Treatment of missed abortion, completed surgically
up to $1127*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $1324*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $2767*
Marsupialization of Bartholin's gland cyst
up to $333*
Endometrial biopsy
up to $310*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $1448*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $2049*
Colpopexy, vaginal
up to $1120*
Cryosurgery of the penis
up to $405*
Treatment of ectopic pregnancy with salpingostomy
up to $1740*
Colpopexy, abdominal approach
up to $1941*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $1371*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $1730*
Laparoscopic treatment of ectopic pregnancy
up to $1687*
Endometrial ablation, thermal
up to $2041*
Loop electrosurgical excision procedure (LEEP)
up to $762*
Colpopexy, vaginal approach
up to $1536*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $3229*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $1822*
Induced abortion by dilation and curettage
up to $655*
Destruction of anal warts by electrocautery
up to $1078*
Ovarian cystectomy, unilateral or bilateral
up to $1675*
Incision and drainage of Bartholin's gland abscess
up to $321*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $192*
Cervical biopsy
up to $305*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $1325*
Treatment of incomplete abortion, any trimester, completed surgically
up to $936*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $594*
Hysteroscopy, diagnostic (separate procedure)
up to $564*
Tubal ligation reversal, microsurgical technique
up to $1999*
Anterior and/or posterior colporrhaphy
up to $1135*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $2209*
Chromotubation of oviduct, including materials
up to $258*
Laparoscopic colpopexy
up to $2155*
Unlisted procedure, female genital system (nonobstetrical)
up to $98*
Mastectomy for gynecomastia
up to $1254*
Vulvar biopsy, single lesion
up to $206*
Human chorionic gonadotropin (hCG) quantitative test
up to $7*
Dilation and curettage, diagnostic and/or therapeutic
up to $712*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $802*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $678*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $1658*
Clitoroplasty for intersex state
up to $2542*
Cytopathology, cervical or vaginal
up to $16*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $2496*
Oophorectomy, partial or total, unilateral or bilateral
up to $1186*
Vaginal hysterectomy, for uterus 250 g or less
up to $1823*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $1998*
Endocervical curettage
up to $315*
Hysterosalpingography, radiological supervision and interpretation
up to $160*
Embryo transfer, intrauterine
up to $299*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $1521*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $313*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $1746*
Neisseria gonorrhoeae, direct probe technique
up to $10*
Vaginal dilation under anesthesia
up to $112*
Hysterosalpingography
up to $258*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $2263*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $3784*
Labiaplasty, wedge excision
up to $1430*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $8536*
Vaginoplasty for congenital anomaly
up to $1991*
Laparoscopy, surgical, supracervical hysterectomy
up to $1597*
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 $1482*
In vitro fertilization
up to $528*
Laparoscopic myomectomy, removal of fibroids
up to $2018*
Vulvar biopsy, each additional lesion
up to $100*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $647*
Insertion, non-biodegradable drug delivery implant
up to $342*
Mammography, screening, bilateral
up to $240*
Complex cystometrogram with voiding pressure studies
up to $756*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $576*
Ultrasound, retroperitoneal, limited
up to $128*
HPV vaccine, types 6, 11, 16, 18
up to $229*
Ultrasound guidance for aspiration of ova
up to $157*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $2592*
Enterocele repair
up to $1913*
Mammogram, both breasts (not for routine screening)
up to $298*
Automated urinalysis test
up to $2*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $1267*