|
Nursing facility discharge management 30 min/less than 99315
|
$41.78 |
$41.78 |
$41.78 |
$132.60
|
|
Observation/inpatient hospital care hi severity 99236
|
$137.03 |
$137.03 |
$137.03 |
$438.60
|
|
Observation/inpatient hospital care low severity 99234
|
$83.55 |
$83.55 |
$83.55 |
$269.40
|
|
Observation/inpatient hospital care mod severity 99235
|
$110.54 |
$110.54 |
$110.54 |
$340.80
|
|
Observation per hour
|
$38.46 |
$38.46 |
$38.46 |
$82.93
|
|
Off/op cnsltj new/est low 30
|
$129.65 |
$129.65 |
$129.65 |
$213.60
|
|
Off/op cnsltj new/est mod 40
|
$188.48 |
$188.48 |
$188.48 |
$319.02
|
|
Off/op consltj new/est hi 55
|
$212.17 |
$212.17 |
$212.17 |
$401.60
|
|
Off/op consltj new/est sf 20
|
$94.75 |
$94.75 |
$94.75 |
$160.00
|
|
Organic acids total quant ea spec
|
$49.67 |
$49.67 |
$49.67 |
$151.36
|
|
Oritavancin 400 mg intravenous solution
|
$2,172.65 |
$2,172.65 |
$2,172.65 |
$3,745.44
|
|
Orthosis lso rigd frm hyperex
|
$330.70 |
$330.70 |
$330.70 |
$813.61
|
|
Oscillation chest wall mechanical per session
|
$36.68 |
$36.68 |
$36.68 |
$221.34
|
|
Osmolality blood
|
$8.16 |
$8.16 |
$8.16 |
$67.60
|
|
Osmolality urine
|
$7.90 |
$7.90 |
$7.90 |
$65.65
|
|
Other immunoelectrophoresis
|
$19.62 |
$19.62 |
$19.62 |
$46.40
|
|
Oth resp proc, indiv
|
$33.88 |
$33.88 |
$33.88 |
$89.70
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$51.47 |
$51.47 |
$51.47 |
$67.80
|
|
Oxytocin 10 unit/ml injection solution
|
$8.47 |
$8.47 |
$8.47 |
$48.29
|
|
Packing strips, non-impreg
|
$3.21 |
$3.21 |
$3.21 |
$7.14
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$67.10 |
$67.10 |
$67.10 |
$131.62
|
|
Parathormone (pth) intact
|
$107.74 |
$107.74 |
$107.74 |
$200.23
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$67.25 |
$67.25 |
$67.25 |
$270.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$2,642.37 |
$2,642.37 |
$2,642.37 |
$4,418.35
|
|
Pelvic CT scan (with and without contrast)
|
$732.27 |
$732.27 |
$732.27 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$639.30 |
$639.30 |
$639.30 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$546.34 |
$546.34 |
$546.34 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$1,243.45 |
$1,243.45 |
$1,243.45 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$1,007.34 |
$1,007.34 |
$1,007.34 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$932.72 |
$932.72 |
$932.72 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$280.68 |
$280.68 |
$280.68 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$79.98 |
$79.98 |
$79.98 |
$445.00
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$389.89 |
$389.89 |
$389.89 |
$643.59
|
|
Penile injection
|
$148.50 |
$148.50 |
$148.50 |
$418.00
|
|
Perc cryo ablate renal tum
|
$2,862.83 |
$2,862.83 |
$2,862.83 |
$12,320.22
|
|
Perc rf ablate renal tumor
|
$3,830.44 |
$3,830.44 |
$3,830.44 |
$6,949.48
|
|
Percut ablate liver rf
|
$4,354.36 |
$4,354.36 |
$4,354.36 |
$7,024.12
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$54.14 |
$54.14 |
$54.14 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$397.59 |
$397.59 |
$397.59 |
$2,573.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$14,120.57 |
$14,120.57 |
$14,120.57 |
$33,990.40
|
|
Ph body fluid
|
$7.65 |
$7.65 |
$7.65 |
$39.20
|
|
Phencyclidine (pcp)
|
$28.28 |
$28.28 |
$28.28 |
$88.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$49.33 |
$49.33 |
$49.33 |
$115.32
|
|
Phenobarbital therapeutic drug level
|
$62.41 |
$62.41 |
$62.41 |
$104.50
|
|
Phentolaine mesylate inj
|
$917.04 |
$917.04 |
$917.04 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$11.03 |
$11.03 |
$11.03 |
$57.09
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$8.47 |
$8.47 |
$8.47 |
$12.06
|
|
Phenytoin total therapeutic drug level
|
$66.99 |
$66.99 |
$66.99 |
$111.27
|
|
Phlebotomy therapeutic
|
$32.35 |
$32.35 |
$32.35 |
$249.00
|
|
Phosphorus
|
$14.27 |
$14.27 |
$14.27 |
$47.81
|
|
Phosphorus 24 hour urine
|
$10.70 |
$10.70 |
$10.70 |
$42.81
|
|
Pin caspar distraction 12mm
|
$3,565.80 |
$3,565.80 |
$3,565.80 |
$11,580.00
