|
Treat humerus fracture
|
$3,169.40 |
$3,169.40 |
$3,169.40 |
$12,299.10
|
|
Treat humerus fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,808.80
|
|
Treat humerus fracture
|
$3,419.00 |
$3,419.00 |
$3,419.00 |
$10,902.51
|
|
Treat humerus fracture
|
$3,876.60 |
$3,876.60 |
$3,876.60 |
$10,742.40
|
|
Treat humerus fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,790.00
|
|
Treat humerus fracture
|
$2,524.60 |
$2,524.60 |
$2,524.60 |
$10,629.07
|
|
Treat humerus fracture
|
$2,974.40 |
$2,974.40 |
$2,974.40 |
$7,906.00
|
|
Treat kneecap dislocation
|
$1,554.80 |
$1,554.80 |
$1,554.80 |
$1,063.40
|
|
Treat kneecap dislocation
|
$3,304.60 |
$3,304.60 |
$3,304.60 |
$6,070.00
|
|
Treat kneecap fracture
|
$2,696.20 |
$2,696.20 |
$2,696.20 |
$6,839.00
|
|
Treat knee dislocation
|
$2,126.80 |
$2,126.80 |
$2,126.80 |
$2,211.05
|
|
Treat knee dislocation
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$7,413.38
|
|
Treat knee dislocation
|
$4,547.40 |
$4,547.40 |
$4,547.40 |
$7,413.38
|
|
Treat knee fracture
|
$3,486.60 |
$3,486.60 |
$3,486.60 |
$3,486.60
|
|
Treat knee fracture
|
$4,521.40 |
$4,521.40 |
$4,521.40 |
$4,521.40
|
|
Treat knee fracture
|
$2,938.00 |
$2,938.00 |
$2,938.00 |
$3,460.60
|
|
Treat knee fracture 27530
|
$896.35 |
$896.35 |
$896.35 |
$550.73
|
|
Treat knee fracture(s)
|
$896.35 |
$896.35 |
$896.35 |
$643.26
|
|
Treat knuckle dislocation
|
$1,138.80 |
$1,138.80 |
$1,138.80 |
$1,726.01
|
|
Treat knuckle dislocation
|
$1,827.80 |
$1,827.80 |
$1,827.80 |
$4,332.00
|
|
Treat lower jaw fracture 21462
|
$2,862.60 |
$2,862.60 |
$2,862.60 |
$7,000.36
|
|
Treat lower leg bone lesion
|
$2,241.20 |
$2,241.20 |
$2,241.20 |
$4,092.85
|
|
Treat lower leg dislocation
|
$896.35 |
$896.35 |
$896.35 |
$532.60
|
|
Treat lower leg fracture
|
$2,886.00 |
$2,886.00 |
$2,886.00 |
$6,475.41
|
|
Treat lower leg fracture
|
$3,845.40 |
$3,845.40 |
$3,845.40 |
$12,905.86
|
|
Treat lower leg fracture
|
$4,791.80 |
$4,791.80 |
$4,791.80 |
$12,653.00
|
|
Treat lower leg joint
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$3,166.15 |
$3,166.15 |
$3,166.15 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,112.55 |
$4,112.55 |
$4,112.55 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$2,733.90 |
$2,733.90 |
$2,733.90 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$10,333.70 |
$10,333.70 |
$10,333.70 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$481.65 |
$481.65 |
$481.65 |
$226.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$131.95 |
$131.95 |
$131.95 |
$148.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,258.40 |
$1,258.40 |
$1,258.40 |
$4,230.80
|
|
Treatment mouth roof lesion
|
$12,121.20 |
$12,121.20 |
$12,121.20 |
$4,256.70
|
|
Treatment of anal fissure
|
$538.20 |
$538.20 |
$538.20 |
$1,278.72
|
|
Treatment of anal fissure w/dilat 46940
|
$611.00 |
$611.00 |
$611.00 |
$3,640.00
|
|
Treatment of ankle fracture
|
$2,275.00 |
$2,275.00 |
$2,275.00 |
$7,913.97
|
|
Treatment of ankle fracture
|
$2,761.20 |
$2,761.20 |
$2,761.20 |
$8,453.60
|
|
Treatment of ankle fracture
|
$2,914.60 |
$2,914.60 |
$2,914.60 |
$7,906.00
|
|
Treatment of ankle fracture
|
$3,421.60 |
$3,421.60 |
$3,421.60 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$896.35 |
$896.35 |
$896.35 |
$528.00
|
|
Treatment of corneal lesion
|
$902.20 |
$902.20 |
$902.20 |
$856.80
|
|
Treatment of eyelid lesions
|
$243.10 |
$243.10 |
$243.10 |
$352.04
|
|
Treatment of fibula fracture
|
$2,514.20 |
$2,514.20 |
$2,514.20 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$896.35 |
$896.35 |
$896.35 |
$528.00
|
|
Treatment of foot infection
|
$725.40 |
$725.40 |
$725.40 |
$2,928.60
|
|
Treatment of foot infection
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$3,839.54
|
|
Treatment of gum lesion
|
$5,536.70 |
$5,536.70 |
$5,536.70 |
$3,164.85
|
|
Treatment of head injury 62010
|
$5,571.80 |
$5,571.80 |
$5,571.80 |
$3,604.00
|
|
Treatment of heel fracture 28400
|
$896.35 |
$896.35 |
