|
Prq revasc byp graft 1 art and/or branches
|
$18,270.00 |
$18,270.00 |
$18,270.00 |
$13,398.65
|
|
Prq revasc byp graft addl
|
$3,878.40 |
$3,878.40 |
$3,878.40 |
$8,940.00
|
|
Prq tcat plmt ntrac st 1 les
|
$6,436.00 |
$6,436.00 |
$6,436.00 |
$13,239.59
|
|
Prq trlml c athrc st angiop1
|
$6,674.40 |
$6,674.40 |
$6,674.40 |
$15,296.00
|
|
Prq trluml c angiop 1art&/br
|
$6,436.00 |
$6,436.00 |
$6,436.00 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$5,400.80 |
$5,400.80 |
$5,400.80 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$18,270.00 |
$18,270.00 |
$18,270.00 |
$15,349.60
|
|
Pr removal drug delivery implant
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
$533.00
|
|
Pr removal intrauterine device
|
$365.60 |
$365.60 |
$365.60 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$639.60 |
$639.60 |
$639.60 |
$711.48
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$232.80 |
$232.80 |
$232.80 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$232.80 |
$232.80 |
$232.80 |
$396.00
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$12,846.00 |
$12,846.00 |
$12,846.00 |
$3,087.15
|
|
Pr tube thoracostomy w/connection to drainage open
|
$3,374.40 |
$3,374.40 |
$3,374.40 |
$1,720.93
|
|
PSA (Prostate) Test
|
$102.00 |
$102.00 |
$102.00 |
$107.50
|
|
Psychoanalysis
|
$806.00 |
$806.00 |
$806.00 |
$250.85
|
|
Psychoeducation 45 min +
|
$277.20 |
$277.20 |
$277.20 |
$201.45
|
|
Psychotherapy group therapy
|
$205.60 |
$205.60 |
$205.60 |
$216.80
|
|
Psychotherapy patient individual therapy 30 minutes
|
$131.60 |
$131.60 |
$131.60 |
$189.14
|
|
Psychotherapy patient individual therapy 45 minutes
|
$220.00 |
$220.00 |
$220.00 |
$247.59
|
|
Psychotherapy patient individual therapy 60 minutes
|
$246.00 |
$246.00 |
$246.00 |
$287.47
|
|
Psychthrp grp 45-50min mcr
|
$338.00 |
$338.00 |
$338.00 |
$243.88
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$58.40 |
$58.40 |
$58.40 |
$87.45
|
|
Pt application of modality >=1 area hot/cold packs
|
$16.80 |
$16.80 |
$16.80 |
$35.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$111.60 |
$111.60 |
$111.60 |
$102.05
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$83.60 |
$83.60 |
$83.60 |
$81.00
|
|
Pt application of modality traction mechanical
|
$105.20 |
$105.20 |
$105.20 |
$91.00
|
|
Pt evaluation high complexity patient/family
|
$250.80 |
$250.80 |
$250.80 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$232.40 |
$232.40 |
$232.40 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$241.60 |
$241.60 |
$241.60 |
$254.88
|
|
Pt re-evaluation patient/family
|
$152.80 |
$152.80 |
$152.80 |
$152.80
|
|
Pt repositioning canalith procedure(s) per day
|
$228.00 |
$228.00 |
$228.00 |
$118.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$250.40 |
$250.40 |
$250.40 |
$81.48
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$71.60 |
$71.60 |
$71.60 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$94.00 |
$94.00 |
$94.00 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$47.20 |
$47.20 |
$47.20 |
$87.50
|
|
Pulmonary vent imaging
|
$552.80 |
$552.80 |
$552.80 |
$908.00
|
|
Pulse ox continuous overnight monitoring
|
$338.40 |
$338.40 |
$338.40 |
$344.00
|
|
Pulse ox multiple
|
$156.40 |
$156.40 |
$156.40 |
$156.40
|
|
Pulse ox single
|
$52.80 |
$52.80 |
$52.80 |
$81.70
|
|
Punc of shunt for asp or inj
|
$1,663.20 |
$1,663.20 |
$1,663.20 |
$957.50
|
|
Puncture arterial withdrawal blood for diagnosis
|
$140.00 |
$140.00 |
$140.00 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$714.80 |
$714.80 |
$714.80 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$881.20 |
$881.20 |
$881.20 |
$1,051.80
|
|
Quant diff pulm perf and vent w/imaging
|
$862.40 |
$862.40 |
$862.40 |
$1,542.40
|
|
Quant diff pulm perf w/imaging
|
$552.80 |
$552.80 |
$552.80 |
$1,199.16
|
|
Quest t3 uptake
|
$13.20 |
$13.20 |
$13.20 |
$52.25
|
|
Radiation handling
|
$218.80 |
$218.80 |
$218.80 |
$324.80
|
|
Radiation physics consult
|
$540.40 |
$540.40 |
$540.40 |
