|
Revasc evasc tpvt athrec sf 1st
|
$32,513.04 |
$32,513.04 |
$32,513.04 |
$26,819.25
|
|
Revasc intra lithotrip-ather
|
$27,014.40 |
$27,014.40 |
$27,014.40 |
$19,624.54
|
|
Revasc intra lithotrip-stent
|
$35,436.80 |
$35,436.80 |
$35,436.80 |
$20,329.50
|
|
Revasc intravasc lithotripsy
|
$13,820.80 |
$13,820.80 |
$13,820.80 |
$11,320.00
|
|
Revasc lithotr-ather tib/per
|
$14,039.20 |
$14,039.20 |
$14,039.20 |
$19,875.58
|
|
Revasc lithotrip-stent-ather
|
$47,112.80 |
$47,112.80 |
$47,112.80 |
$21,249.26
|
|
Revasc lithotrip tibi/perone
|
$7,257.60 |
$7,257.60 |
$7,257.60 |
$13,925.00
|
|
Revasc lithotr-stent tib/per
|
$11,076.80 |
$11,076.80 |
$11,076.80 |
$20,329.50
|
|
Revasc lith-sten-ath tib/per
|
$14,039.20 |
$14,039.20 |
$14,039.20 |
$19,385.85
|
|
Revefenacin inh non-com 1mcg
|
$108.74 |
$108.74 |
$108.74 |
$15.56
|
|
Revise abdomen-venous shunt
|
$8,965.60 |
$8,965.60 |
$8,965.60 |
$4,176.15
|
|
Revise additional leg tendon
|
$8,545.60 |
$8,545.60 |
$8,545.60 |
$486.20
|
|
Revise aqueous shunt eye
|
$7,184.80 |
$7,184.80 |
$7,184.80 |
$4,350.00
|
|
Revise arm/leg nerve
|
$13,647.20 |
$13,647.20 |
$13,647.20 |
$3,754.40
|
|
Revise breast reconst 19380
|
$14,828.80 |
$14,828.80 |
$14,828.80 |
$6,869.50
|
|
Revise eye
|
$8,758.40 |
$8,758.40 |
$8,758.40 |
$4,462.45
|
|
Revise eyelashes
|
$2,066.40 |
$2,066.40 |
$2,066.40 |
$659.20
|
|
Revise eyelashes
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$3,502.99
|
|
Revise eyelid defect
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$2,760.73
|
|
Revise eyelid defect
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,784.00
|
|
Revise eyelid lining
|
$1,724.80 |
$1,724.80 |
$1,724.80 |
$2,698.92
|
|
Revise eyelid lining
|
$2,654.40 |
$2,654.40 |
$2,654.40 |
$3,482.06
|
|
Revise eyelid lining
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$3,269.14
|
|
Revise eye muscle
|
$5,644.80 |
$5,644.80 |
$5,644.80 |
$3,269.14
|
|
Revise eye muscle
|
$6,501.60 |
$6,501.60 |
$6,501.60 |
$3,366.40
|
|
Revise eye muscle add-on
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$1,934.00
|
|
Revise eye muscle(s)
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$3,269.14
|
|
Revise eye muscle(s) add-on
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$2,199.19
|
|
Revise eye muscle w/suture
|
$1,472.80 |
$1,472.80 |
$1,472.80 |
$1,472.80
|
|
Revise eye socket implant
|
$9,632.00 |
$9,632.00 |
$9,632.00 |
$5,110.00
|
|
Revise eye sockets
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$7,000.36
|
|
Revise eye sockets
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$7,000.36
|
|
Revise eye sockets
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$7,000.36
|
|
Revise eye sockets
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$7,000.36
|
|
Revise eye with implant
|
$3,718.40 |
$3,718.40 |
$3,718.40 |
$4,173.97
|
|
Revise finger joint each
|
$8,741.60 |
$8,741.60 |
$8,741.60 |
$3,839.54
|
|
Revise finger joint each
|
$5,594.40 |
$5,594.40 |
$5,594.40 |
$2,211.05
|
|
Revise gastric port open 43886
|
$11,300.80 |
$11,300.80 |
$11,300.80 |
$4,055.70
|
|
Revise/graft eyelid lining
|
$5,488.00 |
$5,488.00 |
$5,488.00 |
$3,269.14
|
|
Revise/graft eyelid lining
|
$9,632.00 |
$9,632.00 |
$9,632.00 |
$4,881.00
|
|
Revise/graft eyelid lining
|
$7,800.80 |
$7,800.80 |
$7,800.80 |
$4,440.96
|
|
Revise/graft eyelid lining
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$3,510.40
|
|
Revise/graft eyelid lining
|
$9,632.00 |
$9,632.00 |
$9,632.00 |
$4,462.45
|
|
Revise graft w/vein
|
$11,620.00 |
$11,620.00 |
$11,620.00 |
$5,419.00
|
|
Revise graft w/vein 35881
|
$11,620.00 |
$11,620.00 |
$11,620.00 |
$5,615.12
|
|
Revise hand/finger tendon
|
$10,225.60 |
$10,225.60 |
$10,225.60 |
$5,886.74
|
|
Revise head/neck of femur
|
$14,481.60 |
$14,481.60 |
$14,481.60 |
$8,453.60
|
|
Revise hernia & sperm veins
|
$6,104.00 |
$6,104.00 |
$6,104.00 |
$4,176.15
|
|
Revise/implant finger joint
|
$5,376.00 |
$5,376.00 |
$5,376.00 |
$5,376.00
|
|
Revise kneecap
|
$15,069.60 |
$15,069.60 |
$15,069.60 |
$7,700.67
|
|
Revise kneecap with implant
|
$19,504.80 |
