| Procedure | Description | Amount |
|---|---|---|
| 66984 | CATARACT EXTRACTION WITH IOL | $2,385.38 |
| 66821 | YAG LASER CAPSULOTOMY | $648.78 |
| 15823 | BLEPHAROPLASTY, UPPER LID | $1,936.75 |
| 65855 | SELECTIVE LASER TRABECULOPLASTY | $371.35 |
| 67904 | PTOSIS REPAIR, LEVATOR | $1,742.32 |
| 66761 | YAG LASER IRIDOTOMY | $464.55 |
| 66982 | COMPLEX CATARACT EXTRACTION WITH IOL | $2,385.38 |
| 67917 | ECTROPION REPAIR EXTENSIVE | $1,631.5 |
| 67042 | VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH REMOVAL OF INTERNAL LIMITING MEMBRANE OF RETINA ... | $3,966.69 |
| 37609 | TEMPORAL ARTERY BIOPSY | $1,115.00 |
| 66711 | CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION, ENDOSCOPIC | $1,263.85 |
| 67900 | BROW PTOSIS REPAIR | $1,631.5 |
| 14060 | TISSUE TRANSFER | $1,275 |
| 65426 | PTERYGIUM WITH GRAFT | $2034.70 |
| 67039 | VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH FOCAL ENDOLASER PHOTOCOAGULATION | $3,966.97 |
| 66170 | TRABECULECTOMY WITH MITOMYCIN | $1,925.95 |
| 0191T | INSERTION OF ANTERIOR SEGMENT AQUEOUS DRAINAGE DEVICE, WITHOUT EXTRAOCULAR RESERVOIR; INTERNAL APPROACH | $1,675.94 |
| 67966 | REPAIR V LAT. CANTHYAL ROTATION | $1,481.50 |
| 65400 | PHOTOTTHERAPUETIC KERATECTOMY | $1,042.83 |
| 68720 | DACRYOCYSTORHINOSTOMY (DCR) | $2,020.33 |
| 67108 | REPAIR OF RETINAL DETACHMENT; WITH VITRECTOMY, ANY METHOD, WITH OR WITHOUT AIR OR GAS TAMPONADE, ... | $3,966.98 |
| 67924 | ENTROPION REPAIR | $1,631.50 |
| 66172 | FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO WITH SCARRING FROM PREVIOUS OCULAR ... | $1,804.38 |
| 67312 | STRABISMUS, 2 HORIZ MUSCLES | $1,843.63 |
| 67961 | EXCISE, REPAIR EYELID | $1,481.5 |
| 65756 | KERATOPLASTY (CORNEAL TRANSPLANT); ENDOTHELIAL | $3,850.00 |
| 67880 | TARSORRHAPHY | $1,381.5 |
| 14040 | ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, .. | $1,600.00 |
| 15260 | FULL THICK GRAFT, UP TO 20 SQ CM | $1,115.00 |
| 66180 | BAERVELDT TUBE SHUNT WITH SCLERAL REINFORCEMENT | $2,747.00 |
| 68815 | PROBING LACRIMAL DUCT/ INSERT TUBE | $1,401.50 |
