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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
2
SYMPATHECTOMYPERIARTERIAL
90014-00[81]
650221
9001400
Y
7,500.00
2
SYMPATHECTOMYPRESACRAL
35012-00[81]
650222
3501200
Y
10,500.00
0
TEMP./PERM. LIG.EXT. CAROTID
34115-00
650223
4,900.00
0
THROMBECTOMY OF ILIAC VEIN
33812-041
650224
7,700.00
0
THROMBECTOMY-ARTERIAL/VEN.GRFT
13106-00
650225
3,900.00
0
THROMBECTOMY-FEM/POPLIT VEIN
33812-001
650226
7,700.00
0
THROMBECTOMY-S.CLAVIAN/AXILY V
33812-031
650227
4,500.00
0
THROMBECTOMY-VENA CAVA/ILIAC V
33812-04
650228
9,900.00
0
TRAN.CATH.THRPY.FOR INF-THROMB
650229
2,600.00
0
ULNAR ARTERY EMBOLECTOMY
33806-031
650230
5,800.00
2
UNI.EXC.OF VESSELS(MULTI.AVULSION OF VARICOSE
32508-00[727]
650231
3250800
Y
3,960.00
0
VALVE TRANSPL FOR CH.VEN INSUF
34821-00[736]
650232
3482100
7,700.00
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