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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | ARTHROPLASTY ELBOW - HEMI | 90536-00[1418] | 620119 | 9053600 | 9,000.00 | ||
0 | ARTHROPLASTY ELBOW - TOTAL | 49115-00[1418] | 620120 | 4911500 | 10,300.00 | ||
0 | ARTHROPLASTY HIP BIPOLAR | 620121 | 4931800 | 12,900.00 | |||
0 | ARTHROPLASTY- METACARPO/ TARSO PHALANGEAL JOINT (SMALL JOINTS) (W/MATERIAL COST 300/ -) | 620122 | 4630901 | 4,400.00 | |||
0 | ARTHROPLASTY OF WRIST | 49209-00[1468] | 620123 | 4920905 | 9,700.00 | ||
0 | ARTHROPLASTY-EACH ADDIT. JOINT | 620124 | 3,800.00 | ||||
0 | ARTHROPLASTY-EACH ADDITIONAL JOINT (SMALL | 620125 | 2,000.00 | ||||
JOINTS) (W/MATERIAL COST 300/-) | |||||||
2 | ARTHROPLASTYTEMPOROMANDIBULAR | 45758-00[1712] | 620126 | 4575800 | Y | 18,000.00 | |
2 | ARTHROSCOPIC ACL + PCL RECONSTRUCTION1 | 49539-00[1522] | 620127 | 4953900 | Y | 16,335.00 | |
0 | ARTHROSCOPIC REPAIR-1 MENISCUS | 45869-00[1362] | 620128 | 4586900 | 9,000.00 | ||
0 | ARTHROSCOPY - BIOPSY, MAJOR JOINT | 620129 | 4936000 | 3,600.00 |
ARTHROPLASTY ELBOW - HEMI
9,000.00
ARTHROPLASTY ELBOW - TOTAL
10,300.00
ARTHROPLASTY HIP BIPOLAR
12,900.00
ARTHROPLASTY- METACARPO/ TARSO PHALANGEAL JOINT (SMALL JOINTS) (W/MATERIAL COST 300/ -)
4,400.00
ARTHROPLASTY OF WRIST
9,700.00
ARTHROPLASTY-EACH ADDIT. JOINT
3,800.00
ARTHROPLASTY-EACH ADDITIONAL JOINT (SMALL
2,000.00
JOINTS) (W/MATERIAL COST 300/-)
ARTHROPLASTYTEMPOROMANDIBULAR
18,000.00
ARTHROSCOPIC ACL + PCL RECONSTRUCTION1
16,335.00
ARTHROSCOPIC REPAIR-1 MENISCUS
9,000.00
ARTHROSCOPY - BIOPSY, MAJOR JOINT
3,600.00
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