|
Prq revasc byp graft addl
|
$4,304.72 |
$4,304.72 |
$4,304.72 |
$11,988.60
|
|
Prq tcat plmt ntrac st 1 les
|
$8,954.40 |
$8,954.40 |
$8,954.40 |
$13,054.80
|
|
Prq trlml c athrc st angiop1
|
$13,335.84 |
$13,335.84 |
$13,335.84 |
$19,875.58
|
|
Prq trluml c angiop 1art&/br
|
$5,576.48 |
$5,576.48 |
$5,576.48 |
$9,255.50
|
|
Prq trluml c athrc 1 art&/br
|
$13,321.84 |
$13,321.84 |
$13,321.84 |
$14,212.25
|
|
Prq trluml revsc ch occ ant
|
$13,383.44 |
$13,383.44 |
$13,383.44 |
$17,474.24
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$192.08 |
$192.08 |
$192.08 |
$742.40
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$173.04 |
$173.04 |
$173.04 |
$365.00
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$192.08 |
$192.08 |
$192.08 |
$370.93
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$5,281.36 |
$5,281.36 |
$5,281.36 |
$2,530.00
|
|
Pr tube thoracostomy w/connection to drainage open
|
$997.36 |
$997.36 |
$997.36 |
$1,653.31
|
|
PSA (Prostate) Test
|
$52.64 |
$52.64 |
$52.64 |
$103.85
|
|
Psychotherapy group therapy
|
$77.84 |
$77.84 |
$77.84 |
$268.80
|
|
Psychotherapy patient individual therapy 30 minutes
|
$132.72 |
$132.72 |
$132.72 |
$196.80
|
|
Psychotherapy patient individual therapy 45 minutes
|
$198.80 |
$198.80 |
$198.80 |
$267.00
|
|
Psychotherapy patient individual therapy 60 minutes
|
$234.08 |
$234.08 |
$234.08 |
$294.00
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$87.49
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$105.95
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$82.55
|
|
Pt application of modality traction mechanical
|
$40.88 |
$40.88 |
$40.88 |
$87.19
|
|
Pten gene dup/delet variant
|
$69.44 |
$69.44 |
$69.44 |
$300.00
|
|
Pten gene full sequence
|
$138.88 |
$138.88 |
$138.88 |
$777.60
|
|
Pt evaluation high complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$247.20
|
|
Pt re-evaluation patient/family
|
$61.04 |
$61.04 |
$61.04 |
$141.93
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$40.88 |
$40.88 |
$40.88 |
$43.92
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$83.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$54.88 |
$54.88 |
$54.88 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$84.90
|
|
Pulmonary vent imaging
|
$310.24 |
$310.24 |
$310.24 |
$828.73
|
|
Pulse ox continuous overnight monitoring
|
$197.68 |
$197.68 |
$197.68 |
$351.20
|
|
Pulse ox multiple
|
$28.56 |
$28.56 |
$28.56 |
$190.25
|
|
Pulse ox single
|
$14.56 |
$14.56 |
$14.56 |
$78.99
|
|
Puncture arterial withdrawal blood for diagnosis
|
$59.92 |
$59.92 |
$59.92 |
$113.75
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$140.00 |
$140.00 |
$140.00 |
$478.80
|
|
Puraply 1 sq cm
|
$138.88 |
$138.88 |
$138.88 |
$256.38
|
|
Pyruvate
|
$8.92 |
$8.92 |
$8.92 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$421.68 |
$421.68 |
$421.68 |
$1,507.40
|
|
Quant diff pulm perf w/imaging
|
$310.24 |
$310.24 |
$310.24 |
$1,228.80
|
|
Quest t3 uptake
|
$12.88 |
$12.88 |
$12.88 |
$55.00
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$2,185.21 |
$2,185.21 |
$2,185.21 |
$1,624.21
|
|
Radiation handling
|
$75.60 |
$75.60 |
$75.60 |
$328.50
|
|
Radiation physics consult
|
$254.24 |
$254.24 |
$254.24 |
$595.40
|
|
Radiation therapy dose plan
|
$190.96 |
$190.96 |
$190.96 |
$514.05
|
|
Radiation treatment aid(s)
|
$430.64 |
$430.64 |
$430.64 |
$525.04
|
|
Radiation treatment aid(s)
|
$557.20 |
$557.20 |
$557.20 |
$644.36
|
|
Radiation treatment aid(s)
|
$855.12 |
$855.12 |
$855.12 |
$1,075.03
|
|
Radiation treatment delivery
|
$219.52 |
$219.52 |
$219.52 |
$573.52
|
|
Radiation treatment delivery
|
$351.12 |
$351.12 |
$351.12 |
$920.00
|
|
Radiology port images(s)
|
$85.68 |
$85.68 |
$85.68 |
$236.40
|
|
Radiotherapy dose plan imrt
|
$1,803.20 |
$1,803.20 |
$1,803.20 |
$5,744.60
