Procedures & surgery prices at Melissa Memorial Hospital

Holyoke, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $476 $595 0.5×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $464 $580 0.5×
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release (23130) $6,776 $8,470 2.0×
Amp leg thru tibia&fibula sec closure/scar rev (27884) $5,160 $6,450 1.5×
Amputation Toe Metatarsophalangeal Joint (28820) $3,388 $4,235 1.0×
Anrct xm surg req anes general spi/edrl dx (45990) $1,245.60 $1,557 0.4×
Appendectomy (44950) $7,390.40 $9,238 1.1×
Appl Mlt-Layer Venous Wound Compress Below Knee (29581) $200.80 $251 1.2×
Application cast elbow finger short arm (29075) $229.20 $286.50 0.8×
Application cast shoulder hand long arm (29065) $276.40 $345.50 0.9×
Application Finger Splint Dynamic (29131) $69.60 $87 1.1×
Application finger splint static (29130) $73.60 $92 0.5×
Application long arm splint shoulder hand (29105) $198 $247.50 1.2×
Application long leg splint thigh ankle/toes (29505) $282.40 $353 1.6×
Application of long leg cast (29345) $320.80 $401 1.1×
Application Short Arm Splint Dynamic (29126) $182.40 $228 1.3×
Application short arm splint forearm-hand static (29125) $129.60 $162 0.9×
Application short leg splint calf foot (29515) $121.20 $151.50 0.7×
Apply multlay comprs arm/hand (29584) $288 $360 1.7×
Apply patella tendon bearing cast (29435) $255.20 $319 0.9×
Apply short leg cast (29405) $149.60 $187 0.5×
Apply short leg cast (29425) $178.80 $223.50 0.6×
Arterial puncture (36600) $69.60 $87 0.5×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $271.60 $339.50 0.8×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $263.60 $329.50 0.8×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $490 $612.50 1.5×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $301.60 $377 0.9×
Arthrodesis great toe interphalangeal joint (28755) $4,666.80 $5,833.50 0.6×
Arthroplasty glenohumeral joint total shoulder (23472) $9,864.80 $12,331 0.5×
Arthroplasty, patella; without prosthesis (27437) $19,983.20 $24,979 2.6×
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction (29888) $7,400.80 $9,251 1.0×
Arthroscopy of joint (29999) $4,182 $5,227.50 16.1×
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited (29897) $2,228 $2,785 0.6×
Arthroscopy, knee, surgical; abrasion arthroplasty or multiple drilling or microfracture (29879) $3,650.40 $4,563 1.1×
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) (29877) $4,058.80 $5,073.50 1.2×
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) $3,630 $4,537.50 1.1×
Arthroscopy, knee, surgical; with lateral release (29873) $4,386.40 $5,483 1.3×
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) $4,592.40 $5,740.50 1.3×
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) $5,121.20 $6,401.50 1.5×
Arthroscopy, shoulder, surgical; biceps tenodesis (29828) $3,916 $4,895 0.5×
Arthroscopy, shoulder, surgical; capsulorrhaphy (29806) $6,814.40 $8,518 0.9×
Arthroscopy, shoulder, surgical; debridement, extensive (29823) $1,838 $2,297.50 0.5×
Arthroscopy, shoulder, surgical; debridement, limited (29822) $4,215.20 $5,269 1.2×
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (29824) $3,917.60 $4,897 1.1×
Arthroscopy, shoulder, surgical; repair of slap lesion (29807)
unusually low: confirm this is the full procedure
