hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|WV,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Preston Memorial Hospital,2024-06-04,2.0.0,Preston Memorial Hospital,"150 Memorial Dr Kingwood, WV 26537",311097818,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,4 MOST PLAN,4 MOST REIMBURSEMENT METHOD,ADVANTRA PLAN,ADVANTRA REIMBURSEMENT METHOD,AETNA PLAN,AETNA REIMBURSEMENT METHOD,AETNA AUTO PLAN,AETNA AUTO REIMBURSEMENT METHOD,AETNA MEDICAL RENTAL PLAN,AETNA MEDICAL RENTAL REIMBURSEMENT METHOD,AETNA MEDICARE PLAN,AETNA MEDICARE REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK ACA PLAN,BLUE CROSS HIGHMARK ACA REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK MEDICAID PLAN,BLUE CROSS HIGHMARK MEDICAID REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK MEDICARE PLAN,BLUE CROSS HIGHMARK MEDICARE REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK POS PLAN,BLUE CROSS HIGHMARK POS REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK PPO PLAN,BLUE CROSS HIGHMARK PPO REIMBURSEMENT METHOD,BLUE CROSS HIGHMARK TRADITIONAL PLAN,BLUE CROSS HIGHMARK TRADITIONAL REIMBURSEMENT METHOD,CARESOURCE MEDICAID PLAN,CARESOURCE MEDICAID REIMBURSEMENT METHOD,CARESOURCE MEDICARE PLAN,CARESOURCE MEDICARE REIMBURSEMENT METHOD,CIGNA PLAN,CIGNA REIMBURSEMENT METHOD,GEHA PLAN,GEHA REIMBURSEMENT METHOD,HEALTH PLAN PLAN,HEALTH PLAN REIMBURSEMENT METHOD,HEALTH PLAN MEDICAID PLAN,HEALTH PLAN MEDICAID REIMBURSEMENT METHOD,HEALTH PLAN MEDICARE PLAN,HEALTH PLAN MEDICARE REIMBURSEMENT METHOD,HUMANA PLAN,HUMANA REIMBURSEMENT METHOD,MEDICARE PLAN,MEDICARE REIMBURSEMENT METHOD,UHC PLAN,UHC REIMBURSEMENT METHOD,UHC VA PLAN,UHC VA REIMBURSEMENT METHOD,UNICARE PLAN,UNICARE REIMBURSEMENT METHOD,UPMC PLAN,UPMC REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE Outpatient Medical Services,LAB,80048,Basic metabolic panel,300,$159.50 ,$154.72 ,97% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.33 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.55 ,90% of billed charges for outpatient setting,$143.55 ,90% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$116.05 ,72.76% of billed charges for outpatient setting,$108.86 ,68.25% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.75 ,80.72% of billed charges for outpatient setting,$128.75 ,80.72% of billed charges for outpatient setting,$141.33 ,88.61% of billed charges for outpatient setting,$105.75 ,66.30% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.74 ,92% of billed charges for outpatient setting,$151.53 ,95% of billed charges for outpatient setting,$154.72 ,97% of billed charges for outpatient setting,$103.68 ,65% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.55 ,90% of billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.33 ,$154.72 ,$79.75 Outpatient Medical Services,LAB,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",300,$130.75 ,$126.83 ,97% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.68 ,90% of billed charges for outpatient setting,$117.68 ,90% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.13 ,72.76% of billed charges for outpatient setting,$89.24 ,68.25% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.54 ,80.72% of billed charges for outpatient setting,$105.54 ,80.72% of billed charges for outpatient setting,$115.86 ,88.61% of billed charges for outpatient setting,$86.69 ,66.30% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$120.29 ,92% of billed charges for outpatient setting,$124.21 ,95% of billed charges for outpatient setting,$126.83 ,97% of billed charges for outpatient setting,$84.99 ,65% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.68 ,90% of billed charges for outpatient setting,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$7.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.08 ,$126.83 ,$65.38 Outpatient Medical Services,LAB,80053,"Blood test, comprehensive group of blood chemicals",300,$208.75 ,$202.49 ,97% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$187.88 ,90% of billed charges for outpatient setting,$187.88 ,90% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$151.89 ,72.76% of billed charges for outpatient setting,$142.47 ,68.25% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$168.50 ,80.72% of billed charges for outpatient setting,$168.50 ,80.72% of billed charges for outpatient setting,$184.97 ,88.61% of billed charges for outpatient setting,$138.40 ,66.30% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$192.05 ,92% of billed charges for outpatient setting,$198.31 ,95% of billed charges for outpatient setting,$202.49 ,97% of billed charges for outpatient setting,$135.69 ,65% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$187.88 ,90% of billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$10.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.16 ,$202.49 ,$104.38 Outpatient Medical Services,LAB,80061,"Blood test, lipids (cholesterol and triglycerides)",300,$49.75 ,$48.26 ,97% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.78 ,90% of billed charges for outpatient setting,$44.78 ,90% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.20 ,72.76% of billed charges for outpatient setting,$33.95 ,68.25% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$40.16 ,80.72% of billed charges for outpatient setting,$40.16 ,80.72% of billed charges for outpatient setting,$44.08 ,88.61% of billed charges for outpatient setting,$32.98 ,66.30% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$45.77 ,92% of billed charges for outpatient setting,$47.26 ,95% of billed charges for outpatient setting,$48.26 ,97% of billed charges for outpatient setting,$32.34 ,65% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.78 ,90% of billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.61 ,$102.86 ,$24.88 Outpatient Medical Services,LAB,80069,Kidney function panel test,300,$205.25 ,$199.09 ,97% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$184.73 ,90% of billed charges for outpatient setting,$184.73 ,90% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$149.34 ,72.76% of billed charges for outpatient setting,$140.08 ,68.25% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$165.68 ,80.72% of billed charges for outpatient setting,$165.68 ,80.72% of billed charges for outpatient setting,$181.87 ,88.61% of billed charges for outpatient setting,$136.08 ,66.30% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$188.83 ,92% of billed charges for outpatient setting,$194.99 ,95% of billed charges for outpatient setting,$199.09 ,97% of billed charges for outpatient setting,$133.41 ,65% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$184.73 ,90% of billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.53 ,$199.09 ,$102.63 Outpatient Medical Services,LAB,80074,Acute hepatitis panel,300,$114.75 ,$111.31 ,97% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.28 ,90% of billed charges for outpatient setting,$103.28 ,90% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.49 ,72.76% of billed charges for outpatient setting,$78.32 ,68.25% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.63 ,80.72% of billed charges for outpatient setting,$92.63 ,80.72% of billed charges for outpatient setting,$101.68 ,88.61% of billed charges for outpatient setting,$76.08 ,66.30% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.57 ,92% of billed charges for outpatient setting,$109.01 ,95% of billed charges for outpatient setting,$111.31 ,97% of billed charges for outpatient setting,$74.59 ,65% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.28 ,90% of billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$47.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.29 ,$111.31 ,$57.38 Outpatient Medical Services,LAB,80076,Liver function blood test panel,300,$158.25 ,$153.50 ,97% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$115.14 ,72.76% of billed charges for outpatient setting,$108.01 ,68.25% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$127.74 ,80.72% of billed charges for outpatient setting,$127.74 ,80.72% of billed charges for outpatient setting,$140.23 ,88.61% of billed charges for outpatient setting,$104.92 ,66.30% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$145.59 ,92% of billed charges for outpatient setting,$150.34 ,95% of billed charges for outpatient setting,$153.50 ,97% of billed charges for outpatient setting,$102.86 ,65% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.08 ,$153.50 ,$79.13 Outpatient Medical Services,LAB,80156,Assay carbamazepine total,300,$46.25 ,$44.86 ,97% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.63 ,90% of billed charges for outpatient setting,$41.63 ,90% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.65 ,72.76% of billed charges for outpatient setting,$31.57 ,68.25% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.33 ,80.72% of billed charges for outpatient setting,$37.33 ,80.72% of billed charges for outpatient setting,$40.98 ,88.61% of billed charges for outpatient setting,$30.66 ,66.30% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.55 ,92% of billed charges for outpatient setting,$43.94 ,95% of billed charges for outpatient setting,$44.86 ,97% of billed charges for outpatient setting,$30.06 ,65% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.63 ,90% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.62 ,$102.86 ,$23.13 Outpatient Medical Services,LAB,80162,Assay of digoxin total,300,$146.25 ,$141.86 ,97% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$131.63 ,90% of billed charges for outpatient setting,$131.63 ,90% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$106.41 ,72.76% of billed charges for outpatient setting,$99.82 ,68.25% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.05 ,80.72% of billed charges for outpatient setting,$118.05 ,80.72% of billed charges for outpatient setting,$129.59 ,88.61% of billed charges for outpatient setting,$96.96 ,66.30% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.55 ,92% of billed charges for outpatient setting,$138.94 ,95% of billed charges for outpatient setting,$141.86 ,97% of billed charges for outpatient setting,$95.06 ,65% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$131.63 ,90% of billed charges for outpatient setting,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.51 ,$141.86 ,$73.13 Outpatient Medical Services,LAB,80164,Assay dipropylacetic acd tot,300,$149.25 ,$144.77 ,97% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.33 ,90% of billed charges for outpatient setting,$134.33 ,90% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.59 ,72.76% of billed charges for outpatient setting,$101.86 ,68.25% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$120.47 ,80.72% of billed charges for outpatient setting,$120.47 ,80.72% of billed charges for outpatient setting,$132.25 ,88.61% of billed charges for outpatient setting,$98.95 ,66.30% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.31 ,92% of billed charges for outpatient setting,$141.79 ,95% of billed charges for outpatient setting,$144.77 ,97% of billed charges for outpatient setting,$97.01 ,65% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.33 ,90% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.74 ,$144.77 ,$74.63 Outpatient Medical Services,LAB,80178,Assay of lithium,300,$67.75 ,$65.72 ,97% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.29 ,72.76% of billed charges for outpatient setting,$46.24 ,68.25% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.69 ,80.72% of billed charges for outpatient setting,$54.69 ,80.72% of billed charges for outpatient setting,$60.03 ,88.61% of billed charges for outpatient setting,$44.92 ,66.30% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.33 ,92% of billed charges for outpatient setting,$64.36 ,95% of billed charges for outpatient setting,$65.72 ,97% of billed charges for outpatient setting,$44.04 ,65% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.73 ,$102.86 ,$33.88 Outpatient Medical Services,LAB,80184,Assay of phenobarbital,300,$14.75 ,$14.31 ,97% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.28 ,90% of billed charges for outpatient setting,$13.28 ,90% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.73 ,72.76% of billed charges for outpatient setting,$10.07 ,68.25% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.91 ,80.72% of billed charges for outpatient setting,$11.91 ,80.72% of billed charges for outpatient setting,$13.07 ,88.61% of billed charges for outpatient setting,$9.78 ,66.30% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.57 ,92% of billed charges for outpatient setting,$14.01 ,95% of billed charges for outpatient setting,$14.31 ,97% of billed charges for outpatient setting,$9.59 ,65% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.28 ,90% of billed charges for outpatient setting,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$15.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.59 ,$102.86 ,$7.38 Outpatient Medical Services,LAB,80185,Assay of phenytoin total,300,$167.00 ,$161.99 ,97% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.30 ,90% of billed charges for outpatient setting,$150.30 ,90% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.51 ,72.76% of billed charges for outpatient setting,$113.98 ,68.25% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.80 ,80.72% of billed charges for outpatient setting,$134.80 ,80.72% of billed charges for outpatient setting,$147.98 ,88.61% of billed charges for outpatient setting,$110.72 ,66.30% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$153.64 ,92% of billed charges for outpatient setting,$158.65 ,95% of billed charges for outpatient setting,$161.99 ,97% of billed charges for outpatient setting,$108.55 ,65% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.30 ,90% of billed charges for outpatient setting,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.49 ,$161.99 ,$83.50 Outpatient Medical Services,LAB,80195,Assay of sirolimus,300,$86.00 ,$83.42 ,97% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$77.40 ,90% of billed charges for outpatient setting,$77.40 ,90% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.57 ,72.76% of billed charges for outpatient setting,$58.70 ,68.25% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$69.42 ,80.72% of billed charges for outpatient setting,$69.42 ,80.72% of billed charges for outpatient setting,$76.20 ,88.61% of billed charges for outpatient setting,$57.02 ,66.30% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.12 ,92% of billed charges for outpatient setting,$81.70 ,95% of billed charges for outpatient setting,$83.42 ,97% of billed charges for outpatient setting,$55.90 ,65% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$77.40 ,90% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.90 ,$102.86 ,$43.00 Outpatient Medical Services,LAB,80197,Test is used to measure the amount of the drug in the blood to determine whether the concentration has reached a therapeutic level and is below the to,300,$149.50 ,$145.02 ,97% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.55 ,90% of billed charges for outpatient setting,$134.55 ,90% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.78 ,72.76% of billed charges for outpatient setting,$102.03 ,68.25% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$120.68 ,80.72% of billed charges for outpatient setting,$120.68 ,80.72% of billed charges for outpatient setting,$132.47 ,88.61% of billed charges for outpatient setting,$99.12 ,66.30% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.54 ,92% of billed charges for outpatient setting,$142.03 ,95% of billed charges for outpatient setting,$145.02 ,97% of billed charges for outpatient setting,$97.18 ,65% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.55 ,90% of billed charges for outpatient setting,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.90 ,$145.02 ,$74.75 Outpatient Medical Services,LAB,80198,Assay of theophylline,300,$163.50 ,$158.60 ,97% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.15 ,90% of billed charges for outpatient setting,$147.15 ,90% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.96 ,72.76% of billed charges for outpatient setting,$111.59 ,68.25% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$131.98 ,80.72% of billed charges for outpatient setting,$131.98 ,80.72% of billed charges for outpatient setting,$144.88 ,88.61% of billed charges for outpatient setting,$108.40 ,66.30% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.42 ,92% of billed charges for outpatient setting,$155.33 ,95% of billed charges for outpatient setting,$158.60 ,97% of billed charges for outpatient setting,$106.28 ,65% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.15 ,90% of billed charges for outpatient setting,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.25 ,$158.60 ,$81.75 Outpatient Medical Services,LAB,80201,Assay of topiramate,300,$114.25 ,$110.82 ,97% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.33 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.83 ,90% of billed charges for outpatient setting,$102.83 ,90% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.13 ,72.76% of billed charges for outpatient setting,$77.98 ,68.25% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.22 ,80.72% of billed charges for outpatient setting,$92.22 ,80.72% of billed charges for outpatient setting,$101.24 ,88.61% of billed charges for outpatient setting,$75.75 ,66.30% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.11 ,92% of billed charges for outpatient setting,$108.54 ,95% of billed charges for outpatient setting,$110.82 ,97% of billed charges for outpatient setting,$74.26 ,65% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.83 ,90% of billed charges for outpatient setting,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$11.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.33 ,$110.82 ,$57.13 Outpatient Medical Services,LAB,80202,Assay of vancomycin,300,$139.50 ,$135.32 ,97% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$101.50 ,72.76% of billed charges for outpatient setting,$95.21 ,68.25% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$112.60 ,80.72% of billed charges for outpatient setting,$112.60 ,80.72% of billed charges for outpatient setting,$123.61 ,88.61% of billed charges for outpatient setting,$92.49 ,66.30% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.34 ,92% of billed charges for outpatient setting,$132.53 ,95% of billed charges for outpatient setting,$135.32 ,97% of billed charges for outpatient setting,$90.68 ,65% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.74 ,$135.32 ,$69.75 Outpatient Medical Services,LAB,80320,Drug screen quantalcohols,300,$114.00 ,$110.58 ,97% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$0.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.60 ,90% of billed charges for outpatient setting,$102.60 ,90% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.95 ,72.76% of billed charges for outpatient setting,$77.81 ,68.25% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.02 ,80.72% of billed charges for outpatient setting,$92.02 ,80.72% of billed charges for outpatient setting,$101.02 ,88.61% of billed charges for outpatient setting,$75.58 ,66.30% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$104.88 ,92% of billed charges for outpatient setting,$108.30 ,95% of billed charges for outpatient setting,$110.58 ,97% of billed charges for outpatient setting,$74.10 ,65% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.60 ,90% of billed charges for outpatient setting,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$68.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$0.01 ,$110.58 ,$57.00 Outpatient Medical Services,LAB,81001,Manual urinalysis test with examination with or without using microscope,300,$69.75 ,$67.66 ,97% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.78 ,90% of billed charges for outpatient setting,$62.78 ,90% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$50.75 ,72.76% of billed charges for outpatient setting,$47.60 ,68.25% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.30 ,80.72% of billed charges for outpatient setting,$56.30 ,80.72% of billed charges for outpatient setting,$61.81 ,88.61% of billed charges for outpatient setting,$46.24 ,66.30% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.17 ,92% of billed charges for outpatient setting,$66.26 ,95% of billed charges for outpatient setting,$67.66 ,97% of billed charges for outpatient setting,$45.34 ,65% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.78 ,90% of billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.75 ,$102.86 ,$34.88 Outpatient Medical Services,LAB,81002,Manual urinalysis test with examination without using microscope,300,$34.75 ,$33.71 ,97% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.28 ,90% of billed charges for outpatient setting,$31.28 ,90% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.28 ,72.76% of billed charges for outpatient setting,$23.72 ,68.25% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.05 ,80.72% of billed charges for outpatient setting,$28.05 ,80.72% of billed charges for outpatient setting,$30.79 ,88.61% of billed charges for outpatient setting,$23.04 ,66.30% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.97 ,92% of billed charges for outpatient setting,$33.01 ,95% of billed charges for outpatient setting,$33.71 ,97% of billed charges for outpatient setting,$22.59 ,65% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.28 ,90% of billed charges for outpatient setting,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.71 ,$102.86 ,$17.38 Outpatient Medical Services,LAB,81003,Automated urinalysis test,300,$34.50 ,$33.47 ,97% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$1.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.10 ,72.76% of billed charges for outpatient setting,$23.55 ,68.25% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.85 ,80.72% of billed charges for outpatient setting,$27.85 ,80.72% of billed charges for outpatient setting,$30.57 ,88.61% of billed charges for outpatient setting,$22.87 ,66.30% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.74 ,92% of billed charges for outpatient setting,$32.78 ,95% of billed charges for outpatient setting,$33.47 ,97% of billed charges for outpatient setting,$22.43 ,65% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$2.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$1.94 ,$102.86 ,$17.25 Outpatient Medical Services,LAB,81025,Urine pregnancy test,300,$10.00 ,$9.70 ,97% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.72 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.00 ,90% of billed charges for outpatient setting,$9.00 ,90% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.28 ,72.76% of billed charges for outpatient setting,$6.83 ,68.25% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.07 ,80.72% of billed charges for outpatient setting,$8.07 ,80.72% of billed charges for outpatient setting,$8.86 ,88.61% of billed charges for outpatient setting,$6.63 ,66.30% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.20 ,92% of billed charges for outpatient setting,$9.50 ,95% of billed charges for outpatient setting,$9.70 ,97% of billed charges for outpatient setting,$6.50 ,65% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.00 ,90% of billed charges for outpatient setting,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.50 ,$102.86 ,$5.00 Outpatient Medical Services,LAB,82010,Acetone assay,300,$98.75 ,$95.79 ,97% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.88 ,90% of billed charges for outpatient setting,$88.88 ,90% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.85 ,72.76% of billed charges for outpatient setting,$67.40 ,68.25% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.71 ,80.72% of billed charges for outpatient setting,$79.71 ,80.72% of billed charges for outpatient setting,$87.50 ,88.61% of billed charges for outpatient setting,$65.47 ,66.30% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$90.85 ,92% of billed charges for outpatient setting,$93.81 ,95% of billed charges for outpatient setting,$95.79 ,97% of billed charges for outpatient setting,$64.19 ,65% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.88 ,90% of billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.08 ,$102.86 ,$49.38 Outpatient Medical Services,LAB,82040,Assay of serum albumin,300,$23.75 ,$23.04 ,97% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.38 ,90% of billed charges for outpatient setting,$21.38 ,90% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.28 ,72.76% of billed charges for outpatient setting,$16.21 ,68.25% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.17 ,80.72% of billed charges for outpatient setting,$19.17 ,80.72% of billed charges for outpatient setting,$21.04 ,88.61% of billed charges for outpatient setting,$15.75 ,66.30% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.85 ,92% of billed charges for outpatient setting,$22.56 ,95% of billed charges for outpatient setting,$23.04 ,97% of billed charges for outpatient setting,$15.44 ,65% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.38 ,90% of billed charges for outpatient setting,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.29 ,$102.86 ,$11.88 Outpatient Medical Services,LAB,82043,Urine test to measure albumin,300,$71.75 ,$69.60 ,97% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.58 ,90% of billed charges for outpatient setting,$64.58 ,90% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.21 ,72.76% of billed charges for outpatient setting,$48.97 ,68.25% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$57.92 ,80.72% of billed charges for outpatient setting,$57.92 ,80.72% of billed charges for outpatient setting,$63.58 ,88.61% of billed charges for outpatient setting,$47.57 ,66.30% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$66.01 ,92% of billed charges for outpatient setting,$68.16 ,95% of billed charges for outpatient setting,$69.60 ,97% of billed charges for outpatient setting,$46.64 ,65% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.58 ,90% of billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.01 ,$102.86 ,$35.88 Outpatient Medical Services,LAB,82085,Assay of aldolase,300,$12.00 ,$11.64 ,97% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.42 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.80 ,90% of billed charges for outpatient setting,$10.80 ,90% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.73 ,72.76% of billed charges for outpatient setting,$8.19 ,68.25% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.69 ,80.72% of billed charges for outpatient setting,$9.69 ,80.72% of billed charges for outpatient setting,$10.63 ,88.61% of billed charges for outpatient setting,$7.96 ,66.30% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.04 ,92% of billed charges for outpatient setting,$11.40 ,95% of billed charges for outpatient setting,$11.64 ,97% of billed charges for outpatient setting,$7.80 ,65% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.80 ,90% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.80 ,$102.86 ,$6.00 Outpatient Medical Services,LAB,82088,Assay of aldosterone,300,$61.50 ,$59.66 ,97% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.35 ,90% of billed charges for outpatient setting,$55.35 ,90% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.75 ,72.76% of billed charges for outpatient setting,$41.97 ,68.25% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.64 ,80.72% of billed charges for outpatient setting,$49.64 ,80.72% of billed charges for outpatient setting,$54.50 ,88.61% of billed charges for outpatient setting,$40.77 ,66.30% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.58 ,92% of billed charges for outpatient setting,$58.43 ,95% of billed charges for outpatient setting,$59.66 ,97% of billed charges for outpatient setting,$39.98 ,65% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.35 ,90% of billed charges for outpatient setting,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$40.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.32 ,$102.86 ,$30.75 Outpatient Medical Services,LAB,82103,Alpha-1-antitrypsin total,300,$16.00 ,$15.52 ,97% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.64 ,72.76% of billed charges for outpatient setting,$10.92 ,68.25% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.92 ,80.72% of billed charges for outpatient setting,$12.92 ,80.72% of billed charges for outpatient setting,$14.18 ,88.61% of billed charges for outpatient setting,$10.61 ,66.30% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.72 ,92% of billed charges for outpatient setting,$15.20 ,95% of billed charges for outpatient setting,$15.52 ,97% of billed charges for outpatient setting,$10.40 ,65% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.40 ,$102.86 ,$8.00 Outpatient Medical Services,LAB,82105,Alpha-fetoprotein serum,300,$16.00 ,$15.52 ,97% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.64 ,72.76% of billed charges for outpatient setting,$10.92 ,68.25% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.92 ,80.72% of billed charges for outpatient setting,$12.92 ,80.72% of billed charges for outpatient setting,$14.18 ,88.61% of billed charges for outpatient setting,$10.61 ,66.30% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.72 ,92% of billed charges for outpatient setting,$15.20 ,95% of billed charges for outpatient setting,$15.52 ,97% of billed charges for outpatient setting,$10.40 ,65% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.40 ,90% of billed charges for outpatient setting,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.40 ,$102.86 ,$8.00 Outpatient Medical Services,LAB,82140,Assay of ammonia,300,$122.25 ,$118.58 ,97% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.03 ,90% of billed charges for outpatient setting,$110.03 ,90% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.95 ,72.76% of billed charges for outpatient setting,$83.44 ,68.25% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.68 ,80.72% of billed charges for outpatient setting,$98.68 ,80.72% of billed charges for outpatient setting,$108.33 ,88.61% of billed charges for outpatient setting,$81.05 ,66.30% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$112.47 ,92% of billed charges for outpatient setting,$116.14 ,95% of billed charges for outpatient setting,$118.58 ,97% of billed charges for outpatient setting,$79.46 ,65% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.03 ,90% of billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.63 ,$118.58 ,$61.13 Outpatient Medical Services,LAB,82150,Assay of amylase,300,$78.75 ,$76.39 ,97% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.88 ,90% of billed charges for outpatient setting,$70.88 ,90% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$57.30 ,72.76% of billed charges for outpatient setting,$53.75 ,68.25% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.57 ,80.72% of billed charges for outpatient setting,$63.57 ,80.72% of billed charges for outpatient setting,$69.78 ,88.61% of billed charges for outpatient setting,$52.21 ,66.30% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.45 ,92% of billed charges for outpatient setting,$74.81 ,95% of billed charges for outpatient setting,$76.39 ,97% of billed charges for outpatient setting,$51.19 ,65% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.88 ,90% of billed charges for outpatient setting,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.62 ,$102.86 ,$39.38 Outpatient Medical Services,LAB,82247,Bilirubin total,300,$31.00 ,$30.07 ,97% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.56 ,72.76% of billed charges for outpatient setting,$21.16 ,68.25% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.02 ,80.72% of billed charges for outpatient setting,$25.02 ,80.72% of billed charges for outpatient setting,$27.47 ,88.61% of billed charges for outpatient setting,$20.55 ,66.30% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.52 ,92% of billed charges for outpatient setting,$29.45 ,95% of billed charges for outpatient setting,$30.07 ,97% of billed charges for outpatient setting,$20.15 ,65% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.34 ,$102.86 ,$15.50 Outpatient Medical Services,LAB,82248,Measurement of direct bilirubin,300,$81.00 ,$78.57 ,97% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.90 ,90% of billed charges for outpatient setting,$72.90 ,90% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$58.94 ,72.76% of billed charges for outpatient setting,$55.28 ,68.25% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$65.38 ,80.72% of billed charges for outpatient setting,$65.38 ,80.72% of billed charges for outpatient setting,$71.77 ,88.61% of billed charges for outpatient setting,$53.70 ,66.30% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$74.52 ,92% of billed charges for outpatient setting,$76.95 ,95% of billed charges for outpatient setting,$78.57 ,97% of billed charges for outpatient setting,$52.65 ,65% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.90 ,90% of billed charges for outpatient setting,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.34 ,$102.86 ,$40.50 Outpatient Medical Services,LAB,82274,Assay test for blood fecal,300,$25.75 ,$24.98 ,97% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.18 ,90% of billed charges for outpatient setting,$23.18 ,90% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.74 ,72.76% of billed charges for outpatient setting,$17.57 ,68.25% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.79 ,80.72% of billed charges for outpatient setting,$20.79 ,80.72% of billed charges for outpatient setting,$22.82 ,88.61% of billed charges for outpatient setting,$17.07 ,66.30% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.69 ,92% of billed charges for outpatient setting,$24.46 ,95% of billed charges for outpatient setting,$24.98 ,97% of billed charges for outpatient setting,$16.74 ,65% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.18 ,90% of billed charges for outpatient setting,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$15.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.78 ,$102.86 ,$12.88 Outpatient Medical Services,LAB,82306,Blood test to monitor vitamin D levels,300,$183.50 ,$178.00 ,97% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$165.15 ,90% of billed charges for outpatient setting,$165.15 ,90% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.51 ,72.76% of billed charges for outpatient setting,$125.24 ,68.25% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$148.12 ,80.72% of billed charges for outpatient setting,$148.12 ,80.72% of billed charges for outpatient setting,$162.60 ,88.61% of billed charges for outpatient setting,$121.66 ,66.30% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$168.82 ,92% of billed charges for outpatient setting,$174.33 ,95% of billed charges for outpatient setting,$178.00 ,97% of billed charges for outpatient setting,$119.28 ,65% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$165.15 ,90% of billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$29.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.65 ,$178.00 ,$91.75 Outpatient Medical Services,LAB,82310,Assay of calcium,300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.47 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,82330,Assay of calcium,300,$14.25 ,$13.82 ,97% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.83 ,90% of billed charges for outpatient setting,$12.83 ,90% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.37 ,72.76% of billed charges for outpatient setting,$9.73 ,68.25% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.50 ,80.72% of billed charges for outpatient setting,$11.50 ,80.72% of billed charges for outpatient setting,$12.63 ,88.61% of billed charges for outpatient setting,$9.45 ,66.30% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.11 ,92% of billed charges for outpatient setting,$13.54 ,95% of billed charges for outpatient setting,$13.82 ,97% of billed charges for outpatient setting,$9.26 ,65% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.83 ,90% of billed charges for outpatient setting,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.26 ,$102.86 ,$7.13 Outpatient Medical Services,LAB,82340,Assay of calcium in urine,300,$83.50 ,$81.00 ,97% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.23 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.15 ,90% of billed charges for outpatient setting,$75.15 ,90% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.75 ,72.76% of billed charges for outpatient setting,$56.99 ,68.25% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.40 ,80.72% of billed charges for outpatient setting,$67.40 ,80.72% of billed charges for outpatient setting,$73.99 ,88.61% of billed charges for outpatient setting,$55.36 ,66.30% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.82 ,92% of billed charges for outpatient setting,$79.33 ,95% of billed charges for outpatient setting,$81.00 ,97% of billed charges for outpatient setting,$54.28 ,65% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.15 ,90% of billed charges for outpatient setting,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.23 ,$102.86 ,$41.75 Outpatient Medical Services,LAB,82360,Calculus assay quant,300,$53.25 ,$51.65 ,97% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.93 ,90% of billed charges for outpatient setting,$47.93 ,90% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.74 ,72.76% of billed charges for outpatient setting,$36.34 ,68.25% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.98 ,80.72% of billed charges for outpatient setting,$42.98 ,80.72% of billed charges for outpatient setting,$47.18 ,88.61% of billed charges for outpatient setting,$35.30 ,66.30% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$48.99 ,92% of billed charges for outpatient setting,$50.59 ,95% of billed charges for outpatient setting,$51.65 ,97% of billed charges for outpatient setting,$34.61 ,65% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.93 ,90% of billed charges for outpatient setting,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$12.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.15 ,$102.86 ,$26.63 Outpatient Medical Services,LAB,82375,Assay carboxyhb quant,300,$92.25 ,$89.48 ,97% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.03 ,90% of billed charges for outpatient setting,$83.03 ,90% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.12 ,72.76% of billed charges for outpatient setting,$62.96 ,68.25% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$74.46 ,80.72% of billed charges for outpatient setting,$74.46 ,80.72% of billed charges for outpatient setting,$81.74 ,88.61% of billed charges for outpatient setting,$61.16 ,66.30% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$84.87 ,92% of billed charges for outpatient setting,$87.64 ,95% of billed charges for outpatient setting,$89.48 ,97% of billed charges for outpatient setting,$59.96 ,65% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.03 ,90% of billed charges for outpatient setting,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$12.