|
Revision of eyelid
|
$455.80 |
$455.80 |
$455.80 |
$3,417.95
|
|
Revision of foot and ankle
|
$770.00 |
$770.00 |
$770.00 |
$6,915.20
|
|
Revision of foot fascia 28250
|
$292.00 |
$292.00 |
$292.00 |
$3,839.54
|
|
Revision of foot tendon
|
$340.60 |
$340.60 |
$340.60 |
$5,886.74
|
|
Revision of ileostomy complicated 44314
|
$677.60 |
$677.60 |
$677.60 |
$2,486.40
|
|
Revision of ileostomy; simple 44312
|
$406.60 |
$406.60 |
$406.60 |
$4,332.25
|
|
Revision of iris
|
$164.80 |
$164.80 |
$164.80 |
$1,388.40
|
|
Revision of kidney/ureter
|
$786.40 |
$786.40 |
$786.40 |
$5,865.60
|
|
Revision of knee joint
|
$557.80 |
$557.80 |
$557.80 |
$15,069.60
|
|
Revision of knee joint
|
$607.20 |
$607.20 |
$607.20 |
$8,885.39
|
|
Revision of knee joint
|
$570.20 |
$570.20 |
$570.20 |
$12,555.20
|
|
Revision of knee joint
|
$790.40 |
$790.40 |
$790.40 |
$14,241.77
|
|
Revision of leg vein 37780
|
$155.40 |
$155.40 |
$155.40 |
$3,724.63
|
|
Revision of nose
|
$296.00 |
$296.00 |
$296.00 |
$3,819.23
|
|
Revision of penis
|
$483.20 |
$483.20 |
$483.20 |
$4,040.25
|
|
Revision of penis
|
$441.00 |
$441.00 |
$441.00 |
$2,739.10
|
|
Revision of penis
|
$288.80 |
$288.80 |
$288.80 |
$4,350.00
|
|
Revision of radius
|
$476.80 |
$476.80 |
$476.80 |
$6,871.42
|
|
Revision of sciatic nerve
|
$414.80 |
$414.80 |
$414.80 |
$2,888.00
|
|
Revision of scrotum
|
$255.20 |
$255.20 |
$255.20 |
$4,081.37
|
|
Revision of thigh muscles
|
$519.80 |
$519.80 |
$519.80 |
$5,886.74
|
|
Revision of ulna
|
$464.00 |
$464.00 |
$464.00 |
$5,376.00
|
|
Revision of unstable kneecap
|
$523.60 |
$523.60 |
$523.60 |
$5,886.74
|
|
Revision of unstable kneecap
|
$521.40 |
$521.40 |
$521.40 |
$6,973.47
|
|
Revision of urethra
|
$317.40 |
$317.40 |
$317.40 |
$4,081.37
|
|
Revision open av fistula without thromb
|
$486.80 |
$486.80 |
$486.80 |
$8,037.35
|
|
Revision/removal of kneecap
|
$525.40 |
$525.40 |
$525.40 |
$6,839.00
|
|
Revis reconst shoulder joint
|
$1,099.80 |
$1,099.80 |
$1,099.80 |
$10,029.25
|
|
Revis reconst shoulder joint
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$7,074.60
|
|
Revj fem anast autog vn grf
|
$782.60 |
$782.60 |
$782.60 |
$6,035.20
|
|
Revj fem anast nonautog grf
|
$755.20 |
$755.20 |
$755.20 |
$6,396.89
|
|
Revj open gstr rstcv px
|
$1,286.60 |
$1,286.60 |
$1,286.60 |
$4,748.80
|
|
Rev-rem impl neurostim gen-rec
|
$205.60 |
$205.60 |
$205.60 |
$4,534.00
|
|
Rev/rmv perph nstim eltrd ra
|
$100.40 |
$100.40 |
$100.40 |
$4,121.65
|
|
Rev/rmv prph sac/gstr npg/r
|
$158.40 |
$158.40 |
$158.40 |
$4,807.27
|
|
Rf abltj nrv nrvtg si jt
|
$136.00 |
$136.00 |
$136.00 |
$3,138.15
|
|
Rheumatoid factor qualitative
|
$18.20 |
$18.20 |
$18.20 |
$57.20
|
|
Rheumatoid factor quantitative
|
$15.40 |
$15.40 |
$15.40 |
$57.00
|
|
Rhinp prim lat&alr crtlge&/elvtn nsl tip
|
$868.00 |
$868.00 |
$868.00 |
$4,256.00
|
|
Rho(d) immune globulin h, sd
|
$28.20 |
$28.20 |
$28.20 |
$3,709.00
|
|
Rho d immune globulin inj
|
$145.00 |
$145.00 |
$145.00 |
$217.71
|
|
Ring fx reform 11-13x17mm
|
$358.20 |
$358.20 |
$358.20 |
$1,509.75
|
|
Risk ascvd tst once pr 12 mo
|
$9.80 |
$9.80 |
$9.80 |
$35.25
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$3,127.42 |
$3,127.42 |
$3,127.42 |
$9,301.22
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$3,035.98 |
$3,035.98 |
$3,035.98 |
$5,343.99
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$2,580.48 |
$2,580.48 |
$2,580.48 |
$5,309.20
|
|
Rmv anterior spine instrumentation 22855
|
$748.40 |
$748.40 |
$748.40 |
$2,667.20
|
|
Rmv implant contraceptive capsule 11976
|
$104.20 |
$104.20 |
$104.20 |
$846.42
|
|
Rmvl esophgl sphnctr dev
|
$452.80 |
$452.80 |
$452.80 |
$5,553.60
|
|
Rmvl ext fixj sys under anes
|
$244.00 |
$244.00 |
$244.00 |
$2,370.00
|
|
Rmvl fb upr arm/elbow deep
|
$286.80 |
$286.80 |
$286.80 |
$3,638.88
|
|
Rmvl fecal impaction/fb spx under anes
