ICD9-CPT Crosswalk UR Advisor (sample data)
ICD9 Code	ICD9 Name	CPT Code	CPT Name	Incidence Rate per 100,000 Workers	% CPT Frequency for ICD9	Visits 25th %	Visits 50th %	Visits 75th %	Visits Mean	Costs Mean	ODG CAA	Bill Review Payment Flag
354.0	Carpal tunnel syndrome	01710	Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified	0.10	0.32%	1	1	1	1.17	$425.74	n/a	Red
354.0	Carpal tunnel syndrome	01810	Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand	6.70	21.38%	1	1	2	1.53	$543.61	n/a	Yellow
354.0	Carpal tunnel syndrome	01820	Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones	0.12	0.39%	1	1	1	1.23	$309.80	n/a	Red
354.0	Carpal tunnel syndrome	01830	Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified	0.27	0.87%	1	1	1	1.22	$382.63	n/a	Red
354.0	Carpal tunnel syndrome	01995	Regional intravenous administration of local anesthetic agent or other medication (upper or lower extremity)	0.44	1.41%	1	1	1	1.20	$161.72	n/a	Red
354.0	Carpal tunnel syndrome	01999	Unlisted anesthesia procedure(s)	0.91	2.91%	1	1	2	1.34	$358.89	n/a	Red
354.0	Carpal tunnel syndrome	15736	Muscle-skin graft, arm	0.19	0.60%	2	2	2	2.15	$3,777.64	n/a	Red
354.0	Carpal tunnel syndrome	20526	Ther injection carpal tunnel	2.11	6.74%	1	1	2	1.43	$186.57	1	Green
354.0	Carpal tunnel syndrome	20550	Inject tendon/ligament/cyst	2.44	7.80%	1	1	2	1.57	$222.59	n/a	Red
354.0	Carpal tunnel syndrome	20551	Inject tendon origin/insert	0.18	0.57%	1	1	1	1.31	$142.93	n/a	Red
354.0	Carpal tunnel syndrome	20552	Inject trigger point, 1 or 2	0.10	0.30%	1	1	3	2.24	$264.21	n/a	Red
354.0	Carpal tunnel syndrome	20600	Drain/inject, joint/bursa	0.59	1.89%	1	1	1	1.29	$128.31	n/a	Red
354.0	Carpal tunnel syndrome	20605	Drain/inject, joint/bursa	1.93	6.15%	1	1	1	1.32	$153.45	n/a	Yellow
354.0	Carpal tunnel syndrome	20610	Drain/inject, joint/bursa	0.50	1.58%	1	1	1	1.45	$186.43	n/a	Red
354.0	Carpal tunnel syndrome	24350	Repair of tennis elbow	0.13	0.41%	1	1	2	1.43	$1,568.34	n/a	Red
354.0	Carpal tunnel syndrome	24356	Revision of tennis elbow	0.17	0.55%	1	1	2	1.45	$1,936.49	n/a	Red
354.0	Carpal tunnel syndrome	25000	Incision of tendon sheath	0.36	1.16%	1	1	2	1.58	$1,224.81	n/a	Red
354.0	Carpal tunnel syndrome	25111	Remove wrist tendon lesion	0.24	0.76%	1	1	2	1.35	$977.48	n/a	Red
354.0	Carpal tunnel syndrome	25115	Remove wrist/forearm lesion	0.63	2.01%	1	1	2	1.58	$2,351.63	n/a	Red
354.0	Carpal tunnel syndrome	26055	Incise finger tendon sheath	0.63	1.99%	1	1	2	1.67	$1,112.27	n/a	Red
354.0	Carpal tunnel syndrome	26145	Tendon excision, palm/finger	0.30	0.96%	1	1	1	1.30	$1,700.83	n/a	Red
354.0	Carpal tunnel syndrome	29075	Application of forearm cast	0.15	0.48%	1	1	1	1.11	$168.97	n/a	Red
354.0	Carpal tunnel syndrome	29125	Apply forearm splint	1.66	5.30%	1	1	1	1.22	$102.16	n/a	Yellow
354.0	Carpal tunnel syndrome	29130	Application of finger splint	0.10	0.32%	1	1	1	1.00	$74.23	n/a	Red
354.0	Carpal tunnel syndrome	29260	Strapping of elbow or wrist	0.45	1.44%	1	1	2	1.47	$99.62	n/a	Red
354.0	Carpal tunnel syndrome	29280	Strapping of hand or finger	0.09	0.28%	1	1	1	1.19	$77.67	n/a	Black
354.0	Carpal tunnel syndrome	29826	Shoulder arthroscopy/surgery	0.11	0.33%	1	1	2	1.58	$3,414.32	n/a	Red
354.0	Carpal tunnel syndrome	29848	Wrist endoscopy/surgery	2.58	8.24%	1	2	3	2.31	$2,614.33	1	Green
354.0	Carpal tunnel syndrome	36415	Collection of venous blood by venipuncture	7.23	23.10%	1	1	1	1.30	$10.11	n/a	Yellow
354.0	Carpal tunnel syndrome	64450	Injection for nerve block	0.15	0.48%	1	1	3	1.93	$337.02	n/a	Red
354.0	Carpal tunnel syndrome	64718	Revise ulnar nerve at elbow	0.12	0.37%	1	1	1	1.14	$1,370.18	n/a	Red
354.0	Carpal tunnel syndrome	64719	Revise ulnar nerve at wrist	0.18	0.58%	1	1	2	1.42	$845.00	n/a	Red
354.0	Carpal tunnel syndrome	64721	Carpal tunnel surgery	17.92	57.23%	1	2	3	2.32	$2,181.52	1	Green
354.0	Carpal tunnel syndrome	64727	Internal nerve revision	0.29	0.92%	1	1	1	1.35	$711.69	n/a	Red
354.0	Carpal tunnel syndrome	70030	X-ray eye for foreign body	0.10	0.30%	1	1	1	1.00	$87.71	n/a	Red
354.0	Carpal tunnel syndrome	71010	Chest x-ray	0.16	0.51%	1	1	1	1.03	$86.84	n/a	Red
354.0	Carpal tunnel syndrome	71020	Chest x-ray	1.72	5.48%	1	1	1	1.05	$103.17	n/a	Yellow
354.0	Carpal tunnel syndrome	72040	X-ray exam of neck spine	0.52	1.66%	1	1	1	1.12	$72.75	n/a	Red
354.0	Carpal tunnel syndrome	72050	X-ray exam of neck spine	0.40	1.28%	1	1	1	1.03	$116.94	n/a	Red
354.0	Carpal tunnel syndrome	72052	X-ray exam of neck spine	0.18	0.57%	1	1	1	1.00	$115.37	n/a	Red
354.0	Carpal tunnel syndrome	72070	X-ray exam of thoracic spine	0.08	0.26%	1	1	1	1.00	$58.88	n/a	Black
354.0	Carpal tunnel syndrome	72100	X-ray exam of lower spine	0.16	0.51%	1	1	1	1.03	$111.52	n/a	Red
354.0	Carpal tunnel syndrome	72141	Mri neck spine w/o dye	0.37	1.17%	1	1	1	1.06	$976.44	n/a	Red
354.0	Carpal tunnel syndrome	73030	X-ray exam of shoulder	0.77	2.46%	1	1	1	1.18	$88.30	n/a	Yellow
354.0	Carpal tunnel syndrome	73070	X-ray exam of elbow	0.45	1.44%	1	1	1	1.26	$64.66	n/a	Red
354.0	Carpal tunnel syndrome	73080	X-ray exam of elbow	0.53	1.69%	1	1	1	1.17	$92.79	n/a	Red
354.0	Carpal tunnel syndrome	73090	X-ray exam of forearm	0.38	1.21%	1	1	1	1.22	$97.43	n/a	Red
354.0	Carpal tunnel syndrome	73100	X-ray exam of wrist	2.21	7.07%	1	1	1	1.15	$70.99	1	Green
354.0	Carpal tunnel syndrome	73110	X-ray exam of wrist	5.73	18.30%	1	1	1	1.26	$100.48	1	Green
354.0	Carpal tunnel syndrome	73120	X-ray exam of hand	0.72	2.30%	1	1	1	1.17	$69.40	n/a	Yellow
354.0	Carpal tunnel syndrome	73130	X-ray exam of hand	2.72	8.67%	1	1	1	1.22	$97.41	n/a	Yellow
354.0	Carpal tunnel syndrome	73140	X-ray exam of finger(s)	0.50	1.60%	1	1	1	1.39	$65.83	n/a	Red
354.0	Carpal tunnel syndrome	73218	Mri upper extremity w/o dye	0.10	0.32%	1	1	1	1.00	$848.42	n/a	Red
354.0	Carpal tunnel syndrome	73221	Mri joint upr extrem w/o dye	1.44	4.60%	1	1	1	1.08	$1,071.70	n/a	Red
354.0	Carpal tunnel syndrome	76000	Fluoroscope examination	0.08	0.26%	1	1	1	1.20	$212.61	n/a	Black
354.0	Carpal tunnel syndrome	78300	Bone imaging, limited area	0.10	0.30%	1	1	1	1.00	$274.49	n/a	Red
354.0	Carpal tunnel syndrome	78315	Bone imaging, 3 phase	0.23	0.73%	1	1	1	1.05	$555.15	n/a	Red
