psychogenic torticollis; Teeth- grinding MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F45.9 Somatoform disorder, unspecified; Psychosomatic disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
NOS
Other specified neurotic disorders; Dhat syndrome; Occupational neurosis,

including writer's cramp; Psychasthenia; Psychasthenic neurosis;
F48.8 Psychogenic syncope MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F48.9 Neurotic disorder, unspecified; Neurosis NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F50.2 Bulimia nervosa; Bulimia NOS; Hyperorexia nervosa MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Mild mental and behavioural disorders associated with the puerperium,
not elsewhere classified; Depression postnatal
F53.0 NOS; Depression postpartum NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Severe mental and behavioural disorders associated with the puerperium,

not elsewhere classified; Puerperal
F53.1 psychosis NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F53.9 Puerperal mental disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Abuse of non-dependence-producing substances; Abuse of antacids;
Abuse of herbal or folk remedies; Abuse of steroids or hormones; Abuse of
F55 vitamins; Laxative habit MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Unspecified behavioural syndromes associated with physiological

disturbances and physical factors;
F59 Psychogenic physiological dysfunction NOS MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Mild mental retardation; feeble-mindedness; mild mental subnormality

with the statement of no, or minimal,
F70.0 impairment of behaviour MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Severe mental retardation; severe mental subnormality without mention

F72.9 of impairment of behaviour MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F78.1 Other mental retardation with significant impairment of MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
behaviour requiring attention or treatment
F78.8 Other mental retardation with other impairments of MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
behaviour
F78.9 Other mental retardation without mention of impairment MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
of behaviour
Unspecified mental retardation; mental deficiency NOS; mental

F79.8 subnormality NOS with other impairments of MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
behaviour
F80.3 Acquired aphasia with epilepsy [Landau-Kleffner] MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Specific developmental disorder of motor function; Clumsy child
F82 syndrome; Developmental coordination disorder; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Developmental dyspraxia
F84.0 Childhood autism; Autistic disorder; Infantile autism; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Infantile psychosis; Kanner's syndrome
F84.2 Rett's syndrome MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Other childhood disintegrative disorder; Dementia
infantilis; Disintegrative psychosis; Heller's syndrome; Symbiotic psychosis
F84.5 Asperger's syndrome; Autistic psychopathy; Schizoid MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
disorder of childhood
F84.9 Pervasive developmental disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F89 Unspecified disorder of psychological development; MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Developmental disorder NOS
F90.8 Other hyperkinetic disorders MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F92.0 Depressive conduct disorder MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
Nonorganic encopresis; Functional encopresis; Incontinence of faeces of
nonorganic origin; Psychogenic
F98.1 encopresis MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
F99 Mental disorder, not otherwise specified; Mental illness MENTAL AND BEHAVIORAL DISORDERS 7,800 2,340
NOS
Disorders of plasma-protein metabolism, not elsewhere classified; a-1-

E88.0 Antitrypsin deficiency; Bisalbuminaemia METABOLIC DISORDERS 10,700 3,210
E88.1 Lipodystrophy, not elsewhere classified; Lipodystrophy NOS METABOLIC DISORDERS 10,700 3,210
E88.8 Other specified metabolic disorders; Launois-Bensaude METABOLIC DISORDERS 10,700 3,210
adenolipomatosis; Trimethylaminuria
E88.9 Metabolic disorder, unspecified METABOLIC DISORDERS 10,700 3,210

P70.0 Syndrome of infant of mother with gestational diabetes METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
Syndrome of infant of a diabetic mother; Maternal diabetes mellitus (pre-

P70.1 existing) affecting fetus or newborn with METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
hypoglycaemia
P70.2 Neonatal diabetes mellitus METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P70.3 Iatrogenic neonatal hypoglycaemia METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P70.4 Other neonatal hypoglycaemia; Transitory neonatal METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
hypoglycaemia
P70.9 Transitory disorder of carbohydrate metabolism of fetus METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
and newborn, unspecified
P71.0 Cow's milk hypocalcaemia in newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P71.1 Other neonatal hypocalcaemia METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P71.3 Neonatal tetany without calcium or magnesium deficiency; METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
Neonatal tetany NOS
P71.4 Transitory neonatal hypoparathyroidism METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P71.9 Transitory neonatal disorder of calcium and magnesium METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
metabolism, unspecified
P72.0 Neonatal goitre, not elsewhere classified; Transitory METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
congenital goitre with normal function
P72.1 Transitory neonatal hyperthyroidism; neonatal METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
thyrotoxicosis
Other transitory neonatal disorders of thyroid function, not elsewhere
P72.2 classified; Transitory neonatal hypothyroidism METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P72.8 Other specified transitory neonatal endocrine disorders METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P72.9 Transitory neonatal endocrine disorder, unspecified METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.0 Late metabolic acidosis of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.1 Dehydration of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.2 Disturbances of sodium balance of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.4 Other transitory electrolyte disturbances of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.8 Other transitory metabolic disturbances of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P74.9 Transitory metabolic disturbance of newborn, unspecified METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P80.9 Hypothermia of newborn, unspecified METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P81.0 Environmental hyperthermia of newborn METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P81.8 Other specified disturbances of temperature regulation of METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
newborn
P81.9 Disturbance of temperature regulation of newborn, METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
unspecified; Fever of newborn NOS
P83.1 Neonatal erythema toxicum METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
P83.4 Breast engorgement of newborn; Noninfective mastitis of METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
newborn
Other specified conditions of integument specific to fetus and newborn;
P83.8 Bronze baby syndrome; Neonatal METABOLIC DISORDERS OF THE NEWBORN 9,300 2,790
scleroderma; Urticaria neonatorum
Blighted ovum and nonhydatidiform mole; Carneous mole; Fleshy mole;

O02.0 Intrauterine mole NOS; Pathological ovum MISCARRIAGE 5,000 1,500
O02.1 Missed abortion; Early fetal death with retention of dead MISCARRIAGE 5,000 1,500
fetus
O02.8 Other specified abnormal products of conception MISCARRIAGE 5,000 1,500
O02.9 Abnormal product of conception, unspecified MISCARRIAGE 5,000 1,500
O03.4 Spontaneous abortion, incomplete, without complication MISCARRIAGE 5,000 1,500
O03.9 Spontaneous abortion, complete or unspecified, without MISCARRIAGE 5,000 1,500

complication
O05.4 Other abortion, incomplete, without complication MISCARRIAGE 5,000 1,500
O05.9 Other abortion, complete or unspecified, without MISCARRIAGE 5,000 1,500
complication
O06.4 Unspecified abortion or induced abortion NOS, incomplete, MISCARRIAGE 5,000 1,500
without complication
O06.9 Unspecified abortion or induced abortion NOS, complete or MISCARRIAGE 5,000 1,500
unspecified, without complication
Failed medical abortion, complicated by genital tract and pelvic infection
with Endometritis; Oophoritis; Parametritis; Parametritis; Pelvic
peritonitis; Salpingitis; Salpingo- oophoritis; Sepsis; Septic shock;
O07.0 Septicaemia MISCARRIAGE 5,000 1,500
Failed medical abortion with other and unspecified complications with
Shock following abortion and ectopic and molar pregnancy; Circulatory
collapase; Postoperative Shock; Renal failure following abortion and
ectopic and molar pregnancy; Oliguria; Acute Renal failure; Renal
O07.3 shutdown; Renal tubular necrosis; Uraemia MISCARRIAGE 5,000 1,500
O07.4 Failed medical abortion without complication; Failed MISCARRIAGE 5,000 1,500
medical abortion NOS
Other and unspecified failed attempted abortion with other and

unspecified complications with with Shock following abortion and ectopic
and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal
failure following abortion and ectopic and molar pregnancy;
O07.8 Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation MISCARRIAGE 5,000 1,500
O07.9 Other and unspecified failed attempted abortion without MISCARRIAGE 5,000 1,500
complication; Failed attempted abortion NOS
Spontaneous abortion, incomplete, complicated by Genital tract and pelvic

infection with Genital tract and pelvic infection following abortion and
ectopic and molar pregnancy; Endometritis; Oophoritis; Parametritis;
Pelvic peritonitis; Salpingitis; Salpingo-oophoritis and/or Sepsis and/or
O03.0 Septic shock and/or Septicaemia MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, incomplete, complicated Delayed or excessive

haemorrhage with Delayed or excessive haemorrhage following abortion
and ectopic and molar pregnancy; Afibrinogenaemia; Defibrination
O03.1 syndrome; Intravascular coagulation MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, incomplete, complicated by Embolism with

Embolism NOS or Air embolism or Amniotic fluid embolism or Blood-clot
embolism or Pulmonary embolism or Pyaemic embolism or Septic or
O03.2 septicopyaemic embolism or Soap embolism MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, incomplete, with other and unspecified

complications with Shock following abortion and ectopic and molar
pregnancy; Circulatory collapase; Postoperative Shock; Renal failure
following abortion and ectopic and molar pregnancy; Oliguria; Acute Renal
O03.3 failure; Renal shutdown; Renal tubular necrosis; Uraemia MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, complete, complicated by Genital tract and pelvic

infection with Genital tract and pelvic infection following abortion and
ectopic and molar pregnancy; Endometritis; Oophoritis; Parametritis;
Pelvic peritonitis; Salpingitis; Salpingo-oophoritis and/or Sepsis and/or
O03.5 Septic shock and/or Septicaemia MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, complete or unspecified, complicated Delayed or

excessive haemorrhage with Delayed or excessive haemorrhage following
abortion and ectopic and molar pregnancy; Afibrinogenaemia;
O03.6 Defibrination syndrome; Intravascular coagulation MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, complete or unspecified, with other complicated

by Embolism with Embolism following abortion and ectopic and molar
pregnancy; Embolism NOS; Air embolism; Amniotic fluid embolism; Blood-
clot embolism; Pulmonary embolism; Pyaemic embolism
O03.7 MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Spontaneous abortion, complete or unspecified, with other and

unspecified complications with Shock following abortion and ectopic and
molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure
following abortion and ectopic and molar pregnancy
Other abortion, incomplete, complicated by Genital tract and pelvic

infection with Endometritis and/or Oophoritis and/or Parametritis and/or
Pelvic peritonitis and/or Salpingitis and/or Salpingo-oophoritis and/or
Sepsis and/or Septic shock and/or Septicaemia
Other abortion, incomplete, complicated Delayed or excessive

haemorrhage with Delayed or excessive haemorrhage following abortion
and ectopic and molar pregnancy; Afibrinogenaemia; Defibrination
O05.1 syndrome; MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Intravascular coagulation
Other abortion, complete, with other and unspecified complications with

Shock following abortion and ectopic and molar pregnancy; Circulatory
collapase; Postoperative Shock; Renal failure following abortion and
O05.8 ectopic and molar pregnancy; Oliguria Acute MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Unspecified abortion or induced abortion NOS, incomplete, complicated
by Genital tract and pelvic infection with Endometritis and/or Oophoritis
and/or Parametritis and/or Pelvic peritonitis and/or Salpingitis and/or
Salpingo- oophoritis and/or Sepsis and/or Septic shock and/or Septicaemia

Delayed or excessive haemorrhage with Afibrinogenaemia or Defibrination
O06.1 syndrome or Intravascular coagulation MISCARRIAGE WITH COMPLICATIONS 6,900 2,070

by Embolism or Embolism NOS with Air embolism or Amniotic fluid
embolism or Blood-clot embolism or Pulmonary embolism or Pyaemic
embolism or Septic or septicopyaemic embolism or Soap embolism
Unspecified abortion or induced abortion NOS, incomplete, with other and

Unspecified abortion or induced abortion NOS, complete, or unspecified,

complicated by Genital tract and pelvic infection or Endometritis and/or
Oophoritis and/or Parametritis and/or Pelvic peritonitis and/or Salpingitis
and/or Salpingo-oophoritis and/or Sepsis and/or Septic shock and/or
O06.5 Septicaemia MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Unspecified abortion or induced abortion NOS, complete, complicated by

Delayed or excessive haemorrhage or Afibrinogenaemia or Defibrination
O06.6 syndrome or Intravascular coagulation MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Unspecified abortion or induced abortion NOS, complete, complicated by

Embolism or Embolism NOS or Air embolism or Amniotic fluid embolism
or Blood-clot embolism or Pulmonary embolism or Pyaemic embolism or
Septic or septicopyaemic embolism or Soap embolism
Unspecified abortion or induced abortion NOS, complete, with other and

Failed medical abortion complicated by delayed or excessive

haemorrhage; Afibrinogenaemia with Delayed or excessive haemorrhage
following abortion and ectopic and molar pregnancy; Afibrinogenaemia;
Other and unspecified failed attempted abortion complicated by genital

tract and pelvic infection with Endometritis; Oophoritis; Parametritis;
Pelvic peritonitis; Salpingitis; Salpingo-oophoritis; Sepsi; Septic shock;
O07.5 Septicaemia MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Other and unspecified failed attempted abortion complicated by delayed

or excessive haemorrhage with Delayed or excessive haemorrhage
following abortion and ectopic and molar pregnancy; Afibrinogenaemia;
O08.3 Shock following abortion and ectopic and molar pregnancy; MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
Circulatory collapase; Postoperative Shock
Other complications following abortion and ectopic and molar pregnancy;

O08.8 Cardiac arrest; Urinary tract infection MISCARRIAGE WITH COMPLICATIONS 6,900 2,070
M60.0 Infective myositis; Tropical pyomyositis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.00 Infective myositis; Tropical pyomyositis Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.01 Infective myositis; Tropical pyomyositis Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.02 Infective myositis; Tropical pyomyositis Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.05 Infective myositis; Tropical pyomyositis Pelvic region and MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
thigh
M60.06 Infective myositis; Tropical pyomyositis Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.07 Infective myositis; Tropical pyomyositis Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.08 Infective myositis; Tropical pyomyositis Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.09 Infective myositis; Tropical pyomyositis Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.1 Interstitial myositis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.11 Interstitial myositis Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.2 Foreign body granuloma of soft tissue, not elsewhere MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
classified
classified Shoulder region
classified Forearm
classified Ankle and foot
M60.8 Other myositis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.80 Other myositis Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.81 Other myositis Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.88 Other myositis Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.89 Other myositis Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.9 Myositis, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.90 Myositis, unspecified Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.91 Myositis, unspecified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.92 Myositis, unspecified Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.95 Myositis, unspecified Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.96 Myositis, unspecified Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.98 Myositis, unspecified Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M60.99 Myositis, unspecified Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M61.3 Calcification and ossification of muscles associated with MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
burns; Myositis ossificans associated with burns
M61.55 Other ossification of muscle Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M61.59 Other ossification of muscle Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M61.9 Calcification and ossification of muscle, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.0 Diastasis of muscle MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.05 Diastasis of muscle Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.08 Diastasis of muscle Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.1 Other rupture of muscle (nontraumatic) MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.48 Contracture of muscle Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.49 Contracture of muscle Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.56 Muscle wasting and atrophy, not elsewhere classified; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Disuse atrophy NEC Lower leg
M62.59 Muscle wasting and atrophy, not elsewhere classified; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Disuse atrophy NEC Site unspecified
M62.60 Muscle strain Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.61 Muscle strain Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.62 Muscle strain Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.63 Muscle strain Forearm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.65 Muscle strain Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.66 Muscle strain Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.67 Muscle strain Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.68 Muscle strain Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.69 Muscle strain Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.8 Muscle (sheath) hernia MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.80 Muscle (sheath) hernia Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.85 Muscle (sheath) hernia Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.86 Muscle (sheath) hernia Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.88 Muscle (sheath) hernia Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.89 Muscle (sheath) hernia Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.9 Disorder of muscle, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.90 Disorder of muscle, unspecified Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.91 Disorder of muscle, unspecified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.95 Disorder of muscle, unspecified Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.96 Disorder of muscle, unspecified Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.97 Disorder of muscle, unspecified Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.98 Disorder of muscle, unspecified Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M62.99 Disorder of muscle, unspecified Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.0 Abscess of tendon sheath MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.1 Other infective tenosynovitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.13 Other infective (teno)synovitis Forearm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.2 Calcific tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.20 Calcific tendinitis Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.22 Calcific tendinitis Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.25 Calcific tendinitis Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.29 Calcific tendinitis Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.3 Trigger finger;Nodular tendinous disease MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.4 Radial styloid tenosynovitis [de Quervain] MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.8 Other synovitis and tenosynovitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.80 Other synovitis and tenosynovitis Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.84 Other synovitis and tenosynovitis Hand MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.86 Other synovitis and tenosynovitis Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.87 Other synovitis and tenosynovitis Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.89 Other synovitis and tenosynovitis Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.9 Synovitis and tenosynovitis, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.90 Synovitis and tenosynovitis, unspecified Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.91 Synovitis and tenosynovitis, unspecified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.92 Synovitis and tenosynovitis, unspecified Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.93 Synovitis and tenosynovitis, unspecified Forearm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.94 Synovitis and tenosynovitis, unspecified Hand MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.95 Synovitis and tenosynovitis, unspecified Pelvic region and MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
thigh
M65.96 Synovitis and tenosynovitis, unspecified Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.97 Synovitis and tenosynovitis, unspecified Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M65.99 Synovitis and tenosynovitis, unspecified Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M66.0 Rupture of popliteal cyst MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M66.4 Spontaneous rupture of other tendons MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M66.5 Spontaneous rupture of unspecified tendon; Rupture at MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
musculotendinous junction, nontraumatic
M67.0 Short Achilles tendon (acquired) MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.1 Other contracture of tendon (sheath) MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.2 Synovial hypertrophy, not elsewhere classified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.3 Transient synovitis; Toxic synovitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.4 Ganglion; Ganglion of joint or tendon (sheath) MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.8 Other specified disorders of synovium and tendon MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M67.9 Disorder of synovium and tendon, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.0 Chronic crepitant synovitis of hand and wrist MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.1 Bursitis of hand MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.2 Olecranon bursitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.3 Other bursitis of elbow MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.4 Prepatellar bursitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.5 Other bursitis of knee MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.6 Trochanteric bursitis; Trochanteric tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.7 Other bursitis of hip; Ischial bursitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M70.8 Other soft tissue disorders related to use, overuse and MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
pressure
M70.9 Unspecified soft tissue disorder related to use, overuse and MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
pressure
M71.1 Other infective bursitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.2 Synovial cyst of popliteal space [Baker] MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.3 Other bursal cyst; Synovial cyst NOS MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.31 Other bursal cyst; Synovial cyst NOS Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.5 Other bursitis, not elsewhere classified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.51 Other bursitis, not elsewhere classified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.8 Other specified bursopathies MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.9 Bursopathy, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.91 Bursopathy, unspecified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M71.99 Bursopathy, unspecified Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M72.0 Palmar fascial fibromatosis [Dupuytren] MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M72.2 Plantar fascial fibromatosis; Plantar fasciitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M72.5 Fasciitis, not elsewhere classified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M72.88 Other fibroblastic disorders; Abscess of fascia Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M72.9 Fibroblastic disorder, unspecified; Fasciitis NOS; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Fibromatosis NOS
Fibromatosis NOS Other
Fibromatosis NOS Site unspecified
M75.0 Adhesive capsulitis of shoulder; Frozen shoulder; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Periarthritis of shoulder
Rotator cuff syndrome; Rotator cuff or supraspinatus tear or rupture

complete)(incomplete), not specified
M75.1 as traumatic; Supraspinatus syndrome MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.2 Bicipital tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.3 Calcific tendinitis of shoulder; Calcified bursa of shoulder MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.4 Impingement syndrome of shoulder MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.5 Bursitis of shoulder MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.8 Other shoulder lesions MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M75.9 Shoulder lesion, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76 Enthesopathies of lower limb, excluding foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.0 Gluteal tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.1 Psoas tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.3 Iliotibial band syndrome MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.4 Tibial collateral bursitis [Pellegrini-Stieda] MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.5 Patellar tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.6 Achilles tendinitis; Achilles bursitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.7 Peroneal tendinitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M76.8 Other enthesopathies of lower limb, excluding foot; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Anterior tibial syndrome; Posterior tibial tendinitis
M76.9 Enthesopathy of lower limb, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.0 Medial epicondylitis MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.1 Lateral epicondylitis; Tennis elbow MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.3 Calcaneal spur MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.5 Other enthesopathy of foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.8 Other enthesopathies, not elsewhere classified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M77.9 Enthesopathy, unspecified; Bone spur NOS; Capsulitis NOS; MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
Periarthritis NOS; Tendinitis NOS
M79.80 Other specified soft tissue disorders Multiple site MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.81 Other specified soft tissue disorders Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.82 Other specified soft tissue disorders Upper arm MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.84 Other specified soft tissue disorders Hand MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.85 Other specified soft tissue disorders Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.86 Other specified soft tissue disorders Lower leg MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.87 Other specified soft tissue disorders Ankle and foot MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.88 Other specified soft tissue disorders Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.89 Other specified soft tissue disorders Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.91 Soft tissue disorder, unspecified Shoulder region MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.95 Soft tissue disorder, unspecified Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.98 Soft tissue disorder, unspecified Other MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.99 Soft tissue disorder, unspecified Site unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS 6,500 1,950
M79.00 Rheumatism, unspecified Multiple site MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.01 Rheumatism, unspecified Shoulder region MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.02 Rheumatism, unspecified Upper arm MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.05 Rheumatism, unspecified Pelvic region and thigh MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.07 Rheumatism, unspecified Ankle and foot MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.08 Rheumatism, unspecified Other MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.09 Rheumatism, unspecified Site unspecified MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.10 Myalgia Multiple site MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.11 Myalgia Shoulder region MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.12 Myalgia Upper arm MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.15 Myalgia Pelvic region and thigh MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.16 Myalgia Lower leg MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.18 Myalgia Other MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.19 Myalgia Site unspecified MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.20 Neuralgia and neuritis, unspecified Multiple site MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.21 Neuralgia and neuritis, unspecified Shoulder region MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.22 Neuralgia and neuritis, unspecified Upper arm MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.25 Neuralgia and neuritis, unspecified Pelvic region and thigh MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.28 Neuralgia and neuritis, unspecified Other MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.29 Neuralgia and neuritis, unspecified Site unspecified MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M79.39 Panniculitis, unspecified Site unspecified MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
M96.8 Other postprocedural musculoskeletal disorders MYALGIA, NEURALGIA, RHEUMATISM 5,900 1,770
P94.0 Transient neonatal myasthenia gravis MYASTHENIA GRAVIS NEWBORN 11,600 3,480
G70.0 Myasthenia gravis MYOPATHIES 7,900 2,370
G70.2 Congenital and developmental myasthenia MYOPATHIES 7,900 2,370
G70.8 Other specified myoneural disorders MYOPATHIES 7,900 2,370
G70.9 Myoneural disorder, unspecified MYOPATHIES 7,900 2,370
Muscular dystrophy; Muscular dystrophy autosomal recessive, childhood
type, resembling Duchenne or Becker; Muscular dystrophy benign
[Becker]; Muscular dystrophy benign; capuloperoneal with early
contractures [Emery- Dreifuss]; Muscular dystrophy distal; Muscular
dystrophy facioscapulohumeral; Muscular dystrophy limb-girdle; Muscular
dystrophy ocular; Muscular dystrophy oculopharyngeal; Muscular
dystrophy scapuloperoneal; Muscular dystrophy severe [Duchenne]
G71.0 MYOPATHIES 7,900 2,370
Myotonic disorders; Dystrophia myotonica [Steinert]; Myotonia,

chondrodystrophic; Myotonia, drug-induced; Myotonia, symptomatic;
Myotonia, congenita NOS; Myotonia, congenita dominant [Thomsen];
Myotonia, congenital recessive [Becker]; Neuromyotonia [Isaac];
G71.1 Paramyotonia congenita; Pseudomyotonia MYOPATHIES 7,900 2,370
Congenital myopathies; Congenital muscular dystrophy NOS; Congenital

muscular dystrophy with specific morphological abnormalities of the
muscle fibre; Central coreDisease ; Minicore Disease ; MulticoreDisease ;
Fibre- type disproportion; Myopathy myotubular (centronuclear);
G71.2 Myopathy nemaline MYOPATHIES 7,900 2,370
G71.9 Primary disorder of muscle, unspecified; Hereditary MYOPATHIES 7,900 2,370

myopathy NOS
G72.0 Drug-induced myopathy MYOPATHIES 7,900 2,370
G72.1 Alcoholic myopathy MYOPATHIES 7,900 2,370
G72.2 Myopathy due to other toxic agents MYOPATHIES 7,900 2,370
Periodic paralysis; Periodic paralysis (familial) hyperkalaemic; Periodic
paralysis (familial) hypokalaemic; Periodic paralysis (familial) myotonic;
G72.3 Periodic paralysis MYOPATHIES 7,900 2,370
(familial) normokalaemic
G72.4 Inflammatory myopathy, not elsewhere classified MYOPATHIES 7,900 2,370

G72.8 Other specified myopathies MYOPATHIES 7,900 2,370
G72.9 Myopathy, unspecified MYOPATHIES 7,900 2,370
P91.0 Neonatal cerebral ischaemia NEONATAL CEREBRAL ISCHEMIA 25,800 7,740
P00.0 Fetus and newborn affected by maternal hypertensive NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
disorders
P00.1 Fetus and newborn affected by maternal renal and urinary NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
tract diseases
P00.2 Fetus and newborn affected by maternal infectious and NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
parasitic diseases
P00.3 Fetus and newborn affected by other maternal circulatory NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
and respiratory diseases
P00.4 Fetus and newborn affected by maternal nutritional NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
disorders; Maternal nutriotion NOS
P00.5 Fetus and newborn affected by maternal injury NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P00.6 Fetus and newborn affected by surgical procedure on NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
mother
P00.7 Fetus and newborn affected by other medical procedures NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
on mother, not elsewhere classified
Fetus and newborn affected by other maternal conditions; Fetus or

newborn affected by maternal genital tract and other localized infections;
Fetus or newborn affected by maternal systemic lupus erythematosus
P00.8 NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P00.9 Fetus and newborn affected by unspecified maternal NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
condition
P01.0 Fetus and newborn affected by incompetent cervix NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P01.1 Fetus and newborn affected by premature rupture of NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
membranes
P01.2 Fetus and newborn affected by oligohydramnios NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P01.3 Fetus and newborn affected by polyhydramnios; NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Hydramnios
P01.4 Fetus and newborn affected by ectopic pregnancy; NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Abdominal pregnancy
P01.5 Fetus and newborn affected by multiple pregnancy; Triplet NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
pregnance; Twin pregnancy
P01.6 Fetus and newborn affected by maternal death NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by malpresentation before labour; Breech
presentation before labor; External version before labour; Face
presentation before labour; Transverse lie before labour; Unstable lie
P01.7 before labour NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by other maternal complications of

pregnancy; Spontaneous abortion, fetus
P01.8 NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P01.9 Fetus and newborn affected by maternal complication of NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
pregnancy, unspecified
P02.0 Fetus and newborn affected by placenta praevia NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by other forms of placental separation and
haemorrhage; Abruptio placentae; Accidental haemorrhage; Antepartum
haemorrhage; Damage to placenta from amniocentesis, caesarian section
or surgical induction; Maternal blood loss; Premature
P02.1 separation of placenta NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by other and unspecified morphological and

functional abnormalities of placenta; Placental dysfunction; Placental
P02.2 infarction; Placental insufficiency NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by placental transfusion syndromes; Placental

and cord abnormalities resulting in
P02.3 twin-to-twin or other transplacental transfusion NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P02.4 Fetus and newborn affected by prolapsed cord NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by other compression of umbilical cord; Cord
(tightly) around neck; Entanglement of
P02.5 cord; Knot in cord NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P02.6 Fetus and newborn affected by other and unspecified NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
conditions of umbilical cord; Short cord; Vasa praevia
P02.7 Fetus and newborn affected by chorioamnionitis; NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Amnionitis; Membranitis; Placentitis
P02.8 Fetus and newborn affected by other abnormalities of NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
membranes
P02.9 Fetus and newborn affected by abnormality of membranes, NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
unspecified
P03.0 Fetus and newborn affected by breech delivery and NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
extraction
Fetus and newborn affected by other malpresentation, malposition and

disproportion during labour and delivery; Contracted pelvis; Persistent
P03.1 occipitoposterior; Transverse NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
lie
P03.2 Fetus and newborn affected by forceps delivery NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P03.3 Fetus and newborn affected by delivery by vacuum NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
extractor [ventouse]
P03.4 Fetus and newborn affected by caesarean delivery NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P03.5 Fetus and newborn affected by precipitate delivery NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Fetus and newborn affected by abnormal uterine contractions; Fetus and
newborn affected by abnormal Hypertonic lahour; Fetus and newborn
P03.6 affected by abnormal Uterine inertia NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P03.8 Fetus and newborn affected by other specified NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
complications of labour and delivery
P03.9 Fetus and newborn affected by complication of labour and NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
delivery, unspecified
P04.0 Fetus and newborn affected by maternal anaesthesia and NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
analgesia in pregnancy, labour and delivery
P04.1 Fetus and newborn affected by other maternal medication; NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
Cancer chemotherapy; Cytotoxic drugs
P04.2 Fetus and newborn affected by maternal use of tobacco NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P04.3 Fetus and newborn affected by maternal use of alcohol NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
P04.5 Fetus and newborn affected by maternal use of nutritional NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
chemical substances
P04.8 Fetus and newborn affected by other maternal noxious NEONATE AFFECTED BY MATERNAL FACTORS 7,700 2,310
influences
Neoplasm of uncertain or unknown behaviour of Lip, oral cavity and

pharynx; Neoplasm of uncertain or unknown behaviour of Aryepiglottic
fold NOS; Neoplasm of uncertain or unknown behaviour of
hypopharyngeal aspect of Aryepiglottic fold; Neoplasm of uncertain or
unknown behaviour of marginal zone of Aryepiglottic fold; Neoplasm of
uncertain or unknown behaviour of Major and minor salivary glands;
Neoplasm of uncertain or unknown behaviour of Vermilion border of lip
D37.0 NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D37.1 Neoplasm of uncertain or unknown behaviour of Stomach NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D37.2 Neoplasm of uncertain or unknown behaviour of Small NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
intestine
D37.3 Neoplasm of uncertain or unknown behaviour of Appendix NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D37.4 Neoplasm of uncertain or unknown behaviour of Colon NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Rectum; Neoplasm of
D37.5 uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Rectosigmoid junction
Neoplasm of uncertain or unknown behaviour of Liver, gallbladder and

D37.6 bile ducts; Neoplasm of uncertain or NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
unknown behaviour of Ampulla of Vater
Neoplasm of uncertain or unknown behaviour of Other digestive organs;

Neoplasm of uncertain or unknown behaviour of Anal canal; Neoplasm of
uncertain or unknown behaviour of Anal sphincter; Neoplasm of
uncertain or unknown behaviour of Anus NOS; Neoplasm of uncertain or
unknown behaviour of Intestine NOS; Neoplasm of uncertain or unknown
behaviour of Oesophagus; Neoplasm of uncertain or unknown behaviour
D37.7 of Pancreas NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D37.9 Neoplasm of uncertain or unknown behaviour of Digestive NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
organ, unspecified
Neoplasm of uncertain or unknown behaviour of Larynx; Neoplasm of
uncertain or unknown behaviour of laryngeal aspect of Aryepiglottic fold;
Neoplasm of uncertain or unknown behaviour of Suprahyoid portion of
D38.0 Epiglottis NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D38.1 Neoplasm of uncertain or unknown behaviour of Trachea, NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
bronchus and lung
D38.2 Neoplasm of uncertain or unknown behaviour of Pleura NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D38.3 Neoplasm of uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Mediastinum
D38.4 Neoplasm of uncertain or unknown behaviour of Thymus NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Other respiratory organs;

Neoplasm of uncertain or unknown behaviour of Accessory sinuses;
Neoplasm of uncertain or unknown behaviour of Cartilage of nose;
Neoplasm of uncertain or unknown behaviour of Middle ear; Neoplasm of
D38.5 uncertain or unknown behaviour of Nasal cavities NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Respiratory organ, unspecified
D39.0 Neoplasm of uncertain or unknown behaviour of Uterus NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D39.1 Neoplasm of uncertain or unknown behaviour of Ovary NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Placenta;
Chorioadenoma destruens; Invasive Hydatidiform mole; Malignant
D39.2 Hydatidiform mole NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Other female genital

D39.7 organs; Neoplasm of uncertain or unknown NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
behaviour of Skin of female genital organs
D39.9 Neoplasm of uncertain or unknown behaviour of Female NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
genital organ, unspecified
D40.0 Neoplasm of uncertain or unknown behaviour of Prostate NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D40.1 Neoplasm of uncertain or unknown behaviour of Testis NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Other
D40.7 male genital organs; Neoplasm of uncertain or unknown behaviour of Skin NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
of male genital organs
D40.9 Neoplasm of uncertain or unknown behaviour of Male NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
genital organ, unspecified
D41.0 Neoplasm of uncertain or unknown behaviour of Kidney NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D41.1 Neoplasm of uncertain or unknown behaviour of Renal NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
pelvis
D41.2 Neoplasm of uncertain or unknown behaviour of Ureter NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D41.3 Neoplasm of uncertain or unknown behaviour of Urethra NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D41.4 Neoplasm of uncertain or unknown behaviour of Bladder NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D41.9 Neoplasm of uncertain or unknown behaviour of Urinary NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
organ, unspecified
D42.0 Neoplasm of uncertain or unknown behaviour of Cerebral NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
meninges
D42.1 Neoplasm of uncertain or unknown behaviour of Spinal NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
meninges
D42.9 Neoplasm of uncertain or unknown behaviour of Meninges, NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
unspecified
Neoplasm of uncertain or unknown behaviour of Brain, supratentorial;

Neoplasm of uncertain or unknown behaviour of Cerebral ventricle;
Neoplasm of uncertain or unknown behaviour of Cerebrum; Neoplasm of
uncertain or unknown behaviour of Frontal lobe; Neoplasm of uncertain or
unknown behaviour of Occipital lobe; Neoplasm of uncertain or unknown
behaviour of Parietal lobe; Neoplasm of uncertain or unknown behaviour
D43.0 of NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Temporal lobe
Neoplasm of uncertain or unknown behaviour of Brain, infratentorial;

Neoplasm of uncertain or unknown behaviour of Brain stem; Neoplasm of
uncertain or unknown behaviour of Cerebellum; Neoplasm of uncertain
D43.1 or unknown behaviour of Fourth ventricle NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D43.2 Neoplasm of uncertain or unknown behaviour of Brain, NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
unspecified
D43.3 Neoplasm of uncertain or unknown behaviour of Cranial NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
nerves
D43.4 Neoplasm of uncertain or unknown behaviour of Spinal NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
cord
D43.7 Neoplasm of uncertain or unknown behaviour of Other NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
parts of central nervous system
Neoplasm of uncertain or unknown behaviour of Central nervous system,
unspecified; Neoplasm of uncertain or unknown behaviour of Central
D43.9 Nervous system NOS NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D44.0 Neoplasm of uncertain or unknown behaviour of Thyroid NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
gland
D44.1 Neoplasm of uncertain or unknown behaviour of Adrenal NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
gland
Parathyroid gland
D44.3 Neoplasm of uncertain or unknown behaviour of Pituitary NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
gland
Craniopharyngeal duct
D44.5 Neoplasm of uncertain or unknown behaviour of Pineal NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
gland
D44.6 Neoplasm of uncertain or unknown behaviour of Carotid NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
body
D44.7 Neoplasm of uncertain or unknown behaviour of Aortic NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
body and other paraganglia
Neoplasm of uncertain or unknown behaviour of Pluriglandular

D44.8 involvement; Multiple endocrine NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
adenomatosis
D44.9 Neoplasm of uncertain or unknown behaviour of Endocrine NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
gland, unspecified
D45 Polycythaemia vera NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660

D46 Myelodysplastic syndromes NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D46.7 Other myelodysplastic syndromes NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Myelodysplastic syndrome, unspecified; Myelodysplastic
syndrome NOS; Myelodysplasia NOS; Preleukaemia syndrome NOS
Histiocytic and mast cell tumours of uncertain and

D47.0 unknown behaviour; Mast cell tumour NOS; Mastocytoma NOS NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Chronic myeloproliferative disease; Myelofibrosis with myeloid

metaplasia; Myeloproliferative disease, unspecified; Megakaryocytic
D47.1 Myelosclerosis with myeloid metaplasia NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
D47.2 Monoclonal gammopathy NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660

Essential thrombocythaemia; Haemorrhagic
thrombocythaemia; Idiopathic haemorrhagic thrombocythaemia
Other specified neoplasms of uncertain or unknown behaviour of

D47.7 lymphoid, haematopoietic and related tissue NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of lymphoid,

D47.9 haematopoietic and related tissue, unspecified; NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Lymphoproliferative disease NOS
D48.0 Neoplasm of uncertain or unknown behaviour of Bone and NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
articular cartilage
Neoplasm of uncertain or unknown behaviour of Connective and other

soft tissue; Neoplasm of uncertain or unknown behaviour of Connective
tissue of ear; Neoplasm of uncertain or unknown behaviour of eyelid
D48.2 Neoplasm of uncertain or unknown behaviour of Peripheral NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
nerves and autonomic nervous system
Retroperitoneum
Peritoneum
Neoplasm of uncertain or unknown behaviour of Breast; Neoplasm of

uncertain or unknown behaviour of Connective tissue of breast;
D48.6 Cystosarcoma phyllodes NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour of Other specified sites;

Neoplasm of uncertain or unknown behaviour of Eye; Neoplasm of
uncertain or unknown behaviour of Heart; Neoplasm of uncertain or
D48.7 unknown behaviour of Peripheral nerves of orbit NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
Neoplasm of uncertain or unknown behaviour, unspecified; "Growth" NOS

D48.9 ; Neoplasm NOS; NEOPLASMS OF UNKNOWN BEHAVIOR 12,200 3,660
New growth NOS; Tumour NOS
G54.0 Brachial plexus disorders; Thoracic outlet syndrome NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.1 Lumbosacral plexus disorders NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.2 Cervical root disorders, not elsewhere classified NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.3 Thoracic root disorders, not elsewhere classified NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.4 Lumbosacral root disorders, not elsewhere classified NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.5 Neuralgic amyotrophy; Parsonage-Aldren-Turner NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
syndrome; Shoulder-girdle neuritis
G54.8 Other nerve root and plexus disorders NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G54.9 Nerve root and plexus disorder, unspecified NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
G55.8* Nerve root and plexus compressions in other diseases NERVE ROOT AND PLEXUS DISORDERS 7,900 2,370
classified elsewhere
P05.0 Light for gestational age NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
WEIGHT/PRETERM
P05.1 Small for gestational age NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
WEIGHT/PRETERM
P05.2 Fetal malnutrition without mention of light or small for NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
gestational age WEIGHT/PRETERM
P05.9 Slow fetal growth, unspecified; Fetal growth retardation NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
NOS WEIGHT/PRETERM
P07.0 Extremely low birth weight; Birth weight 999 g or less. NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
WEIGHT/PRETERM
P07.1 Other low birth weight; Birth weight 1000-2499 g. NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
WEIGHT/PRETERM
P07.2 Extreme immaturity; Less than 28 completed weeks (less NEWBORN COMPLICATED- LOW BIRTH 16,900 5,070
than 196 completed days) of gestation. WEIGHT/PRETERM
Other preterm infants; 28 completed weeks or more but less than 37 NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM
completed weeks (196 completed days but less than 259 completed days)
P07.3 of gestation; Prematurity NOS 16,900 5,070
P08.0 Exceptionally large baby; Usually implies a birth weight of NEWBORN COMPLICATED-LARGE BABY 7,000 2,100
4500 g or more.
Other heavy for gestational age infants; Other fetus or

infant heavy- or large-for-dates regardless of period of gestation.
P08.1 NEWBORN COMPLICATED-LARGE BABY 7,000 2,100
Post-term infant, not heavy for gestational age; Fetus or infant with
gestation period of 42 completed weeks or more (294 days or
more), not heavy- or large-for-dates; Postmaturity NOS
P08.2 NEWBORN COMPLICATED-POSTTERM 7,500 2,250
P36.0 Sepsis of newborn due to streptococcus, group B NEWBORN SEPSIS 11,700 3,510
P36.1 Sepsis of newborn due to other and unspecified NEWBORN SEPSIS 11,700 3,510
streptococci
P36.2 Sepsis of newborn due to Staphylococcus aureus NEWBORN SEPSIS 11,700 3,510
P36.3 Sepsis of newborn due to other and unspecified NEWBORN SEPSIS 11,700 3,510
staphylococci
P36.4 Sepsis of newborn due to Escherichia coli NEWBORN SEPSIS 11,700 3,510
P36.5 Sepsis of newborn due to anaerobes NEWBORN SEPSIS 11,700 3,510
P36.8 Other bacterial sepsis of newborn NEWBORN SEPSIS 11,700 3,510
Bacterial sepsis of newborn, unspecified Sepsis neonatorum
Septicemia, newborn
P36.9 NEWBORN SEPSIS 11,700 3,510
Other noninflammatory disorders of ovary, fallopian tube NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL
N83.8 and broad ligament; Broad ligament laceration syndrome [Allen-Masters] TRACT 8,500 2,550
N83.9 Noninflammatory disorder of ovary, fallopian tube and NONINFLAMMATORY DISORDERS OF THE FEMALE 8,500 2,550
broad ligament, unspecified GENITAL TRACT
N85.8 Other specified noninflammatory disorders of uterus; NONINFLAMMATORY DISORDERS OF THE FEMALE 8,500 2,550
Atrophy of uterus, acquired; Fibrosis of uterus NOS GENITAL TRACT
N85.9 Noninflammatory disorder of uterus, unspecified; Disorder NONINFLAMMATORY DISORDERS OF THE FEMALE 8,500 2,550
of uterus NOS GENITAL TRACT
E50.0 Vitamin A deficiency with conjunctival xerosis NUTRITIONAL DISORDER 9,200 2,760
E50.1 Vitamin A deficiency with Bitot's spot and conjunctival NUTRITIONAL DISORDER 9,200 2,760
xerosis; Bitot's spot in the young child
Other manifestations of vitamin A deficiency; Follicular keratosis due to

vitamin A deficiency; Xeroderma due to
E50.8 vitamin A deficiency NUTRITIONAL DISORDER 9,200 2,760
E50.9 Vitamin A deficiency, unspecified; Hypovitaminosis A NOS NUTRITIONAL DISORDER 9,200 2,760
E51.1 Dry Beriberi NUTRITIONAL DISORDER 9,200 2,760

E51.2 Wernicke's encephalopathy NUTRITIONAL DISORDER 9,200 2,760
E51.8 Other manifestations of thiamine deficiency NUTRITIONAL DISORDER 9,200 2,760
E51.9 Thiamine deficiency, unspecified NUTRITIONAL DISORDER 9,200 2,760
E53.1 Pyridoxine deficiency; Vitamin B6 deficiency NUTRITIONAL DISORDER 9,200 2,760
Deficiency of other specified B group vitamins; Biotin Deficiency;
Cyanocobalamin Deficiency; Folate Deficiency; Folic acid Deficiency;
E53.8 Pantothenic acid Deficiency; Vitamin B12 Deficiency NUTRITIONAL DISORDER 9,200 2,760
E53.9 Vitamin B deficiency, unspecified NUTRITIONAL DISORDER 9,200 2,760

E54 Ascorbic acid deficiency; Deficiency of vitamin C; Scurvy NUTRITIONAL DISORDER 9,200 2,760
E55.0 Rickets, active; Infantile Osteomalacia; Juvenile NUTRITIONAL DISORDER 9,200 2,760
Osteomalacia
E55.9 Vitamin D deficiency, unspecified; Avitaminosis D NUTRITIONAL DISORDER 9,200 2,760
E56.0 Deficiency of vitamin E NUTRITIONAL DISORDER 9,200 2,760
E56.1 Deficiency of vitamin K NUTRITIONAL DISORDER 9,200 2,760
E56.8 Deficiency of other vitamins NUTRITIONAL DISORDER 9,200 2,760
E56.9 Vitamin deficiency, unspecified NUTRITIONAL DISORDER 9,200 2,760
E58 Dietary calcium deficiency NUTRITIONAL DISORDER 9,200 2,760
E60 Dietary zinc deficiency NUTRITIONAL DISORDER 9,200 2,760
E61.1 Iron deficiency NUTRITIONAL DISORDER 9,200 2,760
E61.2 Magnesium deficiency NUTRITIONAL DISORDER 9,200 2,760
E61.6 Vanadium deficiency NUTRITIONAL DISORDER 9,200 2,760
E61.9 Deficiency of nutrient element, unspecified NUTRITIONAL DISORDER 9,200 2,760
E63.1 Imbalance of constituents of food intake NUTRITIONAL DISORDER 9,200 2,760
E63.8 Other specified nutritional deficiencies NUTRITIONAL DISORDER 9,200 2,760
E63.9 Nutritional deficiency, unspecified NUTRITIONAL DISORDER 9,200 2,760
E64.9 Sequelae of unspecified nutritional deficiency NUTRITIONAL DISORDER 9,200 2,760
E67.0 Hypervitaminosis A NUTRITIONAL DISORDER 9,200 2,760
E67.1 Hypercarotenaemia NUTRITIONAL DISORDER 9,200 2,760
E67.3 Hypervitaminosis D NUTRITIONAL DISORDER 9,200 2,760
Extreme obesity with alveolar hypoventilation; Obesity hypoventilation
syndrome (OHS); Pickwickian syndrome
E66.2 OBESITY HYPOVENTILATION 13,600 4,080
N13.0 Hydronephrosis with ureteropelvic junction obstruction OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.1 Hydronephrosis with ureteral stricture, not elsewhere OBSTRUCTIVE UROPATHIES 9,700 2,910
classified
N13.2 Hydronephrosis with renal and ureteral calculous OBSTRUCTIVE UROPATHIES 9,700 2,910
obstruction
N13.3 Other and unspecified hydronephrosis OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.4 Hydroureter OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.5 Kinking and stricture of ureter without hydronephrosis OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.6 Pyonephrosis; Conditions in N13.0-N13.5 with infection; OBSTRUCTIVE UROPATHIES 9,700 2,910
Obstructive uropathy with infection
Vesicoureteral-reflux-associated uropathy; Vesicoureteral reflux NOS;

N13.7 Vesicoureteral reflux with scarring OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.8 Other obstructive and reflux uropathy OBSTRUCTIVE UROPATHIES 9,700 2,910
N13.9 Obstructive and reflux uropathy, unspecified; Urinary tract OBSTRUCTIVE UROPATHIES 9,700 2,910
obstruction NOS
N45.0 Orchitis, epididymitis and epididymo-orchitis with abscess; ORCHITIS 7,900 2,370
Abscess of epididymis or testis
N45.9 Orchitis, epididymitis and epididymo-orchitis without ORCHITIS 7,900 2,370

abscess; Epididymitis NOS; Orchitis NOS
M86.0 Acute haematogenous osteomyelitis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.1 Other acute osteomyelitis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.15 Other acute osteomyelitis Pelvic region and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.17 Other acute osteomyelitis Ankle and foot OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.19 Other acute osteomyelitis Site unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.2 Subacute osteomyelitis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.29 Subacute osteomyelitis Site unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.4 Chronic osteomyelitis with draining sinus OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.5 Other chronic haematogenous osteomyelitis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.50 Other chronic haematogenous osteomyelitis Multiple site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.6 Other chronic osteomyelitis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900

M86.60 Other chronic osteomyelitis Multiple site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.61 Other chronic osteomyelitis Shoulder region OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.62 Other chronic osteomyelitis Upper arm OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.63 Other chronic osteomyelitis Forearm OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.65 Other chronic osteomyelitis Pelvic region and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.66 Other chronic osteomyelitis Lower leg OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.67 Other chronic osteomyelitis Ankle and foot OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.68 Other chronic osteomyelitis Other OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.69 Other chronic osteomyelitis Site unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.8 Other osteomyelitis; Brodie's abscess OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.80 Other osteomyelitis; Brodie's abscess Multiple site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.81 Other osteomyelitis; Brodie's abscess Shoulder region OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.88 Other osteomyelitis; Brodie's abscess Other OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M86.9 Osteomyelitis, unspecified; Infection of bone NOS; OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
Periostitis NOS
Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without

M86.90 mention of osteomyelitis Multiple site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900

M86.91 mention of osteomyelitis Shoulder OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
region

M86.92 mention of osteomyelitis Upper arm OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
Periostitis without mention of osteomyelitis Hand

mention of osteomyelitis Pelvic region
M86.95 and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
Periostitis without mention of osteomyelitis Lower leg

mention of osteomyelitis Ankle and foot
M86.97 OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
Periostitis without mention of osteomyelitis Other

M86.99 mention of osteomyelitis Site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
unspecified
M87.05 Idiopathic aseptic necrosis of bone Pelvic region and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.2 Osteonecrosis due to previous trauma OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.8 Other osteonecrosis OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.85 Other osteonecrosis Pelvic region and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.86 Other osteonecrosis Lower leg OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.9 Osteonecrosis, unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.90 Osteonecrosis, unspecified Multiple site OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.91 Osteonecrosis, unspecified Shoulder region OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.95 Osteonecrosis, unspecified Pelvic region and thigh OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M87.99 Osteonecrosis, unspecified Site unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M88.0 Paget's disease of skull OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
M88.9 Paget's disease of bone, unspecified OSTEOMYELITIS AND OSTEONECROSIS 13,000 3,900
A31.8 Other mycobacterial infections OTHER BACTERIAL DISEASES 8,900 2,670
Mycobacterial infection, unspecified ; Atypical mycobacterium infection
Not Otherwise Specified; Mycobacteriosis NOS; Listeriosis (listerial
A31.9 foodborne OTHER BACTERIAL DISEASES 8,900 2,670
infection)
A42.0 Pulmonary actinomycosis OTHER BACTERIAL DISEASES 8,900 2,670

A42.1 Abdominal actinomycosis OTHER BACTERIAL DISEASES 8,900 2,670
A42.2 Cervicofacial actinomycosis OTHER BACTERIAL DISEASES 8,900 2,670
A42.7 Actinomycotic septicaemia OTHER BACTERIAL DISEASES 8,900 2,670
A42.8 Other forms of actinomycosis OTHER BACTERIAL DISEASES 8,900 2,670
A42.9 Actinomycosis, unspecified OTHER BACTERIAL DISEASES 8,900 2,670
A43.1 Cutaneous nocardiosis OTHER BACTERIAL DISEASES 8,900 2,670
A43.9 Nocardiosis, unspecified OTHER BACTERIAL DISEASES 8,900 2,670
A44.1 Cutaneous and mucocutaneous bartonellosis; Verruga OTHER BACTERIAL DISEASES 8,900 2,670
peruana
A44.9 Bartonellosis, unspecified OTHER BACTERIAL DISEASES 8,900 2,670

A48.8 Other specified bacterial diseases OTHER BACTERIAL DISEASES 8,900 2,670
A49.0 Staphylococcal infection, unspecified OTHER BACTERIAL DISEASES 8,900 2,670
A49.2 Haemophilus influenzae infection, unspecified OTHER BACTERIAL DISEASES 8,900 2,670
A49.3 Mycoplasma infection, unspecified OTHER BACTERIAL DISEASES 8,900 2,670
Other specified cardia arrhythmias; Brugada syndrome; ont QT syndrome;
Long QT syndrome; coronary sinus rhythm disorder; ectopic shythm
A49.8 disorder; nodal rhythm disorder OTHER BACTERIAL DISEASES 8,900 2,670
A49.9 Bacterial infection, unspecified; Bacteraemia NOS OTHER BACTERIAL DISEASES 8,900 2,670
B20.1 HIV disease resulting in other bacterial infections OTHER BACTERIAL DISEASES 8,900 2,670
M89.0 Algoneurodystrophy; Shoulder-hand syndrome; Sudeck's OTHER BONE DISORDERS 8,800 2,640
atrophy; Sympathetic reflex dystrophy
Algoneurodystrophy; Shoulder-hand syndrome; Sudeck's atrophy;

M89.01 Sympathetic reflex dystrophy Shoulder region OTHER BONE DISORDERS 8,800 2,640
M89.2 Other disorders of bone development and growth OTHER BONE DISORDERS 8,800 2,640
M89.4 Other hypertrophic osteoarthropathy; Marie-Bamberger OTHER BONE DISORDERS 8,800 2,640
disease; Pachydermoperiostosis
M89.48 Other hypertrophic osteoarthropathy; Marie-Bamberger OTHER BONE DISORDERS 8,800 2,640
disease; Pachydermoperiostosis Other
M89.5 Osteolysis OTHER BONE DISORDERS 8,800 2,640
M89.54 Osteolysis Hand OTHER BONE DISORDERS 8,800 2,640
M89.6 Osteopathy after poliomyelitis OTHER BONE DISORDERS 8,800 2,640
Other specified disorders of bone; Infantile cortical hyperostoses; Post-
traumatic subperiosteal ossification
M89.8 OTHER BONE DISORDERS 8,800 2,640

traumatic subperiosteal ossification
M89.85 Pelvic region and thigh OTHER BONE DISORDERS 8,800 2,640
Other specified disorders of bone; Infantile cortical

hyperostoses; Post-traumatic subperiosteal ossification Lower leg
M89.86 OTHER BONE DISORDERS 8,800 2,640

M89.87 traumatic subperiosteal ossification OTHER BONE DISORDERS 8,800 2,640
Ankle and foot

M89.88 hyperostoses; Post-traumatic subperiosteal ossification Other OTHER BONE DISORDERS 8,800 2,640

M89.89 hyperostoses; Post-traumatic subperiosteal ossification Site unspecified OTHER BONE DISORDERS 8,800 2,640
M89.95 Disorder of bone, unspecified Pelvic region and thigh OTHER BONE DISORDERS 8,800 2,640
M89.98 Disorder of bone, unspecified Other OTHER BONE DISORDERS 8,800 2,640
M89.99 Disorder of bone, unspecified Site unspecified OTHER BONE DISORDERS 8,800 2,640
M91.1 Juvenile osteochondrosis of head of femur [LEGG-CALVÉ- OTHER BONE DISORDERS 8,800 2,640
PERTHES]
M91.8 Other juvenile osteochondrosis after reduction of OTHER BONE DISORDERS 8,800 2,640
congenital dislocation of hip
M94.0 Chondrocostal junction syndrome [Tietze] OTHER BONE DISORDERS 8,800 2,640
M94.8 Other specified disorders of cartilage OTHER BONE DISORDERS 8,800 2,640
M99.8 Other biomechanical lesions OTHER BONE DISORDERS 8,800 2,640
M99.9 Biomechanical lesion, unspecified OTHER BONE DISORDERS 8,800 2,640
I65.2 Occlusion and stenosis of carotid artery OTHER CEREBROVASCULAR DISEASES 15,200 4,560
I67.0 Dissection of cerebral arteries, nonruptured OTHER CEREBROVASCULAR DISEASES 15,200 4,560
I67.1 Cerebral aneurysm, nonruptured; Cerebral aneurysm NOS; OTHER CEREBROVASCULAR DISEASES 15,200 4,560
Cerebral arteriovenous fistula, acquired
I67.2 Cerebral atherosclerosis; Atheroma of cerebral arteries OTHER CEREBROVASCULAR DISEASES 15,200 4,560
I67.3 Progressive vascular leukoencephalopathy; Binswanger's OTHER CEREBROVASCULAR DISEASES 15,200 4,560
disease
I67.5 Moyamoya disease OTHER CEREBROVASCULAR DISEASES 15,200 4,560

Nonpyogenic thrombosis of intracranial venous system; Nonpyogenic
I67.6 thrombosis of cerebral vein; Nonpyogenic OTHER CEREBROVASCULAR DISEASES 15,200 4,560
thrombosis of intracrannial venous sinus
I67.7 Cerebral arteritis, not elsewhere classified OTHER CEREBROVASCULAR DISEASES 15,200 4,560
Other specified cerebrovascular diseases; Acute
I67.8 cerebrovascular insufficiency NOS; Chronic Cerebral ischaemia OTHER CEREBROVASCULAR DISEASES 15,200 4,560
I67.9+G46.7* Other lacunar syndrome in unspecified cerebrovascular OTHER CEREBROVASCULAR DISEASES 15,200 4,560
disease
I67.9+G46.8* Other vascular syndrome in unspecified cerebrovascular OTHER CEREBROVASCULAR DISEASES 15,200 4,560
disease
A56.4 Chlamydial infection of pharynx OTHER CHLAMYDIAL DISEASES 8,500 2,550

Active stage of trachoma; Trachomatous Granular
conjunctivitis; Trachomatous follicular conjunctivitis; Trachomatous
A71.1 pannus OTHER CHLAMYDIAL DISEASES 8,500 2,550
A71.9 Trachoma, unspecified OTHER CHLAMYDIAL DISEASES 8,500 2,550

A74.9 Chlamydial infection, unspecified; Chlamydiosis NOS OTHER CHLAMYDIAL DISEASES 8,500 2,550
Q85.1 Tuberous sclerosis; Bourneville's disease; Epiloia OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Congenital malformation syndromes predominantly affecting facial
appearance; Acrocephalopolysyndactyly; Acrocephalosyndactyly [Apert];
Cryptophthalmos syndrome; Cyclopia; Goldenhar Syndrome; Moebius
Syndrome; oro-facial-digital Syndrome; Robin Syndrome;
Q87.0 Whistling face OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Congenital malformation syndromes predominantly associated with short

stature; Aarskog Syndrome; Cockayne Syndrome; De Lange Syndrome ;
Dubowitz Syndrome; Noonan Syndrome; Prader-Willi Syndrome;
Robinow-Silverman-Smith Syndrome ;
Q87.1 Russell-Silver Syndrome; Seckel syndrome; Smith-Lemli- OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Opitz syndrome
Congenital malformation syndromes predominantly involving limbs; Holt-

Oram Syndrome; Klippel-Trénaunay- Weber Syndrome; nail patella
Syndrome;
Rubinstein-Taybi Syndrome; sirenomelia Syndrome; thrombocytopenia
Q87.2 Syndrome with absent radius [TAR]; OTHER CONGENITAL MALFORMATIONS 11,600 3,480
VATER
Congenital malformation syndromes involving early overgrowth;

Beckwith-Wiedemann Syndrome; Sotos;
Q87.3 Syndrome Weaver Syndrome OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Q87.4 Marfan's syndrome OTHER CONGENITAL MALFORMATIONS 11,600 3,480

Other specified congenital malformation syndromes, not
Q87.8 elsewhere classified; Alport Syndrome; Laurence-Moon(- Bardet)-Biedl OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Syndrome; Zellweger Syndrome
Q89.0 Congenital malformations of spleen; Asplenia (congenital); OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Congenital splenomegaly
Q89.1 Congenital malformations of adrenal gland OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Congenital malformations of other endocrine glands; Congenital
malformation of parathyroid or thyroid gland;
Q89.2 Persistent thyroglossal duct; Thyroglossal cyst OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Q89.4 Conjoined twins; Craniopagus; Dicephaly; Double monster; OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Pygopagus; Thoracopagus
Multiple congenital malformations, not elsewhere classified; Monster

NOS; Multiple congenital anomalies
Q89.7 NOS; Multiple congenital deformities NOS OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Q89.8 Other specified congenital malformations OTHER CONGENITAL MALFORMATIONS 11,600 3,480
Q89.9 Congenital malformation, unspecified; Congenital anomaly OTHER CONGENITAL MALFORMATIONS 11,600 3,480
NOS; Congenital deformity NOS
I80.0 Phlebitis and thrombophlebitis of superficial vessels of OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
lower extremities
I80.1 Phlebitis and thrombophlebitis of femoral vein OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I80.2 Phlebitis and thrombophlebitis of other deep vessels of OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
lower extremities; Deep vein thrombosis NOS
Phlebitis and thrombophlebitis of lower extremities, unspecified;

I80.3 Embolism or thrombosis of lower extermity OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
NOS
I80.8 Phlebitis and thrombophlebitis of other sites OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I80.9 Phlebitis and thrombophlebitis of unspecified site OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I81 Portal vein thrombosis; Portal (vein) obstruction OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.0 Budd-Chiari syndrome OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.1 Thrombophlebitis migrans OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.2 Embolism and thrombosis of vena cava OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.3 Embolism and thrombosis of renal vein OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.8 Embolism and thrombosis of other specified veins OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
I82.9 Embolism and thrombosis of unspecified vein; Embolism of OTHER DISORDERS OF CIRCULATORY SYSTEM 12,400 3,720
vein NOS; Thrombosis (vein) NOS
Nondiabetic hypoglycaemic coma; Nondiabetic hypoglycaemic coma;

Drug-induced insulin coma in nondiabetic; Hyperinsulinism with
E15 hypoglycaemic coma; Hypoglycaemic coma NOS OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
E16.0 Drug-induced hypoglycaemia without coma OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
Other hypoglycaemia; Functional nonhyperinsulinaemic hypoglycaemia;
Hyperinsulinism NOS; Functional Hyperinsulinism; Hyperplasia of
pancreatic islet beta cells NOS; Posthypoglycaemic coma encephalopathy
E16.1 OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
Increased secretion of glucagon; Hyperplasia of pancreatic endocrine cells

with glucagon excess; Hyperplasia of pancreatic endocrine cells with
E16.3 glucagon excess OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
E16.4 Abnormal secretion of gastrin; Hypergastrinaemia; Zollinger OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
Ellison syndrome
Other specified disorders of pancreatic internal secretion; Increased
secretion from endocrine pancreas of growth hormone-releasing
hormone; Increased secretion from endocrine pancreas of pancreatic
polypeptide; Increased secretion from endocrine pancreas of
somatostatin; Increased secretion from endocrine pancreas of vasoactive-
E16.8 intestinal polypeptide OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
Disorder of pancreatic internal secretion, unspecified; Islet- cell

E16.9 hyperplasia NOS; Pancreatic endocrine cell hyperplasia OTHER DISORDERS OF GLUCOSE REGULATION 8,100 2,430
NOS
N82.0 Vesicovaginal fistula OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
N83.0 Follicular cyst of ovary; Cyst of graafian follicle; OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
Haemorrhagic follicular cyst of ovary TRACT
N83.3 Acquired atrophy of ovary and fallopian tube OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
N83.6 Haematosalpinx OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340

TRACT
N83.7 Haematoma of broad ligament OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
N85.7 Haematometra; Haematosalpinx with haematometra OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
N89.7 Haematocolpos; Haematocolpos with haematometra or OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
haematosalpinx TRACT
Q51.2 Other doubling of uterus' Doubling of uterus NOS OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
Q51.3 Bicornate uterus OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
Q51.8 Other congenital malformations of uterus and cervix; OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
Hypoplasia of uterus and cervix TRACT
Q52.1 Doubling of vagina; Septate vagina OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
Q52.2 Congenital rectovaginal fistula OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
Q52.3 Imperforate hymen OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
TRACT
Q52.8 Other specified congenital malformations of female OTHER DISORDERS OF THE FEMALE GENITAL 7,800 2,340
genitalia TRACT
N47 Redundant prepuce, phimosis and paraphimosis; Adherent OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
prepuce; Tight foreskin
Other specified disorders of penis; Atrophyof corpus cavernosum and

penis ; Hypertrophy of corpus cavernosum and penis ; Thrombosis of
N48.8 corpus cavernosum and penis OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
N50.0 Atrophy of testis OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Vascular disorders of male genital organs; Haematocele of male genital

organs NOS; Haemorrhage of male genital organs;, Thrombosis of male
N50.1 genital organs OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Other specified disorders of male genital organs; Atrophy of scrotum,

seminal vesicle, spermatic cord, testis [except atrophy], tunica vaginalis
and vas deferens; Hypertrophy of scrotum, seminal vesicle, spermatic
cord, testis [except atrophy], tunica vaginalis and vas deferens; Oedema of
scrotum, seminal vesicle, spermatic cord, testis [except atrophy], tunica
vaginalis and vas deferens; Ulcer of scrotum, seminal vesicle, spermatic
cord, testis [except atrophy], tunica vaginalis and vas deferens; Chylocele,
tunica vaginalis (nonfilarial) NOS; Fistula, urethroscrotal; Stricture of
spermatic cord; Stricture of tunica vaginalis; Stricture of vas deferens
N50.8 OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Q55.0 Absence and aplasia of testis; Monorchism OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Q55.1 Hypoplasia of testis and scrotum; Fusion of testes OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Other congenital malformations of testis and scrotum; Congenital

Q55.2 malformation of testis or scrotum NOS; OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Polyorchism; Retractile testis; Testis migrans
Other congenital malformations of vas deferens, epididymis, seminal

vesicles and prostate; Absence or aplasia of prostate; Absence or aplasia
of spermatic cord; Congenital malformation of vas deferens, epididymis,
seminal vesicles or prostate
Q55.4 NOS OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Other congenital malformations of penis; Congenital malformation of

penis NOS; Curvature of penis (lateral);
Q55.6 Hypoplasia of penis OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Congenital malformation of male genital organ, unspecified; Congenital

anomalyNOS of male genital organ
Q55.9 ; Congenital deformity NOS of male genital organ OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Q56.1 Male pseudohermaphroditism, not elsewhere classified; OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
Male pseudohermaphroditism NOS
Q56.3 Pseudohermaphroditism, unspecified OTHER DISORDERS OF THE MALE GENITAL TRACT 6,400 1,920
G90.0 Idiopathic peripheral autonomic neuropathy; Carotid sinus OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
syncope
G90.1 Familial dysautonomia [Riley-Day] OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G90.2 Horner's syndrome; Bernard(-Horner) syndrome OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G90.3 Multi-system degeneration; Neurogenic orthostatic OTHER DISORDERS OF THE NERVOUS SYSTEM N/A N/A
hypotension [Shy-Drager]
G90.4 Autonomic dysreflexia OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
Disorder of autonomic nervous system, unspecified; acquired
G90.9 hydrocephalus OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
Autonomic neuropathy
G93.0 Cerebral cysts; Arachnoid cyst; Porencephalic cyst, acquired OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G93.2 Benign intracranial hypertension OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G93.3 Postviral fatigue syndrome; Benign myalgic OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
encephalomyelitis
G93.4 Encephalopathy, unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G93.7 Reye's syndrome OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G93.8 Other specified disorders of brain OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G93.9 Disorder of brain, unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G94.8* Other specified disorders of brain in diseases classified OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
elswhere
G95.0 Syringomyelia and syringobulbia OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
Vascular myelopathies; Acute infarction of spinal cord (embolic)
(nonembolic); Arterial thrombosis of spinal cord; Haematomyelia;
Nonpyogenic intraspinal phlebitis and thrombophlebitis; Oedema of spinal
G95.1 cord; Subacute necrotic myelopathy OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G95.2 Cord compression, unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
Other specified diseases of spinal cord; Cord bladder NOS; elopathy drug-
induced; Myelopathy radiation-induced Spinal sclerosis
G95.8 OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G95.9 Disease of spinal cord, unspecified; Myelopathy NOS OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G96.0 Cerebrospinal fluid leak OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
Disorders of meninges, not elsewhere classified; Cerebral Meningeal
G96.1 adhesions; Spinal Meningeal adhesions OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G96.8 Other specified disorders of central nervous system OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G96.9 Disorder of central nervous system, unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
G98 Other disorders of nervous system, not elsewhere OTHER DISORDERS OF THE NERVOUS SYSTEM 15,800 4,740
classified; Nervous system disorder NOS
P90 Convulsions of newborn OTHER DISORDERS OF THE NEWBORN 12,000 3,600

Seizures, newborn
P91.1 Acquired periventricular cysts of newborn OTHER DISORDERS OF THE NEWBORN 12,000 3,600
P91.2 Neonatal cerebral leukomalacia OTHER DISORDERS OF THE NEWBORN 12,000 3,600
P94.1 Congenital hypertonia OTHER DISORDERS OF THE NEWBORN 12,000 3,600
P94.2 Congenital hypotonia; Nonspecific floppy baby syndrome OTHER DISORDERS OF THE NEWBORN 12,000 3,600
P94.9 Disorder of muscle tone of newborn, unspecified OTHER DISORDERS OF THE NEWBORN 12,000 3,600
P96.5 Complications of intrauterine procedures, not elsewhere OTHER DISORDERS OF THE NEWBORN 12,000 3,600
classified
P96.8 Other specified conditions originating in the perinatal OTHER DISORDERS OF THE NEWBORN 12,000 3,600
period
P96.9 Condition originating in the perinatal period, unspecified; OTHER DISORDERS OF THE NEWBORN 12,000 3,600
Congenital debility NOS
E06.0 Acute thyroiditis; Abscess of thyroid; Pyogenic Thyroiditis; OTHER DISORDERS OF THE THYROID 8,500 2,550
Suppurative Thyroiditis
Subacute thyroiditis; de Quervain Thyroiditis; Giant-Cell
E06.1 Thyroiditis; Granulomatous Thyroiditis; Nonsuppurative Thyroiditis OTHER DISORDERS OF THE THYROID 8,500 2,550
E06.2 Chronic thyroiditis with transient thyrotoxicosis OTHER DISORDERS OF THE THYROID 8,500 2,550
Autoimmune thyroiditis; Hashimoto's thyroiditis ; Transient hashitoxicosis;
Lymphadenoid goitre; lymphocytic
E06.3 thyroiditis; Struma lymphomatosa OTHER DISORDERS OF THE THYROID 8,500 2,550
Other chronic thyroiditis; Chronic Thyroiditis NOS; Chronic Fibrous

E06.5 Thyroiditis; Ligneous Thyroiditis; Riedel Thyroiditis OTHER DISORDERS OF THE THYROID 8,500 2,550
E06.9 Thyroiditis, unspecified OTHER DISORDERS OF THE THYROID 8,500 2,550

E07.0 Hypersecretion of calcitonin; C-cell hyperplasia of thyroid; OTHER DISORDERS OF THE THYROID 8,500 2,550
Hypersecretion of thyrocalcitonin
E07.1 Dyshormogenetic goitre; Familial dyshormogenetic goitre; OTHER DISORDERS OF THE THYROID 8,500 2,550
Pendred's syndrome
Other specified disorders of thyroid; Abnormality of thyroid- binding

globulin; Haemorrhage of thyroid; Infarction of
E07.8 thyroid; Sick-euthyroid syndrome OTHER DISORDERS OF THE THYROID 8,500 2,550
E25.9 Adrenogenital disorder, unspecified; Adrenogenital OTHER ENDOCRINE DISORDERS 10,900 3,270
syndrome NOS
E28.8 Other ovarian dysfunction; Ovarian hyperfunction NOS OTHER ENDOCRINE DISORDERS 10,900 3,270
Testicular hypofunction; Defective biosynthesis of testicular androgen
NOS; 5-a-Reductase deficiency (with male pseudohermaphroditism);
E29.1 Testicular hypogonadism NOS OTHER ENDOCRINE DISORDERS 10,900 3,270
E29.9 Testicular dysfunction, unspecified OTHER ENDOCRINE DISORDERS 10,900 3,270

E31.0 Autoimmune polyglandular failure OTHER ENDOCRINE DISORDERS 10,900 3,270
E31.1 Polyglandular hyperfunction OTHER ENDOCRINE DISORDERS 10,900 3,270
E31.9 Polyglandular dysfunction, unspecified OTHER ENDOCRINE DISORDERS 10,900 3,270
E32.0 Persistent hyperplasia of thymus; Hypertrophy of thymus OTHER ENDOCRINE DISORDERS 10,900 3,270
E32.8 Other diseases of thymus OTHER ENDOCRINE DISORDERS 10,900 3,270

E32.9 Disease of thymus, unspecified OTHER ENDOCRINE DISORDERS 10,900 3,270
E34.0 Carcinoid syndrome OTHER ENDOCRINE DISORDERS 10,900 3,270
E34.8 Other specified endocrine disorders; Pineal gland OTHER ENDOCRINE DISORDERS 10,900 3,270
dysfunction; Progeria
E34.9 Endocrine disorder, unspecified; Endocrine Disturbance OTHER ENDOCRINE DISORDERS 10,900 3,270
NOS; Hormone Disturbance NOS
Renal osteodystrophy; Azotaemic osteodystrophy; Phosphate-losing

N25.0 tubular disorders; Renal rickets; Renal OTHER NEPHROPATHY 9,500 2,850
short stature
Other disorders resulting from impaired renal tubular function;

Lightwood-Albright syndrome; Renal tubular acidosis NOS; Secondary
N25.8 hyperparathyroidism of renal origin OTHER NEPHROPATHY 9,500 2,850
N25.9 Disorder resulting from impaired renal tubular function, OTHER NEPHROPATHY 9,500 2,850
unspecified
N28.1 Cyst of kidney, acquired; Multiple cyst of kidney, acquired; OTHER NEPHROPATHY 9,500 2,850
Solitary cyst of kidney, acquired
J92.9 Pleural plaque without asbestos; Pleural plaque NOS; OTHER PLEURAL CONDITIONS 13,500 4,050
Pleural thickening
J94.0 Chylous effusion; Chyliform effusion OTHER PLEURAL CONDITIONS 13,500 4,050
J94.1 Fibrothorax OTHER PLEURAL CONDITIONS 13,500 4,050
J94.8 Other specified pleural conditions; Hydrothorax OTHER PLEURAL CONDITIONS 13,500 4,050
J94.9 Pleural condition, unspecified OTHER PLEURAL CONDITIONS 13,500 4,050
Diseases of bronchus, not elsewhere classified; Broncholithiasis;
Calcification of bronchus; Stenosis of bronchus; Ulcer of bronchus;
J98.0 Tracheobronchial collapse; Tracheobronchial dyskinesia OTHER RESPIRATORY DISORDERS 10,200 3,060
J98.4 Other disorders of lung; Calcification of lung; Acquired OTHER RESPIRATORY DISORDERS 10,200 3,060
cystic lung disease; Lung disease NOS; Pulmolithiasis
Diseases of mediastinum, not elsewhere classified; Fibrosis of

mediastinum; Hernia of mediastinum; Retraction of mediastinum;
J98.5 Mediastinitis of mediastinum OTHER RESPIRATORY DISORDERS 10,200 3,060
J98.6 Disorders of diaphragm; Diaphragmatitis; Paralysis of OTHER RESPIRATORY DISORDERS 10,200 3,060
diaphragm; Relaxation of diaphragm
J98.8 Other specified respiratory disorders OTHER RESPIRATORY DISORDERS 10,200 3,060
J98.9 Respiratory disorder, unspecified; Chronic respiratory OTHER RESPIRATORY DISORDERS 10,200 3,060
disease NOS
A66.9 Yaws, unspecified OTHER SPIROCHAETAL DISEASES 8,800 2,640

Intermediate lesions of pinta; Erythematous plaques of
carate pinta; Hyperchromic lesions of carate pinta; Hyperkeratosis of
A67.1 carate pinta; Pintids of carate pinta OTHER SPIROCHAETAL DISEASES 8,800 2,640
A68.9 Relapsing fever, unspecified OTHER SPIROCHAETAL DISEASES 8,800 2,640

Necrotizing ulcerative stomatitis; Cancrum oris; Fusospirochaetal
gangrene; Noma; Stomatitis gangrenosa
A69.0 OTHER SPIROCHAETAL DISEASES 8,800 2,640
Other Vincent's infections; Fusospirochaetal pharyngitis ; Acute

Necrotizing Ulcerative gingivitis; Acute Necrotizing Ulcerative
Gingivostomatitis; Spirochaetal stomatitis, Trench mouth; Vincent's
A69.1 angina; Vincent’s gingivitis OTHER SPIROCHAETAL DISEASES 8,800 2,640
A69.2 Lyme disease; Erythema chronicum migrans due to Borrelia OTHER SPIROCHAETAL DISEASES 8,800 2,640
burgdorferi
A69.9 Spirochaetal infection, unspecified OTHER SPIROCHAETAL DISEASES 8,800 2,640
H65.0 Acute serous otitis media; Acute and subacute secretory OTITIS MEDIA 7,800 2,340
otitis media
Other acute nonsuppurative otitis media; Acute otitis media; Subacute

otitis media; Acute Mucoid allergic otitis media; Subacute mucoid allergic
otitis media; Acute allergic Sanguinous otitis media; Subacute Sanguinous
allergic otitis media; Acute allergic serous otitis media; Subacute allergic
serous otitis media; Acute nonsuppurative NOS otitis media; Subcute
nonsuppurative NOS otitis media; Acute sanguinous otitis media;
Subacute sanguinous otitis media; Acute seromucinous otitis media;
H65.1 Subacute seromucinous otitis media OTITIS MEDIA 7,800 2,340
H65.2 Chronic serous otitis media; Chronic tubotympanal catarrh OTITIS MEDIA 7,800 2,340
Chronic mucoid otitis media; Glue ear; Otitis media, chronic mucinous;
H65.3 Otitis media, chronic secretory; Otitis media, OTITIS MEDIA 7,800 2,340
chronic transudative
Other chronic nonsuppurative otitis media; Otitis media, chronic allergic;

Otitis media, chronic exudative; Otitis media, chronic nonsuppurative
NOS; Otitis media, chronic seromucinous; Otitis media, chronic with
H65.4 effusion (nonpurulent) OTITIS MEDIA 7,800 2,340
Nonsuppurative otitis media, unspecified; Allergic Otitis media ; Catarrhal

Otitis media; Exudative Otitis media ; Mucoid Otitis media ; Secretory
Otitis media ; Seromucinous otitis media; Serous Otitis media;
Transudative Otitis media; Otitis media with (nonpurulent)
H65.9 effusion OTITIS MEDIA 7,800 2,340
H66.0 Acute suppurative otitis media OTITIS MEDIA 7,800 2,340

Chronic tubotympanic suppurative otitis media; Benign chronic
suppurative otitis media; Chronic tubotympanic
H66.1 disease OTITIS MEDIA 7,800 2,340
H66.2 Chronic atticoantral suppurative otitis media; Chronic OTITIS MEDIA 7,800 2,340
atticoantral disease
H66.3 Other chronic suppurative otitis media; Chronic OTITIS MEDIA 7,800 2,340
suppurative otitis media NOS
H66.4 Suppurative otitis media, unspecified; Purulent otitis media OTITIS MEDIA 7,800 2,340
NOS
H66.9 Otitis media, unspecified; Otitis media NOS; Acute Otitis OTITIS MEDIA 7,800 2,340
media NOS; Chronic Otitis media NOS
B05.3+ H67.1* Otitis media in measles OTITIS MEDIA 7,800 2,340

N83.1 Corpus luteum cyst; Haemorrhagic corpus luteum cyst OVARIAN CYSTS 7,800 2,340
N83.2 Other and unspecified ovarian cysts; Retention cyst of OVARIAN CYSTS 7,900 2,370
ovary; Simple cyst of ovary
N70.0 Acute salpingitis and oophoritis PELVIC INFLAMMATORY DISEASES 9,000 2,700
N70.1 Chronic salpingitis and oophoritis; Hydrosalpinx PELVIC INFLAMMATORY DISEASES 9,000 2,700
N70.9 Salpingitis and oophoritis, unspecified PELVIC INFLAMMATORY DISEASES 9,000 2,700
N71.0 Acute inflammatory disease of uterus PELVIC INFLAMMATORY DISEASES 9,000 2,700
N71.1 Chronic inflammatory disease of uterus PELVIC INFLAMMATORY DISEASES 9,000 2,700
N71.9 Inflammatory disease of uterus, unspecified PELVIC INFLAMMATORY DISEASES 9,000 2,700
Inflammatory disease of cervix uteri; Cervicitis with or without erosion or
ectropion; Endocervicitis with or without erosion or ectropion;
N72 Exocervicitis with or without erosion or ectropion PELVIC INFLAMMATORY DISEASES 9,000 2,700
Acute parametritis and pelvic cellulitis; Acute abcess of broad ligament;

N73.0 Acute abscess of parametrium; Acute PELVIC INFLAMMATORY DISEASES 9,000 2,700
pelvic cellulitis, female
N73.1 Chronic parametritis and pelvic cellulitis PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.2 Unspecified parametritis and pelvic cellulitis PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.3 Female acute pelvic peritonitis PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.4 Female chronic pelvic peritonitis PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.5 Female pelvic peritonitis, unspecified PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.6 Female pelvic peritoneal adhesions PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.8 Other specified female pelvic inflammatory diseases PELVIC INFLAMMATORY DISEASES 9,000 2,700
N73.9 Female pelvic inflammatory disease, unspecified; Female PELVIC INFLAMMATORY DISEASES 9,000 2,700
pelvic infection or inflammation NOS
N74.8* Female pelvic inflammatory disorders in other diseases PELVIC INFLAMMATORY DISEASES 9,000 2,700
Genital tract and pelvic infection following abortion and ectopic and molar
pregnancy; Endometritis; Oophoritis; Parametritis; Pelvic peritonitis;
O08.0 Salpingitis; Salpingo- oophoritis; Sepsis; Septic shock; Septicaemia PELVIC INFLAMMATORY DISEASES 9,000 2,700
N94.0 Mittelschmerz PELVIC PAIN 4,800 1,440

N94.1 Dyspareunia PELVIC PAIN 4,800 1,440
N94.2 Vaginismus PELVIC PAIN 4,800 1,440
N94.3 Premenstrual tension syndrome PELVIC PAIN 4,800 1,440
N94.4 Primary dysmenorrhoea PELVIC PAIN 4,800 1,440
N94.5 Secondary dysmenorrhoea PELVIC PAIN 4,800 1,440
N94.6 Dysmenorrhoea, unspecified PELVIC PAIN 4,800 1,440
Gastric ulcer, acute / Acute erosion of stomach/ Pylorus peptic ulcer /
Stomach peptic ulcer with hemorrhage
K25.0 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
Gastric ulcer, acute/ Acute erosion of stomach/ Pylorus peptic ulcer /

Stomach peptic ulcer with perforation

K25.2 Stomach peptic ulcer with both haemorrhage PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
and perforation

K25.4 Stomach peptic ulcer, chronic or unspecified PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
with haemorrhage

K25.5 Stomach peptic ulcer, chronic or unspecified PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
with perforation

Stomach peptic ulcer, chronic or unspecified
K25.6 with both haemorrhage and perforation PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
Duodenal ulcer, acute / Acute erosion of duodenum/ Duodenal peptic

ulcer/ Postpyloric peptic ulcer with
K26.0 haemorrhage PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
Duodenal ulcer, acute / Acute erosion of duodenum/ Duodenal peptic

ulcer/ Postpyloric peptic ulcer with
K26.1 perforation PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
K26.4 Chronic Duodenal/ Postpyloric ulcer/ erosion, or PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
unspecified with haemorrhage
unspecified with perforation
unspecified with both haemorrhage and perforation
K27.0 Acute Peptic ulcer/ Gastroduodenal ulcer NOS, site PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
unspecified, with haemorrhage
K27.1 Acute Peptic ulcer / Gastroduodenal ulcer, site unspecified, PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
with perforation
K27.2 Acute Peptic/ Gastroduodenal ulcer, site unspecified, with PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
both haemorrhage and perforation
K27.4 Chronic or unspecified Peptic/ Gastroduodenal ulcer, site PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
unspecified, with haemorrhage
K27.5 Chronic or unspecified Peptic/ Gastroduodenal ulcer, site PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
unspecified with perforation
Chronic or unspecified Peptic/ Gastroduodenal ulcer, site unspecified, with

K27.6 both haemorrhage and perforation PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/

Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or
erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or
erosion/ Marginal peptic ulcer or erosion/ Stomal peptic ulcer or erosion


Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or

erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer
or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or
erosion/ Marginal peptic ulcer or erosion/ Stomal peptic ulcer or
K28.4 erosion PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840

K28.5 erosion PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840

K29.0 Acute haemorrhagic gastritis; Acute erosive gastritis with PEPTIC ULCER DISEASE WITH HEMORRHAGE 12,800 3,840
haemorrhage

K25.3 Stomach peptic ulcer without haemorrhage PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
or perforation
K25.7 Gastric/ Peptic/ Pyloric ulcer/ erosion, chronic without PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
haemorrhage or perforation
K25.9 Gastric/ Peptic/ Pyloric ulcer/ erosion, unspecified as acute PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
or chronic, without haemorrhage or perforation
Duodenal ulcer, acute / Acute erosion of duodenum/

Duodenal peptic ulcer/ Postpyloric peptic ulcer without haemorrhage or
K26.3 perforation PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K26.7 Chronic Duodenal/ Postpyloric ulcer/ erosion, without PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
haemorrhage or perforation
K26.9 Duodenal/ Postpyloric ulcer/ erosion, unspecified as acute PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
or chronic, without haemorrhage or perforation
Acute Peptic/ Gastroduodenal ulcer, site unspecified, without

haemorrhage or perforation; gastroduodenal ulcer
K27.3 NOS; Peptic ulcer NOS PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
Chronic Peptic/ Gastroduodenal ulcer, site unspecified, without

K27.7 haemorrhage or perforation; gastroduodenal ulcer PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
NOS; Peptic ulcer NOS
Peptic/ Gastroduodenal ulcer, unspecified as acute or chronic, without

K27.9 haemorrhage or perforation; PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
gastroduodenal ulcer NOS; Peptic ulcer NOS
Chronic Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/

K28.7 erosion PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
Unspecified as acute or chronic Gastrojejunal ulcer/ Anastomotic peptic

ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal
peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal
peptic ulcer or erosion/ Marginal peptic ulcer or erosion; Stomal peptic
K28.9 ulcer or erosion PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.1 Other acute gastritis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.2 Alcoholic gastritis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.3 Chronic superficial gastritis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.4 Chronic atrophic gastritis; Gastric atrophy PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.5 Chronic gastritis, unspecified; Chronic Antral gastritis; PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
Chronic Fundal gastritis
K29.6 Other gastritis; Giant hypertrophic gastritis; Granulomatous PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
gastritis; Menetrier's disease
K29.7 Gastritis, unspecified PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.8 Duodenitis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
K29.9 Gastroduodenitis, unspecified PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6,100 1,830
P23.0 Congenital pneumonia due to viral agent PERINATAL INFECTIONS 12,700 3,810
P23.1 Congenital pneumonia due to Chlamydia PERINATAL INFECTIONS 12,700 3,810
P23.2 Congenital pneumonia due to staphylococcus PERINATAL INFECTIONS 12,700 3,810
P23.3 Congenital pneumonia due to streptococcus, group B PERINATAL INFECTIONS 12,700 3,810
P23.4 Congenital pneumonia due to Escherichia coli PERINATAL INFECTIONS 12,700 3,810
P23.5 Congenital pneumonia due to Pseudomonas PERINATAL INFECTIONS 12,700 3,810
Congenital pneumonia due to other bacterial agents; Haemophilus
P23.6 influenzae; Klebsiella pneumonia; PERINATAL INFECTIONS 12,700 3,810
Mycoplasma; Streptococcus, except group B
P23.9 Congenital pneumonia, unspecified PERINATAL INFECTIONS 12,700 3,810

P35.0 Congenital rubella syndrome; Congenital rubella PERINATAL INFECTIONS 12,700 3,810
pneumonitis
P35.1 Congenital cytomegalovirus infection PERINATAL INFECTIONS 12,700 3,810

P35.2 Congenital herpesviral [herpes simplex] infection PERINATAL INFECTIONS 12,700 3,810
P35.3 Congenital viral hepatitis PERINATAL INFECTIONS 12,700 3,810
P35.8 Other congenital viral diseases; Congenital varicella PERINATAL INFECTIONS 12,700 3,810
[chickenpox]
P35.9 Congenital viral disease, unspecified PERINATAL INFECTIONS 12,700 3,810

P37.0 Congenital tuberculosis PERINATAL INFECTIONS 12,700 3,810
P37.1 Congenital toxoplasmosis; Hydrocephalus due to congenital PERINATAL INFECTIONS 12,700 3,810
toxoplasmosis
P37.3 Congenital falciparum malaria PERINATAL INFECTIONS 12,700 3,810

P37.5 Neonatal candidiasis PERINATAL INFECTIONS 12,700 3,810
P37.8 Other specified congenital infectious and parasitic diseases PERINATAL INFECTIONS 12,700 3,810
P37.9 Congenital infectious and parasitic disease, unspecified PERINATAL INFECTIONS 12,700 3,810
P38 Omphalitis of newborn with or without mild haemorrhage PERINATAL INFECTIONS 12,700 3,810
P39.0 Neonatal infective mastitis PERINATAL INFECTIONS 12,700 3,810

P39.1 Neonatal conjunctivitis and dacryocystitis; Neonatal PERINATAL INFECTIONS 12,700 3,810
chlaydial conjunctivitis; Ophthalmia neonatorum NOS
P39.2 Intra-amniotic infection of fetus, not elsewhere classified PERINATAL INFECTIONS 12,700 3,810
P39.3 Neonatal urinary tract infection PERINATAL INFECTIONS 12,700 3,810

