Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified

Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation or transection

Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified

Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral

Anesthesia for vaginal procedures (including biopsy of labia, vagina cervix or endometrium); culdoscopy

Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy or hysterosalpingography or both

Removal, implantable contraceptive capsules

Insertion, nonbiodegradable drug delivery implant

Removal, nonbiodegradable drug delivery implant

Removal with reinsertion, nonbiodegradable drug delivery implant

Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen by brushing or washing (separate procedure)

Laparoscopy, surgical; with biopsy (single or multiple)

Unlisted laparoscopy procedure, abdomen, peritoneum and omentum

Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, installation, or duct radiography, exclusive of radiologic service

Biopsy of testis, needle (separate procedure)

Biopsy of testis, incisional (separate procedure)

Exploration of epididymis, with or without biopsy

Excision of local lesion of epididymis

Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral

Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral

Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)

Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examinations

Incision of sperm duct for X-ray procedure

Removal of growth of sperm cord

Excision of varicocele or ligation of spermatic veins of varicocele; (separate procedure)

Removal of spermatic cord venous dilation or suturing of spermatic veins

Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair

Incision or puncture of fluid-producing glands for sperm movement

Complicated incision of fluid-producing glands for sperm movement

Removal of congenital remnant of fluid-producing glands for sperm movement

Electroejaculation

Irrigation of vagina or application of medicament for treatment of bacterial, parasitic, or fungoid disease or both

Fitting and insertion of pessary or other intravaginal support device

Diaphragm or cervical cap fitting with instructions

Pelvic exam under anesthesia

Endocervical curettage (not done as part of a dilation and curettage)

Suture of cervix

Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach

Dilation of cervical canal

Biopsy of lining of uterus

Dilation and scraping of uterus

Removal of growth of uterus through abdomen, 1-4 growths

Removal of growth of uterus through vagina, 1-4 growths

Insertion of IUD (Intrauterine Device) for pregnancy prevention

Removal of IUD (Intrauterine Device)

Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes

Insertion of tube into fallopian tube

Injection of X-ray contrast into fallopian tube

Repositioning of uterus

Repair of abnormal uterus

Diagnostic exam of uterus using and endoscope

Biopsy of lining of uterus or removal of polyp using an endoscope or both

Release of scar tissue of uterus using an endoscope

Release of scar tissue of uterus and release or removal and septum using an endoscope

Removal of growth of muscle of uterus using an endoscope

Placement of implants to block fallopian tubes using an endoscope

Tying or incision of fallopian tubes

Ligation or transection of fallopian tubes, abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)

Tying or incision of fallopian tubes during cesarean delivery or other abdominal surgery

Tying of fallopian tubes by device through vagina

Removal of scar tissue of ovaries or fallopian tubes using an endoscope

Destruction of fallopian tubes using an endoscope

Blockage of uterine tubes by device using an endoscope

Repair of uterine tube tissue near ovary using an endoscope

Laparoscopy, surgical; with salpingostomy (salpingoneostomy)

Removal of uterine tubes

Removal of scar tissue of ovaries or fallopian tubes

Reconnection of fallopian tubes following tubal ligation

Fimbrioplasty

Salpingostomy

Transposition, ovary or ovaries

Biopsy of ovaries

Partial removal of ovaries

Review by radiologist of uterine tube and ovary image

Review by radiologist of image from placement of uterine tube

Complete ultrasound scan of pelvis

Limited ultrasound scan of pelvis

Ultrasound scan of scrotum

Ultrasound scan of pelvic region through rectum

Ultrasonic guidance for retrieval of egg

DXA bone density measurement of hip, pelvis, spine

DXA bone density measurement of forearm, finger, hand, or foot

Blood test, lipids (cholesterol and triglycerides)

Liver function blood test panel

Manual urinalysis test with examination using microscope, nonautomated

Manual urinalysis test with examination using microscope, automated

Urinalysis, manual test

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, PH, protein, specific gravity, urobilinogen, any number of these constituents

Analysis of urine, except immunoassays

Urinalysis; bacteriuria screen, except by culture of dipstick

Urinalysis; microscopic only

Urine pregnancy test, by visual color comparison methods

Blood, occult, by peroxidase activity (for example: guaiac), qualitative; feces, consecutively collected specimens single determination, for colorectal neoplasm screening (that is, patient was provided 3 cards or single tripe card for consecutive collection)

Cholesterol, serum or whole blood, total

Measurement of total estradiol (hormone)

Folic acid level, serum

Glucose; quantitative, blood (except reagent strip)