$3,654.80 $4,568.50 0.5×
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $4,162 $5,202.50 0.5×
Arthrt w/expl drg/rmvl loose/fb iphal jt (28024) $2,012.80 $2,516 1.2×
Aspirat/Injection Ganglion Cyst(S) (20612) $232.80 $108 0.7×
Avulsion nail plate partial/complete simple 1 (11730) $124 $155 0.6×
Biopsy external ear (69100) $327.20 $409 1.3×
Biopsy muscle deep (20205) $5,388.80 $6,736 1.8×
Biopsy of lip (40490) $327.20 $409 1.3×
Biopsy of tongue (41100) $1,162.40 $1,453 2.0×
Biopsy of uterus lining (58100) $324 $405 1.5×
Biopsy or excision of lymph node(s); open, superficial (38500) $2,907.60 $3,634.50 0.7×
Biopsy/removal lymph nodes (38525) $3,548.80 $4,436 0.9×
Biopsy/removal lymph nodes (38510) $3,718.80 $4,648.50 0.9×
Bladder Instillation Anticarcinogenic Agent (51720) $365.60 $457 0.5×
Bladder Irrigation Simple (51700) $206 $257.50 0.8×
Bladder Scan (51798) $124 $155 2.0×
Blood patch (62273) $724.80 $906 1.0×
Blood transfusion service (36430) $704 $880 1.5×
Bone Marrow Biopsy (38221) $946.40 $1,183 0.5×
Buttock fasciotomy (27027)
unusually low: confirm this is the full procedure
$3,173.60 $3,967 0.4×
Cataract surgery complex (66982) $7,614.40 $9,518 3.1×
Change Cystostomy Tube Simple (51705) $783.20 $979 3.0×
Chemical Cautery Tissue (17250) $177.60 $222 0.8×
Chemodenerv Musc Migraine (64615) $211.20 $264 0.7×
Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) $592 $740 1.8×
Chest tube placement (32551) $879.20 $1,099 0.5×
Chg Collect Blood From Catheter Venous Nos (36592) $177.20 $221.50 1.3×
Claviculectomy; partial (23120) $4,168.80 $5,211 1.2×
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $1,028 $1,285 0.6×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $883.20 $1,104 0.5×
Closed tx knee dislocation w/o anesthesia (27550) $1,007.20 $1,259 3.9×
Closed tx radial shaft fracture w/manipulation (25505) $1,028 $1,285 0.6×
Clsd tx shoulder dislc w/manipulation req anes (23655) $844 $1,055 0.5×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $636 $795 2.4×
Cltx ankle dislc req anes w/wo prq skel fixj (27842) $1,032 $1,290 0.6×
Cltx Carpo/Mtcrpl Dislc Thumb Manj Ea Jt W/Anes (26675) $576.40 $720.50 0.3×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $688.80 $861 2.6×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,281.60 $1,602 0.8×
Cltx fem fx dstl end medial/lat condyle w/manj (27510) $1,423.20 $1,779 0.8×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $297.60 $372 1.1×
Cltx hip dislocation traumatic w/o anesthesia (27250) $144 $180 0.6×
Cltx iphal jt dislc w/manj w/o anes (26770) $531.20 $664 2.0×
Cltx metacarpophalangeal dislc w/manj w/anes (26705) $804.80 $1,006 0.5×
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $388 $485 1.5×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $519.60 $649.50 2.0×
Cltx Post Hip Arthrp Dislc Req Anes (27266) $2,575.20 $3,219 1.5×
Cltx prox fibula/shft fx w/manj (27781) $836 $1,045 0.5×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $162.40 $203 0.6×
Cltx tibial shaft fx w/manj w/wo skel tracj (27752) $1,032 $1,290 0.6×
Colonoscopy flex w/rem forcep (45384) $1,802 $2,252.50 1.4×
Colonoscopy stoma w/biopsy (44389) $1,081.60 $1,352 0.9×
Colonoscopy thru stoma (44388) $1,632.40 $2,040.50 1.7×
Colonoscopy w/ablation (45388) $2,471.20 $3,089 2.0×