P39.4 Neonatal skin infection; Neonatal pyoderma PERINATAL INFECTIONS 12,700 3,810
P39.8 Other specified infections specific to the perinatal period PERINATAL INFECTIONS 12,700 3,810
P39.9 Infection specific to the perinatal period, unspecified PERINATAL INFECTIONS 12,700 3,810
Peritoneal adhesions; Adhesions of abdominal wall; Adhesions of
diaphragm; Adhesions of intestine; Adhesions of male pelvis; Mesenteric
Adhesions; Adhesions of omentum; Adhesions of stomach; Adhesive
K66.0 bands PERITONEAL DISORDERS 10,800 3,240
K66.8 Other specified disorders of peritoneum PERITONEAL DISORDERS 10,800 3,240

K66.9 Disorder of peritoneum, unspecified PERITONEAL DISORDERS 10,800 3,240
Acute peritonitis; Abdominopelvic abscess; Mesenteric abscess; Abscess
of omentum; Abscess of peritoneum; Retrocaecal abscess; Retroperitoneal
abscess; Subdiaphragmatic abscess; Subhepatic abscess; Subphrenic
abscess; Acute Generalized peritonitis; Acute male pelvic peritonitis; Acute
K65.0 subphrenic peritonitis; Acute suppurative PERITONITIS 14,700 4,410
peritonitis
Other peritonitis; Chronic proliferative peritonitis;

K65.8 Mesentric fat necrosis; Mesentric saponification; Peritonitis due to bile; PERITONITIS 14,700 4,410
Peritonitis due to urine
K65.9 Peritonitis, unspecified PERITONITIS 14,700 4,410

Other phakomatoses, not elsewhere classified; Peutz- Jeghers Syndrome;
Q85.8 Sturge-Weber(-Dimitri)Syndrome; von PHAKOMATOSES 10,800 3,240
Hippel-Lindau Syndrome
Q85.9 Phakomatosis, unspecified; Hamartosis NOS PHAKOMATOSES 10,800 3,240

J90 Pleural effusion, not elsewhere classified; Pleurisy with PLEURAL EFFUSION 14,200 4,260
effusion
J91* Pleural effusion in conditions classified elsewhere PLEURAL EFFUSION 14,200 4,260
B20.6 HIV disease resulting in pneumocystis carinii pneumonia PNEUMONIA HIGH RISK 32,000 9,600
J12.03 Adenoviral pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J12.13 Respiratory syncytial virus pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J12.23 Parainfluenza virus pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J12.33 Human metapneumovirus pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J12.93 Viral pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J13.3 Pneumonia [bronchopneumonia]due to Streptococcus PNEUMONIA HIGH RISK 32,000 9,600
pneumoniae, high risk
J14.3 Pneumonia [bronchopneumonia] due to Haemophilus PNEUMONIA HIGH RISK 32,000 9,600
influenzae, high risk
J15.03 Pneumonia due to Klebsiella pneumoniae, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.13 Pneumonia due to Pseudomonas, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.23 Pneumonia due to staphylococcus, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.33 Pneumonia due to streptococcus, group B, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.43 Pneumonia due to other streptococci, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.53 Pneumonia due to Escherichia coli, high risk PNEUMONIA HIGH RISK 32,000 9,600
Pneumonia due to other aerobic Gram-negative bacteria; Pneumonia due
to Serratia marcescens, high risk
J15.63 PNEUMONIA HIGH RISK 32,000 9,600
J15.73 Pneumonia due to Mycoplasma pneumoniae, high risk PNEUMONIA HIGH RISK 32,000 9,600
J15.93 Bacterial pneumonia [bronchopneumonia], high risk PNEUMONIA HIGH RISK 32,000 9,600
J16.03 Chlamydial pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J18.03 Bronchopneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J18.13 Lobar pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
J18.23 Hypostatic pneumonia, high risk PNEUMONIA HIGH RISK 32,000 9,600
Community-acquired pneumonia IV
(This classification utilized the American Thoracic Society
recommendation. This is equivalent to CAP, high risk in the Philippine
Clinical Practice Guidelines on the Diagnosis, Empiric Management, and
Prevention of Community- acquired Pneumonia in Immunocompetent
Adults, 2010 update)
Adult high risk Community Acquired Pneumonia (CAP), organism is not
J18.93 specified PNEUMONIA HIGH RISK 32,000 9,600
Pedia Community Acquired Pneumonia D (PCAP-D) high
risk, organism is not specified
J18.99, Y95 Nosocomial pneumonia PNEUMONIA HIGH RISK 32,000 9,600

Health care associated pneumonia
A01.0+ J17.0* Pneumonia in typhoid fever PNEUMONIA MODERATE RISK 15,000 4,500
A02.2+ J17.0* Pneumonia in salmonella infection PNEUMONIA MODERATE RISK 15,000 4,500
A21.2+ J17.0* Pneumonia in tularemia PNEUMONIA MODERATE RISK 15,000 4,500
A22.1+ J17.0* Pneumonia in anthrax PNEUMONIA MODERATE RISK 15,000 4,500
Pulmonary mycobacterial infection; Infection due to Mycobacterium
avium, Mycobacterium intracellulare
A31.0 [Battey bacillus]; Mycobacterium kansasii PNEUMONIA MODERATE RISK 15,000 4,500
A37.0+ J17.0* Pneumonia in whooping cough due to Bordatella pertusis PNEUMONIA MODERATE RISK 15,000 4,500
A37.1+ J17.0* Pneumonia in whooping cough due to Bordatella PNEUMONIA MODERATE RISK 15,000 4,500
parapertusis
A37.8+ J17.0* Pneumonia in whooping cough due to Bordatella species PNEUMONIA MODERATE RISK 15,000 4,500
other than pertusis or parapertusis
A37.9+ J17.0* Pneumonia in whooping cough PNEUMONIA MODERATE RISK 15,000 4,500
A42.0+ J17.0* Pneumonia in actinomycoses PNEUMONIA MODERATE RISK 15,000 4,500
A48.1 Legionnaires' disease PNEUMONIA MODERATE RISK 15,000 4,500
A43.0+ J17.0* Pneumonia in nocardiosis PNEUMONIA MODERATE RISK 15,000 4,500
A54.8+ J17.0* Pneumonia in gonorrhea PNEUMONIA MODERATE RISK 15,000 4,500
A69.8+ J17.8* Pneumonia in spirochaetal PNEUMONIA MODERATE RISK 15,000 4,500
A70+ J17.8* Pneumonia in ornithosis PNEUMONIA MODERATE RISK 15,000 4,500
A78+ J17.8* Pneumonia in Q fever PNEUMONIA MODERATE RISK 15,000 4,500
B01.2+ J17.1* Pneumonia in varicella PNEUMONIA MODERATE RISK 15,000 4,500
B05.2+ J17.1* Pneumonia in measles PNEUMONIA MODERATE RISK 15,000 4,500
B06.8+ J17.1* Pneumonia in rubella PNEUMONIA MODERATE RISK 15,000 4,500
B25.0+ J17.1* Pneumonia in cytomegalovirus disease PNEUMONIA MODERATE RISK 15,000 4,500
B37.1+ J17.2* Pneumonia in candidiasis PNEUMONIA MODERATE RISK 15,000 4,500
B38.0+ J17.2* Pneumonia in acute pulmonary coccidiomycosis PNEUMONIA MODERATE RISK 15,000 4,500
B38.1+ J17.2* Pneumonia in chronic pulmonary coccidiomycosis PNEUMONIA MODERATE RISK 15,000 4,500
B38.2+ J17.2* Pneumonia in pulmonary coccidioidomycosis PNEUMONIA MODERATE RISK 15,000 4,500
B39.0+ J17.2* Pneumonia in acute pulmonary histoplasmosis capsulati PNEUMONIA MODERATE RISK 15,000 4,500
B39.1+ J17.2* Pneumonia in chronic pulmonary histoplasmosis capsulati PNEUMONIA MODERATE RISK 15,000 4,500
B39.2+ J17.2* Pneumonia in pulmonary histoplasmosis capsulati PNEUMONIA MODERATE RISK 15,000 4,500
B39.9+ J17.2* Pneumonia in histoplasmosis PNEUMONIA MODERATE RISK 15,000 4,500
B44.0+ J17.2* Pneumonia in invasive pulmonary aspergillosis PNEUMONIA MODERATE RISK 15,000 4,500
B44.1+ J17.2* Pneumonia in other pulmonary aspergillosis PNEUMONIA MODERATE RISK 15,000 4,500
B58.3+ J17.3* Pneumonia in taxoplasmosis PNEUMONIA MODERATE RISK 15,000 4,500
B65.0+ J17.3* Pneumonia in schistosomiasis due to Schistosoma PNEUMONIA MODERATE RISK 15,000 4,500
hematobium
B65.1+ J17.3* Pneumonia in schistosomiasis due to Schistosoma mansoni PNEUMONIA MODERATE RISK 15,000 4,500
japonicum
intercalatum; mattheei; mekongi
B65.9+ J17.3* Pneumonia in schistosomiasis PNEUMONIA MODERATE RISK 15,000 4,500

B77.8+ J17.3* Pneumonia in ascariasis PNEUMONIA MODERATE RISK 15,000 4,500
I00+ J17.8* Pneumonia in rheumatic fever PNEUMONIA MODERATE RISK 15,000 4,500
J12.02 Adenoviral pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J12.12 Respiratory syncytial virus pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J12.22 Parainfluenza virus pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J12.32 Human metapneumovirus pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J12.92 Viral pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J13.2 Pneumonia [bronchopneumonia] due to Streptococcus PNEUMONIA MODERATE RISK 15,000 4,500
pneumoniae, moderate risk
J14.2 Pneumonia [bronchopneumonia]due to Haemophilus PNEUMONIA MODERATE RISK 15,000 4,500

influenzae, moderate risk
J15.02 Pneumonia due to Klebsiella pneumoniae, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.12 Pneumonia due to Pseudomonas, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.22 Pneumonia due to staphylococcus, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.32 Pneumonia due to streptococcus, group B, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.42 Pneumonia due to other streptococci, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.52 Pneumonia due to Escherichia coli, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
Pneumonia due to other aerobic Gram-negative bacteria; Pneumonia due
J15.62 to Serratia marcescens, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J15.72 Pneumonia due to Mycoplasma pneumoniae, moderate PNEUMONIA MODERATE RISK 15,000 4,500
risk
J15.92 Bacterial pneumonia [bronchopneumonia], moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J16.02 Chlamydial pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J18.02 Bronchopneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J18.12 Lobar pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
J18.22 Hypostatic pneumonia, moderate risk PNEUMONIA MODERATE RISK 15,000 4,500
Community-acquired pneumonia III
(This classification utilized the American Thoracic Society
recommendation. This is equivalent to CAP, moderate risk in the
Philippine Clinical Practice Guidelines on the Diagnosis, Empiric
Management, and Prevention of Community- acquired Pneumonia in
Immunocompetent Adults, 2010 update)
Adult moderate risk Community Acquired Pneumonia (CAP), organism is
J18.92 not specified PNEUMONIA MODERATE RISK 15,000 4,500
Pedia Community Acquired Pneumonia C (PCAP-C)
moderate risk, organism is not specified
J93.0 Spontaneous tension pneumothorax PNEUMOTHORAX 15,300 4,590

J93.1 Other spontaneous pneumothorax PNEUMOTHORAX 15,300 4,590
Spontaneous pneumothorax
J93.8 Other pneumothorax PNEUMOTHORAX 15,300 4,590

J93.9 Pneumothorax, unspecified PNEUMOTHORAX 15,300 4,590
T40.2 Poisoning by Otheropioids; Poisoning by Codeine; POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Poisoning by Morphine AFFECTING THE NERVOUS SYSTEM
T40.4 Poisoning by Other synthetic narcotics; Poisoning by POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Pethidine AFFECTING THE NERVOUS SYSTEM
T40.6 Poisoning by Other and unspecified narcotics POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
AFFECTING THE NERVOUS SYSTEM
T40.7 Poisoning by Cannabis (derivatives) POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Poisoning by Other and unspecified psychodysleptics [hallucinogens]; POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
T40.9 Poisoning by Mescaline; Poisoning by THE NERVOUS SYSTEM 6,700 2,010
Psilocin; Poisoning by Psilocybine
T41.0 Poisoning by Inhaled anaesthetics POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T41.1 Poisoning by Intravenous anaesthetics; Thiobarbiturates POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T41.3 Poisoning by Local anaesthetics POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T41.5 Poisoning by Therapeutic gases; Carbon dioxide; Oxygen POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T42.0 Poisoning by Hydantoin derivatives POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T42.1 Poisoning by Iminostilbenes; Carbamazepine POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T42.2 Poisoning by Succinimides and oxazolidinediones POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T42.3 Poisoning by Barbiturates POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T42.4 Poisoning by Benzodiazepines POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Poisoning by Other antiepileptic and sedative- POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
hypnoticdrugs; Poisoning by Methaqualone;Poisoning by Valproic acid THE NERVOUS SYSTEM
T42.6 6,700 2,010
Poisoning by Antiepileptic and sedative-hypnotic drugs, unspecified; POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
Poisoning by Draught sleeping NOS; Poisoning by Sleeping drug THE NERVOUS SYSTEM
T42.7 NOS;Poisoning by Sleeping tablet NOS 6,700 2,010
T42.8 Poisoning by Antiparkinsonism drugs and other central POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
muscle-tone depressants; Poisoning by Amantadine AFFECTING THE NERVOUS SYSTEM
T43.2 Poisoning by Other and unspecified antidepressants POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T43.3 Poisoning by Phenothiazine antipsychotics and neuroleptics POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T43.4 Poisoning by Butyrophenone and thioxanthene POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
neuroleptics AFFECTING THE NERVOUS SYSTEM
T43.5 Poisoning by Other and unspecified antipsychotics and POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
neuroleptics AFFECTING THE NERVOUS SYSTEM
T43.6 Poisoning by Psychostimulants with abuse potential POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T43.9 Poisoning by Psychotropic drug, unspecified POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T44.1 Poisoning by Other parasympathomimetics [cholinergics] POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T44.2 Poisoning by Ganglionic blocking drugs, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
classified AFFECTING THE NERVOUS SYSTEM
Poisoning by Other parasympatholytics [anticholinergics and POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
antimuscarinics] and spasmolytics, not elsewhere classified; Poisoning THE NERVOUS SYSTEM
T44.3 byPapaverine 6,700 2,010
Poisoning by Predominantly α-adrenoreceptor agonists, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
T44.4 classified; Poisoning by Metaraminol THE NERVOUS SYSTEM 6,700 2,010
T44.5 Poisoning by Predominantly ß-adrenoreceptor agonists, not POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
elsewhere classified AFFECTING THE NERVOUS SYSTEM
T44.6 Poisoning by α-Adrenoreceptor antagonists, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T44.7 Poisoning by ß-Adrenoreceptor antagonists, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Poisoning by Other and unspecified drugs primarily POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
T44.9 affecting the autonomic nervous system; Drug stimulating both α-and ß- THE NERVOUS SYSTEM 6,700 2,010
adrenoreceptors
T45.0 Poisoning by Antiallergic and antiemetic drugs POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Poisoning by Antineoplastic and immunosuppressive drugs; Poisoning by POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
Antineoplastic antibiotics; Poisoning by THE NERVOUS SYSTEM
T45.1 Cytarabine 6,700 2,010
T45.2 Poisoning by Vitamins, not elsewhere classified POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T45.3 Poisoning by Enzymes, not elsewhere classified POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
T50.7 Poisoning by Analeptics and opioid receptor antagonists POISONING CAUSED BY ANESTHETICS AND DRUGS 6,700 2,010
Drugs, medicaments and biological substances causing adverse effects in POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
therapeutic THE NERVOUS SYSTEM
Y46.2 use: Hydantoin derivatives 6,700 2,010
Y46.6 therapeutic THE NERVOUS SYSTEM 6,700 2,010
use: Other and unspecified antiepileptics
use: Barbiturates, not elsewhere classified
use: Benzodiazepines
Drugs, medicaments and biological substances causing adverse effects in

therapeutic
use: Sedative, hypnotic and antianxiety drug, unspecified;sleeping draught POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
Y47.9 NOS;sleeping drug THE NERVOUS SYSTEM 6,700 2,010
NOS;sleeping tablet NOS
use: Other antipsychotics and neuroleptics
use: Psychodysleptics [hallucinogens]

therapeutic
use: Other parasympatholytics [anticholinergics and antimuscarinics] and POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING
Y51.3 spasmolytics, not elsewhere THE NERVOUS SYSTEM 6,700 2,010
classified;papaverine
therapeutic THE NERVOUS SYSTEM
Y51.7 use: Beta-adrenoreceptor antagonists, not elsewhere 6,700 2,010
classified
T36.0 Poisoning by Penicillins POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

T36.1 Poisoning by Cefalosporins and other ß-lactam antibiotics POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.2 Poisoning by Chloramphenicol group POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

T36.3 Poisoning by Macrolides POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.4 Poisoning by Tetracyclines POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.5 Poisoning by Aminoglycosides; Streptomycin POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.6 Poisoning by Rifamycins POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.8 Poisoning by Other systemic antibiotics POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T36.9 Poisoning by Systemic antibiotic, unspecified POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T37.0 Poisoning by Sulfonamides POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T37.1 Poisoning by Antimycobacterial drugs POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T37.2 Poisoning by Antimalarials and drugs acting on other blood POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
protozoa
T37.4 Poisoning by Anthelminthics POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T37.5 Poisoning by Antiviral drugs POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
Poisoning by Other specified systemic anti-infectives and antiparasitics;
T37.8 Poisoning by Hydroxyquinoline derivatives POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T37.9 Poisoning by Systemic anti-infective and antiparasitic, POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
unspecified

Y40.0 therapeutic POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
use: Systemic antibiotics: Penicillins
therapeutic
Y40.1 use: Systemic antibiotics: Cefalosporins and other beta- POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
lactam antibiotics

use: Systemic antibiotics: Chloramphenicol group

use: Systemic antibiotics: Tetracyclines

use: Systemic antibiotics: Rifamycins

therapeutic
Y40.8 use: Systemic antibiotics: Other systemic antibiotics POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

therapeutic
Y40.9 use: Systemic antibiotics: Systemic antibiotic, unspecified POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

therapeutic use: Other systemic anti-
Y41.0 infectives and antiparasitics; Sulfonamides POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

Y41.1 therapeutic use: Other systemic anti- POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
infectives and antiparasitics; Antimycobacterial drugs

Y41.5 therapeutic use: Other systemic anti- POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
infectives and antiparasitics; Antiviral drugs

therapeutic use: Other specified systemic anti-infectives and
Y41.8 antiparasitics; hydroxyquinoline derivatives POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

therapeutic use: Systemic anti-infective
Y41.9 and antiparasitic, unspecified POISONING CAUSED BY ANTIBIOTICS 7,300 2,190

therapeutic use: Topical agents primarily affecting skin and mucous
membrane and ophthalmological, otorhinolaryngological and dental
drugs: Local antifungal, anti-infective and anti-inflammatory drugs, not
Y56.0 elsewhere classified POISONING CAUSED BY ANTIBIOTICS 7,300 2,190
T39.0 Poisoning by Salicylates POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220

AGENTS
T39.1 Poisoning by 4-Aminophenol derivatives POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220

AGENTS
T39.3 Poisoning by Other nonsteroidal anti-inflammatory drugs POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220
[NSAID] AGENTS
T39.8 Poisoning by Other nonopioid analgesics and antipyretics, POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220
not elsewhere classified AGENTS
T39.9 Poisoning by Nonopioid analgesic, antipyretic and POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220
antirheumatic, unspecified AGENTS
Y45.8 Other analgesics and antipyretics POISONING CAUSED BY ANTI-INFLAMMATORY 7,400 2,220
AGENTS
Drugs, medicaments and biological substances causing adverse effects in POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS
therapeutic
Y45.9 use: Analgesic, antipyretic and anti-inflammatory drug, 7,400 2,220
unspecified
T46.0 Poisoning by Cardiac-stimulant glycosides and drugs of POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
similar action
T46.1 Poisoning by Calcium-channel blockers POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
T46.2 Poisoning by Other antidysrhythmic drugs, not elsewhere POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
classified
T46.3 Poisoning by Coronary vasodilators, not elsewhere POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
classified; Poisoning by Dipyridamole
Poisoning by Other antihypertensive drugs, not elsewhere classified;
Poisoning by Clonidine;Poisoning by
T46.5 Guanethidine; Poisoning by Rauwolfia POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
T46.6 Poisoning by Antihyperlipidaemic and antiarteriosclerotic POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
drugs
T46.7 Poisoning by Peripheral vasodilators;Poisoning by Nicotimic POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
acid (derivatives)
T46.9 Poisoning by Other and unspecified agents primarily POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
affecting the cardiovascular system

therapeutic
Y52.0 use: Cardiac-stimulant glycosides and drugs of similar POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
action

therapeutic
Y52.2 use: Other antidysrhythmic drugs, not elsewhere classified POISONING CAUSED BY CARDIOVASCULAR DRUGS 12,500 3,750
T48.3 Poisoning by Antitussives POISONING CAUSED BY DRUGS AFFECTING THE 6,200 1,860
PULMONARY SYSTEM
T48.4 Poisoning by Expectorants POISONING CAUSED BY DRUGS AFFECTING THE 6,200 1,860
PULMONARY SYSTEM
T48.5 Poisoning by Anti-common-cold drugs POISONING CAUSED BY DRUGS AFFECTING THE 6,200 1,860
PULMONARY SYSTEM
Poisoning by Antiasthmatics, not elsewhere classified; β- POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY
T48.6 adrenoreceptor agonists used in asthma theraphy; Poisoning by SYSTEM 6,200 1,860
Salbutamol
Drugs, medicaments and biological substances causing adverse effects in POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY
Y55.3 therapeutic SYSTEM 6,200 1,860
use: Antitussives
Y55.4 therapeutic SYSTEM 6,200 1,860
use: Expectorants
therapeutic SYSTEM
Y55.6 use: Antiasthmatics, not elsewhere classified: 6,200 1,860
aminophylline, salbutamol, theobromine;theophylline
T50.0 Poisoning by Mineralocorticoids and their antagonists POISONING CAUSED BY DRUGS AFFECTING THE 6,300 1,890
RENAL SYSTEM
T50.1 Poisoning by Loop [high-ceiling] diuretics POISONING CAUSED BY DRUGS AFFECTING THE 6,300 1,890
RENAL SYSTEM
Poisoning by Carbonic-anhydrase inhibitors, POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM
benzothiadiazides and other diuretics;Poisoning by Acetazolamide
T50.2 6,300 1,890
T50.4 Poisoning by Drugs affecting uric acid metabolism POISONING CAUSED BY DRUGS AFFECTING THE 6,300 1,890
RENAL SYSTEM
Poisoning by Other and unspecified drugs, medicaments and biological

substances; Poisoning by Acidifying agents; Poisoning by Alkalizing agents;
Poisoning by Immunoglobulin; Poisoning by Immunologicals; Poisoning by
Lipotropic drugs; Poisoning by Parathyroid hormones and derivatives
T50.9 POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM 6,300 1,890
T47.0 Poisoning by HistamineH2-receptor antagonists POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490

DRUGS
T47.1 Poisoning by Other antacids and anti-gastric-secretion POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
drugs DRUGS
T47.2 Poisoning by Stimulant laxatives POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490

DRUGS
T47.3 Poisoning by Saline and osmotic laxatives POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
DRUGS
T47.4 Poisoning by Other laxatives; Poisoning by Intestinal atonia POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
drugs DRUGS
T47.5 Poisoning by Digestants POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490

DRUGS
T47.6 Poisoning by Antidiarrhoeal drugs POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490

DRUGS
T47.8 Poisoning by Other agents primarily affecting the POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
gastrointestinal system DRUGS
T47.9 Poisoning by Agent primarily affecting the gastrointestinal POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
system, unspecified DRUGS
T48.1 Poisoning by Skeletal muscle relaxants [neuromuscular POISONING CAUSED BY GASTROINTESTINAL 8,300 2,490
blocking agents] DRUGS
Drugs, medicaments and biological substances causing adverse effects in POISONING CAUSED BY GASTROINTESTINAL DRUGS
therapeutic
Y53.8 use: Other agents primarily affecting the gastrointestinal 8,300 2,490
system
T45.4 Poisoning by Iron and its compounds POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
T45.5 Poisoning by Anticoagulants POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
T45.6 Poisoning by Fibrinolysis-affecting drugs POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
T45.7 Poisoning by Anticoagulant antagonists, vitamin K and POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
other coagulants
Poisoning by Other primarily systemic and haematological agents;
Poisoning by Liver preparations and other antianaemic agents; Poisoning
by Natural blood and blood products; Poisoning by Plasma substitute
T45.8 POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
T45.9 Primarily systemic and haematological agent, unspecified POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190

therapeutic
Y44.2 use: Anticoagulants POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190

therapeutic
Y44.3 use: Anticoagulant antagonists, vitamin K and other POISONING CAUSED BY HEMATOLOGIC AGENTS 7,300 2,190
coagulants
T38.0 Poisoning by Glucocorticoids and synthetic analogues POISONING CAUSED BY HORMONES 8,500 2,550
T38.1 Poisoning by Thyroid hormones and substitutes POISONING CAUSED BY HORMONES 8,500 2,550
T38.2 Poisoning by Antithyroid drugs POISONING CAUSED BY HORMONES 8,500 2,550
T38.3 Poisoning by Insulin and oral hypoglycaemic [antidiabetic] POISONING CAUSED BY HORMONES 8,500 2,550
drugs
T38.4 Poisoning by Oral contraceptives; Poisoning by Multiple- POISONING CAUSED BY HORMONES 8,500 2,550
and-single-ingredient preparations
T38.5 Poisoning by Other estrogens and progestogens; Mixtures POISONING CAUSED BY HORMONES 8,500 2,550
and substitutes
Poisoning by Antigonadotrophins, antiestrogens,

T38.6 antiandrogens, not elsewhere classified; Poisoning by Tamoxifen POISONING CAUSED BY HORMONES 8,500 2,550
T38.7 Poisoning by Androgens and anabolic congeners POISONING CAUSED BY HORMONES 8,500 2,550
therapeutic
Y42.0 use: Glucocorticoids and synthetic analogues POISONING CAUSED BY HORMONES 8,500 2,550

therapeutic
Y42.2 use: Antithyroid drugs POISONING CAUSED BY HORMONES 8,500 2,550

therapeutic
Y42.3 use: Insulin and oral hypoglycaemic [antidiabetic] drugs POISONING CAUSED BY HORMONES 8,500 2,550

therapeutic
Y42.4 use: Oral contraceptives;multiple-and single-ingredient POISONING CAUSED BY HORMONES 8,500 2,550
preparations

therapeutic
Y42.5 use: Other estrogens and progestogens;mixtures and POISONING CAUSED BY HORMONES 8,500 2,550
substitutes

Y45.1 therapeutic POISONING CAUSED BY HORMONES 8,500 2,550
use: Salicylates

therapeutic
Y45.2 use: Propionic acid derivatives;propanoic acid derivatives POISONING CAUSED BY HORMONES 8,500 2,550

therapeutic
Y45.3 use: Other nonsteroidal anti-inflammatory drugs [NSAID] POISONING CAUSED BY HORMONES 8,500 2,550

therapeutic
Y45.5 use: 4-Aminophenol derivatives POISONING CAUSED BY HORMONES 8,500 2,550
T51.0 Toxic effect of Ethanol;Toxic effect of Ethyl alcohol POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T51.2 Toxic effect of 2-Propanol; Toxic effect of Isoprophyl POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
aclohol AND HEAVY METALS
Toxic effect of Fusel oil; Toxic effect of Amyl alcohol; Toxic effect of Butyl POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
T51.3 alcohol [1-butanol]; Toxic effect of Propyl METALS 6,400 1,920
alcohol [1-proponol]
T51.8 Toxic effect of Other alcohols POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T51.9 Toxic effect of Alcohol, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
Toxic effect of Petroleum products; Toxic effect of Gasoline [petrol]; Toxic

effect of Kerosine [paraffin oil]; Toxic effect of Paraffin wax; Toxic effect of
Petroleum ether; Toxic effect of Petroleum naphtha; Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
T52.0 Petroleum spirits METALS 6,400 1,920
Toxic effect of Homologues of benzene; Toxic effect of Toluene POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
[methylbenzene]; Toxic effect of Xylene METALS
T52.2 [dimethylbenzene] 6,400 1,920
T52.4 Toxic effect of Ketones POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T52.8 Toxic effect of Other organic solvents POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T52.9 Toxic effect of Organic solvent, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T53.0 Toxic effect of Carbon tetrachloride;Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
Tetrachloromethane AND HEAVY METALS
T53.1 Toxic effect of Chloroform; Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
Trichloromethane AND HEAVY METALS
T53.4 Toxic effect of Dichloromethane;Toxic effect of Methylene POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
chloride AND HEAVY METALS
T53.6 Toxic effect of Other halogen derivatives of aliphatic POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
hydrocarbons AND HEAVY METALS
T53.9 Toxic effect of Halogen derivative of aliphatic and aromatic POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
hydrocarbons, unspecified AND HEAVY METALS
T54.1 Toxic effect of Other corrosive organic compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
Toxic effect of Corrosive acids and acid-like substances; Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
T54.2 Acid hydrochlorie;Toxic effect of Acid METALS 6,400 1,920
sulfurie
Toxic effect of Corrosive alkalis and alkali-like substances; Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
Potassium hydroxide;Toxic effect of Sodium METALS
T54.3 hydroxide 6,400 1,920
T54.9 Toxic effect of Corrosive substance, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T55 Toxic effect of soaps and detergents POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T56.0 Toxic effect of Lead and its compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T56.1 Toxic effect of Mercury and its compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T56.5 Toxic effect of Zinc and its compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T56.8 Toxic effect of Other metals POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T57.0 Toxic effect of Arsenic and its compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T57.1 Toxic effect of Phosphorus and its compounds POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T57.3 Toxic effect of Hydrogen cyanide POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T57.8 Toxic effect of Other specified in organic substances POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T57.9 Toxic effect of Inorganic substance, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T58 Toxic effect of carbon monoxide from all sources POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.0 Toxic effect of Nitrogen oxides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.2 Toxic effect of Formal dehyde POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.3 Toxic effect of Lacrimogenic gas; Toxic effect of Tear gas POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.4 Toxic effect of Chlorine gas POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.7 Toxic effect of Carbon dioxide POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.8 Toxic effect of Other specified gases, fumes and vapours POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T59.9 Toxic effect of Gases, fumes and vapours, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.0 Toxic effect of Organophosphate and carbamate POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
insecticides AND HEAVY METALS
T60.1 Toxic effect of Halogenated insecticides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.2 Other and unspecified insecticides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.3 Toxic effect of Herbicides and fungicides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.4 Toxic effect of Rodenticides; Toxic effect of Thallium POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.8 Toxic effect of Other pesticides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T60.9 Toxic effect of Pesticide, unspecified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T65.0 Toxic effect of Cyanides POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
Toxic effect of Nitro derivatives and aminoderivatives of benzene and its POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY
homologues; Toxic effect of Aniline [benzenamine]; Toxic effect of METALS
T65.3 Nitrobenzene; Toxic effect of Trinitrotoluene 6,400 1,920
T65.4 Toxic effect of Carbondisulfide POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T65.6 Toxic effect of Paints and dyes, not elsewhere classified POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T65.8 Toxic effect of other specified substances POISONING CAUSED BY ORGANIC SUBSTANCES 6,400 1,920
AND HEAVY METALS
T49.2 Poisoning by Local astringents and local detergents POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T49.3 Poisoning by Emollients, demulcents and protectants POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T49.4 Poisoning by Keratolytics, keratoplastics and other hair POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
treatment drugs and preparations
Poisoning by Ophthalmological drugs and preparations; Poisoning by Eye,

T49.5 nose and throat anti-infectives POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T49.7 Poisoning by Dental drugs, topically applied POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T49.8 Othertopical agents; Spermicides POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T49.9 Poisoning by Topical agent, unspecified POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
therapeutic
Y56.2 use: Local astringents and local detergents POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590

therapeutic
Y56.3 use: Emollients, demulcents and protectants POISONING CAUSED BY TOPICAL AGENTS 5,300 1,590
T61.0 Toxic effect of Ciguatera fish poisoning POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T61.1 Toxic effect of Scombroid fish poisoning;Toxic effect of POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Histamine-like syndrome
T61.2 Toxic effect of Other fish and shellfish poisoning POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Fish poisoning
T61.8 Toxic effect of other seafoods POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T61.9 Toxic effect of unspecified seafood POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Seafood poisoning
T62.0 Toxic effect of Ingested mushrooms POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T62.1 Toxic effect of Ingested berries POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T62.2 Toxic effect of Other ingested (parts of) plant(s) POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T62.8 Toxic effect of Other specified noxious substances eaten as POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
food
Toxic effect of Noxious substance eaten as food, unspecified

Food poisoning
T62.9 POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T63.0 Toxic effect of Snake venom;Toxic effect of Sea-snake POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
venom
T63.1 Toxic effect of Venom of other reptiles; Toxic effect of POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Lizard venom
T63.2 Toxic effect of Venom of scorpion POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T63.3 Toxic effect of Venom of spider POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T63.4 Toxic effect of Venom of other arthropods;Toxic effect of POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Insect bite or sting, venomous
T63.5 Toxic effect of contact with fish POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T63.6 Toxic effect of contact with other marine animals; Jellyfish; POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Sea anemone; Shellfish; Starfish
T63.8 Toxic effect of contact with other venomous animals; POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
Venom of amphibian
T63.9 Toxic effect of contact with unspecified venomous animal POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
T64 Toxic effect of aflation and other mycotoxin food POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
contaminants
T65.2 Toxic effect of Tobacco and nicotine POISONING FROM ANIMALS, INSECTS, PLANTS 5,700 1,710
therapeutic
Y43.0 use: Antiallergic and antiemetic drugs POISONING OTHERS 8,300 2,490

therapeutic
Y54.3 use: Benzothiadiazine derivatives POISONING OTHERS 8,300 2,490

Y54.8 therapeutic POISONING OTHERS 8,300 2,490
use: Agents affecting uric acid metabolism

use: Oxytocic drugs;ergot alkaloids

use: Otorhinolaryngological drugs and preparations

therapeutic
Y58.0 use: BCG vaccine POISONING OTHERS 8,300 2,490

therapeutic
Y58.4 use: Tetanus vaccine POISONING OTHERS 8,300 2,490

use: Vaccine or biological substance, unspecified
Hereditary motor and sensory neuropathy; Disease Charcot- Marie-Tooth;

Disease Déjerine-Sottas; Hereditary motor and sensory neuropathy, types
I-IV; Hypertrophic neuropathy of infancy; Peroneal muscular atrophy
axonal type; Peroneal muscular atrophy hypertrophic type; Roussy- Levy
G60.0 syndrome POLYNEUROPATHIES 10,600 3,180
G60.1 Refsum's disease POLYNEUROPATHIES 10,600 3,180

G60.2 Neuropathy in association with hereditary ataxia POLYNEUROPATHIES 10,600 3,180
G60.3 Idiopathic progressive neuropathy POLYNEUROPATHIES 10,600 3,180
Other hereditary and idiopathic neuropathies; Morvan's disease; Nelaton's
syndrome; Sensory neuropathy dominantly inherited; Sensory neuropathy
G60.8 recessively inherited POLYNEUROPATHIES 10,600 3,180
G60.9 Hereditary and idiopathic neuropathy, unspecified POLYNEUROPATHIES 10,600 3,180

G61.0 Guillain-Barré syndrome; Acute post- infective polyneuritis; POLYNEUROPATHIES 10,600 3,180
Acute infective polyneuritis
G61.8 Other inflammatory polyneuropathies POLYNEUROPATHIES 10,600 3,180
G61.9 Inflammatory polyneuropathy, unspecified POLYNEUROPATHIES 10,600 3,180
G62.0 Drug-induced polyneuropathy POLYNEUROPATHIES 10,600 3,180
G62.1 Alcoholic polyneuropathy POLYNEUROPATHIES 10,600 3,180
G62.2 Polyneuropathy due to other toxic agents POLYNEUROPATHIES 10,600 3,180
G62.8 Other specified polyneuropathies; Radiation-induced POLYNEUROPATHIES 10,600 3,180
polyneuropathy
G62.9 Polyneuropathy, unspecified; Neuropathy NOS POLYNEUROPATHIES 10,600 3,180

Peripheral neuropathy
G63.8* Polyneuropathy in other diseases classified elsewhere; POLYNEUROPATHIES 10,600 3,180
Uraemic neuropathy
G64 Other disorders of peripheral nervous system; Disorder of POLYNEUROPATHIES 10,600 3,180
peripheral nervous system NOS
N84.0 Polyp of corpus uteri; Polyp of endometrium; Polyp of POLYPS, FEMALE GENITAL TRACT 5,200 1,560
uterus NOS
N84.1 Polyp of cervix uteri; Mucous polyp of cervix POLYPS, FEMALE GENITAL TRACT 5,200 1,560
N84.2 Polyp of vagina POLYPS, FEMALE GENITAL TRACT 5,200 1,560
N84.3 Polyp of vulva; Polyp of labia POLYPS, FEMALE GENITAL TRACT 5,200 1,560
N84.8 Polyp of other parts of female genital tract POLYPS, FEMALE GENITAL TRACT 5,200 1,560
N84.9 Polyp of female genital tract, unspecified POLYPS, FEMALE GENITAL TRACT 5,200 1,560
Embolism following abortion and ectopic and molar pregnancy; Embolism
NOS; Air embolism; Amniotic fluid embolism; Blood-clot embolism;
Pulmonary embolism; Pyaemic embolism; Septic or septicopyaemic
O08.2 embolism; Soap embolism POST PARTUM COMPLICATIONS 9,300 2,790
O08.5 Metabolic disorders following abortion and ectopic and POST PARTUM COMPLICATIONS 9,300 2,790
molar pregnancy
O08.9 Complication following abortion and ectopic and molar POST PARTUM COMPLICATIONS 9,300 2,790
pregnancy, unspecified
O67.8 Other intrapartum haemorrhage; Excessive intrapartum POST PARTUM COMPLICATIONS 9,300 2,790
haemorrhage
O71.0 Rupture of uterus before on set of labour POST PARTUM COMPLICATIONS 9,300 2,790
O71.1 Rupture of uterus during labour; Rupture of uterus not POST PARTUM COMPLICATIONS 9,300 2,790
stated as occuring before onset of labour
O71.2 Post partum inversion of uterus POST PARTUM COMPLICATIONS 9,300 2,790
O71.3 Obstetric laceration of cervix; Annular detachment of cervix POST PARTUM COMPLICATIONS 9,300 2,790
O71.5 Other obstetric injury to pelvic organs; Obstetric injury to POST PARTUM COMPLICATIONS 9,300 2,790
bladder; Obstetric injury to urethra
Obstetric haematoma of pelvis; Obstetric haematoma of perineum;
O71.7 Obstetric haematoma of vagina; Obstetric POST PARTUM COMPLICATIONS 9,300 2,790
haematoma of vulva
O71.8 Other specified obstetric trauma POST PARTUM COMPLICATIONS 9,300 2,790
O71.9 Obstetric trauma, unspecified POST PARTUM COMPLICATIONS 9,300 2,790
Aspiration pneumonitis due to anaesthesia during labour and delivery;
Inhalation of stomach contents or secretions NOS due to anaesthesia
during labour and delivery; Mendelson's syndrome due to anaesthesia
O74.0 during labour and delivery POST PARTUM COMPLICATIONS 9,300 2,790
Cardiac complications of anaesthesia during labour and delivery; Cardiac

arrest due to anaesthesia during labour and delivery; Cardiac failure due
O74.2 to anaesthesia during labour and delivery POST PARTUM COMPLICATIONS 9,300 2,790
O74.8 Other complications of anaesthesia during labour and POST PARTUM COMPLICATIONS 9,300 2,790
delivery
O75.1 Shock during or following labour and delivery; Obstetic POST PARTUM COMPLICATIONS 9,300 2,790
shock
O75.8 Other specified complications of labour and delivery POST PARTUM COMPLICATIONS 9,300 2,790
O75.9 Complication of labour and delivery, unspecified POST PARTUM COMPLICATIONS 9,300 2,790
Venous complication in the puerperium, unspecified; Puerperal phlebitis
O87.9 NOS; Puerperal phlebopathy NOS; POST PARTUM COMPLICATIONS 9,300 2,790
Puerperal thrombosis NOS
Z39.0 Care and examination immediately after delivery; Care and POSTPARTUM CARE FOR DELIVERIES IN TRANSIT 2,000 600
observation in uncomplicated cases
E89.0 Postprocedural hypothyroidism; Postirradiation POSTPROCEDURAL DISORDERS 10,300 3,090
hypothyroidism; Postsurgical hypothyroidism
E89.2 Postprocedural hypoparathyroidism; Parathyroprival tetany POSTPROCEDURAL DISORDERS 10,300 3,090
E89.3 Postprocedural hypopituitarism; Postirradiation POSTPROCEDURAL DISORDERS 10,300 3,090

hypopituitarism
E89.4 Postprocedural ovarian failure POSTPROCEDURAL DISORDERS 10,300 3,090

E89.5 Postprocedural testicular hypofunction POSTPROCEDURAL DISORDERS 10,300 3,090
E89.6 Postprocedural adrenocortical hypofunction; POSTPROCEDURAL DISORDERS 10,300 3,090
Postprocedural adreno-medullary hypofunction
E89.8 Other postprocedural endocrine and metabolic disorders POSTPROCEDURAL DISORDERS 10,300 3,090
G97.1 Other reaction to spinal and lumbar puncture POSTPROCEDURAL DISORDERS 10,300 3,090
G97.8 Other postprocedural disorders of nervous system POSTPROCEDURAL DISORDERS 10,300 3,090
Vitreous syndrome following cataract surgery Keratopathy (bullous
aphakic) following cataract surgery
H59.0 POSTPROCEDURAL DISORDERS 10,300 3,090
H59.8 Other postprocedural disorders of eye and adnexa; POSTPROCEDURAL DISORDERS 10,300 3,090
Chorioretinal scars after surgery for detachment
H59.9 Postprocedural disorder of eye and adnexa, unspecified POSTPROCEDURAL DISORDERS 10,300 3,090
H95.8 Other postprocedural disorders of ear and mastoid process POSTPROCEDURAL DISORDERS 10,300 3,090
I97.0 Postcardiotomy syndrome POSTPROCEDURAL DISORDERS 10,300 3,090

Postmastectomy lymphoedema syndrome; Elephantiasis due to
mastectomy; Obliteration of lymphatic vessels due
I97.2 to mastectomy POSTPROCEDURAL DISORDERS 10,300 3,090
Tracheostomy malfunction; Haemorrhage from tracheostomy stoma;
Obstruction of tracheostomy airway; Sepsis of tracheostomy stoma;
J95.0 Tracheo-oesophageal fistula POSTPROCEDURAL DISORDERS 10,300 3,090
following tracheostomy
J95.1 Acute pulmonary insufficiency following thoracic surgery POSTPROCEDURAL DISORDERS 10,300 3,090
J95.2 Acute pulmonary insufficiency following nonthoracic POSTPROCEDURAL DISORDERS 10,300 3,090
surgery
J95.4 Mendelson syndrome; Chemical pneumonitis due to POSTPROCEDURAL DISORDERS 10,300 3,090
aspiration during anaesthesia
J95.5 Postprocedural subglottic stenosis POSTPROCEDURAL DISORDERS 10,300 3,090

J95.8 Other postprocedural respiratory disorders POSTPROCEDURAL DISORDERS 10,300 3,090
J95.9 Postprocedural respiratory disorder, unspecified POSTPROCEDURAL DISORDERS 10,300 3,090
K91.0 Vomiting following gastrointestinal surgery POSTPROCEDURAL DISORDERS 10,300 3,090
K91.1 Postgastric surgery syndromes; Dumping syndrome; POSTPROCEDURAL DISORDERS 10,300 3,090
Postgastrectomy syndrome; Postvagotomy syndrome
K91.2 Postsurgical malabsorption, not elsewhere classified; POSTPROCEDURAL DISORDERS 10,300 3,090
Postsurgical blind loop syndrome
K91.3 Postoperative intestinal obstruction POSTPROCEDURAL DISORDERS 10,300 3,090
K91.4 Colostomy and enterostomy malfunction POSTPROCEDURAL DISORDERS 10,300 3,090
K91.5 Postcholecystectomy syndrome POSTPROCEDURAL DISORDERS 10,300 3,090
K91.8 Other postprocedural disorders of digestive system, not POSTPROCEDURAL DISORDERS 10,300 3,090
elsewhere classified
K91.9 Postprocedural disorder of digestive system, unspecified POSTPROCEDURAL DISORDERS 10,300 3,090
N99.0 Postprocedural renal failure POSTPROCEDURAL DISORDERS 10,300 3,090

N99.1 Postprocedural urethral stricture; Postcatheterization POSTPROCEDURAL DISORDERS 10,300 3,090
urethral stricture
N99.4 Postprocedural pelvic peritoneal adhesions POSTPROCEDURAL DISORDERS 10,300 3,090

N99.8 Other postprocedural disorders of genitourinary system; POSTPROCEDURAL DISORDERS 10,300 3,090
Residual ovary syndrome
N99.9 Postprocedural disorder of genitourinary system, POSTPROCEDURAL DISORDERS 10,300 3,090
unspecified
Haemorrhage and haematoma complicating a procedure, not elsewhere

T81.0 classified; Haemorrhage at any site resulting POSTPROCEDURAL DISORDERS 10,300 3,090
from a procedure
Shock during or resulting from a procedure not elsewhere classified;

Collapse NOS during or following a procedure; Endotoxic shock during or
following a procedure; Hypovolaemic during or following a procedure;
Septic shock during or following a procedure;
T81.1 POSTPROCEDURAL DISORDERS 10,300 3,090
Accidental puncture and laceration during a procedure not elsewhere

classified; Accidental perforation of blood vessel by catheter, endoscope,
instrument, probe during a procedure; Accidental perforation of nerve by
T81.2 catheter, POSTPROCEDURAL DISORDERS 10,300 3,090
endoscope, instrument, probe
Disruption of operation wound, not elsewhere classified;

T81.3 Dehiscene of operation wound; Rupture of operation wound POSTPROCEDURAL DISORDERS 10,300 3,090
Infection following a procedure, not elsewhere classified; Intra-abdominal

abscess postprocedural abcess; Intra- abdominal stitch postprocedural
abscess; Intra-abdominal subphrenic postprocedural abcess; Intra-
abdominal wound postprocedural abcess; Septicemia
Other complications of procedures, not elsewhere classified; Complication

of inhalation therapy; Emphysema (subcutaneous) resulting from a
T81.8 procedure; Persistent postoperative fistula POSTPROCEDURAL DISORDERS 10,300 3,090
Mechanical complication of heart valve prosthesis; Mechanical breakdown

due to heart valve prosthesis; Displacement due to heart valve prosthesis;
Failure due to heart valve prosthesis; Leakage due to heart valve
prosthesis; Malposition due to heart valve prosthesis; Mechanical
obstruction due to heart valve prosthesis; Perforation due to heart valve
T82.0 prosthesis; Protrusion due to POSTPROCEDURAL DISORDERS 10,300 3,090
heart valve prosthesis;
Mechanical complication of cardiac electronic device; Conditions listed in

T82.0 due to electrodes; Conditions listed in T82.0 due to pulse generator
T82.1 (battery) POSTPROCEDURAL DISORDERS 10,300 3,090
T82.2 Mechanical complication of coronary artery bypass and POSTPROCEDURAL DISORDERS 10,300 3,090
valve grafts
Mechanical complication of other vascular grafts; Condition listed in T82.0
due to aortic (bifurcation) graft (replacement); Condition listed in T82.0
T82.3 due to arterial (carotid) (femoral) graft (bypass) POSTPROCEDURAL DISORDERS 10,300 3,090
T82.4 Mechanical complication of vascular dialysis catheter POSTPROCEDURAL DISORDERS 10,300 3,090
Mechanical complication of other cardiac and vascular devices and
implants; Conditions listed in T82.0 due to arteriovenous fistula surgically
created; arterivenous Shunt surgically created; Artificial heart; Balloon
counterpulsation device; Infusion catheter; umbrella device
T82.7 Infection and inflammatory reaction due to other cardiac POSTPROCEDURAL DISORDERS 10,300 3,090
and vascular devices, implants and grafts
Other complications of cardiac and vascular prosthetic devices, implants

and grafts; Complication due to cardiac and vascular prosthetic devices,
implants and grafts; Embolism due to cardiac and vascular prosthetic
devices, implants and grafts; Fibrosis due to cardiac and vascular
prosthetic devices, implants and grafts; Haemorrhage due to cardiac and
vascular prosthetic devices, implants and grafts; Pain due to cardiac and
vascular prosthetic devices, implants and grafts; Stenosis due to cardiac
and vascular prosthetic devices, implants and grafts; Thrombosis due to
cardiac and vascular prosthetic devices, implants and grafts;
Mechanical complication of other urinary devices and implants;

Concditions listed in T82.0 due to Urinary electronic stimultor device;
T83.1 Urinary sphincter implant; Urinary stent POSTPROCEDURAL DISORDERS 10,300 3,090
T83.2 Mechanical complication of graft of urinary organ POSTPROCEDURAL DISORDERS 10,300 3,090
T83.3 Mechanical complication of intrauterine contraceptive POSTPROCEDURAL DISORDERS 10,300 3,090
device
T83.5 Infection and inflammatory reaction due to prosthetic POSTPROCEDURAL DISORDERS 10,300 3,090
device, implant and graft in urinary system
T83.8 Other complications of genitourinary prosthetic devices, POSTPROCEDURAL DISORDERS 10,300 3,090
implants and grafts
T83.9 Unspecified complication of genitourinary prosthetic POSTPROCEDURAL DISORDERS 10,300 3,090

device, implants and grafts
T84.0 Mechanical complication of internal joint prosthesis POSTPROCEDURAL DISORDERS 10,300 3,090
T84.1 Mechanical complication of internal fixation device of POSTPROCEDURAL DISORDERS 10,300 3,090
bones of limb
T84.2 Mechanical complication of internal fixation device of other POSTPROCEDURAL DISORDERS 10,300 3,090
bones
T84.4 Mechanical complication of other internal orthopaedic POSTPROCEDURAL DISORDERS 10,300 3,090
devices, implants and grafts
T84.5 Infection and inflammatory reaction due to internal joint POSTPROCEDURAL DISORDERS 10,300 3,090
prosthesis
T84.6 Infection and inflammatory reaction due to internal fixation POSTPROCEDURAL DISORDERS 10,300 3,090
device [any site]
Infection and inflammatory reaction due to other internal orthopaedic

prosthetic devices, implants and grafts
T84.8 Other complications of internal orthopaedic prosthetic POSTPROCEDURAL DISORDERS 10,300 3,090
devices, implants and grafts
T84.9 Unspecified complication of internal orthopaedic prosthetic POSTPROCEDURAL DISORDERS 10,300 3,090
device, implant and graft
T85.0 Mechanical complication of ventricular intracranial POSTPROCEDURAL DISORDERS 10,300 3,090
(communicating) shunt
Mechanical complication of other ocular prosthetic devices, implants and

grafts Conditions listed in T82.0 due to corneal graft; Conditions listed in
T85.3 T82.0 due to prosthetic orbit of eye POSTPROCEDURAL DISORDERS 10,300 3,090
Mechanical complication of gastrointestinal prosthetic devices implants

and grafts; Conditions listed in T82.0 due to Bile-duct prosthesis;
T85.5 Conditions listed in T82.0 POSTPROCEDURAL DISORDERS 10,300 3,090
oesophageal anti-reflux device
Mechanical complication of other specified internal prosthetic devices,

Implants and grafts; Conditions listed in T82.0 due to epidural and
subdural infusion catheter; Conditions listed in T82.0 due to
T85.6 intraperitonael dialysis catheter; Conditions listed POSTPROCEDURAL DISORDERS 10,300 3,090
T85.7 Infection and inflammatory reaction due to other internal POSTPROCEDURAL DISORDERS 10,300 3,090
prosthetic devices, implants and grafts
T85.8 Other complications of internal prosthetic devices, implants POSTPROCEDURAL DISORDERS 10,300 3,090
and grafts, not elsewhere classified
Unspecified complication of internal prosthetic device,

implant and graft; Complication of internal prosthetic device, implants and
T85.9 graft NOS POSTPROCEDURAL DISORDERS 10,300 3,090
Hyperplasia of prostate; Adenofibromatous hypertrophy of prostate;

Adenoma (benign)of prostate ; Enlargement of prostate (benign);
Fibroadenoma of prostate; Fibroma of prostate; Hypertrophy of prostate
(benign); Myoma of prostate; Median bar (prostate); Prostatic obstruction
N40 NOS PROSTATE DISORDERS 9,200 2,760
N41.0 Acute prostatitis PROSTATE DISORDERS 9,200 2,760

N41.1 Chronic prostatitis PROSTATE DISORDERS 9,200 2,760
N41.2 Abscess of prostate PROSTATE DISORDERS 9,200 2,760
N41.3 Prostatocystitis PROSTATE DISORDERS 9,200 2,760
N41.8 Other inflammatory diseases of prostate PROSTATE DISORDERS 9,200 2,760
N41.9 Inflammatory disease of prostate, unspecified; Prostatitis PROSTATE DISORDERS 9,200 2,760
NOS
N42.0 Calculus of prostate; Prostatic stone PROSTATE DISORDERS 9,200 2,760
N42.1 Congestion and haemorrhage of prostate PROSTATE DISORDERS 9,200 2,760
N42.2 Atrophy of prostate PROSTATE DISORDERS 9,200 2,760
N42.8 Other specified disorders of prostate PROSTATE DISORDERS 9,200 2,760
N42.9 Disorder of prostate, unspecified PROSTATE DISORDERS 9,200 2,760
O15.2 Eclampsia in the puerperium PUERPERAL COMPLICATIONS 6,800 2,040
Puerperal sepsis; Puerperal endometritis; Puerperal fever;
Puerperal peritonitis; Puerperal septicaemia; Postpartum sepsis
O85 PUERPERAL COMPLICATIONS 10,600 3,180
Infection of obstetric surgical wound; Infected caesarean section wound

following delivery; Infected perineal repair
O86.0 following delivery PUERPERAL COMPLICATIONS 10,600 3,180
Other infection of genital tract following delivery; Cervicitis following

delivery; Vaginitis following delivery
O86.1 PUERPERAL COMPLICATIONS 10,600 3,180
O86.2 Urinary tract infection following delivery PUERPERAL COMPLICATIONS 10,600 3,180
O86.3 Other genitourinary tract infections following delivery; PUERPERAL COMPLICATIONS 10,600 3,180
Puerperal genitourinary tract infection NOS
O86.4 Pyrexia of unknown origin following delivery; Puerperal PUERPERAL COMPLICATIONS 10,600 3,180
infection NOS; Puerperal pyrexia NOS
O86.8 Other specified puerpera linfections PUERPERAL COMPLICATIONS 10,600 3,180

O87.0 Superficial thrombophlebitis in the puerperium PUERPERAL COMPLICATIONS 10,600 3,180
Deep phlebothrombosis in the puerperium; Deep-vein thrombosis,
postpartum; Pelvic thrombophlebitis,
O87.1 postpartum PUERPERAL COMPLICATIONS 10,600 3,180
O87.2 Haemorrhoids in the puerperium PUERPERAL COMPLICATIONS 10,600 3,180

O87.8 Other venous complications in the puerperium; Genital PUERPERAL COMPLICATIONS 10,600 3,180
varices in the puerperium
O88.1 Amniotic fluid embolism PUERPERAL COMPLICATIONS 10,600 3,180
O88.2 Obstetric blood-clot embolism; Obstetric pulmonary PUERPERAL COMPLICATIONS 10,600 3,180
embolism NOS; Puerperal pulmonary embolism NOS
Pulmonary complications of anaesthesia during the puerperium;

Aspiration pneumonitis due to anaesthesia during the puerperium;
Chemical pneumonitis due to aspiration, due to anaesthesia during the
puerperium; Inhalation of stomach contents or secretions NOS due to
anaestheisa during the puerperium; Mendelson syndrome due to
anaesthesia during the puerperium; Pressure collapse of lung due to
O89.0 anaesthesia during the puerperium PUERPERAL COMPLICATIONS 10,600 3,180
Cardiac complications of anaesthesia during the puerperium; Cardiac

arrest due to anaesthesia during the puerperium; Cardiac failure due to
O89.1 anaesthesia during the puerperium PUERPERAL COMPLICATIONS 10,600 3,180
Central nervous system complications of anaesthesia during the

O89.2 puerperium; Cerebral anoxia due to anaesthesia PUERPERAL COMPLICATIONS 10,600 3,180
during the puerperium
O89.4 Spinal and epidural anaesthesia-induced headache during PUERPERAL COMPLICATIONS 10,600 3,180
the puerperium
O89.8 Other complications of anaesthesia during the puerperium PUERPERAL COMPLICATIONS 10,600 3,180
O89.9 Complication of anaesthesia during the puerperium, PUERPERAL COMPLICATIONS 10,600 3,180
unspecified
O90.0 Disruption of caesarean section wound PUERPERAL COMPLICATIONS 10,600 3,180
Disruption of perineal obstetric wound; Disruption of wound of
episiotomy; Disruption of wound of perineal
O90.1 laceration; Secondary perineal tear PUERPERAL COMPLICATIONS 10,600 3,180
O90.2 Haematoma of obstetric wound PUERPERAL COMPLICATIONS 10,600 3,180

O90.3 Cardiomyopathy in the puerperium PUERPERAL COMPLICATIONS 10,600 3,180
O90.4 Postpartum acute renal failure; Hepatorenal syndrome PUERPERAL COMPLICATIONS 10,600 3,180
following labour and delivery
O90.5 Postpartum thyroiditis PUERPERAL COMPLICATIONS 10,600 3,180

O90.8 Other complications of the puerperium, not elsewhere PUERPERAL COMPLICATIONS 10,600 3,180
classified; Placental polyp
O90.9 Complication of the puerperium, unspecified PUERPERAL COMPLICATIONS 10,600 3,180
P20.0 Intrauterine hypoxia first noted before onset of labour PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P20.1 Intrauterine hypoxia first noted during labour and delivery PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P20.9 Intrauterine hypoxia, unspecified PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
Severe birth asphyxia; Pulse less than 100 per minute at birth and falling
or steady, respiration absent or gasping, colour poor, tone absent;
P21.0 Asphyxia with 1-minute apgar score 0-3; White asphyxia PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
Mild and moderate birth asphyxia; Normal respiration not established

within one minute, but heart rate 100 or above, some muscle tone
present, some response to stimulation; Asphyxia with 1-minute Apgar
score 4-7; Blue asphyxia
P21.1 PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P21.9 Birth asphyxia, unspecified; Anoxia, NOS; Asphyxia, NOS; PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
Hypoxia, NOS
Respiratory distress syndrome of newborn; Hyaline membrane disease

P22.0 Respiratory distress syndrome, child PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P22.1 Transient tachypnoea of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P22.8 Other respiratory distress of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P22.9 Respiratory distress of newborn, unspecified PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P24.0 Neonatal aspiration of meconium PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P24.1 Neonatal aspiration of amniotic fluid and mucus;Aspiration PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
of liquor (amnii)
P24.2 Neonatal aspiration of blood PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P24.3 Neonatal aspiration of milk and regurgitated food PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P24.8 Other neonatal aspiration syndromes PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P24.9 Neonatal aspiration syndrome, unspecified; Neonatal PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
aspiration pneumonia NOS
P25.0 Interstitial emphysema originating in the perinatal period PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
Pneumothorax originating in the perinatal period Pneumothorax of fetus

Pneumothorax of newborn
P25.1 PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P25.2 Pneumomediastinum originating in the perinatal period PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P25.8 Other conditions related to interstitial emphysema PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
originating in the perinatal period
P26.0 Tracheobronchial haemorrhage originating in the perinatal PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
period
P26.1 Massive pulmonary haemorrhage originating in the PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
perinatal period
P26.8 Other pulmonary haemorrhages originating in the perinatal PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
period
P26.9 Unspecified pulmonary haemorrhage originating in the PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
perinatal period
P27.0 Wilson-Mikity syndrome; Pulmonary dysmaturity PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P27.1 Bronchopulmonary dysplasia originating in the perinatal PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
period
Other chronic respiratory diseases originating in the
perinatal period; Congenital pulmonary fibrosis; Ventilator lung in
P27.8 newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P27.9 Unspecified chronic respiratory disease originating in the PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
perinatal period
Primary atelectasis of newborn; Primary failure to expand terminal

respiratory units; Pulmonary hypoplasia associated with short gestation;
P28.0 Pulmonary immaturity NOS PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
Other and unspecified atelectasis of newborn; Atelectasis, NOS;

Atelectasis, partial; Atelectasis, secondary; Resorption atelectasis without
P28.1 respiratory distress syndrome PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P28.2 Cyanotic attacks of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P28.3 Primary sleep apnoea of newborn; leep apnoea of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
NOS
P28.4 Other apnoea of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P28.5 Respiratory failure of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P28.8 Other specified respiratory conditions of newborn; PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
congenital laryngeal stridor NOS; Snuffles in newborn
Persistent fetal circulation; Delayed closure of ductus arteriosus;

P29.3 Persistent pulmonary hypertension of newborn PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
P29.9 Cardiovascular disorder originating in the perinatal period, PULMONARY COMPLICATIONS IN THE NEWBORN 10,900 3,270
unspecified
I26.0 Pulmonary embolism with mention of acute cor pulmonale; PULMONARY EMBOLISM 24,300 7,290
Acute cor pulmonale NOS
I26.9 Pulmonary embolism without mention of acute cor PULMONARY EMBOLISM 24,300 7,290
pulmonale; Pulmonary embolism NOS
I27.0 Primary pulmonary hypertension; Primary idiopathic PULMONARY HEART DISEASE 14,100 4,230
pulmonary artery hypertension
I27.1 Kyphoscoliotic heart disease PULMONARY HEART DISEASE 14,100 4,230

I27.2 Other secondary pulmonary hypertension; Pulmonary PULMONARY HEART DISEASE 14,100 4,230
artery hypertension
I27.8 Other specified pulmonary heart diseases PULMONARY HEART DISEASE 14,100 4,230
I27.9 Pulmonary heart disease, unspecified; Chronic PULMONARY HEART DISEASE 14,100 4,230
cardiopulmonary disease; Chronic Cor pulmonale NOS
Nonobstructive reflux-associated chronic pyelonephritis; Chronic
Pyelonephritis associated with vesicoureteral reflux
N11.0 PYELONEPHRITIS 10,900 3,270
Chronic obstructive pyelonephritis; Chronic pyelonephritis associated with

anomaly of [pelviureteric junction, pyeloureteric junction, ureter]; Chronic
pyelonephritis associated with kinking of [pelviureteric junction,
pyeloureteric junction, ureter]; Chronic pyelonephritis associated with
stircture of[pelviureteric junction, pyeloureteric junction, ureter]
N11.1 PYELONEPHRITIS 10,900 3,270
N11.8 Other chronic tubulo-interstitial nephritis; Nonobstructive PYELONEPHRITIS 10,900 3,270

chronic pyelonephritis NOS
D60.0 Chronic acquired pure red cell aplasia RED CELL APLASIA 7,300 2,190
D60.8 Other acquired pure red cell aplasias RED CELL APLASIA 7,300 2,190
D60.9 Acquired pure red cell aplasia, unspecified RED CELL APLASIA 7,300 2,190
Ischaemia and infarction of kidney; Embolism of renal artery; Obstruction
of renal artery; Occlusion of renal
N28.0 artery; Thrombosis of renal artery; Renal infarct RENAL INFARCT 9,600 2,880
N15.1 Renal and perinephric abscess RENAL/BLADDER ABSCESS 13,900 4,170

N30.8 Other cystitis; Abscess of bladder RENAL/BLADDER ABSCESS 13,900 4,170
Urethral abscess; Abscess of Cowper's gland; Abscess of
Littré's gland; Periurethral Abscess ; Abscess of urethral gland
N34.0 RENAL/BLADDER ABSCESS 13,900 4,170
J60 Coalworker's pneumoconiosis; Anthracosilicosis; RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
Anthracosis; Coalworker's lung AGENTS
J61 Pneumoconiosis due to asbestos and other mineral fibres; RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
Asbestosis AGENTS
J62.0 Pneumoconiosis due to talc dust RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J62.8 Pneumoconiosis due to other dust containing silica; Silicosis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
NOS AGENTS
J63.0 Aluminosis (of lung) RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J63.3 Graphite fibrosis (of lung) RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J63.4 Siderosis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J63.8 Pneumoconiosis due to other specified inorganic dusts RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J64 Unspecified pneumoconiosis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J65 Pneumoconiosis associated with tuberculosis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J66.2 Cannabinosis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410

AGENTS
J66.8 Airway disease due to other specific organic dusts RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J67.0 Farmer's lung; Harvester's lung; Haymaker's lung; Mouldy RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
hay disease AGENTS
J67.1 Bagassosis; Bagasse disease; Bagasse pneumonitis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J67.5 Mushroom-worker's lung RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410

AGENTS
Air-conditioner and humidifier lung; Allergic alveolitis due to fungi, RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
thermophilic actinomycetees and other organisms growing in ventilation
J67.7 (air-conditioning) systems 14,700 4,410
Hypersensitivity pneumonitis due to other organic dusts; Cheese-washer's RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
J67.8 lung; Coffee-worker's lung; Fishmeal- 14,700 4,410
worker's lung; Furrier's lung; Sequoiosis
Hypersensitivity pneumonitis due to unspecified organic RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
dust; Extrinsic allergic alveolitis NOS; Hypersensitivity pneumonitis NOS
J67.9 14,700 4,410
J68.0 Bronchitis and pneumonitis due to chemicals, gases, fumes RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
and vapours; Acute chemical bronchitis AGENTS
Acute pulmonary oedema due to chemicals, gases, fumes and vapours; RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
Acute Chemical pulmonary oedema
J68.1 14,700 4,410
J68.2 Upper respiratory inflammation due to chemicals, gases, RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
fumes and vapours, not elsewhere classified AGENTS
Other acute and subacute respiratory conditions due to chemicals, gases, RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
fumes and vapours; Reactive airways dysfunction syndrome; Hyperactive
J68.3 airway disease 14,700 4,410
Chronic respiratory conditions due to chemicals, gases, fumes and
vapours; Diffuse emphysema due to inhalation of chemicals, gases, fumes
and vapours; Chronic emphysema due to inhalation of chemicals, gases,
fumes and vapours; Chronic obliterative bronchiolitis due to inhalation of
chemicals, gases, fumes and vapours; Subacute obliterative bronchiolitis
due to inhalation of chemicals, gases, fumes and vapours; Chronic
pulmonary fibrosis due to inhalation of chemicals, gases, fumes and
J68.4 vapours RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS 14,700 4,410
J68.8 Other respiratory conditions due to chemicals, gases, fumes RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
and vapours AGENTS
J68.9 Unspecified respiratory condition due to chemicals, gases, RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
fumes and vapours AGENTS
Pneumonitis due to food and vomit; Aspiration pneumonia due to NOS;

Aspiration pneumonia due to regurgitated food; Aspiration pneumonia
due to gastric secretions; Aspiration pneumonia due to milk; Aspiration
J69.0 pneumonia due to vomit RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS 14,700 4,410
J69.1 Pneumonitis due to oils and essences; Lipid pneumonia RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J69.8 Pneumonitis due to other solids and liquids; Pneumonitis RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
due to aspiration of blood AGENTS
J70.0 Acute pulmonary manifestations due to radiation; RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
Radiation pneumonitis AGENTS
J70.2 Acute drug-induced interstitial lung disorders RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J70.4 Drug-induced interstitial lung disorders, unspecified RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J70.8 Respiratory conditions due to other specified external RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
agents AGENTS
J70.9 Respiratory conditions due to unspecified external agent RESPIRATORY CONDITIONS DUE TO EXTERNAL 14,700 4,410
AGENTS
J96.0 Acute respiratory failure RESPIRATORY FAILURE 32,000 9,600
J96.1 Chronic respiratory failure RESPIRATORY FAILURE 32,000 9,600
J96.9 Respiratory failure, unspecified RESPIRATORY FAILURE 32,000 9,600
H34.1 Central retinal artery occlusion RETINAL VASCULAR OCCLUSION 7,700 2,310
Other retinal artery occlusions; Hollenhorst's plaque; Retinal artery
occlusion; Retinal artery branch occlusion ; Retinal artery partial occlusion;
H34.2 Retinal microembolism RETINAL VASCULAR OCCLUSION 7,700 2,310
Other retinal vascular occlusions; Retinal central vein occlusion ; Retinal

H34.8 vein occlusion incipient; Retinal vein RETINAL VASCULAR OCCLUSION 7,700 2,310
occlusion partial; Retinal vein occlusion tributary
H34.9 Retinal vascular occlusion, unspecified RETINAL VASCULAR OCCLUSION 7,700 2,310
Rheumatic fever without mention of heart involvement; Arthritis,
rheumatic, acute or subacute involvement
I00 RHEUMATIC FEVER 10,100 3,030
I01.0 Acute rheumatic pericarditis; Acute rheumatic pericarditis RHEUMATIC FEVER 10,100 3,030
I01.1 Acute rheumatic endocarditis; Acute rheumatic valvulitis RHEUMATIC FEVER 10,100 3,030
I01.2 Acute rheumatic myocarditis; RHEUMATIC FEVER 10,100 3,030

I01.8 Other acute rheumatic heart disease; Acute rheumatic RHEUMATIC FEVER 10,100 3,030
pancarditis
Acute rheumatic heart disease unspecified; Acute rheumatic carditis;
Active rheumatic heart disease; Acute rheumatic heart disease
I01.9 Rheumatic fever with heart involvement RHEUMATIC FEVER 10,100 3,030
I02.0 Rheumatic chorea with heart involvement; Chorea NOS RHEUMATIC FEVER 10,100 3,030
with heart involvement
I02.9 Rheumatic chorea without heart involvement; Rheumatic RHEUMATIC FEVER 10,100 3,030
chorea NOS
I05.0 Mitral stenosis; Rheumatic mitral valve obstruction RHEUMATIC HEART DISEASE 12,800 3,840
I05.1 Rheumatic mitral insufficiency; Rheumatic mitral RHEUMATIC HEART DISEASE 12,800 3,840
incompetence; Rheumatic mitral regurgitation
I05.2 Mitral stenosis with insufficiency; Mitral stenosis with RHEUMATIC HEART DISEASE 12,800 3,840
incompetence or regurgitation
I05.8 Other mitral valve diseases; Mitral valve failure RHEUMATIC HEART DISEASE 12,800 3,840
I05.9 Mitral valve disease unspecified; Chronic mitral valve RHEUMATIC HEART DISEASE 12,800 3,840
disorder NOS
I06.0 Rheumatic aortic stenosis; Rheumatic aortic valve RHEUMATIC HEART DISEASE 12,800 3,840
obstruction
I06.1 Rheumatic aortic insufficiency; Rheumatic aortic RHEUMATIC HEART DISEASE 12,800 3,840
incompetence; Rheumatic aortic regurgitation
Rheumatic aortic stenosis with insufficiency; Rheumatic aortic stenosis

I06.2 with incompetence or regurgitation RHEUMATIC HEART DISEASE 12,800 3,840
I06.8 Other rheumatic aortic valve diseases RHEUMATIC HEART DISEASE 12,800 3,840
I06.9 Rheumatic aortic valve disease unspecified; Rheumatic RHEUMATIC HEART DISEASE 12,800 3,840
aortic valve disease NOS
I07.0 Tricuspid stenosis; Rheumatic tricuspid valve stenosis RHEUMATIC HEART DISEASE 12,800 3,840
I07.1 Tricuspid insufficiency; Rheumatic tricuspid valve RHEUMATIC HEART DISEASE 12,800 3,840
insufficiency
I07.9 Tricuspid valve disease unspecified; Tricuspid valve disorder RHEUMATIC HEART DISEASE 12,800 3,840
NOS
Disorders of both mitral and aortic valves; Involvement of

I08.0 both mitral and aortic valves whether specified as rheumatic or of RHEUMATIC HEART DISEASE 12,800 3,840
unspecified origin
I08.1 Disorders of both mitral and tricuspid valves RHEUMATIC HEART DISEASE 12,800 3,840
I08.2 Disorders of both aortic and tricuspid valves RHEUMATIC HEART DISEASE 12,800 3,840
I08.3 Combined disorders of mitral aortic and tricuspid valves RHEUMATIC HEART DISEASE 12,800 3,840
I08.8 Other multiple valve diseases RHEUMATIC HEART DISEASE 12,800 3,840
I08.9 Multiple valve disease, unspecified RHEUMATIC HEART DISEASE 12,800 3,840
I09.0 Rheumatic myocarditis RHEUMATIC HEART DISEASE 12,800 3,840
Rheumatic diseases of endocardium, valve unspecified;
I09.1 Chronic rheumatic endocarditis; Chronic rheumatic valvulitis RHEUMATIC HEART DISEASE 12,800 3,840
Chronic rheumatic pericarditis; Rheumatic adherent pericardium; Chronic

rheumatic mediastinopericarditis; Chronic rheumatic myopericarditis
I09.2 RHEUMATIC HEART DISEASE 12,800 3,840
I09.8 Other specified rheumatic heart diseases; Rheumatic RHEUMATIC HEART DISEASE 12,800 3,840
disease of pulmonary valve
Epidemic louse-borne typhus fever due to Rickettsia prowazekii; Classical
typhus fever;
A75.0 Epidemic louse-borne typhus RICKETTSIOSES 7,000 2,100
A75.9 Typhus fever, unspecified RICKETTSIOSES 7,000 2,100

A77.0 Spotted fever due to Rickettsia rickettsii; Rocky Mountain RICKETTSIOSES 7,000 2,100
spotted fever; Sao Paulo fever
A79.0 Trench fever ; Quintan fever; Wolhynian fever RICKETTSIOSES 7,000 2,100
A79.9 Rickettsiosis, unspecified; Rickettsial infection NOS RICKETTSIOSES 7,000 2,100
U04.9 Severe Acute Respiratory Syndrome (SARS) SARS
A38 Scarlet fever; Scarlatina SCARLET FEVER 8,300 2,490
A40.0 Sepsis due to streptococcus, group A SEPSIS 32,000 9,600
A40.1 Sepsis due to streptococcus, group B SEPSIS 32,000 9,600
A40.3 Sepsis due to Streptococcus pneumoniae; Pneumococcal SEPSIS 32,000 9,600
septicaemia
A40.8 Other streptococcal sepsis SEPSIS 32,000 9,600
A40.9 Streptococcal septicaemia, unspecified SEPSIS 32,000 9,600
A41.0 Sepsis due to Staphylococcus aureus SEPSIS 32,000 9,600
A41.1 Sepsis due to other specified staphylococcus; Sepsis due SEPSIS 32,000 9,600
to coagulase-negative staphylococcus
A41.2 Sepsis due to unspecified staphylococcus SEPSIS 32,000 9,600
A41.3 Sepsis due to Haemophilus influenzae SEPSIS 32,000 9,600
A41.4 Sepsis due to anaerobes SEPSIS 32,000 9,600
A41.5 Sepsis due to other Gram-negative organisms; Gram- SEPSIS 32,000 9,600
negative septicaemia NOS
A41.8 Other specified septicaemia SEPSIS 32,000 9,600
A41.9 Sepsis , unspecified; Septic shock SEPSIS 32,000 9,600
A48.3 Toxic shock syndrome SEPSIS 32,000 9,600
I69.0 Sequelae of subarachnoid haemorrhage SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090
I69.1 Sequelae of intracerebral haemorrhage SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090
I69.2 Sequelae of other nontraumatic intracranial haemorrhage SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090
I69.3 Sequelae of cerebral infarction SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090

I69.4 Sequelae of stroke, not specified as haemorrhage or SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090
infarction
I69.8 Sequelae of other and unspecified cerebrovascular diseases SEQUELAE OF CEREBROVASCULAR DISEASES 10,300 3,090
B90.0 Sequelae of central nervous system tuberculosis SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
B90.8 Sequelae of tuberculosis of other organs SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
B90.9 Sequelae of respiratory and unspecified tuberculosis; SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
sequelae of tuberculosis NOS DISEASES
B94.1 Sequelae of viral encephalitis SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
B94.2 Sequelae of viral hepatitis SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
B94.8 Sequelae of other specified infectious and parasitic diseases SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
B94.9 Sequelae of unspecified infectious or parasitic disease SEQUELAE OF INFECTIOUS AND PARASITIC 10,700 3,210
DISEASES
G09 Sequelae of inflammatory diseases of central nervous SEQUELAE OF INFLAMMATORY DISEASE OF THE 8,000 2,400
system CENTRAL NERVOUS SYSTEM
E64.8 Sequelae of other nutritional deficiencies SEQUELAE OF NUTRITIONAL DEFICIENCIES 8,800 2,640
T90.0 Sequelae of superficial injury of head SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T90.1 Sequelae of open wound of head SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T90.2 Sequelae of fracture of skull and facial bones SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T90.5 Sequelae of intra cranial injury SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T90.8 Sequelae of other specified injuries of head SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T90.9 Sequelae of unspecified injury of head SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T91.0 Sequelae of superficial injury and open wound of neck and SEQUELAE OF TRAUMA INJURIES 8,500 2,550
trunk
T91.1 Sequelae of fracture of spine SEQUELAE OF TRAUMA INJURIES 8,500 2,550

T91.2 Sequelae of other fracture of thorax and pelvis SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T91.3 Sequelae of injury of spinal cord SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T92.0 Sequelae of open wound of upper limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T92.1 Sequelae of fracture of arm SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T92.8 Sequelae of other specified injuries of upper limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T93.0 Sequelae of open wound of lower limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T93.1 Sequelae of fracture of femur SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T93.2 Sequelae of other fractures of lower limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T93.3 Sequelae of dislocation sprain and strain of lower limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T93.8 Sequelae of other specified injuries of lower limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T94.0 Sequelae of injuries involving multiple body regions SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T94.1 Sequelae of injuries, not specified by body regions SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T95.0 Sequelae of burn, corrosion and frostbite of head and neck SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T95.2 Sequelae of burn, corrosion and frostbite of upper limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T95.3 Sequelae of burn, corrosion and frostbite of lower limb SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T95.8 Sequelae of other specified burn corrosion and frostbite SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T95.9 Sequelae of unspecified burn, corrosion and frostbite SEQUELAE OF TRAUMA INJURIES 8,500 2,550
T98.2 Sequelae of certain early complications of trauma SEQUELAE OF TRAUMA INJURIES 8,500 2,550
R57.0 Cardiogenic shock SHOCK 32,000 9,600
R57.1 Hypovolaemic shock SHOCK 32,000 9,600
R57.8 Other shock; Endotoxic shock SHOCK 32,000 9,600
R57.9 Shock, unspecified; Failure of peripheral circulation NOS SHOCK 32,000 9,600
T88.2 Shock due to anaesthesia; Shock due to anaesthesia in SHOCK 32,000 9,600
which the correct sustance was properly administered
Situs inversus; Dextrocardia with situs inversus; Mirror- image atrial

arrangement with situs inversus; Situs inversus or transverses
abdominalis; Situs inversus or transversus thoracis; Transposition of
Q89.3 abdominal viscera; Transposition of thoracic visce SITUS INVERSUS 6,700 2,010
S02.0 Fracture o f vault of skull; Fracture of Frontal bone; SKULL FRACTURES 10,700 3,210
Fracture of Parietal bone
S02.00 Closed fracture o f vault of skull; Fracture of Frontal bone; SKULL FRACTURES 10,700 3,210
S02.01 Open fracture o f vault of skull; Fracture of Frontal bone; SKULL FRACTURES 10,700 3,210
Fracture of base of skull: Fracture of anterior fossa, middle fossa, posterior

fossa; Fracture of Occiput; Fracture of orbital roof; Fracture of ethmoid
sinus & frontal sinus; Fracture of Sphenoid; Fracture of temporal bone
S02.1 SKULL FRACTURES 10,700 3,210
Closed fracture of base of skull; fracture of anterior fossa; fracture of

middle fossa; fracture of posterior fossa; fracture of occiput; fracture of
orbital roof; fracture of ethmoid sinus; fracture of frontal sinus; fracture of
S02.10 sphenoid; fracture of temporal bone SKULL FRACTURES 10,700 3,210
Opem fracture of base of skull; fracture of anterior fossa; fracture of

middle fossa; fracture of posterior fossa; fracture of occiput; fracture of
orbital roof; fracture of ethmoid sinus; fracture of frontal sinus; fracture of
S02.11 sphenoid; fracture of temporal bone SKULL FRACTURES 10,700 3,210
S02.20 closed fracture of nasal bones SKULL FRACTURES 10,700 3,210

S02.21 open fracture of nasal bones SKULL FRACTURES 10,700 3,210
S02.30 Closed fracture of orbital floor SKULL FRACTURES 10,700 3,210
S02.31 Open fracture of orbital floor SKULL FRACTURES 10,700 3,210
S02.40 Closed Fracture of malar and maxillary bones; superior SKULL FRACTURES 10,700 3,210
maxilla; upper jaw (bone); zygoma
S02.41 Open Fracture of malar and maxillary bones; superior SKULL FRACTURES 10,700 3,210
maxilla; upper jaw (bone); zygoma
S02.50 Closed Fracture of tooth SKULL FRACTURES 10,700 3,210

S02.60 Closed Fracture of mandible SKULL FRACTURES 10,700 3,210
S02.61 Open Fracture of mandible SKULL FRACTURES 10,700 3,210
S02.70 Closed Multiple fractures involving skull and facial bones SKULL FRACTURES 10,700 3,210
S02.71 Open Multiple fractures involving skull and facial bones SKULL FRACTURES 10,700 3,210
S02.80 closed Fractures of other skull and facial bones including SKULL FRACTURES 10,700 3,210
Alveolus, Orbit NOS, Palate
S02.81 open Fractures of other skull and facial bones including SKULL FRACTURES 10,700 3,210
Alveolus, Orbit NOS, Palate
S02.90 Closed Fracture of skull and facial bones, part unspecified SKULL FRACTURES 10,700 3,210
S02.91 Open Fracture of skull and facial bones, part unspecified SKULL FRACTURES 10,700 3,210
G47.3 Sleep apnoea; Central sleep apnoea; obstructive sleep SLEEP APNEA 10,800 3,240
apnoea,
M43.0 Spondylolysis SPONDYLOPATHIES 8,300 2,490

M43.1 Spondylolisthesis SPONDYLOPATHIES 8,300 2,490
M43.2 Other fusion of spine; Ankylosis of spinal joint SPONDYLOPATHIES 8,300 2,490
M43.5 Other recurrent vertebral subluxation SPONDYLOPATHIES 8,300 2,490
M43.6 Torticollis SPONDYLOPATHIES 8,300 2,490
M45 Ankylosing spondylitis; Rheumatoid arthritis of spine SPONDYLOPATHIES 8,300 2,490
M46.0 Spinal enthesopathy; Disorder of ligamentous or muscular SPONDYLOPATHIES 8,300 2,490
attachments of spine
M46.1 Sacroiliitis, not elsewhere classified SPONDYLOPATHIES 8,300 2,490

M46.16 Sacroiliitis, not elsewhere classified lumbar region SPONDYLOPATHIES 8,300 2,490
M46.19 Sacroiliitis, not elsewhere classified site unspecified SPONDYLOPATHIES 8,300 2,490
M46.2 Osteomyelitis of vertebra SPONDYLOPATHIES 8,300 2,490
M46.28 Osteomyelitis of vertebra sacral and sacrococcygeal region SPONDYLOPATHIES 8,300 2,490
M46.29 Osteomyelitis of vertebra site unspecified SPONDYLOPATHIES 8,300 2,490

M46.3 Infection of intervertebral disc (pyogenic) SPONDYLOPATHIES 8,300 2,490
M46.36 Infection of intervertebral disc (pyogenic) lumbar region SPONDYLOPATHIES 8,300 2,490
M46.4 Discitis, unspecified SPONDYLOPATHIES 8,300 2,490

M46.46 Discitis, unspecified lumbar region SPONDYLOPATHIES 8,300 2,490
M46.47 Discitis, unspecified lumbosacral region SPONDYLOPATHIES 8,300 2,490
M46.49 Discitis, unspecified site unspecified SPONDYLOPATHIES 8,300 2,490
M46.5 Other infective spondylopathies SPONDYLOPATHIES 8,300 2,490
M46.8 Other specified inflammatory spondylopathies SPONDYLOPATHIES 8,300 2,490
M46.87 Other specified inflammatory spondylopathies lumbosacral SPONDYLOPATHIES 8,300 2,490
region
M46.9 Inflammatory spondylopathy, unspecified SPONDYLOPATHIES 8,300 2,490
M46.92 Inflammatory spondylopathy, unspecified cervical region SPONDYLOPATHIES 8,300 2,490
M46.97 Inflammatory spondylopathy, unspecified lumbosacral SPONDYLOPATHIES 8,300 2,490

region
M46.98 Inflammatory spondylopathy, unspecified sacral and SPONDYLOPATHIES 8,300 2,490

M46.99 Inflammatory spondylopathy, unspecified site unspecified SPONDYLOPATHIES 8,300 2,490
M47.1 Other spondylosis with myelopathy SPONDYLOPATHIES 8,300 2,490

M47.1+G99.2* Myelopathy in Other spondylosis with myelopathy SPONDYLOPATHIES 8,300 2,490
M47.2 Other spondylosis with radiculopathy SPONDYLOPATHIES 8,300 2,490
M47.20 Other spondylosis with radiculopathy Multiple sites in SPONDYLOPATHIES 8,300 2,490
spine
M47.22 Other spondylosis with radiculopathy cervical region SPONDYLOPATHIES 8,300 2,490
M47.26 Other spondylosis with radiculopathy lumbar region SPONDYLOPATHIES 8,300 2,490
M47.27 Other spondylosis with radiculopathy lumbosacral region SPONDYLOPATHIES 8,300 2,490
M47.29 Other spondylosis with radiculopathy site unspecified SPONDYLOPATHIES 8,300 2,490
Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral
spondylosis without myelopathy or radiculopathy; Thoracic spondylosis
M47.8 without myelopathy or radiculopathy SPONDYLOPATHIES 8,300 2,490

without myelopathy or radiculopathy Multiple sites in spine
M47.80 SPONDYLOPATHIES 8,300 2,490

without myelopathy or radiculopathy occipito-atlanto-axial region

M47.82 without myelopathy or radiculopathy cervical region SPONDYLOPATHIES 8,300 2,490

without myelopathy or radiculopathy cervicothoracic region

M47.84 without myelopathy or radiculopathy thoracic region SPONDYLOPATHIES 8,300 2,490

without myelopathy or radiculopathy thoracolumbar region

M47.86 without myelopathy or radiculopathy lumbar region SPONDYLOPATHIES 8,300 2,490

without myelopathy or radiculopathy lumbosacral region
without myelopathy or radiculopathy sacral and sacrococcygeal region

M47.89 without myelopathy or radiculopathy site unspecified SPONDYLOPATHIES 8,300 2,490
M47.9 Spondylosis, unspecified SPONDYLOPATHIES 8,300 2,490

