You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
An Official
Pennsylvania
Government Website
Translate
DLI
Department of Labor & Industry
I am ...
I am ...
Claimant
Worker
Employer
Researcher
Provider
Services
Services
Unemployment Benefits
Unemployment Tax Services
Workers' Compensation
Disability Determination
Job Search & Career Training
Disability Services
Labor Law Compliance
Occ. & Industrial Safety
Document Downloads
Labor Market & Jobs Data
Divisions
Divisions
Unemployment Compensation
Unemployment Tax Services
Workers' Compensation
PA CareerLink®
PennSERVE
Vocational Rehabilitation
Work Statistics
Labor Law Compliance
Occ. & Industrial Safety
Disability Determinitation
About
About
Contact the Pennsylvania Depar
Equal Opportunity
Guide to Services
Boards
Councils and Committees
Right to Know
Search
Search
Menu
Department of Labor & Industry
Menu
I am ...
I am ...
Claimant
Worker
Employer
Researcher
Provider
Services
Services
Unemployment Benefits
Unemployment Tax Services
Workers' Compensation
Disability Determination
Job Search & Career Training
Disability Services
Labor Law Compliance
Occ. & Industrial Safety
Document Downloads
Labor Market & Jobs Data
Divisions
Divisions
Unemployment Compensation
Unemployment Tax Services
Workers' Compensation
PA CareerLink®
PennSERVE
Vocational Rehabilitation
Work Statistics
Labor Law Compliance
Occ. & Industrial Safety
Disability Determinitation
About
About
Contact the Pennsylvania Depar
Equal Opportunity
Guide to Services
Boards
Councils and Committees
Right to Know
I am a(n)...
Find Services
Bureaus & Offices
Make a Payment
Contact Us
Publications
DLI
>
Businesses
>
Workers' Compensation Services
>
Workers' Compensation
>
Health Care Services Review
>
Medical Fee Review
>
Fee Schedule
>
Fee Schedule 33212-33676
Begin Main Content Area
Page Content
Content Editor
2024 Workers' Compensation Part B Fee Schedule
33212-33676
View the PDF
CPT/HCPC Code
Modifier
Medicare Location
Global Surgery Indicator
Multiple Surgery Indicator
Prevailing Charge Amount
Fee Schedule Amount
Site of Service Amount
33212
003
90
2
X
1,287.68
X
33212
002
90
2
X
1,284.29
X
33212
004
90
2
X
1,271.08
X
33212
001
90
2
X
1,305.88
X
33213
003
90
2
X
1,320.57
X
33213
002
90
2
X
1,386.47
X
33213
004
90
2
X
1,303.71
X
33213
001
90
2
X
1,408.58
X
33214
001
90
2
X
1,580.16
X
33214
004
90
2
X
1,434.76
X
33214
003
90
2
X
1,451.27
X
33214
002
90
2
X
1,554.97
X
33215
004
90
2
X
645.76
X
33215
002
90
2
X
645.76
X
33215
003
90
2
X
645.76
X
33215
001
90
2
X
719.62
X
33216
004
90
2
X
1,155.80
X
33216
001
90
2
X
1,171.04
X
33216
003
90
2
X
1,160.11
X
