|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$94.80 |
$2,587.20 |
$4,545.31 |
|
|
Rpl tun-cvad w subq port
|
$1,446.00 |
$7,909.60 |
$9,209.97 |
|
|
Rpl tun-cvad w subq pump
|
$212.06 |
$8,004.00 |
$15,201.08 |
|
|
Rpl tun cvc wo subq port
|
$2,323.80 |
$4,105.60 |
$12,026.00 |
|
|
Rpm tx mgmt 1st 20 min
|
$19.32 |
$211.20 |
$317.40 |
|
|
Rpm tx mgmt ea addl 20 min
|
$19.32 |
$158.40 |
$238.80 |
|
|
Rpr aa hrn 1st > 10 ncr/strn
|
$664.01 |
$1,308.60 |
$10,089.00 |
|
|
Rpr aa hrn 1st > 10 rdc
|
$500.02 |
$985.80 |
$7,267.80 |
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$482.54 |
$1,625.40 |
$10,089.00 |
|
|
Rpr aa hrn 1st 3-10 rdc
|
$370.76 |
$732.60 |
$9,974.50 |
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$221.26 |
$2,746.00 |
$7,767.60 |
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$308.20 |
$10,089.00 |
$13,452.60 |
|
|
Rpr aa hrn rcr > 10 ncr/strn
|
$805.00 |
$1,585.80 |
$10,089.00 |
|
|
Rpr aa hrn rcr > 10 rdc
|
$574.54 |
$1,131.60 |
$7,267.80 |
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$555.22 |
$1,099.20 |
$10,089.00 |
|
|
Rpr aa hrn rcr 3-10 rdc
|
$413.31 |
$817.80 |
$9,374.50 |
|
|
Rpr aa hrn rcr < 3 ncr/strn
|
$369.61 |
$730.80 |
$10,089.00 |
|
|
Rpr aa hrn rcr < 3 rdc
|
$272.32 |
$808.80 |
$7,267.80 |
|
|
Rpr acq av fistula thrx&abd
|
$957.03 |
$957.03 |
$1,081.86 |
|
|
Rpr blood ves w/vein graft/up ext 35236
|
$642.16 |
$642.16 |
$725.92 |
|
|
Rpr blood vsl grf oth vein lo ex
|
$587.19 |
$587.19 |
$663.78 |
|
|
Rpr blvs gr ot/th vn ntrth w
|
$878.14 |
$878.14 |
$992.68 |
|
|
Rpr blvs gr ot/t vn ntrth wo
|
$926.21 |
$926.21 |
$1,047.02 |
|
|
Rpr blvsl gr ot/th vn ntr-ab
|
$1,037.30 |
$1,037.30 |
$1,172.60 |
|
|
Rpr blvsl vn grf intra-abdl
|
$1,099.40 |
$1,099.40 |
$1,242.80 |
|
|
Rpr blvsl vn grf ntrthrc w/b
|
$911.49 |
$911.49 |
$1,030.38 |
|
|
Rpr cgen av fistula thrx&abd
|
$1,141.26 |
$1,141.26 |
$1,290.12 |
|
|
Rpr choanal atresia ntranasl
|
$469.66 |
$469.66 |
$530.92 |
|
|
Rpr choanal atresia trsnpltn
|
$637.10 |
$637.10 |
$720.20 |
|
|
Rpr csf leak/pseudomeng/laminectomy63709
|
$726.80 |
$726.80 |
$821.60 |
|
|
Rpr diaphragm hernia/chronic/not neonate 39541
|
$603.75 |
$603.75 |
$682.50 |
|
|
Rpr diaphragm lac/any approach 39501
|
$549.01 |
$549.01 |
$620.62 |
|
|
Rpr fem hernia init blocked
|
$411.47 |
$465.14 |
$1,143.60 |
|
|
Rpr hern preemie reduc
|
$518.42 |
$518.42 |
$586.04 |
|
|
Rpr hypopl a-arch w/byp
|
$1,167.71 |
$1,167.71 |
$1,320.02 |
|
|
Rpr hypopl a-arch wo byp
|
$893.32 |
$893.32 |
$1,009.84 |
|
|
Rpr hypspad comp dsj & urtp
|
$651.82 |
$651.82 |
$736.84 |
|
|
Rpr hypspad comp simple
|
$368.69 |
$368.69 |
$416.78 |
|
|
Rpr ing hernia baby blocked
|
$400.89 |
$400.89 |
$453.18 |
|
|
Rpr ing hernia baby reduc
|
$266.57 |
$266.57 |
$301.34 |
|
|
Rpr ing hernia init blocked
|
$395.14 |
$395.14 |
$446.68 |
|
|
Rpr ing hernia init reduce
|
$271.17 |
$306.54 |
$690.60 |
|
|
Rpr ing hern premie blocked
|
$622.61 |
$622.61 |
$703.82 |
|
|
Rpr nsl vlv collapse w/implt
|
$109.02 |
$109.02 |
$123.24 |
|
|
Rpr nsl vlv collapse w/rmdlg
|
$96.60 |
$109.20 |
$881.75 |
|
|
Rpr parastomal hernia rdc 49621
|
$486.91 |
$486.91 |
$550.42 |
|
|
Rpr parastomal hrna ncr/strn 49622
|
$605.59 |
$605.59 |
$684.58 |
|
|
Rpr pul art unifocal without cpb
|
$1,090.20 |
$1,090.20 |
$1,232.40 |
|
|
Rpr&refitg spect xcp aphakia
|
$10.58 |
$10.58 |
$11.96 |
|
|
Rpr rem hernia init reduce
|
$376.74 |
$982.80 |
