[Federal Register: September 8, 1998 (Volume 63, Number 173)]
[Proposed Rules]
[Page 47751-47800]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr08se98-38]
[[pp. 47751-47800]] Medicare Program; Prospective Payment System for Hospital
Outpatient Services
[[Continued from page 47750]]
[[Page 47750]]
L2390...  A                   Offset knee joint each.  .........  .........  .........  ...........  ...........
L2395...  A                   Offset knee joint heavy  .........  .........  .........  ...........  ...........
                               duty.
L2397...  A                   Suspension sleeve lower  .........  .........  .........  ...........  ...........
                               ext.
L2405...  A                   Knee joint drop lock ea  .........  .........  .........  ...........  ...........
                               jnt.
L2415...  A                   Knee joint cam lock      .........  .........  .........  ...........  ...........
                               each joi.
L2425...  A                   Knee disc/dial lock/adj  .........  .........  .........  ...........  ...........
                               flex.
L2430...  A                   Knee jnt ratchet lock    .........  .........  .........  ...........  ...........
                               ea jnt.
L2435...  A                   Knee joint polycentric   .........  .........  .........  ...........  ...........
                               joint.
L2492...  A                   Knee lift loop drop      .........  .........  .........  ...........  ...........
                               lock rin.
L2500...  A                   Thi/glut/ischia wgt      .........  .........  .........  ...........  ...........
                               bearing.
L2510...  A                   Th/wght bear quad-lat    .........  .........  .........  ...........  ...........
                               brim m.
L2520...  A                   Th/wght bear quad-lat    .........  .........  .........  ...........  ...........
                               brim c.
L2525...  A                   Th/wght bear nar m-l     .........  .........  .........  ...........  ...........
                               brim mo.
L2526...  A                   Th/wght bear nar m-l     .........  .........  .........  ...........  ...........
                               brim cu.
L2530...  A                   Thigh/wght bear lacer    .........  .........  .........  ...........  ...........
                               non-mo.
L2540...  A                   Thigh/wght bear lacer    .........  .........  .........  ...........  ...........
                               molded.
L2550...  A                   Thigh/wght bear high     .........  .........  .........  ...........  ...........
                               roll cu.
L2570...  A                   Hip clevis type 2 posit  .........  .........  .........  ...........  ...........
                               jnt.
L2580...  A                   Pelvic control pelvic    .........  .........  .........  ...........  ...........
                               sling.
L2600...  A                   Hip clevis/thrust        .........  .........  .........  ...........  ...........
                               bearing fr.
L2610...  A                   Hip clevis/thrust        .........  .........  .........  ...........  ...........
                               bearing lo.
L2620...  A                   Pelvic control hip       .........  .........  .........  ...........  ...........
                               heavy dut.
L2622...  A                   Hip joint adjustable     .........  .........  .........  ...........  ...........
                               flexion.
L2624...  A                   Hip adj flex ext abduct  .........  .........  .........  ...........  ...........
                               cont.
L2627...  A                   Plastic mold recipro     .........  .........  .........  ...........  ...........
                               hip & c.
L2628...  A                   Metal frame recipro hip  .........  .........  .........  ...........  ...........
                               & ca.
L2630...  A                   Pelvic control band &    .........  .........  .........  ...........  ...........
                               belt u.
L2640...  A                   Pelvic control band &    .........  .........  .........  ...........  ...........
                               belt b.
L2650...  A                   Pelv & thor control      .........  .........  .........  ...........  ...........
                               gluteal.
L2660...  A                   Thoracic control         .........  .........  .........  ...........  ...........
                               thoracic ba.
L2670...  A                   Thorac cont paraspinal   .........  .........  .........  ...........  ...........
                               uprig.
L2680...  A                   Thorac cont lat support  .........  .........  .........  ...........  ...........
                               upri.
L2750...  A                   Plating chrome/nickel    .........  .........  .........  ...........  ...........
                               pr bar.
L2755...  A                   Carbon graphite          .........  .........  .........  ...........  ...........
                               lamination.
L2760...  A                   Extension per extension  .........  .........  .........  ...........  ...........
                               per.
L2770...  A                   Low ext orthosis per     .........  .........  .........  ...........  ...........
                               bar/jnt.
L2780...  A                   Non-corrosive finish...  .........  .........  .........  ...........  ...........
L2785...  A                   Drop lock retainer each  .........  .........  .........  ...........  ...........
L2795...  A                   Knee control full        .........  .........  .........  ...........  ...........
                               kneecap.
L2800...  A                   Knee cap medial or       .........  .........  .........  ...........  ...........
                               lateral p.
L2810...  A                   Knee control condylar    .........  .........  .........  ...........  ...........
                               pad.
L2820...  A                   Soft interface below     .........  .........  .........  ...........  ...........
                               knee se.
L2830...  A                   Soft interface above     .........  .........  .........  ...........  ...........
                               knee se.
L2840...  A                   Tibial length sock fx    .........  .........  .........  ...........  ...........
                               or equ.
L2850...  A                   Femoral lgth sock fx or  .........  .........  .........  ...........  ...........
                               equa.
L2860...  A                   Torsion mechanism knee/  .........  .........  .........  ...........  ...........
                               ankle.
L2999...  A                   Lower extremity          .........  .........  .........  ...........  ...........
                               orthosis NOS.
L3000...  A                   Ft insert ucb berkeley   .........  .........  .........  ...........  ...........
                               shell.
L3001...  A                   Foot insert remov        .........  .........  .........  ...........  ...........
                               molded spe.
L3002...  A                   Foot insert plastazote   .........  .........  .........  ...........  ...........
                               or eq.
L3003...  A                   Foot insert silicone     .........  .........  .........  ...........  ...........
                               gel eac.
L3010...  A                   Foot longitudinal arch   .........  .........  .........  ...........  ...........
                               suppo.
L3020...  A                   Foot longitud/           .........  .........  .........  ...........  ...........
                               metatarsal sup.
L3030...  A                   Foot arch support remov  .........  .........  .........  ...........  ...........
                               prem.
L3040...  A                   Ft arch suprt premold    .........  .........  .........  ...........  ...........
                               longit.
L3050...  A                   Foot arch supp premold   .........  .........  .........  ...........  ...........
                               metat.
L3060...  A                   Foot arch supp longitud/ .........  .........  .........  ...........  ...........
                               meta.
L3070...  A                   Arch suprt att to sho    .........  .........  .........  ...........  ...........
                               longit.
L3080...  A                   Arch supp att to shoe    .........  .........  .........  ...........  ...........
                               metata.
L3090...  A                   Arch supp att to shoe    .........  .........  .........  ...........  ...........
                               long/m.
L3100...  A                   Hallus-valgus nght       .........  .........  .........  ...........  ...........
                               dynamic s.
L3140...  A                   Abduction rotation bar   .........  .........  .........  ...........  ...........
                               shoe.
L3150...  A                   Abduct rotation bar w/o  .........  .........  .........  ...........  ...........
                               shoe.
L3160...  A                   Shoe styled positioning  .........  .........  .........  ...........  ...........
                               dev.
L3170...  A                   Foot plastic heel        .........  .........  .........  ...........  ...........
                               stabilizer.
L3201...  A                   Oxford w supinat/pronat  .........  .........  .........  ...........  ...........
                               inf.
L3202...  A                   Oxford w/ supinat/       .........  .........  .........  ...........  ...........
                               pronator c.
L3203...  A                   Oxford w/ supinator/     .........  .........  .........  ...........  ...........
                               pronator.
L3204...  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator inf.
L3206...  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator chi.
L3207...  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator jun.
L3208...  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               infant.
L3209...  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               child.
L3211...  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               junior.
L3212...  A                   Benesch boot pair        .........  .........  .........  ...........  ...........
                               infant.
[[Page 47751]]
L3213...  A                   Benesch boot pair child  .........  .........  .........  ...........  ...........
L3214...  A                   Benesch boot pair        .........  .........  .........  ...........  ...........
                               junior.
L3215...  A                   Orthopedic ftwear        .........  .........  .........  ...........  ...........
                               ladies oxf.
L3216...  A                   Orthoped ladies shoes    .........  .........  .........  ...........  ...........
                               dpth i.
L3217...  A                   Ladies shoes hightop     .........  .........  .........  ...........  ...........
                               depth i.
L3218...  A                   Ladies surgical boot     .........  .........  .........  ...........  ...........
                               each.
L3219...  A                   Orthopedic mens shoes    .........  .........  .........  ...........  ...........
                               oxford.
L3221...  A                   Orthopedic mens shoes    .........  .........  .........  ...........  ...........
                               dpth i.
L3222...  A                   Mens shoes hightop       .........  .........  .........  ...........  ...........
                               depth inl.
L3223...  A                   Mens surgical boot each  .........  .........  .........  ...........  ...........
L3224...  A                   Woman's shoe oxford      .........  .........  .........  ...........  ...........
                               brace.
L3225...  A                   Man's shoe oxford brace  .........  .........  .........  ...........  ...........
L3230...  A                   Custom shoes depth       .........  .........  .........  ...........  ...........
                               inlay.
L3250...  A                   Custom mold shoe remov   .........  .........  .........  ...........  ...........
                               prost.
L3251...  A                   Shoe molded to pt        .........  .........  .........  ...........  ...........
                               silicone s.
L3252...  A                   Shoe molded plastazote   .........  .........  .........  ...........  ...........
                               cust.
L3253...  A                   Shoe molded plastazote   .........  .........  .........  ...........  ...........
                               cust.
L3254...  A                   Orth foot non-stndard    .........  .........  .........  ...........  ...........
                               size/w.
L3255...  A                   Orth foot non-standard   .........  .........  .........  ...........  ...........
                               size/.
L3257...  A                   Orth foot add charge     .........  .........  .........  ...........  ...........
                               split s.
L3260...  A                   Ambulatory surgical      .........  .........  .........  ...........  ...........
                               boot eac.
L3265...  A                   Plastazote sandal each.  .........  .........  .........  ...........  ...........
L3300...  A                   Sho lift taper to        .........  .........  .........  ...........  ...........
                               metatarsal.
L3310...  A                   Shoe lift elev heel/     .........  .........  .........  ...........  ...........
                               sole neo.
L3320...  A                   Shoe lift elev heel/     .........  .........  .........  ...........  ...........
                               sole cor.
L3330...  A                   Lifts elevation metal    .........  .........  .........  ...........  ...........
                               extens.
L3332...  A                   Shoe lifts tapered to    .........  .........  .........  ...........  ...........
                               one-ha.
L3334...  A                   Shoe lifts elevation     .........  .........  .........  ...........  ...........
                               heel /i.
L3340...  A                   Shoe wedge sach........  .........  .........  .........  ...........  ...........
L3350...  A                   Shoe heel wedge........  .........  .........  .........  ...........  ...........
L3360...  A                   Shoe sole wedge outside  .........  .........  .........  ...........  ...........
                               sole.
L3370...  A                   Shoe sole wedge between  .........  .........  .........  ...........  ...........
                               sole.
L3380...  A                   Shoe clubfoot wedge....  .........  .........  .........  ...........  ...........
L3390...  A                   Shoe outflare wedge....  .........  .........  .........  ...........  ...........
L3400...  A                   Shoe metatarsal bar      .........  .........  .........  ...........  ...........
                               wedge ro.
L3410...  A                   Shoe metatarsal bar      .........  .........  .........  ...........  ...........
                               between.
L3420...  A                   Full sole/heel wedge     .........  .........  .........  ...........  ...........
                               btween.
L3430...  A                   Sho heel count plast     .........  .........  .........  ...........  ...........
                               reinfor.
L3440...  A                   Heel leather reinforced  .........  .........  .........  ...........  ...........
L3450...  A                   Shoe heel sach cushion   .........  .........  .........  ...........  ...........
                               type.
L3455...  A                   Shoe heel new leather    .........  .........  .........  ...........  ...........
                               standa.
L3460...  A                   Shoe heel new rubber     .........  .........  .........  ...........  ...........
                               standar.
L3465...  A                   Shoe heel thomas with    .........  .........  .........  ...........  ...........
                               wedge.
L3470...  A                   Shoe heel thomas extend  .........  .........  .........  ...........  ...........
                               to b.
L3480...  A                   Shoe heel pad & depress  .........  .........  .........  ...........  ...........
                               for.
L3485...  A                   Shoe heel pad removable  .........  .........  .........  ...........  ...........
                               for.
L3500...  A                   Shoe misc add insole     .........  .........  .........  ...........  ...........
                               leather.
L3510...  A                   Shoe misc addition       .........  .........  .........  ...........  ...........
                               insole ru.
L3520...  A                   Shoe insole felt cver w/ .........  .........  .........  ...........  ...........
                                lea.
L3530...  A                   Shoe misc additions      .........  .........  .........  ...........  ...........
                               sole hal.
L3540...  A                   Shoe misc additions      .........  .........  .........  ...........  ...........
                               sole ful.
L3550...  A                   Shoe misc add toe tap    .........  .........  .........  ...........  ...........
                               standa.
L3560...  A                   Shoe misc add toe tap    .........  .........  .........  ...........  ...........
                               horses.
L3570...  A                   Shoe special extension   .........  .........  .........  ...........  ...........
                               to in.
L3580...  A                   Shoe convert instep      .........  .........  .........  ...........  ...........
                               velcro c.
L3590...  A                   Shoe convert firm to     .........  .........  .........  ...........  ...........
                               soft cn.
L3595...  A                   Shoe misc additions      .........  .........  .........  ...........  ...........
                               march ba.
L3600...  A                   Trans shoe calip plate   .........  .........  .........  ...........  ...........
                               exist.
L3610...  A                   Trans shoe caliper       .........  .........  .........  ...........  ...........
                               plate new.
L3620...  A                   Trans shoe solid         .........  .........  .........  ...........  ...........
                               stirrup exi.
L3630...  A                   Trans shoe solid         .........  .........  .........  ...........  ...........
                               stirrup new.
L3640...  A                   Shoe dennis browne       .........  .........  .........  ...........  ...........
                               splint bo.
L3649...  A                   Unlist proc orth shoe    .........  .........  .........  ...........  ...........
                               modif/.
L3650...  A                   Shlder fig 8 abduct      .........  .........  .........  ...........  ...........
                               restrain.
L3660...  A                   Abduct restrainer        .........  .........  .........  ...........  ...........
                               canvas & web.
L3670...  A                   Acromio/clavicular       .........  .........  .........  ...........  ...........
                               canvas & we.
L3700...  A                   Elbow orthoses elas w    .........  .........  .........  ...........  ...........
                               stays.
L3710...  A                   Elbow elastic with       .........  .........  .........  ...........  ...........
                               metal joi.
L3720...  A                   Forearm/arm cuffs free   .........  .........  .........  ...........  ...........
                               motio.
L3730...  A                   Forearm/arm cuffs ext/   .........  .........  .........  ...........  ...........
                               flex a.
L3740...  A                   Cuffs adj lock w/        .........  .........  .........  ...........  ...........
                               active con.
L3800...  A                   Whfo short opponen no    .........  .........  .........  ...........  ...........
                               attach.
L3805...  A                   Whfo long opponens no    .........  .........  .........  ...........  ...........
                               attach.
L3810...  A                   Whfo thumb abduction     .........  .........  .........  ...........  ...........
                               bar.
L3815...  A                   Whfo second m.p.         .........  .........  .........  ...........  ...........
                               abduction a.
[[Page 47752]]
L3820...  A                   Whfo ip ext asst w/ mp   .........  .........  .........  ...........  ...........
                               ext s.
L3825...  A                   Whfo m.p. extension      .........  .........  .........  ...........  ...........
                               stop.
L3830...  A                   Whfo m.p. extension      .........  .........  .........  ...........  ...........
                               assist.
L3835...  A                   Whfo m.p. spring         .........  .........  .........  ...........  ...........
                               extension a.
L3840...  A                   Whfo spring swivel       .........  .........  .........  ...........  ...........
                               thumb.
L3845...  A                   Whfo thumb ip ext ass w/ .........  .........  .........  ...........  ...........
                                mp.
L3850...  A                   Action wrist w/          .........  .........  .........  ...........  ...........
                               dorsiflex as.
L3855...  A                   Whfo adj m.p. flexion    .........  .........  .........  ...........  ...........
                               contro.
L3860...  A                   Whfo adj m.p. flex ctrl  .........  .........  .........  ...........  ...........
                               & i.
L3890...  A                   Torsion mechanism wrist/ .........  .........  .........  ...........  ...........
                               elbo.
L3900...  A                   Hinge extension/flex     .........  .........  .........  ...........  ...........
                               wrist/f.
L3901...  A                   Hinge ext/flex wrist     .........  .........  .........  ...........  ...........
                               finger.
L3902...  A                   Whfo ext power compress  .........  .........  .........  ...........  ...........
                               gas.
L3904...  A                   Whfo electric custom     .........  .........  .........  ...........  ...........
                               fitted.
L3906...  A                   Wrist gauntlet molded    .........  .........  .........  ...........  ...........
                               to pt.
L3907...  A                   Whfo wrst gauntlt thmb   .........  .........  .........  ...........  ...........
                               spica.
L3908...  A                   Wrist cock-up non-       .........  .........  .........  ...........  ...........
                               molded.
L3910...  A                   Whfo swanson design....  .........  .........  .........  ...........  ...........
L3912...  A                   Flex glove w/elastic     .........  .........  .........  ...........  ...........
                               finger.
L3914...  A                   WHO wrist extension      .........  .........  .........  ...........  ...........
                               cock-up.
L3916...  A                   Whfo wrist extens w/     .........  .........  .........  ...........  ...........
                               outrigg.
L3918...  A                   HFO knuckle bender.....  .........  .........  .........  ...........  ...........
L3920...  A                   Knuckle bender with      .........  .........  .........  ...........  ...........
                               outrigge.
L3922...  A                   Knuckle bend 2 seg to    .........  .........  .........  ...........  ...........
                               flex j.
L3924...  A                   Oppenheimer............  .........  .........  .........  ...........  ...........
L3926...  A                   Thomas suspension......  .........  .........  .........  ...........  ...........
L3928...  A                   Finger extension w/      .........  .........  .........  ...........  ...........
                               clock sp.
L3930...  A                   Finger extension with    .........  .........  .........  ...........  ...........
                               wrist.
L3932...  A                   Safety pin spring wire.  .........  .........  .........  ...........  ...........
L3934...  A                   Safety pin modified....  .........  .........  .........  ...........  ...........
L3936...  A                   Palmer.................  .........  .........  .........  ...........  ...........
L3938...  A                   Dorsal wrist...........  .........  .........  .........  ...........  ...........
L3940...  A                   Dorsal wrist w/          .........  .........  .........  ...........  ...........
                               outrigger at.
L3942...  A                   Reverse knuckle bender.  .........  .........  .........  ...........  ...........
L3944...  A                   Reverse knuckle bend w/  .........  .........  .........  ...........  ...........
                               outr.
L3946...  A                   HFO composite elastic..  .........  .........  .........  ...........  ...........
L3948...  A                   Finger knuckle bender..  .........  .........  .........  ...........  ...........
L3950...  A                   Oppenheimer w/ knuckle   .........  .........  .........  ...........  ...........
                               bend.
L3952...  A                   Oppenheimer w/ rev       .........  .........  .........  ...........  ...........
                               knuckle 2.
L3954...  A                   Spreading hand.........  .........  .........  .........  ...........  ...........
L3956...  A                   Add joint upper ext      .........  .........  .........  ...........  ...........
                               orthosis.
L3960...  A                   Sewho airplan desig      .........  .........  .........  ...........  ...........
                               abdu pos.
L3962...  A                   Sewho erbs palsey        .........  .........  .........  ...........  ...........
                               design abd.
L3963...  A                   Molded w/ articulating   .........  .........  .........  ...........  ...........
                               elbow.
L3964...  A                   Seo mobile arm sup att   .........  .........  .........  ...........  ...........
                               to wc.
L3965...  A                   Arm supp att to wc       .........  .........  .........  ...........  ...........
                               rancho ty.
L3966...  A                   Mobile arm supports      .........  .........  .........  ...........  ...........
                               reclinin.
L3968...  A                   Friction dampening arm   .........  .........  .........  ...........  ...........
                               supp.
L3969...  A                   Monosuspension arm/hand  .........  .........  .........  ...........  ...........
                               supp.
L3970...  A                   Elevat proximal arm      .........  .........  .........  ...........  ...........
                               support.
L3972...  A                   Offset/lat rocker arm w/ .........  .........  .........  ...........  ...........
                                ela.
L3974...  A                   Mobile arm support       .........  .........  .........  ...........  ...........
                               supinator.
L3980...  A                   Upp ext fx orthosis      .........  .........  .........  ...........  ...........
                               humeral.
L3982...  A                   Upper ext fx orthosis    .........  .........  .........  ...........  ...........
                               rad/ul.
L3984...  A                   Upper ext fx orthosis    .........  .........  .........  ...........  ...........
                               wrist.
L3985...  A                   Forearm hand fx orth w/  .........  .........  .........  ...........  ...........
                               wr h.
L3986...  A                   Humeral rad/ulna wrist   .........  .........  .........  ...........  ...........
                               fx or.
L3995...  A                   Sock fracture or equal   .........  .........  .........  ...........  ...........
                               each.
L3999...  A                   Upper limb orthosis NOS  .........  .........  .........  ...........  ...........
L4000...  A                   Repl girdle milwaukee    .........  .........  .........  ...........  ...........
                               orth.
L4010...  A                   Replace trilateral       .........  .........  .........  ...........  ...........
                               socket br.
L4020...  A                   Replace quadlat socket   .........  .........  .........  ...........  ...........
                               brim.
L4030...  A                   Replace socket brim      .........  .........  .........  ...........  ...........
                               cust fit.
L4040...  A                   Replace molded thigh     .........  .........  .........  ...........  ...........
                               lacer.
L4045...  A                   Replace non-molded       .........  .........  .........  ...........  ...........
                               thigh lac.
L4050...  A                   Replace molded calf      .........  .........  .........  ...........  ...........
                               lacer.
L4055...  A                   Replace non-molded calf  .........  .........  .........  ...........  ...........
                               lace.
L4060...  A                   Replace high roll cuff.  .........  .........  .........  ...........  ...........
L4070...  A                   Replace prox & dist      .........  .........  .........  ...........  ...........
                               upright.
L4080...  A                   Repl met band kafo-afo   .........  .........  .........  ...........  ...........
                               prox.
L4090...  A                   Repl met band kafo-afo   .........  .........  .........  ...........  ...........
                               calf/.
L4100...  A                   Repl leath cuff kafo     .........  .........  .........  ...........  ...........
                               prox th.
L4110...  A                   Repl leath cuff kafo-    .........  .........  .........  ...........  ...........
                               afo cal.
L4130...  A                   Replace pretibial shell  .........  .........  .........  ...........  ...........
L4205...  A                   Ortho dvc repair per 15  .........  .........  .........  ...........  ...........
                               min.
[[Page 47753]]
L4210...  A                   Orth dev repair/repl     .........  .........  .........  ...........  ...........
                               minor p.
L4310...  A                   Mult-podus/eq orth prep  .........  .........  .........  ...........  ...........
                               mgmt.
L4320...  A                   Low ext mgmt sys ft pos  .........  .........  .........  ...........  ...........
                               afo.
L4350...  A                   Pneumatic ankle cntrl    .........  .........  .........  ...........  ...........
                               splint.
L4360...  A                   Pneumatic walking        .........  .........  .........  ...........  ...........
                               splint.
L4370...  A                   Pneumatic full leg       .........  .........  .........  ...........  ...........
                               splint.
L4380...  A                   Pneumatic knee splint..  .........  .........  .........  ...........  ...........
L4390...  A                   Replace multi-podus      .........  .........  .........  ...........  ...........
                               splint.
L4392...  A                   Replace ankle contrac    .........  .........  .........  ...........  ...........
                               splint.
L4394...  A                   Replace foot drop        .........  .........  .........  ...........  ...........
                               splint.
L4396...  A                   Ankle contracture        .........  .........  .........  ...........  ...........
                               splint.
L4398...  A                   Foot drop splint         .........  .........  .........  ...........  ...........
                               recumbent.
L5000...  A                   Sho insert w arch toe    .........  .........  .........  ...........  ...........
                               filler.
L5010...  A                   Mold socket ank hgt w/   .........  .........  .........  ...........  ...........
                               toe f.
L5020...  A                   Tibial tubercle hgt w/   .........  .........  .........  ...........  ...........
                               toe f.
L5050...  A                   Ank symes mold sckt      .........  .........  .........  ...........  ...........
                               sach ft.
L5060...  A                   Symes met fr leath       .........  .........  .........  ...........  ...........
                               socket ar.
L5100...  A                   Molded socket shin sach  .........  .........  .........  ...........  ...........
                               foot.
L5105...  A                   Plast socket jts/thgh    .........  .........  .........  ...........  ...........
                               lacer.
L5150...  A                   Mold sckt ext knee shin  .........  .........  .........  ...........  ...........
                               sach.
L5160...  A                   Mold socket bent knee    .........  .........  .........  ...........  ...........
                               shin s.
L5200...  A                   Kne sing axis fric shin  .........  .........  .........  ...........  ...........
                               sach.
L5210...  A                   No knee/ankle joints w/  .........  .........  .........  ...........  ...........
                               ft b.
L5220...  A                   No knee joint with       .........  .........  .........  ...........  ...........
                               artic ali.
L5230...  A                   Fem focal defic          .........  .........  .........  ...........  ...........
                               constant fri.
L5250...  A                   Hip canad sing axi cons  .........  .........  .........  ...........  ...........
                               fric.
L5270...  A                   Tilt table locking hip   .........  .........  .........  ...........  ...........
                               sing.
L5280...  A                   Hemipelvect canad sing   .........  .........  .........  ...........  ...........
                               axis.
L5300...  A                   Bk sach soft cover &     .........  .........  .........  ...........  ...........
                               finish.
L5310...  A                   Knee disart sach soft    .........  .........  .........  ...........  ...........
                               cv/fin.
L5320...  A                   Ak open end sach soft    .........  .........  .........  ...........  ...........
                               cv/fin.
L5330...  A                   Hip canadian sach sft    .........  .........  .........  ...........  ...........
                               cv/fin.
L5340...  A                   Hemipelvectomy canad cv/ .........  .........  .........  ...........  ...........
                               fin.
L5400...  A                   Postop dress & 1 cast    .........  .........  .........  ...........  ...........
                               chg bk.
L5410...  A                   Postop dsg bk ea add     .........  .........  .........  ...........  ...........
                               cast ch.
L5420...  A                   Postop dsg & 1 cast chg  .........  .........  .........  ...........  ...........
                               ak/d.
L5430...  A                   Postop dsg ak ea add     .........  .........  .........  ...........  ...........
                               cast ch.
L5450...  A                   Postop app non-wgt bear  .........  .........  .........  ...........  ...........
                               dsg.
L5460...  A                   Postop app non-wgt bear  .........  .........  .........  ...........  ...........
                               dsg.
L5500...  A                   Init bk ptb plaster      .........  .........  .........  ...........  ...........
                               direct.
L5505...  A                   Init ak ischal plstr     .........  .........  .........  ...........  ...........
                               direct.
L5510...  A                   Prep BK ptb plaster      .........  .........  .........  ...........  ...........
                               molded.
L5520...  A                   Prep BK ptb thermopls    .........  .........  .........  ...........  ...........
                               direct.
L5530...  A                   Prep BK ptb thermopls    .........  .........  .........  ...........  ...........
                               molded.
L5535...  A                   Prep BK ptb open end     .........  .........  .........  ...........  ...........
                               socket.
L5540...  A                   Prep BK ptb laminated    .........  .........  .........  ...........  ...........
                               socket.
L5560...  A                   Prep AK ischial plast    .........  .........  .........  ...........  ...........
                               molded.
L5570...  A                   Prep AK ischial direct   .........  .........  .........  ...........  ...........
                               form.
L5580...  A                   Prep AK ischial thermo   .........  .........  .........  ...........  ...........
                               mold.
L5585...  A                   Prep AK ischial open     .........  .........  .........  ...........  ...........
                               end.
L5590...  A                   Prep AK ischial          .........  .........  .........  ...........  ...........
                               laminated.
L5595...  A                   Hip disartic sach        .........  .........  .........  ...........  ...........
                               thermopls.
L5600...  A                   Hip disart sach laminat  .........  .........  .........  ...........  ...........
                               mold.
L5610...  A                   Above knee hydracadence  .........  .........  .........  ...........  ...........
L5611...  A                   Ak 4 bar link w/fric     .........  .........  .........  ...........  ...........
                               swing.
L5613...  A                   Ak 4 bar ling w/hydraul  .........  .........  .........  ...........  ...........
                               swig.
L5614...  A                   4-bar link above knee w/ .........  .........  .........  ...........  ...........
                               swng.
L5616...  A                   Ak univ multiplex sys    .........  .........  .........  ...........  ...........
                               frict.
L5617...  A                   AK/BK self-aligning      .........  .........  .........  ...........  ...........
                               unit ea.
L5618...  A                   Test socket symes......  .........  .........  .........  ...........  ...........
L5620...  A                   Test socket below knee.  .........  .........  .........  ...........  ...........
L5622...  A                   Test socket knee         .........  .........  .........  ...........  ...........
                               disarticula.
L5624...  A                   Test socket above knee.  .........  .........  .........  ...........  ...........
L5626...  A                   Test socket hip          .........  .........  .........  ...........  ...........
                               disarticulat.
L5628...  A                   Test socket              .........  .........  .........  ...........  ...........
                               hemipelvectomy.
L5629...  A                   Below knee acrylic       .........  .........  .........  ...........  ...........
                               socket.
L5630...  A                   Syme typ expandabl wall  .........  .........  .........  ...........  ...........
                               sckt.
L5631...  A                   Ak/knee disartic         .........  .........  .........  ...........  ...........
                               acrylic soc.
L5632...  A                   Symes type ptb brim      .........  .........  .........  ...........  ...........
                               design s.
L5634...  A                   Symes type poster        .........  .........  .........  ...........  ...........
                               opening so.
L5636...  A                   Symes type medial        .........  .........  .........  ...........  ...........
                               opening so.
L5637...  A                   Below knee total         .........  .........  .........  ...........  ...........
                               contact.
L5638...  A                   Below knee leather       .........  .........  .........  ...........  ...........
                               socket.
L5639...  A                   Below knee wood socket.  .........  .........  .........  ...........  ...........
L5640...  A                   Knee disarticulat        .........  .........  .........  ...........  ...........
                               leather so.
[[Page 47754]]
L5642...  A                   Above knee leather       .........  .........  .........  ...........  ...........
                               socket.
L5643...  A                   Hip flex inner socket    .........  .........  .........  ...........  ...........
                               ext fr.
L5644...  A                   Above knee wood socket.  .........  .........  .........  ...........  ...........
L5645...  A                   Ak flexibl inner socket  .........  .........  .........  ...........  ...........
                               ext.
L5646...  A                   Below knee air cushion   .........  .........  .........  ...........  ...........
                               socke.
L5647...  A                   Below knee suction       .........  .........  .........  ...........  ...........
                               socket.
L5648...  A                   Above knee air cushion   .........  .........  .........  ...........  ...........
                               socke.
L5649...  A                   Isch containmt/narrow m- .........  .........  .........  ...........  ...........
                               l so.
L5650...  A                   Tot contact ak/knee      .........  .........  .........  ...........  ...........
                               disart s.
L5651...  A                   Ak flex inner socket     .........  .........  .........  ...........  ...........
                               ext fra.
L5652...  A                   Suction susp ak/knee     .........  .........  .........  ...........  ...........
                               disart.
L5653...  A                   Knee disart expand wall  .........  .........  .........  ...........  ...........
                               sock.
L5654...  A                   Socket insert symes....  .........  .........  .........  ...........  ...........
L5655...  A                   Socket insert below      .........  .........  .........  ...........  ...........
                               knee.
L5656...  A                   Socket insert knee       .........  .........  .........  ...........  ...........
                               articulat.
L5658...  A                   Socket insert above      .........  .........  .........  ...........  ...........
                               knee.
L5660...  A                   Sock insrt syme          .........  .........  .........  ...........  ...........
                               silicone gel.
L5661...  A                   Multi-durometer symes..  .........  .........  .........  ...........  ...........
L5662...  A                   Socket insert bk         .........  .........  .........  ...........  ...........
                               silicone ge.
L5663...  A                   Sock knee disartic       .........  .........  .........  ...........  ...........
                               silicone.
L5664...  A                   Socket insert ak         .........  .........  .........  ...........  ...........
                               silicone ge.
L5665...  A                   Multi-durometer below    .........  .........  .........  ...........  ...........
                               knee.
L5666...  A                   Below knee cuff          .........  .........  .........  ...........  ...........
                               suspension.
L5667...  A                   Socket insert w lock     .........  .........  .........  ...........  ...........
                               lower.
L5668...  A                   Socket insert w/o lock   .........  .........  .........  ...........  ...........
                               lower.
L5669...  A                   Below knee socket w/o    .........  .........  .........  ...........  ...........
                               lock.
L5670...  A                   Bk molded supracondylar  .........  .........  .........  ...........  ...........
                               susp.
L5672...  A                   Bk removable medial      .........  .........  .........  ...........  ...........
                               brim sus.
L5674...  A                   Bk latex sleeve          .........  .........  .........  ...........  ...........
                               suspension/e.
L5675...  A                   Bk latex sleeve susp/eq  .........  .........  .........  ...........  ...........
                               hvy.
L5676...  A                   Bk knee joints single    .........  .........  .........  ...........  ...........
                               axis p.
L5677...  A                   Bk knee joints           .........  .........  .........  ...........  ...........
                               polycentric p.
L5678...  A                   Bk joint covers pair...  .........  .........  .........  ...........  ...........
L5680...  A                   Bk thigh lacer non-      .........  .........  .........  ...........  ...........
                               molded.
L5682...  A                   Bk thigh lacer glut/     .........  .........  .........  ...........  ...........
                               ischia m.
L5684...  A                   Bk fork strap..........  .........  .........  .........  ...........  ...........
L5686...  A                   Bk back check..........  .........  .........  .........  ...........  ...........
L5688...  A                   Bk waist belt webbing..  .........  .........  .........  ...........  ...........
L5690...  A                   Bk waist belt padded     .........  .........  .........  ...........  ...........
                               and lin.
L5692...  A                   Ak pelvic control belt   .........  .........  .........  ...........  ...........
                               light.
L5694...  A                   Ak pelvic control belt   .........  .........  .........  ...........  ...........
                               pad/l.
L5695...  A                   Ak sleeve susp neoprene/ .........  .........  .........  ...........  ...........
                               equa.
L5696...  A                   Ak/knee disartic pelvic  .........  .........  .........  ...........  ...........
                               join.
L5697...  A                   Ak/knee disartic pelvic  .........  .........  .........  ...........  ...........
                               band.
L5698...  A                   Ak/knee disartic         .........  .........  .........  ...........  ...........
                               silesian ba.
L5699...  A                   Shoulder harness.......  .........  .........  .........  ...........  ...........
L5700...  A                   Replace socket below     .........  .........  .........  ...........  ...........
                               knee.
L5701...  A                   Replace socket above     .........  .........  .........  ...........  ...........
                               knee.
L5702...  A                   Replace socket hip.....  .........  .........  .........  ...........  ...........
L5704...  A                   Custom shape covr below  .........  .........  .........  ...........  ...........
                               knee.
L5705...  A                   Custm shape cover above  .........  .........  .........  ...........  ...........
                               knee.
L5706...  A                   Custm shape cvr knee     .........  .........  .........  ...........  ...........
                               disart.
L5707...  A                   Custm shape cover hip    .........  .........  .........  ...........  ...........
                               disart.
L5710...  A                   Kne-shin exo sng axi     .........  .........  .........  ...........  ...........
                               mnl loc.
L5711...  A                   Knee-shin exo mnl lock   .........  .........  .........  ...........  ...........
                               ultra.
L5712...  A                   Knee-shin exo frict swg  .........  .........  .........  ...........  ...........
                               & st.
L5714...  A                   Knee-shin exo variable   .........  .........  .........  ...........  ...........
                               frict.
L5716...  A                   Knee-shin exo mech       .........  .........  .........  ...........  ...........
                               stance ph.
L5718...  A                   Knee-shin exo frct swg   .........  .........  .........  ...........  ...........
                               & sta.
L5722...  A                   Knee-shin pneum swg      .........  .........  .........  ...........  ...........
                               frct exo.
L5724...  A                   Knee-shin exo fluid      .........  .........  .........  ...........  ...........
                               swing ph.
L5726...  A                   Knee-shin ext jnts fld   .........  .........  .........  ...........  ...........
                               swg e.
L5728...  A                   Knee-shin fluid swg &    .........  .........  .........  ...........  ...........
                               stance.
L5780...  A                   Knee-shin pneum/hydra    .........  .........  .........  ...........  ...........
                               pneum.
L5785...  A                   Exoskeletal bk ultralt   .........  .........  .........  ...........  ...........
                               mater.
L5790...  A                   Exoskeletal ak ultra-    .........  .........  .........  ...........  ...........
                               light m.
L5795...  A                   Exoskel hip ultra-light  .........  .........  .........  ...........  ...........
                               mate.
L5810...  A                   Endoskel knee-shin mnl   .........  .........  .........  ...........  ...........
                               lock.
L5811...  A                   Endo knee-shin mnl lck   .........  .........  .........  ...........  ...........
                               ultra.
L5812...  A                   Endo knee-shin frct swg  .........  .........  .........  ...........  ...........
                               & st.
L5814...  A                   Endo knee-shin hydral    .........  .........  .........  ...........  ...........
                               swg ph.
L5816...  A                   Endo knee-shin polyc     .........  .........  .........  ...........  ...........
                               mch sta.
L5818...  A                   Endo knee-shin frct swg  .........  .........  .........  ...........  ...........
                               & st.
L5822...  A                   Endo knee-shin pneum     .........  .........  .........  ...........  ...........
                               swg frc.
L5824...  A                   Endo knee-shin fluid     .........  .........  .........  ...........  ...........
                               swing p.
[[Page 47755]]
L5826...  A                   Pediatric knee joint...  .........  .........  .........  ...........  ...........
L5828...  A                   Endo knee-shin fluid     .........  .........  .........  ...........  ...........
                               swg/sta.
L5830...  A                   Endo knee-shin pneum/    .........  .........  .........  ...........  ...........
                               swg pha.
L5840...  A                   Multi-axial knee/shin    .........  .........  .........  ...........  ...........
                               system.
L5845...  A                   Knee-shin sys stance     .........  .........  .........  ...........  ...........
                               flexion.
L5846...  A                   Knee-shin sys            .........  .........  .........  ...........  ...........
                               microprocessor.
L5850...  A                   Endo ak/hip knee extens  .........  .........  .........  ...........  ...........
                               assi.
L5855...  A                   Mech hip extension       .........  .........  .........  ...........  ...........
                               assist.
L5910...  A                   Endo below knee          .........  .........  .........  ...........  ...........
                               alignable sy.
L5920...  A                   Endo ak/hip alignable    .........  .........  .........  ...........  ...........
                               system.
L5925...  A                   Above knee manual lock.  .........  .........  .........  ...........  ...........
L5930...  A                   High activity knee       .........  .........  .........  ...........  ...........
                               frame.
L5940...  A                   Endo bk ultra-light      .........  .........  .........  ...........  ...........
                               material.
L5950...  A                   Endo ak ultra-light      .........  .........  .........  ...........  ...........
                               material.
L5960...  A                   Endo hip ultra-light     .........  .........  .........  ...........  ...........
                               materia.
L5962...  A                   Below knee flex cover    .........  .........  .........  ...........  ...........
                               system.
L5964...  A                   Above knee flex cover    .........  .........  .........  ...........  ...........
                               system.
L5966...  A                   Hip flexible cover       .........  .........  .........  ...........  ...........
                               system.
L5970...  A                   Foot external keel sach  .........  .........  .........  ...........  ...........
                               foot.
L5972...  A                   Flexible keel foot.....  .........  .........  .........  ...........  ...........
L5974...  A                   Foot single axis ankle/  .........  .........  .........  ...........  ...........
                               foot.
L5976...  A                   Energy storing foot....  .........  .........  .........  ...........  ...........
L5978...  A                   Ft prosth multiaxial     .........  .........  .........  ...........  ...........
                               ankl/ft.
L5979...  A                   Multi-axial ankle/ft     .........  .........  .........  ...........  ...........
                               prosth.
L5980...  A                   Flex foot system.......  .........  .........  .........  ...........  ...........
L5981...  A                   Flex-walk sys low ext    .........  .........  .........  ...........  ...........
                               prosth.
L5982...  A                   Exoskeletal axial        .........  .........  .........  ...........  ...........
                               rotation u.
L5984...  A                   Endoskeletal axial       .........  .........  .........  ...........  ...........
                               rotation.
L5985...  A                   Lwr ext dynamic prosth   .........  .........  .........  ...........  ...........
