|
Repair blood vessel lesion
|
$1,838.28 |
$1,838.28 |
$1,838.28 |
$2,164.52
|
|
Repair blood vessel lesion
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$2,346.40
|
|
Repair blood vessel lesion
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$5,983.35
|
|
Repair blood vessel lesion
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$4,627.00
|
|
Repair blood vessel lesion
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$5,983.35
|
|
Repair blood vessel w/graft lower extremity 35286
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$5,988.54
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$4,341.66
|
|
Repair brow defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,820.92
|
|
Repair carpal bone shorten
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,856.00
|
|
Repair cleft hand
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,986.00
|
|
Repair cleft lip/nasal
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,547.81
|
|
Repair cleft lip/nasal
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$5,108.80
|
|
Repair cleft lip/nasal
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,553.49
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$724.37 |
$724.37 |
$724.37 |
$1,059.20
|
|
Repair corporeal tear
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$2,990.00
|
|
Repair defect arm art 35045
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$6,366.08
|
|
Repair defect of artery 35011
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$6,305.95
|
|
Repair deformity of toe
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,591.33
|
|
Repair degenerated kneecap
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,311.00
|
|
Repair dental ellis ii fx
|
$274.80 |
$274.80 |
$274.80 |
$442.48
|
|
Repair detached retina
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$5,912.40
|
|
Repair detached retina
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$6,889.27
|
|
Repair detached retina
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,468.40
|
|
Repair detached retina crtx
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,905.20
|
|
Repair detached retina pc
|
$649.19 |
$649.19 |
$649.19 |
$1,513.20
|
|
Repair eardrum structures
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,804.50
|
|
Repair elbow deb/attch open
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair elbow perc
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,350.00
|
|
Repair elbow w/deb open
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair esophagus opening
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Repair extns tendon finger without grft ea
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,353.50
|
|
Repair extra toe(s)
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,350.00
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$3,849.60
|
|
Repair eyelid defect
|
$4,462.45 |
$4,462.45 |
$4,462.45 |
$4,462.45
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,966.40
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$3,609.60
|
|
Repair eyelid defect
|
$4,462.45 |
$4,462.45 |
$4,462.45 |
$3,986.00
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,733.00
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,760.73
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,838.93
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,982.40
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,760.73
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,760.73
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,760.73
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,982.40
|
|
Repair eyelid defect
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$3,176.00
|
|
Repair eyelid wound
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$2,760.73
|
|
Repair eyelid wound
|
$2,760.73 |
$2,760.73 |
$2,760.73 |
$3,296.00
|
|
Repair facial nerve
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,759.31
|
|
Repair facial nerve
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,839.00
|
|
Repair fibula nonunion
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Repair finger deformity
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,471.20
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,204.20
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,150.20
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,351.50
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,848.00
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair finger/hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair finger tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,752.25
|
|
Repair foot dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,810.00
|
|
Repair foot dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,307.00
|
|
Repair foot dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,379.20
|
|
Repair forearm tendon/muscle
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair forearm tendon/muscle
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,507.00
|
|
Repair forearm tendon sheath
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair/graft achilles tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,907.11
|
|
Repair/graft eye lesion
|
$6,105.79 |
$6,105.79 |
$6,105.79 |
$6,076.38
|
|
Repair/graft femur head/neck
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$1,292.50
|
|
Repair/graft finger tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair/graft finger tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,786.00
|
|
Repair/graft finger tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,259.84
|
|
Repair/graft hand tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,741.00
|
|
Repair/graft hand tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Repair/graft hand tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Repair/graft hand tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,307.00
|
|
Repair/graft hand tendon
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,977.49
|
|
Repair/graft kneecap tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,855.00
|
|
Repair/graft of foot tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,653.00
|
|
Repair/graft of foot tendon
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,023.20
|
|
Repair/graft of thigh
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$2,875.62
|
|
Repair/graft of thigh muscle
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,943.97
|
|
Repair/graft of tibia
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,464.80
|
|
Repair/graft of tibia
|
$7,413.38 |
$7,413.38 |
$7,413.38 |
$6,208.00
|
|
Repair/graft radius or ulna
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,913.97
|
|
Repair/graft radius or ulna
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Repair/graft radius & ulna
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,159.00
|
|
Repair/graft radius & ulna
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$5,528.00
|
|
Repair/graft wrist bone
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,376.00
|
|
Repair hand joint
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair hand joint with graft
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Repair hand joint with graft
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,336.65
|
|
Repair humerus with graft
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$9,791.00
|
|
Repair ing hernia sliding
|
$4,176.15 |
$4,176.15 |
$4,176.15 |
$3,856.84
|
|
Repair iris & ciliary body
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,698.92
|
|
Repair iris & ciliary body
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,173.34
|
|
Repair lac palate<2 cm
|
$602.63 |
$602.63 |
$602.63 |
$780.65
|