|
Rp loclzj tum spect w/ct 1
|
$3,342.57 |
$3,342.57 |
$3,342.57 |
$2,573.55
|
|
Rp loclzj tum spect w/ct 2
|
$62.10 |
$62.10 |
$62.10 |
$3,186.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$4,545.31 |
$4,545.31 |
$4,545.31 |
$2,175.36
|
|
Rpl tun-cvad w subq port
|
$9,209.97 |
$9,209.97 |
$9,209.97 |
$4,819.80
|
|
Rpl tun-cvad w subq pump
|
$212.06 |
$212.06 |
$212.06 |
$6,067.30
|
|
Rpl tun cvc wo subq port
|
$9,209.97 |
$9,209.97 |
$9,209.97 |
$3,724.63
|
|
Rpm tx mgmt 1st 20 min
|
$19.32 |
$19.32 |
$19.32 |
$72.60
|
|
Rpm tx mgmt ea addl 20 min
|
$19.32 |
$19.32 |
$19.32 |
$73.60
|
|
Rpr aa hrn 1st > 10 ncr/strn
|
$664.01 |
$664.01 |
$664.01 |
$1,982.40
|
|
Rpr aa hrn 1st > 10 rdc
|
$500.02 |
$500.02 |
$500.02 |
$5,855.00
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$482.54 |
$482.54 |
$482.54 |
$6,904.15
|
|
Rpr aa hrn 1st 3-10 rdc
|
$370.76 |
$370.76 |
$370.76 |
$7,383.87
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$221.26 |
$221.26 |
$221.26 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$308.20 |
$308.20 |
$308.20 |
$6,904.15
|
|
Rpr aa hrn rcr > 10 ncr/strn
|
$805.00 |
$805.00 |
$805.00 |
$2,402.40
|
|
Rpr aa hrn rcr > 10 rdc
|
$574.54 |
$574.54 |
$574.54 |
$1,719.20
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$555.22 |
$555.22 |
$555.22 |
$1,663.20
|
|
Rpr aa hrn rcr 3-10 rdc
|
$413.31 |
$413.31 |
$413.31 |
$6,856.20
|
|
Rpr aa hrn rcr < 3 ncr/strn
|
$369.61 |
$369.61 |
$369.61 |
$6,463.42
|
|
Rpr aa hrn rcr < 3 rdc
|
$272.32 |
$272.32 |
$272.32 |
$4,271.28
|
|
Rpr acq av fistula thrx&abd
|
$957.03 |
$957.03 |
$957.03 |
$2,122.76
|
|
Rpr blood ves w/vein graft/up ext 35236
|
$642.16 |
$642.16 |
$642.16 |
$5,983.35
|
|
Rpr blood vsl grf oth vein lo ex
|
$587.19 |
$587.19 |
$587.19 |
$5,907.78
|
|
Rpr blvs gr ot/th vn ntrth w
|
$878.14 |
$878.14 |
$878.14 |
$6,390.80
|
|
Rpr blvs gr ot/t vn ntrth wo
|
$926.21 |
$926.21 |
$926.21 |
$2,098.06
|
|
Rpr blvsl gr ot/th vn ntr-ab
|
$1,037.30 |
$1,037.30 |
$1,037.30 |
$7,815.60
|
|
Rpr blvsl vn grf intra-abdl
|
$1,099.40 |
$1,099.40 |
$1,099.40 |
$1,848.50
|
|
Rpr blvsl vn grf ntrthrc w/b
|
$911.49 |
$911.49 |
$911.49 |
$2,049.00
|
|
Rpr cgen av fistula thrx&abd
|
$1,141.26 |
$1,141.26 |
$1,141.26 |
$1,141.26
|
|
Rpr choanal atresia ntranasl
|
$469.66 |
$469.66 |
$469.66 |
$6,839.00
|
|
Rpr choanal atresia trsnpltn
|
$637.10 |
$637.10 |
$637.10 |
$6,553.49
|
|
Rpr csf leak/pseudomeng/laminectomy63709
|
$726.80 |
$726.80 |
$726.80 |
$1,933.20
|
|
Rpr diaphragm hernia/chronic/not neonate 39541
|
