|
Shrinker prosth below knee
|
$55.00 |
$55.00 |
$55.00 |
$105.12
|
|
Shuntogram nonvascular supervision & interpretation
|
$15.13 |
$15.13 |
$15.13 |
$349.20
|
|
Sialography s&i
|
$118.32 |
$118.32 |
$118.32 |
$499.20
|
|
Sialolithotomy 42330
|
$988.72 |
$988.72 |
$988.72 |
$3,837.72
|
|
Sickling rbc
|
$19.13 |
$19.13 |
$19.13 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$173.57 |
$173.57 |
$173.57 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$65.28 |
$65.28 |
$65.28 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$67.83 |
$67.83 |
$67.83 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$176.63 |
$176.63 |
$176.63 |
$1,444.83
|
|
Sigmoidoscopy w/ablation
|
$92.14 |
$92.14 |
$92.14 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$60.86 |
$60.86 |
$60.86 |
$1,388.56
|
|
Sigmoidoscopy w/plcmt stent
|
$88.40 |
$88.40 |
$88.40 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$126.14 |
$126.14 |
$126.14 |
$2,564.40
|
|
Sigmoidoscopy w/tumr remove
|
$69.36 |
$69.36 |
$69.36 |
$1,558.80
|
|
Sigmoidoscopy w/ultrasound
|
$71.57 |
$71.57 |
$71.57 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$97.41 |
$97.41 |
$97.41 |
$2,106.60
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$54.40 |
$54.40 |
$54.40 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$45.22 |
$45.22 |
$45.22 |
$1,901.90
|
|
Simple cystometrogram 51725
|
$126.48 |
$126.48 |
$126.48 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$271.76 |
$271.76 |
$271.76 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$824.50 |
$824.50 |
$824.50 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$772.65 |
$772.65 |
$772.65 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$738.31 |
$738.31 |
$738.31 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$746.81 |
$746.81 |
$746.81 |
$2,489.25
|
|
Sinusotomy maxillary sinus 31020
|
$315.35 |
$315.35 |
$315.35 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$358.36 |
$358.36 |
$358.36 |
$6,177.60
|
|
Skeletal muscle relaxant 1/2
|
$30.26 |
$30.26 |
$30.26 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$1.02 |
$1.02 |
$1.02 |
$16.12
|
|
Skin Biopsy
|
$91.63 |
$91.63 |
$91.63 |
$360.34
|
|
Skin full graft 20sq cm less 15200
|
$818.72 |
$818.72 |
$818.72 |
$2,371.50
|
|
Skin full graft add-on 15241
|
$61.37 |
$61.37 |
$61.37 |
$675.58
|
|
Skin pedicle flap trunk
|
$428.06 |
$428.06 |
$428.06 |
$2,501.86
|
|
Skin split graft addl 100sq cm 15101
|
$63.07 |
$63.07 |
$63.07 |
$1,793.40
|
|
Skyla, 13.5 mg
|
$310.59 |
$310.59 |
$310.59 |
$1,643.47
|
|
Sleep study attended
|
$140.42 |
$140.42 |
$140.42 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$896.75 |
$896.75 |
$896.75 |
$3,607.50
|
|
Sleep study unattended
|
$238.68 |
$238.68 |
$238.68 |
$580.87
|
|
Sleeve fing rolyan med
|
$67.75 |
$67.75 |
$67.75 |
$203.58
|
|
Sling arm deluxe w/pad xs
|
$6.67 |
$6.67 |
$6.67 |
$30.35
|
|
Sling suprapubic suburetheral
|
$1,685.21 |
$1,685.21 |
$1,685.21 |
$9,679.96
|
|
Slitting of prepuce
|
$714.51 |
$714.51 |
$714.51 |
$3,365.50
|
|
Slp eval non-spch gen comm dev
|
$91.97 |
$91.97 |
$91.97 |
$285.09
|
|
Slp pure tone screening
|
$19.89 |
$19.89 |
$19.89 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$42.67 |
$42.67 |
$42.67 |
$296.34
|
|
Slp ther svc non-spch gen
|
$68.68 |
$68.68 |
$68.68 |
$188.50
|
|
Small bowel endoscopy
|
$82.62 |
$82.62 |
$82.62 |
$2,463.36
|
|
Small bowel endoscopy
|
$117.13 |
$117.13 |
$117.13 |
$2,244.82
|
|
Small bowel endoscopy
|
$137.19 |
$137.19 |
$137.19 |
$2,638.57
|
|
Small bowel endoscopy
|
$140.59 |
$140.59 |
$140.59 |
$2,389.40
|
|
Small bowel endoscopy
|
$162.52 |
$162.52 |
$162.52 |
$2,638.57
|
|
