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Medical coding glossaries

Drive down coding related denials

New updated 2022 codes for Cardiology that has the most errors

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
33249	Insj/rplcmt defib w/lead(s)	NA	$879.18	NA	$960.51	32.7442
93306	Tte w/doppler complete	$192.86	NA	$210.70	NA	32.7442
93458	L hrt artery/ventricle angio	$1,007.21	NA	$1,100.38	NA	32.7442
93566	Njx car cth slctv rv/ra ang	$24.89	$24.89	$27.19	$27.19	32.7442
93653	Compre ep eval tx svt	NA	$799.61	NA	$873.58	32.7442
93000	Electrocardiogram complete	$14.08	NA	$15.38	NA	32.7442
93010	Electrocardiogram report	$7.86	$7.86	$8.59	$8.59	32.7442
93224	Ecg monit/reprt up to 48 hrs	$70.73	NA	$77.27	NA	32.7442
93272	Ecg/review interpret only	$23.25	$23.25	$25.40	$25.40	32.7442
93272	Ecg/review interpret only	$23.25	$23.25	$25.40	$25.40	32.7442

Source: CMS Physician Fee Schedule Search

Preventing mistakes on Anatomical anesthesia coding

S.no	CPT code	Anatomical Area
1	00100-00222	Head
2	00300-00352	Neck
3	00400-00474	Thorax (chest wall and shoulder girdle)
4	00500-00580	Intrathoracic
5	00600-00670	Spine and Spinal Cord
6	00700-00797	Upper Abdomen
7	00800-00882	Lower Abdomen
8	00902-00952	Perineum
9	01112-01173	Pelvis (except hip)
10	01200-01274	Upper Leg (except knee)
11	01320-01444	Knee and Popliteal Area
12	01462-01522	Lower Leg (below knee, including ankle and foot)
13	01610-01680	Shoulder and Axilla
14	01710-01782	Upper Arm and Elbow
15	01810-01860	Forearm, Wrist and Hand
16	01916-01942	Radiological Procedure
17	01951-01953	Burn Excisions or Debridement
18	01958-01969	Obstetric
19	01990-01999	Other Procedure

Internal medicine codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99211	Off/op est may x req phy/qhp	$22.92	$8.51	$25.04	$9.30	32.7442
99212	Office o/p est sf 10 min	$55.67	$34.38	$60.81	$37.56	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
99215	Office o/p est hi 40 min	$177.47	$140.47	$193.89	$153.47	32.7442
99231	Sbsq hosp ip/obs sf/low 25	NA	$48.13	NA	$52.59	32.7442
99232	Sbsq hosp ip/obs moderate 35	NA	$76.62	NA	$83.71	32.7442
99233	Sbsq hosp ip/obs high 50	NA	$115.26	NA	$125.92	32.7442
99238	Hosp ip/obs dschrg mgmt 30	NA	$78.91	NA	$86.21	32.7442
99239	Hosp ip/obs dschrg mgmt >30	NA	$111.33	NA	$121.63	32.7442

Urgent care codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99281	Emr dpt vst mayx req phy/qhp	NA	$11.13	NA	$12.16	32.7442
99282	Emergency dept visit sf mdm	NA	$40.60	NA	$44.36	32.7442
99283	Emergency dept visit low mdm	NA	$69.09	NA	$75.48	32.7442
99284	Emergency dept visit mod mdm	NA	$117.55	NA	$128.43	32.7442
99285	Emergency dept visit hi mdm	NA	$170.27	NA	$186.02	32.7442
93005	Electrocardiogram tracing	$6.22	NA	$6.80	NA	32.7442
99211	Off/op est may x req phy/qhp	$22.92	$8.51	$25.04	$9.30	32.7442
20610	Drain/inj joint/bursa w/o us	$64.18	$44.53	$70.11	$48.65	32.7442
10120	Inc&rmvl fb subq tiss smpl	$150.30	$104.45	$164.20	$114.12	32.7442
97597	Dbrdmt opn wnd 1st 20 cm/<	$99.22	$34.38	$108.39	$37.56	32.7442

