|
Ot evaluation low complexity patient/family
|
$94.62 |
$94.62 |
$94.62 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$104.50 |
$104.50 |
$104.50 |
$263.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$50.35 |
$50.35 |
$50.35 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$42.94 |
$42.94 |
$42.94 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$45.41 |
$45.41 |
$45.41 |
$105.00
|
|
Otolaryngo binocular microscopy 92504
|
$14.06 |
$14.06 |
$14.06 |
$60.45
|
|
Otoplasty 69300
|
$314.26 |
$314.26 |
$314.26 |
$3,589.62
|
|
Ot re-evaluation patient/family
|
$69.92 |
$69.92 |
$69.92 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$42.56 |
$42.56 |
$42.56 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$38.38 |
$38.38 |
$38.38 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$38.38 |
$38.38 |
$38.38 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$40.47 |
$40.47 |
$40.47 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$44.84 |
$44.84 |
$44.84 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$42.18 |
$42.18 |
$42.18 |
$94.25
|
|
Ovarian cystectomy 58925
|
$498.18 |
$498.18 |
$498.18 |
$5,841.60
|
|
Oxytocin 10 unit/ml injection solution
|
$5.73 |
$5.73 |
$5.73 |
$50.40
|
|
Palivizumab 50 mg/0.5 ml inj
|
$605.72 |
$605.72 |
$605.72 |
$5,569.20
|
|
Pancreatectomy dist subtot w/wo splenecto 48140
|
$991.23 |
$991.23 |
$991.23 |
$2,927.40
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$8.13 |
$8.13 |
$8.13 |
$29.31
|
|
Papaverin hcl injection
|
$16.53 |
$16.53 |
$16.53 |
$77.05
|
|
Parathormone (pth) intact
|
$96.71 |
$96.71 |
$96.71 |
$204.87
|
|
Parathyrdec/expl parathyr medstnl sternal/tthrc 60505
|
$910.86 |
$910.86 |
$910.86 |
$3,164.04
|
|
Parathyroid planar imaging
|
$463.41 |
$463.41 |
$463.41 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$535.99 |
$535.99 |
$535.99 |
$1,350.60
|
|
Parial mast w/lymph removal 19302
|
$582.35 |
$582.35 |
$582.35 |
$5,509.55
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$89.11 |
$89.11 |
$89.11 |
$245.00
|
|
Part exc/post vert comp/sng/thorac 22101
|
$582.16 |
$582.16 |
$582.16 |
$6,028.71
|
|
Part hymenectomy/revi hymenal ring 56700
|
$133.95 |
$133.95 |
$133.95 |
$3,762.53
|
|
Partial complicated cystectomy 51555
|
$813.58 |
$813.58 |
$813.58 |
$2,497.20
|
|
Partial exc bone humerus
|
$469.87 |
$469.87 |
$469.87 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$295.64 |
$295.64 |
$295.64 |
$4,914.00
|
|
Partial excision of lip
|
$250.42 |
$250.42 |
$250.42 |
$3,837.72
|
|
Partial hip replacement
|
$741.95 |
$741.95 |
$741.95 |
$3,874.00
|
|
Partial hysterectomy
|
$620.92 |
$620.92 |
$620.92 |
$2,400.00
|
|
Partial proctectomy; perineal 45123
|
$716.30 |
$716.30 |
$716.30 |
$2,772.80
|
|
Partial removal finger bone
|
$334.40 |
$334.40 |
$334.40 |
$2,021.04
|
|
Partial removal finger bone
|
$301.34 |
$301.34 |
$301.34 |
$2,049.27
|
|
Partial removal foot fascia
|
$242.44 |
$242.44 |
$242.44 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$599.64 |
$599.64 |
$599.64 |
$4,315.20
|
|
Partial removal of bladder
|
$622.82 |
$622.82 |
$622.82 |
$1,465.20
|
|
Partial removal of eye fluid
|
$319.01 |
$319.01 |
$319.01 |
$2,698.92
|
|
Partial removal of eye fluid
|
$363.28 |
$363.28 |
$363.28 |
$2,698.92
|
|
Partial removal of fibula
|
$436.62 |
$436.62 |
$436.62 |
$3,786.00
|
|
Partial removal of foot bone
|
$406.60 |
$406.60 |
$406.60 |
$3,839.54
|
|
Partial removal of hand bone
|
$338.77 |
$338.77 |
$338.77 |
$3,839.54
|
|
Partial removal of lip
|
$270.56 |
$270.56 |
$270.56 |
$3,544.29
|
|
Partial removal of lung 32480
|
$917.32 |
$917.32 |
$917.32 |
$2,868.60
|
|
Partial removal of nose
|
$529.53 |
$529.53 |
$529.53 |
$6,603.11
|
|
Partial removal of penis
|
$414.58 |
$414.58 |
$414.58 |
$4,081.37
|
|
Partial removal of radius
|
$394.63 |
