Promenades Surgery Center is committed to providing meaningful information about our healthcare services, including the amount patients may be obligated to pay for those services. The amount that patients pay is largely determined by their health insurance coverage. If a patient does not have health insurance, their financial liability will be determined by the application of our uninsured discount to the bill for our services. To provide you with information that is most helpful and specific to your circumstances, please contact us at (941) 627-5155 to discuss any questions you may have.
The table below contains certain charge and rate information for shoppable services and items that may be offered by our surgery center. This information is subject to the following:
| Description | CPT Code | Discounted Cash Price | Florida Medicare |
|---|---|---|---|
| INCISION & REMOVAL F.B. COMP | 10121 | $939.00 | $670.42 |
| I & D HEMATOMA | 10140 | $142.00 | $101.03 |
| I & D POSTOP INFECTION | 10180 | $1,593.00 | $1,137.66 |
| DEBRIDE SKIN & SUBQ AL | 11042 | $285.00 | $202.93 |
| DEBRIDE SKIN-SUBQ TISSUE AND MUSCLE | 11043 | $436.00 | $310.74 |
| DEBRIDE SKIN-SUBQ MUSCLE&BONE | 11044 | $939.00 | $670.42 |
| SHAVE BIOPSY | 11102 | $97.00 | $68.59 |
| INCISIONAL BIOPSY | 11106 | $148.00 | $105.63 |
| SHAVE BIOPSY 1.1 TO 2.0 CM SCALP,NECK,HA | 11307 | $119.00 | $84.51 |
| SHAVE BIOPSY0.5 CM FACE,EARS,EYELIDS,NOS | 11310 | $109.00 | $77.47 |
| SHAVE BIOPSY 0.6 CM FACE,NOSE,LIPS,EYELI | 11311 | $122.00 | $86.95 |
| SHAVE BIOPSY 1.1 TO 2.0 CM FACE,NOSE,EYE | 11312 | $137.00 | $97.36 |
| SHAVE BIOPSY OVER 2.0 FACE,EARS,NOSE,LIP | 11313 | $152.00 | $108.08 |
| EXCISION BENIGN LESION 0.5 OR LESS TRUNK | 11400 | $121.00 | $86.03 |
| EXCISION BENIGN LESION 0.6 TO 1.0 CM TRU | 11401 | $139.00 | $98.90 |
| EXCISION LESION 1.1 TO 2.0 CM TRUNK,ARMS | 11402 | $152.00 | $108.08 |
| EXCISION LESION 2.1 TO 3.0 TRUNK,ARMS,LE | 11403 | $166.00 | $117.87 |
| EXC BEN/TRUNK,ARMS,LEGS 3.1CM TO 4.0CM | 11404 | $939.00 | $670.42 |
| EXC BEN/TRUNK,ARMS,LEGS OVER 4.0CM | 11406 | $939.00 | $670.42 |
| EXCISION BENIGN LESION 0.5 OR LESS SCALP | 11420 | $114.00 | $81.14 |
| EXCISION BENIGN LESION 0.6 TO 1.0 CM NEC | 11421 | $136.00 | $96.44 |
| EXCISION BENIGN LESION 1.1 TO 2.0 NEC,SC | 11422 | $151.00 | $107.16 |
| EXCISION BENIGN LESION 2.1 TO 3.0 SCALP | 11423 | $166.00 | $118.49 |
| EXC BEN/ 3.1CM TO 4.0CM | 11424 | $939.00 | $670.42 |
| EXC BEN/ OVER 4.0CM | 11426 | $1,593.00 | $1,137.66 |
| EXCISION BENIGN LESION 0.5 OR LESS FACE | 11440 | $133.00 | $94.91 |
| EXCISION LESION 0.6 TO 1.0 CM FACE,EARS | 11441 | $150.00 | $106.86 |
| EXCISION BENIGN LESION 1.1 TO 2.0 CM NOS | 11442 | $164.00 | $116.65 |
| EXCISION BENIGN LESION 2.1 CM | 11443 | $181.00 | $128.90 |