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.68 ,$102.86 ,$46.13 Outpatient Medical Services,LAB,82533,Total cortisol,300,$34.50 ,$33.47 ,97% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.10 ,72.76% of billed charges for outpatient setting,$23.55 ,68.25% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.85 ,80.72% of billed charges for outpatient setting,$27.85 ,80.72% of billed charges for outpatient setting,$30.57 ,88.61% of billed charges for outpatient setting,$22.87 ,66.30% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.74 ,92% of billed charges for outpatient setting,$32.78 ,95% of billed charges for outpatient setting,$33.47 ,97% of billed charges for outpatient setting,$22.43 ,65% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.05 ,90% of billed charges for outpatient setting,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.13 ,$102.86 ,$17.25 Outpatient Medical Services,LAB,82550,Assay of ck (cpk),300,$5.25 ,$5.09 ,97% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.64 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.73 ,90% of billed charges for outpatient setting,$4.73 ,90% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.82 ,72.76% of billed charges for outpatient setting,$3.58 ,68.25% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.24 ,80.72% of billed charges for outpatient setting,$4.24 ,80.72% of billed charges for outpatient setting,$4.65 ,88.61% of billed charges for outpatient setting,$3.48 ,66.30% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.83 ,92% of billed charges for outpatient setting,$4.99 ,95% of billed charges for outpatient setting,$5.09 ,97% of billed charges for outpatient setting,$3.41 ,65% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.73 ,90% of billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.41 ,$102.86 ,$2.63 Outpatient Medical Services,LAB,82553,Blood test to detect heart enzymes,300,$81.25 ,$78.81 ,97% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$73.13 ,90% of billed charges for outpatient setting,$73.13 ,90% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$59.12 ,72.76% of billed charges for outpatient setting,$55.45 ,68.25% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$65.59 ,80.72% of billed charges for outpatient setting,$65.59 ,80.72% of billed charges for outpatient setting,$72.00 ,88.61% of billed charges for outpatient setting,$53.87 ,66.30% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$74.75 ,92% of billed charges for outpatient setting,$77.19 ,95% of billed charges for outpatient setting,$78.81 ,97% of billed charges for outpatient setting,$52.81 ,65% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$73.13 ,90% of billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$11.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.01 ,$102.86 ,$40.63 Outpatient Medical Services,LAB,82565,Assay of creatinine,300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.44 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.44 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,82570,Test to measure creatinine in the urine,300,$11.75 ,$11.40 ,97% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.55 ,72.76% of billed charges for outpatient setting,$8.02 ,68.25% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.48 ,80.72% of billed charges for outpatient setting,$9.48 ,80.72% of billed charges for outpatient setting,$10.41 ,88.61% of billed charges for outpatient setting,$7.79 ,66.30% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.81 ,92% of billed charges for outpatient setting,$11.16 ,95% of billed charges for outpatient setting,$11.40 ,97% of billed charges for outpatient setting,$7.64 ,65% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,$102.86 ,$5.88 Outpatient Medical Services,LAB,82607,Blood test to measure B-12,300,$148.50 ,$144.05 ,97% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.65 ,90% of billed charges for outpatient setting,$133.65 ,90% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.05 ,72.76% of billed charges for outpatient setting,$101.35 ,68.25% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.87 ,80.72% of billed charges for outpatient setting,$119.87 ,80.72% of billed charges for outpatient setting,$131.59 ,88.61% of billed charges for outpatient setting,$98.46 ,66.30% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$136.62 ,92% of billed charges for outpatient setting,$141.08 ,95% of billed charges for outpatient setting,$144.05 ,97% of billed charges for outpatient setting,$96.53 ,65% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.65 ,90% of billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$15.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.07 ,$144.05 ,$74.25 Outpatient Medical Services,LAB,82670,Blood test to measure a type of estrogen in the blood,300,$77.00 ,$74.69 ,97% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.21 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$69.30 ,90% of billed charges for outpatient setting,$69.30 ,90% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.03 ,72.76% of billed charges for outpatient setting,$52.55 ,68.25% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.15 ,80.72% of billed charges for outpatient setting,$62.15 ,80.72% of billed charges for outpatient setting,$68.23 ,88.61% of billed charges for outpatient setting,$51.05 ,66.30% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.84 ,92% of billed charges for outpatient setting,$73.15 ,95% of billed charges for outpatient setting,$74.69 ,97% of billed charges for outpatient setting,$50.05 ,65% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$69.30 ,90% of billed charges for outpatient setting,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$27.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.21 ,$102.86 ,$38.50 Outpatient Medical Services,LAB,82728,Test to determine level of iron in the blood,300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$13.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.82 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,82746,Assay of folic acid serum,300,$152.00 ,$147.44 ,97% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$136.80 ,90% of billed charges for outpatient setting,$136.80 ,90% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.60 ,72.76% of billed charges for outpatient setting,$103.74 ,68.25% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.69 ,80.72% of billed charges for outpatient setting,$122.69 ,80.72% of billed charges for outpatient setting,$134.69 ,88.61% of billed charges for outpatient setting,$100.78 ,66.30% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.84 ,92% of billed charges for outpatient setting,$144.40 ,95% of billed charges for outpatient setting,$147.44 ,97% of billed charges for outpatient setting,$98.80 ,65% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$136.80 ,90% of billed charges for outpatient setting,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.75 ,$147.44 ,$76.00 Outpatient Medical Services,LAB,82784,Test to determine levels of immunoglobulins in the blood,300,$14.50 ,$14.07 ,97% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.05 ,90% of billed charges for outpatient setting,$13.05 ,90% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.55 ,72.76% of billed charges for outpatient setting,$9.90 ,68.25% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.70 ,80.72% of billed charges for outpatient setting,$11.70 ,80.72% of billed charges for outpatient setting,$12.85 ,88.61% of billed charges for outpatient setting,$9.61 ,66.30% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.34 ,92% of billed charges for outpatient setting,$13.78 ,95% of billed charges for outpatient setting,$14.07 ,97% of billed charges for outpatient setting,$9.43 ,65% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.05 ,90% of billed charges for outpatient setting,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$9.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.07 ,$102.86 ,$7.25 Outpatient Medical Services,LAB,82803,Test to measure arterial blood gases,300,$286.25 ,$277.66 ,97% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.33 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.63 ,90% of billed charges for outpatient setting,$257.63 ,90% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$208.28 ,72.76% of billed charges for outpatient setting,$195.37 ,68.25% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$231.06 ,80.72% of billed charges for outpatient setting,$231.06 ,80.72% of billed charges for outpatient setting,$253.65 ,88.61% of billed charges for outpatient setting,$189.78 ,66.30% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$263.35 ,92% of billed charges for outpatient setting,$271.94 ,95% of billed charges for outpatient setting,$277.66 ,97% of billed charges for outpatient setting,$186.06 ,65% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.63 ,90% of billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$26.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.33 ,$277.66 ,$143.13 Outpatient Medical Services,LAB,82947,Quantitative measure of glucose build up in the blood over time,300,$42.50 ,$41.23 ,97% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.92 ,72.76% of billed charges for outpatient setting,$29.01 ,68.25% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.31 ,80.72% of billed charges for outpatient setting,$34.31 ,80.72% of billed charges for outpatient setting,$37.66 ,88.61% of billed charges for outpatient setting,$28.18 ,66.30% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.10 ,92% of billed charges for outpatient setting,$40.38 ,95% of billed charges for outpatient setting,$41.23 ,97% of billed charges for outpatient setting,$27.63 ,65% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.93 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.41 ,$102.86 ,$21.25 Outpatient Medical Services,LAB,82977,Assay of ggt,300,$67.75 ,$65.72 ,97% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.24 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.29 ,72.76% of billed charges for outpatient setting,$46.24 ,68.25% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.69 ,80.72% of billed charges for outpatient setting,$54.69 ,80.72% of billed charges for outpatient setting,$60.03 ,88.61% of billed charges for outpatient setting,$44.92 ,66.30% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.33 ,92% of billed charges for outpatient setting,$64.36 ,95% of billed charges for outpatient setting,$65.72 ,97% of billed charges for outpatient setting,$44.04 ,65% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.98 ,90% of billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$7.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.24 ,$102.86 ,$33.88 Outpatient Medical Services,LAB,83001,Test of hormone in the blood,300,$26.50 ,$25.71 ,97% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.11 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.85 ,90% of billed charges for outpatient setting,$23.85 ,90% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.28 ,72.76% of billed charges for outpatient setting,$18.09 ,68.25% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.39 ,80.72% of billed charges for outpatient setting,$21.39 ,80.72% of billed charges for outpatient setting,$23.48 ,88.61% of billed charges for outpatient setting,$17.57 ,66.30% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.38 ,92% of billed charges for outpatient setting,$25.18 ,95% of billed charges for outpatient setting,$25.71 ,97% of billed charges for outpatient setting,$17.23 ,65% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.85 ,90% of billed charges for outpatient setting,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$18.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.11 ,$102.86 ,$13.25 Outpatient Medical Services,LAB,83036,Blood test to measure average blood glucose levels for past 2-3 months,300,$79.00 ,$76.63 ,97% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.42 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.10 ,90% of billed charges for outpatient setting,$71.10 ,90% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$57.48 ,72.76% of billed charges for outpatient setting,$53.92 ,68.25% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.77 ,80.72% of billed charges for outpatient setting,$63.77 ,80.72% of billed charges for outpatient setting,$70.00 ,88.61% of billed charges for outpatient setting,$52.38 ,66.30% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.68 ,92% of billed charges for outpatient setting,$75.05 ,95% of billed charges for outpatient setting,$76.63 ,97% of billed charges for outpatient setting,$51.35 ,65% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.10 ,90% of billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$9.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.42 ,$102.86 ,$39.50 Outpatient Medical Services,LAB,83516,Chemical test of the blood to measure presence or concentration of a substance in the blood,300,$57.50 ,$55.78 ,97% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.84 ,72.76% of billed charges for outpatient setting,$39.24 ,68.25% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$46.41 ,80.72% of billed charges for outpatient setting,$46.41 ,80.72% of billed charges for outpatient setting,$50.95 ,88.61% of billed charges for outpatient setting,$38.12 ,66.30% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.90 ,92% of billed charges for outpatient setting,$54.63 ,95% of billed charges for outpatient setting,$55.78 ,97% of billed charges for outpatient setting,$37.38 ,65% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$11.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.99 ,$102.86 ,$28.75 Outpatient Medical Services,LAB,83540,Blood test to measure the amount of iron that is in transit in the body,300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.61 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,83550,Blood test that measures the amount of iron carried in the blood,300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.57 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,83605,Assay of lactic acid,300,$92.00 ,$89.24 ,97% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$66.94 ,72.76% of billed charges for outpatient setting,$62.79 ,68.25% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$74.26 ,80.72% of billed charges for outpatient setting,$74.26 ,80.72% of billed charges for outpatient setting,$81.52 ,88.61% of billed charges for outpatient setting,$61.00 ,66.30% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$84.64 ,92% of billed charges for outpatient setting,$87.40 ,95% of billed charges for outpatient setting,$89.24 ,97% of billed charges for outpatient setting,$59.80 ,65% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$11.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.26 ,$102.86 ,$46.00 Outpatient Medical Services,LAB,83690,Assay of lipase,300,$64.50 ,$62.57 ,97% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.97 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$58.05 ,90% of billed charges for outpatient setting,$58.05 ,90% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$46.93 ,72.76% of billed charges for outpatient setting,$44.02 ,68.25% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.06 ,80.72% of billed charges for outpatient setting,$52.06 ,80.72% of billed charges for outpatient setting,$57.15 ,88.61% of billed charges for outpatient setting,$42.76 ,66.30% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$59.34 ,92% of billed charges for outpatient setting,$61.28 ,95% of billed charges for outpatient setting,$62.57 ,97% of billed charges for outpatient setting,$41.93 ,65% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$58.05 ,90% of billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.97 ,$102.86 ,$32.25 Outpatient Medical Services,LAB,83735,Assay of magnesium,300,$21.50 ,$20.86 ,97% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.35 ,90% of billed charges for outpatient setting,$19.35 ,90% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.64 ,72.76% of billed charges for outpatient setting,$14.67 ,68.25% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.35 ,80.72% of billed charges for outpatient setting,$17.35 ,80.72% of billed charges for outpatient setting,$19.05 ,88.61% of billed charges for outpatient setting,$14.25 ,66.30% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.78 ,92% of billed charges for outpatient setting,$20.43 ,95% of billed charges for outpatient setting,$20.86 ,97% of billed charges for outpatient setting,$13.98 ,65% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.35 ,90% of billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.80 ,$102.86 ,$10.75 Outpatient Medical Services,LAB,83880,Blood test used to diagnose heart failure,300,$240.75 ,$233.53 ,97% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$216.68 ,90% of billed charges for outpatient setting,$216.68 ,90% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$175.17 ,72.76% of billed charges for outpatient setting,$164.31 ,68.25% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$194.33 ,80.72% of billed charges for outpatient setting,$194.33 ,80.72% of billed charges for outpatient setting,$213.33 ,88.61% of billed charges for outpatient setting,$159.62 ,66.30% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$221.49 ,92% of billed charges for outpatient setting,$228.71 ,95% of billed charges for outpatient setting,$233.53 ,97% of billed charges for outpatient setting,$156.49 ,65% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$216.68 ,90% of billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$39.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.62 ,$233.53 ,$120.38 Outpatient Medical Services,LAB,83970,Assay of parathormone,300,$256.50 ,$248.81 ,97% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$230.85 ,90% of billed charges for outpatient setting,$230.85 ,90% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$186.63 ,72.76% of billed charges for outpatient setting,$175.06 ,68.25% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$207.05 ,80.72% of billed charges for outpatient setting,$207.05 ,80.72% of billed charges for outpatient setting,$227.28 ,88.61% of billed charges for outpatient setting,$170.06 ,66.30% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$235.98 ,92% of billed charges for outpatient setting,$243.68 ,95% of billed charges for outpatient setting,$248.81 ,97% of billed charges for outpatient setting,$166.73 ,65% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$230.85 ,90% of billed charges for outpatient setting,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$41.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.77 ,$248.81 ,$128.25 Outpatient Medical Services,LAB,84100,Assay of phosphorus,300,$55.50 ,$53.84 ,97% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.11 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.95 ,90% of billed charges for outpatient setting,$49.95 ,90% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$40.38 ,72.76% of billed charges for outpatient setting,$37.88 ,68.25% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.80 ,80.72% of billed charges for outpatient setting,$44.80 ,80.72% of billed charges for outpatient setting,$49.18 ,88.61% of billed charges for outpatient setting,$36.80 ,66.30% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.06 ,92% of billed charges for outpatient setting,$52.73 ,95% of billed charges for outpatient setting,$53.84 ,97% of billed charges for outpatient setting,$36.08 ,65% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.95 ,90% of billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.11 ,$102.86 ,$27.75 Outpatient Medical Services,LAB,84132,Assay of serum potassium,300,$34.00 ,$32.98 ,97% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.60 ,90% of billed charges for outpatient setting,$30.60 ,90% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.74 ,72.76% of billed charges for outpatient setting,$23.21 ,68.25% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.44 ,80.72% of billed charges for outpatient setting,$27.44 ,80.72% of billed charges for outpatient setting,$30.13 ,88.61% of billed charges for outpatient setting,$22.54 ,66.30% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.28 ,92% of billed charges for outpatient setting,$32.30 ,95% of billed charges for outpatient setting,$32.98 ,97% of billed charges for outpatient setting,$22.10 ,65% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.60 ,90% of billed charges for outpatient setting,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.99 ,$102.86 ,$17.00 Outpatient Medical Services,LAB,84134,Blood test to measure level of prealbumin,300,$97.00 ,$94.09 ,97% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.64 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.30 ,90% of billed charges for outpatient setting,$87.30 ,90% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.58 ,72.76% of billed charges for outpatient setting,$66.20 ,68.25% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.30 ,80.72% of billed charges for outpatient setting,$78.30 ,80.72% of billed charges for outpatient setting,$85.95 ,88.61% of billed charges for outpatient setting,$64.31 ,66.30% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$89.24 ,92% of billed charges for outpatient setting,$92.15 ,95% of billed charges for outpatient setting,$94.09 ,97% of billed charges for outpatient setting,$63.05 ,65% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.30 ,90% of billed charges for outpatient setting,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.64 ,$102.86 ,$48.50 Outpatient Medical Services,LAB,84144,Assay of progesterone,300,$24.00 ,$23.28 ,97% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.60 ,90% of billed charges for outpatient setting,$21.60 ,90% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.46 ,72.76% of billed charges for outpatient setting,$16.38 ,68.25% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.37 ,80.72% of billed charges for outpatient setting,$19.37 ,80.72% of billed charges for outpatient setting,$21.27 ,88.61% of billed charges for outpatient setting,$15.91 ,66.30% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.08 ,92% of billed charges for outpatient setting,$22.80 ,95% of billed charges for outpatient setting,$23.28 ,97% of billed charges for outpatient setting,$15.60 ,65% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.60 ,90% of billed charges for outpatient setting,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$20.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.60 ,$102.86 ,$12.00 Outpatient Medical Services,LAB,84145,Procalcitonin (pct),300,$285.50 ,$276.94 ,97% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$256.95 ,90% of billed charges for outpatient setting,$256.95 ,90% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$207.73 ,72.76% of billed charges for outpatient setting,$194.85 ,68.25% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$230.46 ,80.72% of billed charges for outpatient setting,$230.46 ,80.72% of billed charges for outpatient setting,$252.98 ,88.61% of billed charges for outpatient setting,$189.29 ,66.30% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$262.66 ,92% of billed charges for outpatient setting,$271.23 ,95% of billed charges for outpatient setting,$276.94 ,97% of billed charges for outpatient setting,$185.58 ,65% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$256.95 ,90% of billed charges for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.22 ,$276.94 ,$142.75 Outpatient Medical Services,LAB,84146,Assay of prolactin,300,$19.50 ,$18.92 ,97% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.79 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.55 ,90% of billed charges for outpatient setting,$17.55 ,90% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.19 ,72.76% of billed charges for outpatient setting,$13.31 ,68.25% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.74 ,80.72% of billed charges for outpatient setting,$15.74 ,80.72% of billed charges for outpatient setting,$17.28 ,88.61% of billed charges for outpatient setting,$12.93 ,66.30% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.94 ,92% of billed charges for outpatient setting,$18.53 ,95% of billed charges for outpatient setting,$18.92 ,97% of billed charges for outpatient setting,$12.68 ,65% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.55 ,90% of billed charges for outpatient setting,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$19.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.68 ,$102.86 ,$9.75 Outpatient Medical Services,LAB,84153,PSA (prostate specific antigen),300,$85.50 ,$82.94 ,97% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.95 ,90% of billed charges for outpatient setting,$76.95 ,90% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.21 ,72.76% of billed charges for outpatient setting,$58.35 ,68.25% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$69.02 ,80.72% of billed charges for outpatient setting,$69.02 ,80.72% of billed charges for outpatient setting,$75.76 ,88.61% of billed charges for outpatient setting,$56.69 ,66.30% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.66 ,92% of billed charges for outpatient setting,$81.23 ,95% of billed charges for outpatient setting,$82.94 ,97% of billed charges for outpatient setting,$55.58 ,65% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.95 ,90% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.94 ,$102.86 ,$42.75 Outpatient Medical Services,LAB,84154,PSA (prostate specific antigen) measurement,300,$241.75 ,$234.50 ,97% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$217.58 ,90% of billed charges for outpatient setting,$217.58 ,90% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$175.90 ,72.76% of billed charges for outpatient setting,$164.99 ,68.25% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$195.14 ,80.72% of billed charges for outpatient setting,$195.14 ,80.72% of billed charges for outpatient setting,$214.21 ,88.61% of billed charges for outpatient setting,$160.28 ,66.30% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$222.41 ,92% of billed charges for outpatient setting,$229.66 ,95% of billed charges for outpatient setting,$234.50 ,97% of billed charges for outpatient setting,$157.14 ,65% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$217.58 ,90% of billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$18.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.94 ,$234.50 ,$120.88 Outpatient Medical Services,LAB,84156,Assay of protein urine,300,$57.50 ,$55.78 ,97% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.84 ,72.76% of billed charges for outpatient setting,$39.24 ,68.25% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$46.41 ,80.72% of billed charges for outpatient setting,$46.41 ,80.72% of billed charges for outpatient setting,$50.95 ,88.61% of billed charges for outpatient setting,$38.12 ,66.30% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.90 ,92% of billed charges for outpatient setting,$54.63 ,95% of billed charges for outpatient setting,$55.78 ,97% of billed charges for outpatient setting,$37.38 ,65% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.75 ,90% of billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.17 ,$102.86 ,$28.75 Outpatient Medical Services,LAB,84402,Assay of free testosterone,300,$182.75 ,$177.27 ,97% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$164.48 ,90% of billed charges for outpatient setting,$164.48 ,90% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$132.97 ,72.76% of billed charges for outpatient setting,$124.73 ,68.25% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.52 ,80.72% of billed charges for outpatient setting,$147.52 ,80.72% of billed charges for outpatient setting,$161.93 ,88.61% of billed charges for outpatient setting,$121.16 ,66.30% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$168.13 ,92% of billed charges for outpatient setting,$173.61 ,95% of billed charges for outpatient setting,$177.27 ,97% of billed charges for outpatient setting,$118.79 ,65% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$164.48 ,90% of billed charges for outpatient setting,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$25.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.07 ,$177.27 ,$91.38 Outpatient Medical Services,LAB,84403,Assay of total testosterone,300,$216.75 ,$210.25 ,97% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$195.08 ,90% of billed charges for outpatient setting,$195.08 ,90% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$157.71 ,72.76% of billed charges for outpatient setting,$147.93 ,68.25% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$174.96 ,80.72% of billed charges for outpatient setting,$174.96 ,80.72% of billed charges for outpatient setting,$192.06 ,88.61% of billed charges for outpatient setting,$143.71 ,66.30% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$199.41 ,92% of billed charges for outpatient setting,$205.91 ,95% of billed charges for outpatient setting,$210.25 ,97% of billed charges for outpatient setting,$140.89 ,65% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$195.08 ,90% of billed charges for outpatient setting,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$25.81 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.37 ,$210.25 ,$108.38 Outpatient Medical Services,LAB,84439,Blood test to evaluate thyroid function,300,$33.75 ,$32.74 ,97% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.38 ,90% of billed charges for outpatient setting,$30.38 ,90% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.56 ,72.76% of billed charges for outpatient setting,$23.03 ,68.25% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.24 ,80.72% of billed charges for outpatient setting,$27.24 ,80.72% of billed charges for outpatient setting,$29.91 ,88.61% of billed charges for outpatient setting,$22.38 ,66.30% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.05 ,92% of billed charges for outpatient setting,$32.06 ,95% of billed charges for outpatient setting,$32.74 ,97% of billed charges for outpatient setting,$21.94 ,65% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.38 ,90% of billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$9.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.82 ,$102.86 ,$16.88 Outpatient Medical Services,LAB,84443,"Blood test, thyroid stimulating hormone (TSH)",300,$111.25 ,$107.91 ,97% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.13 ,90% of billed charges for outpatient setting,$100.13 ,90% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.95 ,72.76% of billed charges for outpatient setting,$75.93 ,68.25% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$89.80 ,80.72% of billed charges for outpatient setting,$89.80 ,80.72% of billed charges for outpatient setting,$98.58 ,88.61% of billed charges for outpatient setting,$73.76 ,66.30% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.35 ,92% of billed charges for outpatient setting,$105.69 ,95% of billed charges for outpatient setting,$107.91 ,97% of billed charges for outpatient setting,$72.31 ,65% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.13 ,90% of billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.56 ,$107.91 ,$55.63 Outpatient Medical Services,LAB,84450,Transferase (ast) (sgot),300,$37.00 ,$35.89 ,97% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,72.76% of billed charges for outpatient setting,$25.25 ,68.25% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$29.87 ,80.72% of billed charges for outpatient setting,$32.79 ,88.61% of billed charges for outpatient setting,$24.53 ,66.30% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.04 ,92% of billed charges for outpatient setting,$35.15 ,95% of billed charges for outpatient setting,$35.89 ,97% of billed charges for outpatient setting,$24.05 ,65% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,$102.86 ,$18.50 Outpatient Medical Services,LAB,84460,Blood test to evaluate liver function,301,$39.00 ,$37.83 ,97% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.10 ,90% of billed charges for outpatient setting,$35.10 ,90% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.38 ,72.76% of billed charges for outpatient setting,$26.62 ,68.25% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.48 ,80.72% of billed charges for outpatient setting,$31.48 ,80.72% of billed charges for outpatient setting,$34.56 ,88.61% of billed charges for outpatient setting,$25.86 ,66.30% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.88 ,92% of billed charges for outpatient setting,$37.05 ,95% of billed charges for outpatient setting,$37.83 ,97% of billed charges for outpatient setting,$25.35 ,65% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.10 ,90% of billed charges for outpatient setting,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.59 ,$102.86 ,$19.50 Outpatient Medical Services,LAB,84478,Assay of triglycerides,301,$74.50 ,$72.27 ,97% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.98 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.05 ,90% of billed charges for outpatient setting,$67.05 ,90% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.21 ,72.76% of billed charges for outpatient setting,$50.85 ,68.25% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.14 ,80.72% of billed charges for outpatient setting,$60.14 ,80.72% of billed charges for outpatient setting,$66.01 ,88.61% of billed charges for outpatient setting,$49.39 ,66.30% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$68.54 ,92% of billed charges for outpatient setting,$70.78 ,95% of billed charges for outpatient setting,$72.27 ,97% of billed charges for outpatient setting,$48.43 ,65% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.05 ,90% of billed charges for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.98 ,$102.86 ,$37.25 Outpatient Medical Services,LAB,84481,Free assay (ft-3),300,$248.50 ,$241.05 ,97% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.81 ,72.76% of billed charges for outpatient setting,$169.60 ,68.25% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$200.59 ,80.72% of billed charges for outpatient setting,$200.59 ,80.72% of billed charges for outpatient setting,$220.20 ,88.61% of billed charges for outpatient setting,$164.76 ,66.30% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$228.62 ,92% of billed charges for outpatient setting,$236.08 ,95% of billed charges for outpatient setting,$241.05 ,97% of billed charges for outpatient setting,$161.53 ,65% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.68 ,$241.05 ,$124.25 Outpatient Medical Services,LAB,84484,Blood test to measure a certain protein in the blood to determine heart muscle damage,300,$95.75 ,$92.88 ,97% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.18 ,90% of billed charges for outpatient setting,$86.18 ,90% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$69.67 ,72.76% of billed charges for outpatient setting,$65.35 ,68.25% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$77.29 ,80.72% of billed charges for outpatient setting,$77.29 ,80.72% of billed charges for outpatient setting,$84.84 ,88.61% of billed charges for outpatient setting,$63.48 ,66.30% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.09 ,92% of billed charges for outpatient setting,$90.96 ,95% of billed charges for outpatient setting,$92.88 ,97% of billed charges for outpatient setting,$62.24 ,65% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.18 ,90% of billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$12.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.73 ,$102.86 ,$47.88 Outpatient Medical Services,LAB,84520,Assay of urea nitrogen,300,$38.75 ,$37.59 ,97% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.42 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.88 ,90% of billed charges for outpatient setting,$34.88 ,90% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.19 ,72.76% of billed charges for outpatient setting,$26.45 ,68.25% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.28 ,80.72% of billed charges for outpatient setting,$31.28 ,80.72% of billed charges for outpatient setting,$34.34 ,88.61% of billed charges for outpatient setting,$25.69 ,66.30% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.65 ,92% of billed charges for outpatient setting,$36.81 ,95% of billed charges for outpatient setting,$37.59 ,97% of billed charges for outpatient setting,$25.19 ,65% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.88 ,90% of billed charges for outpatient setting,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.42 ,$102.86 ,$19.38 Outpatient Medical Services,LAB,84550,Assay of blood/uric acid,300,$62.00 ,$60.14 ,97% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.80 ,90% of billed charges for outpatient setting,$55.80 ,90% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$45.11 ,72.76% of billed charges for outpatient setting,$42.32 ,68.25% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$50.05 ,80.72% of billed charges for outpatient setting,$50.05 ,80.72% of billed charges for outpatient setting,$54.94 ,88.61% of billed charges for outpatient setting,$41.11 ,66.30% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$57.04 ,92% of billed charges for outpatient setting,$58.90 ,95% of billed charges for outpatient setting,$60.14 ,97% of billed charges for outpatient setting,$40.30 ,65% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.80 ,90% of billed charges for outpatient setting,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.92 ,$102.86 ,$31.00 Outpatient Medical Services,LAB,84702,Chorionic gonadotropin test,300,$198.75 ,$192.79 ,97% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$144.61 ,72.76% of billed charges for outpatient setting,$135.65 ,68.25% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$160.43 ,80.72% of billed charges for outpatient setting,$160.43 ,80.72% of billed charges for outpatient setting,$176.11 ,88.61% of billed charges for outpatient setting,$131.77 ,66.30% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$182.85 ,92% of billed charges for outpatient setting,$188.81 ,95% of billed charges for outpatient setting,$192.79 ,97% of billed charges for outpatient setting,$129.19 ,65% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$15.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.05 ,$192.79 ,$99.38 Outpatient Medical Services,LAB,84703,Blood test to assess for pregnancy,300,$120.50 ,$116.89 ,97% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.45 ,90% of billed charges for outpatient setting,$108.45 ,90% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.68 ,72.76% of billed charges for outpatient setting,$82.24 ,68.25% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$97.27 ,80.72% of billed charges for outpatient setting,$97.27 ,80.72% of billed charges for outpatient setting,$106.78 ,88.61% of billed charges for outpatient setting,$79.89 ,66.30% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.86 ,92% of billed charges for outpatient setting,$114.48 ,95% of billed charges for outpatient setting,$116.89 ,97% of billed charges for outpatient setting,$78.33 ,65% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.45 ,90% of billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$7.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.52 ,$116.89 ,$60.25 Outpatient Medical Services,LAB,85007,Blood test to assess for infection,300,$36.00 ,$34.92 ,97% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.98 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.40 ,90% of billed charges for outpatient setting,$32.40 ,90% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.19 ,72.76% of billed charges for outpatient setting,$24.57 ,68.25% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.06 ,80.72% of billed charges for outpatient setting,$29.06 ,80.72% of billed charges for outpatient setting,$31.90 ,88.61% of billed charges for outpatient setting,$23.87 ,66.30% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.12 ,92% of billed charges for outpatient setting,$34.20 ,95% of billed charges for outpatient setting,$34.92 ,97% of billed charges for outpatient setting,$23.40 ,65% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.40 ,90% of billed charges for outpatient setting,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$3.