Visits & medical services prices at Hiram W. Davis Medical Center

Petersburg, VA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Ablation av node (93650) $806
Acoustic reflex testing (92568) $22
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $55
Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the… (97813) $64
Aep hearing status deter broadband stimuli i&r (92651) $123
Aep neurodiagnostic interpretation and report (92653) $120
Aep Thrshld Est Mlt Freq I&R (92652) $161
Airway inhalation treatment (94640) $16
Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) $20
Application Modality 1/> Areas Infrared (97026) $9
Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes Facility (97036) $48
Assessment of aphasia per hr (96105) $136
Auditory Function, 60 Min (92620) $127
Basic vestibular evaluation (92540) $154
Bedside Swallowing Eval (92610) $119
Behavioral and qualitative analysis of voice and resonance (92524) $153
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $55
Caloric vestibular test w/rec bi bithermal (92537) $57
Caloric vestibular test w/rec bi monothermal (92538) $32
Cardiac Stress Tst,Tracing Only (93017) $49
Cardiopulmonary resuscitation (92950) $462
Cardioversion elective internal (92961) $336
Cbt 1st hour (94644) $86
Chemo Hormon Antineopl Sq/Im (96402) $47
Chemo IV push addl drug (96411) $80
Chemo prolong 8+ hrs infuse w/pump (96416) $187
Chemother,Ia Push Technique (96420) $151
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $106
Chemotx admn IV push tq 1/1st sbst/drug (96409) $147
Chiropractic manipulative treatment (CMT); spinal, 3-4 regions Facility (98941) $55
Color Vision Examination (92283) $75
Color/duplex Doppler, complete (93975) $376
Color/duplex Doppler, limited (93976) $204
Comprehensive Hearing Test (92557) $53
Conditioning Play Audiometry (92582) $108
Cpap/bipap (94660) $89
Cpt initial (94667) $32
Cptrized oph dx img pst segment uni/bi optic nrv (92133) $51
Debridement Open Wound 20 Sq Cm< (97597) $143
Developmental tst admin phys/qhp 1st hour (96112) $176
Distort Product Evoked Otoacoustic Emisns Limitd (92587) $31
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $48
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $256
Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) $166
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $343
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $184
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $176
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $266
Dup-scan xtr veins unilateral/limited study (93971) $169
Duplex scan extracranial art compl bi study (93880) $271
Dx Anal Cochlear Imp,Pt >7 Yrs,Reprog (92604) $128
Dx Anal Cochlear Imp,Pt >7 Yrs,W/Prog (92603) $144
Echo Transthoracic - Congenital Tte Complete (93303) $315
EEG awake and asleep (95819) $626
EEG awake drowsy (95816) $534
EEG cerebral death evaluation (95824) $324
EEG coma or sleep only (95822) $582
EKG rhythm strip (93041) $8
Electrocardiogram Tracing (93005) $9
Electrocochleography (92584) $160
Electroconvulsive Therapy (90870) $241
EMG one extremity (95860) $160
Ep & ablate supravent arrhyt (93653) $1,140
Ep Compre Electrophysiologic Arrhythmia Induction (93620) $1,566
Er level 1 (99281) $30
Er level ii (99282) $59
Er level iii (99283) $99
Er level IV (99284) $167
Er level v (99285) $243
Ergonovine provocation test (93024) $152
Esophageal recording (93615) $72
Eval aud funcj cand/po surg implt dev 1st hr (92626) $123
Eval speech sound production (92522) $155
Evaluate Pt Use Of Inhaler (94664) $24
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $173
Evaluation of speech fluency (92521) $185
External ECG rec>7d<15d recording (93246) $20
External ECG rec>7d<15d scanning alys w/report (93247) $397
External Ecg Scanning Analysis Report (93226) $53
Eye exam, new patient,comprehesv (92004) $207
Filtered Speech Test (92571) $40
Flexible Endoscopic Eval Swallow C/V Rec (92612) $270
Gastroesophag reflx test w/telemtry ph eltrd (91035) $676
Gi tract capsule endoscopy (91110) $1,097
Group Therapeutic Procedures (97150) $25
Hemodialysis (90935) $100
Holter Monitor (93225) $27
Immunization Admin (90471) $24
Ins swan ganz bedside (93503) $121
Interrog dev eval icpms phys/qhp in person (93290) $78
Interrog device eval heart (93289) $104
Interrogate subq defib (93261) $101
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) $12
Iontophoresis 15 min (97033) $28
Irrig drug delivery device (96523) $38
IV infusion hydration each additional hour (96361) $18
IV infusion hydration initial 31 min-1 hour (96360) $48
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $94
IV push ea addl new drug (96375) $23
IV push initial (96374) $55
Liver Elastography W/O Imag W/I&R (91200) $43
Loudness balance test, alternate binaural or monaural Facility (92562) $64
Manual therapy 15 min (97140) $38
Massage 15 min (97124) $42
Mechanical traction (97012) $20
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $128
Nasopharyngoscopy (92511) $166
Needle Electromyography Cranial Nrv Muscle Uni (95867) $152
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $121
Needle Emg W/1 Fiber Electrode Quan Meas Jitter (95872) $296
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $59
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $70
Nerve Conduction Studies 11-12 Studies (95912) $351
Nerve conduction studies 13/> studies (95913) $406
Nerve Conduction Studies 5-6 Studies (95909) $192
Nerve Conduction Studies 7-8 Studies (95910) $251
