|
Repair bronchus add-on
|
$593.60 |
$593.60 |
$593.60 |
$593.60
|
|
Repair brow defect
|
$3,185.60 |
$3,185.60 |
$3,185.60 |
$2,820.92
|
|
Repair cardiac wound without bypass
|
$5,984.80 |
$5,984.80 |
$5,984.80 |
$7,369.60
|
|
Repair carpal bone shorten
|
$3,856.00 |
$3,856.00 |
$3,856.00 |
$3,856.00
|
|
Repair cleft hand
|
$7,454.40 |
$7,454.40 |
$7,454.40 |
$3,986.00
|
|
Repair cleft lip/nasal
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$2,964.00 |
$2,964.00 |
$2,964.00 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$2,487.20 |
$2,487.20 |
$2,487.20 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$5,108.80 |
$5,108.80 |
$5,108.80 |
$5,108.80
|
|
Repair cleft lip/nasal
|
$2,693.60 |
$2,693.60 |
$2,693.60 |
$6,553.49
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,059.20 |
$1,059.20 |
$1,059.20 |
$1,059.20
|
|
Repair corporeal tear
|
$1,700.80 |
$1,700.80 |
$1,700.80 |
$2,990.00
|
|
Repair defect arm art 35045
|
$4,785.60 |
$4,785.60 |
$4,785.60 |
$6,366.08
|
|
Repair defect of artery
|
$6,715.20 |
$6,715.20 |
$6,715.20 |
$2,168.66
|
|
Repair defect of artery
|
$8,723.20 |
$8,723.20 |
$8,723.20 |
$5,706.00
|
|
Repair defect of artery 35011
|
$4,892.80 |
$4,892.80 |
$4,892.80 |
$6,305.95
|
|
Repair defect of artery 35081
|
$4,223.20 |
$4,223.20 |
$4,223.20 |
$3,497.40
|
|
Repair defect of artery 35102
|
$9,164.80 |
$9,164.80 |
$9,164.80 |
$3,922.38
|
|
Repair defect of artery aneurysm 35151
|
$6,035.20 |
$6,035.20 |
$6,035.20 |
$4,292.40
|
|
Repair defect of artery carotid subclav 35001
|
$5,473.60 |
$5,473.60 |
$5,473.60 |
$5,410.60
|
|
Repair deformity of toe
|
$1,307.20 |
$1,307.20 |
$1,307.20 |
$3,591.33
|
|
Repair degenerated kneecap
|
$4,083.20 |
$4,083.20 |
$4,083.20 |
$6,311.00
|
|
Repair dental ellis ii fx
|
$423.12 |
$423.12 |
$423.12 |
$442.48
|
|
Repair detached retina
|
$5,624.00 |
$5,624.00 |
$5,624.00 |
$5,912.40
|
|
Repair detached retina
|
$5,960.00 |
$5,960.00 |
$5,960.00 |
$6,889.27
|
|
Repair detached retina
|
$4,390.40 |
$4,390.40 |
$4,390.40 |
$3,468.40
|
|
Repair detached retina crtx
|
$2,764.80 |
$2,764.80 |
$2,764.80 |
$3,905.20
|
|
Repair detached retina pc
|
$2,539.20 |
$2,539.20 |
$2,539.20 |
$1,513.20
|
|
Repair eardrum structures
|
$4,329.60 |
$4,329.60 |
$4,329.60 |
$6,804.50
|
|
Repair elbow deb/attch open
|
$3,259.20 |
$3,259.20 |
$3,259.20 |
$3,839.54
|
|
Repair elbow perc
|
$2,073.60 |
$2,073.60 |
$2,073.60 |
$4,350.00
|
|
Repair elbow w/deb open
|
$2,590.40 |
$2,590.40 |
$2,590.40 |
$3,839.54
|
|
Repair esophagus and fistula
|
$3,888.00 |
$3,888.00 |
$3,888.00 |
$3,888.00
|
|
Repair esophagus opening
