Visits & medical services prices at Choctaw Memorial Hospital

Hugo, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $243.50 $487 1.2×
Cardiopulmonary resuscitation (92950) $348.50 $697 1.7×
Cardioversion (92960) $722.50 $1,445 1.1×
Cbt 1st hour (94644) $150.50 $301 1.2×
Cpap initiation and management (94660) $243.50 $487 1.2×
Cpt initial (94667) $150.50 $301 1.2×
Critical care (99291) $1,031 $2,062 1.3×
Debridement Open Wound 20 Sq Cm< (97597) $230 $460 1.2×
Demo &/or eval,pt use,aerosol device (94664) $243.50 $487 1.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $684 $1,368 3.0×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $342.50 $685 3.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $570 $1,140 2.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $285.50 $571 2.8×
Dup-scan xtr veins unilateral/limited study (93971) $342.50 $685 3.4×
Duplex scan extracranial art compl bi study (93880) $724.50 $1,449 3.2×
EKG (93005) $82 $164 1.4×
Er level 1 (99281) $65 $130 0.8×
Er level ii (99282) $109.50 $219 0.7×
Er level iii (99283) $174 $348 0.7×
Er level IV (99284) $278.50 $557 0.7×
Er level v (99285) $412 $824 0.7×
Evaluation of speech sound production (92522) $172 $344 1.5×
Evaluation of swallowing function (92610) $130 $260 1.5×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $302.50 $605 1.5×
Group Therapeutic Procedures (97150) $27.50 $55 1.5×
Immunization Admin (90471) $80 $160 1.2×
Injection intra arterial (96373) $270 $540 1.3×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $85.50 $171 1.5×
IV infusion hydration each additional hour (96361) $52.50 $105 1.2×
IV infusion hydration initial 31 min-1 hour (96360) $270 $540 1.3×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $80 $160 1.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $270 $540 1.3×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $52.50 $105 1.2×
IV push initial (96374) $270 $540 1.3×
Manual therapy 15 min (97140) $46.50 $93 1.7×
Massage 15 min (97124) $40.50 $81 1.4×
Mechanical chest wall oscillation (94669) $243.50 $487 1.2×
Mechanical traction (97012) $25 $50 1.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $230 $460 1.2×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $439 $878 1.1×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $191 $382 1.5×
Ot eval high complex 60 min (97167) $246.50 $493 2.5×
Ot eval low complex 30 min (97165) $131 $262 1.3×
Ot eval mod complex 45 min (97166) $196.50 $393 2.0×
Ot Prosthetic Training, Each 15 Min (97761) $51.50 $103 1.3×
Ot re-eval est plan care (97168) $81 $162 1.2×
Pt Electric Current Therapy (97033) $48.50 $97 2.5×
Pt Electrical Stimulation (97032) $29.50 $59 2.0×
Pt eval high complex 45 min (97163) $217.50 $435 2.2×
Pt eval low complex 20 min (97161) $117.50 $235 1.2×
Pt Gait Training Therapy (97116) $44 $88 1.5×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $51.50 $103 1.6×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $167.50 $335 1.7×
Pt re-evaluation (97164) $78.50 $157 1.2×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $49.50 $99 1.5×
Pt Ultrasound Therapy (97035) $20 $40 1.4×
Pt Whirlpool Therapy (97022) $35 $70 2.2×
Pulmonary stress testing (94618) $120 $240 0.9×
Rt Chest Wall Manipulation,Subsequent (94668) $82 $164 0.6×
Sensory Integration Ea 15 Min (97533) $91.50 $183 1.5×
Smoking cessation > 10 min (99407) $66 $132 1.8×
Speech sound lang comprehen (92523) $352.50 $705 1.6×
Spirometry (94010) $191 $382 0.9×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $37.50 $75 1.7×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $34.50 $69 1.6×
Ther/Proph/Diag Inj Sc/Im (96372) $80 $160 1.2×
Therapeutic Activities (97530) $53.50 $107 1.5×
Therapeutic phlebotomy (99195) $121.50 $243 0.9×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $38 $76 1.1×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,050 $2,100 2.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $125.50 $251 1.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $135 $270 1.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $66 $132 1.5×
Unlisted pulmonary service/procedure (94799) $191 $382 1.5×
Vasc Duplex Extrem Venous,Bilat (93970) $684 $1,368 3.0×
Ventilation assist & mgmt inpatient 1st day (94002) $636 $1,272 1.1×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $636 $1,272 1.1×
Wheelchair Mgmt Ea 15 Min (97542) $47.50 $95 1.5×