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Medi-Cal Rates Information

Medi-Cal Rates as of 02/15/2020 (Codes 23200 thru 25444)

Medi-Cal Rates are updated and effective as of the 15th of the month and published to the Medi-Cal website on the 16th of the month


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Proc Type Proc Code Procedure Description Unit Value Basic Rate Child Rate ER Rate Conv Ind ER Ind Cut-back Ind Prof % Rental Rate Non-Physn. Med.Prac. Ind
O 23200 RESECT CLAVICLE TUMOR 4.47 $166.42 --- $209.87 004 1 0 0.00 $0.00 Y
K 23200 RESECT CLAVICLE TUMOR 22.38 $833.21 --- $1050.74 004 1 0 0.00 $0.00 Y
K 23210 RESECT SCAPULA TUMOR 22.22 $827.25 --- $1043.23 004 1 0 0.00 $0.00 Y
O 23210 RESECT SCAPULA TUMOR 4.44 $165.30 --- $208.46 004 1 0 0.00 $0.00 Y
O 23220 RESECT PROX HUMERUS TUMOR 5.10 $189.87 --- $239.45 004 1 0 0.00 $0.00 Y
K 23220 RESECT PROX HUMERUS TUMOR 25.48 $948.62 --- $1196.29 004 1 0 0.00 $0.00 Y
K 23330 REMOVE SHOULDER FOREIGN BODY 3.00 $111.69 --- $140.85 004 1 0 0.00 $0.00 Y
K 23333 REMOVE SHOULDER FB DEEP 10.58 $393.89 --- -- 004 0 0 0.00 $0.00 Y
O 23333 REMOVE SHOULDER FB DEEP 2.12 $78.93 --- -- 004 0 0 0.00 $0.00 Y
O 23334 SHOULDER PROSTHESIS REMOVAL 4.95 $184.29 --- -- 004 0 0 0.00 $0.00 Y
K 23334 SHOULDER PROSTHESIS REMOVAL 24.77 $922.19 --- -- 004 0 0 0.00 $0.00 Y
K 23335 SHOULDER PROSTHESIS REMOVAL 29.46 $1096.80 --- -- 004 0 0 0.00 $0.00 Y
O 23335 SHOULDER PROSTHESIS REMOVAL 5.89 $219.28 --- -- 004 0 0 0.00 $0.00 Y
K 23350 INJECTION FOR SHOULDER X-RAY 4.63 $172.37 --- $217.38 004 1 1 0.00 $0.00 Y
K 23395 MUSCLE TRANSFER SHOULDER/ARM 25.37 $944.53 --- $1191.12 004 1 0 0.00 $0.00 Y
O 23395 MUSCLE TRANSFER SHOULDER/ARM 5.10 $189.87 --- $239.45 004 1 0 0.00 $0.00 Y
O 23397 MUSCLE TRANSFERS 5.15 $191.73 --- $241.79 004 1 0 0.00 $0.00 Y
K 23397 MUSCLE TRANSFERS 25.73 $957.93 --- $1208.02 004 1 0 0.00 $0.00 Y
K 23400 FIXATION OF SHOULDERBLADE 24.18 $900.22 --- $1135.25 004 1 0 0.00 $0.00 Y
O 23400 FIXATION OF SHOULDERBLADE 4.84 $180.19 --- $227.24 004 1 0 0.00 $0.00 Y
O 23405 INCISION OF TENDON & MUSCLE 1.72 $64.04 --- $80.75 004 1 0 0.00 $0.00 Y
K 23405 INCISION OF TENDON & MUSCLE 8.61 $320.55 --- $404.24 004 1 0 0.00 $0.00 Y
K 23406 INCISE TENDON(S) & MUSCLE(S) 10.05 $374.16 --- $471.85 004 1 0 0.00 $0.00 Y
O 23406 INCISE TENDON(S) & MUSCLE(S) 2.01 $74.83 --- $94.37 004 1 0 0.00 $0.00 Y
O 23410 REPAIR ROTATOR CUFF ACUTE 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 23410 REPAIR ROTATOR CUFF ACUTE 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 23412 REPAIR ROTATOR CUFF CHRONIC 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 23412 REPAIR ROTATOR CUFF CHRONIC 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 23415 RELEASE OF SHOULDER LIGAMENT 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 23415 RELEASE OF SHOULDER LIGAMENT 9.04 $336.56 --- $424.43 004 1 0 0.00 $0.00 Y
K 23420 REPAIR OF SHOULDER 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 23420 REPAIR OF SHOULDER 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 23430 TENODESIS OF LONG TENDON OF BICEPS 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 23430 TENODESIS OF LONG TENDON OF BICEPS 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 23440 REMOVE/TRANSPLANT TENDON 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 23440 REMOVE/TRANSPLANT TENDON 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 23450 CAPSULORRHAPHY ANTERIOR 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
K 23450 CAPSULORRHAPHY ANTERIOR 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
K 23455 REPAIR SHOULDER CAPSULE 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
O 23455 REPAIR SHOULDER CAPSULE 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
O 23460 CAPSULORRHAPHY ANTERIOR ANY TYPE 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 23460 CAPSULORRHAPHY ANTERIOR ANY TYPE 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 23462 REPAIR SHOULDER CAPSULE 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 23462 REPAIR SHOULDER CAPSULE 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 23465 REPAIR SHOULDER CAPSULE 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
K 23465 REPAIR SHOULDER CAPSULE 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
K 23466 REPAIR SHOULDER CAPSULE 23.37 $870.07 --- $1097.22 004 1 0 0.00 $0.00 Y
O 23466 REPAIR SHOULDER CAPSULE 4.67 $173.86 --- $219.26 004 1 0 0.00 $0.00 Y
O 23470 RECONSTRUCT SHOULDER JOINT 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 23470 RECONSTRUCT SHOULDER JOINT 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 23472 RECONSTRUCT SHOULDER JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23472 RECONSTRUCT SHOULDER JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23473 REVIS RECONST SHOULDER JOINT 7.28 $271.03 --- -- 004 0 0 0.00 $0.00 Y
K 23473 REVIS RECONST SHOULDER JOINT 36.43 $1356.29 --- -- 004 0 0 0.00 $0.00 Y
K 23474 REVIS RECONST SHOULDER JOINT 39.31 $1463.51 --- -- 004 0 0 0.00 $0.00 Y
O 23474 REVIS RECONST SHOULDER JOINT 7.86 $292.63 --- -- 004 0 0 0.00 $0.00 Y
O 23480 REVISION OF COLLAR BONE 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 23480 REVISION OF COLLAR BONE 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 23485 REVISION OF COLLARBONE 14.72 $548.03 --- $691.10 004 1 0 0.00 $0.00 Y
O 23485 REVISION OF COLLARBONE 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
O 23490 REINFORCE CLAVICLE 4.16 $154.88 --- $195.31 004 1 0 0.00 $0.00 Y
