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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
SM.INTESITINE RESECT/ANASTOM.
630084
4381000
8,700.00
0
SPLENECTOMY
30597-00[815]
630085
8,700.00
0
TENOTOMY OF HAND
46363-00[1440]
620804
4636300
2,600.00
0
TENOTOMY OPEN
620805
3,800.00
0
THR W/ FEMORAL RECONSTRUCTION
620806
4752200
19,400.00
0
TKR W/RECONS-TIB/FEMORL CONDYL
620807
4751900
19,400.00
0
TRANSFER - TENDON SMALL, EACH ADDITIONAL
620808
2,000.00
0
TRANSFER - TENDON, SMALL
620809
4,400.00
0
TRANSFER/ADV SGLE TENDON HAND
46417-00[1466]
620810
4641700
6,500.00
0
TRANSFER/ADV TENDON HAND(@ADD)
46417-00[1466]
620811
1,100.00
0
TRIPLE ARTHRODESIS
620812
4981500
9,500.00
2
TRIPLE ARTHRODESIS (TALUS TO CALAN. TO CUBOID
49815-00[1543]
620813
4981500
Y
9,405.00
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