|
Treat humerus fracture
|
$1,255.80 |
$1,255.80 |
$1,255.80 |
$11,250.40
|
|
Treat humerus fracture
|
$1,335.60 |
$1,335.60 |
$1,335.60 |
$10,629.07
|
|
Treat kneecap dislocation
|
$1,809.00 |
$1,809.00 |
$1,809.00 |
$7,807.24
|
|
Treat kneecap fracture
|
$1,815.60 |
$1,815.60 |
$1,815.60 |
$6,311.00
|
|
Treat knee dislocation
|
$3,583.20 |
$3,583.20 |
$3,583.20 |
$2,220.89
|
|
Treat knee fracture
|
$2,319.60 |
$2,319.60 |
$2,319.60 |
$3,486.60
|
|
Treat knee fracture
|
$2,186.40 |
$2,186.40 |
$2,186.40 |
$4,521.40
|
|
Treat knee fracture
|
$3,380.40 |
$3,380.40 |
$3,380.40 |
$2,938.00
|
|
Treat knee fracture 27530
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$550.00
|
|
Treat knuckle dislocation
|
$984.00 |
$984.00 |
$984.00 |
$1,523.90
|
|
Treat knuckle dislocation
|
$902.40 |
$902.40 |
$902.40 |
$4,332.00
|
|
Treat lower leg bone lesion
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$3,977.49
|
|
Treat lower leg dislocation
|
$474.60 |
$474.60 |
$474.60 |
$530.75
|
|
Treat lower leg dislocation
|
$2,611.80 |
$2,611.80 |
$2,611.80 |
$3,908.80
|
|
Treat lower leg fracture
|
$1,698.60 |
$1,698.60 |
$1,698.60 |
$6,475.41
|
|
Treat lower leg fracture
|
$2,649.60 |
$2,649.60 |
$2,649.60 |
$14,241.77
|
|
Treat lower leg fracture
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$12,653.00
|
|
Treat lower leg joint
|
$1,184.40 |
$1,184.40 |
$1,184.40 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$1,168.20 |
$1,168.20 |
$1,168.20 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$4,722.60 |
$4,722.60 |
$4,722.60 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$145.20 |
$145.20 |
$145.20 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$136.80 |
$136.80 |
$136.80 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$120.00 |
$120.00 |
$120.00 |
$203.35
|
|
Treatment of ankle fracture
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$8,412.89
|
|
Treatment of ankle fracture
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$8,453.60
|
|
Treatment of ankle fracture
|
$2,128.20 |
$2,128.20 |
$2,128.20 |
$7,907.11
|
|
Treatment of ankle fracture
|
$1,890.00 |
$1,890.00 |
$1,890.00 |
$7,913.97
|
|
Treatment of ankle fracture 27786
|
$936.60 |
$936.60 |
$936.60 |
$520.80
|
|
Treatment of fibula fracture
|
$1,726.80 |
$1,726.80 |
$1,726.80 |
$6,311.00
|
|
Treatment of fibula fracture 27780
|
$663.60 |
$663.60 |
$663.60 |
$491.50
|
|
Treatment of foot infection
|
$586.20 |
$586.20 |
$586.20 |
$2,614.25
|
|
Treatment of foot infection
|
$856.20 |
$856.20 |
$856.20 |
$3,821.05
|
|
Treatment of heel fracture 28400
|
$786.00 |
$786.00 |
$786.00 |
$473.00
|
|
Treatment of thigh fracture
|
$1,212.60 |
$1,212.60 |
$1,212.60 |
$476.16
|
|
Treatment of thigh fracture
|
$1,748.40 |
$1,748.40 |
$1,748.40 |
$1,748.40
|
|
Treatment of thigh fracture
|
$3,291.00 |
$3,291.00 |
$3,291.00 |
$5,109.00
|
|
Treatment of thigh fracture
|
$838.80 |
$838.80 |
$838.80 |
$548.90
|
|
Treatment of thigh fracture
|
$3,494.40 |
$3,494.40 |
$3,494.40 |
$6,389.60
|
|
Treatment of thigh fracture
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$1,772.97
|
|
Treatment of thigh fracture
|
$2,218.80 |
$2,218.80 |
$2,218.80 |
$3,409.00
|
|
Treatment of thigh fracture
|
$2,163.60 |
$2,163.60 |
$2,163.60 |
$3,764.80
|
|
Treatment of thigh fracture
|
$3,445.80 |
$3,445.80 |
$3,445.80 |
$5,505.50
|
|
Treatment of thigh fracture
|
$3,322.20 |
$3,322.20 |
$3,322.20 |
$3,796.00
|
|
Treatment of tibia fracture
|
$1,305.60 |
$1,305.60 |
$1,305.60 |
$6,183.84
|
|
Treatment of tibia fracture
|
$2,013.60 |
$2,013.60 |
$2,013.60 |
$8,665.60
|
|
Treatment of tibia fracture
|
$2,413.20 |
$2,413.20 |
$2,413.20 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$337.80 |
$337.80 |
$337.80 |
$369.70
|
|
Treatment radiation delivery level 2
|
$4,742.40 |
$4,742.40 |
$4,742.40 |
$767.65
|
|
Treat metacarpal fracture