Colonoscopy w/fb removal (45379) $1,237.20 $1,546.50 1.0×
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $770.40 $963 2.4×
Colposcopy cervix upper/adjacent vagina (57452) $506.40 $633 2.4×
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix (57455) $610.40 $763 1.9×
Colposcopy,Cervix W/Adj Vagina, Curettag (57456) $536.80 $671 1.7×
Colsc flx with directed submucosal njx any sbst (45381) $1,448 $1,810 1.1×
Complex Drainage, Wound (10180) $2,886.40 $3,608 0.9×
Control Nasal Hemorrhage Anterior Complex (30903) $492 $615 3.5×
Control Nasal Hemorrhage Anterior Simple (30901) $191.60 $239.50 1.4×
Correction hammertoe (28285) $2,758.40 $3,448 0.8×
Correction of bunion (28298)
unusually low: confirm this is the full procedure
$3,768.80 $4,711 0.5×
Correction of bunion (28292) $3,885.20 $4,856.50 1.1×
Correction of bunion (28299)
likely a partial charge, not the full procedure
$2,262 $2,827.50 0.3×
Correction of bunion (28297) $18,983.20 $23,729 1.4×
Corrj hallux valgus w/sesmdc w/dist metar osteot (28296) $4,506.40 $5,633 1.3×
Cover eye w/membrane suture (65779) $5,170.40 $6,463 1.2×
Create eardrum opening (69436) $1,965.60 $2,457 1.2×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $492 $615 3.5×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $492 $615 2.0×
Cystourethroscopy (52000) $1,077.20 $1,346.50 1.5×
Cystourethroscopy Inj Chemodenervation Bladder (52287) $2,581.60 $3,227 1.2×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $1,153.60 $1,442 2.7×
Debride nail 1-5 (11720) $70.40 $88 1.1×
Debride nail 6 or more (11721) $116.80 $146 1.9×
Debridement subcutaneous tissue 20 sq cm/< (11042) $453.20 $566.50 1.1×
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $2,862.80 $3,578.50 3.7×
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $3,482.40 $4,353 2.0×
Declot vascular device (36593) $497.60 $622 1.4×
Decompression of tibia nerve (28035) $2,322.40 $2,903 1.1×
Delivery placenta separate procedure (59414) $2,602.40 $3,253 0.8×
Destruc Benign/Premal,15+ Lesions (17004) $469.60 $587 1.1×
Destruction benign lesions 15 or more (17111) $175.20 $219 0.8×
Destruction Benign Lesions Up To 14 (17110) $110.40 $138 0.5×
Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) $289.60 $362 1.4×
Destruction mal lesion f/e/e/n/l/m 1.1-2.0cm (17282) $347.20 $434 1.6×
Destruction mal lesion f/e/e/n/l/m 2.1-3.0cm (17283) $416.80 $521 1.0×
Destruction mal lesion trunk/arm/leg 0.6-1.0 cm (17261) $149.60 $187 0.7×
Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) $179.20 $224 0.8×
Destruction mal lesion trunk/arm/leg 2.1-3.0cm (17263) $264.80 $331 1.3×
Destruction mal lesion trunk/arm/leg 3.1-4.0cm (17264) $317.60 $397 0.7×
Destruction malignant lesion s/n/h/f/g 0.6-1.0cm (17271) $264.80 $331 1.3×
Destruction malignant lesion s/n/h/f/g 1.1-2.0cm (17272) $317.60 $397 1.5×
Destruction of multiple growths of penis (54065) $467.20 $584 0.2×
Destruction premalignant lesion 1st (17000) $110.40 $138 0.5×
Diagnostic sigmoidoscopy (45330) $768 $960 0.8×
Dilation esoph unguided sound/bougie 1/mult pass (43450) $876.80 $1,096 0.9×
Drainage Finger Abscess Complicated (26011) $624.80 $781 0.4×
Drainage Finger Abscess Simple (26010) $294.40 $368 1.4×
Drainage of deep rectal abscess (45020) $5,056 $6,320 1.7×
Drainage of gum lesion (41800) $369.60 $462 2.6×