Source: CMS Physician Fee Schedule Search

Oncology Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
77427	Radiation tx management x5	$186.64	$186.64	$203.91	$203.91	32.7442
77295	3-d radiotherapy plan	$472.17	NA	$515.85	NA	32.7442
77301	Radiotherapy dose plan imrt	$1,812.72	NA	$1,980.40	NA	32.7442
99205	Office o/p new hi 60 min	$216.77	$176.82	$236.82	$193.17	32.7442
99215	Office o/p est hi 40 min	$177.47	$140.47	$193.89	$153.47	32.7442
96413	Chemo iv infusion 1 hr	$127.05	NA	$138.80	NA	32.7442
96523	Irrig drug delivery device	$24.56	NA	$26.83	NA	32.7442
96450	Chemotherapy into cns	$158.81	$74.00	$173.50	$80.85	32.7442
77435	Sbrt management	$627.38	$627.38	$685.41	$685.41	32.7442
77373	Sbrt delivery	$977.41	NA	$1,067.83	NA	32.7442

Podiatry codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99201-99205	Office o/p new sf 15 min - Office o/p new hi 60 min	$71.06 - $216.77	$46.17 - $176.82	$77.63 - $236.82	$50.44 - $193.17	32.7442
99211 - 99215	Off/op est may x req phy/qhp - Office o/p est hi 40 min	$22.92 - $177.47	$8.51- $140.47	$25.04 - $193.89	$9.30 - $153.47	32.7442
11720 - 11721	Debride nail 1-5 - Debride nail 6 or more	$32.42 - $43.88	$13.75 - $22.92	$35.42 - $47.94	$15.03 - $25.04	32.7442
G0127	Trim nail(s)	$23.58	$7.20	$25.76	$7.87	32.7442
11055 - 11057	Paring/cutg b9 hyprker les 1 - Parng/cutg b9 hyprkr les >4	$70.07 - $88.74	$15.06 - $27.83	$76.55 - $96.95	$16.46 - $30.41	32.7442
11730	Removal of nail plate	$113.30	$52.39	$123.78	$57.24	32.7442
11740	Drain blood from under nail	$56.98	$31.76	$62.25	$34.70	32.7442
11750	Removal of nail bed	$158.48	$100.20	$173.14	$109.47	32.7442
28308	Incision of metatarsal	$562.87	$385.73	$614.94	$421.41	32.7442
29540	Strapping of ankle and/or ft	$27.51	$16.70	$30.05	$18.24	32.7442

Source: CMS Physician Fee Schedule Search

Mental Health

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
90791	Psych diagnostic evaluation	$169.29	$145.06	$184.95	$158.48	32.7442
90834	Psytx w pt 45 minutes	$101.51	$88.74	$110.90	$96.95	32.7442
90837	Psytx w pt 60 minutes	$149.64	$130.98	$163.48	$143.09	32.7442
90847	Family psytx w/pt 50 min	$100.53	$99.87	$109.82	$109.11	32.7442
96130	Psycl tst eval phys/qhp 1st	$117.88	$106.42	$128.78	$116.26	32.7442
90792	Psych diag eval w/med srvcs	$190.57	$166.34	$208.20	$181.73	32.7442
90839	Psytx crisis initial 60 min	$144.07	$126.72	$157.40	$138.44	32.7442
90853	Group psychotherapy	27.18	$23.58	$29.69	$25.76	32.7442
90840	Psytx crisis ea addl 30 min	$71.38	$63.52	$77.99	$69.40	32.7442
90846	Family psytx w/o pt 50 min	$95.94	$95.61	$104.82	$104.46	32.7442