33216
002
90
2
X
1,184.93
X
33217
001
90
2
X
1,183.02
X
33217
003
90
2
X
1,171.83
X
33217
002
90
2
X
1,196.84
X
33217
004
90
2
X
1,167.38
X
33218
003
90
2
X
1,067.35
X
33218
002
90
2
X
1,138.45
X
33218
004
90
2
X
1,054.47
X
33218
001
90
2
X
1,155.74
X
33220
002
90
2
X
1,147.11
X
33220
003
90
2
X
1,075.68
X
33220
001
90
2
X
1,164.42
X
33220
004
90
2
X
1,062.84
X
33221
001
90
2
X
666.07
X
33221
002
90
2
X
595.60
X
33221
003
90
2
X
595.60
X
33221
004
90
2
X
595.60
X
33222
002
90
2
X
1,775.98
X
33222
003
90
2
X
1,589.48
X
33222
004
90
2
X
1,736.50
X
33222
001
90
2
X
1,748.55
X
33223
001
90
2
X
1,804.61
X
33223
002
90
2
X
1,831.66
X
33223
003
90
2
X
1,643.93
X
33223
004
90
2
X
1,790.40
X
33224
001
0
2
X
1,146.44
X
33224
004
0
2
X
1,050.44
X
33224
002
0
2
X
1,050.44
X
33224
003
0
2
X
1,050.44
X
33225
002
ZZZ
0
X
931.67
X
33225
003
ZZZ
0
X
931.67
X
33225
001
ZZZ
0
X
1,015.00
X
33225
004
ZZZ
0
X
931.67
X
33226
003
0
2
X
1,011.49
X
33226
002
0
2
X
1,011.49
X
33226
004
0
2
X
1,011.49
X
33226
001
0
2
X
1,104.80
X
33227
003
90
2
X
568.24
X
33227
001
90
2
X
635.72
X
33227
002
90
2
X
568.24
X
33227
004
90
2
X
568.24
X
33228
004
90
2
X
592.83
X
33228
002
90
2
X
592.83
X
33228
003
90
2
X
592.83
X
33228
001
90
2
X
663.11
X
33229
001
90
2
X
690.48
X
33229
004
90
2
X
617.42
X
33229
003
90
2
X
617.42
X
33229
002
90
2
X
617.42
X
33230
001
90
2
X
717.23
X
33230
004
90
2
X
641.54
X
33230
003
90
2
X
641.54
X
33230
002
90
2
X
641.54
X
33231
001
90
2
X
744.61
X
33231
004
90
2
X
666.13
X
33231
003
90
2
X
666.13
X
33231
002
90
2
X
666.13
X
33233
001
90
2
X
964.78
X
33233
004
90
2
X
962.99
X
33233
002
90
2
X
980.92
X
33233
003
90
2
X
966.42
X
33234
002
90
2
X
1,098.79
X
33234
003
90
2
X
1,069.20
X
33234
001
90
2
X
1,164.34
X
33234
004
90
2
X
1,069.20
X
33235
003
90
2
X
1,019.36
X
33235
002
90
2
X
1,047.56
X
33235
001
90
2
X
1,111.64
X
33235
004
90
2
X
1,019.36
X
33236
002
90
2
X
1,799.21
X
33236
003
90
2
X
1,714.35
X
33236
001
90
2
X
1,819.88
X
33236
004
90
2
X
1,696.15
X
33237
002
90
2
X
2,657.01
X
33237
003
90
2
X
2,479.87
X
33237
004
90
2
X
2,451.59
X
33237
001
90
2
X
2,699.98
X
33238
002
90
2
X
2,961.17
X
33238
003
90
2
X
2,764.05
X
33238
004
90
2
X
2,732.62
X
33238
001
90
2
X
3,009.00
X
33240
004
90
2
X
1,340.13
X
33240
001
90
2
X
1,523.27
X
33240
003
90
2
X
1,357.32
X
33240
002
90
2
X
1,500.37
X
33241
001
90
2
X
598.50
X
33241
003
90
2
X
549.91
X
33241
002
90
2
X
588.96
X
33241
004
90
2
X
543.61
X
33243
002
90
2
X
2,693.67
X
33243
003
90
2
X
2,573.37
X
33243
001
90
2
X
2,673.88
X
33243
004
90
2
X
3,325.98
X
33244
001
90
2
X
2,199.85
X
33244
004
90
2
X
1,944.70
X
33244
003
90
2
X
2,113.36
