|
Ghs closure surg wound/dehiscence-13160
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,973.33
|
|
Ghs clsd red med malleolus fx without manip
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$581.60
|
|
Ghs clsd red med malleolus fx w manip
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,459.25
|
|
Ghs clsd tx frac distal tibia w/manipulation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,399.46
|
|
Ghs cl tx knee disl; wo anesth
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$716.95
|
|
Ghs cl tx metacarpophal disloc without anes
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$547.94
|
|
Ghs conjunctiva foreign body-embed bil
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$448.80
|
|
Ghs conjunctiva foreign body-superf bil
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$316.25
|
|
Ghs corneal fb without slit lamp bilat
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$435.07
|
|
Ghs corneal fb with slit lamp bilat
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$368.16
|
|
Ghs cricothyroidotomy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,207.80
|
|
Ghs cutdown placement age 1 and over
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$411.84
|
|
Ghs cutdown placement under 1 yr
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$152.54
|
|
Ghs diphtheria toxoid ab igg
|
$16.73 |
$16.73 |
$16.73 |
$72.05
|
|
Ghs dislocation elbow closed treatment
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$687.73
|
|
Ghs ed peritoneal lavage w guidance if performed
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,313.95
|
|
Ghs ed rmvl or bivalving cast
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$351.46
|
|
Ghs ed therapeutic lp, drain csf w fluoro
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,439.40
|
|
Ghs epidermal shaving diameter >2.0 cm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$470.51
|
|
Ghs excision ingrown nail
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$457.60
|
|
Ghs eyelid foreign body-embedded - bil
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$536.77
|
|
Ghs fat & muscle
|
$5.34 |
$5.34 |
$5.34 |
$33.00
|
|
Ghs fb removal foot - deep - left
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,880.30
|
|
Ghs fb removal from muscle - complicated
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Ghs fb removal - incisional
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,425.20
|
|
Ghs fb removal - non-incisional
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,794.93
|
|
Ghs febrile agglutinns(mayo)
|
$7.68 |
$7.68 |
$7.68 |
$48.57
|
|
Ghs fish cytogen
|
$23.56 |
$23.56 |
$23.56 |
$175.00
|
|
Ghs fish hybrid in situ 100-300
|
$56.31 |
$56.31 |
$56.31 |
$229.45
|
|
Ghs gastric intub aspiration lavage
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$403.20
|
|
Ghs hcv amplificaiton
|
$38.60 |
$38.60 |
$38.60 |
$187.00
|
|
Ghs heavy metals bld (ars,lead,merc)
|
$25.27 |
$25.27 |
$25.27 |
$27.56
|
|
Ghs hepatitis c virus (hcv riba)
|
$17.04 |
$17.04 |
$17.04 |
$106.05
|
|
Ghs hgb stability-thal
|
$10.42 |
$10.42 |
$10.42 |
$85.28
|
|
Ghs histoplasma antigen
|
$14.58 |
$14.58 |
$14.58 |
$137.80
|
|
Ghs HIV antibody
|
$15.08 |
$15.08 |
$15.08 |
$91.00
|
|
Ghs hla-dr/dq, multiple antigens
|
$116.75 |
$116.75 |
$116.75 |
$462.60
|
|
Ghs i and d abscess/hematoma scrotum
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,822.00
|
|
Ghs i and d perirectal abscess 46040
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,034.00
|
|
Ghs i and d pilonidal cyst complex
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,572.00
|
|
Ghs i and d pilonidal cyst simple
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$794.82
|
|
Ghs immun0electrophoresis
|
$32.91 |
$32.91 |
$32.91 |
$110.00
|
|
Ghs incision thrombosed ext hemorrhoid
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$543.60
|
|
Ghs indirect laryngoscopy/w fb removal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$293.58
|
|
Ghs inf midline insertion
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,234.20
|
|
Ghs inhibitor screen
|
$14.16 |
$14.16 |
$14.16 |
$143.32
|
|
Ghs init tx 1st degree burn
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$300.30
|
|
Ghs inj neurolytic intercostal nerve
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,037.10
|
|
Ghs inj neurolytic other perph nerve
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,972.69
|
|
Ghs inj tendon origin/insertion
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$431.07
|
|
Ghs inj transforaminal cerv single bil
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,861.60
