|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$189.11 |
$223.89 |
$256.27 |
|
|
Sedimentation rate erythrocyte automated
|
$20.80 |
$42.48 |
$59.20 |
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$65.46 |
$85.60 |
$132.80 |
|
|
Semen analysis presence/motility
|
$38.02 |
$56.00 |
$101.60 |
|
|
Semen analysis w/count
|
$56.00 |
$72.00 |
$72.00 |
|
|
Serial casting application 97139app
|
$98.40 |
$98.40 |
$131.20 |
|
|
Serial tonometry
|
$136.00 |
$136.00 |
$136.00 |
|
|
Set radiation therapy field
|
$1,281.60 |
$2,239.73 |
$3,912.83 |
|
|
Set radiation therapy field
|
$1,747.20 |
$2,230.56 |
$3,912.83 |
|
|
Set radiation therapy field
|
$2,239.73 |
$2,710.40 |
$3,912.83 |
|
|
Sevelamer carbonate 800 mg tablet
|
$1.20 |
$2.42 |
$11.55 |
|
|
Sevelamer carbonate pdr 20mg
|
$30.62 |
$30.62 |
$30.62 |
|
|
Sewhfo airplane without jnts cf
|
$2,419.65 |
$3,214.06 |
$3,214.06 |
|
|
Sewhfo airplane w/jnt(s) cf
|
$2,856.67 |
$3,794.67 |
$3,794.67 |
|
|
Sewhfo cap desgn w/jnt(s) cf
|
$2,711.74 |
$3,602.03 |
$3,602.03 |
|
|
Sewhfo cap design without jnt cf
|
$2,419.65 |
$3,214.06 |
$3,214.06 |
|
|
Sewho airplane without jnts cf
|
$2,856.67 |
$3,794.67 |
$3,794.67 |
|
|
Sewho airplane w/jnt(s) cf
|
$2,856.67 |
$3,794.67 |
$3,794.67 |
|
|
Sewho cap design without jnts cf
|
$2,419.65 |
$3,214.06 |
$3,214.06 |
|
|
Sewho cap design w/jnt(s) cf
|
$2,711.74 |
$3,602.03 |
$3,602.03 |
|
|
Sewho erbs palsey design abd
|
$1,038.86 |
$1,379.90 |
$1,379.90 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$224.00 |
$224.00 |
$404.80 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$228.00 |
$228.00 |
$228.00 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$288.00 |
$327.20 |
$327.20 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$196.00 |
$196.80 |
$203.20 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$207.20 |
$207.20 |
$207.20 |
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$207.20 |
$207.20 |
$207.20 |
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$209.60 |
$209.60 |
$209.60 |
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$225.60 |
$225.60 |
$225.60 |
|
|
Sheath above knee
|
$32.65 |
$44.63 |
$44.63 |
|
|
Sheath below knee
|
$24.86 |
$33.94 |
$33.94 |
|
|
Sheath gldlight lasr 12fx50cm
|
$4,545.36 |
$5,302.92 |
$5,302.92 |
|
|
Sheath upper limb
|
$33.82 |
$46.20 |
$46.20 |
|
|
Shlder disart int lock elbow
|
$6,803.16 |
$8,814.12 |
$8,814.12 |
|
|
Shldr disar prosth tiss shap
|
$6,932.58 |
$8,981.84 |
$8,981.84 |
|
|
Shoe clubfoot wedge
|
$78.51 |
$107.24 |
$107.24 |
|
|
Shoe dennis browne splint bo
|
$68.43 |
$93.52 |
$93.52 |
|
|
Shoe heel new leather standa
|
$64.46 |
$88.03 |
$88.03 |
|
|
Shoe heel new rubber standar
|
$54.38 |
$74.31 |
$74.31 |
|
|
Shoe heel pad & depress for
|
$161.52 |
$188.44 |
$188.44 |
|
|
Shoe heel sach cushion type
|
$62.76 |
$195.50 |
$228.09 |
|
|
Shoe heel thomas extend to b
|
$98.56 |
$134.68 |
$134.68 |
|
|
Shoe heel thomas with wedge
|
$92.62 |
$126.56 |
$126.56 |
|
|
Shoe lift elev heel/sole neo
|
$128.80 |
$176.01 |
$176.01 |
|
|
Shoe metatarsal bar between
|
$146.83 |
$200.76 |
$200.76 |
|
|
Shoe metatarsal bar wedge ro
|
$64.46 |
$88.03 |
$88.03 |
|
|
Shoe outflare wedge
|
$78.51 |
$107.24 |
$107.24 |
|
|
Shoe post-op mens m
|
$24.58 |
$28.67 |
$146.13 |
|
|
Shoe sole wedge between sole
|
$78.51 |
$107.24 |