X
33244
002
90
2
X
2,222.46
X
33249
004
90
2
X
3,249.32
X
33249
001
90
2
X
3,994.03
X
33249
003
90
2
X
4,425.40
X
33249
002
90
2
X
3,920.82
X
33250
001
90
2
X
3,546.02
X
33250
004
90
2
X
3,305.28
X
33250
002
90
2
X
3,506.68
X
33250
003
90
2
X
3,344.18
X
33251
003
90
2
X
4,409.70
X
33251
002
90
2
X
4,724.65
X
33251
004
90
2
X
4,359.45
X
33251
001
90
2
X
4,801.07
X
33254
002
90
2
X
2,259.91
X
33254
003
90
2
X
2,259.91
X
33254
004
90
2
X
2,259.91
X
33254
001
90
2
X
2,566.20
X
33255
002
90
2
X
2,722.72
X
33255
003
90
2
X
2,722.72
X
33255
004
90
2
X
2,722.72
X
33255
001
90
2
X
3,083.04
X
33256
001
90
2
X
3,686.18
X
33256
004
90
2
X
3,252.13
X
33256
002
90
2
X
3,252.13
X
33256
003
90
2
X
3,252.13
X
33257
002
ZZZ
0
X
1,011.18
X
33257
003
ZZZ
0
X
1,011.18
X
33257
004
ZZZ
0
X
1,011.18
X
33257
001
ZZZ
0
X
1,128.29
X
33258
002
ZZZ
0
X
1,143.52
X
33258
003
ZZZ
0
X
1,143.52
X
33258
001
ZZZ
0
X
1,276.66
X
33258
004
ZZZ
0
X
1,143.52
X
33259
003
ZZZ
0
X
1,501.07
X
33259
002
ZZZ
0
X
1,501.07
X
33259
004
ZZZ
0
X
1,501.07
X
33259
001
ZZZ
0
X
1,688.43
X
33261
004
90
2
X
4,063.13
X
33261
001
90
2
X
8,638.17
X
33261
002
90
2
X
4,385.62
X
33261
003
90
2
X
8,493.12
X
33262
001
90
2
X
691.02
X
33262
003
90
2
X
618.04
X
33262
002
90
2
X
618.04
X
33262
004
90
2
X
618.04
X
33263
004
90
2
X
642.63
X
33263
002
90
2
X
642.63
X
33263
003
90
2
X
642.63
X
33263
001
90
2
X
718.40
X
33264
001
90
2
X
745.76
X
33264
004
90
2
X
667.24
X
33264
003
90
2
X
667.24
X
33264
002
90
2
X
667.24
X
33265
001
90
2
X
2,566.20
X
33265
004
90
2
X
2,259.91
X
33265
003
90
2
X
2,259.91
X
33265
002
90
2
X
2,259.91
X
33266
003
90
2
X
3,093.69
X
33266
002
90
2
X
3,093.69
X
33266
004
90
2
X
3,093.69
X
33266
001
90
2
X
3,511.13
X
33267
002
90
2
X
1,243.89
X
33267
003
90
2
X
1,243.89
X
33267
004
90
2
X
1,243.89
X
33267
001
90
2
X
1,364.30
X
33268
004
ZZZ
0
X
155.64
X
33268
001
ZZZ
0
X
169.96
X
33268
002
ZZZ
0
X
155.64
X
33268
003
ZZZ
0
X
155.64
X
33269
002
90
2
X
983.25
X
33269
003
90
2
X
983.25
X
33269
001
90
2
X
1,079.75
X
33269
004
90
2
X
983.25
X
33270
001
90
2
X
1,123.94
X
33270
003
90
2
X
1,008.38
X
33270
002
90
2
X
1,008.38
X
33270
004
90
2
X
1,008.38
X
33271
001
90
2
X
839.81
X
33271
004
90
2
X
764.83
X
33271
003
90
2
X
764.83
X
33271
002
90
2
X
764.83
X
33272
004
90
2
X
682.80
X
33272
002
90
2
X
682.80
X
33272
003
90
2
X
682.80
X
33272
001
90
2
X
772.46
X
33273
001
90
2
X
674.74
X
33273
004
90
2
X
617.69
X
33273
002
90
2
X
617.69
X
33273
003
90
2
X
617.69
X
33274
001
90
2
X
769.12
X
33274
004
90
2
X
697.61
X
33274
003
90
2
X
697.61
X
33274
002
90
2
X
697.61
X
33275
002
90
2
X
742.80
X
33275
003
90
2
X
742.80
X
33275
