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

Procedure &
Place of Service
Tarifas
Servicios de Salud
Description Fee
27447-00 arthrp kne condyle&platu medial&lat cmprts $324.00
27448-00 osteotomy femur shaft/supracondylar w/o fixation $682.50
27450-00 osteotomy femur shaft/supracondylar w/fixation $804.38
27454-00 osteot mlt w/relignmt imed rod fem shft $975.00
27455-00 osteot prox tibia fib exc/osteot before epiphysl $710.78
27457-00 osteot prox tibia fib exc/osteot after epiphysl $732.71
27465-00 osteoplasty femur shortening excluding 64876 $975.00
27466-00 osteoplasty femur lengthening $975.00
27468-00 ostpl femur cmbn lngth&shrt w/fem sgm tr $1,316.25
27470-00 rpr non/mal femur dstl h/n w/o grf $867.75
27472-00 rpr non/mal femur dstl h/n w/iliac/autog b1 grf $1,020.00
27475-00 arrest epiphyseal distal femur $594.75
27477-00 arrest epiphyseal tibia&fibula proximal $672.75
27479-00 arrst epiphysl cmbn dstl femur prox tibfib $867.75
27485-00 arrst hemiepiphysl dstl femur/prox tibia/fibula $505.44
27486-00 revj tot kne arthrp +-algrft 1 comp $1,316.25
27487-00 revj tot kne arthrp fem&entire tibl comp $1,950.00
27488-00 rmvl prosth tot kne prosth mma +-insj spacer $1,170.00
27495-00 proph tx n/p/pltwr +-mma femur $877.50
27496-00 dcmprn fasct thi&/kne 1 cmprt $263.25
27497-00 dcmprn fasct thi&/kne 1 dbrdmt nv musc&/nrv $315.90
27498-00 dcmprn fasct thi&/kne mlt cmprts $360.00
27499-00 dcmprn fasct thi&/kne mlt dbrdmt nv musc&/nrv $417.30
27500-00 closed tx femoral shaft fx w/o manipulation $117.00
27501-00 cltx sprcndylr/trnscndylr fem fx w/o mnpj $360.00
27502-00 cltx fem shft fx w/mnpj +-skn/skel tracj $601.97
27503-00 cltx sprcndylr/trnscndylr fem fx w/mnpj $438.75
27506-00 optx fem shft fx w/insj imed implt +-screw $901.19
27507-00 optx fem shft fx w/plate/screws +-cerclage $816.08
27508-00 cltx fem fx dstl end medial/lat condyle w/o mnpj $29.25
27509-00 prq skel fixj fem fx dstl end $315.00
27510-00 cltx fem fx dstl end medial/lat condyle w/mnpj $341.25
27511-00 open tx femoral supracondylar fracture w/o xtn $808.30
27513-00 open tx femoral supracondylar fracture w xtn $900.00
27514-00 open tx femoral fracture distal med/lat condyle $917.10
27516-00 cltx dstl fem epiphysl sep w/o mnpj $19.50
27517-00 cltx dstl fem epiphysl sep w/mnpj +-skn/skel $302.25
27519-00 open tx distal femoral epiphyseal separation $643.50
27520-00 closed tx patellar fracture w/o manipulation $78.00
27524-00 optx patllr fx w/int fixj/patllc&soft tiss rpr $558.97
27530-00 cltx tibl fx prox w/o mnpj $151.13
27532-00 cltx tibl fx prox +-mnpj w/skel tracj $409.79
27535-00 open tx tibial fracture proximal unicondylar $660.60
27536-00 optx tibl fx prox bicondylar +-int fixj $760.79
27538-00 cltx intercondylar spi&/tubrst fx kne +-mnpj $19.50
27540-00 open tx intercondylar spine/tubrst fracture knee $654.62
27550-00 closed tx knee dislocation w/o anesthesia $58.50
27552-00 closed tx knee dislocation w/anesthesia $126.75
27556-00 open tx knee dislocation w/o ligamentous repair $585.00
27557-00 open tx knee dislocation w ligamentous repair $780.00
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