|
Repair anal fistula
|
$1,289.64 |
$1,289.64 |
$1,289.64 |
$3,038.07
|
|
Repair anorectal fist w/plug
|
$1,157.64 |
$1,157.64 |
$1,157.64 |
$3,245.23
|
|
Repair arm/leg nerve
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$6,839.00
|
|
Repair artery rupture aorta
|
$5,413.98 |
$5,413.98 |
$5,413.98 |
$3,553.90
|
|
Repair artery rupture aorta
|
$4,501.86 |
$4,501.86 |
$4,501.86 |
$3,846.40
|
|
Repair art rupture aorta 35082
|
$4,526.28 |
$4,526.28 |
$4,526.28 |
$4,366.80
|
|
Repair art rupture groin 35132
|
$3,404.94 |
$3,404.94 |
$3,404.94 |
$3,404.94
|
|
Repair av fistula ext 35190
|
$1,607.10 |
$1,607.10 |
$1,607.10 |
$6,366.08
|
|
Repair biceps tendon
|
$1,722.60 |
$1,722.60 |
$1,722.60 |
$6,839.00
|
|
Repair bladder defect
|
$1,686.30 |
$1,686.30 |
$1,686.30 |
$5,841.60
|
|
Repair blood ves direct neck 35201
|
$1,982.64 |
$1,982.64 |
$1,982.64 |
$5,907.78
|
|
Repair blood vess/direct/intra/abd 35221
|
$3,138.30 |
$3,138.30 |
$3,138.30 |
$1,904.24
|
|
Repair blood vessel direct hand finger
|
$1,732.50 |
$1,732.50 |
$1,732.50 |
$3,898.50
|
|
Repair blood vessel dir lower extr
|
$1,754.94 |
$1,754.94 |
$1,754.94 |
$1,705.04
|
|
Repair blood vessel dir upper extr
|
$1,723.26 |
$1,723.26 |
$1,723.26 |
$3,879.03
|
|
Repair blood vessel lesion
|
$2,022.24 |
$2,022.24 |
$2,022.24 |
$2,346.40
|
|
Repair blood vessel lesion
|
$2,808.30 |
$2,808.30 |
$2,808.30 |
$5,988.54
|
|
Repair blood vessel lesion
|
$1,842.06 |
$1,842.06 |
$1,842.06 |
$5,983.35
|
|
Repair blood vessel w/graft lower extremity 35286
|
$2,157.54 |
$2,157.54 |
$2,157.54 |
$5,983.35
|
|
Repair bowel-bladder fistula 44660
|
$2,961.42 |
$2,961.42 |
$2,961.42 |
$2,961.42
|
|
Repair bowel-bladder fistula 44661
|
$3,391.08 |
$3,391.08 |
$3,391.08 |
$2,891.40
|
|
Repair bowel fistula 44650
|
$3,154.80 |
$3,154.80 |
$3,154.80 |
$1,558.00
|
|
Repair carpal bone shorten
|
$1,814.34 |
$1,814.34 |
$1,814.34 |
$3,856.00
|
|
Repair cleft hand
|
$3,534.96 |
$3,534.96 |
$3,534.96 |
$4,499.12
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$990.66 |
$990.66 |
$990.66 |
$1,025.95
|
|
Repair corporeal tear
|
$1,551.66 |
$1,551.66 |
$1,551.66 |
$3,769.31
|
|
Repair defect arm art 35045
|
$2,047.32 |
$2,047.32 |
$2,047.32 |
$6,396.89
|
|
Repair defect of artery
|
$2,909.28 |
$2,909.28 |
$2,909.28 |
$2,168.66
|
|
Repair defect of artery
|
$2,092.20 |
$2,092.20 |
$2,092.20 |
$855.90
|
|
Repair defect of artery
|
$2,709.96 |
$2,709.96 |
$2,709.96 |
$1,422.50
|
|
Repair defect of artery
|
$3,706.56 |
$3,706.56 |
$3,706.56 |
$3,131.20
|
|
Repair defect of artery
|
$2,774.64 |
$2,774.64 |
$2,774.64 |
$1,471.00
|
|
Repair defect of artery 35011
|
$2,129.16 |
