Line Type HPD CDM Code HPD CDM Description DRG CPT/ HCPCS HPD Revenue Code Gross or Average Charge Self Pay Cash Price Min Negotiated Rate Max Negotiated Rate Aetna Better Health MA Aetna Comm Aetna Medicare Aetna Signature Administrators AmeriHealth MA AmeriHealth MC Adv CBC Comm CBC Medicare Cigna Gateway MA Gateway Medicare Geisinger Comm Geisinger MA Geisinger Medicare Highmark Choice Blue Highmark Comm Highmark Medicare Humana Medicare Medicare Multiplan PA Health & Wellness PAMA UHC Comm UHC MA UHC MA CHIP UPMC Comm UPMC MA UPMC MA CHIP Vibra Medicare Wellspan 1012 10004 FNA BX W/O IMG GDN EA ADDL Tech 10004 761 56 16.41 14.39 44.80 14.39 29.06 N/A 29.06 N/A N/A 28.56 N/A 33.60 N/A N/A 37.07 N/A N/A N/A N/A N/A N/A N/A 44.80 N/A 35.52 37.52 N/A 22.90 42.00 21.29 25.05 N/A 44.24 1024 10005 FNA BX W/US GDN 1ST LES Tech 10005 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26786 10005 US Fine Needle Aspiration w/ Guidance Tech 10005 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26787 10005 US* FINE NEEDLE ASPIRATION THYROID GLAND Tech 10005 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26788 10005 US Fine Needle Aspiration Thyroid Gland Tech 10005 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1010 10006 FNA BX W/US GDN EA ADDL Tech 10006 761 47 13.78 12.08 40.71 12.08 24.39 N/A 24.39 N/A N/A 23.97 N/A 28.20 N/A N/A 31.11 N/A N/A N/A N/A N/A N/A N/A 37.60 N/A 40.71 31.49 N/A 19.22 35.25 17.86 21.02 N/A 37.13 1017 10007 FNA BX W/FLUOR GDN 1ST LES Tech 10007 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1020 10008 FNA BX W/FLUOR GDN EA ADDL Tech 10008 761 860 252.07 50.01 688.00 221.02 446.34 N/A 446.34 N/A N/A 438.60 N/A 516.00 N/A N/A 569.23 N/A N/A N/A N/A N/A N/A N/A 688.00 N/A 50.01 576.20 N/A 351.74 645.00 326.89 384.68 N/A 679.40 29442 10008 XR FNA BX EACH ADDTL LESION Tech 10008 761 860 252.07 50.01 688.00 221.02 446.34 N/A 446.34 N/A N/A 438.60 N/A 516.00 N/A N/A 569.23 N/A N/A N/A N/A N/A N/A N/A 688.00 N/A 50.01 576.20 N/A 351.74 645.00 326.89 384.68 N/A 679.40 65516 IR FNA BX EACH ADDTL LESION Tech 10008 761 860 252.07 50.01 688.00 221.02 446.34 N/A 446.34 N/A N/A 438.60 N/A 516.00 N/A N/A 569.23 N/A N/A N/A N/A N/A N/A N/A 688.00 N/A 50.01 576.20 N/A 351.74 645.00 326.89 384.68 N/A 679.40 1015 10009 FNA BX W/CT GDN 1ST LES Tech 10009 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1040 10010 FNA BX W/CT GDN EA ADDL Tech 10010 761 929 272.29 67.99 743.20 238.75 482.15 N/A 482.15 N/A N/A 473.79 N/A 557.40 N/A N/A 614.91 N/A N/A N/A N/A N/A N/A N/A 743.20 N/A 67.99 622.43 N/A 379.96 696.75 353.11 415.54 N/A 733.91 1034 10021 FNA BX W/O IMG GDN 1ST LES Tech 10021 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 30142 10021 AP Bill Cytology FNA w/o Imaging 10021 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1029 10030 GUIDE CATHET FLUID DRAINAGE Tech 10030 761 3265 956.97 125.28 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 125.28 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26789 10030 US Drainage Soft Tissue Tech 10030 761 3265 956.97 125.28 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 125.28 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26790 10030 IR Drainage Soft Tissue Tech 10030 761 3265 956.97 125.28 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 125.28 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26791 10030 CT Drain Soft Tissue Fluid w/Cath Perc Tech 10030 761 3265 956.97 125.28 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 125.28 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26793 10035 MG. US Lymph Node Clip Plmnt Lt Tech 10035 761 3265 956.97 70.26 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 70.26 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 26794 10035 MG. US Lymph Node Clip Plmnt Rt Tech 10035 761 3265 956.97 70.26 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 70.26 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 65588 PERQ DEV SOFT TISS 1ST IM Tech 10035 761 3265 956.97 70.26 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 70.26 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1030 10036 PERQ DEV SOFT TISS ADD IMAG Tech 10036 761 2266 664.16 35.41 " 1,812.80 " 582.36 " 1,176.05 " N/A " 1,176.05 " N/A N/A " 1,155.66 " N/A " 1,359.60 " N/A N/A " 1,499.87 " N/A N/A N/A N/A N/A N/A N/A " 1,812.80 " N/A 35.41 " 1,518.22 " N/A 926.79 " 1,699.50 " 861.31 " 1,013.58 " N/A " 1,790.14 " 65610 "PLT STTIS LOCDVCLIP,PLWRENDLAD Tech" 10036 761 2266 664.16 35.41 " 1,812.80 " 582.36 " 1,176.05 " N/A " 1,176.05 " N/A N/A " 1,155.66 " N/A " 1,359.60 " N/A N/A " 1,499.87 " N/A N/A N/A N/A N/A N/A N/A " 1,812.80 " N/A 35.41 " 1,518.22 " N/A 926.79 " 1,699.50 " 861.31 " 1,013.58 " N/A " 1,790.14 " 1035 10040 ACNE SURGERY Tech 10040 761 943 276.39 20.00 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 20.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1069 10060 DRAINAGE OF SKIN ABSCESS Tech 10060 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 619.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 65451 I+D ABSCESS;SIMPLE/SINGLE Tech 10060 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 619.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1042 10061 DRAINAGE OF SKIN ABSCESS Tech 10061 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 600.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1036 10080 DRAINAGE OF PILONIDAL CYST Tech 10080 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1032 10081 DRAINAGE OF PILONIDAL CYST Tech 10081 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 568.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1085 10120 REMOVE FOREIGN BODY Tech 10120 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 777.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1059 10121 REMOVE FOREIGN BODY Tech 10121 761 7387 " 2,165.13 " 720.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 720.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 65618 REMOVAL FOREIGN BODY;COMP Tech 10121 761 7387 " 2,165.13 " 720.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 720.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1060 10140 DRAINAGE OF HEMATOMA/FLUID Tech 10140 761 7387 " 2,165.13 " 619.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 619.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 65450 I+D HEMATOMA SEROMA FLUID Tech 10140 761 7387 " 2,165.13 " 619.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 619.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1049 10160 PUNCTURE DRAINAGE OF LESION Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 26792 10160 US Breast Asp Subcutaneous Fluid Lt Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 26795 10160 US Breast Asp Subcutaneous Fluid Rt Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 26796 10160 MG. US Breast Asp Subcutaneous Fluid Rt - Report Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 26799 10160 US Puncture Aspiration Skin Subcutaneous Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 26803 10160 MG. US Breast Asp Subcutaneous Fluid Lt - Report Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 65616 PUNCTURE ASPIRATION CYST Tech 10160 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1065 10180 COMPLEX DRAINAGE WOUND Tech 10180 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 65434 I+D COMPLEX POST-OP WOUND Tech 10180 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1064 11000 DEBRIDE INFECTED SKIN Tech 11000 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 606.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1092 11001 DEBRIDE INFECTED SKIN ADD-ON Tech 11001 761 280 82.07 14.81 224.00 71.96 145.32 N/A 145.32 N/A N/A 142.80 N/A 168.00 N/A N/A 185.33 N/A N/A N/A N/A N/A N/A N/A 224.00 N/A 14.81 187.60 N/A 114.52 210.00 106.43 125.24 N/A 221.20 1086 11004 DEBRIDE GENITALIA & PERINEUM Tech 11004 761 7406 " 2,170.70 " " 1,903.34 " " 5,924.80 " " 1,903.34 " " 3,843.71 " N/A " 3,843.71 " N/A N/A " 3,777.06 " N/A " 4,443.60 " N/A N/A " 4,902.03 " N/A N/A N/A N/A N/A N/A N/A " 5,924.80 " N/A N/A " 4,962.02 " N/A " 3,029.05 " " 5,554.50 " " 2,815.02 " " 3,312.70 " N/A " 5,850.74 " 1087 11005 DEBRIDE ABDOM WALL Tech 11005 761 2911 853.21 748.13 " 2,328.80 " 748.13 " 1,510.81 " N/A " 1,510.81 " N/A N/A " 1,484.61 " N/A " 1,746.60 " N/A N/A " 1,926.79 " N/A N/A N/A N/A N/A N/A N/A " 2,328.80 " N/A N/A " 1,950.37 " N/A " 1,190.60 " " 2,183.25 " " 1,106.47 " " 1,302.09 " N/A " 2,299.69 " 1079 11006 DEBRIDE GENIT/PER/ABDOM WALL Tech 11006 761 674 197.55 173.22 539.20 173.22 349.81 N/A 349.81 N/A N/A 343.74 N/A 404.40 N/A N/A 446.12 N/A N/A N/A N/A N/A N/A N/A 539.20 N/A N/A 451.58 N/A 275.67 505.50 256.19 301.48 N/A 532.46 1081 11008 REMOVE MESH FROM ABD WALL Tech 11008 761 7671 " 2,248.37 " " 1,971.45 " " 6,136.80 " " 1,971.45 " " 3,981.25 " N/A " 3,981.25 " N/A N/A " 3,912.21 " N/A " 4,602.60 " N/A N/A " 5,077.43 " N/A N/A N/A N/A N/A N/A N/A " 6,136.80 " N/A N/A " 5,139.57 " N/A " 3,137.44 " " 5,753.25 " " 2,915.75 " " 3,431.24 " N/A " 6,060.09 " 1090 11010 DEBRIDE SKIN AT FX SITE Tech 11010 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1089 11011 DEBRIDE SKIN MUSC AT FX SITE Tech 11011 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1094 11012 DEB SKIN BONE AT FX SITE Tech 11012 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1083 11042 DEB SUBQ TISSUE 20 SQ CM/< Tech 11042 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 606.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 65430 DEBRIDE;SKIN/SUBQ TISSUE Tech 11042 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 606.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1091 11043 DEB MUSC/FASCIA 20 SQ CM/< Tech 11043 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 606.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1088 11044 DEB BONE 20 SQ CM/< Tech 11044 761 7387 " 2,165.13 " 606.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 606.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1108 11045 DEB SUBQ TISSUE ADD-ON Tech 11045 761 91 26.67 23.39 72.80 23.39 47.23 N/A 47.23 N/A N/A 46.41 N/A 54.60 N/A N/A 60.23 N/A N/A N/A N/A N/A N/A N/A 72.80 N/A N/A 60.97 N/A 37.22 68.25 34.59 40.70 N/A 71.89 1102 11046 DEB MUSC/FASCIA ADD-ON Tech 11046 761 91 26.67 23.39 72.80 23.39 47.23 N/A 47.23 N/A N/A 46.41 N/A 54.60 N/A N/A 60.23 N/A N/A N/A N/A N/A N/A N/A 72.80 N/A N/A 60.97 N/A 37.22 68.25 34.59 40.70 N/A 71.89 1127 11047 DEB BONE ADD-ON Tech 11047 761 2324 681.16 597.27 " 1,859.20 " 597.27 " 1,206.16 " N/A " 1,206.16 " N/A N/A " 1,185.24 " N/A " 1,394.40 " N/A N/A " 1,538.26 " N/A N/A N/A N/A N/A N/A N/A " 1,859.20 " N/A N/A " 1,557.08 " N/A 950.52 " 1,743.00 " 883.35 " 1,039.53 " N/A " 1,835.96 " 1119 11055 TRIM SKIN LESION Tech 11055 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1093 11056 TRIM SKIN LESIONS 2 TO 4 Tech 11056 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1105 11057 TRIM SKIN LESIONS OVER 4 Tech 11057 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1111 11102 TANGNTL BX SKIN SINGLE LES Tech 11102 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1116 11103 TANGNTL BX SKIN EA SEP/ADDL Tech 11103 761 97 28.43 18.65 77.60 24.93 50.34 N/A 50.34 N/A N/A 49.47 N/A 58.20 N/A N/A 64.20 N/A N/A N/A N/A N/A N/A N/A 77.60 N/A 18.65 64.99 N/A 39.67 72.75 36.87 43.39 N/A 76.63 1097 11104 PUNCH BX SKIN SINGLE LESION Tech 11104 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1133 11105 PUNCH BX SKIN EA SEP/ADDL Tech 11105 761 61 17.88 15.68 48.80 15.68 31.66 N/A 31.66 N/A N/A 31.11 N/A 36.60 N/A N/A 40.38 N/A N/A N/A N/A N/A N/A N/A 48.80 N/A 22.05 40.87 N/A 24.95 45.75 23.19 27.29 N/A 48.19 1101 11106 INCAL BX SKN SINGLE LES Tech 11106 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1109 11107 INCAL BX SKN EA SEP/ADDL Tech 11107 761 67 19.64 17.22 53.60 17.22 34.77 N/A 34.77 N/A N/A 34.17 N/A 40.20 N/A N/A 44.35 N/A N/A N/A N/A N/A N/A N/A 53.60 N/A 26.29 44.89 N/A 27.40 50.25 25.47 29.97 N/A 52.93 1113 11200 REMOVAL OF SKIN TAGS 2.0 CM Tech 11303 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 668.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1158 11305 SHAVE SKIN LESION 0.5 CM/< Tech 11305 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 668.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1137 11306 SHAVE SKIN LESION 0.6-1.0 CM Tech 11306 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 668.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1144 11307 SHAVE SKIN LESION 1.1-2.0 CM Tech 11307 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 668.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1135 11308 SHAVE SKIN LESION >2.0 CM Tech 11308 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 668.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1174 11310 SHAVE SKIN LESION 0.5 CM/< Tech 11310 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 668.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1150 11311 SHAVE SKIN LESION 0.6-1.0 CM Tech 11311 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 668.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1141 11312 SHAVE SKIN LESION 1.1-2.0 CM Tech 11312 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 668.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1142 11313 SHAVE SKIN LESION >2.0 CM Tech 11313 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 668.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1153 11400 EXC TR-EXT B9+MARG 0.5 CM< Tech 11400 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1180 11401 EXC TR-EXT B9+MARG 0.6-1 CM Tech 11401 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 576.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1159 11402 EXC TR-EXT B9+MARG 1.1-2 CM Tech 11402 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 682.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1160 11403 EXC TR-EXT B9+MARG 2.1-3CM Tech 11403 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 586.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1157 11404 EXC TR-EXT B9+MARG 3.1-4 CM Tech 11404 761 7387 " 2,165.13 " " 1,221.44 " " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " " 1,582.00 " " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1169 11406 EXC TR-EXT B9+MARG >4.0 CM Tech 11406 761 7387 " 2,165.13 " 837.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 837.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1168 11420 EXC H-F-NK-SP B9+MARG 0.5/< Tech 11420 761 7387 " 2,165.13 " 572.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 572.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1162 11421 EXC H-F-NK-SP B9+MARG 0.6-1 Tech 11421 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 678.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1176 11422 EXC H-F-NK-SP B9+MARG 1.1-2 Tech 11422 761 7387 " 2,165.13 " 741.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 741.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1163 11423 EXC H-F-NK-SP B9+MARG 2.1-3 Tech 11423 761 7387 " 2,165.13 " 691.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 691.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1182 11424 EXC H-F-NK-SP B9+MARG 3.1-4 Tech 11424 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1170 11426 EXC H-F-NK-SP B9+MARG >4 CM Tech 11426 761 12443 " 3,647.04 " 846.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 846.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1167 11440 EXC FACE-MM B9+MARG 0.5 CM/< Tech 11440 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1183 11441 EXC FACE-MM B9+MARG 0.6-1 CM Tech 11441 761 3265 956.97 527.00 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 527.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1199 11442 EXC FACE-MM B9+MARG 1.1-2 CM Tech 11442 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 755.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1179 11443 EXC FACE-MM B9+MARG 2.1-3 CM Tech 11443 761 7387 " 2,165.13 " 920.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 920.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1175 11444 EXC FACE-MM B9+MARG 3.1-4 CM Tech 11444 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1190 11446 EXC FACE-MM B9+MARG >4 CM Tech 11446 761 12443 " 3,647.04 " 580.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 580.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1188 11450 REMOVAL SWEAT GLAND LESION Tech 11450 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1191 11451 REMOVAL SWEAT GLAND LESION Tech 11451 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1195 11462 REMOVAL SWEAT GLAND LESION Tech 11462 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1223 11463 REMOVAL SWEAT GLAND LESION Tech 11463 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1192 11470 REMOVAL SWEAT GLAND LESION Tech 11470 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1200 11471 REMOVAL SWEAT GLAND LESION Tech 11471 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1202 11600 EXC TR-EXT MAL+MARG 0.5 CM/< Tech 11600 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1209 11601 EXC TR-EXT MAL+MARG 0.6-1 CM Tech 11601 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1203 11602 EXC TR-EXT MAL+MARG 1.1-2 CM Tech 11602 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1207 11603 EXC TR-EXT MAL+MARG 2.1-3 CM Tech 11603 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1211 11604 EXC TR-EXT MAL+MARG 3.1-4 CM Tech 11604 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1208 11606 EXC TR-EXT MAL+MARG >4 CM Tech 11606 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1227 11620 EXC H-F-NK-SP MAL+MARG 0.5/< Tech 11620 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1216 11621 EXC S/N/H/F/G MAL+MRG 0.6-1 Tech 11621 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1219 11622 EXC S/N/H/F/G MAL+MRG 1.1-2 Tech 11622 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1220 11623 EXC S/N/H/F/G MAL+MRG 2.1-3 Tech 11623 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1238 11624 EXC S/N/H/F/G MAL+MRG 3.1-4 Tech 11624 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1234 11626 EXC S/N/H/F/G MAL+MRG >4 CM Tech 11626 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1221 11640 EXC F/E/E/N/L MAL+MRG 0.5CM< Tech 11640 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1228 11641 EXC F/E/E/N/L MAL+MRG 0.6-1 Tech 11641 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1250 11642 EXC F/E/E/N/L MAL+MRG 1.1-2 Tech 11642 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1253 11643 EXC F/E/E/N/L MAL+MRG 2.1-3 Tech 11643 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1224 11644 EXC F/E/E/N/L MAL+MRG 3.1-4 Tech 11644 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1257 11646 EXC F/E/E/N/L MAL+MRG >4 CM Tech 11646 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1263 11719 TRIM NAIL(S) ANY NUMBER Tech 11719 761 292 85.59 48.32 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 N/A 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 1255 11720 DEBRIDE NAIL 1-5 Tech 11720 761 292 85.59 15.57 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 15.57 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 1225 11721 DEBRIDE NAIL 6 OR MORE Tech 11721 761 292 85.59 20.00 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 20.00 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 1244 11730 REMOVAL OF NAIL PLATE Tech 11730 761 943 276.39 25.75 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 25.75 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1273 11732 REMOVE NAIL PLATE ADD-ON Tech 11732 761 49 14.36 12.59 39.20 12.59 25.43 N/A 25.43 N/A N/A 24.99 N/A 29.40 N/A N/A 32.43 N/A N/A N/A N/A N/A N/A N/A 39.20 N/A 25.75 32.83 N/A 20.04 36.75 18.62 21.92 N/A 38.71 1231 11740 DRAIN BLOOD FROM UNDER NAIL Tech 11740 761 588 172.34 97.89 776.00 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 776.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 1243 11750 REMOVAL OF NAIL BED Tech 11750 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1254 11755 BIOPSY NAIL UNIT Tech 11755 761 3265 956.97 75.26 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 75.26 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1261 11760 REPAIR OF NAIL BED Tech 11760 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1251 11762 RECONSTRUCTION OF NAIL BED Tech 11762 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1260 11765 EXCISION OF NAIL FOLD TOE Tech 11765 761 1816 532.27 50.00 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 50.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1252 11770 REMOVE PILONIDAL CYST SIMPLE Tech 11770 761 12443 " 3,647.04 " 690.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 690.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1266 11771 REMOVE PILONIDAL CYST EXTEN Tech 11771 761 12443 " 3,647.04 " 838.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 838.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1264 11772 REMOVE PILONIDAL CYST COMPL Tech 11772 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1258 11900 INJECT SKIN LESIONS 7 Tech 11901 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1265 11920 CORRECT SKIN COLOR 6.0 CM/< Tech 11920 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1274 11921 CORRECT SKN COLOR 6.1-20.0CM Tech 11921 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1281 11950 TX CONTOUR DEFECTS 1 CC/< Tech 11950 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1272 11951 TX CONTOUR DEFECTS 1.1-5.0CC Tech 11951 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1280 11952 TX CONTOUR DEFECTS 5.1-10CC Tech 11952 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1332 11954 TX CONTOUR DEFECTS >10.0 CC Tech 11954 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1297 11960 INSERT TISSUE EXPANDER(S) Tech 11960 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1291 11970 REPLACE TISSUE EXPANDER Tech 11970 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 1277 11971 REMOVE TISSUE EXPANDER(S) Tech 11971 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1299 11976 REMOVE CONTRACEPTIVE CAPSULE Tech 11976 761 3265 956.97 30.50 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 30.50 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1290 11981 INSERT DRUG IMPLANT DEVICE Tech 11981 761 588 172.34 97.89 776.00 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 776.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 1288 11982 REMOVE DRUG IMPLANT DEVICE Tech 11982 761 1419 415.91 235.60 " 1,135.20 " 364.68 736.46 277.18 736.46 235.60 277.18 723.69 277.18 851.40 235.60 296.58 939.24 249.46 277.18 833.93 " 1,042.40 " 274.41 282.72 277.18 " 1,135.20 " 253.62 776.00 950.73 243.92 580.37 " 1,064.25 " 539.36 634.72 282.72 " 1,121.01 " 1293 11983 REMOVE/INSERT DRUG IMPLANT Tech 11983 761 1419 415.91 200.00 " 1,135.20 " 364.68 736.46 277.18 736.46 235.60 277.18 723.69 277.18 851.40 235.60 296.58 939.24 249.46 277.18 833.93 " 1,042.40 " 274.41 282.72 277.18 " 1,135.20 " 253.62 200.00 950.73 243.92 580.37 " 1,064.25 " 539.36 634.72 282.72 " 1,121.01 " 1303 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< Tech 12001 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 526.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1294 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM Tech 12002 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1305 12004 RPR S/N/AX/GEN/TRK7.6-12.5CM Tech 12004 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 738.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1298 12005 RPR S/N/A/GEN/TRK12.6-20.0CM Tech 12005 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1300 12006 RPR S/N/A/GEN/TRK20.1-30.0CM Tech 12006 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1320 12007 RPR S/N/AX/GEN/TRNK >30.0 CM Tech 12007 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1307 12011 RPR F/E/E/N/L/M 2.5 CM/< Tech 12011 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 493.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1309 12013 RPR F/E/E/N/L/M 2.6-5.0 CM Tech 12013 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1314 12014 RPR F/E/E/N/L/M 5.1-7.5 CM Tech 12014 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1329 12015 RPR F/E/E/N/L/M 7.6-12.5 CM Tech 12015 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 549.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1336 12016 RPR FE/E/EN/L/M 12.6-20.0 CM Tech 12016 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1311 12017 RPR FE/E/EN/L/M 20.1-30.0 CM Tech 12017 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1322 12018 RPR F/E/E/N/L/M >30.0 CM Tech 12018 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1339 12020 CLOSURE OF SPLIT WOUND Tech 12020 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1321 12021 CLOSURE OF SPLIT WOUND Tech 12021 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1346 12031 INTMD RPR S/A/T/EXT 2.5 CM/< Tech 12031 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 526.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1342 12032 INTMD RPR S/A/T/EXT 2.6-7.5 Tech 12032 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1325 12034 INTMD RPR S/TR/EXT 7.6-12.5 Tech 12034 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1318 12035 INTMD RPR S/A/T/EXT 12.6-20 Tech 12035 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1330 12036 INTMD RPR S/A/T/EXT 20.1-30 Tech 12036 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1345 12037 INTMD RPR S/TR/EXT >30.0 CM Tech 12037 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1327 12041 INTMD RPR N-HF/GENIT 2.5CM/< Tech 12041 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 526.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1341 12042 INTMD RPR N-HF/GENIT2.6-7.5 Tech 12042 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1337 12044 INTMD RPR N-HF/GENIT7.6-12.5 Tech 12044 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 738.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1334 12045 INTMD RPR N-HF/GENIT12.6-20 Tech 12045 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1351 12046 INTMD RPR N-HF/GENIT20.1-30 Tech 12046 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1352 12047 INTMD RPR N-HF/GENIT >30.0CM Tech 12047 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1350 12051 INTMD RPR FACE/MM 2.5 CM/< Tech 12051 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 493.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1367 12052 INTMD RPR FACE/MM 2.6-5.0 CM Tech 12052 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1377 12053 INTMD RPR FACE/MM 5.1-7.5 CM Tech 12053 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1361 12054 INTMD RPR FACE/MM 7.6-12.5CM Tech 12054 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 549.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1362 12055 INTMD RPR FACE/MM 12.6-20 CM Tech 12055 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1354 12056 INTMD RPR FACE/MM 20.1-30.0 Tech 12056 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1360 12057 INTMD RPR FACE/MM >30.0 CM Tech 12057 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1371 13100 CMPLX RPR TRUNK 1.1-2.5 CM Tech 13100 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1413 13101 CMPLX RPR TRUNK 2.6-7.5 CM Tech 13101 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1369 13102 CMPLX RPR TRUNK ADDL 5CM/< Tech 13102 761 149 43.67 38.29 119.20 38.29 77.33 N/A 77.33 N/A N/A 75.99 N/A 89.40 N/A N/A 98.62 N/A N/A N/A N/A N/A N/A N/A 119.20 N/A N/A 99.83 N/A 60.94 111.75 56.63 66.65 N/A 117.71 1392 13120 CMPLX RPR S/A/L 1.1-2.5 CM Tech 13120 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1372 13121 CMPLX RPR S/A/L 2.6-7.5 CM Tech 13121 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1378 13122 CMPLX RPR S/A/L ADDL 5 CM/> Tech 13122 761 240 70.34 61.68 192.00 61.68 124.56 N/A 124.56 N/A N/A 122.40 N/A 144.00 N/A N/A 158.86 N/A N/A N/A N/A N/A N/A N/A 192.00 N/A N/A 160.80 N/A 98.16 180.00 91.22 107.35 N/A 189.60 1382 13131 CMPLX RPR F/C/C/M/N/AX/G/H/F Tech 13131 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1375 13132 CMPLX RPR F/C/C/M/N/AX/G/H/F Tech 13132 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1395 13133 CMPLX RPR F/C/C/M/N/AX/G/H/F Tech 13133 761 282 82.65 72.47 225.60 72.47 146.36 N/A 146.36 N/A N/A 143.82 N/A 169.20 N/A N/A 186.66 N/A N/A N/A N/A N/A N/A N/A 225.60 N/A N/A 188.94 N/A 115.34 211.50 107.19 126.14 N/A 222.78 1388 13151 CMPLX RPR E/N/E/L 1.1-2.5 CM Tech 13151 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1380 13152 CMPLX RPR E/N/E/L 2.6-7.5 CM Tech 13152 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1381 13153 CMPLX RPR E/N/E/L ADDL 5CM/< Tech 13153 761 117 34.29 30.07 93.60 30.07 60.72 N/A 60.72 N/A N/A 59.67 N/A 70.20 N/A N/A 77.44 N/A N/A N/A N/A N/A N/A N/A 93.60 N/A N/A 78.39 N/A 47.85 87.75 44.47 52.33 N/A 92.43 1385 13160 LATE CLOSURE OF WOUND Tech 13160 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1390 14000 TIS TRNFR TRUNK 10 SQ CM/< Tech 14000 761 9006 " 2,639.66 " 589.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 589.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1386 14001 TIS TRNFR TRUNK 10.1-30SQCM Tech 14001 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1387 14020 TIS TRNFR S/A/L 10 SQ CM/< Tech 14020 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1407 14021 TIS TRNFR S/A/L 10.1-30 SQCM Tech 14021 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1393 14040 TIS TRNFR F/C/C/M/N/A/G/H/F Tech 14040 761 9006 " 2,639.66 " 807.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 807.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1410 14041 TIS TRNFR F/C/C/M/N/A/G/H/F Tech 14041 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1404 14060 TIS TRNFR E/N/E/L 10 SQ CM/< Tech 14060 761 9006 " 2,639.66 " 891.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 891.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1446 14061 TIS TRNFR E/N/E/L10.1-30SQCM Tech 14061 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1396 14301 TIS TRNFR ANY 30.1-60 SQ CM Tech 14301 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1426 14302 TIS TRNFR ADDL 30 SQ CM Tech 14302 761 400 117.24 102.80 320.00 102.80 207.60 N/A 207.60 N/A N/A 204.00 N/A 240.00 N/A N/A 264.76 N/A N/A N/A N/A N/A N/A N/A 320.00 N/A N/A 268.00 N/A 163.60 300.00 152.04 178.92 N/A 316.00 1403 14350 FILLETED FINGER/TOE FLAP Tech 14350 761 9006 " 2,639.66 " 807.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 807.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1411 15002 WOUND PREP TRK/ARM/LEG Tech 15002 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1418 15003 WOUND PREP ADDL 100 CM Tech 15003 761 564 165.31 144.95 451.20 144.95 292.72 N/A 292.72 N/A N/A 287.64 N/A 338.40 N/A N/A 373.31 N/A N/A N/A N/A N/A N/A N/A 451.20 N/A N/A 377.88 N/A 230.68 423.00 214.38 252.28 N/A 445.56 1439 15004 WOUND PREP F/N/HF/G Tech 15004 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1435 15005 WND PREP F/N/HF/G ADDL CM Tech 15005 761 845 247.67 217.17 676.00 217.17 438.56 N/A 438.56 N/A N/A 430.95 N/A 507.00 N/A N/A 559.31 N/A N/A N/A N/A N/A N/A N/A 676.00 N/A N/A 566.15 N/A 345.61 633.75 321.18 377.97 N/A 667.55 1421 15050 SKIN PINCH GRAFT Tech 15050 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1423 15100 SKIN SPLT GRFT TRNK/ARM/LEG Tech 15100 761 9006 " 2,639.66 " 571.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 571.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1440 15101 SKIN SPLT GRFT T/A/L ADD-ON Tech 15101 761 1035 303.36 266.00 828.00 266.00 537.17 N/A 537.17 N/A N/A 527.85 N/A 621.00 N/A N/A 685.07 N/A N/A N/A N/A N/A N/A N/A 828.00 N/A N/A 693.45 N/A 423.32 776.25 393.40 462.96 N/A 817.65 1428 15110 EPIDRM AUTOGRFT TRNK/ARM/LEG Tech 15110 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1434 15111 EPIDRM AUTOGRFT T/A/L ADD-ON Tech 15111 761 1941 568.91 498.84 " 1,552.80 " 498.84 " 1,007.38 " N/A " 1,007.38 " N/A N/A 989.91 N/A " 1,164.60 " N/A N/A " 1,284.75 " N/A N/A N/A N/A N/A N/A N/A " 1,552.80 " N/A N/A " 1,300.47 " N/A 793.87 " 1,455.75 " 737.77 868.21 N/A " 1,533.39 " 1442 15115 EPIDRM A-GRFT FACE/NCK/HF/G Tech 15115 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1450 15120 SKN SPLT A-GRFT FAC/NCK/HF/G Tech 15120 761 18491 " 5,419.71 " 565.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 565.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1437 15121 SKN SPLT A-GRFT F/N/HF/G ADD Tech 15121 761 1112 325.93 285.78 889.60 285.78 577.13 N/A 577.13 N/A N/A 567.12 N/A 667.20 N/A N/A 736.03 N/A N/A N/A N/A N/A N/A N/A 889.60 N/A N/A 745.04 N/A 454.81 834.00 422.67 497.40 N/A 878.48 1452 15130 DERM AUTOGRAFT TRNK/ARM/LEG Tech 15130 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1459 15135 DERM AUTOGRAFT FACE/NCK/HF/G Tech 15135 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1447 15200 SKIN FULL GRAFT TRUNK Tech 15200 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1455 15201 SKIN FULL GRAFT TRUNK ADD-ON Tech 15201 761 1074 314.79 276.02 859.20 276.02 557.41 N/A 557.41 N/A N/A 547.74 N/A 644.40 N/A N/A 710.88 N/A N/A N/A N/A N/A N/A N/A 859.20 N/A N/A 719.58 N/A 439.27 805.50 408.23 480.40 N/A 848.46 1433 15220 SKIN FULL GRAFT SCLP/ARM/LEG Tech 15220 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1475 15221 SKIN FULL GRAFT ADD-ON Tech 15221 761 428 125.45 110.00 342.40 110.00 222.13 N/A 222.13 N/A N/A 218.28 N/A 256.80 N/A N/A 283.29 N/A N/A N/A N/A N/A N/A N/A 342.40 N/A N/A 286.76 N/A 175.05 321.00 162.68 191.44 N/A 338.12 1473 15240 SKIN FULL GRFT FACE/GENIT/HF Tech 15240 761 9006 " 2,639.66 " " 1,081.00 " " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " " 1,081.00 " " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1460 15241 SKIN FULL GRAFT ADD-ON Tech 15241 761 540 158.27 138.78 432.00 138.78 280.26 N/A 280.26 N/A N/A 275.40 N/A 324.00 N/A N/A 357.43 N/A N/A N/A N/A N/A N/A N/A 432.00 N/A N/A 361.80 N/A 220.86 405.00 205.25 241.54 N/A 426.60 1441 15260 SKIN FULL GRAFT EEN & LIPS Tech 15260 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1448 15261 SKIN FULL GRAFT ADD-ON Tech 15261 761 759 222.46 195.06 607.20 195.06 393.92 N/A 393.92 N/A N/A 387.09 N/A 455.40 N/A N/A 502.38 N/A N/A N/A N/A N/A N/A N/A 607.20 N/A N/A 508.53 N/A 310.43 569.25 288.50 339.50 N/A 599.61 1467 15271 SKIN SUB GRAFT TRNK/ARM/LEG Tech 15271 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1477 15272 SKIN SUB GRAFT T/A/L ADD-ON Tech 15272 761 41 12.02 10.54 32.80 10.54 21.28 N/A 21.28 N/A N/A 20.91 N/A 24.60 N/A N/A 27.14 N/A N/A N/A N/A N/A N/A N/A 32.80 N/A N/A 27.47 N/A 16.77 30.75 15.58 18.34 N/A 32.39 1485 15273 SKIN SUB GRFT T/ARM/LG Tech 15273 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1471 15274 SKN SUB GRFT T/A/L ADD Tech 15274 761 85 24.91 21.85 68.00 21.85 44.12 N/A 44.12 N/A N/A 43.35 N/A 51.00 N/A N/A 56.26 N/A N/A N/A N/A N/A N/A N/A 68.00 N/A N/A 56.95 N/A 34.77 63.75 32.31 38.02 N/A 67.15 1478 15275 SKIN SUB GRAFT FACE/NK/HF/G Tech 15275 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1527 15276 SKIN SUB GRAFT F/N/HF/G ADDL Tech 15276 761 660 193.45 169.62 528.00 169.62 342.54 N/A 342.54 N/A N/A 336.60 N/A 396.00 N/A N/A 436.85 N/A N/A N/A N/A N/A N/A N/A 528.00 N/A N/A 442.20 N/A 269.94 495.00 250.87 295.22 N/A 521.40 1457 15277 SKN SUB GRFT F/N/HF/G Tech 15277 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1469 15278 SKN SUB GRFT F/N/HF/G ADD Tech 15278 761 85 24.91 21.85 68.00 21.85 44.12 N/A 44.12 N/A N/A 43.35 N/A 51.00 N/A N/A 56.26 N/A N/A N/A N/A N/A N/A N/A 68.00 N/A N/A 56.95 N/A 34.77 63.75 32.31 38.02 N/A 67.15 1474 15570 SKIN PEDICLE FLAP TRUNK Tech 15570 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1470 15572 SKIN PEDICLE FLAP ARMS/LEGS Tech 15572 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1476 15574 PEDCLE FH/CH/CH/M/N/AX/G/H/F Tech 15574 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1468 15576 PEDICLE E/N/E/L/NTRORAL Tech 15576 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1481 15600 DELAY FLAP TRUNK Tech 15600 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1479 15610 DELAY FLAP ARMS/LEGS Tech 15610 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1507 15620 DELAY FLAP F/C/C/N/AX/G/H/F Tech 15620 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1486 15630 DELAY FLAP EYE/NOS/EAR/LIP Tech 15630 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1497 15650 TRANSFER SKIN PEDICLE FLAP Tech 15650 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1488 15730 MDFC FLAP W/PRSRV VASC PEDCL Tech 15730 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1492 15731 FOREHEAD FLAP W/VASC PEDICLE Tech 15731 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1511 15733 MUSC MYOQ/FSCQ FLP H&N PEDCL Tech 15733 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1490 15734 MUSCLE-SKIN GRAFT TRUNK Tech 15734 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1504 15736 MUSCLE-SKIN GRAFT ARM Tech 15736 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1496 15738 MUSCLE-SKIN GRAFT LEG Tech 15738 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1514 15740 ISLAND PEDICLE FLAP GRAFT Tech 15740 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1513 15750 NEUROVASCULAR PEDICLE FLAP Tech 15750 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1516 15756 FREE MYO/SKIN FLAP MICROVASC Tech 15756 761 3554 " 1,041.68 " 913.38 " 2,843.20 " 913.38 " 1,844.53 " N/A " 1,844.53 " N/A N/A " 1,812.54 " N/A " 2,132.40 " N/A N/A " 2,352.39 " N/A N/A N/A N/A N/A N/A N/A " 2,843.20 " N/A N/A " 2,381.18 " N/A " 1,453.59 " " 2,665.50 " " 1,350.88 " " 1,589.70 " N/A " 2,807.66 " 1518 15757 FREE SKIN FLAP MICROVASC Tech 15757 761 4104 " 1,202.88 " " 1,054.73 " " 3,283.20 " " 1,054.73 " " 2,129.98 " N/A " 2,129.98 " N/A N/A " 2,093.04 " N/A " 2,462.40 " N/A N/A " 2,716.44 " N/A N/A N/A N/A N/A N/A N/A " 3,283.20 " N/A N/A " 2,749.68 " N/A " 1,678.54 " " 3,078.00 " " 1,559.93 " " 1,835.72 " N/A " 3,242.16 " 1532 15758 FREE FASCIAL FLAP MICROVASC Tech 15758 761 20896 " 6,124.62 " " 5,370.27 " " 16,716.80 " " 5,370.27 " " 10,845.02 " N/A " 10,845.02 " N/A N/A " 10,656.96 " N/A " 12,537.60 " N/A N/A " 13,831.06 " N/A N/A N/A N/A N/A N/A N/A " 16,716.80 " N/A N/A " 14,000.32 " N/A " 8,546.46 " " 15,672.00 " " 7,942.57 " " 9,346.78 " N/A " 16,507.84 " 1521 15760 COMPOSITE SKIN GRAFT Tech 15760 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1506 15769 GRFG AUTOL SOFT TISS DIR EXC Tech 15769 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1515 15770 DERMA-FAT-FASCIA GRAFT Tech 15770 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1536 15771 GRFG AUTOL FAT LIPO 50 CC/< Tech 15771 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1530 15772 GRFG AUTOL FAT LIPO EA ADDL Tech 15772 761 587 172.05 150.86 469.60 150.86 304.65 N/A 304.65 N/A N/A 299.37 N/A 352.20 N/A N/A 388.54 N/A N/A N/A N/A N/A N/A N/A 469.60 N/A N/A 393.29 N/A 240.08 440.25 223.12 262.57 N/A 463.73 1539 15773 GRFG AUTOL FAT LIPO 25 CC/< Tech 15773 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1526 15774 GFRG AUTOL FAT LIPO EA ADDL Tech 15774 761 680 199.31 174.76 544.00 174.76 352.92 N/A 352.92 N/A N/A 346.80 N/A 408.00 N/A N/A 450.09 N/A N/A N/A N/A N/A N/A N/A 544.00 N/A N/A 455.60 N/A 278.12 510.00 258.47 304.16 N/A 537.20 1542 15776 HAIR TRNSPL >15 PUNCH GRAFTS Tech 15776 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 N/A " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1519 15777 ACELLULAR DERM MATRIX IMPLT Tech 15777 761 5009 " 1,468.14 " " 1,287.31 " " 4,007.20 " " 1,287.31 " " 2,599.67 " N/A " 2,599.67 " N/A N/A " 2,554.59 " N/A " 3,005.40 " N/A N/A " 3,315.46 " N/A N/A N/A N/A N/A N/A N/A " 4,007.20 " N/A N/A " 3,356.03 " N/A " 2,048.68 " " 3,756.75 " " 1,903.92 " " 2,240.53 " N/A " 3,957.11 " 1551 15780 DERMABRASION TOTAL FACE Tech 15780 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1562 15781 DERMABRASION SEGMENTAL FACE Tech 15781 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 N/A " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1531 15782 DERMABRASION OTHER THAN FACE Tech 15782 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1543 15783 DERMABRASION SUPRFL ANY SITE Tech 15783 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 N/A " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1534 15786 ABRASION LESION SINGLE Tech 15786 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1548 15788 CHEMICAL PEEL FACE EPIDERM Tech 15788 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 N/A " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1545 15789 CHEMICAL PEEL FACE DERMAL Tech 15789 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1565 15792 CHEMICAL PEEL NONFACIAL Tech 15792 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1555 15793 CHEMICAL PEEL NONFACIAL Tech 15793 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 N/A " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1584 15820 REVISION OF LOWER EYELID Tech 15820 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1599 15821 REVISION OF LOWER EYELID Tech 15821 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1561 15822 REVISION OF UPPER EYELID Tech 15822 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1550 15823 REVISION OF UPPER EYELID Tech 15823 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1573 15824 REMOVAL OF FOREHEAD WRINKLES Tech 15824 761 9006 " 2,639.66 " " 1,486.87 " " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " N/A " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1575 15825 REMOVAL OF NECK WRINKLES Tech 15825 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1579 15828 REMOVAL OF FACE WRINKLES Tech 15828 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1591 15829 REMOVAL OF SKIN WRINKLES Tech 15829 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1567 15830 EXC SKIN ABD Tech 15830 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1559 15832 EXCISE EXCESSIVE SKIN THIGH Tech 15832 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1574 15833 EXCISE EXCESSIVE SKIN LEG Tech 15833 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1590 15834 EXCISE EXCESSIVE SKIN HIP Tech 15834 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1596 15835 EXCISE EXCESSIVE SKIN BUTTCK Tech 15835 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1571 15836 EXCISE EXCESSIVE SKIN ARM Tech 15836 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1603 15837 EXCISE EXCESS SKIN ARM/HAND Tech 15837 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1605 15838 EXCISE EXCESS SKIN FAT PAD Tech 15838 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1583 15839 EXCISE EXCESS SKIN & TISSUE Tech 15839 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1569 15840 NERVE PALSY FASCIAL GRAFT Tech 15840 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1592 15842 NERVE PALSY MICROSURG GRAFT Tech 15842 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1593 15845 SKIN AND MUSCLE REPAIR FACE Tech 15845 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1597 15847 EXC SKIN ABD ADD-ON Tech 15847 761 4711 " 1,380.79 " " 1,210.73 " " 3,768.80 " " 1,210.73 " " 2,445.01 " N/A " 2,445.01 " N/A N/A " 2,402.61 " N/A " 2,826.60 " N/A N/A " 3,118.21 " N/A N/A N/A N/A N/A N/A N/A " 3,768.80 " N/A N/A " 3,156.37 " N/A " 1,926.80 " " 3,533.25 " " 1,790.65 " " 2,107.23 " N/A " 3,721.69 " 1600 15850 REMOVE SUTURES SAME SURGEON Tech 15850 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 N/A " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1581 15851 REMOVE SUTURES DIFF SURGEON Tech 15851 761 9006 " 2,639.66 " " 1,486.87 " " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " N/A " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1595 15852 DRESSING CHANGE NOT FOR BURN Tech 15852 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1607 15860 TEST FOR BLOOD FLOW IN GRAFT Tech 15860 761 1419 415.91 235.60 " 1,135.20 " 364.68 736.46 277.18 736.46 235.60 277.18 723.69 277.18 851.40 235.60 296.58 939.24 249.46 277.18 833.93 " 1,042.40 " 274.41 282.72 277.18 " 1,135.20 " 253.62 N/A 950.73 243.92 580.37 " 1,064.25 " 539.36 634.72 282.72 " 1,121.01 " 1626 15876 SUCTION LIPECTOMY HEAD&NECK Tech 15876 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1594 15877 SUCTION LIPECTOMY TRUNK Tech 15877 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1613 15878 SUCTION LIPECTOMY UPR EXTREM Tech 15878 761 9006 " 2,639.66 " " 1,486.87 " " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " N/A " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1606 15879 SUCTION LIPECTOMY LWR EXTREM Tech 15879 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1608 15931 REMOVE SACRUM PRESSURE SORE Tech 15931 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1619 15933 REMOVE SACRUM PRESSURE SORE Tech 15933 761 12443 " 3,647.04 " 338.