001
90
2
X
818.14
X
33275
004
90
2
X
742.80
X
33276
002
90
2
X
606.10
X
33276
003
90
2
X
606.10
X
33276
001
90
2
X
664.02
X
33276
004
90
2
X
606.10
X
33277
004
ZZZ
0
X
318.12
X
33277
003
ZZZ
0
X
318.12
X
33277
002
ZZZ
0
X
318.12
X
33277
001
ZZZ
0
X
347.45
X
33278
002
90
2
X
603.47
X
33278
003
90
2
X
603.47
X
33278
004
90
2
X
603.47
X
33278
001
90
2
X
661.07
X
33279
002
90
2
X
364.05
X
33279
003
90
2
X
364.05
X
33279
004
90
2
X
364.05
X
33279
001
90
2
X
399.67
X
33280
001
90
2
X
238.55
X
33280
004
90
2
X
218.47
X
33280
003
90
2
X
218.47
X
33280
002
90
2
X
218.47
X
33281
001
90
2
X
431.98
X
33281
004
90
2
X
393.83
X
33281
003
90
2
X
393.83
X
33281
002
90
2
X
393.83
X
33285
003
0
2
X
6,831.38
127.64
33285
002
0
2
X
6,831.38
127.64
33285
004
0
2
X
6,831.38
127.64
33285
001
0
2
X
7,832.46
140.37
33286
004
0
2
X
184.04
125.16
33286
003
0
2
X
184.04
125.16
33286
002
0
2
X
184.04
125.16
33286
001
0
2
X
205.17
137.61
33287
002
90
2
X
405.94
X
33287
003
90
2
X
405.94
X
33287
004
90
2
X
405.94
X
33287
001
90
2
X
445.62
X
33288
001
90
2
X
587.41
X
33288
004
90
2
X
536.31
X
33288
002
90
2
X
536.31
X
33288
003
90
2
X
536.31
X
33289
003
0
2
X
469.68
X
33289
002
0
2
X
469.68
X
33289
001
0
2
X
513.76
X
33289
004
0
2
X
469.68
X
33300
004
90
2
X
3,418.22
X
33300
001
90
2
X
3,776.85
X
33300
003
90
2
X
3,458.76
X
33300
002
90
2
X
3,714.81
X
33305
004
90
2
X
4,090.22
X
33305
001
90
2
X
4,517.67
X
33305
003
90
2
X
4,138.90
X
33305
002
90
2
X
4,158.52
X
33310
002
90
2
X
3,379.30
X
33310
003
90
2
X
3,360.01
X
33310
004
90
2
X
3,136.31
X
33310
001
90
2
X
3,429.52
X
33315
001
90
2
X
4,217.50
X
33315
002
90
2
X
4,153.14
X
33315
003
90
2
X
3,887.52
X
33315
004
90
2
X
3,843.03
X
33320
001
90
2
X
3,989.93
X
33320
002
90
2
X
3,964.66
X
33320
003
90
2
X
3,860.46
X
33320
004
90
2
X
3,302.75
X
33321
002
90
2
X
4,908.96
X
33321
003
90
2
X
4,553.15
X
33321
001
90
2
X
5,255.35
X
33321
004
90
2
X
4,497.75
X
33322
001
90
2
X
5,255.35
X
33322
004
90
2
X
4,497.75
X
33322
002
90
2
X
4,908.96
X
33322
003
90
2
X
4,553.15
X
33330
003
90
2
X
3,528.71
X
33330
002
90
2
X
3,749.20
X
33330
001
90
2
X
3,802.68
X
33330
004
90
2
X
3,488.26
X
33335
004
90
2
X
4,674.02
X
33335
001
90
2
X
5,074.65
X
33335
003
90
2
X
4,726.91
X
33335
002
90
2
X
5,006.76
X
33340
004
0
2
X
1,233.38
X
33340
003
0
2
X
1,233.38
X
33340
002
0
2
X
1,233.38
X
33340
001
0
2
X
1,350.96
X
33361
004
0
2
X
2,201.70
X
33361
002
0
2
X
2,201.70
X
33361
003
0
2
X
2,201.70
X
33361
001
0
2
X
2,450.31
X
33362
004
0
2
X
2,409.00
X
33362
002
0
2
X
2,409.00
X
33362
003
0
2
X
2,409.00
X
33362
001
0
2
X
2,680.86
X
33363
002
0
2
X
2,494.39
X
33363
003
0
2
X
