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 />
50280-00 exc/unroofing cst kdn $682.50<br />
50290-00 exc prinephric cst $618.45<br />
50382-00 rmvl&rplcmt intly dw<strong>el</strong>ling urtrl st<strong>en</strong>t $243.17<br />
50384-00 rmvl intly dw<strong>el</strong>ling urtrl st<strong>en</strong>t $221.32<br />
50385-00 remove & replace int dw<strong>el</strong>l ureteral st<strong>en</strong>t trurl $249.60<br />
50386-00 remove int dw<strong>el</strong>l ureteral st<strong>en</strong>t transurethral $160.88<br />
50387-00 rmvl&rplcmt xtrnlly accessible urtrl st<strong>en</strong>t $88.15<br />
50389-00 rmvl nfros tube req fluor gid $48.56<br />
50390-00 aspir&/njx rnl cst/p<strong>el</strong>vis ndl prq $48.75<br />
50391-00 instlj agt rnl p<strong>el</strong>vis&/urtr thru tube $93.89<br />
50392-00 intro intracath/cath in rnl p<strong>el</strong>vis drg&/njx prq $87.75<br />
50393-00 intro urtrl cath/st<strong>en</strong>t thru p<strong>el</strong>vis drg&/njx prq $156.00<br />
50394-00 njx px plog thru tube/cath $9.75<br />
50395-00 intro gd p<strong>el</strong>vis&/urtr w/dilat nfros trc $195.00<br />
50396-00 manometric stds thru tube/ndw<strong>el</strong>lg urtrl cath $9.75<br />
50398-00 chng nfros/py<strong>el</strong>ostomy tube $9.75<br />
50400-00 plop rnl p<strong>el</strong>vis smpl $780.00<br />
50405-00 plop rnl p<strong>el</strong>vis comp $965.25<br />
50500-00 nephrorrhaphy sutr kdn wnd/inj $780.00<br />
50520-00 clsr nephrocutan/py<strong>el</strong>ocutan fstl $780.00<br />
50525-00 clsr nephrovisc fstl w/visc rpr abdl appr $897.00<br />
50526-00 clsr nephrovisc fstl w/visc rpr thrc appr $897.00<br />
50540-00 symphysiotomy horseshoe kdn +-plop uni/bi $975.00<br />
50541-00 laps abltj rnl csts $1,095.56<br />
50542-00 laps abltj rnl mass les w/intraop us $1,382.06<br />
50543-00 laps prtl nfrct $1,765.09<br />
50544-00 laps plop $1,498.77<br />
50545-00 laps radical nfrct $2,632.50<br />
50546-00 laps nfrct w/prtl urtrec $1,421.99<br />
50547-00 laps don nfrct from liv don $877.50<br />
50548-00 laps nfrct w/tot urtrec $2,632.50<br />
50551-00 rnl ndsc nfros/py<strong>el</strong>ostomy $82.88<br />
50553-00 rnl ndsc nfros/py<strong>el</strong>ostomy urtrl cathj $97.50<br />
50555-00 rnl ndsc nfros/py<strong>el</strong>ostomy bx $97.50<br />
50557-00 rnl ndsc nfros/py<strong>el</strong>ostomy fulg&/inc +-bx $102.38<br />
50561-00 rnl ndsc nfros/py<strong>el</strong>ostomy rmvl fb/st1 $102.38<br />
50562-00 rnl ndsc nfros/py<strong>el</strong>ostomy rescj tum $412.74<br />
50570-00 rnl ndsc nfrot/plot $48.75<br />
50572-00 rnl ndsc nfrot/plot w/urtrl cathj +-dilat urtr $58.50<br />
50574-00 rnl ndsc nfrot/plot bx $58.50<br />
50575-00 rnl ndsc nfrot/plot w/<strong>en</strong>doplot $585.00<br />
50576-00 rnl ndsc nfrot fulguration&/inc +-bx $68.25<br />
50580-00 rnl ndsc nfrot/plot w/rmvl fb/st1 $68.25<br />
50590-00 lithotrp xtrcorp shock wave $1,218.75<br />
50600-00 urtrotomy w/expl/drg spx $682.50<br />
50605-00 ureterotomy insertion indw<strong>el</strong>ling st<strong>en</strong>t all types $711.75<br />
50610-00 urtrolithotomy upper one-third ureter $682.50<br />
50620-00 urtrolithotomy middle one-third ureter $672.75<br />
50630-00 urtrolithotomy lower one-third ureter $780.00<br />
50650-00 urtrec w/bldr cuff spx $741.00<br />
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