Blood glucose (sugar) tolerance test, 3 specimens

Gonadotropin, follicle stimulating (reproductive hormone) level

Gonadotropin, luteinizing (reproductive hormone) level

Hemoglobin analysis and measurement, electrophoresis

Hemoglobin; glycated (A1C)

pH; body fluid, not otherwise specified

Prolactin

Blood test, thyroid stimulating hormone (TSH)

Gonadotropin, chorionic (reproductive hormone) level

Gonadotropin, chorionic (HCG); qualitative

Ovulation tests, by visual color comparison methods for human luteinizing hormone

Bleeding time

Blood count; automated differential WBC count

Manual Differential WBC count (Includes RBC morphology and platelet estimation)

Blood count; manual blood smear examination without differential parameters

Blood count; spun microhematocrit

Blood count; other than spun hematocrit

Blood count; hemoglobin

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

Complete blood cell count (red cells, white blood cell, platelets), automated test

Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each

Platelet count, automated test

Blood test, clotting time

Red blood cell sedimentation rate, to detect inflammation, nonautomated

Red blood cell sedimentation rate, to detect inflammation, automated

Coagulation assessment blood test, plasma or whole blood

Syphilis test, nontreponemal antibody; qualitative (EG, VDRL, RPR, ART)

Syphilis test, nontreponemal antibody; quantitative

Antibody; Chlamydia

Antibody; Chlamydia, IgM

Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1)

Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2)

Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV

Analysis for antibody to Herpes simplex virus, type 1

Analysis for antibody to Herpes simplex virus, type 2

Antibody; HIV-1

Antibody; HIV-2

Antibody; HIV-1 and HIV-2, single result

Hepatitis B surface antibody (HBSAB)

Analysis for antibody, Treponema pallidum

Hepatitis C antibody;

Bacterial culture, any other source except urine, blood or stool, aerobic

Bacterial culture, any source, except blood, anaerobic

Culture, presumptive, pathogenic organisms, screening only

Bacterial colony count, urine

Culture, bacterial; with isolation and presumptive identification of each

Culture, mycoplasma, any source

Culture, chlamydia, any source

Identification of organisms by immunologic analysis, immunofluorescent method

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)

Special gram or giemsa stain for microorganism

Special fluorescent or acid fast strain for microorganism or both

Special stain for inclusion bodies or parasites

Smear, primary source with interpretation; wet mount for infectious agents (for example, saline, India ink, KOH preps)

Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect

Virus isolation, centrifuge enhanced

Virus isolation; including identification by nonimmunologic method, other than by cytopathic effect (for example, virus specific enzymatic activity)

Detection test by immunofluorescent technique for chlamydia

Detection test by immunofluorescent technique for herpes simplex virus type 2

Detection test by immunofluorescent technique for herpes simplex virus type 1

Detection test by immunofluorescent technique for treponema pallidum (syphilis organism)

Detection test by immunoassay technique for chlamydia trachomatis

Infectious agent antigen detection by enzyme immunoassay technique, qualitative hepatitis B surface antigen (HBSAG) or semiquantitative, multiple step method; adenovirus enteric types 40 and 41

Infectious agent antigen detection by enzyme immunoassay technique, qualitative for semiquantitative, multiple step method; adenovirus enteric types 40/41 hepatitis be antigen (HBEAG)

Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies

Detection test by immunoassay technique for HIV-1 antigen

Detection test by immunoassay technique for HIV-2 antigen

Detection test by immunoassay technique for other organism

Detection test by nucleic acid for chlamydia, direct probe technique

Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique

Detection test by nucleic acid for chlamydia trachomatis, quantification

Detection test by nucleic acid for herpes simplex virus, direct probe technique

Detection test by nucleic acid for herpes simplex virus, quantification

Detection test by nucleic acid for herpes virus-6, direct probe technique

Detection test by nucleic acid for herpes virus-6, amplified probe technique

Detection test by nucleic acid for herpes virus-6, quantification

Detection test by nucleic acid for HIV-1 virus, direct probe technique

Detection test by nucleic acid for HIV-1 virus, amplified probe technique

Detection test by nucleic acid for HIV-1 virus, quantification

Detection test by nucleic acid for HIV-2 virus, direct probe technique

Detection test by nucleic acid for HIV-2 virus, amplified probe technique

Detection test by nucleic acid for HIV-2 virus, quantification

Detection test by nucleic acid for Mycoplasma genitalium by DNA or RNA probe

Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), direct probe technique

Detection test by nucleic acid for Neisseria gonorrhoeae (honorrhoeae bacteria), amplified probe technique

Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria)

Detection test by nucleic acid for human papillomavirus (HPV), low-risk types

Detection test by nucleic acid for human papillomavirus (HPV), high-risk types

Detection test by nucleic acid for human papillomavirus (HPV), types 16 and 18 only

