Procedures & surgery prices at Jacobson Memorial Hospital Care Center

Elgin, ND · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Acne surgery (10040) $270.75 $361 1.3×
Application finger splint static (29130) $171.75 $229 1.3×
Application long arm splint shoulder hand (29105) $222 $296 1.3×
Application Long Leg Splint (29505) $147.75 $197 0.9×
Application short arm splint forearm-hand static (29125) $175.50 $234 1.3×
Application short leg splint calf foot (29515)
range across 2 matching MRF lines		 $222–$521.25 $296–$695 varies
Arterial puncture (36600) $198.75 $265 1.5×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $407.25 $543 1.3×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $407.25 $543 1.3×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $407.25 $543 1.3×
Aspirate pleura w/ imaging (32555) $792.75 $1,057 1.2×
Aspirate/Inj Ganglion Cyst (20612) $407.25 $543 1.3×
Avulsion nail plate partial/complete simple 1 (11730) $270.75 $361 1.3×
Bladder Irrigation (51700) $402.75 $537 1.6×
Blood Transfusion Service (36430) $3,326.66 $4,435.55 7.4×
Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) $470.25 $627 1.5×
Chest tube placement (32551) $2,001.75 $2,669 1.2×
Cl Tx Scapular Fx; W Manip (23575) $2,134.50 $2,846 1.3×
Clear outer ear canal (69200) $208.50 $278 1.5×
Closed tx ankle dislocation w/o anesthesia (27840) $369.75 $493 1.5×
Clsd tx clavicular fracture w/o manipulation (23500) $369.75 $493 1.5×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $369.75 $493 1.5×
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $2,159.25 $2,879 1.3×
Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) $369.75 $493 1.5×
Cltx dstl fibular fx lat malls w/manj (27788) $369.75 $493 1.5×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $2,159.25 $2,879 1.3×
Cltx iphal jt dislc w/manj w/o anes (26770) $369.75 $493 1.5×
Cltx prox fibula/shft fx w/o manj (27780) $369.75 $493 1.5×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $369.75 $493 1.5×
Cltx trimalleolar ankle fx w/manipulation (27818) $2,134.50 $2,846 1.3×
Collect Blood From Catheter Venous Nos (36592) $147.75 $197 1.1×
Collection of venous blood by venipuncture (36415)
range across 2 matching MRF lines		 $17.25–$22.50 $23–$30 varies
Control Nasal Hemorrhage Anterior Simple (30901) $164.25 $219 1.2×
Debridement subcutaneous tissue 20 sq cm/< (11042) $517.50 $690 1.2×
Destruct B9 Lesion 1-14 (17110) $270.75 $361 1.3×
Destruction Benign Lesions 15/> (17111) $278.25 $371 1.4×
Destruction mal lesion f/e/e/n/l/m 2.1-3.0cm (17283) $517.50 $690 1.2×
Destruction mal lesion f/e/e/n/l/m >4.0 cm (17286) $785.25 $1,047 1.0×
Destruction premalignant lesion 1st (17000) $269.25 $359 1.3×
Drainage of hematoma/fluid (10140) $2,115 $2,820 1.3×
Draw Blood Off Venous Device (36591) $142.50 $190 1.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $517.50 $690 1.2×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $270.75 $361 1.3×
Evacuation of subungual hematoma (11740) $168 $224 1.2×
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $931.50 $1,242 1.3×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $2,115 $2,820 1.3×
Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) $931.50 $1,242 1.3×
Exc Face-Mm B9+Marg 0.6-1 Cm (11441) $931.50 $1,242 1.3×
Exc Face-Mm B9+Marg 1.1-2 Cm (11442) $931.50 $1,242 1.3×
Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) $2,115 $2,820 1.3×
Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) $2,115 $2,820 1.3×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $931.50 $1,242 1.3×
Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) $2,115 $2,820 1.3×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $2,115 $2,820 1.3×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $517.50 $690 1.2×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $931.50 $1,242 1.3×
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $2,115 $2,820 1.3×
Exc Tumor Soft Tissue Forearm &/Wrist Subq <3Cm (25075) $2,261.25 $3,015 1.3×
Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) $931.50 $1,242 1.3×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $931.50 $1,242 1.3×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $846.75 $1,129 2.0×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $931.50 $1,242 1.3×
Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) $2,115 $2,820 1.3×
Excision Malignant Lesion F/E/E/N/L >4.0 Cm (11646) $3,656.25 $4,875 1.2×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $931.50 $1,242 1.3×
I&d abscess simple (10060) $270.75 $361 1.3×
I&d pilonidal cyst complicated (10081) $517.50 $690 0.7×
I&d pilonidal cyst simple (10080) $931.50 $1,242 1.3×
Incision & drainage abscess complicated/multiple (10061) $585 $780 1.4×
Incision & removal foreign body subq tiss simple (10120) $517.50 $690 1.2×
