|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$69.93 |
$69.93 |
$69.93 |
$141.00
|
|
Pretreat rbc absorption reference
|
$110.15 |
$110.15 |
$110.15 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$249.66 |
$249.66 |
$249.66 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$110.15 |
$110.15 |
$110.15 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$164.51 |
$164.51 |
$164.51 |
$166.10
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$139.20 |
$139.20 |
$139.20 |
$178.57
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$521.48 |
$521.48 |
$521.48 |
$1,908.09
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$299.04 |
$299.04 |
$299.04 |
$2,265.60
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$259.08 |
$259.08 |
$259.08 |
$827.94
|
|
Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury
|
$2,428.91 |
$2,428.91 |
$2,428.91 |
$3,938.98
|
|
Pr hospital ip/obs care initial high level per day
|
$383.62 |
$383.62 |
$383.62 |
$365.60
|
|
Pr hospital ip/obs care initial moderate level per day
|
$261.08 |
$261.08 |
$261.08 |
$261.00
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$191.81 |
$191.81 |
$191.81 |
$181.60
|
|
Pr hospital ip/obs care subsequent high level per day
|
$197.14 |
$197.14 |
$197.14 |
$217.60
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$137.87 |
$137.87 |
$137.87 |
$145.60
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$74.60 |
$74.60 |
$74.60 |
$78.60
|
|
Pr incision & drainage abscess complicated/multiple
|
$333.00 |
$333.00 |
$333.00 |
$648.80
|
|
Pr incision & drainage abscess simple/single
|
$179.16 |
$179.16 |
$179.16 |
$438.00
|
|
Pr incision & drainage abscess vulva/perineal
|
$180.49 |
$180.49 |
$180.49 |
$638.55
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$183.82 |
$183.82 |
$183.82 |
$615.60
|
|
Pr management transitional care high w/in 7 days of discharge
|
$277.06 |
$277.06 |
$277.06 |
$251.56
|
|
Pr management transitional care moderate w/in 14 days of discharge
|
$192.48 |
$192.48 |
$192.48 |
$198.90
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$770.57 |
$770.57 |
$770.57 |
$277.60
|
|
Pr neuroplasty and/or transposition ulnar nerve at elbow
|
$1,033.64 |
$1,033.64 |
$1,033.64 |
$2,921.60
|
|
Procalcitonin
|
$135.87 |
$135.87 |
$135.87 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$17.32 |
$17.32 |
$17.32 |
$44.76
|
|
Proctosigmoidoscopy dx 45300
|
$103.23 |
$103.23 |
$103.23 |
$1,073.68
|
|
Progesterone
|
$127.88 |
$127.88 |
$127.88 |
$105.00
|
|
Prolactin
|
$32.27 |
$32.27 |
$32.27 |
$127.50
|
|
Propofol infusion 10 mg/ml
|
$95.33 |
$95.33 |
$95.33 |
$71.09
|
|
Prostate biopsy, any mthd
|
$136.12 |
$136.12 |
$136.12 |
$492.80
|
|
Prostatectomy (turp)
|
$1,537.13 |
$1,537.13 |
$1,537.13 |
$5,741.00
|
|
Prostate laser enucleation
|
$1,497.17 |
$1,497.17 |
$1,497.17 |
$5,631.74
|
|
Protein c activity
|
$23.05 |
$23.05 |
$23.05 |
$115.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$17.89 |
$17.89 |
$17.89 |
$85.20
|
|
Protein s total
|
$8.00 |
$8.00 |
$8.00 |
$78.87
|
|
Protein total 24 hour urine
|
$85.92 |
$85.92 |
$85.92 |
$52.50
|
|
Protein total body fluid
|
$107.23 |
$107.23 |
$107.23 |
$52.57
|
|
Protein total serum plasma whole blood
|
$42.63 |
$42.63 |
$42.63 |
$42.81
|
|
Prp i/hern init block >5 yr
|
$1,543.13 |
$1,543.13 |
$1,543.13 |
$4,176.15
|
|
Pr planning advance care 1st 30 minutes
|
$133.87 |
$133.87 |
$133.87 |
$135.80
|
|
Pr removal drug delivery implant
|
$240.43 |
$240.43 |
$240.43 |
$614.27
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$80.59 |
$80.59 |
$80.59 |
$280.79
|
|
Pr removal intrauterine device
|
$220.45 |
$220.45 |
$220.45 |
$447.78
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$362.31 |
$362.31 |
$362.31 |
$775.50
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$110.56 |
$110.56 |
$110.56 |
$387.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$145.19 |
$145.19 |
$145.19 |
$440.00
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$93.24 |
$93.24 |
$93.24 |
$377.45
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$122.55 |
$122.55 |
$122.55 |
