Outpatient

Virginia Health Information receives information on the outpatient procedures below. The information comes from Hospital Outpatient Departments, Licensed Ambulatory Surgical Centers and Physician Offices. Charges are based on claims forms submitted for payment to health insurance companies, government programs and individuals paying for services out of pocket.

After editing, VHI makes this information available to the public on VHI.org. VHI displays information by health care provider, including how often they performed the procedure and their median charge. Cases with total charges equal to $0 are included in a provider’s totals, but excluded from median calculations for the provider and statewide. Procedures were chosen based on frequency and real or perceived risk to the patient. Detailed descriptions of the procedure explain why you may have the procedure and related information.

Click procedure name to view procedure codes collected by each procedure.

Breast Surgery

Sub Group CPT Code Description ICD-9 Procedure
Diagnostic 19102 Biopsy of breast; percutaneous, needle core, using imaging guidance 8511
19103 Percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance 8511
19110 Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct 850
Repair/ Reconstruction/ Cosmetic Pxs. 19499 Unlisted procedure, breast 8599
19316 Mastopexy 856
19318 Reduction mammaplasty 8531
19324 Mammaplasty, augmentation; without prosthetic implant 8550
19325 with prosthetic implant 8553U
8554B
19328 Removal of intact mammary implant 8594
19330 Removal of mammary implant material 8594
19340 Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction 8553U
8554B
19342 Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction 8553U
8554B
19350 Nipple/areola reconstruction 8587
19355 Correction of inverted nipples 8587
19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion 8595
19361 Breast reconstruction with latissimus dorsi flap, with or without prosthetic implant 8585
8554B
19364 Breast reconstruction with free flap 8581
8582
8583
8584
8586
19366 Breast reconstruction with other technique 8589
19367 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site; 857
19368 with microvascular anastomosis (supercharging) 857
19369 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site 857
19370 Open periprosthetic capsulotomy, breast 850
19371 Periprosthetic capsulectomy, breast 8594
19380 Revision of reconstructed breast 8589
19396 Preparation of moulage for custom breast implant CPT only
Therapeutic 19112 Excision of lactiferous duct fistula 8520
19120 Excision of cyst, fibroadenoma or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19140), open, male or female, one or more lesions 8521
19125 Excision of breast lesion identified by preoperative placement of radiological marker, open, single lesion 8521
19126 Each additional lesion separately identified by a preoperative radiological marker (List separately in addition to code for primary procedure) 8521
19140 Mastectomy for gynecomastia 8534
19160 Mastectomy, partial; 8523
19290 Preoperative placement of needle localization wire, breast 8519
19291 each additional lesion (List separately in addition to code for primary procedure) 8519

Colonoscopy

Sub Group CPT Code Description ICD-9 Procedure
Diagnostic 45355 Colonoscopy, rigid or flexible, transabdominal via colostomy, single or multiple. 4525
4521
4824
45378 Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) 4685
4523
Therapeutic 45379 with removal of foreign body 4523
9805
45380 with biopsy, single or multiple 4525
4824
45382 with control of bleeding, any method 4543
45383 with ablation of tumor(s), polyp(s) or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique 4543
4835
45384 with removal of tumor(s), polyp(s) or other lesion(s) by hot biopsy forceps or bipolar cautery 4543
4832
45385 with removal of tumor(s), polyp(s) or other lesion(s) by snare technique 4542
4836

Facial Surgery

Sub Group CPT Code Description ICD-9 Procedure
Eyes Only 15820 Blepharoplasty, lower eyelid; 0886
15821 with extensive herniated fat pad 0886
15822 Blepharoplasty, upper eyelid 0887
15823 with excessive skin weighing down lid 0887
Facial 15825 Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap) 8682
15828 cheek, chin and neck 8682
Face and Eyes   Face codes & Eye codes****

Gallbladder Removal

CPT Code Description ICD-9 Procedure
47562 Laparoscopy, surgical; cholecystectomy 5123
47563 cholecystectomy with cholangiography 5123
8753
47564 cholecystectomy with exploration of common duct 5123
5151
5183
47570 cholecysto-enterostomy 5132
5421
47579 Unlisted laparoscopy procedure, biliary tract 5199
5421

General laparoscopic procedures

CPT Code Description ICD-9 Procedure
49320 Laparoscopy, abdomen, peritoneum and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) 5421
49321 Laparoscopy, surgical: with biopsy (single or multiple) 5424
5421
49322 with aspiration of cavity or cyst (e.g. Ovarian cyst) single or multiple 5424
6591
5421
49323 with drainage of lymphocele to peritoneal cavity 5421
540
49329 Unlisted laparoscopy procedure, abdomen, peritoneum and omentum 5421
5499
58578 Unlisted laparoscopy procedure, uterus 6999
5421
58579 Unlisted hysteroscopy procedure, uterus 6812
58679 Unlisted laparoscopy procedure, oviduct, ovary 6599
5421

