| Procedure Code | Procedure Description | Pricing Indicator | Rate Type | Mod1 | Mod2 | Mod3 | Mod4 | Max Fee | Max Fee Eff. Date | Max Fee End Date | PA |
| 0001A | ADM SARSCOV2 30MCG/0.3ML 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0001A | ADM SARSCOV2 30MCG/0.3ML 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0002A | ADM SARSCOV2 30MCG/0.3ML 2ND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0002A | ADM SARSCOV2 30MCG/0.3ML 2ND | EAPG | DEF | NA | NA | NA | N | ||||
| 0003A | ADM SARSCOV2 30MCG/0.3ML 3RD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0003A | ADM SARSCOV2 30MCG/0.3ML 3RD | EAPG | DEF | NA | NA | NA | N | ||||
| 0004A | ADM SARSCOV2 30MCG/0.3ML BST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0004A | ADM SARSCOV2 30MCG/0.3ML BST | EAPG | DEF | NA | NA | NA | N | ||||
| 0011A | ADM SARSCOV2 100MCG/0.5ML1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0011A | ADM SARSCOV2 100MCG/0.5ML1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0012A | ADM SARSCOV2 100MCG/0.5ML2ND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0012A | ADM SARSCOV2 100MCG/0.5ML2ND | EAPG | DEF | NA | NA | NA | N | ||||
| 0013A | ADM SARSCOV2 100MCG/0.5ML3RD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0013A | ADM SARSCOV2 100MCG/0.5ML3RD | EAPG | DEF | NA | NA | NA | N | ||||
| 0041A | ADM SARSCOV2 5MCG/0.5ML 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0041A | ADM SARSCOV2 5MCG/0.5ML 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0042A | ADM SARSCOV2 5MCG/0.5ML 2ND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0042A | ADM SARSCOV2 5MCG/0.5ML 2ND | EAPG | DEF | NA | NA | NA | N | ||||
| 0042T | CT PERFUSION W/CONTRAST CBF | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0042T | CT PERFUSION W/CONTRAST CBF | EAPG | DEF | NA | NA | NA | E | ||||
| 0044A | ADM SARSCOV2 5MCG/0.5ML BST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0044A | ADM SARSCOV2 5MCG/0.5ML BST | EAPG | DEF | NA | NA | NA | N | ||||
| 0051A | ADM SARSCV2 30MCG TRS-SUCR 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0051A | ADM SARSCV2 30MCG TRS-SUCR 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0052A | ADM SARSCV2 30MCG TRS-SUCR 2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0052A | ADM SARSCV2 30MCG TRS-SUCR 2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0053A | ADM SARSCV2 30MCG TRS-SUCR 3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0053A | ADM SARSCV2 30MCG TRS-SUCR 3 | EAPG | DEF | NA | NA | NA | N | ||||
| 0054A | ADM SARSCV2 30MCG TRS-SUCR B | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0054A | ADM SARSCV2 30MCG TRS-SUCR B | EAPG | DEF | NA | NA | NA | N | ||||
| 0054T | BONE SRGRY CMPTR FLUOR IMAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0054T | BONE SRGRY CMPTR FLUOR IMAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 0055T | BONE SRGRY CMPTR CT/MRI IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0055T | BONE SRGRY CMPTR CT/MRI IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 0064A | ADM SARSCOV2 50MCG/0.25MLBST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0064A | ADM SARSCOV2 50MCG/0.25MLBST | EAPG | DEF | NA | NA | NA | N | ||||
| 0071A | ADM SARSCV2 10MCG TRS-SUCR 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0071A | ADM SARSCV2 10MCG TRS-SUCR 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0072A | ADM SARSCV2 10MCG TRS-SUCR 2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0072A | ADM SARSCV2 10MCG TRS-SUCR 2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0073A | ADM SARSCV2 10MCG TRS-SUCR 3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0073A | ADM SARSCV2 10MCG TRS-SUCR 3 | EAPG | DEF | NA | NA | NA | N | ||||
| 0074A | ADM SARSCV2 10MCG TRS-SUCR B | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0074A | ADM SARSCV2 10MCG TRS-SUCR B | EAPG | DEF | NA | NA | NA | N | ||||
| 0081A | ADM SARSCV2 3MCG TRS-SUCR 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0081A | ADM SARSCV2 3MCG TRS-SUCR 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0082A | ADM SARSCV2 3MCG TRS-SUCR 2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0082A | ADM SARSCV2 3MCG TRS-SUCR 2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0083A | ADM SARSCV2 3MCG TRS-SUCR 3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0083A | ADM SARSCV2 3MCG TRS-SUCR 3 | EAPG | DEF | NA | NA | NA | N | ||||
| 0090U | ONC CUTAN MLNMA MRNA 23 GENE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0090U | ONC CUTAN MLNMA MRNA 23 GENE | EAPG | DEF | NA | NA | NA | N | ||||
| 0091A | ADM SARSCOV2 50 MCG/.5 ML1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0091A | ADM SARSCOV2 50 MCG/.5 ML1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0092A | ADM SARSCOV2 50 MCG/.5 ML2ND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0092A | ADM SARSCOV2 50 MCG/.5 ML2ND | EAPG | DEF | NA | NA | NA | N | ||||
| 0093A | ADM SARSCOV2 50 MCG/.5 ML3RD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0093A | ADM SARSCOV2 50 MCG/.5 ML3RD | EAPG | DEF | NA | NA | NA | N | ||||
| 0094A | ADM SARSCOV2 50 MCG/.5 MLBST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0094A | ADM SARSCOV2 50 MCG/.5 MLBST | EAPG | DEF | NA | NA | NA | N | ||||
| 0100T | PROSTH RETINA RECEIVE&GEN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0100T | PROSTH RETINA RECEIVE&GEN | EAPG | DEF | NA | NA | NA | E | ||||
| 0101T | ESW MUSCSKEL SYS NOS | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0101T | ESW MUSCSKEL SYS NOS | EAPG | DEF | NA | NA | NA | E | ||||
| 0102T | ESW PHY ANES LAT HMRL EPCNDL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0102T | ESW PHY ANES LAT HMRL EPCNDL | EAPG | DEF | NA | NA | NA | E | ||||
| 0111A | ADM SARSCOV2 25MCG/0.25ML1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0111A | ADM SARSCOV2 25MCG/0.25ML1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0112A | ADM SARSCOV2 25MCG/0.25ML2ND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0112A | ADM SARSCOV2 25MCG/0.25ML2ND | EAPG | DEF | NA | NA | NA | N | ||||
| 0113A | ADM SARSCOV2 25MCG/0.25ML3RD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0113A | ADM SARSCOV2 25MCG/0.25ML3RD | EAPG | DEF | NA | NA | NA | N | ||||
| 0121A | ADM SARSCV2 BVL 30MCG/.3ML 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0121A | ADM SARSCV2 BVL 30MCG/.3ML 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0124A | ADM SARSCV2 BVL 30MCG/.3ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0124A | ADM SARSCV2 BVL 30MCG/.3ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0126T | CHD RISK IMT STUDY | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0126T | CHD RISK IMT STUDY | EAPG | DEF | NA | NA | NA | E | ||||
| 0134A | ADM SARSCV2 BVL 50MCG/.5ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0134A | ADM SARSCV2 BVL 50MCG/.5ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0141A | ADM SRSCV2 BVL 25MCG/.25ML 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0141A | ADM SRSCV2 BVL 25MCG/.25ML 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0142A | ADM SRSCV2 BVL 25MCG/.25ML 2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0142A | ADM SRSCV2 BVL 25MCG/.25ML 2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0144A | ADM SRSCV2 BVL 25MCG/.25ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0144A | ADM SRSCV2 BVL 25MCG/.25ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0151A | ADM SARSCV2 BVL 10MCG/.2ML 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0151A | ADM SARSCV2 BVL 10MCG/.2ML 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0154A | ADM SARSCV2 BVL 10MCG/.2ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0154A | ADM SARSCV2 BVL 10MCG/.2ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0159T | CAD BREAST MRI | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0159T | CAD BREAST MRI | EAPG | DEF | NA | NA | NA | E | ||||
| 0164A | ADM SRSCV2 BVL 10MCG/0.2ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0164A | ADM SRSCV2 BVL 10MCG/0.2ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0171A | ADM SARSCV2 BVL 3MCG/0.2ML 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0171A | ADM SARSCV2 BVL 3MCG/0.2ML 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0172A | ADM SARSCV2 BVL 3MCG/0.2ML 2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0172A | ADM SARSCV2 BVL 3MCG/0.2ML 2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0172U | ONC SLD TUM ALYS BRCA1 BRCA2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0172U | ONC SLD TUM ALYS BRCA1 BRCA2 | EAPG | DEF | NA | NA | NA | N | ||||
| 0173A | ADM SARSCV2 BVL 3MCG/0.2ML 3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0173A | ADM SARSCV2 BVL 3MCG/0.2ML 3 | EAPG | DEF | NA | NA | NA | N | ||||
| 0174A | ADM SARSCV2 BVL 3MCG/0.2ML A | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0174A | ADM SARSCV2 BVL 3MCG/0.2ML A | EAPG | DEF | NA | NA | NA | N | ||||
| 0174T | CAD CXR WITH INTERP | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0174T | CAD CXR WITH INTERP | EAPG | DEF | NA | NA | NA | E | ||||
| 0175T | CAD CXR REMOTE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0175T | CAD CXR REMOTE | EAPG | DEF | NA | NA | NA | E | ||||
| 0190T | PLACE INTRAOC RADIATION SRC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0190T | PLACE INTRAOC RADIATION SRC | EAPG | DEF | NA | NA | NA | E | ||||
| 0191T | INSERT ANT SEGMENT DRAIN INT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0191T | INSERT ANT SEGMENT DRAIN INT | EAPG | DEF | NA | NA | NA | N | ||||
| 0200T | PERQ SACRAL AUGMT UNILAT INJ | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0200T | PERQ SACRAL AUGMT UNILAT INJ | EAPG | DEF | NA | NA | NA | E | ||||
| 0201T | PERQ SACRAL AUGMT BILAT INJ | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0201T | PERQ SACRAL AUGMT BILAT INJ | EAPG | DEF | NA | NA | NA | E | ||||
| 0205T | INIRS EACH VESSEL ADD-ON | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0205T | INIRS EACH VESSEL ADD-ON | EAPG | DEF | NA | NA | NA | E | ||||
| 0206T | CPTR DBS ALYS CAR ELEC DTA | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0206T | CPTR DBS ALYS CAR ELEC DTA | EAPG | DEF | NA | NA | NA | E | ||||
| 0213T | NJX PARAVERT W/US CER/THOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0213T | NJX PARAVERT W/US CER/THOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0214T | NJX PARAVERT W/US CER/THOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0214T | NJX PARAVERT W/US CER/THOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0215T | NJX PARAVERT W/US CER/THOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0215T | NJX PARAVERT W/US CER/THOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0216T | NJX PARAVERT W/US LUMB/SAC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0216T | NJX PARAVERT W/US LUMB/SAC | EAPG | DEF | NA | NA | NA | E | ||||
| 0217T | NJX PARAVERT W/US LUMB/SAC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0217T | NJX PARAVERT W/US LUMB/SAC | EAPG | DEF | NA | NA | NA | E | ||||
| 0218T | NJX PARAVERT W/US LUMB/SAC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0218T | NJX PARAVERT W/US LUMB/SAC | EAPG | DEF | NA | NA | NA | E | ||||
| 0228T | NJX TFRML EPRL W/US CER/THOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0228T | NJX TFRML EPRL W/US CER/THOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0229T | NJX TFRML EPRL W/US CER/THOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0229T | NJX TFRML EPRL W/US CER/THOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0230T | NJX TFRML EPRL W/US LUMB/SAC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0230T | NJX TFRML EPRL W/US LUMB/SAC | EAPG | DEF | NA | NA | NA | N | ||||
| 0231T | NJX TFRML EPRL W/US LUMB/SAC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0231T | NJX TFRML EPRL W/US LUMB/SAC | EAPG | DEF | NA | NA | NA | N | ||||
| 0232T | NJX PLATELET PLASMA | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0232T | NJX PLATELET PLASMA | EAPG | DEF | NA | NA | NA | E | ||||
| 0238T | TRLUML PERIP ATHRC ILIAC ART | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0238T | TRLUML PERIP ATHRC ILIAC ART | EAPG | DEF | NA | NA | NA | E | ||||
| 0249T | LIGATION HEMORRHOID W/US | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0249T | LIGATION HEMORRHOID W/US | EAPG | DEF | NA | NA | NA | E | ||||
| 0253T | INSERT AQUEOUS DRAIN DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0253T | INSERT AQUEOUS DRAIN DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 0263T | IM B1 MRW CEL THER CMPL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0263T | IM B1 MRW CEL THER CMPL | EAPG | DEF | NA | NA | NA | E | ||||
| 0264T | IM B1 MRW CEL THER XCL HRVST | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0264T | IM B1 MRW CEL THER XCL HRVST | EAPG | DEF | NA | NA | NA | E | ||||
| 0265T | IM B1 MRW CEL THER HRVST ONL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0265T | IM B1 MRW CEL THER HRVST ONL | EAPG | DEF | NA | NA | NA | E | ||||
| 0269T | REV/REMVL CRTD SNS DEV TOTAL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0269T | REV/REMVL CRTD SNS DEV TOTAL | EAPG | DEF | NA | NA | NA | E | ||||
| 0270T | REV/REMVL CRTD SNS DEV LEAD | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0270T | REV/REMVL CRTD SNS DEV LEAD | EAPG | DEF | NA | NA | NA | E | ||||
| 0271T | REV/REMVL CRTD SNS DEV GEN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0271T | REV/REMVL CRTD SNS DEV GEN | EAPG | DEF | NA | NA | NA | E | ||||
| 0274T | PERQ LAMOT/LAM CRV/THRC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0274T | PERQ LAMOT/LAM CRV/THRC | EAPG | DEF | NA | NA | NA | E | ||||
| 0275T | PERQ LAMOT/LAM LUMBAR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0275T | PERQ LAMOT/LAM LUMBAR | EAPG | DEF | NA | NA | NA | E | ||||
| 0278T | TEMPR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0278T | TEMPR | EAPG | DEF | NA | NA | NA | E | ||||
| 0290T | LASER INC FOR PKP/LKP RECIP | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0290T | LASER INC FOR PKP/LKP RECIP | EAPG | DEF | NA | NA | NA | E | ||||
| 0299T | ESW WOUND HEALING INIT WOUND | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0299T | ESW WOUND HEALING INIT WOUND | EAPG | DEF | NA | NA | NA | E | ||||
| 0300T | ESW WOUND HEALING ADDL WOUND | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0300T | ESW WOUND HEALING ADDL WOUND | EAPG | DEF | NA | NA | NA | E | ||||
| 0301T | MW THERAPY FOR BREAST TUMOR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0301T | MW THERAPY FOR BREAST TUMOR | EAPG | DEF | NA | NA | NA | E | ||||
| 0302T | ICAR ISCHM MNTRNG SYS COMPL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0302T | ICAR ISCHM MNTRNG SYS COMPL | EAPG | DEF | NA | NA | NA | E | ||||
| 0303T | ICAR ISCHM MNTRNG SYS ELTRD | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0303T | ICAR ISCHM MNTRNG SYS ELTRD | EAPG | DEF | NA | NA | NA | E | ||||
| 0304T | ICAR ISCHM MNTRNG SYS DEVICE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0304T | ICAR ISCHM MNTRNG SYS DEVICE | EAPG | DEF | NA | NA | NA | E | ||||
| 0307T | RMVL ICAR ISCHM MNTRNG DVCE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0307T | RMVL ICAR ISCHM MNTRNG DVCE | EAPG | DEF | NA | NA | NA | E | ||||
| 0308T | INSJ OCULAR TELESCOPE PROSTH | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0308T | INSJ OCULAR TELESCOPE PROSTH | EAPG | DEF | NA | NA | NA | E | ||||
| 0313T | LAPS RMVL NSTIM ARRAY VAGUS | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0313T | LAPS RMVL NSTIM ARRAY VAGUS | EAPG | DEF | NA | NA | NA | E | ||||
| 0314T | LAPS RMVL VGL ARRY&PLS GEN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0314T | LAPS RMVL VGL ARRY&PLS GEN | EAPG | DEF | NA | NA | NA | E | ||||
| 0315T | RMVL VAGUS NERVE PLS GEN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0315T | RMVL VAGUS NERVE PLS GEN | EAPG | DEF | NA | NA | NA | E | ||||
| 0316T | REPLC VAGUS NERVE PLS GEN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0316T | REPLC VAGUS NERVE PLS GEN | EAPG | DEF | NA | NA | NA | E | ||||
| 0329U | ONC NEO XOME&TRNS SEQ ALYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0329U | ONC NEO XOME&TRNS SEQ ALYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0330T | TEAR FILM IMG UNI/BI W/I&R | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0330T | TEAR FILM IMG UNI/BI W/I&R | EAPG | DEF | NA | NA | NA | E | ||||
| 0331T | HEART SYMP IMAGE PLNR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0331T | HEART SYMP IMAGE PLNR | EAPG | DEF | NA | NA | NA | E | ||||
| 0332T | HEART SYMP IMAGE PLNR SPECT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0332T | HEART SYMP IMAGE PLNR SPECT | EAPG | DEF | NA | NA | NA | E | ||||
| 0335T | INSJ SINUS TARSI IMPLANT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0335T | INSJ SINUS TARSI IMPLANT | EAPG | DEF | NA | NA | NA | E | ||||
| 0338T | TRNSCTH RENAL SYMP DENRV UNL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0338T | TRNSCTH RENAL SYMP DENRV UNL | EAPG | DEF | NA | NA | NA | E | ||||
| 0339T | TRNSCTH RENAL SYMP DENRV BIL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0339T | TRNSCTH RENAL SYMP DENRV BIL | EAPG | DEF | NA | NA | NA | E | ||||
| 0340T | ABLATE PULM TUMORS + EXTNSN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0340T | ABLATE PULM TUMORS + EXTNSN | EAPG | DEF | NA | NA | NA | E | ||||
| 0341T | QUANT PUPILLOMETRY W/ RPRT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0341T | QUANT PUPILLOMETRY W/ RPRT | EAPG | DEF | NA | NA | NA | E | ||||
| 0342T | THXP APHERESIS W/HDL DELIP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0342T | THXP APHERESIS W/HDL DELIP | EAPG | DEF | NA | NA | NA | N | ||||
| 0346T | ULTRASOUND ELASTOGRAPHY | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0346T | ULTRASOUND ELASTOGRAPHY | EAPG | DEF | NA | NA | NA | E | ||||
| 0347T | INS BONE DEVICE FOR RSA | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0347T | INS BONE DEVICE FOR RSA | EAPG | DEF | NA | NA | NA | E | ||||
| 0348T | RSA SPINE EXAM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0348T | RSA SPINE EXAM | EAPG | DEF | NA | NA | NA | E | ||||
| 0349T | RSA UPPER EXTR EXAM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0349T | RSA UPPER EXTR EXAM | EAPG | DEF | NA | NA | NA | E | ||||
| 0350T | RSA LOWER EXTR EXAM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0350T | RSA LOWER EXTR EXAM | EAPG | DEF | NA | NA | NA | E | ||||
| 0351T | INTRAOP OCT BRST/NODE SPEC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0351T | INTRAOP OCT BRST/NODE SPEC | EAPG | DEF | NA | NA | NA | E | ||||
| 0353T | INTRAOP OCT BREAST CAVITY | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0353T | INTRAOP OCT BREAST CAVITY | EAPG | DEF | NA | NA | NA | E | ||||
| 0356T | INSRT DRUG DEVICE FOR IOP | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0356T | INSRT DRUG DEVICE FOR IOP | EAPG | DEF | NA | NA | NA | E | ||||
| 0376T | INSERT ANT SEGMENT DRAIN INT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0376T | INSERT ANT SEGMENT DRAIN INT | EAPG | DEF | NA | NA | NA | N | ||||
| 0377T | ANOSCPY INJ AGENT FOR INCONT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0377T | ANOSCPY INJ AGENT FOR INCONT | EAPG | DEF | NA | NA | NA | E | ||||
| 0379T | VIS FIELD ASSMNT TECH SUPPT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0379T | VIS FIELD ASSMNT TECH SUPPT | EAPG | DEF | NA | NA | NA | E | ||||
| 0380T | COMP ANIMAT RET IMAG SERIES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0380T | COMP ANIMAT RET IMAG SERIES | EAPG | DEF | NA | NA | NA | E | ||||
| 0387T | LEADLESS C PM INS/RPL VENTR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0387T | LEADLESS C PM INS/RPL VENTR | EAPG | DEF | NA | NA | NA | E | ||||
| 0388T | LEADLESS C PM REMOVE VENTR | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0388T | LEADLESS C PM REMOVE VENTR | EAPG | DEF | NA | NA | NA | E | ||||
| 0390T | PERIPROC EVAL INPER LEDLS PM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 0390T | PERIPROC EVAL INPER LEDLS PM | EAPG | DEF | NA | NA | NA | E | ||||
| 0394T | HDR ELCTRNC SKN SURF BRCHYTX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0394T | HDR ELCTRNC SKN SURF BRCHYTX | EAPG | DEF | NA | NA | NA | N | ||||
| 0395T | HDR ELCTR NTRST/NTRCV BRCHTX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0395T | HDR ELCTR NTRST/NTRCV BRCHTX | EAPG | DEF | NA | NA | NA | N | ||||
| 0396T | INTRAOP KINETIC BALNCE SENSR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0396T | INTRAOP KINETIC BALNCE SENSR | EAPG | DEF | NA | NA | NA | N | ||||
| 0397T | ERCP W/OPTICAL ENDOMICROSCPY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0397T | ERCP W/OPTICAL ENDOMICROSCPY | EAPG | DEF | NA | NA | NA | N | ||||
| 0399T | MYOCARDIAL STRAIN IMAGING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0399T | MYOCARDIAL STRAIN IMAGING | EAPG | DEF | NA | NA | NA | N | ||||
| 0400T | MLTISPECTRL DIGITAL LES ALYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0400T | MLTISPECTRL DIGITAL LES ALYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0401T | MLTISPECTRL DIGITAL LES ALYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0401T | MLTISPECTRL DIGITAL LES ALYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0402T | COLGN CRS-LINK CRN&PACHYMTRY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0402T | COLGN CRS-LINK CRN&PACHYMTRY | EAPG | DEF | NA | NA | NA | N | ||||
| 0404T | TRNSCRV UTERIN FIBROID ABLTJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0404T | TRNSCRV UTERIN FIBROID ABLTJ | EAPG | DEF | NA | NA | NA | N | ||||
| 0406T | SIN NDSC PLMT DRG ELUT MPLNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0406T | SIN NDSC PLMT DRG ELUT MPLNT | EAPG | DEF | NA | NA | NA | N | ||||
| 0407T | SIN NDSC PLMT DRG ELUT MPLNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0407T | SIN NDSC PLMT DRG ELUT MPLNT | EAPG | DEF | NA | NA | NA | N | ||||
| 0408T | INSJ/RPLC CARDIAC MODULJ SYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0408T | INSJ/RPLC CARDIAC MODULJ SYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0409T | INSJ/RPLC CAR MODULJ PLS GN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0409T | INSJ/RPLC CAR MODULJ PLS GN | EAPG | DEF | NA | NA | NA | N | ||||
| 0410T | INSJ/RPLC CAR MODULJ ATR ELT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0410T | INSJ/RPLC CAR MODULJ ATR ELT | EAPG | DEF | NA | NA | NA | N | ||||
| 0411T | INSJ/RPLC CAR MODULJ VNT ELT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0411T | INSJ/RPLC CAR MODULJ VNT ELT | EAPG | DEF | NA | NA | NA | N | ||||
| 0412T | RMVL CARDIAC MODULJ PLS GEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0412T | RMVL CARDIAC MODULJ PLS GEN | EAPG | DEF | NA | NA | NA | N | ||||
| 0413T | RMVL CAR MODULJ TRANVNS ELT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0413T | RMVL CAR MODULJ TRANVNS ELT | EAPG | DEF | NA | NA | NA | N | ||||
| 0414T | RMVL & RPL CAR MODULJ PLS GN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0414T | RMVL & RPL CAR MODULJ PLS GN | EAPG | DEF | NA | NA | NA | N | ||||
| 0415T | REPOS CAR MODULJ TRANVNS ELT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0415T | REPOS CAR MODULJ TRANVNS ELT | EAPG | DEF | NA | NA | NA | N | ||||
| 0416T | RELOC SKIN POCKET PLS GEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0416T | RELOC SKIN POCKET PLS GEN | EAPG | DEF | NA | NA | NA | N | ||||
| 0419T | DSTRJ NEUROFIBROMA XTNSV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0419T | DSTRJ NEUROFIBROMA XTNSV | EAPG | DEF | NA | NA | NA | N | ||||
| 0420T | DSTRJ NEUROFIBROMA XTNSV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0420T | DSTRJ NEUROFIBROMA XTNSV | EAPG | DEF | NA | NA | NA | N | ||||
| 0422T | TACTILE BREAST IMG UNI/BI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0422T | TACTILE BREAST IMG UNI/BI | EAPG | DEF | NA | NA | NA | N | ||||
| 0424T | INSJ/RPLC NSTIM APNEA COMPL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0424T | INSJ/RPLC NSTIM APNEA COMPL | EAPG | DEF | NA | NA | NA | N | ||||
| 0425T | INSJ/RPLC NSTIM APNEA SEN LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0425T | INSJ/RPLC NSTIM APNEA SEN LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0426T | INSJ/RPLC NSTIM APNEA STM LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0426T | INSJ/RPLC NSTIM APNEA STM LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0427T | INSJ/RPLC NSTIM APNEA PLS GN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0427T | INSJ/RPLC NSTIM APNEA PLS GN | EAPG | DEF | NA | NA | NA | N | ||||
| 0428T | RMVL NSTIM APNEA PLS GEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0428T | RMVL NSTIM APNEA PLS GEN | EAPG | DEF | NA | NA | NA | N | ||||
| 0429T | RMVL NSTIM APNEA SEN LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0429T | RMVL NSTIM APNEA SEN LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0430T | RMVL NSTIM APNEA STIMJ LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0430T | RMVL NSTIM APNEA STIMJ LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0431T | RMVL/RPLC NSTIM APNEA PLS GN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0431T | RMVL/RPLC NSTIM APNEA PLS GN | EAPG | DEF | NA | NA | NA | N | ||||
| 0432T | REPOS NSTIM APNEA STIMJ LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0432T | REPOS NSTIM APNEA STIMJ LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0433T | REPOS NSTIM APNEA SENSING LD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0433T | REPOS NSTIM APNEA SENSING LD | EAPG | DEF | NA | NA | NA | N | ||||
| 0434T | INTERRO EVAL NPGS APNEA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0434T | INTERRO EVAL NPGS APNEA | EAPG | DEF | NA | NA | NA | N | ||||
| 0437T | IMPLTJ SYNTH RNFCMT ABDL WAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0437T | IMPLTJ SYNTH RNFCMT ABDL WAL | EAPG | DEF | NA | NA | NA | N | ||||
| 0438T | TPRNL PLMT BIODEGRDABL MATRL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0438T | TPRNL PLMT BIODEGRDABL MATRL | EAPG | DEF | NA | NA | NA | N | ||||
| 0439T | MYOCRD CONTRAST PRFUJ ECHO | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0439T | MYOCRD CONTRAST PRFUJ ECHO | EAPG | DEF | NA | NA | NA | N | ||||
| 0440T | ABLTJ PERC UXTR/PERPH NRV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0440T | ABLTJ PERC UXTR/PERPH NRV | EAPG | DEF | NA | NA | NA | N | ||||
| 0441T | ABLTJ PERC LXTR/PERPH NRV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0441T | ABLTJ PERC LXTR/PERPH NRV | EAPG | DEF | NA | NA | NA | N | ||||
| 0442T | ABLTJ PERC PLEX/TRNCL NRV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0442T | ABLTJ PERC PLEX/TRNCL NRV | EAPG | DEF | NA | NA | NA | N | ||||
| 0443T | R-T SPCTRL ALYS PRST8 TISS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0443T | R-T SPCTRL ALYS PRST8 TISS | EAPG | DEF | NA | NA | NA | N | ||||
| 0444T | 1ST PLMT DRUG ELUT OC INS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0444T | 1ST PLMT DRUG ELUT OC INS | EAPG | DEF | NA | NA | NA | N | ||||
| 0445T | SBSQT PLMT DRUG ELUT OC INS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0445T | SBSQT PLMT DRUG ELUT OC INS | EAPG | DEF | NA | NA | NA | N | ||||
| 0446T | INSJ IMPLTBL GLUCOSE SENSOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0446T | INSJ IMPLTBL GLUCOSE SENSOR | EAPG | DEF | NA | NA | NA | N | ||||
| 0447T | RMVL IMPLTBL GLUCOSE SENSOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0447T | RMVL IMPLTBL GLUCOSE SENSOR | EAPG | DEF | NA | NA | NA | N | ||||
| 0448T | REMVL INSJ IMPLTBL GLUC SENS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0448T | REMVL INSJ IMPLTBL GLUC SENS | EAPG | DEF | NA | NA | NA | N | ||||
| 0449T | INSJ AQUEOUS DRAIN DEV 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0449T | INSJ AQUEOUS DRAIN DEV 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0450T | INSJ AQUEOUS DRAIN DEV EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0450T | INSJ AQUEOUS DRAIN DEV EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 0465T | SUPCHRDL NJX RX W/O SUPPLY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0465T | SUPCHRDL NJX RX W/O SUPPLY | EAPG | DEF | NA | NA | NA | N | ||||
| 0466T | INSJ CH WAL RESPIR ELTRD/RA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0466T | INSJ CH WAL RESPIR ELTRD/RA | EAPG | DEF | NA | NA | NA | N | ||||
| 0467T | REVJ/RPLMNT CH RESPIR ELTRD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0467T | REVJ/RPLMNT CH RESPIR ELTRD | EAPG | DEF | NA | NA | NA | N | ||||
| 0468T | RMVL CH WAL RESPIR ELTRD/RA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0468T | RMVL CH WAL RESPIR ELTRD/RA | EAPG | DEF | NA | NA | NA | N | ||||
| 0471T | OCT SKN IMG ACQUISJ I&R ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0471T | OCT SKN IMG ACQUISJ I&R ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 0474T | INSJ AQUEOUS DRG DEV IO RSVR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0474T | INSJ AQUEOUS DRG DEV IO RSVR | EAPG | DEF | NA | NA | NA | N | ||||
| 0479T | FXJL ABL LSR 1ST 100 SQ CM | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0479T | FXJL ABL LSR 1ST 100 SQ CM | EAPG | DEF | NA | NA | NA | Y | ||||
| 0480T | FXJL ABL LSR EA ADDL 100SQCM | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0480T | FXJL ABL LSR EA ADDL 100SQCM | EAPG | DEF | NA | NA | NA | Y | ||||
| 0482T | ABSL QUAN MYOCRD BLD FLO PET | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0482T | ABSL QUAN MYOCRD BLD FLO PET | EAPG | DEF | NA | NA | NA | N | ||||
| 0487T | TRVG BIOMCHN MAPG W/REPRT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0487T | TRVG BIOMCHN MAPG W/REPRT | EAPG | DEF | NA | NA | NA | N | ||||
| 0491T | ABL LSR OPN WND 1ST 20 SQCM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0491T | ABL LSR OPN WND 1ST 20 SQCM | EAPG | DEF | NA | NA | NA | N | ||||
| 0492T | ABL LSR OPN WND ADDL 20 SQCM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0492T | ABL LSR OPN WND ADDL 20 SQCM | EAPG | DEF | NA | NA | NA | N | ||||
| 0493T | CNTC NEAR IFR SPECTRSC WOUND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0493T | CNTC NEAR IFR SPECTRSC WOUND | EAPG | DEF | NA | NA | NA | N | ||||
| 0502T | COR FFR DATA PREP & TRANSMIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0502T | COR FFR DATA PREP & TRANSMIS | EAPG | DEF | NA | NA | NA | N | ||||
| 0503T | COR FFR ALYS GNRJ FFR MDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0503T | COR FFR ALYS GNRJ FFR MDL | EAPG | DEF | NA | NA | NA | N | ||||
| 0508T | PLS ECHO US B1 DNS MEAS TIB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0508T | PLS ECHO US B1 DNS MEAS TIB | EAPG | DEF | NA | NA | NA | N | ||||
| 0510T | RMVL SINUS TARSI IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0510T | RMVL SINUS TARSI IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 0511T | RMVL&RINSJ SINUS TARSI IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0511T | RMVL&RINSJ SINUS TARSI IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 0512T | ESW INTEG WND HLG 1ST WND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0512T | ESW INTEG WND HLG 1ST WND | EAPG | DEF | NA | NA | NA | N | ||||
| 0513F | ELEV BP PLAN OF CARE DOCD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0513F | ELEV BP PLAN OF CARE DOCD | EAPG | DEF | NA | NA | NA | N | ||||
| 0513T | ESW INTEG WND HLG EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0513T | ESW INTEG WND HLG EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 0514T | INTRAOP VIS AXIS ID PT FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0514T | INTRAOP VIS AXIS ID PT FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 0523T | NTRAPX C FFR W/3D FUNCJL MAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0523T | NTRAPX C FFR W/3D FUNCJL MAP | EAPG | DEF | NA | NA | NA | N | ||||
| 0524T | EV CATH DIR CHEM ABLTJ W/IMG | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0524T | EV CATH DIR CHEM ABLTJ W/IMG | EAPG | DEF | NA | NA | NA | Y | ||||
| 0525T | INSJ/RPLCMT COMPL IIMS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0525T | INSJ/RPLCMT COMPL IIMS | EAPG | DEF | NA | NA | NA | N | ||||
| 0526T | INSJ/RPLCMT IIMS ELTRD ONLY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0526T | INSJ/RPLCMT IIMS ELTRD ONLY | EAPG | DEF | NA | NA | NA | N | ||||
| 0527T | INSJ/RPLCMT IIMS IMPLT MNTR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0527T | INSJ/RPLCMT IIMS IMPLT MNTR | EAPG | DEF | NA | NA | NA | N | ||||
| 0530T | REMOVAL COMPLETE IIMS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0530T | REMOVAL COMPLETE IIMS | EAPG | DEF | NA | NA | NA | N | ||||
| 0531T | REMOVAL IIMS ELECTRODE ONLY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0531T | REMOVAL IIMS ELECTRODE ONLY | EAPG | DEF | NA | NA | NA | N | ||||
| 0532T | REMOVAL IIMS IMPLT MNTR ONLY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0532T | REMOVAL IIMS IMPLT MNTR ONLY | EAPG | DEF | NA | NA | NA | N | ||||
| 0546T | RF SPECTRSC NTRAOP MRGN ASMT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0546T | RF SPECTRSC NTRAOP MRGN ASMT | EAPG | DEF | NA | NA | NA | N | ||||
| 0548T | TPRNL BALO CNTNC DEV BI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0548T | TPRNL BALO CNTNC DEV BI | EAPG | DEF | NA | NA | NA | N | ||||
| 0549T | TPRNL BALO CNTNC DEV UNI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0549T | TPRNL BALO CNTNC DEV UNI | EAPG | DEF | NA | NA | NA | N | ||||
| 0550T | TPRNL BALO CNTNC DEV RMVL EA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0550T | TPRNL BALO CNTNC DEV RMVL EA | EAPG | DEF | NA | NA | NA | N | ||||
| 0551T | TPRNL BALO CNTNC DEV ADJMT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0551T | TPRNL BALO CNTNC DEV ADJMT | EAPG | DEF | NA | NA | NA | N | ||||
| 0558T | CT SCAN F/BIOMCHN CT ALYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0558T | CT SCAN F/BIOMCHN CT ALYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0559T | ANTMC MDL 3D PRINT 1ST CMPNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0559T | ANTMC MDL 3D PRINT 1ST CMPNT | EAPG | DEF | NA | NA | NA | N | ||||
| 0560T | ANTMC MDL 3D PRINT EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0560T | ANTMC MDL 3D PRINT EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 0561T | ANTMC GUIDE 3D PRINT 1ST GD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0561T | ANTMC GUIDE 3D PRINT 1ST GD | EAPG | DEF | NA | NA | NA | N | ||||
| 0562T | ANTMC GUIDE 3D PRINT EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0562T | ANTMC GUIDE 3D PRINT EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 0563T | EVAC MEIBOMIAN GLND HEAT BI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0563T | EVAC MEIBOMIAN GLND HEAT BI | EAPG | DEF | NA | NA | NA | N | ||||
| 0564T | ONC CHEMO RX CYTOTOX CSC 14 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0564T | ONC CHEMO RX CYTOTOX CSC 14 | EAPG | DEF | NA | NA | NA | N | ||||
| 0565T | AUTOL CELL IMPLT ADPS HRVG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0565T | AUTOL CELL IMPLT ADPS HRVG | EAPG | DEF | NA | NA | NA | N | ||||
| 0566T | AUTOL CELL IMPLT ADPS NJX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0566T | AUTOL CELL IMPLT ADPS NJX | EAPG | DEF | NA | NA | NA | N | ||||
| 0587T | PERQ IMPLTJ/RPLCMT ISDNS PTN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0587T | PERQ IMPLTJ/RPLCMT ISDNS PTN | EAPG | DEF | NA | NA | NA | N | ||||
| 0588T | REVISION/REMOVAL ISDNS PTN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0588T | REVISION/REMOVAL ISDNS PTN | EAPG | DEF | NA | NA | NA | N | ||||
| 0589T | ELEC ALYS SMPL PRGRMG IINS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0589T | ELEC ALYS SMPL PRGRMG IINS | EAPG | DEF | NA | NA | NA | N | ||||
| 0590T | ELEC ALYS CPLX PRGRMG IINS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0590T | ELEC ALYS CPLX PRGRMG IINS | EAPG | DEF | NA | NA | NA | N | ||||
| 0620T | EVASC VEN ARTLZ TIBL/PRNL VN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0620T | EVASC VEN ARTLZ TIBL/PRNL VN | EAPG | DEF | NA | NA | NA | N | ||||
| 0621T | TRABECULOSTOMY INTERNO LASER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0621T | TRABECULOSTOMY INTERNO LASER | EAPG | DEF | NA | NA | NA | N | ||||
| 0622T | TRABECULOSTOMY INT LSR W/SCP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0622T | TRABECULOSTOMY INT LSR W/SCP | EAPG | DEF | NA | NA | NA | N | ||||
| 0627T | PERQ NJX ALGC FLUOR LMBR 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0627T | PERQ NJX ALGC FLUOR LMBR 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0628T | PERQ NJX ALGC FLUOR LMBR EA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0628T | PERQ NJX ALGC FLUOR LMBR EA | EAPG | DEF | NA | NA | NA | N | ||||
| 0629T | PERQ NJX ALGC CT LMBR 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0629T | PERQ NJX ALGC CT LMBR 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0630T | PERQ NJX ALGC CT LMBR EA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0630T | PERQ NJX ALGC CT LMBR EA | EAPG | DEF | NA | NA | NA | N | ||||
| 0633T | CT BREAST W/3D UNI C- | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0633T | CT BREAST W/3D UNI C- | EAPG | DEF | NA | NA | NA | N | ||||
| 0634T | CT BREAST W/3D UNI C+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0634T | CT BREAST W/3D UNI C+ | EAPG | DEF | NA | NA | NA | N | ||||
| 0635T | CT BREAST W/3D UNI C-/C+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0635T | CT BREAST W/3D UNI C-/C+ | EAPG | DEF | NA | NA | NA | N | ||||
| 0636T | CT BREAST W/3D BI C- | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0636T | CT BREAST W/3D BI C- | EAPG | DEF | NA | NA | NA | N | ||||
| 0637T | CT BREAST W/3D BI C+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0637T | CT BREAST W/3D BI C+ | EAPG | DEF | NA | NA | NA | N | ||||
| 0638T | CT BREAST W/3D BI C-/C+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0638T | CT BREAST W/3D BI C-/C+ | EAPG | DEF | NA | NA | NA | N | ||||
| 0671T | INSJ ANT SGM AQ DRG DEV 1+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0671T | INSJ ANT SGM AQ DRG DEV 1+ | EAPG | DEF | NA | NA | NA | N | ||||
| 0673T | ABLTJ B9 THYR NDUL PERQ LASR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0673T | ABLTJ B9 THYR NDUL PERQ LASR | EAPG | DEF | NA | NA | NA | N | ||||
