|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$10,691.85 |
$10,691.85 |
$10,691.85 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$2.18 |
$132.74 |
$132.74 |
$59.40
|
|
Ghs mbp
|
$15.26 |
$85.41 |
$85.41 |
$74.19
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$1,512.15 |
$1,512.15 |
$1,512.15 |
$261.80
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$955.76 |
$955.76 |
$955.76 |
$252.50
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$1,444.33 |
$1,444.33 |
$1,444.33 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$405.80 |
$405.80 |
$507.43 |
$145.60
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$498.41 |
$498.41 |
$498.41 |
$140.00
|
|
Ghs musc test done w/n test comp
|
$511.94 |
$511.94 |
$511.94 |
$349.80
|
|
Ghs musc tst done w/nerv tst lim
|
$419.91 |
$419.91 |
$419.91 |
$269.15
|
|
Ghs musc tst done w/n tst non ext
|
$442.64 |
$442.64 |
$442.64 |
$222.60
|
|
Ghs myocardial strain img spckl track
|
$1.57 |
$150.58 |
$663.26 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$1,978.81 |
$1,978.81 |
$2,025.45 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$9,323.14 |
$9,323.14 |
$9,323.14 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$1,876.88 |
$1,876.88 |
$1,876.88 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$2,882.49 |
$2,882.49 |
$2,882.49 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$2,882.49 |
$2,882.49 |
$2,882.49 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$9,323.14 |
$9,323.14 |
$9,323.14 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$2,845.74 |
$2,845.74 |
$2,845.74 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$3,359.06 |
$3,359.06 |
$3,359.06 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$1,876.88 |
$1,876.88 |
$1,876.88 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$1,876.88 |
$1,876.88 |
$1,876.88 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$1,061.91 |
$1,061.91 |
$1,177.06 |
$468.75
|
|
Ghs o2 saturation
|
$150.80 |
$150.80 |
$150.80 |
$72.45
|
|
Ghs o2 uptake rest & indirect
|
$670.29 |
$670.29 |
$670.29 |
$195.00
|
|
Ghs opcc repair cvp without subq port
|
$6,317.82 |
$6,317.82 |
$6,317.82 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$12,975.70 |
$12,975.70 |
$12,975.70 |
$2,430.56
|
|
Ghs optokenetic
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$196.66
|
|
Ghs oscillating trac
|
$3,212.94 |
$3,212.94 |
$3,212.94 |
$267.15
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$92.42 |
$92.42 |
$92.42 |
$55.77
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$92.42 |
$92.42 |
$92.42 |
$57.65
|
|
Ghs ot dds rom
|
$141.94 |
$141.94 |
$141.94 |
$56.55
|
|
Ghs ot group caregiver training
|
$36.65 |
$36.65 |
$36.65 |
$43.20
|
|
Ghs ot prosthetic training/15 min
|
$363.68 |
$363.68 |
$363.68 |
$92.35
|
|
Ghs ot sensory integrative tech/15min
|
$248.29 |
$248.29 |
$337.81 |
$101.05
|
|
Ghs ot work hardening-additional hours
|
$184.89 |
$184.89 |
$184.89 |
$121.54
|
|
Ghs pacing - transcutaneous
|
$2,295.71 |
$2,623.71 |
$2,623.71 |
$868.68
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$1,906.60 |
$1,906.60 |
$1,906.60 |
$855.60
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$992.84 |
$992.84 |
$992.84 |
$1,003.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$201.01 |
$201.01 |
$201.01 |
$90.15
|
|
Ghs peritonsillar abscess i andd
|
$2,553.81 |
$2,553.81 |
$2,553.81 |
$694.20
|
|
Ghs phenylketonurid
|
$68.40 |
$82.09 |
$82.09 |
$51.58
|
|
Ghs picc line insert < 5
|
$12,975.70 |
$12,975.70 |
$12,975.70 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$662.20
|
|
Ghs plt ct-manual
|
$66.53 |
$66.53 |
$1,168.56 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$4,713.25 |
