|
Clsd tx fx radius/ulna without manip 25560
|
$1,392.00 |
$1,392.00 |
$1,392.00 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$2,532.80 |
$2,532.80 |
$2,532.80 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,985.60 |
$1,985.60 |
$1,985.60 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$1,860.80 |
$1,860.80 |
$1,860.80 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$1,755.20 |
$1,755.20 |
$1,755.20 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$944.80 |
$944.80 |
$944.80 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$564.00 |
$564.00 |
$564.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$725.60 |
$725.60 |
$725.60 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,740.90 |
$1,740.90 |
$1,740.90 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$1,190.40 |
$1,190.40 |
$1,190.40 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$638.40 |
$638.40 |
$638.40 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$574.84 |
$574.84 |
$574.84 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$620.80 |
$620.80 |
$620.80 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,784.00 |
$1,784.00 |
$1,784.00 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$1,830.40 |
$1,830.40 |
$1,830.40 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$1,579.20 |
$1,579.20 |
$1,579.20 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$1,943.46 |
$1,943.46 |
$1,943.46 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$760.00 |
$760.00 |
$760.00 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$5,227.20 |
$5,227.20 |
$5,227.20 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$484.00 |
$484.00 |
$484.00 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$1,281.60 |
$1,281.60 |
$1,281.60 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$2,163.20 |
$2,163.20 |
$2,163.20 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$1,140.80 |
$1,140.80 |
$1,140.80 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$2,102.40 |
$2,102.40 |
$2,102.40 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,708.80 |
$2,708.80 |
$2,708.80 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,459.10 |
$2,459.10 |
$2,459.10 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$669.12 |
$669.12 |
$669.12 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$578.77 |
$578.77 |
$578.77 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,387.20 |
$2,387.20 |
$2,387.20 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,283.20 |
$1,283.20 |
$1,283.20 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$739.20 |
$739.20 |
$739.20 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,496.00 |
$1,496.00 |
$1,496.00 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$2,572.80 |
$2,572.80 |
$2,572.80 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,596.80 |
$1,596.80 |
$1,596.80 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,425.60 |
$1,425.60 |
$1,425.60 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$1,921.60 |
$1,921.60 |
$1,921.60 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$2,368.00 |
$2,368.00 |
$2,368.00 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,865.60 |
$1,865.60 |
$1,865.60 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$1,609.60 |
$1,609.60 |
$1,609.60 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,707.20 |
$2,707.20 |
$2,707.20 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,384.00 |
$2,384.00 |
$2,384.00 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$2,468.80 |
$2,468.80 |
$2,468.80 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$1,543.20 |
$1,543.20 |
$1,543.20 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$1,664.00 |
$1,664.00 |
$1,664.00 |
$4,377.24
|
|
Cltx post ankle fx
|
$1,408.00 |
$1,408.00 |
$1,408.00 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$2,971.64 |
$2,971.64 |
$2,971.64 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,985.60 |
$1,985.60 |
$1,985.60 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$1,908.80 |
$1,908.80 |
$1,908.80 |
$619.30
|
|
Cltx thigh fx
|
$2,148.80 |
$2,148.80 |
$2,148.80 |
$3,986.00
|
|
Cltx thigh fx w/mnpj
|
$2,659.20 |
$2,659.20 |
$2,659.20 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$4,342.40 |
$4,342.40 |
$4,342.40 |
$3,740.85
|
|
Cmbn ant pst colprhy
|
$1,937.60 |
$1,937.60 |
$1,937.60 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$503.20 |
$503.20 |
$503.20 |
$627.89
|
|
C motor evoked uppr limbs
|
$491.20 |
$491.20 |
$491.20 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$1,333.36
|
|
Cmptr ophth dx img ant segmt
|
$65.60 |
$65.60 |
$65.60 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$80.80 |
$80.80 |
$80.80 |
$98.00
|
|
#cms hgb-carboxyhemoglobin
|
$64.28 |
$64.28 |
$64.28 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$33.57 |
$33.57 |
$33.57 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$39.20 |
$39.20 |
$39.20 |
$89.76
|
|
Cmv pcr-sendout
|
$88.80 |
$88.80 |
$88.80 |
$175.70
|
|
Co2 monitor per day
|
$115.20 |
$115.20 |
$115.20 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$4.32 |
$4.32 |
$4.32 |
$11,888.50
|
|
Coagulation time activated teg
|
$32.85 |
$32.85 |
$32.85 |
$52.47
|
|
Coagulation time lee & white
|
$11.20 |
$11.20 |
$11.20 |
$11.20
|
|
Coagulation time otr method
|
$11.20 |
$11.20 |
$11.20 |
$20.00
|
|
Cocaine hcl nasal (numbrino)
|
$2.16 |
$2.16 |
$2.16 |
$512.30
|
|
Cochlear implt f/up exam <7
|
$369.60 |
$369.60 |
$369.60 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$345.60 |
$345.60 |
$345.60 |
$386.64
|
|
Cocm by rhc/fqhc 60 min mo
|
$304.00 |
$304.00 |
$304.00 |
$87.13
|
|
Cold agglutinin screen (arc)
|
$48.57 |
$48.57 |
$48.57 |
$48.10
|
|
Cold agglutinin titer
|
$48.57 |
$48.57 |
$48.57 |
$52.00
|
|
Colectomy/end colost/close dis seg 44143
|
$4,085.60 |
$4,085.60 |
$4,085.60 |
$2,880.80
|
|
Colectomy/ ileostomy without prctect 44150
|
$4,586.40 |
$4,586.40 |
$4,586.40 |
$3,530.40
|
|
Colectomy/ ileostomy w/prctect 44155
|
$5,118.40 |
$5,118.40 |
$5,118.40 |
$4,562.58
|
|
Colectomy partial w/anastomosis 44140
|
$3,296.80 |
$3,296.80 |
$3,296.80 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$4,078.40 |
$4,078.40 |
$4,078.40 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$5,203.20 |
$5,203.20 |
$5,203.20 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$3,053.60 |
$3,053.60 |
$3,053.60 |
$2,136.00
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$4,476.80 |
$4,476.80 |
$4,476.80 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$4,344.00 |
$4,344.00 |
$4,344.00 |
$3,176.40
|
|
Colectomy w/ileoanal anast
|
$5,367.20 |
$5,367.20 |
$5,367.20 |
$5,367.20
|
|
Colectomy w/neo-rectum pouch
|
$5,500.80 |
$5,500.80 |
$5,500.80 |
$5,500.80
|
|
Collagenase, clost hist inj
|
$73.60 |
$73.60 |
$73.60 |
$12,906.28
|
|
Collagen dressing <=16 sq in
|
$59.20 |
$59.20 |
$59.20 |
$42.50
|
|
Collagen imp urinary 2.5 ml
|
$1,629.60 |
$1,629.60 |
$1,629.60 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$297.22 |
$297.22 |
$297.22 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$80.00 |
$80.00 |
$80.00 |
$61.20
|
|
Collar cerv adlt perfit ace extric
|
$192.80 |
$192.80 |
$192.80 |
$67.73
|
|
Collar cerv ascend 172 reg
|
$289.60 |
$289.60 |
$289.60 |
$224.11
|
|
Collar cerv patriot adlt
|
$323.20 |
$323.20 |
$323.20 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$492.35 |
$492.35 |
$492.35 |
$162.00
|