$1,509.60 |
|
|
Rpr tga aortic pulm art rcns
|
$1,493.16 |
$1,493.16 |
$1,687.92 |
|
|
Rpr tga atr bfl clsr vsd
|
$1,248.90 |
$1,248.90 |
$1,411.80 |
|
|
Rpr tga atr bfl rmvl plm bnd
|
$1,180.82 |
$1,180.82 |
$1,334.84 |
|
|
Rpr tga atrial baffle px
|
$1,147.47 |
$1,147.47 |
$1,297.14 |
|
|
Rpr tga bfl rpr sbpulm obstr
|
$1,202.21 |
$1,202.21 |
$1,359.02 |
|
|
Rpr tga rcnstj clsr vsd
|
$1,501.44 |
$1,501.44 |
$1,697.28 |
|
|
Rpr tga rcnstj rmvl plm bnd
|
$1,472.69 |
$1,472.69 |
$1,664.78 |
|
|
Rpr tga rcnstj rpr sbpl obst
|
$1,463.95 |
$1,463.95 |
$1,654.90 |
|
|
Rpr tga without surg enlgmnt vsd
|
$1,342.05 |
$1,342.05 |
$1,517.10 |
|
|
Rpr tga w/surg enlgmnt vsd
|
$1,379.54 |
$1,379.54 |
$1,559.48 |
|
|
Rpr xtnsr tndn leg prim without grft ea tndn
|
$233.22 |
$263.64 |
$603.60 |
|
|
Rrp hypspad comp moblj&urtp
|
$609.50 |
$609.50 |
$689.00 |
|
|
Rsect hip tum incl femur
|
$1,326.18 |
$1,326.18 |
$1,499.16 |
|
|
Rsv assay w/optic
|
$9.20 |
$73.80 |
$210.00 |
|
|
Rtm tx mgmt 1st 20 min
|
$19.78 |
$19.78 |
$22.36 |
|
|
Rtm tx mgmt ea addl 20 min
|
$19.32 |
$19.32 |
$21.84 |
|
|
Rubella antibody igg
|
$56.40 |
$83.40 |
$358.80 |
|
|
Rubeola ag if
|
$41.86 |
$41.86 |
$47.32 |
|
|
Rubeola antibody igg
|
$36.00 |
$82.20 |
$265.60 |
|
|
Runx1 gene targeted seq alys
|
$227.24 |
$227.24 |
$256.88 |
|
|
Russell viper venom diluted
|
$34.50 |
$72.00 |
$2,118.60 |
|
|
Rx metab gen seq alys pnl 6
|
$2,427.00 |
$2,578.90 |
$2,683.45 |
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$66.60 |
$5,043.00 |
$6,723.60 |
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$108.00 |
$397.80 |
$686.40 |
|
|
Safety plan interven
|
$27.83 |
$27.83 |
$31.46 |
|
|
Salivary gland function exam
|
$12.19 |
$13.78 |
$463.20 |
|
|
Salivary gland imaging
|
$13.57 |
$1,228.80 |
$1,228.80 |
|
|
Salivary glnd img serial img
|
$13.57 |
$1,228.80 |
$1,960.80 |
|
|
Salmonella antibody
|
$18.50 |
$102.00 |
$4,265.40 |
|
|
Salpingostomy 58770
|
$556.14 |
$556.14 |
$628.68 |
|
|
Same day nb discharge 99463
|
$69.23 |
$69.23 |
$78.26 |
|
|
Sargramostim injection
|
$477.00 |
$820.80 |
$21,867.60 |
|
|
Sarscov2 vac 5mcg/0.5ml im
|
$105.00 |
$105.00 |
$105.00 |
|
|
Sarscov coronavirus ag ia
|
$24.38 |
$34.80 |
$100.00 |
|
|
Sarscov & inf vir a&b ag ia
|
$48.30 |
$54.60 |
$210.60 |
|
|
S bowel endoscope w/stent
|
$259.44 |
$259.44 |
$293.28 |
|
|
Sbrt management
|
$418.83 |
$418.83 |
$473.46 |
|
|
Sbrt w/positron emission del
|
$14,509.80 |
$14,509.80 |
$14,509.80 |
|
|
Sbsq ic vlbw inf<1,500 gm
|
$84.87 |
$84.87 |
$95.94 |
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$98.67 |
$98.67 |
$111.54 |
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$47.61 |
$47.61 |
$53.82 |
|
|
Sbsq nursing facil care/day new problem 25 min
|
$69.23 |
$69.23 |
$78.26 |
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$25.53 |
$25.53 |
$28.86 |
|
|
Sbsq psyc collab care mgmt
|
$66.01 |
$74.62 |
$95.00 |
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$464.40 |
$819.60 |
$1,608.80 |
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$214.20 |
$394.20 |
$1,127.20 |
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$156.60 |
$555.20 |
$2,028.00 |
|
|
Scan duplex extremity veins unilateral/limited study
|
$256.80 |
$605.60 |
$1,798.60 |
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$275.00 |
$539.40 |
$1,706.20 |
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$273.50 |
$505.20 |
$1,647.60 |
|