|
Repair arm/leg nerve
|
$12,532.80 |
$12,532.80 |
$12,532.80 |
$6,839.00
|
|
Repair av fistula ext 35190
|
$11,916.80 |
$11,916.80 |
$11,916.80 |
$6,366.08
|
|
Repair biceps tendon
|
$436.95 |
$436.95 |
$10,796.80 |
$6,839.00
|
|
Repair bladder defect
|
$7,666.40 |
$7,666.40 |
$7,666.40 |
$5,841.60
|
|
Repair bladder neck
|
$13,098.40 |
$13,098.40 |
$13,098.40 |
$5,841.60
|
|
Repair bladder & vagina
|
$13,311.20 |
$13,311.20 |
$13,311.20 |
$8,708.57
|
|
Repair bladder-vagina lesion
|
$13,311.20 |
$13,311.20 |
$13,311.20 |
$5,841.60
|
|
Repair bladder-vagina lesion
|
$11,093.60 |
$11,093.60 |
$11,093.60 |
$8,185.02
|
|
Repair blood ves direct neck 35201
|
$11,524.80 |
$11,524.80 |
$11,524.80 |
$5,907.78
|
|
Repair blood vessel direct hand finger
|
$10,679.20 |
$10,679.20 |
$10,679.20 |
$3,898.50
|
|
Repair blood vessel dir lower extr
|
$1,999.20 |
$1,999.20 |
$1,999.20 |
$1,705.04
|
|
Repair blood vessel dir upper extr
|
$10,679.20 |
$10,679.20 |
$10,679.20 |
$3,879.03
|
|
Repair blood vessel lesion
|
$5,874.40 |
$5,874.40 |
$5,874.40 |
$2,164.52
|
|
Repair blood vessel lesion
|
$2,296.00 |
$2,296.00 |
$2,296.00 |
$2,346.40
|
|
Repair blood vessel lesion
|
$9,794.40 |
$9,794.40 |
$9,794.40 |
$5,988.54
|
|
Repair blood vessel lesion
|
$9,346.40 |
$9,346.40 |
$9,346.40 |
$4,766.40
|
|
Repair blood vessel lesion
|
$11,446.40 |
$11,446.40 |
$11,446.40 |
$5,983.35
|
|
Repair blood vessel w/graft lower extremity 35286
|
$10,477.60 |
$10,477.60 |
$10,477.60 |
$5,983.35
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$7,789.60 |
$7,789.60 |
$7,789.60 |
$4,341.66
|
|
Repair bowel fistula 44650
|
$778.65 |
$778.65 |
$778.65 |
$1,558.00
|
|
Repair brow defect
|
$446.10 |
$446.10 |
$5,314.40 |
$2,760.73
|
|
Repair carpal bone shorten
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,856.00
|
|
Repair cleft hand
|
$7,285.60 |
$7,285.60 |
$7,285.60 |
$4,499.12
|
|
Repair cleft lip/nasal
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,553.49
|
|
Repair cleft lip/nasal
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$8,181.60 |
$8,181.60 |
$8,181.60 |
$5,108.80
|
|
Repair cleft lip/nasal
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,839.00
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$2,469.60 |
$2,469.60 |
$2,469.60 |
$1,025.95
|
|
Repair corporeal tear
|
$7,481.60 |
$7,481.60 |
$7,481.60 |
$3,769.31
|
|
Repair defect arm art 35045
|
$6,748.00 |
$6,748.00 |
$6,748.00 |
$6,396.89
|
|
Repair defect of artery 35011
|
$11,524.80 |
$11,524.80 |
$11,524.80 |
$6,305.95
|
|
Repair deformity of toe
|
$5,958.40 |
$5,958.40 |
$5,958.40 |
$3,545.97
|
|
Repair degenerated kneecap
|
$14,442.40 |
$14,442.40 |
$14,442.40 |
$5,886.74
|
|
Repair dental ellis ii fx
|
$5,633.60 |
$5,633.60 |
$5,633.60 |
$442.48
|
|
Repair detached retina
|
$14,828.80 |
$14,828.80 |
$14,828.80 |
$5,912.40
|
|
Repair detached retina
|
$17,987.20 |
$17,987.20 |
$17,987.20 |
$6,889.27
|
|
Repair detached retina
|
$7,168.00 |
$7,168.00 |
$7,168.00 |
$3,468.40
|
|
Repair detached retina crtx
|
$7,184.80 |
$7,184.80 |
$7,184.80 |
$3,786.00
|
|
Repair detached retina pc
|
$2,570.40 |
$2,570.40 |
$2,570.40 |
$1,513.20
|
|
Repair eardrum structures
|
$18,009.60 |
$18,009.60 |
$18,009.60 |
$6,553.49
|
|
Repair elbow deb/attch open
|
$392.40 |
$392.40 |
$9,564.80 |
$3,839.54
|
|
Repair elbow perc
|
$251.10 |
$251.10 |
$8,741.60 |
$3,986.00
|
|
Repair elbow w/deb open
|
$319.65 |
$319.65 |
$8,646.40 |
$3,821.05
|
|
Repair esophagus opening
|
$8,820.00 |
$8,820.00 |
$8,820.00 |
$3,837.72
|
|
Repair extns tendon finger without grft ea
|
$389.85 |
$389.85 |
$9,984.80 |
$2,224.00
|
|
Repair extra toe(s)
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,350.00
|
|
Repair eyelid defect
|
$5,493.60 |
$5,493.60 |
$5,493.60 |
$3,849.60
|
|
Repair eyelid defect
|
$6,893.60 |
$6,893.60 |
$6,893.60 |
$4,462.45
|
|
Repair eyelid defect