K 23490 REINFORCE CLAVICLE 20.81 $774.76 --- $977.03 004 1 0 0.00 $0.00 Y
K 23491 REINFORCE SHOULDER BONES 24.61 $916.23 --- $1155.44 004 1 0 0.00 $0.00 Y
O 23491 REINFORCE SHOULDER BONES 4.92 $183.17 --- $230.99 004 1 0 0.00 $0.00 Y
O 23500 TREAT CLAVICLE FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23500 TREAT CLAVICLE FRACTURE 92.93 $92.93 --- -- 042 0 1 0.00 $0.00 Y
K 23505 TREAT CLAVICLE FRACTURE 4.06 $151.15 --- $190.62 004 1 1 0.00 $0.00 Y
O 23505 TREAT CLAVICLE FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23515 TREAT CLAVICLE FRACTURE 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 23515 TREAT CLAVICLE FRACTURE 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
K 23520 TREAT CLAVICLE DISLOCATION 4.80 $178.70 --- $225.36 004 1 1 0.00 $0.00 Y
O 23520 TREAT CLAVICLE DISLOCATION 0.96 $35.74 --- $45.07 004 1 0 0.00 $0.00 Y
O 23525 TREAT CLAVICLE DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23525 TREAT CLAVICLE DISLOCATION 3.83 $142.59 --- $179.82 004 1 1 0.00 $0.00 Y
K 23530 TREAT CLAVICLE DISLOCATION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 23530 TREAT CLAVICLE DISLOCATION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 23532 TREAT CLAVICLE DISLOCATION 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 23532 TREAT CLAVICLE DISLOCATION 13.15 $489.57 --- $617.39 004 1 0 0.00 $0.00 Y
K 23540 TREAT CLAVICLE DISLOCATION 5.16 $192.11 --- $242.26 004 1 0 0.00 $0.00 Y
K 23545 TREAT CLAVICLE DISLOCATION 3.54 $131.79 --- $166.20 004 1 0 0.00 $0.00 Y
K 23550 TREAT CLAVICLE DISLOCATION 12.84 $478.03 --- $602.84 004 1 0 0.00 $0.00 Y
O 23550 TREAT CLAVICLE DISLOCATION 2.57 $95.68 --- $120.66 004 1 0 0.00 $0.00 Y
O 23552 TREAT CLAVICLE DISLOCATION 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
K 23552 TREAT CLAVICLE DISLOCATION 14.40 $536.11 --- $676.08 004 1 0 0.00 $0.00 Y
K 23570 TREAT SHOULDER BLADE FX 95.79 $95.79 --- -- 042 0 1 0.00 $0.00 Y
O 23570 TREAT SHOULDER BLADE FX 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23575 TREAT SHOULDER BLADE FX 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23575 TREAT SHOULDER BLADE FX 4.36 $162.32 --- $204.70 004 1 0 0.00 $0.00 Y
K 23585 TREAT SCAPULA FRACTURE 13.59 $505.96 --- -- 004 0 0 0.00 $0.00 Y
O 23585 TREAT SCAPULA FRACTURE 2.72 $101.27 --- -- 004 0 0 0.00 $0.00 Y
O 23600 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23600 TREAT HUMERUS FRACTURE 137.73 $137.73 --- -- 042 0 1 0.00 $0.00 Y
K 23605 TREAT HUMERUS FRACTURE 5.80 $215.93 --- $272.31 004 1 0 0.00 $0.00 Y
O 23605 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23615 TREAT HUMERUS FRACTURE 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 23615 TREAT HUMERUS FRACTURE 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 23616 TREAT HUMERUS FRACTURE 31.52 $1173.49 --- $1479.86 004 1 0 0.00 $0.00 Y
O 23616 TREAT HUMERUS FRACTURE 6.31 $234.92 --- $296.25 004 1 0 0.00 $0.00 Y
O 23620 TREAT HUMERUS FRACTURE 1.23 $45.79 --- $57.75 004 1 0 0.00 $0.00 Y
K 23620 TREAT HUMERUS FRACTURE 6.16 $229.34 --- $289.21 004 1 1 0.00 $0.00 Y
K 23625 TREAT HUMERUS FRACTURE 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
O 23625 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23630 TREAT HUMERUS FRACTURE 2.60 $96.80 --- $122.07 004 1 0 0.00 $0.00 Y
K 23630 TREAT HUMERUS FRACTURE 13.02 $484.73 --- $611.29 004 1 0 0.00 $0.00 Y
K 23650 TREAT SHOULDER DISLOCATION 140.27 $140.27 --- -- 042 0 1 0.00 $0.00 Y
O 23650 TREAT SHOULDER DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 23655 TREAT SHOULDER DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23655 TREAT SHOULDER DISLOCATION 3.94 $146.69 --- $184.98 004 1 0 0.00 $0.00 Y
K 23660 TREAT SHOULDER DISLOCATION 12.84 $478.03 --- $602.84 004 1 0 0.00 $0.00 Y
O 23660 TREAT SHOULDER DISLOCATION 2.57 $95.68 --- $120.66 004 1 0 0.00 $0.00 Y
O 23665 TREAT DISLOCATION/FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23665 TREAT DISLOCATION/FRACTURE 5.23 $194.71 --- $245.55 004 1 0 0.00 $0.00 Y
K 23670 TREAT DISLOCATION/FRACTURE 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 23670 TREAT DISLOCATION/FRACTURE 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 23675 TREAT DISLOCATION/FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23675 TREAT DISLOCATION/FRACTURE 6.39 $237.90 --- $300.01 004 1 0 0.00 $0.00 Y
K 23680 TREAT DISLOCATION/FRACTURE 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 23680 TREAT DISLOCATION/FRACTURE 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 23700 FIXATION OF SHOULDER 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23700 FIXATION OF SHOULDER 2.59 $96.43 --- $121.60 004 1 0 0.00 $0.00 Y
K 23800 FUSION OF SHOULDER JOINT 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 23800 FUSION OF SHOULDER JOINT 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 23802 FUSION OF SHOULDER JOINT 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 23802 FUSION OF SHOULDER JOINT 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 23900 AMPUTATION OF ARM & GIRDLE 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 23900 AMPUTATION OF ARM & GIRDLE 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 23920 AMPUTATION AT SHOULDER JOINT 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 23920 AMPUTATION AT SHOULDER JOINT 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 23921 AMPUTATION FOLLOW-UP SURGERY 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 23921 AMPUTATION FOLLOW-UP SURGERY 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 23929 SHOULDER SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23929 SHOULDER SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 23930 DRAINAGE OF ARM LESION 4.36 $162.32 --- $204.70 004 1 0 0.00 $0.00 Y
