|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$81.00 |
$81.00 |
$81.00 |
$152.85
|
|
Pretreat rbc absorption reference
|
$17.73 |
$17.73 |
$17.73 |
$150.00
|
|
Pretreat rbc w chem/drugs reference
|
$31.38 |
$31.38 |
$31.38 |
$112.20
|
|
Pretreat rbc w enzyme reference
|
$75.42 |
$75.42 |
$75.42 |
$167.05
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$132.48 |
$132.48 |
$132.48 |
$297.00
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$62.64 |
$62.64 |
$62.64 |
$188.86
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$389.16 |
$389.16 |
$389.16 |
$1,917.33
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$671.76 |
$671.76 |
$671.76 |
$2,265.60
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$499.86 |
$499.86 |
$499.86 |
$779.35
|
|
Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury
|
$870.30 |
$870.30 |
$870.30 |
$3,336.80
|
|
Prgrmg dev eval pm/ldls pm
|
$82.26 |
$82.26 |
$82.26 |
$139.10
|
|
Prgrmg dev eval scrms ip
|
$11.52 |
$11.52 |
$11.52 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$18.90 |
$18.90 |
$18.90 |
$157.00
|
|
Prgrmg eval implantable dfb
|
$127.80 |
$127.80 |
$127.80 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$133.20 |
$133.20 |
$133.20 |
$205.40
|
|
Prgr stim/pace a/iv drug
|
$2,935.26 |
$2,935.26 |
$2,935.26 |
$4,601.35
|
|
Pr hospital ip/obs care initial high level per day
|
$88.20 |
$88.20 |
$88.20 |
$350.35
|
|
Pr hospital ip/obs care initial moderate level per day
|
$60.12 |
$60.12 |
$60.12 |
$246.40
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$37.98 |
$37.98 |
$37.98 |
$180.05
|
|
Pr hospital ip/obs care subsequent high level per day
|
$54.54 |
$54.54 |
$54.54 |
$189.80
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$36.54 |
$36.54 |
$36.54 |
$119.60
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$22.50 |
$22.50 |
$22.50 |
$74.75
|
|
Prim art mech thrmbc non-intracranial
|
$8,139.24 |
$8,139.24 |
$8,139.24 |
$9,149.60
|
|
Prim art mech thrmbc non-intracranial add-on
|
$3,370.32 |
$3,370.32 |
$3,370.32 |
$3,687.00
|
|
Pr incision & drainage abscess complicated/multiple
|
$381.78 |
$381.78 |
$381.78 |
$696.00
|
|
Pr incision & drainage abscess simple/single
|
$180.36 |
$180.36 |
$180.36 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$272.52 |
$272.52 |
$272.52 |
$539.80
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$263.16 |
$263.16 |
$263.16 |
$586.80
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$249.66 |
$249.66 |
$249.66 |
$256.27
|
|
Pr neuroplasty and/or transposition ulnar nerve at elbow
|
$415.08 |
$415.08 |
$415.08 |
$4,154.01
|
|
Probe cryo 1150mm endo flex ster disp
|
$1,871.82 |
$1,871.82 |
$1,871.82 |
$7,267.51
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$58.45 |
$58.45 |
$58.45 |
$670.00
|
|
Procalcitonin
|
$98.46 |
$98.46 |
$98.46 |
$161.11
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$12.23 |
$12.23 |
$12.23 |
$36.72
|
|
Proctosigmoidoscopy dx 45300
|
$738.54 |
$738.54 |
$738.54 |
$1,078.88
|
|
Progesterone
|
$132.12 |
$132.12 |
$132.12 |
$115.64
|
|
Prolactin
|
$86.40 |
$86.40 |
$86.40 |
$123.50
|
|
Prolng ip/obs e/m ea 15 min
|
$94.50 |
$94.50 |
$94.50 |
$63.00
|
|
Prolng off/op e/m ea 15 min 99417
|
$5.94 |
$5.94 |
$5.94 |
$61.10
|
|
Prolong service without contact
|
$56.70 |
$56.70 |
$56.70 |
$165.20
|
|
Prolong serv without contact add
|
$9.72 |
$9.72 |
$9.72 |
$81.20
|
|
Promethazine hcl injection
|
$9.96 |
$9.96 |
$9.96 |
$12.96
|
|
Propofol infusion 10 mg/ml
|
$21.30 |
$21.30 |
$21.30 |
$73.36
|
|
_propoxygc/msur
|
$33.48 |
$33.48 |
$33.48 |
$96.85
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$10.85 |
$10.85 |
$10.85 |
$32.93
|
|
Prostate biopsy, any mthd
|
$101.34 |
$101.34 |
$101.34 |
$481.77
|
|
Protamine 10 mg/ml intravenous solution
|
$24.73 |
$24.73 |
$24.73 |
$57.89
|
|
Protein c activity
|
$2.21 |
$2.21 |
$2.21 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$142.38 |
$142.38 |
$142.38 |
$84.00
|
|
Protein s total
|
$1.86 |
$1.86 |
$1.86 |
$83.52
|
|
Protein total 24 hour urine
|
$52.56 |
$52.56 |
