Treatment of missed abortion, completed surgically
up to $2630*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $2401*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $5388*
Marsupialization of Bartholin's gland cyst
up to $917*
Endometrial biopsy
up to $526*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $2815*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $3719*
Colpopexy, vaginal
up to $2725*
Cryosurgery of the penis
up to $689*
Treatment of ectopic pregnancy with salpingostomy
up to $3369*
Colpopexy, abdominal approach
up to $3793*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $2736*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $2120*
Laparoscopic treatment of ectopic pregnancy
up to $3293*
Endometrial ablation, thermal
up to $3772*
Loop electrosurgical excision procedure (LEEP)
up to $1706*
Colpopexy, vaginal approach
up to $2753*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $5724*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $3279*
Induced abortion by dilation and curettage
up to $1537*
Destruction of anal warts by electrocautery
up to $2166*
Ovarian cystectomy, unilateral or bilateral
up to $3063*
Incision and drainage of Bartholin's gland abscess
up to $588*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $218*
Cervical biopsy
up to $671*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $2578*
Treatment of incomplete abortion, any trimester, completed surgically
up to $2177*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $1121*
Hysteroscopy, diagnostic (separate procedure)
up to $1549*
Tubal ligation reversal, microsurgical technique
up to $3608*
Anterior and/or posterior colporrhaphy
up to $2090*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $3872*
Chromotubation of oviduct, including materials
up to $804*
Laparoscopic colpopexy
up to $3817*
Unlisted procedure, female genital system (nonobstetrical)
up to $98*
Mastectomy for gynecomastia
up to $3167*
Vulvar biopsy, single lesion
up to $470*
Human chorionic gonadotropin (hCG) quantitative test
up to $8*
Dilation and curettage, diagnostic and/or therapeutic
up to $1596*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $2005*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $1351*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $3010*
Clitoroplasty for intersex state
up to $4622*
Cytopathology, cervical or vaginal
up to $28*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $4409*
Oophorectomy, partial or total, unilateral or bilateral
up to $2228*
Vaginal hysterectomy, for uterus 250 g or less
up to $3317*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $3585*
Endocervical curettage
up to $863*
Hysterosalpingography, radiological supervision and interpretation
up to $407*
Embryo transfer, intrauterine
up to $339*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $3292*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $553*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $3200*
Neisseria gonorrhoeae, direct probe technique
up to $26*
Vaginal dilation under anesthesia
up to $267*
Hysterosalpingography
up to $979*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $2666*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $6739*
Labiaplasty, wedge excision
up to $2638*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $12227*
Vaginoplasty for congenital anomaly
up to $3570*
Laparoscopy, surgical, supracervical hysterectomy
up to $2861*
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 $2966*
In vitro fertilization
up to $660*
Laparoscopic myomectomy, removal of fibroids
up to $2018*
Vulvar biopsy, each additional lesion
up to $194*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $1232*
Insertion, non-biodegradable drug delivery implant
up to $438*
Mammography, screening, bilateral
up to $527*
Complex cystometrogram with voiding pressure studies
up to $1506*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $976*
Ultrasound, retroperitoneal, limited
up to $159*
HPV vaccine, types 6, 11, 16, 18
up to $287*
Ultrasound guidance for aspiration of ova
up to $325*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $2945*
Enterocele repair
up to $3441*
Mammogram, both breasts (not for routine screening)
up to $652*
Automated urinalysis test
up to $3*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $2047*