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 />
25107-00 arthrotomy dstl radioulnar joint rpr cartilage $292.50<br />
25109-00 exc t<strong>en</strong>don forearm&/wrist flexor/ext<strong>en</strong>sor ea $333.66<br />
25110-00 excision lesion t<strong>en</strong>don sheath forearm&/wrist $97.50<br />
25111-00 excision ganglion wrist dorsal/volar primary $146.25<br />
25112-00 excision ganglion wrist dorsal/volar recurr<strong>en</strong>t $234.00<br />
25115-00 rad exc bursa synva wrst/f/arm tdn shths flxrs $487.50<br />
25116-00 rad exc bursa synva wrst/f/arm tdn shths xtnsrs $438.75<br />
25118-00 synovectomy ext<strong>en</strong>sor t<strong>en</strong>don shth wrist 1 cmprt $390.00<br />
25119-00 synvct xtnsr tdn shth wrst 1 rescj dstl ulna $370.50<br />
25120-00 excision/curettage cyst/tumor radius/ulna $351.00<br />
25125-00 exc/curtg cyst/tumor radius/ulna w/autograft $429.00<br />
25126-00 exc/curtg cyst/tumor radius/ulna w/allograft $370.50<br />
25130-00 excision/curettage cyst/tumor carpal bones $195.00<br />
25135-00 exc/curtg cyst/tumor carpal bones w/autograft $312.00<br />
25136-00 exc/curtg cyst/tumor carpal bones w/allograft $273.00<br />
25145-00 sequestrectomy forearm &/wrist $564.41<br />
25150-00 partial excision bone ulna $487.50<br />
25151-00 partial excision bone radius $487.50<br />
25170-00 radical resection tumor radius or ulna $633.75<br />
25210-00 carpectomy 1 bone $394.88<br />
25215-00 carpectomy all bones proximal row $419.25<br />
25230-00 radical styloidectomy spx $273.00<br />
25240-00 excision distal ulna partial/complete $379.71<br />
25246-00 injection wrist arthrography $29.25<br />
25248-00 expl w/removal deep foreign body forearm/wrist $224.25<br />
25250-00 removal wrist prosthesis spx $273.00<br />
25251-00 removal wrist prosth complicated w/total wrist $312.00<br />
25259-00 manipulation wrist under anesthesia $195.00<br />
25260-00 rpr tdn/musc flxr f/arm&/wrst prim 1 ea tdn/musc $526.50<br />
25263-00 rpr tdn/musc flxr f/arm&/wrst sec 1 ea tdn/musc $409.50<br />
25265-00 rpr tdn/musc flxr f/arm&/wrst sec fr grf ea $585.00<br />
25270-00 rpr tdn/musc xtnsr f/arm&/wrst prim 1 ea tdn $117.00<br />
25272-00 rpr tdn/musc xtnsr f/arm&/wrst sec 1 ea tdn/musc $611.09<br />
25274-00 rpr tdn/musc xtnsr f/arm&/wrst sec fr grf ea tdn $351.00<br />
25275-00 rpr t<strong>en</strong>don sheath ext<strong>en</strong>sor f/arm&/wrst w/graft $433.49<br />
25280-00 lngth/shrt flxr/xtnsr tdn f/arm&/wrst 1 ea tdn $292.50<br />
25290-00 tnot flxr/xtnsr t<strong>en</strong>don forearm&/wrist 1 ea $292.50<br />
25295-00 tnols flxr/xtnsr t<strong>en</strong>don forearm&/wrist 1 ea $243.75<br />
25300-00 t<strong>en</strong>odesis wrist flexors fingers $463.13<br />
25301-00 t<strong>en</strong>odesis wrist ext<strong>en</strong>sors fingers $404.63<br />
25310-00 tdn trnsplj/tr flxr/xtnsr f/arm&/wrst 1 ea tdn $331.50<br />
25312-00 tdn trnsplj/tr flxr/xtnsr f/arm&/wrst 1/tdn grf $390.00<br />
25315-00 flexor origin slide forearm &/wrist $390.00<br />
25316-00 flexor origin slide f/arm&/wrst t<strong>en</strong>don transfer $487.50<br />
25320-00 capsl-rhphy/rcnstj wrst opn carpl ins $448.50<br />
25332-00 arthrp wrst +-interpos +-xtrnl/int fixj $468.00<br />
25335-00 c<strong>en</strong>tralization wrst ulna $585.00<br />
25337-00 rcnstj stablj dstl u/dstl jt 2 soft tiss stablj $644.09<br />
25350-00 osteotomy radius distal third $684.45<br />
25355-00 osteotomy radius middle/proximal third $472.88<br />
19
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