Incisional biopsy skin single lesion (11106) $785.25 $1,047 1.0×
Injection 1 tendon sheath/ligament aponeurosis (20550) $407.25 $543 1.3×
Injection single/mlt trigger point 1/2 muscles (20552) $407.25 $543 1.3×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $1,140 $1,520 1.6×
Insert Drug Implant Device (11981) $168 $224 1.2×
Insert non-tunnel cv cath (36556) $4,889.25 $6,519 1.5×
Insert Temp Bladder Cath (51702) $171 $228 1.3×
Insert,Non-Indwelling Bladder Catheter (51701) $171 $228 1.3×
Intubation endotracheal emergency procedure (31500) $309 $412 1.3×
N Block Inj Plantar Digit (64455) $470.25 $627 1.5×
Placement of needle for intraosseous infusion (36680) $450.75 $601 1.0×
Punch biopsy skin single lesion (11104) $517.50 $690 1.2×
Removal Foreign Body Foot Subcutaneous (28190) $953.25 $1,271 1.3×
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $2,261.25 $3,015 1.3×
Removal impacted cerumen irrigation/lvg unilat (69209) $113.25 $151 1.9×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $114 $152 1.9×
Removal of nail bed (11750)
range across 2 matching MRF lines		 $517.50–$524.25 $690–$699 varies
Removal skn tags mlt fibrq tags any area upw/15 (11200) $270.75 $361 1.3×
Remove foreign body from eye (65235) $3,846.75 $5,129 1.6×
Remove foreign body from eye (65205) $207.75 $277 1.5×
Remove Nasal Foreign Body (30300) $164.25 $219 1.2×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $785.25 $1,047 1.9×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $785.25 $1,047 1.9×
Repair Hand Tendon (26410) $4,010.25 $5,347 2.4×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $517.50 $690 1.2×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $517.50 $690 1.2×
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $517.50 $690 1.2×
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $786 $1,048 1.0×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $517.50 $690 1.2×
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $785.25 $1,047 1.0×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $517.50 $690 1.2×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $517.50 $690 1.2×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $517.50 $690 1.2×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $517.50 $690 1.2×
Repair of nail bed (11760) $785.25 $1,047 1.0×
Repair tongue laceration (41250) $438 $584 1.0×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $677.25 $903 1.5×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $269.25 $359 1.3×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $270.75 $361 1.3×
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $270.75 $361 1.3×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $270.75 $361 1.3×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $270.75 $361 1.3×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $517.50 $690 1.2×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $270.75 $361 1.3×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $269.25 $359 0.6×
Simple repair f/e/e/n/l/m 2.5cm/< (12011)
range across 2 matching MRF lines		 $269.25–$270.75 $359–$361 varies
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013)
range across 2 matching MRF lines		 $269.25–$270.75 $359–$361 varies
Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) $269.25 $359 0.6×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $269.25 $359 1.3×
Simple Repair F/E/E/N/L/M >30.0 Cm (12018) $269.25 $359 1.3×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001)
range across 2 matching MRF lines		 $269.25–$270.75 $359–$361 varies
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $269.25 $359 1.3×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $269.25 $359 1.3×
Skin Tissue Procedure (17999) $270.75 $361 1.3×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002)
range across 2 matching MRF lines		 $269.25–$270.75 $359–$361 varies
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $269.25 $359 0.6×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $269.25 $359 0.6×
Strapping ankle (29540) $297 $396 1.8×
Strapping elbow or wrist (29260) $85.50 $114 1.4×
Strapping Unna Boot (29580)
range across 2 matching MRF lines		 $222–$297 $296–$396 varies
Sutr Wnd Eyelid/Margin/Tarsus/Conjunc Prtl Thick (67930) $3,703.50 $4,938 1.5×
Tangential biopsy skin single lesion (11102) $270.75 $361 0.7×
Treat Knuckle Dislocation (26700) $369.75 $493 1.5×
Treatment closed elbow dislocation w/o anes (24600) $369.75 $493 1.5×
Trim skin lesion (11055) $270.75 $361 1.3×
Trim skin lesions 2 to 4 (11056) $270.75 $361 1.3×
Trimming Nondystrophic Nails Any Number (11719) $86.25 $115 1.4×
Tx Gastro Intub W/Asp (43753) $429 $572 1.9×
Unlisted Procedure Vascular Surgery (37799) $342.75 $457 0.5×
Vaginal delivery only (59409) $4,020.75 $5,361 1.2×

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.