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 338.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1616 15934 REMOVE SACRUM PRESSURE SORE Tech 15934 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1614 15935 REMOVE SACRUM PRESSURE SORE Tech 15935 761 18491 " 5,419.71 " " 3,056.79 " " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " N/A " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1618 15936 REMOVE SACRUM PRESSURE SORE Tech 15936 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1630 15937 REMOVE SACRUM PRESSURE SORE Tech 15937 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1655 15940 REMOVE HIP PRESSURE SORE Tech 15940 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1636 15941 REMOVE HIP PRESSURE SORE Tech 15941 761 12443 " 3,647.04 " 338.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 338.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1651 15944 REMOVE HIP PRESSURE SORE Tech 15944 761 18491 " 5,419.71 " 630.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 630.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1659 15945 REMOVE HIP PRESSURE SORE Tech 15945 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1672 15946 REMOVE HIP PRESSURE SORE Tech 15946 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1622 15950 REMOVE THIGH PRESSURE SORE Tech 15950 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1632 15951 REMOVE THIGH PRESSURE SORE Tech 15951 761 12443 " 3,647.04 " 488.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 488.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1633 15952 REMOVE THIGH PRESSURE SORE Tech 15952 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1631 15956 REMOVE THIGH PRESSURE SORE Tech 15956 761 9006 " 2,639.66 " 882.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 882.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1629 15958 REMOVE THIGH PRESSURE SORE Tech 15958 761 18491 " 5,419.71 " 945.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 945.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 1641 16000 INITIAL TREATMENT OF BURN(S) Tech 16000 761 943 276.39 18.00 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 18.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1647 16020 DRESS/DEBRID P-THICK BURN S Tech 16020 761 943 276.39 20.00 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 20.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1634 16025 DRESS/DEBRID P-THICK BURN M Tech 16025 761 943 276.39 100.55 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 100.55 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1639 16030 DRESS/DEBRID P-THICK BURN L Tech 16030 761 1816 532.27 115.08 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 115.08 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1658 16035 INCISION OF BURN SCAB INITI Tech 16035 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1644 16036 ESCHAROTOMY ADDL INCISION Tech 16036 761 1113 326.22 286.04 890.40 286.04 577.65 N/A 577.65 N/A N/A 567.63 N/A 667.80 N/A N/A 736.69 N/A N/A N/A N/A N/A N/A N/A 890.40 N/A N/A 745.71 N/A 455.22 834.75 423.05 497.84 N/A 879.27 1652 17000 DESTRUCT PREMALG LESION Tech 17000 761 943 276.39 155.89 923.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 923.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1649 17003 DESTRUCT PREMALG LES 2-14 Tech 17003 761 15 4.40 3.86 12.00 3.86 7.79 N/A 7.79 N/A N/A 7.65 N/A 9.00 N/A N/A 9.93 N/A N/A N/A N/A N/A N/A N/A 12.00 N/A 4.25 10.05 N/A 6.14 11.25 5.70 6.71 N/A 11.85 1666 17004 DESTROY PREMAL LESIONS 15/> Tech 17004 761 1816 532.27 116.39 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 116.39 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1661 17106 DESTRUCTION OF SKIN LESIONS Tech 17106 761 1816 532.27 300.05 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 776.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1646 17107 DESTRUCTION OF SKIN LESIONS Tech 17107 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1657 17108 DESTRUCTION OF SKIN LESIONS Tech 17108 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1667 17110 DESTRUCT B9 LESION 1-14 Tech 17110 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 645.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1664 17111 DESTRUCT LESION 15 OR MORE Tech 17111 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1671 17250 CHEM CAUT OF GRANLTJ TISSUE Tech 17250 761 943 276.39 25.82 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 25.82 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1677 17260 DESTRUCTION OF SKIN LESIONS Tech 17260 761 943 276.39 51.44 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 51.44 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1678 17261 DESTRUCTION OF SKIN LESIONS Tech 17261 761 943 276.39 65.76 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 65.76 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1668 17262 DESTRUCTION OF SKIN LESIONS Tech 17262 761 943 276.39 85.00 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 85.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1707 17263 DESTRUCTION OF SKIN LESIONS Tech 17263 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1699 17264 DESTRUCTION OF SKIN LESIONS Tech 17264 761 1816 532.27 110.56 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 110.56 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1679 17266 DESTRUCTION OF SKIN LESIONS Tech 17266 761 1816 532.27 128.61 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 128.61 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1693 17270 DESTRUCTION OF SKIN LESIONS Tech 17270 761 943 276.39 57.10 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 57.10 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1684 17271 DESTRUCTION OF SKIN LESIONS Tech 17271 761 943 276.39 66.50 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 66.50 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1690 17272 DESTRUCTION OF SKIN LESIONS Tech 17272 761 943 276.39 102.26 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 102.26 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1687 17273 DESTRUCTION OF SKIN LESIONS Tech 17273 761 1816 532.27 113.50 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 113.50 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1710 17274 DESTRUCTION OF SKIN LESIONS Tech 17274 761 1816 532.27 144.48 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 144.48 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1692 17276 DESTRUCTION OF SKIN LESIONS Tech 17276 761 1816 532.27 175.35 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 175.35 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1714 17280 DESTRUCTION OF SKIN LESIONS Tech 17280 761 943 276.39 65.76 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 65.76 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1715 17281 DESTRUCTION OF SKIN LESIONS Tech 17281 761 1816 532.27 93.00 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 93.00 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1696 17282 DESTRUCTION OF SKIN LESIONS Tech 17282 761 1816 532.27 117.39 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 117.39 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1723 17283 DESTRUCTION OF SKIN LESIONS Tech 17283 761 1816 532.27 147.67 " 1,452.80 " 466.71 942.50 353.00 942.50 300.05 353.00 926.16 353.00 " 1,089.60 " 300.05 377.71 " 1,202.01 " 317.70 353.00 " 1,067.30 " " 1,334.11 " 349.47 360.06 353.00 " 1,452.80 " 323.00 147.67 " 1,216.72 " 310.64 742.74 " 1,362.00 " 690.26 812.30 360.06 " 1,434.64 " 1701 17284 DESTRUCTION OF SKIN LESIONS Tech 17284 761 2752 806.61 177.23 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 177.23 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1697 17286 DESTRUCTION OF SKIN LESIONS Tech 17286 761 2752 806.61 242.78 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 242.78 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1712 17311 MOHS 1 STAGE H/N/HF/G Tech 17311 761 2752 806.61 261.55 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 261.55 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1720 17312 MOHS ADDL STAGE Tech 17312 761 265 77.67 68.11 212.00 68.11 137.54 N/A 137.54 N/A N/A 135.15 N/A 159.00 N/A N/A 175.40 N/A N/A N/A N/A N/A N/A N/A 212.00 N/A 139.22 177.55 N/A 108.39 198.75 100.73 118.53 N/A 209.35 1721 17313 MOHS 1 STAGE T/A/L Tech 17313 761 2752 806.61 234.44 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 234.44 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 1709 17314 MOHS ADDL STAGE T/A/L Tech 17314 761 242 70.93 62.19 193.60 62.19 125.60 N/A 125.60 N/A N/A 123.42 N/A 145.20 N/A N/A 160.18 N/A N/A N/A N/A N/A N/A N/A 193.60 N/A 128.74 162.14 N/A 98.98 181.50 91.98 108.25 N/A 191.18 1716 17315 MOHS SURG ADDL BLOCK Tech 17315 761 4 1.17 1.03 36.43 1.03 2.08 N/A 2.08 N/A N/A 2.04 N/A 2.40 N/A N/A 2.65 N/A N/A N/A N/A N/A N/A N/A 3.20 N/A 36.43 2.68 N/A 1.64 3.00 1.52 1.79 N/A 3.16 1713 17999 Ablative fractionated laser resurf w/Cortex C02 l Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1724 17999 Laser Hair Removal 120 min Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1729 17999 Laser Genesis 1 treatment Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1731 17999 Ablative fractionated laser resurf w/Ultrapulse C Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1732 17999 Laser Hair Removal 30 min Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1733 17999 Laser Hair Removal 90 min Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1734 17999 Laser Genesis 5 treatments Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1736 17999 Solar Genesis - 5 treatments Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1738 17999 Solar Genesis - 1 treatment Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1740 17999 Unl Midface Suspension Lift Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1741 17999 Laser Hair Removal 180 min Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1742 17999 Subcision Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1743 17999 Ablative laser resurfacing Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1749 17999 Laser Hair Removal 60 min Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1752 17999 UNL MICRO-NEEDLING Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1753 17999 UNL SUBCUT INJ MATERIAL Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1755 17999 Rejuvenize Peel Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1756 17999 UNL PULSED-DYE LASER/YAG 10-50 CM Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1757 17999 UNL PULSED-DYE LASER/YAG OVER 50CM Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1760 17999 UNLISTED KYBELLA INJECTION Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1763 17999 Unl Mini Abdominoplasty Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1766 17999 Vicryl mesh Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1767 17999 Vascular Therapy Tech 17999 990 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1768 17999 Selective Photothermolysis w/Q-switched laser/YAG Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1771 17999 UNL PULSED-DYE LASER/YAG <10 CM Tech 17999 761 943 276.39 155.89 754.40 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 N/A 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 1765 19000 DRAINAGE OF BREAST LESION RT Tech 19000 761 3265 956.97 36.50 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 36.50 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1773 19000 DRAINAGE OF BREAST LESION LT Tech 19000 761 3265 956.97 36.50 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 36.50 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1774 19000 DRAINAGE OF BREAST LESION Tech 19000 761 3265 956.97 36.50 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 36.50 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1788 19001 DRAIN BREAST LESION ADD-ON Tech 19001 761 76 22.28 19.53 60.80 19.53 39.44 N/A 39.44 N/A N/A 38.76 N/A 45.60 N/A N/A 50.30 N/A N/A N/A N/A N/A N/A N/A 60.80 N/A 20.39 50.92 N/A 31.08 57.00 28.89 33.99 N/A 60.04 29441 19001 BRST PUNCT EA ADD CYST Tech 19001 761 76 22.28 19.53 60.80 19.53 39.44 N/A 39.44 N/A N/A 38.76 N/A 45.60 N/A N/A 50.30 N/A N/A N/A N/A N/A N/A N/A 60.80 N/A 20.39 50.92 N/A 31.08 57.00 28.89 33.99 N/A 60.04 29443 19001 BRST PUNCT EA ADD CYST LT Tech 19001 761 76 22.28 19.53 60.80 19.53 39.44 N/A 39.44 N/A N/A 38.76 N/A 45.60 N/A N/A 50.30 N/A N/A N/A N/A N/A N/A N/A 60.80 N/A 20.39 50.92 N/A 31.08 57.00 28.89 33.99 N/A 60.04 29444 19001 BRST PUNCT EA ADD CYST RT Tech 19001 761 76 22.28 19.53 60.80 19.53 39.44 N/A 39.44 N/A N/A 38.76 N/A 45.60 N/A N/A 50.30 N/A N/A N/A N/A N/A N/A N/A 60.80 N/A 20.39 50.92 N/A 31.08 57.00 28.89 33.99 N/A 60.04 1800 19020 INCISION OF BREAST LESION Tech 19020 761 7387 " 2,165.13 " 821.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 821.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1779 19081 BX BREAST 1ST LESION STRTCTC LT Tech 19081 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1787 19081 BX BREAST 1ST LESION STRTCTC RT Tech 19081 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1811 19081 BX BREAST 1ST LESION STRTCTC Tech 19081 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1806 19082 BX BREAST ADD LESION STRTCTC Tech 19082 761 375 109.91 70.38 300.00 96.38 194.63 N/A 194.63 N/A N/A 191.25 N/A 225.00 N/A N/A 248.21 N/A N/A N/A N/A N/A N/A N/A 300.00 N/A 70.38 251.25 N/A 153.38 281.25 142.54 167.74 N/A 296.25 1786 19083 BX BREAST 1ST LESION US IMAG RT Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1792 19083 BX BREAST 1ST LESION US IMAG Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1812 19083 BX BREAST 1ST LESION US IMAG LT Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26798 19083 MG. US Guide Breast Vac Assisted Bx-Left - Report Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26802 19083 MG. US Guide Breast Vac Assisted Bx-Rt - Report Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26805 19083 MG. US Guided Breast Core Biopsy Left - Report Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26806 19083 MG. US Guided Breast Core Biopsy Right - Report Tech 19083 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1791 19084 BX BREAST ADD LESION US IMAG Tech 19084 761 375 109.91 66.12 300.00 96.38 194.63 N/A 194.63 N/A N/A 191.25 N/A 225.00 N/A N/A 248.21 N/A N/A N/A N/A N/A N/A N/A 300.00 N/A 66.12 251.25 N/A 153.38 281.25 142.54 167.74 N/A 296.25 1796 19085 BX BREAST 1ST LESION MR IMAG RT Tech 19085 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1807 19085 BX BREAST 1ST LESION MR IMAG LT Tech 19085 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1818 19085 BX BREAST 1ST LESION MR IMAG Tech 19085 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1808 19086 BX BREAST ADD LESION MR IMAG Tech 19086 761 1723 505.01 71.66 " 1,378.40 " 442.81 894.24 N/A 894.24 N/A N/A 878.73 N/A " 1,033.80 " N/A N/A " 1,140.45 " N/A N/A N/A N/A N/A N/A N/A " 1,378.40 " N/A 71.66 " 1,154.41 " N/A 704.71 " 1,292.25 " 654.91 770.70 N/A " 1,361.17 " 1822 19086 BX BREAST ADD LESION MR IMAG LT 19086 761 1723 505.01 71.66 " 1,378.40 " 442.81 894.24 N/A 894.24 N/A N/A 878.73 N/A " 1,033.80 " N/A N/A " 1,140.45 " N/A N/A N/A N/A N/A N/A N/A " 1,378.40 " N/A 71.66 " 1,154.41 " N/A 704.71 " 1,292.25 " 654.91 770.70 N/A " 1,361.17 " 64922 19086 BX BREAST ADD LESION MR IMAG RT 19086 761 1723 505.01 71.66 " 1,378.40 " 442.81 894.24 N/A 894.24 N/A N/A 878.73 N/A " 1,033.80 " N/A N/A " 1,140.45 " N/A N/A N/A N/A N/A N/A N/A " 1,378.40 " N/A 71.66 " 1,154.41 " N/A 704.71 " 1,292.25 " 654.91 770.70 N/A " 1,361.17 " 1801 19100 BX BREAST PERCUT W/O IMAGE Tech 19100 761 7387 " 2,165.13 " 869.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 869.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1813 19101 BIOPSY OF BREAST OPEN Tech 19101 761 16578 " 4,859.01 " 774.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 774.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1809 19105 CRYOSURG ABLATE FA EACH Tech 19105 761 16578 " 4,859.01 " 135.27 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 135.27 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1819 19110 NIPPLE EXPLORATION Tech 19110 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1815 19112 EXCISE BREAST DUCT FISTULA Tech 19112 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1823 19120 REMOVAL OF BREAST LESION Tech 19120 761 16578 " 4,859.01 " 833.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 833.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1816 19125 EXCISION BREAST LESION Tech 19125 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1828 19126 EXCISION ADDL BREAST LESION Tech 19126 761 398 116.65 102.29 318.40 102.29 206.56 N/A 206.56 N/A N/A 202.98 N/A 238.80 N/A N/A 263.44 N/A N/A N/A N/A N/A N/A N/A 318.40 N/A N/A 266.66 N/A 162.78 298.50 151.28 178.03 N/A 314.42 1824 19281 PERQ DEVICE BREAST 1ST IMAG RT Tech 19281 761 3265 956.97 82.59 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 82.59 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1830 19281 PERQ DEVICE BREAST 1ST IMAG LT Tech 19281 761 3265 956.97 82.59 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 82.59 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1841 19281 PERQ DEVICE BREAST 1ST IMAG Tech 19281 761 3265 956.97 82.59 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 82.59 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1844 19282 PERQ DEVICE BREAST EA IMAG Tech 19282 761 1305 382.50 39.33 " 1,044.00 " 335.39 677.30 N/A 677.30 N/A N/A 665.55 N/A 783.00 N/A N/A 863.78 N/A N/A N/A N/A N/A N/A N/A " 1,044.00 " N/A 39.33 874.35 N/A 533.75 978.75 496.03 583.73 N/A " 1,030.95 " 29445 19282 PLCMNT CLIP EA ADL MAM GU Tech 19282 761 1305 382.50 39.33 " 1,044.00 " 335.39 677.30 N/A 677.30 N/A N/A 665.55 N/A 783.00 N/A N/A 863.78 N/A N/A N/A N/A N/A N/A N/A " 1,044.00 " N/A 39.33 874.35 N/A 533.75 978.75 496.03 583.73 N/A " 1,030.95 " 65401 CLIP PLACE BR EA ADDL RT Tech 19282 761 1305 382.50 39.33 " 1,044.00 " 335.39 677.30 N/A 677.30 N/A N/A 665.55 N/A 783.00 N/A N/A 863.78 N/A N/A N/A N/A N/A N/A N/A " 1,044.00 " N/A 39.33 874.35 N/A 533.75 978.75 496.03 583.73 N/A " 1,030.95 " 65424 CLIP PLACE BR EA ADDL LT Tech 19282 761 1305 382.50 39.33 " 1,044.00 " 335.39 677.30 N/A 677.30 N/A N/A 665.55 N/A 783.00 N/A N/A 863.78 N/A N/A N/A N/A N/A N/A N/A " 1,044.00 " N/A 39.33 874.35 N/A 533.75 978.75 496.03 583.73 N/A " 1,030.95 " 65677 WIRE PLACE BRST EA ADD LT Tech 19282 761 1305 382.50 39.33 " 1,044.00 " 335.39 677.30 N/A 677.30 N/A N/A 665.55 N/A 783.00 N/A N/A 863.78 N/A N/A N/A N/A N/A N/A N/A " 1,044.00 " N/A 39.33 874.35 N/A 533.75 978.75 496.03 583.73 N/A " 1,030.95 " 1839 19283 PERQ DEV BREAST 1ST STRTCTC Tech 19283 761 3265 956.97 83.38 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 83.38 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 64552 19283 MG. Device Plcmnt w/ Stereo Guide Right Tech 19283 761 3265 956.97 83.38 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 83.38 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1829 19284 PERQ DEV BREAST ADD STRTCTC Tech 19284 761 562 164.72 39.59 449.60 144.43 291.68 N/A 291.68 N/A N/A 286.62 N/A 337.20 N/A N/A 371.99 N/A N/A N/A N/A N/A N/A N/A 449.60 N/A 39.59 376.54 N/A 229.86 421.50 213.62 251.38 N/A 443.98 1840 19285 PERQ DEV BREAST 1ST US IMAG LT Tech 19285 761 3265 956.97 70.71 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 70.71 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1845 19285 PERQ DEV BREAST 1ST US IMAG RT Tech 19285 761 3265 956.97 70.71 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 70.71 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1864 19286 PERQ DEV BREAST ADD US IMAG Tech 19286 761 1317 386.01 33.98 " 1,053.60 " 338.47 683.52 N/A 683.52 N/A N/A 671.67 N/A 790.20 N/A N/A 871.72 N/A N/A N/A N/A N/A N/A N/A " 1,053.60 " N/A 33.98 882.39 N/A 538.65 987.75 500.59 589.09 N/A " 1,040.43 " 29462 19287 MRI Clip Plcmnt 1st Lesion Tech 19287 761 3265 956.97 115.58 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 115.58 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1835 19288 PERQ DEV BREAST ADD MR GUIDE Tech 19288 761 3318 972.51 50.82 " 2,654.40 " 852.73 " 1,722.04 " N/A " 1,722.04 " N/A N/A " 1,692.18 " N/A " 1,990.80 " N/A N/A " 2,196.18 " N/A N/A N/A N/A N/A N/A N/A " 2,654.40 " N/A 50.82 " 2,223.06 " N/A " 1,357.06 " " 2,488.50 " " 1,261.17 " " 1,484.14 " N/A " 2,621.22 " 1842 19296 PLACE PO BREAST CATH FOR RAD Tech 19296 761 46830 " 13,725.87 " 776.00 " 37,464.00 " " 12,035.31 " " 24,304.77 " " 9,106.41 " " 24,304.77 " " 7,740.45 " " 9,106.41 " " 23,883.30 " " 9,106.41 " " 28,098.00 " " 7,740.45 " " 9,743.86 " " 30,996.78 " " 8,195.77 " " 9,106.41 " " 27,528.14 " " 34,409.95 " " 9,015.35 " " 9,288.54 " " 9,106.41 " " 37,464.00 " " 8,332.37 " 776.00 " 31,376.10 " " 8,013.64 " " 19,153.47 " " 35,122.50 " " 17,800.08 " " 20,947.06 " " 9,288.54 " " 36,995.70 " 1858 19297 PLACE BREAST CATH FOR RAD Tech 19297 761 4680 " 1,371.71 " " 1,202.76 " " 3,744.00 " " 1,202.76 " " 2,428.92 " N/A " 2,428.92 " N/A N/A " 2,386.80 " N/A " 2,808.00 " N/A N/A " 3,097.69 " N/A N/A N/A N/A N/A N/A N/A " 3,744.00 " N/A N/A " 3,135.60 " N/A " 1,914.12 " " 3,510.00 " " 1,778.87 " " 2,093.36 " N/A " 3,697.20 " 1869 19300 REMOVAL OF BREAST TISSUE Tech 19300 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1859 19301 PARTIAL MASTECTOMY Tech 19301 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1847 19302 P-MASTECTOMY W/LN REMOVAL Tech 19302 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1862 19303 MAST SIMPLE COMPLETE Tech 19303 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1872 19305 MAST RADICAL Tech 19305 761 16522 " 4,842.60 " " 4,246.15 " " 13,217.60 " " 4,246.15 " " 8,574.92 " N/A " 8,574.92 " N/A N/A " 8,426.22 " N/A " 9,913.20 " N/A N/A " 10,935.91 " N/A N/A N/A N/A N/A N/A N/A " 13,217.60 " N/A N/A " 11,069.74 " N/A " 6,757.50 " " 12,391.50 " " 6,280.01 " " 7,390.29 " N/A " 13,052.38 " 1866 19307 MAST MOD RAD Tech 19307 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1873 19316 SUSPENSION OF BREAST Tech 19316 761 29053 " 8,515.43 " " 4,804.29 " " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " N/A " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1867 19318 REDUCTION OF LARGE BREAST Tech 19318 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1883 19325 ENLARGE BREAST WITH IMPLANT Tech 19325 761 46830 " 13,725.87 " 776.00 " 37,464.00 " " 12,035.31 " " 24,304.77 " " 9,106.41 " " 24,304.77 " " 7,740.45 " " 9,106.41 " " 23,883.30 " " 9,106.41 " " 28,098.00 " " 7,740.45 " " 9,743.86 " " 30,996.78 " " 8,195.77 " " 9,106.41 " " 27,528.14 " " 34,409.95 " " 9,015.35 " " 9,288.54 " " 9,106.41 " " 37,464.00 " " 8,332.37 " 776.00 " 31,376.10 " " 8,013.64 " " 19,153.47 " " 35,122.50 " " 17,800.08 " " 20,947.06 " " 9,288.54 " " 36,995.70 " 1877 19328 REMOVAL OF BREAST IMPLANT Tech 19328 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1891 19330 REMOVAL OF IMPLANT MATERIAL Tech 19330 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1943 19340 IMMEDIATE BREAST PROSTHESIS Tech 19340 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1881 19342 DELAYED BREAST PROSTHESIS Tech 19342 761 46830 " 13,725.87 " 776.00 " 37,464.00 " " 12,035.31 " " 24,304.77 " " 9,106.41 " " 24,304.77 " " 7,740.45 " " 9,106.41 " " 23,883.30 " " 9,106.41 " " 28,098.00 " " 7,740.45 " " 9,743.86 " " 30,996.78 " " 8,195.77 " " 9,106.41 " " 27,528.14 " " 34,409.95 " " 9,015.35 " " 9,288.54 " " 9,106.41 " " 37,464.00 " " 8,332.37 " 776.00 " 31,376.10 " " 8,013.64 " " 19,153.47 " " 35,122.50 " " 17,800.08 " " 20,947.06 " " 9,288.54 " " 36,995.70 " 1902 19350 BREAST RECONSTRUCTION Tech 19350 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1879 19355 CORRECT INVERTED NIPPLE(S) Tech 19355 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1909 19357 BREAST RECONSTRUCTION Tech 19357 761 78376 " 22,972.01 " 776.00 " 62,700.80 " " 20,142.63 " " 40,677.14 " " 15,237.72 " " 40,677.14 " " 12,952.06 " " 15,237.72 " " 39,971.76 " " 15,237.72 " " 47,025.60 " " 12,952.06 " " 16,304.36 " " 51,877.07 " " 13,713.95 " " 15,237.72 " " 46,071.46 " " 57,588.95 " " 15,085.34 " " 15,542.47 " " 15,237.72 " " 62,700.80 " " 13,942.51 " 776.00 " 52,511.92 " " 13,409.19 " " 32,055.78 " " 58,782.00 " " 29,790.72 " " 35,057.58 " " 15,542.47 " " 61,917.04 " 1921 19361 BREAST RECONSTR W/LAT FLAP Tech 19361 761 8766 " 2,569.31 " " 2,252.86 " " 7,012.80 " " 2,252.86 " " 4,549.55 " N/A " 4,549.55 " N/A N/A " 4,470.66 " N/A " 5,259.60 " N/A N/A " 5,802.22 " N/A N/A N/A N/A N/A N/A N/A " 7,012.80 " N/A N/A " 5,873.22 " N/A " 3,585.29 " " 6,574.50 " " 3,331.96 " " 3,921.03 " N/A " 6,925.14 " 1898 19364 BREAST RECONSTRUCTION Tech 19364 761 16238 " 4,759.36 " " 4,173.17 " " 12,990.40 " " 4,173.17 " " 8,427.52 " N/A " 8,427.52 " N/A N/A " 8,281.38 " N/A " 9,742.80 " N/A N/A " 10,747.93 " N/A N/A N/A N/A N/A N/A N/A " 12,990.40 " N/A N/A " 10,879.46 " N/A " 6,641.34 " " 12,178.50 " " 6,172.06 " " 7,263.26 " N/A " 12,828.02 " 1905 19367 BREAST RECONSTRUCTION Tech 19367 761 33792 " 9,904.44 " " 8,684.54 " " 27,033.60 " " 8,684.54 " " 17,538.05 " N/A " 17,538.05 " N/A N/A " 17,233.92 " N/A " 20,275.20 " N/A N/A " 22,366.92 " N/A N/A N/A N/A N/A N/A N/A " 27,033.60 " N/A N/A " 22,640.64 " N/A " 13,820.93 " " 25,344.00 " " 12,844.34 " " 15,115.16 " N/A " 26,695.68 " 1887 19368 BREAST RECONSTRUCTION Tech 19368 761 48141 " 14,110.13 " " 12,372.24 " " 38,512.80 " " 12,372.24 " " 24,985.18 " N/A " 24,985.18 " N/A N/A " 24,551.91 " N/A " 28,884.60 " N/A N/A " 31,864.53 " N/A N/A N/A N/A N/A N/A N/A " 38,512.80 " N/A N/A " 32,254.47 " N/A " 19,689.67 " " 36,105.75 " " 18,298.39 " " 21,533.47 " N/A " 38,031.39 " 1926 19369 BREAST RECONSTRUCTION Tech 19369 761 36803 " 10,786.96 " " 9,458.37 " " 29,442.40 " " 9,458.37 " " 19,100.76 " N/A " 19,100.76 " N/A N/A " 18,769.53 " N/A " 22,081.80 " N/A N/A " 24,359.91 " N/A N/A N/A N/A N/A N/A N/A " 29,442.40 " N/A N/A " 24,658.01 " N/A " 15,052.43 " " 27,602.25 " " 13,988.82 " " 16,461.98 " N/A " 29,074.37 " 1892 19370 SURGERY OF BREAST CAPSULE Tech 19370 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1933 19371 REMOVAL OF BREAST CAPSULE Tech 19371 761 16578 " 4,859.01 " 776.00 " 13,262.40 " " 4,260.55 " " 8,603.98 " " 3,225.00 " " 8,603.98 " " 2,741.25 " " 3,225.00 " " 8,454.78 " " 3,225.00 " " 9,946.80 " " 2,741.25 " " 3,450.75 " " 10,972.98 " " 2,902.50 " " 3,225.00 " " 9,745.10 " " 12,181.30 " " 3,192.75 " " 3,289.50 " " 3,225.00 " " 13,262.40 " " 2,950.88 " 776.00 " 11,107.26 " " 2,838.00 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,289.50 " " 13,096.62 " 1910 19380 REVISE BREAST RECONSTRUCTION Tech 19380 761 29053 " 8,515.43 " 776.00 " 23,242.40 " " 7,466.62 " " 15,078.51 " " 5,652.10 " " 15,078.51 " " 4,804.29 " " 5,652.10 " " 14,817.03 " " 5,652.10 " " 17,431.80 " " 4,804.29 " " 6,047.75 " " 19,230.18 " " 5,086.89 " " 5,652.10 " " 17,078.29 " " 21,347.73 " " 5,595.58 " " 5,765.14 " " 5,652.10 " " 23,242.40 " " 5,171.67 " 776.00 " 19,465.51 " " 4,973.85 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,765.14 " " 22,951.87 " 1894 20100 EXPLORE WOUND NECK Tech 20100 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 776.00 " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 1914 20101 EXPLORE WOUND CHEST Tech 20101 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1901 20102 EXPLORE WOUND ABDOMEN Tech 20102 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 1911 20103 EXPLORE WOUND EXTREMITY Tech 20103 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 1929 20150 EXCISE EPIPHYSEAL BAR Tech 20150 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 1912 20200 MUSCLE BIOPSY Tech 20200 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1922 20205 DEEP MUSCLE BIOPSY Tech 20205 761 12443 " 3,647.04 " 691.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 691.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1960 20206 NEEDLE BIOPSY MUSCLE Tech 20206 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 27559 "20206 XR BX Pelvis/Hip ST, Deep, Subfacia, Im Tech" 20206 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 27562 "20206 XR BX ST(Muscle, Percutaneous Needle) Tech" 20206 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 64944 20206 Biopsy Muscle Percut Needle Tech 20206 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 65377 BIOPSY MUSCLE PERC NDLE Tech 20206 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1918 20220 BONE BIOPSY TROCAR/NEEDLE Tech 20220 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1925 20225 BONE BIOPSY TROCAR/NEEDLE Tech 20225 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26810 20225 CT Biopsy Bone Deep Tech 20225 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26818 20225 XR Bone Bx Deep Percut Tech 20225 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 26836 20225 IR Biopsy Bone Deep Percutaneous Tech 20225 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 65389 BONE DEEP; BX TROCAR/NEED Tech 20225 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1915 20240 BONE BIOPSY OPEN SUPERFICIAL Tech 20240 761 12443 " 3,647.04 " 842.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 842.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1920 20245 BONE BIOPSY OPEN DEEP Tech 20245 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1947 20250 OPEN BONE BIOPSY Tech 20250 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 1955 20251 OPEN BONE BIOPSY Tech 20251 761 32891 " 9,640.35 " 162.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 162.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 1956 20500 INJECTION OF SINUS TRACT Tech 20500 761 7102 " 2,081.60 " 35.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 35.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 65482 INJ OF SINUS TRACT THERAP Tech 20500 761 7102 " 2,081.60 " 35.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 35.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 1953 20501 INJECT SINUS TRACT FOR X-RAY Tech 20501 761 195 57.15 35.00 156.00 50.12 101.21 N/A 101.21 N/A N/A 99.45 N/A 117.00 N/A N/A 129.07 N/A N/A N/A N/A N/A N/A N/A 156.00 N/A 35.00 130.65 N/A 79.76 146.25 74.12 87.22 N/A 154.05 65638 SINUS TRACT INJ Tech 20501 761 195 57.15 35.00 156.00 50.12 101.21 N/A 101.21 N/A N/A 99.45 N/A 117.00 N/A N/A 129.07 N/A N/A N/A N/A N/A N/A N/A 156.00 N/A 35.00 130.65 N/A 79.76 146.25 74.12 87.22 N/A 154.05 1945 20520 REMOVAL OF FOREIGN BODY Tech 20520 761 7387 " 2,165.13 " 748.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 748.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 1950 20525 REMOVAL OF FOREIGN BODY Tech 20525 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 1946 20526 THER INJECTION CARP TUNNEL Tech 20526 761 1371 401.84 49.78 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 49.78 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1938 20527 INJ DUPUYTREN CORD W/ENZYME Tech 20527 761 1371 401.84 46.74 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 46.74 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1936 20550 INJ TENDON SHEATH/LIGAMENT Tech 20550 761 1371 401.84 32.00 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 32.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1961 20551 INJ TENDON ORIGIN/INSERTION Tech 20551 761 1371 401.84 38.76 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 38.76 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1948 20552 INJ TRIGGER POINT 1/2 MUSCL Tech 20552 761 1371 401.84 31.06 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 31.06 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1971 20553 INJECT TRIGGER POINTS 3/> Tech 20553 761 1371 401.84 34.47 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 34.47 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1964 20555 PLACE NDL MUSC/TIS FOR RT Tech 20555 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 1966 20560 NDL INSJ W/O NJX 1 OR 2 MUSC Tech 20560 761 130 38.10 21.45 104.00 33.41 67.47 25.23 67.47 21.45 25.23 66.30 25.23 78.00 21.45 27.00 86.05 22.71 25.23 76.13 95.17 24.98 25.73 25.23 104.00 23.09 N/A 87.10 22.20 53.17 97.50 49.41 58.15 25.73 102.70 1954 20561 NDL INSJ W/O NJX 3+ MUSC Tech 20561 761 130 38.10 21.45 104.00 33.41 67.47 25.23 67.47 21.45 25.23 66.30 25.23 78.00 21.45 27.00 86.05 22.71 25.23 76.13 95.17 24.98 25.73 25.23 104.00 23.09 N/A 87.10 22.20 53.17 97.50 49.41 58.15 25.73 102.70 1967 20600 DRAIN/INJ JOINT/BURSA W/O US LT Tech 20600 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1977 20600 DRAIN/INJ JOINT/BURSA W/O US Tech 20600 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1987 20600 DRAIN/INJ JOINT/BURSA W/O US RT Tech 20600 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26811 "20600 XR Joint Injection Small Finger, Toe Tech" 20600 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26815 "20600 XR Aspiration Small Joint ( Finger, Toe) Tech" 20600 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1970 20604 DRAIN/INJ JOINT/BURSA W/US LT Tech 20604 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1973 20604 DRAIN/INJ JOINT/BURSA W/US RT Tech 20604 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 27563 20604 US Joint/Bursa Lw Sm Arth/Asp/Inj Right Tech 20604 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 27565 20604 US Joint/Bursa Up Sm Arth/Asp/Inj Left Tech 20604 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 64945 20604 Arthrocentesis Small Joint Or Bursa; W/ Us Tech 20604 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1974 20605 DRAIN/INJ JOINT/BURSA W/O US LT Tech 20605 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 " 1,094.00 " 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1985 20605 DRAIN/INJ JOINT/BURSA W/O US RT Tech 20605 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 " 1,094.00 " 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1989 20605 DRAIN/INJ JOINT/BURSA W/O US Tech 20605 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 " 1,094.00 " 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26817 20605 XR Joint Inj Inter TMJ Ankle Elbow Wrist Tech 20605 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 " 1,094.00 " 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26861 "20605 XR Aspiration MED Jt(Wrist, Elbow,Ankle) Tech" 20605 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 " 1,094.00 " 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1972 20606 DRAIN/INJ JOINT/BURSA W/US RT Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 1978 20606 DRAIN/INJ JOINT/BURSA W/US Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 1979 20606 DRAIN/INJ JOINT/BURSA W/US LT Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 27561 20606 US Joint/Bursa Up Int Arth/Asp/Inj Left Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 27564 20606 US Joint/Bursa Up Int Arth/Asp/Inj Right Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 30371 20606 US Joint/Bursa Lw Int Arth/Asp/Inj Left Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 30372 20606 US Joint/Bursa Lw Int Arth/Asp/Inj Right Tech 20606 761 3332 976.61 551.24 " 2,665.60 " 856.32 " 1,729.31 " 648.52 " 1,729.31 " 551.24 648.52 " 1,699.32 " 648.52 " 1,999.20 " 551.24 693.92 " 2,205.45 " 583.67 648.52 " 1,958.41 " " 2,447.99 " 642.03 661.49 648.52 " 2,665.60 " 593.40 776.00 " 2,232.44 " 570.70 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 661.49 " 2,632.28 " 1991 20610 DRAIN/INJ JOINT/BURSA W/O US RT Tech 20610 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1994 20610 DRAIN/INJ JOINT/BURSA W/O US LT Tech 20610 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 2001 20610 DRAIN/INJ JOINT/BURSA W/O US Tech 20610 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26813 "20610 XR Joint Inj Major Hip, Knee Shoulder Tech" 20610 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26816 "20610 XR Aspiration LRG Jt(Hip, Shoulder,Knee) Tech" 20610 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 1998 20611 DRAIN/INJ JOINT/BURSA W/US LT Tech 20611 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 2002 20611 DRAIN/INJ JOINT/BURSA W/US Tech 20611 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 2007 20611 DRAIN/INJ JOINT/BURSA W/US RT Tech 20611 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26820 20611 US Joint/Bursa Up Maj Arth/Asp/Inj Right Tech 20611 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 26824 "20611 IR Joint, Major LT Drain or Inj w/US Tech" 20611 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 2000 20612 ASPIRATE/INJ GANGLION CYST Tech 20612 761 1371 401.84 226.81 " 1,096.80 " 352.35 711.55 266.83 711.55 226.81 266.83 699.21 266.83 822.60 226.81 285.51 907.46 240.15 266.83 806.00 " 1,007.49 " 264.16 272.17 266.83 " 1,096.80 " 244.15 776.00 918.57 234.81 560.74 " 1,028.25 " 521.12 613.25 272.17 " 1,083.09 " 2003 20615 TREATMENT OF BONE CYST Tech 20615 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 776.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 2004 20650 INSERT AND REMOVE BONE PIN Tech 20650 761 14860 " 4,355.47 " 781.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 781.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2015 20660 APPLY REM FIXATION DEVICE Tech 20660 761 7310 " 2,142.56 " " 1,209.13 " " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " N/A " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2013 20661 APPLICATION OF HEAD BRACE Tech 20661 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 2009 20663 APPLICATION OF THIGH BRACE Tech 20663 761 14860 " 4,355.47 " 260.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 260.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2021 20664 APPLICATION OF HALO Tech 20664 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 2026 20665 REMOVAL OF FIXATION DEVICE Tech 20665 761 1419 415.91 235.60 " 1,135.20 " 364.68 736.46 277.18 736.46 235.60 277.18 723.69 277.18 851.40 235.60 296.58 939.24 249.46 277.18 833.93 " 1,042.40 " 274.41 282.72 277.18 " 1,135.20 " 253.62 N/A 950.73 243.92 580.37 " 1,064.25 " 539.36 634.72 282.72 " 1,121.01 " 2025 20670 REMOVAL OF SUPPORT IMPLANT Tech 20670 761 7387 " 2,165.13 " 657.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 657.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2035 20680 REMOVAL OF SUPPORT IMPLANT Tech 20680 761 12443 " 3,647.04 " 720.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 720.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2024 20690 APPLY BONE FIXATION DEVICE Tech 20690 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2031 20692 APPLY BONE FIXATION DEVICE Tech 20692 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2041 20693 ADJUST BONE FIXATION DEVICE Tech 20693 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2029 20694 REMOVE BONE FIXATION DEVICE Tech 20694 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2030 20696 COMP MULTIPLANE EXT FIXATION Tech 20696 761 83308 " 24,417.57 " 776.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 776.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2037 20697 COMP EXT FIXATE STRUT CHANGE Tech 20697 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2016 20700 MNL PREP&INSJ DP RX DLVR DEV Tech 20700 761 353 103.46 90.72 282.40 90.72 183.21 N/A 183.21 N/A N/A 180.03 N/A 211.80 N/A N/A 233.65 N/A N/A N/A N/A N/A N/A N/A 282.40 N/A N/A 236.51 N/A 144.38 264.75 134.18 157.90 N/A 278.87 2028 20701 RMVL DEEP RX DELIVERY DEVICE Tech 20701 761 263 77.09 67.59 210.40 67.59 136.50 N/A 136.50 N/A N/A 134.13 N/A 157.80 N/A N/A 174.08 N/A N/A N/A N/A N/A N/A N/A 210.40 N/A N/A 176.21 N/A 107.57 197.25 99.97 117.64 N/A 207.77 2040 20702 MNL PREP&INSJ IMED RX DEV Tech 20702 761 587 172.05 150.86 469.60 150.86 304.65 N/A 304.65 N/A N/A 299.37 N/A 352.20 N/A N/A 388.54 N/A N/A N/A N/A N/A N/A N/A 469.60 N/A N/A 393.29 N/A 240.08 440.25 223.12 262.57 N/A 463.73 2052 20703 RMVL IMED RX DELIVERY DEVICE Tech 20703 761 420 123.10 107.94 336.00 107.94 217.98 N/A 217.98 N/A N/A 214.20 N/A 252.00 N/A N/A 278.00 N/A N/A N/A N/A N/A N/A N/A 336.00 N/A N/A 281.40 N/A 171.78 315.00 159.64 187.87 N/A 331.80 2055 20704 MNL PREP&INSJ I-ARTIC RX DEV Tech 20704 761 611 179.08 157.03 488.80 157.03 317.11 N/A 317.11 N/A N/A 311.61 N/A 366.60 N/A N/A 404.42 N/A N/A N/A N/A N/A N/A N/A 488.80 N/A N/A 409.37 N/A 249.90 458.25 232.24 273.30 N/A 482.69 2046 20705 RMVL I-ARTIC RX DELIVERY DEV Tech 20705 761 503 147.43 129.27 402.40 129.27 261.06 N/A 261.06 N/A N/A 256.53 N/A 301.80 N/A N/A 332.94 N/A N/A N/A N/A N/A N/A N/A 402.40 N/A N/A 337.01 N/A 205.73 377.25 191.19 224.99 N/A 397.37 2042 20805 REPLANT FOREARM COMPLETE Tech 20805 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2038 20808 REPLANTATION HAND COMPLETE Tech 20808 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2058 20816 REPLANTATION DIGIT COMPLETE Tech 20816 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2054 20822 REPLANTATION DIGIT COMPLETE Tech 20822 761 7310 " 2,142.56 " " 1,209.13 " " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " N/A " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2045 20824 REPLANTATION THUMB COMPLETE Tech 20824 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2059 20827 REPLANTATION THUMB COMPLETE Tech 20827 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2060 20838 REPLANTATION FOOT COMPLETE Tech 20838 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2051 20900 REMOVAL OF BONE FOR GRAFT Tech 20900 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2070 20902 REMOVAL OF BONE FOR GRAFT Tech 20902 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2067 20910 REMOVE CARTILAGE FOR GRAFT Tech 20910 761 2752 806.61 454.66 " 2,201.60 " 707.26 " 1,428.29 " 534.89 " 1,428.29 " 454.66 534.89 " 1,403.52 " 534.89 " 1,651.20 " 454.66 572.33 " 1,821.55 " 481.40 534.89 " 1,617.64 " " 2,022.04 " 529.54 545.59 534.89 " 2,201.60 " 489.42 776.00 " 1,843.84 " 470.70 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 545.59 " 2,174.08 " 2056 20912 REMOVE CARTILAGE FOR GRAFT Tech 20912 761 18491 " 5,419.71 " 776.00 " 14,792.80 " " 4,752.19 " " 9,596.83 " " 3,596.22 " " 9,596.83 " " 3,056.79 " " 3,596.22 " " 9,430.41 " " 3,596.22 " " 11,094.60 " " 3,056.79 " " 3,847.96 " " 12,239.19 " " 3,236.60 " " 3,596.22 " " 10,869.71 " " 13,587.05 " " 3,560.26 " " 3,668.14 " " 3,596.22 " " 14,792.80 " " 3,290.54 " 776.00 " 12,388.97 " " 3,164.67 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,668.14 " " 14,607.89 " 2064 20920 REMOVAL OF FASCIA FOR GRAFT Tech 20920 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 2073 20922 REMOVAL OF FASCIA FOR GRAFT Tech 20922 761 9006 " 2,639.66 " 422.32 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 422.32 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 2063 20924 REMOVAL OF TENDON FOR GRAFT Tech 20924 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2076 20930 SP BONE ALGRFT MORSEL ADD-ON Tech 20930 761 1190 348.79 305.83 952.00 305.83 617.61 N/A 617.61 N/A N/A 606.90 N/A 714.00 N/A N/A 787.66 N/A N/A N/A N/A N/A N/A N/A 952.00 N/A N/A 797.30 N/A 486.71 892.50 452.32 532.29 N/A 940.10 2097 20931 SP BONE ALGRFT STRUCT ADD-ON Tech 20931 761 1400 410.34 359.80 " 1,120.00 " 359.80 726.60 N/A 726.60 N/A N/A 714.00 N/A 840.00 N/A N/A 926.66 N/A N/A N/A N/A N/A N/A N/A " 1,120.00 " N/A N/A 938.00 N/A 572.60 " 1,050.00 " 532.14 626.22 N/A " 1,106.00 " 2074 20932 OSTEOART ALGRFT W/SURF & B1 Tech 20932 761 10727 " 3,144.08 " " 2,756.84 " " 8,581.60 " " 2,756.84 " " 5,567.31 " N/A " 5,567.31 " N/A N/A " 5,470.77 " N/A " 6,436.20 " N/A N/A " 7,100.20 " N/A N/A N/A N/A N/A N/A N/A " 8,581.60 " N/A N/A " 7,187.09 " N/A " 4,387.34 " " 8,045.25 " " 4,077.33 " " 4,798.19 " N/A " 8,474.33 " 2077 20933 HEMICRT INTRCLRY ALGRFT PRTL Tech 20933 761 9841 " 2,884.40 " " 2,529.14 " " 7,872.80 " " 2,529.14 " " 5,107.48 " N/A " 5,107.48 " N/A N/A " 5,018.91 " N/A " 5,904.60 " N/A N/A " 6,513.76 " N/A N/A N/A N/A N/A N/A N/A " 7,872.80 " N/A N/A " 6,593.47 " N/A " 4,024.97 " " 7,380.75 " " 3,740.56 " " 4,401.88 " N/A " 7,774.39 " 2078 20934 INTERCALARY ALGRFT COMPL Tech 20934 761 10722 " 3,142.62 " " 2,755.55 " " 8,577.60 " " 2,755.55 " " 5,564.72 " N/A " 5,564.72 " N/A N/A " 5,468.22 " N/A " 6,433.20 " N/A N/A " 7,096.89 " N/A N/A N/A N/A N/A N/A N/A " 8,577.60 " N/A N/A " 7,183.74 " N/A " 4,385.30 " " 8,041.50 " " 4,075.43 " " 4,795.95 " N/A " 8,470.38 " 2099 20936 SP BONE AGRFT LOCAL ADD-ON Tech 20936 761 1227 359.63 315.34 981.60 315.34 636.81 N/A 636.81 N/A N/A 625.77 N/A 736.20 N/A N/A 812.15 N/A N/A N/A N/A N/A N/A N/A 981.60 N/A N/A 822.09 N/A 501.84 920.25 466.38 548.84 N/A 969.33 2085 20937 SP BONE AGRFT MORSEL ADD-ON Tech 20937 761 1080 316.55 277.56 864.00 277.56 560.52 N/A 560.52 N/A N/A 550.80 N/A 648.00 N/A N/A 714.85 N/A N/A N/A N/A N/A N/A N/A 864.00 N/A N/A 723.60 N/A 441.72 810.00 410.51 483.08 N/A 853.20 2089 20938 SP BONE AGRFT STRUCT ADD-ON Tech 20938 761 1470 430.86 377.79 " 1,176.00 " 377.79 762.93 N/A 762.93 N/A N/A 749.70 N/A 882.00 N/A N/A 972.99 N/A N/A N/A N/A N/A N/A N/A " 1,176.00 " N/A N/A 984.90 N/A 601.23 " 1,102.50 " 558.75 657.53 N/A " 1,161.30 " 2081 20939 BONE MARROW ASPIR BONE GRFG Tech 20939 761 6036 " 1,769.15 " " 1,551.25 " " 4,828.80 " " 1,551.25 " " 3,132.68 " N/A " 3,132.68 " N/A N/A " 3,078.36 " N/A " 3,621.60 " N/A N/A " 3,995.23 " N/A N/A N/A N/A N/A N/A N/A " 4,828.80 " N/A N/A " 4,044.12 " N/A " 2,468.72 " " 4,527.00 " " 2,294.28 " " 2,699.90 " N/A " 4,768.44 " 2088 20950 FLUID PRESSURE MUSCLE Tech 20950 761 3265 956.97 75.00 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 75.