                               pylon.
L5986...  A                   Multi-axial rotation     .........  .........  .........  ...........  ...........
                               unit.
L5987...  A                   Shank ft w vert load     .........  .........  .........  ...........  ...........
                               pylon.
L5999...  A                   Lowr extremity prosthes  .........  .........  .........  ...........  ...........
                               NOS.
L6000...  A                   Par hand robin-aids      .........  .........  .........  ...........  ...........
                               thum rem.
L6010...  A                   Hand robin-aids little/  .........  .........  .........  ...........  ...........
                               ring.
L6020...  A                   Part hand robin-aids no  .........  .........  .........  ...........  ...........
                               fing.
L6050...  A                   Wrst MLd sck flx hng     .........  .........  .........  ...........  ...........
                               tri pad.
L6055...  A                   Wrst mold sock w/exp     .........  .........  .........  ...........  ...........
                               interfa.
L6100...  A                   Elb mold sock flex       .........  .........  .........  ...........  ...........
                               hinge pad.
L6110...  A                   Elbow mold sock          .........  .........  .........  ...........  ...........
                               suspension t.
L6120...  A                   Elbow mold doub splt     .........  .........  .........  ...........  ...........
                               soc ste.
L6130...  A                   Elbow stump activated    .........  .........  .........  ...........  ...........
                               lock h.
L6200...  A                   Elbow mold outsid lock   .........  .........  .........  ...........  ...........
                               hinge.
L6205...  A                   Elbow molded w/ expand   .........  .........  .........  ...........  ...........
                               inter.
L6250...  A                   Elbow inter loc elbow    .........  .........  .........  ...........  ...........
                               forarm.
L6300...  A                   Shlder disart int lock   .........  .........  .........  ...........  ...........
                               elbow.
L6310...  A                   Shoulder passive restor  .........  .........  .........  ...........  ...........
                               comp.
L6320...  A                   Shoulder passive restor  .........  .........  .........  ...........  ...........
                               cap.
L6350...  A                   Thoracic intern lock     .........  .........  .........  ...........  ...........
                               elbow.
L6360...  A                   Thoracic passive restor  .........  .........  .........  ...........  ...........
                               comp.
L6370...  A                   Thoracic passive restor  .........  .........  .........  ...........  ...........
                               cap.
L6380...  A                   Postop dsg cast chg      .........  .........  .........  ...........  ...........
                               wrst/elb.
L6382...  A                   Postop dsg cast chg elb  .........  .........  .........  ...........  ...........
                               dis/.
L6384...  A                   Postop dsg cast chg      .........  .........  .........  ...........  ...........
                               shlder/t.
L6386...  A                   Postop ea cast chg &     .........  .........  .........  ...........  ...........
                               realign.
L6388...  A                   Postop applicat rigid    .........  .........  .........  ...........  ...........
                               dsg on.
L6400...  A                   Below elbow prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
L6450...  A                   Elb disart prosth tiss   .........  .........  .........  ...........  ...........
                               shap.
L6500...  A                   Above elbow prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
L6550...  A                   Shldr disar prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
L6570...  A                   Scap thorac prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
L6580...  A                   Wrist/elbow bowden       .........  .........  .........  ...........  ...........
                               cable mol.
L6582...  A                   Wrist/elbow bowden cbl   .........  .........  .........  ...........  ...........
                               dir f.
L6584...  A                   Elbow fair lead cable    .........  .........  .........  ...........  ...........
                               molded.
L6586...  A                   Elbow fair lead cable    .........  .........  .........  ...........  ...........
                               dir fo.
L6588...  A                   Shdr fair lead cable     .........  .........  .........  ...........  ...........
                               molded.
L6590...  A                   Shdr fair lead cable     .........  .........  .........  ...........  ...........
                               direct.
L6600...  A                   Polycentric hinge pair.  .........  .........  .........  ...........  ...........
L6605...  A                   Single pivot hinge pair  .........  .........  .........  ...........  ...........
L6610...  A                   Flexible metal hinge     .........  .........  .........  ...........  ...........
                               pair.
L6615...  A                   Disconnect locking       .........  .........  .........  ...........  ...........
                               wrist uni.
L6616...  A                   Disconnect insert        .........  .........  .........  ...........  ...........
                               locking wr.
L6620...  A                   Flexion-friction wrist   .........  .........  .........  ...........  ...........
                               unit.
L6623...  A                   Spring-ass rot wrst w/   .........  .........  .........  ...........  ...........
                               latch.
L6625...  A                   Rotation wrst w/ cable   .........  .........  .........  ...........  ...........
                               lock.
L6628...  A                   Quick disconn hook       .........  .........  .........  ...........  ...........
                               adapter o.
[[Page 47756]]
L6629...  A                   Lamination collar w/     .........  .........  .........  ...........  ...........
                               couplin.
L6630...  A                   Stainless steel any      .........  .........  .........  ...........  ...........
                               wrist.
L6632...  A                   Latex suspension sleeve  .........  .........  .........  ...........  ...........
                               each.
L6635...  A                   Lift assist for elbow..  .........  .........  .........  ...........  ...........
L6637...  A                   Nudge control elbow      .........  .........  .........  ...........  ...........
                               lock.
L6640...  A                   Shoulder abduction       .........  .........  .........  ...........  ...........
                               joint pai.
L6641...  A                   Excursion amplifier      .........  .........  .........  ...........  ...........
                               pulley t.
L6642...  A                   Excursion amplifier      .........  .........  .........  ...........  ...........
                               lever ty.
L6645...  A                   Shoulder flexion-        .........  .........  .........  ...........  ...........
                               abduction j.
L6650...  A                   Shoulder universal       .........  .........  .........  ...........  ...........
                               joint.
L6655...  A                   Standard control cable   .........  .........  .........  ...........  ...........
                               extra.
L6660...  A                   Heavy duty control       .........  .........  .........  ...........  ...........
                               cable.
L6665...  A                   Teflon or equal cable    .........  .........  .........  ...........  ...........
                               lining.
L6670...  A                   Hook to hand cable       .........  .........  .........  ...........  ...........
                               adapter.
L6672...  A                   Harness chest/shlder     .........  .........  .........  ...........  ...........
                               saddle.
L6675...  A                   Harness figure of 8      .........  .........  .........  ...........  ...........
                               sing con.
L6676...  A                   Harness figure of 8      .........  .........  .........  ...........  ...........
                               dual con.
L6680...  A                   Test sock wrist disart/  .........  .........  .........  ...........  ...........
                               bel e.
L6682...  A                   Test sock elbw disart/   .........  .........  .........  ...........  ...........
                               above.
L6684...  A                   Test socket shldr        .........  .........  .........  ...........  ...........
                               disart/tho.
L6686...  A                   Suction socket.........  .........  .........  .........  ...........  ...........
L6687...  A                   Frame typ socket bel     .........  .........  .........  ...........  ...........
                               elbow/w.
L6688...  A                   Frame typ sock above     .........  .........  .........  ...........  ...........
                               elb/dis.
L6689...  A                   Frame typ socket         .........  .........  .........  ...........  ...........
                               shoulder di.
L6690...  A                   Frame typ sock           .........  .........  .........  ...........  ...........
                               interscap-tho.
L6691...  A                   Removable insert each..  .........  .........  .........  ...........  ...........
L6692...  A                   Silicone gel insert or   .........  .........  .........  ...........  ...........
                               equal.
L6700...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#3.
L6705...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#5.
L6710...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#5x.
L6715...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#5xa.
L6720...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#6.
L6725...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#7.
L6730...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#7lo.
L6735...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#8.
L6740...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#8x.
L6745...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#88x.
L6750...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#10p.
L6755...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#10x.
L6765...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#12p.
L6770...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#99x.
L6775...  A                   Terminal device          .....<SUP>....  .....<SUP>....  .....<SUP>....  .....<SUP>......  .....<SUP>......
                               model<SUP>#555.
L6780...  A                   Terminal device model    <SUP>.........  <SUP>.........  <SUP>.........  <SUP>...........  <SUP>...........
                               <SUP>#ss555.
L6790...  A                   Hooks-accu hook or       .........  .........  .........  ...........  ...........
                               equal.
L6795...  A                   Hooks-2 load or equal..  .........  .........  .........  ...........  ...........
L6800...  A                   Hooks-aprl vc or equal.  .........  .........  .........  ...........  ...........
L6805...  A                   Modifier wrist flexion   .........  .........  .........  ...........  ...........
                               unit.
L6806...  A                   Trs grip vc or equal...  .........  .........  .........  ...........  ...........
L6807...  A                   Term device grip1/2 or   .........  .........  .........  ...........  ...........
                               equal.
L6808...  A                   Term device infant or    .........  .........  .........  ...........  ...........
                               child.
L6809...  A                   Trs super sport passive  .........  .........  .........  ...........  ...........
L6810...  A                   Pincher tool otto bock   .........  .........  .........  ...........  ...........
                               or eq.
L6825...  A                   Hands dorrance vo......  .........  .........  .........  ...........  ...........
L6830...  A                   Hand aprl vc...........  .........  .........  .........  ...........  ...........
L6835...  A                   Hand sierra vo.........  .........  .........  .........  ...........  ...........
L6840...  A                   Hand becker imperial...  .........  .........  .........  ...........  ...........
L6845...  A                   Hand becker lock grip..  .........  .........  .........  ...........  ...........
L6850...  A                   Term dvc-hand becker     .........  .........  .........  ...........  ...........
                               plylite.
L6855...  A                   Hand robin-aids vo.....  .........  .........  .........  ...........  ...........
L6860...  A                   Hand robin-aids vo soft  .........  .........  .........  ...........  ...........
L6865...  A                   Hand passive hand......  .........  .........  .........  ...........  ...........
L6867...  A                   Hand detroit infant      .........  .........  .........  ...........  ...........
                               hand.
L6868...  A                   Passive inf hand         .........  .........  .........  ...........  ...........
                               steeper/hos.
L6870...  A                   Hand child mitt........  .........  .........  .........  ...........  ...........
L6872...  A                   Hand nyu child hand....  .........  .........  .........  ...........  ...........
L6873...  A                   Hand mech inf steeper    .........  .........  .........  ...........  ...........
                               or equ.
L6875...  A                   Hand bock vc...........  .........  .........  .........  ...........  ...........
L6880...  A                   Hand bock vo...........  .........  .........  .........  ...........  ...........
L6890...  A                   Production glove.......  .........  .........  .........  ...........  ...........
L6895...  A                   Custom glove...........  .........  .........  .........  ...........  ...........
L6900...  A                   Hand restorat thumb/1    .........  .........  .........  ...........  ...........
                               finger.
L6905...  A                   Hand restoration         .........  .........  .........  ...........  ...........
                               multiple fi.
L6910...  A                   Hand restoration no      .........  .........  .........  ...........  ...........
                               fingers.
L6915...  A                   Hand restoration         .........  .........  .........  ...........  ...........
                               replacmnt g.
L6920...  A                   Wrist disarticul switch  .........  .........  .........  ...........  ...........
                               ctrl.
[[Page 47757]]
L6925...  A                   Wrist disart             .........  .........  .........  ...........  ...........
                               myoelectronic c.
L6930...  A                   Below elbow switch       .........  .........  .........  ...........  ...........
                               control.
L6935...  A                   Below elbow              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
L6940...  A                   Elbow disarticulation    .........  .........  .........  ...........  ...........
                               switch.
L6945...  A                   Elbow disart             .........  .........  .........  ...........  ...........
                               myoelectronic c.
L6950...  A                   Above elbow switch       .........  .........  .........  ...........  ...........
                               control.
L6955...  A                   Above elbow              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
L6960...  A                   Shldr disartic switch    .........  .........  .........  ...........  ...........
                               contro.
L6965...  A                   Shldr disartic           .........  .........  .........  ...........  ...........
                               myoelectronic.
L6970...  A                   Interscapular-thor       .........  .........  .........  ...........  ...........
                               switch ct.
L6975...  A                   Interscap-thor           .........  .........  .........  ...........  ...........
                               myoelectronic.
L7010...  A                   Hand otto back steeper/  .........  .........  .........  ...........  ...........
                               eq sw.
L7015...  A                   Hand sys teknik village  .........  .........  .........  ...........  ...........
                               swit.
L7020...  A                   Electronic greifer       .........  .........  .........  ...........  ...........
                               switch ct.
L7025...  A                   Electron hand            .........  .........  .........  ...........  ...........
                               myoelectronic.
L7030...  A                   Hand sys teknik vill     .........  .........  .........  ...........  ...........
                               myoelec.
L7035...  A                   Electron greifer         .........  .........  .........  ...........  ...........
                               myoelectro.
L7040...  A                   Prehensile actuator      .........  .........  .........  ...........  ...........
                               hosmer s.
L7045...  A                   Electron hook child      .........  .........  .........  ...........  ...........
                               michigan.
L7170...  A                   Electronic elbow hosmer  .........  .........  .........  ...........  ...........
                               swit.
L7180...  A                   Electronic elbow utah    .........  .........  .........  ...........  ...........
                               myoele.
L7185...  A                   Electron elbow           .........  .........  .........  ...........  ...........
                               adolescent sw.
L7186...  A                   Electron elbow child     .........  .........  .........  ...........  ...........
                               switch.
L7190...  A                   Elbow adolescent         .........  .........  .........  ...........  ...........
                               myoelectron.
L7191...  A                   Elbow child              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
L7260...  A                   Electron wrist rotator   .........  .........  .........  ...........  ...........
                               otto.
L7261...  A                   Electron wrist rotator   .........  .........  .........  ...........  ...........
                               utah.
L7266...  A                   Servo control steeper    .........  .........  .........  ...........  ...........
                               or equ.
L7272...  A                   Analogue control unb or  .........  .........  .........  ...........  ...........
                               equa.
L7274...  A                   Proportional ctl 12      .........  .........  .........  ...........  ...........
                               volt uta.
L7360...  A                   Six volt bat otto bock/  .........  .........  .........  ...........  ...........
                               eq ea.
L7362...  A                   Battery chrgr six volt   .........  .........  .........  ...........  ...........
                               otto.
L7364...  A                   Twelve volt battery      .........  .........  .........  ...........  ...........
                               utah/equ.
L7366...  A                   Battery chrgr 12 volt    .........  .........  .........  ...........  ...........
                               utah/e.
L7499...  A                   Upper extremity          .........  .........  .........  ...........  ...........
                               prosthes NOS.
L7500...  A                   Prosthetic dvc repair    .........  .........  .........  ...........  ...........
                               hourly.
L7510...  A                   Prosthetic device        .........  .........  .........  ...........  ...........
                               repair rep.
L7520...  A                   Repair prosthesis per    .........  .........  .........  ...........  ...........
                               15 min.
L7900...  A                   Vacuum erection system.  .........  .........  .........  ...........  ...........
L8000...  A                   Mastectomy bra.........  .........  .........  .........  ...........  ...........
L8010...  A                   Mastectomy sleeve......  .........  .........  .........  ...........  ...........
L8020...  A                   Mastectomy form........  .........  .........  .........  ...........  ...........
L8030...  A                   Breast prosthesis        .........  .........  .........  ...........  ...........
                               silicone/e.
L8039...  A                   Breast prosthesis NOS..  .........  .........  .........  ...........  ...........
L8100...  A                   Elas suprt stock bk med  .........  .........  .........  ...........  ...........
                               wgt.
L8110...  A                   Elastic supp stocking    .........  .........  .........  ...........  ...........
                               bk hvy.
L8120...  A                   Elastic supp stockng bk  .........  .........  .........  ...........  ...........
                               surg.
L8130...  A                   Elastic supp stocking    .........  .........  .........  ...........  ...........
                               ak med.
L8140...  A                   Elastic supp stocking    .........  .........  .........  ...........  ...........
                               ak hvy.
L8150...  A                   Elastic supp stockng ak  .........  .........  .........  ...........  ...........
                               surg.
L8160...  A                   Supp stocking full lgth  .........  .........  .........  ...........  ...........
                               med.
L8170...  A                   Supp stocking full lgth  .........  .........  .........  ...........  ...........
                               hvy.
L8180...  A                   Supp stocking heavy      .........  .........  .........  ...........  ...........
                               surg wei.
L8190...  A                   Elas stocking leotards   .........  .........  .........  ...........  ...........
                               med w.
L8200...  A                   Elas stocking leotards   .........  .........  .........  ...........  ...........
                               surg.
L8210...  A                   Elastic stocking custom  .........  .........  .........  ...........  ...........
                               made.
L8220...  A                   Elastic stocking         .........  .........  .........  ...........  ...........
                               lymphedema.
L8230...  A                   Elastic stocking garter  .........  .........  .........  ...........  ...........
                               belt.
L8239...  A                   Elastic support NOS....  .........  .........  .........  ...........  ...........
L8300...  A                   Truss single w/          .........  .........  .........  ...........  ...........
                               standard pad.
L8310...  A                   Truss double w/          .........  .........  .........  ...........  ...........
                               standard pad.
L8320...  A                   Truss addition to std    .........  .........  .........  ...........  ...........
                               pad wa.
L8330...  A                   Truss add to std pad     .........  .........  .........  ...........  ...........
                               scrotal.
L8400...  A                   Sheath below knee......  .........  .........  .........  ...........  ...........
L8410...  A                   Sheath above knee......  .........  .........  .........  ...........  ...........
L8415...  A                   Sheath upper limb......  .........  .........  .........  ...........  ...........
L8417...  A                   Pros sheath/sock w gel   .........  .........  .........  ...........  ...........
                               cushn.
L8420...  A                   Sock wool below knee...  .........  .........  .........  ...........  ...........
L8430...  A                   Sock wool above knee...  .........  .........  .........  ...........  ...........
L8435...  A                   Sock wool upper limb...  .........  .........  .........  ...........  ...........
L8440...  A                   Shrinker below knee....  .........  .........  .........  ...........  ...........
L8460...  A                   Shrinker above knee....  .........  .........  .........  ...........  ...........
L8465...  A                   Shrinker upper limb....  .........  .........  .........  ...........  ...........
L8470...  A                   Stump sock single below  .........  .........  .........  ...........  ...........
                               knee.
L8480...  A                   Stump sock single above  .........  .........  .........  ...........  ...........
                               knee.
[[Page 47758]]
L8485...  A                   Stump sock fitting uppr  .........  .........  .........  ...........  ...........
                               limb.
L8490...  A                   Air seal suction reten   .........  .........  .........  ...........  ...........
                               systm.
L8499...  A                   Unlisted misc            .........  .........  .........  ...........  ...........
                               prosthetic ser.
L8500...  A                   Artificial larynx......  .........  .........  .........  ...........  ...........
L8501...  A                   Tracheostomy speaking    .........  .........  .........  ...........  ...........
                               valve.
L8600...  A                   Implant breast silicone/ .........  .........  .........  ...........  ...........
                               eq.
L8603...  A                   Collagen imp urinary     .........  .........  .........  ...........  ...........
                               2.5 CC.
L8610...  A                   Ocular implant.........  .........  .........  .........  ...........  ...........
L8612...  A                   Aqueous shunt            .........  .........  .........  ...........  ...........
                               prosthesis.
L8613...  A                   Ossicular implant......  .........  .........  .........  ...........  ...........
L8614...  A                   Cochlear device/system.  .........  .........  .........  ...........  ...........
L8619...  A                   Replace cochlear         .........  .........  .........  ...........  ...........
                               processor.
L8630...  A                   Metacarpophalangeal      .........  .........  .........  ...........  ...........
                               implant.
L8641...  A                   Metatarsal joint         .........  .........  .........  ...........  ...........
                               implant.
L8642...  A                   Hallux implant.........  .........  .........  .........  ...........  ...........
L8658...  A                   Interphalangeal joint    .........  .........  .........  ...........  ...........
                               implnt.
L8670...  A                   Vascular graft,          .........  .........  .........  ...........  ...........
                               synthetic.
L8699...  A                   Prosthetic implant NOS.  .........  .........  .........  ...........  ...........
M0064...  X                   Visit for drug                 090       0.85     $45.05       $12.43        $9.01
                               monitoring.
M0075...  E                   Cellular therapy.......  .........  .........  .........  ...........  ...........
M0076...  E                   Prolotherapy...........  .........  .........  .........  ...........  ...........
M0100...  E                   Intragastric             .........  .........  .........  ...........  ...........
                               hypothermia.
M0101...  E                   Foot care hygienic/pm..  .........  .........  .........  ...........  ...........
M0300...  E                   IV chelation therapy...  .........  .........  .........  ...........  ...........
M0301...  E                   Fabric wrapping of       .........  .........  .........  ...........  ...........
                               aneurysm.
M0302...  E                   Assessment of cardiac    .........  .........  .........  ...........  ...........
                               output.
P2028...  A                   Cephalin floculation     .........  .........  .........  ...........  ...........
                               test.
P2029...  A                   Congo red blood test...  .........  .........  .........  ...........  ...........
P2031...  E                   Hair analysis..........  .........  .........  .........  ...........  ...........
P2033...  A                   Blood thymol turbidity.  .........  .........  .........  ...........  ...........
P2038...  A                   Blood mucoprotein......  .........  .........  .........  ...........  ...........
P3000...  A                   Screen pap by tech w md  .........  .........  .........  ...........  ...........
                               supv.
P3001...  A                   Screening pap smear by   .........  .........  .........  ...........  ...........
                               phys.
P7001...  E                   Culture bacterial urine  .........  .........  .........  ...........  ...........
P9010...  N                   Whole blood for          .........  .........  .........  ...........  ...........
                               transfusion.
P9011...  N                   Blood split unit.......  .........  .........  .........  ...........  ...........
P9012...  N                   Cryoprecipitate each     .........  .........  .........  ...........  ...........
                               unit.
P9013...  N                   Unit/s blood fibrinogen  .........  .........  .........  ...........  ...........
P9014...  N                   Gamma globulin 1 ML....  .........  .........  .........  ...........  ...........
P9015...  N                   Rh immune globulin 1 ML  .........  .........  .........  ...........  ...........
P9016...  N                   Leukocyte poor blood,    .........  .........  .........  ...........  ...........
                               unit.
P9017...  N                   One donor fresh frozn    .........  .........  .........  ...........  ...........
                               plasma.
P9018...  N                   Plasma protein fract,    .........  .........  .........  ...........  ...........
                               unit.
P9019...  N                   Platelet concentrate     .........  .........  .........  ...........  ...........
                               unit.
P9020...  N                   Platelet rich plasma     .........  .........  .........  ...........  ...........
                               unit.
P9021...  N                   Red blood cells unit...  .........  .........  .........  ...........  ...........
P9022...  N                   Washed red blood cells   .........  .........  .........  ...........  ...........
                               unit.
P9603...  N                   One-way allow prorated   .........  .........  .........  ...........  ...........
                               miles.
P9604...  N                   One-way allow prorated   .........  .........  .........  ...........  ...........
                               trip.
P9610...  E                   Urine specimen collect   .........  .........  .........  ...........  ...........
                               singl.
P9615...  E                   Urine specimen collect   .........  .........  .........  ...........  ...........
                               mult.
Q0034...  X                   Admin of influenza             901       0.07      $3.92        $2.49         $.78
                               vaccine.
Q0035...  X                   Cardiokymography.......        950       0.35     $18.61       $15.82        $3.72
Q0068...  T                   Extracorpeal                   369       4.33    $229.19       $97.18       $45.84
                               plasmapheresis.
Q0081...  X                   Infusion ther other            906       1.46     $77.38       $42.49       $15.48
                               than che.
Q0082...  X                   Activity therapy w/      .........  .........  .........  ...........  ...........
                               partial h.
Q0083...  S                   Chemo by other than            987       0.65     $34.28       $13.33        $6.86
                               infusion.
Q0084...  S                   Chemotherapy by                989       1.72     $91.09       $40.68       $18.22
                               infusion.
Q0085...  S                   Chemo by both infusion         989       1.72     $91.09       $40.68       $18.22
                               and o.
Q0086...  A                   Physical therapy         .........  .........  .........  ...........  ...........
                               evaluation/.
Q0091...  T                   Obtaining screen pap           561       1.52     $80.32       $24.63       $16.06
                               smear.
Q0092...  N                   Set up port xray         .........  .........  .........  ...........  ...........
                               equipment.
Q0111...  A                   Wet mounts/ w            .........  .........  .........  ...........  ...........
                               preparations.
Q0112...  A                   Potassium hydroxide      .........  .........  .........  ...........  ...........
                               preps.
Q0113...  A                   Pinworm examinations...  .........  .........  .........  ...........  ...........
Q0114...  A                   Fern test..............  .........  .........  .........  ...........  ...........
Q0115...  A                   Post-coital mucous exam  .........  .........  .........  ...........  ...........
Q0132...  A                   Dispensing fee DME neb   .........  .........  .........  ...........  ...........
                               drug.
Q0136...  N                   Non esrd epoetin alpha   .........  .........  .........  ...........  ...........
                               inj.
Q0144...  E                   Azithromycin dihydrate,  .........  .........  .........  ...........  ...........
                               oral.
Q0156...  N                   Human albumin 5%.......  .........  .........  .........  ...........  ...........
Q0157...  N                   Human albumin 25%......  .........  .........  .........  ...........  ...........
Q9920...  A                   Epoetin with hct <= 20.  .........  .........  .........  ...........  ...........
Q9921...  A                   Epoetin with hct = 21..  .........  .........  .........  ...........  ...........
Q9922...  A                   Epoetin with hct = 22..  .........  .........  .........  ...........  ...........
[[Page 47759]]
Q9923...  A                   Epoetin with hct = 23..  .........  .........  .........  ...........  ...........
Q9924...  A                   Epoetin with hct = 24..  .........  .........  .........  ...........  ...........
Q9925...  A                   Epoetin with hct = 25..  .........  .........  .........  ...........  ...........
Q9926...  A                   Epoetin with hct = 26..  .........  .........  .........  ...........  ...........
Q9927...  A                   Epoetin with hct = 27..  .........  .........  .........  ...........  ...........
Q9928...  A                   Epoetin with hct = 28..  .........  .........  .........  ...........  ...........
Q9929...  A                   Epoetin with hct = 29..  .........  .........  .........  ...........  ...........
Q9930...  A                   Epoetin with hct = 30..  .........  .........  .........  ...........  ...........
Q9931...  A                   Epoetin with hct = 31..  .........  .........  .........  ...........  ...........
Q9932...  A                   Epoetin with hct = 32..  .........  .........  .........  ...........  ...........
Q9933...  A                   Epoetin with hct = 33..  .........  .........  .........  ...........  ...........
Q9934...  A                   Epoetin with hct = 34..  .........  .........  .........  ...........  ...........
Q9935...  A                   Epoetin with hct = 35..  .........  .........  .........  ...........  ...........
Q9936...  A                   Epoetin with hct = 36..  .........  .........  .........  ...........  ...........
Q9937...  A                   Epoetin with hct = 37..  .........  .........  .........  ...........  ...........
Q9938...  A                   Epoetin with hct = 38..  .........  .........  .........  ...........  ...........
Q9939...  A                   Epoetin with hct = 39..  .........  .........  .........  ...........  ...........
Q9940...  A                   Epoetin with hct >= 40.  .........  .........  .........  ...........  ...........
R0070...  N                   Transport portable x-    .........  .........  .........  ...........  ...........
                               ray.
R0075...  N                   Transport port x-ray     .........  .........  .........  ...........  ...........
                               multipl.
R0076...  N                   Transport portable EKG.  .........  .........  .........  ...........  ...........
V2020...  A                   Vision svcs frames       .........  .........  .........  ...........  ...........
                               purchases.
V2025...  E                   Eyeglasses delux frames  .........  .........  .........  ...........  ...........
V2100...  A                   Lens spher single plano  .........  .........  .........  ...........  ...........
                               4.00.
V2101...  A                   Single visn sphere 4.12- .........  .........  .........  ...........  ...........
                               7.00.
V2102...  A                   Singl visn sphere 7.12-  .........  .........  .........  ...........  ...........
                               20.00.
V2103...  A                   Spherocylindr 4.00d/12-  .........  .........  .........  ...........  ...........
                               2.00d.
V2104...  A                   Spherocylindr 4.00d/     .........  .........  .........  ...........  ...........
                               2.12-4d.
V2105...  A                   Spherocylinder 4.00d/    .........  .........  .........  ...........  ...........
                               4.25-6d.
V2106...  A                   Spherocylinder 4.00d/    .........  .........  .........  ...........  ...........
                               >6.00d.
V2107...  A                   Spherocylinder 4.25d/12- .........  .........  .........  ...........  ...........
                               2d.
V2108...  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               2.12-4d.
V2109...  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               4.25-6d.
V2110...  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               over 6d.
V2111...  A                   Spherocylindr 7.25d/.25- .........  .........  .........  ...........  ...........
                               2.25.
V2112...  A                   Spherocylindr 7.25d/     .........  .........  .........  ...........  ...........
                               2.25-4d.
V2113...  A                   Spherocylindr 7.25d/     .........  .........  .........  ...........  ...........
                               4.25-6d.
V2114...  A                   Spherocylinder over      .........  .........  .........  ...........  ...........
                               12.00d.
V2115...  A                   Lens lenticular bifocal  .........  .........  .........  ...........  ...........
V2116...  A                   Nonaspheric lens         .........  .........  .........  ...........  ...........
                               bifocal.
V2117...  A                   Aspheric lens bifocal..  .........  .........  .........  ...........  ...........
V2118...  A                   Lens aniseikonic single  .........  .........  .........  ...........  ...........
V2199...  A                   Lens single vision not   .........  .........  .........  ...........  ...........
                               oth c.
V2200...  A                   Lens spher bifoc plano   .........  .........  .........  ...........  ...........
                               4.00d.
V2201...  A                   Lens sphere bifocal      .........  .........  .........  ...........  ...........
                               4.12-7.0.
V2202...  A                   Lens sphere bifocal      .........  .........  .........  ...........  ...........
                               7.12-20.
V2203...  A                   Lens sphcyl bifocal      .........  .........  .........  ...........  ...........
                               4.00d/.1.
V2204...  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/2.1.
V2205...  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/4.2.
V2206...  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/ove.
V2207...  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7d/.
V2208...  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/2.
V2209...  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/4.
V2210...  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/ov.
V2211...  A                   Lens sphcy bifo 7.25-12/ .........  .........  .........  ...........  ...........
                               .25-.
V2212...  A                   Lens sphcyl bifo 7.25-   .........  .........  .........  ...........  ...........
                               12/2.2.
V2213...  A                   Lens sphcyl bifo 7.25-   .........  .........  .........  ...........  ...........
                               12/4.2.
V2214...  A                   Lens sphcyl bifocal      .........  .........  .........  ...........  ...........
                               over 12.
V2215...  A                   Lens lenticular bifocal  .........  .........  .........  ...........  ...........
V2216...  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               nonaspheric.
V2217...  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               aspheric bif.
V2218...  A                   Lens aniseikonic         .........  .........  .........  ...........  ...........
                               bifocal.
V2219...  A                   Lens bifocal seg width   .........  .........  .........  ...........  ...........
                               over.
V2220...  A                   Lens bifocal add over    .........  .........  .........  ...........  ...........
                               3.25d.
V2299...  A                   Lens bifocal speciality  .........  .........  .........  ...........  ...........
V2300...  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               4.00d.
V2301...  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               4.12-7.
V2302...  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               7.12-20.
V2303...  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               .12-.
V2304...  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               2.25.
V2305...  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               4.25.
V2306...  A                   Lens sphcyl trifocal     .........  .........  .........  ...........  ...........
                               4.00/>6.
V2307...  A                   Lens sphcy trifocal      .........  .........  .........  ...........  ...........
                               4.25-7/.
V2308...  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/2.
V2309...  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/4.
[[Page 47760]]
V2310...  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/>6.
V2311...  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               .25-.
V2312...  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               2.25.
V2313...  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               4.25.
V2314...  A                   Lens sphcyl trifocal     .........  .........  .........  ...........  ...........
                               over 12.
V2315...  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               trifocal.
V2316...  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               nonaspheric.
V2317...  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               aspheric tri.
V2318...  A                   Lens aniseikonic         .........  .........  .........  ...........  ...........
                               trifocal.
V2319...  A                   Lens trifocal seg width  .........  .........  .........  ...........  ...........
                               > 28.
V2320...  A                   Lens trifocal add over   .........  .........  .........  ...........  ...........
                               3.25d.
V2399...  A                   Lens trifocal            .........  .........  .........  ...........  ...........
                               speciality.
V2410...  A                   Lens variab asphericity  .........  .........  .........  ...........  ...........
                               sing.
V2430...  A                   Lens variable            .........  .........  .........  ...........  ...........
                               asphericity bi.
V2499...  A                   Variable asphericity     .........  .........  .........  ...........  ...........
                               lens.
V2500...  A                   Contact lens pmma        .........  .........  .........  ...........  ...........
                               spherical.
V2501...  A                   Cntct lens pmma-toric/   .........  .........  .........  ...........  ...........
                               prism.
V2502...  A                   Contact lens pmma        .........  .........  .........  ...........  ...........
                               bifocal.
V2503...  A                   Cntct lens pmma color    .........  .........  .........  ...........  ...........
                               vision.
V2510...  A                   Cntct gas permeable      .........  .........  .........  ...........  ...........
                               sphericl.
V2511...  A                   Cntct toric prism        .........  .........  .........  ...........  ...........
                               ballast.
V2512...  A                   Cntct lens gas permbl    .........  .........  .........  ...........  ...........
                               bifocl.
V2513...  A                   Contact lens extended    .........  .........  .........  ...........  ...........
                               wear.
V2520...  A                   Contact lens             .........  .........  .........  ...........  ...........
                               hydrophilic.
V2521...  A                   Cntct lens hydrophilic   .........  .........  .........  ...........  ...........
                               toric.
V2522...  A                   Cntct lens hydrophil     .........  .........  .........  ...........  ...........
                               bifocl.
V2523...  A                   Cntct lens hydrophil     .........  .........  .........  ...........  ...........
                               extend.
V2530...  A                   Contact lens gas         .........  .........  .........  ...........  ...........
                               impermeable.
V2531...  A                   Contact lens gas         .........  .........  .........  ...........  ...........
                               permeable.
V2599...  A                   Contact lens/es other    .........  .........  .........  ...........  ...........
                               type.
V2600...  A                   Hand held low vision     .........  .........  .........  ...........  ...........
                               aids.
V2610...  A                   Single lens spectacle    .........  .........  .........  ...........  ...........
                               mount.
V2615...  A                   Telescop/othr compound   .........  .........  .........  ...........  ...........
                               lens.
V2623...  A                   Plastic eye prosth       .........  .........  .........  ...........  ...........
                               custom.
V2624...  A                   Polishing artifical eye  .........  .........  .........  ...........  ...........
V2625...  A                   Enlargemnt of eye        .........  .........  .........  ...........  ...........
                               prosthesis.
V2626...  A                   Reduction of eye         .........  .........  .........  ...........  ...........
                               prosthesis.
V2627...  A                   Scleral cover shell....  .........  .........  .........  ...........  ...........
V2628...  A                   Fabrication & fitting..  .........  .........  .........  ...........  ...........
V2629...  A                   Prosthetic eye other     .........  .........  .........  ...........  ...........
                               type.
V2630...  N                   Anter chamber intraocul  .........  .........  .........  ...........  ...........
                               lens.
V2631...  N                   Iris support intraoclr   .........  .........  .........  ...........  ...........
                               lens.
V2632...  N                   Post chmbr intraocular   .........  .........  .........  ...........  ...........
                               lens.
V2700...  A                   Balance lens...........  .........  .........  .........  ...........  ...........
V2710...  A                   Glass/plastic slab off   .........  .........  .........  ...........  ...........
                               prism.
V2715...  A                   Prism lens/es..........  .........  .........  .........  ...........  ...........
V2718...  A                   Fresnell prism press-on  .........  .........  .........  ...........  ...........
                               lens.
V2730...  A                   Special base curve.....  .........  .........  .........  ...........  ...........
V2740...  A                   Rose tint plastic......  .........  .........  .........  ...........  ...........
V2741...  A                   Non-rose tint plastic..  .........  .........  .........  ...........  ...........
V2742...  A                   Rose tint glass........  .........  .........  .........  ...........  ...........
V2743...  A                   Non-rose tint glass....  .........  .........  .........  ...........  ...........
V2744...  A                   Tint photochromatic      .........  .........  .........  ...........  ...........
                               lens/es.
V2750...  A                   Anti-reflective coating  .........  .........  .........  ...........  ...........
V2755...  A                   UV lens/es.............  .........  .........  .........  ...........  ...........
V2760...  A                   Scratch resistant        .........  .........  .........  ...........  ...........
                               coating.
V2770...  A                   Occluder lens/es.......  .........  .........  .........  ...........  ...........
V2780...  A                   Oversize lens/es.......  .........  .........  .........  ...........  ...........
V2781...  A                   Progressive lens per     .........  .........  .........  ...........  ...........
                               lens.
V2785...  N                   Corneal tissue           .........  .........  .........  ...........  ...........
                               processing.
V2799...  A                   Miscellaneous vision     .........  .........  .........  ...........  ...........
                               service.
V5008...  E                   Hearing screening......  .........  .........  .........  ...........  ...........
V5010...  E                   Assessment for hearing   .........  .........  .........  ...........  ...........
                               aid.
V5011...  E                   Hearing aid fitting/     .........  .........  .........  ...........  ...........
                               checking.
V5014...  E                   Hearing aid repair/      .........  .........  .........  ...........  ...........
                               modifying.
V5020...  E                   Conformity evaluation..  .........  .........  .........  ...........  ...........
V5030...  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               air.
V5040...  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               bone.
V5050...  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               in ear.
V5060...  E                   Behind ear hearing aid.  .........  .........  .........  ...........  ...........
V5070...  E                   Glasses air conduction.  .........  .........  .........  ...........  ...........
V5080...  E                   Glasses bone conduction  .........  .........  .........  ...........  ...........
V5090...  E                   Hearing aid dispensing   .........  .........  .........  ...........  ...........
                               fee.
V5100...  E                   Body-worn bilat hearing  .........  .........  .........  ...........  ...........
                               aid.
V5110...  E                   Hearing aid dispensing   .........  .........  .........  ...........  ...........
                               fee.
[[Page 47761]]
V5120...  E                   Body-worn binaur         .........  .........  .........  ...........  ...........
                               hearing aid.
V5130...  E                   In ear binaural hearing  .........  .........  .........  ...........  ...........
                               aid.
V5140...  E                   Behind ear binaur        .........  .........  .........  ...........  ...........
                               hearing ai.
V5150...  E                   Glasses binaural         .........  .........  .........  ...........  ...........
                               hearing aid.
V5160...  E                   Dispensing fee binaural  .........  .........  .........  ...........  ...........
V5170...  E                   Within ear cros hearing  .........  .........  .........  ...........  ...........
                               aid.
V5180...  E                   Behind ear cros hearing  .........  .........  .........  ...........  ...........
                               aid.
V5190...  E                   Glasses cros hearing     .........  .........  .........  ...........  ...........
                               aid.
V5200...  E                   Cros hearing aid         .........  .........  .........  ...........  ...........
                               dispens fee.
V5210...  E                   In ear bicros hearing    .........  .........  .........  ...........  ...........
                               aid.
V5220...  E                   Behind ear bicros        .........  .........  .........  ...........  ...........
                               hearing ai.
V5230...  E                   Glasses bicros hearing   .........  .........  .........  ...........  ...........
                               aid.
V5240...  E                   Dispensing fee bicros..  .........  .........  .........  ...........  ...........
V5299...  A                   Hearing service........  .........  .........  .........  ...........  ...........
V5336...  E                   Repair communication     .........  .........  .........  ...........  ...........
                               device.
V5362...  A                   Speech screening.......  .........  .........  .........  ...........  ...........
V5363...  A                   Language screening.....  .........  .........  .........  ...........  ...........
V5364...  A                   Dysphagia screening....  .........  .........  .........  ...........  ...........
----------------------------------------------------------------------------------------------------------------
  <hbond><hbond><hbond><hbond><hbond><hbond><hbond><hbond><hbond><hbond>
<hbond><hbond>
                     Addendum C.--Proposed Hospital Outpatient Payment for Procedures by APC
----------------------------------------------------------------------------------------------------------------
                                                                       Proposed      National         Minimum
 APC   CPT \1\/    HCPCS Description    Status indicator   Relative     payment     unadjusted      unadjusted
         HCPCS                                              weight       rate       coinsurance     coinsurance
----------\2\---------------------------------------------------------------------------------------------------
031..
