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OCTA Procedural Pricing Request Form
If you are unable to find the information you need in the
research fee schedule
or i
f you need price estimates for costs billed in APeX for procedures that involve
multiple CPT codes
(like bone marrow biopsy and aspirate, lumbar puncture, liver or kidney biopsy, or any procedure involving anesthesia, the operating room, specialty room, treatment room, or recovery room/post-anesthesia care unit)
, please complete this form and an OCTA analyst will get back to you in approximately 5 business days.
This request form is NOT for general pricing such as effort-related activities or medications; for medications please see
Budgeting Resources
and complete the
IDS intake request form
.
If OCTA is preparing your full study budget, you do NOT need to complete this form.
Study contact name
Contact email
Study Identifier (UCSF IRB#/ OnCore#/ P#)
Principal Investigator
Principal Investigator Department
Sponsor Type
Industry
NIH
Non-Profit
Gift / Discretionary Funds
Other
Sponsor Name
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