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 2109 20955 FIBULA BONE GRAFT MICROVASC Tech 20955 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2086 20962 OTHER BONE GRAFT MICROVASC Tech 20962 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2103 20969 BONE/SKIN GRAFT MICROVASC Tech 20969 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2111 20970 BONE/SKIN GRAFT ILIAC CREST Tech 20970 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2125 20974 ELECTRICAL BONE STIMULATION Tech 20974 761 260 76.21 40.99 208.00 66.82 134.94 48.22 134.94 40.99 48.22 132.60 48.22 156.00 40.99 51.60 172.09 43.40 48.22 106.28 132.85 47.74 49.18 48.22 208.00 44.12 42.63 174.20 42.43 106.34 195.00 98.83 116.30 49.18 205.40 2115 20975 ELECTRICAL BONE STIMULATION Tech 20975 761 2486 728.65 638.90 " 1,988.80 " 638.90 " 1,290.23 " N/A " 1,290.23 " N/A N/A " 1,267.86 " N/A " 1,491.60 " N/A N/A " 1,645.48 " N/A N/A N/A N/A N/A N/A N/A " 1,988.80 " N/A 776.00 " 1,665.62 " N/A " 1,016.77 " " 1,864.50 " 944.93 " 1,111.99 " N/A " 1,963.94 " 2096 20982 ABLATE BONE TUMOR(S) PERQ Tech 20982 761 28867 " 8,460.92 " 776.00 " 24,167.67 " " 7,418.82 " " 14,981.97 " " 6,397.05 " " 14,981.97 " " 5,437.49 " " 6,397.05 " " 14,722.17 " " 6,397.05 " " 17,320.20 " " 5,437.49 " " 6,844.84 " " 19,107.07 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 23,093.60 " " 5,853.30 " 776.00 " 19,340.89 " " 5,629.40 " " 11,806.60 " " 21,650.25 " " 10,972.35 " " 12,912.21 " " 6,524.99 " " 22,804.93 " 2104 20983 ABLATE BONE TUMOR(S) PERQ Tech 20983 0 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2105 20999 Unl Fascial Mesh Removal; No Inf Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2106 20999 Unl Lap Component Separation Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2108 20999 Unl BAHA Magnet Implant Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2116 20999 Unl BAHA Magnet Removal Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2136 20999 cadaveric costal graft Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 64300 20999 Unl Exploration Facial Wounds Tech 20999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2122 21011 EXC FACE LES SC <2 CM Tech 21011 761 7387 " 2,165.13 " 189.16 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 189.16 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2148 21012 EXC FACE LES SBQ 2 CM/> Tech 21012 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2118 21013 EXC FACE TUM DEEP < 2 CM Tech 21013 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2137 21014 EXC FACE TUM DEEP 2 CM/> Tech 21014 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2124 21015 RESECT FACE/SCALP TUM < 2 CM Tech 21015 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2113 21016 RESECT FACE/SCALP TUM 2 CM/> Tech 21016 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2139 21025 EXCISION OF BONE LOWER JAW Tech 21025 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2119 21026 EXCISION OF FACIAL BONE(S) Tech 21026 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2135 21029 CONTOUR OF FACE BONE LESION Tech 21029 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2133 21030 EXCISE MAX/ZYGOMA B9 TUMOR Tech 21030 761 26702 " 7,826.36 " " 1,015.00 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " " 1,015.00 " " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2147 21032 REMOVE EXOSTOSIS MAXILLA Tech 21032 761 14366 " 4,210.67 " " 2,374.88 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " N/A " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2143 21034 EXCISE MAX/ZYGOMA MAL TUMOR Tech 21034 761 26702 " 7,826.36 " " 1,015.00 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " " 1,015.00 " " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2128 21040 EXCISE MANDIBLE LESION Tech 21040 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2144 21044 REMOVAL OF JAW BONE LESION Tech 21044 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2153 21045 EXTENSIVE JAW SURGERY Tech 21045 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2150 21046 REMOVE MANDIBLE CYST COMPLEX Tech 21046 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2154 21047 EXCISE LWR JAW CYST W/REPAIR Tech 21047 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2167 21048 REMOVE MAXILLA CYST COMPLEX Tech 21048 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2159 21050 REMOVAL OF JAW JOINT Tech 21050 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2176 21070 REMOVE CORONOID PROCESS Tech 21070 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2169 21073 MNPJ OF TMJ W/ANESTH Tech 21073 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2155 21085 PREPARE FACE/ORAL PROSTHESIS Tech 21085 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2156 21110 INTERDENTAL FIXATION Tech 21110 761 7102 " 2,081.60 " " 1,174.31 " " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " N/A " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2172 21120 RECONSTRUCTION OF CHIN Tech 21120 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2168 21121 RECONSTRUCTION OF CHIN Tech 21121 761 14366 " 4,210.67 " " 2,374.88 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " N/A " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2163 21122 RECONSTRUCTION OF CHIN Tech 21122 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2195 21123 RECONSTRUCTION OF CHIN Tech 21123 761 14366 " 4,210.67 " " 2,374.88 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " N/A " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2162 21137 REDUCTION OF FOREHEAD Tech 21137 761 14366 " 4,210.67 " " 2,374.88 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " N/A " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2216 21138 REDUCTION OF FOREHEAD Tech 21138 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2190 21141 LEFORT I-1 PIECE W/O GRAFT Tech 21141 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2181 21142 LEFORT I-2 PIECE W/O GRAFT Tech 21142 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2191 21143 LEFORT I-3/> PIECE W/O GRAFT Tech 21143 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2166 21145 LEFORT I-1 PIECE W/ GRAFT Tech 21145 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2205 21146 LEFORT I-2 PIECE W/ GRAFT Tech 21146 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2184 21147 LEFORT I-3/> PIECE W/ GRAFT Tech 21147 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2196 21150 LEFORT II ANTERIOR INTRUSION Tech 21150 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2183 21154 LEFORT III W/O LEFORT I Tech 21154 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2180 21172 RECONSTRUCT ORBIT/FOREHEAD Tech 21172 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2187 21175 RECONSTRUCT ORBIT/FOREHEAD Tech 21175 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2193 21179 RECONSTRUCT ENTIRE FOREHEAD Tech 21179 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2222 21180 RECONSTRUCT ENTIRE FOREHEAD Tech 21180 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2194 21181 CONTOUR CRANIAL BONE LESION Tech 21181 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2202 21182 RECONSTRUCT CRANIAL BONE Tech 21182 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2207 21183 RECONSTRUCT CRANIAL BONE Tech 21183 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2210 21188 RECONSTRUCTION OF MIDFACE Tech 21188 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2228 21193 RECONST LWR JAW W/O GRAFT Tech 21193 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2211 21194 RECONST LWR JAW W/GRAFT Tech 21194 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2221 21196 RECONST LWR JAW W/FIXATION Tech 21196 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2235 21198 RECONSTR LWR JAW SEGMENT Tech 21198 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2217 21206 RECONSTRUCT UPPER JAW BONE Tech 21206 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2209 21208 AUGMENTATION OF FACIAL BONES Tech 21208 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2213 21209 REDUCTION OF FACIAL BONES Tech 21209 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2218 21210 FACE BONE GRAFT Tech 21210 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2224 21215 LOWER JAW BONE GRAFT Tech 21215 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2226 21230 RIB CARTILAGE GRAFT Tech 21230 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2220 21235 EAR CARTILAGE GRAFT Tech 21235 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2241 21240 RECONSTRUCTION OF JAW JOINT Tech 21240 761 26702 " 7,826.36 " 697.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 697.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2238 21244 RECONSTRUCTION OF LOWER JAW Tech 21244 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2225 21245 RECONSTRUCTION OF JAW Tech 21245 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2236 21246 RECONSTRUCTION OF JAW Tech 21246 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2245 21247 RECONSTRUCT LOWER JAW BONE Tech 21247 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2233 21248 RECONSTRUCTION OF JAW Tech 21248 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2252 21249 RECONSTRUCTION OF JAW Tech 21249 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2232 21255 RECONSTRUCT LOWER JAW BONE Tech 21255 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2258 21256 RECONSTRUCTION OF ORBIT Tech 21256 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2257 21267 REVISE EYE SOCKETS Tech 21267 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2243 21268 REVISE EYE SOCKETS Tech 21268 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2247 21270 AUGMENTATION CHEEK BONE Tech 21270 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2259 21275 REVISION ORBITOFACIAL BONES Tech 21275 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2262 21280 REVISION OF EYELID Tech 21280 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2249 21282 REVISION OF EYELID Tech 21282 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2254 21295 REVISION OF JAW MUSCLE/BONE Tech 21295 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2276 21299 Unl Placemt Internal Distractn Dev Tech 21299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 67802 21299 Unl Resection Deep Muscle Lip Tech 21299 0 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2260 zz21310 CLOSED TX NOSE FX W/O MANJ Tech 21310 761 1082 317.13 278.07 865.60 278.07 561.56 N/A 561.56 N/A N/A 551.82 N/A 649.20 N/A N/A 716.18 N/A N/A 636.32 795.40 N/A N/A N/A 865.60 N/A 776.00 724.94 N/A 442.54 811.50 411.27 483.98 N/A 854.78 2271 21315 CLOSED TX NOSE FX W/O STABLJ Tech 21315 761 7102 " 2,081.60 " 587.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 587.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2268 21320 CLOSED TX NOSE FX W/ STABLJ Tech 21320 761 14366 " 4,210.67 " 573.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 573.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2267 21325 OPEN TX NOSE FX UNCOMPLICATD Tech 21325 761 14366 " 4,210.67 " 754.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 754.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2293 21330 OPEN TX NOSE FX W/SKELE FIXJ Tech 21330 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2261 21335 OPEN TX NOSE & SEPTAL FX Tech 21335 761 14366 " 4,210.67 " 886.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 886.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2279 21336 OPEN TX SEPTAL FX W/WO STABJ Tech 21336 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2299 21337 CLOSED TX SEPTAL&NOSE FX Tech 21337 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2274 21338 OPEN NASOETHMOID FX W/O FIXJ Tech 21338 761 26702 " 7,826.36 " 754.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 754.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2300 21339 OPEN NASOETHMOID FX W/ FIXJ Tech 21339 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2285 21340 PERQ TX NASOETHMOID FX Tech 21340 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2297 21343 OPEN TX DPRSD FRONT SINUS FX Tech 21343 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2283 21344 OPEN TX COMPL FRONT SINUS FX Tech 21344 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2281 21345 CLOSED TX NOSE/JAW FX Tech 21345 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2305 21346 OPN TX NASOMAX FX W/FIXJ Tech 21346 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2289 21347 OPN TX NASOMAX FX MULTPLE Tech 21347 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2315 21348 OPN TX NASOMAX FX W/GRAFT Tech 21348 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2295 21355 PERQ TX MALAR FRACTURE Tech 21355 761 14366 " 4,210.67 " 583.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 583.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2311 21356 OPN TX DPRSD ZYGOMATIC ARCH Tech 21356 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2290 21360 OPN TX DPRSD MALAR FRACTURE Tech 21360 761 26702 " 7,826.36 " 844.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 844.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2308 21365 OPN TX COMPLX MALAR FX Tech 21365 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2309 21366 OPN TX COMPLX MALAR W/GRFT Tech 21366 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2333 21385 OPN TX ORBIT FX TRANSANTRAL Tech 21385 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2304 21386 OPN TX ORBIT FX PERIORBITAL Tech 21386 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2314 21390 OPN TX ORBIT PERIORBTL IMPLT Tech 21390 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2323 21395 OPN TX ORBIT PERIORBT W/GRFT Tech 21395 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2319 21400 CLOSED TX ORBIT W/O MANIPULJ Tech 21400 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 776.00 " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 2322 21406 OPN TX ORBIT FX W/O IMPLANT Tech 21406 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2338 21407 OPN TX ORBIT FX W/IMPLANT Tech 21407 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2331 21408 OPN TX ORBIT FX W/BONE GRFT Tech 21408 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2318 21421 TREAT MOUTH ROOF FRACTURE Tech 21421 761 14366 " 4,210.67 " 610.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 610.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2330 21422 TREAT MOUTH ROOF FRACTURE Tech 21422 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2332 21423 TREAT MOUTH ROOF FRACTURE Tech 21423 761 10172 " 2,981.41 " " 2,614.20 " " 19,619.95 " " 2,614.20 " " 5,279.27 " N/A " 5,279.27 " N/A N/A " 5,187.72 " N/A " 6,103.20 " N/A N/A " 6,732.85 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 8,137.60 " N/A N/A " 6,815.24 " N/A " 4,160.35 " " 7,629.00 " " 3,866.38 " " 4,549.94 " N/A " 8,035.88 " 2329 21432 TREAT CRANIOFACIAL FRACTURE Tech 21432 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2336 21433 TREAT CRANIOFACIAL FRACTURE Tech 21433 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2321 21435 TREAT CRANIOFACIAL FRACTURE Tech 21435 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2349 21436 TREAT CRANIOFACIAL FRACTURE Tech 21436 761 26702 " 7,826.36 " " 6,862.41 " " 21,361.60 " " 6,862.41 " " 13,858.34 " N/A " 13,858.34 " N/A N/A " 13,618.02 " N/A " 16,021.20 " N/A N/A " 17,674.05 " N/A N/A " 15,696.06 " " 19,619.95 " N/A N/A N/A " 21,361.60 " N/A N/A " 17,890.34 " N/A " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " N/A " 21,094.58 " 2342 21440 TREAT DENTAL RIDGE FRACTURE Tech 21440 761 14366 " 4,210.67 " " 2,374.88 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " N/A " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2339 21445 TREAT DENTAL RIDGE FRACTURE Tech 21445 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2341 21450 TREAT LOWER JAW FRACTURE Tech 21450 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 776.00 " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 2348 21451 TREAT LOWER JAW FRACTURE Tech 21451 761 7102 " 2,081.60 " 953.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 953.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2344 21452 TREAT LOWER JAW FRACTURE Tech 21452 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2356 21453 TREAT LOWER JAW FRACTURE Tech 21453 761 26702 " 7,826.36 " 953.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 953.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2390 21454 TREAT LOWER JAW FRACTURE Tech 21454 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2340 21461 TREAT LOWER JAW FRACTURE Tech 21461 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2351 21462 TREAT LOWER JAW FRACTURE Tech 21462 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2361 21465 TREAT LOWER JAW FRACTURE Tech 21465 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2362 21470 TREAT LOWER JAW FRACTURE Tech 21470 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2357 21480 RESET DISLOCATED JAW Tech 21480 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 569.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2367 21485 RESET DISLOCATED JAW Tech 21485 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2360 21490 REPAIR DISLOCATED JAW Tech 21490 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 2372 21497 INTERDENTAL WIRING Tech 21497 761 7102 " 2,081.60 " " 1,174.31 " " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " N/A " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 2386 21499 Transcervical Styloidectomy Tech 21499 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2365 21501 DRAIN NECK/CHEST LESION Tech 21501 361 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 27268 21501 ICD Procedure Charges Hematoma evacuation tech 21501 361 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 27269 21501 BiV Procedure Charges 21501 Hematoma evacuation tech 21501 361 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2370 21502 DRAIN CHEST LESION Tech 21502 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2371 21510 DRAINAGE OF BONE LESION Tech 21510 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2363 21550 BIOPSY OF NECK/CHEST Tech 21550 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 67885 US Biopsy Neck and Thorax Soft Tissue Tech 21550 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2389 21552 EXC NECK LES SC 3 CM/> Tech 21552 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2383 21554 EXC NECK TUM DEEP 5 CM/> Tech 21554 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2381 21555 EXC NECK LES SC < 3 CM Tech 21555 761 7387 " 2,165.13 " 741.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 741.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2376 21556 EXC NECK TUM DEEP < 5 CM Tech 21556 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2404 21557 RESECT NECK THORAX TUMOR<5CM Tech 21557 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2379 21558 RESECT NECK TUMOR 5 CM/> Tech 21558 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2392 21600 PARTIAL REMOVAL OF RIB Tech 21600 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2385 21601 EXC CHEST WALL TUMOR W/RIBS Tech 21601 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2418 21602 EXC CH WAL TUM W/O LYMPHADEC Tech 21602 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2402 21603 EXC CH WAL TUM W/LYMPHADEC Tech 21603 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2411 21615 REMOVAL OF RIB Tech 21615 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2406 21620 PARTIAL REMOVAL OF STERNUM Tech 21620 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2424 21627 STERNAL DEBRIDEMENT Tech 21627 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2401 21630 EXTENSIVE STERNUM SURGERY Tech 21630 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2413 21685 HYOID MYOTOMY & SUSPENSION Tech 21685 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 2409 21700 REVISION OF NECK MUSCLE Tech 21700 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2400 21705 REVISION OF NECK MUSCLE/RIB Tech 21705 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2419 21720 REVISION OF NECK MUSCLE Tech 21720 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2435 21740 RECONSTRUCTION OF STERNUM Tech 21740 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2412 21742 REPAIR STERN/NUSS W/O SCOPE Tech 21742 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2417 21743 REPAIR STERNUM/NUSS W/SCOPE Tech 21743 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2415 21750 REPAIR OF STERNUM SEPARATION Tech 21750 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2441 21811 OPTX OF RIB FX W/FIXJ SCOPE Tech 21811 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2420 21812 TREATMENT OF RIB FRACTURE Tech 21812 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2437 21813 TREATMENT OF RIB FRACTURE Tech 21813 761 7310 " 2,142.56 " " 1,209.13 " " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " N/A " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2423 21825 TREAT STERNUM FRACTURE Tech 21825 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2425 21899 Robotic rib resection Tech 21899 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2426 21899 Unl Vats Thoracic Duct Ligation Tech 21899 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2434 21899 VATS rib plating Tech 21899 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2443 21899 Unl Adjust Substernal Pectus Bar Tech 21899 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2445 21899 VATS chest wall resection Tech 21899 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 2449 21920 BIOPSY SOFT TISSUE OF BACK Tech 21920 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2458 21925 BIOPSY SOFT TISSUE OF BACK Tech 21925 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2452 21930 EXC BACK LES SC < 3 CM Tech 21930 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2459 21931 EXC BACK LES SC 3 CM/> Tech 21931 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2440 21932 EXC BACK TUM DEEP < 5 CM Tech 21932 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2450 21933 EXC BACK TUM DEEP 5 CM/> Tech 21933 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2446 21935 RESECT BACK TUM < 5 CM Tech 21935 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2451 21936 RESECT BACK TUM 5 CM/> Tech 21936 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2460 22010 I&D P-SPINE C/T/CERV-THOR Tech 22010 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2465 22015 I&D ABSCESS P-SPINE L/S/LS Tech 22015 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2475 22100 REMOVE PART OF NECK VERTEBRA Tech 22100 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2466 22101 REMOVE PART THORAX VERTEBRA Tech 22101 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2471 22102 REMOVE PART LUMBAR VERTEBRA Tech 22102 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2455 22103 REMOVE EXTRA SPINE SEGMENT Tech 22103 761 713 208.98 183.24 570.40 183.24 370.05 N/A 370.05 N/A N/A 363.63 N/A 427.80 N/A N/A 471.93 N/A N/A N/A N/A N/A N/A N/A 570.40 N/A N/A 477.71 N/A 291.62 534.75 271.01 318.92 N/A 563.27 2498 22110 REMOVE PART OF NECK VERTEBRA Tech 22110 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2464 22116 REMOVE EXTRA SPINE SEGMENT Tech 22116 761 6864 " 2,011.84 " " 1,764.05 " " 5,491.20 " " 1,764.05 " " 3,562.42 " N/A " 3,562.42 " N/A N/A " 3,500.64 " N/A " 4,118.40 " N/A N/A " 4,543.28 " N/A N/A N/A N/A N/A N/A N/A " 5,491.20 " N/A N/A " 4,598.88 " N/A " 2,807.38 " " 5,148.00 " " 2,609.01 " " 3,070.27 " N/A " 5,422.56 " 2463 22207 INCIS SPINE 3 COLUMN LUMBAR Tech 22207 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2473 22210 INCIS 1 VERTEBRAL SEG CERV Tech 22210 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2486 22212 INCIS 1 VERTEBRAL SEG THORAC Tech 22212 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2472 22214 INCIS 1 VERTEBRAL SEG LUMBAR Tech 22214 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 2521 22216 INCIS ADDL SPINE SEGMENT Tech 22216 761 838 245.62 215.37 670.40 215.37 434.92 N/A 434.92 N/A N/A 427.38 N/A 502.80 N/A N/A 554.67 N/A N/A N/A N/A N/A N/A N/A 670.40 N/A N/A 561.46 N/A 342.74 628.50 318.52 374.84 N/A 662.02 2490 22220 INCIS W/DISCECTOMY CERVICAL Tech 22220 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2509 22224 INCIS W/DISCECTOMY LUMBAR Tech 22224 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2503 22226 REVISE EXTRA SPINE SEGMENT Tech 22226 761 8463 " 2,480.51 " " 2,174.99 " " 6,770.40 " " 2,174.99 " " 4,392.30 " N/A " 4,392.30 " N/A N/A " 4,316.13 " N/A " 5,077.80 " N/A N/A " 5,601.66 " N/A N/A N/A N/A N/A N/A N/A " 6,770.40 " N/A N/A " 5,670.21 " N/A " 3,461.37 " " 6,347.25 " " 3,216.79 " " 3,785.50 " N/A " 6,685.77 " 2484 22310 CLOSED TX VERT FX W/O MANJ Tech 22310 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 197.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2492 22315 CLOSED TX VERT FX W/MANJ Tech 22315 761 14860 " 4,355.47 " 301.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 301.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2502 22318 TREAT ODONTOID FX W/O GRAFT Tech 22318 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2485 22319 TREAT ODONTOID FX W/GRAFT Tech 22319 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 2482 22325 TREAT SPINE FRACTURE Tech 22325 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2493 22326 TREAT NECK SPINE FRACTURE Tech 22326 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2494 22327 TREAT THORAX SPINE FRACTURE Tech 22327 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2500 22328 TREAT EACH ADD SPINE FX Tech 22328 761 664 194.62 170.65 531.20 170.65 344.62 N/A 344.62 N/A N/A 338.64 N/A 398.40 N/A N/A 439.50 N/A N/A N/A N/A N/A N/A N/A 531.20 N/A N/A 444.88 N/A 271.58 498.00 252.39 297.01 N/A 524.56 2527 22505 MANIPULATION OF SPINE Tech 22505 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2512 22510 PERQ CERVICOTHORACIC INJECT Tech 22510 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2518 22511 PERQ LUMBOSACRAL INJECTION Tech 22511 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2507 22512 VERTEBROPLASTY ADDL INJECT Tech 22512 761 2958 866.99 760.21 " 2,366.40 " 760.21 " 1,535.20 " N/A " 1,535.20 " N/A N/A " 1,508.58 " N/A " 1,774.80 " N/A N/A " 1,957.90 " N/A N/A N/A N/A N/A N/A N/A " 2,366.40 " N/A N/A " 1,981.86 " N/A " 1,209.82 " " 2,218.50 " " 1,124.34 " " 1,323.11 " N/A " 2,336.82 " 65656 VERTEBROPLASTY ADDL INJEC Tech 22512 761 2958 866.99 760.21 " 2,366.40 " 760.21 " 1,535.20 " N/A " 1,535.20 " N/A N/A " 1,508.58 " N/A " 1,774.80 " N/A N/A " 1,957.90 " N/A N/A N/A N/A N/A N/A N/A " 2,366.40 " N/A N/A " 1,981.86 " N/A " 1,209.82 " " 2,218.50 " " 1,124.34 " " 1,323.11 " N/A " 2,336.82 " 2510 22513 PERQ VERTEBRAL AUGMENTATION Tech 22513 409 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2505 22514 PERQ VERTEBRAL AUGMENTATION Tech 22514 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2513 22515 PERQ VERTEBRAL AUGMENTATION Tech 22515 761 3044 892.20 782.31 " 2,435.20 " 782.31 " 1,579.84 " N/A " 1,579.84 " N/A N/A " 1,552.44 " N/A " 1,826.40 " N/A N/A " 2,014.82 " N/A N/A N/A N/A N/A N/A N/A " 2,435.20 " N/A N/A " 2,039.48 " N/A " 1,245.00 " " 2,283.00 " " 1,157.02 " " 1,361.58 " N/A " 2,404.76 " 65613 PERQ VERTEBRAL AUGMENTATN Tech 22515 761 3044 892.20 782.31 " 2,435.20 " 782.31 " 1,579.84 " N/A " 1,579.84 " N/A N/A " 1,552.44 " N/A " 1,826.40 " N/A N/A " 2,014.82 " N/A N/A N/A N/A N/A N/A N/A " 2,435.20 " N/A N/A " 2,039.48 " N/A " 1,245.00 " " 2,283.00 " " 1,157.02 " " 1,361.58 " N/A " 2,404.76 " 2537 22526 IDET SINGLE LEVEL Tech 22526 761 4606 " 1,350.02 " 677.53 " 3,684.80 " " 1,183.74 " " 2,390.51 " N/A " 2,390.51 " N/A N/A " 2,349.06 " N/A " 2,763.60 " N/A N/A " 3,048.71 " N/A N/A 677.53 846.91 N/A N/A N/A " 3,684.80 " N/A N/A " 3,086.02 " N/A " 1,883.85 " " 3,454.50 " " 1,750.74 " " 2,060.26 " N/A " 3,638.74 " 2511 22527 IDET 1 OR MORE LEVELS Tech 22527 761 2163 633.98 318.17 " 1,730.40 " 555.89 " 1,122.60 " N/A " 1,122.60 " N/A N/A " 1,103.13 " N/A " 1,297.80 " N/A N/A " 1,431.69 " N/A N/A 318.17 397.71 N/A N/A N/A " 1,730.40 " N/A N/A " 1,449.21 " N/A 884.67 " 1,622.25 " 822.16 967.51 N/A " 1,708.77 " 2519 22532 LAT THORAX SPINE FUSION Tech 22532 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2522 22533 LAT LUMBAR SPINE FUSION Tech 22533 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2533 22534 LAT THOR/LUMB ADDL SEG Tech 22534 761 538 157.69 138.27 430.40 138.27 279.22 N/A 279.22 N/A N/A 274.38 N/A 322.80 N/A N/A 356.10 N/A N/A N/A N/A N/A N/A N/A 430.40 N/A N/A 360.46 N/A 220.04 403.50 204.49 240.65 N/A 425.02 66775 22548 Arthrod Ant Trans/Xtraoral C1-C2 Tech 22548 0 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2531 22551 NECK SPINE FUSE&REMOV BEL C2 Tech 22551 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2528 22552 ADDL NECK SPINE FUSION Tech 22552 761 1426 417.96 366.48 " 1,140.80 " 366.48 740.09 N/A 740.09 N/A N/A 727.26 N/A 855.60 N/A N/A 943.87 N/A N/A N/A N/A N/A N/A N/A " 1,140.80 " N/A N/A 955.42 N/A 583.23 " 1,069.50 " 542.02 637.85 N/A " 1,126.54 " 2535 22554 NECK SPINE FUSION Tech 22554 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2560 22556 THORAX SPINE FUSION Tech 22556 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2540 22558 LUMBAR SPINE FUSION Tech 22558 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2536 22585 ADDITIONAL SPINAL FUSION Tech 22585 761 1173 343.81 301.46 938.40 301.46 608.79 N/A 608.79 N/A N/A 598.23 N/A 703.80 N/A N/A 776.41 N/A N/A N/A N/A N/A N/A N/A 938.40 N/A N/A 785.91 N/A 479.76 879.75 445.86 524.68 N/A 926.67 2545 22590 SPINE & SKULL SPINAL FUSION Tech 22590 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2541 22595 NECK SPINAL FUSION Tech 22595 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2553 22600 NECK SPINE FUSION Tech 22600 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2534 22610 THORAX SPINE FUSION Tech 22610 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2571 22612 LUMBAR SPINE FUSION Tech 22612 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2543 22614 SPINE FUSION EXTRA SEGMENT Tech 22614 761 926 271.41 237.98 740.80 237.98 480.59 N/A 480.59 N/A N/A 472.26 N/A 555.60 N/A N/A 612.92 N/A N/A N/A N/A N/A N/A N/A 740.80 N/A N/A 620.42 N/A 378.73 694.50 351.97 414.20 N/A 731.54 2539 22630 LUMBAR SPINE FUSION Tech 22630 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " " 16,513.36 " " 16,470.98 " " 14,036.36 " " 16,513.36 " " 16,185.36 " " 16,513.36 " " 19,041.60 " " 14,036.36 " " 17,669.30 " " 21,006.06 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 25,388.80 " " 15,109.72 " N/A " 21,263.12 " " 14,531.76 " " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " " 16,843.63 " " 25,071.44 " 2549 22632 SPINE FUSION EXTRA SEGMENT Tech 22632 761 740 216.89 190.18 592.00 190.18 384.06 N/A 384.06 N/A N/A 377.40 N/A 444.00 N/A N/A 489.81 N/A N/A N/A N/A N/A N/A N/A 592.00 N/A N/A 495.80 N/A 302.66 555.00 281.27 331.00 N/A 584.60 2550 22633 LUMBAR SPINE FUSION COMBINED Tech 22633 761 64652 " 18,949.50 " " 10,704.30 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " N/A " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2564 22634 SPINE FUSION EXTRA SEGMENT Tech 22634 761 555 162.67 142.64 444.00 142.64 288.05 N/A 288.05 N/A N/A 283.05 N/A 333.00 N/A N/A 367.35 N/A N/A N/A N/A N/A N/A N/A 444.00 N/A N/A 371.85 N/A 227.00 416.25 210.96 248.25 N/A 438.45 2561 22800 POST FUSION VERT SEG Tech 22804 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2582 22808 ANT FUSION 2-3 VERT SEG Tech 22808 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2594 22810 ANT FUSION 4-7 VERT SEG Tech 22810 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2568 22812 ANT FUSION 8/> VERT SEG Tech 22812 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2588 22818 KYPHECTOMY 1-2 SEGMENTS Tech 22818 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2573 22830 EXPLORATION OF SPINAL FUSION Tech 22830 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2574 22840 INSERT SPINE FIXATION DEVICE Tech 22840 761 1389 407.12 356.97 " 1,111.20 " 356.97 720.89 N/A 720.89 N/A N/A 708.39 N/A 833.40 N/A N/A 919.38 N/A N/A N/A N/A N/A N/A N/A " 1,111.20 " N/A N/A 930.63 N/A 568.10 " 1,041.75 " 527.96 621.30 N/A " 1,097.31 " 2572 22841 INSERT SPINE FIXATION DEVICE Tech 22841 761 2609 764.70 670.51 " 2,087.20 " 670.51 " 1,354.07 " N/A " 1,354.07 " N/A N/A " 1,330.59 " N/A " 1,565.40 " N/A N/A " 1,726.90 " N/A N/A N/A N/A N/A N/A N/A " 2,087.20 " N/A N/A " 1,748.03 " N/A " 1,067.08 " " 1,956.75 " 991.68 " 1,167.01 " N/A " 2,061.11 " 2579 22842 INSERT SPINE FIXATION DEVICE Tech 22842 761 1103 323.29 283.47 882.40 283.47 572.46 N/A 572.46 N/A N/A 562.53 N/A 661.80 N/A N/A 730.08 N/A N/A N/A N/A N/A N/A N/A 882.40 N/A N/A 739.01 N/A 451.13 827.25 419.25 493.37 N/A 871.37 2585 22843 INSERT SPINE FIXATION DEVICE Tech 22843 761 441 129.26 113.34 352.80 113.34 228.88 N/A 228.88 N/A N/A 224.91 N/A 264.60 N/A N/A 291.90 N/A N/A N/A N/A N/A N/A N/A 352.80 N/A N/A 295.47 N/A 180.37 330.75 167.62 197.26 N/A 348.39 2580 22844 INSERT SPINE FIXATION DEVICE Tech 22844 761 1535 449.91 394.50 " 1,228.00 " 394.50 796.67 N/A 796.67 N/A N/A 782.85 N/A 921.00 N/A N/A " 1,016.02 " N/A N/A N/A N/A N/A N/A N/A " 1,228.00 " N/A N/A " 1,028.45 " N/A 627.82 " 1,151.25 " 583.45 686.61 N/A " 1,212.65 " 2617 22845 INSERT SPINE FIXATION DEVICE Tech 22845 761 1563 458.12 401.69 " 1,250.40 " 401.69 811.20 N/A 811.20 N/A N/A 797.13 N/A 937.80 N/A N/A " 1,034.55 " N/A N/A N/A N/A N/A N/A N/A " 1,250.40 " N/A N/A " 1,047.21 " N/A 639.27 " 1,172.25 " 594.10 699.13 N/A " 1,234.77 " 2602 22846 INSERT SPINE FIXATION DEVICE Tech 22846 761 1441 422.36 370.34 " 1,152.80 " 370.34 747.88 N/A 747.88 N/A N/A 734.91 N/A 864.60 N/A N/A 953.80 N/A N/A N/A N/A N/A N/A N/A " 1,152.80 " N/A N/A 965.47 N/A 589.37 " 1,080.75 " 547.72 644.56 N/A " 1,138.39 " 2606 22847 INSERT SPINE FIXATION DEVICE Tech 22847 761 11363 " 3,330.50 " " 2,920.29 " " 9,090.40 " " 2,920.29 " " 5,897.40 " N/A " 5,897.40 " N/A N/A " 5,795.13 " N/A " 6,817.80 " N/A N/A " 7,521.17 " N/A N/A N/A N/A N/A N/A N/A " 9,090.40 " N/A N/A " 7,613.21 " N/A " 4,647.47 " " 8,522.25 " " 4,319.08 " " 5,082.67 " N/A " 8,976.77 " 2591 22848 INSERT PELV FIXATION DEVICE Tech 22848 761 779 228.32 200.20 623.20 200.20 404.30 N/A 404.30 N/A N/A 397.29 N/A 467.40 N/A N/A 515.62 N/A N/A N/A N/A N/A N/A N/A 623.20 N/A N/A 521.93 N/A 318.61 584.25 296.10 348.45 N/A 615.41 2592 22849 REINSERT SPINAL FIXATION Tech 22849 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2589 22850 REMOVE SPINE FIXATION DEVICE Tech 22850 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2596 22852 REMOVE SPINE FIXATION DEVICE Tech 22852 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2613 22853 INSJ BIOMECHANICAL DEVICE Tech 22853 761 1296 379.86 333.07 " 1,036.80 " 333.07 672.62 N/A 672.62 N/A N/A 660.96 N/A 777.60 N/A N/A 857.82 N/A N/A N/A N/A N/A N/A N/A " 1,036.80 " N/A N/A 868.32 N/A 530.06 972.00 492.61 579.70 N/A " 1,023.84 " 2616 22854 INSJ BIOMECHANICAL DEVICE Tech 22854 761 1228 359.93 315.60 982.40 315.60 637.33 N/A 637.33 N/A N/A 626.28 N/A 736.80 N/A N/A 812.81 N/A N/A N/A N/A N/A N/A N/A 982.40 N/A N/A 822.76 N/A 502.25 921.00 466.76 549.28 N/A 970.12 2604 22855 REMOVE SPINE FIXATION DEVICE Tech 22855 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2600 22856 CERV ARTIFIC DISKECTOMY Tech 22856 761 83308 " 24,417.57 " " 14,036.36 " " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " N/A " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2623 22857 LUMBAR ARTIF DISKECTOMY Tech 22857 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 2607 22858 SECOND LEVEL CER DISKECTOMY Tech 22858 761 3671 " 1,075.97 " 943.45 " 2,936.80 " 943.45 " 1,905.25 " N/A " 1,905.25 " N/A N/A " 1,872.21 " N/A " 2,202.60 " N/A N/A " 2,429.83 " N/A N/A N/A N/A N/A N/A N/A " 2,936.80 " N/A N/A " 2,459.57 " N/A " 1,501.44 " " 2,753.25 " " 1,395.35 " " 1,642.04 " N/A " 2,900.09 " 2621 22859 INSJ BIOMECHANICAL DEVICE Tech 22859 761 3089 905.39 793.87 " 2,471.20 " 793.87 " 1,603.19 " N/A " 1,603.19 " N/A N/A " 1,575.39 " N/A " 1,853.40 " N/A N/A " 2,044.61 " N/A N/A N/A N/A N/A N/A N/A " 2,471.20 " N/A N/A " 2,069.63 " N/A " 1,263.40 " " 2,316.75 " " 1,174.13 " " 1,381.71 " N/A " 2,440.31 " 2629 22861 REVISE CERV ARTIFIC DISC Tech 22861 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2612 22862 REVISE LUMBAR ARTIF DISC Tech 22862 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 2615 22864 REMOVE CERV ARTIF DISC Tech 22864 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2614 22865 REMOVE LUMB ARTIF DISC Tech 22865 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2618 22867 INSJ STABLJ DEV W/DCMPRN Tech 22867 761 83308 " 24,417.57 " " 14,036.36 " " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " N/A " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2636 22868 INSJ STABLJ DEV W/DCMPRN Tech 22868 761 2245 658.01 576.97 " 1,796.00 " 576.97 " 1,165.16 " N/A " 1,165.16 " N/A N/A " 1,144.95 " N/A " 1,347.00 " N/A N/A " 1,485.97 " N/A N/A N/A N/A N/A N/A N/A " 1,796.00 " N/A N/A " 1,504.15 " N/A 918.21 " 1,683.75 " 853.32 " 1,004.19 " N/A " 1,773.55 " 2627 22869 INSJ STABLJ DEV W/O DCMPRN Tech 22869 761 64652 " 18,949.50 " " 10,704.30 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " N/A " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2631 22870 INSJ STABLJ DEV W/O DCMPRN Tech 22870 761 1709 500.91 439.21 " 1,367.20 " 439.21 886.97 N/A 886.97 N/A N/A 871.59 N/A " 1,025.40 " N/A N/A " 1,131.19 " N/A N/A N/A N/A N/A N/A N/A " 1,367.20 " N/A N/A " 1,145.03 " N/A 698.98 " 1,281.75 " 649.59 764.44 N/A " 1,350.11 " 63801 22899 Unl Tot Disc Arthropla Cer 3rd Lvl Tech 22899 360 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2626 22900 EXC ABDL TUM DEEP < 5 CM Tech 22900 761 12443 " 3,647.04 " 837.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 837.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2665 22901 EXC ABDL TUM DEEP 5 CM/> Tech 22901 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2628 22902 EXC ABD LES SC < 3 CM Tech 22902 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2661 22903 EXC ABD LES SC 3 CM/> Tech 22903 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2637 22904 RADICAL RESECT ABD TUMOR<5CM Tech 22904 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2649 22905 RAD RESECT ABD TUMOR 5 CM/> Tech 22905 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 64682 22999 Unl Mesh Placement Deep Than SubQ Tech 22999 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2634 23000 REMOVAL OF CALCIUM DEPOSITS Tech 23000 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2641 23020 RELEASE SHOULDER JOINT Tech 23020 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2640 23030 DRAIN SHOULDER LESION Tech 23030 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2667 23031 DRAIN SHOULDER BURSA Tech 23031 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2652 23035 DRAIN SHOULDER BONE LESION Tech 23035 761 7310 " 2,142.56 " 860.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 860.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2656 23040 EXPLORATORY SHOULDER SURGERY Tech 23040 761 14860 " 4,355.47 " 959.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 959.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2651 23044 EXPLORATORY SHOULDER SURGERY Tech 23044 761 14860 " 4,355.47 " 959.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 959.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2663 23065 BIOPSY SHOULDER TISSUES Tech 23065 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2653 23066 BIOPSY SHOULDER TISSUES Tech 23066 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2671 23071 EXC SHOULDER LES SC 3 CM/> Tech 23071 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2664 23073 EXC SHOULDER TUM DEEP 5 CM/> Tech 23073 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2666 23075 EXC SHOULDER LES SC < 3 CM Tech 23075 761 7387 " 2,165.13 " 682.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 682.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2657 23076 EXC SHOULDER TUM DEEP < 5 CM Tech 23076 761 12443 " 3,647.04 " 837.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 837.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2676 23077 RESECT SHOULDER TUMOR < 5 CM Tech 23077 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2682 23078 RESECT SHOULDER TUMOR 5 CM/> Tech 23078 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2680 23105 REMOVE SHOULDER JOINT LINING Tech 23105 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2669 23107 EXPLORE TREAT SHOULDER JOINT Tech 23107 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2670 23120 PARTIAL REMOVAL COLLAR BONE Tech 23120 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2668 23125 REMOVAL OF COLLAR BONE Tech 23125 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2675 23130 REMOVE SHOULDER BONE PART Tech 23130 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2678 23140 REMOVAL OF BONE LESION Tech 23140 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2683 23146 REMOVAL OF BONE LESION Tech 23146 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2694 23150 REMOVAL OF HUMERUS LESION Tech 23150 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2697 23156 REMOVAL OF HUMERUS LESION Tech 23156 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2714 23170 REMOVE COLLAR BONE LESION Tech 23170 761 14860 " 4,355.47 " 860.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 860.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2708 23174 REMOVE HUMERUS LESION Tech 23174 761 32891 " 9,640.35 " 860.