Procedures & surgery prices at Annie Jeffrey Memorial County Health Center

Osceola, NE · every code in this section with a posted price and a Medicare benchmark.

266 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $1,440 $1,500 1.5×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $1,152 $1,200 1.2×
Amputation Toe Metatarsophalangeal Joint (28820) $2,880 $3,000 0.8×
Anoscopy; with biopsy, single or multiple (46606) $432 $450 0.3×
Application cast elbow finger short arm (29075) $384 $400 1.3×
Application Cast Finger (29086) $144 $150 0.9×
Application Cast Hand & Lower Forearm Gauntlet (29085) $288 $300 1.7×
Application cast shoulder hand long arm (29065) $432 $450 1.5×
Application Finger Splint Dynamic (29131) $168 $175 2.7×
Application finger splint static (29130) $220.80 $230 1.6×
Application long arm splint shoulder hand (29105) $336 $350 2.0×
Application long leg splint thigh ankle/toes (29505) $336 $350 2.0×
Application of cylinder cast (thigh to ankle) (29365) $576 $600 2.0×
Application of long leg cast (29345) $672 $700 2.3×
Application Short Arm Splint Dynamic (29126) $168 $175 1.2×
Application short arm splint forearm-hand static (29125) $288 $300 2.1×
Application short leg splint calf foot (29515) $288 $300 1.7×
Apply short leg cast (29405) $480 $500 1.7×
Apply short leg cast (29425) $240 $250 0.8×
Arterial puncture (36600) $98.88 $103 0.7×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $384 $400 1.2×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $432 $450 1.4×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $432 $450 1.4×
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) $4,800 $5,000 1.4×
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) $3,840 $4,000 1.1×
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) $5,760 $6,000 1.7×
Aspiration Bladder Insert Suprapubic Catheter (51102) $960 $1,000 0.4×
Avulsion nail plate partial/complete simple 1 (11730) $384 $400 1.8×
Biopsy Breast Open Incisional (19101) $3,360 $3,500 0.8×
Biopsy/removal lymph nodes (38510) $3,840 $4,000 0.9×
Bladder Irrigation Simple (51700) $360 $375 1.4×
Bladder Scan (51798) $192 $200 3.1×
Blood transfusion service (36430) $672 $700 1.5×
Bx breast needle core w/o imaging guidance spx (19100) $720 $750 0.4×
Change Cystostomy Tube Complicated (51710) $624 $650 0.9×
Change Cystostomy Tube Simple (51705) $480 $500 1.9×
Chemical Cautery Tissue (17250) $288 $300 1.4×
Chest tube placement (32551) $1,440 $1,500 0.9×
Chg Collect Blood From Catheter Venous Nos (36592) $216 $225 1.6×
Circum 28 days or older (54161) $1,680 $1,750 0.8×
Circumcision (54150) $1,680 $1,750 0.8×
Closed Rx Med Malleolus Fx,Manip (27762) $1,440 $1,500 0.9×
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $960 $1,000 0.6×
Closed Rx Shldr Disloc,Gr Tub Fx (23665) $960 $1,000 0.6×
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation (24576) $336 $350 1.3×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $960 $1,000 0.6×
Closed tx metatarsal fracture w/o manipulation (28470) $336 $350 1.3×
Closed tx nasal fracture w/o stabilization (21315) $864 $900 0.5×
Closed tx patellar dislocation w/anesthesia (27562) $480 $500 1.9×
Closed tx radial head/neck fx w/manipulation (24655) $960 $1,000 0.6×
Closed tx radial head/neck fx w/o manipulation (24650) $336 $350 1.3×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $384 $400 1.5×
Closed tx ulnar fracture prox end w/o manipulate (24670) $336 $350 1.3×
Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) $384 $400 0.7×
Clsd tx acromioclavicular dislc w/manipulation (23545) $480 $500 1.9×
Clsd tx clavicular fracture w/o manipulation (23500) $480 $500 1.9×
Clsd tx shoulder dislc w/manipulation req anes (23655) $1,152 $1,200 0.7×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $480 $500 1.9×
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $720 $750 2.8×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $336 $350 1.3×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $960 $1,000 0.6×
Cltx fx grt toe phlx/phlg w/manj (28495) $336 $350 1.3×
