Procedures & surgery prices at Gothenburg Health

Gothenburg, NE · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $1,350 $1,500 1.4×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $921 $1,023 1.0×
Amniocentesis therapeutic (59001)
range across 2 matching MRF lines		 $333–$929 $370–$1,032 varies
Application finger splint static (29130) $150 $167 1.1×
Application long arm splint shoulder hand (29105) $238 $264 1.4×
Application short arm splint forearm-hand static (29125) $218 $242 1.6×
Application short leg splint calf foot (29515) $230 $255 1.4×
Apply Multlay Comprs Lwr Leg (29581) $360 $400 2.1×
Apply Short Leg Cast (29405) $266 $296 0.9×
Arterial puncture (36600) $116 $129 0.8×
Aspirate/Inj Ganglion Cyst (20612) $144 $160 0.5×
Biopsy Abdominal Mass (49180) $2,070 $2,300 1.2×
Biopsy of liver, needle; percutaneous (47000)
range across 2 matching MRF lines		 $2,250–$2,700 $2,500–$3,000 varies
Biopsy ovary uni/bi separate procedure (58900) $2,181 $2,423 0.6×
Biopsy Tongue Anterior Two-Thirds (41100) $368 $409 0.7×
Biopsy, vestibule of mouth (40808) $365 $406 0.7×
Bladder Scan (51798)
range across 2 matching MRF lines		 $203–$225 $225–$250 varies
Blood Transfusion Service (36430) $1,109 $1,232 2.4×
Bone Marrow Biopsy (38221) $1,800 $2,000 1.0×
Bone Marrow; Aspiration Only (38220) $900 $1,000 0.5×
Bx breast 1st lesion strtctc (19081) $3,240 $3,600 1.9×
Bx breast 1st lesion us imag (19083) $2,498 $2,775 1.5×
Catheter aspiration nasotracheal spx (31720) $251 $279 1.1×
Change Cystostomy Tube Simple (51705) $405 $450 1.6×
Chemical Cautery Tissue (17250) $154 $171 0.7×
Chest tube placement (32551) $1,088 $1,209 0.7×
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $270 $300 1.1×
Closed Treatment Ulnar Styloid Fracture (25650) $748 $831 2.9×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $296 $329 1.2×
Closed Tx Calcaneal Fracture W/O Manipulation (28400)
range across 2 matching MRF lines		 $196–$596 $218–$662 varies
Closed Tx Carpal Scaphoid Fracture W/O Manj (25622)
range across 2 matching MRF lines		 $267–$745 $297–$828 varies
Closed tx femoral fracture prox head w/o manj (27267) $3,650 $4,055 1.1×
Closed tx metatarsal fracture w/o manipulation (28470)
range across 2 matching MRF lines		 $255–$596 $283–$662 varies
Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) $646 $718 0.2×
Closed tx patellar dislocation w/anesthesia (27562) $1,390 $1,544 5.4×
Closed tx radial head/neck fx w/o manipulation (24650)
range across 2 matching MRF lines		 $351–$679 $390–$754 varies
Closed Tx Radial Shaft Fracture W/O Manipulation (25500) $296 $329 1.2×
Closed tx radial&ulnar shaft fractures w/o man (25560)
range across 2 matching MRF lines		 $189–$662 $210–$735 varies
Closed Tx Scapular Fracture W/O Manipulation (23570) $596 $662 2.3×
Closed tx talus fracture w/o manipulation (28430) $216 $240 0.8×
Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670)
range across 2 matching MRF lines		 $311–$633 $346–$703 varies
Closed tx ulnar shaft fracture w/o manipulation (25530)
range across 2 matching MRF lines		 $274–$646 $304–$718 varies
Closure Of Rectovaginal Fistula; Vaginal Or Transanal Approach (57300) $2,582 $2,869 0.8×
Closure of urethrovaginal fistula; Facility (57310)
likely a partial charge, not the full procedure		 $1,876 $2,084 0.2×
Clsd tx clavicular fracture w/o manipulation (23500)
range across 2 matching MRF lines		 $276–$720 $307–$800 varies
Clsd tx shoulder dislc w/manipulation req anes (23655) $1,194 $1,327 0.7×
Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) $270 $300 1.1×
Cltx Carpal Bone Fx W/O Manj Each Bone (25630) $710 $789 2.8×
Cltx dstl fibular fx lat malls w/o manj (27786) $296 $329 1.2×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750)
range across 2 matching MRF lines		 $308–$450 $342–$500 varies
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $788 $875 3.1×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,122 $1,247 0.7×
Cltx Fem Fx Prox End Nck W/O Manj (27230) $270 $300 1.1×
Cltx fx grt toe phlx/phlg w/manj (28495) $374 $416 1.5×