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$19.58 |
$19.58 |
$19.58 |
$101.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$175.75 |
$175.75 |
$175.75 |
$1,679.20
|
|
Platelet aggregation each agent teg
|
$50.94 |
$50.94 |
$50.94 |
$147.96
|
|
Platelet automated
|
$38.46 |
$38.46 |
$38.46 |
$44.00
|
|
Platelets each unit
|
$30.82 |
$30.82 |
$30.82 |
$240.25
|
|
Platelets pheresis leukocytes reduced each unit
|
$530.55 |
$530.55 |
$530.55 |
$1,235.83
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$542.01 |
$542.01 |
$542.01 |
$1,363.70
|
|
Pmp22 gene dup/delet
|
$349.71 |
$349.71 |
$349.71 |
$1,029.75
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$119.20 |
$119.20 |
$119.20 |
$173.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$1,307.63 |
$1,307.63 |
$1,307.63 |
$4,293.60
|
|
Potassium 24 hour urine
|
$11.47 |
$11.47 |
$11.47 |
$50.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$52.38 |
$52.38 |
$52.38 |
$76.40
|
|
Potassium serum/plasma/whole blood
|
$25.98 |
$25.98 |
$25.98 |
$44.64
|
|
Pq thr inj ext pse
|
$310.74 |
$310.74 |
$310.74 |
$872.61
|
|
Pr application of long arm splint
|
$105.45 |
$105.45 |
$105.45 |
$332.75
|
|
Pr application splint static short arm
|
$113.86 |
$113.86 |
$113.86 |
$301.60
|
|
Pr biopsy skin punch single lesion
|
$138.56 |
$138.56 |
$138.56 |
$472.79
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$40.76 |
$40.76 |
$40.76 |
$48.71
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$150.53 |
$150.53 |
$150.53 |
$356.40
|
|
Pr discharge day management hospital ip/obs <=30 min on ecounter date
|
$45.60 |
$45.60 |
$45.60 |
$148.00
|
|
Pr discharge day management hospital ip/obs > 30 min on encounter date
|
$64.19 |
$64.19 |
$64.19 |
$209.60
|
|
Prealbumin
|
$32.10 |
$32.10 |
$32.10 |
$87.20
|
|
Pr ecg 12 lead report only
|
$6.63 |
$6.63 |
$6.63 |
$19.20
|
|
Prednisone 1 mg tablet
|
$1.70 |
$1.70 |
$1.70 |
$3.41
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$1,041.22 |
$1,041.22 |
$1,041.22 |
$2,363.79
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$168.11 |
$168.11 |
$168.11 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$106.98 |
$106.98 |
$106.98 |
$541.45
|
|
Pr e&m preventive medicine initial comprehensive new patient 12-17 years
|
$53.49 |
$53.49 |
$53.49 |
$167.25
|
|
Prep skin to 100cm2 other
|
$689.99 |
$689.99 |
$689.99 |
$1,193.40
|
|
Prep skin to 100cm2 trk/ext
|
$689.99 |
$689.99 |
$689.99 |
$2,164.64
|
|
Pressure max expiratory/inspiratory
|
$41.01 |
$41.01 |
$41.01 |
$253.00
|
|
Prev med cnsl indiv apprx 15
|
$14.01 |
$14.01 |
$14.01 |
$80.60
|
|
Prev med cnsl indiv apprx 30
|
$103.16 |
$103.16 |
$103.16 |
$124.80
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$96.28 |
$96.28 |
$96.28 |
$178.57
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$677.00 |
$677.00 |
$677.00 |
$1,908.09
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$330.10 |
$330.10 |
$330.10 |
$827.94
|
|
Pr hospital ip/obs care initial high level per day
|
$122.52 |
$122.52 |
$122.52 |
$365.60
|
|
Pr hospital ip/obs care initial moderate level per day
|
$83.55 |
$83.55 |
$83.55 |
$261.00
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$61.90 |
$61.90 |
$61.90 |
$181.60
|
|
Pr hospital ip/obs care subsequent high level per day
|
$86.35 |
$86.35 |
$86.35 |
$217.60
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$46.11 |
$46.11 |
$46.11 |
$145.60
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$26.75 |
$26.75 |
$26.75 |
$78.60
|
|
Pr incision & drainage abscess complicated/multiple
|
$245.54 |
$245.54 |
$245.54 |
$648.80
|
|
Pr incision & drainage abscess simple/single
|
$213.44 |
$213.44 |
$213.44 |
$438.00
|
|
Pr incision & drainage abscess vulva/perineal
|
$276.86 |
$276.86 |
$276.86 |
$638.55
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$198.42 |
$198.42 |
$198.42 |
$615.60
|
|
Pr management transitional care high w/in 7 days of discharge
|
$86.35 |
$86.35 |
$86.35 |
$251.56
|
|
Pr management transitional care moderate w/in 14 days of discharge
|
$86.35 |
$86.35 |
$86.35 |
$198.90
|