|
Clsd tx humerus fract without manip 24500
|
$229.50 |
$229.50 |
$229.50 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$221.68 |
$221.68 |
$221.68 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$363.29 |
$363.29 |
$363.29 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$149.60 |
$149.60 |
$149.60 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$192.61 |
$192.61 |
$192.61 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$208.59 |
$208.59 |
$208.59 |
$606.00
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$308.04 |
$308.04 |
$308.04 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$141.78 |
$141.78 |
$141.78 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$137.36 |
$137.36 |
$137.36 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$564.74 |
$564.74 |
$564.74 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$204.34 |
$204.34 |
$204.34 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$210.80 |
$210.80 |
$210.80 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$206.38 |
$206.38 |
$206.38 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$79.39 |
$79.39 |
$79.39 |
$416.35
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$249.73 |
$249.73 |
$249.73 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$129.20 |
$129.20 |
$129.20 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$169.15 |
$169.15 |
$169.15 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$251.09 |
$251.09 |
$251.09 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$154.19 |
$154.19 |
$154.19 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$247.35 |
$247.35 |
$247.35 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$305.32 |
$305.32 |
$305.32 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$249.73 |
$249.73 |
$249.73 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$211.82 |
$211.82 |
$211.82 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$85.68 |
$85.68 |
$85.68 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$56.44 |
$56.44 |
$56.44 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$209.44 |
$209.44 |
$209.44 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$268.60 |
$268.60 |
$268.60 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$170.00 |
$170.00 |
$170.00 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$180.03 |
$180.03 |
$180.03 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$193.80 |
$193.80 |
$193.80 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$196.35 |
$196.35 |
$196.35 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$208.08 |
$208.08 |
$208.08 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$186.15 |
$186.15 |
$186.15 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$250.24 |
$250.24 |
$250.24 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$277.61 |
$277.61 |
$277.61 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$210.97 |
$210.97 |
$210.97 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$312.63 |
$312.63 |
$312.63 |
$1,815.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$198.22 |
$198.22 |
$198.22 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$302.09 |
$302.09 |
$302.09 |
$2,437.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$561.00 |
$561.00 |
$561.00 |
$6,776.64
|
|
Cltx post ankle fx
|
$185.30 |
$185.30 |
$185.30 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$276.25 |
$276.25 |
$276.25 |
$1,893.86
|
|
Cltx strnclav dislc w/mnpj
|
$227.63 |
$227.63 |
$227.63 |
$619.30
|
|
Cmbn ant pst colprhy
|
$451.01 |
$451.01 |
$451.01 |
$4,928.00
|
|
Cmptr ophth dx img ant segmt
|
$12.92 |
$12.92 |
$12.92 |
$115.95
|
|
Cmptr ophth img optic nerve
|
$13.26 |
$13.26 |
$13.26 |
$119.00
|
|
#cmvcul-virus inoculation shell
|
$4.14 |
$4.14 |
$4.14 |
$100.80
|
|
Cmv pcr-sendout
|
$11.14 |
$11.14 |
$11.14 |
$177.50
|
|
Co2 monitor per day
|
$152.83 |
$152.83 |
$152.83 |
$450.60
|
|
Coagulation time activated teg
|
$10.71 |
$10.71 |
$10.71 |
$53.72
|
|
Cocaine 4 % nasal solution