Small bowel endoscopy
|
$219.30 |
$219.30 |
$219.30 |
$2,842.50
|
|
Small bowel endoscopy
|
$43.18 |
$43.18 |
$43.18 |
$1,620.78
|
|
Small bowel endoscopy
|
$87.55 |
$87.55 |
$87.55 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$109.82 |
$109.82 |
$109.82 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$91.29 |
$91.29 |
$91.29 |
$2,413.20
|
|
Small bowel endoscopy/biopsy
|
$170.34 |
$170.34 |
$170.34 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$33.83 |
$33.83 |
$33.83 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$48.96 |
$48.96 |
$48.96 |
$2,381.60
|
|
Smear fluorescent and/or acid fast stain
|
$72.93 |
$72.93 |
$72.93 |
$64.20
|
|
Smear gram stain
|
$58.48 |
$58.48 |
$58.48 |
$55.25
|
|
Smear nasal eosinophil
|
$63.92 |
$63.92 |
$63.92 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$81.94 |
$81.94 |
$81.94 |
$73.15
|
|
Smear wet mount
|
$59.50 |
$59.50 |
$59.50 |
$67.49
|
|
Smpd1 gene common variants
|
$7.99 |
$7.99 |
$7.99 |
$133.84
|
|
Snrpn/ube3a gene
|
$56.95 |
$56.95 |
$56.95 |
$231.85
|
|
Sock fracture or equal each
|
$17.34 |
$17.34 |
$17.34 |
$74.51
|
|
Sodium 24 hour urine
|
$73.78 |
$73.78 |
$73.78 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$46.75 |
$46.75 |
$46.75 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$46.75 |
$46.75 |
$46.75 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$21.33 |
$21.33 |
$21.33 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$25.65 |
$25.65 |
$25.65 |
$40.61
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$263.67 |
$263.67 |
$263.67 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$63.58 |
$63.58 |
$63.58 |
$45.60
|
|
Sp bone agrft morsel add-on
|
$93.16 |
$93.16 |
$93.16 |
$406.40
|
|
Sp bone agrft struct add-on
|
$101.32 |
$101.32 |
$101.32 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$124.95 |
$124.95 |
$124.95 |
$498.55
|
|
Special physics consult
|
$384.03 |
$384.03 |
$384.03 |
$725.00
|
|
Special radiation dosimetry
|
$136.34 |
$136.34 |
$136.34 |
$392.50
|
|
Special radiation treatment
|
$773.50 |
$773.50 |
$773.50 |
$1,986.00
|
|
Special supplies phys/qhp
|
$541.80 |
$541.80 |
$541.80 |
$60.00
|
|
Special teletx port plan
|
$377.57 |
$377.57 |
$377.57 |
$1,086.99
|
|
Specific gravity body fluid
|
$34.34 |
$34.34 |
$34.34 |
$22.00
|
|
Speech recep thresh
|
$13.60 |
$13.60 |
$13.60 |
$82.88
|
|
Sperm antibody test
|
$8.20 |
$8.20 |
$8.20 |
$57.85
|
|
Sphenoid sinus surgery
|
$623.22 |
$623.22 |
$623.22 |
$6,547.81
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$435.54 |
$435.54 |
$435.54 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$61.20 |
$61.20 |
$61.20 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$137.19 |
$137.19 |
$137.19 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$422.11 |
$422.11 |
$422.11 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$263.16 |
$263.16 |
$263.16 |
$543.26
|
|
Spleen imaging
|
$183.60 |
$183.60 |
$183.60 |
$679.00
|
|
Splenectomy total open 38100
|
$651.10 |
$651.10 |
$651.10 |
$2,166.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$246.84 |
$246.84 |
$246.84 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$29.92 |
$29.92 |
$29.92 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$34.34 |
$34.34 |
$34.34 |
$34.00
|
|
Splint finger frog med
|
$15.98 |
$15.98 |
$15.98 |
$38.08
|
|
Splint func pos polyflex ii med
|
$7.14 |
$7.14 |
$7.14 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$40.80 |
$40.80 |
$40.80 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$406.98 |
$406.98 |
$406.98 |
$4,619.65
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$75.31 |
$75.31 |
$75.31 |
$1,612.78
|