Procedures & surgery prices at Dimmit Regional Hospital

Carrizo Springs, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $19,801 $33,002 21.7×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $1,558 $2,596 1.7×
Acne surgery (10040) $355 $592 1.8×
Appl Hip Spica Cast One&One-Half Spica/Both Legs (29325) $645 $1,075 2.3×
Application cast elbow finger short arm (29075)
range across 2 matching MRF lines		 $143–$205 $238–$342 varies
Application Cast Finger (29086) $179 $299 1.1×
Application finger splint static (29130)
range across 3 matching MRF lines		 $97–$278 $162–$464 varies
Application Hip Spica Cast 1 Leg (29305) $583 $972 2.1×
Application long arm splint shoulder hand (29105)
range across 2 matching MRF lines		 $192–$322 $320–$536 varies
Application Long Leg Cast Brace (29358) $377 $628 1.3×
Application Long Leg Splint (29505)
range across 2 matching MRF lines		 $211–$322 $351–$536 varies
Application of cylinder cast (thigh to ankle) (29365) $288 $480 1.0×
Application of long leg cast (29345)
range across 2 matching MRF lines		 $234–$314 $390–$523 varies
Application of rigid total contact leg cast (29445) $180 $300 0.6×
Application short arm splint forearm-hand static (29125)
range across 2 matching MRF lines		 $155–$322 $258–$536 varies
Application short leg splint calf foot (29515)
range across 2 matching MRF lines		 $169–$322 $281–$536 varies
Apply hand/wrist cast (29085) $224 $374 1.4×
Apply long arm cast (29065) $225 $375 0.8×
Apply Multlay Comprs Lwr Leg (29581) $190 $316 1.2×
Apply Short Leg Cast (29405) $187 $311 0.7×
Apply short leg cast (29425) $175 $292 0.6×
Arterial puncture (36600) $316 $526 2.4×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605)
range across 4 matching MRF lines		 $124–$343 $207–$572 varies
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $126 $210 0.2×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610)
range across 3 matching MRF lines		 $147–$709 $245–$1,181 varies
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $480 $800 1.6×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600)
range across 2 matching MRF lines		 $122–$709 $203–$1,181 varies
Aspirate pleura w/ imaging (32555) $1,456 $2,426 2.3×
Aspirate/Inj Ganglion Cyst (20612)
range across 2 matching MRF lines		 $96–$481 $160–$801 varies
Aspiration Bladder Needle (51100) $584 $973 2.3×
Avulsion nail plate partial/complete simple 1 (11730)
range across 2 matching MRF lines		 $473–$477 $789–$795 varies
Biopsy Abdominal Mass (49180) $1,364 $2,273 0.8×
Biopsy muscle percutaneous needle (20206) $472 $787 0.3×
Biopsy of liver, needle; percutaneous (47000) $3,599 $5,999 2.2×
Biopsy soft tissue neck/thorax (21550) $3,599 $5,999 2.2×
Bladder Irrigation (51700) $677 $1,129 2.7×
Bladder Scan (51798) $143 $238 2.4×
Blepharotomy drainage abscess eyelid (67700) $492 $820 1.5×
Blood Transfusion Service (36430)
range across 4 matching MRF lines		 $856–$960 $1,426–$1,600 varies
Bx breast 1st lesion us imag (19083)
range across 3 matching MRF lines		 $1,069–$3,889 $1,782–$6,481 varies
Change Cystostomy Tube Simple (51705) $677 $1,129 2.7×
Change of Windpipe Airway (31502) $260 $434 1.1×
Change ureter stent percut (50382) $3,613 $6,022 1.7×
Chest tube placement (32551) $1,992 $3,320 1.3×
Circumcision Neonate (54160) $300 $500 0.4×
Clear outer ear canal (69200)
range across 2 matching MRF lines		 $180–$209 $300–$349 varies
Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) $1,079 $1,798 4.4×
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $689 $1,148 2.8×
Closed Treatment Sesamoid Fracture (28530) $276 $460 1.1×
Closed Treatment Ulnar Styloid Fracture (25650) $778 $1,297 3.1×
Closed tx ankle dislocation w/o anesthesia (27840)
range across 2 matching MRF lines		 $334–$1,133 $556–$1,889 varies
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $1,809 $3,015 1.1×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $793 $1,321 3.2×
Closed Tx Calcaneal Fracture W/O Manipulation (28400) $579 $965 2.3×
Closed tx carpal scaphoid fracture w/manj (25624) $3,841 $6,402 2.4×
Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) $730 $1,216 2.9×
Closed Tx Femoral Shaft Fx W/O Manipulation (27500) $356 $593 1.4×
Closed tx knee dislocation w/o anesthesia (27550) $356 $593 1.4×