O 23930 DRAINAGE OF ARM LESION 0.87 $32.39 --- $40.85 004 1 0 0.00 $0.00 Y
K 23931 DRAINAGE OF ARM BURSA 3.06 $113.92 --- $143.67 004 1 0 0.00 $0.00 Y
K 23935 DRAIN ARM/ELBOW BONE LESION 14.56 $542.07 --- $683.59 004 1 0 0.00 $0.00 Y
O 23935 DRAIN ARM/ELBOW BONE LESION 2.91 $108.34 --- $136.62 004 1 0 0.00 $0.00 Y
O 24000 EXPLORATORY ELBOW SURGERY 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
K 24000 EXPLORATORY ELBOW SURGERY 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 24006 RELEASE ELBOW JOINT 10.86 $404.32 --- $509.88 004 1 0 0.00 $0.00 Y
O 24006 RELEASE ELBOW JOINT 2.17 $80.79 --- $101.88 004 1 0 0.00 $0.00 Y
K 24065 BIOPSY ARM/ELBOW SOFT TISSUE 3.27 $121.74 --- $153.53 004 1 0 0.00 $0.00 Y
K 24066 BIOPSY ARM/ELBOW SOFT TISSUE 5.91 $220.03 --- $277.47 004 1 0 0.00 $0.00 Y
O 24066 BIOPSY ARM/ELBOW SOFT TISSUE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24071 EXC ARM/ELBOW LES SC 3 CM/> 1.80 $67.01 --- $84.51 004 1 0 0.00 $0.00 Y
K 24071 EXC ARM/ELBOW LES SC 3 CM/> 8.99 $334.70 --- $422.08 004 1 0 0.00 $0.00 Y
K 24073 EX ARM/ELBOW TUM DEEP 5 CM/> 15.37 $572.23 --- -- 004 0 0 0.00 $0.00 Y
O 24073 EX ARM/ELBOW TUM DEEP 5 CM/> 3.07 $114.30 --- -- 004 0 0 0.00 $0.00 Y
O 24075 EXC ARM/ELBOW LES SC < 3 CM 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 24075 EXC ARM/ELBOW LES SC < 3 CM 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 24076 EX ARM/ELBOW TUM DEEP < 5 CM 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 24076 EX ARM/ELBOW TUM DEEP < 5 CM 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 24077 RESECT ARM/ELBOW TUM < 5 CM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24077 RESECT ARM/ELBOW TUM < 5 CM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24079 RESECT ARM/ELBOW TUM 5 CM/> 28.24 $1051.38 --- -- 004 0 0 0.00 $0.00 Y
O 24079 RESECT ARM/ELBOW TUM 5 CM/> 5.65 $210.35 --- -- 004 0 0 0.00 $0.00 Y
O 24100 ARTHROTOMY ELBOW 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
K 24100 ARTHROTOMY ELBOW 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 24101 EXPLORE/TREAT ELBOW JOINT 10.77 $400.97 --- $505.65 004 1 0 0.00 $0.00 Y
O 24101 EXPLORE/TREAT ELBOW JOINT 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 24102 ARTHROTOMY ELBOW 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 24102 ARTHROTOMY ELBOW 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 24105 REMOVAL OF ELBOW BURSA 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 24105 REMOVAL OF ELBOW BURSA 1.09 $40.58 --- $51.18 004 1 0 0.00 $0.00 Y
O 24110 REMOVE HUMERUS LESION 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
K 24110 REMOVE HUMERUS LESION 10.76 $400.59 --- $505.18 004 1 0 0.00 $0.00 Y
K 24115 REMOVE/GRAFT BONE LESION 14.16 $527.18 --- $664.81 004 1 0 0.00 $0.00 Y
O 24115 REMOVE/GRAFT BONE LESION 2.83 $105.36 --- $132.87 004 1 0 0.00 $0.00 Y
O 24116 REMOVE/GRAFT BONE LESION 2.83 $105.36 --- $132.87 004 1 0 0.00 $0.00 Y
K 24116 REMOVE/GRAFT BONE LESION 14.16 $527.18 --- $664.81 004 1 0 0.00 $0.00 Y
K 24120 REMOVE ELBOW LESION 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 24120 REMOVE ELBOW LESION 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 24125 REMOVE/GRAFT BONE LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 24125 REMOVE/GRAFT BONE LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 24126 REMOVE/GRAFT BONE LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 24126 REMOVE/GRAFT BONE LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 24130 REMOVAL OF HEAD OF RADIUS 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 24130 REMOVAL OF HEAD OF RADIUS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 24134 REMOVAL OF ARM BONE LESION 20.91 $778.48 --- $981.72 004 1 0 0.00 $0.00 Y
O 24134 REMOVAL OF ARM BONE LESION 4.18 $155.62 --- $196.25 004 1 0 0.00 $0.00 Y
O 24136 REMOVE RADIUS BONE LESION 2.59 $96.43 --- $121.60 004 1 0 0.00 $0.00 Y
K 24136 REMOVE RADIUS BONE LESION 12.93 $481.38 --- $607.06 004 1 0 0.00 $0.00 Y
K 24138 REMOVE ELBOW BONE LESION 14.15 $526.80 --- $664.34 004 1 0 0.00 $0.00 Y
O 24138 REMOVE ELBOW BONE LESION 2.83 $105.36 --- $132.87 004 1 0 0.00 $0.00 Y
O 24140 PARTIAL REMOVAL OF ARM BONE 2.21 $82.28 --- $103.76 004 1 0 0.00 $0.00 Y
K 24140 PARTIAL REMOVAL OF ARM BONE 11.04 $411.02 --- $518.33 004 1 0 0.00 $0.00 Y
K 24145 PARTIAL REMOVAL OF RADIUS 8.17 $304.17 --- $383.58 004 1 0 0.00 $0.00 Y
O 24145 PARTIAL REMOVAL OF RADIUS 1.63 $60.68 --- $76.53 004 1 0 0.00 $0.00 Y
O 24147 PARTIAL REMOVAL OF ELBOW 1.60 $59.57 --- $75.12 004 1 0 0.00 $0.00 Y
K 24147 PARTIAL REMOVAL OF ELBOW 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
K 24149 RADICAL RESECTION OF ELBOW 21.86 $813.85 --- $1026.33 004 1 0 0.00 $0.00 Y
O 24149 RADICAL RESECTION OF ELBOW 4.37 $162.70 --- $205.17 004 1 0 0.00 $0.00 Y
O 24150 RESECT DISTAL HUMERUS TUMOR 4.89 $182.05 --- $229.59 004 1 0 0.00 $0.00 Y
K 24150 RESECT DISTAL HUMERUS TUMOR 24.47 $911.02 --- $1148.87 004 1 0 0.00 $0.00 Y
K 24152 RESECT RADIUS TUMOR 16.94 $630.68 --- $795.33 004 1 0 0.00 $0.00 Y
O 24152 RESECT RADIUS TUMOR 3.39 $126.21 --- $159.16 004 1 0 0.00 $0.00 Y
O 24155 REMOVAL OF ELBOW JOINT 3.61 $134.40 --- $169.49 004 1 0 0.00 $0.00 Y
K 24155 REMOVAL OF ELBOW JOINT 18.14 $675.35 --- $851.67 004 1 0 0.00 $0.00 Y
