|
Revision of iris
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,566.75
|
|
Revision of iris
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$874.00
|
|
Revision of jaw muscle/bone
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,752.89
|
|
Revision of jaw muscle/bone
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Revision of knee joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$14,061.89
|
|
Revision of knee joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,839.00
|
|
Revision of knee joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$8,885.39
|
|
Revision of knee joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,839.00
|
|
Revision of knee joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$12,836.37
|
|
Revision of larynx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,547.81
|
|
Revision of leg vein 37780
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,724.63
|
|
Revision of neck muscle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,098.15
|
|
Revision of neck muscle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,594.44
|
|
Revision of neck muscle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$973.71
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,627.00
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,627.00
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,547.81
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,547.81
|
|
Revision of nose
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,553.49
|
|
Revision of penis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Revision of penis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Revision of penis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,044.67
|
|
Revision of penis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,261.44
|
|
Revision of pharyngeal walls
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,741.00
|
|
Revision of radius
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,871.42
|
|
Revision of radius
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Revision of sciatic nerve
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,888.00
|
|
Revision of scrotum
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,820.84
|
|
Revision of scrotum
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,881.00
|
|
Revision of spinal shunt
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,419.00
|
|
Revision of testis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,110.00
|
|
Revision of thigh muscles
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
|
Revision of toe
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,594.44
|
|
Revision of ulna
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,855.00
|
|
Revision of unstable kneecap
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
|
Revision of unstable kneecap
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,973.47
|
|
Revision of urethra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Revision of urethra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,891.34
|
|
Revision of urethra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,110.00
|
|
Revision open av fistula without thromb
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$8,037.35
|
|
Revision orbitofacial bones
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,103.72
|
|
Revision/removal of kneecap
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
|
Revision tips
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$9,810.00
|
|
Revis reconst shoulder joint
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$9,257.14
|
|
Revj fem anast autog vn grf
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,035.20
|
|
Revj fem anast nonautog grf
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,019.00
|
|
Revj mstdc rsltg compl mstdc
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,465.11
|
|
Revj mstdc rsltg tympanplsty
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,547.81
|
|
Revj prior hypspad repair
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,626.86
|
|
Revj/rmvl nea pn w/int nstim
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,069.59
|
|
Rev mastoidectomy rsltg modf rad mstdc 69602
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,465.11
|
|
Rev-rem impl neurostim gen-rec
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,069.59
|
|
Rev/rmv perph nstim eltrd ra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,108.26
|
|
Rev/rmv prph sac/gstr npg/r
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,069.59
|
|
Rev/rplcmt sk-mnt crnl nstm
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,741.00
|
|
Rev/rplct hpglsl nstm ary pg
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$13,780.06
|
|
Revsc opn/prq tib/pero stent
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,086.20
|
|
Rf abltj nrv nrvtg si jt
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,685.07
|
|
Rheumatoid factor qualitative
|
$6.75 |
$6.75 |
$6.75 |
$54.60
|
|
Rheumatoid factor quantitative
|
$6.24 |
$6.24 |
$6.24 |
$58.00
|
|
Rhinp prim lat&alr crtlge&/elvtn nsl tip
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,741.00
|
|
R hrt cath chd abnl nt cnj
|
$1,614.53 |
$1,614.53 |
$1,614.53 |
$4,880.85
|
|
R hrt cath chd nml nt cnj
|
$1,202.51 |
$1,202.51 |
$1,202.51 |
$4,925.61
|
|
Rib cartilage graft
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,167.50
|
|
Right ventric recording
|
$1,340.82 |
$1,340.82 |
$1,340.82 |
$1,980.36
|
|
Ring fx reform 11-13x17mm
|
$69.82 |
$69.82 |
$69.82 |
$1,509.75
|
|
R&l hrt cath chd abnl nt cnj
|
$4,166.20 |
$4,166.20 |
$4,166.20 |
$5,173.00
|
|
R&l hrt cath chd nml nt cnj
|
$2,690.19 |
$2,690.19 |
$2,690.19 |
$5,173.00
|
|
Rmv implant contraceptive capsule 11976
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$846.42
|
|
Rmvl esophgl sphnctr dev
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,022.89
|
|
Rmvl ext fixj sys under anes
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,159.40
|
|
Rmvl fb upr arm/elbow deep
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,638.88
|
|
Rmvl fecal impaction/fb spx under anes
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,111.46
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,917.33
|
|
Rmvl hpglsl nstim ary pg
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,839.00
|
|
Rmvl icd by tv extr
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,374.76
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$34,798.50
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$26,561.92
|
|
Rmvl icd pulse gen only
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,114.00
|
|
Rmvl ndwellg tun pleural cath
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,217.97
|
|
Rmvl perm pm pulse gen
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,608.00
|
|
Rmvl phrnc nrv stim pg only
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,069.59
|
|
Rmvl phrnc nrv stim sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,110.00
|
|
Rmvl phrnc nrv stim transvns
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,419.00
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$17,475.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,427.04
|
|
Rmvl prosthhumrl&ulnar cmpnt
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,881.00
|
|
Rmvl sq defib electrode
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,306.60
|
|
Rmvl subq card rhythm mntr
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,991.00
|
|
Rmvl tiss expndr without implant insrtn
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,386.84
|
|
Rmvl tongs/halo anthr indiv
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$504.90
|
|
Rmvl tv pm lead dual
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,069.52
|
|
Rmvl tv pm lead sgl
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,195.80
|
|
Rmv ntr oi implt skl prq esp
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Rmv ntr oi imp sk tc>=100
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,839.54
|
|
Rmv ntr oi imp sk tc esp<100
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,350.00
|
|
Rmv&rplcmt phrnc nrv stim ld
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$15,321.63
|
|
Rmv&rplcmt phrnc nrv stim pg
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$36,000.00
|
