Visits & medical services prices at Delta County Memorial Hospital

Delta, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $224.68 $374.47 1.0×
Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours… (93788) $285.30 $475.50 2.0×
Ambulatory bp recording (93786) $134.55 $224.25 1.0×
Appl on-body injector for timed subq injection (96377) $97.35 $162.25 2.0×
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $67.12 $111.88
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $79.50 $132.50
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $58.24 $97.08
Assessment of aphasia (96105) $174.75 $291.25
Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks… (97755) $72.90 $121.50
Behavioral & qualit analysis voice and resonance (92524) $136.09 $226.82
Biofeedback training by any modality Other Outpatient (90901) $122.70 $204.50
Bipap initial day (94660) $395.40 $659 1.7×
Breathing capacity test (94010) $194.40 $324 0.9×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $360 $600 0.9×
Cardiovascular stress test (93017) $696.75 $1,161.25 3.1×
Cardioversion elective external (92960) $888.90 $1,481.50 1.3×
Chemo anti-neopl sq/im (96401) $162.60 $271 2.1×
Chemo hormon antineopl sq/im (96402) $163.20 $272 2.1×
Chemo IV infus each addl seq (96417) $95.55 $159.25 1.3×
Chemo IV infusion addl hr (96415) $89.25 $148.75 1.2×
Chemo IV push addl drug (96411) $295.05 $491.75 3.9×
Chemother prolong infuse w/pump (96416) $498.45 $830.75 1.4×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $430.42 $717.38 1.2×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $316.28 $527.12 0.9×
Chest physiotherapy initial (94667) $133.88 $223.13 1.0×
Color/duplex Doppler, complete (93975) $275.21 $458.68 1.1×
Color/duplex Doppler, limited (93976) $350.40 $584 3.2×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $57.75 $96.25
Concurrent chemotherapy (96549) $181.05 $301.75 3.7×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $133.88 $223.13 1.0×
Cpr (92950) $598.65 $997.75 2.6×
Critical care ill/injured patient init 30-74 min (99291) $942.60 $1,571 1.1×
Debridement open wound 20 sq cm< (97597) $214.72 $357.87 1.0×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $809.85 $1,349.75 3.2×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $775.95 $1,293.25 3.1×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $557.10 $928.50 5.1×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $575.55 $959.25 2.3×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $321.90 $536.50 2.9×
EEG awake/drowsy (95816) $637.80 $1,063 2.8×
EKG 12 lead tracing only (93005) $115.28 $192.12 1.9×
EKG rhythm strip (93041) $66.56 $110.94 1.1×
Emergency department visit high mdm (99285) $869.10 $1,448.50 1.4×
Emergency department visit low mdm (99283) $276.97 $461.62 1.0×
Emergency department visit may not req phys/qhp (99281) $168.75 $281.25 1.9×
Emergency department visit moderate mdm (99284) $492.15 $820.25 1.1×
Emergency department visit straightforward mdm (99282) $222.75 $371.25 1.4×
Endoscopy swallow (fees) vid (92612) $318.60 $531
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $222.75 $371.25
Evaluate pt use of inhaler (94664) $224.68 $374.47 1.0×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $70.50 $117.50
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $156.19 $260.32
Evaluation of speech fluency (92521) $166.48 $277.46
Evaluation of speech sound production articulate (92522) $109.20 $182
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $196.65 $327.75 1.4×
Fluidotherapy (97022) $133.65 $222.75
Hot/cold pack (97010) $39.30 $65.50
Immunization administration (90471) $86.40 $144 1.1×
Infrared therapy (97026) $18.68 $31.12
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $131.25 $218.75 2.7×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $243.37 $405.61 1.1×
Irrigaj implntd venous access drug delivery syst (96523) $136.28 $227.12 2.2×
IV infusion hydration each additional hour (96361) $70.80 $118 1.4×
