|
Closed tx sesamoid fx 28530
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$352.00
|
|
Closed tx/talus fracture without manip 28430
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$442.80
|
|
Closed tx vert fx w/manj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$481.80
|
|
Close mastoid fistula
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,299.20
|
|
Close tear duct opening
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$436.44
|
|
Close tear duct opening
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$608.62
|
|
Close tear system fistula
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,116.80
|
|
Clostridium toxin a w/optic
|
$17.60 |
$17.60 |
$17.60 |
$17.60
|
|
Clos txnose fx without stablz 21315
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,635.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,183.65
|
|
Closure of eyelid by suture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,146.13
|
|
Closure of salivary fistula
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,589.62
|
|
Closure of windpipe lesion 31820
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,592.74
|
|
Closure paravalvlr leak pq
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$9,285.00
|
|
Clot factor fletcher fact
|
$20.82 |
$20.82 |
$20.82 |
$99.69
|
|
Clot factor viii reltd antgn
|
$22.46 |
$22.46 |
$22.46 |
$95.72
|
|
Clot factor wght kininogen
|
$20.82 |
$20.82 |
$20.82 |
$157.50
|
|
Clot factor xii hageman
|
$21.29 |
$21.29 |
$21.29 |
$125.00
|
|
Clot factor xiii fibrin scrn
|
$10.02 |
$10.02 |
$10.02 |
$50.65
|
|
Clot factor xiii fibrin stab
|
$17.97 |
$17.97 |
$17.97 |
$84.27
|
|
Clotting assay whole blood
|
$25.59 |
$25.59 |
$25.59 |
$105.95
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$626.40
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$543.00
|
|
Clsd tx clav dislc without manip 23520
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,839.79
|
|
Clsd tx clavicle dislocation without manip 23540
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$534.60
|
|
Clsd tx clavicle fracture w/manip 23505
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,916.00
|
|
Clsd tx/clavicular fx without manip 23500
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$494.00
|
|
Clsd tx coccygeal fracture 27200
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$336.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$728.00
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$497.60
|
|
Clsd tx elbow dislocation child 24640
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$525.28
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,587.60
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Clsd tx fracture of radius 25500
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$445.40
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$392.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$472.00
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$597.60
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Clsd tx fx radius/ulna without manip 25560
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$557.60
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,827.71
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$476.00
|
|
Clsd tx hip disloc without anes 27265
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$716.95
|
|
Clsd tx humeral fract without manip 24530
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$623.93
|
|
Clsd tx humerus fract without manip 24500
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$558.40
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,059.20
|
|
Clsd tx mandibular fx without manip 21450
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$529.50
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$716.95
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,545.97
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$580.30
|
|
Clsd tx/metatarsal fx without manip 28470
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,600.75
|
|
Clsd tx of ankle fracture w/manip 28435
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,843.91
|
|
Clsd tx patella disloc without anes 27560
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$681.85
|
|
Clsd tx/patellar fx without manip 27520
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$566.80
|
|
Clsd tx pelvic ring fx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$435.60
|
|
Clsd tx pelvic ring fx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$789.94
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,431.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$501.80
|
|
Clsd tx radius fracture w/manip 24655
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,843.20
|
|
Clsd tx/scapular fx without manip 23570
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,797.83
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,423.85
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,848.69
|
|
Clsd tx temporomandibular dislocat 21480
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$512.40
|
|
Clsd tx toe dislocation without anes28660
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$420.80
|
|
Clsd tx trimall ankle fx without manip 27816
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$666.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$510.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$730.08
|
|
Clsd tx wrist carpal fx without manip 25630
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$682.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$494.77
|
|
Cls tx of heel fracture w/manip 28405
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,232.40
|
|
Cltx carpl scphd fx w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,368.00
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,858.61
|
|
Cltx humrl cndylr fx wo mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$581.99
|
|
Cltx lunate dislc w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,952.64
|
|
Cltx mndblr fx ntrdntl fixj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,835.75
|
|
Cltx mndblr fx w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,819.23
|
|
Cltx palatal/max fx wire fix
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,986.00
|
|
Cltx post ankle fx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$521.30
|
|
Cltx post ankle fx w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,400.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,050.29
|
|
Cltx strnclav dislc w/mnpj
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$786.11
|
|
Cltx thigh fx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,743.15
|
|
Cltx tmprmand dislc comp
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,986.00
|
|
Cmbn ant pst colprhy
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,339.00
|
|
#cms hgb-carboxyhemoglobin
|
$15.48 |
$15.48 |
$15.48 |
$19.42
|