| EXC BEN/ 3.1CM TO 4.0CM | 11444 | $939.00 | $670.42 |
| EXC BEN OVER 4.0CM | 11446 | $1,593.00 | $1,137.66 |
| EXC SKIN & SUBQ AXILLAR | 11450 | $1,593.00 | $1,137.66 |
| EXC SKIN& SUBQ W/ COMPLEX REPAIR | 11451 | $1,593.00 | $1,137.66 |
| EXC SKIN & SUBQ FOR HIDRADENITIS | 11470 | $1,593.00 | $1,137.66 |
| EXCISION MALIGNANT LESION 0.5 CM OR LESS | 11600 | $175.00 | $124.61 |
| EXCISION MALIGNANT LESION 0.6 TO 1.0 TR | 11601 | $195.00 | $138.70 |
| EXCISION MALIGNANT LESION 1.1 TO 2.0 TRU | 11602 | $208.00 | $147.88 |
| EXC MALIG/2.1CM TO 3.0CM | 11603 | $224.00 | $159.82 |
| EXC MALG/3.1CM TO 4.0CM | 11604 | $501.00 | $357.42 |
| EXC MALG/OVER 4.0CM | 11606 | $939.00 | $670.42 |
| EXCISION MALIGNANT LESION 0.5 CM LESS SC | 11620 | $175.00 | $124.61 |
| EXCISION MALIGNANT LESION 0.6 TO 1.0 SCA | 11621 | $195.00 | $139.00 |
| EXCISION MALIGNANT LESION 1.1 TO 2.0 CM | 11622 | $211.00 | $150.03 |
| EXCISION MALIGNANT LESION 2.1 CM | 11623 | $231.00 | $164.72 |
| EXC MALG/3.1CM TO 4.0CM | 11624 | $939.00 | $670.42 |
| EXC MALG/OVER 4.0CM | 11626 | $1,593.00 | $1,137.66 |
| EXCISION MALIGNANT LESION 0.5 OR LESS FA | 11640 | $181.00 | $128.90 |
| EXCISION MALIGNANT LESION 0.6 TO 1.0 NOS | 11641 | $200.00 | $142.67 |
| EXCISION MALIGNAT LESION 1.1 TO 2.0 CM | 11642 | $219.00 | $156.15 |
| EXC MALG/2.1CM TO 3.0CM | 11643 | $240.00 | $171.16 |
| EXC MALG/3.1CM TO 4.0CM | 11644 | $939.00 | $670.42 |
| EXC MALG/OVER 4.0CM | 11646 | $1,593.00 | $1,137.66 |
| SIMPLE REPAIR, SCALP,NECK,TRUNK 12.6-20. | 12005 | $285.00 | $202.93 |
| SIMPLE REPAIR 20.1 TO 30.0 CM TRUNK | 12006 | $285.00 | $202.93 |
| SIMPLE REPAIR OVER 30.0 CM TRUNK, SCALP | 12007 | $142.00 | $101.06 |
| SIMPLE REPAIR 7.6 TO 12.5 CM FACE,EARS | 12015 | $142.00 | $101.06 |
| SIMPLE REPAIR 12.6 TO 20.0 CM FACE,EARS | 12016 | $285.00 | $202.93 |
| SIMPLE REPAIR 20.1 TO 30.0 CM FACE, EARS | 12017 | $285.00 | $202.93 |
| SIMPLE REPAIR OVER 30.0 CM FACE,EARS | 12018 | $142.00 | $101.06 |
| TREATMENT OF SUPERFICIAL WOUND DEHISCENC | 12020 | $436.00 | $310.74 |
| LAYER CLOSURE 2.5 OR LESS TRUNK,ARMS | 12031 | $240.00 | $170.84 |
| REPAIR INTER. 2.6CM TO 7.5CM | 12032 | $270.00 | $192.28 |
| REPAIR INTER. 7.6CM TO 12.5CM | 12034 | $285.00 | $202.93 |
| LAYER CLOSURE, SCALP, TRUNK, 12.6 - 20CM | 12035 | $285.00 | $202.93 |
| LAYER CLOSURE, SCALP, TRUNK 21.0 - 30.0C | 12036 | $436.00 | $310.74 |
| LAYER CLOSURE OVER 30.0 TRUNK,ARMS | 12037 | $1,301.00 | $928.65 |
| LAYER CLOSURE 2.5 CM OR LESS NECK,HANDS | 12041 | $236.00 | $168.09 |
| LAYERED CLOSURE 206 CM TO 7.5 CM | 12042 | $264.00 | $187.99 |
| LAYER CLOSURE 7.6CM TO 12.5CM | 12044 | $436.00 | $310.74 |
| LAYER CLOSURE 12.6 TO 20.0 CM NECK,HANDS | 12045 | $436.00 | $310.74 |
| LAYER CLOSURE 20.1 TO 30.0 CM NECK,HANDS | 12046 | $436.00 | $310.74 |