2,494.39
X
33363
004
0
2
X
2,494.39
X
33363
001
0
2
X
2,775.88
X
33364
001
0
2
X
2,952.13
X
33364
003
0
2
X
2,651.57
X
33364
002
0
2
X
2,651.57
X
33364
004
0
2
X
2,651.57
X
33365
002
0
2
X
2,915.67
X
33365
003
0
2
X
2,915.67
X
33365
001
0
2
X
3,255.15
X
33365
004
0
2
X
2,915.67
X
33366
003
0
2
X
3,177.47
X
33366
002
0
2
X
3,177.47
X
33366
004
0
2
X
3,177.47
X
33366
001
0
2
X
3,499.80
X
33367
002
ZZZ
0
X
1,025.72
X
33367
003
ZZZ
0
X
1,025.72
X
33367
004
ZZZ
0
X
1,025.72
X
33367
001
ZZZ
0
X
1,144.19
X
33368
004
ZZZ
0
X
1,243.16
X
33368
001
ZZZ
0
X
1,386.96
X
33368
003
ZZZ
0
X
1,243.16
X
33368
002
ZZZ
0
X
1,243.16
X
33369
001
ZZZ
0
X
1,830.90
X
33369
004
ZZZ
0
X
1,641.16
X
33369
002
ZZZ
0
X
1,641.16
X
33369
003
ZZZ
0
X
1,641.16
X
33370
004
ZZZ
0
X
158.14
X
33370
001
ZZZ
0
X
172.33
X
33370
003
ZZZ
0
X
158.14
X
33370
002
ZZZ
0
X
158.14
X
33390
004
90
2
X
2,946.78
X
33390
001
90
2
X
3,215.87
X
33390
003
90
2
X
2,946.78
X
33390
002
90
2
X
2,946.78
X
33391
001
90
2
X
3,810.48
X
33391
004
90
2
X
3,491.82
X
33391
003
90
2
X
3,491.82
X
33391
002
90
2
X
3,491.82
X
33404
003
90
2
X
5,200.47
X
33404
002
90
2
X
5,571.29
X
33404
001
90
2
X
5,661.34
X
33404
004
90
2
X
5,141.19
X
33405
004
90
2
X
7,299.96
X
33405
001
90
2
X
7,829.52
X
33405
002
90
2
X
7,741.96
X
33405
003
90
2
X
7,258.79
X
33406
002
90
2
X
7,214.81
X
33406
003
90
2
X
6,696.02
X
33406
004
90
2
X
6,615.74
X
33406
001
90
2
X
7,340.44
X
33410
001
90
2
X
5,709.77
X
33410
002
90
2
X
5,062.87
X
33410
003
90
2
X
5,062.87
X
33410
004
90
2
X
5,062.87
X
33411
002
90
2
X
8,632.04
X
33411
003
90
2
X
7,955.34
X
33411
001
90
2
X
8,795.89
X
33411
004
90
2
X
7,859.14
X
33412
002
90
2
X
6,592.34
X
33412
003
90
2
X
6,221.19
X
33412
001
90
2
X
6,682.03
X
33412
004
90
2
X
6,147.56
X
33413
003
90
2
X
6,696.02
X
33413
002
90
2
X
7,214.81
X
33413
004
90
2
X
6,615.74
X
33413
001
90
2
X
7,340.44
X
33414
001
90
2
X
6,068.47
X
33414
004
90
2
X
6,068.47
X
33414
003
90
2
X
6,068.47
X
33414
002
90
2
X
6,068.47
X
33415
004
90
2
X
4,755.98
X
33415
001
90
2
X
5,169.35
X
33415
003
90
2
X
4,812.83
X
33415
002
90
2
X
5,099.89
X
33416
001
90
2
X
6,997.43
X
33416
002
90
2
X
6,879.44
X
33416
003
90
2
X
6,391.91
X
33416
004
90
2
X
6,315.99
X
33417
002
90
2
X
9,212.33
X
33417
003
90
2
X
9,212.33
X
33417
001
90
2
X
9,212.33
X
33417
004
90
2
X
9,212.33
X
33418
002
90
2
X
2,745.64
2,867.14
33418
003
90
2
X
2,745.64
2,867.14
33418
004
90
2
X
2,745.64
2,867.14
33418
001
90
2
X
2,972.18
3,114.39
33419
003
ZZZ
0
X
882.82
X
33419
002
ZZZ
0
X
882.82
X
33419
004
ZZZ
0
X
882.82
X
33419
001
ZZZ
0
X
997.00
X
33420
003
90
2
X
6,820.48
X
33420
002
90
2
X
7,279.23
X
33420