$394.63 |
$394.63 |
$3,839.54
|
|
Partial removal of radius
|
$295.83 |
$295.83 |
$295.83 |
$3,472.00
|
|
Partial removal of rectum
|
$695.21 |
$695.21 |
$695.21 |
$2,684.00
|
|
Partial removal of rib
|
$379.43 |
$379.43 |
$379.43 |
$5,376.00
|
|
Partial removal of sternum
|
$326.42 |
$326.42 |
$326.42 |
$1,236.00
|
|
Partial removal of thyroid
|
$459.61 |
$459.61 |
$459.61 |
$6,457.82
|
|
Partial removal of thyroid
|
$609.33 |
$609.33 |
$609.33 |
$5,855.00
|
|
Partial removal of tibia
|
$547.39 |
$547.39 |
$547.39 |
$4,108.80
|
|
Partial removal of tongue
|
$707.18 |
$707.18 |
$707.18 |
$5,978.70
|
|
Partial removal of ulna
|
$340.67 |
$340.67 |
$340.67 |
$3,839.54
|
|
Partial removal of ulna
|
$293.93 |
$293.93 |
$293.93 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$354.73 |
$354.73 |
$354.73 |
$3,762.53
|
|
Partial thyroid excision
|
$459.61 |
$459.61 |
$459.61 |
$6,457.82
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$653.79 |
$653.79 |
$653.79 |
$6,376.26
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$2.28 |
$2.28 |
$2.28 |
$4,921.76
|
|
Part removal hip bone deep
|
$641.82 |
$641.82 |
$641.82 |
$2,229.48
|
|
Part removal of metatarsal
|
$200.07 |
$200.07 |
$200.07 |
$3,795.71
|
|
Part removal of metatarsal
|
$290.51 |
$290.51 |
$290.51 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$211.85 |
$211.85 |
$211.85 |
$3,839.54
|
|
Patient recorded spirometry
|
$27.36 |
$27.36 |
$27.36 |
$456.56
|
|
Patient recorded spirometry
|
$15.96 |
$15.96 |
$15.96 |
$338.52
|
|
Pca3/klk3 antigen
|
$48.46 |
$48.46 |
$48.46 |
$510.40
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$478.04 |
$478.04 |
$478.04 |
$2,837.09
|
|
Ped crit care transport
|
$106.40 |
$106.40 |
$106.40 |
$434.40
|
|
Ped crit care transport addl
|
$53.39 |
$53.39 |
$53.39 |
$217.60
|
|
Ped critical care initial
|
$354.92 |
$354.92 |
$354.92 |
$1,446.40
|
|
Ped critical care subsq
|
$182.97 |
$182.97 |
$182.97 |
$724.00
|
|
Pedicle enel/ntroral 15576
|
$432.44 |
$432.44 |
$432.44 |
$2,501.10
|
|
Pelvic CT scan (with and without contrast)
|
$1,116.25 |
$1,116.25 |
$1,116.25 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,016.50 |
$1,016.50 |
$1,016.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$806.17 |
$806.17 |
$806.17 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,593.34 |
$1,593.34 |
$1,593.34 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$1,226.45 |
$1,226.45 |
$1,226.45 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$1,141.52 |
$1,141.52 |
$1,141.52 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$278.73 |
$278.73 |
$278.73 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$197.79 |
$197.79 |
$197.79 |
$430.00
|
|
Peng benzathine/procaine inj
|
$16.34 |
$16.34 |
$16.34 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$270.13 |
$270.13 |
$270.13 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$20.01 |
$20.01 |
$20.01 |
$101.34
|
|
Penicillin g procaine inj
|
$358.91 |
$358.91 |
$358.91 |
$147.96
|
|
Penile injection
|
$61.18 |
$61.18 |
$61.18 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$19,587.67 |
$19,587.67 |
$19,587.67 |
$18,764.94
|
|
Penile vascular study
|
$343.90 |
$343.90 |
$343.90 |
$576.40
|
|
Penile vascular study
|
$15.77 |
$15.77 |
$15.77 |
$574.60
|
|
Penis plastic surgery
|
$470.63 |
$470.63 |
$470.63 |
$4,081.37
|
|
Perc d-e cor revasc chro sin
|
$277.40 |
$277.40 |
$277.40 |
$18,808.65
|
|
Perc d-e cor revasc t cabg s
|
$142.50 |
$142.50 |
$142.50 |
$16,047.20
|
|
Perc d-e cor stent ather s
|
$225.91 |
$225.91 |
$225.91 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$119.89 |
$119.89 |
$119.89 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$235.60 |
$235.60 |
$235.60 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$4,458.35 |
$4,458.35 |
$4,458.35 |
$7,243.60
|