|
Transplant femur ridge
|
$841.86 |
$841.86 |
$841.86 |
$2,057.88
|
|
Transplant forearm tendon
|
$684.18 |
$684.18 |
$684.18 |
$3,591.33
|
|
Transplant forearm tendon
|
$683.10 |
$683.10 |
$683.10 |
$3,821.05
|
|
Transplant/graft hand tendon
|
$833.49 |
$833.49 |
$833.49 |
$3,591.33
|
|
Transplant/graft palm tendon
|
$916.11 |
$916.11 |
$916.11 |
$3,821.05
|
|
Transplant hand tendon
|
$684.72 |
$684.72 |
$684.72 |
$3,821.05
|
|
Transplant of thigh tendon
|
$589.95 |
$589.95 |
$589.95 |
$7,807.24
|
|
Transplant palm tendon
|
$802.17 |
$802.17 |
$802.17 |
$3,821.05
|
|
Transplt allo hct/donor
|
$226.80 |
$226.80 |
$226.80 |
$29,206.10
|
|
Transplt autol hct/donor
|
$167.13 |
$167.13 |
$167.13 |
$3,786.00
|
|
Treat ankle dislocation
|
$472.77 |
$472.77 |
$472.77 |
$2,358.40
|
|
Treat ankle dislocation
|
$683.64 |
$683.64 |
$683.64 |
$7,913.97
|
|
Treat ankle dislocation
|
$748.44 |
$748.44 |
$748.44 |
$5,886.74
|
|
Treat ankle fracture
|
$981.18 |
$981.18 |
$981.18 |
$5,488.00
|
|
Treat big toe fracture
|
$473.31 |
$473.31 |
$473.31 |
$4,307.52
|
|
Treat cheek bone fracturemalar 21360
|
$499.23 |
$499.23 |
$499.23 |
$6,489.73
|
|
Treat each add spine fx
|
$246.78 |
$246.78 |
$246.78 |
$675.20
|
|
Treat ectopic pregnancy
|
$709.83 |
$709.83 |
$709.83 |
$4,350.00
|
|
Treat ectopic pregnancy
|
$693.09 |
$693.09 |
$693.09 |
$6,707.99
|
|
Treat ectopic pregnancy
|
$378.54 |
$378.54 |
$378.54 |
$420.60
|
|
Treat elbow dislocation
|
$462.51 |
$462.51 |
$462.51 |
$2,223.20
|
|
Treat elbow dislocation
|
$676.08 |
$676.08 |
$676.08 |
$7,292.92
|
|
Treat elbow fracture
|
$1,013.85 |
$1,013.85 |
$1,013.85 |
$11,488.80
|
|
Treat elbow fracture
|
$568.62 |
$568.62 |
$568.62 |
$1,919.13
|
|
Treat elbow fracture
|
$648.27 |
$648.27 |
$648.27 |
$6,316.80
|
|
Treat eyelid by injection
|
$32.13 |
$32.13 |
$32.13 |
$481.44
|
|
Treat eyelid lesion 67850
|
$124.74 |
$124.74 |
$124.74 |
$1,146.13
|
|
Treat finger fracture each
|
$463.05 |
$463.05 |
$463.05 |
$4,132.02
|
|
Treat finger fracture each
|
$370.98 |
$370.98 |
$370.98 |
$1,536.00
|
|
Treat foot bone lesion
|
$542.43 |
$542.43 |
$542.43 |
$3,839.54
|
|
Treat foot dislocation
|
$347.76 |
$347.76 |
$347.76 |
$2,993.70
|
|
Treat foot dislocation
|
$305.37 |
$305.37 |
$305.37 |
$446.60
|
|
Treat foot dislocation
|
$384.21 |
$384.21 |
$384.21 |
$3,839.54
|
|
Treat fracture of radius
|
$500.85 |
$500.85 |
$500.85 |
$1,790.00
|
|
Treat fracture of radius
|
$531.09 |
$531.09 |
$531.09 |
$1,849.00
|
|
Treat fracture of ulna
|
$447.66 |
$447.66 |
$447.66 |
$726.05
|
|
Treat/graft heel fracture
|
$1,216.62 |
$1,216.62 |
$1,216.62 |
$10,629.07
|
|
Treat hand bone lesion
|
$534.06 |
$534.06 |
$534.06 |
$3,073.20
|
|
Treat hand dislocation
|
$560.25 |
$560.25 |
$560.25 |
$3,821.05
|
|
Treat hand dislocation
|
$593.73 |
$593.73 |
$593.73 |
$3,839.54
|
|
Treat heel fracture
|
$1,055.43 |
$1,055.43 |
$1,055.43 |
$8,269.81
|
|
Treat hip dislocation
|
$697.95 |
$697.95 |
$697.95 |
$2,192.80
|
|
Treat hip dislocation
|
$878.31 |
$878.31 |
$878.31 |
$3,342.87
|
|
Treat humerus fracture
|
$831.60 |
$831.60 |
$831.60 |
$13,278.70
|
|
Treat humerus fracture
|
$807.03 |
$807.03 |
$807.03 |
$12,896.80
|
|
Treat humerus fracture
|
$554.85 |
$554.85 |
$554.85 |
$1,771.43
|
|
Treat humerus fracture
|
$874.26 |
$874.26 |
$874.26 |
$12,653.00
|
|
Treat humerus fracture
|
$973.89 |
$973.89 |
$973.89 |
$10,742.40
|
|
Treat humerus fracture
|
$484.11 |
$484.11 |
$484.11 |
$1,771.43
|
|
Treat humerus fracture
|
$699.84 |
$699.84 |
$699.84 |
$11,250.40
|
|
Treat humerus fracture
|
$791.91 |
$791.91 |
$791.91 |
$10,629.07
|
|
Treat humerus fracture
|
$782.46 |