K 24160 REMOVE ELBOW JOINT IMPLANT 7.48 $278.48 --- $351.19 004 1 0 0.00 $0.00 Y
O 24160 REMOVE ELBOW JOINT IMPLANT 1.49 $55.47 --- $69.96 004 1 0 0.00 $0.00 Y
O 24164 REMOVE RADIUS HEAD IMPLANT 1.15 $42.81 --- $53.99 004 1 0 0.00 $0.00 Y
K 24164 REMOVE RADIUS HEAD IMPLANT 5.75 $214.07 --- $269.96 004 1 0 0.00 $0.00 Y
K 24200 REMOVAL OF ARM FOREIGN BODY 2.97 $110.57 --- $139.44 004 1 0 0.00 $0.00 Y
K 24201 REMOVAL OF ARM FOREIGN BODY 10.30 $383.47 --- $483.59 004 1 0 0.00 $0.00 Y
O 24201 REMOVAL OF ARM FOREIGN BODY 2.06 $76.69 --- $96.72 004 1 0 0.00 $0.00 Y
K 24220 INJECTION FOR ELBOW X-RAY 5.49 $204.39 --- $257.76 004 1 0 0.00 $0.00 Y
K 24300 MANIPULATE ELBOW W/ANESTH 8.11 $301.94 --- -- 004 0 0 0.00 $0.00 Y
O 24300 MANIPULATE ELBOW W/ANESTH 1.62 $60.31 --- -- 004 0 0 0.00 $0.00 Y
O 24301 MUSCLE/TENDON TRANSFER 3.29 $122.49 --- $154.47 004 1 0 0.00 $0.00 Y
K 24301 MUSCLE/TENDON TRANSFER 16.47 $613.18 --- $773.27 004 1 0 0.00 $0.00 Y
K 24305 ARM TENDON LENGTHENING 7.48 $278.48 --- $351.19 004 1 0 0.00 $0.00 Y
O 24305 ARM TENDON LENGTHENING 1.49 $55.47 --- $69.96 004 1 0 0.00 $0.00 Y
O 24310 REVISION OF ARM TENDON 1.22 $45.42 --- $57.28 004 1 0 0.00 $0.00 Y
K 24310 REVISION OF ARM TENDON 6.08 $226.36 --- $285.46 004 1 0 0.00 $0.00 Y
K 24320 REPAIR OF ARM TENDON 17.99 $669.77 --- $844.63 004 1 0 0.00 $0.00 Y
O 24320 REPAIR OF ARM TENDON 3.60 $134.03 --- $169.02 004 1 0 0.00 $0.00 Y
O 24330 REVISION OF ARM MUSCLES 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 24330 REVISION OF ARM MUSCLES 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 24331 REVISION OF ARM MUSCLES 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 24331 REVISION OF ARM MUSCLES 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 24332 TENOLYSIS TRICEPS 2.21 $82.28 --- -- 004 0 0 0.00 $0.00 Y
K 24332 TENOLYSIS TRICEPS 11.04 $411.02 --- -- 004 0 0 0.00 $0.00 Y
K 24340 TENODESIS OF BICEPS TENDON AT ELBOW 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
O 24340 TENODESIS OF BICEPS TENDON AT ELBOW 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
O 24341 REPAIR ARM TENDON/MUSCLE 2.41 $89.72 --- $113.15 004 1 0 0.00 $0.00 Y
K 24341 REPAIR ARM TENDON/MUSCLE 12.08 $449.74 --- $567.16 004 1 0 0.00 $0.00 Y
K 24342 REPAIR OF RUPTURED TENDON 16.86 $627.70 --- $791.58 004 1 0 0.00 $0.00 Y
O 24342 REPAIR OF RUPTURED TENDON 3.39 $126.21 --- $159.16 004 1 0 0.00 $0.00 Y
O 24343 REPR ELBOW LAT LIGMNT W/TISS 2.93 $109.08 --- -- 004 0 0 0.00 $0.00 Y
K 24343 REPR ELBOW LAT LIGMNT W/TISS 14.63 $544.67 --- -- 004 0 0 0.00 $0.00 Y
K 24344 RECONSTRUCT ELBOW LAT LIGMNT 21.99 $818.69 --- -- 004 0 0 0.00 $0.00 Y
O 24344 RECONSTRUCT ELBOW LAT LIGMNT 4.40 $163.81 --- -- 004 0 0 0.00 $0.00 Y
O 24345 REPR ELBW MED LIGMNT W/TISSU 2.93 $109.08 --- -- 004 0 0 0.00 $0.00 Y
K 24345 REPR ELBW MED LIGMNT W/TISSU 14.63 $544.67 --- -- 004 0 0 0.00 $0.00 Y
K 24346 RECONSTRUCT ELBOW MED LIGMNT 21.99 $818.69 --- -- 004 0 0 0.00 $0.00 Y
O 24346 RECONSTRUCT ELBOW MED LIGMNT 4.40 $163.81 --- -- 004 0 0 0.00 $0.00 Y
O 24357 REPAIR ELBOW PERC 1.70 $63.29 --- -- 004 0 0 0.00 $0.00 Y
K 24357 REPAIR ELBOW PERC 8.49 $316.08 --- -- 004 0 0 0.00 $0.00 Y
K 24358 REPAIR ELBOW W/DEB OPEN 9.99 $371.93 --- -- 004 0 0 0.00 $0.00 Y
O 24358 REPAIR ELBOW W/DEB OPEN 2.00 $74.46 --- -- 004 0 0 0.00 $0.00 Y
O 24359 REPAIR ELBOW DEB/ATTCH OPEN 2.62 $97.54 --- -- 004 0 0 0.00 $0.00 Y
K 24359 REPAIR ELBOW DEB/ATTCH OPEN 12.70 $472.82 --- -- 004 0 0 0.00 $0.00 Y
K 24360 RECONSTRUCT ELBOW JOINT 19.00 $707.37 --- $892.05 004 1 0 0.00 $0.00 Y
O 24360 RECONSTRUCT ELBOW JOINT 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
O 24361 RECONSTRUCT ELBOW JOINT 4.60 $171.26 --- $215.97 004 1 0 0.00 $0.00 Y
K 24361 RECONSTRUCT ELBOW JOINT 22.99 $855.92 --- $1079.38 004 1 0 0.00 $0.00 Y
K 24362 RECONSTRUCT ELBOW JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24362 RECONSTRUCT ELBOW JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24363 REPLACE ELBOW JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24363 REPLACE ELBOW JOINT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24365 RECONSTRUCT HEAD OF RADIUS 14.44 $537.60 --- $677.96 004 1 0 0.00 $0.00 Y
O 24365 RECONSTRUCT HEAD OF RADIUS 2.89 $107.59 --- $135.69 004 1 0 0.00 $0.00 Y
O 24366 RECONSTRUCT HEAD OF RADIUS 2.49 $92.70 --- $116.91 004 1 0 0.00 $0.00 Y
K 24366 RECONSTRUCT HEAD OF RADIUS 12.46 $463.89 --- $585.00 004 1 0 0.00 $0.00 Y
K 24370 REVISE RECONST ELBOW JOINT 34.53 $1285.55 --- -- 004 0 0 0.00 $0.00 Y
O 24370 REVISE RECONST ELBOW JOINT 6.90 $256.89 --- -- 004 0 0 0.00 $0.00 Y
O 24371 REVISE RECONST ELBOW JOINT 7.94 $295.61 --- -- 004 0 0 0.00 $0.00 Y
K 24371 REVISE RECONST ELBOW JOINT 39.72 $1478.78 --- -- 004 0 0 0.00 $0.00 Y
K 24400 REVISION OF HUMERUS 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 24400 REVISION OF HUMERUS 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 24410 REVISION OF HUMERUS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 24410 REVISION OF HUMERUS 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 24420 REVISION OF HUMERUS 19.71 $733.80 --- $925.38 004 1 0 0.00 $0.00 Y
O 24420 REVISION OF HUMERUS 3.96 $147.43 --- $185.92 004 1 0 0.00 $0.00 Y
O 24430 REPAIR OF HUMERUS 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
K 24430 REPAIR OF HUMERUS 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