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.98 ,$102.86 ,$18.00 Outpatient Medical Services,LAB,85014,Hematocrit,300,$18.50 ,$17.95 ,97% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.46 ,72.76% of billed charges for outpatient setting,$12.63 ,68.25% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$16.39 ,88.61% of billed charges for outpatient setting,$12.27 ,66.30% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.02 ,92% of billed charges for outpatient setting,$17.58 ,95% of billed charges for outpatient setting,$17.95 ,97% of billed charges for outpatient setting,$12.03 ,65% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.05 ,$102.86 ,$9.25 Outpatient Medical Services,LAB,85018,Blood test to measure levels of hemoglobin,300,$18.50 ,$17.95 ,97% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.46 ,72.76% of billed charges for outpatient setting,$12.63 ,68.25% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$16.39 ,88.61% of billed charges for outpatient setting,$12.27 ,66.30% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.02 ,92% of billed charges for outpatient setting,$17.58 ,95% of billed charges for outpatient setting,$17.95 ,97% of billed charges for outpatient setting,$12.03 ,65% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$2.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.05 ,$102.86 ,$9.25 Outpatient Medical Services,LAB,85025,"Complete blood cell count, with differential white blood cells, automated",300,$79.50 ,$77.12 ,97% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.73 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.55 ,90% of billed charges for outpatient setting,$71.55 ,90% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$57.84 ,72.76% of billed charges for outpatient setting,$54.26 ,68.25% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.17 ,80.72% of billed charges for outpatient setting,$64.17 ,80.72% of billed charges for outpatient setting,$70.44 ,88.61% of billed charges for outpatient setting,$52.71 ,66.30% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$73.14 ,92% of billed charges for outpatient setting,$75.53 ,95% of billed charges for outpatient setting,$77.12 ,97% of billed charges for outpatient setting,$51.68 ,65% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.55 ,90% of billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$7.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.73 ,$102.86 ,$39.75 Outpatient Medical Services,LAB,85027,"Complete blood count, automated",300,$48.75 ,$47.29 ,97% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$43.88 ,90% of billed charges for outpatient setting,$43.88 ,90% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.47 ,72.76% of billed charges for outpatient setting,$33.27 ,68.25% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.35 ,80.72% of billed charges for outpatient setting,$39.35 ,80.72% of billed charges for outpatient setting,$43.20 ,88.61% of billed charges for outpatient setting,$32.32 ,66.30% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.85 ,92% of billed charges for outpatient setting,$46.31 ,95% of billed charges for outpatient setting,$47.29 ,97% of billed charges for outpatient setting,$31.69 ,65% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$43.88 ,90% of billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.60 ,$102.86 ,$24.38 Outpatient Medical Services,LAB,85610,"Blood test, clotting time",300,$42.50 ,$41.23 ,97% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.92 ,72.76% of billed charges for outpatient setting,$29.01 ,68.25% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.31 ,80.72% of billed charges for outpatient setting,$34.31 ,80.72% of billed charges for outpatient setting,$37.66 ,88.61% of billed charges for outpatient setting,$28.18 ,66.30% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.10 ,92% of billed charges for outpatient setting,$40.38 ,95% of billed charges for outpatient setting,$41.23 ,97% of billed charges for outpatient setting,$27.63 ,65% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.25 ,90% of billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.29 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.41 ,$102.86 ,$21.25 Outpatient Medical Services,LAB,85651,Rbc sed rate nonautomated,300,$39.75 ,$38.56 ,97% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.33 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.78 ,90% of billed charges for outpatient setting,$35.78 ,90% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.92 ,72.76% of billed charges for outpatient setting,$27.13 ,68.25% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.09 ,80.72% of billed charges for outpatient setting,$32.09 ,80.72% of billed charges for outpatient setting,$35.22 ,88.61% of billed charges for outpatient setting,$26.35 ,66.30% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.57 ,92% of billed charges for outpatient setting,$37.76 ,95% of billed charges for outpatient setting,$38.56 ,97% of billed charges for outpatient setting,$25.84 ,65% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.78 ,90% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.33 ,$102.86 ,$19.88 Outpatient Medical Services,LAB,85730,Coagulation assessment blood test,300,$60.75 ,$58.93 ,97% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.68 ,90% of billed charges for outpatient setting,$54.68 ,90% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.20 ,72.76% of billed charges for outpatient setting,$41.46 ,68.25% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.04 ,80.72% of billed charges for outpatient setting,$49.04 ,80.72% of billed charges for outpatient setting,$53.83 ,88.61% of billed charges for outpatient setting,$40.28 ,66.30% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.89 ,92% of billed charges for outpatient setting,$57.71 ,95% of billed charges for outpatient setting,$58.93 ,97% of billed charges for outpatient setting,$39.49 ,65% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.68 ,90% of billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.20 ,$102.86 ,$30.38 Outpatient Medical Services,LAB,86038,Antinuclear antibodies,300,$15.25 ,$14.79 ,97% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.48 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,90% of billed charges for outpatient setting,$13.73 ,90% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$11.10 ,72.76% of billed charges for outpatient setting,$10.41 ,68.25% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.31 ,80.72% of billed charges for outpatient setting,$12.31 ,80.72% of billed charges for outpatient setting,$13.51 ,88.61% of billed charges for outpatient setting,$10.11 ,66.30% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.03 ,92% of billed charges for outpatient setting,$14.49 ,95% of billed charges for outpatient setting,$14.79 ,97% of billed charges for outpatient setting,$9.91 ,65% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.73 ,90% of billed charges for outpatient setting,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$12.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.91 ,$102.86 ,$7.63 Outpatient Medical Services,LAB,86140,C-reactive protein,300,$67.50 ,$65.48 ,97% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.75 ,90% of billed charges for outpatient setting,$60.75 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$49.11 ,72.76% of billed charges for outpatient setting,$46.07 ,68.25% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$54.49 ,80.72% of billed charges for outpatient setting,$54.49 ,80.72% of billed charges for outpatient setting,$59.81 ,88.61% of billed charges for outpatient setting,$44.75 ,66.30% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.10 ,92% of billed charges for outpatient setting,$64.13 ,95% of billed charges for outpatient setting,$65.48 ,97% of billed charges for outpatient setting,$43.88 ,65% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.75 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,$102.86 ,$33.75 Outpatient Medical Services,LAB,86308,Heterophile antibody screen,300,$65.50 ,$63.54 ,97% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$58.95 ,90% of billed charges for outpatient setting,$58.95 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.66 ,72.76% of billed charges for outpatient setting,$44.70 ,68.25% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.87 ,80.72% of billed charges for outpatient setting,$52.87 ,80.72% of billed charges for outpatient setting,$58.04 ,88.61% of billed charges for outpatient setting,$43.43 ,66.30% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.26 ,92% of billed charges for outpatient setting,$62.23 ,95% of billed charges for outpatient setting,$63.54 ,97% of billed charges for outpatient setting,$42.58 ,65% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$58.95 ,90% of billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$5.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.49 ,$102.86 ,$32.75 Outpatient Medical Services,LAB,86317,Immunoassay infectious agent,300,$36.25 ,$35.16 ,97% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.63 ,90% of billed charges for outpatient setting,$32.63 ,90% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.38 ,72.76% of billed charges for outpatient setting,$24.74 ,68.25% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.26 ,80.72% of billed charges for outpatient setting,$29.26 ,80.72% of billed charges for outpatient setting,$32.12 ,88.61% of billed charges for outpatient setting,$24.03 ,66.30% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.35 ,92% of billed charges for outpatient setting,$34.44 ,95% of billed charges for outpatient setting,$35.16 ,97% of billed charges for outpatient setting,$23.56 ,65% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.63 ,90% of billed charges for outpatient setting,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.99 ,$102.86 ,$18.13 Outpatient Medical Services,LAB,86376,Microsomal antibody each,300,$31.00 ,$30.07 ,97% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.56 ,72.76% of billed charges for outpatient setting,$21.16 ,68.25% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.02 ,80.72% of billed charges for outpatient setting,$25.02 ,80.72% of billed charges for outpatient setting,$27.47 ,88.61% of billed charges for outpatient setting,$20.55 ,66.30% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.52 ,92% of billed charges for outpatient setting,$29.45 ,95% of billed charges for outpatient setting,$30.07 ,97% of billed charges for outpatient setting,$20.15 ,65% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.90 ,90% of billed charges for outpatient setting,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.61 ,$102.86 ,$15.50 Outpatient Medical Services,LAB,86430,Rheumatoid factor test qual,300,$51.75 ,$50.20 ,97% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.91 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$46.58 ,90% of billed charges for outpatient setting,$46.58 ,90% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.65 ,72.76% of billed charges for outpatient setting,$35.32 ,68.25% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.77 ,80.72% of billed charges for outpatient setting,$41.77 ,80.72% of billed charges for outpatient setting,$45.86 ,88.61% of billed charges for outpatient setting,$34.31 ,66.30% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.61 ,92% of billed charges for outpatient setting,$49.16 ,95% of billed charges for outpatient setting,$50.20 ,97% of billed charges for outpatient setting,$33.64 ,65% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$46.58 ,90% of billed charges for outpatient setting,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.91 ,$102.86 ,$25.88 Outpatient Medical Services,LAB,86580,Tb intradermal test,300,$27.25 ,$26.43 ,97% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.91 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.53 ,90% of billed charges for outpatient setting,$24.53 ,90% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$19.83 ,72.76% of billed charges for outpatient setting,$18.60 ,68.25% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.00 ,80.72% of billed charges for outpatient setting,$22.00 ,80.72% of billed charges for outpatient setting,$24.15 ,88.61% of billed charges for outpatient setting,$18.07 ,66.30% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.07 ,92% of billed charges for outpatient setting,$25.89 ,95% of billed charges for outpatient setting,$26.43 ,97% of billed charges for outpatient setting,$17.71 ,65% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.53 ,90% of billed charges for outpatient setting,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.91 ,$102.86 ,$13.63 Outpatient Medical Services,LAB,86592,Blood test to screen for syphilis,300,$11.50 ,$11.16 ,97% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.35 ,90% of billed charges for outpatient setting,$10.35 ,90% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.37 ,72.76% of billed charges for outpatient setting,$7.85 ,68.25% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.28 ,80.72% of billed charges for outpatient setting,$9.28 ,80.72% of billed charges for outpatient setting,$10.19 ,88.61% of billed charges for outpatient setting,$7.62 ,66.30% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.58 ,92% of billed charges for outpatient setting,$10.93 ,95% of billed charges for outpatient setting,$11.16 ,97% of billed charges for outpatient setting,$7.48 ,65% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.35 ,90% of billed charges for outpatient setting,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$3.71 ,$102.86 ,$5.75 Outpatient Medical Services,LAB,86617,Lyme disease antibody,300,$334.75 ,$324.71 ,97% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.42 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.28 ,90% of billed charges for outpatient setting,$301.28 ,90% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.56 ,72.76% of billed charges for outpatient setting,$228.47 ,68.25% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.21 ,80.72% of billed charges for outpatient setting,$270.21 ,80.72% of billed charges for outpatient setting,$296.62 ,88.61% of billed charges for outpatient setting,$221.94 ,66.30% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$307.97 ,92% of billed charges for outpatient setting,$318.01 ,95% of billed charges for outpatient setting,$324.71 ,97% of billed charges for outpatient setting,$217.59 ,65% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.28 ,90% of billed charges for outpatient setting,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$15.49 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.42 ,$324.71 ,$167.38 Outpatient Medical Services,LAB,86618,Lyme disease antibody,300,$69.25 ,$67.17 ,97% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.33 ,90% of billed charges for outpatient setting,$62.33 ,90% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$50.39 ,72.76% of billed charges for outpatient setting,$47.26 ,68.25% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$55.90 ,80.72% of billed charges for outpatient setting,$55.90 ,80.72% of billed charges for outpatient setting,$61.36 ,88.61% of billed charges for outpatient setting,$45.91 ,66.30% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.71 ,92% of billed charges for outpatient setting,$65.79 ,95% of billed charges for outpatient setting,$67.17 ,97% of billed charges for outpatient setting,$45.01 ,65% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$62.33 ,90% of billed charges for outpatient setting,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$17.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.76 ,$102.86 ,$34.63 Outpatient Medical Services,LAB,86677,Blood test to if peptic ulcers are caused by a certain bacterium,300,$52.75 ,$51.17 ,97% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.48 ,90% of billed charges for outpatient setting,$47.48 ,90% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.38 ,72.76% of billed charges for outpatient setting,$36.00 ,68.25% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.58 ,80.72% of billed charges for outpatient setting,$42.58 ,80.72% of billed charges for outpatient setting,$46.74 ,88.61% of billed charges for outpatient setting,$34.97 ,66.30% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$48.53 ,92% of billed charges for outpatient setting,$50.11 ,95% of billed charges for outpatient setting,$51.17 ,97% of billed charges for outpatient setting,$34.29 ,65% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.48 ,90% of billed charges for outpatient setting,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.14 ,$102.86 ,$26.38 Outpatient Medical Services,LAB,86803,Blood test to determine infection with Hepatitis C,300,$29.00 ,$28.13 ,97% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.36 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.10 ,90% of billed charges for outpatient setting,$26.10 ,90% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.10 ,72.76% of billed charges for outpatient setting,$19.79 ,68.25% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.41 ,80.72% of billed charges for outpatient setting,$23.41 ,80.72% of billed charges for outpatient setting,$25.70 ,88.61% of billed charges for outpatient setting,$19.23 ,66.30% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.68 ,92% of billed charges for outpatient setting,$27.55 ,95% of billed charges for outpatient setting,$28.13 ,97% of billed charges for outpatient setting,$18.85 ,65% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.10 ,90% of billed charges for outpatient setting,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$14.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.36 ,$102.86 ,$14.50 Outpatient Medical Services,LAB,86850,Blood test to screen for antibodies that could harm red blood cells,300,$131.50 ,$127.56 ,97% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,90% of billed charges for outpatient setting,$118.35 ,90% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.68 ,72.76% of billed charges for outpatient setting,$89.75 ,68.25% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$106.15 ,80.72% of billed charges for outpatient setting,$106.15 ,80.72% of billed charges for outpatient setting,$116.52 ,88.61% of billed charges for outpatient setting,$87.18 ,66.30% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$120.98 ,92% of billed charges for outpatient setting,$124.93 ,95% of billed charges for outpatient setting,$127.56 ,97% of billed charges for outpatient setting,$85.48 ,65% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,90% of billed charges for outpatient setting,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$9.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.62 ,$127.56 ,$65.75 Outpatient Medical Services,LAB,86900,Blood typing serologic abo,300,$40.00 ,$38.80 ,97% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.10 ,72.76% of billed charges for outpatient setting,$27.30 ,68.25% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.29 ,80.72% of billed charges for outpatient setting,$32.29 ,80.72% of billed charges for outpatient setting,$35.44 ,88.61% of billed charges for outpatient setting,$26.52 ,66.30% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.80 ,92% of billed charges for outpatient setting,$38.00 ,95% of billed charges for outpatient setting,$38.80 ,97% of billed charges for outpatient setting,$26.00 ,65% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.59 ,$102.86 ,$20.00 Outpatient Medical Services,LAB,86901,Blood typing serologic rh(d),300,$40.00 ,$38.80 ,97% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.10 ,72.76% of billed charges for outpatient setting,$27.30 ,68.25% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.29 ,80.72% of billed charges for outpatient setting,$32.29 ,80.72% of billed charges for outpatient setting,$35.44 ,88.61% of billed charges for outpatient setting,$26.52 ,66.30% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.80 ,92% of billed charges for outpatient setting,$38.00 ,95% of billed charges for outpatient setting,$38.80 ,97% of billed charges for outpatient setting,$26.00 ,65% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.00 ,90% of billed charges for outpatient setting,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$2.99 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.59 ,$102.86 ,$20.00 Outpatient Medical Services,LAB,87040,Blood test to screen for bacteria in the blood,300,$198.75 ,$192.79 ,97% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$144.61 ,72.76% of billed charges for outpatient setting,$135.65 ,68.25% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$160.43 ,80.72% of billed charges for outpatient setting,$160.43 ,80.72% of billed charges for outpatient setting,$176.11 ,88.61% of billed charges for outpatient setting,$131.77 ,66.30% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$182.85 ,92% of billed charges for outpatient setting,$188.81 ,95% of billed charges for outpatient setting,$192.79 ,97% of billed charges for outpatient setting,$129.19 ,65% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$178.88 ,90% of billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$10.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.95 ,$192.79 ,$99.38 Outpatient Medical Services,LAB,87070,Test of body fluid other than blood to assess for bacteria,300,$87.50 ,$84.88 ,97% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.75 ,90% of billed charges for outpatient setting,$78.75 ,90% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.67 ,72.76% of billed charges for outpatient setting,$59.72 ,68.25% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.63 ,80.72% of billed charges for outpatient setting,$70.63 ,80.72% of billed charges for outpatient setting,$77.53 ,88.61% of billed charges for outpatient setting,$58.01 ,66.30% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.50 ,92% of billed charges for outpatient setting,$83.13 ,95% of billed charges for outpatient setting,$84.88 ,97% of billed charges for outpatient setting,$56.88 ,65% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.75 ,90% of billed charges for outpatient setting,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.46 ,$102.86 ,$43.75 Outpatient Medical Services,LAB,87077,Test of a wound for type of bacterial infection,300,$58.50 ,$56.75 ,97% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.65 ,90% of billed charges for outpatient setting,$52.65 ,90% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.56 ,72.76% of billed charges for outpatient setting,$39.93 ,68.25% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$47.22 ,80.72% of billed charges for outpatient setting,$47.22 ,80.72% of billed charges for outpatient setting,$51.84 ,88.61% of billed charges for outpatient setting,$38.79 ,66.30% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$53.82 ,92% of billed charges for outpatient setting,$55.58 ,95% of billed charges for outpatient setting,$56.75 ,97% of billed charges for outpatient setting,$38.03 ,65% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.65 ,90% of billed charges for outpatient setting,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.00 ,$102.86 ,$29.25 Outpatient Medical Services,LAB,87081,Medical test to find an infection,300,$92.00 ,$89.24 ,97% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$66.94 ,72.76% of billed charges for outpatient setting,$62.79 ,68.25% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$74.26 ,80.72% of billed charges for outpatient setting,$74.26 ,80.72% of billed charges for outpatient setting,$81.52 ,88.61% of billed charges for outpatient setting,$61.00 ,66.30% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$84.64 ,92% of billed charges for outpatient setting,$87.40 ,95% of billed charges for outpatient setting,$89.24 ,97% of billed charges for outpatient setting,$59.80 ,65% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.80 ,90% of billed charges for outpatient setting,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$6.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.74 ,$102.86 ,$46.00 Outpatient Medical Services,LAB,87086,Culture of the urine to determine number of bacteria,300,$87.25 ,$84.63 ,97% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.53 ,90% of billed charges for outpatient setting,$78.53 ,90% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.48 ,72.76% of billed charges for outpatient setting,$59.55 ,68.25% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$70.43 ,80.72% of billed charges for outpatient setting,$70.43 ,80.72% of billed charges for outpatient setting,$77.31 ,88.61% of billed charges for outpatient setting,$57.85 ,66.30% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.27 ,92% of billed charges for outpatient setting,$82.89 ,95% of billed charges for outpatient setting,$84.63 ,97% of billed charges for outpatient setting,$56.71 ,65% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.53 ,90% of billed charges for outpatient setting,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.00 ,$102.86 ,$43.63 Outpatient Medical Services,LAB,87186,A test used to determine which medications work on bacteria for fungi,300,$41.25 ,$40.01 ,97% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.13 ,90% of billed charges for outpatient setting,$37.13 ,90% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.01 ,72.76% of billed charges for outpatient setting,$28.15 ,68.25% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.30 ,80.72% of billed charges for outpatient setting,$33.30 ,80.72% of billed charges for outpatient setting,$36.55 ,88.61% of billed charges for outpatient setting,$27.35 ,66.30% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.95 ,92% of billed charges for outpatient setting,$39.19 ,95% of billed charges for outpatient setting,$40.01 ,97% of billed charges for outpatient setting,$26.81 ,65% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.13 ,90% of billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.50 ,$102.86 ,$20.63 Outpatient Medical Services,LAB,87389,Test for HIV,300,$11.75 ,$11.40 ,97% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.55 ,72.76% of billed charges for outpatient setting,$8.02 ,68.25% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$9.48 ,80.72% of billed charges for outpatient setting,$9.48 ,80.72% of billed charges for outpatient setting,$10.41 ,88.61% of billed charges for outpatient setting,$7.79 ,66.30% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.81 ,92% of billed charges for outpatient setting,$11.16 ,95% of billed charges for outpatient setting,$11.40 ,97% of billed charges for outpatient setting,$7.64 ,65% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$10.58 ,90% of billed charges for outpatient setting,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$24.08 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.64 ,$102.86 ,$5.88 Outpatient Medical Services,LAB,87486,Chylmd pneum dna amp probe,300,$488.75 ,$474.09 ,97% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$439.88 ,90% of billed charges for outpatient setting,$439.88 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$355.61 ,72.76% of billed charges for outpatient setting,$333.57 ,68.25% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$394.52 ,80.72% of billed charges for outpatient setting,$394.52 ,80.72% of billed charges for outpatient setting,$433.08 ,88.61% of billed charges for outpatient setting,$324.04 ,66.30% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$449.65 ,92% of billed charges for outpatient setting,$464.31 ,95% of billed charges for outpatient setting,$474.09 ,97% of billed charges for outpatient setting,$317.69 ,65% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$439.88 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,$474.09 ,$244.38 Outpatient Medical Services,LAB,87491,Test that detects Chlamydia,300,$378.75 ,$367.39 ,97% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$340.88 ,90% of billed charges for outpatient setting,$340.88 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$275.58 ,72.76% of billed charges for outpatient setting,$258.50 ,68.25% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$305.73 ,80.72% of billed charges for outpatient setting,$305.73 ,80.72% of billed charges for outpatient setting,$335.61 ,88.61% of billed charges for outpatient setting,$251.11 ,66.30% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$348.45 ,92% of billed charges for outpatient setting,$359.81 ,95% of billed charges for outpatient setting,$367.39 ,97% of billed charges for outpatient setting,$246.19 ,65% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$340.88 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,$367.39 ,$189.38 Outpatient Medical Services,LAB,87507,Iadna-dna/rna probe tq 12-25,300,"$1,239.00 ","$1,201.83 ",97% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$361.21 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,115.10 ",90% of billed charges for outpatient setting,"$1,115.10 ",90% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$901.50 ,72.76% of billed charges for outpatient setting,$845.62 ,68.25% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,000.12 ",80.72% of billed charges for outpatient setting,"$1,000.12 ",80.72% of billed charges for outpatient setting,"$1,097.88 ",88.61% of billed charges for outpatient setting,$821.46 ,66.30% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,139.88 ",92% of billed charges for outpatient setting,"$1,177.05 ",95% of billed charges for outpatient setting,"$1,201.83 ",97% of billed charges for outpatient setting,$805.35 ,65% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,115.10 ",90% of billed charges for outpatient setting,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$416.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$901.50 ,$619.50 Outpatient Medical Services,LAB,87581,M.pneumon dna amp probe,306,$105.00 ,$101.85 ,97% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.50 ,90% of billed charges for outpatient setting,$94.50 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.40 ,72.76% of billed charges for outpatient setting,$71.66 ,68.25% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$84.76 ,80.72% of billed charges for outpatient setting,$84.76 ,80.72% of billed charges for outpatient setting,$93.04 ,88.61% of billed charges for outpatient setting,$69.62 ,66.30% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$96.60 ,92% of billed charges for outpatient setting,$99.75 ,95% of billed charges for outpatient setting,$101.85 ,97% of billed charges for outpatient setting,$68.25 ,65% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.50 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,$102.86 ,$52.50 Outpatient Medical Services,LAB,87591,Blood test for an STD,300,$131.75 ,$127.80 ,97% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.58 ,90% of billed charges for outpatient setting,$118.58 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.86 ,72.76% of billed charges for outpatient setting,$89.92 ,68.25% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$106.35 ,80.72% of billed charges for outpatient setting,$106.35 ,80.72% of billed charges for outpatient setting,$116.74 ,88.61% of billed charges for outpatient setting,$87.35 ,66.30% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.21 ,92% of billed charges for outpatient setting,$125.16 ,95% of billed charges for outpatient setting,$127.80 ,97% of billed charges for outpatient setting,$85.64 ,65% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.58 ,90% of billed charges for outpatient setting,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$35.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.41 ,$127.80 ,$65.88 Outpatient Medical Services,LAB,87635,Sars-cov-2 covid-19 amp prb,300,$216.50 ,$210.01 ,97% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.95 ,30% of total billed charges for outpatient setting,$194.85 ,90% of billed charges for outpatient setting,$194.85 ,90% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$157.53 ,72.76% of billed charges for outpatient setting,$147.76 ,68.25% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$174.76 ,80.72% of billed charges for outpatient setting,$174.76 ,80.72% of billed charges for outpatient setting,$191.84 ,88.61% of billed charges for outpatient setting,$143.54 ,66.30% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$199.18 ,92% of billed charges for outpatient setting,$205.68 ,95% of billed charges for outpatient setting,$210.01 ,97% of billed charges for outpatient setting,$140.73 ,65% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$194.85 ,90% of billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$51.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.31 ,$210.01 ,$108.25 Outpatient Medical Services,LAB,87804,Flu test,300,$110.25 ,$106.94 ,97% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.91 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.23 ,90% of billed charges for outpatient setting,$99.23 ,90% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.22 ,72.76% of billed charges for outpatient setting,$75.25 ,68.25% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.99 ,80.72% of billed charges for outpatient setting,$88.99 ,80.72% of billed charges for outpatient setting,$97.69 ,88.61% of billed charges for outpatient setting,$73.10 ,66.30% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$101.43 ,92% of billed charges for outpatient setting,$104.74 ,95% of billed charges for outpatient setting,$106.94 ,97% of billed charges for outpatient setting,$71.66 ,65% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.23 ,90% of billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.91 ,$106.94 ,$55.13 Outpatient Medical Services,LAB,87880,Test for strep A,300,$33.50 ,$32.50 ,97% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.15 ,90% of billed charges for outpatient setting,$30.15 ,90% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.37 ,72.76% of billed charges for outpatient setting,$22.86 ,68.25% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.04 ,80.72% of billed charges for outpatient setting,$27.04 ,80.72% of billed charges for outpatient setting,$29.68 ,88.61% of billed charges for outpatient setting,$22.21 ,66.30% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.82 ,92% of billed charges for outpatient setting,$31.83 ,95% of billed charges for outpatient setting,$32.50 ,97% of billed charges for outpatient setting,$21.78 ,65% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.15 ,90% of billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$16.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$12.89 ,$102.86 ,$16.75 Outpatient Medical Services,RADIOLOGY,70030,X-ray eye for foreign body,320,$270.25 ,$262.14 ,97% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$196.63 ,72.76% of billed charges for outpatient setting,$184.45 ,68.25% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$218.15 ,80.72% of billed charges for outpatient setting,$218.15 ,80.72% of billed charges for outpatient setting,$239.47 ,88.61% of billed charges for outpatient setting,$179.18 ,66.30% of billed charges for outpatient setting,$218.90 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$248.63 ,92% of billed charges for outpatient setting,$256.74 ,95% of billed charges for outpatient setting,$262.14 ,97% of billed charges for outpatient setting,$175.66 ,65% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.02 ,$262.14 ,$135.13 Outpatient Medical Services,RADIOLOGY,70100,X-ray exam of jaw <4views,320,$150.25 ,$145.74 ,97% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.32 ,72.76% of billed charges for outpatient setting,$102.55 ,68.25% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,80.72% of billed charges for outpatient setting,$121.28 ,80.72% of billed charges for outpatient setting,$133.14 ,88.61% of billed charges for outpatient setting,$99.62 ,66.30% of billed charges for outpatient setting,$121.70 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$138.23 ,92% of billed charges for outpatient setting,$142.74 ,95% of billed charges for outpatient setting,$145.74 ,97% of billed charges for outpatient setting,$97.66 ,65% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.27 ,$145.74 ,$75.13 Outpatient Medical Services,RADIOLOGY,70140,X-ray exam of facial bones,320,$158.25 ,$153.50 ,97% of billed charges for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$115.14 ,72.76% of billed charges for outpatient setting,$108.01 ,68.25% of billed charges for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$127.74 ,80.72% of billed charges for outpatient setting,$127.74 ,80.72% of billed charges for outpatient setting,$140.23 ,88.61% of billed charges for outpatient setting,$104.92 ,66.30% of billed charges for outpatient setting,$128.18 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$145.59 ,92% of billed charges for outpatient setting,$150.34 ,95% of billed charges for outpatient setting,$153.50 ,97% of billed charges for outpatient setting,$102.86 ,65% of billed charges for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.43 ,90% of billed charges for outpatient setting,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$94.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.02 ,$153.50 ,$79.13 Outpatient Medical Services,RADIOLOGY,70150,X-ray exam of facial bones,320,$214.50 ,$208.07 ,97% of billed charges for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$193.05 ,90% of billed charges for outpatient setting,$193.05 ,90% of billed charges for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$156.07 ,72.76% of billed charges for outpatient setting,$146.40 ,68.25% of billed charges for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$173.14 ,80.72% of billed charges for outpatient setting,$173.14 ,80.72% of billed charges for outpatient setting,$190.07 ,88.61% of billed charges for outpatient setting,$142.21 ,66.30% of billed charges for outpatient setting,$173.75 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$197.34 ,92% of billed charges for outpatient setting,$203.78 ,95% of billed charges for outpatient setting,$208.07 ,97% of billed charges for outpatient setting,$139.43 ,65% of billed charges for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$193.05 ,90% of billed charges for outpatient setting,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$128.