$782.46 |
$782.46 |
$6,839.00
|
|
Treat kneecap dislocation
|
$475.74 |
$475.74 |
$475.74 |
$1,068.90
|
|
Treat kneecap fracture
|
$712.26 |
$712.26 |
$712.26 |
$6,311.00
|
|
Treat knee dislocation
|
$607.50 |
$607.50 |
$607.50 |
$2,220.89
|
|
Treat knee fracture
|
$833.22 |
$833.22 |
$833.22 |
$3,486.60
|
|
Treat knee fracture
|
$1,107.81 |
$1,107.81 |
$1,107.81 |
$4,521.40
|
|
Treat knee fracture
|
$768.69 |
$768.69 |
$768.69 |
$2,938.00
|
|
Treat knee fracture 27530
|
$310.77 |
$310.77 |
$310.77 |
$550.00
|
|
Treat knuckle dislocation
|
$391.77 |
$391.77 |
$391.77 |
$1,523.90
|
|
Treat knuckle dislocation
|
$554.31 |
$554.31 |
$554.31 |
$4,332.00
|
|
Treat lower jaw fracture 21462
|
$1,110.51 |
$1,110.51 |
$1,110.51 |
$7,000.36
|
|
Treat lower leg bone lesion
|
$563.49 |
$563.49 |
$563.49 |
$3,977.49
|
|
Treat lower leg dislocation
|
$720.09 |
$720.09 |
$720.09 |
$6,311.00
|
|
Treat lower leg fracture
|
$807.57 |
$807.57 |
$807.57 |
$6,475.41
|
|
Treat lower leg fracture
|
$1,055.43 |
$1,055.43 |
$1,055.43 |
$14,241.77
|
|
Treat lower leg fracture
|
$1,239.84 |
$1,239.84 |
$1,239.84 |
$12,653.00
|
|
Treat lower leg joint
|
$670.95 |
$670.95 |
$670.95 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$789.48 |
$789.48 |
$789.48 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$998.73 |
$998.73 |
$998.73 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$710.10 |
$710.10 |
$710.10 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$279.18 |
$279.18 |
$279.18 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$181.17 |
$181.17 |
$181.17 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$86.13 |
$86.13 |
$86.13 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$244.35 |
$244.35 |
$244.35 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$356.40 |
$356.40 |
$356.40 |
$3,982.44
|
|
Treatment mouth roof lesion
|
$216.00 |
$216.00 |
$216.00 |
$4,256.70
|
|
Treatment of ankle fracture
|
$611.55 |
$611.55 |
$611.55 |
$8,412.89
|
|
Treatment of ankle fracture
|
$721.17 |
$721.17 |
$721.17 |
$8,453.60
|
|
Treatment of ankle fracture
|
$825.12 |
$825.12 |
$825.12 |
$7,907.11
|
|
Treatment of ankle fracture
|
$926.37 |
$926.37 |
$926.37 |
$7,913.97
|
|
Treatment of ankle fracture 27786
|
$428.76 |
$428.76 |
$428.76 |
$520.80
|
|
Treatment of fibula fracture
|
$673.11 |
$673.11 |
$673.11 |
$6,311.00
|
|
Treatment of fibula fracture 27780
|
$311.85 |
$311.85 |
$311.85 |
$491.50
|
|
Treatment of foot infection
|
$130.14 |
$130.14 |
$130.14 |
$2,614.25
|
|
Treatment of foot infection
|
$352.89 |
$352.89 |
$352.89 |
$3,821.05
|
|
Treatment of heel fracture 28400
|
$247.86 |
$247.86 |
$247.86 |
$473.00
|
|
Treatment of miscarriage
|
$345.33 |
$345.33 |
$345.33 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$249.21 |
$249.21 |
$249.21 |
$3,589.62
|
|
Treatment of penis lesion
|
$581.04 |
$581.04 |
$581.04 |
$4,081.37
|
|
Treatment of penis lesion
|
$402.03 |
$402.03 |
$402.03 |
$3,515.40
|
|
Treatment of retinal lesion
|
$470.34 |
$470.34 |
$470.34 |
$1,033.14
|
|
Treatment of thigh fracture
|
$1,246.05 |
$1,246.05 |
$1,246.05 |
$5,109.00
|
|
Treatment of thigh fracture
|
$510.84 |
$510.84 |
$510.84 |
$548.90
|
|
Treatment of thigh fracture
|
$645.84 |
$645.84 |
$645.84 |
$6,389.60
|
|
Treatment of thigh fracture
|
$639.90 |
$639.90 |
$639.90 |
$1,772.97
|
|
Treatment of thigh fracture
|
$921.78 |
$921.78 |
$921.78 |
$3,409.00
|
|
Treatment of thigh fracture
|
$900.18 |
$900.18 |
$900.18 |
$3,764.80
|
|
Treatment of thigh fracture
|
$1,137.24 |
$1,137.24 |
$1,137.24 |
$5,505.50
|
|
Treatment of thigh fracture
|
$895.86 |
$895.86 |
$895.86 |
$3,796.00
|
