2010 HCPCS Schedule - DE Medical Assistance Program

4084F ASPIRIN RECVD W/IN 24 HRS 9 $0.00
40899 MOUTH SURGERY PROCEDURE 5 $0.00
4090F PT RCVNG EPO THXPY 9 $0.00
4095F PT NOT RCVNG EPO THXPY 9 $0.00
41000 DRAINAGE OF MOUTH LESION 3 $150.40
41005 DRAINAGE OF MOUTH LESION 3 $212.19
41006 DRAINAGE OF MOUTH LESION 3 $337.50
41007 DRAINAGE OF MOUTH LESION 3 $337.43
41008 DRAINAGE OF MOUTH LESION 3 $347.05
41009 DRAINAGE OF MOUTH LESION 3 $368.63
4100F BIPHOS THXPY VEIN ORD/RECVD 9 $0.00
41010 INCISION OF TONGUE FOLD 3 $190.79
41015 DRAINAGE OF MOUTH LESION 3 $397.24
41016 DRAINAGE OF MOUTH LESION 3 $404.91
41017 DRAINAGE OF MOUTH LESION 3 $409.44
41018 DRAINAGE OF MOUTH LESION 3 $466.16
41019 PLACE NEEDLES H&N FOR RT 3 $476.92
41100 BIOPSY OF TONGUE 3 $158.36
41105 BIOPSY OF TONGUE 3 $159.44
41108 BIOPSY OF FLOOR OF MOUTH 3 $137.13
4110F INT MAM ART USED FOR CABG 9 $0.00
41110 EXCISION OF TONGUE LESION 3 $197.73
41112 EXCISION OF TONGUE LESION 3 $310.33
41113 EXCISION OF TONGUE LESION 3 $339.08
41114 EXCISION OF TONGUE LESION 3 $612.41
41115 EXCISION OF TONGUE FOLD 3 $227.93
41116 EXCISION OF MOUTH LESION 3 $305.32
41120 PARTIAL REMOVAL OF TONGUE 3 $1,010.10
41130 PARTIAL REMOVAL OF TONGUE 3 $1,250.91
41135 TONGUE AND NECK SURGERY 3 $2,078.75
41140 REMOVAL OF TONGUE 3 $2,120.21
41145 TONGUE REMOVAL, NECK SURGERY 3 $2,666.30
41150 TONGUE, MOUTH, JAW SURGERY 3 $2,115.05
41153 TONGUE, MOUTH, NECK SURGERY 3 $2,296.06
41155 TONGUE, JAW, & NECK SURGERY 3 $2,868.36
4115F BETA BLCKR ADMIN W/IN 24 HRS 9 $0.00
4120F ANTIBIOT RXD/GIVEN 9 $0.00
4124F ANTIBIOT NOT RXD/GIVEN 9 $0.00
41250 REPAIR TONGUE LACERATION 3 $219.61
41251 REPAIR TONGUE LACERATION 3 $227.73
41252 REPAIR TONGUE LACERATION 3 $291.27
4130F TOPICAL PREP RX AOE 9 $0.00
4131F SYST ANTIMICROBIAL THX RX 9 $0.00
4132F NO SYST ANTIMICROBIAL THX RX 9 $0.00
4133F ANTIHIST/DECONG RX/RECOM 9 $0.00
4134F NO ANTIHIST/DECONG RX/RECOM 9 $0.00
4135F SYSTEMIC CORTICOSTEROIDS RX 9 $0.00
4136F SYST CORTICOSTEROIDS NOT RX 9 $0.00
4148F HEP A VAC INJXN ADMIN/RECVD 9 $0.00