fee schedule 2009 new - DE Medical Assistance Program

58356 3 ENDOMETRIAL CRYOABLATION 2,302.70
58400 3 SUSPENSION OF UTERUS 415.14
58410 3 SUSPENSION OF UTERUS 742.96
58520 3 REPAIR OF RUPTURED UTERUS 723.72
58540 3 REVISION OF UTERUS 840.13
58541 3 LSH, UTERUS 250 G OR LESS 784.93
58542 3 LSH W/T/O UT 250 G OR LESS 868.44
58543 3 LSH UTERUS ABOVE 250 G 882.77
58544 3 LSH W/T/O UTERUS ABOVE 250 G 954.07
58545 3 LAPAROSCOPIC MYOMECTOMY 833.26
58546 3 LAPARO-MYOMECTOMY, COMPLEX 1,055.42
58548 3 LAP RADICAL HYST 1,661.02
58550 3 LAPARO-ASST VAG HYSTERECTOMY 822.70
58551 O LAPAROSCOPY, REMOVE MYOMA 0.00
58552 3 LAPARO-VAG HYST INCL T/O 907.13
58553 3 LAPARO-VAG HYST, COMPLEX 1,060.05
58554 3 LAPARO-VAG HYST W/T/O, COMPL 1,213.52
58555 3 HYSTEROSCOPY, DX, SEP PROC 222.23
58558 3 HYSTEROSCOPY, BIOPSY 291.54
58559 3 HYSTEROSCOPY, LYSIS 324.63
58560 3 HYSTEROSCOPY, RESECT SEPTUM 368.28
58561 3 HYSTEROSCOPY, REMOVE MYOMA 520.23
58562 3 HYSTEROSCOPY, REMOVE FB 310.67
58563 3 HYSTEROSCOPY, ABLATION 325.03
58565 3 HYSTEROSCOPY, STERILIZATION 417.94
58570 3 TLH, UTERUS 250 G OR LESS 842.10
58571 3 TLH W/T/O 250 G OR LESS 922.31
58572 3 TLH, UTERUS OVER 250 G 1,044.31
58573 3 TLH W/T/O UTERUS OVER 250 G 1,178.11
58578 5 LAPARO PROC, UTERUS 0.00
58579 5 HYSTEROSCOPE PROCEDURE 0.00
58600 3 DIVISION OF FALLOPIAN TUBE 341.37
58605 3 DIVISION OF FALLOPIAN TUBE 309.85
58611 3 LIGATE OVIDUCT(S) ADD-ON 73.50
58615 3 OCCLUDE FALLOPIAN TUBE(S) 239.61
58660 3 LAPAROSCOPY, LYSIS 624.65
58661 3 LAPAROSCOPY, REMOVE ADNEXA 601.80
58662 3 LAPAROSCOPY, EXCISE LESIONS 659.36
58670 3 LAPAROSCOPY, TUBAL CAUTERY 340.88
58671 3 LAPAROSCOPY, TUBAL BLOCK 341.17
58672 3 LAPAROSCOPY, FIMBRIOPLASTY 699.61
58673 3 LAPAROSCOPY, SALPINGOSTOMY 754.86
58679 5 LAPARO PROC, OVIDUCT-OVARY 0.00
58700 3 REMOVAL OF FALLOPIAN TUBE 706.02
58720 3 REMOVAL OF OVARY/TUBE(S) 664.48
58740 3 ADHESIOLYSIS TUBE, OVARY 811.52
58750 9 REPAIR OVIDUCT 0.00
58752 9 REVISE OVARIAN TUBE(S) 0.00
58760 9 FIMBRIOPLASTY 0.00
58770 3 CREATE NEW TUBAL OPENING 798.81