|
$159.60 |
$159.60 |
$159.60 |
$2,093.02
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$159.00 |
$159.00 |
$159.00 |
$1,822.05
|
|
Rmvl icd by tv extr
|
$568.40 |
$568.40 |
$568.40 |
$4,306.60
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$256.00 |
$256.00 |
$256.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$266.60 |
$266.60 |
$266.60 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$246.60 |
$246.60 |
$246.60 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$144.60 |
$144.60 |
$144.60 |
$3,977.32
|
|
Rmvl ndwellg tun pleural cath
|
$106.80 |
$106.80 |
$106.80 |
$1,156.80
|
|
Rmvl ninfct mesh hernia rpr 49623
|
$132.80 |
$132.80 |
$132.80 |
$470.40
|
|
Rmvl perm pm pulse gen
|
$157.60 |
$157.60 |
$157.60 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$247.00 |
$247.00 |
$247.00 |
$14,929.60
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$225.00 |
$225.00 |
$225.00 |
$10,542.00
|
|
Rmvl pq iabp
|
$21.80 |
$21.80 |
$21.80 |
$1,008.04
|
|
Rmvl pq vad left hrt vein sep session
|
$120.20 |
$120.20 |
$120.20 |
$2,407.50
|
|
Rmvl prosthhumrl&ulnar cmpnt
|
$866.00 |
$866.00 |
$866.00 |
$5,741.00
|
|
Rmvl subq card rhythm mntr
|
$88.00 |
$88.00 |
$88.00 |
$1,734.00
|
|
Rmvl tot arthrp 1ntrspc crv
|
$1,367.20 |
$1,367.20 |
$1,367.20 |
$7,413.38
|
|
Rmvl tv pm lead dual
|
$421.60 |
$421.60 |
$421.60 |
$4,028.20
|
|
Rmvl tv pm lead sgl
|
$320.40 |
$320.40 |
$320.40 |
$4,031.69
|
|
Rmv prosth mat/mesh/abd wall/infec 11008
|
$177.00 |
$177.00 |
$177.00 |
$538.85
|
|
Romiplostim 125 mcg subcutaneous solution
|
$2,510.75 |
$2,510.75 |
$2,510.75 |
$8,950.11
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$1,198.79 |
$1,198.79 |
$1,198.79 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$39.50 |
$39.50 |
$39.50 |
$188.50
|
|
Routine footcare pt w lops
|
$43.20 |
$43.20 |
$43.20 |
$223.08
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$2,173.60
|
|
Rp loclzj tum 2+area 1+d img
|
$555.00 |
$555.00 |
$555.00 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$52.60 |
$52.60 |
$52.60 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$1,437.80 |
$1,437.80 |
$1,437.80 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$39.40 |
$39.40 |
$39.40 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$192.00 |
$192.00 |
$192.00 |
$4,647.04
|
|
Rpl tun cvc wo subq port
|
$123.20 |
$123.20 |
$123.20 |
$3,687.00
|
|
Rpr aa hrn 1st > 10 ncr/strn
|
$675.20 |
$675.20 |
$675.20 |
$1,982.40
|
|
Rpr aa hrn 1st > 10 rdc
|
$509.40 |
$509.40 |
$509.40 |
$5,110.00
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$490.80 |
$490.80 |
$490.80 |
$6,904.15
|
|
Rpr aa hrn 1st 3-10 rdc
|
$377.80 |
$377.80 |
$377.80 |
$6,912.52
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$2,969.80 |
$2,969.80 |
$2,969.80 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$314.00 |
$314.00 |
$314.00 |
$6,904.15
|
|
Rpr aa hrn rcr > 10 ncr/strn
|
$818.00 |
$818.00 |
$818.00 |
$2,402.40
|
|
Rpr aa hrn rcr > 10 rdc
|
$585.60 |
$585.60 |
$585.60 |
$1,719.20
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$564.60 |
$564.60 |
$564.60 |
$1,663.20
|
|
Rpr aa hrn rcr 3-10 rdc
|
$421.40 |
$421.40 |
$421.40 |
$6,819.30
|
|
Rpr aa hrn rcr < 3 ncr/strn
|
$376.80 |
$376.80 |
$376.80 |
$6,457.82
|
|
Rpr aa hrn rcr < 3 rdc
|
$278.80 |
$278.80 |
$278.80 |
$4,176.15
|
|
Rpr blood ves w/vein graft/up ext 35236
|
$657.20 |
$657.20 |
$657.20 |
$5,983.35
|
|
Rpr blood vsl grf oth vein lo ex
|
$592.80 |
$592.80 |
$592.80 |
$5,983.35
|
|
Rpr blvsl vn grf intra-abdl
|
$1,113.20 |
$1,113.20 |
$1,113.20 |
$1,881.00
|
|
Rpr csf leak/pseudomeng/laminectomy63709
|
$755.40 |
$755.40 |
$755.40 |
$2,492.82
|
|
Rpr diaphragm hernia/chronic/not neonate 39541
|
$622.00 |
$622.00 |
$622.00 |
$1,791.00
|
|
Rpr diaphragm lac/any approach 39501
|
$569.40 |
$569.40 |
$569.40 |
$1,539.60
|