$19,504.80 |
$19,504.80 |
$9,625.50
|
|
Revise knuckle joint
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$5,023.20
|
|
Revise knuckle with implant
|
$7,224.00 |
$7,224.00 |
$7,224.00 |
$5,886.74
|
|
Revise low back nerve(s)
|
$5,622.40 |
$5,622.40 |
$5,622.40 |
$3,603.20
|
|
Revise lower leg tendon
|
$12,045.60 |
$12,045.60 |
$12,045.60 |
$3,986.00
|
|
Revise lower leg tendon
|
$12,376.00 |
$12,376.00 |
$12,376.00 |
$4,934.00
|
|
Revise lower leg tendons
|
$10,712.80 |
$10,712.80 |
$10,712.80 |
$3,839.54
|
|
Revise middle ear bone
|
$16,038.40 |
$16,038.40 |
$16,038.40 |
$6,839.00
|
|
Revise middle ear bone
|
$16,357.60 |
$16,357.60 |
$16,357.60 |
$6,547.81
|
|
Revise middle ear bone
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,373.79
|
|
Revise middle ear & mastoid
|
$13,350.40 |
$13,350.40 |
$13,350.40 |
$6,553.49
|
|
Revise middle ear & mastoid
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,560.00
|
|
Revise middle ear & mastoid
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,547.81
|
|
Revise middle ear & mastoid
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$7,000.36
|
|
Revise middle ear & mastoid
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$7,000.36
|
|
Revise middle ear & mastoid 69645
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$7,000.36
|
|
Revise ocular implant
|
$6,244.00 |
$6,244.00 |
$6,244.00 |
$2,760.73
|
|
Revise ocular implant
|
$8,758.40 |
$8,758.40 |
$8,758.40 |
$4,462.45
|
|
Revise palsy hand tendon(s)
|
$12,045.60 |
$12,045.60 |
$12,045.60 |
$7,907.11
|
|
Revise palsy hand tendon(s)
|
$14,481.60 |
$14,481.60 |
$14,481.60 |
$8,453.60
|
|
Revise penis/urethra
|
$8,215.20 |
$8,215.20 |
$8,215.20 |
$4,478.01
|
|
Revise penis/urethra
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$4,478.01
|
|
Revise penis/urethra
|
$8,215.20 |
$8,215.20 |
$8,215.20 |
$4,478.01
|
|
Revise prosth vag graft lap
|
$10,029.60 |
$10,029.60 |
$10,029.60 |
$8,185.02
|
|
Revise radius or ulna
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,627.00
|
|
Revise radius & ulna
|
$14,476.00 |
$14,476.00 |
$14,476.00 |
$14,241.77
|
|
Revise radius & ulna
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,692.80
|
|
Revise reconst elbow joint
|
$24,640.00 |
$24,640.00 |
$24,640.00 |
$14,241.77
|
|
Revise reconst elbow joint
|
$28,672.00 |
$28,672.00 |
$28,672.00 |
$16,139.55
|
|
Revise/remove neuroelectrode
|
$10,236.80 |
$10,236.80 |
$10,236.80 |
$4,069.59
|
|
Revise/remove neuroreceiver
|
$12,432.00 |
$12,432.00 |
$12,432.00 |
$9,079.85
|
|
Revise/remove sling repair
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$3,720.50
|
|
Revise/repl vagus n eltrd
|
$18,855.20 |
$18,855.20 |
$18,855.20 |
$13,628.55
|
|
Revise spermatic cord veins
|
$11,043.20 |
$11,043.20 |
$11,043.20 |
$4,345.52
|
|
Revise spermatic cord veins
|
$10,757.60 |
$10,757.60 |
$10,757.60 |
$7,149.07
|
|
Revise spine eltrd perq aray
|
$17,567.20 |
$17,567.20 |
$17,567.20 |
$7,496.58
|
|
Revise spine eltrd plate
|
$19,465.60 |
$19,465.60 |
$19,465.60 |
$14,685.79
|
|
Revise thigh muscles/tendons
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$7,907.11
|
|
Revise thumb tendon
|
$3,018.40 |
$3,018.40 |
$3,018.40 |
$3,591.33
|
|
Revise thumb tendon
|
$2,273.60 |
$2,273.60 |
$2,273.60 |
$3,594.44
|
|
Revise two eye muscles
|
$9,828.00 |
$9,828.00 |
$9,828.00 |
$4,462.45
|
|
Revise two eye muscles
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$4,000.00
|
|
Revise ulnar nerve at wrist
|
$7,106.40 |
$7,106.40 |
$7,106.40 |
$2,823.38
|
|
Revise ureter
|
$9,856.00 |
$9,856.00 |
$9,856.00 |
$4,350.00
|
|
Revise urethra stage 1
|
$11,480.00 |
$11,480.00 |
$11,480.00 |
$5,986.78
|
|
Revise urethra stage 2
|
$11,480.00 |
$11,480.00 |
$11,480.00 |
$5,645.75
|
|
Revise vag graft via vagina
|
$8,747.20 |
$8,747.20 |
$8,747.20 |
$3,762.53
|
|
Revise windpipe scar
|
$8,820.00 |
$8,820.00 |
$8,820.00 |
$3,837.72
|
|
Revise wrist/forearm tendon
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$3,017.99
|
|
Revise wrist joint
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$4,155.20
|
