|
Clot factor xiii fibrin stab
|
$2.90 |
$2.90 |
$2.90 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$246.00 |
$246.00 |
$246.00 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$250.60 |
$250.60 |
$250.60 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$260.00 |
$260.00 |
$260.00 |
$476.80
|
|
Clsd tx clavicle dislocation without manip 23540
|
$176.40 |
$176.40 |
$176.40 |
$419.29
|
|
Clsd tx/clavicular fx without manip 23500
|
$171.00 |
$171.00 |
$171.00 |
$448.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$143.40 |
$143.40 |
$143.40 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$279.00 |
$279.00 |
$279.00 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$232.80 |
$232.80 |
$232.80 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$74.20 |
$74.20 |
$74.20 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$521.60 |
$521.60 |
$521.60 |
$2,184.08
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$513.80 |
$513.80 |
$513.80 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$213.80 |
$213.80 |
$213.80 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$106.40 |
$106.40 |
$106.40 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$122.00 |
$122.00 |
$122.00 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$255.00 |
$255.00 |
$255.00 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$391.40 |
$391.40 |
$391.40 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$217.80 |
$217.80 |
$217.80 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$377.80 |
$377.80 |
$377.80 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$202.80 |
$202.80 |
$202.80 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$299.40 |
$299.40 |
$299.40 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$284.40 |
$284.40 |
$284.40 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$270.00 |
$270.00 |
$270.00 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$260.80 |
$260.80 |
$260.80 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$427.40 |
$427.40 |
$427.40 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$176.00 |
$176.00 |
$176.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$226.60 |
$226.60 |
$226.60 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$245.40 |
$245.40 |
$245.40 |
$606.00
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$362.40 |
$362.40 |
$362.40 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$166.80 |
$166.80 |
$166.80 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$161.60 |
$161.60 |
$161.60 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$155.00 |
$155.00 |
$155.00 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$240.40 |
$240.40 |
$240.40 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$248.00 |
$248.00 |
$248.00 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$242.80 |
$242.80 |
$242.80 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$93.40 |
$93.40 |
$93.40 |
$416.35
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$293.80 |
$293.80 |
$293.80 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$152.00 |
$152.00 |
$152.00 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$199.00 |
$199.00 |
$199.00 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$295.40 |
$295.40 |
$295.40 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$181.40 |
$181.40 |
$181.40 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$291.00 |
$291.00 |
$291.00 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$359.20 |
$359.20 |
$359.20 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$293.80 |
$293.80 |
$293.80 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$249.20 |
$249.20 |
$249.20 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$100.80 |
$100.80 |
$100.80 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$66.40 |
$66.40 |
$66.40 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$246.40 |
$246.40 |
$246.40 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$316.00 |
$316.00 |
$316.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$200.00 |
$200.00 |
$200.00 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$211.80 |
$211.80 |
$211.80 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$228.00 |
$228.00 |
$228.00 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$231.00 |
$231.00 |
$231.00 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$244.80 |
$244.80 |
$244.80 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$219.00 |
$219.00 |
$219.00 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$294.40 |
$294.40 |
$294.40 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$326.60 |
$326.60 |
$326.60 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$248.20 |
$248.20 |
$248.20 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$367.80 |
$367.80 |
$367.80 |
$1,815.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$233.20 |
$233.20 |
$233.20 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$355.40 |
$355.40 |
$355.40 |
$2,437.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$660.00 |
$660.00 |
$660.00 |
$6,776.64
|
|
Cltx post ankle fx
|
$218.00 |
$218.00 |
$218.00 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$325.00 |
$325.00 |
$325.00 |
$1,893.86
|
|
Cltx strnclav dislc w/mnpj
|
$267.80 |
$267.80 |
$267.80 |
$619.30
|
|
Cmbn ant pst colprhy
|
$530.60 |
$530.60 |
$530.60 |
$4,928.00
|
|
Cmptr ophth dx img ant segmt
|
$15.20 |
$15.20 |
$15.20 |
$115.95
|
|
Cmptr ophth img optic nerve
|
$15.60 |
$15.60 |
$15.60 |
$119.00
|
|
#cmvcul-virus inoculation shell
|
$4.87 |
$4.87 |
$4.87 |
$100.80
|
|
Cmv pcr-sendout
|
$98.00 |
$98.00 |
$98.00 |
$177.50
|
|
Co2 monitor per day
|
$210.00 |
$210.00 |
$210.00 |
$450.60
|
|
Cold agglutinin screen (arc)
|
$11.80 |
$11.80 |
$11.80 |
$45.00
|
|
Cold agglutinin titer
|
$32.60 |
$32.60 |
$32.60 |
$50.00
|
|
Colectomy/end colost/close dis seg 44143
|
$1,097.20 |
$1,097.20 |
$1,097.20 |
$2,880.80
|
|
Colectomy/ ileostomy without prctect 44150
|
$1,239.40 |
$1,239.40 |
$1,239.40 |
$3,530.40
|
|
Colectomy/ ileostomy w/prctect 44155
|
$1,382.60 |
$1,382.60 |
$1,382.60 |
$4,562.58
|
|
Colectomy partial w/anastomosis 44140
|
$895.40 |
$895.40 |
$895.40 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$1,282.60 |
$1,282.60 |
$1,282.60 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$1,099.00 |
$1,099.00 |
$1,099.00 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$829.60 |
$829.60 |
$829.60 |
$2,343.60
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$1,206.00 |
$1,206.00 |
$1,206.00 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$1,172.20 |
$1,172.20 |
$1,172.20 |
$3,176.40
|
|
Collagenase, clost hist inj
|
$51.40 |
$51.40 |
$51.40 |
$12,906.28
|
|
Collagen dressing <=16 sq in
|
$14.60 |
$14.60 |
$14.60 |
$42.50
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$31.60 |
$31.60 |
$31.60 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$51.80 |
$51.80 |
$51.80 |
$70.00
|
|
Collection blood specimen from completely implantable venous access device
|
$66.20 |
$66.20 |
$66.20 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$105.60 |
$105.60 |
$105.60 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$19.20 |
$19.20 |
$19.20 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$124.60 |
$124.60 |
$124.60 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$168.00 |
$168.00 |
$168.00 |
$1,946.25
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$152.60 |
$152.60 |
$152.60 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$133.40 |
$133.40 |
$133.40 |
$1,645.43
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$204.20 |
$204.20 |
$204.20 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$151.40 |
$151.40 |
$151.40 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$135.40 |
$135.40 |
$135.40 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$105.20 |
$105.20 |
$105.20 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$181.40 |
$181.40 |
$181.40 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$142.80 |
$142.80 |
$142.80 |
$1,645.43
|
