Procedures & surgery prices at Liberty Dayton Regional Medical Center

Liberty, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $1,969 $2,813 2.2×
Application cast elbow finger short arm (29075) $193 $275 0.7×
Application cast shoulder hand long arm (29065) $211 $301 0.8×
Application finger splint static (29130) $181 $258.50 1.4×
Application long arm splint shoulder hand (29105) $331 $473 2.0×
Application long leg splint thigh ankle/toes (29505) $331 $473 2.0×
Application of long leg cast (29345) $295 $421 1.0×
Application short arm splint forearm-hand static (29125) $207.50 $296.50 1.6×
Application short leg splint calf foot (29515) $244.50 $349 1.5×
Apply short leg cast (29405) $174 $249 0.6×
Arterial puncture (36600) $151 $215.50 1.1×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $117 $167 0.4×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $138 $197 0.4×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $113 $162 0.4×
Aspirat/Injection Ganglion Cyst(S) (20612) $137 $196 0.4×
Avulsion nail plate partial/complete simple 1 (11730) $236 $337 1.2×
Biopsy of uterus lining (58100) $211 $302 1.0×
Bladder Scan (51798) $305 $435 5.1×
Blood transfusion service (36430) $918 $1,312 2.1×
Catheter Aspiration Nasotracheal Spx (31720) $270 $385.50 1.2×
Change Cystostomy Tube Simple (51705) $311.50 $445 1.2×
Chemical Cautery Tissue (17250) $179 $256 0.9×
Chest tube placement (32551) $1,879.50 $2,685 1.2×
Chg Collect Blood From Catheter Venous Nos (36592) $271 $387 2.0×
Closed Rx Mid Humerus Fx,Manipulatn (24505) $2,178.50 $3,112 1.3×
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $2,196.50 $3,137.50 1.4×
Closed Rx Radial Shaft Fx (25500) $540 $771.50 2.2×
Closed Rx Shldr Disloc,Gr Tub Fx (23665) $2,125.50 $3,036 1.3×
Closed Rx Spontaneous Hip Disloc (27256) $517.50 $739 2.1×
Closed Rx Tibia Shaft Fx (27750) $611 $872.50 2.5×
Closed Rx Trimalleolar Fx (27816) $684 $977 2.8×
Closed tx ankle dislocation w/o anesthesia (27840) $858 $1,226 3.5×
Closed tx knee dislocation w/o anesthesia (27550) $782 $1,117 3.2×
Closed tx patellar dislocation w/o anesthesia (27560) $632 $902.50 2.6×
Closed tx patellar fracture w/o manipulation (27520) $586.50 $837.50 2.4×
Closed tx radial shaft fracture w/manipulation (25505) $1,164.50 $1,664 0.7×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $286.50 $409 1.2×
Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) $441.50 $630.50 1.9×
Clsd tx acromioclavicular dislc w/manipulation (23545) $612 $874.50 2.5×
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $516 $737 2.1×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $713 $1,018 2.9×
Cltx Carpo/Metacarpal Dislocation Thumb W/Manj (26641) $675.50 $965 2.7×
Cltx dstl fibular fx lat malls w/manj (27788) $678.50 $969.50 2.7×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $465.50 $665 1.9×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $702 $1,002.50 2.8×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $2,246.50 $3,209 1.4×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $384 $548.50 1.5×
Cltx hip dislocation traumatic w/o anesthesia (27250) $450 $642.50 1.8×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $355.50 $507.50 1.4×
Cltx iphal jt dislc w/manj w/o anes (26770) $595 $850.50 2.4×
Cltx metacarpal fx w/manipulation each bone (26605) $676.50 $966.50 2.7×
Cltx metacarpal fx w/o manipulation each bone (26600) $646 $923 2.6×
Cltx metacarpophalangeal dislc w/manj w/anes (26705) $2,121 $3,029.50 1.3×
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $709 $1,012.50 2.9×
Cltx metatarsophlngl jt dislc w/o anes (28630) $372.50 $532.50 1.5×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $698 $997 2.8×
Cltx post hip arthrp dislc w/o anes (27265) $714.50 $1,020.50 2.9×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $337 $481.50 1.4×
Cltx sprcndylr/transcndylr humeral fx w/manj (24535) $1,315 $1,878.50 0.8×
Cltx trimalleolar ankle fx w/manipulation (27818) $2,177 $3,110 1.3×
Control Nasal Hemorrhage Anterior Simple (30901) $196.50 $281 1.5×
Cryotherapy of skin (17340) $116 $166 2.0×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $250 $357 1.9×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $387 $553 1.6×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $122 $175 0.3×
Debride nail 1-5 (11720) $73 $104 1.2×
Debride nail 6 or more (11721) $99 $142 1.7×
Debride skin musc at fx site (11011) $1,060.50 $1,515 1.5×
