Procedures & surgery prices at Lost Rivers Medical Center
Arco, ID · every code in this section with a posted price and a Medicare benchmark.
491 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) range across 2 matching MRF lines |
$232.80–$1,172 | $291–$1,465 | varies |
| Acne surgery (10040) range across 2 matching MRF lines |
$142.40–$177.60 | $178–$222 | varies |
| Adding Walker Previously Applied Cast (29440) | $65.60 | $82 | 0.4× |
| Adjt tis trns/reargmt f/c/c/m/n/a/g/h/f 10sqcm/< (14040) range across 3 matching MRF lines |
$1,146.40–$3,229.60 | $1,433–$4,037 | varies |
| Amniocentesis diagnostic (59000) | $180.80 | $226 | 0.2× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) | $1,108 | $1,385 | 0.3× |
| Amputation toe interphalangeal joint (28825) range across 3 matching MRF lines |
$462.40–$6,840.80 | $578–$8,551 | varies |
| Amputation toe metatarsophalangeal joint (28820) range across 3 matching MRF lines |
$499.20–$6,909.60 | $624–$8,637 | varies |
| Anoscopy Control Bleeding (46614) range across 2 matching MRF lines |
$259.20–$4,110.40 | $324–$5,138 | varies |
| Anoscopy diagnostic (46600) | $186.40 | $233 | 1.4× |
| Appendectomy (44950) likely a partial charge, not the full procedure |
$952.80 | $1,191 | 0.1× |
| Application cast elbow finger short arm (29075) range across 3 matching MRF lines |
$127.20–$296.80 | $159–$371 | varies |
| Application Cast Finger (29086) | $112.80 | $141 | 0.7× |
| Application finger splint static (29130) range across 2 matching MRF lines |
$62.40–$95.20 | $78–$119 | varies |
| Application long arm splint shoulder hand (29105) range across 2 matching MRF lines |
$128–$132 | $160–$165 | varies |
| Application Long Leg Splint (29505) range across 2 matching MRF lines |
$144.80–$167.20 | $181–$209 | varies |
| Application of long leg cast (29345) | $201.60 | $252 | 0.7× |
| Application Short Arm Splint Dynamic (29126) range across 2 matching MRF lines |
$120–$122.40 | $150–$153 | varies |
| Application short arm splint forearm-hand static (29125) range across 2 matching MRF lines |
$110.40–$112.80 | $138–$141 | varies |
| Application short leg splint calf foot (29515) range across 2 matching MRF lines |
$107.20–$122.40 | $134–$153 | varies |
| Apply hand/wrist cast (29085) range across 2 matching MRF lines |
$126.40–$141.60 | $158–$177 | varies |
| Apply long arm cast (29065) | $144 | $180 | 0.5× |
| Apply Multlay Comprs Lwr Leg (29581) range across 2 matching MRF lines |
$170.40–$376.80 | $213–$471 | varies |
| Apply Short Leg Cast (29405) | $120 | $150 | 0.4× |
| Apply short leg cast (29425) | $114.40 | $143 | 0.4× |
| Arterial puncture (36600) | $228 | $285 | 1.7× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) range across 2 matching MRF lines |
$82.40–$102.40 | $103–$128 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 2 matching MRF lines |
$107.20–$109.60 | $134–$137 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) | $196 | $245 | 0.6× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) | $79.20 | $99 | 0.3× |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) | $662.40 | $828 | 0.4× |
| Arthrt w/expl drg/rmvl loose/fb mttarphlngl jt (28022) range across 2 matching MRF lines |
$852.80–$3,207.20 | $1,066–$4,009 | varies |
| Aspirate Pleura W/O Imaging (32554) range across 2 matching MRF lines |
$238.40–$373.60 | $298–$467 | varies |
| Aspirate/Inj Ganglion Cyst (20612) | $102.40 | $128 | 0.3× |
| Avulsion nail plate partial/complete simple 1 (11730) range across 4 matching MRF lines |
$103.20–$692.80 | $129–$866 | varies |
| Biopsy Bone Trocar/Needle Superficial (20220) | $385.60 | $482 | 0.2× |
| Biopsy External Auditory Canal (69105) | $232.80 | $291 | 0.2× |
| Biopsy muscle percutaneous needle (20206) | $403.20 | $504 | 0.2× |
| Biopsy Muscle Superficial (20200) | $359.20 | $449 | 0.2× |
| Biopsy of breast; open, incisional (19101) | $518.40 | $648 | 0.1× |
| Biopsy of floor of mouth (41108) | $262.40 | $328 | 0.2× |
| Biopsy of rectum (45100) | $452.80 | $566 | 0.2× |
| Biopsy of urethra (53200) | $243.20 | $304 | 0.1× |
| Biopsy soft tissue back/flank deep (21925) | $772.80 | $966 | 0.5× |
| Biopsy Soft Tissue Back/Flank Superficial (21920) | $452 | $565 | 0.3× |
| Biopsy soft tissue neck/thorax (21550) | $453.60 | $567 | 0.3× |
| Biopsy Soft Tissue Shoulder Superficial (23065) | $376 | $470 | 0.2× |
| Biopsy Soft Tissue Upper Arm/Elbow Superficial (24065) | $447.20 | $559 | 0.3× |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) | $148 | $185 | 0.2× |
| Bladder Irrigation (51700) range across 2 matching MRF lines |
$80–$444 | $100–$555 | varies |
| Bladder Scan (51798) | $228 | $285 | 3.9× |
| Blepharotomy drainage abscess eyelid (67700) | $472 | $590 | 1.5× |
| Blood Transfusion Service (36430) range across 2 matching MRF lines |
$1,129.60–$2,264 | $1,412–$2,830 | varies |
| Bx breast needle core w/o imaging guidance spx (19100) | $260 | $325 | 0.2× |
| Bx Cervix (57500) | $241.60 | $302 | 0.3× |
| Bx/exc lymph node open deep axillary node (38525) | $653.60 | $817 | 0.2× |
| Capsul mttarphlngl jt w/wo tenorrhaphy ea jt spx (28270) range across 3 matching MRF lines |
$857.60–$3,827.20 | $1,072–$4,784 | varies |
| Change Cystostomy Tube Simple (51705) | $613.60 | $767 | 2.5× |
| Chemical Cautery Tissue (17250) | $137.60 | $172 | 0.7× |
| Chemical exfoliation for acne (17360) | $188 | $235 | 0.9× |
| Chest tube placement (32551) | $219.20 | $274 | 0.1× |