$4,713.25 |
$4,713.25 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$168.17 |
$168.17 |
$304.65 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$7.00 |
$7.63 |
$149.10 |
$40.56
|
|
Ghs protein, misc fluid
|
$86.59 |
$86.59 |
$86.59 |
$24.60
|
|
Ghs protoporphyrins fract
|
$221.50 |
$221.50 |
$221.50 |
$64.35
|
|
Ghs pr without cont pulse ox
|
$350.07 |
$350.07 |
$350.07 |
$156.70
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$12.69 |
$189.08 |
$284.61 |
$45.05
|
|
Ghs pt - work hardening/int 2hrs
|
$425.13 |
$425.13 |
$425.13 |
$255.60
|
|
Ghs quinidine
|
$13.23 |
$13.23 |
$336.37 |
$68.40
|
|
Ghs refill of implantable pump
|
$47.66 |
$47.66 |
$47.66 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$324.35
|
|
Ghs removal pharyngeal foreign body
|
$1,061.91 |
$1,061.91 |
$1,177.06 |
$460.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$18.05 |
$18.05 |
$291.81 |
$42.40
|
|
Ghs reticulocyte count
|
$66.53 |
$66.53 |
$722.07 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$273.12 |
$505.17 |
$1,839.81 |
$101.15
|
|
Ghs sedimentation rate
|
$65.91 |
$65.91 |
$135.12 |
$45.50
|
|
Ghs sensitivity (per antimicro)
|
$129.71 |
$129.71 |
$1,788.23 |
$59.90
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$2,827.66 |
$2,827.66 |
$2,827.66 |
$590.40
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$4,765.88 |
$4,765.88 |
$4,765.88 |
$705.00
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$3,457.14 |
$3,457.14 |
$3,457.14 |
$670.08
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$5,754.08 |
$5,754.08 |
$5,754.08 |
$585.90
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$2,801.99 |
$2,801.99 |
$2,801.99 |
$487.50
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$2,198.18 |
$2,198.18 |
$2,198.18 |
$470.47
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$3,514.99 |
$3,514.99 |
$3,514.99 |
$538.64
|
|
Ghs simple repair over 30 cm - 12007
|
$4,296.44 |
$4,296.44 |
$4,296.44 |
$660.00
|
|
Ghs simple repair over 30 cm - 12018
|
$6,479.59 |
$6,479.59 |
$6,479.59 |
$589.18
|
|
Ghs sleep study unattended
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$3,044.60 |
$3,044.60 |
$4,060.76 |
$947.48
|
|
Ghs somatosensory testing upper & lower limbs
|
$5,921.18 |
$5,921.18 |
$8,818.79 |
$1,435.00
|
|
Ghs speech-gen aug dev eval iii, st
|
$442.74 |
$442.74 |
$442.74 |
$124.80
|
|
Ghs sphenopalatine ganglion block
|
$432.38 |
$432.38 |
$432.38 |
$706.56
|
|
Ghs spont nystagmus
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$217.57
|
|
Ghs sp train/fitting sp device - kx
|
$432.87 |
$432.87 |
$432.87 |
$261.95
|
|
Ghs st - eval for alt comm
|
$418.76 |
$418.76 |
$418.76 |
$99.75
|
|
Ghs strapping shoulder - 29240
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$243.07
|
|
Ghs st - re-eval for alt comm
|
$533.81 |
$533.81 |
$533.81 |
$309.00
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$492.86 |
$492.86 |
$492.86 |
$93.75
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$329.02 |
$329.02 |
$329.02 |
$351.45
|
|
Ghs superficial wnd dehiscence simp12020
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$976.98
|
|
Ghs superficial wnd dehis w packing12021
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$761.28
|
|
Ghs tracheostomy emergency - transtracheal
|
$4,910.50 |
$4,910.50 |
$16,867.52 |
$2,225.73
|
|
Ghs trypsin (fecal)
|
$26.16 |
$26.16 |
$26.16 |
$21.84
|
|
Ghs tx distal phalangeal fx with manipulation
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$591.00
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$540.00
|
|
Ghs urine, porphyrins quant
|
$18.49 |
$227.05 |
$227.05 |
$70.20
|
|
Ghs vaginal delivery only
|
$10,282.01 |
$10,282.01 |
$11,100.44 |
$3,525.06
|
