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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 />

45395-00 laps prctect compl cmbn abdominoprnl w/clst $1,216.22<br />

45397-00 laps prctect cmbn pull-thru crtj rsvr $213.69<br />

45400-00 laps proctopexy for prolapse $710.78<br />

45402-00 laps proctopexy for prolapse sigmoid rescj $956.48<br />

45500-00 proctoplasty st<strong>en</strong>osis $390.00<br />

45505-00 proctoplasty prolapse muc memb $390.00<br />

45520-00 prirct njx sclrsg sln prolapse $19.50<br />

45540-00 proctopexy abdl appr $585.00<br />

45541-00 proctopexy prnl appr $585.00<br />

45550-00 proctopexy w/sigmoid rescj abdl appr $877.50<br />

45560-00 rpr rectoc<strong>el</strong>e spx $234.00<br />

45562-00 expl rpr&presac drg rct inj $605.48<br />

45563-00 expl rpr&presac drg rct inj w/clst $920.50<br />

45800-00 clsr rectovesical fstl $585.00<br />

45805-00 clsr rectovesical fstl w/clst $828.75<br />

45820-00 clsr rectourtl fstl $682.50<br />

45825-00 clsr rectourtl fstl w/clst $936.00<br />

45900-00 rdctj procid<strong>en</strong>tia spx under anes $19.50<br />

45905-00 dilat anal sphnctr spx under anes oth/thn local $29.25<br />

45910-00 dilat rct strix spx under anes oth/thn local $29.25<br />

45915-00 rmvl fecal impaction/fb spx under anes $29.25<br />

45990-00 anrct xm surg req anes g<strong>en</strong>eral spi/edrl dx $70.20<br />

46020-00 plmt seton $154.58<br />

46030-00 rmvl anal seton oth marker $19.50<br />

46040-00 i&d ischiorct&/prirct absc spx $97.50<br />

46045-00 i&d intramural im/absc transanal anes $87.75<br />

46050-00 i&d prianal absc supfc $19.50<br />

46060-00 i&d ischiorct/intramural absc +-seton $390.00<br />

46070-00 inc anal septum inft $48.75<br />

46080-00 sphnctrotomy anal div sphnctr spx $48.75<br />

46083-00 inc thrombosed hemorrhoid xtrnl $29.25<br />

46200-00 fissurectomy incl sphincterotomy wh<strong>en</strong> performed $195.00<br />

46220-00 excision single external papilla or tag anus $29.25<br />

46221-00 hemorrhoidectomy internal rubber band ligations $53.63<br />

46230-00 excision multiple external papillae/tags anus $48.75<br />

46250-00 hemorrhoidectomy xtrnl 2+ column/group $244.82<br />

46255-00 hemorrhoidectomy ntrnl & xtrnl 1 column/group $292.50<br />

46257-00 hrhc smpl w/fissurectomy $292.50<br />

46258-00 hrhc 1 col/grp w/fstulectmy incl fssrectomy $390.00<br />

46260-00 hemorrhoidectomy int & xtrnl 2+ column/group $390.00<br />

46261-00 hrhc cplx/x10sv w/fissurectomy $419.25<br />

46262-00 hrhc 2+ col/grp w/fstulectmy incl fssrectmy $433.88<br />

46270-00 surg tx anal fstl subq $230.78<br />

46275-00 surg tx anal fistula intersphincteric $390.00<br />

46280-00 tx anal fstl trans/supra/xtrasphnctrc incl seton $438.75<br />

46285-00 surg tx anal fstl 2nd stg $97.50<br />

46288-00 clsr anal fstl w/rct advmnt flap $351.00<br />

46320-00 exc thrombosed hemorrhoid xtrnl $142.16<br />

46500-00 njx sclrsg sln hemorrhoids $19.50<br />

46505-00 chemodnrvtj int anal sphnctr $122.85<br />

67

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