| LAYER CLOSURE 30.0 CM NECK,HAND,FEET | 12047 | $1,301.00 | $928.65 |
| LAYER CLOSURE 2.5CM OR LESS | 12051 | $250.00 | $177.89 |
| LAYERD CLOSURE 2.6 CMTTO5.0 CM | 12052 | $266.00 | $189.83 |
| LAYER CLOSURE 5.1CM TO 7.5CM | 12053 | $285.00 | $202.93 |
| LAYER CLOSURE 7.6CM TO 12.5 | 12054 | $285.00 | $202.93 |
| LAYER CLOS FACE&/LIPS; 20.1-30.0 CM | 12056 | $285.00 | $202.93 |
| REPAIR, COMPLEX, TRUNK, 1.1 CM TO 2.5CM | 13100 | $436.00 | $310.74 |
| COMPLEX REPAIR TRUNK | 13101 | $436.00 | $310.74 |
| LAYER CLOSURE 1.1CM TO 2.5CM | 13120 | $436.00 | $310.74 |
| LAYER CLOSURE 2.6CM TO 7.5CM | 13121 | $436.00 | $310.74 |
| LAYER CLOSURE 1.1CM TO 2.5CM | 13131 | $285.00 | $202.93 |
| LAYER CLOSURE 2.6CM TO 7.5CM | 13132 | $436.00 | $310.74 |
| LAYER CLOSURE 1.1CM TO 2.5CM | 13151 | $436.00 | $310.74 |
| LAYER CLOSURE 2.6TO 7.5CM | 13152 | $436.00 | $310.74 |
| 2ARY CLOSURE SURGICAL WOUND | 13160 | $1,301.00 | $928.65 |
| ADJACENT TISSUE TRANSFER TRUNK 10SQCM | 14000 | $1,301.00 | $928.65 |
| ADJ TISSUE TRANSFER TRUNCK 10.1SQCM | 14001 | $1,301.00 | $928.65 |
| ADJ TISS TRANS SCALP,ARMS,LEGS,10SQCM | 14020 | $1,301.00 | $928.65 |
| ADJ TISS TRANS SCALP ARMS LEGS 10.1SQCM | 14021 | $1,301.00 | $928.65 |
| ADJ TISS TRANS FACE, NECK, HANDS,FEET 10 | 14040 | $1,301.00 | $928.65 |
| ADJ TISS TRANS FACE,NECK,HANDS,10.1SQ | 14041 | $1,301.00 | $928.65 |
| ADJ TISS TRANS EYELIDS, NOSE,EARS,10SQCM | 14060 | $1,301.00 | $928.65 |
| ASJ TISS TRANS EYELIDS,NOSE,EARS,10SQCM | 14061 | $1,301.00 | $928.65 |
| Adjacent tissue transfer any area 30.1 | 14301 | $2,594.00 | $1,852.71 |
| SURGICAL PREPARATION OF RECIPIENT SITE | 15002 | $1,301.00 | $928.65 |
| SURGICAL PREPARATION FACE, SCALP, EYELID | 15004 | $436.00 | $310.74 |
| FULL THICKNESS GFT 20SQCM OR LESS | 15200 | $1,301.00 | $928.65 |
| FULL THICKNESS GFT 20 SQCM OR LESS | 15220 | $1,301.00 | $928.65 |
| FULL THICKNESS GFT FOREHEAD,NECK HANDA | 15240 | $1,301.00 | $928.65 |
| FULL THICKNESS GFT 20SQ CM OR LESS | 15260 | $1,301.00 | $928.65 |
| APPLICATION OF SKIN SUBSTITUTE GRAFT | 15275 | $118.00 | $84.20 |
| FORMATION OF PEDICLE FLAP | 15570 | $1,301.00 | $928.65 |
| FORMATION OF PEDICLE FLAP | 15572 | $2,594.00 | $1,852.71 |
| FORMATION OF PEDICLE FLAP | 15574 | $1,301.00 | $928.65 |
| FORMATION OF PEDICLE FLAP | 15576 | $1,301.00 | $928.65 |
| DELAY OF FLAP / SECTIONING OF FLAP TRUNK | 15600 | $2,594.00 | $1,852.71 |
| SECTIONING OF FLAP SCALP ARMS LEGS | 15610 | $1,301.00 | $928.65 |
| Delay of flap or sectioning of flap | 15620 | $1,301.00 | $928.65 |
| SECTIONING OF FLAP EYELIDS NOSE EAR LIP | 15630 | $1,301.00 | $928.65 |
| MUSCLE MYOCUTANEOUS FLAP TRUNK | 15734 | $2,594.00 | $1,852.71 |
| MUSCLE MYOCUTANEOUS UPPER EXTREMITY | 15736 | $1,301.00 | $928.65 |
