Listas para Publicar en el Portal-1 (2) - Triple-S Salud

Procedure &
Place of Service
Tarifas
Servicios de Salud
Description Fee
26432-00 cltx dstl xtnsr tdn insj +-prq pinning $107.25
26433-00 repair extensor tendon distal insertion w/o grf $117.00
26434-00 repair extensor tendon distal insertion w/graft $273.00
26437-00 realignment extensor tendon hand each tendon $273.00
26440-00 tenolysis flexor tendon palm/finger each tendon $214.50
26442-00 tenolysis flexor tendon palm&finger each tendon $253.50
26445-00 tenolysis extensor tendon hand/finger each $523.94
26449-00 tenolysis cplx xtnsr tendon finger w/forearm ea $507.00
26450-00 tenotomy flexor palm open each tendon $160.88
26455-00 tenotomy flexor finger open each tendon $107.25
26460-00 tenotomy extensor hand/finger open each tendon $107.25
26471-00 tenodesis proximal interphalangeal joint each $273.00
26474-00 tenodesis distal joint each $273.00
26476-00 lengthening tendon extensor hand/finger each $312.00
26477-00 shortening tendon extensor hand/finger each $312.00
26478-00 lengthening tendon flexor hand/finger each $351.00
26479-00 shortening tendon flexor hand/finger each $351.00
26480-00 tr/trnspl tdn carp/mtcrpl hand w/o fr grf ea tdn $341.25
26483-00 tendon transfer transplant carp/mtcrpl graft $448.50
26485-00 transfer/transplant tendon palmar w/o graft each $429.00
26489-00 transfer/transplant tendon palmar w/graft each $536.25
26490-00 opponensplasty supfcis tdn tr typ ea tdn $429.00
26492-00 opponensplasty tdn tr w/grf ea tdn $536.25
26494-00 opponensplasty hypothenar musc tr $482.63
26497-00 tr tdn restore intrnsc funcj ring&sm fngr $390.00
26498-00 tr tdn restore intrnsc funcj all 4 fngrs $585.00
26499-00 correction claw finger other methods $390.00
26500-00 rcnstj tendon pulley each w/local tissues spx $273.00
26502-00 rcnstj tdn pulley ea tdn w/tdn/fscal grf spx $321.75
26508-00 release thenar muscle $321.75
26510-00 cross intrinsic transfer each tendon $268.13
26516-00 capsulodesis mtcarphlngl joint single digit $273.00
26517-00 capsulodesis mtcarphlngl joint 2 digits $390.00
26518-00 capsulodesis mtcarphlngl joint 3/4 digits $482.63
26520-00 capsulectomy/capsulotomy mtcarphlngl joint each $273.00
26525-00 capsulectomy/capsulotomy iphal joint each $273.00
26530-00 arthroplasty metacarpophalangeal joint each $321.75
26531-00 arthrp mtcarphlngl jt w/prostc implt ea jt $480.68
26535-00 arthroplasty interphalangeal joint each $273.00
26536-00 arthroplasty interphalangeal jt w/prosthetic ea $444.89
26540-00 rpr coltrl ligm mtcarphlngl/iphal jt $370.50
26541-00 rcnstj coltrl ligm mtcarphlngl 1 w/tdn/fscal grf $458.25
26542-00 rcnstj coltrl ligm mtcarphlngl 1 w/local tiss $303.23
26545-00 rcnstj coltrl ligm iphal jt 1 w/grf ea jt $321.75
26546-00 rpr non-union mtcrpl/phalanx $456.30
26548-00 rpr&rcnstj finger volar plate interphalangeal jt $334.43
26550-00 pollicization digit $1,113.45
26551-00 tr toe-to-hand w/mvasc anast grt toe wrp/arnd $2,249.69
26553-00 tr toe-to-hand w/mvasc anast oth/thn grt toe 1 $1,162.79
26554-00 tr toe-to-hand w/mvasc anast oth/thn grt toe 2 $1,032.29
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