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$38.46 ,$208.07 ,$107.25 Outpatient Medical Services,RADIOLOGY,70160,X-ray exam of nasal bones,320,$155.00 ,$150.35 ,97% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$112.78 ,72.76% of billed charges for outpatient setting,$105.79 ,68.25% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.12 ,80.72% of billed charges for outpatient setting,$125.12 ,80.72% of billed charges for outpatient setting,$137.35 ,88.61% of billed charges for outpatient setting,$102.77 ,66.30% of billed charges for outpatient setting,$125.55 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$142.60 ,92% of billed charges for outpatient setting,$147.25 ,95% of billed charges for outpatient setting,$150.35 ,97% of billed charges for outpatient setting,$100.75 ,65% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.22 ,$150.35 ,$77.50 Outpatient Medical Services,RADIOLOGY,70210,X-ray exam of sinuses,320,$155.00 ,$150.35 ,97% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$112.78 ,72.76% of billed charges for outpatient setting,$105.79 ,68.25% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.12 ,80.72% of billed charges for outpatient setting,$125.12 ,80.72% of billed charges for outpatient setting,$137.35 ,88.61% of billed charges for outpatient setting,$102.77 ,66.30% of billed charges for outpatient setting,$125.55 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$142.60 ,92% of billed charges for outpatient setting,$147.25 ,95% of billed charges for outpatient setting,$150.35 ,97% of billed charges for outpatient setting,$100.75 ,65% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.50 ,90% of billed charges for outpatient setting,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$93.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.82 ,$150.35 ,$77.50 Outpatient Medical Services,RADIOLOGY,70220,X-ray exam of sinuses,320,$203.25 ,$197.15 ,97% of billed charges for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$182.93 ,90% of billed charges for outpatient setting,$182.93 ,90% of billed charges for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.88 ,72.76% of billed charges for outpatient setting,$138.72 ,68.25% of billed charges for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$164.06 ,80.72% of billed charges for outpatient setting,$164.06 ,80.72% of billed charges for outpatient setting,$180.10 ,88.61% of billed charges for outpatient setting,$134.75 ,66.30% of billed charges for outpatient setting,$164.63 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$186.99 ,92% of billed charges for outpatient setting,$193.09 ,95% of billed charges for outpatient setting,$197.15 ,97% of billed charges for outpatient setting,$132.11 ,65% of billed charges for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$182.93 ,90% of billed charges for outpatient setting,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$121.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.51 ,$197.15 ,$101.63 Outpatient Medical Services,RADIOLOGY,70250,X-ray exam of skull,320,$179.25 ,$173.87 ,97% of billed charges for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$161.33 ,90% of billed charges for outpatient setting,$161.33 ,90% of billed charges for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.42 ,72.76% of billed charges for outpatient setting,$122.34 ,68.25% of billed charges for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$144.69 ,80.72% of billed charges for outpatient setting,$144.69 ,80.72% of billed charges for outpatient setting,$158.83 ,88.61% of billed charges for outpatient setting,$118.84 ,66.30% of billed charges for outpatient setting,$145.19 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$164.91 ,92% of billed charges for outpatient setting,$170.29 ,95% of billed charges for outpatient setting,$173.87 ,97% of billed charges for outpatient setting,$116.51 ,65% of billed charges for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$161.33 ,90% of billed charges for outpatient setting,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$107.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.56 ,$173.87 ,$89.63 Outpatient Medical Services,RADIOLOGY,70260,X-ray exam of skull,320,$248.50 ,$241.05 ,97% of billed charges for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.81 ,72.76% of billed charges for outpatient setting,$169.60 ,68.25% of billed charges for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$200.59 ,80.72% of billed charges for outpatient setting,$200.59 ,80.72% of billed charges for outpatient setting,$220.20 ,88.61% of billed charges for outpatient setting,$164.76 ,66.30% of billed charges for outpatient setting,$201.29 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$228.62 ,92% of billed charges for outpatient setting,$236.08 ,95% of billed charges for outpatient setting,$241.05 ,97% of billed charges for outpatient setting,$161.53 ,65% of billed charges for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.65 ,90% of billed charges for outpatient setting,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$149.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$42.31 ,$241.05 ,$124.25 Outpatient Medical Services,RADIOLOGY,70360,X-ray exam of neck,320,$132.50 ,$128.53 ,97% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$96.41 ,72.76% of billed charges for outpatient setting,$90.43 ,68.25% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$106.95 ,80.72% of billed charges for outpatient setting,$106.95 ,80.72% of billed charges for outpatient setting,$117.41 ,88.61% of billed charges for outpatient setting,$87.85 ,66.30% of billed charges for outpatient setting,$107.33 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$121.90 ,92% of billed charges for outpatient setting,$125.88 ,95% of billed charges for outpatient setting,$128.53 ,97% of billed charges for outpatient setting,$86.13 ,65% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.62 ,$128.53 ,$66.25 Outpatient Medical Services,RADIOLOGY,70450,CT scan head or brain without dye,351,"$1,125.75 ","$1,091.98 ",97% of billed charges for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.84 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,013.18 ",90% of billed charges for outpatient setting,"$1,013.18 ",90% of billed charges for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$819.10 ,72.76% of billed charges for outpatient setting,$768.32 ,68.25% of billed charges for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$908.71 ,80.72% of billed charges for outpatient setting,$908.71 ,80.72% of billed charges for outpatient setting,$997.53 ,88.61% of billed charges for outpatient setting,$746.37 ,66.30% of billed charges for outpatient setting,$911.86 ,135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,035.69 ",92% of billed charges for outpatient setting,"$1,069.46 ",95% of billed charges for outpatient setting,"$1,091.98 ",97% of billed charges for outpatient setting,$731.74 ,65% of billed charges for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,013.18 ",90% of billed charges for outpatient setting,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$675.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.84 ,$997.53 ,$562.88 Outpatient Medical Services,RADIOLOGY,70470,Ct head/brain w/o & w/dye,351,"$1,737.00 ","$1,684.89 ",97% of billed charges for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$169.06 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,563.30 ",90% of billed charges for outpatient setting,"$1,563.30 ",90% of billed charges for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,263.84 ",72.76% of billed charges for outpatient setting,"$1,185.50 ",68.25% of billed charges for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,402.11 ",80.72% of billed charges for outpatient setting,"$1,402.11 ",80.72% of billed charges for outpatient setting,"$1,539.16 ",88.61% of billed charges for outpatient setting,"$1,151.63 ",66.30% of billed charges for outpatient setting,"$1,406.97 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,598.04 ",92% of billed charges for outpatient setting,"$1,650.15 ",95% of billed charges for outpatient setting,"$1,684.89 ",97% of billed charges for outpatient setting,"$1,129.05 ",65% of billed charges for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,563.30 ",90% of billed charges for outpatient setting,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,042.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$169.06 ,$868.50 Outpatient Medical Services,RADIOLOGY,70482,Ct orbit/ear/fossa w/o&w/dye,351,"$2,098.25 ","$2,035.30 ",97% of billed charges for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$238.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,888.43 ",90% of billed charges for outpatient setting,"$1,888.43 ",90% of billed charges for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,526.69 ",72.76% of billed charges for outpatient setting,"$1,432.06 ",68.25% of billed charges for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,693.71 ",80.72% of billed charges for outpatient setting,"$1,693.71 ",80.72% of billed charges for outpatient setting,"$1,859.26 ",88.61% of billed charges for outpatient setting,"$1,391.14 ",66.30% of billed charges for outpatient setting,"$1,699.58 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,930.39 ",92% of billed charges for outpatient setting,"$1,993.34 ",95% of billed charges for outpatient setting,"$2,035.30 ",97% of billed charges for outpatient setting,"$1,363.86 ",65% of billed charges for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,888.43 ",90% of billed charges for outpatient setting,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,258.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$238.27 ,"$1,049.13 " Outpatient Medical Services,RADIOLOGY,70486,CT Scan of the face and jaw without dye,351,"$1,358.50 ","$1,317.75 ",97% of billed charges for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,222.65 ",90% of billed charges for outpatient setting,"$1,222.65 ",90% of billed charges for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$988.44 ,72.76% of billed charges for outpatient setting,$927.18 ,68.25% of billed charges for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,096.58 ",80.72% of billed charges for outpatient setting,"$1,096.58 ",80.72% of billed charges for outpatient setting,"$1,203.77 ",88.61% of billed charges for outpatient setting,$900.69 ,66.30% of billed charges for outpatient setting,"$1,100.39 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,249.82 ",92% of billed charges for outpatient setting,"$1,290.58 ",95% of billed charges for outpatient setting,"$1,317.75 ",97% of billed charges for outpatient setting,$883.03 ,65% of billed charges for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,222.65 ",90% of billed charges for outpatient setting,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$815.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$988.44 ,$679.25 Outpatient Medical Services,RADIOLOGY,70487,Ct maxillofacial w/dye,351,"$1,637.00 ","$1,587.89 ",97% of billed charges for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,473.30 ",90% of billed charges for outpatient setting,"$1,473.30 ",90% of billed charges for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,191.08 ",72.76% of billed charges for outpatient setting,"$1,117.25 ",68.25% of billed charges for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,321.39 ",80.72% of billed charges for outpatient setting,"$1,321.39 ",80.72% of billed charges for outpatient setting,"$1,450.55 ",88.61% of billed charges for outpatient setting,"$1,085.33 ",66.30% of billed charges for outpatient setting,"$1,325.97 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,506.04 ",92% of billed charges for outpatient setting,"$1,555.15 ",95% of billed charges for outpatient setting,"$1,587.89 ",97% of billed charges for outpatient setting,"$1,064.05 ",65% of billed charges for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,473.30 ",90% of billed charges for outpatient setting,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$982.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$147.83 ,$818.50 Outpatient Medical Services,RADIOLOGY,70490,Ct soft tissue neck w/o dye,351,"$1,362.00 ","$1,321.14 ",97% of billed charges for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,225.80 ",90% of billed charges for outpatient setting,"$1,225.80 ",90% of billed charges for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$990.99 ,72.76% of billed charges for outpatient setting,$929.57 ,68.25% of billed charges for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,099.41 ",80.72% of billed charges for outpatient setting,"$1,099.41 ",80.72% of billed charges for outpatient setting,"$1,206.87 ",88.61% of billed charges for outpatient setting,$903.01 ,66.30% of billed charges for outpatient setting,"$1,103.22 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,253.04 ",92% of billed charges for outpatient setting,"$1,293.90 ",95% of billed charges for outpatient setting,"$1,321.14 ",97% of billed charges for outpatient setting,$885.30 ,65% of billed charges for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,225.80 ",90% of billed charges for outpatient setting,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$817.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$990.99 ,$681.00 Outpatient Medical Services,RADIOLOGY,70491,CT scan of neck with dye,351,"$1,624.75 ","$1,576.01 ",97% of billed charges for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$179.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,462.28 ",90% of billed charges for outpatient setting,"$1,462.28 ",90% of billed charges for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,182.17 ",72.76% of billed charges for outpatient setting,"$1,108.89 ",68.25% of billed charges for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,311.50 ",80.72% of billed charges for outpatient setting,"$1,311.50 ",80.72% of billed charges for outpatient setting,"$1,439.69 ",88.61% of billed charges for outpatient setting,"$1,077.21 ",66.30% of billed charges for outpatient setting,"$1,316.05 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,494.77 ",92% of billed charges for outpatient setting,"$1,543.51 ",95% of billed charges for outpatient setting,"$1,576.01 ",97% of billed charges for outpatient setting,"$1,056.09 ",65% of billed charges for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,462.28 ",90% of billed charges for outpatient setting,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$974.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$179.35 ,$812.38 Outpatient Medical Services,RADIOLOGY,70496,Ct angiography head,351,"$4,154.50 ","$4,029.87 ",97% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$252.96 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,022.81 ",72.76% of billed charges for outpatient setting,"$2,835.45 ",68.25% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,353.51 ",80.72% of billed charges for outpatient setting,"$3,353.51 ",80.72% of billed charges for outpatient setting,"$3,681.30 ",88.61% of billed charges for outpatient setting,"$2,754.43 ",66.30% of billed charges for outpatient setting,"$3,365.15 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,822.14 ",92% of billed charges for outpatient setting,"$3,946.78 ",95% of billed charges for outpatient setting,"$4,029.87 ",97% of billed charges for outpatient setting,"$2,700.43 ",65% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$252.96 ,"$2,077.25 " Outpatient Medical Services,RADIOLOGY,70498,Ct angiography neck,351,"$2,586.50 ","$2,508.91 ",97% of billed charges for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$252.96 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,327.85 ",90% of billed charges for outpatient setting,"$2,327.85 ",90% of billed charges for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,881.94 ",72.76% of billed charges for outpatient setting,"$1,765.29 ",68.25% of billed charges for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,087.82 ",80.72% of billed charges for outpatient setting,"$2,087.82 ",80.72% of billed charges for outpatient setting,"$2,291.90 ",88.61% of billed charges for outpatient setting,"$1,714.85 ",66.30% of billed charges for outpatient setting,"$2,095.07 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,379.58 ",92% of billed charges for outpatient setting,"$2,457.18 ",95% of billed charges for outpatient setting,"$2,508.91 ",97% of billed charges for outpatient setting,"$1,681.23 ",65% of billed charges for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,327.85 ",90% of billed charges for outpatient setting,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,551.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$252.96 ,"$1,293.25 " Outpatient Medical Services,RADIOLOGY,70543,Mri orbt/fac/nck w/o &w/dye,614,"$4,689.50 ","$4,548.82 ",97% of billed charges for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$347.54 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,220.55 ",90% of billed charges for outpatient setting,"$4,220.55 ",90% of billed charges for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,412.08 ",72.76% of billed charges for outpatient setting,"$3,200.58 ",68.25% of billed charges for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,785.36 ",80.72% of billed charges for outpatient setting,"$3,785.36 ",80.72% of billed charges for outpatient setting,"$4,155.37 ",88.61% of billed charges for outpatient setting,"$3,109.14 ",66.30% of billed charges for outpatient setting,"$3,798.50 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,314.34 ",92% of billed charges for outpatient setting,"$4,455.03 ",95% of billed charges for outpatient setting,"$4,548.82 ",97% of billed charges for outpatient setting,"$3,048.18 ",65% of billed charges for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,220.55 ",90% of billed charges for outpatient setting,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,813.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$347.54 ,"$2,344.75 " Outpatient Medical Services,RADIOLOGY,70544,Mr angiography head w/o dye,615,"$2,635.25 ","$2,556.19 ",97% of billed charges for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$242.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,371.73 ",90% of billed charges for outpatient setting,"$2,371.73 ",90% of billed charges for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,917.41 ",72.76% of billed charges for outpatient setting,"$1,798.56 ",68.25% of billed charges for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,127.17 ",80.72% of billed charges for outpatient setting,"$2,127.17 ",80.72% of billed charges for outpatient setting,"$2,335.10 ",88.61% of billed charges for outpatient setting,"$1,747.17 ",66.30% of billed charges for outpatient setting,"$2,134.55 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,424.43 ",92% of billed charges for outpatient setting,"$2,503.49 ",95% of billed charges for outpatient setting,"$2,556.19 ",97% of billed charges for outpatient setting,"$1,712.91 ",65% of billed charges for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,371.73 ",90% of billed charges for outpatient setting,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,581.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$242.26 ,"$1,317.63 " Outpatient Medical Services,RADIOLOGY,70551,MRI of brain stem without dye,611,"$2,818.75 ","$2,734.19 ",97% of billed charges for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$199.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,536.88 ",90% of billed charges for outpatient setting,"$2,536.88 ",90% of billed charges for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,050.92 ",72.76% of billed charges for outpatient setting,"$1,923.80 ",68.25% of billed charges for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,275.30 ",80.72% of billed charges for outpatient setting,"$2,275.30 ",80.72% of billed charges for outpatient setting,"$2,497.69 ",88.61% of billed charges for outpatient setting,"$1,868.83 ",66.30% of billed charges for outpatient setting,"$2,283.19 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,593.25 ",92% of billed charges for outpatient setting,"$2,677.81 ",95% of billed charges for outpatient setting,"$2,734.19 ",97% of billed charges for outpatient setting,"$1,832.19 ",65% of billed charges for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,536.88 ",90% of billed charges for outpatient setting,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,691.25 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$199.92 ,"$1,409.38 " Outpatient Medical Services,RADIOLOGY,70553,MRI scan of brain before and after contrast,611,"$4,756.75 ","$4,614.05 ",97% of billed charges for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$326.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,281.08 ",90% of billed charges for outpatient setting,"$4,281.08 ",90% of billed charges for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,461.01 ",72.76% of billed charges for outpatient setting,"$3,246.48 ",68.25% of billed charges for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,839.65 ",80.72% of billed charges for outpatient setting,"$3,839.65 ",80.72% of billed charges for outpatient setting,"$4,214.96 ",88.61% of billed charges for outpatient setting,"$3,153.73 ",66.30% of billed charges for outpatient setting,"$3,852.97 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,376.21 ",92% of billed charges for outpatient setting,"$4,518.91 ",95% of billed charges for outpatient setting,"$4,614.05 ",97% of billed charges for outpatient setting,"$3,091.89 ",65% of billed charges for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,281.08 ",90% of billed charges for outpatient setting,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,854.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$326.82 ,"$2,378.38 " Outpatient Medical Services,RADIOLOGY,71045,Single view,320,$126.50 ,$122.71 ,97% of billed charges for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$113.85 ,90% of billed charges for outpatient setting,$113.85 ,90% of billed charges for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.04 ,72.76% of billed charges for outpatient setting,$86.34 ,68.25% of billed charges for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.11 ,80.72% of billed charges for outpatient setting,$102.11 ,80.72% of billed charges for outpatient setting,$112.09 ,88.61% of billed charges for outpatient setting,$83.87 ,66.30% of billed charges for outpatient setting,$102.47 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$116.38 ,92% of billed charges for outpatient setting,$120.18 ,95% of billed charges for outpatient setting,$122.71 ,97% of billed charges for outpatient setting,$82.23 ,65% of billed charges for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$113.85 ,90% of billed charges for outpatient setting,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$75.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$22.18 ,$122.71 ,$63.25 Outpatient Medical Services,RADIOLOGY,71046,"2 views, front and back",324,$164.25 ,$159.32 ,97% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.51 ,72.76% of billed charges for outpatient setting,$112.10 ,68.25% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$145.54 ,88.61% of billed charges for outpatient setting,$108.90 ,66.30% of billed charges for outpatient setting,$133.04 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$151.11 ,92% of billed charges for outpatient setting,$156.04 ,95% of billed charges for outpatient setting,$159.32 ,97% of billed charges for outpatient setting,$106.76 ,65% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.07 ,$159.32 ,$82.13 Outpatient Medical Services,RADIOLOGY,71047,3 views,324,$164.25 ,$159.32 ,97% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.21 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.51 ,72.76% of billed charges for outpatient setting,$112.10 ,68.25% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$145.54 ,88.61% of billed charges for outpatient setting,$108.90 ,66.30% of billed charges for outpatient setting,$133.04 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$151.11 ,92% of billed charges for outpatient setting,$156.04 ,95% of billed charges for outpatient setting,$159.32 ,97% of billed charges for outpatient setting,$106.76 ,65% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.21 ,$159.32 ,$82.13 Outpatient Medical Services,RADIOLOGY,71100,X-ray exam ribs uni 2 views,320,$164.25 ,$159.32 ,97% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.47 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.51 ,72.76% of billed charges for outpatient setting,$112.10 ,68.25% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$132.58 ,80.72% of billed charges for outpatient setting,$145.54 ,88.61% of billed charges for outpatient setting,$108.90 ,66.30% of billed charges for outpatient setting,$133.04 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$151.11 ,92% of billed charges for outpatient setting,$156.04 ,95% of billed charges for outpatient setting,$159.32 ,97% of billed charges for outpatient setting,$106.76 ,65% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.83 ,90% of billed charges for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.47 ,$159.32 ,$82.13 Outpatient Medical Services,RADIOLOGY,71101,Radiologic examination of one side of the chest/ribs,320,$197.25 ,$191.33 ,97% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.06 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.52 ,72.76% of billed charges for outpatient setting,$134.62 ,68.25% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$174.78 ,88.61% of billed charges for outpatient setting,$130.78 ,66.30% of billed charges for outpatient setting,$159.77 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$181.47 ,92% of billed charges for outpatient setting,$187.39 ,95% of billed charges for outpatient setting,$191.33 ,97% of billed charges for outpatient setting,$128.21 ,65% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.06 ,$191.33 ,$98.63 Outpatient Medical Services,RADIOLOGY,71110,X-ray exam ribs bil 3 views,320,$211.50 ,$205.16 ,97% of billed charges for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.51 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$190.35 ,90% of billed charges for outpatient setting,$190.35 ,90% of billed charges for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$153.89 ,72.76% of billed charges for outpatient setting,$144.35 ,68.25% of billed charges for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$170.72 ,80.72% of billed charges for outpatient setting,$170.72 ,80.72% of billed charges for outpatient setting,$187.41 ,88.61% of billed charges for outpatient setting,$140.22 ,66.30% of billed charges for outpatient setting,$171.32 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$194.58 ,92% of billed charges for outpatient setting,$200.93 ,95% of billed charges for outpatient setting,$205.16 ,97% of billed charges for outpatient setting,$137.48 ,65% of billed charges for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$190.35 ,90% of billed charges for outpatient setting,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$126.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.51 ,$205.16 ,$105.75 Outpatient Medical Services,RADIOLOGY,71111,X-ray exam ribs/chest4/> vws,320,$259.50 ,$251.72 ,97% of billed charges for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$43.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$233.55 ,90% of billed charges for outpatient setting,$233.55 ,90% of billed charges for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$188.81 ,72.76% of billed charges for outpatient setting,$177.11 ,68.25% of billed charges for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$209.47 ,80.72% of billed charges for outpatient setting,$209.47 ,80.72% of billed charges for outpatient setting,$229.94 ,88.61% of billed charges for outpatient setting,$172.05 ,66.30% of billed charges for outpatient setting,$210.20 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$238.74 ,92% of billed charges for outpatient setting,$246.53 ,95% of billed charges for outpatient setting,$251.72 ,97% of billed charges for outpatient setting,$168.68 ,65% of billed charges for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$233.55 ,90% of billed charges for outpatient setting,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$155.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$43.40 ,$251.72 ,$129.75 Outpatient Medical Services,RADIOLOGY,71120,X-ray exam breastbone 2/>vws,320,$171.75 ,$166.60 ,97% of billed charges for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$154.58 ,90% of billed charges for outpatient setting,$154.58 ,90% of billed charges for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$124.97 ,72.76% of billed charges for outpatient setting,$117.22 ,68.25% of billed charges for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$138.64 ,80.72% of billed charges for outpatient setting,$138.64 ,80.72% of billed charges for outpatient setting,$152.19 ,88.61% of billed charges for outpatient setting,$113.87 ,66.30% of billed charges for outpatient setting,$139.12 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$158.01 ,92% of billed charges for outpatient setting,$163.16 ,95% of billed charges for outpatient setting,$166.60 ,97% of billed charges for outpatient setting,$111.64 ,65% of billed charges for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$154.58 ,90% of billed charges for outpatient setting,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$103.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.67 ,$166.60 ,$85.88 Outpatient Medical Services,RADIOLOGY,71250,CT scan of the thorax without dye,352,"$1,453.75 ","$1,410.14 ",97% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$140.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,057.75 ",72.76% of billed charges for outpatient setting,$992.18 ,68.25% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,173.47 ",80.72% of billed charges for outpatient setting,"$1,173.47 ",80.72% of billed charges for outpatient setting,"$1,288.17 ",88.61% of billed charges for outpatient setting,$963.84 ,66.30% of billed charges for outpatient setting,"$1,177.54 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,337.45 ",92% of billed charges for outpatient setting,"$1,381.06 ",95% of billed charges for outpatient setting,"$1,410.14 ",97% of billed charges for outpatient setting,$944.94 ,65% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$992.18 ,$726.88 Outpatient Medical Services,RADIOLOGY,71260,CT scan of the thorax with dye,352,"$1,735.25 ","$1,683.19 ",97% of billed charges for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$173.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,561.73 ",90% of billed charges for outpatient setting,"$1,561.73 ",90% of billed charges for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,262.57 ",72.76% of billed charges for outpatient setting,"$1,184.31 ",68.25% of billed charges for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,400.69 ",80.72% of billed charges for outpatient setting,"$1,400.69 ",80.72% of billed charges for outpatient setting,"$1,537.61 ",88.61% of billed charges for outpatient setting,"$1,150.47 ",66.30% of billed charges for outpatient setting,"$1,405.55 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,596.43 ",92% of billed charges for outpatient setting,"$1,648.49 ",95% of billed charges for outpatient setting,"$1,683.19 ",97% of billed charges for outpatient setting,"$1,127.91 ",65% of billed charges for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,561.73 ",90% of billed charges for outpatient setting,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,041.15 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$173.10 ,$867.63 Outpatient Medical Services,RADIOLOGY,71275,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest,352,"$2,977.00 ","$2,887.69 ",97% of billed charges for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$256.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,679.30 ",90% of billed charges for outpatient setting,"$2,679.30 ",90% of billed charges for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,166.07 ",72.76% of billed charges for outpatient setting,"$2,031.80 ",68.25% of billed charges for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,403.03 ",80.72% of billed charges for outpatient setting,"$2,403.03 ",80.72% of billed charges for outpatient setting,"$2,637.92 ",88.61% of billed charges for outpatient setting,"$1,973.75 ",66.30% of billed charges for outpatient setting,"$2,411.37 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,738.84 ",92% of billed charges for outpatient setting,"$2,828.15 ",95% of billed charges for outpatient setting,"$2,887.69 ",97% of billed charges for outpatient setting,"$1,935.05 ",65% of billed charges for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,679.30 ",90% of billed charges for outpatient setting,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,786.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$256.30 ,"$1,488.50 " Outpatient Medical Services,RADIOLOGY,71552,Mri chest w/o & w/dye,614,"$5,038.25 ","$4,887.10 ",97% of billed charges for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$430.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,534.43 ",90% of billed charges for outpatient setting,"$4,534.43 ",90% of billed charges for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,665.83 ",72.76% of billed charges for outpatient setting,"$3,438.61 ",68.25% of billed charges for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,066.88 ",80.72% of billed charges for outpatient setting,"$4,066.88 ",80.72% of billed charges for outpatient setting,"$4,464.39 ",88.61% of billed charges for outpatient setting,"$3,340.36 ",66.30% of billed charges for outpatient setting,"$4,080.98 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,635.19 ",92% of billed charges for outpatient setting,"$4,786.34 ",95% of billed charges for outpatient setting,"$4,887.10 ",97% of billed charges for outpatient setting,"$3,274.86 ",65% of billed charges for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,534.43 ",90% of billed charges for outpatient setting,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$3,022.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$430.78 ,"$2,519.13 " Outpatient Medical Services,RADIOLOGY,72040,"Radiologic examination of the neck/spine, 2-3 views",320,$181.25 ,$175.81 ,97% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$131.88 ,72.76% of billed charges for outpatient setting,$123.70 ,68.25% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.31 ,80.72% of billed charges for outpatient setting,$146.31 ,80.72% of billed charges for outpatient setting,$160.61 ,88.61% of billed charges for outpatient setting,$120.17 ,66.30% of billed charges for outpatient setting,$146.81 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$166.75 ,92% of billed charges for outpatient setting,$172.19 ,95% of billed charges for outpatient setting,$175.81 ,97% of billed charges for outpatient setting,$117.81 ,65% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.26 ,$175.81 ,$90.63 Outpatient Medical Services,RADIOLOGY,72050,"Radiologic examination of the neck/spine, 4-5 views",320,$257.50 ,$249.78 ,97% of billed charges for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$231.75 ,90% of billed charges for outpatient setting,$231.75 ,90% of billed charges for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$187.36 ,72.76% of billed charges for outpatient setting,$175.74 ,68.25% of billed charges for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$207.85 ,80.72% of billed charges for outpatient setting,$207.85 ,80.72% of billed charges for outpatient setting,$228.17 ,88.61% of billed charges for outpatient setting,$170.72 ,66.30% of billed charges for outpatient setting,$208.58 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$236.90 ,92% of billed charges for outpatient setting,$244.63 ,95% of billed charges for outpatient setting,$249.78 ,97% of billed charges for outpatient setting,$167.38 ,65% of billed charges for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$231.75 ,90% of billed charges for outpatient setting,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$154.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.55 ,$249.78 ,$128.75 Outpatient Medical Services,RADIOLOGY,72052,X-ray exam neck spine 6/>vws,320,$323.25 ,$313.55 ,97% of billed charges for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$290.93 ,90% of billed charges for outpatient setting,$290.93 ,90% of billed charges for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$235.20 ,72.76% of billed charges for outpatient setting,$220.62 ,68.25% of billed charges for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$260.93 ,80.72% of billed charges for outpatient setting,$260.93 ,80.72% of billed charges for outpatient setting,$286.43 ,88.61% of billed charges for outpatient setting,$214.31 ,66.30% of billed charges for outpatient setting,$261.83 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$297.39 ,92% of billed charges for outpatient setting,$307.09 ,95% of billed charges for outpatient setting,$313.55 ,97% of billed charges for outpatient setting,$210.11 ,65% of billed charges for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$290.93 ,90% of billed charges for outpatient setting,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$193.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.89 ,$313.55 ,$161.63 Outpatient Medical Services,RADIOLOGY,72070,"Radiologic examination of the middle spine, 2 views",320,$173.00 ,$167.81 ,97% of billed charges for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$155.70 ,90% of billed charges for outpatient setting,$155.70 ,90% of billed charges for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.87 ,72.76% of billed charges for outpatient setting,$118.07 ,68.25% of billed charges for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$139.65 ,80.72% of billed charges for outpatient setting,$139.65 ,80.72% of billed charges for outpatient setting,$153.30 ,88.61% of billed charges for outpatient setting,$114.70 ,66.30% of billed charges for outpatient setting,$140.13 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$159.16 ,92% of billed charges for outpatient setting,$164.35 ,95% of billed charges for outpatient setting,$167.81 ,97% of billed charges for outpatient setting,$112.45 ,65% of billed charges for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$155.70 ,90% of billed charges for outpatient setting,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$103.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.17 ,$167.81 ,$86.50 Outpatient Medical Services,RADIOLOGY,72072,"Radiologic examination of the middle spine, 3 views",320,$194.00 ,$188.18 ,97% of billed charges for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.96 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$174.60 ,90% of billed charges for outpatient setting,$174.60 ,90% of billed charges for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$141.15 ,72.76% of billed charges for outpatient setting,$132.41 ,68.25% of billed charges for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$156.60 ,80.72% of billed charges for outpatient setting,$156.60 ,80.72% of billed charges for outpatient setting,$171.90 ,88.61% of billed charges for outpatient setting,$128.62 ,66.30% of billed charges for outpatient setting,$157.14 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$178.48 ,92% of billed charges for outpatient setting,$184.30 ,95% of billed charges for outpatient setting,$188.18 ,97% of billed charges for outpatient setting,$126.10 ,65% of billed charges for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$174.60 ,90% of billed charges for outpatient setting,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$116.