|
Circumcise/surg/28 days or < 54160
|
$433.60 |
$593.40 |
$1,219.20 |
|
|
Circumcision (newborn)
|
$283.80 |
$1,219.20 |
$2,788.50 |
|
|
Cisplatin 1 mg/ml desensitization
|
$12.00 |
$556.00 |
$8,095.80 |
|
|
C-kit mutation liquid tumor - sendout
|
$876.80 |
$4,054.80 |
$4,055.40 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$25.80 |
$329.60 |
$5,773.80 |
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$1,320.00 |
$3,909.60 |
$25,185.60 |
|
|
Claviculectomy partial
|
$1,090.80 |
$4,007.40 |
$4,201.75 |
|
|
Clean out mastoid cavity
|
$250.80 |
$250.80 |
$620.00 |
|
|
Clearance of airways
|
$154.20 |
$309.60 |
$2,579.40 |
|
|
Clearance of tear duct
|
$365.00 |
$365.00 |
$365.00 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$5.40 |
$47.40 |
$156.80 |
|
|
Clip ligating vesolock lg
|
$160.80 |
$1,151.40 |
$6,953.40 |
|
|
Clip phn wireless f/baha4 proc
|
$225.60 |
$225.60 |
$225.60 |
|
|
Cllr miami j sm
|
$19.20 |
$19.20 |
$248.80 |
|
|
Clofarabine 1 mg/ml intravenous solution
|
$681.00 |
$681.00 |
$879.00 |
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$3.50 |
$348.60 |
$4,447.80 |
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$397.80 |
$1,420.80 |
$4,099.20 |
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$1,351.20 |
$3,021.60 |
$3,647.40 |
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$3,001.80 |
$3,630.40 |
$8,284.20 |
|
|
Closed tx/acetabululm without manip 27220
|
$298.50 |
$759.00 |
$5,784.00 |
|
|
Closed tx humerus fx with manip 23605
|
$1,480.00 |
$2,055.00 |
$4,767.60 |
|
|
Closed tx humerus fx without manip 23600
|
$378.00 |
$825.60 |
$3,355.20 |
|
|
Closed tx humerus fx w/manip 24505
|
$379.80 |
$2,055.00 |
$3,584.40 |
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$283.50 |
$628.20 |
$1,980.60 |
|
|
Closed tx orbit without manipulj
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$1,114.20 |
$3,362.40 |
$4,884.00 |
|
|
Closed tx septal&nose fx
|
$3,971.40 |
$3,971.40 |
$3,971.40 |
|
|
Closed tx sesamoid fx 28530
|
$397.80 |
$759.00 |
$1,258.80 |
|
|
Closed tx/talus fracture without manip 28430
|
$327.60 |
$327.60 |
$998.40 |
|
|
Closed tx vert fx w/manj
|
$4,193.40 |
$4,193.40 |
$4,193.40 |
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$288.50 |
$660.00 |
$2,009.40 |
|
|
Close tear duct opening
|
$365.00 |
$365.00 |
$365.00 |
|
|
Clostridium toxin a w/optic
|
$105.00 |
$105.00 |
$105.00 |
|
|
Clos txnose fx without stablz 21315
|
$267.00 |
$2,635.80 |
$4,779.60 |
|
|
Closure enterostomy lg/sm intestine 44620
|
$8,212.50 |
$8,212.50 |
$8,212.50 |
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$4,242.60 |
$4,242.60 |
$4,242.60 |
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$1,663.80 |
$1,663.80 |
$3,363.00 |
|
|
Closure of eyelid by suture
|
$125.40 |
$1,146.00 |
$2,357.40 |
|
|
Closure of windpipe lesion 31820
|
$2,503.20 |
$2,503.20 |
$3,810.50 |
|
|
Closure paravalvlr leak pq
|
$93.00 |
$5,734.80 |
$14,788.80 |
|
|
Clot factor fletcher fact
|
$88.20 |
$230.40 |
$1,704.00 |
|
|
Clot factor viii reltd antgn
|
$201.00 |
$288.00 |
$371.40 |
|
|
Clot factor wght kininogen
|
$186.60 |
$230.40 |
$1,704.00 |
|
|
Clot factor xii hageman
|
$75.00 |
$141.00 |
$1,503.00 |
|
|
Clot factor xiii fibrin scrn
|
$70.80 |
$75.00 |
$369.60 |
|
|
Clot factor xiii fibrin stab
|
$69.60 |
$106.20 |
$2,105.40 |
|
|
Clozapine, 25 mg
|
$1.00 |
$6.80 |
$22.80 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$375.00 |
$926.40 |
$3,560.40 |
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$283.50 |
$1,266.00 |
$3,560.40 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$76.20 |
$327.60 |
$1,074.00 |
|
|
Clsd tx clav dislc without manip 23520
|
$1,266.00 |
$2,055.00 |
$2,055.00 |
|
|
Clsd tx clavicle dislocation without manip 23540
|
$283.50 |
$819.60 |
$1,686.40 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,266.00 |