Source: CMS Physician Fee Schedule Search

Orthopedic codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
29881	Knee arthroscopy/surgery	NA	$540.28	NA	$590.26	32.7442
29826	Sho arthrs srg decompression	NA	$167.00	NA	$182.44	32.7442
29823	Sho arthrs srg xtnsv dbrdmt	NA	$590.71	NA	$645.35	32.7442
27447	Total knee arthroplasty	NA	$1,262.94	NA	$1,379.77	32.7442
27750	Treatment of tibia fracture	$356.26	$330.72	$389.21	$361.31	32.7442
20610	Drain/inj joint/bursa w/o us	$64.18	$44.53	$70.11	$48.65	32.7442
20550	Inj tendon sheath/ligament	$56.98	$37.98	$62.25	$41.50	32.7442
20605	Drain/inj joint/bursa w/o us	$54.36	$36.02	$59.38	$39.35	32.7442
27279	Arthrd si jt perq/min nvas	NA	$791.10	NA	$864.28	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442

Source: CMS Physician Fee Schedule Search

OBGYN codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
59400	Obstetrical care	NA	$2,390.33	NA	$2,611.43	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
76805	Ob us >= 14 wks sngl fetus	$133.27	NA	$145.60	NA	32.7442
58100	Biopsy of uterus lining	$100.20	$61.89	$109.47	$67.61	32.7442
57454	Bx/curett of cervix w/scope	$167.00	$131.30	$182.44	$143.45	32.7442
58558	Hysteroscopy biopsy	$1,295.03	$226.59	$1,414.82	$247.55	32.7442
76801	Ob us < 14 wks single fetus	$115.26	NA	$125.92	NA	32.7442
58661	Laparoscopy remove adnexa	NA	$643.42	NA	$702.94	32.7442
58110	Bx done w/colposcopy add-on	$49.44	$39.29	$54.02	$42.93	32.7442

Source: CMS Physician Fee Schedule Search

Urology codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
52332	Cystoscopy and treatment	$392.60	$150.62	$428.92	$164.56	32.7442
52352	Cystoscopy and treatment	$392.60	$150.62	$428.92	$164.56	32.7442
52000	Cystoscopy	$235.43	$77.93	$257.21/td>	$85.14	32.7442
52601	Prostatectomy (turp)	NA	$711.53	NA	$777.35	32.7442
51798	Us urine capacity measure	$11.13	NA	$12.16	NA	32.7442
51741	Electro-uroflowmetry first	$14.08	NA	$15.38	NA	32.7442
52000	Cystoscopy	$235.43	$77.93	$257.21	$85.14	32.7442
51798	Us urine capacity measure	$11.13	NA	$12.16/td>	NA	32.7442
54050	Destruction penis lesion(s)	$143.09	$105.76	$156.33	$115.55	32.7442/td>
54400	Insert semi-rigid prosthesis	NA	$522.60	NA	$570.94	32.7442/td>

Optometry Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
67516	Sprchoroidal spc njx rx agt	$117.22	$93.98	$128.07	$102.67	32.7442
65125	Revise ocular implant	$445.65	$287.82	$486.87	$314.45	32.7442
65210	Remove foreign body from eye	$37.33	$34.71	$40.78	$37.92	32.7442
68761	Close tear duct opening	$142.76	$114.28	$155.97	$124.85	32.7442
67820	Revise eyelashes	$18.34	$21.61	$20.03	$23.61	32.7442
99211	Off/op est may x req phy/qhp	$22.92	$8.51	$25.04	$9.30	32.7442
99204	Office o/p new mod 45 min	$164.38	$129.99	$179.58	$142.02	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
99215	Office o/p est hi 40 min	$177.47	$140.47	$193.89	$153.47	32.7442