(1)De         S  1.34                  $67.90                 $13.58      $13.58
 ntal
 proc
 edur
 es
031..     D0150  Comprehensive oral
                  evaluation
031..     D0240  Intraoral occlusal
                  film
031..     D0250  Extraoral first film
031..     D0260  Extraoral ea
                  additional film
031..     D0270  Dental bitewing
                  single film
031..     D0272  Dental bitewings two
                  films
031..     D0274  Dental bitewings
                  four films
031..     D0460  Pulp vitality test
031..     D0471  Diagnostic
                  photographs
031..     D0501  Histopathologic
                  examinations
031..     D0502  Other oral pathology
                  procedure
031..     D0999  Unspecified
                  diagnostic
                  procedure
031..     D1510  Space maintainer fxd
                  unilat
031..     D1515  Fixed bilat space
                  maintainer
031..     D1520  Remove unilat space
                  maintain
031..     D1525  Remove bilat space
                  maintain
031..     D1550  Recement space
                  maintainer
031..     D2970  Temporary- fractured
                  tooth
031..     D2999  Dental unspec
                  restorative pr
031..     D3460  Endodontic
                  endosseous implan
031..     D3999  Endodontic procedure
031..     D4250  Mucogingival surg
                  per quadra
031..     D4260  Osseous surgery per
                  quadrant
031..     D4263  Bone replce graft
                  first site
031..     D4264  Bone replce graft
                  each add
031..     D4270  Pedicle soft tissue
                  graft pr
031..     D4271  Free soft tissue
                  graft proc
031..     D4273  Subepithelial tissue
                  graft
031..     D4355  Full mouth
                  debridement
031..     D4381  Localized chemo
                  delivery
031..     D5911  Facial moulage
                  sectional
031..     D5912  Facial moulage
                  complete
031..     D5983  Radiation applicator
031..     D5984  Radiation shield
031..     D5985  Radiation cone
                  locator
031..     D5987  Commissure splint
031..     D6920  Dental connector bar
031..     D7110  Oral surgery single
                  tooth
031..     D7120  Each add tooth
                  extraction
031..     D7130  Tooth root removal
031..     D7210  Rem imp tooth w
                  mucoper flp
031..     D7220  Impact tooth remov
                  soft tiss
031..     D7230  Impact tooth remov
                  part bony
031..     D7240  Impact tooth remov
                  comp bony
031..     D7241  Impact tooth rem
                  bony w/comp
031..     D7250  Tooth root removal
031..     D7260  Oral antral fistula
                  closure
031..     D7291  Transseptal
                  fiberotomy
[[Page 47762]]
031..     D7940  Reshaping bone
                  orthognathic
031..     D9630  Other drugs/
                  medicaments
031..     D9930  Treatment of
                  complications
031..     D9940  Dental occlusal
                  guard
031..     D9950  Occlusion analysis
031..     D9951  Limited occlusal
                  adjustment
031..     D9952  Complete occlusal
                  adjustment
031..     K0445  Auricular prosthesis
061..
(1)Le         X  1.04                  $52.70                 $36.61      $10.54
 vel
 I
 Chem
 othe
 rape
 utic
 agen
 ts
061..     J8610  Methotrexate oral
                  2.5 MG
061..     J8999  Oral prescription
                  drug chemo
061..     J9015  Aldesleukin/single
                  use vial
061..     J9070  Cyclophosphamide 100
                  MG inj
061..     J9080  Cyclophosphamide 200
                  MG inj
061..     J9090  Cyclophosphamide 500
                  MG inj
061..     J9093  Cyclophosphamide
                  lyophilized
061..     J9094  Cyclophosphamide
                  lyophilized
061..     J9095  Cyclophosphamide
                  lyophilized
061..     J9100  Cytarabine hcl 100
                  MG inj
061..     J9110  Cytarabine hcl 500
                  MG inj
061..     J9120  Dactinomycin
                  actinomycin d
061..     J9130  Dacarbazine 10 MG
                  inj
061..     J9140  Dacarbazine 200 MG
                  inj
061..     J9165  Diethylstilbestrol
                  injection
061..     J9170  Docetaxel
061..     J9181  Etoposide 10 MG inj
061..     J9190  Fluorouracil
                  injection
061..     J9201  Gemcitabine HCl
061..     J9206  Irinotecan injection
061..     J9214  Interferon alfa-2b
                  inj
061..     J9215  Interferon alfa-n3
                  inj
061..     J9218  Leuprolide acetate
                  injection
061..     J9230  Mechlorethamine hcl
                  inj
061..     J9250  Methotrexate sodium
                  inj
061..     J9260  Methotrexate sodium
                  inj
061..     J9266  Pegaspargase/singl
                  dose vial
061..     J9350  Topotecan
061..     J9360  Vinblastine sulfate
                  inj
061..     J9390  Vinorelbine tartrate/
                  10 mg
061..     J9600  Porfimer sodium
061..     J9999  Chemotherapy drug
062..
(1)Le         X  1.69                  $85.63                 $36.61      $17.13
 vel
 II
 Chem
 othe
 rape
 utic
 agen
 ts
062..     J9000  Doxorubic hcl 10 MG
                  vl chemo
062..     J9020  Asparaginase
                  injection
062..     J9060  Cisplatin 10 MG
                  injection
062..     J9065  Inj cladribine per 1
                  MG
062..     J9091  Cyclophosphamide 1.0
                  grm inj
062..     J9092  Cyclophosphamide 2.0
                  grm inj
062..     J9096  Cyclophosphamide
                  lyophilized
062..     J9097  Cyclophosphamide
                  lyophilized
062..     J9150  Daunorubicin
062..     J9211  Idarubicin hcl
                  injection
062..     J9213  Interferon alfa-2a
                  inj
062..     J9265  Paclitaxel injection
062..     J9268  Pentostatin
                  injection
062..     J9370  Vincristine sulfate
                  1 MG inj
063..
(1)Le         X  2.89                  $146.43               $110.97      $29.29
 vel
 III
 Chem
 othe
 rape
 utic
 agen
 ts
063..     J9031  Bcg live
                  intravesical vac
063..     J9040  Bleomycin sulfate
                  injection
063..     J9045  Carboplatin
                  injection
063..     J9050  Carmus bischl nitro
                  inj
063..     J9062  Cisplatin 50 MG
                  injection
063..     J9182  Etoposide 100 MG inj
063..     J9185  Fludarabine
                  phosphate inj
063..     J9200  Floxuridine
                  injection
063..     J9202  Goserelin acetate
                  implant
063..     J9208  Ifosfomide injection
063..     J9209  Mesna injection
063..     J9216  Interferon gamma 1-b
                  inj
063..     J9270  Plicamycin
                  (mithramycin) inj
063..     J9280  Mitomycin 5 MG inj
063..     J9320  Streptozocin
                  injection
063..     J9340  Thiotepa injection
063..     J9375  Vincristine sulfate
                  2 MG inj
[[Page 47763]]
063..     J9380  Vincristine sulfate
                  5 MG inj
064..
(1)Le         X  4.17                  $211.29               $140.12      $42.26
 vel
 IV
 Chem
 othe
 rape
 utic
 agen
 ts
064..     J0640  Leucovorin calcium
                  injection
064..     J9217  Leuprolide acetate
                  suspnsion
064..     J9245  Inj melphalan
                  hydrochl 50 MG
064..     J9290  Mitomycin 20 MG inj
064..     J9291  Mitomycin 40 MG inj
064..     J9293  Mitoxantrone
                  hydrochl / 5 MG
089..
(1)Ne         X  2.54                  $128.7                 $37.29      $25.74
 urop
 sych
 olog
 ical
 Test
 ing
089..     96100
(5)PS
 YCHO
 LOGI
 CAL
 TEST
 ING
 (INC
 LUDE
 S
 PSYC
 HODI
 AGNO
 STIC
 ASSE
 SSME
 NT
 OF
 PERS
 ONAL
 ITY,
 PSYC
 HOPA
 THOL
 OGY,
 EMOT
 IONA
 LITY
 ,
 INTE
 LLEC
 TUAL
 ABIL
 ITIE
 S,
 EG,
 WAIS-
 R,
 RORS
 CHAC
 H,
 MMPI
 )
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT,
 PER
 HOUR
089..     96105
(5)AS
 SESS
 MENT
 OF
 APHA
 SIA
 (INC
 LUDE
 S
 ASSE
 SSME
 NT
 OF
 EXPR
 ESSI
 VE
 AND
 RECE
 PTIV
 E
 SPEE
 CH
 AND
 LANG
 UAGE
 FUNC
 TION
 ,
 LANG
 UAGE
 COMP
 REHE
 NSIO
 N,
 SPEE
 CH
 PROD
 UCTI
 ON
 ABIL
 ITY,
 READ
 ING,
 SPEL
 LING
 ,
 WRIT
 ING,
 EG,
 BY
 BOST
 ON
 DIAG
 NOST
 IC
 APHA
 SIA
 EXAM
 INAT
 ION)
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT
089..     96110
(5)DE
 VELO
 PMEN
 TAL
 TEST
 ING;
 LIMI
 TED
 (EG,
 DEVE
 LOPM
 ENTA
 L
 SCRE
 ENIN
 G
 TEST
 II,
 EARL
 Y
 LANG
 UAGE
 MILE
 STON
 E
 SCRE
 EN),
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT
089..     96111
(5)DE
 VELO
 PMEN
 TAL
 TEST
 ING;
 EXTE
 NDED
 (INC
 LUDE
 S
 ASSE
 SSME
 NT
 OF
 MOTO
 R,
 LANG
 UAGE
 ,
 SOCI
 AL,
 ADAP
 TIVE
 AND/
 OR
 COGN
 ITIV
 E
 FUNC
 TION
 ING
 BY
 STAN
 DARD
 IZED
 DEVE
 LOPM
 ENTA
 L
 INST
 RUME
 NTS,
 EG,
 BAYL
 EY
 SCAL
 ES
 OF
 INFA
 NT
 DEVE
 LOPM
 ENT)
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT,
 PER
 HOUR
089..     96115
(5)NE
 UROB
 EHAV
 IORA
 L
 STAT
 US
 EXAM
 (CLI
 NICA
 L
 ASSE
 SSME
 NT
 OF
 THIN
 KING
 ,
 REAS
 ONIN
 G
 AND
 JUDG
 MENT
 ,
 EG,
 ACQU
 IRED
 KNOW
 LEDG
 E,
 ATTE
 NTIO
 N,
 MEMO
 RY,
 VISU
 AL
 SPAT
 IAL
 ABIL
 ITIE
 S,
 LANG
 UAGE
 FUNC
 TION
 S,
 PLAN
 NING
 )
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT,
 PER
 HOUR
089..     96117
(5)NE
 UROP
 SYCH
 OLOG
 ICAL
 TEST
 ING
 BATT
 ERY
 (EG,
 HALS
 TEAD-
 REIT
 AN,
 LURI
 A,
 WAIS-
 R)
 WITH
 INTE
 RPRE
 TATI
 ON
 AND
 REPO
 RT,
 PER
 HOUR
090..
(1)Mo         X  0.85                  $43.07                 $12.43       $8.61
 nito
 ring
 psyc
 hiat
 ric
 drug
 s
090..     90862
(5)PH
 ARMA
 COLO
 GIC
 MANA
 GEME
 NT,
 INCL
 UDIN
 G
 PRES
 CRIP
 TION
 ,
 USE,
 AND
 REVI
 EW
 OF
 MEDI
 CATI
 ON
 WITH
 NO
 MORE
 THAN
 MINI
 MAL
 MEDI
 CAL
 PSYC
 HOTH
 ERAP
 Y
090..     M0064
(5)Vi
 sit
 for
 drug
 moni
 tori
 ng
091..
(1)Br         S  1.09                  $55.23                 $14.01      $11.05
 ief
 Indi
 vidu
 al
 Psyc
 hoth
 erap
 y
091..     90804
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 20
 TO
 30
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
091..     90805
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 20
 TO
 30
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 MEDI
 CAL
 EVAL
 UATI
 ON
 AND
 MANA
 GEME
 NT
 SERV
 ICES
091..     90810
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 20
 TO
 30
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
091..     90811
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 20
 TO
 30
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 M
091..     90899
(5)UN
 LIST
 ED
 PSYC
 HIAT
 RIC
 SERV
 ICE
 OR
 PROC
 EDUR
 E
092..
(1)Ex         S  1.57                  $79.55                 $21.92      $15.91
 tend
 ed
 Indi
 vidu
 al
 Psyc
 hoth
 erap
 y
092..     90801
(5)PS
 YCHI
 ATRI
 C
 DIAG
 NOST
 IC
 INTE
 RVIE
 W
 EXAM
 INAT
 ION
092..     90802
(5)IN
 TERA
 CTIV
 E
 PSYC
 HIAT
 RIC
 DIAG
 NOST
 IC
 INTE
 RVIE
 W
 EXAM
 INAT
 ION
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 COMM
 UNIC
 ATIO
 N
092..     90806
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 45
 TO
 50
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
092..     90807
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 45
 TO
 50
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 MEDI
 CAL
 EVAL
 UATI
 ON
 AND
 MANA
 GEME
 NT
 SERV
 ICES
092..     90808
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 75
 TO
 80
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
092..     90809
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INSI
 GHT
 ORIE
 NTED
 ,
 BEHA
 VIOR
 MODI
 FYIN
 G
 AND/
 OR
 SUPP
 ORTI
 VE,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 75
 TO
 80
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 MEDI
 CAL
 EVAL
 UATI
 ON
 AND
 MANA
 GEME
 NT
 SERV
 ICES
092..     90812
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 45
 TO
 50
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
092..     90813
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 45
 TO
 50
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 M
092..     90814
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 75
 TO
 80
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
092..     90815
(5)IN
 DIVI
 DUAL
 PSYC
 HOTH
 ERAP
 Y,
 INTE
 RACT
 IVE,
 USIN
 G
 PLAY
 EQUI
 PMEN
 T,
 PHYS
 ICAL
 DEVI
 CES,
 LANG
 UAGE
 INTE
 RPRE
 TER,
 OR
 OTHE
 R
 MECH
 ANIS
 MS
 OF
 NON-
 VERB
 AL
 COMM
 UNIC
 ATIO
 N,
 IN
 AN
 OFFI
 CE
 OR
 OUTP
 ATIE
 NT
 FACI
 LITY
 ,
 APPR
 OXIM
 ATEL
 Y 75
 TO
 80
 MINU
 TES
 FACE-
 TO-
 FACE
 WITH
 THE
 PATI
 ENT;
 WITH
 M
092..     90845
(5)PS
 YCHO
 ANAL
 YSIS
092..     90865
(5)NA
 RCOS
 YNTH
 ESIS
 FOR
 PSYC
 HIAT
 RIC
 DIAG
 NOST
 IC
 AND
 THER
 APEU
 TIC
 PURP
 OSES
 (EG,
 SODI
 UM
 AMOB
 ARBI
 TAL
 (AMY
 TAL)
 INTE
 RVIE
 W
092..     90880
(5)HY
 PNOT
 HERA
 PY
093..
(1)Fa
 mily
 Psyc
 hoth
 erap
 y
              S  1.54                  $78.03                 $20.11      $15.61
[[Page 47764]]
093..     90846
(5)FA
 MILY
 PSYC
 HOTH
 ERAP
 Y
 (WIT
 HOUT
 THE
 PATI
 ENT
 PRES
 ENT)
093..     90847
(5)FA
 MILY
 PSYC
 HOTH
 ERAP
 Y
 (CON
 JOIN
 T
 PSYC
 HOTH
 ERAP
 Y)
 (WIT
 H
 PATI
 ENT
 PRES
 ENT)
094..
(1)Gr         S  1.24                  $62.83                 $20.11      $12.57
 oup
 Psyc
 hoth
 erap
 y
094..     90849
(5)MU
 LTIP
 LE-
 FAMI
 LY
 GROU
 P
 PSYC
 HOTH
 ERAP
 Y
094..     90853
(5)GR
 OUP
 PSYC
 HOTH
 ERAP
 Y
 (OTH
 ER
 THAN
 OF A
 MULT
 IPLE-
 FAMI
 LY
 GROU
 P)
094..     90857
(5)IN
 TERA
 CTIV
 E
 GROU
 P
 PSYC
 HOTH
 ERAP
 Y
121..
(1)Le         T  0.67                  $33.95                 $20.91       $6.79
 vel
 I
 need
 le
 biop
 sy/
 aspi
 rati
 on
121..     17999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 SKIN
 ,
 MUCO
 US
 MEMB
 RANE
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
121..     19000
(5)PU
 NCTU
 RE
 ASPI
 RATI
 ON
 OF
 CYST
 OF
 BREA
 ST;
121..     19001
(5)PU
 NCTU
 RE
 ASPI
 RATI
 ON
 OF
 CYST
 OF
 BREA
 ST;
 EACH
 ADDI
 TION
 AL
 CYST
121..     20615
(5)AS
 PIRA
 TION
 AND
 INJE
 CTIO
 N
 FOR
 TREA
 TMEN
 T OF
 BONE
 CYST
121..     55000
(5)PU
 NCTU
 RE
 ASPI
 RATI
 ON
 OF
 HYDR
 OCEL
 E,
 TUNI
 CA
 VAGI
 NALI
 S,
 WITH
 OR
 WITH
 OUT
 INJE
 CTIO
 N OF
 MEDI
 CATI
 ON
121..     60001
(5)AS
 PIRA
 TION
 AND/
 OR
 INJE
 CTIO
 N,
 THYR
 OID
 CYST
121..     60699
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 ENDO
 CRIN
 E
 SYST
 EM
121..     85095
(5)BO
 NE
 MARR
 OW;
 ASPI
 RATI
 ON
 ONLY
121..     85102
(5)BO
 NE
 MARR
 OW
 BIOP
 SY,
 NEED
 LE
 OR
 TROC
 AR
121..     88170
(5)FI
 NE
 NEED
 LE
 ASPI
 RATI
 ON
 WITH
 OR
 WITH
 OUT
 PREP
 ARAT
 ION
 OF
 SMEA
 RS;
 SUPE
 RFIC
 IAL
 TISS
 UE
 (EG,
 THYR
 OID,
 BREA
 ST,
 PROS
 TATE
121..     88171
(5)FI
 NE
 NEED
 LE
 ASPI
 RATI
 ON
 WITH
 OR
 WITH
 OUT
 PREP
 ARAT
 ION
 OF
 SMEA
 RS;
 DEEP
 TISS
 UE
 UNDE
 R
 RADI
 OLOG
 IC
 GUID
 ANCE
122..
(1)Le         T  4.87                  $246.76               $115.03      $49.35
 vel
 II
 need
 le
 biop
 sy/
 aspi
 rati
 on
122..     19100
(5)BI
 OPSY
 OF
 BREA
 ST;
 NEED
 LE
 CORE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
122..     20206
(5)BI
 OPSY
 ,
 MUSC
 LE,
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     32400
(5)BI
 OPSY
 ,
 PLEU
 RA;
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     32405
(5)BI
 OPSY
 ,
 LUNG
 OR
 MEDI
 ASTI
 NUM,
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     38505
(5)BI
 OPSY
 OR
 EXCI
 SION
 OF
 LYMP
 H
 NODE
 (S);
 BY
 NEED
 LE,
 SUPE
 RFIC
 IAL
 (EG,
 CERV
 ICAL
 ,
 INGU
 INAL
 ,
 AXIL
 LARY
 )
122..     42400
(5)BI
 OPSY
 OF
 SALI
 VARY
 GLAN
 D;
 NEED
 LE
122..     47000
(5)BI
 OPSY
 OF
 LIVE
 R,
 NEED
 LE;
 PERC
 UTAN
 EOUS
122..     47399
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 LIVE
 R
122..     48102
(5)BI
 OPSY
 OF
 PANC
 REAS
 ,
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     48999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 PANC
 REAS
122..     49180
(5)BI
 OPSY
 ,
 ABDO
 MINA
 L OR
 RETR
 OPER
 ITON
 EAL
 MASS
 ,
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     50200
(5)RE
 NAL
 BIOP
 SY;
 PERC
 UTAN
 EOUS
 , BY
 TROC
 AR
 OR
 NEED
 LE
122..     50390
(5)AS
 PIRA
 TION
 AND/
 OR
 INJE
 CTIO
 N OF
 RENA
 L
 CYST
 OR
 PELV
 IS
 BY
 NEED
 LE,
 PERC
 UTAN
 EOUS
122..     54500
(5)BI
 OPSY
 OF
 TEST
 IS,
 NEED
 LE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
122..     54800
(5)BI
 OPSY
 OF
 EPID
 IDYM
 IS,
 NEED
 LE
122..     60100
(5)BI
 OPSY
 THYR
 OID,
 PERC
 UTAN
 EOUS
 CORE
 NEED
 LE
122..     62269
(5)BI
 OPSY
 OF
 SPIN
 AL
 CORD
 ,
 PERC
 UTAN
 EOUS
 NEED
 LE
122..     67415
(5)FI
 NE
 NEED
 LE
 ASPI
 RATI
 ON
 OF
 ORBI
 TAL
 CONT
 ENTS
131..
(1)Le         T  1.94                  $98.30                 $36.61      $19.66
 vel
 I
 inci
 sion
 &
 drai
 nage
131..     10040
(5)AC
 NE
 SURG
 ERY
 (EG,
 MARS
 UPIA
 LIZA
 TION
 ,
 OPEN
 ING
 OR
 REMO
 VAL
 OF
 MULT
 IPLE
 MILI
 A,
 COME
 DONE
 S,
 CYST
 S,
 PUST
 ULES
 )
131..     10060
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 ABSC
 ESS
 (EG,
 CARB
 UNCL
 E,
 SUPP
 URAT
 IVE
 HIDR
 ADEN
 ITIS
 ,
 CUTA
 NEOU
 S OR
 SUBC
 UTAN
 EOUS
 ABSC
 ESS,
 CYST
 ,
 FURU
 NCLE
 , OR
 PARO
 NYCH
 IA);
 SIMP
 LE
 OR
 SING
 LE
131..     10061
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 ABSC
 ESS
 (EG,
 CARB
 UNCL
 E,
 SUPP
 URAT
 IVE
 HIDR
 ADEN
 ITIS
 ,
 CUTA
 NEOU
 S OR
 SUBC
 UTAN
 EOUS
 ABSC
 ESS,
 CYST
 ,
 FURU
 NCLE
 , OR
 PARO
 NYCH
 IA);
 COMP
 LICA
 TED
 OR
 MULT
 IPLE
131..     10080
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 PILO
 NIDA
 L
 CYST
 ;
 SIMP
 LE
131..     10081
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 PILO
 NIDA
 L
 CYST
 ;
 COMP
 LICA
 TED
131..     10120
(5)IN
 CISI
 ON
 AND
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UES;
 SIMP
 LE
131..     10140
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 HEMA
 TOMA
 ,
 SERO
 MA
 OR
 FLUI
 D
 COLL
 ECTI
 ON
131..     10160
(5)PU
 NCTU
 RE
 ASPI
 RATI
 ON
 OF
 ABSC
 ESS,
 HEMA
 TOMA
 ,
 BULL
 A,
 OR
 CYST
131..     10180
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 COMP
 LEX,
 POST
 OPER
 ATIV
 E
 WOUN
 D
 INFE
 CTIO
 N
131..     11976
(5)RE
 MOVA
 L,
 IMPL
 ANTA
 BLE
 CONT
 RACE
 PTIV
 E
 CAPS
 ULES
131..     20000
(5)IN
 CISI
 ON
 OF
 SOFT
 TISS
 UE
 ABSC
 ESS
 (EG,
 SECO
 NDAR
 Y TO
 OSTE
 OMYE
 LITI
 S);
 SUPE
 RFIC
 IAL
131..     26010
(5)DR
 AINA
 GE
 OF
 FING
 ER
 ABSC
 ESS;
 SIMP
 LE
131..     26011
(5)DR
 AINA
 GE
 OF
 FING
 ER
 ABSC
 ESS;
 COMP
 LICA
 TED
 (EG,
 FELO
 N)
131..     69000
(5)DR
 AINA
 GE
 EXTE
 RNAL
 EAR,
 ABSC
 ESS
 OR
 HEMA
 TOMA
 ;
 SIMP
 LE
131..     69005
(5)DR
 AINA
 GE
 EXTE
 RNAL
 EAR,
 ABSC
 ESS
 OR
 HEMA
 TOMA
 ;
 COMP
 LICA
 TED
131..     69020
(5)DR
 AINA
 GE
 EXTE
 RNAL
 AUDI
 TORY
 CANA
 L,
 ABSC
 ESS
132..
(1)Le         T  6.04                  $306.04               $134.13      $61.21
 vel
 II
 inci
 sion
 &
 drai
 nage
132..     19020
(5)MA
 STOT
 OMY
 WITH
 EXPL
 ORAT
 ION
 OR
 DRAI
 NAGE
 OF
 ABSC
 ESS,
 DEEP
132..     20950
(5)MO
 NITO
 RING
 OF
 INTE
 RSTI
 TIAL
 FLUI
 D
 PRES
 SURE
 (INC
 LUDE
 S
 INSE
 RTIO
 N OF
 DEVI
 CE,
 EG,
 WICK
 CATH
 ETER
 TECH
 NIQU
 E,
 NEED
 LE
 MANO
 METE
 R
 TECH
 NIQU
 E)
 IN
 DETE
 CTIO
 N OF
 MUSC
 LE
 COMP
 ARTM
 ENT
 SYND
 ROME
132..     21501
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
 ,
 SOFT
 TISS
 UES
 OF
 NECK
 OR
 THOR
 AX;
132..     21700
(5)DI
 VISI
 ON
 OF
 SCAL
 ENUS
 ANTI
 CUS;
 WITH
 OUT
 RESE
 CTIO
 N OF
 CERV
 ICAL
 RIB
132..     21720
(5)DI
 VISI
 ON
 OF
 STER
 NOCL
 EIDO
 MAST
 OID
 FOR
 TORT
 ICOL
 LIS,
 OPEN
 OPER
 ATIO
 N;
 WITH
 OUT
 CAST
 APPL
 ICAT
 ION
132..     21725
(5)DI
 VISI
 ON
 OF
 STER
 NOCL
 EIDO
 MAST
 OID
 FOR
 TORT
 ICOL
 LIS,
 OPEN
 OPER
 ATIO
 N;
 WITH
 CAST
 APPL
 ICAT
 ION
132..     23030
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 SHOU
 LDER
 AREA
 ;
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
132..     23031
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 SHOU
 LDER
 AREA
 ;
 INFE
 CTED
 BURS
 A
132..     23930
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
132..     23931
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 INFE
 CTED
 BURS
 A
132..     27301
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 DEEP
 ABSC
 ESS,
 INFE
 CTED
 BURS
 A,
 OR
 HEMA
 TOMA
 ,
 THIG
 H OR
 KNEE
 REGI
 ON
132..     27603
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 LEG
 OR
 ANKL
 E;
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
132..     28001
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 INFE
 CTED
 BURS
 A,
 FOOT
132..     38300
(5)DR
 AINA
 GE
 OF
 LYMP
 H
 NODE
 ABSC
 ESS
 OR
 LYMP
 HADE
 NITI
 S;
 SIMP
 LE
[[Page 47765]]
132..     38305
(5)DR
 AINA
 GE
 OF
 LYMP
 H
 NODE
 ABSC
 ESS
 OR
 LYMP
 HADE
 NITI
 S;
 EXTE
 NSIV
 E
132..     38999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 HEMI
 C OR
 LYMP
 HATI
 C
 SYST
 EM
132..     51080
(5)DR
 AINA
 GE
 OF
 PERI
 VESI
 CAL
 OR
 PREV
 ESIC
 AL
 SPAC
 E
 ABSC
 ESS
132..     54015
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 OF
 PENI
 S,
 DEEP
132..     54115
(5)RE
 MOVA
 L
 FORE
 IGN
 BODY
 FROM
 DEEP
 PENI
 LE
 TISS
 UE
 (EG,
 PLAS
 TIC
 IMPL
 ANT)
132..     55100
(5)DR
 AINA
 GE
 OF
 SCRO
 TAL
 WALL
 ABSC
 ESS
137..
(1)Na         T  0.46                  $23.31                  $4.66       $4.66
 il
 proc
 edur
 es
137..     11719
(5)TR
 IMMI
 NG
 OF
 NOND
 YSTR
 OPHI
 C
 NAIL
 S,
 ANY
 NUMB
 ER
137..     11720
(5)DE
 BRID
 EMEN
 T OF
 NAIL
 (S)
 BY
 ANY
 METH
 OD(S
 );
 ONE
 TO
 FIVE
137..     11721
(5)DE
 BRID
 EMEN
 T OF
 NAIL
 (S)
 BY
 ANY
 METH
 OD(S
 );
 SIX
 OR
 MORE
137..     11740
(5)EV
 ACUA
 TION
 OF
 SUBU
 NGUA
 L
 HEMA
 TOMA
137..     11755
(5)BI
 OPSY
 OF
 NAIL
 UNIT
 ,
 ANY
 METH
 OD
 (EG,
 PLAT
 E,
 BED,
 MATR
 IX,
 HYPO
 NYCH
 IUM,
 PROX
 IMAL
 AND
 LATE
 RAL
 NAIL
 FOLD
 S)
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
141..
(1)Le         T  0.59                  $29.90                  $9.49       $5.98
 vel
 I
 Dest
 ruct
 ion
 of
 lesi
 on
141..     17000
(5)DE
 STRU
 CTIO
 N BY
 ANY
 METH
 OD,
 INCL
 UDIN
 G
 LASE
 R,
 WITH
 OR
 WITH
 OUT
 SURG
 ICAL
 CURE
 TTEM
 ENT,
 ALL
 BENI
 GN
 OR
 PREM
 ALIG
 NANT
 LESI
 ONS
 (EG,
 ACTI
 NIC
 KERA
 TOSE
 S)
 OTHE
 R
 THAN
 SKIN
 TAGS
 OR
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS,
 INCL
 UDIN
 G
 LOCA
 L
 ANES
 THES
 IA;
 FIRS
 T
 LESI
 ON
141..     17003
(5)DE
 STRU
 CTIO
 N BY
 ANY
 METH
 OD,
 INCL
 UDIN
 G
 LASE
 R,
 WITH
 OR
 WITH
 OUT
 SURG
 ICAL
 CURE
 TTEM
 ENT,
 ALL
 BENI
 GN
 OR
 PREM
 ALIG
 NANT
 LESI
 ONS
 (EG,
 ACTI
 NIC
 KERA
 TOSE
 S)
 OTHE
 R
 THAN
 SKIN
 TAGS
 OR
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS,
 INCL
 UDIN
 G
 LOCA
 L
 ANES
 THES
 IA;
 SECO
 ND
 THRO
 UGH
 14
 LE
141..     17106
(5)DE
 STRU
 CTIO
 N OF
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS
 (EG,
 LASE
 R
 TECH
 NIQU
 E);
 LESS
 THAN
 10
 SQ
 CM
141..     17110
(5)DE
 STRU
 CTIO
 N BY
 ANY
 METH
 OD
 OF
 FLAT
 WART
 S,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 OR
 MILI
 A;
 UP
 TO
 14
 LESI
 ONS
142..
(1)Le         T  3.77                  $191.02                $73.00      $38.20
 vel
 II
 Dest
 ruct
 ion
 of
 lesi
 on
142..     17004
(5)DE
 STRU
 CTIO
 N BY
 ANY
 METH
 OD,
 INCL
 UDIN
 G
 LASE
 R,
 WITH
 OR
 WITH
 OUT
 SURG
 ICAL
 CURE
 TTEM
 ENT,
 ALL
 BENI
 GN
 OR
 PREM
 ALIG
 NANT
 LESI
 ONS
 (EG,
 ACTI
 NIC
 KERA
 TOSE
 S)
 OTHE
 R
 THAN
 SKIN
 TAGS
 OR
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS,
 INCL
 UDIN
 G
 LOCA
 L
 ANES
 THES
 IA;
 15
 OR
 MORE
 LESI
 ONS
142..     17107
(5)DE
 STRU
 CTIO
 N OF
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS
 (EG,
 LASE
 R
 TECH
 NIQU
 E);
 10.0
 -50.
 0 SQ
 CM
142..     17108
(5)DE
 STRU
 CTIO
 N OF
 CUTA
 NEOU
 S
 VASC
 ULAR
 PROL
 IFER
 ATIV
 E
 LESI
 ONS
 (EG,
 LASE
 R
 TECH
 NIQU
 E);
 OVER
 50.0
 SQ
 CM
142..     17111
(5)DE
 STRU
 CTIO
 N BY
 ANY
 METH
 OD
 OF
 FLAT
 WART
 S,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 OR
 MILI
 A;
 15
 OR
 MORE
 LESI
 ONS
151..
(1)Le         T  1.74                  $88.16                 $35.71      $17.63
 vel
 I
 debr
 idem
 ent/
 dest
 ruct
 ion
151..     11000
(5)DE
 BRID
 EMEN
 T OF
 EXTE
 NSIV
 E
 ECZE
 MATO
 US
 OR
 INFE
 CTED
 SKIN
 ; UP
 TO
 10%
 OF
 BODY
 SURF
 ACE
151..     11001
(5)DE
 BRID
 EMEN
 T OF
 EXTE
 NSIV
 E
 ECZE
 MATO
 US
 OR
 INFE
 CTED
 SKIN
 ;
 EACH
 ADDI
 TION
 AL
 10%
 OF
 THE
 BODY
 SURF
 ACE
151..     11040
(5)DE
 BRID
 EMEN
 T;
 SKIN
 ,
 PART
 IAL
 THIC
 KNES
 S
151..     11041
(5)DE
 BRID
 EMEN
 T;
 SKIN
 ,
 FULL
 THIC
 KNES
 S
151..     11042
(5)DE
 BRID
 EMEN
 T;
 SKIN
 ,
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
151..     11055
(5)PA
 RING
 OR
 CUTT
 ING
 OF
 BENI
 GN
 HYPE
 RKER
 ATOT
 IC
 LESI
 ON
 (EG,
 CORN
 OR
 CALL
 US);
 SING
 LE
 LESI
 ON
151..     11056
(5)PA
 RING
 OR
 CUTT
 ING
 OF
 BENI
 GN
 HYPE
 RKER
 ATOT
 IC
 LESI
 ON
 (EG,
 CORN
 OR
 CALL
 US);
 TWO
 TO
 FOUR
 LESI
 ONS
151..     11057
(5)PA
 RING
 OR
 CUTT
 ING
 OF
 BENI
 GN
 HYPE
 RKER
 ATOT
 IC
 LESI
 ON
 (EG,
 CORN
 OR
 CALL
 US);
 MORE
 THAN
 FOUR
 LESI
 ONS
151..     11200
(5)RE
 MOVA
 L OF
 SKIN
 TAGS
 ,
 MULT
 IPLE
 FIBR
 OCUT
 ANEO
 US
 TAGS
 ,
 ANY
 AREA
 ; UP
 TO
 AND
 INCL
 UDIN
 G 15
 LESI
 ONS
151..     11201
(5)RE
 MOVA
 L OF
 SKIN
 TAGS
 ,
 MULT
 IPLE
 FIBR
 OCUT
 ANEO
 US
 TAGS
 ,
 ANY
 AREA
 ;
 EACH
 ADDI
 TION
 AL
 TEN
 LESI
 ONS
151..     11300
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     11301
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     11302
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     11303
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 2.0
 CM
151..     11305
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     11306
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     11307
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     11308
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 OVER
 2.0
 CM
151..     11310
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     11311
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     11312
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     11313
(5)SH
 AVIN
 G OF
 EPID
 ERMA
 L OR
 DERM
 AL
 LESI
 ON,
 SING
 LE
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 2.0
 CM
151..     11730
(5)AV
 ULSI
 ON
 OF
 NAIL
 PLAT
 E,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 SIMP
 LE;
 SING
 LE
151..     11731
(5)AV
 ULSI
 ON
 OF
 NAIL
 PLAT
 E,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 SIMP
 LE;
 SECO
 ND
 NAIL
 PLAT
 E
151..     11732
(5)AV
 ULSI
 ON
 OF
 NAIL
 PLAT
 E,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 SIMP
 LE;
 EACH
 ADDI
 TION
 AL
 NAIL
 PLAT
 E
151..     11765
(5)WE
 DGE
 EXCI
 SION
 OF
 SKIN
 OF
 NAIL
 FOLD
 (EG,
 FOR
 INGR
 OWN
 TOEN
 AIL)
151..     11900
(5)IN
 JECT
 ION,
 INTR
 ALES
 IONA
 L;
 UP
 TO
 AND
 INCL
 UDIN
 G
 SEVE
 N
 LESI
 ONS
151..     11901
(5)IN
 JECT
 ION,
 INTR
 ALES
 IONA
 L;
 MORE
 THAN
 SEVE
 N
 LESI
 ONS
151..     15783
(5)DE
 RMAB
 RASI
 ON;
 SUPE
 RFIC
 IAL,
 ANY
 SITE
 ,
 (EG,
 TATT
 OO
 REMO
 VAL)
151..     15786
(5)AB
 RASI
 ON;
 SING
 LE
 LESI
 ON
 (EG,
 KERA
 TOSI
 S,
 SCAR
 )
151..     15787
(5)AB
 RASI
 ON;
 EACH
 ADDI
 TION
 AL
 FOUR
 LESI
 ONS
 OR
 LESS
151..     15788
(5)CH
 EMIC
 AL
 PEEL
 ,
 FACI
 AL;
 EPID
 ERMA
 L
151..     15789
(5)CH
 EMIC
 AL
 PEEL
 ,
 FACI
 AL;
 DERM
 AL
151..     15792
(5)CH
 EMIC
 AL
 PEEL
 ,
 NONF
 ACIA
 L;
 EPID
 ERMA
 L
151..     15793
(5)CH
 EMIC
 AL
 PEEL
 ,
 NONF
 ACIA
 L;
 DERM
 AL
[[Page 47766]]
151..     15810
(5)SA
 LABR
 ASIO
 N;
 20
 SQ
 CM
 OR
 LESS
151..     15850
(5)RE
 MOVA
 L OF
 SUTU
 RES
 UNDE
 R
 ANES
 THES
 IA
 (OTH
 ER
 THAN
 LOCA
 L),
 SAME
 SURG
 EON
151..     15851
(5)RE
 MOVA
 L OF
 SUTU
 RES
 UNDE
 R
 ANES
 THES
 IA
 (OTH
 ER
 THAN
 LOCA
 L),
 OTHE
 R
 SURG
 EON
151..     15852
(5)DR
 ESSI
 NG
 CHAN
 GE
 (FOR
 OTHE
 R
 THAN
 BURN
 S)
 UNDE
 R
 ANES
 THES
 IA
 (OTH
 ER
 THAN
 LOCA
 L)
151..     16000
(5)IN
 ITIA
 L
 TREA
 TMEN
 T,
 FIRS
 T
 DEGR
 EE
 BURN
 ,
 WHEN
 NO
 MORE
 THAN
 LOCA
 L
 TREA
 TMEN
 T IS
 REQU
 IRED
151..     16020
(5)DR
 ESSI
 NGS
 AND/
 OR
 DEBR
 IDEM
 ENT,
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT;
 WITH
 OUT
 ANES
 THES
 IA,
 OFFI
 CE
 OR
 HOSP
 ITAL
 ,
 SMAL
 L
151..     16025
(5)DR
 ESSI
 NGS
 AND/
 OR
 DEBR
 IDEM
 ENT,
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT;
 WITH
 OUT
 ANES
 THES
 IA,
 MEDI
 UM
 (EG,
 WHOL
 E
 FACE
 OR
 WHOL
 E
 EXTR
 EMIT
 Y)
151..     16030
(5)DR
 ESSI
 NGS
 AND/
 OR
 DEBR
 IDEM
 ENT,
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT;
 WITH
 OUT
 ANES
 THES
 IA,
 LARG
 E
 (EG,
 MORE
 THAN
 ONE
 EXTR
 EMIT
 Y)
151..     17250
(5)CH
 EMIC
 AL
 CAUT
 ERIZ
 ATIO
 N OF
 GRAN
 ULAT
 ION
 TISS
 UE
 (PRO
 UD
 FLES
 H,
 SINU
 S OR
 FIST
 ULA)
151..     17260
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     17261
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     17262
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     17263
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
151..     17264
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
151..     17266
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
151..     17270
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     17271
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     17272
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     17273
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
151..     17274
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
151..     17276
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
151..     17280
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
151..     17281
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
151..     17282
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
151..     17283
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
151..     17284
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
151..     17286
(5)DE
 STRU
 CTIO
 N,
 MALI
 GNAN
 T
 LESI
 ON,
 ANY
 METH
 OD,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
151..     17340
(5)CR
 YOTH
 ERAP
 Y
 (CO2
 SLUS
 H,
 LIQU
 ID
 N2)
 FOR
 ACNE
151..     17360
(5)CH
 EMIC
 AL
 EXFO
 LIAT
 ION
 FOR
 ACNE
 (EG,
 ACNE
 PAST
 E,
 ACID
 )
151..     17380
(5)EL
 ECTR
 OLYS
 IS
 EPIL
 ATIO
 N,
 EACH
 1/2
 HOUR
151..     42809
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 FROM
 PHAR
 YNX
151..     69220
(5)DE
 BRID
 EMEN
 T,
 MAST
 OIDE
 CTOM
 Y
 CAVI
 TY,
 SIMP
 LE
 (EG,
 ROUT
 INE
 CLEA
 NING
 )
152..
