|
Repair biceps tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,055.92
|
|
Repair bladder defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,553.40
|
|
Repair bladder neck
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,463.96
|
|
Repair bladder & vagina
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,855.00
|
|
Repair bladder-vagina lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,463.96
|
|
Repair bladder-vagina lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$7,607.20
|
|
Repair blood ves direct neck 35201
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,413.25
|
|
Repair blood vessel direct hand finger
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,083.20
|
|
Repair blood vessel dir lower extr
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,788.00
|
|
Repair blood vessel dir upper extr
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,255.67
|
|
Repair blood vessel lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,144.00
|
|
Repair blood vessel lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,724.63
|
|
Repair blood vessel lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,988.54
|
|
Repair blood vessel lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,341.66
|
|
Repair blood vessel lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,907.78
|
|
Repair blood vessel w/graft lower extremity 35286
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,907.78
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,724.63
|
|
Repair brow defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,820.92
|
|
Repair carpal bone shorten
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,856.00
|
|
Repair cleft hand
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair cleft lip/nasal
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,419.00
|
|
Repair cleft lip/nasal
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,339.00
|
|
Repair cleft lip/nasal
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,339.00
|
|
Repair cleft lip/nasal
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,881.00
|
|
Repair cleft lip/nasal
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,855.00
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,193.40
|
|
Repair corporeal tear
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,817.53
|
|
Repair defect arm art 35045
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,983.35
|
|
Repair defect of artery 35011
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,988.54
|
|
Repair deformity of toe
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,594.44
|
|
Repair degenerated kneecap
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,855.00
|
|
Repair dental ellis ii fx
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$432.55
|
|
Repair detached retina
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,624.00
|
|
Repair detached retina
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,683.61
|
|
Repair detached retina
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,173.34
|
|
Repair detached retina crtx
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,764.80
|
|
Repair detached retina pc
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,170.32
|
|
Repair eardrum structures
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,855.00
|
|
Repair elbow deb/attch open
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair elbow perc
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,499.12
|
|
Repair elbow w/deb open
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair esophagus opening
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,819.23
|
|
Repair extns tendon finger without grft ea
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,702.15
|
|
Repair extra toe(s)
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,462.45
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,966.40
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,269.14
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,440.96
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,982.40
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,924.80
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,760.73
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,982.40
|
|
Repair eyelid defect
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,176.00
|
|
Repair eyelid wound
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,917.20
|
|
Repair eyelid wound
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,254.34
|
|
Repair facial nerve
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,553.49
|
|
Repair facial nerve
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,465.11
|
|
Repair fibula nonunion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,879.60
|
|
Repair finger deformity
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,893.86
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,108.00
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,958.50
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,842.58
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,594.44
|
|
Repair finger/hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair finger tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,752.25
|
|
Repair foot dislocation
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,419.00
|
|
Repair foot dislocation
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,419.00
|
|
Repair foot dislocation
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,855.00
|
|
Repair forearm tendon sheath
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$8,453.60
|
|
Repair/graft eye lesion
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,339.00
|
|
Repair/graft finger tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,791.08
|
|
Repair/graft finger tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,594.44
|
|
Repair/graft finger tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
|
Repair/graft hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,560.25
|
|
Repair/graft hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,110.00
|
|
Repair/graft hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,703.55
|
|
Repair/graft hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,886.74
|
|
Repair/graft hand tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,931.20
|
|
Repair/graft kneecap tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,193.88
|
|
Repair/graft of foot tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,886.74
|
|
Repair/graft of foot tendon
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$7,907.11
|
|
Repair/graft of thigh muscle
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,943.97
|
|
Repair/graft of tibia
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$6,311.00
|
|
Repair/graft radius or ulna
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$7,807.24
|
|
Repair/graft radius or ulna
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$5,886.74
|
|
Repair/graft radius & ulna
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$7,907.11
|
|
Repair/graft radius & ulna
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,881.00
|
|
Repair/graft wrist bone
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$7,897.93
|
|
Repair hand joint
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,839.54
|
