Procedures & surgery prices at Gordon Memorial Hospital District
Gordon, NE · every code in this section with a posted price and a Medicare benchmark.
461 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abd paracentesis w/imaging (49083) | $1,520 | $1,520 | 1.6× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) | $260 | $260 | 0.3× |
| Acne surgery (10040) | $194 | $194 | 0.9× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) | $2,555 | $2,555 | 0.8× |
| Amputation foot transmetarsal (28805) | $89 | $89 | 0.0× |
| Amputation metatarsal with toe single (28810) range across 2 matching MRF lines |
$1,510–$11,500 | $1,510–$11,500 | varies |
| Amputation toe interphalangeal joint (28825) | $4,000 | $4,000 | 1.2× |
| Anoscopy diagnostic (46600) range across 2 matching MRF lines |
$145–$177 | $145–$177 | varies |
| Anterior colporraphy rpr cystocele w/cysto (57240) | $11,000 | $11,000 | 2.1× |
| Appl Mltlayr Compres Sys Uparm Lwarm Hand&Fing (29584) | $55 | $55 | 0.3× |
| Application cast elbow finger short arm (29075) range across 2 matching MRF lines |
$220–$306 | $220–$306 | varies |
| Application finger splint static (29130) range across 2 matching MRF lines |
$100–$145 | $100–$145 | varies |
| Application long arm splint shoulder hand (29105) range across 2 matching MRF lines |
$145–$288 | $145–$288 | varies |
| Application Long Leg Splint (29505) range across 2 matching MRF lines |
$185–$320 | $185–$320 | varies |
| Application of long leg cast (29345) range across 2 matching MRF lines |
$324–$350 | $324–$350 | varies |
| Application short arm splint forearm-hand static (29125) range across 2 matching MRF lines |
$145–$233 | $145–$233 | varies |
| Application short leg splint calf foot (29515) range across 2 matching MRF lines |
$175–$310 | $175–$310 | varies |
| Apply hand/wrist cast (29085) | $308 | $308 | 1.8× |
| Apply long arm cast (29065) range across 2 matching MRF lines |
$240–$338 | $240–$338 | varies |
| Apply Multlay Comprs Lwr Leg (29581) range across 3 matching MRF lines |
$90–$275 | $90–$275 | varies |
| Apply Short Leg Cast (29405) range across 3 matching MRF lines |
$185–$280 | $185–$280 | varies |
| Apply short leg cast (29425) | $314 | $314 | 1.1× |
| Arterial puncture (36600) | $151 | $151 | 1.1× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) range across 5 matching MRF lines |
$130–$2,250 | $130–$2,250 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 5 matching MRF lines |
$153–$2,550 | $153–$2,550 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) range across 2 matching MRF lines |
$2,200–$3,300 | $2,200–$3,300 | varies |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) range across 5 matching MRF lines |
$127–$2,250 | $127–$2,250 | varies |
| Arthrodesis triple (28715) likely a partial charge, not the full procedure |
$54 | $54 | 0.0× |
| Arthroplasty glenohumeral joint total shoulder (23472) | $38,000 | $38,000 | 2.1× |
| Arthroplasty interposition intercarpal or carpometacarpal joints (25447) | $19,000 | $19,000 | 5.6× |
| Arthroscopy shoulder distal claviculectomy (29824) | $15,500 | $15,500 | 4.6× |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) | $16,500 | $16,500 | 4.9× |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) | $22,500 | $22,500 | 3.0× |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) | $14,000 | $14,000 | 4.1× |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) | $12,000 | $12,000 | 3.5× |
| Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) | $27,000 | $27,000 | 3.6× |
| Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130) | $33,500 | $33,500 | 2.5× |
| Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888) | $24,500 | $24,500 | 3.3× |
| Arthrs Knee Abrasion Arthrp/Mlt Drlg/Microfx (29879) | $15,500 | $15,500 | 4.6× |
| Arthrs Knee W/Meniscectomy Med&Lat W/Shaving (29880) | $8,000 | $8,000 | 2.4× |
| Aspirate pleura w/ imaging (32555) | $1,620 | $1,620 | 2.5× |
| Aspirate Pleura W/O Imaging (32554) | $315 | $315 | 0.5× |
| Aspirate/Inj Ganglion Cyst (20612) range across 3 matching MRF lines |
$130–$1,500 | $130–$1,500 | varies |
| Avulsion nail plate partial/complete simple 1 (11730) range across 4 matching MRF lines |
$170–$278 | $170–$278 | varies |
| Biopsy of penis (54100) | $2,500 | $2,500 | 1.5× |
| Biopsy Soft Tissue Shoulder Deep (23066) | $10 | $10 | 0.0× |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) | $3,500 | $3,500 | 3.7× |
| Bladder instillation anticarcinogenic agent (51720) range across 2 matching MRF lines |
$135–$323 | $135–$323 | varies |
| Bladder Irrigation (51700) range across 2 matching MRF lines |
$95–$246 | $95–$246 | varies |
| Bladder Scan (51798) range across 2 matching MRF lines |
$35–$275 | $35–$275 | varies |
| Blood Transfusion Service (36430) range across 5 matching MRF lines |
$140–$2,070 | $140–$2,070 | varies |
| Bx breast needle core w/o imaging guidance spx (19100) | $421 | $421 | 0.2× |
