|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$640.00 |
$809.60 |
$928.80 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$524.80 |
$818.40 |
$1,008.80 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$718.40 |
$804.00 |
$887.20 |
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$669.60 |
$718.40 |
$1,003.20 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$902.40 |
$1,149.60 |
$1,476.80 |
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$770.40 |
$999.20 |
$1,156.00 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$584.80 |
$839.20 |
$1,158.40 |
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$611.20 |
$653.60 |
$1,484.00 |
|
|
Ghs layered repair over 30.0 cm -12047
|
$1,020.80 |
$1,020.80 |
$1,857.60 |
|
|
Ghs layered repair over 3.0 cm -12057
|
$560.00 |
$944.00 |
$2,000.00 |
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$118.40 |
$223.89 |
$256.27 |
|
|
Ghs moderate sedation < 5 yr, 30 min, other
|
$186.09 |
$223.89 |
$256.27 |
|
|
Ghs moderate sedation, > 5 yr, 30 min, other
|
$186.09 |
$223.89 |
$256.27 |
|
|
Ghs moderate sedation ea addtl 15 min
|
$38.40 |
$74.70 |
$186.40 |
|
|
Ghs moderate sedation ea addtl 15 min, other
|
$62.10 |
$85.44 |
$137.60 |
|
|
Ghs musc test done w/n test comp
|
$140.78 |
$140.78 |
$408.00 |
|
|
Ghs musc tst done w/nerv tst lim
|
$117.26 |
$117.26 |
$358.40 |
|
|
Ghs musc tst done w/n tst non ext
|
$90.62 |
$90.62 |
$245.60 |
|
|
Ghs myocardial strain img spckl track
|
$140.50 |
$173.26 |
$566.40 |
|
|
Ghs nailbed repair/nail removal
|
$605.60 |
$710.40 |
$980.00 |
|
|
Ghs nerve blk intercostal, ea addtl level
|
$141.62 |
$141.62 |
$1,748.00 |
|
|
Ghs nerve blk intercostal, single level
|
$993.44 |
$1,004.25 |
$2,108.00 |
|
|
Ghs nerve block axillary nerve
|
$480.98 |
$480.98 |
$1,832.80 |
|
|
Ghs nerve block brachial plexus
|
$314.40 |
$480.59 |
$930.40 |
|
|
Ghs nerve block celiac plexus
|
$1,426.61 |
$1,426.61 |
$2,196.80 |
|
|
Ghs nerve block interscaline
|
$1,540.61 |
$1,540.61 |
$2,215.20 |
|
|
Ghs nerve block lumbar or thoracic symp
|
$1,592.98 |
$1,871.58 |
$2,360.50 |
|
|
Ghs nerve block sciatic nerve
|
$993.44 |
$1,004.25 |
$1,769.60 |
|
|
Ghs nerve block suprascapular
|
$465.79 |
$1,282.29 |
$1,343.38 |
|
|
Ghs ng placement w fluoro guidance
|
$326.40 |
$631.20 |
$775.77 |
|
|
Ghs o2 saturation
|
$52.56 |
$88.03 |
$88.03 |
|
|
Ghs o2 uptake rest & indirect
|
$498.62 |
$731.81 |
$731.81 |
|
|
Ghs ob unlisted IV or art inj or infusion
|
$126.40 |
$359.28 |
$366.97 |
|
|
Ghs opcc repair cvp without subq port
|
$468.78 |
$468.78 |
$1,507.20 |
|
|
Ghs opcc repair cvp w subq port
|
$1,805.86 |
$1,805.86 |
$2,664.80 |
|
|
Ghs optokenetic
|
$144.59 |
$144.59 |
$188.74 |
|
|
Ghs oscillating trac
|
$82.32 |
$82.32 |
$107.52 |
|
|
Ghs osteopathic manipulative tx, 1-2 regions
|
$42.96 |
$42.96 |
$63.20 |
|
|
Ghs osteopathic manipulative tx, 3-4 regions
|
$42.96 |
$42.96 |
$42.96 |
|
|
Ghs ot dds rom
|
$84.80 |
$139.44 |
$146.61 |
|
|
Ghs ot group caregiver training
|
$50.40 |
$54.40 |
$59.20 |
|
|
Ghs ot prosthetic training/15 min
|
$65.46 |
$81.48 |
$128.00 |
|
|
Ghs ot sensory integrative tech/15min
|
$65.46 |
$81.48 |
$124.80 |
|
|
Ghs ot work hardening-additional hours
|
$153.60 |
$228.58 |
$240.35 |
|
|
Ghs pacing - transcutaneous
|
$731.20 |
$4,112.30 |
$5,358.08 |
|
|
Ghs paravert facet/nerve cerv ea add bil
|
$507.92 |
$507.92 |
$1,455.94 |
|
|
Ghs paravert facet/nerve lumb ea add bil
|
$164.70 |
$701.90 |
$1,081.60 |
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$69.60 |
$91.20 |
$91.20 |
|
|
Ghs peritonsillar abscess i andd
|
$505.60 |
$576.00 |
$593.60 |
