|
Prq revasc byp graft 1 art and/or branches
|
$9,632.00 |
$9,632.00 |
$9,632.00 |
$13,398.65
|
|
Prq revasc byp graft addl
|
$4,271.00 |
$4,271.00 |
$4,271.00 |
$8,940.00
|
|
Prq tcat plmt ntrac st 1 les
|
$13,590.00 |
$13,590.00 |
$13,590.00 |
$13,239.59
|
|
Prq tcat plmt ntrac st 2+les
|
$28,093.00 |
$28,093.00 |
$28,093.00 |
$22,098.20
|
|
Prq trlml c athrc st angiop1
|
$13,553.00 |
$13,553.00 |
$13,553.00 |
$15,296.00
|
|
Prq trl rvs ch occ ant&rtrgr
|
$17,691.50 |
$17,691.50 |
$17,691.50 |
$23,158.66
|
|
Prq trluml c angiop 1art&/br
|
$11,792.00 |
$11,792.00 |
$11,792.00 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$25,232.00 |
$25,232.00 |
$25,232.00 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$8,095.00 |
$8,095.00 |
$8,095.00 |
$15,349.60
|
|
Pr removal drug delivery implant
|
$342.00 |
$342.00 |
$342.00 |
$533.00
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$348.50 |
$348.50 |
$348.50 |
$251.43
|
|
Pr removal intrauterine device
|
$639.50 |
$639.50 |
$639.50 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$988.50 |
$988.50 |
$988.50 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$562.50 |
$562.50 |
$562.50 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$583.50 |
$583.50 |
$583.50 |
$414.00
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$591.50 |
$591.50 |
$591.50 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$562.50 |
$562.50 |
$562.50 |
$396.00
|
|
Pr robotic surgical system
|
$2,974.00 |
$2,974.00 |
$2,974.00 |
$0.52
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$7,897.00 |
$7,897.00 |
$7,897.00 |
$3,087.15
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,761.00 |
$1,761.00 |
$1,761.00 |
$1,720.93
|
|
PSA (Prostate) Test
|
$316.00 |
$316.00 |
$316.00 |
$107.50
|
|
Psychotherapy group therapy
|
$594.00 |
$594.00 |
$594.00 |
$216.80
|
|
Psytx complex interactive
|
$364.00 |
$364.00 |
$364.00 |
$47.60
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$221.00 |
$221.00 |
$221.00 |
$87.45
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$196.50 |
$196.50 |
$196.50 |
$102.05
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$178.50 |
$178.50 |
$178.50 |
$81.00
|
|
Pt application of modality traction mechanical
|
$183.00 |
$183.00 |
$183.00 |
$91.00
|
|
Pten gene full sequence
|
$1,019.50 |
$1,019.50 |
$1,019.50 |
$826.00
|
|
Pt evaluation high complexity patient/family
|
$473.50 |
$473.50 |
$473.50 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$335.50 |
$335.50 |
$335.50 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$378.00 |
$378.00 |
$378.00 |
$254.88
|
|
Pt re-evaluation patient/family
|
$229.50 |
$229.50 |
$229.50 |
$152.80
|
|
Pt repositioning canalith procedure(s) per day
|
$290.50 |
$290.50 |
$290.50 |
$118.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$211.50 |
$211.50 |
$211.50 |
$81.48
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$205.00 |
$205.00 |
$205.00 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$169.50 |
$169.50 |
$169.50 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$156.50 |
$156.50 |
$156.50 |
$87.50
|
|
Pulmonary vent imaging
|
$2,076.50 |
$2,076.50 |
$2,076.50 |
$908.00
|
|
Pulse ox continuous overnight monitoring
|
$569.50 |
$569.50 |
$569.50 |
$344.00
|
|
Pulse ox multiple
|
$314.50 |
$314.50 |
$314.50 |
$156.40
|
|
Pulse ox single
|
$178.00 |
$178.00 |
$178.00 |
$81.70
|
|
Puncture arterial withdrawal blood for diagnosis
|
$150.50 |
$150.50 |
$150.50 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$725.00 |
$725.00 |
$725.00 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$1,360.50 |
$1,360.50 |
$1,360.50 |
$1,051.80
|
|
Pvb thoracic cont infusion
|
$3,312.50 |
$3,312.50 |
$3,312.50 |
$1,544.80
|
|
Pvb thoracic single inj site
|
$2,360.50 |
$2,360.50 |
$2,360.50 |
$1,320.80
|
|
Pwr pck base combo vad, rep
|
$138,449.00 |
$138,449.00 |
$138,449.00 |
$19,344.64
|
|
Pyruvate
|
$28.00 |
$28.00 |
$28.00 |
$66.00
|
|
Pyruvate kinase
|
$35.00 |
$35.00 |
$35.00 |
$80.64
|
|
Quant diff pulm perf and vent w/imaging
|
$2,126.50 |
$2,126.50 |
