Procedures & surgery prices at Lexington Regional Health Center
Lexington, NE · every code in this section with a posted price and a Medicare benchmark.
407 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abd paracentesis w/imaging (49083) | $540.48 | $563 | 0.6× |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) | $731.52 | $762 | 0.8× |
| Acne surgery (10040) range across 2 matching MRF lines |
$24–$225.60 | $25–$235 | varies |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect Local Flap (26952) | $1,773.12 | $1,847 | 0.5× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) | $1,773.12 | $1,847 | 0.5× |
| Amputation toe interphalangeal joint (28825) | $2,256 | $2,350 | 0.7× |
| Anoscopy diagnostic (46600) range across 3 matching MRF lines |
$24–$1,659.84 | $25–$1,729 | varies |
| Anoscopy W/Rmvl Foreign Body (46608) | $509.76 | $531 | 0.5× |
| Application cast elbow finger short arm (29075) range across 3 matching MRF lines |
$24–$253.44 | $25–$264 | varies |
| Application finger splint static (29130) range across 3 matching MRF lines |
$24–$124.80 | $25–$130 | varies |
| Application long arm splint shoulder hand (29105) range across 3 matching MRF lines |
$24–$164.16 | $25–$171 | varies |
| Application Long Leg Splint (29505) range across 3 matching MRF lines |
$24–$144.96 | $25–$151 | varies |
| Application of cylinder cast (thigh to ankle) (29365) | $253.44 | $264 | 0.9× |
| Application of long leg cast (29345) range across 2 matching MRF lines |
$24–$253.44 | $25–$264 | varies |
| Application short arm splint forearm-hand static (29125) range across 3 matching MRF lines |
$24–$124.80 | $25–$130 | varies |
| Application short leg splint calf foot (29515) range across 3 matching MRF lines |
$24–$137.28 | $25–$143 | varies |
| Apply hand/wrist cast (29085) range across 3 matching MRF lines |
$24–$190.08 | $25–$198 | varies |
| Apply long arm cast (29065) range across 3 matching MRF lines |
$24–$253.44 | $25–$264 | varies |
| Apply Multlay Comprs Lwr Leg (29581) | $24 | $25 | 0.1× |
| Apply Short Leg Cast (29405) range across 3 matching MRF lines |
$24–$253.44 | $25–$264 | varies |
| Apply short leg cast (29425) | $253.44 | $264 | 0.9× |
| Arterial puncture (36600) range across 2 matching MRF lines |
$77.95–$91.20 | $81.20–$95 | varies |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) range across 3 matching MRF lines |
$24–$254.40 | $25–$265 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 3 matching MRF lines |
$24–$254.40 | $25–$265 | varies |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) range across 3 matching MRF lines |
$24–$254.40 | $25–$265 | varies |
| Aspirate pleura w/ imaging (32555) | $24 | $25 | 0.0× |
| Aspirate Pleura W/O Imaging (32554) | $887.04 | $924 | 1.4× |
| Aspirate/Inj Ganglion Cyst (20612) range across 2 matching MRF lines |
$24–$120.96 | $25–$126 | varies |
| Avulsion nail plate partial/complete simple 1 (11730) range across 3 matching MRF lines |
$24–$196.80 | $25–$205 | varies |
| Biopsy bone open superficial (20240) | $24 | $25 | 0.0× |
| Biopsy nail unit (11755) range across 2 matching MRF lines |
$24–$298.56 | $25–$311 | varies |
| Biopsy of liver, needle; percutaneous (47000) | $580.80 | $605 | 0.3× |
| Biopsy of penis (54100) range across 2 matching MRF lines |
$24–$451.20 | $25–$470 | varies |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) | $1,442.88 | $1,503 | 1.5× |
| Bladder Scan (51798) range across 5 matching MRF lines |
$24–$207.36 | $25–$216 | varies |
| Blepharotomy drainage abscess eyelid (67700) | $295.68 | $308 | 0.9× |
| Blood Transfusion Service (36430) | $965.76 | $1,006 | 2.1× |
| Bx breast 1st lesion strtctc (19081) | $3,872.64 | $4,034 | 2.3× |
| Bx breast 1st lesion us imag (19083) | $1,756.80 | $1,830 | 1.0× |
| Bx Cervix (57500) range across 2 matching MRF lines |
$24–$214.08 | $25–$223 | varies |
| Capsulorrhaphy Anterior Putti-Platt/Magnuson (23450) | $4,929.60 | $5,135 | 0.7× |
| Catheter aspiration nasotracheal spx (31720) | $101.76 | $106 | 0.4× |
| Change Cystostomy Tube Simple (51705) range across 3 matching MRF lines |
$24–$694.08 | $25–$723 | varies |
| Chemical Cautery Tissue (17250) range across 3 matching MRF lines |
$24–$230.40 | $25–$240 | varies |
| Chemodenerv Musc Migraine (64615) range across 2 matching MRF lines |
$24–$255.36 | $25–$266 | varies |
| Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) range across 2 matching MRF lines |
$24–$134.40 | $25–$140 | varies |
| Chest tube placement (32551) | $364.80 | $380 | 0.2× |
| Cl Tx Tib Shft Fx W Manip (27752) | $193.92 | $202 | 0.1× |
| Clear outer ear canal (69200) range across 3 matching MRF lines |