| Bx Cervix (57500) range across 2 matching MRF lines |
$275–$700 | $275–$700 | varies |
| Carpal Tunnel Surgery (64721) | $8,500 | $8,500 | 4.2× |
| Cataract surgery complex (66982) range across 3 matching MRF lines |
$7,000–$11,500 | $7,000–$11,500 | varies |
| Catheter aspiration nasotracheal spx (31720) | $154 | $154 | 0.7× |
| Cautery Cervix Cryocautery Initial/Repeat (57511) | $341 | $341 | 1.1× |
| Change Cystostomy Tube Simple (51705) | $185 | $185 | 0.7× |
| Chemodenerv Musc Migraine (64615) | $3,300 | $3,300 | 10.4× |
| Chemodenerv musc neck dyston (64616) | $2,800 | $2,800 | 8.8× |
| Chemodenervation of internal anal sphincter (46505) | $3,500 | $3,500 | 2.8× |
| Chest tube placement (32551) | $535 | $535 | 0.3× |
| Circumcision w/clamp/oth dev w/block (54150) | $520 | $520 | 0.2× |
| Cl Tx Tib Shft Fx W Manip (27752) | $1,760 | $1,760 | 1.1× |
| Clear outer ear canal (69200) | $170 | $170 | 1.2× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) | $1,455 | $1,455 | 5.7× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) | $1,540 | $1,540 | 0.9× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) | $1,125 | $1,125 | 4.4× |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) range across 2 matching MRF lines |
$845–$6,434 | $845–$6,434 | varies |
| Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) | $1,040 | $1,040 | 4.1× |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) | $1,720 | $1,720 | 6.7× |
| Closed tx knee dislocation w/o anesthesia (27550) | $1,700 | $1,700 | 6.6× |
| Closed tx metatarsal fracture w/o manipulation (28470) | $760 | $760 | 3.0× |
| Closed tx patellar dislocation w/o anesthesia (27560) | $1,245 | $1,245 | 4.9× |
| Closed Tx Patellar Fracture W/O Manipulation (27520) | $1,105 | $1,105 | 4.3× |
| Closed tx radial head/neck fx w/manipulation (24655) | $1,470 | $1,470 | 0.9× |
| Closed tx radial head/neck fx w/o manipulation (24650) | $905 | $905 | 3.5× |
| Closed tx radial shaft fracture w/manipulation (25505) | $1,670 | $1,670 | 1.0× |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) | $950 | $950 | 3.7× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) range across 2 matching MRF lines |
$1,680–$1,769 | $1,680–$1,769 | varies |
| Closed tx radial&ulnar shaft fractures w/o man (25560) | $955 | $955 | 3.7× |
| Closed Tx Scapular Fracture W/O Manipulation (23570) | $895 | $895 | 3.5× |
| Closed tx ulnar shaft fracture w/o manipulation (25530) | $895 | $895 | 3.5× |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) | $870 | $870 | 3.4× |
| Clsd tx clavicular fracture w/o manipulation (23500) | $840 | $840 | 3.3× |
| Clsd tx fx orbit except blowout w/o manipulation (21400) | $610 | $610 | 1.1× |
| Clsd Tx Pelvic Ring Fx (27198) | $1,115 | $1,115 | 4.4× |
| Clsd Tx Pelvic Ring Fx W/O Manipulation (27197) | $475 | $475 | 1.9× |
| Clsd tx shoulder dislc w/manipulation req anes (23655) range across 2 matching MRF lines |
$1,475–$2,238 | $1,475–$2,238 | varies |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) range across 4 matching MRF lines |
$337–$1,085 | $337–$1,085 | varies |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) | $1,225 | $1,225 | 0.7× |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) | $820 | $820 | 3.2× |
| Cltx Carpal Bone Fx W/O Manj Each Bone (25630) | $1,045 | $1,045 | 4.1× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) | $1,135 | $1,135 | 4.4× |
| Cltx dstl fibular fx lat malls w/manj (27788) | $1,395 | $1,395 | 5.4× |
| Cltx dstl fibular fx lat malls w/o manj (27786) | $1,055 | $1,055 | 4.1× |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) range across 2 matching MRF lines |
$1,005–$1,800 | $1,005–$1,800 | varies |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) | $700 | $700 | 2.7× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) | $1,195 | $1,195 | 4.7× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) range across 2 matching MRF lines |
$1,719–$1,845 | $1,719–$1,845 | varies |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) | $20 | $20 | 0.0× |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) | $1,795 | $1,795 | 7.0× |
| Cltx Fem Fx Prox End Nck W/O Manj (27230) | $1,715 | $1,715 | 6.7× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) range across 2 matching MRF lines |
$405–$460 | $405–$460 | varies |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) | $530 | $530 | 2.1× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) | $445 | $445 | 1.7× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) | $1,120 | $1,120 | 4.4× |
| Cltx greater humeral tuberosity fx w/o manj (23620) | $955 | $955 | 3.7× |
| Cltx hip dislocation traumatic req anesthesia (27252) | $2,645 | $2,645 | 1.6× |
| Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) | $1,155 | $1,155 | 4.5× |
| Cltx inter/peri/subtrochanteric fem fx w/o manj (27238) | $1,675 | $1,675 | 1.0× |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) | $460 | $460 | 1.6× |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) | $1,300 | $1,300 | 4.5× |
