|
Closed tx nose/jaw fx
|
$4,054.40 |
$4,054.40 |
$4,054.40 |
$2,903.97
|
|
Closed tx orbit without manipulj
|
$2,816.80 |
$2,816.80 |
$2,816.80 |
$998.40
|
|
Closed tx orbit w/manipulj
|
$4,132.80 |
$4,132.80 |
$4,132.80 |
$3,136.80
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$343.20 |
$343.20 |
$6,512.80 |
$2,520.60
|
|
Closed tx septal&nose fx
|
$7,044.80 |
$7,044.80 |
$7,044.80 |
$3,624.40
|
|
Closed tx sesamoid fx 28530
|
$935.20 |
$935.20 |
$935.20 |
$445.00
|
|
Closed tx/talus fracture without manip 28430
|
$132.90 |
$132.90 |
$935.20 |
$421.40
|
|
Closed tx vert fx w/manj
|
$4,748.80 |
$4,748.80 |
$4,748.80 |
$3,839.54
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$481.80
|
|
Close mastoid fistula
|
$4,692.80 |
$4,692.80 |
$4,692.80 |
$3,299.20
|
|
Close tear duct opening
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$436.44
|
|
Close tear duct opening
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$353.74
|
|
Close tear system fistula
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$3,586.17
|
|
Clostridium toxin a w/optic
|
$94.08 |
$94.08 |
$109.50 |
$35.20
|
|
Clos txnose fx without stablz 21315
|
$4,961.60 |
$4,961.60 |
$4,961.60 |
$2,326.08
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$137.10 |
$137.10 |
$137.10 |
$2,835.00
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$88.65 |
$88.65 |
$88.65 |
$1,934.40
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$2,816.80 |
$2,816.80 |
$2,816.80 |
$1,259.62
|
|
Closure of eyelid by suture
|
$5,398.40 |
$5,398.40 |
$5,398.40 |
$1,613.00
|
|
Closure of salivary fistula
|
$3,169.60 |
$3,169.60 |
$3,169.60 |
$3,169.60
|
|
Closure of windpipe lesion 31820
|
$8,820.00 |
$8,820.00 |
$8,820.00 |
$3,837.72
|
|
Closure paravalvlr leak pq
|
$5,745.60 |
$5,745.60 |
$5,745.60 |
$7,723.17
|
|
Clot factor fletcher fact
|
$17.27 |
$17.27 |
$192.64 |
$119.50
|
|
Clot factor viii reltd antgn
|
$208.88 |
$208.88 |
$208.88 |
$158.20
|
|
Clot factor wght kininogen
|
$26.78 |
$26.78 |
$192.64 |
$167.96
|
|
Clot factor xii hageman
|
$2.58 |
$2.58 |
$155.68 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$1.19 |
$1.19 |
$55.44 |
$55.44
|
|
Clot factor xiii fibrin stab
|
$2.18 |
$2.18 |
$146.72 |
$105.00
|
|
Clotting assay whole blood
|
$76.05 |
$76.05 |
$83.44 |
$98.50
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$700.00 |
$700.00 |
$700.00 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$194.40 |
$194.40 |
$1,125.60 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$476.80
|
|
Clsd tx clav dislc without manip 23520
|
$3,332.00 |
$3,332.00 |
$3,332.00 |
$2,021.04
|
|
Clsd tx clavicle dislocation without manip 23540
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$419.29
|
|
Clsd tx clavicle fracture w/manip 23505
|
$4,687.20 |
$4,687.20 |
$4,687.20 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$146.70 |
$146.70 |
$1,125.60 |
$448.80
|
|
Clsd tx coccygeal fracture 27200
|
$935.20 |
$935.20 |
$935.20 |
$388.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$123.15 |
$123.15 |
$1,092.00 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$935.20 |
$935.20 |
$935.20 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$59.70 |
$59.70 |
$1,282.40 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$6,384.00 |
$6,384.00 |
$6,384.00 |
$2,184.08
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$5,247.20 |
$5,247.20 |
$5,247.20 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$90.90 |
$90.90 |
$1,282.40 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$210.60 |
$210.60 |
$1,148.00 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$310.65 |
$310.65 |
$2,010.40 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$281.40 |
$281.40 |
$1,276.80 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$165.90 |
$165.90 |
$1,125.60 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$1,220.80 |
$1,220.80 |
$1,220.80 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$935.20 |
$935.20 |
$935.20 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$211.65 |
$211.65 |
$1,125.60 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$828.80 |
$828.80 |
$828.80 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,836.80 |
$1,836.80 |
$1,836.80 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$142.80 |
$142.80 |
$1,086.40 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$185.70 |
$185.70 |
$1,125.60 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$188.40 |
$188.40 |
$1,148.00 |
$606.00
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$6,305.60 |
$6,305.60 |
$6,305.60 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$130.65 |
$130.65 |
$1,282.40 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$7,890.40 |
$7,890.40 |
$7,890.40 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$4,748.80 |
$4,748.80 |
$4,748.80 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$79.20 |
$79.20 |
$1,209.60 |
$416.35
|
|
Clsd tx pelvic ring fx
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$398.55 |
$398.55 |
$5,359.20 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$122.40 |
$122.40 |
$1,125.60 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$155.55 |
$155.55 |
$1,125.60 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,808.00 |
$3,808.00 |
$3,808.00 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,198.40 |
$1,198.40 |
$1,198.40 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$249.00 |
$249.00 |
$6,512.80 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$5,252.80 |
$5,252.80 |
$5,252.80 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,047.20 |
$1,047.20 |
$1,047.20 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$265.95 |
$265.95 |
$3,808.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$157.65 |
$157.65 |
$1,125.60 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$929.60 |
$929.60 |
$929.60 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$935.20 |
$935.20 |
$935.20 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$523.53
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$496.61
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$193.35 |
$193.35 |
$1,260.00 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$3,332.00 |
$3,332.00 |
$3,332.00 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$5,700.80 |
$5,700.80 |
$5,700.80 |
$2,317.60
|
|
Cltx hum epcndylr fx wo mnpj
|
$935.20 |
$935.20 |
$935.20 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$1,815.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$5,846.40 |
$5,846.40 |
$5,846.40 |
$2,437.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$14,397.60 |
$14,397.60 |
$14,397.60 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$5,986.40 |
$5,986.40 |
$5,986.40 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$8,192.80 |
$8,192.80 |
$8,192.80 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$11,776.80 |
$11,776.80 |
$11,776.80 |
$4,350.00
|
|
Cltx post ankle fx
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$483.60
|