$24–$236.16 | $25–$246 | varies |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) | $193.92 | $202 | 0.8× |
| Closed Treatment Sesamoid Fracture (28530) | $591.36 | $616 | 2.3× |
| Closed Treatment Ulnar Styloid Fracture (25650) | $193.92 | $202 | 0.8× |
| Closed tx ankle dislocation w/o anesthesia (27840) | $193.92 | $202 | 0.8× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) | $193.92 | $202 | 0.1× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) | $193.92 | $202 | 0.8× |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) | $193.92 | $202 | 0.8× |
| Closed tx carpal scaphoid fracture w/manj (25624) | $193.92 | $202 | 0.1× |
| Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) range across 3 matching MRF lines |
$24–$527.04 | $25–$549 | varies |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) | $193.92 | $202 | 0.8× |
| Closed Tx Knee Dislocation W/Anesthesia (27552) | $1,423.68 | $1,483 | 0.9× |
| Closed tx knee dislocation w/o anesthesia (27550) | $193.92 | $202 | 0.8× |
| Closed tx metatarsal fracture w/o manipulation (28470) range across 3 matching MRF lines |
$24–$384.96 | $25–$401 | varies |
| Closed Tx Nasal Bone Fx W/Mnpj W/O Stabilization (21315) | $236.16 | $246 | 0.1× |
| Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) | $917.76 | $956 | 0.3× |
| Closed tx patellar dislocation w/anesthesia (27562) | $1,625.28 | $1,693 | 6.3× |
| Closed tx patellar dislocation w/o anesthesia (27560) | $193.92 | $202 | 0.8× |
| Closed Tx Patellar Fracture W/O Manipulation (27520) | $193.92 | $202 | 0.8× |
| Closed tx radial head/neck fx w/o manipulation (24650) range across 3 matching MRF lines |
$24–$453.12 | $25–$472 | varies |
| Closed tx radial shaft fracture w/manipulation (25505) | $193.92 | $202 | 0.1× |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) range across 3 matching MRF lines |
$24–$471.36 | $25–$491 | varies |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) | $503.04 | $524 | 0.3× |
| Closed tx radial&ulnar shaft fractures w/o man (25560) | $193.92 | $202 | 0.8× |
| Closed Tx Scapular Fracture W/O Manipulation (23570) | $193.92 | $202 | 0.8× |
| Closed Tx Sternoclavicular Dislc W/Manipulation (23525) | $193.92 | $202 | 0.8× |
| Closed tx talus fracture w/o manipulation (28430) | $193.92 | $202 | 0.8× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) | $236.16 | $246 | 0.9× |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) range across 3 matching MRF lines |
$24–$507.84 | $25–$529 | varies |
| Closed tx ulnar shaft fracture w/o manipulation (25530) | $193.92 | $202 | 0.8× |
| Clsd tx acromioclavicular dislc w/manipulation (23545) | $193.92 | $202 | 0.8× |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) | $193.92 | $202 | 0.8× |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) | $213.12 | $222 | 0.1× |
| Clsd tx clavicular fracture w/o manipulation (23500) range across 3 matching MRF lines |
$24–$401.28 | $25–$418 | varies |
| Clsd tx shoulder dislc w/manipulation req anes (23655) | $1,625.28 | $1,693 | 1.0× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) | $193.92 | $202 | 0.8× |
| Clsd tx sternoclavicular dislc w/o manipulation (23520) | $193.92 | $202 | 0.1× |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) | $193.92 | $202 | 0.1× |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) | $193.92 | $202 | 0.8× |
| Cltx Carpal Bone Fx W/Manj Each Bone (25635) | $193.92 | $202 | 0.1× |
| Cltx Carpal Bone Fx W/O Manj Each Bone (25630) | $193.92 | $202 | 0.8× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) | $193.92 | $202 | 0.8× |
| Cltx Carpo/Mtcrpl Dislc Thumb Manj Ea Jt W/Anes (26675) | $193.92 | $202 | 0.1× |
| Cltx dstl fibular fx lat malls w/manj (27788) | $193.92 | $202 | 0.8× |
| Cltx dstl fibular fx lat malls w/o manj (27786) range across 3 matching MRF lines |
$24–$563.52 | $25–$587 | varies |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) | $193.92 | $202 | 0.8× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) | $193.92 | $202 | 0.8× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) range across 3 matching MRF lines |
$24–$933.12 | $25–$972 | varies |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) | $503.04 | $524 | 0.3× |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) | $193.92 | $202 | 0.1× |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) | $193.92 | $202 | 0.8× |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) | $193.92 | $202 | 0.1× |
| Cltx fx grt toe phlx/phlg w/manj (28495) | $193.92 | $202 | 0.8× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) | $193.92 | $202 | 0.8× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) | $193.92 | $202 | 0.8× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) | $193.92 | $202 | 0.8× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) | $193.92 | $202 | 0.1× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) | $193.92 | $202 | 0.8× |
| Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) range across 3 matching MRF lines |
$24–$589.44 | $25–$614 | varies |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) | $2,424.96 | $2,526 | 8.3× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) | $457.92 | $477 | 1.8× |
| Cltx iphal jt dislc w/manj w/o anes (26770) range across 3 matching MRF lines |
$24–$794.88 | $25–$828 | varies |
| Cltx Medial Ankle Fx (27760) | $193.92 | $202 | 0.8× |
| Cltx metacarpal fx w/manipulation each bone (26605) | $193.92 | $202 | 0.8× |
| Cltx metacarpal fx w/o manipulation each bone (26600) range across 3 matching MRF lines |
$24–$500.16 | $25–$521 | varies |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) | $740.16 | $771 | 0.4× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) range across 2 matching MRF lines |
$24–$193.92 | $25–$202 | varies |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) range across 3 matching MRF lines |
$24–$487.68 | $25–$508 | varies |
| Cltx post hip arthrp dislc w/o anes (27265) | $193.92 | $202 | 0.8× |
| Cltx prox fibula/shft fx w/manj (27781) | $193.92 | $202 | 0.1× |
| Cltx prox fibula/shft fx w/o manj (27780) | $193.92 | $202 | 0.8× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) range across 3 matching MRF lines |
$24–$230.40 | $25–$240 | varies |
| Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) | $193.92 | $202 | 0.1× |
| Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) range across 3 matching MRF lines |
$24–$671.04 | $25–$699 | varies |
| Cltx tibial fx proximal w/o manipulation (27530) | $193.92 | $202 | 0.8× |
| Cltx tibial shaft fx w/o manipulation (27750) range across 3 matching MRF lines |
$24–$986.88 | $25–$1,028 | varies |
| Cltx trimalleolar ankle fx w/manipulation (27818) | $1,562.88 | $1,628 | 0.9× |
| Collection of venous blood by venipuncture (36415) range across 4 matching MRF lines |
$23.42–$24 | $24.40–$25 | varies |
| Colonoscopy through stoma; with biopsy, single or multiple (44389) | $1,949.76 | $2,031 | 1.6× |
| Colonoscopy thru stoma (44388) | $1,949.76 | $2,031 | 2.0× |
| Colsc flx w/removal lesion by hot bx forceps (45384) | $1,949.76 | $2,031 | 1.6× |
| Complex drainage wound (10180) | $1,824 | $1,900 | 0.6× |
| Control Nasal Hemorrhage Anterior Complex (30903) range across 2 matching MRF lines |
$24–$138.24 | $25–$144 | varies |
| Control Nasal Hemorrhage Anterior Simple (30901) range across 3 matching MRF lines |
$24–$221.76 | $25–$231 | varies |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) | $138.24 | $144 | 1.0× |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) | $138.24 | $144 | 0.6× |
| Cysto calibration dilat urtl strix/stenosis (52281) | $24 | $25 | 0.0× |
| Cysto W/Simple Removal Stone & Stent (52310) range across 2 matching MRF lines |
$24–$192 | $25–$200 | varies |
| Cystometrogram W/Vp (51728) range across 2 matching MRF lines |
$24–$33.60 | $25–$35 | varies |
| Cystourethroscopy (52000) | $601.92 | $627 | 0.8× |
| Cystourethroscopy inj chemodenervation bladder (52287) | $24 | $25 | 0.0× |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) range across 3 matching MRF lines |
$24–$121.92 | $25–$127 | varies |
| Deb Musc/Fascia 20 Sq Cm/< (11043) | $24 | $25 | 0.0× |
| Debride nail 1-5 (11720) range across 2 matching MRF lines |
$24–$64.32 | $25–$67 | varies |
| Debride nail 6 or more (11721) | $24 | $25 | 0.4× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) | $755.52 | $787 | 0.4× |
| Debridement Mastoidectomy Cavity Simple (69220) | $24 | $25 | 0.1× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) range across 3 matching MRF lines |
$24–$282.24 | $25–$294 | varies |
| Destruct B9 Lesion 1-14 (17110) range across 2 matching MRF lines |
$24–$224.64 | $25–$234 | varies |
| Destruction Benign Lesions 15/> (17111) | $24 | $25 | 0.1× |
| Destruction Internal Hemorrhoid Thermal Energy (46930) | $24 | $25 | 0.0× |
| Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) range across 2 matching MRF lines |
$24–$371.52 | $25–$387 | varies |
| Destruction mal lesion f/e/e/n/l/m 1.1-2.0cm (17282) range across 2 matching MRF lines |
$24–$455.04 | $25–$474 | varies |
| Destruction mal lesion f/e/e/n/l/m 3.1-4.0cm (17284) | $573.12 | $597 | 0.7× |
| Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) range across 2 matching MRF lines |
$24–$388.80 | $25–$405 | varies |
| Destruction mal lesion trunk/arm/leg 2.1-3.0cm (17263) range across 2 matching MRF lines |
$24–$416.64 | $25–$434 | varies |
| Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) range across 2 matching MRF lines |
$24–$312 | $25–$325 | varies |
| Destruction malignant lesion s/n/h/f/g 1.1-2.0cm (17272) range across 2 matching MRF lines |
$24–$396.48 | $25–$413 | varies |
| Destruction malignant lesion s/n/h/f/g 2.1-3.0cm (17273) range across 2 matching MRF lines |
$24–$418.56 | $25–$436 | varies |
| Destruction Premalignant Lesion 15/> (17004) range across 2 matching MRF lines |
$24–$295.68 | $25–$308 | varies |
| Destruction premalignant lesion 1st (17000) range across 3 matching MRF lines |
$24–$171.84 | $25–$179 | varies |
| Diagnostic sigmoidoscopy (45330) | $533.76 | $556 | 0.6× |
| Dilat Female Urethra W/Suppository&/Instlj Ini (53660) | $24 | $25 | 0.2× |
| Dilat Urethral Strix Dilator Male Sbsq (53601) | $24 | $25 | 0.2× |
| Dilate Esophagus 1/Mult Pass (43450) | $473.28 | $493 | 0.5× |
| Dilate Urethra Stricture (53600) | $24 | $25 | 0.1× |
| Drain/inj small joint/bursa w/us (20604) | $109.44 | $114 | 0.3× |
| Drainage External Ear Abscess/Hematoma Simple (69000) range across 2 matching MRF lines |
$24–$373.44 | $25–$389 | varies |
| Drainage of finger abscess simple (26010) | $24 | $25 | 0.1× |
| Drainage of gum lesion (41800) | $236.16 | $246 | 1.7× |
| Drainage of hematoma/fluid (10140) range across 2 matching MRF lines |
$328.32–$1,307.52 | $342–$1,362 | varies |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) | $287.04 | $299 | 0.4× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) | $184.32 | $192 | 0.4× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) | $123.84 | $129 | 0.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) range across 3 matching MRF lines |
$24–$149.76 | $25–$156 | varies |
| Dstrj les/scar vestibule mouth physical meths (40820) | $673.92 | $702 | 0.2× |
| Egd cautery tumor polyp (43250) | $1,754.88 | $1,828 | 0.9× |
| Egd Flexible Foreign Body Removal (43247) | $1,754.88 | $1,828 | 1.9× |
| Egd place gastrostomy tube (43246) | $2,049.60 | $2,135 | 1.0× |
| Electro-Uroflowmetry First (51741) range across 2 matching MRF lines |
$24–$42.24 | $25–$44 | varies |
| Endometrial Biopsy (58100) range across 2 matching MRF lines |
$24–$192.96 | $25–$201 | varies |
| Endoven abltj incmptnt vein xtr laser 1st vein (36478) range across 2 matching MRF lines |
$80.64–$161.28 | $84–$168 | varies |
| Evacuation of subungual hematoma (11740) range across 3 matching MRF lines |
$24–$90.24 | $25–$94 | varies |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) range across 2 matching MRF lines |
$24–$265.92 | $25–$277 | varies |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) range across 2 matching MRF lines |
$24–$423.36 | $25–$441 | varies |
| Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) | $518.40 | $540 | 0.7× |
| Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) | $578.88 | $603 | 0.8× |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) range across 2 matching MRF lines |
$24–$361.92 | $25–$377 | varies |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) range across 2 matching MRF lines |
$24–$361.92 | $25–$377 | varies |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) range across 2 matching MRF lines |
$24–$401.28 | $25–$418 | varies |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) | $483.84 | $504 | 0.3× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) range across 2 matching MRF lines |
$24–$292.80 | $25–$305 | varies |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) range across 2 matching MRF lines |
$24–$340.80 | $25–$355 | varies |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) range across 2 matching MRF lines |
$24–$371.52 | $25–$387 | varies |
| Exc Lesion Tongue W/Clsr Anterior Two-Thirds (41112) | $991.68 | $1,033 | 0.3× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) range across 2 matching MRF lines |
$24–$408.96 | $25–$426 | varies |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) | $499.20 | $520 | 0.3× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) | $728.64 | $759 | 0.4× |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) | $799.68 | $833 | 0.5× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) | $1,409.28 | $1,468 | 0.8× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) range across 2 matching MRF lines |
$371.52–$2,232.96 | $387–$2,326 | varies |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) range across 2 matching MRF lines |
$24–$319.68 | $25–$333 | varies |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) range across 2 matching MRF lines |
$24–$356.16 | $25–$371 | varies |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) | $518.40 | $540 | 0.3× |
