|
Revasc evasc tpvt athrec sf 1st
|
$87,498.45 |
$87,498.45 |
$87,498.45 |
$25,720.00
|
|
Revasc intra lithotrip-ather
|
$83,891.60 |
$83,891.60 |
$83,891.60 |
$19,875.58
|
|
Revasc intra lithotrip-stent
|
$30,315.35 |
$30,315.35 |
$30,315.35 |
$20,213.00
|
|
Revasc intravasc lithotripsy
|
$52,981.50 |
$52,981.50 |
$52,981.50 |
$11,278.00
|
|
Revasc lithotr-ather tib/per
|
$29,529.50 |
$29,529.50 |
$29,529.50 |
$20,300.00
|
|
Revasc lithotrip-stent-ather
|
$27,999.40 |
$27,999.40 |
$27,999.40 |
$21,280.02
|
|
Revasc lithotrip tibi/perone
|
$21,798.40 |
$21,798.40 |
$21,798.40 |
$13,925.00
|
|
Revasc lithotr-stent tib/per
|
$37,495.90 |
$37,495.90 |
$37,495.90 |
$20,329.50
|
|
Revasc lith-sten-ath tib/per
|
$31,556.85 |
$31,556.85 |
$31,556.85 |
$19,750.50
|
|
Revise abdomen-venous shunt
|
$2,706.60 |
$2,706.60 |
$2,706.60 |
$4,176.15
|
|
Revise additional leg tendon
|
$486.20 |
$486.20 |
$486.20 |
$3,532.79
|
|
Revise aqueous shunt eye
|
$2,750.80 |
$2,750.80 |
$2,750.80 |
$4,538.03
|
|
Revise arm/leg nerve
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$3,754.40
|
|
Revise bladder & ureter(s)
|
$6,156.80 |
$6,156.80 |
$6,156.80 |
$3,277.60
|
|
Revise breast reconst 19380
|
$3,194.75 |
$3,194.75 |
$3,194.75 |
$7,127.17
|
|
Revise circulation to head
|
$8,135.40 |
$8,135.40 |
$8,135.40 |
$7,891.02
|
|
Revise esophagus & stomach 43325
|
$5,876.00 |
$5,876.00 |
$5,876.00 |
$3,326.40
|
|
Revise eye
|
$1,887.60 |
$1,887.60 |
$1,887.60 |
$4,462.45
|
|
Revise eyelashes
|
$408.85 |
$408.85 |
$408.85 |
$659.20
|
|
Revise eyelid defect
|
$1,448.20 |
$1,448.20 |
$1,448.20 |
$2,760.73
|
|
Revise eyelid lining
|
$1,502.80 |
$1,502.80 |
$1,502.80 |
$2,698.92
|
|
Revise eyelid lining
|
$2,238.60 |
$2,238.60 |
$2,238.60 |
$3,269.14
|
|
Revise eye socket implant
|
$3,166.80 |
$3,166.80 |
$3,166.80 |
$5,008.35
|
|
Revise eye sockets
|
$5,379.40 |
$5,379.40 |
$5,379.40 |
$7,000.36
|
|
Revise eye sockets
|
$7,038.20 |
$7,038.20 |
$7,038.20 |
$6,048.05
|
|
Revise eye with implant
|
$1,830.40 |
$1,830.40 |
$1,830.40 |
$4,173.97
|
|
Revise finger joint each
|
$1,853.80 |
$1,853.80 |
$1,853.80 |
$3,839.54
|
|
Revise finger joint each
|
$1,648.40 |
$1,648.40 |
$1,648.40 |
$2,211.05
|
|
Revise gastric port open 43886
|
$1,206.40 |
$1,206.40 |
$1,206.40 |
$4,055.70
|
|
Revise/graft eyelid lining
|
$1,899.30 |
$1,899.30 |
$1,899.30 |
$3,628.80
|
|
Revise/graft eyelid lining
|
$2,189.20 |
$2,189.20 |
$2,189.20 |
$4,462.45
|
|
Revise graft w/vein
|
$4,526.60 |
$4,526.60 |
$4,526.60 |
$5,110.00
|
|
Revise graft w/vein 35881
|
$5,031.00 |
$5,031.00 |
$5,031.00 |
$5,339.00
|
|
Revise hand/finger tendon
|