Cltx fx grt toe phlx/phlg w/o manj (28490) $230 $255 0.9×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $335 $372 1.3×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510)
range across 2 matching MRF lines		 $284–$348 $315–$387 varies
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $761 $845 3.0×
Cltx Greater Trochanteric Fx W/O Manj (27246) $203 $225 0.8×
Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576)
range across 2 matching MRF lines		 $268–$842 $298–$935 varies
Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560)
range across 2 matching MRF lines		 $216–$715 $240–$794 varies
Cltx Iphal Jt Dislc W/Manj Req Anes (26775) $844 $938 2.9×
Cltx iphal jt dislc w/manj w/o anes (26770) $695 $772 2.7×
Cltx Medial Ankle Fx (27760)
range across 2 matching MRF lines		 $315–$764 $350–$849 varies
Cltx metacarpal fx w/manipulation each bone (26605) $794 $882 3.1×
Cltx metacarpal fx w/o manipulation each bone (26600)
range across 2 matching MRF lines		 $318–$720 $353–$800 varies
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $792 $880 3.1×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720)
range across 2 matching MRF lines		 $275–$532 $306–$591 varies
Cltx post hip arthrp dislc req anes (27266) $1,409 $1,565 0.8×
Cltx prox fibula/shft fx w/o manj (27780)
range across 2 matching MRF lines		 $227–$621 $252–$690 varies
Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) $914 $1,016 0.5×
Cltx tibial fx proximal w/o manipulation (27530) $943 $1,048 3.7×
Cltx tibial shaft fx w/o manipulation (27750)
range across 2 matching MRF lines		 $311–$908 $345–$1,009 varies
Cltx trimalleolar ankle fx w/o manipulation (27816) $360 $400 1.4×
Cmbnd anterpost colporraphy w/cysto w/ntrcl rpr (57265) $3,669 $4,077 0.7×
Collect Blood From Catheter Venous Nos (36592) $116 $129 0.8×
Collection of venous blood by venipuncture (36415)
range across 4 matching MRF lines		 $32–$54 $36–$60 varies
Colpocleisis (le fort type) (57120)
likely a partial charge, not the full procedure		 $493 $548 0.1×
Colpotomy; with drainage of pelvic abscess (57010) $1,812 $2,013 0.5×
Colpotomy; with exploration (57000) $788 $876 0.2×
Control Nasal Hemorrhage Anterior Simple (30901) $283 $314 2.0×
Deb Musc/Fascia 20 Sq Cm/< (11043) $1,069 $1,188 1.4×
Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) $2,111 $2,346 1.2×
Debridement subcutaneous tissue 20 sq cm/< (11042) $750 $833 1.8×
Declot vascular device (36593) $436 $484 1.3×
Destruction Lesions Vulva Extensive (56515) $844 $938 0.4×
Dilation And Curettage Of Cervical Stump (57558) $584 $649 0.2×
Dilation Cervical Canal (57800) $282 $313 0.1×
Drainage of hematoma/fluid (10140) $2,029 $2,254 1.2×
Drainage of hydrocele (55000) $282 $313 0.4×
Drainage Ovarian Cyst Uni/Bi Spx Abdominal (58805) $1,750 $1,944 0.5×
Drainage Ovarian Cyst Uni/Bi Spx Vaginal Appr (58800) $1,535 $1,705 0.5×
Draw Blood Off Venous Device (36591) $116 $129 0.8×
Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) $357 $397 0.5×
Dstrj Lesion Anus Simple Chemical (46900) $501 $557 1.2×
Dstrj Lesion Penis Simple Chemical (54050) $231 $257 0.5×
Dstrj Lesion Penis Simple Cryosurgery (54056) $298 $331 1.4×
Dx Bone Marrow Bx & Aspir (38222) $2,520 $2,800 0.8×
Epidural Blood Patch (62273) $1,229 $1,365 1.7×
Evacuate mole of uterus (59870) $1,831 $2,034 0.5×
Exc arm/elbow les sc < 3 cm (24075) $939 $1,043 0.5×
Exc Back Les Sc < 3 Cm (21930) $1,043 $1,159 0.6×
Exc F/E/E/N/L Mal+Mrg 3.1-4 (11644) $844 $938 0.5×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $497 $552 0.3×
Exc Face-Mm B9+Marg 3.1-4 Cm (11444) $639 $710 0.4×
Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) $541 $601 0.3×
Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) $596 $662 0.3×
Exc tumor soft tissue abdl wall subfascial <5cm (22900) $1,192 $1,324 0.4×
Exc tumor soft tissue abdominal wall subq <3cm (22902) $993 $1,103 0.6×
Excis Mouth Mucosa/Sub,No Repair (40810) $356 $395 0.1×
Excision of cervical stump, vaginal approach; with anterior and/or posterior repair Facility (57555) $2,822 $3,136 0.5×
Excision of cervical stump, vaginal approach; with repair of enterocele Facility (57556) $2,655 $2,950 0.5×