Hernia Repair

Sub Group CPT Code Description ICD-9 Procedure
Children 49500 Repair initial inguinal hernia, age 6 months to under 5 years, with or without hydrocelectomy; reducible 5300
49501 incarcerated or strangulated 5300
49580 Repair umbilical hernia, under age 5 years; reducible 5359
49582 incarcerated or strangulated 5359
Infants 49495 Repair initial inguinal hernia, under age 6 months, with or without hydrocelectomy; reducible 5300
49496 incarcerated or strangulated 5300
49605 Repair of large omphalocele or gastroschisis; with or without prosthesis 5341
49606 with removal of prosthesis, final reduction  and closure, in operating room 5341
49610 Repair of omphalocele (Gross type operation); first stage 5349
49611 second stage 5349
Unspecified Age 49505 Repair initial inguinal hernia, age 5 years or over; reducible 5300
49507 incarcerated or strangulated 5300
49520 Repair recurrent inguinal hernia, any age; reducible 5300
49521 incarcerated or strangulated 5300
49525 Repair inguinal hernia; sliding, any age 5300
49540 Repair lumbar hernia 539
49550 Repair initial femoral hernia, any age; reducible 5329
49553 incarcerated or strangulated 5329
49555 Repair recurrent femoral hernia; reducible 5329
49557 incarcerated or strangulated 5329
49560 Repair initial incisional or ventral hernia; reducible 5351
49561 incarcerated or strangulated 5351
49565 Repair recurrent incisional or ventral hernia; reducible 5351
49566 incarcerated or strangulated 5351
49568 Implantation of mesh or other prosthesis for incisional or ventral hernia repair (List separately in addition to code for the incisional or ventral hernia repair) 5351
(49565)
49570 Repair epigastric hernia (e.g. Preperitoneal fat); reducible (separate procedure) 5359
49572 incarcerated or strangulated 5359
49585 Repair umbilical hernia, age 5 years or over;      reducible 5349
49587 incarcerated or strangulated 5349
49590 Repair spigelian hernia 5359
49600 Repair of small omphalocele, with primary closure 5349
49650 Laparoscopy, surgical: repair initial inguinal hernia 5300
5421
49651 Repair recurrent inguinal hernia 5300
5421
49659 Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy 539
5421

Hysterectomy

CPT Code Description ICD-9 Procedure
58550 Laparoscopy, surgical: with vaginal hysterectomy with or without removal of tube(s), with or without removal of ovary(s) (laparoscopic assisted vaginal hysterectomy) 6851
58551 with removal of leiomyomata (single or multiple) 6829
5421

Knee Anthroscopy

CPT Code Description ICD-9 Procedure
29871 Arthroscopy, knee, surgical; for infection, lavage and drainage 8016
29874 for removal of loose body or foreign body (e.g. Osteochondritis dissecans fragmentation, chondral fragmentation) 8016
29875 synovectomy, limited (e.g. Plica or shelf resection) (separate procedure) 8076
29876 synovectomy, major, two or more compartments (e.g. medial or lateral) 8076
29877 debridement/shaving of articular cartilage (chondroplasty) 8086
29879 abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture 8147
29880 with meniscectomy (medial AND lateral, including any meniscal shaving) 806
29881 with meniscectomy (medial OR lateral, including any meniscal shaving) 806
29882 with meniscus repair (medial OR lateral) 8147
29883 with meniscus repair (medial AND lateral) 8147
29884 with lysis of adhesions, with or without manipulation (separate procedure) 8046
29885 drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion) 8147
29886 drilling for intact osteochondritis dissecans lesion 8147
29887 drilling for intact osteochondritis dissecans lesion with internal fixation 8147
29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction 8145
29889 Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction 8145

Liposuction

Sub Group CPT Code Description ICD-9 Procedure
Head neck 15876 Suction assisted lipectomy; head and neck 8683
Lower Extremity 15879 lower extremity 8683
Upper Extremity 15878 upper extremity 8683
Trunk Ext. 15877 trunk 8683

Other Gynecological Procedures

Sub Group CPT Code Description ICD-9 Procedure
Birth Control 58671 with occlusion of oviducts by device (e.g. band, clip or Falope ring) 6629
D&C/Removal Fabroids 58559 with lysis of intrauterine adhesions (any method) 6821
6812
58561 with removal of leiomyomata 6829
6812
58563 with endometrial ablation (any method) 6823
58661 with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) 6541
58670 with fulguration of oviducts (with or without transection) 6629
Fertility related 58560 with division or resection of intrauterine septum (any method) 6822
6812
58672 with fimbrioplasty 6679
5421
58673 with salpingostomy (salpingoneostomy) 6602
5421
Removal adhesions 58660 Laparoscopy, surgical with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) 6581
58662 with fulguration or excision of lesions of the ovary, pelvic viscera or peritoneal surface by any method 6525