Procedure Cost Estimation
| CODE | PROCEDURE DESCRIPTIONS | BASE | MAP 1 unit =$42.00 |
| 00100 | Anesthesia for salivary glands | 5 | $210.00 |
| 00103 | For reconstruction procedures of eyelid | 5 | $210.00 |
| 00104 | Anesthesia for electroconvulsive therapy | 4 | $168.00 |
| 00120 | Anesthesia for procedures on external, middle, and inner ear | 5 | $210.00 |
| 00124 | otoscopy | 4 | $168.00 |
| 00126 | typmpanotomy | 4 | $168.00 |
| 00140 | Anesthesia for procedures on eye | 5 | $210.00 |
| 00142 | lens surgery | 4 | $168.00 |
| 00144 | corneal transplant | 6 | $252.00 |
| 00145 | Vitrectomy | 6 | $252.00 |
| 00147 | Iridectomy | 6 | $252.00 |
| 00148 | ophthalmoscopy | 4 | $168.00 |
| 00160 | Anesthesia for procedures on nose and accessory sinuses | 5 | $210.00 |
| 00162 | radical surgery | 7 | $294.00 |
| 00164 | biopsy, soft tissue | 4 | $168.00 |
| 00170 | Anesthesia for intra-oral procedures | 5 | $210.00 |
| 00174 | Excision of retropharygeal tumor | 6 | $252.00 |
| 00176 | radical surgery | 7 | $294.00 |
| 00190 | Anesthesia for facial bones or skull | 5 | $210.00 |
| 00192 | radical surgery | 7 | $294.00 |
| 00210 | Anesthesia for intracranial procedures | 11 | $462.00 |
| 00212 | subdural taps | 5 | $210.00 |
| 00214 | burr holes | 9 | $378.00 |
| 00215 | elevation of depressed skull fracture, extradural | 9 | $378.00 |
| 00216 | vascular procedures | 15 | $630.00 |
| 00218 | sitting position | 13 | $546.00 |
| 00220 | spinal fluid shunting procedures | 10 | $420.00 |
| 00222 | electrocoagulation of intracranial nerve | 6 | $252.00 |
| 00300 | Anesthesia for all procedures on integumentary system of neck | 5 | $210.00 |
| 00320 | Anesthesia for esophagus, thyroid, larynx, trachea, lymphatic system of neck | 6 | $252.00 |
| 00322 | needle biopsy of thyroid | 3 | $126.00 |
| 00350 | Anesthesia for procedures on major vessels of neck | 10 | $420.00 |
| 00352 | simple ligation | 5 | $210.00 |
| 00400 | Anesthesia for anterior integumentary system of extrem. and trunk | 3 | $126.00 |
| 00402 | reconstruction procedures on breast | 5 | $210.00 |
| 00404 | radical or modified radical proc. | 5 | $210.00 |
| 00410 | electrical conversion of arrhythmias | 4 | $168.00 |
| 00450 | Anesthesia for procedures on clavicle and scapula | 5 | $252.00 |
| 00452 | radical surgery | 6 | $252.00 |
| 00454 | biopsy of clavicle | 3 | $126.00 |
| 00470 | Anesthesia for partial rib resection | 6 | $252.00 |
| 00472 | thoracoplasty (any type) | 10 | $420.00 |
| 00474 | radical procedures (e.g., pectus excavatum) | 13 | $546.00 |
| 00500 | Anesthesia for all procedures on esophagus | 15 | $630.00 |
| 00520 | Anesthesia for closed chest procedures (including bronchoscopy) | 6 | $252.00 |
| 00522 | needle biopsy of pleura | 4 | $168.00 |
| 00524 | pneumocentesis | 4 | $168.00 |
| 00528 | mediastinoscopy, not using one lung | 8 | $336.00 |
| 00530 | Anesthesia for permanent transvenous pacemaker insertion | 4 | $168.00 |
| 00532 | Anesthesia for access to central venous circulation | 4 | $168.00 |
| 00534 | Anesthesia for transvenous insertion or replacement of pacing cardioverter | 7 | $294.00 |
| 00537 | Anesthesia for cardiac electrophysiologic proc/ | 10 | $420.00 |
| 00539 | Anesthesia for tracheobronchial reconstruction | 18 | $756.00 |
| 00540 | Anesthesia for thoracotomy procedures | 13 | $546.00 |
