|
Circumcise/surg/28 days or < 54160
|
$151.00 |
$801.50 |
$4,141.00 |
|
|
Circumcision (newborn)
|
$98.00 |
$2,788.50 |
$4,599.00 |
|
|
Cisplatin 1 mg/ml desensitization
|
$31.81 |
$70.86 |
$195.30 |
|
|
C-kit mutation liquid tumor - sendout
|
$394.00 |
$394.00 |
$1,180.00 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$164.41 |
$164.41 |
$217.25 |
|
|
C-laminoplasty w/graft/plate
|
$25,812.50 |
$25,812.50 |
$25,812.50 |
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$2,311.40 |
$2,928.00 |
$8,566.00 |
|
|
Claviculectomy partial
|
$620.00 |
$2,305.34 |
$9,001.50 |
|
|
Clean out mastoid cavity
|
$156.00 |
$620.00 |
$7,977.75 |
|
|
Clearance of airways
|
$210.00 |
$246.50 |
$335.00 |
|
|
Clearance of airways
|
$81.50 |
$81.50 |
$130.40 |
|
|
Clearance of tear duct
|
$328.50 |
$365.00 |
$405.50 |
|
|
C-lens fitg corneosclrl lens
|
$173.50 |
$173.50 |
$173.50 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$9.08 |
$19.92 |
$58.80 |
|
|
Clip ligating vesolock lg
|
$398.23 |
$461.50 |
$2,389.50 |
|
|
Clip phn wireless f/baha4 proc
|
$1,113.50 |
$1,113.50 |
$1,113.50 |
|
|
Clitoroplasty intersex state
|
$3,302.75 |
$3,302.75 |
$3,302.75 |
|
|
Clofarabine 1 mg/ml intravenous solution
|
$822.19 |
$822.19 |
$822.19 |
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$2.50 |
$3.50 |
$140.00 |
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$191.00 |
$407.50 |
$673.60 |
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$1,848.50 |
$1,848.50 |
$2,197.50 |
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$804.50 |
$804.50 |
$1,287.20 |
|
|
Closed tx/acetabululm without manip 27220
|
$241.00 |
$438.50 |
$880.00 |
|
|
Closed tx humerus fx with manip 23605
|
$454.50 |
$1,526.50 |
$3,104.00 |
|
|
Closed tx humerus fx without manip 23600
|
$189.00 |
$358.00 |
$659.00 |
|
|
Closed tx humerus fx w/manip 24505
|
$286.80 |
$1,769.50 |
$10,837.00 |
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$125.00 |
$308.50 |
$454.00 |
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$1,540.00 |
$2,272.50 |
$4,164.00 |
|
|
Closed tx septal&nose fx
|
$660.00 |
$2,749.50 |
$7,016.00 |
|
|
Closed tx sesamoid fx 28530
|
$108.00 |
$110.50 |
$378.40 |
|
|
Closed tx/talus fracture without manip 28430
|
$221.00 |
$284.00 |
$491.50 |
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$189.50 |
$275.50 |
$458.00 |
|
|
Close tear duct opening
|
$138.50 |
$221.60 |
$1,453.50 |
|
|
Close tear duct opening
|
$111.50 |
$178.40 |
$1,042.00 |
|
|
Clos txnose fx without stablz 21315
|
$61.50 |
$478.80 |
$5,738.00 |
|
|
Closure enterostomy lg/sm intestine 44620
|
$918.50 |
$963.50 |
$7,598.50 |
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$1,697.50 |
$1,719.00 |
$6,188.00 |
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$1,071.00 |
$1,088.00 |
$1,740.80 |
|
|
Closure intestinal cutaneous fistula 44640
|
$16,118.00 |
$16,118.00 |
$16,118.00 |
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$804.00 |
$804.00 |
$810.00 |
|
|
Closure of eyelid by suture
|
$89.50 |
$143.20 |
$3,967.75 |
|
|
Closure of windpipe lesion 31820
|
$622.80 |
$3,811.00 |
$11,312.50 |
|
|
Closure paravalvlr leak pq
|
$924.50 |
$924.50 |
$924.50 |
|
|
Closure ureter/skin fistula
|
$910.50 |
$910.50 |
$1,456.80 |
|
|
Clot factor viii reltd antgn
|
$134.50 |
$134.50 |
$134.50 |
|
|
Clot factor xii hageman
|
$10.00 |
$157.50 |
$640.20 |
|
|
Clot factor xiii fibrin scrn
|
$63.50 |
$124.50 |
$212.40 |
|
|
Clot factor xiii fibrin stab
|
$60.00 |
$61.50 |
$150.00 |
|
|
Clotting assay whole blood
|
$94.50 |
$94.50 |
$106.50 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$286.80 |
$520.50 |
$3,194.50 |
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$185.50 |
$383.50 |
$983.50 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$185.50 |
$340.50 |
$628.80 |
|
|
Clsd tx clavicle dislocation without manip 23540