Drainage of hematoma/fluid (10140) $276 $345 0.2×
Draw blood off venous device (36591) $148.80 $186 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $113.60 $142 0.5×
Dry Needling 3+ Muscles (20561) $16 $20 0.5×
Dstrj lesion anus simple surg excision (46922) $1,919.20 $2,399 0.7×
Egd balloon dilation esophagus <30 mm diam (43249) $1,815.60 $2,269.50 0.9×
Egd place gastrostomy tube (43246) $2,427.20 $3,034 1.2×
Egd rem tumr/polyp forcep (43250) $1,555.60 $1,944.50 0.8×
Egd remove lesion snare (43251) $1,668.80 $2,086 0.8×
Egd Transoral Control Bleeding Any Method - Egd (43255) $1,210 $1,512.50 0.6×
Endocervical Curettage (57505) $663.20 $829 0.7×
Evacuation of subungual hematoma (11740) $67.20 $84 0.5×
Ex tum/vasc mal sft tis hand/fngr subfsc 1.5+cm (26113) $8,481.60 $10,602 4.9×
Exc abd les sc 3 cm/> (22903) $2,694.80 $3,368.50 0.9×
Exc arm/elbow les sc < 3 cm (24075) $1,186.40 $1,483 0.7×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $560.80 $701 0.3×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $1,530 $1,912.50 0.9×
Exc back les sc < 3 cm (21930) $2,805.20 $3,506.50 1.6×
Exc face les sbq 2 cm/> (21012) $1,513.60 $1,892 0.9×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $1,922 $2,402.50 2.6×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $2,370.40 $2,963 1.4×
Exc hydrocele sprmatic cord uni spx (55500) $2,391.20 $2,989 0.6×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $1,068 $1,335 1.4×
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $421.20 $526.50 1.0×
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $688.80 $861 0.9×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $972.80 $1,216 1.3×
Exc Skin Benig 3.1- 4 Cm Face,Facial (11444) $84 $105 0.0×
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $1,470.40 $1,838 0.8×
Exc Skin Benig >4 Cm Face,Facial (11446) $2,080 $2,600 0.7×
Exc Skin Benig >4 Cm Remaindr Body (11426) $4,905.20 $6,131.50 1.6×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $2,834.40 $3,543 1.6×
Exc Skin Malig 2.1-3 Cm Face,Facial (11643) $2,950.40 $3,688 1.7×
Exc Skin Malig >4 Cm Face,Facial (11646) $2,515.20 $3,144 0.8×
Exc Skin Malig >4 Cm Remaindr Body (11626) $4,197.20 $5,246.50 1.4×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $1,772.80 $2,216 1.0×
Exc thigh/knee les sc 3 cm/> (27337) $2,412 $3,015 0.8×
Exc tr-ext b9+marg 0.5 cm or less (11400) $344.80 $431 0.5×
Exc tum/vas mal sft tis hand/fngr subfasc<1.5cm (26116) $2,796.80 $3,496 1.6×
Exc tumor soft tiss back/flank subfascial 5 cm/> (21933) $1,845.60 $2,307 0.6×
Exc tumor soft tiss upr arm/elbow subfasc <5cm (24076) $3,814.80 $4,768.50 1.2×
Exc tumor soft tissue leg/ankle subq <3cm (27618) $4,000 $5,000 2.3×
Exc Tumor Soft Tissue Neck/Ant Thorax Subq 3+Cm (21552) $3,114.40 $3,893 1.0×
Exc tumor soft tissue neck/ant thorax subq <3cm (21555) $743.20 $929 0.4×
Exc tumor soft tissue pelvis & hip subq <3cm (27047) $4,490.40 $5,613 1.5×
Excis Tendon Sheath Lesion, Hand/Finger (26160) $1,725.60 $2,157 1.0×
Excise/repair mouth lesion (40812) $613.20 $766.50 0.4×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $294.40 $368 0.4×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $484.40 $605.50 1.1×
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $1,063.20 $1,329 1.4×
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $1,151.20 $1,439 1.5×