| 00541 | Utilizing one lung ventilation | 15 | $630.00 |
| 00542 | Decortication | 15 | $630.00 |
| 00546 | pulmonary resection with thoracoplasty | 15 | $630.00 |
| 00548 | intrathoracic procdures on `trachea and bronchi | 15 | $630.00 |
| 00550 | Anesthesia forsternal debridement | 10 | $420.00 |
| 00560 | Anesthesia for procedures on heart, pericardium, and great vessels of chest; | 15 | $630.00 |
| 00562 | with pump oxygenator | 20 | $840.00 |
| 00563 | With pump oxygenator/hypothermic | 25 | $1,050.00 |
| 00566 | Anestheisa for direct coronary bypass grafting | 25 | $1,050.00 |
| 00580 | Anesthesia for heart transplant or heart/lung transplant | 20 | $840.00 |
| 00600 | Anesthesia for procedures on cervical spine and cord | 10 | $420.00 |
| 00604 | posterior cervical laminectomy in sitting position | 13 | $546.00 |
| 00620 | Anesthesia for procedures on thoracic spine and cord; not otherwise specified | 10 | $420.00 |
| 00622 | thoracolumbar sympathectomy | 13 | $546.00 |
| 00630 | Anesthesia for procedures in lumbar region; not otherwise specified | 8 | $336.00 |
| 00632 | lumbar sympathectomy | 7 | $294.00 |
| 00634 | Chemonucleolysis | 10 | $420.00 |
| 00635 | Diagnostic or therapeutic lumbar puncture | 4 | $168.00 |
| 00640 | Anesthesia for manipulation of spine or for closed procedures | 3 | $126.00 |
| 00670 | Anesthesia for extensive spine and spinal cord procedures | 13 | $546.00 |
| 00700 | Anesthesia for procedures on upper abd. Wall | 3 | $126.00 |
| 00702 | percutaneous liver biopsy | 4 | $168.00 |
| 00730 | Anesthesia for upper posterior abdominal wall | 5 | $210.00 |
| 00740 | Anesthesia for upper gastrointestinal endoscopic procedures | 5 | $210.00 |
| 00750 | Anesthesia for hernia repairs in upper abdomen; not otherwise specified | 4 | $168.00 |
| 00752 | lumbar and ventral (incisional) hernias and/or wound dehiscence | 6 | $252.00 |
| 00754 | Omphalocele | 7 | $294.00 |
| 00756 | transabdominal repair of diaphragmatic hernia | 7 | $294.00 |
| 00770 | Anesthesia for all procedures on major abdominal blood vessels | 15 | $630.00 |
| 00790 | Anesthesia for intraperitoneal procedures in upper abdomen | 7 | $294.00 |
| 00792 | partial hepatectomy or mgmt of liver hemorrage | 13 | $546.00 |
| 00794 | pancreatectomy, partial or total (e.g., Whipple procedure) | 8 | $336.00 |
| 00796 | Liver transplant-recipient | 30 | $1,250.00 |
| 00800 | Anesthesia for procedures on lower anterior abdominal wall | 3 | $126.00 |
| 00802 | Panniculectomy | 5 | $210.00 |
| 00810 | Anesthesia for lower intestinal endoscopic procedures | 6 | $252.00 |
| 00820 | Anesthesia for procedures on lower posterior abdominal wall | 5 | $210.00 |
| 00830 | Anesthesia for hernia repairs in lower abdomen | 4 | $168.00 |
| 00832 | ventral and incisional hernias | 6 | $252.00 |
| 00840 | Anesthesia for intraperitoneal procedures in lower abdomen | 6 | $252.00 |
| 00842 | Amniocentesis | 4 | $168.00 |
| 00844 | abdominoperineal resection | 7 | $294.00 |
| 00860 | Anesthesia for extraperitoneal procedures in lower abdomen; inc urinary tract | 6 | $252.00 |
| 00862 | renal procedures, including upper 1/3 of ureter, or donor nephrectomy | 7 | $294.00 |
| 00864 | total cystectomy | 8 | $336.00 |
| 00865 | radical prostatectomy | 7 | $294.00 |
| 00866 | Adrenalectomy | 10 | $420.00 |
| 00868 | renal transplant | 10 | $420.00 |
