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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
REL.CAP./LIG.CAR. ANKLE
620612
4970600
6,900.00
0
REL.CAP./LIG.CAR.WRIST
620613
4921200
6,900.00
0
REL.CAP./LIG.CART. FOOT
620614
4980900
6,900.00
0
REL.CAP./LIG.CART. HAND
620615
4636300
6,900.00
0
REL.CAP./LIG.OR CAR. SHOULDER
620616
9060001
8,400.00
0
REL.CAP./LIG.OR CAR.HIP
620617
4930300
8,400.00
0
REL.CAP./LIG.OR.CAR.ELBOW
620618
4910002
7,500.00
0
REL.CAP./LIG.OR.CAR.KNEE
620619
4950004
7,500.00
0
RELEASE - CONTRACTURE BY CAPSULOTOMY - INTERMEDIATE JOINT
46381-00[1440]
620621
4638100
4,400.00
1
RELEASE OF DUPUYTRENS CONTRACTURE(OTHER
46369-00[1447]
620622
4636900
Y
6,435.00
FASCIETOMY
0
REM PROSTHESIS FROM ANKLE
620623
4951500
6,900.00
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