Dermatology codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
11642	Exc f/e/e/n/l mal+mrg 1.1-2	$264.57	$178.46	$289.05	$194.96	32.7442
17000	Destruct premalg lesion	$66.80	$54.36	$72.98	$59.38	32.7442
13151	Destruct premalg lesion	$66.80	$54.36	$72.98/td>	$59.38	32.7442
13151	Cmplx rpr e/n/e/l 1.1-2.5 cm	$415.52	$271.12	$453.96	$296.20	32.7442
15777	Acellular derm	$208.58	$208.58	$227.87	$227.87	32.7442
99203	Office o/p new low 30 min	$109.69	$79.90	$119.84	$87.29	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
17110	Destruct b9 lesion 1-14	$112.31	$67.78	$122.70	$74.05	32.7442
11301	Shave skin lesion 0.6-1.0 cm	$119.52	$49.77	$130.57	$54.38/td>	32.7442
11402	Exc tr-ext b9+marg 1.1-2 cm	$169.94	$114.28	$185.66	$124.85	32.7442
14040	Tis trnfr f/c/c/m/n/a/g/h/f	$750.50	$613.30	$819.92	$670.03	32.7442

Geriatrics codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99304	1st nf care sf/low mdm 25	$78.26	$78.26	$85.50	$85.50	32.7442
99306	1st nf care high mdm 50	$177.47	$177.47	$193.89	$193.89	32.7442
99307	Sbsq nf care sf mdm 10	$39.29	$39.29	$42.93	$42.93	32.7442
99308	Sbsq nf care low mdm 20	$72.69	$72.69	$79.42	$79.42	32.7442
99309	Sbsq nf care moderate mdm 30	$105.11	$105.11	$114.83	$114.83	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
99203	Office o/p new low 30 min	$109.69	$79.90	$119.84	$87.29	32.7442
99204	Office o/p new mod 45 min	$164.38	$129.99	$179.58	$142.02	32.7442
99205	Office o/p new hi 60 min	$216.77	$176.82	$236.82	$193.17	32.7442

Family Medicine codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
99204	Office o/p new mod 45 min	$164.38	$129.99	$179.58	$142.02	32.7442
99223	1st hosp ip/obs high 75	NA	$168.31	NA	$183.87	32.7442
99232	Sbsq hosp ip/obs moderate 35	NA	$76.62	NA	$83.71	32.7442
99238	Hosp ip/obs dschrg mgmt 30/<	NA	$78.91	NA	$86.21	32.7442
99239	Hosp ip/obs dschrg mgmt >30	NA	$111.33	NA	$121.63	32.7442
99285	Emergency dept visit hi mdm	NA	$170.27	NA	$186.02	32.7442
99222	1st hosp ip/obs moderate 55	NA	$127.05	NA	$138.80	32.7442
G0402	Initial preventive exam	$163.07	$127.70	$178.15	$139.51	32.7442

Psychiatry codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
90832	Psytx w pt 30 minutes	$76.95	$67.13	$84.07	$73.33	32.7442
90834	Psytx w pt 45 minutes	$101.51	$88.74	$110.90	$96.95	32.7442
90837	Psytx w pt 60 minutes	$149.64	$130.98	$163.48	$143.09	32.7442
90853	Group psychotherapy	$27.18	$23.58	$29.69	$25.76	32.7442
90839	Psytx crisis initial 60 min	$144.07	$126.72	$157.40	$138.44	32.7442
90846	Family psytx w/o pt 50 min	$95.94	$95.61	$104.82	$104.46	32.7442
90847	Family psytx w/pt 50 min	$100.53	$99.87	$109.82	$109.11	32.7442
90849	Multiple family group psytx	$37.00	$28.82	$40.42	$31.48	32.7442
96130	Psycl tst eval phys/qhp 1st	$117.88	$106.42	$128.78	$116.26	32.7442
96136	Psycl/nrpsyc tst phy/qhp 1st	$40.93	$22.59	$44.72	$24.68	32.7442

Radiology codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
71045	X-ray exam chest 1 view	$25.21	NA	$27.55	NA	32.7442
71046	X-ray exam chest 2 views	$33.07	NA	$36.13	NA	32.7442
74177	Ct abd & pelv w/contrast	$133.92	NA	$146.31	NA	32.7442
76700	Us exam abdom complete	$114.28	NA	$124.85	NA	32.7442
70450	Ct head/brain w/o dye	$106.75	NA	$116.62	NA	32.7442
70486	Ct maxillofacial w/o dye	$129.01	NA	$140.95	NA	32.7442
72170	X-ray exam of pelvis	$27.51	NA	$30.05	NA	32.7442
73221	Mri joint upr extrem w/o dye	$204.98	NA	$223.94	NA	32.7442
77067	Scr mammo bi incl cad	$125.74	NA	$137.37	NA	32.7442
72141	Mri neck spine w/o dye	$192.54	NA	$210.35	NA	32.7442

