|
Circum 28 days or older
|
$130.15 |
$130.15 |
$130.15 |
$3,860.64
|
|
Circumcise/surg/28 days or < 54160
|
$148.20 |
$148.20 |
$148.20 |
$1,219.20
|
|
Circumcision (newborn)
|
$98.61 |
$98.61 |
$98.61 |
$1,395.20
|
|
C-laminoplasty w/graft/plate
|
$1,079.96 |
$1,079.96 |
$1,079.96 |
$4,108.00
|
|
Claviculectomy partial
|
$396.53 |
$396.53 |
$396.53 |
$3,594.44
|
|
Clean out mastoid cavity
|
$146.30 |
$146.30 |
$146.30 |
$1,033.60
|
|
Clearance of tear duct
|
$167.96 |
$167.96 |
$167.96 |
$656.38
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$8.39 |
$8.39 |
$8.39 |
$55.20
|
|
Clip ligating vesolock lg
|
$1,385.10 |
$1,385.10 |
$1,385.10 |
$4,320.00
|
|
Clip phn wireless f/baha4 proc
|
$474.43 |
$474.43 |
$474.43 |
$538.82
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$18.05 |
$18.05 |
$18.05 |
$81.90
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$266.57 |
$266.57 |
$266.57 |
$508.45
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$475.19 |
$475.19 |
$475.19 |
$1,615.35
|
|
Closed tx humerus fx with manip 23605
|
$325.66 |
$325.66 |
$325.66 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$236.93 |
$236.93 |
$236.93 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$310.27 |
$310.27 |
$310.27 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$73.91 |
$73.91 |
$73.91 |
$376.96
|
|
Closed tx orbit without manipulj
|
$151.62 |
$151.62 |
$151.62 |
$998.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$388.93 |
$388.93 |
$388.93 |
$2,520.60
|
|
Closed tx septal&nose fx
|
$205.20 |
$205.20 |
$205.20 |
$3,624.40
|
|
Closed tx sesamoid fx 28530
|
$72.96 |
$72.96 |
$72.96 |
$445.00
|
|
Closed tx/talus fracture without manip 28430
|
$168.91 |
$168.91 |
$168.91 |
$421.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$153.52 |
$153.52 |
$153.52 |
$481.80
|
|
Close tear duct opening
|
$98.04 |
$98.04 |
$98.04 |
$436.44
|
|
Close tear duct opening
|
$97.66 |
$97.66 |
$97.66 |
$353.74
|
|
Clostridium toxin a w/optic
|
$60.80 |
$60.80 |
$60.80 |
$35.20
|
|
Clos txnose fx without stablz 21315
|
$105.45 |
$105.45 |
$105.45 |
$2,326.08
|
|
Closure enterostomy lg/sm intestine 44620
|
$551.57 |
$551.57 |
$551.57 |
$1,641.60
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$1,001.11 |
$1,001.11 |
$1,001.11 |
$2,835.00
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$643.72 |
$643.72 |
$643.72 |
$1,934.40
|
|
Closure intestinal cutaneous fistula 44640
|
$880.84 |
$880.84 |
$880.84 |
$3,443.20
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$136.99 |
$136.99 |
$136.99 |
$1,259.62
|
|
Closure of eyelid by suture
|
$63.46 |
$63.46 |
$63.46 |
$1,613.00
|
|
Closure of windpipe lesion 31820
|
$220.21 |
$220.21 |
$220.21 |
$3,837.72
|
|
Clot factor fletcher fact
|
$21.87 |
$21.87 |
$21.87 |
$119.50
|
|
Clot factor wght kininogen
|
$33.92 |
$33.92 |
$33.92 |
$167.96
|
|
Clot factor xii hageman
|
$3.27 |
$3.27 |
$3.27 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$1.50 |
$1.50 |
$1.50 |
$55.44
|
|
Clot factor xiii fibrin stab
|
$2.76 |
$2.76 |
$2.76 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$233.70 |
$233.70 |
$233.70 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$238.07 |
$238.07 |
$238.07 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$247.00 |
$247.00 |
$247.00 |
$476.80
|
|
Clsd tx clavicle dislocation without manip 23540
|
$167.58 |
$167.58 |
$167.58 |
$419.29
|
|
Clsd tx/clavicular fx without manip 23500
|
$162.45 |
$162.45 |
$162.45 |
$448.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$136.23 |
$136.23 |
$136.23 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$265.05 |
$265.05 |
$265.05 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$221.16 |
$221.16 |
$221.16 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$70.49 |
$70.49 |
$70.49 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$495.52 |
$495.52 |
$495.52 |
$2,184.08
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$372.21 |
$372.21 |
$372.21 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$203.11 |
$203.11 |
$203.11 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$101.08 |
$101.08 |
$101.08 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$115.90 |
$115.90 |
$115.90 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$242.25 |
$242.25 |
$242.25 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$371.83 |
$371.83 |
$371.83 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$206.91 |
$206.91 |
$206.91 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$358.91 |
$358.91 |
$358.91 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$192.66 |
$192.66 |
$192.66 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$284.43 |
$284.43 |
$284.43 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$270.18 |
$270.18 |
$270.18 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$256.50 |
$256.50 |
$256.50 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$247.76 |
$247.76 |
$247.76 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$406.03 |
$406.03 |
$406.03 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$167.20 |
$167.20 |
$167.20 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$215.27 |
$215.27 |
$215.27 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$233.13 |
$233.13 |
$233.13 |
$606.00
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$344.28 |
$344.28 |
$344.28 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$158.46 |
$158.46 |
$158.46 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$153.52 |
$153.52 |
$153.52 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$147.25 |
$147.25 |
$147.25 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$228.38 |
$228.38 |
$228.38 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$235.60 |
$235.60 |
$235.60 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$230.66 |
$230.66 |
$230.66 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$88.73 |
$88.73 |
$88.73 |
$416.35
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$279.11 |
$279.11 |
$279.11 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$144.40 |
$144.40 |
$144.40 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$189.05 |
$189.05 |
$189.05 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$280.63 |
$280.63 |
$280.63 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$172.33 |
$172.33 |
$172.33 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$276.45 |
$276.45 |
$276.45 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$341.24 |
$341.24 |
$341.24 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$279.11 |
$279.11 |
$279.11 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$236.74 |
$236.74 |
$236.74 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$95.76 |
$95.76 |
$95.76 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$63.08 |
$63.08 |
$63.08 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$234.08 |
$234.08 |
$234.08 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$300.20 |
$300.20 |
$300.20 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$190.00 |
$190.00 |
$190.00 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$201.21 |
$201.21 |
$201.21 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$216.60 |
$216.60 |
$216.60 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$219.45 |
$219.45 |
$219.45 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$232.56 |
$232.56 |
$232.56 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$208.05 |
$208.05 |
$208.05 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$279.68 |
$279.68 |
$279.68 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$310.27 |
$310.27 |
$310.27 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$235.79 |
$235.79 |
$235.79 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$349.41 |
$349.41 |
$349.41 |
$1,815.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$221.54 |
$221.54 |
$221.54 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$337.63 |
$337.63 |
$337.63 |
$2,437.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$627.00 |
$627.00 |
$627.00 |
$6,776.64
|