$52.56 |
$52.50
|
|
Protein total body fluid
|
$43.74 |
$43.74 |
$43.74 |
$49.80
|
|
Protein total serum plasma whole blood
|
$37.26 |
$37.26 |
$37.26 |
$42.81
|
|
Prothrombin complex kcentra
|
$0.71 |
$0.71 |
$0.71 |
$7.40
|
|
Prothrombin time substitution plasma fractions each
|
$67.32 |
$67.32 |
$67.32 |
$41.50
|
|
Prp i/hern init block >5 yr
|
$329.22 |
$329.22 |
$329.22 |
$4,176.15
|
|
Pr planning advance care 1st 30 minutes
|
$41.94 |
$41.94 |
$41.94 |
$121.00
|
|
Prq card revasc mi 1 vsl
|
$6,558.12 |
$6,558.12 |
$6,558.12 |
$15,190.50
|
|
Prq card revasc mi 1 vsl drug-eluting
|
$8,530.92 |
$8,530.92 |
$8,530.92 |
$18,150.00
|
|
Prq revasc byp graft 1 art and/or branches
|
$10,791.18 |
$10,791.18 |
$10,791.18 |
$13,398.65
|
|
Prq tcat plmt ntrac st 1 les
|
$8,076.06 |
$8,076.06 |
$8,076.06 |
$13,239.59
|
|
Prq tcat plmt ntrac st 2+les
|
$11,003.04 |
$11,003.04 |
$11,003.04 |
$22,098.20
|
|
Prq trlml c athrc st angiop1
|
$10,113.66 |
$10,113.66 |
$10,113.66 |
$15,296.00
|
|
Prq trl rvs ch occ ant&rtrgr
|
$6,368.94 |
$6,368.94 |
$6,368.94 |
$23,158.66
|
|
Prq trluml c angiop 1art&/br
|
$6,051.96 |
$6,051.96 |
$6,051.96 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$7,070.58 |
$7,070.58 |
$7,070.58 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$6,363.54 |
$6,363.54 |
$6,363.54 |
$15,349.60
|
|
Pr removal drug delivery implant
|
$306.00 |
$306.00 |
$306.00 |
$533.00
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$378.90 |
$378.90 |
$378.90 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$128.52 |
$128.52 |
$128.52 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$138.06 |
$138.06 |
$138.06 |
$414.00
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$109.62 |
$109.62 |
$109.62 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$134.28 |
$134.28 |
$134.28 |
$396.00
|
|
Pr robotic surgical system
|
$26.82 |
$26.82 |
$26.82 |
$0.52
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$408.96 |
$408.96 |
$408.96 |
$3,087.15
|
|
Pr subsequent hospital care e/m normal newborn per day
|
$18.54 |
$18.54 |
$18.54 |
$71.40
|
|
Prtl excision bone clavicle
|
$469.80 |
$469.80 |
$469.80 |
$6,311.00
|
|
Pr visit complexity e&m service serious/complex condition
|
$12.24 |
$12.24 |
$12.24 |
$27.30
|
|
PSA (Prostate) Test
|
$77.22 |
$77.22 |
$77.22 |
$107.50
|
|
Psychotherapy group therapy
|
$80.46 |
$80.46 |
$80.46 |
$216.80
|
|
Psychotherapy patient individual therapy 30 minutes
|
$124.20 |
$124.20 |
$124.20 |
$189.14
|
|
Psychotherapy patient individual therapy 45 minutes
|
$133.56 |
$133.56 |
$133.56 |
$247.59
|
|
Psychotherapy patient individual therapy 60 minutes
|
$133.56 |
$133.56 |
$133.56 |
$287.47
|
|
Psytx complex interactive
|
$72.18 |
$72.18 |
$72.18 |
$47.60
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$55.80 |
$55.80 |
$55.80 |
$87.45
|
|
Pt application of modality >=1 area hot/cold packs
|
$32.04 |
$32.04 |
$32.04 |
$35.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$59.22 |
$59.22 |
$59.22 |
$102.05
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$45.72 |
$45.72 |
$45.72 |
$81.00
|
|
Pt application of modality traction mechanical
|
$59.94 |
$59.94 |
$59.94 |
$91.00
|
|
Pten gene known fam variant
|
$6.85 |
$6.85 |
$6.85 |
$127.86
|
|
Pt evaluation high complexity patient/family
|
$246.96 |
$246.96 |
$246.96 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$241.20 |
$241.20 |
$241.20 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$244.80 |
$244.80 |
$244.80 |
$254.88
|
|
Pt re-evaluation patient/family
|
$115.20 |
$115.20 |
$115.20 |
$152.80
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$64.98 |
$64.98 |
$64.98 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$42.66 |
$42.66 |
$42.66 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$66.24 |
$66.24 |
$66.24 |
$87.50
|
|
Pul art balloon repr percut
|
$2,820.06 |
$2,820.06 |
$2,820.06 |
$9,760.40
|
|
Pul art balloon repr percut
|
$2,255.94 |
$2,255.94 |
$2,255.94 |
$3,965.20
|
|
Pulmonary vent imaging
|
$402.66 |
$402.66 |
$402.66 |
$908.00
|