Dental codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
D0140	Limit oral eval problm focus	$0.00	$0.00	$0.00	$0.00	32.7442
D0220	Intraoral periapical first	$0.00	NA	$0.00	NA	32.7442
D1110	Dental prophylaxis adult	$0.00	$0.00	$0.00	$0.00	32.7442
D2330	Resin one surface-anterior	$0.00	$0.00	$0.00	$0.00	32.7442
D2740	Crown porcelain/ceramic	$0.00	$0.00	$0.00	$0.00	32.7442
21030	Excise max/zygoma b9 tumor	$450.89	$354.95	$492.60	$387.78	32.7442
21031	Remove exostosis mandible	$377.21	$268.50	$412.11	$293.34	32.7442
D7280	Exposure of unerupted tooth	$0.00	$0.00	$0.00	$0.00	32.7442
D7310	Alveoplasty w/ extraction	$0.00	$0.00	$0.00	$0.00	32.7442
21248	Reconstruction of jaw	$963.33	$777.35	$1,052.44	$849.25	32.7442

Neurosurgery codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
61070	Brain canal shunt procedure	NA	$55.01	NA	$60.10	32.7442
61253	Pierce skull & explore	NA	$995.75	NA	$1,087.86	32.7442
61576	Skull base/brainstem surgery	NA	$4,142.80	NA	$4,526.01	32.7442
61619	Repair dura	NA	$1,419.13	NA	$1,550.40	32.7442
61651	Evasc prlng admn rx agnt add	NA	$243.62	NA	$266.15	32.7442
61711	Fusion of skull arteries	NA	$2,593.34	NA	$2,833.23	32.7442
61791	Treat trigeminal tract	NA	$1,129.35	NA	$1,233.81	32.7442
61800	Apply srs headframe add-on	NA	$148.66	$162.41	NA	32.7442
61892	Rmv sk-mnt crnl nstm pg/rcvr	NA	$812.71	NA	$887.89	32.7442
62148	Retr bone flap to fix skull	$123.77	NA	$135.22	NA	32.7442

Chiropractic codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
98940	Chiropract manj 1-2 regions	$26.85	$21.28	$29.33	$23.25	32.7442
97110	Therapeutic exercises	$28.82	NA	$31.48	NA	32.7442
97140	Manual therapy 1/> regions	$26.52	NA	$28.98	NA	32.7442
97530	Therapeutic activities	$36.02	NA	$39.35	NA	32.7442
G0283	Elec stim other than wound	$11.46	NA	$12.52	NA	32.7442
98941	Chiropract manj 3-4 regions	$38.64	$32.74	$42.21	$35.77	32.7442
98942	Chiropractic manj 5 regions	$49.77	$43.88	$54.38	$47.94	32.7442
97112	Neuromuscular reeducation	$33.07	NA	$36.13	NA	32.7442
97116	Gait training therapy	$28.82	NA	$31.48	NA	32.7442
97760	Orthotic mgmt&traing 1st enc	$46.82	NA	$51.16	NA	32.7442

Emergency department codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99281	Emr dpt vst mayx req phy/qhp	NA	$11.13	NA	$12.16	32.7442
99282	Emergency dept visit sf mdm	NA	$40.60	NA	$44.36	32.7442
99291	Critical care first hour	$267.85	$206.62	$292.62	$225.73	32.7442
93005	Electrocardiogram tracing	$6.22	NA	$6.80	NA	32.7442
96372	Ther/proph/diag inj sc/im	$14.08	NA	$15.38	NA	32.7442
93010	Electrocardiogram report	$7.86	$7.86	$8.59	$8.59	32.7442
99211	Off/op est may x req phy/qhp	$22.92	$8.51	$25.04	$9.30	32.7442
99205	Office o/p new hi 60 min	$216.77	$176.82	$236.82	$193.17	32.7442
99281	Emr dpt vst mayx req phy/qhp	NA	$11.13	NA	$12.16	32.7442
99292	Critical care addl 30 min	$117.22	$104.13	$128.07	$113.76	32.7442

