Orange County NC Website
Browse       Search
North Carolina Breast and Cervical Cancer Control Program <br /> 2015-2016 Services Fee Schedule(1) <br /> Breast Procedures Continued <br /> CPT 15-16 Office Fee <br /> Code Fee Allowed <br /> Screening Digital Mammogram,Tomosynthesis(3D)Bilateral 77063 No charge No <br /> (List seperately in addition to code for primary proceed,will be reported 77063-TC No charge <br /> together with Screening Mammogram 77057) 77063-26 No charge <br /> Surgical Evaluation/Consultation N/A (2) Yes <br /> Fine Needle Aspiration 10021 $ 142.64 Yes <br /> Fine Needle Aspiration(with imaging guidance) 10022 $ 135.83 Yes <br /> Ultrasonic guidance for needle placement,imaging 76942 $ 58.27 No <br /> supervision and interpretation(performed in 76942-TC $ 25.25 <br /> conjunction with 10022 or 19000) 76942-26 $ 33.02 <br /> Cytopathology,evaluation of fine needle aspirate 88172 $ 54.55 No <br /> 88172-TC $ 18.25 <br /> 88172-26 $ 36.30 <br /> Cytopathology,evaluation of fine needle aspirate 88173 $ 144.48 No <br /> >Interpretation and Report 88173-TC $ 73.80 <br /> 88173-26 $ 70.68 <br /> Puncture Aspiration 19000 $ 108.07 Yes <br /> -each additional procedure,use in addition to 19000 19001 $ 26.40 Yes <br /> Breast Biopsy(with placement of localization device and imaging of 19081 $ 635.44 Yes <br /> biopsy specimen,percutaneous;stereotactic guidance;first lesion)(3) <br /> Each additional lesion(3) 19082 $ 516.63 Yes <br /> Breast Biopsy(with placement of localization device and imaging of 19083 $ 619.27 Yes <br /> biopsy specimen,percutaneous;ultrasound guidance;first lesion)(3) <br /> Each additional lesion(3) 19084 $ 497.74 Yes <br /> Needle Core Biopsy 19100 $ 144.06 Yes <br /> Needle Core Biopsy(open,Incisional) 19101 $ 326.61 Yes <br /> Excision of cyst,fibroadenoma,or other tumor,aberrant breast tissue <br /> -duct lesion,nipple or areolar lesion,open, <br /> - 1 or more lesions. 19120 $ 474.25 Yes <br /> Excision of breast lesion identified by preop placement 19125 $ 526.02 Yes <br /> -of radiological marker,open,single lesion. <br /> -each additional lesion separately identified by a preop <br /> radiological marker(list separately) 19126 $ 158.55 Yes <br /> Placement of breast localization device,percutaneous;mammographic 19281 $ 230.65 Yes <br /> guidance;first lesion(4) <br /> Each additional lesion(4) 19282 $ 163.38 Yes <br /> Placement of breast localization device,percutaneous;stereotactic 19283 $ 261.95 Yes <br /> guidance;first lesion(4) <br /> Each additional lesion(4) 19284 $ 195.67 Yes <br />