$107.24 |
|
|
Shoe sole wedge outside sole
|
$28.44 |
$66.00 |
$77.00 |
|
|
Shoe wedge sach
|
$134.90 |
$184.24 |
$184.24 |
|
|
Sho heel count plast reinfor
|
$253.57 |
$346.47 |
$346.47 |
|
|
Sho insert w arch toe filler
|
$908.71 |
$1,207.02 |
$1,207.02 |
|
|
Sho lift taper to metatarsal
|
$82.49 |
$112.78 |
$112.78 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$58.63 |
$122.88 |
$176.80 |
|
|
Shoulder abduction joint pai
|
$533.79 |
$709.07 |
$709.07 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$138.43 |
$240.80 |
$470.40 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$138.43 |
$208.80 |
$416.00 |
|
|
Shoulder flexion-abduction j
|
$577.30 |
$766.86 |
$766.86 |
|
|
Shoulder lock actuator
|
$823.37 |
$1,093.62 |
$1,093.62 |
|
|
Shoulder MRI (with and without contrast)
|
$1,276.99 |
$3,592.00 |
$4,205.60 |
|
|
Shoulder MRI (with contrast)
|
$1,276.99 |
$3,234.06 |
$3,704.80 |
|
|
Shoulder MRI (without contrast)
|
$912.00 |
$2,506.40 |
$3,237.60 |
|
|
Shoulder universal joint
|
$626.14 |
$831.77 |
$831.77 |
|
|
Shoulder X-ray
|
$207.79 |
$274.40 |
$530.40 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$150.40 |
$220.00 |
$369.60 |
|
|
Shrinker prosth above knee
|
$105.11 |
$143.58 |
$227.02 |
|
|
Shrinker prosth below knee
|
$73.86 |
$100.97 |
$217.66 |
|
|
Shrinker upper limb
|
$97.10 |
$132.66 |
$132.66 |
|
|
Shunt glaucoma baerveldt 350mm
|
$2,788.80 |
$3,253.60 |
$6,000.00 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$862.85 |
$862.85 |
$862.85 |
|
|
Sialography s&i
|
$708.80 |
$821.74 |
$862.85 |
|
|
Sialolithotomy 42330
|
$1,075.03 |
$1,075.03 |
$3,776.80 |
|
|
Sickling rbc
|
$28.00 |
$135.36 |
$170.58 |
|
|
Sigmoidoscopy w/ablation
|
$2,820.80 |
$2,820.80 |
$2,820.80 |
|
|
Signal avg ecg w or without ecg 93278
|
$77.62 |
$77.62 |
$77.62 |
|
|
Simple cystometrogram 51725
|
$747.55 |
$747.55 |
$747.55 |
|
|
Sincalide 5 mcg solution for injection
|
$239.19 |
$279.06 |
$463.20 |
|
|
Single pivot hinge pair
|
$370.16 |
$505.74 |
$505.74 |
|
|
Sinus CT scan (with and without contrast)
|
$863.71 |
$1,824.98 |
$3,016.00 |
|
|
Sinus CT scan (with contrast)
|
$647.76 |
$2,156.00 |
$2,519.20 |
|
|
Sinus CT scan (without contrast)
|
$863.71 |
$1,824.98 |
$2,285.60 |
|
|
Sinus/juglr venogram s&i
|
$1,285.63 |
$1,285.63 |
$3,350.40 |
|
|
Sinus X-ray (complete)
|
$138.43 |
$240.80 |
$539.20 |
|
|
Sinus X-ray (limited)
|
$138.43 |
$200.80 |
$356.00 |
|
|
Sio flex pelvisacral custom
|
$422.91 |
$561.79 |
$561.79 |
|
|
Sirolimus, oral
|
$7.20 |
$16.04 |
$57.67 |
|
|
Skin Biopsy
|
$224.78 |
$444.00 |
$459.20 |
|
|
Skull X-ray (1 to 3 views)
|
$207.79 |
$257.66 |
$433.60 |
|
|
Skull X-ray (complete)
|
$138.43 |
$290.40 |
$771.20 |
|
|
Skyla, 13.5 mg
|
$719.68 |
$780.88 |
$1,000.80 |
|
|
Sleep study attended
|
$724.85 |
$1,675.69 |
$1,675.69 |
|
|
Sleep Study (Polysomnography)
|
$2,486.50 |
$3,084.09 |
$4,452.00 |
|
|
Sleep study unattended
|
$708.00 |
$895.82 |
$978.88 |
|
|
Sleeve fing rolyan med
|
$307.22 |
$359.86 |
$419.83 |
|
|
Sling pelv split sam med
|
$43.73 |
$51.02 |
$227.88 |
|
|
Sling suprapubic suburetheral
|
$3,230.40 |
$3,372.00 |
$18,777.20 |
|
|
Slitting of prepuce
|
$4,891.20 |
$4,891.20 |
$4,891.20 |
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$117.77 |
$146.61 |
$146.61 |
|
|
Slp eval non-spch gen comm dev
|
$192.92 |
$240.35 |
$385.60 |
|