$603.75 |
$603.75 |
$603.75 |
$1,705.80
|
|
Rpr diaphragm lac/any approach 39501
|
$549.01 |
$549.01 |
$549.01 |
$1,509.66
|
|
Rpr fem hernia init blocked
|
$411.47 |
$411.47 |
$411.47 |
$4,176.15
|
|
Rpr hern preemie reduc
|
$518.42 |
$518.42 |
$518.42 |
$6,839.00
|
|
Rpr hypopl a-arch w/byp
|
$1,167.71 |
$1,167.71 |
$1,167.71 |
$4,469.60
|
|
Rpr hypopl a-arch wo byp
|
$893.32 |
$893.32 |
$893.32 |
$2,009.87
|
|
Rpr hypspad comp dsj & urtp
|
$651.82 |
$651.82 |
$651.82 |
$5,631.74
|
|
Rpr hypspad comp simple
|
$368.69 |
$368.69 |
$368.69 |
$4,350.00
|
|
Rpr ing hernia baby blocked
|
$400.89 |
$400.89 |
$400.89 |
$4,156.03
|
|
Rpr ing hernia baby reduc
|
$266.57 |
$266.57 |
$266.57 |
$4,176.15
|
|
Rpr ing hernia init blocked
|
$395.14 |
$395.14 |
$395.14 |
$4,176.15
|
|
Rpr ing hernia init reduce
|
$271.17 |
$271.17 |
$271.17 |
$5,411.37
|
|
Rpr ing hern premie blocked
|
$622.61 |
$622.61 |
$622.61 |
$4,691.20
|
|
Rpr nsl vlv collapse w/implt
|
$109.02 |
$109.02 |
$109.02 |
$8,139.99
|
|
Rpr nsl vlv collapse w/rmdlg
|
$96.60 |
$96.60 |
$96.60 |
$8,139.99
|
|
Rpr parastomal hernia rdc 49621
|
$486.91 |
$486.91 |
$486.91 |
$1,450.40
|
|
Rpr parastomal hrna ncr/strn 49622
|
$605.59 |
$605.59 |
$605.59 |
$1,786.40
|
|
Rpr pul art unifocal without cpb
|
$1,090.20 |
$1,090.20 |
$1,090.20 |
$2,433.62
|
|
Rpr&refitg spect xcp aphakia
|
$10.58 |
$10.58 |
$10.58 |
$10.58
|
|
Rpr rem hernia init reduce
|
$376.74 |
$376.74 |
$376.74 |
$3,906.18
|
|
Rpr tga aortic pulm art rcns
|
$1,493.16 |
$1,493.16 |
$1,493.16 |
$3,334.30
|
|
Rpr tga atr bfl clsr vsd
|
$1,248.90 |
$1,248.90 |
$1,248.90 |
$2,802.10
|
|
Rpr tga atr bfl rmvl plm bnd
|
$1,180.82 |
$1,180.82 |
$1,180.82 |
$2,647.72
|
|
Rpr tga atrial baffle px
|
$1,147.47 |
$1,147.47 |
$1,147.47 |
$2,577.95
|
|
Rpr tga bfl rpr sbpulm obstr
|
$1,202.21 |
$1,202.21 |
$1,202.21 |
$2,686.46
|
|
Rpr tga rcnstj clsr vsd
|
$1,501.44 |
$1,501.44 |
$1,501.44 |
$3,340.51
|
|
Rpr tga rcnstj rmvl plm bnd
|
$1,472.69 |
$1,472.69 |
$1,472.69 |
$3,275.43
|
|
Rpr tga rcnstj rpr sbpl obst
|
$1,463.95 |
$1,463.95 |
$1,463.95 |
$3,252.38
|
|
Rpr tga without surg enlgmnt vsd
|
$1,342.05 |
$1,342.05 |
$1,342.05 |
$2,990.02
|
|
Rpr tga w/surg enlgmnt vsd
|
$1,379.54 |
$1,379.54 |
$1,379.54 |
$3,066.58
|
|
Rpr xtnsr tndn leg prim without grft ea tndn
|
$233.22 |
$233.22 |
$233.22 |
$5,959.65
|
|
Rrp hypspad comp moblj&urtp
|
$609.50 |
$609.50 |
$609.50 |
$10,106.03
|
|
Rsect hip tum incl femur
|
$1,326.18 |
$1,326.18 |
$1,326.18 |
$10,735.20
|
|
Rsv assay w/optic
|
$9.20 |
$9.20 |