K 24435 REPAIR HUMERUS WITH GRAFT 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 24435 REPAIR HUMERUS WITH GRAFT 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 24470 REVISION OF ELBOW JOINT 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 24470 REVISION OF ELBOW JOINT 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 24495 DECOMPRESSION OF FOREARM 15.59 $580.42 --- $731.95 004 1 0 0.00 $0.00 Y
O 24495 DECOMPRESSION OF FOREARM 3.12 $116.16 --- $146.48 004 1 0 0.00 $0.00 Y
O 24498 REINFORCE HUMERUS 4.12 $153.39 --- $193.43 004 1 0 0.00 $0.00 Y
K 24498 REINFORCE HUMERUS 20.58 $766.19 --- $966.23 004 1 0 0.00 $0.00 Y
K 24500 TREAT HUMERUS FRACTURE 176.90 $176.90 --- -- 042 0 1 0.00 $0.00 Y
O 24500 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24505 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24505 TREAT HUMERUS FRACTURE 7.23 $269.17 --- $339.45 004 1 1 0.00 $0.00 Y
K 24515 TREAT HUMERUS FRACTURE 12.46 $463.89 --- $585.00 004 1 0 0.00 $0.00 Y
O 24515 TREAT HUMERUS FRACTURE 2.49 $92.70 --- $116.91 004 1 0 0.00 $0.00 Y
O 24516 TREAT HUMERUS FRACTURE 3.02 $112.43 --- $141.79 004 1 0 0.00 $0.00 Y
K 24516 TREAT HUMERUS FRACTURE 15.12 $562.92 --- $709.88 004 1 0 0.00 $0.00 Y
K 24530 TREAT HUMERUS FRACTURE 198.98 $198.98 --- -- 042 0 1 0.00 $0.00 Y
O 24530 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24535 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24535 TREAT HUMERUS FRACTURE 8.08 $300.82 --- $379.36 004 1 0 0.00 $0.00 Y
K 24538 TREAT HUMERUS FRACTURE 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 24538 TREAT HUMERUS FRACTURE 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 24545 TREAT HUMERUS FRACTURE 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 24545 TREAT HUMERUS FRACTURE 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 24546 TREAT HUMERUS FRACTURE 17.77 $661.58 --- $834.30 004 1 0 0.00 $0.00 Y
O 24546 TREAT HUMERUS FRACTURE 3.56 $132.54 --- $167.14 004 1 0 0.00 $0.00 Y
O 24560 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24560 TREAT HUMERUS FRACTURE 165.99 $165.99 --- -- 042 0 1 0.00 $0.00 Y
K 24565 TREAT HUMERUS FRACTURE 6.98 $259.87 --- $327.71 004 1 1 0.00 $0.00 Y
O 24565 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24566 PERCUT SKEL FIXAT OF HUMERAL EPIC FRACTU 1.71 $63.66 --- $80.28 004 1 0 0.00 $0.00 Y
K 24566 PERCUT SKEL FIXAT OF HUMERAL EPIC FRACTU 8.57 $319.06 --- $402.36 004 1 0 0.00 $0.00 Y
K 24575 TREAT HUMERUS FRACTURE 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
O 24575 TREAT HUMERUS FRACTURE 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
O 24576 TREAT HUMERUS FRACTURE 1.63 $60.68 --- $76.53 004 1 0 0.00 $0.00 Y
K 24576 TREAT HUMERUS FRACTURE 8.14 $303.05 --- $382.17 004 1 1 0.00 $0.00 Y
K 24577 TREAT HUMERUS FRACTURE 7.23 $269.17 --- $339.45 004 1 0 0.00 $0.00 Y
O 24577 TREAT HUMERUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24579 TREAT HUMERUS FRACTURE 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 24579 TREAT HUMERUS FRACTURE 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
K 24582 PERCUT SKEL FIXAT OF HUMERAL CON FRACTUR 9.37 $348.85 --- $439.92 004 1 0 0.00 $0.00 Y
O 24582 PERCUT SKEL FIXAT OF HUMERAL CON FRACTUR 1.87 $69.62 --- $87.80 004 1 0 0.00 $0.00 Y
O 24586 TREAT ELBOW FRACTURE 4.49 $167.16 --- $210.81 004 1 0 0.00 $0.00 Y
K 24586 TREAT ELBOW FRACTURE 22.43 $835.07 --- $1053.09 004 1 0 0.00 $0.00 Y
K 24587 TREAT ELBOW FRACTURE 23.63 $879.74 --- $1109.43 004 1 0 0.00 $0.00 Y
O 24587 TREAT ELBOW FRACTURE 4.73 $176.10 --- $222.07 004 1 0 0.00 $0.00 Y
O 24600 TREAT ELBOW DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24600 TREAT ELBOW DISLOCATION 221.73 $221.73 --- -- 042 0 1 0.00 $0.00 Y
K 24605 TREAT ELBOW DISLOCATION 4.65 $173.12 --- $218.32 004 1 0 0.00 $0.00 Y
O 24605 TREAT ELBOW DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24615 TREAT ELBOW DISLOCATION 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 24615 TREAT ELBOW DISLOCATION 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 24620 TREAT ELBOW FRACTURE 6.15 $228.96 --- $288.74 004 1 0 0.00 $0.00 Y
O 24620 TREAT ELBOW FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24635 TREAT ELBOW FRACTURE 3.09 $115.04 --- $145.08 004 1 0 0.00 $0.00 Y
K 24635 TREAT ELBOW FRACTURE 15.47 $575.95 --- $726.32 004 1 0 0.00 $0.00 Y
K 24640 TREAT ELBOW DISLOCATION 3.05 $113.55 --- $143.20 004 1 1 0.00 $0.00 Y
O 24640 TREAT ELBOW DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24650 TREAT RADIUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24650 TREAT RADIUS FRACTURE 149.31 $149.31 --- -- 042 0 1 0.00 $0.00 Y
K 24655 TREAT RADIUS FRACTURE 6.21 $231.20 --- $291.56 004 1 0 0.00 $0.00 Y
O 24655 TREAT RADIUS FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24665 TREAT RADIUS FRACTURE 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 24665 TREAT RADIUS FRACTURE 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 24666 TREAT RADIUS FRACTURE 12.46 $463.89 --- $585.00 004 1 0 0.00 $0.00 Y
O 24666 TREAT RADIUS FRACTURE 2.49 $92.70 --- $116.91 004 1 0 0.00 $0.00 Y
O 24670 TREAT ULNAR FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24670 TREAT ULNAR FRACTURE 154.54 $154.54 --- -- 042 0 1 0.00 $0.00 Y
K 24675 TREAT ULNAR FRACTURE 6.44 $239.76 --- $302.36 004 1 1 0.00 $0.00 Y
O 24675 TREAT ULNAR FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24685 TREAT ULNAR FRACTURE 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 24685 TREAT ULNAR FRACTURE 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 24800 FUSION OF ELBOW JOINT 17.44 $649.29 --- $818.81 004 1 0 0.00 $0.00 Y