Closed Tx Lunate Dislocation W/Manipulation (25690) $1,436 $2,393 0.9×
Closed tx metatarsal fracture w/o manipulation (28470)
range across 2 matching MRF lines		 $258–$508 $430–$847 varies
Closed tx patellar dislocation w/o anesthesia (27560) $303 $505 1.2×
Closed Tx Patellar Fracture W/O Manipulation (27520) $770 $1,283 3.1×
Closed tx radial head/neck fx w/o manipulation (24650) $629 $1,048 2.5×
Closed Tx Radial Shaft Fracture W/O Manipulation (25500) $676 $1,127 2.7×
Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) $1,809 $3,015 1.1×
Closed tx radial&ulnar shaft fractures w/o man (25560) $689 $1,148 2.8×
Closed Tx Scapular Fracture W/O Manipulation (23570) $578 $963 2.3×
Closed tx talus fracture w/o manipulation (28430) $561 $935 2.3×
Closed tx tarsometatarsal dislocation w/o anes (28600) $511 $852 2.1×
Closed tx ulnar shaft fracture w/o manipulation (25530) $630 $1,050 2.5×
Closure Laceration Vestibule Mouth 2.5 Cm/< (40830) $503 $839 2.1×
Clsd tx acromioclavicular dislc w/manipulation (23545) $325 $542 1.3×
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $563 $938 2.3×
Clsd tx clavicular fracture w/o manipulation (23500)
range across 2 matching MRF lines		 $325–$545 $542–$908 varies
Clsd tx shoulder dislc w/manipulation req anes (23655) $2,223 $3,705 1.4×
Clsd tx shoulder dislc w/manipulation w/o anes (23650)
range across 2 matching MRF lines		 $557–$788 $928–$1,314 varies
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $1,809 $3,015 1.1×
Cltx Carpal Bone Fx W/O Manj Each Bone (25630) $725 $1,209 2.9×
Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) $303 $505 1.2×
Cltx dstl fibular fx lat malls w/manj (27788) $297 $495 1.2×
Cltx dstl fibular fx lat malls w/o manj (27786)
range across 2 matching MRF lines		 $356–$737 $593–$1,228 varies
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755)
range across 2 matching MRF lines		 $557–$761 $928–$1,269 varies
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750)
range across 2 matching MRF lines		 $297–$576 $495–$960 varies
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $802 $1,336 3.2×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $2,582 $4,304 1.6×
Cltx fx grt toe phlx/phlg w/manj (28495) $576 $960 2.3×
Cltx fx grt toe phlx/phlg w/o manj (28490) $332 $553 1.3×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510)
range across 2 matching MRF lines		 $258–$576 $430–$960 varies
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $2,561 $4,268 1.6×
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $743 $1,239 3.0×
Cltx greater humeral tuberosity fx w/o manj (23620)
range across 2 matching MRF lines		 $325–$643 $542–$1,071 varies
Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) $830 $1,384 3.3×
Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560) $785 $1,309 3.2×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660)
range across 2 matching MRF lines		 $258–$290 $430–$484 varies
Cltx Iphal Jt Dislc W/Manj Req Anes (26775) $328 $547 1.2×
Cltx iphal jt dislc w/manj w/o anes (26770) $373 $621 1.5×
Cltx Med Ankle Fx W/Mnpj (27762) $2,411 $4,019 1.5×
Cltx Medial Ankle Fx (27760) $788 $1,313 3.2×
Cltx metacarpal fx w/o manipulation each bone (26600) $714 $1,190 2.9×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $682 $1,136 2.8×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720)
range across 2 matching MRF lines		 $258–$479 $430–$799 varies
Cltx prox fibula/shft fx w/o manj (27780) $731 $1,219 3.0×
Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) $1,809 $3,015 1.1×
Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) $576 $960 2.3×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $557 $928 2.2×
Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) $1,351 $2,251 0.8×
Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) $1,024 $1,706 0.6×
Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) $1,291 $2,152 0.8×
Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) $904 $1,506 3.6×
Cltx tibial fx proximal w/o manipulation (27530) $683 $1,138 2.8×
Cltx tibial shaft fx w/o manipulation (27750) $820 $1,366 3.3×
Cltx Trans-Scaphoprilunar Typ Fx Dislc W/Manj (25680)
range across 2 matching MRF lines		 $356–$1,550 $593–$2,583 varies
Cltx trimalleolar ankle fx w/manipulation (27818) $2,582 $4,304 1.6×
