Medical Procedure Costs

21296

Revision of jaw muscle/bone

Surgery - Musculoskeletal

$370

—

21315

Clsd tx nsl fx mnpj wo stblj

Surgery - Musculoskeletal

$54

—

21320

Clsd tx nsl fx w/mnpj&stablj

Surgery - Musculoskeletal

$82

—

21325

Open tx nose fx uncomplicatd

Surgery - Musculoskeletal

$414

—

21330

Open tx nose fx w/skele fixj

Surgery - Musculoskeletal

$490

—

21335

Open tx nose & septal fx

Surgery - Musculoskeletal

$649

—

21336

Open tx septal fx w/wo stabj

Surgery - Musculoskeletal

$583

—

21337

Closed tx septal&nose fx

Surgery - Musculoskeletal

$282

—

21338

Open nasoethmoid fx w/o fixj

Surgery - Musculoskeletal

$627

—

21339

Open nasoethmoid fx w/ fixj

Surgery - Musculoskeletal

$700

—

21340

Perq tx nasoethmoid fx

Surgery - Musculoskeletal

$660

—

21343

Open tx dprsd front sinus fx

Surgery - Musculoskeletal

$975

—

21344

Open tx compl front sinus fx

Surgery - Musculoskeletal

$1,215

—

21345

Closed tx nose/jaw fx

Surgery - Musculoskeletal

$568

—

21346

Opn tx nasomax fx w/fixj

Surgery - Musculoskeletal

$914

—

21347

Opn tx nasomax fx multple

Surgery - Musculoskeletal

$939

—

21348

Opn tx nasomax fx w/graft

Surgery - Musculoskeletal

$948

—

21355

Perq tx malar fracture

Surgery - Musculoskeletal

$294

—

21356

Opn tx dprsd zygomatic arch

Surgery - Musculoskeletal

$380

—

21360

Opn tx dprsd malar fracture

Surgery - Musculoskeletal

$469

—

21365

Opn tx complx malar fx

Surgery - Musculoskeletal

$963

—

21366

Opn tx complx malar w/grft

Surgery - Musculoskeletal

$1,139

—

21385

Opn tx orbit fx transantral

Surgery - Musculoskeletal

$674

—

21386

Opn tx orbit fx periorbital

Surgery - Musculoskeletal

$631

—

21387

Opn tx orbit fx combined

Surgery - Musculoskeletal

$702

—

21390

Opn tx orbit periorbtl implt

Surgery - Musculoskeletal

$708

—

21395

Opn tx orbit periorbt w/grft

Surgery - Musculoskeletal

$897

—

21400

Closed tx orbit w/o manipulj

Surgery - Musculoskeletal

$173

—

21401

Closed tx orbit w/manipulj

Surgery - Musculoskeletal

$316

—

21406

Opn tx orbit fx w/o implant

Surgery - Musculoskeletal

$542

—

21407

Opn tx orbit fx w/implant

Surgery - Musculoskeletal

$578

—

21408

Opn tx orbit fx w/bone grft

Surgery - Musculoskeletal

$814

—

21421

Cltx palatal/max fx wire fix

Surgery - Musculoskeletal

$514

—

21422

Optx palatal/max fracture

Surgery - Musculoskeletal

$590

—

21423

Optx palatal/max fx comp

Surgery - Musculoskeletal

$722

—

21431

Cltx craniofacial separation

Surgery - Musculoskeletal

$647

—

21432

Optx cranfcl sep w/wiring

Surgery - Musculoskeletal

$672

—

21433

Optx cranfcl sep comp mlt

Surgery - Musculoskeletal

$1,526

—

21435

Optx crnfc sep comp int&/xtr

Surgery - Musculoskeletal

$1,262

—

21436

Optx crnfcl sep comp mlt int

Surgery - Musculoskeletal

$1,805

—

21440

Cltx mndblr/max alv ridge fx

Surgery - Musculoskeletal

$602

—

21445

Optx mndblr/max alv ridge fx

Surgery - Musculoskeletal

$567

—

21450

Cltx mndblr fx w/o mnpj

Surgery - Musculoskeletal

$460

—

21451

Cltx mndblr fx w/mnpj

Surgery - Musculoskeletal

$608

—

21452

Perq tx mndblr fx xtrnl fixj

Surgery - Musculoskeletal

$459

—

21453

Cltx mndblr fx ntrdntl fixj

Surgery - Musculoskeletal

$892

—

21454

Optx mndblr fx xtrnl fixj

Surgery - Musculoskeletal

$451

—

21461

Optx mndblr fx wo ntrdntl

Surgery - Musculoskeletal

$970

—

21462

Optx mndblr fx w/ntrdntl

Surgery - Musculoskeletal

$1,107

—

21465

Optx mndblr cndylr fx

Surgery - Musculoskeletal

$724

—

My Cost List