|
Revision of iris
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$1,480.00
|
|
Revision of iris
|
$2,361.60 |
$2,361.60 |
$2,361.60 |
$1,271.00
|
|
Revision of jaw muscle/bone
|
$928.00 |
$928.00 |
$928.00 |
$1,752.89
|
|
Revision of jaw muscle/bone
|
$2,006.40 |
$2,006.40 |
$2,006.40 |
$3,837.72
|
|
Revision of kidney/ureter
|
$5,865.60 |
$5,865.60 |
$5,865.60 |
$1,748.16
|
|
Revision of kidney/ureter
|
$7,056.00 |
$7,056.00 |
$7,056.00 |
$7,056.00
|
|
Revision of knee joint
|
$3,923.20 |
$3,923.20 |
$3,923.20 |
$15,069.60
|
|
Revision of knee joint
|
$4,052.80 |
$4,052.80 |
$4,052.80 |
$12,555.20
|
|
Revision of knee joint
|
$4,291.20 |
$4,291.20 |
$4,291.20 |
$8,885.39
|
|
Revision of knee joint
|
$3,998.40 |
$3,998.40 |
$3,998.40 |
$12,555.20
|
|
Revision of knee joint
|
$5,704.00 |
$5,704.00 |
$5,704.00 |
$14,254.12
|
|
Revision of larynx
|
$2,418.40 |
$2,418.40 |
$2,418.40 |
$7,000.36
|
|
Revision of leg vein 37780
|
$1,139.20 |
$1,139.20 |
$1,139.20 |
$3,724.63
|
|
Revision of neck muscle
|
$1,740.80 |
$1,740.80 |
$1,740.80 |
$5,419.00
|
|
Revision of neck muscle
|
$1,232.80 |
$1,232.80 |
$1,232.80 |
$3,839.54
|
|
Revision of neck muscle
|
$1,328.80 |
$1,328.80 |
$1,328.80 |
$1,328.80
|
|
Revision of nose
|
$1,258.40 |
$1,258.40 |
$1,258.40 |
$3,811.00
|
|
Revision of nose
|
$2,541.60 |
$2,541.60 |
$2,541.60 |
$5,773.60
|
|
Revision of nose
|
$3,218.40 |
$3,218.40 |
$3,218.40 |
$4,082.40
|
|
Revision of nose
|
$4,261.60 |
$4,261.60 |
$4,261.60 |
$7,000.36
|
|
Revision of nose
|
$2,044.00 |
$2,044.00 |
$2,044.00 |
$6,759.31
|
|
Revision of nose
|
$3,931.20 |
$3,931.20 |
$3,931.20 |
$6,839.00
|
|
Revision of penis
|
$1,627.20 |
$1,627.20 |
$1,627.20 |
$4,667.00
|
|
Revision of penis
|
$1,892.00 |
$1,892.00 |
$1,892.00 |
$4,081.37
|
|
Revision of penis
|
$1,777.60 |
$1,777.60 |
$1,777.60 |
$4,040.25
|
|
Revision of penis
|
$1,612.80 |
$1,612.80 |
$1,612.80 |
$2,739.10
|
|
Revision of penis
|
$1,045.60 |
$1,045.60 |
$1,045.60 |
$4,453.20
|
|
Revision of pharyngeal walls
|
$4,636.00 |
$4,636.00 |
$4,636.00 |
$6,547.81
|
|
Revision of radius
|
$3,329.60 |
$3,329.60 |
$3,329.60 |
$6,871.42
|
|
Revision of radius
|
$3,761.60 |
$3,761.60 |
$3,761.60 |
$4,499.12
|
|
Revision of sciatic nerve
|
$2,888.00 |
$2,888.00 |
$2,888.00 |
$2,888.00
|
|
Revision of scrotum
|
$912.80 |
$912.80 |
$912.80 |
$4,081.37
|
|
Revision of scrotum
|
$1,743.20 |
$1,743.20 |
$1,743.20 |
$5,626.86
|
|
Revision of spinal shunt
|
$1,613.60 |
$1,613.60 |
$1,613.60 |
$6,998.88
|
|
Revision of testis
|
$1,796.80 |
$1,796.80 |
$1,796.80 |
$5,986.78
|
|
Revision of thigh muscles