Rehab Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
90832	Psytx w pt 30 minutes	$76.95	$67.13	$84.07	$73.33	32.7442
90837	Psytx w pt 60 minutes	$149.64	$130.98	$163.48	$143.09	32.7442
90847	Family psytx w/pt 50 min	$100.53	$99.87	$109.82	$109.11	32.7442
90853	Group psychotherapy	$27.18	$23.58	$29.69	$25.76	32.7442
90833	Psytx w pt w e/m 30 min	$70.73	$62.87	$77.27	$68.68	32.7442
90849	Multiple family group psytx	$37.00	$28.82	$40.42	$31.48	32.7442
99484	Care mgmt svc bhvl hlth cond	$54.03	$42.90	$59.03	$46.86	32.7442
G0396	Alcohol/subs interv 15-30mn	$33.73	$30.78	$36.85	$33.63	32.7442
G0397	Alcohol/subs interv >30 min	$65.49	$62.54	$71.55	$68.33	32.7442
96127	Brief emotional/behav assmt	$4.58	NA	$5.01	NA	32.7442

Pulmonology Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
94010	Breathing capacity test	$26.85	NA	$29.33	NA	32.7442
94726	Pulm funct tst plethysmograp	$55.01	NA	$60.10	NA	32.7442
94727	Pulm function test by gas	$43.88	NA	$47.94	NA	32.7442
94060	Evaluation of wheezing<	$38.31	NA	$41.85	NA	32.7442
32491	Lung volume reduction<	NA	$1,428.63	NA	$1,560.78	32.7442
31622	Dx bronchoscope/wash	$244.93	$127.70	$267.58	$139.51	32.7442
32674	Thoracoscopy lymph node exc	NA	$206.62	NA	$225.73	32.7442
31645	Brnchsc w/ther aspir 1st	$268.83	$141.46	$293.70	$154.54	32.7442
32998	Ablate pulm tumor perq rf	$2,976.45	$418.80	$3,251.77	$457.54	32.7442
94729	Co/membane diffuse capacity	$55.67	NA	$60.81	NA	32.7442

Neurology Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99215	Office o/p est hi 40 min	$177.47	$140.47	$193.89	$153.47	32.7442
95819	Eeg awake and asleep	$446.96	NA	$488.30	NA	32.7442
95816	Eeg awake and drowsy	$388.02	NA	$423.91	NA	32.7442
96372	Ther/proph/diag inj sc/im	$14.08	NA	$15.38	NA	32.7442
93970	Extremity study	$183.70	NA	$200.69	NA	32.7442
64615	Chemodenerv musc migraine	$151.93	$121.15	$165.99	$132.36	32.7442
64405	Njx aa&/strd gr ocpl nrv	$74.33	$51.74	$81.21	$56.52	32.7442
62270	Dx lmbr spi pnxr	$143.75	$62.21	$157.04	$67.97	32.7442
92540	Basic vestibular evaluation	$104.78	NA	$114.47	NA	32.7442
64510	N block stellate ganglion	$144.07	$75.31	$157.40	$82.28	32.7442