Cltx trimalleolar ankle fx w/o manipulation (27816) $781 $1,301 3.2×
Collection of venous blood by venipuncture (36415)
range across 3 matching MRF lines		 $9–$15 $15–$25 varies
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $180 $300 0.6×
Colposcopy cervix upper/adjacent vagina (57452) $150 $250 0.7×
Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx (57455) $180 $300 0.6×
Complex drainage wound (10180)
range across 2 matching MRF lines		 $590–$3,285 $983–$5,475 varies
Control Nasal Hemorrhage Anterior Simple (30901) $270 $450 2.0×
Core Needle Bx Lung/Mediastinum Perq W/Img (32408) $3,599 $5,999 2.2×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $149 $248 1.1×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $1,469 $2,449 3.6×
Deb Musc/Fascia 20 Sq Cm/< (11043) $1,469 $2,449 2.0×
Debride nail 1-5 (11720) $60 $100 1.0×
Debride nail 6 or more (11721) $90 $150 1.5×
Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) $3,889 $6,481 2.3×
Debridement subcutaneous tissue 20 sq cm/< (11042)
range across 2 matching MRF lines		 $443–$959 $739–$1,598 varies
Destruct B9 Lesion 1-14 (17110)
range across 4 matching MRF lines		 $130–$477 $216–$795 varies
Destruction Lesions Vulva Extensive (56515) $180 $300 0.1×
Destruction Lesions Vulva Simple (56501) $144 $240 0.1×
Destruction Premalignant Lesion 15/> (17004) $210 $350 0.5×
Destruction premalignant lesion 1st (17000) $48 $80 0.2×
Destruction Vaginal Lesions Extensive (57065) $210 $350 0.1×
Destruction Vaginal Lesions Simple (57061) $180 $300 0.1×
Drainage External Ear Abscess/Hematoma Simple (69000) $1,688 $2,814 2.4×
Drainage Mouth Roof Lesion (42000) $374 $624 1.6×
Drainage of finger abscess simple (26010) $512 $854 2.5×
Drainage of gum lesion (41800) $309 $515 2.3×
Drainage of hematoma/fluid (10140)
range across 2 matching MRF lines		 $1,627–$3,889 $2,711–$6,481 varies
Drainage of scrotum (54700) $4,916 $8,194 2.3×
Draw Blood Off Venous Device (36591) $149 $248 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $436 $727 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020)
range across 2 matching MRF lines		 $192–$473 $320–$789 varies
Egd place gastrostomy tube (43246) $1,983 $3,305 1.0×
Endometrial Biopsy (58100) $120 $200 0.6×
Evacuation of subungual hematoma (11740)
range across 3 matching MRF lines		 $94–$292 $157–$487 varies
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $1,688 $2,814 2.4×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $381 $635 0.2×
Exc Face-Mm B9+Marg 0.6-1 Cm (11441) $1,688 $2,814 2.4×
Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) $195 $325 0.1×
Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421)
range across 3 matching MRF lines		 $267–$357 $445–$595 varies
Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) $3,889 $6,481 2.3×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $1,688 $2,814 2.4×
Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) $438 $730 0.3×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $3,889 $6,481 2.3×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $3,889 $6,481 2.3×
Exc thigh/knee les sc 3 cm/> (27337) $6,869 $11,448 2.4×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $959 $1,598 2.3×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $1,688 $2,814 2.4×
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $438 $730 0.3×
Exc tumor soft tiss forearm&/wrist subfasc <3cm (25076) $3,889 $6,481 2.3×
Excis Mouth Mucosa/Sub,Simpl Repair (40812) $3,555 $5,925 2.3×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $511 $852 0.7×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $1,688 $2,814 2.4×
Excision of ganglion, wrist (dorsal or volar); primary (25111) $3,841 $6,402 2.4×
Exploration penetrating wound spx extremity (20103) $3,889 $6,481 2.3×
Fetal non-stress test (59025) $570 $950 2.8×
Fine needle aspiration without imaging guidance (10021) $959 $1,598 2.3×
Fluoro exam of g/colon tube (49465) $454 $756 1.9×
Fna bx w/us gdn 1st les (10005) $1,688 $2,814 2.4×
Foreskin manipulation (54450) $677 $1,129 2.7×
I&d abscess simple (10060)
range across 2 matching MRF lines		 $325–$477 $542–$795 varies
I&D Deep Absc/Hematoma Neck/Chest (21501) $6,869 $11,448 2.4×
I&d perianal abscess superficial (46050) $1,518 $2,530 1.6×