|
$683.36 |
$683.36 |
$683.36 |
$629.41
|
|
Cold agglutinin screen (arc)
|
$29.75 |
$29.75 |
$29.75 |
$45.00
|
|
Cold agglutinin titer
|
$105.57 |
$105.57 |
$105.57 |
$50.00
|
|
Colectomy/end colost/close dis seg 44143
|
$932.62 |
$932.62 |
$932.62 |
$2,880.80
|
|
Colectomy/ ileostomy without prctect 44150
|
$1,053.49 |
$1,053.49 |
$1,053.49 |
$3,530.40
|
|
Colectomy/ ileostomy w/prctect 44155
|
$1,175.21 |
$1,175.21 |
$1,175.21 |
$4,562.58
|
|
Colectomy partial w/anastomosis 44140
|
$761.09 |
$761.09 |
$761.09 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$1,090.21 |
$1,090.21 |
$1,090.21 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$934.15 |
$934.15 |
$934.15 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$1,188.30 |
$1,188.30 |
$1,188.30 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$705.16 |
$705.16 |
$705.16 |
$2,343.60
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$1,025.10 |
$1,025.10 |
$1,025.10 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$996.37 |
$996.37 |
$996.37 |
$3,176.40
|
|
Collagenase, clost hist inj
|
$51.00 |
$51.00 |
$51.00 |
$12,906.28
|
|
Collagen dressing <=16 sq in
|
$12.41 |
$12.41 |
$12.41 |
$42.50
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$26.86 |
$26.86 |
$26.86 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$44.03 |
$44.03 |
$44.03 |
$70.00
|
|
Collection blood specimen from completely implantable venous access device
|
$48.28 |
$48.28 |
$48.28 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$49.81 |
$49.81 |
$49.81 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$8.16 |
$8.16 |
$8.16 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$105.91 |
$105.91 |
$105.91 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$142.80 |
$142.80 |
$142.80 |
$1,946.25
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$129.71 |
$129.71 |
$129.71 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$113.39 |
$113.39 |
$113.39 |
$1,645.43
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$173.57 |
$173.57 |
$173.57 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$128.69 |
$128.69 |
$128.69 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$115.09 |
$115.09 |
$115.09 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$89.42 |
$89.42 |
$89.42 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$154.19 |
$154.19 |
$154.19 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$121.38 |
$121.38 |
$121.38 |
$1,645.43
|
|
Colonoscopy w/band ligation
|
$133.79 |
$133.79 |
$133.79 |
$2,080.80
|
|
Colonoscopy w/control bleed
|
$394.91 |
$394.91 |
$394.91 |
$2,030.25
|
|
Colonoscopy w/decompression
|
$132.60 |
$132.60 |
$132.60 |
$2,184.00
|
|
Colonoscopy w/dilation
|
$105.40 |
$105.40 |
$105.40 |
$2,495.25
|
|
Colonoscopy w/endoscope Ultrasound
|
$147.56 |
$147.56 |
$147.56 |
$1,645.43
|
|
Colonoscopy w/endoscopic fnb
|
$173.74 |
$173.74 |
$173.74 |
$1,645.43
|
|
Colonoscopy/w endoscopic stent 45389
|
$165.24 |
$165.24 |
$165.24 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$136.51 |
$136.51 |
$136.51 |
$1,395.28
|
|
Colonoscopy w/injection
|
$98.43 |
$98.43 |
$98.43 |
$2,449.20
|
|
Colonoscopy with ablation
|
$138.55 |
$138.55 |
$138.55 |
$3,405.12
|
|
Colonoscopy (with biopsy)
|
$115.09 |
$115.09 |
$115.09 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$246.67 |
$246.67 |
$246.67 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$145.35 |
$145.35 |
$145.35 |
$2,288.00
|
|
Colonoscopy w/ndl aspir/bx
|
$157.42 |
$157.42 |
$157.42 |
$2,495.25
|
|
Colonoscopy w/resection
|
$189.72 |
$189.72 |
$189.72 |
$3,029.60
|
|
Colonoscopy w/stent plcmt
|
$149.43 |
$149.43 |
$149.43 |
$5,824.00
|
|
Colonoscopy w/ultrasound
|
$131.41 |
$131.41 |
$131.41 |
$2,704.00
|
|
Colostomy skin level cecostomy 44320
|
$684.59 |
$684.59 |
$684.59 |
$2,269.80
|
|
Colotomy exploration/bx/foreign body removal 44025
|
$558.96 |
$558.96 |
$558.96 |
$1,746.00
|
|
Colpocleisis (le forte type) 57120
|
$310.76 |
$310.76 |
$310.76 |
$5,419.00
|