|
$3,649.60 |
$3,649.60 |
$3,649.60 |
$6,834.58
|
|
Revision of toe
|
$1,254.40 |
$1,254.40 |
$1,254.40 |
$3,108.00
|
|
Revision of tricuspid valve w/bypass 33460
|
$5,873.60 |
$5,873.60 |
$5,873.60 |
$5,873.60
|
|
Revision of ulna
|
$3,222.40 |
$3,222.40 |
$3,222.40 |
$5,376.00
|
|
Revision of unstable kneecap
|
$3,660.80 |
$3,660.80 |
$3,660.80 |
$6,036.13
|
|
Revision of unstable kneecap
|
$3,660.80 |
$3,660.80 |
$3,660.80 |
$7,112.94
|
|
Revision of ureter
|
$4,675.20 |
$4,675.20 |
$4,675.20 |
$4,339.40
|
|
Revision of urethra
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$4,081.37
|
|
Revision of urethra
|
$1,153.60 |
$1,153.60 |
$1,153.60 |
$4,081.37
|
|
Revision of urethra
|
$833.60 |
$833.60 |
$833.60 |
$5,741.00
|
|
Revision open av fistula without thromb
|
$1,846.40 |
$1,846.40 |
$1,846.40 |
$8,319.20
|
|
Revision orbitofacial bones
|
$2,089.60 |
$2,089.60 |
$2,089.60 |
$6,547.81
|
|
Revision/removal of kneecap
|
$3,676.80 |
$3,676.80 |
$3,676.80 |
$6,311.00
|
|
Revision tips
|
$15,049.60 |
$15,049.60 |
$15,049.60 |
$10,358.00
|
|
Revis reconst shoulder joint
|
$7,987.20 |
$7,987.20 |
$7,987.20 |
$10,629.07
|
|
Revis reconst shoulder joint
|
$4,315.20 |
$4,315.20 |
$4,315.20 |
$7,841.60
|
|
Revj fem anast autog vn grf
|
$6,035.20 |
$6,035.20 |
$6,035.20 |
$6,035.20
|
|
Revj fem anast nonautog grf
|
$5,864.00 |
$5,864.00 |
$5,864.00 |
$6,396.89
|
|
Revj mstdc rsltg compl mstdc
|
$5,049.60 |
$5,049.60 |
$5,049.60 |
$6,966.64
|
|
Revj mstdc rsltg tympanplsty
|
$5,456.00 |
$5,456.00 |
$5,456.00 |
$6,547.81
|
|
Revj open gstr rstcv px
|
$4,748.80 |
$4,748.80 |
$4,748.80 |
$4,667.00
|
|
Revj prior hypspad repair
|
$3,580.00 |
$3,580.00 |
$3,580.00 |
$6,015.75
|
|
Rev mastoidectomy rsltg modf rad mstdc 69602
|
$5,336.00 |
$5,336.00 |
$5,336.00 |
$6,966.64
|
|
Rev-rem impl neurostim gen-rec
|
$908.00 |
$908.00 |
$908.00 |
$4,534.00
|
|
Rev/rmvl gstr nstim eltrd
|
$3,552.00 |
$3,552.00 |
$3,552.00 |
$3,552.00
|
|
Rev/rmv perph nstim eltrd ra
|
$607.20 |
$607.20 |
$607.20 |
$4,412.35
|
|
Rev/rmv prph sac/gstr npg/r
|
$645.60 |
$645.60 |
$645.60 |
$4,721.00
|
|
Rev rplcm arthrp 1ntrspc crv
|
$5,440.80 |
$5,440.80 |
$5,440.80 |
$5,440.80
|
|
Rev/rplcmt sk-mnt crnl nstm
|
$3,140.80 |
$3,140.80 |
$3,140.80 |
$23,756.52
|
|
Rev rplc/rmv thrc vrt tethrg
|
$5,033.60 |
$5,033.60 |
$5,033.60 |
$5,033.60
|
|
Revsc opn/prq tib/pero stent
|
$18,817.60 |
$18,817.60 |
$18,817.60 |
$9,196.55
|
|
Rf abltj nrv nrvtg si jt
|
$2,441.60 |
$2,441.60 |
$2,441.60 |
$3,188.50
|
|
Rheumatoid factor qualitative
|
$48.57 |
$48.57 |
$48.57 |
$57.07