| 0686T | HISTOTRIPSY MAL HEPATCEL TIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0686T | HISTOTRIPSY MAL HEPATCEL TIS | EAPG | DEF | NA | NA | NA | N | ||||
| 0689T | QUAN US TIS CHARAC W/O DX US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0689T | QUAN US TIS CHARAC W/O DX US | EAPG | DEF | NA | NA | NA | N | ||||
| 0697T | QUAN MR TIS WO MRI MLT ORGN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0697T | QUAN MR TIS WO MRI MLT ORGN | EAPG | DEF | NA | NA | NA | N | ||||
| 0699T | NJX PST CHMBR EYE MEDICATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0699T | NJX PST CHMBR EYE MEDICATION | EAPG | DEF | NA | NA | NA | N | ||||
| 0707T | NJX B1 SUB MTRL SBCHDRL DFCT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0707T | NJX B1 SUB MTRL SBCHDRL DFCT | EAPG | DEF | NA | NA | NA | N | ||||
| 0740T | REM AUTON ALG NSLN CAL SETUP | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0740T | REM AUTON ALG NSLN CAL SETUP | EAPG | DEF | NA | NA | NA | Y | ||||
| 0741T | REM AUTON ALG NSLN DATA COLL | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0741T | REM AUTON ALG NSLN DATA COLL | EAPG | DEF | NA | NA | NA | Y | ||||
| 0751T | DGTZ GLS MCRSCP SLD LEVEL II | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0751T | DGTZ GLS MCRSCP SLD LEVEL II | EAPG | DEF | NA | NA | NA | N | ||||
| 0752T | DGTZ GLS MCRSCP SLD LVL III | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0752T | DGTZ GLS MCRSCP SLD LVL III | EAPG | DEF | NA | NA | NA | N | ||||
| 0753T | DGTZ GLS MCRSCP SLD LEVEL IV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0753T | DGTZ GLS MCRSCP SLD LEVEL IV | EAPG | DEF | NA | NA | NA | N | ||||
| 0754T | DGTZ GLS MCRSCP SLD LEVEL V | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0754T | DGTZ GLS MCRSCP SLD LEVEL V | EAPG | DEF | NA | NA | NA | N | ||||
| 0755T | DGTZ GLS MCRSCP SLD LEVEL VI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0755T | DGTZ GLS MCRSCP SLD LEVEL VI | EAPG | DEF | NA | NA | NA | N | ||||
| 0756T | DGTZ GLS MCRSCP SLD SPC GRPI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0756T | DGTZ GLS MCRSCP SLD SPC GRPI | EAPG | DEF | NA | NA | NA | N | ||||
| 0757T | DGTZ GLS MCRSCP SL SPC GRPII | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0757T | DGTZ GLS MCRSCP SL SPC GRPII | EAPG | DEF | NA | NA | NA | N | ||||
| 0758T | DGTZ GLS MCRSCP SL SPC HCHEM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0758T | DGTZ GLS MCRSCP SL SPC HCHEM | EAPG | DEF | NA | NA | NA | N | ||||
| 0759T | DGTZ GLS MCRSCP SL SP GRPIII | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0759T | DGTZ GLS MCRSCP SL SP GRPIII | EAPG | DEF | NA | NA | NA | N | ||||
| 0760T | DGTZ GLS MCRSCP SL IMM 1ST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0760T | DGTZ GLS MCRSCP SL IMM 1ST | EAPG | DEF | NA | NA | NA | N | ||||
| 0761T | DGTZ GLS MCRSCP SL IMM EA 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0761T | DGTZ GLS MCRSCP SL IMM EA 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 0762T | DGTZ GLS MCRSCP SL IMM EA M | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0762T | DGTZ GLS MCRSCP SL IMM EA M | EAPG | DEF | NA | NA | NA | N | ||||
| 0763T | DGTZ GLS MCRSCP MPHMTRC ALYS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0763T | DGTZ GLS MCRSCP MPHMTRC ALYS | EAPG | DEF | NA | NA | NA | N | ||||
| 0766T | TC MAG STIMJ PN 1ST TX 1NRV | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0766T | TC MAG STIMJ PN 1ST TX 1NRV | EAPG | DEF | NA | NA | NA | Y | ||||
| 0767T | TC MAG STIMJ PN 1ST TX EA | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0767T | TC MAG STIMJ PN 1ST TX EA | EAPG | DEF | NA | NA | NA | Y | ||||
| 0768T | TC MAG STIMJ PN SBSQ TX 1NRV | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0768T | TC MAG STIMJ PN SBSQ TX 1NRV | EAPG | DEF | NA | NA | NA | Y | ||||
| 0769T | TC MAG STIMJ PN SBSQ TX EA | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0769T | TC MAG STIMJ PN SBSQ TX EA | EAPG | DEF | NA | NA | NA | Y | ||||
| 0775T | ARTHRD SI JT PRQ IARTIC IMPL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 0775T | ARTHRD SI JT PRQ IARTIC IMPL | EAPG | DEF | NA | NA | NA | N | ||||
| 0777T | R-T PRS SENSING EDRL GDN SYS | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 0777T | R-T PRS SENSING EDRL GDN SYS | EAPG | DEF | NA | NA | NA | Y | ||||
| 10004 | FNA BX W/O IMG GDN EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10004 | FNA BX W/O IMG GDN EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 10005 | FNA BX W/US GDN 1ST LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10005 | FNA BX W/US GDN 1ST LES | EAPG | DEF | NA | NA | NA | N | ||||
| 10006 | FNA BX W/US GDN EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10006 | FNA BX W/US GDN EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 10007 | FNA BX W/FLUOR GDN 1ST LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10007 | FNA BX W/FLUOR GDN 1ST LES | EAPG | DEF | NA | NA | NA | N | ||||
| 10008 | FNA BX W/FLUOR GDN EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10008 | FNA BX W/FLUOR GDN EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 10009 | FNA BX W/CT GDN 1ST LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10009 | FNA BX W/CT GDN 1ST LES | EAPG | DEF | NA | NA | NA | N | ||||
| 10010 | FNA BX W/CT GDN EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10010 | FNA BX W/CT GDN EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 10011 | FNA BX W/MR GDN 1ST LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10011 | FNA BX W/MR GDN 1ST LES | EAPG | DEF | NA | NA | NA | N | ||||
| 10012 | FNA BX W/MR GDN EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10012 | FNA BX W/MR GDN EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 10021 | FNA BX W/O IMG GDN 1ST LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10021 | FNA BX W/O IMG GDN 1ST LES | EAPG | DEF | NA | NA | NA | N | ||||
| 10022 | FNA W/IMAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10022 | FNA W/IMAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 10030 | GUIDE CATHET FLUID DRAINAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10030 | GUIDE CATHET FLUID DRAINAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 10035 | PERQ DEV SOFT TISS 1ST IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10035 | PERQ DEV SOFT TISS 1ST IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 10036 | PERQ DEV SOFT TISS ADD IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10036 | PERQ DEV SOFT TISS ADD IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 10040 | ACNE SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10040 | ACNE SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 10060 | DRAINAGE OF SKIN ABSCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10060 | DRAINAGE OF SKIN ABSCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 10061 | DRAINAGE OF SKIN ABSCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10061 | DRAINAGE OF SKIN ABSCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 10080 | DRAINAGE OF PILONIDAL CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10080 | DRAINAGE OF PILONIDAL CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 10081 | DRAINAGE OF PILONIDAL CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10081 | DRAINAGE OF PILONIDAL CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 10120 | REMOVE FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10120 | REMOVE FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 10121 | REMOVE FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10121 | REMOVE FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 10140 | DRAINAGE OF HEMATOMA/FLUID | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10140 | DRAINAGE OF HEMATOMA/FLUID | EAPG | DEF | NA | NA | NA | N | ||||
| 10160 | PUNCTURE DRAINAGE OF LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10160 | PUNCTURE DRAINAGE OF LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 10180 | COMPLEX DRAINAGE WOUND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 10180 | COMPLEX DRAINAGE WOUND | EAPG | DEF | NA | NA | NA | N | ||||
| 11000 | DEBRIDE INFECTED SKIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11000 | DEBRIDE INFECTED SKIN | EAPG | DEF | NA | NA | NA | N | ||||
| 11001 | DEBRIDE INFECTED SKIN ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11001 | DEBRIDE INFECTED SKIN ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11010 | DEBRIDE SKIN AT FX SITE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11010 | DEBRIDE SKIN AT FX SITE | EAPG | DEF | NA | NA | NA | N | ||||
| 11011 | DEBRIDE SKIN MUSC AT FX SITE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11011 | DEBRIDE SKIN MUSC AT FX SITE | EAPG | DEF | NA | NA | NA | N | ||||
| 11012 | DEB SKIN BONE AT FX SITE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11012 | DEB SKIN BONE AT FX SITE | EAPG | DEF | NA | NA | NA | N | ||||
| 11042 | DEB SUBQ TISSUE 20 SQ CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11042 | DEB SUBQ TISSUE 20 SQ CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11043 | DEB MUSC/FASCIA 20 SQ CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11043 | DEB MUSC/FASCIA 20 SQ CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11044 | DEB BONE 20 SQ CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11044 | DEB BONE 20 SQ CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11045 | DEB SUBQ TISSUE ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11045 | DEB SUBQ TISSUE ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11046 | DEB MUSC/FASCIA ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11046 | DEB MUSC/FASCIA ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11047 | DEB BONE ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11047 | DEB BONE ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11055 | TRIM SKIN LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11055 | TRIM SKIN LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11056 | TRIM SKIN LESIONS 2 TO 4 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11056 | TRIM SKIN LESIONS 2 TO 4 | EAPG | DEF | NA | NA | NA | N | ||||
| 11057 | TRIM SKIN LESIONS OVER 4 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11057 | TRIM SKIN LESIONS OVER 4 | EAPG | DEF | NA | NA | NA | N | ||||
| 11100 | BIOPSY SKIN LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11100 | BIOPSY SKIN LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11101 | BIOPSY SKIN ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11101 | BIOPSY SKIN ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11102 | TANGNTL BX SKIN SINGLE LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11102 | TANGNTL BX SKIN SINGLE LES | EAPG | DEF | NA | NA | NA | N | ||||
| 11103 | TANGNTL BX SKIN EA SEP/ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11103 | TANGNTL BX SKIN EA SEP/ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 11104 | PUNCH BX SKIN SINGLE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11104 | PUNCH BX SKIN SINGLE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11105 | PUNCH BX SKIN EA SEP/ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11105 | PUNCH BX SKIN EA SEP/ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 11106 | INCAL BX SKN SINGLE LES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11106 | INCAL BX SKN SINGLE LES | EAPG | DEF | NA | NA | NA | N | ||||
| 11107 | INCAL BX SKN EA SEP/ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11107 | INCAL BX SKN EA SEP/ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 11200 | REMOVAL OF SKIN TAGS <W/15 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11200 | REMOVAL OF SKIN TAGS <W/15 | EAPG | DEF | NA | NA | NA | N | ||||
| 11201 | REMOVE SKIN TAGS ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11201 | REMOVE SKIN TAGS ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11300 | SHAVE SKIN LESION 0.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11300 | SHAVE SKIN LESION 0.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11301 | SHAVE SKIN LESION 0.6-1.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11301 | SHAVE SKIN LESION 0.6-1.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11302 | SHAVE SKIN LESION 1.1-2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11302 | SHAVE SKIN LESION 1.1-2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11303 | SHAVE SKIN LESION >2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11303 | SHAVE SKIN LESION >2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11305 | SHAVE SKIN LESION 0.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11305 | SHAVE SKIN LESION 0.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11306 | SHAVE SKIN LESION 0.6-1.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11306 | SHAVE SKIN LESION 0.6-1.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11307 | SHAVE SKIN LESION 1.1-2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11307 | SHAVE SKIN LESION 1.1-2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11308 | SHAVE SKIN LESION >2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11308 | SHAVE SKIN LESION >2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11310 | SHAVE SKIN LESION 0.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11310 | SHAVE SKIN LESION 0.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11311 | SHAVE SKIN LESION 0.6-1.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11311 | SHAVE SKIN LESION 0.6-1.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11312 | SHAVE SKIN LESION 1.1-2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11312 | SHAVE SKIN LESION 1.1-2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11313 | SHAVE SKIN LESION >2.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11313 | SHAVE SKIN LESION >2.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11400 | EXC TR-EXT B9+MARG 0.5 CM< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11400 | EXC TR-EXT B9+MARG 0.5 CM< | EAPG | DEF | NA | NA | NA | N | ||||
| 11401 | EXC TR-EXT B9+MARG 0.6-1 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11401 | EXC TR-EXT B9+MARG 0.6-1 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11402 | EXC TR-EXT B9+MARG 1.1-2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11402 | EXC TR-EXT B9+MARG 1.1-2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11403 | EXC TR-EXT B9+MARG 2.1-3CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11403 | EXC TR-EXT B9+MARG 2.1-3CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11404 | EXC TR-EXT B9+MARG 3.1-4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11404 | EXC TR-EXT B9+MARG 3.1-4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11406 | EXC TR-EXT B9+MARG >4.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11406 | EXC TR-EXT B9+MARG >4.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11420 | EXC H-F-NK-SP B9+MARG 0.5/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11420 | EXC H-F-NK-SP B9+MARG 0.5/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11421 | EXC H-F-NK-SP B9+MARG 0.6-1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11421 | EXC H-F-NK-SP B9+MARG 0.6-1 | EAPG | DEF | NA | NA | NA | N | ||||
| 11422 | EXC H-F-NK-SP B9+MARG 1.1-2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11422 | EXC H-F-NK-SP B9+MARG 1.1-2 | EAPG | DEF | NA | NA | NA | N | ||||
| 11423 | EXC H-F-NK-SP B9+MARG 2.1-3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11423 | EXC H-F-NK-SP B9+MARG 2.1-3 | EAPG | DEF | NA | NA | NA | N | ||||
| 11424 | EXC H-F-NK-SP B9+MARG 3.1-4 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11424 | EXC H-F-NK-SP B9+MARG 3.1-4 | EAPG | DEF | NA | NA | NA | N | ||||
| 11426 | EXC H-F-NK-SP B9+MARG >4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11426 | EXC H-F-NK-SP B9+MARG >4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11440 | EXC FACE-MM B9+MARG 0.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11440 | EXC FACE-MM B9+MARG 0.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11441 | EXC FACE-MM B9+MARG 0.6-1 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11441 | EXC FACE-MM B9+MARG 0.6-1 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11442 | EXC FACE-MM B9+MARG 1.1-2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11442 | EXC FACE-MM B9+MARG 1.1-2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11443 | EXC FACE-MM B9+MARG 2.1-3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11443 | EXC FACE-MM B9+MARG 2.1-3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11444 | EXC FACE-MM B9+MARG 3.1-4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11444 | EXC FACE-MM B9+MARG 3.1-4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11446 | EXC FACE-MM B9+MARG >4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11446 | EXC FACE-MM B9+MARG >4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11450 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11450 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11451 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11451 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11462 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11462 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11463 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11463 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11470 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11470 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11471 | REMOVAL SWEAT GLAND LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11471 | REMOVAL SWEAT GLAND LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 11600 | EXC TR-EXT MAL+MARG 0.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11600 | EXC TR-EXT MAL+MARG 0.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11601 | EXC TR-EXT MAL+MARG 0.6-1 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11601 | EXC TR-EXT MAL+MARG 0.6-1 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11602 | EXC TR-EXT MAL+MARG 1.1-2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11602 | EXC TR-EXT MAL+MARG 1.1-2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11603 | EXC TR-EXT MAL+MARG 2.1-3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11603 | EXC TR-EXT MAL+MARG 2.1-3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11604 | EXC TR-EXT MAL+MARG 3.1-4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11604 | EXC TR-EXT MAL+MARG 3.1-4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11606 | EXC TR-EXT MAL+MARG >4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11606 | EXC TR-EXT MAL+MARG >4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11620 | EXC H-F-NK-SP MAL+MARG 0.5/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11620 | EXC H-F-NK-SP MAL+MARG 0.5/< | EAPG | DEF | NA | NA | NA | N | ||||
| 11621 | EXC S/N/H/F/G MAL+MRG 0.6-1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11621 | EXC S/N/H/F/G MAL+MRG 0.6-1 | EAPG | DEF | NA | NA | NA | N | ||||
| 11622 | EXC S/N/H/F/G MAL+MRG 1.1-2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11622 | EXC S/N/H/F/G MAL+MRG 1.1-2 | EAPG | DEF | NA | NA | NA | N | ||||
| 11623 | EXC S/N/H/F/G MAL+MRG 2.1-3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11623 | EXC S/N/H/F/G MAL+MRG 2.1-3 | EAPG | DEF | NA | NA | NA | N | ||||
| 11624 | EXC S/N/H/F/G MAL+MRG 3.1-4 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11624 | EXC S/N/H/F/G MAL+MRG 3.1-4 | EAPG | DEF | NA | NA | NA | N | ||||
| 11626 | EXC S/N/H/F/G MAL+MRG >4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11626 | EXC S/N/H/F/G MAL+MRG >4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11640 | EXC F/E/E/N/L MAL+MRG 0.5CM< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11640 | EXC F/E/E/N/L MAL+MRG 0.5CM< | EAPG | DEF | NA | NA | NA | N | ||||
| 11641 | EXC F/E/E/N/L MAL+MRG 0.6-1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11641 | EXC F/E/E/N/L MAL+MRG 0.6-1 | EAPG | DEF | NA | NA | NA | N | ||||
| 11642 | EXC F/E/E/N/L MAL+MRG 1.1-2 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11642 | EXC F/E/E/N/L MAL+MRG 1.1-2 | EAPG | DEF | NA | NA | NA | N | ||||
| 11643 | EXC F/E/E/N/L MAL+MRG 2.1-3 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11643 | EXC F/E/E/N/L MAL+MRG 2.1-3 | EAPG | DEF | NA | NA | NA | N | ||||
| 11644 | EXC F/E/E/N/L MAL+MRG 3.1-4 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11644 | EXC F/E/E/N/L MAL+MRG 3.1-4 | EAPG | DEF | NA | NA | NA | N | ||||
| 11646 | EXC F/E/E/N/L MAL+MRG >4 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11646 | EXC F/E/E/N/L MAL+MRG >4 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 11719 | TRIM NAIL(S) ANY NUMBER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11719 | TRIM NAIL(S) ANY NUMBER | EAPG | DEF | NA | NA | NA | N | ||||
| 11720 | DEBRIDE NAIL 1-5 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11720 | DEBRIDE NAIL 1-5 | EAPG | DEF | NA | NA | NA | N | ||||
| 11721 | DEBRIDE NAIL 6 OR MORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11721 | DEBRIDE NAIL 6 OR MORE | EAPG | DEF | NA | NA | NA | N | ||||
| 11730 | REMOVAL OF NAIL PLATE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11730 | REMOVAL OF NAIL PLATE | EAPG | DEF | NA | NA | NA | N | ||||
| 11732 | REMOVE NAIL PLATE ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11732 | REMOVE NAIL PLATE ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 11740 | DRAIN BLOOD FROM UNDER NAIL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11740 | DRAIN BLOOD FROM UNDER NAIL | EAPG | DEF | NA | NA | NA | N | ||||
| 11750 | REMOVAL OF NAIL BED | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11750 | REMOVAL OF NAIL BED | EAPG | DEF | NA | NA | NA | N | ||||
| 11755 | BIOPSY NAIL UNIT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11755 | BIOPSY NAIL UNIT | EAPG | DEF | NA | NA | NA | N | ||||
| 11760 | REPAIR OF NAIL BED | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11760 | REPAIR OF NAIL BED | EAPG | DEF | NA | NA | NA | N | ||||
| 11762 | RECONSTRUCTION OF NAIL BED | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11762 | RECONSTRUCTION OF NAIL BED | EAPG | DEF | NA | NA | NA | N | ||||
| 11765 | EXCISION OF NAIL FOLD TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11765 | EXCISION OF NAIL FOLD TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 11770 | REMOVE PILONIDAL CYST SIMPLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11770 | REMOVE PILONIDAL CYST SIMPLE | EAPG | DEF | NA | NA | NA | N | ||||
| 11771 | REMOVE PILONIDAL CYST EXTEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11771 | REMOVE PILONIDAL CYST EXTEN | EAPG | DEF | NA | NA | NA | N | ||||
| 11772 | REMOVE PILONIDAL CYST COMPL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11772 | REMOVE PILONIDAL CYST COMPL | EAPG | DEF | NA | NA | NA | N | ||||
| 11900 | INJECT SKIN LESIONS </W 7 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11900 | INJECT SKIN LESIONS </W 7 | EAPG | DEF | NA | NA | NA | N | ||||
| 11901 | INJECT SKIN LESIONS >7 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11901 | INJECT SKIN LESIONS >7 | EAPG | DEF | NA | NA | NA | N | ||||
| 11920 | CORRECT SKIN COLOR 6.0 CM/< | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11920 | CORRECT SKIN COLOR 6.0 CM/< | EAPG | DEF | NA | NA | NA | E | ||||
| 11921 | CORRECT SKN COLOR 6.1-20.0CM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11921 | CORRECT SKN COLOR 6.1-20.0CM | EAPG | DEF | NA | NA | NA | E | ||||
| 11922 | CORRECT SKIN COLOR EA 20.0CM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11922 | CORRECT SKIN COLOR EA 20.0CM | EAPG | DEF | NA | NA | NA | E | ||||
| 11950 | TX CONTOUR DEFECTS 1 CC/< | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11950 | TX CONTOUR DEFECTS 1 CC/< | EAPG | DEF | NA | NA | NA | E | ||||
| 11951 | TX CONTOUR DEFECTS 1.1-5.0CC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11951 | TX CONTOUR DEFECTS 1.1-5.0CC | EAPG | DEF | NA | NA | NA | E | ||||
| 11952 | TX CONTOUR DEFECTS 5.1-10CC | PRXOVR | DEF | NA | NA | NA | E | ||||
| 11952 | TX CONTOUR DEFECTS 5.1-10CC | EAPG | DEF | NA | NA | NA | E | ||||
| 11954 | TX CONTOUR DEFECTS >10.0 CC | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 11954 | TX CONTOUR DEFECTS >10.0 CC | EAPG | DEF | NA | NA | NA | Y | ||||
| 11960 | INSERT TISSUE EXPANDER(S) | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 11960 | INSERT TISSUE EXPANDER(S) | EAPG | DEF | NA | NA | NA | Y | ||||
| 11970 | RPLCMT TISS XPNDR PERM IMPLT | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 11970 | RPLCMT TISS XPNDR PERM IMPLT | EAPG | DEF | NA | NA | NA | Y | ||||
| 11971 | RMVL TIS XPNDR WO INSJ IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11971 | RMVL TIS XPNDR WO INSJ IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 11976 | REMOVE CONTRACEPTIVE CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11976 | REMOVE CONTRACEPTIVE CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 11980 | IMPLANT HORMONE PELLET(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11980 | IMPLANT HORMONE PELLET(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 11981 | INSERTION DRUG DLVR IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11981 | INSERTION DRUG DLVR IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 11982 | REMOVE DRUG IMPLANT DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11982 | REMOVE DRUG IMPLANT DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 11983 | REMOVE/INSERT DRUG IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 11983 | REMOVE/INSERT DRUG IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 12001 | RPR S/N/AX/GEN/TRNK 2.5CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12001 | RPR S/N/AX/GEN/TRNK 2.5CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 12002 | RPR S/N/AX/GEN/TRNK2.6-7.5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12002 | RPR S/N/AX/GEN/TRNK2.6-7.5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12004 | RPR S/N/AX/GEN/TRK7.6-12.5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12004 | RPR S/N/AX/GEN/TRK7.6-12.5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12005 | RPR S/N/A/GEN/TRK12.6-20.0CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12005 | RPR S/N/A/GEN/TRK12.6-20.0CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12006 | RPR S/N/A/GEN/TRK20.1-30.0CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12006 | RPR S/N/A/GEN/TRK20.1-30.0CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12007 | RPR S/N/AX/GEN/TRNK >30.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12007 | RPR S/N/AX/GEN/TRNK >30.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12011 | RPR F/E/E/N/L/M 2.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12011 | RPR F/E/E/N/L/M 2.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 12013 | RPR F/E/E/N/L/M 2.6-5.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12013 | RPR F/E/E/N/L/M 2.6-5.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12014 | RPR F/E/E/N/L/M 5.1-7.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12014 | RPR F/E/E/N/L/M 5.1-7.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12015 | RPR F/E/E/N/L/M 7.6-12.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12015 | RPR F/E/E/N/L/M 7.6-12.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12016 | RPR FE/E/EN/L/M 12.6-20.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12016 | RPR FE/E/EN/L/M 12.6-20.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12017 | RPR FE/E/EN/L/M 20.1-30.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12017 | RPR FE/E/EN/L/M 20.1-30.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12018 | RPR F/E/E/N/L/M >30.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12018 | RPR F/E/E/N/L/M >30.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12020 | CLOSURE OF SPLIT WOUND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12020 | CLOSURE OF SPLIT WOUND | EAPG | DEF | NA | NA | NA | N | ||||
| 12021 | CLOSURE OF SPLIT WOUND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12021 | CLOSURE OF SPLIT WOUND | EAPG | DEF | NA | NA | NA | N | ||||
| 12031 | INTMD RPR S/A/T/EXT 2.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12031 | INTMD RPR S/A/T/EXT 2.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 12032 | INTMD RPR S/A/T/EXT 2.6-7.5 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12032 | INTMD RPR S/A/T/EXT 2.6-7.5 | EAPG | DEF | NA | NA | NA | N | ||||
| 12034 | INTMD RPR S/TR/EXT 7.6-12.5 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12034 | INTMD RPR S/TR/EXT 7.6-12.5 | EAPG | DEF | NA | NA | NA | N | ||||
| 12035 | INTMD RPR S/A/T/EXT 12.6-20 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12035 | INTMD RPR S/A/T/EXT 12.6-20 | EAPG | DEF | NA | NA | NA | N | ||||
| 12036 | INTMD RPR S/A/T/EXT 20.1-30 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12036 | INTMD RPR S/A/T/EXT 20.1-30 | EAPG | DEF | NA | NA | NA | N | ||||
| 12037 | INTMD RPR S/TR/EXT >30.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12037 | INTMD RPR S/TR/EXT >30.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12041 | INTMD RPR N-HF/GENIT 2.5CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12041 | INTMD RPR N-HF/GENIT 2.5CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 12042 | INTMD RPR N-HF/GENIT2.6-7.5 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12042 | INTMD RPR N-HF/GENIT2.6-7.5 | EAPG | DEF | NA | NA | NA | N | ||||
| 12044 | INTMD RPR N-HF/GENIT7.6-12.5 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12044 | INTMD RPR N-HF/GENIT7.6-12.5 | EAPG | DEF | NA | NA | NA | N | ||||
| 12045 | INTMD RPR N-HF/GENIT12.6-20 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12045 | INTMD RPR N-HF/GENIT12.6-20 | EAPG | DEF | NA | NA | NA | N | ||||
| 12046 | INTMD RPR N-HF/GENIT20.1-30 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12046 | INTMD RPR N-HF/GENIT20.1-30 | EAPG | DEF | NA | NA | NA | N | ||||
| 12047 | INTMD RPR N-HF/GENIT >30.0CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12047 | INTMD RPR N-HF/GENIT >30.0CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12051 | INTMD RPR FACE/MM 2.5 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12051 | INTMD RPR FACE/MM 2.5 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 12052 | INTMD RPR FACE/MM 2.6-5.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12052 | INTMD RPR FACE/MM 2.6-5.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12053 | INTMD RPR FACE/MM 5.1-7.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12053 | INTMD RPR FACE/MM 5.1-7.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12054 | INTMD RPR FACE/MM 7.6-12.5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12054 | INTMD RPR FACE/MM 7.6-12.5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12055 | INTMD RPR FACE/MM 12.6-20 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12055 | INTMD RPR FACE/MM 12.6-20 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 12056 | INTMD RPR FACE/MM 20.1-30.0 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12056 | INTMD RPR FACE/MM 20.1-30.0 | EAPG | DEF | NA | NA | NA | N | ||||
| 12057 | INTMD RPR FACE/MM >30.0 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 12057 | INTMD RPR FACE/MM >30.0 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13100 | CMPLX RPR TRUNK 1.1-2.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13100 | CMPLX RPR TRUNK 1.1-2.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13101 | CMPLX RPR TRUNK 2.6-7.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13101 | CMPLX RPR TRUNK 2.6-7.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13102 | CMPLX RPR TRUNK ADDL 5CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13102 | CMPLX RPR TRUNK ADDL 5CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 13120 | CMPLX RPR S/A/L 1.1-2.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13120 | CMPLX RPR S/A/L 1.1-2.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13121 | CMPLX RPR S/A/L 2.6-7.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13121 | CMPLX RPR S/A/L 2.6-7.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13122 | CMPLX RPR S/A/L ADDL 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13122 | CMPLX RPR S/A/L ADDL 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 13131 | CMPLX RPR F/C/C/M/N/AX/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13131 | CMPLX RPR F/C/C/M/N/AX/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 13132 | CMPLX RPR F/C/C/M/N/AX/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13132 | CMPLX RPR F/C/C/M/N/AX/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 13133 | CMPLX RPR F/C/C/M/N/AX/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13133 | CMPLX RPR F/C/C/M/N/AX/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 13150 | CMPLX RPR E/N/E/L 1.0 CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13150 | CMPLX RPR E/N/E/L 1.0 CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 13151 | CMPLX RPR E/N/E/L 1.1-2.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13151 | CMPLX RPR E/N/E/L 1.1-2.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13152 | CMPLX RPR E/N/E/L 2.6-7.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13152 | CMPLX RPR E/N/E/L 2.6-7.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 13153 | CMPLX RPR E/N/E/L ADDL 5CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13153 | CMPLX RPR E/N/E/L ADDL 5CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 13160 | LATE CLOSURE OF WOUND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13160 | LATE CLOSURE OF WOUND | EAPG | DEF | NA | NA | NA | N | ||||
| 13300 | REPAIR OF WOUND OR LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 13300 | REPAIR OF WOUND OR LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 14000 | TIS TRNFR TRUNK 10 SQ CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14000 | TIS TRNFR TRUNK 10 SQ CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 14001 | TIS TRNFR TRUNK 10.1-30SQCM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14001 | TIS TRNFR TRUNK 10.1-30SQCM | EAPG | DEF | NA | NA | NA | N | ||||
| 14020 | TIS TRNFR S/A/L 10 SQ CM/< | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 14020 | TIS TRNFR S/A/L 10 SQ CM/< | EAPG | DEF | NA | NA | NA | Y | ||||
| 14021 | TIS TRNFR S/A/L 10.1-30 SQCM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14021 | TIS TRNFR S/A/L 10.1-30 SQCM | EAPG | DEF | NA | NA | NA | N | ||||
| 14040 | TIS TRNFR F/C/C/M/N/A/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14040 | TIS TRNFR F/C/C/M/N/A/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 14041 | TIS TRNFR F/C/C/M/N/A/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14041 | TIS TRNFR F/C/C/M/N/A/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 14060 | TIS TRNFR E/N/E/L 10 SQ CM/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14060 | TIS TRNFR E/N/E/L 10 SQ CM/< | EAPG | DEF | NA | NA | NA | N | ||||
| 14061 | TIS TRNFR E/N/E/L10.1-30SQCM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14061 | TIS TRNFR E/N/E/L10.1-30SQCM | EAPG | DEF | NA | NA | NA | N | ||||
| 14300 | SKIN TISSUE REARRANGEMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14300 | SKIN TISSUE REARRANGEMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 14301 | TIS TRNFR ANY 30.1-60 SQ CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14301 | TIS TRNFR ANY 30.1-60 SQ CM | EAPG | DEF | NA | NA | NA | N | ||||
| 14302 | TIS TRNFR ADDL 30 SQ CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14302 | TIS TRNFR ADDL 30 SQ CM | EAPG | DEF | NA | NA | NA | N | ||||
| 14350 | FILLETED FINGER/TOE FLAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 14350 | FILLETED FINGER/TOE FLAP | EAPG | DEF | NA | NA | NA | N | ||||
| 15000 | WOUND PREP; 1ST 100 SQ CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15000 | WOUND PREP; 1ST 100 SQ CM | EAPG | DEF | NA | NA | NA | N | ||||
| 15002 | WOUND PREP TRK/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15002 | WOUND PREP TRK/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15003 | WOUND PREP ADDL 100 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15003 | WOUND PREP ADDL 100 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 15004 | WOUND PREP F/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15004 | WOUND PREP F/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15005 | WND PREP F/N/HF/G ADDL CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15005 | WND PREP F/N/HF/G ADDL CM | EAPG | DEF | NA | NA | NA | N | ||||
| 15040 | HARVEST CULTURED SKIN GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15040 | HARVEST CULTURED SKIN GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15050 | SKIN PINCH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15050 | SKIN PINCH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15100 | SKIN SPLT GRFT TRNK/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15100 | SKIN SPLT GRFT TRNK/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15101 | SKIN SPLT GRFT T/A/L ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15101 | SKIN SPLT GRFT T/A/L ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15110 | EPIDRM AUTOGRFT TRNK/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15110 | EPIDRM AUTOGRFT TRNK/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15111 | EPIDRM AUTOGRFT T/A/L ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15111 | EPIDRM AUTOGRFT T/A/L ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15115 | EPIDRM A-GRFT FACE/NCK/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15115 | EPIDRM A-GRFT FACE/NCK/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15116 | EPIDRM A-GRFT F/N/HF/G ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15116 | EPIDRM A-GRFT F/N/HF/G ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15120 | SKN SPLT A-GRFT FAC/NCK/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15120 | SKN SPLT A-GRFT FAC/NCK/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15121 | SKN SPLT A-GRFT F/N/HF/G ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15121 | SKN SPLT A-GRFT F/N/HF/G ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15130 | DERM AUTOGRAFT TRNK/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15130 | DERM AUTOGRAFT TRNK/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15131 | DERM AUTOGRAFT T/A/L ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15131 | DERM AUTOGRAFT T/A/L ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15135 | DERM AUTOGRAFT FACE/NCK/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15135 | DERM AUTOGRAFT FACE/NCK/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15136 | DERM AUTOGRAFT F/N/HF/G ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15136 | DERM AUTOGRAFT F/N/HF/G ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15150 | CULT SKIN GRFT T/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15150 | CULT SKIN GRFT T/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15151 | CULT SKIN GRFT T/A/L ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15151 | CULT SKIN GRFT T/A/L ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15152 | CULT SKIN GRAFT T/A/L +% | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15152 | CULT SKIN GRAFT T/A/L +% | EAPG | DEF | NA | NA | NA | N | ||||