(1)Le         T  10.43                 $528.48               $261.71      $105.7
 vel
 II
 debr
 idem
 ent/
 dest
 ruct
 ion
152..     16010
(5)DR
 ESSI
 NGS
 AND/
 OR
 DEBR
 IDEM
 ENT,
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT;
 UNDE
 R
 ANES
 THES
 IA,
 SMAL
 L
152..     16015
(5)DR
 ESSI
 NGS
 AND/
 OR
 DEBR
 IDEM
 ENT,
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT;
 UNDE
 R
 ANES
 THES
 IA,
 MEDI
 UM
 OR
 LARG
 E,
 OR
 WITH
 MAJO
 R
 DEBR
 IDEM
 ENT
152..     46900
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 CHEM
 ICAL
152..     46910
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 ELEC
 TROD
 ESIC
 CATI
 ON
152..     46916
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 CRYO
 SURG
 ERY
152..     46917
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 LASE
 R
 SURG
 ERY
152..     46922
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 SURG
 ICAL
 EXCI
 SION
152..     46924
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 ANUS
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 EXTE
 NSIV
 E,
 ANY
 METH
 OD
152..     54050
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 CHEM
 ICAL
152..     54055
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 ELEC
 TROD
 ESIC
 CATI
 ON
152..     54056
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 CRYO
 SURG
 ERY
152..     54057
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 LASE
 R
 SURG
 ERY
152..     54060
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 SIMP
 LE;
 SURG
 ICAL
 EXCI
 SION
152..     54065
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 PENI
 S
 (EG,
 COND
 YLOM
 A,
 PAPI
 LLOM
 A,
 MOLL
 USCU
 M
 CONT
 AGIO
 SUM,
 HERP
 ETIC
 VESI
 CLE)
 ,
 EXTE
 NSIV
 E,
 ANY
 METH
 OD
152..     56501
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 VULV
 A;
 SIMP
 LE,
 ANY
 METH
 OD
152..     56515
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON(S
 ),
 VULV
 A;
 EXTE
 NSIV
 E,
 ANY
 METH
 OD
161..
(1)Le         T  3.50                  $177.34                $75.48      $35.47
 vel
 I
 exci
 sion/
 biop
 sy
161..     11100
(5)BI
 OPSY
 OF
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 (INC
 LUDI
 NG
 SIMP
 LE
 CLOS
 URE)
 ,
 UNLE
 SS
 OTHE
 RWIS
 E
 LIST
 ED
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 SING
 LE
 LESI
 ON
161..     11101
(5)BI
 OPSY
 OF
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 (INC
 LUDI
 NG
 SIMP
 LE
 CLOS
 URE)
 ,
 UNLE
 SS
 OTHE
 RWIS
 E
 LIST
 ED
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 EACH
 SEPA
 RATE/
 ADDI
 TION
 AL
 LESI
 ON
[[Page 47767]]
161..     11400
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11401
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11402
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11403
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11420
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11421
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11422
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11423
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11440
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11441
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11442
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11443
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11600
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11601
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11602
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11603
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11620
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11621
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11622
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11623
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11640
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 0.5
 CM
 OR
 LESS
161..     11641
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 0.6
 TO
 1.0
 CM
161..     11642
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 1.1
 TO
 2.0
 CM
161..     11643
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 2.1
 TO
 3.0
 CM
161..     11750
(5)EX
 CISI
 ON
 OF
 NAIL
 AND
 NAIL
 MATR
 IX,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 (EG,
 INGR
 OWN
 OR
 DEFO
 RMED
 NAIL
 )
 FOR
 PERM
 ANEN
 T
 REMO
 VAL;
161..     20520
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 IN
 MUSC
 LE
 OR
 TEND
 ON
 SHEA
 TH;
 SIMP
 LE
161..     21550
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 NECK
 OR
 THOR
 AX
161..     21920
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 BACK
 OR
 FLAN
 K;
 SUPE
 RFIC
 IAL
161..     23065
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 SHOU
 LDER
 AREA
 ;
 SUPE
 RFIC
 IAL
161..     24065
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 SUPE
 RFIC
 IAL
161..     24200
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 SUBC
 UTAN
 EOUS
161..     25065
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 SUPE
 RFIC
 IAL
161..     27613
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 LEG
 OR
 ANKL
 E
 AREA
 ;
 SUPE
 RFIC
 IAL
161..     28190
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 FOOT
 ;
 SUBC
 UTAN
 EOUS
161..     56605
(5)BI
 OPSY
 OF
 VULV
 A OR
 PERI
 NEUM
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 ONE
 LESI
 ON
161..     56606
(5)BI
 OPSY
 OF
 VULV
 A OR
 PERI
 NEUM
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 EACH
 SEPA
 RATE
 ADDI
 TION
 AL
 LESI
 ON
161..     58999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 FEMA
 LE
 GENI
 TAL
 SYST
 EM
 (NON
 OBST
 ETRI
 CAL)
161..     69100
(5)BI
 OPSY
 EXTE
 RNAL
 EAR
161..     69105
(5)BI
 OPSY
 EXTE
 RNAL
 AUDI
 TORY
 CANA
 L
162..
(1)Le         T  5.67                  $287.30               $125.43      $57.46
 vel
 II
 exci
 sion/
 biop
 sy
162..     11043
(5)DE
 BRID
 EMEN
 T;
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE,
 AND
 MUSC
 LE
162..     11044
(5)DE
 BRID
 EMEN
 T;
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE,
 MUSC
 LE,
 AND
 BONE
162..     11404
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
162..     11424
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
162..     11444
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
162..     11604
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
162..     11770
(5)EX
 CISI
 ON
 OF
 PILO
 NIDA
 L
 CYST
 OR
 SINU
 S;
 SIMP
 LE
162..     16035
(5)ES
 CHAR
 OTOM
 Y
162..     16040
(5)EX
 CISI
 ON
 BURN
 WOUN
 D,
 WITH
 OUT
 SKIN
 GRAF
 TING
 ,
 EMPL
 OYIN
 G
 ALLO
 PLAS
 TIC
 DRES
 SING
 (EG,
 SYNT
 HETI
 C
 MESH
 ),
 ANY
 ANAT
 OMIC
 SITE
 ; UP
 TO
 ONE
 PERC
 ENT
 TOTA
 L
 BODY
 SURF
 ACE
 AREA
162..     16041
(5)EX
 CISI
 ON
 BURN
 WOUN
 D,
 WITH
 OUT
 SKIN
 GRAF
 TING
 ,
 EMPL
 OYIN
 G
 ALLO
 PLAS
 TIC
 DRES
 SING
 (EG,
 SYNT
 HETI
 C
 MESH
 ),
 ANY
 ANAT
 OMIC
 SITE
 ;
 GREA
 TER
 THAN
 ONE
 PERC
 ENT
 AND
 UP
 TO
 NINE
 PERC
 ENT
 TOTA
 L
 BODY
 SURF
 ACE
 AREA
162..     16042
(5)EX
 CISI
 ON
 BURN
 WOUN
 D,
 WITH
 OUT
 SKIN
 GRAF
 TING
 ,
 EMPL
 OYIN
 G
 ALLO
 PLAS
 TIC
 DRES
 SING
 (EG,
 SYNT
 HETI
 C
 MESH
 ),
 ANY
 ANAT
 OMIC
 SITE
 ;
 EACH
 ADDI
 TION
 AL
 NINE
 PERC
 ENT
 TOTA
 L
 BODY
 SURF
 ACE
 AREA
 , OR
 PART
 THER
 EOF
162..     17304
(5)CH
 EMOS
 URGE
 RY
 (MOH
 S`
 MICR
 OGRA
 PHIC
 TECH
 NIQU
 E),
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 ALL
 GROS
 S
 TUMO
 R,
 SURG
 ICAL
 EXCI
 SION
 OF
 TISS
 UE
 SPEC
 IMEN
 S,
 MAPP
 ING,
 COLO
 R
 CODI
 NG
 OF
 SPEC
 IMEN
 S,
 MICR
 OSCO
 PIC
 EXAM
 INAT
 ION
 OF
 SPEC
 IMEN
 S BY
 THE
 SURG
 EON,
 AND
 COMP
 LETE
 HIST
 OPAT
 HOLO
 GIC
 PREP
 ARAT
 ION;
 FI
162..     17305
(5)CH
 EMOS
 URGE
 RY
 (MOH
 S`
 MICR
 OGRA
 PHIC
 TECH
 NIQU
 E),
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 ALL
 GROS
 S
 TUMO
 R,
 SURG
 ICAL
 EXCI
 SION
 OF
 TISS
 UE
 SPEC
 IMEN
 S,
 MAPP
 ING,
 COLO
 R
 CODI
 NG
 OF
 SPEC
 IMEN
 S,
 MICR
 OSCO
 PIC
 EXAM
 INAT
 ION
 OF
 SPEC
 IMEN
 S BY
 THE
 SURG
 EON,
 AND
 COMP
 LETE
 HIST
 OPAT
 HOLO
 GIC
 PREP
 ARAT
 ION;
 SE
[[Page 47768]]
162..     17306
(5)CH
 EMOS
 URGE
 RY
 (MOH
 S`
 MICR
 OGRA
 PHIC
 TECH
 NIQU
 E),
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 ALL
 GROS
 S
 TUMO
 R,
 SURG
 ICAL
 EXCI
 SION
 OF
 TISS
 UE
 SPEC
 IMEN
 S,
 MAPP
 ING,
 COLO
 R
 CODI
 NG
 OF
 SPEC
 IMEN
 S,
 MICR
 OSCO
 PIC
 EXAM
 INAT
 ION
 OF
 SPEC
 IMEN
 S BY
 THE
 SURG
 EON,
 AND
 COMP
 LETE
 HIST
 OPAT
 HOLO
 GIC
 PREP
 ARAT
 ION;
 TH
162..     17307
(5)CH
 EMOS
 URGE
 RY
 (MOH
 S`
 MICR
 OGRA
 PHIC
 TECH
 NIQU
 E),
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 ALL
 GROS
 S
 TUMO
 R,
 SURG
 ICAL
 EXCI
 SION
 OF
 TISS
 UE
 SPEC
 IMEN
 S,
 MAPP
 ING,
 COLO
 R
 CODI
 NG
 OF
 SPEC
 IMEN
 S,
 MICR
 OSCO
 PIC
 EXAM
 INAT
 ION
 OF
 SPEC
 IMEN
 S BY
 THE
 SURG
 EON,
 AND
 COMP
 LETE
 HIST
 OPAT
 HOLO
 GIC
 PREP
 ARAT
 ION;
 AD
162..     17310
(5)CH
 EMOS
 URGE
 RY
 (MOH
 S`
 MICR
 OGRA
 PHIC
 TECH
 NIQU
 E),
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 ALL
 GROS
 S
 TUMO
 R,
 SURG
 ICAL
 EXCI
 SION
 OF
 TISS
 UE
 SPEC
 IMEN
 S,
 MAPP
 ING,
 COLO
 R
 CODI
 NG
 OF
 SPEC
 IMEN
 S,
 MICR
 OSCO
 PIC
 EXAM
 INAT
 ION
 OF
 SPEC
 IMEN
 S BY
 THE
 SURG
 EON,
 AND
 COMP
 LETE
 HIST
 OPAT
 HOLO
 GIC
 PREP
 ARAT
 ION;
 MO
162..     20200
(5)BI
 OPSY
 ,
 MUSC
 LE;
 SUPE
 RFIC
 IAL
162..     20205
(5)BI
 OPSY
 ,
 MUSC
 LE;
 DEEP
162..     20220
(5)BI
 OPSY
 ,
 BONE
 ,
 TROC
 AR,
 OR
 NEED
 LE;
 SUPE
 RFIC
 IAL
 (EG,
 ILIU
 M,
 STER
 NUM,
 SPIN
 OUS
 PROC
 ESS,
 RIBS
 )
162..     20225
(5)BI
 OPSY
 ,
 BONE
 ,
 TROC
 AR,
 OR
 NEED
 LE;
 DEEP
 (VER
 TEBR
 AL
 BODY
 ,
 FEMU
 R)
162..     20670
(5)RE
 MOVA
 L OF
 IMPL
 ANT;
 SUPE
 RFIC
 IAL,
 (EG,
 BURI
 ED
 WIRE
 ,
 PIN
 OR
 ROD)
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
162..     23000
(5)RE
 MOVA
 L OF
 SUBD
 ELTO
 ID
 (OR
 INTR
 ATEN
 DINO
 US)
 CALC
 AREO
 US
 DEPO
 SITS
 ,
 OPEN
 METH
 OD
162..     23075
(5)EX
 CISI
 ON,
 TUMO
 R,
 SHOU
 LDER
 AREA
 ;
 SUBC
 UTAN
 EOUS
162..     24075
(5)EX
 CISI
 ON,
 TUMO
 R,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 SUBC
 UTAN
 EOUS
162..     25075
(5)EX
 CISI
 ON,
 TUMO
 R,
 FORE
 ARM
 AND/
 OR
 WRIS
 T
 AREA
 ;
 SUBC
 UTAN
 EOUS
162..     27040
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 PELV
 IS
 AND
 HIP
 AREA
 ;
 SUPE
 RFIC
 IAL
162..     27323
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 THIG
 H OR
 KNEE
 AREA
 ;
 SUPE
 RFIC
 IAL
162..     28043
(5)EX
 CISI
 ON,
 TUMO
 R,
 FOOT
 ;
 SUBC
 UTAN
 EOUS
162..     37609
(5)LI
 GATI
 ON
 OR
 BIOP
 SY,
 TEMP
 ORAL
 ARTE
 RY
162..     37799
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 VASC
 ULAR
 SURG
 ERY
162..     54100
(5)BI
 OPSY
 OF
 PENI
 S;
 CUTA
 NEOU
 S
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
162..     54105
(5)BI
 OPSY
 OF
 PENI
 S;
 DEEP
 STRU
 CTUR
 ES
162..     67350
(5)BI
 OPSY
 OF
 EXTR
 AOCU
 LAR
 MUSC
 LE
162..     67399
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 OCUL
 AR
 MUSC
 LE
162..     68100
(5)BI
 OPSY
 OF
 CONJ
 UNCT
 IVA
162..     68110
(5)EX
 CISI
 ON
 OF
 LESI
 ON,
 CONJ
 UNCT
 IVA;
 UP
 TO 1
 CM
162..     68115
(5)EX
 CISI
 ON
 OF
 LESI
 ON,
 CONJ
 UNCT
 IVA;
 OVER
 1 CM
162..     68135
(5)DE
 STRU
 CTIO
 N OF
 LESI
 ON,
 CONJ
 UNCT
 IVA
162..     68399
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 CONJ
 UNCT
 IVA
163..
(1)Le         T  10.69                 $541.66               $264.65     $108.33
 vel
 III
 exci
 sion/
 biop
 sy
163..     10121
(5)IN
 CISI
 ON
 AND
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UES;
 COMP
 LICA
 TED
163..     11010
(5)DE
 BRID
 EMEN
 T
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 FORE
 IGN
 MATE
 RIAL
 ASSO
 CIAT
 ED
 WITH
 OPEN
 FRAC
 TURE
 (S)
 AND/
 OR
 DISL
 OCAT
 ION(
 S);
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UES
163..     11011
(5)DE
 BRID
 EMEN
 T
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 FORE
 IGN
 MATE
 RIAL
 ASSO
 CIAT
 ED
 WITH
 OPEN
 FRAC
 TURE
 (S)
 AND/
 OR
 DISL
 OCAT
 ION(
 S);
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE,
 MUSC
 LE
 FASC
 IA,
 AND
 MUSC
 LE
163..     11012
(5)DE
 BRID
 EMEN
 T
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 FORE
 IGN
 MATE
 RIAL
 ASSO
 CIAT
 ED
 WITH
 OPEN
 FRAC
 TURE
 (S)
 AND/
 OR
 DISL
 OCAT
 ION(
 S);
 SKIN
 ,
 SUBC
 UTAN
 EOUS
 TISS
 UE,
 MUSC
 LE
 FASC
 IA,
 MUSC
 LE,
 AND
 BONE
163..     11406
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 TRUN
 K,
 ARMS
 OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
163..     11426
(5)EX
 CISI
 ON,
 BENI
 GN
 LESI
 ON,
 EXCE
 PT
 SKIN
 TAG
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
163..     11446
(5)EX
 CISI
 ON,
 OTHE
 R
 BENI
 GN
 LESI
 ON
 (UNL
 ESS
 LIST
 ED
 ELSE
 WHER
 E),
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ,
 MUCO
 US
 MEMB
 RANE
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
163..     11450
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 AXIL
 LARY
 ;
 WITH
 SIMP
 LE
 OR
 INTE
 RMED
 IATE
 REPA
 IR
163..     11451
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 AXIL
 LARY
 ;
 WITH
 COMP
 LEX
 REPA
 IR
163..     11462
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 INGU
 INAL
 ;
 WITH
 SIMP
 LE
 OR
 INTE
 RMED
 IATE
 REPA
 IR
163..     11463
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 INGU
 INAL
 ;
 WITH
 COMP
 LEX
 REPA
 IR
163..     11470
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 PERI
 ANAL
 ,
 PERI
 NEAL
 , OR
 UMBI
 LICA
 L;
 WITH
 SIMP
 LE
 OR
 INTE
 RMED
 IATE
 REPA
 IR
163..     11471
(5)EX
 CISI
 ON
 OF
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 FOR
 HIDR
 ADEN
 ITIS
 ,
 PERI
 ANAL
 ,
 PERI
 NEAL
 , OR
 UMBI
 LICA
 L;
 WITH
 COMP
 LEX
 REPA
 IR
163..     11606
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 TRUN
 K,
 ARMS
 , OR
 LEGS
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
163..     11624
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
163..     11626
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 SCAL
 P,
 NECK
 ,
 HAND
 S,
 FEET
 ,
 GENI
 TALI
 A;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
163..     11644
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 3.1
 TO
 4.0
 CM
163..     11646
(5)EX
 CISI
 ON,
 MALI
 GNAN
 T
 LESI
 ON,
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 ;
 LESI
 ON
 DIAM
 ETER
 OVER
 4.0
 CM
163..     11752
(5)EX
 CISI
 ON
 OF
 NAIL
 AND
 NAIL
 MATR
 IX,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 (EG,
 INGR
 OWN
 OR
 DEFO
 RMED
 NAIL
 )
 FOR
 PERM
 ANEN
 T
 REMO
 VAL;
 WITH
 AMPU
 TATI
 ON
 OF
 TUFT
 OF
 DIST
 AL
 PHAL
 ANX
163..     11771
(5)EX
 CISI
 ON
 OF
 PILO
 NIDA
 L
 CYST
 OR
 SINU
 S;
 EXTE
 NSIV
 E
163..     11772
(5)EX
 CISI
 ON
 OF
 PILO
 NIDA
 L
 CYST
 OR
 SINU
 S;
 COMP
 LICA
 TED
163..     11971
(5)RE
 MOVA
 L OF
 TISS
 UE
 EXPA
 NDER
 (S)
 WITH
 OUT
 INSE
 RTIO
 N OF
 PROS
 THES
 IS
163..     15780
(5)DE
 RMAB
 RASI
 ON;
 TOTA
 L
 FACE
 (EG,
 FOR
 ACNE
 SCAR
 RING
 ,
 FINE
 WRIN
 KLIN
 G,
 RHYT
 IDS,
 GENE
 RAL
 KERA
 TOSI
 S)
163..     15781
(5)DE
 RMAB
 RASI
 ON;
 SEGM
 ENTA
 L,
 FACE
163..     15782
(5)DE
 RMAB
 RASI
 ON;
 REGI
 ONAL
 ,
 OTHE
 R
 THAN
 FACE
163..     15811
(5)SA
 LABR
 ASIO
 N;
 OVER
 20
 SQ
 CM
163..     15838
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 SUBM
 ENTA
 L
 FAT
 PAD
163..     15920
(5)EX
 CISI
 ON,
 COCC
 YGEA
 L
 PRES
 SURE
 ULCE
 R,
 WITH
 COCC
 YGEC
 TOMY
 ;
 WITH
 PRIM
 ARY
 SUTU
 RE
163..     15931
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
163..     15933
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
 WITH
 OSTE
 CTOM
 Y
163..     15940
(5)EX
 CISI
 ON,
 ISCH
 IAL
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
163..     15941
(5)EX
 CISI
 ON,
 ISCH
 IAL
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
 WITH
 OSTE
 CTOM
 Y
 (ISC
 HIEC
 TOMY
 )
163..     15950
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
163..     15951
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 PRIM
 ARY
 SUTU
 RE;
 WITH
 OSTE
 CTOM
 Y
163..     15999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 EXCI
 SION
 PRES
 SURE
 ULCE
 R
[[Page 47769]]
163..     20240
(5)BI
 OPSY
 ,
 EXCI
 SION
 AL;
 SUPE
 RFIC
 IAL
 (EG,
 ILIU
 M,
 STER
 NUM,
 SPIN
 OUS
 PROC
 ESS,
 RIBS
 ,
 TROC
 HANT
 ER
 OF
 FEMU
 R)
163..     20245
(5)BI
 OPSY
 ,
 EXCI
 SION
 AL;
 DEEP
 (EG,
 HUME
 RUS,
 ISCH
 IUM,
 FEMU
 R)
163..     20525
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 IN
 MUSC
 LE
 OR
 TEND
 ON
 SHEA
 TH;
 DEEP
 OR
 COMP
 LICA
 TED
163..     20680
(5)RE
 MOVA
 L OF
 IMPL
 ANT;
 DEEP
 (EG,
 BURI
 ED
 WIRE
 ,
 PIN,
 SCRE
 W,
 META
 L
 BAND
 ,
 NAIL
 ,
 ROD
 OR
 PLAT
 E)
163..     21555
(5)EX
 CISI
 ON
 TUMO
 R,
 SOFT
 TISS
 UE
 OF
 NECK
 OR
 THOR
 AX;
 SUBC
 UTAN
 EOUS
163..     21556
(5)EX
 CISI
 ON
 TUMO
 R,
 SOFT
 TISS
 UE
 OF
 NECK
 OR
 THOR
 AX;
 DEEP
 ,
 SUBF
 ASCI
 AL,
 INTR
 AMUS
 CULA
 R
163..     21925
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 BACK
 OR
 FLAN
 K;
 DEEP
163..     21930
(5)EX
 CISI
 ON,
 TUMO
 R,
 SOFT
 TISS
 UE
 OF
 BACK
 OR
 FLAN
 K
163..     21935
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 BACK
 OR
 FLAN
 K
163..     22900
(5)EX
 CISI
 ON,
 ABDO
 MINA
 L
 WALL
 TUMO
 R,
 SUBF
 ASCI
 AL
 (EG,
 DESM
 OID)
163..     22999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 ABDO
 MEN,
 MUSC
 ULOS
 KELE
 TAL
 SYST
 EM
163..     23066
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 SHOU
 LDER
 AREA
 ;
 DEEP
163..     23076
(5)EX
 CISI
 ON,
 TUMO
 R,
 SHOU
 LDER
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL,
 OR
 INTR
 AMUS
 CULA
 R
163..     23077
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 SHOU
 LDER
 AREA
163..     23330
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 SHOU
 LDER
 ;
 SUBC
 UTAN
 EOUS
163..     23331
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 SHOU
 LDER
 ;
 DEEP
 (EG,
 NEER
 PROS
 THES
 IS
 REMO
 VAL)
163..     24066
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 DEEP
163..     24076
(5)EX
 CISI
 ON,
 TUMO
 R,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL
 OR
 INTR
 AMUS
 CULA
 R
163..     24077
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
163..     24201
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 UPPE
 R
 ARM
 OR
 ELBO
 W
 AREA
 ;
 DEEP
163..     25066
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 DEEP
163..     25076
(5)EX
 CISI
 ON,
 TUMO
 R,
 FORE
 ARM
 AND/
 OR
 WRIS
 T
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL
 OR
 INTR
 AMUS
 CULA
 R
163..     25077
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 FORE
 ARM
 AND/
 OR
 WRIS
 T
 AREA
163..     26115
(5)EX
 CISI
 ON,
 TUMO
 R OR
 VASC
 ULAR
 MALF
 ORMA
 TION
 ,
 HAND
 OR
 FING
 ER;
 SUBC
 UTAN
 EOUS
163..     26116
(5)EX
 CISI
 ON,
 TUMO
 R OR
 VASC
 ULAR
 MALF
 ORMA
 TION
 ,
 HAND
 OR
 FING
 ER;
 DEEP
 ,
 SUBF
 ASCI
 AL,
 INTR
 AMUS
 CULA
 R
163..     26117
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 HAND
 OR
 FING
 ER
163..     26320
(5)RE
 MOVA
 L OF
 IMPL
 ANT
 FROM
 FING
 ER
 OR
 HAND
163..     27041
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 PELV
 IS
 AND
 HIP
 AREA
 ;
 DEEP
163..     27047
(5)EX
 CISI
 ON,
 TUMO
 R,
 PELV
 IS
 AND
 HIP
 AREA
 ;
 SUBC
 UTAN
 EOUS
163..     27048
(5)EX
 CISI
 ON,
 TUMO
 R,
 PELV
 IS
 AND
 HIP
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL,
 INTR
 AMUS
 CULA
 R
163..     27049
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 PELV
 IS
 AND
 HIP
 AREA
163..     27324
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 THIG
 H OR
 KNEE
 AREA
 ;
 DEEP
163..     27327
(5)EX
 CISI
 ON,
 TUMO
 R,
 THIG
 H OR
 KNEE
 AREA
 ;
 SUBC
 UTAN
 EOUS
163..     27328
(5)EX
 CISI
 ON,
 TUMO
 R,
 THIG
 H OR
 KNEE
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL,
 OR
 INTR
 AMUS
 CULA
 R
163..     27329
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 THIG
 H OR
 KNEE
 AREA
163..     27372
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 DEEP
 ,
 THIG
 H
 REGI
 ON
 OR
 KNEE
 AREA
163..     27614
(5)BI
 OPSY
 ,
 SOFT
 TISS
 UE
 OF
 LEG
 OR
 ANKL
 E
 AREA
 ;
 DEEP
163..     27618
(5)EX
 CISI
 ON,
 TUMO
 R,
 LEG
 OR
 ANKL
 E
 AREA
 ;
 SUBC
 UTAN
 EOUS
163..     27619
(5)EX
 CISI
 ON,
 TUMO
 R,
 LEG
 OR
 ANKL
 E
 AREA
 ;
 DEEP
 ,
 SUBF
 ASCI
 AL
 OR
 INTR
 AMUS
 CULA
 R
163..     28192
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 FOOT
 ;
 DEEP
163..     28193
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 FOOT
 ;
 COMP
 LICA
 TED
163..     69110
(5)EX
 CISI
 ON
 EXTE
 RNAL
 EAR;
 PART
 IAL,
 SIMP
 LE
 REPA
 IR
163..     69145
(5)EX
 CISI
 ON
 SOFT
 TISS
 UE
 LESI
 ON,
 EXTE
 RNAL
 AUDI
 TORY
 CANA
 L
163..     69205
(5)RE
 MOVA
 L
 FORE
 IGN
 BODY
 FROM
 EXTE
 RNAL
 AUDI
 TORY
 CANA
 L;
 WITH
 GENE
 RAL
 ANES
 THES
 IA
181..
(1)Le         T  2.19                  $110.97                $43.84      $22.19
 vel
 I
 skin
 repa
 ir
181..     11760
(5)RE
 PAIR
 OF
 NAIL
 BED
181..     11762
(5)RE
 CONS
 TRUC
 TION
 OF
 NAIL
 BED
 WITH
 GRAF
 T
181..     11920
(5)TA
 TTOO
 ING,
 INTR
 ADER
 MAL
 INTR
 ODUC
 TION
 OF
 INSO
 LUBL
 E
 OPAQ
 UE
 PIGM
 ENTS
 TO
 CORR
 ECT
 COLO
 R
 DEFE
 CTS
 OF
 SKIN
 ,
 INCL
 UDIN
 G
 MICR
 OPIG
 MENT
 ATIO
 N;
 6.0
 SQ
 CM
 OR
 LESS
181..     11921
(5)TA
 TTOO
 ING,
 INTR
 ADER
 MAL
 INTR
 ODUC
 TION
 OF
 INSO
 LUBL
 E
 OPAQ
 UE
 PIGM
 ENTS
 TO
 CORR
 ECT
 COLO
 R
 DEFE
 CTS
 OF
 SKIN
 ,
 INCL
 UDIN
 G
 MICR
 OPIG
 MENT
 ATIO
 N;
 6.1
 TO
 20.0
 SQ
 CM
181..     11922
(5)TA
 TTOO
 ING,
 INTR
 ADER
 MAL
 INTR
 ODUC
 TION
 OF
 INSO
 LUBL
 E
 OPAQ
 UE
 PIGM
 ENTS
 TO
 CORR
 ECT
 COLO
 R
 DEFE
 CTS
 OF
 SKIN
 ,
 INCL
 UDIN
 G
 MICR
 OPIG
 MENT
 ATIO
 N;
 EACH
 ADDI
 TION
 AL
 20.0
 SQ
 CM
181..     11950
(5)SU
 BCUT
 ANEO
 US
 INJE
 CTIO
 N OF
 ''FI
 LLIN
 G''
 MATE
 RIAL
 (EG,
 COLL
 AGEN
 ); 1
 CC
 OR
 LESS
181..     11951
(5)SU
 BCUT
 ANEO
 US
 INJE
 CTIO
 N OF
 ''FI
 LLIN
 G''
 MATE
 RIAL
 (EG,
 COLL
 AGEN
 );
 1.1
 TO
 5.0
 CC
181..     11952
(5)SU
 BCUT
 ANEO
 US
 INJE
 CTIO
 N OF
 ''FI
 LLIN
 G''
 MATE
 RIAL
 (EG,
 COLL
 AGEN
 );
 5.1
 TO
 10.0
 CC
181..     11954
(5)SU
 BCUT
 ANEO
 US
 INJE
 CTIO
 N OF
 ''FI
 LLIN
 G''
 MATE
 RIAL
 (EG,
 COLL
 AGEN
 );
 OVER
 10.0
 CC
181..     12001
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 2.5
 CM
 OR
 LESS
181..     12002
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 2.6
 CM
 TO
 7.5
 CM
181..     12004
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 7.6
 CM
 TO
 12.5
 CM
181..     12005
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 12.6
 CM
 TO
 20.0
 CM
181..     12006
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 20.1
 CM
 TO
 30.0
 CM
181..     12007
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 SCAL
 P,
 NECK
 ,
 AXIL
 LAE,
 EXTE
 RNAL
 GENI
 TALI
 A,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (INC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 OVER
 30.0
 CM
181..     12011
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 2.5
 CM
 OR
 LESS
181..     12013
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 2.6
 CM
 TO
 5.0
 CM
181..     12014
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 5.1
 CM
 TO
 7.5
 CM
181..     12015
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 7.6
 CM
 TO
 12.5
 CM
181..     12016
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 12.6
 CM
 TO
 20.0
 CM
[[Page 47770]]
181..     12017
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 20.1
 CM
 TO
 30.0
 CM
181..     12018
(5)SI
 MPLE
 REPA
 IR
 OF
 SUPE
 RFIC
 IAL
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 OVER
 30.0
 CM
181..     12020
(5)TR
 EATM
 ENT
 OF
 SUPE
 RFIC
 IAL
 WOUN
 D
 DEHI
 SCEN
 CE;
 SIMP
 LE
 CLOS
 URE
181..     12021
(5)TR
 EATM
 ENT
 OF
 SUPE
 RFIC
 IAL
 WOUN
 D
 DEHI
 SCEN
 CE;
 WITH
 PACK
 ING
181..     12031
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 2.5
 CM
 OR
 LESS
181..     12032
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 2.6
 CM
 TO
 7.5
 CM
181..     12034
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 7.6
 CM
 TO
 12.5
 CM
181..     12035
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 12.6
 CM
 TO
 20.0
 CM
181..     12036
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 20.1
 CM
 TO
 30.0
 CM
181..     12041
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 2.5
 CM
 OR
 LESS
181..     12042
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 2.6
 CM
 TO
 7.5
 CM
181..     12044
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 7.6
 CM
 TO
 12.5
 CM
181..     12045
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 12.6
 CM
 TO
 20.0
 CM
181..     12046
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 20.1
 CM
 TO
 30.0
 CM
181..     12051
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 2.5
 CM
 OR
 LESS
181..     12052
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 2.6
 CM
 TO
 5.0
 CM
181..     12053
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 5.1
 CM
 TO
 7.5
 CM
181..     12054
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 7.6
 CM
 TO
 12.5
 CM
181..     12055
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 12.6
 CM
 TO
 20.0
 CM
181..     12056
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 20.1
 CM
 TO
 30.0
 CM
181..     20500
(5)IN
 JECT
 ION
 OF
 SINU
 S
 TRAC
 T;
 THER
 APEU
 TIC
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
182..
(1)Le         T  4.                    $202.68                $84.98      $40.54
 vel
 II
 skin
 repa
 ir
182..     13100
(5)RE
 PAIR
 ,
 COMP
 LEX,
 TRUN
 K;
 1.1
 CM
 TO
 2.5
 CM
182..     13101
(5)RE
 PAIR
 ,
 COMP
 LEX,
 TRUN
 K;
 2.6
 CM
 TO
 7.5
 CM
182..     13120
(5)RE
 PAIR
 ,
 COMP
 LEX,
 SCAL
 P,
 ARMS
 ,
 AND/
 OR
 LEGS
 ;
 1.1
 CM
 TO
 2.5
 CM
182..     13121
(5)RE
 PAIR
 ,
 COMP
 LEX,
 SCAL
 P,
 ARMS
 ,
 AND/
 OR
 LEGS
 ;
 2.6
 CM
 TO
 7.5
 CM
182..     13131
(5)RE
 PAIR
 ,
 COMP
 LEX,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S
 AND/
 OR
 FEET
 ;
 1.1
 CM
 TO
 2.5
 CM
182..     13132
(5)RE
 PAIR
 ,
 COMP
 LEX,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S
 AND/
 OR
 FEET
 ;
 2.6
 CM
 TO
 7.5
 CM
182..     13150
(5)RE
 PAIR
 ,
 COMP
 LEX,
 EYEL
 IDS,
 NOSE
 ,
 EARS
 AND/
 OR
 LIPS
 ;
 1.0
 CM
 OR
 LESS
182..     13151
(5)RE
 PAIR
 ,
 COMP
 LEX,
 EYEL
 IDS,
 NOSE
 ,
 EARS
 AND/
 OR
 LIPS
 ;
 1.1
 CM
 TO
 2.5
 CM
182..     13152
(5)RE
 PAIR
 ,
 COMP
 LEX,
 EYEL
 IDS,
 NOSE
 ,
 EARS
 AND/
 OR
 LIPS
 ;
 2.6
 CM
 TO
 7.5
 CM
182..     13160
(5)SE
 COND
 ARY
 CLOS
 URE
 OF
 SURG
 ICAL
 WOUN
 D OR
 DEHI
 SCEN
 CE,
 EXTE
 NSIV
 E OR
 COMP
 LICA
 TED
182..     13300
(5)RE
 PAIR
 ,
 UNUS
 UAL,
 COMP
 LICA
 TED,
 OVER
 7.5
 CM,
 ANY
 AREA
182..     43870
(5)CL
 OSUR
 E OF
 GAST
 ROST
 OMY,
 SURG
 ICAL
183..