| Cltx iphal jt dislc w/manj w/o anes (26770) | $960 | $960 | 3.7× |
| Cltx Medial Ankle Fx (27760) | $1,130 | $1,130 | 4.4× |
| Cltx metacarpal fx w/manipulation each bone (26605) range across 2 matching MRF lines |
$1,095–$1,178 | $1,095–$1,178 | varies |
| Cltx metacarpal fx w/o manipulation each bone (26600) | $1,060 | $1,060 | 4.1× |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) | $1,440 | $1,440 | 0.9× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) | $1,115 | $1,115 | 4.4× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) | $700 | $700 | 2.7× |
| Cltx post hip arthrp dislc req anes (27266) | $1,508 | $1,508 | 0.9× |
| Cltx post hip arthrp dislc w/o anes (27265) | $1,490 | $1,490 | 5.8× |
| Cltx prox fibula/shft fx w/o manj (27780) | $1,050 | $1,050 | 4.1× |
| Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) | $1,081 | $1,081 | 4.2× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) | $295 | $295 | 1.2× |
| Cltx tibial fx proximal w/o manipulation (27530) | $1,065 | $1,065 | 4.2× |
| Cltx tibial shaft fx w/o manipulation (27750) | $1,180 | $1,180 | 4.6× |
| Cltx trimalleolar ankle fx w/manipulation (27818) | $1,580 | $1,580 | 0.9× |
| Cltx trimalleolar ankle fx w/o manipulation (27816) | $1,075 | $1,075 | 4.2× |
| Cmbnd anterpost colporraphy w/cysto w/ntrcl rpr (57265) | $40,000 | $40,000 | 7.7× |
| Collection of venous blood by venipuncture (36415) range across 2 matching MRF lines |
$14–$39 | $14–$39 | varies |
| Colonoscopy w/ablation (45388) | $5,500 | $5,500 | 4.4× |
| Colonoscopy W/Band Ligation (45398) | $5,000 | $5,000 | 4.0× |
| Colonoscopy w/fb removal (45379) | $5,000 | $5,000 | 4.0× |
| Colonoscopy w/submucosal inj (45381) | $4,000 | $4,000 | 3.2× |
| Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) | $370 | $370 | 1.2× |
| Colposcopy cervix upper/adjacent vagina (57452) | $300 | $300 | 1.4× |
| Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx (57455) | $390 | $390 | 1.2× |
| Colposcopy entire vagina w/cervix if present (57420) | $288 | $288 | 0.9× |
| Colsc flx w/removal lesion by hot bx forceps (45384) | $4,500 | $4,500 | 3.6× |
| Combined anteroposterior colporrhaphy; (57260) | $15,000 | $15,000 | 2.9× |
| Conization cervix w/wo d&c rpr eltrd exc (57522) | $4,000 | $4,000 | 1.2× |
| Conization of cervix (57520) | $11,000 | $11,000 | 3.3× |
| Control Nasal Hemorrhage Anterior Complex (30903) range across 2 matching MRF lines |
$375–$427 | $375–$427 | varies |
| Control Nasal Hemorrhage Anterior Simple (30901) range across 2 matching MRF lines |
$200–$377 | $200–$377 | varies |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) | $370 | $370 | 2.7× |
| Ctrl Oropharyngeal Hemorrhage W/Sec Surg Ivntj (42962) | $649 | $649 | 0.2× |
| Cystourethroscopy (52000) range across 2 matching MRF lines |
$574–$667 | $574–$667 | varies |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) | $100 | $100 | 0.2× |
| Debride nail 1-5 (11720) | $115 | $115 | 1.9× |
| Debride nail 6 or more (11721) | $118 | $118 | 1.9× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) | $450 | $450 | 1.1× |
| Declot vascular device (36593) | $105 | $105 | 0.3× |
| Delivery of placenta (59414) | $260 | $260 | 0.1× |
| Destroy cerv/thor facet jnt (64633) | $5,500 | $5,500 | 2.7× |
| Destroy lumb/sac facet jnt (64635) range across 2 matching MRF lines |
$5,500–$8,250 | $5,500–$8,250 | varies |
| Destruct B9 Lesion 1-14 (17110) | $274 | $274 | 1.3× |
| Destruction by neurolytic agent, intercostal nerve (64620) | $4,900 | $4,900 | 5.3× |
| Destruction neurolytic agt genicular nerve w/img (64624) range across 2 matching MRF lines |
$4,300–$6,450 | $4,300–$6,450 | varies |
| Destruction Premalignant Lesion 15/> (17004) | $341 | $341 | 0.8× |
| Destruction premalignant lesion 1st (17000) | $162 | $162 | 0.8× |
| Dilat Female Urethra W/Suppository&/Instlj Ini (53660) | $214 | $214 | 1.6× |
| Dilate Urethra Stricture (53600) | $225 | $225 | 0.9× |
| Dilation Cervical Canal (57800) | $181 | $181 | 0.1× |
| Dilation of vagina (57400) | $4 | $4 | 0.0× |
| Disarticulation of shoulder; secondary closure or scar revision Facility (23921) range across 3 matching MRF lines |
$66–$146 | $66–$146 | varies |
| Drainage External Ear Abscess/Hematoma Simple (69000) | $455 | $455 | 0.6× |
| Drainage Finger Abscess Complicated (26011) | $665 | $665 | 0.4× |
| Drainage of finger abscess simple (26010) range across 2 matching MRF lines |
$510–$525 | $510–$525 | varies |
| Drainage of gum lesion (41800) | $45 | $45 | 0.3× |
| Drainage of hematoma/fluid (10140) range across 2 matching MRF lines |
$406–$425 | $406–$425 | varies |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) | $390 | $390 | 1.9× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) range across 2 matching MRF lines |
