|
Clsd tx/metacarpal fx/sg without manip 26600
|
$192.50 |
$192.50 |
$192.50 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$218.00 |
$218.00 |
$218.00 |
$613.14
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$353.00 |
$353.00 |
$353.00 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$353.00 |
$353.00 |
$353.00 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$2,169.00 |
$2,169.00 |
$2,169.00 |
$3,678.17
|
|
Clsd tx patella disloc without anes 27560
|
$192.50 |
$192.50 |
$192.50 |
$577.20
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,172.50 |
$1,172.50 |
$1,172.50 |
$2,211.05
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$192.50 |
$192.50 |
$192.50 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$309.50 |
$309.50 |
$309.50 |
$451.68
|
|
Clsd tx radius fracture w/manip 24655
|
$805.00 |
$805.00 |
$805.00 |
$1,772.97
|
|
Clsd tx shoulder dislc/fx 23665
|
$805.00 |
$805.00 |
$805.00 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$805.00 |
$805.00 |
$805.00 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$140.50 |
$140.50 |
$140.50 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$278.00 |
$278.00 |
$278.00 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$381.00 |
$381.00 |
$381.00 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$744.00 |
$744.00 |
$744.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$258.50 |
$258.50 |
$258.50 |
$463.20
|
|
Clsd tx wrist carpal fx without manip 25630
|
$254.00 |
$254.00 |
$254.00 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$162.50 |
$162.50 |
$162.50 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$349.00 |
$349.00 |
$349.00 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$380.50 |
$380.50 |
$380.50 |
$611.10
|
|
Cls tx of heel fracture w/manip 28405
|
$1,172.50 |
$1,172.50 |
$1,172.50 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$1,274.50 |
$1,274.50 |
$1,274.50 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$805.00 |
$805.00 |
$805.00 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$327.00 |
$327.00 |
$327.00 |
$535.60
|
|
Cltx mndblr fx ntrdntl fixj
|
$6,639.00 |
$6,639.00 |
$6,639.00 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$2,381.50 |
$2,381.50 |
$2,381.50 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$3,210.50 |
$3,210.50 |
$3,210.50 |
$3,837.72
|
|
Cltx palatal/max fx wire fix
|
$5,919.50 |
$5,919.50 |
$5,919.50 |
$4,377.24
|
|
Cltx post ankle fx w/mnpj
|
$805.00 |
$805.00 |
$805.00 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$805.00 |
$805.00 |
$805.00 |
$1,985.60
|
|
C motor evoked lwr limbs
|
$1,376.50 |
$1,376.50 |
$1,376.50 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,376.50 |
$1,376.50 |
$1,376.50 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,376.50 |
$1,376.50 |
$1,376.50 |
$1,308.00
|
|
Cmptr ophth dx img ant segmt
|
$47.00 |
$47.00 |
$47.00 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$47.00 |
$47.00 |
$47.00 |
$98.00
|
|
#cmvcul-virus inoculation shell
|
$23.50 |
$23.50 |
$23.50 |
$87.75
|
|
Cmv pcr-sendout
|
$406.50 |
$406.50 |
$406.50 |
$177.50
|
|
Co2 monitor per day
|
$286.00 |
$286.00 |
$286.00 |
$459.20
|
|
Coagulation time activated teg
|
$40.00 |
$40.00 |
$40.00 |
$53.55
|
|
Coch implant microphone repl
|
$421.00 |
$421.00 |
$421.00 |
$890.83
|
|
Coil axium 3d 14mmx40cm qc
|
$3,610.00 |
$3,610.00 |
$3,610.00 |
$308.00
|
|
Cold agglutinin titer
|
$71.00 |
$71.00 |
$71.00 |
$51.60
|
|
Collagen based wound filler
|
$2,424.00 |
$2,424.00 |
$2,424.00 |
$1,823.25
|
|
Collagen drsg>16<=48 sq in
|
$4,368.00 |
$4,368.00 |
$4,368.00 |
$25.75
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$68.50 |
$68.50 |
$68.50 |
$62.40
|
|
Collar cerv ascend 172 reg
|
$338.50 |
$338.50 |
$338.50 |
$213.89
|
|
Collar cerv patriot adlt
|
$14.50 |
$14.50 |
$14.50 |
$134.66
|
|
Collar extrication adult univ
|
$908.00 |
$908.00 |
$908.00 |
$800.32
|
|
Collection blood specimen from completely implantable venous access device
|
$79.50 |
