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 />
61710-00 arysm vasc malfrmj ia embolization $1,401.00<br />
61711-00 anast artl xtrc-icra arts $2,195.00<br />
61720-00 crtj les strtctc burr globus pallidus/thalamus $1,332.00<br />
61735-00 crtj les strtctc burr subcortical strux oth/thn $1,082.00<br />
61750-00 strtctc bx aspir/exc burr icra les $1,139.00<br />
61751-00 strtctc bx aspir/exc burr icra les w/ct&/mrg $1,337.00<br />
61760-00 strtctc impltj <strong>el</strong>trd cerebrum seizure mntr $1,200.00<br />
61770-00 strtctc loclzj insj cath/prb plmt radj src $1,200.00<br />
61781-00 strtctc cptr asstd px idrl crnl $137.48<br />
61782-00 strtctc cptr asstd px xdrl crnl $115.22<br />
61783-00 strtctc cptr asstd px spinal $130.65<br />
61790-00 crtj les strtctc prq nulyt gasserian $909.00<br />
61791-00 crtj les strtctc prq nulyt trigeminal trc $825.00<br />
61850-00 tdh/burr impltj nstim <strong>el</strong>trd cortical $658.00<br />
61860-00 crnec/crx impltj nstim <strong>el</strong>trd cere cortical $1,095.00<br />
61863-00 strtctc impltj nstim <strong>el</strong>trd w/o mer 1st ra $810.00<br />
61864-00 strtctc impltj nstim <strong>el</strong>trd w/o mer ea ra $229.00<br />
61867-00 strtctc impltj nstim <strong>el</strong>trd w/mer 1st ra $1,205.00<br />
61868-00 strtctc impltj nstim <strong>el</strong>trdw/mer ea ra $381.00<br />
61870-00 crnec impltj nstim <strong>el</strong>trd cereb<strong>el</strong>lar cortical $796.00<br />
61875-00 crnec impltj nstim <strong>el</strong>trd cereb<strong>el</strong>lar subcortical $775.00<br />
61880-00 revj/rmvl icra nstim <strong>el</strong>trds $375.00<br />
61885-00 insj/rplcmt crnl npgr 1 <strong>el</strong>trd ra $335.00<br />
61886-00 insj/rplcmt crnl npgr 2+ <strong>el</strong>trd ra $457.00<br />
61888-00 revj/rmvl crnl npgr $290.00<br />
62000-00 <strong>el</strong>vtn deprs skl fx smpl xdrl $731.25<br />
62005-00 <strong>el</strong>vtn deprs skl fx compound/commind xdrl $1,000.00<br />
62010-00 <strong>el</strong>vtn deprs skl fx w/rpr dura&/dbrdmt brn $1,220.00<br />
62100-00 crx rpr dural/csf leak rhinorrhea/otorrhea $975.00<br />
62115-00 rdctj craniomegalic skl x w/b1 grfs/crnop $1,400.00<br />
62116-00 rdctj craniomegalic skl w/smpl crnop $1,500.00<br />
62117-00 rdctj craniomegalic req crx&rcnstj +-b1 grf $1,600.00<br />
62120-00 rpr <strong>en</strong>cephaloc<strong>el</strong>e skl vault w/crnop $1,033.50<br />
62121-00 craniotomy for <strong>en</strong>cephaloc<strong>el</strong>e repair skull base $1,225.00<br />
62140-00 cranioplasty skull defect up to 5 cm diameter $850.00<br />
62141-00 cranioplasty skull defect larger than 5 cm diam $1,039.00<br />
62142-00 rmvl b1 flap/prostc plate skl $802.00<br />
62143-00 rplcmt b1 flap/prostc plate skl $705.00<br />
62145-00 cranioplasty skull defect re<strong>para</strong>tive brain surg $994.00<br />
62146-00 crnop w/agrft up 5 cm diam $745.88<br />
62147-00 crnop w/agrft > 5 cm diam $1,018.00<br />
62148-00 incise&retrieval subq cranioplasty bone graft $94.00<br />
62160-00 nundsc icra plmt/rplcmt v<strong>en</strong>tr cath shunt sys $135.00<br />
62161-00 nundsc icra dsj ads f<strong>en</strong>estration septum csts $968.00<br />
62162-00 nundsc icra f<strong>en</strong>estration/exc cst plmt cath drg $1,243.00<br />
62163-00 nundsc icra w/retrieval fb $787.30<br />
62164-00 nundsc icra exc tum plmt cath drg $1,344.00<br />
62165-00 nundsc icra exc pituitary tum $1,052.00<br />
62180-00 v<strong>en</strong>triculocisternostomy $1,238.25<br />
62190-00 crtj shunt sarach/sdrl-atr-jug-aur $1,043.25<br />
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