| Circumcision Neonate (54160) | $350.40 | $438 | 0.5× |
| Circumcision w/clamp/oth dev w/block (54150) | $237.60 | $297 | 0.1× |
| Cl Tx Scapular Fx; W Manip (23575) | $684.80 | $856 | 0.4× |
| Cl Tx Tib Shft Fx W Manip (27752) | $714.40 | $893 | 0.4× |
| Clear outer ear canal (69200) range across 2 matching MRF lines |
$136–$140 | $170–$175 | varies |
| Closed Treat Vert Body Fract (22310) | $521.60 | $652 | 2.1× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) | $288 | $360 | 1.2× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) | $288 | $360 | 1.2× |
| Closed Treatment Sternum Fracture (21820) | $245.60 | $307 | 1.0× |
| Closed Treatment Ulnar Styloid Fracture (25650) | $288 | $360 | 1.2× |
| Closed tx ankle dislocation w/o anesthesia (27840) range across 2 matching MRF lines |
$640.80–$720 | $801–$900 | varies |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) range across 2 matching MRF lines |
$284.80–$808.80 | $356–$1,011 | varies |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) | $288 | $360 | 1.2× |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) | $376.80 | $471 | 1.5× |
| Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) | $525.60 | $657 | 2.2× |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) | $288 | $360 | 1.2× |
| Closed tx knee dislocation w/o anesthesia (27550) | $852.80 | $1,066 | 3.5× |
| Closed tx metatarsal fracture w/o manipulation (28470) range across 2 matching MRF lines |
$305.60–$333.60 | $382–$417 | varies |
| Closed Tx Nasal Bone Fx W/Mnpj W/O Stabilization (21315) | $494.40 | $618 | 0.3× |
| Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) | $412.80 | $516 | 0.1× |
| Closed tx patellar dislocation w/anesthesia (27562) | $288 | $360 | 1.2× |
| Closed tx patellar dislocation w/o anesthesia (27560) range across 2 matching MRF lines |
$503.20–$572.80 | $629–$716 | varies |
| Closed Tx Patellar Fracture W/O Manipulation (27520) | $288 | $360 | 1.2× |
| Closed tx radial head/neck fx w/o manipulation (24650) | $451.20 | $564 | 1.9× |
| Closed tx radial shaft fracture w/manipulation (25505) | $863.20 | $1,079 | 0.5× |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) | $288 | $360 | 1.2× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) | $681.60 | $852 | 0.4× |
| Closed tx radial&ulnar shaft fractures w/o man (25560) | $288 | $360 | 1.2× |
| Closed Tx Scapular Fracture W/O Manipulation (23570) | $397.60 | $497 | 1.6× |
| Closed tx septal&nose fx (21337) | $710.40 | $888 | 0.2× |
| Closed Tx Sternoclavicular Dislc W/Manipulation (23525) | $646.40 | $808 | 2.7× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) | $210.40 | $263 | 0.9× |
| Closed tx ulnar shaft fracture w/o manipulation (25530) | $452 | $565 | 1.9× |
| Clsd tx acromioclavicular dislc w/manipulation (23545) range across 2 matching MRF lines |
$480.80–$598.40 | $601–$748 | varies |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) | $384.80 | $481 | 1.6× |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) | $603.20 | $754 | 0.4× |
| Clsd tx clavicular fracture w/o manipulation (23500) range across 2 matching MRF lines |
$337.60–$342.40 | $422–$428 | varies |
| Clsd tx shoulder dislc w/manipulation req anes (23655) range across 2 matching MRF lines |
$596.80–$616.80 | $746–$771 | varies |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) range across 2 matching MRF lines |
$447.20–$495.20 | $559–$619 | varies |
| Clsd tx sternoclavicular dislc w/o manipulation (23520) | $395.20 | $494 | 0.2× |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) | $288 | $360 | 1.2× |
| Cltx dstl fibular fx lat malls w/manj (27788) | $780 | $975 | 3.2× |
| Cltx dstl fibular fx lat malls w/o manj (27786) | $480.80 | $601 | 2.0× |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) range across 2 matching MRF lines |
$415.20–$540 | $519–$675 | varies |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) range across 2 matching MRF lines |
$131.20–$317.60 | $164–$397 | varies |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) range across 2 matching MRF lines |
$486.40–$514.40 | $608–$643 | varies |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) range across 2 matching MRF lines |
$748.80–$820.80 | $936–$1,026 | varies |
| Cltx fx grt toe phlx/phlg w/o manj (28490) | $216 | $270 | 0.9× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) | $280 | $350 | 1.1× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) | $185.60 | $232 | 0.8× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) | $288 | $360 | 1.2× |
| Cltx greater humeral tuberosity fx w/o manj (23620) | $464 | $580 | 1.9× |
| Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) | $651.20 | $814 | 0.4× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) | $357.60 | $447 | 1.5× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) range across 2 matching MRF lines |
$201.60–$204.80 | $252–$256 | varies |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) | $598.40 | $748 | 2.2× |
| Cltx iphal jt dislc w/manj w/o anes (26770) | $436 | $545 | 1.8× |
| Cltx Med Ankle Fx W/Mnpj (27762) | $817.60 | $1,022 | 0.5× |
| Cltx Medial Ankle Fx (27760) | $288 | $360 | 1.2× |
| Cltx metacarpal fx w/manipulation each bone (26605) range across 2 matching MRF lines |
$442.40–$501.60 | $553–$627 | varies |
| Cltx metacarpal fx w/o manipulation each bone (26600) range across 2 matching MRF lines |
