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Procedure Code Category
CPT Codes
Procedure Code Descriptions
Code Status
AMP
28805
Amputation, foot; transmetatarsal
No Change
AMP
28810
Amputation, metatarsal, with toe, single
No Change
AMP
28820
Amputation, toe; metatarsophalangeal joint
No Change
CPT CODE
PROCEDURE
PRICE
0
CT LIVER PELVIS w/ & w/o contrast,
0
0
CT UROGRAM w/ & w/o contrast
0
73700
CT LOWER EXTREMITY w/o contrast
0
73701
CT LOWER EXTREMITY w/ contrast
0
73702
CT LOWER EXTREMITY w/ & w/o contrast
0
72131
CT LUMBAR SPINE w/o contrast
0
72132
CT LUMBAR SPINE w/ contrast
0
G0297
CT LUNG SCREENING w/o contrast
0
70486
CT MAXILLOFACIAL w/o contrast
0
70490
CT NECK SOFT TISSUE w/o contrast
0
TEST ID
Test Name
CPT Code
DYS2
Dysautonomia, Autoimmune/Paraneoplastic Evaluation, Serum
83519 86255 x 7 84182 AN1BS (if appropriate) 86256 AN1TS (if appropriate) 84182 AN2BS (if appropriate) 86255 APBCS (if appropriate) 86256 APBTS (if appropriate) 86256 CRMTS (if appropriate) 84182 CRMWS (if appropriate) 86255 DPPCS (if appropriate) 86256 DPPTS (if appropriate) 86256 PC2TS (if appropriate)
FROS2
Fructose, Qualitative, Semen
82757
HCVQN
Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR, Serum
87522
SPEP
Electrophoresis, Protein, Serum
84155 84165 0077U (if appropriate) 86334 (if appropriate)
ZW1
Miscellaneous MML Referral Test 1
ZW2
Miscellaneous MML Referral Test 2
Varies
ZW3
Miscellaneous MML Referral Test 3
PHI11
Prostate Health Index Reflex, Serum
84153 - Total PSA 84154 - Free PSA (if appropriate) 86316 - [-2]ProPSA (if appropriate)
CRHEP
Chronic Hepatitis (Unknown Type), Serum
86704 86706 86803 87340 87341 (if appropriate) 87522 (if appropriate)
HCVDX
Hepatitis C Virus (HCV) Antibody with Reflex to HCV RNA, PCR, Symptomatic, Serum
86803 87522 (if appropriate)
HCSRN
Hepatitis C Virus (HCV) Antibody Screen with Reflex to HCV RNA, PCR, Asymptomatic, Serum
86803 G0472 (if appropriate for government payers) 87522 Hepatitis C, quantification (if appropriate)
HICBL
Histoplasma/Blastomyces Panel, Spinal Fluid
86698 x3 86612
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