| 00870 | Cystolithotomy | 5 | $210.00 |
| 00872 | Anesthsia for lithotripsy, with water bath | 7 | $294.00 |
| 00873 | Without water bath | 5 | $210.00 |
| 00880 | Anesthesia for procedures on major lower abdominal vessels | 15 | $630.00 |
| 00882 | inferior vena cava ligation | 10 | $420.00 |
| 00902 | Anesthesia for anorectal procedure | 5 | $210.00 |
| 00904 | radical perineal procedure | 7 | $294.00 |
| 00906 | vulvectomy | 4 | $168.00 |
| 00908 | perineal porstatectomy | 6 | $252.00 |
| 00910 | Anesthesia for transurethral procedures | 3 | $126.00 |
| 00912 | transurethral resection of bladder tumors | 5 | $210.00 |
| 00914 | transurethral rescection of prostate | 5 | $210.00 |
| 00916 | post-transurethral resection bleeding | 5 | $210.00 |
| 00918 | With fragmentation, manip. or removal of ureteral calculus | 5 | $210.00 |
| 00920 | Anesthesia for procedures on male external genitalia | 3 | $126.00 |
| 00922 | seminal vesicles | 6 | $252.00 |
| 00926 | radical orchiectomy, inguinal | 4 | $168.00 |
| 00928 | radical orchiectomy, abdominal | 6 | $252.00 |
| 00930 | orchiopexy, unilateral or bilateral | 4 | $168.00 |
| 00932 | complete amputation of penis | 4 | $168.00 |
| 00934 | radical amputation of penis with bilateral inguinal lymphadenectomy | 6 | $252.00 |
| 00936 | radical amputation of penis with bilateral inguinal and iliac lymphadenectomy | 8 | $336.00 |
| 00938 | insertion of penile prosthesis (perineal approach) | 4 | $168.00 |
| 00940 | Anesthesia for vaginal procedures | 3 | $126.00 |
| 00942 | colpotomy, colpectomy, colporrhaphy and open urethral | 4 | $168.00 |
| 00944 | vaginal hysterectomy | 6 | $252.00 |
| 00948 | cervical cerclage | 4 | $168.00 |
| 00950 | culdoscopy | 5 | $210.00 |
| 00952 | Hysteroscopy and/or hysterosalpingography | 4 | $168.00 |
| 01112 | Anesthesia for bone marrow aspiration/iliac crest | 5 | $210.00 |
| 01120 | Anesthesia for procedures on bony pelvis | 6 | $252.00 |
| 01130 | Anesthesia for body cast application or revision | 3 | $126.00 |
| 01140 | Anesthesia for interpelviabdominal (hind quarter) amputation | 15 | $630.00 |
| 01160 | Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint | 4 | $168.00 |
| 01170 | Anesthesia for open procedures involving symphysis pubis or sacroiliac joint | 8 | $336.00 |
| 01180 | Anesthesia for obturator neurectomy; extrapelvic | 3 | $126.00 |
| 01190 | intrapelvic | 4 | $168.00 |
| 01200 | Anesthesia for all closed procedures involving hip joint | 4 | $168.00 |
| 01202 | Anesthesia for arthroscopic procedures of hip joint | 4 | $168.00 |
| 01210 | Anesthesia for open procedures involving hip joint; not otherwise specified | 6 | $252.00 |
| 01212 | hip disarticulation | 10 | $420.00 |
| 01214 | total hip replacement or revision | 10 | $420.00 |
| 01215 | Revision total hip replacement | 10 | $420.00 |
| 01220 | Anesthesia for all closed procedures involving upper 2/3 of femur | 4 | $168.00 |
| 01230 | Anesthesia for open procedures involving upper 2/3 of femur | 6 | $252.00 |
| 01232 | amputation | 5 | $210.00 |
| 01234 | radical resection | 8 | $336.00 |
| 01250 | Anesthesia for nerves, muscles, tendons, fascia, bursae of upper leg | 4 | $168.00 |
| 01260 | Anesthesia for all procedures involving veins of upper leg | 3 | $126.00 |
| 01270 | Anesthesia for procedures involving arteries of upper leg | 8 | $336.00 |
