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Commissioner Approved Fee Schedule - FY 2024-25 41 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 29130 Apply Finger Splint,Static $44.00 2009 <br /> 30300 Remove foreign body intranasal $244.00 2009 <br /> 30901 Control Nosebleed $123.00 2009 <br /> 36415 Lab:Venipuncture $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 <br /> 46083 Incise External Hemmorrhoids $184.00 2009 <br /> 46600 Diagnostic Anoscopy $100.00 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 $150.00 2018 <br /> 54060 Treatment of Lesion(Male) $155.00 2018 <br /> 54065 Destruction of Lesion(Male)Extensive $210.00 2018 <br /> 56405 Incision/Drainage of Vulva or Perineum $140.00 2009 <br /> 56420 Incision/Drainage of Gland Abscess $173.00 2009 <br /> 56501 Destroy Lesions(Female) $260.00 2012 <br /> 57170 Diaphragm Fit $95.00 2009 <br /> 57452 Colposcopy of the cervix(without biopsy) $160.00 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 $208.00 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 $193.00 2012 <br /> Self Pay Only 57455LU Minimum Fee-Colposcopy of the Cervix wBiopsy $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) $160.00 2012 <br /> 58301 IUD Removal $200.00 2012 <br /> 59025 Fetal Non Stress $90.00 2012 <br /> 59425 Antepartum package 4-6 visits $1,900.44 2014 <br /> 59426 Antepartum package 7+visits $3,408.75 2014 <br /> 59430 Postpartum care only $180.00 2024 <br /> 64435 Paracervical Block $176.00 2008 <br /> 65205 Remove Foreign Body from External Eye $67.00 2007 <br /> 69200 Remove Foreign Body from Outer Ear Canal $140.00 2006 <br /> 69210 Remove Ear Wax $67.00 2006 <br /> 76801-26 Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation $50.00 2020 <br /> 76801-TC Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation $70.00 2020 <br /> 76801 Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation $120.00 2020 <br /> 76805-TC Ultrasound,Pregnant Uterus,B-Scan and/or Real <br /> Time with Image Documentation $90.00 2020 <br /> 76805 Ultrasound,Pregnant Uterus,B-Scan and/or Real <br /> Time with Image Documentation 1$135.00 2020 <br />