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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | REVISION OF STUMP - MAJOR | 620672 | 4648300 | 7,500.00 | |||
0 | REVISION OF STUMP - MINOR | 620673 | 4,600.00 | ||||
0 | REVISION OF STUMP-INTERMEDIATE | 620674 | 5,600.00 | ||||
3 | REVISION OF T.K.R. OPERATION (KNEE)-ONE | 49527-00[1524] | 620675 | 4952700 | Y | 22,500.00 | |
3 | REVISION OF T.K.R. OPERATION(KNEE)-BOTH | 49527-00[1524] | 620676 | 4952700 | Y | 34,500.00 | |
0 | REVISION TOTAL HIP/KNEE REPLACE | 49545-00[1524] | 620677 | 4954500 | 25,800.00 | ||
0 | ROTATOR CUFF REP - ARTHRSCOPY | 620678 | 4890600 | 10,300.00 | |||
0 | ROTATOR CUFF TEAR REP(OPEN) L | 620679 | 4890900 | 9,000.00 | |||
0 | ROTATOR CUFF TEAR REP(OPEN)SM | 620680 | 6,500.00 | ||||
2 | SALTERS OSTEOTOMY W/ INTERNAL FIXATION (HIP)1 | 48427-06[1499] | 620681 | 4842706 | Y | 9,801.00 | |
2 | SEQUESTRACTOMY OF SMALL BONES | 90603-20[1534] | 620682 | 9060320 | Y | 6,000.00 | |
0 | SEQUESTRECTOMY - SMALL BONE/SMALL LESION | 90573-00[1563] | 620683 | 9057300 | 4,400.00 |
REVISION OF STUMP - MAJOR
7,500.00
REVISION OF STUMP - MINOR
4,600.00
REVISION OF STUMP-INTERMEDIATE
5,600.00
REVISION OF T.K.R. OPERATION (KNEE)-ONE
22,500.00
REVISION OF T.K.R. OPERATION(KNEE)-BOTH
34,500.00
REVISION TOTAL HIP/KNEE REPLACE
25,800.00
ROTATOR CUFF REP - ARTHRSCOPY
10,300.00
ROTATOR CUFF TEAR REP(OPEN) L
9,000.00
ROTATOR CUFF TEAR REP(OPEN)SM
6,500.00
SALTERS OSTEOTOMY W/ INTERNAL FIXATION (HIP)1
9,801.00
SEQUESTRACTOMY OF SMALL BONES
6,000.00
SEQUESTRECTOMY - SMALL BONE/SMALL LESION
4,400.00
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