|
Revision of foot tendon
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$3,388.00
|
|
Revision of heart chamber
|
$2,187.91 |
$2,187.91 |
$2,187.91 |
$2,187.91
|
|
Revision of heart chamber
|
$1,871.60 |
$1,871.60 |
$1,871.60 |
$1,871.60
|
|
Revision of heart chamber
|
$2,025.96 |
$2,025.96 |
$2,025.96 |
$2,025.96
|
|
Revision of heart veins dir/ptch 33645
|
$2,459.85 |
$2,459.85 |
$2,459.85 |
$3,492.00
|
|
Revision of hip bone
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,413.38
|
|
Revision of hip bones
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$8,420.80
|
|
Revision of hip tendon
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Revision of horseshoe kidney
|
$1,486.45 |
$1,486.45 |
$1,486.45 |
$1,486.45
|
|
Revision of ileostomy complicated 44314
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
$2,236.08
|
|
Revision of ileostomy; simple 44312
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
$4,332.25
|
|
Revision of infusion pump
|
$5,138.46 |
$5,138.46 |
$5,138.46 |
$4,285.86
|
|
Revision of iris
|
$756.27 |
$756.27 |
$756.27 |
$1,480.00
|
|
Revision of iris
|
$756.27 |
$756.27 |
$756.27 |
$1,271.00
|
|
Revision of jaw muscle/bone
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$1,752.89
|
|
Revision of jaw muscle/bone
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,837.72
|
|
Revision of kidney/ureter
|
$1,497.96 |
$1,497.96 |
$1,497.96 |
$1,748.16
|
|
Revision of kidney/ureter
|
$1,804.34 |
$1,804.34 |
$1,804.34 |
$7,056.00
|
|
Revision of knee joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$15,069.60
|
|
Revision of knee joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$12,555.20
|
|
Revision of knee joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$8,885.39
|
|
Revision of knee joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$12,555.20
|
|
Revision of knee joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$14,254.12
|
|
Revision of larynx
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$7,000.36
|
|
Revision of leg vein 37780
|
$4,341.66 |
$4,341.66 |
$4,341.66 |
$3,724.63
|
|
Revision of lung
|
$1,772.18 |
$1,772.18 |
$1,772.18 |
$1,772.18
|
|
Revision of mitral valve
|
$2,087.88 |
$2,087.88 |
$2,087.88 |
$4,886.26
|
|
Revision of mitral valve
|
$2,393.10 |
$2,393.10 |
$2,393.10 |
$2,393.10
|
|
Revision of neck muscle
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,419.00
|
|
Revision of neck muscle
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Revision of neck muscle
|
$973.71 |
$973.71 |
$973.71 |
$1,328.80
|
|
Revision of neck muscle/rib
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,413.38
|
|
Revision of nose
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,811.00
|
|
Revision of nose
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$5,773.60
|
|
Revision of nose
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$4,082.40
|
|
Revision of nose
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$7,000.36
|
|
Revision of nose
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,759.31
|
|
Revision of nose
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,839.00
|
|
Revision of pelvis
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,413.38
|
|
Revision of penis
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,667.00
|
|
Revision of penis
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,081.37
|
|
Revision of penis
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,040.25
|
|
Revision of penis
|
$837.32 |
$837.32 |
$837.32 |
$2,739.10
|
|
Revision of penis
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,453.20
|
|
Revision of pharyngeal walls
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Revision of pharyngeal walls
|
$2,974.18 |
$2,974.18 |
$2,974.18 |
$2,974.18
|
|
Revision of pulmonary artery
|
$2,181.42 |
$2,181.42 |
$2,181.42 |
$2,181.42
|
|
Revision of pulmonary valve
|
$3,098.40 |
$3,098.40 |
$3,098.40 |
$3,098.40
|
|
Revision of radius
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,871.42
|
|
Revision of radius
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$4,499.12
|
|