| Exc Tumor Soft Tissue Forearm &/Wrist Subq <3Cm (25075) | $1,039.68 | $1,083 | 0.6× |
| Excis Mouth Mucosa/Sub,Simpl Repair (40812) | $592.32 | $617 | 0.4× |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) | $651.84 | $679 | 0.9× |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) range across 2 matching MRF lines |
$24–$400.32 | $25–$417 | varies |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) | $499.20 | $520 | 0.7× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) range across 2 matching MRF lines |
$24–$573.12 | $25–$597 | varies |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) | $660.48 | $688 | 0.9× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) range across 2 matching MRF lines |
$24–$465.60 | $25–$485 | varies |
| Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) | $639.36 | $666 | 0.4× |
| Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) | $489.60 | $510 | 0.7× |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) | $24 | $25 | 0.0× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) | $811.20 | $845 | 0.5× |
| Excision of bartholin's gland or cyst (56740) | $506.88 | $528 | 0.2× |
| Excision of pilonidal cyst or sinus; simple (11770) | $24 | $25 | 0.0× |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) | $974.40 | $1,015 | 0.6× |
| Excision Tumor Soft Tissue Thigh/Knee Subq <3Cm (27327) | $913.92 | $952 | 0.5× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) | $993.60 | $1,035 | 0.6× |
| Exploration penetrating wound spx extremity (20103) | $541.44 | $564 | 0.3× |
| Fetal Contraction Stress Test (59020) | $383.04 | $399 | 1.8× |
| Fetal non-stress test (59025) | $383.04 | $399 | 1.8× |
| Fine needle aspiration without imaging guidance (10021) range across 2 matching MRF lines |
$24–$262.08 | $25–$273 | varies |
| Fluid Pressure Muscle (20950) | $173.76 | $181 | 0.2× |
| Fna bx w/us gdn 1st les (10005) | $898.56 | $936 | 1.2× |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) | $24 | $25 | 0.0× |
| Hemorrhoidectomy, internal, by rubber band ligation(s) (46221) | $1,448.64 | $1,509 | 1.5× |
| I&d abscess simple (10060) range across 3 matching MRF lines |
$24–$217.92 | $25–$227 | varies |
| I&d deep absc bursa/hematoma thigh/knee region (27301) | $1,789.44 | $1,864 | 0.6× |
| I&d perianal abscess superficial (46050) range across 2 matching MRF lines |
$24–$398.40 | $25–$415 | varies |
| I&d pilonidal cyst complicated (10081) | $1,307.52 | $1,362 | 1.8× |
| I&d pilonidal cyst simple (10080) range across 3 matching MRF lines |
$24–$363.84 | $25–$379 | varies |
| Incise external hemorrhoid (46083) range across 3 matching MRF lines |
$24–$398.40 | $25–$415 | varies |
| Incision & drainage abscess complicated/multiple (10061) range across 3 matching MRF lines |
$24–$316.80 | $25–$330 | varies |
| Incision & removal foreign body subq tiss compl (10121) | $816.96 | $851 | 0.5× |
| Incision & removal foreign body subq tiss simple (10120) range across 3 matching MRF lines |
$24–$305.28 | $25–$318 | varies |
| Incision and drainage of bartholin's gland abscess (56420) range across 3 matching MRF lines |
$24–$309.12 | $25–$322 | varies |
| Incision and drainage of vulva or perineal abscess (56405) range across 3 matching MRF lines |
$24–$270.72 | $25–$282 | varies |
| Incision of eardrum (69420) | $236.16 | $246 | 1.0× |
| Incision of lingual frenum (frenotomy) (41010) range across 2 matching MRF lines |
$24–$478.08 | $25–$498 | varies |
| Incision of rectal abscess (46040) | $2,045.76 | $2,131 | 1.6× |
| Incisional biopsy skin single lesion (11106) | $1,680 | $1,750 | 2.2× |
| Initial Tx 1st Degree Burn Local Tx (16000) range across 3 matching MRF lines |
$24–$170.88 | $25–$178 | varies |
| Injection 1 tendon sheath/ligament aponeurosis (20550) range across 3 matching MRF lines |
$24–$254.40 | $25–$265 | varies |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) | $612.48 | $638 | 0.7× |
| Injection enzyme palmar fascial cord (20527) range across 2 matching MRF lines |
$24–$125.76 | $25–$131 | varies |
| Injection single tendon origin/insertion (20551) range across 2 matching MRF lines |
$24–$120 | $25–$125 | varies |
| Injection single/mlt trigger point 1/2 muscles (20552) range across 3 matching MRF lines |
$24–$181.44 | $25–$189 | varies |
| Injection single/mlt trigger point 3/> muscles (20553) range across 3 matching MRF lines |
$24–$257.28 | $25–$268 | varies |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) range across 3 matching MRF lines |
$24–$285.12 | $25–$297 | varies |
| Injection, intralesional; up to and including 7 lesions (11900) range across 2 matching MRF lines |
$24–$122.88 | $25–$128 | varies |
