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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
1 | REMOVAL OF IMPLANTED LENS1 | 42704-00[194] | 420336 | 4270400 | Y | 3,960.00 | |
2 | REMOVAL OF VITREOUS ANTERIOR APPROACH1 | 42719-01[207] | 420337 | 4271901 | Y | 6,732.00 | |
0 | MEMBRANECTOMY | 42719-021 | 420244 | 2,800.00 | |||
0 | MIRROR FUNDOSCOPY | 42503-001 | 420245 | 130 | |||
0 | MIRROR-3 FUNDOSCOPY | 420246 | 80 | ||||
0 | MOLTENO VAL. IMPLT. VAL EXCLD. | 42752-001 | 420250 | 2,800.00 | |||
1 | MUCOUS MEM.GRAFTING/TRICHIASIS | 420251 | 67835 | Y | 6,000.00 | ||
0 | MUCOUS MEMBRANE GRAFT | 42641-001 | 420252 | 2,800.00 | |||
0 | MUSCLE INJURY REPAIR | 42530-021 | 420253 | 4,300.00 | |||
0 | OCULAR BLOOD FLOW (OBF) ANALYSIS | 420254 | 9091100 | 290 | |||
0 | OCULAR MUSCLE BOTOX INJECTION | 18360-00[1552] | 420255 | 9008100 | 1,372.00 | ||
0 | OCULAR PARACENTESIS | 90061-001 | 420256 | 1,300.00 |
REMOVAL OF IMPLANTED LENS1
3,960.00
REMOVAL OF VITREOUS ANTERIOR APPROACH1
6,732.00
MEMBRANECTOMY
2,800.00
MIRROR FUNDOSCOPY
130
MIRROR-3 FUNDOSCOPY
80
MOLTENO VAL. IMPLT. VAL EXCLD.
2,800.00
MUCOUS MEM.GRAFTING/TRICHIASIS
6,000.00
MUCOUS MEMBRANE GRAFT
2,800.00
MUSCLE INJURY REPAIR
4,300.00
OCULAR BLOOD FLOW (OBF) ANALYSIS
290
OCULAR MUSCLE BOTOX INJECTION
1,372.00
OCULAR PARACENTESIS
1,300.00
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