|
Treat foot dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,856.00
|
|
Treat foot dislocation
|
$283.86 |
$283.86 |
$283.86 |
$535.60
|
|
Treat foot dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,112.80
|
|
Treat foot dislocation
|
$283.86 |
$283.86 |
$283.86 |
$445.80
|
|
Treat foot dislocation
|
$283.86 |
$283.86 |
$283.86 |
$440.04
|
|
Treat foot dislocation
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Treat fracture of radius
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,839.55
|
|
Treat fracture of radius
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,849.00
|
|
Treat fracture of ulna
|
$283.86 |
$283.86 |
$283.86 |
$731.04
|
|
Treat/graft heel fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,629.07
|
|
Treat hand bone lesion
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,073.20
|
|
Treat hand dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,772.97
|
|
Treat hand dislocation
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Treat hand dislocation
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,986.00
|
|
Treat heel fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,907.11
|
|
Treat hip dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Treat hip dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,643.60
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$9,803.49
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$12,299.10
|
|
Treat humerus fracture
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,808.80
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,902.51
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,742.40
|
|
Treat humerus fracture
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,790.00
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,629.07
|
|
Treat humerus fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$7,906.00
|
|
Treat humerus fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,311.00
|
|
Treat kneecap dislocation
|
$283.86 |
$283.86 |
$283.86 |
$1,063.40
|
|
Treat kneecap dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,070.00
|
|
Treat kneecap fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,839.00
|
|
Treat knee dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Treat knee fracture 27530
|
$283.86 |
$283.86 |
$283.86 |
$550.73
|
|
Treat knee fracture(s)
|
$283.86 |
$283.86 |
$283.86 |
$643.26
|
|
Treat knuckle dislocation
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,726.01
|
|
Treat knuckle dislocation
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,332.00
|
|
Treat lower jaw fracture 21462
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$7,000.36
|
|
Treat lower leg bone lesion
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,092.85
|
|
Treat lower leg dislocation
|
$283.86 |
$283.86 |
$283.86 |
$532.60
|
|
Treat lower leg dislocation
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,908.80
|
|
Treat lower leg dislocation
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,072.59
|
|
Treat lower leg fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,475.41
|
|
Treat lower leg fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$12,905.86
|
|
Treat lower leg fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$12,653.00
|
|
Treat lower leg joint
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$152.54 |
$152.54 |
$152.54 |
$226.20
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$4,230.80
|
|
Treatment mouth roof lesion
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,256.70
|
|
Treatment of anal fissure
|
$1,078.88 |
$1,078.88 |
$1,078.88 |
$1,278.72
|
|
Treatment of anal fissure w/dilat 46940
|
$3,245.23 |
$3,245.23 |
$3,245.23 |
$3,640.00
|
|
Treatment of ankle fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,913.97
|
|
Treatment of ankle fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,453.60
|
|
Treatment of ankle fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,906.00
|
|
Treatment of ankle fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$283.86 |
$283.86 |
$283.86 |
$528.00
|
|
Treatment of choroid lesion
|
$649.19 |
$649.19 |
$649.19 |
$1,253.20
|
|
Treatment of corneal lesion
|
$353.74 |
$353.74 |
$353.74 |
$856.80
|
|
Treatment of eyelid lesions
|
$353.74 |
$353.74 |
$353.74 |
$352.04
|
|
Treatment of fibula fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$283.86 |
$283.86 |
$283.86 |
$528.00
|
|
Treatment of foot infection
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,928.60
|
|
Treatment of foot infection
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Treatment of gum lesion
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$3,164.85
|
|
Treatment of heel fracture 28400
|
$283.86 |
$283.86 |
$283.86 |
$478.40
|
|
Treatment of miscarriage
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,734.50
|
|
Treatment of penis lesion
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,081.37
|
|
Treatment of penis lesion
|
$3,386.84 |
$3,386.84 |
$3,386.84 |
$3,515.40
|
|
Treatment of rectal prolapse
|
$1,078.88 |
$1,078.88 |
$1,078.88 |
$1,052.80
|
|
Treatment of retinal lesion
|
$353.74 |
$353.74 |
$353.74 |
$1,741.60
|
|
Treatment of retinal lesion
|
$649.19 |
$649.19 |
$649.19 |
$1,336.20
|
|
Treatment of retinal lesion
|
$4,462.45 |
$4,462.45 |
$4,462.45 |
$5,419.00
|
|
Treatment of thigh fracture
|
$283.86 |
$283.86 |
$283.86 |
$487.50
|
|
Treatment of thigh fracture
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,749.06
|
|
Treatment of thigh fracture
|
$283.86 |
$283.86 |
$283.86 |
$570.40
|
|
Treatment of thigh fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,389.60
|
|
Treatment of thigh fracture
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,790.00
|
|
Treatment of tibia fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,183.84
|
|
Treatment of tibia fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$6,347.40
|
|
Treatment of tibia fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$283.86 |
$283.86 |
$283.86 |
$371.40
|
|
Treatment of urethra lesion
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,061.71
|
|
Treatment of urethra lesion
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,061.71
|
|
Treatment of urethra lesion
|
$2,424.12 |
$2,424.12 |
$2,424.12 |
$2,874.36
|
|
Treatment radiation delivery level 2
|
$311.20 |
$311.20 |
$311.20 |
$867.24
|
|
Treatment x10sv retinopathy
|
$649.19 |
$649.19 |
$649.19 |
$1,513.20
|
|
Treat metacarpal fracture
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,289.60
|
|
Treat metacarpal fracture
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$5,741.00
|
|
Treat metatarsal fracture
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Treat metatarsal fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,241.00
|
|
Treat midfoot fracture each
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,893.86
|
|
Treat midfoot fracture each
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,445.00
|
|
Treat penis lesion graft
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,986.78
|
|
Treat penis lesion graft
|
$10,942.71 |
$10,942.71 |
$10,942.71 |
$7,976.07
|
|
Treat radius fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,907.11
|
|
Treat radius fracture
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$9,791.00
|
|
Treat sesamoid bone fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,907.11
|
|
Treat skull fracture
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|