|
$252.00 |
$277.50 |
$471.50 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,800.50 |
$1,848.50 |
$2,346.00 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$220.50 |
$358.50 |
$679.00 |
|
|
Clsd tx coccygeal fracture 27200
|
$266.00 |
$284.00 |
$319.00 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$182.00 |
$302.00 |
$494.50 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$180.00 |
$456.50 |
$3,709.33 |
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$230.50 |
$346.00 |
$553.60 |
|
|
Clsd tx elbow dislocation child 24640
|
$237.50 |
$348.50 |
$823.50 |
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$803.50 |
$1,867.50 |
$4,478.00 |
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$1,867.50 |
$1,867.50 |
$2,054.00 |
|
|
Clsd tx fracture of radius 25500
|
$185.50 |
$295.00 |
$679.00 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$141.00 |
$292.50 |
$491.50 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$156.00 |
$318.50 |
$3,165.00 |
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$190.00 |
$425.00 |
$1,314.00 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,540.00 |
$2,462.00 |
$9,010.50 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$185.50 |
$296.00 |
$565.50 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$564.50 |
$2,272.50 |
$4,332.50 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$185.50 |
$334.00 |
$547.50 |
|
|
Clsd tx hip disloc without anes 27265
|
$189.00 |
$543.00 |
$1,098.00 |
|
|
Clsd tx humeral fract without manip 24530
|
$190.00 |
$394.00 |
$915.50 |
|
|
Clsd tx humerus fract without manip 24500
|
$190.00 |
$378.50 |
$728.00 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$308.50 |
$391.00 |
$2,823.00 |
|
|
Clsd tx mandibular fx without manip 21450
|
$600.00 |
$620.00 |
$863.50 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$185.50 |
$278.50 |
$390.40 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$212.00 |
$425.00 |
$4,207.30 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$286.80 |
$446.50 |
$3,527.50 |
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,761.00 |
$3,761.00 |
$4,179.00 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$241.50 |
$284.00 |
$4,000.50 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$205.50 |
$283.50 |
$887.00 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$499.20 |
$3,988.50 |
$5,480.50 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$349.00 |
$1,919.00 |
$4,400.00 |
|
|
Clsd tx patella disloc without anes 27560
|
$270.00 |
$378.50 |
$711.00 |
|
|
Clsd tx/patellar fx without manip 27520
|
$189.00 |
$341.00 |
$717.50 |
|
|
Clsd tx pelvic ring fx
|
$93.50 |
$236.50 |
$1,074.00 |
|
|
Clsd tx pelvic ring fx
|
$211.00 |
$284.00 |
$315.50 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,800.50 |
$2,000.50 |
$9,593.00 |
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$189.00 |
$341.00 |
$2,016.00 |
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$185.50 |
$295.20 |
$2,931.00 |
|
|
Clsd tx radius fracture w/manip 24655
|
$449.50 |
$1,848.00 |
$14,567.00 |
|
|
Clsd tx/scapular fx without manip 23570
|
$175.50 |
$286.50 |
$494.50 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$443.50 |
$1,927.50 |
$2,763.00 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$532.50 |
$1,919.00 |
$2,641.60 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$462.50 |
$2,272.50 |
$5,011.00 |
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$359.50 |
$373.00 |
$4,360.50 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$36.00 |
$338.50 |
$1,300.00 |
|
|
Clsd tx toe dislocation without anes28660
|
$112.50 |
$446.50 |
$873.00 |
|
|
Clsd tx trimall ankle fx without manip 27816
|
$185.50 |
$340.50 |
$627.50 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$927.50 |
$2,218.50 |
$6,859.90 |
|
