|
Repair art rupture arm 35013
|
$6,039.80 |
$6,039.80 |
$6,039.80 |
$1,665.77
|
|
Repair av fistula ext 35190
|
$3,489.20 |
$3,489.20 |
$3,489.20 |
$6,366.08
|
|
Repair biceps tendon
|
$2,644.20 |
$2,644.20 |
$2,644.20 |
$7,502.40
|
|
Repair bladder defect
|
$3,469.05 |
$3,469.05 |
$3,469.05 |
$6,311.00
|
|
Repair bladder neck
|
$2,639.00 |
$2,639.00 |
$2,639.00 |
$5,841.60
|
|
Repair bladder & vagina
|
$3,328.00 |
$3,328.00 |
$3,328.00 |
$8,192.12
|
|
Repair bladder-vagina lesion
|
$2,308.80 |
$2,308.80 |
$2,308.80 |
$5,841.60
|
|
Repair bladder-vagina lesion
|
$3,434.60 |
$3,434.60 |
$3,434.60 |
$8,081.64
|
|
Repair bladder/vagina lesion
|
$3,803.80 |
$3,803.80 |
$3,803.80 |
$2,080.80
|
|
Repair blood ves direct neck 35201
|
$25,255.10 |
$25,255.10 |
$25,255.10 |
$5,783.00
|
|
Repair blood vess/direct/intra/abd 35221
|
$6,921.20 |
$6,921.20 |
$6,921.20 |
$1,647.50
|
|
Repair blood vessel direct hand finger
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$3,898.50
|
|
Repair blood vessel direct intrathoracic without bypass 35216
|
$9,518.60 |
$9,518.60 |
$9,518.60 |
$8,080.00
|
|
Repair blood vessel dir lower extr
|
$3,978.00 |
$3,978.00 |
$3,978.00 |
$1,731.55
|
|
Repair blood vessel dir upper extr
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$4,051.32
|
|
Repair blood vessel lesion
|
$4,680.00 |
$4,680.00 |
$4,680.00 |
$5,983.35
|
|
Repair blood vessel lesion
|
$4,929.60 |
$4,929.60 |
$4,929.60 |
$4,627.00
|
|
Repair blood vessel lesion
|
$4,115.80 |
$4,115.80 |
$4,115.80 |
$5,983.35
|
|
Repair blood vessel w/graft lower extremity 35286
|
$4,955.60 |
$4,955.60 |
$4,955.60 |
$5,988.54
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$5,501.60 |
$5,501.60 |
$5,501.60 |
$4,341.66
|
|
Repair bowel-bladder fistula 44660
|
$6,682.65 |
$6,682.65 |
$6,682.65 |
$2,041.80
|
|
Repair bowel-bladder fistula 44661
|
$7,111.00 |
$7,111.00 |
$7,111.00 |
$2,664.80
|
|
Repair bowel fistula 44650
|
$6,531.20 |
$6,531.20 |
$6,531.20 |
$1,558.00
|
|
Repair brain fluid leakage
|
$6,729.45 |
$6,729.45 |
$6,729.45 |
$2,223.26
|
|
Repair bronchus add-on
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$593.60
|
|
Repair brow defect
|
$1,950.65 |
$1,950.65 |
$1,950.65 |
$2,820.92
|
|
Repair cardiac wound without bypass
|
$15,189.85 |
$15,189.85 |
$15,189.85 |
$7,369.60
|
|
Repair carpal bone shorten
|
$2,821.00 |
$2,821.00 |
$2,821.00 |
$3,856.00
|
|
Repair cleft lip/nasal
|
$3,710.20 |
$3,710.20 |
$3,710.20 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$4,118.40 |
$4,118.40 |
$4,118.40 |
$6,553.49
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,491.75 |
$1,491.75 |
$1,491.75 |
$1,059.20
|
|
Repair corporeal tear
|
$2,990.00 |