| Insert Bladder Cath Complex (51703) range across 3 matching MRF lines |
$24–$312.96 | $25–$326 | varies |
| Insert Drug Implant Device (11981) range across 2 matching MRF lines |
$24–$270.72 | $25–$282 | varies |
| Insert non-tunnel cv cath (36556) | $1,042.56 | $1,086 | 0.3× |
| Insert Temp Bladder Cath (51702) range across 3 matching MRF lines |
$24–$441.60 | $25–$460 | varies |
| Insert,Non-Indwelling Bladder Catheter (51701) range across 3 matching MRF lines |
$24–$185.28 | $25–$193 | varies |
| Insertion indwelling tunneled pleural catheter (32550) | $364.80 | $380 | 0.1× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) | $935.04 | $974 | 0.6× |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) | $381.12 | $397 | 0.9× |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) | $381.12 | $397 | 0.9× |
| Intubation endotracheal emergency procedure (31500) | $229.44 | $239 | 0.9× |
| Laryngoscopy flexible diagnostic (31575) | $24 | $25 | 0.1× |
| Lysis of labial adhesions (56441) range across 2 matching MRF lines |
$24–$161.28 | $25–$168 | varies |
| Maniplatn palar fascial crd post inj single cord (26341) | $24 | $25 | 0.1× |
| N Block Inj Paracervical (64435) range across 2 matching MRF lines |
$24–$200.64 | $25–$209 | varies |
| N Block Inj Plantar Digit (64455) | $24 | $25 | 0.1× |
| Nasal/Orogastric W/Tube Plmt (43752) | $149.76 | $156 | 0.3× |
| Neuroeltrd Stim Post Tibial (64566) range across 2 matching MRF lines |
$24–$319.68 | $25–$333 | varies |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) range across 2 matching MRF lines |
$24–$360 | $25–$375 | varies |
| Occipital Nerve Block (64405) range across 2 matching MRF lines |
$24–$257.28 | $25–$268 | varies |
| Open treatment interphalangeal joint dislocation (28675) | $4,289.28 | $4,468 | 1.3× |
| Open treatment of nasal fracture; uncomplicated Facility (21325) | $2,638.08 | $2,748 | 0.8× |
| Open Tx Distal Phalangeal Fracture Each (26765) | $4,289.28 | $4,468 | 1.3× |
| Partial Excision Distal Phalanx Finger (26236) | $1,773.12 | $1,847 | 1.1× |
| Partical Excision Bone Phalanx Toe (28124) | $24 | $25 | 0.0× |
| Perineoplasty rpr perineum nonobstetrical spx (56810) range across 2 matching MRF lines |
$24–$266.88 | $25–$278 | varies |
| Perq dev breast 1st strtctc (19283) | $713.28 | $743 | 1.0× |
| Placement of needle for intraosseous infusion (36680) | $237.12 | $247 | 0.5× |
| Plmt Urtrl Stnt Prq New Acess W/O Sep Nfros Cath (50694) | $1,458.24 | $1,519 | 0.4× |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) | $533.76 | $556 | 0.6× |
| Proctosigmoidoscopy, rigid; with biopsy, single or multiple (45305) | $901.44 | $939 | 0.7× |
| Punch biopsy skin single lesion (11104) | $24 | $25 | 0.1× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) range across 3 matching MRF lines |
$24–$261.12 | $25–$272 | varies |
| Puncture Aspiration Cyst Breast (19000) range across 6 matching MRF lines |
$221.76–$1,148.16 | $231–$1,196 | varies |
| Removal Foreign Body Foot Subcutaneous (28190) range across 3 matching MRF lines |
$24–$471.36 | $25–$491 | varies |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) | $471.36 | $491 | 0.3× |
| Removal impacted cerumen irrigation/lvg unilat (69209) range across 3 matching MRF lines |
$24–$116.16 | $25–$121 | varies |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) range across 3 matching MRF lines |
$24–$122.88 | $25–$128 | varies |
| Removal Implant Superficial Separate Procedure (20670) | $24 | $25 | 0.0× |
| Removal implantable contraceptive capsules (11976) range across 2 matching MRF lines |
$24–$262.08 | $25–$273 | varies |
| Removal of foreign body from pharynx (42809) | $525.12 | $547 | 1.1× |
| Removal of infusion pump (36262) | $1,038.72 | $1,082 | 0.3× |
| Removal of nail bed (11750) range across 3 matching MRF lines |
$24–$471.36 | $25–$491 | varies |
| Removal or bivalving full arm or full leg cast (29705) range across 2 matching MRF lines |
$24–$109.44 | $25–$114 | varies |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) range across 2 matching MRF lines |
$24–$193.92 | $25–$202 | varies |
| Removal sweat gland lesion (11450) | $2,218.56 | $2,311 | 0.7× |
| Removal/bivalving gauntlet boot/body cast (29700) range across 3 matching MRF lines |
$24–$153.60 | $25–$160 | varies |
| Remove drug implant device (11982) range across 2 matching MRF lines |
$24–$310.08 | $25–$323 | varies |
| Remove foreign body from eye (65205) range across 3 matching MRF lines |
$24–$258.24 | $25–$269 | varies |
| Remove Int Dwell Ureteral Stent Transurethral (50386) range across 2 matching MRF lines |
$24–$408 | $25–$425 | varies |
| Remove Intrauterine Device (58301) range across 3 matching MRF lines |