O 24800 FUSION OF ELBOW JOINT 3.49 $129.93 --- $163.86 004 1 0 0.00 $0.00 Y
O 24802 FUSION/GRAFT OF ELBOW JOINT 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 24802 FUSION/GRAFT OF ELBOW JOINT 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 24900 AMPUTATION OF UPPER ARM 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 24900 AMPUTATION OF UPPER ARM 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 24920 AMPUTATION OF UPPER ARM 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 24920 AMPUTATION OF UPPER ARM 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
K 24925 AMPUTATION FOLLOWUP SURGERY 7.02 $261.35 --- $329.59 004 1 0 0.00 $0.00 Y
O 24925 AMPUTATION FOLLOWUP SURGERY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24930 AMPUTATION FOLLOWUP SURGERY 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 24930 AMPUTATION FOLLOWUP SURGERY 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 24931 AMPUTATE UPPER ARM & IMPLANT 15.06 $560.68 --- $707.07 004 1 0 0.00 $0.00 Y
O 24931 AMPUTATE UPPER ARM & IMPLANT 3.06 $113.92 --- $143.67 004 1 0 0.00 $0.00 Y
O 24935 REVISION OF AMPUTATION 5.11 $190.25 --- $239.91 004 1 0 0.00 $0.00 Y
K 24935 REVISION OF AMPUTATION 25.53 $950.48 --- $1198.63 004 1 0 0.00 $0.00 Y
K 24940 REVISION OF UPPER ARM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24940 REVISION OF UPPER ARM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 24999 UPPER ARM/ELBOW SURGERY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 24999 UPPER ARM/ELBOW SURGERY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 25000 INCISION OF TENDON SHEATH 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 25000 INCISION OF TENDON SHEATH 1.00 $37.23 --- $46.95 004 1 0 0.00 $0.00 Y
O 25001 INCISE FLEXOR CARPI RADIALIS 1.35 $50.26 --- -- 004 0 0 0.00 $0.00 Y
K 25001 INCISE FLEXOR CARPI RADIALIS 6.75 $251.30 --- -- 004 0 0 0.00 $0.00 Y
K 25020 DECOMPRESS FOREARM 1 SPACE 13.38 $498.14 --- $628.19 004 1 0 0.00 $0.00 Y
O 25020 DECOMPRESS FOREARM 1 SPACE 2.68 $99.78 --- $125.83 004 1 0 0.00 $0.00 Y
O 25023 DECOMPRESS FOREARM 1 SPACE 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 25023 DECOMPRESS FOREARM 1 SPACE 13.04 $485.48 --- $612.23 004 1 0 0.00 $0.00 Y
K 25024 DECOMPRESS FOREARM 2 SPACES 15.53 $578.18 --- -- 004 0 0 0.00 $0.00 Y
O 25024 DECOMPRESS FOREARM 2 SPACES 3.11 $115.79 --- -- 004 0 0 0.00 $0.00 Y
O 25025 DECOMPRESS FOREARM 2 SPACES 5.01 $186.52 --- -- 004 0 0 0.00 $0.00 Y
K 25025 DECOMPRESS FOREARM 2 SPACES 25.03 $931.87 --- -- 004 0 0 0.00 $0.00 Y
K 25028 DRAINAGE OF FOREARM LESION 12.24 $455.70 --- $574.67 004 1 0 0.00 $0.00 Y
O 25028 DRAINAGE OF FOREARM LESION 2.45 $91.21 --- $115.03 004 1 0 0.00 $0.00 Y
O 25031 DRAINAGE OF FOREARM BURSA 2.20 $81.91 --- $103.29 004 1 0 0.00 $0.00 Y
K 25031 DRAINAGE OF FOREARM BURSA 11.01 $409.90 --- $516.92 004 1 0 0.00 $0.00 Y
K 25035 TREAT FOREARM BONE LESION 9.73 $362.25 --- $456.82 004 1 0 0.00 $0.00 Y
O 25035 TREAT FOREARM BONE LESION 1.95 $72.60 --- $91.55 004 1 0 0.00 $0.00 Y
K 25040 ARTHROTOMY RADIOCARPAL/MIDCARPAL JOINT 7.09 $263.96 --- $332.88 004 1 0 0.00 $0.00 Y
K 25065 BIOPSY FOREARM SOFT TISSUES 2.08 $77.44 --- $97.66 004 1 0 0.00 $0.00 Y
K 25066 BIOPSY FOREARM SOFT TISSUES 5.10 $189.87 --- $239.45 004 1 0 0.00 $0.00 Y
O 25066 BIOPSY FOREARM SOFT TISSUES 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 25071 EXC FOREARM LES SC 3 CM/> 1.89 $70.36 --- $88.74 004 1 0 0.00 $0.00 Y
K 25071 EXC FOREARM LES SC 3 CM/> 9.43 $351.08 --- $442.74 004 1 0 0.00 $0.00 Y
K 25073 EXC FOREARM TUM DEEP 3 CM/> 11.80 $439.31 --- -- 004 0 0 0.00 $0.00 Y
O 25073 EXC FOREARM TUM DEEP 3 CM/> 2.36 $87.86 --- -- 004 0 0 0.00 $0.00 Y
O 25075 EXC FOREARM LES SC < 3 CM 1.76 $65.52 --- $82.63 004 1 0 0.00 $0.00 Y
K 25075 EXC FOREARM LES SC < 3 CM 8.82 $328.37 --- $414.10 004 1 0 0.00 $0.00 Y
K 25076 EXC FOREARM TUM DEEP < 3 CM 4.61 $171.76 --- $216.44 004 1 0 0.00 $0.00 Y
O 25076 EXC FOREARM TUM DEEP < 3 CM 0.92 $34.35 --- $43.19 004 1 0 0.00 $0.00 Y
O 25077 RESECT FOREARM/WRIST TUM<3CM 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 25077 RESECT FOREARM/WRIST TUM<3CM 20.01 $744.97 --- $939.47 004 1 0 0.00 $0.00 Y
K 25078 RESECT FORARM/WRIST TUM 3CM> 24.70 $919.58 --- -- 004 0 0 0.00 $0.00 Y
O 25078 RESECT FORARM/WRIST TUM 3CM> 4.94 $183.92 --- -- 004 0 0 0.00 $0.00 Y
O 25085 INCISION OF WRIST CAPSULE 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 25085 INCISION OF WRIST CAPSULE 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 25100 ARTHROTOMY WRIST JOINT 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
O 25100 ARTHROTOMY WRIST JOINT 1.13 $42.07 --- $53.05 004 1 0 0.00 $0.00 Y
O 25101 EXPLORE/TREAT WRIST JOINT 1.54 $57.33 --- $72.30 004 1 0 0.00 $0.00 Y
K 25101 EXPLORE/TREAT WRIST JOINT 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
K 25105 ARTHROTOMY WRIST JOINT 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 25105 ARTHROTOMY WRIST JOINT 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 25107 REMOVE WRIST JOINT CARTILAGE 1.70 $63.29 --- $79.82 004 1 0 0.00 $0.00 Y
K 25107 REMOVE WRIST JOINT CARTILAGE 8.49 $316.08 --- $398.61 004 1 0 0.00 $0.00 Y
K 25109 EXCISE TENDON FOREARM/WRIST 11.34 $422.29 --- -- 004 0 0 0.00 $0.00 Y
O 25109 EXCISE TENDON FOREARM/WRIST 2.27 $84.46 --- -- 004 0 0 0.00 $0.00 Y
O 25110 REMOVE WRIST TENDON LESION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 25110 REMOVE WRIST TENDON LESION 5.11 $190.25 --- $239.91 004 1 0 0.00 $0.00 Y
K 25111 REMOVE WRIST TENDON LESION 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