$507.20–$518.40 | $634–$648 | varies |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) | $453.60 | $567 | 1.9× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) | $342.40 | $428 | 1.4× |
| Cltx post hip arthrp dislc w/o anes (27265) range across 2 matching MRF lines |
$611.20–$618.40 | $764–$773 | varies |
| Cltx prox fibula/shft fx w/o manj (27780) | $530.40 | $663 | 2.2× |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) | $796 | $995 | 0.5× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) range across 2 matching MRF lines |
$156.80–$196.80 | $196–$246 | varies |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) | $590.40 | $738 | 0.4× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) | $1,049.60 | $1,312 | 0.7× |
| Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) | $652.80 | $816 | 2.7× |
| Cltx trimalleolar ankle fx w/manipulation (27818) | $646.40 | $808 | 0.4× |
| Collect Blood From Catheter Venous Nos (36592) | $115.20 | $144 | 0.9× |
| Collection of venous blood by venipuncture (36415) range across 2 matching MRF lines |
$13.60–$16 | $17–$20 | varies |
| Colonoscopy Flexible With Decompression (45393) | $2,108 | $2,635 | 1.8× |
| Colonoscopy stoma rmvl les by hot biopsy forceps (44392) | $2,508 | $3,135 | 2.1× |
| Colonoscopy thru stoma (44388) | $492 | $615 | 0.5× |
| Colonoscopy W/Band Ligation (45398) | $2,318.40 | $2,898 | 2.0× |
| Colonoscopy w/fb removal (45379) | $2,222.40 | $2,778 | 1.9× |
| Colonoscopy W/Resection (45390) | $2,600.80 | $3,251 | 0.9× |
| Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) | $259.20 | $324 | 0.9× |
| Colposcopy Cervix Vag Loop Eltrd Bx Cervix (57460) | $501.60 | $627 | 0.2× |
| Colsc Flexible W/Control Bleeding Any Method (45382) | $2,145.60 | $2,682 | 1.8× |
| Colsc Flexible W/Transendoscopic Balloon Dilat (45386) | $3,320 | $4,150 | 2.8× |
| Colsc flx w/removal lesion by hot bx forceps (45384) | $2,581.60 | $3,227 | 2.2× |
| Complex drainage wound (10180) range across 2 matching MRF lines |
$252.80–$399.20 | $316–$499 | varies |
| Control Nasal Hemorrhage Anterior Complex (30903) range across 2 matching MRF lines |
$240–$389.60 | $300–$487 | varies |
| Control Nasal Hemorrhage Anterior Simple (30901) range across 2 matching MRF lines |
$137.60–$247.20 | $172–$309 | varies |
| Correction hammertoe (28285) range across 2 matching MRF lines |
$571.20–$1,623.20 | $714–$2,029 | varies |
| Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) range across 2 matching MRF lines |
$1,900–$5,298.40 | $2,375–$6,623 | varies |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (28292) range across 3 matching MRF lines |
$1,095.20–$4,422.40 | $1,369–$5,528 | varies |
| Cryotherapy Co2 Slush Liquid N2 Acne (17340) | $86.40 | $108 | 1.5× |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) range across 2 matching MRF lines |
$272.80–$564.80 | $341–$706 | varies |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) range across 2 matching MRF lines |
$332.80–$587.20 | $416–$734 | varies |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) range across 3 matching MRF lines |
$88.80–$208.80 | $111–$261 | varies |
| Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) | $2,540.80 | $3,176 | 0.9× |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) range across 2 matching MRF lines |
$441.60–$716.80 | $552–$896 | varies |
| Dbrdmt W/Rmvl Fm Fx&/Dislc Skn Subq T/M/F Musc (11011) range across 2 matching MRF lines |
$473.60–$788.80 | $592–$986 | varies |
| Deb Musc/Fascia 20 Sq Cm/< (11043) | $393.60 | $492 | 0.5× |
| Debride nail 1-5 (11720) | $54.40 | $68 | 0.9× |
| Debride nail 6 or more (11721) range across 2 matching MRF lines |
$68.80–$76.80 | $86–$96 | varies |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) range across 3 matching MRF lines |
$424.80–$2,633.60 | $531–$3,292 | varies |
| Debridement subcutaneous tissue 20 sq cm/< (11042) | $200 | $250 | 0.5× |
| Declot vascular device (36593) | $580 | $725 | 1.8× |
| Destroy cerv/thor facet jnt (64633) | $852 | $1,065 | 0.4× |
| Destruct B9 Lesion 1-14 (17110) range across 4 matching MRF lines |
$145.60–$416.80 | $182–$521 | varies |
| Destruction Benign Lesions 15/> (17111) | $216.80 | $271 | 1.1× |
| Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) | $273.60 | $342 | 1.4× |
| Destruction mal lesion f/e/e/n/l/m 1.1-2.0cm (17282) | $349.60 | $437 | 1.8× |
| Destruction mal lesion trunk/arm/leg 0.6-1.0 cm (17261) | $247.20 | $309 | 1.2× |
| Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) | $300 | $375 | 1.5× |
| Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) | $242.40 | $303 | 1.2× |
| Destruction malignant lesion s/n/h/f/g 0.5 cm/> (17270) | $228 | $285 | 1.2× |
| Destruction malignant lesion s/n/h/f/g 0.6-1.0cm (17271) | $280.80 | $351 | 1.4× |
| Destruction malignant lesion s/n/h/f/g 1.1-2.0cm (17272) | $319.20 | $399 | 1.6× |
| Destruction malignant lesion t/a/l 0.5 cm/< (17260) | $143.20 | $179 | 0.7× |
| Destruction Premalignant Lesion 15/> (17004) | $252 | $315 | 0.6× |
| Destruction premalignant lesion 1st (17000) | $111.20 | $139 | 0.6× |
| Diagnostic sigmoidoscopy (45330) | $1,758.40 | $2,198 | 1.9× |
| Dilation & curettage dx&/ther nonobstetric (58120) | $455.20 | $569 | 0.1× |
| Drainage External Ear Abscess/Hematoma Simple (69000) | $329.60 | $412 | 0.5× |
| Drainage Finger Abscess Complicated (26011) | $677.60 | $847 | 0.4× |
| Drainage of finger abscess simple (26010) | $525.60 | $657 | 2.7× |
| Drainage of gum lesion (41800) | $491.20 | $614 | 3.7× |