$422.00
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$2,753.28
|
|
Prtl exc bone olecrn process
|
$1,095.57 |
$1,095.57 |
$1,095.57 |
$3,819.82
|
|
Pr tube thoracostomy w/connection to drainage open
|
$305.03 |
$305.03 |
$305.03 |
$1,790.60
|
|
Pr visit complexity e&m service serious/complex condition
|
$27.98 |
$27.98 |
$27.98 |
$32.00
|
|
PSA (Prostate) Test
|
$127.21 |
$127.21 |
$127.21 |
$109.35
|
|
Psychoeducation 45 min +
|
$121.22 |
$121.22 |
$121.22 |
$201.45
|
|
Psychotherapy patient individual therapy 30 minutes
|
$165.84 |
$165.84 |
$165.84 |
$200.00
|
|
Psychotherapy patient individual therapy 45 minutes
|
$220.45 |
$220.45 |
$220.45 |
$267.00
|
|
Psychotherapy patient individual therapy 60 minutes
|
$352.32 |
$352.32 |
$352.32 |
$294.45
|
|
Psytx pt w/e&m 16-37 min
|
$132.54 |
$132.54 |
$132.54 |
$126.14
|
|
Pulmonary vent imaging
|
$2,923.74 |
$2,923.74 |
$2,923.74 |
$845.28
|
|
Pulse ox continuous overnight monitoring
|
$509.49 |
$509.49 |
$509.49 |
$368.00
|
|
Pulse ox multiple
|
$1,152.18 |
$1,152.18 |
$1,152.18 |
$194.33
|
|
Pulse ox single
|
$113.89 |
$113.89 |
$113.89 |
$88.63
|
|
Puncture arterial withdrawal blood for diagnosis
|
$161.84 |
$161.84 |
$161.84 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$2,019.98 |
$2,019.98 |
$2,019.98 |
$525.50
|
|
Puncture spinal lumbar diagnostic
|
$1,845.49 |
$1,845.49 |
$1,845.49 |
$1,134.64
|
|
Pyloroplasty 43800
|
$1,595.07 |
$1,595.07 |
$1,595.07 |
$2,285.60
|
|
Pyruvate kinase
|
$23.31 |
$23.31 |
$23.31 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$3,372.63 |
$3,372.63 |
$3,372.63 |
$1,524.16
|
|
Quant diff pulm perf w/imaging
|
$3,372.63 |
$3,372.63 |
$3,372.63 |
$1,209.44
|
|
Quest t3 uptake
|
$10.78 |
$10.78 |
$10.78 |
$56.10
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$11,103.62 |
$11,103.62 |
$11,103.62 |
$3,213.80
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$5,292.71 |
$5,292.71 |
$5,292.71 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$9,744.92 |
$9,744.92 |
$9,744.92 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$5,406.59 |
$5,406.59 |
$5,406.59 |
$2,377.65
|
|
Radphm lcl tumor plr sgl day
|
$2,891.78 |
$2,891.78 |
$2,891.78 |
$1,139.40
|
|
Rapid Strep Test
|
$17.32 |
$17.32 |
$17.32 |
$74.10
|
|
Reconstruct elbow med ligmnt
|
$1,912.09 |
$1,912.09 |
$1,912.09 |
$11,365.24
|
|
Reconstruction knee
|
$2,002.67 |
$2,002.67 |
$2,002.67 |
$8,814.96
|
|
Reconstruct shoulder joint
|
$2,131.87 |
$2,131.87 |
$2,131.87 |
$10,629.07
|
|
Reconstruct shoulder joint
|
$2,603.40 |
$2,603.40 |
$2,603.40 |
$7,160.00
|
|
Red blood cells leukocytes reduced each unit
|
$170.50 |
$170.50 |
$170.50 |
$439.45
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$217.12 |
$217.12 |
$217.12 |
$540.00
|
|
Reduce testis torsion
|
$829.17 |
$829.17 |
$829.17 |
$4,081.37
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$841.18 |
$841.18 |
$841.18 |
$468.96
|
|
Reinforce shoulder bones
|
$1,816.19 |
$1,816.19 |
$1,816.19 |
$10,629.07
|
|
Release finger contracture
|
$1,187.48 |
$1,187.48 |
$1,187.48 |
$1,893.86
|
|
Release knuckle contracture
|
$1,186.82 |
$1,186.82 |
$1,186.82 |
$3,591.33
|
|
Release of lower leg tendon
|
$788.55 |
$788.55 |
$788.55 |
$3,591.33
|
|
Release palm contracture
|
$579.42 |
$579.42 |
$579.42 |
$1,893.86
|
|
Release palm contracture
|
$782.55 |
$782.55 |
$782.55 |
$3,839.54
|
|
Release palm contracture
|
$1,801.53 |
$1,801.53 |
$1,801.53 |
$4,112.00
|
|
Release palm contracture
|
$481.52 |
$481.52 |
$481.52 |
$873.24
|
|
Release palm contracture 26045
|
$813.86 |
$813.86 |
$813.86 |
$3,545.97
|
|
Release wrist/forearm tendon
|
$909.76 |
$909.76 |
$909.76 |
$3,591.33
|
|
Rem/biv cast full arm/leg
|
$85.92 |
$85.92 |
$85.92 |
$370.80
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,808.86 |
$1,808.86 |
$1,808.86 |
$2,599.13
|
|
Removal cerumen impacted (both sides)
|
$67.94 |
$67.94 |
$67.94 |
$177.60
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$153.18 |
$153.18 |
$153.18 |
$245.60
|
|
Removal foreign body foot subcutaneous right
|
$487.52 |
$487.52 |
$487.52 |
$1,256.00
|