Procedures & surgery prices at Ellett Memorial Hospital

Appleton City, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Application cast elbow finger short arm (29075) $131.25 $175 0.5×
Application Cast Finger (29086) $120 $160 0.7×
Application cast shoulder hand long arm (29065) $174.56 $232.75 0.6×
Application Finger Splint Dynamic (29131) $81 $108 1.4×
Application finger splint static (29130) $53.44 $71.25 0.4×
Application long arm splint shoulder hand (29105) $181.12 $241.50 1.1×
Application Short Arm Splint Dynamic (29126) $118.12 $157.50 0.9×
Application short arm splint forearm-hand static (29125) $82.59 $110.12 0.6×
Application short leg splint calf foot (29515) $136.50 $182 0.8×
Apply short leg cast (29405) $198.75 $265 0.7×
Apply short leg cast (29425) $87 $116 0.3×
Arterial puncture (36600) $107.62 $143.50 0.8×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $87 $116 0.3×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $165.56 $220.75 0.5×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $69 $92 0.2×
Aspirat/Injection Ganglion Cyst(S) (20612) $165.75 $221 0.5×
Avulsion nail plate partial/complete simple 1 (11730) $131.25 $175 0.7×
Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) $170.25 $227 0.2×
Biopsy of uterus lining (58100) $236.25 $315 1.2×
Biopsy or excision of lymph node(s); open, superficial (38500) $414 $552 0.1×
Bladder Scan (51798) $159.19 $212.25 2.7×
Blood patch (62273) $646.69 $862.25 0.9×
Blood transfusion service (36430) $264.47 $352.62 0.6×
Bx vulva/perineum 1 lesion (56605) $150 $200 0.2×
Change Cystostomy Tube Simple (51705) $232.12 $309.50 0.9×
Chemical Cautery Tissue (17250) $116.25 $155 0.6×
Chemodenerv Musc Migraine (64615) $283.50 $378 0.9×
Chg Collect Blood From Catheter Venous Nos (36592) $108.84 $145.12 0.8×
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $521.25 $695 0.3×
Closed Rx Radial Shaft Fx (25500) $521.25 $695 2.1×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $962.81 $1,283.75 0.6×
Colonoscopy flex w/rem forcep (45384) $702.94 $937.25 0.6×
Colsc Flexible W/Transendoscopic Balloon Dilat - Colonoscopy (45386) $702.94 $937.25 0.6×
Colsc flx with directed submucosal njx any sbst (45381) $702.94 $937.25 0.6×
Contrast Inj Cent Ven Cath, Inc Flouro (36598) $164.25 $219 0.8×
Control Nasal Hemorrhage Anterior Simple (30901) $143.44 $191.25 1.1×
Cystourethroscopy (52000) $1,033.69 $1,378.25 1.5×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $66 $88 0.2×
Debride nail 1-5 (11720) $39.75 $53 0.7×
Debride nail 6 or more (11721) $78.75 $105 1.3×
Debridement subcutaneous tissue 20 sq cm/< (11042) $178.50 $238 0.4×
Destruc Benign/Premal,15+ Lesions (17004) $240 $320 0.6×
Destruction benign lesions 15 or more (17111) $75 $100 0.4×
Destruction Benign Lesions Up To 14 (17110) $93.75 $125 0.5×
Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) $174 $232 0.9×
Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) $228 $304 1.1×
Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) $165.75 $221 0.8×
Destruction malignant lesion s/n/h/f/g 0.5 cm/> (17270) $128.25 $171 0.6×
Destruction malignant lesion s/n/h/f/g 0.6-1.0cm (17271) $248.25 $331 1.2×
Destruction premalignant lesion 1st (17000) $66 $88 0.3×
Diagnostic sigmoidoscopy (45330) $325.03 $433.38 0.3×
Dilate Urethra Stricture (53600) $165.38 $220.50 0.7×
Dilation esoph unguided sound/bougie 1/mult pass (43450) $688.12 $917.50 0.8×
Dilation of female urethra including suppository and/or instillation; initial (53660) $165.38 $220.50 1.3×
Drainage of hematoma/fluid (10140) $256.50 $342 0.2×
Draw blood off venous device (36591) $115.31 $153.75 0.9×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $291.56 $388.75 1.5×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $87 $116 0.4×
Egd balloon dilation esophagus <30 mm diam (43249) $688.12 $917.50 0.4×
Egd flexible foreign body removal (43247) $688.12 $917.50 0.8×
Egd guide wire insertion (43248) $688.12 $917.50 0.8×
Egd Transoral Control Bleeding Any Method - Egd (43255) $688.12 $917.50 0.4×
Esophagogastroduodenoscopy submucosal injection (43236) $688.12 $917.50 0.8×
Evacuation of subungual hematoma (11740) $44.25 $59 0.3×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $306 $408 0.2×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $318.75 $425 0.2×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $131.25 $175 0.2×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $360 $480 0.2×