|
$786.00 |
$786.00 |
$786.00 |
$3,977.49
|
|
Treat metacarpal fracture
|
$858.60 |
$858.60 |
$858.60 |
$5,464.97
|
|
Treat metatarsal fracture
|
$537.00 |
$537.00 |
$537.00 |
$3,839.54
|
|
Treat metatarsal fracture
|
$1,486.80 |
$1,486.80 |
$1,486.80 |
$8,453.60
|
|
Treat midfoot fracture each
|
$491.40 |
$491.40 |
$491.40 |
$1,851.78
|
|
Treat midfoot fracture each
|
$1,306.20 |
$1,306.20 |
$1,306.20 |
$6,192.78
|
|
Treat pelvic fracture(s)
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$1,506.40
|
|
Treat pelvic ring fracture
|
$2,727.00 |
$2,727.00 |
$2,727.00 |
$2,223.20
|
|
Treat pelvic ring fracture
|
$3,330.00 |
$3,330.00 |
$3,330.00 |
$2,727.20
|
|
Treat pelvic ring fracture
|
$3,496.20 |
$3,496.20 |
$3,496.20 |
$3,332.00
|
|
Treat radius fracture
|
$1,929.00 |
$1,929.00 |
$1,929.00 |
$7,807.24
|
|
Treat radius fracture
|
$1,459.80 |
$1,459.80 |
$1,459.80 |
$14,061.89
|
|
Treat skull fracture
|
$1,679.40 |
$1,679.40 |
$1,679.40 |
$2,984.80
|
|
Treat slipped epiphysis
|
$2,032.20 |
$2,032.20 |
$2,032.20 |
$4,499.12
|
|
Treat sternum fracture
|
$151.20 |
$151.20 |
$151.20 |
$423.00
|
|
Treat thigh fracture
|
$1,480.80 |
$1,480.80 |
$1,480.80 |
$6,510.40
|
|
Treat thigh fracture
|
$2,623.20 |
$2,623.20 |
$2,623.20 |
$4,083.00
|
|
Treat thigh fracture
|
$2,122.80 |
$2,122.80 |
$2,122.80 |
$1,893.86
|
|
Treat thigh fracture
|
$3,726.60 |
$3,726.60 |
$3,726.60 |
$4,726.80
|
|
Treat thigh fracture
|
$751.20 |
$751.20 |
$751.20 |
$618.80
|
|
Treat thigh fracture
|
$1,662.60 |
$1,662.60 |
$1,662.60 |
$2,802.80
|
|
Treat thigh fracture
|
$976.20 |
$976.20 |
$976.20 |
$2,032.10
|
|
Treat thigh fracture
|
$2,650.20 |
$2,650.20 |
$2,650.20 |
$3,580.50
|
|
Treat thigh fx growth plate
|
$1,540.20 |
$1,540.20 |
$1,540.20 |
$1,938.38
|
|
Treat thigh fx growth plate
|
$2,004.60 |
$2,004.60 |
$2,004.60 |
$7,413.38
|
|
Treat thumb fracture
|
$765.00 |
$765.00 |
$765.00 |
$2,508.80
|
|
Treat toe dislocation
|
$375.60 |
$375.60 |
$375.60 |
$3,821.05
|
|
Treat ulnar fracture
|
$1,672.20 |
$1,672.20 |
$1,672.20 |
$1,662.00
|
|
Treat ulnar fracture
|
$1,620.60 |
$1,620.60 |
$1,620.60 |
$5,926.25
|
|
Treat vaginal bleeding
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$379.60
|
|
Treat wrist bone fracture
|
$729.00 |
$729.00 |
$729.00 |
$1,548.40
|
|
Treat wrist dislocation
|
$372.00 |
$372.00 |
$372.00 |
$656.25
|
|
Treponema pallidum antibody
|
$144.00 |
$144.00 |
$144.00 |
$70.40
|
|
Trg gene rearrangement anal
|
$760.80 |
$760.80 |
$760.80 |
$455.70
|
|
Triglycerides
|
$93.00 |
$93.00 |
$93.00 |
$58.05
|
|
Trim nondyst nails
|
$228.00 |
$228.00 |
$228.00 |
$113.40
|
|
Trnscath plc stent crv crtd without prtct
|
$5,721.00 |
$5,721.00 |
$5,721.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,418.00 |
$11,418.00 |
$11,418.00 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$3,420.60 |
$3,420.60 |
$3,420.60 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$21,957.60 |
$21,957.60 |
$21,957.60 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$23,000.40 |
$23,000.40 |
$23,000.40 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$23,000.40 |
$23,000.40 |
$23,000.40 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,270.00 |
$6,270.00 |
$6,270.00 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,460.20 |
$3,460.20 |
$3,460.20 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,005.80 |
$2,005.80 |
$2,005.80 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,005.80 |
$2,005.80 |
$2,005.80 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,028.60 |
$2,028.60 |
$2,028.60 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$4,918.80 |
$4,918.80 |
$4,918.80 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$1,689.60 |
$1,689.60 |
$1,689.60 |
$3,078.00
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$1,431.00 |
$1,431.00 |
$1,431.00 |
$2,371.50
|
