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

Procedure &
Place of Service
Tarifas
Servicios de Salud
Description Fee
47122-00 hptc rescj lvr trisgmectomy $1,404.00
47125-00 hptc rescj lvr tot l lobec $1,160.25
47130-00 hptc rescj lvr tot r lobec $1,267.50
47300-00 marsupialization cst/absc lvr $682.50
47350-00 mgmt lvr hemrrg smpl sutr lvr wnd/inj $585.00
47360-00 mgmt lvr hemrrg cplx sutr wnd/inj $887.25
47361-00 mgmt lvr hemrrg expl wnd dbrdmt coagj/sutr $1,171.46
47362-00 mgmt lvr hemrrg re-expl wnd rmvl packing $418.57
47380-00 abltj opn 1+ lvr tum rf $1,077.38
47400-00 hepatcotomy/hepatcostomy w/expl drg/rmvl st1 $682.50
47420-00 choledochot/ost w/o sphnctrotomy/sphnctrop $682.50
47425-00 choledochot/ost w/sphnctrotomy/sphnctrop $809.25
47460-00 transduol sphnctrotomy/sphnctrop +-xtrj st1 spx $780.00
47480-00 cholecstot/cholecstost w/expl drg/rmvl st1 spx $487.50
47490-00 cholecstost prq w/img gid $263.25
47500-00 njx prq transhepatc cholangrph $97.50
47505-00 njx cholangrph thru an cath $63.38
47510-00 intro prq transhepatc cath biliary drg $160.88
47511-00 intro prq transhepatc stent biliary drg $333.45
47525-00 chng prq biliary drg cath $175.50
47530-00 revj&/rinsj transhepatc tube $184.28
47550-00 biliary ndsc intraop $136.50
47552-00 biliary ndsc prq t-tube dx +-collj spec spx $175.50
47553-00 biliary ndsc prq t-tube w/bx 1/mlt $253.50
47554-00 biliary ndsc prq t-tube rmvl st1 $321.75
47555-00 biliary ndsc prq t-tube dilat strix w/o stent $243.75
47556-00 biliary ndsc prq t-tube dilat strix w/stent $298.35
47560-00 laps surg w/gid transhepatc cholangrph w/o bx $329.55
47561-00 laps surg w/gid transhepatc cholangrph w/bx $351.00
47562-00 laps surg cholecstc $702.00
47563-00 laps surg cholecstc w/cholangrph $702.00
47564-00 laps surg cholecstc w/expl common dux $777.08
47570-00 laps surg cholecstontrstm $675.68
47600-00 cholecstc $585.00
47605-00 cholecstc cholangrph $594.75
47610-00 cholecstc expl dux $645.45
47612-00 cholecstc expl dux choledochontrstm $780.98
47620-00 cholecstc expl dux sphnctrotomy/sphnctrop $838.50
47630-00 biliary dux stone xtrj prq via basket/snare $195.00
47700-00 expl cgen atresia bile duxs $487.50
47701-00 portontrstm $1,053.00
47711-00 exc bile dux tum +-prim rpr xtrhepatc $916.11
47712-00 exc bile dux tum +-prim rpr intrahepatc $1,182.87
47715-00 exc choledochal cst $636.68
47720-00 cholecstontrstm dir $604.50
47721-00 cholecstontrstm w/gastrontrstm $633.75
47740-00 cholecstontrstm roux-en-y $633.75
47741-00 cholecstontrstm roux-en-y w/gastrontrstm $965.25
47760-00 anast xtrhepatc biliary duxs&gi $731.25
47765-00 anast intrahepatc duxs&gi $848.25
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