$170–$268 | $170–$268 | varies |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) range across 2 matching MRF lines |
$3,500–$5,250 | $3,500–$5,250 | varies |
| Dstrj nulyt w/worad mntr suprior hypogstr plexus (64681) range across 3 matching MRF lines |
$20–$234 | $20–$234 | varies |
| Dx gastr intub w/asp spec (43754) | $130 | $130 | 0.6× |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) | $3,000 | $3,000 | 1.5× |
| Egd cautery tumor polyp (43250) | $3,500 | $3,500 | 1.8× |
| Egd Flexible Foreign Body Removal (43247) | $3,500 | $3,500 | 3.7× |
| Egd remove lesion snare (43251) | $4,000 | $4,000 | 2.0× |
| Endometrial Biopsy (58100) | $243 | $243 | 1.2× |
| Epidural Blood Patch (62273) | $360 | $360 | 0.5× |
| Evacuation of subungual hematoma (11740) range across 2 matching MRF lines |
$102–$115 | $102–$115 | varies |
| Exc abdl tum deep 5 cm/> (22901) | $11,000 | $11,000 | 3.6× |
| Exc arm/elbow les sc < 3 cm (24075) | $5,000 | $5,000 | 2.9× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) range across 3 matching MRF lines |
$308–$1,000 | $308–$1,000 | varies |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) | $541 | $541 | 0.3× |
| Exc Back Tum Deep 5 Cm/> (21933) | $12,000 | $12,000 | 4.0× |
| Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) | $432 | $432 | 0.6× |
| Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) | $643 | $643 | 0.9× |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) | $346 | $346 | 0.5× |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) | $301 | $301 | 0.4× |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) | $477 | $477 | 0.6× |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) | $595 | $595 | 0.3× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) | $228 | $228 | 0.1× |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) | $292 | $292 | 0.4× |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) | $368 | $368 | 0.2× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) | $444 | $444 | 0.6× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) range across 3 matching MRF lines |
$779–$4,000 | $779–$4,000 | varies |
| Exc Skin Benig >4cm Face,Facial (11446) | $2,500 | $2,500 | 0.8× |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) | $632 | $632 | 0.4× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) | $1,685 | $1,685 | 1.0× |
| Exc thigh/knee les sc 3 cm/> (27337) | $6,500 | $6,500 | 2.2× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) range across 2 matching MRF lines |
$405–$427 | $405–$427 | varies |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) range across 3 matching MRF lines |
$375–$1,500 | $375–$1,500 | varies |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) | $347 | $347 | 0.5× |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) | $609 | $609 | 0.4× |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) | $4,500 | $4,500 | 2.6× |
| Exc/Curettage Cyst/Tumor Talus/Calcaneus Algrft (28103) likely a partial charge, not the full procedure |
$12 | $12 | 0.0× |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) | $1,029 | $1,029 | 1.4× |
| Excision Excessive Skin & Subq Tissue Other Area (15839) | $5,000 | $5,000 | 1.7× |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) | $474 | $474 | 0.6× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) | $549 | $549 | 0.7× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) | $589 | $589 | 1.4× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) | $1,170 | $1,170 | 1.6× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) | $367 | $367 | 0.5× |
| Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) | $638 | $638 | 0.4× |
| Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) | $422 | $422 | 0.6× |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) | $509 | $509 | 0.7× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) range across 3 matching MRF lines |
$728–$1,304 | $728–$1,304 | varies |
| Excision of pilonidal cyst or sinus; simple (11770) | $3,000 | $3,000 | 1.0× |
| Excision olecranon bursa (24105) | $6,500 | $6,500 | 1.9× |
| Excision Pilonidal Cyst/Sinus Complicated (11772) | $8,000 | $8,000 | 2.7× |
| Excision Pilonidal Cyst/Sinus Extensive (11771) | $7,000 | $7,000 | 2.3× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) | $7,500 | $7,500 | 4.4× |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) | $6,500 | $6,500 | 3.8× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) | $7,000 | $7,000 | 2.3× |
| Exploration of knee joint (27310) | $17,000 | $17,000 | 5.0× |
| Exploration penetrating wound spx extremity (20103) | $1,210 | $1,210 | 0.7× |
| Eye Surg Ant Sgmt Proc Unlisted (66999) | $2,300 | $2,300 | 1.0× |
| Fetal non-stress test (59025) range across 4 matching MRF lines |
$124–$410 | $124–$410 | varies |
| Fine needle aspiration without imaging guidance (10021) range across 2 matching MRF lines |
$168–$340 | $168–$340 | varies |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) range across 2 matching MRF lines |
