|
Repair/graft radius or ulna
|
$3,902.60 |
$3,902.60 |
$3,902.60 |
$7,913.97
|
|
Repair/graft radius or ulna
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$7,807.24
|
|
Repair/graft radius & ulna
|
$4,430.40 |
$4,430.40 |
$4,430.40 |
$8,159.00
|
|
Repair/graft wrist bone
|
$2,776.80 |
$2,776.80 |
$2,776.80 |
$5,376.00
|
|
Repair hand joint
|
$1,716.00 |
$1,716.00 |
$1,716.00 |
$3,839.54
|
|
Repair hand joint with graft
|
$2,290.60 |
$2,290.60 |
$2,290.60 |
$3,839.54
|
|
Repair hand joint with graft
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$3,336.65
|
|
Repair heart septum defect 33681
|
$9,249.50 |
$9,249.50 |
$9,249.50 |
$4,489.60
|
|
Repair heart septum defects dir/patch 33647
|
$9,438.00 |
$9,438.00 |
$9,438.00 |
$2,805.51
|
|
Repair heart-vein defect 33732
|
$7,529.60 |
$7,529.60 |
$7,529.60 |
$2,362.17
|
|
Repair heart-vein defect(s)
|
$9,396.40 |
$9,396.40 |
$9,396.40 |
$2,854.30
|
|
Repair heart vessel fistula
|
$7,264.40 |
$7,264.40 |
$7,264.40 |
$2,242.54
|
|
Repair heart vessel fistula
|
$5,072.60 |
$5,072.60 |
$5,072.60 |
$5,987.80
|
|
Repair heart wound w/bypass 33305
|
$20,001.80 |
$20,001.80 |
$20,001.80 |
$17,708.60
|
|
Repair humerus with graft
|
$3,897.40 |
$3,897.40 |
$3,897.40 |
$9,791.00
|
|
Repair ing hernia sliding
|
$2,321.80 |
$2,321.80 |
$2,321.80 |
$3,856.84
|
|
Repair iris & ciliary body
|
$2,072.20 |
$2,072.20 |
$2,072.20 |
$2,698.92
|
|
Repair iris & ciliary body
|
$2,272.40 |
$2,272.40 |
$2,272.40 |
$3,173.34
|
|
Repair lac palate<2 cm
|
$1,522.95 |
$1,522.95 |
$1,522.95 |
$780.65
|
|
Repair laminectomy defect
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$482.70
|
|
Repair leg fascia defect
|
$1,224.60 |
$1,224.60 |
$1,224.60 |
$3,839.54
|
|
Repair lip full thkns =<one-half vert height
|
$1,522.95 |
$1,522.95 |
$1,522.95 |
$1,326.51
|
|
Repair lip full thkns >one-half vert height/cmplx
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,928.07
|
|
Repair liver wound 47350
|
$5,847.40 |
$5,847.40 |
$5,847.40 |
$2,581.80
|
|
Repair liver wound 47360
|
$8,140.60 |
$8,140.60 |
$8,140.60 |
$2,909.40
|
|
Repair lower leg epiphyses
|
$2,295.80 |
$2,295.80 |
$2,295.80 |
$3,839.54
|
|
Repair lower leg tendons
|
$1,911.00 |
$1,911.00 |
$1,911.00 |
$3,839.54
|
|
Repair lower leg tendons
|
$2,269.80 |
$2,269.80 |
$2,269.80 |
$7,906.00
|
|
Repair lumbar hernia
|
$2,792.40 |
$2,792.40 |
$2,792.40 |
$6,457.82
|
|
Repair lung hernia 32800
|
$4,084.60 |
$4,084.60 |
$4,084.60 |
$2,303.20
|
|
Repair major blood vessel(s) w/bypass 33322
|
$6,349.20 |
$6,349.20 |
$6,349.20 |
$3,392.00
|
|
Repair major blood vessel(s) without bypass 33320
|
$4,820.40 |
$4,820.40 |
$4,820.40 |
$2,071.80
|
