|
Repair of ruptured tendon
|
$6,484.80 |
$6,484.80 |
$6,484.80 |
$6,484.80
|
|
Repair of shoulder
|
$16,990.40 |
$16,990.40 |
$16,990.40 |
$6,661.18
|
|
Repair of sperm duct
|
$11,261.60 |
$11,261.60 |
$11,261.60 |
$4,525.95
|
|
Repair of thigh muscle
|
$13,759.20 |
$13,759.20 |
$13,759.20 |
$6,727.70
|
|
Repair of tibia
|
$17,382.40 |
$17,382.40 |
$17,382.40 |
$7,349.27
|
|
Repair of tibia epiphysis
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair of toe dislocation
|
$8,741.60 |
$8,741.60 |
$8,741.60 |
$3,839.54
|
|
Repair of ulnar motor nerve 64836
|
$9,144.80 |
$9,144.80 |
$9,144.80 |
$4,881.00
|
|
Repair of urethra defect
|
$7,336.00 |
$7,336.00 |
$7,336.00 |
$4,081.37
|
|
Repair of urethra defect
|
$12,504.80 |
$12,504.80 |
$12,504.80 |
$6,015.75
|
|
Repair of urethra injury
|
$12,504.80 |
$12,504.80 |
$12,504.80 |
$5,741.00
|
|
Repair of urethra injury
|
$10,343.20 |
$10,343.20 |
$10,343.20 |
$6,015.75
|
|
Repair of urethra injury
|
$10,416.00 |
$10,416.00 |
$10,416.00 |
$6,015.75
|
|
Repair of urethra injury 53502
|
$8,215.20 |
$8,215.20 |
$8,215.20 |
$4,272.89
|
|
Repair of urethral lesion
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$3,852.58
|
|
Repair of web finger
|
$6,294.40 |
$6,294.40 |
$6,294.40 |
$2,211.05
|
|
Repair of web finger
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair of web finger
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair of windpipe
|
$11,138.40 |
$11,138.40 |
$11,138.40 |
$6,547.81
|
|
Repair of windpipe
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,547.81
|
|
Repair of windpipe defect
|
$3,180.80 |
$3,180.80 |
$3,180.80 |
$3,589.62
|
|
Repair oronasal fistula 30600
|
$13,227.20 |
$13,227.20 |
$13,227.20 |
$6,705.77
|
|
Repair palate
|
$6,826.40 |
$6,826.40 |
$6,826.40 |
$6,966.64
|
|
Repair palate
|
$9,413.60 |
$9,413.60 |
$9,413.60 |
$6,547.81
|
|
Repair palate pharynx/uvula
|
$5,544.00 |
$5,544.00 |
$5,544.00 |
$5,544.00
|
|
Repair paravag defect lap
|
$13,770.40 |
$13,770.40 |
$13,770.40 |
$11,419.92
|
|
Repair paravag defect vag 57285
|
$16,374.40 |
$16,374.40 |
$16,374.40 |
$8,185.02
|
|
Repair penis
|
$9,856.00 |
$9,856.00 |
$9,856.00 |
$2,874.36
|
|
Repair penis
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$2,874.36
|
|
Repair pm/icd lead dual
|
$11,093.60 |
$11,093.60 |
$11,093.60 |
$4,343.82
|
|
Repair pm/icd lead sgl
|
$11,037.60 |
$11,037.60 |
$11,037.60 |
$4,339.00
|
|
Repair radius or ulna
|
$19,415.20 |
$19,415.20 |
$19,415.20 |
$8,412.89
|
|
Repair radius & ulna
|
$17,729.60 |
$17,729.60 |
$17,729.60 |
$8,453.60
|
|
Repair rectum & vagina
|
$13,238.40 |
$13,238.40 |
$13,238.40 |
$5,394.95
|
|
Repair rectum-vagina fistula
|
$8,344.00 |
$8,344.00 |
$8,344.00 |
$4,035.20
|
|
Repair recur fem hernia reduce 49555
|
$10,757.60 |
$10,757.60 |
$10,757.60 |
$4,176.15
|
|
Repair retinal detach cplx
|
$23,559.20 |
$23,559.20 |
$23,559.20 |
$6,657.60
|
|
Repair & revise nerve add-on
|
$6,199.20 |
$6,199.20 |
$6,199.20 |
$4,448.60
|
|
Repair/revise wrist joint
|
$12,191.20 |
$12,191.20 |
$12,191.20 |
$6,311.00
|
|
Repair rotator cuff acute
|
$19,034.40 |
$19,034.40 |
$19,034.40 |
$7,612.08
|
|
Repair rotator cuff chronic
|
$15,657.60 |
$15,657.60 |
$15,657.60 |
$6,311.00
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$3,382.40 |
$3,382.40 |
$3,382.40 |
$1,006.50
|
|
Repair rpr lip full thickness vermilion only
|
$3,382.40 |
$3,382.40 |
$3,382.40 |
$1,224.63
|
|
Repair salivary duct
|
$4,082.40 |
$4,082.40 |
$4,082.40 |
$6,447.37
|
|
Repair salivary duct
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,547.81
|
|
Repair sciatic nerve
|
$12,532.80 |
$12,532.80 |
$12,532.80 |
$4,858.97
|
|
Repair shoulder capsule
|
$14,862.40 |
$14,862.40 |
$14,862.40 |
$8,070.30
|
|
Repair shoulder capsule
|
$16,833.60 |
$16,833.60 |
$16,833.60 |
$7,842.71
|
|
Repair shoulder capsule
|
$15,159.20 |
$15,159.20 |
$15,159.20 |
$6,820.77
|
|
Repair shoulder capsule
|
$16,990.40 |
$16,990.40 |
$16,990.40 |
$5,855.00
|
|
Repair shoulder capsule
|
$16,990.40 |