| MUSCLE MYOCUTANEOUS LOWER EXTREMITY | 15738 | $2,594.00 | $1,852.71 |
| FLAP, ISLAND PEDICLE | 15740 | $1,301.00 | $928.65 |
| GRAFT COMPOSITE | 15760 | $1,301.00 | $928.65 |
| — | 15770 | $2,594.00 | $1,852.71 |
| BLEPHAROPLASTY UPPER EYELID | 15823 | $1,301.00 | $928.65 |
| GRAFT FOR FACIAL NERVE PARALYSIS | 15840 | $2,594.00 | $1,852.71 |
| BIOPSY OF BREAST, OPEN, INCISIONAL | 19101 | $317.00 | $226.36 |
| BIOPSY OF BREAST, OPEN, INCISIONAL | 19101 | $2,039.00 | $1,455.84 |
| EXCISION OF CYST, FIBROMA,BREAST TISSUE | 19120 | $2,039.00 | $1,455.84 |
| MASTECTOMY FOR GYNECOMASTIA | 19300 | $2,039.00 | $1,455.84 |
| MASTECTOMY, PARTIAL, LUMPECTOMY, | 19301 | $2,039.00 | $1,455.84 |
| MASTECTOMY WITH AXILLARYLYMPHADENECTOMY | 19302 | $3,555.00 | $2,539.03 |
| mastectomy, simple, complete | 19303 | $3,555.00 | $2,539.03 |
| MASTOPEXY | 19316 | $3,555.00 | $2,539.03 |
| REDUCTION MAMMOPLASTY- FACILITY FEE | 19318 | $3,555.00 | $2,539.03 |
| BREAST AUGMENTATION | 19325 | $4,207.00 | $3,004.73 |
| REMOVAL OF IMPLANT WITHOUT REP-FACIL FEE | 19328 | $2,039.00 | $1,455.84 |
| REMOVAL OF MAMMARY IMPLANT MATERIAL | 19330 | $2,039.00 | $1,455.84 |
| IMEDIATE INSERTION OF IMPL- FACILITY FEE | 19340 | $3,555.00 | $2,539.03 |
| Delayed insertion of implant after maste | 19342 | $4,207.00 | $3,004.73 |
| NIPPLE/AREOLA RECONSTRUCTION | 19350 | $2,039.00 | $1,455.84 |
| CORRECTION OF INVERTED NIPPLES | 19355 | $2,039.00 | $1,455.84 |
| OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST | 19370 | $2,039.00 | $1,455.84 |
| PERIPROSROSTHETIC CAPSULECTOMY | 19371 | $2,039.00 | $1,455.84 |
| REVISION OF RECONSTRUCTED BREAST | 19380 | $3,555.00 | $2,539.03 |
| REMOVAL FOREIGN BODY DEEP | 20525 | $1,593.00 | $1,137.66 |
| Excision tumor soft tissue face or scalp | 21013 | $417.00 | $297.29 |
| EXCISION TUMOR SOFT TISSUE OF FACE SCALP | 21014 | $1,593.00 | $1,137.66 |
| RADICAL RESECTION OF TUMOR FACE OR SCALP | 21015 | $1,593.00 | $1,137.66 |
| RADICAL RESECTION OF TUMOR SOFT TISSUE | 21016 | $1,593.00 | $1,137.66 |
| Excision mass/lesion facial bone | 21026 | $3,866.00 | $2,761.42 |
| REMOVAL OF BENIGN TUMOR OF FACIAL BONE | 21029 | $1,848.00 | $1,319.92 |
| CANTHOPEXY LATERAL | 21282 | $1,848.00 | $1,319.92 |
| CLOSED TREATMENT NASAL FRACT W/O STABIL | 21315 | $872.00 | $622.24 |
| CLOSED TREATMENT NASAL FRACT WITH STABIL | 21320 | $1,848.00 | $1,319.92 |
| OPEN TREATMENT OF NASAL FRACTURE; UNCOMP | 21325 | $1,848.00 | $1,319.92 |
| OPEN TREATMENT OF NASAL FRACTURE | 21330 | $3,866.00 | $2,761.42 |
| INCISION AND DRAINAGE DEEP ABCESS HEMATO | 21501 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR SOFT TISSUE NECK | 21552 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR SOFT TISSUE NECK OR THORA | 21554 | $1,593.00 | $1,137.66 |