|
$2,524.00 |
$2,524.00 |
$2,524.00 |
$3,837.72
|
|
Repair esophagus opening
|
$3,518.40 |
$3,518.40 |
$3,518.40 |
$3,518.40
|
|
Repair esophagus wound 43410
|
$2,546.40 |
$2,546.40 |
$2,546.40 |
$2,546.40
|
|
Repair esophagus wound 43415
|
$6,279.20 |
$6,279.20 |
$6,279.20 |
$6,279.20
|
|
Repair extns tendon finger without grft ea
|
$2,785.15 |
$2,785.15 |
$2,785.15 |
$2,353.50
|
|
Repair extra toe(s)
|
$2,137.60 |
$2,137.60 |
$2,137.60 |
$4,350.00
|
|
Repair eyelid defect
|
$3,849.60 |
$3,849.60 |
$3,849.60 |
$3,849.60
|
|
Repair eyelid defect
|
$3,595.20 |
$3,595.20 |
$3,595.20 |
$4,462.45
|
|
Repair eyelid defect
|
$2,966.40 |
$2,966.40 |
$2,966.40 |
$2,966.40
|
|
Repair eyelid defect
|
$3,649.60 |
$3,649.60 |
$3,649.60 |
$3,609.60
|
|
Repair eyelid defect
|
$2,518.40 |
$2,518.40 |
$2,518.40 |
$3,986.00
|
|
Repair eyelid defect
|
$2,548.80 |
$2,548.80 |
$2,548.80 |
$2,733.00
|
|
Repair eyelid defect
|
$2,366.40 |
$2,366.40 |
$2,366.40 |
$2,760.73
|
|
Repair eyelid defect
|
$1,499.20 |
$1,499.20 |
$1,499.20 |
$2,838.93
|
|
Repair eyelid defect
|
$2,982.40 |
$2,982.40 |
$2,982.40 |
$2,982.40
|
|
Repair eyelid defect
|
$3,044.80 |
$3,044.80 |
$3,044.80 |
$2,760.73
|
|
Repair eyelid defect
|
$2,318.40 |
$2,318.40 |
$2,318.40 |
$2,760.73
|
|
Repair eyelid defect
|
$1,459.20 |
$1,459.20 |
$1,459.20 |
$2,760.73
|
|
Repair eyelid defect
|
$2,982.40 |
$2,982.40 |
$2,982.40 |
$2,982.40
|
|
Repair eyelid defect
|
$3,176.00 |
$3,176.00 |
$3,176.00 |
$3,176.00
|
|
Repair eyelid wound
|
$1,820.80 |
$1,820.80 |
$1,820.80 |
$2,760.73
|
|
Repair eyelid wound
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$3,296.00
|
|
Repair facial nerve
|
$5,726.40 |
$5,726.40 |
$5,726.40 |
$6,759.31
|
|
Repair facial nerve
|
$6,097.60 |
$6,097.60 |
$6,097.60 |
$6,839.00
|
|
Repair fibula nonunion
|
$4,726.40 |
$4,726.40 |
$4,726.40 |
$7,807.24
|
|
Repair finger deformity
|
$3,471.20 |
$3,471.20 |
$3,471.20 |
$3,471.20
|
|
Repair finger/hand tendon
|
$1,776.80 |
$1,776.80 |
$1,776.80 |
$4,204.20
|
|
Repair finger/hand tendon
|
$1,955.20 |
$1,955.20 |
$1,955.20 |
$4,150.20
|
|
Repair finger/hand tendon
|
$2,182.40 |
$2,182.40 |
$2,182.40 |
$4,351.50
|
|
Repair finger/hand tendon
|
$1,878.40 |
$1,878.40 |
$1,878.40 |
$3,848.00
|
|
Repair finger/hand tendon
|
$2,104.80 |
$2,104.80 |
$2,104.80 |
$3,839.54
|
|
Repair finger/hand tendon
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$3,839.54
|
|
Repair finger tendon
|
$1,334.40 |
$1,334.40 |
$1,334.40 |
$3,752.25
|
|
Repair fistula w/colostomy
|
$3,759.20 |
$3,759.20 |
$3,759.20 |
$3,759.20
|
|
Repair foot dislocation
|
$4,235.20 |