| 01272 | femoral artery ligation | 4 | $168.00 |
| 01274 | femoral artery embolectomy | 6 | $252.00 |
| 01320 | Anesthesia for nerves, muscles, tendons, fascia, bursae of knee, popliteal area | 4 | $168.00 |
| 01340 | Anesthesia for all closed procedures on lower 1/3 of femur | 4 | $168.00 |
| 01360 | Anesthesia for all open procedures on lower 1/3 of femur | 5 | $210.00 |
| 01380 | Anesthesia for all closed procedures on knee joint | 3 | $126.00 |
| 01382 | Anesthesia for arthroscopic procedures of knee joint | 3 | $126.00 |
| 01390 | Anesthesia for all closed procedures on upper ends of tibia, fibula, patella | 3 | $126.00 |
| 01392 | Anesthesia for all open procedures on upper ends of tibia, fibula, patella | 4 | $168.00 |
| 01400 | Anesthesia for open procedures or arthroscopic, knee | 4 | $168.00 |
| 01402 | total knee replacement | 7 | $294.00 |
| 01404 | disarticulation at knee | 5 | $210.00 |
| 01420 | Anesthesia for all cast applications, removal, or repair involving knee joint | 3 | $126.00 |
| 01430 | Anesthesia for procedures on veins of knee and popliteal area | 3 | $126.00 |
| 01432 | arteriovenous fistula | 5 | $210.00 |
| 01440 | Anesthesia for procedures on arteries of knee and popliteal area | 5 | $210.00 |
| 01442 | popliteal thromboendarterectomy, with or without patch graft | 8 | $336.00 |
| 01444 | popliteal excision and graft or repair for occlusion or aneurysm | 8 | $336.00 |
| 01462 | Anesthesia for all closed procedures on lower leg, ankle, and foot | 3 | $126.00 |
| 01464 | Anesthesia for arthroscopic procedures of ankle joint | 3 | $126.00 |
| 01470 | Anesthesia for nerves, muscles, tendons, fascia of lower leg, ankle, & foot | 3 | $126.00 |
| 01472 | repair of ruptured Achilles tendon, with or without graft | 5 | $210.00 |
| 01474 | gastrocnemius recession (e.g., Strayer procedure) | 5 | $210.00 |
| 01480 | Anesthesia/open procedures on bones of lower leg, ankle, and foot; | 3 | $126.00 |
| 01482 | radical resection | 4 | $168.00 |
| 01484 | osteotomy or osteoplasty of tibia and/or fibula | 4 | $168.00 |
| 01486 | total ankle replacement | 7 | $294.00 |
| 01490 | Anesthesia for lower leg cast application, removal, or repair | 3 | $126.00 |
| 01500 | Anesthesia for procedures on arteries of lower leg, including bypass graft | 8 | $336.00 |
| 01502 | embolectomy, direct or with catheter | 6 | $252.00 |
| 01520 | Anesthesia for procedures on veins of lower leg | 3 | $126.00 |
| 01522 | venous thrombectomy, direct or with catheter | 5 | $210.00 |
| 01610 | Anesthesia / proc. on nerves, muscles, tendons, fascia, bursae/ upper leg | 5 | $210.00 |
| 01620 | Anesthesia for all closed procedures on humeral head and neck, | 4 | $168.00 |
| 01622 | Anesthesia for arthroscopic procedures of shoulder joint | 4 | $168.00 |
| 01630 | Anesthesia for open procedures on humeral head and neck, | 5 | $210.00 |
| 01632 | radical resection | 6 | $252.00 |
| 01634 | shoulder disarticulation | 9 | $378.00 |
| 01636 | interthoracoscapular (forequarter) amputation | 15 | $630.00 |
| 01638 | total shoulder replacement | 10 | $420.00 |
| 01650 | Anesthesia for procedures on arteries of shoulder/axilla | 6 | $252.00 |
| 01652 | axillary-brachial aneurysm | 10 | $420.00 |
| 01654 | bypass graft | 8 | $336.00 |
| 01656 | axillary-femoral bypass graft | 10 | $420.00 |