Exc lesion tendon sheath/capsule w/synvct toe ea (28092) $645 $860 0.4×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $240 $320 0.3×
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $131.25 $175 0.3×
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $131.25 $175 0.2×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $289.50 $386 0.4×
Exc Skin Benig 3.1- 4 Cm Face,Facial (11444) $426 $568 0.3×
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $376.50 $502 0.2×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $426 $568 0.3×
Exc Skin Malig 2.1-3 Cm Face,Facial (11643) $261 $348 0.2×
Exc Skin Malig >4 Cm Remaindr Body (11626) $562.50 $750 0.2×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $261 $348 0.2×
Exc tr-ext b9+marg 0.5 cm or less (11400) $87 $116 0.1×
Excis Tendon Sheath Lesion, Hand/Finger (26160) $9 $12 0.0×
Excision mal lesion trunk/arm/leg 0.5 cm/< (11600) $342.75 $457 0.5×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $152.25 $203 0.2×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $174 $232 0.4×
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $426 $568 0.6×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $218.25 $291 0.3×
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $356.25 $475 0.5×
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $196.50 $262 0.3×
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $239.25 $319 0.3×
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $732 $976 0.4×
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $294 $392 0.2×
Excision malignant lesion s/n/h/f/g 0.6-1.0 cm (11621) $348 $464 0.5×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $426 $568 0.6×
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $463.50 $618 0.3×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $513 $684 0.3×
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $256.50 $342 0.4×
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $314.25 $419 0.4×
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $131.25 $175 0.1×
Excision of lesion other than skin tag </= 0.5 cm (11420) $186.75 $249 0.1×
Excision of nail fold toe (11765) $131.25 $175 0.3×
I&d abscess simple (10060) $131.25 $175 0.7×
I&d pilonidal cyst simple (10080) $231.75 $309 0.3×
Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd - Enteroscopy (44380) $702.94 $937.25 0.8×
Image Cath Fluid Colxn Visc (49405) $1,430.06 $1,906.75 0.9×
Incision & drainage abscess complicated/multiple (10061) $152.25 $203 0.4×
Incision & removal foreign body subq tiss simple (10120) $231.75 $309 0.6×
Incision thrombosed hemorrhoid external (46083) $376.50 $502 1.5×
Initial tx 1st degree burn local tx (16000) $99.75 $133 0.5×
Inj tendon sheath/ligament (20550) $109.50 $146 0.4×
Inj,Anes Agent,Brachial Plexus,Single (64415) $646.69 $862.25 0.7×
Inj,Anes Agent,Femoral Nerve,Single (64447) $565.69 $754.25 0.8×
Inject Anes/Steroid Plantar Common Digital Nerve (64455) $109.50 $146 0.4×
Inject Nerv Blck,Axillary Nerv (64417) $646.69 $862.25 0.7×
Inject Tendon Origin/Insert (20551) $87 $116 0.3×
Injection aa&/strd suprascapular nerve (64418) $646.69 $862.25 0.9×
Injection anes other peripheral nerve/branch (64450) $357.84 $477.12 0.5×
Injection single/mlt trigger point 1/2 muscles (20552) $172.50 $230 0.6×
Injection single/mlt trigger point 3/> muscles (20553) $87 $116 0.3×
Injection, intralesional; up to and including 7 lesions (11900) $69 $92 0.3×
Insert Drug Implant Device (11981) $289.50 $386 2.2×
Insert non-tunnel cv cath (36556) $704.16 $938.88 0.2×
Insert pessary/other device (57160) $138.75 $185 0.7×
Insert Temp Bladder Cath (51702) $142.22 $189.62 1.1×
Insert,Non-Indwelling Bladder Catheter (51701) $103.31 $137.75 0.8×
Intubation endotracheal emergency procedure (31500) $281.16 $374.88 1.2×
Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) $162.19 $216.25 0.0×
Partical Excision Bone Phalanx Toe (28124) $835.50 $1,114 0.3×
Punch biopsy skin single lesion (11104) $131.25 $175 0.3×
Removal fb intranasal (30300) $131.25 $175 1.0×
Removal foreign body foot subcutaneous (28190) $131.25 $175 0.2×