|
|
Ghs phenylketonurid
|
$18.93 |
$18.93 |
$108.00 |
|
|
Ghs picc line insert < 5
|
$1,064.95 |
$1,208.76 |
$2,200.80 |
|
|
Ghs plngl fx pm cl
|
$447.20 |
$636.00 |
$680.00 |
|
|
Ghs polysom <6 yrs 4/> parameters
|
$3,961.38 |
$3,961.38 |
$4,258.69 |
|
|
Ghs pos nystagmus
|
$542.98 |
$542.98 |
$708.14 |
|
|
Ghs ppd (tb intradermal)
|
$10.56 |
$27.05 |
$66.40 |
|
|
Ghs prostatic acid phosphatase (mayo)
|
$56.00 |
$56.00 |
$56.00 |
|
|
Ghs protoporphyrins fract
|
$35.14 |
$40.99 |
$44.30 |
|
|
Ghs pr without cont pulse ox
|
$165.60 |
$257.82 |
$298.40 |
|
|
Ghs pt - work hardening/int 2hrs
|
$337.60 |
$387.17 |
$407.06 |
|
|
Ghs refill of implantable pump
|
$713.04 |
$713.04 |
$713.04 |
|
|
Ghs removal intranasal foreign body
|
$212.80 |
$283.20 |
$349.60 |
|
|
Ghs removal pharyngeal foreign body
|
$380.80 |
$510.40 |
$608.00 |
|
|
Ghs repair extensor tendon hand, ea tendon
|
$3,368.00 |
$3,368.00 |
$4,123.20 |
|
|
Ghs repair tendon ext forearm/wrist ea
|
$4,710.40 |
$4,710.40 |
$4,710.40 |
|
|
Ghs reticulocyte count
|
$26.40 |
$26.40 |
$26.40 |
|
|
Ghs rsv eia (respir synctial vrs)
|
$117.60 |
$231.20 |
$231.20 |
|
|
Ghs sedimentation rate
|
$24.00 |
$32.42 |
$64.80 |
|
|
Ghs semen analysis fert
|
$100.00 |
$100.00 |
$140.00 |
|
|
Ghs sensitivity (per antimicro)
|
$25.98 |
$28.42 |
$114.40 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12005
|
$456.80 |
$531.20 |
$645.60 |
|
|
Ghs simple repair 12.6 - 20.0 cm - 12016
|
$478.40 |
$680.80 |
$733.60 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12006
|
$514.40 |
$573.60 |
$807.20 |
|
|
Ghs simple repair 20.1 - 30.0 cm - 12017
|
$602.40 |
$683.20 |
$892.80 |
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$365.60 |
$448.00 |
$584.00 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12004
|
$356.00 |
$429.60 |
$539.20 |
|
|
Ghs simple repair 7.6 - 12.5 cm - 12015
|
$424.00 |
$520.00 |
$644.00 |
|
|
Ghs simple repair over 30 cm - 12007
|
$505.60 |
$560.80 |
$696.00 |
|
|
Ghs simple repair over 30 cm - 12018
|
$358.40 |
$465.60 |
$640.00 |
|
|
Ghs sleep study unattended
|
$376.00 |
$660.80 |
$1,289.96 |
|
|
Ghs somatosensory testing lower extremit
|
$231.50 |
$862.96 |
$1,276.00 |
|
|
Ghs somatosensory testing upper & lower limbs
|
$448.70 |
$1,725.47 |
$1,725.47 |
|
|
Ghs speech-gen aug dev eval iii, st
|
$61.60 |
$228.58 |
$240.35 |
|
|
Ghs sphenopalatine ganglion block
|
$851.20 |
$1,146.10 |
$1,146.10 |
|
|
Ghs spont nystagmus
|
$206.25 |
$206.25 |
$268.80 |
|
|
Ghs sp train/fitting sp device - kx
|
$192.92 |
$240.35 |
$315.20 |
|
|
Ghs st - eval for alt comm
|
$77.45 |
$88.80 |
$101.14 |
|
|
Ghs strapping shoulder - 29240
|
$65.46 |
$81.48 |
$203.20 |
|
|
Ghs st - re-eval for alt comm
|
$228.58 |
$240.35 |
$439.20 |
|
|
Ghs subcutaneous infus, for therapy ea. add. hr
|
$151.20 |
$236.60 |
$236.60 |
|
|
Ghs subcutaneous infus. for therapy init 1 hr
|
$193.60 |
$371.73 |
$482.64 |
|
|
Ghs superficial wnd dehiscence simp12020
|
$996.62 |
$1,283.20 |
$1,839.20 |
|
|
Ghs superficial wnd dehis w packing12021
|
$445.20 |
$445.20 |
$980.80 |
|
|
Ghs tracheostomy emergency - transtracheal
|
$2,300.00 |
$2,320.80 |
$2,568.80 |
|
|
Ghs tx distal phalangeal fx with manipulation
|
$474.40 |
$572.00 |
$700.00 |
|
|
Ghs tx sp hip disloc abd splnt/trac wo
|
$455.20 |
$761.60 |
$761.60 |
|
|
Ghs urine, porphyrins quant
|
$50.40 |
$76.90 |
$96.88 |
|
|
Ghs vaginal delivery only
|
$2,749.60 |
$3,338.40 |
$3,528.00 |
|
|
Ghs windowing of cast
|
$284.00 |
$284.00 |
$284.00 |
|
|
Giardia lamblia antibody
|
$194.40 |
$194.40 |
$260.00 |
|
|
Gi inhouse confirmation
|
$17.28 |
$20.16 |
$116.00 |
|