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $2,188.80 $2,736 2.9×
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $866.40 $1,083 0.5×
Excision malignant lesion s/n/h/f/g 0.6-1.0 cm (11621) $347.60 $434.50 0.5×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $1,232.80 $1,541 1.7×
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $1,416 $1,770 0.8×
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $355.60 $444.50 0.5×
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $866.40 $1,083 1.2×
Excision of ganglion, wrist (dorsal or volar); recurrent (25112) $805.20 $1,006.50 0.5×
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle (27630) $2,724 $3,405 0.8×
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $1,255.20 $1,569 0.7×
Excision of lesion other than skin tag </= 0.5 cm (11420) $518.40 $648 0.3×
Excision of nail fold toe (11765) $292.40 $365.50 0.7×
Excision of neuroma; hand or foot, except digital nerve (64782) $3,537.60 $4,422 1.7×
Excision of pilonidal cyst or sinus; simple (11770) $1,791.60 $2,239.50 0.6×
Excision of single external papilla or tag, anus (46220) $1,657.20 $2,071.50 1.3×
Excision olecranon bursa (24105) $3,664.80 $4,581 1.1×
Excision pilonidal cyst/sinus complicated (11772) $2,148.40 $2,685.50 0.7×
Excision tumor soft tis back/flank subq 3 cm/> (21931) $1,604 $2,005 0.9×
Excision tumor soft tissue thigh/knee subq <3cm (27327) $2,182.40 $2,728 1.3×
Excision, interdigital (Morton) neuroma, single, each (28080) $3,995.20 $4,994 2.4×
Excision, lesion of tendon sheath, forearm and/or wrist (25110) $2,127.20 $2,659 1.3×
Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater (21014) $1,121.60 $1,402 0.4×
Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater (27632) $1,831.60 $2,289.50 0.6×
Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) $2,790 $3,487.50 0.9×
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) $1,834 $2,292.50 1.1×
Exploration penetrating wound spx chest (20101) $5,056 $6,320 2.3×
Exploration penetrating wound spx extremity (20103) $724.80 $906 0.4×
Exploration Penetrating Wound Spx Neck (20100) $2,753.60 $3,442 4.8×
Explore & Treat Metacarpo-Phal Jt (26075) $3,593.20 $4,491.50 1.0×
Explore/treat hand joint (26070) $4,490.40 $5,613 2.6×
Fasciotomy foot and/or toe (28008) $2,226.40 $2,783 0.6×
Fasct prtl palmar 1 dgt prox iphal jt w/wo rpr (26123) $3,537.60 $4,422 1.0×
Fetal Contraction Stress Test (59020) $471.20 $589 2.2×
Fetal non-stress test (59025) $448 $560 2.1×
Fixation of knee joint (27570) $327.20 $409 0.2×
Fixation of shoulder (23700) $1,448.80 $1,811 0.9×
Fusion Finger Joint (26860) $2,364 $2,955 0.7×
Fusion of knuckle (26850)
unusually low: confirm this is the full procedure
$2,502 $3,127.50 0.3×
Fusion of thumb (26841) $5,354.40 $6,693 0.7×
Fusion/graft of finger joint (26862) $1,966.40 $2,458 0.6×
Gastric Intubation/Aspiration, Therapeutic (43753) $45.60 $57 0.2×
Hallux rigidus w/cheilectomy 1st mp jt w/implt (28291) $4,302.80 $5,378.50 0.6×
Hemorrhoidectomy (46255) $2,619.20 $3,274 0.9×
Hemorrhoidectomy, internal and external, single column/group; with fissurectomy (46257) $2,756.80 $3,446 0.9×
Hysteroscopy ablation (58563) $4,490.40 $5,613 0.9×
Hysteroscopy biopsy (58558) $6,486.40 $8,108 1.9×
I&d abscess simple (10060) $236.40 $295.50 1.1×