Cltx fx grt toe phlx/phlg w/o manj (28490) $336 $350 1.3×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $336 $350 1.3×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $288 $300 1.1×
Cltx Interphalangeal Joint Dislocation Req Anes (28665) $336 $350 1.2×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $336 $350 1.3×
Cltx iphal jt dislc w/manj w/o anes (26770) $336 $350 1.3×
Cltx metacarpal fx w/manipulation each bone (26605) $864 $900 3.4×
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $480 $500 1.9×
Cltx Metatarsophlngl Jt Dislc Req Anes (28635) $1,440 $1,500 0.9×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $528 $550 2.1×
Cltx Post Hip Arthrp Dislc Req Anes (27266) $1,200 $1,250 0.7×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $336 $350 1.3×
Colonoscopy flex w/rem forcep (45384) $1,920 $2,000 1.5×
Colonoscopy w/ablation (45388) $1,920 $2,000 1.5×
Complete replacement picc rs&i (36584) $1,920 $2,000 1.2×
Control Nasal Hemorrhage Anterior Complex (30903) $384 $400 2.8×
Control Nasal Hemorrhage Anterior Simple (30901) $288 $300 2.1×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $480 $500 3.5×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $288 $300 1.2×
Curettage postpartum (59160) $4,080 $4,250 1.2×
Cysto W/Simple Removal Stone & Stent (52310) $1,070.88 $1,115.50 0.5×
Cystourethroscopy (52000) $984 $1,025 1.4×
Debridement subcutaneous tissue 20 sq cm/< (11042) $576 $600 1.4×
Declot vascular device (36593) $480 $500 1.4×
Destruction Benign Lesions Up To 14 (17110) $254.40 $265 1.2×
Destruction Lesions Vulva Simple (56501) $1,920 $2,000 0.9×
Destruction premalignant lesion 1st (17000) $196.80 $205 0.9×
Dilation & curettage dx&/ther nonobstetric (58120) $4,080 $4,250 1.2×
Division of fallopian tube (58600) $2,640 $2,750 0.8×
Drainage External Ear Abscess/Hematoma Simple (69000) $624 $650 0.8×
Drainage Finger Abscess Simple (26010) $240 $250 1.2×
Drainage of hematoma/fluid (10140) $720 $750 0.4×
Draw blood off venous device (36591) $216 $225 1.6×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $480 $500 2.3×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $336 $350 1.6×
Dstrj lesion anus simple surg excision (46922) $3,840 $4,000 1.3×
Egd Balloon Dil Esoph30 Mm/> (43233) $1,632 $1,700 0.8×
Egd balloon dilation esophagus <30 mm diam (43249) $1,632 $1,700 0.8×
Egd Dilation Gastric/Duodenal Stricture - Egd (43245) $1,632 $1,700 0.8×
Egd flexible foreign body removal (43247) $1,632 $1,700 1.7×
Egd guide wire insertion (43248) $1,632 $1,700 1.7×
Egd remove lesion snare (43251) $1,632 $1,700 0.8×
Endoscopic us exam esoph (43237) $1,632 $1,700 0.8×
Epididymectomy unilateral (54860) $1,920 $2,000 0.5×
Esophagoscopy flex biopsy (43202) $1,632 $1,700 0.8×
Evacuation of subungual hematoma (11740) $168 $175 1.2×
Exc abd les sc 3 cm/> (22903) $2,160 $2,250 0.7×
Exc arm/elbow les sc 3 cm/> (24071) $4,032 $4,200 1.3×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $1,920 $2,000 1.1×
Exc frenum labial/buccal (40819) $1,440 $1,500 0.9×
Exc hand les sc < 1.5 cm (26115) $2,592 $2,700 1.5×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $1,920 $2,000 2.6×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $2,880 $3,000 1.7×
Exc Skin Malig 2.1-3 Cm Face,Facial (11643) $1,920 $2,000 1.1×
Exc Thrombosed Hemorrhoid Xtrnl (46320) $624 $650 0.5×
Exc tumor soft tiss back/flank subfascial 5 cm/> (21933) $2,880 $3,000 1.0×
Exc tumor soft tissue abdominal wall subq <3cm (22902) $2,160 $2,250 1.3×
Excis Tendon Sheath Lesion, Hand/Finger (26160) $2,592 $2,700 1.6×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $576 $600 0.8×
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $480 $500 0.7×
Excision Multiple External Papillae/Tags Anus (46230) $1,056 $1,100 0.4×
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $1,440 $1,500 2.0×
Excision of hydrocele; unilateral (55040) $3,360 $3,500 0.9×
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $2,400 $2,500 1.4×
Excision of local lesion of epididymis (54830) $3,840 $4,000 1.0×
Excision of pilonidal cyst or sinus; simple (11770) $2,640 $2,750 0.9×
Excision of single external papilla or tag, anus (46220) $2,688 $2,800 2.2×
