|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,497.90 |
$2,497.90 |
$2,497.90 |
$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
|
$571.20 |
$571.20 |
$571.20 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$436.70 |
$436.70 |
$436.70 |
$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
|
$5,553.79 |
$5,553.79 |
$5,553.79 |
$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
|
$2,172.80 |
$2,172.80 |
$2,172.80 |
$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
|
$6,751.20 |
$6,751.20 |
$6,751.20 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$6,540.72 |
$6,540.72 |
$6,540.72 |
$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
|
$1,649.74 |
$1,649.74 |
$1,649.74 |
$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 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
|
|
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
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$306.65 |
$306.65 |
$306.65 |
$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
|
$93.16 |
$93.16 |
$93.16 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$93.16 |
$93.16 |
$93.16 |
$155.40
|
|
Collj & interpj data ea 30 d
|
$128.80 |
$128.80 |
$128.80 |
$172.35
|
|
Colon motility 6 hr study
|
$308.00 |
$308.00 |
$308.00 |
$477.92
|
|
Colonoscopy (diagnostic)
|
$813.60 |
$813.60 |
$813.60 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$690.40 |
$690.40 |
$690.40 |
$2,288.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$2,288.00
|
|
Colonoscopy for bleeding 44391
|
$1,658.40 |
$1,658.40 |
$1,658.40 |
$2,147.00
|
|
Colonoscopy for foreign body
|
$971.20 |
$971.20 |
$971.20 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$908.80 |
$908.80 |
$908.80 |
$1,645.43
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$769.60 |
$769.60 |
$769.60 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$1,039.20 |
$1,039.20 |
$1,039.20 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$746.40 |
$746.40 |
$746.40 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$7,082.40 |
$7,082.40 |
$7,082.40 |
$3,029.00
|
|
Colonoscopy w/balloon dilat
|
$1,497.60 |
$1,497.60 |
$1,497.60 |
$1,681.30
|
|
Colonoscopy w/band ligation
|
$1,916.00 |
$1,916.00 |
$1,916.00 |
$2,288.00
|
|
Colonoscopy w/control bleed
|
$1,724.80 |
$1,724.80 |
$1,724.80 |
$2,101.71
|
|
Colonoscopy w/decompression
|
$628.80 |
$628.80 |
$628.80 |
$1,572.20
|
|
Colonoscopy w/dilation
|
$1,368.80 |
$1,368.80 |
$1,368.80 |
$2,495.25
|
|
Colonoscopy w/endoscope Ultrasound
|
$652.00 |
$652.00 |
$652.00 |
$2,288.00
|
|
Colonoscopy w/endoscopic fnb
|
$769.60 |
$769.60 |
$769.60 |
$2,004.81
|
|
Colonoscopy/w endoscopic stent 45389
|
$732.80 |
$732.80 |
$732.80 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$1,050.40 |
$1,050.40 |
$1,050.40 |
$1,645.43
|
|
Colonoscopy w/injection
|
$980.00 |
$980.00 |
$980.00 |
$2,449.20
|
|
Colonoscopy with ablation
|
$6,856.00 |
$6,856.00 |
$6,856.00 |
$3,290.95
|
|
Colonoscopy (with biopsy)
|
$1,047.20 |
$1,047.20 |
$1,047.20 |
$2,214.00
|
|
Colonoscopy with biopsy
|
$984.00 |
$984.00 |
$984.00 |
$1,555.20
|
|
Colonoscopy (with polyp removal)
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$2,288.00
|
|
Colonoscopy w/ndl aspir/bx
|
$697.60 |
$697.60 |
$697.60 |
$2,704.00
|
|
Colonoscopy w/resection
|
$842.40 |
$842.40 |
$842.40 |
$3,035.44
|
