|
Treat finger fracture each
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$4,108.00
|
|
Treat finger fracture each
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,815.75
|
|
Treat foot dislocation
|
$140.00 |
$140.00 |
$140.00 |
$435.60
|
|
Treat foot dislocation
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$3,935.24
|
|
Treat foot dislocation
|
$140.00 |
$140.00 |
$140.00 |
$527.28
|
|
Treat foot dislocation
|
$156.80 |
$156.80 |
$156.80 |
$478.40
|
|
Treat foot dislocation
|
$258.65 |
$258.65 |
$258.65 |
$404.04
|
|
Treat fracture of radius
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$2,030.33
|
|
Treat fracture of radius
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$2,316.75
|
|
Treat fracture of ulna
|
$156.80 |
$156.80 |
$156.80 |
$766.72
|
|
Treat hand dislocation
|
$1,193.50 |
$1,193.50 |
$1,193.50 |
$1,893.86
|
|
Treat hip dislocation
|
$2,558.85 |
$2,558.85 |
$2,558.85 |
$2,561.90
|
|
Treat hip dislocation
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$3,152.05
|
|
Treat hip socket fracture
|
$3,930.50 |
$3,930.50 |
$3,930.50 |
$1,340.10
|
|
Treat humerus fracture
|
$9,313.85 |
$9,313.85 |
$9,313.85 |
$11,850.08
|
|
Treat humerus fracture
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,950.60
|
|
Treat humerus fracture
|
$9,313.85 |
$9,313.85 |
$9,313.85 |
$12,653.00
|
|
Treat humerus fracture
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$2,045.35
|
|
Treat kneecap dislocation
|
$190.05 |
$190.05 |
$190.05 |
$1,351.35
|
|
Treat knee dislocation
|
$2,558.85 |
$2,558.85 |
$2,558.85 |
$2,592.08
|
|
Treat knee fracture 27530
|
$140.00 |
$140.00 |
$140.00 |
$580.20
|
|
Treat knee fracture(s)
|
$140.00 |
$140.00 |
$140.00 |
$642.00
|
|
Treat knuckle dislocation
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,893.86
|
|
Treat lower leg dislocation
|
$156.80 |
$156.80 |
$156.80 |
$532.60
|
|
Treat lower leg dislocation
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$4,350.00
|
|
Treat lower leg fracture
|
$9,313.85 |
$9,313.85 |
$9,313.85 |
$12,905.86
|
|
Treat lower leg fracture
|
$9,313.85 |
$9,313.85 |
$9,313.85 |
$12,653.00
|
|
Treat lower leg joint
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$3,165.75 |
$3,165.75 |
$3,165.75 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$1,246.00 |
$1,246.00 |
$1,246.00 |
$3,806.40
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$386.05 |
$386.05 |
$386.05 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,246.00 |
$1,246.00 |
$1,246.00 |
$3,820.53
|
|
Treatment mouth roof lesion
|
$1,470.70 |
$1,470.70 |
$1,470.70 |
$4,350.00
|
|
Treatment of ankle fracture
|
$3,165.75 |
$3,165.75 |
$3,165.75 |
$7,907.11
|
|
Treatment of ankle fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,907.11
|
|
Treatment of ankle fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,348.32
|
|
Treatment of ankle fracture 27786
|
$156.80 |
$156.80 |
$156.80 |
$580.00
|
|
Treatment of fibula fracture
|
$3,165.75 |
$3,165.75 |
$3,165.75 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$156.80 |
$156.80 |
$156.80 |
$558.75
|
|
Treatment of heel fracture 28400
|
$140.00 |
$140.00 |
$140.00 |
$494.00
|
|
Treatment of miscarriage
|
$1,246.00 |
$1,246.00 |
$1,246.00 |
$4,146.69
|
|
Treatment of thigh fracture
|
$227.15 |
$227.15 |
$227.15 |
$467.25
|
|
Treatment of thigh fracture
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$1,893.86
|
|
Treatment of thigh fracture
|
$156.80 |
$156.80 |
$156.80 |
$659.00
|
|
Treatment of thigh fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$6,651.45
|
|
Treatment of thigh fracture
|
$2,558.85 |
$2,558.85 |
$2,558.85 |
$2,055.00
|
|
Treatment of tibia fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$6,183.84
|
|
Treatment of toe fracture 28510
|
$156.80 |
$156.80 |
$156.80 |
$371.40
|
|