$1,260–$5,500 | $1,260–$5,500 | varies |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) | $5,000 | $5,000 | 1.7× |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; (46260) | $7,500 | $7,500 | 2.6× |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy Facility (46261) | $8,500 | $8,500 | 2.9× |
| Hemorrhoidectomy, internal, by rubber band ligation(s) (46221) | $3,000 | $3,000 | 3.1× |
| Hemorrhoidopexy by stapling (46947) | $3,800 | $3,800 | 1.3× |
| Hysteroscopy Biopsy (58558) | $10,000 | $10,000 | 3.0× |
| Hysteroscopy Dx Sep Proc (58555) | $8,000 | $8,000 | 2.4× |
| Hysteroscopy Endometrial Ablation (58563) | $7,500 | $7,500 | 1.4× |
| Hysteroscopy Removal Impacted Foreign Body (58562) | $18,000 | $18,000 | 5.4× |
| I&d abscess peritonsillar (42700) | $364 | $364 | 1.5× |
| I&d abscess simple (10060) range across 2 matching MRF lines |
$303–$385 | $303–$385 | varies |
| I&d pilonidal cyst simple (10080) | $375 | $375 | 0.5× |
| Implant neuroelectrodes (63650) | $11,300 | $11,300 | 1.7× |
| Incise external hemorrhoid (46083) range across 3 matching MRF lines |
$340–$2,000 | $340–$2,000 | varies |
| Incise finger tendon sheath (26055) | $11,000 | $11,000 | 6.6× |
| Incision & drainage abscess complicated/multiple (10061) range across 2 matching MRF lines |
$479–$665 | $479–$665 | varies |
| Incision & removal foreign body subq tiss compl (10121) | $660 | $660 | 0.4× |
| Incision & removal foreign body subq tiss simple (10120) range across 3 matching MRF lines |
$362–$1,500 | $362–$1,500 | varies |
| Incision extensor tendon sheath wrist (25000) | $6,500 | $6,500 | 3.9× |
| Initial Tx 1st Degree Burn Local Tx (16000) | $160 | $160 | 0.8× |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) range across 2 matching MRF lines |
$3,300–$4,950 | $3,300–$4,950 | varies |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) range across 2 matching MRF lines |
$4,000–$5,850 | $4,000–$5,850 | varies |
| Injection 1 tendon sheath/ligament aponeurosis (20550) range across 3 matching MRF lines |
$203–$1,700 | $203–$1,700 | varies |
| Injection aa&/strd axillary nerve w/img gdn (64417) | $2,500 | $2,500 | 2.7× |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) | $1,300 | $1,300 | 1.4× |
| Injection Anes Agent Sphenopalatine Ganglion (64505) | $595 | $595 | 1.9× |
| Injection single tendon origin/insertion (20551) range across 2 matching MRF lines |
$1,500–$1,700 | $1,500–$1,700 | varies |
| Injection single/mlt trigger point 1/2 muscles (20552) range across 4 matching MRF lines |
$127–$1,500 | $127–$1,500 | varies |
| Injection single/mlt trigger point 3/> muscles (20553) range across 4 matching MRF lines |
$150–$1,600 | $150–$1,600 | varies |
| Injection therapeutic carpal tunnel (20526) range across 2 matching MRF lines |
$175–$2,000 | $175–$2,000 | varies |
| Injection, anesthetic agent; brachial plexus, single (64415) | $2,800 | $2,800 | 3.0× |
| Injection, anesthetic agent; femoral nerve, single (64447) | $2,600 | $2,600 | 3.5× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) range across 4 matching MRF lines |
$135–$2,400 | $135–$2,400 | varies |
| Insert Bladder Cath Complex (51703) range across 2 matching MRF lines |
$400–$527 | $400–$527 | varies |
| Insert cath pleura w/ image (32557) | $540 | $540 | 0.3× |
| Insert cath pleura w/o image (32556) | $435 | $435 | 0.2× |
| Insert Drug Implant Device (11981) | $300 | $300 | 2.2× |
| Insert non-tunnel cv cath (36556) | $625 | $625 | 0.2× |
| Insert pessary/other device (57160) | $367 | $367 | 1.7× |
| Insert Picc W/O Sub-Q Port <5 Y/O (36568) | $3,125 | $3,125 | 1.9× |
| Insert Temp Bladder Cath (51702) range across 3 matching MRF lines |
$80–$205 | $80–$205 | varies |
| Insert tunneled cv cath (36561) | $6,500 | $6,500 | 2.0× |
| Insert,Non-Indwelling Bladder Catheter (51701) range across 2 matching MRF lines |
$197–$225 | $197–$225 | varies |
| Insertion Picc W/Rs&I 5 Yr/> (36573) range across 2 matching MRF lines |
$3,600–$3,850 | $3,600–$3,850 | varies |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) range across 4 matching MRF lines |
$283–$2,805 | $283–$2,805 | varies |
| Insj/Rplcmt Spinal Npg/Rcvr Pocket Crtj&Connj (63685) likely a partial charge, not the full procedure |
$8,300 | $8,300 | 0.3× |
| Intubation endotracheal emergency procedure (31500) | $1,020 | $1,020 | 4.1× |
| Lap paraesoph her rpr w/mesh (43282) | $32,500 | $32,500 | 2.9× |
| Lap paraesophag hern repair (43281) | $29,000 | $29,000 | 2.6× |
| Laparo-vag hyst incl t/o (58552) | $22,000 | $22,000 | 2.0× |
| Laparoscopy Enterolysis Separate Procedure (44180) | $16,500 | $16,500 | 2.6× |
| Laparoscopy fulguration oviducts (58670) | $10,000 | $10,000 | 1.6× |
| Laparoscopy salpingostomy (58673) | $9,000 | $9,000 | 0.8× |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) | $7,000 | $7,000 | 1.1× |
| Laparoscopy W/Lysis Of Adhesions (58660) | $24,000 | $24,000 | 3.8× |
