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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
(LA) | |||||||
0 | I AND D- LACRIMAL SAC (DACRYOCYSTOSTOMY/ | 42596-00[244] | 420166 | 4259600 | 2,000.00 | ||
DACROCYSTOTOMY) | |||||||
0 | ICCE | 42698-001 | 420167 | 2,600.00 | |||
0 | ICCE + IOL WITHOUT IMPLANT | 42702-011 | 420168 | 3,000.00 | |||
3 | INCISION and DRAINAGE OF NASOLACRIMAL DUCT1 | 42596-03[244] | 420169 | 4259603 | Y | 2,475.00 | |
0 | INCISION AND ADJUSTMENT OF LENS PROSTHESIS | 420170 | 4270401 | 2,800.00 | |||
3 | INCISION OF LACRIMAL CYST WITH DRAINAGE1 | 42596-00[244] | 420171 | 4259600 | Y | 2,475.00 | |
0 | INDIRECT OPHTHALMOSCOPY | 42503-001 | 420172 | 130 | |||
0 | INDOCYANINE GREEN ANGIOGRAPHY (ICG) | 420173 | 92240 | 1,000.00 | |||
0 | INJECTION- INTRAORBITAL (TENONS CAPSULE) | 420174 | 67500 | 280 | |||
0 | INJECTION OF INTRA-VITREAL (WITH MEDICATION BOTOX) | 18360-00[1552] | 420175 | 4274003 | 2,800.00 |
(LA)
I AND D- LACRIMAL SAC (DACRYOCYSTOSTOMY/
2,000.00
DACROCYSTOTOMY)
ICCE
2,600.00
ICCE + IOL WITHOUT IMPLANT
3,000.00
INCISION and DRAINAGE OF NASOLACRIMAL DUCT1
2,475.00
INCISION AND ADJUSTMENT OF LENS PROSTHESIS
2,800.00
INCISION OF LACRIMAL CYST WITH DRAINAGE1
2,475.00
INDIRECT OPHTHALMOSCOPY
130
INDOCYANINE GREEN ANGIOGRAPHY (ICG)
1,000.00
INJECTION- INTRAORBITAL (TENONS CAPSULE)
280
INJECTION OF INTRA-VITREAL (WITH MEDICATION BOTOX)
2,800.00
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