I&d pilonidal cyst complicated (10081) $1,170 $1,950 1.6×
I&d pilonidal cyst simple (10080)
range across 2 matching MRF lines		 $801–$1,688 $1,335–$2,814 varies
Incise external hemorrhoid (46083) $259 $431 1.0×
Incision & drainage abscess complicated/multiple (10061)
range across 2 matching MRF lines		 $672–$959 $1,120–$1,598 varies
Incision & removal foreign body subq tiss compl (10121) $3,889 $6,481 2.3×
Incision & removal foreign body subq tiss simple (10120)
range across 2 matching MRF lines		 $882–$959 $1,470–$1,598 varies
Incision and drainage of bartholin's gland abscess (56420) $211 $351 1.0×
Incision and drainage of vulva or perineal abscess (56405) $518 $864 1.7×
Initial Tx 1st Degree Burn Local Tx (16000) $325 $542 1.6×
Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) $1,513 $2,522 1.7×
Injection 1 tendon sheath/ligament aponeurosis (20550)
range across 3 matching MRF lines		 $480–$709 $800–$1,181 varies
Injection aa&/strd axillary nerve w/img gdn (64417) $1,513 $2,522 1.7×
Injection aa&/strd intercostal nrv ea addl lvl (64421) $1,513 $2,522 1.7×
Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) $1,168 $1,946 1.6×
Injection Aa&/Strd Sciatic Nrv Cont Nfs Cath Img (64446) $1,513 $2,522 1.7×
Injection anesthetic agent suprascapular nerve (64418) $1,168 $1,946 1.6×
Injection enzyme palmar fascial cord (20527) $481 $801 1.6×
Injection single tendon origin/insertion (20551) $709 $1,181 2.3×
Injection single/mlt trigger point 1/2 muscles (20552)
range across 3 matching MRF lines		 $120–$649 $200–$1,082 varies
Injection single/mlt trigger point 3/> muscles (20553)
range across 2 matching MRF lines		 $114–$480 $190–$800 varies
Injection therapeutic carpal tunnel (20526)
range across 2 matching MRF lines		 $130–$481 $216–$801 varies
Injection, anesthetic agent; brachial plexus, single (64415) $1,513 $2,522 1.7×
Injection, anesthetic agent; femoral nerve, single (64447) $1,168 $1,946 1.6×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $1,168 $1,946 1.6×
Insert Drug Implant Device (11981) $330 $550 2.5×
Insert non-tunnel cv cath (36556) $2,728 $4,546 0.9×
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines		 $310–$316 $516–$526 varies
Insert,Non-Indwelling Bladder Catheter (51701) $137 $228 1.0×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) $1,292 $2,153 0.8×
Intubation endotracheal emergency procedure (31500)
range across 3 matching MRF lines		 $512–$698 $854–$1,164 varies
Laryngoscopy diagnostic (31505) $232 $386 1.2×
Laryngoscopy Indirect W/Removal Foreign Body (31511) $232 $386 1.2×
Late closure of wound (13160) $2,165 $3,609 0.6×
N Block Inj Ilio-Ing/Hypogi (64425)
range across 2 matching MRF lines		 $1,168–$1,662 $1,946–$2,770 varies
N block inj intercost sng (64420) $1,168 $1,946 1.6×
Needle Biopsy Lymph Nodes (38505)
range across 2 matching MRF lines		 $385–$3,599 $641–$5,998 varies
Njx Anes Trigeminal Nrv Any Div/Branch (64400) $124 $206 0.4×
Occipital Nerve Block (64405) $480 $800 1.6×
Perq sft tiss loc device plmt 1st les w/gdnce (10035) $1,560 $2,600 2.2×
Placement of needle for intraosseous infusion (36680) $392 $653 0.9×
Punch biopsy skin single lesion (11104) $959 $1,598 2.3×
Puncture aspiration abscess hematoma bulla/cyst (10160)
range across 3 matching MRF lines		 $292–$512 $487–$854 varies
Puncture Aspiration Cyst Breast (19000)
range across 3 matching MRF lines		 $792–$1,688 $1,320–$2,814 varies
Removal Foreign Body Foot Subcutaneous (28190) $1,411 $2,351 2.0×
Removal impacted cerumen irrigation/lvg unilat (69209)
range across 3 matching MRF lines		 $35–$140 $58–$233 varies
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210)
range across 2 matching MRF lines		 $60–$103 $100–$171 varies
Removal of nail bed (11750)
range across 3 matching MRF lines		 $270–$959 $450–$1,598 varies
Removal or bivalving full arm or full leg cast (29705) $637 $1,062 2.3×
Removal skn tags mlt fibrq tags any area upw/15 (11200)
range across 2 matching MRF lines		 $325–$477 $542–$795 varies
Remove drug implant device (11982) $240 $400 0.5×
Remove foreign body from eye (65205) $232 $387 1.7×
Remove Intrauterine Device (58301)
range across 2 matching MRF lines		 $246–$608 $410–$1,013 varies
Remove Nasal Foreign Body (30300)
range across 2 matching MRF lines		 $135–$316 $225–$526 varies