M47.90 Spondylosis, unspecified Multiple sites in spine SPONDYLOPATHIES 8,300 2,490
M47.92 Spondylosis, unspecified cervical region SPONDYLOPATHIES 8,300 2,490
M47.94 Spondylosis, unspecified thoracic region SPONDYLOPATHIES 8,300 2,490
M47.95 Spondylosis, unspecified thoracolumbar region SPONDYLOPATHIES 8,300 2,490
M47.96 Spondylosis, unspecified lumbar region SPONDYLOPATHIES 8,300 2,490
M47.97 Spondylosis, unspecified lumbosacral region SPONDYLOPATHIES 8,300 2,490
M47.99 Spondylosis, unspecified site unspecified SPONDYLOPATHIES 8,300 2,490
M48.0 Spinal stenosis; Caudal stenosis SPONDYLOPATHIES 8,300 2,490
M48.00 Spinal stenosis; Caudal stenosis Multiple sites in spine SPONDYLOPATHIES 8,300 2,490
M48.02 Spinal stenosis; Caudal stenosis cervical region SPONDYLOPATHIES 8,300 2,490
M48.03 Spinal stenosis; Caudal stenosis cervicothoracic region SPONDYLOPATHIES 8,300 2,490
M48.04 Spinal stenosis; Caudal stenosis thoracic region SPONDYLOPATHIES 8,300 2,490
M48.05 Spinal stenosis; Caudal stenosis thoracolumbar region SPONDYLOPATHIES 8,300 2,490
M48.06 Spinal stenosis; Caudal stenosis lumbar region SPONDYLOPATHIES 8,300 2,490
M48.07 Spinal stenosis; Caudal stenosis lumbosacral region SPONDYLOPATHIES 8,300 2,490
M48.08 Spinal stenosis; Caudal stenosis sacral and sacrococcygeal SPONDYLOPATHIES 8,300 2,490
region
M48.09 Spinal stenosis; Caudal stenosis site unspecified SPONDYLOPATHIES 8,300 2,490
M48.1 Ankylosing hyperostosis [Forestier]; Diffuse idiopathic SPONDYLOPATHIES 8,300 2,490
skeletal hyperostosis [DISH]
M48.16 Ankylosing hyperostosis [Forestier]; Diffuse idiopathic SPONDYLOPATHIES 8,300 2,490

skeletal hyperostosis [DISH] lumbar region
M48.2 Kissing spine SPONDYLOPATHIES 8,300 2,490
M48.3 Traumatic spondylopathy SPONDYLOPATHIES 8,300 2,490
M48.32 Traumatic spondylopathy cervical region SPONDYLOPATHIES 8,300 2,490
M48.4 Fatigue fracture of vertebra; Stress fracture of vertebra SPONDYLOPATHIES 8,300 2,490
M48.5 Collapsed vertebra, not elsewhere classified; Collapsed SPONDYLOPATHIES 8,300 2,490
vertebra NOS; Wedging of vertebra NOS
M48.54 Collapsed vertebra NOS; Wedging of vertebra NOS thoracic SPONDYLOPATHIES 8,300 2,490
region
M48.56 Collapsed vertebra NOS; Wedging of vertebra NOS lumbar SPONDYLOPATHIES 8,300 2,490
region
M48.57 Collapsed vertebra NOS; Wedging of vertebra NOS SPONDYLOPATHIES 8,300 2,490
lumbosacral region
M48.8 Other specified spondylopathies; Ossification of posterior SPONDYLOPATHIES 8,300 2,490
longitudinal ligament
M48.80 Ossification of posterior longitudinal ligament Multiple sites SPONDYLOPATHIES 8,300 2,490
in spine
M48.85 Ossification of posterior longitudinal ligament SPONDYLOPATHIES 8,300 2,490
thoracolumbar region
M48.86 Ossification of posterior longitudinal ligament lumbar SPONDYLOPATHIES 8,300 2,490

region
M48.89 Ossification of posterior longitudinal ligament site SPONDYLOPATHIES 8,300 2,490

unspecified
M48.9 Spondylopathy, unspecified SPONDYLOPATHIES 8,300 2,490

M48.92 Spondylopathy, unspecified cervical region SPONDYLOPATHIES 8,300 2,490
M48.95 Spondylopathy, unspecified thoracolumbar region SPONDYLOPATHIES 8,300 2,490
M48.96 Spondylopathy, unspecified lumbar region SPONDYLOPATHIES 8,300 2,490
M48.98 Spondylopathy, unspecified sacral and sacrococcygeal SPONDYLOPATHIES 8,300 2,490
region
M48.99 Spondylopathy, unspecified site unspecified SPONDYLOPATHIES 8,300 2,490

M49.0* Tuberculosis of spine; Pott's curvature SPONDYLOPATHIES 8,300 2,490
M49.8* Spondylopathy in other diseases classified elsewhere SPONDYLOPATHIES 8,300 2,490
L00 Staphylococcal scalded skin syndrome; Pemphigus STAPHYLOCCOCAL SCALDED SKIN SYNDROME 10,200 3,060
neonatorum; Ritter's disease
G41.0 Grand mal status epilepticus; Tonic-clonic status epilepticus STATUS EPILEPTICUS 15,600 4,680
G41.1 Petit mal status epilepticus; Epileptic absence status STATUS EPILEPTICUS 15,600 4,680
G41.2 Complex partial status epilepticus STATUS EPILEPTICUS 15,600 4,680
G41.8 Other status epilepticus STATUS EPILEPTICUS 15,600 4,680
G41.9 Status epilepticus, unspecified STATUS EPILEPTICUS 15,600 4,680
L51.1 Bullous erythema multiforme; Stevens-Johnson syndrome STEVEN JOHNSONS SYNDROME 12,300 3,690
I60.0 Subarachnoid haemorrhage from carotid siphon and STROKE - HEMORRHAGIC 38,000 11,400
bifurcation
I60.1 Subarachnoid haemorrhage from middle cerebral artery STROKE - HEMORRHAGIC 38,000 11,400
I60.2 Subarachnoid haemorrhage from anterior communicating STROKE - HEMORRHAGIC 38,000 11,400
artery
I60.3 Subarachnoid haemorrhage from posterior communicating STROKE - HEMORRHAGIC 38,000 11,400
artery
I60.4 Subarachnoid haemorrhage from basilar artery STROKE - HEMORRHAGIC 38,000 11,400
I60.5 Subarachnoid haemorrhage from vertebral artery STROKE - HEMORRHAGIC 38,000 11,400
I60.6 Subarachnoid haemorrhage from other intracranial STROKE - HEMORRHAGIC 38,000 11,400
arteries; Multiple involvement of intracranial arteries
Subarachnoid haemorrhage from intracranial artery, unspecified;

Congenital ruptured berry aneurysm NOS; Subarachnoid haemorrhage
from cerebral artery NOS; Subarachnoid haemorrhage from
I60.7 communicating artery STROKE - HEMORRHAGIC 38,000 11,400
NOS
Other subarachnoid haemorrhage; Meningeal haemorrhage; Rupture of

cerebral arteriovenous
I60.8 malformation STROKE - HEMORRHAGIC 38,000 11,400
I60.9 Subarachnoid haemorrhage, unspecified; Congenital STROKE - HEMORRHAGIC 38,000 11,400

ruptured cerebral aneurysm NOS
I61.0 Intracerebral haemorrhage in hemisphere, subcortical; STROKE - HEMORRHAGIC 38,000 11,400

Deep intracerebral haemorrhage
Intracerebral haemorrhage in hemisphere, cortical; Cerebral lobe

haemorrhage; Superficial intracerebral
I61.1 haemorrhage STROKE - HEMORRHAGIC 38,000 11,400
I61.2 Intracerebral haemorrhage in hemisphere, unspecified STROKE - HEMORRHAGIC 38,000 11,400

I61.3 Intracerebral haemorrhage in brain stem STROKE - HEMORRHAGIC 38,000 11,400
I61.4 Intracerebral haemorrhage in cerebellum STROKE - HEMORRHAGIC 38,000 11,400
I61.5 Intracerebral haemorrhage, intraventricular STROKE - HEMORRHAGIC 38,000 11,400
I61.6 Intracerebral haemorrhage, multiple localized STROKE - HEMORRHAGIC 38,000 11,400
I61.8 Other intracerebral haemorrhage STROKE - HEMORRHAGIC 38,000 11,400
I61.9 Intracerebral haemorrhage, unspecified STROKE - HEMORRHAGIC 38,000 11,400
Cerebrovascular Accident hemorrhage
I62.0 Acute Subdural haemorrhage; Nontraumatic Subdural STROKE - HEMORRHAGIC 38,000 11,400
haemorrhage
I62.1 Nontraumatic extradural haemorrhage; Nontraumatic STROKE - HEMORRHAGIC 38,000 11,400

epidural haemorrhage
I62.9 Intracranial haemorrhage (nontraumatic), unspecified STROKE - HEMORRHAGIC 38,000 11,400

I63.0 Cerebral infarction due to thrombosis of precerebral STROKE - INFARCTION 28,000 8,400
arteries
I63.1 Cerebral infarction due to embolism of precerebral arteries STROKE - INFARCTION 28,000 8,400
I63.2 Cerebral infarction due to unspecified occlusion or stenosis STROKE - INFARCTION 28,000 8,400
of precerebral arteries
Cerebral infarction due to thrombosis of cerebral arteries Cerebrovascular

I63.3 disease (CVD), thrombotic infarct STROKE - INFARCTION 28,000 8,400
I63.4 Cerebral infarction due to embolism of cerebral arteries STROKE - INFARCTION 28,000 8,400
I63.5 Cerebral infarction due to unspecified occlusion or stenosis STROKE - INFARCTION 28,000 8,400
of cerebral arteries
I63.6 Cerebral infarction due to cerebral venous thrombosis, STROKE - INFARCTION 28,000 8,400
nonpyogenic
I63.8 Other cerebral infarction STROKE - INFARCTION 28,000 8,400

Cerebral infarction, unspecified
Reversible Ischemic Neurologic Deficit (RIND) CVA with infarction
I63.9 STROKE - INFARCTION 28,000 8,400
I63.9+G46.7* Other lacunar syndrome in unspecified cerebral infarction STROKE - INFARCTION 28,000 8,400
Stroke, not specified as hemorrhage or infarction; Cerebrovascular

Accident (CVA)
I64 Cardioembolic CVA STROKE - INFARCTION 28,000 8,400
G10 Huntington's disease; Huntington's chorea SYSTEMIC ATROPHIES INVOLVING CENTRAL 10,400 3,120
NERVOUS SYSTEM
G11.0 Congenital nonprogressive ataxia SYSTEMIC ATROPHIES INVOLVING CENTRAL 10,400 3,120
NERVOUS SYSTEM
Early-onset cerebellar ataxia including Early-onset cerebellar ataxia with
essential tremor; Early-onset cerebellar ataxia with myoclonus [Hunt's
ataxia]; Early- onset cerebellar ataxia with retained tendon reflexes;
G11.1 Friedreich's ataxia (autosomal recessiv SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM 10,400 3,120
G11.3 Cerebellar ataxia with defective DNA repair; Ataxia SYSTEMIC ATROPHIES INVOLVING CENTRAL 10,400 3,120
telangiectasia [Louis-Bar] NERVOUS SYSTEM
Hereditary ataxia, unspecified; Hereditary cerebellar ataxia NOS; SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
Hereditary cerebellar degeneration; Hereditary cerebellar disease;
G11.9 Hereditary cerebellar syndrome 10,400 3,120
G12.0 Infantile spinal muscular atrophy, type I [Werdnig-Hoffman] SYSTEMIC ATROPHIES INVOLVING CENTRAL 10,400 3,120
NERVOUS SYSTEM
Other inherited spinal muscular atrophy; Progressive bulbar palsy of

childhood [Fazio-Londe]; Spinal muscular atrophy adult form;
Spinal muscular atrophy childhood form, type II; Spinal muscular atrophy
distal; Spinal muscular atrophy juvenile form, type III [Kugelberg-
G12.1 FWelander]; Spinal muscular SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM 10,400 3,120
atrophy scapuloperoneal form
Motor neuron disease; Familial motor neuron disease; AmyotrophicLateral SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
sclerosis; Primary Lateral sclerosis ; Progressive bulbar palsy; Progressive
G12.2 spinal muscular atrophy 10,400 3,120
G12.9 Spinal muscular atrophy, unspecified SYSTEMIC ATROPHIES INVOLVING CENTRAL 10,400 3,120
NERVOUS SYSTEM
Parkinson's disease; Hemiparkinsonism; Paralysis agitans; Parkinsonism or SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
Parkinson's disease NOS; Idiopathic Parkinsonism or Parkinson's disease;
G20 Primary Parkinsonism or Parkinson's disease 10,400 3,120
L93.0 Discoid lupus erythematosus; Lupus erythematosus NOS SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
L93.1 Subacute cutaneous lupus erythematosus SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
L93.2 Other local lupus erythematosus; Lupus erymatosus SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
profundus; Lupus panniculitis
M32.0 Drug-induced systemic lupus erythematosus SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
M32.8 Other forms of systemic lupus erythematosus SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
M32.9 Systemic lupus erythematosus, unspecified SYSTEMIC LUPUS ERYTHEMATOSUS 11,900 3,570
A33 Tetanus neonatorum TETANUS 16,500 4,950
A34 Obstetrical tetanus TETANUS 16,500 4,950
A35 Other tetanus; Tetanus NOS TETANUS 16,500 4,950
R29.0 Tetany; Carpopedal spasm TETANUS 16,500 4,950
D56.0 Alpha thalassaemia THALASSEMIA 5,600 1,680
Beta thalassaemia; Cooley's anaemia; Severe beta thalassaemia; Sickle-cell
D56.1 bet thalassaemia; Thalassaemia THALASSEMIA 5,600 1,680
intermedia; Thalassaemia major;
D56.2 Delta-beta thalassaemia THALASSEMIA 5,600 1,680

D56.3 Thalassaemia trait THALASSEMIA 5,600 1,680
D56.4 Hereditary persistence of fetal haemoglobin [HPFH] THALASSEMIA 5,600 1,680
D56.8 Other thalassaemias THALASSEMIA 5,600 1,680
L51.2 Toxic epidermal necrolysis [Lyell] TOXIC EPIDERMAL NECROLYSIS 15,900 4,770
G45.0 Vertebro-basilar artery syndrome TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
G45.1 Carotid artery syndrome (Hemispheric) TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
G45.2 Multiple and bilateral precerebral artery syndromes TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
G45.3 Amaurosis fugax TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
G45.4 Transient global amnesia TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
G45.8 Other transient cerebral ischaemic attacks and related TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
syndromes
Transient cerebral ischaemic attack, unspecified; Spasm of cerebral artery;

Transient cerebral ischaemia NOS
G45.9 TRANSIENT CEREBRAL ISCHEMIC ATTACKS 7,300 2,190
P10.0 Subdural haemorrhage due to birth injury; Subdural TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
haematoma (localized) due to birth injury
P10.1 Cerebral haemorrhage due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P10.2 Intraventricular haemorrhage due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P10.3 Subarachnoid haemorrhage due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P10.4 Tentorial tear due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P10.9 Unspecified intracranial laceration and haemorrhage due to TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
birth injury
P11.1 Other specified brain damage due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P11.2 Unspecified brain damage due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P11.9 Birth injury to central nervous system, unspecified TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P12.0 Cephalhaematoma due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P12.3 Bruising of scalp due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P12.8 Other birth injuries to scalp TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P12.9 Birth injury to scalp, unspecified TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P13.2 Birth injury to femur TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P13.4 Fracture of clavicle due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P13.8 Birth injuries to other parts of skeleton TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P13.9 Birth injury to skeleton, unspecified TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P14.0 Erb's paralysis due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P14.3 Other brachial plexus birth injuries TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P15.4 Birth injury to face; Facial congestion due to birth injury TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P15.5 Birth injury to external genitalia TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P15.8 Other specified birth injuries TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
P15.9 Birth injury, unspecified TRAUMA RELATED TO BIRTH PROCESS 13,800 4,140
Tuberculosis of intrathoracic lymph nodes, confirmed bacteriologically &
histologicaly; Tuberculosis of hilar lymph nodes, confirmed
bacteriologically & histologicaly; Tuberculosis of mediastinal lymph nodes,
confirmed bacteriologically & histologicaly; Tuberculosis of
A15.4 tracheobronchial lymph nodes, confirmed bacteriologically & histologicaly TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Tuberculosis of larynx, trachea and bronchus, confirmed bacteriologically

and histologically; Tuberculosis of bronchus confirmed bacteriologically
and histologically; Tuberculosis of glottis confirmed bacteriologically and
histologically; Tuberculosis of larynx confirmed bacteriologically and
histologically; Tuberculosis of trachea, confirmed bacteriologically and
A15.5 histologically TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Tuberculous pleurisy, confirmed bacteriologically and histologically;

Tuberculosis of pleura, confirmed bacteriologically and histologically;
Tuberculous empyema, confirmed bacteriologically & histologically
A15.6 TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Other respiratory tuberculosis, confirmed bacteriologically and
histologically; Mediastinal tuberculosis, confirmed bacteriologically and
histologically; Nasopharyngeal tuberculosis, confirmed bacteriologically
and histologically; Tuberculosis of nose confirmed bacteriologically and
histologically; Tuberculosis of sinus (any nasal) confirmed bacteriologically
A15.8 and histologically TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Tuberculosis of intrathoracic lymph nodes, without mention of

bacteriological or histological confirmation; Tuberculosis of hillar lymph
nodes NOS (without mention of bacteriological or histological
confirmation); Tuberculosis of intrathoracic lymph nodes NOS (without
mention of bacteriological or histological confirmation); Tuberculosis of
mediastinal lymp nodes NOS (without mention of bacteriological or
histological confirmation); Tuberculosis of tracheobronchial lymph nodes
A16.3 NOS (without mention of bacteriological or histological TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
confirmation)
Tuberculosis of larynx, trachea, glottis and bronchus, without mention of

bacteriological or histological onfirmation; Tuberculosis of bronchus NOS
(without mention of bacteriological or histological onfirmation):
Tuberculosis of glottis NOS (without mention of bacteriological or
histological onfirmation); Tuberculosis of larynx NOS (without mention of
bacteriological or histological onfirmation); Tuberculosis of trachea NOS
(without mention of bacteriological or histological
A16.4 onfirmation) TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Tuberculous pleurisy, without mention of bacteriological or histological

confirmation; Tuberculosis of pleura, NOS (without mention of
bacteriological or histological confirmation); Tuberculous empyema NOS
(without mention of bacteriological or histological confirmation);
A16.5 Tuberculous TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
plurisy NOS (without mention of bacteriological or
Other respiratory tuberculosis, without mention of bacteriological or

histological confirmation; Mediastinal tuberculosis, NOS without mention
of bacteriological or histological confirmation; Nasopharyngeal
tuberculosis, NOS without mention of bacteriological or histological
confirmation; Tuberculosis of nose; sinus (any nasal), NOS without
mention of bacteriological or histological confirmation
A16.8 TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
A18.2 Tuberculous peripheral lymphadenopathy; Tuberculous TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570

adenitis
Tuberculosis of intestines, peritoneum and mesenteric glands;
Tuberculosis of anus and rectum; Tuberculosis of intestine (large)(small);
Tuberculosis of retroperitoneal (lymph nodes); Tuberculous ascites;
A18.3 Tuberculous enteritis; TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
Tuberculous peritonitis
Tuberculosis of skin and subcutaneous tissue; Erythema tuberculous

induratum, ; Lupus exedens; Lupus vulgaris; Lupus exedens, NOS; Lupus
A18.4 vulgaris, NOS; Scrofuloderma TUBERCULOSIS, EXTRAPULMONARY 11,900 3,570
A19.0 Acute miliary tuberculosis of a single specified site TUBERCULOSIS, MILIARY 15,100 4,530
A19.1 Acute miliary tuberculosis of multiple sites TUBERCULOSIS, MILIARY 15,100 4,530
A19.2 Acute miliary tuberculosis, unspecified TUBERCULOSIS, MILIARY 15,100 4,530
A19.8 Other miliary tuberculosis TUBERCULOSIS, MILIARY 15,100 4,530
A19.9 Miliary tuberculosis, unspecified TUBERCULOSIS, MILIARY 15,100 4,530
Tuberculosis of lung, confirmed by sputum microscopy with or without
culture; Tuberculous Bronchiectasis' confirmed by sputum microscopy
with or without culture; Tuberculous fibrosis of lung, confirmed by
sputum microscopy with or without culture; Tuberculous pneumonia,
confirmed by sputum microscopy with or without culture; Tuberculous
pneumothorax, confirmed by sputum microscopy with or without culture
A15.0 TUBERCULOSIS, PULMONARY 9,800 2,940
Tuberculosis of lung, confirmed by culture only; Tuberculous:

Bronchiectasis; fibrosis of lung; pneumonia; pneumothorax, confirmed by
A15.1 culture only TUBERCULOSIS, PULMONARY 9,800 2,940
A15.2 Tuberculosis of lung, confirmed histologically; Tuberculous: TUBERCULOSIS, PULMONARY 9,800 2,940
Bronchiectasis; fibrosis of lung; pneumonia; pneumothorax, confirmed
histologically only
Tuberculosis of lung, confirmed by unspecified means; Tuberculous:

Bronchiectasis; fibrosis of lung; pneumonia; pneumothorax, confirmed but
unspecified whether bacteriologically or histologically
A15.3 TUBERCULOSIS, PULMONARY 9,800 2,940
Primary respiratory tuberculosis, confirmed bacteriologically and
histologically
A15.7 Childhood type (first infection) pulmonary tuberculosis TUBERCULOSIS, PULMONARY 9,800 2,940
confirmed bacteriologically and histologically
A15.9 Respiratory tuberculosis unspecified, confirmed TUBERCULOSIS, PULMONARY 9,800 2,940

bacteriologically and histologically
Tuberculosis of lung, bacteriologically and histologically negative;

Tuberculous Bronchiectasis , bacteriologically and histologically negative;
Tuberculous fibrosis of lung, bacteriologically and histologically negative;
Tuberculous pneumonia, bacteriologically and histologically negative;
Tuberculous pneumothorax, bacteriologically and
A16.0 histologically negative TUBERCULOSIS, PULMONARY 9,800 2,940
Tuberculosis of lung, bacteriological and histological examination not

A16.1 done TUBERCULOSIS, PULMONARY 9,800 2,940
Tuberculosis of lung, without mention of bacteriological or histological

confirmation; Tuberculous: bronchiectasis; fibrosis of lung; pneumonia;
pneumothorax; NOS ( without mention of bacteriological or histological
A16.2 confirmation) TUBERCULOSIS, PULMONARY 9,800 2,940
Primary respiratory tuberculosis without mention of bacteriological or

histological confirmation; Primary respiratory tuberculosis NOS; Primary
tuberculous complex
A16.7 Childhood type (first infection) pulmonary tuberculosis TUBERCULOSIS, PULMONARY 9,800 2,940
Respiratory tuberculosis unspecified, without mention of bacteriological

or histological confirmation; Respiratory tuberculosis NOS; Tuberculosis
A16.9 NOS TUBERCULOSIS, PULMONARY 9,800 2,940
Koch's Infection; Koch's Disease
A01.0 Typhoid fever; infection due to Salmonella typhi TYPHOID FEVER 10,000 3,000
A01.1 Paratyphoid fever A TYPHOID FEVER 10,000 3,000
A01.2 Paratyphoid fever B TYPHOID FEVER 10,000 3,000
A01.3 Paratyphoid fever C TYPHOID FEVER 10,000 3,000
A01.4 Paratyphoid fever, unspecified; Infection due to Salmonella TYPHOID FEVER 10,000 3,000
paratyphi NOS
A02.0 Salmonella enteritis; Salmonellosis TYPHOID FEVER 10,000 3,000

A02.1 Salmonella sepsis TYPHOID FEVER 10,000 3,000
Localized salmonella infections; Salmonella arthritis; salmonella
meningitis; salmonella osteomyelitis; salmonella pneumonia; salmonella
A02.2 renal tubulo-interstitial disease TYPHOID FEVER 10,000 3,000
A02.8 Other specified salmonella infections TYPHOID FEVER 10,000 3,000

A02.9 Salmonella infection, unspecified TYPHOID FEVER 10,000 3,000
N26 Unspecified contracted kidney; Atrophy of kidney URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
(terminal); Renal sclerosis NOS
N27.0 Small kidney, unilateral URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390

N27.1 Small kidney, bilateral URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
N27.9 Small kidney, unspecified URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
Other specified disorders of kidney and ureter; Hypertrophy of kidney;
Megaloureter; Nephroptosis; Pyelitis cystica; Pyeloureteritis cystica;
N28.8 Ureteritis cystica; Ureterocele URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
N28.9 Disorder of kidney and ureter, unspecified; Nephropathy URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
NOS; Renal disease NOS
N29.8* Other disorders of kidney and ureter in other diseases URINARY TRACT ATROPHY/HYPERTROPHY 11,300 3,390
N30.0 Acute cystitis URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250

N30.1 Chronic Interstitial cystitis URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250
N30.2 Other chronic cystitis URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250
N30.3 Trigonitis; Urethrotrigonitis URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250
N30.9 Cystitis, unspecified URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250
N39.0 Urinary tract infection, site not specified URINARY TRACT INFECTION [ADMISSIBLE] 7,500 2,250
M50.1 Cervical disc disorder with radiculopathy VERTEBRAL DISC DISORDERS 7,800 2,340
M50.2 Other cervical disc displacement VERTEBRAL DISC DISORDERS 7,800 2,340
M50.3 Other cervical disc degeneration VERTEBRAL DISC DISORDERS 7,800 2,340
M50.8 Other cervical vertebral disc disorders VERTEBRAL DISC DISORDERS 7,800 2,340
Lumbar and other intervertebral disc disorders with radiculopathy; Sciatica
due to intervertebral disc disorder
M51.1 VERTEBRAL DISC DISORDERS 7,800 2,340
M51.2 Other specified intervertebral disc displacement VERTEBRAL DISC DISORDERS 7,800 2,340
Lumbago due to displacement of intervertebral disc
M51.3 Other specified intervertebral disc degenerations VERTEBRAL DISC DISORDERS 7,800 2,340
M51.4 Schmorl's node VERTEBRAL DISC DISORDERS 7,800 2,340
M51.8 Other specified intervertebral disc disorders VERTEBRAL DISC DISORDERS 7,800 2,340
M99.0 Segmental and somatic dysfunction, rib cage VERTEBRAL DISC DISORDERS 7,800 2,340
M99.1 Subluxation complex (vertebral) VERTEBRAL DISC DISORDERS 7,800 2,340
M99.3 Osseous stenosis of neural canal VERTEBRAL DISC DISORDERS 7,800 2,340
M99.5 Intervertebral disc stenosis of neural canal VERTEBRAL DISC DISORDERS 7,800 2,340
M99.7 Connective tissue and disc stenosis of intervertebral VERTEBRAL DISC DISORDERS 7,800 2,340
foramina
H81.0 Ménière's disease; Labyrinthine hydrops; Ménière's VERTIGINOUS DISORDERS 5,700 1,710
syndrome or vertigo
H81.1 Benign paroxysmal vertigo VERTIGINOUS DISORDERS 5,700 1,710

H81.2 Vestibular neuronitis VERTIGINOUS DISORDERS 5,700 1,710
H81.3 Other peripheral vertigo; Lermoyez' syndrome; Aural VERTIGINOUS DISORDERS 5,700 1,710
Vertigo ; Otogenic Vertigo; Peripheral NOS Vertigo
H81.4 Vertigo of central origin; Central positional nystagmus VERTIGINOUS DISORDERS 5,700 1,710
H81.8 Other disorders of vestibular function VERTIGINOUS DISORDERS 5,700 1,710
H81.9 Disorder of vestibular function, unspecified; Vertiginous VERTIGINOUS DISORDERS 5,700 1,710
syndrome NOS
H83.1 Labyrinthine fistula VERTIGINOUS DISORDERS 5,700 1,710

Labyrinthine dysfunction; Hypersensitivity of labyrinth; Hypofunction of
labyrinth; Loss of function Of labyrinth
H83.2 VERTIGINOUS DISORDERS 5,700 1,710
R42 Dizziness and giddiness; Light-headedness; Vertigo NOS VERTIGINOUS DISORDERS 5,700 1,710
A96.0 Junin haemorrhagic fever; Argentinian haemorrhagic fever VIRAL HEMORRHAGIC FEVER 7,900 2,370
A96.1 Machupo haemorrhagic fever; Bolivian haemorrhagic fever VIRAL HEMORRHAGIC FEVER 7,900 2,370
A98.8 Other specified viral haemorrhagic fevers VIRAL HEMORRHAGIC FEVER 7,900 2,370
A99 Unspecified viral haemorrhagic fever VIRAL HEMORRHAGIC FEVER 7,900 2,370
B15.0 Acute Hepatitis A with hepatic coma VIRAL HEPATITIS 11,800 3,540
B15.9 Acute hepatitis A without hepatic coma; Hepatitis A VIRAL HEPATITIS 11,800 3,540
(acute)(viral) NOS
B16.0 Acute hepatitis B with delta-agent (coinfection) with VIRAL HEPATITIS 11,800 3,540
hepatic coma
B16.1 Acute hepatitis B with delta-agent (coinfection) without VIRAL HEPATITIS 11,800 3,540
hepatic coma
B16.2 Acute hepatitis B without delta-agent with hepatic coma VIRAL HEPATITIS 11,800 3,540
B16.9 Acute hepatitis B without delta-agent and without hepatic VIRAL HEPATITIS 11,800 3,540
coma; Acute hepatitis B (viral) NOS
B17.0 Acute delta-(super) infection of hepatitis B carrier VIRAL HEPATITIS 11,800 3,540
B17.1 Acute hepatitis C VIRAL HEPATITIS 11,800 3,540
B17.2 Acute hepatitis E VIRAL HEPATITIS 11,800 3,540
B17.8 Other specified acute viral hepatitis; Hepatitis non-A non-B VIRAL HEPATITIS 11,800 3,540
(acute)(viral) NEC
B18.0 Chronic viral hepatitis B with delta-agent VIRAL HEPATITIS 11,800 3,540
B18.1 Chronic viral hepatitis B wtihout delta-agent: Hepatitis B VIRAL HEPATITIS 11,800 3,540
(viral) NOS
B18.2 Chronic viral hepatitis C VIRAL HEPATITIS 11,800 3,540

B18.8 Other chronic viral hepatitis VIRAL HEPATITIS 11,800 3,540
B18.9 Chronic viral hepatitis, unspecified VIRAL HEPATITIS 11,800 3,540
B19.0 Unspecified viral hepatitis hepatic coma VIRAL HEPATITIS 11,800 3,540
B19.9 Unspecified viral hepatitis without hepatic coma; Viral VIRAL HEPATITIS 11,800 3,540
Hepatitis NOS
A80.1 Acute paralytic poliomyelitis, wild virus, imported VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A80.2 Acute paralytic poliomyelitis, wild virus, indigenous VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A80.9 Acute poliomyelitis, unspecified VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A81.0 Creutzfeldt-Jakob disease; Subacute spongiform VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
encephalopathy
Subacute sclerosing panencephalitis; Dawson's inclusion body encephalitis

A81.1 ; Van Bogaert's sclerosing VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
leukoencephalopathy
A81.2 Progressive multifocal leukoencephalopathy; Multifocal VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
leukoencephalopathy NOS
Atypical virus infection of central nervous system, unspecified; Prion

disease of central nervous system NOS
A81.9 VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A82.0 Sylvatic rabies VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A82.1 Urban rabies VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A82.9 Rabies, unspecified VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A83.0 Japanese encephalitis VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A83.2 Eastern equine encephalitis VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A83.5 California encephalitis; California meningoencephalitis VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
La Crosse encephalitis
A83.8 Other mosquito-borne viral encephalitis VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A83.9 Mosquito-borne viral encephalitis, unspecified VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A85.2 Arthropod-borne viral encephalitis, unspecified; VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A85.8 Other specified viral encephalitis; Encephalitis lethargica; VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
Von Economo-Cruchet disease
A86 Unspecified viral encephalitis; Viral encephalomyelitis NOS; VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
Viral meningoencephalitis NOS
A88.8 Other specified viral infections of central nervous system VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A89 Unspecified viral infection of central nervous system VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM 21,100 6,330
A37.0 Whooping cough due to Bordetella pertussis WHOOPING COUGH 10,600 3,180
A37.1 Whooping cough due to Bordetella parapertussis WHOOPING COUGH 10,600 3,180
A37.8 Whooping cough due to other Bordetella species WHOOPING COUGH 10,600 3,180
A37.9 Whooping cough, unspecified WHOOPING COUGH 10,600 3,180
A20.0 Bubonic plague ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A20.9 Plague, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A21.0 Ulceroglandular tularaemia; Ophthalmic tularaemia ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A21.1 Oculoglandular tularaemia; Ophthalmic tularaemia ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A21.2 Pulmonary tularaemia ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A21.3 Gastrointestinal tularaemia; Abdominal tularaemia ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A21.9 Tularaemia, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A22.0 Cutaneous anthrax; Malignant carbuncle; Malignant ZOONOTIC BACTERIAL DISEASES 11,700 3,510
pustule
A22.2 Gastrointestinal anthrax ZOONOTIC BACTERIAL DISEASES 11,700 3,510

A22.7 Anthrax sepsis ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A22.9 Anthrax, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A23.1 Brucellosis due to Brucella abortus ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A23.9 Brucellosis, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A24.0 Glanders; Infection due to Pseudomonas mallei; Malleus ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A24.1 Acute and fulminating melioidosis; Melioidosis pneumonia ZOONOTIC BACTERIAL DISEASES 11,700 3,510
; Melioidosis septicaemia
A25.9 Rat-bite fever, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510

A26.8 Other forms of erysipeloid ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A26.9 Erysipeloid, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A28.0 Pasteurellosis ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A28.1 Cat-scratch disease; Cat-scratch fever ZOONOTIC BACTERIAL DISEASES 11,700 3,510
A28.8 Other specified zoonotic bacterial diseases, not elsewhere ZOONOTIC BACTERIAL DISEASES 11,700 3,510
classified
A28.9 Zoonotic bacterial disease, unspecified ZOONOTIC BACTERIAL DISEASES 11,700 3,510
Insulin-dependent diabetes mellitus with renal complications: diabetic
nephropathy; Glomerular disorders in diabetes mellitus; Brittle diabetes
(mellitus); Juvenile- onset diabetes (mellitus); Ketosis-prone diabetes
(mellitus); Type I diabetes (mellitus) DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E10.2+ N08.3* Insulin-dependent diabetes mellitus nephropathy COMA AND KETOSIS 12,600 3,780
Non-insulin-dependent diabetes mellitus with renal complications:

diabetic nephropathy; Glomerular disorders in diabetes mellitus; Adult-
onset diabetes (mellitus)(nonobese)(obese); Maturity-onset diabetes
(mellitus)(nonobese)(obese); Nonketonic diabetes (mellitus)(nonobese)
(obese); Stable diabetes (mellitus)(nonobese)(obese); Type II diabetes
(mellitus)(nonobese)(obese); Non-insulin-dependent diabetes of the
young
Non - insulin-dependent diabetes mellitus nephropathy DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E11.2+ N08.3* COMA AND KETOSIS 12,600 3,780
Malnutrition-related diabetes mellitus with renal complications: diabetic DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E12.2+ N08.3* nephropathy; Glomerular disorders COMA AND KETOSIS 12,600 3,780
in diabetes mellitus;
Other specified diabetes mellitus with renal complications: diabetic DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
E13.2+ N08.3* nephropathy;Glomerular disorders in diabetes COMA AND KETOSIS 12,600 3,780
mellitus
Unspecified diabetes mellitus with renal complications: diabetic DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN
nephropathy; Glomerular disorders in diabetes mellitus COMA AND KETOSIS
E14.2+ N08.3* 12,600 3,780
B05.8 Measles with other complications; Measles keratitis and VIRAL INFECTION (ADMISSIBLE) 7,700 2,310
keratoconjunctivitis
B05.9 Measles without complications; Measles NOS VIRAL INFECTION (ADMISSIBLE) 7,700 2,310
B01.9 Varicella [chickenpox] without complication; Varicella NOS VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B06.8 Rubella with other complications; Encephalitis Rubella; VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
Meningitis Rubella; Meningoencephalitis Rubella
B06.9 Rubella without complication; Rubella NOS VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
Unspecified viral infection characterized by skin and
mucous membrane lesions; Viral enanthema NOS; Viral exanthem
B09 VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B34.1 Enterovirus infection, unspecified; Coxsackievirus infection VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
NOS; Echovirus infection NOS
B34.2 Coronavirus infection, unspecified VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B34.3 Parvovirus infection, unspecified VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B34.4 Papovavirus infection, unspecified VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B34.8 Other viral infections of unspecified site VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B34.9 Viral infection, unspecified; Viraemia NOS VIRAL INFECTION WITHOUT COMPLICATIONS 4,000 1,200
Systemic Viral Infection
B50.9 Plasmodium falciparum malaria, unspecified MALARIA WITHOUT COMPLICATIONS 4,000 1,200
B51.9 Plasmodium vivax malaria without complications; MALARIA WITHOUT COMPLICATIONS 4,000 1,200
Plasmodium vivax malaria NOS
B52.9 Plasmodium malariae malaria without complications; MALARIA WITHOUT COMPLICATIONS 4,000 1,200
Plasmodium malariae malaria NOS
B65.1 Schistosomiasis due to Schistosoma mansoni [intestinal PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
schistosomiasis]
B65.2 Schistosomiasis due to Schistosoma japonicum; Asiatic PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
schistosomiasis
B65.3 Cercarial dermatitis; Swimmer's itch PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B65.8 Infection due to Schistosoma intercalatum, Schistosoma PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
mattheei , Schistosoma mekongi
B65.9 Schistosomiasis, unspecified PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B77.9 Ascariasis, unspecified PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B82.0 Intestinal helminthiasis, unspecified PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
B82.9 Intestinal parasitism, unspecified PARASITIC INFECTION WITHOUT COMPLICATIONS 4,000 1,200
Non-insulin-dependent diabetes mellitus without complications (NIDDM)

E11.9 Type II diabetes mellitus DIABETES MELLITUS WITHOUT COMPLICATIONS 4,000 1,200
Insulin dependent diabetes mellitus without complications (IDDM)

E10.9 Type I diabetes mellitus DIABETES MELLITUS WITHOUT COMPLICATIONS 4,000 1,200
E16.2 Hypoglycemia, unspecified HYPOGLYCEMIA 4,000 1,200

E86.1 Moderate dehydration DEHYDRATION 4,000 1,200
E86.2 Severe dehydration DEHYDRATION 4,000 1,200
I25.0 Atherosclerotic cardiovascular disease (ASCVD) CHRONIC HEART DISEASES WITHOUT 4,000 1,200
COMPLICATIONS
Atherosclerotic heart disease; Coronary artery atheroma; Coronary artery
atherosclerosis; Coronary artery disease; Coronary artery sclerosis
Arteriosclerotic heart disease (ASHD)
Coronary artery disease (CAD) Cardiac sclresosis
I25.1 CHRONIC HEART DISEASES WITHOUT COMPLICATIONS 4,000 1,200
I25.3 Aneurysm of heart; Mural aneurysm; Venticular aneurysm CHRONIC HEART DISEASES WITHOUT 4,000 1,200
COMPLICATIONS
I25.4 Coronary artery aneurysm; Coronary arteriovenous fistula, CHRONIC HEART DISEASES WITHOUT 4,000 1,200
acquired COMPLICATIONS
J03.0 Streptococcal tonsillitis UPPER RESPIRATORY TRACT INFECTION 4,000 1,200

J03.8 Acute tonsillitis due to other specified organisms UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
Acute tonsillitis, unspecified; Acute tonsillitis NOS; Acute Follicular
tonsillitis; Acute Gangrenous tonsillitis; Acute Infective tonsillitis; Acute
J03.9 Ulcerative tonsillitis; Septic tonsillitis UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J06.0 Acute laryngopharyngitis UPPER RESPIRATORY TRACT INFECTION 4,000 1,200

Other acute upper respiratory infections of multiple sites Acute
tonsillopharyngitis
J06.8 UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
Acute upper respiratory infection, unspecified; Acute upper respiratory

disease; Upper respiratory infection NOS
J06.9 Upper Respiratory Tract Infection UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.0 Acute bronchitis due to Mycoplasma pneumoniae UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.1 Acute bronchitis due to Haemophilus influenzae UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.2 Acute bronchitis due to streptococcus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.3 Acute bronchitis due to coxsackievirus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.4 Acute bronchitis due to parainfluenza virus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.5 Acute bronchitis due to respiratory syncytial virus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.6 Acute bronchitis due to rhinovirus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.7 Acute bronchitis due to echovirus UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.8 Acute bronchitis due to other specified organisms UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
J20.9 Acute bronchitis, unspecified UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
Unspecified acute lower respiratory infection; Acute (lower) respiratory
(tract) infection NOS
J22 Acute Respiratory Infection LOWER RESPIRATORY TRACT INFECTION 4,000 1,200
Severe Acute Respiratory Infection
Bronchitis, not specified as acute or chronic; Bronchitis NOS; Catarrhal

J40 Bronchitis; Bronchitis with tracheitis NOS; UPPER RESPIRATORY TRACT INFECTION 4,000 1,200
Trancheobronchitis NOS
Pulpitis; Pulpal abscess; Pulpal polyp; Acute pulpitis; Hyperplastic chronic

pulpitis; Ulcerative chronic pulpitis;
K04.0 Supparative pulpitis DENTAL DISORDERS 4,000 1,200
K04.1 Necrosis of pulp; Pulpal gangrene DENTAL DISORDERS 4,000 1,200

K04.2 Pulp degeneration; Denticles; Pulpal calcifications; Pulpal DENTAL DISORDERS 4,000 1,200
stones
K04.3 Abnormal hard tissue formation in pulp; Secondary or DENTAL DISORDERS 4,000 1,200
irregular dentine
K04.4 Acute apical periodontitis of pulpal origin; Acute apical DENTAL DISORDERS 4,000 1,200
periodontitis NOS
K04.5 Chronic apical periodontitis; Apical or periapical granuloma; DENTAL DISORDERS 4,000 1,200
Apical periodontitis NOS
K04.6 Periapical abscess with sinus; Dental abscess with sinus; DENTAL DISORDERS 4,000 1,200
Dentoalveolar abscess with sinus
K04.7 Periapical abscess without sinus; Dental abscess NOS; DENTAL DISORDERS 4,000 1,200
Dentoalveolar abscess NOS; Periapical abscess NOS
K04.8 Radicular cyst; Periodontal apical cyst; Periapical cyst; DENTAL DISORDERS 4,000 1,200
Residual radicular cyst
K04.9 Other and unspecified diseases of pulp and periapical DENTAL DISORDERS 4,000 1,200
tissues
K30 Dyspepsia; Indigestion BOWEL MOVEMENT DISORDERS 4,000 1,200

K31.0 Acute dilatation of stomach; Acute distension of stomach BOWEL MOVEMENT DISORDERS 4,000 1,200
K31.9 Disease of stomach and duodenum, unspecified BOWEL MOVEMENT DISORDERS 4,000 1,200
K59.0 Constipation BOWEL MOVEMENT DISORDERS 4,000 1,200
L02.0 Cutaneous abscess, furuncle and carbuncle of face SKIN INFECTIONS 4,000 1,200
L02.1 Cutaneous abscess, furuncle and carbuncle of neck SKIN INFECTIONS 4,000 1,200
Cutaneous abscess, furuncle and carbuncle of trunk; Cutaneous abscess,
furuncle and carbuncle of Abdominal wall; Cutaneous abscess, furuncle
and carbuncle of Back [any part, except buttock]; Cutaneous abscess,
furuncle and carbuncle of Chest wall; Cutaneous abscess, furuncle and
carbuncle of Groin; Cutaneous abscess, furuncle and carbuncle of
Perineum; Cutaneous abscess, furuncle and carbuncle of Umbilicus
L02.2 SKIN INFECTIONS 4,000 1,200
Cutaneous abscess, furuncle and carbuncle of buttock;

L02.3 Cutaneous abscess, furuncle and carbuncle of Gluteal region SKIN INFECTIONS 4,000 1,200
L02.4 Cutaneous abscess, furuncle and carbuncle of limb, Axilla, SKIN INFECTIONS 4,000 1,200
Hip & Shoulder
L02.8 Cutaneous abscess, furuncle and carbuncle of other sites: SKIN INFECTIONS 4,000 1,200
Head [any part, except face]; Scalp
L02.9 Cutaneous abscess, furuncle and carbuncle, unspecified; SKIN INFECTIONS 4,000 1,200
Furunculosis NOS
L72.0 Epidermal cyst CUTANEOUS CYSTS 4,000 1,200
L72.1 Trichilemmal cyst; Pilar cyst; Sebaceous cyst CUTANEOUS CYSTS 4,000 1,200
L72.2 Steatocystoma multiplex CUTANEOUS CYSTS 4,000 1,200
L72.8 Other follicular cysts of skin and subcutaneous tissue CUTANEOUS CYSTS 4,000 1,200
L72.9 Follicular cyst of skin and subcutaneous tissue, unspecified CUTANEOUS CYSTS 4,000 1,200
N20.0 Calculus of kidney; Nephrolithiasis NOS; Renal calculus or UROLITHIASIS 4,000 1,200
stone; Staghorn calculus; Stone in kidney
N20.1 Calculus of ureter; Ureteric stone UROLITHIASIS 4,000 1,200
N20.2 Calculus of kidney with calculus of ureter UROLITHIASIS 4,000 1,200
N20.9 Urinary calculus, unspecified; Calculous pyelonephritis UROLITHIASIS 4,000 1,200
N30.4 Irradiation cystitis IRRADIATION CYSTITIS 4,000 1,200
O23.1 Infections of bladder in pregnancy URINARY TRACT INFECTION IN PREGNANCY 4,000 1,200
O23.2 Infections of urethra in pregnancy URINARY TRACT INFECTION IN PREGNANCY 4,000 1,200
O23.4 Unspecified infection of urinary tract in pregnancy URINARY TRACT INFECTION IN PREGNANCY 4,000 1,200
O23.5 Infections of the genital tract in pregnancy URINARY TRACT INFECTION IN PREGNANCY 4,000 1,200
Other and unspecified genitourinary tract infection in pregnancy;
O23.9 Genitourinary tract infection in pregnancy NOS URINARY TRACT INFECTION IN PREGNANCY 4,000 1,200
S00.0 Superficial injury of scalp SUPERFICIAL INJURIES 4,000 1,200

S00.1 Contusion of eyelid and periocular area; Black eye SUPERFICIAL INJURIES 4,000 1,200
S00.2 Other superficial injuries of eyelid and periocular area SUPERFICIAL INJURIES 4,000 1,200
S00.3 Superficial injury of nose SUPERFICIAL INJURIES 4,000 1,200
S00.4 Superficial injury of ear SUPERFICIAL INJURIES 4,000 1,200
S00.5 Superficial injury of lip and oral cavity SUPERFICIAL INJURIES 4,000 1,200
S00.7 Multiple superficial injuries of head SUPERFICIAL INJURIES 4,000 1,200
S00.8 Superficial injury of other parts of head SUPERFICIAL INJURIES 4,000 1,200
S00.9 Superficial injury of head, part unspecified SUPERFICIAL INJURIES 4,000 1,200
S01.0 Open wound of scalp SUPERFICIAL INJURIES 4,000 1,200
S01.1 Open wound of eyelid and periocular area SUPERFICIAL INJURIES 4,000 1,200
S01.2 Open wound of nose SUPERFICIAL INJURIES 4,000 1,200
S01.3 Open wound of ear SUPERFICIAL INJURIES 4,000 1,200
S01.4 Open wound of cheek and temporomandibular area SUPERFICIAL INJURIES 4,000 1,200
S01.5 Open wound of lip and oral cavity SUPERFICIAL INJURIES 4,000 1,200
S01.7 Multiple open wounds of head SUPERFICIAL INJURIES 4,000 1,200
S01.8 Open wound of other parts of head SUPERFICIAL INJURIES 4,000 1,200
S01.9 Open wound of head, part unspecified SUPERFICIAL INJURIES 4,000 1,200
S61.0 Open wound of finger(s) without damage to nail; Open SUPERFICIAL INJURIES 4,000 1,200
wound of finger(s) NOS
S61.1 Open wound of finger(s) with damage to nail SUPERFICIAL INJURIES 4,000 1,200
S61.7 Multiple open wounds of wrist and hand SUPERFICIAL INJURIES 4,000 1,200
S61.8 Open wound of other parts of wrist and hand SUPERFICIAL INJURIES 4,000 1,200
S61.9 Open wound of wrist and hand part, part unspecified SUPERFICIAL INJURIES 4,000 1,200
S81.0 Open wound of knee SUPERFICIAL INJURIES 4,000 1,200
S81.7 Multiple open wounds of lower leg SUPERFICIAL INJURIES 4,000 1,200
S81.8 Open wound of other parts of lower leg SUPERFICIAL INJURIES 4,000 1,200
S81.9 Open wound of lower leg, part unspecified SUPERFICIAL INJURIES 4,000 1,200
S91.0 Open wound of ankle SUPERFICIAL INJURIES 4,000 1,200
S91.1 Open wound of toe(s) without damage to nail; open wound SUPERFICIAL INJURIES 4,000 1,200
of toe (s) NOS
S91.2 Open wound of toe(s) with damage to nail SUPERFICIAL INJURIES 4,000 1,200
S91.3 Open wound of other parts of foot; open wound of foot SUPERFICIAL INJURIES 4,000 1,200
NOS
S91.7 Multiple open wounds of ankle and foot SUPERFICIAL INJURIES 4,000 1,200
T00.0 Superficial injuries involving head with neck SUPERFICIAL INJURIES 4,000 1,200
T00.1 Superficial injuries involving thorax with abdomen lower SUPERFICIAL INJURIES 4,000 1,200
back and pelvis
T00.2 Superficial injuries involving multiple regions of upper SUPERFICIAL INJURIES 4,000 1,200
limb(s)
T00.3 Superficial injuries involving multiple regions of lower SUPERFICIAL INJURIES 4,000 1,200
limb(s)
T00.6 Superficial injuries involving multiple regions of upper SUPERFICIAL INJURIES 4,000 1,200
limb(s) with lower limb(s)
T00.8 Superficial injuries involving other combinations of body SUPERFICIAL INJURIES 4,000 1,200
regions
Multiple superficial injuries, unspecified; Multiple abrasions NOS; Multiple

nonthermal blisters NOS; Multiple bruises NOS; Multiple contusions NOS;
Multiple haematomas NOS; Multiple nonvenomous insect bite NOS
T00.9 SUPERFICIAL INJURIES 4,000 1,200
J12.8, B97.2 Middle East Respiratory Syndrome (MERS-CoV) MIDDLE EAST RESPIRATORY SYNDROME 50,000 up to
100,000
A98.4 Ebola Virus Disease (EVD) EBOLA VIRUS DISEASE 110,000 up to

222,000
U06.9 Zika virus disease, unspecified; Zika; Zika virus fever; Zika ZIKA VIRUS DISEASE 8,100 2,430
virus infection
Incision and drainage of abscess (e.g., carbuncle,

suppurative hidradenitis, cutaneous or subcutaneous
10060 abscess, cyst, furuncle, or paronychia) 3,640 840
10080 Incision and drainage of pilonidal cyst 3,640 840

10120 Incision and removal of foreign body, subcutaneous 3,640 840
tissues
10140 Incision and drainage of hematoma, seroma, or fluid 3,640 840
collection
10160 Puncture aspiration of abscess, hematoma, bulla, or 3,640 840
cyst
10180 Incision and drainage, complex, postoperative wound 5,560 1,260
infection
11000 Debridement of extensive eczematous or infected skin 10,540 5,040
11010 Debridement including removal of foreign material 10,540 5,040

associated w/ open
fracture(s) and/or dislocation(s); skin and
subcutaneous tissues
Debridement including removal of foreign material

associated w/ open
fracture(s) and/or dislocation(s); skin, subcutaneous
11011 tissue, muscle fascia, and muscle 11,980 5,880
Debridement including removal of foreign material

associated w/ open
fracture(s) and/or dislocation(s); skin, subcutaneous
11012 tissue, muscle fascia, muscle, and bone 12,120 6,720
11040 Debridement; skin, partial thickness 3,640 840

11041 Debridement; skin, full thickness 3,640 840
11042 Debridement; skin, and subcutaneous tissue 5,680 1,680
11043 Debridement; skin, subcutaneous tissue, and muscle 8,020 2,520
11044 Debridement; skin, subcutaneous tissue, muscle, and 8,020 2,520

bone
11050 Paring or curettement of benign hyperkeratotic skin N/A N/A
lesion w/ or w/o chemical cauterization (such as
verrucae or clavi) not extending through the stratum
corneum (e.g., callus or wart) w/ or w/o local
anesthesia; single
lesion
anesthesia; two to
four lesions

anesthesia; more
than four lesions
Biopsy of skin, subcutaneous tissue and/or mucous

membrane (including simple closure), unless
11100 otherwise listed; single or multiple lesion 3,640 840
11300 Shaving of epidermal or dermal lesion, single lesion, 5,560 1,260

trunk, arms or legs;
lesion diameter 0.5 cm or less
lesion diameter 0.6 to 1.0 cm
lesion diameter 1.1 to 2.0 cm
lesion diameter over 2.0 cm
scalp, neck, hands, feet,
genitalia; lesion diameter 0.5 cm or less
genitalia; lesion diameter 0.6 to 1.0 cm
genitalia; lesion diameter over 2.0 cm
face, ears, eyelids, nose
,lips, mucous membrane; lesion diameter 0.5 cm or
less

,lips, mucous membrane; lesion diameter 0.6 to 1.0
cm

,lips, mucous membrane; lesion diameter 1.1 to 2.0
cm

,lips, mucous membrane; lesion diameter over 2.0 cm
11400 Excision, benign lesion, except skin tag (unless listed 3,640 840
elsewhere), trunk, arms
or legs; lesion diameter 0.5 cm or less
or legs; lesion diameter 0.6 to 1.0 cm
or legs; lesion diameter over 4.0 cm
elsewhere), scalp, neck,
hands, feet, genitalia; lesion diameter 0.5 cm or less
hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
hands, feet, genitalia; lesion diameter over 4.0 cm
11440 Excision, other benign lesion (unless listed elsewhere), 4,108 1,008
face, ears, eyelids,
nose, lips, mucous membrane; lesion diameter 0.5 cm
or less
nose, lips, mucous membrane; lesion diameter 0.6 to
1.0 cm
2.0 cm
3.0 cm
4.0 cm
nose, lips, mucous membrane; lesion diameter over
4.0 cm
11450 Excision of skin and subcutaneous tissue for 8,020 2,520

hidradenitis, axillary
hidradenitis, inguinal
hidradenitis, perianal, perineal
or umbilical
11600 Excision, malignant lesion, trunk, arms, or legs; lesion 5,560 1,260
diameter 0.5 cm or
less
diameter 0.6 to 1.0 cm
diameter over 4.0 cm
11620 Excision, malignant lesion, scalp, neck, hands, feet, 5,680 1,680
genitalia; lesion
diameter 0.5 cm or less
genitalia; lesion
genitalia; lesion
genitalia; lesion
genitalia; lesion
genitalia; lesion
11640 Excision, malignant lesion, face, ears, eyelids, nose, 5,680 1,680
lips; lesion diameter 0.5
cm or less
to 1.0 cm
to 2.0 cm
to 3.0 cm
to 4.0 cm
lips; lesion diameter
over 4.0 cm
11720 Debridement of nail(s) by any method(s); one to five 3,640 840
11721 Debridement of nail(s) by any method(s); six or more 5,560 1,260
11730 Avulsion of nail plate, partial or complete 3,640 840

11740 Evacuation of subungual hematoma 3,640 840
11750 Excision of nail and nail matrix, partial or complete 3,640 840
(e.g., ingrown or
deformed nail) for permanent removal
Excision of nail and nail matrix, partial or complete
(e.g., ingrown or
11752 deformed nail) for permanent removal w/ amputation 9,300 2,100
of tuft of distal phalanx
11755 Biopsy of nail unit, any method (e.g., plate, bed, 3,640 840
matrix, hyponychium,
proximal and lateral nail folds)
11760 Repair of nail bed 5,560 1,260
11762 Reconstruction of nail bed w/ graft 9,300 2,100
11765 Wedge excision of skin of nail fold (e.g., for ingrown 3,640 840
toenail)
11770 Excision of pilonidal cyst or sinus 5,680 1,680
Simple repair of superficial wounds of scalp, neck,
axillae, external genitalia, trunk and/or extremities
12001 (including hands and feet); 2.5 cm or less 3,640 840
12002 (including hands and feet); 2.6 cm to 7.5 cm 5,560 1,260




12007 (including hands and feet); over 30.0 cm 5,680 1,680
12011 Simple repair of superficial wounds of face, ears, 5,680 1,680

eyelids, nose, lips and/or
mucous membranes; 2.5 cm or less
mucous membranes; 2.6 cm to 5.0 cm
mucous membranes; over 30.0 cm
12031 Layer closure of wounds of scalp, axillae, trunk, and/or 3,640 840
extremities
(excluding hands and feet); 2.5 cm or less
12032 Layer closure of wounds of scalp, axillae, trunk, and/or 5,560 1,260
extremities
(excluding hands and feet); 2.6 cm to 7.5 cm
extremities
extremities
extremities
extremities
(excluding hands and feet); over 30.0 cm
12041 Layer closure of wounds of neck, hands, feet and/or 5,680 1,680
external genitalia; 2.5
cm or less
cm to 7.5 cm
cm to 12.5 cm
cm to 20.0 cm
cm to 30.0 cm
external genitalia; over
30.0 cm
12051 Layer closure of wounds of face, ears, eyelids, nose, 5,680 1,680
lips and/or mucous
membrances; 2.5 cm or less
lips and/or mucous
membrances; 2.6 cm to 5.0 cm
lips and/or mucous
lips and/or mucous
lips and/or mucous
lips and/or mucous
lips and/or mucous
membrances; over 30.0 cm
14000 Adjacent tissue transfer or rearrangement, trunk; 12,120 6,720
defect 10 sq cm or less
14001 Adjacent tissue transfer or rearrangement, trunk; 12,120 6,720

defect 10.1 sq cm to 30.0
sq cm
14020 Adjacent tissue transfer or rearrangement, scalp, arms 10,540 5,040

and/or legs; defect
10 sq cm or less
14021 Adjacent tissue transfer or rearrangement, scalp, arms 11,980 5,880

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
14040 and/or feet; defect 10 sq cm or less 12,120 6,720
Adjacent tissue transfer or rearrangement, forehead,

cheeks, chin, mouth, neck, axillae, genitalia, hands
and/or feet; defect 10.1 sq cm to 30.0 sq cm
14041 18,000 8,400
14060 Adjacent tissue transfer or rearrangement, eyelids, 18,000 8,400

nose, ears and/or lips;
defect 10 sq cm or less
14061 Adjacent tissue transfer or rearrangement, eyelids, 18,000 8,400

nose, ears and/or lips;
defect 10.1 sq cm to 30.0 sq cm
14300 Adjacent tissue transfer or rearrangement, more than 18,000 8,400

30 sq cm, unusual or
complicated, any area
14350 Filleted finger or toe flap, including preparation of 27,120 15,120
recipient site
Pinch graft, single or multiple, to cover small ulcer, tip
or digit, or other minimal open area (except on face),
15050 up to defect size 2 cm diameter 8,260 3,360
Split graft, trunk, scalp, arms, legs, hands, and/or feet

(except multiple digits); 100 sq cm or less, or each one
percent of body area of infants and
15100 children (except 15050) 8,260 3,360
Split graft, face, eyelids, mouth, neck, ears, orbits,

genitalia, and/or multiple digits; 100 sq cm or less, or
each one percent of body area of infants and
15120 children (except 15050) 21,940 9,240
15200 Full thickness graft, free, including direct closure of 21,940 9,240
donor site, trunk; 20 sq
cm or less
donor site, scalp, arms,
and/or legs; 20 sq cm or less
Full thickness graft, free, including direct closure of
donor site, forehead,
cheeks, chin, mouth, neck, axillae, genitalia, hands,
15240 and/or feet; 20 sq cm or less 30,740 13,440
donor site, nose, ears,
eyelids, and/or lips; 20 sq cm or less
15350 Application of allograft, skin 30,300 16,800
15400 Application of xenograft, skin 30,300 16,800
15570 Formation of direct or tubed pedicle, w/ or w/o 18,000 8,400
transfer; trunk
transfer; scalp, arms, or legs
transfer; forehead, cheeks,
chin, mouth, neck, axillae, genitalia, hands or feet

transfer; eyelids, nose, ears,
lips or intraoral
15580 Cross finger flap, including free graft to donor site 21,940 9,240
15650 Transfer, intermediate, of any pedicle flap (e.g., 21,940 9,240

abdomen to wrist,
"Walking" tube), any location
15732 Muscle, myocutaneous, or fasciocutaneous flap; head 47,340 26,040
and neck (e.g.,
temporalis, masseter, sternocleidomastoid, levator
scapulae)
15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk 47,340 26,040
15736 Muscle, myocutaneous, or fasciocutaneous flap; upper 47,340 26,040

extremity
15738 Muscle, myocutaneous, or fasciocutaneous flap; lower 47,340 26,040
extremity
15740 Flap; island pedicle 38,640 21,840
15750 Flap; neurovascular pedicle 38,640 21,840
15756 Free muscle flap w/ or w/o skin graft w/ microvascular 38,640 21,840
anastomosis
15757 Free skin flap w/ microvascular anastomosis 38,640 21,840
15758 Free fascial flap w/ microvascular anastomosis 38,640 21,840

15760 Graft; composite (e.g., full thickness of external ear or 21,940 9,240
nasal ala), including
primary closure, donor area
15770 Graft; derma-fat-fascia 21,940 9,240
15820 Blepharoplasty, lower eyelid 10,120 4,620
15822 Blepharoplasty, upper eyelid; 10,120 4,620
15823 Blepharoplasty, upper eyelid; with excessive skin 11,980 5,880
weighting down lid
15840 Graft for facial nerve paralysis; free fascia graft 30,300 16,800
(including obtaining fascia)
15841 Graft for facial nerve paralysis; free muscle graft 30,300 16,800
(including obtaining graft)
15842 Graft for facial nerve paralysis; free muscle graft by 38,640 21,840
microsurgical technique
15845 Graft for facial nerve paralysis; regional muscle 30,300 16,800
transfer
15920 Excision, coccygeal pressure ulcer, w/ coccygectomy; 30,740 13,440
w/ primary suture
15922 Excision, coccygeal pressure ulcer, w/ coccygectomy; 30,300 16,800
w/ flap closure
15931 Excision, sacral pressure ulcer, w/ primary suture 21,940 9,240
15933 Excision, sacral pressure ulcer, w/ primary suture w/ 30,740 13,440

ostectomy
15934 Excision, sacral pressure ulcer, w/ skin flap closure 12,120 6,720
15935 Excision, sacral pressure ulcer, w/ skin flap closure w/ 30,300 16,800
ostectomy
15936 Excision, sacral pressure ulcer, w/ muscle or 38,440 19,740
myocutaneous flap closure
15937 Excision, sacral pressure ulcer, w/ muscle or 37,800 21,000
myocutaneous flap closure w/
ostectomy
15940 Excision, ischial pressure ulcer, w/ primary suture 12,120 6,720
15941 Excision, ischial pressure ulcer, w/ primary suture w/ 21,940 9,240

ostectomy
(ischiectomy)
15944 Excision, ischial pressure ulcer, w/ skin flap closure 30,740 13,440
15945 Excision, ischial pressure ulcer, w/ skin flap closure w/ 30,300 16,800
ostectomy
15946 Excision, ischial pressure ulcer, w/ ostectomy, w/ 38,440 19,740
muscle or myocutaneous
flap closure
15950 Excision, trochanteric pressure ulcer, w/ primary 11,980 5,880
suture
15951 Excision, trochanteric pressure ulcer, w/ primary 21,940 9,240
suture w/ ostectomy
15952 Excision, trochanteric pressure ulcer, w/ skin flap 21,940 9,240
closure
15953 Excision, trochanteric pressure ulcer, w/ skin flap 30,740 13,440
closure; w/ ostectomy
15956 Excision, trochanteric pressure ulcer, w/ muscle or 31,140 17,640
myocutaneous flap
closure
15958 Excision, trochanteric pressure ulcer, w/ muscle or 38,440 19,740
myocutaneous flap
closure; w/ ostectomy
16010 Dressings and/or debridement, initial or subsequent 8,260 3,360
16035 Escharotomy 30,740 13,440

16040 Excision burn wound, w/o skin grafting, employing 9,700 4,200
alloplastic dressing (e.g.,
synthetic mesh), any anatomic site
Destruction by any method, including laser, w/ or w/o
surgical curettement, all benign facial lesions or
premalignant lesions in any location, or benign lesions
other than cutaneous vascular proliferative lesions,
17000 including local anesthesia; any number of lesions N/A N/A
Destruction by any method, including laser, of benign

skin lesions other than cutaneous vascular
proliferative lesions on any area other than the
17100 face, including local anesthesia; any number of lesions N/A N/A
17106 Destruction of cutaneous vascular proliferative lesions 6,000 2,200

(e.g., laser
technique)
17110 Destruction by any method of flat warts or molluscum N/A N/A
contagiosum, milia,
all lesions
17200 Electosurgical destruction of multiple fibrocutaneous N/A N/A
tags; all lesions
17250 Chemical cauterization of granulation tissue (proud 5,680 1,680
flesh, sinus or fistula)
17260 Destruction, malignant lesion, any method, trunk, 5,680 1,680
arms or legs; lesion
diameter 0.5 cm or less
17270 Destruction, malignant lesion, any method, scalp, 5,680 1,680
neck, hands, feet,
genitalia; lesion diameter 0.5 cm or less
neck, hands, feet,
neck, hands, feet,
neck, hands, feet,
neck, hands, feet,
neck, hands, feet,
genitalia; lesion diameter over 4.0 cm
17280 Destruction, malignant lesion, any method, face, ears, 9,300 2,100
eyelids, nose, lips,
mucous membrane; lesion diameter 0.5 cm or less
mucous membrane; lesion diameter 0.6 to 1.0 cm
mucous membrane; lesion diameter over 4.0 cm
Chemosurgery (Mohs micrographic technique),

including removal of all gross tumor, surgical excision
of tissue specimens, mapping, color coding of
specimens, microscopic examination of specimens by
the surgeon, and complete histopathologic
17304 preparation; first stage, fresh tissue technique, up 8,020 2,520
to 5 specimens
19000 Puncture aspiration of cyst of breast; 3,640 840

19020 Mastotomy w/ exploration or drainage of abscess, 9,700 4,200
deep
19100 Biopsy of breast; needle core 3,640 840
19101 Biopsy of breast; incisional 5,560 1,260
19110 Nipple exploration, w/ or w/o excision of a solitary 8,440 2,940
lactiferous duct or a
papilloma lactiferous duct
19112 Excision of lactiferous duct fistula 8,260 3,360
Excision of cyst, fibroadenoma, or other benign or
malignant tumor aberrant breast tissue, duct lesion or
nipple lesion (except 19140), male or
19120 female, one or more lesions 8,020 2,520
19125 Excision of breast lesion identified by preoperative 8,020 2,520

placement of
radiological marker; single lesion
19140 Mastectomy for gynecomastia 22,000 8,800
19160 Mastectomy, partial 22,000 8,800
19162 Mastectomy, partial with axillary lymphadenectomy 22,000 8,800
19180 Mastectomy, simple, complete 22,000 8,800

19182 Mastectomy, subcutaneous 22,000 8,800
19200 Mastectomy, radical, including pectoral muscles, 22,000 8,800
axillary lymph nodes
19220 Mastectomy, radical, including pectoral muscles, 22,000 8,800
axillary and internal
mammary lymph nodes (Urban type operation)
19240 Mastectomy, modified radical, including axillary lymph 22,000 8,800

nodes, w/ or w/o
pectoralis minor muscle, but excluding pectoralis
major muscle
19260 Excision of chest wall tumor including ribs 46,500 25,200

19271 Excision of chest wall tumor involving ribs, w/ plastic 55,000 33,600
reconstruction; w/o
mediastinal lymphadenectomy
19272 Excision of chest wall tumor involving ribs, w/ plastic 58,800 37,800
reconstruction; w/
mediastinal lymphadenectomy
19340 Immediate insertion of breast prosthesis following 37,800 21,000
mastopexy, mastectomy
or in reconstruction
19342 Delayed insertion of breast prosthesis following 37,800 21,000
mastopexy, mastectomy or
in reconstruction
19350 Nipple/areola reconstruction 30,300 16,800
19357 Breast reconstruction, immediate or delayed, with 37,800 21,000
tissue expander,
including subsequent expansion
19361 Breast reconstruction with latissimus dorsi flap, with 55,000 33,600
or without prosthetic
implant
19364 Breast reconstruction with free flap 55,000 33,600
19366 Breast reconstruction with other technique 55,000 33,600
Breast reconstruction with transverse rectus

abdominis myocutaneous flap (TRAM), single pedicle,
19367 including closure of donor site; 55,000 33,600
Breast reconstruction with transverse rectus

abdominis myocutaneous flap (TRAM), double pedicle,
19369 including closure of donor site 55,000 33,600
19370 Open periprosthetic capsulotomy, breast 30,300 16,800

19371 Periprosthetic capsulectomy, breast 37,800 21,000
20200 Biopsy, muscle 4,108 1,008
20206 Biopsy, muscle, percutaneous needle 3,504 504
20220 Biopsy, bone, trocar, or needle; superficial (e.g., ilium, 10,880 3,780
sternum, spinous
process, ribs)
20225 Biopsy, bone, trocar, or needle; deep (vertebral body, 18,000 8,400
femur)
20240 Biopsy, excisional; superficial (e.g., ilium, sternum, 9,700 4,200
spinous process, ribs,
trochanter of femur)
20245 Biopsy, excisional; deep (e.g., humerus, ischium, 12,540 7,140
femur)
20250 Biopsy, vertebral body, open; thoracic 23,300 12,600
20251 Biopsy, vertebral body, open; lumbar or cervical 30,740 13,440
20520 Removal of foreign body in muscle or tendon sheath 8,020 2,520
20600 Arthrocentesis, aspiration and/or injection; small joint, 5,560 1,260

bursa or ganglion
cyst (e.g., fingers, toes)
Arthrocentesis, aspiration and/or injection;
intermediate joint, bursa or ganglion cyst (e.g.,
temporomandibular, acromioclavicular, wrist, elbow
20605 or 9,300 2,100
ankle, olecranon bursa)
20610 Arthrocentesis, aspiration and/or injection; major joint 9,300 2,100

or bursa (e.g.,
shoulder, hip, knee joint, subacromial bursa)
20615 Aspiration and injection for treatment of bone cyst 8,260 3,360
20650 Insertion of wire or pin w/ application of skeletal 8,020 2,520

traction, including removal
20660 Application of cranial tongs, caliper, or stereotactic 9,868 4,368
frame, including removal
20661 Application of halo, including removal; cranial 8,608 3,108
20662 Application of halo, including removal; pelvic 23,300 12,600
20663 Application of halo, including removal; femoral 21,940 9,240

20670 Removal of implant; superficial (e.g., buried wire, pin 10,540 5,040
or rod)
20680 Removal of implant; deep (e.g., buried wire, pin, 11,980 5,880
screw, metal band, nail,
rod or plate)
20690 Application of a uniplane (pins or wires in one plane), 12,120 6,720
unilateral, external
fixation system
20692 Application of multiplane (pins or wires in more than 39,280 20,580
one plane), unilateral,
external fixation system (e.g., llizarov, Monticelli type)
20802 Replantation, arm (includes surgical neck of humerus 9,300 2,100

through elbow joint),
complete amputation
20805 Replantation, forearm (includes radius and ulna to 40,320 23,520
radial carpal joint),
complete amputation
20808 Replantation, hand (includes hand through 40,320 23,520
metacarpophalangeal joint(s),
complete amputation
20816 Replantation, digit, excluding thumb (includes 23,300 12,600
metacarpophalangeal joint to
insertion of flexor sublimis tendon), complete
amputation
20822 Replantation, digit, excluding thumb (includes distal 23,300 12,600

tip to sublimis tendon
insertion), complete amputation
20824 Replantation, thumb (includes carpometacarpal joint 30,300 16,800
to MP joint), complete
amputation
20827 Replantation, thumb (includes distal tip to MP joint), 23,300 12,600

complete amputation
20838 Replantation, foot, complete amputation 37,800 21,000
20900 Bone graft, any donor area; minor or small (e.g., dowel 10,540 5,040
or button)
20902 Bone graft, any donor area; major or large 18,000 8,400
20910 Cartilage graft; costochondral 12,120 6,720
20912 Cartilage graft; nasal septum 12,120 6,720
20920 Fascia lata graft; by stripper 9,700 4,200
20922 Fascia lata graft; by incision and area exposure, 12,120 6,720
complex or sheet
20924 Tendon graft, form a distance (e.g., palmaris, toe 10,960 5,460
extensor, plantaris)
20926 Tissue grafts, other (e.g., paratenon, fat, dermis) 9,700 4,200
20930 Allograft for spine surgery only; morselized 12,120 6,720

20931 Allograft for spine surgery only; structural 18,420 8,820
Autograft for spine surgery only (includes harvesting
the graft); local (e.g., ribs, spinous process, or laminar
20936 fragments) obtained from same incision 10,540 5,040
20937 Autograft for spine surgery only (includes harvesting 10,540 5,040
the graft); morselized
(through separate skin or fascial incision)
Autograft for spine surgery only (includes harvesting
the graft); structural, bicortical or tricortical (through
20938 separate skin or fascial incision) 18,000 8,400
20955 Bone graft w/ microvascular anastomosis; fibula 37,800 21,000
20956 Bone graft w/ microvascular anastomosis; iliac crest 37,800 21,000
20957 Bone graft w/ microvascular anastomosis; metatarsal 20,980 10,080

20962 Bone graft w/ microvascular anastomosis; other than 27,120 15,120
fibula, iliac crest, or
metatarsal
20969 Free osteocutaneous flap w/ microvascular 37,800 21,000
anastomosis; other than iliac
crest, metatarsal, or great toe

anastomosis; iliac crest
anastomosis; metatarsal
anastomosis; great toe w/ web
space
Ablation, bone tumor(s) (e.g., osteoid osteoma,

metastasis) radiofrequency, percutaneous, including
20982 computed tomographic guidance 9,700 4,200
21010 Arthrotomy, temporomandibular joint 9,700 4,200

21015 Radical resection of tumor (e.g., malignant neoplasm), 23,300 12,600
soft tissue of face or
scalp
21025 Excision of bone (e.g., for osteomyelitis or bone 18,000 8,400
abscess); mandible
21026 Excision of bone (e.g., for osteomyelitis or bone 18,000 8,400
abscess); facial bone(s)
21029 Removal by contouring of benign tumor of facial bone 18,000 8,400
(e.g., fibrous
dysplasia)
21030 Excision of benign tumor or cyst of facial bone other 18,000 8,400
than mandible
21031 Excision of torus mandibularis 18,000 8,400
21032 Excision of maxillary torus palatinus 18,000 8,400
21034 Excision of malignant tumor of facial bone other than 23,300 12,600
mandible
21040 Excision of benign cyst or tumor of mandible; simple 18,000 8,400
21041 Excision of benign cyst or tumor of mandible; complex 21,940 9,240
21044 Excision of malignant tumor of mandible 23,300 12,600

21045 Excision of malignant tumor of mandible radical 30,300 16,800
resection
21050 Condylectomy, temporomandibular joint 30,300 16,800
21060 Meniscectomy, partial or complete, 30,300 16,800
temporomandibular joint
21070 Coronoidectomy 30,300 16,800
21120 Genioplasty; augmentation (autograft, allograft, 18,000 8,400
prosthetic material)
21121 Genioplasty; sliding osteotomy, single piece 46,500 25,200
21122 Genioplasty; sliding osteotomies, two or more 30,300 16,800

osteotomies (e.g., wedge
excision or bone wedge reversal for asymmetrical
chin)
21123 Genioplasty; sliding, augmentation w/ interpositional 30,300 16,800

bone grafts (includes
obtaining autografts)
21125 Augmentation, mandibular body or angle; prosthetic 30,300 16,800
material
21127 Augmentation, mandibular body or angle; w/ bone 46,500 25,200
graft, onlay or
interpositional (includes obtaining autograft)
21137 Reduction forehead; contouring only 18,000 8,400

21138 Reduction forehead; contouring and application of 46,500 25,200
prosthetic material or
bone graft (includes obtaining autograft)
21139 Reduction forehead; contouring and setback of 30,300 16,800
anterior frontal sinus wall
21141 Reconstruction midface, LeFort I; single piece, 53,400 29,400
segment movement in any
direction (e.g., for Long Face Syndrome), w/o bone
graft
21142 Reconstruction midface, LeFort I; two pieces, segment 46,500 25,200

movement in any
direction, w/o bone graft
21143 Reconstruction midface, LeFort I; three or more 46,500 25,200
pieces, segment movement
in any direction, w/o bone graft
21145 Reconstruction midface, LeFort I; single piece, 46,500 25,200
segment movement in any
direction, requiring bone grafts (includes obtaining
autografts)
Reconstruction midface, LeFort I; two pieces, segment

movement in any direction, requiring bone grafts
(includes obtaining autografts) (e.g.,
21146 ungrafted unilateral alveolar cleft) 46,500 25,200
21147 Reconstruction midface, LeFort I; three or more 55,000 33,600

pieces, segment movement in any direction, requiring
bone grafts (includes obtaining autografts) (e.g.,
ungrafted bilateral alveolar cleft or multiple
osteotomies)
21150 Reconstruction midface, LeFort II; anterior intrusion 55,000 33,600

(e.g., Treacher-Collins
Syndrome)
21151 Reconstruction midface, LeFort II; any direction, 55,000 33,600
requiring bone grafts
(includes obtaining autografts)
21154 Reconstruction midface, LeFort III (extracranial), any 58,800 37,800
type, requiring bone
grafts (includes obtaining autografts); w/o LeFort I
21155 Reconstruction midface, LeFort III (extracranial), any 55,000 33,600

type, requiring bone
grafts (includes obtaining autografts); w/ LeFort I
Reconstruction midface, LeFort III (extra and

intracranial) w/ forehead advancement (e.g., mono
bloc), requiring bone grafts (includes obtaining
21159 autografts); w/o LeFort I 55,000 33,600
Reconstruction midface, LeFort III (extra and

intracranial) w/ forehead
advancement (e.g., mono bloc), requiring bone grafts
21160 (includes obtaining autografts); w/ LeFort I 46,500 25,200
Reconstruction superior-lateral orbital rim and lower

forehead, advancement or alteration, w/ or w/o grafts
21172 (includes obtaining autografts) 55,000 33,600
21175 Reconstruction, bifrontal, superior-lateral orbital rims 55,000 33,600

and lower forehead, advancement or alteration (e.g.,
plagiocephaly, trigonocephaly, brachycephaly), w/ or
w/o grafts (includes obtaining autografts)
21179 Reconstruction, entire or majority of forehead and/or 55,000 33,600

supraorbital rims; w/
grafts (allograft or prosthetic material)
21180 Reconstruction, entire or majority of forehead and/or 55,000 33,600
supraorbital rims; w/
autograft (includes obtaining grafts)
21181 Reconstruction by contouring of benign tumor of 53,400 29,400
cranial bones (e.g., fibrous
dysplasia), extracranial
21182 Reconstruction of orbital walls, rims, forehead, 46,500 25,200
nasoethmoid complex following intra-and extracranial
excision of benign tumor of cranial bone (e.g., fibrous
dysplasia), w/ multiple autografts (includes obtaining
grafts);
total area of bone grafting less
Reconstruction of orbital walls, rims, forehead,

grafts); total area of bone grafting greater than 40 cm2
21183 but less than 80 cm2 53,400 29,400
21184 Reconstruction of orbital walls, rims, forehead, 55,000 33,600

grafts);
total area of bone grafting greater than 80 cm2
21188 Reconstruction midface, osteotomies (other than 55,000 33,600

LeFort type) and bone
grafts (includes obtaining autografts)
21193 Reconstruction of mandibular rami, horizontal, 46,500 25,200
vertical, "C", or "L"
osteotomy; w/o bone graft
21194 Reconstruction of mandibular rami, horizontal, 55,000 33,600
vertical, "C", or "L"
osteotomy; w/ bone graft (includes obtaining graft)
21195 Reconstruction of mandibular rami and/or body, 46,500 25,200

sagittal split; w/o internal
rigid fixation
21196 Reconstruction of mandibular rami and/or body, 55,000 33,600
sagittal split; w/ internal
rigid fixation
21198 Osteotomy, mandible, segmental 30,300 16,800
21206 Osteotomy, maxilla, segmental (e.g., Wassmund or 46,500 25,200
Schuchard)
21210 Graft, bone; nasal, maxillary or malar areas (includes 46,500 25,200
obtaining graft)
21215 Graft, bone; mandible (includes obtaining graft) 55,000 33,600
21230 Graft; rib cartilage, autogenous, to face, chin, nose or 46,500 25,200
ear (includes
obtaining graft)
21235 Graft; ear cartilage, autogenous, to nose or ear 30,300 16,800
(includes obtaining graft)
21240 Arthroplasty, temporomandibular joint, w/ or w/o 46,500 25,200
autograft (includes
obtaining graft)
21242 Arthroplasty, temporomandibular joint, w/ allograft 46,500 25,200
21243 Arthroplasty, temporomandibular joint, w/ prosthetic 55,000 33,600

joint replacement
21244 Reconstruction of mandible, extraoral, w/ transosteal 46,500 25,200
bone plate (e.g.,
mandibular staple bone plate)
21245 Reconstruction of mandible or maxilla, subperiosteal 53,400 29,400
implant partial
21246 Reconstruction of mandible or maxilla, subperiosteal 55,000 33,600
implant complete
Reconstruction of mandibular condyle w/ bone and
cartilage autografts (includes obtaining grafts) (e.g.,
21247 for hemifacial microsomia) 55,000 33,600
21248 Reconstruction of mandible or maxilla, endosteal 55,000 33,600
implant (e.g. blade,
cylinder); partial
21249 Reconstruction of mandible or maxilla, endosteal 63,000 42,000
implant (e.g. blade,
cylinder); complete
21255 Reconstruction of zygomatic arch and glenoid fossa w/ 55,000 33,600
bone and cartilage
(includes obtaining autografts)
21256 Reconstruction of orbit w/ osteotomies (extracranial) 55,000 33,600
and w/ bone grafts
(includes obtaining autografts) (e.g., micro-
ophthalmia)
21260 Periorbital osteotomies for orbital hypertelorism, w/ 55,000 33,600

bone grafts
21267 Orbital repositioning, periorbital osteotomies, 55,000 33,600
unilateral, w/ bone grafts;
extracranial approach
21300 Closed treatment of skull fracture w/o operation 10,540 5,040
21315 Closed treatment of nasal bone fracture 10,540 5,040

21325 Open treatment of nasal fracture; uncomplicated 12,120 6,720
21330 Open treatment of nasal fracture; complicated, w/ 12,120 6,720

internal and/or external
skeletal fixation
21335 Open treatment of nasal fracture; w/ concomitant 12,120 6,720
open treatment of
fractured septum
21336 Open treatment of nasal septal fracture, w/ or w/o 12,120 6,720
stabilization
21337 Closed treatment of nasal septal fracture 10,540 5,040
21338 Open treatment of nasoethmoid fracture; w/o 12,120 6,720
external fixation
21339 Open treatment of nasoethmoid fracture; w/ external 18,000 8,400
fixation
Percutaneous treatment of nasoethmoid complex
fracture, w/ splint, wire or headcap fixation, including
repair of canthal ligaments and/or the
21340 nasolacrimal apparatus 21,940 9,240
21343 Open treatment of depressed frontal sinus fracture 21,940 9,240
Open treatment of complicated (e.g., comminuted or

involving posterior wall) frontal sinus fracture, via
21344 coronal or multiple approaches 23,300 12,600
21345 Closed treatment of nasomaxillary complex fracture 22,660 11,760

(LeFort II type), w/
interdental wire fixation or fixation of denture or
splint
21346 Open treatment of nasomaxillary complex fracture 23,300 12,600

(LeFort II type); w/
wiring and/or local fixation
(LeFort II type);
requiring multiple open approaches
(LeFort II type); w/ bone
grafting (includes obtaining graft)
21355 Percutaneous treatment of fracture of malar area, 21,940 9,240
including zygomatic arch
and malar tripod, w/ manipulation
21356 Open treatment of depressed zygomatic arch fracture 23,300 12,600
(e.g., Gilles approach)
21360 Open treatment of depressed malar fracture, including 30,300 16,800
zygomatic arch and
malar tripod
21365 Open treatment of complicated (e.g., comminuted or 37,800 21,000
involving cranial nerve foramina) fracture(s) of malar
area, including zygomatic arch and malar tripod; w/
internal fixation and multiple surgical approaches
Open treatment of complicated (e.g., comminuted or

involving cranial nerve
foramina) fracture(s) of malar area, including
21366 zygomatic arch and malar tripod; w/ bone grafting 46,500 25,200
21385 Open treatment of orbital floor "blowout" fracture; 20,980 10,080

transantral approach
(Caldwell-Luc type operation)
periorbital approach
combined approach
periorbital approach,
w/ alloplastic or other implant
periorbital approach w/
bone graft (includes obtaining graft)
21400 Closed treatment of fracture of orbit, except 18,000 8,400
"blowout"
21406 Open treatment of fracture of orbit, except "blowout"; 20,980 10,080
w/o implant
w/ implant
w/ bone grafting
21421 Closed treatment of palatal or maxillary fracture 12,120 6,720
(LeFort I type), w/
interdental wire fixation or fixation of denture or
splint
21422 Open treatment of palatal or maxillary fracture (LeFort 20,980 10,080

I type)
Open treatment of palatal or maxillary fracture (LeFort
I type) complicated (comminuted or involving cranial
21423 nerve foramina), multiple approaches 23,300 12,600
21431 Closed treatment of craniofacial separation (LeFort III 12,120 6,720

type) using
interdental wire fixation of denture or splint
21432 Open treatment of craniofacial separation (LeFort III 23,300 12,600
type); w/ wiring and/or
internal fixation
Open treatment of craniofacial separation (LeFort III
type); complicated
(e.g., comminuted or involving cranial nerve
21433 foramina); multiple surgical approaches 18,000 8,400

type); complicated, utilizing internal and/or external
fixation techniques (e.g., head cap, halo
21435 device, and/or intermaxillary fixation) 23,300 12,600

type); complicated,
multiple surgical approaches, internal fixation, w/
21436 bone grafting (includes obtaining graft) 46,500 25,200
21440 Closed treatment of mandibular or maxillary alveolar 12,120 6,720

ridge fracture
21445 Open treatment of mandibular or maxillary alveolar 18,000 8,400
ridge fracture
21450 Closed treatment of mandibular fracture 18,000 8,400
21452 Percutaneous treatment of mandibular fractue, w/ 23,300 12,600
external fixation
21453 Closed treatment of mandibular fracture; w/ 14,960 7,560
interdental fixation
21454 Open treatment of mandibular fracture; w/ external 22,660 11,760
fixation
21461 Open treatment of mandibular fracture; w/o 22,660 11,760
21462 Open treatment of mandibular fracture; w/ 23,300 12,600
21465 Open treatment of mandibular condylar fracture 30,300 16,800
Open treatment of complicated mandibular fracture

by multiple surgical approaches including internal
fixation, interdental fixation, and/or wiring of
21470 dentures or splints 37,800 21,000
21480 Closed treatment of temporomandibular dislocation; 9,700 4,200

initial or subsequent
Closed treatment of temporomandibular dislocation;
complicated (e.g., recurrent requiring intermaxillary
21485 fixation or splinting), initial or subsequent 20,980 10,080
21490 Open treatment of temporomandibular dislocation 30,300 16,800
21493 Closed treatment of hyoid fracture 18,000 8,400

21495 Open treatment of hyoid fracture 23,300 12,600
21497 Interdental wiring, for condition other than fracture 12,120 6,720
21501 Incision and drainage, deep abscess or hematoma, soft 5,680 1,680
tissues of neck or
thorax
21502 Incision and drainage, deep abscess or hematoma, soft 8,020 2,520
tissues of neck or
thorax w/ partial rib ostectomy
21510 Incision, deep, w/ opening of bone cortex (e.g., for 4,108 1,008
osteomyelitis or bone
abscess), thorax
21550 Biopsy, soft tissue of neck or thorax 5,680 1,680
21555 Excision tumor, soft tissue of neck or thorax; 8,020 2,520
subcutaneous
21556 Excision tumor, soft tissue of neck or thorax; deep, 9,700 4,200
subfascial, intramuscular
soft tissue of neck or
thorax
21600 Excision of rib, partial 10,540 5,040

21610 Costotransversectomy 20,980 10,080
21615 Excision first and/or cervical rib 37,180 18,480
21616 Excision first and/or cervical rib w/ sympathectomy 37,800 21,000
21620 Ostectomy of sternum, partial 27,120 15,120