$79.50 |
$79.50 |
$160.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$69.00 |
$69.00 |
$69.00 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$7.00 |
$7.00 |
$7.00 |
$21.00
|
|
Colon motility 6 hr study
|
$304.50 |
$304.50 |
$304.50 |
$477.92
|
|
Colonoscopy (with polyp removal)
|
$535.00 |
$535.00 |
$535.00 |
$2,288.00
|
|
Colpocentesis 57020
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$4,232.80
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$2,373.00 |
$2,373.00 |
$2,373.00 |
$3,762.53
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$401.50 |
$401.50 |
$401.50 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$242.50 |
$242.50 |
$242.50 |
$314.00
|
|
Colposcopy vulva 56820
|
$174.50 |
$174.50 |
$174.50 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$174.50 |
$174.50 |
$174.50 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$349.00 |
$349.00 |
$349.00 |
$485.50
|
|
Combination bilateral ho
|
$4,015.50 |
$4,015.50 |
$4,015.50 |
$4,015.50
|
|
Compatibility test each unit antiglobulin technique
|
$73.50 |
$73.50 |
$73.50 |
$172.00
|
|
Compatibility test each unit electronic
|
$56.00 |
$56.00 |
$56.00 |
$166.26
|
|
Compatibility test each unit immediate spin technique
|
$130.00 |
$130.00 |
$130.00 |
$167.17
|
|
Compatibility test incubate
|
$56.00 |
$56.00 |
$56.00 |
$149.60
|
|
Comp cystometrogram/void presssure 51728
|
$526.00 |
$526.00 |
$526.00 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$345.50 |
$345.50 |
$345.50 |
$1,111.03
|
|
Complement antigen each component c3
|
$399.50 |
$399.50 |
$399.50 |
$110.00
|
|
Complex cystometrogram 51726
|
$550.50 |
$550.50 |
$550.50 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$449.50 |
$449.50 |
$449.50 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$982.50 |
$982.50 |
$982.50 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$285.00 |
$285.00 |
$285.00 |
$344.68
|
|
Compl oph exam general anes
|
$973.00 |
$973.00 |
$973.00 |
$2,161.60
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$529.00 |
$529.00 |
$529.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$637.00 |
$637.00 |
$637.00 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$304.50 |
$304.50 |
$304.50 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$365.00 |
$365.00 |
$365.00 |
$789.60
|
|
Complx repair fccmnaxghf 13132
|
$449.50 |
$449.50 |
$449.50 |
$1,066.92
|
|
Complx repair fccmnaxghf 13133
|
$348.50 |
$348.50 |
$348.50 |
$493.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$304.50 |
$304.50 |
$304.50 |
$494.34
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$653.50 |
$653.50 |
$653.50 |
$1,003.80
|
|
Complx repair trunk addl 5cm/< 13102
|
$348.50 |
$348.50 |
$348.50 |
$502.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$1,442.50 |
$1,442.50 |
$1,442.50 |
$1,350.27
|
|
Composite graft/pri close/don area 15760
|
$2,485.00 |
$2,485.00 |
$2,485.00 |
$2,816.50
|
|
Compre oph exam est pt 1/>
|
$53.50 |
$53.50 |
$53.50 |
$207.20
|
|
Compre oph exam new pt 1/>
|
$71.00 |
$71.00 |
$71.00 |
$188.51
|
|
Concentration infection agents any type
|
$77.50 |
$77.50 |
$77.50 |
$51.32
|
|
Condylomata destruction 56420
|
$375.50 |
$375.50 |
$375.50 |
$463.98
|
|
Conization/cerv/loop electrode exc 57522
|
$2,543.00 |
$2,543.00 |
$2,543.00 |
$4,752.00
|
|
Connect omega .5mm
|
$1,091.00 |
$1,091.00 |
$1,091.00 |
$1,260.00
|
|
Connector tis 2x10mm
|
$4,055.00 |
$4,055.00 |
$4,055.00 |
$4,055.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$257.00 |
$257.00 |
$257.00 |
$407.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$71.50 |
$71.50 |
$71.50 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$162.00 |
$162.00 |
$162.00 |
$224.87
|
|
Consultation/report referred material w/preparation of slides
|
$53.00 |
$53.00 |
$53.00 |
$224.80
|
|
Contact lens fitg aphakia 1
|
$110.00 |
$110.00 |
$110.00 |
$472.21
|
|
Contact lens fitting for tx
|
$44.50 |
$44.50 |
$44.50 |
$92.96
|
|
Cont intraop neuro monitor
|
$220.00 |
$220.00 |
$220.00 |
$73.60
|
