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 />
54060-00 dstrj les pns smpl surg exc $39.00<br />
54065-00 dstrj les pns x10sv $112.13<br />
54100-00 bx pns spx $29.25<br />
54105-00 bx pns dp struxs $58.50<br />
54110-00 exc p<strong>en</strong> plaque $302.25<br />
54111-00 exc p<strong>en</strong> plaque grf 5 cm l<strong>en</strong>gth $536.25<br />
54112-00 exc p<strong>en</strong> plaque grf > 5 cm l<strong>en</strong>gth $633.75<br />
54115-00 rmvl fb from dp p<strong>en</strong> tiss $185.25<br />
54120-00 amp pns prtl $390.00<br />
54125-00 amp pns compl $585.00<br />
54130-00 amp pns rad w/bi inguinofem lmphadec $975.00<br />
54135-00 amp pns rad bi p<strong>el</strong> lmphadec $1,199.25<br />
54150-00 circumcision w/clamp/oth dev w/block $29.25<br />
54160-00 circumcision neonate $97.50<br />
54161-00 circumcision >28 days $107.25<br />
54162-00 lss/exc p<strong>en</strong> post-circumcision ads $139.52<br />
54163-00 rpr incompl circumcision $133.38<br />
54164-00 fr<strong>en</strong>ulotomy pns $115.83<br />
54200-00 njx peyronie $19.50<br />
54205-00 njx peyronie expos plaque $302.25<br />
54220-00 irrigation corpora cavernosa priapism $165.75<br />
54230-00 injection corpora cavernosograpy $35.10<br />
54231-00 dynamic cavernosometry njx vasoactive drugs $131.63<br />
54235-00 njx c/p/a cavernosa w/pharmacologic agt $39.00<br />
54240-00 p<strong>en</strong> plethysmograpy $56.55<br />
54240-26 p<strong>en</strong> plethysmograpy $13.57<br />
54240-TC p<strong>en</strong> plethysmograpy $22.62<br />
54250-00 nocturnal p<strong>en</strong> tumesc<strong>en</strong>ce&/rgdity tst $72.15<br />
54250-26 nocturnal p<strong>en</strong> tumesc<strong>en</strong>ce&/rgdity tst $17.32<br />
54250-TC nocturnal p<strong>en</strong> tumesc<strong>en</strong>ce&/rgdity tst $28.86<br />
54300-00 pns straight<strong>en</strong>ing chordee $292.50<br />
54304-00 pns corrj chordee 1st stg hypspad rpr $516.75<br />
54308-00 urtp 2nd stg hypspad rpr < 3 cm $516.75<br />
54312-00 urtp 2nd stg hypspad rpr > 3 cm $575.25<br />
54316-00 urtp 2nd stg hypspad rpr skn grf $643.50<br />
54318-00 urtp 3rd stg hypspad rpr rls pns $331.50<br />
54322-00 1 stg dstl hypspad rpr w/smpl meatal advmnt $617.18<br />
54324-00 1 stg dstl hypspad rpr w/urtp skn flaps $516.75<br />
54326-00 1 stg dstl hypspad rpr urtp skn flaps&moblj $764.40<br />
54328-00 1 stg dstl hypspad rpr w/x10sv dsj $575.25<br />
54332-00 1 stg prox p<strong>en</strong>/p<strong>en</strong>oscrotal hypspad rpr $741.00<br />
54336-00 1 stg prnl hypspad rpr req x10sv dsj skn grf $1,021.41<br />
54340-00 rpr hypspad complctjs clsr inc/exc smpl $253.50<br />
54344-00 rpr hypspad complctjs moblj flaps&urtp $448.50<br />
54348-00 rpr hypspad complctjs x10sv dsj&urtp flap/grf $482.63<br />
54352-00 rpr hypspad cripple req x10sv dsj&exc $877.50<br />
54360-00 plstc pns correct angulation $419.25<br />
54380-00 plstc pns epspad dstl sphnctr $487.50<br />
54385-00 plstc pns epspad dstl sphnctr w/incont $604.50<br />
54390-00 plstc pns epspad dstl sphnctr w/exstrophy bldr $838.50<br />
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