|
Pr removal foreign body external auditory canal without anesthesia
|
$127.50 |
$204.50 |
$269.50 |
|
|
Pr removal intrauterine device
|
$193.50 |
$267.50 |
$10,050.00 |
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$349.00 |
$615.50 |
$10,118.68 |
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$216.00 |
$322.00 |
$878.00 |
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$220.50 |
$322.00 |
$884.50 |
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$160.00 |
$360.50 |
$853.80 |
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$308.00 |
$430.50 |
$853.80 |
|
|
Pr robotic surgical system
|
$0.01 |
$0.01 |
$0.01 |
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$1,755.00 |
$2,426.50 |
$4,177.00 |
|
|
Pr tube thoracostomy w/connection to drainage open
|
$943.00 |
$1,303.50 |
$5,528.40 |
|
|
PSA (Prostate) Test
|
$90.50 |
$231.00 |
$539.00 |
|
|
Psych/neuropsych test admin automated result 96146
|
$16.00 |
$19.50 |
$19.50 |
|
|
Psychoeducation 45 min +
|
$167.70 |
$359.50 |
$441.00 |
|
|
Psychotherapy group therapy
|
$325.00 |
$449.50 |
$1,544.50 |
|
|
Psychotherapy patient individual therapy 30 minutes
|
$78.00 |
$108.00 |
$108.00 |
|
|
Psychotherapy patient individual therapy 45 minutes
|
$102.50 |
$142.00 |
$142.00 |
|
|
Psychotherapy patient individual therapy 60 minutes
|
$115.50 |
$160.50 |
$309.40 |
|
|
Psych test eval svc phys/qhp 1st hr
|
$131.50 |
$162.00 |
$162.00 |
|
|
Psych test eval svc phys/qhp ea addl hr
|
$99.00 |
$122.00 |
$122.00 |
|
|
Psychthrp grp 45-50min mcr
|
$617.50 |
$853.50 |
$853.50 |
|
|
Psycl/nrpsyc tech 1st
|
$17.00 |
$21.00 |
$21.00 |
|
|
Psy/npsy phys/qhp 2> tst 1st 30 min
|
$16.00 |
$19.50 |
$19.50 |
|
|
Psy/npsy phys/qhp 2> tst ea l 30 min
|
$12.50 |
$15.50 |
$15.50 |
|
|
Psy/npsy tst admin tech 2> ea l 30 min
|
$13.00 |
$16.00 |
$16.00 |
|
|
Psytx pt w/e&m 16-37 min
|
$78.00 |
$108.00 |
$108.00 |
|
|
Psytx pt w/e&m 38-52 min
|
$102.50 |
$142.00 |
$142.00 |
|
|
Psytx pt w/e&m 53+ min
|
$115.50 |
$160.50 |
$160.50 |
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$70.00 |
$105.50 |
$252.50 |
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$53.50 |
$98.40 |
$202.50 |
|
|
Pt application of modality traction mechanical
|
$51.50 |
$75.50 |
$253.50 |
|
|
Pten gene full sequence
|
$303.00 |
$306.50 |
$486.00 |
|
|
Pt prgrm for implt neurostim
|
$3,027.00 |
$4,447.50 |
$6,758.50 |
|
|
Pt repositioning canalith procedure(s) per day
|
$29.00 |
$42.00 |
$158.50 |
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$83.00 |
$101.40 |
$565.50 |
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$51.50 |
$78.00 |
$232.50 |
|
|
Pt wheelchair management each 15 minutes
|
$74.00 |
$91.00 |
$191.50 |
|
|
Pul art balloon repr percut
|
$6,113.50 |
$7,547.50 |
$7,547.50 |
|
|
Pul art balloon repr percut
|
$1,897.00 |
$2,341.50 |
$2,341.50 |
|
|
Pulmonary vent imaging
|
$322.50 |
$424.00 |
$2,253.00 |
|
|
Pulse ox continuous overnight monitoring
|
$123.50 |
$164.50 |
$540.00 |
|
|
Pulse ox multiple
|
$91.50 |
$164.50 |
$205.00 |
|
|
Pulse ox single
|
$60.00 |
$108.00 |
$326.00 |
|
|
Pump on-q 100mlx2ml/hr 2 day delivery
|
$2,696.10 |
$2,696.10 |
$2,696.10 |
|
|
Punc of shunt for asp or inj
|
$400.00 |
$553.50 |
$2,713.50 |
|
|
Puncture arterial withdrawal blood for diagnosis
|
$48.00 |
$113.40 |
$263.00 |
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$288.00 |
$461.50 |
$802.00 |
|
|
Puncture spinal lumbar diagnostic
|
$398.00 |
$719.00 |
$1,529.50 |
|
|
Puraply 1 sq cm
|
$270.50 |
$270.50 |
$32,165.10 |
|
|
Puraply xt 1 sq cm
|
