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Commissioner Approved Fee Schedule - FY 2025-26 40 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 16000 Initial Burn(s)Treatment $84.00 2009 <br /> 16020 1 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 DestructLesion(s), 1-14 $109.00 2009 <br /> 17250 Chem.Cant of granulation tissue $79.00 2009 <br /> 17280 Destruction Malig Face,Nose,Lip<0.6cm $147.57 2022 <br /> 11765 Excision of Nail Fold,Toe $92.37 2024 <br /> 20550 jInject 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 $329.00 2009 <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 /> Self Pay Only 36415LU Lab:Venipuncture(Minimum Fee for Primary Care Labs On $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 endocervical curetl$208.00 2012 <br /> Self Pay Only 57454LU Minimum Fee-Colposcopy of the Cervis wBiopsy and End $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 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 w/Endocervical <br /> Self Pay Only curettage $37.00 2020 <br /> 58100 Endometrial Biopsy $85.88 2018 <br /> 58300 Insert Intrauterine Device(AID) $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 $50.00 <br /> Documentation 2020 <br /> 76801-TC Ultrasound,Pregnant Uterus,Real Time with Image $70.00 <br /> Documentation 2020 <br />