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$754.32 |
$754.32 |
$754.32 |
$1,646.00
|
|
Radphm lcl tomogr sgl area sgl day
|
$870.24 |
$870.24 |
$870.24 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$253.12 |
$253.12 |
$253.12 |
$1,075.78
|
|
Rapid Strep Test
|
$54.88 |
$54.88 |
$54.88 |
$67.80
|
|
Rasburicase 1.5 mg intravenous solution
|
$168.83 |
$168.83 |
$168.83 |
$568.06
|
|
Rbc count only automated
|
$11.76 |
$11.76 |
$11.76 |
$20.00
|
|
Rbc deglycerolized each unit
|
$684.32 |
$684.32 |
$684.32 |
$785.20
|
|
Rbc serum pretx incubj drugs
|
$17.92 |
$17.92 |
$17.92 |
$223.08
|
|
Red blood cells each unit
|
$320.88 |
$320.88 |
$320.88 |
$380.25
|
|
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit
|
$447.44 |
$447.44 |
$447.44 |
$537.70
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$414.96 |
$414.96 |
$414.96 |
$624.65
|
|
Red blood cells leukocytes reduced each unit
|
$369.04 |
$369.04 |
$369.04 |
$519.35
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$375.20 |
$375.20 |
$375.20 |
$645.45
|
|
Red blood cells washed each unit
|
$236.88 |
$236.88 |
$236.88 |
$561.60
|
|
Redo endovas vena cava filtr
|
$4,362.96 |
$4,362.96 |
$4,362.96 |
$4,732.80
|
|
Relocation skin pocket aicd
|
$1,735.44 |
$1,735.44 |
$1,735.44 |
$3,153.93
|
|
Relocation skin pocket pm
|
$2,082.64 |
$2,082.64 |
$2,082.64 |
$2,939.25
|
|
Rem/biv cast full arm/leg
|
$86.24 |
$86.24 |
$86.24 |
$320.25
|
|
Rem endovas vena cava filter
|
$5,994.24 |
$5,994.24 |
$5,994.24 |
$5,866.00
|
|
Removal biliary drg cath
|
$1,150.80 |
$1,150.80 |
$1,150.80 |
$1,324.89
|
|
Removal central venous catheter tunneled without port/pump
|
$2,176.16 |
$2,176.16 |
$2,176.16 |
$1,538.15
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,268.40 |
$1,268.40 |
$1,268.40 |
$2,164.52
|
|
Removal cerumen impacted (both sides)
|
$161.84 |
$161.84 |
$161.84 |
$161.25
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$245.28 |
$245.28 |
$245.28 |
$236.64
|
|
Removal foreign body foot subcutaneous right
|
$2,682.96 |
$2,682.96 |
$2,682.96 |
$1,256.00
|
|
Removal of implant deep
|
$2,287.04 |
$2,287.04 |
$2,287.04 |
$3,285.96
|
|
Removal/replacement ppm generator dual lead system
|
$16,884.56 |
$16,884.56 |
$16,884.56 |
$12,702.00
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$291.76 |
$291.76 |
$291.76 |
$313.53
|
|
Removal tunnled intprtnl cath
|
$2,763.04 |
$2,763.04 |
$2,763.04 |
$4,200.00
|
|
Remove renal tube w/fluoro
|
$990.08 |
$990.08 |
$990.08 |
$1,281.75
|
|
Remove stent via transureth
|
$711.76 |
$711.76 |
$711.76 |
$2,523.30
|
|
Remove ureter stent percut
|
$1,928.08 |
$1,928.08 |
$1,928.08 |
$3,524.00
|
|
Renal cyst study s&i
|
$631.68 |
$631.68 |
$631.68 |
$599.23
|
|
Renal function panel
|
$37.52 |
$37.52 |
$37.52 |
$95.76
|
|
Renal venogram bil s&i
|
$1,696.80 |
$1,696.80 |
$1,696.80 |
$3,386.25
|
|
Repair blood vessel dir lower extr
|
$2,121.28 |
$2,121.28 |
$2,121.28 |
$2,000.88
|
|
Repair pm/icd lead dual
|
$5,728.80 |
$5,728.80 |
$5,728.80 |
$4,343.82
|
|
Repair pm/icd lead sgl
|
$5,728.80 |
$5,728.80 |
$5,728.80 |
$4,343.82
|
|
Replace duod/jej tube perc
|
$602.56 |
$602.56 |
$602.56 |
$1,354.54
|
|
Replace g/c tube perc
|
$297.36 |
$297.36 |
$297.36 |
$1,243.19
|
|
Replace g-j tube perc
|
$725.20 |
$725.20 |
$725.20 |
$1,479.75
|
|
Reposition pm/icd lead
|
$2,647.12 |
$2,647.12 |
$2,647.12 |
$4,089.00
|
|
Reposition vad w/image rt/lt sep session
|
$1,103.76 |
$1,103.76 |
$1,103.76 |
$2,085.00
|
|
Repos lv lead pm/icd
|
$2,889.04 |
$2,889.04 |
$2,889.04 |
$3,866.21
|
|
Repos sq defib eltrd
|
$5,382.72 |
$5,382.72 |
$5,382.72 |
$4,495.26
|
|
Reptilase test
|
$16.84 |
$16.84 |
$16.84 |
$65.72
|
|
Respirator motion mgmt simul
|
$265.44 |
$265.44 |
$265.44 |
$1,262.00
|
|
#resp virpnl dfa-parainfluenza
|
$36.96 |
$36.96 |
$36.96 |
$44.40
|
