|
Prq revasc byp graft 1 art and/or branches
|
$35,920.20 |
$35,920.20 |
$35,920.20 |
$13,398.65
|
|
Prq tcat plmt ntrac st 1 les
|
$28,270.20 |
$28,270.20 |
$28,270.20 |
$13,239.59
|
|
Prq trlml c athrc st angiop1
|
$35,920.20 |
$35,920.20 |
$35,920.20 |
$15,296.00
|
|
Prq trluml c angiop 1art&/br
|
$19,294.80 |
$19,294.80 |
$19,294.80 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$35,920.20 |
$35,920.20 |
$35,920.20 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$35,920.20 |
$35,920.20 |
$35,920.20 |
$15,349.60
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$148.20 |
$148.20 |
$148.20 |
$251.43
|
|
Pr removal intrauterine device
|
$16,616.44 |
$16,616.44 |
$16,616.44 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$262.20 |
$262.20 |
$262.20 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$286.20 |
$286.20 |
$286.20 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$142.80 |
$142.80 |
$142.80 |
$414.00
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$286.20 |
$286.20 |
$286.20 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$286.20 |
$286.20 |
$286.20 |
$396.00
|
|
Pr robotic surgical system
|
$0.01 |
$0.01 |
$0.01 |
$0.52
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$17,734.44 |
$17,734.44 |
$17,734.44 |
$3,087.15
|
|
Pr tube thoracostomy w/connection to drainage open
|
$2,808.60 |
$2,808.60 |
$2,808.60 |
$1,720.93
|
|
PSA (Prostate) Test
|
$99.60 |
$99.60 |
$99.60 |
$107.50
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$73.20 |
$73.20 |
$73.20 |
$87.45
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$78.60 |
$78.60 |
$78.60 |
$102.05
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$67.20 |
$67.20 |
$67.20 |
$81.00
|
|
Pt application of modality traction mechanical
|
$66.00 |
$66.00 |
$66.00 |
$91.00
|
|
Pten gene dup/delet variant
|
$244.80 |
$244.80 |
$244.80 |
$330.00
|
|
Pten gene full sequence
|
$525.00 |
$525.00 |
$525.00 |
$826.00
|
|
Pt evaluation high complexity patient/family
|
$328.80 |
$328.80 |
$328.80 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$285.60 |
$285.60 |
$285.60 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$328.80 |
$328.80 |
$328.80 |
$254.88
|
|
Pt re-evaluation patient/family
|
$218.40 |
$218.40 |
$218.40 |
$152.80
|
|
Pt repositioning canalith procedure(s) per day
|
$105.00 |
$105.00 |
$105.00 |
$118.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$48.00 |
$48.00 |
$48.00 |
$81.48
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$52.20 |
$52.20 |
$52.20 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$36.00 |
$36.00 |
$36.00 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$84.60 |
$84.60 |
$84.60 |
$87.50
|
|
Pulmonary vent imaging
|
$2,285.40 |
$2,285.40 |
$2,285.40 |
$908.00
|
|
Pulse ox continuous overnight monitoring
|
$808.20 |
$808.20 |
$808.20 |
$344.00
|
|
Pulse ox multiple
|
$1,131.60 |
$1,131.60 |
$1,131.60 |
$156.40
|
|
Pulse ox single
|
$66.60 |
$66.60 |
$66.60 |
$81.70
|
|
Pump on-q 100mlx2ml/hr 2 day delivery
|
$1,311.18 |
$1,311.18 |
$1,311.18 |
$969.00
|
|
Puncture arterial withdrawal blood for diagnosis
|
$202.80 |
$202.80 |
$202.80 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$417.60 |
$417.60 |
$417.60 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$759.00 |
$759.00 |
$759.00 |
$1,051.80
|
|
Puraply 1 sq cm
|
$15,642.70 |
$15,642.70 |
$15,642.70 |
$304.50
|
|
Puraply xt 1 sq cm
|
$5,183.74 |
$5,183.74 |
$5,183.74 |
$171.12
|
|
Pvb thoracic single inj site
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,320.80
|
|
Pyridoxine hcl 100 mg
|
$40.80 |
$40.80 |
$40.80 |
$48.70
|
|
Pyruvate
|
$133.80 |
$133.80 |
$133.80 |
$66.00
|
|
Pyruvate kinase
|
$133.80 |
$133.80 |
$133.80 |
$80.64
|
|
Quant diff pulm perf w/imaging
|
$4,194.60 |
$4,194.60 |
$4,194.60 |
$1,199.16
|
|
Quest t3 uptake
|
$83.40 |
$83.40 |
$83.40 |
$52.25
|
|
Rabies ig ht&sol human im/sc
|
$2,236.86 |
$2,236.86 |
$2,236.86 |
$2,756.77
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$10,207.44 |
$10,207.44 |
$10,207.44 |
$4,262.90
