|
Prq revasc byp graft addl
|
$12,288.00 |
$12,288.00 |
$12,288.00 |
$9,180.60
|
|
Prq tcat plmt ntrac st 1 les
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$13,127.50
|
|
Prq trlml c athrc st angiop1
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$15,296.00
|
|
Prq trluml c angiop 1art&/br
|
$6,886.00 |
$6,886.00 |
$6,886.00 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$13,410.10
|
|
Prq trluml revsc ch occ ant
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$15,349.60
|
|
Pr removal drug delivery implant
|
$8,209.00 |
$8,209.00 |
$8,209.00 |
$533.00
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$252.00
|
|
Pr removal intrauterine device
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$8,661.00 |
$8,661.00 |
$8,661.00 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$381.16
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$371.00 |
$371.00 |
$371.00 |
$406.35
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$397.80
|
|
Pr robotic surgical system
|
$0.01 |
$0.01 |
$0.01 |
$0.52
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,218.80
|
|
Prtl exc bone olecrn process
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,208.80
|
|
Prtl excision bone clavicle
|
$7,811.00 |
$7,811.00 |
$7,811.00 |
$7,807.24
|
|
Prtl excision bone scapula
|
$7,811.00 |
$7,811.00 |
$7,811.00 |
$7,285.60
|
|
Pr tube thoracostomy w/connection to drainage open
|
$4,548.00 |
$4,548.00 |
$4,548.00 |
$1,761.00
|
|
PSA (Prostate) Test
|
$264.00 |
$264.00 |
$264.00 |
$108.11
|
|
Psychotherapy group therapy
|
$351.00 |
$351.00 |
$351.00 |
$223.60
|
|
Psychotherapy patient individual therapy 30 minutes
|
$408.00 |
$408.00 |
$408.00 |
$189.21
|
|
Psychotherapy patient individual therapy 45 minutes
|
$628.00 |
$628.00 |
$628.00 |
$249.44
|
|
Psychotherapy patient individual therapy 60 minutes
|
$628.00 |
$628.00 |
$628.00 |
$287.47
|
|
Psychthrp grp 45-50min mcr
|
$315.00 |
$315.00 |
$315.00 |
$243.88
|
|
Psycl/nrpsyc tech 1st
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$328.80
|
|
Psy/npsy phys/qhp 2> tst 1st 30 min
|
$336.00 |
$336.00 |
$336.00 |
$206.40
|
|
Psy/npsy phys/qhp 2> tst ea l 30 min
|
$162.00 |
$162.00 |
$162.00 |
$156.00
|
|
Psy/npsy tst admin tech 2> ea l 30 min
|
$145.00 |
$145.00 |
$145.00 |
$123.63
|
|
Psytx complex interactive
|
$513.00 |
$513.00 |
$513.00 |
$47.60
|
|
Psytx pt w/e&m 16-37 min
|
$331.00 |
$331.00 |
$331.00 |
$124.00
|
|
Psytx pt w/e&m 38-52 min
|
$419.00 |
$419.00 |
$419.00 |
$161.86
|
|
Psytx pt w/e&m 53+ min
|
$554.00 |
$554.00 |
$554.00 |
$235.20
|
|
Pt application of modality >=1 area hot/cold packs
|
$35.00 |
$35.00 |
$35.00 |
$35.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$135.00 |
$135.00 |
$135.00 |
$103.20
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$112.00 |
$112.00 |
$112.00 |
$81.48
|
|
Pt application of modality traction mechanical
|
$153.00 |
$153.00 |
$153.00 |
$91.80
|
|
Pterygomaxillary fossa surg any appr 31040
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$6,966.64
|
|
Pt repositioning canalith procedure(s) per day
|
$320.00 |
$320.00 |
$320.00 |
$119.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$308.00 |
$308.00 |
$308.00 |
$83.00
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$136.00 |
$136.00 |
$136.00 |
$80.30
|
|
Pt wheelchair management each 15 minutes
|
$160.00 |
$160.00 |
$160.00 |
$88.20
|
|
Pul art balloon repr percut
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$9,760.40
|
|
Pul art balloon repr percut
|
$3,154.00 |
$3,154.00 |
$3,154.00 |
$3,766.10
|
|
Pulmonary vent imaging
|
$1,727.00 |
$1,727.00 |
$1,727.00 |
$955.80
|
|
Pulse ox continuous overnight monitoring
|
$961.00 |
$961.00 |
$961.00 |
$349.86
|
|
Pulse ox multiple
|
$202.00 |
$202.00 |
$202.00 |
$159.16
|
|
Pulse ox single
|
$124.00 |
$124.00 |
$124.00 |
$84.80
|
|
Punc of shunt for asp or inj
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$974.00
|
|
Puncture arterial withdrawal blood for diagnosis
|
$524.00 |
$524.00 |
$524.00 |
$129.36