I&d epididymis tstis&/scrotal space (54700) $341.20 $426.50 0.2×
I&D Pelvis/Hip Jt Area Deep Abscess/Hematoma (26990) $3,839.20 $4,799 1.1×
I&d pilonidal cyst simple (10080) $613.20 $766.50 0.8×
I&D Upper Arm/Elbow Bursa (23931) $536 $670 0.3×
Incise finger tendon sheath (26055) $2,588.80 $3,236 1.5×
Incision & drainage abscess complicated/multiple (10061) $332 $415 0.8×
Incision & removal foreign body subq tiss compl (10121) $761.60 $952 0.4×
Incision & removal foreign body subq tiss simple (10120) $220.80 $276 0.5×
Incision and drainage of bartholin's gland abscess (56420) $191.20 $239 0.9×
Incision extensor tendon sheath wrist (25000) $2,122.80 $2,653.50 1.3×
Incision of eardrum (69421) $1,965.60 $2,457 0.6×
Incision of metatarsal (28308) $1,922.80 $2,403.50 0.6×
Incision of rectal abscess (46040) $1,504.40 $1,880.50 1.2×
Incision thrombosed hemorrhoid external (46083) $507.60 $634.50 1.9×
INCISION, FLEXOR TENDON SHEATH, WRIST (EG, FLEXOR CARPI radials (25001) $1,500 $1,875 0.4×
Incisional biopsy skin single lesion (11106) $147.20 $184 0.2×
Inj paravert f jnt c/t 1 lev (64490) $1,622.80 $2,028.50 1.7×
Inj tendon sheath/ligament (20550) $218.40 $273 0.7×
Inj,Anes Agent,Brachial Plexus,Single (64415) $1,468 $1,835 1.6×
Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) $1,542 $1,927.50 1.7×
Inj,Anes Agent,Femoral Nerve,Single (64447) $1,388 $1,735 1.9×
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $2,262.80 $2,828.50 2.4×
Inject Anes/Steroid Plantar Common Digital Nerve (64455) $251.20 $314 0.8×
Inject Nerv Blck,Axillary Nerv (64417) $2,015.60 $2,519.50 2.2×
Inject Nerv Blck,Intercost,Multpl (64421) $1,680 $2,100 1.8×
Inject Nerv Blck,Intercostal,One (64420) $1,382.80 $1,728.50 1.9×
Inject Tendon Origin/Insert (20551) $184.40 $230.50 0.6×
Injection aa&/strd nerves nrvtg si joint w/img (64451) $745.20 $931.50 1.0×
Injection aa&/strd sciatic nerve w/img gdn (64445) $1,388 $1,735 1.9×
Injection aa&/strd trigeminal nerve each branch (64400) $375.20 $469 1.2×
Injection anes other peripheral nerve/branch (64450) $168.80 $211 0.2×
Injection for identification of sentinel node (38792) $88 $110 0.2×
Injection single/mlt trigger point 1/2 muscles (20552) $422.40 $528 1.3×
Injection single/mlt trigger point 3/> muscles (20553) $95.20 $119 0.3×
Injection therapeutic carpal tunnel (20526) $166 $207.50 0.5×
Injection, anesthetic agent; greater occipital nerve (64405) $1,382.80 $1,728.50 4.3×
Injection, Intralesional; More Than 7 Lesions (11901) $151.20 $189 0.7×
Injection, intralesional; up to and including 7 lesions (11900) $88 $110 0.4×
Insert anter drainage dev w/o extraoc reservoir (66183) $3,492 $4,365 0.8×
Insert Bladder Cath Complex (51703) $492.80 $616 3.6×
Insert non-tunnel cv cath (36556) $177.60 $222 0.1×
Insert pessary/other device (57160) $216.80 $271 1.0×
Insert picc cath (36569) $1,397.60 $1,747 0.8×
Insert Temp Bladder Cath (51702) $327.60 $409.50 2.3×
Insert tunneled cv cath (36561) $3,118.80 $3,898.50 0.9×
Insert,Non-Indwelling Bladder Catheter (51701) $346.40 $433 2.5×
Insertion Picc W/Rs&I 5 Yr/> (36573) $768 $960 0.5×
Insj prph ctr vad w/subq port age 5 yr/> (36571) $1,329.60 $1,662 0.4×
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $548 $685 0.2×
Intubation endotracheal emergency procedure (31500) $358.80 $448.50 1.4×