Excision pilonidal cyst/sinus complicated (11772) $5,760 $6,000 1.9×
Excision tumor soft tis back/flank subq 3 cm/> (21931) $1,920 $2,000 1.1×
Expl W/Removal Deep Foreign Body Forearm/Wrist (25248) $960 $1,000 0.6×
Fetal non-stress test (59025) $384 $400 1.8×
Fine needle aspiration bx w/us gdn 1st lesion (10005) $1,248 $1,300 1.7×
Fixation of knee joint (27570) $1,680 $1,750 1.0×
Fixation of shoulder (23700) $1,680 $1,750 1.0×
Gastric Intubation/Aspiration, Therapeutic (43753) $312 $325 1.4×
Hemorrhoidectomy (46255) $2,688 $2,800 0.9×
Hemorrhoidectomy external complete (46250) $2,400 $2,500 0.8×
I&d abscess simple (10060) $576 $600 2.8×
I&d epididymis tstis&/scrotal space (54700) $864 $900 0.4×
I&d perianal abscess superficial (46050) $720 $750 0.7×
I&d pilonidal cyst simple (10080) $768 $800 1.0×
I&d upper arm/elbow deep abscess/hematoma (23930) $960 $1,000 0.3×
Incise finger tendon sheath (26055) $2,160 $2,250 1.3×
Incision & drainage abscess complicated/multiple (10061) $1,152 $1,200 2.7×
Incision & removal foreign body subq tiss simple (10120) $480 $500 1.1×
Incision and drainage of bartholin's gland abscess (56420) $336 $350 1.6×
Incision and drainage of vulva or perineal abscess (56405) $816 $850 2.6×
Incision extensor tendon sheath wrist (25000) $2,400 $2,500 1.4×
Incision thrombosed hemorrhoid external (46083) $576 $600 2.2×
Initial tx 1st degree burn local tx (16000) $240 $250 1.2×
Inj tendon sheath/ligament (20550) $384 $400 1.2×
Inject Tendon Origin/Insert (20551) $384 $400 1.2×
Injection aa&/strd trigeminal nerve each branch (64400) $561.60 $585 1.8×
Injection single/mlt trigger point 1/2 muscles (20552) $384 $400 1.2×
Injection single/mlt trigger point 3/> muscles (20553) $816 $850 2.6×
Insert cervical dilator (59200) $216 $225 0.7×
Insert picc cath (36569) $1,440 $1,500 0.9×
Insert Temp Bladder Cath (51702) $230.40 $240 1.7×
Insert,Non-Indwelling Bladder Catheter (51701) $240 $250 1.7×
Insertion indwelling tunneled pleural catheter (32550) $2,400 $2,500 0.6×
Insertion of wire and dilation of esophagus using an endoscope (43196) $1,632 $1,700 0.8×
Insertion Picc W/Rs&I 5 Yr/> (36573) $1,920 $2,000 1.2×
Intubation endotracheal emergency procedure (31500) $624 $650 2.5×
Knee arthroscopy/surgery (29883) $5,760 $6,000 1.7×
Laparoscopy appendectomy (44970) $5,040 $5,250 0.8×
Laparoscopy biopsy (49321) $5,040 $5,250 0.8×
Laparoscopy Remove Adnexa (58661) $4,656 $4,850 0.7×
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec (49320) $3,840 $4,000 0.6×
Ligation of hemorrhoid(s) (46221) $2,592 $2,700 2.7×
Liver Biopsy (47000) $3,072 $3,200 1.8×
Mastectomy partial (19301) $3,120 $3,250 0.8×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $384 $400 0.8×
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62320) $864 $900 1.2×
Onc prst8 ca alys all PSA structural isoforms (0359U) $470.40 $490 0.6×
Open tx fracture great toe/phalanx/phalanges (28505) $2,688 $2,800 0.8×
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $384 $400 0.2×
Perq replacement gtube not req revj gstrst trc (43762) $480 $500 1.9×
Placement of needle for intraosseous infusion (36680) $384 $400 0.8×
Puncture Aspiration (10160) $288 $300 0.7×
Removal Anal Seton Other Marker (46030) $1,200 $1,250 1.0×
Removal fb intranasal (30300) $240 $250 1.7×
Removal foreign body foot deep (28192) $1,440 $1,500 0.8×
Removal foreign body foot subcutaneous (28190) $720 $750 1.0×
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $480 $500 0.3×
Removal impacted cerumen irrigation/lvg unilat (69209) $144 $150 2.4×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $192 $200 3.1×
Removal of anal fissure (46200) $2,400 $2,500 0.8×
Removal of arm foreign body (24200) $960 $1,000 0.6×
Removal of knee cartilage (27332) $3,120 $3,250 0.9×
Removal of nail bed (11750) $720 $750 1.7×
Removal/bivalving gauntlet boot/body cast (29700) $192 $200 0.7×
Remove Eyelid Foreign Body (67938) $384 $400 1.2×
Remove foreign body from eye (65235) $576 $600 0.2×
Remove foreign body from eye (65210) $384 $400 0.8×
Remove in/ex hem groups 2+ (46260) $3,264 $3,400 1.1×
