Treatment of missed abortion, completed surgically
up to $2665*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $3681*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $7689*
Marsupialization of Bartholin's gland cyst
up to $795*
Endometrial biopsy
up to $1359*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $6465*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $5044*
Colpopexy, vaginal
up to $2751*
Cryosurgery of the penis
up to $1349*
Treatment of ectopic pregnancy with salpingostomy
up to $5380*
Colpopexy, abdominal approach
up to $5230*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $3699*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $4275*
Laparoscopic treatment of ectopic pregnancy
up to $5246*
Endometrial ablation, thermal
up to $5665*
Loop electrosurgical excision procedure (LEEP)
up to $1467*
Colpopexy, vaginal approach
up to $3776*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $8983*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $14057*
Induced abortion by dilation and curettage
up to $1521*
Destruction of anal warts by electrocautery
up to $3254*
Ovarian cystectomy, unilateral or bilateral
up to $4119*
Incision and drainage of Bartholin's gland abscess
up to $756*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $436*
Cervical biopsy
up to $712*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $6557*
Treatment of incomplete abortion, any trimester, completed surgically
up to $2235*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $1593*
Hysteroscopy, diagnostic (separate procedure)
up to $1492*
Tubal ligation reversal, microsurgical technique
up to $5327*
Anterior and/or posterior colporrhaphy
up to $2791*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $5422*
Chromotubation of oviduct, including materials
up to $698*
Laparoscopic colpopexy
up to $5317*
Unlisted procedure, female genital system (nonobstetrical)
up to $66*
Mastectomy for gynecomastia
up to $2409*
Vulvar biopsy, single lesion
up to $456*
Human chorionic gonadotropin (hCG) quantitative test
up to $35*
Dilation and curettage, diagnostic and/or therapeutic
up to $1427*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $1883*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $2378*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $4082*
Clitoroplasty for intersex state
up to $10150*
Cytopathology, cervical or vaginal
up to $111*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $6125*
Oophorectomy, partial or total, unilateral or bilateral
up to $2920*
Vaginal hysterectomy, for uterus 250 g or less
up to $4519*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $6091*
Endocervical curettage
up to $749*
Hysterosalpingography, radiological supervision and interpretation
up to $492*
Embryo transfer, intrauterine
up to $4726*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $4906*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $836*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $4298*
Neisseria gonorrhoeae, direct probe technique
up to $55*
Vaginal dilation under anesthesia
up to $250*
Hysterosalpingography
up to $4240*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $11241*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $10593*
Labiaplasty, wedge excision
up to $4027*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $16237*
Vaginoplasty for congenital anomaly
up to $5427*
Laparoscopy, surgical, supracervical hysterectomy
up to $3923*
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 $5357*
In vitro fertilization
up to $5134*
Laparoscopic myomectomy, removal of fibroids
up to $9835*
Vulvar biopsy, each additional lesion
up to $210*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $1743*
Insertion, non-biodegradable drug delivery implant
up to $646*
Mammography, screening, bilateral
up to $863*
Complex cystometrogram with voiding pressure studies
up to $2744*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $1401*
Ultrasound, retroperitoneal, limited
up to $339*
HPV vaccine, types 6, 11, 16, 18
up to $229*
Ultrasound guidance for aspiration of ova
up to $1400*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $9269*
Enterocele repair
up to $4992*
Mammogram, both breasts (not for routine screening)
up to $1069*
Automated urinalysis test
up to $8*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $1748*