Treatment of missed abortion, completed surgically
up to $2628*
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
up to $3045*
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C
up to $1258*
Marsupialization of Bartholin's gland cyst
up to $719*
Endometrial biopsy
up to $667*
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
up to $2172*
Abdominal myomectomy, removal of fibroids through abdominal incision
up to $4252*
Colpopexy, vaginal
up to $2314*
Cryosurgery of the penis
up to $872*
Treatment of ectopic pregnancy with salpingostomy
up to $3648*
Colpopexy, abdominal approach
up to $4363*
Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
up to $3108*
Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less
up to $4299*
Laparoscopic treatment of ectopic pregnancy
up to $2361*
Endometrial ablation, thermal
up to $5017*
Loop electrosurgical excision procedure (LEEP)
up to $1758*
Colpopexy, vaginal approach
up to $3184*
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
up to $5510*
Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g
up to $4464*
Induced abortion by dilation and curettage
up to $1501*
Destruction of anal warts by electrocautery
up to $2671*
Ovarian cystectomy, unilateral or bilateral
up to $3434*
Incision and drainage of Bartholin's gland abscess
up to $770*
New patient preventive medicine evaluation for individuals aged 18-39 years
up to $497*
Cervical biopsy
up to $672*
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
up to $2964*
Treatment of incomplete abortion, any trimester, completed surgically
up to $2170*
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
up to $1579*
Hysteroscopy, diagnostic (separate procedure)
up to $1546*
Tubal ligation reversal, microsurgical technique
up to $4261*
Anterior and/or posterior colporrhaphy
up to $2366*
Laparoscopic vaginal hysterectomy, with removal of tubes and/or ovaries
up to $4534*
Chromotubation of oviduct, including materials
up to $605*
Laparoscopic colpopexy
up to $4447*
Unlisted procedure, female genital system (nonobstetrical)
up to $98*
Mastectomy for gynecomastia
up to $3213*
Vulvar biopsy, single lesion
up to $476*
Human chorionic gonadotropin (hCG) quantitative test
up to $28*
Dilation and curettage, diagnostic and/or therapeutic
up to $1635*
Hysteroscopy, surgical; with removal of leiomyomata and/or polyps
up to $2247*
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic
up to $1515*
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $2238*
Clitoroplasty for intersex state
up to $5296*
Cytopathology, cervical or vaginal
up to $97*
Laparoscopic myomectomy, removal of very large or multiple fibroids
up to $5194*
Oophorectomy, partial or total, unilateral or bilateral
up to $2426*
Vaginal hysterectomy, for uterus 250 g or less
up to $3824*
Laparoscopic supracervical hysterectomy, with removal of tubes and/or ovaries
up to $4797*
Endocervical curettage
up to $680*
Hysterosalpingography, radiological supervision and interpretation
up to $375*
Embryo transfer, intrauterine
up to $775*
Excision of breast lesion identified by preoperative placement of radiological marker, open
up to $3484*
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus
up to $692*
Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)
up to $3608*
Neisseria gonorrhoeae, direct probe technique
up to $32*
Vaginal dilation under anesthesia
up to $242*
Hysterosalpingography
up to $572*
Total abdominal hysterectomy with removal of tubes and/or ovaries
up to $4613*
Hysteroscopy, surgical, with bilateral fallopian tube cannulation
up to $9350*
Labiaplasty, wedge excision
up to $2826*
Routine obstetric (pregnancy) care for vaginal delivery, incl pre- and post- delivery care
up to $17926*
Vaginoplasty for congenital anomaly
up to $4142*
Laparoscopy, surgical, supracervical hysterectomy
up to $3998*
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 $3145*
Laparoscopic myomectomy, removal of fibroids
up to $4135*
Vulvar biopsy, each additional lesion
up to $221*
Hysteroscopy, surgical; with division or resection of intrauterine septum
up to $1779*
Insertion, non-biodegradable drug delivery implant
up to $701*
Mammography, screening, bilateral
up to $623*
Complex cystometrogram with voiding pressure studies
up to $1628*
Insertion of mesh or other prosthesis for repair of pelvic floor
up to $1159*
Ultrasound, retroperitoneal, limited
up to $524*
Ultrasound guidance for aspiration of ova
up to $156*
Stereotactic radiosurgery (SRS), complete course of treatment of cranial lesion(s)
up to $6738*
Enterocele repair
up to $4194*
Mammogram, both breasts (not for routine screening)
up to $774*
Automated urinalysis test
up to $9*
Biopsy of breast; percutaneous, needle core, not using imaging guidance
up to $3295*