|
Repair artery rupture thigh 35142
|
$1,410.50 |
$1,410.50 |
$1,410.50 |
$6,489.60
|
|
Repair art rupture aorta 35082
|
$2,320.00 |
$2,320.00 |
$2,320.00 |
$4,366.80
|
|
Repair art rupture arm 35013
|
$1,274.50 |
$1,274.50 |
$1,274.50 |
$1,665.77
|
|
Repair art rupture chest 35022
|
$1,528.50 |
$1,528.50 |
$1,528.50 |
$2,799.00
|
|
Repair art rupture groin 35132
|
$1,759.00 |
$1,759.00 |
$1,759.00 |
$3,404.94
|
|
Repair av fistula ext 35190
|
$803.50 |
$803.50 |
$803.50 |
$6,366.08
|
|
Repair biceps tendon
|
$5,819.76 |
$5,819.76 |
$5,819.76 |
$6,839.00
|
|
Repair bladder defect
|
$6,692.50 |
$6,692.50 |
$6,692.50 |
$5,841.60
|
|
Repair blood ves direct neck 35201
|
$988.50 |
$988.50 |
$988.50 |
$5,907.78
|
|
Repair blood vess/direct/intra/abd 35221
|
$1,570.50 |
$1,570.50 |
$1,570.50 |
$1,904.24
|
|
Repair blood vessel direct hand finger
|
$795.00 |
$795.00 |
$795.00 |
$3,898.50
|
|
Repair blood vessel direct intrathoracic without bypass 35216
|
$2,213.50 |
$2,213.50 |
$2,213.50 |
$9,518.60
|
|
Repair blood vessel dir lower extr
|
$883.50 |
$883.50 |
$883.50 |
$1,705.04
|
|
Repair blood vessel dir upper extr
|
$2,310.50 |
$2,310.50 |
$2,310.50 |
$3,879.03
|
|
Repair blood vessel lesion
|
$1,037.50 |
$1,037.50 |
$1,037.50 |
$2,346.40
|
|
Repair blood vessel lesion
|
$1,054.50 |
$1,054.50 |
$1,054.50 |
$4,766.40
|
|
Repair blood vessel lesion
|
$923.00 |
$923.00 |
$923.00 |
$5,983.35
|
|
Repair blood vessel lesion 35211
|
$1,479.50 |
$1,479.50 |
$1,479.50 |
$2,285.40
|
|
Repair blood vessel w/graft intra-abd 35281
|
$1,658.50 |
$1,658.50 |
$1,658.50 |
$2,239.64
|
|
Repair blood vessel w/graft lower extremity 35286
|
$1,088.50 |
$1,088.50 |
$1,088.50 |
$5,983.35
|
|
Repair blood vessel w/vein graft lower extremity 35256
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$4,341.66
|
|
Repair bowel-bladder fistula 44661
|
$1,645.50 |
$1,645.50 |
$1,645.50 |
$2,891.40
|
|
Repair bowel fistula 44650
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$1,558.00
|
|
Repair brow defect
|
$531.00 |
$531.00 |
$531.00 |
$2,760.73
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,309.00 |
$1,309.00 |
$1,309.00 |
$1,025.95
|
|
Repair defect arm art 35045
|
$1,033.00 |
$1,033.00 |
$1,033.00 |
$6,396.89
|
|
Repair defect of artery
|
$1,481.00 |
$1,481.00 |
$1,481.00 |
$2,168.66
|
|
Repair defect of artery
|
$1,335.50 |
$1,335.50 |
$1,335.50 |
$1,422.50
|
|
Repair defect of artery
|
$1,912.50 |
$1,912.50 |
$1,912.50 |
$3,131.20
|
|
Repair defect of artery
|
$1,430.50 |
$1,430.50 |
$1,430.50 |
$1,471.00
|
|
Repair defect of artery 35011
|
$1,075.50 |