Excision of vaginal cyst or tumor (57135) $892 $991 0.3×
Excision of vaginal septum (57130) $1,876 $2,084 0.6×
Explo/Drain Breast Abscess (19020) $1,043 $1,159 0.6×
Fetal non-stress test (59025)
range across 3 matching MRF lines		 $90–$360 $100–$400 varies
Fetal Scalp Blood Sampling (59030) $375 $417 1.2×
Fine needle aspiration without imaging guidance (10021)
range across 2 matching MRF lines		 $255–$324 $283–$360 varies
Hysteroscopy Dx Sep Proc (58555) $1,402 $1,558 0.4×
Hysterotomy Abdominal (59100) $3,178 $3,531 0.6×
I&d abscess simple (10060) $371 $412 1.8×
I&d pilonidal cyst simple (10080) $388 $431 0.5×
I&d vaginal hematoma obstetrical/postpartum (57022) $721 $801 0.2×
Image Cath Fluid Colxn Visc (49405) $1,260 $1,400 0.7×
Implant Periph/Gastric Neurostim/Receiver (64590) $21,373 $23,748 1.1×
Incision & drainage abscess complicated/multiple (10061) $432 $480 1.0×
Incision & removal foreign body subq tiss simple (10120) $394 $438 0.9×
Incisional biopsy skin single lesion (11106) $365 $405 0.5×
Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) $1,870 $2,078 2.0×
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $2,076 $2,307 2.3×
Injection aa&/strd axillary nerve w/img gdn (64417) $2,404 $2,671 2.6×
Injection Aa&/Strd Brach Plex Cont Nfs Cath Img (64416) $2,404 $2,671 2.6×
Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) $1,870 $2,078 2.6×
Injection Aa&/Strd Sciatic Nrv Cont Nfs Cath Img (64446) $1,870 $2,078 2.0×
Injection single tendon origin/insertion (20551) $140 $155 0.4×
Injection single/mlt trigger point 1/2 muscles (20552) $120 $133 0.4×
Injection single/mlt trigger point 3/> muscles (20553) $101 $112 0.3×
Injection therapeutic carpal tunnel (20526) $194 $216 0.6×
Injection, anesthetic agent; brachial plexus, single (64415) $2,404 $2,671 2.6×
Injection, anesthetic agent; femoral nerve, single (64447) $1,816 $2,018 2.5×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $2,404 $2,671 3.3×
Insert Bladder Cath Complex (51703) $248 $276 1.9×
Insert cervical dilator (59200) $347 $385 1.1×
Insert pessary/other device (57160) $187 $208 0.9×
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines		 $156–$189 $173–$210 varies
Intubation endotracheal emergency procedure (31500)
range across 2 matching MRF lines		 $526–$675 $584–$750 varies
Laparoscopy fulguration oviducts (58670)
unusually low: confirm this is the full procedure		 $2,070 $2,300 0.3×
Late closure of wound (13160) $3,384 $3,760 0.9×
Marsupialization of bartholin's gland cyst (56440) $1,074 $1,193 0.3×
Nasal/Orogastric W/Tube Plmt (43752) $360 $400 0.8×
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $1,935 $2,150 2.6×
Open Implantation Nea Sacral Nerve (64581) $6,137 $6,819 0.9×
Ovarian cystectomy, unilateral or bilateral (58925) $3,348 $3,720 0.6×
Perq device breast 1st imag (19281) $412 $458 0.2×
Placement of needle for intraosseous infusion (36680) $314 $349 0.7×
Plastic Repair Of Urethrocele (57230) $1,581 $1,757 0.5×
Prostatic microwave thermotx (53850) $15,709 $17,454 4.3×
Punch biopsy skin single lesion (11104) $254 $282 0.6×
Removal impacted cerumen irrigation/lvg unilat (69209)
range across 2 matching MRF lines		 $48–$96 $53–$107 varies
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $86 $96 1.4×
Removal of foreign body from pharynx (42809) $423 $470 0.9×
Removal of infusion pump (36262) $3,276 $3,640 0.8×
Removal of residual cervix (57550)
unusually low: confirm this is the full procedure		 $1,913 $2,126 0.4×
Removal subcutaneous cardiac rhythm monitor (33286) $557 $619 0.8×
Remove foreign body from eye (65205) $104 $116 0.8×
Remove Tendon Sheath Lesion (26160) $993 $1,103 0.6×
Renal Biopsy Perq (50200) $1,530 $1,700 0.9×
Repair Bladder-Vagina Lesion (57320)
unusually low: confirm this is the full procedure		 $2,104 $2,338 0.4×
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151)
range across 2 matching MRF lines		 $696–$916 $773–$1,018 varies
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $841 $934 1.1×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $588 $653 1.4×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $660 $733 1.6×