$4,235.20 |
$4,235.20 |
$5,810.00
|
|
Repair foot dislocation
|
$4,337.60 |
$4,337.60 |
$4,337.60 |
$6,307.00
|
|
Repair foot dislocation
|
$2,012.80 |
$2,012.80 |
$2,012.80 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$1,847.20 |
$1,847.20 |
$1,847.20 |
$4,379.20
|
|
Repair forearm tendon/muscle
|
$1,370.40 |
$1,370.40 |
$1,370.40 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$1,641.60 |
$1,641.60 |
$1,641.60 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$1,548.00 |
$1,548.00 |
$1,548.00 |
$5,507.00
|
|
Repair forearm tendon sheath
|
$3,313.60 |
$3,313.60 |
$3,313.60 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$3,339.20 |
$3,339.20 |
$3,339.20 |
$7,907.11
|
|
Repair/graft eye lesion
|
$4,638.40 |
$4,638.40 |
$4,638.40 |
$6,076.38
|
|
Repair/graft finger tendon
|
$1,766.40 |
$1,766.40 |
$1,766.40 |
$3,839.54
|
|
Repair/graft finger tendon
|
$1,885.60 |
$1,885.60 |
$1,885.60 |
$3,786.00
|
|
Repair/graft finger tendon
|
$1,626.40 |
$1,626.40 |
$1,626.40 |
$4,259.84
|
|
Repair/graft hand tendon
|
$1,992.80 |
$1,992.80 |
$1,992.80 |
$5,741.00
|
|
Repair/graft hand tendon
|
$2,414.40 |
$2,414.40 |
$2,414.40 |
$7,807.24
|
|
Repair/graft hand tendon
|
$2,192.00 |
$2,192.00 |
$2,192.00 |
$7,807.24
|
|
Repair/graft hand tendon
|
$2,406.40 |
$2,406.40 |
$2,406.40 |
$6,307.00
|
|
Repair/graft hand tendon
|
$1,688.00 |
$1,688.00 |
$1,688.00 |
$3,977.49
|
|
Repair/graft kneecap tendon
|
$3,982.40 |
$3,982.40 |
$3,982.40 |
$5,855.00
|
|
Repair/graft of foot tendon
|
$1,518.40 |
$1,518.40 |
$1,518.40 |
$6,653.00
|
|
Repair/graft of foot tendon
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$5,023.20
|
|
Repair/graft of thigh muscle
|
$4,156.80 |
$4,156.80 |
$4,156.80 |
$5,943.97
|
|
Repair/graft of tibia
|
$4,388.80 |
$4,388.80 |
$4,388.80 |
$7,464.80
|
|
Repair/graft of tibia
|
$6,208.00 |
$6,208.00 |
$6,208.00 |
$6,208.00
|
|
Repair/graft radius or ulna
|
$5,116.80 |
$5,116.80 |
$5,116.80 |
$7,913.97
|
|
Repair/graft radius or ulna
|
$4,739.20 |
$4,739.20 |
$4,739.20 |
$7,807.24
|
|
Repair/graft radius & ulna
|
$5,739.20 |
$5,739.20 |
$5,739.20 |
$8,159.00
|
|
Repair/graft radius & ulna
|
$5,528.00 |
$5,528.00 |
$5,528.00 |
$5,528.00
|
|
Repair/graft wrist bone
|
$3,788.80 |
$3,788.80 |
$3,788.80 |
$5,376.00
|
|
Repair hand joint
|
$1,651.20 |
$1,651.20 |
$1,651.20 |
$3,839.54
|
|
Repair hand joint with graft
|
$1,996.00 |
$1,996.00 |
$1,996.00 |
$3,839.54
|
|
Repair hand joint with graft
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$3,336.65
|
|
Repair heart septum defect 33681
|
$4,489.60 |
$4,489.60 |
$4,489.60 |
$4,489.60
|
