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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
3 | PHLEBECTOMYW/ GRAFT REPLACEMENT- PREPHERAL VEIN - | 32766-01[733] | 650146 | 3276601 | Y | 81,000.00 | |
0 | POP.ART.ANEURCTOMY & BYPASS | 650147 | 3381805 | 10,300.00 | |||
0 | POPLIT AR.TRANSLUM ATHERECTOMY | 650148 | 3410304 | 4,500.00 | |||
0 | POPLITEAL ARTERY EMBOLECTOMY | 33806-10[702] | 650149 | 3380610 | 5,800.00 | ||
0 | POPLITEAL ARTERY EXPLORATION | 34103-04[695] | 650150 | 3410304 | 2,800.00 | ||
0 | POPLITEAL TIB.PERONEAL ART.BYP | 32754-02[713] | 650151 | 3275402 | 11,600.00 | ||
0 | POPLT.ART.THROMBOENDARTRICTOMY | 650152 | 3381505 | 9,000.00 | |||
0 | POPT.AR.TRANSLUM BAL.ANGOPLSTY | 650153 | 3381805 | 5,200.00 | |||
0 | PORTOCAVAL DECOMPRESSN PROCED. | 650154 | 9,900.00 | ||||
0 | PROF.ARTY.THROMBOENDARTRICTOMY | 650155 | 7,700.00 | ||||
3 | PULMONARY VALVE MELODY * CONGENITAL/ | 650156 | Y | 240,000.00 | |||
STRUCTURAL |
PHLEBECTOMYW/ GRAFT REPLACEMENT- PREPHERAL VEIN -
81,000.00
POP.ART.ANEURCTOMY & BYPASS
10,300.00
POPLIT AR.TRANSLUM ATHERECTOMY
4,500.00
POPLITEAL ARTERY EMBOLECTOMY
5,800.00
POPLITEAL ARTERY EXPLORATION
2,800.00
POPLITEAL TIB.PERONEAL ART.BYP
11,600.00
POPLT.ART.THROMBOENDARTRICTOMY
9,000.00
POPT.AR.TRANSLUM BAL.ANGOPLSTY
5,200.00
PORTOCAVAL DECOMPRESSN PROCED.
9,900.00
PROF.ARTY.THROMBOENDARTRICTOMY
7,700.00
PULMONARY VALVE MELODY * CONGENITAL/
240,000.00
STRUCTURAL
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