|
Cine/video x-rays add-on
|
$91.20 |
$91.20 |
$91.20 |
$293.05
|
|
Circum 28 days or older
|
$496.00 |
$496.00 |
$496.00 |
$4,074.80
|
|
Circumcise/surg/28 days or < 54160
|
$1,465.93 |
$1,465.93 |
$1,465.93 |
$1,219.20
|
|
Circumcision (newborn)
|
$4,024.90 |
$4,024.90 |
$4,024.90 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$4.00 |
$4.00 |
$4.00 |
$205.56
|
|
C-kit mutation liquid tumor - sendout
|
$659.20 |
$659.20 |
$659.20 |
$666.60
|
|
C-laminoplasty w/graft/plate
|
$4,108.00 |
$4,108.00 |
$4,108.00 |
$4,108.00
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$6,528.73 |
$6,528.73 |
$6,528.73 |
$15,560.16
|
|
Claviculectomy partial
|
$2,875.20 |
$2,875.20 |
$2,875.20 |
$3,839.54
|
|
Claviculectomy total
|
$3,488.00 |
$3,488.00 |
$3,488.00 |
$4,499.12
|
|
Clean out mastoid cavity
|
$1,033.60 |
$1,033.60 |
$1,033.60 |
$1,033.60
|
|
Clearance of airways
|
$140.00 |
$140.00 |
$140.00 |
$213.07
|
|
Clearance of airways
|
$201.60 |
$201.60 |
$201.60 |
$444.60
|
|
Clearance of tear duct
|
$2,134.40 |
$2,134.40 |
$2,134.40 |
$795.53
|
|
C-lens fitg corneosclrl lens
|
$203.20 |
$203.20 |
$203.20 |
$165.50
|
|
C-lens fitg tech aphakia 1
|
$160.80 |
$160.80 |
$160.80 |
$165.50
|
|
C-lens fitg tech aphakia ou
|
$200.80 |
$200.80 |
$200.80 |
$197.60
|
|
C-lens fitg tech corneosclrl
|
$168.00 |
$168.00 |
$168.00 |
$122.20
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$31.07 |
$31.07 |
$31.07 |
$55.20
|
|
Clip ligating vesolock lg
|
$842.32 |
$842.32 |
$842.32 |
$4,320.00
|
|
Clitoroplasty intersex state
|
$2,900.00 |
$2,900.00 |
$2,900.00 |
$3,786.00
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$74.04 |
$74.04 |
$74.04 |
$85.37
|
|
Close bladder-uterus fistula
|
$1,926.40 |
$1,926.40 |
$1,926.40 |
$1,926.40
|
|
Close bronchial fistula 32815
|
$6,816.80 |
$6,816.80 |
$6,816.80 |
$6,816.80
|
|
Close chest after drainage
|
$2,191.20 |
$2,191.20 |
$2,191.20 |
$2,191.20
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$1,876.80 |
$1,876.80 |
$1,876.80 |
$520.80
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$2,110.40 |
$2,110.40 |
$2,110.40 |
$1,806.01
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$1,642.82
|
|
Closed tx/acetabululm without manip 27220
|
$2,113.60 |
$2,113.60 |
$2,113.60 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$2,291.20 |
$2,291.20 |
$2,291.20 |
$2,291.20
|
|
Closed tx humerus fx without manip 23600
|
$1,612.80 |
$1,612.80 |
$1,612.80 |
$498.40
|
|
Closed tx humerus fx w/manip 24505
|
$2,444.80 |
$2,444.80 |
$2,444.80 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$386.40 |
$386.40 |
$386.40 |
$386.40
|
|
Closed tx nose/jaw fx
|
$1,929.60 |
$1,929.60 |
$1,929.60 |
$2,903.97
|
|
Closed tx orbit without manipulj
|
$1,197.07 |
$1,197.07 |
$1,197.07 |
$998.40
|
|
Closed tx orbit w/manipulj
|
$2,528.00 |
$2,528.00 |
$2,528.00 |
$3,136.80
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,864.00 |
$2,864.00 |
$2,864.00 |
$2,569.28
|
|
Closed tx septal&nose fx
|
$1,004.80 |
$1,004.80 |
$1,004.80 |
$3,651.90
|
|
Closed tx sesamoid fx 28530
|
$572.80 |
$572.80 |
$572.80 |
$445.50
|
|
Closed tx/talus fracture without manip 28430
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$442.80
|
|
Closed tx vert fx w/manj
|
$2,140.80 |
$2,140.80 |
$2,140.80 |
$3,839.54
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$682.40 |
$682.40 |
$682.40 |
$472.50
|
|
Close mastoid fistula
|
$3,299.20 |
$3,299.20 |
$3,299.20 |
$3,299.20
|
|