(1)Le         T  11.17                 $565.98               $286.46     $113.20
 vel
 III
 skin
 repa
 ir
183..     11960
(5)IN
 SERT
 ION
 OF
 TISS
 UE
 EXPA
 NDER
 (S)
 FOR
 OTHE
 R
 THAN
 BREA
 ST,
 INCL
 UDIN
 G
 SUBS
 EQUE
 NT
 EXPA
 NSIO
 N
183..     11970
(5)RE
 PLAC
 EMEN
 T OF
 TISS
 UE
 EXPA
 NDER
 WITH
 PERM
 ANEN
 T
 PROS
 THES
 IS
183..     12037
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 SCAL
 P,
 AXIL
 LAE,
 TRUN
 K
 AND/
 OR
 EXTR
 EMIT
 IES
 (EXC
 LUDI
 NG
 HAND
 S
 AND
 FEET
 );
 OVER
 30.0
 CM
183..     12047
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 NECK
 ,
 HAND
 S,
 FEET
 AND/
 OR
 EXTE
 RNAL
 GENI
 TALI
 A;
 OVER
 30.0
 CM
183..     12057
(5)LA
 YER
 CLOS
 URE
 OF
 WOUN
 DS
 OF
 FACE
 ,
 EARS
 ,
 EYEL
 IDS,
 NOSE
 ,
 LIPS
 AND/
 OR
 MUCO
 US
 MEMB
 RANE
 S;
 OVER
 30.0
 CM
183..     14000
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 TRUN
 K;
 DEFE
 CT
 10
 SQ
 CM
 OR
 LESS
183..     14001
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 TRUN
 K;
 DEFE
 CT
 10.1
 SQ
 CM
 TO
 30.0
 SQ
 CM
183..     14020
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 SCAL
 P,
 ARMS
 AND/
 OR
 LEGS
 ;
 DEFE
 CT
 10
 SQ
 CM
 OR
 LESS
183..     14021
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 SCAL
 P,
 ARMS
 AND/
 OR
 LEGS
 ;
 DEFE
 CT
 10.1
 SQ
 CM
 TO
 30.0
 SQ
 CM
183..     14040
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S
 AND/
 OR
 FEET
 ;
 DEFE
 CT
 10
 SQ
 CM
 OR
 LESS
183..     14041
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S
 AND/
 OR
 FEET
 ;
 DEFE
 CT
 10.1
 SQ
 CM
 TO
 30.0
 SQ
 CM
183..     14060
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 EYEL
 IDS,
 NOSE
 ,
 EARS
 AND/
 OR
 LIPS
 ;
 DEFE
 CT
 10
 SQ
 CM
 OR
 LESS
183..     14061
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 EYEL
 IDS,
 NOSE
 ,
 EARS
 AND/
 OR
 LIPS
 ;
 DEFE
 CT
 10.1
 SQ
 CM
 TO
 30.0
 SQ
 CM
183..     14300
(5)AD
 JACE
 NT
 TISS
 UE
 TRAN
 SFER
 OR
 REAR
 RANG
 EMEN
 T,
 MORE
 THAN
 30
 SQ
 CM,
 UNUS
 UAL
 OR
 COMP
 LICA
 TED,
 ANY
 AREA
183..     14350
(5)FI
 LLET
 ED
 FING
 ER
 OR
 TOE
 FLAP
 ,
 INCL
 UDIN
 G
 PREP
 ARAT
 ION
 OF
 RECI
 PIEN
 T
 SITE
183..     15000
(5)EX
 CISI
 ONAL
 PREP
 ARAT
 ION
 OR
 CREA
 TION
 OF
 RECI
 PIEN
 T
 SITE
 BY
 EXCI
 SION
 OF
 ESSE
 NTIA
 LLY
 INTA
 CT
 SKIN
 (INC
 LUDI
 NG
 SUBC
 UTAN
 EOUS
 TISS
 UES)
 ,
 SCAR
 , OR
 OTHE
 R
 LESI
 ON
 PRIO
 R TO
 REPA
 IR
 WITH
 FREE
 SKIN
 GRAF
 T
 (LIS
 T AS
 SEPA
 RATE
 SERV
 ICE
 IN
 ADDI
 TION
 TO
 SKIN
 GRAF
 T)
183..     15050
(5)PI
 NCH
 GRAF
 T,
 SING
 LE
 OR
 MULT
 IPLE
 , TO
 COVE
 R
 SMAL
 L
 ULCE
 R,
 TIP
 OF
 DIGI
 T,
 OR
 OTHE
 R
 MINI
 MAL
 OPEN
 AREA
 (EXC
 EPT
 ON
 FACE
 ),
 UP
 TO
 DEFE
 CT
 SIZE
 2 CM
 DIAM
 ETER
183..     15100
(5)SP
 LIT
 GRAF
 T,
 TRUN
 K,
 SCAL
 P,
 ARMS
 ,
 LEGS
 ,
 HAND
 S,
 AND/
 OR
 FEET
 (EXC
 EPT
 MULT
 IPLE
 DIGI
 TS);
 100
 SQ
 CM
 OR
 LESS
 , OR
 EACH
 ONE
 PERC
 ENT
 OF
 BODY
 AREA
 OF
 INFA
 NTS
 AND
 CHIL
 DREN
 (EXC
 EPT
 1505
 0)
183..     15101
(5)SP
 LIT
 GRAF
 T,
 TRUN
 K,
 SCAL
 P,
 ARMS
 ,
 LEGS
 ,
 HAND
 S,
 AND/
 OR
 FEET
 (EXC
 EPT
 MULT
 IPLE
 DIGI
 TS);
 EACH
 ADDI
 TION
 AL
 100
 SQ
 CM,
 OR
 EACH
 ONE
 PERC
 ENT
 OF
 BODY
 AREA
 OF
 INFA
 NTS
 AND
 CHIL
 DREN
 , OR
 PART
 THER
 EOF
183..     15120
(5)SP
 LIT
 GRAF
 T,
 FACE
 ,
 EYEL
 IDS,
 MOUT
 H,
 NECK
 ,
 EARS
 ,
 ORBI
 TS,
 GENI
 TALI
 A,
 AND/
 OR
 MULT
 IPLE
 DIGI
 TS;
 100
 SQ
 CM
 OR
 LESS
 , OR
 EACH
 ONE
 PERC
 ENT
 OF
 BODY
 AREA
 OF
 INFA
 NTS
 AND
 CHIL
 DREN
 (EXC
 EPT
 1505
 0)
183..     15121
(5)SP
 LIT
 GRAF
 T,
 FACE
 ,
 EYEL
 IDS,
 MOUT
 H,
 NECK
 ,
 EARS
 ,
 ORBI
 TS,
 GENI
 TALI
 A,
 AND/
 OR
 MULT
 IPLE
 DIGI
 TS;
 EACH
 ADDI
 TION
 AL
 100
 SQ
 CM,
 OR
 EACH
 ONE
 PERC
 ENT
 OF
 BODY
 AREA
 OF
 INFA
 NTS
 AND
 CHIL
 DREN
 , OR
 PART
 THER
 EOF
183..     15200
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 TRUN
 K;
 20
 SQ
 CM
 OR
 LESS
183..     15201
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 TRUN
 K;
 EACH
 ADDI
 TION
 AL
 20
 SQ
 CM
183..     15220
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 SCAL
 P,
 ARMS
 ,
 AND/
 OR
 LEGS
 ; 20
 SQ
 CM
 OR
 LESS
183..     15221
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 SCAL
 P,
 ARMS
 ,
 AND/
 OR
 LEGS
 ;
 EACH
 ADDI
 TION
 AL
 20
 SQ
 CM
183..     15240
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S,
 AND/
 OR
 FEET
 ; 20
 SQ
 CM
 OR
 LESS
[[Page 47771]]
183..     15241
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S,
 AND/
 OR
 FEET
 ;
 EACH
 ADDI
 TION
 AL
 20
 SQ
 CM
183..     15260
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 NOSE
 ,
 EARS
 ,
 EYEL
 IDS,
 AND/
 OR
 LIPS
 ; 20
 SQ
 CM
 OR
 LESS
183..     15261
(5)FU
 LL
 THIC
 KNES
 S
 GRAF
 T,
 FREE
 ,
 INCL
 UDIN
 G
 DIRE
 CT
 CLOS
 URE
 OF
 DONO
 R
 SITE
 ,
 NOSE
 ,
 EARS
 ,
 EYEL
 IDS,
 AND/
 OR
 LIPS
 ;
 EACH
 ADDI
 TION
 AL
 20
 SQ
 CM
183..     15350
(5)AP
 PLIC
 ATIO
 N OF
 ALLO
 GRAF
 T,
 SKIN
183..     15400
(5)AP
 PLIC
 ATIO
 N OF
 XENO
 GRAF
 T,
 SKIN
183..     15570
(5)FO
 RMAT
 ION
 OF
 DIRE
 CT
 OR
 TUBE
 D
 PEDI
 CLE,
 WITH
 OR
 WITH
 OUT
 TRAN
 SFER
 ;
 TRUN
 K
183..     15572
(5)FO
 RMAT
 ION
 OF
 DIRE
 CT
 OR
 TUBE
 D
 PEDI
 CLE,
 WITH
 OR
 WITH
 OUT
 TRAN
 SFER
 ;
 SCAL
 P,
 ARMS
 , OR
 LEGS
183..     15574
(5)FO
 RMAT
 ION
 OF
 DIRE
 CT
 OR
 TUBE
 D
 PEDI
 CLE,
 WITH
 OR
 WITH
 OUT
 TRAN
 SFER
 ;
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 MOUT
 H,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S OR
 FEET
183..     15576
(5)FO
 RMAT
 ION
 OF
 DIRE
 CT
 OR
 TUBE
 D
 PEDI
 CLE,
 WITH
 OR
 WITH
 OUT
 TRAN
 SFER
 ;
 EYEL
 IDS,
 NOSE
 ,
 EARS
 ,
 LIPS
 , OR
 INTR
 AORA
 L
183..     15580
(5)CR
 OSS
 FING
 ER
 FLAP
 ,
 INCL
 UDIN
 G
 FREE
 GRAF
 T TO
 DONO
 R
 SITE
183..     15600
(5)DE
 LAY
 OF
 FLAP
 OR
 SECT
 IONI
 NG
 OF
 FLAP
 (DIV
 ISIO
 N
 AND
 INSE
 T);
 AT
 TRUN
 K
183..     15610
(5)DE
 LAY
 OF
 FLAP
 OR
 SECT
 IONI
 NG
 OF
 FLAP
 (DIV
 ISIO
 N
 AND
 INSE
 T);
 AT
 SCAL
 P,
 ARMS
 , OR
 LEGS
183..     15620
(5)DE
 LAY
 OF
 FLAP
 OR
 SECT
 IONI
 NG
 OF
 FLAP
 (DIV
 ISIO
 N
 AND
 INSE
 T);
 AT
 FORE
 HEAD
 ,
 CHEE
 KS,
 CHIN
 ,
 NECK
 ,
 AXIL
 LAE,
 GENI
 TALI
 A,
 HAND
 S
 (EXC
 EPT
 1562
 5),
 OR
 FEET
183..     15625
(5)DE
 LAY
 OF
 FLAP
 OR
 SECT
 IONI
 NG
 OF
 FLAP
 (DIV
 ISIO
 N
 AND
 INSE
 T);
 SECT
 ION
 PEDI
 CLE
 OF
 CROS
 S
 FING
 ER
 FLAP
183..     15630
(5)DE
 LAY
 OF
 FLAP
 OR
 SECT
 IONI
 NG
 OF
 FLAP
 (DIV
 ISIO
 N
 AND
 INSE
 T);
 AT
 EYEL
 IDS,
 NOSE
 ,
 EARS
 , OR
 LIPS
183..     15650
(5)TR
 ANSF
 ER,
 INTE
 RMED
 IATE
 , OF
 ANY
 PEDI
 CLE
 FLAP
 (EG,
 ABDO
 MEN
 TO
 WRIS
 T,
 ``WA
 LKIN
 G''
 TUBE
 ),
 ANY
 LOCA
 TION
183..     15775
(5)PU
 NCH
 GRAF
 T
 FOR
 HAIR
 TRAN
 SPLA
 NT;
 1 TO
 15
 PUNC
 H
 GRAF
 TS
183..     15776
(5)PU
 NCH
 GRAF
 T
 FOR
 HAIR
 TRAN
 SPLA
 NT;
 MORE
 THAN
 15
 PUNC
 H
 GRAF
 TS
183..     15819
(5)CE
 RVIC
 OPLA
 STY
183..     15820
(5)BL
 EPHA
 ROPL
 ASTY
 ,
 LOWE
 R
 EYEL
 ID
183..     15821
(5)BL
 EPHA
 ROPL
 ASTY
 ,
 LOWE
 R
 EYEL
 ID;
 WITH
 EXTE
 NSIV
 E
 HERN
 IATE
 D
 FAT
 PAD
183..     15822
(5)BL
 EPHA
 ROPL
 ASTY
 ,
 UPPE
 R
 EYEL
 ID
183..     15823
(5)BL
 EPHA
 ROPL
 ASTY
 ,
 UPPE
 R
 EYEL
 ID;
 WITH
 EXCE
 SSIV
 E
 SKIN
 WEIG
 HTIN
 G
 DOWN
 LID
183..     15825
(5)RH
 YTID
 ECTO
 MY;
 NECK
 WITH
 PLAT
 YSMA
 L
 TIGH
 TENI
 NG
 (PLA
 TYSM
 AL
 FLAP
 ,
 ``P-
 FLAP
 '')
183..     15829
(5)RH
 YTID
 ECTO
 MY;
 SUPE
 RFIC
 IAL
 MUSC
 ULOA
 PONE
 UROT
 IC
 SYST
 EM
 (SMA
 S)
 FLAP
183..     15835
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 BUTT
 OCK
183..     20910
(5)CA
 RTIL
 AGE
 GRAF
 T;
 COST
 OCHO
 NDRA
 L
183..     20912
(5)CA
 RTIL
 AGE
 GRAF
 T;
 NASA
 L
 SEPT
 UM
183..     20920
(5)FA
 SCIA
 LATA
 GRAF
 T;
 BY
 STRI
 PPER
183..     20922
(5)FA
 SCIA
 LATA
 GRAF
 T;
 BY
 INCI
 SION
 AND
 AREA
 EXPO
 SURE
 ,
 COMP
 LEX
 OR
 SHEE
 T
183..     20926
(5)TI
 SSUE
 GRAF
 TS,
 OTHE
 R
 (EG,
 PARA
 TENO
 N,
 FAT,
 DERM
 IS)
183..     23921
(5)DI
 SART
 ICUL
 ATIO
 N OF
 SHOU
 LDER
 ;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
183..     25929
(5)TR
 ANSM
 ETAC
 ARPA
 L
 AMPU
 TATI
 ON;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
183..     44312
(5)RE
 VISI
 ON
 OF
 ILEO
 STOM
 Y;
 SIMP
 LE
 (REL
 EASE
 OF
 SUPE
 RFIC
 IAL
 SCAR
 )
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
183..     44340
(5)RE
 VISI
 ON
 OF
 COLO
 STOM
 Y;
 SIMP
 LE
 (REL
 EASE
 OF
 SUPE
 RFIC
 IAL
 SCAR
 )
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
183..     65270
(5)RE
 PAIR
 OF
 LACE
 RATI
 ON;
 CONJ
 UNCT
 IVA,
 WITH
 OR
 WITH
 OUT
 NONP
 ERFO
 RATI
 NG
 LACE
 RATI
 ON
 SCLE
 RA,
 DIRE
 CT
 CLOS
 URE
184..
(1)Le         T  15.17                 $768.66               $396.40     $153.73
 vel
 IV
 skin
 repa
 ir
184..     15732
(5)MU
 SCLE
 ,
 MYOC
 UTAN
 EOUS
 , OR
 FASC
 IOCU
 TANE
 OUS
 FLAP
 ;
 HEAD
 AND
 NECK
 (EG,
 TEMP
 ORAL
 IS,
 MASS
 ETER
 ,
 STER
 NOCL
 EIDO
 MAST
 OID,
 LEVA
 TOR
 SCAP
 ULAE
 )
184..     15734
(5)MU
 SCLE
 ,
 MYOC
 UTAN
 EOUS
 , OR
 FASC
 IOCU
 TANE
 OUS
 FLAP
 ;
 TRUN
 K
184..     15736
(5)MU
 SCLE
 ,
 MYOC
 UTAN
 EOUS
 , OR
 FASC
 IOCU
 TANE
 OUS
 FLAP
 ;
 UPPE
 R
 EXTR
 EMIT
 Y
184..     15738
(5)MU
 SCLE
 ,
 MYOC
 UTAN
 EOUS
 , OR
 FASC
 IOCU
 TANE
 OUS
 FLAP
 ;
 LOWE
 R
 EXTR
 EMIT
 Y
184..     15740
(5)FL
 AP;
 ISLA
 ND
 PEDI
 CLE
184..     15750
(5)FL
 AP;
 NEUR
 OVAS
 CULA
 R
 PEDI
 CLE
184..     15760
(5)GR
 AFT;
 COMP
 OSIT
 E
 (EG,
 FULL
 THIC
 KNES
 S OF
 EXTE
 RNAL
 EAR
 OR
 NASA
 L
 ALA)
 ,
 INCL
 UDIN
 G
 PRIM
 ARY
 CLOS
 URE,
 DONO
 R
 AREA
184..     15770
(5)GR
 AFT;
 DERM
 A-
 FAT-
 FASC
 IA
184..     15824
(5)RH
 YTID
 ECTO
 MY;
 FORE
 HEAD
184..     15826
(5)RH
 YTID
 ECTO
 MY;
 GLAB
 ELLA
 R
 FROW
 N
 LINE
 S
184..     15828
(5)RH
 YTID
 ECTO
 MY;
 CHEE
 K,
 CHIN
 ,
 AND
 NECK
184..     15831
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 ABDO
 MEN
 (ABD
 OMIN
 OPLA
 STY)
184..     15832
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 THIG
 H
184..     15833
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 LEG
184..     15834
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 HIP
184..     15836
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 ARM
184..     15837
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 FORE
 ARM
 OR
 HAND
184..     15839
(5)EX
 CISI
 ON,
 EXCE
 SSIV
 E
 SKIN
 AND
 SUBC
 UTAN
 EOUS
 TISS
 UE
 (INC
 LUDI
 NG
 LIPE
 CTOM
 Y);
 OTHE
 R
 AREA
184..     15840
(5)GR
 AFT
 FOR
 FACI
 AL
 NERV
 E
 PARA
 LYSI
 S;
 FREE
 FASC
 IA
 GRAF
 T
 (INC
 LUDI
 NG
 OBTA
 ININ
 G
 FASC
 IA)
184..     15841
(5)GR
 AFT
 FOR
 FACI
 AL
 NERV
 E
 PARA
 LYSI
 S;
 FREE
 MUSC
 LE
 GRAF
 T
 (INC
 LUDI
 NG
 OBTA
 ININ
 G
 GRAF
 T)
184..     15842
(5)GR
 AFT
 FOR
 FACI
 AL
 NERV
 E
 PARA
 LYSI
 S;
 FREE
 MUSC
 LE
 GRAF
 T BY
 MICR
 OSUR
 GICA
 L
 TECH
 NIQU
 E
184..     15845
(5)GR
 AFT
 FOR
 FACI
 AL
 NERV
 E
 PARA
 LYSI
 S;
 REGI
 ONAL
 MUSC
 LE
 TRAN
 SFER
184..     15876
(5)SU
 CTIO
 N
 ASSI
 STED
 LIPE
 CTOM
 Y;
 HEAD
 AND
 NECK
184..     15877
(5)SU
 CTIO
 N
 ASSI
 STED
 LIPE
 CTOM
 Y;
 TRUN
 K
184..     15878
(5)SU
 CTIO
 N
 ASSI
 STED
 LIPE
 CTOM
 Y;
 UPPE
 R
 EXTR
 EMIT
 Y
184..     15879
(5)SU
 CTIO
 N
 ASSI
 STED
 LIPE
 CTOM
 Y;
 LOWE
 R
 EXTR
 EMIT
 Y
184..     15922
(5)EX
 CISI
 ON,
 COCC
 YGEA
 L
 PRES
 SURE
 ULCE
 R,
 WITH
 COCC
 YGEC
 TOMY
 ;
 WITH
 FLAP
 CLOS
 URE
184..     15934
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE
184..     15935
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE;
 WITH
 OSTE
 CTOM
 Y
184..     15936
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 MUSC
 LE
 OR
 MYOC
 UTAN
 EOUS
 FLAP
 CLOS
 URE
184..     15937
(5)EX
 CISI
 ON,
 SACR
 AL
 PRES
 SURE
 ULCE
 R,
 WITH
 MUSC
 LE
 OR
 MYOC
 UTAN
 EOUS
 FLAP
 CLOS
 URE;
 WITH
 OSTE
 CTOM
 Y
184..     15944
(5)EX
 CISI
 ON,
 ISCH
 IAL
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE
[[Page 47772]]
184..     15945
(5)EX
 CISI
 ON,
 ISCH
 IAL
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE;
 WITH
 OSTE
 CTOM
 Y
184..     15946
(5)EX
 CISI
 ON,
 ISCH
 IAL
 PRES
 SURE
 ULCE
 R,
 WITH
 OSTE
 CTOM
 Y,
 WITH
 MUSC
 LE
 OR
 MYOC
 UTAN
 EOUS
 FLAP
 CLOS
 URE
184..     15952
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE
184..     15953
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 SKIN
 FLAP
 CLOS
 URE;
 WITH
 OSTE
 CTOM
 Y
184..     15956
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 MUSC
 LE
 OR
 MYOC
 UTAN
 EOUS
 FLAP
 CLOS
 URE
184..     15958
(5)EX
 CISI
 ON,
 TROC
 HANT
 ERIC
 PRES
 SURE
 ULCE
 R,
 WITH
 MUSC
 LE
 OR
 MYOC
 UTAN
 EOUS
 FLAP
 CLOS
 URE;
 WITH
 OSTE
 CTOM
 Y
197..
(1)In         T  12.13                 $614.62               $310.75     $122.92
 cisi
 on/
 exci
 sion
 brea
 st
197..     19101
(5)BI
 OPSY
 OF
 BREA
 ST;
 INCI
 SION
 AL
197..     19110
(5)NI
 PPLE
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 EXCI
 SION
 OF A
 SOLI
 TARY
 LACT
 IFER
 OUS
 DUCT
 OR A
 PAPI
 LLOM
 A
 LACT
 IFER
 OUS
 DUCT
197..     19112
(5)EX
 CISI
 ON
 OF
 LACT
 IFER
 OUS
 DUCT
 FIST
 ULA
197..     19120
(5)EX
 CISI
 ON
 OF
 CYST
 ,
 FIBR
 OADE
 NOMA
 , OR
 OTHE
 R
 BENI
 GN
 OR
 MALI
 GNAN
 T
 TUMO
 R
 ABER
 RANT
 BREA
 ST
 TISS
 UE,
 DUCT
 LESI
 ON,
 NIPP
 LE
 OR
 AREO
 LAR
 LESI
 ON
 (EXC
 EPT
 1914
 0),
 MALE
 OR
 FEMA
 LE,
 ONE
 OR
 MORE
 LESI
 ONS
197..     19125
(5)EX
 CISI
 ON
 OF
 BREA
 ST
 LESI
 ON
 IDEN
 TIFI
 ED
 BY
 PREO
 PERA
 TIVE
 PLAC
 EMEN
 T OF
 RADI
 OLOG
 ICAL
 MARK
 ER;
 SING
 LE
 LESI
 ON
197..     19126
(5)EX
 CISI
 ON
 OF
 BREA
 ST
 LESI
 ON
 IDEN
 TIFI
 ED
 BY
 PREO
 PERA
 TIVE
 PLAC
 EMEN
 T OF
 RADI
 OLOG
 ICAL
 MARK
 ER;
 EACH
 ADDI
 TION
 AL
 LESI
 ON
 SEPA
 RATE
 LY
 IDEN
 TIFI
 ED
 BY A
 RADI
 OLOG
 ICAL
 MARK
 ER
197..     19140
(5)MA
 STEC
 TOMY
 FOR
 GYNE
 COMA
 STIA
197..     19290
(5)PR
 EOPE
 RATI
 VE
 PLAC
 EMEN
 T OF
 NEED
 LE
 LOCA
 LIZA
 TION
 WIRE
 ,
 BREA
 ST
197..     19291
(5)PR
 EOPE
 RATI
 VE
 PLAC
 EMEN
 T OF
 NEED
 LE
 LOCA
 LIZA
 TION
 WIRE
 ,
 BREA
 ST;
 EACH
 ADDI
 TION
 AL
 LESI
 ON
197..     19396
(5)PR
 EPAR
 ATIO
 N OF
 MOUL
 AGE
 FOR
 CUST
 OM
 BREA
 ST
 IMPL
 ANT
197..     19499
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 BREA
 ST
198..
(1)Br         T  19.17                 $971.33               $530.20     $194.27
 east
 reco
 nstr
 ucti
 on/
 mast
 ecto
 my
198..     19160
(5)MA
 STEC
 TOMY
 ,
 PART
 IAL;
198..     19162
(5)MA
 STEC
 TOMY
 ,
 PART
 IAL;
 WITH
 AXIL
 LARY
 LYMP
 HADE
 NECT
 OMY
198..     19180
(5)MA
 STEC
 TOMY
 ,
 SIMP
 LE,
 COMP
 LETE
198..     19182
(5)MA
 STEC
 TOMY
 ,
 SUBC
 UTAN
 EOUS
198..     19316
(5)MA
 STOP
 EXY
198..     19318
(5)RE
 DUCT
 ION
 MAMM
 APLA
 STY
198..     19324
(5)MA
 MMAP
 LAST
 Y,
 AUGM
 ENTA
 TION
 ;
 WITH
 OUT
 PROS
 THET
 IC
 IMPL
 ANT
198..     19325
(5)MA
 MMAP
 LAST
 Y,
 AUGM
 ENTA
 TION
 ;
 WITH
 PROS
 THET
 IC
 IMPL
 ANT
198..     19328
(5)RE
 MOVA
 L OF
 INTA
 CT
 MAMM
 ARY
 IMPL
 ANT
198..     19330
(5)RE
 MOVA
 L OF
 MAMM
 ARY
 IMPL
 ANT
 MATE
 RIAL
198..     19340
(5)IM
 MEDI
 ATE
 INSE
 RTIO
 N OF
 BREA
 ST
 PROS
 THES
 IS
 FOLL
 OWIN
 G
 MAST
 OPEX
 Y,
 MAST
 ECTO
 MY
 OR
 IN
 RECO
 NSTR
 UCTI
 ON
198..     19342
(5)DE
 LAYE
 D
 INSE
 RTIO
 N OF
 BREA
 ST
 PROS
 THES
 IS
 FOLL
 OWIN
 G
 MAST
 OPEX
 Y,
 MAST
 ECTO
 MY
 OR
 IN
 RECO
 NSTR
 UCTI
 ON
198..     19350
(5)NI
 PPLE/
 AREO
 LA
 RECO
 NSTR
 UCTI
 ON
198..     19355
(5)CO
 RREC
 TION
 OF
 INVE
 RTED
 NIPP
 LES
198..     19357
(5)BR
 EAST
 RECO
 NSTR
 UCTI
 ON,
 IMME
 DIAT
 E OR
 DELA
 YED,
 WITH
 TISS
 UE
 EXPA
 NDER
 ,
 INCL
 UDIN
 G
 SUBS
 EQUE
 NT
 EXPA
 NSIO
 N
198..     19366
(5)BR
 EAST
 RECO
 NSTR
 UCTI
 ON
 WITH
 OTHE
 R
 TECH
 NIQU
 E
198..     19370
(5)OP
 EN
 PERI
 PROS
 THET
 IC
 CAPS
 ULOT
 OMY,
 BREA
 ST
198..     19371
(5)PE
 RIPR
 OSTH
 ETIC
 CAPS
 ULEC
 TOMY
 ,
 BREA
 ST
198..     19380
(5)RE
 VISI
 ON
 OF
 RECO
 NSTR
 UCTE
 D
 BREA
 ST
200..
(1)Ar         T  1.89                  $95.77                 $39.10      $19.15
 thro
 cent
 esis
 &
 Liga
 ment/
 Tend
 on
 Inje
 ctio
 n
200..     20550
(5)IN
 JECT
 ION,
 TEND
 ON
 SHEA
 TH,
 LIGA
 MENT
 ,
 TRIG
 GER
 POIN
 TS
 OR
 GANG
 LION
 CYST
200..     20600
(5)AR
 THRO
 CENT
 ESIS
 ,
 ASPI
 RATI
 ON
 AND/
 OR
 INJE
 CTIO
 N;
 SMAL
 L
 JOIN
 T,
 BURS
 A OR
 GANG
 LION
 CYST
 (EG,
 FING
 ERS,
 TOES
 )
200..     20605
(5)AR
 THRO
 CENT
 ESIS
 ,
 ASPI
 RATI
 ON
 AND/
 OR
 INJE
 CTIO
 N;
 INTE
 RMED
 IATE
 JOIN
 T,
 BURS
 A OR
 GANG
 LION
 CYST
 (EG,
 TEMP
 OROM
 ANDI
 BULA
 R,
 ACRO
 MIOC
 LAVI
 CULA
 R,
 WRIS
 T,
 ELBO
 W OR
 ANKL
 E,
 OLEC
 RANO
 N
 BURS
 A)
200..     20610
(5)AR
 THRO
 CENT
 ESIS
 ,
 ASPI
 RATI
 ON
 AND/
 OR
 INJE
 CTIO
 N;
 MAJO
 R
 JOIN
 T OR
 BURS
 A
 (EG,
 SHOU
 LDER
 ,
 HIP,
 KNEE
 JOIN
 T,
 SUBA
 CROM
 IAL
 BURS
 A)
207..
(1)Cl         T  1.70                  $86.14                 $31.64      $17.23
 osed
 trea
 tmen
 t
 frac
 ture
 fing
 er/
 toe/
 trun
 k
207..     21800
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RIB
 FRAC
 TURE
 ,
 UNCO
 MPLI
 CATE
 D,
 EACH
207..     21820
(5)CL
 OSED
 TREA
 TMEN
 T OF
 STER
 NUM
 FRAC
 TURE
207..     21899
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 NECK
 OR
 THOR
 AX
207..     22305
(5)CL
 OSED
 TREA
 TMEN
 T OF
 VERT
 EBRA
 L
 PROC
 ESS
 FRAC
 TURE
 (S)
207..     22310
(5)CL
 OSED
 TREA
 TMEN
 T OF
 VERT
 EBRA
 L
 BODY
 FRAC
 TURE
 (S),
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 REQU
 IRIN
 G
 AND
 INCL
 UDIN
 G
 CAST
 ING
 OR
 BRAC
 ING
207..     22315
(5)CL
 OSED
 TREA
 TMEN
 T OF
 VERT
 EBRA
 L
 FRAC
 TURE
 (S)
 AND/
 OR
 DISL
 OCAT
 ION(
 S)
 REQU
 IRIN
 G
 CAST
 ING
 OR
 BRAC
 ING,
 WITH
 AND
 INCL
 UDIN
 G
 CAST
 ING
 AND/
 OR
 BRAC
 ING,
 WITH
 OR
 WITH
 OUT
 ANES
 THES
 IA,
 BY
 MANI
 PULA
 TION
 OR
 TRAC
 TION
207..     22899
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 SPIN
 E
207..     23500
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CLAV
 ICUL
 AR
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
207..     23505
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CLAV
 ICUL
 AR
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
207..     23520
(5)CL
 OSED
 TREA
 TMEN
 T OF
 STER
 NOCL
 AVIC
 ULAR
 DISL
 OCAT
 ION;
 WITH
 OUT
 MANI
 PULA
 TION
207..     23525
(5)WI
 TH
 MANI
 PULA
 TION
207..     23540
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ACRO
 MIOC
 LAVI
 CULA
 R
 DISL
 OCAT
 ION;
 WITH
 OUT
 MANI
 PULA
 TION
207..     23545
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ACRO
 MIOC
 LAVI
 CULA
 R
 DISL
 OCAT
 ION;
 WITH
 MANI
 PULA
 TION
207..     23570
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SCAP
 ULAR
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
207..     23575
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SCAP
 ULAR
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKEL
 ETAL
 TRAC
 TION
 (WIT
 H OR
 WITH
 OUT
 SHOU
 LDER
 JOIN
 T
 INVO
 LVEM
 ENT)
207..     23650
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
 ;
 WITH
 OUT
 ANES
 THES
 IA
207..     23929
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 SHOU
 LDER
207..     26700
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 CARP
 OPHA
 LANG
 EAL
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 WITH
 OUT
 ANES
 THES
 IA
207..     26720
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PHAL
 ANGE
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 PROX
 IMAL
 OR
 MIDD
 LE
 PHAL
 ANX,
 FING
 ER
 OR
 THUM
 B;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
207..     26725
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PHAL
 ANGE
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 PROX
 IMAL
 OR
 MIDD
 LE
 PHAL
 ANX,
 FING
 ER
 OR
 THUM
 B;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
 ,
 EACH
[[Page 47773]]
207..     26740
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ARTI
 CULA
 R
 FRAC
 TURE
 ,
 INVO
 LVIN
 G
 META
 CARP
 OPHA
 LANG
 EAL
 OR
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
207..     26750
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 PHAL
 ANGE
 AL
 FRAC
 TURE
 ,
 FING
 ER
 OR
 THUM
 B;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
207..     26755
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 PHAL
 ANGE
 AL
 FRAC
 TURE
 ,
 FING
 ER
 OR
 THUM
 B;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
207..     26770
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 WITH
 OUT
 ANES
 THES
 IA
207..     26989
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 HAND
 S OR
 FING
 ERS
207..     27200
(5)CL
 OSED
 TREA
 TMEN
 T OF
 COCC
 YGEA
 L
 FRAC
 TURE
207..     27299
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 PELV
 IS
 OR
 HIP
 JOIN
 T
207..     28490
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 GREA
 T
 TOE,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S;
 WITH
 OUT
 MANI
 PULA
 TION
207..     28495
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 GREA
 T
 TOE,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S;
 WITH
 MANI
 PULA
 TION
207..     28510
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 ,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S,
 OTHE
 R
 THAN
 GREA
 T
 TOE;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
207..     28515
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 ,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S,
 OTHE
 R
 THAN
 GREA
 T
 TOE;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
207..     28630
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 TARS
 OPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
207..     28660
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
207..     28899
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 FOOT
 OR
 TOES
207..     31585
(5)TR
 EATM
 ENT
 OF
 CLOS
 ED
 LARY
 NGEA
 L
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
207..     31599
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 LARY
 NX
209..
(1)Cl         T  1.94                  $98.30                 $37.29      $19.66
 osed
 trea
 tmen
 t
 frac
 ture/
 disl
 ocat
 ion/
 exce
 pt
 fing
 er/
 toe/
 trun
 k
209..     23600
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 HUME
 RAL
 (SUR
 GICA
 L OR
 ANAT
 OMIC
 AL
 NECK
 )
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     23605
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 HUME
 RAL
 (SUR
 GICA
 L OR
 ANAT
 OMIC
 AL
 NECK
 )
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKEL
 ETAL
 TRAC
 TION
209..     23620
(5)CL
 OSED
 TREA
 TMEN
 T OF
 GREA
 TER
 TUBE
 ROSI
 TY
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     23625
(5)CL
 OSED
 TREA
 TMEN
 T OF
 GREA
 TER
 TUBE
 ROSI
 TY
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     23665
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 FRAC
 TURE
 OF
 GREA
 TER
 TUBE
 ROSI
 TY,
 WITH
 MANI
 PULA
 TION
209..     23675
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 SURG
 ICAL
 OR
 ANAT
 OMIC
 AL
 NECK
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
209..     24500
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24505
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKEL
 ETAL
 TRAC
 TION
209..     24530
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 HUME
 RAL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24535
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 HUME
 RAL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
209..     24560
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 EPIC
 ONDY
 LAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24565
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 EPIC
 ONDY
 LAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL;
 WITH
 MANI
 PULA
 TION
209..     24576
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 COND
 YLAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24577
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HUME
 RAL
 COND
 YLAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL;
 WITH
 MANI
 PULA
 TION
209..     24600
(5)TR
 EATM
 ENT
 OF
 CLOS
 ED
 ELBO
 W
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     24620
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MONT
 EGGI
 A
 TYPE
 OF
 FRAC
 TURE
 DISL
 OCAT
 ION
 AT
 ELBO
 W
 (FRA
 CTUR
 E
 PROX
 IMAL
 END
 OF
 ULNA
 WITH
 DISL
 OCAT
 ION
 OF
 RADI
 AL
 HEAD
 ),
 WITH
 MANI
 PULA
 TION
209..     24640
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 HEAD
 SUBL
 UXAT
 ION
 IN
 CHIL
 D,
 ``NU
 RSEM
 AID
 ELBO
 W'',
 WITH
 MANI
 PULA
 TION
209..     24650
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 HEAD
 OR
 NECK
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24655
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 HEAD
 OR
 NECK
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     24670
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ULNA
 R
 FRAC
 TURE
 ,
 PROX
 IMAL
 END
 (OLE
 CRAN
 ON
 PROC
 ESS)
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     24675
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ULNA
 R
 FRAC
 TURE
 ,
 PROX
 IMAL
 END
 (OLE
 CRAN
 ON
 PROC
 ESS)
 ;
 WITH
 MANI
 PULA
 TION
209..     24999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 HUME
 RUS
 OR
 ELBO
 W
209..     25500
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     25505
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     25520
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 DISL
 OCAT
 ION
 OF
 DIST
 AL
 RADI
 O-
 ULNA
 R
 JOIN
 T
 (GAL
 EAZZ
 I
 FRAC
 TURE/
 DISL
 OCAT
 ION)
209..     25530
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     25535
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     25560
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 AND
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 S;
 WITH
 OUT
 MANI
 PULA
 TION
209..     25565
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 AL
 AND
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 S;
 WITH
 MANI
 PULA
 TION
209..     25600
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 RADI
 AL
 FRAC
 TURE
 (EG,
 COLL
 ES
 OR
 SMIT
 H
 TYPE
 ) OR
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON,
 WITH
 OR
 WITH
 OUT
 FRAC
 TURE
 OF
 ULNA
 R
 STYL
 OID;
 WITH
 OUT
 MANI
 PULA
 TION
209..     25605
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 RADI
 AL
 FRAC
 TURE
 (EG,
 COLL
 ES
 OR
 SMIT
 H
 TYPE
 ) OR
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON,
 WITH
 OR
 WITH
 OUT
 FRAC
 TURE
 OF
 ULNA
 R
 STYL
 OID;
 WITH
 MANI
 PULA
 TION
209..     25622
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR)
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     25624
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR)
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     25630
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 AL
 BONE
 FRAC
 TURE
 (EXC
 LUDI
 NG
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR))
 ;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
 BONE
209..     25635
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 AL
 BONE
 FRAC
 TURE
 (EXC
 LUDI
 NG
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR))
 ;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
 BONE
209..     25650
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ULNA
 R
 STYL
 OID
 FRAC
 TURE
209..     25660
(5)CL
 OSED
 TREA
 TMEN
 T OF
 RADI
 OCAR
 PAL
 OR
 INTE
 RCAR
 PAL
 DISL
 OCAT
 ION,
 ONE
 OR
 MORE
 BONE
 S,
 WITH
 MANI
 PULA
 TION
209..     25675
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 RADI
 OULN
 AR
 DISL
 OCAT
 ION
 WITH
 MANI
 PULA
 TION
209..     25680
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TRAN
 S-
 SCAP
 HOPE
 RILU
 NAR
 TYPE
 OF
 FRAC
 TURE
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
209..     25690
(5)CL
 OSED
 TREA
 TMEN
 T OF
 LUNA
 TE
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
209..     25999
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 FORE
 ARM
 OR
 WRIS
 T
209..     26600
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 CARP
 AL
 FRAC
 TURE
 ,
 SING
 LE;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
 BONE
209..     26605
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 CARP
 AL
 FRAC
 TURE
 ,
 SING
 LE;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
 BONE
209..     26607
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 CARP
 AL
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
 BONE
209..     26641
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 THUM
 B,
 WITH
 MANI
 PULA
 TION
209..     26645
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 FRAC
 TURE
 DISL
 OCAT
 ION,
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 WITH
 MANI
 PULA
 TION
209..     26670
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 WITH
 OUT
 ANES
 THES
 IA
[[Page 47774]]
209..     26706
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 META
 CARP
 OPHA
 LANG
 EAL
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
209..     26742
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ARTI
 CULA
 R
 FRAC
 TURE
 ,
 INVO
 LVIN
 G
 META
 CARP
 OPHA
 LANG
 EAL
 OR
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
209..     27193
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PELV
 IC
 RING
 FRAC
 TURE
 ,
 DISL
 OCAT
 ION,
 DIAS
 TASI
 S OR
 SUBL
 UXAT
 ION;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27220
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ACET
 ABUL
 UM
 (HIP
 SOCK
 ET)
 FRAC
 TURE
 (S);
 WITH
 OUT
 MANI
 PULA
 TION
209..     27230
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FEMO
 RAL
 FRAC
 TURE
 ,
 PROX
 IMAL
 END,
 NECK
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27238
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RTRO
 CHAN
 TERI
 C,
 PERT
 ROCH
 ANTE
 RIC,
 OR
 SUBT
 ROCH
 ANTE
 RIC
 FEMO
 RAL
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27246
(5)CL
 OSED
 TREA
 TMEN
 T OF
 GREA
 TER
 TROC
 HANT
 ERIC
 FRAC
 TURE
 ,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27250
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HIP
 DISL
 OCAT
 ION,
 TRAU
 MATI
 C;
 WITH
 OUT
 ANES
 THES
 IA
209..     27256
(5)TR
 EATM
 ENT
 OF
 SPON
 TANE
 OUS
 HIP
 DISL
 OCAT
 ION
 (DEV
 ELOP
 MENT
 AL,
 INCL
 UDIN
 G
 CONG
 ENIT
 AL
 OR
 PATH
 OLOG
 ICAL
 ),
 BY
 ABDU
 CTIO
 N,
 SPLI
 NT
 OR
 TRAC
 TION
 ;
 WITH
 OUT
 ANES
 THES
 IA,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27265
(5)CL
 OSED
 TREA
 TMEN
 T OF
 POST
 HIP
 ARTH
 ROPL
 ASTY
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     27500
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FEMO
 RAL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27501
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 FEMO
 RAL
 FRAC
 TURE
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27502
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FEMO
 RAL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
209..     27503
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 FEMO
 RAL
 FRAC
 TURE
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N,
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
209..     27508
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FEMO
 RAL
 FRAC
 TURE
 ,
 DIST
 AL
 END,
 MEDI
 AL
 OR
 LATE
 RAL
 COND
 YLE,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27510
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FEMO
 RAL
 FRAC
 TURE
 ,
 DIST
 AL
 END,
 MEDI
 AL
 OR
 LATE
 RAL
 COND
 YLE,
 WITH
 MANI
 PULA
 TION
209..     27516
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 FEMO
 RAL
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27517
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 FEMO
 RAL
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
209..     27520
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PATE
 LLAR
 FRAC
 TURE
 ,
 WITH
 OUT
 MANI
 PULA
 TION
209..     27530
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TIBI
 AL
 FRAC
 TURE
 ,
 PROX
 IMAL
 (PLA
 TEAU
 );
 WITH
 OUT
 MANI
 PULA
 TION
209..     27532
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TIBI
 AL
 FRAC
 TURE
 ,
 PROX
 IMAL
 (PLA
 TEAU
 );
 WITH
 OR
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 WITH
 SKEL
 ETAL
 TRAC
 TION
209..     27538
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RCON
 DYLA
 R
 SPIN
 E(S)
 AND/
 OR
 TUBE
 ROSI
 TY
 FRAC
 TURE
 (S)
 OF
 KNEE
 ,
 WITH
 OR
 WITH
 OUT
 MANI
 PULA
 TION
209..     27550
(5)CL
 OSED
 TREA
 TMEN
 T OF
 KNEE
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     27560
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PATE
 LLAR
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     27599
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 FEMU
 R OR
 KNEE
209..     27750
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TIBI
 AL
 SHAF
 T
 FRAC
 TURE
 (WIT
 H OR
 WITH
 OUT
 FIBU
 LAR
 FRAC
 TURE
 );
 WITH
 OUT
 MANI
 PULA
 TION
209..     27752
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TIBI
 AL
 SHAF
 T
 FRAC
 TURE
 (WIT
 H OR
 WITH
 OUT
 FIBU
 LAR
 FRAC
 TURE
 );
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKEL
 ETAL
 TRAC
 TION
209..     27760
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MEDI
 AL
 MALL
 EOLU
 S
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27762
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MEDI
 AL
 MALL
 EOLU
 S
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 SKIN
 OR
 SKEL
 ETAL
 TRAC
 TION
209..     27780
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 FIBU
 LA
 OR
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27781
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 FIBU
 LA
 OR
 SHAF
 T
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     27786
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 FIBU
 LAR
 FRAC
 TURE
 (LAT
 ERAL
 MALL
 EOLU
 S);
 WITH
 OUT
 MANI
 PULA
 TION
209..     27788
(5)CL
 OSED
 TREA
 TMEN
 T OF
 DIST
 AL
 FIBU
 LAR
 FRAC
 TURE
 (LAT
 ERAL
 MALL
 EOLU
 S);
 WITH
 MANI
 PULA
 TION
209..     27808
(5)CL
 OSED
 TREA
 TMEN
 T OF
 BIMA
 LLEO
 LAR
 ANKL
 E
 FRAC
 TURE
 ,
 (INC
 LUDI
 NG
 POTT
 S);
 WITH
 OUT
 MANI
 PULA
 TION
209..     27810
(5)CL
 OSED
 TREA
 TMEN
 T OF
 BIMA
 LLEO
 LAR
 ANKL
 E
 FRAC
 TURE
 ,
 (INC
 LUDI
 NG
 POTT
 S);
 WITH
 MANI
 PULA
 TION
209..     27816
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TRIM
 ALLE
 OLAR
 ANKL
 E
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27818
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TRIM
 ALLE
 OLAR
 ANKL
 E
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     27824
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 WEIG
 HT
 BEAR
 ING
 ARTI
 CULA
 R
 PORT
 ION
 OF
 DIST
 AL
 TIBI
 A
 (EG,
 PILO
 N OR
 TIBI
 AL
 PLAF
 OND)
 ,
 WITH
 OR
 WITH
 OUT
 ANES
 THES
 IA;
 WITH
 OUT
 MANI
 PULA
 TION
209..     27825
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 WEIG
 HT
 BEAR
 ING
 ARTI
 CULA
 R
 PORT
 ION
 OF
 DIST
 AL
 TIBI
 A
 (EG,
 PILO
 N OR
 TIBI
 AL
 PLAF
 OND)
 ,
 WITH
 OR
 WITH
 OUT
 ANES
 THES
 IA;
 WITH
 SKEL
 ETAL
 TRAC
 TION
 AND/
 OR
 REQU
 IRIN
 G
 MANI
 PULA
 TION
209..     27830
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 TIBI
 OFIB
 ULAR
 JOIN
 T
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     27840
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ANKL
 E
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     27899
(5)UN
 LIST
 ED
 PROC
 EDUR
 E,
 LEG
 OR
 ANKL
 E
209..     28400
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CALC
 ANEA
 L
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     28405
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CALC
 ANEA
 L
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     28430
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TALU
 S
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
209..     28435
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TALU
 S
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
209..     28450
(5)TR
 EATM
 ENT
 OF
 TARS
 AL
 BONE
 FRAC
 TURE
 (EXC
 EPT
 TALU
 S
 AND
 CALC
 ANEU
 S);
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
209..     28455
(5)TR
 EATM
 ENT
 OF
 TARS
 AL
 BONE
 FRAC
 TURE
 (EXC
 EPT
 TALU
 S
 AND
 CALC
 ANEU
 S);
 WITH
 MANI
 PULA
 TION
 ,
 EACH
209..     28470
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 TARS
 AL
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
 ,
 EACH
209..     28475
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 TARS
 AL
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
 ,
 EACH
209..     28530
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SESA
 MOID
 FRAC
 TURE
209..     28540
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TARS
 AL
 BONE
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 TALO
 TARS
 AL;
 WITH
 OUT
 ANES
 THES
 IA
209..     28570
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TALO
 TARS
 AL
 JOIN
 T
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     28600
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TARS
 OMET
 ATAR
 SAL
 JOIN
 T
 DISL
 OCAT
 ION;
 WITH
 OUT
 ANES
 THES
 IA
209..     31586
(5)TR
 EATM
 ENT
 OF
 CLOS
 ED
 LARY
 NGEA
 L
 FRAC
 TURE
 ;
 WITH
 CLOS
 ED
 MANI
 PULA
 TIVE
 REDU
 CTIO
 N
210..