$2,126.50 |
$1,542.40
|
|
Quant diff pulm perf w/imaging
|
$1,569.50 |
$1,569.50 |
$1,569.50 |
$1,199.16
|
|
Quest t3 uptake
|
$6.00 |
$6.00 |
$6.00 |
$52.25
|
|
Radiation handling
|
$668.00 |
$668.00 |
$668.00 |
$324.80
|
|
Radiation physics consult
|
$1,137.50 |
$1,137.50 |
$1,137.50 |
$606.50
|
|
Radiation therapy dose plan
|
$942.00 |
$942.00 |
$942.00 |
$514.05
|
|
Radiation treatment aid(s)
|
$1,369.00 |
$1,369.00 |
$1,369.00 |
$520.00
|
|
Radiation treatment aid(s)
|
$1,449.50 |
$1,449.50 |
$1,449.50 |
$644.16
|
|
Radiation treatment aid(s)
|
$2,745.50 |
$2,745.50 |
$2,745.50 |
$1,076.78
|
|
Radiation treatment delivery
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$552.40
|
|
Radiation treatment delivery
|
$1,677.50 |
$1,677.50 |
$1,677.50 |
$920.00
|
|
Radiology port images(s)
|
$398.00 |
$398.00 |
$398.00 |
$251.50
|
|
Radiotherapy dose plan imrt
|
$13,983.00 |
$13,983.00 |
$13,983.00 |
$5,744.60
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$2,969.00 |
$2,969.00 |
$2,969.00 |
$2,048.87
|
|
Radphm lcl tmr plnr bdy two day img
|
$2,911.50 |
$2,911.50 |
$2,911.50 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$2,879.00 |
$2,879.00 |
$2,879.00 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$1,806.50 |
$1,806.50 |
$1,806.50 |
$1,120.50
|
|
Rapid Strep Test
|
$152.50 |
$152.50 |
$152.50 |
$75.24
|
|
Rbc count only automated
|
$27.00 |
$27.00 |
$27.00 |
$20.40
|
|
Rbc osmotic fragility
|
$72.50 |
$72.50 |
$72.50 |
$75.04
|
|
Reconstruct extra finger
|
$17,691.50 |
$17,691.50 |
$17,691.50 |
$3,591.33
|
|
Red blood cells leukocytes reduced each unit
|
$376.00 |
$376.00 |
$376.00 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$465.00 |
$465.00 |
$465.00 |
$528.45
|
|
Red blood cells washed each unit
|
$410.00 |
$410.00 |
$410.00 |
$572.46
|
|
Reduce testis torsion
|
$9,631.00 |
$9,631.00 |
$9,631.00 |
$4,350.00
|
|
Reduction of procidentia 45900
|
$1,993.00 |
$1,993.00 |
$1,993.00 |
$1,226.10
|
|
Refill maint impl spine pump
|
$400.00 |
$400.00 |
$400.00 |
$366.60
|
|
Refill/maint pump/resvr syst
|
$763.00 |
$763.00 |
$763.00 |
$397.60
|
|
Relocation skin pocket aicd
|
$5,095.50 |
$5,095.50 |
$5,095.50 |
$2,761.55
|
|
Relocation skin pocket pm
|
$4,148.00 |
$4,148.00 |
$4,148.00 |
$2,585.00
|
|
Rem/biv cast full arm/leg
|
$338.50 |
$338.50 |
$338.50 |
$320.79
|
|
Rem endovas vena cava filter
|
$2,462.00 |
$2,462.00 |
$2,462.00 |
$5,509.05
|
|
Removal biliary drg cath
|
$3,239.50 |
$3,239.50 |
$3,239.50 |
$1,380.82
|
|
Removal central venous catheter tunneled without port/pump
|
$3,715.00 |
$3,715.00 |
$3,715.00 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$4,340.00 |
$4,340.00 |
$4,340.00 |
$2,356.71
|
|
Removal cerclage w/anes
|
$6,868.00 |
$6,868.00 |
$6,868.00 |
$3,762.53
|
|
Removal cerumen impacted (both sides)
|
$585.00 |
$585.00 |
$585.00 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$264.50 |
$264.50 |
$264.50 |
$249.60
|
|
Removal duct glbldr calculi
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$2,771.60
|
|
Removal embedded foreign body vestibule mouth smpl
|
$634.00 |
$634.00 |
$634.00 |
$783.75
|
|
Removal foreign body extrn auditory canal with anes
|
$2,048.50 |
$2,048.50 |
$2,048.50 |
$2,446.00
|
|
Removal foreign body foot subcutaneous right
|
$1,970.00 |
$1,970.00 |
$1,970.00 |
$1,256.00
|
|
Removal of anal fissure
|
$3,896.00 |
$3,896.00 |
$3,896.00 |
$3,038.07
|
|
Removal of fallopian tube 58700
|
$2,569.50 |
$2,569.50 |
$2,569.50 |
$1,498.80
|
|
Removal of foreign body
|
$8,773.50 |
$8,773.50 |
$8,773.50 |
$3,994.09
|
|
Removal of vein clot
|
$3,895.00 |
$3,895.00 |
$3,895.00 |
$4,341.66
|
|
Removal/replacement ppm generator dual lead system
|
$7,487.00 |
$7,487.00 |
$7,487.00 |
$12,384.25
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$746.50 |
$746.50 |
$746.50 |
$292.50
|
|
Removal tunnled intprtnl cath
|
$7,164.00 |
$7,164.00 |
$7,164.00 |
$4,195.00
|
|
Remove ankle joint lining
|
$6,732.50 |
$6,732.50 |
$6,732.50 |
$3,839.54
|
|
Remove cva lumen obstruct
|
$1,196.50 |
$1,196.50 |
$1,196.50 |
$490.80
|