| 15155 | CULT SKIN GRAFT F/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15155 | CULT SKIN GRAFT F/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15156 | CULT SKIN GRFT F/N/HFG ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15156 | CULT SKIN GRFT F/N/HFG ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15157 | CULT EPIDERM GRFT F/N/HFG +% | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15157 | CULT EPIDERM GRFT F/N/HFG +% | EAPG | DEF | NA | NA | NA | N | ||||
| 15200 | SKIN FULL GRAFT TRUNK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15200 | SKIN FULL GRAFT TRUNK | EAPG | DEF | NA | NA | NA | N | ||||
| 15201 | SKIN FULL GRAFT TRUNK ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15201 | SKIN FULL GRAFT TRUNK ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15220 | SKIN FULL GRAFT SCLP/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15220 | SKIN FULL GRAFT SCLP/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15221 | SKIN FULL GRAFT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15221 | SKIN FULL GRAFT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15240 | SKIN FULL GRFT FACE/GENIT/HF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15240 | SKIN FULL GRFT FACE/GENIT/HF | EAPG | DEF | NA | NA | NA | N | ||||
| 15241 | SKIN FULL GRAFT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15241 | SKIN FULL GRAFT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15260 | SKIN FULL GRAFT EEN & LIPS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15260 | SKIN FULL GRAFT EEN & LIPS | EAPG | DEF | NA | NA | NA | N | ||||
| 15261 | SKIN FULL GRAFT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15261 | SKIN FULL GRAFT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15271 | SKIN SUB GRAFT TRNK/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15271 | SKIN SUB GRAFT TRNK/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15272 | SKIN SUB GRAFT T/A/L ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15272 | SKIN SUB GRAFT T/A/L ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15273 | SKIN SUB GRFT T/ARM/LG CHILD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15273 | SKIN SUB GRFT T/ARM/LG CHILD | EAPG | DEF | NA | NA | NA | N | ||||
| 15274 | SKN SUB GRFT T/A/L CHILD ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15274 | SKN SUB GRFT T/A/L CHILD ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15275 | SKIN SUB GRAFT FACE/NK/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15275 | SKIN SUB GRAFT FACE/NK/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15276 | SKIN SUB GRAFT F/N/HF/G ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15276 | SKIN SUB GRAFT F/N/HF/G ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15277 | SKN SUB GRFT F/N/HF/G CHILD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15277 | SKN SUB GRFT F/N/HF/G CHILD | EAPG | DEF | NA | NA | NA | N | ||||
| 15278 | SKN SUB GRFT F/N/HF/G CH ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15278 | SKN SUB GRFT F/N/HF/G CH ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15300 | APPLY SKINALLOGRFT T/ARM/LG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15300 | APPLY SKINALLOGRFT T/ARM/LG | EAPG | DEF | NA | NA | NA | N | ||||
| 15301 | APPLY SKNALLOGRFT T/A/L ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15301 | APPLY SKNALLOGRFT T/A/L ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15320 | APPLY SKIN ALLOGRFT F/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15320 | APPLY SKIN ALLOGRFT F/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15321 | APLY SKNALLOGRFT F/N/HFG ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15321 | APLY SKNALLOGRFT F/N/HFG ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15330 | APLY ACELL ALOGRFT T/ARM/LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15330 | APLY ACELL ALOGRFT T/ARM/LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15331 | APLY ACELL GRFT T/A/L ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15331 | APLY ACELL GRFT T/A/L ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15335 | APPLY ACELL GRAFT F/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15335 | APPLY ACELL GRAFT F/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15336 | APLY ACELL GRFT F/N/HF/G ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15336 | APLY ACELL GRFT F/N/HF/G ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15350 | SKIN HOMOGRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15350 | SKIN HOMOGRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15351 | SKIN HOMOGRAFT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15351 | SKIN HOMOGRAFT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15400 | APPLY SKIN XENOGRAFT T/A/L | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15400 | APPLY SKIN XENOGRAFT T/A/L | EAPG | DEF | NA | NA | NA | N | ||||
| 15401 | APPLY SKN XENOGRFT T/A/L ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15401 | APPLY SKN XENOGRFT T/A/L ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15420 | APPLY SKIN XGRAFT F/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15420 | APPLY SKIN XGRAFT F/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 15421 | APPLY SKN XGRFT F/N/HF/G ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15421 | APPLY SKN XGRFT F/N/HF/G ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15430 | APPLY ACELLULAR XENOGRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15430 | APPLY ACELLULAR XENOGRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15431 | APPLY ACELLULAR XGRAFT ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15431 | APPLY ACELLULAR XGRAFT ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 15570 | SKIN PEDICLE FLAP TRUNK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15570 | SKIN PEDICLE FLAP TRUNK | EAPG | DEF | NA | NA | NA | N | ||||
| 15572 | SKIN PEDICLE FLAP ARMS/LEGS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15572 | SKIN PEDICLE FLAP ARMS/LEGS | EAPG | DEF | NA | NA | NA | N | ||||
| 15574 | PEDCLE FH/CH/CH/M/N/AX/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15574 | PEDCLE FH/CH/CH/M/N/AX/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 15576 | PEDICLE E/N/E/L/NTRORAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15576 | PEDICLE E/N/E/L/NTRORAL | EAPG | DEF | NA | NA | NA | N | ||||
| 15580 | ATTACH SKIN PEDICLE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15580 | ATTACH SKIN PEDICLE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15600 | DELAY FLAP TRUNK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15600 | DELAY FLAP TRUNK | EAPG | DEF | NA | NA | NA | N | ||||
| 15610 | DELAY FLAP ARMS/LEGS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15610 | DELAY FLAP ARMS/LEGS | EAPG | DEF | NA | NA | NA | N | ||||
| 15620 | DELAY FLAP F/C/C/N/AX/G/H/F | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15620 | DELAY FLAP F/C/C/N/AX/G/H/F | EAPG | DEF | NA | NA | NA | N | ||||
| 15625 | SKIN GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15625 | SKIN GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15630 | DELAY FLAP EYE/NOS/EAR/LIP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15630 | DELAY FLAP EYE/NOS/EAR/LIP | EAPG | DEF | NA | NA | NA | N | ||||
| 15650 | TRANSFER SKIN PEDICLE FLAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15650 | TRANSFER SKIN PEDICLE FLAP | EAPG | DEF | NA | NA | NA | N | ||||
| 15730 | MDFC FLAP W/PRSRV VASC PEDCL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15730 | MDFC FLAP W/PRSRV VASC PEDCL | EAPG | DEF | NA | NA | NA | N | ||||
| 15731 | FOREHEAD FLAP W/VASC PEDICLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15731 | FOREHEAD FLAP W/VASC PEDICLE | EAPG | DEF | NA | NA | NA | N | ||||
| 15732 | MUSCLE-SKIN GRAFT HEAD/NECK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15732 | MUSCLE-SKIN GRAFT HEAD/NECK | EAPG | DEF | NA | NA | NA | N | ||||
| 15733 | MUSC MYOQ/FSCQ FLP H&N PEDCL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15733 | MUSC MYOQ/FSCQ FLP H&N PEDCL | EAPG | DEF | NA | NA | NA | N | ||||
| 15734 | MUSCLE-SKIN GRAFT TRUNK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15734 | MUSCLE-SKIN GRAFT TRUNK | EAPG | DEF | NA | NA | NA | N | ||||
| 15736 | MUSCLE-SKIN GRAFT ARM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15736 | MUSCLE-SKIN GRAFT ARM | EAPG | DEF | NA | NA | NA | N | ||||
| 15738 | MUSCLE-SKIN GRAFT LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15738 | MUSCLE-SKIN GRAFT LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 15740 | ISLAND PEDICLE FLAP GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15740 | ISLAND PEDICLE FLAP GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15750 | NEUROVASCULAR PEDICLE FLAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15750 | NEUROVASCULAR PEDICLE FLAP | EAPG | DEF | NA | NA | NA | N | ||||
| 15755 | MICROVASCULAR FLAP GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15755 | MICROVASCULAR FLAP GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15760 | COMPOSITE SKIN GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15760 | COMPOSITE SKIN GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15769 | GRFG AUTOL SOFT TISS DIR EXC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15769 | GRFG AUTOL SOFT TISS DIR EXC | EAPG | DEF | NA | NA | NA | N | ||||
| 15770 | DERMA-FAT-FASCIA GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15770 | DERMA-FAT-FASCIA GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15771 | GRFG AUTOL FAT LIPO 50 CC/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15771 | GRFG AUTOL FAT LIPO 50 CC/< | EAPG | DEF | NA | NA | NA | N | ||||
| 15772 | GRFG AUTOL FAT LIPO EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15772 | GRFG AUTOL FAT LIPO EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15773 | GRFG AUTOL FAT LIPO 25 CC/< | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15773 | GRFG AUTOL FAT LIPO 25 CC/< | EAPG | DEF | NA | NA | NA | N | ||||
| 15774 | GFRG AUTOL FAT LIPO EA ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15774 | GFRG AUTOL FAT LIPO EA ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 15775 | HAIR TRNSPL 1-15 PUNCH GRFTS | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15775 | HAIR TRNSPL 1-15 PUNCH GRFTS | EAPG | DEF | NA | NA | NA | E | ||||
| 15776 | HAIR TRNSPL >15 PUNCH GRAFTS | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15776 | HAIR TRNSPL >15 PUNCH GRAFTS | EAPG | DEF | NA | NA | NA | E | ||||
| 15777 | ACELLULAR DERM MATRIX IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15777 | ACELLULAR DERM MATRIX IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 15778 | IMPL ABSRB MSH/PRSTH DLY CLS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15778 | IMPL ABSRB MSH/PRSTH DLY CLS | EAPG | DEF | NA | NA | NA | N | ||||
| 15780 | DERMABRASION TOTAL FACE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15780 | DERMABRASION TOTAL FACE | EAPG | DEF | NA | NA | NA | E | ||||
| 15781 | DERMABRASION SEGMENTAL FACE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15781 | DERMABRASION SEGMENTAL FACE | EAPG | DEF | NA | NA | NA | E | ||||
| 15782 | DERMABRASION OTHER THAN FACE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15782 | DERMABRASION OTHER THAN FACE | EAPG | DEF | NA | NA | NA | E | ||||
| 15783 | DERMABRASION SUPRFL ANY SITE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15783 | DERMABRASION SUPRFL ANY SITE | EAPG | DEF | NA | NA | NA | E | ||||
| 15786 | ABRASION LESION SINGLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15786 | ABRASION LESION SINGLE | EAPG | DEF | NA | NA | NA | N | ||||
| 15787 | ABRASION LESIONS ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15787 | ABRASION LESIONS ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 15788 | CHEMICAL PEEL FACE EPIDERM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15788 | CHEMICAL PEEL FACE EPIDERM | EAPG | DEF | NA | NA | NA | E | ||||
| 15789 | CHEMICAL PEEL FACE DERMAL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15789 | CHEMICAL PEEL FACE DERMAL | EAPG | DEF | NA | NA | NA | E | ||||
| 15792 | CHEMICAL PEEL NONFACIAL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15792 | CHEMICAL PEEL NONFACIAL | EAPG | DEF | NA | NA | NA | E | ||||
| 15793 | CHEMICAL PEEL NONFACIAL | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15793 | CHEMICAL PEEL NONFACIAL | EAPG | DEF | NA | NA | NA | E | ||||
| 15819 | PLASTIC SURGERY NECK | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15819 | PLASTIC SURGERY NECK | EAPG | DEF | NA | NA | NA | E | ||||
| 15820 | REVISION OF LOWER EYELID | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15820 | REVISION OF LOWER EYELID | EAPG | DEF | NA | NA | NA | E | ||||
| 15821 | REVISION OF LOWER EYELID | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15821 | REVISION OF LOWER EYELID | EAPG | DEF | NA | NA | NA | N | ||||
| 15822 | REVISION OF UPPER EYELID | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15822 | REVISION OF UPPER EYELID | EAPG | DEF | NA | NA | NA | E | ||||
| 15823 | REVISION OF UPPER EYELID | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15823 | REVISION OF UPPER EYELID | EAPG | DEF | NA | NA | NA | E | ||||
| 15824 | REMOVAL OF FOREHEAD WRINKLES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15824 | REMOVAL OF FOREHEAD WRINKLES | EAPG | DEF | NA | NA | NA | E | ||||
| 15825 | REMOVAL OF NECK WRINKLES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15825 | REMOVAL OF NECK WRINKLES | EAPG | DEF | NA | NA | NA | E | ||||
| 15826 | REMOVAL OF BROW WRINKLES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15826 | REMOVAL OF BROW WRINKLES | EAPG | DEF | NA | NA | NA | E | ||||
| 15828 | REMOVAL OF FACE WRINKLES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15828 | REMOVAL OF FACE WRINKLES | EAPG | DEF | NA | NA | NA | E | ||||
| 15829 | REMOVAL OF SKIN WRINKLES | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15829 | REMOVAL OF SKIN WRINKLES | EAPG | DEF | NA | NA | NA | E | ||||
| 15830 | EXC SKIN ABD | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15830 | EXC SKIN ABD | EAPG | DEF | NA | NA | NA | E | ||||
| 15832 | EXCISE EXCESSIVE SKIN THIGH | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15832 | EXCISE EXCESSIVE SKIN THIGH | EAPG | DEF | NA | NA | NA | E | ||||
| 15833 | EXCISE EXCESSIVE SKIN LEG | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15833 | EXCISE EXCESSIVE SKIN LEG | EAPG | DEF | NA | NA | NA | E | ||||
| 15834 | EXCISE EXCESSIVE SKIN HIP | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15834 | EXCISE EXCESSIVE SKIN HIP | EAPG | DEF | NA | NA | NA | E | ||||
| 15835 | EXCISE EXCESSIVE SKIN BUTTCK | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15835 | EXCISE EXCESSIVE SKIN BUTTCK | EAPG | DEF | NA | NA | NA | E | ||||
| 15836 | EXCISE EXCESSIVE SKIN ARM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15836 | EXCISE EXCESSIVE SKIN ARM | EAPG | DEF | NA | NA | NA | E | ||||
| 15837 | EXCISE EXCESS SKIN ARM/HAND | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15837 | EXCISE EXCESS SKIN ARM/HAND | EAPG | DEF | NA | NA | NA | E | ||||
| 15838 | EXCISE EXCESS SKIN FAT PAD | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15838 | EXCISE EXCESS SKIN FAT PAD | EAPG | DEF | NA | NA | NA | E | ||||
| 15839 | EXCISE EXCESS SKIN & TISSUE | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15839 | EXCISE EXCESS SKIN & TISSUE | EAPG | DEF | NA | NA | NA | E | ||||
| 15840 | NERVE PALSY FASCIAL GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15840 | NERVE PALSY FASCIAL GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15841 | NERVE PALSY MUSCLE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15841 | NERVE PALSY MUSCLE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15842 | NERVE PALSY MICROSURG GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15842 | NERVE PALSY MICROSURG GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15845 | SKIN AND MUSCLE REPAIR FACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15845 | SKIN AND MUSCLE REPAIR FACE | EAPG | DEF | NA | NA | NA | N | ||||
| 15847 | EXC SKIN ABD ADD-ON | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15847 | EXC SKIN ABD ADD-ON | EAPG | DEF | NA | NA | NA | E | ||||
| 15850 | REMOVE SUTURES SAME SURGEON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15850 | REMOVE SUTURES SAME SURGEON | EAPG | DEF | NA | NA | NA | N | ||||
| 15851 | REMOVAL SUTR/STAPLE REQ ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15851 | REMOVAL SUTR/STAPLE REQ ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 15852 | DRESSING CHANGE NOT FOR BURN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15852 | DRESSING CHANGE NOT FOR BURN | EAPG | DEF | NA | NA | NA | N | ||||
| 15853 | REMOVAL SUTR/STAPL XREQ ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15853 | REMOVAL SUTR/STAPL XREQ ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 15854 | REMOVAL SUTR&STAPL XREQ ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15854 | REMOVAL SUTR&STAPL XREQ ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 15860 | TEST FOR BLOOD FLOW IN GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15860 | TEST FOR BLOOD FLOW IN GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 15876 | SUCTION LIPECTOMY HEAD&NECK | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15876 | SUCTION LIPECTOMY HEAD&NECK | EAPG | DEF | NA | NA | NA | E | ||||
| 15877 | SUCTION LIPECTOMY TRUNK | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15877 | SUCTION LIPECTOMY TRUNK | EAPG | DEF | NA | NA | NA | E | ||||
| 15878 | SUCTION LIPECTOMY UPR EXTREM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15878 | SUCTION LIPECTOMY UPR EXTREM | EAPG | DEF | NA | NA | NA | E | ||||
| 15879 | SUCTION LIPECTOMY LWR EXTREM | PRXOVR | DEF | NA | NA | NA | E | ||||
| 15879 | SUCTION LIPECTOMY LWR EXTREM | EAPG | DEF | NA | NA | NA | E | ||||
| 15920 | REMOVAL OF TAIL BONE ULCER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15920 | REMOVAL OF TAIL BONE ULCER | EAPG | DEF | NA | NA | NA | N | ||||
| 15922 | REMOVAL OF TAIL BONE ULCER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15922 | REMOVAL OF TAIL BONE ULCER | EAPG | DEF | NA | NA | NA | N | ||||
| 15931 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15931 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15933 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15933 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15934 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15934 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15935 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15935 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15936 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15936 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15937 | REMOVE SACRUM PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15937 | REMOVE SACRUM PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15940 | REMOVE HIP PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15940 | REMOVE HIP PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15941 | REMOVE HIP PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15941 | REMOVE HIP PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15944 | REMOVE HIP PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15944 | REMOVE HIP PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15945 | REMOVE HIP PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15945 | REMOVE HIP PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15946 | REMOVE HIP PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15946 | REMOVE HIP PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15950 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15950 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15951 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15951 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15952 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15952 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15953 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15953 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15956 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15956 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 15958 | REMOVE THIGH PRESSURE SORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 15958 | REMOVE THIGH PRESSURE SORE | EAPG | DEF | NA | NA | NA | N | ||||
| 16000 | INITIAL TREATMENT OF BURN(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16000 | INITIAL TREATMENT OF BURN(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 16015 | TREATMENT OF BURN(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16015 | TREATMENT OF BURN(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 16020 | DRESS/DEBRID P-THICK BURN S | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16020 | DRESS/DEBRID P-THICK BURN S | EAPG | DEF | NA | NA | NA | N | ||||
| 16025 | DRESS/DEBRID P-THICK BURN M | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16025 | DRESS/DEBRID P-THICK BURN M | EAPG | DEF | NA | NA | NA | N | ||||
| 16030 | DRESS/DEBRID P-THICK BURN L | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16030 | DRESS/DEBRID P-THICK BURN L | EAPG | DEF | NA | NA | NA | N | ||||
| 16035 | INCISION OF BURN SCAB INITI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 16035 | INCISION OF BURN SCAB INITI | EAPG | DEF | NA | NA | NA | N | ||||
| 17000 | DESTRUCT PREMALG LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17000 | DESTRUCT PREMALG LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 17003 | DESTRUCT PREMALG LES 2-14 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17003 | DESTRUCT PREMALG LES 2-14 | EAPG | DEF | NA | NA | NA | N | ||||
| 17004 | DESTROY PREMAL LESIONS 15/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17004 | DESTROY PREMAL LESIONS 15/> | EAPG | DEF | NA | NA | NA | N | ||||
| 17106 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17106 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17107 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17107 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17108 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17108 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17110 | DESTRUCT B9 LESION 1-14 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17110 | DESTRUCT B9 LESION 1-14 | EAPG | DEF | NA | NA | NA | N | ||||
| 17111 | DESTRUCT LESION 15 OR MORE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17111 | DESTRUCT LESION 15 OR MORE | EAPG | DEF | NA | NA | NA | N | ||||
| 17250 | CHEM CAUT OF GRANLTJ TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17250 | CHEM CAUT OF GRANLTJ TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 17260 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17260 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17261 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17261 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17262 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17262 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17263 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17263 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17264 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17264 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17266 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17266 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17270 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17270 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17271 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17271 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17272 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17272 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17273 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17273 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17274 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17274 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17276 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17276 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17280 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17280 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17281 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17281 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17282 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17282 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17283 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17283 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17284 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17284 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17286 | DESTRUCTION OF SKIN LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17286 | DESTRUCTION OF SKIN LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 17311 | MOHS 1 STAGE H/N/HF/G | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17311 | MOHS 1 STAGE H/N/HF/G | EAPG | DEF | NA | NA | NA | N | ||||
| 17312 | MOHS ADDL STAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17312 | MOHS ADDL STAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 17313 | MOHS 1 STAGE T/A/L | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17313 | MOHS 1 STAGE T/A/L | EAPG | DEF | NA | NA | NA | N | ||||
| 17314 | MOHS ADDL STAGE T/A/L | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17314 | MOHS ADDL STAGE T/A/L | EAPG | DEF | NA | NA | NA | N | ||||
| 17315 | MOHS SURG ADDL BLOCK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17315 | MOHS SURG ADDL BLOCK | EAPG | DEF | NA | NA | NA | N | ||||
| 17340 | CRYOTHERAPY OF SKIN | PRXOVR | DEF | NA | NA | NA | E | ||||
| 17340 | CRYOTHERAPY OF SKIN | EAPG | DEF | NA | NA | NA | E | ||||
| 17360 | SKIN PEEL THERAPY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 17360 | SKIN PEEL THERAPY | EAPG | DEF | NA | NA | NA | N | ||||
| 17380 | HAIR REMOVAL BY ELECTROLYSIS | PRXOVR | DEF | NA | NA | NA | E | ||||
| 17380 | HAIR REMOVAL BY ELECTROLYSIS | EAPG | DEF | NA | NA | NA | E | ||||
| 19000 | DRAINAGE OF BREAST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19000 | DRAINAGE OF BREAST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 19001 | DRAIN BREAST LESION ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19001 | DRAIN BREAST LESION ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 19020 | INCISION OF BREAST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19020 | INCISION OF BREAST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 19030 | INJECTION FOR BREAST X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19030 | INJECTION FOR BREAST X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 19081 | BX BREAST 1ST LESION STRTCTC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19081 | BX BREAST 1ST LESION STRTCTC | EAPG | DEF | NA | NA | NA | N | ||||
| 19082 | BX BREAST ADD LESION STRTCTC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19082 | BX BREAST ADD LESION STRTCTC | EAPG | DEF | NA | NA | NA | N | ||||
| 19083 | BX BREAST 1ST LESION US IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19083 | BX BREAST 1ST LESION US IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19084 | BX BREAST ADD LESION US IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19084 | BX BREAST ADD LESION US IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19085 | BX BREAST 1ST LESION MR IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19085 | BX BREAST 1ST LESION MR IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19086 | BX BREAST ADD LESION MR IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19086 | BX BREAST ADD LESION MR IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19100 | BX BREAST PERCUT W/O IMAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19100 | BX BREAST PERCUT W/O IMAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 19101 | BIOPSY OF BREAST OPEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19101 | BIOPSY OF BREAST OPEN | EAPG | DEF | NA | NA | NA | N | ||||
| 19102 | BX BREAST PERCUT W/IMAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19102 | BX BREAST PERCUT W/IMAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 19103 | BX BREAST PERCUT W/DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19103 | BX BREAST PERCUT W/DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 19105 | CRYOSURG ABLATE FA EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19105 | CRYOSURG ABLATE FA EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 19110 | NIPPLE EXPLORATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19110 | NIPPLE EXPLORATION | EAPG | DEF | NA | NA | NA | N | ||||
| 19112 | EXCISE BREAST DUCT FISTULA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19112 | EXCISE BREAST DUCT FISTULA | EAPG | DEF | NA | NA | NA | N | ||||
| 19120 | REMOVAL OF BREAST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19120 | REMOVAL OF BREAST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 19125 | EXCISION BREAST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19125 | EXCISION BREAST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 19126 | EXCISION ADDL BREAST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19126 | EXCISION ADDL BREAST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 19140 | REMOVAL OF BREAST TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19140 | REMOVAL OF BREAST TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 19160 | PARTIAL MASTECTOMY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19160 | PARTIAL MASTECTOMY | EAPG | DEF | NA | NA | NA | N | ||||
| 19162 | P-MASTECTOMY W/LN REMOVAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19162 | P-MASTECTOMY W/LN REMOVAL | EAPG | DEF | NA | NA | NA | N | ||||
| 19180 | REMOVAL OF BREAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19180 | REMOVAL OF BREAST | EAPG | DEF | NA | NA | NA | N | ||||
| 19182 | REMOVAL OF BREAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19182 | REMOVAL OF BREAST | EAPG | DEF | NA | NA | NA | N | ||||
| 19281 | PERQ DEVICE BREAST 1ST IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19281 | PERQ DEVICE BREAST 1ST IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19282 | PERQ DEVICE BREAST EA IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19282 | PERQ DEVICE BREAST EA IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19283 | PERQ DEV BREAST 1ST STRTCTC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19283 | PERQ DEV BREAST 1ST STRTCTC | EAPG | DEF | NA | NA | NA | N | ||||
| 19284 | PERQ DEV BREAST ADD STRTCTC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19284 | PERQ DEV BREAST ADD STRTCTC | EAPG | DEF | NA | NA | NA | N | ||||
| 19285 | PERQ DEV BREAST 1ST US IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19285 | PERQ DEV BREAST 1ST US IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19286 | PERQ DEV BREAST ADD US IMAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19286 | PERQ DEV BREAST ADD US IMAG | EAPG | DEF | NA | NA | NA | N | ||||
| 19287 | PERQ DEV BREAST 1ST MR GUIDE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19287 | PERQ DEV BREAST 1ST MR GUIDE | EAPG | DEF | NA | NA | NA | N | ||||
| 19288 | PERQ DEV BREAST ADD MR GUIDE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19288 | PERQ DEV BREAST ADD MR GUIDE | EAPG | DEF | NA | NA | NA | N | ||||
| 19290 | PLACE NEEDLE WIRE BREAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19290 | PLACE NEEDLE WIRE BREAST | EAPG | DEF | NA | NA | NA | N | ||||
| 19291 | PLACE NEEDLE WIRE BREAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19291 | PLACE NEEDLE WIRE BREAST | EAPG | DEF | NA | NA | NA | N | ||||
| 19294 | PREPJ TUM CAV IORT PRTL MAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19294 | PREPJ TUM CAV IORT PRTL MAST | EAPG | DEF | NA | NA | NA | N | ||||
| 19295 | PLACE BREAST CLIP PERCUT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19295 | PLACE BREAST CLIP PERCUT | EAPG | DEF | NA | NA | NA | N | ||||
| 19296 | PLACE PO BREAST CATH FOR RAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19296 | PLACE PO BREAST CATH FOR RAD | EAPG | DEF | NA | NA | NA | N | ||||
| 19297 | PLACE BREAST CATH FOR RAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19297 | PLACE BREAST CATH FOR RAD | EAPG | DEF | NA | NA | NA | N | ||||
| 19298 | PLACE BREAST RAD TUBE/CATHS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19298 | PLACE BREAST RAD TUBE/CATHS | EAPG | DEF | NA | NA | NA | N | ||||
| 19300 | REMOVAL OF BREAST TISSUE | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19300 | REMOVAL OF BREAST TISSUE | EAPG | DEF | NA | NA | NA | Y | ||||
| 19301 | PARTIAL MASTECTOMY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19301 | PARTIAL MASTECTOMY | EAPG | DEF | NA | NA | NA | N | ||||
| 19302 | P-MASTECTOMY W/LN REMOVAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19302 | P-MASTECTOMY W/LN REMOVAL | EAPG | DEF | NA | NA | NA | N | ||||
| 19303 | MAST SIMPLE COMPLETE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19303 | MAST SIMPLE COMPLETE | EAPG | DEF | NA | NA | NA | N | ||||
| 19304 | MAST SUBQ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19304 | MAST SUBQ | EAPG | DEF | NA | NA | NA | N | ||||
| 19316 | SUSPENSION OF BREAST | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19316 | SUSPENSION OF BREAST | EAPG | DEF | NA | NA | NA | Y | ||||
| 19318 | BREAST REDUCTION | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19318 | BREAST REDUCTION | EAPG | DEF | NA | NA | NA | Y | ||||
| 19324 | ENLARGE BREAST | PRXOVR | DEF | NA | NA | NA | E | ||||
| 19324 | ENLARGE BREAST | EAPG | DEF | NA | NA | NA | E | ||||
| 19325 | BREAST AUGMENTATION W/IMPLT | PRXOVR | DEF | NA | NA | NA | E | ||||
| 19325 | BREAST AUGMENTATION W/IMPLT | EAPG | DEF | NA | NA | NA | E | ||||
| 19328 | RMVL INTACT BREAST IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19328 | RMVL INTACT BREAST IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 19330 | RMVL RUPTURED BREAST IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 19330 | RMVL RUPTURED BREAST IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 19340 | INSJ BREAST IMPLT SM D MAST | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19340 | INSJ BREAST IMPLT SM D MAST | EAPG | DEF | NA | NA | NA | Y | ||||
| 19342 | INSJ/RPLCMT BRST IMPLT SEP D | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19342 | INSJ/RPLCMT BRST IMPLT SEP D | EAPG | DEF | NA | NA | NA | Y | ||||
| 19350 | BREAST RECONSTRUCTION | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19350 | BREAST RECONSTRUCTION | EAPG | DEF | NA | NA | NA | Y | ||||
| 19355 | CORRECT INVERTED NIPPLE(S) | PRXOVR | DEF | NA | NA | NA | E | ||||
| 19355 | CORRECT INVERTED NIPPLE(S) | EAPG | DEF | NA | NA | NA | E | ||||
| 19357 | TISS XPNDR PLMT BRST RCNSTJ | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19357 | TISS XPNDR PLMT BRST RCNSTJ | EAPG | DEF | NA | NA | NA | Y | ||||
| 19366 | BREAST RECONSTRUCTION | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19366 | BREAST RECONSTRUCTION | EAPG | DEF | NA | NA | NA | Y | ||||
| 19370 | REVJ PERI-IMPLT CAPSULE BRST | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19370 | REVJ PERI-IMPLT CAPSULE BRST | EAPG | DEF | NA | NA | NA | Y | ||||
| 19371 | PERI-IMPLT CAPSLC BRST COMPL | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19371 | PERI-IMPLT CAPSLC BRST COMPL | EAPG | DEF | NA | NA | NA | Y | ||||
| 19380 | REVJ RECONSTRUCTED BREAST | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19380 | REVJ RECONSTRUCTED BREAST | EAPG | DEF | NA | NA | NA | Y | ||||
| 19396 | DESIGN CUSTOM BREAST IMPLANT | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 19396 | DESIGN CUSTOM BREAST IMPLANT | EAPG | DEF | NA | NA | NA | Y | ||||
| 20005 | I&D ABSCESS SUBFASCIAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20005 | I&D ABSCESS SUBFASCIAL | EAPG | DEF | NA | NA | NA | N | ||||
| 20103 | EXPLORE WOUND EXTREMITY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20103 | EXPLORE WOUND EXTREMITY | EAPG | DEF | NA | NA | NA | N | ||||
| 20150 | EXCISE EPIPHYSEAL BAR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20150 | EXCISE EPIPHYSEAL BAR | EAPG | DEF | NA | NA | NA | N | ||||
| 20200 | MUSCLE BIOPSY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20200 | MUSCLE BIOPSY | EAPG | DEF | NA | NA | NA | N | ||||
| 20205 | DEEP MUSCLE BIOPSY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20205 | DEEP MUSCLE BIOPSY | EAPG | DEF | NA | NA | NA | N | ||||
| 20206 | NEEDLE BIOPSY MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20206 | NEEDLE BIOPSY MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 20220 | BONE BIOPSY TROCAR/NEEDLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20220 | BONE BIOPSY TROCAR/NEEDLE | EAPG | DEF | NA | NA | NA | N | ||||
| 20225 | BONE BIOPSY TROCAR/NEEDLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20225 | BONE BIOPSY TROCAR/NEEDLE | EAPG | DEF | NA | NA | NA | N | ||||
