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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | FREEING OF PREPUTIAL ADHESION | 90402-01[1194] | 630040 | 9040201 | 1,300.00 | ||
0 | FUNDOPLICATION (LAPAROSCOPIC) | 30527-00[886] | 630041 | 3052700 | 15,000.00 | ||
0 | FUNDOPLICATION (OPEN) | 630042 | 3047603 | 9,000.00 | |||
0 | GANGLION EXCISION (MINOR) | 30107-00[1564] | 630043 | 3010700 | 1,800.00 | ||
0 | HERNIOTOMY-INCARCTD INGUIN.HERNIA | 30613-03[990] | 630047 | 3061303 | 3,700.00 | ||
0 | HYDROCELECTOMY (L.P.P.V.)-BILAT | 30641-01[1184] | 630048 | 3064101 | 4,300.00 | ||
0 | HYDROCELECTOMY (L.P.P.V.)-UNILAT | 30641-00[1184] | 630049 | 3064100 | 3,000.00 | ||
0 | HYPOSPADIAS (DISTAL-REPAIR) | 37821-00[1198] | 630050 | 3782100 | 3,900.00 | ||
0 | I & D ABSCESS - G.A. | 630051 | 1,800.00 | ||||
0 | I & D OF PERIANAL ABSCESS (GA) | 32174-01[930] | 630052 | 3217401 | 1,800.00 | ||
0 | ILEOSTOMY | 30375-01[897] | 630053 | 3037501 | 5,000.00 | ||
0 | INTERVASCULAR CANNULIZATION | 630055 | 6919909 | 80 |
FREEING OF PREPUTIAL ADHESION
1,300.00
FUNDOPLICATION (LAPAROSCOPIC)
15,000.00
FUNDOPLICATION (OPEN)
9,000.00
GANGLION EXCISION (MINOR)
1,800.00
HERNIOTOMY-INCARCTD INGUIN.HERNIA
3,700.00
HYDROCELECTOMY (L.P.P.V.)-BILAT
4,300.00
HYDROCELECTOMY (L.P.P.V.)-UNILAT
3,000.00
HYPOSPADIAS (DISTAL-REPAIR)
3,900.00
I & D ABSCESS - G.A.
1,800.00
I & D OF PERIANAL ABSCESS (GA)
1,800.00
ILEOSTOMY
5,000.00
INTERVASCULAR CANNULIZATION
80
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