$24–$225.60 | $25–$235 | varies |
| Remove lung catheter (32552) | $24 | $25 | 0.0× |
| Remove Nasal Foreign Body (30300) range across 3 matching MRF lines |
$24–$429.12 | $25–$447 | varies |
| Remove Tendon Sheath Lesion (26160) | $24 | $25 | 0.0× |
| Remove/Insert Drug Implant (11983) range across 2 matching MRF lines |
$24–$428.16 | $25–$446 | varies |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) | $572.16 | $596 | 0.7× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) | $604.80 | $630 | 0.8× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) | $572.16 | $596 | 1.4× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) | $572.16 | $596 | 1.4× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) | $572.16 | $596 | 1.4× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) | $572.16 | $596 | 1.4× |
| Repair complex trunk 1.1-2.5 cm (13100) | $604.80 | $630 | 0.8× |
| Repair complex trunk 2.6-7.5 cm (13101) range across 2 matching MRF lines |
$604.80–$782.40 | $630–$815 | varies |
| Repair extensor tendon finger w/o graft each (26418) | $1,773.12 | $1,847 | 1.1× |
| Repair Hand Tendon (26410) | $1,454.40 | $1,515 | 0.9× |
| Repair incomplete circumcision (54163) | $1,075.20 | $1,120 | 0.5× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) range across 2 matching MRF lines |
$24–$381.12 | $25–$397 | varies |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) range across 3 matching MRF lines |
$24–$582.72 | $25–$607 | varies |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) | $381.12 | $397 | 0.9× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) | $381.12 | $397 | 0.9× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) | $381.12 | $397 | 0.5× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) | $381.12 | $397 | 0.9× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) | $381.12 | $397 | 0.9× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) | $381.12 | $397 | 0.5× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) | $381.12 | $397 | 0.9× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) range across 3 matching MRF lines |
$24–$525.12 | $25–$547 | varies |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) range across 3 matching MRF lines |
$24–$612.48 | $25–$638 | varies |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) | $381.12 | $397 | 0.5× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) | $381.12 | $397 | 0.9× |
| Repair intermediate s/a/t/e >30.0 cm (12037) | $604.80 | $630 | 0.3× |
| Repair of nail bed (11760) range across 2 matching MRF lines |
$415.68–$550.08 | $433–$573 | varies |
| Repair Tendon Extensor Foot 1/2 Each Tendon (28208) | $2,256 | $2,350 | 0.7× |
| Repair tongue laceration (41250) | $226.56 | $236 | 0.5× |
| Replantation digit complete (20822) | $2,844.48 | $2,963 | 1.7× |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) | $70.08 | $73 | 0.1× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) | $141.12 | $147 | 0.3× |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) | $2,218.56 | $2,311 | 0.7× |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) range across 2 matching MRF lines |
$24–$357.12 | $25–$372 | varies |
| Rmvl/Bivalv Sho/Hip Spica Minerva/Risser Jacket (29710) | $253.44 | $264 | 0.9× |
| Rplc Gtube No Revj Trc (43762) range across 2 matching MRF lines |
$24–$278.40 | $25–$290 | varies |
| Rplc gtube revj gstrst trc (43763) | $24 | $25 | 0.1× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) | $287.04 | $299 | 1.4× |
| Rpr Tdn Flxr Foot 1/2 W/O Free Grafg Each Tendon (28200) | $2,256 | $2,350 | 0.7× |
| Rpr Tdn/Musc Flxr F/Arm&/Wrst Prim 1 Ea Tdn/Mu (25260) | $2,708.16 | $2,821 | 0.8× |
| Shave skin lesion 0.5 cm/< (11300) range across 2 matching MRF lines |
$24–$210.24 | $25–$219 | varies |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) range across 2 matching MRF lines |
$24–$230.40 | $25–$240 | varies |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) range across 3 matching MRF lines |
$24–$212.16 | $25–$221 | varies |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) range across 2 matching MRF lines |
$24–$263.04 | $25–$274 | varies |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) range across 2 matching MRF lines |
$24–$330.24 | $25–$344 | varies |
| Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) range across 2 matching MRF lines |
$24–$337.92 | $25–$352 | varies |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) range across 2 matching MRF lines |
$24–$239.04 | $25–$249 | varies |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) range across 2 matching MRF lines |
$24–$383.04 | $25–$399 | varies |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) range across 2 matching MRF lines |