|
Repair major vessel
|
$5,410.60 |
$5,410.60 |
$5,410.60 |
$1,717.69
|
|
Repair meningocele <5cm diam 63700
|
$4,542.20 |
$4,542.20 |
$4,542.20 |
$2,028.72
|
|
Repair middle ear structures
|
$2,571.40 |
$2,571.40 |
$2,571.40 |
$4,558.89
|
|
Repair modified fontan
|
$9,331.40 |
$9,331.40 |
$9,331.40 |
$2,843.12
|
|
Repair multi-comp penis pros
|
$3,616.60 |
$3,616.60 |
$3,616.60 |
$6,015.75
|
|
Repair muscles of hand
|
$966.55 |
$966.55 |
$966.55 |
$3,591.33
|
|
Repair nasal septum defect
|
$1,895.40 |
$1,895.40 |
$1,895.40 |
$3,837.72
|
|
Repair nasal stenosis
|
$3,213.60 |
$3,213.60 |
$3,213.60 |
$6,547.81
|
|
Repair nerve add-on
|
$1,625.00 |
$1,625.00 |
$1,625.00 |
$4,063.62
|
|
Repair nerve add-on 64832
|
$1,469.00 |
$1,469.00 |
$1,469.00 |
$2,386.86
|
|
Repair nonunion carpal bone
|
$2,831.40 |
$2,831.40 |
$2,831.40 |
$7,907.11
|
|
Repair nonunion hand
|
$2,815.80 |
$2,815.80 |
$2,815.80 |
$5,886.74
|
|
Repair nose to lip fistula
|
$2,657.20 |
$2,657.20 |
$2,657.20 |
$6,547.81
|
|
Repair of achilles tendon
|
$2,737.80 |
$2,737.80 |
$2,737.80 |
$5,594.25
|
|
Repair of anal sphincter
|
$4,537.00 |
$4,537.00 |
$4,537.00 |
$3,816.64
|
|
Repair of anal sphincter
|
$3,975.40 |
$3,975.40 |
$3,975.40 |
$3,816.64
|
|
Repair of anal sphincter
|
$2,418.00 |
$2,418.00 |
$2,418.00 |
$979.32
|
|
Repair of anal stricture
|
$2,550.60 |
$2,550.60 |
$2,550.60 |
$3,038.07
|
|
Repair of anal stricture
|
$1,931.80 |
$1,931.80 |
$1,931.80 |
$1,376.80
|
|
Repair of aneurysm
|
$5,436.60 |
$5,436.60 |
$5,436.60 |
$4,560.00
|
|
Repair of ankle ligament
|
$1,742.00 |
$1,742.00 |
$1,742.00 |
$6,311.00
|
|
Repair of ankle ligament
|
$2,498.60 |
$2,498.60 |
$2,498.60 |
$5,886.74
|
|
Repair of ankle ligaments
|
$2,230.80 |
$2,230.80 |
$2,230.80 |
$5,339.00
|
|
Repair of aortic valve
|
$10,236.20 |
$10,236.20 |
$10,236.20 |
$5,242.40
|
|
Repair of arm nerves
|
$5,431.40 |
$5,431.40 |
$5,431.40 |
$4,858.97
|
|
Repair of bladder opening
|
$2,046.20 |
$10,312.25 |
$10,312.25 |
$4,081.37
|
|
Repair of bowel lesion
|
$5,740.80 |
$5,740.80 |
$5,740.80 |
$2,006.40
|
|
Repair of circumcision
|
$6,124.95 |
$6,124.95 |
$6,124.95 |
$3,316.80
|
|
Repair of cloacal anomaly
|
$15,324.40 |
$15,324.40 |
$15,324.40 |
$5,004.13
|
|
Repair of cloacal anomaly
|
$17,014.40 |
$17,014.40 |
$17,014.40 |
$5,502.86
|
|
Repair of diaphragm hernia
|
$28,316.60 |
$28,316.60 |
$28,316.60 |
$10,292.00
|
|
Repair of diaphragm hernia
|
$3,788.20 |
$3,788.20 |
$3,788.20 |
$1,232.66
|
|
Repair of digit nerve hand/foot 1 nerve
|
$2,381.60 |
$2,381.60 |
$2,381.60 |
$3,619.45
|
|
Repair of enterocele abdominal approach 57270
|
$3,554.20 |
$3,554.20 |
$3,554.20 |
$2,022.40
|
|
