|
Post non-seg/spine instrumentation 22840
|
$548.60 |
$548.60 |
$548.60 |
$1,831.20
|
|
Postpartum Care Only
|
$130.26 |
$130.26 |
$130.26 |
$364.80
|
|
Post seg spine instrument/3-6 seg 22842
|
$555.10 |
$555.10 |
$555.10 |
$1,837.60
|
|
Potassium 24 hour urine
|
$30.34 |
$30.34 |
$30.34 |
$50.74
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$18.88 |
$18.88 |
$18.88 |
$61.80
|
|
Potassium hydroxide preps
|
$4.68 |
$4.68 |
$4.68 |
$22.40
|
|
Potassium serum/plasma/whole blood
|
$30.34 |
$30.34 |
$30.34 |
$47.40
|
|
Ppp2r2b gen detc abnor allel
|
$107.12 |
$107.12 |
$107.12 |
$189.06
|
|
Pq biliary strict dil s&i
|
$1,280.20 |
$1,280.20 |
$1,280.20 |
$1,102.53
|
|
Pq dr cath chg w cont s&i
|
$2,997.00 |
$2,997.00 |
$2,997.00 |
$724.68
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$20,088.04 |
$20,088.04 |
$20,088.04 |
$10,203.30
|
|
Pq thr inj ext pse
|
$1,738.26 |
$1,738.26 |
$1,738.26 |
$792.50
|
|
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl
|
$6,842.78 |
$6,842.78 |
$6,842.78 |
$2,975.00
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$9,123.46 |
$9,123.46 |
$9,123.46 |
$4,675.78
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$295.88 |
$295.88 |
$295.88 |
$4,811.54
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$509.60 |
$509.60 |
$509.60 |
$3,738.90
|
|
Pr application of long arm splint
|
$443.26 |
$443.26 |
$443.26 |
$334.20
|
|
Pr application splint static short arm
|
$362.60 |
$362.60 |
$362.60 |
$288.75
|
|
Pr biopsy skin punch single lesion
|
$1,123.32 |
$1,123.32 |
$1,123.32 |
$458.25
|
|
Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method
|
$440.70 |
$440.70 |
$440.70 |
$6,653.00
|
|
Pr correction hammertoe
|
$286.52 |
$286.52 |
$286.52 |
$4,028.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$8.58 |
$8.58 |
$8.58 |
$48.10
|
|
Prcrd drg 0-5yr or w/anomly
|
$5,460.46 |
$5,460.46 |
$5,460.46 |
$2,157.55
|
|
Prcrd drg 6+yr without anomly
|
$5,460.46 |
$5,460.46 |
$5,460.46 |
$2,260.00
|
|
Pr cystourethroscopy with insertion indwelling ureteral stent
|
$112.84 |
$112.84 |
$112.84 |
$5,262.80
|
|
Pr discharge day management hospital ip/obs <=30 min on ecounter date
|
$59.02 |
$59.02 |
$59.02 |
$130.40
|
|
Pr discharge day management hospital ip/obs > 30 min on encounter date
|
$83.20 |
$83.20 |
$83.20 |
$178.75
|
|
Prealbumin
|
$91.76 |
$91.76 |
$91.76 |
$93.00
|
|
Pr ecg 12 lead report only
|
$5.98 |
$5.98 |
$5.98 |
$20.40
|
|
Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp
|
$13.26 |
$13.26 |
$13.26 |
$51.75
|
|
Prednisone 1 mg tablet
|
$72.84 |
$72.84 |
$72.84 |
$2.88
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$144.30 |
$144.30 |
$144.30 |
$2,334.15
|
|
Pregnancy associated plasma protein-a
|
$94.72 |
$94.72 |
$94.72 |
$70.85
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$560.92 |
$560.92 |
$560.92 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$560.92 |
$560.92 |
$560.92 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$560.92 |
$560.92 |
$560.92 |
$459.00
|
|
Pr e&m preventive medicine initial comprehensive new patient 12-17 years
|
$74.62 |
$74.62 |
$74.62 |
$149.50
|
|
Prenatal Care Only (4-6 visits)
|
$316.42 |
$316.42 |
$316.42 |
$613.78
|
|
Prenatal Care Only (7+ visits)
|
$581.10 |
$581.10 |
$581.10 |
$1,143.04
|
|
Preparation for bladder xray
|
$27.82 |
$27.82 |
$27.82 |
$1,222.00
|
|
Preparation palate mold
|
$79.04 |
$79.04 |
$79.04 |
$602.63
|
|
Prepare embryo for transfer
|
$93.60 |
$93.60 |
$93.60 |
$273.28
|
|
Prepare fecal microbiota
|
$55.12 |
$55.12 |
$55.12 |
$425.60
|
|
Prepare heart-aorta conduit
|
$1,254.24 |
$1,254.24 |
$1,254.24 |
$2,509.83
|
|
Prepare penis study
|
$58.50 |
$58.50 |
$58.50 |
$275.52
|
|
Prepare sperm duct x-ray
|
$135.46 |
$135.46 |
$135.46 |
$504.00
|
|
Prep cadaver renal allograft
|
$285.74 |
$285.74 |
$285.74 |
$476.00
|
|
Prep donor intestine/artery
|
$277.68 |
$277.68 |
$277.68 |
$530.09
|
|
Prep donor intestine/venous
|
$198.12 |
$198.12 |
$198.12 |
$379.22
|
|
Prep donor liver/arterial
|
