Treatment of missed abortion, completed surgically
up to $1500*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $1776*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $4006*
Marsupialization of Bartholin's gland cyst
up to $481*
Endometrial biopsy
up to $426*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $2641*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $3066*
Colpopexy, vaginal
up to $2095*
Cryosurgery of the penis
up to $548*
Treatment of ectopic pregnancy with salpingostomy
up to $2088*
Colpopexy, abdominal approach
up to $3006*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $2493*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $4795*
Laparoscopic treatment of ectopic pregnancy
up to $2023*
Endometrial ablation, thermal
up to $5022*
Loop electrosurgical excision procedure (LEEP)
up to $921*
Colpopexy, vaginal approach
up to $2488*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $7671*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $6557*
Induced abortion by dilation and curettage
up to $1069*
Destruction of anal warts by electrocautery
up to $1637*
Ovarian cystectomy, unilateral or bilateral
up to $2400*
Incision and drainage of Bartholin's gland abscess
up to $394*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $358*
Cervical biopsy
up to $371*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $2946*
Treatment of incomplete abortion, any trimester, completed surgically
up to $971*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $1425*
Hysteroscopy, diagnostic (separate procedure)
up to $2100*
Tubal ligation reversal, microsurgical technique
up to $2816*
Anterior and/or posterior colporrhaphy
up to $1748*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $4254*
Chromotubation of oviduct, including materials
up to $301*
Laparoscopic colpopexy
up to $3182*
Unlisted procedure, female genital system (nonobstetrical)
up to $98*
Mastectomy for gynecomastia
up to $1573*
Vulvar biopsy, single lesion
up to $306*
Human chorionic gonadotropin (hCG) quantitative test
up to $34*
Dilation and curettage, diagnostic and/or therapeutic
up to $2118*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $1036*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $1771*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $2511*
Clitoroplasty for intersex state
up to $3815*
Cytopathology, cervical or vaginal
up to $96*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $5281*
Oophorectomy, partial or total, unilateral or bilateral
up to $1679*
Vaginal hysterectomy, for uterus 250 g or less
up to $3325*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $5248*
Endocervical curettage
up to $315*
Hysterosalpingography, radiological supervision and interpretation
up to $269*
Embryo transfer, intrauterine
up to $467*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $1611*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $491*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $1588*
Neisseria gonorrhoeae, direct probe technique
up to $42*
Vaginal dilation under anesthesia
up to $148*
Hysterosalpingography
up to $683*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $3857*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $5467*
Labiaplasty, wedge excision
up to $2109*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $15170*
Vaginoplasty for congenital anomaly
up to $2849*
Laparoscopy, surgical, supracervical hysterectomy
up to $5928*
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm)
up to $2277*
In vitro fertilization
up to $2163*
Laparoscopic myomectomy, removal of fibroids
up to $4189*
Vulvar biopsy, each additional lesion
up to $167*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $1503*
Insertion, non-biodegradable drug delivery implant
up to $431*
Mammography, screening, bilateral
up to $564*
Complex cystometrogram with voiding pressure studies
up to $1272*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $1013*
Ultrasound, retroperitoneal, limited
up to $326*
HPV vaccine, types 6, 11, 16, 18
up to $624*
Ultrasound guidance for aspiration of ova
up to $237*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $5293*
Enterocele repair
up to $2863*
Mammogram, both breasts (not for routine screening)
up to $698*
Automated urinalysis test
up to $11*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $2548*