Visits & medical services prices at Dorminy Medical Center

Fitzgerald, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $57.38 $114.75 0.3×
Analyze Neurostim Complex (95972) $244.25 $488.50 2.9×
Appl on-body injector for timed subq injection (96377) $103 $206 2.5×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $219.69 $439.38 0.7×
Canalith Repositioning (95992) $66.88 $133.75 1.6×
Cardiac Stress Tst,Tracing Only (93017) $461.38 $922.75 2.4×
Cardiopulmonary exercise testing (94621) $367.50 $735 1.1×
Cardiopulmonary resuscitation (92950) $447.50 $895 2.4×
Cardioversion (92960) $155.76 $311.50 0.3×
Cbt 1st hour (94644) $83.88 $167.75 0.7×
Chemo Hormon Antineopl Sq/Im (96402) $91.13 $182.25 1.4×
Chemo IV push addl drug (96411) $137.88 $275.75 2.2×
Chemo Iv Push Sngl Drug (96409) $287.75 $575.50 1.0×
Chemo prolong 8+ hrs infuse w/pump (96416) $479 $958 1.7×
Chemother, IV infusion, 1 hr (96413) $458.50 $917 1.6×
Chemother, IV infusion, ea add hr (96415) $95.06 $190.12 1.5×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $69 $138 1.1×
Chemotx Admn Cns Req Spinal Puncture (96450) $398.38 $796.75 1.4×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $182.25 $364.50 2.9×
Color/duplex Doppler, complete (93975) $269.13 $538.25 1.3×
Cpap initiation and management (94660) $413.38 $826.75 2.2×
Cpt initial (94667) $73.25 $146.50 0.6×
Critical care (99291) $548 $1,096 0.8×
Debridement Open Wound 20 Sq Cm< (97597) $79.50 $159 0.5×
Demo &/or eval,pt use,aerosol device (94664) $58 $116 0.3×
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $269.13 $538.25 2.9×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $534.50 $1,069 2.6×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $355.88 $711.75 3.9×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $417.88 $835.75 2.0×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $306.50 $613 3.3×
Dup-scan xtr veins unilateral/limited study (93971) $393.38 $786.75 4.3×
Duplex scan extracranial art compl bi study (93880) $533.50 $1,067 2.6×
Echo transesophageal (93312) $1,452.25 $2,904.50 3.0×
EKG (93005) $50.50 $101 1.0×
EKG rhythm strip (93041) $57.69 $115.38 1.1×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $622.63 $1,245.25 3.3×
EMG cranial nerve bilat (95868) $263.25 $526.50 1.4×
EMG four extremities (95864) $422.75 $845.50 3.7×
EMG one extremity (95860) $248.88 $497.75 2.1×
EMG three extremities (95863) $365.25 $730.50 3.2×
EMG two extremities (95861) $386.88 $773.75 3.3×
Ep Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters (93642) $38.50 $77 0.0×
Er level 1 (99281) $256.25 $512.50 3.5×
Er level ii (99282) $333.13 $666.25 2.5×
Er level iii (99283) $563.75 $1,127.50 2.4×
Er level IV (99284) $1,153.13 $2,306.25 3.2×
Er level v (99285) $1,409.36 $2,818.72 2.7×
Evoked auditory test,limited (92587) $41 $82 0.2×
Exercise tst brncspsm (94617) $151.50 $303 1.3×
Exhaled air analysis o2 (94680) $190.50 $381 1.7×
External Ecg Scanning Analysis Report (93226) $192.25 $384.50 3.7×
Flow volume loop (94375) $367.50 $735 1.9×
Holter Monitor Recording (93225) $138.38 $276.75 1.2×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $25.50 $51 0.4×
Immunization Admin (90471) $47.13 $94.25 0.7×
Injection intra arterial (96373) $65.38 $130.75 0.4×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $31.75 $63.50 0.6×
IV infusion hydration each additional hour (96361) $58.13 $116.25 1.4×
IV infusion hydration initial 31 min-1 hour (96360) $175.75 $351.50 0.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $55.50 $111 0.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $131.38 $262.75 0.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $56.25 $112.50 1.4×
IV push initial (96374) $61.50 $123 0.3×
Maximum voluntary ventilation (94200) $80.88 $161.75 1.6×
Mechanical chest wall oscillation (94669) $252 $504 1.3×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $39 $78 1.2×
Multiple sleep latency test (95805) $1,306.25 $2,612.50 1.7×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $92.50 $185 0.8×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $62.25 $124.50 0.4×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $86.38 $172.75 0.2×
Nerve conduction studies 13/> studies (95913) $239.38 $478.75 0.7×
Nerve Conduction Studies 3-4 Studies (95908) $76.13 $152.25 0.4×
Nerve Conduction Studies 9-10 Studies (95911) $194.88 $389.75 0.6×
Nerve conduction studies; 1-2 studies (95907) $58 $116 0.3×
Nerve conduction studies; 11-12 studies (95912) $221.88 $443.75 0.7×
Nerve conduction studies; 5-6 studies (95909) $140.63 $281.25 0.7×
Nerve conduction studies; 7-8 studies (95910) $167.75 $335.50 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $152.50 $305 1.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $316.25 $632.50 1.7×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $77.13 $154.25 0.7×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $223.13 $446.25 0.7×
Phy/qhp op pulm rhb w/mntr (94626) $75 $150 1.5×
Phy/qhp op pulm rhb w/o mntr (94625) $126 $252 2.4×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $2,069.38 $4,138.75 2.7×
Pulm function test by gas (94727) $164.12 $328.25 0.9×
Pulmonary stress testing (94618) $151.50 $303 1.3×
Refill/Maint Pump/Resvr Syst (96522) $217.38 $434.75 1.2×
Refill/maint, portable pump (96521) $244.94 $489.88 1.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $362 $724 11.1×
Rt Chest Wall Manipulation,Subsequent (94668) $115.69 $231.38 1.0×
Sleep study unattended (95806) $253.63 $507.25 1.3×
Slp Stdy Unatnd W/Hrt Rate/O2 Sat/Resp/Slp Time (95800) $250 $500 1.3×
Spirometry (94010) $122.56 $245.12 0.6×
Surfactant Admin Thru Tube (94610) $192.25 $384.50 1.0×
Temp transcutaneous pacing (92953) $250 $500 0.4×
Testing of autonomic (sympathetic) nervous system function (95923) $152.50 $305 1.3×
Testing of autonomic nervous system function heart rate (95921) $191.50 $383 1.7×
Ther/Proph/Diag Inj Sc/Im (96372) $42.63 $85.25 0.7×
Therapeutic phlebotomy (99195) $60.32 $120.62 0.5×
Trans Care Mgmt 14 Day Disch (99495) $144.63 $289.25 1.2×
Trans Care Mgmt 7 Day Disch (99496) $199.38 $398.75 1.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $870.69 $1,741.38 1.8×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $403.63 $807.25 1.9×
Tx/Pro/Dx Inj New Drug Addon (96375) $74 $148 1.8×
Unlisted pulmonary service/procedure (94799) $190.50 $381 1.7×
Vasc Duplex Extrem Venous,Bilat (93970) $558.88 $1,117.75 2.7×
Ventilation assist & mgmt inpatient 1st day (94002) $872.50 $1,745 1.6×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $340.50 $681 0.6×
Vital capacity total (94150) $190.50 $381 1.7×
Xtrnl mobile cv telemetry w/technical support (93229) $70.13 $140.25 0.2×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $53.25 $106.50 0.6×