| 01670 | Anesthesia for all procedures on veins of shoulder and axilla | 4 | $168.00 |
| 01680 | Anesthesia for shoulder cast application, removal or repair; | 3 | $126.00 |
| 01682 | shoulder spica | 4 | $168.00 |
| 01710 | Anesthesia/proc.on nerves, muscles, tendons, fascia, bursae of upper arm | 3 | $126.00 |
| 01712 | tenotomy, elbow to shoulder, open | 5 | $210.00 |
| 01714 | tenoplasty, elbow to shoulder | 5 | $210.00 |
| 01716 | tenodesis, rupture of long tendon of biceps | 5 | $210.00 |
| 01730 | Anesthesia for all closed procedures on humerus and elbow | 3 | $126.00 |
| 01732 | Anesthesia for arthroscopic procedures of elbow joint | 3 | $126.00 |
| 01740 | Anesthesia for open procedures on humerus and elbow | 4 | $210.00 |
| 01742 | osteotomy of humerus | 5 | $210.00 |
| 01744 | repair of nonunion or malunion of humerus | 5 | $210.00 |
| 01756 | radical procedures | 6 | $252.00 |
| 01758 | excision of cyst or tumor of humerus | 5 | $210.00 |
| 01760 | total elbow replacement | 7 | $294.00 |
| 01770 | Anesthesia for procedures on arteries of upper arm and elbow | 8 | $336.00 |
| 01772 | embolectomy | 6 | $252.00 |
| 01780 | Anesthesia for procedures on veins of upper arm and elbow | 3 | $126.00 |
| 01782 | phleborrhaphy | 4 | $168.00 |
| 01810 | Anesthesia/on nerves, muscles, tendons, fascia, bursae of forearm, wrist, hand | 3 | $126.00 |
| 01820 | Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones | 3 | $126.00 |
| 01829 | Anesthesia for diagnostic arthroscopic procedures on wrist | 3 | $126.00 |
| 01830 | Anesthesia for open procedures on radius, ulna, wrist, or hand bones | 3 | $126.00 |
| 01832 | total wrist replacement | 6 | $252.00 |
| 01840 | Anesthesia for procedures on arteries of forearm, wrist, and hand | 6 | $252.00 |
| 01842 | Embolectomy | 6 | $252.00 |
| 01844 | Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis) | 6 | $252.00 |
| 01850 | Anesthesia for procedures on veins of forearm, wrist, and hand; | 3 | $126.00 |
| 01852 | Phleborrhaphy | 4 | $168.00 |
| 01860 | Anesthesia for forearm, wrist, or hand cast application, removal, or repair | 3 | $126.00 |
| 01905 | Anesthesia for injection procedure for myelography; | 5 | $210.00 |
| 01916 | Anesthesia for diagnostic arteriograms, | 5 | $210.00 |
| 01920 | Anesthesia for cardiac catheterization including coronary arteriography | 7 | $294.00 |
| 01922 | Anesthesia for non-invasive imaging or radiation therapy | 7 | $294.00 |
| 01951 | Anesthesia for 2nd and 3rd degree burn excision or debridement | 3 | $126.00 |
| 01952 | one percent-nine percent to nine percent total body surface | 5 | $210.00 |
| 01953 | each additional nine today body surface area | 1 | $42.00 |
| 01990 | Physiological support for harvesting organs from brain dead patient | 7 | $294.00 |
| 01991 | Anesthesia for diagnostic or therapeutic nerve blocks and injections | 3 | $126.00 |
| 01992 | prone position | 5 | $210.00 |
| 01995 | Regional IV administration of local anesthetic agent (upper or lower extremity) | 5 | $210.00 |
| 01996 | Daily management of epidural or subarachnoid drug administration | 3 | $126.00 |
| 01999 | Unlisted anesthesia procedure(s) | BR | BR |
| 01999PA | Patient Controlled Analgesia. Refer to R 418.10915 for payment conditions | $137.00 | |
| 99140 | Anesthesia performed as an emergency procedure | 2 | $84.00 |