$10,659.00 |
$10,659.00 |
$10,659.00 |
|
|
Pvb thoracic 2nd+ inj site
|
$443.50 |
$614.00 |
$614.00 |
|
|
Pvb thoracic single inj site
|
$889.00 |
$1,230.00 |
$1,704.60 |
|
|
Pyridoxine hcl 100 mg
|
$90.29 |
$90.29 |
$101.05 |
|
|
Pyruvate
|
$27.50 |
$89.50 |
$451.00 |
|
|
Pyruvate kinase
|
$47.00 |
$79.00 |
$100.20 |
|
|
Quan puplmtry phy/qhp uni/bi
|
$112.00 |
$112.00 |
$112.00 |
|
|
Quant diff pulm perf and vent w/imaging
|
$504.00 |
$662.00 |
$4,556.50 |
|
|
Quant diff pulm perf w/imaging
|
$322.50 |
$424.00 |
$3,764.00 |
|
|
Quest t3 uptake
|
$72.00 |
$113.40 |
$183.00 |
|
|
Quinupristin/dalfopristin
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
|
|
Rabies ig ht&sol human im/sc
|
$4,047.81 |
$4,617.00 |
$4,617.00 |
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$4,617.00 |
$4,617.00 |
$16,331.86 |
|
|
Radiation handling
|
$291.50 |
$661.00 |
$854.00 |
|
|
Radiation physics consult
|
$268.00 |
$622.50 |
$1,463.00 |
|
|
Radiation therapy dose plan
|
$92.00 |
$502.50 |
$684.00 |
|
|
Radiation treatment aid(s)
|
$346.50 |
$447.00 |
$2,893.00 |
|
|
Radiation treatment aid(s)
|
$508.00 |
$655.50 |
$3,309.00 |
|
|
Radiation treatment aid(s)
|
$219.00 |
$1,265.50 |
$3,748.00 |
|
|
Radiation treatment delivery
|
$373.00 |
$482.00 |
$10,018.00 |
|
|
Radiation treatment delivery
|
$661.00 |
$944.50 |
$11,365.00 |
|
|
Radiology port images(s)
|
$185.00 |
$239.00 |
$622.00 |
|
|
Radiotherapy dose plan imrt
|
$5,047.00 |
$6,516.50 |
$15,862.00 |
|
|
Radium ra223 dichl ther/uci
|
$2,119.00 |
$2,119.00 |
$61,952.54 |
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$807.00 |
$1,059.50 |
$9,131.00 |
|
|
Radphm lcl tmr plnr bdy two day img
|
$856.00 |
$1,196.00 |
$2,840.50 |
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$728.50 |
$1,525.00 |
$2,840.50 |
|
|
Radphm lcl tomogr sgl area sgl day
|
$991.50 |
$1,626.50 |
$3,407.00 |
|
|
Radphm lcl tumor plr sgl day
|
$363.50 |
$478.00 |
$1,196.00 |
|
|
Radphm quant measure sgl area add-on
|
$1,161.50 |
$1,525.00 |
$1,525.00 |
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$37,369.67 |
$37,369.67 |
$42,772.52 |
|
|
Range of motion measurements
|
$29.50 |
$41.00 |
$338.00 |
|
|
Rapid Strep Test
|
$83.00 |
$121.00 |
$245.00 |
|
|
Rasburicase 1.5 mg intravenous solution
|
$23,246.83 |
$23,246.83 |
$26,567.81 |
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$1,281.00 |
$1,281.00 |
$137,173.68 |
|
|
Rbc count only automated
|
$26.00 |
$26.00 |
$27.00 |
|
|
Rbc deglycerolized each unit
|
$627.00 |
$1,052.50 |
$1,816.50 |
|
|
Rbc depletion of harvest
|
$4,479.50 |
$6,193.50 |
$6,193.50 |
|
|
Rbc irradiated each unit
|
$506.00 |
$562.50 |
$1,049.50 |
|
|
Rbc osmotic fragility
|
$169.20 |
$169.20 |
$169.20 |
|
|
Rbc serum pretx incubj drugs
|
$326.00 |
$326.00 |
$326.00 |
|
|
Rechanneling w/wo patch graft deep profunda fem art 35372
|
$4,448.00 |
$5,491.50 |
$5,491.50 |
|
|
Reconstruct ankle joint
|
$127,406.09 |
$127,406.09 |
$127,406.09 |
|
|
Reconstruct extra finger
|
$1,767.50 |
$2,400.00 |
$2,400.00 |
|
|
Reconstruction knee
|
$81,606.53 |
$81,606.53 |
$81,606.53 |
|
|
Reconstruction of eyelid
|
$2,128.00 |
$3,152.50 |
$3,152.50 |
|
|
Reconstruction of eyelid
|
$2,128.00 |
$3,152.50 |
$3,152.50 |
|
|
Reconstruction of eyelid
|
$1,113.50 |
$1,649.50 |
$1,649.50 |
|
|
Reconstruction of mouth
|
$5,492.00 |
$5,492.00 |
$5,492.00 |
|
|
Reconstruction of nail bed
|
$1,469.50 |
$2,032.00 |
$2,032.00 |
|
|
Reconstruction of nose
|
$18,700.10 |
$18,700.10 |
$18,700.10 |
|
|
Reconstruction tongue fold
|
$8,374.64 |
$8,374.64 |
$8,374.64 |
|
