“BCBST
UM Guidelines
General Surgery

Listed by Conditions


Fundoplasty, Esophagogastric, by Laparoscopy

Fundoplasty, Esophagogastric, by Laparoscopy, Pediatric

Hernia Repair (Non-Hiatal)

Lysis of Adhesions by Laparoscopy

Mastectomy, Modified Radical

Mastectomy, Modified Radical, with Insertion of Breast Prosthesis or Tissue Expander

Mastectomy, Partial (Lumpectomy) with Axillary Lymphadenectomy

Radical Neck Dissection

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