| 20240 | BONE BIOPSY OPEN SUPERFICIAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20240 | BONE BIOPSY OPEN SUPERFICIAL | EAPG | DEF | NA | NA | NA | N | ||||
| 20245 | BONE BIOPSY OPEN DEEP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20245 | BONE BIOPSY OPEN DEEP | EAPG | DEF | NA | NA | NA | N | ||||
| 20250 | OPEN BONE BIOPSY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20250 | OPEN BONE BIOPSY | EAPG | DEF | NA | NA | NA | N | ||||
| 20251 | OPEN BONE BIOPSY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20251 | OPEN BONE BIOPSY | EAPG | DEF | NA | NA | NA | N | ||||
| 20500 | INJECTION OF SINUS TRACT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20500 | INJECTION OF SINUS TRACT | EAPG | DEF | NA | NA | NA | N | ||||
| 20501 | INJECT SINUS TRACT FOR X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20501 | INJECT SINUS TRACT FOR X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 20520 | REMOVAL OF FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20520 | REMOVAL OF FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 20525 | REMOVAL OF FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20525 | REMOVAL OF FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 20526 | THER INJECTION CARP TUNNEL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20526 | THER INJECTION CARP TUNNEL | EAPG | DEF | NA | NA | NA | N | ||||
| 20527 | INJ DUPUYTREN CORD W/ENZYME | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20527 | INJ DUPUYTREN CORD W/ENZYME | EAPG | DEF | NA | NA | NA | N | ||||
| 20550 | INJ TENDON SHEATH/LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20550 | INJ TENDON SHEATH/LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 20551 | INJ TENDON ORIGIN/INSERTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20551 | INJ TENDON ORIGIN/INSERTION | EAPG | DEF | NA | NA | NA | N | ||||
| 20552 | INJ TRIGGER POINT 1/2 MUSCL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20552 | INJ TRIGGER POINT 1/2 MUSCL | EAPG | DEF | NA | NA | NA | N | ||||
| 20553 | INJECT TRIGGER POINTS 3/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20553 | INJECT TRIGGER POINTS 3/> | EAPG | DEF | NA | NA | NA | N | ||||
| 20555 | PLACE NDL MUSC/TIS FOR RT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20555 | PLACE NDL MUSC/TIS FOR RT | EAPG | DEF | NA | NA | NA | N | ||||
| 20600 | DRAIN/INJ JOINT/BURSA W/O US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20600 | DRAIN/INJ JOINT/BURSA W/O US | EAPG | DEF | NA | NA | NA | N | ||||
| 20604 | DRAIN/INJ JOINT/BURSA W/US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20604 | DRAIN/INJ JOINT/BURSA W/US | EAPG | DEF | NA | NA | NA | N | ||||
| 20605 | DRAIN/INJ JOINT/BURSA W/O US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20605 | DRAIN/INJ JOINT/BURSA W/O US | EAPG | DEF | NA | NA | NA | N | ||||
| 20606 | DRAIN/INJ JOINT/BURSA W/US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20606 | DRAIN/INJ JOINT/BURSA W/US | EAPG | DEF | NA | NA | NA | N | ||||
| 20610 | DRAIN/INJ JOINT/BURSA W/O US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20610 | DRAIN/INJ JOINT/BURSA W/O US | EAPG | DEF | NA | NA | NA | N | ||||
| 20611 | DRAIN/INJ JOINT/BURSA W/US | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20611 | DRAIN/INJ JOINT/BURSA W/US | EAPG | DEF | NA | NA | NA | N | ||||
| 20612 | ASPIRATE/INJ GANGLION CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20612 | ASPIRATE/INJ GANGLION CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 20615 | TREATMENT OF BONE CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20615 | TREATMENT OF BONE CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 20650 | INSERT AND REMOVE BONE PIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20650 | INSERT AND REMOVE BONE PIN | EAPG | DEF | NA | NA | NA | N | ||||
| 20662 | APPLICATION OF PELVIS BRACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20662 | APPLICATION OF PELVIS BRACE | EAPG | DEF | NA | NA | NA | N | ||||
| 20663 | APPLICATION OF THIGH BRACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20663 | APPLICATION OF THIGH BRACE | EAPG | DEF | NA | NA | NA | N | ||||
| 20665 | REMOVAL OF FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20665 | REMOVAL OF FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20670 | REMOVAL OF SUPPORT IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20670 | REMOVAL OF SUPPORT IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 20680 | REMOVAL OF SUPPORT IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20680 | REMOVAL OF SUPPORT IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 20690 | APPLY BONE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20690 | APPLY BONE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20692 | APPLY BONE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20692 | APPLY BONE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20693 | ADJUST BONE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20693 | ADJUST BONE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20694 | REMOVE BONE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20694 | REMOVE BONE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20696 | COMP MULTIPLANE EXT FIXATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20696 | COMP MULTIPLANE EXT FIXATION | EAPG | DEF | NA | NA | NA | N | ||||
| 20697 | COMP EXT FIXATE STRUT CHANGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20697 | COMP EXT FIXATE STRUT CHANGE | EAPG | DEF | NA | NA | NA | N | ||||
| 20700 | MNL PREP&INSJ DP RX DLVR DEV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20700 | MNL PREP&INSJ DP RX DLVR DEV | EAPG | DEF | NA | NA | NA | N | ||||
| 20701 | RMVL DEEP RX DELIVERY DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20701 | RMVL DEEP RX DELIVERY DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20702 | MNL PREP&INSJ IMED RX DEV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20702 | MNL PREP&INSJ IMED RX DEV | EAPG | DEF | NA | NA | NA | N | ||||
| 20703 | RMVL IMED RX DELIVERY DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20703 | RMVL IMED RX DELIVERY DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 20704 | MNL PREP&INSJ I-ARTIC RX DEV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20704 | MNL PREP&INSJ I-ARTIC RX DEV | EAPG | DEF | NA | NA | NA | N | ||||
| 20705 | RMVL I-ARTIC RX DELIVERY DEV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20705 | RMVL I-ARTIC RX DELIVERY DEV | EAPG | DEF | NA | NA | NA | N | ||||
| 20822 | REPLANTATION DIGIT COMPLETE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20822 | REPLANTATION DIGIT COMPLETE | EAPG | DEF | NA | NA | NA | N | ||||
| 20900 | REMOVAL OF BONE FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20900 | REMOVAL OF BONE FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20902 | REMOVAL OF BONE FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20902 | REMOVAL OF BONE FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20910 | REMOVE CARTILAGE FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20910 | REMOVE CARTILAGE FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20912 | REMOVE CARTILAGE FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20912 | REMOVE CARTILAGE FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20920 | REMOVAL OF FASCIA FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20920 | REMOVAL OF FASCIA FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20922 | REMOVAL OF FASCIA FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20922 | REMOVAL OF FASCIA FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20924 | REMOVAL OF TENDON FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20924 | REMOVAL OF TENDON FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20926 | REMOVAL OF TISSUE FOR GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20926 | REMOVAL OF TISSUE FOR GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 20930 | SP BONE ALGRFT MORSEL ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20930 | SP BONE ALGRFT MORSEL ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 20931 | SP BONE ALGRFT STRUCT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20931 | SP BONE ALGRFT STRUCT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 20932 | OSTEOART ALGRFT W/SURF & B1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20932 | OSTEOART ALGRFT W/SURF & B1 | EAPG | DEF | NA | NA | NA | N | ||||
| 20933 | HEMICRT INTRCLRY ALGRFT PRTL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20933 | HEMICRT INTRCLRY ALGRFT PRTL | EAPG | DEF | NA | NA | NA | N | ||||
| 20934 | INTERCALARY ALGRFT COMPL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20934 | INTERCALARY ALGRFT COMPL | EAPG | DEF | NA | NA | NA | N | ||||
| 20936 | SP BONE AGRFT LOCAL ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20936 | SP BONE AGRFT LOCAL ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 20937 | SP BONE AGRFT MORSEL ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20937 | SP BONE AGRFT MORSEL ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 20938 | SP BONE AGRFT STRUCT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20938 | SP BONE AGRFT STRUCT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 20939 | BONE MARROW ASPIR BONE GRFG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20939 | BONE MARROW ASPIR BONE GRFG | EAPG | DEF | NA | NA | NA | N | ||||
| 20950 | FLUID PRESSURE MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20950 | FLUID PRESSURE MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 20972 | BONE/SKIN GRAFT METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20972 | BONE/SKIN GRAFT METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 20973 | BONE/SKIN GRAFT GREAT TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20973 | BONE/SKIN GRAFT GREAT TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 20975 | ELECTRICAL BONE STIMULATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20975 | ELECTRICAL BONE STIMULATION | EAPG | DEF | NA | NA | NA | N | ||||
| 20979 | US BONE STIMULATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20979 | US BONE STIMULATION | EAPG | DEF | NA | NA | NA | N | ||||
| 20982 | ABLATE BONE TUMOR(S) PERQ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20982 | ABLATE BONE TUMOR(S) PERQ | EAPG | DEF | NA | NA | NA | N | ||||
| 20983 | ABLATE BONE TUMOR(S) PERQ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20983 | ABLATE BONE TUMOR(S) PERQ | EAPG | DEF | NA | NA | NA | N | ||||
| 20985 | CPTR-ASST DIR MS PX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 20985 | CPTR-ASST DIR MS PX | EAPG | DEF | NA | NA | NA | N | ||||
| 21010 | INCISION OF JAW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21010 | INCISION OF JAW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 21011 | EXC FACE LES SC <2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21011 | EXC FACE LES SC <2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21012 | EXC FACE LES SBQ 2 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21012 | EXC FACE LES SBQ 2 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21013 | EXC FACE TUM DEEP < 2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21013 | EXC FACE TUM DEEP < 2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21014 | EXC FACE TUM DEEP 2 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21014 | EXC FACE TUM DEEP 2 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21015 | RESECT FACE/SCALP TUM < 2 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21015 | RESECT FACE/SCALP TUM < 2 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21016 | RESECT FACE/SCALP TUM 2 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21016 | RESECT FACE/SCALP TUM 2 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21025 | EXCISION OF BONE LOWER JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21025 | EXCISION OF BONE LOWER JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21026 | EXCISION OF FACIAL BONE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21026 | EXCISION OF FACIAL BONE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 21029 | CONTOUR OF FACE BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21029 | CONTOUR OF FACE BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21030 | EXCISE MAX/ZYGOMA B9 TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21030 | EXCISE MAX/ZYGOMA B9 TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 21031 | REMOVE EXOSTOSIS MANDIBLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21031 | REMOVE EXOSTOSIS MANDIBLE | EAPG | DEF | NA | NA | NA | N | ||||
| 21032 | REMOVE EXOSTOSIS MAXILLA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21032 | REMOVE EXOSTOSIS MAXILLA | EAPG | DEF | NA | NA | NA | N | ||||
| 21034 | EXCISE MAX/ZYGOMA MAL TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21034 | EXCISE MAX/ZYGOMA MAL TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 21040 | EXCISE MANDIBLE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21040 | EXCISE MANDIBLE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21044 | REMOVAL OF JAW BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21044 | REMOVAL OF JAW BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21046 | REMOVE MANDIBLE CYST COMPLEX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21046 | REMOVE MANDIBLE CYST COMPLEX | EAPG | DEF | NA | NA | NA | N | ||||
| 21047 | EXCISE LWR JAW CYST W/REPAIR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21047 | EXCISE LWR JAW CYST W/REPAIR | EAPG | DEF | NA | NA | NA | N | ||||
| 21048 | REMOVE MAXILLA CYST COMPLEX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21048 | REMOVE MAXILLA CYST COMPLEX | EAPG | DEF | NA | NA | NA | N | ||||
| 21050 | REMOVAL OF JAW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21050 | REMOVAL OF JAW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 21060 | REMOVE JAW JOINT CARTILAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21060 | REMOVE JAW JOINT CARTILAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 21070 | REMOVE CORONOID PROCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21070 | REMOVE CORONOID PROCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 21073 | MNPJ OF TMJ W/ANESTH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21073 | MNPJ OF TMJ W/ANESTH | EAPG | DEF | NA | NA | NA | N | ||||
| 21076 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21076 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21077 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21077 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21079 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21079 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21080 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21080 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21081 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21081 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21082 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21082 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21083 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21083 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21084 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21084 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21085 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21085 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21086 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21086 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21087 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21087 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21088 | PREPARE FACE/ORAL PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21088 | PREPARE FACE/ORAL PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 21100 | MAXILLOFACIAL FIXATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21100 | MAXILLOFACIAL FIXATION | EAPG | DEF | NA | NA | NA | N | ||||
| 21110 | INTERDENTAL FIXATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21110 | INTERDENTAL FIXATION | EAPG | DEF | NA | NA | NA | N | ||||
| 21116 | INJECTION JAW JOINT X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21116 | INJECTION JAW JOINT X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 21120 | RECONSTRUCTION OF CHIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21120 | RECONSTRUCTION OF CHIN | EAPG | DEF | NA | NA | NA | N | ||||
| 21121 | RECONSTRUCTION OF CHIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21121 | RECONSTRUCTION OF CHIN | EAPG | DEF | NA | NA | NA | N | ||||
| 21122 | RECONSTRUCTION OF CHIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21122 | RECONSTRUCTION OF CHIN | EAPG | DEF | NA | NA | NA | N | ||||
| 21123 | RECONSTRUCTION OF CHIN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21123 | RECONSTRUCTION OF CHIN | EAPG | DEF | NA | NA | NA | N | ||||
| 21125 | AUGMENTATION LOWER JAW BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21125 | AUGMENTATION LOWER JAW BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21127 | AUGMENTATION LOWER JAW BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21127 | AUGMENTATION LOWER JAW BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21137 | REDUCTION OF FOREHEAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21137 | REDUCTION OF FOREHEAD | EAPG | DEF | NA | NA | NA | N | ||||
| 21138 | REDUCTION OF FOREHEAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21138 | REDUCTION OF FOREHEAD | EAPG | DEF | NA | NA | NA | N | ||||
| 21139 | REDUCTION OF FOREHEAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21139 | REDUCTION OF FOREHEAD | EAPG | DEF | NA | NA | NA | N | ||||
| 21150 | LEFORT II ANTERIOR INTRUSION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21150 | LEFORT II ANTERIOR INTRUSION | EAPG | DEF | NA | NA | NA | N | ||||
| 21181 | CONTOUR CRANIAL BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21181 | CONTOUR CRANIAL BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21198 | RECONSTR LWR JAW SEGMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21198 | RECONSTR LWR JAW SEGMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 21199 | RECONSTR LWR JAW W/ADVANCE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21199 | RECONSTR LWR JAW W/ADVANCE | EAPG | DEF | NA | NA | NA | N | ||||
| 21206 | RECONSTRUCT UPPER JAW BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21206 | RECONSTRUCT UPPER JAW BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21208 | AUGMENTATION OF FACIAL BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21208 | AUGMENTATION OF FACIAL BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 21209 | REDUCTION OF FACIAL BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21209 | REDUCTION OF FACIAL BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 21210 | FACE BONE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21210 | FACE BONE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 21215 | LOWER JAW BONE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21215 | LOWER JAW BONE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 21230 | RIB CARTILAGE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21230 | RIB CARTILAGE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 21235 | EAR CARTILAGE GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21235 | EAR CARTILAGE GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 21240 | RECONSTRUCTION OF JAW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21240 | RECONSTRUCTION OF JAW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 21242 | RECONSTRUCTION OF JAW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21242 | RECONSTRUCTION OF JAW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 21243 | RECONSTRUCTION OF JAW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21243 | RECONSTRUCTION OF JAW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 21244 | RECONSTRUCTION OF LOWER JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21244 | RECONSTRUCTION OF LOWER JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21245 | RECONSTRUCTION OF JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21245 | RECONSTRUCTION OF JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21246 | RECONSTRUCTION OF JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21246 | RECONSTRUCTION OF JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21248 | RECONSTRUCTION OF JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21248 | RECONSTRUCTION OF JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21249 | RECONSTRUCTION OF JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21249 | RECONSTRUCTION OF JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21260 | REVISE EYE SOCKETS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21260 | REVISE EYE SOCKETS | EAPG | DEF | NA | NA | NA | N | ||||
| 21267 | REVISE EYE SOCKETS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21267 | REVISE EYE SOCKETS | EAPG | DEF | NA | NA | NA | N | ||||
| 21270 | AUGMENTATION CHEEK BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21270 | AUGMENTATION CHEEK BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21275 | REVISION ORBITOFACIAL BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21275 | REVISION ORBITOFACIAL BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 21280 | REVISION OF EYELID | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21280 | REVISION OF EYELID | EAPG | DEF | NA | NA | NA | N | ||||
| 21282 | REVISION OF EYELID | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21282 | REVISION OF EYELID | EAPG | DEF | NA | NA | NA | N | ||||
| 21295 | REVISION OF JAW MUSCLE/BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21295 | REVISION OF JAW MUSCLE/BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21296 | REVISION OF JAW MUSCLE/BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21296 | REVISION OF JAW MUSCLE/BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 21300 | TREATMENT OF SKULL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21300 | TREATMENT OF SKULL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21310 | CLOSED TX NOSE FX W/O MANJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21310 | CLOSED TX NOSE FX W/O MANJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21315 | CLSD TX NSL FX MNPJ WO STBLJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21315 | CLSD TX NSL FX MNPJ WO STBLJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21320 | CLSD TX NSL FX W/MNPJ&STABLJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21320 | CLSD TX NSL FX W/MNPJ&STABLJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21325 | OPEN TX NOSE FX UNCOMPLICATD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21325 | OPEN TX NOSE FX UNCOMPLICATD | EAPG | DEF | NA | NA | NA | N | ||||
| 21330 | OPEN TX NOSE FX W/SKELE FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21330 | OPEN TX NOSE FX W/SKELE FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21335 | OPEN TX NOSE & SEPTAL FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21335 | OPEN TX NOSE & SEPTAL FX | EAPG | DEF | NA | NA | NA | N | ||||
| 21336 | OPEN TX SEPTAL FX W/WO STABJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21336 | OPEN TX SEPTAL FX W/WO STABJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21337 | CLOSED TX SEPTAL&NOSE FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21337 | CLOSED TX SEPTAL&NOSE FX | EAPG | DEF | NA | NA | NA | N | ||||
| 21338 | OPEN NASOETHMOID FX W/O FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21338 | OPEN NASOETHMOID FX W/O FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21339 | OPEN NASOETHMOID FX W/ FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21339 | OPEN NASOETHMOID FX W/ FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21340 | PERQ TX NASOETHMOID FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21340 | PERQ TX NASOETHMOID FX | EAPG | DEF | NA | NA | NA | N | ||||
| 21345 | CLOSED TX NOSE/JAW FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21345 | CLOSED TX NOSE/JAW FX | EAPG | DEF | NA | NA | NA | N | ||||
| 21355 | PERQ TX MALAR FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21355 | PERQ TX MALAR FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21356 | OPN TX DPRSD ZYGOMATIC ARCH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21356 | OPN TX DPRSD ZYGOMATIC ARCH | EAPG | DEF | NA | NA | NA | N | ||||
| 21360 | OPN TX DPRSD MALAR FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21360 | OPN TX DPRSD MALAR FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21390 | OPN TX ORBIT PERIORBTL IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21390 | OPN TX ORBIT PERIORBTL IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 21400 | CLOSED TX ORBIT W/O MANIPULJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21400 | CLOSED TX ORBIT W/O MANIPULJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21401 | CLOSED TX ORBIT W/MANIPULJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21401 | CLOSED TX ORBIT W/MANIPULJ | EAPG | DEF | NA | NA | NA | N | ||||
| 21406 | OPN TX ORBIT FX W/O IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21406 | OPN TX ORBIT FX W/O IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 21407 | OPN TX ORBIT FX W/IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21407 | OPN TX ORBIT FX W/IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 21421 | TREAT MOUTH ROOF FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21421 | TREAT MOUTH ROOF FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21440 | TREAT DENTAL RIDGE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21440 | TREAT DENTAL RIDGE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21445 | TREAT DENTAL RIDGE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21445 | TREAT DENTAL RIDGE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21450 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21450 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21451 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21451 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21452 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21452 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21453 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21453 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21454 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21454 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21461 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21461 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21462 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21462 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21465 | TREAT LOWER JAW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21465 | TREAT LOWER JAW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21480 | RESET DISLOCATED JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21480 | RESET DISLOCATED JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21485 | RESET DISLOCATED JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21485 | RESET DISLOCATED JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21490 | REPAIR DISLOCATED JAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21490 | REPAIR DISLOCATED JAW | EAPG | DEF | NA | NA | NA | N | ||||
| 21493 | TREAT HYOID BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21493 | TREAT HYOID BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21494 | TREAT HYOID BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21494 | TREAT HYOID BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21495 | TREAT HYOID BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21495 | TREAT HYOID BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21497 | INTERDENTAL WIRING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21497 | INTERDENTAL WIRING | EAPG | DEF | NA | NA | NA | N | ||||
| 21501 | DRAIN NECK/CHEST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21501 | DRAIN NECK/CHEST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21502 | DRAIN CHEST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21502 | DRAIN CHEST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 21550 | BIOPSY OF NECK/CHEST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21550 | BIOPSY OF NECK/CHEST | EAPG | DEF | NA | NA | NA | N | ||||
| 21552 | EXC NECK LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21552 | EXC NECK LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21554 | EXC NECK TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21554 | EXC NECK TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21555 | EXC NECK LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21555 | EXC NECK LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21556 | EXC NECK TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21556 | EXC NECK TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21557 | RESECT NECK THORAX TUMOR<5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21557 | RESECT NECK THORAX TUMOR<5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21558 | RESECT NECK TUMOR 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21558 | RESECT NECK TUMOR 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21600 | PARTIAL REMOVAL OF RIB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21600 | PARTIAL REMOVAL OF RIB | EAPG | DEF | NA | NA | NA | N | ||||
| 21610 | PARTIAL REMOVAL OF RIB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21610 | PARTIAL REMOVAL OF RIB | EAPG | DEF | NA | NA | NA | N | ||||
| 21685 | HYOID MYOTOMY & SUSPENSION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21685 | HYOID MYOTOMY & SUSPENSION | EAPG | DEF | NA | NA | NA | N | ||||
| 21700 | REVISION OF NECK MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21700 | REVISION OF NECK MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 21720 | REVISION OF NECK MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21720 | REVISION OF NECK MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 21725 | REVISION OF NECK MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21725 | REVISION OF NECK MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 21800 | TREATMENT OF RIB FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21800 | TREATMENT OF RIB FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21805 | TREATMENT OF RIB FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21805 | TREATMENT OF RIB FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21820 | TREAT STERNUM FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21820 | TREAT STERNUM FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 21920 | BIOPSY SOFT TISSUE OF BACK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21920 | BIOPSY SOFT TISSUE OF BACK | EAPG | DEF | NA | NA | NA | N | ||||
| 21925 | BIOPSY SOFT TISSUE OF BACK | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21925 | BIOPSY SOFT TISSUE OF BACK | EAPG | DEF | NA | NA | NA | N | ||||
| 21930 | EXC BACK LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21930 | EXC BACK LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21931 | EXC BACK LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21931 | EXC BACK LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21932 | EXC BACK TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21932 | EXC BACK TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21933 | EXC BACK TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21933 | EXC BACK TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 21935 | RESECT BACK TUM < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21935 | RESECT BACK TUM < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 21936 | RESECT BACK TUM 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 21936 | RESECT BACK TUM 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 22102 | REMOVE PART LUMBAR VERTEBRA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22102 | REMOVE PART LUMBAR VERTEBRA | EAPG | DEF | NA | NA | NA | N | ||||
| 22103 | REMOVE EXTRA SPINE SEGMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22103 | REMOVE EXTRA SPINE SEGMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 22305 | CLOSED TX SPINE PROCESS FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22305 | CLOSED TX SPINE PROCESS FX | EAPG | DEF | NA | NA | NA | N | ||||
| 22310 | CLOSED TX VERT FX W/O MANJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22310 | CLOSED TX VERT FX W/O MANJ | EAPG | DEF | NA | NA | NA | N | ||||
| 22315 | CLOSED TX VERT FX W/MANJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22315 | CLOSED TX VERT FX W/MANJ | EAPG | DEF | NA | NA | NA | N | ||||
| 22505 | MANIPULATION OF SPINE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22505 | MANIPULATION OF SPINE | EAPG | DEF | NA | NA | NA | N | ||||
| 22510 | PERQ CERVICOTHORACIC INJECT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22510 | PERQ CERVICOTHORACIC INJECT | EAPG | DEF | NA | NA | NA | N | ||||
| 22511 | PERQ LUMBOSACRAL INJECTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22511 | PERQ LUMBOSACRAL INJECTION | EAPG | DEF | NA | NA | NA | N | ||||
| 22512 | VERTEBROPLASTY ADDL INJECT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22512 | VERTEBROPLASTY ADDL INJECT | EAPG | DEF | NA | NA | NA | N | ||||
| 22513 | PERQ VERTEBRAL AUGMENTATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22513 | PERQ VERTEBRAL AUGMENTATION | EAPG | DEF | NA | NA | NA | N | ||||
| 22514 | PERQ VERTEBRAL AUGMENTATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22514 | PERQ VERTEBRAL AUGMENTATION | EAPG | DEF | NA | NA | NA | N | ||||
| 22515 | PERQ VERTEBRAL AUGMENTATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22515 | PERQ VERTEBRAL AUGMENTATION | EAPG | DEF | NA | NA | NA | N | ||||
| 22520 | PERCUT VERTEBROPLASTY THOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22520 | PERCUT VERTEBROPLASTY THOR | EAPG | DEF | NA | NA | NA | N | ||||
| 22521 | PERCUT VERTEBROPLASTY LUMB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22521 | PERCUT VERTEBROPLASTY LUMB | EAPG | DEF | NA | NA | NA | N | ||||
| 22522 | PERCUT VERTEBROPLASTY ADDL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22522 | PERCUT VERTEBROPLASTY ADDL | EAPG | DEF | NA | NA | NA | N | ||||
| 22523 | PERCUT KYPHOPLASTY THOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22523 | PERCUT KYPHOPLASTY THOR | EAPG | DEF | NA | NA | NA | N | ||||
| 22524 | PERCUT KYPHOPLASTY LUMBAR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22524 | PERCUT KYPHOPLASTY LUMBAR | EAPG | DEF | NA | NA | NA | N | ||||
| 22525 | PERCUT KYPHOPLASTY ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22525 | PERCUT KYPHOPLASTY ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 22526 | IDET SINGLE LEVEL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22526 | IDET SINGLE LEVEL | EAPG | DEF | NA | NA | NA | N | ||||
| 22527 | IDET 1 OR MORE LEVELS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22527 | IDET 1 OR MORE LEVELS | EAPG | DEF | NA | NA | NA | N | ||||
| 22551 | ARTHRD ANT NTRBDY CERVICAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22551 | ARTHRD ANT NTRBDY CERVICAL | EAPG | DEF | NA | NA | NA | N | ||||
| 22552 | ARTHRD ANT NTRBD CERVICAL EA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22552 | ARTHRD ANT NTRBD CERVICAL EA | EAPG | DEF | NA | NA | NA | N | ||||
| 22554 | ARTHRD ANT NTRBD MIN DSC CRV | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22554 | ARTHRD ANT NTRBD MIN DSC CRV | EAPG | DEF | NA | NA | NA | N | ||||
| 22585 | ARTHRD ANT NTRBD MIN DSC EA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22585 | ARTHRD ANT NTRBD MIN DSC EA | EAPG | DEF | NA | NA | NA | N | ||||
| 22612 | ARTHRD PST TQ 1NTRSPC LUMBAR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22612 | ARTHRD PST TQ 1NTRSPC LUMBAR | EAPG | DEF | NA | NA | NA | N | ||||
| 22614 | ARTHRD PST TQ 1NTRSPC EA ADD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22614 | ARTHRD PST TQ 1NTRSPC EA ADD | EAPG | DEF | NA | NA | NA | N | ||||
| 22840 | INSERT SPINE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22840 | INSERT SPINE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22842 | INSERT SPINE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22842 | INSERT SPINE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22845 | INSERT SPINE FIXATION DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22845 | INSERT SPINE FIXATION DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22853 | INSJ BIOMECHANICAL DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22853 | INSJ BIOMECHANICAL DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22854 | INSJ BIOMECHANICAL DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22854 | INSJ BIOMECHANICAL DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22856 | TOT DISC ARTHRP 1NTRSPC CRV | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 22856 | TOT DISC ARTHRP 1NTRSPC CRV | EAPG | DEF | NA | NA | NA | Y | ||||
| 22859 | INSJ BIOMECHANICAL DEVICE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22859 | INSJ BIOMECHANICAL DEVICE | EAPG | DEF | NA | NA | NA | N | ||||
| 22867 | INSJ STABLJ DEV W/DCMPRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22867 | INSJ STABLJ DEV W/DCMPRN | EAPG | DEF | NA | NA | NA | N | ||||
| 22868 | INSJ STABLJ DEV W/DCMPRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22868 | INSJ STABLJ DEV W/DCMPRN | EAPG | DEF | NA | NA | NA | N | ||||
| 22869 | INSJ STABLJ DEV W/O DCMPRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22869 | INSJ STABLJ DEV W/O DCMPRN | EAPG | DEF | NA | NA | NA | N | ||||
| 22870 | INSJ STABLJ DEV W/O DCMPRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22870 | INSJ STABLJ DEV W/O DCMPRN | EAPG | DEF | NA | NA | NA | N | ||||