$606.50
|
|
Radiation therapy dose plan
|
$496.80 |
$496.80 |
$496.80 |
$514.05
|
|
Radiation treatment aid(s)
|
$334.40 |
$334.40 |
$334.40 |
$520.00
|
|
Radiation treatment aid(s)
|
$387.60 |
$387.60 |
$387.60 |
$644.16
|
|
Radiation treatment aid(s)
|
$818.40 |
$818.40 |
$818.40 |
$1,076.78
|
|
Radiation treatment delivery
|
$437.20 |
$437.20 |
$437.20 |
$552.40
|
|
Radiation treatment delivery
|
$877.20 |
$877.20 |
$877.20 |
$920.00
|
|
Radiology port images(s)
|
$133.20 |
$133.20 |
$133.20 |
$251.50
|
|
Radiotherapy dose plan imrt
|
$1,390.40 |
$1,390.40 |
$1,390.40 |
$5,744.60
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$1,278.40 |
$1,278.40 |
$1,278.40 |
$2,048.87
|
|
Radphm lcl tmr plnr bdy two day img
|
$1,306.00 |
$1,306.00 |
$1,306.00 |
$2,728.42
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$2,292.00 |
$2,292.00 |
$2,292.00 |
$2,495.00
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,338.80 |
$1,338.80 |
$1,338.80 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$663.20 |
$663.20 |
$663.20 |
$1,120.50
|
|
Radphm quant measure sgl area add-on
|
$324.80 |
$324.80 |
$324.80 |
$711.20
|
|
Rapid Strep Test
|
$30.40 |
$30.40 |
$30.40 |
$75.24
|
|
Rb82 rubidium
|
$200.00 |
$200.00 |
$200.00 |
$866.88
|
|
Rbc count only automated
|
$21.20 |
$21.20 |
$21.20 |
$20.40
|
|
Rbc deglycerolized each unit
|
$896.80 |
$896.80 |
$896.80 |
$841.75
|
|
Rbc irradiated each unit
|
$578.40 |
$578.40 |
$578.40 |
$560.00
|
|
Rbc osmotic fragility
|
$144.00 |
$144.00 |
$144.00 |
$75.04
|
|
Red blood cells each unit
|
$412.80 |
$412.80 |
$412.80 |
$387.36
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$302.40 |
$302.40 |
$302.40 |
$577.71
|
|
Red blood cells leukocytes reduced each unit
|
$375.60 |
$375.60 |
$375.60 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$512.80 |
$512.80 |
$512.80 |
$528.45
|
|
Red blood cells washed each unit
|
$314.40 |
$314.40 |
$314.40 |
$572.46
|
|
Red cell mass multiple
|
$635.60 |
$635.60 |
$635.60 |
$636.97
|
|
Red cell survival study
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$549.70
|
|
Redo endovas vena cava filtr
|
$3,390.00 |
$3,390.00 |
$3,390.00 |
$4,435.43
|
|
Refill maint impl spine pump
|
$330.80 |
$330.80 |
$330.80 |
$366.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$19.28 |
$19.28 |
$19.28 |
$364.47
|
|
Relocation skin pocket aicd
|
$720.40 |
$720.40 |
$720.40 |
$2,761.55
|
|
Relocation skin pocket pm
|
$720.40 |
$720.40 |
$720.40 |
$2,585.00
|
|
Rem endovas vena cava filter
|
$4,171.20 |
$4,171.20 |
$4,171.20 |
$5,509.05
|
|
Remote 30 day ecg tech supp
|
$846.00 |
$846.00 |
$846.00 |
$683.25
|
|
Removal biliary drg cath
|
$2,227.20 |
$2,227.20 |
$2,227.20 |
$1,380.82
|
|
Removal central venous catheter tunneled without port/pump
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$2,163.20 |
$2,163.20 |
$2,163.20 |
$2,356.71
|
|
Removal cerumen impacted (both sides)
|
$86.80 |
$86.80 |
$86.80 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$372.00 |
$372.00 |
$372.00 |
$249.60
|
|
Removal duct glbldr calculi
|
$1,496.40 |
$1,496.40 |
$1,496.40 |
$2,771.60
|
|
Removal foreign body foot subcutaneous right
|
$1,311.60 |
$1,311.60 |
$1,311.60 |
$1,256.00
|
|
Removal of eye lesion
|
$3,113.60 |
$3,113.60 |
$3,113.60 |
$2,943.33
|
|
Removal of heel bone
|
$6,298.80 |
$6,298.80 |
$6,298.80 |
$3,821.05
|
|
Removal of vein clot
|
$3,773.20 |
$3,773.20 |
$3,773.20 |
$4,341.66
|
|
Removal of vein clot
|
$3,773.20 |
$3,773.20 |
$3,773.20 |
$5,608.61
|
|
Removal/replacement ppm generator dual lead system
|
$8,517.20 |
$8,517.20 |
$8,517.20 |
$12,384.25
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$498.80 |
$498.80 |
$498.80 |
$292.50
|
|
Removal sutr and stapl no anes
|
$104.00 |
$104.00 |
$104.00 |
$82.05
|
|
Removal sutr or stapl no anes
|
$104.00 |
$104.00 |
$104.00 |
$95.00
|
|
Removal tunnled intprtnl cath
|
$11,040.80 |
$11,040.80 |
$11,040.80 |
$4,195.00
|
|
Removal w/reinsrt nonbiogrdble
|
$350.00 |
$350.00 |
$350.00 |
$530.40
|
