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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | POLYDACTYL 2 FINGERS | 47906-01[1632] | 640091 | 4790601 | 5,600.00 | ||
0 | POLYDACTYLY (1 FINGER)-SIMPLE | 47906-01[1632] | 640092 | 4790601 | 1,900.00 | ||
0 | PROMINENT EARS (BILATERAL) | 45665-021 | 640093 | 7,700.00 | |||
0 | PROMINENT EARS (UNILATERAL) | 45665-021 | 640094 | 5,200.00 | |||
0 | PTOSIS (BILATERAL) | 45588-001 | 640095 | 5,800.00 | |||
0 | REFASHIO.OF AMPUTATION STUMP | 90675-001 | 640096 | 4,800.00 | |||
0 | RELEASE CONTRACT.BY SG (MAJ) | 45519-001 | 640097 | 7,700.00 | |||
0 | RELEASE CONTRACT.BY SG (MED) | 45519-001 | 640098 | 5,800.00 | |||
0 | RELEASE CONTRACT.BY SG (SM) | 45519-001 | 640099 | 3,200.00 | |||
0 | RELEASE CONTRACT.Z-PLAST(SM) | 45519-001 | 640100 | 2,600.00 | |||
0 | RELEASE CONTRCT.ZPLASTY(MAJ) | 45519-001 | 640101 | 5,600.00 | |||
0 | RELEASE CONTRCT.ZPLASTY(MED) | 45519-001 | 640102 | 4,000.00 |
POLYDACTYL 2 FINGERS
5,600.00
POLYDACTYLY (1 FINGER)-SIMPLE
1,900.00
PROMINENT EARS (BILATERAL)
7,700.00
PROMINENT EARS (UNILATERAL)
5,200.00
PTOSIS (BILATERAL)
5,800.00
REFASHIO.OF AMPUTATION STUMP
4,800.00
RELEASE CONTRACT.BY SG (MAJ)
7,700.00
RELEASE CONTRACT.BY SG (MED)
5,800.00
RELEASE CONTRACT.BY SG (SM)
3,200.00
RELEASE CONTRACT.Z-PLAST(SM)
2,600.00
RELEASE CONTRCT.ZPLASTY(MAJ)
5,600.00
RELEASE CONTRCT.ZPLASTY(MED)
4,000.00
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