$2,990.00 |
$2,990.00 |
$2,990.00
|
|
Repair defect arm art 35045
|
$4,682.60 |
$4,682.60 |
$4,682.60 |
$6,366.08
|
|
Repair defect of artery
|
$6,864.00 |
$6,864.00 |
$6,864.00 |
$2,168.66
|
|
Repair defect of artery
|
$5,764.20 |
$5,764.20 |
$5,764.20 |
$1,335.50
|
|
Repair defect of artery
|
$9,191.00 |
$9,191.00 |
$9,191.00 |
$5,706.00
|
|
Repair defect of artery
|
$6,832.80 |
$6,832.80 |
$6,832.80 |
$1,471.00
|
|
Repair defect of artery 35011
|
$4,830.80 |
$4,830.80 |
$4,830.80 |
$6,305.95
|
|
Repair defect of artery 35081
|
$8,717.80 |
$8,717.80 |
$8,717.80 |
$3,497.40
|
|
Repair defect of artery 35102
|
$9,497.80 |
$9,497.80 |
$9,497.80 |
$3,922.38
|
|
Repair defect of artery 35121
|
$8,195.20 |
$8,195.20 |
$8,195.20 |
$1,751.50
|
|
Repair defect of artery aneurysm 35151
|
$6,167.20 |
$6,167.20 |
$6,167.20 |
$4,292.40
|
|
Repair defect of artery carotid subclav 35001
|
$5,410.60 |
$5,410.60 |
$5,410.60 |
$5,410.60
|
|
Repair deformity of toe
|
$1,472.90 |
$1,472.90 |
$1,472.90 |
$3,591.33
|
|
Repair degenerated kneecap
|
$3,016.00 |
$3,016.00 |
$3,016.00 |
$6,311.00
|
|
Repair dental ellis ii fx
|
$195.00 |
$195.00 |
$195.00 |
$442.48
|
|
Repair detached retina pc
|
$881.40 |
$881.40 |
$881.40 |
$1,513.20
|
|
Repair dura
|
$4,859.40 |
$4,859.40 |
$4,859.40 |
$1,854.09
|
|
Repair dura
|
$5,746.00 |
$5,746.00 |
$5,746.00 |
$2,422.30
|
|
Repair eardrum structures
|
$2,613.00 |
$2,613.00 |
$2,613.00 |
$6,804.50
|
|
Repair elbow deb/attch open
|
$2,334.80 |
$2,334.80 |
$2,334.80 |
$3,839.54
|
|
Repair elbow perc
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,350.00
|
|
Repair elbow w/deb open
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$3,839.54
|
|
Repair esophagus and fistula
|
$4,706.00 |
$4,706.00 |
$4,706.00 |
$1,370.78
|
|
Repair esophagus and fistula
|
$7,605.00 |
$7,605.00 |
$7,605.00 |
$3,888.00
|
|
Repair esophagus opening
|
$4,362.80 |
$4,362.80 |
$4,362.80 |
$3,837.72
|
|
Repair esophagus opening
|
$6,510.40 |
$6,510.40 |
$6,510.40 |
$3,518.40
|
|
Repair esophagus wound 43410
|
$4,266.60 |
$4,266.60 |
$4,266.60 |
$2,546.40
|
|
Repair esophagus wound 43415
|
$11,668.80 |
$11,668.80 |
$11,668.80 |
$6,279.20
|
|
Repair extns tendon finger without grft ea
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$2,353.50
|
|
Repair extra toe(s)
|
$1,258.40 |
$1,258.40 |
$1,258.40 |
$4,350.00
|
|
Repair eyelid defect
|
$2,553.20 |
$2,553.20 |
$2,553.20 |
$4,462.45
|
|
Repair eyelid defect
|
$1,692.60 |
$1,692.60 |
$1,692.60 |
$2,966.40
|
|
Repair eyelid defect
|
$2,279.55 |
$2,279.55 |
$2,279.55 |
$3,609.60
|
|
Repair eyelid defect
|
$1,515.80 |
$1,515.80 |
$1,515.80 |
$2,733.00
|
|
Repair eyelid defect
|
$975.00 |