354.0	Carpal tunnel syndrome	80048	Basic metabolic panel This panel must include the following: Calcium (82310) Carbon dioxide (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)	2.91	9.28%	1	1	1	1.15	$44.70	n/a	Yellow
354.0	Carpal tunnel syndrome	80051	Electrolyte panel This panel must include the following: Carbon dioxide (82374) Chloride (82435) Potassium (84132) Sodium (84295)	0.73	2.32%	1	1	1	1.16	$43.23	n/a	Yellow
354.0	Carpal tunnel syndrome	80053	Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphatase, alkaline (84075) Potassium (84132) Protein, total (84155) Sodium (84295) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450) Urea nitrogen (BUN) (84520)	0.97	3.10%	1	1	1	1.13	$65.91	n/a	Yellow
354.0	Carpal tunnel syndrome	80061	Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	0.23	0.74%	1	1	1	1.02	$42.11	n/a	Red
354.0	Carpal tunnel syndrome	80076	Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450)	0.15	0.46%	1	1	1	1.15	$46.84	n/a	Red
354.0	Carpal tunnel syndrome	81000	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy	0.10	0.32%	1	1	1	1.28	$21.00	n/a	Red
354.0	Carpal tunnel syndrome	81001	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy	0.55	1.74%	1	1	1	1.15	$20.19	n/a	Yellow
354.0	Carpal tunnel syndrome	81002	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy	0.18	0.58%	1	1	1	1.12	$15.05	n/a	Red
354.0	Carpal tunnel syndrome	81003	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy	0.54	1.71%	1	1	1	1.14	$15.87	n/a	Yellow
354.0	Carpal tunnel syndrome	81025	Urine pregnancy test, by visual color comparison methods	0.60	1.92%	1	1	1	1.22	$36.50	n/a	Yellow
354.0	Carpal tunnel syndrome	82310	Calcium; total	0.22	0.69%	1	1	1	1.13	$16.82	n/a	Red
354.0	Carpal tunnel syndrome	82374	Carbon dioxide (bicarbonate)	0.15	0.48%	1	1	1	1.15	$9.36	n/a	Red
354.0	Carpal tunnel syndrome	82435	Chloride; blood	0.24	0.76%	1	1	1	1.12	$9.63	n/a	Red
354.0	Carpal tunnel syndrome	82550	Creatine kinase (CK), (CPK); total	0.11	0.33%	1	1	1	1.00	$21.19	n/a	Red
354.0	Carpal tunnel syndrome	82565	Creatinine; blood	0.87	2.78%	1	1	1	1.15	$14.70	n/a	Yellow
354.0	Carpal tunnel syndrome	82947	Glucose; quantitative, blood (except reagent strip)	0.83	2.66%	1	1	1	1.17	$14.47	n/a	Yellow
354.0	Carpal tunnel syndrome	82948	Glucose; blood, reagent strip	0.13	0.41%	1	1	2	1.26	$169.86	n/a	Red
354.0	Carpal tunnel syndrome	82962	Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use	0.16	0.49%	1	1	1	1.14	$19.53	n/a	Red
354.0	Carpal tunnel syndrome	84132	Potassium; serum	0.78	2.48%	1	1	1	1.13	$14.61	n/a	Yellow
354.0	Carpal tunnel syndrome	84295	Sodium; serum	0.28	0.89%	1	1	1	1.10	$11.33	n/a	Red
354.0	Carpal tunnel syndrome	84436	Thyroxine; total	0.18	0.58%	1	1	1	1.00	$22.21	n/a	Red
354.0	Carpal tunnel syndrome	84443	Thyroid stimulating hormone (TSH)	0.51	1.62%	1	1	1	1.04	$49.69	n/a	Yellow
354.0	Carpal tunnel syndrome	84450	Transferase; aspartate amino (AST) (SGOT)	0.11	0.33%	1	1	1	1.26	$16.96	n/a	Red
354.0	Carpal tunnel syndrome	84460	Transferase; alanine amino (ALT) (SGPT)	0.11	0.35%	1	1	1	1.25	$17.58	n/a	Red
354.0	Carpal tunnel syndrome	84479	Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)	0.10	0.30%	1	1	1	1.00	$21.36	n/a	Red
354.0	Carpal tunnel syndrome	84520	Urea nitrogen; quantitative	0.95	3.03%	1	1	1	1.15	$13.79	n/a	Yellow
354.0	Carpal tunnel syndrome	84550	Uric acid; blood	0.28	0.89%	1	1	1	1.04	$15.98	n/a	Red
354.0	Carpal tunnel syndrome	84702	Gonadotropin, chorionic (hCG); quantitative	0.20	0.64%	1	1	1	1.17	$42.40	n/a	Red
354.0	Carpal tunnel syndrome	84703	Gonadotropin, chorionic (hCG); qualitative	1.40	4.46%	1	1	1	1.25	$38.62	n/a	Yellow
354.0	Carpal tunnel syndrome	85014	Blood count; hematocrit (Hct)	1.17	3.73%	1	1	1	1.25	$12.60	n/a	Yellow
354.0	Carpal tunnel syndrome	85018	Blood count; hemoglobin (Hgb)	1.29	4.10%	1	1	1	1.27	$12.01	n/a	Yellow
354.0	Carpal tunnel syndrome	85025	Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	4.93	15.74%	1	1	1	1.21	$35.31	n/a	Yellow
354.0	Carpal tunnel syndrome	85027	Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	1.41	4.49%	1	1	1	1.18	$24.79	n/a	Yellow
354.0	Carpal tunnel syndrome	85610	Prothrombin time;	1.38	4.40%	1	1	1	1.17	$23.76	n/a	Yellow
354.0	Carpal tunnel syndrome	85651	Sedimentation rate, erythrocyte; non-automated	0.43	1.37%	1	1	1	1.08	$16.01	n/a	Yellow
354.0	Carpal tunnel syndrome	85652	Sedimentation rate, erythrocyte; automated	0.40	1.26%	1	1	1	1.13	$19.38	n/a	Yellow
354.0	Carpal tunnel syndrome	85730	Thromboplastin time, partial (PTT); plasma or whole blood	1.35	4.30%	1	1	1	1.20	$29.46	n/a	Yellow
354.0	Carpal tunnel syndrome	86038	Antinuclear antibodies (ANA);	0.35	1.10%	1	1	1	1.02	$39.18	n/a	Yellow
354.0	Carpal tunnel syndrome	86039	Antinuclear antibodies (ANA); titer	0.10	0.30%	1	1	1	1.00	$40.02	n/a	Red
354.0	Carpal tunnel syndrome	86140	C-reactive protein;	0.11	0.33%	1	1	1	1.00	$31.00	n/a	Red
354.0	Carpal tunnel syndrome	86430	Rheumatoid factor; qualitative	0.23	0.73%	1	1	1	1.00	$25.07	n/a	Red
354.0	Carpal tunnel syndrome	86431	Rheumatoid factor; quantitative	0.23	0.74%	1	1	1	1.07	$26.05	n/a	Red
354.0	Carpal tunnel syndrome	87070	Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates	0.11	0.35%	1	1	1	1.05	$36.38	n/a	Red
354.0	Carpal tunnel syndrome	88304	Tissue exam by pathologist	1.55	4.94%	1	1	2	1.31	$89.17	n/a	Yellow
354.0	Carpal tunnel syndrome	88305	Tissue exam by pathologist	0.40	1.28%	1	1	1	1.29	$140.19	n/a	Red
354.0	Carpal tunnel syndrome	90801	Psy dx interview	0.11	0.33%	1	1	1	1.21	$165.23	n/a	Red
354.0	Carpal tunnel syndrome	90806	Psytx, off, 45-50 min	0.14	0.44%	1	3	5	5.00	$477.72	n/a	Red
354.0	Carpal tunnel syndrome	90808	Psytx, office, 75-80 min	0.12	0.37%	2	3	6	4.29	$600.14	n/a	Red
354.0	Carpal tunnel syndrome	93000	Electrocardiogram, complete	0.65	2.08%	1	1	1	1.10	$42.31	n/a	Yellow
354.0	Carpal tunnel syndrome	93005	Electrocardiogram, tracing	4.29	13.71%	1	1	1	1.10	$62.90	n/a	Yellow
354.0	Carpal tunnel syndrome	93010	Electrocardiogram report	2.16	6.89%	1	1	1	1.08	$14.41	n/a	Yellow
354.0	Carpal tunnel syndrome	93041	Rhythm ECG, tracing	0.26	0.82%	1	1	2	1.35	$74.54	n/a	Red
354.0	Carpal tunnel syndrome	94640	Airway inhalation treatment	0.22	0.71%	1	1	1	1.13	$25.59	n/a	Red
354.0	Carpal tunnel syndrome	94664	Aerosol or vapor inhalations	0.20	0.64%	1	1	1	1.19	$35.36	n/a	Red
