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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
CERVICAL L.N BX - L.A.
630011
3142300
650
0
CERVICAL L.N. BX - G.A.
630012
3142300
1,800.00
0
CLEFT LIP (BILATERAL)
45683-00[1689]
630014
4568300
7,700.00
0
CLEFT LIP (UNILATERAL)
45677-00[1689]
630015
4567700
6,200.00
0
CLEFT PALATE (COMPLETE)
630016
9,000.00
0
CLEFT PALATE (EACH STAGE)
45701-00[1689]
630017
4570100
4,600.00
0
CLEFT PALATE (INCOMPLETE)
630018
4570700
6,500.00
0
CLOSURE OF URETHRAL FISTULA
37833-00[1198]
630019
3783300
3,900.00
0
CORRECTION OF PENILE CHORDEE
37417-00[1197]
630020
3741700
2,600.00
0
CORRECTION SMALL BOWEL ATRESIA (MECONIUM ILEUS, MALROTATION
13706-02[1893]
630021
4380100
4,400.00
0
CYSTOSCOPY DIAGNOSTIC
36812-00[1089]
630022
3682100
1,800.00
0
DEF. SURGERY FOR HIRSCHSPRUNG DISEASE-SOAVE I
630023
8,500.00
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