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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
3 | MENISCECTOMY-KNEE(ARTHROSCOPIC) | 49560-03[1503] | 620481 | 4956003 | Y | 7,500.00 | |
1 | MOBILIZATION OF FROZEN SHOULDER-G.A. | 620485 | 9060001 | Y | 2,250.00 | ||
1 | MOBILIZATION OF JOINTS OTHER THAN SPINE (EXAM. | 620486 | Y | 2,475.00 | |||
1 | MOBILIZATION OF SPINE UNDER G.A1 | 620487 | Y | 2,970.00 | |||
0 | MULTI P CDH OPEN REDN+PELVIC O | 620488 | 12,900.00 | ||||
0 | MULTI PR CDH OPEN REDN+FEM OST | 620489 | 12,900.00 | ||||
0 | MULTI PROC CDH OPEN REDN+BOTH | 620490 | 15,900.00 | ||||
0 | NERVE REPAIR | 39300-00[83] | 620491 | 3930000 | 4,600.00 | ||
0 | O.R.&F.W/S.T.W.S&B.MCARPUS | 620492 | 4735100 | 6,500.00 | |||
0 | O.R.&F.W/S.T.W.S&B.MTA | 620493 | 4734200 | 6,500.00 | |||
0 | O.R.&F.W/S.TW,S&B FEMUR | 620494 | 4752800 | 7,500.00 | |||
0 | O.R.&F.W/S.TW,S&B HUMERUS | 620495 | 4745000 | 7,500.00 |
MENISCECTOMY-KNEE(ARTHROSCOPIC)
7,500.00
MOBILIZATION OF FROZEN SHOULDER-G.A.
2,250.00
MOBILIZATION OF JOINTS OTHER THAN SPINE (EXAM.
2,475.00
MOBILIZATION OF SPINE UNDER G.A1
2,970.00
MULTI P CDH OPEN REDN+PELVIC O
12,900.00
MULTI PR CDH OPEN REDN+FEM OST
12,900.00
MULTI PROC CDH OPEN REDN+BOTH
15,900.00
NERVE REPAIR
4,600.00
O.R.&F.W/S.T.W.S&B.MCARPUS
6,500.00
O.R.&F.W/S.T.W.S&B.MTA
6,500.00
O.R.&F.W/S.TW,S&B FEMUR
7,500.00
O.R.&F.W/S.TW,S&B HUMERUS
7,500.00
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