354.0	Carpal tunnel syndrome	94760	Measure blood oxygen level	0.65	2.07%	1	1	2	1.47	$69.77	n/a	Yellow
354.0	Carpal tunnel syndrome	94761	Measure blood oxygen level	0.62	1.98%	1	1	2	1.72	$69.95	n/a	Red
354.0	Carpal tunnel syndrome	95831	Limb muscle testing, manual	0.17	0.53%	1	1	1	1.57	$47.42	n/a	Red
354.0	Carpal tunnel syndrome	95832	Hand muscle testing, manual	0.41	1.32%	1	1	3	2.36	$83.78	n/a	Red
354.0	Carpal tunnel syndrome	95851	Range of motion measurements	0.30	0.94%	1	1	3	3.00	$75.68	n/a	Red
354.0	Carpal tunnel syndrome	95852	Range of motion measurements	0.45	1.44%	1	2	3	3.05	$53.95	n/a	Red
354.0	Carpal tunnel syndrome	95860	Muscle test, one limb	9.92	31.67%	1	1	1	1.22	$125.84	1	Green
354.0	Carpal tunnel syndrome	95861	Muscle test, two limbs	7.63	24.37%	1	1	1	1.15	$190.76	n/a	Yellow
354.0	Carpal tunnel syndrome	95869	Muscle test, thor paraspinal	0.60	1.91%	1	1	1	1.07	$69.17	n/a	Red
354.0	Carpal tunnel syndrome	95870	Muscle test, nonparaspinal	0.37	1.19%	1	1	1	1.06	$51.47	n/a	Red
354.0	Carpal tunnel syndrome	95872	Muscle test, one fiber	0.10	0.32%	1	1	1	1.00	$80.48	n/a	Red
354.0	Carpal tunnel syndrome	95900	Motor nerve conduction test	13.75	43.90%	1	1	1	1.21	$191.14	1	Green
354.0	Carpal tunnel syndrome	95903	Motor nerve conduction test	5.98	19.08%	1	1	1	1.15	$237.68	n/a	Yellow
354.0	Carpal tunnel syndrome	95904	Sense nerve conduction test	17.50	55.90%	1	1	1	1.24	$238.35	1	Green
354.0	Carpal tunnel syndrome	95934	H-reflex test	0.17	0.53%	1	1	1	1.07	$142.94	n/a	Red
354.0	Carpal tunnel syndrome	95936	H-reflex test	0.09	0.28%	1	1	1	1.19	$147.54	n/a	Black
354.0	Carpal tunnel syndrome	95999	Unlisted neurological or neuromuscular diagnostic procedure	0.21	0.67%	1	1	1	1.03	$39.27	n/a	Red
354.0	Carpal tunnel syndrome	97001	Pt evaluation	6.08	19.42%	1	1	2	1.38	$122.02	1	Green
354.0	Carpal tunnel syndrome	97002	Pt re-evaluation	1.96	6.24%	1	1	2	1.89	$85.47	1	Green
354.0	Carpal tunnel syndrome	97003	Ot evaluation	9.21	29.40%	1	1	2	1.43	$124.90	1	Green
354.0	Carpal tunnel syndrome	97004	Ot re-evaluation	2.94	9.39%	1	1	2	1.93	$85.96	1	Green
354.0	Carpal tunnel syndrome	97010	Hot or cold packs therapy	4.60	14.69%	2	6	14	10.67	$182.96	n/a	Yellow
354.0	Carpal tunnel syndrome	97012	Mechanical traction therapy	0.81	2.57%	2	5	13	10.59	$260.23	n/a	Red
354.0	Carpal tunnel syndrome	97014	Electric stimulation therapy	4.56	14.56%	3	9	20	15.50	$343.49	n/a	Yellow
354.0	Carpal tunnel syndrome	97016	Vasopneumatic device therapy	0.18	0.57%	1	3	8	5.66	$152.46	n/a	Red
354.0	Carpal tunnel syndrome	97018	Paraffin bath therapy	3.21	10.26%	2	6	11	8.27	$167.90	n/a	Yellow
354.0	Carpal tunnel syndrome	97022	Whirlpool therapy	3.61	11.53%	2	5	11	8.20	$275.80	n/a	Yellow
354.0	Carpal tunnel syndrome	97024	Diathermy treatment	0.17	0.55%	1	4	10	10.58	$207.54	n/a	Red
354.0	Carpal tunnel syndrome	97026	Infrared therapy	0.10	0.32%	1	5	9	8.56	$91.60	n/a	Red
354.0	Carpal tunnel syndrome	97032	Electrical stimulation	1.34	4.28%	1	5	11	9.74	$279.79	n/a	Red
354.0	Carpal tunnel syndrome	97033	Electric current therapy	2.36	7.53%	3	6	10	7.42	$318.91	n/a	Red
354.0	Carpal tunnel syndrome	97034	Contrast bath therapy	0.20	0.64%	1	1	3	2.25	$56.09	n/a	Red
354.0	Carpal tunnel syndrome	97035	Ultrasound therapy	8.85	28.26%	4	8	14	11.64	$269.87	n/a	Yellow
354.0	Carpal tunnel syndrome	97039	Physical therapy treatment	0.60	1.92%	2	4	8	7.25	$182.00	n/a	Red
354.0	Carpal tunnel syndrome	97110	Therapeutic exercises	13.73	43.84%	5	11	21	16.10	$1,062.02	6	Green
354.0	Carpal tunnel syndrome	97112	Neuromuscular reeducation	2.07	6.60%	2	5	12	10.09	$425.97	n/a	Red
354.0	Carpal tunnel syndrome	97124	Massage therapy	3.30	10.53%	2	5	12	8.59	$299.09	n/a	Yellow
354.0	Carpal tunnel syndrome	97139	Physical medicine procedure	0.18	0.57%	1	3	6	4.69	$127.24	n/a	Red
354.0	Carpal tunnel syndrome	97140	Manual therapy	6.41	20.47%	3	6	13	11.11	$542.50	n/a	Yellow
354.0	Carpal tunnel syndrome	97150	Group therapeutic procedures	0.40	1.28%	1	2	8	7.07	$453.83	n/a	Red
354.0	Carpal tunnel syndrome	97530	Therapeutic activities	6.76	21.58%	2	5	12	9.55	$556.80	6	Green
354.0	Carpal tunnel syndrome	97535	Self care mngment training	1.40	4.48%	1	1	3	2.57	$109.45	n/a	Yellow
354.0	Carpal tunnel syndrome	97537	Community/work reintegration	0.26	0.82%	1	2	4	2.87	$256.92	n/a	Red
354.0	Carpal tunnel syndrome	97602	Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session	0.17	0.53%	1	2	3	2.20	$81.39	n/a	Red
354.0	Carpal tunnel syndrome	97750	Physical performance test	2.42	7.71%	1	1	2	1.50	$422.86	n/a	Red
354.0	Carpal tunnel syndrome	97799	Unlisted physical medicine/rehabilitation service or procedure	0.15	0.46%	1	1	2	2.42	$450.26	n/a	Red
354.0	Carpal tunnel syndrome	98925	Osteopathic manipulation	0.10	0.30%	1	4	13	9.47	$386.43	n/a	Red
354.0	Carpal tunnel syndrome	98940	Chiropractic manipulation	0.96	3.07%	2	4	15	14.22	$525.22	n/a	Red
354.0	Carpal tunnel syndrome	98941	Chiropractic manipulation	0.12	0.37%	1	3	9	6.19	$309.32	n/a	Red
354.0	Carpal tunnel syndrome	98943	Chiropractic manipulation	1.78	5.67%	11	23	45	31.35	$1,146.82	n/a	Red
354.0	Carpal tunnel syndrome	99058	Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service	0.22	0.69%	1	1	1	1.05	$33.15	n/a	Red
354.0	Carpal tunnel syndrome	99070	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)	2.07	6.62%	1	1	3	2.51	$195.00	n/a	Yellow
354.0	Carpal tunnel syndrome	99201	Office/outpatient visit, new	1.57	4.99%	1	1	1	1.25	$120.97	n/a	Yellow
354.0	Carpal tunnel syndrome	99202	Office/outpatient visit, new	4.91	15.69%	1	1	1	1.20	$83.33	n/a	Yellow
354.0	Carpal tunnel syndrome	99203	Office/outpatient visit, new	9.08	28.99%	1	1	1	1.22	$117.23	1	Green
354.0	Carpal tunnel syndrome	99204	Office/outpatient visit, new	4.23	13.51%	1	1	1	1.16	$153.39	n/a	Yellow
354.0	Carpal tunnel syndrome	99205	Office/outpatient visit, new	1.60	5.10%	1	1	1	1.07	$176.77	n/a	Yellow
354.0	Carpal tunnel syndrome	99211	Office/outpatient visit, est	2.01	6.42%	1	1	2	2.14	$62.08	n/a	Yellow
354.0	Carpal tunnel syndrome	99212	Office/outpatient visit, est	12.90	41.20%	1	2	3	3.32	$137.13	6	Green
354.0	Carpal tunnel syndrome	99213	Office/outpatient visit, est	20.27	64.73%	1	3	6	4.98	$281.76	6	Green
354.0	Carpal tunnel syndrome	99214	Office/outpatient visit, est	8.88	28.36%	1	1	3	3.01	$262.81	n/a	Yellow