Repair complex trunk 1.1-2.5 cm (13100) $802 $891 1.0×
Repair initial femoral hernia, any age; incarcerated or strangulated (49553) $2,970 $3,300 0.8×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051)
range across 2 matching MRF lines		 $507–$513 $563–$570 varies
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $518 $575 1.2×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $516 $573 1.2×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $477 $530 1.1×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $593 $659 1.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $590 $656 1.4×
Repair of enterocele, vaginal approach (separate procedure) (57268)
unusually low: confirm this is the full procedure		 $2,130 $2,367 0.4×
Repair of nail bed (11760) $571 $634 0.7×
Revision of urethra (57220)
likely a partial charge, not the full procedure		 $1,255 $1,394 0.2×
Revj/rmvl peripheral neurostimulator electrode (64585) $3,565 $3,961 1.0×
Rplc Gtube No Revj Trc (43762) $497 $552 1.9×
Salpingostomy (salpingoneostomy) (58770) $4,247 $4,719 1.3×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $282 $313 0.7×
Simple repair f/e/e/n/l/m 2.5cm/< (12011)
range across 2 matching MRF lines		 $338–$344 $376–$382 varies
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013)
range across 2 matching MRF lines		 $359–$360 $399–$400 varies
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014)
range across 2 matching MRF lines		 $332–$360 $369–$400 varies
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001)
range across 2 matching MRF lines		 $285–$323 $317–$359 varies
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004)
range across 2 matching MRF lines		 $338–$363 $376–$403 varies
Skin sub graft face/nk/hf/g (15275) $675 $750 0.9×
Skin sub graft trnk/arm/leg (15271) $360 $400 0.5×
Skin sub grft t/arm/lg child (15273) $1,260 $1,400 0.6×
Skn sub grft f/n/hf/g child (15277) $1,170 $1,300 0.5×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002)
range across 2 matching MRF lines		 $323–$348 $359–$387 varies
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $406 $451 1.0×
Spinal puncture lumbar diagnostic (62270) $851 $946 1.2×
Strapping ankle (29540) $143 $159 0.8×
Strapping elbow or wrist (29260)
range across 2 matching MRF lines		 $100–$141 $111–$157 varies
Strapping hand/finger (29280) $96 $107 1.6×
Strapping Hip (29520) $145 $161 1.0×
Strapping knee (29530)
range across 2 matching MRF lines		 $122–$178 $135–$198 varies
Strapping shoulder (29240)
range across 2 matching MRF lines		 $63–$191 $70–$212 varies
Strapping Unna Boot (29580) $180 $200 1.1×
Tangential biopsy skin single lesion (11102) $204 $227 0.5×
Thyroid biopsy (60100) $495 $550 0.7×
Transabdominal Amnioinfusion W/Ultrsnd Guidance (59070) $1,547 $1,719 4.9×
Treat humerus fracture (24500)
range across 2 matching MRF lines		 $307–$844 $341–$938 varies
Treat humerus fracture (23600) $770 $855 3.0×
Treat Knuckle Dislocation (26700) $695 $772 2.7×
Treat Tail Bone Fracture (27200) $500 $555 2.0×
Treatment Closed Elbow Dislocation Req Anes (24605) $1,401 $1,557 0.8×
Treatment closed elbow dislocation w/o anes (24600) $793 $881 3.1×
Treatment mouth roof lesion (42160) $491 $546 0.1×
Tx Missed Abortion Second Trimester Surgical (59821) $1,743 $1,937 0.5×
Tx Superficial Wound Dehiscence Simple Closure (12020) $815 $906 1.1×
Tx superficial wound dehiscence w/packing (12021) $306 $340 0.7×
Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) $344 $382 1.3×
Unlisted laparoscopy procedure, maternity care and delivery (59898)
likely a partial charge, not the full procedure		 $971 $1,079 0.2×
Unlisted procedure anus (46999) $360 $400 0.4×
Vag hyst complex (58290) $4,798 $5,331 0.6×
Vag hyst incl t/o complex (58291) $5,206 $5,784 1.0×
Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele Facility (58270) $4,304 $4,782 0.8×
Wedge Rescj/Bisctj Ovary Uni/Bi (58920)
unusually low: confirm this is the full procedure		 $3,511 $3,901 0.5×

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.