|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$209.44 |
$209.44 |
$209.44 |
$742.40
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$193.20 |
$193.20 |
$193.20 |
$365.00
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$209.44 |
$209.44 |
$209.44 |
$370.93
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$4,339.44 |
$4,339.44 |
$4,339.44 |
$2,530.00
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,023.12 |
$1,023.12 |
$1,023.12 |
$1,653.31
|
|
PSA (Prostate) Test
|
$52.08 |
$52.08 |
$52.08 |
$103.85
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$14.56 |
$14.56 |
$14.56 |
$87.49
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$84.56 |
$84.56 |
$84.56 |
$105.95
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$73.36 |
$73.36 |
$73.36 |
$82.55
|
|
Pt application of modality traction mechanical
|
$73.36 |
$73.36 |
$73.36 |
$87.19
|
|
Pt evaluation high complexity patient/family
|
$147.28 |
$147.28 |
$147.28 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$147.28 |
$147.28 |
$147.28 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$147.28 |
$147.28 |
$147.28 |
$247.20
|
|
Pt re-evaluation patient/family
|
$91.28 |
$91.28 |
$91.28 |
$141.93
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$81.20 |
$81.20 |
$81.20 |
$43.92
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$62.72 |
$62.72 |
$62.72 |
$83.20
|
|
Pt wheelchair management each 15 minutes
|
$62.72 |
$62.72 |
$62.72 |
$84.90
|
|
Pulmonary vent imaging
|
$316.40 |
$316.40 |
$316.40 |
$828.73
|
|
Pulse ox continuous overnight monitoring
|
$235.20 |
$235.20 |
$235.20 |
$351.20
|
|
Pulse ox multiple
|
$57.68 |
$57.68 |
$57.68 |
$190.25
|
|
Pulse ox single
|
$21.84 |
$21.84 |
$21.84 |
$78.99
|
|
Puncture arterial withdrawal blood for diagnosis
|
$19.60 |
$19.60 |
$19.60 |
$113.75
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$514.64 |
$514.64 |
$514.64 |
$478.80
|
|
Puncture spinal lumbar diagnostic
|
$537.04 |
$537.04 |
$537.04 |
$1,087.80
|
|
Puraply 1 sq cm
|
$137.76 |
$137.76 |
$137.76 |
$256.38
|
|
Pyruvate
|
$13.44 |
$13.44 |
$13.44 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$496.16 |
$496.16 |
$496.16 |
$1,507.40
|
|
Quant diff pulm perf w/imaging
|
$316.40 |
$316.40 |
$316.40 |
$1,228.80
|
|
Quest t3 uptake
|
$21.28 |
$21.28 |
$21.28 |
$55.00
|
|
Radiation physics consult
|
$174.72 |
$174.72 |
$174.72 |
$595.40
|
|
Radiation therapy dose plan
|
$178.64 |
$178.64 |
$178.64 |
$514.05
|
|
Radiation treatment aid(s)
|
$218.40 |
$218.40 |
$218.40 |
$525.04
|
|
Radiation treatment aid(s)
|
$218.40 |
$218.40 |
$218.40 |
$644.36
|
|
Radiation treatment aid(s)
|
$222.32 |
$222.32 |
$222.32 |
$1,075.03
|
|
Radiation treatment delivery
|
$133.84 |
$133.84 |
$133.84 |
$130.96
|
|
Radiation treatment delivery
|
$133.84 |
$133.84 |
$133.84 |
$573.52
|
|
Radiation treatment delivery
|
$286.16 |
$286.16 |
$286.16 |
$920.00
|
|
Radiology port images(s)
|
$73.36 |
$73.36 |
$73.36 |
$236.40
|
|
Radiotherapy dose plan imrt
|
$2,750.16 |
$2,750.16 |
$2,750.16 |
$5,744.60
|
|
Radium ra223 dichl ther/uci
|
$131.04 |
$131.04 |
$131.04 |
$286.80
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$661.92 |
$661.92 |
$661.92 |
$1,646.00
|
|
Radphm lcl tmr plnr bdy two day img
|
$802.48 |
$802.48 |
$802.48 |
$2,582.32
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$1,076.88 |
$1,076.88 |
$1,076.88 |
$2,683.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,136.24 |
$1,136.24 |
$1,136.24 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$253.12 |
$253.12 |
$253.12 |
$1,075.78
|
|
Radphm quant measure sgl area add-on
|
$1,076.88 |
$1,076.88 |
$1,076.88 |
$403.49
|
|
Rapid Strep Test
|
$30.80 |
$30.80 |
$30.80 |
$67.80
|
|
Rbc count only automated
|
$9.52 |
$9.52 |
$9.52 |
$20.00
|
|
Rbc deglycerolized each unit
|
$403.76 |
$403.76 |
$403.76 |
$785.20
|
|
Rbc irradiated each unit
|
$171.36 |
$171.36 |
$171.36 |
$443.95
|
|
Red blood cells each unit
|
$194.32 |
$194.32 |
