|
Trmt of fracture (femoral shaft) 27500
|
$315.56 |
$759.00 |
$1,656.00 |
|
|
Trnscath plc stent crv crtd without prtct
|
$998.66 |
$8,784.00 |
$13,863.00 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$624.22 |
$10,705.80 |
$17,777.40 |
|
|
Trnscath plc stnt ante carotid art
|
$525.32 |
$7,544.40 |
$14,686.50 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$361.00 |
$10,516.80 |
$24,887.17 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$361.00 |
$13,400.40 |
$24,887.17 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$4,478.40 |
$17,189.40 |
$33,182.38 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,669.50 |
$7,288.20 |
$24,280.80 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,252.40 |
$6,966.60 |
$15,817.34 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$951.60 |
$5,324.40 |
$9,296.40 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$814.20 |
$5,324.40 |
$11,678.40 |
|
|
Trnscath tx thromblytc vein ini day
|
$2,669.50 |
$5,236.20 |
$15,167.40 |
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$560.28 |
$4,073.00 |
$15,103.20 |
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$138.00 |
$582.00 |
$2,118.60 |
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$428.72 |
$2,371.50 |
$5,275.20 |
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$526.93 |
$595.66 |
$3,955.80 |
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$457.70 |
$2,371.50 |
$9,337.20 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$422.05 |
$1,053.00 |
$7,986.60 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$326.37 |
$3,768.60 |
$7,827.00 |
|
|
Trnsxj/repos abrrnt rnl vsls
|
$700.81 |
$700.81 |
$792.22 |
|
|
Troponin quantitative
|
$47.40 |
$81.62 |
$291.00 |
|
|
Tr retinal les preterm inf
|
$730.25 |
$730.25 |
$825.50 |
|
|
Trurl dstrj prst8 tiss rf wv
|
$247.25 |
$279.50 |
$976.00 |
|
|
Truss add to std pad scrotal
|
$16.80 |
$16.80 |
$16.80 |
|
|
Tte w or without contr, cont ecg
|
$1,630.00 |
$2,405.40 |
$3,415.80 |
|
|
Tte w or without fol w/con,stres
|
$626.40 |
$2,457.00 |
$2,860.20 |
|
|
Tte w or without fol w/cont, com
|
$766.80 |
$904.80 |
$3,003.60 |
|
|
Tte w or without fol w/cont, f/u
|
$520.80 |
$1,928.40 |
$2,227.20 |
|
|
Tubal Ligation (Laparoscopic)
|
$240.12 |
$678.00 |
$936.60 |
|
|
Tube drain vert dev st 5-40f
|
$4.20 |
$16.80 |
$19.20 |
|
|
Tube trach disp innr can 5 xlt
|
$73.32 |
$266.40 |
$4,183.80 |
|
|
Tube trach disp innr can 6 xlt
|
$13.80 |
$77.40 |
$85.20 |
|
|
Tube trach fen sz 6 uncuffed
|
$41.71 |
$96.00 |
$3,744.60 |
|
|
Tubular dressing
|
$2.40 |
$4.80 |
$85.80 |
|
|
Tumor cell deplete of harvst
|
$48.76 |
$48.76 |
$55.12 |
|
|
Tvh >250 gms 58290
|
$742.90 |
$742.90 |
$839.80 |
|
|
Tvh w/mmk 58267
|
$690.23 |
$690.23 |
$780.26 |
|
|
Tx atrial fib pulm vein isol
|
$596.39 |
$30,975.00 |
$59,370.00 |
|
|
Tx closed distal humerus fx
|
$75.60 |
$122.40 |
$342.00 |
|
|
Tx closed hip disl traumatic without anes
|
$308.00 |
$1,266.00 |
$3,584.40 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$431.34 |
$3,316.20 |
$9,493.33 |
|
|
Tx closed tib shaft fx without manip
|
$243.36 |
$1,266.00 |
$4,470.00 |
|
|
Tx contour defects >10.0 cc
|
$72.22 |
$81.64 |
$849.50 |
|
|
Tx contour defects 1.1-5.0cc 11951
|
$46.69 |
$52.78 |
$849.50 |
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$612.95 |
$612.95 |
$692.90 |
|
|
Tx ectopic pregnancy ntrstl prtl rescj uter 59136
|
$581.67 |
$581.67 |
$657.54 |
|
|
Tx l/r atrial fib addl
|
$193.43 |
$4,257.00 |
$59,370.00 |
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$485.53 |
$904.80 |
$6,869.40 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$331.20 |
$4,558.80 |
$9,123.46 |
