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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
3
PERCUTANEOUS ASPIRTION OF SEMINAL VESICLE
30094-08[1163]
650132
3009408
Y
2,475.00
1
PERIPHERAL STENTING * PERIPHRAL INTERVENTION
650133
Y
20,000.00
3
PHLEBECTOM, WITH GRAFT REPLACEMENT , PREPERAL VEINS ,
32766-01[733]
650134
3276601
Y
7,500.00
3
PHLEBECTOMY , WITH GRAFT REPLACEMENT ,
32766-00[709]
650135
3276600
Y
7,500.00
PREPHERAL ARTERIES
3
PHLEBECTOMY W/ ANESTOMOSIS-ABDOMINAL
33836-03[709]
650136
3383603
Y
52,500.00
ARTERIES
3
PHLEBECTOMY W/ ANESTOMOSIS-ABDOMINAL VEINS
33836-07[733]
650137
Y
52,500.00
3
PHLEBECTOMY W/ ANESTOMOSIS-AORTA
90210-02[709]
650138
9021002
Y
52,500.00
3
PHLEBECTOMY W/ GRAFT REPLACEMENT-ABDOMINAL ARTERIES
33836-03[709]
650139
3383603
Y
52,500.00
3
PHLEBECTOMY W/ GRAFT REPLACEMENT-ABDOMINAL VEINS
33836-09[733]
650140
3383609
Y
52,500.00
3
PHLEBECTOMY.WITH ANASTOMOSISINTRACANIAL
32766-01[733]
650142
3276601
Y
52,500.00
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