Nerve Conduction Studies 9-10 Studies (95911) $302
Neurobehavioral Status Exam (96116) $131
Neuromuscular Junct Tstg Ea Nrv Any 1 Meth (95937) $150
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $116
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $37
Nrpsyc tst eval phys/qhp 1st (96132) $181
Oph Bmtry Prtl Coher Intrfrmtry Io Lens Pwr Cal (92136) $69
Ophth medical xm&eval comprhnsv estab pt 1/> (92014) $175
Ophth medical xm&eval intermediate estab pt (92012) $124
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92002) $119
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording Non-Facility (92544) $25
Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) $68
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $45
Ot Contrast Bath Ea 15 Min (97034) $21
Ot eval high complex 60 min (97167) $141
Ot eval low complex 30 min (97165) $141
Ot eval mod complex 45 min (97166) $141
Ot Prosthetic Training, Each 15 Min (97761) $58
Ot Range Motion Measure,Each Extrem (95851) $29
Ot re-evaluation (97168) $97
Ot therapeutic activity 15 min (97530) $52
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $36
Paraffin bath pt (97018) $8
Patch/Application Test Specify Number Tests (95044) $7
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $17
Percutaneous tests w/allergenic extracts (95004) $6
Peritoneal Dialysis (90945) $118
Phlebotomy therapeutic (99195) $142
Pm device eval in person (93288) $82
Pm device progr eval dual (93280) $115
Pm device progr eval multi (93281) $121
Pm device progr eval sngl (93279) $97
Pm/Icd Remote Tech Serv (93296) $33
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $882
Polysom Any Age Sleep Stage 1-3 Addl Param Attnd (95808) $932
Positional Nystagmus Test (92542) $41
Prepj& allergen immunotherapy 1/mlt antigen (95165) $22
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $14
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) $116
Prq balloon valvuloplasty aortic valve (92986) $1,808
Prq Card Stent/Ath/Angio (92933) $902
Psychiatric diagnostic evaluation (90791) $210
Psycl tst eval phys/qhp 1st (96130) $166
Psycl/nrpsyc tech 1st (96138) $48
Psycl/nrpsyc tst phy/qhp 1st (96136) $62
Psycl/nrpsycl tst elec platform auto result (96146) $3
Pt Aquatic Therapy/Exercises (97113) $52
Pt Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $53
Pt diathermy (97024) $10
Pt Electrical Stimulation (97032) $21
Pt eval high complex 45 min (97163) $140
Pt eval low complex 20 min (97161) $140
Pt eval mod complex 30 min (97162) $140
Pt gait training 15 min (97116) $35.50
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $48
Pt Physical Performance Test (97750) $47
Pt re-evaluation (97164) $96
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $46
Pt ultraviolet (97028) $12
Pt Whirlpool Therapy (97022) $24
Pulmonary stress test simple (94618) $47
Pure Tone Audiometry Air & Bone (92553) $57
Pure Tone Audiometry Air Only (92552) $47
Qualified nonphysician health care professional online digital assessment and management, for an established patient,… (98971) $29
R hrt coronary artery angio (93456) $1,633
R& L Hrt Cath W/Injec Hrt Art/Grft& L Vent I (93461) $1,985
Rem interrog icpms <30 d phys/qhp (93297) $37
Rem Interrog Scrms <30 D Phys/Qhp (93298) $37
Rom meas&reprt hand w/wo comparison normal sid (95852) $24
Rt Chest Wall Manipulation,Subsequent (94668) $49
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $69
Rx/Physical Eeg Activaj Phys/Qhp Attendance (95954) $566
Select Picture Audiometry (92583) $71
Sensory Integration Ea 15 Min (97533) $90
Short-latency somatosens ep std upr limbs (95925) $258
Sleep study attended (95807) $527
Sleep study unattended (95806) $127
Speech Audiometry Complete (92556) $56
Speech audiometry threshold (92555) $36
Speech sound lang comprehen (92523) $315
Spirometry (94010) $38
Spontaneous nystagmus test (92541) $36
Staggered Spondaic Word Test (92572) $57
Standardized Cognitive Performance Testing (96125) $144
Stenger Test Speech (92577) $26
Stenger Test, Pure Tone (92565) $27
Stress echo (93350) $265
Synthetic Sentence Identification Test (92576) $53
Test to assess hearing loss using different tone pitches (92575) $98
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $145
Therapeutic prophylactic/dx injection subq/im (96372) $20
Tinnitus assessment (92625) $96
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $22
Tone Decay Test (92563) $45
Trans Care Mgmt 14 Day Disch (99495) $284
Tte w/doppler, complete (93306) $279
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $196
Tx atrial fib pulm vein isol (93656) $1,529
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $107
Tx Speech Language Voice Commj Auditry 2/>Indiv (92508) $33
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $119
Tympanometry (92567) $24
Tympanometry And Reflex Threshold Measurements (92550) $32
Upr/lxtr art stdy 3+ lvls (93923) $181
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $223
Vasopneumatic device (97016) $17
Vent mgmt inpat init day (94002) $127
Visual Evoked Potential Test (95930) $92
Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann… (92083) $87
Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at… (92082) $64
Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent… (92081) $46
Visual reinforcement audiometry (vra) (92579) $64
Wada Activation Test Hemispheric Function W/Eeg (95958) $877
Wheelchair Mgmt Ea 15 Min (97542) $45
Xtrnl Ocular Photog W/I&R Docmt Medical Progre (92285) $32