| Drainage of hematoma/fluid (10140) range across 2 matching MRF lines |
$189.60–$261.60 | $237–$327 | varies |
| Drainage of scrotal wall abscess (55100) | $358.40 | $448 | 0.2× |
| Draw Blood Off Venous Device (36591) | $144 | $180 | 1.1× |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) | $324.80 | $406 | 0.5× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) | $320 | $400 | 0.8× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) range across 3 matching MRF lines |
$176–$342.40 | $220–$428 | varies |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) range across 4 matching MRF lines |
$123.20–$292 | $154–$365 | varies |
| Dstrj Lesion Penis Simple Cryosurgery (54056) | $217.60 | $272 | 1.1× |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) | $398.40 | $498 | 0.5× |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) | $2,800 | $3,500 | 1.5× |
| Egd cautery tumor polyp (43250) | $2,087.20 | $2,609 | 1.1× |
| Egd control bleeding any (43255) | $2,362.40 | $2,953 | 1.2× |
| Egd dilation gastric/duodenal stricture (43245) | $2,253.60 | $2,817 | 1.2× |
| Egd endo mucosal resection (43254) | $2,666.40 | $3,333 | 1.4× |
| Egd Flexible Foreign Body Removal (43247) | $2,253.60 | $2,817 | 2.5× |
| Egd Injection Sclerosis Esophgl/Gastric Varices (43243) | $1,891.20 | $2,364 | 1.0× |
| Egd remove lesion snare (43251) | $2,164.80 | $2,706 | 1.1× |
| Egd us transmural injxn/mark (43253) | $3,080.80 | $3,851 | 1.6× |
| Egd Varices Ligation (43244) | $2,511.20 | $3,139 | 1.3× |
| Egd W/Transmural Drain Cyst (43240) | $3,016 | $3,770 | 0.5× |
| Endocervical curettage (57505) | $229.60 | $287 | 0.3× |
| Endometrial Biopsy (58100) | $150.40 | $188 | 0.8× |
| Epidural Blood Patch (62273) | $299.20 | $374 | 0.4× |
| Esophagogastroduodenoscopy Submucosal Injection (43236) | $1,891.20 | $2,364 | 2.1× |
| Evacuation of subungual hematoma (11740) range across 2 matching MRF lines |
$86.40–$104.80 | $108–$131 | varies |
| Exc arm/elbow les sc < 3 cm (24075) | $820 | $1,025 | 0.5× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) | $189.60 | $237 | 0.3× |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) range across 3 matching MRF lines |
$315.20–$2,447.20 | $394–$3,059 | varies |
| Exc Back Les Sc < 3 Cm (21930) | $763.20 | $954 | 0.5× |
| Exc Back Tum Deep 5 Cm/> (21933) | $1,096.80 | $1,371 | 0.4× |
| Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) | $366.40 | $458 | 0.5× |
| Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) | $412 | $515 | 0.6× |
| Exc F/E/E/N/L Mal+Mrg 3.1-4 (11644) | $596 | $745 | 0.4× |
| Exc Face Les Sbq 2 Cm/> (21012) range across 2 matching MRF lines |
$572–$3,950.40 | $715–$4,938 | varies |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) | $220.80 | $276 | 0.3× |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) | $268 | $335 | 0.4× |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) | $295.20 | $369 | 0.4× |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) | $350.40 | $438 | 0.2× |
| Exc Face-Mm B9+Marg 3.1-4 Cm (11444) | $436 | $545 | 0.3× |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) | $198.40 | $248 | 0.1× |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) range across 3 matching MRF lines |
$246.40–$1,748.80 | $308–$2,186 | varies |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) range across 3 matching MRF lines |
$277.60–$2,226.40 | $347–$2,783 | varies |
| Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) | $722.40 | $903 | 0.5× |
| Exc lesion tendon sheath/capsule w/synvct toe ea (28092) | $652 | $815 | 0.4× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) | $296.80 | $371 | 0.4× |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) range across 3 matching MRF lines |
$360.80–$3,033.60 | $451–$3,792 | varies |
| Exc Skin Benig >4 Cm Remaindr Body (11426) range across 3 matching MRF lines |
$513.60–$3,903.20 | $642–$4,879 | varies |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) | $483.20 | $604 | 0.3× |
| Exc Skin Benig >4cm Face,Facial (11446) | $594.40 | $743 | 0.2× |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) | $454.40 | $568 | 0.3× |
| Exc Skin Malig >4 Cm Remaindr Body (11626) | $620.80 | $776 | 0.2× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) | $678.40 | $848 | 0.4× |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) | $328 | $410 | 0.3× |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) | $240 | $300 | 0.6× |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) | $256 | $320 | 0.4× |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) | $336 | $420 | 0.2× |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) | $5,301.60 | $6,627 | 1.8× |
| Exc tumor soft tiss upper arm/elbw subfasc 5+cm (24073) | $1,168 | $1,460 | 0.4× |
| Exc tumor soft tissue abdominal wall subq <3cm (22902) | $716.80 | $896 | 0.4× |
| Exc tumor soft tissue foot/toe subfasc 1.5+cm (28041) range across 2 matching MRF lines |
$852.80–$5,163.20 | $1,066–$6,454 | varies |
| Exc tumor soft tissue foot/toe subfasc <1.5cm (28045) range across 3 matching MRF lines |
$749.60–$2,686.40 | $937–$3,358 | varies |
| Exc Tumor Soft Tissue Forearm &/Wrist Subq <3Cm (25075) | $800.80 | $1,001 | 0.5× |
| Exc tumor soft tissue neck/ant thorax subq <3cm (21555) | $723.20 | $904 | 0.4× |
| Exc Tumor Soft Tissue Upper Arm/Elbow Subq 3+Cm (24071) | $624.80 | $781 | 0.2× |
| Excis Mouth Mucosa/Sub,Simpl Repair (40812) | $506.40 | $633 | 0.3× |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) | $427.20 | $534 | 0.6× |