21627 Sternal debridement 12,288 6,888
21630 Radical resection of sternum; 37,800 21,000
21700 Division of scalenus anticus; w/o resection of cervical 18,000 8,400
rib
21705 Division of scalenus anticus; w/ resection of cervical 23,300 12,600
rib
21720 Division of sternocleidomastoid for torticollis, open 18,000 8,400
operation
21740 Reconstructive repair of pectus excavatum or 27,120 15,120
carinatum
21750 Closure of sternotomy separation w/ or w/o 23,300 12,600
debridement
21800 Closed treatment of rib fracture 8,020 2,520
21805 Open treatment of rib fracture w/o fixation 10,960 5,460
21810 Treatment of rib fracture requiring external fixation 20,980 10,080
("flail chest")
21820 Closed treatment of sternum fracture 9,868 4,368
21825 Open treatment of sternum fracture w/ or w/o 21,940 9,240
skeletal fixation
21920 Biopsy, soft tissue of back or flank 3,504 504
21930 Excision, tumor, soft tissue of back or flank 5,680 1,680
soft tissue of back or
flank
Partial excision of posterior vertebral component (e.g.,

spinous process, lamina or facet) for intrinsic bony
22100 lesion, single vertebral segment; cervical 27,120 15,120

22101 lesion, single vertebral segment; thoracic 27,120 15,120

22102 lesion, single vertebral segment; lumbar 27,120 15,120
Partial excision of vertebral body, for intrinsic bony

lesion, w/o
22110 decompression of spinal cord or nerve root(s), single 46,500 25,200
vertebral segment; cervical

lesion, w/o
vertebral segment; thoracic

lesion, w/o
vertebral segment; lumbar
22210 Osteotomy of spine, posterior or posterolateral 46,500 25,200

approach, one vertebral
segment; cervical
segment; thoracic
segment; lumbar
22220 Osteotomy of spine, including diskectomy, anterior 53,400 29,400
approach, single
vertebral segment; cervical
approach, single
vertebral segment; thoracic
approach, single
vertebral segment; lumbar
22305 Closed treatment of vertebral process fracture(s) 23,300 12,600
22310 Closed treatment of vertebral body fracture(s), 30,740 13,440

requiring and including
casting or bracing
Open treatment and/or reduction of vertebral
fracture(s) and/or dislocation(s), posterior approach,
one fractured vertebrae or dislocated
22325 segment; lumbar 38,860 20,160
22326 segment; cervical 38,640 21,840

22327 segment; thoracic 37,800 21,000
22548 Arthrodesis, anterior transoral or extraoral technique, 40,320 23,520

clivus-C1-C2 (atlas-
axis), w/ or w/o excision of odontoid process
Arthrodesis, anterior interbody technique, including

minimal diskectomy to prepare interspace (other than
22554 for decompression); cervical below C2 53,400 29,400

22556 for decompression); thoracic 46,500 25,200

22558 for decompression); lumbar 46,500 25,200
22590 Arthrodesis; posterior technique, craniocervical 53,400 29,400

(occiput-C2)
22595 Arthrodesis, posterior technique, atlas-axis (C1-C2) 53,400 29,400
22600 Arthrodesis, posterior or posterolateral technique, 53,400 29,400

single level; cervical
below C2 segment
Arthrodesis, posterior or posterolateral technique,
single level; cervical below C2 segment thoracic (w/ or
22610 w/o lateral transverse technique) 30,300 16,800
Arthrodesis, posterior or posterolateral technique,

single level; cervical below C2 segment lumbar (w/ or
22612 w/o lateral transverse technique) 30,300 16,800
22630 Arthrodesis, posterior interbody technique, single 40,320 23,520

interspace; lumbar
22800 Arthrodesis, posterior, for spinal deformity, w/ or w/o 58,800 37,800
cast; up to 6
vertebral segments
cast; 7 to 12 vertebral
segments
cast; 13 or more
vertebral segments
22808 Arthrodesis, anterior, for spinal deformity, w/ or w/o 55,000 33,600
segments
segments
cast; 8 or more
vertebral segments
22840 Posterior non-segmental instrumentation (e.g., single 55,000 33,600
Harrington rod
technique)
22841 Internal spinal fixation by wiring of spinous processes 53,400 29,400
22842 Posterior segmental instrumentation (e.g., pedicle 54,660 30,660

fixation, dual rods w/
multiple hooks and sublaminal wires); 3 to 6 vertebral
segments
22843 Posterior segmental instrumentation (e.g., pedicle 58,800 37,800
fixation, dual rods w/
multiple hooks and sublaminal wires); 7 to 12
vertebral segments
Posterior segmental instrumentation (e.g., pedicle

fixation, dual rods w/ multiple hooks and sublaminal
22844 wires); 13 or more vertebral segments 67,200 46,200
22845 Anterior instrumentation; 2 to 3 vertebral segments 55,000 33,600
22846 Anterior instrumentation; 4 to 7 vertebral segments 58,800 37,800
22847 Anterior instrumentation; 8 or more vertebral 67,200 46,200

segments
22848 Pelvic fixation (attachment of caudal end of 55,000 33,600
instrumentation to pelvic bony
structures) other than sacrum
22849 Reinsertion of spinal fixation device 53,400 29,400
22850 Removal of posterior nonsegmental instrumentation 21,940 9,240
(e.g., Harrington rod)
22851 Application of prosthetic device (e.g., metal cages, 58,800 37,800
methylmethacrylate) to
vertebral defect or interspace
22852 Removal of posterior segmental instrumentation 27,120 15,120
22855 Removal of anterior instrumentation 30,300 16,800

22900 Excision, abdominal wall tumor, subfascial (e.g., 23,300 12,600
desmoid)
23000 Removal of subdeltoid (or intratendinous) calcareous 20,980 10,080
deposits, open
method
23020 Capsular contracture release (Sever type procedure) 27,120 15,120
23030 Incision and drainage, shoulder area; deep abscess or 18,000 8,400
hematoma
23031 Incision and drainage, shoulder area; infected bursa 14,960 7,560
23035 Incision, deep, w/ opening of cortex (e.g., for 20,980 10,080

abscess), shoulder area
23040 Arthrotomy, glenohumeral joint, for infection, w/ 23,300 12,600
exploration, drainage, or
removal of foreign body
23044 Arthrotomy, acromioclavicular, sternoclavicular joint, 20,980 10,080
for infection, w/
exploration, drainage, or removal of foreign body
23065 Biopsy, soft tissue of shoulder area 3,504 504

23075 Excision, tumor, shoulder area; subcutaneous 5,680 1,680
23076 Excision, tumor, shoulder area; deep, subfascial, or 8,020 2,520

intramuscular
soft tissue of
shoulder area
23100 Arthrotomy w/ biopsy, glenohumeral joint 23,300 12,600
23101 Arthrotomy w/ biopsy, or w/ excision of torn cartilage, 27,120 15,120
acromioclavicular,
sternoclavicular joint
23105 Arthrotomy w/ synovectomy; glenohumeral joint 27,120 15,120
23106 Arthrotomy w/ synovectomy; sternoclavicular joint 21,820 10,920
23107 Arthrotomy, glenohumeral joint, w/ joint exploration, 30,740 13,440

w/ or w/o removal of
loose or foreign body
23120 Claviculectomy; partial 23,300 12,600
23125 Claviculectomy; total 27,960 15,960
23130 Acromioplasty or acromionectomy, partial 27,540 15,540
23140 Excision or curettage of bone cyst or benign tumor of 20,980 10,080
clavicle or scapula
clavicle or scapula w/
autograft (includes obtaining graft)
clavicle or scapula w/
allograft
proximal humerus
proximal humerus w/
proximal humerus w/
allograft
23170 Sequestrectomy (e.g., for osteomyelitis or bone 20,980 10,080
abscess), clavicle
abscess), scapula
abscess), humeral head to
surgical neck
23180 Partial excision (craterization, saucerization,or 21,400 10,500
diaphysectomy) of bone
(e.g., for osteomyelitis), clavicle
23182 Partial excision (craterization, saucerization,or 21,652 10,752
(e.g., for osteomyelitis), scapula
23184 Partial excision (craterization, suacerization, or 21,820 10,920
(e.g., for osteomyelitis), proximal humerus
23190 Ostectomy of scapula, partial (e.g., superior medial 21,820 10,920
angle)
23195 Resection humeral head 27,120 15,120
23200 Radical resection for tumor; clavicle 27,120 15,120
23210 Radical resection for tumor; scapula 27,540 15,540
23220 Radical resection for tumor, proximal humerus 37,180 18,480
23221 Radical resection for tumor, proximal humerus w/ 40,320 23,520

autograft (includes
obtaining graft)
23222 Radical resection for tumor, proximal humerus w/ 53,400 29,400
prosthetic replacement
23330 Removal of foreign body, shoulder; subcutaneous 5,560 1,260
23331 Removal of foreign body, shoulder; deep (e.g., Neer 12,900 6,300
prosthesis removal)
23332 Removal of foreign body, shoulder; complicated , 14,960 7,560
including "total shoulder"
23395 Muscle transfer, any type, shoulder or upper arm 22,240 11,340
single
23397 Muscle transfer, any type, shoulder or upper arm 23,300 12,600
multiple
23400 Scapulopexy (e.g., Sprengels deformity or for 27,120 15,120
paralysis)
23405 Tenomyotomy, shoulder area; single 21,940 9,240
23406 Tenomyotomy, shoulder area; multiple through same 23,080 12,180
incision
23410 Repair of ruptured musculotendinous cuff (e.g., 20,980 10,080
rotator cuff); acute
23412 Repair of ruptured musculotendinous cuff (e.g., 22,240 11,340
rotator cuff); chronic
23415 Coracoacromial ligament release, w/ or w/o 21,148 10,248
acromioplasty
23420 Repair of complete shoulder (rotator) cuff avulsion, 23,300 12,600
chronic (includes
acromioplasty)
23430 Tenodesis of long tendon of biceps 21,940 9,240
23440 Resection or transplantation of long tendon of biceps 20,980 10,080
23450 Capsulorrhaphy, anterior; Putti-Platt procedure or 37,800 21,000

Magnuson type
operation
23455 Capsulorrhaphy, anterior; Bankart type operation w/ 38,860 20,160
or w/o stapling
23460 Capsulorrhaphy, anterior, any type; w/ bone block 38,860 20,160
23462 Capsulorrhaphy, anterior, any type; w/ coracoid 37,180 18,480

process transfer
23465 Capsulorrhaphy for recurrent dislocation, posterior, 37,800 21,000
w/ or w/o bone block
23466 Capsulorrhaphy w/ any type multi-directional 40,320 23,520
instability
23470 Arthroplasty w/ proximal humeral implant (e.g., Neer 48,180 26,880
type operation)
23472 Arthroplasty w/ glenoid and proximal humeral 53,400 29,400
replacement (e.g. total
shoulder)
23480 Osteotomy, clavicle, w/ or w/o internal fixation; 27,120 15,120
Osteotomy, clavicle, w/ or w/o internal fixation; w/

bone graft for nonunion or malunion (includes
23485 obtaining graft and/or necessary fixation) 28,380 16,380
23490 Prophylactic treatment (nailing, pinning, plating or 27,120 15,120

wiring) w/ or w/o
methylmethacrylate; clavicle
wiring) w/ or w/o
methylmethacrylate; proximal humerus and humeral
head
23500 Closed treatment of clavicular fracture 8,020 2,520

23515 Open treatment of clavicular fracture, w/ or w/o 12,456 7,056
internal or external
fixation
23520 Closed treatment of sternoclavicular dislocation 10,880 3,780
23530 Open treatment of sternoclavicular disloction, acute 20,980 10,080

or chronic
23532 Open treatment of sternoclavicular disloction, acute 27,120 15,120
or chronic w/ fascial
graft (includes obtaining graft)
23540 Closed treatment of acromioclavicular dislocation 8,020 2,520
23550 Open treatment of acromioclavicular dislocation, 21,940 9,240

acute or chronic
23552 Open treatment of acromioclavicular dislocation, 20,980 10,080
acute or chronic w/ fascial
23570 Closed treatment of scapular fracture 8,020 2,520
23585 Open treatment of scapular fracture (body, glenoid or 20,980 10,080
acromion) w/ or w/o
internal fixation
23600 Closed treatment of proximal humeral (surgical or 10,540 5,040
anatomical neck) fracture
Open treatment of proximal humeral (surgical or
anatomical neck) fracture, w/ or w/o internal or
23615 external fixation, w/ or w/o repair of tuberosity(-ies); 23,300 12,600
Open treatment of proximal humeral (surgical or
anatomical neck) fracture, w/ or w/o internal or
external fixation, w/ or w/o repair of tuberosity(-ies);
23616 w/ proximal humeral prosthetic replacement 47,340 26,040
23620 Closed treatment of greater tuberosity fracture 9,700 4,200
23630 Open treatment of greater tuberosity fracture, w/ or 23,300 12,600

w/o internal or
external fixation
23650 Closed treatment of shoulder dislocation 10,540 5,040
23657 Thoracoscopy, surgical; w/ wedge resection of lung, 41,160 24,360
single or mutiple
23660 Open treatment of acute shoulder dislocation 27,120 15,120
23665 Closed treatment of shoulder dislocation,/ fracture of 11,980 5,880

greater tuberosity
23670 Open treatment of shoulder dislocation, w/ fracture of 27,120 15,120
greater tuberosity,
w/ or w/o internal or external fixation
23675 Closed treatment of shoulder dislocation, w/ surgical 12,120 6,720
or anatomical neck
fracture
23680 Open treatment of shoulder dislocation, w/ surgical or 27,120 15,120
anatomical neck
fracture, w/ or w/o internal or external fixation
23700 Manipulation under anesthesia, shoulder joint, 9,700 4,200

including application of
fixation apparatus (dislocation excluded)
23800 Arthrodesis, shoulder joint w/ or w/o local bone graft 12,456 7,056
23802 Arthrodesis, shoulder joint w/ primary autogenous 37,180 18,480

graft (includes obtaining
graft)
23900 Interthoracoscapular amputation (forequarter) 30,300 16,800
23920 Disarticulation of shoulder 27,120 15,120

23930 Incision and drainage, upper arm or elbow area deep 4,108 1,008
abscess or hematoma
23931 Incision and drainage, upper arm or elbow area 5,560 1,260
infected bursa
osteomyelitis of bone
abscess), humerus or elbow
24000 Arthrotomy, elbow, for infection, w/ exploration, 22,360 9,660
drainage or removal of
foreign body
24006 Arthrotomy of the elbow, w/ capsular excision for 20,980 10,080
capsular release
24065 Biopsy, soft tissue of upper arm or elbow area 3,504 504
24075 Excision, tumor, upper arm or elbow area 5,680 1,680

subcutaneous
24076 Excision, tumor, upper arm or elbow area deep, 8,020 2,520
subfascial or intramuscular
soft tissue of upper
arm or elbow area
24100 Arthrotomy, elbow w/ synovial biopsy only 20,980 10,080
24101 Arthrotomy, elbow w/ joint exploration, w/ or w/o 21,820 10,920
biopsy, w/ or w/o
removal of loose or foreign body
24102 Arthrotomy, elbow w/ synovectomy 23,300 12,600
24105 Excision, olecranon bursa 8,260 3,360
24110 Excision or curettage of bone cyst or benign tumor, 20,980 10,080
humerus
humerus w/ autograft
humerus w/ allograft
head or neck of radius
or olecranon process
or olecranon process w/ autograft (includes obtaining
graft)

or olecranon process w/ allograft
24130 Excision, radial head 20,980 10,080
abscess), shaft or distal
humerus
abscess), radial head or
neck
abscess), olecranon process
24140 Partial excision (craterization, saucerization, or 20,980 10,080
(e.g., for osteomyelitis), humerus
(e.g., for osteomyelitis), radial head or neck

(e.g., for osteomyelitis), olecranon process
24149 Radical resection of capsule, soft tissue, and 21,400 10,500

heterotopic bone, elbow, w/
contracture release
24150 Radical resection for tumor, shaft or distal humerus 23,080 12,180
24151 Radical resection for tumor, shaft or distal humerus w/ 30,300 16,800
autograft (includes
obtaining graft)
24152 Radical resection for tumor, radial head or neck 23,300 12,600
24153 Radical resection for tumor, radial head or neck w/ 27,120 15,120
autograft (includes
obtaining graft)
24155 Resection of elbow joint (arthrectomy) 27,120 15,120
24160 Implant removal elbow joint 21,940 9,240
24164 Implant removal radial head 22,360 9,660
24200 Removal of foreign body, upper arm or elbow area 8,272 2,772
24301 Muscle or tendon transfer, any type, upper arm or 23,300 12,600
elbow, single
24305 Tendon lengthening, upper arm or elbow, single, each 20,980 10,080
24310 Tenotomy, open, elbow to shoulder, single, each 21,940 9,240
24320 Tenoplasty, w/ muscle transfer, w/ or w/o free graft, 27,120 15,120

elbow to shoulder,
single (Seddon-Brookes type procedure)
24330 Flexor-plasty, elbow (e.g., Steindler type 30,740 13,440
advancement)
24331 Flexor-plasty, elbow (e.g., Steindler type 27,120 15,120
advancement) w/ extensor
advancement
24340 Tenodesis of biceps tendon at elbow 8,260 3,360
24341 Repair, tendon or muscle, upper arm or elbow, each 20,980 10,080
tendon or muscle,
primary or secondary (excludes rotator cuff)
24342 Reinsertion of ruptured biceps or triceps tendon, 12,120 6,720

distal, w/ or w/o tendon
graft
24350 Fasciotomy, lateral or medial (e.g., "tennis elbow" or 10,540 5,040
epicondylitis);
epicondylitis); w/
extensor origin detachment
epicondylitis); w/
annular ligament resection
epicondylitis); w/
stripping
epicondylitis); w/
partial ostectomy
24360 Arthroplasty, elbow w/ membrane 27,120 15,120
24361 Arthroplasty, elbow w/ membrane w/ distal humeral 37,180 18,480
prosthetic
replacement
24362 Arthroplasty, elbow w/ membrane w/ implant and 27,120 15,120
fascia lata ligament
reconstruction
24363 Arthroplasty, elbow w/ membrane w/ distal humerus 38,640 21,840
and proximal ulnar
prosthetic replacement ("total elbow")
24365 Arthroplasty, radial head 21,940 9,240
24366 Arthroplasty, radial head w/ implant 27,120 15,120
24400 Osteotomy, humerus, w/ or w/o internal fixation 20,980 10,080
24410 Multiple osteotomies w/ realignment on 20,980 10,080

intramedullary rod, humeral shaft
(Sofield type procedure)
24420 Osteoplasty, humerus (e.g., shortening or lengthening) 23,300 12,600
24430 Repair of non-union or malunion, humerus; w/o graft 23,080 12,180

(e.g., compression
technique);
Repair of non-union or malunion, humerus; w/o graft
(e.g., compression technique); w/ iliac or other
24435 autograft (includes obtaining graft) 27,120 15,120
24470 Hemiepiphyseal arrest (e.g., for cubitus varus or 22,360 9,660

valgus, distal humerus)
24495 Decompression fasciotomy, forearm, w/ brachial 27,120 15,120
artery exploration
wiring), w/ or w/o
methylmethacrylate, humerus
24500 Closed treatment of humeral shaft fracture 10,120 4,620
24515 Open treatment of humeral shaft fracture w/ 30,740 13,440
plate/screws, w/ or w/o
cerclage
24516 Open treatment of humeral shaft fracture, w/ 30,740 13,440
insertion of intramedullary
implant, w/ or w/o cerclage and/or locking screws
24530 Closed treatment of supracondylar or transcondylar 10,120 4,620

humeral fracture, w/ or
w/o intercondylar extension
24538 Percutaneous skeletal fixation of supracondylar or 27,120 15,120
transcondylar humeral
fracture, w/ or w/o intercondylar extension
24545 Open treatment of humeral supracondylar or 12,456 7,056
transcondylar fracture, w/ or
w/o internal or external fixation w/o intercondylar
extension
24546 Open treatment of humeral supracondylar or 32,000 14,700

transcondylar fracture, w/ or
w/o internal or external fixation w/ intercondylar
extension
24560 Closed treatment of humeral epicondylar fracture, 10,880 3,780

medial or lateral;
24566 Percutaneous skeletal fixation of humeral epicondylar 27,120 15,120
fracture, medial or
lateral, w/ manipulation
24575 Open treatment of humeral epicondylar fracture, 18,000 8,400
medial or lateral, w/ or
w/o internal or external fixation
24576 Closed treatment of humeral condylar fracture, medial 10,880 3,780
or lateral
24579 Open treatment of humeral condylar fracture, medial 18,000 8,400
or lateral, w/ or w/o
internal or external fixation
24582 Percutaneous skeletal fixation of humeral condylar 27,120 15,120
fracture, medial or
lateral, w/ manipulation
Open treatment of periarticular fracture and/or
dislocation of the elbow (fracture distal humerus and
24586 proximal ulna and/or proximal radius) 22,660 11,760
Open treatment of periarticular fracture and/or

dislocation of the elbow
(fracture distal humerus and proximal ulna and/or
24587 proximal radius) w/ implant arthroplasty 37,800 21,000
24600 Treatment of closed elbow dislocation 10,540 5,040

24615 Open treatment of acute or chronic elbow dislocation 23,300 12,600
24620 Closed treatment of Monteggia type of fracture 10,880 3,780

dislocation at elbow
(fracture proximal end of ulna w/ dislocation of radial
head)
Open treatment of Monteggia type of fracture

dislocation at elbow (fracture proximal end of ulna w/
dislocation of radial head), w/ or w/o
24635 internal or external fixation 21,940 9,240
24640 Closed treatment of radial head subluxation in child, 5,680 1,680

"nursemaid elbow"
24650 Closed treatment of radial head or neck fracture 10,880 3,780
24665 Open treatment of radial head or neck fracture, w/ or 20,980 10,080

w/o internal fixation
or radial head excision
Open treatment of radial head or neck fracture, w/ or
w/o internal fixation or radial head excision w/ radial
24666 head prosthetic replacement 27,120 15,120
24670 Closed treatment of ulnar fracture, proximal end 10,880 3,780

(olecranon process)
24685 Open treatment of ulnar fracture proximal end 21,940 9,240
(olecranon process), w/ or
24800 Arthrodesis, elbow joint w/ or w/o local autograft or 27,120 15,120
allograft
24802 Arthrodesis, elbow joint w/ autograft (includes 28,380 16,380
obtaining graft other than
locally obtained)
24900 Amputation, arm through humerus w/ primary closure 18,000 8,400
open, circular
(guillotine)
secondary closure or
scar revision
re-amputation
w/ implant
24935 Stump elongation, upper extremity 12,120 6,720
24940 Cineplasty, upper extremity, complete procedure 27,120 15,120
25000 Tendon sheath incision at radial styloid (e.g., for 10,540 5,040
deQuervains disease)
25020 Decompression fasciotomy, forearm and/or wrist, 18,000 8,400
flexor or extensor
compartment
25023 Decompression fasciotomy, forearm and/or wrist, 14,960 7,560
flexor or extensor
compartment w/ debridement of nonviable muscle
and/or nerve
25028 Incision and drainage, forearm and/or wrist deep 10,880 3,780
abscess or hematoma
25031 Incision and drainage, forearm and/or wrist deep 10,120 4,620
abscess or hematoma
infected bursa
abscess), forearm and/or wrist
25040 Arthrotomy, radiocarpal or midcarpal joint, w/ 10,120 4,620
exploration, drainage, or
25065 Biopsy, soft tissue of forearm and/or wrist 3,504 504
25075 Excision, tumor, forearm and/or wrist area 5,680 1,680
subcutaneous
25076 Excision, tumor, forearm and/or wrist area deep, 8,020 2,520
subfascial or intramuscular
25077 Radical resection of tumor (e.g. malignant neoplasm), 23,300 12,600
soft tissue of forearm
and/or wrist area
25085 Capsulotomy, wrist (e.g., for contracture) 15,380 7,980
25100 Arthrotomy, wrist joint w/ biopsy 11,044 5,544
25101 Arthrotomy, wrist joint w/ joint exploration, w/ or w/o 12,540 7,140
biopsy, w/ or w/o
25105 Arthrotomy, wrist joint w/ synovectomy 20,980 10,080
25107 Arthrotomy, distal radioulnar joint for repair of 20,980 10,080
triangle cartilage complex
25110 Excision, lesion of tendon sheath, forearm and/or 8,020 2,520
wrist
25111 Excision of ganglion, wrist (dorsal or volar) 8,260 3,360
Radical excision of bursa, synovia of wrist, or forearm
tendon sheaths (e.g., tenosynovitis, fungus, Tbc, or
other granulomas, rheumatoid arthritis);
25115 flexors 21,820 10,920
25116 Radical excision of bursa, synovia of wrist, or forearm 18,420 8,820

tendon sheaths (e.g., tenosynovitis, fungus, Tbc, or
other granulomas, rheumatoid arthritis); extensors, w/
or w/o transposition of dorsal retinaculum
25118 Synovectomy, extensor tendon sheath, wrist, single 9,952 4,452

compartment
25119 Synovectomy, extensor tendon sheath, wrist, single 21,940 9,240
compartment w/
resection of distal ulna
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) w/ autograft
25125 (includes obtaining graft) 21,820 10,920

radius or ulna
(excluding head or neck of radius and olecranon
process) w/ allograft

carpal bones
carpal bones w/
carpal bones w/
allograft
abscess), forearm and/or
wrist
(e.g., for osteomyelitis); ulna
(e.g., for osteomyelitis); radius
25170 Radical resection for tumor, radius or ulna 27,120 15,120
25210 Carpectomy one bone 5,932 1,932
25215 Carpectomy all bones of proximal row 22,360 9,660
25230 Radial styloidectomy 10,540 5,040
25240 Excision distal ulna partial or complete (e.g., Darrach 10,540 5,040
type or matched
resection)
25248 Exploration w/ removal of deep foreign body, forearm 8,260 3,360
or wrist
25250 Removal of wrist prosthesis 21,940 9,240
25251 Removal of wrist prosthesis complicated, including 30,740 13,440
"total wrist"
25260 Repair, tendon or muscle, flexor, forearm and/or wrist 10,540 5,040
primary, single, each
tendon or muscle
secondary, single,
each tendon or muscle
secondary, w/ free
graft (includes obtaining graft), each tendon or muscle
25270 Repair, tendon or muslce, extensor, forearm and/or 10,540 5,040

wrist primary, single,
25272 Repair, tendon or muslce, extensor, forearm and/or 8,260 3,360
wrist secondary, single,
Repair, tendon or muscle, extensor, secondary, w/
tendon graft (includes obtaining graft), forearm and/or
25274 wrist, each tendon or muscle 10,540 5,040
25280 Lengthening or shortening of flexor or extensor 10,880 3,780

tendon, forearm and/or
wrist, single, each tendon
25290 Tenotomy, open, flexor or extensor tendon, forearm 10,880 3,780
and/or wrist, single,
each tendon
25295 Tenolysis, flexor or extensor tendon, forearm and/or 8,260 3,360
wrist, single each
tendon
25300 Tenodesis at wrist flexors of fingers 10,960 5,460
25301 Tenodesis at wrist extensors of fingers 10,540 5,040
25310 Tendon transplantation or transfer, flexor or extensor, 20,980 10,080
forearm and/or
wrist, single each tendon
Tendon transplantation or transfer, flexor or extensor,
forearm and/or wrist, single w/ tendon graft(s)
25312 (includes obtaining graft), each tendon 21,820 10,920
25315 Flexor origin slide (e.g. for cerebral palsy, Volkmann 30,300 16,800
contracture), forearm
and/or wrist
25316 Flexor origin slide (e.g. for cerebral palsy, Volkmann 37,180 18,480
contracture), forearm
and/or wrist w/ tendon(s) transfer
Capsulorrhaphy or reconstruction, wrist, any method
(e.g., capsulodesis, ligament repair, tendon transfer or
graft) (includes synovectomy,
25320 capsulotomy and open reduction) for carpal instability 27,120 15,120
25332 Arthroplasty, wrist, w/ or w/o interposition, w/ or w/o 30,300 16,800

external or internal
fixation
25335 Centralization of wrist on ulna (e.g., radial club hand) 31,140 17,640
25337 Reconstruction for stabilization of unstable distal ulna 27,960 15,960

or distal radioulnar joint, secondary by soft tissue
stabilization (e.g., tendon transfer, tendon graft or
weave, or tenodesis) w/ or w/o open reduction of
distal radioulnar
joint
25350 Osteotomy, radius distal third 18,000 8,400

25355 Osteotomy, radius middle or proximal third 21,940 9,240
25360 Osteotomy ulna 18,420 8,820
25365 Osteotomy radius and ulna 23,300 12,600
25370 Multiple osteotomies, w/ realignment on 30,740 13,440
intramedullary rod (Sofield type
procedure) radius or ulna
25375 Multiple osteotomies, w/ realignment on 27,960 15,960
intramedullary rod (Sofield type
procedure) radius and ulna
25390 Osteoplasty, radius or ulna shortening 27,120 15,120
25391 Osteoplasty, radius or ulna lengthening w/ autograft 27,960 15,960
25392 Osteoplasty, radius and ulna shortening 27,120 15,120

25393 Osteoplasty, radius and ulna lengthening w/ autograft 27,960 15,960
25400 Repair of nonunion or malunion, radius or ulna w/o 20,980 10,080

graft (compression
technique)
25405 Repair of nonunion or malunion, radius or ulna w/ iliac 23,300 12,600
or other autograft
25415 Repair of nonunion or malunion, radius and ulna w/o 30,740 13,440
graft (e.g.
compression technique)
25420 Repair of nonunion or malunion, radius and ulna w/ 27,960 15,960
iliac or other autograft
25425 Repair of defect w/ autograft radius or ulna 21,940 9,240
25426 Repair of defect w/ autograft radius and ulna 30,740 13,440
25440 Repair of nonunion, scaphoid (navicular) bone, w/ or 23,720 13,020

w/o radial
styloidectomy (includes obtaining graft and necessary
fixation)
25441 Arthroplasty w/ prosthetic replacement distal radius 30,300 16,800
25442 Arthroplasty w/ prosthetic replacement distal ulna 27,120 15,120
25443 Arthroplasty w/ prosthetic replacement scaphoid 27,120 15,120

(navicular)
25444 Arthroplasty w/ prosthetic replacement lunate 27,120 15,120
25445 Arthroplasty w/ prosthetic replacement trapezium 31,580 14,280
25446 Arthroplasty w/ prosthetic replacement distal radius 37,800 21,000

and partial or entire
carpus ("total wrist")
25447 Arthroplasty w/ prosthetic replacement Interposition 27,960 15,960
arthroplasty,
intercarpal or carpometacarpal joints
25449 Revision of arthroplasty, including removal of implant, 40,320 23,520
wrist joint
25450 Epiphyseal arrest by epiphysiodesis or stapling distal 20,980 10,080
radius or ulna
25455 Epiphyseal arrest by epiphysiodesis or stapling distal 30,740 13,440
radius and ulna
wiring) w/ or w/o
methylmethacrylate radius
wiring) w/ or w/o
methylmethacrylate ulna
wiring) w/ or w/o
methylmethacrylate radius and ulna
25500 Closed treatment of radial shaft fracture 9,700 4,200
25515 Open treatment of radial shaft fracture, w/ or w/o 21,940 9,240
fixation
25520 Closed treatment of radial shaft fracture, w/ 9,700 4,200
dislocation of distal radio-ulnar
joint (Galeazzi fracture/dislocation)
25525 Open treatment of radial shaft fracture, w/ internal 20,980 10,080
and/or external fixation and closed treatment of
dislocation of distal radio-ulnar joint (Galeazzi
fracture/dislocation), w/ or w/o percutaneous skeletal
fixation
25526 Open treatment of radial shaft fracture, w/ internal 22,660 11,760

and/or external fixation and open treatment, w/ or
w/o internal or external fixation of distal radioulnar
joint (Galleazi fracture/dislocation), includes repair of
triangular
cartilage
25530 Closed treatment of ulnar shaft fracture 8,260 3,360

25545 Open treatment of ulnar shaft fracture, w/ or w/o 18,000 8,400
fixation
25560 Closed treatment of radial and ulnar shaft fractures 9,700 4,200
25574 Open treatment of radial and ulnar shaft fractures, w/ 27,960 15,960
fixation of radius or ulna
25575 Open treatment of radial and ulnar shaft fractures, w/ 27,120 15,120
fixation of radius and ulna
25600 Closed treatment of distal radial fracture (e.g., Colles 8,260 3,360
or Smith type) or
epiphyseal separation, w/ or w/o fracture of ulnar
styloid
Percutaneous skeletal fixation of distal radial fracture

(e.g., Colles or Smith
type) or epiphyseal separation, w/ or w/o fracture of
25611 ulnar styloid , requiring manipulation, w/ or w/o 23,300 12,600
external fixation
Open treatment of distal radial fracture (e.g., Colles or

Smith type) or
epiphyseal separation, w/ or w/o fracture of ulnar
25620 styloid, w/ or w/o internal or external fixation 23,300 12,600
25622 Closed treatment of carpal scaphoid (navicular) 8,260 3,360

fracture
25628 Open treatment of carpal scaphoid (navicular) 21,820 10,920
fracture, w/ or w/o internal
or external fixation
25630 Closed treatment of carpal bone fracture (excluding 8,260 3,360
carpal scaphoid
(navicular))
25645 Open treatment of carpal bone fracture (excluding 21,904 11,004
carpal scaphoid
(navicular)), each bone
25650 Closed treatment of ulnar styloid fracture 8,440 2,940
25660 Closed treatment of radiocarpal or intercarpal 8,260 3,360
dislocation, one or more
bones
25670 Open treatment of radiocarpal or intercarpal 18,000 8,400
dislocation, one or more
bones
25675 Closed treatment of distal radioulnar dislocation 8,260 3,360
25676 Open treatment of distal radioulnar dislocation, acute 21,820 10,920

or chronic
25680 Closed treatment of trans-scaphoperilunar type of 8,260 3,360
fracture dislocation
25685 Open treatment of trans-scaphoperilunar type of 20,980 10,080

fracture dislocation
25690 Closed treatment of lunate dislocation 8,260 3,360
25695 Open treatment of lunate dislocation 21,940 9,240
25800 Arthrodesis, wrist joint (including radiocarpal and/or 18,000 8,400
ulnocarpal fusion) w/o
bone graft
ulnocarpal fusion) w/
sliding graft
ulnocarpal fusion) w/
iliac or other autograft (includes obtaining graft)
25820 Intercarpal fusion w/o bone graft 12,900 6,300

25825 Intercarpal fusion w/ autograft (includes obtaining 14,960 7,560
graft)
25830 Distal radioulnar joint arthrodesis and segmental 21,820 10,920
resection of ulna (e.g.
Sauve-Kapandji procedure), w/ or w/o bone graft
25900 Amputation, forearm, through, radius and ulna 18,000 8,400
25905 Amputation, forearm, through, radius and ulna open, 12,120 6,720
circular (guillotine)
25907 Amputation, forearm, through, radius and ulna 10,960 5,460
secondary closure or scar
revision
25909 Amputation, forearm, through, radius and ulna re- 14,960 7,560
amputation
25915 Krukenberg procedure 37,800 21,000
25920 Disarticulation through wrist 14,960 7,560
25922 Disarticulation through wrist secondary closure or scar 8,440 2,940
revision
25924 Disarticulation through wrist re-amputation 14,960 7,560
25927 Transmetacarpal amputation 14,960 7,560

25929 Transmetacarpal amputation secondary closure or 8,440 2,940
scar revision
25931 Transmetacarpal amputation re-amputation 14,960 7,560
26010 Drainage of finger abscess simple 3,504 504

26011 Drainage of finger abscess; complicated (e.g., felon) 4,108 1,008
26020 Drainage of tendon sheath, one digit and/or palm 8,020 2,520
26025 Drainage of palmar bursa single, ulnar or radial 10,880 3,780
26030 Drainage of palmar bursa single, multiple or 10,540 5,040

complicated
26034 Inicision, deep, w/ opening of bone cortex (e.g., for 21,940 9,240
abscess), hand or finger
26035 Decompression fingers and/or hand, injection injury 14,960 7,560
(e.g., grease gun)
26037 Decompressive fasciotomy, hand (excludes 26035) 21,940 9,240
26040 Fasciotomy, palmar, for Dupuytrens contracture 12,120 6,720

percutaneous
26045 Fasciotomy, palmar, for Dupuytrens contracture open, 12,120 6,720
partial
26055 Tendon sheath incision (e.g., for trigger finger) 10,540 5,040
26060 Tenotomy, percutaneous, single, each digit 9,700 4,200
26070 Arthrotomy, w/ exploration, drainage, or removal of 10,880 3,780

foreign body
carpometacarpal joint
foreign body
metacarpophalangeal joint
foreign body
interphalangeal joint, each
26100 Arthrotomy w/ synovial biopsy carpometacarpal joint 12,120 6,720
26105 Arthrotomy w/ synovial biopsy metacarpophalangeal 12,900 6,300

joint
26110 Arthrotomy w/ synovial biopsy interphalangeal joint, 11,980 5,880
each
26115 Excision, tumor or vascular malformation, hand or 20,980 10,080
finger subcutaneous
26116 Excision, tumor or vascular malformation, hand or 23,300 12,600
finger deep, subfascial,
intramuscular
soft tissue of hand or
finger
26121 Fasciectomy, palm only, w/ or w/o Z-plasty, other 27,120 15,120

local tissue
rearrangement, or skin grafting (includes obtaining
graft)
Fasciectomy, partial palmar w/ release of single digit
including proximal interphalangeal joint, w/ or w/o Z-
plasty, other local tissue rearrangement,
26123 or skin grafting (includes obtaining graft) 22,660 11,760
Fasciectomy, partial palmar w/ release of single digit

including proximal interphalangeal joint, w/ or w/o Z-
plasty, other local tissue rearrangement, or skin
grafting (includes obtaining graft) each additional digit
26125 (List separately in addition to code for primary 8,260 3,360
procedure
26130 Synovectomy, capometacarpal joint 22,660 11,760

26135 Synovectomy, metacarpophalangeal joint including 12,984 6,384
intrinsic release and
extensor hood reconstruction, each digit
26140 Synovectomy, proximal interphalangeal joint, 12,984 6,384
including extensor
reconstruction, each interphalangeal joint
26145 Synovectomy tendon sheath, radical 15,380 7,980
(tenosynovectomy), flexor, palm or
finger, single, each digit
26160 Excision of lesion of tendon sheath or capsule (e.g., 11,980 5,880
cyst, mucous cyst, or
ganglion), hand or finger
26170 Excision of tendon, palm, flexor, single , each 8,440 2,940
26180 Excision of tendon, finger, flexor 8,260 3,360

26185 Sesamoidectomy, thumb or finger 15,380 7,980
metacarpal
metacarpal w/
proximal, middle or
distal phalanx of finger
Excision or curettage of bone cyst or benign tumor of
proximal, middle or distal phalanx of finger w/
26215 autograft (includes obtaining graft) 15,380 7,980

diaphysectomy) of bone (e.g.
for osteomyelitis) metacarpal

for osteomyelitis) proximal or middle phalanx of finger

for osteomyelitis) distal phalanx of finger
26250 Radical resection (ostectomy) for tumor, metacarpal; 23,636 12,936
26255 Radical resection (ostectomy) for tumor, metacarpal; 32,000 14,700

w/ autograft (includes
obtaining graft)
26260 Radical resection (ostectomy) for tumor, proximal or 30,740 13,440
middle phalanx of
finger;
26261 Radical resection (ostectomy) for tumor, proximal or 31,580 14,280
middle phalanx of
finger; w/ autograft (includes obtaining graft)
26262 Radical resection (ostectomy) for tumor, distal 23,080 12,180

phalanx of finger
26350 Flexor tendon repair or advancement, single, not in 12,120 6,720
"no mans land" primary
or secondary w/o free graft, each tendon
26352 Flexor tendon repair or advancement, single, not in 10,540 5,040
"no mans land"
secondary w/ free graft (includes obtaining graft),
each tendon
26356 Flexor tendon repair or advancement, single, in "no 10,880 3,780

mans land" primary,
each tendon
mans land" secondary,
each tendon
mans land" secondary
w/ free graft (includes obtaining graft), each tendon
26370 Profundus tendon repair or advancement, w/ intact 10,880 3,780

sublimis primary
sublimis secondary w/
free graft (includes obtaining graft)
sublimis secondary w/o
free graft
26390 Flexor tendon excision, implantation of plastic tube or 10,880 3,780
rod for delayed
tendon graft, hand or finger
26392 Removal of tube or rod and insertion of flexor tendon 10,880 3,780
graft (includes
obtaining graft), hand or finger
26410 Extensor tendon repair, dorsum of hand, single, 8,260 3,360
primary or secondary w/o
free graft, each tendon
26412 Extensor tendon repair, dorsum of hand, single, 8,260 3,360
primary or secondary w/
free graft (includes obtaining graft), each tendon
26415 Extensor tendon excision, implantation of plastic tube 10,880 3,780

or rod for delayed
extensor tendon graft, hand or finger
26416 Removal of tube or rod and insertion of extensor 8,692 3,192
tendon graft (includes
obtaining graft), hand or finger
26418 Extensor tendon repair, dorsum of finger, single, 8,260 3,360
primary or secondary w/o
26420 Extensor tendon repair, dorsum of finger, single, 8,260 3,360
primary or secondary w/
free graft (includes obtaining graft), each tendon
26426 Extensor tendon repair, central slip repair, secondary 8,260 3,360
(boutonniere
deformity) using local tissues
26428 Extensor tendon repair, central slip repair, secondary 8,260 3,360
(boutonniere
deformity) w/ free graft (includes obtaining graft)
26432 Extensor tendon repair, distal insertion ("mallet 8,260 3,360

finger"), closed splinting w/
or w/o percutaneous pinning
finger"), open, primary or
secondary repair w/o graft
finger"), open, primary or
secondary repair w/ free graft (includes obtaining
graft)
26437 Extensor tendon realignment, hand 10,540 5,040

26440 Tenolysis, simple, flexor tendon palm or finger, single, 8,020 2,520
each tendon
26442 Tenolysis, simple, flexor tendon palm and finger, each 8,440 2,940
tendon
26445 Tenolysis, extensor tendon, dorsum of hand or finger; 8,020 2,520
each tendon
26449 Tenolysis, complex, extensor tendon, dorsum of hand 8,440 2,940
or finger, including
hand and forearm
26450 Tenotomy, flexor, single, palm, open, each 8,440 2,940
26455 Tenotomy, flexor, single, finger, open, each 8,440 2,940
26460 Tenotomy, extensor, hand or finger, single, open, each 8,440 2,940
26471 Tenodesis for proximal interphalangeal joint 8,260 3,360

stabilization
26474 Tenodesis for distal joint stabilizaton 10,880 3,780
26476 Tendon lengthening, extensor, hand or finger, single, 8,440 2,940
each
26477 Tendon shortening, extensor, hand or finger, single, 8,440 2,940
each
26478 Tendon lengthening, flexor, hand or finger, single, 8,440 2,940
each
each tendon shortening,
flexor, hand or finger, single, each
Tendon lengthening, flexor, hand or finger, single,
each tendon transfer or transplant, carpometacarpal
area or dorsum of hand, single w/o free graft,
26480 each 8,440 2,940

each w/ free tendon
graft (includes obtaining graft), each tendon
26485 Tendon transfer or transplant, palmar, single, each 8,260 3,360

tendon w/o free tendon
graft
26489 Tendon transfer or transplant, palmar, single, each 8,260 3,360
tendon w/ free tendon
graft (includes obtaining graft), each tendon
26490 Opponensplasty sublimis tendon transfer type 10,540 5,040
26492 Opponensplasty tendon transfer w/ graft (includes 10,960 5,460

obtaining graft)
26494 Opponensplasty hypothenar muscle transfer 10,540 5,040
26496 Opponensplasty other methods 10,540 5,040

26497 Tendon trasfer to restore intrinsic function ring and 8,428 3,528
small finger
26498 Tendon trasfer to restore intrinsic function all four 18,000 8,400
fingers
26499 Correction claw finger,other methods 21,940 9,240
26500 Tendon pulley reconstruction w/ local tissues 10,880 3,780
26502 Tendon pulley reconstruction w/ tendon or fascial 10,120 4,620

graft)
26504 Tendon pulley reconstruction w/ tendon prosthesis 12,900 6,300
26508 Thenar muscle release for thumb contracture 8,428 3,528
26510 Cross intrinsic transfer 10,960 5,460

26516 Capsulodesis for M-P joint stabilization single digit 10,540 5,040
26517 Capsulodesis for M-P joint stabilization two digits 12,120 6,720
26518 Capsulodesis for M-P joint stabilization three or four 18,000 8,400
digits
26520 Capsulectomy or capsulotomy for contracture 10,880 3,780
metacarpophalangeal joint,
single, each
26525 Capsulectomy or capsulotomy for contracture 5,628 3,752
interphalangeal joint, single,
each
26530 Arthroplasty, metacarpophalangeal joint single, each 4,788 3,192
joint
26531 Arthroplasty, metacarpophalangeal joint w/ prosthetic 8,020 2,520
implant, single, each
joint
26535 Arthroplasty interphalangeal joint, single, each joint 18,000 8,400
26536 Arthroplasty interphalangeal joint, single, each joint 20,980 10,080

w/ prosthetic implant,
single, each joint
26540 Repair of collateral ligament, metacarpophalangeal or 8,428 3,528
interphalangeal joint
26541 Reconstruction, collateral ligament, 8,428 3,528

metacarpophalangeal joint, single; w/
tendon or fascial graft (includes obtainig graft)
26542 Reconstruction, collateral ligament, 8,428 3,528

metacarpophalangeal joint, single, w/
local tissue (e.g., adductor advancement)
26545 Reconstruction, collateral ligament, interphalangeal 10,880 3,780
joint, single, including
graft, each joint
26546 Repair non-union, metacarpal or phalanx, (includes 10,540 5,040
obtaining bone graft w/
or w/o external or internal fixation)
26548 Repair and reconstruction, finger, volar plate, 8,428 3,528
26550 Pollicization of a digit 20,980 10,080
26551 Toe-to-hand transfer w/ microvascular anastmosis 30,300 16,800
great toe "wrap-around"
w/ bone graft
other than great toe,
single
other than great toe,
double
26555 Positional change of other finger 14,960 7,560
26556 Free toe joint transfer w/ microvascular anastomosis 27,120 15,120
26560 Repair of syndactyly (web finger) each web space w/ 18,000 8,400
skin flaps
26561 Repair of syndactyly (web finger) each web space w/ 20,980 10,080
skin flaps and grafts
26562 Repair of syndactyly (web finger) each web space 30,740 13,440
complex (e.g., involving
bone, nails)
26565 Osteotomy for correction of deformity metacarpal 23,300 12,600
26567 Osteotomy for correction of deformity phalanx of 23,300 12,600

finger
26568 Osteoplasty for lengthening of metacarpal or phalanx 23,300 12,600
26580 Repair cleft hand 20,980 10,080

26585 Repair bifid digit 20,980 10,080
26587 Reconstruction of supernumerary digit, soft tissue and 23,300 12,600
bone
26590 Repair macrodactylia 30,740 13,440
26591 Repair, intrinsic muscles of hand (specify) 30,740 13,440
26593 Release, intrinsic muscles of hand (specify) 20,980 10,080
26596 Excision of constricting ring of finger, w/ multiple Z- 21,820 10,920

plasties
26597 Release of scar contracture, flexor or extensor, w/ skin 21,820 10,920
grafts,
rearrangement flaps, or Z-plasties, hand and/or finger
26600 Closed treatment of metacarpal fracture, single 10,120 4,620
26607 Closed treatment of metacarpal fracture, w/ internal 12,900 6,300

26608 Percutaneous skeletal fixation of metacarpal fracture, 12,120 6,720
each bone
26615 Open treatment of metacarpal fracture, single, w/ or 12,120 6,720
w/o internal or
external fixation, each bone
26641 Closed treatment of carpometacarpal dislocation, 10,540 5,040
thumb
26645 Closed tratment of carpometacarpal fracture 12,120 6,720
dislocation, thumb (Bennett
fracture)
Percutaneous skeletal fixation of carpometacarpal
fracture dislocation, thumb (Bennett fracture), w/
26650 manipulation, w/ or w/o external fixation 14,960 7,560
26665 Open treatment of carpometacarpal fracture 14,960 7,560

dislocation, thumb (Bennett
fracture), w/ or w/o internal or external fixation
26670 Closed treatment of carpometacarpal dislocation, 10,540 5,040

other than thumb
(Bennett fracture); single
26676 Percutaneous skeletal fixation of carpometacarpal 14,960 7,560
dislocation, other than
thumb (Bennett fracture), single, w/ manipulation
26685 Open treatment of carpometacarpal dislocation, other 10,540 5,040

than thumb (Bennett fracture) single, w/ or w/o
Open treatment of carpometacarpal dislocation, other

than thumb (Bennett fracture) single, complex,
26686 multiple or delayed reduction 11,980 5,880
26700 Closed treatment of metacarpophalangeal dislocation, 10,540 5,040

single
26706 Percutaneous skeletal fixation of 14,960 7,560
metacarpophalangeal dislocation, single,
w/ manipulation
26715 Open treatment of metacarpophalangeal dislocation, 12,540 7,140
single, w/ or w/o
26720 Closed treatment of phalangeal shaft fracture, 10,120 4,620
proximal or middle phalanx,
finger or thumb
26727 Percutaneous skeletal fixation of unstable phalangeal 14,960 7,560
shaft fracture,
proximal or middle phalanx, finger or thumb, w/
manipulation, each
26735 Open treatment of phalangeal shaft fracture, proximal 14,960 7,560

or middle phalanx,
finger or thumb, w/ or w/o internal or external
fixation, each
26740 Closed treatment of articular fracture, involving 10,120 4,620

metacarpophalangeal or
26746 Open treatment of articular fracture, involving 12,540 7,140
metacarpophalangeal or
interphalangeal joint, w/ or w/o internal or external
fixation, each
26750 Closed treatment of distal phalangeal fracture, finger 10,120 4,620

or thumb
26756 Percutaneous skeletal fixation of distal phalangeal 14,960 7,560
fracture, finger or thumb,
each
26765 Open treatment of distal phalangeal fracture, finger or 12,120 6,720
thumb, w/ or w/o
internal or external fixation, each
26770 Closed treatment of interphalangeal joint dislocation, 10,880 3,780
single
26776 Percutaneous skeletal fixation of interphalangeal joint 12,540 7,140
dislocation, single, w/
manipulation
26785 Open treatment of interphalangeal joint dislocation, 12,540 7,140

w/ or w/o internal or
external fixation, single
26820 Fusion in opposition, thumb, w/ autogenous graft 21,820 10,920
26841 Arthrodesis, carpometacarpal joint, thumb, w/ or w/o 20,980 10,080

internal fixation
26842 Arthrodesis, carpometacarpal joint, thumb, w/ or w/o 20,980 10,080
internal fixation w/
26843 Arthrodesis, carpometacarpal joint, digits, other than 21,940 9,240
thumb
26844 Arthrodesis, carpometacarpal joint, digits, other than 20,980 10,080
thumb;w/ autograft
26850 Arthrodesis, metacarpophalangeal joint, w/ or w/o 20,980 10,080
internal fixation
26852 Arthrodesis, metacarpophalangeal joint, w/ or w/o 21,820 10,920
internal fixation w/
26860 Arthrodesis, interphalangeal joint, w/ or w/o internal 20,980 10,080
fixation
26862 Arthrodesis, interphalangeal joint, w/ or w/o internal 21,820 10,920
fixation w/ autograft
26910 Amputation, metacarpal, w/ finger or thumb (ray 12,120 6,720
amputation), single, w/ or
w/o interosseous transfer
26951 Amputation, finger or thumb, primary or secondary, 11,980 5,880
any joint or phalanx,
single, including neurectomies w/ direct closure
Amputation, finger or thumb, primary or secondary,

any joint or phalanx, single, including neurectomies w/
26952 local advancement flaps (V-Y, hood) 21,940 9,240
26990 Incision and drainage, pelvis or hip joint area deep 12,120 6,720
abscess or hematoma
26991 Incision and drainage, pelvis or hip joint area infected 12,120 6,720
bursa
abscess), pelvis and/or hip joint
27000 Tenotomy, adductor of hip, subcutaneous, closed 12,120 6,720
27001 Tenotomy, adductor of hip, subcutaneous, open 14,960 7,560
27003 Tenotomy, adductor, subcutaneous, open, w/ 30,740 13,440

obturator neurectomy
27005 Tenotomy, iliopsoas, open 23,300 12,600
27006 Tenotomy, abductors of hip, open 23,300 12,600
27025 Fasciotomy, hip or thigh, any type 21,820 10,920
27030 Arthrotomy, hip, for infection, w/ drainage 30,740 13,440
27033 Arthrotomy, hip, w/ exploration or removal of loose or 30,740 13,440
foreign body
27035 Hip joint denervation, intrapelvic or extrapelvic intra- 30,300 16,800
articular branches of
sciatic, femoral, or obturator nerves
27036 Capsulectomy or capsulotomy of hip, w/ or w/o 37,800 21,000
excision of heterotopic bone, w/ release of hip flexor
muscles (ie, gluteus medius, gluteus minimus, tensor
fascia latae, rectus femoris, sartorius, iliopsoas)
27040 Biopsy, soft tissue of pelvis and hip area 3,504 504
27047 Excision, tumor, pelvis and hip area subcutaneous 5,680 1,680
27048 Excision, tumor, pelvis and hip area deep, subfascial, 8,260 3,360
intramuscular
soft tissue of pelvis
and hip area
27050 Arthrotomy w/ biopsy sacroiliac joint 27,960 15,960
27052 Arthrotomy w/ biopsy hip joint 37,180 18,480
27054 Arthrotomy w/ synovectomy, hip joint 31,140 17,640
27060 Excision; ischial bursa 27,120 15,120
27062 Excision; trochanteric bursa or calcification 27,120 15,120
27065 Excision of bone cyst or benign tumor; superficial 27,960 15,960

(wing of ilium, symphysis
pubis, or greater trochanter of femur) w/ or w/o
autograft
27066 Excision of bone cyst or benign tumor; deep, w/ or 30,300 16,800

w/o autograft
27067 Excision of bone cyst or benign tumor; w/ autograft 31,140 17,640
requiring separate
incision
Partial excision (craterization, saucerization) (e.g., for
osteomyelitis); superficial (e.g., wing of ilium,
symphysis pubis or greater trochanter of
27070 femur) 46,500 25,200
27071 Partial excision (craterization, saucerization) (e.g., for 46,500 25,200

osteomyelitis); deep
27075 Radical resection of tumor or infection; wing of ilium, 38,860 20,160

one pubic or ischial
ramus or symphysis pubis
27076 Radical resection of tumor or infection; ilium, 38,860 20,160
including acetabulum, both
pubic rami, or ischium and acetabulum
27077 Radical resection of tumor or infection; innominate 37,180 18,480
bone, total
27078 Radical resection of tumor or infection; ischial 31,140 17,640
tuberosity and greater
trochanter of femur
27079 Radical resection of tumor or infection; ischial 31,560 18,060
tuberosity and greater
trochanter of femur, w/ skin flaps
27080 Coccygectomy, primary 15,380 7,980
27086 Removal of foreign body, pelvis or hip 14,960 7,560
27090 Removal of hip prosthesis 30,300 16,800
27091 Removal of hip prosthesis complicated, including 38,020 19,320
"total hip" and
methlmethacrylate, when applicable
27097 Hamstring recession, proximal 22,660 11,760
27098 Adductor transfer to ischium 23,300 12,600
27100 Transfer external oblique muscle to greater trochanter 30,740 13,440
including fascial or
tendon extension (graft)
27105 Transfer paraspinal muscle to hip (includes fascial or 30,740 13,440
tendon extension
graft)
27110 Transfer iliopsoas; to greater trochanter 30,740 13,440
27111 Transfer iliopsoas; to femoral neck 30,740 13,440
27120 Acetabuloplasty; (e.g., Whitman, Colonna, Haygroves, 37,180 18,480
or cup type)
27122 Acetabuloplasty; resection femoral head (Girdlestone 37,180 18,480
procedure)
27125 Partial hip replacement, prosthesis (e.g., femoral stem 37,180 18,480
prosthesis, bipolar
arthroplasty)
27130 Arthroplasty, acetabular and proximal femoral 53,400 29,400
prosthetic replacement
(total hip replacement), w/ or w/o autograft or
allograft
27132 Conversion of previous hip surgery to total hip 55,080 31,080

replacement, w/ or w/o
autograft or allograft
27134 Revision of total hip arthroplasty; both components, 55,000 33,600
w/ or w/o autograft or
allograft
27137 Revision of total hip arthroplasty; acetabular 38,640 21,840
component only, w/ or w/o
autograft or allograft
27138 Revision of total hip arthroplasty; femoral component 38,640 21,840
only, w/ or w/o
allograft
27140 Osteotomy and transfer of greater trochanter 27,960 15,960
27146 Osteotomy , iliac, acetabular or innominate bone 30,300 16,800
27147 Osteotomy , iliac, acetabular or innominate bone w/ 31,140 17,640

open reduction of hip
femoral osteotomy
femoral osteotomy
and w/ open reduction of hip
27158 Osteotomy, pelvis, bilateral (e.g., for congenital 37,800 21,000
malformation)
27161 Osteotomy, femoral neck 31,140 17,640
27165 Osteotomy, intertrochanteric or subtrochanteric 37,180 18,480
including internal or
external fixation and/or cast
27170 Bone graft, femoral head, neck, intertrochanteric or 31,140 17,640
subtrochanteric area
(includes obtaining bone graft)
27175 Treatment of slipped femoral epiphysis; by traction, 23,300 12,600
w/o reduction
27176 Treatment of slipped femoral epiphysis; by single or 30,300 16,800
multiple pinning, in situ
27177 Open treatment of slipped femoral epiphysis; single of 31,140 17,640
multiple pinning or
bone graft (includes obtaining graft)
27178 Open treatment of slipped femoral epiphysis; closed 31,140 17,640
manipulation w/ single
or multiple pinning
27179 Open treatment of slipped femoral epiphysis; 31,140 17,640
osteoplasty of femoral neck
(Heyman type procedure)
27181 Open treatment of slipped femoral epiphysis; 37,180 18,480
osteotomy and internal
fixation
27185 Epiphyseal arrest by epiphysiodesis or stapling, greater 27,960 15,960
trochanter
27187 Prophylactic treatment (nailing, pinning, plating, or 31,140 17,640
wiring) w/ or w/o
methylmethacrylate, femoral neck and proximal femur
27193 Closed treatment of pelvic ring fracture, dislocation, 27,960 15,960

diastasis or subluxation
27200 Closed treatment of coccygeal fracture 14,960 7,560
27202 Open treatment of coccygeal fracture 22,660 11,760
Open treatment of iliac spine(s), tuberosity avulsion,
or iliac wing fracture(s)
27215 (e.g., pelvic fracture(s) w/c do not disrupt the pelvic 37,800 21,000
ring), w/ internal fixation
27216 Percutaneous skeletal fixation of posterior pelvic ring 40,320 23,520

fracture and/or
dislocation (includes ilium, sacroiliac joint and/or
sacrum)
27217 Open treatment of anterior ring fracture and/or 46,500 25,200

dislocation w/ internal
fixation (includes pubic symphysis and/or rami)
27218 Open treatment of posterior ring fracture and/or 46,500 25,200

dislocation w/ internal
fixation (includes ilium, sacroiliac joint and/or sacrum)
27220 Closed treatment of acetabulum (hip socket) 30,740 13,440

fracture(s)
27226 Open treatment of posterior or anterior acetabular 38,640 21,840
wall fracture, w/
internal fixation
Open treatment of acetabular fracture(s) involving
anterior or posterior (one) column, or a fracture
running transversely across the acetabulum, w/
27227 internal fixation 40,320 23,520
27228 Open treatment of acetabular fracture(s) involving 46,500 25,200

anterior and posterior (two) columns, includes T-
fracture and both column fracture w/ complete
articular detachment, or single column or transverse
fracture w/ associated
acetabular wall fracture, w/ inte
27230 Closed treatment of femoral fracture, proximal end, 23,300 12,600

neck
27235 Percutaneous skeletal fixation of femoral fracture, 46,500 25,200
proximal end, neck,
undisplaced, mildly displaced, or impacted fracture
27236 Open treatment of femoral fracture, proximal end, 46,500 25,200

neck, internal fixation or
prosthetic replacement (direct fracture exposure)
27238 Closed treatment of intertrochanteric, 23,300 12,600

pertrochanteric, or subtrochanteric
femoral fracture
Open treatment of intertrochanteric, pertrochanteric,
or subtrochanteric femoral fracture w/ plate/screw
27244 type implant, w/ or w/o cerclage 46,500 25,200
Open treatment of intertrochanteric, pertrochanteric,

or subtrochanteric femoral fracture w/ intramedullary
implant, w/ or w/o interlocking screws
27245 and/or cerclage 31,140 17,640
27246 Closed treatment of greater trochanteric fracture 23,300 12,600
27248 Open treatment of greater trochanteric fracture, w/ or 27,120 15,120

w/o internal or
external fixation
27250 Closed treatment of hip dislocation, traumatic 23,300 12,600
27253 Open treatment of hip dislocation, traumatic, w/o 37,180 18,480

internal fixation
27254 Open treatment of hip dislocation, traumatic w/ 40,320 23,520
acetabular wall and
femoral head fracture, w/ or w/o internal or external
fixation
27258 Open treatment of spontaneous hip dislocation 30,300 16,800

(developmental, including congenital or pathological),
replacement of femoral head in acetabulum (including
tenotomy, etc)
27259 Open treatment of spontaneous hip dislocation 37,180 18,480

(developmental, including congenital or pathological),
replacement of femoral head in acetabulum (including
tenotomy, etc) w/ femoral shaft shortening
27265 Closed treatment of post hip arthroplasty dislocation 18,000 8,400
27280 Arthrodesis, sacroiliac joint (including obtaining graft) 37,800 21,000
27282 Arthrodesis, symphysis pubis (including obtaining 27,960 15,960

graft)
27284 Arthrodesis, hip joint (includes obtaining graft) 37,800 21,000
27286 Arthrodesis, hip joint (includes obtaining graft) w/ 40,320 23,520

subtrochanteric
osteotomy
27290 Interpelviabdominal amputation (hindquarter 46,500 25,200
amputation)
27295 Disarticulation of hip 30,300 16,800
27301 Incision and drainage of deep abscess, infected bursa, 8,260 3,360
or hematoma, thigh
or knee region
abscess), femur or knee
27305 Fasciotomy, iliotibial (tenotomy), open 18,000 8,400
27306 Tenotomy, subcutaneous, closed, adductor or 18,000 8,400
hamstring; single
27307 Tenotomy, subcutaneous, closed, adductor or 21,820 10,920
hamstring; multiple
27310 Arthrotomy, knee, for infection, w/ exploration, 27,120 15,120
drainage or removal of
foreign body
27315 Neurectomy, hamstring muscle 23,300 12,600
27320 Neurectomy, popliteal (gastrocnemius) 23,300 12,600
27323 Biopsy, soft tissue of thigh or knee area 3,504 504
27327 Excision, tumor, thigh or knee area; subcutaneous 5,680 1,680
27328 Excision, tumor, thigh or knee area; deep, subfascial, 8,020 2,520
or intramuscular
soft tissue of thigh or
knee area
27330 Arthrotomy, knee; w/ synovial biopsy only 20,980 10,080

27331 Arthrotomy, knee; w/ joint exploration, w/ or w/o 23,300 12,600
biopsy, w/ or w/o
removal of loose or foreign bodies
27332 Arthrotomy, knee, w/ excision of semilunar cartilage 31,580 14,280
(meniscectomy);
medial or lateral
27333 Arthrotomy, knee, w/ excision of semilunar cartilage 27,960 15,960
(meniscectomy);
medial and lateral
27334 Arthrotomy, knee, w/ synovectomy; anterior or 13,152 6,552
posterior
27335 Arthrotomy, knee, w/ synovectomy; anterior and 23,300 12,600
posterior including
popliteal area
27340 Excision, prepatellar bursa 14,960 7,560
27345 Excision of synovial cyst of popliteal space (Bakers 20,980 10,080
cyst)
27350 Patellectomy or hemipatellectomy 30,740 13,440
femur
femur w/ allograft
femur w/ autograft
femur w/ internal
fixation
(e.g., for osteomyelitis), femur, proximal tibia and/or
fibula
27365 Radical resection of tumor, bone, femur or knee 27,120 15,120
27372 Removal of foreign body, deep, thigh region or knee 18,000 8,400
area
27380 Suture of infrapatellar tendon; primary 23,300 12,600
27381 Suture of infrapatellar tendon; secondary 27,120 15,120
reconstruction, including fascial
or tendon graft
27385 Suture of quadriceps or hamstring muscle rupture; 32,000 14,700
primary
27386 Suture of quadriceps or hamstring muscle rupture; 27,120 15,120
secondary
reconstruction, including fascial or tendon graft
27390 Tenotomy, open, hamstring, knee to hip; single 18,000 8,400
27391 Tenotomy, open, hamstring, knee to hip; multiple, one 21,940 9,240
leg
27392 Tenotomy, open, hamstring, knee to hip; multiple, 20,980 10,080
bilateral
27393 Lengthening of hamstring tendon; single 23,300 12,600
27394 Lengthening of hamstring tendon; multiple, one leg 21,940 9,240
27395 Lengthening of hamstring tendon; multiple, bilateral 20,980 10,080
27396 Transplant, hamstring tendon to patella; single 23,300 12,600
27397 Transplant, hamstring tendon to patella; multiple 22,360 9,660
27400 Tendon or muscle transfer, hamstrings to femur (e.g. 23,300 12,600

Eggers type
procedure)
27403 Arthrotomy w/ open meniscus repair 27,960 15,960
27405 Repair, primary, torn ligament and/or capsule, knee; 27,120 15,120
collateral
cruciate
collateral and cruciate
ligaments
27418 Anterior tibial tubercleplasty (e.g., for chondromalacia 22,660 11,760
patellae)
27420 Reconstruction for recurrent dislocating patella; (e.g. 23,080 12,180
Hauser type
procedure)
Reconstruction for recurrent dislocating patella; w/
extensor realignment
and/or muscle advancement or release (e.g. Campbell,
27422 Goldwaite type procedure) 30,740 13,440
27424 Reconstruction for recurrent dislocating patella; w/ 30,740 13,440

patellectomy
27425 Lateral retinacular release (any method) 21,820 10,920
27427 Ligamentous reconstruction (augmentation), knee; 30,300 16,800
extra-articular
intra-articular (open)

intra-articular (open)
and extra-articular
27430 Quadricepsplasty (e.g. Bennett or Thompson type) 27,120 15,120
27435 Capsulotomy, knee, posterior capsular release 30,740 13,440
27437 Arthroplasty, patella; w/o prosthesis 30,740 13,440

27438 Arthroplasty, patella; w/ prosthesis 31,140 17,640
27440 Arthroplasty, knee, tibial plateau 37,800 21,000
27441 Arthroplasty, knee, tibial plateau w/ debridement and 38,640 21,840
partial synovectomy
27442 Arthroplasty, knee, femoral condyles or tibial plateaus 38,640 21,840
Arthroplasty, knee, femoral condyles or tibial plateaus

27443 w/ debridement and partial synovectomy 39,480 22,680
27445 Arthroplasty, knee, constrained prosthesis (e.g., 46,500 25,200

Walldius type)
27446 Arthroplasty, knee, condyle and plateau; medial or 39,480 22,680
lateral compartment
Arthroplasty, knee, condyle and plateau; medial and
lateral compartments w/ or w/o patella resurfacing
27447 ("total knee replacement") 40,320 23,520
27448 Osteotomy, femur, shaft or supracondylar; w/o 18,420 8,820

fixation
27450 Osteotomy, femur, shaft or supracondylar; w/ fixation 23,300 12,600
27454 Osteotomy, multiple, femoral shaft, w/ realignment 27,120 15,120

on intramedullary rod
(Sofield type procedure)
Osteotomy, proximal tibia, including fibular excision or
osteotomy (includes correction of genu varus (bowleg)
or genu valgus (knock-knee)); before
27455 epiphyseal closure 27,120 15,120
Osteotomy, proximal tibia, including fibular excision or

osteotomy (includes correction of genu varus (bowleg)
or genu valgus (knock-knee)); after
27457 epiphyseal closure 27,120 15,120
27465 Osteoplasty, femur; shortening (excluding 64876) 27,120 15,120
27466 Osteoplasty, femur; lengthening 27,120 15,120

27468 Osteoplasty, femur; combined, lengthening and 37,180 18,480
shortening w/ femoral
segment transfer
27470 Repair, nonunion or malunion, femur, distal to head 31,580 14,280
and neck; w/o graft
(e.g., compression technique)
27472 Repair, nonunion or malunion, femur, distal to head 27,960 15,960
and neck; w/ iliac or
other autogenous bone graft (includes obtaining graft)
27475 Epiphyseal arrest by epiphysiodesis or stapling; distal 30,740 13,440

femur
27477 Epiphyseal arrest by epiphysiodesis or stapling; tibia 23,300 12,600
and fibula, proximal
27479 Epiphyseal arrest by epiphysiodesis or stapling; 27,120 15,120
combined distal femur,
proximal tibia and fibula
27485 Arrest, hemiepiphyseal, distal femur or proximal leg 30,740 13,440
(e.g., for genu varus or
valgus)
27486 Revision of total knee arthroplasty, w/ or w/o 53,400 29,400
allograft; one component
27487 Revision of total knee arthroplasty, w/ or w/o 55,000 33,600
allograft; all components
27488 Removal of knee prosthesis, including "total knee" 37,180 18,480
methylmethacrylate and
insertion of spacer, when applicable
writing) w/ or w/o
methylmethacrylate, femur
27496 Decompression fasciotomy, thigh and/or knee, one 20,980 10,080
compartment (flexor or
extensor or adductor)
Decompression fasciotomy, thigh and/or knee, one
compartment (flexor or extensor or adductor) w/
27497 debridement of nonviable muscle and/or nerve 21,820 10,920
27498 Decompression fasciotomy, thigh and/or knee, 21,820 10,920

multiple compartments
27499 Decompression fasciotomy, thigh and/or knee, 23,300 12,600
multiple compartments w/
debridement of nonviable muscle and/or nerve

femoral fracture w/ or
w/o intercondylar extension
27502 Closed treatment of femoral shaft fracture, w/ or w/o 18,420 8,820
skin or skeletal
traction
femoral fracture w/ or
w/o intercondylar extension, w/ or w/o skin or
skeletal traction
Open treatment of femoral shaft fracture, w/ or w/o

external fixation, w/ insertion of intramedullary
implant, w/ or w/o cerclage and/or locking
27506 screws 30,740 13,440
27507 Open treatment of femoral shaft fracture w/ 30,740 13,440

plate/screws, w/ or w/o
cerclage
Percutaneous skeletal fixation of femoral fracture,
distal end, medial or
lateral condyle, or supracondylar or transcondylar, w/
27509 or w/o intercondylar extension, or distal femoral 37,180 18,480
epiphyseal separation
27510 Closed treatment of femoral fracture, distal end, 18,420 8,820

medial or lateral condyle
27511 Open treatment of femoral supracondylar or 37,180 18,480
transcondylar fracture w/o
intercondylar extension, w/ or w/o internal or external
fixation
27513 Open treatment of femoral supracondylar or 37,800 21,000
transcondylar fracture w/
intercondylar extension, w/ or w/o internal or external
fixation
27514 Open treatment of femoral fracture, distal end, medial 30,740 13,440
or lateral condyle,
w/ or w/o internal or external fixation
27516 Closed treatment of distal femoral epiphyseal 23,300 12,600
separation
27519 Open treatment of distal femoral epiphyseal 22,660 11,760
separation, w/ or w/o internal
27520 Closed treatment of patellar fracture 20,980 10,080
27524 Open treatment of patellar fracture, w/ internal 20,980 10,080
fixation and/or partial or
complete patellectomy and soft tissue repair
27530 Closed treatment of tibial fracture, proximal (plateau) 18,420 8,820
27535 Open treatment of tibial fracture, proximal (plateau); 30,740 13,440

unicondylar, w/ or
27536 Open treatment of tibial fracture, proximal (plateau); 27,120 15,120
bicondylar, w/ or w/o
internal fixation
27538 Closed treatment of intercondylar spine(s) and/or 10,540 5,040
tuberosity fracture(s) of
knee
27540 Open treatment of intercondylar spine(s) and/or 21,820 10,920
tuberosity fracture(s) of
the knee, w/ or w/o internal or external fixation
27550 Closed treatment of knee dislocation 10,540 5,040

Open treatment of knee dislocation, w/ or w/o
internal or external fixation; w/o primary ligamentous
27556 repair or augmentation/reconstruction 27,120 15,120
27557 Open treatment of knee dislocation, w/ or w/o 27,960 15,960

internal or external fixation;
w/ primary ligamentous repair
Open treatment of knee dislocation, w/ or w/o
internal or external fixation; w/ primary ligamentous
27558 repair, w/ augmentation/reconstruction 37,800 21,000
27560 Closed treatment of patellar dislocation 20,980 10,080

27566 Open treatment of patellar dislocation, w/ or w/o 27,120 15,120
partial or total
patellectomy
27580 Fusion of knee, any technique 30,740 13,440
27590 Amputation, thigh, through femur, any level; 30,300 16,800

immediate fitting technique
including first cast
27592 Amputation, thigh, through femur, any level; open, 23,300 12,600
secondary closure or scar
revision
27596 Amputation, thigh, through femur, any level; re- 22,660 11,760
amputaion
27598 Disarticulation at knee 27,120 15,120
27600 Decompression fasciotomy, leg; anterior and/or 8,020 2,520
lateral compartments only
27601 Decompression fasciotomy, leg; posterior 8,020 2,520
compartments(s) only
lateral, and posterior
compartment(s)
27603 Incision and drainage, leg or ankle; deep abscess or 4,108 1,008
hematoma
27604 Incision and drainage, leg or ankle; infected bursa 5,680 1,680
27605 Tenotomy, Achilles tendon, subcutaneous ; local 12,540 7,140

anesthesia
27606 Tenotomy, Achilles tendon, subcutaneous ; general 18,420 8,820
anesthesia
abscess), leg or ankle
27610 Arthrotomy, ankle, for infection, w/ exploration, 21,940 9,240
drainage, or removal of
foreign body
27612 Arthrotomy, ankle, posterior capsular release, w/ or 22,660 11,760
w/o Achilles tendon
lengthening
27613 Biopsy, soft tissue of leg or ankle area 3,504 504
soft tissue of leg or
ankle area
27618 Excision, tumor, leg or ankle area; subcutaneous 5,680 1,680
27619 Excision, tumor, leg or ankle area; deep, subfascial or 8,020 2,520
intramuscular
27620 Arthrotomy, ankle, w/ joint exploration, w/ or w/o 12,900 6,300
biopsy, w/ or w/o
27625 Arthrotomy, ankle, w/ synovectomy 18,420 8,820
27626 Arthrotomy, ankle, w/ synovectomy including 21,940 9,240
tenosynovectomy
27630 Excision of lesion of tendon sheath or capsule (e.g., 5,680 1,680
cyst or ganglion), leg
and/or ankle
tibia or fibula
tibia or fibula w/
autograft(includes obtaining graft)
tibia or fibula w/
allograft
(e.g., for osteomyelitis or exostosis); tibia
(e.g., for osteomyelitis or exostosis); fibula
27645 Radical resection of tumor, bone; tibia 23,300 12,600
27646 Radical resection of tumor, bone; fibula 22,660 11,760
27647 Radical resection of tumor, bone; talus or calcaneus 23,300 12,600
27650 Repair, primary, open or percutaneous, ruptured 21,940 9,240

Achilles tendon
27652 Repair, primary, open or percutaneous, ruptured 23,300 12,600
Achilles tendon w/ graft
27654 Repair, secondary, ruptured Achilles tendon, w/ or 21,820 10,920
w/o graft
27656 Repair, fascial defect of leg 5,680 1,680
27658 Repair or suture of flexor tendon of leg; primary, w/o 15,380 7,980
graft, single, each
27659 Repair or suture of flexor tendon of leg; secondary w/ 18,000 8,400
or w/o graft, single
tendon, each
27664 Repair or suture of extensor tendon of leg; primary, 15,380 7,980
w/o graft, single, each
27665 Repair or suture of extensor tendon of leg; secondary 18,000 8,400
w/ or w/o graft, single
tendon, each
27675 Repair for dislocating peroneal tendons; w/o fibular 18,000 8,400
osteotomy
27676 Repair for dislocating peroneal tendons; w/ fibular 22,360 9,660
osteotomy
27680 Tenolysis, including tibia, fibula, and ankle flexor; 18,000 8,400
single
27681 Tenolysis, including tibia, fibula, and ankle flexor; 21,940 9,240
multiple (through same
incision), each
27685 Lengthening or shortening of tendon, leg or ankle; 18,000 8,400
single
27686 Lengthening or shortening of tendon, leg or ankle; 18,000 8,400
multiple (through same
incision), each
27687 Gastrocnemius recession (e.g., Strayer procedure) 14,960 7,560
27690 Transfer or transplant of single tendon (w/ muscle 18,420 8,820

redirection or rerouting);
superficial (e.g., anterior tibial extensors into midfoot)
27692 Transfer or transplant of single tendon (w/ muscle 15,380 7,980

redirection or rerouting);
each additional tendon
27695 Suture, primary, torn, ruptured or severed ligament, 18,000 8,400
ankle; collateral
27696 Suture, primary, torn, ruptured or severed ligament, 23,300 12,600
ankle; both collateral
ligaments
27698 Suture, secondary repair, torn, ruptured or severed 18,000 8,400
ligament, ankle,
collateral (e.g. Watson-Jones procedure)
27700 Arthroplasty, ankle; 27,120 15,120
27702 Arthroplasty, ankle; w/ implant ("total ankle") 31,140 17,640
27703 Arthroplasty, ankle; secondary reconstruction, total 37,180 18,480

ankle
27704 Removal of ankle implant 21,820 10,920
27705 Osteotomy; tibia 21,940 9,240
27707 Osteotomy; fibula 18,000 8,400
27709 Osteotomy; tibia and fibula 22,660 11,760
27712 Osteotomy; multiple, w/ realignment on 23,720 13,020
intramedullary rod (e.g. Sofield
type procedure)
27715 Osteoplasty, tibia and fibula, lengthening 27,960 15,960
27720 Repair of nonunion or malunion, tibia; w/o graft, (e.g., 18,000 8,400
compression
technique)
compression
technique) w/ sliding graft
compression
technique) w/ iliac or other autograft (includes
obtaining graft)
compression
technique) by synostosis, w/ fibula, any method
27727 Repair of congenital pseudarthrosis, tibia 23,300 12,600

tibia
fibula
tibia and fibula
Epiphyseal arrest by epiphysiodesis or stapling,
27740 combined, proximal and distal tibia and fibula 23,300 12,600
27742 Epiphyseal arrest by epiphysiodesis or stapling, 22,660 11,760

combined, proximal and
distal tibia and fibula and distal femur
wiring) w/ or w/o
methylmethacrylate, tibia
27750 Closed treatment of tibial shaft fracture (w/ or w/o 12,120 6,720
fibular fracture)
27752 Closed treatment of tibial shaft fracture (with or 12,120 6,720
without fibular fracture);
with manipulation, with or without skeletal traction
27756 Percutaneous skeletal fixation of tibial shaft fracture 21,820 10,920

(w/ or w/o fibular
fracture) (e.g., pins or screws)
27758 Open treatment of tibial shaft fracture (w/ or w/o 22,660 11,760
fibular fracture) w/
plate/screws, w/ or w/o cerclage
Open treatment of tibial shaft fracture (w/ or w/o
fibular fracture) by intramedullary implant, w/ or w/o
27759 interlocking screws and/or cerclage 27,120 15,120
27760 Closed treatment of medial malleolus fracture 10,960 5,460
27766 Open treatment of medial malleolus fracture, w/ or 12,120 6,720

w/o internal or external
fixation
27780 Closed treatment of proximal fibula or shaft fracture 10,960 5,460
27784 Open treatment of proximal fibula or shaft fracture, 22,660 11,760

external fixation
27786 Closed treatment of distal fibular fracture (lateral 10,540 5,040
malleolus)
27792 Open treatment of distal fibular fracture (lateral 20,980 10,080
malleolus), w/ or w/o
internal or external fixation w/o manipulation
27808 Closed treatment of bimalleolar ankle fracture, 12,900 6,300

(including Potts)
27814 Open treatment of bimalleolar ankle fracture, w/ or 23,300 12,600
w/o internal or external
fixation
27816 Closed treatment of trimalleolar ankle fracture 23,300 12,600
Open treatment of trimalleolar ankle fracture, w/ or

w/o internal or external fixation, medial and/or lateral
malleolus; w/o fixation of posterior
27822 lip 23,300 12,600
Open treatment of trimalleolar ankle fracture, w/ or

w/o internal or external fixation, medial and/or lateral
27823 malleolus; w/ fixation of posterior lip 23,300 12,600
27824 Closed treatment of fracture of weight bearing 10,540 5,040

articular portion of distal
tibia (e.g., pilon or tibial plafond)
Open treatment of fracture of weight bearing articular
surface/portion of distal tibia (e.g., pilon or tibial
plafond), w/ internal or external fixation; of
27826 fibula only 20,980 10,080
27827 tibia only 21,940 9,240

27828 both tibia and fibula 21,820 10,920
27829 Open treatment of distal tibiofibular joint 20,980 10,080

(syndesmosis) disruption, w/ or
27830 Closed treatment of proximal tibiofibular joint 10,960 5,460
dislocation
27832 Open treatment of proximal tibiofibular joint 11,980 5,880
dislocation, w/ or w/o internal
or external fixation, or w/ excision of proximal fibula
27840 Closed treatment of ankle dislocation 10,960 5,460

27846 Open treatment of ankle dislocation, w/ or w/o 22,660 11,760
percutaneous skeletal
fixation; w/o repair or internal fixation
27848 Open treatment of ankle dislocation, w/ or w/o 23,720 13,020
percutaneous skeletal
fixation; w/ repair or internal or external fixation
27870 Arthrodesis, ankle, any method 18,000 8,400

27871 Arthrodesis, tibiofibular joint, proximal or distal 21,400 10,500
27880 Amputation, leg, through tibia and fibula; 30,300 16,800

27881 Amputation, leg, through tibia and fibula; w/ 30,740 13,440
immediate fitting technique
including application of first cast
27882 Amputation, leg, through tibia and fibula; open, 18,000 8,400
27884 Amputation, leg, through tibia and fibula; secondary 12,120 6,720
closure or scar revision
27886 Amputation, leg, through tibia and fibula; re- 23,300 12,600
amputation
27888 Amputation, ankle, through malleoli of tibia and fibula 23,300 12,600
(Syme, Pirogoff type
procedures), w/ plastic closure and resection of nerves
27889 Ankle disarticulation 21,940 9,240

Decompression fasciotomy, leg; anterior and/or
lateral compartments only, w/ debridement of
27892 nonviable muscle and/or nerve 18,000 8,400
27893 Decompression fasciotomy, leg; posterior 18,000 8,400

compartment(s) only, w/
debridement of nonviable muscle and/or nerve

lateral, and posterior
compartment(s), w/ debridement of nonviable muscle
and/or nerve
28001 Incision and drainage, infected bursa, foot 5,680 1,680
Incision and drainage, infected bursa, foot deep

dissection below fascia, for deep infection of foot, w/
or w/o tendon sheath involvement; single bursal
28002 space, specify 8,260 3,360
28003 Incision and drainage, infected bursa, foot multiple 9,700 4,200
areas
28005 Incision, deep, w/ opening of bone cortex (e.g. for 10,540 5,040
abscess), foot
28008 Fasciotomy, foot and/or toe 12,120 6,720
28010 Tenotomy, subcutaneous, toe; single 8,260 3,360
28011 Tenotomy, subcutaneous, toe; multiple 10,540 5,040
loose or foreign body;
intertarsal or tarsometatarsal joint
metatarsophalangeal joint
28030 Neurectomy of intrinsic musculature of foot 11,132 4,032
28035 Tarsal tunnel release (posterior tibial nerve 18,000 8,400

decompression)
28043 Excision, tumor, foot subcutaneous 5,680 1,680
28045 Excision, tumor, foot deep, subfascial, intramuscular 8,020 2,520

soft tissue of foot
28050 Arthrotomy for synovial biopsy; intertarsal or 10,120 4,620
tarsometatarsal joint
28052 Arthrotomy for synovial biopsy; metatarsophalangeal 10,120 4,620
joint
28054 Arthrotomy for synovial biopsy; interphalangeal joint 9,700 4,200
28060 Fasciectomy, excision of plantar fascia; partial 9,700 4,200
28062 Fasciectomy, excision of plantar fascia; radical 10,960 5,460
28070 Synovectomy; intertarsal or tarsometatarsal joint, 11,980 5,880

each
28072 Synovectomy; metatarsophalangeal joint, each 10,960 5,460
28080 Excision of interdigital (Morton) neuroma, single, each 5,680 1,680
28086 Synovectomy, tendon sheath, foot flexor 10,960 5,460

28088 Synovectomy, tendon sheath, foot extensor 10,960 5,460
28090 Excision of lesion of tendon or fibrous sheath or 8,440 2,940

capsule (including synovectomy) (cyst or ganglion)
foot
28092 Excision of lesion of tendon or fibrous sheath or 8,260 3,360
capsule (including
synovectomy) (cyst or ganglion) toes
talus or calcaneus
talus or calcaneus w/ iliac or other autograft (includes
obtaining graft)

talus or calcaneus w/
allograft
talus or metatarsal
bones, except tarsal or calcaneus;
Excision or curettage of bone cyst or benign tumor,
talus or metatarsal bones, except tarsal or calcaneus;
w/ iliac or other autograft (includes
28106 obtaining graft) 21,940 9,240
talus or metatarsal
bones, except tarsal or calcaneus; w/ allograft

phalanges of foot
28110 Ostectomy, partial excision, fifth metatarsal head 21,940 9,240
(bunionette)
28111 Ostectomy, complete excision; first metatarsal head 18,420 8,820
28112 Ostectomy, complete excision; other metatarsal head 18,420 8,820

(second, third or
fourth)
28113 Ostectomy, complete excision; fifth metatarsal head 18,000 8,400
Ostectomy, complete excision; all metatarsal heads,

w/ partial proximal phalangectomy, excluding first
28114 metatarsal (e.g. Clayton type procedure) 20,980 10,080
28116 Ostectomy, excision of tarsal coalition 15,380 7,980

28118 Ostectomy, calcaneus; 15,380 7,980
28119 Ostectomy, calcaneus; for spur, w/ or w/o plantar 14,960 7,560
fascial release
Partial excision (craterization, saucerization,
sequestrectomy, or
diaphysectomy) of bone (e.g., for osteomyelitis or
28120 talar bossing); talus or calcaneus 21,940 9,240
Partial excision (craterization, saucerization, or

(e.g., for osteomyelitis or tarsal bossing), tarsal or
28122 metatarsal bone, except talus or calcaneus 18,000 8,400

(e.g., for osteomyelitis or dorsal bossing), phalanx of
toe
28126 Resection, partial or complete, phalangeal base, single 12,540 7,140

toe, each
28130 Talectomy (astragalectomy) 22,660 11,760
28140 Metatarsectomy 18,000 8,400
28150 Phalangectomy of toe, single, each 12,120 6,720
28153 Resection, head of phalanx, toe 12,120 6,720
28160 Hemiphalangectomy or interphalangeal joint excision, 10,540 5,040
toe, single, each
28171 Radical resection of tumor, bone; tarsal (except talus 30,740 13,440
or calcaneus)
28173 Radical resection of tumor, bone; metatarsal 22,660 11,760
28175 Radical resection of tumor, bone; phalanx of toe 21,940 9,240
28200 Repair or suture of tendon, foot, flexor, single; primary 18,000 8,400
or secondary, w/o
28202 Repair or suture of tendon, foot, flexor, single; 18,000 8,400
secondary w/ free graft, each
tendon (includes obtaining graft)
28208 Repair or suture of tendon, foot, extensor, single; 12,540 7,140
primary or secondary,
each tendon
28210 Repair or suture of tendon, foot, extensor, single; 12,540 7,140
secondary w/ free graft,
each tendon (includes obtaining graft)
28220 Tenolysis, flexor, foot; single 10,880 3,780
28222 Tenolysis, flexor, foot; multiple (through same 10,960 5,460
incision)
28225 Tenolysis, extensor, foot; single 10,880 3,780
28226 Tenolysis, extensor, foot; multiple (through same 10,960 5,460
incision)
28230 Tenotomy, open, flexor; foot, single or multiple; 10,960 5,460
28232 Tenotomy, open, flexor; foot, single or multiple; toe, 10,880 3,780
single
28234 Tenotomy, open, extensor, foot or toe 11,132 4,032
28238 Advancement of posterior tibial tendon w/ excision of 18,420 8,820
accessory navicular
bone (e.g. Kidner type procedure)
28240 Tenotomy, lengthening, or release, abductor hallucis 12,540 7,140
muscle
28250 Division of plantar fascia and muscle (e.g. Steindler 12,540 7,140
stripping)
28260 Capsulotomy, midfoot; medial release only 12,540 7,140
28261 Capsulotomy, midfoot; w/ tendon lengthening 18,000 8,400
Capsulotomy, midfoot; extensive, including posterior

talotibial capsulotomy and tendon(s) lengthening as
28262 for resistant clubfoot deformity 20,980 10,080
28264 Capsulotomy, midtarsal (e.g. Heyman type procedure) 12,120 6,720
28270 Capsulotomy; metatarsophalangeal joint, w/ or w/o 12,120 6,720

tenorrhaphy, single,
each joint
28272 Capsulotomy; interphalangeal joint, single each joint 12,900 6,300
28280 Webbing operation (create syndactylism of toes) (e.g. 20,980 10,080