(1)Bo         T  10.46                 $530.00               $283.40     $106.00
 ne/
 join
 t
 mani
 pula
 tion
 unde
 r
 anes
 thes
 ia
210..     22505
(5)MA
 NIPU
 LATI
 ON
 OF
 SPIN
 E
 REQU
 IRIN
 G
 ANES
 THES
 IA,
 ANY
 REGI
 ON
210..     23655
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
 ;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     23700
(5)MA
 NIPU
 LATI
 ON
 UNDE
 R
 ANES
 THES
 IA,
 SHOU
 LDER
 JOIN
 T,
 INCL
 UDIN
 G
 APPL
 ICAT
 ION
 OF
 FIXA
 TION
 APPA
 RATU
 S
 (DIS
 LOCA
 TION
 EXCL
 UDED
 )
210..     24605
(5)TR
 EATM
 ENT
 OF
 CLOS
 ED
 ELBO
 W
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     26675
(5)CL
 OSED
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     26705
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 CARP
 OPHA
 LANG
 EAL
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     26775
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
 ;
 REQU
 IRIN
 G
 ANES
 THES
 IA
[[Page 47775]]
210..     27194
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PELV
 IC
 RING
 FRAC
 TURE
 ,
 DISL
 OCAT
 ION,
 DIAS
 TASI
 S OR
 SUBL
 UXAT
 ION;
 WITH
 MANI
 PULA
 TION
 ,
 REQU
 IRIN
 G
 MORE
 THAN
 LOCA
 L
 ANES
 THES
 IA
210..     27252
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HIP
 DISL
 OCAT
 ION,
 TRAU
 MATI
 C;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     27257
(5)TR
 EATM
 ENT
 OF
 SPON
 TANE
 OUS
 HIP
 DISL
 OCAT
 ION
 (DEV
 ELOP
 MENT
 AL,
 INCL
 UDIN
 G
 CONG
 ENIT
 AL
 OR
 PATH
 OLOG
 ICAL
 ),
 BY
 ABDU
 CTIO
 N,
 SPLI
 NT
 OR
 TRAC
 TION
 ;
 WITH
 MANI
 PULA
 TION
 ,
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     27275
(5)MA
 NIPU
 LATI
 ON,
 HIP
 JOIN
 T,
 REQU
 IRIN
 G
 GENE
 RAL
 ANES
 THES
 IA
210..     27552
(5)CL
 OSED
 TREA
 TMEN
 T OF
 KNEE
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     27562
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PATE
 LLAR
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     27570
(5)MA
 NIPU
 LATI
 ON
 OF
 KNEE
 JOIN
 T
 UNDE
 R
 GENE
 RAL
 ANES
 THES
 IA
 (INC
 LUDE
 S
 APPL
 ICAT
 ION
 OF
 TRAC
 TION
 OR
 OTHE
 R
 FIXA
 TION
 DEVI
 CES)
210..     27831
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PROX
 IMAL
 TIBI
 OFIB
 ULAR
 JOIN
 T
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     27842
(5)CL
 OSED
 TREA
 TMEN
 T OF
 ANKL
 E
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA,
 WITH
 OR
 WITH
 OUT
 PERC
 UTAN
 EOUS
 SKEL
 ETAL
 FIXA
 TION
210..     27860
(5)MA
 NIPU
 LATI
 ON
 OF
 ANKL
 E
 UNDE
 R
 GENE
 RAL
 ANES
 THES
 IA
 (INC
 LUDE
 S
 APPL
 ICAT
 ION
 OF
 TRAC
 TION
 OR
 OTHE
 R
 FIXA
 TION
 APPA
 RATU
 S)
210..     28545
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TARS
 AL
 BONE
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 TALO
 TARS
 AL;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     28575
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TALO
 TARS
 AL
 JOIN
 T
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     28605
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TARS
 OMET
 ATAR
 SAL
 JOIN
 T
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     28635
(5)CL
 OSED
 TREA
 TMEN
 T OF
 META
 TARS
 OPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
210..     28665
(5)CL
 OSED
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 ANES
 THES
 IA
216..
(1)Op         T  20.13                 $1,019.98             $520.82     $204.00
 en/
 perc
 utan
 eous
 trea
 tmen
 t
 frac
 ture
 or
 disl
 ocat
 ion
216..     21336
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASA
 L
 SEPT
 AL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 STAB
 ILIZ
 ATIO
 N
216..     21805
(5)OP
 EN
 TREA
 TMEN
 T OF
 RIB
 FRAC
 TURE
 WITH
 OUT
 FIXA
 TION
 ,
 EACH
216..     23515
(5)OP
 EN
 TREA
 TMEN
 T OF
 CLAV
 ICUL
 AR
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     23530
(5)OP
 EN
 TREA
 TMEN
 T OF
 STER
 NOCL
 AVIC
 ULAR
 DISL
 OCAT
 ION,
 ACUT
 E OR
 CHRO
 NIC;
216..     23532
(5)OP
 EN
 TREA
 TMEN
 T OF
 STER
 NOCL
 AVIC
 ULAR
 DISL
 OCAT
 ION,
 ACUT
 E OR
 CHRO
 NIC;
 WITH
 FASC
 IAL
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
216..     23550
(5)OP
 EN
 TREA
 TMEN
 T OF
 ACRO
 MIOC
 LAVI
 CULA
 R
 DISL
 OCAT
 ION,
 ACUT
 E OR
 CHRO
 NIC;
216..     23552
(5)OP
 EN
 TREA
 TMEN
 T OF
 ACRO
 MIOC
 LAVI
 CULA
 R
 DISL
 OCAT
 ION,
 ACUT
 E OR
 CHRO
 NIC;
 WITH
 FASC
 IAL
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
216..     23585
(5)OP
 EN
 TREA
 TMEN
 T OF
 SCAP
 ULAR
 FRAC
 TURE
 (BOD
 Y,
 GLEN
 OID
 OR
 ACRO
 MION
 )
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
216..     23615
(5)OP
 EN
 TREA
 TMEN
 T OF
 PROX
 IMAL
 HUME
 RAL
 (SUR
 GICA
 L OR
 ANAT
 OMIC
 AL
 NECK
 )
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 REPA
 IR
 OF
 TUBE
 ROSI
 TY(-
 IES)
 ;
216..     23616
(5)OP
 EN
 TREA
 TMEN
 T OF
 PROX
 IMAL
 HUME
 RAL
 (SUR
 GICA
 L OR
 ANAT
 OMIC
 AL
 NECK
 )
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 REPA
 IR
 OF
 TUBE
 ROSI
 TY(-
 IES)
 ;
 WITH
 PROX
 IMAL
 HUME
 RAL
 PROS
 THET
 IC
 REPL
 ACEM
 ENT
216..     23630
(5)OP
 EN
 TREA
 TMEN
 T OF
 GREA
 TER
 TUBE
 ROSI
 TY
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     23660
(5)OP
 EN
 TREA
 TMEN
 T OF
 ACUT
 E
 SHOU
 LDER
 DISL
 OCAT
 ION
216..     23670
(5)OP
 EN
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 FRAC
 TURE
 OF
 GREA
 TER
 TUBE
 ROSI
 TY,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     23680
(5)OP
 EN
 TREA
 TMEN
 T OF
 SHOU
 LDER
 DISL
 OCAT
 ION,
 WITH
 SURG
 ICAL
 OR
 ANAT
 OMIC
 AL
 NECK
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     24515
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 SHAF
 T
 FRAC
 TURE
 WITH
 PLAT
 E/
 SCRE
 WS,
 WITH
 OR
 WITH
 OUT
 CERC
 LAGE
216..     24516
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 INSE
 RTIO
 N OF
 INTR
 AMED
 ULLA
 RY
 IMPL
 ANT,
 WITH
 OR
 WITH
 OUT
 CERC
 LAGE
 AND/
 OR
 LOCK
 ING
 SCRE
 WS
216..     24538
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 HUME
 RAL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N
216..     24545
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ;
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N
216..     24546
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ;
 WITH
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N
216..     24566
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 HUME
 RAL
 EPIC
 ONDY
 LAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL,
 WITH
 MANI
 PULA
 TION
216..     24575
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 EPIC
 ONDY
 LAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     24579
(5)OP
 EN
 TREA
 TMEN
 T OF
 HUME
 RAL
 COND
 YLAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     24582
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 HUME
 RAL
 COND
 YLAR
 FRAC
 TURE
 ,
 MEDI
 AL
 OR
 LATE
 RAL,
 WITH
 MANI
 PULA
 TION
216..     24586
(5)OP
 EN
 TREA
 TMEN
 T OF
 PERI
 ARTI
 CULA
 R
 FRAC
 TURE
 AND/
 OR
 DISL
 OCAT
 ION
 OF
 THE
 ELBO
 W
 (FRA
 CTUR
 E
 DIST
 AL
 HUME
 RUS
 AND
 PROX
 IMAL
 ULNA
 AND/
 OR
 PROX
 IMAL
 RADI
 US);
216..     24587
(5)OP
 EN
 TREA
 TMEN
 T OF
 PERI
 ARTI
 CULA
 R
 FRAC
 TURE
 AND/
 OR
 DISL
 OCAT
 ION
 OF
 THE
 ELBO
 W
 (FRA
 CTUR
 E
 DIST
 AL
 HUME
 RUS
 AND
 PROX
 IMAL
 ULNA
 AND/
 OR
 PROX
 IMAL
 RADI
 US);
 WITH
 IMPL
 ANT
 ARTH
 ROPL
 ASTY
216..     24615
(5)OP
 EN
 TREA
 TMEN
 T OF
 ACUT
 E OR
 CHRO
 NIC
 ELBO
 W
 DISL
 OCAT
 ION
216..     24635
(5)OP
 EN
 TREA
 TMEN
 T OF
 MONT
 EGGI
 A
 TYPE
 OF
 FRAC
 TURE
 DISL
 OCAT
 ION
 AT
 ELBO
 W
 (FRA
 CTUR
 E
 PROX
 IMAL
 END
 OF
 ULNA
 WITH
 DISL
 OCAT
 ION
 OF
 RADI
 AL
 HEAD
 ),
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     24665
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 HEAD
 OR
 NECK
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
 OR
 RADI
 AL
 HEAD
 EXCI
 SION
 ;
216..     24666
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 HEAD
 OR
 NECK
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
 OR
 RADI
 AL
 HEAD
 EXCI
 SION
 ;
 WITH
 RADI
 AL
 HEAD
 PROS
 THET
 IC
 REPL
 ACEM
 ENT
216..     24685
(5)OP
 EN
 TREA
 TMEN
 T OF
 ULNA
 R
 FRAC
 TURE
 PROX
 IMAL
 END
 (OLE
 CRAN
 ON
 PROC
 ESS)
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     25515
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     25525
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 INTE
 RNAL
 AND/
 OR
 EXTE
 RNAL
 FIXA
 TION
 AND
 CLOS
 ED
 TREA
 TMEN
 T OF
 DISL
 OCAT
 ION
 OF
 DIST
 AL
 RADI
 O-
 ULNA
 R
 JOIN
 T
 (GAL
 EAZZ
 I
 FRAC
 TURE/
 DISL
 OCAT
 ION)
 ,
 WITH
 OR
 WITH
 OUT
 PERC
 UTAN
 EOUS
 SKEL
 ETAL
 FIXA
 TION
216..     25526
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 INTE
 RNAL
 AND/
 OR
 EXTE
 RNAL
 FIXA
 TION
 AND
 OPEN
 TREA
 TMEN
 T,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 OF
 DIST
 AL
 RADI
 O-
 ULNA
 R
 JOIN
 T
 (GAL
 EAZZ
 I
 FRAC
 TURE/
 DISL
 OCAT
 ION)
 ,
 INCL
 UDES
 REPA
 IR
 OF
 TRIA
 NGUL
 AR
 CART
 ILAG
 E
216..     25545
(5)OP
 EN
 TREA
 TMEN
 T OF
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     25574
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 AND
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 S,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ; OF
 RADI
 US
 OR
 ULNA
[[Page 47776]]
216..     25575
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 AL
 AND
 ULNA
 R
 SHAF
 T
 FRAC
 TURE
 S,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ; OF
 RADI
 US
 AND
 ULNA
216..     25611
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 DIST
 AL
 RADI
 AL
 FRAC
 TURE
 (EG,
 COLL
 ES
 OR
 SMIT
 H
 TYPE
 ) OR
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON,
 WITH
 OR
 WITH
 OUT
 FRAC
 TURE
 OF
 ULNA
 R
 STYL
 OID,
 REQU
 IRIN
 G
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 EXTE
 RNAL
 FIXA
 TION
216..     25620
(5)OP
 EN
 TREA
 TMEN
 T OF
 DIST
 AL
 RADI
 AL
 FRAC
 TURE
 (EG,
 COLL
 ES
 OR
 SMIT
 H
 TYPE
 ) OR
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON,
 WITH
 OR
 WITH
 OUT
 FRAC
 TURE
 OF
 ULNA
 R
 STYL
 OID,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     25628
(5)OP
 EN
 TREA
 TMEN
 T OF
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR)
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     25645
(5)OP
 EN
 TREA
 TMEN
 T OF
 CARP
 AL
 BONE
 FRAC
 TURE
 (EXC
 LUDI
 NG
 CARP
 AL
 SCAP
 HOID
 (NAV
 ICUL
 AR))
 ,
 EACH
 BONE
216..     25670
(5)OP
 EN
 TREA
 TMEN
 T OF
 RADI
 OCAR
 PAL
 OR
 INTE
 RCAR
 PAL
 DISL
 OCAT
 ION,
 ONE
 OR
 MORE
 BONE
 S
216..     25676
(5)OP
 EN
 TREA
 TMEN
 T OF
 DIST
 AL
 RADI
 OULN
 AR
 DISL
 OCAT
 ION,
 ACUT
 E OR
 CHRO
 NIC
216..     25685
(5)OP
 EN
 TREA
 TMEN
 T OF
 TRAN
 S-
 SCAP
 HOPE
 RILU
 NAR
 TYPE
 OF
 FRAC
 TURE
 DISL
 OCAT
 ION
216..     25695
(5)OP
 EN
 TREA
 TMEN
 T OF
 LUNA
 TE
 DISL
 OCAT
 ION
216..     26608
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 META
 CARP
 AL
 FRAC
 TURE
 ,
 EACH
 BONE
216..     26615
(5)OP
 EN
 TREA
 TMEN
 T OF
 META
 CARP
 AL
 FRAC
 TURE
 ,
 SING
 LE,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
 BONE
216..     26650
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 CARP
 OMET
 ACAR
 PAL
 FRAC
 TURE
 DISL
 OCAT
 ION,
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 WITH
 MANI
 PULA
 TION
 ,
 WITH
 OR
 WITH
 OUT
 EXTE
 RNAL
 FIXA
 TION
216..     26665
(5)OP
 EN
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 FRAC
 TURE
 DISL
 OCAT
 ION,
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     26676
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 ),
 SING
 LE,
 WITH
 MANI
 PULA
 TION
216..     26685
(5)OP
 EN
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 );
 SING
 LE,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     26686
(5)OP
 EN
 TREA
 TMEN
 T OF
 CARP
 OMET
 ACAR
 PAL
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 THUM
 B
 (BEN
 NETT
 FRAC
 TURE
 );
 COMP
 LEX,
 MULT
 IPLE
 OR
 DELA
 YED
 REDU
 CTIO
 N
216..     26715
(5)OP
 EN
 TREA
 TMEN
 T OF
 META
 CARP
 OPHA
 LANG
 EAL
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     26727
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 UNST
 ABLE
 PHAL
 ANGE
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 PROX
 IMAL
 OR
 MIDD
 LE
 PHAL
 ANX,
 FING
 ER
 OR
 THUM
 B,
 WITH
 MANI
 PULA
 TION
 ,
 EACH
216..     26735
(5)OP
 EN
 TREA
 TMEN
 T OF
 PHAL
 ANGE
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 PROX
 IMAL
 OR
 MIDD
 LE
 PHAL
 ANX,
 FING
 ER
 OR
 THUM
 B,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     26746
(5)OP
 EN
 TREA
 TMEN
 T OF
 ARTI
 CULA
 R
 FRAC
 TURE
 ,
 INVO
 LVIN
 G
 META
 CARP
 OPHA
 LANG
 EAL
 OR
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     26756
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 DIST
 AL
 PHAL
 ANGE
 AL
 FRAC
 TURE
 ,
 FING
 ER
 OR
 THUM
 B,
 EACH
216..     26765
(5)OP
 EN
 TREA
 TMEN
 T OF
 DIST
 AL
 PHAL
 ANGE
 AL
 FRAC
 TURE
 ,
 FING
 ER
 OR
 THUM
 B,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     26776
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 SING
 LE,
 WITH
 MANI
 PULA
 TION
216..     26785
(5)OP
 EN
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 SING
 LE
216..     27202
(5)OP
 EN
 TREA
 TMEN
 T OF
 COCC
 YGEA
 L
 FRAC
 TURE
216..     27509
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 FEMO
 RAL
 FRAC
 TURE
 ,
 DIST
 AL
 END,
 MEDI
 AL
 OR
 LATE
 RAL
 COND
 YLE,
 OR
 SUPR
 ACON
 DYLA
 R OR
 TRAN
 SCON
 DYLA
 R,
 WITH
 OR
 WITH
 OUT
 INTE
 RCON
 DYLA
 R
 EXTE
 NSIO
 N,
 OR
 DIST
 AL
 FEMO
 RAL
 EPIP
 HYSE
 AL
 SEPA
 RATI
 ON
216..     27556
(5)OP
 EN
 TREA
 TMEN
 T OF
 KNEE
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ;
 WITH
 OUT
 PRIM
 ARY
 LIGA
 MENT
 OUS
 REPA
 IR
 OR
 AUGM
 ENTA
 TION/
 RECO
 NSTR
 UCTI
 ON
216..     27566
(5)OP
 EN
 TREA
 TMEN
 T OF
 PATE
 LLAR
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 PART
 IAL
 OR
 TOTA
 L
 PATE
 LLEC
 TOMY
216..     27615
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 LEG
 OR
 ANKL
 E
 AREA
216..     27756
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TIBI
 AL
 SHAF
 T
 FRAC
 TURE
 (WIT
 H OR
 WITH
 OUT
 FIBU
 LAR
 FRAC
 TURE
 )
 (EG,
 PINS
 OR
 SCRE
 WS)
216..     27758
(5)OP
 EN
 TREA
 TMEN
 T OF
 TIBI
 AL
 SHAF
 T
 FRAC
 TURE
 ,
 (WIT
 H OR
 WITH
 OUT
 FIBU
 LAR
 FRAC
 TURE
 )
 WITH
 PLAT
 E/
 SCRE
 WS,
 WITH
 OR
 WITH
 OUT
 CERC
 LAGE
216..     27759
(5)OP
 EN
 TREA
 TMEN
 T OF
 TIBI
 AL
 SHAF
 T
 FRAC
 TURE
 (WIT
 H OR
 WITH
 OUT
 FIBU
 LAR
 FRAC
 TURE
 ) BY
 INTR
 AMED
 ULLA
 RY
 IMPL
 ANT,
 WITH
 OR
 WITH
 OUT
 INTE
 RLOC
 KING
 SCRE
 WS
 AND/
 OR
 CERC
 LAGE
216..     27766
(5)OP
 EN
 TREA
 TMEN
 T OF
 MEDI
 AL
 MALL
 EOLU
 S
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     27784
(5)OP
 EN
 TREA
 TMEN
 T OF
 PROX
 IMAL
 FIBU
 LA
 OR
 SHAF
 T
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     27792
(5)OP
 EN
 TREA
 TMEN
 T OF
 DIST
 AL
 FIBU
 LAR
 FRAC
 TURE
 (LAT
 ERAL
 MALL
 EOLU
 S),
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     27814
(5)OP
 EN
 TREA
 TMEN
 T OF
 BIMA
 LLEO
 LAR
 ANKL
 E
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     27822
(5)OP
 EN
 TREA
 TMEN
 T OF
 TRIM
 ALLE
 OLAR
 ANKL
 E
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 MEDI
 AL
 AND/
 OR
 LATE
 RAL
 MALL
 EOLU
 S;
 WITH
 OUT
 FIXA
 TION
 OF
 POST
 ERIO
 R
 LIP
216..     27823
(5)OP
 EN
 TREA
 TMEN
 T OF
 TRIM
 ALLE
 OLAR
 ANKL
 E
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 MEDI
 AL
 AND/
 OR
 LATE
 RAL
 MALL
 EOLU
 S;
 WITH
 FIXA
 TION
 OF
 POST
 ERIO
 R
 LIP
216..     27826
(5)OP
 EN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 WEIG
 HT
 BEAR
 ING
 ARTI
 CULA
 R
 SURF
 ACE/
 PORT
 ION
 OF
 DIST
 AL
 TIBI
 A
 (EG,
 PILO
 N OR
 TIBI
 AL
 PLAF
 OND)
 ,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ; OF
 FIBU
 LA
 ONLY
216..     27827
(5)OP
 EN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 WEIG
 HT
 BEAR
 ING
 ARTI
 CULA
 R
 SURF
 ACE/
 PORT
 ION
 OF
 DIST
 AL
 TIBI
 A
 (EG,
 PILO
 N OR
 TIBI
 AL
 PLAF
 OND)
 ,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ; OF
 TIBI
 A
 ONLY
216..     27828
(5)OP
 EN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 WEIG
 HT
 BEAR
 ING
 ARTI
 CULA
 R
 SURF
 ACE/
 PORT
 ION
 OF
 DIST
 AL
 TIBI
 A
 (EG,
 PILO
 N OR
 TIBI
 AL
 PLAF
 OND)
 ,
 WITH
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ; OF
 BOTH
 TIBI
 A
 AND
 FIBU
 LA
216..     27829
(5)OP
 EN
 TREA
 TMEN
 T OF
 DIST
 AL
 TIBI
 OFIB
 ULAR
 JOIN
 T
 (SYN
 DESM
 OSIS
 )
 DISR
 UPTI
 ON,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     27832
(5)OP
 EN
 TREA
 TMEN
 T OF
 PROX
 IMAL
 TIBI
 OFIB
 ULAR
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 , OR
 WITH
 EXCI
 SION
 OF
 PROX
 IMAL
 FIBU
 LA
216..     27846
(5)OP
 EN
 TREA
 TMEN
 T OF
 ANKL
 E
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 PERC
 UTAN
 EOUS
 SKEL
 ETAL
 FIXA
 TION
 ;
 WITH
 OUT
 REPA
 IR
 OR
 INTE
 RNAL
 FIXA
 TION
216..     27848
(5)OP
 EN
 TREA
 TMEN
 T OF
 ANKL
 E
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 PERC
 UTAN
 EOUS
 SKEL
 ETAL
 FIXA
 TION
 ;
 WITH
 REPA
 IR
 OR
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28406
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 CALC
 ANEA
 L
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
216..     28415
(5)OP
 EN
 TREA
 TMEN
 T OF
 CALC
 ANEA
 L
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ;
216..     28420
(5)OP
 EN
 TREA
 TMEN
 T OF
 CALC
 ANEA
 L
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ;
 WITH
 PRIM
 ARY
 ILIA
 C OR
 OTHE
 R
 AUTO
 GENO
 US
 BONE
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
216..     28436
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TALU
 S
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
216..     28445
(5)OP
 EN
 TREA
 TMEN
 T OF
 TALU
 S
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28456
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TARS
 AL
 BONE
 FRAC
 TURE
 (EXC
 EPT
 TALU
 S
 AND
 CALC
 ANEU
 S),
 WITH
 MANI
 PULA
 TION
 ,
 EACH
[[Page 47777]]
216..     28465
(5)OP
 EN
 TREA
 TMEN
 T OF
 TARS
 AL
 BONE
 FRAC
 TURE
 (EXC
 EPT
 TALU
 S
 AND
 CALC
 ANEU
 S),
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     28476
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 META
 TARS
 AL
 FRAC
 TURE
 ,
 WITH
 MANI
 PULA
 TION
 ,
 EACH
216..     28485
(5)OP
 EN
 TREA
 TMEN
 T OF
 META
 TARS
 AL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     28496
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 FRAC
 TURE
 GREA
 T
 TOE,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S,
 WITH
 MANI
 PULA
 TION
216..     28505
(5)OP
 EN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 GREA
 T
 TOE,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28525
(5)OP
 EN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 ,
 PHAL
 ANX
 OR
 PHAL
 ANGE
 S,
 OTHE
 R
 THAN
 GREA
 T
 TOE,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
 ,
 EACH
216..     28531
(5)OP
 EN
 TREA
 TMEN
 T OF
 SESA
 MOID
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
216..     28546
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TARS
 AL
 BONE
 DISL
 OCAT
 ION,
 OTHE
 R
 THAN
 TALO
 TARS
 AL,
 WITH
 MANI
 PULA
 TION
216..     28555
(5)OP
 EN
 TREA
 TMEN
 T OF
 TARS
 AL
 BONE
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28576
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TALO
 TARS
 AL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
216..     28585
(5)OP
 EN
 TREA
 TMEN
 T OF
 TALO
 TARS
 AL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28606
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 TARS
 OMET
 ATAR
 SAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
216..     28615
(5)OP
 EN
 TREA
 TMEN
 T OF
 TARS
 OMET
 ATAR
 SAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28636
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 META
 TARS
 OPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
216..     28645
(5)OP
 EN
 TREA
 TMEN
 T OF
 META
 TARS
 OPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
216..     28666
(5)PE
 RCUT
 ANEO
 US
 SKEL
 ETAL
 FIXA
 TION
 OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 MANI
 PULA
 TION
216..     28675
(5)OP
 EN
 TREA
 TMEN
 T OF
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T
 DISL
 OCAT
 ION,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 OR
 EXTE
 RNAL
 FIXA
 TION
217..
(1)Ar         T  20.48                 $1,037.71             $526.81     $207.54
 thro
 plas
 ty
217..     24360
(5)AR
 THRO
 PLAS
 TY,
 ELBO
 W;
 WITH
 MEMB
 RANE
217..     24365
(5)AR
 THRO
 PLAS
 TY,
 RADI
 AL
 HEAD
 ;
217..     25332
(5)AR
 THRO
 PLAS
 TY,
 WRIS
 T,
 WITH
 OR
 WITH
 OUT
 INTE
 RPOS
 ITIO
 N,
 WITH
 OR
 WITH
 OUT
 EXTE
 RNAL
 OR
 INTE
 RNAL
 FIXA
 TION
217..     25447
(5)IN
 TERP
 OSIT
 ION
 ARTH
 ROPL
 ASTY
 ,
 INTE
 RCAR
 PAL
 OR
 CARP
 OMET
 ACAR
 PAL
 JOIN
 TS
217..     25449
(5)RE
 VISI
 ON
 OF
 ARTH
 ROPL
 ASTY
 ,
 INCL
 UDIN
 G
 REMO
 VAL
 OF
 IMPL
 ANT,
 WRIS
 T
 JOIN
 T
217..     26530
(5)AR
 THRO
 PLAS
 TY,
 META
 CARP
 OPHA
 LANG
 EAL
 JOIN
 T;
 SING
 LE,
 EACH
217..     26535
(5)AR
 THRO
 PLAS
 TY
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T;
 SING
 LE,
 EACH
217..     27266
(5)CL
 OSED
 TREA
 TMEN
 T OF
 POST
 HIP
 ARTH
 ROPL
 ASTY
 DISL
 OCAT
 ION;
 REQU
 IRIN
 G
 REGI
 ONAL
 OR
 GENE
 RAL
 ANES
 THES
 IA
217..     27437
(5)AR
 THRO
 PLAS
 TY,
 PATE
 LLA;
 WITH
 OUT
 PROS
 THES
 IS
217..     27440
(5)AR
 THRO
 PLAS
 TY,
 KNEE
 ,
 TIBI
 AL
 PLAT
 EAU;
217..     27441
(5)AR
 THRO
 PLAS
 TY,
 KNEE
 ,
 TIBI
 AL
 PLAT
 EAU;
 WITH
 DEBR
 IDEM
 ENT
 AND
 PART
 IAL
 SYNO
 VECT
 OMY
217..     27442
(5)AR
 THRO
 PLAS
 TY,
 KNEE
 ,
 FEMO
 RAL
 COND
 YLES
 OR
 TIBI
 AL
 PLAT
 EAUS
 ;
217..     27443
(5)AR
 THRO
 PLAS
 TY,
 KNEE
 ,
 FEMO
 RAL
 COND
 YLES
 OR
 TIBI
 AL
 PLAT
 EAUS
 ;
 WITH
 DEBR
 IDEM
 ENT
 AND
 PART
 IAL
 SYNO
 VECT
 OMY
217..     27700
(5)AR
 THRO
 PLAS
 TY,
 ANKL
 E;
218..
(1)Ar         T  27.49                 $1,392.90             $715.52     $278.58
 thro
 plas
 ty
 with
 pros
 thes
 is
218..     21243
(5)AR
 THRO
 PLAS
 TY,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T,
 WITH
 PROS
 THET
 IC
 JOIN
 T
 REPL
 ACEM
 ENT
218..     24361
(5)AR
 THRO
 PLAS
 TY,
 ELBO
 W;
 WITH
 DIST
 AL
 HUME
 RAL
 PROS
 THET
 IC
 REPL
 ACEM
 ENT
218..     24362
(5)AR
 THRO
 PLAS
 TY,
 ELBO
 W;
 WITH
 IMPL
 ANT
 AND
 FASC
 IA
 LATA
 LIGA
 MENT
 RECO
 NSTR
 UCTI
 ON
218..     24363
(5)AR
 THRO
 PLAS
 TY,
 ELBO
 W;
 WITH
 DIST
 AL
 HUME
 RUS
 AND
 PROX
 IMAL
 ULNA
 R
 PROS
 THET
 IC
 REPL
 ACEM
 ENT
 (``T
 OTAL
 ELBO
 W'')
218..     24366
(5)AR
 THRO
 PLAS
 TY,
 RADI
 AL
 HEAD
 ;
 WITH
 IMPL
 ANT
218..     25441
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 DIST
 AL
 RADI
 US
218..     25442
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 DIST
 AL
 ULNA
218..     25443
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 SCAP
 HOID
 (NAV
 ICUL
 AR)
218..     25444
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 LUNA
 TE
218..     25445
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 TRAP
 EZIU
 M
218..     25446
(5)AR
 THRO
 PLAS
 TY
 WITH
 PROS
 THET
 IC
 REPL
 ACEM
 ENT;
 DIST
 AL
 RADI
 US
 AND
 PART
 IAL
 OR
 ENTI
 RE
 CARP
 US
 (``T
 OTAL
 WRIS
 T'')
218..     26531
(5)AR
 THRO
 PLAS
 TY,
 META
 CARP
 OPHA
 LANG
 EAL
 JOIN
 T;
 WITH
 PROS
 THET
 IC
 IMPL
 ANT,
 SING
 LE,
 EACH
218..     26536
(5)AR
 THRO
 PLAS
 TY
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T;
 WITH
 PROS
 THET
 IC
 IMPL
 ANT,
 SING
 LE,
 EACH
218..     27438
(5)AR
 THRO
 PLAS
 TY,
 PATE
 LLA;
 WITH
 PROS
 THES
 IS
226..
(1)Ma         T  1.59                  $80.56                 $21.92      $16.11
 xill
 ofac
 ial
 pros
 thes
 es
226..     21076
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 SURG
 ICAL
 OBTU
 RATO
 R
 PROS
 THES
 IS
226..     21077
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 ORBI
 TAL
 PROS
 THES
 IS
226..     21079
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 INTE
 RIM
 OBTU
 RATO
 R
 PROS
 THES
 IS
226..     21080
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 DEFI
 NITI
 VE
 OBTU
 RATO
 R
 PROS
 THES
 IS
226..     21081
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 MAND
 IBUL
 AR
 RESE
 CTIO
 N
 PROS
 THES
 IS
226..     21082
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 PALA
 TAL
 AUGM
 ENTA
 TION
 PROS
 THES
 IS
226..     21083
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 PALA
 TAL
 LIFT
 PROS
 THES
 IS
226..     21084
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 SPEE
 CH
 AID
 PROS
 THES
 IS
226..     21086
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 AURI
 CULA
 R
 PROS
 THES
 IS
226..     21087
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 NASA
 L
 PROS
 THES
 IS
226..     21088
(5)IM
 PRES
 SION
 AND
 CUST
 OM
 PREP
 ARAT
 ION;
 FACI
 AL
 PROS
 THES
 IS
226..     21089
(5)UN
 LIST
 ED
 MAXI
 LLOF
 ACIA
 L
 PROS
 THET
 IC
 PROC
 EDUR
 E
231..
(1)Le         T  12.02                 $609.05                $299.9     $121.81
 vel
 I
 skul
 l
 and
 faci
 al
 bone
 proc
 edur
 es
231..     21015
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R
 (EG,
 MALI
 GNAN
 T
 NEOP
 LASM
 ),
 SOFT
 TISS
 UE
 OF
 FACE
 OR
 SCAL
 P
231..     21025
(5)EX
 CISI
 ON
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ;
 MAND
 IBLE
231..     21026
(5)EX
 CISI
 ON
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ;
 FACI
 AL
 BONE
 (S)
231..     21029
(5)RE
 MOVA
 L BY
 CONT
 OURI
 NG
 OF
 BENI
 GN
 TUMO
 R OF
 FACI
 AL
 BONE
 (EG,
 FIBR
 OUS
 DYSP
 LASI
 A)
231..     21030
(5)EX
 CISI
 ON
 OF
 BENI
 GN
 TUMO
 R OR
 CYST
 OF
 FACI
 AL
 BONE
 OTHE
 R
 THAN
 MAND
 IBLE
231..     21031
(5)EX
 CISI
 ON
 OF
 TORU
 S
 MAND
 IBUL
 ARIS
231..     21032
(5)EX
 CISI
 ON
 OF
 MAXI
 LLAR
 Y
 TORU
 S
 PALA
 TINU
 S
231..     21040
(5)EX
 CISI
 ON
 OF
 BENI
 GN
 CYST
 OR
 TUMO
 R OF
 MAND
 IBLE
 ;
 SIMP
 LE
231..     21041
(5)EX
 CISI
 ON
 OF
 BENI
 GN
 CYST
 OR
 TUMO
 R OF
 MAND
 IBLE
 ;
 COMP
 LEX
231..     21100
(5)AP
 PLIC
 ATIO
 N OF
 HALO
 TYPE
 APPL
 IANC
 E
 FOR
 MAXI
 LLOF
 ACIA
 L
 FIXA
 TION
 ,
 INCL
 UDES
 REMO
 VAL
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
[[Page 47778]]
231..     21110
(5)AP
 PLIC
 ATIO
 N OF
 INTE
 RDEN
 TAL
 FIXA
 TION
 DEVI
 CE
 FOR
 COND
 ITIO
 NS
 OTHE
 R
 THAN
 FRAC
 TURE
 OR
 DISL
 OCAT
 ION,
 INCL
 UDES
231..     21120
(5)GE
 NIOP
 LAST
 Y;
 AUGM
 ENTA
 TION
 (AUT
 OGRA
 FT,
 ALLO
 GRAF
 T,
 PROS
 THET
 IC
 MATE
 RIAL
 )
231..     21125
(5)AU
 GMEN
 TATI
 ON,
 MAND
 IBUL
 AR
 BODY
 OR
 ANGL
 E;
 PROS
 THET
 IC
 MATE
 RIAL
231..     21280
(5)ME
 DIAL
 CANT
 HOPE
 XY
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
231..     21282
(5)LA
 TERA
 L
 CANT
 HOPE
 XY
231..     21295
(5)RE
 DUCT
 ION
 OF
 MASS
 ETER
 MUSC
 LE
 AND
 BONE
 (EG,
 FOR
 TREA
 TMEN
 T OF
 BENI
 GN
 MASS
 ETER
 IC
 HYPE
 RTRO
 PHY)
 ;
 EXTR
 AORA
 L
 APPR
 OACH
231..     21296
(5)RE
 DUCT
 ION
 OF
 MASS
 ETER
 MUSC
 LE
 AND
 BONE
 (EG,
 FOR
 TREA
 TMEN
 T OF
 BENI
 GN
 MASS
 ETER
 IC
 HYPE
 RTRO
 PHY)
 ;
 INTR
 AORA
 L
 APPR
 OACH
231..     21299
(5)UN
 LIST
 ED
 CRAN
 IOFA
 CIAL
 AND
 MAXI
 LLOF
 ACIA
 L
 PROC
 EDUR
 E
231..     21300
(5)CL
 OSED
 TREA
 TMEN
 T OF
 SKUL
 L
 FRAC
 TURE
 WITH
 OUT
 OPER
 ATIO
 N
231..     21310
(5)CL
 OSED
 TREA
 TMEN
 T OF
 NASA
 L
 BONE
 FRAC
 TURE
 WITH
 OUT
 MANI
 PULA
 TION
231..     21315
(5)CL
 OSED
 TREA
 TMEN
 T OF
 NASA
 L
 BONE
 FRAC
 TURE
 ;
 WITH
 OUT
 STAB
 ILIZ
 ATIO
 N
231..     21320
(5)CL
 OSED
 TREA
 TMEN
 T OF
 NASA
 L
 BONE
 FRAC
 TURE
 ;
 WITH
 STAB
 ILIZ
 ATIO
 N
231..     21325
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASA
 L
 FRAC
 TURE
 ;
 UNCO
 MPLI
 CATE
 D
231..     21337
(5)CL
 OSED
 TREA
 TMEN
 T OF
 NASA
 L
 SEPT
 AL
 FRAC
 TURE
 ,
 WITH
 OR
 WITH
 OUT
 STAB
 ILIZ
 ATIO
 N
231..     21355
(5)PE
 RCUT
 ANEO
 US
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 MALA
 R
 AREA
 ,
 INCL
 UDIN
 G
 ZYGO
 MATI
 C
 ARCH
 AND
 MALA
 R
 TRIP
 OD,
 WITH
 MANI
 PULA
 TION
231..     21400
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 ORBI
 T,
 EXCE
 PT
 ''BL
 OWOU
 T'';
 WITH
 OUT
 MANI
 PULA
 TION
231..     21401
(5)CL
 OSED
 TREA
 TMEN
 T OF
 FRAC
 TURE
 OF
 ORBI
 T,
 EXCE
 PT
 ``BL
 OWOU
 T'';
 WITH
 MANI
 PULA
 TION
231..     21440
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 OR
 MAXI
 LLAR
 Y
 ALVE
 OLAR
 RIDG
 E
 FRAC
 TURE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
231..     21451
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
231..     21480
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TEMP
 OROM
 ANDI
 BULA
 R
 DISL
 OCAT
 ION;
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT
231..     21485
(5)CL
 OSED
 TREA
 TMEN
 T OF
 TEMP
 OROM
 ANDI
 BULA
 R
 DISL
 OCAT
 ION;
 COMP
 LICA
 TED
 (EG,
 RECU
 RREN
 T
 REQU
 IRIN
 G
 INTE
 RMAX
 ILLA
 RY
 FIXA
 TION
 OR
 SPLI
 NTIN
 G),
 INIT
 IAL
 OR
 SUBS
 EQUE
 NT
231..     21493
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HYOI
 D
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
231..     21494
(5)CL
 OSED
 TREA
 TMEN
 T OF
 HYOI
 D
 FRAC
 TURE
 ;
 WITH
 MANI
 PULA
 TION
231..     21497
(5)IN
 TERD
 ENTA
 L
 WIRI
 NG,
 FOR
 COND
 ITIO
 N
 OTHE
 R
 THAN
 FRAC
 TURE
231..     21499
(5)UN
 LIST
 ED
 MUSC
 ULOS
 KELE
 TAL
 PROC
 EDUR
 E,
 HEAD
231..     41822
(5)EX
 CISI
 ON
 OF
 FIBR
 OUS
 TUBE
 ROSI
 TIES
 ,
 DENT
 OALV
 EOLA
 R
 STRU
 CTUR
 ES
231..     41823
(5)EX
 CISI
 ON
 OF
 OSSE
 OUS
 TUBE
 ROSI
 TIES
 ,
 DENT
 OALV
 EOLA
 R
 STRU
 CTUR
 ES
232..