| Excision H/P/P/U Simple/Intermediate Repair (11470) | $712 | $890 | 0.2× |
| Excision Hidradenitis Inguinal Smpl/Intrm Rpr (11462) | $642.40 | $803 | 0.2× |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) | $308.80 | $386 | 0.4× |
| Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) | $353.60 | $442 | 0.5× |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) | $376.80 | $471 | 0.9× |
| Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) | $476.80 | $596 | 0.7× |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) | $316 | $395 | 0.5× |
| Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) | $484.80 | $606 | 0.3× |
| Excision Malignant Lesion F/E/E/N/L >4.0 Cm (11646) | $772.80 | $966 | 0.3× |
| Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) | $309.60 | $387 | 0.2× |
| Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) | $355.20 | $444 | 0.5× |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) | $389.60 | $487 | 0.6× |
| Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) | $517.60 | $647 | 0.3× |
| Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod… (26415) | $1,349.60 | $1,687 | 0.4× |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) | $472 | $590 | 0.3× |
| Excision of pilonidal cyst or sinus; simple (11770) | $531.20 | $664 | 0.2× |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) | $699.20 | $874 | 0.4× |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) range across 3 matching MRF lines |
$603.20–$3,212 | $754–$4,015 | varies |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) | $626.40 | $783 | 0.4× |
| Excision Tumor Soft Tissue Thigh/Knee Subq <3Cm (27327) | $768 | $960 | 0.5× |
| Excision, interdigital (morton) neuroma, single, each (28080) | $918.40 | $1,148 | 0.6× |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) | $2,884.80 | $3,606 | 1.0× |
| Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) | $812.80 | $1,016 | 0.5× |
| Exploration penetrating wound spx extremity (20103) range across 2 matching MRF lines |
$516.80–$880.80 | $646–$1,101 | varies |
| Explore/Treat Wrist Joint (25040) | $3,893.60 | $4,867 | 1.2× |
| Fetal non-stress test (59025) | $82.40 | $103 | 0.4× |
| Fine needle aspiration without imaging guidance (10021) range across 2 matching MRF lines |
$154.40–$157.60 | $193–$197 | varies |
| Foreskin manipulation (54450) | $292 | $365 | 1.2× |
| Fth/gft free w/direct closure s/a/l 20 cm/< (15220) | $1,324.80 | $1,656 | 0.6× |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) range across 2 matching MRF lines |
$748–$3,700.80 | $935–$4,626 | varies |
| Hysteroscopy Biopsy (58558) | $2,296.80 | $2,871 | 0.7× |
| I&d abscess peritonsillar (42700) | $217.60 | $272 | 0.9× |
| I&d abscess simple (10060) range across 3 matching MRF lines |
$153.60–$420 | $192–$525 | varies |
| I&d deep absc bursa/hematoma thigh/knee region (27301) | $1,032 | $1,290 | 0.4× |
| I&D Deep Absc/Hematoma Neck/Chest (21501) | $793.60 | $992 | 0.3× |
| I&d perianal abscess superficial (46050) | $365.60 | $457 | 0.4× |
| I&d pilonidal cyst complicated (10081) range across 2 matching MRF lines |
$269.60–$522.40 | $337–$653 | varies |
| I&d pilonidal cyst simple (10080) range across 2 matching MRF lines |
$200–$380 | $250–$475 | varies |
| I&d upper arm/elbow deep abscess/hematoma (23930) | $614.40 | $768 | 0.2× |
| Incise external hemorrhoid (46083) range across 2 matching MRF lines |
$242.40–$325.60 | $303–$407 | varies |
| Incise finger tendon sheath (26055) | $971.20 | $1,214 | 0.6× |
| Incision & drainage abscess complicated/multiple (10061) range across 2 matching MRF lines |
$266.40–$322.40 | $333–$403 | varies |
| Incision & removal foreign body subq tiss compl (10121) range across 2 matching MRF lines |
$274.40–$414.40 | $343–$518 | varies |
| Incision & removal foreign body subq tiss simple (10120) range across 2 matching MRF lines |
$180.80–$236 | $226–$295 | varies |
| Incision and drainage of bartholin's gland abscess (56420) | $180.80 | $226 | 0.9× |
| Incision and drainage of vulva or perineal abscess (56405) | $219.20 | $274 | 0.7× |
| Incision of Foot Tendon (28234) range across 3 matching MRF lines |
$717.60–$2,223.20 | $897–$2,779 | varies |
| Incision of lingual frenum (frenotomy) (41010) | $368 | $460 | 0.2× |
| Incision of rectal abscess (46040) | $853.60 | $1,067 | 0.7× |
| Incision&Drainage Upper Arm/Elbow Bursa (23931) | $474.40 | $593 | 0.3× |
| Initial Tx 1st Degree Burn Local Tx (16000) | $116.80 | $146 | 0.6× |
| Injection 1 tendon sheath/ligament aponeurosis (20550) range across 2 matching MRF lines |
$85.60–$98.40 | $107–$123 | varies |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) | $52 | $65 | 0.1× |
| Injection Anes Agent Sphenopalatine Ganglion (64505) range across 2 matching MRF lines |
$204–$208 | $255–$260 | varies |
| Injection single tendon origin/insertion (20551) | $87.20 | $109 | 0.3× |
| Injection single/mlt trigger point 1/2 muscles (20552) range across 3 matching MRF lines |
$81.60–$356 | $102–$445 | varies |
| Injection single/mlt trigger point 3/> muscles (20553) range across 2 matching MRF lines |
$152–$380 | $190–$475 | varies |
| Injection therapeutic carpal tunnel (20526) | $128 | $160 | 0.4× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) range across 2 matching MRF lines |
$125.60–$152 | $157–$190 | varies |
| Injection, Intralesional; More Than 7 Lesions (11901) | $118.40 | $148 | 0.6× |