| Laparoscopy w/rmvl adnexal structures (58661) | $16,500 | $16,500 | 2.6× |
| Laparoscopy, surgical, appendectomy (44970) | $10,500 | $10,500 | 1.7× |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; (58550) | $20,000 | $20,000 | 3.2× |
| Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; (58553) | $25,000 | $25,000 | 2.3× |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) | $12,500 | $12,500 | 2.0× |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) | $9,000 | $9,000 | 1.4× |
| Laparoscopy, Tubal Block (58671) | $16,000 | $16,000 | 2.5× |
| Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) | $8,500 | $8,500 | 1.4× |
| Laryngoscopy diagnostic (31505) | $211 | $211 | 1.0× |
| Lateral retinacular release open (27425) | $9,500 | $9,500 | 2.8× |
| Lavage cannulation sphenoid sinus (31002) range across 2 matching MRF lines |
$29–$53 | $29–$53 | varies |
| Manipulation spine requiring anesthesia (22505) | $3 | $3 | 0.0× |
| N block inj intercost sng (64420) | $2,200 | $2,200 | 3.0× |
| N Block Inj Plantar Digit (64455) | $240 | $240 | 0.8× |
| Needle insertion w/o injection 1 or 2 muscles (20560) | $80 | $80 | 2.7× |
| Needle insertion w/o injection 3 or more muscles (20561) | $95 | $95 | 3.2× |
| Neuroplasty and/or transposition; ulnar nerve at elbow (64718) | $12,500 | $12,500 | 6.2× |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) | $608 | $608 | 1.5× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) range across 2 matching MRF lines |
$170–$300 | $170–$300 | varies |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) range across 2 matching MRF lines |
$2,800–$6,300 | $2,800–$6,300 | varies |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) | $3,500 | $3,500 | 4.8× |
| Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62320) | $306 | $306 | 0.4× |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) | $3,200 | $3,200 | 4.4× |
| Occipital Nerve Block (64405) range across 3 matching MRF lines |
$175–$2,850 | $175–$2,850 | varies |
| Open treatment of clavicular fracture, includes internal fixation, when performed (23515) | $16,500 | $16,500 | 2.2× |
| Open treatment of craniofacial separation (LeFort III type); complicated (eg, comminuted or involving cranial nerve… (21433) range across 2 matching MRF lines |
$1,595–$1,675 | $1,595–$1,675 | varies |
| Open Tx Distal Fibular Fracture Lat Malleolus (27792) | $15,000 | $15,000 | 2.0× |
| Open tx trimalleolar ankle fx w/o fixj pst lip (27822) | $19,500 | $19,500 | 2.6× |
| Open tx ulnar fx proximal end (24685) | $14,500 | $14,500 | 1.9× |
| Optx dstl radl i-artic fx/epiphysl sep 2 frag (25608) | $19,000 | $19,000 | 2.5× |
| Optx dstl radl i-artic fx/epiphysl sep 3 frag (25609) | $24,500 | $24,500 | 3.3× |
| Optx humeral shft fx w/plate/screws w/wocerclage (24515) range across 2 matching MRF lines |
$2,657–$11,291 | $2,657–$11,291 | varies |
| Osteochondral allograft knee open (27415) | $34,000 | $34,000 | 2.6× |
| Osteot w/wo lngth shrt/corrj 1st metar (28306) likely a partial charge, not the full procedure |
$32 | $32 | 0.0× |
| Partial Excision Distal Phalanx Finger (26236) | $1,585 | $1,585 | 0.9× |
| Pelvic examination under anesthesia (other than local) (57410) | $3,000 | $3,000 | 0.9× |
| Pericardiocentesis W/Imaging (33016) | $395 | $395 | 0.2× |
| Perq Lumbosacral Injection (22511) | $11,500 | $11,500 | 3.4× |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) | $12,500 | $12,500 | 1.7× |
| Perq Vertebral Augmentation (22513) | $13,500 | $13,500 | 1.8× |
| Placement of needle for intraosseous infusion (36680) | $205 | $205 | 0.4× |
| Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy (57250) | $10,000 | $10,000 | 1.9× |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) | $170 | $170 | 0.2× |
| Punch biopsy skin single lesion (11104) range across 2 matching MRF lines |
$150–$303 | $150–$303 | varies |
| Puncture aspiration abscess hematoma bulla/cyst (10160) range across 2 matching MRF lines |
$253–$355 | $253–$355 | varies |
| Puncture Aspiration Cyst Breast (19000) | $246 | $246 | 0.3× |
| Pvb Thoracic Single Injection Site W/Img Gid (64461) | $3,200 | $3,200 | 4.4× |
| Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) | $5,600 | $5,600 | 2.8× |
| Removal Foreign Body Foot Subcutaneous (28190) range across 2 matching MRF lines |
$485–$669 | $485–$669 | varies |
| Removal impacted cerumen irrigation/lvg unilat (69209) range across 2 matching MRF lines |
$36–$55 | $36–$55 | varies |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) range across 2 matching MRF lines |
$114–$115 | $114–$115 | varies |
| Removal Implant Deep (20680) | $10,500 | $10,500 | 3.5× |
| Removal implantable contraceptive capsules (11976) | $302 | $302 | 0.4× |
| Removal of nail bed (11750) range across 2 matching MRF lines |
$386–$460 | $386–$460 | varies |
| Removal of sesamoid bone (28315) | $54 | $54 | 0.0× |
