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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
3 | OPERATION ON 2 OR MORE EXTRAOCULAR MUSCLES (1 OR BOTH EYES)1 | 90081-00[220] | 420257 | 9008100 | Y | 6,435.00 | |
3 | OPERATIONVITREOUS | 90078-00[208] | 420258 | 9007800 | Y | 22,500.00 | |
0 | OPHTHALMODYNAMOMETRY | 420259 | 92260 | 80 | |||
0 | OPHTHALMOSCOPY | 42503-00[160] | 420260 | 40 | |||
0 | OPTHALMIC BIOMETRY BY B-SCAN + A-SCAN | 55030-00[1940] | 420261 | 76510 | 520 | ||
0 | OPTHALMIC ULTRASOUND B-SCAN | 55030-00[1940] | 420262 | 76512 | 440 | ||
0 | OPTHALMIC ULTRASOUND, ECHOGRAPHY A SCAN | 55030-00[1940] | 420263 | 76511 | 360 | ||
0 | OPTIC NERVE TOPOGRAPHY | 42503-001 | 420264 | 450 | |||
1 | Optical coherence Tomography (OCT) AS ADDITIONAL | 420265 | Y | 9,000.00 | |||
SERVICE * CORONARY INTERVENTION | |||||||
0 | ORBIT CYST REMOVAL | 42575-001 | 420266 | 3,900.00 | |||
0 | ORBIT EXENTERATION | 42536-001 | 420267 | 7,100.00 |
OPERATION ON 2 OR MORE EXTRAOCULAR MUSCLES (1 OR BOTH EYES)1
6,435.00
OPERATIONVITREOUS
22,500.00
OPHTHALMODYNAMOMETRY
80
OPHTHALMOSCOPY
40
OPTHALMIC BIOMETRY BY B-SCAN + A-SCAN
520
OPTHALMIC ULTRASOUND B-SCAN
440
OPTHALMIC ULTRASOUND, ECHOGRAPHY A SCAN
360
OPTIC NERVE TOPOGRAPHY
450
Optical coherence Tomography (OCT) AS ADDITIONAL
9,000.00
SERVICE * CORONARY INTERVENTION
ORBIT CYST REMOVAL
3,900.00
ORBIT EXENTERATION
7,100.00
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