| Injection, intralesional; up to and including 7 lesions (11900) | $94.40 | $118 | 0.5× |
| Insert Bladder Cath Complex (51703) | $71.20 | $89 | 0.6× |
| Insert cath pleura w/o image (32556) | $1,259.20 | $1,574 | 0.7× |
| Insert cervical dilator (59200) | $184.80 | $231 | 0.6× |
| Insert Drug Implant Device (11981) | $156.80 | $196 | 1.2× |
| Insert non-tunnel cv cath (36556) range across 2 matching MRF lines |
$330.40–$344 | $413–$430 | varies |
| Insert Temp Bladder Cath (51702) range across 2 matching MRF lines |
$100.80–$216 | $126–$270 | varies |
| Insert,Non-Indwelling Bladder Catheter (51701) range across 2 matching MRF lines |
$72–$178.40 | $90–$223 | varies |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) | $6,891.20 | $8,614 | 0.8× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) | $1,864 | $2,330 | 1.2× |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) range across 2 matching MRF lines |
$559.20–$812 | $699–$1,015 | varies |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) | $938.40 | $1,173 | 2.3× |
| Intro Gastrointestinal Tube (44500) | $462.40 | $578 | 0.5× |
| Intubation endotracheal emergency procedure (31500) range across 2 matching MRF lines |
$202.40–$213.60 | $253–$267 | varies |
| IV injection test vascular flow flap/graft (15860) | $159.20 | $199 | 0.4× |
| Laparoscopy, surgical, appendectomy (44970) likely a partial charge, not the full procedure |
$893.60 | $1,117 | 0.1× |
| Laryngoscopy diagnostic (31505) | $146.40 | $183 | 0.7× |
| Laryngoscopy Indirect W/Removal Foreign Body (31511) | $280 | $350 | 1.4× |
| Laryngoscopy W/WO Tracheoscopy Dx Newborn (31520) | $183.20 | $229 | 0.5× |
| Late closure of wound (13160) | $1,194.40 | $1,493 | 0.3× |
| Manipulation Elbow Under Anesthesia (24300) | $709.60 | $887 | 0.4× |
| Manipulation spine requiring anesthesia (22505) | $208 | $260 | 0.1× |
| N block inj intercost sng (64420) | $156 | $195 | 0.2× |
| N Block Inj Plantar Digit (64455) | $76 | $95 | 0.3× |
| Nasal Endoscopy Dx (31231) | $312.80 | $391 | 1.6× |
| Nasal/Orogastric W/Tube Plmt (43752) | $68 | $85 | 0.2× |
| Needle Biopsy Lymph Nodes (38505) | $245.60 | $307 | 0.2× |
| Needle insertion w/o injection 3 or more muscles (20561) | $51.20 | $64 | 1.8× |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) | $1,632 | $2,040 | 3.9× |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) range across 3 matching MRF lines |
$160.80–$195.20 | $201–$244 | varies |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) | $197.60 | $247 | 0.2× |
| Occipital Nerve Block (64405) range across 2 matching MRF lines |
$112.80–$140.80 | $141–$176 | varies |
| Open Tx Fracture Phalanx/Phalanges Not Great Toe (28525) range across 2 matching MRF lines |
$765.60–$3,916.80 | $957–$4,896 | varies |
| Ostc prtl exostc/condylc metar head (28288) | $1,051.20 | $1,314 | 0.3× |
| Ostectomy Complete Other Metatarsal Head 2/3/4 (28112) | $750.40 | $938 | 0.2× |
| Ostectomy of sternum, partial Facility (21620) | $757.60 | $947 | 0.2× |
| Ostectomy, complete excision; fifth metatarsal head (28113) range across 3 matching MRF lines |
$905.60–$3,878.40 | $1,132–$4,848 | varies |
| Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) range across 3 matching MRF lines |
$808.80–$3,847.20 | $1,011–$4,809 | varies |
| Partial removal of toe (28160) range across 2 matching MRF lines |
$675.20–$1,664.80 | $844–$2,081 | varies |
| Partical Excision Bone Phalanx Toe (28124) range across 3 matching MRF lines |
$739.20–$3,516 | $924–$4,395 | varies |
| Pelvic examination under anesthesia (other than local) (57410) | $182.40 | $228 | 0.1× |
| Perq skel fixj distal radial fx/epiphysl sep (25606) | $1,125.60 | $1,407 | 0.3× |
| Phalangectomy toe each toe (28150) | $3,150.40 | $3,938 | 1.0× |
| Placement of needle for intraosseous infusion (36680) | $479.20 | $599 | 1.1× |
| Prtl exc b1 tarsal/metar b1 xcp talus/calcaneus (28122) range across 3 matching MRF lines |
$645.60–$1,274.40 | $807–$1,593 | varies |
| Punch biopsy skin single lesion (11104) | $198.40 | $248 | 0.5× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) range across 2 matching MRF lines |
$163.20–$200 | $204–$250 | varies |
| Puncture Aspiration Cyst Breast (19000) | $164.80 | $206 | 0.2× |
| Release of big toe (28240) | $757.60 | $947 | 0.2× |
| Removal Foreign Body Foot Subcutaneous (28190) | $398.40 | $498 | 0.6× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) | $334.40 | $418 | 0.2× |
| Removal impacted cerumen irrigation/lvg unilat (69209) range across 2 matching MRF lines |
$24.80–$75.20 | $31–$94 | varies |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) range across 2 matching MRF lines |
$73.60–$101.60 | $92–$127 | varies |
| Removal implantable contraceptive capsules (11976) | $246.40 | $308 | 0.4× |
| Removal of nail bed (11750) range across 4 matching MRF lines |
$202.40–$759.20 | $253–$949 | varies |
| Removal of sesamoid bone (28315) range across 3 matching MRF lines |
$480.80–$4,729.60 | $601–$5,912 | varies |
| Removal or bivalving full arm or full leg cast (29705) | $115.20 | $144 | 0.4× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) | $132.80 | $166 | 0.7× |
| Removal subcutaneous cardiac rhythm monitor (33286) range across 2 matching MRF lines |
$208.80–$2,228 | $261–$2,785 | varies |
| Removal Sutures/Staples Requiring Anesthesia (15851) range across 2 matching MRF lines |
$148.80–$171.20 | $186–$214 | varies |
| Removal sweat gland lesion (11450) | $656 | $820 | 0.2× |