004
90
2
X
7,039.38
X
33420
001
90
2
X
4,841.21
X
33422
002
90
2
X
9,261.99
X
33422
003
90
2
X
8,664.73
X
33422
004
90
2
X
6,368.08
X
33422
001
90
2
X
9,204.02
X
33425
001
90
2
X
8,953.62
X
33425
004
90
2
X
8,370.92
X
33425
002
90
2
X
9,239.76
X
33425
003
90
2
X
8,811.36
X
33426
004
90
2
X
6,561.12
X
33426
003
90
2
X
6,641.59
X
33426
002
90
2
X
9,480.03
X
33426
001
90
2
X
8,320.79
X
33427
004
90
2
X
7,521.58
X
33427
002
90
2
X
8,213.86
X
33427
003
90
2
X
7,612.61
X
33427
001
90
2
X
8,359.36
X
33430
001
90
2
X
9,458.94
X
33430
004
90
2
X
9,124.73
X
33430
003
90
2
X
9,142.74
X
33430
002
90
2
X
9,675.26
X
33440
003
90
2
X
4,856.10
X
33440
002
90
2
X
4,856.10
X
33440
004
90
2
X
4,856.10
X
33440
001
90
2
X
5,307.48
X
33460
003
90
2
X
7,018.70
X
33460
002
90
2
X
6,944.08
X
33460
004
90
2
X
5,386.70
X
33460
001
90
2
X
7,193.02
X
33463
004
90
2
X
4,667.07
X
33463
003
90
2
X
4,720.84
X
33463
002
90
2
X
5,057.52
X
33463
001
90
2
X
5,139.32
X
33464
004
90
2
X
4,996.14
X
33464
003
90
2
X
5,053.65
X
33464
002
90
2
X
5,413.93
X
33464
001
90
2
X
5,501.34
X
33465
003
90
2
X
7,495.13
X
33465
002
90
2
X
7,555.27
X
33465
004
90
2
X
6,701.31
X
33465
001
90
2
X
7,815.61
X
33468
004
90
2
X
5,349.19
X
33468
001
90
2
X
5,871.09
X
33468
002
90
2
X
5,781.26
X
33468
003
90
2
X
5,410.95
X
33471
001
90
2
X
7,340.44
X
33471
003
90
2
X
6,696.02
X
33471
002
90
2
X
7,214.81
X
33471
004
90
2
X
6,615.74
X
33474
002
90
2
X
3,965.63
X
33474
003
90
2
X
3,751.49
X
33474
004
90
2
X
3,708.12
X
33474
001
90
2
X
4,017.45
X
33475
004
90
2
X
6,615.74
X
33475
003
90
2
X
6,696.02
X
33475
002
90
2
X
7,214.81
X
33475
001
90
2
X
7,340.44
X
33476
001
90
2
X
7,039.26
X
33476
004
90
2
X
6,233.56
X
33476
002
90
2
X
6,808.60
X
33476
003
90
2
X
6,322.48
X
33477
004
0
2
X
2,021.51
X
33477
001
0
2
X
2,183.64
X
33477
003
0
2
X
2,021.51
X
33477
002
0
2
X
2,021.51
X
33478
001
90
2
X
7,595.80
X
33478
004
90
2
X
6,717.41
X
33478
003
90
2
X
6,814.14
X
33478
002
90
2
X
7,344.85
X
33496
001
90
2
X
6,368.03
X
33496
004
90
2
X
5,506.98
X
33496
003
90
2
X
5,506.98
X
33496
002
90
2
X
5,506.98
X
33500
001
90
2
X
4,798.20
X
33500
004
90
2
X
4,373.71
X
33500
002
90
2
X
6,296.07
X
33500
003
90
2
X
4,423.48
X
33501
002
90
2
X
5,875.89
X
33501
003
90
2
X
3,598.37
X
33501
001
90
2
X
3,948.01
X
33501
004
90
2
X
3,556.28
X
33502
004
90
2
X
5,120.38
X
33502
001
90
2
X
3,930.63
X
33502
003
90
2
X
3,654.13
X
33502
002
90
2
X
3,876.77
X
33503
003
90
2
X
3,631.64
X
33503
002
90
2
X
4,484.51
X
33503
001
90
2
X
3,859.06
X
33503
004
90
2
X
5,492.16
X
33504
004
90
2
X
4,062.39
X
33504
001
90
2
X
4,442.60
X
33504
003
90
2
X
4,108.14
X
33504
002
90
2