354.0	Carpal tunnel syndrome	99215	Office/outpatient visit, est	1.87	5.96%	1	1	2	1.80	$216.80	n/a	Red
354.0	Carpal tunnel syndrome	99218	Observation care	0.10	0.30%	1	1	2	1.47	$349.51	n/a	Red
354.0	Carpal tunnel syndrome	99234	Observ/hosp same date	0.11	0.35%	1	1	1	1.20	$263.62	n/a	Red
354.0	Carpal tunnel syndrome	99241	Office consultation	1.08	3.46%	1	1	1	1.05	$56.29	n/a	Yellow
354.0	Carpal tunnel syndrome	99242	Office consultation	3.29	10.51%	1	1	1	1.11	$113.44	n/a	Yellow
354.0	Carpal tunnel syndrome	99243	Office consultation	8.50	27.13%	1	1	1	1.19	$159.74	n/a	Yellow
354.0	Carpal tunnel syndrome	99244	Office consultation	3.40	10.87%	1	1	1	1.14	$206.57	1	Green
354.0	Carpal tunnel syndrome	99245	Office consultation	1.08	3.46%	1	1	1	1.08	$265.17	n/a	Red
354.0	Carpal tunnel syndrome	99281	Emergency dept visit	0.61	1.94%	1	1	1	1.26	$71.70	n/a	Red
354.0	Carpal tunnel syndrome	99282	Emergency dept visit	1.78	5.69%	1	1	2	1.40	$107.86	n/a	Yellow
354.0	Carpal tunnel syndrome	99283	Emergency dept visit	2.47	7.89%	1	1	2	1.50	$158.66	n/a	Yellow
354.0	Carpal tunnel syndrome	99284	Emergency dept visit	0.55	1.76%	1	1	1	1.26	$214.29	n/a	Red
354.0	Carpal tunnel syndrome	99361	Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient not present); approximately 30 minutes	0.10	0.30%	1	2	4	2.59	$209.04	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	00300	Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified	0.12	0.36%	1	2	3	2.33	$472.90	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	00630	Anesthesia for procedures in lumbar region; not otherwise specified	2.96	9.25%	1	1	1	1.36	$1,027.01	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	00632	Anesthesia for procedures in lumbar region; lumbar sympathectomy	0.11	0.33%	1	1	1	1.05	$287.08	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	00670	Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)	0.21	0.66%	1	1	1	1.05	$1,523.00	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	01905	Anesthesia for myelography, diskography, vertebroplasty	0.21	0.66%	1	1	1	1.03	$461.60	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	01992	Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different provider); prone position	0.24	0.75%	1	2	3	2.53	$787.36	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	01995	Regional intravenous administration of local anesthetic agent or other medication (upper or lower extremity)	0.16	0.50%	1	1	3	2.34	$167.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	01999	Unlisted anesthesia procedure(s)	0.51	1.61%	1	1	1	1.30	$491.89	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20550	Inject tendon/ligament/cyst	1.00	3.11%	1	1	3	2.71	$444.69	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20551	Inject tendon origin/insert	0.09	0.28%	1	2	3	2.88	$278.30	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	20552	Inject trigger point, 1 or 2	1.15	3.60%	1	2	4	3.28	$354.80	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20553	Inject trigger points, > 3	0.32	0.99%	1	2	4	3.23	$332.91	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20605	Drain/inject, joint/bursa	0.12	0.36%	1	1	2	1.67	$332.23	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20610	Drain/inject, joint/bursa	0.68	2.11%	1	1	2	1.45	$184.32	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	20926	Removal of tissue for graft	0.09	0.28%	1	1	1	1.13	$551.59	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	20930	Allograft for spine surgery only; morselized	0.09	0.28%	1	1	1	1.00	$238.18	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	20931	Spinal bone allograft	0.18	0.57%	1	1	1	1.00	$263.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20936	Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision	0.44	1.36%	1	1	1	1.05	$367.08	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	20937	Spinal bone autograft	0.79	2.46%	1	1	1	1.03	$423.37	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22558	Lumbar spine fusion	0.10	0.29%	1	1	1	1.06	$4,409.34	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22612	Lumbar spine fusion	1.12	3.51%	1	1	1	1.04	$3,180.97	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22614	Spine fusion, extra segment	0.41	1.29%	1	1	1	1.05	$1,090.17	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22630	Lumbar spine fusion	1.27	3.97%	1	1	1	1.02	$2,405.27	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22632	Spine fusion, extra segment	0.18	0.57%	1	1	1	1.00	$786.92	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22840	Insert spine fixation device	0.93	2.92%	1	1	1	1.02	$1,679.11	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22842	Insert spine fixation device	0.67	2.10%	1	1	1	1.03	$1,582.55	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	22851	Apply spine prosth device	1.72	5.37%	1	1	1	1.03	$1,213.00	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	27096	Inject sacroiliac joint	0.98	3.08%	1	2	3	2.34	$1,215.36	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	29881	Knee arthroscopy/surgery	0.10	0.29%	1	1	2	1.65	$2,575.49	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	36000	Place needle in vein	0.19	0.59%	1	1	1	1.26	$65.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	36415	Collection of venous blood by venipuncture	7.02	21.96%	1	1	2	1.52	$12.19	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	36620	Insertion catheter, artery	0.34	1.06%	1	1	1	1.02	$128.80	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	61795	Brain surgery using computer	0.10	0.31%	1	1	1	1.00	$570.29	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62263	Lysis epidural adhesions	0.22	0.68%	1	2	3	2.51	$1,607.81	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62264	Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day	0.18	0.57%	1	2	2	1.79	$1,125.79	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62273	Treat epidural spine lesion	0.22	0.68%	1	2	2	1.72	$574.52	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62282	Treat spinal canal lesion	0.20	0.63%	1	1	2	1.72	$652.78	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62284	Injection for myelogram	2.15	6.72%	1	2	2	1.84	$437.19	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62287	Percutaneous intradiscal therapy/IDET	0.61	1.92%	1	2	2	1.83	$2,316.64	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62290	Inject for spine disk x-ray	2.29	7.15%	1	2	2	1.79	$1,464.18	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	62310	Inject spine c/t	0.21	0.64%	1	1	2	1.49	$423.71	2	Green