Close median sternotomy separation 21750
|
$1,660.00 |
$1,660.00 |
$1,660.00 |
$1,660.00
|
|
Close tear duct opening
|
$1,054.40 |
$1,054.40 |
$1,054.40 |
$436.44
|
|
Close tear duct opening
|
$732.80 |
$732.80 |
$732.80 |
$353.74
|
|
Close tear system fistula
|
$3,116.80 |
$3,116.80 |
$3,116.80 |
$3,586.17
|
|
Clostridium toxin a w/optic
|
$35.20 |
$35.20 |
$35.20 |
$35.20
|
|
Clos txnose fx without stablz 21315
|
$668.80 |
$668.80 |
$668.80 |
$2,392.80
|
|
Closure enterostomy lg/sm intestine 44620
|
$2,134.40 |
$2,134.40 |
$2,134.40 |
$1,641.60
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$3,936.80 |
$3,936.80 |
$3,936.80 |
$2,835.00
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$2,504.80 |
$2,504.80 |
$2,504.80 |
$1,934.40
|
|
Closure intestinal cutaneous fistula 44640
|
$3,443.20 |
$3,443.20 |
$3,443.20 |
$3,443.20
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$970.24 |
$970.24 |
$970.24 |
$1,259.62
|
|
Closure of eyelid by suture
|
$868.80 |
$868.80 |
$868.80 |
$1,701.96
|
|
Closure of salivary fistula
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$3,169.60
|
|
Closure of windpipe lesion 31820
|
$1,069.60 |
$1,069.60 |
$1,069.60 |
$3,837.72
|
|
Closure paravalvlr leak pq
|
$22,833.32 |
$22,833.32 |
$22,833.32 |
$9,434.46
|
|
Clot factor fletcher fact
|
$39.20 |
$39.20 |
$39.20 |
$119.50
|
|
Clot factor viii reltd antgn
|
$95.72 |
$95.72 |
$95.72 |
$140.42
|
|
Clot factor wght kininogen
|
$38.40 |
$38.40 |
$38.40 |
$157.50
|
|
Clot factor xii hageman
|
$95.72 |
$95.72 |
$95.72 |
$138.40
|
|
Clot factor xiii fibrin scrn
|
$32.85 |
$32.85 |
$32.85 |
$56.85
|
|
Clot factor xiii fibrin stab
|
$39.20 |
$39.20 |
$39.20 |
$106.40
|
|
Clotting assay whole blood
|
$95.72 |
$95.72 |
$95.72 |
$105.95
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$1,566.40 |
$1,566.40 |
$1,566.40 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$1,635.20 |
$1,635.20 |
$1,635.20 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$842.40 |
$842.40 |
$842.40 |
$489.60
|
|
Clsd tx clav dislc without manip 23520
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$1,980.00
|
|
Clsd tx clavicle dislocation without manip 23540
|
$1,137.60 |
$1,137.60 |
$1,137.60 |
$419.40
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,747.20 |
$1,747.20 |
$1,747.20 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$1,078.40 |
$1,078.40 |
$1,078.40 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$453.60 |
$453.60 |
$453.60 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$454.40 |
$454.40 |
$454.40 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$2,084.80 |
$2,084.80 |
$2,084.80 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$1,556.80 |
$1,556.80 |
$1,556.80 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$507.20 |
$507.20 |
$507.20 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$3,737.60 |
$3,737.60 |
$3,737.60 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$1,363.20 |
$1,363.20 |
$1,363.20 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$700.80 |
$700.80 |
$700.80 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$466.05 |
$466.05 |
$466.05 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,654.40 |
$2,654.40 |
$2,654.40 |
$1,726.01
|
|
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
|
$796.80 |
$796.80 |
$796.80 |
$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
|
$538.40 |
$538.40 |
$538.40 |
$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
|