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 860.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2702 23180 REMOVE COLLAR BONE LESION Tech 23180 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2695 23182 REMOVE SHOULDER BLADE LESION Tech 23182 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2701 23184 REMOVE HUMERUS LESION Tech 23184 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2698 23190 PARTIAL REMOVAL OF SCAPULA Tech 23190 761 14860 " 4,355.47 " " 1,256.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,256.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2706 23195 REMOVAL OF HEAD OF HUMERUS Tech 23195 761 32891 " 9,640.35 " 520.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 520.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2700 23200 RESECT CLAVICLE TUMOR Tech 23200 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2709 23210 RESECT SCAPULA TUMOR Tech 23210 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2710 23220 RESECT PROX HUMERUS TUMOR Tech 23220 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 2747 23330 REMOVE SHOULDER FOREIGN BODY Tech 23330 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 720.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 2711 23333 REMOVE SHOULDER FB DEEP Tech 23333 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2707 23334 SHOULDER PROSTHESIS REMOVAL Tech 23334 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2717 23335 SHOULDER PROSTHESIS REMOVAL Tech 23335 761 4740 " 1,389.29 " " 1,218.18 " " 9,142.55 " " 1,218.18 " " 2,460.06 " N/A " 2,460.06 " N/A N/A " 2,417.40 " N/A " 2,844.00 " N/A N/A " 3,137.41 " N/A N/A " 7,314.09 " " 9,142.55 " N/A N/A N/A " 3,792.00 " N/A N/A " 3,175.80 " N/A " 1,938.66 " " 3,555.00 " " 1,801.67 " " 2,120.20 " N/A " 3,744.60 " 2723 23350 INJECTION FOR SHOULDER X-RAY Tech 23350 761 140 41.03 35.98 776.00 35.98 72.66 N/A 72.66 N/A N/A 71.40 N/A 84.00 N/A N/A 92.67 N/A N/A N/A N/A N/A N/A N/A 112.00 N/A 776.00 93.80 N/A 57.26 105.00 53.21 62.62 N/A 110.60 2718 23395 MUSCLE TRANSFER SHOULDER/ARM Tech 23395 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2725 23397 MUSCLE TRANSFERS Tech 23397 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2738 23400 FIXATION OF SHOULDER BLADE Tech 23400 761 32891 " 9,640.35 " 707.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 707.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2728 23405 INCISION OF TENDON & MUSCLE Tech 23405 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2720 23406 INCISE TENDON(S) & MUSCLE(S) Tech 23406 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2758 23410 REPAIR ROTATOR CUFF ACUTE Tech 23410 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2753 23412 REPAIR ROTATOR CUFF CHRONIC Tech 23412 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2752 23415 RELEASE OF SHOULDER LIGAMENT Tech 23415 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2742 23420 REPAIR OF SHOULDER Tech 23420 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2745 23430 REPAIR BICEPS TENDON Tech 23430 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2759 23440 REMOVE/TRANSPLANT TENDON Tech 23440 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2739 23450 REPAIR SHOULDER CAPSULE Tech 23450 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2751 23455 REPAIR SHOULDER CAPSULE Tech 23455 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2746 23460 REPAIR SHOULDER CAPSULE Tech 23460 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2743 23462 REPAIR SHOULDER CAPSULE Tech 23462 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2756 23465 REPAIR SHOULDER CAPSULE Tech 23465 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2744 23466 REPAIR SHOULDER CAPSULE Tech 23466 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2755 23470 RECONSTRUCT SHOULDER JOINT Tech 23470 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2757 23472 RECONSTRUCT SHOULDER JOINT Tech 23472 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " " 12,593.29 " " 12,782.97 " " 10,704.30 " " 12,593.29 " " 12,561.30 " " 12,593.29 " " 14,778.00 " " 10,704.30 " " 13,474.82 " " 16,302.60 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 19,704.00 " " 11,522.86 " N/A " 16,502.10 " " 11,082.10 " " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " " 12,845.16 " " 19,457.70 " 2767 23473 REVIS RECONST SHOULDER JOINT Tech 23473 761 64652 " 18,949.50 " " 10,704.30 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " N/A " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2754 23474 REVIS RECONST SHOULDER JOINT Tech 23474 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2763 23480 REVISION OF COLLAR BONE Tech 23480 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2783 23485 REVISION OF COLLAR BONE Tech 23485 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2784 23490 REINFORCE CLAVICLE Tech 23490 761 32891 " 9,640.35 " 276.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 276.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2769 23491 REINFORCE SHOULDER BONES Tech 23491 761 64652 " 18,949.50 " 443.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 443.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2777 23500 TREAT CLAVICLE FRACTURE Tech 23500 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2765 23505 TREAT CLAVICLE FRACTURE Tech 23505 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2773 23515 TREAT CLAVICLE FRACTURE Tech 23515 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2780 23520 TREAT CLAVICLE DISLOCATION Tech 23520 761 7310 " 2,142.56 " 67.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 67.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2782 23525 TREAT CLAVICLE DISLOCATION Tech 23525 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2779 23530 TREAT CLAVICLE DISLOCATION Tech 23530 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2804 23532 TREAT CLAVICLE DISLOCATION Tech 23532 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2789 23540 TREAT CLAVICLE DISLOCATION Tech 23540 761 1082 317.13 63.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 63.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2775 23550 TREAT CLAVICLE DISLOCATION Tech 23550 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2786 23552 TREAT CLAVICLE DISLOCATION Tech 23552 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2785 23570 TREAT SHOULDER BLADE FX Tech 23570 761 1082 317.13 73.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 73.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2798 23585 TREAT SCAPULA FRACTURE Tech 23585 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2808 23600 TREAT HUMERUS FRACTURE Tech 23600 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2793 23605 TREAT HUMERUS FRACTURE Tech 23605 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2807 23615 TREAT HUMERUS FRACTURE Tech 23615 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2803 23616 TREAT HUMERUS FRACTURE Tech 23616 761 83308 " 24,417.57 " " 14,036.36 " " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " N/A " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2810 23620 TREAT HUMERUS FRACTURE Tech 23620 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2811 23625 TREAT HUMERUS FRACTURE Tech 23625 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2814 23630 TREAT HUMERUS FRACTURE Tech 23630 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2802 23650 TREAT SHOULDER DISLOCATION Tech 23650 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2799 23655 TREAT SHOULDER DISLOCATION Tech 23655 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2824 23660 TREAT SHOULDER DISLOCATION Tech 23660 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2834 23665 TREAT DISLOCATION/FRACTURE Tech 23665 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2805 23670 TREAT DISLOCATION/FRACTURE Tech 23670 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2830 23680 TREAT DISLOCATION/FRACTURE Tech 23680 761 64652 " 18,949.50 " 525.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 525.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2848 23700 FIXATION OF SHOULDER Tech 23700 761 7310 " 2,142.56 " 567.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 567.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2817 23800 FUSION OF SHOULDER JOINT Tech 23800 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2837 23802 FUSION OF SHOULDER JOINT Tech 23802 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2840 23900 AMPUTATION OF ARM & GIRDLE Tech 23900 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 2818 23920 AMPUTATION AT SHOULDER JOINT Tech 23920 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 2831 23929 Unl Open Humeral Head Core Decompr Tech 23929 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2833 23930 DRAINAGE OF ARM LESION Tech 23930 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2828 23931 DRAINAGE OF ARM BURSA Tech 23931 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2855 23935 DRAIN ARM/ELBOW BONE LESION Tech 23935 761 14860 " 4,355.47 " 860.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 860.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2852 24000 EXPLORATORY ELBOW SURGERY Tech 24000 761 14860 " 4,355.47 " 916.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 916.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2838 24006 RELEASE ELBOW JOINT Tech 24006 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2844 24065 BIOPSY ARM/ELBOW SOFT TISSUE Tech 24065 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2847 24066 BIOPSY ARM/ELBOW SOFT TISSUE Tech 24066 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2843 24071 EXC ARM/ELBOW LES SC 3 CM/> Tech 24071 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2859 24073 EX ARM/ELBOW TUM DEEP 5 CM/> Tech 24073 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2853 24075 EXC ARM/ELBOW LES SC < 3 CM Tech 24075 761 7387 " 2,165.13 " 682.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 682.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2862 24076 EX ARM/ELBOW TUM DEEP < 5 CM Tech 24076 761 12443 " 3,647.04 " 837.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 837.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2863 24077 RESECT ARM/ELBOW TUM < 5 CM Tech 24077 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2858 24079 RESECT ARM/ELBOW TUM 5 CM/> Tech 24079 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2875 24101 EXPLORE/TREAT ELBOW JOINT Tech 24101 761 14860 " 4,355.47 " 916.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 916.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2869 24102 REMOVE ELBOW JOINT LINING Tech 24102 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2876 24105 REMOVAL OF ELBOW BURSA Tech 24105 761 14860 " 4,355.47 " 765.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 765.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2856 24110 REMOVE HUMERUS LESION Tech 24110 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2874 24115 REMOVE/GRAFT BONE LESION Tech 24115 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2880 24116 REMOVE/GRAFT BONE LESION Tech 24116 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2867 24120 REMOVE ELBOW LESION Tech 24120 761 14860 " 4,355.47 " 689.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 689.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2871 24126 REMOVE/GRAFT BONE LESION Tech 24126 761 32891 " 9,640.35 " 689.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 689.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2897 24130 REMOVAL OF HEAD OF RADIUS Tech 24130 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2882 24134 REMOVAL OF ARM BONE LESION Tech 24134 761 32891 " 9,640.35 " 860.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 860.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2877 24140 PARTIAL REMOVAL OF ARM BONE Tech 24140 761 14860 " 4,355.47 " 939.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 939.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2879 24145 PARTIAL REMOVAL OF RADIUS Tech 24145 761 32891 " 9,640.35 " 939.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 939.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2892 24147 PARTIAL REMOVAL OF ELBOW Tech 24147 761 14860 " 4,355.47 " 939.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 939.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2906 24149 RADICAL RESECTION OF ELBOW Tech 24149 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2883 24150 RESECT DISTAL HUMERUS TUMOR Tech 24150 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2887 24160 REMOVE ELBOW JOINT IMPLANT Tech 24160 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2891 24164 REMOVE RADIUS HEAD IMPLANT Tech 24164 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2888 24200 REMOVAL OF ARM FOREIGN BODY Tech 24200 761 7387 " 2,165.13 " 777.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 777.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 2896 24201 REMOVAL OF ARM FOREIGN BODY Tech 24201 761 12443 " 3,647.04 " 720.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 720.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 2916 24220 INJECTION FOR ELBOW X-RAY Tech 24220 761 248 72.69 35.00 198.40 63.74 128.71 N/A 128.71 N/A N/A 126.48 N/A 148.80 N/A N/A 164.15 N/A N/A N/A N/A N/A N/A N/A 198.40 N/A 35.00 166.16 N/A 101.43 186.00 94.26 110.93 N/A 195.92 65458 INJ FOR ARTHROGRAM ELBOW Tech 24220 761 248 72.69 35.00 198.40 63.74 128.71 N/A 128.71 N/A N/A 126.48 N/A 148.80 N/A N/A 164.15 N/A N/A N/A N/A N/A N/A N/A 198.40 N/A 35.00 166.16 N/A 101.43 186.00 94.26 110.93 N/A 195.92 2900 24300 MANIPULATE ELBOW W/ANESTH Tech 24300 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2903 24301 MUSCLE/TENDON TRANSFER Tech 24301 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2910 24305 ARM TENDON LENGTHENING Tech 24305 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2901 24310 REVISION OF ARM TENDON Tech 24310 761 14860 " 4,355.47 " 753.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 753.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2914 24332 TENOLYSIS TRICEPS Tech 24332 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2912 24340 REPAIR OF BICEPS TENDON Tech 24340 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2923 24341 REPAIR ARM TENDON/MUSCLE Tech 24341 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2911 24342 REPAIR OF RUPTURED TENDON Tech 24342 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2925 24343 REPR ELBOW LAT LIGMNT W/TISS Tech 24343 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2924 24344 RECONSTRUCT ELBOW LAT LIGMNT Tech 24344 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2932 24345 REPR ELBW MED LIGMNT W/TISSU Tech 24345 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2920 24346 RECONSTRUCT ELBOW MED LIGMNT Tech 24346 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2946 24358 REPAIR ELBOW W/DEB OPEN Tech 24358 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2921 24359 REPAIR ELBOW DEB/ATTCH OPEN Tech 24359 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 2926 24360 RECONSTRUCT ELBOW JOINT Tech 24360 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2928 24363 REPLACE ELBOW JOINT Tech 24363 761 83308 " 24,417.57 " " 14,036.36 " " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " N/A " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2927 24366 RECONSTRUCT HEAD OF RADIUS Tech 24366 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2943 24370 REVISE RECONST ELBOW JOINT Tech 24370 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2933 24371 REVISE RECONST ELBOW JOINT Tech 24371 761 83308 " 24,417.57 " 776.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 776.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2939 24400 REVISION OF HUMERUS Tech 24400 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2942 24420 REVISION OF HUMERUS Tech 24420 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2965 24430 REPAIR OF HUMERUS Tech 24430 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2952 24435 REPAIR HUMERUS WITH GRAFT Tech 24435 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2948 24495 DECOMPRESSION OF FOREARM Tech 24495 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2947 24498 REINFORCE HUMERUS Tech 24498 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2958 24500 TREAT HUMERUS FRACTURE Tech 24500 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2974 24505 TREAT HUMERUS FRACTURE Tech 24505 761 7310 " 2,142.56 " 740.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 740.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2944 24515 TREAT HUMERUS FRACTURE Tech 24515 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2967 24516 TREAT HUMERUS FRACTURE Tech 24516 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2951 24530 TREAT HUMERUS FRACTURE Tech 24530 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2950 24535 TREAT HUMERUS FRACTURE Tech 24535 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2954 24538 TREAT HUMERUS FRACTURE Tech 24538 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2955 24545 TREAT HUMERUS FRACTURE Tech 24545 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2966 24546 TREAT HUMERUS FRACTURE Tech 24546 761 83308 " 24,417.57 " 776.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 776.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 2962 24560 TREAT HUMERUS FRACTURE Tech 24560 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2971 24565 TREAT HUMERUS FRACTURE Tech 24565 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2985 24566 TREAT HUMERUS FRACTURE Tech 24566 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2964 24575 TREAT HUMERUS FRACTURE Tech 24575 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2982 24576 TREAT HUMERUS FRACTURE Tech 24576 761 1082 317.13 111.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 111.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2991 24577 TREAT HUMERUS FRACTURE Tech 24577 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2972 24579 TREAT HUMERUS FRACTURE Tech 24579 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2992 24582 TREAT HUMERUS FRACTURE Tech 24582 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2984 24586 TREAT ELBOW FRACTURE Tech 24586 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3005 24587 TREAT ELBOW FRACTURE Tech 24587 761 64652 " 18,949.50 " 780.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 780.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 2990 24600 TREAT ELBOW DISLOCATION Tech 24600 761 1082 317.13 102.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 102.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 2989 24605 TREAT ELBOW DISLOCATION Tech 24605 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 2981 24615 TREAT ELBOW DISLOCATION Tech 24615 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3002 24620 TREAT ELBOW FRACTURE Tech 24620 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3019 24635 TREAT ELBOW FRACTURE Tech 24635 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3008 24640 TREAT ELBOW DISLOCATION Tech 24640 700 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3010 24650 TREAT RADIUS FRACTURE Tech 24650 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3012 24655 TREAT RADIUS FRACTURE Tech 24655 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3000 24665 TREAT RADIUS FRACTURE Tech 24665 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 2993 24666 TREAT RADIUS FRACTURE Tech 24666 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3014 24670 TREAT ULNAR FRACTURE Tech 24670 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3003 24675 TREAT ULNAR FRACTURE Tech 24675 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3024 24685 TREAT ULNAR FRACTURE Tech 24685 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3027 24800 FUSION OF ELBOW JOINT Tech 24800 761 32891 " 9,640.35 " 598.50 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 598.50 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3016 24802 FUSION/GRAFT OF ELBOW JOINT Tech 24802 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3025 24900 AMPUTATION OF UPPER ARM Tech 24900 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 3031 24920 AMPUTATION OF UPPER ARM Tech 24920 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 3037 24925 AMPUTATION FOLLOW-UP SURGERY Tech 24925 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3013 24930 AMPUTATION FOLLOW-UP SURGERY Tech 24930 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3018 24935 REVISION OF AMPUTATION Tech 24935 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 64683 24999 Unl Fasciotomy of Upper Arm Tech 24999 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3022 25000 INCISION OF TENDON SHEATH Tech 25000 761 7310 " 2,142.56 " 550.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 550.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3042 25001 INCISE FLEXOR CARPI RADIALIS Tech 25001 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3036 25020 DECOMPRESS FOREARM 1 SPACE Tech 25020 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3047 25023 DECOMPRESS FOREARM 1 SPACE Tech 25023 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3041 25024 DECOMPRESS FOREARM 2 SPACES Tech 25024 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3055 25025 DECOMPRESS FOREARM 2 SPACES Tech 25025 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3044 25028 DRAINAGE OF FOREARM LESION Tech 25028 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3064 25031 DRAINAGE OF FOREARM BURSA Tech 25031 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3048 25035 TREAT FOREARM BONE LESION Tech 25035 761 32891 " 9,640.35 " 860.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 860.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3075 25040 EXPLORE/TREAT WRIST JOINT Tech 25040 761 14860 " 4,355.47 " 634.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 634.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3034 25065 BIOPSY FOREARM SOFT TISSUES Tech 25065 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3045 25066 BIOPSY FOREARM SOFT TISSUES Tech 25066 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3050 25071 EXC FOREARM LES SC 3 CM/> Tech 25071 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3057 25073 EXC FOREARM TUM DEEP 3 CM/> Tech 25073 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3087 25075 EXC FOREARM LES SC < 3 CM Tech 25075 761 7387 " 2,165.13 " 837.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 837.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3056 25076 EXC FOREARM TUM DEEP < 3 CM Tech 25076 761 7387 " 2,165.13 " 837.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 837.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3052 25077 RESECT FOREARM/WRIST TUM<3CM Tech 25077 761 12443 " 3,647.04 " " 2,058.32 " " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " N/A " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3066 25078 RESECT FORARM/WRIST TUM 3CM> Tech 25078 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3076 25085 INCISION OF WRIST CAPSULE Tech 25085 761 14860 " 4,355.47 " 634.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 634.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3077 25100 BIOPSY OF WRIST JOINT Tech 25100 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3072 25101 EXPLORE/TREAT WRIST JOINT Tech 25101 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3082 25105 REMOVE WRIST JOINT LINING Tech 25105 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3083 25107 REMOVE WRIST JOINT CARTILAGE Tech 25107 761 14860 " 4,355.47 " 634.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 634.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3067 25109 EXCISE TENDON FOREARM/WRIST Tech 25109 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3104 25110 REMOVE WRIST TENDON LESION Tech 25110 761 7310 " 2,142.56 " 691.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 691.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3069 25111 REMOVE WRIST TENDON LESION Tech 25111 761 7310 " 2,142.56 " 854.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 854.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3080 25112 REREMOVE WRIST TENDON LESION Tech 25112 761 7310 " 2,142.56 " 854.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 854.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3091 25115 REMOVE WRIST/FOREARM LESION Tech 25115 761 7310 " 2,142.56 " 819.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 819.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3086 25116 REMOVE WRIST/FOREARM LESION Tech 25116 761 14860 " 4,355.47 " 819.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 819.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3074 25118 EXCISE WRIST TENDON SHEATH Tech 25118 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3079 25119 PARTIAL REMOVAL OF ULNA Tech 25119 761 14860 " 4,355.47 " 768.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 768.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3092 25120 REMOVAL OF FOREARM LESION Tech 25120 761 14860 " 4,355.47 " 746.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 746.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3098 25126 REMOVE/GRAFT FOREARM LESION Tech 25126 761 14860 " 4,355.47 " 746.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 746.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3093 25130 REMOVAL OF WRIST LESION Tech 25130 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3089 25135 REMOVE & GRAFT WRIST LESION Tech 25135 761 32891 " 9,640.35 " 695.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 695.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3101 25145 REMOVE FOREARM BONE LESION Tech 25145 761 14860 " 4,355.47 " 860.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 860.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3095 25150 PARTIAL REMOVAL OF ULNA Tech 25150 761 14860 " 4,355.47 " 904.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 904.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3106 25151 PARTIAL REMOVAL OF RADIUS Tech 25151 761 14860 " 4,355.47 " 904.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 904.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3103 25170 RESECT RADIUS/ULNAR TUMOR Tech 25170 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3117 25210 REMOVAL OF WRIST BONE Tech 25210 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3107 25215 REMOVAL OF WRIST BONES Tech 25215 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3109 25230 PARTIAL REMOVAL OF RADIUS Tech 25230 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3116 25240 PARTIAL REMOVAL OF ULNA Tech 25240 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 65456 25246 INJ FOR ARTHROGRAM WRIST Tech 25246 761 184 53.93 35.00 147.20 47.29 95.50 N/A 95.50 N/A N/A 93.84 N/A 110.40 N/A N/A 121.79 N/A N/A N/A N/A N/A N/A N/A 147.20 N/A 35.00 123.28 N/A 75.26 138.00 69.94 82.30 N/A 145.36 3128 25248 REMOVE FOREARM FOREIGN BODY Tech 25248 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3110 25250 REMOVAL OF WRIST PROSTHESIS Tech 25250 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3130 25251 REMOVAL OF WRIST PROSTHESIS Tech 25251 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3122 25259 MANIPULATE WRIST W/ANESTHES Tech 25259 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3121 25260 REPAIR FOREARM TENDON/MUSCLE Tech 25260 761 14860 " 4,355.47 " 849.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 849.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3143 25263 REPAIR FOREARM TENDON/MUSCLE Tech 25263 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3142 25265 REPAIR FOREARM TENDON/MUSCLE Tech 25265 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3127 25270 REPAIR FOREARM TENDON/MUSCLE Tech 25270 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3129 25272 REPAIR FOREARM TENDON/MUSCLE Tech 25272 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3139 25274 REPAIR FOREARM TENDON/MUSCLE Tech 25274 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3138 25275 REPAIR FOREARM TENDON SHEATH Tech 25275 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3131 25280 REVISE WRIST/FOREARM TENDON Tech 25280 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3136 25290 INCISE WRIST/FOREARM TENDON Tech 25290 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3135 25295 RELEASE WRIST/FOREARM TENDON Tech 25295 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3148 25300 FUSION OF TENDONS AT WRIST Tech 25300 761 14860 " 4,355.47 " 987.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 987.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3150 25301 FUSION OF TENDONS AT WRIST Tech 25301 761 14860 " 4,355.47 " 987.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 987.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3152 25310 TRANSPLANT FOREARM TENDON Tech 25310 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3154 25312 TRANSPLANT FOREARM TENDON Tech 25312 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3177 25315 REVISE PALSY HAND TENDON(S) Tech 25315 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3159 25316 REVISE PALSY HAND TENDON(S) Tech 25316 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3182 25320 REPAIR/REVISE WRIST JOINT Tech 25320 761 32891 " 9,640.35 " 597.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 597.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3153 25332 REVISE WRIST JOINT Tech 25332 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3160 25335 REALIGNMENT OF HAND Tech 25335 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3179 25337 RECONSTRUCT ULNA/RADIOULNAR Tech 25337 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3174 25350 REVISION OF RADIUS Tech 25350 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3158 25355 REVISION OF RADIUS Tech 25355 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3187 25360 REVISION OF ULNA Tech 25360 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3175 25365 REVISE RADIUS & ULNA Tech 25365 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3185 25390 SHORTEN RADIUS OR ULNA Tech 25390 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3197 25391 LENGTHEN RADIUS OR ULNA Tech 25391 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3161 25392 SHORTEN RADIUS & ULNA Tech 25392 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3180 25394 REPAIR CARPAL BONE SHORTEN Tech 25394 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3191 25400 REPAIR RADIUS OR ULNA Tech 25400 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3170 25405 REPAIR/GRAFT RADIUS OR ULNA Tech 25405 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3198 25415 REPAIR RADIUS & ULNA Tech 25415 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3178 25420 REPAIR/GRAFT RADIUS & ULNA Tech 25420 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3221 25425 REPAIR/GRAFT RADIUS OR ULNA Tech 25425 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3190 25430 VASC GRAFT INTO CARPAL BONE Tech 25430 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3196 25431 REPAIR NONUNION CARPAL BONE Tech 25431 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3186 25440 REPAIR/GRAFT WRIST BONE Tech 25440 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3206 25441 RECONSTRUCT WRIST JOINT Tech 25441 761 64652 " 18,949.50 " 749.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 749.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3195 25442 RECONSTRUCT WRIST JOINT Tech 25442 761 83308 " 24,417.57 " 776.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 776.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 3213 25444 RECONSTRUCT WRIST JOINT Tech 25444 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3215 25446 WRIST REPLACEMENT Tech 25446 761 83308 " 24,417.57 " 749.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 749.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 3199 25447 REPAIR WRIST JOINTS Tech 25447 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3220 25449 REMOVE WRIST JOINT IMPLANT Tech 25449 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3208 25450 REVISION OF WRIST JOINT Tech 25450 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3224 25490 REINFORCE RADIUS Tech 25490 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3212 25491 REINFORCE ULNA Tech 25491 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3210 25500 TREAT FRACTURE OF RADIUS Tech 25500 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3209 25505 TREAT FRACTURE OF RADIUS Tech 25505 761 7310 " 2,142.56 " 619.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 619.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3216 25515 TREAT FRACTURE OF RADIUS Tech 25515 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3225 25520 TREAT FRACTURE OF RADIUS Tech 25520 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3226 25525 TREAT FRACTURE OF RADIUS Tech 25525 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3238 25526 TREAT FRACTURE OF RADIUS Tech 25526 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3235 25530 TREAT FRACTURE OF ULNA Tech 25530 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3227 25535 TREAT FRACTURE OF ULNA Tech 25535 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3247 25545 TREAT FRACTURE OF ULNA Tech 25545 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3229 25560 TREAT FRACTURE RADIUS & ULNA Tech 25560 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3233 25565 TREAT FRACTURE RADIUS & ULNA Tech 25565 761 7310 " 2,142.56 " 688.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 688.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3249 25574 TREAT FRACTURE RADIUS & ULNA Tech 25574 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3239 25575 TREAT FRACTURE RADIUS/ULNA Tech 25575 761 32891 " 9,640.35 " " 1,202.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,202.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3236 25600 TREAT FRACTURE RADIUS/ULNA Tech 25600 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3240 25605 TREAT FRACTURE RADIUS/ULNA Tech 25605 761 7310 " 2,142.56 " 994.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 994.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3253 25606 TREAT FX DISTAL RADIAL Tech 25606 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3288 25607 TREAT FX RAD EXTRA-ARTICUL Tech 25607 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3276 25608 TREAT FX RAD INTRA-ARTICUL Tech 25608 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3241 25609 TREAT FX RADIAL 3+ FRAG Tech 25609 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3251 25622 TREAT WRIST BONE FRACTURE Tech 25622 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3246 25624 TREAT WRIST BONE FRACTURE Tech 25624 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3250 25628 TREAT WRIST BONE FRACTURE Tech 25628 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3261 25630 TREAT WRIST BONE FRACTURE Tech 25630 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3266 25635 TREAT WRIST BONE FRACTURE Tech 25635 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3269 25645 TREAT WRIST BONE FRACTURE Tech 25645 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3271 25650 TREAT WRIST BONE FRACTURE Tech 25650 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3263 25651 PIN ULNAR STYLOID FRACTURE Tech 25651 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3258 25652 TREAT FRACTURE ULNAR STYLOID Tech 25652 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3273 25660 TREAT WRIST DISLOCATION Tech 25660 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3278 25670 TREAT WRIST DISLOCATION Tech 25670 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3316 25671 PIN RADIOULNAR DISLOCATION Tech 25671 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3281 25675 TREAT WRIST DISLOCATION Tech 25675 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3286 25676 TREAT WRIST DISLOCATION Tech 25676 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3275 25680 TREAT WRIST FRACTURE Tech 25680 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3284 25685 TREAT WRIST FRACTURE Tech 25685 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3295 25690 TREAT WRIST DISLOCATION Tech 25690 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3303 25695 TREAT WRIST DISLOCATION Tech 25695 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3287 25800 FUSION OF WRIST JOINT Tech 25800 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3285 25805 FUSION/GRAFT OF WRIST JOINT Tech 25805 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3293 25810 FUSION/GRAFT OF WRIST JOINT Tech 25810 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3296 25820 FUSION OF HAND BONES Tech 25820 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3302 25825 FUSE HAND BONES WITH GRAFT Tech 25825 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3299 25830 FUSION RADIOULNAR JNT/ULNA Tech 25830 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3314 25900 AMPUTATION OF FOREARM Tech 25900 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3306 25905 AMPUTATION OF FOREARM Tech 25905 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 3297 25907 AMPUTATION FOLLOW-UP SURGERY Tech 25907 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3308 25909 AMPUTATION FOLLOW-UP SURGERY Tech 25909 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3305 25920 AMPUTATE HAND AT WRIST Tech 25920 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3311 25927 AMPUTATION OF HAND Tech 25927 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 3313 26010 DRAINAGE OF FINGER ABSCESS Tech 26010 761 943 276.39 155.89 776.00 242.35 489.42 183.40 489.42 155.89 183.40 480.93 183.40 565.80 155.89 196.24 624.17 165.06 183.40 554.11 692.63 181.57 187.07 183.40 754.40 167.81 776.00 631.81 161.39 385.69 707.25 358.43 421.80 187.07 744.97 3321 26011 DRAINAGE OF FINGER ABSCESS Tech 26011 761 7387 " 2,165.13 " 700.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 700.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3328 26020 DRAIN HAND TENDON SHEATH Tech 26020 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3329 26025 DRAINAGE OF PALM BURSA Tech 26025 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3315 26030 DRAINAGE OF PALM BURSAS Tech 26030 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3320 26034 TREAT HAND BONE LESION Tech 26034 761 7310 " 2,142.56 " 860.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 860.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3323 26035 DECOMPRESS FINGERS/HAND Tech 26035 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3326 26037 DECOMPRESS FINGERS/HAND Tech 26037 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3324 26040 RELEASE PALM CONTRACTURE Tech 26040 761 7310 " 2,142.56 " 844.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 844.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3330 26045 RELEASE PALM CONTRACTURE Tech 26045 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3344 26055 INCISE FINGER TENDON SHEATH Tech 26055 761 7310 " 2,142.56 " 643.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 643.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 64684 26060 Tenotomy Percut Single Each Digit Tech 26060 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3349 26070 EXPLORE/TREAT HAND JOINT Tech 26070 761 7310 " 2,142.56 " 678.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 678.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3336 26075 EXPLORE/TREAT FINGER JOINT Tech 26075 761 14860 " 4,355.47 " 852.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 852.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3337 26080 EXPLORE/TREAT FINGER JOINT Tech 26080 761 7310 " 2,142.56 " 571.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 571.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3360 26100 BIOPSY HAND JOINT LINING Tech 26100 761 14860 " 4,355.47 " 742.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 742.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3334 26105 BIOPSY FINGER JOINT LINING Tech 26105 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3346 26110 BIOPSY FINGER JOINT LINING Tech 26110 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3355 26111 EXC HAND LES SC 1.5 CM/> Tech 26111 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3351 26113 EXC HAND TUM DEEP 1.5 CM/> Tech 26113 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3352 26115 EXC HAND LES SC < 1.5 CM Tech 26115 761 7387 " 2,165.13 " 741.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 741.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3342 26116 EXC HAND TUM DEEP < 1.5 CM Tech 26116 761 7387 " 2,165.13 " 804.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 804.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3394 26117 RAD RESECT HAND TUMOR < 3 CM Tech 26117 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3361 26118 RAD RESECT HAND TUMOR 3 CM/> Tech 26118 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3390 26121 RELEASE PALM CONTRACTURE Tech 26121 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3364 26123 RELEASE PALM CONTRACTURE Tech 26123 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3379 26125 RELEASE PALM CONTRACTURE Tech 26125 761 3483 " 1,020.87 " 895.13 " 2,786.40 " 895.13 " 1,807.68 " N/A " 1,807.68 " N/A N/A " 1,776.33 " N/A " 2,089.80 " N/A N/A " 2,305.40 " N/A N/A N/A N/A N/A N/A N/A " 2,786.40 " N/A N/A " 2,333.61 " N/A " 1,424.55 " " 2,612.25 " " 1,323.89 " " 1,557.95 " N/A " 2,751.57 " 3350 26130 REMOVE WRIST JOINT LINING Tech 26130 761 14860 " 4,355.47 " 834.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 834.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3362 26135 REVISE FINGER JOINT EACH Tech 26135 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3376 26145 TENDON EXCISION PALM/FINGER Tech 26145 761 7310 " 2,142.56 " 201.50 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 201.50 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3366 26160 REMOVE TENDON SHEATH LESION Tech 26160 761 7310 " 2,142.56 " 775.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 775.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3384 26170 REMOVAL OF PALM TENDON EACH Tech 26170 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3400 26180 REMOVAL OF FINGER TENDON Tech 26180 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3389 26185 REMOVE FINGER BONE Tech 26185 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3377 26200 REMOVE HAND BONE LESION Tech 26200 761 7310 " 2,142.56 " 765.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 765.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3369 26205 REMOVE/GRAFT BONE LESION Tech 26205 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3411 26210 REMOVAL OF FINGER LESION Tech 26210 761 7310 " 2,142.56 " 440.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 440.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3382 26215 REMOVE/GRAFT FINGER LESION Tech 26215 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3381 26230 PARTIAL REMOVAL OF HAND BONE Tech 26230 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3385 26235 PARTIAL REMOVAL FINGER BONE Tech 26235 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3403 26236 PARTIAL REMOVAL FINGER BONE Tech 26236 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3391 26320 REMOVAL OF IMPLANT FROM HAND Tech 26320 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3395 26340 MANIPULATE FINGER W/ANESTH Tech 26340 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3388 26341 MANIPULAT PALM CORD POST INJ Tech 26341 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3409 26350 REPAIR FINGER/HAND TENDON Tech 26350 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3402 26352 REPAIR/GRAFT HAND TENDON Tech 26352 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3417 26356 REPAIR FINGER/HAND TENDON Tech 26356 761 14860 " 4,355.47 " 849.