$975.00 |
$975.00 |
$2,760.73
|
|
Repair eyelid defect
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$2,982.40
|
|
Repair eyelid defect
|
$1,541.80 |
$1,541.80 |
$1,541.80 |
$2,760.73
|
|
Repair eyelid defect
|
$902.20 |
$902.20 |
$902.20 |
$2,760.73
|
|
Repair eyelid defect
|
$1,567.15 |
$1,567.15 |
$1,567.15 |
$2,982.40
|
|
Repair eyelid defect
|
$1,541.80 |
$1,541.80 |
$1,541.80 |
$3,176.00
|
|
Repair eyelid wound
|
$8,719.75 |
$8,719.75 |
$8,719.75 |
$2,760.73
|
|
Repair eyelid wound
|
$8,719.75 |
$8,719.75 |
$8,719.75 |
$3,296.00
|
|
Repair fibula nonunion
|
$3,728.40 |
$3,728.40 |
$3,728.40 |
$7,807.24
|
|
Repair finger/hand tendon
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,204.20
|
|
Repair finger/hand tendon
|
$2,485.60 |
$2,485.60 |
$2,485.60 |
$4,150.20
|
|
Repair finger/hand tendon
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$4,351.50
|
|
Repair finger/hand tendon
|
$1,892.80 |
$1,892.80 |
$1,892.80 |
$3,848.00
|
|
Repair finger/hand tendon
|
$2,186.60 |
$2,186.60 |
$2,186.60 |
$3,839.54
|
|
Repair finger/hand tendon
|
$1,643.20 |
$1,643.20 |
$1,643.20 |
$3,839.54
|
|
Repair finger tendon
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$3,752.25
|
|
Repair fistula w/colostomy
|
$6,063.20 |
$6,063.20 |
$6,063.20 |
$2,094.00
|
|
Repair fistula w/colostomy
|
$6,284.20 |
$6,284.20 |
$6,284.20 |
$3,759.20
|
|
Repair foot dislocation
|
$2,509.00 |
$2,509.00 |
$2,509.00 |
$5,810.00
|
|
Repair foot dislocation
|
$2,893.80 |
$2,893.80 |
$2,893.80 |
$6,307.00
|
|
Repair foot dislocation
|
$2,782.00 |
$2,782.00 |
$2,782.00 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$2,626.00 |
$2,626.00 |
$2,626.00 |
$4,379.20
|
|
Repair forearm tendon/muscle
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$2,324.40 |
$2,324.40 |
$2,324.40 |
$3,839.54
|
|
Repair forearm tendon sheath
|
$2,329.60 |
$2,329.60 |
$2,329.60 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$2,802.80 |
$2,802.80 |
$2,802.80 |
$7,907.11
|
|
Repair/graft femur head/neck
|
$4,578.60 |
$4,578.60 |
$4,578.60 |
$1,292.50
|
|
Repair/graft finger tendon
|
$1,804.40 |
$1,804.40 |
$1,804.40 |
$3,839.54
|
|
Repair/graft finger tendon
|
$1,627.60 |
$1,627.60 |
$1,627.60 |
$4,259.84
|
|
Repair/graft hand tendon
|
$2,046.20 |
$2,046.20 |
$2,046.20 |
$5,741.00
|
|
Repair/graft hand tendon
|
$2,342.60 |
$2,342.60 |
$2,342.60 |
$7,807.24
|
|
Repair/graft hand tendon
|
$2,730.00 |
$2,730.00 |
$2,730.00 |
$6,307.00
|
|
Repair/graft hand tendon
|
$1,684.80 |
$1,684.80 |
$1,684.80 |
$3,977.49
|
|
Repair/graft kneecap tendon
|
$2,797.60 |
$2,797.60 |
$2,797.60 |
$5,855.00
|
|
Repair/graft of thigh
|
$5,354.05 |
$5,354.05 |
$5,354.05 |
$2,875.62
|