| Remove drug implant device (11982) | $182.40 | $228 | 0.4× |
| Remove foreign body from eye (65205) range across 2 matching MRF lines |
$45.60–$73.60 | $57–$92 | varies |
| Remove Intrauterine Device (58301) | $185.60 | $232 | 0.6× |
| Remove Nasal Foreign Body (30300) range across 2 matching MRF lines |
$207.20–$323.20 | $259–$404 | varies |
| Remove Shoulder Foreign Body (23330) | $470.40 | $588 | 0.3× |
| Remove Tendon Sheath Lesion (26160) | $936 | $1,170 | 0.6× |
| Remove/Insert Drug Implant (11983) | $220 | $275 | 0.5× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) | $722.40 | $903 | 1.0× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) range across 2 matching MRF lines |
$632.80–$820 | $791–$1,025 | varies |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) | $660.80 | $826 | 1.6× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) range across 2 matching MRF lines |
$430.40–$730.40 | $538–$913 | varies |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) range across 2 matching MRF lines |
$332–$552 | $415–$690 | varies |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) range across 2 matching MRF lines |
$392–$661.60 | $490–$827 | varies |
| Repair complex trunk 1.1-2.5 cm (13100) | $680 | $850 | 0.9× |
| Repair complex trunk 2.6-7.5 cm (13101) | $734.40 | $918 | 1.0× |
| Repair extensor tendon finger w/o graft each (26418) | $952.80 | $1,191 | 0.6× |
| Repair Finger/Hand Tendon (26350) | $3,893.60 | $4,867 | 1.2× |
| Repair Hallux Rigidus (28289) range across 3 matching MRF lines |
$1,083.20–$4,961.60 | $1,354–$6,202 | varies |
| Repair Hand Tendon (26410) | $960.80 | $1,201 | 0.6× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) range across 2 matching MRF lines |
$262.40–$436 | $328–$545 | varies |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) range across 2 matching MRF lines |
$343.20–$482.40 | $429–$603 | varies |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) | $596 | $745 | 1.5× |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) | $636 | $795 | 1.6× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) range across 2 matching MRF lines |
$691.20–$774.40 | $864–$968 | varies |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) range across 2 matching MRF lines |
$244.80–$406.40 | $306–$508 | varies |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) range across 2 matching MRF lines |
$474.40–$1,164 | $593–$1,455 | varies |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) | $618.40 | $773 | 0.8× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) range across 2 matching MRF lines |
$344.80–$667.20 | $431–$834 | varies |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) range across 2 matching MRF lines |
$244–$404 | $305–$505 | varies |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) range across 2 matching MRF lines |
$296.80–$470.40 | $371–$588 | varies |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) | $727.20 | $909 | 1.0× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) range across 2 matching MRF lines |
$303.20–$512 | $379–$640 | varies |
| Repair of nail bed (11760) range across 3 matching MRF lines |
$213.60–$337.60 | $267–$422 | varies |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) | $5,160.80 | $6,451 | 0.7× |
| Resection, condyle(s), distal end of phalanx, each toe Facility (28153) range across 3 matching MRF lines |
$634.40–$2,071.20 | $793–$2,589 | varies |
| Resection, partial or complete, phalangeal base, each toe (28126) range across 2 matching MRF lines |
$604.80–$1,848.80 | $756–$2,311 | varies |
| Rmvl embedded fb from dentalvlr struxs soft tiss (41805) | $497.60 | $622 | 0.3× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) range across 2 matching MRF lines |
$99.20–$112.80 | $124–$141 | varies |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) range across 2 matching MRF lines |
$117.60–$132 | $147–$165 | varies |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) | $60 | $75 | 0.1× |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) | $734.40 | $918 | 0.3× |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) range across 2 matching MRF lines |
$265.60–$353.60 | $332–$442 | varies |
| Rpr Aa Hernia 1st < 3 Cm Reducible (49591) | $6,936 | $8,670 | 2.0× |
| Rpr aa hernia recr 3-10 cm reducible (49615) | $5,467.20 | $6,834 | 0.9× |
| Rpr blood vessel direct lower extremity (35226) | $1,213.60 | $1,517 | 1.7× |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) range across 2 matching MRF lines |
$294.40–$324 | $368–$405 | varies |
| Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) | $766.40 | $958 | 1.0× |
| Rpr Lip Full Thickness Half/< Vertical Height (40652) | $524.80 | $656 | 1.0× |
| Rpr Tdn/Musc Flxr F/Arm&/Wrst Prim 1 Ea Tdn/Mu (25260) | $1,069.60 | $1,337 | 0.3× |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) | $1,901.60 | $2,377 | 1.6× |
| Shave skin lesion 0.5 cm/< (11300) | $159.20 | $199 | 0.4× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) | $196 | $245 | 1.0× |
| Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) | $319.20 | $399 | 0.8× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) | $166.40 | $208 | 0.8× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) | $192 | $240 | 1.0× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) | $221.60 | $277 | 1.1× |
| Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) | $236 | $295 | 0.6× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) | $213.60 | $267 | 1.1× |
| Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) | $244 | $305 | 0.6× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) | $190.40 | $238 | 1.0× |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) | $239.20 | $299 | 0.6× |
| Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) | $216.80 | $271 | 1.1× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) | $366.40 | $458 | 0.9× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) range across 2 matching MRF lines |
$147.20–$173.60 | $184–$217 | varies |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) range across 2 matching MRF lines |
$151.20–$180 | $189–$225 | varies |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) | $227.20 | $284 | 0.6× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) range across 2 matching MRF lines |
$172–$241.60 | $215–$302 | varies |
| Simple Repair F/E/E/N/L/M >30.0 Cm (12018) | $238.40 | $298 | 1.2× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) range across 2 matching MRF lines |
$132.80–$155.20 | $166–$194 | varies |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) range across 2 matching MRF lines |
$200–$201.60 | $250–$252 | varies |
| Skin Full Grft Face/Genit/Hf (15240) | $1,148.80 | $1,436 | 0.6× |
| Skin Pinch Graft (15050) | $980.80 | $1,226 | 1.3× |
| Skin sub graft face/nk/hf/g (15275) range across 3 matching MRF lines |
$245.60–$1,623.20 | $307–$2,029 | varies |
| Skin sub graft trnk/arm/leg (15271) range across 2 matching MRF lines |
$268–$1,550.40 | $335–$1,938 | varies |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) range across 2 matching MRF lines |
$186.40–$192 | $233–$240 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) range across 2 matching MRF lines |
$188–$268.80 | $235–$336 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) range across 2 matching MRF lines |
$233.60–$344 | $292–$430 | varies |
| Spinal puncture lumbar diagnostic (62270) range across 2 matching MRF lines |
$203.20–$270.40 | $254–$338 | varies |
| Strapping ankle (29540) | $42.40 | $53 | 0.3× |
| Strapping elbow or wrist (29260) | $45.60 | $57 | 0.8× |
| Strapping hand/finger (29280) | $87.20 | $109 | 1.5× |
| Strapping knee (29530) | $154.40 | $193 | 1.2× |
| Strapping shoulder (29240) | $47.20 | $59 | 0.4× |
| Strapping toes (29550) range across 2 matching MRF lines |
$29.60–$77.60 | $37–$97 | varies |
| Strapping Unna Boot (29580) range across 3 matching MRF lines |
$90.40–$376 | $113–$470 | varies |
| Subcutaneous Hormone Pellet Implantation (11980) | $148 | $185 | 0.3× |
| Tangential biopsy skin single lesion (11102) | $159.20 | $199 | 0.4× |
| Tenolysis extensor foot single tendon (28225) range across 2 matching MRF lines |
$717.60–$2,876.80 | $897–$3,596 | varies |
| Tenolysis flexor foot single tendon (28220) | $3,124 | $3,905 | 2.0× |
| Tenolysis, extensor, foot; multiple tendons Facility (28226) | $1,036.80 | $1,296 | 0.3× |
| Tenotomy Percutaneous Toe Single Tendon (28010) range across 2 matching MRF lines |
$398.40–$1,415.20 | $498–$1,769 | varies |
| Ther Apheresis,Red Blood Cells (36512) | $3,007.20 | $3,759 | 2.0× |
| Therapeutic pneumothorax (32960) | $960 | $1,200 | 1.5× |
| Thrombolytic Therapy Stroke (37195) | $620 | $775 | 1.9× |
| Tracheostomy planned (31600) | $3,161.60 | $3,952 | 1.0× |
| Treat humerus fracture (24500) | $615.20 | $769 | 2.5× |
| Treat Humerus Fracture (24505) range across 2 matching MRF lines |
$764–$851.20 | $955–$1,064 | varies |
| Treat humerus fracture (23600) | $564 | $705 | 2.3× |
| Treat knee fracture (27532) | $3,893.60 | $4,867 | 1.2× |
| Treat Thumb Dislocation (26641) | $288 | $360 | 1.2× |
| Treat toe dislocation (28630) | $161.60 | $202 | 0.7× |
| Treatment closed elbow dislocation w/o anes (24600) range across 2 matching MRF lines |
$507.20–$628 | $634–$785 | varies |
| Trim skin lesion (11055) | $107.20 | $134 | 0.5× |
| Trim skin lesions 2 to 4 (11056) range across 3 matching MRF lines |
$123.20–$222.40 | $154–$278 | varies |
| Trim skin lesions over 4 (11057) | $135.20 | $169 | 0.7× |
| Trimming Nondystrophic Nails Any Number (11719) | $22.40 | $28 | 0.4× |
| Tubal ligation (58600) | $624.80 | $781 | 0.2× |
| Tx Gastro Intub W/Asp (43753) range across 2 matching MRF lines |
$32.80–$80 | $41–$100 | varies |
| Tx open tendon flexor toe 1 tendon spx (28232) range across 2 matching MRF lines |
$747.20–$2,025.60 | $934–$2,532 | varies |
| Tx Opn Tendon Flexor Foot Single/Mult Tendon Spx (28230) | $2,324.80 | $2,906 | 1.5× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) range across 2 matching MRF lines |
$283.20–$460.80 | $354–$576 | varies |
| Tx superficial wound dehiscence w/packing (12021) | $292 | $365 | 0.7× |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) | $288 | $360 | 1.2× |
| Unlisted Procedure Hands/Fingers (26989) | $204 | $255 | 0.8× |
| Unlisted procedure nervous system (64999) | $164.80 | $206 | 0.5× |
| Vaginal Delivery After Cesarean Delivery (59612) | $1,403.20 | $1,754 | 0.4× |
| Vaginal delivery only (59409) range across 2 matching MRF lines |
$1,192.80–$1,272.80 | $1,491–$1,591 | varies |
| Vasectomy uni/bi spx w/postop semen exams (55250) | $556.80 | $696 | 0.3× |
| Wedge excision skin nail fold (11765) | $260.80 | $326 | 0.6× |
| Wound Prep F/N/Hf/G (15004) range across 3 matching MRF lines |
$379.20–$2,049.60 | $474–$2,562 | 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.