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 849.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3398 26357 REPAIR FINGER/HAND TENDON Tech 26357 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3404 26358 REPAIR/GRAFT HAND TENDON Tech 26358 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3401 26370 REPAIR FINGER/HAND TENDON Tech 26370 761 14860 " 4,355.47 " 849.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 849.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3423 26372 REPAIR/GRAFT HAND TENDON Tech 26372 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3415 26373 REPAIR FINGER/HAND TENDON Tech 26373 761 14860 " 4,355.47 " 849.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 849.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3419 26390 REVISE HAND/FINGER TENDON Tech 26390 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3414 26392 REPAIR/GRAFT HAND TENDON Tech 26392 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3416 26410 REPAIR HAND TENDON Tech 26410 761 7310 " 2,142.56 " 808.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 808.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3432 26412 REPAIR/GRAFT HAND TENDON Tech 26412 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3424 26415 EXCISION HAND/FINGER TENDON Tech 26415 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3429 26416 GRAFT HAND OR FINGER TENDON Tech 26416 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3437 26418 REPAIR FINGER TENDON Tech 26418 761 7310 " 2,142.56 " 809.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 809.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3433 26420 REPAIR/GRAFT FINGER TENDON Tech 26420 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3441 26426 REPAIR FINGER/HAND TENDON Tech 26426 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3425 26428 REPAIR/GRAFT FINGER TENDON Tech 26428 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3455 26432 REPAIR FINGER TENDON Tech 26432 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3434 26433 REPAIR FINGER TENDON Tech 26433 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3435 26434 REPAIR/GRAFT FINGER TENDON Tech 26434 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3453 26437 REALIGNMENT OF TENDONS Tech 26437 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3445 26440 RELEASE PALM/FINGER TENDON Tech 26440 761 7310 " 2,142.56 " 744.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 744.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3440 26442 RELEASE PALM & FINGER TENDON Tech 26442 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3467 26445 RELEASE HAND/FINGER TENDON Tech 26445 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3449 26449 RELEASE FOREARM/HAND TENDON Tech 26449 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3458 26450 INCISION OF PALM TENDON Tech 26450 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3474 26455 INCISION OF FINGER TENDON Tech 26455 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3452 26460 INCISE HAND/FINGER TENDON Tech 26460 761 7310 " 2,142.56 " 940.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 940.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3460 26471 FUSION OF FINGER TENDONS Tech 26471 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3457 26476 TENDON LENGTHENING Tech 26476 761 14860 " 4,355.47 " 808.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 808.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3447 26477 TENDON SHORTENING Tech 26477 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3473 26478 LENGTHENING OF HAND TENDON Tech 26478 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3462 26479 SHORTENING OF HAND TENDON Tech 26479 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3464 26480 TRANSPLANT HAND TENDON Tech 26480 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3487 26483 TRANSPLANT/GRAFT HAND TENDON Tech 26483 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3468 26485 TRANSPLANT PALM TENDON Tech 26485 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3469 26489 TRANSPLANT/GRAFT PALM TENDON Tech 26489 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3472 26490 REVISE THUMB TENDON Tech 26490 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 64240 "26492 Opponensplasty; W/Graft, Ea Tendon Tech" 26492 0 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3488 26494 HAND TENDON/MUSCLE TRANSFER Tech 26494 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3479 26496 REVISE THUMB TENDON Tech 26496 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3503 26497 FINGER TENDON TRANSFER Tech 26497 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3498 26498 FINGER TENDON TRANSFER Tech 26498 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3471 26499 REVISION OF FINGER Tech 26499 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3486 26500 HAND TENDON RECONSTRUCTION Tech 26500 761 32891 " 9,640.35 " " 1,001.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,001.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3499 26502 HAND TENDON RECONSTRUCTION Tech 26502 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3483 26508 RELEASE THUMB CONTRACTURE Tech 26508 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3519 26516 FUSION OF KNUCKLE JOINT Tech 26516 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3491 26518 FUSION OF KNUCKLE JOINTS Tech 26518 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3497 26520 RELEASE KNUCKLE CONTRACTURE Tech 26520 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3493 26525 RELEASE FINGER CONTRACTURE Tech 26525 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3502 26530 REVISE KNUCKLE JOINT Tech 26530 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3508 26531 REVISE KNUCKLE WITH IMPLANT Tech 26531 761 32891 " 9,640.35 " " 1,030.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,030.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3507 26535 REVISE FINGER JOINT Tech 26535 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3528 26536 REVISE/IMPLANT FINGER JOINT Tech 26536 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3515 26540 REPAIR HAND JOINT Tech 26540 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3505 26541 REPAIR HAND JOINT WITH GRAFT Tech 26541 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3526 26542 REPAIR HAND JOINT WITH GRAFT Tech 26542 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3510 26545 RECONSTRUCT FINGER JOINT Tech 26545 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3521 26546 REPAIR NONUNION HAND Tech 26546 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3512 26548 RECONSTRUCT FINGER JOINT Tech 26548 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3541 26550 CONSTRUCT THUMB REPLACEMENT Tech 26550 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3529 26560 REPAIR OF WEB FINGER Tech 26560 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3518 26561 REPAIR OF WEB FINGER Tech 26561 761 14860 " 4,355.47 " 905.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 905.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3543 26562 REPAIR OF WEB FINGER Tech 26562 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3534 26565 CORRECT METACARPAL FLAW Tech 26565 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3546 26567 CORRECT FINGER DEFORMITY Tech 26567 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3531 26568 LENGTHEN METACARPAL/FINGER Tech 26568 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3542 26580 REPAIR HAND DEFORMITY Tech 26580 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3551 26587 RECONSTRUCT EXTRA FINGER Tech 26587 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3536 26590 REPAIR FINGER DEFORMITY Tech 26590 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3537 26591 REPAIR MUSCLES OF HAND Tech 26591 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3533 26593 RELEASE MUSCLES OF HAND Tech 26593 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3553 26600 TREAT METACARPAL FRACTURE Tech 26600 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3550 26605 TREAT METACARPAL FRACTURE Tech 26605 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3562 26607 TREAT METACARPAL FRACTURE Tech 26607 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3575 26608 TREAT METACARPAL FRACTURE Tech 26608 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3556 26615 TREAT METACARPAL FRACTURE Tech 26615 761 14860 " 4,355.47 " 873.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 873.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3539 26641 TREAT THUMB DISLOCATION Tech 26641 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3555 26645 TREAT THUMB FRACTURE Tech 26645 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3563 26650 TREAT THUMB FRACTURE Tech 26650 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3558 26665 TREAT THUMB FRACTURE Tech 26665 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3548 26670 TREAT HAND DISLOCATION Tech 26670 761 1082 317.13 48.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 48.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3572 26675 TREAT HAND DISLOCATION Tech 26675 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3570 26676 PIN HAND DISLOCATION Tech 26676 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3559 26685 TREAT HAND DISLOCATION Tech 26685 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3585 26686 TREAT HAND DISLOCATION Tech 26686 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3566 26700 TREAT KNUCKLE DISLOCATION Tech 26700 761 1082 317.13 39.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 39.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3576 26705 TREAT KNUCKLE DISLOCATION Tech 26705 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3591 26706 PIN KNUCKLE DISLOCATION Tech 26706 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3577 26715 TREAT KNUCKLE DISLOCATION Tech 26715 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3574 26720 TREAT FINGER FRACTURE EACH Tech 26720 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3582 26725 TREAT FINGER FRACTURE EACH Tech 26725 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 731.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3578 26727 TREAT FINGER FRACTURE EACH Tech 26727 761 14860 " 4,355.47 " 900.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 900.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3583 26735 TREAT FINGER FRACTURE EACH Tech 26735 761 14860 " 4,355.47 " 900.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 900.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3602 26740 TREAT FINGER FRACTURE EACH Tech 26740 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3598 26742 TREAT FINGER FRACTURE EACH Tech 26742 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3590 26746 TREAT FINGER FRACTURE EACH Tech 26746 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3603 26750 TREAT FINGER FRACTURE EACH Tech 26750 761 1082 317.13 48.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 48.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3586 26755 TREAT FINGER FRACTURE EACH Tech 26755 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3596 26756 PIN FINGER FRACTURE EACH Tech 26756 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3593 26765 TREAT FINGER FRACTURE EACH Tech 26765 761 14860 " 4,355.47 " 832.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 832.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3595 26770 TREAT FINGER DISLOCATION Tech 26770 761 1082 317.13 36.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 36.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3626 26775 TREAT FINGER DISLOCATION Tech 26775 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 3618 26776 PIN FINGER DISLOCATION Tech 26776 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3606 26785 TREAT FINGER DISLOCATION Tech 26785 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3629 26841 FUSION OF THUMB Tech 26841 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3601 26842 THUMB FUSION WITH GRAFT Tech 26842 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3616 26843 FUSION OF HAND JOINT Tech 26843 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3630 26844 FUSION/GRAFT OF HAND JOINT Tech 26844 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3612 26850 FUSION OF KNUCKLE Tech 26850 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3622 26852 FUSION OF KNUCKLE WITH GRAFT Tech 26852 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3617 26860 FUSION OF FINGER JOINT Tech 26860 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3620 26861 FUSION OF FINGER JNT ADD-ON Tech 26861 761 798 233.89 205.09 638.40 205.09 414.16 N/A 414.16 N/A N/A 406.98 N/A 478.80 N/A N/A 528.20 N/A N/A N/A N/A N/A N/A N/A 638.40 N/A N/A 534.66 N/A 326.38 598.50 303.32 356.95 N/A 630.42 3634 26862 FUSION/GRAFT OF FINGER JOINT Tech 26862 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3653 26910 AMPUTATE METACARPAL BONE Tech 26910 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3633 26951 AMPUTATION OF FINGER/THUMB Tech 26951 761 14860 " 4,355.47 " 526.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 526.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3636 26952 AMPUTATION OF FINGER/THUMB Tech 26952 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3642 26989 Unl Capsulodesis Carpometa Joint Tech 26989 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3646 26989 Unl Open Tx Hand Fx Dsloc Not Thmb Tech 26989 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3669 26990 DRAINAGE OF PELVIS LESION Tech 26990 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3628 26991 DRAINAGE OF PELVIS BURSA Tech 26991 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3667 26992 DRAINAGE OF BONE LESION Tech 26992 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3643 27000 INCISION OF HIP TENDON Tech 27000 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3657 27001 INCISION OF HIP TENDON Tech 27001 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3661 27003 INCISION OF HIP TENDON Tech 27003 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3649 27005 INCISION OF HIP TENDON Tech 27005 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3650 27006 INCISION OF HIP TENDONS Tech 27006 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3678 27025 INCISION OF HIP/THIGH FASCIA Tech 27025 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3648 27027 BUTTOCK FASCIOTOMY Tech 27027 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3659 27030 DRAINAGE OF HIP JOINT Tech 27030 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3663 27033 EXPLORATION OF HIP JOINT Tech 27033 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3655 27036 EXCISION OF HIP JOINT/MUSCLE Tech 27036 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3660 27040 BIOPSY OF SOFT TISSUES Tech 27040 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3681 27041 BIOPSY OF SOFT TISSUES Tech 27041 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3671 27043 EXC HIP PELVIS LES SC 3 CM/> Tech 27043 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3682 27045 EXC HIP/PELV TUM DEEP 5 CM/> Tech 27045 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3683 27047 EXC HIP/PELVIS LES SC < 3 CM Tech 27047 761 12443 " 3,647.04 " 682.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 682.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3680 27048 EXC HIP/PELV TUM DEEP < 5 CM Tech 27048 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3688 27049 RESECT HIP/PELV TUM < 5 CM Tech 27049 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3698 27050 BIOPSY OF SACROILIAC JOINT Tech 27050 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3706 27054 REMOVAL OF HIP JOINT LINING Tech 27054 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 3684 27057 BUTTOCK FASCIOTOMY W/DBRDMT Tech 27057 761 7310 " 2,142.56 " " 1,209.13 " " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " N/A " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3689 27059 RESECT HIP/PELV TUM 5 CM/> Tech 27059 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3729 27060 REMOVAL OF ISCHIAL BURSA Tech 27060 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3687 27062 REMOVE FEMUR LESION/BURSA Tech 27062 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3694 27065 REMOVE HIP BONE LES SUPER Tech 27065 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3713 27066 REMOVE HIP BONE LES DEEP Tech 27066 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3686 27070 PART REMOVE HIP BONE SUPER Tech 27070 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3700 27071 PART REMOVAL HIP BONE DEEP Tech 27071 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3711 27075 RESECT HIP TUMOR Tech 27075 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3731 27076 RESECT HIP TUM INCL ACETABUL Tech 27076 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3692 27078 RSECT HIP TUM INCL FEMUR Tech 27078 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 3710 27080 REMOVAL OF TAIL BONE Tech 27080 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3703 27086 REMOVE HIP FOREIGN BODY Tech 27086 761 12443 " 3,647.04 " 777.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 777.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3723 27087 REMOVE HIP FOREIGN BODY Tech 27087 761 14860 " 4,355.47 " 720.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 720.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3707 27090 REMOVAL OF HIP PROSTHESIS Tech 27090 761 12443 " 3,647.04 " " 3,197.85 " " 9,954.40 " " 3,197.85 " " 6,457.92 " N/A " 6,457.92 " N/A N/A " 6,345.93 " N/A " 7,465.80 " N/A N/A " 8,236.02 " N/A N/A " 7,314.09 " " 9,142.55 " N/A N/A N/A " 9,954.40 " N/A N/A " 8,336.81 " N/A " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " N/A " 9,829.97 " 3709 27091 REMOVAL OF HIP PROSTHESIS Tech 27091 761 4740 " 1,389.29 " " 1,218.18 " " 9,142.55 " " 1,218.18 " " 2,460.06 " N/A " 2,460.06 " N/A N/A " 2,417.40 " N/A " 2,844.00 " N/A N/A " 3,137.41 " N/A N/A " 7,314.09 " " 9,142.55 " N/A N/A N/A " 3,792.00 " N/A N/A " 3,175.80 " N/A " 1,938.66 " " 3,555.00 " " 1,801.67 " " 2,120.20 " N/A " 3,744.60 " 65466 27093 INJ FOR ARTHROGRAM HIP Tech 27093 761 116 34.00 29.81 92.80 29.81 60.20 N/A 60.20 N/A N/A 59.16 N/A 69.60 N/A N/A 76.78 N/A N/A N/A N/A N/A N/A N/A 92.80 N/A 48.00 77.72 N/A 47.44 87.00 44.09 51.89 N/A 91.64 3718 27095 INJECTION FOR HIP X-RAY Tech 27095 761 3648 " 1,069.23 " 776.00 " 2,918.40 " 937.54 " 1,893.31 " N/A " 1,893.31 " N/A N/A " 1,860.48 " N/A " 2,188.80 " N/A N/A " 2,414.61 " N/A N/A N/A N/A N/A N/A N/A " 2,918.40 " N/A 776.00 " 2,444.16 " N/A " 1,492.03 " " 2,736.00 " " 1,386.60 " " 1,631.75 " N/A " 2,881.92 " 3740 27096 INJECT SACROILIAC JOINT Tech 27096 761 3332 976.61 61.19 " 2,665.60 " 856.32 " 1,729.31 " N/A " 1,729.31 " N/A N/A " 1,699.32 " N/A " 1,999.20 " N/A N/A " 2,205.45 " N/A N/A N/A N/A N/A N/A N/A " 2,665.60 " N/A 61.19 " 2,232.44 " N/A " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " N/A " 2,632.28 " 3721 27097 REVISION OF HIP TENDON Tech 27097 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3739 27100 TRANSFER OF ABDOMINAL MUSCLE Tech 27100 761 32891 " 9,640.35 " 560.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 560.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3733 27120 RECONSTRUCTION OF HIP SOCKET Tech 27120 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 3746 27122 RECONSTRUCTION OF HIP SOCKET Tech 27122 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3720 27125 PARTIAL HIP REPLACEMENT Tech 27125 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3741 27130 TOTAL HIP ARTHROPLASTY Tech 27130 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3730 27132 TOTAL HIP ARTHROPLASTY Tech 27132 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3751 27134 REVISE HIP JOINT REPLACEMENT Tech 27134 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3757 27137 REVISE HIP JOINT REPLACEMENT Tech 27137 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3728 27138 REVISE HIP JOINT REPLACEMENT Tech 27138 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3742 27140 TRANSPLANT FEMUR RIDGE Tech 27140 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3750 27146 INCISION OF HIP BONE Tech 27146 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3743 27147 REVISION OF HIP BONE Tech 27147 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3756 27151 INCISION OF HIP BONES Tech 27151 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3749 27156 REVISION OF HIP BONES Tech 27156 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3760 27158 REVISION OF PELVIS Tech 27158 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3761 27161 INCISION OF NECK OF FEMUR Tech 27161 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3763 27165 INCISION/FIXATION OF FEMUR Tech 27165 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3755 27170 REPAIR/GRAFT FEMUR HEAD/NECK Tech 27170 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3774 27176 TREAT SLIPPED EPIPHYSIS Tech 27176 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3762 27177 TREAT SLIPPED EPIPHYSIS Tech 27177 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3764 27178 TREAT SLIPPED EPIPHYSIS Tech 27178 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3771 27179 REVISE HEAD/NECK OF FEMUR Tech 27179 761 32891 " 9,640.35 " 598.50 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 598.50 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3782 27181 TREAT SLIPPED EPIPHYSIS Tech 27181 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3779 27185 REVISION OF FEMUR EPIPHYSIS Tech 27185 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3777 27187 REINFORCE HIP BONES Tech 27187 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3770 27197 CLSD TX PELVIC RING FX Tech 27197 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3788 27198 CLSD TX PELVIC RING FX Tech 27198 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3785 27200 TREAT TAIL BONE FRACTURE Tech 27200 761 1082 317.13 46.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 46.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3781 27202 TREAT TAIL BONE FRACTURE Tech 27202 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3790 27215 TREAT PELVIC FRACTURE(S) Tech 27215 761 6202 " 1,817.81 " 912.29 " 4,961.60 " " 1,593.91 " " 3,218.84 " N/A " 3,218.84 " N/A N/A " 3,163.02 " N/A " 3,721.20 " N/A N/A " 4,105.10 " N/A N/A 912.29 " 1,140.36 " N/A N/A N/A " 4,961.60 " N/A N/A " 4,155.34 " N/A " 2,536.62 " " 4,651.50 " " 2,357.38 " " 2,774.15 " N/A " 4,899.58 " 3780 27216 TREAT PELVIC RING FRACTURE Tech 27216 761 4600 " 1,348.26 " 676.64 " 3,680.00 " " 1,182.20 " " 2,387.40 " N/A " 2,387.40 " N/A N/A " 2,346.00 " N/A " 2,760.00 " N/A N/A " 3,044.74 " N/A N/A 676.64 845.80 N/A N/A N/A " 3,680.00 " N/A 776.00 " 3,082.00 " N/A " 1,881.40 " " 3,450.00 " " 1,748.46 " " 2,057.58 " N/A " 3,634.00 " 3791 27217 TREAT PELVIC RING FRACTURE Tech 27217 761 7766 " 2,276.21 " " 1,142.34 " " 6,212.80 " " 1,995.86 " " 4,030.55 " N/A " 4,030.55 " N/A N/A " 3,960.66 " N/A " 4,659.60 " N/A N/A " 5,140.32 " N/A N/A " 1,142.34 " " 1,427.93 " N/A N/A N/A " 6,212.80 " N/A N/A " 5,203.22 " N/A " 3,176.29 " " 5,824.50 " " 2,951.86 " " 3,473.73 " N/A " 6,135.14 " 3797 27218 TREAT PELVIC RING FRACTURE Tech 27218 761 10627 " 3,114.77 " " 1,563.19 " " 8,501.60 " " 2,731.14 " " 5,515.41 " N/A " 5,515.41 " N/A N/A " 5,419.77 " N/A " 6,376.20 " N/A N/A " 7,034.01 " N/A N/A " 1,563.19 " " 1,953.99 " N/A N/A N/A " 8,501.60 " N/A N/A " 7,120.09 " N/A " 4,346.44 " " 7,970.25 " " 4,039.32 " " 4,753.46 " N/A " 8,395.33 " 3802 27220 TREAT HIP SOCKET FRACTURE Tech 27220 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3807 27222 TREAT HIP SOCKET FRACTURE Tech 27222 761 1082 317.13 278.07 865.60 278.07 561.56 N/A 561.56 N/A N/A 551.82 N/A 649.20 N/A N/A 716.18 N/A N/A 636.32 795.40 N/A N/A N/A 865.60 N/A N/A 724.94 N/A 442.54 811.50 411.27 483.98 N/A 854.78 3789 27226 TREAT HIP WALL FRACTURE Tech 27226 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3793 27227 TREAT HIP FRACTURE(S) Tech 27227 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3794 27228 TREAT HIP FRACTURE(S) Tech 27228 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3809 27230 TREAT THIGH FRACTURE Tech 27230 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 262.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3801 27232 TREAT THIGH FRACTURE Tech 27232 761 7310 " 2,142.56 " " 1,878.67 " " 5,848.00 " " 1,878.67 " " 3,793.89 " N/A " 3,793.89 " N/A N/A " 3,728.10 " N/A " 4,386.00 " N/A N/A " 4,838.49 " N/A N/A " 4,296.93 " " 5,371.13 " N/A N/A N/A " 5,848.00 " N/A N/A " 4,897.70 " N/A " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " N/A " 5,774.90 " 3805 27235 TREAT THIGH FRACTURE Tech 27235 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3817 27236 TREAT THIGH FRACTURE Tech 27236 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3826 27238 TREAT THIGH FRACTURE Tech 27238 761 7310 " 2,142.56 " 243.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 243.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3825 27240 TREAT THIGH FRACTURE Tech 27240 761 2785 816.28 715.75 " 5,371.13 " 715.75 " 1,445.42 " N/A " 1,445.42 " N/A N/A " 1,420.35 " N/A " 1,671.00 " N/A N/A " 1,843.39 " N/A N/A " 4,296.93 " " 5,371.13 " N/A N/A N/A " 2,228.00 " N/A N/A " 1,865.95 " N/A " 1,139.07 " " 2,088.75 " " 1,058.58 " " 1,245.73 " N/A " 2,200.15 " 3812 27244 TREAT THIGH FRACTURE Tech 27244 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3821 27245 TREAT THIGH FRACTURE Tech 27245 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3819 27246 TREAT THIGH FRACTURE Tech 27246 761 1082 317.13 112.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 112.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3829 27248 TREAT THIGH FRACTURE Tech 27248 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3814 27250 TREAT HIP DISLOCATION Tech 27250 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 204.65 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3835 27252 TREAT HIP DISLOCATION Tech 27252 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3822 27253 TREAT HIP DISLOCATION Tech 27253 761 5661 " 1,659.24 " " 1,454.88 " " 10,918.55 " " 1,454.88 " " 2,938.06 " N/A " 2,938.06 " N/A N/A " 2,887.11 " N/A " 3,396.60 " N/A N/A " 3,747.02 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 4,528.80 " N/A N/A " 3,792.87 " N/A " 2,315.35 " " 4,245.75 " " 2,151.75 " " 2,532.17 " N/A " 4,472.19 " 3827 27254 TREAT HIP DISLOCATION Tech 27254 761 5661 " 1,659.24 " " 1,454.88 " " 10,918.55 " " 1,454.88 " " 2,938.06 " N/A " 2,938.06 " N/A N/A " 2,887.11 " N/A " 3,396.60 " N/A N/A " 3,747.02 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 4,528.80 " N/A N/A " 3,792.87 " N/A " 2,315.35 " " 4,245.75 " " 2,151.75 " " 2,532.17 " N/A " 4,472.19 " 3840 27256 TREAT HIP DISLOCATION Tech 27256 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3838 27257 TREAT HIP DISLOCATION Tech 27257 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3862 27258 TREAT HIP DISLOCATION Tech 27258 761 5661 " 1,659.24 " " 1,454.88 " " 10,918.55 " " 1,454.88 " " 2,938.06 " N/A " 2,938.06 " N/A N/A " 2,887.11 " N/A " 3,396.60 " N/A N/A " 3,747.02 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 4,528.80 " N/A N/A " 3,792.87 " N/A " 2,315.35 " " 4,245.75 " " 2,151.75 " " 2,532.17 " N/A " 4,472.19 " 3834 27259 TREAT HIP DISLOCATION Tech 27259 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 3831 27265 TREAT HIP DISLOCATION Tech 27265 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 237.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3839 27266 TREAT HIP DISLOCATION Tech 27266 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3841 27267 CLTX THIGH FX Tech 27267 761 14860 " 4,355.47 " 292.40 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 292.40 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3837 27268 CLTX THIGH FX W/MNPJ Tech 27268 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 3854 27269 OPTX THIGH FX Tech 27269 761 7310 " 2,142.56 " " 1,878.67 " " 5,848.00 " " 1,878.67 " " 3,793.89 " N/A " 3,793.89 " N/A N/A " 3,728.10 " N/A " 4,386.00 " N/A N/A " 4,838.49 " N/A N/A " 4,296.93 " " 5,371.13 " N/A N/A N/A " 5,848.00 " N/A N/A " 4,897.70 " N/A " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " N/A " 5,774.90 " 3843 27275 MANIPULATION OF HIP JOINT Tech 27275 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 3866 27279 ARTHRODESIS SACROILIAC JOINT Tech 27279 761 83308 " 24,417.57 " " 14,036.36 " " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " N/A " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 3845 27280 FUSION OF SACROILIAC JOINT Tech 27280 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 3853 27282 FUSION OF PUBIC BONES Tech 27282 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3873 27284 FUSION OF HIP JOINT Tech 27284 761 83308 " 24,417.57 " " 21,410.16 " " 66,646.40 " " 21,410.16 " " 43,236.85 " N/A " 43,236.85 " N/A N/A " 42,487.08 " N/A " 49,984.80 " N/A N/A " 55,141.57 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 66,646.40 " N/A N/A " 55,816.36 " N/A " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " N/A " 65,813.32 " 3850 27290 AMPUTATION OF LEG AT HIP Tech 27290 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 3878 27295 AMPUTATION OF LEG AT HIP Tech 27295 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 3851 27299 UNL HIP CORE DECOMPRESSION Tech 27299 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3857 "27299 Open rt hip anterior arthrotomy,hip,cam,pincer Tech" 27299 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3861 27299 Open right gluteus medius repair Tech 27299 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4359 27299 Unl Perc Pin Acetabular Fracture Tech 27299 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 64242 27299 Unl Hip Capsule Repair Tech 27299 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 64496 27299 Unl IT Band Repair Tech 27299 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 3863 27301 DRAIN THIGH/KNEE LESION Tech 27301 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3858 27303 DRAINAGE OF BONE LESION Tech 27303 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 3871 27305 INCISE THIGH TENDON & FASCIA Tech 27305 761 14860 " 4,355.47 " 603.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 603.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3875 27306 INCISION OF THIGH TENDON Tech 27306 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3877 27307 INCISION OF THIGH TENDONS Tech 27307 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3891 27310 EXPLORATION OF KNEE JOINT Tech 27310 761 14860 " 4,355.47 " 895.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 895.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3872 27323 BIOPSY THIGH SOFT TISSUES Tech 27323 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3881 27324 BIOPSY THIGH SOFT TISSUES Tech 27324 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3899 27325 NEURECTOMY HAMSTRING Tech 27325 761 9211 " 2,699.74 " 776.00 " 7,368.80 " " 2,367.23 " " 4,780.51 " " 1,793.31 " " 4,780.51 " " 1,524.31 " " 1,793.31 " " 4,697.61 " " 1,793.31 " " 5,526.60 " " 1,524.31 " " 1,918.84 " " 6,096.76 " " 1,613.98 " " 1,793.31 " " 5,414.22 " " 6,767.73 " " 1,775.38 " " 1,829.18 " " 1,793.31 " " 7,368.80 " " 1,640.88 " 776.00 " 6,171.37 " " 1,578.11 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,829.18 " " 7,276.69 " 3907 27326 NEURECTOMY POPLITEAL Tech 27326 761 9211 " 2,699.74 " 776.00 " 7,368.80 " " 2,367.23 " " 4,780.51 " " 1,793.31 " " 4,780.51 " " 1,524.31 " " 1,793.31 " " 4,697.61 " " 1,793.31 " " 5,526.60 " " 1,524.31 " " 1,918.84 " " 6,096.76 " " 1,613.98 " " 1,793.31 " " 5,414.22 " " 6,767.73 " " 1,775.38 " " 1,829.18 " " 1,793.31 " " 7,368.80 " " 1,640.88 " 776.00 " 6,171.37 " " 1,578.11 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,829.18 " " 7,276.69 " 3887 27327 EXC THIGH/KNEE LES SC < 3 CM Tech 27327 761 7387 " 2,165.13 " 837.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 837.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 3904 27328 EXC THIGH/KNEE TUM DEEP <5CM Tech 27328 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3882 27329 RESECT THIGH/KNEE TUM < 5 CM Tech 27329 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3894 27330 BIOPSY KNEE JOINT LINING Tech 27330 761 14860 " 4,355.47 " 756.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 756.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3893 27331 EXPLORE/TREAT KNEE JOINT Tech 27331 761 14860 " 4,355.47 " 895.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 895.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 64685 27332 Arthro Meniscectomy Knee Med/Lat Tech 27332 0 14860 " 4,355.47 " " 1,006.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,006.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3889 27334 REMOVE KNEE JOINT LINING Tech 27334 761 14860 " 4,355.47 " 963.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 963.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3902 27335 REMOVE KNEE JOINT LINING Tech 27335 761 32891 " 9,640.35 " 963.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 963.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3903 27337 EXC THIGH/KNEE LES SC 3 CM/> Tech 27337 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3900 27339 EXC THIGH/KNEE TUM DEP 5CM/> Tech 27339 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3918 27340 REMOVAL OF KNEECAP BURSA Tech 27340 761 14860 " 4,355.47 " 793.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 793.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3909 27345 REMOVAL OF KNEE CYST Tech 27345 761 14860 " 4,355.47 " 704.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 704.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3911 27347 REMOVE KNEE CYST Tech 27347 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3906 27350 REMOVAL OF KNEECAP Tech 27350 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3923 27355 REMOVE FEMUR LESION Tech 27355 761 14860 " 4,355.47 " 788.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 788.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3912 27356 REMOVE FEMUR LESION/GRAFT Tech 27356 761 64652 " 18,949.50 " 788.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 788.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3928 27357 REMOVE FEMUR LESION/GRAFT Tech 27357 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3937 27358 REMOVE FEMUR LESION/FIXATION Tech 27358 761 5208 " 1,526.46 " 263.66 " 4,166.40 " " 1,338.46 " " 2,702.95 " N/A " 2,702.95 " N/A N/A " 2,656.08 " N/A " 3,124.80 " N/A N/A " 3,447.18 " N/A N/A N/A N/A N/A N/A N/A " 4,166.40 " N/A 263.66 " 3,489.36 " N/A " 2,130.07 " " 3,906.00 " " 1,979.56 " " 2,329.54 " N/A " 4,114.32 " 3929 27360 PARTIAL REMOVAL LEG BONE(S) Tech 27360 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3939 27364 RESECT THIGH/KNEE TUM 5 CM/> Tech 27364 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3921 27365 RESECT FEMUR/KNEE TUMOR Tech 27365 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3936 27369 NJX CNTRST KNE ARTHG/CT/MRI Tech 27369 761 787 230.67 33.25 629.60 202.26 408.45 N/A 408.45 N/A N/A 401.37 N/A 472.20 N/A N/A 520.92 N/A N/A N/A N/A N/A N/A N/A 629.60 N/A 33.25 527.29 N/A 321.88 590.25 299.14 352.03 N/A 621.73 65472 INJ FOR ARTHROGRAM KNEE Tech 27369 761 787 230.67 33.25 629.60 202.26 408.45 N/A 408.45 N/A N/A 401.37 N/A 472.20 N/A N/A 520.92 N/A N/A N/A N/A N/A N/A N/A 629.60 N/A 33.25 527.29 N/A 321.88 590.25 299.14 352.03 N/A 621.73 3925 27372 REMOVAL OF FOREIGN BODY Tech 27372 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 3943 27380 REPAIR OF KNEECAP TENDON Tech 27380 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3959 27381 REPAIR/GRAFT KNEECAP TENDON Tech 27381 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3953 27385 REPAIR OF THIGH MUSCLE Tech 27385 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3940 27386 REPAIR/GRAFT OF THIGH MUSCLE Tech 27386 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3944 27390 INCISION OF THIGH TENDON Tech 27390 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3964 27391 INCISION OF THIGH TENDONS Tech 27391 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3927 27392 INCISION OF THIGH TENDONS Tech 27392 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3933 27393 LENGTHENING OF THIGH TENDON Tech 27393 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3952 27394 LENGTHENING OF THIGH TENDONS Tech 27394 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3951 27395 LENGTHENING OF THIGH TENDONS Tech 27395 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3942 27396 TRANSPLANT OF THIGH TENDON Tech 27396 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3969 27400 REVISE THIGH MUSCLES/TENDONS Tech 27400 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3989 27403 REPAIR OF KNEE CARTILAGE Tech 27403 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3954 27405 REPAIR OF KNEE LIGAMENT Tech 27405 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3955 27407 REPAIR OF KNEE LIGAMENT Tech 27407 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3975 27409 REPAIR OF KNEE LIGAMENTS Tech 27409 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3968 27412 AUTOCHONDROCYTE IMPLANT KNEE Tech 27412 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3961 27415 OSTEOCHONDRAL KNEE ALLOGRAFT Tech 27415 761 64652 " 18,949.50 " " 10,704.30 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " N/A " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3960 27416 OSTEOCHONDRAL KNEE AUTOGRAFT Tech 27416 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3981 27418 REPAIR DEGENERATED KNEECAP Tech 27418 761 32891 " 9,640.35 " " 1,039.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,039.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3985 27420 REVISION OF UNSTABLE KNEECAP Tech 27420 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3976 27422 REVISION OF UNSTABLE KNEECAP Tech 27422 761 32891 " 9,640.35 " 688.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 688.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3987 27424 REVISION/REMOVAL OF KNEECAP Tech 27424 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3967 27425 LAT RETINACULAR RELEASE OPEN Tech 27425 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3979 27427 RECONSTRUCTION KNEE Tech 27427 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3999 27428 RECONSTRUCTION KNEE Tech 27428 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3977 27429 RECONSTRUCTION KNEE Tech 27429 761 64652 " 18,949.50 " " 1,000.00 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " " 1,000.00 " " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 3991 27430 REVISION OF THIGH MUSCLES Tech 27430 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 3978 27435 INCISION OF KNEE JOINT Tech 27435 761 14860 " 4,355.47 " 833.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 833.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 3996 27437 REVISE KNEECAP Tech 27437 761 32891 " 9,640.35 " " 1,039.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,039.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4011 27438 REVISE KNEECAP WITH IMPLANT Tech 27438 761 64652 " 18,949.50 " 743.79 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 743.79 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4002 27445 REVISION OF KNEE JOINT Tech 27445 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 3988 27446 REVISION OF KNEE JOINT Tech 27446 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4001 27447 TOTAL KNEE ARTHROPLASTY Tech 27447 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4030 27448 INCISION OF THIGH Tech 27448 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 3994 27450 INCISION OF THIGH Tech 27450 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4008 27454 REALIGNMENT OF THIGH BONE Tech 27454 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4017 27455 REALIGNMENT OF KNEE Tech 27455 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4024 27457 REALIGNMENT OF KNEE Tech 27457 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4023 27465 SHORTENING OF THIGH BONE Tech 27465 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4004 27466 LENGTHENING OF THIGH BONE Tech 27466 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4029 27468 SHORTEN/LENGTHEN THIGHS Tech 27468 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4010 27470 REPAIR OF THIGH Tech 27470 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4022 27472 REPAIR/GRAFT OF THIGH Tech 27472 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4034 27475 SURGERY TO STOP LEG GROWTH Tech 27475 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4009 27477 SURGERY TO STOP LEG GROWTH Tech 27477 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4028 27479 SURGERY TO STOP LEG GROWTH Tech 27479 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4019 27485 SURGERY TO STOP LEG GROWTH Tech 27485 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4032 27486 REVISE/REPLACE KNEE JOINT Tech 27486 761 24630 " 7,219.05 " 776.00 " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A 776.00 " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 4035 27487 REVISE/REPLACE KNEE JOINT Tech 27487 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 4031 27488 REMOVAL OF KNEE PROSTHESIS Tech 27488 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4043 27495 REINFORCE THIGH Tech 27495 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4041 27496 DECOMPRESSION OF THIGH/KNEE Tech 27496 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4060 27497 DECOMPRESSION OF THIGH/KNEE Tech 27497 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4033 27498 DECOMPRESSION OF THIGH/KNEE Tech 27498 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4047 27499 DECOMPRESSION OF THIGH/KNEE Tech 27499 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4048 27500 TREATMENT OF THIGH FRACTURE Tech 27500 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4056 27501 TREATMENT OF THIGH FRACTURE Tech 27501 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4053 27502 TREATMENT OF THIGH FRACTURE Tech 27502 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4054 27503 TREATMENT OF THIGH FRACTURE Tech 27503 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4065 27506 TREATMENT OF THIGH FRACTURE Tech 27506 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4078 27507 TREATMENT OF THIGH FRACTURE Tech 27507 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4069 27508 TREATMENT OF THIGH FRACTURE Tech 27508 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4083 27509 TREATMENT OF THIGH FRACTURE Tech 27509 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4057 27510 TREATMENT OF THIGH FRACTURE Tech 27510 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4055 27511 TREATMENT OF THIGH FRACTURE Tech 27511 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4062 27513 TREATMENT OF THIGH FRACTURE Tech 27513 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4063 27514 TREATMENT OF THIGH FRACTURE Tech 27514 761 12530 " 3,672.54 " 776.00 " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A 776.00 " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4059 27516 TREAT THIGH FX GROWTH PLATE Tech 27516 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 244.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4080 27517 TREAT THIGH FX GROWTH PLATE Tech 27517 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4084 27519 TREAT THIGH FX GROWTH PLATE Tech 27519 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4122 27520 TREAT KNEECAP FRACTURE Tech 27520 761 1082 317.13 131.