O 25111 REMOVE WRIST TENDON LESION 1.13 $42.07 --- $53.05 004 1 0 0.00 $0.00 Y
O 25112 REREMOVE WRIST TENDON LESION 1.13 $42.07 --- $53.05 004 1 0 0.00 $0.00 Y
K 25112 REREMOVE WRIST TENDON LESION 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
K 25115 REMOVE WRIST/FOREARM LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 25116 REMOVE WRIST/FOREARM LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25116 REMOVE WRIST/FOREARM LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25118 EXCISE WRIST TENDON SHEATH 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
K 25118 EXCISE WRIST TENDON SHEATH 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 25119 PARTIAL REMOVAL OF ULNA 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25119 PARTIAL REMOVAL OF ULNA 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25120 REMOVAL OF FOREARM LESION 1.71 $63.66 --- $80.28 004 1 0 0.00 $0.00 Y
K 25120 REMOVAL OF FOREARM LESION 8.54 $317.94 --- $400.95 004 1 0 0.00 $0.00 Y
K 25125 REMOVE/GRAFT FOREARM LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25125 REMOVE/GRAFT FOREARM LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25126 REMOVE/GRAFT FOREARM LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 25126 REMOVE/GRAFT FOREARM LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 25130 REMOVAL OF WRIST LESION 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
O 25130 REMOVAL OF WRIST LESION 1.13 $42.07 --- $53.05 004 1 0 0.00 $0.00 Y
O 25135 REMOVE & GRAFT WRIST LESION 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 25135 REMOVE & GRAFT WRIST LESION 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 25136 REMOVE & GRAFT WRIST LESION 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
O 25136 REMOVE & GRAFT WRIST LESION 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
O 25145 REMOVE FOREARM BONE LESION 3.24 $120.63 --- $152.12 004 1 0 0.00 $0.00 Y
K 25145 REMOVE FOREARM BONE LESION 16.20 $603.13 --- $760.59 004 1 0 0.00 $0.00 Y
K 25150 PARTIAL REMOVAL OF ULNA 8.07 $300.45 --- $378.89 004 1 0 0.00 $0.00 Y
O 25150 PARTIAL REMOVAL OF ULNA 1.61 $59.94 --- $75.59 004 1 0 0.00 $0.00 Y
O 25151 PARTIAL REMOVAL OF RADIUS 1.90 $70.74 --- $89.21 004 1 0 0.00 $0.00 Y
K 25151 PARTIAL REMOVAL OF RADIUS 9.49 $353.31 --- $445.56 004 1 0 0.00 $0.00 Y
K 25170 RESECT RADIUS/ULNAR TUMOR 24.10 $897.24 --- $1131.50 004 1 0 0.00 $0.00 Y
O 25170 RESECT RADIUS/ULNAR TUMOR 4.82 $179.45 --- $226.30 004 1 0 0.00 $0.00 Y
O 25210 REMOVAL OF WRIST BONE 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 25210 REMOVAL OF WRIST BONE 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 25215 REMOVAL OF WRIST BONES 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25215 REMOVAL OF WRIST BONES 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25230 PARTIAL REMOVAL OF RADIUS 1.13 $42.07 --- $53.05 004 1 0 0.00 $0.00 Y
K 25230 PARTIAL REMOVAL OF RADIUS 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
K 25240 EXCISION DISTAL ULNA PARTIAL OR COMPLETE 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 25240 EXCISION DISTAL ULNA PARTIAL OR COMPLETE 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
K 25246 INJECTION FOR WRIST XRAY 4.89 $182.05 --- $229.59 004 1 0 0.00 $0.00 Y
K 25248 EXPLOR W/REMOVAL OF DEEP FOREIGN BODY 12.51 $465.75 --- $587.34 004 1 0 0.00 $0.00 Y
O 25248 EXPLOR W/REMOVAL OF DEEP FOREIGN BODY 2.50 $93.08 --- $117.38 004 1 0 0.00 $0.00 Y
O 25250 REMOVAL OF WRIST PROSTHESIS 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 25250 REMOVAL OF WRIST PROSTHESIS 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 25251 REMOVAL OF WRIST PROSTHESIS 10.44 $388.68 --- $490.16 004 1 0 0.00 $0.00 Y
O 25251 REMOVAL OF WRIST PROSTHESIS 2.09 $77.81 --- $98.13 004 1 0 0.00 $0.00 Y
K 25259 MANIPULATE WRIST W/ANESTHES 8.01 $298.21 --- -- 004 0 0 0.00 $0.00 Y
K 25260 REPAIR FOREARM TENDON/MUSCLE 10.04 $373.79 --- $471.38 004 1 0 0.00 $0.00 Y
O 25260 REPAIR FOREARM TENDON/MUSCLE 2.01 $74.83 --- $94.37 004 1 0 0.00 $0.00 Y
O 25263 REPAIR FOREARM TENDON/MUSCLE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 25263 REPAIR FOREARM TENDON/MUSCLE 10.61 $395.01 --- $498.14 004 1 0 0.00 $0.00 Y
K 25265 REPAIR FOREARM TENDON/MUSCLE 15.06 $560.68 --- $707.07 004 1 0 0.00 $0.00 Y
O 25265 REPAIR FOREARM TENDON/MUSCLE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 25270 REPAIR FOREARM TENDON/MUSCLE 1.75 $65.15 --- $82.16 004 1 0 0.00 $0.00 Y
K 25270 REPAIR FOREARM TENDON/MUSCLE 8.74 $325.39 --- $410.34 004 1 0 0.00 $0.00 Y
K 25272 REPAIR FOREARM TENDON/MUSCLE 9.48 $352.94 --- $445.09 004 1 0 0.00 $0.00 Y
O 25272 REPAIR FOREARM TENDON/MUSCLE 1.90 $70.74 --- $89.21 004 1 0 0.00 $0.00 Y
O 25274 REPAIR FOREARM TENDON/MUSCLE 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
K 25274 REPAIR FOREARM TENDON/MUSCLE 10.75 $400.22 --- $504.71 004 1 0 0.00 $0.00 Y
K 25275 REPAIR FOREARM TENDON SHEATH 14.11 $525.32 --- -- 004 0 0 0.00 $0.00 Y
O 25275 REPAIR FOREARM TENDON SHEATH 2.82 $104.99 --- -- 004 0 0 0.00 $0.00 Y
O 25280 REVISE WRIST/FOREARM TENDON 1.87 $69.62 --- $87.80 004 1 0 0.00 $0.00 Y
K 25280 REVISE WRIST/FOREARM TENDON 9.37 $348.85 --- $439.92 004 1 0 0.00 $0.00 Y
K 25290 INCISE WRIST/FOREARM TENDON 9.14 $340.28 --- $429.12 004 1 0 0.00 $0.00 Y
O 25290 INCISE WRIST/FOREARM TENDON 1.83 $68.13 --- $85.92 004 1 0 0.00 $0.00 Y
O 25295 RELEASE WRIST/FOREARM TENDON 1.79 $66.64 --- $84.04 004 1 0 0.00 $0.00 Y