$2,129.16 |
$2,129.16 |
$6,305.95
|
|
Repair defect of artery 35081
|
$3,614.16 |
$3,614.16 |
$3,614.16 |
$3,497.40
|
|
Repair defect of artery 35102
|
$3,922.38 |
$3,922.38 |
$3,922.38 |
$3,772.80
|
|
Repair defect of artery 35121
|
$3,294.06 |
$3,294.06 |
$3,294.06 |
$2,224.66
|
|
Repair defect of artery aneurysm 35151
|
$2,593.14 |
$2,593.14 |
$2,593.14 |
$5,776.00
|
|
Repair defect of artery carotid subclav 35001
|
$2,337.06 |
$2,337.06 |
$2,337.06 |
$2,165.40
|
|
Repair deformity of toe
|
$852.72 |
$852.72 |
$852.72 |
$3,545.97
|
|
Repair degenerated kneecap
|
$1,886.94 |
$1,886.94 |
$1,886.94 |
$5,886.74
|
|
Repair dental ellis ii fx
|
$139.26 |
$139.26 |
$139.26 |
$442.48
|
|
Repair detached retina pc
|
$635.58 |
$635.58 |
$635.58 |
$1,513.20
|
|
Repair eardrum structures
|
$2,055.90 |
$2,055.90 |
$2,055.90 |
$6,553.49
|
|
Repair elbow deb/attch open
|
$1,545.06 |
$1,545.06 |
$1,545.06 |
$3,839.54
|
|
Repair elbow perc
|
$981.42 |
$981.42 |
$981.42 |
$3,986.00
|
|
Repair elbow w/deb open
|
$1,250.70 |
$1,250.70 |
$1,250.70 |
$3,821.05
|
|
Repair extns tendon finger without grft ea
|
$1,483.02 |
$1,483.02 |
$1,483.02 |
$2,224.00
|
|
Repair eyelid defect
|
$1,108.14 |
$1,108.14 |
$1,108.14 |
$2,966.40
|
|
Repair eyelid defect
|
$1,002.54 |
$1,002.54 |
$1,002.54 |
$2,732.50
|
|
Repair eyelid defect
|
$768.24 |
$768.24 |
$768.24 |
$2,760.73
|
|
Repair eyelid defect
|
$997.26 |
$997.26 |
$997.26 |
$2,982.40
|
|
Repair eyelid defect
|
$1,054.68 |
$1,054.68 |
$1,054.68 |
$2,760.73
|
|
Repair eyelid defect
|
$731.28 |
$731.28 |
$731.28 |
$2,760.73
|
|
Repair eyelid defect
|
$997.26 |
$997.26 |
$997.26 |
$2,982.40
|
|
Repair eyelid defect
|
$1,056.66 |
$1,056.66 |
$1,056.66 |
$2,856.80
|
|
Repair fibula nonunion
|
$2,188.56 |
$2,188.56 |
$2,188.56 |
$6,879.60
|
|
Repair finger/hand tendon
|
$1,762.20 |
$1,762.20 |
$1,762.20 |
$4,150.20
|
|
Repair finger/hand tendon
|
$1,870.44 |
$1,870.44 |
$1,870.44 |
$4,150.20
|
|
Repair finger/hand tendon
|
$1,839.42 |
$1,839.42 |
$1,839.42 |
$3,848.00
|
|
Repair finger/hand tendon
|
$2,054.58 |
$2,054.58 |
$2,054.58 |
$3,839.54
|
|
Repair finger/hand tendon
|
$1,190.64 |
$1,190.64 |
$1,190.64 |
$3,839.54
|
|
Repair finger tendon
|
$1,348.38 |
$1,348.38 |
$1,348.38 |
$3,594.44
|
|
Repair foot dislocation
|
$1,505.46 |
$1,505.46 |
$1,505.46 |
$5,886.74
|
|
Repair foot dislocation
|
$1,929.18 |
$1,929.18 |
$1,929.18 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$1,310.76 |
$1,310.76 |
$1,310.76 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$1,557.60 |
$1,557.60 |
$1,557.60 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$1,486.32 |
$1,486.32 |