|
|
Rheumatoid factor quantitative
|
$48.57 |
$48.57 |
$48.57 |
$57.00
|
|
Rh ig minidose im
|
$80.00 |
$80.00 |
$80.00 |
$100.24
|
|
Rhinp prim lat&alr crtlge&/elvtn nsl tip
|
$2,936.00 |
$2,936.00 |
$2,936.00 |
$4,256.00
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$22.82 |
$22.82 |
$22.82 |
$234.12
|
|
Rho d immune globulin 50 mcg
|
$28.00 |
$28.00 |
$28.00 |
$106.14
|
|
Rho d immune globulin inj
|
$94.40 |
$94.40 |
$94.40 |
$217.71
|
|
Rho(d) immune globulin (rhig) human full dose im
|
$132.00 |
$132.00 |
$132.00 |
$172.80
|
|
Rhythm ecg with report
|
$28.00 |
$28.00 |
$28.00 |
$28.00
|
|
Rib and Chest X-ray (3 views, left side)
|
$360.36 |
$360.36 |
$360.36 |
$360.85
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$484.56 |
$484.56 |
$484.56 |
$491.70
|
|
Rib cartilage graft
|
$1,844.00 |
$1,844.00 |
$1,844.00 |
$6,547.81
|
|
Rib X-ray (3 views, both sides)
|
$288.86 |
$288.86 |
$288.86 |
$397.10
|
|
Right ventric recording
|
$453.60 |
$453.60 |
$453.60 |
$2,187.60
|
|
Risankizumab-rzaa 60 mg/ml intravenous solution
|
$27.36 |
$27.36 |
$27.36 |
$30,071.50
|
|
Risk ascvd tst once pr 12 mo
|
$34.40 |
$34.40 |
$34.40 |
$35.25
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$13.60 |
$13.60 |
$13.60 |
$2,429.37
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$115.40 |
$115.40 |
$115.40 |
$6,287.16
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$111.76 |
$111.76 |
$111.76 |
$5,309.20
|
|
Rmv anterior spine instrumentation 22855
|
$2,667.20 |
$2,667.20 |
$2,667.20 |
$2,667.20
|
|
Rmv implant contraceptive capsule 11976
|
$356.80 |
$356.80 |
$356.80 |
$846.42
|
|
Rmvl esophgl sphnctr dev
|
$1,639.20 |
$1,639.20 |
$1,639.20 |
$5,553.60
|
|
Rmvl ext fixj sys under anes
|
$1,047.20 |
$1,047.20 |
$1,047.20 |
$2,797.08
|
|
Rmvl fb upr arm/elbow deep
|
$2,676.80 |
$2,676.80 |
$2,676.80 |
$3,648.96
|
|
Rmvl fecal impaction/fb spx under anes
|
$848.00 |
$848.00 |
$848.00 |
$2,111.46
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$1,876.00
|
|
Rmvl i-artic rx delivery dev 20705
|
$298.40 |
$298.40 |
$298.40 |
$559.00
|
|
Rmvl icd by tv extr
|
$2,120.80 |
$2,120.80 |
$2,120.80 |
$4,375.80
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$952.80 |
$952.80 |
$952.80 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$994.40 |
$994.40 |
$994.40 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$916.00 |
$916.00 |
$916.00 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$525.60 |
$525.60 |
$525.60 |
$4,069.52
|
|
Rmvl lung xcp tot pneumonectomy sleeve lob 32486
|
$5,736.80 |
$5,736.80 |
$5,736.80 |
$5,736.80
|