722.10	Lumbar intervertebral disc without myelopathy	62311	Inject spine l/s (cd)	10.72	33.56%	2	4	6	4.43	$1,310.67	2	Green
722.10	Lumbar intervertebral disc without myelopathy	62319	Inject spine w/cath l/s (cd)	0.45	1.41%	1	2	3	2.70	$1,013.72	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63005	Removal of spinal lamina	0.10	0.31%	1	1	1	1.06	$1,912.73	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63030	Low back disk surgery	7.78	24.36%	1	1	2	1.33	$2,913.35	1	Green
722.10	Lumbar intervertebral disc without myelopathy	63035	Spinal disk surgery add-on	0.68	2.11%	1	1	1	1.09	$566.82	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63042	Laminotomy, single lumbar	1.05	3.27%	1	1	1	1.16	$3,209.77	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63044	Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disk, reexploration, single interspace; each additional lumbar interspace (List separately in addition to code for primary procedure)	0.12	0.38%	1	1	1	1.00	$1,358.88	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63047	Removal of spinal lamina	2.10	6.58%	1	1	1	1.07	$2,290.67	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63048	Remove spinal lamina add-on	0.71	2.22%	1	1	1	1.04	$604.53	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63056	Decompress spinal cord	0.30	0.94%	1	1	1	1.00	$2,979.46	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63090	Removal of vertebral body	0.18	0.57%	1	1	1	1.06	$4,161.04	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63650	Implant neuroelectrodes	0.12	0.36%	2	2	3	2.43	$4,314.93	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	63685	Implant neuroreceiver	0.08	0.26%	1	1	2	1.60	$2,249.11	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	64445	Injection for nerve block	0.17	0.52%	1	1	3	2.50	$382.51	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64475	Inj paravertebral l/s	1.88	5.88%	1	2	3	2.38	$777.42	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64476	Inj paravertebral l/s add-on	1.41	4.42%	1	2	3	2.11	$888.25	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64479	Inj foramen epidural c/t	0.10	0.31%	1	1	1	1.11	$345.53	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64483	Inj foramen epidural l/s	4.43	13.87%	2	2	4	3.14	$1,177.75	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	64484	Inj foramen epidural add-on	1.48	4.62%	1	2	3	2.38	$766.92	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64520	Injection for nerve block	0.09	0.28%	1	1	2	2.94	$825.45	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	64550	Apply neurostimulator	0.24	0.75%	1	1	1	1.05	$50.74	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64622	Destr paravertebrl nerve l/s	0.29	0.89%	1	2	2	2.06	$995.82	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64623	Destr paravertebral n add-on	0.26	0.80%	1	2	2	1.89	$831.71	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64640	Injection treatment of nerve	0.16	0.50%	1	1	2	1.38	$633.69	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	64999	Unlisted procedure, nervous system	0.17	0.52%	1	1	1	1.17	$2,763.86	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	69990	Microsurgery add-on	3.76	11.76%	1	1	1	1.12	$518.82	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	70030	X-ray eye for foreign body	1.38	4.32%	1	1	1	1.06	$89.89	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	70140	X-ray exam of facial bones	0.13	0.40%	1	1	1	1.00	$63.74	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	70200	X-ray exam of eye sockets	0.28	0.87%	1	1	1	1.00	$101.83	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	70250	X-ray exam of skull	0.18	0.56%	1	1	1	1.00	$69.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	70450	Ct head/brain w/o dye	0.29	0.91%	1	1	1	1.13	$641.02	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	71010	Chest x-ray	0.30	0.94%	1	1	1	1.06	$106.72	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	71020	Chest x-ray	3.30	10.34%	1	1	1	1.11	$127.94	1	Green
722.10	Lumbar intervertebral disc without myelopathy	71101	X-ray exam of ribs/chest	0.09	0.28%	1	1	1	1.13	$147.60	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	72010	X-ray exam of spine	0.47	1.47%	1	1	1	1.29	$117.09	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72020	X-ray exam of spine	4.00	12.51%	1	1	1	1.32	$151.39	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72040	X-ray exam of neck spine	1.12	3.51%	1	1	1	1.16	$88.95	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72050	X-ray exam of neck spine	1.00	3.11%	1	1	1	1.10	$145.67	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72052	X-ray exam of neck spine	0.30	0.92%	1	1	1	1.06	$124.83	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72070	X-ray exam of thoracic spine	1.39	4.35%	1	1	1	1.11	$74.82	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72072	X-ray exam of thoracic spine	0.48	1.48%	1	1	1	1.02	$116.93	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72080	X-ray exam of trunk spine	0.16	0.50%	1	1	1	1.10	$65.84	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72100	X-ray exam of lower spine	17.39	54.42%	1	1	2	1.81	$163.07	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72110	X-ray exam of lower spine	9.74	30.48%	1	1	1	1.21	$156.90	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72114	X-ray exam of lower spine	2.80	8.75%	1	1	1	1.15	$147.28	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72120	X-ray exam of lower spine	0.70	2.18%	1	1	1	1.13	$87.99	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72131	Ct lumbar spine w/o dye	3.01	9.41%	1	1	1	1.15	$752.69	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72132	Ct lumbar spine w/dye	1.60	5.00%	1	1	1	1.12	$809.47	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72141	Mri neck spine w/o dye	0.73	2.27%	1	1	1	1.08	$977.75	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72146	Mri chest spine w/o dye	0.54	1.68%	1	1	1	1.04	$924.23	