|
|
Ghs insertion of needle - bone
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$461.58
|
|
Ghs intermed repair 12.6 - 20.0 cm-12035
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$943.80
|
|
Ghs intermed repair 20.1 - 30.0 cm-12036
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,160.28
|
|
Ghs intermed repair over 30 cm - 12037
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,164.64
|
|
Ghs irrigate corpora cavernosa for priapism
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$637.92
|
|
Ghs IV inf sq injection, on-body injector
|
$51.80 |
$51.80 |
$51.80 |
$117.00
|
|
Ghs IV thrombolytics - cerebral
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$657.60
|
|
Ghs lac repair mouth.ant tong 2.5cm/less
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$547.95
|
|
Ghs layer closure 2.5 cm or less - 12031
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$617.60
|
|
Ghs layer closure 2.5 cm or less - 12041
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$619.20
|
|
Ghs layer closure 2.5cm or less - 12051
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$648.00
|
|
Ghs layer closure 2.6 - 5.0 cm - 12052
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$741.00
|
|
Ghs layer closure 2.6 - 7.5 cm - 12042
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$741.00
|
|
Ghs layer closure 5.1 - 7.5 cm - 12053
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$779.35
|
|
Ghs layer closure 7.6 - 12.5 cm - 12034
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$810.00
|
|
Ghs layer closure 7.6 - 12.5 cm - 12044
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$795.20
|
|
Ghs layer closure 7.6 - 12.5 cm - 12054
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$779.35
|
|
Ghs layered repair 12.6 - 20.0 cm -12045
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$995.20
|
|
Ghs layered repair 12.6 - 20.0 cm -12055
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$879.60
|
|
Ghs layered repair 20.1 - 30.0 cm -12046
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,188.80
|
|
Ghs layered repair 20.1 - 30.0 cm -12056
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,030.80
|
|
Ghs layered repair over 30.0 cm -12047
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,024.70
|
|
Ghs layered repair over 3.0 cm -12057
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,064.98
|
|
Ghs leukocyte alkaline phos (mayo)
|
$9.46 |
$9.46 |
$9.46 |
$59.40
|
|
Ghs mbp
|
$18.92 |
$18.92 |
$18.92 |
$74.19
|
|
Ghs myocardial strain img spckl track
|
$176.06 |
$176.06 |
$176.06 |
$503.85
|
|
Ghs nailbed repair/nail removal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$808.80
|
|
Ghs nerve blk intercostal, ea addtl level
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,618.50
|
|
Ghs nerve blk intercostal, single level
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,230.80
|
|
Ghs nerve block axillary nerve
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,541.40
|
|
Ghs nerve block brachial plexus
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,768.00
|
|
Ghs nerve block celiac plexus
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,712.00
|
|
Ghs nerve block interscaline
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,607.45
|
|
Ghs nerve block lumbar or thoracic symp
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,042.60
|
|
Ghs nerve block sciatic nerve
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,636.80
|
|
Ghs nerve block suprascapular
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,223.00
|
|
Ghs ng placement w fluoro guidance
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$468.75
|
|
Ghs o2 saturation
|
$10.75 |
$10.75 |
$10.75 |
$72.45
|
|
Ghs ob unlisted IV or art inj or infusion
|
$12.76 |
$12.76 |
$12.76 |
$86.19
|
|
Ghs opcc repair cvp without subq port
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,302.54
|
|
Ghs opcc repair cvp w subq port
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,430.56
|
|
Ghs peritonsillar abscess i andd
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$694.20
|
|
Ghs phenylketonurid
|
$6.05 |
$6.05 |
$6.05 |
$51.58
|
|
Ghs picc line insert < 5
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,060.40
|
|
Ghs plngl fx pm cl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$662.20
|
|
Ghs plt ct-manual
|
$4.74 |
$4.74 |
$4.74 |
$39.20
|
|
Ghs polysom <6 yrs 4/> parameters
|
$1,529.56 |
$1,529.56 |
$1,529.56 |
$3,705.80
|
|
Ghs ppd (tb intradermal)
|
$16.14 |
$16.14 |
$16.14 |
$43.45
|
|
Ghs prostatic acid phosphatase (mayo)
|
$10.63 |
$10.63 |
$10.63 |
$40.56
|
