|
Treat lower leg joint
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$3,166.15 |
$3,166.15 |
$3,166.15 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,112.55 |
$4,112.55 |
$4,112.55 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$2,733.90 |
$2,733.90 |
$2,733.90 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,266.70 |
$8,266.70 |
$8,266.70 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$385.45 |
$385.45 |
$385.45 |
$226.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$105.30 |
$105.30 |
$105.30 |
$148.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$8,266.70 |
$8,266.70 |
$8,266.70 |
$4,230.80
|
|
Treatment mouth roof lesion
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$4,256.70
|
|
Treatment of anal fissure
|
$538.20 |
$538.20 |
$538.20 |
$1,278.72
|
|
Treatment of anal fissure w/dilat 46940
|
$611.00 |
$611.00 |
$611.00 |
$3,640.00
|
|
Treatment of ankle fracture
|
$2,275.00 |
$2,275.00 |
$2,275.00 |
$7,913.97
|
|
Treatment of ankle fracture
|
$2,761.20 |
$2,761.20 |
$2,761.20 |
$8,453.60
|
|
Treatment of ankle fracture
|
$2,914.60 |
$2,914.60 |
$2,914.60 |
$7,906.00
|
|
Treatment of ankle fracture
|
$3,421.60 |
$3,421.60 |
$3,421.60 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$716.95 |
$716.95 |
$785.20 |
$528.00
|
|
Treatment of choroid lesion
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$1,253.20
|
|
Treatment of corneal lesion
|
$902.20 |
$902.20 |
$902.20 |
$856.80
|
|
Treatment of fibula fracture
|
$2,514.20 |
$2,514.20 |
$2,514.20 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$716.95 |
$716.95 |
$735.80 |
$528.00
|
|
Treatment of foot infection
|
$725.40 |
$725.40 |
$725.40 |
$2,928.60
|
|
Treatment of foot infection
|
$1,372.80 |
$9,701.25 |
$9,701.25 |
$3,839.54
|
|
Treatment of gum lesion
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$3,164.85
|
|
Treatment of head injury 62010
|
$5,571.80 |
$5,571.80 |
$5,571.80 |
$3,604.00
|
|
Treatment of heel fracture 28400
|
$716.95 |
$716.95 |
$716.95 |
$478.40
|
|
Treatment of miscarriage
|
$8,266.70 |
$8,266.70 |
$8,266.70 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,734.50
|
|
Treatment of penis lesion
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
$4,081.37
|
|
Treatment of penis lesion
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$3,515.40
|
|
Treatment of rectal prolapse
|
$143.00 |
$143.00 |
$143.00 |
$1,052.80
|
|
Treatment of retinal lesion
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$1,741.60
|
|
Treatment of retinal lesion
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$1,336.20
|
|
Treatment of retinal lesion
|
$5,822.70 |
$5,822.70 |
$5,822.70 |
$5,419.00
|
|
Treatment of thigh fracture
|
$716.95 |
$716.95 |
$1,677.00 |
$487.50
|
|
Treatment of thigh fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,749.06
|
|
Treatment of thigh fracture
|
$5,109.00 |
$5,109.00 |
$5,109.00 |
$4,785.00
|
|
Treatment of thigh fracture
|
$716.95 |
$716.95 |
$1,612.00 |
$570.40
|
|
Treatment of thigh fracture
|
$2,116.40 |
$2,116.40 |
$2,116.40 |
$6,389.60
|
|
Treatment of thigh fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,790.00
|
|
Treatment of thigh fracture
|
$4,321.20 |
$4,321.20 |
$4,321.20 |
$2,896.50
|
|
Treatment of thigh fracture
|
$3,764.80 |
$3,764.80 |
$3,764.80 |
$2,254.50
|
|
Treatment of thigh fracture
|
$5,505.50 |
$5,505.50 |
$5,505.50 |
$4,380.00
|
|
Treatment of thigh fracture
|
$3,796.00 |
$3,796.00 |
$3,796.00 |
$3,796.00
|
|
Treatment of tibia fracture
|
$1,937.00 |
$1,937.00 |
$1,937.00 |
$6,183.84
|
|
Treatment of tibia fracture
|
$3,260.40 |
$3,260.40 |
$3,260.40 |
$6,347.40
|
|
Treatment of tibia fracture
|
$3,757.00 |
$3,757.00 |
$3,757.00 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$716.95 |
$716.95 |
$716.95 |
$371.40
|
|
Treatment of urethra lesion
|
$1,983.80 |
$1,983.80 |
$1,983.80 |
$4,061.71
|
|
Treatment of urethra lesion
|
$787.80 |
