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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
21
HYPOPLASTIC LEFT HEART SYNDROME REPAIR (NORWOOD) * CARDIAC SURGERY
660045
Y
136,500.00
5
Impella * Inpatient services
660046
Y
135,000.00
3
IMPLANTATION HEART ASSIST SYSTEMOTHER
38393-00[653]
660047
3839300
Y
37,500.00
3
IMPLANTATION PULSATION BALLOON
38362-00[682]
660048
3836200
Y
37,500.00
2
INSERTION OF SWANZ GANZ CATHETER as additional procedure * Inpatient services
13818-00[657]
660049
1381800
Y
4,500.00
3
INSERTION-INFUSION PUMPTOTALLY IMPLANTABLE
39127-00[39]
660050
3912700
Y
37,500.00
12
INTERRUPTED AORTIC ARCH REPAIR * CARDIAC SURGERY
660051
Y
72,000.00
3
INTERRUPTIONVENA CAVA
34800-00[726]
660052
348000
Y
52,500.00
2
INTRA-AORTIC BALLOON INSERTION AS ADDITIONAL
38362-00[682]
660053
3836200
Y
20,000.00
SERVICE * CORONARY INTERVENTION
10
KAWASHIMA PROCEDURE * CARDIAC SURGERY
660054
Y
61,000.00
10
KONNO PROCEDURE * CARDIAC SURGERY
660055
Y
61,000.00
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