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.

Click to Continue

+
Coding

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.

Click to Continue

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.

Click to Continue

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.

Calculate your Pending AR

RCM Services

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.

Click to Continue

Struggling To Bill With Your EHR?


At BillingParadise we know the features and workarounds of your EHR system. All our RCM tools are integrated with the system you use.


Get paid Three times faster with our 24/7 medical billing services.

Work with medical billers who understand your EHR's billing process backwards and forwards

Avail Free RCM Audit Worth $2,000! Check out 19 different KPI reports that stops your cash flow.