$787.80 |
$787.80 |
$4,061.71
|
|
Treatment of urethra lesion
|
$6,124.95 |
$6,124.95 |
$6,124.95 |
$2,874.36
|
|
Treatment radiation delivery level 2
|
$2,202.20 |
$2,202.20 |
$2,202.20 |
$867.24
|
|
Treatment x10sv retinopathy
|
$1,640.60 |
$1,640.60 |
$1,640.60 |
$1,513.20
|
|
Treat metacarpal fracture
|
$1,443.00 |
$1,443.00 |
$1,443.00 |
$4,289.60
|
|
Treat metacarpal fracture
|
$1,838.20 |
$1,838.20 |
$1,838.20 |
$5,741.00
|
|
Treat metatarsal fracture
|
$936.00 |
$936.00 |
$936.00 |
$3,839.54
|
|
Treat metatarsal fracture
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$8,241.00
|
|
Treat midfoot fracture each
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,893.86
|
|
Treat midfoot fracture each
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$6,445.00
|
|
Treat neck spine fracture
|
$5,418.40 |
$5,418.40 |
$5,418.40 |
$3,572.80
|
|
Treat odontoid fx without graft
|
$5,907.20 |
$5,907.20 |
$5,907.20 |
$5,448.00
|
|
Treat pelvic fracture(s)
|
$2,717.00 |
$2,717.00 |
$2,717.00 |
$1,506.40
|
|
Treat pelvic ring fracture
|
$4,089.80 |
$4,089.80 |
$4,089.80 |
$2,223.20
|
|
Treat pelvic ring fracture
|
$4,189.90 |
$4,189.90 |
$4,189.90 |
$2,727.20
|
|
Treat pelvic ring fracture
|
$5,441.80 |
$5,441.80 |
$5,441.80 |
$3,332.00
|
|
Treat penis lesion graft
|
$3,749.20 |
$3,749.20 |
$3,749.20 |
$5,986.78
|
|
Treat penis lesion graft
|
$4,414.80 |
$4,414.80 |
$4,414.80 |
$7,976.07
|
|
Treat radius fracture
|
$2,173.60 |
$2,173.60 |
$2,173.60 |
$7,907.11
|
|
Treat radius fracture
|
$2,563.60 |
$2,563.60 |
$2,563.60 |
$9,791.00
|
|
Treat sesamoid bone fracture
|
$668.20 |
$668.20 |
$668.20 |
$7,907.11
|
|
Treat skull fracture
|
$3,621.80 |
$3,621.80 |
$3,621.80 |
$3,837.72
|
|
Treat skull fracture
|
$4,583.80 |
$4,583.80 |
$4,583.80 |
$2,984.80
|
|
Treat slipped epiphysis
|
$3,359.20 |
$3,359.20 |
$3,359.20 |
$3,359.20
|
|
Treat slipped epiphysis
|
$4,183.40 |
$4,183.40 |
$4,183.40 |
$3,342.87
|
|
Treat slipped epiphysis
|
$3,359.20 |
$3,359.20 |
$3,359.20 |
$3,342.87
|
|
Treat slipped epiphysis
|
$4,206.80 |
$4,206.80 |
$4,206.80 |
$7,413.38
|
|
Treat spinal cord lesion
|
$683.80 |
$683.80 |
$683.80 |
$1,142.50
|
|
Treat spinal cord lesion
|
$3,992.95 |
$3,992.95 |
$3,992.95 |
$1,337.00
|
|
Treat spine fracture
|
$5,166.20 |
$5,166.20 |
$5,166.20 |
$3,485.60
|
|
Treat sternum fracture
|
$716.95 |
$716.95 |
$716.95 |
$423.00
|
|
Treat tail bone fracture
|
$2,090.40 |
$2,090.40 |
$2,090.40 |
$3,839.54
|
|
Treat thigh fracture
|
$716.95 |
$716.95 |
$1,510.60 |
$661.00
|
|
Treat thigh fracture
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$6,510.40
|
|
Treat thigh fracture
|
$4,578.60 |
$4,578.60 |
$4,578.60 |
$3,933.60
|
|
Treat thigh fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,893.86
|
|
Treat thigh fracture
|
$4,726.80 |
$4,726.80 |
$4,726.80 |
$4,726.80
|
|
Treat thigh fracture
|
$716.95 |
$716.95 |
$1,255.80 |
$618.80
|
|
Treat thigh fracture
|
$2,802.80 |
$2,802.80 |
$2,802.80 |
$2,802.80
|
|
Treat thigh fracture
|
$1,183.00 |
$1,183.00 |
$3,590.60 |
$2,008.18
|
|
Treat thigh fracture
|
$4,726.80 |
$4,726.80 |
$4,726.80 |
$3,580.50
|
|
Treat thigh fx growth plate
|
$1,453.40 |
$1,453.40 |
$1,453.40 |
$475.68
|
|
Treat thigh fx growth plate
|
$3,445.00 |
$3,445.00 |
$3,445.00 |
$7,413.38
|
|
Treat thorax spine fracture
|
$5,400.20 |
$5,400.20 |
$5,400.20 |
$3,624.00
|
|
Treat thumb fracture
|
$1,391.00 |
$1,391.00 |
$1,391.00 |
$2,508.80
|
|
Treat thumb fracture
|
$2,064.40 |
$2,064.40 |
$2,064.40 |
$3,839.54
|
|
Treat toe dislocation
|
$720.20 |
$720.20 |
$720.20 |
$3,839.54
|
|
Treat toe dislocation
|
$794.30 |
$794.30 |
$794.30 |
$756.00
|
|
Treat toe dislocation
|
$691.60 |
$691.60 |
$691.60 |
$3,839.54
|
|
Treat toe fracture
|
$1,461.20 |
$1,461.20 |
$1,461.20 |
$3,839.54
|
|
Treat trigeminal nerve
|
$3,016.00 |
$3,016.00 |
$3,016.00 |
$3,754.40
|
|
Treat ulnar fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,678.55
|