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$31.96 ,$188.18 ,$97.00 Outpatient Medical Services,RADIOLOGY,72080,X-ray exam thoracolmb 2/> vw,320,$211.00 ,$204.67 ,97% of billed charges for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$189.90 ,90% of billed charges for outpatient setting,$189.90 ,90% of billed charges for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$153.52 ,72.76% of billed charges for outpatient setting,$144.01 ,68.25% of billed charges for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$170.32 ,80.72% of billed charges for outpatient setting,$170.32 ,80.72% of billed charges for outpatient setting,$186.97 ,88.61% of billed charges for outpatient setting,$139.89 ,66.30% of billed charges for outpatient setting,$170.91 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$194.12 ,92% of billed charges for outpatient setting,$200.45 ,95% of billed charges for outpatient setting,$204.67 ,97% of billed charges for outpatient setting,$137.15 ,65% of billed charges for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$189.90 ,90% of billed charges for outpatient setting,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$126.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.87 ,$204.67 ,$105.50 Outpatient Medical Services,RADIOLOGY,72081,X-ray exam entire spi 1 vw,320,$224.75 ,$218.01 ,97% of billed charges for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.91 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$202.28 ,90% of billed charges for outpatient setting,$202.28 ,90% of billed charges for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.53 ,72.76% of billed charges for outpatient setting,$153.39 ,68.25% of billed charges for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$181.42 ,80.72% of billed charges for outpatient setting,$181.42 ,80.72% of billed charges for outpatient setting,$199.15 ,88.61% of billed charges for outpatient setting,$149.01 ,66.30% of billed charges for outpatient setting,$182.05 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$206.77 ,92% of billed charges for outpatient setting,$213.51 ,95% of billed charges for outpatient setting,$218.01 ,97% of billed charges for outpatient setting,$146.09 ,65% of billed charges for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$202.28 ,90% of billed charges for outpatient setting,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$134.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.91 ,$218.01 ,$112.38 Outpatient Medical Services,RADIOLOGY,72082,X-ray exam entire spi 2/3 vw,320,$335.00 ,$324.95 ,97% of billed charges for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.83 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.50 ,90% of billed charges for outpatient setting,$301.50 ,90% of billed charges for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.75 ,72.76% of billed charges for outpatient setting,$228.64 ,68.25% of billed charges for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.41 ,80.72% of billed charges for outpatient setting,$270.41 ,80.72% of billed charges for outpatient setting,$296.84 ,88.61% of billed charges for outpatient setting,$222.11 ,66.30% of billed charges for outpatient setting,$271.35 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$308.20 ,92% of billed charges for outpatient setting,$318.25 ,95% of billed charges for outpatient setting,$324.95 ,97% of billed charges for outpatient setting,$217.75 ,65% of billed charges for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.50 ,90% of billed charges for outpatient setting,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$201.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.83 ,$324.95 ,$167.50 Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,320,$190.75 ,$185.03 ,97% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$138.79 ,72.76% of billed charges for outpatient setting,$130.19 ,68.25% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$153.97 ,80.72% of billed charges for outpatient setting,$153.97 ,80.72% of billed charges for outpatient setting,$169.02 ,88.61% of billed charges for outpatient setting,$126.47 ,66.30% of billed charges for outpatient setting,$154.51 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$175.49 ,92% of billed charges for outpatient setting,$181.21 ,95% of billed charges for outpatient setting,$185.03 ,97% of billed charges for outpatient setting,$123.99 ,65% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.26 ,$185.03 ,$95.38 Outpatient Medical Services,RADIOLOGY,72110,"X-ray of lower and sacral spine, minimum of 4 views",320,$265.75 ,$257.78 ,97% of billed charges for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$45.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$239.18 ,90% of billed charges for outpatient setting,$239.18 ,90% of billed charges for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$193.36 ,72.76% of billed charges for outpatient setting,$181.37 ,68.25% of billed charges for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$214.51 ,80.72% of billed charges for outpatient setting,$214.51 ,80.72% of billed charges for outpatient setting,$235.48 ,88.61% of billed charges for outpatient setting,$176.19 ,66.30% of billed charges for outpatient setting,$215.26 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$244.49 ,92% of billed charges for outpatient setting,$252.46 ,95% of billed charges for outpatient setting,$257.78 ,97% of billed charges for outpatient setting,$172.74 ,65% of billed charges for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$239.18 ,90% of billed charges for outpatient setting,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$159.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$45.15 ,$257.78 ,$132.88 Outpatient Medical Services,RADIOLOGY,72114,X-ray exam l-s spine bending,320,$344.25 ,$333.92 ,97% of billed charges for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.19 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$309.83 ,90% of billed charges for outpatient setting,$309.83 ,90% of billed charges for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$250.48 ,72.76% of billed charges for outpatient setting,$234.95 ,68.25% of billed charges for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$277.88 ,80.72% of billed charges for outpatient setting,$277.88 ,80.72% of billed charges for outpatient setting,$305.04 ,88.61% of billed charges for outpatient setting,$228.24 ,66.30% of billed charges for outpatient setting,$278.84 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$316.71 ,92% of billed charges for outpatient setting,$327.04 ,95% of billed charges for outpatient setting,$333.92 ,97% of billed charges for outpatient setting,$223.76 ,65% of billed charges for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$309.83 ,90% of billed charges for outpatient setting,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$206.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.19 ,$333.92 ,$172.13 Outpatient Medical Services,RADIOLOGY,72120,X-ray bend only l-s spine,320,$238.75 ,$231.59 ,97% of billed charges for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.66 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$214.88 ,90% of billed charges for outpatient setting,$214.88 ,90% of billed charges for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$173.71 ,72.76% of billed charges for outpatient setting,$162.95 ,68.25% of billed charges for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$192.72 ,80.72% of billed charges for outpatient setting,$192.72 ,80.72% of billed charges for outpatient setting,$211.56 ,88.61% of billed charges for outpatient setting,$158.29 ,66.30% of billed charges for outpatient setting,$193.39 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$219.65 ,92% of billed charges for outpatient setting,$226.81 ,95% of billed charges for outpatient setting,$231.59 ,97% of billed charges for outpatient setting,$155.19 ,65% of billed charges for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$214.88 ,90% of billed charges for outpatient setting,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$143.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.66 ,$231.59 ,$119.38 Outpatient Medical Services,RADIOLOGY,72125,Ct neck spine w/o dye,352,"$1,455.50 ","$1,411.84 ",97% of billed charges for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$145.43 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,309.95 ",90% of billed charges for outpatient setting,"$1,309.95 ",90% of billed charges for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,059.02 ",72.76% of billed charges for outpatient setting,$993.38 ,68.25% of billed charges for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,174.88 ",80.72% of billed charges for outpatient setting,"$1,174.88 ",80.72% of billed charges for outpatient setting,"$1,289.72 ",88.61% of billed charges for outpatient setting,$965.00 ,66.30% of billed charges for outpatient setting,"$1,178.96 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,339.06 ",92% of billed charges for outpatient setting,"$1,382.73 ",95% of billed charges for outpatient setting,"$1,411.84 ",97% of billed charges for outpatient setting,$946.08 ,65% of billed charges for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,309.95 ",90% of billed charges for outpatient setting,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$873.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$993.38 ,$727.75 Outpatient Medical Services,RADIOLOGY,72128,Ct chest spine w/o dye,350,"$1,453.75 ","$1,410.14 ",97% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,057.75 ",72.76% of billed charges for outpatient setting,$992.18 ,68.25% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,173.47 ",80.72% of billed charges for outpatient setting,"$1,173.47 ",80.72% of billed charges for outpatient setting,"$1,288.17 ",88.61% of billed charges for outpatient setting,$963.84 ,66.30% of billed charges for outpatient setting,"$1,177.54 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,337.45 ",92% of billed charges for outpatient setting,"$1,381.06 ",95% of billed charges for outpatient setting,"$1,410.14 ",97% of billed charges for outpatient setting,$944.94 ,65% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,308.38 ",90% of billed charges for outpatient setting,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$872.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$992.18 ,$726.88 Outpatient Medical Services,RADIOLOGY,72131,CT scan of lower spine without dye,352,"$1,452.25 ","$1,408.68 ",97% of billed charges for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,307.03 ",90% of billed charges for outpatient setting,"$1,307.03 ",90% of billed charges for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,056.66 ",72.76% of billed charges for outpatient setting,$991.16 ,68.25% of billed charges for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,172.26 ",80.72% of billed charges for outpatient setting,"$1,172.26 ",80.72% of billed charges for outpatient setting,"$1,286.84 ",88.61% of billed charges for outpatient setting,$962.84 ,66.30% of billed charges for outpatient setting,"$1,176.32 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,336.07 ",92% of billed charges for outpatient setting,"$1,379.64 ",95% of billed charges for outpatient setting,"$1,408.68 ",97% of billed charges for outpatient setting,$943.96 ,65% of billed charges for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,307.03 ",90% of billed charges for outpatient setting,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$871.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$991.16 ,$726.13 Outpatient Medical Services,RADIOLOGY,72141,MRI of the neck or spine without dye,612,"$2,657.00 ","$2,577.29 ",97% of billed charges for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$195.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,391.30 ",90% of billed charges for outpatient setting,"$2,391.30 ",90% of billed charges for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,933.23 ",72.76% of billed charges for outpatient setting,"$1,813.40 ",68.25% of billed charges for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,144.73 ",80.72% of billed charges for outpatient setting,"$2,144.73 ",80.72% of billed charges for outpatient setting,"$2,354.37 ",88.61% of billed charges for outpatient setting,"$1,761.59 ",66.30% of billed charges for outpatient setting,"$2,152.17 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,444.44 ",92% of billed charges for outpatient setting,"$2,524.15 ",95% of billed charges for outpatient setting,"$2,577.29 ",97% of billed charges for outpatient setting,"$1,727.05 ",65% of billed charges for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,391.30 ",90% of billed charges for outpatient setting,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,594.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$195.28 ,"$1,328.50 " Outpatient Medical Services,RADIOLOGY,72146,MRI of chest and spine without dye,612,"$2,784.25 ","$2,700.72 ",97% of billed charges for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$195.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,505.83 ",90% of billed charges for outpatient setting,"$2,505.83 ",90% of billed charges for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,025.82 ",72.76% of billed charges for outpatient setting,"$1,900.25 ",68.25% of billed charges for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,247.45 ",80.72% of billed charges for outpatient setting,"$2,247.45 ",80.72% of billed charges for outpatient setting,"$2,467.12 ",88.61% of billed charges for outpatient setting,"$1,845.96 ",66.30% of billed charges for outpatient setting,"$2,255.24 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,561.51 ",92% of billed charges for outpatient setting,"$2,645.04 ",95% of billed charges for outpatient setting,"$2,700.72 ",97% of billed charges for outpatient setting,"$1,809.76 ",65% of billed charges for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,505.83 ",90% of billed charges for outpatient setting,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,670.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$195.58 ,"$1,392.13 " Outpatient Medical Services,RADIOLOGY,72148,MRI scan of lower spinal canal,612,"$2,754.75 ","$2,672.11 ",97% of billed charges for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$195.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,479.28 ",90% of billed charges for outpatient setting,"$2,479.28 ",90% of billed charges for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,004.36 ",72.76% of billed charges for outpatient setting,"$1,880.12 ",68.25% of billed charges for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,223.63 ",80.72% of billed charges for outpatient setting,"$2,223.63 ",80.72% of billed charges for outpatient setting,"$2,440.98 ",88.61% of billed charges for outpatient setting,"$1,826.40 ",66.30% of billed charges for outpatient setting,"$2,231.35 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,534.37 ",92% of billed charges for outpatient setting,"$2,617.01 ",95% of billed charges for outpatient setting,"$2,672.11 ",97% of billed charges for outpatient setting,"$1,790.59 ",65% of billed charges for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,479.28 ",90% of billed charges for outpatient setting,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,652.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$195.58 ,"$1,377.38 " Outpatient Medical Services,RADIOLOGY,72156,MRI of neck/spine with and without dye,612,"$4,771.75 ","$4,628.60 ",97% of billed charges for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$328.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,294.58 ",90% of billed charges for outpatient setting,"$4,294.58 ",90% of billed charges for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,471.93 ",72.76% of billed charges for outpatient setting,"$3,256.72 ",68.25% of billed charges for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,851.76 ",80.72% of billed charges for outpatient setting,"$3,851.76 ",80.72% of billed charges for outpatient setting,"$4,228.25 ",88.61% of billed charges for outpatient setting,"$3,163.67 ",66.30% of billed charges for outpatient setting,"$3,865.12 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,390.01 ",92% of billed charges for outpatient setting,"$4,533.16 ",95% of billed charges for outpatient setting,"$4,628.60 ",97% of billed charges for outpatient setting,"$3,101.64 ",65% of billed charges for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,294.58 ",90% of billed charges for outpatient setting,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,863.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$328.92 ,"$2,385.88 " Outpatient Medical Services,RADIOLOGY,72158,MRI of lower back with and without dye,612,"$4,721.00 ","$4,579.37 ",97% of billed charges for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$328.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,248.90 ",90% of billed charges for outpatient setting,"$4,248.90 ",90% of billed charges for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,435.00 ",72.76% of billed charges for outpatient setting,"$3,222.08 ",68.25% of billed charges for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,810.79 ",80.72% of billed charges for outpatient setting,"$3,810.79 ",80.72% of billed charges for outpatient setting,"$4,183.28 ",88.61% of billed charges for outpatient setting,"$3,130.02 ",66.30% of billed charges for outpatient setting,"$3,824.01 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,343.32 ",92% of billed charges for outpatient setting,"$4,484.95 ",95% of billed charges for outpatient setting,"$4,579.37 ",97% of billed charges for outpatient setting,"$3,068.65 ",65% of billed charges for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,248.90 ",90% of billed charges for outpatient setting,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,832.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$328.32 ,"$2,360.50 " Outpatient Medical Services,RADIOLOGY,72170,Radiologic examination of the pelvis,320,$136.00 ,$131.92 ,97% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.95 ,72.76% of billed charges for outpatient setting,$92.82 ,68.25% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$120.51 ,88.61% of billed charges for outpatient setting,$90.17 ,66.30% of billed charges for outpatient setting,$110.16 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$125.12 ,92% of billed charges for outpatient setting,$129.20 ,95% of billed charges for outpatient setting,$131.92 ,97% of billed charges for outpatient setting,$88.40 ,65% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.02 ,$131.92 ,$68.00 Outpatient Medical Services,RADIOLOGY,72192,CT of pelvis without dye,352,"$1,401.50 ","$1,359.46 ",97% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$129.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,019.73 ",72.76% of billed charges for outpatient setting,$956.52 ,68.25% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,131.29 ",80.72% of billed charges for outpatient setting,"$1,131.29 ",80.72% of billed charges for outpatient setting,"$1,241.87 ",88.61% of billed charges for outpatient setting,$929.19 ,66.30% of billed charges for outpatient setting,"$1,135.22 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,289.38 ",92% of billed charges for outpatient setting,"$1,331.43 ",95% of billed charges for outpatient setting,"$1,359.46 ",97% of billed charges for outpatient setting,$910.98 ,65% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$956.52 ,$700.75 Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",352,"$1,654.50 ","$1,604.87 ",97% of billed charges for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$204.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,489.05 ",90% of billed charges for outpatient setting,"$1,489.05 ",90% of billed charges for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,203.81 ",72.76% of billed charges for outpatient setting,"$1,129.20 ",68.25% of billed charges for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,335.51 ",80.72% of billed charges for outpatient setting,"$1,335.51 ",80.72% of billed charges for outpatient setting,"$1,466.05 ",88.61% of billed charges for outpatient setting,"$1,096.93 ",66.30% of billed charges for outpatient setting,"$1,340.15 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,522.14 ",92% of billed charges for outpatient setting,"$1,571.78 ",95% of billed charges for outpatient setting,"$1,604.87 ",97% of billed charges for outpatient setting,"$1,075.43 ",65% of billed charges for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,489.05 ",90% of billed charges for outpatient setting,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$992.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$204.46 ,$827.25 Outpatient Medical Services,RADIOLOGY,72200,X-ray exam si joints,320,$145.25 ,$140.89 ,97% of billed charges for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.73 ,90% of billed charges for outpatient setting,$130.73 ,90% of billed charges for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.68 ,72.76% of billed charges for outpatient setting,$99.13 ,68.25% of billed charges for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.25 ,80.72% of billed charges for outpatient setting,$117.25 ,80.72% of billed charges for outpatient setting,$128.71 ,88.61% of billed charges for outpatient setting,$96.30 ,66.30% of billed charges for outpatient setting,$117.65 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$133.63 ,92% of billed charges for outpatient setting,$137.99 ,95% of billed charges for outpatient setting,$140.89 ,97% of billed charges for outpatient setting,$94.41 ,65% of billed charges for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.73 ,90% of billed charges for outpatient setting,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$87.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.22 ,$140.89 ,$72.63 Outpatient Medical Services,RADIOLOGY,72202,X-ray exam si joints 3/> vws,320,$176.00 ,$170.72 ,97% of billed charges for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.62 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$158.40 ,90% of billed charges for outpatient setting,$158.40 ,90% of billed charges for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.06 ,72.76% of billed charges for outpatient setting,$120.12 ,68.25% of billed charges for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.07 ,80.72% of billed charges for outpatient setting,$142.07 ,80.72% of billed charges for outpatient setting,$155.95 ,88.61% of billed charges for outpatient setting,$116.69 ,66.30% of billed charges for outpatient setting,$142.56 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$161.92 ,92% of billed charges for outpatient setting,$167.20 ,95% of billed charges for outpatient setting,$170.72 ,97% of billed charges for outpatient setting,$114.40 ,65% of billed charges for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$158.40 ,90% of billed charges for outpatient setting,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$105.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.62 ,$170.72 ,$88.00 Outpatient Medical Services,RADIOLOGY,72220,X-ray exam sacrum tailbone,320,$153.25 ,$148.65 ,97% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$111.50 ,72.76% of billed charges for outpatient setting,$104.59 ,68.25% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$135.79 ,88.61% of billed charges for outpatient setting,$101.60 ,66.30% of billed charges for outpatient setting,$124.13 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$140.99 ,92% of billed charges for outpatient setting,$145.59 ,95% of billed charges for outpatient setting,$148.65 ,97% of billed charges for outpatient setting,$99.61 ,65% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.92 ,$148.65 ,$76.63 Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,320,$137.50 ,$133.38 ,97% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.05 ,72.76% of billed charges for outpatient setting,$93.84 ,68.25% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.99 ,80.72% of billed charges for outpatient setting,$110.99 ,80.72% of billed charges for outpatient setting,$121.84 ,88.61% of billed charges for outpatient setting,$91.16 ,66.30% of billed charges for outpatient setting,$111.38 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$126.50 ,92% of billed charges for outpatient setting,$130.63 ,95% of billed charges for outpatient setting,$133.38 ,97% of billed charges for outpatient setting,$89.38 ,65% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.67 ,$133.38 ,$68.75 Outpatient Medical Services,RADIOLOGY,73010,X-ray exam of shoulder blade,320,$286.00 ,$277.42 ,97% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$208.09 ,72.76% of billed charges for outpatient setting,$195.20 ,68.25% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$230.86 ,80.72% of billed charges for outpatient setting,$230.86 ,80.72% of billed charges for outpatient setting,$253.42 ,88.61% of billed charges for outpatient setting,$189.62 ,66.30% of billed charges for outpatient setting,$231.66 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$263.12 ,92% of billed charges for outpatient setting,$271.70 ,95% of billed charges for outpatient setting,$277.42 ,97% of billed charges for outpatient setting,$185.90 ,65% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.12 ,$277.42 ,$143.00 Outpatient Medical Services,RADIOLOGY,73020,X-ray exam of shoulder,320,$121.50 ,$117.86 ,97% of billed charges for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.13 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.35 ,90% of billed charges for outpatient setting,$109.35 ,90% of billed charges for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$88.40 ,72.76% of billed charges for outpatient setting,$82.92 ,68.25% of billed charges for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.07 ,80.72% of billed charges for outpatient setting,$98.07 ,80.72% of billed charges for outpatient setting,$107.66 ,88.61% of billed charges for outpatient setting,$80.55 ,66.30% of billed charges for outpatient setting,$98.42 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$111.78 ,92% of billed charges for outpatient setting,$115.43 ,95% of billed charges for outpatient setting,$117.86 ,97% of billed charges for outpatient setting,$78.98 ,65% of billed charges for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.35 ,90% of billed charges for outpatient setting,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$72.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$21.13 ,$117.86 ,$60.75 Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,320,$305.00 ,$295.85 ,97% of billed charges for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$274.50 ,90% of billed charges for outpatient setting,$274.50 ,90% of billed charges for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$221.92 ,72.76% of billed charges for outpatient setting,$208.16 ,68.25% of billed charges for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$246.20 ,80.72% of billed charges for outpatient setting,$246.20 ,80.72% of billed charges for outpatient setting,$270.26 ,88.61% of billed charges for outpatient setting,$202.22 ,66.30% of billed charges for outpatient setting,$247.05 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$280.60 ,92% of billed charges for outpatient setting,$289.75 ,95% of billed charges for outpatient setting,$295.85 ,97% of billed charges for outpatient setting,$198.25 ,65% of billed charges for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$274.50 ,90% of billed charges for outpatient setting,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$183.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.67 ,$295.85 ,$152.50 Outpatient Medical Services,RADIOLOGY,73050,X-ray exam of shoulders,320,$181.25 ,$175.81 ,97% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$131.88 ,72.76% of billed charges for outpatient setting,$123.70 ,68.25% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.31 ,80.72% of billed charges for outpatient setting,$146.31 ,80.72% of billed charges for outpatient setting,$160.61 ,88.61% of billed charges for outpatient setting,$120.17 ,66.30% of billed charges for outpatient setting,$146.81 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$166.75 ,92% of billed charges for outpatient setting,$172.19 ,95% of billed charges for outpatient setting,$175.81 ,97% of billed charges for outpatient setting,$117.81 ,65% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.13 ,90% of billed charges for outpatient setting,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$108.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.76 ,$175.81 ,$90.63 Outpatient Medical Services,RADIOLOGY,73060,X-ray exam of humerus,320,$150.25 ,$145.74 ,97% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.32 ,72.76% of billed charges for outpatient setting,$102.55 ,68.25% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,80.72% of billed charges for outpatient setting,$121.28 ,80.72% of billed charges for outpatient setting,$133.14 ,88.61% of billed charges for outpatient setting,$99.62 ,66.30% of billed charges for outpatient setting,$121.70 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$138.23 ,92% of billed charges for outpatient setting,$142.74 ,95% of billed charges for outpatient setting,$145.74 ,97% of billed charges for outpatient setting,$97.66 ,65% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.23 ,90% of billed charges for outpatient setting,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$90.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.57 ,$145.74 ,$75.13 Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",320,$136.00 ,$131.92 ,97% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.83 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.95 ,72.76% of billed charges for outpatient setting,$92.82 ,68.25% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$120.51 ,88.61% of billed charges for outpatient setting,$90.17 ,66.30% of billed charges for outpatient setting,$110.16 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$125.12 ,92% of billed charges for outpatient setting,$129.20 ,95% of billed charges for outpatient setting,$131.92 ,97% of billed charges for outpatient setting,$88.40 ,65% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.83 ,$131.92 ,$68.00 Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",320,$167.75 ,$162.72 ,97% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.05 ,72.76% of billed charges for outpatient setting,$114.49 ,68.25% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.41 ,80.72% of billed charges for outpatient setting,$135.41 ,80.72% of billed charges for outpatient setting,$148.64 ,88.61% of billed charges for outpatient setting,$111.22 ,66.30% of billed charges for outpatient setting,$135.88 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$154.33 ,92% of billed charges for outpatient setting,$159.36 ,95% of billed charges for outpatient setting,$162.72 ,97% of billed charges for outpatient setting,$109.04 ,65% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$26.32 ,$162.72 ,$83.88 Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,320,$137.50 ,$133.38 ,97% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.05 ,72.76% of billed charges for outpatient setting,$93.84 ,68.25% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.99 ,80.72% of billed charges for outpatient setting,$110.99 ,80.72% of billed charges for outpatient setting,$121.84 ,88.61% of billed charges for outpatient setting,$91.16 ,66.30% of billed charges for outpatient setting,$111.38 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$126.50 ,92% of billed charges for outpatient setting,$130.63 ,95% of billed charges for outpatient setting,$133.38 ,97% of billed charges for outpatient setting,$89.38 ,65% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.75 ,90% of billed charges for outpatient setting,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$82.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.77 ,$133.38 ,$68.75 Outpatient Medical Services,RADIOLOGY,73100,3 or more views,320,$139.50 ,$135.32 ,97% of billed charges for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.07 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$101.50 ,72.76% of billed charges for outpatient setting,$95.21 ,68.25% of billed charges for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$112.60 ,80.72% of billed charges for outpatient setting,$112.60 ,80.72% of billed charges for outpatient setting,$123.61 ,88.61% of billed charges for outpatient setting,$92.49 ,66.30% of billed charges for outpatient setting,$113.00 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$128.34 ,92% of billed charges for outpatient setting,$132.53 ,95% of billed charges for outpatient setting,$135.32 ,97% of billed charges for outpatient setting,$90.68 ,65% of billed charges for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$125.55 ,90% of billed charges for outpatient setting,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$83.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.07 ,$135.32 ,$69.75 Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,320,$162.25 ,$157.38 ,97% of billed charges for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.01 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.03 ,90% of billed charges for outpatient setting,$146.03 ,90% of billed charges for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.05 ,72.76% of billed charges for outpatient setting,$110.74 ,68.25% of billed charges for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.97 ,80.72% of billed charges for outpatient setting,$130.97 ,80.72% of billed charges for outpatient setting,$143.77 ,88.61% of billed charges for outpatient setting,$107.57 ,66.30% of billed charges for outpatient setting,$131.42 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$149.27 ,92% of billed charges for outpatient setting,$154.14 ,95% of billed charges for outpatient setting,$157.38 ,97% of billed charges for outpatient setting,$105.46 ,65% of billed charges for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$146.03 ,90% of billed charges for outpatient setting,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$97.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.01 ,$157.38 ,$81.13 Outpatient Medical Services,RADIOLOGY,73120,X-ray of the hand with 2 views,320,$136.00 ,$131.92 ,97% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.95 ,72.76% of billed charges for outpatient setting,$92.82 ,68.25% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$109.78 ,80.72% of billed charges for outpatient setting,$120.51 ,88.61% of billed charges for outpatient setting,$90.17 ,66.30% of billed charges for outpatient setting,$110.16 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$125.12 ,92% of billed charges for outpatient setting,$129.20 ,95% of billed charges for outpatient setting,$131.92 ,97% of billed charges for outpatient setting,$88.40 ,65% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.40 ,90% of billed charges for outpatient setting,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$81.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.67 ,$131.92 ,$68.00 Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,320,$153.25 ,$148.65 ,97% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$111.50 ,72.76% of billed charges for outpatient setting,$104.59 ,68.25% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$135.79 ,88.61% of billed charges for outpatient setting,$101.60 ,66.30% of billed charges for outpatient setting,$124.13 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$140.99 ,92% of billed charges for outpatient setting,$145.59 ,95% of billed charges for outpatient setting,$148.65 ,97% of billed charges for outpatient setting,$99.61 ,65% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.32 ,$148.65 ,$76.63 Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,$134.75 ,$130.71 ,97% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.42 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.04 ,72.76% of billed charges for outpatient setting,$91.97 ,68.25% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$119.40 ,88.61% of billed charges for outpatient setting,$89.34 ,66.30% of billed charges for outpatient setting,$109.15 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$123.97 ,92% of billed charges for outpatient setting,$128.01 ,95% of billed charges for outpatient setting,$130.71 ,97% of billed charges for outpatient setting,$87.59 ,65% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.42 ,$130.71 ,$67.38 Outpatient Medical Services,RADIOLOGY,73200,Ct upper extremity w/o dye,352,"$1,335.75 ","$1,295.68 ",97% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$971.89 ,72.76% of billed charges for outpatient setting,$911.65 ,68.25% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,078.22 ",80.72% of billed charges for outpatient setting,"$1,078.22 ",80.72% of billed charges for outpatient setting,"$1,183.61 ",88.61% of billed charges for outpatient setting,$885.60 ,66.30% of billed charges for outpatient setting,"$1,081.96 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,228.89 ",92% of billed charges for outpatient setting,"$1,268.96 ",95% of billed charges for outpatient setting,"$1,295.68 ",97% of billed charges for outpatient setting,$868.24 ,65% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$971.89 ,$667.88 Outpatient Medical Services,RADIOLOGY,73201,Ct upper extremity w/dye,352,"$1,590.75 ","$1,543.03 ",97% of billed charges for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$195.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,431.68 ",90% of billed charges for outpatient setting,"$1,431.68 ",90% of billed charges for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,157.43 ",72.76% of billed charges for outpatient setting,"$1,085.69 ",68.25% of billed charges for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,284.05 ",80.72% of billed charges for outpatient setting,"$1,284.05 ",80.72% of billed charges for outpatient setting,"$1,409.56 ",88.61% of billed charges for outpatient setting,"$1,054.67 ",66.30% of billed charges for outpatient setting,"$1,288.51 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,463.49 ",92% of billed charges for outpatient setting,"$1,511.21 ",95% of billed charges for outpatient setting,"$1,543.03 ",97% of billed charges for outpatient setting,"$1,033.99 ",65% of billed charges for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,431.68 ",90% of billed charges for outpatient setting,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$954.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$195.17 ,$795.38 Outpatient Medical Services,RADIOLOGY,73218,Mri upper extremity w/o dye,614,"$3,125.75 ","$3,031.98 ",97% of billed charges for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$257.84 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,813.18 ",90% of billed charges for outpatient setting,"$2,813.18 ",90% of billed charges for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,274.30 ",72.76% of billed charges for outpatient setting,"$2,133.32 ",68.25% of billed charges for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,523.11 ",80.72% of billed charges for outpatient setting,"$2,523.11 ",80.72% of billed charges for outpatient setting,"$2,769.73 ",88.61% of billed charges for outpatient setting,"$2,072.37 ",66.30% of billed charges for outpatient setting,"$2,531.86 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,875.69 ",92% of billed charges for outpatient setting,"$2,969.46 ",95% of billed charges for outpatient setting,"$3,031.98 ",97% of billed charges for outpatient setting,"$2,031.74 ",65% of billed charges for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,813.18 ",90% of billed charges for outpatient setting,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,875.