|
Repair blood vessel direct hand finger
|
$5,194.40 |
$5,194.40 |
$5,194.40 |
$3,898.50
|
|
Repair blood vessel direct intrathoracic without bypass 35216
|
$3,619.20 |
$3,619.20 |
$3,619.20 |
$9,518.60
|
|
Repair blood vessel dir lower extr
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$1,705.04
|
|
Repair blood vessel dir upper extr
|
$4,067.20 |
$4,067.20 |
$4,067.20 |
$3,879.03
|
|
Repair blood vessel lesion
|
$1,708.00 |
$1,708.00 |
$1,708.00 |
$2,346.40
|
|
Repair blood vessel lesion
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$4,766.40
|
|
Repair blood vessel lesion
|
$1,512.80 |
$1,512.80 |
$1,512.80 |
$5,983.35
|
|
Repair blood vessel lesion 35211
|
$2,496.80 |
$2,496.80 |
$2,496.80 |
$2,285.40
|
|
Repair blood vessel w/graft intra-abd 35281
|
$2,809.60 |
$2,809.60 |
$2,809.60 |
$2,239.64
|
|
Repair blood vessel w/graft lower extremity 35286
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$5,983.35
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$2,023.20 |
$2,023.20 |
$2,023.20 |
$4,341.66
|
|
Repair bowel-bladder fistula 44661
|
$2,664.80 |
$2,664.80 |
$2,664.80 |
$2,891.40
|
|
Repair bowel fistula 44650
|
$2,492.80 |
$2,492.80 |
$2,492.80 |
$1,558.00
|
|
Repair brow defect
|
$763.20 |
$763.20 |
$763.20 |
$2,760.73
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$1,025.95
|
|
Repair defect arm art 35045
|
$1,679.20 |
$1,679.20 |
$1,679.20 |
$6,396.89
|
|
Repair defect of artery
|
$2,436.00 |
$2,436.00 |
$2,436.00 |
$2,168.66
|
|
Repair defect of artery
|
$2,276.00 |
$2,276.00 |
$2,276.00 |
$1,422.50
|
|
Repair defect of artery
|
$3,131.20 |
$3,131.20 |
$3,131.20 |
$3,131.20
|
|
Repair defect of artery
|
$2,353.60 |
$2,353.60 |
$2,353.60 |
$1,471.00
|
|
Repair defect of artery 35011
|
$1,760.80 |
$1,760.80 |
$1,760.80 |
$6,305.95
|
|
Repair defect of artery 35081
|
$3,055.20 |
$3,055.20 |
$3,055.20 |
$3,497.40
|
|
Repair defect of artery 35102
|
$3,304.00 |
$3,304.00 |
$3,304.00 |
$3,772.80
|
|
Repair defect of artery 35121
|
$2,802.40 |
$2,802.40 |
$2,802.40 |
$2,224.66
|
|
Repair defect of artery carotid subclav 35001
|
$1,940.80 |
$1,940.80 |
$1,940.80 |
$2,165.40
|
|
Repair deformity of toe
|
$616.00 |
$616.00 |
$616.00 |
$3,545.97
|
|
Repair degenerated kneecap
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$5,886.74
|
|
Repair detached retina
|
$1,220.00 |
$1,220.00 |
$1,220.00 |
$3,468.40
|
|
Repair elbow deb/attch open
|
$2,013.34 |
$2,013.34 |
$2,013.34 |
$3,839.54
|
|
Repair elbow w/deb open
|
$892.00 |
$892.00 |
$892.00 |
$3,821.05
|
|
Repair extns tendon finger without grft ea
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
$2,224.00
|
|
Repair eyelid defect
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$4,462.45
|
|
Repair eyelid defect
|
$893.60 |
$893.60 |
$893.60 |
$3,357.30
|
|
Repair eyelid defect
|
$652.80 |
$652.80 |
$652.80 |
$2,732.50
|
|
Repair eyelid defect
|
$505.60 |
$505.60 |
$505.60 |
$2,760.73
|
|
Repair eyelid defect
|
$3,644.00 |
$3,644.00 |
$3,644.00 |
$2,982.40
|
|
Repair eyelid defect
|
$687.20 |
$687.20 |
$687.20 |
$2,760.73
|
|
Repair eyelid defect
|
$686.40 |
$686.40 |
$686.40 |
$2,856.80
|
|
Repair fibula nonunion
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$6,879.60
|
|
Repair finger/hand tendon
|
$1,265.60 |
$1,265.60 |
$1,265.60 |
$4,150.20
|
|
Repair finger/hand tendon
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$4,150.20
|
|
Repair finger/hand tendon
|
$1,313.60 |
$1,313.60 |
$1,313.60 |
$3,848.00
|
|
Repair finger/hand tendon
|
$847.20 |
$847.20 |
$847.20 |
$3,839.54
|
|
Repair finger tendon
|
$972.00 |
$972.00 |
$972.00 |
$3,594.44
|
|
Repair foot dislocation
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$5,886.74
|
|
Repair foot dislocation
|
$1,410.40 |
$1,410.40 |
$1,410.40 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$960.00 |
$960.00 |
$960.00 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$1,088.80 |
$1,088.80 |
$1,088.80 |
$6,311.00
|
|
Repair/graft achilles tendon
|
