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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | LAVAGE - SINUS, BILATERAL (GA) | 41704-00[382] | 360219 | 4170400 | 2,800.00 | ||
0 | LIGATION - INTERNAL MAXILLARY ARTERY, | 41707-00[697] | 360220 | 4170700 | 3,680.00 | ||
TRANSANTRAL | |||||||
0 | LIGATION ETHMOID ART. | 41737-01 | 360221 | 4,800.00 | |||
3 | LIMITED RHINOLASTY OR PLASTIC REP. OF NASALABIAL FLAP1 | 20--[1679]45206-01[1 | 360223 | 4563201 | Y | 8,415.00 | |
0 | LYSIS - INTRA NASAL SYNECHIA | 41683-00[372] | 360224 | 4168300 | 2,200.00 | ||
0 | LYSIS - NASAL ADHESIONS BY LASER | 41683-00[372] | 360225 | 30117 | 4,000.00 | ||
0 | LYSIS- NASAL ADHESIONS (LA) | 41683-00[372] | 360226 | 800 | |||
3 | MARSUPIALIZATION OF BARTHOLIN GLAND (OR CYST)1 | 35520-00[1290] | 360227 | 3552000 | Y | 2,970.00 | |
3 | MARSUPIALIZATION OF LARYNGEAL CYST1 | 90164-00[ | 360228 | 9016400 | Y | 4,950.00 | |
3 | MASTECTOMY IN MALES W/ HISTOPATHOLOGY | 360229 | 3152401 | Y | 9,000.00 | ||
MASTOIDECTOMY- SIMPLE | 41545-00[323] | 360230 | 4154500 | 4,000.00 |
LAVAGE - SINUS, BILATERAL (GA)
2,800.00
LIGATION - INTERNAL MAXILLARY ARTERY,
3,680.00
TRANSANTRAL
LIGATION ETHMOID ART.
4,800.00
LIMITED RHINOLASTY OR PLASTIC REP. OF NASALABIAL FLAP1
8,415.00
LYSIS - INTRA NASAL SYNECHIA
2,200.00
LYSIS - NASAL ADHESIONS BY LASER
4,000.00
LYSIS- NASAL ADHESIONS (LA)
800
MARSUPIALIZATION OF BARTHOLIN GLAND (OR CYST)1
2,970.00
MARSUPIALIZATION OF LARYNGEAL CYST1
4,950.00
MASTECTOMY IN MALES W/ HISTOPATHOLOGY
9,000.00
MASTOIDECTOMY- SIMPLE
4,000.00
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