| EXC TUMOR NECK OR THROAT | 21555 | $939.00 | $670.42 |
| EXCISION SUBFACIAL INTRAMUSCULAR | 21556 | $1,593.00 | $1,137.66 |
| EXC SOFT TISSUE TUMOR BACK | 21930 | $939.00 | $670.42 |
| EXCISION TUMOR SOFT TISSUE BADK 3CM | 21931 | $939.00 | $670.42 |
| EXCSION TUMOR SOFT TISSUE BACK | 21932 | $1,593.00 | $1,137.66 |
| EXCISION SOFT TISSUE BACK GREATER 5 CM | 21933 | $1,593.00 | $1,137.66 |
| RADICAL RESECTION OF TUMOR SOFT TISSUE | 21936 | $1,593.00 | $1,137.66 |
| EXCISION ABDOMINAL WALL TUMOR | 22900 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR SOFT TISSUE ABDOMINAL WAL | 22902 | $939.00 | $670.42 |
| EXCISION TUMOR SOFT TISSUE ABDOMINAL WAL | 22903 | $1,593.00 | $1,137.66 |
| BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL | 23071 | $939.00 | $670.42 |
| EXCISION TUMOR SOFT TISSUE SHOULDER | 23073 | $1,593.00 | $1,137.66 |
| EXC SOFT TISSUE TUMOR SHOULDER S | 23075 | $939.00 | $670.42 |
| Excision soft tissue upper arm 3 cm | 24071 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR SOFT TISSUE ARM 5 CM | 24073 | $1,593.00 | $1,137.66 |
| EXC TUM UPPER ARM OR ELBOW | 24075 | $939.00 | $670.42 |
| EXC TUMOR UPPER ARM DEEP, SUBFASCIAL | 24076 | $1,593.00 | $1,137.66 |
| Tenotomy, open elbow to shoulder | 24310 | $2,093.00 | $1,494.75 |
| INCISION TENDON SHEATH WRIST | 25000 | $1,111.00 | $793.48 |
| INCISION & DRAINAGE FOREARM/WRIST | 25028 | $2,093.00 | $1,494.75 |
| EXCISION TUMOR SOFT TISSUE FOREARM >3CM | 25071 | $939.00 | $670.42 |
| EEXCISION TUMOR SOFT TISSUE FOREARM | 25073 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR, FOREARM AND/WRIST SUBCUT | 25075 | $939.00 | $670.42 |
| EXC TUMOR FOREARM, DEEP SUBFASCIAL/INTRA | 25076 | $939.00 | $670.42 |
| RADICAL RESECTION SOFT TISSUE FOREARM | 25077 | $1,593.00 | $1,137.66 |
| EX GANGLION WRIST | 25111 | $1,111.00 | $793.48 |
| TENDON SHEATH INCISION (TRIG FINGER) | 26055 | $1,111.00 | $793.48 |
| EXCISION TUMOR HAND OR FINGER SUBCUTANEO | 26115 | $939.00 | $670.42 |
| EXC TUMOR HAND OR FINGER DEEP SUBFASCIAL | 26116 | $939.00 | $670.42 |
| FASCIECTOMY PARTIAL PALMAR SINGLE DIGIT | 26123 | $2,093.00 | $1,494.75 |
| EXC OF LES TENDON SHEATH (EG GANGLION) | 26160 | $1,111.00 | $793.48 |
| EXCISION TUMOR DISTAL PHALANX OF FINGER | 26262 | $1,111.00 | $793.48 |
| Amputation metacarpal | 26951 | $2,093.00 | $1,494.75 |
| AMPUTATION FINGER OR THUMB | 26952 | $2,093.00 | $1,494.75 |
| I&D ABSCESS/HEMATOMA THIGH | 27301 | $1,593.00 | $1,137.66 |
| EXC TUMOR,THIGH/KNEE SUBCUTANEOUS | 27327 | $939.00 | $670.42 |
| EXC TUMOR THIGH/KNEE AREA DEEP, AL | 27328 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR THIGH KNEE GREATER 5 CIM | 27339 | $1,593.00 | $1,137.66 |
| EXCISION, TUMOR SOFT TISSUE LEG | 27618 | $939.00 | $670.42 |