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72148	Mri lumbar spine w/o dye	25.49	79.78%	1	1	2	1.34	$1,233.78	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72149	Mri lumbar spine w/dye	0.24	0.75%	1	1	1	1.05	$1,065.57	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72158	Mri lumbar spine w/o&w dye	6.21	19.44%	1	1	2	1.45	$2,254.68	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72170	X-ray exam of pelvis	2.20	6.87%	1	1	1	1.17	$66.16	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	72192	Ct pelvis w/o dye	0.13	0.42%	1	1	1	1.00	$589.73	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72193	Ct pelvis w/dye	0.16	0.49%	1	1	1	1.04	$738.76	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72195	Mri pelvis w/o dye	0.13	0.42%	1	1	1	1.00	$697.13	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72200	X-ray exam sacroiliac joints	0.16	0.49%	1	1	1	1.00	$50.35	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72202	X-ray exam sacroiliac joints	0.09	0.28%	1	1	1	1.19	$120.96	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	72220	X-ray exam of tailbone	0.63	1.96%	1	1	1	1.18	$117.76	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72265	Contrast x-ray, lower spine	2.01	6.28%	1	1	1	1.12	$498.24	1	Green
722.10	Lumbar intervertebral disc without myelopathy	72275	Epidurography	0.90	2.81%	1	2	3	2.17	$484.83	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	72295	X-ray of lower spine disk	1.43	4.46%	1	1	1	1.11	$963.94	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73030	X-ray exam of shoulder	0.46	1.43%	1	1	1	1.17	$130.55	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73080	X-ray exam of elbow	0.17	0.54%	1	1	1	1.16	$116.70	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73110	X-ray exam of wrist	0.18	0.56%	1	1	1	1.22	$114.99	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73130	X-ray exam of hand	0.12	0.36%	1	1	1	1.14	$122.46	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73221	Mri joint upr extrem w/o dye	0.21	0.64%	1	1	1	1.16	$1,022.29	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73500	X-ray exam of hip	0.11	0.35%	1	1	1	1.05	$56.71	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73510	X-ray exam of hip	1.40	4.39%	1	1	1	1.14	$106.19	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	73520	X-ray exam of hips	0.10	0.31%	1	1	1	1.00	$80.41	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73542	X-ray exam, sacroiliac joint	0.08	0.26%	1	1	3	1.87	$360.10	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	73550	X-ray exam of thigh	0.13	0.40%	1	1	1	1.04	$104.27	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73560	X-ray exam of knee, 1 or 2	0.39	1.20%	1	1	1	1.19	$95.53	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73562	X-ray exam of knee, 3	0.22	0.68%	1	1	1	1.05	$92.77	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73564	X-ray exam, knee, 4 or more	0.25	0.78%	1	1	1	1.18	$137.95	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73590	X-ray exam of lower leg	0.16	0.49%	1	1	1	1.00	$102.18	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73610	X-ray exam of ankle	0.27	0.84%	1	1	1	1.19	$110.34	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73630	X-ray exam of foot	0.16	0.50%	1	1	1	1.03	$82.77	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	73721	Mri joint of lwr extre w/o d	0.46	1.43%	1	1	1	1.12	$1,029.70	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	74150	Ct abdomen w/o dye	0.09	0.28%	1	1	1	1.00	$561.80	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	74160	Ct abdomen w/dye	0.16	0.50%	1	1	1	1.03	$824.54	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	76000	Fluoroscope examination	2.54	7.94%	1	1	2	1.57	$247.16	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	76001	Fluoroscope exam, extensive	0.58	1.80%	1	1	1	1.09	$323.55	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	76003	Needle localization by x-ray	0.50	1.57%	1	1	1	1.39	$264.78	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	76005	Fluoroguide for spine inject	6.63	20.75%	1	3	4	3.03	$580.58	2	Green
722.10	Lumbar intervertebral disc without myelopathy	76499	Unlisted diagnostic radiographic procedure	0.14	0.43%	1	1	1	1.12	$150.00	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	78306	Bone imaging, whole body	0.50	1.57%	1	1	1	1.02	$529.35	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	78315	Bone imaging, 3 phase	0.08	0.26%	1	1	1	1.00	$515.69	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	78320	Bone imaging (3D)	0.16	0.49%	1	1	1	1.04	$454.13	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	78465	Heart image (3d), multiple	0.13	0.42%	1	1	1	1.00	$842.27	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	78478	Heart wall motion add-on	0.13	0.42%	1	1	1	1.00	$199.61	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	78480	Heart function add-on	0.12	0.38%	1	1	1	1.09	$190.10	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	80048	Basic metabolic panel This panel must include the following: Calcium (82310) Carbon dioxide (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)	3.07	9.60%	1	1	1	1.25	$52.69	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	80051	Electrolyte panel This panel must include the following: Carbon dioxide (82374) Chloride (82435) Potassium (84132) Sodium (84295)	1.47	4.60%	1	1	1	1.16	$42.27	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	80053	Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphatase, alkaline (84075) Potassium (84132) Protein, total (84155) Sodium (84295) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450) Urea nitrogen (BUN) (84520)	1.81	5.67%	1	1	1	1.27	$75.01	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	80061	Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	0.20	0.61%	1	1	1	1.03	$49.24	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	80076	Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450)	0.65	2.04%	1	1	1	1.38	$55.21	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	80100	Drug screen, qualitative; multiple drug classes chromatographic method, each procedure	0.49	1.52%	1	1	2	1.49	$83.42	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	80101	Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class	0.64	2.01%	1	1	2	1.57	$173.01	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	80102	Drug confirmation, each procedure	0.10	0.29%	1	1	2	1.71	$70.01	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	81000	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy	0.36	1.13%	1	1	1	1.22	$11.27	1	Green