$16,990.40 |
$16,990.40 |
$7,154.78
|
|
Repair shoulder capsule
|
$16,990.40 |
$16,990.40 |
$16,990.40 |
$7,690.89
|
|
Repair stern/nuss without scope
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,499.12
|
|
Repair sternum/nuss w/scope
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,499.12
|
|
Repair stomach opening
|
$11,160.80 |
$11,160.80 |
$11,160.80 |
$4,402.32
|
|
Repair tear ducts
|
$6,367.20 |
$6,367.20 |
$6,367.20 |
$2,993.60
|
|
Repair tendon extensor foot 1/2 each tendon
|
$10,925.60 |
$10,925.60 |
$10,925.60 |
$3,839.54
|
|
Repair tendon/muscle forearm/wrist prime sngl ea
|
$5,812.80 |
$5,812.80 |
$5,812.80 |
$4,350.00
|
|
Repair testis injury
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$3,863.60
|
|
Repair throat wound
|
$5,258.40 |
$5,258.40 |
$5,258.40 |
$1,915.20
|
|
Repair toe dislocation
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,591.33
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$478.00
|
|
Repair/transpose mp nerve 64856
|
$12,532.80 |
$12,532.80 |
$12,532.80 |
$5,419.00
|
|
Repair umbilical lesion
|
$8,965.60 |
$8,965.60 |
$8,965.60 |
$4,176.15
|
|
Repair upper arm/elbow tendon/muscle ea
|
$11,748.80 |
$11,748.80 |
$11,748.80 |
$8,453.60
|
|
Repair upper jaw fistula
|
$7,543.20 |
$7,543.20 |
$7,543.20 |
$6,523.41
|
|
Repair urethrovaginal lesion 57310
|
$15,282.40 |
$15,282.40 |
$15,282.40 |
$7,093.16
|
|
Repair uro sphincter
|
$14,000.00 |
$14,000.00 |
$14,000.00 |
$10,106.03
|
|
Repair vagina
|
$7,145.60 |
$7,145.60 |
$7,145.60 |
$5,841.60
|
|
Repair vagina/perineum
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$4,094.65
|
|
Repair valve femoral vein
|
$10,332.00 |
$10,332.00 |
$10,332.00 |
$5,983.35
|
|
Repair webbed toe(s)
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$1,893.86
|
|
Repair windpipe opening
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,547.81
|
|
Repeat thyroid surgery
|
$16,038.40 |
$16,038.40 |
$16,038.40 |
$6,553.49
|
|
Replace afo soft interface
|
$25.20 |
$25.20 |
$25.20 |
$31.08
|
|
Replace aortic valve open axillry 33363
|
$2,710.40 |
$2,710.40 |
$2,710.40 |
$17,009.00
|
|
Replace aortic valve open femoral 33362
|
$2,615.20 |
$2,615.20 |
$2,615.20 |
$15,454.40
|
|
Replace aortic valve open iliac 33364
|
$2,699.20 |
$2,699.20 |
$2,699.20 |
$13,308.36
|
|
Replace aortic valve open transaortic 33365
|
$2,833.60 |
$2,833.60 |
$2,833.60 |
$14,593.50
|
|
Replace aortic valve w/byp cntrl aprch 33369
|
$1,920.80 |
$1,920.80 |
$1,920.80 |
$2,399.20
|
|
Replace aortic valve w/byp open aprch 33368
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$2,638.68
|
|
Replace aortic valve w/byp prq aprch 33367
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$3,088.80
|
|
Replace duod/jej tube perc
|
$2,587.20 |
$2,587.20 |
$2,587.20 |
$1,354.54
|
|
Replace elbow joint
|
$34,412.00 |
$34,412.00 |
$34,412.00 |
$16,139.55
|
|
Replace eye fluid
|
$5,992.00 |
$5,992.00 |
$5,992.00 |
$3,905.20
|
|
Replace foot drop spint
|
$19.60 |
$19.60 |
$19.60 |
$19.60
|
|
Replace g/c tube perc
|
$2,312.80 |
$2,312.80 |
$2,312.80 |
$1,341.50
|
|
Replace g-j tube perc
|
$2,312.80 |
$2,312.80 |
$2,312.80 |
$1,498.53
|
|
Replace high roll cuff
|
$448.00 |
$448.00 |
$448.00 |
$448.00
|
|
Replace/irrigate catheter
|
$4,328.80 |
$4,328.80 |
$4,328.80 |
$3,676.40
|
|
Replace/irrigate catheter
|
$7,873.60 |
$7,873.60 |
$7,873.60 |
$7,088.41
|
|
Replacement of contact lens
|
$256.48 |
$256.48 |
$256.48 |
$107.50
|
|
Replacemnt lithium ionbatter
|
$431.20 |
$431.20 |
$431.20 |
$431.20
|
|
Replace molded calf lacer
|
$582.40 |
$582.40 |
$582.40 |
$582.40
|
|
Replace molded thigh lacer
|
$576.80 |
$576.80 |
$576.80 |
$576.80
|
|
Replace non-molded calf lace
|
$378.00 |
$378.00 |
$378.00 |
$378.00
|
|
Replace non-molded thigh lac
|
$462.00 |
$462.00 |
$462.00 |
$462.00
|
|
Replace picvad cath
|
$7,884.80 |
$7,884.80 |
$7,884.80 |
$3,724.63
|
|
Replace pretibial shell
|
$700.00 |
$700.00 |
$700.00 |
$700.00
|
|
Replace prox & dist upright
|
$397.60 |
$397.60 |
$397.60 |
$397.60
|