K 25295 RELEASE WRIST/FOREARM TENDON 8.97 $333.95 --- $421.14 004 1 0 0.00 $0.00 Y
K 25300 FUSION OF TENDONS AT WRIST 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 25300 FUSION OF TENDONS AT WRIST 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 25301 FUSION OF TENDONS AT WRIST 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 25301 FUSION OF TENDONS AT WRIST 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 25310 TRANSPLANT FOREARM TENDON 10.76 $400.59 --- $505.18 004 1 0 0.00 $0.00 Y
O 25310 TRANSPLANT FOREARM TENDON 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 25312 TRANSPLANT FOREARM TENDON 2.31 $86.00 --- $108.45 004 1 0 0.00 $0.00 Y
K 25312 TRANSPLANT FOREARM TENDON 11.54 $429.63 --- $541.80 004 1 0 0.00 $0.00 Y
K 25315 FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 25315 FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 25316 REVISE PALSY HAND TENDON(S) 6.16 $229.34 --- $289.21 004 1 0 0.00 $0.00 Y
K 25316 REVISE PALSY HAND TENDON(S) 30.82 $1147.43 --- $1447.00 004 1 0 0.00 $0.00 Y
K 25320 REPAIR/REVISE WRIST JOINT 18.58 $691.73 --- $872.33 004 1 0 0.00 $0.00 Y
O 25320 REPAIR/REVISE WRIST JOINT 3.72 $138.50 --- $174.65 004 1 0 0.00 $0.00 Y
O 25332 REVISE WRIST JOINT 4.18 $155.62 --- $196.25 004 1 0 0.00 $0.00 Y
K 25332 REVISE WRIST JOINT 20.88 $777.36 --- $980.32 004 1 0 0.00 $0.00 Y
K 25335 REALIGNMENT OF HAND 22.17 $825.39 --- $1040.88 004 1 0 0.00 $0.00 Y
O 25335 REALIGNMENT OF HAND 4.43 $164.93 --- $207.99 004 1 0 0.00 $0.00 Y
O 25337 RECONS STABILIZ OF UNSTABLE DISTAL ULNA 2.13 $79.30 --- $100.00 004 1 0 0.00 $0.00 Y
K 25337 RECONS STABILIZ OF UNSTAB DISTAL ULNA 10.66 $396.87 --- $500.49 004 1 0 0.00 $0.00 Y
K 25350 REVISION OF RADIUS 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25350 REVISION OF RADIUS 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25355 REVISION OF RADIUS 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 25355 REVISION OF RADIUS 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 25360 REVISION OF ULNA 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 25360 REVISION OF ULNA 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 25365 REVISE RADIUS & ULNA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 25365 REVISE RADIUS & ULNA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 25370 REVISE RADIUS OR ULNA 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 25370 REVISE RADIUS OR ULNA 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 25375 REVISE RADIUS & ULNA 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 25375 REVISE RADIUS & ULNA 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 25390 SHORTEN RADIUS OR ULNA 12.46 $463.89 --- $585.00 004 1 0 0.00 $0.00 Y
O 25390 SHORTEN RADIUS OR ULNA 2.49 $92.70 --- $116.91 004 1 0 0.00 $0.00 Y
O 25391 LENGTHEN RADIUS OR ULNA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 25391 LENGTHEN RADIUS OR ULNA 15.63 $581.90 --- $733.83 004 1 0 0.00 $0.00 Y
K 25392 SHORTEN RADIUS & ULNA 17.44 $649.29 --- $818.81 004 1 0 0.00 $0.00 Y
O 25392 SHORTEN RADIUS & ULNA 3.51 $130.68 --- $164.79 004 1 0 0.00 $0.00 Y
O 25393 LENGTHEN RADIUS & ULNA 3.96 $147.43 --- $185.92 004 1 0 0.00 $0.00 Y
K 25393 LENGTHEN RADIUS & ULNA 19.71 $733.80 --- $925.38 004 1 0 0.00 $0.00 Y
K 25394 REPAIR CARPAL BONE SHORTEN 16.45 $612.43 --- -- 004 0 0 0.00 $0.00 Y
O 25394 REPAIR CARPAL BONE SHORTEN 3.29 $122.49 --- -- 004 0 0 0.00 $0.00 Y
O 25400 REPAIR RADIUS OR ULNA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 25400 REPAIR RADIUS OR ULNA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 25405 REPAIR/GRAFT RADIUS OR ULNA 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
O 25405 REPAIR/GRAFT RADIUS OR ULNA 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
O 25415 REPAIR RADIUS & ULNA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 25415 REPAIR RADIUS & ULNA 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 25420 REPAIR/GRAFT RADIUS & ULNA 26.05 $969.84 --- $1223.05 004 1 0 0.00 $0.00 Y
O 25420 REPAIR/GRAFT RADIUS & ULNA 5.21 $193.97 --- $244.61 004 1 0 0.00 $0.00 Y
O 25425 REPAIR/GRAFT RADIUS OR ULNA 3.37 $125.47 --- $158.22 004 1 0 0.00 $0.00 Y
K 25425 REPAIR/GRAFT RADIUS OR ULNA 16.60 $618.02 --- $779.37 004 1 0 0.00 $0.00 Y
K 25426 REPAIR/GRAFT RADIUS & ULNA 19.71 $733.80 --- $925.38 004 1 0 0.00 $0.00 Y
O 25426 REPAIR/GRAFT RADIUS & ULNA 3.96 $147.43 --- $185.92 004 1 0 0.00 $0.00 Y
O 25430 VASC GRAFT INTO CARPAL BONE 2.92 $108.71 --- -- 004 0 0 0.00 $0.00 Y
K 25430 VASC GRAFT INTO CARPAL BONE 14.61 $543.93 --- -- 004 0 0 0.00 $0.00 Y
K 25431 REPAIR NONUNION CARPAL BONE 14.35 $534.25 --- -- 004 0 0 0.00 $0.00 Y
O 25431 REPAIR NONUNION CARPAL BONE 2.87 $106.85 --- -- 004 0 0 0.00 $0.00 Y
O 25440 REPAIR/GRAFT WRIST BONE 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 25440 REPAIR/GRAFT WRIST BONE 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 25441 RECONSTRUCT WRIST JOINT 22.68 $844.38 --- $1064.83 004 1 0 0.00 $0.00 Y
O 25441 RECONSTRUCT WRIST JOINT 4.54 $169.02 --- $213.15 004 1 0 0.00 $0.00 Y
O 25442 RECONSTRUCT WRIST JOINT 2.07 $77.07 --- $97.19 004 1 0 0.00 $0.00 Y
K 25442 RECONSTRUCT WRIST JOINT 10.36 $385.70 --- $486.40 004 1 0 0.00 $0.00 Y
K 25443 RECONSTRUCT WRIST JOINT 10.87 $404.69 --- $510.35 004 1 0 0.00 $0.00 Y
O 25443 RECONSTRUCT WRIST JOINT 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 25444 RECONSTRUCT WRIST JOINT 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
K 25444 RECONSTRUCT WRIST JOINT 10.87 $404.69 --- $510.35 004 1 0 0.00 $0.00 Y