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 131.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4075 27524 TREAT KNEECAP FRACTURE Tech 27524 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4071 27530 TREAT KNEE FRACTURE Tech 27530 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4070 27532 TREAT KNEE FRACTURE Tech 27532 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4098 27535 TREAT KNEE FRACTURE Tech 27535 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4090 27536 TREAT KNEE FRACTURE Tech 27536 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4077 27538 TREAT KNEE FRACTURE(S) Tech 27538 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4088 27540 TREAT KNEE FRACTURE Tech 27540 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4086 27550 TREAT KNEE DISLOCATION Tech 27550 761 1082 317.13 157.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 157.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4093 27552 TREAT KNEE DISLOCATION Tech 27552 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4097 27556 TREAT KNEE DISLOCATION Tech 27556 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4092 27557 TREAT KNEE DISLOCATION Tech 27557 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4096 27558 TREAT KNEE DISLOCATION Tech 27558 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4099 27560 TREAT KNEECAP DISLOCATION Tech 27560 761 1082 317.13 102.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 102.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4104 27562 TREAT KNEECAP DISLOCATION Tech 27562 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4112 27566 TREAT KNEECAP DISLOCATION Tech 27566 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4127 27570 FIXATION OF KNEE JOINT Tech 27570 761 7310 " 2,142.56 " 695.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 695.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4103 27580 FUSION OF KNEE Tech 27580 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 4134 27590 AMPUTATE LEG AT THIGH Tech 27590 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 4130 27591 AMPUTATE LEG AT THIGH Tech 27591 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 4111 27592 AMPUTATE LEG AT THIGH Tech 27592 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 4107 27594 AMPUTATION FOLLOW-UP SURGERY Tech 27594 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4109 27596 AMPUTATION FOLLOW-UP SURGERY Tech 27596 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4121 27598 AMPUTATE LOWER LEG AT KNEE Tech 27598 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 4128 27600 DECOMPRESSION OF LOWER LEG Tech 27600 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4124 27601 DECOMPRESSION OF LOWER LEG Tech 27601 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4118 27602 DECOMPRESSION OF LOWER LEG Tech 27602 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4131 27603 DRAIN LOWER LEG LESION Tech 27603 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4129 27604 DRAIN LOWER LEG BURSA Tech 27604 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4126 27605 INCISION OF ACHILLES TENDON Tech 27605 761 7310 " 2,142.56 " 878.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 878.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4143 27606 INCISION OF ACHILLES TENDON Tech 27606 761 14860 " 4,355.47 " 878.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 878.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4149 27607 TREAT LOWER LEG BONE LESION Tech 27607 761 14860 " 4,355.47 " 860.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 860.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4147 27610 EXPLORE/TREAT ANKLE JOINT Tech 27610 761 14860 " 4,355.47 " 869.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 869.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4161 27612 EXPLORATION OF ANKLE JOINT Tech 27612 761 14860 " 4,355.47 " " 1,300.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,300.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4150 27613 BIOPSY LOWER LEG SOFT TISSUE Tech 27613 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4139 27614 BIOPSY LOWER LEG SOFT TISSUE Tech 27614 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4144 27615 RESECT LEG/ANKLE TUM < 5 CM Tech 27615 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4168 27616 RESECT LEG/ANKLE TUM 5 CM/> Tech 27616 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4146 27618 EXC LEG/ANKLE TUM < 3 CM Tech 27618 761 7387 " 2,165.13 " 682.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 682.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4160 27619 EXC LEG/ANKLE TUM DEEP <5 CM Tech 27619 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4183 27620 EXPLORE/TREAT ANKLE JOINT Tech 27620 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4174 27625 REMOVE ANKLE JOINT LINING Tech 27625 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4173 27626 REMOVE ANKLE JOINT LINING Tech 27626 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4157 27630 REMOVAL OF TENDON LESION Tech 27630 761 14860 " 4,355.47 " 817.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 817.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4166 27632 EXC LEG/ANKLE LES SC 3 CM/> Tech 27632 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4171 27634 EXC LEG/ANKLE TUM DEP 5 CM/> Tech 27634 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4178 27635 REMOVE LOWER LEG BONE LESION Tech 27635 761 14860 " 4,355.47 " 673.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 673.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4165 27637 REMOVE/GRAFT LEG BONE LESION Tech 27637 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4163 27638 REMOVE/GRAFT LEG BONE LESION Tech 27638 761 32891 " 9,640.35 " 673.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 673.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4169 27640 PARTIAL REMOVAL OF TIBIA Tech 27640 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4190 27641 PARTIAL REMOVAL OF FIBULA Tech 27641 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4176 27645 RESECT TIBIA TUMOR Tech 27645 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4185 27646 RESECT FIBULA TUMOR Tech 27646 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4177 27647 RESECT TALUS/CALCANEUS TUM Tech 27647 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4182 27648 INJECTION FOR ANKLE X-RAY Tech 27648 761 324 94.96 25.00 259.20 83.27 168.16 N/A 168.16 N/A N/A 165.24 N/A 194.40 N/A N/A 214.46 N/A N/A N/A N/A N/A N/A N/A 259.20 N/A 25.00 217.08 N/A 132.52 243.00 123.15 144.93 N/A 255.96 65463 INJ FOR ARTHROGRAM ANKLE Tech 27648 761 324 94.96 25.00 259.20 83.27 168.16 N/A 168.16 N/A N/A 165.24 N/A 194.40 N/A N/A 214.46 N/A N/A N/A N/A N/A N/A N/A 259.20 N/A 25.00 217.08 N/A 132.52 243.00 123.15 144.93 N/A 255.96 4196 27650 REPAIR ACHILLES TENDON Tech 27650 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4197 27652 REPAIR/GRAFT ACHILLES TENDON Tech 27652 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4200 27654 REPAIR OF ACHILLES TENDON Tech 27654 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4192 27656 REPAIR LEG FASCIA DEFECT Tech 27656 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4207 27658 REPAIR OF LEG TENDON EACH Tech 27658 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4193 27659 REPAIR OF LEG TENDON EACH Tech 27659 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4195 27664 REPAIR OF LEG TENDON EACH Tech 27664 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4191 27665 REPAIR OF LEG TENDON EACH Tech 27665 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4201 27675 REPAIR LOWER LEG TENDONS Tech 27675 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4204 27676 REPAIR LOWER LEG TENDONS Tech 27676 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4205 27680 RELEASE OF LOWER LEG TENDON Tech 27680 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4232 27681 RELEASE OF LOWER LEG TENDONS Tech 27681 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4229 27685 REVISION OF LOWER LEG TENDON Tech 27685 761 14860 " 4,355.47 " 672.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 672.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4210 27686 REVISE LOWER LEG TENDONS Tech 27686 761 14860 " 4,355.47 " 672.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 672.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4225 27687 REVISION OF CALF TENDON Tech 27687 761 14860 " 4,355.47 " 672.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 672.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4213 27690 REVISE LOWER LEG TENDON Tech 27690 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4215 27691 REVISE LOWER LEG TENDON Tech 27691 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4221 27692 REVISE ADDITIONAL LEG TENDON Tech 27692 761 608 178.20 156.26 486.40 156.26 315.55 N/A 315.55 N/A N/A 310.08 N/A 364.80 N/A N/A 402.44 N/A N/A N/A N/A N/A N/A N/A 486.40 N/A N/A 407.36 N/A 248.67 456.00 231.10 271.96 N/A 480.32 4231 27695 REPAIR OF ANKLE LIGAMENT Tech 27695 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4218 27696 REPAIR OF ANKLE LIGAMENTS Tech 27696 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4222 27698 REPAIR OF ANKLE LIGAMENT Tech 27698 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4223 27700 REVISION OF ANKLE JOINT Tech 27700 761 32891 " 9,640.35 " 878.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 878.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4244 27702 RECONSTRUCT ANKLE JOINT Tech 27702 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " " 12,593.29 " " 12,782.97 " " 10,704.30 " " 12,593.29 " " 12,561.30 " " 12,593.29 " " 14,778.00 " " 10,704.30 " " 13,474.82 " " 16,302.60 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 19,704.00 " " 11,522.86 " N/A " 16,502.10 " " 11,082.10 " " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " " 12,845.16 " " 19,457.70 " 4219 27703 RECONSTRUCTION ANKLE JOINT Tech 27703 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 4235 27704 REMOVAL OF ANKLE IMPLANT Tech 27704 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4240 27705 INCISION OF TIBIA Tech 27705 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4263 27707 INCISION OF FIBULA Tech 27707 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4239 27709 INCISION OF TIBIA & FIBULA Tech 27709 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4251 27712 REALIGNMENT OF LOWER LEG Tech 27712 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 4245 27715 REVISION OF LOWER LEG Tech 27715 761 24630 " 7,219.05 " " 6,329.91 " " 47,505.42 " " 6,329.91 " " 12,782.97 " N/A " 12,782.97 " N/A N/A " 12,561.30 " N/A " 14,778.00 " N/A N/A " 16,302.60 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 19,704.00 " N/A N/A " 16,502.10 " N/A " 10,073.67 " " 18,472.50 " " 9,361.86 " " 11,017.00 " N/A " 19,457.70 " 4269 27720 REPAIR OF TIBIA Tech 27720 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4271 27724 REPAIR/GRAFT OF TIBIA Tech 27724 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4278 27725 REPAIR OF LOWER LEG Tech 27725 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4264 27726 REPAIR FIBULA NONUNION Tech 27726 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4250 27730 REPAIR OF TIBIA EPIPHYSIS Tech 27730 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4247 27732 REPAIR OF FIBULA EPIPHYSIS Tech 27732 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4248 27734 REPAIR LOWER LEG EPIPHYSES Tech 27734 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4262 27740 REPAIR OF LEG EPIPHYSES Tech 27740 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4275 27745 REINFORCE TIBIA Tech 27745 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4255 27750 TREATMENT OF TIBIA FRACTURE Tech 27750 761 1082 317.13 142.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 142.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4254 27752 TREATMENT OF TIBIA FRACTURE Tech 27752 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4267 27756 TREATMENT OF TIBIA FRACTURE Tech 27756 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4260 27758 TREATMENT OF TIBIA FRACTURE Tech 27758 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4281 27759 TREATMENT OF TIBIA FRACTURE Tech 27759 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4285 27760 CLTX MEDIAL ANKLE FX Tech 27760 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4266 27762 CLTX MED ANKLE FX W/MNPJ Tech 27762 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4284 27766 OPTX MEDIAL ANKLE FX Tech 27766 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4270 27767 CLTX POST ANKLE FX Tech 27767 761 1082 317.13 177.26 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 177.26 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4315 27768 CLTX POST ANKLE FX W/MNPJ Tech 27768 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4280 27769 OPTX POST ANKLE FX Tech 27769 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4298 27780 TREATMENT OF FIBULA FRACTURE Tech 27780 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4309 27781 TREATMENT OF FIBULA FRACTURE Tech 27781 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4299 27784 TREATMENT OF FIBULA FRACTURE Tech 27784 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4274 27786 TREATMENT OF ANKLE FRACTURE Tech 27786 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4291 27788 TREATMENT OF ANKLE FRACTURE Tech 27788 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4317 27792 TREATMENT OF ANKLE FRACTURE Tech 27792 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4288 27808 TREATMENT OF ANKLE FRACTURE Tech 27808 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4289 27810 TREATMENT OF ANKLE FRACTURE Tech 27810 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4314 27814 TREATMENT OF ANKLE FRACTURE Tech 27814 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4300 27816 TREATMENT OF ANKLE FRACTURE Tech 27816 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4310 27818 TREATMENT OF ANKLE FRACTURE Tech 27818 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4321 27822 TREATMENT OF ANKLE FRACTURE Tech 27822 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4311 27823 TREATMENT OF ANKLE FRACTURE Tech 27823 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4326 27824 TREAT LOWER LEG FRACTURE Tech 27824 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4330 27825 TREAT LOWER LEG FRACTURE Tech 27825 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4346 27826 TREAT LOWER LEG FRACTURE Tech 27826 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4320 27827 TREAT LOWER LEG FRACTURE Tech 27827 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4332 27828 TREAT LOWER LEG FRACTURE Tech 27828 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4334 27829 TREAT LOWER LEG JOINT Tech 27829 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4316 27832 TREAT LOWER LEG DISLOCATION Tech 27832 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4318 27840 TREAT ANKLE DISLOCATION Tech 27840 761 1082 317.13 89.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 89.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4340 27842 TREAT ANKLE DISLOCATION Tech 27842 761 7310 " 2,142.56 " 791.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 791.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4338 27846 TREAT ANKLE DISLOCATION Tech 27846 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4337 27848 TREAT ANKLE DISLOCATION Tech 27848 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4329 27860 FIXATION OF ANKLE JOINT Tech 27860 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4350 27870 FUSION OF ANKLE JOINT OPEN Tech 27870 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4345 27871 FUSION OF TIBIOFIBULAR JOINT Tech 27871 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4373 27880 AMPUTATION OF LOWER LEG Tech 27880 761 31736 " 9,301.82 " " 8,156.15 " " 61,212.90 " " 8,156.15 " " 16,470.98 " N/A " 16,470.98 " N/A N/A " 16,185.36 " N/A " 19,041.60 " N/A N/A " 21,006.06 " N/A N/A " 48,970.64 " " 61,212.90 " N/A N/A N/A " 25,388.80 " N/A N/A " 21,263.12 " N/A " 12,980.02 " " 23,802.00 " " 12,062.85 " " 14,195.51 " N/A " 25,071.44 " 4357 27881 AMPUTATION OF LOWER LEG Tech 27881 761 32891 " 9,640.35 " " 8,452.99 " " 26,312.80 " " 8,452.99 " " 17,070.43 " N/A " 17,070.43 " N/A N/A " 16,774.41 " N/A " 19,734.60 " N/A N/A " 21,770.55 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 26,312.80 " N/A N/A " 22,036.97 " N/A " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " N/A " 25,983.89 " 4339 27882 AMPUTATION OF LOWER LEG Tech 27882 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4354 27884 AMPUTATION FOLLOW-UP SURGERY Tech 27884 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4335 27886 AMPUTATION FOLLOW-UP SURGERY Tech 27886 761 12530 " 3,672.54 " " 3,220.21 " " 24,167.67 " " 3,220.21 " " 6,503.07 " N/A " 6,503.07 " N/A N/A " 6,390.30 " N/A " 7,518.00 " N/A N/A " 8,293.61 " N/A N/A " 19,334.26 " " 24,167.67 " N/A N/A N/A " 10,024.00 " N/A N/A " 8,395.10 " N/A " 5,124.77 " " 9,397.50 " " 4,762.65 " " 5,604.67 " N/A " 9,898.70 " 4353 27888 AMPUTATION OF FOOT AT ANKLE Tech 27888 761 64652 " 18,949.50 " " 16,615.56 " " 51,721.60 " " 16,615.56 " " 33,554.39 " N/A " 33,554.39 " N/A N/A " 32,972.52 " N/A " 38,791.20 " N/A N/A " 42,793.16 " N/A N/A " 38,004.58 " " 47,505.42 " N/A N/A N/A " 51,721.60 " N/A N/A " 43,316.84 " N/A " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " N/A " 51,075.08 " 4347 27889 AMPUTATION OF FOOT AT ANKLE Tech 27889 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4356 27892 DECOMPRESSION OF LEG Tech 27892 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4358 27893 DECOMPRESSION OF LEG Tech 27893 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4348 27894 DECOMPRESSION OF LEG Tech 27894 761 14860 " 4,355.47 " 344.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 344.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 64686 27899 Unl Leg/Ankle Surgery Procedure Tech 27899 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4363 28001 DRAINAGE OF BURSA OF FOOT Tech 28001 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4360 28002 TREATMENT OF FOOT INFECTION Tech 28002 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4367 28003 TREATMENT OF FOOT INFECTION Tech 28003 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4362 28005 TREAT FOOT BONE LESION Tech 28005 761 14860 " 4,355.47 " 860.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 860.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4365 28008 INCISION OF FOOT FASCIA Tech 28008 761 14860 " 4,355.47 " 888.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 888.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4383 28010 INCISION OF TOE TENDON Tech 28010 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4374 28011 INCISION OF TOE TENDONS Tech 28011 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4392 28020 EXPLORATION OF FOOT JOINT Tech 28020 761 14860 " 4,355.47 " " 1,015.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,015.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4380 28022 EXPLORATION OF FOOT JOINT Tech 28022 761 14860 " 4,355.47 " 962.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 962.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4391 28024 EXPLORATION OF TOE JOINT Tech 28024 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4378 28035 DECOMPRESSION OF TIBIA NERVE Tech 28035 761 9211 " 2,699.74 " 776.00 " 7,368.80 " " 2,367.23 " " 4,780.51 " " 1,793.31 " " 4,780.51 " " 1,524.31 " " 1,793.31 " " 4,697.61 " " 1,793.31 " " 5,526.60 " " 1,524.31 " " 1,918.84 " " 6,096.76 " " 1,613.98 " " 1,793.31 " " 5,414.22 " " 6,767.73 " " 1,775.38 " " 1,829.18 " " 1,793.31 " " 7,368.80 " " 1,640.88 " 776.00 " 6,171.37 " " 1,578.11 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,829.18 " " 7,276.69 " 4386 28039 EXC FOOT/TOE TUM SC 1.5 CM/> Tech 28039 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4381 28041 EXC FOOT/TOE TUM DEP 1.5CM/> Tech 28041 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4384 28043 EXC FOOT/TOE TUM SC < 1.5 CM Tech 28043 761 7387 " 2,165.13 " 741.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 741.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4393 28045 EXC FOOT/TOE TUM DEEP <1.5CM Tech 28045 761 12443 " 3,647.04 " 804.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 804.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4389 28046 RESECT FOOT/TOE TUMOR < 3 CM Tech 28046 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4396 28047 RESECT FOOT/TOE TUMOR 3 CM/> Tech 28047 761 12443 " 3,647.04 " 776.00 " 9,954.40 " " 3,197.85 " " 6,457.92 " " 2,421.55 " " 6,457.92 " " 2,058.32 " " 2,421.55 " " 6,345.93 " " 2,421.55 " " 7,465.80 " " 2,058.32 " " 2,591.06 " " 8,236.02 " " 2,179.40 " " 2,421.55 " " 7,314.09 " " 9,142.55 " " 2,397.33 " " 2,469.98 " " 2,421.55 " " 9,954.40 " " 2,215.72 " 776.00 " 8,336.81 " " 2,130.96 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,469.98 " " 9,829.97 " 4403 28050 BIOPSY OF FOOT JOINT LINING Tech 28050 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4394 28055 NEURECTOMY FOOT Tech 28055 761 9211 " 2,699.74 " 776.00 " 7,368.80 " " 2,367.23 " " 4,780.51 " " 1,793.31 " " 4,780.51 " " 1,524.31 " " 1,793.31 " " 4,697.61 " " 1,793.31 " " 5,526.60 " " 1,524.31 " " 1,918.84 " " 6,096.76 " " 1,613.98 " " 1,793.31 " " 5,414.22 " " 6,767.73 " " 1,775.38 " " 1,829.18 " " 1,793.31 " " 7,368.80 " " 1,640.88 " 776.00 " 6,171.37 " " 1,578.11 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,829.18 " " 7,276.69 " 4411 28060 PARTIAL REMOVAL FOOT FASCIA Tech 28060 761 14860 " 4,355.47 " 628.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 628.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4398 28062 REMOVAL OF FOOT FASCIA Tech 28062 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4413 28070 REMOVAL OF FOOT JOINT LINING Tech 28070 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4417 28072 REMOVAL OF FOOT JOINT LINING Tech 28072 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4404 28080 REMOVAL OF FOOT LESION Tech 28080 761 7310 " 2,142.56 " 779.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 779.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4416 28086 EXCISE FOOT TENDON SHEATH Tech 28086 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4401 28090 REMOVAL OF FOOT LESION Tech 28090 761 7310 " 2,142.56 " 886.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 886.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4420 28092 REMOVAL OF TOE LESIONS Tech 28092 761 7310 " 2,142.56 " 823.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 823.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4424 28100 REMOVAL OF ANKLE/HEEL LESION Tech 28100 761 14860 " 4,355.47 " " 1,032.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,032.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4422 28102 REMOVE/GRAFT FOOT LESION Tech 28102 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4426 28103 REMOVE/GRAFT FOOT LESION Tech 28103 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4423 28104 REMOVAL OF FOOT LESION Tech 28104 761 14860 " 4,355.47 " 912.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 912.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4441 28106 REMOVE/GRAFT FOOT LESION Tech 28106 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4432 28107 REMOVE/GRAFT FOOT LESION Tech 28107 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4421 28108 REMOVAL OF TOE LESIONS Tech 28108 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4436 28110 PART REMOVAL OF METATARSAL Tech 28110 761 14860 " 4,355.47 " 904.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 904.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4429 28111 PART REMOVAL OF METATARSAL Tech 28111 761 14860 " 4,355.47 " " 1,025.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,025.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4430 28112 PART REMOVAL OF METATARSAL Tech 28112 761 14860 " 4,355.47 " " 1,025.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,025.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4442 28113 PART REMOVAL OF METATARSAL Tech 28113 761 14860 " 4,355.47 " " 1,025.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,025.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4439 28114 REMOVAL OF METATARSAL HEADS Tech 28114 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4451 28116 REVISION OF FOOT Tech 28116 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4448 28118 REMOVAL OF HEEL BONE Tech 28118 761 14860 " 4,355.47 " 832.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 832.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4440 28119 REMOVAL OF HEEL SPUR Tech 28119 761 14860 " 4,355.47 " 832.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 832.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4443 28120 PART REMOVAL OF ANKLE/HEEL Tech 28120 761 14860 " 4,355.47 " " 1,011.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,011.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4454 28122 PARTIAL REMOVAL OF FOOT BONE Tech 28122 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4480 28124 PARTIAL REMOVAL OF TOE Tech 28124 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4458 28126 PARTIAL REMOVAL OF TOE Tech 28126 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4465 28130 REMOVAL OF ANKLE BONE Tech 28130 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4444 28140 REMOVAL OF METATARSAL Tech 28140 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4468 28150 REMOVAL OF TOE Tech 28150 761 14860 " 4,355.47 " 799.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 799.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4471 28160 PARTIAL REMOVAL OF TOE Tech 28160 761 14860 " 4,355.47 " 935.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 935.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4464 28171 RESECT TARSAL TUMOR Tech 28171 761 14860 " 4,355.47 " 445.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 445.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4474 28190 REMOVAL OF FOOT FOREIGN BODY Tech 28190 761 3265 956.97 540.21 " 2,612.00 " 839.11 " 1,694.54 " 635.54 " 1,694.54 " 540.21 635.54 " 1,665.15 " 635.54 " 1,959.00 " 540.21 680.03 " 2,161.10 " 571.99 635.54 " 1,919.46 " " 2,399.31 " 629.18 648.25 635.54 " 2,612.00 " 581.52 777.00 " 2,187.55 " 559.28 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 648.25 " 2,579.35 " 4456 28192 REMOVAL OF FOOT FOREIGN BODY Tech 28192 761 7387 " 2,165.13 " 720.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 720.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4470 28193 REMOVAL OF FOOT FOREIGN BODY Tech 28193 761 7387 " 2,165.13 " 720.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 720.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 4462 28200 REPAIR OF FOOT TENDON Tech 28200 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4463 28208 REPAIR OF FOOT TENDON Tech 28208 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4493 28210 REPAIR/GRAFT OF FOOT TENDON Tech 28210 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4469 28220 RELEASE OF FOOT TENDON Tech 28220 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4467 28225 RELEASE OF FOOT TENDON Tech 28225 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4477 28226 RELEASE OF FOOT TENDONS Tech 28226 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4481 28230 INCISION OF FOOT TENDON(S) Tech 28230 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4473 28232 INCISION OF TOE TENDON Tech 28232 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4498 28234 INCISION OF FOOT TENDON Tech 28234 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4490 28238 REVISION OF FOOT TENDON Tech 28238 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4496 28240 RELEASE OF BIG TOE Tech 28240 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4483 28250 REVISION OF FOOT FASCIA Tech 28250 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4494 28260 RELEASE OF MIDFOOT JOINT Tech 28260 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4489 28261 REVISION OF FOOT TENDON Tech 28261 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4523 28262 REVISION OF FOOT AND ANKLE Tech 28262 761 32891 " 9,640.35 " 841.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 841.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4491 28264 RELEASE OF MIDFOOT JOINT Tech 28264 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4501 28270 RELEASE OF FOOT CONTRACTURE Tech 28270 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4499 28272 RELEASE OF TOE JOINT EACH Tech 28272 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4510 28280 FUSION OF TOES Tech 28280 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4515 28285 REPAIR OF HAMMERTOE Tech 28285 761 14860 " 4,355.47 " 947.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 947.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4506 28286 REPAIR OF HAMMERTOE Tech 28286 761 14860 " 4,355.47 " 947.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 947.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4511 28288 PARTIAL REMOVAL OF FOOT BONE Tech 28288 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4513 28289 CORRJ HALUX RIGDUS W/O IMPLT Tech 28289 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4524 28291 CORRJ HALUX RIGDUS W/IMPLT Tech 28291 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4519 28292 CORRECTION HALLUX VALGUS Tech 28292 761 14860 " 4,355.47 " " 1,236.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,236.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4529 28295 CORRECTION HALLUX VALGUS Tech 28295 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4540 28296 CORRECTION HALLUX VALGUS Tech 28296 761 14860 " 4,355.47 " " 1,085.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,085.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4518 28297 CORRECTION HALLUX VALGUS Tech 28297 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4514 28298 CORRECTION HALLUX VALGUS Tech 28298 761 32891 " 9,640.35 " " 1,372.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,372.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4530 28299 CORRECTION HALLUX VALGUS Tech 28299 761 32891 " 9,640.35 " " 1,085.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,085.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4527 28300 INCISION OF HEEL BONE Tech 28300 761 32891 " 9,640.35 " " 1,384.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,384.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4535 28302 INCISION OF ANKLE BONE Tech 28302 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4531 28304 INCISION OF MIDFOOT BONES Tech 28304 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4534 28305 INCISE/GRAFT MIDFOOT BONES Tech 28305 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4549 28306 INCISION OF METATARSAL Tech 28306 761 32891 " 9,640.35 " " 1,136.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,136.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4547 28307 INCISION OF METATARSAL Tech 28307 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4585 28308 INCISION OF METATARSAL Tech 28308 761 14860 " 4,355.47 " " 1,036.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,036.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4537 28309 INCISION OF METATARSALS Tech 28309 761 32891 " 9,640.35 " " 1,036.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,036.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4557 28310 REVISION OF BIG TOE Tech 28310 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4542 28312 REVISION OF TOE Tech 28312 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4541 28313 REPAIR DEFORMITY OF TOE Tech 28313 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4570 28315 REMOVAL OF SESAMOID BONE Tech 28315 761 14860 " 4,355.47 " 973.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 973.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4548 28320 REPAIR OF FOOT BONES Tech 28320 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4554 28322 REPAIR OF METATARSALS Tech 28322 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4592 28341 RESECT ENLARGED TOE Tech 28341 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4559 28344 REPAIR EXTRA TOE(S) Tech 28344 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4558 28345 REPAIR WEBBED TOE(S) Tech 28345 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4564 28360 RECONSTRUCT CLEFT FOOT Tech 28360 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4582 28400 TREATMENT OF HEEL FRACTURE Tech 28400 761 1082 317.13 140.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 140.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4572 28405 TREATMENT OF HEEL FRACTURE Tech 28405 761 1082 317.13 178.93 " 1,701.00 " 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 " 1,701.00 " 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4565 28406 TREATMENT OF HEEL FRACTURE Tech 28406 761 32891 " 9,640.35 " " 1,701.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,701.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4563 28415 TREAT HEEL FRACTURE Tech 28415 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4556 28420 TREAT/GRAFT HEEL FRACTURE Tech 28420 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4568 28430 TREATMENT OF ANKLE FRACTURE Tech 28430 761 1082 317.13 111.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 111.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4578 28435 TREATMENT OF ANKLE FRACTURE Tech 28435 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4587 28436 TREATMENT OF ANKLE FRACTURE Tech 28436 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4593 28445 TREAT ANKLE FRACTURE Tech 28445 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4597 28446 OSTEOCHONDRAL TALUS AUTOGRFT Tech 28446 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4605 28450 TREAT MIDFOOT FRACTURE EACH Tech 28450 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4589 28455 TREAT MIDFOOT FRACTURE EACH Tech 28455 761 7310 " 2,142.56 " 127.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 127.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4574 28456 TREAT MIDFOOT FRACTURE Tech 28456 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4579 28465 TREAT MIDFOOT FRACTURE EACH Tech 28465 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4596 28470 TREAT METATARSAL FRACTURE Tech 28470 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4591 28475 TREAT METATARSAL FRACTURE Tech 28475 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4588 28476 TREAT METATARSAL FRACTURE Tech 28476 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4600 28485 TREAT METATARSAL FRACTURE Tech 28485 761 32891 " 9,640.35 " 848.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 848.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4595 28490 TREAT BIG TOE FRACTURE Tech 28490 761 1082 317.13 55.00 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 55.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4607 28495 TREAT BIG TOE FRACTURE Tech 28495 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4603 28496 TREAT BIG TOE FRACTURE Tech 28496 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4614 28505 TREAT BIG TOE FRACTURE Tech 28505 761 14860 " 4,355.47 " " 1,287.00 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " " 1,287.00 " " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4622 28510 TREATMENT OF TOE FRACTURE Tech 28510 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4604 28515 TREATMENT OF TOE FRACTURE Tech 28515 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4608 28525 TREAT TOE FRACTURE Tech 28525 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4618 28530 TREAT SESAMOID BONE FRACTURE Tech 28530 761 1082 317.13 89.45 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 89.45 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4641 28531 TREAT SESAMOID BONE FRACTURE Tech 28531 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4623 28540 TREAT FOOT DISLOCATION Tech 28540 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 64688 28545 Clsd Trtmt Tarsal Disloc Req Anes Tech 28545 761 14860 " 4,355.47 " 118.50 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 118.50 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4617 28546 TREAT FOOT DISLOCATION Tech 28546 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4612 28555 REPAIR FOOT DISLOCATION Tech 28555 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4629 28575 TREAT FOOT DISLOCATION Tech 28575 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4626 28576 TREAT FOOT DISLOCATION Tech 28576 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4615 28585 REPAIR FOOT DISLOCATION Tech 28585 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4620 28600 TREAT FOOT DISLOCATION Tech 28600 761 1082 317.13 54.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 54.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4639 28605 TREAT FOOT DISLOCATION Tech 28605 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 776.00 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4625 28606 TREAT FOOT DISLOCATION Tech 28606 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4644 28615 REPAIR FOOT DISLOCATION Tech 28615 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4632 28630 TREAT TOE DISLOCATION Tech 28630 761 1082 317.13 54.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 54.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4651 28635 TREAT TOE DISLOCATION Tech 28635 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4636 28636 TREAT TOE DISLOCATION Tech 28636 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4655 28645 REPAIR TOE DISLOCATION Tech 28645 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4648 28660 TREAT TOE DISLOCATION Tech 28660 761 1082 317.13 48.50 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 48.50 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4654 28665 TREAT TOE DISLOCATION Tech 28665 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4653 28666 TREAT TOE DISLOCATION Tech 28666 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4657 28675 REPAIR OF TOE DISLOCATION Tech 28675 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4676 28705 FUSION OF FOOT BONES Tech 28705 761 83308 " 24,417.57 " 776.00 " 66,646.40 " " 21,410.16 " " 43,236.85 " " 16,513.36 " " 43,236.85 " " 14,036.36 " " 16,513.36 " " 42,487.08 " " 16,513.36 " " 49,984.80 " " 14,036.36 " " 17,669.30 " " 55,141.57 " " 14,862.02 " " 16,513.36 " " 48,970.64 " " 61,212.90 " " 16,348.23 " " 16,843.63 " " 16,513.36 " " 66,646.40 " " 15,109.72 " 776.00 " 55,816.36 " " 14,531.76 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,843.63 " " 65,813.32 " 4684 28715 FUSION OF FOOT BONES Tech 28715 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4664 28725 FUSION OF FOOT BONES Tech 28725 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4681 28730 FUSION OF FOOT BONES Tech 28730 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4649 28735 FUSION OF FOOT BONES Tech 28735 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4671 28737 REVISION OF FOOT BONES Tech 28737 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4693 28740 FUSION OF FOOT BONES Tech 28740 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4687 28750 FUSION OF BIG TOE JOINT Tech 28750 761 32891 " 9,640.35 " " 1,053.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,053.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4677 28755 FUSION OF BIG TOE JOINT Tech 28755 761 32891 " 9,640.35 " " 1,045.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,045.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4672 28760 FUSION OF BIG TOE JOINT Tech 28760 761 32891 " 9,640.35 " " 1,019.00 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " " 1,019.00 " " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4683 28800 AMPUTATION OF MIDFOOT Tech 28800 761 14860 " 4,355.47 " " 3,819.02 " " 11,888.00 " " 3,819.02 " " 7,712.34 " N/A " 7,712.34 " N/A N/A " 7,578.60 " N/A " 8,916.00 " N/A N/A " 9,835.83 " N/A N/A " 8,734.90 " " 10,918.55 " N/A N/A N/A " 11,888.00 " N/A N/A " 9,956.20 " N/A " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " N/A " 11,739.40 " 4689 28805 AMPUTATION THRU METATARSAL Tech 28805 761 14860 " 4,355.47 " " 2,458.44 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " N/A " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4667 28810 AMPUTATION TOE & METATARSAL Tech 28810 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4666 28820 AMPUTATION OF TOE Tech 28820 761 14860 " 4,355.47 " 730.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 730.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4682 28825 PARTIAL AMPUTATION OF TOE Tech 28825 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4686 29010 APPLICATION OF BODY CAST Tech 29010 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4688 29065 APPLICATION OF LONG ARM CAST Tech 29065 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4695 29075 APPLICATION OF FOREARM CAST Tech 29075 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4697 29085 APPLY HAND/WRIST CAST Tech 29085 700 741 217.19 122.65 776.00 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 776.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4711 29105 APPLY LONG ARM SPLINT Tech 29105 700 741 217.19 122.65 776.00 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 776.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4690 29125 APPLY FOREARM SPLINT Tech 29125 700 588 172.34 26.00 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 26.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4709 29126 APPLY FOREARM SPLINT Tech 29126 700 588 172.34 26.00 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 26.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4694 29130 APPLICATION OF FINGER SPLINT Tech 29130 700 588 172.34 97.89 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 N/A 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4696 29131 APPLICATION OF FINGER SPLINT Tech 29131 700 292 85.59 27.71 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 27.71 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 4739 29240 STRAPPING OF SHOULDER Tech 29240 761 588 172.34 19.50 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 19.50 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4706 29280 STRAPPING OF HAND OR FINGER 29280 450 292 85.59 48.32 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 N/A 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 4701 29305 APPLICATION OF HIP CAST Tech 29305 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4705 29325 APPLICATION OF HIP CASTS Tech 29325 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4710 29345 APPLICATION OF LONG LEG CAST Tech 29345 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4720 29355 APPLICATION OF LONG LEG CAST Tech 29355 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4721 29358 APPLY LONG LEG CAST BRACE Tech 29358 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4723 29365 APPLICATION OF LONG LEG CAST Tech 29365 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4718 29405 APPLY SHORT LEG CAST Tech 29405 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4727 29425 APPLY SHORT LEG CAST Tech 29425 700 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 776.00 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4749 29445 APPLY RIGID LEG CAST Tech 29445 420 1266 371.06 101.47 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 101.47 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 27627 29445 WOCN TOTAL CONTACT CAST Tech 29445 420 1266 371.06 101.47 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 101.47 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4719 29450 APPLICATION OF LEG CAST Tech 29450 700 741 217.19 122.65 776.00 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 776.