|
$6,994.40 |
$6,994.40 |
$6,994.40 |
$2,966.40
|
|
Repair eyelid defect
|
$5,712.00 |
$5,712.00 |
$5,712.00 |
$3,357.30
|
|
Repair eyelid defect
|
$2,996.00 |
$2,996.00 |
$2,996.00 |
$4,121.25
|
|
Repair eyelid defect
|
$4,961.60 |
$4,961.60 |
$4,961.60 |
$2,732.50
|
|
Repair eyelid defect
|
$3,236.80 |
$3,236.80 |
$3,236.80 |
$2,760.73
|
|
Repair eyelid defect
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$2,838.93
|
|
Repair eyelid defect
|
$5,045.60 |
$5,045.60 |
$5,045.60 |
$2,982.40
|
|
Repair eyelid defect
|
$5,958.40 |
$5,958.40 |
$5,958.40 |
$2,760.73
|
|
Repair eyelid defect
|
$5,241.60 |
$5,241.60 |
$5,241.60 |
$2,760.73
|
|
Repair eyelid defect
|
$6,871.20 |
$6,871.20 |
$6,871.20 |
$2,760.73
|
|
Repair eyelid defect
|
$4,547.20 |
$4,547.20 |
$4,547.20 |
$2,982.40
|
|
Repair eyelid defect
|
$4,452.00 |
$4,452.00 |
$4,452.00 |
$2,856.80
|
|
Repair eyelid wound
|
$1,836.80 |
$1,836.80 |
$1,836.80 |
$2,760.73
|
|
Repair eyelid wound
|
$7,694.40 |
$7,694.40 |
$7,694.40 |
$3,254.34
|
|
Repair facial nerve
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,759.31
|
|
Repair facial nerve
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,966.64
|
|
Repair fibula nonunion
|
$550.80 |
$550.80 |
$17,382.40 |
$6,879.60
|
|
Repair finger deformity
|
$5,112.80 |
$5,112.80 |
$5,112.80 |
$3,471.20
|
|
Repair finger/hand tendon
|
$460.50 |
$460.50 |
$10,348.80 |
$4,150.20
|
|
Repair finger/hand tendon
|
$479.40 |
$479.40 |
$10,925.60 |
$4,150.20
|
|
Repair finger/hand tendon
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$4,350.00
|
|
Repair finger/hand tendon
|
$10,712.80 |
$10,712.80 |
$10,712.80 |
$3,848.00
|
|
Repair finger/hand tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair finger/hand tendon
|
$304.35 |
$304.35 |
$8,568.00 |
$3,839.54
|
|
Repair finger tendon
|
$352.50 |
$352.50 |
$2,508.80 |
$3,594.44
|
|
Repair foot dislocation
|
$17,382.40 |
$17,382.40 |
$17,382.40 |
$5,886.74
|
|
Repair foot dislocation
|
$417.45 |
$417.45 |
$11,692.80 |
$5,886.74
|
|
Repair foot dislocation
|
$17,382.40 |
$17,382.40 |
$17,382.40 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$4,379.20 |
$4,379.20 |
$4,379.20 |
$4,350.00
|
|
Repair forearm tendon/muscle
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$6,311.00
|
|
Repair forearm tendon sheath
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$15,495.20 |
$15,495.20 |
$15,495.20 |
$8,429.28
|
|
Repair/graft eye lesion
|
$8,131.20 |
$8,131.20 |
$8,131.20 |
$5,741.00
|
|
Repair/graft finger tendon
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,839.54
|
|
Repair/graft finger tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,821.05
|
|
Repair/graft finger tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,259.84
|
|
Repair/graft hand tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$5,560.25
|
|
Repair/graft hand tendon
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$6,311.00
|
|
Repair/graft hand tendon
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$6,839.00
|
|
Repair/graft hand tendon
|
$10,225.60 |
$10,225.60 |
$10,225.60 |
$5,886.74
|
|
Repair/graft hand tendon
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,931.20
|
|
Repair/graft kneecap tendon
|
$482.85 |
$482.85 |
$9,839.20 |
$5,339.00
|
|
Repair/graft of foot tendon
|
$9,245.60 |
$9,245.60 |
$9,245.60 |
$5,886.74
|
|
Repair/graft of foot tendon
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$5,023.20
|
|
Repair/graft of thigh muscle
|
$10,959.20 |
$10,959.20 |
$10,959.20 |
$5,741.00
|
|
Repair/graft of tibia
|
$7,464.80 |
$7,464.80 |
$7,464.80 |
$7,464.80
|
|
Repair/graft radius or ulna
|
$601.80 |
$601.80 |
$17,382.40 |
$7,907.11
|
|
Repair/graft radius or ulna
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$7,907.11
|
|
Repair/graft radius & ulna
|
$14,481.60 |
$14,481.60 |
$14,481.60 |
$7,913.97
|