X
4,377.25
X
33505
002
90
2
X
4,377.25
X
33505
003
90
2
X
4,108.14
X
33505
004
90
2
X
4,062.39
X
33505
001
90
2
X
4,442.60
X
33506
004
90
2
X
4,062.39
X
33506
001
90
2
X
4,442.60
X
33506
003
90
2
X
4,108.14
X
33506
002
90
2
X
4,377.25
X
33507
004
90
2
X
3,316.04
X
33507
002
90
2
X
3,316.04
X
33507
003
90
2
X
3,316.04
X
33507
001
90
2
X
3,722.69
X
33508
001
ZZZ
0
X
39.12
X
33508
003
ZZZ
0
X
35.26
X
33508
002
ZZZ
0
X
35.26
X
33508
004
ZZZ
0
X
35.26
X
33509
002
ZZZ
0
X
205.54
X
33509
003
ZZZ
0
X
205.54
X
33509
001
ZZZ
0
X
224.44
X
33509
004
ZZZ
0
X
205.54
X
33510
001
90
2
X
7,084.74
X
33510
003
90
2
X
6,521.70
X
33510
002
90
2
X
6,956.76
X
33510
004
90
2
X
6,514.51
X
33511
001
90
2
X
8,156.23
X
33511
004
90
2
X
7,469.02
X
33511
003
90
2
X
7,549.72
X
33511
002
90
2
X
8,041.54
X
33512
002
90
2
X
8,658.88
X
33512
003
90
2
X
8,102.23
X
33512
004
90
2
X
8,056.81
X
33512
001
90
2
X
8,762.83
X
33513
002
90
2
X
9,244.82
X
33513
003
90
2
X
8,620.03
X
33513
001
90
2
X
9,350.49
X
33513
004
90
2
X
8,584.93
X
33514
001
90
2
X
9,686.82
X
33514
004
90
2
X
9,010.94
X
33514
002
90
2
X
9,618.63
X
33514
003
90
2
X
9,077.81
X
33516
003
90
2
X
9,671.49
X
33516
002
90
2
X
9,962.84
X
33516
004
90
2
X
9,627.60
X
33516
001
90
2
X
9,882.14
X
33517
002
ZZZ
0
X
731.71
X
33517
003
ZZZ
0
X
674.41
X
33517
004
ZZZ
0
X
672.11
X
33517
001
ZZZ
0
X
720.77
X
33518
001
ZZZ
0
X
1,386.65
X
33518
004
ZZZ
0
X
1,289.12
X
33518
003
ZZZ
0
X
1,282.83
X
33518
002
ZZZ
0
X
1,403.68
X
33519
002
ZZZ
0
X
1,873.39
X
33519
003
ZZZ
0
X
1,768.54
X
33519
004
ZZZ
0
X
1,764.20
X
33519
001
ZZZ
0
X
1,835.05
X
33521
001
ZZZ
0
X
2,183.45
X
33521
003
ZZZ
0
X
2,331.23
X
33521
002
ZZZ
0
X
2,301.94
X
33521
004
ZZZ
0
X
2,313.15
X
33522
004
ZZZ
0
X
2,996.38
X
33522
001
ZZZ
0
X
2,661.13
X
33522
003
ZZZ
0
X
3,031.43
X
33522
002
ZZZ
0
X
2,873.23
X
33523
002
ZZZ
0
X
3,116.58
X
33523
003
ZZZ
0
X
3,258.17
X
33523
001
ZZZ
0
X
2,908.47
X
33523
004
ZZZ
0
X
3,220.40
X
33530
004
ZZZ
0
X
1,888.78
X
33530
001
ZZZ
0
X
2,141.53
X
33530
003
ZZZ
0
X
1,912.41
X
33530
002
ZZZ
0
X
2,096.84
X
33533
001
90
2
X
7,546.43
X
33533
004
90
2
X
6,878.07
X
33533
002
90
2
X
7,408.13
X
33533
003
90
2
X
6,925.07
X
33534
002
90
2
X
8,212.79
X
33534
003
90
2
X
7,698.08
X
33534
004
90
2
X
7,643.19
X
33534
001
90
2
X
8,333.47
X
33535
001
90
2
X
9,041.87
X
33535
002
90
2
X
8,932.66
X
33535
003
90
2
X
8,370.08
X
33535
004
90
2
X
8,320.95
X
33536
001
90
2
X
9,731.51
X
33536
004
90
2
X
8,982.46
X
33536
002
90
2
X
9,633.60
X
33536
003
90
2
X
9,032.00
X
33542
003
90
2
X
10,612.07
X
33542
002
90
2
X
11,428.28
X
33542
004
90
2
X
10,879.20
X
33542
001
90
2
X
10,760.74
X
33545
