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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
3
CRYOTHRAOY OF WART
30189-01[1619]
640023
3018901
Y
375
0
CUT EAR LOBULE (BILATERAL) LA
45206-031
640024
1,300.00
0
CUT EAR LOBULE(UNILATERAL) LA
45206-031
640025
970
0
DIR REP EXTR TEND WRT/HAND 1
90676-00
640026
5,400.00
0
DIR REP FLEX TEND WRT/HAND 1
90676-00
640027
6,500.00
0
DIVISION CROSS FINGER FLAP- LA
90676-00
640028
2,700.00
0
DIVISION OF SKIN FLAP (MAJOR)
45239-00
640029
9,500.00
0
DIVISION OF SKIN FLAP (MED)
45239-00
640030
5,600.00
0
DIVISION OF SKIN FLAP (SMALL)
45239-00
640031
2,800.00
0
DIVISION-CROSS FINGER FLAP-GA
45448-07
640032
5,600.00
0
DYNAMIC SLING FOR FACIAL PALSY
45581-001
640033
11,600.00
0
EAR RECONSTRUCTION - STAGE I
45206-03
640034
9,700.00
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