Kelikian type
procedure)
28285 Hammertoe operation, one toe (e.g., interphalangeal 15,380 7,980
fusion, filleting,
phalangectomy)
28286 Cock-up fifth toe operation w/ plastic skin closure (e.g. 21,940 9,240
Ruiz-Mora type
procedure)
28288 Ostectomy, partial, exostectomy or condylectomy, 15,380 7,980
single, metatarsal head,
first through fifth, each metatarsal head
28290 Hallux valgus (bunion) correction, w/ or w/o 20,980 10,080
sesamoidectomy; simple
exostectomy (e.g. Silver type procedure)
sesamoidectomy; Keller,
McBride, or Mayo type procedure
sesamoidectomy; resection of
joint w/ implant
sesamoidectomy; w/ tendon
transplants (Joplin type procedure)
Hallux valgus (bunion) correction, w/ or w/o
sesamoidectomy; w/ metatarsal osteotomy (e.g.,
Mitchell, Chevron, or concentric type
28296 procedures) 22,660 11,760

sesamoidectomy; Lapidus type
procedure
sesamoidectomy; by phalanx
osteotomy
sesamoidectomy; by other methods (e.g., double
osteotomy)
28300 Osteotomy; calcaneus (e.g. Dwyer or Chambers type 21,400 10,500
procedure), w/ or w/o
internal fixation
28302 Osteotomy; talus 20,980 10,080
28304 Osteotomy, midtarsal bones, other than calcaneus or 15,380 7,980
talus;
28305 Osteotomy, midtarsal bones, other than calcaneus or 18,420 8,820
talus; w/ autograft
(includes obtaining graft)(e.g. Fowler type)
Osteotomy, metatarsal, base or shaft, single, w/ or
w/o lenghtening, for shortening or angular correction;
28306 first metatarsal 22,360 9,660

28307 first metatarsal w/ autograft 22,360 9,660

28308 other than first metatarsal 22,360 9,660
28309 Osteotomy, metatarsals, multiple, for cavus foot (e.g. 21,940 9,240
Swanson type
procedure)
28310 Osteotomy for shortening, angular or rotational 18,420 8,820
correction; proximal
phalanx, first toe
28312 Osteotomy for shortening, angular or rotational 14,960 7,560
correction; other
phalanges, any toe
28313 Reconstruction, angular deformity of toe (overlapping 22,360 9,660
second toe, fifth toe,
curly toes), soft tissue procedures only
28315 Sesamoidectomy, first toe 12,540 7,140
Repair of nonunion or malunion; tarsal bones (e.g.,
28320 calcaneus, talus) 21,940 9,240
28322 Repair of nonunion or malunion; metatarsal, w/ or 14,960 7,560
w/o bone graft (includes
obtaining graft)
28340 Reconstruction, toe, macrodactyly; soft tissue 12,120 6,720
resection
28341 Reconstruction, toe, macrodactyly; requiring bone 12,540 7,140
resection
28344 Reconstruction, toe(s); polydactyly 21,940 9,240
28345 Reconstruction, toe(s); syndactyly, w/ or w/o skin 22,360 9,660
graft(s)
28360 Reconstruction, cleft foot 15,380 7,980
28400 Closed treatment of calcaneal fracture 10,960 5,460
28406 Percutaneous skeletal fixation of calcaneal fracture, 11,980 5,880
w/ manipulation
28415 Open treatment of calcaneal fracture, w/ or w/o 18,000 8,400
fixation;
Open treatment of calcaneal fracture, w/ or w/o
internal or external fixation; w/ primary iliac or other
autogenous bone graft (includes obtaining
28420 graft) 22,360 9,660
28430 Closed treatment of talus fracture 10,960 5,460

28436 Percutaneous skeletal fixation of talus fracture, w/ 9,700 4,200
manipulation
28445 Open treatment of talus fracture, w/ or w/o internal 15,380 7,980
28450 Treatment of tarsal bone fracture (except talus and 11,132 4,032
calcaneus)
28456 Percutaneous skeletal fixation of tarsal bone fracture 11,980 5,880
(except talus and
calcaneus), w/ manipulation
28465 Open treatment of tarsal bone fracture (except talus 10,120 4,620
and calcaneus), w/ or
28470 Closed treatment of metatarsal fracture 10,880 3,780
28476 Percutaneous skeletal fixation of metatarsal fracture, 8,260 3,360
w/ manipulation
28485 Open treatment of metatarsal fracture, w/ or w/o 10,880 3,780
fixation
28490 Closed treatment of fracture great toe, phalanx or 10,120 4,620
phalanges
28496 Percutaneous skeletal fixation of fracture great toe, 10,540 5,040
phalanx or phalanges,
w/ manipulation
28505 Open treatment of fracture great toe, phalanx or 12,120 6,720
phalanges, w/ or w/o
28510 Closed treatment of fracture, phalanx or phalanges, 10,120 4,620
other than great toe
28525 Open treatment of fracture, phalanx or phalanges, 12,120 6,720
other than great toe, w/
or w/o internal or external fixation
28530 Closed treatment of sesamoid fracture 8,260 3,360
28531 Open treatment of sesamoid fracture, w/ or w/o 10,120 4,620
internal fixation
28540 Closed treatment of tarsal bone dislocation, other 8,260 3,360
than talotarsal
28546 Percutaneous skeletal fixation of tarsal bone 12,540 7,140
dislocation, other than
talotarsal ,w/ manipulation
28555 Open treatment of tarsal bone dislocation, w/ or w/o 12,540 7,140
fixation
28570 Closed treatment of talotarsal joint dislocation 10,880 3,780
28576 Percutaneous skeletal fixation of talotarsal joint 12,540 7,140

dislocation, w/
manipulation
28585 Open treatment of talotarsal joint dislocation, w/ or 18,000 8,400
w/o internal or
external fixation
28600 Closed treatment of tarsometatarsal joint dislocation 10,960 5,460
28606 Percutaneous skeletal fixation of tarsometatarsal joint 12,540 7,140

dislocation, w/
manipulation
28615 Open treatment of tarsometatarsal joint dislocation, 18,000 8,400
external fixation
28630 Closed treatment of metatarsophalangeal joint 8,260 3,360
dislocation
28636 Percutaneous skeletal fixation of metatarsophalangeal 12,540 7,140
joint dislocation, w/
manipulation
28645 Open treatment of metatarsophalangeal joint 18,000 8,400
dislocation, w/ or w/o
28660 Closed treatment of interphalangeal joint dislocation 10,880 3,780
28666 Percutaneous skeletal fixation of interphalangeal joint 12,540 7,140

dislocation, w/
manipulation
28675 Open treatment of interphalangeal joint dislocation, 18,000 8,400
external fixation
28705 Pantalar arthrodesis 27,120 15,120
28715 Triple arthrodesis 27,960 15,960
28725 Subtalar arthrodesis 27,120 15,120
28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or 23,300 12,600
transverse;
28735 Arthrodesis, midtarsal or tarsometatarsal, multiple or 23,080 12,180
transverse; w/
osteotomy as for flatfoot correction
28737 Arthrodesis, midtarsal navicular-cuneiform, w/ tendon 21,940 9,240
lengthening and
advancement (e.g. Miller type procedure)
28740 Arthrodesis, midtarsal or tarsometatarsal, single joint 18,420 8,820
28750 Arthrodesis, great toe; metatarsophalangeal joint 18,420 8,820
28755 Arthrodesis, great toe; interphalangeal joint 15,380 7,980
Arthrodesis, great toe, interphalangeal joint, w/

extensor hallucis longus transfer to first metatarsal
28760 neck (e.g. Jones type procedure) 22,240 11,340
28800 Amputation, foot; midtarsal (e.g. Chopart type 23,300 12,600

procedure)
28802 Deep disection below fascia, for deep infection of 8,260 3,360
foot, w/ or w/o tendon
shealth involvement; single bursal space specify
28805 Deep disection below fascia, for deep infection of 21,820 10,920
foot, w/ or w/o tendon
shealth involvement; transmetatarsal
28810 Amputation, metatarsal, w/ toe, single 12,120 6,720
28820 Amputation, toe; metatarsophalangeal joint 18,000 8,400
28825 Amputation, toe; interphalangeal joint 12,120 6,720

29000 Application of halo type body cast (see 20661-20663 10,540 5,040
for insertion)
29010 Application of Risser jacket, localizer, body; only 10,540 5,040
29015 Application of Risser jacket, localizer, body; including 10,540 5,040

head
29020 Application of turnbuckle jacket, body; only 10,540 5,040
29025 Application of turnbuckle jacket, body; including head 10,540 5,040
29035 Application of body cast, shoulder to hips; 10,540 5,040

29040 Application of body cast, shoulder to hips; including 10,540 5,040
head, Minerva type
one thigh
both thighs
29055 Application of body cast, shoulder to hips; shoulder 9,300 2,100
spica
29058 Application of body cast, shoulder to hips; plaster 5,560 1,260
Velpeau
29065 Application of body cast, shoulder to hips; shoulder to 5,680 1,680
hand (long arm)
29075 Application of body cast, shoulder to hips; elbow to 5,560 1,260
finger (short arm)
29085 Application of body cast, shoulder to hips; hand and 5,560 1,260
lower forearm
(gauntlet)
29305 Application of hip spica cast; one leg 8,020 2,520
29325 Application of hip spica cast; one and one-half spica or 8,440 2,940
both legs
29345 Application of long leg cast (thigh to toes); 8,020 2,520
29355 Application of long leg cast (thigh to toes); walker or 8,440 2,940
ambulatory type
29358 Application of long leg cast brace 8,440 2,940
29365 Application of cylinder cast (thigh to ankle) 8,020 2,520
29405 Application of short leg cast (below knee to toes); 8,020 2,520
29425 Application of short leg cast (below knee to toes); 8,020 2,520
walking or ambulatory
type
29435 Application of patellar tendon bearing (PTB) cast 8,020 2,520
29445 Application of rigid total contact leg cast 5,680 1,680

29450 Application of clubfoot cast w/ molding or 5,680 1,680
manipulation, long or short leg
29800 Arthroscopy, temporomandibular joint, diagnostic, w/ 18,000 8,400
or w/o synovial
biopsy
29804 Arthroscopy, temporomandibular joint, surgical 20,980 10,080
29815 Arthroscopy, shoulder, diagnostic, w/ or w/o synovial 18,000 8,400

biopsy
29819 Arthroscopy, shoulder, surgical; w/ removal of loose 21,940 9,240
body or foreign body
29820 Arthroscopy, shoulder, surgical; synovectomy, partial 20,980 10,080
29821 Arthroscopy, shoulder, surgical; synovectomy, 21,820 10,920

complete
29822 Arthroscopy, shoulder, surgical; debridement, limited 20,980 10,080
29823 Arthroscopy, shoulder, surgical; debridement, 23,300 12,600

extensive
29825 Arthroscopy, shoulder, surgical; w/ lysis and resection 30,740 13,440
of adhesions, w/ or
w/o manipulation
Arthroscopy, shoulder, surgical; decompression of
subacromial space w/ partial acromioplasty, w/ or w/o
29826 coracoacromial release 27,120 15,120
29830 Arthroscopy, elbow, dianostic, with or without 18,000 8,400

synovial biopsy
29834 Arthroscopy, elbow, surgical; w/ removal of loose 21,940 9,240
body or foreign body
29835 Arthroscopy, elbow, surgical; synovectomy, partial 20,980 10,080
29836 Arthroscopy, elbow, surgical; synovectomy, complete 21,820 10,920
29837 Arthroscopy, elbow, surgical; debridement, limited 20,980 10,080
29838 Arthroscopy, elbow, surgical; debridement, extensive 23,300 12,600
29840 Arthroscopy, wrist, diagnostic, with or without 12,120 6,720

synovial biopsy
29843 Arthroscopy, wrist, surgical; for infection, lavage and 21,940 9,240
drainage
29844 Arthroscopy, wrist, surgical; synovectomy, partial 20,980 10,080
29845 Arthroscopy, wrist, surgical; synovectomy, complete 21,820 10,920
29846 Arthroscopy, wrist, surgical; excision and/or repair of 23,300 12,600

triangular
fibrocartilage and/or joint debridement
29847 Arthroscopy, wrist, surgical; internal fixation for 23,300 12,600
fracture or instability
29848 Arthroscopy, wrist, surgical; w/ release of transverse 23,300 12,600
carpal ligament
29850 Arthroscopically aided treatment of intercondylar 27,120 15,120
spine(s) and/or tuberosity fracture(s) of the knee, w/
or w/o manipulation; w/o internal or external fixation
(includes arthroscopy)
29851 Arthroscopically aided treatment of intercondylar 27,120 15,120

spine(s) and/or tuberosity fracture(s) of the knee, w/
or w/o manipulation; w/ internal or external fixation
(includes arthroscopy)
Arthroscopically aided treatment of tibial fracture,
proximal (plateau); unicondylar, w/ or w/o internal or
29855 external fixation (includes arthroscopy) 27,120 15,120
Arthroscopically aided treatment of tibial fracture,

proximal (plateau); bicondylar, w/ or w/o internal or
29856 external fixation (includes arthroscopy) 27,960 15,960
29870 Arthroscopy, knee, diagnostic, w/ or w/o synovial 18,000 8,400

biopsy
29871 Arthroscopy, knee, surgical; for infection, lavage and 20,980 10,080
drainage
Arthroscopy, knee, surgical; for removal of loose body
or foreign body (e.g., osteochondritis dissecans
29874 fragmentation, chondral fragmentation) 21,940 9,240
29875 Arthroscopy, knee, surgical; synovectomy, limited 30,740 13,440

(e.g., plica or shelf
resection)
29876 Arthroscopy, knee, surgical; synovectomy, major, two 31,580 14,280
or more
compartments (e.g., medial or lateral)
29877 Arthroscopy, knee, surgical; debridement/shaving of 23,300 12,600
articular cartilage
(chondroplasty)
29879 Arthroscopy, knee, surgical; abrasion arthroplasty 23,300 12,600
(includes chondroplasty
where necessary) or multiple drilling
29880 Arthroscopy, knee, surgical; w/ meniscectomy (medial 30,740 13,440
AND lateral, including
any meniscal shaving)
29881 Arthroscopy, knee, surgical; w/ meniscectomy (medial 30,740 13,440

OR lateral, including
any meniscal shaving)
29882 Arthroscopy, knee, surgical; w/ meniscus repair 27,120 15,120

(medial OR lateral)
Arthroscopy, knee, surgical; w/ meniscus repair
29883 (medial AND lateral) 30,300 16,800
29884 Arthroscopy, knee, surgical; w/ lysis of adhesions, w/ 23,300 12,600
or w/o manipulation
Arthroscopy, knee, surgical; drilling for osteochondritis
dissecans w/ bone grafting, w/ or w/o internal fixation
(including debridement of base of
29885 lesion) 23,300 12,600
29886 Arthroscopy, knee, surgical; drilling for intact 27,120 15,120

osteochondritis dissecans
lesion
29887 Arthroscopy, knee, surgical; drilling for intact 23,300 12,600
osteochondritis dissecans
lesion w/ internal fixation
29888 Arthroscopically aided anterior cruciate ligament 37,180 18,480
repair/augmentation or
reconstruction
29889 Arthroscopically aided posterior cruciate ligament 38,860 20,160
repair/augmentation or
reconstruction
29894 Arthroscopy, ankle (tibiotalar and fibulotalar joints), 21,940 9,240
surgical; w/ removal of
loose body or foreign body
surgical; synovectomy,
partial
surgical; debridement,
limited
surgical; debridement,
extensive
30000 Drainage abscess or hematoma, nasal, internal 5,560 1,260
approach
30020 Drainage abscess or hematoma, nasal septum 5,560 1,260
30100 Biopsy, intranasal 5,680 1,680

30110 Excision, nasal polyp(s), simple 8,020 2,520
30115 Excision, nasal polyp(s), extensive 9,700 4,200
30117 Excision or destruction, any method (including laser), 9,700 4,200
intranasal lesion;
internal approach
30118 Excision or destruction, any method (including laser), 9,700 4,200
intranasal lesion;
external approach (lateral rhinotomy)
30130 Excision turbinate, partial or complete 12,900 6,300
30140 Submucous resection turbinate, partial or complete 12,900 6,300
30310 Removal foreign body, intranasal; requiring general 8,020 2,520

anesthesia
30320 Removal foreign body, intranasal; by lateral rhinotomy 8,020 2,520
30460 Rhinoplasty for nasal deformity secondary to 30,300 16,800

congenital cleft tip and/or
palate, including columellar lengthening; tip only
Rhinoplasty for nasal deformity secondary to

congenital cleft tip and/or palate, including columellar
30462 lengthening; tip, septum, osteotomies 30,300 16,800
30465 Rhinoplasty for nasal vestibular stenosis 37,800 21,000

30520 Septoplasty or submucous resection, w/ or w/o 12,900 6,300
cartilage scoring, contouring
or replacement w/ graft
30540 Repair choanal atresia; intranasal 12,900 6,300
30545 Repair choanal atresia; transpalatine 18,000 8,400
30560 Lysis intranasal synechia 8,260 3,360
30580 Repair fistula; oromaxillary (combine w/ 31030 if 12,120 6,720
antrotomy is included)
30600 Repair fistula; oronasal 12,120 6,720
30630 Repair nasal septal perforations 12,120 6,720
30801 Cauterization and/or ablation, mucosa of turbinates, 9,700 4,200
unilateral or bilateral,
any method, ; superficial
30802 Cauterization and/or ablation, mucosa of turbinates, 9,700 4,200
unilateral or bilateral,
any method, ; intramural
30905 Control nasal hemorrhage, posterior, w/ posterior 8,020 2,520
nasal packs and/or
cauterization, any method; initial
30915 Ligation arteries; ethmoidal 12,120 6,720
30920 Ligation arteries; internal maxillary artery, transantral 12,120 6,720
30930 Fracture nasal turbinate(s), therapeutic 9,700 4,200

31000 Lavage by cannulation; maxillary sinus (antrum 9,300 2,100
puncture or natural ostium)
31002 Lavage by cannulation; sphenoid sinus 8,020 2,520
31020 Sinusotomy, maxillary (antrotomy); intranasal 9,700 4,200
31030 Sinusotomy, maxillary (antrotomy); radical (Caldwell- 12,120 6,720

Luc) w/o removal of
antrochoanal polyps
31032 Sinusotomy, maxillary (antrotomy); radical (Caldwell- 12,120 6,720
Luc) w/ removal of
antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach 23,300 12,600
31050 Sinusotomy, sphenoid, w/ or w/o biopsy; 23,300 12,600

31051 Sinusotomy, sphenoid, w/ or w/o biopsy; w/ mucosal 23,300 12,600
stripping or removal
of polyp(s)
31070 Sinusotomy frontal; external, simple (trephine 12,120 6,720
operation)
31075 Sinusotomy frontal; transorbital, unilateral (for 12,120 6,720
mucocele or osteoma, Lynch
type)
31080 Sinusotomy frontal; obliterative w/o osteoplastic flap, 12,120 6,720
brow incision
(includes ablation)
31081 Sinusotomy frontal; obliterative, w/o osteoplastic flap, 12,120 6,720
coronal inicision
(includes ablation)
31084 Sinusotomy frontal; obliterative, w/ osteoplastic flap, 12,120 6,720
brow incision
31085 Sinusotomy frontal; obliterative, w/ osteoplastic flap, 23,300 12,600
coronal incision
31086 Sinusotomy frontal; nonobliterative, w/ osteoplastic 23,300 12,600
flap, brow incision
31087 Sinusotomy frontal; nonobliterative, w/ osteoplastic 23,300 12,600
flap, coronal incision
31090 Sinusotomy combined, three or more sinuses 23,300 12,600
31200 Ethmoidectomy; intranasal, anterior 12,120 6,720

31201 Ethmoidectomy; intranasal, total 12,120 6,720
31205 Ethmoidectomy; extranasal, total 12,120 6,720
31225 Maxillectomy; w/o orbital exenteration 46,500 25,200
31230 Maxillectomy; w/ orbital exenteration (en bloc) 53,400 29,400
31231 Nasal endoscopy, diagnostic, unilateral or bilateral 10,540 5,040
31233 Nasal/sinus endoscopy, diagnostic w/ maxillary 10,540 5,040

sinusoscopy (via inferior
meatus or canine fossa puncture)
31235 Nasal/sinus endoscopy, diagnostic w/ sphenoid 10,540 5,040
sinusoscopy (via puncture of
sphenoidal face or cannulation of ostium)
31237 Nasal/sinus endoscopy, surgical; w/ biopsy, 12,120 6,720
polypectomy or debridement
31238 Nasal/sinus endoscopy, surgical; w/ control of 12,120 6,720
epistaxis
31239 Nasal/sinus endoscopy, surgical; w/ 12,120 6,720
dacrylocystorhinostomy
31240 Nasal/sinus endoscopy, surgical; w/ concha bullosa 18,000 8,400
resection
31254 Nasal/sinus endoscopy, surgical; w/ ethmoidectomy, 18,000 8,400
partial (anterior)
31255 Nasal/sinus endoscopy, surgical; w/ ethmoidectomy, 18,000 8,400
total (anterior and
posterior)
31256 Nasal/sinus endoscopy, surgical, w/ maxillary 18,000 8,400
antrostomy
31267 Nasal/sinus endoscopy, surgical, w/ maxillary 18,000 8,400
antrostomy w/ removal of tissue from maxillary sinus
31276 Nasal/sinus endoscopy, surgical w/ frontal sinus 18,000 8,400

exploration, w/ or w/o
removal of tissue from frontal sinus
31287 Nasal/sinus endoscopy, surgical, w/ sphenoidotomy 18,000 8,400
31288 Nasal/sinus endoscopy, surgical, w/ removal of tissure 18,000 8,400

from the sphenoid
sinus
31290 Nasal/sinus endoscopy, surgical, w/ repair of 18,000 8,400
cerebrospinal fluid leak;
ethmoid region
31291 Nasal/sinus endoscopy, surgical, sphenoid region 18,000 8,400
31292 Nasal/sinus endoscopy, surgical; w/ medial or inferior 18,000 8,400

orbital wall
decompression
31293 Nasal/sinus endoscopy, surgical; w/ medial orbital wall 18,000 8,400
and inferior orbital
wall decompression
31294 Nasal/sinus endoscopy, surgical; w/ optic nerve 23,300 12,600
decompression
31300 Laryngotomy (thyrotomy, laryngofissure); w/ removal 18,000 8,400
of tumor or
laryngocele, cordectomy
31360 Laryngectomy; total, w/o radical neck dissection 31,140 17,640
31365 Laryngectomy; total, w/ radical neck dissection 37,800 21,000
31367 Laryngectomy; subtotal supraglottic, w/o radical neck 37,180 18,480

dissection
31368 Laryngectomy; subtotal supraglottic, w/ radical neck 38,860 20,160
dissection
31370 Partial laryngectomy (hemilaryngectomy); horizontal 31,140 17,640
31375 Partial laryngectomy (hemilaryngectomy); 31,140 17,640

laterovertical
31380 Partial laryngectomy (hemilaryngectomy); 31,140 17,640
anterovertical
31382 Partial laryngectomy (hemilaryngectomy); antero- 31,140 17,640
latero-vertical
31390 Pharyngolaryngectomy, w/ radical neck dissection; 37,800 21,000
w/o reconstruction
31395 Pharyngolaryngectomy, w/ radical neck dissection; w/ 46,500 25,200
reconstruction
31400 Arytenoidectomy or arytenoidopexy, external 30,300 16,800
approach
31420 Epiglottidectomy 23,300 12,600
31515 Laryngoscopy direct, w/ or w/o tracheoscopy; for 8,020 2,520
aspiration
31520 Laryngoscopy direct, w/ or w/o tracheoscopy; 9,700 4,200
diagnostic, newborn
diagnostic, except newborn

diagnostic, w/ operating
microscope
31527 Laryngoscopy direct, w/ or w/o tracheoscopy; w/ 8,020 2,520
insertion of obturator
dilatation, initial
dilatation, subsequent
31530 Laryngoscopy, direct, operative, w/ foreign body 12,120 6,720
removal;
31531 Laryngoscopy, direct, operative, w/ foreign body 12,120 6,720
removal; w/ operating
microscope
31535 Laryngoscopy, direct, operative, w/ biopsy; 12,120 6,720
31536 Laryngoscopy, direct, operative, w/ biopsy; w/ 12,120 6,720

operating microscope
31540 Laryngoscopy, direct, operative, w/ excision of tumor 12,120 6,720
and/or stripping of
vocal cords or epiglottis;
31541 Laryngoscopy, direct, operative, w/ excision of tumor 12,120 6,720
and/or stripping of
vocal cords or epiglottis; w/ operating microscope
31560 Laryngoscopy, direct, operative, w/ arytenoidectomy; 30,300 16,800
31561 Laryngoscopy, direct, operative, w/ arytenoidectomy; 30,300 16,800

w/ operating
microscope
31570 Laryngoscopy, direct, w/ injection into vocal cord(s), 12,120 6,720
therapeutic;
31571 Laryngoscopy, direct, w/ injection into vocal cord(s), 12,120 6,720
therapeutic; w/
operating microscope
31575 Laryngoscopy, flexible fiberoptic; diagnostic 12,120 6,720
31576 Laryngoscopy, flexible fiberoptic; w/ biopsy 12,120 6,720
31577 Laryngoscopy, flexible fiberoptic; w/ removal of 12,120 6,720

foreign body
31578 Laryngoscopy, flexible fiberoptic; w/ removal of lesion 12,120 6,720
31579 Laryngoscopy, flexible or rigid fiberoptic, w/ 12,120 6,720

stroboscopy
31580 Laryngoplasty; for laryngeal web, two stage, w/ keel 30,300 16,800
insertion and removal
31582 Laryngoplasty; for laryngeal stenosis, w/ graft or core 30,300 16,800
mold, including
tracheotomy
31584 Laryngoplasty; w/ open reduction of fracture 30,300 16,800
31586 Laryngoplasty; w/ closed manipulative reduction 30,300 16,800
31587 Laryngoplasty, cricoid split 30,300 16,800

31588 Laryngoplasty, not otherwise specified (e.g., for burns, 30,300 16,800
reconstruction after
partial laryngectomy)
31590 Laryngeal reinnervation by neuromuscular pedicle 30,300 16,800
31595 Section recurrent laryngeal nerve, therapeutic , 23,300 12,600

unilateral
31600 Tracheostomy, planned ; 12,120 6,720
31601 Tracheostomy, planned ; under two years 12,540 7,140
31603 Tracheostomy, emergency procedure; transtracheal 7,140 4,760
31605 Tracheostomy, emergency procedure; cricothyroid 12,540 7,140

membrane
31610 Tracheostomy, fenestration procedure with skin flaps 12,540 7,140
Construction of tracheoesophageal fistula and

subsequent insertion of an alaryngeal speech
31611 prosthesis (e.g., voice button, Blom-Singer prosthesis) 14,960 7,560
31612 Tracheal puncture, percutaneous w/ transtracheal 12,900 6,300

aspiration and/or
injection
31613 Tracheostoma revision; simple, w/o flap rotation 12,120 6,720
31614 Tracheostoma revision; complex, w/ flap rotation 14,960 7,560
31615 Tracheobronchoscopy through established 12,120 6,720

tracheostomy incision
31622 Bronchoscopy; diagnostic, (flexible or rigid), w/ or w/o 10,960 5,460
cell washing or
brushing
31625 Bronchoscopy; w/ biopsy 10,960 5,460
31628 Bronchoscopy; w/ transbronchial lung biopsy, w/ or 10,960 5,460
w/o fluoroscopic
guidance
31629 Bronchoscopy; w/ transbronchial needle aspiration 10,960 5,460
biopsy
31630 Bronchoscopy; w/ tracheal or bronchial dilation or 18,000 8,400
closed reduction of
fracture
31631 Bronchoscopy; w/ tracheal dilation and placement of 18,000 8,400
tracheal stent
31635 Bronchoscopy; w/ removal of foreign body 18,000 8,400
31636 Bronchoscopy; diagnostic, (flexible or rigid),w/ 18,000 8,400
placement of bronchial
stents
31640 Bronchoscopy; w/ excision of tumor 30,300 16,800
31641 Bronchoscopy; w/ destruction of tumor or relief of 30,300 16,800
stenosis by any method
other than excision (e.g., laser)
31643 Bronchoscopy; w/ placement of catheters for 18,000 8,400
intracavitary radioelement
application
31645 Bronchoscopy; w/ therapeutic aspiration of 23,300 12,600
tracheobronchial tree, (e.g., drainage of lung abscess)
31710 Catheterization for bronchography, w/ or w/o 5,560 1,260

instillation of contrast
material
31717 Catheterization w/ bronchial brush biopsy 23,300 12,600
31750 Tracheoplasty; cervical 37,800 21,000
31755 Tracheoplasty; tracheopharyngeal fistulization, each 37,800 21,000
stage
31760 Tracheoplasty; intrathoracic 53,400 29,400
31766 Carinal reconstruction 55,000 33,600
31770 Bronchoplasty; graft repair 55,000 33,600
31775 Bronchoplasty; excision stenosis and anastomosis 55,000 33,600
31780 Excision tracheal stenosis and anastomosis; cervical 46,500 25,200
31781 Excision tracheal stenosis and anastomosis; 53,400 29,400

cervicothoracic
31785 Excision of tracheal tumor or carcinoma; cervical 37,800 21,000
31786 Excision of tracheal tumor or carcinoma; thoracic 55,000 33,600
31800 Suture of tracheal wound or injury; cervical 23,300 12,600
31805 Suture of tracheal wound or injury; intrathoracic 37,800 21,000
31820 Surgical closure tracheostomy or fistula w/o plastic 8,440 2,940

repair
31825 Surgical closure tracheostomy or fistula with plastic 9,700 4,200
repair
32000 Thoracentesis, puncture of pleural cavity for 1,260 840
aspiration, initial or
subsequent
32002 Thoracentesis w/ insertion of tube w/ or w/o water 10,540 5,040
seal (e.g., for
pneumothorax)
32005 Chemical pleurodesis (e.g., for recurrent or persistent 10,540 5,040
pneumothorax)
32020 Tube thoracostomy w/ or w/o water seal (e.g., for 7,980 5,320
abscess, hemothorax,
empyema)
32035 Thoracostomy; w/ rib resection for empyema 12,120 6,720
32036 Thoracostomy; w/ open flap drainage for empyema 18,420 8,820

32095 Thoracotomy, limited, for biopsy of lung or pleura 31,140 17,640
32100 Thoracotomy, major; w/ exploration and biopsy 37,800 21,000
32110 Thoracotomy, major; w/ control of traumatic 37,800 21,000

hemorrhage and/or repair of
lung tear
32120 Thoracotomy, major; for postoperative complications 37,800 21,000
32124 Thoracotomy, major; w/ open intrapleural 37,800 21,000

pneumonolysis
32140 Thoracotomy, major; w/ cyst(s) removal, w/ or w/o a 37,800 21,000
pleural procedure
32141 Thoracotomy, major; w/ excision-plication of bullae, 41,160 24,360
w/ or w/o a pleural
procedure
32150 Thoracotomy, major; w/ removal of intrapleural 38,440 19,740
foreign body or fibrin
deposit
32151 Thoracotomy, major; w/ removal of intrapulmonary 38,440 19,740
foreign body
32160 Thoracotomy major; w/ cardiac massage 38,440 19,740
32200 Pneumonostomy, w/ open drainage of abscess or cyst 10,120 4,620
32215 Pleural scarification for repeat pneumothorax 38,640 21,840
32220 Decortication, pulmonary ; total 38,440 19,740

32225 Decortication, pulmonary ; partial 30,300 16,800
32310 Pleurectomy, parietal 37,800 21,000
32320 Decortication and parietal pleurectomy 37,800 21,000
32400 Biopsy, pleura; percutaneous needle 5,560 1,260
32402 Biopsy, pleura; open 37,180 18,480
32405 Biopsy, lung or mediastinum, percutaneous needle 8,440 2,940
32420 Pneumonocentesis, puncture of lung for aspiration 5,560 1,260
32440 Removal of lung, total pneumonectomy 46,500 25,200

Removal of lung, total pneumonectomy w/ resection
of segment of trachea followed by broncho-tracheal
32442 anastomosis (sleeve pneumonectomy) 55,080 31,080
32445 Removal of lung, total pneumonectomy extrapleural 55,080 31,080
32480 Removal of lung, other than total pneumonectomy; 41,160 24,360

single lobe (lobectomy)
two lobes
(bilobectomy)
single segment
(segmentectomy)
Removal of lung, other than total pneumonectomy;
w/ circumferential resection of segment of bronchus
followed by broncho-bronchial
32486 anastomosis (sleeve lobectomy) 55,080 31,080
Removal of lung, other than total pneumonectomy; all

remaining lung following previous removal of a
portion of lung (completion
32488 pneumonectomy) 53,400 29,400

excision-plication of emphysematous lung(s) (bullous
or non-bullous) for lung volume reduction, sternal split
or transthoracic approach, w/ or w/o any pleural
procedure
wedge resection, single
or multiple
32520 Resection of lung; w/ resection of chest wall 53,400 29,400
32522 Resection of lung; w/ reconstruction of chest wall, w/o 53,400 29,400

prothesis
32525 Resection of lung; w/ major reconstruction of chest 53,400 29,400
wall, w/ prosthesis
32540 Extrapleural enucleation of empyema 38,440 19,740
(empyemectomy)
32601 Thoracoscopy, diagnostic ; lungs and pleural space, 11,980 5,880
w/o biopsy
32602 Thoracoscopy, diagnostic ; lungs and pleural space, w/ 12,900 6,300
biopsy
32603 Thoracoscopy, diagnostic ; pericardial sac, w/o biopsy 12,120 6,720
32604 Thoracoscopy, diagnostic ; pericardial sac, w/ biopsy 12,120 6,720
32605 Thoracoscopy, diagnostic ; mediastinal space, w/o 12,120 6,720

biopsy
32606 Thoracoscopy, diagnostic ; mediastinal space, w/ 12,120 6,720
biopsy
32650 Thoracoscopy, surgical; w/ pleurodesis, any method 12,120 6,720
32651 Thoracoscopy, surgical; w/ partial pulmonary 12,120 6,720

decortication
32652 Thoracoscopy, surgical; w/ total pulmonary 12,120 6,720
decortication, including
intrapleural pneumonolysis
32653 Thoracoscopy, surgical; w/ removal of intrapleural 12,120 6,720
foreign body or firbin
deposit
32654 Thoracoscopy, surgical; w/ control of traumatic 30,300 16,800
hemorrhage
32655 Thoracoscopy, surgical; w/ excision-plication of bullae, 41,160 24,360
including any pleural
procedure
32656 Thoracoscopy, surgical; w/ parietal pleurectomy 38,640 21,840
32658 Thoracoscopy, surgical; w/ removal of clot or foreign 38,640 21,840

body from pericardial
sac
32659 Thoracoscopy, surgical; w/ creation of percardial 38,640 21,840
window or partial
resection of pericardial sac for drainage
32660 Thoracoscopy, surgical; w/ total pericardiectomy 41,160 24,360
32661 Thoracoscopy, surgical; w/ excision of pericardial cyst, 41,160 24,360

tumor, or mass
32662 Thoracoscopy, surgical; w/ excision of mediastinal 41,160 24,360
cyst, tumor, or mass
32663 Thoracoscopy, surgical; w/ lobectomy, total or 46,500 25,200
segmental
32664 Thoracoscopy, surgical; w/ thoracic sympathectomy 41,160 24,360
32665 Thoracoscopy, surgical; w/ esophagomyotomy (Heller 41,160 24,360

type)
32800 Repair lung hernia through chest wall 23,300 12,600
32810 Closure of chest wall following open flap drainage for 23,300 12,600
empyema (Clagett
type procedure)
32815 Open closure of major bronchial fistula 46,500 25,200
32820 Major reconstruction, chest wall (posttraumatic) 46,500 25,200
32850 Donor pneumonectomy(ies) w/ preparation and 55,000 33,600

maintenance of allograft
(cadaver)
32851 Lung transplant, single; w/o cardiopulmonary bypass 63,000 42,000
32852 Lung transplant, single; w/ cardiopulmonary bypass 64,680 43,680
32853 Lung transplant, double (bilateral sequential or en 65,520 44,520

bloc); w/o
cardiopulmonary bypass
32854 Lung transplant, double (bilateral sequential or en 65,520 44,520
bloc); w/
32900 Resection of ribs, extrapleural, all stages 46,500 25,200
32905 Thoracoplasty, Schede type or extrapleural (all stages); 46,500 25,200
32906 Thoracoplasty, Schede type or extrapleural (all stages); 46,500 25,200

w/ closure of
bronchial fistula
32940 Pneumonolysis, extraperiosteal, including filling or 30,300 16,800
packing procedures
32960 Pneumothorax, therapeutic, intrapleural injection of 5,560 1,260
air
33010 Pericardiocentesis 8,020 2,520
33015 Tube pericardiostomy 9,700 4,200
33020 Pericardiotomy for removal of clot or foreign body 18,000 8,400
(primary procedure)
33025 Creation of pericardial window or partial resection for 32,000 14,700
drainage
33030 Pericardiectomy, subtotal or complete; w/o 46,500 25,200
33031 Pericardiectomy, subtotal or complete; w/ 58,800 37,800
33050 Excision of pericardial cyst or tumor 37,800 21,000
33120 Excision of intracardiac tumor, resection w/ 60,900 39,900
33130 Resection of external cardiac tumor 39,900 23,100
33200 Insertion of permanent pacemaker w/ epicardial 21,400 10,500
electrode(s); by
thoracotomy
33201 Insertion of permanent pacemaker w/ epicardial 21,400 10,500
electrode(s); by xiphoid
approach
33206 Insertion or replacement of permanent pacemaker w/ 18,000 8,400
transvenous
electrode(s); atrial
transvenous
electrode(s); ventricular
transvenous
electrode(s); atrial and ventricular
33210 Insertion or placement of temporary transvenous 9,700 4,200
single chamber cardiac
electrodes
33211 Insertion or replacement of temporary transvenous 9,700 4,200
dual chamber cardiac
electrodes
33212 Insertion or replacement of pacemaker pulse 9,700 4,200
generator only; single
chamber
33213 Insertion or replacement of pacemaker pulse 12,900 6,300
generator only; dual chamber
33214 Upgrade of implanted pacemaker system, conversion 32,000 14,700
of single chamber system to dual chamber system
(includes removal of previously placed pulse
generator, testing of existing lead, insertion of new
lead, insertion of
new pulse generator)
Insertion, replacement or repositioning of permanent
transvenous electrode(s) only (15 days or more after
initial insertion); single chamber,
33216 atrial or ventricular 12,900 6,300
Insertion, replacement or repositioning of permanent

transvenous electrode(s) only (15 days or more after
33217 initial insertion); dual chamber 18,000 8,400
Repair of single transvenous electrode for a single

chamber, permanent pacemaker or single chamber
33218 pacing cardioverter-defibrillator 23,300 12,600
Repair of two transvenous electrode for a dual

chamber, permanent pacemaker or dual chamber
33220 pacing cardioverter-defibrillator 23,300 12,600
33222 Revision or relocation of skin pocket for pacemaker 18,000 8,400
33223 Revision or relocation of skin pocket for single or dual 18,000 8,400
chamber pacing
cardioverter-defibrillator
33233 Removal of transvenous pacemaker pulse generator 12,900 6,300
33234 Removal of permanent of transvenous pacemaker 23,300 12,600

electrode(s); single lead
system, atrial or ventricular
33235 Removal of permanent of transvenous pacemaker 32,000 14,700
electrode(s); dual lead
chamber
33236 Removal of permanent epicardial pacemaker and 30,300 16,800
electrodes by
thoracotomy; single lead system, atrial or ventricular
33237 Removal of permanent epicardial pacemaker and 37,600 18,900

electrodes by
thoracotomy; dual lead chamber
33238 Removal of permanent transvenous electrode(s) by 30,300 16,800
thoracotomy
33240 Insertion or replacement of implantable cardioverter- 18,000 8,400
defibrillator pulse
generator
33241 Removal of implantable cardioverter-defibrillator 18,000 8,400
pulse generator
pulse generator and/or
lead system; by thoracotomy
pulse generator and/or
lead system; by transvenous extraction
33245 Implantation or replacement of implantable 12,900 6,300
cardioverter-defibrillator pads
by thoracotomy, w/ or w/o sensing electrodes;
Implantation or replacement of implantable

cardioverter-defibrillator pads by thoracotomy, w/ or
w/o sensing electrodes; w/ insertion of implantable
33246 cardioverter-defibrillator pulse generator 21,400 10,500
Implantation or replacement of implantable

cardioverter-defibrillator pads
by thoracotomy, w/ or w/o sensing electrodes; w/
33249 insertion of cardio- defibrillator pulse generator 18,000 8,400
Operative ablation of supraventicular arrhythmogenic

focus or pathway (e.g., Wolff-Parkinson-White, A-V
node reentry), tract(s) and/or focus (foci); w/o
33250 cardiopulmonary bypass 37,600 18,900
Operative ablation of supraventicular arrhythmogenic
focus or pathway (e.g., Wolff-Parkinson-White, A-V
node reentry), tract(s) and/or focus (foci); w/
33253 Operative incisions and reconstruction of atria for 58,800 37,800

treatment of atrial
fibrillation or atrial flutter (e.g., maze procedure)
33261 Operative ablation of ventricular arrhythmogenic 58,800 37,800

focus w/ cardiopulmonary
bypass
33300 Repair of cardiac wound; w/o bypass 46,500 25,200
33305 Repair of cardiac wound; w/ cardiopulmonary bypass 58,800 37,800
33310 Cardiotomy, exploratory (includes removal of foreign 46,500 25,200

body); w/o bypass
33315 Cardiotomy, exploratory (includes removal of foreign 58,800 37,800
body); w/
33320 Suture repair of aorta or great vessels; w/o shunt or 30,300 16,800
cardiopulmonary
bypass
33321 Suture repair of aorta or great vessels; w/ shunt 58,800 37,800
bypass
33322 Suture repair of aorta or great vessels; w/ 58,800 37,800
33330 Insertion of graft, aorta or great vessels; w/o shunt, or 46,500 25,200
cardiopulmonary
bypass
33332 Insertion of graft, aorta or great vessels; w/ shunt 63,000 42,000
bypass
33335 Insertion of graft, aorta or great vessels; w/ 63,000 42,000
33400 Valvuloplasty, aortic valve; open, w/ cardiopulmonary 53,400 29,400
bypass
33401 Valvuloplasty, aortic valve; open, w/ inflow occlusion 53,400 29,400
33403 Valvuloplasty, aortic valve; using transventricular 55,000 33,600

dilation, w/
33404 Construction of apica-aortic conduit 58,800 37,800
33405 Replacement, aortic valve, w/ cardiopulmonary 53,400 29,400
bypass; w/ prosthetic valve
other than homograft
33406 Replacement, aortic valve, w/ cardiopulmonary 58,800 37,800

bypass; w/ homograft valve
(freehand)
33411 Replacement, aortic valve; w/ aortic annulus 55,000 33,600

enlargement, noncoronary
cusp
33412 Replacement, aortic valve; w/ transventricular aortic 58,800 37,800
annulus enlargement
(Konno procedure)
33413 Replacement, aortic valve; w/ translocation of 71,400 50,400

autologous pulmonary valve
w/ hemograft repacement of pulmonary valve (Ross
procedure)
33414 Repair of left ventricular outflow tract obstruction by 46,500 25,200

patch enlargement of
the outflow tract
33415 Resection or incision of subvalvular tissue for discrete 46,500 25,200
subaortic stenosis (e.g., asymmetric septal
hypertrophy)
33416 Ventriculomyotomy (-myectomy) for idiopathic 55,000 33,600
hypertrophic subaortic
stenosis (e.g., asymmetric septal hypertrophy)
33417 Aortoplasty (gusset) for supravalvular stenosis 46,500 25,200
33420 Valvotomy, mitral valve; closed heart 37,800 21,000

33422 Valvotomy, mitral valve; open heart, w/ 53,400 29,400
33425 Valvuloplasty, mitral valve, w/ cardiopulmonary 55,000 33,600
bypass;
bypass; w/ prosthetic ring

bypass; radical
reconstruction, w/ or w/o ring
33430 Replacement, mitral valve, w/ cardiopulmonary 46,500 25,200
bypass
33460 Valvectomy, tricuspid valve, w/ cardiopulmonary 46,500 25,200
bypass
33463 Valvuloplasty, tricuspid valve; w/o ring insertion 53,400 29,400
33464 Valvuloplasty, tricuspid valve; w/ ring insertion 55,000 33,600
33465 Replacement, tricuspid valve, w/ cardiopulmonary 53,400 29,400

bypass
33468 Tricuspid valve repositioning and plication for Ebstein 58,800 37,800
anomaly
33470 Valvotomy, pulmonary valve, closed heart; 30,300 16,800
transventricular
33471 Valvotomy, pulmonary valve, closed heart; via 23,300 12,600
pulmonary artery
33472 Valvotomy, pulmonary valve, open heart; w/ inflow 46,500 25,200
occlusion
33474 Valvotomy, pulmonary valve, open heart; w/ 46,500 25,200
33475 Replacement, pulmonary valve 53,400 29,400
33476 Right ventricular resection for infundibular stenosis, 46,500 25,200
with or without
commisurotomy
33478 Outflow tract augmentation (gusset), w/ or w/o 53,400 29,400
commissurotomy or
infundibular resection
33500 Repair of coronary arteriovenous or arteriocardiac 46,500 25,200
chamber fistula; w/
33501 Repair of coronary arteriovenous or arteriocardiac 30,300 16,800
chamber fistula; w/o
33502 Repair of anomalous coronary artery; by ligation 30,300 16,800
33503 Repair of anomalous coronary artery; by graft, w/o 46,500 25,200

33504 Repair of anomalous coronary artery; by graft, w/ 53,400 29,400
33505 Repair of anomalous coronary artery; with 53,400 29,400
construction of intrapulmonary
artery tunnel (Takeuchi procedure)
33506 Repair of anomalous coronary artery; by translocation 53,400 29,400
from pulmonary
artery to aorta
33510 Coronary artery bypass, vein only; single coronary 53,400 29,400
venous graft
33511 Coronary artery bypass, vein only; two coronary 53,400 29,400
venous grafts
33512 Coronary artery bypass, vein only; three coronary 55,000 33,600
venous grafts
33513 Coronary artery bypass, vein only; four coronary 58,800 37,800
venous grafts
33514 Coronary artery bypass, vein only; five coronary 58,800 37,800
venous grafts
33516 Coronary artery bypass, vein only; six or more 58,800 37,800
coronary venous grafts
33517 Coronary artery bypass, using venous graft(s) and 53,400 29,400
arterial graft(s); single
vein graft (list separately in addition to code for
arterial graft)
Coronary artery bypass, using venous graft(s) and

arterial graft(s); two venous grafts (list separately in
33518 addition to code for arterial graft) 53,400 29,400

arterial graft(s); three venous grafts (list separately in

arterial graft(s); four venous grafts (list separately in

arterial graft(s); five venous grafts (list separately in

arterial graft(s); six or more venous grafts (list
33523 separately in addition to code for arterial graft) 58,800 37,800
Reoperation, coronary artery bypass procedure or

valve procedure, more
than one month after original operation (list
33530 separately in addition to code for primary procedure) 63,000 42,000
33533 Coronary artery bypass, using arterial graft(s); single 53,400 29,400
arterial graft
33534 Coronary artery bypass, using arterial graft(s); two 53,400 29,400
coronary arterial grafts
33535 Coronary artery bypass, using arterial graft(s); three 55,000 33,600
coronary arterial grafts
33536 Coronary artery bypass, using arterial graft(s); four or 58,800 37,800
more coronary
arterial grafts
33542 Myocardial resection (e.g., ventricular 63,000 42,000
aneurysmectomy)
33545 Repair of postinfarction ventricular septal defect, w/ 63,000 42,000
or w/o myocardial
resection
33572 Coronary endarterectomy, open, any method, of left 9,700 4,200
anterior descending, circumflex, or right coronary
artery performed in conjuction w/ coronary artery
bypass graft procedure, each vessel (list separately in
addition to
primary procedure)
33600 Closure of atrioventricular valve (mitral or tricuspid) 46,500 25,200

by suture or patch
33602 Closure of semilunar valve (aortic or pulmonary) by 46,500 25,200
suture or patch
33606 Anastomosis of pulmonary artery to aorta (Damus- 53,400 29,400
Kaye-Stansel procedure)
33608 Repair of complex cardiac anomaly other than 55,000 33,600
pulmonary atresia with ventricular septal defect by
construction or replacemnet of conduit from right or
left ventricle to pulmonary artery
Repair of complex cardiac anomalies (e.g., single
ventricle with subaortic obstruction) by surgical
33610 enlargement of interventricular septal defect 55,000 33,600
33611 Repair of double outlet right ventricle with 55,000 33,600

intraventricular tunnel repair
Repair of double outlet right ventricle with
33612 intraventricular tunnel repair with repair of right 55,000 33,600
ventricular outflow tract obstruction
Repair of complex cardiac anomalies (e.g., tricuspid
atresia) by closure of atrial septal defect and
anastomosis of atria or vena cava to pulmonary
33615 artery (simple Fontan procedure) 55,000 33,600
33617 Repair of complex cardiac anomalies (e.g., single 55,000 33,600

ventricle) by modified
Fontan procedure
Repair of single ventricle w/ aortic outflow obstruction
and aortic arch hypoplasia (hypoplastic left heart
33619 syndrome) (e.g., Norwood procedure) 63,000 42,000
33641 Repair atrial septal defect, secundum, w/ 46,500 25,200

cardiopulmonary bypass, w/ or
w/o patch
33645 Direct or patch closure, sinus venosus, w/ or w/o 53,400 29,400
anomalous pulmonary
venous drainage
33647 Repair of atrial septal defect and ventricular septal 55,000 33,600
defect, w/ direct or
patch closure
Repair of incomplete or partial atrioventricular canal
(ostium primum atrial septal defect), w/ or w/o
33660 atrioventricular valve repair 55,000 33,600
33665 Repair of intermediate or transitional atrioventricular 55,000 33,600

canal, w/ or w/o
atrioventricular valve repair
33670 Repair of complete atrioventricular canal, w/ or w/o 58,800 37,800
prosthetic valve
33681 Closure of ventricular septal defect, w/ or w/o patch; 46,500 25,200

with pulmonary
valvotomy or infundibular resection (acyanotic)

with removal of
pulmonary artery band, w/ or w/o gusset
33690 Banding of pulmonary artery 21,400 10,500
33692 Complete repair of tetralogy of Fallot w/o pulmonary 55,000 33,600
atresia;
33694 Complete repair of tetralogy of Fallot w/o pulmonary 55,000 33,600
atresia; with
transannular patch
Complete repair of tetralogy of Fallot w/ pulmonary
atresia including construction of conduit right ventricle
to pulmonary artery and closure of
33697 ventricular septal defect 55,000 33,600
33702 Repair sinus of Valsalva fistula, w/ cardiopulmonary 46,500 25,200

bypass
33710 Repair sinus of Valsalva fistula, w/ cardiopulmonary 55,000 33,600
bypass with repair of
ventricular septal defect
33720 Repair sinus of Valsalva aneurysm, with 53,400 29,400
33722 Closure of aortico-left ventricular tunnel 53,400 29,400
33730 Complete repair of anomalous venous return 55,000 33,600
(supracardiac, intracardiac, or
infracardiac types)
33732 Repair of cor triatum or supravalvular mitra ring by 55,000 33,600
resection of left atrial
membrane
33735 Atrial septectomy or septostomy; closed heart 21,400 10,500
(Blalock-Hanlon type
operation)
33736 Atrial septectomy or septostomy; open heart w/ 46,500 25,200
33737 Atrial septectomy or septostomy; open heart w/ 46,500 25,200
inflow occlusion
33750 Shunt; subclavian to pulmonary artery (Blalock- 30,300 16,800
Taussig type operation)
33764 Shunt; central, w/ prosthetic graft 23,300 12,600
33766 Shunt; superior vena cava to pulmonary artery for 30,300 16,800
flow to one lung (classical
Glenn procedure)
33767 Shunt; superior vena cava to pulmonary artery for 46,500 25,200
flow to both lungs
(bidirectional Glenn procedure)
Repair of transposition of great arteries w/ ventricular
septal defect and subpulmonary stenosis; w/o surgical
enlargement of ventricular septal
33770 defect 58,800 37,800
Repair of transposition of great arteries w/ ventricular

septal defect and
33771 subpulmonary stenosis; with surgical enlagement of 58,800 37,800
Repair of transposition of the great arteries, atrial

baffle procedure (e.g., Mustard or Senning type) w/

33775 removal of pulmonary band 60,900 39,900

33776 closure of ventricular septal defect 60,900 39,900

33777 repair of subpulmonic obstruction 60,900 39,900
Repair of transposition of the great arteries, aortic

33778 pulmonary artery reconstruction (e.g., Jatene type) 63,000 42,000

pulmonary artery reconstruction (e.g., Jatene type) w/
33779 removal of pulmonary band 65,100 44,100

33780 closure of ventricular septal defect 71,400 50,400

33781 repair of subpulmonic obstruction 71,400 50,400
33786 Total repair, truncus arteriosus (Rastelli type 58,800 37,800

operation)
33788 Reimplantation of an anomalous pulmonary artery 55,000 33,600
33800 Aortic suspension (aortopexy) for tracheal 21,400 10,500

decompression (e.g., for
tracheomalacia)
33802 Division of aberrant vessel (vascular ring) 21,400 10,500
33803 Division of aberrant vessel (vascular ring) w/ 23,300 12,600
reanastomosis
33814 Division of aberrant vessel (vascular ring) w/ 46,500 25,200
33820 Repair of patent ductus arteriosus; by ligation 32,000 14,700
33822 Repair of patent ductus arteriosus; by division, under 30,300 16,800

18 years
33824 Repair of patent ductus arteriosus; by division, 18 30,300 16,800
years and older
33840 Excision of coarctation of aorta, w/ or w/o associated 30,300 16,800
patent ductus
arteriosus; w/ direct anastomosis
33845 Excision of coarctation of aorta, w/ or w/o associated 30,300 16,800
patent ductus
arteriosus; with graft
Excision of coarctation of aorta, w/ or w/o associated
patent ductus
arteriosus; repair using either left subclavian artery or
33851 prosthetic material as gusset for enlargement 30,300 16,800
33852 Repair of hypoplastic or interrupted aortic arch using 30,300 16,800

autogenous or
prosthetic material; w/o cardiopulmonary bypass
33853 Repair of hypoplastic or interrupted aortic arch using 46,500 25,200

autogenous or
prosthetic material; w/ cardiopulmonary bypass
33860 Ascending aorta graft, w/ cardiopulmonary bypass, w/ 55,000 33,600

or w/o valve
suspension;
33861 Ascending aorta graft, w/ cardiopulmonary bypass, w/ 58,800 37,800
or w/o valve
suspension; w/ coronary reconstruction
Ascending aorta graft, w/ cardiopulmonary bypass, w/
or w/o valve suspension; w/ aortic root replacement
using composite prosthesis and
33863 coronary reconstruction 71,400 50,400
33870 Transverse arch graft, w/ cardiopulmonary bypass 71,400 50,400
33875 Descending thoracic aorta graft, w/ or w/o bypass 63,000 42,000
33877 Repair of thoracoabdominal aortic aneurysm w/ graft, 71,400 50,400

w/ or w/o
33910 Pulmonary artery embolectomy; w/ cardiopulmonary 46,500 25,200
bypass
33915 Pulmonary artery embolectomy; w/o cardiopulmonary 30,300 16,800
bypass
33916 Pulmonary endarterectomy, w/ or w/o embolectomy, 53,400 29,400
w/ cardiopulmonary
bypass
33917 Repair of pulmonary artery stenosis by reconstruction 53,400 29,400
w/ patch or graft
Repair of pulmonary atresia w/ ventricular septal
defect, by unifocalization of pulmonary arteries; w/o

defect, by unifocalization of pulmonary arteries; w/

defect, by construction or replacement of conduit
33920 from right or left ventricle to pulmonary artery 58,800 37,800
33922 Transection of pulmonary artery w/ cardiopulmonary 46,500 25,200
bypass
Ligation and takedown of a systemic-to-pulmonary
artery shunt, performed in conjuction w/ a congenital
heart procedure (List separately in addition to
33924 code for primary procedure) 18,000 8,400
33930 Donor cardiectomy-pneumonectomy, w/ preparation 46,500 25,200

and maintenance of
allograft
33935 Heart-lung transplant w/ recipient cardiectomy- 75,600 54,600
pneumonectomy
33940 Donor cardiectomy, w/ preparation and maintenance 46,500 25,200
of allograft
33945 Heart transplant, w/ or w/o recipient cardiectomy 75,600 54,600
33970 Insertion of intra-aortic balloon assist device through 12,900 6,300

the femoral artery,
open approach
33971 Removal of intra-aortic balloon assist device including 9,700 4,200
repair of femoral
artery w/ or w/o graft
33973 Insertion of intra-aortic balloon assist device through 21,400 10,500
the ascending aorta
Removal of intra-aortic balloon assist device from the
ascending aorta, including repair of the ascending
33974 aorta, w/ or w/o graft 30,300 16,800
33975 Implantation of ventricular assist device; single 46,500 25,200

ventricle support
33976 Implantation of ventricular assist device; biventricular 55,000 33,600
support
33977 Removal of ventricular assist device; single ventricle 37,800 21,000
support
33978 Removal of ventricular assist device; biventricular 46,500 25,200
support
34001 Embolectomy or thrombectomy, w/ or w/o catheter; 32,000 14,700
carotid, subclavian or
innominate artery, by neck incision
innominate,
subclavian artery, by thoracic incision
axillary, brachial,
innominate, subclavian artery, by arm incision

radial or ulnar artery,
by arm incision
renal, celiac,
mesentery, aortoiliac artery, by abdominal incision

femoropopliteal,
aortoiliac artery, by leg incision
popliteal-tibio-
peroneal artery, by leg incision
34401 Thrombectomy, direct or w/ catheter; vena cava, iliac 30,300 16,800
vein, by abdominal
incision
34421 Thrombectomy, direct or w/ catheter; vena cava, iliac, 32,000 14,700
femoropopliteal vein,
by leg incision
34451 Thrombectomy, direct or w/ catheter; vena cava, iliac, 37,600 18,900
femoropopliteal vein,
by abdominal and leg incision
34471 Thrombectomy, direct or w/ catheter; subclavian vein, 32,000 14,700
by neck incision
34490 Thrombectomy, direct or w/ catheter; axillary and 23,300 12,600
subclavian vein, by arm
incision
34501 Valvuloplasty, femoral vein 30,300 16,800
34502 Reconstruction of vena cava, any method 30,300 16,800
34510 Venous valve transposition, any vein donor 30,300 16,800
34520 Cross-over vein graft to venous sytem 30,300 16,800

34530 Saphenopopliteal vein anastomosis 30,300 16,800
35001 Direct repair of aneurysm, false aneurysm, or excision 23,300 12,600
(partial or total) and graft insertion, w/ or w/o patch
graft; for aneurysm and associated occlusive disease,
carotid, subclavian artery, by neck incision
Direct repair of aneurysm, false aneurysm, or excision

(partial or total) and
graft insertion, w/ or w/o patch graft; for ruptured
35002 aneurysm, carotid, subclavian artery, by neck incision 30,300 16,800

graft; for aneurysm, false aneurysm, and associated
occlusive disease, vertebral artery

graft; for aneurysm and associated occlusive disease,
axillary-brachial artery, by arm incision

graft; for ruptured aneurysm, axillary-
35013 brachial artery, by arm incision 23,300 12,600

occlusive disease, innominate, subclavian artery, by
thoracic
incision

graft; for ruptured aneurysm, innominate,
35022 subclavian artery, by thoracic insertion 30,300 16,800

occlusive disease, radial or ulnar artery

occlusive disease, abdominal aorta

35082 graft insertion, w/ or w/o patch graft; for ruptured 53,400 29,400
aneurysm, abdominal aorta
occlusive disease, abdominal aorta involving visceral
vessels
(mesenteric, celiac, renal)

graft; for ruptured aneurysm, abdominal aorta
involving visceral vessels (mesenteric, celiac, renal)

occlusive disease, abdominal aorta involving iliac
vessels
(common, hypogastric, external)

graft; for ruptured aneurysm, abdominal aorta
involving iliac vessels (common, hypogastric, external)

graft insertion, w/ or w/o patch graft; for aneurysm,
35111 false aneurysm, and associated occlusive disease, 46,500 25,200
splenic artery

35112 graft; for ruptured aneurysm, splenic artery 53,400 29,400

occlusive disease, hepatic, celiac, renal, or mesenteric
artery

graft; for ruptured aneurysm, hepatic,
35122 celiac, renal, or mesenteric artery 53,400 29,400

occlusive disease, iliac artery (common, hypogastric,
external)

graft; for ruptured aneurysm, iliac artery
35132 (common, hypogastric, external) 30,300 16,800

occlusive disease, common femoral artery (profunda
femoris,
superficial femoral)
graft; for ruptured aneurysm, common femoral artery
(profunda femoris, superficial femoral)

occlusive disease, popliteal artery

graft; for ruptured aneurysm, popliteal
35152 artery 37,800 21,000

graft; for aneurysm, false aneurysm, and
35161 associated occlusive disease, other arteries 30,300 16,800

35162 graft; for ruptured aneurysm, other arteries 37,800 21,000
35180 Repair, congenital arteriovenous fistula; head and 23,300 12,600

neck
35182 Repair, congenital arteriovenous fistula; thorax and 30,300 16,800
abdomen
35184 Repair, congenital arteriovenous fistula; extremities 23,300 12,600
35188 Repair, acquired or traumatic arteriovenous fistula; 23,300 12,600

head and neck
thorax and abdomen

extremities
35201 Repair blood vessel, direct; neck 18,000 8,400
35206 Repair blood vessel, direct; upper extremity 18,000 8,400
35207 Repair blood vessel, direct; hand, finger 18,000 8,400

35211 Repair blood vessel, direct; intrathoracic, w/ bypass 46,500 25,200
35216 Repair blood vessel, direct; intrathoracic, w/o bypass 30,300 16,800
35221 Repair blood vessel, direct; intra-abdominal 18,000 8,400
35226 Repair blood vessel, direct; lower extremity 18,000 8,400
35231 Repair blood vessel w/ vein graft; neck 23,300 12,600

35236 Repair blood vessel w/ vein graft; upper extremity 18,000 8,400
35241 Repair blood vessel w/ vein graft; intrathoracic, w/ 46,500 25,200

bypass
35246 Repair blood vessel w/ vein graft; intrathoracic, w/o 30,300 16,800
bypass
35251 Repair blood vessel w/ vein graft; intra-abdominal 23,300 12,600
35256 Repair blood vessel w/ vein graft; lower extremity 18,000 8,400
35261 Repair blood vessel w/ graft other than vein; neck 23,300 12,600
35266 Repair blood vessel w/ graft other than vein; upper 18,000 8,400
extremity
35271 Repair blood vessel w/ graft other than vein; 46,500 25,200
intrathoracic, w/ bypass
35276 Repair blood vessel w/ graft other than vein; 30,300 16,800
intrathoracic, w/o bypass
35281 Repair blood vessel w/ graft other than vein; intra- 23,300 12,600
abdominal
35286 Repair blood vessel w/ graft other than vein; lower 18,000 8,400
extremity
35301 Thromboendarterectomy, w/ or w/o patch graft; 37,600 18,900
carotid, vertebral,
subclavian, by neck incision
subclavian, innominate, by
thoracic incision
axillary-brachial
abdominal aorta
mesenteric, celiac, or renal
35351 Thromboendarterectomy, w/ or w/o patch graft; iliac 30,300 16,800

iliofemoral
combined aortoiliac
combined aortoiliofemoral
common femoral
35372 Thromboendarterectomy, w/ or w/o patch graft; deep 23,300 12,600
(profunda) femoral
femoral and/or popliteal,
and/or tibioperoneal
35450 Transluminal balloon angioplasty, open; renal or other 21,400 10,500
visceral artery
35452 Transluminal balloon angioplasty, open; aortic 21,400 10,500
35454 Transluminal balloon angioplasty, open; iliac 21,400 10,500
35456 Transluminal balloon angioplasty, open; femoral- 21,400 10,500

popliteal
35458 Transluminal balloon angioplasty, open; 21,400 10,500
brachiocephalic trunk or branches,
each vessel
35459 Transluminal balloon angioplasty, open; tibioperoneal 21,400 10,500
trunk and branches
35460 Transluminal balloon angioplasty, open; venous 21,400 10,500
35470 Transluminal balloon angioplasty, percutaneous; 12,900 6,300

tibioperoneal trunk or
branches, each vessel
35471 Transluminal balloon angioplasty, percutaneous; renal 12,900 6,300
or visceral artery
aortic
35473 Transluminal balloon angioplasty, percutaneous; iliac 12,900 6,300

femoral-popliteal
branchiocephalic trunk or
venous
35480 Transluminal peripheral atherectomy, open; renal or 23,300 12,600
other visceral artery
35481 Transluminal peripheral atherectomy, open; aortic 23,300 12,600
35482 Transluminal peripheral atherectomy, open; iliac 23,300 12,600

35483 Transluminal peripheral atherectomy, open; femoral- 23,300 12,600
popliteal
35484 Transluminal peripheral atherectomy, open; 23,300 12,600
brachiocephalic trunk or
35485 Transluminal peripheral atherectomy, open; 23,300 12,600
tibioperoneal trunk and
branches
35490 Transluminal peripheral atherectomy, percutaneous; 21,400 10,500
renal or other visceral
artery
aortic
iliac
femoral-popliteal
branchiocephalic
trunk or branches, each vessel
tibioperoneal trunk
and branches
35501 Bypass graft, w/ vein; carotid 37,600 18,900
35506 Bypass graft, w/ vein; carotid-subclavian 37,600 18,900
35507 Bypass graft, w/ vein; subclavian-carotid 37,600 18,900
35508 Bypass graft, w/ vein; carotid-vertebral 37,600 18,900
35509 Bypass graft, w/ vein; carotid-carotid 37,600 18,900
35511 Bypass graft, w/ vein; subclavian-subclavian 37,600 18,900
35515 Bypass graft, w/ vein; subclavian-vertebral 37,600 18,900
35516 Bypass graft, w/ vein; subclavian-axillary 37,600 18,900

35518 Bypass graft, w/ vein; axillary-axillary 37,600 18,900
35521 Bypass graft, w/ vein; axillary-femoral 37,600 18,900
35526 Bypass graft, w/ vein; aortosubclavian or carotid 46,500 25,200
35531 Bypass graft, w/ vein; aortoceliac or aortomesenteric 46,500 25,200
35533 Bypass graft, w/ vein; axillary-femoral-femoral 46,500 25,200
35536 Bypass graft, w/ vein; splenorenal 46,500 25,200

35541 Bypass graft, w/ vein; aortoiliac or bi-iliac 46,500 25,200
35546 Bypass graft, w/ vein; aortofemoral or bifemoral 46,500 25,200
35548 Bypass graft, w/ vein; aortoilliofemoral, unilateral 46,500 25,200
35549 Bypass graft, w/ vein; aortoilliofemoral, bilateral 46,500 25,200
35551 Bypass graft, w/ vein; aortofemoral - popliteal 46,500 25,200
35556 Bypass graft, w/ vein; femoral - popliteal 30,300 16,800

35558 Bypass graft, w/ vein; femoral-femoral 23,300 12,600
35560 Bypass graft, w/ vein; aortorenal 37,800 21,000
35563 Bypass graft, w/ vein; ilioiliac 30,300 16,800
35565 Bypass graft, w/ vein; iliofemoral 30,300 16,800
35566 Bypass graft, w/ vein; femoral - anterior tibial, 30,300 16,800
posterior tibial, peroneal
artery or other distal vessels
35571 Bypass graft, w/ vein; popliteal-tibial, peroneal artery 23,300 12,600
or other distal vessels
35582 In-situ vein bypass; aortofemoral-popliteal (only 46,500 25,200
femoral-popliteal portion
in-situ)
35583 In-situ vein bypass;femoral-popliteal 37,800 21,000
35585 In-situ vein bypass; femoral-anterior tibial, posterior 37,800 21,000
tibial, or peroneal
artery
35587 In-situ vein bypass; popliteal -tibial, peroneal 37,800 21,000
35601 Bypass graft, with other than vein; carotid 37,600 18,900
35606 Bypass graft, with other than vein; carotid-subclavian 37,600 18,900
35612 Bypass graft, with other than vein; subclavian- 37,600 18,900
subclavian
35616 Bypass graft, with other than vein; subclavian-axillary 37,600 18,900
35621 Bypass graft, with other than vein; axillary-femoral 37,600 18,900
35623 Bypass graft, with other than vein; axillary-popliteal or 37,600 18,900
-tibial
35626 Bypass graft, with other than vein; aortosubclavian or 46,500 25,200
carotid
35631 Bypass graft, with other than vein; aortoceliac, 46,500 25,200
aortomesenteric, aortorenal
35636 Bypass graft, with other than vein; splenorenal (splenic 46,500 25,200
to renal arterial
anastomosis)
35641 Bypass graft, with other than vein; aortoiliac or bi-iliac 46,500 25,200
35642 Bypass graft, with other than vein; carotid-vertebral 37,600 18,900
35645 Bypass graft, with other than vein; subclavian- 37,600 18,900
vertebral
35646 Bypass graft, with other than vein; aortofemoral or 46,500 25,200
bifemoral
35650 Bypass graft, with other than vein; axillary-axillary 37,600 18,900
35651 Bypass graft, with other than vein; aortofemoral- 46,500 25,200
popliteal
35654 Bypass graft, with other than vein; axillary-femoral- 37,600 18,900
femoral
35656 Bypass graft, with other than vein; femoral-popliteal 30,300 16,800
35661 Bypass graft, with other than vein; femoral-femoral 23,300 12,600
35663 Bypass graft, with other than vein; ilioiliac 30,300 16,800
35665 Bypass graft, with other than vein; iliofemoral 30,300 16,800
35666 Bypass graft, with other than vein; femoral-anterior 30,300 16,800
tibial, posterior tibial,
or peroneal artery
35671 Bypass graft, with other than vein; popliteal-tibial or - 23,300 12,600
peroneal artery
35681 Bypass graft; composite 46,500 25,200
35691 Transposition and/or reimplantation; vertebral to 37,600 18,900
carotid artery
35693 Transposition and/or reimplantation; vertebral to 37,600 18,900
subclavian artery
35694 Transposition and/or reimplantation; subclavian to 37,600 18,900
carotid artery
35695 Transposition and/or reimplantation; carotid to 37,600 18,900
subclavian artery
35700 Reoperation, femoral-popliteal or femoral (popliteal) - 18,000 8,400
anterior tibial,posterior tibial, peroneal artery or other
distal vessels, more than one month after original
operation (List separately in addition to code for
primary procedure)
35701 Exploration (not followed by surgical repair), w/ or 18,000 8,400

w/o lysis of artery;
carotid artery
femoral artery
popliteal artery
w/o lysis of artery; other
vessels
35800 Exploration for postoperative hemorrhage, thrombosis 9,700 4,200
or infection; neck
or infection; chest
or infection;
abdomen
or infection;
extremity
35870 Repair of graft-enteric fistula 23,300 12,600
35875 Thrombectomy of arterial or venous graft; 23,300 12,600
35876 Thrombectomy of arterial or venous graft; w/ revision 23,300 12,600
of arterial or venous
graft
35901 Excision of infected graft; neck 30,300 16,800
35903 Excision of infected graft; extremity 30,300 16,800
35905 Excision of infected graft; thorax 37,800 21,000
35907 Excision of infected graft; abdomen 30,300 16,800
36010 Introduction of catheter, superior or inferior vena cava 3,640 840
36011 Selective catheter placement, venous system; first 9,300 2,100

order branch (e.g., renal
vein, jugular vein)
36012 Selective catheter placement, venous system; second 8,020 2,520
order, or more
selective, branch (e.g., left adrenal vein, petrosal sinus)
36013 Introduction of catheter, right heart or main 8,020 2,520

pulmonary artery
36014 Selective catheter placement, left or right pulmonary 8,020 2,520
artery
36015 Selective catheter placement, segmental or 8,440 2,940
subsegmental pulmonary artery
36100 Introduction of needle or intracatheter, carotid or 8,440 2,940
vertebral artery
36120 Introduction of needle or intracatheter; retrograde 9,300 2,100
brachial artery
36140 Introduction of needle or intracatheter; extremity 9,300 2,100
artery
36145 Introduction of needle or intracatheter; arteriovenous 8,260 3,360
shunt created for
dialysis (cannula, fistula, or graft)
36200 Introduction of catheter, aorta 9,300 2,100
36215 Selective catheter placement, arterial system; each 9,300 2,100
first order thoracic or
brachiocephalic branch, w/in a vascular family
36216 Selective catheter placement, arterial system; initial 9,300 2,100

second order thoracic
or brachiocephalic branch, w/in a vascular family
Selective catheter placement, arterial system; initial

third order or more selective thoracic or
36217 brachiocephalic branch, w/in a vascular family 8,020 2,520
Selective catheter placement, arterial system; each
first order abdominal, pelvic, or lower extremity artery
36245 branch, w/in a vascular family 9,300 2,100

second order abdominal, pelvic or lower extremity
36246 artery branch, w/in a vascular family 9,300 2,100

third order or more selective abdominal, pelvic or
lower extremity artery branch, w/in a vascular
36247 family 8,020 2,520
36260 Insertion of implantable intra-arterial infusion pump 23,300 12,600

(e.g., for
chemotherapy of liver)
36261 Revision of implanted intra-arterial infusion pump 9,700 4,200
36262 Removal of implanted intra-arterial infusion pump 9,700 4,200
36430 Outpatient Transfusion of Blood or Blood Products; 3,640 840

one or more units
36450 Exchange transfusion, blood 5,680 1,680
36481 Percutaneous portal vein catheterization by any 9,300 2,100
method
Placement of central venous catheter (subclavian,
jugular, or other vein)
(e.g., for central venous pressure, hyperalimentation,
36488 hemodialysis, or chemotherapy); percutaneous or 9,700 4,200
cutdown
36510 Catheterization of umbilical vein for diagnosis or 3,640 840

therapy, newborn
36511 Therapeutic apheresis 3,640 840
36568 Insertion of peripherally inserted central venous 9,700 4,200
catheter (PICC)
36640 Arterial catheterization for prolonged infusion therapy 3,640 840
(chemotherapy),
cutdown
36660 Catheterization, umbilical artery, newborn, for 5,680 1,680
diagnosis or therapy
36781 Percutaneousportal vein catheterization by any 9,300 2,100
method
36800 Insertion of cannula for hemodialysis, other purpose ; 9,300 2,100
vein to vein
arteriovenous,
external (e.g. Scribner type)
arteriovenous,
external revision, or closure
36821 Arteriovenous anastomosis, direct, any site (e.g., 9,700 4,200
Cimino type)
36822 Insertion of cannula(s) for prolonged extracorporeal 18,000 8,400
circulation for
cardiopulmonary insufficiency (ECMO)
36825 Creation of arteriovenous fistula by other than direct 12,900 6,300
arteriovenous
anastomosis ; autogenous graft
36830 Creation of arteriovenous fistula by other than direct 12,900 6,300
arteriovenous
anastomosis ; nonautogenous graft
36832 Revision of an arteriovenous fistula, w/ or w/o 9,700 4,200
thrombectomy, autogenous
or nonautogenous graft
36834 Plastic repair of arteriovenous aneurysm 8,260 3,360
36835 Insertion of Thomas shunt 9,300 2,100
37140 Venous anastomosis; portocaval 30,300 16,800
37145 Venous anastomosis; renoportal 37,800 21,000
37160 Venous anastomosis; caval-mesenteric 30,300 16,800
37180 Venous anastomosis; splenorenal, proximal 37,600 18,900
37181 Venous anastomosis; splenorenal, distal (selective 37,800 21,000

decompression of
esophagogastric varices, any technique)
Insertion of transvenous intrahepatic portosystemic
shunt(s) (TIPS) includes venous access, hepatic and
portal vein catheterization, portography,
hemodynamic evaluation, intrahepatic tract
formation/dilatation, stent placement and all
37182 associated imaging guidance and documentation) 53,400 29,400
37184 Primary percutaneous transluminal mechanical 46,500 25,200

thrombectomy, non- coronary, arterial or arterial
bypass graft including fluoroscopic guidance and
intraprocedural pharmacological thrombolytic
injections; one or more
vessels
Percutaneous transluminal mechanical

thrombectomy, veins, including intraprocedural
pharmacological thrombolytic injections and
37187 fluoroscopic 46,500 25,200
guidance; one or more vessels
37200 Transcatheter biopsy 8,260 3,360

37201 Transcatheter therapy, infusion for thrombolysis other 8,020 2,520
than coronary
37202 Transchatheter therapy, infusion other than for 8,020 2,520
thrombolysis, any type (e.g., spasmolytic,
vasoconstrictive)
37203 Transcatheter retrieval, percutaneous, of intravascular 9,700 4,200
foreign body (e.g.,
fractured venous or arterial catheter)
37204 Transcatheter occlusion or embolization (e.g., for 46,500 25,200
tumor destruction, to achieve hemostasis, to occlude
a vascular malformation), percutaneous, any method,
non-central nervous system, non-head or neck
37205 Transcatheter placement of an intravascular stent(s), 46,500 25,200

(non-coronary vessel),
percutaneous; initial vessel
37207 Transcatheter placement of an intravascular stent(s), 23,300 12,600

(non-coronary vessel),
open; initial vessel
37565 Ligation, internal jugular vein 5,680 1,680

37600 Ligation; external carotid artery 5,680 1,680
37605 Ligation; internal or common carotid artery 18,000 8,400
37606 Ligation; internal or common carotid artery, w/ 21,940 9,240
gradual occlusion, as w/
Selverstone or Crutchfield camp
37607 Ligation or banding of angioaccess arteriovenous 9,300 2,100
fistula
37609 Ligation or biopsy, temporal artery 9,300 2,100
37615 Ligation, major artery (e.g., post-traumatic, rupture); 18,000 8,400
neck
chest
abdomen
extremity
Interruption, partial or complete, of inferior vena cava
by suture, ligation, plication, clip, extravascular,
37620 intravascular (umbrella device) 23,300 12,600
37650 Ligation of femoral vein 9,300 2,100

37660 Ligation of common iliac vein 12,900 6,300
37700 Ligation and division of long saphenous vein at 9,300 2,100
saphenofemoral junction, or
distal interruptions
37720 Ligation and division and complete stripping of long or 12,900 6,300
short saphenous
veins
37730 Ligation and division and complete stripping of long 18,000 8,400
and short saphenous
veins
37735 Ligation and division and complete stripping of long or 21,400 10,500
short saphenous veins w/ radical excision of ulcer and
skin graft and/or interruption of communicating veins
of lower leg, w/ excision of deep fascia
37760 Ligation of perforators, subfascial, radical (Linton 21,400 10,500

type), w/ or w/o skin graft
37780 Ligation and division of short saphenous vein at 9,700 4,200
saphenopopliteal junction
37788 Penile revascularization, artery, w/ or w/o vein graft 46,500 25,200
37790 Penile venous occlusive procedure 23,300 12,600

38100 Splenectomy; total 30,740 13,440
38101 Splenectomy; partial 23,300 12,600
38102 Splenectomy; total, en bloc for extensive disease, in 32,000 14,700
conjuction w/ other
procedure
38115 Repair of ruptured spleen (splenorrhaphy) w/ or w/o 30,300 16,800
partial splenectomy
38120 Laparoscopy, surgical; splenectomy 30,740 13,440
38205 Blood-derived hematopoietic progenitor cell 10,880 3,780
harvesting for transplantation
38220 Bone marrow aspiration or biopsy 10,880 3,780
38230 Bone marrow harvesting for transplantation 18,000 8,400
38240 Bone marrow or peripheral blood derived peripheral 37,800 21,000

stem cell
transplantation
38300 Drainage of lymph node abscess or lymphadenitis 8,260 3,360
38380 Suture and/or ligation of thoracic duct; cervical 30,300 16,800

approach
38381 Suture and/or ligation of thoracic duct; thoracic 30,300 16,800
approach
38382 Suture and/or ligation of thoracic duct; abdominal 30,300 16,800
approach
38500 Biopsy or excision or lymph node(s); superficial 5,680 1,680
38505 Biopsy or excision or lymph node(s); by needle, 5,680 1,680

superficial (e.g., cervical,
inguinal, axillary)
38510 Biopsy or excision or lymph node(s); deep cervical 8,260 3,360
node(s)
38520 Biopsy or excision or lymph node(s); deep cervical 9,300 2,100
node(s) w/ excision
scalene fat pad
38525 Biopsy or excision or lymph node(s); deep axillary 9,300 2,100
node(s)
38530 Biopsy or excision or lymph node(s); internal 9,300 2,100
mammary node(s)
38542 Dissection, deep jugular node(s) 21,940 9,240
38550 Excision of cystic hygroma, axillary or cervical; w/o 37,800 21,000
deep neurovascular
dissection
38555 Excision of cystic hygroma, axillary or cervical; w/ deep 46,500 25,200
neurovascular
dissection
38570 Laparoscopy, surgical; with retroperitoneal lymph 27,120 15,120
node sampling (biopsy),
single or multiple
38571 Laparoscopy, surgical; with bilateral total pelvic 30,300 16,800

lymphadenectomy
Laparoscopy, surgical; with bilateral total pelvic
lymphadenectomy and peri- aortic lymph node
38572 sampling (biopsy), single or multiple 58,800 37,800
38700 Suprahyoid lymphadenectomy 27,120 15,120

38720 Cervical lymphadenectomy (complete) 30,300 16,800
38724 Cervical lymphadenectomy (modified radical neck 30,300 16,800
dissection)
38740 Axillary lymphadenectomy; superficial 23,300 12,600
38745 Axillary lymphadenectomy; complete 30,300 16,800
38746 Thoracic lymphadenectomy, regional, including 37,800 21,000
mediastinal and
peritracheal nodes
38747 Abdominal lymphadenectomy, regional, including 23,300 12,600
celiac, para-aortic and
venal caval nodes
Inguinofemoral lymphadenectomy, superficial,

38760 including Cloquet's node 23,300 12,600
Inguinofemoral lymphadenectomy, superficial, in
continuity w/ pelvic lymphadenectomy, including
external iliac, hypogastric, and obturator
38765 nodes 23,300 12,600
38770 Pelvic lymphadenectomy, including external iliac, 37,800 21,000

hypogastric, and
obturator nodes
38780 Retroperitoneal transabdominal lymphadenectomy, 37,800 21,000
extensive, including
pelvic, aortic, and renal nodes
39000 Mediastinotomy with exploration, drainage, removal 18,000 8,400
of foreign body, or
biopsy; cervical approach
Mediastinotomy with exploration, drainage, removal
of foreign body, or
39010 biopsy; transthoracic approach, including either 23,300 12,600
transthoracic or median sternotomy
39200 Excision of mediastinal cyst 37,800 21,000

39220 Excision of mediastinal tumor 41,160 24,360
39400 Mediastinoscopy, with or without biopsy 14,960 7,560
39501 Repair, laceration of diaphragm, any approach 37,800 21,000
39502 Repair, paraesophageal hiatus hernia, transabdominal, 40,320 23,520

with or without
fundoplasty, vagotomy, and/or pyloroplasty, except
neonatal
39503 Repair, neonatal diaphragmatic hernia, with or 40,320 23,520

without chest tube insertion
and with or without creation of ventral hernia
39520 Repair, diaphragmatic hernia (esophageal hiatal); 40,320 23,520

transthoracic
39530 Repair, diaphragmatic hernia (esophageal hiatal); 40,320 23,520
combined,
thoracoabdominal
Repair, diaphragmatic hernia (esophageal hiatal);
combined, thoracoabdominal, with dilation of
39531 stricture (with or without gastroplasty) 40,320 23,520
39540 Repair, diaphragmatic hernia (other than neonatal), 40,320 23,520

traumatic; acute
39541 Repair, diaphragmatic hernia (other than neonatal), 46,500 25,200
traumatic; chronic
39545 Imbrication of diaphragm for eventration, 40,320 23,520
transthoracic or transabdominal,
paralytic or nonparalytic
40490 Biopsy of lip 5,560 1,260
40500 Vermilionectomy (lip shave), w/ mucosal 8,020 2,520
advancement
40510 Excision of lip; transverse wedge excision w/ primary 8,020 2,520
closure
40520 V-excision w/ primary defect linear closure; 8,020 2,520
40525 V-excision w/ primary defect linear closure; full 23,300 12,600

thickness, reconstruction w/
local flap (e.g., Estlander or fan)
40527 V-excision w/ primary defect linear closure; full 30,740 13,440
thickness, reconstruction w/
cross lip flap (e.g. Abbe-Estlander)
40530 Resection of lip, more than one-fourth, w/o 8,260 3,360
reconstruction
40650 Repair lip, full thickness; vermilion only 9,700 4,200
40652 Repair lip, full thickness; up to half vertical height 9,700 4,200
40654 Repair lip, full thickness; over one-half vertical height, 9,700 4,200
or complex
40700 Plastic repair of cleft lip/nasal deformity; primary, 37,800 21,000
partial or complete,
unilateral
40701 Plastic repair of cleft lip/nasal deformity; primary 37,800 21,000
bilateral, one stage
procedure
40702 Plastic repair of cleft lip/nasal deformity; primary 30,300 16,800
bilateral, one of two
stages
40720 Plastic repair of cleft lip/nasal deformity; secondary, 30,300 16,800
by recreation of defect
and reclosure
Plastic repair of cleft lip/nasal deformity; w/ cross lip
pedicle flap (Abbe- Estlander type), including
40761 sectioning and inserting of pedicle 37,800 21,000
40800 Drainage of abscess, cyst, hematoma, vestibule of 5,680 1,680

mouth
40808 Biopsy, vestibule of mouth 5,680 1,680
40810 Excision of lesion of mucosa and submucosa, vestibule 5,680 1,680
of mouth
40818 Excision of mucosa of vestibule of mouth as donor 8,440 2,940
graft
40819 Excision of frenum, labial or buccal (frenumectomy, 9,300 2,100
frenulectomy,
frenectomy)
40830 Closure of laceration, vestibule of mouth; 2.5 cm or 5,680 1,680
less
40831 Closure of laceration, vestibule of mouth; over 2.5 cm 5,680 1,680
or complex
40840 Vestibuloplasty; anterior 12,120 6,720
40842 Vestibuloplasty; posterior, unilateral 12,120 6,720
40843 Vestibuloplasty; posterior, bilateral 12,120 6,720
40844 Vestibuloplasty; entire arch 18,000 8,400
40845 Vestibuloplasty; complex (including ridge extension, 18,000 8,400
muscle repositioning)
41000 Intraoral incision and drainage of abscess, cyst, or 5,680 1,680
hematoma of tongue or
floor of mouth; lingual
floor of mouth; sublingual, superficial
floor of mouth; sublingual, deep, supramylohyoid

floor of mouth; submental space
floor of mouth; submandibular space
floor of mouth; masticator space
41015 Extraoral incision and drainage of abscess,cyst,or 5,680 1,680
hematoma of floor of
mouth; sublingual
mouth; submental
mouth; submandibular
mouth; masticator space
41100 Biopsy of tongue; anterior two-thirds 5,560 1,260
41105 Biopsy of tongue; posterior one-third 5,560 1,260
41108 Biopsy of floor of mouth 5,560 1,260
41110 Excision of lesion of tongue w/o closure 9,300 2,100
41112 Excision of lesion of tongue w/ closure; anterior two- 9,300 2,100
thirds
41113 Excision of lesion of tongue w/ closure; posterior one- 9,300 2,100
third
41114 Excision of lesion of tongue w/ closure; w/ local 9,300 2,100
tongue flap
41115 Excision of lingual frenum (frenectomy) 9,300 2,100
41116 Excision, lesion of floor of mouth 9,300 2,100
41120 Glossectomy; less than one-half tongue 8,260 3,360
41130 Glossectomy; hemiglossectomy 10,880 3,780
41135 Glossectomy; partial, w/ unilateral radical neck 37,800 21,000
dissection
41140 Glossectomy; complete or total, w/ or w/o 37,800 21,000
tracheostomy, w/o radical neck
dissection
41145 Glossectomy; complete or total, w/ or w/o 37,800 21,000
tracheostomy, w/ unilateral
radical neck dissection
41150 Glossectomy; composite procedure w/ resection floor 40,320 23,520
of mouth and
mandibular resection, w/o radical neck dissection
41153 Glossectomy; composite procedure w/ resection floor 46,500 25,200

of mouth, w/
suprahyoid neck dissection
Glossectomy; composite procedure w/ resection floor
of mouth, mandibular resection, and radical neck
41155 dissection (Commando type) 53,400 29,400
41250 Repair of laceration 2.5 cm or less; floor of mouth 9,700 4,200

and/or anterior two-
thirds of tongue
41251 Repair of laceration 2.5 cm or less; posterior one-third 9,700 4,200
of tongue
41252 Repair of laceration of tongue, floor of mouth, over 9,700 4,200
2.6 cm or complex
41500 Frenoplasty (surgical revision of frenum, eg, w/ Z- 9,700 4,200
plasty)
41510 Suture of tongue to lip for micrognathia (Douglas type 9,700 4,200
procedure)
41520 Frenoplasty (surgical revision of frenum, eg, w/ Z- 9,700 4,200
plasty)
41800 Drainage of abscess, cyst, hematoma from 5,680 1,680
dentoalveolar structures
41805 Removal of embedded foreign body from 3,640 840
dentoalveolar structures; soft
tissues
41806 Removal of embedded foreign body from 3,640 840
dentoalveolar structures; bone
41820 Gingivectomy, excision gingiva 8,020 2,520
41821 Operculectomy, excision pericoronal tissues 8,020 2,520
41822 Excision of fibrous tuberosities, dentoalveolar 8,020 2,520

structures
41823 Excision of osseous tuberosities, dentoalveolar 8,020 2,520
structures
41825 Excision of lesion or or tumor (except listed above), 8,020 2,520
dentoalveolar
structures
41828 Excision of hyperplastic alveolar mucosa 8,020 2,520
41830 Alveolectomy, including curettage of osteitis or 8,260 3,360
sequestrectomy
41850 Destruction of lesion (except excision), dentoalveolar 8,260 3,360
structures
41870 Periodontal mucosal grafting 8,260 3,360
41872 Gingivoplasty 18,000 8,400
41874 Alveoloplasty 18,000 8,400
42000 Drainage of abscess of palate, uvula 8,020 2,520
42100 Biopsy of palate, uvula 5,560 1,260
42104 Excision, lesion of palate , uvula; w/o closure 5,680 1,680
42106 Excision, lesion of palate , uvula; w/ simple primary 9,300 2,100

closure
42107 Excision, lesion of palate , uvula; w/ local flap closure 9,300 2,100
42120 Resection of palate or extensive resection of lesion 20,980 10,080
42140 Uvulectomy, excision of uvula 12,120 6,720

