|
Clsd tx iphal jnt disl w/manip req anes
|
$507.33 |
$507.33 |
$507.33 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$741.60 |
$741.60 |
$741.60 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$339.18 |
$339.18 |
$339.18 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$420.71 |
$420.71 |
$420.71 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$440.47 |
$440.47 |
$440.47 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$339.18 |
$339.18 |
$339.18 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$339.18 |
$339.18 |
$339.18 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$566.72 |
$566.72 |
$566.72 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$439.16 |
$439.16 |
$439.16 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$339.18 |
$339.18 |
$339.18 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$418.90 |
$418.90 |
$418.90 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$339.18 |
$339.18 |
$339.18 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$362.86 |
$362.86 |
$362.86 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$356.04 |
$356.04 |
$356.04 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$339.18 |
$339.18 |
$339.18 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$339.18 |
$339.18 |
$339.18 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$443.09 |
$443.09 |
$443.09 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$356.63 |
$356.63 |
$356.63 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$419.99 |
$419.99 |
$419.99 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$411.01 |
$411.01 |
$411.01 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$416.43 |
$416.43 |
$416.43 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$744.22 |
$744.22 |
$744.22 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$459.80 |
$459.80 |
$459.80 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$397.14 |
$397.14 |
$397.14 |
$487.15
|
|
Clsr 1 vsd w/wo patch w/vlvt
|
$2,679.31 |
$2,679.31 |
$2,679.31 |
$2,679.31
|
|
Clsr 1vsd w/wo ptch rmvl bnd
|
$2,659.32 |
$2,659.32 |
$2,659.32 |
$2,659.32
|
|
Cls tx of heel fracture w/manip 28405
|
$573.11 |
$573.11 |
$573.11 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,893.86
|
|
Cltx craniofacial separation
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$8,139.99
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$451.41 |
$451.41 |
$451.41 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$475.77 |
$475.77 |
$475.77 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$4,377.24
|
|
Cltx post ankle fx
|
$420.42 |
$420.42 |
$420.42 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$521.06 |
$521.06 |
$521.06 |
$619.30
|
|
Cltx thigh fx
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,986.00
|
|
Cltx thigh fx w/mnpj
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$3,740.85
|
|
Cmbn ant pst colprhy
|
$6,878.55 |
$6,878.55 |
$6,878.55 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$513.11 |
$513.11 |
$513.11 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$1,333.36
|
|
Cmp rpr tof wo plm atrs ptch
|
$2,765.23 |
$2,765.23 |
$2,765.23 |
$2,765.23
|
|
Cmptr ophth dx img ant segmt
|
$81.12 |
$81.12 |
$81.12 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$81.12 |
$81.12 |
$81.12 |
$98.00
|
|
#cms hgb-carboxyhemoglobin
|
$19.42 |
$19.42 |
$19.42 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$12.14 |
$12.14 |
$12.14 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$26.99 |
$26.99 |
$26.99 |
$89.76
|
|
Cmv pcr-sendout
|
$48.42 |
$48.42 |
$48.42 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$189.06 |
$189.06 |
$189.06 |
$313.60
|
|
Cntct lens hydrophil photoch
|
$236.66 |
$236.66 |
$236.66 |
$236.66
|
|
Co2 monitor per day
|
$513.11 |
$513.11 |
$513.11 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$3.62 |
$3.62 |
$3.62 |
$11,888.50
|
|
Coagulation time activated teg
|
$5.91 |
$5.91 |
$5.91 |
$52.47
|
|
Coagulation time lee & white
|
$6.47 |
$6.47 |
$6.47 |
$11.20
|
|
Coagulation time otr method
|
$6.20 |
$6.20 |
$6.20 |
$20.00
|
|
Coch imp ext proc/contr rplc
|
$14,283.08 |
$14,283.08 |
$14,283.08 |
$17,034.00
|
|
Coch implant headset replace
|
$766.38 |
$766.38 |
$766.38 |
$1,064.00
|
|
Coch implant microphone repl
|
$178.49 |
$178.49 |
$178.49 |
$890.83
|
|
Coch implant tran cable repl
|
$44.56 |
$44.56 |
$44.56 |
$193.52
|
|
Coch implant trans coil repl
|
$155.91 |
$155.91 |
$155.91 |
$677.57
|
|
Cochlear implt f/up exam <7
|
$176.93 |
$176.93 |
$176.93 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$176.93 |
$176.93 |
$176.93 |
$386.64
|
|
Cogenex amnio memb per sq cm
|
$171.12 |
$171.12 |
$171.12 |
$1.00
|
|
Cold agglutinin screen (arc)
|
$11.14 |
$11.14 |
$11.14 |
$48.10
|
|
Cold agglutinin titer
|
$11.12 |
$11.12 |
$11.12 |
$52.00
|
|
Colectomy/end colost/close dis seg 44143
|
$2,301.58 |
$2,301.58 |
$2,301.58 |
$2,880.80
|
|
Colectomy/ ileostomy without prctect 44150
|
$2,577.63 |
$2,577.63 |
$2,577.63 |
$3,530.40
|
|
Colectomy/ ileostomy w/prctect 44155
|
$2,859.55 |
$2,859.55 |
$2,859.55 |
$4,562.58
|
|
Colectomy partial w/anastomosis 44140
|
$1,879.89 |
$1,879.89 |
$1,879.89 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$2,639.58 |
$2,639.58 |
$2,639.58 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$2,268.07 |
$2,268.07 |
$2,268.07 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$2,904.14 |
$2,904.14 |
$2,904.14 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$1,736.94 |
$1,736.94 |
$1,736.94 |
$2,136.00
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$2,537.02 |
$2,537.02 |
$2,537.02 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$2,457.19 |
$2,457.19 |
$2,457.19 |
$3,176.40
|
|
Colectomy w/ileoanal anast
|
$3,085.40 |
$3,085.40 |
$3,085.40 |
$5,367.20
|
|
Colectomy w/neo-rectum pouch
|
$3,160.99 |
$3,160.99 |
$3,160.99 |
$5,500.80
|
|
Colistimethate sodium inj
|
$16.67 |
$16.67 |
$16.67 |
$82.71
|
|
Collagenase, clost hist inj
|
$104.53 |
$104.53 |
$104.53 |
$12,906.28
|
|
Collagen based wound filler
|
$60.91 |
$60.91 |
$60.91 |
$1,794.78
|
|
Collagen dressing <=16 sq in
|
$41.36 |
$41.36 |
$41.36 |
$42.50
|
|
Collagen drsg>16<=48 sq in
|
$41.36 |
$41.36 |
$41.36 |
$25.75
|
