Specialty Practices (non-surgical)

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Service Description	CPT Code	Charge Type	Speciality Practice Price
FRUCTOSAMINE PP	82985	Tech	$32.64
FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/< PP	15241	Prof	$413.02
full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit PP	D4355	Prof	$207.30
FULL THICKNESS GRAFT,FREE,W DIRECT CLOSURE DONOR,TRUNK,<=20SQ CM PP	15200	Prof	$1542.94
FULL THICKNESS GRAFT,FREE,W DIRECT CLOSURE DONOR,TRUNK,EA ADTL 20SQ CM PP	15201	Prof	$185.11
FULL THICKNESS SKIN GRAFT,FREE,DIRECT CLOSURE DONOR SITE,FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HAND/FEET,20SQ CM OR LESS PP	15240	Prof	$2232.02
FULL THICKNESS SKIN GRAFT,FREE,DIRECT CLOSURE DONOR SITE,SCALP/ARM/LEG,20CM OR LESS PP	15220	Prof	$1409.19
FUNDUS PHOTOGRAPHY,W I&R PPG	92250	Prof	$63.13
FUNDUS PHOTOGRAPHY,W I&R TP	92250	Tech	$136.96
FUSION OF BIG TOE JOINT PP	28750	Prof	$687.74
FUSION OF FOOT BONES PP	28740	Prof	$745.52
GASTRECTOMY,PARTIAL,DISTAL,W GASTRODUODENOSTOMY PP	43631	Prof	$3365.15
GASTRECTOMY,PARTIAL,DISTAL,W GASTROJEJUNOSTOMY PP	43632	Prof	$4706.93
GASTRECTOMY,PARTIAL,DISTAL,W ROUX-EN Y RECONSTRUCTION PP	43633	Prof	$4387.00
GASTRECTOMY,TOTAL,W ESOPHAGOENTEROSTOMY PP	43620	Prof	$4553.92
GASTRECTOMY,TOTAL,W ROUX-EN-Y RECONSTRUCTION PP	43621	Prof	$5278.31
GASTRIC RESTRICTIVE PROC,WO BYPASS,V-BAND GASTROPLASTY PP	43842	Prof	$2765.95
GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM PP	43845	Prof	$4574.25
GastricPort and Device Open PP	43999	Prof	$2281.51
GASTROCNEMIUS RECESSION PP	27687	Prof	$1132.06