Repair of enterocele vaginal approach 57268
|
$1,968.20 |
$1,968.20 |
$1,968.20 |
$4,900.30
|
|
Repair of esophagus
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$793.36
|
|
Repair of esophagus
|
$6,827.60 |
$6,827.60 |
$6,827.60 |
$3,617.60
|
|
Repair of eye socket wound
|
$1,697.80 |
$1,697.80 |
$1,697.80 |
$4,462.45
|
|
Repair of eye wound
|
$6,975.80 |
$6,975.80 |
$6,975.80 |
$2,760.73
|
|
Repair of eye wound
|
$6,975.80 |
$6,975.80 |
$6,975.80 |
$3,269.14
|
|
Repair of eye wound
|
$1,635.40 |
$1,635.40 |
$1,635.40 |
$4,625.45
|
|
Repair of eye wound
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$5,741.00
|
|
Repair of eye wound
|
$3,993.60 |
$3,993.60 |
$3,993.60 |
$6,076.38
|
|
Repair of eye wound
|
$6,819.15 |
$6,819.15 |
$6,819.15 |
$2,888.50
|
|
Repair of facial nerve
|
$3,835.00 |
$3,835.00 |
$3,835.00 |
$6,588.00
|
|
Repair of facial nerve
|
$4,183.40 |
$4,183.40 |
$4,183.40 |
$5,855.00
|
|
Repair of fibula epiphysis
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$3,839.54
|
|
Repair of foot bones
|
$2,436.20 |
$2,436.20 |
$2,436.20 |
$10,629.07
|
|
Repair of foot tendon
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$3,977.49
|
|
Repair of hand or foot nerve
|
$2,810.60 |
$2,810.60 |
$2,810.60 |
$4,858.97
|
|
Repair of hand or foot nerve
|
$3,354.65 |
$3,354.65 |
$3,354.65 |
$4,697.33
|
|
Repair of heart chambers
|
$10,476.05 |
$10,476.05 |
$10,476.05 |
$2,778.64
|
|
Repair of heart damage
|
$14,835.60 |
$14,835.60 |
$14,835.60 |
$4,353.24
|
|
Repair of heart defect
|
$7,087.60 |
$7,087.60 |
$7,087.60 |
$3,772.80
|
|
Repair of heart defects
|
$9,061.00 |
$9,061.00 |
$9,061.00 |
$2,714.29
|
|
Repair of heart defects
|
$7,082.40 |
$7,082.40 |
$7,082.40 |
$2,213.96
|
|
Repair of heart defects
|
$9,750.00 |
$9,750.00 |
$9,750.00 |
$2,905.65
|
|
Repair of heart defects incplt/prtl without av valve 33660
|
$9,103.25 |
$9,103.25 |
$9,103.25 |
$3,557.40
|
|
Repair of humerus
|
$3,965.00 |
$3,965.00 |
$3,965.00 |
$6,588.00
|
|
Repair of hydrocele 55060
|
$1,599.00 |
$1,599.00 |
$1,599.00 |
$3,786.00
|
|
Repair of imperforated anus
|
$10,436.40 |
$10,436.40 |
$10,436.40 |
$6,104.80
|
|
Repair of kidney wound
|
$5,517.20 |
$5,517.20 |
$5,517.20 |
$3,058.40
|
|
Repair of kneecap tendon
|
$1,937.00 |
$1,937.00 |
$1,937.00 |
$6,311.00
|
|
Repair of knee cartilage
|
$2,241.20 |
$2,241.20 |
$2,241.20 |
$5,855.00
|
|
Repair of knee ligament
|
$2,360.80 |
$2,360.80 |
$2,360.80 |
$5,886.13
|
|
Repair of knee ligament
|
$2,821.00 |
$2,821.00 |
$2,821.00 |
$6,311.00
|
|
Repair of knee ligaments
|
$3,564.60 |
$3,564.60 |
$3,564.60 |
$8,453.60
|
|
Repair of leg epiphyses
|
$2,498.60 |
$2,498.60 |
$2,498.60 |
$4,350.00
|
