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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
MUSCLE FLAP
45015-00
640075
10,300.00
0
MYOCUTAENOUS FLAP (MAJOR)
45006-001
640076
10,300.00
0
MYOCUTANEOUS FLAP (MEDIUM)
45003-001
640077
6,500.00
0
NIPPLE RECONSTRUCTION( BILAT)
45545-001
640078
8,600.00
0
NIPPLE RECONSTRUCTION(UNILAT)
45545-001
640079
5,100.00
0
NV. REPAIR PRIM/SEC.SUTURING
90676-001
640080
6,500.00
0
OSTEOMYOCUTANEOUS FLAP
45753-001
640081
18,100.00
0
OTHER ANOMALY OF FINGERS
90676-00
640082
6,200.00
0
OTOPLASTY-POST TRAUMATIC UNILA
45656-011
640083
16,800.00
0
PALATAL FISTULA
45710-00
640084
7,100.00
0
SPLENECTOMY PARTIAL/REPAIR
630086
3059600
7,200.00
0
STERNOTOMY FOR MEDIASTINAL MASS
50402-00[1374]
630087
3844603
11,600.00
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