DELETED FEE SCHEDULE CODES
LOCATION CODE DESCRIPTION
MRI X422 M.R.I. – head – multislice I.R.
  X432 M.R.I. – neck – multislice I.R
  X442 M.R.I. – thorax – multislice I.R
  X452 M.R.I. – abdomen – multislice I.R
  X462 M.R.I. – pelvis – multislice I.R
  X472 M.R.I. – extremities – multislice I.R
  X491 M.R.I. – limited spine (one segment) – multislice I.R
  X494 M.R.I. – intermediate spine (2 adjoining segments) multislice I.R.
  X497 M.R.I. – complex spine (2 or more non-adjoining segments) – multislice I.R.
DIAGNOSTIC & THERAPEUTIC PROCEDURES G474 Urethral pressure profile alone including interpretation
  G472 Minor teleradiotherapy X-ray
  G484 Cystometrogram with selective sacral nerve block studies
DIGESTIVE SYSTEM Z572 Electrocoagulation and or excision of rectal carcinoma (I.O.P.) –repeat
  Z573 Electrocoagulation and or excision of rectal carcinoma (I.O.P.) –repeat
UROGENITAL SYSTEM E774

E779

Balloon dilatation of prostrate and bladder neck
  S479 Cystotomy or Cystostomy and electrocoagulation of tumor
FEMALE GENITAL SYSTEM E850 Vulvectomy – with bilateral inguinal node dissection with or without skin graft
  E851 Vulvectomy – with bilateral common iliac node dissection with skin graft
  S705 Ligation – of varicose vein of the labia
  S713 Culdotomoy – incision and exploration
  S769 Hysterectomy (with or without adnexa) – Radical (Schauta) - vaginal
  Z581 Office endometrial curettage (I.O.P.)
  Z719 Endometrial biopsy, cytology – wash or brush (I.O.P.)
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