722.10	Lumbar intervertebral disc without myelopathy	81001	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy	1.60	5.00%	1	1	1	1.15	$22.77	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	81002	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy	0.72	2.25%	1	1	1	1.35	$11.30	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	81003	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy	2.27	7.10%	1	1	1	1.19	$32.48	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	81015	Urinalysis; microscopic only	0.21	0.66%	1	1	1	1.00	$8.83	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	81025	Urine pregnancy test, by visual color comparison methods	0.38	1.19%	1	1	1	1.34	$35.68	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	82040	Albumin; serum	0.15	0.47%	1	1	1	1.07	$10.81	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82150	Amylase	0.15	0.47%	1	1	1	1.07	$33.03	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82247	Bilirubin; total	0.12	0.36%	1	1	1	1.10	$8.74	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82248	Bilirubin; direct	0.09	0.28%	1	1	1	1.25	$21.17	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	82310	Calcium; total	0.25	0.78%	1	1	1	1.04	$9.64	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82374	Carbon dioxide (bicarbonate)	0.27	0.85%	1	1	1	1.06	$9.29	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82435	Chloride; blood	0.33	1.03%	1	1	1	1.05	$12.00	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	82550	Creatine kinase (CK), (CPK); total	0.14	0.43%	1	1	1	1.08	$32.07	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82553	Creatine kinase (CK), (CPK); MB fraction only	0.09	0.28%	1	1	1	1.00	$54.84	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	82565	Creatinine; blood	1.75	5.47%	1	1	1	1.19	$17.07	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	82570	Creatinine; other source	0.15	0.47%	1	1	1	1.52	$10.51	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82945	Glucose, body fluid, other than blood	0.16	0.50%	1	1	1	1.00	$19.78	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82947	Glucose; quantitative, blood (except reagent strip)	1.35	4.23%	1	1	1	1.11	$16.07	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	82962	Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use	0.12	0.36%	1	1	1	1.43	$24.47	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	82977	Glutamyltransferase, gamma (GGT)	0.09	0.28%	1	1	1	1.38	$16.92	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	83615	Lactate dehydrogenase (LD), (LDH);	0.09	0.28%	1	1	1	1.31	$13.78	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	83690	Lipase	0.12	0.36%	1	1	1	1.05	$37.83	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	83735	Magnesium	0.08	0.26%	1	1	1	1.27	$19.43	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	83925	Opiates, (eg, morphine, meperidine)	0.14	0.43%	1	1	1	1.24	$65.43	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	83986	pH, body fluid, except blood	0.09	0.28%	1	1	1	1.50	$11.60	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	84075	Phosphatase, alkaline;	0.16	0.49%	1	1	1	1.07	$13.44	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84100	Phosphorus inorganic (phosphate);	0.09	0.28%	1	1	1	1.38	$12.92	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	84132	Potassium; serum	0.61	1.90%	1	1	1	1.11	$12.08	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	84155	Protein, total, except by refractometry; serum	0.45	1.40%	1	1	1	1.06	$19.59	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	84295	Sodium; serum	0.44	1.38%	1	1	1	1.04	$10.71	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	84443	Thyroid stimulating hormone (TSH)	0.27	0.84%	1	1	1	1.00	$52.07	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84450	Transferase; aspartate amino (AST) (SGOT)	0.29	0.89%	1	1	1	1.16	$17.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84460	Transferase; alanine amino (ALT) (SGPT)	0.23	0.71%	1	1	1	1.05	$15.23	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84484	Troponin, quantitative	0.11	0.35%	1	1	1	1.00	$50.88	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84520	Urea nitrogen; quantitative	1.52	4.76%	1	1	1	1.18	$16.34	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	84550	Uric acid; blood	0.10	0.31%	1	1	1	1.28	$12.81	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	84703	Gonadotropin, chorionic (hCG); qualitative	0.60	1.87%	1	1	1	1.26	$46.36	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	85002	Bleeding time	0.27	0.85%	1	1	1	1.08	$47.66	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	85007	Blood count; blood smear, microscopic examination with manual differential WBC count	0.13	0.40%	1	1	1	1.17	$15.00	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	85014	Blood count; hematocrit (Hct)	1.10	3.43%	1	1	1	1.12	$14.88	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	85018	Blood count; hemoglobin (Hgb)	1.01	3.15%	1	1	1	1.12	$11.69	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	85025	Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count	5.29	16.55%	1	1	1	1.38	$40.60	1	Green
722.10	Lumbar intervertebral disc without myelopathy	85027	Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	2.91	9.10%	1	1	1	1.27	$28.24	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	85049	Blood count; platelet, automated	0.20	0.61%	1	1	1	1.06	$17.61	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	85610	Prothrombin time;	4.75	14.87%	1	1	1	1.25	$23.11	1	Green
722.10	Lumbar intervertebral disc without myelopathy	85651	Sedimentation rate, erythrocyte; non-automated	0.94	2.95%	1	1	1	1.36	$20.52	1	Green
722.10	Lumbar intervertebral disc without myelopathy	85652	Sedimentation rate, erythrocyte; automated	0.72	2.25%	1	1	1	1.20	$22.59	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	85730	Thromboplastin time, partial (PTT); plasma or whole blood	4.54	14.21%	1	1	1	1.22	$30.01	1	Green
