|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$1,190.40 |
$1,190.40 |
$1,190.40 |
$789.50
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$1,188.80 |
$1,188.80 |
$1,188.80 |
$1,016.25
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$1,397.60 |
$1,397.60 |
$1,397.60 |
$922.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,304.00 |
$1,304.00 |
$1,304.00 |
$1,930.50
|
|
Ghs layered repair over 3.0 cm -12057
|
$1,485.60 |
$1,485.60 |
$1,485.60 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$33.57 |
$33.57 |
$33.57 |
$73.50
|
|
Ghs mbp
|
$64.28 |
$64.28 |
$64.28 |
$76.64
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$278.86 |
$278.86 |
$278.86 |
$246.40
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$226.85 |
$226.85 |
$226.85 |
$228.45
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$278.86 |
$278.86 |
$278.86 |
$239.20
|
|
Ghs moderate sedation ea addtl 15 min
|
$139.44 |
$139.44 |
$139.44 |
$151.20
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$142.40 |
$142.40 |
$142.40 |
$142.40
|
|
Ghs musc test done w/n test comp
|
$212.80 |
$212.80 |
$212.80 |
$331.20
|
|
Ghs musc tst done w/nerv tst lim
|
$136.00 |
$136.00 |
$136.00 |
$272.48
|
|
Ghs musc tst done w/n tst non ext
|
$184.80 |
$184.80 |
$184.80 |
$184.80
|
|
Ghs myocardial strain img spckl track
|
$664.15 |
$664.15 |
$664.15 |
$457.80
|
|
Ghs nailbed repair/nail removal
|
$689.43 |
$689.43 |
$689.43 |
$726.86
|
|
Ghs nerve blk intercostal, ea addtl level
|
$931.08 |
$931.08 |
$931.08 |
$1,556.24
|
|
Ghs nerve blk intercostal, single level
|
$931.08 |
$931.08 |
$931.08 |
$1,160.00
|
|
Ghs nerve block axillary nerve
|
$1,641.71 |
$1,641.71 |
$1,641.71 |
$1,601.60
|
|
Ghs nerve block brachial plexus
|
$886.74 |
$886.74 |
$886.74 |
$1,710.80
|
|
Ghs nerve block celiac plexus
|
$1,327.94 |
$1,327.94 |
$1,327.94 |
$1,668.80
|
|
Ghs nerve block interscaline
|
$1,314.73 |
$1,314.73 |
$1,314.73 |
$1,541.40
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,268.04 |
$1,268.04 |
$1,268.04 |
$1,706.50
|
|
Ghs nerve block sciatic nerve
|
$931.08 |
$931.08 |
$931.08 |
$1,450.80
|
|
Ghs nerve block suprascapular
|
$1,066.47 |
$1,066.47 |
$1,066.47 |
$1,198.62
|
|
Ghs ng placement w fluoro guidance
|
$466.04 |
$466.04 |
$466.04 |
$485.00
|
|
Ghs o2 saturation
|
$33.57 |
$33.57 |
$33.57 |
$69.50
|
|
Ghs o2 uptake rest & exercise
|
$118.40 |
$118.40 |
$118.40 |
$239.05
|
|
Ghs o2 uptake rest & indirect
|
$108.80 |
$108.80 |
$108.80 |
$173.50
|
|
Ghs ob unlisted IV or art inj or infusion
|
$28.80 |
$28.80 |
$28.80 |
$82.62
|
|
Ghs opcc repair cvp without subq port
|
$392.00 |
$392.00 |
$392.00 |
$1,236.96
|
|
Ghs opcc repair cvp w subq port
|
$829.60 |
$829.60 |
$829.60 |
$2,194.40
|
|
Ghs optokenetic
|
$50.40 |
$50.40 |
$50.40 |
$214.00
|
|
Ghs oscillating trac
|
$46.40 |
$46.40 |
$46.40 |
$296.91
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$69.60 |
$69.60 |
$69.60 |
$58.00
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$100.80 |
$100.80 |
$100.80 |
$61.11
|
|
Ghs ot dds rom
|
$48.00 |
$48.00 |
$48.00 |
$66.95
|
|
Ghs ot group caregiver training
|
$52.00 |
$52.00 |
$52.00 |
$34.80
|
|
Ghs ot prosthetic training/15 min
|
$107.31 |
$107.31 |
$107.31 |
$93.50
|
|
Ghs ot sensory integrative tech/15min
|
$113.60 |
$113.60 |
$113.60 |
$96.60
|
|
Ghs ot work hardening-additional hours
|
$103.66 |
$103.66 |
$103.66 |
$126.40
|
|
Ghs pacing - transcutaneous
|
$467.00 |
$467.00 |
$467.00 |
$839.65
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$2,247.88 |
$2,247.88 |
$2,247.88 |
$880.00
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$2,043.52 |
$2,043.52 |
$2,043.52 |
$962.00
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$55.20 |
$55.20 |
$55.20 |
$72.80
|
|
Ghs peritonsillar abscess i andd
|
$468.80 |
$468.80 |
$468.80 |
$560.53
|
|
Ghs phenylketonurid
|
$33.57 |
$33.57 |
$33.57 |
$53.76
|
|
Ghs picc line insert < 5
|
$2,318.73 |
$2,318.73 |
$2,318.73 |
$2,019.50
|
|