$2,451.80 |
$2,451.80 |
$2,451.80 |
$7,807.24
|
|
Revise hernia & sperm veins
|
$2,158.00 |
$2,158.00 |
$2,158.00 |
$4,176.15
|
|
Revise hip joint replacement
|
$8,659.95 |
$8,659.95 |
$8,659.95 |
$8,659.95
|
|
Revise hip joint replacement
|
$6,778.20 |
$6,778.20 |
$6,778.20 |
$7,536.00
|
|
Revise hip joint replacement
|
$6,492.20 |
$6,492.20 |
$6,492.20 |
$6,492.20
|
|
Revise/implant finger joint
|
$1,705.60 |
$1,705.60 |
$1,705.60 |
$5,376.00
|
|
Revise kneecap
|
$2,321.80 |
$2,321.80 |
$2,321.80 |
$7,700.67
|
|
Revise kneecap with implant
|
$3,091.40 |
$3,091.40 |
$3,091.40 |
$10,629.07
|
|
Revise knuckle joint
|
$1,788.80 |
$1,788.80 |
$1,788.80 |
$5,023.20
|
|
Revise knuckle with implant
|
$2,113.80 |
$2,113.80 |
$2,113.80 |
$6,511.82
|
|
Revise low back nerve(s)
|
$2,743.00 |
$2,743.00 |
$2,743.00 |
$3,603.20
|
|
Revise lower leg tendon
|
$2,384.20 |
$2,384.20 |
$2,384.20 |
$4,627.00
|
|
Revise lower leg tendon
|
$2,727.40 |
$2,727.40 |
$2,727.40 |
$5,339.00
|
|
Revise middle ear bone
|
$3,127.80 |
$3,127.80 |
$3,127.80 |
$6,680.76
|
|
Revise middle ear bone
|
$4,139.20 |
$4,139.20 |
$4,139.20 |
$6,465.11
|
|
Revise middle ear bone
|
$4,056.00 |
$4,056.00 |
$4,056.00 |
$6,373.79
|
|
Revise middle ear & mastoid
|
$3,351.40 |
$3,351.40 |
$3,351.40 |
$6,547.81
|
|
Revise middle ear & mastoid
|
$4,435.60 |
$4,435.60 |
$4,435.60 |
$6,560.00
|
|
Revise middle ear & mastoid
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$6,547.81
|
|
Revise middle ear & mastoid
|
$4,479.80 |
$4,479.80 |
$4,479.80 |
$7,000.36
|
|
Revise middle ear & mastoid
|
$4,776.20 |
$4,776.20 |
$4,776.20 |
$7,000.36
|
|
Revise middle ear & mastoid 69645
|
$4,344.60 |
$4,344.60 |
$4,344.60 |
$7,000.36
|
|
Revise palsy hand tendon(s)
|
$2,776.80 |
$2,776.80 |
$2,776.80 |
$7,907.11
|
|
Revise palsy hand tendon(s)
|
$3,689.40 |
$3,689.40 |
$3,689.40 |
$8,453.60
|
|
Revise prosth vag graft lap
|
$3,718.00 |
$3,718.00 |
$3,718.00 |
$8,185.02
|
|
Revise radius or ulna
|
$3,666.00 |
$3,666.00 |
$3,666.00 |
$4,499.12
|
|
Revise radius & ulna
|
$3,356.60 |
$3,356.60 |
$3,356.60 |
$10,629.07
|
|
Revise reconst elbow joint
|
$6,123.00 |
$6,123.00 |
$6,123.00 |
$14,061.89
|
|
Revise reconst elbow joint
|
$7,150.00 |
$7,150.00 |
$7,150.00 |
$14,873.09
|
|
Revise/remove neuroelectrode
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$4,069.59
|
|
Revise/remove neuroreceiver
|
$1,359.80 |
$1,359.80 |
$1,359.80 |
$9,079.85
|
|
Revise/remove sling repair
|
$2,899.00 |
$2,899.00 |
$2,899.00 |
$3,744.41
|
|
Revise/repair chest wall 32905
|
$6,055.40 |
$6,055.40 |
$6,055.40 |
$3,250.40
|
|
Revise/replace knee joint
|
$5,491.20 |