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $131.25 $175 0.1×
Removal impacted cerumen irrigation/lvg unilat (69209) $80.25 $107 1.4×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $40.50 $54 0.7×
Removal Implantable Contraceptive Capsules (11976) $152.25 $203 0.2×
Removal of intrauterine device (iud) (58301) $149.25 $199 0.5×
Removal of nail bed (11750) $174 $232 0.4×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $66 $88 0.3×
Remove drug implant device (11982) $152.25 $203 0.3×
Remove foreign body from eye (65210) $108 $144 0.2×
Remove wrist tendon lesion (25111) $840 $1,120 0.5×
Remv Ext Canal Foreign Body (69200) $211.50 $282 1.6×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $699 $932 0.9×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $475.50 $634 1.2×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $802.50 $1,070 2.0×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $653.25 $871 1.6×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $401.25 $535 1.0×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $442.50 $590 1.1×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $261 $348 0.6×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $294 $392 0.7×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $348 $464 0.9×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $339.75 $453 0.8×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $438.75 $585 1.1×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $360 $480 0.9×
Replace g/c tube perc (49450) $140.06 $186.75 0.2×
Replacement gastro-jejunostomy tube percutaneous (49452) $781.50 $1,042 0.9×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $252.75 $337 0.6×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $99.75 $133 0.7×
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $365.62 $487.50 0.2×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $264.38 $352.50 0.4×
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $109.50 $146 0.5×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $66 $88 0.3×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $182.25 $243 0.9×
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $141 $188 0.7×
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $168.75 $225 0.4×
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $66 $88 0.2×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $109.50 $146 0.5×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $153 $204 0.4×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $178.50 $238 0.9×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $168.75 $225 0.4×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $136.50 $182 0.7×
Sigmoidoscopy flx w/biopsy single/multiple (45331) $337.50 $450 0.4×
Simple destruction of growth of penis using electric current (54055) $213.56 $284.75 0.1×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $109.50 $146 0.5×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $131.25 $175 0.7×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $112.50 $150 0.6×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $438.75 $585 2.2×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $152.25 $203 0.8×
Small bowel endoscopy/biopsy (44377) $702.94 $937.25 0.4×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $131.25 $175 0.7×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $314.25 $419 0.8×
Spinal puncture lumbar diagnostic (62270) $404.44 $539.25 0.6×
Strapping ankle (29540) $41.25 $55 0.3×
Strapping elbow/wrist (29260) $46.31 $61.75 0.8×
Strapping hand/finger (29280) $46.88 $62.50 0.8×
Strapping Hip (29520) $178.88 $238.50 1.3×
Strapping knee (29530) $46.31 $61.75 0.3×
Strapping shoulder (29240) $144.94 $193.25 1.1×
Strapping thorax (29200) $48.38 $64.50 0.3×
Strapping toes (29550) $29.62 $39.50 0.5×
Strapping unna boot (29580) $93.75 $125 0.6×
Tangential biopsy skin single lesion (11102) $112.50 $150 0.3×
Tenotomy Percutaneous Toe Single Tendon (28010) $243.75 $325 0.2×
Trim skin lesion (11055) $66 $88 0.3×
Trim skin lesions 2 to 4 (11056) $87 $116 0.4×
Trim skin lesions over 4 (11057) $91.50 $122 0.5×
Trimming Of Nondystrophic Nails, Any Number (11719) $23.25 $31 0.4×
Unlisted Procedure Casting/Strapping (29799) $188.81 $251.75 1.2×
Vasectomy (55250) $835.50 $1,114 0.4×
Venipuncture (36415) $12.56 $16.75 1.3×