Detection test by nucleic acid for Zika virus, amplified probe technique

Detection test by nucleic acid for organism, direct probe technique

Detection test by nucleic acid for organism, amplified probe technique

Detection test by nucleic acid for organism, quantification

Detection test by nucleic acid for multiple organisms, direct probes technique

Detection test by immunoassay with direct visual observation for HIV-1 Antigen, with HIV-1 and HIV-2 antibodies

Detection test by immunoassay with direct visual observation for chlamydia trachomatis

Pap test

Pap test, manual screening

Pap test, manual screening and rescreening

Pap test (Pap smear), automated system

Pap test (Pap smear), automated system with manual screening

Pap test, slides, manual screening

Pap test, slides, automated system with computer-assisted rescreening

Pap test, slides, manual screening and rescreening

Pap test, slides, definitive hormonal evaluation

Screening examination of specimen cells, screening and interpretation

Screening examination of specimen cells, preparation, screening and interpretation

Screening examination of specimen cells, extended study

Pap test, slides, manual screening (the Bethesda System)

Pap test, slides, manual screening and rescreening (the Bethesda System)

Pap test, slides, manual screening and computer-assisted rescreening (the Bethesda System)

Pap test, slides, manual screening and computer-assisted rescreening using cell selection (the Bethesda System)

Pap test, automated thin layer preparation; automated system

Pap test, automated thin layer preparation; automated system and manual rescreening

Pathology examination of tissue using a microscope, limited examination

Level II – Surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers and toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incidental vas deferens, sterilization

Semen analysis; presence or motility of sperm including Huhner test (post coital)

Semen analysis; sperm presence and motility of sperm, if performed

Complete ultrasound of abdomen and pelvis artery and vein blood flow

Ultrasound of abdomen and pelvis artery and vein blood flow

Injection of drug or substance under skin or into muscle

Education provided in a group setting

New patient outpatient visit, total time 15-29 minutes

New patient office or other outpatient visit, 30-44 minutes

New patient office or other outpatient visit, 45-59 minutes

New patient office or other outpatient visit, 60-74 minutes

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

Established patient office or other outpatient visit, 10-19 minutes

Established patient office or other outpatient visit, 20-29 minutes

Established patient office or other outpatient visit, 30-39 minutes

Established patient office or other outpatient visit, 40-54 minutes

Office consultation, typically 15 minutes

Office consultation, typically 30 minutes

Office consultation, typically 40 minutes

Office consultation, typically 1 hour

Office consultation, typically 80 minutes

Initial new patient preventive medicine evaluation (12-17 years)

Initial new patient preventive medicine evaluation (18-39 years)

Initial new patient preventive medicine evaluation (40-64 years)

Established patient periodic preventive medicine examination (12-17 years)

Established patient periodic preventive medicine examination (18-39 years)

Established patient periodic preventive medicine examination (40-64 years)

Preventive medicine counseling, typically 15 minutes

Preventive medicine counseling, typically 30 minutes

Preventive medicine counseling, typically 45 minutes

Preventive medicine counseling, typically 1 hour

Group preventive medicine counseling, typically 30 minutes

Group preventive medicine counseling, typically 1 hour

Cervical cap contraceptive use

Diaphragm for contraceptive use

Contraceptive supply, condom, male, each

Contraceptive supply, condom, female, each

Contraceptive supply, spermicide (for example, foam, gel), each

Semen analysis; presence and/or motility of sperm excluding Huhner

Infectious agent antibody detection of enzyme-linked immunosorbent assay

Nonmedical family planning education, per session

Injection, bezlotoxumab, 10 mg

Injection, Medroxyprogesterone acetate, 1 mg

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Segesterone acetate and ethinyl estradiol, 0.15 mg, 0.013 mg per 24 hours; yearly vaginal system, each

Ethinyl estradiol and etonogestrel, 0.015 mg, 0.12 mg per 24 hours; monthly vaginal ring, each

Levonorgestrel-releasing intrauterine contraceptive system, (Kyleena), 19.5 mg

Levonorgestrel-releasing intrauterine contraceptive system, (Liletta), 52 mg

Levonorgestrel-releasing intrauterine contraceptive system, (Mirena), 52 mg

Intrauterine copper contraceptive

Levonorgestrel-releasing intrauterine contraceptive system (Skyla), 13.5 mg

Etonogestrel (contraceptive) implant system, including implant and supplies

Contraceptive supply, hormone containing patch, each

Etonogestrel (contraceptive) implant system, including implant and supplies

Prescription drug, oral, nonchemotherapeutic, not otherwise specified

Contraceptive intrauterine device (for example, progestacert intrauterine device), including implants and supplies

Contraceptive pills for birth control