Treatment of missed abortion, completed surgically
up to $2334*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $3414*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $3388*
Marsupialization of Bartholin's gland cyst
up to $788*
Endometrial biopsy
up to $536*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $4079*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $5275*
Colpopexy, vaginal
up to $2933*
Cryosurgery of the penis
up to $827*
Treatment of ectopic pregnancy with salpingostomy
up to $4630*
Colpopexy, abdominal approach
up to $1424*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $3877*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $4521*
Laparoscopic treatment of ectopic pregnancy
up to $1687*
Endometrial ablation, thermal
up to $5813*
Loop electrosurgical excision procedure (LEEP)
up to $1580*
Colpopexy, vaginal approach
up to $3940*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $6952*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $4676*
Induced abortion by dilation and curettage
up to $1349*
Destruction of anal warts by electrocautery
up to $3124*
Ovarian cystectomy, unilateral or bilateral
up to $4350*
Incision and drainage of Bartholin's gland abscess
up to $660*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $192*
Cervical biopsy
up to $779*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $3744*
Treatment of incomplete abortion, any trimester, completed surgically
up to $1296*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $1097*
Hysteroscopy, diagnostic (separate procedure)
up to $1721*
Tubal ligation reversal, microsurgical technique
up to $5113*
Anterior and/or posterior colporrhaphy
up to $2937*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $5656*
Chromotubation of oviduct, including materials
up to $627*
Laparoscopic colpopexy
up to $5554*
Unlisted procedure, female genital system (nonobstetrical)
up to $98*
Mastectomy for gynecomastia
up to $3178*
Vulvar biopsy, single lesion
up to $330*
Human chorionic gonadotropin (hCG) quantitative test
up to $26*
Dilation and curettage, diagnostic and/or therapeutic
up to $1557*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $2116*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $1936*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $4339*
Clitoroplasty for intersex state
up to $6518*
Cytopathology, cervical or vaginal
up to $111*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $6340*
Oophorectomy, partial or total, unilateral or bilateral
up to $3124*
Vaginal hysterectomy, for uterus 250 g or less
up to $4715*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $5254*
Endocervical curettage
up to $435*
Hysterosalpingography, radiological supervision and interpretation
up to $319*
Embryo transfer, intrauterine
up to $1165*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $3281*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $814*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $4537*
Neisseria gonorrhoeae, direct probe technique
up to $10*
Vaginal dilation under anesthesia
up to $282*
Hysterosalpingography
up to $388*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $5900*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $10723*
Labiaplasty, wedge excision
up to $1430*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $15522*
Vaginoplasty for congenital anomaly
up to $5094*
Laparoscopy, surgical, supracervical hysterectomy
up to $4080*
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 $2753*
Laparoscopic myomectomy, removal of fibroids
up to $5166*
Vulvar biopsy, each additional lesion
up to $222*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $753*
Insertion, non-biodegradable drug delivery implant
up to $556*
Mammography, screening, bilateral
up to $789*
Complex cystometrogram with voiding pressure studies
up to $2094*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $965*
Ultrasound, retroperitoneal, limited
up to $224*
HPV vaccine, types 6, 11, 16, 18
up to $229*
Ultrasound guidance for aspiration of ova
up to $1140*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $5935*
Enterocele repair
up to $2059*
Mammogram, both breasts (not for routine screening)
up to $980*
Automated urinalysis test
up to $2*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $3802*