|
Circum 28 days or older
|
$388.80 |
$388.80 |
$388.80 |
$4,074.80
|
|
Circumcise/surg/28 days or < 54160
|
$435.60 |
$435.60 |
$435.60 |
$1,219.20
|
|
Circumcision (newborn)
|
$406.80 |
$406.80 |
$406.80 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$395.67 |
$395.67 |
$395.67 |
$205.56
|
|
C-kit mutation liquid tumor - sendout
|
$551.40 |
$551.40 |
$551.40 |
$666.60
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$484.20 |
$484.20 |
$484.20 |
$576.60
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$14,062.80 |
$14,062.80 |
$14,062.80 |
$15,560.16
|
|
Claviculectomy partial
|
$1,008.60 |
$1,008.60 |
$1,008.60 |
$3,839.54
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$40.80 |
$40.80 |
$40.80 |
$55.20
|
|
Clip ligating vesolock lg
|
$528.60 |
$528.60 |
$528.60 |
$4,320.00
|
|
Cllr miami j sm
|
$186.00 |
$186.00 |
$186.00 |
$536.64
|
|
Clofarabine 1 mg/ml intravenous solution
|
$4,163.69 |
$4,163.69 |
$4,163.69 |
$4,784.71
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$122.66 |
$122.66 |
$122.66 |
$85.37
|
|
Close bronchial fistula 32815
|
$5,377.80 |
$5,377.80 |
$5,377.80 |
$6,816.80
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$682.80 |
$682.80 |
$682.80 |
$520.80
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$793.20 |
$793.20 |
$793.20 |
$1,806.01
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$1,498.80 |
$1,498.80 |
$1,498.80 |
$1,642.82
|
|
Closed tx/acetabululm without manip 27220
|
$999.60 |
$999.60 |
$999.60 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$871.80 |
$871.80 |
$871.80 |
$2,291.20
|
|
Closed tx humerus fx without manip 23600
|
$606.00 |
$606.00 |
$606.00 |
$498.40
|
|
Closed tx humerus fx w/manip 24505
|
$934.20 |
$934.20 |
$934.20 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$294.60 |
$294.60 |
$294.60 |
$386.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$1,022.40 |
$1,022.40 |
$1,022.40 |
$2,569.28
|
|
Closed tx septal&nose fx
|
$781.20 |
$781.20 |
$781.20 |
$3,651.90
|
|
Closed tx sesamoid fx 28530
|
$217.20 |
$217.20 |
$217.20 |
$445.50
|
|
Closed tx/talus fracture without manip 28430
|
$442.80 |
$442.80 |
$442.80 |
$442.80
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$504.60 |
$504.60 |
$504.60 |
$472.50
|
|
Close median sternotomy separation 21750
|
$1,331.40 |
$1,331.40 |
$1,331.40 |
$1,660.00
|
|
Clos txnose fx without stablz 21315
|
$537.00 |
$537.00 |
$537.00 |
$2,392.80
|
|
Closure enterostomy lg/sm intestine 44620
|
$1,641.60 |
$1,641.60 |
$1,641.60 |
$1,641.60
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$2,457.00 |
$2,457.00 |
$2,457.00 |
$2,835.00
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$1,934.40
|
|
Closure intestinal cutaneous fistula 44640
|
$2,654.40 |
$2,654.40 |
$2,654.40 |
$3,443.20
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$641.40 |
$641.40 |
$641.40 |
$1,259.62
|
|
Closure of windpipe lesion 31820
|
$849.00 |
$849.00 |
$849.00 |
$3,837.72
|
|
Closure paravalvlr leak pq
|
$652.20 |
$652.20 |
$652.20 |
$9,434.46
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$579.60 |
$579.60 |
$579.60 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$626.40 |
$626.40 |
$626.40 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$640.20 |
$640.20 |
$640.20 |
$489.60
|
|
Clsd tx clav dislc without manip 23520
|
$427.80 |
$427.80 |
$427.80 |
$1,980.00
|
|
Clsd tx clavicle dislocation without manip 23540
|
$419.40 |
$419.40 |
$419.40 |
$419.40
|
|
Clsd tx clavicle fracture w/manip 23505
|
$652.80 |
$652.80 |
$652.80 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$408.60 |
$408.60 |
$408.60 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$336.60 |
$336.60 |
$336.60 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$343.80 |
$343.80 |
$343.80 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$819.60 |
$819.60 |
$819.60 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$588.00 |
$588.00 |
$588.00 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$376.80 |
$376.80 |
$376.80 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$935.40 |
$935.40 |
$935.40 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$507.00 |
$507.00 |
$507.00 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$273.00 |
$273.00 |
$273.00 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$303.60 |
$303.60 |
$303.60 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$597.60 |
$597.60 |
$597.60 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,914.00 |
$1,914.00 |
$1,914.00 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$511.80 |
$511.80 |
$511.80 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$974.40 |
$974.40 |
$974.40 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$504.60 |
$504.60 |
$504.60 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$756.60 |
$756.60 |
$756.60 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$711.00 |
$711.00 |
$711.00 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$666.00 |
$666.00 |
$666.00 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$719.40 |
$719.40 |
$719.40 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,141.80 |
$1,141.80 |
$1,141.80 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$427.80 |
$427.80 |
$427.80 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$544.80 |
$544.80 |
$544.80 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$603.00 |
$603.00 |
$603.00 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$857.40 |
$857.40 |
$857.40 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$494.40 |
$494.40 |
$494.40 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$401.40 |
$401.40 |
$401.40 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$496.80 |
$496.80 |
$496.80 |
$3,678.17
|
|
Clsd tx nose fx without manip 21310
|
$236.40 |
$236.40 |
$236.40 |
$323.95
|
|
Clsd tx of ankle fracture w/manip 28435
|
$696.60 |
$696.60 |
$696.60 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$709.20 |
$709.20 |
$709.20 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$604.80 |
$604.80 |
$604.80 |
$498.85
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$677.40 |
$677.40 |
$677.40 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$369.60 |
$369.60 |
$369.60 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$488.40 |
$488.40 |
$488.40 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$825.60 |
$825.60 |
$825.60 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$433.20 |
$433.20 |
$433.20 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$842.40 |
$842.40 |
$842.40 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$979.80 |
$979.80 |
$979.80 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,914.00 |
$1,914.00 |
$1,914.00 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$349.80 |
$349.80 |
$349.80 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$183.60 |
$183.60 |
$183.60 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$276.60 |
$276.60 |
$276.60 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$597.60 |
$597.60 |
$597.60 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$917.40 |
$917.40 |
$917.40 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$487.80 |
$487.80 |
$487.80 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$572.40 |
$572.40 |
$572.40 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$572.40 |
$572.40 |
$572.40 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$568.80 |
$568.80 |
$568.80 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$894.60 |
$894.60 |
$894.60 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$600.60 |
$600.60 |
$600.60 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$543.00 |
$543.00 |
$543.00 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$761.40 |
$761.40 |
$761.40 |
$725.40
|
|
Cmbn ant pst colprhy
|
$1,616.40 |
$1,616.40 |
$1,616.40 |
$4,928.00
|
|
#cms hgb-carboxyhemoglobin
|
$54.00 |
$54.00 |
$54.00 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$160.80 |
$160.80 |
$160.80 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$69.00 |
$69.00 |
$69.00 |
$89.76
|
|
Cmv pcr-sendout
|
$117.60 |
$117.60 |
$117.60 |
$175.70
|