$24–$261.12 | $25–$272 | varies |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) range across 2 matching MRF lines |
$24–$364.80 | $25–$380 | varies |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) range across 2 matching MRF lines |
$24–$296.64 | $25–$309 | varies |
| Sigmoidoscopy & Polypectomy (45333) | $1,793.28 | $1,868 | 1.9× |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) | $1,447.68 | $1,508 | 1.5× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) | $287.04 | $299 | 0.7× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) range across 3 matching MRF lines |
$24–$330.24 | $25–$344 | varies |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) range across 3 matching MRF lines |
$24–$383.04 | $25–$399 | varies |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) range across 3 matching MRF lines |
$24–$291.84 | $25–$304 | varies |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) range across 3 matching MRF lines |
$24–$315.84 | $25–$329 | varies |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) | $287.04 | $299 | 1.4× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) range across 3 matching MRF lines |
$24–$429.12 | $25–$447 | varies |
| Skin sub graft face/nk/hf/g (15275) range across 2 matching MRF lines |
$24–$225.60 | $25–$235 | varies |
| Skin sub graft trnk/arm/leg (15271) range across 2 matching MRF lines |
$24–$204.48 | $25–$213 | varies |
| Skin Tissue Procedure (17999) range across 37 matching MRF lines |
$53.76–$2,146.56 | $56–$2,236 | varies |
| Slitting of prepuce (54001) | $514.56 | $536 | 0.2× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) range across 3 matching MRF lines |
$24–$345.60 | $25–$360 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) range across 3 matching MRF lines |
$24–$365.76 | $25–$381 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) | $287.04 | $299 | 0.7× |
| Strapping ankle (29540) | $124.80 | $130 | 0.7× |
| Strapping elbow or wrist (29260) | $124.80 | $130 | 2.0× |
| Strapping hand/finger (29280) | $124.80 | $130 | 2.0× |
| Strapping knee (29530) | $124.80 | $130 | 0.9× |
| Strapping shoulder (29240) | $124.80 | $130 | 0.9× |
| Strapping thorax (29200) | $226.56 | $236 | 1.3× |
| Strapping toes (29550) range across 2 matching MRF lines |
$24–$124.80 | $25–$130 | varies |
| Strapping Unna Boot (29580) range across 3 matching MRF lines |
$24–$124.80 | $25–$130 | varies |
| Suture infrapatellar tendon primary (27380) unusually low: confirm this is the full procedure |
$3,135.36 | $3,266 | 0.4× |
| Tangential biopsy skin single lesion (11102) range across 2 matching MRF lines |
$24–$207.36 | $25–$216 | varies |
| Tenotomy Percutaneous Toe Single Tendon (28010) | $24 | $25 | 0.0× |
| Therapeutic pneumothorax (32960) | $364.80 | $380 | 0.6× |
| Tooth extraction (41899) | $236.16 | $246 | 1.0× |
| Treat humerus fracture (24500) | $193.92 | $202 | 0.8× |
| Treat Humerus Fracture (24505) | $193.92 | $202 | 0.1× |
| Treat humerus fracture (23600) range across 3 matching MRF lines |
$24–$572.16 | $25–$596 | varies |
| Treat knee fracture (27532) | $193.92 | $202 | 0.1× |
| Treat Knuckle Dislocation (26700) | $193.92 | $202 | 0.8× |
| Treat Metatarsal Fracture (28475) | $193.92 | $202 | 0.8× |
| Treat Thumb Dislocation (26641) | $193.92 | $202 | 0.8× |
| Treat toe dislocation (28630) | $657.60 | $685 | 2.6× |
| Treat Vaginal Bleeding (57180) | $270.72 | $282 | 1.3× |
| Treatment Closed Elbow Dislocation Req Anes (24605) | $1,625.28 | $1,693 | 1.0× |
| Treatment closed elbow dislocation w/o anes (24600) | $193.92 | $202 | 0.8× |
| Trim skin lesion (11055) range across 3 matching MRF lines |
$24–$98.88 | $25–$103 | varies |
| Trim skin lesions 2 to 4 (11056) range across 2 matching MRF lines |
$24–$117.12 | $25–$122 | varies |
| Trim skin lesions over 4 (11057) | $24 | $25 | 0.1× |
| Trimming Nondystrophic Nails Any Number (11719) | $24 | $25 | 0.4× |
| Tx Gastro Intub W/Asp (43753) | $164.16 | $171 | 0.7× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) range across 2 matching MRF lines |
$381.12–$563.52 | $397–$587 | varies |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj (28455) | $193.92 | $202 | 0.1× |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) | $193.92 | $202 | 0.8× |
| Unlisted procedure foot or toes (28899) | $24 | $25 | 0.1× |
| Vasectomy uni/bi spx w/postop semen exams (55250) | $1,075.20 | $1,120 | 0.5× |
| Vulvectomy simple partial (56620) | $552 | $575 | 0.2× |
| Wedge excision skin nail fold (11765) range across 2 matching MRF lines |
$24–$328.32 | $25–$342 | 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.