42145 Palatopharyngoplasty (e.g., 23,300 12,600
uvulopalatopharyngoplasty,
uvulopharyngoplasty)
42160 Destruction of lesion, palate or uvula (thermal, cryo or 10,540 5,040
chemical)
42180 Repair, laceration of palate; up to 2 cm 12,120 6,720
42182 Repair, laceration of palate; over 2 cm or complex 18,000 8,400
42200 Palatoplasty for cleft palate, soft and/or hard palate 20,980 10,080
only
42205 Palatoplasty for cleft palate, w/ closure of alveolar 21,820 10,920
ridge; soft tissue only
42210 Palatoplasty for cleft palate, w/ closure of alveolar 22,660 11,760
ridge; w/ bone graft to
alveolar ridge (includes obtaining graft)
42215 Palatoplasty for cleft palate; major revision 23,300 12,600
42220 Palatoplasty for cleft palate; secondary lengthening 23,300 12,600
procedure
42225 Palatoplasty for cleft palate; attachment pharyngeal 30,740 13,440
flap
42226 Lengthening of palate, and pharyngeal flap 23,300 12,600
42227 Lengthening of palate, w/ island flap 23,300 12,600

42235 Repair of anterior palate, including vomer flap 23,300 12,600
42260 Repair of nasolabial fistula 12,120 6,720

42300 Drainage of abscess; parotid 5,680 1,680
42310 Drainage of abscess; submaxillary or sublingual, 5,680 1,680
intraoral
42320 Drainage of abscess; submaxillary, external 5,680 1,680
42325 Fistulization of sublingual salivary cyst (ranula); 5,680 1,680
42326 Fistulization of sublingual salivary cyst (ranula); w/ 9,300 2,100

prosthesis
42330 Sialolithotomy; submandibular (submaxillary), 9,300 2,100
sublingual or parotid,
intraoral
42400 Biopsy of salivary gland; needle 5,560 1,260
42405 Biopsy of salivary gland; incisional 5,560 1,260
42408 Excision of sublingual salivary cyst (ranula) 9,300 2,100
42409 Marsupialization of sublingual salivary cyst (ranula) 9,300 2,100
42410 Excision of parotid tumor or parotid gland; lateral 23,300 12,600

lobe, w/o nerve
dissection
42415 Excision of parotid tumor or parotid gland; lateral 30,300 16,800
lobe, w/ dissection and
preservation of facial nerve
42420 Excision of parotid tumor or parotid gland; total, w/ 30,300 16,800
dissection and
preservation of facial nerve
42425 Excision of parotid tumor or parotid gland; total, en 30,300 16,800
bloc removal w/
sacrifice of facial nerve
42426 Excision of parotid tumor or parotid gland; total, w/ 37,800 21,000
unilateral radical neck
dissection
42440 Excision of submandibular (submaxillary) gland 18,000 8,400
42450 Excision of sublingual gland 18,000 8,400

42500 Plastic repair of salivary duct, sialodochoplasty; 18,000 8,400
primary or simple
42505 Plastic repair of salivary duct, sialodochoplasty; 18,000 8,400
secondary or complicated
42507 Parotid duct diversion, bilateral (Wilke type 18,000 8,400

procedure);
procedure); w/ excision of one
submandibular gland
procedure); w/ excision of both
submandibular glands
procedure); w/ ligation of both
submandibular (Whartons) ducts
42600 Closure salivary fistula 8,260 3,360
42665 Ligation salivary duct, intraoral 8,260 3,360
42700 Incision and drainage abscess; peritonsillar 8,260 3,360
42720 Incision and drainage abscess; retropharyngeal or 8,260 3,360

parapharyngeal, intraoral
approach
42725 Incision and drainage abscess; retropharyngeal or 8,260 3,360
parapharyngeal, external
approach
42800 Biopsy; oropharynx 8,020 2,520

42802 Biopsy; hypopharynx 8,020 2,520
42804 Biopsy; nasopharynx, visible lesion, simple 8,020 2,520
42806 Biopsy; nasopharynx, survey for unknown primary 8,020 2,520

lesion
42808 Excision or destruction of lesion of pharynx, any 8,020 2,520
method
42809 Removal of foreign body from pharynx 8,020 2,520
42810 Excision branchial cleft cyst or vestige, confined to skin 18,000 8,400
and subcutaneous
tissues
42815 Excision branchial cleft cyst, vestige, or fistula, 18,000 8,400
extending beneath
subcutaneous tissues and/or into pharynx
42820 Tonsillectomy and adenoidectomy 18,000 8,400
42825 Tonsillectomy, primary or secondary 18,000 8,400
42830 Adenoidectomy, primary 18,000 8,400
42835 Adenoidectomy, secondary 18,000 8,400
42842 Radical resection of tonsil, tonsillar pillars, and/or 10,540 5,040
retromolar trigone; w/o
closure
retromolar trigone;
closure w/ local flap (e.g., tongue, buccal)
retromolar trigone;
closure w/ other flap
42860 Excision of tonsil tags 8,020 2,520
42870 Excision or destruction lingual tonsil, any method 8,020 2,520
42890 Limited pharyngectomy 37,800 21,000

Resection of lateral pharyngeal wall or pyriform sinus,
direct closure by advancement of lateral and posterior
42892 pharyngeal walls 46,500 25,200
42894 Resection of pharyngeal wall requiring closure w/ 53,400 29,400

myocutaneous flap
42900 Suture pharynx for wound or injury 20,980 10,080
42950 Pharyngoplasty (plastic or reconstructive operation on 20,980 10,080
pharynx)
42953 Pharyngoesophageal repair 23,300 12,600
42955 Pharyngostomy (fistulization of pharynx, external for 8,020 2,520
feeding)
43020 Esophagotomy, cervical approach, w/ removal of 12,120 6,720
foreign body
43030 Cricopharyngeal myotomy 18,000 8,400
43045 Esophagotomy, thoracic approach, w/ removal of 37,800 21,000
foreign body
43100 Excision of lesion, esophagus, w/ primary repair; 23,300 12,600
cervical approach
43101 Excision of lesion, esophagus, w/ primary repair; 37,800 21,000
thoracic or abdominal
approach
Total or near esophagectomy, w/o thoracotomy; w/
pharyngogastrostomy or cervical
43107 esophagogastrostomy, w/ or w/o pyloroplasty 55,000 33,600
(transhiatal)
Total or near esophagectomy, w/o thoracotomy; w/
colon interposition or small bowel reconstruction,
including bowel mobilization, preparation and
43108 anastomosis(es) 58,800 37,800
Total or near total esophagectomy, w/ thoracotomy;

w/
pharyngogastrostomy, or cervical
43112 esophagogastrostomy, w/ or w/o pyloroplasty 59,640 38,640
Total or near total esophagectomy, w/ thoracotomy;

w/ colon interposition
or small bowel reconstruction, including bowel
43113 mobilization, preparation and anastomosis(es) 63,000 42,000
Partial esophagectomy, cervical, w/ free intestinal

graft, including microvascular anastomosis, obtaining
43116 the graft and intestinal reconstruction 55,000 33,600
43117 Partial esophagectomy, distal two-thirds, w/ 55,000 33,600

thoracotomy and separate abdominal incision, w/ or
w/o proximal gastrectomy; w/ thoracic
esophagogastrotomy, w/ or w/o pyloroplasty (Ivor
Lewis)
43118 Partial esophagectomy, distal two-thirds, w/ 58,800 37,800

thoracotomy and separate abdominal incision, w/ or
w/o proximal gastrectomy; w/ colon interposition or
small bowel reconstruction, including bowel
mobilization, preparation,
and anastomosis(ses)
Partial esophagectomy, distal two-thirds, w/

thoracotomy only, w/ or w/o proximal gastrectomy,
w/ thoracic esophagogastrostomy, w/ or w/o
43121 pyloroplasty 55,000 33,600
Partial esophagectomy, thoracoabdominal or

abdominal approach, w/ or w/o proximal
gastrectomy; w/ esophagogastrotomy, w/ or w/o
43122 pyloroplasty 55,000 33,600
43123 Partial esophagectomy, thoracoabdominal or 58,800 37,800

abdominal approach, w/ or w/o proximal
gastrectomy; w/ colon interposition or small bowel
reconstruction, including bowel mobilization,
preparation, and
anastomosis(ses)
43124 Total or partial esophagectomy, w/o reconstruction 46,500 25,200

(any approach), w/
cervical esophagostomy
43130 Diverticulectomy of hypopharynx, or esophagus, w/ or 23,300 12,600
w/o myotomy;
cervical approach
43135 Diverticulectomy of hypopharynx, or esophagus, w/ or 37,800 21,000
w/o myotomy;
thoracic approach
43200 Esophagoscopy, rigid or flexible; diagnostic, w/ or w/o 10,540 5,040
collection of
specimen(s) by brushing or washing
43202 Esophagoscopy, rigid or flexible; w/ biopsy, single or 10,540 5,040
multiple
43204 Esophagoscopy, rigid or flexible; w/ injection sclerosis 14,960 7,560
of esophageal varices
43205 Esophagoscopy, rigid or flexible; w/ band ligation of 14,960 7,560
esophageal varices
43215 Esophagoscopy, rigid or flexible; w/ removal of foreign 14,960 7,560
body
43216 Esophagoscopy, rigid or flexible; w/ removal of 11,980 5,880
tumor(s), polyp(s), or other
lesion(s) by hot biopsy forceps or bipolar cautery
43217 Esophagoscopy, rigid or flexible; w/ removal of 12,120 6,720

tumor(s), polyp(s), or other
lesion(s) by snare technique
43219 Esophagoscopy, rigid or flexible; w/ insertion of plastic 18,000 8,400
tube or stent
43220 Esophagoscopy, rigid or flexible; w/ balloon dilation 18,000 8,400
(less than 30 mm
diameter)
43226 Esophagoscopy, rigid or flexible; w/ insertion of guide 18,000 8,400
wire followed by
dilation over guide wire
43227 Esophagoscopy, rigid or flexible; w/ control of 14,960 7,560
bleeding, any method
Esophagoscopy, rigid or flexible; w/ ablation of
tumor(s) polyp(s), or other lesion(s), not amenable to
removal by hot biopsy forceps, bipolar cautery or
43228 snare technique 18,000 8,400
43234 Upper gastrointestinal endoscopy, simple primary 10,540 5,040

examination ( e.g. w/
small diameter flexible endoscope)
Upper gastrointestinal endoscopy including
esophagus, stomach, and either
the duodenum and/or jejunum as appropriate;
diagnostic, w/ or w/o collection of specimen(s) by
43235 brushing or washing 10,540 5,040

esophagus, stomach, and either the duodenum and/or
43239 jejunum as appropriate; w/ biopsy, single or multiple 10,540 5,040

jejunum as appropriate; w/ transendoscopic tube or
43241 catheter placement 12,120 6,720
43243 Upper gastrointestinal endoscopy including 14,960 7,560

jejunum as appropriate; w/ injection sclerosis of
esophageal and/or gastric varices

jejunum as appropriate; w/ band ligation of
esophageal and/or gastric varices

jejunum as appropriate; w/ dilation of gastric outlet
for obstruction, any method

jejunum as appropriate; w/ directed placement of
percutaneous gastrostomy tube

43247 jejunum as appropriate; w/ removal or foreign body 14,960 7,560
jejunum as appropriate; w/ insertion of guide wire
43248 followed by dilation of esophagus over guide wire 18,000 8,400

jejunum as appropriate; w/ ballon dilation of
esophagus (less than 30 mm diameter)

jejunum as appropriate; w/ removal of tumor(s),
polyp(s), or other lesion(s) by hot biopsy forceps or
bipolar cautery

jejunum as appropriate; w/ removal of tumor(s),
polyp(s), or other lesion(s) by snare technique

esophagus, stomach, and either
the duodenum and/or jejunum as appropriate; w/
43255 control of bleeding, any method 14,960 7,560

jejunum as appropriate; w/ ablation of tumor(s),
polyp(s), or other lesion(s) not amenable to removal
43258 by hot biopsy forceps, bipolar cautery or snare 18,000 8,400
technique

jejunum as appropriate; w/ endoscopic ultrasound
43259 examination 14,960 7,560
43260 Endoscopic retrograde cholangiopancreatography 20,980 10,080

(ERCP); diagnostic, w/ or
w/o collection of specimen(s) by brushing or washing

(ERCP); w/ biopsy, single
or multiple

(ERCP); w/
sphincterotomy/papillotomy
Endoscopic retrograde cholangiopancreatography
(ERCP); w/ pressure measurement of sphincter of Oddi
(pancreatic duct or common bile duct)
43263 21,820 10,920

(ERCP); w/ endoscopic retrograde removal of stone(s)
from biliary and/or pancreatic ducts
43264 23,300 12,600

(ERCP); w/ endoscopic retrograde destruction,
43265 lithotripsy of stone(s), any method 30,740 13,440
(ERCP); w/ endoscopic retrograde insertion of
nasobiliary or nasopancreatic drainage tube
43267 22,660 11,760

(ERCP); w/ endoscopic retrograde insertion of tube or
43268 stent into bile or pancreatic duct 22,660 11,760

(ERCP); w/ endoscopic retrograde removal of foreign
43269 body and/or change of tube or stent 22,660 11,760

(ERCP); w/ endoscopic retrograde balloon dilation of
43271 ampulla, biliary and/or pancreatic duct(s) 23,300 12,600

(ERCP); w/ ablation of tumor(s), polyp(s), or other
lesion(s) not amenable to removal by hot biopsy
forceps, bipolar cautery or snare technique
43280 Laparoscopy, surgical, esophagogastic fundoplasty 46,500 25,200

(e.g., Nissen, Toupet
procedures)
43300 Esophagoplasty, (plastic repair or reconstruction), 30,300 16,800
cervical approach; w/o
repair of tracheoesophageal fistula
cervical approach; w/
thoracic approach; w/o
thoracic approach; w/
43320 Esophagogastrostomy (cardioplasty), w/ or w/o 46,500 25,200
vagotomy and pyloroplasty,
transabdominal or transthoracic approach
43324 Esophagogastric fundoplasty (e.g., Nissen, Belsey IV, 46,500 25,200

Hill procedures)
43325 Esophagogastric fundoplasty; w/ fundic patch (Thal- 46,500 25,200
Nissen procedure)
43326 Esophagogastric fundoplasty; w/ gastroplasty (e.g., 48,600 27,300
Collis)
43330 Esophagomyotomy (Heller type); abdominal approach 37,800 21,000
43331 Esophagomyotomy (Heller type); thoracic approach 46,500 25,200
43340 Esophagojejunostomy (w/o total gastrectomy); 37,800 21,000

abdominal approach
43341 Esophagojejunostomy (w/o total gastrectomy); 46,500 25,200
thoracic approach
43350 Esophagostomy, fistulization of esophagus, external; 23,300 12,600
abdominal approach

thoracic approach
cervical approach
Gastrointestinal reconstruction for previous
esophagectomy, for obstructing esophageal lesion or
fistula, or for previous esophageal exclusion; w/
43360 stomach, w/ or w/o pyloroplasty 58,800 37,800
Gastrointestinal reconstruction for previous
esophagectomy, for obstructing esophageal lesion or
fistula, or for previous esophageal exclusion; w/ colon
interposition or small bowel reconstruction, including
bowel mobilization, preparation, and anastomosis(es)
43361 63,000 42,000
43400 Ligation, direct, esophageal varices 37,800 21,000

43401 Transection of esophagus w/ repair, for esophageal 37,800 21,000
varices
43405 Ligation or stapling at gastroesophageal junction for 37,800 21,000
pre-existing esophageal
perforation
43410 Suture of esophageal wound or injury; cervical 12,120 6,720
approach
43415 Suture of esophageal wound or injury; transthoracic or 37,800 21,000
transabdominal
approach
43420 Closure of esophagostomy or fistula; cervical approach 12,120 6,720
43425 Closure of esophagostomy or fistula; transthoracic or 37,800 21,000

transabdominal
approach
43450 Dilation of esophagus, by unguided sound or bougie, 8,260 3,360
single or multiple
passes
43453 Dilation of esophagus, over guide wire 8,260 3,360
43456 Dilation of esophagus, by balloon or dilator, 8,260 3,360
retrograde
43458 Dilation of esophagus w/ balloon (30 mm diameter or 8,260 3,360
larger) for achalasia
43460 Esophagogastric tamponade, w/ balloon (Sengstaaken 9,700 4,200
type)
43496 Free jejunum transfer w/ microvascular anastomosis 58,800 37,800
43500 Gastrotomy; w/ exploration or foreign body removal 30,300 16,800
43501 Gastrotomy; w/ suture repair of bleeding ulcer 38,020 19,320
43502 Gastrotomy; w/ suture repair of pre-existing 38,020 19,320

esophagogastric laceration
(e.g., Mallory-Weiss)
43510 Gastrotomy; w/ esophageal dilation and insertion of 38,020 19,320
permanent
intraluminal tube (e.g., Celestin or Mousseaux-Barbin)
43520 Pyloromyotomy, cutting of pyloric muscle (Fredet- 38,020 19,320

Ramstedt type operation)
43600 Biopsy of stomach; by capsule, tube, peroral (one or 8,260 3,360
more specimens)
43605 Biopsy of stomach; by laparotomy 30,300 16,800
43610 Excision, local; ulcer or benign tumor of stomach 38,020 19,320
43611 Excision, local; malignant tumor of stomach 38,020 19,320
43620 Gastrectomy, total; w/ esophagoenterostomy 63,000 42,000
43621 Gastrectomy, total; w/ Roux-en-Y reconstruction 67,200 46,200
43622 Gastrectomy, total; w/ formation of intestinal pouch, 67,200 46,200

any type
43631 Gastrectomy, partial, distal; w/ gastroduodenostomy 55,000 33,600
43632 Gastrectomy, partial, distal; w/ gastrojejunostomy 55,000 33,600
43633 Gastrectomy, partial, distal; w/ Roux-en-Y 63,000 42,000

reconstruction
43634 Gastrectomy, partial, distal; w/ formation of intestinal 63,000 42,000
pouch
43638 Gastrectomy, partial, proximal, thoracic or abdominal 63,000 42,000
approach including
esophagogastrostomy, w/ vagotomy;
Gastrectomy, partial, proximal, thoracic or abdominal
approach including esophagogastrostomy, w/
43639 vagotomy; w/ pyloroplasty or pyloromyotomy 67,200 46,200
43640 Vagotomy including pyloroplasty, w/ or w/o 37,800 21,000

gastrostomy; truncal or
selective
43641 Vagotomy including pyloroplasty, w/ or w/o 46,500 25,200
gastrostomy; parietal cell
(highly selective)
43651 Laparoscopy, surgical; transection of vagus nerves, 18,000 8,400
truncal
43652 Laparoscopy, surgical; transection of vagus nerve, 21,940 9,240
selective or highly
selective
43653 Laparoscopy, surgical; gastrostomy, without 18,000 8,400
construction of gastric tube
(e.g., Stamm Procedure)
43750 Percutaneous placement of gastrostomy tube 8,020 2,520
43760 Change of gastrostomy tube 5,560 1,260

43800 Pyloroplasty 37,800 21,000
43810 Gastroduodenostomy 63,000 42,000
43820 Gastrojejunostomy; w/o vagotomy 46,500 25,200
43825 Gastrojejunostomy; w/ vagotomy, any type 53,400 29,400
43830 Gastrostomy, temporary (tube, rubber or plastic) ; 37,800 21,000
43831 Gastrostomy, temporary (tube, rubber or plastic) ; 37,800 21,000

neonatal, for feeding
43832 Gastrostomy, permanent, w/ construction of gastric 37,800 21,000
tube
43840 Gastrorrhaphy, suture of perforated duodenal or 46,500 25,200
gastric ulcer, wound, or
injury
43842 Gastric restrictive procedure, w/o gastric bypass, for 55,000 33,600
morbid obesity;
vertical-banded gastroplasty
43843 Gastric restrictive procedure, w/o gastric bypass, for 58,800 37,800
morbid obesity; other
than vertical-banded gastroplasty
Gastric restrictive procedure, w/ gastric bypass for
morbid obesity; w/ short limb (less than 100 cm)
43846 Roux-en-Y gastroenterostomy 58,800 37,800
43847 Gastric restrictive procedure, w/ gastric bypass for 58,800 37,800

morbid obesity; w/ small
bowel reconstruction to limit absorption
43848 Revision of gastric restrictive procedure for morbid 58,800 37,800
obesity
43850 Revision of gastroduodenal anastomosis 58,800 37,800
(gastroduodenostomy) w/
reconstruction; w/o vagotomy
43855 Revision of gastroduodenal anastomosis 63,000 42,000
(gastroduodenostomy) w/
reconstruction; w/ vagotomy
Revision of gastrojejunal anastomosis
(gastrojejunostomy) w/ reconstruction, w/ or w/o
partial gastrectomy or bowel resection; w/o
43860 vagotomy 58,800 37,800
Revision of gastrojejunal anastomosis
(gastrojejunostomy) w/ reconstruction, w/ or w/o
partial gastrectomy or bowel resection; w/
43865 vagotomy 63,000 42,000
43870 Closure of gastrostomy, surgical 46,500 25,200

43880 Closure of gastrocolic fistula 58,800 37,800
44005 Enterolysis (freeing of intestinal adhesion) 58,800 37,800
44010 Duodenotomy, for exploration, biopsy(s), or foreign 53,400 29,400
body removal
44020 Enterotomy, small bowel, other than duodenum; for 37,800 21,000
exploration, biopsy(s),
or foreign body removal;
Enterotomy, small bowel, other than duodenum; for
exploration, biopsy(s), or foreign body removal; for
44021 decompression (e.g., Baker tube) 37,800 21,000
44025 Colotomy, for exploration, biopsy(s), or foreign body 37,800 21,000

removal
44050 Reduction of volvulus, intussusception, internal 53,400 29,400
hernia, by laparotomy
44055 Correction of malrotation by lysis of duodenal bands 55,000 33,600
and/or reduction of
midgut volvulus (e.g., Ladd procedure)
44100 Biopsy of intestine by capsule, tube, peroral (one or 18,000 8,400
more specimens)
44110 Excision of one or more lessions of small or large 37,800 21,000
bowel not requiring
anastomosis, exteriorization, or fistulization; single
enterotomy
44111 Excision of one or more lessions of small or large 46,500 25,200

bowel not requiring
anastomosis, exteriorization, or fistulization; multiple
enterotomies
44120 Enterectomy, resection of small intestine; single 46,500 25,200

resection and anastomosis
44125 Enterectomy, resection of small intestine; w/ 46,500 25,200
enterostomy
44130 Enteroenterostomy, anastomosis of intestine, w/ or 53,400 29,400
w/o cutaneous
enterostomy
44140 Colectomy, partial; w/ anastomosis 58,800 37,800
44141 Colectomy, partial; w/ skin level cecostomy or 58,800 37,800
colostomy
44143 Colectomy, partial; w/ end colostomy and closure of 58,800 37,800
distal segment
(Hartmann type procedure)
44144 Colectomy, partial; w/ resection, w/ colostomy or 58,800 37,800
ileostomy and creation of
mucofistula
44145 Colectomy, partial; w/ coloproctostomy (low pelvic 56,680 35,280
anastomosis)
44146 Colectomy, partial; w/ coloproctostomy (low pelvic 58,800 37,800
anastomosis), w/
colostomy
44147 Colectomy, partial; abdominal and transanal approach 63,000 42,000
44150 Colectomy, total, abdominal, w/o proctectomy; w/ 63,000 42,000

ileostomy or
ileoproctostomy
continent ileostomy
rectal mucosectomy,
ileoanal anastomosis, w/ or w/o loop ileostomy
Colectomy, total, abdominal, w/o proctectomy; w/
rectal mucosectomy, ileoanal anastomosis, creation of
ileal reservior (S or J), w/ or w/o loop
44153 ileostomy 67,200 46,200
44155 Colectomy, total, abdominal, w/ proctectomy; w/ 67,200 46,200

ileostomy
44156 Colectomy, total, abdominal, w/ proctectomy; w/ 67,200 46,200
continent ileostomy
44160 Colectomy w/ removal of terminal ileum and 67,200 46,200
ileocolostomy
44180 Laparoscopy, surgical, enterolysis (freeing of intestinal 18,000 8,400
adhesion)
44186 Laparoscopy, surgical; jejunostomy (e.g., for 12,120 6,720
decompression or feeding;
44187 Laparoscopy, surgical; jejunostomy (e.g., for 12,120 6,720
decompression or feeding); ileostomy or jejunostomy,
non-tube
44188 Laparoscopy, surgical, colostomy or skin level 18,000 8,400
cecostomy
44202 Laparoscopy, surgical; enterectomy, resection of small 23,300 12,600
intestine, single
44204 Laparoscopy, surgical; colectomy, partial, with 37,800 21,000
anastomosis
removal of terminal ileum
with ileocolostomy
44206 Laparoscopy, surgical; colectomy, partial, with end 37,800 21,000
colostomy and closure of
distal segment (Hartmann type procedure)

anastomosis, with
coloproctostomy (low pelvic anastomosis)
anastomosis, with
coloproctostomy (low pelvic anastomosis) with
colostomy
44210 Laparoscopy, surgical; colectomy, total, abdominal, 55,000 33,600

without protectomy,
with ileostomy or ileoproctostomy
with protectomy, with ileo-anal anastomosis, creation
of ileal reservoir (S or J), with loop ileostomy, with or
without rectal mucosectomy

with protectomy, with
ileostomy
44227 Laparoscopy, surgical; closure of enterostomy, large or 23,300 12,600
small intestine, with
44300 Enterostomy or cecostomy, tube (e.g., for 18,000 8,400
decompression or feeding)
44310 Ileostomy or jejunostomy, non- tube 21,820 10,920
44312 Revision of ileostomy; simple (release of superficial 23,300 12,600
scar)
44314 Revision of ileostomy; complicated (reconstruction in- 21,820 10,920
depth)
44316 Continent ileostomy (Koch procedure) 30,300 16,800
44320 Colostomy or skin level cecostomy; 23,300 12,600
44322 Colostomy or skin level cecostomy; w/ multiple 30,300 16,800
biopsies (e.g., for
Hirschsprung disease)
44340 Revision of colostomy; simple (release of superficial 23,300 12,600
scar)
44345 Revision of colostomy; complicated (reconstruction in 30,300 16,800
- depth )
44346 Revision of colostomy; w/ repair of paracolostomy 30,300 16,800
hernia
Small intestinal endoscopy, enteroscopy, beyond
second portion of
duodenum, not including ileum; diagnostic, w/ or w/o
44360 collection of specimen(s) by brushing or washing 14,960 7,560

second portion of duodenum, not including ileum; w/
44361 biopsy, single or multiple 14,960 7,560

44363 second portion of duodenum, not including ileum; w/ 18,000 8,400
second portion of
duodenum, not including ileum; w/ removal of
44364 tumor(s), polyp(s), or other lesions(s) by snare 18,000 8,400
technique
44365 Small intestinal endoscopy, enteroscopy, beyond 18,000 8,400

removal of tumor(s), polyp(s), or other lesion(s) by hot
biopsy forceps or bipolar cautery


ablation of tumor(s), polyp(s), or other lesion(s) not
amenable to removal by hot biopsy forceps, bipolar
cautery or
snare tenchnique

placement of percutaneous
44372 jejunostomy tube 21,940 9,240

conversion of percutaneous gastrostomy tube to
percutaneous jejunostomy tube
Small intestinal endoscopy, enteroscopy beyond

second portion of duodenum, including ileum;
diagnostic, w/ or w/o collection of specimen(s)
44376 by brushing or washing 18,000 8,400
44377 Small intestinal endoscopy, enteroscopy beyond 18,000 8,400

second portion of
duodenum, including ileum;w/ biopsy, single or
multiple
Small intestinal endoscopy, enteroscopy beyond

second portion of duodenum, including ileum;w/
44380 Ileoscopy, through stoma; diagnostic, w/ or w/o 14,960 7,560

collection of specimen(s) by
brushing or washing
44382 Ileoscopy, through stoma; w/ biopsy, single or 14,960 7,560
multiple
Endoscopic evaluation of small intestinal (abdominal
or pelvic) pouch; diagnostic, w/ or w/o collection of
44385 specimen(s) by brushing or washing 14,960 7,560
44386 Endoscopic evaluation of small intestinal (abdominal 14,960 7,560

or pelvic) pouch; w/
biopsy, single or multiple
44388 Colonoscopy through stoma; diagnostic, w/ or w/o 14,960 7,560
collection of specimen(s)
by brushing or washing
44389 Colonoscopy through stoma; w/ biopsy, single or 14,960 7,560
multiple
44390 Colonoscopy through stoma; w/ removal of foreign 18,000 8,400
body
44391 Colonoscopy through stoma; w/ control of bleeding, 18,000 8,400
any method
44392 Colonoscopy through stoma; w/ removal of tumor(s), 18,000 8,400
polyp(s), or other
lesion(s) by hot biopsy forceps or bipolar cautery
Colonoscopy through stoma; w/ ablation of tumor(s),

by hot biopsy forceps, bipolar caurtery
44393 or snare technique 21,940 9,240
44394 Colonoscopy through stoma; w/ removal of tumor(s), 21,940 9,240

polyp(s), or other
lesion(s) by snare technique
44500 Introduction of long gastrointestinal tube (e.g., Miller- 8,020 2,520
Abbott)
44602 Suture of small intestine (enterorrhaphy) for 37,800 21,000
perforated ulcer, diverticulum,
wound, injury or rupture; single perforation
44603 Suture of small intestine (enterorrhaphy) for 37,800 21,000
perforated ulcer, diverticulum,
wound, injury or rupture; multiple perforation
Suture of large intestine (colorrhaphy) for perforated

ulcer, diverticulum, wound, injury or rupture (single or
44604 multiple perforations); w/o colostomy 37,800 21,000
Suture of large intestine (colorrhaphy) for perforated

ulcer, diverticulum, wound, injury or rupture (single or
44605 multiple perforations); w/ colostomy 37,800 21,000
44615 Intestinal stricturoplasty (enterotomy and 37,800 21,000

enterorrhaphy) w/ or w/o
dilation, for intestinal obstruction
44620 Closure of enterostomy, large or small intestine; 30,300 16,800
44625 Closure of enterostomy, large or small intestine; w/ 30,300 16,800

resection and
anastomosis
44640 Closure of intestinal cutaneous fistula 30,300 16,800
44650 Closure of enteroenteric or enterocolic fistula 30,300 16,800
44660 Closure of enterovesical fistula; w/o intestinal or 37,800 21,000

bladder resection
44661 Closure of enterovesical fistula; w/ bowel and/or 37,800 21,000
bladder resection
44800 Excision of Meckels diverticulum (diverticulectomy) or 18,000 8,400
omphalomesenteric
duct
44820 Excision of lesion of mesentery 18,000 8,400
44850 Suture of mesentery 12,120 6,720
44900 Incision and drainage of appendiceal abscess, 10,540 5,040
transabdominal
44950 Appendectomy; 24,000 9,600
44960 Appendectomy; for ruptured appendix w/ abscess or 24,000 9,600
generalized peritonitis
44970 Laparoscopy, surgical; appendectomy 24,000 9,600
45000 Transrectal drainage of pelvic abscess 30,300 16,800
45005 Incision and drainage of submucosal abscess, rectum 18,000 8,400
45020 Incision and drainage of deep supralevator, pelvirectal, 30,300 16,800
or retrorectal
abscess
45100 Biopsy of anorectal wall, anal approach (e.g., 23,300 12,600
congenital megacolon)
45108 Anorectal myomectomy 30,300 16,800
45110 Proctectomy; complete, combined abdominoperineal, 55,000 33,600
w/ colostomy
45111 Proctectomy; partial resection of rectum, 55,000 33,600
transabdominal approach
45112 Proctectomy, combined abdominoperineal, pull- 55,000 33,600
through procedure (e.g.,
colo-anal anastomosis)
Proctectomy, partial, w/ rectal mucosectomy, ileoanal

anastomosis, creation of ileal reservoir (S or J), w/ or
45113 w/o loop ileostomy 58,800 37,800
45114 Proctectomy, partial, w/ anastomosis; abdominal and 58,800 37,800

transsacral approach
45116 Proctectomy, partial, w/ anastomosis; transsacral 55,000 33,600
approach only (Kraske
type)
Proctectomy, complete (for congenital megacolon),
abdominal and perineal approach; w/ pull-through
procedure and anastomosis (e.g., Swenson,
45120 Duhamel, or Soave type operation) 58,800 37,800
Proctectomy, complete (for congenital megacolon),

abdominal and perineal approach; w/ subtotal or total
45121 colectomy, w/ multiple biopsies 58,800 37,800
45123 Proctectomy, partial, w/o anastomosis, perineal 55,000 33,600

approach
45130 Excision of rectal procidentia, w/ anatomosis; perineal 53,400 29,400
approach
45135 Excision of rectal procidentia, w/ anatomosis; 55,000 33,600
abdominal and perineal
approach
45150 Division of stricture of rectum 12,120 6,720
45160 Excision of rectal tumor by proctotomy, transsacral or 55,000 33,600
transcoccygeal
approach
45170 Excision of rectal tumor, transanal approach 18,000 8,400
45190 Destruction of rectal tumor, any method (e.g., 18,000 8,400

electrodesiccation) transanal
approach
45300 Proctosigmoidoscopy, rigid; diagnostic, w/ or w/o 8,020 2,520
collection of specimen(s)
by brushing or washing
45303 Proctosigmoidoscopy, rigid; w/ dilation, any method 9,700 4,200
45305 Proctosigmoidoscopy, rigid; w/ biopsy, single or 8,020 2,520

multiple
45307 Proctosigmoidoscopy, rigid; w/ removal of foreign 8,260 3,360
body
45308 Proctosigmoidoscopy, rigid; w/ removal of single 9,700 4,200
tumor, polyp, or other
lesion by hot biopsy forceps or bipolar cautery
45309 Proctosigmoidoscopy, rigid; w/ removal of single 9,700 4,200

tumor, polyp, or other
lesion by snare technique
Proctosigmoidoscopy, rigid; w/ removal of multiple
tumors, polyps or other lesions by hot biopsy forceps,
45315 bipolar cautery or snare technique 10,540 5,040
45317 Proctosigmoidoscopy, rigid; w/ control of bleeding, 10,540 5,040
any method
Proctosigmoidoscopy, rigid; w/ ablation of tumor(s),
polyp(s), or other
45320 forceps, bipolar cautery or snare technique (e.g., laser) 10,540 5,040
45321 Proctosigmoidoscopy, rigid; w/ decompression of 10,540 5,040

volvulus
45330 Sigmoidoscopy, flexible; diagnostic, w/ or w/o 8,260 3,360
collection of specimen(s) by
brushing or washing
45331 Sigmoidoscopy, flexible; w/ biopsy, single or multiple 8,260 3,360
45332 Sigmoidoscopy, flexible; w/ removal of foreign body 9,700 4,200
45333 Sigmoidoscopy, flexible; w/ removal of tumor(s), 9,700 4,200

polyp(s), or other lesion(s)
by hot biopsy forceps or bipolar cautery
45334 Sigmoidoscopy, flexible; w/ control of bleeding, any 10,540 5,040
method
45337 Sigmoidoscopy, flexible; w/ decompression of 12,120 6,720
volvulus, any method
45338 Sigmoidoscopy, flexible; w/ removal of tumor(s), 10,540 5,040
polyp(s), or other lesion(s)
by snare technique
Sigmoidoscopy, flexible; w/ ablation of tumor(s),
by hot biopsy forceps, bipolar cautery or snare
45339 technique 11,980 5,880
45355 Colonoscopy, rigid or flexible, transabdominal via 10,540 5,040

colotomy, single or
multiple
Colonoscopy, flexible, proximal to splenic flexure;
diagnostic, w/ or w/o
45378 collection of specimen(s) by brushing or washing, w/ 12,120 6,720
or w/o colon decompression
45379 Colonoscopy, flexible, proximal to splenic flexure; w/ 12,120 6,720

removal of foreign
body
biopsy, single or
multiple
control of bleeding,
any method
ablation of tumor(s), polyp(s), or other lesion(s) not
amenable to removal by hot biopsy forceps, bipolar
cautery or snare technique
Colonoscopy, flexible, proximal to splenic flexure; w/

removal of tumor(s), polyp(s), or other lesion(s) by hot
45384 biopsy forceps or bipolar cautery 14,960 7,560

removal of tumor(s),
polyp(s), or other lesion(s) by snare technique
45395 Laparoscopy, surgical; proctectomy, complete 55,000 33,600

combined abdominoperineal,
with colostomy
45397 Laparoscopy, surgical; protectomy, combined 55,000 33,600
abdominoperineal pull through procedure (e.g., colo-
anal anastomosis), with creation of colonic reservoir
(e.g., J-pouch), with diverting enterostomy, when
performed
45400 Laparoscopy, surgical; proctopexy (for prolapse) 27,120 15,120
45402 Laparoscopy, surgical; proctopexy (for prolapse), with 30,300 16,800

sigmoid resection
45500 Proctoplasty; for stenosis 18,000 8,400
45505 Proctoplasty; for prolapse of mucous membrane 18,000 8,400
45540 Proctopexy for prolapse; abdominal approach 27,120 15,120
45541 Proctopexy for prolapse; perineal approach 27,120 15,120
45550 Proctopexy combined w/ sigmoid resection, 30,300 16,800

abdominal approach
45560 Repair of rectocele 18,000 8,400
45562 Exploration, repair and presacral drainage for rectal 23,300 12,600
injury;
45563 Exploration, repair and presacral drainage for rectal 27,120 15,120
injury; w/ colostomy
45800 Closure of rectovesical fistula; 30,300 16,800
45805 Closure of rectovesical fistula; w/ colostomy 37,800 21,000
45820 Closure of rectourethral fistula; 30,300 16,800

45825 Closure of rectourethral fistula; w/ colostomy 37,800 21,000
45905 Dilation of anal sphincter under anesthesia other than 8,260 3,360
local
45910 Dilation of rectal stricture under anesthesia other 8,260 3,360
than local
45915 Removal of fecal impaction or foreign body under 8,260 3,360
anesthesia
46040 Incision and drainage of ischiorectal and/or perirectal 8,260 3,360
abscess
46045 Incision and drainage of intramural, intramuscular, or 9,700 4,200
submucosal abscess,
transanal, under anesthesia
46050 Incision and drainage, perianal abscess, superficial 8,260 3,360
Incision and drainage of ischiorectal or intramural

abscess, w/ fistulectomy or fistulotomy, submuscular,
46060 w/ or w/o placement of seton 9,700 4,200
46070 Incision, anal septum (infant) 9,700 4,200

46080 Sphincterotomy, anal, division of sphincter 9,700 4,200
46083 Incision of thrombosed hemorrhoid, external 8,020 2,520
46200 Fissurectomy, w/ or w/o sphincterotomy 8,260 3,360

46210 Cryptectomy; single 8,260 3,360
46211 Cryptectomy; multiple 9,700 4,200
46220 Papillectomy or excision of single tag, anus 8,260 3,360
46221 Hemorrhoidectomy, by simple ligature (e.g., rubber 12,120 6,720

band)
46230 Excision of external hemorrhoid tags and/or multiple 12,120 6,720
papillae
46250 Hemorrhoidectomy, external, complete 12,120 6,720
46255 Hemorrhoidectomy, internal and external, simple; 12,120 6,720
46257 Hemorrhoidectomy, internal and external, simple; w/ 12,120 6,720

fissurectomy
46258 Hemorrhoidectomy, internal and external, simple; w/ 12,120 6,720
fistulectomy, w/ or
w/o fissurectomy
46260 Hemorrhoidectomy, internal and external, complex or 12,120 6,720
extensive;
extensive; w/
fissurectomy
extensive; w/
fistulectomy, w/ or w/o fissurectomy
46270 Surgical treatment of anal fistula 12,120 6,720
(fistulectomy/fistulotomy); subcutaneous
(fistulectomy/fistulotomy); submuscular
(fistulectomy/fistulotomy); complex or
multiple, w/ or w/o placement of seton
(fistulectomy/fistulotomy); second stage
46288 Closure of anal fistula w/ rectal advancement flap 18,000 8,400
46320 Enucleation or excision of external thrombotic 12,120 6,720

hemorrhoid
46600 Anoscopy; diagnostic, w/ or w/o collection of 5,680 1,680
specimen(s) by brushing or
washing
46604 Anoscopy; w/ dilation, any method 5,680 1,680
46606 Anoscopy; w/ biopsy, single or multiple 5,680 1,680
46608 Anoscopy; w/ removal of foreign body 5,680 1,680
46610 Anoscopy; w/ removal of single tumor, polyp, or other 8,020 2,520
lesion by hot biopsy
forceps or bipolar cautery
46611 Anoscopy; w/ removal of single tumor, polyp or other 8,260 3,360
lesion by snare
technique
Anoscopy; w/ removal of multiple tumor, polyps, or
other lesions by hot biopsy forceps, bipolar cautery or
46612 snare technique 8,260 3,360
46614 Anoscopy; w/ control of bleeding, any method 8,020 2,520
Anoscopy; w/ ablation of tumor(s), polyp(s), or other

46615 forceps, bipolar cautery or snare technique 9,700 4,200
46700 Anoplasty, plastic operation for stricture; adult 12,900 6,300
46705 Anoplasty, plastic operation for stricture; infant 23,300 12,600
46715 Repair of low imperforate anus; w/ anoperineal fistula 23,300 12,600

("cut-back"
procedure)
46716 Repair of low imperforate anus; w/ transportation of 37,800 21,000
anoperineal or
anovestibular fistula
46730 Repair of high imperforate anus w/o fistula; perineal 37,800 21,000
or sacroperineal
approach
46735 Repair of high imperforate anus w/o fistula; combined 46,500 25,200
transabdominal and
sacroperineal approaches
46740 Repair of high imperforate anus w/ rectourethral or 30,300 16,800
rectovaginal fistula;
perineal or sacroperineal approach
46742 Repair of high imperforate anus w/ rectourethral or 53,400 29,400
rectovaginal fistula;
combined transabdominal and sacroperineal
approaches
46744 Repair of cloacal anomaly by anorectovaginoplasty 58,800 37,800

and urethroplasty,
sacroperineal approach
Repair of cloacal anomaly by anorectovaginoplasty
and urethroplasty, combined abdominal and
46746 sacroperineal approach; 63,000 42,000
46748 Repair of cloacal anomaly by anorectovaginoplasty 63,000 42,000

and urethroplasty, combined abdominal and
sacroperineal approach; w/ vaginal lengthening by
intestinal graft or pedicle flaps
46750 Sphincteroplasty, anal, for incontinence or prolapse; 14,960 7,560

adult
46751 Sphincteroplasty, anal, for incontinence or prolapse; 23,300 12,600
child
46753 Graft (Thiersch operation) for rectal incontinence 9,700 4,200
and/or prolapse
46754 Removal of Thiersch wire or suture, anal canal 8,260 3,360
46760 Sphincteroplasty, anal, for incontinence, adult; muscle 40,320 23,520

transplant
46761 Sphincteroplasty, anal, for incontinence, adult; levator 20,980 10,080
muscle imbrication
(Park posterior anal repair)
46762 Sphincteroplasty, anal, for incontinence, adult; 40,320 23,520
implantation artificial
sphincter
46900 Destruction of lesion(s), anus (e.g., condyloma, 8,260 3,360
papilloma, molluscum
contagiosum, herpetic vesicle), simple; chemical

contagiosum, herpetic vesicle), simple;
electrodesiccation

contagiosum, herpetic vesicle), simple; cryosurgery

contagiosum, herpetic vesicle), simple; laser surgery

contagiosum, herpetic vesicle), simple; surgical
excision

contagiosum, herpetic vesicle), extensive, any method
46934 Destruction of hemorrhoids, any method; internal 9,700 4,200
46935 Destruction of hemorrhoids, any method; external 9,700 4,200
46936 Destruction of hemorrhoids, any method; internal and 9,700 4,200

external
46937 Cryosurgery of rectal tumor; benign 9,700 4,200
46938 Cryosurgery of rectal tumor; malignant 9,700 4,200
46940 Curettage or cauterization of anal fissure, including 9,700 4,200
dilation of anal
sphincter
46945 Ligation of internal hemorrhoids 8,260 3,360
47000 Biopsy of liver, needle; percutaneous 8,020 2,520
47010 Hepatotomy for drainage of abscess or cyst, one or 18,000 8,400
two stages
47015 Laparotomy, w/ aspiration and/or injection of hepatic 18,000 8,400
parasitic (e.g.,
amoebic or echinococcal) cyst(s) or abscess(es)
47100 Biopsy of liver, wedge 18,000 8,400
47120 Hepatectomy, resection of liver; partial lobectomy 53,400 29,400
47122 Hepatectomy, resection of liver; trisegmentectomy 55,000 33,600
47125 Hepatectomy, resection of liver; total left lobectomy 46,500 25,200
47130 Hepatectomy, resection of liver; total right lobectomy 53,400 29,400
47134 Donor hepatectomy, w/ preparation and maintenance 46,500 25,200

of allograft; partial,
from living donor
47135 Liver allotransplantation; orthotopic, partial or whole, 55,000 33,600
from cadaver or living
donor, any age
47136 Liver allotransplantation; heterotopic, partial or 55,000 33,600
whole, from cadaver or
living donor, any age
47300 Marsupialization of cyst or abscess of liver 18,000 8,400
47350 Management of liver hemorrhage; simple suture of 23,300 12,600
liver wound or injury
47360 Management of liver hemorrhage; complex suture of 46,500 25,200
liver wound or injury,
w/ or w/o hepatic artery ligation
Management of liver hemorrhage; exploration of
hepatic wound, extensive debridement, coagulation
47361 and/or suture, w/ or w/o packing of liver 37,800 21,000
47362 Management of liver hemorrhage; re-exploration of 37,800 21,000

hepatic wound for
removal of packing
47370 Laparoscopy, surgical, ablation of one or more liver 18,000 8,400
tumor(s);
radiofrequency
47371 Laparoscopy, surgical, ablation of one or more liver 18,000 8,400
tumor(s); cryosurgical
47380 Ablation, open, of or more liver tumor(s); 9,700 4,200
radiofrequency
47381 Ablation, open, of or more liver tumor(s); cryosurgical 9,700 4,200
47382 Ablation, one or more liver tumor(s), percutaneous 9,700 4,200

radiofrequency
47400 Hepaticotomy or hepaticostomy w/ exploration, 53,400 29,400
calculus
Choledochotomy or choledochostomy w/ exploration,
drainage, or removal
of calculus, w/ or w/o cholecystotomy; w/o
47420 transduodenal sphincterotomy or sphincteroplasty 37,800 21,000
Choledochotomy or choledochostomy w/ exploration,

drainage, or removal of calculus, w/ or w/o
cholecystotomy; w/ transduodenal sphincterotomy or
47425 sphincteroplasty 46,500 25,200
47460 Transduodenal sphincterotomy or sphincteroplasty, 46,500 25,200

w/ or w/o
transduodenal extraction of calculus
47480 Cholecystotomy or cholecystostomy w/ exploration, 30,300 16,800
calculus
47490 Percutaneous cholecystostomy 30,300 16,800
47510 Introduction of percutaneous transhepatic catheter 30,300 16,800
for biliary drainage
47511 Introduction of percutaneous transhepatic stent for 30,300 16,800
internal and external
biliary drainage
47525 Change of percutaneous biliary drainage catheter 8,020 2,520
47530 Revision and/or reinsertion of transhepatic tube 8,260 3,360
47552 Biliary endoscopy, percutaneous via T- tube or other 23,300 12,600

tract; diagnostic, w/ or
w/o collection of specimen(s) by brushing and/or
washing
Biliary endoscopy, percutaneous via T- tube or other

tract; diagnostic, w/ or w/o collection of specimen(s)
by brushing and/or washing w/ biopsy, single
47553 or multiple 23,300 12,600

by brushing and/or washing w/ removal of
47554 stone(s) 23,300 12,600

by brushing and/or washing w/ dilation of
47555 biliary duct stricture(s) w/o stent 23,300 12,600

by brushing and/or washing w/ dilation of
47556 biliary duct stricture(s) w/ stent 23,300 12,600
Laparoscopy, surgical; with guided transhepatic

47560 cholangiography, without biopsy 31,000 12,400
47561 Laparoscopy, surgical; with guided transhepatic 31,000 12,400

cholangiography, with
biopsy
47562 Laparoscopy, surgical; cholecystectomy (any method) 31,000 12,400
47563 Laparoscopy, surgical; cholecystectomy with 31,000 12,400

cholangiography
47564 Laparoscopy, surgical; cholecystectomy with 46,500 25,200
exploration of common duct
47570 Laparoscopy, surgical; cholecystoenterostomy 31,000 12,400
47600 Cholecystectomy; 31,000 12,400

47605 Cholecystectomy; w/ cholangiography 31,000 12,400
47610 Cholecystectomy w/ exploration of common duct; 46,500 25,200
47612 Cholecystectomy w/ exploration of common duct; w/ 53,400 29,400

choledochoenterostomy
Cholecystectomy w/ exploration of common duct; w/

transduodenal sphincterotomy or sphincteroplasty,
47620 w/ or w/o cholangiography 46,500 25,200
47630 Biliary duct stone extraction, percutaneous via T-tube 23,300 12,600
tract, basket, or
snare (e.g., Burhenne technique)
47700 Exploration for congenital atresia of bile ducts, w/o 53,400 29,400
repair, w/ or w/o liver
biopsy, w/ or w/o cholangiography
47701 Portoenterostomy (e.g., Kasai procedure) 55,000 33,600
47711 Excision of bile duct tumor, w/ or w/o primary repair 55,000 33,600
of bile duct;
extrahepatic
47712 Excision of bile duct tumor, w/ or w/o primary repair 58,800 37,800
of bile duct;
intrahepatic
47715 Excision of choledochal cyst 55,000 33,600
47716 Anastomosis, choledochal cyst, w/o excision 46,500 25,200
47720 Cholecystoenterostomy; direct 37,800 21,000

47721 Cholecystoenterostomy; w/ gastroenterostomy 46,500 25,200
47740 Roux-en-Y 53,400 29,400

47741 Roux-en-Y w/ gastroenterostomy 53,400 29,400
47760 Anastomosis, of extrahepatic biliary ducts and 46,500 25,200
gastrointestinal tract
47765 Anastomosis, of intrahepatic ducts and 53,400 29,400
gastrointestinal tract
47780 Anastomosis, Roux-en-Y, of extrahepatic biliary ducts 46,500 25,200
and gastrointestinal
tract
47785 Anastomosis, Roux-en-Y, of intrahepatic biliary ducts 53,400 29,400
and gastrointestinal
tract
47800 Reconstruction, plastic, of extrahepatic biliary ducts 46,500 25,200
w/ end-to-end
anastomosis
47801 Placement of choledochal stent 37,800 21,000
47802 U-tube hepaticoenterostomy 37,800 21,000
47900 Suture of extrahepatic biliary duct for pre-existing 46,500 25,200
injury
48000 Placement of drains, peripancreatic, for acute 23,300 12,600
pancreatitis;
48001 Placement of drains, peripancreatic, for acute 46,500 25,200
pancreatitis; w/
cholecystostomy, gastrostomy, and jejunostomy
48005 Resection or debridement of pancreas and 46,500 25,200

peripancreatic tissue for acute
necrotizing pancreatitis
48020 Removal of pancreatic calculus 37,800 21,000
48100 Biopsy of pancreas, open, any method (e.g., fine 12,120 6,720
needle aspiration, needle
core biopsy, wedge biopsy)
48102 Biopsy of pancreas, percutaneous needle 9,700 4,200
48120 Excision of lesion of pancreas (e.g., cyst, adenoma) 30,300 16,800
48140 Pancreatectomy, distal subtotal, w/ or w/o 46,500 25,200

splenectomy; w/o
pancreaticojejunostomy
48145 Pancreatectomy, distal subtotal, w/ or w/o 53,400 29,400
splenectomy; w/
pancreaticojejunostomy
48146 Pancreatectomy, distal, near-total w/ preservation of 53,400 29,400
duodenum (Child-type
procedure)
48148 Excision of ampulla of Vater 46,500 25,200
48150 Pancreatectomy, proximal subtotal w/ total 58,800 37,800
duodenectomy, partial gastrectomy,
choledochoenterostomy and gastrojejunostomy
(Whipple- type procedure); w/ pancreatojejunostomy
48152 Pancreatectomy, proximal subtotal w/ total 55,000 33,600

duodenectomy, partial gastrectomy,
choledochoenterostomy and gastrojejunostomy
(Whipple- type procedure); w/o
pancreatojejunostomy
Pancreatectomy, proximal subtotal w/ near total

duodenectomy,
choledochoenterostomy and duodenojejunostomy
48153 (pylorus-sparing, Whipple-type procedure); w/ 63,000 42,000
pancreatojejunostomy
Pancreatectomy, proximal subtotal w/ near total
duodenectomy, choledochoenterostomy and
duodenojejunostomy (pylorus-sparing,
48154 Whipple-type procedure); w/o pancreatojejunostomy 58,800 37,800
48155 Pancreatectomy, total 63,000 42,000

48160 Pancreatectomy, total or subtotal, w/ autologous 63,000 42,000
transplantation of
pancreas or pancreatic islets
48180 Pancreaticojejunostomy, side-to-side anastomosis 55,000 33,600
(Puestow-type
operation)
48500 Marsupialization of cyst of pancreas 30,300 16,800
48510 External drainage, psuedocyst of pancreas 23,300 12,600
48520 Internal anastomosis of pacreatic cyst to 46,500 25,200

gastrointestinal tract; direct
48540 Internal anastomosis of pacreatic cyst to 46,500 25,200
gastrointestinal tract; Roux-en-Y
48545 Pancreatorrhaphy for trauma 53,400 29,400
48547 Duodenal exclusion w/ gastrojejunostomy for 53,400 29,400
pancreatic trauma
48550 Donor pancreatectomy, w/ preparation and 30,300 16,800
maintenance of allograft from
cadaver donor, w/ or w/o duodenal segment for
transplantation
48554 Transplantation of pancreatic allograft 30,300 16,800

48556 Removal of transplanted pancreatic allograft 23,300 12,600
49000 Exploratory laparotomy, exploratory celiotomy w/ or 23,300 12,600

w/o biopsy(s)
49010 Exploration, retroperitoneal area w/ or w/o biopsy(s) 23,300 12,600
49020 Drainage of peritoneal abscess or localized peritonitis, 23,300 12,600

exclusive of
appendiceal abscess; open
49021 Drainage of peritoneal abscess or localized peritonitis, 8,260 3,360
exclusive of
appendiceal abscess; percutaneous
49040 Drainage of subdiaphargmatic or subphrenic abscess 23,300 12,600
49060 Drainage of retroperitoneal abscess 23,300 12,600

49080 Peritoneocentesis, abdominal paracentesis, or 8,020 2,520
peritoneal lavage (diagnostic
or therapeutic)
49085 Removal of peritoneal foreign body from peritoneal 23,300 12,600

cavity
49180 Biopsy, abdominal or retroperitoneal mass, 8,260 3,360
percutaneous needle
49200 Excision or destruction by any method of intra- 37,800 21,000
abdominal or retroperitoneal
tumors or cysts or endometriomas;
49201 Excision or destruction by any method of intra- 53,400 29,400
abdominal or retroperitoneal
tumors or cysts or endometriomas; extensive
49215 Excision of presacral or sacrococcygeal tumor 46,500 25,200
Staging celiotomy (laparotomy) for Hodgkins disease

or lymphoma (includes splenectomy, needle or open
biopsies of both liver lobes, possibly also removal of
abdominal nodes, abdominal node and/or bone
49220 marrow biopsies, ovarian repositioning) 23,300 12,600
49250 Umbilectomy, omphalectomy, excision of umbilicus 9,700 4,200
49255 Omentectomy, epiploectomy, resection of omentum 9,700 4,200
Laparoscopy, abdomen, peritoneum, and omentum,

diagnostic, with or without collection of specimen(s)
49320 by brushing or washing 5,680 1,680
49321 Laparoscopy, surgical; with biopsy (single or multiple) 9,700 4,200
49322 Laparoscopy, surgical; with aspiration of cavity or cyst 12,120 6,720

(single or multiple)
49323 Laparoscopy, surgical; with drainage of lymphocele to 8,260 3,360
peritoneal cavity
49420 Insertion of intraperitoneal cannula or catheter for 8,260 3,360
drainage or dialysis
49425 Insertion of peritoneal-venous shunt 18,000 8,400
49495 Repair initial inguinal hernia, under age 6 months, w/ 21,000 8,400
or w/o
hydrocelectomy; reducible
or w/o
hydrocelectomy; incarcerated
or w/o
hydrocelectomy; strangulated
49500 Repair initial inguinal hernia, age 6 months to under 5 21,000 8,400
years, w/ or w/o
hydrocelectomy; reducible
years, w/ or w/o
hydrocelectomy; incarcerated
years, w/ or w/o
hydrocelectomy; strangulated
49505 Repair initial inguinal hernia, age 5 years or over; 21,000 8,400
reducible
incarcerated
strangulated
49520 Repair recurrent inguinal hernia, any age; reducible 21,000 8,400
49521 Repair recurrent inguinal hernia, any age; incarcerated 21,000 8,400
49522 Repair recurrent inguinal hernia, any age; strangulated 21,000 8,400
49525 Repair inguinal hernia, sliding, any age 21,000 8,400

49540 Repair lumbar hernia 21,000 8,400
49550 Repair initial femoral hernia, any age; reducible 21,000 8,400
49553 Repair initial femoral hernia, any age; incarcerated 21,000 8,400
49554 Repair initial femoral hernia, any age; strangulated 21,000 8,400
49555 Repair recurrent femoral hernia; reducible 21,000 8,400

49557 Repair recurrent femoral hernia; incarcerated 21,000 8,400
49558 Repair recurrent femoral hernia; strangulated 21,000 8,400
49560 Repair initial incisional hernia; reducible 21,000 8,400

49561 Repair initial incisional hernia; incarcerated 21,000 8,400
49562 Repair initial incisional hernia; strangulated 21,000 8,400
49565 Repair recurrent incisional hernia; reducible 21,000 8,400

49566 Repair recurrent incisional hernia; incarcerated 21,000 8,400
49567 Repair recurrent incisional hernia; strangulated 21,000 8,400
49570 Repair epigastric hernia (e.g., preperitoneal fat); 21,000 8,400

reducible
incarcerated
strangulated
49580 Repair umbilical hernia, under age 5 years; reducible 21,000 8,400
49582 Repair umbilical hernia, under age 5 years; 21,000 8,400

incarcerated
49583 Repair umbilical hernia, under age 5 years; 21,000 8,400
strangulated
49585 Repair umbilical hernia, age 5 years or over; reducible 21,000 8,400
49587 Repair umbilical hernia, age 5 years or over; 21,000 8,400

incarcerated
49588 Repair umbilical hernia, age 5 years or over; 21,000 8,400
strangulated
49590 Repair spigelian hernia 21,000 8,400
49600 Repair of small omphalocele, w/ primary closure 23,300 12,600
49605 Repair large omphalocele or gastroschisis; w/ or w/o 37,800 21,000

prosthesis
49606 Repair large omphalocele or gastroschisis; w/ removal 30,300 16,800
of prosthesis, final
reduction and closure, in operating room
49610 Repair of omphalocele (Gross type operation); first 23,300 12,600

stage
49611 Repair of omphalocele (Gross type operation); second 30,300 16,800
stage
49650 Laparoscopy, surgical; repair of initial inguinal hernia 21,000 8,400
49651 Laparoscopy, surgical; repair of recurrent inguinal 21,000 8,400

hernia
49900 Suture, secondary, of abdominal wall for evisceration 18,000 8,400
or dehiscence
49905 Omental flap (e.g., for reconstruction of sternal and 23,300 12,600
chest wall defects) (list
separately in addition to code for primary procedure)
49906 Free omental flap w/ microvascular anastomosis 30,300 16,800
50010 Renal exploration, not necessitating other specific 20,980 10,080

procedures
50020 Drainage of perirenal or renal abscess 18,000 8,400
50040 Nephrostomy, nephrotomy w/ drainage 18,000 8,400
50045 Nephrotomy, w/ exploration 18,000 8,400
50060 Nephrolithotomy; removal of calculus 27,120 15,120
50065 Nephrolithotomy; secondary surgical operation for 30,300 16,800
calculus
50070 Nephrolithotomy; complicated by congenital kidney 27,120 15,120
abnormality
50075 Nephrolithotomy; removal of large staghorn calculus 37,800 21,000
filling renal pelvis and
calyces (including anatrophic pyelolithotomy)
Percutaneous nephrostolithotomy or
pyelostolithotomy, w/ or w/o dilation, endoscopy,
50080 lithotripsy, stenting, or basket extraction; up to 2 cm 30,300 16,800
Percutaneous nephrostolithotomy or
pyelostolithotomy, w/ or w/o dilation, endoscopy,
50081 lithotripsy, stenting, or basket extraction; over 2 cm 30,300 16,800
50100 Transection or repositioning of aberrant renal vessels 30,300 16,800
50120 Pyelotomy; w/ exploration 18,000 8,400

50125 Pyelotomy; w/ drainage, pyelostomy 18,000 8,400
50130 Pyelotomy; w/ removal of calculus (pyelolithotomy, 23,300 12,600
pelviolithotomy,
including coagulum pyelolithotomy)
50135 Pyelotomy; complicated (e.g., secondary operation, 31,580 14,280
congenital kidney
abnormality)
50200 Renal biopsy; percutaneous, by trocar or needle 8,020 2,520
50205 Renal biopsy; by surgical exposure of kidney 18,000 8,400
50220 Nephrectomy, including partial ureterectomy, any 27,120 15,120

approach including rib
resection;
Nephrectomy, including partial ureterectomy, any
approach including rib resection; complicated because
50225 of previous surgery on same kidney 30,300 16,800
Nephrectomy, including partial ureterectomy, any

approach including rib
resection; radical, w/ regional lymphadenectomy
50230 and/or vena caval thrombectomy 30,300 16,800
50234 Nephrectomy w/ total ureterectomy and bladder cuff; 30,300 16,800

through same
incision
50236 Nephrectomy w/ total ureterectomy and bladder cuff; 30,300 16,800
through separate
incision
50240 Nephrectomy, partial 27,120 15,120
50250 Ablation, open, one or more renal mass lesion(s), 9,700 4,200
cryosurgical, including
intraoperative ultrasound, if performed
50280 Excision or unroofing of cyst(s) of kidney 20,980 10,080
50290 Excision of perinephric cyst 20,980 10,080
50320 Donor nephrectomy, w/ preparation and maintenance 27,120 15,120
of allograft; from
living donor
50340 Recipient nephrectomy 23,300 12,600
50360 Renal allotransplantation, implantation of graft; 46,500 25,200
excluding donor and
recipient nephrectomy
50365 Renal allotransplantation, implantation of graft; w/ 61,320 40,320
recipient nephrectomy
50370 Removal of transplanted renal allograft 30,300 16,800
50380 Renal autotransplantation, reimplantation of kidney 53,400 29,400
50390 Aspiration and/or injection of renal cyst or pelvis by 5,680 1,680

needle, percutaneous
Instillation of therapeutic agent into renal pelvis
and/or ureter through established nephrostomy,
50391 pyelostomy or ureterostomy tube 9,700 4,200
50392 Introduction of intracatheter or catheter into renal 9,700 4,200

pelvis for drainage
and/or injection, percutaneous
50393 Introduction of ureteral catheter or stent into ureter 9,700 4,200
through renal pelvis
for drainage and/or injection, percutaneous
50395 Introduction of guide into renal pelvis and/or ureter 8,260 3,360
w/ dilation to establish
nephrostomy tract, percutaneous
Pyeloplasty (Foley Y-pyeloplasty), plastic operation on
renal pelvis, w/ or w/o plastic operation on ureter,
nephropexy, nephrostomy, pyelostomy, or
50400 ureteral splinting; simple 30,300 16,800
Pyeloplasty (Foley Y-pyeloplasty), plastic operation on

renal pelvis, w/ or w/o plastic operation on ureter,
nephropexy, nephrostomy, pyelostomy, or ureteral
splinting; complicated (congenital kidney abnormality,
50405 secondary pyeloplasty, solitary kidney, calycoplasty) 37,180 18,480
50500 Nephrorrhaphy, suture of kidney wound or injury 23,300 12,600
50520 Closure of nephrocutaneous or pyelocutaneous fistula 18,000 8,400
50525 Closure of nephrovisceral fistula (e.g., renocolic), 23,300 12,600

including visceral repair;
abdominal approach
50526 Closure of nephrovisceral fistula (e.g., renocolic), 30,300 16,800
including visceral repair;
thoracic approach
Symphysiotomy for horseshoe kidney w/ or w/o
pyeloplasty and/or other plastic procedure, unilateral
50540 or bilateral (one operation) 30,300 16,800
50541 Laparoscopy, surgical; ablation of renal cysts 10,540 5,040
50542 Laparoscopy, surgical; ablation of renal mass lesion(s) 9,700 4,200
50543 Laparoscopy, surgical; partial nephrectomy 30,300 16,800
50544 Laparoscopy, surgical; pyeloplasty 27,120 15,120

Laparoscopy, surgical; radical nephrectomy (includes
removal of Gerotas fascia and surrounding fatty tissue,
removal of regional lymph nodes and
50545 adrenalectomy) 27,120 15,120
50546 Laparoscopy, surgical; nephrectomy, including partial 23,300 12,600

ureterectomy
50547 Laparoscopy, surgical; donor nephrectomy (including 23,300 12,600
cold preservation),
from living donor
50548 Laparoscopy, surgical; nephrectomy with total 30,300 16,800

ureterectomy
Renal endoscopy through established nephrostomy or
pyelostomy, w/ or w/o irrigation, instillation, or
ureteropyelography, exclusive of radiologic
50551 service; 8,692 3,192
50553 Renal endoscopy through established nephrostomy or 8,260 3,360

ureteropyelography, exclusive of radiologic service; w/
ureteral catheterization, w/ or w/o dilation of ureter

ureteropyelography, exclusive of radiologic
50555 service; w/ biopsy 10,880 3,780
pyelostomy, w/ or
w/o irrigation, instillation, or ureteropyelography,
50557 exclusive of radiologic service; w/ fulguration and/or 8,104 2,604
incision, w/ or w/o biopsy

insertion of radioactive substance w/ or w/out biopsy
and/or
fulguration

removal of foreign body or calculus
Renal endoscopy through nephrotomy or pyelotomy,

w/ or w/o irrigation, instillation, or
50570 ureteropyelography, exclusive of radiologic service; 8,260 3,360

w/ or w/o irrigation,
instillation, or ureteropyelography, exclusive of
50572 radiologic service; w/ ureteral catheterization, w/ or 8,260 3,360
w/o dilation of ureter

50574 ureteropyelography, exclusive of radiologic service; w/ 8,260 3,360
biopsy

endopyelotomy (includes cystoscopy, ureteroscopy,
dilation of ureter and ureteral pelvic junction, incision
50575 of ureteral pelvic junction and insertion of 9,700 4,200
endopyelotomy stent)
50576 Renal endoscopy through nephrotomy or pyelotomy, 9,700 4,200

fulguration and/or incision, w/ or w/o biopsy
50578 Renal endoscopy through nephrotomy or pyelotomy, 9,700 4,200

insertion of radioactive substance, w/ or w/o biopsy
and/or fulguration

50580 removal of foreign body or calculus 9,700 4,200
50590 Lithotripsy, extracorporeal shock wave 18,000 8,400

50592 Ablation, one or more renal tumor(s), percutaneous, 9,700 4,200
unilateral frequency
50600 Ureterotomy w/ exploration or drainage 12,120 6,720
50605 Ureterotomy for insertion of indwelling stent, all types 12,120 6,720
50610 Ureterolithotomy; upper one-third of ureter 21,820 10,920
50620 Ureterolithotomy; middle one-third of ureter 20,980 10,080
50630 Ureterolithotomy; lower one-third of ureter 21,820 10,920

50650 Ureterectomy, w/ bladder cuff 21,820 10,920
50660 Ureterectomy, total, ectopic ureter, combination 20,980 10,080
abdominal, vaginal and/or
perineal approach
50700 Ureteroplasty, plastic operation on ureter (e.g., 21,820 10,920
stricture)
50715 Ureterolysis, w/ or w/o repositioning of ureter for 21,820 10,920
retroperitoneal fibrosis
50722 Ureterolysis for ovarian vein syndrome 20,980 10,080
50725 Ureterolysis for retrocaval ureter, w/ reanastomosis of 23,300 12,600
upper urinary tract
or vena cava
50727 Revision of urinary-cutaneous anastomosis (any type 22,660 11,760
urostomy);
50728 Revision of urinary-cutaneous anastomosis (any type 22,660 11,760
urostomy); w/ repair
of fascial defect and hernia
50740 Ureteropyelostomy, anastomosis of ureter and renal 23,300 12,600

pelvis
50750 Ureterocalycostomy, anastomosis of ureter to renal 27,120 15,120
calyx
50760 Ureteroureterostomy 21,820 10,920
50770 Transureteroureterostomy, anastomosis of ureter to 27,120 15,120
contralateral ureter
50780 Ureteroneocystostomy; anastomosis of single ureter 27,120 15,120
to bladder
50782 Ureteroneocystostomy; anastomosis of duplicated 30,300 16,800
ureter to bladder
50783 Ureteroneocystostomy; w/ extensive ureteral tailoring 37,800 21,000
50785 Ureteroneocystostomy; w/ vesico-psoas hitch or 30,300 16,800

bladder flap
50800 Ureteroenterostomy, direct anastomosis of ureter to 30,740 13,440
intestine
Ureterosigmoidostomy, w/ creation of sigmoid
bladder and establishment of abdominal or perineal
50810 colostomy, including bowel anastomosis 37,800 21,000
50815 Ureterocolon conduit, including bowel anastomosis 37,800 21,000
50820 Ureteroileal conduit (ileal bladder), including bowel 40,320 23,520

anastomosis (Bricker
operation)
50825 Continent diversion, including bowel anastomosis 46,500 25,200
using any segment of
small and/or large bowel (Kock pouch or Camey
enterocystoplasty
Urinary undiversion (e.g., taking down of ureteroileal

conduit,
ureterosigmoidostomy or ureteroenterostomy w/
50830 ureteroureterostomy or ureteroneocystostomy) 37,800 21,000
50840 Replacement of all or part of ureter by bowel 37,800 21,000

segment, including bowel
anastomosis
50845 Cutaneous appendico-vesicostomy 30,300 16,800
50860 Ureterostomy, transplantation of ureter to skin 20,980 10,080
50900 Ureterorrhaphy, suture of ureter 18,000 8,400

50920 Closure of ureterocutaneous fistula 20,980 10,080
50930 Closure of ureterovisceral fistula (including visceral 23,300 12,600
repair)
50940 Deligation of ureter 21,820 10,920
50945 Laparoscopy, surgical; ureterolithotomy 21,940 9,240
50947 Laparoscopy, surgical; ureteroneocystostomy with 23,300 12,600
cystoscopy and ureteral
stent placement
50948 Laparoscopy, surgical; ureteroneocystostomy without 23,300 12,600

cystoscopy and
ureteral stent placement
Ureteral endoscopy through established

ureterostomy, w/ or w/o irrigation, instillation, or
50951 ureteropyelography, exclusive of radiologic service; 8,260 3,360

50953 ureteral catheterization, w/ or w/o dilation of ureter 8,260 3,360

50955 ureteropyelography, exclusive of radiologic service; w/ 8,260 3,360
biopsy
50957 Ureteral endoscopy through established 10,880 3,780

fulguration and/or incision, w/ or w/o biopsy

insertion of radioactive substance, w/ or w/o biopsy
50959 and/or fulguration (not including provision of 9,700 4,200
material)

50961 removal of foreign body or calculus 11,980 5,880
Ureteral endoscopy through ureterotomy, w/ or w/o

irrigation, instillation, or ureteropyelography, exclusive
50970 of radiologic service; 8,260 3,360
Ureteral endoscopy through ureterostomy, w/ or w/o

of radiologic service; w/ ureteral catheterization, w/
50972 or w/o dilation of ureter 8,260 3,360

50974 of radiologic service; w/ biopsy 8,260 3,360

of radiologic service; w/ fulguration
50976 and/or incision, w/ or w/o biopsy 10,880 3,780

of radiologic service; w/ insertion of radioactive
substance, w/ or w/o biopsy and/or fulguration (not
including
50978 provision of material) 9,700 4,200
of radiologic service; w/ removal of foreign body or
50980 calculus 11,980 5,880
51010 Aspiration of bladder; by trocar or intracatheter w/ 5,680 1,680

insertion of suprapubic
catheter
51020 Cystotomy or cystostomy; w/ fulguration and/or 9,700 4,200
insertion of radioactive
material
51030 Cystotomy or cystostomy; w/ cryosurgical destruction 9,700 4,200
of intravesical lesion
51040 Cystostomy, cystotomy w/ drainage 9,700 4,200
51045 Cystotomy, w/ insertion of ureteral catheter or stent 10,540 5,040
51050 Cystolithotomy, cystotomy w/ removal of calculus, 12,540 7,140

w/o vesical neck
resection
51060 Transvesical ureterolithotomy 21,820 10,920
51065 Cystotomy, w/ stone basket extraction and/or 21,820 10,920
ultrasonic or electrohydraulic
fragmentation of ureteral calculus
51080 Drainage of perivesical or prevesical space abscess 10,540 5,040
51500 Excision of urachal cyst or sinus, w/ or w/o umbilical 30,300 16,800

hernia repair
51520 Cystotomy; for simple excision of vesical neck 20,980 10,080
51525 Cystotomy; for excision of bladder diverticulum, single 27,120 15,120

or multiple
51530 Cystotomy; for excision of bladder tumor 27,120 15,120
51535 Cystotomy for excision, incision, or repair of 23,300 12,600
ureterocele
51550 Cystectomy, partial 30,740 13,440
51555 Cystectomy, complicated (e.g., postradiation, previous 37,800 21,000
surgery, difficult
location)
51565 Cystectomy, partial, w/ reimplantation of ureter(s) 30,300 16,800
into bladder
(ureteroneocystostomy)
51570 Cystectomy, complete; 37,800 21,000
51575 Cystectomy, complete; w/ bilateral pelvic 46,500 25,200
lymphadenectomy, including
external iliac, hypogastric, and obturator nodes
51580 Cystectomy, complete, w/ ureterosigmoidostomy or 40,320 23,520

ureterocutaneous
transplantations;
Cystectomy, complete, w/ ureterosigmoidostomy or

ureterocutaneous
transplantations; w/ bilateral pelvic
51585 lymphadenectomy, including external iliac, 53,400 29,400
hypogastric, and obturator nodes
51590 Cystectomy, complete, w/ ureteroileal conduit or 55,920 31,920

sigmoid bladder, including
bowel anastomosis;
51595 Cystectomy, complete, w/ ureteroileal conduit or 55,840 34,440
sigmoid bladder, including bowel anastomosis; w/
bilateral pelvic lymphadenectomy, including external
iliac, hypogastric, and obturator nodes
Cystectomy, complete, w/ continent diversion, any

technique, using any segment of small and/or large
51596 bowel to construct neobladder 58,800 37,800
Pelvic exenteration, complete, for vesical, prostatic or
urethral malignancy, w/ removal of bladder and
ureteral transplantations, w/ or w/o hysterectomy
and/or abdominoperineal resection of rectum and
51597 colon and colostomy, or any combination thereof 71,400 50,400
51600 Injection procedure for cystography or voiding 8,020 2,520

urethrocystography
51720 Bladder instillation of anticarcinogenic agent 8,020 2,520
51800 Cystoplasty or cystourethroplasty, plastic operation on 20,980 10,080

bladder and/or vesical neck (anterior Y-plasty, vesical
fundus resection), any procedure, w/ or w/o wedge
resection of posterior vesical neck
51820 Cystourethroplasty w/ unilateral or bilateral 27,120 15,120

ureteroneocystostomy
51840 Anterior vesicourethropexy, or urethropexy (Marshall- 20,980 10,080
Marchetti-Krantz
type)
51841 Anterior vesicourethropexy, or urethropexy (Marshall- 30,740 13,440
Marchetti-Krantz
type) complicated (e.g., secondary repair)
51845 Abdomino-vaginal vesical neck suspension, w/ or w/o 20,980 10,080
endoscopic control
(e.g., Stamey, Raz, modified Pereyra)
51860 Cystorrhaphy, suture of bladder wound, injury or 12,120 6,720
rupture
51880 Closure of cystostomy 10,880 3,780
51900 Closure of vesicovaginal fistula, abdominal approach 23,300 12,600
51920 Closure of vesicouterine fistula; 23,300 12,600

51925 Closure of vesicouterine fistula; w/ hysterectomy 30,300 16,800
51940 Closure of bladder exstrophy 30,300 16,800

51960 Enterocystoplasty, including bowel anastomosis 30,740 13,440
51980 Cutaneous vesicostomy 12,120 6,720

51990 Laparoscopy, surgical; urethral suspension for stress 30,300 16,800
incontinence
51992 Laparoscopy, surgical; sling operation for stress 30,300 16,800
incontinence (e.g., fascia or
synthetic)
52000 Cystourethroscopy 8,260 3,360
Cystourethroscopy, w/ ureteral catheterization, w/ or
w/o irrigation, instillation, or ureteropyelography,
52005 exclusive of radiologic service; 9,700 4,200
Cystourethroscopy, w/ ureteral catheterization, w/ or

w/o irrigation,
instillation, or ureteropyelography, exclusive of
52007 radiologic service; w/ brush biopsy of ureter and/or 8,260 3,360
renal pelvis
Cystourethroscopy, w/ ejaculatory duct

catheterization, w/ or w/o irrigation, instillation, or
52010 duct radiography, exclusive of radiologic service 8,260 3,360
52204 Cystourethroscopy, w/ biopsy 10,540 5,040

Cystourethroscopy, w/ fulguration (including
cryosurgery or laser surgery) of trigone, bladder neck,
52214 prostatic fossa, urethra, or periurethral glands 11,980 5,880

cryosurgery or laser surgery) or treatment of MINOR
52224 (less than 0.5 cm) lesion(s) w/ or w/o biopsy 11,980 5,880
cryosurgery or laser surgery) and/or resection of;
52234 SMALL bladder tumor(s) (0.5 cm to 2.0 cm) 20,980 10,080

cryosurgery or laser surgery) and/or resection of
52235 MEDIUM bladder tumor(s) (2.0 to 5.0 cm) 22,240 11,340
52240 Cystourethroscopy, w/ fulguration (including 23,300 12,600

cryosurgery or laser surgery) and/or resection of
LARGE bladder tumor(s)
52250 Cystourethroscopy w/ insertionof radioactive 30,740 13,440

substance, w/ or w/o biopsy
or fulguration
52260 Cystourethroscopy, w/ dilation of bladder for 11,980 5,880
interstitial cystitis; general or
conduction (spinal) anesthesia
52265 Cystourethroscopy, w/ dilation of bladder for 8,020 2,520
interstitial cystitis; local
anesthesia
52270 Cystourethroscopy, w/ internal urethrotomy; female 12,900 6,300
52275 Cystourethroscopy, w/ internal urethrotomy; male 12,900 6,300
52276 Cystourethroscopy w/ direct vision internal 12,540 7,140

urethrotomy
52277 Cystourethroscopy, w/ resection of external sphincter 12,120 6,720
(sphincterotomy)
Cystourethroscopy, w/ calibration and/or dilation of
urethral stricture or stenosis, w/ or w/o meatotomy
and injection procedure for cystography,
52281 male or female 8,020 2,520
52283 Cystourethroscopy, w/ steroid injection into stricture 8,020 2,520
Cystourethroscopy, for treatment of the female

urethral syndrome w/ any or all of the following:
urethral meatotomy, urethral dilation, internal
urethrotomy, lysis of urethrovaginal septal fibrosis,
lateral incisions of the bladder neck, and fulguration of
52285 polyp(s) of urethra, bladder neck, and/or 10,540 5,040
trigone
52290 Cystourethroscopy; w/ ureteral meatotomy, unilateral 11,980 5,880

or bilateral
52300 Cystourethroscopy; w/ resection or fulguration of 21,940 9,240
orthotopic ureterocele(s),
unilateral or bilateral
52301 Cystourethroscopy; w/ resection or fulguration of 21,940 9,240
ectopic ureterocele(s),
52305 Cystourethroscopy; w/ incision or resection of orifice 12,120 6,720
of bladder
diverticulum, single or multiple
52310 Cystourethroscopy, w/ removal of foreign body, 10,540 5,040
calculus, or ureteral stent
from urethra or bladder
52317 Litholapaxy: crushing or fragmentation of calculus by 18,000 8,400
any means in bladder
and removal of fragments; simple or small (less than
2.5 cm)
52318 Litholapaxy: crushing or fragmentation of calculus by 21,940 9,240

any means in bladder
and removal of fragments; complicated or large (over
2.5 cm)
52320 Cystourethroscopy (including ureteral 11,980 5,880

catheterization); w/ removal of
ureteral calculus
Cystourethroscopy (including ureteral
catheterization); w/ fragmentation of ureteral calculus
52325 (e.g., ultrasonic or electro-hydraulic technique) 18,000 8,400

catheterization); w/ subureteric
injection of implant material
catheterization); w/ manipulation,
w/o removal of ureteral calculus
52332 Cystourethroscopy, w/ insertion of indwelling ureteral 10,540 5,040
stent (e.g., Gibbons
or double-J type)
52334 Cystourethroscopy w/ insertion of ureteral guide wire 9,700 4,200
through kidney to
establish a percutaneous nephrostomy, retrograde
Cystourethroscopy, w/ ureteroscopy and/or

pyeloscopy (includes dilation of the ureter and/or
52335 pyeloureteral junction by any method); 12,120 6,720
52336 Cystourethroscopy, w/ ureteroscopy and/or 12,120 6,720

pyeloureteral junction by any method); w/ removal or
manipulation of calculus (ureteral catheterization is
included)

pyeloureteral junction by any method); w/ lithotripsy
52337 (ureteral catheterization is included) 21,940 9,240

pyeloureteral junction by any method); w/ biopsy
52338 and/or fulguration of lesion 21,940 9,240

pyeloscopy (includes dilation
52339 of the ureter and/or pyeloureteral junction by any 12,120 6,720
method); w/ resection of tumor
Cystourethroscopy w/ incision, fulguration, or

resection of congenital posterior urethral valves, or
congenital obstructive hypertrophic mucosal
52340 folds 21,940 9,240
52450 Transurethral incision of prostate 23,300 12,600

52500 Transurethral resection of bladder neck 23,300 12,600
52510 Transurethral balloon dilation of the prostatic urethra, 12,120 6,720
any method
52601 Transurethral electrosurgical resection of prostate, 37,800 21,000
including control of postoperative bleeding, complete
(vasectomy, meatomy, cystourethroscopy, urethral
calibration and/or dilation, and internal
urethrotomy are included)
52606 Transurethral fulguration for postoperative bleeding 18,000 8,400

occuring after the
usual follow-up time
52612 Transurethral resection of prostate; first stage of two- 21,940 9,240
stage resection
(partial resection)
52614 Transurethral resection of prostate; second stage of 21,940 9,240
two-stage resection
(resection completed)
52620 Transurethral resection; of residual obstructive tissue 20,980 10,080
after 90 days
postoperative
52630 Transurethral resection; of regrowth of obstructive 37,800 21,000
tissue longer than one
year postoperative
52640 Transurethral resection; of postoperative bladder neck 20,980 10,080
contracture
52647 Non-contact laser coagulation of prostate, including 27,120 15,120
control of postoperative bleeding, complete
(vasectomy, meatotomy, cystourethroscopy, urethral
calibration and/or dilation, and internal
urethrotomy are included)
52648 Contact laser vaporization w/ or w/o transurethral 27,120 15,120

resection of prostate, including control of
postoperative bleeding, complete (vasectomy,
meatotomy, cystourethroscopy, urethral calibration
and/or dilation, and
internal urethrotomy are included)
52649 High intensity focused ultrasound (HIFU) of the 37,800 21,000

prostate including
transurethral resection of the prostate (TURP)
52700 Transurethral drainage of prostatic abscess 18,000 8,400
53000 Urethrotomy or urethrostomy, external ; pendulous 5,680 1,680

urethra
53010 Urethrotomy or urethrostomy, external ; perineal 8,260 3,360
urethra, external
53020 Meatotomy, cutting of meatus ; except infant 5,560 1,260
53025 Meatotomy, cutting of meatus ; infant 8,260 3,360

53040 Drainage of deep periurethral abscess 9,300 2,100
53060 Drainage of Skenes gland abscess or cyst 5,560 1,260
53080 Drainage of perineal urinary extravasation 8,020 2,520
53200 Biopsy of urethra 5,560 1,260
53210 Urethrectomy, total, including cystostomy; female 21,940 9,240
53215 Urethrectomy, total, including cystostomy; male 21,820 10,920
53220 Excision of fulguration of carcinoma of urethra 9,700 4,200
53230 Excision of urethral diverticulum ; female 18,000 8,400

