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Manager Recommended Fee Schedule - F'Y 20 - 3 43 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 12001 Repair Superficial Wound(s) 2 . 5cm or less $ 171000 2008 <br /> 12002 Repair Superficial Wound(s) 2 . 6- 7 . 5cm $ 184000 2009 <br /> 16000 Initial Burn (s) Treatment $ 84 . 00 2009 <br /> 16020 Dsg and/or debridement, small $97 . 00 2009 <br /> 17000 Destroy Benign/Premal Lesion $ 72 . 00 2009 <br /> 17003 Destroy Lesions, 2- 14 $ 18 . 00 2009 <br /> 17110 Destruct Lesion(s), 144 $ 109000 2009 <br /> 17250 Chem . Cant of granulation tissue $79 . 00 2009 <br /> 17280 Destruction Malig Face, Nose, Lip <0 . 6cm $ 147 . 57 2022 <br /> i <br /> 20550 Inject Single Tendon-Ligament- Cyst $ 72 . 00 2009 <br /> 20551 Inject Single Tendon Orgin ? Insertion $ 67 . 00 2009 <br /> 20552 Inject Single-Multi Trigger Pts, 1 -2 Muscles $ 67 . 00 2008 <br /> 20553 Inject Single-Multi Trigger Pts, 3+ Muscles $ 78 . 00 2009 <br /> 20600 Drain/Inject, Small Joint or Bursa $ 67 . 00 2008 <br /> 20605 Drain/Inject, Intermediate Joint or Bursa $72 . 00 2007 <br /> 20610 Drain/Inject, Major Joint or Bursa $ 84 . 00 2009 <br /> 26010 Drain Finger Abscess, Simple $329000 2009 <br /> 29130 Apply Finger Splint, Static $44 . 00 2009 <br /> 30300 Remove foreign body intranasal $244000 2009 <br /> 30901 Control Nosebleed $ 123 . 00 2009 <br /> 36415 Lab : Veni uncture $ 18 . 00 2009 <br /> 36415LU Lab : Venipuncture (Minimum Fee for Primary Care <br /> Self Pay Only Labs Only) (OCHD Lab) $ 15 . 00 2016 <br /> 36416 Capillary Puncture $ 15 . 00 2012 1 <br /> 46083 Incise External Hemmorrhoids $ 184000 2009 <br /> 46600 Diagnostic Anoscopy $ 100000 2009 <br /> 51701 Insertion of non-dwelling bladder cath $94 . 00 2009 <br /> 54050 Destroy Lesion (Male) $315 . 00 2012 <br /> 54056 Destruction of Lesion (Male) Simple Cryosurgery $ 150000 2018 <br /> 54060 Treatment of Lesion (Male) $ 155400 2018 <br /> 54065 Destruction of Lesion (Male) Extensive $210000 2018 <br /> 56405 Incision/Drainage of Vulva or Perineum $ 140600 2009 <br /> 56420 Incision/Drainage of Gland Abscess $ 173400 2009 <br /> 56501 Destroy Lesions (Female) $260000 2012 !% <br /> 57170 Diaphragm Fit $ 95 . 00 2009 <br /> 57452 Colposcopy of the cervix without biopsy) $ 160000 2012 <br /> Self Pay Only 57452LU Minimum Fee - Colposcopy of the Cervix $32 . 00 2020 <br /> 57454 Colposcopy of the cervix, with biopsy and <br /> endocervical curettage $208000 2012 <br /> 57454LU Minimum Fee - Colposcopy of the Cervis wBiopsy <br /> Self Pay Only and Endocervical Curettage $42 . 00 2020 <br /> 57455 Colposcopy of the cervix, with biopsy $ 193000 2012 <br /> Self Pay Only 57455LU Minimum Fee - Colposcopy of the Cervix w/Biopsy $39 . 00 2020 <br /> 57456 Colposcopy of the cervix, with endocervical curettage $ 183 . 00 2012 <br /> 57456LU Minimum Fee - Colposcopy of the Cervix <br /> Self Pay Only w/Endocervical curettage $37 . 00 2020 <br /> 58100 Endometrial Biopsy $ 85 . 88 2018 <br /> 58300 Insert Intrauterine Device (IUD) $ 160000 2012 <br /> 58301 IUD Removal $200 . 00 2012 <br /> 59025 Fetal Non Stress $90 . 00 2012 <br /> 59425 JAntepartura package 4- 6 visits 1 $ 1 , 900044 12014 <br />