Procedures & surgery prices at Avera Missouri River Health Center

Gettysburg, SD · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Application long arm splint shoulder hand (29105) $270.63 $279 1.6×
Application short arm splint forearm-hand static (29125) $323.98 $334 2.4×
Application short leg splint calf foot (29515) $291.97 $301 1.8×
Apply Multlay Comprs Lwr Leg (29581)
range across 3 matching MRF lines		 $171.69–$315.25 $177–$325 varies
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $317.19 $327 1.0×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $304.58 $314 1.0×
Avulsion nail plate partial/complete simple 1 (11730) $198.85 $205 1.0×
Bladder Irrigation (51700) $248.32 $256 1.0×
Bladder Scan (51798)
range across 2 matching MRF lines		 $59.17–$217.28 $61–$224 varies
Blood Transfusion Service (36430) $437.47 $451 1.0×
Chemodenerv Musc Migraine (64615) $154.23 $159 0.5×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $384.12 $396 1.5×
Closed Tx Calcaneal Fracture W/O Manipulation (28400) $403.52 $416 1.6×
Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) $384.12 $396 1.5×
Closed tx metatarsal fracture w/o manipulation (28470) $403.52 $416 1.6×
Closed tx radial head/neck fx w/o manipulation (24650) $345.32 $356 1.4×
Cltx dstl fibular fx lat malls w/o manj (27786) $384.12 $396 1.5×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $384.12 $396 1.5×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $384.12 $396 1.5×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,593.71 $1,643 1.0×
Cltx fx grt toe phlx/phlg w/o manj (28490) $403.52 $416 1.6×
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $403.52 $416 1.6×
Cltx metacarpal fx w/o manipulation each bone (26600) $384.12 $396 1.5×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $476.27 $491 1.9×
Cltx prox fibula/shft fx w/o manj (27780) $384.12 $396 1.5×
Cltx tibial fx proximal w/o manipulation (27530) $403.52 $416 1.6×
Collection of venous blood by venipuncture (36415)
range across 3 matching MRF lines		 $52.38–$55.29 $54–$57 varies
Control Nasal Hemorrhage Anterior Simple (30901) $363.75 $375 2.7×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $403.52 $416 1.0×
Debride nail 1-5 (11720) $72.75 $75 1.2×
Debridement subcutaneous tissue 20 sq cm/< (11042) $403.52 $416 1.0×
Declot vascular device (36593) $419.04 $432 1.2×
Destruct B9 Lesion 1-14 (17110) $198.85 $205 1.0×
Destruction premalignant lesion 1st (17000) $218.25 $225 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $344.35 $355 1.7×
Exc Face-Mm B9+Marg 0.6-1 Cm (11441) $702.28 $724 1.0×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $406.43 $419 1.0×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $702.28 $724 1.0×
I&d abscess simple (10060) $198.85 $205 1.0×
Incision & drainage abscess complicated/multiple (10061) $443.29 $457 1.1×
Incision & removal foreign body subq tiss simple (10120) $501.49 $517 1.2×
Incisional biopsy skin single lesion (11106) $733.32 $756 1.0×
Injection 1 tendon sheath/ligament aponeurosis (20550) $318.16 $328 1.0×
Injection single tendon origin/insertion (20551) $37.83 $39 0.1×
Injection single/mlt trigger point 1/2 muscles (20552) $38.80 $40 0.1×
Injection single/mlt trigger point 3/> muscles (20553) $179.45 $185 0.6×
Insert pessary/other device (57160) $47.53 $49 0.2×
Insert Temp Bladder Cath (51702)
range across 3 matching MRF lines		 $162.96–$239.59 $168–$247 varies
Insert,Non-Indwelling Bladder Catheter (51701)
range across 3 matching MRF lines		 $177.51–$210.49 $183–$217 varies
Needle insertion w/o injection 1 or 2 muscles (20560) $39.77 $41 1.3×
Needle insertion w/o injection 3 or more muscles (20561) $39.77 $41 1.3×
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $843.90 $870 2.0×
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493)
range across 2 matching MRF lines		 $433.59–$648.93 $447–$669 varies
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $363.75 $375 0.5×
Punch biopsy skin single lesion (11104) $403.52 $416 1.0×
Puncture aspiration abscess hematoma bulla/cyst (10160) $407.40 $420 1.0×
Removal impacted cerumen irrigation/lvg unilat (69209)
range across 3 matching MRF lines		 $59.17–$88.27 $61–$91 varies
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210)
range across 3 matching MRF lines		 $100.88–$151.32 $104–$156 varies
Removal Implant Superficial Separate Procedure (20670) $1,637.36 $1,688 1.0×
Removal of nail bed (11750) $439.41 $453 1.1×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $801.22 $826 1.9×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $801.22 $826 1.9×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $801.22 $826 1.9×
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $801.22 $826 1.1×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $417.10 $430 1.0×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $679 $700 3.3×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $679 $700 3.3×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $679 $700 3.3×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $646.02 $666 3.2×
Simple Repair F/E/E/N/L/M >30.0 Cm (12018) $679 $700 3.3×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001)
range across 2 matching MRF lines		 $229.89–$679 $237–$700 varies
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $646.02 $666 3.2×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $679 $700 3.3×
Tangential biopsy skin single lesion (11102) $403.52 $416 1.0×
Treat humerus fracture (23600) $677.06 $698 2.7×
Treatment closed elbow dislocation w/o anes (24600) $345.32 $356 1.4×
Trim skin lesion (11055) $229.89 $237 1.1×
Trim skin lesions 2 to 4 (11056) $198.85 $205 1.0×
Wedge excision skin nail fold (11765) $488.88 $504 1.2×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.