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$361.10 |
$5,289.00 |
$6,223.80 |
|
|
Tx open nsl fx uncomp
|
$283.36 |
$2,391.60 |
$6,492.00 |
|
|
Tx open nsl sptl fx
|
$406.87 |
$459.94 |
$1,135.20 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$390.77 |
$5,776.80 |
$7,082.40 |
|
|
Tx septic abortion surgical 59830
|
$299.23 |
$299.23 |
$338.26 |
|
|
Tx tarsal bone fx without manip 28450
|
$143.52 |
$509.40 |
$825.60 |
|
|
Tympanic membrane repair
|
$185.38 |
$549.60 |
$8,426.40 |
|
|
Tympanolysis transcanal 69450
|
$347.07 |
$347.07 |
$392.34 |
|
|
Tympanometry & reflex thresh
|
$136.00 |
$240.00 |
$312.00 |
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$85.56 |
$270.60 |
$4,470.00 |
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$891.94 |
$891.94 |
$1,008.28 |
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$813.97 |
$813.97 |
$920.14 |
|
|
Tyms gene com variants
|
$120.52 |
$999.60 |
$1,070.40 |
|
|
Ua w/micro/comp poc
|
$2.76 |
$18.60 |
$33.60 |
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$133.20 |
$1,047.00 |
$1,047.00 |
|
|
Ugt1a1 gene analy common variants
|
$180.00 |
$1,240.20 |
$1,252.20 |
|
|
Ultrasound bone density measure
|
$1.84 |
$2.08 |
$111.60 |
|
|
Ultrasound breast complete
|
$25.48 |
$540.80 |
$2,310.00 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$209.40 |
$479.40 |
$2,080.20 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$15.18 |
$257.40 |
$745.20 |
|
|
Ultrasound dx ophth b-scan
|
$389.00 |
$549.60 |
$634.20 |
|
|
Ultrasound elastography ea l target les
|
$14.95 |
$16.90 |
$945.00 |
|
|
Ultrasound elastography parenchyma
|
$202.20 |
$202.20 |
$583.66 |
|
|
Ultrasound encephalogram
|
$249.50 |
$588.80 |
$1,273.80 |
|
|
Ultrasound exam k transpl w/doppler
|
$249.50 |
$544.00 |
$1,491.00 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$198.00 |
$425.40 |
$909.60 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$234.00 |
$780.80 |
$2,769.60 |
|
|
Ultrasound guidance for vascular access
|
$53.40 |
$400.20 |
$663.60 |
|
|
Ultrasound guide intraoperative
|
$41.40 |
$890.40 |
$1,819.80 |
|
|
Ultrasound guide tissue ablation
|
$64.86 |
$649.80 |
$1,161.00 |
|
|
Ultrasound hips infant dynamic
|
$153.50 |
$482.79 |
$1,209.60 |
|
|
Ultrasound infant hips ltd without stress
|
$196.80 |
$280.20 |
$796.80 |
|
|
Ultrasound joint complete left
|
$278.40 |
$576.60 |
$1,524.60 |
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$37.26 |
$37.26 |
$42.12 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$171.00 |
$719.40 |
$1,906.20 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$110.40 |
$309.00 |
$1,168.20 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$681.60 |
$1,104.80 |
$2,256.60 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$225.60 |
$474.00 |
$1,057.80 |
|
|
Ultrasound prostate/transrectal
|
$20.70 |
$560.92 |
$1,914.00 |
|
|
Ultrasound spinal canal and contents
|
$249.50 |
$512.80 |
$1,041.60 |
|
|
Ultrasound transabd ea addl gest
|
$188.50 |
$349.80 |
$1,279.20 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$49.45 |
$938.32 |
$1,413.60 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$25.99 |
$703.74 |
$1,413.60 |
|
|
Umbilical artery cath newborn 36660
|
$43.47 |
$43.47 |
$682.28 |
|
|
Umbilical cord occlud w/us
|
$335.34 |
$379.08 |
$3,562.80 |
|
|
Umbilicoplasty 15847
|
$304.98 |
$304.98 |
$344.76 |
|
|
Unit mobile power mpu
|
$34,384.20 |
$34,384.20 |
$34,384.20 |
|
|
Unlistd noninvas vasc dx std
|
$23.00 |
$26.00 |
$528.80 |
|
|
Unlisted chemotherapy px
|
$20.47 |
$23.14 |
$571.50 |
|
|
Unlisted cranfcl&maxlfcl px
|
$114.60 |
$114.60 |
$2,406.60 |
|
|
Unlisted CT procedure
|
$84.00 |
$700.80 |
$2,254.20 |
|