Ophthalmology Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
92004	Compre oph exam new pt 1/>	$146.04	$90.70	$159.55	$99.09	32.7442
92014	Compre oph exam est pt 1/>	$123.45	$73.02	$134.86	$79.77	32.7442
92012	Intrm oph exam est patient	$87.43	$48.46	$95.51	$52.94	32.7442
92002	Intrm oph exam new patient	$83.17	$43.88	$90.86	$47.94	32.7442
99204	Office o/p new mod 45 min	$164.38	$129.99	$179.58	$142.02	32.7442
66821	After cataract laser surgery	$326.79	$304.19	$357.02	$332.33	32.7442
67028	Injection eye drug	$110.35	$88.74	$120.56	$96.95	32.7442
65855	Trabeculoplasty laser surg	$239.36	$199.41	$261.50	$217.86	32.7442
66761	Revision of iris	$292.41	$230.19	$319.45	$251.48	32.7442
66984	Xcapsl ctrc rmvl w/o ecp	NA	$528.49	NA	$577.38	32.7442

General Surgery Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
49505	Prp i/hern init reduc >5 yr	NA	$518.01	NA	$565.93	32.7442
44970	Laparoscopy appendectomy	NA	$595.29	NA	$650.35	32.7442
47562	Laparoscopic cholecystectomy	NA	$652.26	NA	$712.60	32.7442
11400	Exc tr-ext b9+marg 0.5 cm<	$126.72	$83.50	$138.44	$91.22	32.7442
12001	Rpr s/n/ax/gen/trnk 2.5cm/<	$92.99	$43.88	$101.60	$47.94	32.7442
60220	Partial removal of thyroid	NA	$697.78	NA	$762.32	32.7442
19120	Removal of breast lesion	$515.07	$414.54	$562.71	$452.89	32.7442
45378	Diagnostic colonoscopy	$333.66	$178.46	$364.53	$194.96	32.7442
44180	Lap enterolysis	NA	$904.40	NA	$988.05	32.7442
19300	Removal of breast tissue	$570.08	$427.97	$622.81	$467.55	32.7442

Pediatric Codes

HCPCS Code	Short Description	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	Conv Fact
99291	Critical care first hour	$267.85	$206.62	$292.62	$225.73	32.7442
99468	Neonate crit care initial	NA	$867.07	NA	$947.27	32.7442
99223	1st hosp ip/obs high 75	NA	$168.31	NA	$183.87	32.7442
99460	Init nb em per day hosp	NA	$90.05	NA	$98.38	32.7442
99213	Office o/p est low 20 min	$89.39	$64.18	$97.66	$70.11	32.7442
90471	Immunization admin	$20.30	NA	$22.18	NA	32.7442
99214	Office o/p est mod 30 min	$126.07	$94.63	$137.73	$103.38	32.7442
99232	Sbsq hosp ip/obs moderate 35	NA	$76.62	NA	$83.71	32.7442
99204	Office o/p new mod 45 min	$164.38	$129.99	$179.58	$142.02	32.7442
99310	Sbsq nf care high mdm 45	$149.97	$149.97	$163.84	$163.84	32.7442

Specialized Support

An answer for your every need

Billing & Collections

Do you want a powerful cardiology for your billing aches? BillingParadise is your answer. Our cardiology billing experts can up your collections ratio and decrease workflow hassles. And the best aspect of working with us is that we have a solution for every concern of yours.

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EMR Support

Contain costs with our cardiology EHR/EMR billing support. Missed dinner again?Most users complain that an EHR adds to the number of hours they work. We bill and process claims within your EHR system so you can get back home early. And spend less time worrying about,whether you fed your system with the right billing information.

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Coding

Most cardiology practices struggle with revenue loss after a compliance update. At BillingParadise we minimize regulatory pressures by staying on top of evolving regulations and ensuring that your practice is completely compliant. Mitigate the risk of non-compliance and eliminate audit risks.

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Old AR

BillingParadise's stand alone old AR clean up / recovery service will let you submit accurate & error free claims. Which means our dedicated AR management team will follow up with your old unpaid claims. We will assign you a dedicated insurance specific calling team who knows the language of your payer. Our AR callers are cardiology specific, trained and certified professionals.

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Optimize the many moving parts of your revenue cycle with BillingParadise’s cardiology revenue cycle management services. Our certified revenue cycle specialists will improve the compliance and performance of your cardiology RCM processes.

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