|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$156.00 |
$156.00 |
$156.00 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$365.50 |
$365.50 |
$365.50 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,556.50 |
$1,556.50 |
$1,556.50 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$296.00 |
$296.00 |
$296.00 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$564.50 |
$564.50 |
$564.50 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$293.50 |
$293.50 |
$293.50 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$543.00 |
$543.00 |
$543.00 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$392.00 |
$392.00 |
$392.00 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$378.50 |
$378.50 |
$378.50 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$391.00 |
$391.00 |
$391.00 |
$883.00
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$244.00 |
$244.00 |
$244.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$322.50 |
$322.50 |
$322.50 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$338.50 |
$338.50 |
$338.50 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$246.50 |
$246.50 |
$246.50 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$236.50 |
$236.50 |
$236.50 |
$418.20
|
|
Clsd tx of ankle fracture w/manip 28435
|
$360.50 |
$360.50 |
$360.50 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$435.50 |
$435.50 |
$435.50 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$717.50 |
$717.50 |
$717.50 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$236.50 |
$236.50 |
$236.50 |
$416.35
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$236.50 |
$236.50 |
$236.50 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$278.00 |
$278.00 |
$278.00 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$484.50 |
$484.50 |
$484.50 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$273.00 |
$273.00 |
$273.00 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$458.50 |
$458.50 |
$458.50 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$567.50 |
$567.50 |
$567.50 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,972.50 |
$1,972.50 |
$1,972.50 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$373.00 |
$373.00 |
$373.00 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$285.00 |
$285.00 |
$285.00 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$239.00 |
$239.00 |
$239.00 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$340.50 |
$340.50 |
$340.50 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,105.50 |
$2,105.50 |
$2,105.50 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$273.50 |
$273.50 |
$273.50 |
$452.40
|
|
Clsd tx wrist carpal fx without manip 25630
|
$316.50 |
$316.50 |
$316.50 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$319.50 |
$319.50 |
$319.50 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$353.50 |
$353.50 |
$353.50 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$305.00 |
$305.00 |
$305.00 |
$474.50
|
|
Cltx carpl scphd fx w/mnpj
|
$489.00 |
$489.00 |
$489.00 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$346.50 |
$346.50 |
$346.50 |
$520.80
|
|
Cltx humrl cndylr fx wo mnpj
|
$364.50 |
$364.50 |
$364.50 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$533.50 |
$533.50 |
$533.50 |
$2,437.00
|
|
Cltx post ankle fx
|
$322.50 |
$322.50 |
$322.50 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$488.00 |
$488.00 |
$488.00 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$417.00 |
$417.00 |
$417.00 |
$2,021.04
|
|
Cltx thigh fx w/mnpj
|
$580.00 |
$580.00 |
$580.00 |
$3,503.71
|
|
Cmbn ant pst colprhy
|
$795.50 |
$795.50 |
$795.50 |
$4,928.00
|
|
Cmptr ophth dx img ant segmt
|
$17.00 |
$17.00 |
$17.00 |
$115.95
|
|
Cmptr ophth img optic nerve
|
$18.00 |
$18.00 |
$18.00 |
$119.00
|
|
#cms hgb-sulfhemoglobin
|
$74.00 |
$74.00 |
$74.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$37.00 |
$37.00 |
$37.00 |
$100.80
|
|
Cmv pcr-sendout
|
$92.00 |
$92.00 |
$92.00 |
$177.50
|
|
Cold agglutinin titer
|
$3.00 |
$3.00 |
$3.00 |
$50.00
|
|
