Medical Procedure Costs

G0027

Semen analysis; presence and/or motility of sperm excluding huhner

Pathology/Laboratory

$7

—

G0076

Care manag h vst new pt 20 m

HCPCS - Temporary Procedures

$49

—

G0077

Care manag h vst new pt 30 m

HCPCS - Temporary Procedures

$74

—

G0078

Care manag h vst new pt 45 m

HCPCS - Temporary Procedures

$120

—

G0079

Care manag h vst new pt 60 m

HCPCS - Temporary Procedures

$164

—

G0080

Care manag h vst new pt 75 m

HCPCS - Temporary Procedures

$217

—

G0081

Care man h v ext pt 20 mi

HCPCS - Temporary Procedures

$49

—

G0082

Care man h v ext pt 30 m

HCPCS - Temporary Procedures

$81

—

G0083

Care man h v ext pt 45 m

HCPCS - Temporary Procedures

$129

—

G0084

Care man h v ext pt 60 m

HCPCS - Temporary Procedures

$182

—

G0085

Care man h v ext pt 75 m

HCPCS - Temporary Procedures

$217

—

G0086

Care man home care plan 30 m

HCPCS - Temporary Procedures

$74

—

G0087

Care man home care plan 60 m

HCPCS - Temporary Procedures

$103

—

G0101

Ca screen;pelvic/breast exam

HCPCS - Temporary Procedures

$25

—

G0102

Prostate ca screening; dre

HCPCS - Temporary Procedures

$8

—

G0103

Prostate cancer screening; prostate specific antigen test (psa)

Pathology/Laboratory

$19

—

G0104

Ca screen;flexi sigmoidscope

HCPCS - Temporary Procedures

$53

—

G0105

Colorectal scrn; hi risk ind

HCPCS - Temporary Procedures

$165

—

G0108

Diab manage trn per indiv

HCPCS - Temporary Procedures

$56

—

G0109

Diab manage trn ind/group

HCPCS - Temporary Procedures

$16

—

G0117

Glaucoma scrn hgh risk direc

HCPCS - Temporary Procedures

$64

—

G0118

Glaucoma scrn hgh risk direc

HCPCS - Temporary Procedures

$40

—

G0121

Colon ca scrn not hi rsk ind

HCPCS - Temporary Procedures

$165

—

G0123

Screening cytopathology, cervical or vaginal (any reporting system), collected

Pathology/Laboratory

$20

—

G0124

Screen c/v thin layer by md

HCPCS - Temporary Procedures

$24

—

G0127

Trim nail(s)

HCPCS - Temporary Procedures

$7

—

G0128

Corf skilled nursing service

HCPCS - Temporary Procedures

$11

—

G0130

Single energy x-ray study

HCPCS - Temporary Procedures

$40

—

G0136

Adm of pa/n assess 5-15 m

HCPCS - Temporary Procedures

$8

—

G0138

Iv cipaglucosidase alfa-atga

HCPCS - Temporary Procedures

$196

—

G0140

Nav srv peer sup 60 min pr m

HCPCS - Temporary Procedures

$44

—

G0141

Scr c/v cyto,autosys and md

HCPCS - Temporary Procedures

$24

—

G0143

Screening cytopathology, cervical or vaginal (any reporting system), collected

Pathology/Laboratory

$27

—

G0144

Screening cytopathology, cervical or vaginal (any reporting system), collected

Pathology/Laboratory

$44

—

G0145

Screening cytopathology, cervical or vaginal (any reporting system), collected

Pathology/Laboratory

$26

—

G0146

Nav srv peer sup add 30 pr m

HCPCS - Temporary Procedures

$30

—

G0147

Screening cytopathology smears, cervical or vaginal, performed by automated

Pathology/Laboratory

$19

—

G0148

Screening cytopathology smears, cervical or vaginal, performed by automated

Pathology/Laboratory

$32

—

G0166

Extrnl counterpulse, per tx

HCPCS - Temporary Procedures

$103

—

G0168

Wound closure by adhesive

HCPCS - Temporary Procedures

$14

—

G0179

Md recertification hha pt

HCPCS - Temporary Procedures

$44

—

G0180

Md certification hha patient

HCPCS - Temporary Procedures

$57

—

G0181

Home health care supervision

HCPCS - Temporary Procedures

$110

—

G0182

Hospice care supervision

HCPCS - Temporary Procedures

$109

—

G0237

Therapeutic procd strg endur

HCPCS - Temporary Procedures

$13

—

G0238

Oth resp proc, indiv

HCPCS - Temporary Procedures

$11

—

G0239

Oth resp proc, group

HCPCS - Temporary Procedures

$14

—

G0245

Initial foot exam pt lops

HCPCS - Temporary Procedures

$35

—

G0246

Followup eval of foot pt lop

HCPCS - Temporary Procedures

$17

—

G0247

Routine footcare pt w lops

HCPCS - Temporary Procedures

$19

—

My Cost List