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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
1 | BILATERAL DACROCYSTORHINOSTOMY1 | 23-00[247]42623-00[ | 620177 | 4262300 | Y | 7,425.00 | |
1 | BILATERAL DIVISION OF SOFT TISSUE OF HAND | 3-00[1440]46363-00[ | 620178 | 4636300 | Y | 4,455.00 | |
(TRIGGER FINGE) | |||||||
3 | BILATERAL OPEN REDUCTION OF # FEMUR W/ INTER. | 8-01[1486]47528-01[ | 620179 | 4752801 | Y | 19,602.00 | |
FIXATION I.M. NAIL1 | |||||||
3 | BILATERAL PARTIAL OSTECTOMY (HIGH TIBIAL OSTEOTOMY)1 | 8-01[1504]48418-01[ | 620180 | 4841801 | Y | 14,355.00 | |
1 | BILATERAL REMOVAL OF IMPLANTED DEVICE FORM BONE1 | 0-00[1554]47930-00[ | 620181 | 4793000 | Y | 6,930.00 | |
3 | BILATERAL REPAIR OF CRUCIATE LIGAMENT (ARTHROTOMY | 9-00[1522]49539-00[ | 620182 | 4953900 | Y | 17,820.00 | |
0 | ARTHRODESIS- METACARPOPHALANGEAL/ METATARSOPHALANGEAL JOINT/TOE JOINTS- EACH ADDITIONAL JOINT (INCLUDING MATERIAL COST 200/-) | 620097 | 4630001 | 2,000.00 | |||
0 | ARTHRODESIS OF CERVICAL SPINE (ANT) | 620098 | 4866000 | 32,300.00 | |||
0 | ARTHRODESIS OF CERVICAL SPINE(POST) | 620099 | 4865700 | 25,800.00 | |||
0 | ARTHRODESIS OF WRIST | 49200-00[1468] | 620100 | 25800 | 7,700.00 |
BILATERAL DACROCYSTORHINOSTOMY1
7,425.00
BILATERAL DIVISION OF SOFT TISSUE OF HAND
4,455.00
(TRIGGER FINGE)
BILATERAL OPEN REDUCTION OF # FEMUR W/ INTER.
19,602.00
FIXATION I.M. NAIL1
BILATERAL PARTIAL OSTECTOMY (HIGH TIBIAL OSTEOTOMY)1
14,355.00
BILATERAL REMOVAL OF IMPLANTED DEVICE FORM BONE1
6,930.00
BILATERAL REPAIR OF CRUCIATE LIGAMENT (ARTHROTOMY
17,820.00
ARTHRODESIS- METACARPOPHALANGEAL/ METATARSOPHALANGEAL JOINT/TOE JOINTS- EACH ADDITIONAL JOINT (INCLUDING MATERIAL COST 200/-)
2,000.00
ARTHRODESIS OF CERVICAL SPINE (ANT)
32,300.00
ARTHRODESIS OF CERVICAL SPINE(POST)
25,800.00
ARTHRODESIS OF WRIST
7,700.00
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