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4735 29505 APPLICATION LONG LEG SPLINT Tech 29505 700 741 217.19 37.00 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 37.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4729 29515 APPLICATION LOWER LEG SPLINT Tech 29515 700 741 217.19 35.00 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 35.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4752 29520 STRAPPING OF HIP Tech 29520 700 588 172.34 32.99 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 32.99 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4737 29540 STRAPPING OF ANKLE AND/OR FT 29540 450 741 217.19 20.00 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 20.00 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4750 29550 STRAPPING OF TOES Tech 29550 761 292 85.59 20.00 233.60 75.04 151.55 56.85 151.55 48.32 56.85 148.92 56.85 175.20 48.32 60.83 193.27 51.17 56.85 171.77 214.71 56.28 57.99 56.85 233.60 52.02 20.00 195.64 50.03 119.43 219.00 110.99 130.61 57.99 230.68 4730 29580 APPLICATION OF PASTE BOOT Tech 29580 761 741 217.19 122.65 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 N/A 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4755 29580 APPLICATION OF PASTE BOOT Tech PT 29580 420 741 217.19 122.65 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 N/A 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 27628 29580 WOCN UNNA BOOT Tech 29580 420 741 217.19 122.65 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 N/A 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 27629 29580 WOCN UNNA BOOT BIL Tech 29580 420 741 217.19 122.65 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 N/A 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4748 29581 APPLY MULTLAY COMPRS LWR LEG Tech 29581 761 741 217.19 25.27 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 25.27 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 27620 29581 APPLY MULTLAY COMPRS LWR LEG BIL Tech 29581 510 741 217.19 25.27 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 25.27 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 27623 29581 WOCN MULTI-LAYER WRAP Tech 29581 420 741 217.19 25.27 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 25.27 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 27624 29581 WOCN MULTI-LAYER WRAP BIL Tech 29581 420 741 217.19 25.27 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 25.27 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4744 29584 APPL MULTLAY COMPRS ARM/HAND Tech 29584 761 741 217.19 12.07 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 12.07 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4777 29700 REMOVAL/REVISION OF CAST Tech 29700 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 N/A 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4770 29705 REMOVAL/REVISION OF CAST Tech 29705 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 N/A 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4736 29710 REMOVAL/REVISION OF CAST Tech 29710 761 1266 371.06 209.42 " 1,012.80 " 325.36 657.05 246.38 657.05 209.42 246.38 645.66 246.38 759.60 209.42 263.63 837.97 221.74 246.38 744.27 930.34 243.92 251.31 246.38 " 1,012.80 " 225.44 N/A 848.22 216.81 517.79 949.50 481.21 566.28 251.31 " 1,000.14 " 4754 29730 WINDOWING OF CAST Tech 29730 761 741 217.19 40.99 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 40.99 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 64241 29730 Windowing Cast Tech 29730 0 741 217.19 40.99 592.80 190.44 384.58 144.29 384.58 122.65 144.29 377.91 144.29 444.60 122.65 154.39 490.47 129.86 144.29 435.70 544.62 142.85 147.18 144.29 592.80 132.03 40.99 496.47 126.98 303.07 555.75 281.65 331.45 147.18 585.39 4741 29805 SHOULDER ARTHROSCOPY DX Tech 29805 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4761 29806 SHOULDER ARTHROSCOPY/SURGERY Tech 29806 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4760 29807 SHOULDER ARTHROSCOPY/SURGERY Tech 29807 761 32891 " 9,640.35 " 788.28 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 788.28 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4753 29819 SHOULDER ARTHROSCOPY/SURGERY Tech 29819 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4765 29820 SHOULDER ARTHROSCOPY/SURGERY Tech 29820 761 32891 " 9,640.35 " 932.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 932.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4783 29821 SHOULDER ARTHROSCOPY/SURGERY Tech 29821 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4766 29822 SHOULDER ARTHROSCOPY/SURGERY Tech 29822 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4778 29823 SHOULDER ARTHROSCOPY/SURGERY Tech 29823 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4758 29824 SHOULDER ARTHROSCOPY/SURGERY Tech 29824 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4790 29825 SHOULDER ARTHROSCOPY/SURGERY Tech 29825 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4780 29826 SHOULDER ARTHROSCOPY/SURGERY Tech 29826 761 3863 " 1,132.25 " 776.00 " 3,090.40 " 992.79 " 2,004.90 " N/A " 2,004.90 " N/A N/A " 1,970.13 " N/A " 2,317.80 " N/A N/A " 2,556.92 " N/A N/A N/A N/A N/A N/A N/A " 3,090.40 " N/A 776.00 " 2,588.21 " N/A " 1,579.97 " " 2,897.25 " " 1,468.33 " " 1,727.92 " N/A " 3,051.77 " 4784 29827 ARTHROSCOP ROTATOR CUFF REPR Tech 29827 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4776 29828 ARTHROSCOPY BICEPS TENODESIS Tech 29828 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4786 29830 ELBOW ARTHROSCOPY Tech 29830 761 14860 " 4,355.47 " 970.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 970.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4785 29834 ELBOW ARTHROSCOPY/SURGERY Tech 29834 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4812 29835 ELBOW ARTHROSCOPY/SURGERY Tech 29835 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4792 29836 ELBOW ARTHROSCOPY/SURGERY Tech 29836 761 32891 " 9,640.35 " 932.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 932.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4769 29837 ELBOW ARTHROSCOPY/SURGERY Tech 29837 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4775 29838 ELBOW ARTHROSCOPY/SURGERY Tech 29838 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4787 29840 WRIST ARTHROSCOPY Tech 29840 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4793 29844 WRIST ARTHROSCOPY/SURGERY Tech 29844 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4800 29845 WRIST ARTHROSCOPY/SURGERY Tech 29845 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4814 29846 WRIST ARTHROSCOPY/SURGERY Tech 29846 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4804 29847 WRIST ARTHROSCOPY/SURGERY Tech 29847 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4788 29848 WRIST ENDOSCOPY/SURGERY Tech 29848 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4806 29850 KNEE ARTHROSCOPY/SURGERY Tech 29850 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4810 29851 KNEE ARTHROSCOPY/SURGERY Tech 29851 761 7310 " 2,142.56 " 776.00 " 5,848.00 " " 1,878.67 " " 3,793.89 " " 1,422.51 " " 3,793.89 " " 1,209.13 " " 1,422.51 " " 3,728.10 " " 1,422.51 " " 4,386.00 " " 1,209.13 " " 1,522.09 " " 4,838.49 " " 1,280.26 " " 1,422.51 " " 4,296.93 " " 5,371.13 " " 1,408.28 " " 1,450.96 " " 1,422.51 " " 5,848.00 " " 1,301.60 " 776.00 " 4,897.70 " " 1,251.81 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,450.96 " " 5,774.90 " 4815 29855 TIBIAL ARTHROSCOPY/SURGERY Tech 29855 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4795 29856 TIBIAL ARTHROSCOPY/SURGERY Tech 29856 761 64652 " 18,949.50 " " 10,704.30 " " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " N/A " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4816 29860 HIP ARTHROSCOPY DX Tech 29860 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4801 29861 HIP ARTHRO W/FB REMOVAL Tech 29861 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4807 29862 HIP ARTHR0 W/DEBRIDEMENT Tech 29862 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4826 29863 HIP ARTHR0 W/SYNOVECTOMY Tech 29863 761 14860 " 4,355.47 " " 2,458.44 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " N/A " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4825 29866 AUTGRFT IMPLNT KNEE W/SCOPE Tech 29866 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4824 29867 ALLGRFT IMPLNT KNEE W/SCOPE Tech 29867 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4841 29868 MENISCAL TRNSPL KNEE W/SCPE Tech 29868 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4819 29870 KNEE ARTHROSCOPY DX Tech 29870 761 14860 " 4,355.47 " 970.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 970.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4836 29871 KNEE ARTHROSCOPY/DRAINAGE Tech 29871 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4856 29873 KNEE ARTHROSCOPY/SURGERY Tech 29873 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4838 29874 KNEE ARTHROSCOPY/SURGERY Tech 29874 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4830 29875 KNEE ARTHROSCOPY/SURGERY Tech 29875 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4827 29876 KNEE ARTHROSCOPY/SURGERY Tech 29876 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4852 29877 KNEE ARTHROSCOPY/SURGERY Tech 29877 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4835 29879 KNEE ARTHROSCOPY/SURGERY Tech 29879 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4849 29880 KNEE ARTHROSCOPY/SURGERY Tech 29880 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4834 29881 KNEE ARTHROSCOPY/SURGERY Tech 29881 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4869 29882 KNEE ARTHROSCOPY/SURGERY Tech 29882 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4844 29883 KNEE ARTHROSCOPY/SURGERY Tech 29883 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4845 29884 KNEE ARTHROSCOPY/SURGERY Tech 29884 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4868 29885 KNEE ARTHROSCOPY/SURGERY Tech 29885 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4853 29886 KNEE ARTHROSCOPY/SURGERY Tech 29886 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4855 29887 KNEE ARTHROSCOPY/SURGERY Tech 29887 761 32891 " 9,640.35 " 932.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 932.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4850 29888 KNEE ARTHROSCOPY/SURGERY Tech 29888 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4857 29889 KNEE ARTHROSCOPY/SURGERY Tech 29889 761 64652 " 18,949.50 " 776.00 " 51,721.60 " " 16,615.56 " " 33,554.39 " " 12,593.29 " " 33,554.39 " " 10,704.30 " " 12,593.29 " " 32,972.52 " " 12,593.29 " " 38,791.20 " " 10,704.30 " " 13,474.82 " " 42,793.16 " " 11,333.96 " " 12,593.29 " " 38,004.58 " " 47,505.42 " " 12,467.36 " " 12,845.16 " " 12,593.29 " " 51,721.60 " " 11,522.86 " 776.00 " 43,316.84 " " 11,082.10 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,845.16 " " 51,075.08 " 4878 29891 ANKLE ARTHROSCOPY/SURGERY Tech 29891 761 14860 " 4,355.47 " " 2,458.44 " " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " N/A " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4858 29892 ANKLE ARTHROSCOPY/SURGERY Tech 29892 761 32891 " 9,640.35 " " 5,437.49 " " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " N/A " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4861 29893 SCOPE PLANTAR FASCIOTOMY Tech 29893 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4883 29894 ANKLE ARTHROSCOPY/SURGERY Tech 29894 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4870 29895 ANKLE ARTHROSCOPY/SURGERY Tech 29895 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4867 29897 ANKLE ARTHROSCOPY/SURGERY Tech 29897 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4881 29898 ANKLE ARTHROSCOPY/SURGERY Tech 29898 761 14860 " 4,355.47 " 932.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 932.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4890 29899 ANKLE ARTHROSCOPY/SURGERY Tech 29899 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4874 29900 MCP JOINT ARTHROSCOPY DX Tech 29900 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4886 29906 SUBTALAR ARTHRO W/DEB Tech 29906 761 14860 " 4,355.47 " 776.00 " 11,888.00 " " 3,819.02 " " 7,712.34 " " 2,892.28 " " 7,712.34 " " 2,458.44 " " 2,892.28 " " 7,578.60 " " 2,892.28 " " 8,916.00 " " 2,458.44 " " 3,094.74 " " 9,835.83 " " 2,603.05 " " 2,892.28 " " 8,734.90 " " 10,918.55 " " 2,863.36 " " 2,950.13 " " 2,892.28 " " 11,888.00 " " 2,646.44 " 776.00 " 9,956.20 " " 2,545.21 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,950.13 " " 11,739.40 " 4885 29914 HIP ARTHRO W/FEMOROPLASTY Tech 29914 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4893 29915 HIP ARTHRO ACETABULOPLASTY Tech 29915 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4882 29916 HIP ARTHRO W/LABRAL REPAIR Tech 29916 761 32891 " 9,640.35 " 776.00 " 26,312.80 " " 8,452.99 " " 17,070.43 " " 6,397.05 " " 17,070.43 " " 5,437.49 " " 6,397.05 " " 16,774.41 " " 6,397.05 " " 19,734.60 " " 5,437.49 " " 6,844.84 " " 21,770.55 " " 5,757.35 " " 6,397.05 " " 19,334.26 " " 24,167.67 " " 6,333.08 " " 6,524.99 " " 6,397.05 " " 26,312.80 " " 5,853.30 " 776.00 " 22,036.97 " " 5,629.40 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,524.99 " " 25,983.89 " 4879 29999 arthroscopic lat meniscus w/trephanation evac Tech 29999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4894 29999 Unl Arthro Thermal Capsulorrhaphy Tech 29999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4901 29999 endoscopic rt knee prepatellar bursectomy Tech 29999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4902 29999 arthroscopic Iliopsoas release Tech 29999 761 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 64406 29999 Unl Arthro Lig ReconKneeEx-Articul Tech 29999 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 67781 29999 Arthroscopic Capslr Plication; Hip Tech 29999 0 1082 317.13 178.93 865.60 278.07 561.56 210.50 561.56 178.93 210.50 551.82 210.50 649.20 178.93 225.24 716.18 189.45 210.50 636.32 795.40 208.40 214.71 210.50 865.60 192.61 N/A 724.94 185.24 442.54 811.50 411.27 483.98 214.71 854.78 4915 30000 DRAINAGE OF NOSE LESION Tech 30000 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 4896 30020 DRAINAGE OF NOSE LESION Tech 30020 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 797.00 " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 4899 30100 INTRANASAL BIOPSY Tech 30100 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4897 30110 REMOVAL OF NOSE POLYP(S) Tech 30110 761 7102 " 2,081.60 " 971.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 971.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4921 30115 REMOVAL OF NOSE POLYP(S) Tech 30115 761 14366 " 4,210.67 " 745.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 745.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4911 30117 REMOVAL OF INTRANASAL LESION Tech 30117 761 14366 " 4,210.67 " 615.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 615.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4926 30118 REMOVAL OF INTRANASAL LESION Tech 30118 761 14366 " 4,210.67 " 615.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 615.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4924 30120 REVISION OF NOSE Tech 30120 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4925 30124 REMOVAL OF NOSE LESION Tech 30124 761 7102 " 2,081.60 " 580.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 580.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4922 30125 REMOVAL OF NOSE LESION Tech 30125 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4914 30130 EXCISE INFERIOR TURBINATE Tech 30130 761 14366 " 4,210.67 " 704.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 704.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4931 30140 RESECT INFERIOR TURBINATE Tech 30140 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4928 30150 PARTIAL REMOVAL OF NOSE Tech 30150 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4917 30160 REMOVAL OF NOSE Tech 30160 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4913 30220 INSERT NASAL SEPTAL BUTTON Tech 30220 761 7102 " 2,081.60 " " 1,174.31 " " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " N/A " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4918 30300 REMOVE NASAL FOREIGN BODY Tech 30300 761 588 172.34 97.89 776.00 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 776.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4923 30310 REMOVE NASAL FOREIGN BODY Tech 30310 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4943 30320 REMOVE NASAL FOREIGN BODY Tech 30320 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4940 30400 RECONSTRUCTION OF NOSE Tech 30400 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4937 30410 RECONSTRUCTION OF NOSE Tech 30410 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4945 30420 RECONSTRUCTION OF NOSE Tech 30420 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4946 30430 REVISION OF NOSE Tech 30430 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4951 30435 REVISION OF NOSE Tech 30435 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4950 30450 REVISION OF NOSE Tech 30450 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4961 30460 REVISION OF NOSE Tech 30460 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4956 30462 REVISION OF NOSE Tech 30462 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4957 30465 REPAIR NASAL STENOSIS Tech 30465 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4962 30520 REPAIR OF NASAL SEPTUM Tech 30520 761 14366 " 4,210.67 " 823.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 823.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4960 30540 REPAIR NASAL DEFECT Tech 30540 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4968 30560 RELEASE OF NASAL ADHESIONS Tech 30560 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 " 1,336.00 " " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 4955 30580 REPAIR UPPER JAW FISTULA Tech 30580 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4966 30600 REPAIR MOUTH/NOSE FISTULA Tech 30600 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5005 30620 INTRANASAL RECONSTRUCTION Tech 30620 761 26702 " 7,826.36 " 468.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 468.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 4988 30630 REPAIR NASAL SEPTUM DEFECT Tech 30630 761 14366 " 4,210.67 " 468.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 468.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4969 30801 ABLATE INF TURBINATE SUPERF Tech 30801 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 4996 30802 ABLATE INF TURBINATE SUBMUC Tech 30802 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 5001 30901 CONTROL OF NOSEBLEED Tech 30901 761 588 172.34 97.89 776.00 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 776.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 5028 30903 CONTROL OF NOSEBLEED Tech 30903 761 588 172.34 97.89 470.40 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 397.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4997 30905 CONTROL OF NOSEBLEED Tech 30905 761 588 172.34 97.89 776.00 151.12 305.17 115.16 305.17 97.89 115.16 299.88 115.16 352.80 97.89 123.22 389.20 103.64 115.16 345.49 431.86 114.01 117.46 115.16 470.40 105.37 776.00 393.96 101.34 240.49 441.00 223.50 263.01 117.46 464.52 4982 30906 REPEAT CONTROL OF NOSEBLEED Tech 30906 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 4989 30920 LIGATION UPPER JAW ARTERY Tech 30920 761 15024 " 4,403.53 " 630.50 " 12,019.20 " " 3,861.17 " " 7,797.46 " " 2,923.63 " " 7,797.46 " " 2,485.09 " " 2,923.63 " " 7,662.24 " " 2,923.63 " " 9,014.40 " " 2,485.09 " " 3,128.28 " " 9,944.39 " " 2,631.27 " " 2,923.63 " " 8,831.37 " " 11,039.14 " " 2,894.39 " " 2,982.10 " " 2,923.63 " " 12,019.20 " " 2,675.12 " 630.50 " 10,066.08 " " 2,572.79 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,982.10 " " 11,868.96 " 5009 30930 THER FX NASAL INF TURBINATE Tech 30930 761 14366 " 4,210.67 " " 1,091.00 " " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " " 1,091.00 " " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 4993 30999 Unl Latera Nasal Implant Tech 30999 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5002 30999 Unl Middle Turbinate Excsn Tech 30999 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5007 30999 Unl Open Concha Bullosa Tech 30999 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5011 30999 UNLISTED NASOSEPTAL FLAP Tech 30999 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5018 30999 MIDDLE TURBINECTOMY Tech 30999 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 4998 31000 IRRIGATION MAXILLARY SINUS Tech 31000 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5043 31002 IRRIGATION SPHENOID SINUS Tech 31002 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 5015 31020 EXPLORATION MAXILLARY SINUS Tech 31020 761 14366 " 4,210.67 " 738.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 738.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5006 31030 EXPLORATION MAXILLARY SINUS Tech 31030 761 26702 " 7,826.36 " " 1,035.00 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " " 1,035.00 " " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5025 31032 EXPLORE SINUS REMOVE POLYPS Tech 31032 761 26702 " 7,826.36 " " 1,035.00 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " " 1,035.00 " " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5021 31040 EXPLORATION BEHIND UPPER JAW Tech 31040 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5032 31050 EXPLORATION SPHENOID SINUS Tech 31050 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5033 31051 SPHENOID SINUS SURGERY Tech 31051 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5024 31070 EXPLORATION OF FRONTAL SINUS Tech 31070 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5038 31075 EXPLORATION OF FRONTAL SINUS Tech 31075 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5049 31080 REMOVAL OF FRONTAL SINUS Tech 31080 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5046 31081 REMOVAL OF FRONTAL SINUS Tech 31081 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5044 31084 REMOVAL OF FRONTAL SINUS Tech 31084 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5035 31085 REMOVAL OF FRONTAL SINUS Tech 31085 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5031 31086 REMOVAL OF FRONTAL SINUS Tech 31086 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5023 31087 REMOVAL OF FRONTAL SINUS Tech 31087 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5055 31090 EXPLORATION OF SINUSES Tech 31090 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5034 31200 REMOVAL OF ETHMOID SINUS Tech 31200 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5060 31201 REMOVAL OF ETHMOID SINUS Tech 31201 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 5045 31205 REMOVAL OF ETHMOID SINUS Tech 31205 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5061 31225 REMOVAL OF UPPER JAW Tech 31225 761 3863 " 1,132.25 " 992.79 " 3,090.40 " 992.79 " 2,004.90 " N/A " 2,004.90 " N/A N/A " 1,970.13 " N/A " 2,317.80 " N/A N/A " 2,556.92 " N/A N/A N/A N/A N/A N/A N/A " 3,090.40 " N/A N/A " 2,588.21 " N/A " 1,579.97 " " 2,897.25 " " 1,468.33 " " 1,727.92 " N/A " 3,051.77 " 5062 31230 REMOVAL OF UPPER JAW Tech 31230 761 2147 629.29 551.78 " 1,717.60 " 551.78 " 1,114.29 " N/A " 1,114.29 " N/A N/A " 1,094.97 " N/A " 1,288.20 " N/A N/A " 1,421.10 " N/A N/A N/A N/A N/A N/A N/A " 1,717.60 " N/A N/A " 1,438.49 " N/A 878.12 " 1,610.25 " 816.07 960.35 N/A " 1,696.13 " 5041 31231 NASAL ENDOSCOPY DX Tech 31231 761 863 252.95 142.90 776.00 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 776.00 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5048 31233 NSL/SINS NDSC DX MAX SINUSC Tech 31233 761 1977 579.46 326.30 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 776.00 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5069 31235 NSL/SINS NDSC DX SPHN SINUSC Tech 31235 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5053 31237 NASAL/SINUS ENDOSCOPY SURG Tech 31237 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5076 31238 NASAL/SINUS ENDOSCOPY SURG Tech 31238 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5058 31239 NASAL/SINUS ENDOSCOPY SURG Tech 31239 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5054 31240 NASAL/SINUS ENDOSCOPY SURG Tech 31240 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5078 31241 NSL/SINS NDSC W/ARTERY LIG Tech 31241 761 7856 " 2,302.59 " " 1,298.80 " " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " N/A " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5068 31253 NSL/SINS NDSC TOTAL Tech 31253 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5085 31254 NSL/SINS NDSC W/PRTL ETHMDCT Tech 31254 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5091 31255 NSL/SINS NDSC W/TOT ETHMDCT Tech 31255 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5090 31256 EXPLORATION MAXILLARY SINUS Tech 31256 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5121 31257 NSL/SINS NDSC TOT W/SPHENDT Tech 31257 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5070 31259 NSL/SINS NDSC SPHN TISS RMVL Tech 31259 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5079 31267 ENDOSCOPY MAXILLARY SINUS Tech 31267 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5075 31276 NSL/SINS NDSC FRNT TISS RMVL Tech 31276 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5087 31287 NASAL/SINUS ENDOSCOPY SURG Tech 31287 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5100 31288 NASAL/SINUS ENDOSCOPY SURG Tech 31288 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5093 31290 NASAL/SINUS ENDOSCOPY SURG Tech 31290 761 2792 818.34 717.54 " 2,233.60 " 717.54 " 1,449.05 " N/A " 1,449.05 " N/A N/A " 1,423.92 " N/A " 1,675.20 " N/A N/A " 1,848.02 " N/A N/A N/A N/A N/A N/A N/A " 2,233.60 " N/A N/A " 1,870.64 " N/A " 1,141.93 " " 2,094.00 " " 1,061.24 " " 1,248.86 " N/A " 2,205.68 " 5096 31291 NASAL/SINUS ENDOSCOPY SURG Tech 31291 761 2708 793.71 695.96 " 2,166.40 " 695.96 " 1,405.45 " N/A " 1,405.45 " N/A N/A " 1,381.08 " N/A " 1,624.80 " N/A N/A " 1,792.43 " N/A N/A N/A N/A N/A N/A N/A " 2,166.40 " N/A N/A " 1,814.36 " N/A " 1,107.57 " " 2,031.00 " " 1,029.31 " " 1,211.29 " N/A " 2,139.32 " 5095 31292 NSL/SINS NDSC MED/INF DCMPRN Tech 31292 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5107 31293 NSL/SINS NDSC MED&INF DCMPRN Tech 31293 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5106 31294 NSL/SINS NDSC SURG ON DCMPRN Tech 31294 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5103 31295 NSL/SINS NDSC SURG MAX SINS Tech 31295 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5094 31296 NSL/SINS NDSC SURG FRNT SINS Tech 31296 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5099 31297 NSL/SINS NDSC SURG SPHN SINS Tech 31297 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5108 31299 Unl Skull Base Nasopharyngectomy Tech 31299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5109 31299 Unl Endo Craniofacial App Ant Fos Tech 31299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5111 31299 Unl Endo Approach Clivus Tumor Tech 31299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5118 31299 UNL ANT APPR NDSC RPR ENCEPHALOCEL Tech 31299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5140 31299 Unl Craniophargyngioma Via Scope Tech 31299 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5126 31300 REMOVAL OF LARYNX LESION Tech 31300 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5129 31360 REMOVAL OF LARYNX Tech 31360 761 4284 " 1,255.64 " " 1,100.99 " " 3,427.20 " " 1,100.99 " " 2,223.40 " N/A " 2,223.40 " N/A N/A " 2,184.84 " N/A " 2,570.40 " N/A N/A " 2,835.58 " N/A N/A N/A N/A N/A N/A N/A " 3,427.20 " N/A N/A " 2,870.28 " N/A " 1,752.16 " " 3,213.00 " " 1,628.35 " " 1,916.23 " N/A " 3,384.36 " 5114 31365 REMOVAL OF LARYNX Tech 31365 761 31616 " 9,266.65 " " 8,125.31 " " 25,292.80 " " 8,125.31 " " 16,408.70 " N/A " 16,408.70 " N/A N/A " 16,124.16 " N/A " 18,969.60 " N/A N/A " 20,926.63 " N/A N/A N/A N/A N/A N/A N/A " 25,292.80 " N/A N/A " 21,182.72 " N/A " 12,930.94 " " 23,712.00 " " 12,017.24 " " 14,141.84 " N/A " 24,976.64 " 5117 31367 PARTIAL REMOVAL OF LARYNX Tech 31367 761 4314 " 1,264.43 " " 1,108.70 " " 3,451.20 " " 1,108.70 " " 2,238.97 " N/A " 2,238.97 " N/A N/A " 2,200.14 " N/A " 2,588.40 " N/A N/A " 2,855.44 " N/A N/A N/A N/A N/A N/A N/A " 3,451.20 " N/A N/A " 2,890.38 " N/A " 1,764.43 " " 3,235.50 " " 1,639.75 " " 1,929.65 " N/A " 3,408.06 " 5136 31368 PARTIAL REMOVAL OF LARYNX Tech 31368 761 33748 " 9,891.54 " " 8,673.24 " " 26,998.40 " " 8,673.24 " " 17,515.21 " N/A " 17,515.21 " N/A N/A " 17,211.48 " N/A " 20,248.80 " N/A N/A " 22,337.80 " N/A N/A N/A N/A N/A N/A N/A " 26,998.40 " N/A N/A " 22,611.16 " N/A " 13,802.93 " " 25,311.00 " " 12,827.61 " " 15,095.48 " N/A " 26,660.92 " 5135 31375 PARTIAL REMOVAL OF LARYNX Tech 31375 761 19517 " 5,720.43 " " 5,015.87 " " 15,613.60 " " 5,015.87 " " 10,129.32 " N/A " 10,129.32 " N/A N/A " 9,953.67 " N/A " 11,710.20 " N/A N/A " 12,918.30 " N/A N/A N/A N/A N/A N/A N/A " 15,613.60 " N/A N/A " 13,076.39 " N/A " 7,982.45 " " 14,637.75 " " 7,418.41 " " 8,729.95 " N/A " 15,418.43 " 5137 31390 REMOVAL OF LARYNX & PHARYNX Tech 31390 761 58671 " 17,196.47 " " 15,078.45 " " 46,936.80 " " 15,078.45 " " 30,450.25 " N/A " 30,450.25 " N/A N/A " 29,922.21 " N/A " 35,202.60 " N/A N/A " 38,834.33 " N/A N/A N/A N/A N/A N/A N/A " 46,936.80 " N/A N/A " 39,309.57 " N/A " 23,996.44 " " 44,003.25 " " 22,300.85 " " 26,243.54 " N/A " 46,350.09 " 5127 31395 RECONSTRUCT LARYNX & PHARYNX Tech 31395 761 56089 " 16,439.69 " " 14,414.87 " " 44,871.20 " " 14,414.87 " " 29,110.19 " N/A " 29,110.19 " N/A N/A " 28,605.39 " N/A " 33,653.40 " N/A N/A " 37,125.31 " N/A N/A N/A N/A N/A N/A N/A " 44,871.20 " N/A N/A " 37,579.63 " N/A " 22,940.40 " " 42,066.75 " " 21,319.43 " " 25,088.61 " N/A " 44,310.31 " 5124 31420 REMOVAL OF EPIGLOTTIS Tech 31420 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5145 31500 INSERT EMERGENCY AIRWAY Tech 31500 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5144 31502 CHANGE OF WINDPIPE AIRWAY Tech 31502 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5130 31505 DIAGNOSTIC LARYNGOSCOPY Tech 31505 761 863 252.95 142.90 690.40 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 N/A 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5141 31510 LARYNGOSCOPY WITH BIOPSY Tech 31510 761 16265 " 4,767.27 " 779.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 779.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5139 31511 REMOVE FOREIGN BODY LARYNX Tech 31511 761 863 252.95 142.90 776.00 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 776.00 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5150 31515 LARYNGOSCOPY FOR ASPIRATION Tech 31515 761 1977 579.46 326.30 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 748.00 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5148 31520 DX LARYNGOSCOPY NEWBORN Tech 31520 761 1977 579.46 326.30 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 692.00 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5149 31525 DX LARYNGOSCOPY EXCL NB Tech 31525 761 7856 " 2,302.59 " 746.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 746.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5154 31526 DX LARYNGOSCOPY W/OPER SCOPE Tech 31526 761 7856 " 2,302.59 " 746.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 746.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5153 31527 LARYNGOSCOPY FOR TREATMENT Tech 31527 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5157 31528 LARYNGOSCOPY AND DILATION Tech 31528 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5163 31529 LARYNGOSCOPY AND DILATION Tech 31529 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5160 31530 LARYNGOSCOPY W/FB REMOVAL Tech 31530 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5179 31531 LARYNGOSCOPY W/FB & OP SCOPE Tech 31531 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5164 31535 LARYNGOSCOPY W/BIOPSY Tech 31535 761 16265 " 4,767.27 " 762.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 762.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5165 31536 LARYNGOSCOPY W/BX & OP SCOPE Tech 31536 761 16265 " 4,767.27 " 762.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 762.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5208 31540 LARYNGOSCOPY W/EXC OF TUMOR Tech 31540 761 16265 " 4,767.27 " " 1,036.00 " " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " " 1,036.00 " " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5174 31541 LARYNSCOP W/TUMR EXC + SCOPE Tech 31541 761 16265 " 4,767.27 " " 1,036.00 " " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " " 1,036.00 " " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5167 31545 REMOVE VC LESION W/SCOPE Tech 31545 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5168 31560 LARYNGOSCOP W/ARYTENOIDECTOM Tech 31560 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5178 31561 LARYNSCOP REMVE CART + SCOP Tech 31561 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5171 31570 LARYNGOSCOPE W/VC INJ Tech 31570 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5188 31571 LARYNGOSCOP W/VC INJ + SCOPE Tech 31571 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5204 31572 LARGSC W/LASER DSTRJ LES Tech 31572 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5209 31573 LARGSC W/THER INJECTION Tech 31573 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5199 31574 LARGSC W/NJX AUGMENTATION Tech 31574 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5177 31575 DIAGNOSTIC LARYNGOSCOPY Tech 31575 761 863 252.95 142.90 776.00 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 776.00 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5198 31576 LARYNGOSCOPY WITH BIOPSY Tech 31576 761 7856 " 2,302.59 " 762.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 762.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5191 31577 LARGSC W/RMVL FOREIGN BDY(S) Tech 31577 761 1977 579.46 326.30 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 776.00 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5180 31578 LARGSC W/REMOVAL LESION Tech 31578 761 16265 " 4,767.27 " " 1,036.00 " " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " " 1,036.00 " " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5223 31579 LARYNGOSCOPY TELESCOPIC Tech 31579 761 1977 579.46 75.00 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 75.00 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5214 31580 LARYNGOPLASTY LARYNGEAL WEB Tech 31580 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5206 31584 LARYNGOPLASTY FX RDCTJ FIXJ Tech 31584 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5186 31587 LARYNGOPLASTY CRICOID SPLIT Tech 31587 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5189 31591 LARYNGOPLASTY MEDIALIZATION Tech 31591 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5217 31592 CRICOTRACHEAL RESECTION Tech 31592 761 26702 " 7,826.36 " " 4,415.13 " " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " N/A " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5193 31599 Laryngoscopy laser stenosis Tech 31599 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5197 31599 Surpraglottoplasty Tech 31599 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5200 31599 Unl Tracheostomy Stoma Dilation Tech 31599 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5212 31599 Laryngoscopy w laser ablation Tech 31599 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 N/A 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5218 31600 INCISION OF WINDPIPE Tech 31600 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5211 31601 INCISION OF WINDPIPE Tech 31601 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5224 31603 INCISION OF WINDPIPE Tech 31603 761 7102 " 2,081.60 " 776.00 " 5,681.60 " " 1,825.21 " " 3,685.94 " " 1,381.54 " " 3,685.94 " " 1,174.31 " " 1,381.54 " " 3,622.02 " " 1,381.54 " " 4,261.20 " " 1,174.31 " " 1,478.25 " " 4,700.81 " " 1,243.39 " " 1,381.54 " " 4,174.85 " " 5,218.52 " " 1,367.72 " " 1,409.17 " " 1,381.54 " " 5,681.60 " " 1,264.11 " 776.00 " 4,758.34 " " 1,215.76 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,409.17 " " 5,610.58 " 5219 31605 INCISION OF WINDPIPE Tech 31605 761 1111 325.63 183.66 888.80 285.53 576.61 216.07 576.61 183.66 216.07 566.61 216.07 666.60 183.66 231.19 735.37 194.46 216.07 653.02 816.27 213.91 220.39 216.07 888.80 197.70 776.00 744.37 190.14 454.40 833.25 422.29 496.95 220.39 877.69 5222 31610 INCISION OF WINDPIPE Tech 31610 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5225 31611 SURGERY/SPEECH PROSTHESIS Tech 31611 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5256 31612 PUNCTURE/CLEAR WINDPIPE Tech 31612 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5236 31613 REPAIR WINDPIPE OPENING Tech 31613 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5246 31614 REPAIR WINDPIPE OPENING Tech 31614 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5233 31615 VISUALIZATION OF WINDPIPE Tech 31615 761 2375 696.11 392.62 " 1,900.00 " 610.38 " 1,232.63 " 461.90 " 1,232.63 " 392.62 461.90 " 1,211.25 " 461.90 " 1,425.00 " 392.62 494.23 " 1,572.01 " 415.71 461.90 " 1,396.03 " " 1,745.02 " 457.28 471.14 461.90 " 1,900.00 " 422.64 746.00 " 1,591.25 " 406.47 971.38 " 1,781.25 " 902.74 " 1,062.34 " 471.14 " 1,876.25 " 5251 31622 DX BRONCHOSCOPE/WASH Tech 31622 761 7856 " 2,302.59 " 655.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 655.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 27545 31622 PFT DX BRONCHOSCOPE Tech 31622 761 7856 " 2,302.59 " 655.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 655.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5238 31623 DX BRONCHOSCOPE/BRUSH Tech 31623 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5237 31624 DX BRONCHOSCOPE/LAVAGE Tech 31624 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5260 31625 BRONCHOSCOPY W/BIOPSY(S) Tech 31625 761 7856 " 2,302.59 " 664.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 664.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5274 31626 BRONCHOSCOPY W/MARKERS Tech 31626 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5240 31627 NAVIGATIONAL BRONCHOSCOPY Tech 31627 761 479 140.39 123.10 383.20 123.10 248.60 N/A 248.60 N/A N/A 244.29 N/A 287.40 N/A N/A 317.05 N/A N/A N/A N/A N/A N/A N/A 383.20 N/A N/A 320.93 N/A 195.91 359.25 182.07 214.26 N/A 378.41 5254 31628 BRONCHOSCOPY/LUNG BX EACH Tech 31628 761 16265 " 4,767.27 " 767.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 767.