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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | FRACT.MAX.LEFORT II ZYGOMATIC SUSP(CLOSE) | 320132 | 2007660 | 7,000.00 | |||
0 | FRACT.MAX.LEFORT III FRONTAL SUSP(CLOSE) | 320133 | 21139 | 9,300.00 | |||
0 | FRACTURE, ALVEOLAR, DEBRIDEMENT, TEETH REMOVAL � MAJOR | 97415-00[462] | 320134 | 21445 | 2,560.00 | ||
0 | FRACTURE, ALVEOLAR, DEBRIDEMENT, TEETH REMOVAL - MINOR. | 97434-00[463] | 320135 | 21440 | 2,000.00 | ||
0 | FRENECTOMY � GA | 320136 | 2007960 | 1,200.00 | |||
0 | FRENECTOMY � LA | 320137 | 41115 | 800 | |||
1 | GINGIRECTOMY UNDER G.A. | 97231-00[456] | 320138 | 9723100 | Y | 1,800.00 | |
1 | GINGIVECTOMY UNDER L.A. | 97231-00[456] | 320139 | 9723100 | Y | 900 | |
3 | GLOSSECTOMY-COMPLETE | 41779-01[392] | 320140 | 4177901 | Y | 27,000.00 | |
3 | GLOSSECTOMY-RADIACAL | 41779-01[392] | 320141 | 4177901 | Y | 30,000.00 | |
0 | GUM TREATMENT | 320142 | 260 | ||||
0 | GUM TREATMENT - COMPLEX | 320143 | 20011101 | 270 |
FRACT.MAX.LEFORT II ZYGOMATIC SUSP(CLOSE)
7,000.00
FRACT.MAX.LEFORT III FRONTAL SUSP(CLOSE)
9,300.00
FRACTURE, ALVEOLAR, DEBRIDEMENT, TEETH REMOVAL � MAJOR
2,560.00
FRACTURE, ALVEOLAR, DEBRIDEMENT, TEETH REMOVAL - MINOR.
2,000.00
FRENECTOMY � GA
1,200.00
FRENECTOMY � LA
800
GINGIRECTOMY UNDER G.A.
1,800.00
GINGIVECTOMY UNDER L.A.
900
GLOSSECTOMY-COMPLETE
27,000.00
GLOSSECTOMY-RADIACAL
30,000.00
GUM TREATMENT
260
GUM TREATMENT - COMPLEX
270
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