| EXCISION TUMOR SOFT TISSUE LEG 3 CM | 27632 | $1,593.00 | $1,137.66 |
| EXCISION TUMOR SOFT TISSUE LEG OR ANKLE | 27634 | $1,593.00 | $1,137.66 |
| EXCISION OF SKIN OF NOSE RHINOPHEMA | 30120 | $1,848.00 | $1,319.92 |
| REMOVAL OF TUNNELED CENTRAL VENOUS | 36590 | $839.00 | $598.60 |
| LIGATION OR BANDING OF ANGIOACCESS | 37607 | $2,106.00 | $1,503.77 |
| LIGATION, TEMPORAL ARTERY | 37609 | $939.00 | $670.42 |
| LIGATION OF PERFORATOR. | 37760 | $2,106.00 | $1,503.77 |
| LIGATION, VARICOSE VEIN | 37785 | $2,106.00 | $1,503.77 |
| OPEN, DEEP CERVIAL NODES WITH EXCISION | 38520 | $2,039.00 | $1,455.84 |
| SUPRAHYOID LYMPHADENECTOMY | 38700 | $3,555.00 | $2,539.03 |
| AXILLARY LYMPHADENECTOMY | 38740 | $3,791.00 | $2,707.44 |
| AXILLARY LYMPHADENECTOMY | 38745 | $3,791.00 | $2,707.44 |
| INGUINOFEMORAL LYMPHADENECTOMY | 38760 | $3,555.00 | $2,539.03 |
| VERMILIONECTOMY | 40500 | $1,848.00 | $1,319.92 |
| EXC LIP TRANSVER WEDGE | 40510 | $1,848.00 | $1,319.92 |
| V-EXCISION OF LIP W/DIRECT LINEAR CLOSUR | 40520 | $1,848.00 | $1,319.92 |
| EXCISION LESION OF MUCOSA VESTIBULE | 40814 | $1,848.00 | $1,319.92 |
| EXCISION LESION MUCOSA AND SUBMUCOS | 40816 | $1,848.00 | $1,319.92 |
| EXCISION LESION OF TONGUE WITH CLOSURE | 41112 | $1,848.00 | $1,319.92 |
| GLOSSECTOMY, LESS THAN ONE HALF TONGUE | 41120 | $3,866.00 | $2,761.42 |
| EXCISION PAROTID TUMOR WITHOUT NERVE | 42410 | $3,866.00 | $2,761.42 |
| EXC PAROTID TUMOR WITH DISSECTIONIT | 42415 | $3,866.00 | $2,761.42 |
| EX PAROTID TUMOR WITH DISSECTIONITA | 42420 | $3,866.00 | $2,761.42 |
| ANAL FISTULA | 46270 | $1,853.00 | $1,323.25 |
| ULNAR NERVE AT THE ELBOW | 64718 | $1,226.00 | $875.49 |
| ULNAR NERVE AT WRIST | 64719 | $1,226.00 | $875.49 |
| MEDIAN NERVE AT CARPAL TUNNEL | 64721 | $1,226.00 | $875.49 |
| MAJOR PERIPHERAL NERVE, EXCEPT SCIATIC | 64784 | $1,226.00 | $875.49 |
| SCIATIC NERVE | 64786 | $4,095.00 | $2,924.48 |
| ORBITOTOMY WITH REMOVAL OF LESION | 67412 | $1,360.00 | $971.16 |
| REPAIR OF BROW PTOSIS | 67900 | $1,360.00 | $971.16 |
| REPAIR BELPHAROPTOSIS LEVATOR RESECT | 67903 | $1,360.00 | $971.16 |
| LEVATOR RESECTION-EXT APPROACH | 67904 | $1,360.00 | $971.16 |
| Ectropian repair sutute | 67914 | $1,360.00 | $971.16 |
| BLEPHAROPLASTY, EXCISION TARSAL WEDGE | 67916 | $1,360.00 | $971.16 |
| EXTENSIVE TARSAL STRIP | 67917 | $1,360.00 | $971.16 |
| BLEPHAROPLASTY, EXC. TARSAL WEDGE- ENTRO | 67923 | $1,360.00 | $971.16 |
| INTROPION, EXTENSIVE TARSAL FASCIA REPAI | 67924 | $1,360.00 | $971.16 |
| EXCISION AND REPAIR OR EYELID | 67961 | $1,360.00 | $971.16 |
| EXCISION AND REPAIR OF EYELID | 67966 | $1,360.00 | $971.16 |
| RECONSTRUCTION OF EYELID, FULL THICKNESS | 67971 | $1,360.00 | $971.16 |
| EXCISION EXTERNAL EAR, PARTIAL SIMPLE | 69110 | $1,593.00 | $1,137.66 |