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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | I AND D ABSCESS � SIMPLE | 320144 | 40800 | 80 | |||
0 | I&D OF ABCESS INTRA/EXTRA ORAL | 96215-00[401] | 320145 | 750 | |||
0 | INTERMAXILLARY FIXATION, SLPINTS PER ARCH | 52096-00[1360] | 320146 | 21445 | 1,200.00 | ||
0 | INVISALIGN INSERTION,EACH VISIT | 320147 | 1,320.00 | ||||
3 | MANDIBULECTOMY-PARTIAL | 45605-00[1699] | 320148 | 4560600 | Y | 30,000.00 | |
3 | MANDIBULECTOMY-TOTAL-WITH SYNCHRONOUS | 45599-00[1699] | 320149 | 4559900 | Y | 52,500.00 | |
0 | MENISECTOMY TMJ | 45869-00[1362] | 320150 | 21060 | 3,600.00 | ||
0 | MICRO / MACRO ABRASION | 320151 | 117303 | 80 | |||
0 | MUCOGINGIVAL SURGERY / CONNECTIVE TISSUE | 97235-00[456] | 320155 | 2004250 | 1,680.00 | ||
GRAFT /TOOTH | |||||||
0 | MUCOGINGIVAL SURGERY / GINGIVAL TISSUE GRAFT | 97235-00[456] | 320156 | 2004250 | 1,600.00 | ||
/TOOTH |
I AND D ABSCESS � SIMPLE
80
I&D OF ABCESS INTRA/EXTRA ORAL
750
INTERMAXILLARY FIXATION, SLPINTS PER ARCH
1,200.00
INVISALIGN INSERTION,EACH VISIT
1,320.00
MANDIBULECTOMY-PARTIAL
30,000.00
MANDIBULECTOMY-TOTAL-WITH SYNCHRONOUS
52,500.00
MENISECTOMY TMJ
3,600.00
MICRO / MACRO ABRASION
80
MUCOGINGIVAL SURGERY / CONNECTIVE TISSUE
1,680.00
GRAFT /TOOTH
MUCOGINGIVAL SURGERY / GINGIVAL TISSUE GRAFT
1,600.00
/TOOTH
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