Remove Pilonidal Cyst Exten (11771) $5,280 $5,500 1.8×
Remv Ext Canal Foreign Body (69200) $240 $250 1.7×
Remv F.B.,Eye,Superf Conjunc (65205) $240 $250 1.7×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $720 $750 1.7×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $1,200 $1,250 2.8×
Repair complex trunk 2.6-7.5 cm (13101) $1,200 $1,250 1.6×
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) $5,040 $5,250 1.4×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $480 $500 1.1×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $480 $500 1.1×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $480 $500 1.1×
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $1,056 $1,100 1.4×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $672 $700 1.6×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $720 $750 1.7×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $864 $900 2.0×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $528 $550 1.3×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $576 $600 1.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $768 $800 1.8×
Repair of eye socket wound (65290) $816 $850 0.2×
Repair Of Foot Tendon (28208) $2,880 $3,000 0.8×
Repair of nail bed (11760) $960 $1,000 1.3×
Rerepair ing hernia reduce (49520) $5,040 $5,250 1.4×
Revise Eyelashes,Forceps (67820) $336 $350 2.4×
Revise median n/carpal tunnel surg (64721) $2,160 $2,250 1.1×
Revise ulnar nerve at elbow (64718) $3,840 $4,000 1.9×
Revise ulnar nerve at wrist (64719) $1,920 $2,000 0.9×
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $288 $300 0.3×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $384 $400 0.8×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $288 $300 2.1×
Rmvl fecal impaction/fb spx under anes (45915) $960 $1,000 0.8×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $192 $200 0.3×
Rpr aa hernia 1st 3-10 cm reducible (49593) $6,480 $6,750 1.0×
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) $6,240 $6,500 1.0×
Rpr aa hernia 1st < 3 cm reducible (49591) $6,240 $6,500 1.7×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $422.40 $440 2.0×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $384 $400 0.9×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $384 $400 1.8×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $408 $425 2.0×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $432 $450 2.1×
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $480 $500 2.3×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $288 $300 1.4×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $528 $550 2.5×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $408 $425 2.0×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $312 $325 1.5×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $384 $400 0.9×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $480 $500 1.1×
Spinal puncture lumbar diagnostic (62270) $864 $900 1.2×
Strapping ankle (29540) $144 $150 0.9×
Strapping elbow/wrist (29260) $96 $100 1.6×
Strapping hand/finger (29280) $96 $100 1.6×
Strapping knee (29530) $192 $200 1.4×
Strapping shoulder (29240) $288 $300 2.1×
Strapping toes (29550) $96 $100 1.6×
Strapping unna boot (29580) $288 $300 1.7×
Tangential biopsy skin single lesion (11102) $336 $350 0.8×
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $960 $1,000 1.5×
Thoracentesis needle/cath pleura w/o imaging (32554) $672 $700 1.0×
Thrombolytic Therapy, Stroke (37195) $384 $400 1.1×
Treat Fracture Radius & Ulna (25560) $336 $350 1.3×
Treat humerus fracture (24500) $336 $350 1.3×
Treat humerus fracture (23600) $480 $500 1.9×
Treat knee fracture (27532) $912 $950 0.3×
Treat Metatarsal Fracture (28475) $336 $350 1.3×
Treatment closed elbow dislocation req anes (24605) $912 $950 0.5×
Treatment closed elbow dislocation w/o anes (24600) $336 $350 1.3×
Trimming Of Nondystrophic Nails, Any Number (11719) $81.60 $85 1.3×
Tx Incomplete Abortion Any Trimester Surgical (59812) $3,840 $4,000 1.1×
Tx Missed Abortion First Trimester Surgical (59820) $4,080 $4,250 1.2×
Tx superficial wound dehiscence w/packing (12021) $288 $300 0.7×
Venipuncture (36415) $29.47 $30.70 3.2×