Remove/Insert Drug Implant (11983) $330 $550 0.7×
Renal Biopsy Perq (50200) $3,599 $5,998 2.2×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $743 $1,238 1.0×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $434 $724 1.1×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $642 $1,070 1.6×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $642 $1,070 1.6×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $642 $1,070 1.6×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $383 $639 0.9×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $434 $724 1.1×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $434 $724 1.1×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $434 $724 1.1×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $672 $1,120 1.6×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $434 $724 1.1×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $672 $1,120 1.6×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $672 $1,120 1.6×
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $662 $1,103 0.9×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $672 $1,120 1.6×
Repair of nail bed (11760) $1,046 $1,743 1.4×
Repair, primary, disrupted ligament, ankle; collateral (27695)
likely a partial charge, not the full procedure		 $1,182 $1,970 0.2×
Replace duodenostomy/jejunostomy tube perq (49451) $1,040 $1,733 1.1×
Replace g/c tube perc (49450) $1,040 $1,733 1.1×
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $392 $653 0.4×
Rmvl FB Xtrnl Auditory Canal Anes (69205) $1,837 $3,062 1.1×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $679 $1,132 1.5×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $492 $820 3.7×
Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) $958 $1,596 2.1×
Rplc Gtube No Revj Trc (43762) $328 $546 1.3×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $325 $542 1.6×
Rpr Lip Full Thickness Vermilion Only (40650) $1,033 $1,722 1.9×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $267 $445 1.3×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $227 $379 0.6×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $269 $448 1.3×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $325 $542 1.6×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $325 $542 1.6×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $269 $448 1.3×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $325 $542 1.6×
Skin sub graft face/nk/hf/g (15275) $3,128 $5,213 4.2×
Skin sub graft trnk/arm/leg (15271) $3,128 $5,213 4.2×
Skin sub grft t/arm/lg child (15273) $684 $1,140 0.3×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $269 $448 1.3×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $672 $1,120 1.6×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $639 $1,065 1.6×
Spinal puncture lumbar diagnostic (62270) $1,136 $1,894 1.6×
Strapping ankle (29540) $350 $583 2.1×
Strapping hand/finger (29280) $67 $112 1.1×
Strapping knee (29530) $278 $464 2.1×
Strapping shoulder (29240)
range across 5 matching MRF lines		 $209–$278 $349–$464 varies
Strapping Unna Boot (29580) $451 $751 2.8×
Thrombolytic Therapy Stroke (37195) $308 $513 0.9×
Thrombolytic Venous Therapy (37212) $1,663 $2,771 0.5×
Thyroid biopsy (60100) $1,557 $2,595 2.2×
Treat Humerus Fracture (24505) $1,809 $3,015 1.1×
Treat humerus fracture (23600) $789 $1,315 3.2×
Treat Knuckle Dislocation (26700) $356 $593 1.4×
Treat toe dislocation (28630)
range across 2 matching MRF lines		 $259–$355 $431–$592 varies
Treatment Closed Elbow Dislocation Req Anes (24605) $378 $630 0.2×
Treatment closed elbow dislocation w/o anes (24600) $576 $960 2.3×
Trim skin lesion (11055) $477 $795 2.4×
Trim skin lesions 2 to 4 (11056) $477 $795 2.4×
Tx Gastro Intub W/Asp (43753) $190 $316 0.9×
Tx Missed Abortion First Trimester Surgical (59820) $420 $700 0.1×
Tx Superficial Wound Dehiscence Simple Closure (12020) $788 $1,314 1.1×
Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) $611 $1,018 2.5×
Unlisted Procedure Intestine (44799) $1,486 $2,477 1.6×
Vaginal delivery only (59409)
range across 3 matching MRF lines		 $1,200–$7,631 $2,000–$12,718 varies
Wedge excision skin nail fold (11765) $434 $724 1.1×
Wound Prep F/N/Hf/G (15004) $1,077 $1,795 2.6×

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.