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5249 31629 BRONCHOSCOPY/NEEDLE BX EACH Tech 31629 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5245 31630 BRONCHOSCOPY DILATE/FX REPR Tech 31630 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5261 31631 BRONCHOSCOPY DILATE W/STENT Tech 31631 761 30569 " 8,959.77 " 213.75 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 213.75 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5267 31632 BRONCHOSCOPY/LUNG BX ADDL Tech 31632 761 251 73.57 50.49 200.80 64.51 130.27 N/A 130.27 N/A N/A 128.01 N/A 150.60 N/A N/A 166.14 N/A N/A N/A N/A N/A N/A N/A 200.80 N/A 50.49 168.17 N/A 102.66 188.25 95.41 112.27 N/A 198.29 5257 31633 BRONCHOSCOPY/NEEDLE BX ADDL Tech 31633 761 100 29.31 25.70 80.00 25.70 51.90 N/A 51.90 N/A N/A 51.00 N/A 60.00 N/A N/A 66.19 N/A N/A N/A N/A N/A N/A N/A 80.00 N/A 62.08 67.00 N/A 40.90 75.00 38.01 44.73 N/A 79.00 5252 31634 BRONCH W/BALLOON OCCLUSION Tech 31634 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5253 31635 BRONCHOSCOPY W/FB REMOVAL Tech 31635 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5297 31636 BRONCHOSCOPY BRONCH STENTS Tech 31636 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5258 31637 BRONCHOSCOPY STENT ADD-ON Tech 31637 761 237 69.46 60.91 189.60 60.91 123.00 N/A 123.00 N/A N/A 120.87 N/A 142.20 N/A N/A 156.87 N/A N/A N/A N/A N/A N/A N/A 189.60 N/A 66.63 158.79 N/A 96.93 177.75 90.08 106.01 N/A 187.23 5259 31638 BRONCHOSCOPY REVISE STENT Tech 31638 761 30569 " 8,959.77 " 776.00 " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " 776.00 " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5285 31640 BRONCHOSCOPY W/TUMOR EXCISE Tech 31640 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5263 31641 BRONCHOSCOPY TREAT BLOCKAGE Tech 31641 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5278 31643 DIAG BRONCHOSCOPE/CATHETER Tech 31643 761 7856 " 2,302.59 " 163.41 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 163.41 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5271 31645 BRNCHSC W/THER ASPIR 1ST Tech 31645 761 7856 " 2,302.59 " 776.00 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 776.00 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5276 31646 BRNCHSC W/THER ASPIR SBSQ Tech 31646 761 1977 579.46 128.44 " 1,581.60 " 508.09 " 1,026.06 " 383.88 " 1,026.06 " 326.30 383.88 " 1,008.27 " 383.88 " 1,186.20 " 326.30 410.75 " 1,308.58 " 345.49 383.88 " 1,161.95 " " 1,452.42 " 380.04 391.56 383.88 " 1,581.60 " 351.25 128.44 " 1,324.59 " 337.81 808.59 " 1,482.75 " 751.46 884.31 391.56 " 1,561.83 " 5269 31647 BRONCHIAL VALVE INIT INSERT Tech 31647 761 30569 " 8,959.77 " " 5,055.36 " " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " N/A " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5287 31648 BRONCHIAL VALVE REMOV INIT Tech 31648 761 16265 " 4,767.27 " " 2,689.04 " " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " N/A " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5283 31649 BRONCHIAL VALVE REMOV ADDL Tech 31649 761 7856 " 2,302.59 " " 1,298.80 " " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " N/A " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5282 31651 BRONCHIAL VALVE ADDL INSERT Tech 31651 761 2338 685.27 600.87 " 1,870.40 " 600.87 " 1,213.42 " N/A " 1,213.42 " N/A N/A " 1,192.38 " N/A " 1,402.80 " N/A N/A " 1,547.52 " N/A N/A N/A N/A N/A N/A N/A " 1,870.40 " N/A N/A " 1,566.46 " N/A 956.24 " 1,753.50 " 888.67 " 1,045.79 " N/A " 1,847.02 " 5291 31652 BRONCH EBUS SAMPLNG 1/2 NODE Tech 31652 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5315 31653 BRONCH EBUS SAMPLNG 3/> NODE Tech 31653 761 16265 " 4,767.27 " 776.00 " 13,012.00 " " 4,180.11 " " 8,441.54 " " 3,163.58 " " 8,441.54 " " 2,689.04 " " 3,163.58 " " 8,295.15 " " 3,163.58 " " 9,759.00 " " 2,689.04 " " 3,385.03 " " 10,765.80 " " 2,847.22 " " 3,163.58 " " 9,560.80 " " 11,950.92 " " 3,131.94 " " 3,226.85 " " 3,163.58 " " 13,012.00 " " 2,894.68 " 776.00 " 10,897.55 " " 2,783.95 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,226.85 " " 12,849.35 " 5295 31654 BRONCH EBUS IVNTJ PERPH LES Tech 31654 761 684 200.48 54.95 547.20 175.79 355.00 N/A 355.00 N/A N/A 348.84 N/A 410.40 N/A N/A 452.74 N/A N/A N/A N/A N/A N/A N/A 547.20 N/A 54.95 458.28 N/A 279.76 513.00 259.99 305.95 N/A 540.36 5313 31660 BRONCH THERMOPLSTY 1 LOBE Tech 31660 761 30569 " 8,959.77 " " 5,055.36 " " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " N/A " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5301 31661 BRONCH THERMOPLSTY 2/> LOBES Tech 31661 761 30569 " 8,959.77 " " 5,055.36 " " 24,455.20 " " 7,856.23 " " 15,865.31 " " 5,947.48 " " 15,865.31 " " 5,055.36 " " 5,947.48 " " 15,590.19 " " 5,947.48 " " 18,341.40 " " 5,055.36 " " 6,363.80 " " 20,233.62 " " 5,352.73 " " 5,947.48 " " 17,969.62 " " 22,461.88 " " 5,888.01 " " 6,066.43 " " 5,947.48 " " 24,455.20 " " 5,441.94 " N/A " 20,481.23 " " 5,233.78 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 6,066.43 " " 24,149.51 " 5321 31720 CLEARANCE OF AIRWAYS Tech 31720 761 986 289.00 33.00 788.80 253.40 511.73 191.97 511.73 163.17 191.97 502.86 191.97 591.60 163.17 205.41 652.63 172.77 191.97 579.82 724.77 190.05 195.81 191.97 788.80 175.65 33.00 660.62 168.93 403.27 739.50 374.78 441.04 195.81 778.94 5290 31730 INTRO WINDPIPE WIRE/TUBE Tech 31730 761 7856 " 2,302.59 " 133.39 " 6,284.80 " " 2,018.99 " " 4,077.26 " " 1,528.00 " " 4,077.26 " " 1,298.80 " " 1,528.00 " " 4,006.56 " " 1,528.00 " " 4,713.60 " " 1,298.80 " " 1,634.96 " " 5,199.89 " " 1,375.20 " " 1,528.00 " " 4,618.01 " " 5,772.47 " " 1,512.72 " " 1,558.56 " " 1,528.00 " " 6,284.80 " " 1,398.12 " 133.39 " 5,263.52 " " 1,344.64 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,558.56 " " 6,206.24 " 5292 31750 REPAIR OF WINDPIPE Tech 31750 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5327 31775 RECONSTRUCT BRONCHUS Tech 31775 761 33384 " 9,784.85 " " 8,579.69 " " 26,707.20 " " 8,579.69 " " 17,326.30 " N/A " 17,326.30 " N/A N/A " 17,025.84 " N/A " 20,030.40 " N/A N/A " 22,096.87 " N/A N/A N/A N/A N/A N/A N/A " 26,707.20 " N/A N/A " 22,367.28 " N/A " 13,654.06 " " 25,038.00 " " 12,689.26 " " 14,932.66 " N/A " 26,373.36 " 5302 31780 RECONSTRUCT WINDPIPE Tech 31780 761 18607 " 5,453.71 " " 4,782.00 " " 14,885.60 " " 4,782.00 " " 9,657.03 " N/A " 9,657.03 " N/A N/A " 9,489.57 " N/A " 11,164.20 " N/A N/A " 12,315.97 " N/A N/A N/A N/A N/A N/A N/A " 14,885.60 " N/A N/A " 12,466.69 " N/A " 7,610.26 " " 13,955.25 " " 7,072.52 " " 8,322.91 " N/A " 14,699.53 " 5298 31785 REMOVE WINDPIPE LESION Tech 31785 761 26702 " 7,826.36 " 776.00 " 21,361.60 " " 6,862.41 " " 13,858.34 " " 5,194.27 " " 13,858.34 " " 4,415.13 " " 5,194.27 " " 13,618.02 " " 5,194.27 " " 16,021.20 " " 4,415.13 " " 5,557.87 " " 17,674.05 " " 4,674.84 " " 5,194.27 " " 15,696.06 " " 19,619.95 " " 5,142.33 " " 5,298.16 " " 5,194.27 " " 21,361.60 " " 4,752.76 " 776.00 " 17,890.34 " " 4,570.96 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,298.16 " " 21,094.58 " 5293 31786 REMOVE WINDPIPE LESION Tech 31786 761 17867 " 5,236.82 " " 4,591.82 " " 14,293.60 " " 4,591.82 " " 9,272.97 " N/A " 9,272.97 " N/A N/A " 9,112.17 " N/A " 10,720.20 " N/A N/A " 11,826.17 " N/A N/A N/A N/A N/A N/A N/A " 14,293.60 " N/A N/A " 11,970.89 " N/A " 7,307.60 " " 13,400.25 " " 6,791.25 " " 7,991.91 " N/A " 14,114.93 " 5319 31800 REPAIR OF WINDPIPE INJURY Tech 31800 761 6372 " 1,867.63 " " 1,637.60 " " 5,097.60 " " 1,637.60 " " 3,307.07 " N/A " 3,307.07 " N/A N/A " 3,249.72 " N/A " 3,823.20 " N/A N/A " 4,217.63 " N/A N/A N/A N/A N/A N/A N/A " 5,097.60 " N/A N/A " 4,269.24 " N/A " 2,606.15 " " 4,779.00 " " 2,422.00 " " 2,850.20 " N/A " 5,033.88 " 5309 31805 REPAIR OF WINDPIPE INJURY Tech 31805 761 10192 " 2,987.28 " " 2,619.34 " " 8,153.60 " " 2,619.34 " " 5,289.65 " N/A " 5,289.65 " N/A N/A " 5,197.92 " N/A " 6,115.20 " N/A N/A " 6,746.08 " N/A N/A N/A N/A N/A N/A N/A " 8,153.60 " N/A N/A " 6,828.64 " N/A " 4,168.53 " " 7,644.00 " " 3,873.98 " " 4,558.88 " N/A " 8,051.68 " 5312 31820 CLOSURE OF WINDPIPE LESION Tech 31820 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5303 31825 REPAIR OF WINDPIPE DEFECT Tech 31825 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5349 31830 REVISE WINDPIPE SCAR Tech 31830 761 14366 " 4,210.67 " 776.00 " 11,492.80 " " 3,692.06 " " 7,455.95 " " 2,793.98 " " 7,455.95 " " 2,374.88 " " 2,793.98 " " 7,326.66 " " 2,793.98 " " 8,619.60 " " 2,374.88 " " 2,989.56 " " 9,508.86 " " 2,514.58 " " 2,793.98 " " 8,444.77 " " 10,555.90 " " 2,766.04 " " 2,849.86 " " 2,793.98 " " 11,492.80 " " 2,556.49 " 776.00 " 9,625.22 " " 2,458.70 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,849.86 " " 11,349.14 " 5311 31899 Unl Endobronch Blocker Placement Tech 31899 761 863 252.95 142.90 690.40 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 N/A 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5314 31899 Robotic bronchoplasty w/ pleural flap Tech 31899 761 863 252.95 142.90 690.40 221.79 447.90 168.12 447.90 142.90 168.12 440.13 168.12 517.80 142.90 179.89 571.22 151.31 168.12 507.32 634.15 166.44 171.48 168.12 690.40 153.83 N/A 578.21 147.95 352.97 647.25 328.03 386.02 171.48 681.77 5322 32035 THORACOSTOMY W/RIB RESECTION Tech 32035 761 12667 " 3,712.70 " " 3,255.42 " " 10,133.60 " " 3,255.42 " " 6,574.17 " N/A " 6,574.17 " N/A N/A " 6,460.17 " N/A " 7,600.20 " N/A N/A " 8,384.29 " N/A N/A N/A N/A N/A N/A N/A " 10,133.60 " N/A N/A " 8,486.89 " N/A " 5,180.80 " " 9,500.25 " " 4,814.73 " " 5,665.95 " N/A " 10,006.93 " 5326 32036 THORACOSTOMY W/FLAP DRAINAGE Tech 32036 761 11991 " 3,514.56 " " 3,081.69 " " 9,592.80 " " 3,081.69 " " 6,223.33 " N/A " 6,223.33 " N/A N/A " 6,115.41 " N/A " 7,194.60 " N/A N/A " 7,936.84 " N/A N/A N/A N/A N/A N/A N/A " 9,592.80 " N/A N/A " 8,033.97 " N/A " 4,904.32 " " 8,993.25 " " 4,557.78 " " 5,363.57 " N/A " 9,472.89 " 5339 32096 OPEN WEDGE/BX LUNG INFILTR Tech 32096 761 9840 " 2,884.10 " " 2,528.88 " " 7,872.00 " " 2,528.88 " " 5,106.96 " N/A " 5,106.96 " N/A N/A " 5,018.40 " N/A " 5,904.00 " N/A N/A " 6,513.10 " N/A N/A N/A N/A N/A N/A N/A " 7,872.00 " N/A N/A " 6,592.80 " N/A " 4,024.56 " " 7,380.00 " " 3,740.18 " " 4,401.43 " N/A " 7,773.60 " 5346 32097 OPEN WEDGE/BX LUNG NODULE Tech 32097 761 11995 " 3,515.73 " " 3,082.72 " " 9,596.00 " " 3,082.72 " " 6,225.41 " N/A " 6,225.41 " N/A N/A " 6,117.45 " N/A " 7,197.00 " N/A N/A " 7,939.49 " N/A N/A N/A N/A N/A N/A N/A " 9,596.00 " N/A N/A " 8,036.65 " N/A " 4,905.96 " " 8,996.25 " " 4,559.30 " " 5,365.36 " N/A " 9,476.05 " 5359 32098 OPEN BIOPSY OF LUNG PLEURA Tech 32098 761 11153 " 3,268.94 " " 2,866.32 " " 8,922.40 " " 2,866.32 " " 5,788.41 " N/A " 5,788.41 " N/A N/A " 5,688.03 " N/A " 6,691.80 " N/A N/A " 7,382.17 " N/A N/A N/A N/A N/A N/A N/A " 8,922.40 " N/A N/A " 7,472.51 " N/A " 4,561.58 " " 8,364.75 " " 4,239.26 " " 4,988.74 " N/A " 8,810.87 " 5343 32100 EXPLORATION OF CHEST Tech 32100 761 2002 586.79 514.51 " 1,601.60 " 514.51 " 1,039.04 " N/A " 1,039.04 " N/A N/A " 1,021.02 " N/A " 1,201.20 " N/A N/A " 1,325.12 " N/A N/A N/A N/A N/A N/A N/A " 1,601.60 " N/A N/A " 1,341.34 " N/A 818.82 " 1,501.50 " 760.96 895.49 N/A " 1,581.58 " 5337 32110 EXPLORE/REPAIR CHEST Tech 32110 761 2474 725.13 635.82 " 1,979.20 " 635.82 " 1,284.01 " N/A " 1,284.01 " N/A N/A " 1,261.74 " N/A " 1,484.40 " N/A N/A " 1,637.54 " N/A N/A N/A N/A N/A N/A N/A " 1,979.20 " N/A N/A " 1,657.58 " N/A " 1,011.87 " " 1,855.50 " 940.37 " 1,106.62 " N/A " 1,954.46 " 5334 32120 RE-EXPLORATION OF CHEST Tech 32120 761 15548 " 4,557.12 " " 3,995.84 " " 12,438.40 " " 3,995.84 " " 8,069.41 " N/A " 8,069.41 " N/A N/A " 7,929.48 " N/A " 9,328.80 " N/A N/A " 10,291.22 " N/A N/A N/A N/A N/A N/A N/A " 12,438.40 " N/A N/A " 10,417.16 " N/A " 6,359.13 " " 11,661.00 " " 5,909.79 " " 6,954.62 " N/A " 12,282.92 " 5355 32124 EXPLORE CHEST FREE ADHESIONS Tech 32124 761 5606 " 1,643.12 " " 1,440.74 " " 4,484.80 " " 1,440.74 " " 2,909.51 " N/A " 2,909.51 " N/A N/A " 2,859.06 " N/A " 3,363.60 " N/A N/A " 3,710.61 " N/A N/A N/A N/A N/A N/A N/A " 4,484.80 " N/A N/A " 3,756.02 " N/A " 2,292.85 " " 4,204.50 " " 2,130.84 " " 2,507.56 " N/A " 4,428.74 " 5353 32140 REMOVAL OF LUNG LESION(S) Tech 32140 761 10426 " 3,055.86 " " 2,679.48 " " 8,340.80 " " 2,679.48 " " 5,411.09 " N/A " 5,411.09 " N/A N/A " 5,317.26 " N/A " 6,255.60 " N/A N/A " 6,900.97 " N/A N/A N/A N/A N/A N/A N/A " 8,340.80 " N/A N/A " 6,985.42 " N/A " 4,264.23 " " 7,819.50 " " 3,962.92 " " 4,663.55 " N/A " 8,236.54 " 5345 32141 REMOVE/TREAT LUNG LESIONS Tech 32141 761 646 189.34 166.02 516.80 166.02 335.27 N/A 335.27 N/A N/A 329.46 N/A 387.60 N/A N/A 427.59 N/A N/A N/A N/A N/A N/A N/A 516.80 N/A N/A 432.82 N/A 264.21 484.50 245.54 288.96 N/A 510.34 5361 32150 REMOVAL OF LUNG LESION(S) Tech 32150 761 3120 914.47 801.84 " 2,496.00 " 801.84 " 1,619.28 " N/A " 1,619.28 " N/A N/A " 1,591.20 " N/A " 1,872.00 " N/A N/A " 2,065.13 " N/A N/A N/A N/A N/A N/A N/A " 2,496.00 " N/A N/A " 2,090.40 " N/A " 1,276.08 " " 2,340.00 " " 1,185.91 " " 1,395.58 " N/A " 2,464.80 " 5342 32151 REMOVE LUNG FOREIGN BODY Tech 32151 761 4484 " 1,314.26 " " 1,152.39 " " 3,587.20 " " 1,152.39 " " 2,327.20 " N/A " 2,327.20 " N/A N/A " 2,286.84 " N/A " 2,690.40 " N/A N/A " 2,967.96 " N/A N/A N/A N/A N/A N/A N/A " 3,587.20 " N/A N/A " 3,004.28 " N/A " 1,833.96 " " 3,363.00 " " 1,704.37 " " 2,005.69 " N/A " 3,542.36 " 5356 32160 OPEN CHEST HEART MASSAGE Tech 32160 761 2705 792.84 695.19 " 2,164.00 " 695.19 " 1,403.90 " N/A " 1,403.90 " N/A N/A " 1,379.55 " N/A " 1,623.00 " N/A N/A " 1,790.44 " N/A N/A N/A N/A N/A N/A N/A " 2,164.00 " N/A N/A " 1,812.35 " N/A " 1,106.35 " " 2,028.75 " " 1,028.17 " " 1,209.95 " N/A " 2,136.95 " 5344 32200 DRAIN OPEN LUNG LESION Tech 32200 761 8095 " 2,372.64 " " 2,080.42 " " 6,476.00 " " 2,080.42 " " 4,201.31 " N/A " 4,201.31 " N/A N/A " 4,128.45 " N/A " 4,857.00 " N/A N/A " 5,358.08 " N/A N/A N/A N/A N/A N/A N/A " 6,476.00 " N/A N/A " 5,423.65 " N/A " 3,310.86 " " 6,071.25 " " 3,076.91 " " 3,620.89 " N/A " 6,395.05 " 5357 32215 TREAT CHEST LINING Tech 32215 761 5061 " 1,483.38 " " 1,300.68 " " 4,048.80 " " 1,300.68 " " 2,626.66 " N/A " 2,626.66 " N/A N/A " 2,581.11 " N/A " 3,036.60 " N/A N/A " 3,349.88 " N/A N/A N/A N/A N/A N/A N/A " 4,048.80 " N/A N/A " 3,390.87 " N/A " 2,069.95 " " 3,795.75 " " 1,923.69 " " 2,263.79 " N/A " 3,998.19 " 5347 32220 RELEASE OF LUNG Tech 32220 761 5925 " 1,736.62 " " 1,522.73 " " 4,740.00 " " 1,522.73 " " 3,075.08 " N/A " 3,075.08 " N/A N/A " 3,021.75 " N/A " 3,555.00 " N/A N/A " 3,921.76 " N/A N/A N/A N/A N/A N/A N/A " 4,740.00 " N/A N/A " 3,969.75 " N/A " 2,423.33 " " 4,443.75 " " 2,252.09 " " 2,650.25 " N/A " 4,680.75 " 5348 32225 PARTIAL RELEASE OF LUNG Tech 32225 761 14313 " 4,195.14 " " 3,678.44 " " 11,450.40 " " 3,678.44 " " 7,428.45 " N/A " 7,428.45 " N/A N/A " 7,299.63 " N/A " 8,587.80 " N/A N/A " 9,473.77 " N/A N/A N/A N/A N/A N/A N/A " 11,450.40 " N/A N/A " 9,589.71 " N/A " 5,854.02 " " 10,734.75 " " 5,440.37 " " 6,402.20 " N/A " 11,307.27 " 5384 32310 REMOVAL OF CHEST LINING Tech 32310 761 12454 " 3,650.27 " " 3,200.68 " " 9,963.20 " " 3,200.68 " " 6,463.63 " N/A " 6,463.63 " N/A N/A " 6,351.54 " N/A " 7,472.40 " N/A N/A " 8,243.30 " N/A N/A N/A N/A N/A N/A N/A " 9,963.20 " N/A N/A " 8,344.18 " N/A " 5,093.69 " " 9,340.50 " " 4,733.77 " " 5,570.67 " N/A " 9,838.66 " 5360 32320 FREE/REMOVE CHEST LINING Tech 32320 761 14649 " 4,293.62 " " 3,764.79 " " 11,719.20 " " 3,764.79 " " 7,602.83 " N/A " 7,602.83 " N/A N/A " 7,470.99 " N/A " 8,789.40 " N/A N/A " 9,696.17 " N/A N/A N/A N/A N/A N/A N/A " 11,719.20 " N/A N/A " 9,814.83 " N/A " 5,991.44 " " 10,986.75 " " 5,568.08 " " 6,552.50 " N/A " 11,572.71 " 5369 32400 NEEDLE BIOPSY CHEST LINING Tech 32400 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 5382 32408 PERCUT BX LUNG/MEDIASTINUM Tech 32408 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 65678 TRANSTHORACIC NEEDLE BX Tech 32408 761 7387 " 2,165.13 " 776.00 " 5,909.60 " " 1,898.46 " " 3,833.85 " " 1,436.99 " " 3,833.85 " " 1,221.44 " " 1,436.99 " " 3,767.37 " " 1,436.99 " " 4,432.20 " " 1,221.44 " " 1,537.58 " " 4,889.46 " " 1,293.29 " " 1,436.99 " " 4,342.14 " " 5,427.64 " " 1,422.62 " " 1,465.73 " " 1,436.99 " " 5,909.60 " " 1,314.85 " 776.00 " 4,949.29 " " 1,264.55 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,465.73 " " 5,835.73 " 5390 32440 REMOVE LUNG PNEUMONECTOMY Tech 32440 761 12539 " 3,675.18 " " 3,222.52 " " 10,031.20 " " 3,222.52 " " 6,507.74 " N/A " 6,507.74 " N/A N/A " 6,394.89 " N/A " 7,523.40 " N/A N/A " 8,299.56 " N/A N/A N/A N/A N/A N/A N/A " 10,031.20 " N/A N/A " 8,401.13 " N/A " 5,128.45 " " 9,404.25 " " 4,766.07 " " 5,608.69 " N/A " 9,905.81 " 5387 32442 SLEEVE PNEUMONECTOMY Tech 32442 761 20107 " 5,893.36 " " 5,167.50 " " 16,085.60 " " 5,167.50 " " 10,435.53 " N/A " 10,435.53 " N/A N/A " 10,254.57 " N/A " 12,064.20 " N/A N/A " 13,308.82 " N/A N/A N/A N/A N/A N/A N/A " 16,085.60 " N/A N/A " 13,471.69 " N/A " 8,223.76 " " 15,080.25 " " 7,642.67 " " 8,993.86 " N/A " 15,884.53 " 5364 32445 REMOVAL OF LUNG EXTRAPLEURAL Tech 32445 761 27794 " 8,146.42 " " 7,143.06 " " 22,235.20 " " 7,143.06 " " 14,425.09 " N/A " 14,425.09 " N/A N/A " 14,174.94 " N/A " 16,676.40 " N/A N/A " 18,396.85 " N/A N/A N/A N/A N/A N/A N/A " 22,235.20 " N/A N/A " 18,621.98 " N/A " 11,367.75 " " 20,845.50 " " 10,564.50 " " 12,432.26 " N/A " 21,957.26 " 5371 32480 PARTIAL REMOVAL OF LUNG Tech 32480 761 2306 675.89 592.64 " 1,844.80 " 592.64 " 1,196.81 " N/A " 1,196.81 " N/A N/A " 1,176.06 " N/A " 1,383.60 " N/A N/A " 1,526.34 " N/A N/A N/A N/A N/A N/A N/A " 1,844.80 " N/A N/A " 1,545.02 " N/A 943.15 " 1,729.50 " 876.51 " 1,031.47 " N/A " 1,821.74 " 5377 32482 BILOBECTOMY Tech 32482 761 27788 " 8,144.66 " " 7,141.52 " " 22,230.40 " " 7,141.52 " " 14,421.97 " N/A " 14,421.97 " N/A N/A " 14,171.88 " N/A " 16,672.80 " N/A N/A " 18,392.88 " N/A N/A N/A N/A N/A N/A N/A " 22,230.40 " N/A N/A " 18,617.96 " N/A " 11,365.29 " " 20,841.00 " " 10,562.22 " " 12,429.57 " N/A " 21,952.52 " 5375 32484 SEGMENTECTOMY Tech 32484 761 19207 " 5,629.57 " " 4,936.20 " " 15,365.60 " " 4,936.20 " " 9,968.43 " N/A " 9,968.43 " N/A N/A " 9,795.57 " N/A " 11,524.20 " N/A N/A " 12,713.11 " N/A N/A N/A N/A N/A N/A N/A " 15,365.60 " N/A N/A " 12,868.69 " N/A " 7,855.66 " " 14,405.25 " " 7,300.58 " " 8,591.29 " N/A " 15,173.53 " 5376 32486 SLEEVE LOBECTOMY Tech 32486 761 26368 " 7,728.46 " " 6,776.58 " " 21,094.40 " " 6,776.58 " " 13,684.99 " N/A " 13,684.99 " N/A N/A " 13,447.68 " N/A " 15,820.80 " N/A N/A " 17,452.98 " N/A N/A N/A N/A N/A N/A N/A " 21,094.40 " N/A N/A " 17,666.56 " N/A " 10,784.51 " " 19,776.00 " " 10,022.48 " " 11,794.41 " N/A " 20,830.72 " 5383 32488 COMPLETION PNEUMONECTOMY Tech 32488 761 23769 " 6,966.69 " " 6,108.63 " " 19,015.20 " " 6,108.63 " " 12,336.11 " N/A " 12,336.11 " N/A N/A " 12,122.19 " N/A " 14,261.40 " N/A N/A " 15,732.70 " N/A N/A N/A N/A N/A N/A N/A " 19,015.20 " N/A N/A " 15,925.23 " N/A " 9,721.52 " " 17,826.75 " " 9,034.60 " " 10,631.87 " N/A " 18,777.51 " 5388 32491 LUNG VOLUME REDUCTION Tech 32491 761 10348 " 3,033.00 " " 2,659.44 " " 8,278.40 " " 2,659.44 " " 5,370.61 " N/A " 5,370.61 " N/A N/A " 5,277.48 " N/A " 6,208.80 " N/A N/A " 6,849.34 " N/A N/A N/A N/A N/A N/A N/A " 8,278.40 " N/A N/A " 6,933.16 " N/A " 4,232.33 " " 7,761.00 " " 3,933.27 " " 4,628.66 " N/A " 8,174.92 " 5381 32501 REPAIR BRONCHUS ADD-ON Tech 32501 761 2246 658.30 577.22 " 1,796.80 " 577.22 " 1,165.67 " N/A " 1,165.67 " N/A N/A " 1,145.46 " N/A " 1,347.60 " N/A N/A " 1,486.63 " N/A N/A N/A N/A N/A N/A N/A " 1,796.80 " N/A N/A " 1,504.82 " N/A 918.61 " 1,684.50 " 853.70 " 1,004.64 " N/A " 1,774.34 " 5389 32503 RESECT APICAL LUNG TUMOR Tech 32503 761 17172 " 5,033.11 " " 4,413.20 " " 13,737.60 " " 4,413.20 " " 8,912.27 " N/A " 8,912.27 " N/A N/A " 8,757.72 " N/A " 10,303.20 " N/A N/A " 11,366.15 " N/A N/A N/A N/A N/A N/A N/A " 13,737.60 " N/A N/A " 11,505.24 " N/A " 7,023.35 " " 12,879.00 " " 6,527.08 " " 7,681.04 " N/A " 13,565.88 " 5397 32504 RESECT APICAL LUNG TUM/CHEST Tech 32504 761 25958 " 7,608.29 " " 6,671.21 " " 20,766.40 " " 6,671.21 " " 13,472.20 " N/A " 13,472.20 " N/A N/A " 13,238.58 " N/A " 15,574.80 " N/A N/A " 17,181.60 " N/A N/A N/A N/A N/A N/A N/A " 20,766.40 " N/A N/A " 17,391.86 " N/A " 10,616.82 " " 19,468.50 " " 9,866.64 " " 11,611.01 " N/A " 20,506.82 " 5385 32505 WEDGE RESECT OF LUNG INITIAL Tech 32505 761 4341 " 1,272.35 " " 1,115.64 " " 3,472.80 " " 1,115.64 " " 2,252.98 " N/A " 2,252.98 " N/A N/A " 2,213.91 " N/A " 2,604.60 " N/A N/A " 2,873.31 " N/A N/A N/A N/A N/A N/A N/A " 3,472.80 " N/A N/A " 2,908.47 " N/A " 1,775.47 " " 3,255.75 " " 1,650.01 " " 1,941.73 " N/A " 3,429.39 " 5400 32506 WEDGE RESECT OF LUNG ADD-ON Tech 32506 761 11239 " 3,294.15 " " 2,888.42 " " 8,991.20 " " 2,888.42 " " 5,833.04 " N/A " 5,833.04 " N/A N/A " 5,731.89 " N/A " 6,743.40 " N/A N/A " 7,439.09 " N/A N/A N/A N/A N/A N/A N/A " 8,991.20 " N/A N/A " 7,530.13 " N/A " 4,596.75 " " 8,429.25 " " 4,271.94 " " 5,027.20 " N/A " 8,878.81 " 5391 32507 WEDGE RESECT OF LUNG DIAG Tech 32507 761 11239 " 3,294.15 " " 2,888.42 " " 8,991.20 " " 2,888.42 " " 5,833.04 " N/A " 5,833.04 " N/A N/A " 5,731.89 " N/A " 6,743.40 " N/A N/A " 7,439.09 " N/A N/A N/A N/A N/A N/A N/A " 8,991.20 " N/A N/A " 7,530.13 " N/A " 4,596.75 " " 8,429.25 " " 4,271.94 " " 5,027.20 " N/A " 8,878.81 " 5392 32540 REMOVAL OF LUNG LESION Tech 32540 761 10162 " 2,978.48 " " 2,611.63 " " 8,129.60 " " 2,611.63 " " 5,274.08 " N/A " 5,274.08 " N/A N/A " 5,182.62 " N/A " 6,097.20 " N/A N/A " 6,726.23 " N/A N/A N/A N/A N/A N/A N/A " 8,129.60 " N/A N/A " 6,808.54 " N/A " 4,156.26 " " 7,621.50 " " 3,862.58 " " 4,545.46 " N/A " 8,027.98 " 26808 32550 CT Tunnelled Catheter Insert Perc Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 26812 32550 IR Chest Tube Repostion Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 26828 32550 US Tunnelled Catheter Insert Perc Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 26829 32550 IR Tunnelled Pleural Cath Insert Perc Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 26830 32550 IR Tunneled Pleural Drain Placement Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 26837 32550 US Tunnelled Pleural Cath Insert Perc Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 65559 IR* TUNNELD PLEURAL DRAINPLMNT Tech 32550 761 16713 " 4,898.58 " 776.00 " 13,370.40 " " 4,295.24 " " 8,674.05 " " 3,249.35 " " 8,674.05 " " 2,761.95 " " 3,249.35 " " 8,523.63 " " 3,249.35 " " 10,027.80 " " 2,761.95 " " 3,476.80 " " 11,062.33 " " 2,924.42 " " 3,249.35 " " 9,824.32 " " 12,280.32 " " 3,216.86 " " 3,314.34 " " 3,249.35 " " 13,370.40 " " 2,973.16 " 776.00 " 11,197.71 " " 2,859.43 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,314.34 " " 13,203.27 " 5394 32551 INSERTION OF CHEST TUBE Tech 32551 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 26814 32551 CT Thoracostomy w/ Drainage Tech 32551 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 26832 32551 IR Thoracostomy w/ Drainage Tech 32551 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 65411 CHEST TUBE FOR FLUID DRN Tech 32551 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 5408 32552 REMOVE LUNG CATHETER Tech 32552 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26819 32552 CT Remove Chest Catheter Tech 32552 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26834 32552 XR Removal Chest Catheter Tech 32552 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26835 32552 IR Removal Chest Tube Tech 32552 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 65624 REMOVE INDWELL TUN CATH Tech 32552 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5420 32554 ASPIRATE PLEURA W/O IMAGING Tech 32554 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 65368 ASPIRATE PLEURA W/O IMAGI Tech 32554 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5428 32555 ASPIRATE PLEURA W/ IMAGING Tech 32555 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26826 32555 US Thoracentesis Tech 32555 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26827 32555 CT Thoracentesis w/ CT Guidance Tech 32555 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 26855 32555 IR Thoracentesis w/ Image Guidance Tech 32555 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 65643 THORACENTESIS WITH GUIDAN Tech 32555 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5419 32556 INSERT CATH PLEURA W/O IMAGE Tech 32556 761 8531 " 2,500.44 " 776.00 " 6,824.80 " " 2,192.47 " " 4,427.59 " " 1,658.81 " " 4,427.59 " " 1,409.99 " " 1,658.81 " " 4,350.81 " " 1,658.81 " " 5,118.60 " " 1,409.99 " " 1,774.93 " " 5,646.67 " " 1,492.93 " " 1,658.81 " " 5,014.97 " " 6,268.68 " " 1,642.22 " " 1,691.99 " " 1,658.81 " " 6,824.80 " " 1,517.81 " 776.00 " 5,715.77 " " 1,459.75 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,691.99 " " 6,739.49 " 5410 32557 INSERT CATH PLEURA W/ IMAGE Tech 32557 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 65666 PLEURAL DRAIN W/ GUIDANCE Tech 32557 761 7382 " 2,163.66 " 776.00 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 776.00 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 5417 32560 TREAT PLEURODESIS W/AGENT Tech 32560 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 776.00 " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5406 32561 LYSE CHEST FIBRIN INIT DAY Tech 32561 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 N/A " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5416 32562 LYSE CHEST FIBRIN SUBQ DAY Tech 32562 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 N/A " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5415 32601 THORACOSCOPY DIAGNOSTIC Tech 32601 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5412 32606 THORACOSCOPY W/BX MED SPACE Tech 32606 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5423 32607 THORACOSCOPY W/BX INFILTRATE Tech 32607 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5418 32608 THORACOSCOPY W/BX NODULE Tech 32608 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5433 32609 THORACOSCOPY W/BX PLEURA Tech 32609 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5431 32650 THORACOSCOPY W/PLEURODESIS Tech 32650 761 6543 " 1,917.75 " " 1,681.55 " " 5,234.40 " " 1,681.55 " " 3,395.82 " N/A " 3,395.82 " N/A N/A " 3,336.93 " N/A " 3,925.80 " N/A N/A " 4,330.81 " N/A N/A N/A N/A N/A N/A N/A " 5,234.40 " N/A N/A " 4,383.81 " N/A " 2,676.09 " " 4,907.25 " " 2,486.99 " " 2,926.68 " N/A " 5,168.97 " 5426 32651 THORACOSCOPY REMOVE CORTEX Tech 32651 761 8406 " 2,463.80 " " 2,160.34 " " 6,724.80 " " 2,160.34 " " 4,362.71 " N/A " 4,362.71 " N/A N/A " 4,287.06 " N/A " 5,043.60 " N/A N/A " 5,563.93 " N/A N/A N/A N/A N/A N/A N/A " 6,724.80 " N/A N/A " 5,632.02 " N/A " 3,438.05 " " 6,304.50 " " 3,195.12 " " 3,760.00 " N/A " 6,640.74 " 5432 32652 THORACOSCOPY REM TOTL CORTEX Tech 32652 761 1605 470.43 412.49 " 1,284.00 " 412.49 833.00 N/A 833.00 N/A N/A 818.55 N/A 963.00 N/A N/A " 1,062.35 " N/A N/A N/A N/A N/A N/A N/A " 1,284.00 " N/A N/A " 1,075.35 " N/A 656.45 " 1,203.75 " 610.06 717.92 N/A " 1,267.95 " 5427 32653 THORACOSCOPY REMOV FB/FIBRIN Tech 32653 761 2496 731.58 641.47 " 1,996.80 " 641.47 " 1,295.42 " N/A " 1,295.42 " N/A N/A " 1,272.96 " N/A " 1,497.60 " N/A N/A " 1,652.10 " N/A N/A N/A N/A N/A N/A N/A " 1,996.80 " N/A N/A " 1,672.32 " N/A " 1,020.86 " " 1,872.00 " 948.73 " 1,116.46 " N/A " 1,971.84 " 5438 32654 THORACOSCOPY CONTRL BLEEDING Tech 32654 761 11128 " 3,261.62 " " 2,859.90 " " 8,902.40 " " 2,859.90 " " 5,775.43 " N/A " 5,775.43 " N/A N/A " 5,675.28 " N/A " 6,676.80 " N/A N/A " 7,365.62 " N/A N/A N/A N/A N/A N/A N/A " 8,902.40 " N/A N/A " 7,455.76 " N/A " 4,551.35 " " 8,346.00 " " 4,229.75 " " 4,977.55 " N/A " 8,791.12 " 5448 32655 THORACOSCOPY RESECT BULLAE Tech 32655 761 9314 " 2,729.93 " " 2,393.70 " " 7,451.20 " " 2,393.70 " " 4,833.97 " N/A " 4,833.97 " N/A N/A " 4,750.14 " N/A " 5,588.40 " N/A N/A " 6,164.94 " N/A N/A N/A N/A N/A N/A N/A " 7,451.20 " N/A N/A " 6,240.38 " N/A " 3,809.43 " " 6,985.50 " " 3,540.25 " " 4,166.15 " N/A " 7,358.06 " 5440 32656 THORACOSCOPY W/PLEURECTOMY Tech 32656 761 4394 " 1,287.88 " " 1,129.26 " " 3,515.20 " " 1,129.26 " " 2,280.49 " N/A " 2,280.49 " N/A N/A " 2,240.94 " N/A " 2,636.40 " N/A N/A " 2,908.39 " N/A N/A N/A N/A N/A N/A N/A " 3,515.20 " N/A N/A " 2,943.98 " N/A " 1,797.15 " " 3,295.50 " " 1,670.16 " " 1,965.44 " N/A " 3,471.26 " 5447 32658 THORACOSCOPY W/SAC FB REMOVE Tech 32658 761 8372 " 2,453.83 " " 2,151.60 " " 6,697.60 " " 2,151.60 " " 4,345.07 " N/A " 4,345.07 " N/A N/A " 4,269.72 " N/A " 5,023.20 " N/A N/A " 5,541.43 " N/A N/A N/A N/A N/A N/A N/A " 6,697.60 " N/A N/A " 5,609.24 " N/A " 3,424.15 " " 6,279.00 " " 3,182.20 " " 3,744.80 " N/A " 6,613.88 " 5450 32659 THORACOSCOPY W/SAC DRAINAGE Tech 32659 761 6689 " 1,960.55 " " 1,719.07 " " 5,351.20 " " 1,719.07 " " 3,471.59 " N/A " 3,471.59 " N/A N/A " 3,411.39 " N/A " 4,013.40 " N/A N/A " 4,427.45 " N/A N/A N/A N/A N/A N/A N/A " 5,351.20 " N/A N/A " 4,481.63 " N/A " 2,735.80 " " 5,016.75 " " 2,542.49 " " 2,991.99 " N/A " 5,284.31 " 5460 32661 THORACOSCOPY W/PERICARD EXC Tech 32661 761 8223 " 2,410.16 " " 2,113.31 " " 6,578.40 " " 2,113.31 " " 4,267.74 " N/A " 4,267.74 " N/A N/A " 4,193.73 " N/A " 4,933.80 " N/A N/A " 5,442.80 " N/A N/A N/A N/A N/A N/A N/A " 6,578.40 " N/A N/A " 5,509.41 " N/A " 3,363.21 " " 6,167.25 " " 3,125.56 " " 3,678.15 " N/A " 6,496.17 " 5463 32662 THORACOSCOPY W/MEDIAST EXC Tech 32662 761 5958 " 1,746.29 " " 1,531.21 " " 4,766.40 " " 1,531.21 " " 3,092.20 " N/A " 3,092.20 " N/A N/A " 3,038.58 " N/A " 3,574.80 " N/A N/A " 3,943.60 " N/A N/A N/A N/A N/A N/A N/A " 4,766.40 " N/A N/A " 3,991.86 " N/A " 2,436.82 " " 4,468.50 " " 2,264.64 " " 2,665.01 " N/A " 4,706.82 " 5451 32663 THORACOSCOPY W/LOBECTOMY Tech 32663 761 14444 " 4,233.54 " " 3,712.11 " " 11,555.20 " " 3,712.11 " " 7,496.44 " N/A " 7,496.44 " N/A N/A " 7,366.44 " N/A " 8,666.40 " N/A N/A " 9,560.48 " N/A N/A N/A N/A N/A N/A N/A " 11,555.20 " N/A N/A " 9,677.48 " N/A " 5,907.60 " " 10,833.00 " " 5,490.16 " " 6,460.80 " N/A " 11,410.76 " 5462 32664 THORACOSCOPY W/ TH NRV EXC Tech 32664 761 8894 " 2,606.83 " " 2,285.76 " " 7,115.20 " " 2,285.76 " " 4,615.99 " N/A " 4,615.99 " N/A N/A " 4,535.94 " N/A " 5,336.40 " N/A N/A " 5,886.94 " N/A N/A N/A N/A N/A N/A N/A " 7,115.20 " N/A N/A " 5,958.98 " N/A " 3,637.65 " " 6,670.50 " " 3,380.61 " " 3,978.29 " N/A " 7,026.26 " 5449 32665 THORACOSCOP W/ESOPH MUSC EXC Tech 32665 761 14768 " 4,328.50 " " 3,795.38 " " 11,814.40 " " 3,795.38 " " 7,664.59 " N/A " 7,664.59 " N/A N/A " 7,531.68 " N/A " 8,860.80 " N/A N/A " 9,774.94 " N/A N/A N/A N/A N/A N/A N/A " 11,814.40 " N/A N/A " 9,894.56 " N/A " 6,040.11 " " 11,076.00 " " 5,613.32 " " 6,605.73 " N/A " 11,666.72 " 5471 32666 THORACOSCOPY W/WEDGE RESECT Tech 32666 761 7496 " 2,197.08 " " 1,926.47 " " 5,996.80 " " 1,926.47 " " 3,890.42 " N/A " 3,890.42 " N/A N/A " 3,822.96 " N/A " 4,497.60 " N/A N/A " 4,961.60 " N/A N/A N/A N/A N/A N/A N/A " 5,996.80 " N/A N/A " 5,022.32 " N/A " 3,065.86 " " 5,622.00 " " 2,849.23 " " 3,352.96 " N/A " 5,921.84 " 5452 32667 THORACOSCOPY W/W RESECT ADDL Tech 32667 761 3565 " 1,044.90 " 916.21 " 2,852.00 " 916.21 " 1,850.24 " N/A " 1,850.24 " N/A N/A " 1,818.15 " N/A " 2,139.00 " N/A N/A " 2,359.67 " N/A N/A N/A N/A N/A N/A N/A " 2,852.00 " N/A N/A " 2,388.55 " N/A " 1,458.09 " " 2,673.75 " " 1,355.06 " " 1,594.62 " N/A " 2,816.35 " 5461 32668 THORACOSCOPY W/W RESECT DIAG Tech 32668 761 4411 " 1,292.86 " " 1,133.63 " " 3,528.80 " " 1,133.63 " " 2,289.31 " N/A " 2,289.31 " N/A N/A " 2,249.61 " N/A " 2,646.60 " N/A N/A " 2,919.64 " N/A N/A N/A N/A N/A N/A N/A " 3,528.80 " N/A N/A " 2,955.37 " N/A " 1,804.10 " " 3,308.25 " " 1,676.62 " " 1,973.04 " N/A " 3,484.69 " 5453 32669 THORACOSCOPY REMOVE SEGMENT Tech 32669 761 3529 " 1,034.35 " 906.95 " 2,823.20 " 906.95 " 1,831.55 " N/A " 1,831.55 " N/A N/A " 1,799.79 " N/A " 2,117.40 " N/A N/A " 2,335.85 " N/A N/A N/A N/A N/A N/A N/A " 2,823.20 " N/A N/A " 2,364.43 " N/A " 1,443.36 " " 2,646.75 " " 1,341.37 " " 1,578.52 " N/A " 2,787.91 " 5469 32670 THORACOSCOPY BILOBECTOMY Tech 32670 761 24473 " 7,173.04 " " 6,289.56 " " 19,578.40 " " 6,289.56 " " 12,701.49 " N/A " 12,701.49 " N/A N/A " 12,481.23 " N/A " 14,683.80 " N/A N/A " 16,198.68 " N/A N/A N/A N/A N/A N/A N/A " 19,578.40 " N/A N/A " 16,396.91 " N/A " 10,009.46 " " 18,354.75 " " 9,302.19 " " 10,946.77 " N/A " 19,333.67 " 5467 32671 THORACOSCOPY PNEUMONECTOMY Tech 32671 761 21557 " 6,318.36 " " 5,540.15 " " 17,245.60 " " 5,540.15 " " 11,188.08 " N/A " 11,188.08 " N/A N/A " 10,994.07 " N/A " 12,934.20 " N/A N/A " 14,268.58 " N/A N/A N/A N/A N/A N/A N/A " 17,245.60 " N/A N/A " 14,443.19 " N/A " 8,816.81 " " 16,167.75 " " 8,193.82 " " 9,642.45 " N/A " 17,030.03 " 5459 32672 THORACOSCOPY FOR LVRS Tech 32672 761 9904 " 2,902.86 " " 2,545.33 " " 7,923.20 " " 2,545.33 " " 5,140.18 " N/A " 5,140.18 " N/A N/A " 5,051.04 " N/A " 5,942.40 " N/A N/A " 6,555.46 " N/A N/A N/A N/A N/A N/A N/A " 7,923.20 " N/A N/A " 6,635.68 " N/A " 4,050.74 " " 7,428.00 " " 3,764.51 " " 4,430.06 " N/A " 7,824.16 " 5488 32673 THORACOSCOPY W/THYMUS RESECT Tech 32673 761 12469 " 3,654.66 " " 3,204.53 " " 9,975.20 " " 3,204.53 " " 6,471.41 " N/A " 6,471.41 " N/A N/A " 6,359.19 " N/A " 7,481.40 " N/A N/A " 8,253.23 " N/A N/A N/A N/A N/A N/A N/A " 9,975.20 " N/A N/A " 8,354.23 " N/A " 5,099.82 " " 9,351.75 " " 4,739.47 " " 5,577.38 " N/A " 9,850.51 " 5480 32674 THORACOSCOPY LYMPH NODE EXC Tech 32674 761 2212 648.34 568.48 " 1,769.60 " 568.48 " 1,148.03 " N/A " 1,148.03 " N/A N/A " 1,128.12 " N/A " 1,327.20 " N/A N/A " 1,464.12 " N/A N/A N/A N/A N/A N/A N/A " 1,769.60 " N/A N/A " 1,482.04 " N/A 904.71 " 1,659.00 " 840.78 989.43 N/A " 1,747.48 " 5476 32800 REPAIR LUNG HERNIA Tech 32800 761 12489 " 3,660.53 " " 3,209.67 " " 9,991.20 " " 3,209.67 " " 6,481.79 " N/A " 6,481.79 " N/A N/A " 6,369.39 " N/A " 7,493.40 " N/A N/A " 8,266.47 " N/A N/A N/A N/A N/A N/A N/A " 9,991.20 " N/A N/A " 8,367.63 " N/A " 5,108.00 " " 9,366.75 " " 4,747.07 " " 5,586.33 " N/A " 9,866.31 " 5490 32810 CLOSE CHEST AFTER DRAINAGE Tech 32810 761 8238 " 2,414.56 " " 2,117.17 " " 6,590.40 " " 2,117.17 " " 4,275.52 " N/A " 4,275.52 " N/A N/A " 4,201.38 " N/A " 4,942.80 " N/A N/A " 5,452.73 " N/A N/A N/A N/A N/A N/A N/A " 6,590.40 " N/A N/A " 5,519.46 " N/A " 3,369.34 " " 6,178.50 " " 3,131.26 " " 3,684.86 " N/A " 6,508.02 " 5489 32815 CLOSE BRONCHIAL FISTULA Tech 32815 761 19587 " 5,740.95 " " 5,033.86 " " 15,669.60 " " 5,033.86 " " 10,165.65 " N/A " 10,165.65 " N/A N/A " 9,989.37 " N/A " 11,752.20 " N/A N/A " 12,964.64 " N/A N/A N/A N/A N/A N/A N/A " 15,669.60 " N/A N/A " 13,123.29 " N/A " 8,011.08 " " 14,690.25 " " 7,445.02 " " 8,761.27 " N/A " 15,473.73 " 5501 32820 RECONSTRUCT INJURED CHEST Tech 32820 761 17368 " 5,090.56 " " 4,463.58 " " 13,894.40 " " 4,463.58 " " 9,013.99 " N/A " 9,013.99 " N/A N/A " 8,857.68 " N/A " 10,420.80 " N/A N/A " 11,495.88 " N/A N/A N/A N/A N/A N/A N/A " 13,894.40 " N/A N/A " 11,636.56 " N/A " 7,103.51 " " 13,026.00 " " 6,601.58 " " 7,768.71 " N/A " 13,720.72 " 5486 32900 REMOVAL OF RIB(S) Tech 32900 761 13018 " 3,815.58 " " 3,345.63 " " 10,414.40 " " 3,345.63 " " 6,756.34 " N/A " 6,756.34 " N/A N/A " 6,639.18 " N/A " 7,810.80 " N/A N/A " 8,616.61 " N/A N/A N/A N/A N/A N/A N/A " 10,414.40 " N/A N/A " 8,722.06 " N/A " 5,324.36 " " 9,763.50 " " 4,948.14 " " 5,822.95 " N/A " 10,284.22 " 5487 32905 REVISE & REPAIR CHEST WALL Tech 32905 761 13572 " 3,977.95 " " 3,488.00 " " 10,857.60 " " 3,488.00 " " 7,043.87 " N/A " 7,043.87 " N/A N/A " 6,921.72 " N/A " 8,143.20 " N/A N/A " 8,983.31 " N/A N/A N/A N/A N/A N/A N/A " 10,857.60 " N/A N/A " 9,093.24 " N/A " 5,550.95 " " 10,179.00 " " 5,158.72 " " 6,070.76 " N/A " 10,721.88 " 5496 32906 REVISE & REPAIR CHEST WALL Tech 32906 761 19136 " 5,608.76 " " 4,917.95 " " 15,308.80 " " 4,917.95 " " 9,931.58 " N/A " 9,931.58 " N/A N/A " 9,759.36 " N/A " 11,481.60 " N/A N/A " 12,666.12 " N/A N/A N/A N/A N/A N/A N/A " 15,308.80 " N/A N/A " 12,821.12 " N/A " 7,826.62 " " 14,352.00 " " 7,273.59 " " 8,559.53 " N/A " 15,117.44 " 5492 32997 TOTAL LUNG LAVAGE Tech 32997 761 3710 " 1,087.40 " 953.47 " 2,968.00 " 953.47 " 1,925.49 " N/A " 1,925.49 " N/A N/A " 1,892.10 " N/A " 2,226.00 " N/A N/A " 2,455.65 " N/A N/A N/A N/A N/A N/A N/A " 2,968.00 " N/A N/A " 2,485.70 " N/A " 1,517.39 " " 2,782.50 " " 1,410.17 " " 1,659.48 " N/A " 2,930.90 " 5493 32998 ABLATE PULM TUMOR PERQ RF LT Tech 32998 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5507 32998 ABLATE PULM TUMOR PERQ RF Tech 32998 761 26567 " 7,786.79 " 776.00 " 21,253.60 " " 6,827.72 " " 13,788.27 " " 5,167.69 " " 13,788.27 " " 4,392.54 " " 5,167.69 " " 13,549.17 " " 5,167.69 " " 15,940.20 " " 4,392.54 " " 5,529.43 " " 17,584.70 " " 4,650.92 " " 5,167.69 " " 15,617.02 " " 19,521.15 " " 5,116.01 " " 5,271.04 " " 5,167.69 " " 21,253.60 " " 4,728.44 " 776.00 " 17,799.89 " " 4,547.57 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,271.04 " " 20,987.93 " 5510 32999 Unl Evacuation Clot In Chest Tube Tech 32999 761 2844 833.58 469.23 " 2,275.20 " 730.91 " 1,476.04 " 552.04 " 1,476.04 " 469.23 552.04 " 1,450.44 " 552.04 " 1,706.40 " 469.23 590.68 " 1,882.44 " 496.84 552.04 " 1,671.49 " " 2,089.35 " 546.52 563.08 552.04 " 2,275.20 " 505.12 N/A " 1,905.48 " 485.80 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 563.08 " 2,246.76 " 5512 33016 PERICARDIOCENTESIS W/IMAGING Tech 33016 761 7382 " 2,163.66 " 193.93 " 5,905.60 " " 1,897.17 " " 3,831.26 " " 1,436.16 " " 3,831.26 " " 1,220.74 " " 1,436.16 " " 3,764.82 " " 1,436.16 " " 4,429.20 " " 1,220.74 " " 1,536.69 " " 4,886.15 " " 1,292.54 " " 1,436.16 " " 4,339.49 " " 5,424.33 " " 1,421.80 " " 1,464.88 " " 1,436.16 " " 5,905.60 " " 1,314.09 " 193.93 " 4,945.94 " " 1,263.82 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,464.88 " " 5,831.78 " 5506 33017 PRCRD DRG 6YR+ W/O CGEN CAR Tech 33017 761 2413 707.25 620.14 " 1,930.40 " 620.14 " 1,252.35 " N/A " 1,252.35 " N/A N/A " 1,230.63 " N/A " 1,447.80 " N/A N/A " 1,597.16 " N/A N/A N/A N/A N/A N/A N/A " 1,930.40 " N/A N/A " 1,616.71 " N/A 986.92 " 1,809.75 " 917.18 " 1,079.33 " N/A " 1,906.27 " 5508 33018 PRCRD DRG 0-5YR OR W/ANOMLY Tech 33018 761 2567 752.39 659.72 " 2,053.60 " 659.72 " 1,332.27 " N/A " 1,332.27 " N/A N/A " 1,309.17 " N/A " 1,540.20 " N/A N/A " 1,699.10 " N/A N/A N/A N/A N/A N/A N/A " 2,053.60 " N/A N/A " 1,719.89 " N/A " 1,049.90 " " 1,925.25 " 975.72 " 1,148.22 " N/A " 2,027.93 " 5513 33019 PERQ PRCRD DRG INSJ CATH CT Tech 33019 761 2233 654.49 573.88 " 1,786.40 " 573.88 " 1,158.93 " N/A " 1,158.93 " N/A N/A " 1,138.83 " N/A " 1,339.80 " N/A N/A " 1,478.02 " N/A N/A N/A N/A N/A N/A N/A " 1,786.40 " N/A N/A " 1,496.11 " N/A 913.30 " 1,674.75 " 848.76 998.82 N/A " 1,764.07 " 5515 33020 INCISION OF HEART SAC Tech 33020 761 1332 390.41 342.32 " 1,065.60 " 342.32 691.31 N/A 691.31 N/A N/A 679.32 N/A 799.20 N/A N/A 881.65 N/A N/A N/A N/A N/A N/A N/A " 1,065.60 " N/A N/A 892.44 N/A 544.79 999.00 506.29 595.80 N/A " 1,052.28 " 5514 33025 INCISION OF HEART SAC Tech 33025 761 3063 897.77 787.19 " 2,450.40 " 787.19 " 1,589.70 " N/A " 1,589.70 " N/A N/A " 1,562.13 " N/A " 1,837.80 " N/A N/A " 2,027.40 " N/A N/A N/A N/A N/A N/A N/A " 2,450.40 " N/A N/A " 2,052.21 " N/A " 1,252.77 " " 2,297.25 " " 1,164.25 " " 1,370.08 " N/A " 2,419.77 " 5518 33030 PARTIAL REMOVAL OF HEART SAC Tech 33030 761 3860 " 1,131.37 " 992.02 " 3,088.00 " 992.02 " 2,003.34 " N/A " 2,003.34 " N/A N/A " 1,968.60 " N/A " 2,316.00 " N/A N/A " 2,554.93 " N/A N/A N/A N/A N/A N/A N/A " 3,088.00 " N/A N/A " 2,586.20 " N/A " 1,578.74 " " 2,895.00 " " 1,467.19 " " 1,726.58 " N/A " 3,049.40 " 5521 33031 PARTIAL REMOVAL OF HEART SAC Tech 33031 761 16328 " 4,785.74 " " 4,196.30 " " 13,062.40 " " 4,196.30 " " 8,474.23 " N/A " 8,474.23 " N/A N/A " 8,327.28 " N/A " 9,796.80 " N/A N/A " 10,807.50 " N/A N/A N/A N/A N/A N/A N/A " 13,062.40 " N/A N/A " 10,939.76 " N/A " 6,678.15 " " 12,246.00 " " 6,206.27 " " 7,303.51 " N/A " 12,899.12 " 5545 33050 RESECT HEART SAC LESION Tech 33050 761 7436 " 2,179.49 " " 1,911.05 " " 5,948.80 " " 1,911.05 " " 3,859.28 " N/A " 3,859.28 " N/A N/A " 3,792.36 " N/A " 4,461.60 " N/A N/A " 4,921.89 " N/A N/A N/A N/A N/A N/A N/A " 5,948.80 " N/A N/A " 4,982.12 " N/A " 3,041.32 " " 5,577.00 " " 2,826.42 " " 3,326.12 " N/A " 5,874.44 " 5530 33120 REMOVAL OF HEART LESION Tech 33120 761 7826 " 2,293.80 " " 2,011.28 " " 6,260.80 " " 2,011.28 " " 4,061.69 " N/A " 4,061.69 " N/A N/A " 3,991.26 " N/A " 4,695.60 " N/A N/A " 5,180.03 " N/A N/A N/A N/A N/A N/A N/A " 6,260.80 " N/A N/A " 5,243.42 " N/A " 3,200.83 " " 5,869.50 " " 2,974.66 " " 3,500.57 " N/A " 6,182.54 " 5526 33130 REMOVAL OF HEART LESION Tech 33130 761 20800 " 6,096.48 " " 5,345.60 " " 16,640.00 " " 5,345.60 " " 10,795.20 " N/A " 10,795.20 " N/A N/A " 10,608.00 " N/A " 12,480.00 " N/A N/A " 13,767.52 " N/A N/A N/A N/A N/A N/A N/A " 16,640.00 " N/A N/A " 13,936.00 " N/A " 8,507.20 " " 15,600.00 " " 7,906.08 " " 9,303.84 " N/A " 16,432.00 " 5517 33202 INSERT EPICARD ELTRD OPEN Tech 33202 761 8206 " 2,405.18 " " 2,108.94 " " 6,564.80 " " 2,108.94 " " 4,258.91 " N/A " 4,258.91 " N/A N/A " 4,185.06 " N/A " 4,923.60 " N/A N/A " 5,431.55 " N/A N/A N/A N/A N/A N/A N/A " 6,564.80 " N/A N/A " 5,498.02 " N/A " 3,356.25 " " 6,154.50 " " 3,119.10 " " 3,670.54 " N/A " 6,482.74 " 5523 33203 INSERT EPICARD ELTRD ENDO Tech 33203 761 3500 " 1,025.85 " 899.50 " 2,800.00 " 899.50 " 1,816.50 " N/A " 1,816.50 " N/A N/A " 1,785.00 " N/A " 2,100.00 " N/A N/A " 2,316.65 " N/A N/A N/A N/A N/A N/A N/A " 2,800.00 " N/A N/A " 2,345.00 " N/A " 1,431.50 " " 2,625.00 " " 1,330.35 " " 1,565.55 " N/A " 2,765.00 " 5534 33206 INSERT HEART PM ATRIAL Tech 33206 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5537 33207 INSERT HEART PM VENTRICULAR Tech 33207 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 27263 33207 BiV Proc Charg Insert sing pacer (new or repl) tech 33207 481 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5529 33208 INSRT HEART PM ATRIAL & VENT Tech 33208 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 27266 33208 BiV Proc Char Insrt dual lead (new or replace) tech 33208 481 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5541 33210 INSERT ELECTRD/PM CATH SNGL Tech 33210 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 5544 33211 INSERT CARD ELECTRODES DUAL Tech 33211 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 5535 33212 INSERT PULSE GEN SNGL LEAD Tech 33212 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 5543 33213 INSERT PULSE GEN DUAL LEADS Tech 33213 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 27265 33213 BiV Procedure Charges Generator replace dual tech 33213 481 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5557 33214 UPGRADE OF PACEMAKER SYSTEM Tech 33214 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 27277 33214 BiV Procedure Charg Upgrade single to dual pacer tech 33214 481 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5546 33215 REPOSITION PACING-DEFIB LEAD Tech 33215 761 15024 " 4,403.53 " 776.00 " 12,019.20 " " 3,861.17 " " 7,797.46 " " 2,923.63 " " 7,797.46 " " 2,485.09 " " 2,923.63 " " 7,662.24 " " 2,923.63 " " 9,014.40 " " 2,485.09 " " 3,128.28 " " 9,944.39 " " 2,631.27 " " 2,923.63 " " 8,831.37 " " 11,039.14 " " 2,894.39 " " 2,982.10 " " 2,923.63 " " 12,019.20 " " 2,675.12 " 776.00 " 10,066.08 " " 2,572.79 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,982.10 " " 11,868.96 " 27264 33215 PPM Proc CharLead repositioning (RA or RV) tech 33215 481 15024 " 4,403.53 " 776.00 " 12,019.20 " " 3,861.17 " " 7,797.46 " " 2,923.63 " " 7,797.46 " " 2,485.09 " " 2,923.63 " " 7,662.24 " " 2,923.63 " " 9,014.40 " " 2,485.09 " " 3,128.28 " " 9,944.39 " " 2,631.27 " " 2,923.63 " " 8,831.37 " " 11,039.14 " " 2,894.39 " " 2,982.10 " " 2,923.63 " " 12,019.20 " " 2,675.12 " 776.00 " 10,066.08 " " 2,572.79 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,982.10 " " 11,868.96 " 27275 33215 ICD Procedure ChargLead repositioning (RA or RV) tech 33215 481 15024 " 4,403.53 " 776.00 " 12,019.20 " " 3,861.17 " " 7,797.46 " " 2,923.63 " " 7,797.46 " " 2,485.09 " " 2,923.63 " " 7,662.24 " " 2,923.63 " " 9,014.40 " " 2,485.09 " " 3,128.28 " " 9,944.39 " " 2,631.27 " " 2,923.63 " " 8,831.37 " " 11,039.14 " " 2,894.39 " " 2,982.10 " " 2,923.63 " " 12,019.20 " " 2,675.12 " 776.00 " 10,066.08 " " 2,572.79 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,982.10 " " 11,868.96 " 5558 33216 INSERT 1 ELECTRODE PM-DEFIB Tech 33216 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 27271 33216 BiV Proc Charg Insert of sing lead (pacer defib) tech 33216 481 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 27272 33216 ICD Proc Char Insert of single lead (pacer defib) tech 33216 481 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 5551 33217 INSERT 2 ELECTRODE PM-DEFIB Tech 33217 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 27274 33217 BiV Proc Charg Insert of two leads (pacer defib) tech 33217 481 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 27283 33217 ICD ProcCharg Insert of 2 leads (pacer or defib) tech 33217 481 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.80 " " 7,624.12 " 776.00 " 28,676.67 " " 7,332.49 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,499.02 " " 33,812.79 " 5552 33218 REPAIR LEAD PACE-DEFIB ONE Tech 33218 761 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 27270 33218 ICD Proc Char Repair one lead for single cham dev tech 33218 481 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 27279 33218 BiV Proc Chargone lead for single chamber device tech 33218 481 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 5549 33220 REPAIR LEAD PACE-DEFIB DUAL Tech 33220 761 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 27276 33220 BiV Proc Chrg Rep 1 or 2 leads for dual cham dev tech 33220 481 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 27278 33220 ICD Pro Char Rep of 1 or 2 lead for dual cham dev tech 33220 481 18062 " 5,293.97 " 776.00 " 14,449.60 " " 4,641.93 " " 9,374.18 " " 3,516.82 " " 9,374.18 " " 2,989.30 " " 3,516.82 " " 9,211.62 " " 3,516.82 " " 10,837.20 " " 2,989.30 " " 3,763.00 " " 11,955.24 " " 3,165.14 " " 3,516.82 " " 10,617.33 " " 13,271.57 " " 3,481.65 " " 3,587.16 " " 3,516.82 " " 14,449.60 " " 3,217.89 " 776.00 " 12,101.54 " " 3,094.80 " " 7,387.36 " " 13,546.50 " " 6,865.37 " " 8,079.13 " " 3,587.16 " " 14,268.98 " 5554 33221 INSERT PULSE GEN MULT LEADS Tech 33221 761 97709 " 28,638.51 " 776.00 " 78,167.20 " " 25,111.21 " " 50,710.97 " " 19,020.79 " " 50,710.97 " " 16,167.67 " " 19,020.79 " " 49,831.59 " " 19,020.79 " " 58,625.40 " " 16,167.67 " " 20,352.25 " " 64,673.59 " " 17,118.71 " " 19,020.79 " " 57,436.21 " " 71,794.80 " " 18,830.58 " " 19,401.21 " " 19,020.79 " " 78,167.20 " " 17,404.02 " 776.00 " 65,465.03 " " 16,738.30 " " 39,962.98 " " 73,281.75 " " 37,139.19 " " 43,705.24 " " 19,401.21 " " 77,190.11 " 5565 33222 RELOCATION POCKET PACEMAKER Tech 33222 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 27273 "33222 BiV Procedure Charges Pacemaker, rev skin pocket tech" 33222 481 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 5579 33223 RELOCATE POCKET FOR DEFIB Tech 33223 761 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 27289 "33223 BiV Proc Charges ICD, rev of skin pocket tech" 33223 481 9006 " 2,639.66 " 776.00 " 7,204.80 " " 2,314.54 " " 4,674.11 " " 1,749.26 " " 4,674.11 " " 1,486.87 " " 1,749.26 " " 4,593.06 " " 1,749.26 " " 5,403.60 " " 1,486.87 " " 1,871.71 " " 5,961.07 " " 1,574.33 " " 1,749.26 " " 5,293.77 " " 6,617.17 " " 1,731.77 " " 1,784.25 " " 1,749.26 " " 7,204.80 " " 1,600.57 " 776.00 " 6,034.02 " " 1,539.35 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,784.25 " " 7,114.74 " 5569 33224 INSERT PACING LEAD & CONNECT Tech 33224 761 54601 " 16,003.55 " 776.00 " 43,680.80 " " 14,032.46 " " 28,337.92 " " 10,619.32 " " 28,337.92 " " 9,026.42 " " 10,619.32 " " 27,846.51 " " 10,619.32 " " 32,760.60 " " 9,026.42 " " 11,362.67 " " 36,140.40 " " 9,557.39 " " 10,619.32 " " 32,095.90 " " 40,119.62 " " 10,513.13 " " 10,831.71 " " 10,619.32 " " 43,680.80 " " 9,716.68 " 776.00 " 36,582.67 " " 9,345.00 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,831.71 " " 43,134.79 " 5561 33225 L VENTRIC PACING LEAD ADD-ON Tech 33225 761 2743 803.97 704.95 " 2,194.40 " 704.95 " 1,423.62 " N/A " 1,423.62 " N/A N/A " 1,398.93 " N/A " 1,645.80 " N/A N/A " 1,815.59 " N/A N/A N/A N/A N/A N/A N/A " 2,194.40 " N/A N/A " 1,837.81 " N/A " 1,121.89 " " 2,057.25 " " 1,042.61 " " 1,226.94 " N/A " 2,166.97 " 5575 33226 REPOSITION L VENTRIC LEAD Tech 33226 761 15024 " 4,403.53 " 776.00 " 12,019.20 " " 3,861.17 " " 7,797.46 " " 2,923.63 " " 7,797.46 " " 2,485.09 " " 2,923.63 " " 7,662.24 " " 2,923.63 " " 9,014.40 " " 2,485.09 " " 3,128.28 " " 9,944.39 " " 2,631.27 " " 2,923.63 " " 8,831.37 " " 11,039.14 " " 2,894.39 " " 2,982.10 " " 2,923.63 " " 12,019.20 " " 2,675.12 " 776.00 " 10,066.08 " " 2,572.79 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,982.10 " " 11,868.96 " 5568 33227 REMOVE&REPLACE PM GEN SINGL Tech 33227 761 42801 " 12,544.97 " 776.00 " 34,240.80 " " 10,999.86 " " 22,213.72 " " 8,332.37 " " 22,213.72 " " 7,082.51 " " 8,332.37 " " 21,828.51 " " 8,332.37 " " 25,680.60 " " 7,082.51 " " 8,915.64 " " 28,329.98 " " 7,499.13 " " 8,332.37 " " 25,159.68 " " 31,449.39 " " 8,249.05 " " 8,499.02 " " 8,332.37 " " 34,240.8