004
90
2
X
7,738.95
X
33545
001
90
2
X
8,406.86
X
33545
003
90
2
X
8,107.15
X
33545
002
90
2
X
8,464.39
X
33548
004
90
2
X
4,352.98
X
33548
002
90
2
X
4,352.98
X
33548
003
90
2
X
4,352.98
X
33548
001
90
2
X
4,913.80
X
33572
002
ZZZ
0
X
981.91
X
33572
003
ZZZ
0
X
919.53
X
33572
004
ZZZ
0
X
907.35
X
33572
001
ZZZ
0
X
1,012.16
X
33600
001
90
2
X
5,804.48
X
33600
004
90
2
X
5,188.02
X
33600
003
90
2
X
5,251.72
X
33600
002
90
2
X
5,696.71
X
33602
004
90
2
X
4,525.00
X
33602
001
90
2
X
4,983.22
X
33602
003
90
2
X
4,577.18
X
33602
002
90
2
X
4,903.96
X
33606
001
90
2
X
9,261.55
X
33606
004
90
2
X
8,140.82
X
33606
003
90
2
X
8,258.82
X
33606
002
90
2
X
8,937.72
X
33608
004
90
2
X
8,224.41
X
33608
002
90
2
X
9,024.14
X
33608
003
90
2
X
8,343.26
X
33608
001
90
2
X
9,349.10
X
33610
001
90
2
X
9,261.55
X
33610
004
90
2
X
8,140.82
X
33610
003
90
2
X
8,258.82
X
33610
002
90
2
X
8,937.72
X
33611
001
90
2
X
9,492.24
X
33611
003
90
2
X
8,481.37
X
33611
002
90
2
X
9,165.47
X
33611
004
90
2
X
8,361.13
X
33612
002
90
2
X
9,262.43
X
33612
003
90
2
X
8,576.09
X
33612
004
90
2
X
8,454.87
X
33612
001
90
2
X
9,590.40
X
33615
003
90
2
X
8,398.01
X
33615
002
90
2
X
9,080.21
X
33615
004
90
2
X
8,278.72
X
33615
001
90
2
X
9,405.90
X
33617
002
90
2
X
9,279.91
X
33617
003
90
2
X
8,593.14
X
33617
001
90
2
X
9,608.18
X
33617
004
90
2
X
8,471.86
X
33619
003
90
2
X
9,625.08
X
33619
002
90
2
X
10,389.18
X
33619
004
90
2
X
9,488.29
X
33619
001
90
2
X
10,751.93
X
33620
001
90
2
X
3,385.86
X
33620
004
90
2
X
3,028.80
X
33620
003
90
2
X
3,028.80
X
33620
002
90
2
X
3,028.80
X
33621
004
90
2
X
1,624.19
X
33621
002
90
2
X
1,624.19
X
33621
003
90
2
X
1,624.19
X
33621
001
90
2
X
1,809.23
X
33622
004
90
2
X
6,372.93
X
33622
001
90
2
X
7,100.43
X
33622
003
90
2
X
6,372.93
X
33622
002
90
2
X
6,372.93
X
33641
004
90
2
X
5,188.02
X
33641
003
90
2
X
5,251.72
X
33641
002
90
2
X
5,696.71
X
33641
001
90
2
X
5,804.48
X
33645
002
90
2
X
4,654.25
X
33645
003
90
2
X
4,392.13
X
33645
004
90
2
X
4,340.21
X
33645
001
90
2
X
4,717.52
X
33647
90
2
X
*
X
33660
001
90
2
X
7,481.04
X
33660
004
90
2
X
6,607.84
X
33660
002
90
2
X
7,231.58
X
33660
003
90
2
X
6,703.38
X
33665
001
90
2
X
7,827.60
X
33665
002
90
2
X
7,573.78
X
33665
003
90
2
X
7,037.86
X
33665
004
90
2
X
6,938.78
X
33670
001
90
2
X
9,492.24
X
33670
003
90
2
X
8,481.37
X
33670
002
90
2
X
9,165.47
X
33670
004
90
2
X
8,361.13
X
33675
003
90
2
X
3,598.18
X
33675
002
90
2
X
3,598.18
X
33675
004
90
2
X
3,598.18
X
33675
001
90
2
X
4,096.06
X
33676
001
90
2
X
4,232.26
X
33676
003
90
2
X
3,708.64
X
33676
002
90
2
X
3,708.64
X
33676
004
90
2
X
3,708.64
X
Return to CPT/HCPC List