Specialty Practices (non-surgical)

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Service Description	CPT Code	Charge Type	Speciality Practice Price
DP 2 CORE MAINT SESS ATTENDED IN MONTHS 10-12,GOAL NOT ACH PP	G9877	Prof	$104.86
DP 2 CORE MAINT SESS ATTENDED IN MONTHS 7-9, GOAL ACH PP	G9878	Prof	$157.29
DP 2 CORE MAINT SESS ATTENDED IN MONTHS 7-9,GOAL NOT ACH PP	G9876	Prof	$41.73
DP 2 ONGOING MAINT SESS ATTENDED MONTHS 13-15,GOAL MAIN PP	G9882	Prof	$130.54
DP 2 ONGOING MAINT SESS ATTENDED MONTHS 16-18,GOAL MAIN PP	G9883	Prof	$130.54
DP 2 ONGOING MAINT SESS ATTENDED MONTHS 19-21,GOAL MAIN PP	G9884	Prof	$80.25
DP 2 ONGOING MAINT SESS ATTENDED MONTHS 22-24,GOAL MAIN PP	G9885	Prof	$132.68
DP 4 TOTAL CORE SESSIONS ATTENDED PP	G9874	Prof	$130.54
DP 5 PERCENT WEIGHT LOSS FROM BASELINE ACHIEVED PP	G9880	Prof	$409.81
DP 9 PERCENT WEIGHT LOSS FROM BASELINE ACHIEVED PP	G9881	Prof	$68.48
DP 9 TOTAL CORE SESSIONS ATTENDED PP	G9875	Prof	$232.19
DP BRIDGE PAYMENT,1ST SESS,BY MDPP,PREV RECVD SERV PP	G9890	Prof	$52.43
DRAINAGE ABSCESS PAROTID COMPLICATED PP	42305	Prof	$987.88
DRAINAGE ABSCESS PAROTID SIMPLE PP	42300	Prof	$98.44
DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL PP	42320	Prof	$405.26
DRAINAGE OF PALMAR BURSA MULTIPLE BURSA PP	26030	Prof	$1137.14
DRAINAGE OF PALMAR BURSA SINGLE BURSA PP	26025	Prof	$971.83
DRAINAGE OF SKENES GLAND ABSCESS/CYST PP	53060	Prof	$387.34
DRAINAGE, FINGER ABSCESS PP	26010	Prof	$314.58
DRAINAGE,ABSCESS,CYST,HEMATOMA PP	41800	Prof	$345.61