Colectomy/end colost/close dis seg 44143
|
$1,800.50 |
$1,800.50 |
$1,800.50 |
$2,880.80
|
|
Colectomy partial w/anastomosis 44140
|
$1,438.50 |
$1,438.50 |
$1,438.50 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$2,073.00 |
$2,073.00 |
$2,073.00 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$1,780.00 |
$1,780.00 |
$1,780.00 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$2,274.50 |
$2,274.50 |
$2,274.50 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$1,359.00 |
$1,359.00 |
$1,359.00 |
$2,343.60
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$1,981.50 |
$1,981.50 |
$1,981.50 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$1,923.00 |
$1,923.00 |
$1,923.00 |
$3,176.40
|
|
Colectomy w/ileoanal anast
|
$2,407.00 |
$2,407.00 |
$2,407.00 |
$5,367.20
|
|
Collagenase, clost hist inj
|
$123.50 |
$123.50 |
$123.50 |
$12,906.28
|
|
Collection blood specimen from completely implantable venous access device
|
$127.50 |
$127.50 |
$127.50 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$127.50 |
$127.50 |
$127.50 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$5.50 |
$5.50 |
$5.50 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$649.50 |
$649.50 |
$649.50 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$252.00 |
$252.00 |
$252.00 |
$1,946.25
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$668.50 |
$668.50 |
$668.50 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$208.50 |
$208.50 |
$208.50 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$245.00 |
$245.00 |
$245.00 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$217.00 |
$217.00 |
$217.00 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$163.00 |
$163.00 |
$163.00 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$293.50 |
$293.50 |
$293.50 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$214.50 |
$214.50 |
$214.50 |
$1,645.43
|
|
Colonoscopy w/band ligation
|
$242.00 |
$242.00 |
$242.00 |
$2,080.80
|
|
Colonoscopy w/control bleed
|
$280.00 |
$280.00 |
$280.00 |
$2,030.25
|
|
Colonoscopy w/dilation
|
$185.50 |
$185.50 |
$185.50 |
$2,495.25
|
|
Colonoscopy w/endoscope Ultrasound
|
$258.00 |
$258.00 |
$258.00 |
$1,645.43
|
|
Colonoscopy/w endoscopic stent 45389
|
$290.00 |
$290.00 |
$290.00 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$240.50 |
$240.50 |
$240.50 |
$1,395.28
|
|
Colonoscopy w/injection
|
$175.50 |
$175.50 |
$175.50 |
$2,449.20
|
|
Colonoscopy (with biopsy)
|
$709.50 |
$709.50 |
$709.50 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$186.50 |
$186.50 |
$186.50 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$762.00 |
$762.00 |
$762.00 |
$2,288.00
|
|
Colonoscopy w/resection
|
$332.50 |
$332.50 |
$332.50 |
$3,029.60
|
|
Colostomy skin level cecostomy 44320
|
$1,310.50 |
$1,310.50 |
$1,310.50 |
$2,269.80
|
|
Colotomy exploration/bx/foreign body removal 44025
|
$1,080.50 |
$1,080.50 |
$1,080.50 |
$1,746.00
|
|
Colpocleisis (le forte type) 57120
|
$540.50 |
$540.50 |
$540.50 |
$5,419.00
|
|
Colpopexy abdominal approach 57280
|
$1,015.50 |
$1,015.50 |
$1,015.50 |
$1,863.60
|
|
Colpopexy extraperitoneal
|
$728.00 |
$728.00 |
$728.00 |
$5,110.00
|
|
Colpopexy intraperitoneal
|
$774.00 |
$774.00 |
$774.00 |
$6,906.50
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$342.00 |
$342.00 |
$342.00 |
$3,762.53
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$128.50 |
$128.50 |
$128.50 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$190.50 |
$190.50 |
$190.50 |
$3,744.41
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$95.00 |
$95.00 |
$95.00 |
$312.90
|
|
Colposcopy vulva 56820
|
$88.00 |
$88.00 |
$88.00 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$292.00 |
$292.00 |
$292.00 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$113.50 |
$113.50 |
$113.50 |
$502.80
|
|
Colpotomy drng of abscess 57010
|
$465.00 |
$465.00 |
$465.00 |
$3,762.53
|
|
Colpotomy w/exploration 57000
|
$203.00 |
$203.00 |
$203.00 |
$3,905.53
|
|
Compatibility test each unit antiglobulin technique
|
$57.00 |
$57.00 |
$57.00 |
$170.05
|