Revision of sciatic nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$2,888.00
|
|
Revision of scrotum
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,081.37
|
|
Revision of scrotum
|
$7,372.68 |
$7,372.68 |
$7,372.68 |
$5,626.86
|
|
Revision of spinal shunt
|
$4,697.33 |
$4,697.33 |
$4,697.33 |
$6,998.88
|
|
Revision of testis
|
$7,372.68 |
$7,372.68 |
$7,372.68 |
$5,986.78
|
|
Revision of thigh muscles
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,834.58
|
|
Revision of toe
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,108.00
|
|
Revision of tricuspid valve
|
$3,465.62 |
$3,465.62 |
$3,465.62 |
$3,465.62
|
|
Revision of tricuspid valve w/bypass 33460
|
$3,406.53 |
$3,406.53 |
$3,406.53 |
$5,873.60
|
|
Revision of ulna
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,376.00
|
|
Revision of unstable kneecap
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,036.13
|
|
Revision of unstable kneecap
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,112.94
|
|
Revision of upper arm
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$13,116.76
|
|
Revision of ureter
|
$1,205.49 |
$1,205.49 |
$1,205.49 |
$4,339.40
|
|
Revision of urethra
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,081.37
|
|
Revision of urethra
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,081.37
|
|
Revision of urethra
|
$6,878.55 |
$6,878.55 |
$6,878.55 |
$5,741.00
|
|
Revision of urinary tract
|
$1,411.27 |
$1,411.27 |
$1,411.27 |
$1,411.27
|
|
Revision open av fistula without thromb
|
$7,651.38 |
$7,651.38 |
$7,651.38 |
$8,319.20
|
|
Revision orbitofacial bones
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Revision/removal of kneecap
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,311.00
|
|
Revision tips
|
$7,826.12 |
$7,826.12 |
$7,826.12 |
$10,358.00
|
|
Revis reconst shoulder joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$10,629.07
|
|
Revis reconst shoulder joint
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$7,841.60
|
|
Revitalon 1 square cm
|
$171.12 |
$171.12 |
$171.12 |
$1.00
|
|
Revita, per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$389.83
|
|
Revj fem anast autog vn grf
|
$7,651.38 |
$7,651.38 |
$7,651.38 |
$6,035.20
|
|
Revj fem anast nonautog grf
|
$7,651.38 |
$7,651.38 |
$7,651.38 |
$6,396.89
|
|
Revj mstdc rsltg compl mstdc
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,966.64
|
|
Revj mstdc rsltg tympanplsty
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Revj open gstr rstcv px
|
$2,714.36 |
$2,714.36 |
$2,714.36 |
$4,667.00
|
|
Revj prior hypspad repair
|
$7,372.68 |
$7,372.68 |
$7,372.68 |
$6,015.75
|
|
Revj/rmvl nea pn w/int nstim
|
$4,807.27 |
$4,807.27 |
$4,807.27 |
$5,682.40
|
|
Rev mastoidectomy rsltg modf rad mstdc 69602
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,966.64
|
|
Rev-rem impl neurostim gen-rec
|
$4,807.27 |
$4,807.27 |
$4,807.27 |
$4,534.00
|
|
Rev/rmv perph nstim eltrd ra
|
$4,807.27 |
$4,807.27 |
$4,807.27 |
$4,412.35
|
|
Rev/rmv prph sac/gstr npg/r
|
$4,807.27 |
$4,807.27 |
$4,807.27 |
$4,721.00
|
|
Rev rplcm arthrp 1ntrspc crv
|
$24,109.66 |
$24,109.66 |
$24,109.66 |
$5,440.80
|
|
Rev rplcm rthrp 1ntrspc lmbr
|
$24,109.66 |
$24,109.66 |
$24,109.66 |
$17,913.59
|
|
Rev/rplcmt sk-mnt crnl nstm
|
$42,430.50 |
$42,430.50 |
$42,430.50 |
$23,756.52
|
|
Rev rplc/rmv thrc vrt tethrg
|
$24,109.66 |
$24,109.66 |
$24,109.66 |
$5,033.60
|
|
Rev/rplct hpglsl nstm ary pg
|
$15,321.63 |
$15,321.63 |
$15,321.63 |
$14,685.79
|
|
Rezafungin 200 mg intravenous solution
|
$14.92 |
$14.92 |
$14.92 |
$4,987.55
|
|
Rf abltj nrv nrvtg si jt
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$3,188.50
|
|
Rheumatoid factor qualitative
|
$8.47 |
$8.47 |
$8.47 |
$57.07
|
|
Rheumatoid factor quantitative
|
$7.82 |
$7.82 |
$7.82 |
$57.00
|
|
Rh ig minidose im
|
$110.40 |
$110.40 |
$110.40 |
$100.24
|
|
Rhinp prim lat&alr crtlge&/elvtn nsl tip
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$4,256.00
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$6.66 |
$6.66 |
$6.66 |
$234.12
|
|
Rho d immune globulin 50 mcg
|
$31.64 |
$31.64 |
$31.64 |
$106.14
|
