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 />
42226-00 lngth palate&pharyngeal flap $515.09<br />
42227-00 lngth palate w/island flap $465.08<br />
42235-00 rpr ant palate w/vomer flap $643.50<br />
42260-00 rpr nasolabial fstl $204.75<br />
42300-00 drg absc prtd smpl $48.75<br />
42305-00 drg absc prtd comp $224.25<br />
42310-00 drg absc submax/sublngl intraoral $29.25<br />
42320-00 drg absc submax xtrnl $39.00<br />
42330-00 sialot submndblr sublngl/prtd uncomp intraoral $19.50<br />
42335-00 sialolithotomy submndblr submax comp intraoral $97.50<br />
42340-00 sialolithotomy prtd xtroral/comp intraoral $243.75<br />
42400-00 bx salivary glnd ndl $48.75<br />
42405-00 bx salivary glnd incal $78.00<br />
42408-00 exc sublngl salivary cst ranula $136.50<br />
42409-00 marsupialization sublngl salivary cst ranula $136.50<br />
42410-00 exc prtd tum/prtd glnd lat lobe w/o nrv dsj $195.00<br />
42415-00 exc prtd tum/prtd glnd lat dsj&prsrv facial nrv $585.00<br />
42420-00 exc prtd tum/prtd glnd tot dsj&prsrv facial nrv $682.50<br />
42425-00 exc prtd tum/prtd glnd tot <strong>en</strong> bloc rmvl $585.00<br />
42426-00 exc prtd tum/prtd glnd tot w/uni rad nck dsj $1,126.13<br />
42440-00 exc submndblr submax glnd $390.00<br />
42450-00 exc sublngl glnd $214.50<br />
42500-00 plstc rpr salivary dux sialodochoplasty prim $341.25<br />
42505-00 plstc rpr salivary dux sialodochoplasty sec/comp $331.50<br />
42507-00 prtd dux dvrj bi $326.63<br />
42508-00 prtd dux dvrj bi w/exc 1 submndblr glnd $399.75<br />
42509-00 prtd dux dvrj bi w/exc bth submndblr glnds $775.13<br />
42510-00 parotid duct dvrj bilateral with lig both ducts $468.00<br />
42550-00 njx sialograpy $9.75<br />
42600-00 clsr salivary fstl $390.00<br />
42650-00 dilat salivary dux $9.75<br />
42660-00 dilat&cathj salivary dux +-njx $19.50<br />
42665-00 lig salivary dux intraoral $107.25<br />
42700-00 i&d absc pritonsillar $29.25<br />
42720-00 i&d absc rtrphrngl/<strong>para</strong>pharyngeal intraoral $97.50<br />
42725-00 i&d absc rtrphrngl/<strong>para</strong>pharyngeal xtrnl appr $204.75<br />
42800-00 bx oropharynx $29.25<br />
42802-00 bx hypopharynx $48.75<br />
42804-00 bx nasopharynx visible les smpl $48.75<br />
42806-00 bx nasopharynx surv unknown prim les $87.75<br />
42808-00 exc/dstrj les pharynx any meth $117.00<br />
42809-00 rmvl fb from pharynx $234.00<br />
42810-00 exc branchial cl cst confined skn&subq tiss $146.25<br />
42815-00 exc branchial cl cst extg b<strong>el</strong>w subq tiss&/phrnx $487.50<br />
42820-00 tonsillectomy&ad<strong>en</strong>oidectomy under age 12 $146.25<br />
42821-00 tonsillectomy&ad<strong>en</strong>oidectomy age 12/> $195.00<br />
42825-00 tonsillectomy 1/2 under age 12 $146.25<br />
42826-00 tonsillectomy 1/2 age 12/> $195.00<br />
42830-00 ad<strong>en</strong>oidectomy prim under age 12 $97.50<br />
42831-00 ad<strong>en</strong>oidectomy prim age 12/> $97.50<br />
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