$1,075.50 |
$1,075.50 |
$6,305.95
|
|
Repair defect of artery 35081
|
$1,850.50 |
$1,850.50 |
$1,850.50 |
$3,497.40
|
|
Repair defect of artery 35102
|
$2,012.50 |
$2,012.50 |
$2,012.50 |
$3,772.80
|
|
Repair defect of artery 35121
|
$1,702.00 |
$1,702.00 |
$1,702.00 |
$2,224.66
|
|
Repair defect of artery carotid subclav 35001
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
$2,165.40
|
|
Repair deformity of toe
|
$380.00 |
$380.00 |
$380.00 |
$3,545.97
|
|
Repair degenerated kneecap
|
$862.00 |
$862.00 |
$862.00 |
$5,886.74
|
|
Repair dental ellis ii fx
|
$28.50 |
$28.50 |
$28.50 |
$442.48
|
|
Repair detached retina
|
$847.50 |
$847.50 |
$847.50 |
$3,468.40
|
|
Repair elbow deb/attch open
|
$730.50 |
$730.50 |
$730.50 |
$3,839.54
|
|
Repair elbow w/deb open
|
$561.00 |
$561.00 |
$561.00 |
$3,821.05
|
|
Repair extns tendon finger without grft ea
|
$2,249.00 |
$2,249.00 |
$2,249.00 |
$2,224.00
|
|
Repair eyelid defect
|
$724.00 |
$724.00 |
$724.00 |
$4,462.45
|
|
Repair eyelid defect
|
$624.00 |
$624.00 |
$624.00 |
$3,357.30
|
|
Repair eyelid defect
|
$429.50 |
$429.50 |
$429.50 |
$2,732.50
|
|
Repair eyelid defect
|
$328.00 |
$328.00 |
$328.00 |
$2,760.73
|
|
Repair eyelid defect
|
$2,187.00 |
$2,187.00 |
$2,187.00 |
$2,982.40
|
|
Repair eyelid defect
|
$477.00 |
$477.00 |
$477.00 |
$2,760.73
|
|
Repair eyelid defect
|
$457.00 |
$457.00 |
$457.00 |
$2,856.80
|
|
Repair fibula nonunion
|
$1,013.50 |
$1,013.50 |
$1,013.50 |
$6,879.60
|
|
Repair finger/hand tendon
|
$791.00 |
$791.00 |
$791.00 |
$4,150.20
|
|
Repair finger/hand tendon
|
$864.00 |
$864.00 |
$864.00 |
$4,150.20
|
|
Repair finger/hand tendon
|
$829.50 |
$829.50 |
$829.50 |
$3,848.00
|
|
Repair finger/hand tendon
|
$552.50 |
$552.50 |
$552.50 |
$3,839.54
|
|
Repair finger tendon
|
$574.00 |
$574.00 |
$574.00 |
$3,594.44
|
|
Repair foot dislocation
|
$772.50 |
$772.50 |
$772.50 |
$5,886.74
|
|
Repair foot dislocation
|
$6,541.50 |
$6,541.50 |
$6,541.50 |
$5,886.74
|
|
Repair forearm tendon/muscle
|
$617.50 |
$617.50 |
$617.50 |
$3,839.54
|
|
Repair forearm tendon/muscle sec 25263
|
$697.00 |
$697.00 |
$697.00 |
$6,311.00
|
|
Repair/graft achilles tendon
|
$736.00 |
$736.00 |
$736.00 |
$8,429.28
|
|
Repair/graft femur head/neck
|
$1,293.00 |
$1,293.00 |
$1,293.00 |
$1,293.00
|
|
Repair/graft hand tendon
|
$722.50 |
$722.50 |
$722.50 |
$3,931.20
|
|
Repair/graft kneecap tendon
|
$898.00 |
$898.00 |
$898.00 |
$5,339.00
|
|
Repair/graft of foot tendon
|
$1,781.17 |
$1,781.17 |
$1,781.17 |
$5,886.74
|
|
Repair/graft of foot tendon
|
$461.50 |
$461.50 |
$461.50 |
$5,023.20
|
|
