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 />
54401-00 insj p<strong>en</strong> prosth nfltbl s<strong>el</strong>f-contained $680.55<br />
54405-00 insj multi-compon<strong>en</strong>t nfltbl p<strong>en</strong> prosth $1,053.00<br />
54406-00 rmvl nfltbl p<strong>en</strong> prosth w/o rplcmt prosth $580.13<br />
54408-00 rpr compon<strong>en</strong>t multi-compon<strong>en</strong>t nfltbl p<strong>en</strong> prosth $580.13<br />
54410-00 rmvl&rplcmt nfltbl p<strong>en</strong> prosth sm sess $580.13<br />
54411-00 rmvl&rplcmt nfltbl p<strong>en</strong> prosth thru infct fld $730.94<br />
54415-00 rmvl non-nfltbl/nfltbl p<strong>en</strong> prosth w/o rplcmt $354.90<br />
54416-00 rmvl&rplcmt non-nfltbl/nfltbl prosth sm sess $354.90<br />
54417-00 rmvl&rplcmt non-nfltbl/nfltbl p<strong>en</strong> infct sm sess $644.84<br />
54420-00 c/p/a cavernosa-saph<strong>en</strong>ous vein shunt uni/bi $351.00<br />
54430-00 c/p/a cavernosa-corpus spongiosum shunt uni/bi $400.73<br />
54435-00 corpora cavernosa-glans p<strong>en</strong>is fstlj priapism $351.00<br />
54440-00 plastic operation p<strong>en</strong>is injury $487.50<br />
54450-00 foreskn mnpj w/lss preputial ads&stretching $78.00<br />
54500-00 bx tstis ndl spx $19.50<br />
54505-00 bx tstis incal spx $97.50<br />
54512-00 exc xtrpar<strong>en</strong>chymal les tstis $351.98<br />
54520-00 orchiectomy smpl scrotal/ingun appr $731.25<br />
54522-00 orchiectomy prtl $260.06<br />
54530-00 orchiectomy rad tum ingun appr $487.50<br />
54535-00 orchiectomy rad tum w/abdl expl $526.50<br />
54550-00 expl undesc<strong>en</strong>ded tstis ingun/scrotal area $302.25<br />
54560-00 expl undesc<strong>en</strong>ded tstis w/abdl expl $458.25<br />
54600-00 rdctj torsion tstis +-fixj clat tstis $292.50<br />
54620-00 fixj clat tstis spx $195.00<br />
54640-00 orchiopexy ingun appr +-hrna rpr $487.50<br />
54650-00 orchiopexy abdl appr intra-abdl tstis $513.34<br />
54660-00 insj tsticular prosth spx $146.25<br />
54670-00 sutr/rpr tsticular inj $302.25<br />
54680-00 trnsplj tstis thi $370.50<br />
54690-00 laparoscopy surgical orchiectomy $528.45<br />
54692-00 laparoscopy orchiopexy intra-abdominal testis $548.44<br />
54700-00 i&d epididymis tstis&/scrotal space $29.25<br />
54800-00 bx epididymis ndl $19.50<br />
54830-00 exc local les epididymis $97.50<br />
54840-00 exc sprmatoc<strong>el</strong>e +-epididymectomy $292.50<br />
54860-00 epididymectomy uni $292.50<br />
54861-00 epididymectomy bi $438.75<br />
54865-00 exploration epididymis w/wo biopsy $97.50<br />
54900-00 epididymovasostomy anast epididymis uni $390.00<br />
54901-00 epididymovasostomy anast epididymis bi $487.50<br />
55000-00 pnxr aspir hydroc<strong>el</strong>e tunica vagis +-njx med $19.50<br />
55040-00 exc hydroc<strong>el</strong>e uni $292.50<br />
55041-00 exc hydroc<strong>el</strong>e bi $438.75<br />
55060-00 rpr tunica vagis hydroc<strong>el</strong>e bottle typ $195.00<br />
55100-00 drg scrotal wall absc $19.50<br />
55110-00 scrotal expl $214.50<br />
55120-00 rmvl fb scrotum $204.75<br />
55150-00 rescj scrotum $321.75<br />
55175-00 scrotoplasty smpl $292.50<br />
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