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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
TENDON ACHILLES REPAIR
49718-01[1542]
620775
4971801
5,200.00
0
TENDON ARCHILLES LENGTHENING/ 2 SIDE (PEDIATRICS)
49718-01[1542]
620776
4971801
4,400.00
0
TENDON ARCHILLES LENGTHENING/ ONE SIDE
49718-01[1542]
620777
4971801
3,200.00
(PEDIATRICS)
0
TENDON GRAFT (ADDED)
620778
1,500.00
0
TENDON GRAFT (SINGLE)
620779
6,200.00
0
TENDON LENG.EXCN BURSA FOR GRA
620780
3,300.00
0
TENDON LENG.EXCN MUSC.FOR GRAF
47957-00[1572]
620781
4795700
3,800.00
0
TENDON LENG.EXCN NERV.FOR GRAF
39318-00[83]
620782
3931800
3,800.00
0
TENDON LENG.EXCN.TENDON GRAFT
620783
9058400
3,800.00
0
TENDON LENG.REL.OF.CONT.OR.CAP
620784
9059301
7,500.00
0
TENDON LENGTHENING CLOSED
620785
28010
2,600.00
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