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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | FONTAN | 310092 | 33617 | 45,000.00 | |||
0 | FRACTIONAL FLOW RATIO (FFR) | 38588-00[642] | 310094 | 3858800 | 7,500.00 | ||
11 | FRACTIONAL FLOW RATIO (FFR) AS ADDITIONAL SERVICE * CORONARY INTERVENTION | 310095 | Y | 7,500.00 | |||
0 | GLENN SHUNT | 40012-01[19] | 310097 | 4001201 | 50,000.00 | ||
1 | HOLTER MONITORING-24 HOURS * Inpatient services | 11709-00[1853] | 310099 | 1170900 | Y | 2,500.00 | |
0 | ICD ( DUAL) | 38353-00[650] | 310100 | 3835300 | 80,000.00 | ||
0 | ICD ) DUAL | 38353-00[650] | 310102 | 80,000.00 | |||
1 | ICD ) DUAL * ELECTROPHYSIOLOGY | 310103 | Y | 90,000.00 | |||
0 | ICD ) SINGLE | 38353-00[650] | 310104 | 75,000.00 | |||
1 | ICD ) SINGLE * ELECTROPHYSIOLOGY | 310105 | Y | 85,000.00 | |||
0 | Impella | 38618-00[608] | 310106 | 3861500 | 130,000.00 | ||
3 | INSERTION OF PERMANENT TRANSTHORACIC PACEMAKER | 38350-00[648] | 310108 | 3835000 | Y | 25,500.00 |
FONTAN
45,000.00
FRACTIONAL FLOW RATIO (FFR)
7,500.00
FRACTIONAL FLOW RATIO (FFR) AS ADDITIONAL SERVICE * CORONARY INTERVENTION
7,500.00
GLENN SHUNT
50,000.00
HOLTER MONITORING-24 HOURS * Inpatient services
2,500.00
ICD ( DUAL)
80,000.00
ICD ) DUAL
80,000.00
ICD ) DUAL * ELECTROPHYSIOLOGY
90,000.00
ICD ) SINGLE
75,000.00
ICD ) SINGLE * ELECTROPHYSIOLOGY
85,000.00
Impella
130,000.00
INSERTION OF PERMANENT TRANSTHORACIC PACEMAKER
25,500.00
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