722.10	Lumbar intervertebral disc without myelopathy	86140	C-reactive protein;	0.48	1.50%	1	1	1	1.26	$27.15	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	86703	Antibody; HIV-1 and HIV-2, single assay	0.10	0.29%	1	1	1	1.06	$30.88	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	86850	Antibody screen, RBC, each serum technique	2.48	7.77%	1	1	1	1.17	$40.35	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	86880	Antihuman globulin test (Coombs test); direct, each antiserum	0.12	0.36%	1	1	1	1.10	$24.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	86885	Antihuman globulin test (Coombs test); indirect, qualitative, each antiserum	0.08	0.26%	1	1	1	1.00	$60.37	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	86900	Blood typing; ABO	2.41	7.54%	1	1	1	1.17	$19.34	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	86901	Blood typing; Rh (D)	2.42	7.57%	1	1	1	1.17	$19.60	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	86920	Compatibility test each unit; immediate spin technique	0.17	0.52%	1	1	1	1.03	$88.19	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87040	Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)	0.12	0.38%	1	1	1	1.14	$110.33	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87070	Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates	0.25	0.77%	1	1	1	1.07	$51.15	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87086	Culture, bacterial; quantitative colony count, urine	0.31	0.96%	1	1	1	1.04	$30.44	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87088	Culture, bacterial; with isolation and presumptive identification of isolates, urine	0.20	0.61%	1	1	1	1.00	$33.60	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87186	Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration (MIC) or breakpoint), each multi-antimicrobial, per plate	0.13	0.40%	1	1	1	1.04	$42.45	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87205	Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types	0.16	0.49%	1	1	1	1.11	$19.48	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	87340	Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple step method; hepatitis B surface antigen (HBsAg)	0.10	0.31%	1	1	1	1.00	$30.87	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	88300	Surgical path, gross	0.23	0.71%	1	1	1	1.02	$23.23	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	88304	Tissue exam by pathologist	3.18	9.94%	1	1	1	1.19	$78.59	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	88311	Decalcify tissue	0.82	2.57%	1	1	1	1.17	$34.10	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	89051	Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count	0.25	0.78%	1	1	1	1.00	$25.70	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	90471	Immunization admin	0.11	0.33%	1	1	1	1.05	$21.95	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	90801	Psy dx interview	0.84	2.64%	1	1	1	1.25	$191.72	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	90804	Psytx, office, 20-30 min	0.18	0.56%	1	2	4	3.06	$197.43	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	90806	Psytx, off, 45-50 min	0.70	2.18%	2	4	7	5.98	$628.15	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	90808	Psytx, office, 75-80 min	0.45	1.41%	2	4	6	4.56	$676.95	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	90853	Group psychotherapy	0.19	0.59%	7	12	23	15.56	$1,919.65	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	93000	Electrocardiogram, complete	0.90	2.81%	1	1	1	1.14	$38.79	1	Green
722.10	Lumbar intervertebral disc without myelopathy	93005	Electrocardiogram, tracing	4.04	12.63%	1	1	1	1.14	$76.52	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	93010	Electrocardiogram report	3.27	10.23%	1	1	1	1.14	$14.47	1	Green
722.10	Lumbar intervertebral disc without myelopathy	93015	Cardiovascular stress test	0.09	0.28%	1	1	1	1.00	$131.47	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	93018	Cardiovascular stress test	0.08	0.26%	1	1	1	1.00	$21.89	n/a	Black
722.10	Lumbar intervertebral disc without myelopathy	93041	Rhythm ECG, tracing	0.16	0.49%	1	1	2	1.57	$117.72	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	93971	Extremity study	0.26	0.82%	1	1	1	1.09	$282.73	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94010	Breathing capacity test	0.15	0.45%	1	1	1	1.00	$33.82	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94150	Vital capacity test	0.11	0.33%	1	1	1	1.11	$42.81	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94640	Airway inhalation treatment	0.20	0.63%	1	1	1	1.14	$39.87	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94664	Aerosol or vapor inhalations	0.10	0.29%	1	1	1	1.06	$35.11	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94760	Measure blood oxygen level	1.23	3.85%	1	1	2	1.49	$40.01	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	94761	Measure blood oxygen level	0.50	1.55%	1	1	2	1.45	$58.73	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	94799	Unlisted pulmonary service or procedure	0.11	0.35%	1	1	2	1.35	$14.69	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	95831	Limb muscle testing, manual	0.89	2.78%	1	1	2	2.33	$117.22	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	95833	Body muscle testing, manual	0.10	0.29%	1	1	1	1.29	$50.20	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	95851	Range of motion measurements	1.63	5.11%	1	1	3	2.65	$76.77	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	95860	Muscle test, one limb	4.37	13.66%	1	1	1	1.11	$115.80	1	Green
722.10	Lumbar intervertebral disc without myelopathy	95861	Muscle test, two limbs	4.86	15.20%	1	1	1	1.13	$195.19	1	Green
722.10	Lumbar intervertebral disc without myelopathy	95864	Muscle test, 4 limbs	0.11	0.33%	1	1	1	1.16	$303.50	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	95869	Muscle test, thor paraspinal	0.15	0.45%	1	1	1	1.04	$60.89	n/a	Red
722.10	Lumbar intervertebral disc without myelopathy	95900	Motor nerve conduction test	4.71	14.73%	1	1	1	1.13	$171.05	1	Green
722.10	Lumbar intervertebral disc without myelopathy	95903	Motor nerve conduction test	3.89	12.18%	1	1	1	1.15	$262.33	n/a	Yellow
722.10	Lumbar intervertebral disc without myelopathy	95904	Sense nerve conduction test	7.29	22.82%