$277.42 |
$277.42 |
$277.42 |
$528.21
|
|
Prep donor liver/venous
|
$237.12 |
$237.12 |
$237.12 |
$454.03
|
|
Prep donor liver whole
|
$378.82 |
$378.82 |
$378.82 |
$1,618.00
|
|
Prep donor pancreas
|
$212.42 |
$212.42 |
$212.42 |
$212.42
|
|
Prep donor pancreas/venous
|
$170.56 |
$170.56 |
$170.56 |
$325.54
|
|
Prep donor renal graft
|
$142.48 |
$142.48 |
$142.48 |
$415.20
|
|
Prepj skn cll ssp agrft 1st
|
$92.56 |
$92.56 |
$92.56 |
$14,138.80
|
|
Prepj tum cav iort prtl mast
|
$119.60 |
$119.60 |
$119.60 |
$780.00
|
|
Prep renal graft/arterial
|
$137.54 |
$137.54 |
$137.54 |
$466.40
|
|
Prep renal graft/ureteral
|
$130.78 |
$130.78 |
$130.78 |
$444.80
|
|
Prep renal graft/venous
|
$156.52 |
$156.52 |
$156.52 |
$532.00
|
|
Prep skin to 100cm2 other
|
$189.80 |
$189.80 |
$189.80 |
$1,193.40
|
|
Prep skin to 100cm2 trk/ext
|
$159.90 |
$159.90 |
$159.90 |
$2,186.41
|
|
Prep skn trk/ext adl 100cm2
|
$32.24 |
$32.24 |
$32.24 |
$1,100.06
|
|
Pressure treatment esophagus
|
$153.14 |
$153.14 |
$153.14 |
$2,035.50
|
|
Pressure velocity wire add ves
|
$12,025.00 |
$12,025.00 |
$12,025.00 |
$1,636.60
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$1,084.10 |
$1,084.10 |
$1,084.10 |
$162.00
|
|
Pretreat rbc absorption reference
|
$375.92 |
$375.92 |
$375.92 |
$148.80
|
|
Pretreat rbc density gradient separation reference
|
$1,084.10 |
$1,084.10 |
$1,084.10 |
$182.31
|
|
Pretreat rbc w chem/drugs reference
|
$375.92 |
$375.92 |
$375.92 |
$114.00
|
|
Pretreat rbc w enzyme reference
|
$1,084.10 |
$1,084.10 |
$1,084.10 |
$167.05
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$124.80 |
$124.80 |
$124.80 |
$308.00
|
|
Preventive counseling group
|
$5.72 |
$5.72 |
$5.72 |
$29.60
|
|
Preventive counseling group
|
$9.62 |
$9.62 |
$9.62 |
$44.80
|
|
Prev med cnsl indiv apprx 15
|
$18.20 |
$18.20 |
$18.20 |
$74.88
|
|
Prev med cnsl indiv apprx 30
|
$36.66 |
$36.66 |
$36.66 |
$116.00
|
|
Prev med cnsl indiv apprx 45
|
$54.86 |
$54.86 |
$54.86 |
$175.68
|
|
Prev med cnsl indiv apprx 60
|
$73.06 |
$73.06 |
$73.06 |
$209.40
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$94.90 |
$94.90 |
$94.90 |
$188.86
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$60.32 |
$60.32 |
$60.32 |
$1,917.33
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$120.90 |
$120.90 |
$120.90 |
$2,271.01
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$1,123.32 |
$1,123.32 |
$1,123.32 |
$788.40
|
|
Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury
|
$994.76 |
$994.76 |
$994.76 |
$3,336.80
|
|
Prgrmg dev eval impltbl sys
|
$29.90 |
$29.90 |
$29.90 |
$130.00
|
|
Prgrmg dev eval pm/ldls pm
|
$22.62 |
$22.62 |
$22.62 |
$139.10
|
|
Prgrmg dev eval scrms ip
|
$18.20 |
$18.20 |
$18.20 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$29.64 |
$29.64 |
$29.64 |
$158.55
|
|
Prgrmg eval implantable dfb
|
$40.04 |
$40.04 |
$40.04 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$43.68 |
$43.68 |
$43.68 |
$206.25
|
|
Prgr stim/pace a/iv drug
|
$88.14 |
$88.14 |
$88.14 |
$4,555.93
|
|
Pr hospital ip/obs care initial high level per day
|
$126.36 |
$126.36 |
$126.36 |
$348.40
|
|
Pr hospital ip/obs care initial moderate level per day
|
$94.64 |
$94.64 |
$94.64 |
$246.40
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$60.06 |
$60.06 |
$60.06 |
$180.05
|
|
Pr hospital ip/obs care subsequent high level per day
|
$86.06 |
$86.06 |
$86.06 |
$189.80
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$57.72 |
$57.72 |
$57.72 |
$117.65
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$35.62 |
$35.62 |
$35.62 |
$74.75
|
|
Prim art mech thrmbc non-intracranial
|
$50,494.64 |
$50,494.64 |
$50,494.64 |
$9,492.40
|
|
Prim art mech thrmbc non-intracranial add-on
|
$8,763.82 |
$8,763.82 |
$8,763.82 |
$3,687.00
|
|
Prin care mgmt staff 1st 30
|
$35.88 |
$35.88 |
$35.88 |
$108.93
|
|
Pr incision & drainage abscess complicated/multiple
|
$1,123.32 |
$1,123.32 |
$1,123.32 |
$712.80
|
|
Pr incision & drainage abscess simple/single
|
$558.70 |
$558.70 |
$558.70 |
$467.85
|
