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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | RHINOPLASY - COSMETIC | 90684-001 | 640116 | 10,800.00 | |||
0 | SKIN BIOPSY BENIGN LES.DC-LA | 45442-001 | 640117 | 1,400.00 | |||
0 | SKIN FLAP (MAJOR) | 45212-00 | 640118 | 7,100.00 | |||
0 | SKIN FLAP (MEDIUM) | 45200-001 | 640119 | 5,400.00 | |||
0 | SKIN FLAP (SMALL) | 45200-00 | 640120 | 3,200.00 | |||
0 | SKIN GRAFT (MAJOR) | 45442-00 | 640121 | 5,600.00 | |||
0 | SKIN GRAFT (MEDIUM) | 45442-00 | 640122 | 3,900.00 | |||
0 | SKIN GRAFT SMALL | 45442-00 | 640123 | 2,400.00 | |||
0 | SMALL JOINT ARTHRODESIS | 5019-00[1571] | 640124 | 501900 | 5,400.00 | ||
0 | SMALL LOCAL FLAP | 30554-01 | 640125 | 2,600.00 | |||
0 | SMALL LOCAL FLAP DIVISION (LA) | 30554-01 | 640126 | 1,300.00 | |||
0 | SPLIT SKIN GRAFT APPLICAT(L)GA | 90668-011 | 640127 | 3,900.00 |
RHINOPLASY - COSMETIC
10,800.00
SKIN BIOPSY BENIGN LES.DC-LA
1,400.00
SKIN FLAP (MAJOR)
7,100.00
SKIN FLAP (MEDIUM)
5,400.00
SKIN FLAP (SMALL)
3,200.00
SKIN GRAFT (MAJOR)
5,600.00
SKIN GRAFT (MEDIUM)
3,900.00
SKIN GRAFT SMALL
2,400.00
SMALL JOINT ARTHRODESIS
5,400.00
SMALL LOCAL FLAP
2,600.00
SMALL LOCAL FLAP DIVISION (LA)
1,300.00
SPLIT SKIN GRAFT APPLICAT(L)GA
3,900.00
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