Irrigate corpora cavernosa for priapism (54220) $270.40 $338 1.0×
Irrigate vagina w meds (57150) $187.20 $234 3.0×
Laparoscopy appendectomy (44970) $4,787.20 $5,984 0.8×
Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) (44180) $4,585.20 $5,731.50 0.7×
Laparoscopy, surgical; cholecystectomy with cholangiography (47563) $6,555.20 $8,194 1.0×
Laryngoscopy Flexible Diagnostic (31575) $207.20 $259 1.0×
Late closure of wound (13160) $3,129.60 $3,912 0.8×
Lateral retinacular release open (27425) $3,884.40 $4,855.50 1.1×
Ligamentous reconstruction (augmentation), knee; intra-articular (open) (27428) $19,983.20 $24,979 1.5×
Ligation of hemorrhoid(s) (46221) $1,240.80 $1,551 1.3×
Manipulation finger joint under anes each joint (26340) $1,380 $1,725 0.8×
Mast mod rad (19307) $8,589.60 $10,737 1.2×
Mastectomy partial (19301) $4,963.60 $6,204.50 1.2×
Mastectomy simple complete (19303) $7,300.80 $9,126 1.0×
Muscle/tendon transfer upper arm/elbow single (24301)
likely a partial charge, not the full procedure
$1,626 $2,032.50 0.2×
Nasal Endoscopy Diagnostic Uni/Bi Spx (31231) $328.80 $411 1.6×
Nasal/Sinus Ndsc Surg W/Bx Polypc/Dbrdmt Spx (31237) $2,137.60 $2,672 1.1×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $424 $530 0.9×
Needle insertion w/o injection 1 or 2 muscles (20560) $8 $10 0.3×
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $1,622.80 $2,028.50 1.7×
Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) $1,962.40 $2,453 2.6×
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62320) $866.40 $1,083 1.2×
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $1,748 $2,185 2.3×
Omntc Epiploectomy Rescj Omentum Spx (49255)
likely a partial charge, not the full procedure
$1,685.60 $2,107 0.2×
Open Treatment Bimalleolar Ankle Fracture (27814)
unusually low: confirm this is the full procedure
$3,728.80 $4,661 0.5×
Open Treatment Medial Malleolus Fracture (27766) $4,407.20 $5,509 0.6×
Open treatment metatarsal fracture each (28485) $6,569.20 $8,211.50 0.9×
Open treatment of acromioclavicular dislocation, acute or chronic; (23550) $14,056 $17,570 1.8×
Open treatment of clavicular fracture, includes internal fixation, when performed (23515) $3,922.40 $4,903 0.5×
Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement (27236) $5,265.20 $6,581.50 0.7×
Open tx interphalangeal joint dislocation (26785) $2,560.80 $3,201 0.7×
Open tx nose fx uncomplicatd (21325) $688.80 $861 0.2×
Open tx of distal tibiofibular joint disruption, includes internal fixation, when performed (27829) $4,828.40 $6,035.50 0.6×
Open tx of tarsometatarsal joint dislocation, includes internal fixation, when performed (28615) $6,914 $8,642.50 0.9×
Ostectomy, complete excision; other metatarsal head (second, third or fourth) (28112) $1,878.40 $2,348 0.5×
Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head (28288) $3,132 $3,915 0.9×
Osteochondral allograft, knee, open (27415) $19,983.20 $24,979 1.5×
Osteot w/wo lngth shrt/corrj 1st metar (28306)
unusually low: confirm this is the full procedure
$3,132 $3,915 0.4×
Osteotomy Clavicle W Bone Graft (23485) $10,760 $13,450 0.8×
Partial excision bone talus/calcaneus (28120) $6,776 $8,470 2.0×
Partial excision of bone; tarsal or metatarsal bone, except talus or calcaneus (28122) $3,911.20 $4,889 1.1×