Repair/graft of thigh muscle
|
$936.00 |
$936.00 |
$936.00 |
$5,741.00
|
|
Repair/graft of tibia
|
$1,328.00 |
$1,328.00 |
$1,328.00 |
$5,020.60
|
|
Repair/graft radius or ulna
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$7,907.11
|
|
Repair humerus with graft
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$11,718.66
|
|
Repair ing hernia sliding
|
$645.50 |
$645.50 |
$645.50 |
$2,812.80
|
|
Repair iris & ciliary body
|
$594.50 |
$594.50 |
$594.50 |
$2,698.92
|
|
Repair iris & ciliary body
|
$660.50 |
$660.50 |
$660.50 |
$3,110.11
|
|
Repair lac palate<2 cm
|
$194.50 |
$194.50 |
$194.50 |
$780.65
|
|
Repair lip full thkns =<one-half vert height
|
$399.50 |
$399.50 |
$399.50 |
$1,308.00
|
|
Repair lumbar hernia
|
$726.00 |
$726.00 |
$726.00 |
$6,457.82
|
|
Repair nonunion hand
|
$1,069.50 |
$1,069.50 |
$1,069.50 |
$5,886.74
|
|
Repair of achilles tendon
|
$782.50 |
$782.50 |
$782.50 |
$5,326.50
|
|
Repair of aneurysm
|
$1,168.50 |
$1,168.50 |
$1,168.50 |
$4,013.30
|
|
Repair of ankle ligament
|
$6,350.50 |
$6,350.50 |
$6,350.50 |
$7,913.97
|
|
Repair of ankle ligament
|
$3,456.34 |
$3,456.34 |
$3,456.34 |
$5,741.00
|
|
Repair of ankle ligaments
|
$575.00 |
$575.00 |
$575.00 |
$5,741.00
|
|
Repair of bladder opening
|
$486.00 |
$486.00 |
$486.00 |
$4,081.37
|
|
Repair of circumcision
|
$227.50 |
$227.50 |
$227.50 |
$2,874.36
|
|
Repair of diaphragm hernia
|
$6,221.50 |
$6,221.50 |
$6,221.50 |
$14,392.80
|
|
Repair of diaphragm hernia
|
$926.00 |
$926.00 |
$926.00 |
$1,246.56
|
|
Repair of enterocele vaginal approach 57268
|
$528.00 |
$528.00 |
$528.00 |
$4,900.30
|
|
Repair of eye wound
|
$2,277.50 |
$2,277.50 |
$2,277.50 |
$2,760.73
|
|
Repair of eye wound
|
$666.50 |
$666.50 |
$666.50 |
$5,638.94
|
|
Repair of eye wound
|
$1,101.00 |
$1,101.00 |
$1,101.00 |
$5,741.00
|
|
Repair of foot tendon
|
$354.00 |
$354.00 |
$354.00 |
$3,842.58
|
|
Repair of humerus
|
$1,163.00 |
$1,163.00 |
$1,163.00 |
$12,591.64
|
|
Repair of hydrocele 55060
|
$396.50 |
$396.50 |
$396.50 |
$3,817.53
|
|
Repair of kneecap tendon
|
$678.00 |
$678.00 |
$678.00 |
$7,907.11
|
|
Repair of knee ligament
|
$715.00 |
$715.00 |
$715.00 |
$5,886.13
|
|
Repair of leg tendon each
|
$402.00 |
$402.00 |
$402.00 |
$3,680.78
|
|
Repair of leg tendon each
|
$517.00 |
$517.00 |
$517.00 |
$6,311.00
|
|
Repair of leg tendon each
|
$461.50 |
$461.50 |
$461.50 |
$7,177.39
|
|
Repair of metatarsals
|
$633.00 |
$633.00 |
$633.00 |
$6,512.80
|
|
Repair of ruptured tendon
|
$852.50 |
$852.50 |
$852.50 |
$6,484.80
|
|
Repair of ruptured uterus
|
$841.00 |
$841.00 |
$841.00 |
$1,989.60
|