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$520.80
|
|
Puncture/clear windpipe 31612
|
$18,857.00 |
$18,857.00 |
$18,857.00 |
$3,986.00
|
|
Puncture spinal lumbar diagnostic
|
$3,352.00 |
$3,352.00 |
$3,352.00 |
$1,082.90
|
|
Pvb thoracic 2nd+ inj site
|
$4,631.00 |
$4,631.00 |
$4,631.00 |
$859.30
|
|
Pvb thoracic single inj site
|
$4,631.00 |
$4,631.00 |
$4,631.00 |
$1,320.80
|
|
Pyridoxine hcl 100 mg
|
$93.77 |
$93.77 |
$93.77 |
$49.08
|
|
Pyruvate
|
$78.00 |
$78.00 |
$78.00 |
$66.00
|
|
Quant diff pulm perf and vent w/imaging
|
$3,409.00 |
$3,409.00 |
$3,409.00 |
$1,547.04
|
|
Quant diff pulm perf w/imaging
|
$3,409.00 |
$3,409.00 |
$3,409.00 |
$1,199.16
|
|
Quest t3 uptake
|
$63.00 |
$63.00 |
$63.00 |
$52.25
|
|
Rabies ig ht&sol human im/sc
|
$1,095.20 |
$1,095.20 |
$1,095.20 |
$2,658.73
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$841.10 |
$841.10 |
$841.10 |
$3,848.39
|
|
Radial keratotomy
|
$5,364.00 |
$5,364.00 |
$5,364.00 |
$1,282.40
|
|
Radiation handling
|
$220.00 |
$220.00 |
$220.00 |
$324.80
|
|
Radiation physics consult
|
$1,270.00 |
$1,270.00 |
$1,270.00 |
$610.68
|
|
Radiation therapy dose plan
|
$722.00 |
$722.00 |
$722.00 |
$518.76
|
|
Radiation treatment aid(s)
|
$4,377.00 |
$4,377.00 |
$4,377.00 |
$526.80
|
|
Radiation treatment aid(s)
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$655.50
|
|
Radiation treatment aid(s)
|
$1,956.00 |
$1,956.00 |
$1,956.00 |
$1,100.38
|
|
Radiation treatment delivery
|
$742.00 |
$742.00 |
$742.00 |
$552.40
|
|
Radiation treatment delivery
|
$1,305.00 |
$1,305.00 |
$1,305.00 |
$921.00
|
|
Radical rescj tumor clavicle
|
$9,290.00 |
$9,290.00 |
$9,290.00 |
$9,290.00
|
|
Radical rescj tumor prox hum
|
$8,576.00 |
$8,576.00 |
$8,576.00 |
$3,724.00
|
|
Radical rescj tumor scapula
|
$10,290.00 |
$10,290.00 |
$10,290.00 |
$9,977.57
|
|
Radical resection of elbow
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$5,788.80
|
|
Radic resect shoulder tumor 5cm/> 23078
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$4,460.78
|
|
Radiology port images(s)
|
$264.00 |
$264.00 |
$264.00 |
$253.50
|
|
Radiotherapy dose plan imrt
|
$11,781.00 |
$11,781.00 |
$11,781.00 |
$5,750.25
|
|
Radium ra223 dichl ther/uci
|
$283.99 |
$283.99 |
$283.99 |
$217.50
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$2,098.00 |
$2,098.00 |
$2,098.00 |
$2,051.70
|
|
Radphm lcl tmr plnr bdy two day img
|
$2,648.00 |
$2,648.00 |
$2,648.00 |
$2,728.42
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$4,772.00 |
$4,772.00 |
$4,772.00 |
$2,566.53
|
|
Radphm lcl tomogr sgl area sgl day
|
$2,858.00 |
$2,858.00 |
$2,858.00 |
$2,242.80
|
|
Radphm lcl tumor plr sgl day
|
$1,678.00 |
$1,678.00 |
$1,678.00 |
$1,126.32
|
|
Rad rescj tum dstl/shft hum
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$7,628.80
|
|
Rad rescj tum shoulder<5 cm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$4,881.00
|
|
Rad rescj tum tiss a/e 5 cm+
|
$16,385.00 |
$16,385.00 |
$16,385.00 |
$5,339.00
|
|
Rad rescj tum tiss a/e <5cm
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$4,087.20
|
|
Rad resec soft tis tum/ft/toe/<3cm 28046
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$3,620.80
|
|
Rad resect abd tumor 5 cm/>
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$3,495.54
|
|
Rad resect hand tumor < 3 cm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,386.84
|
|
Rad resect hand tumor 3 cm/>
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$4,137.20
|
|
Rad resection tum radial h/n
|
$17,291.00 |
$17,291.00 |
$17,291.00 |
$8,453.60
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$171.94 |
$171.94 |
$171.94 |
$13,136.04
|
|
Range of motion measurements
|
$202.00 |
$202.00 |
$202.00 |
$64.50
|
|
Rapid desensitization
|
$821.00 |
$821.00 |
$821.00 |
$472.21
|
|
Rapid Strep Test
|
$236.00 |
$236.00 |
$236.00 |
$76.00
|
|
Rasburicase 1.5 mg intravenous solution
|
$886.30 |
$886.30 |
$886.30 |
$4,331.80
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$527.69 |
$527.69 |
$527.69 |
$41,926.70
|