| Removal or bivalving full arm or full leg cast (29705) | $160 | $160 | 0.6× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) | $220 | $220 | 1.1× |
| Remove drug implant device (11982) | $333 | $333 | 0.7× |
| Remove foreign body from eye (65205) range across 3 matching MRF lines |
$105–$107 | $105–$107 | varies |
| Remove Intrauterine Device (58301) range across 4 matching MRF lines |
$235–$5,000 | $235–$5,000 | varies |
| Remove Nasal Foreign Body (30300) | $455 | $455 | 3.3× |
| Remove Peritoneal Foreign Body (49402) | $15,500 | $15,500 | 4.2× |
| Remove Tendon Sheath Lesion (26160) | $6,500 | $6,500 | 3.9× |
| Remove/Insert Drug Implant (11983) | $400 | $400 | 0.9× |
| Repair Achilles Tendon (27650) | $16,000 | $16,000 | 2.1× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) | $1,000 | $1,000 | 1.3× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) range across 2 matching MRF lines |
$1,210–$4,030 | $1,210–$4,030 | varies |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) range across 3 matching MRF lines |
$496–$6,500 | $496–$6,500 | varies |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) range across 2 matching MRF lines |
$1,095–$1,298 | $1,095–$1,298 | varies |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) range across 2 matching MRF lines |
$553–$835 | $553–$835 | varies |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) range across 2 matching MRF lines |
$930–$951 | $930–$951 | varies |
| Repair complex trunk 1.1-2.5 cm (13100) | $725 | $725 | 0.9× |
| Repair complex trunk 2.6-7.5 cm (13101) | $895 | $895 | 1.2× |
| Repair Ectropion Suture (67914) | $4,500 | $4,500 | 1.8× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) range across 3 matching MRF lines |
$610–$626 | $610–$626 | varies |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) range across 2 matching MRF lines |
$701–$720 | $701–$720 | varies |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) | $775 | $775 | 1.8× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) | $780 | $780 | 1.8× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) range across 2 matching MRF lines |
$968–$970 | $968–$970 | varies |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) range across 2 matching MRF lines |
$525–$636 | $525–$636 | varies |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) range across 2 matching MRF lines |
$626–$710 | $626–$710 | varies |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) | $765 | $765 | 1.0× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) range across 2 matching MRF lines |
$845–$852 | $845–$852 | varies |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) range across 2 matching MRF lines |
$550–$634 | $550–$634 | varies |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) range across 2 matching MRF lines |
$569–$690 | $569–$690 | varies |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) range across 2 matching MRF lines |
$672–$735 | $672–$735 | varies |
| Repair intermediate s/a/t/e >30.0 cm (12037) | $1,199 | $1,199 | 0.6× |
| Repair of nail bed (11760) range across 2 matching MRF lines |
$1,000–$3,000 | $1,000–$3,000 | varies |
| Repair Rotator Cuff Chronic (23412) | $20,500 | $20,500 | 2.7× |
| Repair, primary, disrupted ligament, ankle; collateral (27695) | $11,500 | $11,500 | 1.5× |
| Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft Facility (27137) | $39,000 | $39,000 | 2.9× |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) | $410 | $410 | 0.4× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) range across 2 matching MRF lines |
$124–$150 | $124–$150 | varies |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) | $185 | $185 | 1.3× |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) | $135 | $135 | 0.3× |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) | $870 | $870 | 0.3× |
| Rmvl spinal nstim eltrd prq array incl fluor (63661) | $8,200 | $8,200 | 4.0× |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) range across 2 matching MRF lines |
$2,730–$3,500 | $2,730–$3,500 | varies |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) range across 2 matching MRF lines |
$480–$505 | $480–$505 | varies |
| Rplc Gtube No Revj Trc (43762) | $130 | $130 | 0.5× |
| Rplcmt Compl Prph Cvc W/O Subq Port/Pmp (36584) range across 2 matching MRF lines |
$1,620–$1,910 | $1,620–$1,910 | varies |
| Rpr Aa Hernia 1st < 3 Cm Reducible (49591) | $6,500 | $6,500 | 1.7× |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) | $8,000 | $8,000 | 2.2× |
| Rpr aa hrn 1st 3-10 rdc (49593) | $11,000 | $11,000 | 1.6× |
| Rpr aa hrn 1st < 3 ncr/strn (49592) | $9,500 | $9,500 | 1.5× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) | $320 | $320 | 1.5× |
| Rpr Tdn/Musc Xtnsr F/Arm&/Wrist Prim 1 Ea Tdn (25270) | $1,780 | $1,780 | 0.5× |