$9.20 |
$75.45
|
|
Rtm tx mgmt 1st 20 min
|
$19.78 |
$19.78 |
$19.78 |
$81.90
|
|
Rtm tx mgmt ea addl 20 min
|
$19.32 |
$19.32 |
$19.32 |
$70.85
|
|
Rubella antibody igg
|
$95.48 |
$95.48 |
$95.48 |
$77.80
|
|
Rubeola ag if
|
$41.86 |
$41.86 |
$41.86 |
$83.90
|
|
Rubeola antibody igg
|
$84.70 |
$84.70 |
$84.70 |
$80.00
|
|
Runx1 gene targeted seq alys
|
$227.24 |
$227.24 |
$227.24 |
$454.72
|
|
Russell viper venom diluted
|
$63.14 |
$63.14 |
$63.14 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$2,683.45 |
$2,683.45 |
$2,683.45 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$534.38 |
$534.38 |
$534.38 |
$313.66
|
|
Safety plan interven
|
$27.83 |
$27.83 |
$27.83 |
$47.60
|
|
Salivary gland function exam
|
$12.19 |
$12.19 |
$12.19 |
$719.16
|
|
Salivary gland imaging
|
$13.57 |
$13.57 |
$13.57 |
$585.00
|
|
Salivary glnd img serial img
|
$13.57 |
$13.57 |
$13.57 |
$701.73
|
|
Salmonella antibody
|
$87.01 |
$87.01 |
$87.01 |
$37.58
|
|
Salpingostomy 58770
|
$556.14 |
$556.14 |
$556.14 |
$4,304.00
|
|
Same day nb discharge 99463
|
$69.23 |
$69.23 |
$69.23 |
$183.07
|
|
Sarscov coronavirus ag ia
|
$24.38 |
$24.38 |
$24.38 |
$59.40
|
|
Sarscov & inf vir a&b ag ia
|
$48.30 |
$48.30 |
$48.30 |
$104.00
|
|
S bowel endoscope w/stent
|
$259.44 |
$259.44 |
$259.44 |
$4,379.25
|
|
Sbrt management
|
$418.83 |
$418.83 |
$418.83 |
$1,156.00
|
|
Sbsq ic vlbw inf<1,500 gm
|
$84.87 |
$84.87 |
$84.87 |
$248.00
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$98.67 |
$98.67 |
$98.67 |
$198.31
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$47.61 |
$47.61 |
$47.61 |
$106.38
|
|
Sbsq nursing facil care/day new problem 25 min
|
$69.23 |
$69.23 |
$69.23 |
$144.30
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$25.53 |
$25.53 |
$25.53 |
$67.60
|
|
Sbsq psyc collab care mgmt
|
$66.01 |
$66.01 |
$66.01 |
$109.46
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$884.73 |
$884.73 |
$884.73 |
$767.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$388.85 |
$388.85 |
$388.85 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$388.85 |
$388.85 |
$388.85 |
$582.50
|
|
Scan duplex extremity veins unilateral/limited study
|
$388.85 |
$388.85 |
$388.85 |
$721.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$388.85 |
$388.85 |
$388.85 |
$651.60
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$388.85 |
$388.85 |
$388.85 |
$595.35
|
|
Scan proc cranial extra
|
$111.32 |
$111.32 |
$111.32 |
$2,248.40
|
|
Scan proc cranial intra 61781
|
$152.26 |
$152.26 |
$152.26 |
$1,015.00
|