$3,029.40 |
$3,355.20 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$244.80 |
$819.60 |
$3,355.20 |
|
|
Clsd tx coccygeal fracture 27200
|
$283.50 |
$327.60 |
$576.00 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$229.20 |
$592.80 |
$1,792.00 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$320.50 |
$1,225.20 |
$3,222.60 |
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$358.20 |
$844.20 |
$3,355.20 |
|
|
Clsd tx elbow dislocation child 24640
|
$210.00 |
$400.80 |
$1,651.80 |
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,810.80 |
$2,828.80 |
$4,281.00 |
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$1,941.60 |
$3,354.00 |
$6,887.40 |
|
|
Clsd tx fracture of radius 25500
|
$283.50 |
$366.60 |
$998.40 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$260.00 |
$370.80 |
$1,374.40 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$210.00 |
$429.60 |
$2,392.80 |
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$359.40 |
$539.40 |
$1,635.20 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$495.60 |
$2,055.00 |
$5,969.40 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$283.50 |
$930.00 |
$1,427.40 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$825.60 |
$2,055.00 |
$4,765.20 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$325.00 |
$993.00 |
$3,355.20 |
|
|
Clsd tx hip disloc without anes 27265
|
$379.80 |
$1,547.40 |
$3,772.80 |
|
|
Clsd tx humeral fract without manip 24530
|
$389.00 |
$759.00 |
$3,355.20 |
|
|
Clsd tx humerus fract without manip 24500
|
$389.00 |
$759.00 |
$3,355.20 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$332.00 |
$3,964.20 |
$5,469.00 |
|
|
Clsd tx mandibular fx without manip 21450
|
$620.00 |
$669.60 |
$6,864.00 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$256.80 |
$370.80 |
$882.40 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$361.20 |
$470.40 |
$1,196.00 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$379.80 |
$1,408.00 |
$4,762.20 |
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,760.50 |
$3,760.50 |
$4,493.40 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$283.50 |
$759.00 |
$5,052.60 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$337.50 |
$520.80 |
$1,834.40 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$199.20 |
$4,314.00 |
$4,599.00 |
|
|
Clsd tx nose fx without manip 21310
|
$819.60 |
$819.60 |
$1,693.20 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$477.60 |
$2,440.80 |
$5,052.60 |
|
|
Clsd tx patella disloc without anes 27560
|
$308.00 |
$1,225.20 |
$3,560.40 |
|
|
Clsd tx/patellar fx without manip 27520
|
$389.00 |
$803.20 |
$3,355.20 |
|
|
Clsd tx pelvic ring fx
|
$409.50 |
$448.00 |
$496.20 |
|
|
Clsd tx pelvic ring fx
|
$283.50 |
$1,195.80 |
$5,307.00 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$825.60 |
$2,322.60 |
$3,570.00 |
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$229.20 |
$543.60 |
$1,406.40 |
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$331.80 |
$399.20 |
$998.40 |
|
|
Clsd tx radius fracture w/manip 24655
|
$958.40 |
$2,284.80 |
$4,070.40 |
|
|
Clsd tx/scapular fx without manip 23570
|
$283.50 |
$496.20 |
$3,435.60 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,264.80 |
$3,055.20 |
$4,739.40 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,386.00 |
$2,131.00 |
$4,790.40 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,279.80 |
$2,184.60 |
$3,791.20 |
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$538.20 |
$538.20 |
$538.20 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$231.60 |
$1,225.20 |
$3,560.40 |
|
|
Clsd tx toe dislocation without anes28660
|
$308.00 |
$530.40 |
$1,980.60 |
|
|
Clsd tx trimall ankle fx without manip 27816
|
$283.50 |
$825.60 |
$3,647.40 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$709.60 |
$2,055.00 |
$3,560.40 |
|