$5,491.20 |
$5,491.20 |
$5,491.20
|
|
Revise/replace knee joint
|
$7,048.60 |
$7,048.60 |
$7,048.60 |
$7,048.60
|
|
Revise/repl vagus n eltrd
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$13,628.55
|
|
Revise spermatic cord veins
|
$1,495.00 |
$1,495.00 |
$1,495.00 |
$4,345.52
|
|
Revise spermatic cord veins
|
$1,869.40 |
$1,869.40 |
$1,869.40 |
$7,149.07
|
|
Revise spinal cord vsls thrc
|
$11,606.40 |
$11,606.40 |
$11,606.40 |
$4,548.69
|
|
Revise spine cord vsl thrlmb
|
$11,603.80 |
$11,603.80 |
$11,603.80 |
$4,547.78
|
|
Revise spine eltrd perq aray
|
$2,216.50 |
$2,216.50 |
$2,216.50 |
$7,766.27
|
|
Revise spine eltrd plate
|
$3,294.85 |
$3,294.85 |
$3,294.85 |
$14,756.87
|
|
Revise stomach bowel fusion 43860
|
$7,251.40 |
$7,251.40 |
$7,251.40 |
$3,110.40
|
|
Revise thumb tendon
|
$2,236.00 |
$2,236.00 |
$2,236.00 |
$3,594.44
|
|
Revise thumb tendon
|
$2,542.80 |
$2,542.80 |
$2,542.80 |
$3,591.33
|
|
Revise ulnar nerve at wrist
|
$1,292.20 |
$1,292.20 |
$1,292.20 |
$3,151.20
|
|
Revise ureter
|
$2,152.80 |
$2,152.80 |
$2,152.80 |
$4,081.37
|
|
Revise ureter
|
$3,166.80 |
$3,166.80 |
$3,166.80 |
$917.58
|
|
Revise urethra stage 1
|
$3,673.80 |
$3,673.80 |
$3,673.80 |
$5,882.50
|
|
Revise urine flow
|
$8,780.20 |
$8,780.20 |
$8,780.20 |
$2,322.51
|
|
Revise vag graft open abd
|
$4,305.60 |
$4,305.60 |
$4,305.60 |
$2,372.80
|
|
Revise vag graft via vagina
|
$2,033.20 |
$2,033.20 |
$2,033.20 |
$3,762.53
|
|
Revise windpipe scar
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$3,837.72
|
|
Revise wrist/forearm tendon
|
$1,921.40 |
$1,921.40 |
$1,921.40 |
$3,017.99
|
|
Revise wrist joint
|
$3,052.40 |
$3,052.40 |
$3,052.40 |
$4,155.20
|
|
Revision gastrojejunal anastomosis w/reconstruct-43865
|
$7,553.00 |
$7,553.00 |
$7,553.00 |
$4,189.60
|
|
Revision of ankle joint
|
$2,511.60 |
$2,511.60 |
$2,511.60 |
$8,412.89
|
|
Revision of aqueous shunt
|
$2,490.80 |
$2,490.80 |
$2,490.80 |
$3,173.34
|
|
Revision of arm nerve(s)
|
$2,964.00 |
$2,964.00 |
$2,964.00 |
$3,833.60
|
|
Revision of big toe
|
$1,448.20 |
$1,448.20 |
$1,448.20 |
$6,307.00
|
|
Revision of bladder & bowel
|
$7,264.40 |
$7,264.40 |
$7,264.40 |
$1,792.73
|
|
Revision of bladder neck
|
$2,116.40 |
$2,116.40 |
$2,116.40 |
$4,350.00
|
|
Revision of bladder/urethra
|
$4,911.40 |
$4,911.40 |
$4,911.40 |
$1,082.50
|
|
Revision of calf tendon
|
$1,666.60 |
$1,666.60 |
$1,666.60 |
$3,839.54
|
|
Revision of cervix
|
$1,198.60 |
$1,198.60 |
$1,198.60 |
$3,721.00
|
|
Revision of circulation
|
$10,400.00 |
$10,400.00 |
$10,400.00 |
$2,547.00
|
|
Revision of circulation
|
$9,880.00 |
$9,880.00 |
$9,880.00 |
$3,884.80
|