IV infusion hydration initial 31 min-1 hour (96360) $268.80 $448 1.2×
IV infusion ther proph addl sequential to 1 hr (96367) $82.50 $137.50 1.1×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $297.75 $496.25 1.3×
IV tx, each additional hour (96366) $58.95 $98.25 1.2×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $133.88 $223.13 1.0×
Mechanical traction therapy (97012) $54.75 $91.25
Methacholine challenge (94070) $524.55 $874.25 1.3×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $320.40 $534
Multiple sleep latency (95805) $2,456.70 $4,094.50 2.7×
Nasopharyngoscopy (92511) $473.85 $789.75 2.3×
Negative pressure wound therapy dme </= 50 sq cm (97605) $218.35 $363.92 1.0×
Negative pressure wound therapy dme >50 sq cm (97606) $451.09 $751.82 1.1×
Noninvasive ear/pulse oximetry overnight monitor (94762) $224.68 $374.47 1.7×
Occupational therapy eval high complex 60 mins (97167) $120.52 $200.86
Occupational therapy eval low complex 30 mins (97165) $120.52 $200.86
Occupational therapy eval mod complex 45 mins (97166) $120.52 $200.86
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92002) $162 $270 1.2×
Oral function therapy (92526) $144.58 $240.96
Oral speech device eval (92597) $100.35 $167.25
Orthc/prostc mgmt sbsq enc (97763) $112.28 $187.14
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $117.82 $196.38
Ot manual therapy ea 15 min (97140) $74.14 $123.56
Ot neuromuscular re-education (97112) $75 $125
Ot paraffin bath (97018) $52.12 $86.88
Ot re-evaluation (97168) $69 $115
OT Therapeutic Activities Charges (97530) $68.25 $113.75
Ot wheelchair management (97542) $73.20 $122
Outpatient cardiac rehab w/cont ECG monitoring (93798) $138.80 $231.33 1.0×
Peripheral vascular rehab (93668) $115.20 $192 1.9×
Phlebotomy therapeutic (99195) $159.60 $266 1.1×
Phy/qhp op pulm rhb w/o mntr (94625) $115.20 $192 1.9×
Physical therapy evaluation high complex 45 mins (97163) $236.40 $394
Physical therapy evaluation low complex 20 mins (97161) $181.80 $303
Physical therapy evaluation mod complex 30 mins (97162) $209.40 $349
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $2,579.40 $4,299 2.8×
Polysom <6 yrs sleep w/cpap/bilvl vent 4/> param (95783) $2,579.40 $4,299 2.8×
Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a… (95782) $2,339.70 $3,899.50 2.6×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $74.25 $123.75
Pt gait training 15 min (97116) $78.87 $131.45
Pt physical performance test (97750) $84.45 $140.75
Pt re-evaluation (97164) $85.36 $142.26
Pulm funct tst plethysmograp (94726) $401.10 $668.50 1.0×
Pulmonary stress testing (94618) $133.88 $223.13 1.0×
Refilling and maintenance of portable pump (96521) $362.85 $604.75 1.6×
Remote 30 day ECG rev/report (93270) $247.20 $412 6.3×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $64.35 $107.25
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $79.58 $132.62
Sleep study unattended (95806) $166.89 $278.15 0.7×
Speech sound lang comprehen (92523) $221.56 $369.26
Standardized cognitive performance testing (96125) $210.15 $350.25
Stress tte only (93350) $943.35 $1,572.25 1.6×
Temp transcutaneous pacing (92953) $809.10 $1,348.50 1.2×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $132.52 $220.88
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $35.55 $59.25
Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Other Outpatient (97113) $54.30 $90.50
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $72.45 $120.75
Therapeutic prophylactic/dx injection subq/im (96372) $114.30 $190.50 1.5×
Tte f-up or lmtd (93308) $288.90 $481.50 1.1×
Tte w/doppler complete (93306) $1,557.30 $2,595.50 2.7×
Upr/l xtremity art 2 levels (93922) $140.39 $233.98 1.0×
Ventilation ip/obs initial day (94002) $1,545.30 $2,575.50 2.4×
Ventilator subsequent day (94003) $1,252.65 $2,087.75 1.9×
Vital capacity total (94150) $166.89 $278.15 1.2×
Wound(s) care non-selective (97602) $214.72 $357.87 1.0×