(1)Le         T  23.93                 $1,212.52             $639.35     $242.50
 vel
 II
 skul
 l
 and
 faci
 al
 bone
 proc
 edur
 es
232..     21010
(5)AR
 THRO
 TOMY
 ,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T
232..     21034
(5)EX
 CISI
 ON
 OF
 MALI
 GNAN
 T
 TUMO
 R OF
 FACI
 AL
 BONE
 OTHE
 R
 THAN
 MAND
 IBLE
232..     21044
(5)EX
 CISI
 ON
 OF
 MALI
 GNAN
 T
 TUMO
 R OF
 MAND
 IBLE
232..     21050
(5)CO
 NDYL
 ECTO
 MY,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
232..     21060
(5)ME
 NISC
 ECTO
 MY,
 PART
 IAL
 OR
 COMP
 LETE
 ,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
232..     21070
(5)CO
 RONO
 IDEC
 TOMY
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
232..     21121
(5)GE
 NIOP
 LAST
 Y;
 SLID
 ING
 OSTE
 OTOM
 Y,
 SING
 LE
 PIEC
 E
232..     21122
(5)GE
 NIOP
 LAST
 Y;
 SLID
 ING
 OSTE
 OTOM
 IES,
 TWO
 OR
 MORE
 OSTE
 OTOM
 IES
 (EG,
 WEDG
 E
 EXCI
 SION
 OR
 BONE
 WEDG
 E
 REVE
 RSAL
 FOR
 ASYM
 METR
 ICAL
 CHIN
 )
232..     21123
(5)GE
 NIOP
 LAST
 Y;
 SLID
 ING,
 AUGM
 ENTA
 TION
 WITH
 INTE
 RPOS
 ITIO
 NAL
 BONE
 GRAF
 TS
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 AUTO
 GRAF
 TS)
232..     21127
(5)AU
 GMEN
 TATI
 ON,
 MAND
 IBUL
 AR
 BODY
 OR
 ANGL
 E;
 WITH
 BONE
 GRAF
 T,
 ONLA
 Y OR
 INTE
 RPOS
 ITIO
 NAL
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 AUTO
 GRAF
 T)
232..     21181
(5)RE
 CONS
 TRUC
 TION
 BY
 CONT
 OURI
 NG
 OF
 BENI
 GN
 TUMO
 R OF
 CRAN
 IAL
 BONE
 S
 (EG,
 FIBR
 OUS
 DYSP
 LASI
 A),
 EXTR
 ACRA
 NIAL
232..     21206
(5)OS
 TEOT
 OMY,
 MAXI
 LLA,
 SEGM
 ENTA
 L
 (EG,
 WASS
 MUND
 OR
 SCHU
 CHAR
 D)
232..     21208
(5)OS
 TEOP
 LAST
 Y,
 FACI
 AL
 BONE
 S;
 AUGM
 ENTA
 TION
 (AUT
 OGRA
 FT,
 ALLO
 GRAF
 T,
 OR
 PROS
 THET
 IC
 IMPL
 ANT)
232..     21209
(5)OS
 TEOP
 LAST
 Y,
 FACI
 AL
 BONE
 S;
 REDU
 CTIO
 N
232..     21210
(5)GR
 AFT,
 BONE
 ;
 NASA
 L,
 MAXI
 LLAR
 Y OR
 MALA
 R
 AREA
 S
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
232..     21215
(5)GR
 AFT,
 BONE
 ;
 MAND
 IBLE
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
232..     21230
(5)GR
 AFT;
 RIB
 CART
 ILAG
 E,
 AUTO
 GENO
 US,
 TO
 FACE
 ,
 CHIN
 ,
 NOSE
 OR
 EAR
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
232..     21235
(5)GR
 AFT;
 EAR
 CART
 ILAG
 E,
 AUTO
 GENO
 US,
 TO
 NOSE
 OR
 EAR
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
232..     21240
(5)AR
 THRO
 PLAS
 TY,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T,
 WITH
 OR
 WITH
 OUT
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
232..     21242
(5)AR
 THRO
 PLAS
 TY,
 TEMP
 OROM
 ANDI
 BULA
 R
 JOIN
 T,
 WITH
 ALLO
 GRAF
 T
232..     21244
(5)RE
 CONS
 TRUC
 TION
 OF
 MAND
 IBLE
 ,
 EXTR
 AORA
 L,
 WITH
 TRAN
 SOST
 EAL
 BONE
 PLAT
 E
 (EG,
 MAND
 IBUL
 AR
 STAP
 LE
 BONE
 PLAT
 E)
232..     21245
(5)RE
 CONS
 TRUC
 TION
 OF
 MAND
 IBLE
 OR
 MAXI
 LLA,
 SUBP
 ERIO
 STEA
 L
 IMPL
 ANT;
 PART
 IAL
232..     21246
(5)RE
 CONS
 TRUC
 TION
 OF
 MAND
 IBLE
 OR
 MAXI
 LLA,
 SUBP
 ERIO
 STEA
 L
 IMPL
 ANT;
 COMP
 LETE
232..     21248
(5)RE
 CONS
 TRUC
 TION
 OF
 MAND
 IBLE
 OR
 MAXI
 LLA,
 ENDO
 STEA
 L
 IMPL
 ANT
 (EG,
 BLAD
 E,
 CYLI
 NDER
 );
 PART
 IAL
232..     21249
(5)RE
 CONS
 TRUC
 TION
 OF
 MAND
 IBLE
 OR
 MAXI
 LLA,
 ENDO
 STEA
 L
 IMPL
 ANT
 (EG,
 BLAD
 E,
 CYLI
 NDER
 );
 COMP
 LETE
232..     21260
(5)PE
 RIOR
 BITA
 L
 OSTE
 OTOM
 IES
 FOR
 ORBI
 TAL
 HYPE
 RTEL
 ORIS
 M,
 WITH
 BONE
 GRAF
 TS;
 EXTR
 ACRA
 NIAL
 APPR
 OACH
232..     21267
(5)OR
 BITA
 L
 REPO
 SITI
 ONIN
 G,
 PERI
 ORBI
 TAL
 OSTE
 OTOM
 IES,
 UNIL
 ATER
 AL,
 WITH
 BONE
 GRAF
 TS;
 EXTR
 ACRA
 NIAL
 APPR
 OACH
232..     21270
(5)MA
 LAR
 AUGM
 ENTA
 TION
 ,
 PROS
 THET
 IC
 MATE
 RIAL
232..     21275
(5)SE
 COND
 ARY
 REVI
 SION
 OF
 ORBI
 TOCR
 ANIO
 FACI
 AL
 RECO
 NSTR
 UCTI
 ON
232..     21330
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASA
 L
 FRAC
 TURE
 ;
 COMP
 LICA
 TED,
 WITH
 INTE
 RNAL
 AND/
 OR
 EXTE
 RNAL
 SKEL
 ETAL
 FIXA
 TION
232..     21335
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASA
 L
 FRAC
 TURE
 ;
 WITH
 CONC
 OMIT
 ANT
 OPEN
 TREA
 TMEN
 T OF
 FRAC
 TURE
 D
 SEPT
 UM
232..     21338
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASO
 ETHM
 OID
 FRAC
 TURE
 ;
 WITH
 OUT
 EXTE
 RNAL
 FIXA
 TION
232..     21339
(5)OP
 EN
 TREA
 TMEN
 T OF
 NASO
 ETHM
 OID
 FRAC
 TURE
 ;
 WITH
 EXTE
 RNAL
 FIXA
 TION
232..     21340
(5)PE
 RCUT
 ANEO
 US
 TREA
 TMEN
 T OF
 NASO
 ETHM
 OID
 COMP
 LEX
 FRAC
 TURE
 ,
 WITH
 SPLI
 NT,
 WIRE
 OR
 HEAD
 CAP
 FIXA
 TION
 ,
 INCL
 UDIN
 G
 REPA
 IR
 OF
 CANT
 HAL
 LIGA
 MENT
 S
 AND/
 OR
 THE
 NASO
 LACR
 IMAL
 APPA
 RATU
 S
232..     21343
(5)OP
 EN
 TREA
 TMEN
 T OF
 DEPR
 ESSE
 D
 FRON
 TAL
 SINU
 S
 FRAC
 TURE
232..     21345
(5)CL
 OSED
 TREA
 TMEN
 T OF
 NASO
 MAXI
 LLAR
 Y
 COMP
 LEX
 FRAC
 TURE
 (LEF
 ORT
 II
 TYPE
 ),
 WITH
 INTE
 RDEN
 TAL
 WIRE
 FIXA
 TION
 OR
 FIXA
 TION
 OF
 DENT
 URE
 OR
 SPLI
 NT
232..     21421
(5)CL
 OSED
 TREA
 TMEN
 T OF
 PALA
 TAL
 OR
 MAXI
 LLAR
 Y
 FRAC
 TURE
 (LEF
 ORT
 I
 TYPE
 ),
 WITH
 INTE
 RDEN
 TAL
 WIRE
 FIXA
 TION
 OR
 FIXA
 TION
 OF
 DENT
 URE
 OR
 SPLI
 NT
232..     21445
(5)OP
 EN
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 OR
 MAXI
 LLAR
 Y
 ALVE
 OLAR
 RIDG
 E
 FRAC
 TURE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
[[Page 47779]]
232..     21450
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 ;
 WITH
 OUT
 MANI
 PULA
 TION
232..     21452
(5)PE
 RCUT
 ANEO
 US
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 ,
 WITH
 EXTE
 RNAL
 FIXA
 TION
232..     21453
(5)CL
 OSED
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 WITH
 INTE
 RDEN
 TAL
 FIXA
 TION
232..     21454
(5)OP
 EN
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 WITH
 EXTE
 RNAL
 FIXA
 TION
232..     21461
(5)OP
 EN
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 ;
 WITH
 OUT
 INTE
 RDEN
 TAL
 FIXA
 TION
232..     21462
(5)OP
 EN
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 FRAC
 TURE
 ;
 WITH
 INTE
 RDEN
 TAL
 FIXA
 TION
232..     21465
(5)OP
 EN
 TREA
 TMEN
 T OF
 MAND
 IBUL
 AR
 COND
 YLAR
 FRAC
 TURE
232..     21490
(5)OP
 EN
 TREA
 TMEN
 T OF
 TEMP
 OROM
 ANDI
 BULA
 R
 DISL
 OCAT
 ION
232..     67420
(5)OR
 BITO
 TOMY
 WITH
 BONE
 FLAP
 OR
 WIND
 OW,
 LATE
 RAL
 APPR
 OACH
 (EG,
 KROE
 NLEI
 N);
 WITH
 REMO
 VAL
 OF
 LESI
 ON
232..     67430
(5)OR
 BITO
 TOMY
 WITH
 BONE
 FLAP
 OR
 WIND
 OW,
 LATE
 RAL
 APPR
 OACH
 (EG,
 KROE
 NLEI
 N);
 WITH
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
232..     67440
(5)OR
 BITO
 TOMY
 WITH
 BONE
 FLAP
 OR
 WIND
 OW,
 LATE
 RAL
 APPR
 OACH
 (EG,
 KROE
 NLEI
 N);
 WITH
 DRAI
 NAGE
232..     67450
(5)OR
 BITO
 TOMY
 WITH
 BONE
 FLAP
 OR
 WIND
 OW,
 LATE
 RAL
 APPR
 OACH
 (EG,
 KROE
 NLEI
 N);
 FOR
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 BIOP
 SY
251..
(1)Le         T  14.26                 $722.55               $366.12     $144.51
 vel
 I
 musc
 ulos
 kele
 tal
 proc
 edur
 es
251..     20005
(5)IN
 CISI
 ON
 OF
 SOFT
 TISS
 UE
 ABSC
 ESS
 (EG,
 SECO
 NDAR
 Y TO
 OSTE
 OMYE
 LITI
 S);
 DEEP
 OR
 COMP
 LICA
 TED
251..     20250
(5)BI
 OPSY
 ,
 VERT
 EBRA
 L
 BODY
 ,
 OPEN
 ;
 THOR
 ACIC
251..     20251
(5)BI
 OPSY
 ,
 VERT
 EBRA
 L
 BODY
 ,
 OPEN
 ;
 LUMB
 AR
 OR
 CERV
 ICAL
251..     20650
(5)IN
 SERT
 ION
 OF
 WIRE
 OR
 PIN
 WITH
 APPL
 ICAT
 ION
 OF
 SKEL
 ETAL
 TRAC
 TION
 ,
 INCL
 UDIN
 G
 REMO
 VAL
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
251..     20693
(5)AD
 JUST
 MENT
 OR
 REVI
 SION
 OF
 EXTE
 RNAL
 FIXA
 TION
 SYST
 EM
 REQU
 IRIN
 G
 ANES
 THES
 IA
 (EG,
 NEW
 PIN(
 S)
 OR
 WIRE
 (S)
 AND/
 OR
 NEW
 RING
 (S)
 OR
 BAR(
 S))
251..     20694
(5)RE
 MOVA
 L,
 UNDE
 R
 ANES
 THES
 IA,
 OF
 EXTE
 RNAL
 FIXA
 TION
 SYST
 EM
251..     20975
(5)EL
 ECTR
 ICAL
 STIM
 ULAT
 ION
 TO
 AID
 BONE
 HEAL
 ING;
 INVA
 SIVE
 (OPE
 RATI
 VE)
251..     23100
(5)AR
 THRO
 TOMY
 WITH
 BIOP
 SY,
 GLEN
 OHUM
 ERAL
 JOIN
 T
251..     23140
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CLAV
 ICLE
 OR
 SCAP
 ULA;
251..     23935
(5)IN
 CISI
 ON,
 DEEP
 ,
 WITH
 OPEN
 ING
 OF
 BONE
 CORT
 EX
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 HUME
 RUS
 OR
 ELBO
 W
251..     24100
(5)AR
 THRO
 TOMY
 ,
 ELBO
 W;
 WITH
 SYNO
 VIAL
 BIOP
 SY
 ONLY
251..     24105
(5)EX
 CISI
 ON,
 OLEC
 RANO
 N
 BURS
 A
251..     24110
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 HUME
 RUS;
251..     24120
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 HEAD
 OR
 NECK
 OF
 RADI
 US
 OR
 OLEC
 RANO
 N
 PROC
 ESS;
251..     24310
(5)TE
 NOTO
 MY,
 OPEN
 ,
 ELBO
 W TO
 SHOU
 LDER
 ,
 SING
 LE,
 EACH
251..     24925
(5)AM
 PUTA
 TION
 ,
 ARM
 THRO
 UGH
 HUME
 RUS;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
251..     25000
(5)TE
 NDON
 SHEA
 TH
 INCI
 SION
 ; AT
 RADI
 AL
 STYL
 OID
 (EG,
 FOR
 DEQU
 ERVA
 IN'S
 DISE
 ASE)
251..     25020
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 FLEX
 OR
 OR
 EXTE
 NSOR
 COMP
 ARTM
 ENT
251..     25028
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
251..     25031
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 INFE
 CTED
 BURS
 A
251..     25035
(5)IN
 CISI
 ON,
 DEEP
 ,
 WITH
 OPEN
 ING
 OF
 BONE
 CORT
 EX
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T
251..     25085
(5)CA
 PSUL
 OTOM
 Y,
 WRIS
 T
 (EG,
 FOR
 CONT
 RACT
 URE)
251..     25100
(5)AR
 THRO
 TOMY
 ,
 WRIS
 T
 JOIN
 T;
 WITH
 BIOP
 SY
251..     25110
(5)EX
 CISI
 ON,
 LESI
 ON
 OF
 TEND
 ON
 SHEA
 TH,
 FORE
 ARM
 AND/
 OR
 WRIS
 T
251..     25115
(5)RA
 DICA
 L
 EXCI
 SION
 OF
 BURS
 A,
 SYNO
 VIA
 OF
 WRIS
 T,
 OR
 FORE
 ARM
 TEND
 ON
 SHEA
 THS
 (EG,
 TENO
 SYNO
 VITI
 S,
 FUNG
 US,
 TBC,
 OR
 OTHE
 R
 GRAN
 ULOM
 AS,
 RHEU
 MATO
 ID
 ARTH
 RITI
 S);
 FLEX
 ORS
251..     25116
(5)RA
 DICA
 L
 EXCI
 SION
 OF
 BURS
 A,
 SYNO
 VIA
 OF
 WRIS
 T,
 OR
 FORE
 ARM
 TEND
 ON
 SHEA
 THS
 (EG,
 TENO
 SYNO
 VITI
 S,
 FUNG
 US,
 TBC,
 OR
 OTHE
 R
 GRAN
 ULOM
 AS,
 RHEU
 MATO
 ID
 ARTH
 RITI
 S);
 EXTE
 NSOR
 S,
 WITH
 OR
 WITH
 OUT
 TRAN
 SPOS
 ITIO
 N OF
 DORS
 AL
 RETI
 NACU
 LUM
251..     25248
(5)EX
 PLOR
 ATIO
 N
 WITH
 REMO
 VAL
 OF
 DEEP
 FORE
 IGN
 BODY
 ,
 FORE
 ARM
 OR
 WRIS
 T
251..     25295
(5)TE
 NOLY
 SIS,
 FLEX
 OR
 OR
 EXTE
 NSOR
 TEND
 ON,
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 SING
 LE,
 EACH
 TEND
 ON
251..     25907
(5)AM
 PUTA
 TION
 ,
 FORE
 ARM,
 THRO
 UGH
 RADI
 US
 AND
 ULNA
 ;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
251..     25922
(5)DI
 SART
 ICUL
 ATIO
 N
 THRO
 UGH
 WRIS
 T;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
251..     26990
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 PELV
 IS
 OR
 HIP
 JOIN
 T
 AREA
 ;
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
251..     26991
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 PELV
 IS
 OR
 HIP
 JOIN
 T
 AREA
 ;
 INFE
 CTED
 BURS
 A
251..     27000
(5)TE
 NOTO
 MY,
 ADDU
 CTOR
 OF
 HIP,
 SUBC
 UTAN
 EOUS
 ,
 CLOS
 ED
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
251..     27050
(5)AR
 THRO
 TOMY
 ,
 WITH
 BIOP
 SY;
 SACR
 OILI
 AC
 JOIN
 T
251..     27052
(5)AR
 THRO
 TOMY
 ,
 WITH
 BIOP
 SY;
 HIP
 JOIN
 T
251..     27060
(5)EX
 CISI
 ON;
 ISCH
 IAL
 BURS
 A
251..     27062
(5)EX
 CISI
 ON;
 TROC
 HANT
 ERIC
 BURS
 A OR
 CALC
 IFIC
 ATIO
 N
251..     27065
(5)EX
 CISI
 ON
 OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R;
 SUPE
 RFIC
 IAL
 (WIN
 G OF
 ILIU
 M,
 SYMP
 HYSI
 S
 PUBI
 S,
 OR
 GREA
 TER
 TROC
 HANT
 ER
 OF
 FEMU
 R)
 WITH
 OR
 WITH
 OUT
 AUTO
 GRAF
 T
251..     27086
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 PELV
 IS
 OR
 HIP;
 SUBC
 UTAN
 EOUS
 TISS
 UE
251..     27087
(5)RE
 MOVA
 L OF
 FORE
 IGN
 BODY
 ,
 PELV
 IS
 OR
 HIP;
 DEEP
251..     27305
(5)FA
 SCIO
 TOMY
 ,
 ILIO
 TIBI
 AL
 (TEN
 OTOM
 Y),
 OPEN
251..     27306
(5)TE
 NOTO
 MY,
 SUBC
 UTAN
 EOUS
 ,
 CLOS
 ED,
 ADDU
 CTOR
 OR
 HAMS
 TRIN
 G,
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 SING
 LE
251..     27307
(5)TE
 NOTO
 MY,
 SUBC
 UTAN
 EOUS
 ,
 CLOS
 ED,
 ADDU
 CTOR
 OR
 HAMS
 TRIN
 G,
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 MULT
 IPLE
251..     27340
(5)EX
 CISI
 ON,
 PREP
 ATEL
 LAR
 BURS
 A
251..     27345
(5)EX
 CISI
 ON
 OF
 SYNO
 VIAL
 CYST
 OF
 POPL
 ITEA
 L
 SPAC
 E
 (BAK
 ER'S
 CYST
 )
251..     27380
(5)SU
 TURE
 OF
 INFR
 APAT
 ELLA
 R
 TEND
 ON;
 PRIM
 ARY
251..     27381
(5)SU
 TURE
 OF
 INFR
 APAT
 ELLA
 R
 TEND
 ON;
 SECO
 NDAR
 Y
 RECO
 NSTR
 UCTI
 ON,
 INCL
 UDIN
 G
 FASC
 IAL
 OR
 TEND
 ON
 GRAF
 T
251..     27385
(5)SU
 TURE
 OF
 QUAD
 RICE
 PS
 OR
 HAMS
 TRIN
 G
 MUSC
 LE
 RUPT
 URE;
 PRIM
 ARY
251..     27386
(5)SU
 TURE
 OF
 QUAD
 RICE
 PS
 OR
 HAMS
 TRIN
 G
 MUSC
 LE
 RUPT
 URE;
 SECO
 NDAR
 Y
 RECO
 NSTR
 UCTI
 ON,
 INCL
 UDIN
 G
 FASC
 IAL
 OR
 TEND
 ON
 GRAF
 T
251..     27390
(5)TE
 NOTO
 MY,
 OPEN
 ,
 HAMS
 TRIN
 G,
 KNEE
 TO
 HIP;
 SING
 LE
251..     27391
(5)TE
 NOTO
 MY,
 OPEN
 ,
 HAMS
 TRIN
 G,
 KNEE
 TO
 HIP;
 MULT
 IPLE
 ,
 ONE
 LEG
251..     27392
(5)TE
 NOTO
 MY,
 OPEN
 ,
 HAMS
 TRIN
 G,
 KNEE
 TO
 HIP;
 MULT
 IPLE
 ,
 BILA
 TERA
 L
251..     27496
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 THIG
 H
 AND/
 OR
 KNEE
 ,
 ONE
 COMP
 ARTM
 ENT
 (FLE
 XOR
 OR
 EXTE
 NSOR
 OR
 ADDU
 CTOR
 );
251..     27497
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 THIG
 H
 AND/
 OR
 KNEE
 ,
 ONE
 COMP
 ARTM
 ENT
 (FLE
 XOR
 OR
 EXTE
 NSOR
 OR
 ADDU
 CTOR
 );
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
251..     27498
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 THIG
 H
 AND/
 OR
 KNEE
 ,
 MULT
 IPLE
 COMP
 ARTM
 ENTS
 ;
[[Page 47780]]
251..     27499
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 THIG
 H
 AND/
 OR
 KNEE
 ,
 MULT
 IPLE
 COMP
 ARTM
 ENTS
 ;
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
251..     27594
(5)AM
 PUTA
 TION
 ,
 THIG
 H,
 THRO
 UGH
 FEMU
 R,
 ANY
 LEVE
 L;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
251..     27600
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 ANTE
 RIOR
 AND/
 OR
 LATE
 RAL
 COMP
 ARTM
 ENTS
 ONLY
251..     27601
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 POST
 ERIO
 R
 COMP
 ARTM
 ENT(
 S)
 ONLY
251..     27602
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 ANTE
 RIOR
 AND/
 OR
 LATE
 RAL,
 AND
 POST
 ERIO
 R
 COMP
 ARTM
 ENT(
 S)
251..     27604
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 LEG
 OR
 ANKL
 E;
 INFE
 CTED
 BURS
 A
251..     27606
(5)TE
 NOTO
 MY,
 ACHI
 LLES
 TEND
 ON,
 SUBC
 UTAN
 EOUS
 (SEP
 ARAT
 E
 PROC
 EDUR
 E);
 GENE
 RAL
 ANES
 THES
 IA
251..     27607
(5)IN
 CISI
 ON,
 DEEP
 ,
 WITH
 OPEN
 ING
 OF
 BONE
 CORT
 EX
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 LEG
 OR
 ANKL
 E
251..     27630
(5)EX
 CISI
 ON
 OF
 LESI
 ON
 OF
 TEND
 ON
 SHEA
 TH
 OR
 CAPS
 ULE
 (EG,
 CYST
 OR
 GANG
 LION
 ),
 LEG
 AND/
 OR
 ANKL
 E
251..     27656
(5)RE
 PAIR
 ,
 FASC
 IAL
 DEFE
 CT
 OF
 LEG
251..     27658
(5)RE
 PAIR
 OR
 SUTU
 RE
 OF
 FLEX
 OR
 TEND
 ON
 OF
 LEG;
 PRIM
 ARY,
 WITH
 OUT
 GRAF
 T,
 SING
 LE,
 EACH
251..     27659
(5)RE
 PAIR
 OR
 SUTU
 RE
 OF
 FLEX
 OR
 TEND
 ON
 OF
 LEG;
 SECO
 NDAR
 Y
 WITH
 OR
 WITH
 OUT
 GRAF
 T,
 SING
 LE
 TEND
 ON,
 EACH
251..     27664
(5)RE
 PAIR
 OR
 SUTU
 RE
 OF
 EXTE
 NSOR
 TEND
 ON
 OF
 LEG;
 PRIM
 ARY,
 WITH
 OUT
 GRAF
 T,
 SING
 LE,
 EACH
251..     27675
(5)RE
 PAIR
 FOR
 DISL
 OCAT
 ING
 PERO
 NEAL
 TEND
 ONS;
 WITH
 OUT
 FIBU
 LAR
 OSTE
 OTOM
 Y
251..     27704
(5)RE
 MOVA
 L OF
 ANKL
 E
 IMPL
 ANT
251..     27707
(5)OS
 TEOT
 OMY;
 FIBU
 LA
251..     27884
(5)AM
 PUTA
 TION
 ,
 LEG,
 THRO
 UGH
 TIBI
 A
 AND
 FIBU
 LA;
 SECO
 NDAR
 Y
 CLOS
 URE
 OR
 SCAR
 REVI
 SION
251..     27892
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 ANTE
 RIOR
 AND/
 OR
 LATE
 RAL
 COMP
 ARTM
 ENTS
 ONLY
 ,
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
251..     27893
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 POST
 ERIO
 R
 COMP
 ARTM
 ENT(
 S)
 ONLY
 ,
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
251..     27894
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 LEG;
 ANTE
 RIOR
 AND/
 OR
 LATE
 RAL,
 AND
 POST
 ERIO
 R
 COMP
 ARTM
 ENT(
 S),
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
251..     28002
(5)DE
 EP
 DISS
 ECTI
 ON
 BELO
 W
 FASC
 IA,
 FOR
 DEEP
 INFE
 CTIO
 N OF
 FOOT
 ,
 WITH
 OR
 WITH
 OUT
 TEND
 ON
 SHEA
 TH
 INVO
 LVEM
 ENT;
 SING
 LE
 BURS
 AL
 SPAC
 E,
 SPEC
 IFY
251..     28003
(5)DE
 EP
 DISS
 ECTI
 ON
 BELO
 W
 FASC
 IA,
 FOR
 DEEP
 INFE
 CTIO
 N OF
 FOOT
 ,
 WITH
 OR
 WITH
 OUT
 TEND
 ON
 SHEA
 TH
 INVO
 LVEM
 ENT;
 MULT
 IPLE
 AREA
 S
252..