53235 Excision of urethral diverticulum ; male 14,960 7,560
53240 Marsupialization of urethral diverticulum, male or 9,300 2,100
female
53250 Excision of bulbourethral gland (Cowpers gland) 12,120 6,720
53260 Excision or fulguration; urethral polyp(s), distal urethra 5,560 1,260
53265 Excision or fulguration; urethral caruncle 5,560 1,260

53270 Skene's glands 5,560 1,260
53275 Skene's glands urethral prolapse 9,300 2,100
53400 Urethroplasty; first stage, for fistula, diverticulum, or 30,300 16,800
stricture (e.g.,
Johannsen type)
53405 Urethroplasty; second stage (formation of urethra), 27,120 15,120
including urinary
diversion
53410 Urethroplasty, one-stage reconstruction of male 14,960 7,560
anterior urethra
53415 Urethroplasty, transpubic or perineal, one stage, for 40,320 23,520
reconstruction or
repair of prostatic or membranous urethra
53420 Urethroplasty, two-stage reconstruction or repair of 37,800 21,000
prostatic or
membranous urethra; first stage
53425 Urethroplasty, two-stage reconstruction or repair of 27,120 15,120
prostatic or
membranous urethra; second stage
53430 Urethroplasty, reconstruction of female urethra 18,000 8,400
53440 Operation for correction of male urinary incontinence, 18,000 8,400

w/ or w/o
introduction of prosthesis
53442 Removal of perineal prosthesis introduced for 18,000 8,400
continence
53443 Urethroplasty w/ tubularization of posterior urethra 31,140 17,640
and/or lower bladder
for incontinence (e.g., Tenago, Leadbetter procedure)
Operation for correction of urinary incontinence w/

placement of inflatable
urethral or bladder neck sphincter, including
53445 placement of pump and/or reservoir 37,180 18,480
53447 Removal, repair, or replacement of inflatable 40,320 23,520

sphincter including pump
and/or reservoir and/or cuff
53449 Surgical correction of hydraulic abnormality of 18,000 8,400
inflatable sphincter device
53450 Urethromeatoplasty, w/ mucosal advancement 8,260 3,360
53460 Urethromeatoplasty, w/ partial excision of distal 8,260 3,360

urethral segment
(Richardson type procedure)
53502 Urethrorrhaphy, suture of urethral wound or injury, 9,700 4,200
female
53505 Urethrorrhaphy, suture of urethral wound or injury; 9,700 4,200
penile
perineal
prostatomembranous
53520 Closure of urethrostomy or urethrocutaneous fistula, 8,020 2,520
male
53600 Dilation of urethral stricture by passage of sound or 5,680 1,680
urethral dilator, male
53605 Dilation of urethral stricture or vesical neck, male, 5,680 1,680
general or conduction
(spinal) anesthesia
53665 Dilation of female urethra, general or conduction 5,680 1,680
(spinal) anesthesia
Transurethral destruction of prostate tissue; by
microwave thermotherapy
53850 i.e. Transurethral Microwave Thermotherapy (TUMT) 37,800 21,000
Transurethral destruction of prostate tissue; by

radiofrequncy ablation i.e., Transurethral Needle
Ablation (TUNA), transurethral laser incision of the
53852 prostate (TULIP) 37,800 21,000
54015 Incision and drainage of penis 3,640 840

54050 Destruction of lesion(s), penis (e.g., condyloma, 3,640 840
contagiosum, herpetic vesicle), any method
54100 Biopsy of penis 3,504 504

54110 Excision of penile plaque (Peyronie disease); 9,300 2,100
54111 Excision of penile plaque (Peyronie disease); w/ graft 10,540 5,040

to 5 cm in length
54112 Excision of penile plaque (Peyronie disease); w/ graft 11,980 5,880
greater than 5 cm in
length
Removal of foreign body from deep penile tissue (e.g.,
54115 plastic implant) 8,260 3,360
54120 Amputation of penis; partial 10,540 5,040
54125 Amputation of penis; complete 21,400 10,500
54130 Amputation of penis, radical; w/ bilateral 37,800 21,000
inguinofemoral lymphadenectomy
Amputation of penis, radical; in continuity w/ bilateral
pelvic lymphadenectomy, including external iliac,
54135 hypogastric and obturator nodes 46,500 25,200
54150 Circumcision, using clamp or other device; newborn 1,260 840
54152 Circumcision, using clamp or other device; except 1,260 840

newborn
54160 Circumcision, surgical excision other than clamp, 1,260 840
device or dorsal slit;
newborn
54161 Circumcision, surgical excision other than clamp, 1,260 840
device or dorsal slit; except
newborn
54200 Injection procedure for Peyronie disease; 5,560 1,260
54205 Injection procedure for Peyronie disease;w/ surgical 5,680 1,680
exposure of plaque
54220 Irrigation of corpora cavernosa for priapism 8,020 2,520
54300 Plastic operation of penis for straightening of chordee 9,700 4,200

(e.g., hypospadias),
w/ or w/o mobilization of urethra
Plastic operation on penis for correction of chordee or
for first stage hypospadias repair w/ or w/o
54304 transplantation of prepuce and/or skin flaps 14,960 7,560
54308 Urethroplasty for second stage hypospadias repair 23,300 12,600

(including urinary
diversion); less than 3 cm
(including urinary
diversion); greater than 3 cm
(including urinary
diversion) w/ free skin graft obtained from site other
than genitalia
54318 Urethroplasty for third stage hypospadias repair to 12,120 6,720

release penis from
scrotum (e.g., third stage Cecil repair)
54322 One stage distal hypospadias repair (w/ or w/o 27,120 15,120
chordee or circumcision); w/
simple meatal advancement (e.g., Magpi, V-flap)
One stage distal hypospadias repair (w/ or w/o

chordee or circumcision); w/ urethroplasty by local
54324 skin flaps (e.g., flip-flap, prepucial flap) 27,120 15,120

chordee or circumcision); w/ urethroplasty by local
54326 skin flaps and mobilization of urethra 27,120 15,120

chordee or circumcision); w/ extensive dissection to
correct chordee and urethroplasty w/ local skin
54328 flaps, skin graft patch, and/or island flap 30,300 16,800
One stage proximal penile or penoscrotal hypospadias

repair requiring extensive dissection to correct
chordee and urethroplasty by use of skin
54332 graft tube and/or island flap 37,180 18,480
One stage perineal hypospadias repair requiring
extensive dissection to correct chordee and
urethroplasty by use of skin graft tube and/or island
54336 flap 37,180 18,480
54340 Repair of hypospadias complications (ie, fistula, 37,180 18,480

stricture, diverticula); by
closure, incision, or excision, simple
Repair of hypospadias complications (ie, fistula,
stricture, diverticula); requiring mobilization of skin
54344 flaps and urethroplasty w/ flap or patch graft 18,000 8,400
Repair of hypospadias complications (ie, fistula,

stricture, diverticula); requiring extensive dissection
and urethroplasty w/ flap, patch or tubed
54348 graft (includes urinary diversion) 20,980 10,080
Repair of hypospadias cripple requiring extensive

dissection and excision of previously constructed
structures including re-release of chordee and
reconstruction of urethra and penis by use of local skin
54352 as grafts and island flaps and skin brought in as flaps or 37,800 21,000
grafts
54380 Plastic operation on penis for epispadias distal to 30,300 16,800

external sphincter;
external sphincter;w/
incontinence
external sphincter;w/
exstrophy of bladder
54420 Corpora cavernosa-saphenous vein shunt (priapism 12,120 6,720
operation), unilateral or
bilateral
54430 Corpora cavernosa-corpus spongiosum shunt 12,120 6,720
(priapism operation),
54435 Corpora cavernosa-glans penis fistulization (e.g., 8,260 3,360
biopsy needle, Winter
procedure, rongeur, or punch) for priapism
54440 Plastic operation of penis for injury 12,120 6,720

54500 Biopsy of testis, needle 3,504 504
54505 Biopsy of testis, incisional 5,680 1,680
54510 Excision of local lesion of testis 5,680 1,680
54520 Orchiectomy, simple (including subcapsular), w/ or 10,540 5,040
w/o testicular
prosthesis, scrotal or inguinal approach
54530 Orchiectomy, radical, for tumor; inguinal approach 10,960 5,460
54535 Orchiectomy, radical, for tumor; w/ abdominal 12,540 7,140

exploration
54550 Exploration for undescended testis (inguinal or scrotal 10,540 5,040
area)
54560 Exploration for undescended testis w/ abdominal 12,540 7,140
exploration
54600 Reduction of torsion of testis, surgical, w/ or w/o 10,960 5,460
fixation of contralateral
testis
54620 Fixation of contralateral testis 9,300 2,100
54640 Orchiopexy, inguinal approach, w/ or w/o hernia 10,540 5,040
repair
54650 Orchiopexy, abdominal approach, for intra-abdominal 12,540 7,140
testis (e.g., Fowler-
Stephens)
54670 Suture or repair of testicular injury 9,700 4,200
54680 Transplantation of testis(es) to thigh (because of 8,260 3,360
scrotal destruction)
54690 Laparoscopy, surgical; orchiectomy 9,700 4,200
54692 Laparoscopy, surgical; orchiopexy for intra-abdominal 11,980 5,880
testis
54700 Incision and drainage of epididymis, testis and/or 4,108 1,008
scrotal space (e.g.,
abscess or hematoma)
54800 Biopsy of epididymis, needle 3,504 504
54820 Exploration of epididymis, w/ or w/o biopsy 9,300 2,100
54830 Excision of local lesion of epidydimis 5,680 1,680
54840 Excision of spermatocele, w/ or w/o epididymectomy 8,020 2,520
54860 Epididymectomy; unilateral 9,300 2,100

54861 Epididymectomy; bilateral 8,440 2,940
54900 Epididymovasostomy, anastomosis of epididymis to 10,540 5,040
vas deferens; unilateral
54901 Epididymovasostomy, anastomosis of epididymis to 18,000 8,400
vas deferens; bilateral
55000 Puncture aspiration of hydrocele, tunica vaginalis, w/ 3,504 504
or w/o injection of
medication
55040 Excision of hydrocele; unilateral 9,700 4,200
55041 Excision of hydrocele; bilateral 18,000 8,400
55060 Repair of tunica vaginalis hydrocele (Bottle type) 9,700 4,200
55100 Drainage of scrotal wall abscess 3,504 504

55101 Drainage and debridement of Fourniers gangrene of 9,300 2,100
the scrotum
55110 Scrotal exploration 9,300 2,100
55120 Removal of foreign body in scrotum 4,108 1,008
55150 Resection of scrotum 5,560 1,260
55175 Scrotoplasty 5,680 1,680
55200 Vasotomy, cannulization w/ or w/o incision of vas, 5,680 1,680
55250 Vasectomy, unilateral or bilateral 4,000 1,000
55400 Vasovasostomy, vasovasorrhaphy 10,540 5,040
55500 Excision of hydrocele of spermatic cord, unilateral 9,700 4,200
55520 Excision of lesion of spermatic cord 8,260 3,360

55530 Excision of varicocele or ligation of spermatic veins for 12,900 6,300
varicocele;
varicocele;
abdominal approach
varicocele; w/ hernia
repair
55550 Laparoscopy, surgical; with ligation of spermatic veins 14,960 7,560
for varicocele
55600 Vesiculotomy; 10,120 4,620
55650 Vesiculectomy, any approach 18,000 8,400
55680 Excision of Mullerian duct cyst 18,000 8,400
55700 Biopsy, prostate; needle or punch, single or multiple, 9,300 2,100
any approach
55720 Prostatotomy, external drainage of prostatic abscess, 5,680 1,680
any approach
Prostatectomy, perineal, subtotal (including control of
postoperative bleeding, vasectomy, meatotomy,
urethral calibration and/or dilation, and
55801 internal urethrotomy) 38,860 20,160
55810 Prostatectomy, perineal radical; 46,500 25,200

55812 Prostatectomy, perineal radical; w/ lymph node 48,180 26,880
biopsy(s) (limited pelvic
lymphadenectomy)
Prostatectomy, perineal radical; w/ bilateral pelvic
lymphadenectomy, including external iliac,
55815 hypogastric and obturator nodes 48,180 26,880
Prostatectomy (including control of postoperative

bleeding, vasectomy,
meatotomy, urethral calibration and/or dilation, and
55821 internal urethrotomy); suprapubic, subtotal, one or 38,860 20,160
two stages
Prostatectomy (including control of postoperative

bleeding, vasectomy,
meatotomy, urethral calibration and/or dilation, and
55831 internal urethrotomy); retropubic, subtotal 30,300 16,800
55840 Prostatectomy, retropubic radical, w/ or w/o nerve 46,500 25,200

sparing;
55842 Prostatectomy, retropubic radical, w/ or w/o nerve 48,180 26,880
sparing; w/ lymph node
biopsy(s) (limited pelvic lymphadenectomy)
Prostatectomy, retropubic radical, w/ or w/o nerve

sparing; w/ bilateral pelvic lymphadenectomy,
including external iliac, hypogastric, and
55845 obturator nodes 48,180 26,880
Transperineal placement of needles, catheters or

pellets into prostate for interstitial radioelement
application, with or without cystoscopy, ultrasound
55859 or CT scan guidance 18,000 8,400
55860 Exposure of prostate, any approach, for insertion of 9,700 4,200

radioactive substance;
Exposure of prostate, any approach, for insertion of
radioactive substance; w/ lymph node biopsy(s)
55862 (limited pelvic lymphadenectomy) 18,000 8,400
Exposure of prostate, any approach, for insertion of

radioactive substance; w/ bilateral pelvic
lymphadenectomy, including external iliac,
55865 hypogastric 23,300 12,600
and obturator nodes
55866 Laparoscopy, surgical prostatectomy, retropubic 46,500 25,200

radical, including nerve
sparing
55873 Cryosurgical ablation of the prostate (cryotherapy of 55,000 33,600
the prostate)
56405 Incision and drainage of vulva or perineal abscess 5,560 1,260
56420 Incision and drainage of Bartholins gland abscess 9,300 2,100
56440 Marsupialization of Bartholins gland cyst 9,700 4,200

56441 Lysis of labial adhesions 9,300 2,100
56501 Destruction of lesion(s), vulva; any method 9,300 2,100
56605 Biopsy of vulva or perineum ; one lesion 9,300 2,100

56620 Vulvectomy simple; partial 12,120 6,720
56625 Vulvectomy simple; complete 23,300 12,600
56630 Vulvectomy, radical, partial; 27,120 15,120
56631 Vulvectomy, radical, partial; w/ unilateral 30,300 16,800
inguinofemoral
lymphadenectomy
56632 Vulvectomy, radical, partial; w/ bilateral 37,800 21,000
inguinofemoral lymphadenectomy
56633 Vulvectomy, radical, complete; 46,500 25,200
56634 Vulvectomy, radical, complete; w/ unilateral 53,400 29,400
inguinofemoral
lymphadenectomy
56637 Vulvectomy, radical, complete; w/ bilateral 55,000 33,600
inguinofemoral
lymphadenectomy
56640 Vulvectomy, radical, complete, w/ inguinofemoral, 58,800 37,800
iliac, and pelvic
lymphadenectomy
56700 Partial hymenectomy or revision of hymenal ring 9,700 4,200
56720 Hymenotomy, simple incision 9,300 2,100

56740 Excision of Bartholins gland or cyst 9,700 4,200
57000 Colpotomy; w/ exploration 12,120 6,720
57020 Colpocentesis 5,680 1,680
57061 Destruction of vaginal lesion(s) 5,680 1,680
57100 Biopsy of vaginal mucosa 5,680 1,680
57108 Colpectomy, obliteration of vagina; partial 23,300 12,600
57110 Colpectomy, obliteration of vagina; complete 30,300 16,800
57120 Colpocleisis (Le Fort type) 27,120 15,120

57130 Excision of vaginal septum 9,300 2,100
57135 Excision of vaginal cyst or tumor 9,700 4,200
57155 Insertion of uterine tandems and/or vaginal ovoids for 9,700 4,200
clinical
brachytherapy
57200 Colporrhaphy, suture of injury of vagina 8,020 2,520
(nonobsterical)
57210 Colpoperineorrhaphy, suture of injury of vagina 10,540 5,040
and/or perineum
(nonobstetrical)
57220 Plastic operation on urethral sphincter, vaginal 12,120 6,720
approach (e.g., Kelly urethral
plication)
57230 Plastic repair of urethrocele 12,120 6,720
57240 Anterior colporrhaphy, repair of cystocele w/ or w/o 20,980 10,080
repair of urethrocele
57250 Posterior colporrhaphy, repair of rectocele w/ or w/o 20,980 10,080
perineorrhaphy
57260 Combined anteroposterior colporrhaphy; 23,300 12,600
57265 Combined anteroposterior colporrhaphy; w/ 30,300 16,800
enterocele repair
57268 Repair of enterocele, vaginal approach 23,300 12,600
57270 Repair of enterocele, abdominal approach 27,120 15,120
57280 Colpopexy, abdominal approach 27,120 15,120

57282 Sacrospinous ligament fixation for prolapse of vagina 27,120 15,120
57284 Paravaginal defect repair (including repair of 27,120 15,120

cystocele, stress urinary
incontinence, and/or incomplete vaginal prolapse)
57288 Sling operation for stress incontinence (e.g., fascia or 30,300 16,800
synthetic)
57289 Pereyra procedure, including anterior colporrhaphy 30,300 16,800
57300 Closure of rectovaginal fistula; vaginal or transanal 20,980 10,080

approach
57305 Closure of rectovaginal fistula; abdominal approach 23,300 12,600
57307 Closure of rectovaginal fistula; abdominal approach, 30,300 16,800

w/ concomitant
colostomy
57310 Closure of urethrovaginal fistula; 20,980 10,080
57311 Closure of urethrovaginal fistula; w/ bulbocavernosus 30,300 16,800
transplant
57320 Closure of vesicovaginal fistula; vaginal approach 23,300 12,600
57330 Closure of vesicovaginal fistula; transvesical and 30,300 16,800

vaginal approach
57415 Removal of impacted vaginal foreign body under 8,260 3,360
anesthesia
57425 Laparoscopy, surgical, colpopexy (suspension of 27,120 15,120
vaginal apex)
57452 Colposcopy (Vaginoscopy) 8,020 2,520
57454 Colposcopy; w/ biopsy(s) of the cervix and/or 8,260 3,360
endocervical curettage
57460 Colposcopy; w/ loop electrode excision procedure of 9,700 4,200
the cervix
57500 Biopsy, single or multiple, or local excision of lesion, 5,680 1,680
w/ or w/o fulguration
57510 Cauterization of cervix; any method 5,680 1,680
57520 Conization of cervix, w/ or w/o fulguration, w/ or w/o 9,700 4,200
dilation and
curettage, w/ or w/o repair; cold knife or laser
57522 Conization of cervix, w/ or w/o fulguration, w/ or w/o 12,900 6,300

dilation and
curettage, w/ or w/o repair; loop electrode excision
57530 Trachelectomy (cervicectomy), amputation of cervix 18,000 8,400
57540 Excision of cervical stump, abdominal approach; 30,300 16,800
57545 Excision of cervical stump, abdominal approach; w/ 37,800 21,000

pelvic floor repair
57550 Excision of cervical stump, vaginal approach; 23,300 12,600
57555 Excision of cervical stump, vaginal approach; w/ 37,800 21,000

anterior and/or posterior
repair
57556 Excision of cervical stump, vaginal approach; w/ repair 39,900 23,100
of enterocele
57700 Cerclage of uterine cervix, nonobstetrical 9,700 4,200
57720 Trachelorrhaphy, plastic repair of uterine cervix, 18,000 8,400
vaginal approach
58100 Endometrial sampling (biopsy) w/ or w/o endocervical 11,000 4,400
sampling (biopsy),
w/o cervical dilation, any method
58120 Dilation and curettage 11,000 4,400
58140 Myomectomy, excision of fibroid tumor of uterus, 23,300 12,600
single or multiple ;
abdominal approach
58145 Myomectomy, excision of fibroid tumor of uterus, 18,000 8,400
single or multiple ;
vaginal approach
58150 Total abdominal hysterectomy (corpus and cervix), w/ 30,000 12,000
or w/o removal of
tube(s), w/ or w/o removal of ovary(s);
Total abdominal hysterectomy (corpus and cervix), w/
or w/o removal of
tube(s), w/ or w/o removal of ovary(s); w/ colpo-
58152 urethrocystopexy (Marshall-Marchetti-Krantz type) 30,000 12,000
58180 Supracervical abdominal hysterectomy (subtotal 30,000 12,000

hysterectomy), w/ or w/o
removal of tube(s), w/ or w/o removal of ovary(s)
Total abdominal hysterectomy, including partial
vaginectomy, w/ para- aortic and pelvic lymph node
sampling, w/ or w/o removal of tube(s), w/ or
58200 w/o removal of ovary(s) 30,000 12,000
Radical abdominal hysterectomy, w/ bilateral total

pelvic lymphadenectomy
and para-aortic lymph node sampling (biopsy), w/ or
58210 w/o removal of tube(s), w/ or w/o removal of ovary(s) 55,000 33,600
Pelvic exenteration for gynecologic malignancy, w/

total abdominal hysterectomy or cervicectomy, w/ or
w/o removal of tube(s), w/ or w/o removal of
ovary(s), w/ removal of bladder and ureteral
transplantations, and/or abdominoperineal resection
58240 of rectum and colon and colostomy, or 71,400 50,400
any combination thereof
58260 Vaginal hysterectomy; 30,300 16,800

58262 Vaginal hysterectomy; w/ removal of tube(s), and/or 30,300 16,800
ovary(s)
58263 Vaginal hysterectomy; w/ removal of tube(s), and/or 37,800 21,000
ovary(s), w/ repair of
enterocele
58267 Vaginal hysterectomy; w/ colpo-urethrocystopexy 46,500 25,200
(Marshall-Marchetti-
Krantz type, Pereyra type, w/ or w/o endoscopic
control)
58270 Vaginal hysterectomy; w/ repair of enterocele 46,500 25,200
58275 Vaginal hysterectomy, w/ total or partial colpectomy; 37,800 21,000
58280 Vaginal hysterectomy, w/ total or partial colpectomy; 46,500 25,200

w/ repair of
enterocele
58285 Vaginal hysterectomy, radical (Schauta type 46,500 25,200
operation)
58300 Insertion of intrauterine device (IUD) 2,000 800
Transcervical introduction of fallopian tube catheter
for diagnosis and/or re- establishing patency (any
58345 method), w/ or w/o hysterosalpingography 18,000 8,400
58346 Insertion of heyman capsules for brachytherapy 9,700 4,200
58400 Uterine suspension, w/ or w/o shortening of round 23,300 12,600

ligaments, w/ or w/o
shortening of sacrouterine ligaments;
Uterine suspension, w/ or w/o shortening of round
ligaments, w/ or w/o shortening of sacrouterine
58410 ligaments; w/ presacral sympathectomy 27,120 15,120
58520 Hysterorrhaphy, repair of ruptured uterus 23,300 12,600

(nonobstetrical)
58540 Hysteroplasty, repair of uterine anomaly (Strassman 37,800 21,000
type)
58600 Ligation or transection of fallopian tube(s), abdominal 4,000 1,000
or vaginal approach,
58545 Laparoscopy, surgical, myomectomy, excision; 23,300 12,600
intramural myomas and/or
removal of surface myomas
58550 Laparoscopy surgical, with vaginal hysterectomy; 30,300 16,800
58552 Laparoscopy surgical, with vaginal hysterectomy; with 30,300 16,800

removal of tube(s)
and/or ovary(s)
58555 Hysteroscopy, diagnostic 9,700 4,200
58558 Hysteroscopy, surgical; with sampling (biopsy) of 12,900 6,300
endometrium and/or
polypectomy, with or without D&C
58559 Hysteroscopy, surgical; with lysis of intrauterine 18,000 8,400
adhesions (any method)
58560 Hysteroscopy, surgical; with division or resection of 18,000 8,400
intrauterine septum
(any method)
58561 Hysteroscopy, surgical; with removal of leiomyomata 23,300 12,600
58562 Hysteroscopy, surgical; with removal of impacted 12,900 6,300

foreign body
58563 Hysteroscopy, surgical; with endometrial ablation 12,120 6,720
(e.g., endometrial
resection, electrosurgical ablation thermoablation)
58565 Hysteroscopy, surgical; with bilateral fallopian tube 5,680 1,680

cannulation to induce
occlusion by placement of permanent implants
58660 Laparoscopy, surgical; with lysis of adhesions 21,400 10,500

(salphingolysis, ovariolysis)
58661 Laparoscopy, surgical; with removal of adnexal 53,400 29,400
structures (partial or total
oophorectomy and/or salpingectomy)
58662 Laparoscopy, surgical; with fulguration or excision of 14,960 7,560
lesions of the ovary,
pelvic viscera, or peritoneal surface by any method
58670 Laparoscopy, surgical; with fulguration of oviducts 14,960 7,560

(with or without
transection)
58671 Laparoscopy, surgical; with occlusion of oviducts by 12,900 6,300
device (e.g., band, clip,
or Falope ring)
58672 Laparoscopy, surgical; with fimbrioplasty 21,400 10,500
58673 Laparoscopy, surgical; with salphingostomy 23,300 12,600
(salpingoneostomy)
58700 Salpingectomy, complete or partial, unilateral or 20,980 10,080
bilateral
58720 Salpingo-oophorectomy, complete or partial, 23,300 12,600
58740 Lysis of adhesions (salpingolysis, ovariolysis) 23,300 12,600
58750 Tubotubal anastomosis 18,000 8,400

58760 Fimbrioplasty 23,300 12,600
58770 Salpingostomy (salpingoneostomy) 23,300 12,600
58800 Drainage of ovarian cyst(s), unilateral or bilateral ; 20,980 10,080
vaginal approach
58805 Drainage of ovarian cyst(s), unilateral or bilateral ; 20,980 10,080
abdominal approach
58820 Drainage of ovarian abscess; vaginal approach 20,980 10,080
58822 Drainage of ovarian abscess; abdominal approach 20,980 10,080
58825 Transposition, ovary(s) 20,980 10,080

58900 Biopsy of ovary, unilateral or bilateral 18,000 8,400
58920 Wedge resection or bisection of ovary, unilateral or 18,000 8,400
bilateral
58925 Ovarian cystectomy, unilateral or bilateral 23,300 12,600
58940 Oophorectomy, partial or total, unilateral or bilateral; 18,000 8,400
58943 Oophorectomy, partial or total, unilateral or bilateral; 30,300 16,800
for ovarian malignancy, w/ para-aortic and pelvic
lymph node biopsies, peritoneal washings, peritoneal
biopsies, diaphragmatic assessments, w/ or w/o
salpingectomy(s), w/ or w/o omentectomy
58950 Resection of ovarian malignancy w/ bilateral salpingo- 53,400 29,400

oophorectomy and
omentectomy;
Resection of ovarian malignancy w/ bilateral salpingo-
oophorectomy and omentectomy; w/ total abdominal
hysterectomy, pelvic and limited para-
58951 aortic lymphadenectomy 55,000 33,600
58952 Resection of ovarian malignancy w/ bilateral salpingo- 58,800 37,800

oophorectomy and
omentectomy; w/ radical dissection for debulking
58960 Laparotomy, for staging or restaging of ovarian 27,120 15,120

malignancy ("second look"), w/ or w/o omentectomy,
peritoneal washing, biopsy of abdominal and pelvic
peritoneum, diaphragmatic assessment w/ pelvic and
limited para-
aortic lymphadenectomy
59100 Hysterotomy, abdominal (e.g., for hydatidiform mole, 23,300 12,600

abortion)
59120 Surgical treatment of ectopic pregnancy; tubal or 27,120 15,120
ovarian, requiring
salpingectomy and/or oophorectomy, abdominal or
vaginal approach
59121 Surgical treatment of ectopic pregnancy; tubal or 27,120 15,120

ovarian, w/o
salpingectomy and/or oophorectomy
59130 Surgical treatment of ectopic pregnancy; abdominal 46,500 25,200
pregnancy
59135 Surgical treatment of ectopic pregnancy; interstitial, 37,800 21,000
uterine pregnancy
requiring total hysterectomy
59136 Surgical treatment of ectopic pregnancy; interstitial, 37,600 18,900
uterine pregnancy w/
partial resection of uterus
59140 Surgical treatment of ectopic pregnancy; cervical, w/ 30,300 16,800
evacuation
59150 Laparoscopic treatment of ectopic pregnancy; w/o 27,120 15,120
salpingectomy and/or
oophorectomy
59151 Laparoscopic treatment of ectopic pregnancy; w/ 27,120 15,120
salpingectomy and/or
oophorectomy
59320 Cerclage of cervix, during pregnancy; vaginal 18,000 8,400
59325 Cerclage of cervix, during pregnancy; abdominal 18,000 8,400
59350 Hysterorrhaphy of ruptured uterus 30,300 16,800

59409 Vaginal delivery only (w/ episiotomy) 9,700 4,200
59411 Breech extraction 12,120 6,720
59513 Cesarean section, primary 19,000 7,600
59514 Cesarean delivery 19,000 7,600
59525 Subtotal or total hysterectomy after cesarean delivery 30,000 12,000
59612 Vaginal delivery only, after previous cesarean delivery 12,120 6,720
(w/ or w/o
episiotomy)
59620 Cesarean delivery only, following attempted vaginal 19,000 7,600
delivery after previous
cesarean delivery;
59812 Treatment of incomplete abortion, any trimester, 11,000 4,400
completed surgically
59814 Manual vacuum aspiration for spontaneous abortion 11,000 4,400
59870 Uterine evacuation and curettage for hydatidiform 12,120 6,720

mole
60000 Incision and drainage of thyroglossal cyst, infected 3,504 504
60001 Aspiration and/or injection, thyroid cyst 8,260 3,360

60100 Biopsy thyroid, percutaneous core needle 8,260 3,360
60200 Excision of cyst or adenoma of thyroid , or transection 20,980 10,080
of isthmus
60210 Partial thyroid lobectomy, unilateral; w/ or w/o 31,000 12,400
isthmusectomy
60212 Partial thyroid lobectomy, unilateral; w/ contralateral 31,000 12,400
subtotal lobectomy,
including isthmusectomy
60220 Total thyroid lobectomy, unilateral; w/ or w/o 31,000 12,400
isthmusectomy
60225 Total thyroid lobectomy, unilateral; w/ contralateral 31,000 12,400
subtotal lobectomy,
including isthmusectomy
60240 Thyroidectomy, total or complete 31,000 12,400
60252 Thyroidectomy, total or subtotal for malignancy; w/ 31,000 12,400
limited neck dissection
60254 Thyroidectomy, total or subtotal for malignancy; w/ 46,500 25,200
radical neck dissection
60260 Thyroidectomy, removal of all remaining thyroid 31,000 12,400
tissue following previous
removal of a portion of thyroid
60270 Thyroidectomy, including substernal thyroid gland; 46,500 25,200
sternal split or
transhoracic approach
60271 Thyroidectomy, including substernal thyroid gland; 46,500 25,200
cervical approach
60280 Excision of thyroglossal duct cyst or sinus; 20,980 10,080
60281 Excision of thyroglossal duct cyst or sinus; recurrent 23,300 12,600
60500 Parathyroidectomy or exploration of parathyroid(s); 30,740 13,440

re-exploration
w/ mediastinal
exploration, sternal split or transthoracic approach
60512 Parathyroid autotransplantation 30,300 16,800

60520 Thymectomy, partial or total; transcervical approach 39,900 23,100
60521 Thymectomy, partial or total; sternal split or 39,900 23,100

transthoracic approach, w/o
radical mediastinal dissection
60522 Thymectomy, partial or total; sternal split or 39,900 23,100
transthoracic approach, w/
radical mediastinal dissection
60540 Adrenalectomy, partial or complete, or exploration of 30,300 16,800
adrenal gland w/ or
w/o biopsy, transabdominal, lumbar or dorsal;
Adrenalectomy, partial or complete, or exploration of

adrenal gland w/ or w/o biopsy, transabdominal,
lumbar or dorsal; w/ excision of adjacent
60545 retroperitoneal tumor 37,600 18,900
60600 Excision of carotid body tumor; w/o excision of carotid 30,300 16,800
artery
60605 Excision of carotid body tumor; w/ excision of carotid 37,800 21,000
artery
Laparoscopy, surgical, with adrenalectomy, partial or
complete, or exploration of adrenal gland with or
without biopsy, transabdominal,
60650 lumbar or dorsal 30,300 16,800
61000 Subdural tap through fontanelle, or suture, infant, 5,680 1,680

61020 Ventricular puncture through previous burr hole, 5,680 1,680
fontanelle, suture, or
implanted ventricular catheter/reservoir
61050 Cisternal or lateral cervical (C1-C2) puncture 10,540 5,040
61105 Twist drill hole for subdural or ventricular puncture; 18,000 8,400
not followed by other
surgery
followed by other
surgery
for implanting
venticular catheter or pressure recording device
for evacuation and/or
drainage of subdural hematoma
Burr hole(s) for ventricular puncture (including
injection of gas, contrast media, dye, or radioactive
61120 material); not followed by other surgery 23,300 12,600
Burr hole(s) for ventricular puncture (including

injection of gas, contrast media, dye, or radioactive
61130 material); followed by other surgery 22,240 11,340
61140 Burr hole(s) or trephine; w/ biopsy of brain or 37,800 21,000

intracranial lesion
61150 Burr hole(s) or trephine; w/ drainage of brain abscess 37,800 21,000
or cyst
61154 Burr hole(s) w/ evacuation and/or drainage of 37,800 21,000
hematoma, extradural or
subdural
61156 Burr hole(s); w/ aspiration of hematoma or cyst, 37,800 21,000
intracerebral
61250 Burr hole(s) or trephine, supratentorial 23,300 12,600
61253 Burr hole(s) or trephine, infratentorial, unilateral or 30,300 16,800
bilateral
61304 Craniectomy or craniotomy, exploratory; 37,800 21,000
supratentorial
61305 Craniectomy or craniotomy, exploratory; infratentorial 46,500 25,200
(posterior fossa)
61312 Craniectomy or craniotomy for evacuation of 46,500 25,200
hematoma, supratentorial;
extradural or subdural
hematoma, supratentorial;
intracerebral
hematoma, infratentorial;
extradural or subdural
hematoma, infratentorial;
intracerebellar
61320 Craniectomy or craniotomy, drainage of intracranial 46,500 25,200
abscess; supratentorial
61321 Craniectomy or craniotomy, drainage of intracranial 53,400 29,400
abscess; infratentorial
61330 Decompression of orbit only, transcranial approach 46,500 25,200
61332 Exploration of orbit (transcranial approach); w/ biopsy 53,400 29,400

61333 Exploration of orbit (transcranial approach); w/ 53,400 29,400
removal of lesion
61334 Exploration of orbit (transcranial approach); w/ 53,400 29,400
61340 Other cranial decompression (e.g., subtemporal), 37,800 21,000
supratentorial
Craniectomy, suboccipital w/ cervical laminectomy for
decompression of medulla and spinal cord, w/ or w/o
dural graft (e.g., Arnold-Chiari
61343 malformation) 53,400 29,400
61345 Other cranial decompression, posterior fossa 46,500 25,200
61440 Craniotomy for section of tentorium cerebelli 46,500 25,200
61450 Craniectomy, subtemporal, for section, compression, 53,400 29,400

or decompression of
sensory root of gasserian ganglion
61458 Craniectomy, suboccipital; for exploration or 53,400 29,400
decompression of cranial
nerves
61460 Craniectomy, suboccipital; for section of one or more 55,000 33,600
cranial nerves
61470 Craniectomy, suboccipital; for medullary tractotomy 55,000 33,600
61480 Craniectomy, suboccipital; for mesencephalic 55,000 33,600

tractotomy or pedunculotomy
61490 Craniotomy for lobotomy, including cingulotomy 46,500 25,200
61500 Craniectomy; w/ excision of tumor or other bone 55,000 33,600

lesion of skull
61501 Craniectomy; for osteomyelitis 37,800 21,000
61510 Craniectomy, trephination, bone flap craniotomy; for 55,000 33,600
excision of brain
tumor, supratentorial, except meningioma
excision of
meningioma, supratentorial
excision of brain
abscess, supratentorial
excision or
fenestration of cyst, supratentorial
Craniectomy for excision of brain tumor, infratentorial
or posterior fossa;
except meningioma, cerebellopontine angle tumor, or
61518 midline tumor at base of skull 65,100 44,100
61519 Craniectomy for excision of brain tumor, infratentorial 67,200 46,200

or posterior fossa;
meningioma
or posterior fossa;
cerebellopontine angle tumor
or posterior fossa;
midline tumor at base of skull
61522 Craniectomy, infratentorial or posterior fossa; for 55,000 33,600
excision of brain abscess
61524 Craniectomy, infratentorial or posterior fossa; for 55,000 33,600
excision or fenestration of
cyst,
61526 Craniectomy, bone flap craniotomy, transtemporal 75,600 54,600
(mastoid) for excision of
cerebellopontine angle tumor;
Craniectomy, bone flap craniotomy, transtemporal
(mastoid) for excision of
cerebellopontine angle tumor; combined w/
61530 middle/posterior fossa craniotomy/ craniectomy 75,600 54,600
61531 Subdural implantation of strip electrodes through one 53,400 29,400

or more burr or
trephine hole(s) for long term seizure monitoring
61533 Craniotomy w/ elevation of bone flap; for subdural 53,400 29,400

implantation of an
electrode array, for long term seizure monitoring
61534 Craniotomy w/ elevation of bone flap; for excision of 53,400 29,400

epileptogenic focus
w/o electrocorticography during surgery
61535 Craniotomy w/ elevation of bone flap; for removal of 53,400 29,400
epidural or subdural
electrode array, w/o excision of cerebral tissue
Craniotomy w/ elevation of bone flap; for excision of

cerebral epileptogenic focus, w/ electrocorticography
during surgery (includes removal of
61536 electrode array) 55,000 33,600
61538 Craniotomy w/ elevation of bone flap; for lobectomy 53,400 29,400

w/
electrocorticography during surgery, temporal lobe
Craniotomy w/ elevation of bone flap; for lobectomy

w/
61539 electrocorticography during surgery, other than 53,400 29,400
temporal lobe, partial or total
61541 Craniotomy w/ elevation of bone flap; for transection 53,400 29,400

of corpus callosum
61542 Craniotomy w/ elevation of bone flap; for total 67,200 46,200
hemispherectomy
61543 Craniotomy w/ elevation of bone flap; for partial or 63,000 42,000
subtotal
hemispherectomy
coagulation of choroid
plexus
craniopharyngioma
61546 Craniotomy for hypophysectomy or excision of 63,000 42,000
pituitary tumor, intracranial
approach
61548 Hypophysectomy or excision of pituitary tumor, 63,000 42,000
transnasal or transseptal
approach, nonstereotactic
61550 Craniectomy for craniosynostosis; single cranial suture 37,800 21,000
61552 Craniectomy for craniosynostosis; multiple cranial 46,500 25,200

sutures
61556 Craniotomy for craniosynostosis; frontal or parietal 46,500 25,200
bone flap
61557 Craniotomy for craniosynostosis; bifrontal bone flap 46,500 25,200
61558 Extensive craniectomy for multiple cranial suture 58,800 37,800

craniosynostosis (e.g.,
cloverleaf skull); not requiring bone grafts
Extensive craniectomy for multiple cranial suture
craniosynostosis (e.g., cloverleaf skull); recontouring
w/ multiple osteotomies and bone autografts
61559 (e.g., barrel-stave procedure) (includes obtaining 58,800 37,800
grafts)
61563 Excision, intra and extracranial, benign tumor of 58,800 37,800
cranial bone (e.g., fibrous
dysplasia); w/o optic nerve decompression
61564 Excision, intra and extracranial, benign tumor of 58,800 37,800

cranial bone (e.g., fibrous
dysplasia); w/ optic nerve decompression
61570 Craniectomy or craniotomy; w/ excision of foreign 53,400 29,400
body from brain
61571 Craniectomy or craniotomy; w/ treatment of 55,500 31,500
penetrating wound of brain
61575 Transoral approach to skull base, brain stem or upper 75,600 54,600
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 of tongue and/or
61576 mandible (including tracheostomy) 75,600 54,600
Craniofacial approach to anterior cranial fossa;

extradural, including lateral rhinotomy,
ethmoidectomy, sphenoidectomy, w/o maxillectomy
61580 or orbital 63,000 42,000
exenteration

extradural, including lateral
rhinotomy, orbital exenteration, ethmoidectomy,
61581 sphenoidectomy and/or maxillectomy 63,000 42,000

extradural, including unilateral or bifrontal
craniotomy, elevation of frontal lobe(s), osteotomy of
61582 base of anterior cranial fossa 63,000 42,000

intradural, including
unilateral or bifrontal craniotomy, elevation or
61583 resection of frontal lobe, osteotomy of base of 63,000 42,000
anterior cranial fossa
Orbitocranial approach to anterior cranial fossa,

extradural, including supraorbital ridge osteotomy and
elevation of frontal and/or temporal
61584 lobe(s); w/o orbital exenteration 63,000 42,000
Orbitocranial approach to anterior cranial fossa,

extradural, including
supraorbital ridge osteotomy and elevation of frontal
61585 and/or temporal lobe(s); w/ orbital exenteration 63,000 42,000
61586 Bicoronal, transzygomatic and/or LeFort I osteotomy 63,000 42,000

approach to anterior
cranial fossa w/ or w/o internal fixation, w/o bone
graft
61590 Infratemporal pre-auricular approach to middle cranial 71,400 50,400

fossa (parapharyngeal space, infratemporal and
midline skull base, nasopharynx), w/ or w/o
disarticulation of the mandible, including
parotidectomy,
craniotomy, decompression and/or mobilization of th
61591 Infratemporal post-auricular approach to middle 71,400 50,400
cranial fossa (internal auditory meatus, petrous apex,
tentorium, cavernous sinus, parasellar area,
infratemporal fossa) inlcuding mastoidectomy,
resection of sigmoid sinus,
w/ or w/o decompression and/or mo
61592 Orbitocranial zygomatic approach to middle cranial 67,200 46,200

fossa (cavernous sinus and carotid artery, clivus,
basilar artery or petrous apex) including osteotomy of
zygoma, craniotomy, extra- or intradural elevation of
temporal lobe
Transtemporal approach to posterior cranial fossa,

jugular foramen or midline skull base, including
mastoidectomy, decompression of sigmoid
61595 sinus and/or facial nerve, w/ or w/o mobilization 71,400 50,400
Transcochlear approach to posterior cranial fossa,

jugular foramen or midline skull base, including
labyrinthectomy, decompression, w/ or w/o
61596 mobilization of facial nerve and/or petrous carotid 71,400 50,400
artery
61597 Transcondylar (far lateral) approach to posterior 71,400 50,400

cranial fossa, jugular foramen or midline skull base,
including occiptal condylectomy, mastoidectomy,
resection of C1-C3 vertebral body(s), decompression
of
vertebral artery, w/ or w/o mobilization
Transpetrosal approach to posterior cranial fossa,

clivus or framen magnum, including ligation of
61598 superior petrosal sinus and/or sigmoid sinus 71,400 50,400
61600 Resection or excision of neoplastic, vascular or 67,200 46,200

infectious lesion of base of
anterior cranial fossa; extradural
Resection or excision of neoplastic, vascular or
infectious lesion of base of anterior cranial fossa;
61601 intradural, including dural repair,w/ or w/o graft 67,200 46,200

infectious lesion of
infratemporal fossa, parapharyngeal space, petrous
apex; extradural

infectious lesion of infratemporal fossa,
parapharyngeal space, petrous apex; intradural,
61606 including dural repair, w/ or w/o graft 71,400 50,400

infectious lesion of parasellar area, cavernous sinus,
61607 clivus or midline skull base; extradural 71,400 50,400

infectious lesion of parasellar
area, cavernous sinus, clivus or midline skull base;
61608 intradural, including dural repair, w/ or w/o graft 71,400 50,400
61609 Transection or ligation, carotid artery in cavernous 71,400 50,400

sinus; w/o repair
61610 Transection or ligation, carotid artery in cavernous 71,400 50,400
sinus; w/ repair by
anastomosis or graft
61611 Transection or ligation , carotid artery in petrous 63,000 42,000
canal; w/o repair
61612 Transection or ligation , carotid artery in petrous 71,400 50,400
canal; w/ repair by
anastomosis or graft
61613 Obliteration of carotid aneurysm, arteriovenous 71,400 50,400
malformation, or carotid-
cavernous fistula by dissection w/in cavernous sinus

infectious lesion of base of posterior cranial fossa,
jugular foramen, foramen magnum, or CI-C3
61615 vertebral bodies; extradural 71,400 50,400

infectious lesion of base of posterior cranial fossa,
jugular foramen, foramen magnum, or CI-C3 vertebral
bodies; intradural, including dural repair, w/ or w/o
graft
61618 Secondary repair of dura for CSF leak, anterior, middle 67,200 46,200
or posterior cranial fossa following surgery of the skull
base; by free tissue graft (e.g., pericranium, fascia,
tensor fascia lata, adipose tissue, homologous or
synthetic grafts)
61619 Secondary repair of dura for CSF leak, anterior, middle 63,000 42,000
or posterior cranial fossa following surgery of the skull
base; by local or regionalized vascularized pedicle flap
or myocutaneous flap (including galea,temporalis,
frontalis or occipitalis muscle)
61624 Transcatheter oclussion or embolization (e.g., for 71,400 50,400

a vascular malformation), percutaneous, any method;
central nervous system (intracranial, spinal cord)
61626 Transcatheter oclussion or embolization (e.g., for 55,000 33,600

a vascular malformation), percutaneous, any method;
non-central nervous system, head or neck
(extracranial,
brachiocephalic branch)
61680 Surgery of intracranial arteriovenous malformation; 63,000 42,000

supratentorial, simple
supratentorial, complex
infratentorial, simple
infratentorial, complex
dural, simple
dural, complex
61700 Surgery of intracranial aneurysm, intracranial 71,400 50,400
approach; carotid circulation
61702 Surgery of intracranial aneurysm, intracranial 75,600 54,600
approach; vertebral-basilar
circulation
Surgery of intracranial aneurysm, cervical approach by
application of occluding clamp to cervical carotid
61703 artery (Selverstone-Crutchfield type) 23,300 12,600
61705 Surgery of aneurysm, vascular malformation or 71,400 50,400
carotid-cavernous fistula; by
intracranial and cervical occlusion of carotid artery
61708 Surgery of aneurysm, vascular malformation or 37,800 21,000

carotid-cavernous fistula; by
intracranial electrothrombosis
Surgery of aneurysm, vascular malformation or

carotid-cavernous fistula; by intra-arterial
61710 embolization, injection procedure or balloon catheter 63,000 42,000
61711 Anastomosis, arterial, extracranial-intracranial (e.g., 67,200 46,200

middle
cerebral/cortical) arteries
61712 Microdissection, intracranial or spinal procedure (list 67,200 46,200
separately in addition
to code for primary procedure)
Creation of lesion by stereotactic method, including
burr hole(s) and localizing and recording techniques,
single or multiple stages; globus
61720 pallidus or thalamus 67,200 46,200
Creation of lesion by stereotactic method, including

burr hole(s) and
localizing and recording techniques, single or multiple
61735 stages; subcortical structure(s) other than globus 63,000 42,000
pallidus or thalamus
61750 Stereotactic biopsy, aspiration, or excision,including 63,000 42,000

burr hole(s), for
intracranial lesion;
61751 Stereotactic biopsy, aspiration, or excision,including 63,000 42,000
burr hole(s), for
intracranial lesion; w/ computerized axial tomography
61760 Stereotactic implantation of depth electrodes into the 63,000 42,000

cerebrum for long
term seizure monitoring
61770 Stereotactic localization , any method, including burr 30,300 16,800
hole(s), w/ insertion of
catheter(s) for brachytherapy
Creation of lesion by stereotactic method,
percutaneous, by neurolytic agent (e.g., alcohol,
61790 thermal, electrical, radiofrequency); gasserian 37,800 21,000
ganglion
Creation of lesion by stereotactic method,

percutaneous, by neurolytic agent (e.g., alcohol,
thermal, electrical, radiofrequency); trigeminal
61791 medullary tract 37,800 21,000
61793 Stereotactic radiosurgery (particle beam,gamma ray or 63,000 42,000

linear accelerator)
61795 Stereotactic computer assisted volumetric intracranial 63,000 42,000
procedure
61850 Twist drill or burr hole(s) for implantation of 53,400 29,400
neurostimulator electrodes;
cortical
61855 Twist drill or burr hole(s) for implantation of 67,200 46,200
neurostimulator electrodes;
subcortical
61860 Craniectomy or craniotomy for implantation of 58,800 37,800
neurostimulator electrodes,
cerebral; cortical
61865 Craniectomy or craniotomy for implantation of 46,500 25,200

neurostimulator electrodes,
cerebral; subcortical
61870 Craniectomy for implantation of neurostimulator 58,800 37,800
electrodes, cerebellar;
cortical
61875 Craniectomy for implantation of neurostimulator 67,200 46,200
electrodes, cerebellar;
subcortical
61885 Incision and subcutaneous placement of cranial 37,800 21,000
neurostimulator pulse
generator or receiver, direct or inductive coupling
62000 Elevation of depressed skull fracture; simple, 30,300 16,800

extradural
62005 Elevation of depressed skull fracture; compound or 37,800 21,000
comminuted, extradural
62010 Elevation of depressed skull fracture; w/ repair of dura 46,500 25,200
and /or debridement
of brain
62100 Craniotomy for repair of dural /CSF leak, including 71,400 50,400
surgery for
rhinorrhea/otorrhea
62115 Reduction of craniomegalic skull (e.g., treated 37,800 21,000
hydrocephalus); not requiring
bone grafts or cranioplasty
62116 Reduction of craniomegalic skull (e.g., treated 46,500 25,200
hydrocephalus); w/ simple
cranioplasty
Reduction of craniomegalic skull (e.g., treated
hydrocephalus); requiring craniotomy and
reconstruction w/ or w/o bone graft (includes
62117 obtaining 53,400 29,400
grafts)
62120 Repair of encephalocele, skull vault, including 58,800 37,800

cranioplasty
62121 Craniotomy for repair of encephalocele , skull base 55,000 33,600
62140 Cranioplasty for skull defect; up to 5 cm diameter 30,300 16,800
62141 Cranioplasty for skull defect; larger than 5 cm 30,300 16,800

diameter
62142 Removal of bone flap or prosthetic plate of skull 30,300 16,800
62143 Replacement of bone flap or prosthetic plate of skull 30,300 16,800
62145 Cranioplasty for skull defect w/ reparative brain 53,400 29,400

surgery
62146 Cranioplasty w/ autograft (includes obtaining bone 53,400 29,400
grafts); up to 5 cm
diameter
62147 Cranioplasty w/ autograft (includes obtaining bone 55,000 33,600
grafts); larger than 5 cm
diameter
Neuroendoscopy, intracranial, for placement or
replacement of ventricular catheter and attachment to
62160 shunt system or external drainage 37,800 21,000
Neuroendoscopy, intracranial; with dissection of

adhesions, fenestration of septum pellucidum or
intraventricular cyst (including placement,
62161 replacement or removal of ventricular catheter) 46,500 25,200
Neuroendoscopy, intracranial; with fenestration or

excision of colloid cyst, including placement of
62162 external ventricular catheter for drainage 46,500 25,200
62163 Neuroendoscopy, intracranial; with retrieval of foreign 46,500 25,200

body
62165 Neuroendoscopy, intracranial; with excision of 46,500 25,200
pituitary tumor, transnasal
or transphenoidal approach
62180 Ventriculocisternostomy (Torkildsen type operation) 37,800 21,000
62190 Creation of shunt; subarachnoid/subdural-atrial, - 23,300 12,600

jugular, -auricular
62192 Creation of shunt; subarachnoid/subdural-peritonial, - 23,300 12,600
pleural, other
terminus
62200 Ventriculocisternostomy, third ventricle; 37,800 21,000
62201 Ventriculocisternostomy, third ventricle; stereotactic 46,500 25,200
method
62220 Creation of shunt; ventriculo-atrial, -jugular,-auricular 30,300 16,800
62223 Creation of shunt; ventriculo-peritonial,-pleural, other 30,300 16,800

terminus
62230 Replacement or revision of CSF (VP) shunt, obstructed 23,300 12,600
valve, or distal
catheter in shunt system
62268 Percutaneous aspiration, spinal cord cyst or syrinx 12,900 6,300
62269 Biopsy of spinal cord, percutaneous needle 12,900 6,300
62270 Spinal puncture, lumbar, diagnostic 5,680 1,680

62272 Spinal puncture , therapeutic, for drainage of spinal 5,560 1,260
fluid (by needle or
catheter)
62287 Aspiration procedure, percutaneous, of nucleus 23,300 12,600
pulposus of intervertebral
disk, any method, single or multiple levels, lumbar
Implantation, revision or repositioning of intrathecal

or epidural catheter, for implantable reservoir or
62350 implantable infusion pump; w/o laminectomy 18,000 8,400
Implantation, revision or repositioning of intrathecal

or epidural catheter, for implantable reservoir or
62351 implantable infusion pump; w/ laminectomy 37,800 21,000
62360 Implantation or replacement of device for intrathecal 9,700 4,200

or epidural drug
infusion; subcutaneous reservoir
62361 Implantation or replacement of device for intrathecal 18,000 8,400
or epidural drug
infusion; non-programmable pump
Implantation or replacement of device for intrathecal
or epidural drug infusion; programmable pump,
including preparation of pump, w/ or w/o
62362 programming 23,300 12,600
Implantation or replacement of device for intrathecal

or epidural drug
infusion; with excision of brain tumor, including
62464 placement of external ventricular catheter for 46,500 25,200
drainage
Laminectomy w/ exploration and/or decompression of

spinal cord and/or
cauda equina, w/o facetectomy, foraminotomy or
63001 diskectomy, (e.g., spinal stenosis), one or two 55,000 33,600
vertebral segments; cervical

spinal cord and/or cauda equina, w/o facetectomy,
foraminotomy or diskectomy, (e.g., spinal
63003 stenosis), one or two vertebral segments; thoracic 53,400 29,400
63005 Laminectomy w/ exploration and/or decompression of 37,800 21,000
foraminotomy or diskectomy, (e.g., spinal stenosis),
one or two vertebral segments; lumbar,except for
spondylolisthesis

63011 stenosis), one or two vertebral segments; sacral 37,800 21,000
Laminectomy w/ removal of abnormal facets and/or

pars inter-articularis
w/ decompression of cauda equina and nerve roots
63012 for spondylolisthesis, lumbar (Gill type procedure) 53,400 29,400

63015 stenosis) , more than 2 vertebral segments; cervical 55,000 33,600

63016 stenosis) , more than 2 vertebral segments; thoracic 53,400 29,400

63017 stenosis) , more than 2 vertebral segments; lumbar 46,500 25,200
Laminotomy (hemilaminectomy), w/ decompression

of nerve root (s), including partial facetectomy ,
foraminotomy and/or excision of herniated
63020 intervertebral disk; one interspace, cervical 55,000 33,600

foraminotomy and/or excision of herniated
63030 intervertebral disk; one interspace,lumbar 46,500 25,200

foraminotomy and/or excision or herniated
63040 intervertebral disk; re-exploration; cervical 53,400 29,400

foraminotomy and/or excision or herniated
63042 intervertebral disk; re-exploration; lumbar 46,500 25,200
63045 Laminectomy, facetectomy and foraminotomy 55,000 33,600

(unilateral or bilateral w/ decompression of spinal
cord, cauda equina and/or nerve root(s), ( eg, spinal or
lateral recess stenosis), single vertebral segment;
cervical

thoracic
lumbar
Transpedicular approach w/ decompression of spinal

cord, equina and/ or nerve root(s) (e.g., herniated
intervetebral disk), single segment; thoracic
63055 53,400 29,400
Transpedicular approach w/ decompression of spinal

cord, equina and/ or nerve root(s) (e.g., herniated
63056 intervetebral disk), single segment; lumbar 46,500 25,200
63064 Costovertebral approach w/ decompression of spinal 53,400 29,400

cord or nerve root(s),
(e.g., herniated intervertebral disk), thoracic; single
segment
63075 Diskectomy, anterior, w/ decompression of spinal cord 55,000 33,600

and/ or nerve
root(s), including osteophytectomy; cervical, single
interspace
63077 Diskectomy, anterior, w/ decompression of spinal cord 37,800 21,000

and/ or nerve
root(s), including osteophytectomy; thoracic, single
interspace
Vertebral corpectomy (vertebral body resection),

partial or complete, anterior approach w/
decompression of spinal cord and/ or nerve root(s);
63081 cervical, single segment 55,000 33,600

partial or complete,
transthoracic approach w/ decompression of spinal
63085 cord and/ or nerve root(s); thoracic, single segment 53,400 29,400
63087 Vertebral corpectomy (vertebral body resection), 46,500 25,200

partial or complete, combined thoracolumbar
approach w/ decompression of spinal cord, cauda
equina or nerve root(s), lower thoracic or lumbar;
single segment

partial or complete, transperitoneal or retroperitoneal
approach w/ decompression of spinal cord, cauda
equina or nerve root(s), lower thoracic, lumbar, or
sacral; single
segment
63170 Laminectomy w/ myelotomy (e.g., Bischof or DREZ 58,800 37,800

type), cervical thoracic,
or thoracolumbar
63172 Laminectomy w/ drainage of intramedullary cyst/ 53,400 29,400
syrinx; to subarachnoid
space
63173 Laminectomy w/ drainage of intramedullary cyst/ 55,000 33,600

syrinx; to peritoneal space
63180 Laminectomy and section of dentate ligaments, w/ or 55,000 33,600

w/o dural graft,
cervical; one of two segments
63182 Laminectomy and section of dentate ligaments, w/ or 55,000 33,600
w/o dural graft,
cervical; more than two segments
63185 Laminectomy w/ rhizotomy; one or two segments 53,400 29,400
63190 Laminectomy w/ rhizotomy; more than two segments 53,400 29,400
63191 Laminectomy w/ section of spinal accessory nerve 57,520 36,120
63194 Laminectomy w/ cordotomy, w/ section of one 55,000 33,600

spinothalamic tract, one
stage; cervical
63195 Laminectomy w/ cordotomy, w/ section of one 53,400 29,400
spinothalamic tract, one
stage; thoracic
63196 Laminectomy w/ cordotomy w/ section of both 55,000 33,600
spinothalamic tracts, one
stage; cervical
spinothalamic tracts, one
stage; thoracic
spinothalamic tracts, two
stages w/in 14 days; cervical
spinothalamic tracts, two
stages w/in 14 days; thoracic
63200 Laminectomy, w/ release of tethered spinal cord, 49,020 27,720
lumbar
63250 Laminectomy for excision or occlusion of 55,000 33,600
arteriovenous malformation of
spinal cord; cervical
spinal cord; thoracic
spinal cord; thoracolumbar
63265 Laminectomy for excision or evacuation of intraspinal 55,000 33,600
lesion other than
neoplasm; extradural; cervical
lesion other than
neoplasm; extradural; thoracic
lesion other than
neoplasm; extradural; lumbar
lesion other than
neoplasm; extradural; sacral
63270 Laminectomy for excision of intraspinal lesion other 55,000 33,600
than neoplasm;
intradural; cervical
than neoplasm;
intradural; thoracic
than neoplasm;
intradural; lumbar
than neoplasm;
intradural; sacral
63275 Laminectomy for biopsy/ excision of intraspinal 55,000 33,600
neoplasm; extradural,
cervical
extradural, thoracic
extradural, lumbar
extradural, sacral
intradural, extramedullary, cervical
intradural, extramedullarry, thoracic
intradural, extramedullary, lumbar
intradural, sacral
intradural, intramedullary, cervical
intradural, intramedullary, thoracic
intradural, intramedullary, thoracolumbar
combined extradural-intradural lesion, any level

partial or complete, for
excision of intraspinal lesion, single segment;
extradural, cervical

partial or complete, for excision of intraspinal lesion,
single segment; extradural, thoracic by
63301 transthoracic approach 53,400 29,400

single segment; extradural, thoracic by
63302 thoracolumbar approach 53,400 29,400

single segment; extradural, lumbar or sacral by
63303 transperitoneal or retroperitoneal approach 53,400 29,400

partial or complete, for
excision of intraspinal lesion, single segment;
intradural, cervical

single segment; intradural, thoracic by
63305 transthoracic approach 53,400 29,400

single segment; intradural, thoracic by
63306 thoracolumbar approach 53,400 29,400

single segment; intradural, lumbar or sacral by
63307 transperitoneal or retroperitoneal approach 53,400 29,400
63600 Creation of lesion of spinal cord by stereotactic 30,300 16,800

method, percutaneous, any
modality (including stimulation and/ or recording)
63610 Stereotactic stimulation of spinal cord, percutaneous, 30,300 16,800
separate procedure
not followed by other surgery
63615 Stereotactic biopsy, aspiration, or excision of lesion, 37,600 18,900
spinal cord
63650 Percutaneous implantation of neurostimulator 8,020 2,520
electrodes; epidural
63655 Laminectomy for implantation of neurostimulator 46,500 25,200
electrodes; epidural
63685 Incision and subscutaneous placement of spinal 21,820 10,920
neurostimulator pulse
generator or receiver, direct or inductive coupling
63700 Repair of meningocele; less than 5 cm diameter 30,300 16,800
63702 Repair of meningocele; larger than 5 diameter 37,180 18,480
63704 Repair of myelomeningocele; less than 5 cm diameter 37,800 21,000
63706 Repair of myelomeningocele; larger than 5 diameter 46,500 25,200
63707 Repair of dural/ CSF leak, not requiring laminectomy 30,300 16,800
63709 Repair of dural/ CSF leak or pseudomeningocele, w/ 46,500 25,200

laminectomy
63710 Dural graft, spinal 46,500 25,200
63740 Creation of shunt, lumbar, subarachnoid-peritoneal, - 30,300 16,800
pleural, or other;
including laminectomy
63741 Creation of shunt, lumbar, subarachnoid-peritoneal, - 23,300 12,600
pleural, or other;
percutaneous, not requiring laminectomy
64702 Neuroplasty; digital, one or both, same digit 12,120 6,720
64704 Neuroplasty; nerve of hand or foot 12,120 6,720

64708 Neuroplasty, major peripheral nerve, arm or leg; other 18,000 8,400
than specified
64712 Neuroplasty, major peripheral nerve, arm or leg; 20,980 10,080
sciatic nerve
brachial plexus
lumbar plexus
64716 Neuroplasty and/or transposition; cranial nerve 37,800 21,000
(specify)
64718 Neuroplasty and/or transposition; ulnar nerve at 18,000 8,400
elbow
64719 Neuroplasty and/or transposition; ulnar nerve at wrist 18,000 8,400
64721 Neuroplasty and/or transposition; median nerve at 18,000 8,400

carpal tunnel
64722 Decompression; unspecified nerve(s) (specify) 18,000 8,400
64726 Decompression; plantar digital nerve 18,000 8,400

Internal neurolysis, requiring use of operating
microscope (list separately in addition to code for
64727 neuroplasty) (Neuroplasty inlcudes external 30,300 16,800
neurolysis)
64732 Transection or avulsion of; supraorbital nerve 9,700 4,200
64734 Transection or avulsion of; infraorbital nerve 9,700 4,200
64736 Transection or avulsion of; mental nerve 9,700 4,200

64738 Transection or avulsion of; inferior alveolar nerve by 9,700 4,200
osteotomy
64740 Transection or avulsion of; lingual nerve 9,700 4,200
64742 Transection or avulsion of; facial nerve, differential or 12,120 6,720
complete
64744 Transection or avulsion of; greater occipital nerve 9,700 4,200
64746 Transection or avulsion of; phrenic nerve 12,120 6,720

64752 Transection or avulsion of; vagus nerve (vagotomy), 21,940 9,240
transthoracic
Transection or avulsion of; vagi limited to proximal
stomach (selective proximal vagotomy, proximal
gastric vagotomy, parietal cell vagotomy,
64755 supra- or highly selective vagotomy) 21,940 9,240
64760 Transection or avulsion of; vagus nerve (vagotomy), 18,000 8,400

abdominal
64761 Transection or avulsion of; pudendal nerve 9,700 4,200
64763 Transection or avulsion of obturator nerve, 18,000 8,400

extrapelvic, w/ or w/o adductor
tenotomy
64766 Transection or avulsion of obturator nerve, intrapelvic, 18,000 8,400
w/ or w/o adductor
tenotomy
64771 Transection or avulsion of other cranial nerve, 37,800 21,000
intradural
64772 Transection or avulsion of other spinal nerve, 30,300 16,800
extradural
64774 Excision of neuroma; cutaneous nerve, surgically 8,020 2,520
identifiable
64776 Excision of neuroma; digital nerve, one or both, same 8,020 2,520
digit
64782 Excision of neuroma; hand or foot, except digital nerve 8,020 2,520
64784 Excision of neuroma; major peripheral nerve, except 8,020 2,520

sciatic
64786 Excision of neuroma; sciatic nerve 9,700 4,200
64788 Excision of neurofibroma or neurolemmoma; 8,020 2,520
cutaneous nerve
64790 Excision of neurofibroma or neurolemmoma; major 8,020 2,520
peripheral nerve
64792 Excision of neurofibroma or neurolemmoma; 9,700 4,200
extensive (including malignant
type)
64795 Biopsy of nerve 8,020 2,520

64802 Sympathectomy, cervical 18,000 8,400
64804 Sympathectomy, cervicothoracic 18,000 8,400
64809 Sympathectomy, thoracolumbar 18,000 8,400
64818 Sympathectomy, lumbar 18,000 8,400
64820 Sympathectomy, digital arteries, w/ magnification, 12,120 6,720
each digit
64830 Microdissection and/or microrepair of nerve (list 20,980 10,080
separately in addition to
code for nerve repair)
64831 Suture of digital nerve, hand or foot; one nerve 18,000 8,400
64832 Suture of digital nerve, hand or foot; each additional 8,020 2,520
digital nerve
64834 Suture of one nerve, hand or foot; common sensory 18,000 8,400
nerve
64835 Suture of one nerve, hand or foot; median motor 18,000 8,400
thenar
64836 Suture of one nerve, hand or foot; ulnar motor 18,000 8,400
64837 Suture of each additional nerve, hand or foot 8,020 2,520
64840 Suture of posterior tibial nerve 18,000 8,400

64856 Suture of major peripheral nerve, arm or leg, except 20,980 10,080
sciatic; including
transposition
64857 Suture of major peripheral nerve, arm or leg, except 18,000 8,400
sciatic; w/o
transposition
64858 Suture of sciatic nerve 18,000 8,400
64859 Suture of each additional major peripheral nerve 8,020 2,520
64861 Suture of; brachial plexus 20,980 10,080

64862 Suture of; lumbar plexus 20,980 10,080
64864 Suture of facial nerve; extracranial 20,980 10,080
64865 Suture of facial nerve; infratemporal, w/ or w/o 20,980 10,080
grafting
64866 Anastomosis; facial-spinal accessory 23,300 12,600
64868 Anastomosis; facial-hypoglossal 23,300 12,600
64870 Anastomosis; facial-phrenic 23,300 12,600
64885 Nerve graft (includes obtaining graft), head or neck; up 23,300 12,600
to 4cm in length
64886 Nerve graft (includes obtaining graft), head or neck; 31,580 14,280
more than 4 cm length
64890 Nerve graft (includes obtaining graft), single strand, 30,300 16,800
hand or foot; up to 4
cm length
hand or foot; more than
4 cm length
arm or leg; up to 4 cm
length
arm or leg; more than 4
cm length
64895 Nerve graft (includes obtaining graft), multiple strands 27,120 15,120
(cable), hand or foot;
up to 4 cm length
(cable), hand or foot;
(cable), arm or leg;
up to 4 cm length
(cable), arm or leg;
64901 Nerve graft, each additional nerve; single strand 8,020 2,520
64902 Nerve graft, each additional nerve; multiple strands 8,020 2,520
(cable)
64905 Nerve pedicle transfer; first stage 20,980 10,080
64907 Nerve pedicle transfer; second stage 20,980 10,080
65091 Evisceration of ocular contents; w/o implant 12,120 6,720
65093 Evisceration of ocular contents; w/ implant 12,120 6,720

65101 Enucleation of eye; w/o implant 12,120 6,720
65103 Enucleation of eye; w/ implant, muscles not attached 12,120 6,720
to implant
65105 Enucleation of eye; w/ implant, muscles attached to 12,120 6,720
implant
65110 Exenteration of orbit without skin graft, removal of 37,800 21,000
orbital contents; only
orbital contents; w/
therapeutic removal of bone
orbital contents; w/
muscle or myocutaneous flap
65130 Insertion of ocular implant; after evisceration, in 10,960 5,460
scleral shell
65135 Insertion of ocular implant; after enucleation, muscles 10,960 5,460
not attached to
implant
65140 Insertion of ocular implant; after enucleation, muscles 11,980 5,880
attached to implant
65150 Reinsertion of ocular implant; with or without 11,980 5,880
conjunctival graft
65155 Reinsertion of ocular implant; with use of foreign 11,980 5,880
material for
reinforcement and/or attachment of muscles to
implant
65175 Removal of ocular implant 9,700 4,200

65205 Removal of foreign body, external eye; conjunctival, 3,500 1,000
superficial
65210 Removal of foreign body, external eye; 4,500 2,000
subconjunctival or scleral, with slit
lamp
65222 Removal of foreign body, external eye; cornea, with 4,180 1,680
slit lamp
65235 Removal of foreign body, intraocular; from anterior 18,000 8,400
chamber or lens
65260 Removal of foreign body, intraocular; from posterior 53,400 29,400
segment, magnetic
extraction, anterior or posterior route
65265 Removal of foreign body, intraocular; from posterior 55,000 33,600
segment, nonmagnetic
extraction
65270 Repair of laceration; conjunctiva, w/ or w/o 8,020 2,520
nonperforating laceration
sclera, direct closure
65273 Repair of laceration; conjunctiva, by mobilization and 8,020 2,520
rearrangement
65275 Repair of laceration; cornea, nonperforating, w/ or 9,700 4,200
w/o removal foreign
body
65280 Repair of laceration; cornea and/or sclera, perforating, 20,980 10,080
not involving uveal
tissue
65285 Repair of laceration; cornea and/or sclera, perforating, 23,300 12,600
w/ reposition or
resection of uveal tissue
65286 Repair of laceration; application of tissue glue, wounds 9,700 4,200
of cornea and/or
sclera
65290 Repair of wound, extraocular muscle, tendon and/ or 9,700 4,200
Tenons capsule
65400 Excision of lesion, cornea (keratectomy, lamellar, 8,260 3,360
partial), except pterygium
65410 Biopsy of cornea 8,020 2,520
65420 Excision or transposition of pterygium; without graft 8,260 3,360
65426 Excision or transposition of pterygium; with graft 9,700 4,200
65450 Destruction of lesion of cornea by cryotherapy, 8,020 2,520

photocoagulation or
thermocauterization
65710 Keratoplasty (corneal transplant); lamellar 30,300 16,800
65730 Keratoplasty (corneal transplant); penetrating (except 30,300 16,800
in aphakia)
65750 Keratoplasty (corneal transplant); penetrating (in 30,300 16,800
aphakia)
65755 Keratoplasty (corneal transplant); penetrating (in 30,300 16,800
pseudophakia)
65760 Keratomileusis N/A N/A
65765 Keratophakia 10,540 5,040
65767 Epikeratoplasty 18,000 8,400
65770 Keratoprosthesis 30,300 16,800
65771 Radial keratotomy 14,960 7,560
65772 Corneal relaxing incision for correction of surgically 14,960 7,560
induced astigmatism
65775 Corneal wedge resection for correction of surgically 14,960 7,560
induced astigmatism
65780 Ocular surface reconstruction; amniotic membrane 30,300 16,800
transplantation
65781 Ocular surface reconstruction; limbal stem cell 30,300 16,800
allograft (eg, cadaveric or
living donor)
65782 Ocular surface reconstruction; limbal conjunctival 30,300 16,800
autograft (includes
obtaining graft)
65805 Paracentesis of anterior chamber of eye; w/ 8,020 2,520
therapeutic release of aqueous
Paracentesis of anterior chamber of eye; w/ removal
of vitreous and/or discission of anterior hyaloid
65810 membrane, w/ or w/o air injection 9,700 4,200
65815 Paracentesis of anterior chamber of eye; w/ removal 9,700 4,200

of blood, w/ or w/o
irrigation and/or air injection
65820 Goniotomy 23,300 12,600
65850 Trabeculotomy ab externo 23,300 12,600
65855 Trabeculoplasty by laser surgery, one or more sessions 12,120 6,720
(defined treatment
series)
65860 Severing adhesions of anterior segment, laser 10,540 5,040
technique
65865 Severing adhesions of anterior segment of eye, 10,540 5,040
incisional technique (w/ or
w/o injection of air or liquid); goniosynechiae
Severing adhesions of anterior segment of eye,

incisional technique (w/ or w/o injection of air or
65870 liquid); anterior synechiae, except goniosynechiae 10,540 5,040

w/o injection of air or liquid); posterior synechiae

w/o injection of air or liquid); corneovitreal adhesions
65900 Removal of epithelial material, anterior segment eye 10,540 5,040
65920 Removal of implanted material, anterior segment eye 12,120 6,720
65930 Removal of blood clot, anterior segment eye 8,020 2,520
66130 Excision of lesion, sclera 8,260 3,360

66150 Fistulization of sclera for glaucoma; trephination w/ 18,000 8,400
iridectomy
66155 Fistulization of sclera for glaucoma; 18,000 8,400
thermocauterization w/ iridectomy
66160 Fistulization of sclera for glaucoma; sclerectomy w/ 18,000 8,400
punch or scissors, w/
iridectomy
66165 Fistulization of sclera for glaucoma; iridencleisis or 18,000 8,400
iridotasis
66170 Fistulization of sclera for glaucoma; trabeculectomy 18,000 8,400
ab externo in absence
of previous surgery
Fistulization of sclera for glaucoma; trabeculectomy ab
externo w/ scarring
66172 from previous ocular surgery or trauma (includes 27,120 15,120
injection of antifibrotic agents)
66180 Aquenous shunt to extraocular reservoir (e.g., 30,300 16,800
Molteno, Schocket, Denver-
Krupin)
66185 Revision of aqueous shunt to extraocular reservoir 30,300 16,800
66220 Repair of scleral staphyloma; w/o graft 12,120 6,720

66225 Repair of scleral staphyloma; w/ graft 23,300 12,600
66250 Revision or repair of operative wound of anterior 14,960 7,560
segment, any type, early
or late, major or minor procedure
66500 Iridotomy by stab incision; except transfixion 10,540 5,040
66505 Iridotomy by stab incision; w/ transfixion as for iris 10,540 5,040

bombe
66600 Iridectomy, w/ corneoscleral or corneal section; for 12,120 6,720
removal of lesion
66605 Iridectomy, w/ corneoscleral or corneal section; w/ 18,000 8,400
cyclectomy
66625 Iridectomy, w/ corneoscleral or corneal section; 12,120 6,720
peripheral for glaucoma
66630 Iridectomy, w/ corneoscleral or corneal section; sector 12,120 6,720
for glaucoma
66680 Repair of iris, ciliary body (as for iridodialysis) 18,000 8,400
66682 Suture of iris, ciliary body w/ retrieval of suture 14,960 7,560

through small incision (e.g.,
McCannel suture)
66700 Ciliary body destruction; diathermy 11,980 5,880
66710 Ciliary body destruction; cyclophotocoagulation 11,980 5,880
66720 Ciliary body destruction; cryotherapy 11,980 5,880

66740 Ciliary body destruction; cyclodialysis 11,980 5,880
66761 Iridotomy/iridectomy by laser surgery (e.g., for 10,540 5,040
glaucoma) ( one or more
sessions)
66762 Iridoplasty by photocoagulation (one or more 12,120 6,720
sessions) (e.g., for
improvement of vision, for widening of anterior
chamber angle)
66770 Destruction of cyst or lesion iris or ciliary body 10,540 5,040

(nonexcisional procedure)
Discission of secondary membranous cataract
(opacified posterior lens capsule and/or anterior
hyaloid); stab incision technique (Ziegler or
66820 Wheeler knife) 12,120 6,720
Discission of secondary membranous cataract

hyaloid); laser surgery (e.g., YAG laser) (one or more
66821 stages) 8,260 3,360
66825 Repositioning of intraocular lens prosthesis, requiring 18,000 8,400

an incision
66830 Removal of secondary membranous cataract 12,120 6,720
hyaloid) w/ corneo-scleral section, w/ or w/o
iridectomy (iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material; aspiration technique, one or 16,000 6,400

more stages
Removal of lens material; phacofragmentation
technique (mechanical or ultrasonic) (e.g.,
66850 phacoemulsification), w/ aspiration 16,000 6,400
66852 Removal of lens material; pars plana approach, with or 16,000 6,400
without vitrectomy
66920 Removal of lens material; intracapsular 16,000 6,400
66930 Removal of lens material; intracapsular, for dislocated 16,000 6,400
lens
66940 Removal of lens material; extracapsular 16,000 6,400
Extracapsular cataract removal with insertion of
intraocular lens prosthesis (one stage procedure),
manual or mechanical technique (eg, irrigation and
aspiration or phacoemulsification), complex, requiring
devices or techniques not generally used in routine
cataract surgery (e.g. iris expansion device, suture
support for intraocular lens, or primary posterior
66982 capsullorhexis) or performed on patients in the 16,000 6,400
amblyogenic developmental stage
66983 Intracapsular cataract extraction w/ insertion of 16,000 6,400

intraocular lens prosthesis
(one stage procedure)
66984 Extracapsular cataract removal w/ insertion of 16,000 6,400
(one stage procedure), (e.g., irrigation and aspiration)
66985 Insertion of intraocular lens prosthesis, not associated 16,000 6,400

with cataract
removal
66986 Exchange of intraocular lens 16,000 6,400
66987 Extracapsular cataract removal w/ insertion of 16,000 6,400
(one stage procedure), (e.g., phacoemulsification)
66991 Revision of failed filter; with or without 37,800 21,000

explantation/exchange of shunt
66992 Revision of failed filter; with excision of bleb cyst 37,800 21,000
66993 Revision of failed filter; with choroidal tap 30,300 16,800

66994 Revision of failed filter; with posterior sclerotomy 30,300 16,800
66995 Revision of failed filter; with anterior chamber 30,300 16,800

reformation
66996 Revision of filtering bleb, needling technique; without 12,120 6,720
injection of anti-
metabolite
66997 Revision of filtering bleb, needling technique; with 18,000 8,400
injection of anti-
metabolite
66998 Release of scleral flap suture by laser suture lysis (new 9,700 4,200
code)
66999 Revision of overfiltering bleb (includes autologous 18,000 8,400
blood injection,
cryotherapy, mattress sutures, etc.)
67005 Removal of vitreous, anterior approach (open sky 37,800 21,000
technique or limbal
incision); partial removal
67010 Removal of vitreous, anterior approach (open sky 45,000 21,000
technique or limbal
incision); subtotal removal w/ mechanical vitrectomy
67015 Aspiration or release of vitreous, subretinal or 9,700 4,200

choroidal fluid, pars plana
approach (posterior sclerotomy)
67025 Injection of vitreous substitute, pars plana or limbal 12,120 6,720
approach, (fluid-gas
exchange), w/ or w/o aspiration
67027 Implantation of intravitreal drug delivery system (eg, 31,580 14,280
ganciclovir implant),
includes concomitant removal of vitreous
67030 Discission of vitreous strands (w/o removal), pars 12,900 6,300
plana approach
67031 Severing of vitreous strands, vitreous face adhesions, 10,540 5,040
sheets, membranes or
opacities, laser surgery (one or more stages)
67036 Vitrectomy, mechanical, pars plana approach; 46,500 25,200
67038 Vitrectomy, mechanical, pars plana approach; w/ 46,500 25,200

epiretinal membrane
stripping
67039 Vitrectomy, mechanical, pars plana approach; w/ focal 46,500 25,200
endolaser
photocoagulation
67040 Vitrectomy, mechanical, pars plana approach; w/ 46,500 25,200
endolaser panretinal
photocoagulation
67041 Vitrectomy, mechanical, pars plana approach; with 46,500 25,200
internal limiting
membrane (ILM) peeling
radial optic nerve
neurotomy (RON)
sheathotomy for branch
retinal vein occlusion
macular translocation
(limited by retinotomy and/or scleral imbrication)

macular translocation
(total)
removal of subretinal
membranes
removal of choroidal
neovascular membrane
Vitrectomy, mechanical, pars plana approach; with
endodrainage of subretinal hemorrhage (with or
67048 without tPA injection) 46,500 25,200

removal of dropped IOL
phacofragmentation for
dropped lens material
internal tamponade with
air, gas, silicone oil, perfluorocarbon liquid
insertion of scleral
fixated intraocular lens, with or without anterior
vitrectomy
67101 Repair of retinal detachment, one or more sessions; 46,500 25,200

cryotherapy or
diathermy, w/ or w/o drainage of subretinal fluid
67105 Repair of retinal detachment, one or more sessions; 37,180 18,480

photocoagulation, w/
or w/o drainage of subretinal fluid
67107 Repair of retinal detachment; scleral buckling (such as 46,500 25,200
lamellar scleral dissection, imbrication or encircling
procedure), w/ or w/o implant, w/ or w/o
cryotherapy, photocoagulation, and drainage of
subretinal fluid
67108 Repair of retinal detachment; w/ vitrectomy, any 46,500 25,200
method, w/ or w/o air or gas tamponade, focal
endolaser photocoagulation, cryotherapy, drainage of
subretinal fluid, scleral buckling, and/or removal of
lens by same technique
67110 Repair of retinal detachment; by injection of air or 30,300 16,800

other gas (e.g.,
pneumatic retinopexy)
Repair of retinal detachment; by scleral buckling or
vitrectomy, on patient having previous ipsilateral
retinal detachment repair(s) using scleral
67112 buckling or vitrectomy techniques 46,500 25,200
67115 Release of encircling material (posterior segment) 12,120 6,720
67120 Removal of implanted material, posterior segment; 12,120 6,720

extraocular
67121 Removal of implanted material, posterior segment; 20,980 10,080
intraocular
Destruction of localized lesion of retina (e.g.,
maculopathy, choroidopathy, small tumors), one or
67208 more sessions; cryotherapy, diathermy 12,120 6,720

67210 more sessions; photocoagulation (laser or xenon arc) 12,120 6,720

more sessions; radiation by implantation of source
67218 (includes removal of source) 12,120 6,720
Destruction of localized lesion of choroid (e.g.,

choroidal neovascularization); photocoagulation (e.g.,
67220 laser), one or more sessions 12,120 6,720
Destruction of localized lesion of choroid (e.g.,

choroidal neovascularization); photodynamic therapy
67221 (includes intravenous infusions 12,120 6,720
67222 Destruction of localized lesion of choroid (e.g., 12,120 6,720

choroidal
neovascularization); transpupillary thermotherapy
Destruction of extensive or progressive retinopathy

(e.g., diabetic retinopathy), one or more sessions;
67227 cryotherapy, diathermy 12,120 6,720
Destruction of extensive or progressive retinopathy

(e.g., diabetic retinopathy), one or more sessions;
67228 photocoagulation (laser or xenon arc) 12,120 6,720
67250 Scleral reinforcement 12,120 6,720

67311 Strabismus surgery, recession or resection procedure 10,120 4,620
(patient not
previously operated on); one horizontal muscle
67312 Strabismus surgery, recession or resection procedure 12,120 6,720

(patient not
previously operated on); two horizontal muscles
Strabismus surgery, recession or resection procedure

(patient not previously operated on); one vertical
67314 muscle (excluding superior oblique) 12,120 6,720
Strabismus surgery, recession or resection procedure
(patient not previously operated on); two or more
vertical muscles (excluding superior
67316 oblique) 18,000 8,400
67318 Strabismus surgery, any procedure (patient not 18,000 8,400

previously operated on),
superior oblique muscle
67320 Transposition procedure (e.g., for paretic extraocular 18,000 8,400
muscle), any
extraocular muscle (specify)
67331 Strabismus surgery on patient w/ previous eye surgery 18,000 8,400
or injury that did not
involve the extraocular muscles
Strabismus surgery on patient w/ scaring of
extraocular muscles (e.g., prior ocular injury,
strabismus or retinal detachment surgery) or
67332 restrictive 21,940 9,240
myopathy (e.g., dysthyroid ophthalmopathy)
67334 Strabismus surgery by posterior fixation suture 11,980 5,880

technique, w/ or w/o muscle
recession
67340 Strabismus surgery involving exploration and/or repair 22,660 11,760
of detached
extraocular muscle(s)
67343 Release of extensive scar tissue w/o detaching 18,000 8,400
extraocular muscle
67345 Chemodenervation of extraocular muscle 9,700 4,200
67350 Biopsy of extraocular muscle 9,700 4,200
67400 Orbitotomy w/o bone flap (frontal or 46,500 25,200
transconjunctival approach); for
exploration, w/ or w/o biopsy
transconjunctival approach); w/
drainage only
removal of lesion
removal of bone for decompression
67415 Fine needle aspiration of orbital contents 46,500 25,200
67420 Orbitotomy w/ bone flap or window, lateral approach 46,500 25,200
(e.g., Kroenlein); w/
removal of lesion
drainage
removal of bone for decompression
67550 Orbital implant (implant outside muscle cone); 10,960 5,460
insertion
67560 Orbital implant (implant outside muscle cone); 10,960 5,460
removal or revision
67570 Optic nerve decompression (e.g., incision or 53,400 29,400
fenestration of optic nerve
sheath)
67580 Repair of anophthalmic socket; with insertion or 12,120 6,720
removal of orbital implant
within muscle cone
67581 Repair of anophthalmic socket; with exchange or 20,980 10,080
orbital implant
67582 Repair of anophthalmic socket; with exchange of 20,980 10,080
orbital implant and
reattachment of muscles
67583 Repair of anophthalmic socket; with fornix 20,980 10,080
reconstruction using sutures
67584 Repair of anophthalmic socket; with fornix 20,980 10,080
reconstruction using buccal
mucosal graft or amnion graft, including harvesting of
graft
67585 Repair of anophthalmic socket; with revision of 20,980 10,080

implant and fornix
reconstruction using sutures
Repair of anophthalmic socket; with revision of
implant and fornix reconstruction using buccal
mucosal graft, or amnion graft (including
67586 harvesting of graft) 20,980 10,080
67700 Blepharotomy, drainage of abscess, eyelid 5,680 1,680
67710 Severing of tarsorrhaphy 5,680 1,680

67715 Canthotomy 5,680 1,680
67800 Excision of chalazion 5,680 1,680
67810 Biopsy of eyelid 5,680 1,680
67825 Repair of trichiasis; by electroepilation, electrosurgery, 5,680 1,680
cryotherapy or laser
surgery
67830 Repair of trichiasis; incision of lid margin 3,640 840
67835 Repair of trichiasis; incision of lid margin, with free 9,300 2,100
mucous membrane graft
67840 Excision of lesion of eyelid (except chalazion) without 5,560 1,260
closure or with simple
direct closure
67875 Temporary closure of eyelids suture (e.g., frost suture) 5,680 1,680
67880 Construction of intermargin adhesions, median 5,680 1,680

tarsorrhaphy, or
canthorrhaphy;
67882 Construction of intermargin adhesions, median 8,020 2,520
tarsorrhaphy, or
canthorrhaphy; with transportation of tarsal plate
67900 Repair of brow ptosis (supraciliary, midforehead or 18,000 8,400

coronal approach)
67901 Repair of blepharoptosis; frontalis muscle technique 18,000 8,400
with suture or other
material
67902 Repair of blepharoptosis; frontalis muscle technique 20,980 10,080
with fascial sling
(includes obtaining fascia)
67903 Repair of blepharoptosis; (tarso) levator resection or 18,000 8,400
advancement, internal
approach
67904 Repair of blepharoptosis; (tarso) levator resection or 18,000 8,400
advancement, external
approach
67906 Repair of blepharoptosis; superior rectus technique 18,000 8,400
with fascial sling
(includes obtaining fascia)
67908 Repair of blepharoptosis; conjunctivo-tarso-Mullers 18,000 8,400
muscle-levator
resection (Fasanella-Servat type)
67911 Repair of lid retraction (eyelid recession); without 21,400 10,500
spacer
67912 Correction of lagophthalmos, with implantation of 32,000 14,700
upper eyelid load
67914 Repair of ectropion; suture 8,020 2,520
67915 Repair of ectropion; thermocauterization 8,020 2,520
67916 Blepharoplasty, excision tarsal wedge 9,700 4,200
67917 Blepharoplasty, extensive (e.g., Kuhnt-Szymanowski or 12,900 6,300
tarsal strip
operations)
67921 Repair of entropion; suture 5,680 1,680
67922 Repair of entropion; thermocauterization 5,680 1,680
67923 Blepharoplasty, excision tarsal wedge 9,700 4,200
67924 Blepharoplasty, extensive (e.g., Wheeler operation) 12,900 6,300
67930 Suture of recent wound, eyelid, involving lid margin, 9,700 4,200
tarsus, and/ or
palpebral conjunctiva direct closure; partial thickness
67935 Suture of recent wound, eyelid, involving lid margin, 12,120 6,720
tarsus, and/ or
palpebral conjunctiva direct closure; full thickness
67950 Canthoplasty (reconstruction of canthus) 12,120 6,720