| Shave skin lesion 0.5 cm/< (11300) | $244 | $244 | 0.6× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) | $219 | $219 | 1.1× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) | $165 | $165 | 0.8× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) | $199 | $199 | 1.0× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) | $195 | $195 | 0.9× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) | $331 | $331 | 1.6× |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) | $1,500 | $1,500 | 1.6× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) range across 2 matching MRF lines |
$190–$267 | $190–$267 | varies |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) range across 3 matching MRF lines |
$175–$455 | $175–$455 | varies |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) | $255 | $255 | 1.2× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) range across 2 matching MRF lines |
$155–$223 | $155–$223 | varies |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) range across 2 matching MRF lines |
$250–$482 | $250–$482 | varies |
| Slitting of prepuce (54001) range across 5 matching MRF lines |
$4–$10 | $4–$10 | varies |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) range across 2 matching MRF lines |
$200–$269 | $200–$269 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) | $325 | $325 | 0.8× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) | $400 | $400 | 0.9× |
| Spinal puncture lumbar diagnostic (62270) range across 2 matching MRF lines |
$190–$215 | $190–$215 | varies |
| Strapping ankle (29540) | $65 | $65 | 0.4× |
| Strapping elbow or wrist (29260) | $70 | $70 | 1.1× |
| Strapping hand/finger (29280) | $70 | $70 | 1.1× |
| Strapping knee (29530) | $70 | $70 | 0.5× |
| Strapping shoulder (29240) | $70 | $70 | 0.5× |
| Strapping toes (29550) | $40 | $40 | 0.7× |
| Strapping Unna Boot (29580) range across 4 matching MRF lines |
$240–$260 | $240–$260 | varies |
| Suture infrapatellar tendon primary (27380) | $13,000 | $13,000 | 1.7× |
| Tenodesis long tendon biceps (23430) | $17,500 | $17,500 | 2.3× |
| Tnot elbow lateral/medial debride open (24358) | $11,500 | $11,500 | 3.4× |
| Tnot elbow lateral/medial debride open tdn rpr (24359) | $15,500 | $15,500 | 4.6× |
| Tooth extraction (41899) | $3,050 | $3,050 | 12.4× |
| Total Knee Arthroplasty (27447) | $33,500 | $33,500 | 2.5× |
| Transcatheter biopsy (37200) likely a partial charge, not the full procedure |
$34 | $34 | 0.0× |
| Transplant hand tendon (26480) | $12,000 | $12,000 | 3.5× |
| Treat elbow fracture (24586) likely a partial charge, not the full procedure |
$310 | $310 | 0.0× |
| Treat Finger Fracture Each (26727) | $9,500 | $9,500 | 2.8× |
| Treat Fx Rad Extra-Articul (25607) | $16,500 | $16,500 | 2.2× |
| Treat humerus fracture (24500) | $1,225 | $1,225 | 4.8× |
| Treat humerus fracture (23600) | $1,165 | $1,165 | 4.5× |
| Treat Kneecap Fracture (27524) | $18,000 | $18,000 | 2.4× |
| Treat Knuckle Dislocation (26700) range across 2 matching MRF lines |
$1,140–$1,209 | $1,140–$1,209 | varies |
| Treat Metatarsal Fracture (28475) | $840 | $840 | 3.3× |
| Treat Tail Bone Fracture (27200) | $690 | $690 | 2.7× |
| Treat Thumb Dislocation (26641) | $1,390 | $1,390 | 5.4× |
| Treat toe dislocation (28630) | $400 | $400 | 1.6× |
| Treatment closed elbow dislocation w/o anes (24600) | $1,235 | $1,235 | 4.8× |
| Treatment of gum lesion (41850) | $380 | $380 | 0.2× |
| Trim skin lesion (11055) | $93 | $93 | 0.4× |
| Trim skin lesions 2 to 4 (11056) | $139 | $139 | 0.7× |
| Trimming Nondystrophic Nails Any Number (11719) | $35 | $35 | 0.6× |
| Tx Gastro Intub W/Asp (43753) | $75 | $75 | 0.3× |
| Tx Missed Abortion First Trimester Surgical (59820) | $865 | $865 | 0.3× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) | $313 | $313 | 0.4× |
| Unlisted procedure colon (45399) | $1,000 | $1,000 | 1.0× |
| Unlisted procedure shoulder (23929) | $637 | $637 | 2.5× |
| Unlisted Procedure Vascular Surgery (37799) | $2,415 | $2,415 | 3.7× |
| Vag hyst complex (58290) | $16,000 | $16,000 | 2.1× |
| Vag hyst incl t/o complex (58291) | $18,000 | $18,000 | 3.5× |
| Vag hyst w/t/o & vag repair (58263) | $30,000 | $30,000 | 5.8× |
| Vaginal Delivery After Cesarean Delivery (59612) range across 2 matching MRF lines |
$2,570–$2,966 | $2,570–$2,966 | varies |
| Vaginal delivery only (59409) | $7,650 | $7,650 | 2.3× |
| Vaginal hysterectomy, for uterus 250 g or less; (58260) | $14,000 | $14,000 | 2.7× |
| Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele Facility (58270) | $25,000 | $25,000 | 4.8× |
| Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele… (58292) | $32,000 | $32,000 | 4.2× |
| Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele Facility (58294) | $27,000 | $27,000 | 5.2× |
| Vaginal hysterectomy; with removal of tube(s), and/or ovary(s) (58262) | $16,000 | $16,000 | 3.1× |
| Vulvectomy simple partial (56620) | $4,000 | $4,000 | 1.2× |
| Wedge excision skin nail fold (11765) range across 2 matching MRF lines |
$247–$1,500 | $247–$1,500 | varies |
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.