(1)Le         T  19.39                 $982.48               $509.18      $196.5
 vel
 II
 Musc
 ulos
 kele
 tal
 Proc
 edur
 es
252..     20690
(5)AP
 PLIC
 ATIO
 N OF
 A
 UNIP
 LANE
 (PIN
 S OR
 WIRE
 S IN
 ONE
 PLAN
 E),
 UNIL
 ATER
 AL,
 EXTE
 RNAL
 FIXA
 TION
 SYST
 EM
252..     20692
(5)AP
 PLIC
 ATIO
 N OF
 A
 MULT
 IPLA
 NE
 (PIN
 S OR
 WIRE
 S IN
 MORE
 THAN
 ONE
 PLAN
 E),
 UNIL
 ATER
 AL,
 EXTE
 RNAL
 FIXA
 TION
 SYST
 EM
 (EG,
 ILIZ
 AROV
 ,
 MONT
 ICEL
 LI
 TYPE
 )
252..     20900
(5)BO
 NE
 GRAF
 T,
 ANY
 DONO
 R
 AREA
 ;
 MINO
 R OR
 SMAL
 L
 (EG,
 DOWE
 L OR
 BUTT
 ON)
252..     20902
(5)BO
 NE
 GRAF
 T,
 ANY
 DONO
 R
 AREA
 ;
 MAJO
 R OR
 LARG
 E
252..     20924
(5)TE
 NDON
 GRAF
 T,
 FROM
 A
 DIST
 ANCE
 (EG,
 PALM
 ARIS
 ,
 TOE
 EXTE
 NSOR
 ,
 PLAN
 TARI
 S)
252..     21502
(5)IN
 CISI
 ON
 AND
 DRAI
 NAGE
 ,
 DEEP
 ABSC
 ESS
 OR
 HEMA
 TOMA
 ,
 SOFT
 TISS
 UES
 OF
 NECK
 OR
 THOR
 AX;
 WITH
 PART
 IAL
 RIB
 OSTE
 CTOM
 Y
252..     21600
(5)EX
 CISI
 ON
 OF
 RIB,
 PART
 IAL
252..     21610
(5)CO
 STOT
 RANS
 VERS
 ECTO
 MY
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
252..     23040
(5)AR
 THRO
 TOMY
 ,
 GLEN
 OHUM
 ERAL
 JOIN
 T,
 FOR
 INFE
 CTIO
 N,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     23044
(5)AR
 THRO
 TOMY
 ,
 ACRO
 MIOC
 LAVI
 CULA
 R,
 STER
 NOCL
 AVIC
 ULAR
 JOIN
 T,
 FOR
 INFE
 CTIO
 N,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     23101
(5)AR
 THRO
 TOMY
 WITH
 BIOP
 SY,
 OR
 WITH
 EXCI
 SION
 OF
 TORN
 CART
 ILAG
 E,
 ACRO
 MIOC
 LAVI
 CULA
 R,
 STER
 NOCL
 AVIC
 ULAR
 JOIN
 T
252..     23105
(5)AR
 THRO
 TOMY
 WITH
 SYNO
 VECT
 OMY;
 GLEN
 OHUM
 ERAL
 JOIN
 T
252..     23106
(5)AR
 THRO
 TOMY
 WITH
 SYNO
 VECT
 OMY;
 STER
 NOCL
 AVIC
 ULAR
 JOIN
 T
252..     23107
(5)AR
 THRO
 TOMY
 ,
 GLEN
 OHUM
 ERAL
 JOIN
 T,
 WITH
 JOIN
 T
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODY
252..     23145
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CLAV
 ICLE
 OR
 SCAP
 ULA;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     23146
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CLAV
 ICLE
 OR
 SCAP
 ULA;
 WITH
 ALLO
 GRAF
 T
252..     23150
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 PROX
 IMAL
 HUME
 RUS;
252..     23155
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 PROX
 IMAL
 HUME
 RUS;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     23156
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 PROX
 IMAL
 HUME
 RUS;
 WITH
 ALLO
 GRAF
 T
252..     23170
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 CLAV
 ICLE
252..     23172
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 SCAP
 ULA
252..     23174
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 HUME
 RAL
 HEAD
 TO
 SURG
 ICAL
 NECK
252..     23180
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 CLAV
 ICLE
252..     23182
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 SCAP
 ULA
252..     23184
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 PROX
 IMAL
 HUME
 RUS
252..     23190
(5)OS
 TECT
 OMY
 OF
 SCAP
 ULA,
 PART
 IAL
 (EG,
 SUPE
 RIOR
 MEDI
 AL
 ANGL
 E)
252..     23405
(5)TE
 NOMY
 OTOM
 Y,
 SHOU
 LDER
 AREA
 ;
 SING
 LE
252..     23406
(5)TE
 NOMY
 OTOM
 Y,
 SHOU
 LDER
 AREA
 ;
 MULT
 IPLE
 THRO
 UGH
 SAME
 INCI
 SION
252..     24000
(5)AR
 THRO
 TOMY
 ,
 ELBO
 W,
 FOR
 INFE
 CTIO
 N,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     24006
(5)AR
 THRO
 TOMY
 OF
 THE
 ELBO
 W,
 WITH
 CAPS
 ULAR
 EXCI
 SION
 FOR
 CAPS
 ULAR
 RELE
 ASE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
252..     24101
(5)AR
 THRO
 TOMY
 ,
 ELBO
 W;
 WITH
 JOIN
 T
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 BIOP
 SY,
 WITH
 OR
 WITH
 OUT
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODY
252..     24102
(5)AR
 THRO
 TOMY
 ,
 ELBO
 W;
 WITH
 SYNO
 VECT
 OMY
252..     24115
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 HUME
 RUS;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     24116
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 HUME
 RUS;
 WITH
 ALLO
 GRAF
 T
252..     24125
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 HEAD
 OR
 NECK
 OF
 RADI
 US
 OR
 OLEC
 RANO
 N
 PROC
 ESS;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     24126
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 HEAD
 OR
 NECK
 OF
 RADI
 US
 OR
 OLEC
 RANO
 N
 PROC
 ESS;
 WITH
 ALLO
 GRAF
 T
252..     24130
(5)EX
 CISI
 ON,
 RADI
 AL
 HEAD
252..     24134
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 SHAF
 T OR
 DIST
 AL
 HUME
 RUS
[[Page 47781]]
252..     24136
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 RADI
 AL
 HEAD
 OR
 NECK
252..     24138
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 OLEC
 RANO
 N
 PROC
 ESS
252..     24140
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 HUME
 RUS
252..     24145
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 RADI
 AL
 HEAD
 OR
 NECK
252..     24147
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 OLEC
 RANO
 N
 PROC
 ESS
252..     24160
(5)IM
 PLAN
 T
 REMO
 VAL;
 ELBO
 W
 JOIN
 T
252..     24164
(5)IM
 PLAN
 T
 REMO
 VAL;
 RADI
 AL
 HEAD
252..     24301
(5)MU
 SCLE
 OR
 TEND
 ON
 TRAN
 SFER
 ,
 ANY
 TYPE
 ,
 UPPE
 R
 ARM
 OR
 ELBO
 W,
 SING
 LE
 (EXC
 LUDI
 NG
 2432
 0-
 2433
 1)
252..     24305
(5)TE
 NDON
 LENG
 THEN
 ING,
 UPPE
 R
 ARM
 OR
 ELBO
 W,
 SING
 LE,
 EACH
252..     24350
(5)FA
 SCIO
 TOMY
 ,
 LATE
 RAL
 OR
 MEDI
 AL
 (EG,
 ``TE
 NNIS
 ELBO
 W''
 OR
 EPIC
 ONDY
 LITI
 S);
252..     24351
(5)FA
 SCIO
 TOMY
 ,
 LATE
 RAL
 OR
 MEDI
 AL
 (EG,
 ``TE
 NNIS
 ELBO
 W''
 OR
 EPIC
 ONDY
 LITI
 S);
 WITH
 EXTE
 NSOR
 ORIG
 IN
 DETA
 CHME
 NT
252..     24352
(5)FA
 SCIO
 TOMY
 ,
 LATE
 RAL
 OR
 MEDI
 AL
 (EG,
 ''TE
 NNIS
 ELBO
 W''
 OR
 EPIC
 ONDY
 LITI
 S);
 WITH
 ANNU
 LAR
 LIGA
 MENT
 RESE
 CTIO
 N
252..     24354
(5)FA
 SCIO
 TOMY
 ,
 LATE
 RAL
 OR
 MEDI
 AL
 (EG,
 ''TE
 NNIS
 ELBO
 W''
 OR
 EPIC
 ONDY
 LITI
 S);
 WITH
 STRI
 PPIN
 G
252..     24356
(5)FA
 SCIO
 TOMY
 ,
 LATE
 RAL
 OR
 MEDI
 AL
 (EG,
 ''TE
 NNIS
 ELBO
 W''
 OR
 EPIC
 ONDY
 LITI
 S);
 WITH
 PART
 IAL
 OSTE
 CTOM
 Y
252..     24400
(5)OS
 TEOT
 OMY,
 HUME
 RUS,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
252..     24410
(5)MU
 LTIP
 LE
 OSTE
 OTOM
 IES
 WITH
 REAL
 IGNM
 ENT
 ON
 INTR
 AMED
 ULLA
 RY
 ROD,
 HUME
 RAL
 SHAF
 T
 (SOF
 IELD
 TYPE
 PROC
 EDUR
 E)
252..     24495
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 FORE
 ARM,
 WITH
 BRAC
 HIAL
 ARTE
 RY
 EXPL
 ORAT
 ION
252..     25023
(5)DE
 COMP
 RESS
 ION
 FASC
 IOTO
 MY,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 WITH
 DEBR
 IDEM
 ENT
 OF
 NONV
 IABL
 E
 MUSC
 LE
 AND/
 OR
 NERV
 E
252..     25040
(5)AR
 THRO
 TOMY
 ,
 RADI
 OCAR
 PAL
 OR
 MIDC
 ARPA
 L
 JOIN
 T,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     25101
(5)AR
 THRO
 TOMY
 ,
 WRIS
 T
 JOIN
 T;
 WITH
 JOIN
 T
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 BIOP
 SY,
 WITH
 OR
 WITH
 OUT
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODY
252..     25105
(5)AR
 THRO
 TOMY
 ,
 WRIS
 T
 JOIN
 T;
 WITH
 SYNO
 VECT
 OMY
252..     25107
(5)AR
 THRO
 TOMY
 ,
 DIST
 AL
 RADI
 OULN
 AR
 JOIN
 T
 FOR
 REPA
 IR
 OF
 TRIA
 NGUL
 AR
 CART
 ILAG
 E
 COMP
 LEX
252..     25118
(5)SY
 NOVE
 CTOM
 Y,
 EXTE
 NSOR
 TEND
 ON
 SHEA
 TH,
 WRIS
 T,
 SING
 LE
 COMP
 ARTM
 ENT;
252..     25119
(5)SY
 NOVE
 CTOM
 Y,
 EXTE
 NSOR
 TEND
 ON
 SHEA
 TH,
 WRIS
 T,
 SING
 LE
 COMP
 ARTM
 ENT;
 WITH
 RESE
 CTIO
 N OF
 DIST
 AL
 ULNA
252..     25120
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 RADI
 US
 OR
 ULNA
 (EXC
 LUDI
 NG
 HEAD
 OR
 NECK
 OF
 RADI
 US
 AND
 OLEC
 RANO
 N
 PROC
 ESS)
 ;
252..     25125
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 RADI
 US
 OR
 ULNA
 (EXC
 LUDI
 NG
 HEAD
 OR
 NECK
 OF
 RADI
 US
 AND
 OLEC
 RANO
 N
 PROC
 ESS)
 ;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     25126
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 RADI
 US
 OR
 ULNA
 (EXC
 LUDI
 NG
 HEAD
 OR
 NECK
 OF
 RADI
 US
 AND
 OLEC
 RANO
 N
 PROC
 ESS)
 ;
 WITH
 ALLO
 GRAF
 T
252..     25130
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CARP
 AL
 BONE
 S;
252..     25135
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CARP
 AL
 BONE
 S;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     25136
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 CARP
 AL
 BONE
 S;
 WITH
 ALLO
 GRAF
 T
252..     25145
(5)SE
 QUES
 TREC
 TOMY
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T
252..     25150
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S);
 ULNA
252..     25151
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S);
 RADI
 US
252..     25230
(5)RA
 DIAL
 STYL
 OIDE
 CTOM
 Y
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
252..     25240
(5)EX
 CISI
 ON
 DIST
 AL
 ULNA
 PART
 IAL
 OR
 COMP
 LETE
 (EG,
 DARR
 ACH
 TYPE
 OR
 MATC
 HED
 RESE
 CTIO
 N)
252..     25250
(5)RE
 MOVA
 L OF
 WRIS
 T
 PROS
 THES
 IS;
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
252..     25251
(5)RE
 MOVA
 L OF
 WRIS
 T
 PROS
 THES
 IS;
 COMP
 LICA
 TED,
 INCL
 UDIN
 G
 ''TO
 TAL
 WRIS
 T''
252..     25260
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 FLEX
 OR,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 PRIM
 ARY,
 SING
 LE,
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25263
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 FLEX
 OR,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 SECO
 NDAR
 Y,
 SING
 LE,
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25265
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 FLEX
 OR,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 SECO
 NDAR
 Y,
 WITH
 FREE
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T),
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25270
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 EXTE
 NSOR
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 PRIM
 ARY,
 SING
 LE,
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25272
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 EXTE
 NSOR
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 SECO
 NDAR
 Y,
 SING
 LE,
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25274
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 EXTE
 NSOR
 ,
 SECO
 NDAR
 Y,
 WITH
 TEND
 ON
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T),
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 EACH
 TEND
 ON
 OR
 MUSC
 LE
252..     25280
(5)LE
 NGTH
 ENIN
 G OR
 SHOR
 TENI
 NG
 OF
 FLEX
 OR
 OR
 EXTE
 NSOR
 TEND
 ON,
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 SING
 LE,
 EACH
 TEND
 ON
252..     25290
(5)TE
 NOTO
 MY,
 OPEN
 ,
 FLEX
 OR
 OR
 EXTE
 NSOR
 TEND
 ON,
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 SING
 LE,
 EACH
 TEND
 ON
252..     25300
(5)TE
 NODE
 SIS
 AT
 WRIS
 T;
 FLEX
 ORS
 OF
 FING
 ERS
252..     25301
(5)TE
 NODE
 SIS
 AT
 WRIS
 T;
 EXTE
 NSOR
 S OF
 FING
 ERS
252..     25360
(5)OS
 TEOT
 OMY;
 ULNA
252..     25365
(5)OS
 TEOT
 OMY;
 RADI
 US
 AND
 ULNA
252..     25400
(5)RE
 PAIR
 OF
 NONU
 NION
 OR
 MALU
 NION
 ,
 RADI
 US
 OR
 ULNA
 ;
 WITH
 OUT
 GRAF
 T
 (EG,
 COMP
 RESS
 ION
 TECH
 NIQU
 E)
252..     25415
(5)RE
 PAIR
 OF
 NONU
 NION
 OR
 MALU
 NION
 ,
 RADI
 US
 AND
 ULNA
 ;
 WITH
 OUT
 GRAF
 T
 (EG,
 COMP
 RESS
 ION
 TECH
 NIQU
 E)
252..     27001
(5)TE
 NOTO
 MY,
 ADDU
 CTOR
 OF
 HIP,
 SUBC
 UTAN
 EOUS
 ,
 OPEN
252..     27003
(5)TE
 NOTO
 MY,
 ADDU
 CTOR
 ,
 SUBC
 UTAN
 EOUS
 ,
 OPEN
 ,
 WITH
 OBTU
 RATO
 R
 NEUR
 ECTO
 MY
252..     27066
(5)EX
 CISI
 ON
 OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R;
 DEEP
 ,
 WITH
 OR
 WITH
 OUT
 AUTO
 GRAF
 T
252..     27067
(5)EX
 CISI
 ON
 OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R;
 WITH
 AUTO
 GRAF
 T
 REQU
 IRIN
 G
 SEPA
 RATE
 INCI
 SION
252..     27080
(5)CO
 CCYG
 ECTO
 MY,
 PRIM
 ARY
252..     27097
(5)HA
 MSTR
 ING
 RECE
 SSIO
 N,
 PROX
 IMAL
252..     27098
(5)AD
 DUCT
 OR
 TRAN
 SFER
 TO
 ISCH
 IUM
252..     27310
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ,
 FOR
 INFE
 CTIO
 N,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     27330
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ;
 WITH
 SYNO
 VIAL
 BIOP
 SY
 ONLY
252..     27331
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ;
 WITH
 JOIN
 T
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 BIOP
 SY,
 WITH
 OR
 WITH
 OUT
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODI
 ES
252..     27332
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ,
 WITH
 EXCI
 SION
 OF
 SEMI
 LUNA
 R
 CART
 ILAG
 E
 (MEN
 ISCE
 CTOM
 Y);
 MEDI
 AL
 OR
 LATE
 RAL
252..     27333
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ,
 WITH
 EXCI
 SION
 OF
 SEMI
 LUNA
 R
 CART
 ILAG
 E
 (MEN
 ISCE
 CTOM
 Y);
 MEDI
 AL
 AND
 LATE
 RAL
252..     27334
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ,
 WITH
 SYNO
 VECT
 OMY;
 ANTE
 RIOR
 OR
 POST
 ERIO
 R
252..     27335
(5)AR
 THRO
 TOMY
 ,
 KNEE
 ,
 WITH
 SYNO
 VECT
 OMY;
 ANTE
 RIOR
 AND
 POST
 ERIO
 R
 INCL
 UDIN
 G
 POPL
 ITEA
 L
 AREA
252..     27350
(5)PA
 TELL
 ECTO
 MY
 OR
 HEMI
 PATE
 LLEC
 TOMY
[[Page 47782]]
252..     27355
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 FEMU
 R;
252..     27356
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 FEMU
 R;
 WITH
 ALLO
 GRAF
 T
252..     27357
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 FEMU
 R;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     27358
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 FEMU
 R;
 WITH
 INTE
 RNAL
 FIXA
 TION
 (LIS
 T IN
 ADDI
 TION
 TO
 2735
 5,
 2735
 6,
 OR
 2735
 7)
252..     27360
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S),
 FEMU
 R,
 PROX
 IMAL
 TIBI
 A
 AND/
 OR
 FIBU
 LA
252..     27393
(5)LE
 NGTH
 ENIN
 G OF
 HAMS
 TRIN
 G
 TEND
 ON;
 SING
 LE
252..     27394
(5)LE
 NGTH
 ENIN
 G OF
 HAMS
 TRIN
 G
 TEND
 ON;
 MULT
 IPLE
 ,
 ONE
 LEG
252..     27396
(5)TR
 ANSP
 LANT
 ,
 HAMS
 TRIN
 G
 TEND
 ON
 TO
 PATE
 LLA;
 SING
 LE
252..     27403
(5)AR
 THRO
 TOMY
 WITH
 OPEN
 MENI
 SCUS
 REPA
 IR
252..     27425
(5)LA
 TERA
 L
 RETI
 NACU
 LAR
 RELE
 ASE
 (ANY
 METH
 OD)
252..     27610
(5)AR
 THRO
 TOMY
 ,
 ANKL
 E,
 FOR
 INFE
 CTIO
 N,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
252..     27612
(5)AR
 THRO
 TOMY
 ,
 ANKL
 E,
 POST
 ERIO
 R
 CAPS
 ULAR
 RELE
 ASE,
 WITH
 OR
 WITH
 OUT
 ACHI
 LLES
 TEND
 ON
 LENG
 THEN
 ING
252..     27620
(5)AR
 THRO
 TOMY
 ,
 ANKL
 E,
 WITH
 JOIN
 T
 EXPL
 ORAT
 ION,
 WITH
 OR
 WITH
 OUT
 BIOP
 SY,
 WITH
 OR
 WITH
 OUT
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODY
252..     27625
(5)AR
 THRO
 TOMY
 ,
 ANKL
 E,
 WITH
 SYNO
 VECT
 OMY;
252..     27626
(5)AR
 THRO
 TOMY
 ,
 ANKL
 E,
 WITH
 SYNO
 VECT
 OMY;
 INCL
 UDIN
 G
 TENO
 SYNO
 VECT
 OMY
252..     27635
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 TIBI
 A OR
 FIBU
 LA;
252..     27637
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 TIBI
 A OR
 FIBU
 LA;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
252..     27638
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R,
 TIBI
 A OR
 FIBU
 LA;
 WITH
 ALLO
 GRAF
 T
252..     27641
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 EXOS
 TOSI
 S);
 FIBU
 LA
252..     27665
(5)RE
 PAIR
 OR
 SUTU
 RE
 OF
 EXTE
 NSOR
 TEND
 ON
 OF
 LEG;
 SECO
 NDAR
 Y
 WITH
 OR
 WITH
 OUT
 GRAF
 T,
 SING
 LE
 TEND
 ON,
 EACH
252..     27676
(5)RE
 PAIR
 FOR
 DISL
 OCAT
 ING
 PERO
 NEAL
 TEND
 ONS;
 WITH
 FIBU
 LAR
 OSTE
 OTOM
 Y
252..     27680
(5)TE
 NOLY
 SIS,
 INCL
 UDIN
 G
 TIBI
 A,
 FIBU
 LA,
 AND
 ANKL
 E
 FLEX
 OR;
 SING
 LE
252..     27681
(5)TE
 NOLY
 SIS,
 INCL
 UDIN
 G
 TIBI
 A,
 FIBU
 LA,
 AND
 ANKL
 E
 FLEX
 OR;
 MULT
 IPLE
 (THR
 OUGH
 SAME
 INCI
 SION
 ),
 EACH
252..     27685
(5)LE
 NGTH
 ENIN
 G OR
 SHOR
 TENI
 NG
 OF
 TEND
 ON,
 LEG
 OR
 ANKL
 E;
 SING
 LE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
252..     27686
(5)LE
 NGTH
 ENIN
 G OR
 SHOR
 TENI
 NG
 OF
 TEND
 ON,
 LEG
 OR
 ANKL
 E;
 MULT
 IPLE
 (THR
 OUGH
 SAME
 INCI
 SION
 ),
 EACH
252..     27687
(5)GA
 STRO
 CNEM
 IUS
 RECE
 SSIO
 N
 (EG,
 STRA
 YER
 PROC
 EDUR
 E)
252..     27695
(5)SU
 TURE
 ,
 PRIM
 ARY,
 TORN
 ,
 RUPT
 URED
 OR
 SEVE
 RED
 LIGA
 MENT
 ,
 ANKL
 E;
 COLL
 ATER
 AL
252..     27696
(5)SU
 TURE
 ,
 PRIM
 ARY,
 TORN
 ,
 RUPT
 URED
 OR
 SEVE
 RED
 LIGA
 MENT
 ,
 ANKL
 E;
 BOTH
 COLL
 ATER
 AL
 LIGA
 MENT
 S
252..     27698
(5)SU
 TURE
 ,
 SECO
 NDAR
 Y
 REPA
 IR,
 TORN
 ,
 RUPT
 URED
 OR
 SEVE
 RED
 LIGA
 MENT
 ,
 ANKL
 E,
 COLL
 ATER
 AL
 (EG,
 WATS
 ON-
 JONE
 S
 PROC
 EDUR
 E)
252..     27709
(5)OS
 TEOT
 OMY;
 TIBI
 A
 AND
 FIBU
 LA
252..     27730
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ;
 DIST
 AL
 TIBI
 A
252..     27732
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ;
 DIST
 AL
 FIBU
 LA
252..     27734
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ;
 DIST
 AL
 TIBI
 A
 AND
 FIBU
 LA
252..     27740
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ,
 COMB
 INED
 ,
 PROX
 IMAL
 AND
 DIST
 AL
 TIBI
 A
 AND
 FIBU
 LA;
252..     27889
(5)AN
 KLE
 DISA
 RTIC
 ULAT
 ION
253..
(1)Le         T  26.33                 $1,334.13             $699.24     $266.83
 vel
 III
 Musc
 ulos
 kele
 tal
 Proc
 edur
 es
253..     23020
(5)CA
 PSUL
 AR
 CONT
 RACT
 URE
 RELE
 ASE
 (SEV
 ER
 TYPE
 PROC
 EDUR
 E)
253..     23120
(5)CL
 AVIC
 ULEC
 TOMY
 ;
 PART
 IAL
253..     23130
(5)AC
 ROMI
 OPLA
 STY
 OR
 ACRO
 MION
 ECTO
 MY,
 PART
 IAL
253..     23415
(5)CO
 RACO
 ACRO
 MIAL
 LIGA
 MENT
 RELE
 ASE,
 WITH
 OR
 WITH
 OUT
 ACRO
 MIOP
 LAST
 Y
253..     23480
(5)OS
 TEOT
 OMY,
 CLAV
 ICLE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
 ;
253..     23485
(5)OS
 TEOT
 OMY,
 CLAV
 ICLE
 ,
 WITH
 OR
 WITH
 OUT
 INTE
 RNAL
 FIXA
 TION
 ;
 WITH
 BONE
 GRAF
 T
 FOR
 NONU
 NION
 OR
 MALU
 NION
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T
 AND/
 OR
 NECE
 SSAR
 Y
 FIXA
 TION
 )
253..     23490
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE;
 CLAV
 ICLE
253..     23491
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE;
 PROX
 IMAL
 HUME
 RUS
 AND
 HUME
 RAL
 HEAD
253..     23800
(5)AR
 THRO
 DESI
 S,
 SHOU
 LDER
 JOIN
 T;
 WITH
 OR
 WITH
 OUT
 LOCA
 L
 BONE
 GRAF
 T
253..     23802
(5)AR
 THRO
 DESI
 S,
 SHOU
 LDER
 JOIN
 T;
 WITH
 PRIM
 ARY
 AUTO
 GENO
 US
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
253..     24155
(5)RE
 SECT
 ION
 OF
 ELBO
 W
 JOIN
 T
 (ART
 HREC
 TOMY
 )
253..     24320
(5)TE
 NOPL
 ASTY
 ,
 WITH
 MUSC
 LE
 TRAN
 SFER
 ,
 WITH
 OR
 WITH
 OUT
 FREE
 GRAF
 T,
 ELBO
 W TO
 SHOU
 LDER
 ,
 SING
 LE
 (SED
 DON-
 BROO
 KES
 TYPE
 PROC
 EDUR
 E)
253..     24330
(5)FL
 EXOR-
 PLAS
 TY,
 ELBO
 W
 (EG,
 STEI
 NDLE
 R
 TYPE
 ADVA
 NCEM
 ENT)
 ;
253..     24331
(5)FL
 EXOR-
 PLAS
 TY,
 ELBO
 W
 (EG,
 STEI
 NDLE
 R
 TYPE
 ADVA
 NCEM
 ENT)
 ;
 WITH
 EXTE
 NSOR
 ADVA
 NCEM
 ENT
253..     24340
(5)TE
 NODE
 SIS
 OF
 BICE
 PS
 TEND
 ON
 AT
 ELBO
 W
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
253..     24341
(5)RE
 PAIR
 ,
 TEND
 ON
 OR
 MUSC
 LE,
 UPPE
 R
 ARM
 OR
 ELBO
 W,
 EACH
 TEND
 ON
 OR
 MUSC
 LE,
 PRIM
 ARY
 OR
 SECO
 NDAR
 Y
 (EXC
 LUDE
 S
 ROTA
 TOR
 CUFF
 )
253..     24342
(5)RE
 INSE
 RTIO
 N OF
 RUPT
 URED
 BICE
 PS
 OR
 TRIC
 EPS
 TEND
 ON,
 DIST
 AL,
 WITH
 OR
 WITH
 OUT
 TEND
 ON
 GRAF
 T
253..     24420
(5)OS
 TEOP
 LAST
 Y,
 HUME
 RUS
 (EG,
 SHOR
 TENI
 NG
 OR
 LENG
 THEN
 ING)
 (EXC
 LUDI
 NG
 6487
 6)
253..     24430
(5)RE
 PAIR
 OF
 NONU
 NION
 OR
 MALU
 NION
 ,
 HUME
 RUS;
 WITH
 OUT
 GRAF
 T
 (EG,
 COMP
 RESS
 ION
 TECH
 NIQU
 E)
253..     24435
(5)RE
 PAIR
 OF
 NONU
 NION
 OR
 MALU
 NION
 ,
 HUME
 RUS;
 WITH
 ILIA
 C OR
 OTHE
 R
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
253..     24470
(5)HE
 MIEP
 IPHY
 SEAL
 ARRE
 ST
 (EG,
 FOR
 CUBI
 TUS
 VARU
 S OR
 VALG
 US,
 DIST
 AL
 HUME
 RUS)
253..     24498
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG),
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE,
 HUME
 RUS
253..     24800
(5)AR
 THRO
 DESI
 S,
 ELBO
 W
 JOIN
 T;
 WITH
 OR
 WITH
 OUT
 LOCA
 L
 AUTO
 GRAF
 T OR
 ALLO
 GRAF
 T
253..     24802
(5)AR
 THRO
 DESI
 S,
 ELBO
 W
 JOIN
 T;
 WITH
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T
 OTHE
 R
 THAN
 LOCA
 LLY
 OBTA
 INED
 )
253..     25310
(5)TE
 NDON
 TRAN
 SPLA
 NTAT
 ION
 OR
 TRAN
 SFER
 ,
 FLEX
 OR
 OR
 EXTE
 NSOR
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 SING
 LE;
 EACH
 TEND
 ON
253..     25312
(5)TE
 NDON
 TRAN
 SPLA
 NTAT
 ION
 OR
 TRAN
 SFER
 ,
 FLEX
 OR
 OR
 EXTE
 NSOR
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T,
 SING
 LE;
 WITH
 TEND
 ON
 GRAF
 T(S)
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T),
 EACH
 TEND
 ON
253..     25315
(5)FL
 EXOR
 ORIG
 IN
 SLID
 E
 (EG,
 FOR
 CERE
 BRAL
 PALS
 Y,
 VOLK
 MANN
 CONT
 RACT
 URE)
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
253..     25316
(5)FL
 EXOR
 ORIG
 IN
 SLID
 E
 (EG,
 FOR
 CERE
 BRAL
 PALS
 Y,
 VOLK
 MANN
 CONT
 RACT
 URE)
 ,
 FORE
 ARM
 AND/
 OR
 WRIS
 T;
 WITH
 TEND
 ON(S
 )
 TRAN
 SFER
253..     25320
(5)CA
 PSUL
 ORRH
 APHY
 OR
 RECO
 NSTR
 UCTI
 ON,
 WRIS
 T,
 ANY
 METH
 OD
 (EG,
 CAPS
 ULOD
 ESIS
 ,
 LIGA
 MENT
 REPA
 IR,
 TEND
 ON
 TRAN
 SFER
 OR
 GRAF
 T)
 (INC
 LUDE
 S
 SYNO
 VECT
 OMY,
 CAPS
 ULOT
 OMY
 AND
 OPEN
 REDU
 CTIO
 N)
 FOR
 CARP
 AL
 INST
 ABIL
 ITY
[[Page 47783]]
253..     25335
(5)CE
 NTRA
 LIZA
 TION
 OF
 WRIS
 T ON
 ULNA
 (EG,
 RADI
 AL
 CLUB
 HAND
 )
253..     25337
(5)RE
 CONS
 TRUC
 TION
 FOR
 STAB
 ILIZ
 ATIO
 N OF
 UNST
 ABLE
 DIST
 AL
 ULNA
 OR
 DIST
 AL
 RADI
 OULN
 AR
 JOIN
 T,
 SECO
 NDAR
 Y BY
 SOFT
 TISS
 UE
 STAB
 ILIZ
 ATIO
 N
 (EG,
 TEND
 ON
 TRAN
 SFER
 ,
 TEND
 ON
 GRAF
 T OR
 WEAV
 E,
 OR
 TENO
 DESI
 S)
 WITH
 OR
 WITH
 OUT
 OPEN
 REDU
 CTIO
 N OF
 DIST
 AL
 RADI
 OULN
 AR
 JOIN
 T
253..     25350
(5)OS
 TEOT
 OMY,
 RADI
 US;
 DIST
 AL
 THIR
 D
253..     25355
(5)OS
 TEOT
 OMY,
 RADI
 US;
 MIDD
 LE
 OR
 PROX
 IMAL
 THIR
 D
253..     25370
(5)MU
 LTIP
 LE
 OSTE
 OTOM
 IES,
 WITH
 REAL
 IGNM
 ENT
 ON
 INTR
 AMED
 ULLA
 RY
 ROD
 (SOF
 IELD
 TYPE
 PROC
 EDUR
 E);
 RADI
 US
 OR
 ULNA
253..     25375
(5)MU
 LTIP
 LE
 OSTE
 OTOM
 IES,
 WITH
 REAL
 IGNM
 ENT
 ON
 INTR
 AMED
 ULLA
 RY
 ROD
 (SOF
 IELD
 TYPE
 PROC
 EDUR
 E);
 RADI
 US
 AND
 ULNA
253..     25425
(5)RE
 PAIR
 OF
 DEFE
 CT
 WITH
 AUTO
 GRAF
 T;
 RADI
 US
 OR
 ULNA
253..     25426
(5)RE
 PAIR
 OF
 DEFE
 CT
 WITH
 AUTO
 GRAF
 T;
 RADI
 US
 AND
 ULNA
253..     25440
(5)RE
 PAIR
 OF
 NONU
 NION
 ,
 SCAP
 HOID
 (NAV
 ICUL
 AR)
 BONE
 ,
 WITH
 OR
 WITH
 OUT
 RADI
 AL
 STYL
 OIDE
 CTOM
 Y
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T
 AND
 NECE
 SSAR
 Y
 FIXA
 TION
 )
253..     25450
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ;
 DIST
 AL
 RADI
 US
 OR
 ULNA
253..     25455
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ;
 DIST
 AL
 RADI
 US
 AND
 ULNA
253..     25490
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE;
 RADI
 US
253..     25491
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE;
 ULNA
253..     25492
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE;
 RADI
 US
 AND
 VLNA
253..     25800
(5)AR
 THRO
 DESI
 S,
 WRIS
 T
 JOIN
 T
 (INC
 LUDI
 NG
 RADI
 OCAR
 PAL
 AND/
 OR
 ULNO
 CARP
 AL
 FUSI
 ON);
 WITH
 OUT
 BONE
 GRAF
 T
253..     25805
(5)AR
 THRO
 DESI
 S,
 WRIS
 T
 JOIN
 T
 (INC
 LUDI
 NG
 RADI
 OCAR
 PAL
 AND/
 OR
 ULNO
 CARP
 AL
 FUSI
 ON);
 WITH
 SLID
 ING
 GRAF
 T
253..     25810
(5)AR
 THRO
 DESI
 S,
 WRIS
 T
 JOIN
 T
 (INC
 LUDI
 NG
 RADI
 OCAR
 PAL
 AND/
 OR
 ULNO
 CARP
 AL
 FUSI
 ON);
 WITH
 ILIA
 C OR
 OTHE
 R
 AUTO
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
253..     25830
(5)DI
 STAL
 RADI
 OULN
 AR
 JOIN
 T
 ARTH
 RODE
 SIS
 AND
 SEGM
 ENTA
 L
 RESE
 CTIO
 N OF
 ULNA
 (EG,
 SAUV
 E-
 KAPA
 NDJI
 PROC
 EDUR
 E),
 WITH
 OR
 WITH
 OUT
 BONE
 GRAF
 T
253..     27033
(5)AR
 THRO
 TOMY
 ,
 HIP,
 WITH
 EXPL
 ORAT
 ION
 OR
 REMO
 VAL
 OF
 LOOS
 E OR
 FORE
 IGN
 BODY
253..     27100
(5)TR
 ANSF
 ER
 EXTE
 RNAL
 OBLI
 QUE
 MUSC
 LE
 TO
 GREA
 TER
 TROC
 HANT
 ER
 INCL
 UDIN
 G
 FASC
 IAL
 OR
 TEND
 ON
 EXTE
 NSIO
 N
 (GRA
 FT)
253..     27105
(5)TR
 ANSF
 ER
 PARA
 SPIN
 AL
 MUSC
 LE
 TO
 HIP
 (INC
 LUDE
 S
 FASC
 IAL
 OR
 TEND
 ON
 EXTE
 NSIO
 N
 GRAF
 T)
253..     27110
(5)TR
 ANSF
 ER
 ILIO
 PSOA
 S;
 TO
 GREA
 TER
 TROC
 HANT
 ER
253..     27111
(5)TR
 ANSF
 ER
 ILIO
 PSOA
 S;
 TO
 FEMO
 RAL
 NECK
253..     27395
(5)LE
 NGTH
 ENIN
 G OF
 HAMS
 TRIN
 G
 TEND
 ON;
 MULT
 IPLE
 ,
 BILA
 TERA
 L
253..     27397
(5)TR
 ANSP
 LANT
 ,
 HAMS
 TRIN
 G
 TEND
 ON
 TO
 PATE
 LLA;
 MULT
 IPLE
253..     27400
(5)TE
 NDON
 OR
 MUSC
 LE
 TRAN
 SFER
 ,
 HAMS
 TRIN
 GS
 TO
 FEMU
 R
 (EGG
 ERS
 TYPE
 PROC
 EDUR
 E)
253..     27405
(5)RE
 PAIR
 ,
 PRIM
 ARY,
 TORN
 LIGA
 MENT
 AND/
 OR
 CAPS
 ULE,
 KNEE
 ;
 COLL
 ATER
 AL
253..     27407
(5)RE
 PAIR
 ,
 PRIM
 ARY,
 TORN
 LIGA
 MENT
 AND/
 OR
 CAPS
 ULE,
 KNEE
 ;
 CRUC
 IATE
253..     27409
(5)RE
 PAIR
 ,
 PRIM
 ARY,
 TORN
 LIGA
 MENT
 AND/
 OR
 CAPS
 ULE,
 KNEE
 ;
 COLL
 ATER
 AL
 AND
 CRUC
 IATE
 LIGA
 MENT
 S
253..     27418
(5)AN
 TERI
 OR
 TIBI
 AL
 TUBE
 RCLE
 PLAS
 TY
 (EG,
 FOR
 CHON
 DROM
 ALAC
 IA
 PATE
 LLAE
 )
253..     27420
(5)RE
 CONS
 TRUC
 TION
 FOR
 RECU
 RREN
 T
 DISL
 OCAT
 ING
 PATE
 LLA;
 (HAU
 SER
 TYPE
 PROC
 EDUR
 E)
253..     27422
(5)RE
 CONS
 TRUC
 TION
 FOR
 RECU
 RREN
 T
 DISL
 OCAT
 ING
 PATE
 LLA;
 WITH
 EXTE
 NSOR
 REAL
 IGNM
 ENT
 AND/
 OR
 MUSC
 LE
 ADVA
 NCEM
 ENT
 OR
 RELE
 ASE
 (CAM
 PBEL
 L,
 GOLD
 WAIT
 E
 TYPE
 PROC
 EDUR
 E)
253..     27424
(5)RE
 CONS
 TRUC
 TION
 FOR
 RECU
 RREN
 T
 DISL
 OCAT
 ING
 PATE
 LLA;
 WITH
 PATE
 LLEC
 TOMY
253..     27430
(5)QU
 ADRI
 CEPS
 PLAS
 TY
 (BEN
 NETT
 OR
 THOM
 PSON
 TYPE
 )
253..     27435
(5)CA
 PSUL
 OTOM
 Y,
 KNEE
 ,
 POST
 ERIO
 R
 CAPS
 ULAR
 RELE
 ASE
253..     27640
(5)PA
 RTIA
 L
 EXCI
 SION
 (CRA
 TERI
 ZATI
 ON,
 SAUC
 ERIZ
 ATIO
 N,
 OR
 DIAP
 HYSE
 CTOM
 Y)
 OF
 BONE
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 EXOS
 TOSI
 S);
 TIBI
 A
253..     27647
(5)RA
 DICA
 L
 RESE
 CTIO
 N OF
 TUMO
 R,
 BONE
 ;
 TALU
 S OR
 CALC
 ANEU
 S
253..     27650
(5)RE
 PAIR
 ,
 PRIM
 ARY,
 OPEN
 OR
 PERC
 UTAN
 EOUS
 ,
 RUPT
 URED
 ACHI
 LLES
 TEND
 ON;
253..     27652
(5)RE
 PAIR
 ,
 PRIM
 ARY,
 OPEN
 OR
 PERC
 UTAN
 EOUS
 ,
 RUPT
 URED
 ACHI
 LLES
 TEND
 ON;
 WITH
 GRAF
 T
 (INC
 LUDE
 S
 OBTA
 ININ
 G
 GRAF
 T)
253..     27654
(5)RE
 PAIR
 ,
 SECO
 NDAR
 Y,
 RUPT
 URED
 ACHI
 LLES
 TEND
 ON,
 WITH
 OR
 WITH
 OUT
 GRAF
 T
253..     27690
(5)TR
 ANSF
 ER
 OR
 TRAN
 SPLA
 NT
 OF
 SING
 LE
 TEND
 ON
 (WIT
 H
 MUSC
 LE
 REDI
 RECT
 ION
 OR
 RERO
 UTIN
 G);
 SUPE
 RFIC
 IAL
 (EG,
 ANTE
 RIOR
 TIBI
 AL
 EXTE
 NSOR
 S
 INTO
 MIDF
 OOT)
253..     27691
(5)TR
 ANSF
 ER
 OR
 TRAN
 SPLA
 NT
 OF
 SING
 LE
 TEND
 ON
 (WIT
 H
 MUSC
 LE
 REDI
 RECT
 ION
 OR
 RERO
 UTIN
 G);
 DEEP
 (EG,
 ANTE
 RIOR
 TIBI
 AL
 OR
 POST
 ERIO
 R
 TIBI
 AL
 THRO
 UGH
 INTE
 ROSS
 EOUS
 SPAC
 E,
 FLEX
 OR
 DIGI
 TORU
 M
 LONG
 US,
 FLEX
 OR
 HALL
 UCIS
 LONG
 US,
 OR
 PERO
 NEAL
 TEND
 ON
 TO
 MIDF
 OOT
 OR
 HIND
 FOOT
 )
253..     27692
(5)TR
 ANSF
 ER
 OR
 TRAN
 SPLA
 NT
 OF
 SING
 LE
 TEND
 ON
 (WIT
 H
 MUSC
 LE
 REDI
 RECT
 ION
 OR
 RERO
 UTIN
 G);
 EACH
 ADDI
 TION
 AL
 TEND
 ON
253..     27705
(5)OS
 TEOT
 OMY;
 TIBI
 A
253..     27742
(5)EP
 IPHY
 SEAL
 ARRE
 ST
 BY
 EPIP
 HYSI
 ODES
 IS
 OR
 STAP
 LING
 ,
 COMB
 INED
 ,
 PROX
 IMAL
 AND
 DIST
 AL
 TIBI
 A
 AND
 FIBU
 LA;
 AND
 DIST
 AL
 FEMU
 R
253..     27745
(5)PR
 OPHY
 LACT
 IC
 TREA
 TMEN
 T
 (NAI
 LING
 ,
 PINN
 ING,
 PLAT
 ING
 OR
 WIRI
 NG)
 WITH
 OR
 WITH
 OUT
 METH
 YLME
 THAC
 RYLA
 TE,
 TIBI
 A
253..     27870
(5)AR
 THRO
 DESI
 S,
 ANKL
 E,
 ANY
 METH
 OD
253..     27871
(5)AR
 THRO
 DESI
 S,
 TIBI
 OFIB
 ULAR
 JOIN
 T,
 PROX
 IMAL
 OR
 DIST
 AL
254..
(1)Le         T  34.37                 $1,741.51             $937.11     $348.30
 vel
 IV
 Musc
 ulos
 kele
 tal
 Proc
 edur
 es
254..     23410
(5)RE
 PAIR
 OF
 RUPT
 URED
 MUSC
 ULOT
 ENDI
 NOUS
 CUFF
 (EG,
 ROTA
 TOR
 CUFF
 );
 ACUT
 E
254..     23412
(5)RE
 PAIR
 OF
 RUPT
 URED
 MUSC
 ULOT
 ENDI
 NOUS
 CUFF
 (EG,
 ROTA
 TOR
 CUFF
 );
 CHRO
 NIC
254..     23420
(5)RE
 PAIR
 OF
 COMP
 LETE
 SHOU
 LDER
 (ROT
 ATOR
 )
 CUFF
 AVUL
 SION
 ,
 CHRO
 NIC
 (INC
 LUDE
 S
 ACRO
 MIOP
 LAST
 Y)
254..     23430
(5)TE
 NODE
 SIS
 OF
 LONG
 TEND
 ON
 OF
 BICE
 PS
254..     23450
(5)CA
 PSUL
 ORRH
 APHY
 ,
 ANTE
 RIOR
 ;
 PUTT
 I-
 PLAT
 T
 PROC
 EDUR
 E OR
 MAGN
 USON
 TYPE
 OPER
 ATIO
 N
254..     23455
(5)CA
 PSUL
 ORRH
 APHY
 ,
 ANTE
 RIOR
 ;
 BANK
 ART
 TYPE
 OPER
 ATIO
 N
 WITH
 OR
 WITH
 OUT
 STAP
 LING
254..     23460
(5)CA
 PSUL
 ORRH
 APHY
 ,
 ANTE
 RIOR
 ,
 ANY
 TYPE
 ;
 WITH
 BONE
 BLOC
 K
254..     23462
(5)CA
 PSUL
 ORRH
 APHY
 ,
 ANTE
 RIOR
 ,
 ANY
 TYPE
 ;
 WITH
 CORA
 COID
 PROC
 ESS
 TRAN
 SFER
254..     23465
(5)CA
 PSUL
 ORRH
 APHY
 FOR
 RECU
 RREN
 T
 DISL
 OCAT
 ION,
 POST
 ERIO
 R,
 WITH
 OR
 WITH
 OUT
 BONE
 BLOC
 K
254..     23466
(5)CA
 PSUL
 ORRH
 APHY
 WITH
 ANY
 TYPE
 MULT
 I-
 DIRE
 CTIO
 NAL
 INST
 ABIL
 ITY
254..     27427
(5)LI
 GAME
 NTOU
 S
 RECO
 NSTR
 UCTI
 ON
 (AUG
 MENT
 ATIO
 N),
 KNEE
 ;
 EXTR
 A-
 ARTI
 CULA
 R
254..     27428
(5)LI
 GAME
 NTOU
 S
 RECO
 NSTR
 UCTI
 ON
 (AUG
 MENT
 ATIO
 N),
 KNEE
 ;
 INTR
 A-
 ARTI
 CULA
 R
 (OPE
 N)
254..     27429
(5)LI
 GAME
 NTOU
 S
 RECO
 NSTR
 UCTI
 ON
 (AUG
 MENT
 ATIO
 N),
 KNEE
 ;
 INTR
 A-
 ARTI
 CULA
 R
 (OPE
 N)
 AND
 EXTR
 A-
 ARTI
 CULA
 R
261..
(1)Le         T  10.54                 $534.06               $261.48     $106.81
 vel
 I
 Hand
 Musc
 ulos
 kele
 tal
 Proc
 edur
 es
261..     25111
(5)EX
 CISI
 ON
 OF
 GANG
 LION
 ,
 WRIS
 T
 (DOR
 SAL
 OR
 VOLA
 R);
 PRIM
 ARY
[[Page 47784]]
261..     25112
(5)EX
 CISI
 ON
 OF
 GANG
 LION
 ,
 WRIS
 T
 (DOR
 SAL
 OR
 VOLA
 R);
 RECU
 RREN
 T
261..     25820
(5)IN
 TERC
 ARPA
 L
 FUSI
 ON;
 WITH
 OUT
 BONE
 GRAF
 T
261..     26020
(5)DR
 AINA
 GE
 OF
 TEND
 ON
 SHEA
 TH,
 ONE
 DIGI
 T
 AND/
 OR
 PALM
261..     26025
(5)DR
 AINA
 GE
 OF
 PALM
 AR
 BURS
 A;
 SING
 LE,
 ULNA
 R OR
 RADI
 AL
261..     26030
(5)DR
 AINA
 GE
 OF
 PALM
 AR
 BURS
 A;
 MULT
 IPLE
 OR
 COMP
 LICA
 TED
261..     26034
(5)IN
 CISI
 ON,
 DEEP
 ,
 WITH
 OPEN
 ING
 OF
 BONE
 CORT
 EX
 (EG,
 FOR
 OSTE
 OMYE
 LITI
 S OR
 BONE
 ABSC
 ESS)
 ,
 HAND
 OR
 FING
 ER
261..     26035
(5)DE
 COMP
 RESS
 ION
 FING
 ERS
 AND/
 OR
 HAND
 ,
 INJE
 CTIO
 N
 INJU
 RY
 (EG,
 GREA
 SE
 GUN)
261..     26037
(5)DE
 COMP
 RESS
 IVE
 FASC
 IOTO
 MY,
 HAND
 (EXC
 LUDE
 S
 2603
 5)
261..     26055
(5)TE
 NDON
 SHEA
 TH
 INCI
 SION
 (EG,
 FOR
 TRIG
 GER
 FING
 ER)
261..     26060
(5)TE
 NOTO
 MY,
 PERC
 UTAN
 EOUS
 ,
 SING
 LE,
 EACH
 DIGI
 T
261..     26070
(5)AR
 THRO
 TOMY
 ,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
 ;
 CARP
 OMET
 ACAR
 PAL
 JOIN
 T
261..     26075
(5)AR
 THRO
 TOMY
 ,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
 ;
 META
 CARP
 OPHA
 LANG
 EAL
 JOIN
 T
261..     26080
(5)AR
 THRO
 TOMY
 ,
 WITH
 EXPL
 ORAT
 ION,
 DRAI
 NAGE
 , OR
 REMO
 VAL
 OF
 FORE
 IGN
 BODY
 ;
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T,
 EACH
261..     26100
(5)AR
 THRO
 TOMY
 WITH
 SYNO
 VIAL
 BIOP
 SY;
 CARP
 OMET
 ACAR
 PAL
 JOIN
 T
261..     26105
(5)AR
 THRO
 TOMY
 WITH
 SYNO
 VIAL
 BIOP
 SY;
 META
 CARP
 OPHA
 LANG
 EAL
 JOIN
 T
261..     26110
(5)AR
 THRO
 TOMY
 WITH
 SYNO
 VIAL
 BIOP
 SY;
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T,
 EACH
261..     26130
(5)SY
 NOVE
 CTOM
 Y,
 CARP
 OMET
 ACAR
 PAL
 JOIN
 T
261..     26140
(5)SY
 NOVE
 CTOM
 Y,
 PROX
 IMAL
 INTE
 RPHA
 LANG
 EAL
 JOIN
 T,
 INCL
 UDIN
 G
 EXTE
 NSOR
 RECO
 NSTR
 UCTI
 ON,
 EACH
 INTE
 RPHA
 LANG
 EAL
261..     26145
(5)SY
 NOVE
 CTOM
 Y
 TEND
 ON
 SHEA
 TH,
 RADI
 CAL
 (TEN
 OSYN
 OVEC
 TOMY
 ),
 FLEX
 OR,
 PALM
 OR
 FING
 ER,
 SING
 LE,
 EACH
 DIGI
 T
261..     26160
(5)EX
 CISI
 ON
 OF
 LESI
 ON
 OF
 TEND
 ON
 SHEA
 TH
 OR
 CAPS
 ULE
 (EG,
 CYST
 ,
 MUCO
 US
 CYST
 , OR
 GANG
 LION
 ),
 HAND
 OR
 FING
 ER
261..     26170
(5)EX
 CISI
 ON
 OF
 TEND
 ON,
 PALM
 ,
 FLEX
 OR,
 SING
 LE
 (SEP
 ARAT
 E
 PROC
 EDUR
 E),
 EACH
261..     26180
(5)EX
 CISI
 ON
 OF
 TEND
 ON,
 FING
 ER,
 FLEX
 OR
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
261..     26185
(5)SE
 SAMO
 IDEC
 TOMY
 ,
 THUM
 B OR
 FING
 ER
 (SEP
 ARAT
 E
 PROC
 EDUR
 E)
261..     26200
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 META
 CARP
 AL;
261..     26210
(5)EX
 CISI
 ON
 OR
 CURE
 TTAG
 E OF
 BONE
 CYST
 OR
 BENI
 GN
 TUMO
 R OF
 PROX
 IMAL
 ,
 MIDD
 LE,
 OR
 DIST
 AL