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CPT Code* Fee <br /> <br />Established Patient <br /> <br />99351 <br />99352 <br />99353 <br /> <br />Other <br />58805 <br /> <br />58800 <br />11975 <br />11976 <br /> <br />59841 <br /> <br />99082 <br /> <br />58943 <br /> <br />59870 <br /> <br />70.00 <br />90.00 <br />110.00 <br /> <br />500.00 <br />400.00 <br />800.00 <br />325.00 <br />1,000.00 <br /> <br /> 400.00 <br /> 200.00 <br /> <br />1,300.00 <br /> <br /> 250.00 <br /> <br />~rocedure <br /> <br />Problem focused interval history and examination, <br />straight-forward/low complexity medical decision <br /> <br />Expanded problem; focused interval history and <br />examination, moderate complexity medical decision <br /> <br />Detailed interval history and examination, high <br />complexity medical decision <br /> <br />Drainage of ovarian cyst(s), unilateral or bilateral, <br />(separate procedure); abdominal approach <br /> <br />Drainage of ovarian cyst(s), unilateral or bilateral <br />(separate procedure); vaginal approach <br /> <br />Insertion procedure, implantable contraceptive <br />capsules <br /> <br />Removal without reinsertion, implantable <br />contraceptive capsules <br /> <br />Removal and reinsertion, implantable contraceptive <br />capsules <br /> <br />Induced abortion, by dilation and evacuation <br /> <br />Unusual travel (eg., transportation and escort of <br />patient) <br /> <br />Oophorectomy, partial or total, unilateral or <br />bilateral <br /> <br />Uterine evacuation and curettage for hydatidform mole <br /> <br /> <br />