G259

PDF page 421 / J7

Vascular cannulation
  Z459 Arterial puncture ...................................................................... 10.20
# G268 Cannulation of artery for pressure measurements including cut
          down as necessary..............................................................       31.25
      Note:
      G268 is not eligible for payment with G249, G259, G261, G176, G177, G178, G288,
      Z443 or Z440.
# G269 Cannulation of central vein for pressure measurements or for
         feeding line - not to be billed with right heart catheterization
         (Z439) or with Swan-Ganz catheter insertion......................                           31.25
# G270 Intraosseous infusion...............................................................          23.90
# G309 Umbilical artery catheterization (including obtaining of blood
          sample)................................................................................    45.55
    Venipuncture
+ G480 - infant....................................................................................  9.90
+ G482 - child ..................................................................................... 7.35
+ G489 - adolescent or adult ..............................................................          3.54
     Note:
     G489 is not insured when rendered for the monitoring of adverse effects resulting from a calorie
     restricted weight loss program.
+ G483 Therapeutic venisection...........................................................             9.70
  G282 Umbilical vein catheterization (including obtaining of blood
          sample)................................................................................    43.60
# Z438 Insertion of Swan-Ganz catheter (not included in respiratory or
          critical care benefits) ...........................................................       162.50    6
          Note:
          1.Swan-Ganz catheter insertion is included in the anaesthesia basic units of any surgical
            services where anaesthesia basic units are listed
          2.Z438 includes dye dilution densitometry and/or thermal dilution studies, when rendered
            (except in the setting of a cardiac catheterization laboratory).
          [Commentary:
          See G285 for dye dilution densitometry and G286 for thermal dilution studies performed using a
          Swan-Ganz catheter in a cardiac catheterization laboratory.]
# Z456 Insertion of implantable central venous catheter .....................                       296.50    6
# Z457 Surgical removal or repair of tunneled central venous catheter                                60.00    6
# Z446 Insertion of subcutaneous venous access reservoir ...............                            168.00    6
# Z447 - revision same site................................................................         130.70    6
# E684           - when performed in infant or child, to Z456 or Z446 ....add                       233.65

PDF page 426 / J12

Arrhythmia induction
     To include programmed electrical stimulation, drug provocation and termination of arrhythmia, if
     necessary - once per patient per 24 hours.
# G261 - atrial.................................................................................... 331.05
# G259 - ventricular...........................................................................     383.30
       Note:
       G261and/or G259 are not eligible for payment with G521, G522, G523, G395 and G391.

PDF page 427 / J13

Electrophysiologic pacing, mapping and ablation
# G178 - catheter ablation therapy....................................................            352.05
# G179 - repeat pacing, mapping and catheter ablation for additional
          distinct arrhythmia(s) without the use of an advanced
          mapping system .................................................................        111.20
          Note:
          G179 is not eligible for payment with Z423.
# Z424         - transseptal left heart catheterization, with or without
                 pressure measurements, with or without dye injection.......                      297.15    6
          Note:
          1.Z424 is only eligible for payment when rendered with G176, G177 and/or G178.
          2.Z424 is eligible for payment for each transseptal catheter placement to a maximum of 2.
# Z422         - retrograde aortic left heart catheterization with or without
                 pressure measurement(s) ..................................................       210.55    6
          Note:
          1.Z422 is only eligible for payment when rendered with G176, G177 and/or G178.
          2.Z422 is limited to a maximum of one per electrophysiological pacing, mapping and/or
            ablation sitting.
   G115 External cardiac pacing (temporary transthoracic) once per 24-
          hour period .........................................................................    46.30
      Note:
      G115 is not eligible for payment with G521, G522, G523, G395 and G391.
# G366 Testing of arrhythmia inducibility by acute administration of
         anti-arrhythmic or adrenergic drugs to a maximum of 2 per
         24 hours .............................................................................   148.50
          Note:
          G366 is not eligible for payment for the use of isoproterenol for arrhythmia induction when
          rendered with G261 and/or G259.
# Z443 Insertion of temporary endocardial electrode .........................                     154.10    6
# Z431 Repositioning of temporary endocardial electrode .................                          64.25    6
    Endomyocardial Biopsy
# G288 - transvascular, right or left ...................................................         200.00
    Tilt table testing of vasomotor syncope
# G314 - to include arterial cannulation, provocative and blocking
           drugs, physician must be continually present.....................                      112.00

PDF page 662 / Q4

Note:
         Induction of ventricular arrhythmia at time of CD implant payable at 85%. See note re: G259 in
         Diagnostic and Therapeutic Procedures.
# Z415 Removal and/or replacement of implantable cardioverter
         defibrillator ..........................................................................         6         339.45         7

Master, record 1973. Record Layout PDF, page 1.

G25920250401999999990000383300000001916500000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.