$1,486.32 |
$6,311.00
|
|
Repair forearm tendon sheath
|
$1,573.44 |
$1,573.44 |
$1,573.44 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$1,541.76 |
$1,541.76 |
$1,541.76 |
$8,429.28
|
|
Repair/graft femur head/neck
|
$2,655.84 |
$2,655.84 |
$2,655.84 |
$1,293.00
|
|
Repair/graft finger tendon
|
$1,735.80 |
$1,735.80 |
$1,735.80 |
$3,839.54
|
|
Repair/graft finger tendon
|
$1,865.16 |
$1,865.16 |
$1,865.16 |
$3,821.05
|
|
Repair/graft hand tendon
|
$1,948.98 |
$1,948.98 |
$1,948.98 |
$5,560.25
|
|
Repair/graft hand tendon
|
$2,282.28 |
$2,282.28 |
$2,282.28 |
$6,311.00
|
|
Repair/graft hand tendon
|
$2,320.56 |
$2,320.56 |
$2,320.56 |
$5,886.74
|
|
Repair/graft hand tendon
|
$1,677.72 |
$1,677.72 |
$1,677.72 |
$3,931.20
|
|
Repair/graft kneecap tendon
|
$1,898.16 |
$1,898.16 |
$1,898.16 |
$5,339.00
|
|
Repair/graft of foot tendon
|
$1,003.86 |
$1,003.86 |
$1,003.86 |
$5,886.74
|
|
Repair/graft of foot tendon
|
$978.78 |
$978.78 |
$978.78 |
$5,023.20
|
|
Repair/graft of thigh
|
$2,875.62 |
$2,875.62 |
$2,875.62 |
$5,354.05
|
|
Repair/graft of thigh muscle
|
$1,981.98 |
$1,981.98 |
$1,981.98 |
$5,741.00
|
|
Repair/graft of tibia
|
$2,834.70 |
$2,834.70 |
$2,834.70 |
$5,020.60
|
|
Repair/graft radius or ulna
|
$2,383.26 |
$2,383.26 |
$2,383.26 |
$7,907.11
|
|
Repair/graft radius & ulna
|
$2,659.14 |
$2,659.14 |
$2,659.14 |
$7,913.97
|
|
Repair/graft wrist bone
|
$1,783.98 |
$1,783.98 |
$1,783.98 |
$5,376.00
|
|
Repair hand joint
|
$1,645.38 |
$1,645.38 |
$1,645.38 |
$3,839.54
|
|
Repair hand joint with graft
|
$1,956.24 |
$1,956.24 |
$1,956.24 |
$3,839.54
|
|
Repair humerus with graft
|
$2,486.88 |
$2,486.88 |
$2,486.88 |
$11,718.66
|
|
Repair ing hernia sliding
|
$1,286.34 |
$1,286.34 |
$1,286.34 |
$2,812.80
|
|
Repair leg fascia defect
|
$795.30 |
$795.30 |
$795.30 |
$3,821.05
|
|
Repair lip full thkns =<one-half vert height
|
$848.76 |
$848.76 |
$848.76 |
$1,308.00
|
|
Repair lip full thkns >one-half vert height/cmplx
|
$997.92 |
$997.92 |
$997.92 |
$1,928.07
|
|
Repair liver wound 47350
|
$3,007.62 |
$3,007.62 |
$3,007.62 |
$2,581.80
|
|
Repair liver wound 47360
|
$4,098.60 |
$4,098.60 |
$4,098.60 |
$2,909.40
|
|
Repair lower leg tendons
|
$1,156.98 |
$1,156.98 |
$1,156.98 |
$3,821.05
|
|
Repair lumbar hernia
|
$1,503.48 |
$1,503.48 |
$1,503.48 |
$6,457.82
|
|
Repair major blood vessel(s) without bypass 33320
|
$2,303.40 |
$2,303.40 |
$2,303.40 |
$2,071.80
|
|
Repair middle ear structures
|
$1,863.18 |
$1,863.18 |
$1,863.18 |
$3,961.60
|
|
Repair muscles of hand
|
$1,165.56 |
$1,165.56 |
$1,165.56 |
$3,591.33
|
|
Repair nasal septum defect
|
$1,552.32 |
$1,552.32 |
$1,552.32 |
$3,819.23
|