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 />
20663-00 application halo femoral including removal $156.00<br />
20664-00 appl halo 6/> pins thin skull osteology $473.40<br />
20665-00 removal tong/halo applied by another physician $19.50<br />
20670-00 Removal of support implant, removal implant superficial spx $19.50<br />
20680-00 Removal of support implant, removal implant deep $146.25<br />
20690-00 application uniplane external fixation system $156.00<br />
20692-00 application multiplane external fixation system $351.98<br />
20693-00 adjustm<strong>en</strong>t/revj xtrnl fixation system req anes $183.30<br />
20694-00 removal external fixation system under anes $185.25<br />
20696-00 xtrnl fixj w/stereotactic adjustm<strong>en</strong>t 1st&subq $343.10<br />
20697-00 xtrnl fixj w/strtctc adjustm<strong>en</strong>t exchange strut $403.65<br />
20802-00 replantation arm complete amputation $2,121.60<br />
20805-00 replantation forearm complete amputation $2,597.40<br />
20808-00 replantation hand complete amputation $3,229.20<br />
20816-00 rplj dgt except thmb mtcarphlngl jt compl amp $1,592.18<br />
20822-00 rplj dgt excluding thmb sublimis tdn compl amp $1,461.53<br />
20824-00 rplj thmb carp/mtcrpl jt mp jt compl amputation $1,303.58<br />
20827-00 rplj thumb distal tip mp joint compl amputation $1,312.35<br />
20838-00 replantation foot complete amputation $2,125.50<br />
20900-00 bone graft any donor area minor/small $361.92<br />
20902-00 bone graft any donor area major/large $204.75<br />
20910-00 cartilage graft costochondral $204.75<br />
20912-00 cartilage graft nasal septum $682.50<br />
20920-00 fascia lata graft by stripper $312.56<br />
20922-00 fascia lata graft incision & area exposure $175.50<br />
20924-00 t<strong>en</strong>don graft from a distance $282.75<br />
20930-00 allograft for spine surgery only mors<strong>el</strong>ized $117.00<br />
20931-00 allograft for spine surgery only structural $97.50<br />
20936-00 autograft spine surgery local from same incision $131.63<br />
20937-00 autograft spine surgery mors<strong>el</strong>ized sep incision $166.73<br />
20938-00 autograft spine surgery bicort/tricort sep inc $185.00<br />
20950-00 mntr interstitial fluid pressure cmprt syndrome $93.02<br />
20955-00 bone graft microvascular anastomosis fibula $1,864.69<br />
20956-00 bone graft microvascular anast iliac crest $1,876.97<br />
20957-00 bone graft microvascular anast metatarsal $1,755.00<br />
20969-00 free ostq flap w/mvasc anast metar/great toe $2,044.58<br />
20970-00 free ostq flap w/mvasc anastomosis iliac crest $1,977.01<br />
20972-00 free ostq flap w/mvasc anastomosis metatarsal $1,714.05<br />
20973-00 fr ostq flap w/mvasc anast grt toe w/web space $2,053.35<br />
20974-00 <strong>el</strong>ectrical stimulation bone healing noninvasive $28.08<br />
20975-00 <strong>el</strong>ectrical stimulation bone healing invasive $111.44<br />
20979-00 low int<strong>en</strong>sity us stimj bone healing noninvasive $34.24<br />
20982-00 ablation bone tumor rf percutaneous ct guidance $348.88<br />
21010-00 arthrotomy temporomandibular joint $390.00<br />
21011-00 excision tumor soft tiss face/scalp subq < 2cm $149.18<br />
21012-00 excision tumor soft tiss face/scalp subq 2+cm $160.88<br />
21013-00 exc tumor soft tiss face&scalp subfascial < 2cm $232.05<br />
21014-00 exc tumor soft tiss face&scalp subfascial 2+cm $247.65<br />
21015-00 rad resection tumor soft tiss face/scalp < 2cm $342.23<br />
21016-00 rad resection tumor soft tiss face/scalp 2+cm $376.35<br />
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