| 22900 | EXC ABDL TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22900 | EXC ABDL TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 22901 | EXC ABDL TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22901 | EXC ABDL TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 22902 | EXC ABD LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22902 | EXC ABD LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 22903 | EXC ABD LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22903 | EXC ABD LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 22904 | RADICAL RESECT ABD TUMOR<5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22904 | RADICAL RESECT ABD TUMOR<5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 22905 | RAD RESECT ABD TUMOR 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 22905 | RAD RESECT ABD TUMOR 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 23000 | REMOVAL OF CALCIUM DEPOSITS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23000 | REMOVAL OF CALCIUM DEPOSITS | EAPG | DEF | NA | NA | NA | N | ||||
| 23020 | RELEASE SHOULDER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23020 | RELEASE SHOULDER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 23030 | DRAIN SHOULDER LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23030 | DRAIN SHOULDER LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23031 | DRAIN SHOULDER BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23031 | DRAIN SHOULDER BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 23035 | DRAIN SHOULDER BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23035 | DRAIN SHOULDER BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23040 | EXPLORATORY SHOULDER SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23040 | EXPLORATORY SHOULDER SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 23044 | EXPLORATORY SHOULDER SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23044 | EXPLORATORY SHOULDER SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 23065 | BIOPSY SHOULDER TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23065 | BIOPSY SHOULDER TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 23066 | BIOPSY SHOULDER TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23066 | BIOPSY SHOULDER TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 23071 | EXC SHOULDER LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23071 | EXC SHOULDER LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 23073 | EXC SHOULDER TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23073 | EXC SHOULDER TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 23075 | EXC SHOULDER LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23075 | EXC SHOULDER LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 23076 | EXC SHOULDER TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23076 | EXC SHOULDER TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 23077 | RESECT SHOULDER TUMOR < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23077 | RESECT SHOULDER TUMOR < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 23078 | RESECT SHOULDER TUMOR 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23078 | RESECT SHOULDER TUMOR 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 23100 | BIOPSY OF SHOULDER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23100 | BIOPSY OF SHOULDER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 23101 | SHOULDER JOINT SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23101 | SHOULDER JOINT SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 23105 | REMOVE SHOULDER JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23105 | REMOVE SHOULDER JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 23106 | INCISION OF COLLARBONE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23106 | INCISION OF COLLARBONE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 23107 | EXPLORE TREAT SHOULDER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23107 | EXPLORE TREAT SHOULDER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 23120 | PARTIAL REMOVAL COLLAR BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23120 | PARTIAL REMOVAL COLLAR BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 23125 | REMOVAL OF COLLAR BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23125 | REMOVAL OF COLLAR BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 23130 | REMOVE SHOULDER BONE PART | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23130 | REMOVE SHOULDER BONE PART | EAPG | DEF | NA | NA | NA | N | ||||
| 23140 | REMOVAL OF BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23140 | REMOVAL OF BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23145 | REMOVAL OF BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23145 | REMOVAL OF BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23146 | REMOVAL OF BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23146 | REMOVAL OF BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23150 | REMOVAL OF HUMERUS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23150 | REMOVAL OF HUMERUS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23155 | REMOVAL OF HUMERUS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23155 | REMOVAL OF HUMERUS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23156 | REMOVAL OF HUMERUS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23156 | REMOVAL OF HUMERUS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23170 | REMOVE COLLAR BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23170 | REMOVE COLLAR BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23172 | REMOVE SHOULDER BLADE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23172 | REMOVE SHOULDER BLADE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23174 | REMOVE HUMERUS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23174 | REMOVE HUMERUS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23180 | REMOVE COLLAR BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23180 | REMOVE COLLAR BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23182 | REMOVE SHOULDER BLADE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23182 | REMOVE SHOULDER BLADE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23184 | REMOVE HUMERUS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23184 | REMOVE HUMERUS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 23190 | PARTIAL REMOVAL OF SCAPULA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23190 | PARTIAL REMOVAL OF SCAPULA | EAPG | DEF | NA | NA | NA | N | ||||
| 23195 | REMOVAL OF HEAD OF HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23195 | REMOVAL OF HEAD OF HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 23330 | REMOVE SHOULDER FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23330 | REMOVE SHOULDER FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 23331 | REMOVE SHOULDER FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23331 | REMOVE SHOULDER FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 23333 | REMOVE SHOULDER FB DEEP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23333 | REMOVE SHOULDER FB DEEP | EAPG | DEF | NA | NA | NA | N | ||||
| 23334 | SHOULDER PROSTHESIS REMOVAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23334 | SHOULDER PROSTHESIS REMOVAL | EAPG | DEF | NA | NA | NA | N | ||||
| 23350 | INJECTION FOR SHOULDER X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23350 | INJECTION FOR SHOULDER X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 23395 | MUSCLE TRANSFER SHOULDER/ARM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23395 | MUSCLE TRANSFER SHOULDER/ARM | EAPG | DEF | NA | NA | NA | N | ||||
| 23397 | MUSCLE TRANSFERS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23397 | MUSCLE TRANSFERS | EAPG | DEF | NA | NA | NA | N | ||||
| 23400 | FIXATION OF SHOULDER BLADE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23400 | FIXATION OF SHOULDER BLADE | EAPG | DEF | NA | NA | NA | N | ||||
| 23405 | INCISION OF TENDON & MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23405 | INCISION OF TENDON & MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 23406 | INCISE TENDON(S) & MUSCLE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23406 | INCISE TENDON(S) & MUSCLE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 23410 | REPAIR ROTATOR CUFF ACUTE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23410 | REPAIR ROTATOR CUFF ACUTE | EAPG | DEF | NA | NA | NA | N | ||||
| 23412 | REPAIR ROTATOR CUFF CHRONIC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23412 | REPAIR ROTATOR CUFF CHRONIC | EAPG | DEF | NA | NA | NA | N | ||||
| 23415 | RELEASE OF SHOULDER LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23415 | RELEASE OF SHOULDER LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 23420 | REPAIR OF SHOULDER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23420 | REPAIR OF SHOULDER | EAPG | DEF | NA | NA | NA | N | ||||
| 23430 | REPAIR BICEPS TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23430 | REPAIR BICEPS TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 23440 | REMOVE/TRANSPLANT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23440 | REMOVE/TRANSPLANT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 23450 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23450 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23455 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23455 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23460 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23460 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23462 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23462 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23465 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23465 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23466 | REPAIR SHOULDER CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23466 | REPAIR SHOULDER CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 23480 | REVISION OF COLLAR BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23480 | REVISION OF COLLAR BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 23485 | REVISION OF COLLAR BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23485 | REVISION OF COLLAR BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 23490 | REINFORCE CLAVICLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23490 | REINFORCE CLAVICLE | EAPG | DEF | NA | NA | NA | N | ||||
| 23491 | REINFORCE SHOULDER BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23491 | REINFORCE SHOULDER BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 23500 | CLTX CLAVICULAR FX W/O MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23500 | CLTX CLAVICULAR FX W/O MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23505 | CLTX CLAVICULAR FX W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23505 | CLTX CLAVICULAR FX W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23515 | OPTX CLAVICULAR FX W/INT FIX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23515 | OPTX CLAVICULAR FX W/INT FIX | EAPG | DEF | NA | NA | NA | N | ||||
| 23520 | CLTX STRNCLAV DISLC W/O MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23520 | CLTX STRNCLAV DISLC W/O MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23525 | CLTX STRNCLAV DISLC W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23525 | CLTX STRNCLAV DISLC W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23530 | OPTX STRNCLAV DISLC AQT/CHRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23530 | OPTX STRNCLAV DISLC AQT/CHRN | EAPG | DEF | NA | NA | NA | N | ||||
| 23532 | OPTX STRCLV DSLC AQ/CHRN GRF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23532 | OPTX STRCLV DSLC AQ/CHRN GRF | EAPG | DEF | NA | NA | NA | N | ||||
| 23540 | CLTX ACROMCLAV DISLC WO MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23540 | CLTX ACROMCLAV DISLC WO MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23545 | CLTX ACROMCLAV DISLC W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23545 | CLTX ACROMCLAV DISLC W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23550 | OPTX ACROMCLV DISLC AQT/CHRN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23550 | OPTX ACROMCLV DISLC AQT/CHRN | EAPG | DEF | NA | NA | NA | N | ||||
| 23552 | OPTX ACRCLV DSLC AQ/CHRN GRF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23552 | OPTX ACRCLV DSLC AQ/CHRN GRF | EAPG | DEF | NA | NA | NA | N | ||||
| 23570 | CLTX SCAPULAR FX W/O MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23570 | CLTX SCAPULAR FX W/O MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23575 | CLTX SCAP FX W/MNPJ +-TRACTJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23575 | CLTX SCAP FX W/MNPJ +-TRACTJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23585 | OPTX SCAPULAR FX W/INT FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23585 | OPTX SCAPULAR FX W/INT FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23600 | CLTX PROX HUMRL FX W/O MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23600 | CLTX PROX HUMRL FX W/O MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23605 | CLTX PRX HMRL FX MNPJ+-TRACT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23605 | CLTX PRX HMRL FX MNPJ+-TRACT | EAPG | DEF | NA | NA | NA | N | ||||
| 23615 | OPTX PROX HUMRL FX W/INT FIX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23615 | OPTX PROX HUMRL FX W/INT FIX | EAPG | DEF | NA | NA | NA | N | ||||
| 23616 | OPTX PRX HMRL FX FIX RPR RPL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23616 | OPTX PRX HMRL FX FIX RPR RPL | EAPG | DEF | NA | NA | NA | N | ||||
| 23620 | CLTX GR HMRL TBRS FX WO MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23620 | CLTX GR HMRL TBRS FX WO MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23625 | CLTX GR HMRL TBRS FX W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23625 | CLTX GR HMRL TBRS FX W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23630 | OPTX GR HMRL TBRS FX INT FIX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23630 | OPTX GR HMRL TBRS FX INT FIX | EAPG | DEF | NA | NA | NA | N | ||||
| 23650 | CLTX SHO DSLC W/MNPJ WO ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23650 | CLTX SHO DSLC W/MNPJ WO ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 23655 | CLTX SHO DSLC W/MNPJ W/ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23655 | CLTX SHO DSLC W/MNPJ W/ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 23660 | OPTX ACUTE SHOULDER DISLC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23660 | OPTX ACUTE SHOULDER DISLC | EAPG | DEF | NA | NA | NA | N | ||||
| 23665 | CLTX SHO DSLC FX GR HMRL TBR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23665 | CLTX SHO DSLC FX GR HMRL TBR | EAPG | DEF | NA | NA | NA | N | ||||
| 23670 | OPTX SHO DISLC FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23670 | OPTX SHO DISLC FX | EAPG | DEF | NA | NA | NA | N | ||||
| 23675 | CLTX SHO DISLC NECK FX MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23675 | CLTX SHO DISLC NECK FX MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23680 | OPTX SHO DISLC NECK FX FIXJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23680 | OPTX SHO DISLC NECK FX FIXJ | EAPG | DEF | NA | NA | NA | N | ||||
| 23700 | MNPJ ANES SHO JT FIXJ APRATS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23700 | MNPJ ANES SHO JT FIXJ APRATS | EAPG | DEF | NA | NA | NA | N | ||||
| 23800 | ARTHRODESIS GLENOHUMERAL JT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23800 | ARTHRODESIS GLENOHUMERAL JT | EAPG | DEF | NA | NA | NA | N | ||||
| 23802 | ARTHRD GLENOHUMERAL JT W/GRF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23802 | ARTHRD GLENOHUMERAL JT W/GRF | EAPG | DEF | NA | NA | NA | N | ||||
| 23921 | DISARTICULATION SHO SEC CLSR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23921 | DISARTICULATION SHO SEC CLSR | EAPG | DEF | NA | NA | NA | N | ||||
| 23930 | I&D UPR A/E DP ABSC/HMTMA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23930 | I&D UPR A/E DP ABSC/HMTMA | EAPG | DEF | NA | NA | NA | N | ||||
| 23931 | I&D UPR A/E BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23931 | I&D UPR A/E BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 23935 | INC DP OPN B1 CRTX HUM/ELBW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 23935 | INC DP OPN B1 CRTX HUM/ELBW | EAPG | DEF | NA | NA | NA | N | ||||
| 24000 | ARTHRT ELBW EXPL DRG/RMVL FB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24000 | ARTHRT ELBW EXPL DRG/RMVL FB | EAPG | DEF | NA | NA | NA | N | ||||
| 24006 | ARTHRT ELBW CAPSL EXC RLS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24006 | ARTHRT ELBW CAPSL EXC RLS | EAPG | DEF | NA | NA | NA | N | ||||
| 24065 | BIOPSY ARM/ELBOW SOFT TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24065 | BIOPSY ARM/ELBOW SOFT TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 24066 | BIOPSY ARM/ELBOW SOFT TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24066 | BIOPSY ARM/ELBOW SOFT TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 24071 | EXC ARM/ELBOW LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24071 | EXC ARM/ELBOW LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 24073 | EX ARM/ELBOW TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24073 | EX ARM/ELBOW TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 24075 | EXC ARM/ELBOW LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24075 | EXC ARM/ELBOW LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 24076 | EX ARM/ELBOW TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24076 | EX ARM/ELBOW TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 24077 | RAD RESCJ TUM TISS A/E <5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24077 | RAD RESCJ TUM TISS A/E <5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 24079 | RAD RESCJ TUM TISS A/E 5 CM+ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24079 | RAD RESCJ TUM TISS A/E 5 CM+ | EAPG | DEF | NA | NA | NA | N | ||||
| 24100 | ARTHRT ELBW SYNOVIAL BX ONLY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24100 | ARTHRT ELBW SYNOVIAL BX ONLY | EAPG | DEF | NA | NA | NA | N | ||||
| 24101 | ARTHRT ELBW JT EXPL BX RMVL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24101 | ARTHRT ELBW JT EXPL BX RMVL | EAPG | DEF | NA | NA | NA | N | ||||
| 24102 | ARTHRT ELBOW W/SYNOVECTOMY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24102 | ARTHRT ELBOW W/SYNOVECTOMY | EAPG | DEF | NA | NA | NA | N | ||||
| 24105 | EXCISION OLECRANON BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24105 | EXCISION OLECRANON BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 24110 | EXC/CURTG B1 CST/B9 TUM HUM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24110 | EXC/CURTG B1 CST/B9 TUM HUM | EAPG | DEF | NA | NA | NA | N | ||||
| 24115 | EXC/CRTG B1 CST/TUM HUM AGRF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24115 | EXC/CRTG B1 CST/TUM HUM AGRF | EAPG | DEF | NA | NA | NA | N | ||||
| 24116 | EXC/CRTG B1 CST/TUM HUM ALGR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24116 | EXC/CRTG B1 CST/TUM HUM ALGR | EAPG | DEF | NA | NA | NA | N | ||||
| 24120 | EXC/CRTG B1 CST/B9 TUM RDS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24120 | EXC/CRTG B1 CST/B9 TUM RDS | EAPG | DEF | NA | NA | NA | N | ||||
| 24125 | EXC/CRTG B1 CST/TUM RDS AGRF | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24125 | EXC/CRTG B1 CST/TUM RDS AGRF | EAPG | DEF | NA | NA | NA | N | ||||
| 24126 | EXC/CRTG B1 CST/TUM RDS ALGR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24126 | EXC/CRTG B1 CST/TUM RDS ALGR | EAPG | DEF | NA | NA | NA | N | ||||
| 24130 | EXCISION RADIAL HEAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24130 | EXCISION RADIAL HEAD | EAPG | DEF | NA | NA | NA | N | ||||
| 24134 | SEQUESTRECTOMY SHFT/DSTL HUM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24134 | SEQUESTRECTOMY SHFT/DSTL HUM | EAPG | DEF | NA | NA | NA | N | ||||
| 24136 | SEQUESTRECTOMY RADIAL H/N | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24136 | SEQUESTRECTOMY RADIAL H/N | EAPG | DEF | NA | NA | NA | N | ||||
| 24138 | SEQUESTRECTOMY OLECRN PROCES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24138 | SEQUESTRECTOMY OLECRN PROCES | EAPG | DEF | NA | NA | NA | N | ||||
| 24140 | PARTIAL EXC BONE HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24140 | PARTIAL EXC BONE HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24145 | PRTL EXC BONE RADIAL H/N | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24145 | PRTL EXC BONE RADIAL H/N | EAPG | DEF | NA | NA | NA | N | ||||
| 24147 | PRTL EXC BONE OLECRN PROCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24147 | PRTL EXC BONE OLECRN PROCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 24149 | RADICAL RESECTION OF ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24149 | RADICAL RESECTION OF ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24152 | RAD RESECTION TUM RADIAL H/N | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24152 | RAD RESECTION TUM RADIAL H/N | EAPG | DEF | NA | NA | NA | N | ||||
| 24153 | EXTENSIVE RADIUS SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24153 | EXTENSIVE RADIUS SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 24155 | RESECTION OF ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24155 | RESECTION OF ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24160 | RMVL PROSTHHUMRL&ULNAR CMPNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24160 | RMVL PROSTHHUMRL&ULNAR CMPNT | EAPG | DEF | NA | NA | NA | N | ||||
| 24164 | REMOVAL PROSTH RADIAL HEAD | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24164 | REMOVAL PROSTH RADIAL HEAD | EAPG | DEF | NA | NA | NA | N | ||||
| 24200 | RMVL FB UPPER ARM/ELBW SUBQ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24200 | RMVL FB UPPER ARM/ELBW SUBQ | EAPG | DEF | NA | NA | NA | N | ||||
| 24201 | RMVL FB UPPER ARM/ELBW DEEP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24201 | RMVL FB UPPER ARM/ELBW DEEP | EAPG | DEF | NA | NA | NA | N | ||||
| 24220 | INJECTION PX FOR ELBOW ARTHG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24220 | INJECTION PX FOR ELBOW ARTHG | EAPG | DEF | NA | NA | NA | N | ||||
| 24300 | MNPJ ELBOW UNDER ANES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24300 | MNPJ ELBOW UNDER ANES | EAPG | DEF | NA | NA | NA | N | ||||
| 24301 | MUSC/TDN TRANSFER UPR A/E 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24301 | MUSC/TDN TRANSFER UPR A/E 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 24305 | TENDON LNGTH UPR A/E EA TDN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24305 | TENDON LNGTH UPR A/E EA TDN | EAPG | DEF | NA | NA | NA | N | ||||
| 24310 | TNOT OPN ELBW TO SHO EA TDN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24310 | TNOT OPN ELBW TO SHO EA TDN | EAPG | DEF | NA | NA | NA | N | ||||
| 24320 | TENOPLASTY ELBOW TO SHO 1 | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24320 | TENOPLASTY ELBOW TO SHO 1 | EAPG | DEF | NA | NA | NA | N | ||||
| 24330 | FLEXOR-PLASTY ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24330 | FLEXOR-PLASTY ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24331 | FLEXOR-PLASTY ELBW W/ADVMNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24331 | FLEXOR-PLASTY ELBW W/ADVMNT | EAPG | DEF | NA | NA | NA | N | ||||
| 24332 | TENOLYSIS TRICEPS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24332 | TENOLYSIS TRICEPS | EAPG | DEF | NA | NA | NA | N | ||||
| 24340 | TENODESIS BICEPS TDN AT ELBW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24340 | TENODESIS BICEPS TDN AT ELBW | EAPG | DEF | NA | NA | NA | N | ||||
| 24341 | RPR TDN/MUSC UPR A/E EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24341 | RPR TDN/MUSC UPR A/E EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 24342 | REPAIR OF RUPTURED TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24342 | REPAIR OF RUPTURED TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 24343 | REPR ELBOW LAT LIGMNT W/TISS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24343 | REPR ELBOW LAT LIGMNT W/TISS | EAPG | DEF | NA | NA | NA | N | ||||
| 24344 | RECONSTRUCT ELBOW LAT LIGMNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24344 | RECONSTRUCT ELBOW LAT LIGMNT | EAPG | DEF | NA | NA | NA | N | ||||
| 24345 | REPR ELBW MED LIGMNT W/TISSU | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24345 | REPR ELBW MED LIGMNT W/TISSU | EAPG | DEF | NA | NA | NA | N | ||||
| 24346 | RECONSTRUCT ELBOW MED LIGMNT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24346 | RECONSTRUCT ELBOW MED LIGMNT | EAPG | DEF | NA | NA | NA | N | ||||
| 24350 | REPAIR OF TENNIS ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24350 | REPAIR OF TENNIS ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24351 | REPAIR OF TENNIS ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24351 | REPAIR OF TENNIS ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24352 | REPAIR OF TENNIS ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24352 | REPAIR OF TENNIS ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24354 | REPAIR OF TENNIS ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24354 | REPAIR OF TENNIS ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24356 | REVISION OF TENNIS ELBOW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24356 | REVISION OF TENNIS ELBOW | EAPG | DEF | NA | NA | NA | N | ||||
| 24357 | REPAIR ELBOW PERC | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24357 | REPAIR ELBOW PERC | EAPG | DEF | NA | NA | NA | N | ||||
| 24358 | REPAIR ELBOW W/DEB OPEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24358 | REPAIR ELBOW W/DEB OPEN | EAPG | DEF | NA | NA | NA | N | ||||
| 24359 | REPAIR ELBOW DEB/ATTCH OPEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24359 | REPAIR ELBOW DEB/ATTCH OPEN | EAPG | DEF | NA | NA | NA | N | ||||
| 24360 | RECONSTRUCT ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24360 | RECONSTRUCT ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24361 | RECONSTRUCT ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24361 | RECONSTRUCT ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24362 | RECONSTRUCT ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24362 | RECONSTRUCT ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24363 | REPLACE ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24363 | REPLACE ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24365 | RECONSTRUCT HEAD OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24365 | RECONSTRUCT HEAD OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24366 | RECONSTRUCT HEAD OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24366 | RECONSTRUCT HEAD OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24370 | REVISE RECONST ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24370 | REVISE RECONST ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24371 | REVISE RECONST ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24371 | REVISE RECONST ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24400 | REVISION OF HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24400 | REVISION OF HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24410 | REVISION OF HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24410 | REVISION OF HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24420 | REVISION OF HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24420 | REVISION OF HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24430 | REPAIR OF HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24430 | REPAIR OF HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24435 | REPAIR HUMERUS WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24435 | REPAIR HUMERUS WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 24470 | REVISION OF ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24470 | REVISION OF ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24495 | DECOMPRESSION OF FOREARM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24495 | DECOMPRESSION OF FOREARM | EAPG | DEF | NA | NA | NA | N | ||||
| 24498 | REINFORCE HUMERUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24498 | REINFORCE HUMERUS | EAPG | DEF | NA | NA | NA | N | ||||
| 24500 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24500 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24505 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24505 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24515 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24515 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24516 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24516 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24530 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24530 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24535 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24535 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24538 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24538 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24545 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24545 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24546 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24546 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24560 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24560 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24565 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24565 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24566 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24566 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24575 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24575 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24576 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24576 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24577 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24577 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24579 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24579 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24582 | TREAT HUMERUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24582 | TREAT HUMERUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24586 | TREAT ELBOW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24586 | TREAT ELBOW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24587 | TREAT ELBOW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24587 | TREAT ELBOW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24600 | TREAT ELBOW DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24600 | TREAT ELBOW DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 24605 | TREAT ELBOW DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24605 | TREAT ELBOW DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 24615 | TREAT ELBOW DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24615 | TREAT ELBOW DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 24620 | TREAT ELBOW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24620 | TREAT ELBOW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24635 | TREAT ELBOW FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24635 | TREAT ELBOW FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24640 | TREAT ELBOW DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24640 | TREAT ELBOW DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 24650 | TREAT RADIUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24650 | TREAT RADIUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24655 | TREAT RADIUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24655 | TREAT RADIUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24665 | TREAT RADIUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24665 | TREAT RADIUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24666 | TREAT RADIUS FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24666 | TREAT RADIUS FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24670 | TREAT ULNAR FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24670 | TREAT ULNAR FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24675 | TREAT ULNAR FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24675 | TREAT ULNAR FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24685 | TREAT ULNAR FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24685 | TREAT ULNAR FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 24800 | FUSION OF ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24800 | FUSION OF ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24802 | FUSION/GRAFT OF ELBOW JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24802 | FUSION/GRAFT OF ELBOW JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 24925 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 24925 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 25000 | INCISION OF TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25000 | INCISION OF TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 25001 | INCISE FLEXOR CARPI RADIALIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25001 | INCISE FLEXOR CARPI RADIALIS | EAPG | DEF | NA | NA | NA | N | ||||
| 25020 | DECOMPRESS FOREARM 1 SPACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25020 | DECOMPRESS FOREARM 1 SPACE | EAPG | DEF | NA | NA | NA | N | ||||
| 25023 | DECOMPRESS FOREARM 1 SPACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25023 | DECOMPRESS FOREARM 1 SPACE | EAPG | DEF | NA | NA | NA | N | ||||
| 25024 | DECOMPRESS FOREARM 2 SPACES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25024 | DECOMPRESS FOREARM 2 SPACES | EAPG | DEF | NA | NA | NA | N | ||||
| 25025 | DECOMPRESS FOREARM 2 SPACES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25025 | DECOMPRESS FOREARM 2 SPACES | EAPG | DEF | NA | NA | NA | N | ||||
| 25028 | DRAINAGE OF FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25028 | DRAINAGE OF FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25031 | DRAINAGE OF FOREARM BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25031 | DRAINAGE OF FOREARM BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 25035 | TREAT FOREARM BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25035 | TREAT FOREARM BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25040 | EXPLORE/TREAT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25040 | EXPLORE/TREAT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25065 | BIOPSY FOREARM SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25065 | BIOPSY FOREARM SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 25066 | BIOPSY FOREARM SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25066 | BIOPSY FOREARM SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 25071 | EXC FOREARM LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25071 | EXC FOREARM LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 25073 | EXC FOREARM TUM DEEP 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25073 | EXC FOREARM TUM DEEP 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 25075 | EXC FOREARM LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25075 | EXC FOREARM LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 25076 | EXC FOREARM TUM DEEP < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25076 | EXC FOREARM TUM DEEP < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 25077 | RESECT FOREARM/WRIST TUM<3CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25077 | RESECT FOREARM/WRIST TUM<3CM | EAPG | DEF | NA | NA | NA | N | ||||
| 25078 | RESECT FORARM/WRIST TUM 3CM> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25078 | RESECT FORARM/WRIST TUM 3CM> | EAPG | DEF | NA | NA | NA | N | ||||
| 25085 | INCISION OF WRIST CAPSULE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25085 | INCISION OF WRIST CAPSULE | EAPG | DEF | NA | NA | NA | N | ||||
| 25100 | BIOPSY OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25100 | BIOPSY OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25101 | EXPLORE/TREAT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25101 | EXPLORE/TREAT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25105 | REMOVE WRIST JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25105 | REMOVE WRIST JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 25107 | REMOVE WRIST JOINT CARTILAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25107 | REMOVE WRIST JOINT CARTILAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 25109 | EXCISE TENDON FOREARM/WRIST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25109 | EXCISE TENDON FOREARM/WRIST | EAPG | DEF | NA | NA | NA | N | ||||