Treatment radiation delivery level 2
|
$124.25 |
$124.25 |
$124.25 |
$735.00
|
|
Treat metacarpal fracture
|
$3,930.50 |
$3,930.50 |
$3,930.50 |
$3,958.50
|
|
Treat metacarpal fracture
|
$3,930.50 |
$3,930.50 |
$3,930.50 |
$4,627.00
|
|
Treat metatarsal fracture
|
$3,165.75 |
$3,165.75 |
$3,165.75 |
$7,913.97
|
|
Treat midfoot fracture each
|
$1,193.50 |
$1,193.50 |
$1,193.50 |
$1,893.86
|
|
Treat sternum fracture
|
$361.90 |
$361.90 |
$361.90 |
$423.00
|
|
Treat thigh fracture
|
$156.80 |
$156.80 |
$156.80 |
$661.00
|
|
Treat thigh fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,372.60
|
|
Treat thigh fracture
|
$1,193.50 |
$1,193.50 |
$1,193.50 |
$2,021.04
|
|
Treat thigh fracture
|
$140.00 |
$140.00 |
$140.00 |
$716.95
|
|
Treat thigh fracture
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$2,090.14
|
|
Treat thigh fx growth plate
|
$140.00 |
$140.00 |
$140.00 |
$421.50
|
|
Treat toe dislocation
|
$190.05 |
$190.05 |
$190.05 |
$855.66
|
|
Treat toe fracture
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$3,981.06
|
|
Treat ulnar fracture
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,861.60
|
|
Treat vaginal bleeding
|
$156.80 |
$156.80 |
$156.80 |
$400.86
|
|
Treat wrist bone fracture
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,907.64
|
|
Treat wrist dislocation
|
$190.05 |
$190.05 |
$190.05 |
$760.00
|
|
Trg gene rearrangement anal
|
$73.50 |
$73.50 |
$73.50 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$34.14 |
$34.14 |
$34.14 |
$55.80
|
|
Triglycerides
|
$53.90 |
$53.90 |
$53.90 |
$54.60
|
|
Trim nondyst nails
|
$122.85 |
$122.85 |
$122.85 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$140.00 |
$140.00 |
$140.00 |
$777.00
|
|
Trnscath plc stent crv crtd w/prtct
|
$28,273.70 |
$28,273.70 |
$28,273.70 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,041.90 |
$2,041.90 |
$2,041.90 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,041.90 |
$2,041.90 |
$2,041.90 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$4,764.20 |
$4,764.20 |
$4,764.20 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$7,378.35 |
$7,378.35 |
$7,378.35 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$7,137.20 |
$7,137.20 |
$7,137.20 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$8,381.80 |
$8,381.80 |
$8,381.80 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$8,381.80 |
$8,381.80 |
$8,381.80 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$5,662.65 |
$5,662.65 |
$5,662.65 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$4,805.85 |
$4,805.85 |
$4,805.85 |
$4,805.85
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$1,371.30 |
$1,371.30 |
$1,371.30 |
$2,343.60
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,146.85 |
$3,146.85 |
$3,146.85 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,146.85 |
$3,146.85 |
$3,146.85 |
$3,322.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$3,146.85 |
$3,146.85 |
$3,146.85 |
$2,355.65
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$3,152.80 |
$3,152.80 |
$3,152.80 |
$2,328.30
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,644.30 |
$1,644.30 |
$1,644.30 |
$2,190.24
|
|
Troponin quantitative
|
$156.10 |
$156.10 |
$156.10 |
$123.75
|
|
Tube trach disp innr can 5 xlt
|
$375.95 |
$375.95 |
$375.95 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$14,138.60 |
$14,138.60 |
$14,138.60 |
$32,426.20
|
|
Tx closed hip disl traumatic without anes
|
$156.80 |
$156.80 |
$156.80 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$229.25 |
$229.25 |
$229.25 |
$635.46
|
|
Tx l/r atrial fib addl
|
$3,400.60 |
$3,400.60 |
$3,400.60 |
$7,717.80
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$4,449.44
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$4,281.00
|
|
Tx open nsl fx uncomp
|
$1,470.70 |
$1,470.70 |
$1,470.70 |
$4,007.22
|