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$1,366.20 |
$1,366.20 |
$1,366.20 |
$2,048.87
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$2,495.00
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$1,063.80 |
$1,063.80 |
$1,063.80 |
$1,120.50
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$23,277.30 |
$23,277.30 |
$23,277.30 |
$13,136.04
|
|
Rapid Strep Test
|
$113.40 |
$113.40 |
$113.40 |
$75.24
|
|
Rasburicase 1.5 mg intravenous solution
|
$3,321.00 |
$3,321.00 |
$3,321.00 |
$4,331.80
|
|
Rbc count only automated
|
$22.80 |
$22.80 |
$22.80 |
$20.40
|
|
Rbc irradiated each unit
|
$830.40 |
$830.40 |
$830.40 |
$560.00
|
|
Rbc osmotic fragility
|
$111.00 |
$111.00 |
$111.00 |
$75.04
|
|
Reconstruct shoulder joint
|
$54,605.15 |
$54,605.15 |
$54,605.15 |
$11,340.00
|
|
Red blood cells each unit
|
$266.40 |
$266.40 |
$266.40 |
$387.36
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$487.80 |
$487.80 |
$487.80 |
$577.71
|
|
Red blood cells leukocytes reduced each unit
|
$243.00 |
$243.00 |
$243.00 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$348.00 |
$348.00 |
$348.00 |
$528.45
|
|
Red blood cells washed each unit
|
$1,009.20 |
$1,009.20 |
$1,009.20 |
$572.46
|
|
Reduction of procidentia 45900
|
$1,572.60 |
$1,572.60 |
$1,572.60 |
$1,226.10
|
|
Refill/maint pump/resvr syst
|
$694.80 |
$694.80 |
$694.80 |
$397.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$93.78 |
$93.78 |
$93.78 |
$364.47
|
|
Reinforced solid stirrup
|
$788.99 |
$788.99 |
$788.99 |
$405.22
|
|
Relocation skin pocket aicd
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$2,761.55
|
|
Relocation skin pocket pm
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$2,585.00
|
|
Remdesivir 100 mg intravenous powder for solution
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,524.70
|
|
Rem endovas vena cava filter
|
$3,021.60 |
$3,021.60 |
$3,021.60 |
$5,509.05
|
|
Rem interrog dev eval icpms
|
$58.80 |
$58.80 |
$58.80 |
$99.00
|
|
Rem interrog dev eval scrms
|
$58.80 |
$58.80 |
$58.80 |
$101.25
|
|
Rem interrog evl pm/ids
|
$58.80 |
$58.80 |
$58.80 |
$139.10
|
|
Removal central venous catheter tunneled without port/pump
|
$2,698.20 |
$2,698.20 |
$2,698.20 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$4,540.80 |
$4,540.80 |
$4,540.80 |
$2,356.71
|
|
Removal cerclage w/anes
|
$5,021.40 |
$5,021.40 |
$5,021.40 |
$3,762.53
|
|
Removal cerumen impacted (both sides)
|
$121.80 |
$121.80 |
$121.80 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$369.00 |
$369.00 |
$369.00 |
$249.60
|
|
Removal embedded foreign body vestibule mouth smpl
|
$1,695.00 |
$1,695.00 |
$1,695.00 |
$783.75
|
|
Removal foreign body foot subcutaneous right
|
$807.00 |
$807.00 |
$807.00 |
$1,256.00
|
|
Removal foreign body jawbone
|
$2,594.40 |
$2,594.40 |
$2,594.40 |
$2,133.48
|
|
Removal implant superficial separate procedure
|
$2,845.20 |
$2,845.20 |
$2,845.20 |
$2,986.62
|
|
Removal of heel spur
|
$15,674.52 |
$15,674.52 |
$15,674.52 |
$3,839.54
|
|
Removal of hydrocele
|
$11,181.24 |
$11,181.24 |
$11,181.24 |
$4,176.15
|
|
Removal of implant deep
|
$76,540.73 |
$76,540.73 |
$76,540.73 |
$4,484.80
|
|
Removal/replacement ppm generator dual lead system
|
$24,835.64 |
$24,835.64 |
$24,835.64 |
$12,384.25
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$142.80 |
$142.80 |
$142.80 |
$292.50
|
|
Removal sutr or stapl no anes
|
$130.20 |
$130.20 |
$130.20 |
$95.00
|
|
Removal tunnled intprtnl cath
|
$3,268.20 |
$3,268.20 |
$3,268.20 |
$4,195.00
|
|
Remove anal fist subq
|
$9,717.96 |
$9,717.96 |
$9,717.96 |
$3,721.44
|
|
Remove bladder stone
|
$15,629.95 |
$15,629.95 |
$15,629.95 |
$6,311.00
|
|
Remove ext hem groups 2+
|
$18,438.60 |
$18,438.60 |
$18,438.60 |
$3,245.23
|
|
Remove femur lesion
|
$14,541.60 |
$14,541.60 |
$14,541.60 |
$3,839.54
|
|
Remove foreign body from eye
|
$3,981.00 |
$3,981.00 |
$3,981.00 |
$3,364.50
|
|
Remove in/ex hem groups 2+
|
$18,478.68 |
$18,478.68 |
$18,478.68 |
$4,185.98
|
|
Remove int/ext hem 1 group
|
$24,064.86 |
$24,064.86 |
$24,064.86 |
$3,816.64
|