| 25110 | REMOVE WRIST TENDON LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25110 | REMOVE WRIST TENDON LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25111 | REMOVE WRIST TENDON LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25111 | REMOVE WRIST TENDON LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25112 | REREMOVE WRIST TENDON LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25112 | REREMOVE WRIST TENDON LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25115 | REMOVE WRIST/FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25115 | REMOVE WRIST/FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25116 | REMOVE WRIST/FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25116 | REMOVE WRIST/FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25118 | EXCISE WRIST TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25118 | EXCISE WRIST TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 25119 | PARTIAL REMOVAL OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25119 | PARTIAL REMOVAL OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25120 | REMOVAL OF FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25120 | REMOVAL OF FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25125 | REMOVE/GRAFT FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25125 | REMOVE/GRAFT FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25126 | REMOVE/GRAFT FOREARM LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25126 | REMOVE/GRAFT FOREARM LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25130 | REMOVAL OF WRIST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25130 | REMOVAL OF WRIST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25135 | REMOVE & GRAFT WRIST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25135 | REMOVE & GRAFT WRIST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25136 | REMOVE & GRAFT WRIST LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25136 | REMOVE & GRAFT WRIST LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25145 | REMOVE FOREARM BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25145 | REMOVE FOREARM BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 25150 | PARTIAL REMOVAL OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25150 | PARTIAL REMOVAL OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25151 | PARTIAL REMOVAL OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25151 | PARTIAL REMOVAL OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25210 | REMOVAL OF WRIST BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25210 | REMOVAL OF WRIST BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 25215 | REMOVAL OF WRIST BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25215 | REMOVAL OF WRIST BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 25230 | PARTIAL REMOVAL OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25230 | PARTIAL REMOVAL OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25240 | PARTIAL REMOVAL OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25240 | PARTIAL REMOVAL OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25246 | INJECTION FOR WRIST X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25246 | INJECTION FOR WRIST X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 25248 | REMOVE FOREARM FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25248 | REMOVE FOREARM FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 25250 | REMOVAL OF WRIST PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25250 | REMOVAL OF WRIST PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 25251 | REMOVAL OF WRIST PROSTHESIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25251 | REMOVAL OF WRIST PROSTHESIS | EAPG | DEF | NA | NA | NA | N | ||||
| 25259 | MANIPULATE WRIST W/ANESTHES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25259 | MANIPULATE WRIST W/ANESTHES | EAPG | DEF | NA | NA | NA | N | ||||
| 25260 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25260 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25263 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25263 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25265 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25265 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25270 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25270 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25272 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25272 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25274 | REPAIR FOREARM TENDON/MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25274 | REPAIR FOREARM TENDON/MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 25275 | REPAIR FOREARM TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25275 | REPAIR FOREARM TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 25280 | REVISE WRIST/FOREARM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25280 | REVISE WRIST/FOREARM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 25290 | INCISE WRIST/FOREARM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25290 | INCISE WRIST/FOREARM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 25295 | RELEASE WRIST/FOREARM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25295 | RELEASE WRIST/FOREARM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 25300 | FUSION OF TENDONS AT WRIST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25300 | FUSION OF TENDONS AT WRIST | EAPG | DEF | NA | NA | NA | N | ||||
| 25301 | FUSION OF TENDONS AT WRIST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25301 | FUSION OF TENDONS AT WRIST | EAPG | DEF | NA | NA | NA | N | ||||
| 25310 | TRANSPLANT FOREARM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25310 | TRANSPLANT FOREARM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 25312 | TRANSPLANT FOREARM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25312 | TRANSPLANT FOREARM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 25315 | REVISE PALSY HAND TENDON(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25315 | REVISE PALSY HAND TENDON(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 25316 | REVISE PALSY HAND TENDON(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25316 | REVISE PALSY HAND TENDON(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 25320 | REPAIR/REVISE WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25320 | REPAIR/REVISE WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25332 | REVISE WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25332 | REVISE WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25335 | REALIGNMENT OF HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25335 | REALIGNMENT OF HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 25337 | RECONSTRUCT ULNA/RADIOULNAR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25337 | RECONSTRUCT ULNA/RADIOULNAR | EAPG | DEF | NA | NA | NA | N | ||||
| 25350 | REVISION OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25350 | REVISION OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25355 | REVISION OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25355 | REVISION OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25360 | REVISION OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25360 | REVISION OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25365 | REVISE RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25365 | REVISE RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25370 | REVISE RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25370 | REVISE RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25375 | REVISE RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25375 | REVISE RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25390 | SHORTEN RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25390 | SHORTEN RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25391 | LENGTHEN RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25391 | LENGTHEN RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25392 | SHORTEN RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25392 | SHORTEN RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25393 | LENGTHEN RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25393 | LENGTHEN RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25394 | REPAIR CARPAL BONE SHORTEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25394 | REPAIR CARPAL BONE SHORTEN | EAPG | DEF | NA | NA | NA | N | ||||
| 25400 | REPAIR RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25400 | REPAIR RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25405 | REPAIR/GRAFT RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25405 | REPAIR/GRAFT RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25415 | REPAIR RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25415 | REPAIR RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25420 | REPAIR/GRAFT RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25420 | REPAIR/GRAFT RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25425 | REPAIR/GRAFT RADIUS OR ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25425 | REPAIR/GRAFT RADIUS OR ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25426 | REPAIR/GRAFT RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25426 | REPAIR/GRAFT RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25430 | VASC GRAFT INTO CARPAL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25430 | VASC GRAFT INTO CARPAL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 25431 | REPAIR NONUNION CARPAL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25431 | REPAIR NONUNION CARPAL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 25440 | REPAIR/GRAFT WRIST BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25440 | REPAIR/GRAFT WRIST BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 25441 | RECONSTRUCT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25441 | RECONSTRUCT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25442 | RECONSTRUCT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25442 | RECONSTRUCT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25443 | RECONSTRUCT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25443 | RECONSTRUCT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25444 | RECONSTRUCT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25444 | RECONSTRUCT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25445 | RECONSTRUCT WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25445 | RECONSTRUCT WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25446 | WRIST REPLACEMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25446 | WRIST REPLACEMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 25447 | REPAIR WRIST JOINTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25447 | REPAIR WRIST JOINTS | EAPG | DEF | NA | NA | NA | N | ||||
| 25449 | REMOVE WRIST JOINT IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25449 | REMOVE WRIST JOINT IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 25450 | REVISION OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25450 | REVISION OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25455 | REVISION OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25455 | REVISION OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25490 | REINFORCE RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25490 | REINFORCE RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25491 | REINFORCE ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25491 | REINFORCE ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25492 | REINFORCE RADIUS AND ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25492 | REINFORCE RADIUS AND ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25500 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25500 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25505 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25505 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25515 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25515 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25520 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25520 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25525 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25525 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25526 | TREAT FRACTURE OF RADIUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25526 | TREAT FRACTURE OF RADIUS | EAPG | DEF | NA | NA | NA | N | ||||
| 25530 | TREAT FRACTURE OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25530 | TREAT FRACTURE OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25535 | TREAT FRACTURE OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25535 | TREAT FRACTURE OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25545 | TREAT FRACTURE OF ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25545 | TREAT FRACTURE OF ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25560 | TREAT FRACTURE RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25560 | TREAT FRACTURE RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25565 | TREAT FRACTURE RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25565 | TREAT FRACTURE RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25574 | TREAT FRACTURE RADIUS & ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25574 | TREAT FRACTURE RADIUS & ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25575 | TREAT FRACTURE RADIUS/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25575 | TREAT FRACTURE RADIUS/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25600 | TREAT FRACTURE RADIUS/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25600 | TREAT FRACTURE RADIUS/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25605 | TREAT FRACTURE RADIUS/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25605 | TREAT FRACTURE RADIUS/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25606 | TREAT FX DISTAL RADIAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25606 | TREAT FX DISTAL RADIAL | EAPG | DEF | NA | NA | NA | N | ||||
| 25607 | TREAT FX RAD EXTRA-ARTICUL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25607 | TREAT FX RAD EXTRA-ARTICUL | EAPG | DEF | NA | NA | NA | N | ||||
| 25608 | TREAT FX RAD INTRA-ARTICUL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25608 | TREAT FX RAD INTRA-ARTICUL | EAPG | DEF | NA | NA | NA | N | ||||
| 25609 | TREAT FX RADIAL 3+ FRAG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25609 | TREAT FX RADIAL 3+ FRAG | EAPG | DEF | NA | NA | NA | N | ||||
| 25611 | TREAT FRACTURE RADIUS/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25611 | TREAT FRACTURE RADIUS/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25620 | TREAT FRACTURE RADIUS/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25620 | TREAT FRACTURE RADIUS/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25622 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25622 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25624 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25624 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25628 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25628 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25630 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25630 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25635 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25635 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25645 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25645 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25650 | TREAT WRIST BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25650 | TREAT WRIST BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25651 | PIN ULNAR STYLOID FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25651 | PIN ULNAR STYLOID FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25652 | TREAT FRACTURE ULNAR STYLOID | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25652 | TREAT FRACTURE ULNAR STYLOID | EAPG | DEF | NA | NA | NA | N | ||||
| 25660 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25660 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25670 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25670 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25671 | PIN RADIOULNAR DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25671 | PIN RADIOULNAR DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25675 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25675 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25676 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25676 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25680 | TREAT WRIST FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25680 | TREAT WRIST FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25685 | TREAT WRIST FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25685 | TREAT WRIST FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 25690 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25690 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25695 | TREAT WRIST DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25695 | TREAT WRIST DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 25800 | FUSION OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25800 | FUSION OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25805 | FUSION/GRAFT OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25805 | FUSION/GRAFT OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25810 | FUSION/GRAFT OF WRIST JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25810 | FUSION/GRAFT OF WRIST JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 25820 | FUSION OF HAND BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25820 | FUSION OF HAND BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 25825 | FUSE HAND BONES WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25825 | FUSE HAND BONES WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 25830 | FUSION RADIOULNAR JNT/ULNA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25830 | FUSION RADIOULNAR JNT/ULNA | EAPG | DEF | NA | NA | NA | N | ||||
| 25907 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25907 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 25922 | AMPUTATE HAND AT WRIST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25922 | AMPUTATE HAND AT WRIST | EAPG | DEF | NA | NA | NA | N | ||||
| 25929 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25929 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 25931 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 25931 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 26010 | DRAINAGE OF FINGER ABSCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26010 | DRAINAGE OF FINGER ABSCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 26011 | DRAINAGE OF FINGER ABSCESS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26011 | DRAINAGE OF FINGER ABSCESS | EAPG | DEF | NA | NA | NA | N | ||||
| 26020 | DRAIN HAND TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26020 | DRAIN HAND TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 26025 | DRAINAGE OF PALM BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26025 | DRAINAGE OF PALM BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 26030 | DRAINAGE OF PALM BURSAS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26030 | DRAINAGE OF PALM BURSAS | EAPG | DEF | NA | NA | NA | N | ||||
| 26034 | TREAT HAND BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26034 | TREAT HAND BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26035 | DECOMPRESS FINGERS/HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26035 | DECOMPRESS FINGERS/HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26037 | DECOMPRESS FINGERS/HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26037 | DECOMPRESS FINGERS/HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26040 | RELEASE PALM CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26040 | RELEASE PALM CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26045 | RELEASE PALM CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26045 | RELEASE PALM CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26055 | INCISE FINGER TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26055 | INCISE FINGER TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 26060 | INCISION OF FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26060 | INCISION OF FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26070 | EXPLORE/TREAT HAND JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26070 | EXPLORE/TREAT HAND JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26075 | EXPLORE/TREAT FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26075 | EXPLORE/TREAT FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26080 | EXPLORE/TREAT FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26080 | EXPLORE/TREAT FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26100 | BIOPSY HAND JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26100 | BIOPSY HAND JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 26105 | BIOPSY FINGER JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26105 | BIOPSY FINGER JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 26110 | BIOPSY FINGER JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26110 | BIOPSY FINGER JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 26111 | EXC HAND LES SC 1.5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26111 | EXC HAND LES SC 1.5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 26113 | EXC HAND TUM DEEP 1.5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26113 | EXC HAND TUM DEEP 1.5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 26115 | EXC HAND LES SC < 1.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26115 | EXC HAND LES SC < 1.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 26116 | EXC HAND TUM DEEP < 1.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26116 | EXC HAND TUM DEEP < 1.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 26117 | RAD RESECT HAND TUMOR < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26117 | RAD RESECT HAND TUMOR < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 26118 | RAD RESECT HAND TUMOR 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26118 | RAD RESECT HAND TUMOR 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 26121 | RELEASE PALM CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26121 | RELEASE PALM CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26123 | RELEASE PALM CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26123 | RELEASE PALM CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26125 | RELEASE PALM CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26125 | RELEASE PALM CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26130 | REMOVE WRIST JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26130 | REMOVE WRIST JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 26135 | REVISE FINGER JOINT EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26135 | REVISE FINGER JOINT EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26140 | REVISE FINGER JOINT EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26140 | REVISE FINGER JOINT EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26145 | TENDON EXCISION PALM/FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26145 | TENDON EXCISION PALM/FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26160 | REMOVE TENDON SHEATH LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26160 | REMOVE TENDON SHEATH LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26170 | REMOVAL OF PALM TENDON EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26170 | REMOVAL OF PALM TENDON EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26180 | REMOVAL OF FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26180 | REMOVAL OF FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26185 | REMOVE FINGER BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26185 | REMOVE FINGER BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 26200 | REMOVE HAND BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26200 | REMOVE HAND BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26205 | REMOVE/GRAFT BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26205 | REMOVE/GRAFT BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26210 | REMOVAL OF FINGER LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26210 | REMOVAL OF FINGER LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26215 | REMOVE/GRAFT FINGER LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26215 | REMOVE/GRAFT FINGER LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26230 | PARTIAL REMOVAL OF HAND BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26230 | PARTIAL REMOVAL OF HAND BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 26235 | PARTIAL REMOVAL FINGER BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26235 | PARTIAL REMOVAL FINGER BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 26236 | PARTIAL REMOVAL FINGER BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26236 | PARTIAL REMOVAL FINGER BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 26250 | EXTENSIVE HAND SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26250 | EXTENSIVE HAND SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 26255 | EXTENSIVE HAND SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26255 | EXTENSIVE HAND SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 26260 | RESECT PROX FINGER TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26260 | RESECT PROX FINGER TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 26261 | EXTENSIVE FINGER SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26261 | EXTENSIVE FINGER SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 26262 | RESECT DISTAL FINGER TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26262 | RESECT DISTAL FINGER TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 26320 | REMOVAL OF IMPLANT FROM HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26320 | REMOVAL OF IMPLANT FROM HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26340 | MANIPULATE FINGER W/ANESTH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26340 | MANIPULATE FINGER W/ANESTH | EAPG | DEF | NA | NA | NA | N | ||||
| 26341 | MANIPULAT PALM CORD POST INJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26341 | MANIPULAT PALM CORD POST INJ | EAPG | DEF | NA | NA | NA | N | ||||
| 26350 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26350 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26352 | REPAIR/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26352 | REPAIR/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26356 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26356 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26357 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26357 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26358 | REPAIR/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26358 | REPAIR/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26370 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26370 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26372 | REPAIR/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26372 | REPAIR/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26373 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26373 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26390 | REVISE HAND/FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26390 | REVISE HAND/FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26392 | REPAIR/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26392 | REPAIR/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26410 | REPAIR HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26410 | REPAIR HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26412 | REPAIR/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26412 | REPAIR/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26415 | EXCISION HAND/FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26415 | EXCISION HAND/FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26416 | GRAFT HAND OR FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26416 | GRAFT HAND OR FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26418 | REPAIR FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26418 | REPAIR FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26420 | REPAIR/GRAFT FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26420 | REPAIR/GRAFT FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26426 | REPAIR FINGER/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26426 | REPAIR FINGER/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26428 | REPAIR/GRAFT FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26428 | REPAIR/GRAFT FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26432 | REPAIR FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26432 | REPAIR FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26433 | REPAIR FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26433 | REPAIR FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26434 | REPAIR/GRAFT FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26434 | REPAIR/GRAFT FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26437 | REALIGNMENT OF TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26437 | REALIGNMENT OF TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 26440 | RELEASE PALM/FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26440 | RELEASE PALM/FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26442 | RELEASE PALM & FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26442 | RELEASE PALM & FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26445 | RELEASE HAND/FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26445 | RELEASE HAND/FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26449 | RELEASE FOREARM/HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26449 | RELEASE FOREARM/HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26450 | INCISION OF PALM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26450 | INCISION OF PALM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26455 | INCISION OF FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26455 | INCISION OF FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26460 | INCISE HAND/FINGER TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26460 | INCISE HAND/FINGER TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26471 | FUSION OF FINGER TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26471 | FUSION OF FINGER TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 26474 | FUSION OF FINGER TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26474 | FUSION OF FINGER TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 26476 | TENDON LENGTHENING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26476 | TENDON LENGTHENING | EAPG | DEF | NA | NA | NA | N | ||||
| 26477 | TENDON SHORTENING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26477 | TENDON SHORTENING | EAPG | DEF | NA | NA | NA | N | ||||
| 26478 | LENGTHENING OF HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26478 | LENGTHENING OF HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26479 | SHORTENING OF HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26479 | SHORTENING OF HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26480 | TRANSPLANT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26480 | TRANSPLANT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26483 | TRANSPLANT/GRAFT HAND TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26483 | TRANSPLANT/GRAFT HAND TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26485 | TRANSPLANT PALM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26485 | TRANSPLANT PALM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26489 | TRANSPLANT/GRAFT PALM TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26489 | TRANSPLANT/GRAFT PALM TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26490 | REVISE THUMB TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26490 | REVISE THUMB TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26492 | TENDON TRANSFER WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26492 | TENDON TRANSFER WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26494 | HAND TENDON/MUSCLE TRANSFER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26494 | HAND TENDON/MUSCLE TRANSFER | EAPG | DEF | NA | NA | NA | N | ||||
| 26496 | REVISE THUMB TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26496 | REVISE THUMB TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 26497 | FINGER TENDON TRANSFER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26497 | FINGER TENDON TRANSFER | EAPG | DEF | NA | NA | NA | N | ||||
| 26498 | FINGER TENDON TRANSFER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26498 | FINGER TENDON TRANSFER | EAPG | DEF | NA | NA | NA | N | ||||
| 26499 | REVISION OF FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26499 | REVISION OF FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26500 | HAND TENDON RECONSTRUCTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26500 | HAND TENDON RECONSTRUCTION | EAPG | DEF | NA | NA | NA | N | ||||
| 26502 | HAND TENDON RECONSTRUCTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26502 | HAND TENDON RECONSTRUCTION | EAPG | DEF | NA | NA | NA | N | ||||
| 26504 | HAND TENDON RECONSTRUCTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26504 | HAND TENDON RECONSTRUCTION | EAPG | DEF | NA | NA | NA | N | ||||
| 26508 | RELEASE THUMB CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26508 | RELEASE THUMB CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26510 | THUMB TENDON TRANSFER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26510 | THUMB TENDON TRANSFER | EAPG | DEF | NA | NA | NA | N | ||||
| 26516 | FUSION OF KNUCKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26516 | FUSION OF KNUCKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26517 | FUSION OF KNUCKLE JOINTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26517 | FUSION OF KNUCKLE JOINTS | EAPG | DEF | NA | NA | NA | N | ||||
| 26518 | FUSION OF KNUCKLE JOINTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26518 | FUSION OF KNUCKLE JOINTS | EAPG | DEF | NA | NA | NA | N | ||||
| 26520 | RELEASE KNUCKLE CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26520 | RELEASE KNUCKLE CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26525 | RELEASE FINGER CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26525 | RELEASE FINGER CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26530 | REVISE KNUCKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26530 | REVISE KNUCKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26531 | REVISE KNUCKLE WITH IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26531 | REVISE KNUCKLE WITH IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 26535 | REVISE FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26535 | REVISE FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26536 | REVISE/IMPLANT FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26536 | REVISE/IMPLANT FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26540 | REPAIR HAND JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26540 | REPAIR HAND JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26541 | REPAIR HAND JOINT WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26541 | REPAIR HAND JOINT WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26542 | REPAIR HAND JOINT WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26542 | REPAIR HAND JOINT WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26545 | RECONSTRUCT FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26545 | RECONSTRUCT FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26546 | REPAIR NONUNION HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26546 | REPAIR NONUNION HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26548 | RECONSTRUCT FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26548 | RECONSTRUCT FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26550 | CONSTRUCT THUMB REPLACEMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26550 | CONSTRUCT THUMB REPLACEMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 26555 | POSITIONAL CHANGE OF FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26555 | POSITIONAL CHANGE OF FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26560 | REPAIR OF WEB FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26560 | REPAIR OF WEB FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26561 | REPAIR OF WEB FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26561 | REPAIR OF WEB FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26562 | REPAIR OF WEB FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26562 | REPAIR OF WEB FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26565 | CORRECT METACARPAL FLAW | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26565 | CORRECT METACARPAL FLAW | EAPG | DEF | NA | NA | NA | N | ||||
| 26567 | CORRECT FINGER DEFORMITY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26567 | CORRECT FINGER DEFORMITY | EAPG | DEF | NA | NA | NA | N | ||||
| 26568 | LENGTHEN METACARPAL/FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26568 | LENGTHEN METACARPAL/FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26580 | REPAIR HAND DEFORMITY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26580 | REPAIR HAND DEFORMITY | EAPG | DEF | NA | NA | NA | N | ||||
| 26585 | REPAIR FINGER DEFORMITY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26585 | REPAIR FINGER DEFORMITY | EAPG | DEF | NA | NA | NA | N | ||||
| 26587 | RECONSTRUCT EXTRA FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26587 | RECONSTRUCT EXTRA FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 26590 | REPAIR FINGER DEFORMITY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26590 | REPAIR FINGER DEFORMITY | EAPG | DEF | NA | NA | NA | N | ||||
| 26591 | REPAIR MUSCLES OF HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26591 | REPAIR MUSCLES OF HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26593 | RELEASE MUSCLES OF HAND | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26593 | RELEASE MUSCLES OF HAND | EAPG | DEF | NA | NA | NA | N | ||||
