Listas para Publicar en el Portal-1 (2) - Triple-S Salud
Listas para Publicar en el Portal-1 (2) - Triple-S Salud
Listas para Publicar en el Portal-1 (2) - Triple-S Salud
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Procedure &<br />
Place of Service<br />
Tarifas<br />
Servicios de <strong>Salud</strong><br />
Description Fee<br />
69535-00 rescj temporal b1 xtrnl $1,452.75<br />
69540-00 exc aural polyp $39.00<br />
69550-00 exc aural glomus tum transcanal $897.00<br />
69552-00 exc aural glomus tum transmastoid $1,082.25<br />
69554-00 exc aural glomus tum extnd $1,189.50<br />
69601-00 revj mstdc rsltg compl mstdc $877.50<br />
69602-00 revj mstdc rsltg modf rad mstdc $926.25<br />
69603-00 revj mstdc rsltg rad mstdc $950.63<br />
69604-00 revj mstdc rsltg tmpp $1,126.13<br />
69605-00 revj mstdc w/apicectomy $1,008.15<br />
69610-00 tympanic memb rpr +-sit prepj prf8j patch $19.50<br />
69620-00 myringoplasty $780.00<br />
69631-00 tmpp w/o mstdc 1st/revj w/o ocr $975.00<br />
69632-00 tmpp w/o mstdc 1st/revj ocr $1,072.50<br />
69633-00 tmpp w/o mstdc 1st/revj prosth torp $1,072.50<br />
69635-00 tmpp antrt/mastoidotomy w/o ocr $1,170.00<br />
69636-00 tmpp antrt/mastoidotomy ocr $1,296.75<br />
69637-00 tmpp antrt/mastoidotomy prosth torp $1,092.00<br />
69641-00 tmpp mstdc w/o ocr $994.50<br />
69642-00 tmpp mstdc ocr $1,126.13<br />
69643-00 tmpp mstdc ntc/rcnsted wall w/o ocr $1,126.13<br />
69644-00 tmpp mstdc ntc/rcnsted canal wall ocr $1,189.50<br />
69645-00 tmpp mstdc rad/compl w/o ocr $994.50<br />
69646-00 tmpp mstdc rad/compl ocr $1,126.13<br />
69650-00 stapes moblj $682.50<br />
69660-00 stapedectomy/stapedotomy $975.00<br />
69661-00 stapedectomy/stapedotomy w/footplate drill out $830.70<br />
69662-00 revj stapedectomy/stapedotomy $1,140.75<br />
69666-00 rpr oval window fstl $975.00<br />
69667-00 rpr round window fstl $975.00<br />
69670-00 mastoid obltrj spx $780.00<br />
69676-00 tympanic neurectomy $538.20<br />
69700-00 clsr postaur fstl mastoid spx $243.75<br />
69710-00 impltj/rplcmt emgnt b1 cndj dev temporal b1 $702.00<br />
69711-00 rmvl/rpr emgnt b1 cndj dev temporal b1 $482.63<br />
69714-00 impltj oi implt b1 w/o mstdc $665.15<br />
69715-00 impltj oi implt b1 mstdc $846.79<br />
69717-00 rplcmt oi implt b1 w/o mstdc $676.55<br />
69718-00 rplcmt oi implt b1 mstdc $850.30<br />
69720-00 dcmprn nrv itprl lat g<strong>en</strong>iculate $975.00<br />
69725-00 dcmprn nrv itprl medial g<strong>en</strong>iculate $1,160.25<br />
69740-00 sutr nrv itprl +-grf/dcmprn lat g<strong>en</strong>iculate $1,170.00<br />
69745-00 sutr nrv itprl +-grf/dcmprn medial g<strong>en</strong>iculate $1,355.25<br />
69801-00 labyrinthotomy transcanal $975.00<br />
69802-00 labyrinthotomy mastoidectomy $1,033.50<br />
69805-00 <strong>en</strong>dolymphatic sac w/o shunt $1,033.50<br />
69806-00 <strong>en</strong>dolymphatic sac shunt $1,140.75<br />
69820-00 f<strong>en</strong>estration semicircular canal $975.00<br />
69840-00 revj f<strong>en</strong>estration opration $585.00<br />
69905-00 labyrinthectomy transcanal $975.00<br />
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