Debridement subcutaneous tissue 20 sq cm/< (11042) $264 $377 0.6×
Destruc Benign/Premal,15+ Lesions (17004) $214 $305 0.5×
Destruction benign lesions 15 or more (17111) $275 $393 1.4×
Destruction Benign Lesions Up To 14 (17110) $145 $207 0.7×
Destruction premalignant lesion 1st (17000) $117 $167 0.6×
Drainage abscess/hematoma nasal int approach (30000) $374 $534.50 1.6×
Drainage Finger Abscess Simple (26010) $417 $596 2.1×
Drainage of abscess; submaxillary or sublingual, intraoral (42310) $678.50 $969 1.3×
Drainage of gum lesion (41800) $303 $432.50 2.3×
Drainage of hematoma/fluid (10140) $1,828 $2,611.50 1.1×
Drainage of scrotal wall abscess (55100) $3,403 $4,861 2.1×
Draw blood off venous device (36591) $271 $387 2.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $563 $804.50 1.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $300 $428.50 1.5×
Escharotomy initial incision (16035) $426 $609 1.0×
Evacuation of subungual hematoma (11740) $170 $242.50 1.3×
Exc arm/elbow les sc < 3 cm (24075) $1,177 $1,681 0.7×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $454 $649 0.3×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $319 $456 0.4×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $331 $473 0.5×
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $239 $342 0.6×
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $368 $525 0.5×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $698 $997 0.4×
Exc tr-ext b9+marg 0.5 cm or less (11400) $188 $268 0.3×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $475 $679 0.7×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $510 $728 1.2×
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $422 $603 0.6×
Excision malignant lesion s/n/h/f/g 0.6-1.0 cm (11621) $317 $453 0.4×
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $380 $543 0.5×
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $398 $569 0.2×
Excision of lesion other than skin tag </= 0.5 cm (11420) $276 $394 0.2×
Excision of nail fold toe (11765) $227 $324 0.6×
Fine needle aspiration without imaging guidance (10021) $839 $1,199 2.1×
Gastric Intubation/Aspiration, Therapeutic (43753) $654 $934 3.0×
I&D Abscess Peritonsillar (42700) $488 $697 2.1×
I&d abscess simple (10060) $226.50 $323.50 1.1×
I&d perianal abscess superficial (46050) $1,914 $2,735 2.0×
I&d pilonidal cyst simple (10080) $852 $1,217 1.2×
I&D Upper Arm/Elbow Bursa (23931) $417 $595 0.3×
Incision & drainage abscess complicated/multiple (10061) $616.50 $881 1.5×
Incision & removal foreign body subq tiss simple (10120) $326 $466 0.8×
Incision and drainage of bartholin's gland abscess (56420) $333.50 $476.50 1.6×
Incision and drainage of vulva or perineal abscess (56405) $308 $440 1.0×
Incision of rectal abscess (46040) $2,476 $3,537 2.1×
Incision thrombosed hemorrhoid external (46083) $511 $730 2.0×
Incisional biopsy skin single lesion (11106) $140 $200 0.2×
Initial tx 1st degree burn local tx (16000) $258 $368.50 1.3×
Inj tendon sheath/ligament (20550) $122 $175 0.4×
Inj,Anes Agent,Brachial Plexus,Single (64415) $1,870 $2,671 2.1×
Inject Anes/Steroid Plantar Common Digital Nerve (64455) $109 $156 0.4×
Inject Nerv Blck,Axillary Nerv (64417) $1,870 $2,671 2.1×
Inject Nerv Blck,Intercost,Multpl (64421) $1,870 $2,671 2.1×
Inject Nerv Blck,Intercostal,One (64420) $1,455 $2,078 2.1×
Inject Tendon Origin/Insert (20551) $131 $187 0.4×
Injection aa&/strd trigeminal nerve each branch (64400) $620 $886 2.0×
Injection anes other peripheral nerve/branch (64450) $773 $1,104 1.1×
Injection single/mlt trigger point 1/2 muscles (20552) $119 $170 0.4×
Injection single/mlt trigger point 3/> muscles (20553) $136 $194 0.4×
Injection therapeutic carpal tunnel (20526) $371 $530.50 1.2×
Injection treatment of nerve (64600) $1,870 $2,671 2.1×
Injection(s) spider veins (36468) $53 $75 0.1×
Injection, anesthetic agent; greater occipital nerve (64405) $858 $1,225 2.8×
Injection, intralesional; up to and including 7 lesions (11900) $119 $170 0.6×
Insert Drug Implant Device (11981) $309 $442 2.3×
Insert non-tunnel cv cath (36556) $3,060.50 $4,372 1.0×
Insert picc cath (36569) $1,813.50 $2,591 1.1×
Insert Temp Bladder Cath (51702) $240 $343 1.8×
Insert,Non-Indwelling Bladder Catheter (51701) $271 $387 2.0×
Insertion Picc W/Rs&I 5 Yr/> (36573) $3,425 $4,893 2.2×
Insertion picc w/rs&i < 5 yr (36572) $735.50 $1,050.50 1.2×
Intraoral i&d tongue/floor lingual (41000) $652 $931 1.2×
Intraoral i&d tongue/floor submental space (41007) $1,792.50 $2,560.50 1.2×
