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

Procedure &
Place of Service
Tarifas
Servicios de Salud
Description Fee
29800-00 arthrs tmprmand jt dx +-synval bx spx $394.88
29804-00 arthroscopy temporomandibular joint surgical $658.13
29805-00 arthroscopy shoulder dx +-synovial biopsy spx $386.10
29806-00 arthroscopy shoulder surgical capsulorrhaphy $725.69
29807-00 arthroscopy shoulder surgical repair slap lesion $680.94
29819-00 arthroscopy shoulder surgical removal loose/fb $390.00
29820-00 arthroscopy shoulder surg synovectomy partial $292.50
29821-00 arthroscopy shoulder surg synovectomy complete $390.00
29822-00 arthroscopy shoulder surg debridement limited $512.00
29823-00 arthroscopy shoulder surg debridement extensive $494.38
29824-00 arthroscopy shoulder distal claviculectomy $503.52
29825-00 arthroscopy shoulder lysis&rescj adhesion +-mnpj $509.52
29826-00 shoulder scope bone shaving $789.75
29827-00 arthroscopy shoulder rotator cuff repair $873.70
29828-00 arthroscopy shoulder biceps tenodesis $576.00
29830-00 arthroscopy elbow diagnostic +-synovial bx spx $253.50
29834-00 arthroscopy elbow surgical w/removal loose/fb $390.00
29835-00 arthroscopy elbow surgical synovectomy partial $390.00
29836-00 arthroscopy elbow surgical synovectomy complete $438.75
29837-00 arthroscopy elbow surgical debridement limited $390.00
29838-00 arthroscopy elbow surgical debridement extensive $487.50
29840-00 arthroscopy wrist diagnostic +-synovial bx spx $254.48
29843-00 arthroscopy wrist infection lavage&drainage $333.45
29844-00 arthroscopy wrist surgical synovectomy partial $346.13
29845-00 arthroscopy wrist surgical synovectomy complete $409.50
29846-00 arthrs wrst exc&/rpr triang fibrocart&/jt dbrdmt $503.10
29847-00 arthrs wrst surg int fixj f/fx/ins $402.68
29848-00 ndsc wrst surg w/rls transvrs carpl ligm $232.05
29850-00 arthrs aid tx spi&/fx kne w/o fixj $569.40
29851-00 arthrs aid tx spi&/fx kne w/fixj $695.18
29855-00 arthrs aid tibial fracture proximal unicondylar $629.85
29856-00 arthrs aid tibial fx prox unicondylar bicondylar $741.00
29860-00 arthroscopy hip diagnostic +-synovial biopsy spx $347.49
29861-00 arthroscopy hip surgical w/removal loose/fb $515.09
29862-00 arthrs hip debridement/shaving articular crtlg $566.87
29863-00 arthroscopy hip surgical w/synovectomy $517.73
29866-00 arthroscopy knee osteochondral agrft mosaicplast $853.00
29867-00 arthroscopy knee osteochondral allograft $980.10
29868-00 arthroscopy knee meniscal trnsplj med/lat $1,137.24
29870-00 arthroscopy knee diagnostic +-synovial bx spx $321.75
29871-00 arthroscopy knee infection lavage & drainage $366.80
29873-00 arthroscopy knee lateral release $346.50
29874-00 arthroscopy knee removal loose/foreign body $487.50
29875-00 arthroscopy knee synovectomy limited spx $458.25
29876-00 arthroscopy knee synovectomy 2/>compartments $585.00
29877-00 arthrs knee debridement/shaving artclr crtlg $480.87
29879-00 arthrs knee abrasion arthrp/mlt drlg/microfx $542.10
29880-00 arthrs knee w/meniscectomy med&lat w/shaving $706.88
29881-00 arthrs kne surg w/meniscectomy med/lat w/shvg $633.75
29882-00 arthroscopy knee w/meniscus rpr medial/lateral $789.75
37