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$257.84 ,"$1,562.88 " Outpatient Medical Services,RADIOLOGY,73221,MRI of upper extremity without dye,614,"$2,671.00 ","$2,590.87 ",97% of billed charges for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$205.11 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,403.90 ",90% of billed charges for outpatient setting,"$2,403.90 ",90% of billed charges for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,943.42 ",72.76% of billed charges for outpatient setting,"$1,822.96 ",68.25% of billed charges for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,156.03 ",80.72% of billed charges for outpatient setting,"$2,156.03 ",80.72% of billed charges for outpatient setting,"$2,366.77 ",88.61% of billed charges for outpatient setting,"$1,770.87 ",66.30% of billed charges for outpatient setting,"$2,163.51 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,457.32 ",92% of billed charges for outpatient setting,"$2,537.45 ",95% of billed charges for outpatient setting,"$2,590.87 ",97% of billed charges for outpatient setting,"$1,736.15 ",65% of billed charges for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,403.90 ",90% of billed charges for outpatient setting,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,602.60 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$205.11 ,"$1,335.50 " Outpatient Medical Services,RADIOLOGY,73222,Mri joint upr extrem w/dye,614,"$3,022.50 ","$2,931.83 ",97% of billed charges for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$323.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,720.25 ",90% of billed charges for outpatient setting,"$2,720.25 ",90% of billed charges for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,199.17 ",72.76% of billed charges for outpatient setting,"$2,062.86 ",68.25% of billed charges for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,439.76 ",80.72% of billed charges for outpatient setting,"$2,439.76 ",80.72% of billed charges for outpatient setting,"$2,678.24 ",88.61% of billed charges for outpatient setting,"$2,003.92 ",66.30% of billed charges for outpatient setting,"$2,448.23 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,780.70 ",92% of billed charges for outpatient setting,"$2,871.38 ",95% of billed charges for outpatient setting,"$2,931.83 ",97% of billed charges for outpatient setting,"$1,964.63 ",65% of billed charges for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,720.25 ",90% of billed charges for outpatient setting,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,813.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$323.46 ,"$1,511.25 " Outpatient Medical Services,RADIOLOGY,73501,X-ray exam hip uni 1 view,320,$301.50 ,$292.46 ,97% of billed charges for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$271.35 ,90% of billed charges for outpatient setting,$271.35 ,90% of billed charges for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$219.37 ,72.76% of billed charges for outpatient setting,$205.77 ,68.25% of billed charges for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.37 ,80.72% of billed charges for outpatient setting,$243.37 ,80.72% of billed charges for outpatient setting,$267.16 ,88.61% of billed charges for outpatient setting,$199.89 ,66.30% of billed charges for outpatient setting,$244.22 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$277.38 ,92% of billed charges for outpatient setting,$286.43 ,95% of billed charges for outpatient setting,$292.46 ,97% of billed charges for outpatient setting,$195.98 ,65% of billed charges for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$271.35 ,90% of billed charges for outpatient setting,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$180.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.27 ,$292.46 ,$150.75 Outpatient Medical Services,RADIOLOGY,73502,X-ray exam hip uni 2-3 views,320,$313.50 ,$304.10 ,97% of billed charges for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.66 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$282.15 ,90% of billed charges for outpatient setting,$282.15 ,90% of billed charges for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$228.10 ,72.76% of billed charges for outpatient setting,$213.96 ,68.25% of billed charges for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$253.06 ,80.72% of billed charges for outpatient setting,$253.06 ,80.72% of billed charges for outpatient setting,$277.79 ,88.61% of billed charges for outpatient setting,$207.85 ,66.30% of billed charges for outpatient setting,$253.94 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$288.42 ,92% of billed charges for outpatient setting,$297.83 ,95% of billed charges for outpatient setting,$304.10 ,97% of billed charges for outpatient setting,$203.78 ,65% of billed charges for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$282.15 ,90% of billed charges for outpatient setting,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$188.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$37.66 ,$304.10 ,$156.75 Outpatient Medical Services,RADIOLOGY,73521,X-ray exam hips bi 2 views,320,$197.25 ,$191.33 ,97% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.76 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.52 ,72.76% of billed charges for outpatient setting,$134.62 ,68.25% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$174.78 ,88.61% of billed charges for outpatient setting,$130.78 ,66.30% of billed charges for outpatient setting,$159.77 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$181.47 ,92% of billed charges for outpatient setting,$187.39 ,95% of billed charges for outpatient setting,$191.33 ,97% of billed charges for outpatient setting,$128.21 ,65% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$33.76 ,$191.33 ,$98.63 Outpatient Medical Services,RADIOLOGY,73522,X-ray exam hips bi 3-4 views,320,$245.25 ,$237.89 ,97% of billed charges for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$220.73 ,90% of billed charges for outpatient setting,$220.73 ,90% of billed charges for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$178.44 ,72.76% of billed charges for outpatient setting,$167.38 ,68.25% of billed charges for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$197.97 ,80.72% of billed charges for outpatient setting,$197.97 ,80.72% of billed charges for outpatient setting,$217.32 ,88.61% of billed charges for outpatient setting,$162.60 ,66.30% of billed charges for outpatient setting,$198.65 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$225.63 ,92% of billed charges for outpatient setting,$232.99 ,95% of billed charges for outpatient setting,$237.89 ,97% of billed charges for outpatient setting,$159.41 ,65% of billed charges for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$220.73 ,90% of billed charges for outpatient setting,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$147.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.15 ,$237.89 ,$122.63 Outpatient Medical Services,RADIOLOGY,73552,X-ray exam of femur 2/>,320,$148.75 ,$144.29 ,97% of billed charges for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.88 ,90% of billed charges for outpatient setting,$133.88 ,90% of billed charges for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.23 ,72.76% of billed charges for outpatient setting,$101.52 ,68.25% of billed charges for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$120.07 ,80.72% of billed charges for outpatient setting,$120.07 ,80.72% of billed charges for outpatient setting,$131.81 ,88.61% of billed charges for outpatient setting,$98.62 ,66.30% of billed charges for outpatient setting,$120.49 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$136.85 ,92% of billed charges for outpatient setting,$141.31 ,95% of billed charges for outpatient setting,$144.29 ,97% of billed charges for outpatient setting,$96.69 ,65% of billed charges for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.88 ,90% of billed charges for outpatient setting,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$89.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.37 ,$144.29 ,$74.38 Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,320,$286.00 ,$277.42 ,97% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.37 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$208.09 ,72.76% of billed charges for outpatient setting,$195.20 ,68.25% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$230.86 ,80.72% of billed charges for outpatient setting,$230.86 ,80.72% of billed charges for outpatient setting,$253.42 ,88.61% of billed charges for outpatient setting,$189.62 ,66.30% of billed charges for outpatient setting,$231.66 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$263.12 ,92% of billed charges for outpatient setting,$271.70 ,95% of billed charges for outpatient setting,$277.42 ,97% of billed charges for outpatient setting,$185.90 ,65% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.40 ,90% of billed charges for outpatient setting,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$171.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.37 ,$277.42 ,$143.00 Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,320,$167.75 ,$162.72 ,97% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.66 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$122.05 ,72.76% of billed charges for outpatient setting,$114.49 ,68.25% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.41 ,80.72% of billed charges for outpatient setting,$135.41 ,80.72% of billed charges for outpatient setting,$148.64 ,88.61% of billed charges for outpatient setting,$111.22 ,66.30% of billed charges for outpatient setting,$135.88 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$154.33 ,92% of billed charges for outpatient setting,$159.36 ,95% of billed charges for outpatient setting,$162.72 ,97% of billed charges for outpatient setting,$109.04 ,65% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.98 ,90% of billed charges for outpatient setting,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$100.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$32.66 ,$162.72 ,$83.88 Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,$190.75 ,$185.03 ,97% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$138.79 ,72.76% of billed charges for outpatient setting,$130.19 ,68.25% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$153.97 ,80.72% of billed charges for outpatient setting,$153.97 ,80.72% of billed charges for outpatient setting,$169.02 ,88.61% of billed charges for outpatient setting,$126.47 ,66.30% of billed charges for outpatient setting,$154.51 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$175.49 ,92% of billed charges for outpatient setting,$181.21 ,95% of billed charges for outpatient setting,$185.03 ,97% of billed charges for outpatient setting,$123.99 ,65% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.68 ,90% of billed charges for outpatient setting,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$114.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$36.46 ,$185.03 ,$95.38 Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,320,$278.50 ,$270.15 ,97% of billed charges for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.97 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$250.65 ,90% of billed charges for outpatient setting,$250.65 ,90% of billed charges for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$202.64 ,72.76% of billed charges for outpatient setting,$190.08 ,68.25% of billed charges for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$224.81 ,80.72% of billed charges for outpatient setting,$224.81 ,80.72% of billed charges for outpatient setting,$246.78 ,88.61% of billed charges for outpatient setting,$184.65 ,66.30% of billed charges for outpatient setting,$225.59 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$256.22 ,92% of billed charges for outpatient setting,$264.58 ,95% of billed charges for outpatient setting,$270.15 ,97% of billed charges for outpatient setting,$181.03 ,65% of billed charges for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$250.65 ,90% of billed charges for outpatient setting,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$167.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.97 ,$270.15 ,$139.25 Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,320,$270.25 ,$262.14 ,97% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$196.63 ,72.76% of billed charges for outpatient setting,$184.45 ,68.25% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$218.15 ,80.72% of billed charges for outpatient setting,$218.15 ,80.72% of billed charges for outpatient setting,$239.47 ,88.61% of billed charges for outpatient setting,$179.18 ,66.30% of billed charges for outpatient setting,$218.90 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$248.63 ,92% of billed charges for outpatient setting,$256.74 ,95% of billed charges for outpatient setting,$262.14 ,97% of billed charges for outpatient setting,$175.66 ,65% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.23 ,90% of billed charges for outpatient setting,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$162.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.17 ,$262.14 ,$135.13 Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,320,$153.25 ,$148.65 ,97% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.32 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$111.50 ,72.76% of billed charges for outpatient setting,$104.59 ,68.25% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$135.79 ,88.61% of billed charges for outpatient setting,$101.60 ,66.30% of billed charges for outpatient setting,$124.13 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$140.99 ,92% of billed charges for outpatient setting,$145.59 ,95% of billed charges for outpatient setting,$148.65 ,97% of billed charges for outpatient setting,$99.61 ,65% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$29.32 ,$148.65 ,$76.63 Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",320,$134.75 ,$130.71 ,97% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.88 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.04 ,72.76% of billed charges for outpatient setting,$91.97 ,68.25% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$119.40 ,88.61% of billed charges for outpatient setting,$89.34 ,66.30% of billed charges for outpatient setting,$109.15 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$123.97 ,92% of billed charges for outpatient setting,$128.01 ,95% of billed charges for outpatient setting,$130.71 ,97% of billed charges for outpatient setting,$87.59 ,65% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.88 ,$130.71 ,$67.38 Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,320,$153.25 ,$148.65 ,97% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.52 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$111.50 ,72.76% of billed charges for outpatient setting,$104.59 ,68.25% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$123.70 ,80.72% of billed charges for outpatient setting,$135.79 ,88.61% of billed charges for outpatient setting,$101.60 ,66.30% of billed charges for outpatient setting,$124.13 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$140.99 ,92% of billed charges for outpatient setting,$145.59 ,95% of billed charges for outpatient setting,$148.65 ,97% of billed charges for outpatient setting,$99.61 ,65% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$137.93 ,90% of billed charges for outpatient setting,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$91.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$27.52 ,$148.65 ,$76.63 Outpatient Medical Services,RADIOLOGY,73650,Radiologic examination of the heel,320,$132.50 ,$128.53 ,97% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.88 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$96.41 ,72.76% of billed charges for outpatient setting,$90.43 ,68.25% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$106.95 ,80.72% of billed charges for outpatient setting,$106.95 ,80.72% of billed charges for outpatient setting,$117.41 ,88.61% of billed charges for outpatient setting,$87.85 ,66.30% of billed charges for outpatient setting,$107.33 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$121.90 ,92% of billed charges for outpatient setting,$125.88 ,95% of billed charges for outpatient setting,$128.53 ,97% of billed charges for outpatient setting,$86.13 ,65% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.25 ,90% of billed charges for outpatient setting,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$79.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$23.88 ,$128.53 ,$66.25 Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,$130.25 ,$126.34 ,97% of billed charges for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.22 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.23 ,90% of billed charges for outpatient setting,$117.23 ,90% of billed charges for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.77 ,72.76% of billed charges for outpatient setting,$88.90 ,68.25% of billed charges for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.14 ,80.72% of billed charges for outpatient setting,$105.14 ,80.72% of billed charges for outpatient setting,$115.41 ,88.61% of billed charges for outpatient setting,$86.36 ,66.30% of billed charges for outpatient setting,$105.50 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$119.83 ,92% of billed charges for outpatient setting,$123.74 ,95% of billed charges for outpatient setting,$126.34 ,97% of billed charges for outpatient setting,$84.66 ,65% of billed charges for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.23 ,90% of billed charges for outpatient setting,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$78.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.22 ,$126.34 ,$65.13 Outpatient Medical Services,RADIOLOGY,73700,CT scan of leg without dye,352,"$1,335.75 ","$1,295.68 ",97% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$142.39 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$971.89 ,72.76% of billed charges for outpatient setting,$911.65 ,68.25% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,078.22 ",80.72% of billed charges for outpatient setting,"$1,078.22 ",80.72% of billed charges for outpatient setting,"$1,183.61 ",88.61% of billed charges for outpatient setting,$885.60 ,66.30% of billed charges for outpatient setting,"$1,081.96 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,228.89 ",92% of billed charges for outpatient setting,"$1,268.96 ",95% of billed charges for outpatient setting,"$1,295.68 ",97% of billed charges for outpatient setting,$868.24 ,65% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,202.18 ",90% of billed charges for outpatient setting,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$801.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$971.89 ,$667.88 Outpatient Medical Services,RADIOLOGY,73706,Ct angio lwr extr w/o&w/dye,352,"$2,647.50 ","$2,568.08 ",97% of billed charges for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$259.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,382.75 ",90% of billed charges for outpatient setting,"$2,382.75 ",90% of billed charges for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,926.32 ",72.76% of billed charges for outpatient setting,"$1,806.92 ",68.25% of billed charges for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,137.06 ",80.72% of billed charges for outpatient setting,"$2,137.06 ",80.72% of billed charges for outpatient setting,"$2,345.95 ",88.61% of billed charges for outpatient setting,"$1,755.29 ",66.30% of billed charges for outpatient setting,"$2,144.48 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,435.70 ",92% of billed charges for outpatient setting,"$2,515.13 ",95% of billed charges for outpatient setting,"$2,568.08 ",97% of billed charges for outpatient setting,"$1,720.88 ",65% of billed charges for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,382.75 ",90% of billed charges for outpatient setting,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,588.50 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$259.25 ,"$1,323.75 " Outpatient Medical Services,RADIOLOGY,73718,MRI of leg without dye,614,"$4,106.50 ","$3,983.31 ",97% of billed charges for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$229.53 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,695.85 ",90% of billed charges for outpatient setting,"$3,695.85 ",90% of billed charges for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,987.89 ",72.76% of billed charges for outpatient setting,"$2,802.69 ",68.25% of billed charges for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,314.77 ",80.72% of billed charges for outpatient setting,"$3,314.77 ",80.72% of billed charges for outpatient setting,"$3,638.77 ",88.61% of billed charges for outpatient setting,"$2,722.61 ",66.30% of billed charges for outpatient setting,"$3,326.27 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,777.98 ",92% of billed charges for outpatient setting,"$3,901.18 ",95% of billed charges for outpatient setting,"$3,983.31 ",97% of billed charges for outpatient setting,"$2,669.23 ",65% of billed charges for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,695.85 ",90% of billed charges for outpatient setting,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,463.90 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$229.53 ,"$2,053.25 " Outpatient Medical Services,RADIOLOGY,73720,Mri lwr extremity w/o&w/dye,614,"$4,709.75 ","$4,568.46 ",97% of billed charges for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$348.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,238.78 ",90% of billed charges for outpatient setting,"$4,238.78 ",90% of billed charges for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,426.81 ",72.76% of billed charges for outpatient setting,"$3,214.40 ",68.25% of billed charges for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,801.71 ",80.72% of billed charges for outpatient setting,"$3,801.71 ",80.72% of billed charges for outpatient setting,"$4,173.31 ",88.61% of billed charges for outpatient setting,"$3,122.56 ",66.30% of billed charges for outpatient setting,"$3,814.90 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,332.97 ",92% of billed charges for outpatient setting,"$4,474.26 ",95% of billed charges for outpatient setting,"$4,568.46 ",97% of billed charges for outpatient setting,"$3,061.34 ",65% of billed charges for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$4,238.78 ",90% of billed charges for outpatient setting,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,825.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$348.74 ,"$2,354.88 " Outpatient Medical Services,RADIOLOGY,73721,MRI of lower extremity joint (knee/ankle) without dye,614,"$2,700.75 ","$2,619.73 ",97% of billed charges for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$205.11 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,430.68 ",90% of billed charges for outpatient setting,"$2,430.68 ",90% of billed charges for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,965.07 ",72.76% of billed charges for outpatient setting,"$1,843.26 ",68.25% of billed charges for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,180.05 ",80.72% of billed charges for outpatient setting,"$2,180.05 ",80.72% of billed charges for outpatient setting,"$2,393.13 ",88.61% of billed charges for outpatient setting,"$1,790.60 ",66.30% of billed charges for outpatient setting,"$2,187.61 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,484.69 ",92% of billed charges for outpatient setting,"$2,565.71 ",95% of billed charges for outpatient setting,"$2,619.73 ",97% of billed charges for outpatient setting,"$1,755.49 ",65% of billed charges for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,430.68 ",90% of billed charges for outpatient setting,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,620.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$205.11 ,"$1,350.38 " Outpatient Medical Services,RADIOLOGY,74018,X-ray exam abdomen 1 view,320,$134.75 ,$130.71 ,97% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.04 ,72.76% of billed charges for outpatient setting,$91.97 ,68.25% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$108.77 ,80.72% of billed charges for outpatient setting,$119.40 ,88.61% of billed charges for outpatient setting,$89.34 ,66.30% of billed charges for outpatient setting,$109.15 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$123.97 ,92% of billed charges for outpatient setting,$128.01 ,95% of billed charges for outpatient setting,$130.71 ,97% of billed charges for outpatient setting,$87.59 ,65% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$121.28 ,90% of billed charges for outpatient setting,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$80.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$25.17 ,$130.71 ,$67.38 Outpatient Medical Services,RADIOLOGY,74019,X-ray exam abdomen 2 views,320,$197.25 ,$191.33 ,97% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$143.52 ,72.76% of billed charges for outpatient setting,$134.62 ,68.25% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$159.22 ,80.72% of billed charges for outpatient setting,$174.78 ,88.61% of billed charges for outpatient setting,$130.78 ,66.30% of billed charges for outpatient setting,$159.77 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$181.47 ,92% of billed charges for outpatient setting,$187.39 ,95% of billed charges for outpatient setting,$191.33 ,97% of billed charges for outpatient setting,$128.21 ,65% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$177.53 ,90% of billed charges for outpatient setting,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$118.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$30.82 ,$191.33 ,$98.63 Outpatient Medical Services,RADIOLOGY,74022,Serial radiologic examination of the abdomen,320,$235.75 ,$228.68 ,97% of billed charges for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.31 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$212.18 ,90% of billed charges for outpatient setting,$212.18 ,90% of billed charges for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$171.53 ,72.76% of billed charges for outpatient setting,$160.90 ,68.25% of billed charges for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$190.30 ,80.72% of billed charges for outpatient setting,$190.30 ,80.72% of billed charges for outpatient setting,$208.90 ,88.61% of billed charges for outpatient setting,$156.30 ,66.30% of billed charges for outpatient setting,$190.96 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$216.89 ,92% of billed charges for outpatient setting,$223.96 ,95% of billed charges for outpatient setting,$228.68 ,97% of billed charges for outpatient setting,$153.24 ,65% of billed charges for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$212.18 ,90% of billed charges for outpatient setting,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$141.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.31 ,$228.68 ,$117.88 Outpatient Medical Services,RADIOLOGY,74150,CT of abdomen without dye,352,"$1,401.50 ","$1,359.46 ",97% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$133.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,019.73 ",72.76% of billed charges for outpatient setting,$956.52 ,68.25% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,131.29 ",80.72% of billed charges for outpatient setting,"$1,131.29 ",80.72% of billed charges for outpatient setting,"$1,241.87 ",88.61% of billed charges for outpatient setting,$929.19 ,66.30% of billed charges for outpatient setting,"$1,135.22 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,289.38 ",92% of billed charges for outpatient setting,"$1,331.43 ",95% of billed charges for outpatient setting,"$1,359.46 ",97% of billed charges for outpatient setting,$910.98 ,65% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,261.35 ",90% of billed charges for outpatient setting,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$840.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$956.52 ,$700.75 Outpatient Medical Services,RADIOLOGY,74160,CT of abdomen with dye,352,"$1,799.25 ","$1,745.27 ",97% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$208.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,309.13 ",72.76% of billed charges for outpatient setting,"$1,227.99 ",68.25% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,452.35 ",80.72% of billed charges for outpatient setting,"$1,452.35 ",80.72% of billed charges for outpatient setting,"$1,594.32 ",88.61% of billed charges for outpatient setting,"$1,192.90 ",66.30% of billed charges for outpatient setting,"$1,457.39 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,655.31 ",92% of billed charges for outpatient setting,"$1,709.29 ",95% of billed charges for outpatient setting,"$1,745.27 ",97% of billed charges for outpatient setting,"$1,169.51 ",65% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$208.90 ,$899.63 Outpatient Medical Services,RADIOLOGY,74170,CT of abdomen with and without dye,352,"$1,799.25 ","$1,745.27 ",97% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$235.77 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,309.13 ",72.76% of billed charges for outpatient setting,"$1,227.99 ",68.25% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,452.35 ",80.72% of billed charges for outpatient setting,"$1,452.35 ",80.72% of billed charges for outpatient setting,"$1,594.32 ",88.61% of billed charges for outpatient setting,"$1,192.90 ",66.30% of billed charges for outpatient setting,"$1,457.39 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,655.31 ",92% of billed charges for outpatient setting,"$1,709.29 ",95% of billed charges for outpatient setting,"$1,745.27 ",97% of billed charges for outpatient setting,"$1,169.51 ",65% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,619.33 ",90% of billed charges for outpatient setting,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,079.55 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$235.77 ,$899.63 Outpatient Medical Services,RADIOLOGY,74174,Ct angio abd&pelv w/o&w/dye,352,"$4,154.50 ","$4,029.87 ",97% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$347.64 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,022.81 ",72.76% of billed charges for outpatient setting,"$2,835.45 ",68.25% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,353.51 ",80.72% of billed charges for outpatient setting,"$3,353.51 ",80.72% of billed charges for outpatient setting,"$3,681.30 ",88.61% of billed charges for outpatient setting,"$2,754.43 ",66.30% of billed charges for outpatient setting,"$3,365.15 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,822.14 ",92% of billed charges for outpatient setting,"$3,946.78 ",95% of billed charges for outpatient setting,"$4,029.87 ",97% of billed charges for outpatient setting,"$2,700.43 ",65% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,739.05 ",90% of billed charges for outpatient setting,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,492.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$347.64 ,"$2,077.25 " Outpatient Medical Services,RADIOLOGY,74175,Ct angio abdom w/o & w/dye,352,"$2,737.75 ","$2,655.62 ",97% of billed charges for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$255.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,463.98 ",90% of billed charges for outpatient setting,"$2,463.98 ",90% of billed charges for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,991.99 ",72.76% of billed charges for outpatient setting,"$1,868.51 ",68.25% of billed charges for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,209.91 ",80.72% of billed charges for outpatient setting,"$2,209.91 ",80.72% of billed charges for outpatient setting,"$2,425.92 ",88.61% of billed charges for outpatient setting,"$1,815.13 ",66.30% of billed charges for outpatient setting,"$2,217.58 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,518.73 ",92% of billed charges for outpatient setting,"$2,600.86 ",95% of billed charges for outpatient setting,"$2,655.62 ",97% of billed charges for outpatient setting,"$1,779.54 ",65% of billed charges for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,463.98 ",90% of billed charges for outpatient setting,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,642.65 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$255.70 ,"$1,368.88 " Outpatient Medical Services,RADIOLOGY,74176,CT of abdomen and pelvis without dye,352,"$2,802.00 ","$2,717.94 ",97% of billed charges for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$179.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,521.80 ",90% of billed charges for outpatient setting,"$2,521.80 ",90% of billed charges for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,038.74 ",72.76% of billed charges for outpatient setting,"$1,912.37 ",68.25% of billed charges for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,261.77 ",80.72% of billed charges for outpatient setting,"$2,261.77 ",80.72% of billed charges for outpatient setting,"$2,482.85 ",88.61% of billed charges for outpatient setting,"$1,857.73 ",66.30% of billed charges for outpatient setting,"$2,269.62 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,577.84 ",92% of billed charges for outpatient setting,"$2,661.90 ",95% of billed charges for outpatient setting,"$2,717.94 ",97% of billed charges for outpatient setting,"$1,821.30 ",65% of billed charges for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,521.80 ",90% of billed charges for outpatient setting,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,681.20 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$179.65 ,"$1,401.00 " Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,352,"$3,451.75 ","$3,348.20 ",97% of billed charges for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$280.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,106.58 ",90% of billed charges for outpatient setting,"$3,106.58 ",90% of billed charges for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,511.49 ",72.76% of billed charges for outpatient setting,"$2,355.82 ",68.25% of billed charges for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,786.25 ",80.72% of billed charges for outpatient setting,"$2,786.25 ",80.72% of billed charges for outpatient setting,"$3,058.60 ",88.61% of billed charges for outpatient setting,"$2,288.51 ",66.30% of billed charges for outpatient setting,"$2,795.92 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,175.61 ",92% of billed charges for outpatient setting,"$3,279.16 ",95% of billed charges for outpatient setting,"$3,348.20 ",97% of billed charges for outpatient setting,"$2,243.64 ",65% of billed charges for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,106.58 ",90% of billed charges for outpatient setting,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,071.05 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$280.12 ,"$1,725.88 " Outpatient Medical Services,RADIOLOGY,74178,"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections ",352,"$4,378.00 ","$4,246.66 ",97% of billed charges for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$316.13 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,940.20 ",90% of billed charges for outpatient setting,"$3,940.20 ",90% of billed charges for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,185.43 ",72.76% of billed charges for outpatient setting,"$2,987.99 ",68.25% of billed charges for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,533.92 ",80.72% of billed charges for outpatient setting,"$3,533.92 ",80.72% of billed charges for outpatient setting,"$3,879.35 ",88.61% of billed charges for outpatient setting,"$2,902.61 ",66.30% of billed charges for outpatient setting,"$3,546.18 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,027.76 ",92% of billed charges for outpatient setting,"$4,159.10 ",95% of billed charges for outpatient setting,"$4,246.66 ",97% of billed charges for outpatient setting,"$2,845.70 ",65% of billed charges for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,940.20 ",90% of billed charges for outpatient setting,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,626.80 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$316.13 ,"$2,189.00 " Outpatient Medical Services,RADIOLOGY,74181,MRI of abdomen without dye,614,"$2,601.25 ","$2,523.21 ",97% of billed charges for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$214.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,341.13 ",90% of billed charges for outpatient setting,"$2,341.13 ",90% of billed charges for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,892.67 ",72.76% of billed charges for outpatient setting,"$1,775.35 ",68.25% of billed charges for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,099.73 ",80.72% of billed charges for outpatient setting,"$2,099.73 ",80.72% of billed charges for outpatient setting,"$2,304.97 ",88.61% of billed charges for outpatient setting,"$1,724.63 ",66.30% of billed charges for outpatient setting,"$2,107.01 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,393.15 ",92% of billed charges for outpatient setting,"$2,471.19 ",95% of billed charges for outpatient setting,"$2,523.21 ",97% of billed charges for outpatient setting,"$1,690.81 ",65% of billed charges for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,341.13 ",90% of billed charges for outpatient setting,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,560.75 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$214.80 ,"$1,300.63 " Outpatient Medical Services,RADIOLOGY,74183,MRI of abdomen without and with dye,614,"$4,224.50 ","$4,097.77 ",97% of billed charges for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$350.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,802.05 ",90% of billed charges for outpatient setting,"$3,802.05 ",90% of billed charges for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,073.75 ",72.76% of billed charges for outpatient setting,"$2,883.22 ",68.25% of billed charges for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,410.02 ",80.72% of billed charges for outpatient setting,"$3,410.02 ",80.72% of billed charges for outpatient setting,"$3,743.33 ",88.61% of billed charges for outpatient setting,"$2,800.84 ",66.30% of billed charges for outpatient setting,"$3,421.85 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,886.54 ",92% of billed charges for outpatient setting,"$4,013.28 ",95% of billed charges for outpatient setting,"$4,097.77 ",97% of billed charges for outpatient setting,"$2,745.93 ",65% of billed charges for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,802.05 ",90% of billed charges for outpatient setting,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,534.70 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$350.34 ,"$2,112.25 " Outpatient Medical Services,RADIOLOGY,74220,X-ray xm esophagus 1cntrst,320,$408.00 ,$395.76 ,97% of billed charges for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$85.