Intubation endotracheal emergency procedure (31500) $488 $697 2.1×
Irrigate corpora cavernosa for priapism (54220) $511 $730 2.0×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $838 $1,197 1.9×
Perq replacement gtube not req revj gstrst trc (43762) $559 $798 2.2×
Placement of needle for intraosseous infusion (36680) $483.50 $690.50 1.1×
Preputial Stretching (54450) $511 $730 2.0×
Punch biopsy skin single lesion (11104) $115 $165 0.3×
Puncture Aspiration (10160) $284 $406 0.7×
Removal fb intranasal (30300) $266.50 $380.50 2.0×
Removal foreign body foot subcutaneous (28190) $1,431 $2,044 2.0×
Removal impacted cerumen irrigation/lvg unilat (69209) $34 $48 0.6×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $115 $165 1.9×
Removal Implantable Contraceptive Capsules (11976) $319 $455 0.4×
Removal of nail bed (11750) $565 $807 1.4×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $160 $228 0.8×
Remove drug implant device (11982) $343 $490 0.8×
Remv Ext Canal Foreign Body (69200) $225 $321.50 1.7×
Remv F.B.,Eye,Superf Conjunc (65205) $271 $387 2.0×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $995 $1,421.50 1.3×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $704 $1,006 1.7×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $962.50 $1,375 2.4×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $887.50 $1,268 2.2×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $915.50 $1,308 2.2×
Repair extensor tendon finger w/o graft each (26418) $2,351 $3,358 1.5×
Repair forearm tendon/muscle (25260) $3,989.50 $5,699.50 1.2×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $600 $857 1.5×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $631.50 $902 1.5×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $648.50 $926.50 1.6×
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $655.50 $936.50 1.6×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $574 $820 1.4×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $627.50 $896.50 1.5×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $679 $970 1.7×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $580 $829 1.4×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $417 $595 1.0×
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $953.50 $1,362.50 1.3×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $638.50 $912 1.6×
Repair Laceration Palate </2 Cm (42180) $1,070 $1,528 2.0×
Repair of nail bed (11760) $759.50 $1,085 1.0×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $838 $1,197 1.9×
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $483 $690 0.3×
Rmvl w/rinsj non-biodegradable drug dlvr implt (11983) $568 $811 1.3×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $559.50 $799.50 1.4×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $248 $354 1.2×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $272 $388.50 1.3×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $291 $415.50 1.4×
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $312 $445.50 1.5×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $201 $287 1.0×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $366 $523 1.8×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $289 $413 1.4×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $244 $349 1.2×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $523.50 $748 1.3×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $546 $780.50 1.3×
Spinal puncture lumbar diagnostic (62270) $1,455 $2,078 2.1×
Strapping hand/finger (29280) $84 $120 1.4×
Strapping shoulder (29240) $267.50 $382 2.0×
Strapping toes (29550) $74.50 $106 1.3×
Strapping unna boot (29580) $131 $187 0.8×
Tangential biopsy skin single lesion (11102) $90 $129 0.2×
Thoracentesis needle/cath pleura w/o imaging (32554) $756 $1,079.50 1.2×
Thrombolytic Therapy, Stroke (37195) $697 $995 2.1×
Tongue and mouth surg unlisted (41599) $376 $537 1.6×
Tracheostomy emergency cricothyroid membrane (31605) $778 $1,112 3.3×
Tracheostomy planned (31600) $3,347 $4,781.50 1.0×
Treat finger dislocation (26775) $803.50 $1,148 2.9×
Treat Fracture Radius & Ulna (25560) $586.50 $838 2.4×
Treat humerus fracture (24500) $692.50 $989.50 2.8×
Treat Metatarsal Fracture (28475) $502.50 $718 2.0×
Treatment closed elbow dislocation w/o anes (24600) $776.50 $1,109 3.1×
Trim skin lesion (11055) $144 $206 0.7×
Tx superficial wound dehiscence w/packing (12021) $368 $526 0.9×
Venipuncture (36415) $18.50 $26.50 2.0×