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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | RECONSTRUCTION- EYELID | 45614-00[1684] | 420317 | 4561400 | 1,600.00 | ||
1 | RECONSTRUCTION OF EYELID WITH FLAPS OR | 45671-01[1684] | 420318 | 4567101 | Y | 7,920.00 | |
GRAFTS1 | |||||||
1 | RECONSTRUCTIONEYELID | 45614-00[1684] | 420319 | 4561400 | Y | 15,000.00 | |
1 | RECURRENT PTERYGIUM | 420320 | 4268300 | Y | 5,250.00 | ||
1 | RECURRENT PTOSIS | 420321 | 4562302 | Y | 9,000.00 | ||
1 | RECURRENT PTYREGIUM W/GRAFTING | 420322 | 4264100 | Y | 6,000.00 | ||
1 | REFRACTIVE SURGERY - LASIK | 42671-011 | 420323 | Y | 10,300.00 | ||
0 | REMOVAL CONJUNCTIVAL CYST | 42632-01[252] | 420324 | 4263201 | 200 | ||
0 | REMOVAL- CONJUNCTIVAL PAPILLAE | 42632-01[252] | 420325 | 4263201 | 160 | ||
0 | REMOVAL CORNEAL GRAFT SUTURE (DAY CASE) (GA) | 42668-00[166] | 420326 | 4266800 | 2,000.00 | ||
0 | REMOVAL- CORNEAL SUTURE (GA) | 42668-00[166] | 420327 | 4266800 | 1,200.00 |
RECONSTRUCTION- EYELID
1,600.00
RECONSTRUCTION OF EYELID WITH FLAPS OR
7,920.00
GRAFTS1
RECONSTRUCTIONEYELID
15,000.00
RECURRENT PTERYGIUM
5,250.00
RECURRENT PTOSIS
9,000.00
RECURRENT PTYREGIUM W/GRAFTING
6,000.00
REFRACTIVE SURGERY - LASIK
10,300.00
REMOVAL CONJUNCTIVAL CYST
200
REMOVAL- CONJUNCTIVAL PAPILLAE
160
REMOVAL CORNEAL GRAFT SUTURE (DAY CASE) (GA)
2,000.00
REMOVAL- CORNEAL SUTURE (GA)
1,200.00
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