67961 Excision and repair of eyelid, involving lid margin, 30,740 13,440
tarsus, conjunctiva, canthus, or full thickness, may
include preparation for skin graft or pedicle flap with
adjacent tissue transfer or rearrangement; up to one-
fourth of lid
margin
67966 Excision and repair of eyelid, involving lid margin, 27,120 15,120
tarsus, conjunctiva, canthus, or full thickness, may
include preparation for skin graft or pedicle flap with
adjacent tissue transfer or rearrangement; over one-
fourth of lid
margin
Reconstruction of eyelid, full thickness by transfer of

tarsoconjunctival flap from opposing eyelid; up to
67971 two-thirds of eyelid, one stage or first stage 30,300 16,800

tarsoconjunctival flap from opposing eyelid; total
67973 eyelid, lower, one stage or first stage 37,800 21,000

tarsoconjunctival flap from opposing eyelid; total
67974 eyelid, upper, one stage or first stage 37,800 21,000
67975 Reconstruction of eyelid, full thickness by transfer of 30,300 16,800

tarsoconjunctival flap
from opposing eyelid; second stage
68100 Biopsy of conjunctiva 5,680 1,680
68110 Excision of lesion, conjunctiva; up to 1 cm 8,020 2,520
68115 Excision of lesion, conjunctiva; over 1 cm 8,020 2,520
68130 Excision of lesion, conjunctiva; with adjacent sclera 8,020 2,520
68320 Conjunctivoplasty; with conjunctival graft or extensive 10,540 5,040

rearrangement
68325 Conjunctivoplasty; with buccal mucous membrane 12,120 6,720
graft)
68326 Conjunctivoplasty reconstruction cul-de-sac; with 14,960 7,560
conjunctival graft or
extensive rearrangement
68328 Conjunctivoplasty reconstruction cul-de-sac; with 18,000 8,400
buccal mucous membrane
68330 Repair of symblepharon; conjunctivoplasty, without 14,960 7,560
graft
68335 Repair of symblepharon; with free graft conjunctiva or 21,940 9,240
buccal mucous
membrane (includes obtaining graft)
68340 Repair of symblepharon; division of symblepharon, 18,000 8,400
with or without
insertion of conformer or contact lens
68360 Conjunctival flap; bridge or partial 11,980 5,880
68362 Conjunctival flap; total (such as Gunderson thin flap or 11,980 5,880
purse string flap)
68371 Harvesting conjunctival allograft, living donor 20,980 10,080
68400 Incision, drainage of lacrimal gland 5,680 1,680

68420 Incision, drainage of lacrimal sac (dacryocystostomy) 5,680 1,680
68440 Snip incision of lacrimal punctum 5,680 1,680

68500 Excision of lacrimal gland (dacryoadenectomy), except 12,120 6,720
for tumor
68510 Biopsy of lacrimal gland 5,680 1,680
68520 Excision of lacrimal sac (dacryocystectomy) 12,120 6,720
68525 Biopsy of lacrimal sac 5,680 1,680

68530 Removal of foreign body or dacryolith, lacrimal N/A N/A
passages
68540 Excision of lacrimal gland tumor; frontal approach 18,000 8,400
68550 Excision of lacrimal gland tumor; involving osteotomy 18,000 8,400
68700 Plastic repair of canaliculi 9,700 4,200

68705 Correction of everted punctum, cautery 3,640 840
68720 Dacryocystorhinostomy (fistulization of lacrimal sac to 18,000 8,400
nasal cavity)
68745 Conjunctivorhinostomy (fistulization of conjunctiva to 18,000 8,400
nasal cavity); without
tube
68750 Conjunctivorhinostomy (fistulization of conjunctiva to 20,980 10,080
nasal cavity); with
insertion of tube or stent
68760 Closure of the lacrimal punctum; by 8,020 2,520
thermocauterization, ligation, or laser
surgery
68770 Closure of lacrimal fistula 10,880 3,780
68811 Probing of nasolacrimal duct; requiring general 8,020 2,520
anesthesia
68815 Probing of nasolacrimal duct; with insertion of tube or 9,700 4,200
stent
69000 Drainage external ear, abscess or hematoma 3,672 672
69020 Drainage external auditory canal, abscess 3,472 252
69100 Biopsy external ear 5,680 1,680

69105 Biopsy external auditory canal 5,680 1,680
69110 Excision external ear; partial, simple repair 8,260 3,360
69120 Excision external ear; complete amputation 12,120 6,720
69140 Excision exostosis(es), external auditory canal 9,700 4,200
69145 Excision soft tissue lesion, external auditory canal 9,700 4,200
69150 Radical excision external auditory canal lesion; w/o 23,300 12,600
neck dissection
69155 Radical excision external auditory canal lesion; w/ 30,300 16,800
neck dissection
69200 Removal foreign body from external auditory canal; 9,300 2,100
w/ general anesthesia
69220 Debridement, mastoidectomy cavity, simple (e.g., 8,020 2,520
routine cleaning)
69222 Debridement, mastoidectomy cavity, complex (e.g., 9,700 4,200
w/ anesthesia or more
than routine cleaning)
69310 Reconstruction of external auditory canal 23,300 12,600
(meatoplasty) (e.g., for stenosis
due to trauma, infection)
69320 Reconstruction external auditory canal for congenital 23,300 12,600
atresia, single stage
69400 Eustachian tube inflation, transnasal; w/ 5,812 1,512
catheterization
69405 Eustachian tube catheterization, transtympanic 5,680 1,680
69420 Myringotomy including aspiration and/or eustachian 5,680 1,680

tube inflation
69421 Myringotomy including aspiration and/or eustachian 8,020 2,520
tube inflation
requiring general anesthesia
69433 Tympanostomy (requiring insertion of ventilating 8,260 3,360
tube), local or topical
anesthesia
69436 Tympanostomy (requiring insertion of ventilating 8,260 3,360
tube), w/ general
anesthesia
69440 Middle ear exploration through postauricular or ear 18,000 8,400
canal incision
69450 Tympanolysis, transcanal 9,700 4,200
69501 Transmastoid antrotomy ("simple" mastoidectomy) 20,980 10,080
69502 Mastoidectomy; complete 23,300 12,600

69505 Mastoidectomy; modified radical 23,300 12,600
69511 Mastoidectomy; radical 23,300 12,600
69530 Petrous apicectomy including radical mastoidectomy 23,300 12,600
69535 Resection temporal bone, external approach 46,500 25,200
69540 Excision aural polyp 8,020 2,520

69550 Excision aural glomus tumor; transcanal 30,300 16,800
69552 Excision aural glomus tumor; transmastoid 30,300 16,800
69554 Excision aural glomus tumor; extended 30,300 16,800
(extratemporal)
69601 Revision mastoidectomy; resulting in complete 23,300 12,600
mastoidectomy
69602 Revision mastoidectomy; resulting in modified radical 31,580 14,280
mastoidectomy
69603 Revision mastoidectomy; resulting in radical 23,300 12,600
mastoidectomy
69604 Revision mastoidectomy; resulting in tympanoplasty 23,300 12,600
69605 Revision mastoidectomy; w/ apicectomy 23,300 12,600

69610 Tympanic membrane repair, w/ or w/o site 12,120 6,720
preparation or perforation for
closure, w/ or w/o patch
69620 Myringoplasty (surgery confined to drumhead and 20,980 10,080
donor area)
Tympanoplasty w/o mastoidectomy (including
canalplasty, atticotomy and/ or middle ear surgery),
69631 initial or revision; w/o ossicular chain reconstruction 30,740 13,440

canalplasty, atticotomy and/
or middle ear surgery), initial or revision; w/ ossicular
69632 chain reconstruction (e.g., postfenestration) 30,740 13,440
canalplasty, atticotomy and/ or middle ear surgery),
initial or revision; w/ ossicular chain reconstruction
and synthetic prosthesis (e.g., partial ossicular
69633 replacement prosthesis, (PORP), total ossicular 30,740 13,440
replacement prosthesis (TORP)
Tympanoplasty w/ antrotomy or mastoidotomy

(including canalplasty,
atticotomy, middle ear surgery, and/ or tympanic
69635 membrane repair); w/o ossicular chain reconstruction 46,500 25,200

(including canalplasty,
atticotomy, middle ear surgery, and/ or tympanic
69636 membrane repair); w/ ossicular chain reconstruction 47,340 26,040

(including canalplasty, atticotomy, middle ear surgery,
and/ or tympanic membrane repair); w/ ossicular
chain reconstruction and synthetic prosthesis (e.g.
partial ossicular replacement prosthesis, (PORP), total
69637 ossicular replacement prosthesis (TORP) 47,340 26,040
Tympanoplasty w/ mastoidectomy (including

canalplasty, middle ear surgery, tympanic membrane
69641 repair); w/o ossicular chain reconstruction 46,500 25,200

69642 repair); w/ ossicular chain reconstruction 47,340 26,040

repair); w/ intact or reconstructed wall, w/o
69643 ossicular chain reconstruction 48,180 26,880

repair); w/ intact or reconstructed canal wall,
69644 w/ ossicular chain reconstruction 49,020 27,720

repair); radical or complete, w/o ossicular
69645 chain reconstruction 46,500 25,200

repair); radical or complete, w/ ossicular
69646 chain reconstruction 46,500 25,200
69650 Stapes mobilization 37,800 21,000

69660 Stapedectomy or stapedotomy w/ reestablishment of 38,640 21,840
ossicular continuity,
w/ or w/o use of foreign material;
Stapedectomy or stapedotomy w/ reestablishment of
ossicular continuity, w/ or w/o use of foreign material;
69661 w/ footplate drill out 38,640 21,840
69662 Revision of stapedectomy or stapedotomy 38,640 21,840

69666 Repair oval window fistula 38,640 21,840
69667 Repair round window fistula 38,640 21,840
69670 Mastoid obliteration 31,580 14,280
69676 Tympanic neurectomy 30,300 16,800
69700 Closure postauricular fistula, mastoid 10,540 5,040
69720 Decompression facial nerve, intratemporal; lateral to 30,300 16,800
geniculate ganglion
69725 Decompression facial nerve, intratemporal; including 30,300 16,800

medial to geniculate
ganglion
69740 Suture facial nerve, intratemporal, w/ or w/o graft or 37,800 21,000

decompression;
lateral to geniculate ganglion
69745 Suture facial nerve, intratemporal, w/ or w/o graft or 37,800 21,000
decompression;
including medial to geniculate ganglion
Labyrinthotomy, w/ or w/o cryosurgery including
other nonexcisional destructive procedures or
perfusion of vestbuloactive drugs (single or
69801 multiple perfusions); transcanal 38,640 21,840
69802 Labyrinthotomy, w/ or w/o cryosurgery including 39,480 22,680

other nonexcisional destructive procedures or
perfusion of vestbuloactive drugs (single or multiple
perfusions); w/ mastoidectomy
69805 Endolymphatic sac operation; w/o shunt 46,500 25,200

69806 Endolymphatic sac operation; w/ shunt 53,400 29,400
69820 Fenestration semicircular canal 46,500 25,200
69840 Revision fenestration operation 53,400 29,400
69905 Labyrinthectomy; transcanal 46,500 25,200
69910 Labyrinthectomy; w/ mastoidectomy 53,400 29,400
69915 Vestibular nerve section, translabyrinthine approach 53,400 29,400
69930 Cochlear device implantation, w/ or w/o 55,000 33,600

mastoidectomy
69950 Vestibular nerve section, transcranial approach 55,000 33,600
69955 Total facial nerve decompression and/or repair (may 55,000 33,600
include graft)
69960 Decompression internal auditory canal 53,400 29,400
69970 Removal of tumor, temporal bone 46,500 25,200
70010 Myelography, brain, including spinal puncture and 8,020 2,520
radiological supervision
and interpretation
70390 Sialography; including duct catheterization and 8,020 2,520
radiological supervision and
interpretation
71090 Insertion pacemaker, fluoroscopy and radiography, 8,020 2,520

and interpretation
72240 Myelography, spine, including spinal puncture and 8,020 2,520
and interpretation
74300 Cholangiography and/or pancreatography, 8,020 2,520
intraoperative, radiological
supervision and interpretation
74328 Endoscopic catheterization of the biliary ductal 8,020 2,520

system, radiological
74329 Endoscopic catheterization of the pancreatic ductal 8,020 2,520
system, radiological
74330 Combined endoscopic catheterization of the biliary 8,020 2,520
and pancreatic ductal
system, radiological supervision and interpretation
74340 Introduction of long gastrointestinal tube (e.g., Miller- 9,700 4,200
Abbott ), radiological
74350 Percutaneous placement of gastrostomy tube, 9,700 4,200
interpretation
74355 Percutaneous placement of enteroclysis tube, 9,700 4,200
interpretation
74360 Intraluminal dilation of strictures and/or obstructions, 9,700 4,200
radiological
74363 Percutaneous transhepatic dilation of sbiliary duct 18,000 8,400
stricture, radiological
Introduction of intracatheter or catheter into renal
pelvis for drainage and/or injection, percutaneous,
74475 radiological supervision and interpretation 18,000 8,400
Introduction of ureteral catheter or stent into ureter

through renal pelvis for drainage and/or injection,
percutaneous, radiological supervision and
74480 interpretation 18,000 8,400
74742 Transcervical catheterization of fallopian tube, 8,020 2,520

interpretation
75600 Aortography, thoracic, radiological supervision and 9,700 4,200
interpretation
75625 Aortography, abdominal, radiological supervision and 9,700 4,200
interpretation
75630 Aortography, abdominal plus bilateral iliofemoral 9,700 4,200
lower extremity,
radiological supervision and interpretation
Computed tomographic angiography, abdominal aorta
and bilateral iliofemoral lower extremity, radiological
75635 supervision and interpretation 9,700 4,200
75650 Angiography, cervicocerebral, radiological supervision 9,700 4,200

and interpretation
75658 Angiography, brachial retrograde, radiological 9,700 4,200
supervision and
interpretation
75660 Angiography, external carotid, unilateral, selective, 9,700 4,200
and interpretation
75662 Angiography, external carotid, bilateral, selective, 9,700 4,200
and interpretation
75665 Angiography, cerebral, radiological supervision and 9,700 4,200
interpretation
75671 Angiography, carotid, cerebral, bilateral, radiological 9,700 4,200
supervision and
interpretation
75676 Angiography, carotid, cervical, unilateral, radiological 9,700 4,200
supervision and
interpretation
75680 Angiography, carotid, cervical, bilateral, radiological 9,700 4,200
supervision and
interpretation
75685 Angiography, vertebral, cervical and/or intracranial, 9,700 4,200
and interpretation
75705 Angiography, spinal, radiological supervision and 9,700 4,200
interpretation
75710 Angiography, extremity, unilateral, radiological 9,700 4,200
supervision and
interpretation
75716 Angiography, extremity, bilateral, radiological 9,700 4,200
supervision and
interpretation
75722 Angiography, renal, unilateral, radiological supervision 9,700 4,200
and interpretation
75724 Angiography, renal, bilateral, radiological supervision 9,700 4,200
and interpretation
75726 Angiography, visceral, radiological supervision and 9,700 4,200
interpretation
75731 Angiography, adrenal, unilateral, radiological 9,700 4,200
75733 Angiography, adrenal, bilateral, radiological 9,700 4,200
75736 Angiography, pelvis, radiological supervision and 9,700 4,200
interpretation
75741 Angiography, pulmonary, unilateral, radiological 9,700 4,200
supervision and
interpretation
75743 Angiography, pulmonary, bilateral, radiological 9,700 4,200
supervision and
interpretation
75746 Angiography, pulmonary, nonselective, radiological 9,700 4,200
supervision and
interpretation
75756 Angiography, internal mammary, radiological 9,700 4,200
75757 Angiography, fluorescein (eye) 3,500 500
75790 Angiography, arteriovenous shunt (e.g., dialysis 9,700 4,200
patient), radiological
75801 Lymphangiography, extremity, unilateral, radiological 9,700 4,200
supervision and
interpretation
75803 Lymphangiography, extremity, bilateral, radiological 9,700 4,200
supervision and
interpretation
75805 Lymphangiography, pelvic/abdominal, unilateral , 9,700 4,200
and interpretation
75807 Lymphangiography, pelvic/abdominal, bilateral, 9,700 4,200
interpretation
75810 Splenoportography, radiological supervision and 9,700 4,200
interpretation
75820 Venography, extremity, unilateral or bilateral, 9,700 4,200
interpretation
75825 Venography, caval, inferior, radiological supervision 9,700 4,200
and interpretation
75827 Venography, caval, superior, radiological supervision 9,700 4,200
and interpretation
75831 Venography, renal, unilateral, radiological supervision 9,700 4,200
and interpretation
75833 Venography, renal, bilateral, radiological supervision 9,700 4,200
and interpretation
75840 Venography, adrenal, unilateral, radiological 9,700 4,200
75842 Venography, adrenal, bilateral, radiological 9,700 4,200
75860 Venography, venous sinus(e.g., petrosal and inferior 9,700 4,200
sagittal) or jugular,
75870 Venography, superior sagittal sinus, radiological 9,700 4,200
supervision and
interpretation
75872 Venography, epidural, radiological supervision and 9,700 4,200
interpretation
75880 Venography, orbital, radiological supervision and 9,700 4,200
interpretation
75885 Percutaneous transhepatic portography, radiological 12,900 6,300
supervision and
interpretation
75889 Hepatic venography, radiological supervision and 12,900 6,300
interpretation
Exchanged of a previously placed intravascular
catheter during thrombolytic therapy with contrast
monitoring, radiological supervision and
Mechanical removal of pericatheter obstructive

material (e.g., fibrin sheath)
from central venous device via separate venous
75901 access, radiologic supervision and interpretation 9,700 4,200
Mechanical removal of intraluminal (intracatheter)

obstructive material from central venous device
through device lumen, radiologic supervision
75902 and interpretation 9,700 4,200
75940 Percutaneous placement of IVC filter, radiologic 23,300 12,600

supervision and
interpretation
75945 Intravascular ultrasound (non-coronary-vessel), 9,700 4,200
interpretation; initial vessel
75952 Endovascular repair of infrarenal abdominal aortic 53,400 29,400
aneurysm or dissection,
75953 Placement of proximal or distal extension prosthesis 55,000 33,600
for endovascular repair of infrarenal aortic or iliac
artery aneurysm, pseudoanuerysm, or dissection,
Endovascular repair of iliac artery aneurysm,

pseudoaneurysm, arteriovenous malformation, or
trauma, radiological supervision and
75956 Endovascular repair of descending thoracic aorta (e.g.,

aneurysm, psuedoaneurysm, dissection, penetrating
ulcer, intramural hematoma, or traumatic disruption);
involving coverage of left subclavian artery origin,
initial endoprosthesis plus
descending thoracic aortic extension(s), if required, to
level of celiac artery
origin, radiologic supervision and interpretation 55,000 33,600
Endovascular repair of descending thoracic aorta (e.g.,

aneurysm, psuedoaneurysm, dissection, penetrating
ulcer, intramural hematoma, or traumatic disruption);
not involving coverage of left subclavian artery origin,
initial endoprosthesis plus descending thoracic aortic
extension(s), if required, to level of celiac artery origin,
75957 radiologic supervision and interpretation 53,400 29,400
75958 Placement of proximal extension prosthesis for 55,000 33,600

endovascular repair of descending thoracic aorta (e.g.,
aneurysm, pseudoaneurysm, dissection, penetrating
ulcer, intramural hematoma, or traumatic disruption),
radiologic supervision and interpretation
Placement of distal extension prosthesis(s) (delayed)
after endovascular repair of descending thoracic aorta,
as needed, to level of celiac origin,
Transcatheter induction of intravascular stent(s),

(except coronary, carotid, and vertebral vessel),
percutaneous and/ or open, radiological supervision
75960 and interpretation 46,500 25,200
Transcatheter retrieval, percutaneous, of

intravascular foreign body (e.g., fractured venous or
arterial catheter), radiological supervision and
75962 Transluminal balloon angioplasty, peripheral artery, 23,300 12,600

and interpretation
75966 Transluminal balloon angioplasty, renal or other 23,300 12,600
visceral artery, radiological
75970 Transcatheter biopsy, radiological supervision and 23,300 12,600
interpretation
75978 Transluminal balloon angioplasty, venous (e.g., 23,300 12,600
subclavian stenosis)
75980 Percutaneous transhepatic biliary drainage with 37,800 21,000
contrast monitoring,
75982 Percutaneous placement of drainagecatheter 46,500 25,200
combined internal and external billiary drainage or of
a drainage stent for internal billiary drainage in
patients with an inoperable mechanical billiary
obstruction, radiologic
supervision and interpretation.
Change of percutaneous tube or drainage catheter

with contrast monitoring (e.g., gastrointestinal system,
genitourinary system, abscess),
75984 radiologic supervision and interpretation 8,020 2,520
Radiological guidance for percutaneous drainage

(abscess, cyst, fluid collection), with placement of
catheter and radiological supervision and
75992 Transluminal atherectomy, peripheral artery, 23,300 12,600

interpretation
75994 Transluminal atherectomy, renal, radiological 23,300 12,600
75995 Transluminal atherectomy, visceral, radiological 23,300 12,600
supervision and
interpretation
76003 Fluoroscopic guidance for needle placement (e.g., 8,020 2,520
biopsy, aspiration,
injection, localization device)
Radiological supervision and interpretation,
percutaneous vertebroplasty or
vertebral augmentation including cavity creation;
76012 under fluoroscopic guidance 30,300 16,800
Radiological supervision and interpretation,

percutaneous vertebroplasty or vertebral
augmentation including cavity creation; under CT
76013 guidance 30,300 16,800
Radiologic examination, abscess, fistula or sinus tract
study, including catheterization of lesion and
76086 Mammary ductogram or galactogram, 1 or multiple 8,020 2,520

duct, injection and
Stereotactic localization guidance for breast biopsy or
needle placement (e.g., for wire localization or for
injection), one or more lesion, radiological
Mammographic guidance for needle placement,

breast (e.g., for wire localization or for injection),
each lesion, radiological supervision and
76355 Computed tomography guidance for stereotactic 8,020 2,520

localization
Computed tomography guidance for needle
placement (e.g., biopsy, aspiration, injection,
localization device), radiological supervision and
76362 Computed tomography guidance for visceral tissue 8,020 2,520

ablation
Magnetic resonance guidance for needle placement
(e.g., for biopsy, needle aspiration, injection, or
placement of localization device) radiological
76394 Magnetic resonance guidance for visceral tissue 8,020 2,520

ablation
76930 Ultrasonic guidance for pericardiocentesis, imaging 8,020 2,520
supervision and
interpretation
76932 Ultrasonic guidance for endomyocardial biopsy, 8,020 2,520

imaging supervision and
interpretation
Ultrasound guided compression repair of arterial
pseudoaneurysm or arteriovenous fistulae (includes
diagnostic ultrasound evaluation,
76936 compression of lesion and imaging) 8,020 2,520
76940 Ultrasonic guidance for visceral tissue ablation 8,020 2,520
Ultrasonic guidance for needle placement (e.g.,

biopsy, aspiration, injection, localization device),
76942 imaging supervision and interpretation 8,020 2,520
76965 Ultrasonic guidance for interstitial radioelement 8,020 2,520

application
76986 Ultrasonic guidance, intraoperative 8,020 2,520
Therapeutic radiology treatment planning; simple,
intermediate or complex, (Only one may be reported
77261 for a given course of therapy) 18,000 8,400
77401 Radiation treatment delivery (Linear Accelerator) 3,000 800
77401 Radiation treatment delivery (Cobalt) 2,000 800

Intensity modulated treatment delivery, single or
multiple fields/arcs, via narrow spatially and
temporally modulated beams, binary, dynamic MLC
77418 per session 5,680 1,680
77421 Stereoscopic X-ray guidance for localization of target 30,300 16,800

volume for the
delivery of radiation therapy
77432 Stereotactic radiation treatment management of 30,300 16,800
cerebral lesion(s)
Hyperthermia for treatment of malignancy, one or
more sessions during the course of therapy including
77600 follow-up care for 90 days after procedure 12,120 6,720
77750 Infusion or instillation of radioelement solution 5,680 1,680
77761 Intracavitary radiation source application, 1 or more 18,000 8,400

sources/ribbons (Brachytherapy), one or more
sessions during the course of therapy including follow-
up care for 90 days after procedure
77776 Interstitial radiation source application, 1 or more 18,000 8,400

sources/ribbons (Brachytherapy), one or more
up care for 90 days after procedure
77781 Remote after loading high intensity brachytherapy 5,680 1,680

(RAHIB); 1 or more
source position or catheters per session
Surface application of radiation source
(Brachytherapy), one or more
77789 up care for 90 days after procedure 9,700 4,200
79000 Radiopharmaceutical (radioactive iodine) therapy 3,640 840
79005 Radiopharmaceutical ablation of gland for thyroid 8,020 2,520

carcinoma or metastases
of thyroid carcinoma
79200 Radiopharmaceutical therapy, by intracavitary 9,700 4,200
administration
79300 Radiopharmaceutical therapy, by interstitial 9,700 4,200
radioactive colloid
administration
79403 Radiopharmaceutical therapy, by radiolabeled 8,020 2,520
monoclonal antibody by
intravenous infusion
79440 Radiopharmaceutical therapy, by intra-articular 8,020 2,520
administration
79445 Radiopharmaceutical therapy, by intra-arterial 8,020 2,520
particulate administration
Evaluation of aspirate (CT-guided biopsy) with or
without preparation of smears; immediate cytologic
study to determine adequacy of specimen(s),
88174 interpretation and report 5,680 1,680
88331 Pathology consultation during surgery; with frozen 5,680 1,680

section(s), single block
88332 Pathology consultation during surgery; with frozen 9,700 4,200
section(s), two (2) or
more blocks
90935 Hemodialysis procedure 4,000 500
90945 Dialysis procedure other than hemodialysis (e.g. 4,000 500
peritoneal, hemofiltration)
Esophagus, gastroesophageal reflux test; with nasal

catheter pH electrode(s) placement, recording,
91034 analysis and interpretation 8,260 3,360
Esophageal function test, gastroesophageal reflux test

with nasal catheter intraluminal impedance
electrode(s) placement, recording, analysis and
91037 interpretation; 8,260 3,360
91100 Intestinal bleeding tube, passage, positioning and 8,260 3,360

monitoring
91105 Gastric intubation, and aspiration or lavage for 8,260 3,360
treatment (e.g., for ingested
poisons)
92973 Percutaneous transluminal coronary thrombectomy 30,300 16,800
92975 Thrombolysis, coronary; by intracoronary infusion, 23,300 12,600

including coronary
angiography
Transcatheter placement of an intracoronary stent(s),
percutaneous, with or without other therapeutic
92980 interventions, any method; single vessel 30,300 16,800
Transcatheter placement of an intracoronary stent(s),

percutaneous, with or without other therapeutic
interventions, any method; each additional
92981 vessel 30,300 16,800
92982 Percutaneous transluminal coronary balloon 30,300 16,800

angioplasty, one or more
vessel
92986 Percutaneous balloon valvuloplasty; aortic 53,400 29,400
92987 Percutaneous balloon valvuloplasty; mitral 53,400 29,400
92990 Percutaneous balloon valvuloplasty; pulmonary valve 53,400 29,400
92992 Atrial septectomy or septostomy; transvenous 21,400 10,500

method, balloon (e.g.,
Rashkind type) (includes cardiac catheterization)
92993 Atrial septectomy or septostomy; blade method (Park 21,400 10,500

septostomy)
(includes cardiac catheterization)
Percutaneous transluminal coronary atherectomy, by
mechanical or other method, with or without balloon
92995 angioplasty, one or more vessel 30,300 16,800
92997 Percutaneous transluminal pulmonary balloon 12,900 6,300

angioplasty, one or more
vessel
93501 Right heart catheterization 18,000 8,400
93503 Insertion and placement of flow directed catheter 9,700 4,200
(e.g., Swan-Ganz) for
monitoring purposes
93505 Endomyocardial biopsy 23,300 12,600
Catheter placement in coronary artery(s), arterial
coronary conduits and/or
venous coronary bypass grafts for coronary
93508 angiography without concomitant left heart 9,700 4,200
catheterization
93510 Left heart catheterization, retrograde, from the 18,000 8,400

brachial artery, axillary
artery or femoral artery; percutaneous
93511 Left heart catheterization, retrograde, from the 18,000 8,400
brachial artery, axillary
artery or femoral artery; by cutdown
93514 Left heart catheterization by left ventricular puncture 18,000 8,400
93524 Combined transseptal and retrograde left heart 23,300 12,600

catheterization
93526 Combined right heart catheterization and retrograde 23,300 12,600
left heart
catheterization
Combined right heart catheterization and transseptal
left heart catheterization through intact septum (with
or without retrograde left heart
93527 catheterization) 23,300 12,600
93528 Combined right heart catheterization with left 23,300 12,600
ventricular puncture (with or
without retrograde left heart catheterization)
Combined right heart catheterization and left heart

catheterization through
93529 existing septal opening (with or without retrograde 23,300 12,600
left heart catheterization)
93530 Right heart catheterization, for congenital cardiac 18,000 8,400

anomalies
93531 Combined right heart catheterization and retrograde 23,300 12,600
left heart
catheterization, for congenital cardiac anomalies
Combined right heart catheterization and transseptal

left heart catheterization through intact septum with
or without retrograde left heart catheterization, for
93532 congenital cardiac anomalies 9,700 4,200
93533 Combined right heart catheterization and transseptal 9,700 4,200

left heart catheterization through existing septal
opening, with or without retrograde left heart
catheterization, for congenital cardiac anomalies
Injection procedure during cardiac catheterization; for

selective opacification of arterial conduits (e.g.,
internal mammary), whether native
93539 or used bypass 9,700 4,200

selective opacification of aortocoronary venous
bypass grafts, one or more coronary
93540 arteries 9,700 4,200
93541 Injection procedure during cardiac catheterization; for 9,700 4,200

pulmonary
angiography
selective right
ventricular or right atrial angiography
selective coronary angiography (injection of
93543 radiopaque material may be by hand) 9,700 4,200

aortography
selective coronary angiography (injection of
93545 radiopaque material may be by hand) 9,700 4,200
Imaging supervision, interpretation and report for

injection procedure(s) during cardiac catheterization;
93555 ventricular and/or atrial angiography 9,700 4,200
Imaging supervision, interpretation and report for

injection procedure(s) during cardiac catheterization;
pulmonary angiography, aortography, and/or selective
coronary angiography including venous bypass grafts
and arterial conduits (whether native or used in
93556 bypass) 9,700 4,200
Percutaneous transcatheter closure of congenital

interatrial communications (i.e., Fontan fenestration,
93580 atrial septal defect) with implant 55,000 33,600
93581 Percutaneous transcatheter closure of congenital 55,000 33,600

with implant
93600 Bundle of His recording 9,700 4,200
93602 Intra-atrial recording 9,700 4,200
93603 Right ventricular recording 9,700 4,200
93610 Intra-atrial pacing 9,700 4,200
93612 Intraventricular pacing 9,700 4,200
93615 Esophageal recording of atrial electrogram with or 9,700 4,200
without ventricular
electrogram(s);
93616 Esophageal recording of atrial electrogram with or 9,700 4,200
without ventricular
electrogram(s); with pacing
93618 Induction of arrhythmia by electrical pacing 9,700 4,200
Comprehensive electrophysiologic evaluation with

right atrial pacing and recording, right ventricular
pacing and recording, His bundle recording, including
insertion and repositioning of multiple electrode
93619 catheters, without induction of arrhythmia 9,700 4,200
93620 Comprehensive electrophysiologic evaluation 9,700 4,200

including insertion and repositioning of multiple
electrode catheters with induction or attempted
induction of arrhythmia; with right atrial pacing and
recording, His bundle
recording
Electrophysiologic follow-up study with pacing and

recording to test effectiveness of therapy, including
induction or attempted induction of
93624 arrhythmia 9,700 4,200
Intra-operative epicardial and endocardial pacing and

mapping to localize the site tachycardia or zone of
93631 slow conduction for surgical correction 9,700 4,200
Electrophysiologic evaluation of single or dual

chamber pacing cardioverter- defibrillator leads
including defibrillation threshold evaluation (induction
of arrhythmia, evaluation of sensing and pacing for
93640 arrhythmia termination) at time of initial implantation 9,700 4,200
or replacement;

chamber pacing cardioverter- defibrillator leads
including defibrillation threshold evaluation (induction
of arrhythmia, evaluation of sensing and pacing for
arrhythmia termination) at time of initial implantation
93641 or replacement; with testing of single or dual chamber 9,700 4,200
pacing cardioverter-defribrillator pulse generator

chamber pacing cardioverter- defibrillator (includes
defibrillation threshold evaluation, induction of
arrhythmia, evaluation of sensing and pacing for
93642 arrhythmia termination, and programming or 9,700 4,200
reprogramming
Intracardiac catheter ablation of atrioventricular node

function,
atrioventricular conduction for creation of complete
93650 heart block, with or without temporary pacemaker 9,700 4,200
placement
93651 Intracardiac catheter ablation of arrhythmogenic 9,700 4,200
focus; for treatment of supraventricular tachycardia
by ablation of fast or slow atrioventricular pathways,
accessory atrioventricular connections or other atrial
foci, singly
or in combination
93652 Intracardiac catheter ablation of arrhythmogenic 9,700 4,200

focus; for treatment of
ventricular tachycardia
93660 Evaluation of cardiovascular function with tilt table 9,700 4,200
evaluation, with continuous ECG monitoring and
intermittent blood pressure monitoring, with or
without pharmacological intervention
96408 Chemotherapy administration 7,280 1,680

96440 Chemotherapy administration into pleural cavity, 5,560 1,260
thoracentesis
96445 Chemotherapy administration into peritoneal cavity, 8,020 2,520
peritoneocentesis
96450 Chemotherapy administration into CNS, requiring and 5,560 1,260
including spinal
puncture
96542 Chemotherapy injection, subarachnoid or 3,640 840
interventricular via subcutaneous
reservoir
96567 Photodynamic therapy by external application of light 8,020 2,520
to destroy premalignant and/or malignant lesions of
the skin and adjacent mucosa (e.g., lip) by activation
of photosensitive drug(s), 1 or more phototherapy
exposure session
ANC01 Essential services during antenatal period (Antenatal 1,500 600

Care Package)
Antenatal care services with intrapartum monitoring
or labor watch (without delivery)
(infirmaries/dispensaries, birthing homes/maternity
ANC02 clinics) 2,150 860
59403 Intrapartum monitoring or labor watch (without 650 260

delivery)
(infirmaries/dispensaries, birthing homes/maternity
clinics)
Essential health services during antenatal, intrapartum 6,500 2,600

and postpartum period including antenatal care,
intrapartum monitoring, normal delivery postpartum
care (Maternity Care Package) (hospitals)
MCP01 Essential health services during antenatal, intrapartum 8,000 3,200

and postpartum period including antenatal care,
intrapartum monitoring, normal delivery postpartum
care (Maternity Care Package)
(infirmaries/dispensaries,
birthing homes/maternity clinics)
Essential health services during intrapartum period

including intrapartum
monitoring, normal delivery and postpartum care (no
antenatal care) (Normal Spontaneous Delivery 5,000 2,000
Package) (hospitals)
NSD01
NSD01 Essential health services during intrapartum period 6,500 2,600
including intrapartum monitoring, normal delivery and
postpartum care (no antenatal care) (Normal
Spontaneous Delivery Package)
(infirmaries/dispensaries, birthing
homes/maternity clinics)
99432 Newborn Care Package 1,750 500

59402 Routine obstetric care including antepartum care,
vaginal delivery and/or
postpartum care for hospitals; with bilateral tubal N/A N/A
ligation
87207 Outpatient Malaria Package 600

89221 Directly Observed Treatment Short-course; intensive 2,500
phase
89222 Directly Observed Treatment Short-course; 1,500
continuation phase
90375 Animal bite package 3,000
99246 Outpatient HIV / AIDS Package 7,500
per quarter
P0001 Referral package 4,000 1,200

P0000 Resuscitation package 4,000 1,200
Health Care
Institution Fee
8,400
8,400
8,400
8,400
8,400
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
4,200
13,510
13,510
13,510
13,510
13,510
13,510
22,400
4,340
4,340
4,340
4,340
4,340
4,340
7,000
4,200
4,200
4,200
4,200
4,200
4,200
7,770
5,320
5,320
5,320
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
5,670
5,670
5,670
5,670
5,670
5,670
5,670
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
4,900
6,300
6,300
6,300
6,300
6,300
9,660
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
3,360
15,680
5,530
5,530
5,530
5,530
5,530
5,530
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
11,270
11,270
11,270
11,270
11,270
11,270
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
15,890
15,890
15,890
15,890
15,890
6,160
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,650
6,650
6,650
6,650
6,650
6,650
6,650
9,240
9,240
7,910
7,910
7,910
7,910
7,910
7,910
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
N/A
10,150
N/A
10,150
10,150
8,540
8,540
8,540
8,540
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,740
5,740
5,740
5,740
8,400
8,400
8,400
8,400
8,400
8,400
8,400
7,350
7,350
7,350
7,350
7,350
7,350
7,350
7,350
7,350
7,350
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
6,720
5,390
5,390
5,390
5,390
10,360
10,360
10,360
10,360
10,360
10,360
10,360
10,360
10,360
10,360
10,360
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
5,810
5,810
5,810
5,810
5,810
10,080
10,080
10,080
10,080
10,080
10,080
10,080
6,300
6,300
7,070
7,070
7,070
7,070
7,070
7,070
7,070
7,070
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
5,460
10,640
10,640
10,640
2,800
2,800
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
6,510
6,510
6,510
6,510
6,510
6,510
6,510
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
7,910
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
6,930
6,930
6,930
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
15,190
15,190
15,190
15,190
15,190
15,190
15,190
15,190
15,190
15,190
7,700
7,700
7,700
7,700
7,700
7,700
7,700
2,800
2,800
2,800
2,800
3,010
3,010
3,010
3,010
3,010
3,010
3,010
3,010
3,010
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
8,960
8,960
8,960
8,960
8,960
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
9,660
9,660
9,660
9,660
9,660
9,660
9,660
N/A
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,740
6,650
6,650
6,650
6,650
6,650
6,650
5,110
5,110
5,110
5,110
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
7,000
7,000
11,200
7,070
7,070
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
6,090
6,090
6,090
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
8,470
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
6,300
6,300
6,300
6,300
4,340
4,340
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
8,820
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
9,170
3,220
3,220
3,220
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,670
5,670
5,670
5,670
4,200
6,930
6,930
6,930
6,930
6,930
6,930
6,930
6,930
6,930
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
4,060
4,060
4,060
4,060
4,060
4,060
7,420
7,630
7,630
7,630
7,630
7,630
4,620
4,620
4,620
4,620
4,620
4,620
4,620
5,110
5,110
5,110
5,110
5,110
5,110
5,110
6,650
6,650
6,860
6,860
6,860
6,860
6,860
4,900
6,510
6,510
6,510
6,510
6,510
6,510
8,260
8,260
7,280
7,280
7,280
7,280
7,280
22,400
22,400
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
5,320
4,970
5,460
5,460
5,460
5,460
5,460
5,460
3,780
3,780
7,980
7,980
7,980
7,980
7,980
7,980
7,980
15,540
15,540
15,540
15,540
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
6,790
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
4,900
4,900
6,090
6,090
6,090
6,090
6,090
4,900
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
6,090
9,240
9,240
9,240
4,270
4,270
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
3,850
8,610
8,610
8,610
8,610
8,610
8,610
8,610
10,990
10,990
10,990
10,990
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
5,880
4,550
4,550
4,550
4,550
4,550
4,550
4,550
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
14,140
4,900
4,900
4,900
4,900
4,900
4,900
4,900
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
14,420
14,420
14,420
14,420
4,620
4,620
4,620
12,110
12,110
12,110
12,110
12,110
12,110
12,110
12,110
5,180
5,180
5,180
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,670
5,670
5,670
5,670
5,670
5,670
5,670
5,670
5,670
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
6,370
15,120
15,120
15,120
15,120
15,120
15,120
15,120
15,120
15,120
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
10,080
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
12,880
12,880
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
5,040
9,800
9,800
9,800
9,800
9,800
9,800
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
6,650
2,870
2,870
2,870
2,870
2,870
2,870
2,870
7,070
7,070
7,070
7,070
7,070
7,070
7,070
7,070
19,530
19,530
19,530
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
17,920
17,920
17,920
17,920
17,920
17,920
17,920
17,920
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
13,230
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
5,180
6,160
6,160
6,160
6,160
6,160
6,160
6,160
7,700
7,700
7,700
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
10,570
10,570
10,570
10,570
10,570
10,570
10,570
10,570
10,570
10,570
10,570
4,760
6,230
6,230
6,230
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
9,870
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,550
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
9,940
7,210
7,210
11,830
11,830
11,830
11,830
11,830
11,830
11,830
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
8,050
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
N/A
9,730
N/A
9,730
9,730
9,730
9,730
9,730
9,730
N/A
9,730
9,730
N/A
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
9,730
N/A
9,730
9,730
9,730
N/A
9,730
9,730
9,730
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
9,380
7,420
7,420
7,420
7,420
11,270
11,270
11,270
11,270
11,270
11,270
11,270
11,270
11,270
11,270
9,310
9,310
9,310
9,310
9,310
9,310
9,310
9,310
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
10,220
7,420
10,220
10,220
10,220
10,220
10,220
10,220
8,050
8,050
8,050
8,050
8,050
8,050
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
7,980
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
4,760
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
17,990
13,860
13,860
13,860
13,860
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
4,620
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
7,490
7,490
7,490
7,490
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
3,500
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,830
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,550
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
4,130
8,120
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
18,060
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
5,390
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
8,540
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
5,530
11,830
11,830
11,830
11,830
11,830
11,830
11,830
11,830
4,900
4,900
5,250
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
5,950
5,950
5,950
5,950
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
9,520
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
6,790
5,530
5,530
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
9,100
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,230
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
6,160
10,640
10,640
10,640
10,640
10,640
10,640
10,640
10,640
10,640
10,640
10,640
5,950
5,950
5,950
5,950
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,120
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
8,680
5,670
5,670
5,670
5,670
5,670
5,670
5,670
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
11,060
11,060
11,060
N/A
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
11,060
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
8,400
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
6,650
6,650
6,650
6,650
9,450
9,450
9,450
9,450
9,450
7,140
7,140
7,140
7,140
7,140
7,140
6,160
6,160
6,160
6,160
6,160
6,160
6,160
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,530
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
6,300
3,360
3,360
3,360
3,360
3,360
3,360
3,360
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
4,270
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
8,890
7,560
7,560
7,560
10,290
10,290
10,290
7,560
7,560
9,940
9,940
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,500
10,710
10,710
10,710
10,710
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
4,690
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,180
5,180
5,180
5,180
5,180
5,180
5,180
8,750
8,750
8,750
8,750
8,750
8,750
8,750
8,750
8,750
8,750
4,340
4,340
4,340
4,340
4,340
4,340
4,340
4,410
4,410
4,410
4,410
4,410
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,110
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
4,480
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,710
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
3,640
3,640
3,640
3,640
3,640
3,640
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
6,510
1,400
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
7,210
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
6,440
4,760
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,420
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
7,630
17,010
17,010
9,870
9,870
9,870
9,870
9,870
7,630
7,630
7,630
5,110
5,110
5,110
6,720
9,730
9,730
9,730
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
10,290
22,400
22,400
22,400
5,390
5,390
5,390
5,390
7,070
7,070
7,070
7,070
7,070
7,070
7,070
7,070
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
8,960
4,900
4,900
4,900
4,900
4,900
5,810
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
22,400
7,210
7,210
7,210
7,210
7,210
7,210
7,490
7,490
7,490
7,490
7,490
7,490
7,490
5,600
6,160
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
5,950
22,400
22,400
22,400
22,400
22,400
4,690
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,490
7,560
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
5,810
7,140
10,920
10,920
10,920
10,920
10,920
8,610
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
26,600
19,600
19,600
19,600
19,600
19,600
19,600
19,600
19,600
19,600
19,600
19,600
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
7,280
8,330
8,330
8,330
8,330
8,330
8,330
11,550
11,550
11,550
11,550
3,920
3,920
3,920
3,920
3,920
3,920
11,130
5,110
5,110
5,110
5,110
5,110
5,110
5,110
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
9,660
8,330
8,330
8,330
8,330
8,330
8,330
8,330
8,330
8,330
8,330
8,330
10,570
10,570
10,570
10,570
10,570
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
6,860
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,000
7,910
7,910
7,910
7,910
7,910
7,910
7,910
5,250
5,250
5,250
5,250
5,250
5,250
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
5,460
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
3,990
5,530
5,530
5,530
5,530
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
8,260
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
14,770
7,420
7,420
7,420
7,420
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,190
8,820
8,820
8,820
8,820
8,820
5,390
5,390
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
5,670
2,800
2,800
2,800
2,800
2,800
4,300
5,500
5,500
6,100
5,400
2,800
2,800
4,000
5,500
5,500
N/A
N/A
N/A
2,800
4,300
2,356
5,500
5,500
4,300
2,356
5,500
5,500
2,356
5,500
5,500
4,900
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
2,800
3,100
3,100
3,100
3,100
3,100
3,100
5,500
5,500
5,500
4,300
4,300
4,300
4,300
4,300
4,300
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
2,800
4,300
2,800
2,800
2,800
7,200
2,800
4,300
7,200
2,800
4,000
2,800
4,300
4,000
4,000
4,000
4,000
4,000
7,200
7,200
5,500
5,500
5,500
5,500
2,800
4,300
4,000
4,000
4,000
4,000
4,000
7,200
5,500
5,500
4,900
7,100
4,000
4,000
5,500
5,500
4,900
4,900
5,500
5,400
5,400
5,500
6,100
5,400
9,600
9,600
9,600
9,600
12,000
4,900
4,900
12,700
12,700
12,700
17,300
13,500
13,500
13,500
9,600
17,300
17,300
13,500
12,700
12,700
21,300
21,300
21,300
21,300
16,800
16,800
16,800
16,800
16,800
12,700
12,700
5,500
5,500
6,100
13,500
13,500
16,800
13,500
17,300
13,500
12,700
17,300
5,400
13,500
18,700
16,800
5,400
12,700
17,300
13,500
18,700
6,100
12,700
12,700
17,300
13,500
18,700
4,900
17,300
5,500
N/A
N/A
3,800
N/A
N/A
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
7,200
7,200
7,200
7,200
7,200
7,200
5,500
2,800
5,500
2,800
4,300
5,500
4,900
5,500
5,500
13,200
13,200
13,200
13,200
13,200
13,200
13,200
13,200
21,300
21,400
21,000
16,800
16,800
13,500
16,800
21,400
21,400
21,400
21,400
21,400
13,500
16,800
3,100
3,000
7,100
9,600
5,500
5,400
10,700
17,300
5,500
4,300
7,200
7,200
4,900
5,500
5,500
5,500
10,700
12,700
5,500
6,100
5,400
18,700
7,200
16,800
16,800
10,700
10,700
13,500
10,700
16,800
5,500
9,600
5,400
5,400
5,500
5,400
5,500
5,500
5,400
9,600
5,500
5,500
9,600
16,800
16,800
10,900
12,000
16,800
13,500
10,700
12,000
5,500
5,500
10,700
9,600
9,600
9,600
9,600
9,600
9,600
10,700
9,600
12,700
10,700
13,500
13,500
13,500
13,500
9,600
21,300
13,500
13,500
13,500
21,300
9,600
21,300
13,500
24,000
21,300
21,300
21,300
21,300
21,400
21,400
21,400
21,000
21,400
21,400
21,300
21,400
21,400
21,400
21,400
24,000
21,300
24,000
21,400
21,400
21,300
21,400
21,300
21,400
13,500
21,300
21,300
21,400
21,300
13,500
21,300
21,300
21,400
21,300
24,000
21,400
21,400
21,400
21,000
21,400
21,400
21,400
21,400
5,500
5,500
5,400
5,400
5,400
5,400
5,500
5,400
9,600
12,700
12,700
10,700
10,900
10,700
13,500
16,800
12,700
10,700
13,500
16,800
21,300
10,900
9,600
16,800
17,300
17,300
9,600
10,900
17,300
17,300
5,400
10,900
10,700
5,400
10,700
9,600
10,700
21,300
5,400
9,600
9,600
10,700
7,400
10,900
10,900
10,700
13,500
16,800
5,500
10,900
13,500
9,600
10,700
5,400
4,000
5,500
3,100
4,000
5,500
5,500
13,500
5,500
10,900
18,700
16,800
12,000
5,400
16,800
9,600
10,700
9,600
12,000
10,700
5,500
5,500
10,900
5,500
12,700
3,000
4,000
10,700
12,000
12,000
12,000
21,300
13,500
13,500
21,300
21,300
21,300
24,000
24,000
24,000
10,700
17,300
18,700
16,800
16,800
16,800
24,000
21,300
21,300
24,000
24,000
24,000
13,500
13,500
16,800
21,000
21,000
21,000
21,400
21,000
21,000
21,400
24,000
24,000
21,000
21,000
21,400
21,000
21,000
21,400
24,000
12,700
21,000
12,000
13,500
10,700
10,900
12,000
9,600
7,400
10,900
10,700
10,900
3,000
4,000
5,500
16,800
10,700
12,000
12,000
10,900
17,300
10,700
12,000
12,000
10,900
10,900
10,900
17,300
17,300
17,300
10,900
10,900
10,700
10,900
10,900
10,900
10,900
12,000
12,000
12,000
18,700
16,800
24,000
4,300
6,600
7,400
10,900
10,700
12,000
12,700
10,900
10,900
10,900
10,900
10,700
12,700
10,900
16,800
18,700
18,700
18,700
16,800
16,800
21,300
24,000
12,000
12,000
12,000
12,000
5,500
5,400
7,100
10,900
12,000
5,500
12,700
10,900
5,500
10,900
5,500
10,700
21,300
5,500
10,700
5,500
16,800
12,000
6,100
12,000
5,400
12,000
5,500
5,400
18,700
13,500
12,000
3,100
4,300
12,700
12,700
10,900
3,000
4,000
5,500
10,700
10,900
10,900
10,700
4,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
13,500
10,700
12,000
12,000
12,700
12,700
5,500
10,700
10,900
12,700
12,000
17,300
12,000
4,900
10,900
5,400
5,500
5,400
5,400
5,400
5,400
12,000
18,700
12,000
16,800
12,700
12,000
10,900
10,900
10,700
10,900
12,000
12,700
12,000
10,900
5,500
17,300
17,300
5,500
12,000
5,400
17,300
7,100
12,000
9,600
7,100
9,600
12,000
10,900
16,800
5,500
10,700
7,100
12,700
4,000
7,100
10,900
12,000
7,100
12,700
12,000
12,000
9,600
5,400
5,500
7,400
7,400
5,400
12,000
5,500
9,600
7,400
7,100
5,500
5,400
5,500
3,000
4,000
5,500
10,700
7,400
5,500
5,400
10,900
10,900
5,500
4,900
10,900
9,600
5,500
12,700
10,900
10,900
10,900
5,500
6,600
6,600
12,700
12,700
12,700
12,000
4,000
12,700
5,500
5,500
4,900
12,700
17,300
5,500
4,900
5,500
5,500
4,900
5,500
7,100
7,100
4,900
5,500
5,500
10,900
10,900
13,500
18,700
12,000
13,500
13,500
12,000
9,600
12,700
9,600
10,700
17,300
12,000
12,000
12,000
12,000
12,000
10,900
10,700
17,300
12,000
12,700
17,300
10,700
13,500
12,000
12,000
12,000
17,300
16,800
12,000
16,800
10,900
17,300
12,700
12,700
18,700
5,500
12,700
5,500
10,900
10,900
4,900
9,600
5,500
12,000
12,000
4,900
10,700
10,700
4,900
10,900
4,900
10,900
5,500
4,900
9,600
4,900
10,900
4,900
10,900
4,900
12,700
9,600
10,900
10,900
6,600
7,400
10,900
9,600
5,400
5,500
7,400
16,800
7,400
5,500
7,400
7,400
5,500
7,400
3,000
3,100
5,500
7,100
5,500
12,700
7,400
12,700
5,400
5,400
5,500
5,500
7,100
7,100
4,900
5,400
6,600
6,100
10,900
10,700
12,000
12,000
10,900
4,900
10,900
6,600
6,600
7,400
6,100
5,500
4,900
7,400
5,400
12,700
5,400
7,400
12,700
7,400
5,400
10,700
17,300
17,300
17,300
10,900
5,400
5,500
7,100
7,100
7,100
7,100
5,500
7,100
7,100
7,100
4,900
4,900
7,100
5,500
4,900
4,900
4,900
4,900
4,900
4,900
7,100
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
4,900
7,100
5,500
5,500
5,500
5,500
5,500
7,100
4,900
4,900
5,500
5,500
5,500
5,500
4,900
9,600
12,700
7,100
5,500
6,600
4,900
5,500
5,500
5,400
9,600
7,100
1,876
1,596
5,500
9,600
10,900
4,900
4,900
4,900
7,100
5,500
4,900
10,900
13,500
17,300
12,000
7,400
12,000
9,600
10,900
17,300
10,700
10,700
10,700
10,900
10,900
10,700
17,300
17,300
10,900
10,900
10,900
5,500
6,600
5,400
5,400
5,500
5,400
7,400
7,400
5,500
7,400
5,500
6,100
5,500
7,400
5,400
5,500
7,400
7,400
5,500
5,400
5,500
7,400
5,400
7,100
5,400
5,400
10,900
10,900
10,900
12,700
10,900
10,900
10,900
10,900
10,900
5,400
6,100
12,700
5,400
5,400
10,700
5,400
7,400
17,300
10,700
10,700
10,900
17,300
17,300
13,500
16,800
3,000
4,000
4,900
16,800
12,000
18,700
13,500
12,000
12,000
12,000
13,500
13,500
21,300
21,300
18,700
18,700
18,700
13,500
13,500
7,400
7,400
13,500
18,700
10,900
10,700
17,300
17,300
17,300
17,300
18,700
18,700
18,700
24,000
24,000
21,400
16,800
16,800
12,000
13,500
13,500
18,700
18,700
16,800
13,500
18,700
13,500
10,700
13,500
13,500
13,500
13,500
18,700
12,000
13,500
12,000
7,400
10,900
16,800
16,800
21,300
21,300
17,300
16,800
16,800
21,300
10,700
21,300
21,300
10,700
21,300
13,500
10,700
12,000
10,700
18,700
16,800
13,500
18,700
9,600
16,800
12,000
16,800
16,800
21,300
13,500
4,900
10,700
9,600
9,600
10,900
12,000
10,700
10,700
3,000
4,000
5,500
12,000
10,900
10,700
17,300
12,000
6,600
10,700
7,400
10,900
17,300
10,900
10,700
10,700
12,000
10,700
12,000
9,600
10,700
12,000
17,300
12,000
9,600
12,700
10,900
10,700
12,700
10,900
10,700
12,700
10,700
12,000
12,000
13,500
16,800
10,900
10,900
17,300
17,300
10,900
13,500
13,500
18,700
12,000
17,300
17,300
13,500
16,800
16,800
16,800
16,800
21,300
16,800
16,800
9,600
10,700
12,000
12,000
12,000
12,000
12,000
18,700
17,300
12,000
17,300
10,700
12,000
17,300
24,000
21,400
18,700
17,300
10,900
10,900
10,900
10,700
7,400
9,600
9,600
17,300
17,300
18,700
9,600
18,700
16,800
17,300
10,700
10,900
10,900
10,900
9,600
17,300
12,000
5,500
10,900
5,500
12,000
12,000
16,800
10,900
12,000
17,300
13,500
10,700
10,700
6,100
10,900
12,000
5,500
5,500
4,900
3,100
4,000
5,400
9,600
10,900
12,700
10,900
3,000
10,900
4,000
5,500
6,600
9,600
12,700
4,000
7,400
12,700
12,700
9,600
9,600
10,700
10,900
10,700
12,700
10,700
10,900
4,000
7,400
9,600
7,400
9,600
9,600
12,700
9,600
12,700
9,600
9,600
7,400
9,600
7,400
9,600
10,700
9,600
12,000
13,500
18,700
10,900
12,700
9,600
10,900
10,700
12,000
9,600
10,900
10,900
10,900
10,700
10,900
10,900
10,700
10,700
10,900
17,300
5,400
5,400
10,900
10,900
12,000
5,500
5,400
5,500
10,900
5,500
10,900
6,600
10,700
10,700
10,700
10,700
5,500
10,900
12,700
10,900
10,900
5,500
6,100
5,500
10,900
10,700
9,600
10,900
13,500
17,300
9,600
5,400
10,700
10,700
12,700
9,600
9,600
9,600
4,000
4,900
5,500
5,500
5,400
4,900
5,500
6,600
4,900
4,900
7,100
9,600
4,000
5,500
16,800
5,500
5,500
5,500
5,500
5,500
6,100
5,500
4,000
5,500
5,500
5,500
4,900
7,400
12,700
12,700
7,400
12,700
12,700
7,400
12,700
9,600
9,600
9,600
10,900
7,400
7,400
7,400
12,700
9,600
9,600
5,400
10,900
9,600
5,400
5,400
5,500
17,300
10,900
12,700
9,600
9,600
5,400
5,400
7,100
5,500
7,100
5,500
5,500
7,100
7,100
9,600
5,400
5,400
5,400
9,600
10,900
5,400
5,400
6,600
10,900
7,400
12,700
7,400
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
7,400
9,600
12,700
12,700
12,700
12,700
9,600
7,400
12,700
5,400
12,700
7,400
5,400
5,400
12,700
12,700
7,400
5,500
6,100
9,600
12,700
5,500
5,500
7,400
7,100
6,100
5,500
7,100
4,900
7,100
5,500
5,500
5,400
5,500
5,400
4,900
5,500
4,900
5,400
5,400
7,100
5,400
9,600
5,500
5,400
9,600
4,900
5,400
9,600
7,100
5,400
9,600
12,000
12,000
12,000
10,700
10,900
12,700
9,600
9,600
7,400
10,900
10,700
4,900
10,900
5,400
9,600
5,400
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,400
5,400
7,200
4,300
4,000
4,300
4,300
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
4,000
4,000
9,600
10,900
9,600
12,700
10,900
10,900
10,900
10,700
17,300
12,000
9,600
12,700
10,900
10,900
10,900
10,700
5,400
12,700
10,900
10,900
10,700
10,700
10,700
12,000
12,000
12,000
12,000
9,600
10,900
12,700
17,300
17,300
10,700
10,700
17,300
17,300
12,000
13,500
10,700
10,700
12,000
10,700
18,700
18,700
12,700
10,900
10,900
10,900
4,300
4,300
4,000
5,500
5,500
5,500
5,500
6,600
6,600
5,500
5,500
13,500
13,500
16,800
6,600
6,600
9,600
4,900
5,400
5,400
5,400
5,500
5,500
5,500
5,400
5,400
5,500
7,200
5,500
5,500
5,400
5,400
10,700
10,700
10,700
5,400
5,400
5,400
5,400
5,400
10,700
10,700
10,700
10,700
5,400
5,400
5,400
21,300
24,000
5,500
5,500
5,500
5,400
5,400
5,400
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
10,700
9,600
13,500
16,800
18,700
18,700
13,500
13,500
13,500
13,500
16,800
21,300
13,500
10,700
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,400
5,400
5,400
5,400
5,400
5,400
13,500
13,500
5,400
5,400
5,400
5,400
5,400
5,400
5,400
13,500
13,500
13,500
13,500
13,500
13,500
13,500
10,700
5,400
5,400
2,380
5,400
5,400
7,400
6,600
5,400
7,400
5,400
5,500
5,500
5,500
5,500
9,600
9,600
9,600
9,600
13,500
13,500
9,600
10,700
4,300
10,700
16,800
16,800
24,000
21,400
21,400
21,400
21,300
24,000
16,800
21,400
10,700
16,800
5,500
5,500
420
5,500
5,500
2,660
5,400
9,600
13,500
16,800
16,800
16,800
16,800
16,800
16,800
18,700
18,700
18,700
5,500
16,800
18,700
13,500
16,800
16,800
4,300
18,700
5,500
4,300
21,300
24,000
24,000
16,800
21,300
21,300
24,000
24,000
16,800
16,800
24,000
24,000
24,000
18,700
6,100
6,600
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
13,500
16,800
16,800
16,800
16,800
16,800
16,800
16,800
21,300
16,800
16,800
10,700
10,700
21,300
21,300
21,400
21,000
21,000
21,000
21,000
21,300
21,300
21,300
13,500
4,300
5,500
5,500
9,600
17,300
21,300
21,000
16,800
21,000
16,800
10,900
10,900
9,600
9,600
10,900
5,500
5,500
5,500
6,600
17,300
6,600
9,600
10,700
10,700
9,600
9,600
6,600
10,700
17,300
13,500
18,700
13,500
9,600
9,600
13,500
13,500
6,600
10,900
9,600
18,700
24,000
21,000
21,000
21,300
21,000
21,300
21,000
13,500
21,000
21,000
21,300
21,000
21,000
24,000
24,000
21,400
21,000
24,000
21,000
21,400
21,000
21,000
21,300
21,300
21,400
21,300
16,800
24,000
21,400
21,400
21,000
21,300
21,300
24,000
21,400
24,000
21,000
13,500
10,700
21,300
21,300
24,000
21,300
24,000
21,300
13,500
13,500
21,300
24,000
24,000
24,000
24,000
24,000
21,400
21,000
21,000
21,000
24,000
24,000
21,400
21,000
21,000
21,000
21,000
24,000
24,000
21,400
21,000
21,000
21,000
5,500
21,300
21,300
24,000
21,400
21,400
21,400
21,400
21,400
21,400
21,000
21,300
24,000
21,400
21,400
21,400
21,000
21,300
21,400
21,400
10,900
21,400
21,400
21,400
21,300
21,400
24,000
24,000
21,400
21,400
10,900
21,300
21,300
13,500
10,700
13,500
21,300
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,400
10,900
10,900
10,700
21,300
17,300
13,500
13,500
13,500
13,500
13,500
13,500
21,300
21,400
21,000
21,000
21,000
21,000
21,000
21,300
13,500
24,000
24,000
13,500
21,300
21,000
21,300
9,600
21,300
21,000
21,300
21,000
6,600
5,500
10,900
13,500
21,300
21,400
16,800
21,300
17,300
17,300
10,700
10,700
13,500
10,700
10,700
13,500
17,300
18,700
17,300
10,700
13,500
13,500
13,500
13,500
13,500
10,700
13,500
13,500
9,600
10,700
10,700
13,500
9,600
21,300
24,000
24,000
21,400
21,300
24,000
21,300
24,000
21,300
24,000
10,700
13,500
10,700
13,500
13,500
16,800
13,500
16,800
10,700
13,500
10,700
10,700
13,500
10,700
9,600
9,600
9,600
21,300
13,500
9,600
9,600
10,700
9,600
21,300
13,500
10,700
9,600
10,700
9,600
21,300
13,500
10,700
9,600
18,700
18,700
18,700
18,700
18,700
13,500
13,500
21,300
10,700
10,700
10,700
13,500
10,900
10,900
10,900
10,900
10,900
10,900
10,900
6,600
6,600
6,600
6,600
6,600
6,600
6,600
10,700
10,700
10,700
10,700
10,700
10,700
10,900
10,900
10,900
10,900
10,900
10,900
18,700
18,700
18,700
18,700
18,700
18,700
18,700
18,700
18,700
18,700
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
13,500
10,700
16,800
13,500
13,500
13,500
10,700
21,300
16,800
16,800
16,800
18,700
18,700
18,700
18,700
18,700
18,700
21,300
21,300
21,300
21,300
18,700
18,700
21,300
18,700
21,300
18,700
13,500
10,700
13,500
13,500
13,500
10,700
21,300
18,700
18,700
18,700
18,700
9,600
9,600
9,600
9,600
9,600
5,500
9,600
9,600
5,500
10,700
10,700
10,700
13,500
13,500
16,800
13,500
2,800
7,200
5,500
5,500
5,500
5,500
5,500
7,200
7,200
4,900
7,200
7,200
7,200
5,500
7,200
7,200
5,500
10,700
5,500
5,500
2,800
4,000
7,200
5,500
2,800
2,800
5,500
2,800
4,000
7,200
7,200
5,500
5,500
5,500
9,600
6,600
6,600
5,500
4,900
7,200
13,500
16,800
13,500
18,700
16,800
24,000
21,300
21,300
4,900
5,500
5,500
5,500
21,300
21,300
10,700
4,000
4,000
9,600
12,700
7,200
7,200
9,600
10,900
9,600
6,600
10,700
7,200
6,600
7,200
6,600
9,600
10,900
10,900
5,500
21,300
10,700
17,300
10,700
17,300
13,500
17,300
7,100
7,100
9,600
16,800
4,900
13,500
13,500
13,500
4,000
4,000
4,900
7,200
7,200
7,200
12,700
16,800
21,300
12,000
13,500
21,000
12,000
13,500
13,500
10,700
13,500
16,800
10,700
10,700
10,700
16,800
16,800
9,600
10,700
16,800
16,800
7,400
16,800
16,800
16,800
16,800
16,800
16,800
16,800
21,300
16,800
4,300
5,500
5,500
5,500
10,700
17,300
4,900
5,500
5,500
5,500
16,800
16,800
13,500
13,500
16,800
4,000
4,000
4,000
5,500
7,200
4,000
4,000
5,400
5,400
5,400
9,600
9,600
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,000
4,300
4,300
4,300
7,200
7,200
7,200
7,200
7,200
7,200
4,900
7,100
16,800
16,800
16,800
16,800
21,300
24,000
5,500
5,500
5,500
5,500
5,500
5,500
4,000
2,800
2,800
5,500
5,500
5,500
5,500
5,500
5,500
4,900
4,900
4,900
9,600
9,600
5,500
4,300
4,000
7,200
7,200
10,900
5,400
10,700
5,500
5,400
9,600
10,900
10,900
10,900
10,700
10,700
17,300
10,700
10,700
10,700
5,400
4,000
4,000
4,000
4,000
7,200
7,200
4,300
4,300
7,200
7,200
10,700
13,500
13,500
13,500
16,800
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
4,900
4,900
4,900
4,900
4,900
5,500
5,500
5,500
5,500
5,500
5,500
9,600
9,600
9,600
9,600
9,600
9,600
5,500
5,400
5,400
5,500
5,500
16,800
21,300
24,000
10,900
10,900
10,700
5,500
5,400
9,600
16,800
10,700
16,800
21,400
21,000
21,000
21,000
21,400
21,400
21,000
21,400
21,400
21,000
21,300
10,700
16,800
5,500
5,500
7,400
7,400
7,400
6,100
5,400
9,600
9,600
9,600
7,400
9,600
5,500
5,500
5,500
5,400
7,400
7,400
9,600
9,600
7,400
9,600
9,600
6,100
5,400
7,400
9,600
7,400
10,900
10,900
10,900
10,900
10,700
17,300
10,900
10,900
10,900
10,700
10,700
21,300
13,500
13,500
21,300
24,000
21,300
21,300
21,300
21,300
16,800
21,300
16,800
21,300
10,700
13,500
5,400
21,000
21,000
16,800
16,800
16,800
5,400
16,800
5,400
16,800
4,900
4,900
4,900
4,900
5,500
21,000
13,500
18,700
18,700
18,700
18,700
4,900
13,500
18,700
18,700
21,000
21,000
21,000
21,400
21,400
21,000
21,000
21,000
21,000
16,800
21,300
9,600
12,700
9,600
5,500
4,300
16,800
21,000
21,300
24,000
16,800
16,800
16,800
21,300
21,400
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,300
21,000
21,000
24,000
16,800
16,800
16,800
24,000
21,400
9,600
16,800
21,300
21,300
21,300
24,000
21,000
21,000
21,000
21,000
21,400
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
9,600
5,400
5,400
9,600
10,700
16,800
21,000
16,800
21,400
21,000
21,400
21,000
21,400
10,700
9,600
10,900
10,700
10,900
13,500
10,700
13,500
10,700
13,500
13,500
7,400
7,400
9,600
9,600
9,600
9,600
12,700
12,700
12,700
9,600
9,600
12,700
7,400
7,400
7,400
7,400
7,400
7,400
9,600
9,600
9,600
12,700
12,700
5,500
16,800
16,800
16,800
16,800
16,800
13,500
13,500
13,500
13,500
16,800
16,800
9,600
9,600
5,400
5,500
14,400
14,400
14,400
13,500
9,600
13,500
10,700
13,500
21,400
21,400
21,400
21,000
21,000
21,400
21,000
21,000
21,400
24,000
21,400
5,400
21,400
9,600
9,600
5,500
5,500
5,500
4,900
5,500
5,500
5,500
5,500
5,500
5,500
4,900
4,900
5,500
5,500
5,500
5,400
5,500
6,100
5,500
5,400
5,400
5,400
9,600
7,400
7,400
9,600
21,400
21,400
12,000
13,500
9,600
9,600
12,000
12,000
13,500
9,600
10,700
12,000
13,500
16,800
13,500
16,800
4,900
4,900
4,900
4,900
5,500
4,900
5,500
5,500
5,500
5,500
4,900
4,900
5,500
4,900
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
9,600
5,400
4,000
4,000
4,000
4,000
5,500
4,900
4,900
5,500
5,500
6,600
10,700
10,700
16,800
16,800
21,300
13,500
24,000
21,000
21,000
21,000
7,400
10,700
5,500
4,900
16,800
10,900
16,800
4,900
4,900
4,900
4,900
4,900
5,500
5,500
5,500
5,500
5,500
5,500
5,500
4,900
5,500
9,600
9,600
9,600
24,000
21,400
21,300
24,000
21,300
21,400
21,400
9,600
10,700
21,300
16,800
16,800
9,600
9,600
5,500
5,500
5,500
24,000
16,800
21,300
21,300
13,500
13,500
13,500
13,500
5,500
4,900
10,700
10,700
10,700
10,700
10,700
18,600
18,600
18,600
18,600
21,300
18,600
18,600
18,600
21,300
24,000
21,300
10,700
24,000
21,400
21,400
21,000
21,400
21,300
16,800
21,300
24,000
24,000
21,300
24,000
21,300
24,000
21,300
16,800
16,800
21,300
10,700
21,300
21,300
16,800
5,400
5,500
13,500
21,300
24,000
24,000
21,300
21,000
21,400
21,000
21,000
21,000
21,000
21,400
13,500
10,700
21,300
21,300
24,000
24,000
13,500
13,500
10,700
10,700
10,700
10,700
4,900
10,700
10,700
5,500
10,700
4,900
16,800
24,000
21,300
10,700
5,500
5,500
4,000
5,500
5,400
4,900
4,900
9,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
12,600
10,700
16,800
13,500
10,700
13,500
12,600
12,600
9,600
10,700
13,500
10,900
9,600
9,600
9,600
12,000
13,500
12,000
16,800
13,500
13,500
13,500
9,600
9,600
10,700
17,300
5,500
9,600
12,000
13,500
13,500
13,500
13,500
12,000
5,500
10,900
10,900
12,000
10,700
21,300
21,000
13,500
24,000
4,000
5,500
5,500
5,500
4,900
13,500
18,700
10,700
9,600
10,700
13,500
13,500
5,500
5,500
13,500
12,000
12,000
10,700
10,700
13,500
5,500
4,900
7,100
5,500
5,500
5,500
4,900
4,900
4,900
5,500
5,500
5,500
5,500
9,600
5,500
5,400
5,400
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,900
10,700
10,900
10,900
10,700
12,000
10,900
12,000
12,000
13,500
16,800
13,500
17,300
16,800
16,800
16,800
21,300
16,800
16,800
13,500
10,900
9,600
10,900
10,700
10,900
12,700
10,700
10,700
4,900
4,900
4,900
7,100
5,500
6,100
4,900
4,900
4,900
7,100
5,500
6,100
4,000
5,500
5,500
5,500
5,500
5,400
10,900
10,900
5,500
13,500
10,900
12,000
12,000
10,700
17,300
16,800
13,500
16,800
21,300
16,800
24,000
24,000
21,400
21,000
21,000
5,500
5,500
10,900
12,000
10,900
17,300
10,900
5,400
7,100
10,700
10,700
13,500
13,500
17,300
5,400
13,500
13,500
4,900
5,500
4,900
4,900
5,500
6,100
6,100
10,900
10,900
10,700
17,300
6,100
5,500
6,600
6,600
5,400
5,400
5,500
5,500
5,500
6,100
12,700
12,700
5,400
5,500
9,600
12,700
6,100
9,600
5,500
5,500
5,500
5,500
5,400
5,400
12,700
12,700
5,400
12,700
10,700
10,700
5,400
16,800
9,600
12,700
12,700
10,900
16,800
10,900
12,000
12,000
16,800
9,600
4,000
4,900
4,300
4,900
7,200
4,300
5,500
4,300
12,700
10,900
5,500
9,600
7,400
7,200
5,400
4,300
4,300
4,300
7,200
13,500
12,000
7,400
16,800
16,800
12,000
9,600
9,600
9,600
13,500
18,700
16,800
9,600
4,900
4,900
5,500
5,500
5,500
5,500
5,500
4,000
4,000
4,000
16,800
16,800
2,800
2,800
3,000
7,200
5,500
6,100
4,900
5,500
10,900
16,800
21,300
420
420
420
420
4,300
4,000
5,500
5,500
7,400
10,700
10,700
10,700
5,400
12,000
12,000
12,000
13,500
18,700
18,700
18,700
9,600
10,900
16,800
13,500
18,700
16,800
5,400
5,400
4,900
5,400
3,000
4,000
4,000
5,500
5,500
5,400
5,500
5,400
5,500
7,200
5,500
5,400
5,500
4,900
5,500
6,100
3,100
3,000
7,200
4,000
5,500
7,200
5,500
5,500
9,600
3,000
5,500
9,600
5,500
3,000
7,200
7,200
3,100
4,300
4,000
4,000
3,000
5,500
5,500
4,900
6,600
7,400
7,400
7,400
5,500
9,600
9,600
7,200
4,000
18,700
21,300
21,300
21,300
18,700
13,500
21,300
21,300
21,300
9,600
5,500
9,600
10,700
21,300
21,400
4,300
7,200
5,500
7,200
7,200
7,200
5,400
10,700
12,000
13,500
16,800
21,300
24,000
21,400
21,000
5,500
7,200
5,500
5,400
4,000
4,000
4,000
10,700
13,500
12,000
7,200
5,500
5,500
5,500
5,500
5,400
5,400
10,900
10,900
10,700
13,500
10,700
12,000
12,000
12,000
12,000
13,500
13,500
10,900
10,700
13,500
10,900
13,500
10,700
13,500
4,900
12,000
5,500
4,900
5,500
4,000
4,000
5,500
6,600
9,600
13,500
16,800
10,700
16,800
16,800
5,500
9,600
6,600
6,600
10,700
9,600
18,000
18,000
18,000
18,000
21,400
21,000
13,500
13,500
16,800
21,300
21,300
16,800
21,300
21,300
1,200
9,600
5,500
10,700
12,000
10,700
16,800
3,000
10,700
13,500
13,500
5,500
6,600
9,600
9,600
10,700
6,600
5,400
4,000
10,900
24,000
7,400
7,400
6,600
10,900
10,700
10,900
10,700
10,700
9,600
10,700
10,700
10,900
10,900
10,900
10,900
10,900
9,600
9,600
10,700
9,600
13,500
24,000
21,400
21,000
12,000
10,700
12,000
12,000
21,300
16,800
18,700
13,500
12,000
12,000
9,600
9,600
13,500
5,500
5,400
11,400
11,400
18,000
5,400
11,400
6,600
6,600
5,400
3,000
4,900
4,900
10,900
18,600
18,600
18,600
18,600
18,600
18,600
21,300
18,600
21,300
21,300
10,900
10,700
17,300
12,000
16,800
13,500
16,800
16,800
16,800
13,500
18,700
13,500
16,800
13,500
4,000
4,000
5,500
9,600
9,600
13,500
16,800
10,700
10,900
16,800
16,800
16,800
16,800
10,700
13,500
16,800
21,300
21,300
21,300
24,000
24,000
21,300
24,000
21,300
24,000
24,000
24,000
16,800
24,000
21,300
21,300
24,000
24,000
21,400
21,400
21,400
21,300
21,400
16,800
21,400
21,000
24,000
24,000
21,000
21,000
21,000
21,000
21,400
21,400
21,000
21,000
24,000
24,000
24,000
24,000
21,400
24,000
24,000
24,000
21,000
21,000
24,000
21,000
21,000
21,000
16,800
21,300
21,300
21,300
21,000
21,000
21,000
21,000
24,000
24,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,400
21,000
21,000
21,000
21,000
21,400
21,000
21,000
21,000
10,700
21,000
16,800
21,000
21,000
21,000
21,000
21,000
21,000
21,000
21,000
13,500
16,800
16,800
21,000
21,000
24,000
21,000
21,000
21,300
21,000
21,000
16,800
13,500
16,800
21,300
21,000
16,800
21,300
24,000
21,000
21,400
13,500
13,500
13,500
13,500
24,000
24,000
21,400
16,800
21,300
21,300
21,300
21,300
16,800
10,700
10,700
16,800
21,300
13,500
13,500
10,700
6,600
6,600
4,000
4,300
10,700
9,600
16,800
5,500
9,600
10,700
21,300
21,400
24,000
16,800
16,800
24,000
21,400
24,000
21,300
21,400
21,300
24,000
21,300
21,400
24,000
21,300
24,000
21,300
24,000
21,400
16,800
21,400
24,000
21,300
24,000
21,000
24,000
21,400
21,400
21,400
24,000
24,000
21,400
21,400
24,000
21,400
24,000
21,400
24,000
21,300
21,400
24,000
21,300
21,400
24,000
21,300
16,800
21,400
24,000
21,300
16,800
21,400
24,000
21,300
16,800
21,000
21,400
24,000
21,300
21,000
21,400
24,000
21,300
21,400
24,000
24,000
24,000
21,400
24,000
24,000
24,000
13,500
13,500
18,700
5,500
21,300
10,900
13,500
18,700
16,800
21,300
13,500
21,300
21,300
13,500
10,700
5,400
5,400
9,600
10,900
10,900
10,900
16,800
9,600
9,600
9,600
9,600
9,600
13,500
5,500
5,500
5,500
5,500
5,500
5,400
5,500
5,400
12,700
12,700
9,600
5,500
9,600
9,600
16,800
13,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
9,600
9,600
9,600
9,600
5,400
10,900
9,600
5,500
9,600
9,600
9,600
5,500
9,600
10,900
9,600
9,600
5,500
10,900
10,900
10,900
10,900
10,700
10,700
10,700
10,700
17,300
13,500
13,500
10,700
17,300
12,000
13,500
10,700
17,300
5,500
5,500
10,900
10,900
5,400
5,400
5,400
5,400
5,400
16,800
16,800
16,800
5,500
5,500
6,100
6,100
6,100
5,500
2,500
2,500
2,500
9,600
24,000
21,400
5,500
5,500
5,500
10,900
10,700
5,500
5,500
4,900
5,500
4,900
5,500
5,500
13,500
13,500
13,500
13,500
N/A
5,500
9,600
13,500
7,400
7,400
7,400
13,500
13,500
13,500
5,500
5,500
5,500
10,700
10,700
5,400
5,500
5,500
5,500
5,500
5,500
5,500
5,400
5,500
4,900
9,600
9,600
9,600
9,600
9,600
12,000
13,500
13,500
5,400
10,700
7,400
5,500
5,500
5,400
9,600
5,400
5,400
9,600
7,400
6,100
6,100
6,100
6,100
5,500
5,400
5,500
5,400
4,900
9,600
5,400
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
9,600
16,800
16,800
13,500
13,500
13,500
5,400
9,600
5,500
9,600
16,800
24,000
5,500
5,400
17,300
6,600
5,500
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
16,800
21,300
18,700
21,300
21,300
13,500
21,300
5,400
5,400
10,900
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,400
5,500
5,400
5,400
9,600
9,600
9,600
9,600
12,700
6,100
10,900
9,600
5,500
5,500
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
5,500
5,500
24,000
5,400
10,900
10,900
10,900
10,900
10,900
10,900
4,000
4,000
4,000
4,000
4,000
4,000
2,800
7,200
4,300
4,000
4,000
5,500
9,600
9,600
10,900
9,600
9,600
9,600
9,600
10,900
17,300
5,500
5,500
5,500
6,600
4,000
4,000
5,500
6,600
5,500
5,400
5,400
17,300
12,000
13,500
16,800
16,800
13,500
4,000
5,500
5,500
5,500
5,500
5,400
7,400
9,600
7,400
12,700
9,600
6,100
6,100
10,900
4,000
4,000
4,000
5,400
4,000
5,400
4,000
N/A
9,600
9,600
5,500
2,800
9,600
9,600
10,900
5,500
7,100
5,500
5,500
3,000
3,220
4,000
4,000
4,900
5,400
5,500
5,500
10,700
13,500
7,200
5,500
5,500
10,700
10,700
4,300
4,000
4,000
5,500
4,900
4,900
9,600
5,500
10,900
10,700
10,700
10,700
10,700
21,300
5,500
13,500
13,500
13,500
10,700
17,300
10,700
10,700
10,700
5,400
10,900
17,300
17,300
17,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
21,300
16,800
16,800
16,800
16,800
16,800
16,800
17,300
13,500
5,500
13,500
13,500
16,800
16,800
16,800
16,800
21,300
24,000
21,300
24,000
21,300
24,000
24,000
21,400
21,400
21,400
24,000
21,300
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
9,600
9,600
9,600
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
3,000
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
6,600
6,600
13,500
5,500
5,500
10,700
5,500
24,000
21,400
24,000
21,400
24,000
21,400
21,400
21,300
21,300
10,700
10,700
10,700
10,700
16,800
21,300
5,500
5,500
10,700
10,700
10,700
5,500
13,500
13,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
9,600
2,200
1,200
4,000
13,500
13,500
5,400
4,000
9,600
9,600
4,000
5,500
2,800
5,500
5,500
5,500
5,500
5,500
5,500
4,000
4,000
5,500
3,500
3,500
4,900
4,900
4,900
4,900
13,500
10,700
13,500
13,500
13,500
24,000
24,000
24,000
10,900
10,900
13,500
6,600
9,600
5,500
10,700
5,500
9,600
9,600
9,600
10,700
10,700
10,700
10,700
10,700
9,600
10,700
5,500
5,500
5,500
5,500
5,500
5,500
5,500
10,700
5,500
5,500
5,500
21,400
21,400
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,500
5,600
4,300
5,500
4,300
2,800
5,500
900
1,290
390
3,900
4,800
3,000
3,900
1,250
N/A
600
2,500
1,500
3,000
7,500
per quarter
2,800
2,800

AnnexA MedicalCaseRates

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ICD 10 CODE DESCRIPTION GROUP Professional

Case Rate Fee

J85.3 Abscess of mediastinum ABSCESS OF RESPIRATORY TRACT 10,000 3,000

A05.0 Foodborne staphylococcal intoxication ACUTE GASTROENTERITIS 6,000 1,800

A05.3 Foodborne Vibrio parahaemolyticus intoxication ACUTE GASTROENTERITIS 6,000 1,800

Protozoal intestinal disease, unspecified;Flagellate

A08.0 Rotaviral enteritis ACUTE GASTROENTERITIS 6,000 1,800

A08.2 Adenoviral enteritis ACUTE GASTROENTERITIS 6,000 1,800

A08.5 Other specified intestinal infections ACUTE GASTROENTERITIS 6,000 1,800

A09.9 ACUTE GASTROENTERITIS 6,000 1,800

Noninfective gastroenteritis and colitis, unspecified; Diarrhoea specified as

Acute renal failure with acute cortical necrosis; Cortical

Acute renal failure with medullary necrosis; Medullary papillary necrosis,

E85.8 Other amyloidosis; Localized amyloidosis AMYLOIDOSIS 11,100 3,330

D50.1 Sideropenic dysphagia; Kelly-Paterson syndrome; Plummer- ANEMIA 10,000 3,000

D51.8 Other vitamin B12 deficiency anaemias ANEMIA 10,000 3,000

D53.0 Protein deficiency anaemia; Amino-acid deficiency ANEMIA 10,000 3,000

D53.2 Scorbutic anaemia ANEMIA 10,000 3,000

Anaemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency;

Anaemia due to other disorders of glutathione metabolism; Anaemia due

Anaemia due to disorders of glycolytic enzymes; Haemolytic

D55.8 Other anaemias due to enzyme disorders ANEMIA 10,000 3,000

D57.8 Other sickle-cell disorders ANEMIA 10,000 3,000

D58.1 Hereditary elliptocytosis; Congenital Elliptocytosis; ANEMIA 10,000 3,000

D58.8 Other specified hereditary haemolytic anaemias; ANEMIA 10,000 3,000

D58.9 Hereditary haemolytic anaemia, unspecified; Acquired ANEMIA 10,000 3,000

D59.0 Drug-induced autoimmune haemolytic anaemia ANEMIA 10,000 3,000

D59.2 Drug-induced nonautoimmune haemolytic anaemia; Drug- ANEMIA 10,000 3,000

Other nonautoimmune haemolytic anaemias; Mechanical Haemolytic

D59.5 Paroxysmal nocturnal haemoglobinuria [Marchiafava- ANEMIA 10,000 3,000

Haemoglobinuria due to haemolysis from other external causes;

D59.8 Other acquired haemolytic anaemias ANEMIA 10,000 3,000

D61.1 Drug-induced aplastic anaemia ANEMIA 10,000 3,000

D64.1 Secondary sideroblastic anaemia due to disease ANEMIA 10,000 3,000

Other sideroblastic anaemias; Sideroblastic anaemia NOS; pyridoxine-

D64.8 Other specified anaemias; Infantile pseudoleukaemia; ANEMIA 10,000 3,000

D64.9 Anaemia, unspecified ANEMIA 10,000 3,000

M02.39 Reiter's disease, site unspecified ARTHRITIS INFECTIOUS 9,700 2,910

Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis with or

M13.00 Polyarthritis, unspecified multiple sites ARTHRITIS NONINFECTIOUS 7,000 2,100

A92.1 O'nyong-nyong fever ARTHROPOD BORNE VIRAL FEVER 8,100 2,430

Unspecified arthropod-borne viral fever; Unspecified arthropod-borne

M15.0 Primary generalized (osteo)arthrosis ARTHROSIS 7,000 2,100

M15.4 Erosive (osteo)arthrosis ARTHROSIS 7,000 2,100

M16.0 Primary coxarthrosis, bilateral ARTHROSIS 7,000 2,100

M16.9 Coxarthrosis, unspecified ARTHROSIS 7,000 2,100

M17.2 Post-traumatic gonarthrosis, bilateral ARTHROSIS 7,000 2,100

M17.5 Other secondary gonarthrosis; Secondary gonarthrosis ARTHROSIS 7,000 2,100

M17.9 Gonarthrosis, unspecified ARTHROSIS 7,000 2,100

M18.9 Arthrosis of first carpometacarpal joint, unspecified ARTHROSIS 7,000 2,100

M19.10 Post-traumatic arthrosis of other joints; Post-traumatic ARTHROSIS 7,000 2,100

M19.11 Post-traumatic arthrosis of other joints; Post-traumatic ARTHROSIS 7,000 2,100

M19.12 Post-traumatic arthrosis of other joints; Post-traumatic ARTHROSIS 7,000 2,100

M19.19 Post-traumatic arthrosis of other joints; Post-traumatic ARTHROSIS 7,000 2,100

Predominantly allergic asthma; Allergic bronchitis NOS; Allergic rhinitis

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or

Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or