Ghs plngl fx pm cl
|
$832.80 |
$832.80 |
$832.80 |
$578.00
|
|
Ghs plt ct-manual
|
$33.57 |
$33.57 |
$33.57 |
$37.96
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
$3,557.58
|
|
Ghs pos nystagmus
|
$73.60 |
$73.60 |
$73.60 |
$232.70
|
|
Ghs ppd (tb intradermal)
|
$48.57 |
$48.57 |
$48.57 |
$37.44
|
|
Ghs prostatic acid phosphatase (mayo)
|
$33.57 |
$33.57 |
$33.57 |
$43.55
|
|
Ghs protein, misc fluid
|
$33.57 |
$33.57 |
$33.57 |
$24.60
|
|
Ghs protoporphyrins fract
|
$64.28 |
$64.28 |
$64.28 |
$60.75
|
|
Ghs pr without cont pulse ox
|
$361.90 |
$361.90 |
$361.90 |
$147.00
|
|
Ghs pseudocholinesterase,dibucain-inhibi
|
$31.20 |
$31.20 |
$31.20 |
$47.55
|
|
Ghs pt - work hardening/int 2hrs
|
$207.41 |
$207.41 |
$207.41 |
$285.60
|
|
Ghs quinidine
|
$66.43 |
$66.43 |
$66.43 |
$85.00
|
|
Ghs refill of implantable pump
|
$189.60 |
$189.60 |
$189.60 |
$539.13
|
|
Ghs removal intranasal foreign body
|
$464.00 |
$464.00 |
$464.00 |
$283.51
|
|
Ghs removal pharyngeal foreign body
|
$718.13 |
$718.13 |
$718.13 |
$441.68
|
|
Ghs repair extensor tendon hand, ea tendon
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$2,517.00
|
|
Ghs repair tendon ext forearm/wrist ea
|
$1,212.80 |
$1,212.80 |
$1,212.80 |
$4,150.20
|
|
Ghs respiratory syncytical virus igg/m
|
$48.57 |
$48.57 |
$48.57 |
$73.50
|
|
Ghs reticulocyte count
|
$33.57 |
$33.57 |
$33.57 |
$34.45
|
|
Ghs rsv eia (respir synctial vrs)
|
$38.58 |
$38.58 |
$38.58 |
$99.00
|
|
Ghs sedimentation rate
|
$33.57 |
$33.57 |
$33.57 |
$45.50
|
|
Ghs semen analysis fert
|
$56.44 |
$56.44 |
$56.44 |
$124.15
|
|
Ghs semen analysis, post-vas
|
$56.44 |
$56.44 |
$56.44 |
$32.37
|
|
Ghs sensitivity (per antimicro)
|
$38.58 |
$38.58 |
$38.58 |
$57.60
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$497.96 |
$497.96 |
$497.96 |
$572.00
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$525.60 |
$525.60 |
$525.60 |
$607.35
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$497.96 |
$497.96 |
$497.96 |
$590.40
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$438.91 |
$438.91 |
$438.91 |
$607.35
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$341.60 |
$341.60 |
$341.60 |
$449.15
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$315.20 |
$315.20 |
$315.20 |
$437.60
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$412.80 |
$412.80 |
$412.80 |
$491.30
|
|
Ghs simple repair over 30 cm - 12007
|
$784.32 |
$784.32 |
$784.32 |
$592.20
|
|
Ghs simple repair over 30 cm - 12018
|
$432.00 |
$432.00 |
$432.00 |
$537.60
|
|
Ghs sleep study unattended
|
$357.60 |
$357.60 |
$357.60 |
$503.38
|
|
Ghs somatosensory testing lower extremit
|
$302.40 |
$302.40 |
$302.40 |
$925.91
|
|
Ghs somatosensory testing upper & lower limbs
|
$745.60 |
$745.60 |
$745.60 |
$1,416.80
|
|
Ghs speech-gen aug dev eval iii, st
|
$265.43 |
$265.43 |
$265.43 |
$157.50
|
|
Ghs sphenopalatine ganglion block
|
$931.08 |
$931.08 |
$931.08 |
$637.92
|
|
Ghs spont nystagmus
|
$70.40 |
$70.40 |
$70.40 |
$242.00
|
|
Ghs sp train/fitting sp device - kx
|
$265.43 |
$265.43 |
$265.43 |
$254.15
|
|
Ghs st - eval for alt comm
|
$35.20 |
$35.20 |
$35.20 |
$96.40
|
|
Ghs strapping shoulder - 29240
|
$180.16 |
$180.16 |
$180.16 |
$217.60
|
|
Ghs st - re-eval for alt comm
|
$328.26 |
$328.26 |
$328.26 |
$309.60
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$33.60 |
$33.60 |
$33.60 |
$99.98
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$342.40 |
$342.40 |
$342.40 |
$360.80
|
|
Ghs superficial wnd dehiscence simp12020
|
$720.80 |
$720.80 |
$720.80 |
$955.80
|
|
Ghs superficial wnd dehis w packing12021
|
$438.91 |
$438.91 |
$438.91 |
$696.68
|
|
Ghs tracheostomy emergency - transtracheal
|
$800.00 |
$800.00 |
$800.00 |
$1,867.84
|
|
Ghs trypsin (fecal)
|
$18.40 |
$18.40 |
$18.40 |
$50.93
|
|
Ghs tx distal phalangeal fx with manipulation
|
$779.20 |
$779.20 |
$779.20 |
$535.60
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$1,491.20 |
$1,491.20 |
$1,491.20 |
$513.80
|