$1,114.40 |
$1,114.40 |
$1,114.40 |
$8,429.28
|
|
Repair/graft femur head/neck
|
$1,959.20 |
$1,959.20 |
$1,959.20 |
$1,293.00
|
|
Repair/graft hand tendon
|
$1,199.20 |
$1,199.20 |
$1,199.20 |
$3,931.20
|
|
Repair/graft kneecap tendon
|
$1,392.80 |
$1,392.80 |
$1,392.80 |
$5,339.00
|
|
Repair/graft of foot tendon
|
$728.80 |
$728.80 |
$728.80 |
$5,886.74
|
|
Repair/graft of foot tendon
|
$710.40 |
$710.40 |
$710.40 |
$5,023.20
|
|
Repair/graft of thigh muscle
|
$9,178.40 |
$9,178.40 |
$9,178.40 |
$5,741.00
|
|
Repair/graft of tibia
|
$2,093.60 |
$2,093.60 |
$2,093.60 |
$5,020.60
|
|
Repair/graft radius or ulna
|
$1,711.20 |
$1,711.20 |
$1,711.20 |
$7,907.11
|
|
Repair humerus with graft
|
$1,820.80 |
$1,820.80 |
$1,820.80 |
$11,718.66
|
|
Repair ing hernia sliding
|
$1,031.20 |
$1,031.20 |
$1,031.20 |
$2,812.80
|
|
Repair iris & ciliary body
|
$891.20 |
$891.20 |
$891.20 |
$2,698.92
|
|
Repair iris & ciliary body
|
$992.80 |
$992.80 |
$992.80 |
$3,110.11
|
|
Repair lac palate<2 cm
|
$840.80 |
$840.80 |
$840.80 |
$780.65
|
|
Repair lip full thkns =<one-half vert height
|
$639.20 |
$639.20 |
$639.20 |
$1,308.00
|
|
Repair lumbar hernia
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
$6,457.82
|
|
Repair nonunion hand
|
$1,735.20 |
$1,735.20 |
$1,735.20 |
$5,886.74
|
|
Repair of achilles tendon
|
$1,215.20 |
$1,215.20 |
$1,215.20 |
$5,326.50
|
|
Repair of aneurysm
|
$1,918.40 |
$1,918.40 |
$1,918.40 |
$4,013.30
|
|
Repair of ankle ligament
|
$830.40 |
$830.40 |
$830.40 |
$7,913.97
|
|
Repair of ankle ligament
|
$1,076.80 |
$1,076.80 |
$1,076.80 |
$5,741.00
|
|
Repair of ankle ligaments
|
$918.40 |
$918.40 |
$918.40 |
$5,741.00
|
|
Repair of bladder opening
|
$783.20 |
$783.20 |
$783.20 |
$4,081.37
|
|
Repair of circumcision
|
$370.40 |
$370.40 |
$370.40 |
$2,874.36
|
|
Repair of diaphragm hernia
|
$10,292.00 |
$10,292.00 |
$10,292.00 |
$14,392.80
|
|
Repair of diaphragm hernia
|
$1,540.80 |
$1,540.80 |
$1,540.80 |
$1,246.56
|
|
Repair of enterocele vaginal approach 57268
|
$829.60 |
$829.60 |
$829.60 |
$4,900.30
|
|
Repair of eye wound
|
$3,644.00 |
$3,644.00 |
$3,644.00 |
$2,760.73
|
|
Repair of eye wound
|
$996.00 |
$996.00 |
$996.00 |
$5,638.94
|
|
Repair of eye wound
|
$1,640.80 |
$1,640.80 |
$1,640.80 |
$5,741.00
|
|
Repair of foot tendon
|
$555.20 |
$555.20 |
$555.20 |
$3,842.58
|
|
Repair of humerus
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$12,591.64
|
|
Repair of hydrocele 55060
|
$639.20 |
$639.20 |
$639.20 |
$3,817.53
|
|
Repair of kneecap tendon
|
$1,061.60 |
$1,061.60 |
$1,061.60 |
$7,907.11
|
|
Repair of knee ligament
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$5,886.13
|
|
Repair of leg tendon each
|
$634.40 |
$634.40 |
$634.40 |
$3,680.78
|
|
Repair of leg tendon each
|
$800.80 |
$800.80 |
$800.80 |
$6,311.00
|
|
Repair of leg tendon each
|
$709.60 |
$709.60 |
$709.60 |
$7,177.39
|
|
Repair of metatarsals
|
$973.60 |
$973.60 |
$973.60 |
$6,512.80
|
|
Repair of ruptured tendon
|
$4,992.00 |
$4,992.00 |
$4,992.00 |
$6,484.80
|
|
Repair of ruptured uterus
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$1,989.60
|
|
Repair of shoulder
|
$6,104.54 |
$6,104.54 |
$6,104.54 |
$6,661.18
|
|
Repair of thigh
|
$1,984.00 |
$1,984.00 |
$1,984.00 |
$4,456.40
|
|
Repair of thigh muscle
|
$4,160.00 |
$4,160.00 |
$4,160.00 |
$6,727.70
|
|
Repair of ureter
|
$1,394.40 |
$1,394.40 |
$1,394.40 |
$3,910.40
|
|
Repair paravag defect vag 57285
|
$1,135.20 |
$1,135.20 |
$1,135.20 |
$8,185.02
|
|
Repair pm/icd lead dual
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,343.82
|
|
Repair pm/icd lead sgl
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,339.00
|
|
Repair radius or ulna
|
$1,336.00 |
$1,336.00 |
$1,336.00 |
$8,412.89
|
|
Repair radius & ulna
|
$1,632.00 |
$1,632.00 |
$1,632.00 |
$8,453.60
|
|
Repair rectourethral fistula
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$1,822.36
|
|
Repair rectum & vagina
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$5,394.95
|