$194.32 |
$380.25
|
|
Red blood cells leukocytes reduced each unit
|
$261.52 |
$261.52 |
$261.52 |
$519.35
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$226.80 |
$226.80 |
$226.80 |
$645.45
|
|
Red blood cells washed each unit
|
$258.16 |
$258.16 |
$258.16 |
$561.60
|
|
Refill/maint pump/resvr syst
|
$191.52 |
$191.52 |
$191.52 |
$403.76
|
|
Relocation skin pocket aicd
|
$2,270.24 |
$2,270.24 |
$2,270.24 |
$3,153.93
|
|
Relocation skin pocket pm
|
$2,064.16 |
$2,064.16 |
$2,064.16 |
$2,939.25
|
|
Rem/biv cast full arm/leg
|
$116.48 |
$116.48 |
$116.48 |
$320.25
|
|
Rem endovas vena cava filter
|
$4,924.08 |
$4,924.08 |
$4,924.08 |
$5,866.00
|
|
Rem interrog dev eval scrms
|
$154.56 |
$154.56 |
$154.56 |
$139.10
|
|
Rem interrog evl pm/ids
|
$66.08 |
$66.08 |
$66.08 |
$139.10
|
|
Removal biliary drg cath
|
$1,331.68 |
$1,331.68 |
$1,331.68 |
$1,324.89
|
|
Removal central venous catheter tunneled without port/pump
|
$739.20 |
$739.20 |
$739.20 |
$1,538.15
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,279.04 |
$1,279.04 |
$1,279.04 |
$2,164.52
|
|
Removal cerumen impacted (both sides)
|
$177.52 |
$177.52 |
$177.52 |
$161.25
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$262.08 |
$262.08 |
$262.08 |
$236.64
|
|
Removal foreign body foot subcutaneous right
|
$936.88 |
$936.88 |
$936.88 |
$1,256.00
|
|
Removal of implant deep
|
$2,872.24 |
$2,872.24 |
$2,872.24 |
$3,285.96
|
|
Removal/replacement ppm generator dual lead system
|
$15,670.48 |
$15,670.48 |
$15,670.48 |
$12,702.00
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$263.20 |
$263.20 |
$263.20 |
$313.53
|
|
Removal tunnled intprtnl cath
|
$2,476.32 |
$2,476.32 |
$2,476.32 |
$4,200.00
|
|
Remove ventricular device 33977
|
$4,377.52 |
$4,377.52 |
$4,377.52 |
$2,748.80
|
|
Renal function panel
|
$37.52 |
$37.52 |
$37.52 |
$95.76
|
|
Repair pm/icd lead dual
|
$6,017.76 |
$6,017.76 |
$6,017.76 |
$4,343.82
|
|
Repair pm/icd lead sgl
|
$6,017.76 |
$6,017.76 |
$6,017.76 |
$4,343.82
|
|
Replace aortic valve open axillry 33363
|
$6,024.48 |
$6,024.48 |
$6,024.48 |
$13,308.36
|
|
Replace g/c tube perc
|
$609.84 |
$609.84 |
$609.84 |
$1,243.19
|
|
Reposition pm/icd lead
|
$2,780.96 |
$2,780.96 |
$2,780.96 |
$4,089.00
|
|
Repos lv lead pm/icd
|
$1,915.76 |
$1,915.76 |
$1,915.76 |
$3,866.21
|
|
Resect part/compl phalangeal base ea 28126
|
$3,627.12 |
$3,627.12 |
$3,627.12 |
$2,198.53
|
|
#resp virpnl dfa-adenovirus
|
$36.96 |
$36.96 |
$36.96 |
$62.40
|
|
#resp virpnl dfa-parainfluenza
|
$39.20 |
$39.20 |
$39.20 |
$44.40
|
|
Resp virus 6-11 targets
|
$495.04 |
$495.04 |
$495.04 |
$465.60
|
|
Resuscitation cardiopulmonary
|
$1,124.48 |
$1,124.48 |
$1,124.48 |
$895.44
|
|
Reticulocyte automated
|
$25.20 |
$25.20 |
$25.20 |
$54.27
|
|
Revasc intra lithotrip-ather
|
$18,706.80 |
$18,706.80 |
$18,706.80 |
$20,329.50
|
|
Revasc intra lithotrip-stent
|
$18,706.80 |
$18,706.80 |
$18,706.80 |
$20,329.50
|
|
Revasc intravasc lithotripsy
|
$9,136.40 |
$9,136.40 |
$9,136.40 |
$12,552.42
|
|
Revasc lithotrip-stent-ather
|
$32,397.12 |
$32,397.12 |
$32,397.12 |
$20,329.50
|
|
Revision of cervix
|
$2,032.24 |
$2,032.24 |
$2,032.24 |
$3,854.76
|
|
Revision tips
|
$6,099.52 |
$6,099.52 |
$6,099.52 |
$9,810.00
|
|
Rheumatoid factor qualitative
|
$34.72 |
$34.72 |
$34.72 |
$54.60
|
|
Rheumatoid factor quantitative
|
$14.56 |
$14.56 |
$14.56 |
$59.80
|
|
Right ventric recording
|
$4,487.28 |
$4,487.28 |
$4,487.28 |
$1,795.00
|
|
Rmvl icd by tv extr
|
$4,717.44 |
$4,717.44 |
$4,717.44 |
$4,589.40
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$24,864.00 |
$24,864.00 |
$24,864.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$26,283.04 |
$26,283.04 |
$26,283.04 |
$36,067.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$23,507.68 |
$23,507.68 |
$23,507.68 |
$27,258.51
|
|
Rmvl icd pulse gen only
|
$3,360.56 |
$3,360.56 |
$3,360.56 |
$4,069.52
|
|
Rmvl ndwellg tun pleural cath
|
$1,020.88 |
$1,020.88 |
$1,020.88 |
$1,061.36
|
