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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
2 | REPAIR OF REC. RETINAL DETACHMENT | 90079-00[212] | 420361 | 9007900 | Y | 10,500.00 | |
2 | REPAIR OF RECURRENT PTOSIS | 45623-05[1677] | 420362 | 4562305 | Y | 9,750.00 | |
0 | REPAIR- OPEN WOUND W/ PROLAPSE (EYE) | 42554-00[162] | 420363 | 4255400 | 3,600.00 | ||
0 | REPAIR- ORBITAL SOCKET | 90082-00[228] | 420364 | 9008200 | 3,200.00 | ||
1 | REPAIR- PTERYGIUM (DAY CASE) | 90089-00[256] | 420365 | 9008900 | Y | 3,200.00 | |
0 | REPAIR- PTOSIS (BLEPHAROPTOSIS) | 45588-01[1675] | 420366 | 4558801 | 2,800.00 | ||
0 | REPAIR- PTOSIS BY LEVATOR MUSCLE RESECTION | 45623-03[1677] | 420367 | 4562303 | 2,000.00 | ||
0 | REPAIR- PTOSIS W/FACIAL SLING | 45623-01[1677] | 420368 | 4562301 | 2,000.00 | ||
0 | REPAIR- RETINAL DETACHMENT | 90079-00[212] | 420369 | 9007900 | 4,000.00 | ||
0 | REPAIR- RETINAL DETACHMENT (CRYOTHERAPY/ DIATHERMY) | 42773-01[212] | 420370 | 4277301 | 2,000.00 | ||
0 | REPAIR- RETINAL DETACHMENT BY PHOTOCOAGULATION/ LASER | 42809-01[212] | 420371 | 4280901 | 1,280.00 | ||
0 | REPAIR- RETINAL DETACHMENT BY SCLERAL | 42776-00[212] | 420372 | 4277600 | 3,600.00 |
REPAIR OF REC. RETINAL DETACHMENT
10,500.00
REPAIR OF RECURRENT PTOSIS
9,750.00
REPAIR- OPEN WOUND W/ PROLAPSE (EYE)
3,600.00
REPAIR- ORBITAL SOCKET
3,200.00
REPAIR- PTERYGIUM (DAY CASE)
3,200.00
REPAIR- PTOSIS (BLEPHAROPTOSIS)
2,800.00
REPAIR- PTOSIS BY LEVATOR MUSCLE RESECTION
2,000.00
REPAIR- PTOSIS W/FACIAL SLING
2,000.00
REPAIR- RETINAL DETACHMENT
4,000.00
REPAIR- RETINAL DETACHMENT (CRYOTHERAPY/ DIATHERMY)
2,000.00
REPAIR- RETINAL DETACHMENT BY PHOTOCOAGULATION/ LASER
1,280.00
REPAIR- RETINAL DETACHMENT BY SCLERAL
3,600.00
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