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$367.20 ,90% of billed charges for outpatient setting,$367.20 ,90% of billed charges for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$296.86 ,72.76% of billed charges for outpatient setting,$278.46 ,68.25% of billed charges for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$329.34 ,80.72% of billed charges for outpatient setting,$329.34 ,80.72% of billed charges for outpatient setting,$361.53 ,88.61% of billed charges for outpatient setting,$270.50 ,66.30% of billed charges for outpatient setting,$330.48 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$375.36 ,92% of billed charges for outpatient setting,$387.60 ,95% of billed charges for outpatient setting,$395.76 ,97% of billed charges for outpatient setting,$265.20 ,65% of billed charges for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$367.20 ,90% of billed charges for outpatient setting,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$244.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$85.90 ,$395.76 ,$204.00 Outpatient Medical Services,RADIOLOGY,74230,X-ray xm swlng funcj c+,320,$428.50 ,$415.65 ,97% of billed charges for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$110.82 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$385.65 ,90% of billed charges for outpatient setting,$385.65 ,90% of billed charges for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$311.78 ,72.76% of billed charges for outpatient setting,$292.45 ,68.25% of billed charges for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$345.89 ,80.72% of billed charges for outpatient setting,$345.89 ,80.72% of billed charges for outpatient setting,$379.69 ,88.61% of billed charges for outpatient setting,$284.10 ,66.30% of billed charges for outpatient setting,$347.09 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$394.22 ,92% of billed charges for outpatient setting,$407.08 ,95% of billed charges for outpatient setting,$415.65 ,97% of billed charges for outpatient setting,$278.53 ,65% of billed charges for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$385.65 ,90% of billed charges for outpatient setting,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$257.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$415.65 ,$214.25 Outpatient Medical Services,RADIOLOGY,74240,X-ray xm upr gi trc 1cntrst,320,$512.00 ,$496.64 ,97% of billed charges for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$107.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$460.80 ,90% of billed charges for outpatient setting,$460.80 ,90% of billed charges for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$372.53 ,72.76% of billed charges for outpatient setting,$349.44 ,68.25% of billed charges for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$413.29 ,80.72% of billed charges for outpatient setting,$413.29 ,80.72% of billed charges for outpatient setting,$453.68 ,88.61% of billed charges for outpatient setting,$339.46 ,66.30% of billed charges for outpatient setting,$414.72 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$471.04 ,92% of billed charges for outpatient setting,$486.40 ,95% of billed charges for outpatient setting,$496.64 ,97% of billed charges for outpatient setting,$332.80 ,65% of billed charges for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$460.80 ,90% of billed charges for outpatient setting,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$307.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$496.64 ,$256.00 Outpatient Medical Services,RADIOLOGY,74246,X-ray xm upr gi trc 2cntrst,320,$623.25 ,$604.55 ,97% of billed charges for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$560.93 ,90% of billed charges for outpatient setting,$560.93 ,90% of billed charges for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$453.48 ,72.76% of billed charges for outpatient setting,$425.37 ,68.25% of billed charges for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$503.09 ,80.72% of billed charges for outpatient setting,$503.09 ,80.72% of billed charges for outpatient setting,$552.26 ,88.61% of billed charges for outpatient setting,$413.21 ,66.30% of billed charges for outpatient setting,$504.83 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$573.39 ,92% of billed charges for outpatient setting,$592.09 ,95% of billed charges for outpatient setting,$604.55 ,97% of billed charges for outpatient setting,$405.11 ,65% of billed charges for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$560.93 ,90% of billed charges for outpatient setting,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$373.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$604.55 ,$311.63 Outpatient Medical Services,RADIOLOGY,74280,X-ray xm colon 2cntrst std,320,$899.00 ,$872.03 ,97% of billed charges for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$198.06 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$809.10 ,90% of billed charges for outpatient setting,$809.10 ,90% of billed charges for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$654.11 ,72.76% of billed charges for outpatient setting,$613.57 ,68.25% of billed charges for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$725.67 ,80.72% of billed charges for outpatient setting,$725.67 ,80.72% of billed charges for outpatient setting,$796.60 ,88.61% of billed charges for outpatient setting,$596.04 ,66.30% of billed charges for outpatient setting,$728.19 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$827.08 ,92% of billed charges for outpatient setting,$854.05 ,95% of billed charges for outpatient setting,$872.03 ,97% of billed charges for outpatient setting,$584.35 ,65% of billed charges for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$809.10 ,90% of billed charges for outpatient setting,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$539.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$872.03 ,$449.50 Outpatient Medical Services,RADIOLOGY,75635,Ct angio abdominal arteries,352,"$3,268.25 ","$3,170.20 ",97% of billed charges for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$283.18 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,941.43 ",90% of billed charges for outpatient setting,"$2,941.43 ",90% of billed charges for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,377.98 ",72.76% of billed charges for outpatient setting,"$2,230.58 ",68.25% of billed charges for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,638.13 ",80.72% of billed charges for outpatient setting,"$2,638.13 ",80.72% of billed charges for outpatient setting,"$2,896.00 ",88.61% of billed charges for outpatient setting,"$2,166.85 ",66.30% of billed charges for outpatient setting,"$2,647.28 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$3,006.79 ",92% of billed charges for outpatient setting,"$3,104.84 ",95% of billed charges for outpatient setting,"$3,170.20 ",97% of billed charges for outpatient setting,"$2,124.36 ",65% of billed charges for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,941.43 ",90% of billed charges for outpatient setting,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,960.95 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$283.18 ,"$1,634.13 " Outpatient Medical Services,RADIOLOGY,76000,"Flouroscopy, or x-ray ""movie"" that takes less than an hour",320,$430.75 ,$417.83 ,97% of billed charges for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.96 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$387.68 ,90% of billed charges for outpatient setting,$387.68 ,90% of billed charges for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$313.41 ,72.76% of billed charges for outpatient setting,$293.99 ,68.25% of billed charges for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$347.70 ,80.72% of billed charges for outpatient setting,$347.70 ,80.72% of billed charges for outpatient setting,$381.69 ,88.61% of billed charges for outpatient setting,$285.59 ,66.30% of billed charges for outpatient setting,$348.91 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$396.29 ,92% of billed charges for outpatient setting,$409.21 ,95% of billed charges for outpatient setting,$417.83 ,97% of billed charges for outpatient setting,$279.99 ,65% of billed charges for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$387.68 ,90% of billed charges for outpatient setting,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$258.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$41.96 ,$417.83 ,$215.38 Outpatient Medical Services,RADIOLOGY,76010,X-ray nose to rectum,320,$142.25 ,$137.98 ,97% of billed charges for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.03 ,90% of billed charges for outpatient setting,$128.03 ,90% of billed charges for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$103.50 ,72.76% of billed charges for outpatient setting,$97.09 ,68.25% of billed charges for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.82 ,80.72% of billed charges for outpatient setting,$114.82 ,80.72% of billed charges for outpatient setting,$126.05 ,88.61% of billed charges for outpatient setting,$94.31 ,66.30% of billed charges for outpatient setting,$115.22 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$130.87 ,92% of billed charges for outpatient setting,$135.14 ,95% of billed charges for outpatient setting,$137.98 ,97% of billed charges for outpatient setting,$92.46 ,65% of billed charges for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$128.03 ,90% of billed charges for outpatient setting,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$85.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$24.28 ,$137.98 ,$71.13 Outpatient Medical Services,RADIOLOGY,76098,X-ray exam surgical specimen,401,$88.00 ,$85.36 ,97% of billed charges for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.19 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.20 ,90% of billed charges for outpatient setting,$79.20 ,90% of billed charges for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$64.03 ,72.76% of billed charges for outpatient setting,$60.06 ,68.25% of billed charges for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$71.03 ,80.72% of billed charges for outpatient setting,$71.03 ,80.72% of billed charges for outpatient setting,$77.98 ,88.61% of billed charges for outpatient setting,$58.34 ,66.30% of billed charges for outpatient setting,$71.28 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$80.96 ,92% of billed charges for outpatient setting,$83.60 ,95% of billed charges for outpatient setting,$85.36 ,97% of billed charges for outpatient setting,$57.20 ,65% of billed charges for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.20 ,90% of billed charges for outpatient setting,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$52.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$15.19 ,$102.86 ,$44.00 Outpatient Medical Services,RADIOLOGY,76536,Ultrasound of head and neck,402,$513.25 ,$497.85 ,97% of billed charges for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.78 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$461.93 ,90% of billed charges for outpatient setting,$461.93 ,90% of billed charges for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$373.44 ,72.76% of billed charges for outpatient setting,$350.29 ,68.25% of billed charges for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$414.30 ,80.72% of billed charges for outpatient setting,$414.30 ,80.72% of billed charges for outpatient setting,$454.79 ,88.61% of billed charges for outpatient setting,$340.28 ,66.30% of billed charges for outpatient setting,$415.73 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$472.19 ,92% of billed charges for outpatient setting,$487.59 ,95% of billed charges for outpatient setting,$497.85 ,97% of billed charges for outpatient setting,$333.61 ,65% of billed charges for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$461.93 ,90% of billed charges for outpatient setting,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$307.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$100.78 ,$497.85 ,$256.63 Outpatient Medical Services,RADIOLOGY,76604,Us exam chest,402,$419.25 ,$406.67 ,97% of billed charges for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.56 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$377.33 ,90% of billed charges for outpatient setting,$377.33 ,90% of billed charges for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$305.05 ,72.76% of billed charges for outpatient setting,$286.14 ,68.25% of billed charges for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$338.42 ,80.72% of billed charges for outpatient setting,$338.42 ,80.72% of billed charges for outpatient setting,$371.50 ,88.61% of billed charges for outpatient setting,$277.96 ,66.30% of billed charges for outpatient setting,$339.59 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$385.71 ,92% of billed charges for outpatient setting,$398.29 ,95% of billed charges for outpatient setting,$406.67 ,97% of billed charges for outpatient setting,$272.51 ,65% of billed charges for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$377.33 ,90% of billed charges for outpatient setting,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$251.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.56 ,$406.67 ,$209.63 Outpatient Medical Services,RADIOLOGY,76641,Ultrasound breast complete,402,$970.50 ,$941.39 ,97% of billed charges for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.89 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$873.45 ,90% of billed charges for outpatient setting,$873.45 ,90% of billed charges for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$706.14 ,72.76% of billed charges for outpatient setting,$662.37 ,68.25% of billed charges for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$783.39 ,80.72% of billed charges for outpatient setting,$783.39 ,80.72% of billed charges for outpatient setting,$859.96 ,88.61% of billed charges for outpatient setting,$643.44 ,66.30% of billed charges for outpatient setting,$786.11 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$892.86 ,92% of billed charges for outpatient setting,$921.98 ,95% of billed charges for outpatient setting,$941.39 ,97% of billed charges for outpatient setting,$630.83 ,65% of billed charges for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$873.45 ,90% of billed charges for outpatient setting,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$582.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$94.89 ,$941.39 ,$485.25 Outpatient Medical Services,RADIOLOGY,76642,Limited ultrasound of the breast,402,$334.50 ,$324.47 ,97% of billed charges for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.17 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.05 ,90% of billed charges for outpatient setting,$301.05 ,90% of billed charges for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$243.38 ,72.76% of billed charges for outpatient setting,$228.30 ,68.25% of billed charges for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.01 ,80.72% of billed charges for outpatient setting,$270.01 ,80.72% of billed charges for outpatient setting,$296.40 ,88.61% of billed charges for outpatient setting,$221.77 ,66.30% of billed charges for outpatient setting,$270.95 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$307.74 ,92% of billed charges for outpatient setting,$317.78 ,95% of billed charges for outpatient setting,$324.47 ,97% of billed charges for outpatient setting,$217.43 ,65% of billed charges for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.05 ,90% of billed charges for outpatient setting,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$200.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.17 ,$324.47 ,$167.25 Outpatient Medical Services,RADIOLOGY,76700,Ultrasound of abdomen with all areas scanned,402,$655.50 ,$635.84 ,97% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$107.58 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$476.94 ,72.76% of billed charges for outpatient setting,$447.38 ,68.25% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$529.12 ,80.72% of billed charges for outpatient setting,$529.12 ,80.72% of billed charges for outpatient setting,$580.84 ,88.61% of billed charges for outpatient setting,$434.60 ,66.30% of billed charges for outpatient setting,$530.96 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$603.06 ,92% of billed charges for outpatient setting,$622.73 ,95% of billed charges for outpatient setting,$635.84 ,97% of billed charges for outpatient setting,$426.08 ,65% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$635.84 ,$327.75 Outpatient Medical Services,RADIOLOGY,76705,A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen,402,$491.00 ,$476.27 ,97% of billed charges for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.26 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$441.90 ,90% of billed charges for outpatient setting,$441.90 ,90% of billed charges for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$357.25 ,72.76% of billed charges for outpatient setting,$335.11 ,68.25% of billed charges for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$396.34 ,80.72% of billed charges for outpatient setting,$396.34 ,80.72% of billed charges for outpatient setting,$435.08 ,88.61% of billed charges for outpatient setting,$325.53 ,66.30% of billed charges for outpatient setting,$397.71 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$451.72 ,92% of billed charges for outpatient setting,$466.45 ,95% of billed charges for outpatient setting,$476.27 ,97% of billed charges for outpatient setting,$319.15 ,65% of billed charges for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$441.90 ,90% of billed charges for outpatient setting,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$294.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$80.26 ,$476.27 ,$245.50 Outpatient Medical Services,RADIOLOGY,76706,Us abdl aorta screen aaa,402,$655.50 ,$635.84 ,97% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.23 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$476.94 ,72.76% of billed charges for outpatient setting,$447.38 ,68.25% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$529.12 ,80.72% of billed charges for outpatient setting,$529.12 ,80.72% of billed charges for outpatient setting,$580.84 ,88.61% of billed charges for outpatient setting,$434.60 ,66.30% of billed charges for outpatient setting,$530.96 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$603.06 ,92% of billed charges for outpatient setting,$622.73 ,95% of billed charges for outpatient setting,$635.84 ,97% of billed charges for outpatient setting,$426.08 ,65% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$589.95 ,90% of billed charges for outpatient setting,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$393.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.23 ,$635.84 ,$327.75 Outpatient Medical Services,RADIOLOGY,76770,Ultrasound of back wall of the abdomen with all areas viewed,402,$631.00 ,$612.07 ,97% of billed charges for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.74 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$567.90 ,90% of billed charges for outpatient setting,$567.90 ,90% of billed charges for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$459.12 ,72.76% of billed charges for outpatient setting,$430.66 ,68.25% of billed charges for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$509.34 ,80.72% of billed charges for outpatient setting,$509.34 ,80.72% of billed charges for outpatient setting,$559.13 ,88.61% of billed charges for outpatient setting,$418.35 ,66.30% of billed charges for outpatient setting,$511.11 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$580.52 ,92% of billed charges for outpatient setting,$599.45 ,95% of billed charges for outpatient setting,$612.07 ,97% of billed charges for outpatient setting,$410.15 ,65% of billed charges for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$567.90 ,90% of billed charges for outpatient setting,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$378.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$99.74 ,$612.07 ,$315.50 Outpatient Medical Services,RADIOLOGY,76775,Ultrasound of back wall of the abdomen with limited areas viewed,402,$494.25 ,$479.42 ,97% of billed charges for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.95 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$444.83 ,90% of billed charges for outpatient setting,$444.83 ,90% of billed charges for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$359.62 ,72.76% of billed charges for outpatient setting,$337.33 ,68.25% of billed charges for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$398.96 ,80.72% of billed charges for outpatient setting,$398.96 ,80.72% of billed charges for outpatient setting,$437.95 ,88.61% of billed charges for outpatient setting,$327.69 ,66.30% of billed charges for outpatient setting,$400.34 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$454.71 ,92% of billed charges for outpatient setting,$469.54 ,95% of billed charges for outpatient setting,$479.42 ,97% of billed charges for outpatient setting,$321.26 ,65% of billed charges for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$444.83 ,90% of billed charges for outpatient setting,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$296.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$52.95 ,$479.42 ,$247.13 Outpatient Medical Services,RADIOLOGY,76801,Abdominal ultrasound of pregnant uterus (less than 14 weeks) single or first fetus,402,$607.25 ,$589.03 ,97% of billed charges for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$109.68 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$546.53 ,90% of billed charges for outpatient setting,$546.53 ,90% of billed charges for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$441.84 ,72.76% of billed charges for outpatient setting,$414.45 ,68.25% of billed charges for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$490.17 ,80.72% of billed charges for outpatient setting,$490.17 ,80.72% of billed charges for outpatient setting,$538.08 ,88.61% of billed charges for outpatient setting,$402.61 ,66.30% of billed charges for outpatient setting,$491.87 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$558.67 ,92% of billed charges for outpatient setting,$576.89 ,95% of billed charges for outpatient setting,$589.03 ,97% of billed charges for outpatient setting,$394.71 ,65% of billed charges for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$546.53 ,90% of billed charges for outpatient setting,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$364.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$589.03 ,$303.63 Outpatient Medical Services,RADIOLOGY,76817,Transvaginal ultrasound of uterus,402,$496.25 ,$481.36 ,97% of billed charges for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$446.63 ,90% of billed charges for outpatient setting,$446.63 ,90% of billed charges for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$361.07 ,72.76% of billed charges for outpatient setting,$338.69 ,68.25% of billed charges for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$400.57 ,80.72% of billed charges for outpatient setting,$400.57 ,80.72% of billed charges for outpatient setting,$439.73 ,88.61% of billed charges for outpatient setting,$329.01 ,66.30% of billed charges for outpatient setting,$401.96 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$456.55 ,92% of billed charges for outpatient setting,$471.44 ,95% of billed charges for outpatient setting,$481.36 ,97% of billed charges for outpatient setting,$322.56 ,65% of billed charges for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$446.63 ,90% of billed charges for outpatient setting,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$297.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.46 ,$481.36 ,$248.13 Outpatient Medical Services,RADIOLOGY,76830,Ultrasound of the pelvis through vagina,402,$563.75 ,$546.84 ,97% of billed charges for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$107.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$507.38 ,90% of billed charges for outpatient setting,$507.38 ,90% of billed charges for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$410.18 ,72.76% of billed charges for outpatient setting,$384.76 ,68.25% of billed charges for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$455.06 ,80.72% of billed charges for outpatient setting,$455.06 ,80.72% of billed charges for outpatient setting,$499.54 ,88.61% of billed charges for outpatient setting,$373.77 ,66.30% of billed charges for outpatient setting,$456.64 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$518.65 ,92% of billed charges for outpatient setting,$535.56 ,95% of billed charges for outpatient setting,$546.84 ,97% of billed charges for outpatient setting,$366.44 ,65% of billed charges for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$507.38 ,90% of billed charges for outpatient setting,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$338.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$546.84 ,$281.88 Outpatient Medical Services,RADIOLOGY,76856,Complete ultrasound of the pelvis,402,$565.25 ,$548.29 ,97% of billed charges for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$96.79 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$508.73 ,90% of billed charges for outpatient setting,$508.73 ,90% of billed charges for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$411.28 ,72.76% of billed charges for outpatient setting,$385.78 ,68.25% of billed charges for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$456.27 ,80.72% of billed charges for outpatient setting,$456.27 ,80.72% of billed charges for outpatient setting,$500.87 ,88.61% of billed charges for outpatient setting,$374.76 ,66.30% of billed charges for outpatient setting,$457.85 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$520.03 ,92% of billed charges for outpatient setting,$536.99 ,95% of billed charges for outpatient setting,$548.29 ,97% of billed charges for outpatient setting,$367.41 ,65% of billed charges for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$508.73 ,90% of billed charges for outpatient setting,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$339.15 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$96.79 ,$548.29 ,$282.63 Outpatient Medical Services,RADIOLOGY,76857,Limited ultrasound of the pelvis,402,$483.00 ,$468.51 ,97% of billed charges for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$434.70 ,90% of billed charges for outpatient setting,$434.70 ,90% of billed charges for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$351.43 ,72.76% of billed charges for outpatient setting,$329.65 ,68.25% of billed charges for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$389.88 ,80.72% of billed charges for outpatient setting,$389.88 ,80.72% of billed charges for outpatient setting,$427.99 ,88.61% of billed charges for outpatient setting,$320.23 ,66.30% of billed charges for outpatient setting,$391.23 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$444.36 ,92% of billed charges for outpatient setting,$458.85 ,95% of billed charges for outpatient setting,$468.51 ,97% of billed charges for outpatient setting,$313.95 ,65% of billed charges for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$434.70 ,90% of billed charges for outpatient setting,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$289.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$44.46 ,$468.51 ,$241.50 Outpatient Medical Services,RADIOLOGY,76870,Ultrasound of the scrotum,402,$558.00 ,$541.26 ,97% of billed charges for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.94 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$502.20 ,90% of billed charges for outpatient setting,$502.20 ,90% of billed charges for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$406.00 ,72.76% of billed charges for outpatient setting,$380.84 ,68.25% of billed charges for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$450.42 ,80.72% of billed charges for outpatient setting,$450.42 ,80.72% of billed charges for outpatient setting,$494.44 ,88.61% of billed charges for outpatient setting,$369.95 ,66.30% of billed charges for outpatient setting,$451.98 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$513.36 ,92% of billed charges for outpatient setting,$530.10 ,95% of billed charges for outpatient setting,$541.26 ,97% of billed charges for outpatient setting,$362.70 ,65% of billed charges for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$502.20 ,90% of billed charges for outpatient setting,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$334.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.94 ,$541.26 ,$279.00 Outpatient Medical Services,RADIOLOGY,76882,"Diagnostic ultrasound of an extremity excluding the bone, joints or vessels",402,$569.25 ,$552.17 ,97% of billed charges for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$512.33 ,90% of billed charges for outpatient setting,$512.33 ,90% of billed charges for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$414.19 ,72.76% of billed charges for outpatient setting,$388.51 ,68.25% of billed charges for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$459.50 ,80.72% of billed charges for outpatient setting,$459.50 ,80.72% of billed charges for outpatient setting,$504.41 ,88.61% of billed charges for outpatient setting,$377.41 ,66.30% of billed charges for outpatient setting,$461.09 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$523.71 ,92% of billed charges for outpatient setting,$540.79 ,95% of billed charges for outpatient setting,$552.17 ,97% of billed charges for outpatient setting,$370.01 ,65% of billed charges for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$512.33 ,90% of billed charges for outpatient setting,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$341.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$51.60 ,$552.17 ,$284.63 Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,$356.25 ,$345.56 ,97% of billed charges for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.92 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$320.63 ,90% of billed charges for outpatient setting,$320.63 ,90% of billed charges for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$259.21 ,72.76% of billed charges for outpatient setting,$243.14 ,68.25% of billed charges for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$287.57 ,80.72% of billed charges for outpatient setting,$287.57 ,80.72% of billed charges for outpatient setting,$315.67 ,88.61% of billed charges for outpatient setting,$236.19 ,66.30% of billed charges for outpatient setting,$288.56 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$327.75 ,92% of billed charges for outpatient setting,$338.44 ,95% of billed charges for outpatient setting,$345.56 ,97% of billed charges for outpatient setting,$231.56 ,65% of billed charges for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$320.63 ,90% of billed charges for outpatient setting,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$213.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$345.56 ,$178.13 Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,$466.25 ,$452.26 ,97% of billed charges for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$148.98 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$419.63 ,90% of billed charges for outpatient setting,$419.63 ,90% of billed charges for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$339.24 ,72.76% of billed charges for outpatient setting,$318.22 ,68.25% of billed charges for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$376.36 ,80.72% of billed charges for outpatient setting,$376.36 ,80.72% of billed charges for outpatient setting,$413.14 ,88.61% of billed charges for outpatient setting,$309.12 ,66.30% of billed charges for outpatient setting,$377.66 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$428.95 ,92% of billed charges for outpatient setting,$442.94 ,95% of billed charges for outpatient setting,$452.26 ,97% of billed charges for outpatient setting,$303.06 ,65% of billed charges for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$419.63 ,90% of billed charges for outpatient setting,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$279.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$452.26 ,$233.13 Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,$300.50 ,$291.49 ,97% of billed charges for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$119.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.45 ,90% of billed charges for outpatient setting,$270.45 ,90% of billed charges for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$218.64 ,72.76% of billed charges for outpatient setting,$205.09 ,68.25% of billed charges for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$242.56 ,80.72% of billed charges for outpatient setting,$242.56 ,80.72% of billed charges for outpatient setting,$266.27 ,88.61% of billed charges for outpatient setting,$199.23 ,66.30% of billed charges for outpatient setting,$243.41 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$276.46 ,92% of billed charges for outpatient setting,$285.48 ,95% of billed charges for outpatient setting,$291.49 ,97% of billed charges for outpatient setting,$195.33 ,65% of billed charges for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.45 ,90% of billed charges for outpatient setting,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$180.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$291.49 ,$150.25 Outpatient Medical Services,RADIOLOGY,77077,Joint survey single view,320,$83.75 ,$81.24 ,97% of billed charges for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.67 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.38 ,90% of billed charges for outpatient setting,$75.38 ,90% of billed charges for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$60.94 ,72.76% of billed charges for outpatient setting,$57.16 ,68.25% of billed charges for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.60 ,80.72% of billed charges for outpatient setting,$67.60 ,80.72% of billed charges for outpatient setting,$74.21 ,88.61% of billed charges for outpatient setting,$55.53 ,66.30% of billed charges for outpatient setting,$67.84 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$77.05 ,92% of billed charges for outpatient setting,$79.56 ,95% of billed charges for outpatient setting,$81.24 ,97% of billed charges for outpatient setting,$54.44 ,65% of billed charges for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$75.38 ,90% of billed charges for outpatient setting,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$50.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$34.67 ,$102.86 ,$41.88 Outpatient Medical Services,RADIOLOGY,77080,Scan to measure bone mineral density (BMD) at the spine and hip,320,$472.00 ,$457.84 ,97% of billed charges for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.16 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$424.80 ,90% of billed charges for outpatient setting,$424.80 ,90% of billed charges for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$343.43 ,72.76% of billed charges for outpatient setting,$322.14 ,68.25% of billed charges for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$381.00 ,80.72% of billed charges for outpatient setting,$381.00 ,80.72% of billed charges for outpatient setting,$418.24 ,88.61% of billed charges for outpatient setting,$312.94 ,66.30% of billed charges for outpatient setting,$382.32 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$434.24 ,92% of billed charges for outpatient setting,$448.40 ,95% of billed charges for outpatient setting,$457.84 ,97% of billed charges for outpatient setting,$306.80 ,65% of billed charges for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$424.80 ,90% of billed charges for outpatient setting,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$283.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$35.16 ,$457.84 ,$236.00 Outpatient Medical Services,RADIOLOGY,78014,Scan using a radioactive medication (radiopharmaceutical) to take pictures or images of the thyroid gland.,341,"$1,039.25 ","$1,008.07 ",97% of billed charges for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$211.63 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$935.33 ,90% of billed charges for outpatient setting,$935.33 ,90% of billed charges for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$756.16 ,72.76% of billed charges for outpatient setting,$709.29 ,68.25% of billed charges for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$838.88 ,80.72% of billed charges for outpatient setting,$838.88 ,80.72% of billed charges for outpatient setting,$920.88 ,88.61% of billed charges for outpatient setting,$689.02 ,66.30% of billed charges for outpatient setting,$841.79 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$956.11 ,92% of billed charges for outpatient setting,$987.29 ,95% of billed charges for outpatient setting,"$1,008.07 ",97% of billed charges for outpatient setting,$675.51 ,65% of billed charges for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$935.33 ,90% of billed charges for outpatient setting,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$623.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$987.29 ,$519.63 Outpatient Medical Services,RADIOLOGY,78226,Hepatobiliary system imaging,341,"$1,286.75 ","$1,248.15 ",97% of billed charges for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$290.14 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,158.08 ",90% of billed charges for outpatient setting,"$1,158.08 ",90% of billed charges for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$936.24 ,72.76% of billed charges for outpatient setting,$878.21 ,68.25% of billed charges for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,038.66 ",80.72% of billed charges for outpatient setting,"$1,038.66 ",80.72% of billed charges for outpatient setting,"$1,140.19 ",88.61% of billed charges for outpatient setting,$853.12 ,66.30% of billed charges for outpatient setting,"$1,042.27 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,183.81 ",92% of billed charges for outpatient setting,"$1,222.41 ",95% of billed charges for outpatient setting,"$1,248.15 ",97% of billed charges for outpatient setting,$836.39 ,65% of billed charges for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,158.08 ",90% of billed charges for outpatient setting,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$772.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$936.24 ,$643.38 Outpatient Medical Services,RADIOLOGY,78227,Hepatobil syst image w/drug,341,"$1,353.75 ","$1,313.14 ",97% of billed charges for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$391.61 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,218.38 ",90% of billed charges for outpatient setting,"$1,218.38 ",90% of billed charges for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$984.99 ,72.76% of billed charges for outpatient setting,$923.93 ,68.25% of billed charges for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,092.75 ",80.72% of billed charges for outpatient setting,"$1,092.75 ",80.72% of billed charges for outpatient setting,"$1,199.56 ",88.61% of billed charges for outpatient setting,$897.54 ,66.30% of billed charges for outpatient setting,"$1,096.54 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,245.45 ",92% of billed charges for outpatient setting,"$1,286.06 ",95% of billed charges for outpatient setting,"$1,313.14 ",97% of billed charges for outpatient setting,$879.94 ,65% of billed charges for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,218.38 ",90% of billed charges for outpatient setting,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$812.