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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | EXCISION CORNEAL DERMOID CYST | 42647-00[170] | 420129 | 4264700 | 3,200.00 | ||
0 | EXCISION EYELID (TARSECTOMY) | 45665-01[1662] | 420130 | 4566501 | 1,200.00 | ||
0 | EXCISION- EYELID LESION + REPAIR (GA) | 45626-01[239] | 420131 | 4562601 | 3,200.00 | ||
0 | EXCISION- EYELID LESION + REPAIR (LA) | 45626-01[239] | 420132 | 4562601 | 1,280.00 | ||
0 | EXCISION OF LACRIMAL GLAND | 42593-00[246] | 420133 | 4259300 | 2,000.00 | ||
(DACRYOADENECTOMY- PARTIAL) | |||||||
0 | EXCISION OF LACRIMAL GLAND | 42593-00[246] | 420134 | 4259300 | 2,800.00 | ||
(DACRYOADENECTOMY-TOTAL) | |||||||
0 | EXCISION OF LACRIMAL SAC (DACRYOCYSTECTOMY) | 42596-01[246] | 420135 | 4259601 | 2,400.00 | ||
3 | EXCISION OF LESION OF ORBIT | 42574-00[226] | 420136 | 4257400 | Y | 12,000.00 | |
0 | EXCISION OF PTERYGIUM | 42686-00[172] | 420137 | 4268600 | 2,000.00 | ||
3 | EXCISION OF PTERYGIUM (LIMBAL CYST)1 | 42686-00[172] | 420138 | 4268600 | Y | 2,970.00 |
EXCISION CORNEAL DERMOID CYST
3,200.00
EXCISION EYELID (TARSECTOMY)
1,200.00
EXCISION- EYELID LESION + REPAIR (GA)
3,200.00
EXCISION- EYELID LESION + REPAIR (LA)
1,280.00
EXCISION OF LACRIMAL GLAND
2,000.00
(DACRYOADENECTOMY- PARTIAL)
EXCISION OF LACRIMAL GLAND
2,800.00
(DACRYOADENECTOMY-TOTAL)
EXCISION OF LACRIMAL SAC (DACRYOCYSTECTOMY)
2,400.00
EXCISION OF LESION OF ORBIT
12,000.00
EXCISION OF PTERYGIUM
2,000.00
EXCISION OF PTERYGIUM (LIMBAL CYST)1
2,970.00
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