| 26596 | EXCISION CONSTRICTING TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26596 | EXCISION CONSTRICTING TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 26597 | RELEASE OF SCAR CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26597 | RELEASE OF SCAR CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26600 | TREAT METACARPAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26600 | TREAT METACARPAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26605 | TREAT METACARPAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26605 | TREAT METACARPAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26607 | TREAT METACARPAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26607 | TREAT METACARPAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26608 | TREAT METACARPAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26608 | TREAT METACARPAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26615 | TREAT METACARPAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26615 | TREAT METACARPAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26641 | TREAT THUMB DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26641 | TREAT THUMB DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26645 | TREAT THUMB FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26645 | TREAT THUMB FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26650 | TREAT THUMB FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26650 | TREAT THUMB FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26665 | TREAT THUMB FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26665 | TREAT THUMB FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 26670 | TREAT HAND DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26670 | TREAT HAND DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26675 | TREAT HAND DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26675 | TREAT HAND DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26676 | PIN HAND DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26676 | PIN HAND DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26685 | TREAT HAND DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26685 | TREAT HAND DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26686 | TREAT HAND DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26686 | TREAT HAND DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26700 | TREAT KNUCKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26700 | TREAT KNUCKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26705 | TREAT KNUCKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26705 | TREAT KNUCKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26706 | PIN KNUCKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26706 | PIN KNUCKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26715 | TREAT KNUCKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26715 | TREAT KNUCKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26720 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26720 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26725 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26725 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26727 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26727 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26735 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26735 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26740 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26740 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26742 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26742 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26746 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26746 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26750 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26750 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26755 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26755 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26756 | PIN FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26756 | PIN FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26765 | TREAT FINGER FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26765 | TREAT FINGER FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 26770 | TREAT FINGER DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26770 | TREAT FINGER DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26775 | TREAT FINGER DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26775 | TREAT FINGER DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26776 | PIN FINGER DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26776 | PIN FINGER DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26785 | TREAT FINGER DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26785 | TREAT FINGER DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 26820 | THUMB FUSION WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26820 | THUMB FUSION WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26841 | FUSION OF THUMB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26841 | FUSION OF THUMB | EAPG | DEF | NA | NA | NA | N | ||||
| 26842 | THUMB FUSION WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26842 | THUMB FUSION WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26843 | FUSION OF HAND JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26843 | FUSION OF HAND JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26844 | FUSION/GRAFT OF HAND JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26844 | FUSION/GRAFT OF HAND JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26850 | FUSION OF KNUCKLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26850 | FUSION OF KNUCKLE | EAPG | DEF | NA | NA | NA | N | ||||
| 26852 | FUSION OF KNUCKLE WITH GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26852 | FUSION OF KNUCKLE WITH GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 26860 | FUSION OF FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26860 | FUSION OF FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26861 | FUSION OF FINGER JNT ADD-ON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26861 | FUSION OF FINGER JNT ADD-ON | EAPG | DEF | NA | NA | NA | N | ||||
| 26862 | FUSION/GRAFT OF FINGER JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26862 | FUSION/GRAFT OF FINGER JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26863 | FUSE/GRAFT ADDED JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26863 | FUSE/GRAFT ADDED JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 26910 | AMPUTATE METACARPAL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26910 | AMPUTATE METACARPAL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 26951 | AMPUTATION OF FINGER/THUMB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26951 | AMPUTATION OF FINGER/THUMB | EAPG | DEF | NA | NA | NA | N | ||||
| 26952 | AMPUTATION OF FINGER/THUMB | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26952 | AMPUTATION OF FINGER/THUMB | EAPG | DEF | NA | NA | NA | N | ||||
| 26990 | DRAINAGE OF PELVIS LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26990 | DRAINAGE OF PELVIS LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 26991 | DRAINAGE OF PELVIS BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 26991 | DRAINAGE OF PELVIS BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 27000 | INCISION OF HIP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27000 | INCISION OF HIP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27001 | INCISION OF HIP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27001 | INCISION OF HIP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27003 | INCISION OF HIP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27003 | INCISION OF HIP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27033 | EXPLORATION OF HIP JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27033 | EXPLORATION OF HIP JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27035 | DENERVATION OF HIP JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27035 | DENERVATION OF HIP JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27040 | BIOPSY OF SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27040 | BIOPSY OF SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 27041 | BIOPSY OF SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27041 | BIOPSY OF SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 27043 | EXC HIP PELVIS LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27043 | EXC HIP PELVIS LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27045 | EXC HIP/PELV TUM DEEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27045 | EXC HIP/PELV TUM DEEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27047 | EXC HIP/PELVIS LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27047 | EXC HIP/PELVIS LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27048 | EXC HIP/PELV TUM DEEP < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27048 | EXC HIP/PELV TUM DEEP < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27049 | RESECT HIP/PELV TUM < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27049 | RESECT HIP/PELV TUM < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27050 | BIOPSY OF SACROILIAC JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27050 | BIOPSY OF SACROILIAC JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27052 | BIOPSY OF HIP JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27052 | BIOPSY OF HIP JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27059 | RESECT HIP/PELV TUM 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27059 | RESECT HIP/PELV TUM 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27060 | REMOVAL OF ISCHIAL BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27060 | REMOVAL OF ISCHIAL BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 27062 | REMOVE FEMUR LESION/BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27062 | REMOVE FEMUR LESION/BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 27065 | REMOVE HIP BONE LES SUPER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27065 | REMOVE HIP BONE LES SUPER | EAPG | DEF | NA | NA | NA | N | ||||
| 27066 | REMOVE HIP BONE LES DEEP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27066 | REMOVE HIP BONE LES DEEP | EAPG | DEF | NA | NA | NA | N | ||||
| 27067 | REMOVE/GRAFT HIP BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27067 | REMOVE/GRAFT HIP BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27080 | REMOVAL OF TAIL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27080 | REMOVAL OF TAIL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 27086 | REMOVE HIP FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27086 | REMOVE HIP FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 27087 | REMOVE HIP FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27087 | REMOVE HIP FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 27093 | INJECTION FOR HIP X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27093 | INJECTION FOR HIP X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 27095 | INJECTION FOR HIP X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27095 | INJECTION FOR HIP X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 27097 | REVISION OF HIP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27097 | REVISION OF HIP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27098 | TRANSFER TENDON TO PELVIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27098 | TRANSFER TENDON TO PELVIS | EAPG | DEF | NA | NA | NA | N | ||||
| 27100 | TRANSFER OF ABDOMINAL MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27100 | TRANSFER OF ABDOMINAL MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27105 | TRANSFER OF SPINAL MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27105 | TRANSFER OF SPINAL MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27110 | TRANSFER OF ILIOPSOAS MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27110 | TRANSFER OF ILIOPSOAS MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27111 | TRANSFER OF ILIOPSOAS MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27111 | TRANSFER OF ILIOPSOAS MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27193 | TREAT PELVIC RING FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27193 | TREAT PELVIC RING FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27194 | TREAT PELVIC RING FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27194 | TREAT PELVIC RING FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27197 | CLSD TX PELVIC RING FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27197 | CLSD TX PELVIC RING FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27198 | CLSD TX PELVIC RING FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27198 | CLSD TX PELVIC RING FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27200 | TREAT TAIL BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27200 | TREAT TAIL BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27202 | TREAT TAIL BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27202 | TREAT TAIL BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27220 | TREAT HIP SOCKET FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27220 | TREAT HIP SOCKET FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27230 | TREAT THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27230 | TREAT THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27238 | TREAT THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27238 | TREAT THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27246 | TREAT THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27246 | TREAT THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27250 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27250 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27252 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27252 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27256 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27256 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27257 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27257 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27265 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27265 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27266 | TREAT HIP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27266 | TREAT HIP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27267 | CLTX THIGH FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27267 | CLTX THIGH FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27275 | MANIPULATION OF HIP JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27275 | MANIPULATION OF HIP JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27279 | ARTHRD SI JT PERQ/MIN NVAS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27279 | ARTHRD SI JT PERQ/MIN NVAS | EAPG | DEF | NA | NA | NA | N | ||||
| 27301 | DRAIN THIGH/KNEE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27301 | DRAIN THIGH/KNEE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27305 | INCISE THIGH TENDON & FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27305 | INCISE THIGH TENDON & FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 27306 | INCISION OF THIGH TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27306 | INCISION OF THIGH TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27307 | INCISION OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27307 | INCISION OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27310 | EXPLORATION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27310 | EXPLORATION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27315 | PARTIAL REMOVAL; THIGH NERVE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27315 | PARTIAL REMOVAL; THIGH NERVE | EAPG | DEF | NA | NA | NA | N | ||||
| 27320 | PARTIAL REMOVAL; THIGH NERVE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27320 | PARTIAL REMOVAL; THIGH NERVE | EAPG | DEF | NA | NA | NA | N | ||||
| 27323 | BIOPSY THIGH SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27323 | BIOPSY THIGH SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 27324 | BIOPSY THIGH SOFT TISSUES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27324 | BIOPSY THIGH SOFT TISSUES | EAPG | DEF | NA | NA | NA | N | ||||
| 27325 | NEURECTOMY HAMSTRING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27325 | NEURECTOMY HAMSTRING | EAPG | DEF | NA | NA | NA | N | ||||
| 27326 | NEURECTOMY POPLITEAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27326 | NEURECTOMY POPLITEAL | EAPG | DEF | NA | NA | NA | N | ||||
| 27327 | EXC THIGH/KNEE LES SC < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27327 | EXC THIGH/KNEE LES SC < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27328 | EXC THIGH/KNEE TUM DEEP <5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27328 | EXC THIGH/KNEE TUM DEEP <5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27329 | RESECT THIGH/KNEE TUM < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27329 | RESECT THIGH/KNEE TUM < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27330 | BIOPSY KNEE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27330 | BIOPSY KNEE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 27331 | EXPLORE/TREAT KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27331 | EXPLORE/TREAT KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27332 | REMOVAL OF KNEE CARTILAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27332 | REMOVAL OF KNEE CARTILAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 27333 | REMOVAL OF KNEE CARTILAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27333 | REMOVAL OF KNEE CARTILAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 27334 | REMOVE KNEE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27334 | REMOVE KNEE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 27335 | REMOVE KNEE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27335 | REMOVE KNEE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 27337 | EXC THIGH/KNEE LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27337 | EXC THIGH/KNEE LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27339 | EXC THIGH/KNEE TUM DEP 5CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27339 | EXC THIGH/KNEE TUM DEP 5CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27340 | REMOVAL OF KNEECAP BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27340 | REMOVAL OF KNEECAP BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 27345 | REMOVAL OF KNEE CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27345 | REMOVAL OF KNEE CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 27347 | REMOVE KNEE CYST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27347 | REMOVE KNEE CYST | EAPG | DEF | NA | NA | NA | N | ||||
| 27350 | REMOVAL OF KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27350 | REMOVAL OF KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27355 | REMOVE FEMUR LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27355 | REMOVE FEMUR LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27356 | REMOVE FEMUR LESION/GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27356 | REMOVE FEMUR LESION/GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 27357 | REMOVE FEMUR LESION/GRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27357 | REMOVE FEMUR LESION/GRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 27358 | REMOVE FEMUR LESION/FIXATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27358 | REMOVE FEMUR LESION/FIXATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27360 | PARTIAL REMOVAL LEG BONE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27360 | PARTIAL REMOVAL LEG BONE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 27364 | RESECT THIGH/KNEE TUM 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27364 | RESECT THIGH/KNEE TUM 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27369 | NJX CNTRST KNE ARTHG/CT/MRI | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27369 | NJX CNTRST KNE ARTHG/CT/MRI | EAPG | DEF | NA | NA | NA | N | ||||
| 27370 | INJECTION FOR KNEE X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27370 | INJECTION FOR KNEE X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 27372 | REMOVAL OF FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27372 | REMOVAL OF FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 27380 | REPAIR OF KNEECAP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27380 | REPAIR OF KNEECAP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27381 | REPAIR/GRAFT KNEECAP TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27381 | REPAIR/GRAFT KNEECAP TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27385 | REPAIR OF THIGH MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27385 | REPAIR OF THIGH MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27386 | REPAIR/GRAFT OF THIGH MUSCLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27386 | REPAIR/GRAFT OF THIGH MUSCLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27390 | INCISION OF THIGH TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27390 | INCISION OF THIGH TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27391 | INCISION OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27391 | INCISION OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27392 | INCISION OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27392 | INCISION OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27393 | LENGTHENING OF THIGH TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27393 | LENGTHENING OF THIGH TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27394 | LENGTHENING OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27394 | LENGTHENING OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27395 | LENGTHENING OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27395 | LENGTHENING OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27396 | TRANSPLANT OF THIGH TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27396 | TRANSPLANT OF THIGH TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27397 | TRANSPLANTS OF THIGH TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27397 | TRANSPLANTS OF THIGH TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27400 | REVISE THIGH MUSCLES/TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27400 | REVISE THIGH MUSCLES/TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27403 | REPAIR OF KNEE CARTILAGE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27403 | REPAIR OF KNEE CARTILAGE | EAPG | DEF | NA | NA | NA | N | ||||
| 27405 | REPAIR OF KNEE LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27405 | REPAIR OF KNEE LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 27407 | REPAIR OF KNEE LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27407 | REPAIR OF KNEE LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 27409 | REPAIR OF KNEE LIGAMENTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27409 | REPAIR OF KNEE LIGAMENTS | EAPG | DEF | NA | NA | NA | N | ||||
| 27415 | OSTEOCHONDRAL KNEE ALLOGRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27415 | OSTEOCHONDRAL KNEE ALLOGRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 27416 | OSTEOCHONDRAL KNEE AUTOGRAFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27416 | OSTEOCHONDRAL KNEE AUTOGRAFT | EAPG | DEF | NA | NA | NA | N | ||||
| 27418 | REPAIR DEGENERATED KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27418 | REPAIR DEGENERATED KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27420 | REVISION OF UNSTABLE KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27420 | REVISION OF UNSTABLE KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27422 | REVISION OF UNSTABLE KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27422 | REVISION OF UNSTABLE KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27424 | REVISION/REMOVAL OF KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27424 | REVISION/REMOVAL OF KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27425 | LAT RETINACULAR RELEASE OPEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27425 | LAT RETINACULAR RELEASE OPEN | EAPG | DEF | NA | NA | NA | N | ||||
| 27427 | RECONSTRUCTION KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27427 | RECONSTRUCTION KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27428 | RECONSTRUCTION KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27428 | RECONSTRUCTION KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27429 | RECONSTRUCTION KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27429 | RECONSTRUCTION KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27430 | REVISION OF THIGH MUSCLES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27430 | REVISION OF THIGH MUSCLES | EAPG | DEF | NA | NA | NA | N | ||||
| 27435 | INCISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27435 | INCISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27437 | REVISE KNEECAP | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27437 | REVISE KNEECAP | EAPG | DEF | NA | NA | NA | N | ||||
| 27438 | REVISE KNEECAP WITH IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27438 | REVISE KNEECAP WITH IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 27440 | REVISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27440 | REVISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27441 | REVISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27441 | REVISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27442 | REVISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27442 | REVISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27443 | REVISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27443 | REVISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27446 | REVISION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27446 | REVISION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27447 | TOTAL KNEE ARTHROPLASTY | PRXOVR | DEF | NA | NA | NA | Y | ||||
| 27447 | TOTAL KNEE ARTHROPLASTY | EAPG | DEF | NA | NA | NA | Y | ||||
| 27475 | SURGERY TO STOP LEG GROWTH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27475 | SURGERY TO STOP LEG GROWTH | EAPG | DEF | NA | NA | NA | N | ||||
| 27479 | SURGERY TO STOP LEG GROWTH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27479 | SURGERY TO STOP LEG GROWTH | EAPG | DEF | NA | NA | NA | N | ||||
| 27496 | DECOMPRESSION OF THIGH/KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27496 | DECOMPRESSION OF THIGH/KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27497 | DECOMPRESSION OF THIGH/KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27497 | DECOMPRESSION OF THIGH/KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27498 | DECOMPRESSION OF THIGH/KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27498 | DECOMPRESSION OF THIGH/KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27499 | DECOMPRESSION OF THIGH/KNEE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27499 | DECOMPRESSION OF THIGH/KNEE | EAPG | DEF | NA | NA | NA | N | ||||
| 27500 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27500 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27501 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27501 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27502 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27502 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27503 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27503 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27508 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27508 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27509 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27509 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27510 | TREATMENT OF THIGH FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27510 | TREATMENT OF THIGH FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27516 | TREAT THIGH FX GROWTH PLATE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27516 | TREAT THIGH FX GROWTH PLATE | EAPG | DEF | NA | NA | NA | N | ||||
| 27517 | TREAT THIGH FX GROWTH PLATE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27517 | TREAT THIGH FX GROWTH PLATE | EAPG | DEF | NA | NA | NA | N | ||||
| 27520 | TREAT KNEECAP FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27520 | TREAT KNEECAP FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27524 | TREAT KNEECAP FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27524 | TREAT KNEECAP FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27530 | TREAT KNEE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27530 | TREAT KNEE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27532 | TREAT KNEE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27532 | TREAT KNEE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27538 | TREAT KNEE FRACTURE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27538 | TREAT KNEE FRACTURE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 27550 | TREAT KNEE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27550 | TREAT KNEE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27552 | TREAT KNEE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27552 | TREAT KNEE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27560 | TREAT KNEECAP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27560 | TREAT KNEECAP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27562 | TREAT KNEECAP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27562 | TREAT KNEECAP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27566 | TREAT KNEECAP DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27566 | TREAT KNEECAP DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27570 | FIXATION OF KNEE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27570 | FIXATION OF KNEE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27594 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27594 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 27600 | DECOMPRESSION OF LOWER LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27600 | DECOMPRESSION OF LOWER LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 27601 | DECOMPRESSION OF LOWER LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27601 | DECOMPRESSION OF LOWER LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 27602 | DECOMPRESSION OF LOWER LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27602 | DECOMPRESSION OF LOWER LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 27603 | DRAIN LOWER LEG LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27603 | DRAIN LOWER LEG LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27604 | DRAIN LOWER LEG BURSA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27604 | DRAIN LOWER LEG BURSA | EAPG | DEF | NA | NA | NA | N | ||||
| 27605 | INCISION OF ACHILLES TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27605 | INCISION OF ACHILLES TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27606 | INCISION OF ACHILLES TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27606 | INCISION OF ACHILLES TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27607 | TREAT LOWER LEG BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27607 | TREAT LOWER LEG BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27610 | EXPLORE/TREAT ANKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27610 | EXPLORE/TREAT ANKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27612 | EXPLORATION OF ANKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27612 | EXPLORATION OF ANKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27613 | BIOPSY LOWER LEG SOFT TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27613 | BIOPSY LOWER LEG SOFT TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 27614 | BIOPSY LOWER LEG SOFT TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27614 | BIOPSY LOWER LEG SOFT TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 27615 | RESECT LEG/ANKLE TUM < 5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27615 | RESECT LEG/ANKLE TUM < 5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27616 | RESECT LEG/ANKLE TUM 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27616 | RESECT LEG/ANKLE TUM 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27618 | EXC LEG/ANKLE TUM < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27618 | EXC LEG/ANKLE TUM < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27619 | EXC LEG/ANKLE TUM DEEP <5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27619 | EXC LEG/ANKLE TUM DEEP <5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 27620 | EXPLORE/TREAT ANKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27620 | EXPLORE/TREAT ANKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27625 | REMOVE ANKLE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27625 | REMOVE ANKLE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 27626 | REMOVE ANKLE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27626 | REMOVE ANKLE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 27630 | REMOVAL OF TENDON LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27630 | REMOVAL OF TENDON LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27632 | EXC LEG/ANKLE LES SC 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27632 | EXC LEG/ANKLE LES SC 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27634 | EXC LEG/ANKLE TUM DEP 5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27634 | EXC LEG/ANKLE TUM DEP 5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 27635 | REMOVE LOWER LEG BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27635 | REMOVE LOWER LEG BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27637 | REMOVE/GRAFT LEG BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27637 | REMOVE/GRAFT LEG BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27638 | REMOVE/GRAFT LEG BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27638 | REMOVE/GRAFT LEG BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 27640 | PARTIAL REMOVAL OF TIBIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27640 | PARTIAL REMOVAL OF TIBIA | EAPG | DEF | NA | NA | NA | N | ||||
| 27641 | PARTIAL REMOVAL OF FIBULA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27641 | PARTIAL REMOVAL OF FIBULA | EAPG | DEF | NA | NA | NA | N | ||||
| 27647 | RESECT TALUS/CALCANEUS TUM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27647 | RESECT TALUS/CALCANEUS TUM | EAPG | DEF | NA | NA | NA | N | ||||
| 27648 | INJECTION FOR ANKLE X-RAY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27648 | INJECTION FOR ANKLE X-RAY | EAPG | DEF | NA | NA | NA | N | ||||
| 27650 | REPAIR ACHILLES TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27650 | REPAIR ACHILLES TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27652 | REPAIR/GRAFT ACHILLES TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27652 | REPAIR/GRAFT ACHILLES TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27654 | REPAIR OF ACHILLES TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27654 | REPAIR OF ACHILLES TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27656 | REPAIR LEG FASCIA DEFECT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27656 | REPAIR LEG FASCIA DEFECT | EAPG | DEF | NA | NA | NA | N | ||||
| 27658 | REPAIR OF LEG TENDON EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27658 | REPAIR OF LEG TENDON EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 27659 | REPAIR OF LEG TENDON EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27659 | REPAIR OF LEG TENDON EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 27664 | REPAIR OF LEG TENDON EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27664 | REPAIR OF LEG TENDON EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 27665 | REPAIR OF LEG TENDON EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27665 | REPAIR OF LEG TENDON EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 27675 | REPAIR LOWER LEG TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27675 | REPAIR LOWER LEG TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27676 | REPAIR LOWER LEG TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27676 | REPAIR LOWER LEG TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27680 | RELEASE OF LOWER LEG TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27680 | RELEASE OF LOWER LEG TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27681 | RELEASE OF LOWER LEG TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27681 | RELEASE OF LOWER LEG TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27685 | REVISION OF LOWER LEG TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27685 | REVISION OF LOWER LEG TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27686 | REVISE LOWER LEG TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27686 | REVISE LOWER LEG TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 27687 | REVISION OF CALF TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27687 | REVISION OF CALF TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27690 | REVISE LOWER LEG TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27690 | REVISE LOWER LEG TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27691 | REVISE LOWER LEG TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27691 | REVISE LOWER LEG TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27692 | REVISE ADDITIONAL LEG TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27692 | REVISE ADDITIONAL LEG TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 27695 | REPAIR OF ANKLE LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27695 | REPAIR OF ANKLE LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 27696 | REPAIR OF ANKLE LIGAMENTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27696 | REPAIR OF ANKLE LIGAMENTS | EAPG | DEF | NA | NA | NA | N | ||||
| 27698 | REPAIR OF ANKLE LIGAMENT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27698 | REPAIR OF ANKLE LIGAMENT | EAPG | DEF | NA | NA | NA | N | ||||
| 27700 | REVISION OF ANKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27700 | REVISION OF ANKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27704 | REMOVAL OF ANKLE IMPLANT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27704 | REMOVAL OF ANKLE IMPLANT | EAPG | DEF | NA | NA | NA | N | ||||
| 27705 | INCISION OF TIBIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27705 | INCISION OF TIBIA | EAPG | DEF | NA | NA | NA | N | ||||
| 27707 | INCISION OF FIBULA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27707 | INCISION OF FIBULA | EAPG | DEF | NA | NA | NA | N | ||||
| 27709 | INCISION OF TIBIA & FIBULA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27709 | INCISION OF TIBIA & FIBULA | EAPG | DEF | NA | NA | NA | N | ||||
| 27720 | REPAIR OF TIBIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27720 | REPAIR OF TIBIA | EAPG | DEF | NA | NA | NA | N | ||||
| 27726 | REPAIR FIBULA NONUNION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27726 | REPAIR FIBULA NONUNION | EAPG | DEF | NA | NA | NA | N | ||||
| 27730 | REPAIR OF TIBIA EPIPHYSIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27730 | REPAIR OF TIBIA EPIPHYSIS | EAPG | DEF | NA | NA | NA | N | ||||
| 27732 | REPAIR OF FIBULA EPIPHYSIS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27732 | REPAIR OF FIBULA EPIPHYSIS | EAPG | DEF | NA | NA | NA | N | ||||
| 27734 | REPAIR LOWER LEG EPIPHYSES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27734 | REPAIR LOWER LEG EPIPHYSES | EAPG | DEF | NA | NA | NA | N | ||||