$896.35 |
$478.40
|
|
Treatment of miscarriage
|
$10,333.70 |
$10,333.70 |
$10,333.70 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$348.40 |
$348.40 |
$348.40 |
$3,734.50
|
|
Treatment of penis lesion
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
$4,081.37
|
|
Treatment of penis lesion
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$3,515.40
|
|
Treatment of rectal prolapse
|
$143.00 |
$143.00 |
$143.00 |
$1,052.80
|
|
Treatment of retinal lesion
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$1,741.60
|
|
Treatment of retinal lesion
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$1,336.20
|
|
Treatment of thigh fracture
|
$1,677.00 |
$1,677.00 |
$1,677.00 |
$487.50
|
|
Treatment of thigh fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,749.06
|
|
Treatment of thigh fracture
|
$5,109.00 |
$5,109.00 |
$5,109.00 |
$4,785.00
|
|
Treatment of thigh fracture
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$570.40
|
|
Treatment of thigh fracture
|
$2,116.40 |
$2,116.40 |
$2,116.40 |
$6,389.60
|
|
Treatment of thigh fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,790.00
|
|
Treatment of thigh fracture
|
$4,321.20 |
$4,321.20 |
$4,321.20 |
$2,896.50
|
|
Treatment of thigh fracture
|
$3,764.80 |
$3,764.80 |
$3,764.80 |
$2,254.50
|
|
Treatment of thigh fracture
|
$5,505.50 |
$5,505.50 |
$5,505.50 |
$4,380.00
|
|
Treatment of thigh fracture
|
$3,796.00 |
$3,796.00 |
$3,796.00 |
$3,796.00
|
|
Treatment of tibia fracture
|
$1,937.00 |
$1,937.00 |
$1,937.00 |
$6,183.84
|
|
Treatment of tibia fracture
|
$3,260.40 |
$3,260.40 |
$3,260.40 |
$6,347.40
|
|
Treatment of tibia fracture
|
$3,757.00 |
$3,757.00 |
$3,757.00 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$896.35 |
$896.35 |
$896.35 |
$371.40
|
|
Treatment of urethra lesion
|
$1,983.80 |
$1,983.80 |
$1,983.80 |
$4,061.71
|
|
Treatment of urethra lesion
|
$787.80 |
$787.80 |
$787.80 |
$4,061.71
|
|
Treatment of urethra lesion
|
$824.20 |
$824.20 |
$824.20 |
$2,874.36
|
|
Treatment radiation delivery level 2
|
$2,753.40 |
$2,753.40 |
$2,753.40 |
$867.24
|
|
Treatment x10sv retinopathy
|
$1,255.80 |
$1,255.80 |
$1,255.80 |
$1,513.20
|
|
Treat metacarpal fracture
|
$1,443.00 |
$1,443.00 |
$1,443.00 |
$4,289.60
|
|
Treat metacarpal fracture
|
$1,838.20 |
$1,838.20 |
$1,838.20 |
$5,741.00
|
|
Treat metatarsal fracture
|
$936.00 |
$936.00 |
$936.00 |
$3,839.54
|
|
Treat metatarsal fracture
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$8,241.00
|
|
Treat midfoot fracture each
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,893.86
|
|
Treat midfoot fracture each
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$6,445.00
|
|
Treat neck spine fracture
|
$5,418.40 |
$5,418.40 |
$5,418.40 |
$3,572.80
|
|
Treat odontoid fx without graft
|
$5,907.20 |
$5,907.20 |
$5,907.20 |
$5,448.00
|
|
Treat pelvic ring fracture
|
$4,189.90 |
$4,189.90 |
$4,189.90 |
$2,727.20
|
|
Treat pelvic ring fracture
|
$5,441.80 |
$5,441.80 |
$5,441.80 |
$3,332.00
|
|
Treat penis lesion graft
|
$3,749.20 |
$3,749.20 |
$3,749.20 |
$5,986.78
|
|
Treat penis lesion graft
|
$4,414.80 |
$4,414.80 |
$4,414.80 |
$7,976.07
|
|
Treat radius fracture
|
$2,173.60 |
$2,173.60 |
$2,173.60 |
$7,907.11
|
|
Treat radius fracture
|
$2,563.60 |
$2,563.60 |
$2,563.60 |
$9,791.00
|
|
Treat sesamoid bone fracture
|
$668.20 |
$668.20 |
$668.20 |
$7,907.11
|
|
Treat skull fracture
|
$4,583.80 |
$4,583.80 |
$4,583.80 |
$2,984.80
|
|
Treat spinal cord lesion
|
$683.80 |
$683.80 |
$683.80 |
$1,142.50
|
|
Treat spinal cord lesion
|
$691.60 |
$691.60 |
$691.60 |
$1,337.00
|
|
Treat spine fracture
|
$5,166.20 |
$5,166.20 |
$5,166.20 |
$3,485.60
|
|
Treat sternum fracture
|
$896.35 |
$896.35 |
$896.35 |
$423.00
|
|
Treat thigh fracture
|
$1,510.60 |
$1,510.60 |
$1,510.60 |
$661.00
|
|
Treat thigh fracture
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$6,510.40
|
|
Treat thigh fracture
|
$4,578.60 |
$4,578.60 |
$4,578.60 |
$3,933.60
|