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$984.99 ,$676.88 Outpatient Medical Services,RADIOLOGY,78264,Gastric emptying imag study,341,$737.75 ,$715.62 ,97% of billed charges for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$294.28 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$663.98 ,90% of billed charges for outpatient setting,$663.98 ,90% of billed charges for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$536.79 ,72.76% of billed charges for outpatient setting,$503.51 ,68.25% of billed charges for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$595.51 ,80.72% of billed charges for outpatient setting,$595.51 ,80.72% of billed charges for outpatient setting,$653.72 ,88.61% of billed charges for outpatient setting,$489.13 ,66.30% of billed charges for outpatient setting,$597.58 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$678.73 ,92% of billed charges for outpatient setting,$700.86 ,95% of billed charges for outpatient setting,$715.62 ,97% of billed charges for outpatient setting,$479.54 ,65% of billed charges for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$663.98 ,90% of billed charges for outpatient setting,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$442.65 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$715.62 ,$368.88 Outpatient Medical Services,RADIOLOGY,78452,Image of the heart to assess perfusion,341,"$2,595.75 ","$2,517.88 ",97% of billed charges for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$417.38 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,336.18 ",90% of billed charges for outpatient setting,"$2,336.18 ",90% of billed charges for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,888.67 ",72.76% of billed charges for outpatient setting,"$1,771.60 ",68.25% of billed charges for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,095.29 ",80.72% of billed charges for outpatient setting,"$2,095.29 ",80.72% of billed charges for outpatient setting,"$2,300.09 ",88.61% of billed charges for outpatient setting,"$1,720.98 ",66.30% of billed charges for outpatient setting,"$2,102.56 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,388.09 ",92% of billed charges for outpatient setting,"$2,465.96 ",95% of billed charges for outpatient setting,"$2,517.88 ",97% of billed charges for outpatient setting,"$1,687.24 ",65% of billed charges for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,336.18 ",90% of billed charges for outpatient setting,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,557.45 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$417.38 ,"$1,297.88 " Outpatient Medical Services,RADIOLOGY,93971,One sided or limited bilateral study,320,$796.25 ,$772.36 ,97% of billed charges for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$716.63 , Case Rates,$716.63 ,90% of billed charges for outpatient setting,$716.63 ,90% of billed charges for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$579.35 ,72.76% of billed charges for outpatient setting,$543.44 ,68.25% of billed charges for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$642.73 ,80.72% of billed charges for outpatient setting,$642.73 ,80.72% of billed charges for outpatient setting,$705.56 ,88.61% of billed charges for outpatient setting,$527.91 ,66.30% of billed charges for outpatient setting,$644.96 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$732.55 ,92% of billed charges for outpatient setting,$756.44 ,95% of billed charges for outpatient setting,$772.36 ,97% of billed charges for outpatient setting,$517.56 ,65% of billed charges for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$716.63 ,90% of billed charges for outpatient setting,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$477.75 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$772.36 ,$398.13 Outpatient Medical Services,EMERGENCY,99281,Emergency dept visit,450,$144.50 ,$140.17 ,97% of billed charges for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.41 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.05 ,90% of billed charges for outpatient setting,$130.05 ,90% of billed charges for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.14 ,72.76% of billed charges for outpatient setting,$98.62 ,68.25% of billed charges for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$116.64 ,80.72% of billed charges for outpatient setting,$116.64 ,80.72% of billed charges for outpatient setting,$128.04 ,88.61% of billed charges for outpatient setting,$95.80 ,66.30% of billed charges for outpatient setting,$117.05 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$132.94 ,92% of billed charges for outpatient setting,$137.28 ,95% of billed charges for outpatient setting,$140.17 ,97% of billed charges for outpatient setting,$93.93 ,65% of billed charges for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.05 ,90% of billed charges for outpatient setting,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$86.70 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$20.41 ,$140.17 ,$72.25 Outpatient Medical Services,EMERGENCY,99282,Emergency dept visit,450,$225.00 ,$218.25 ,97% of billed charges for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.84 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$202.50 ,90% of billed charges for outpatient setting,$202.50 ,90% of billed charges for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$163.71 ,72.76% of billed charges for outpatient setting,$153.56 ,68.25% of billed charges for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$181.62 ,80.72% of billed charges for outpatient setting,$181.62 ,80.72% of billed charges for outpatient setting,$199.37 ,88.61% of billed charges for outpatient setting,$149.18 ,66.30% of billed charges for outpatient setting,$182.25 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$207.00 ,92% of billed charges for outpatient setting,$213.75 ,95% of billed charges for outpatient setting,$218.25 ,97% of billed charges for outpatient setting,$146.25 ,65% of billed charges for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$202.50 ,90% of billed charges for outpatient setting,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$135.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$39.84 ,$218.25 ,$112.50 Outpatient Medical Services,EMERGENCY,99283,"Emergency department visit, moderately severe problem",450,$372.00 ,$360.84 ,97% of billed charges for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$59.71 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$334.80 ,90% of billed charges for outpatient setting,$334.80 ,90% of billed charges for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$270.67 ,72.76% of billed charges for outpatient setting,$253.89 ,68.25% of billed charges for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$300.28 ,80.72% of billed charges for outpatient setting,$300.28 ,80.72% of billed charges for outpatient setting,$329.63 ,88.61% of billed charges for outpatient setting,$246.64 ,66.30% of billed charges for outpatient setting,$301.32 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$342.24 ,92% of billed charges for outpatient setting,$353.40 ,95% of billed charges for outpatient setting,$360.84 ,97% of billed charges for outpatient setting,$241.80 ,65% of billed charges for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$334.80 ,90% of billed charges for outpatient setting,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$223.20 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$59.71 ,$360.84 ,$186.00 Outpatient Medical Services,EMERGENCY,99284,"Emergency department visit, problem of high severity",450,$585.50 ,$567.94 ,97% of billed charges for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$113.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$526.95 ,90% of billed charges for outpatient setting,$526.95 ,90% of billed charges for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$426.01 ,72.76% of billed charges for outpatient setting,$399.60 ,68.25% of billed charges for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$472.62 ,80.72% of billed charges for outpatient setting,$472.62 ,80.72% of billed charges for outpatient setting,$518.81 ,88.61% of billed charges for outpatient setting,$388.19 ,66.30% of billed charges for outpatient setting,$474.26 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$538.66 ,92% of billed charges for outpatient setting,$556.23 ,95% of billed charges for outpatient setting,$567.94 ,97% of billed charges for outpatient setting,$380.58 ,65% of billed charges for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$526.95 ,90% of billed charges for outpatient setting,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$351.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$567.94 ,$292.75 Outpatient Medical Services,EMERGENCY,99285,"Emergency department visit, problem with significant threat to life or function",450,$930.75 ,$902.83 ,97% of billed charges for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$167.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$837.68 ,90% of billed charges for outpatient setting,$837.68 ,90% of billed charges for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$677.21 ,72.76% of billed charges for outpatient setting,$635.24 ,68.25% of billed charges for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$751.30 ,80.72% of billed charges for outpatient setting,$751.30 ,80.72% of billed charges for outpatient setting,$824.74 ,88.61% of billed charges for outpatient setting,$617.09 ,66.30% of billed charges for outpatient setting,$753.91 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$856.29 ,92% of billed charges for outpatient setting,$884.21 ,95% of billed charges for outpatient setting,$902.83 ,97% of billed charges for outpatient setting,$604.99 ,65% of billed charges for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$837.68 ,90% of billed charges for outpatient setting,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$558.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$902.83 ,$465.38 Outpatient Medical Services,CLINIC,36415,Collection of venous blood by venipuncture,300,$18.50 ,$17.95 ,97% of billed charges for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.34 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$13.46 ,72.76% of billed charges for outpatient setting,$12.63 ,68.25% of billed charges for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$14.93 ,80.72% of billed charges for outpatient setting,$16.39 ,88.61% of billed charges for outpatient setting,$12.27 ,66.30% of billed charges for outpatient setting,$11.57 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$17.02 ,92% of billed charges for outpatient setting,$17.58 ,95% of billed charges for outpatient setting,$17.95 ,97% of billed charges for outpatient setting,$12.03 ,65% of billed charges for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$16.65 ,90% of billed charges for outpatient setting,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$8.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.34 ,$102.86 ,$9.25 Outpatient Medical Services,CLINIC,51702,Insert temp bladder cath,761,$127.25 ,$123.43 ,97% of billed charges for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.57 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.53 ,90% of billed charges for outpatient setting,$114.53 ,90% of billed charges for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$92.59 ,72.76% of billed charges for outpatient setting,$86.85 ,68.25% of billed charges for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.72 ,80.72% of billed charges for outpatient setting,$102.72 ,80.72% of billed charges for outpatient setting,$112.76 ,88.61% of billed charges for outpatient setting,$84.37 ,66.30% of billed charges for outpatient setting,$103.07 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$117.07 ,92% of billed charges for outpatient setting,$120.89 ,95% of billed charges for outpatient setting,$123.43 ,97% of billed charges for outpatient setting,$82.71 ,65% of billed charges for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$114.53 ,90% of billed charges for outpatient setting,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$76.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$56.57 ,$123.43 ,$63.63 Outpatient Medical Services,CLINIC,90675,Rabies vaccine im,250,$617.50 ,$598.98 ,97% of billed charges for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$297.59 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$555.75 ,90% of billed charges for outpatient setting,$555.75 ,90% of billed charges for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$449.29 ,72.76% of billed charges for outpatient setting,$421.44 ,68.25% of billed charges for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$498.45 ,80.72% of billed charges for outpatient setting,$498.45 ,80.72% of billed charges for outpatient setting,$547.17 ,88.61% of billed charges for outpatient setting,$409.40 ,66.30% of billed charges for outpatient setting,$500.18 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$568.10 ,92% of billed charges for outpatient setting,$586.63 ,95% of billed charges for outpatient setting,$598.98 ,97% of billed charges for outpatient setting,$401.38 ,65% of billed charges for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$555.75 ,90% of billed charges for outpatient setting,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$370.50 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$598.98 ,$308.75 Outpatient Medical Services,CLINIC,93005,Electrocardiogram tracing,730,$130.75 ,$126.83 ,97% of billed charges for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.68 , Case Rates,$117.68 ,90% of billed charges for outpatient setting,$117.68 ,90% of billed charges for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.13 ,72.76% of billed charges for outpatient setting,$89.24 ,68.25% of billed charges for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$105.54 ,80.72% of billed charges for outpatient setting,$105.54 ,80.72% of billed charges for outpatient setting,$115.86 ,88.61% of billed charges for outpatient setting,$86.69 ,66.30% of billed charges for outpatient setting,$105.91 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$120.29 ,92% of billed charges for outpatient setting,$124.21 ,95% of billed charges for outpatient setting,$126.83 ,97% of billed charges for outpatient setting,$84.99 ,65% of billed charges for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.68 ,90% of billed charges for outpatient setting,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$78.45 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$84.99 ,$126.83 ,$65.38 Outpatient Medical Services,CLINIC,93017,Cardiovascular stress test,482,$959.00 ,$930.23 ,97% of billed charges for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$863.10 , Case Rates,$863.10 ,90% of billed charges for outpatient setting,$863.10 ,90% of billed charges for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$697.77 ,72.76% of billed charges for outpatient setting,$654.52 ,68.25% of billed charges for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$774.10 ,80.72% of billed charges for outpatient setting,$774.10 ,80.72% of billed charges for outpatient setting,$849.77 ,88.61% of billed charges for outpatient setting,$635.82 ,66.30% of billed charges for outpatient setting,$776.79 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$882.28 ,92% of billed charges for outpatient setting,$911.05 ,95% of billed charges for outpatient setting,$930.23 ,97% of billed charges for outpatient setting,$623.35 ,65% of billed charges for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$863.10 ,90% of billed charges for outpatient setting,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$575.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$930.23 ,$479.50 Outpatient Medical Services,CLINIC,93306,"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function",972,"$1,754.00 ",N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,#VALUE!,135% CMS Medicare OPPS fee schedule for outpatient setting,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,N/A,Not separately reimbursable per CMS guidelines,,,$877.00 Outpatient Medical Services,CLINIC,94760,Measure blood oxygen level,460,$8.00 ,$7.76 ,97% of billed charges for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.27 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.20 ,90% of billed charges for outpatient setting,$7.20 ,90% of billed charges for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$5.82 ,72.76% of billed charges for outpatient setting,$5.46 ,68.25% of billed charges for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$6.46 ,80.72% of billed charges for outpatient setting,$6.46 ,80.72% of billed charges for outpatient setting,$7.09 ,88.61% of billed charges for outpatient setting,$5.30 ,66.30% of billed charges for outpatient setting,$6.48 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$7.36 ,92% of billed charges for outpatient setting,$7.60 ,95% of billed charges for outpatient setting,$7.76 ,97% of billed charges for outpatient setting,$5.20 ,65% of billed charges for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$7.20 ,90% of billed charges for outpatient setting,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$4.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$2.27 ,$102.86 ,$4.00 Outpatient Medical Services,CLINIC,99203,"New patient office or other outpatient visit, typically 30 min",510,$161.75 ,$156.90 ,97% of billed charges for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$145.58 ,90% of billed charges for outpatient setting,$145.58 ,90% of billed charges for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$117.69 ,72.76% of billed charges for outpatient setting,$110.39 ,68.25% of billed charges for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$130.56 ,80.72% of billed charges for outpatient setting,$130.56 ,80.72% of billed charges for outpatient setting,$143.33 ,88.61% of billed charges for outpatient setting,$107.24 ,66.30% of billed charges for outpatient setting,$131.02 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$148.81 ,92% of billed charges for outpatient setting,$153.66 ,95% of billed charges for outpatient setting,$156.90 ,97% of billed charges for outpatient setting,$105.14 ,65% of billed charges for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$145.58 ,90% of billed charges for outpatient setting,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$97.05 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.55 ,$156.90 ,$80.88 Outpatient Medical Services,CLINIC,99204,"New patient office of other outpatient visit, typically 45 min",510,$265.00 ,$257.05 ,97% of billed charges for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$150.90 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$238.50 ,90% of billed charges for outpatient setting,$238.50 ,90% of billed charges for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$192.81 ,72.76% of billed charges for outpatient setting,$180.86 ,68.25% of billed charges for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$213.91 ,80.72% of billed charges for outpatient setting,$213.91 ,80.72% of billed charges for outpatient setting,$234.82 ,88.61% of billed charges for outpatient setting,$175.70 ,66.30% of billed charges for outpatient setting,$214.65 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$243.80 ,92% of billed charges for outpatient setting,$251.75 ,95% of billed charges for outpatient setting,$257.05 ,97% of billed charges for outpatient setting,$172.25 ,65% of billed charges for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$238.50 ,90% of billed charges for outpatient setting,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$159.00 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$257.05 ,$132.50 Outpatient Medical Services,SLEEP,95810,Sleep monitoring of patient (6 years or older) in sleep lab,920,"$2,399.75 ","$2,327.76 ",97% of billed charges for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$540.87 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,159.78 ",90% of billed charges for outpatient setting,"$2,159.78 ",90% of billed charges for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,746.06 ",72.76% of billed charges for outpatient setting,"$1,637.83 ",68.25% of billed charges for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,937.08 ",80.72% of billed charges for outpatient setting,"$1,937.08 ",80.72% of billed charges for outpatient setting,"$2,126.42 ",88.61% of billed charges for outpatient setting,"$1,591.03 ",66.30% of billed charges for outpatient setting,"$1,943.80 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$2,207.77 ",92% of billed charges for outpatient setting,"$2,279.76 ",95% of billed charges for outpatient setting,"$2,327.76 ",97% of billed charges for outpatient setting,"$1,559.84 ",65% of billed charges for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,159.78 ",90% of billed charges for outpatient setting,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,439.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$540.87 ,"$1,199.88 " Outpatient Medical Services,THERAPY,97110,"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",430,$109.00 ,$105.73 ,97% of billed charges for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.03 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.10 ,90% of billed charges for outpatient setting,$98.10 ,90% of billed charges for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$79.31 ,72.76% of billed charges for outpatient setting,$74.39 ,68.25% of billed charges for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$87.98 ,80.72% of billed charges for outpatient setting,$87.98 ,80.72% of billed charges for outpatient setting,$96.58 ,88.61% of billed charges for outpatient setting,$72.27 ,66.30% of billed charges for outpatient setting,$88.29 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$100.28 ,92% of billed charges for outpatient setting,$103.55 ,95% of billed charges for outpatient setting,$105.73 ,97% of billed charges for outpatient setting,$70.85 ,65% of billed charges for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$98.10 ,90% of billed charges for outpatient setting,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$65.40 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$28.03 ,$105.73 ,$54.50 Outpatient Medical Services,THERAPY,99213,"Established patient office or other outpatient visit, typically 15 minutes",761,$106.00 ,$102.82 ,97% of billed charges for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.40 ,90% of billed charges for outpatient setting,$95.40 ,90% of billed charges for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$77.13 ,72.76% of billed charges for outpatient setting,$72.35 ,68.25% of billed charges for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$85.56 ,80.72% of billed charges for outpatient setting,$85.56 ,80.72% of billed charges for outpatient setting,$93.93 ,88.61% of billed charges for outpatient setting,$70.28 ,66.30% of billed charges for outpatient setting,$85.86 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$97.52 ,92% of billed charges for outpatient setting,$100.70 ,95% of billed charges for outpatient setting,$102.82 ,97% of billed charges for outpatient setting,$68.90 ,65% of billed charges for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$95.40 ,90% of billed charges for outpatient setting,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$63.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$67.12 ,$102.86 ,$53.00 Outpatient Medical Services,SURGERY,19120,REMOVAL OF BREAST LESION,360,"$1,023.50 ",$992.80 ,97% of billed charges for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$412.09 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$921.15 ,90% of billed charges for outpatient setting,$921.15 ,90% of billed charges for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$744.70 ,72.76% of billed charges for outpatient setting,$698.54 ,68.25% of billed charges for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$826.17 ,80.72% of billed charges for outpatient setting,$826.17 ,80.72% of billed charges for outpatient setting,$906.92 ,88.61% of billed charges for outpatient setting,$678.58 ,66.30% of billed charges for outpatient setting,$829.04 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$941.62 ,92% of billed charges for outpatient setting,$972.33 ,95% of billed charges for outpatient setting,$992.80 ,97% of billed charges for outpatient setting,$665.28 ,65% of billed charges for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$921.15 ,90% of billed charges for outpatient setting,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$614.10 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$992.80 ,$511.75 Outpatient Medical Services,SURGERY,29826,Shaving of shoulder bone using an endoscope,360,"$4,349.75 ","$4,219.26 ",97% of billed charges for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$177.60 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,914.78 ",90% of billed charges for outpatient setting,"$3,914.78 ",90% of billed charges for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,164.88 ",72.76% of billed charges for outpatient setting,"$2,968.70 ",68.25% of billed charges for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,511.12 ",80.72% of billed charges for outpatient setting,"$3,511.12 ",80.72% of billed charges for outpatient setting,"$3,854.31 ",88.61% of billed charges for outpatient setting,"$2,883.88 ",66.30% of billed charges for outpatient setting,"$3,523.30 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$4,001.77 ",92% of billed charges for outpatient setting,"$4,132.26 ",95% of billed charges for outpatient setting,"$4,219.26 ",97% of billed charges for outpatient setting,"$2,827.34 ",65% of billed charges for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$3,914.78 ",90% of billed charges for outpatient setting,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$2,609.85 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$177.60 ,"$2,174.88 " Outpatient Medical Services,SURGERY,29881,Surgery to remove of all or part of a torn meniscus in one compartment,360,"$1,892.25 ","$1,835.48 ",97% of billed charges for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$527.86 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,703.03 ",90% of billed charges for outpatient setting,"$1,703.03 ",90% of billed charges for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,376.80 ",72.76% of billed charges for outpatient setting,"$1,291.46 ",68.25% of billed charges for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,527.42 ",80.72% of billed charges for outpatient setting,"$1,527.42 ",80.72% of billed charges for outpatient setting,"$1,676.72 ",88.61% of billed charges for outpatient setting,"$1,254.56 ",66.30% of billed charges for outpatient setting,"$1,532.72 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,740.87 ",92% of billed charges for outpatient setting,"$1,797.64 ",95% of billed charges for outpatient setting,"$1,835.48 ",97% of billed charges for outpatient setting,"$1,229.96 ",65% of billed charges for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,703.03 ",90% of billed charges for outpatient setting,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,135.35 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$527.86 ,$946.13 Outpatient Medical Services,SURGERY,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,"$1,375.50 ","$1,334.24 ",97% of billed charges for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$281.84 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,237.95 ",90% of billed charges for outpatient setting,"$1,237.95 ",90% of billed charges for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,000.81 ",72.76% of billed charges for outpatient setting,$938.78 ,68.25% of billed charges for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,110.30 ",80.72% of billed charges for outpatient setting,"$1,110.30 ",80.72% of billed charges for outpatient setting,"$1,218.83 ",88.61% of billed charges for outpatient setting,$911.96 ,66.30% of billed charges for outpatient setting,"$1,114.16 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,265.46 ",92% of billed charges for outpatient setting,"$1,306.73 ",95% of billed charges for outpatient setting,"$1,334.24 ",97% of billed charges for outpatient setting,$894.08 ,65% of billed charges for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,237.95 ",90% of billed charges for outpatient setting,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$825.30 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$938.78 ,$687.75 Outpatient Medical Services,SURGERY,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",360,$693.00 ,$672.21 ,97% of billed charges for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$325.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$623.70 ,90% of billed charges for outpatient setting,$623.70 ,90% of billed charges for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$504.23 ,72.76% of billed charges for outpatient setting,$472.97 ,68.25% of billed charges for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$559.39 ,80.72% of billed charges for outpatient setting,$559.39 ,80.72% of billed charges for outpatient setting,$614.07 ,88.61% of billed charges for outpatient setting,$459.46 ,66.30% of billed charges for outpatient setting,$561.33 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$637.56 ,92% of billed charges for outpatient setting,$658.35 ,95% of billed charges for outpatient setting,$672.21 ,97% of billed charges for outpatient setting,$450.45 ,65% of billed charges for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$623.70 ,90% of billed charges for outpatient setting,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$415.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$672.21 ,$346.50 Outpatient Medical Services,SURGERY,45378,Diagnostic examination of large bowel using an endoscope,360,$794.25 ,$770.42 ,97% of billed charges for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$301.46 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$714.83 ,90% of billed charges for outpatient setting,$714.83 ,90% of billed charges for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$577.90 ,72.76% of billed charges for outpatient setting,$542.08 ,68.25% of billed charges for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$641.12 ,80.72% of billed charges for outpatient setting,$641.12 ,80.72% of billed charges for outpatient setting,$703.78 ,88.61% of billed charges for outpatient setting,$526.59 ,66.30% of billed charges for outpatient setting,$643.34 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$730.71 ,92% of billed charges for outpatient setting,$754.54 ,95% of billed charges for outpatient setting,$770.42 ,97% of billed charges for outpatient setting,$516.26 ,65% of billed charges for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$714.83 ,90% of billed charges for outpatient setting,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$476.55 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$770.42 ,$397.13 Outpatient Medical Services,SURGERY,45380,Biopsy of large bowel using an endoscope,360,"$1,204.75 ","$1,168.61 ",97% of billed charges for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$382.12 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,084.28 ",90% of billed charges for outpatient setting,"$1,084.28 ",90% of billed charges for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$876.58 ,72.76% of billed charges for outpatient setting,$822.24 ,68.25% of billed charges for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$972.47 ,80.72% of billed charges for outpatient setting,$972.47 ,80.72% of billed charges for outpatient setting,"$1,067.53 ",88.61% of billed charges for outpatient setting,$798.75 ,66.30% of billed charges for outpatient setting,$975.85 ,135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,108.37 ",92% of billed charges for outpatient setting,"$1,144.51 ",95% of billed charges for outpatient setting,"$1,168.61 ",97% of billed charges for outpatient setting,$783.09 ,65% of billed charges for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,084.28 ",90% of billed charges for outpatient setting,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$722.85 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$972.47 ,$602.38 Outpatient Medical Services,SURGERY,45385,Removal of polyps or growths of large bowel using an endoscope,360,"$1,082.25 ","$1,049.78 ",97% of billed charges for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$407.25 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$974.03 ,90% of billed charges for outpatient setting,$974.03 ,90% of billed charges for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$787.45 ,72.76% of billed charges for outpatient setting,$738.64 ,68.25% of billed charges for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$873.59 ,80.72% of billed charges for outpatient setting,$873.59 ,80.72% of billed charges for outpatient setting,$958.98 ,88.61% of billed charges for outpatient setting,$717.53 ,66.30% of billed charges for outpatient setting,$876.62 ,135% CMS Medicare OPPS fee schedule for outpatient setting,$995.67 ,92% of billed charges for outpatient setting,"$1,028.14 ",95% of billed charges for outpatient setting,"$1,049.78 ",97% of billed charges for outpatient setting,$703.46 ,65% of billed charges for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$974.03 ,90% of billed charges for outpatient setting,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$649.35 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$995.67 ,$541.13 Outpatient Medical Services,SURGERY,47562,Removal of gallbladder using an endoscope,360,"$2,153.50 ","$2,088.90 ",97% of billed charges for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$668.23 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,938.15 ",90% of billed charges for outpatient setting,"$1,938.15 ",90% of billed charges for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,566.89 ",72.76% of billed charges for outpatient setting,"$1,469.76 ",68.25% of billed charges for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,738.31 ",80.72% of billed charges for outpatient setting,"$1,738.31 ",80.72% of billed charges for outpatient setting,"$1,908.22 ",88.61% of billed charges for outpatient setting,"$1,427.77 ",66.30% of billed charges for outpatient setting,"$1,744.34 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,981.22 ",92% of billed charges for outpatient setting,"$2,045.83 ",95% of billed charges for outpatient setting,"$2,088.90 ",97% of billed charges for outpatient setting,"$1,399.78 ",65% of billed charges for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,938.15 ",90% of billed charges for outpatient setting,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,"$1,292.10 ",100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$668.23 ,"$1,076.75 " Outpatient Medical Services,SURGERY,49505,Repair of groin hernia patient age 5 years or older,360,"$1,498.00 ","$1,453.06 ",97% of billed charges for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$525.33 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,348.20 ",90% of billed charges for outpatient setting,"$1,348.20 ",90% of billed charges for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,089.94 ",72.76% of billed charges for outpatient setting,"$1,022.39 ",68.25% of billed charges for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,209.19 ",80.72% of billed charges for outpatient setting,"$1,209.19 ",80.72% of billed charges for outpatient setting,"$1,327.38 ",88.61% of billed charges for outpatient setting,$993.17 ,66.30% of billed charges for outpatient setting,"$1,213.38 ",135% CMS Medicare OPPS fee schedule for outpatient setting,"$1,378.16 ",92% of billed charges for outpatient setting,"$1,423.10 ",95% of billed charges for outpatient setting,"$1,453.06 ",97% of billed charges for outpatient setting,$973.70 ,65% of billed charges for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,"$1,348.20 ",90% of billed charges for outpatient setting,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,Case Rate,$898.80 ,100% CMS Medicare OPPS fee schedule for outpatient setting,$102.86 ,$993.17 ,$749.00 Outpatient Medical Services,BEHAVIORAL,90832,"Psychotherapy, 30 minute",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,BEHAVIORAL,90834,"Psychotherapy, 45 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,BEHAVIORAL,90837,"Psychotherapy, 60 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,BEHAVIORAL,90847,"Family psychotherapy, including patient, 50 min",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,BEHAVIORAL,90853,Group psychotherapy,900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OFFICE VISIT,99205,"New patient office of other outpatient visit, typically 60 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OFFICE VISIT,99243,"Patient office consultation, typically 40 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OFFICE VISIT,99244,"Patient office consultation, typically 60 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OFFICE VISIT,99385,"Initial new patient preventive medicine evaluation, for those ages 18 to 39",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OFFICE VISIT,99386,"Initial new patient preventive medicine evaluation, for those ages 40 to 64",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,LAB,80055,Obstetric blood test panel,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,LAB,81000,Manual urinalysis test with examination using microscope,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,RADIOLOGY,76805,"Abdominal ultrasound of pregnant uterus, greater or equal to 14 weeks 0 days, single or first fetus",402,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscop",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,45391,Ultrasound examination of lower large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,55700,Biopsy of prostate gland,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,59400,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,59510,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,59610,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,66821,Removal of recurring cataract in lens capsule using laser,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,OUTPATIENT SERVICES,66984,Removal of cataract with insertion of lens,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,ECCG,93000,"Electrocardiogram, routine, with interpretation and report",730,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Outpatient Medical Services,CARDIOLOGY,93452,Insertion of catheter into left heart for diagnosis,480,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Inpatient Medical Services,INPATIENT PROCEDURES,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Inpatient Medical Services,INPATIENT PROCEDURES,460,Spinal fusion except cervical without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Inpatient Medical Services,INPATIENT PROCEDURES,470,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Inpatient Medical Services,INPATIENT PROCEDURES,473,Cervical spinal fusion without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A Inpatient Medical Services,INPATIENT PROCEDURES,743,Uterine and adnexa procedures for non-malignancy without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A