| 27740 | REPAIR OF LEG EPIPHYSES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27740 | REPAIR OF LEG EPIPHYSES | EAPG | DEF | NA | NA | NA | N | ||||
| 27742 | REPAIR OF LEG EPIPHYSES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27742 | REPAIR OF LEG EPIPHYSES | EAPG | DEF | NA | NA | NA | N | ||||
| 27745 | REINFORCE TIBIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27745 | REINFORCE TIBIA | EAPG | DEF | NA | NA | NA | N | ||||
| 27750 | TREATMENT OF TIBIA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27750 | TREATMENT OF TIBIA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27752 | TREATMENT OF TIBIA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27752 | TREATMENT OF TIBIA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27756 | TREATMENT OF TIBIA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27756 | TREATMENT OF TIBIA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27758 | TREATMENT OF TIBIA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27758 | TREATMENT OF TIBIA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27759 | TREATMENT OF TIBIA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27759 | TREATMENT OF TIBIA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27760 | CLTX MEDIAL ANKLE FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27760 | CLTX MEDIAL ANKLE FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27762 | CLTX MED ANKLE FX W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27762 | CLTX MED ANKLE FX W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 27766 | OPTX MEDIAL ANKLE FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27766 | OPTX MEDIAL ANKLE FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27767 | CLTX POST ANKLE FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27767 | CLTX POST ANKLE FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27768 | CLTX POST ANKLE FX W/MNPJ | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27768 | CLTX POST ANKLE FX W/MNPJ | EAPG | DEF | NA | NA | NA | N | ||||
| 27769 | OPTX POST ANKLE FX | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27769 | OPTX POST ANKLE FX | EAPG | DEF | NA | NA | NA | N | ||||
| 27780 | TREATMENT OF FIBULA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27780 | TREATMENT OF FIBULA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27781 | TREATMENT OF FIBULA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27781 | TREATMENT OF FIBULA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27784 | TREATMENT OF FIBULA FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27784 | TREATMENT OF FIBULA FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27786 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27786 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27788 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27788 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27792 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27792 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27808 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27808 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27810 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27810 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27814 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27814 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27816 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27816 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27818 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27818 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27822 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27822 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27823 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27823 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27824 | TREAT LOWER LEG FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27824 | TREAT LOWER LEG FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27825 | TREAT LOWER LEG FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27825 | TREAT LOWER LEG FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27826 | TREAT LOWER LEG FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27826 | TREAT LOWER LEG FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27827 | TREAT LOWER LEG FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27827 | TREAT LOWER LEG FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27828 | TREAT LOWER LEG FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27828 | TREAT LOWER LEG FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 27829 | TREAT LOWER LEG JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27829 | TREAT LOWER LEG JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27830 | TREAT LOWER LEG DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27830 | TREAT LOWER LEG DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27831 | TREAT LOWER LEG DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27831 | TREAT LOWER LEG DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27832 | TREAT LOWER LEG DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27832 | TREAT LOWER LEG DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27840 | TREAT ANKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27840 | TREAT ANKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27842 | TREAT ANKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27842 | TREAT ANKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27846 | TREAT ANKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27846 | TREAT ANKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27848 | TREAT ANKLE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27848 | TREAT ANKLE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 27860 | FIXATION OF ANKLE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27860 | FIXATION OF ANKLE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27870 | FUSION OF ANKLE JOINT OPEN | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27870 | FUSION OF ANKLE JOINT OPEN | EAPG | DEF | NA | NA | NA | N | ||||
| 27871 | FUSION OF TIBIOFIBULAR JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27871 | FUSION OF TIBIOFIBULAR JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 27884 | AMPUTATION FOLLOW-UP SURGERY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27884 | AMPUTATION FOLLOW-UP SURGERY | EAPG | DEF | NA | NA | NA | N | ||||
| 27889 | AMPUTATION OF FOOT AT ANKLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27889 | AMPUTATION OF FOOT AT ANKLE | EAPG | DEF | NA | NA | NA | N | ||||
| 27892 | DECOMPRESSION OF LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27892 | DECOMPRESSION OF LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 27893 | DECOMPRESSION OF LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27893 | DECOMPRESSION OF LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 27894 | DECOMPRESSION OF LEG | PRXOVR | DEF | NA | NA | NA | N | ||||
| 27894 | DECOMPRESSION OF LEG | EAPG | DEF | NA | NA | NA | N | ||||
| 28001 | DRAINAGE OF BURSA OF FOOT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28001 | DRAINAGE OF BURSA OF FOOT | EAPG | DEF | NA | NA | NA | N | ||||
| 28002 | TREATMENT OF FOOT INFECTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28002 | TREATMENT OF FOOT INFECTION | EAPG | DEF | NA | NA | NA | N | ||||
| 28003 | TREATMENT OF FOOT INFECTION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28003 | TREATMENT OF FOOT INFECTION | EAPG | DEF | NA | NA | NA | N | ||||
| 28005 | TREAT FOOT BONE LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28005 | TREAT FOOT BONE LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28008 | INCISION OF FOOT FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28008 | INCISION OF FOOT FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 28010 | INCISION OF TOE TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28010 | INCISION OF TOE TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28011 | INCISION OF TOE TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28011 | INCISION OF TOE TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 28020 | EXPLORATION OF FOOT JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28020 | EXPLORATION OF FOOT JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28022 | EXPLORATION OF FOOT JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28022 | EXPLORATION OF FOOT JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28024 | EXPLORATION OF TOE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28024 | EXPLORATION OF TOE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28030 | REMOVAL OF FOOT NERVE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28030 | REMOVAL OF FOOT NERVE | EAPG | DEF | NA | NA | NA | N | ||||
| 28035 | DECOMPRESSION OF TIBIA NERVE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28035 | DECOMPRESSION OF TIBIA NERVE | EAPG | DEF | NA | NA | NA | N | ||||
| 28039 | EXC FOOT/TOE TUM SC 1.5 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28039 | EXC FOOT/TOE TUM SC 1.5 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 28041 | EXC FOOT/TOE TUM DEP 1.5CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28041 | EXC FOOT/TOE TUM DEP 1.5CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 28043 | EXC FOOT/TOE TUM SC < 1.5 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28043 | EXC FOOT/TOE TUM SC < 1.5 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 28045 | EXC FOOT/TOE TUM DEEP <1.5CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28045 | EXC FOOT/TOE TUM DEEP <1.5CM | EAPG | DEF | NA | NA | NA | N | ||||
| 28046 | RESECT FOOT/TOE TUMOR < 3 CM | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28046 | RESECT FOOT/TOE TUMOR < 3 CM | EAPG | DEF | NA | NA | NA | N | ||||
| 28047 | RESECT FOOT/TOE TUMOR 3 CM/> | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28047 | RESECT FOOT/TOE TUMOR 3 CM/> | EAPG | DEF | NA | NA | NA | N | ||||
| 28050 | BIOPSY OF FOOT JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28050 | BIOPSY OF FOOT JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 28052 | BIOPSY OF FOOT JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28052 | BIOPSY OF FOOT JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 28054 | BIOPSY OF TOE JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28054 | BIOPSY OF TOE JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 28055 | NEURECTOMY FOOT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28055 | NEURECTOMY FOOT | EAPG | DEF | NA | NA | NA | N | ||||
| 28060 | PARTIAL REMOVAL FOOT FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28060 | PARTIAL REMOVAL FOOT FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 28062 | REMOVAL OF FOOT FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28062 | REMOVAL OF FOOT FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 28070 | REMOVAL OF FOOT JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28070 | REMOVAL OF FOOT JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 28072 | REMOVAL OF FOOT JOINT LINING | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28072 | REMOVAL OF FOOT JOINT LINING | EAPG | DEF | NA | NA | NA | N | ||||
| 28080 | REMOVAL OF FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28080 | REMOVAL OF FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28086 | EXCISE FOOT TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28086 | EXCISE FOOT TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 28088 | EXCISE FOOT TENDON SHEATH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28088 | EXCISE FOOT TENDON SHEATH | EAPG | DEF | NA | NA | NA | N | ||||
| 28090 | REMOVAL OF FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28090 | REMOVAL OF FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28092 | REMOVAL OF TOE LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28092 | REMOVAL OF TOE LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 28100 | REMOVAL OF ANKLE/HEEL LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28100 | REMOVAL OF ANKLE/HEEL LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28102 | REMOVE/GRAFT FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28102 | REMOVE/GRAFT FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28103 | REMOVE/GRAFT FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28103 | REMOVE/GRAFT FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28104 | REMOVAL OF FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28104 | REMOVAL OF FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28106 | REMOVE/GRAFT FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28106 | REMOVE/GRAFT FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28107 | REMOVE/GRAFT FOOT LESION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28107 | REMOVE/GRAFT FOOT LESION | EAPG | DEF | NA | NA | NA | N | ||||
| 28108 | REMOVAL OF TOE LESIONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28108 | REMOVAL OF TOE LESIONS | EAPG | DEF | NA | NA | NA | N | ||||
| 28110 | PART REMOVAL OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28110 | PART REMOVAL OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28111 | PART REMOVAL OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28111 | PART REMOVAL OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28112 | PART REMOVAL OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28112 | PART REMOVAL OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28113 | PART REMOVAL OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28113 | PART REMOVAL OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28114 | REMOVAL OF METATARSAL HEADS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28114 | REMOVAL OF METATARSAL HEADS | EAPG | DEF | NA | NA | NA | N | ||||
| 28116 | REVISION OF FOOT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28116 | REVISION OF FOOT | EAPG | DEF | NA | NA | NA | N | ||||
| 28118 | REMOVAL OF HEEL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28118 | REMOVAL OF HEEL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28119 | REMOVAL OF HEEL SPUR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28119 | REMOVAL OF HEEL SPUR | EAPG | DEF | NA | NA | NA | N | ||||
| 28120 | PART REMOVAL OF ANKLE/HEEL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28120 | PART REMOVAL OF ANKLE/HEEL | EAPG | DEF | NA | NA | NA | N | ||||
| 28122 | PARTIAL REMOVAL OF FOOT BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28122 | PARTIAL REMOVAL OF FOOT BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28124 | PARTIAL REMOVAL OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28124 | PARTIAL REMOVAL OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28126 | PARTIAL REMOVAL OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28126 | PARTIAL REMOVAL OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28130 | REMOVAL OF ANKLE BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28130 | REMOVAL OF ANKLE BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28140 | REMOVAL OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28140 | REMOVAL OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28150 | REMOVAL OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28150 | REMOVAL OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28153 | PARTIAL REMOVAL OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28153 | PARTIAL REMOVAL OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28160 | PARTIAL REMOVAL OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28160 | PARTIAL REMOVAL OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28171 | RESECT TARSAL TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28171 | RESECT TARSAL TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 28173 | RESECT METATARSAL TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28173 | RESECT METATARSAL TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 28175 | RESECT PHALANX OF TOE TUMOR | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28175 | RESECT PHALANX OF TOE TUMOR | EAPG | DEF | NA | NA | NA | N | ||||
| 28190 | REMOVAL OF FOOT FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28190 | REMOVAL OF FOOT FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 28192 | REMOVAL OF FOOT FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28192 | REMOVAL OF FOOT FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 28193 | REMOVAL OF FOOT FOREIGN BODY | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28193 | REMOVAL OF FOOT FOREIGN BODY | EAPG | DEF | NA | NA | NA | N | ||||
| 28200 | REPAIR OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28200 | REPAIR OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28202 | REPAIR/GRAFT OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28202 | REPAIR/GRAFT OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28208 | REPAIR OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28208 | REPAIR OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28210 | REPAIR/GRAFT OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28210 | REPAIR/GRAFT OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28220 | RELEASE OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28220 | RELEASE OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28222 | RELEASE OF FOOT TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28222 | RELEASE OF FOOT TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 28225 | RELEASE OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28225 | RELEASE OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28226 | RELEASE OF FOOT TENDONS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28226 | RELEASE OF FOOT TENDONS | EAPG | DEF | NA | NA | NA | N | ||||
| 28230 | INCISION OF FOOT TENDON(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28230 | INCISION OF FOOT TENDON(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 28232 | INCISION OF TOE TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28232 | INCISION OF TOE TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28234 | INCISION OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28234 | INCISION OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28238 | REVISION OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28238 | REVISION OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28240 | RELEASE OF BIG TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28240 | RELEASE OF BIG TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28250 | REVISION OF FOOT FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28250 | REVISION OF FOOT FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 28260 | RELEASE OF MIDFOOT JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28260 | RELEASE OF MIDFOOT JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28261 | REVISION OF FOOT TENDON | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28261 | REVISION OF FOOT TENDON | EAPG | DEF | NA | NA | NA | N | ||||
| 28262 | REVISION OF FOOT AND ANKLE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28262 | REVISION OF FOOT AND ANKLE | EAPG | DEF | NA | NA | NA | N | ||||
| 28264 | RELEASE OF MIDFOOT JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28264 | RELEASE OF MIDFOOT JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28270 | RELEASE OF FOOT CONTRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28270 | RELEASE OF FOOT CONTRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28272 | RELEASE OF TOE JOINT EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28272 | RELEASE OF TOE JOINT EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 28280 | FUSION OF TOES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28280 | FUSION OF TOES | EAPG | DEF | NA | NA | NA | N | ||||
| 28285 | REPAIR OF HAMMERTOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28285 | REPAIR OF HAMMERTOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28286 | REPAIR OF HAMMERTOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28286 | REPAIR OF HAMMERTOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28288 | PARTIAL REMOVAL OF FOOT BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28288 | PARTIAL REMOVAL OF FOOT BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28289 | CORRJ HALUX RIGDUS W/O IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28289 | CORRJ HALUX RIGDUS W/O IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 28290 | CORRECTION OF BUNION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28290 | CORRECTION OF BUNION | EAPG | DEF | NA | NA | NA | N | ||||
| 28291 | CORRJ HALUX RIGDUS W/IMPLT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28291 | CORRJ HALUX RIGDUS W/IMPLT | EAPG | DEF | NA | NA | NA | N | ||||
| 28292 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28292 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28293 | CORRECTION OF BUNION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28293 | CORRECTION OF BUNION | EAPG | DEF | NA | NA | NA | N | ||||
| 28294 | CORRECTION OF BUNION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28294 | CORRECTION OF BUNION | EAPG | DEF | NA | NA | NA | N | ||||
| 28295 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28295 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28296 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28296 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28297 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28297 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28298 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28298 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28299 | CORRECTION HALLUX VALGUS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28299 | CORRECTION HALLUX VALGUS | EAPG | DEF | NA | NA | NA | N | ||||
| 28300 | INCISION OF HEEL BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28300 | INCISION OF HEEL BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28302 | INCISION OF ANKLE BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28302 | INCISION OF ANKLE BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28304 | INCISION OF MIDFOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28304 | INCISION OF MIDFOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28305 | INCISE/GRAFT MIDFOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28305 | INCISE/GRAFT MIDFOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28306 | INCISION OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28306 | INCISION OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28307 | INCISION OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28307 | INCISION OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28308 | INCISION OF METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28308 | INCISION OF METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28309 | INCISION OF METATARSALS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28309 | INCISION OF METATARSALS | EAPG | DEF | NA | NA | NA | N | ||||
| 28310 | REVISION OF BIG TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28310 | REVISION OF BIG TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28312 | REVISION OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28312 | REVISION OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28313 | REPAIR DEFORMITY OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28313 | REPAIR DEFORMITY OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28315 | REMOVAL OF SESAMOID BONE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28315 | REMOVAL OF SESAMOID BONE | EAPG | DEF | NA | NA | NA | N | ||||
| 28320 | REPAIR OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28320 | REPAIR OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28322 | REPAIR OF METATARSALS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28322 | REPAIR OF METATARSALS | EAPG | DEF | NA | NA | NA | N | ||||
| 28340 | RESECT ENLARGED TOE TISSUE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28340 | RESECT ENLARGED TOE TISSUE | EAPG | DEF | NA | NA | NA | N | ||||
| 28341 | RESECT ENLARGED TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28341 | RESECT ENLARGED TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28344 | REPAIR EXTRA TOE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28344 | REPAIR EXTRA TOE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 28345 | REPAIR WEBBED TOE(S) | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28345 | REPAIR WEBBED TOE(S) | EAPG | DEF | NA | NA | NA | N | ||||
| 28400 | TREATMENT OF HEEL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28400 | TREATMENT OF HEEL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28405 | TREATMENT OF HEEL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28405 | TREATMENT OF HEEL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28406 | TREATMENT OF HEEL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28406 | TREATMENT OF HEEL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28415 | TREAT HEEL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28415 | TREAT HEEL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28420 | TREAT/GRAFT HEEL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28420 | TREAT/GRAFT HEEL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28430 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28430 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28435 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28435 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28436 | TREATMENT OF ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28436 | TREATMENT OF ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28445 | TREAT ANKLE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28445 | TREAT ANKLE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28446 | OSTEOCHONDRAL TALUS AUTOGRFT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28446 | OSTEOCHONDRAL TALUS AUTOGRFT | EAPG | DEF | NA | NA | NA | N | ||||
| 28450 | TREAT MIDFOOT FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28450 | TREAT MIDFOOT FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 28455 | TREAT MIDFOOT FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28455 | TREAT MIDFOOT FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 28456 | TREAT MIDFOOT FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28456 | TREAT MIDFOOT FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28465 | TREAT MIDFOOT FRACTURE EACH | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28465 | TREAT MIDFOOT FRACTURE EACH | EAPG | DEF | NA | NA | NA | N | ||||
| 28470 | TREAT METATARSAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28470 | TREAT METATARSAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28475 | TREAT METATARSAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28475 | TREAT METATARSAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28476 | TREAT METATARSAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28476 | TREAT METATARSAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28485 | TREAT METATARSAL FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28485 | TREAT METATARSAL FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28490 | TREAT BIG TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28490 | TREAT BIG TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28495 | TREAT BIG TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28495 | TREAT BIG TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28496 | TREAT BIG TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28496 | TREAT BIG TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28505 | TREAT BIG TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28505 | TREAT BIG TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28510 | TREATMENT OF TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28510 | TREATMENT OF TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28515 | TREATMENT OF TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28515 | TREATMENT OF TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28525 | TREAT TOE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28525 | TREAT TOE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28530 | TREAT SESAMOID BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28530 | TREAT SESAMOID BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28531 | TREAT SESAMOID BONE FRACTURE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28531 | TREAT SESAMOID BONE FRACTURE | EAPG | DEF | NA | NA | NA | N | ||||
| 28540 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28540 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28545 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28545 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28546 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28546 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28555 | REPAIR FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28555 | REPAIR FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28570 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28570 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28575 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28575 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28576 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28576 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28585 | REPAIR FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28585 | REPAIR FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28600 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28600 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28605 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28605 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28606 | TREAT FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28606 | TREAT FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28615 | REPAIR FOOT DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28615 | REPAIR FOOT DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28630 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28630 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28635 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28635 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28636 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28636 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28645 | REPAIR TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28645 | REPAIR TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28660 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28660 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28665 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28665 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28666 | TREAT TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28666 | TREAT TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28675 | REPAIR OF TOE DISLOCATION | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28675 | REPAIR OF TOE DISLOCATION | EAPG | DEF | NA | NA | NA | N | ||||
| 28705 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28705 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28715 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28715 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28725 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28725 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28730 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28730 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28735 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28735 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28737 | REVISION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28737 | REVISION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28740 | FUSION OF FOOT BONES | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28740 | FUSION OF FOOT BONES | EAPG | DEF | NA | NA | NA | N | ||||
| 28750 | FUSION OF BIG TOE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28750 | FUSION OF BIG TOE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28755 | FUSION OF BIG TOE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28755 | FUSION OF BIG TOE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28760 | FUSION OF BIG TOE JOINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28760 | FUSION OF BIG TOE JOINT | EAPG | DEF | NA | NA | NA | N | ||||
| 28810 | AMPUTATION TOE & METATARSAL | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28810 | AMPUTATION TOE & METATARSAL | EAPG | DEF | NA | NA | NA | N | ||||
| 28820 | AMPUTATION OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28820 | AMPUTATION OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28825 | PARTIAL AMPUTATION OF TOE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28825 | PARTIAL AMPUTATION OF TOE | EAPG | DEF | NA | NA | NA | N | ||||
| 28890 | HI ENRGY ESWT PLANTAR FASCIA | PRXOVR | DEF | NA | NA | NA | N | ||||
| 28890 | HI ENRGY ESWT PLANTAR FASCIA | EAPG | DEF | NA | NA | NA | N | ||||
| 29000 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29000 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29010 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29010 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29015 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29015 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29035 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29035 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29040 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29040 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29044 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29044 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29046 | APPLICATION OF BODY CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29046 | APPLICATION OF BODY CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29049 | APPLICATION OF FIGURE EIGHT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29049 | APPLICATION OF FIGURE EIGHT | EAPG | DEF | NA | NA | NA | N | ||||
| 29055 | APPLICATION OF SHOULDER CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29055 | APPLICATION OF SHOULDER CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29058 | APPLICATION OF SHOULDER CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29058 | APPLICATION OF SHOULDER CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29065 | APPLICATION OF LONG ARM CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29065 | APPLICATION OF LONG ARM CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29075 | APPLICATION OF FOREARM CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29075 | APPLICATION OF FOREARM CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29085 | APPLY HAND/WRIST CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29085 | APPLY HAND/WRIST CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29086 | APPLY FINGER CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29086 | APPLY FINGER CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29105 | APPLY LONG ARM SPLINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29105 | APPLY LONG ARM SPLINT | EAPG | DEF | NA | NA | NA | N | ||||
| 29125 | APPLY FOREARM SPLINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29125 | APPLY FOREARM SPLINT | EAPG | DEF | NA | NA | NA | N | ||||
| 29126 | APPLY FOREARM SPLINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29126 | APPLY FOREARM SPLINT | EAPG | DEF | NA | NA | NA | N | ||||
| 29130 | APPLICATION OF FINGER SPLINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29130 | APPLICATION OF FINGER SPLINT | EAPG | DEF | NA | NA | NA | N | ||||
| 29131 | APPLICATION OF FINGER SPLINT | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29131 | APPLICATION OF FINGER SPLINT | EAPG | DEF | NA | NA | NA | N | ||||
| 29200 | STRAPPING OF CHEST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29200 | STRAPPING OF CHEST | EAPG | DEF | NA | NA | NA | N | ||||
| 29240 | STRAPPING OF SHOULDER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29240 | STRAPPING OF SHOULDER | EAPG | DEF | NA | NA | NA | N | ||||
| 29260 | STRAPPING OF ELBOW OR WRIST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29260 | STRAPPING OF ELBOW OR WRIST | EAPG | DEF | NA | NA | NA | N | ||||
| 29280 | STRAPPING OF HAND OR FINGER | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29280 | STRAPPING OF HAND OR FINGER | EAPG | DEF | NA | NA | NA | N | ||||
| 29305 | APPLICATION OF HIP CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29305 | APPLICATION OF HIP CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29325 | APPLICATION OF HIP CASTS | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29325 | APPLICATION OF HIP CASTS | EAPG | DEF | NA | NA | NA | N | ||||
| 29345 | APPLICATION OF LONG LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29345 | APPLICATION OF LONG LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29355 | APPLICATION OF LONG LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29355 | APPLICATION OF LONG LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29358 | APPLY LONG LEG CAST BRACE | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29358 | APPLY LONG LEG CAST BRACE | EAPG | DEF | NA | NA | NA | N | ||||
| 29365 | APPLICATION OF LONG LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29365 | APPLICATION OF LONG LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29405 | APPLY SHORT LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29405 | APPLY SHORT LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29425 | APPLY SHORT LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29425 | APPLY SHORT LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29435 | APPLY SHORT LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29435 | APPLY SHORT LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29440 | ADDITION OF WALKER TO CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29440 | ADDITION OF WALKER TO CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29445 | APPLY RIGID LEG CAST | PRXOVR | DEF | NA | NA | NA | N | ||||
| 29445 | APPLY RIGID LEG CAST | EAPG | DEF | NA | NA | NA | N | ||||
| 29450 | APPLICATION OF LEG CAST | PRXOVR | DEF</ |