Partical Excision Bone Phalanx Toe (28124) $1,545.20 $1,931.50 0.4×
Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) $1,876.40 $2,345.50 0.5×
Perineoplasty rpr perineum nonobstetrical spx (56810) $7,428 $9,285 2.2×
Perq device breast 1st imag (19281) $342.80 $428.50 0.2×
Perq Drainage Pleura Insert Cath W/Imaging (32557) $304 $380 0.2×
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $251.20 $314 0.1×
Perq replacement gtube not req revj gstrst trc (43762) $420 $525 1.6×
Placement of needle for intraosseous infusion (36680) $271.20 $339 0.6×
Preputial Stretching (54450) $314 $392.50 1.2×
Prostatic microwave thermotx (53850) $7,121.60 $8,902 1.9×
Punch biopsy skin single lesion (11104) $356 $445 0.8×
Puncture Aspiration (10160) $210.40 $263 0.5×
Puncture Aspiration Cyst Breast (19000) $718.80 $898.50 1.0×
Pvb thoracic single inj site (64461) $378.80 $473.50 0.5×
Rcnstj pst tibl tdn w/exc accessory tarsl navclr (28238) $6,437.60 $8,047 0.8×
Reconstruc toe deform,soft tissue (28313) $1,426 $1,782.50 0.4×
Reconstruct Shoulder Joint (23470) $6,927.20 $8,659 0.5×
Reconstruction of dislocating patella; (eg, Hauser type procedure) (27420)
unusually low: confirm this is the full procedure
$3,665.60 $4,582 0.5×
Release hip flexion contracture (27036) $4,624.80 $5,781 0.6×
Removal foreign body foot subcutaneous (28190) $689.60 $862 0.9×
Removal foreign body pharynx (42809) $373.60 $467 0.8×
Removal impacted cerumen irrigation/lvg unilat (69209) $29.60 $37 0.5×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $140.40 $175.50 2.3×
Removal Implant Deep (20680) $3,048.80 $3,811 1.0×
Removal Implant From Finger/Hand (26320) $1,269.20 $1,586.50 0.7×
Removal Implant Superficial Separate Procedure (20670) $3,252.80 $4,066 1.9×
Removal of adenoids (42830) $11,189.60 $13,987 3.2×
Removal of arm foreign body (24200) $452 $565 0.3×
Removal of heel bone (28118) $4,262.40 $5,328 1.2×
Removal of heel spur (28119) $2,565.20 $3,206.50 0.7×
Removal of nail bed (11750) $363.60 $454.50 0.8×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $204 $255 1.0×
Removal or relocation of corneal conjunctiva (65420) $2,751.20 $3,439 1.1×
Removal or relocation of corneal conjunctiva with graft (65426) $4,413.60 $5,517 1.8×
Removal/bivalving full arm/full leg cast (29705) $103.20 $129 0.3×
Removal/bivalving gauntlet boot/body cast (29700) $139.60 $174.50 0.5×
Remove by ligat int hem grp (46945) $900 $1,125 0.3×
Remove by ligat int hem grps (46946) $1,059.20 $1,324 0.4×
Remove foreign body from eye (65210) $364.80 $456 0.8×
Remove in/ex hem groups 2+ (46260) $2,412.40 $3,015.50 0.8×
Remove wrist tendon lesion (25111) $2,250.40 $2,813 1.3×
Remv Ext Canal Foreign Body (69200) $161.60 $202 1.2×
Remv F.B.,Eye,Superf Conjunc (65205) $145.60 $182 1.0×
Repair achilles tendon (27650) $5,176.80 $6,471 0.7×
Repair collat ankle ligmnt,secondary (27698) $8,089.60 $10,112 1.1×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $545.60 $682 1.3×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $738 $922.50 1.7×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $581.60 $727 1.4×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $595.20 $744 1.4×
Repair complex trunk 2.6-7.5 cm (13101) $2,086.40 $2,608 2.7×
Repair elbow deb/attch open (24359) $3,277.20 $4,096.50 0.9×
Repair extensor tendon finger w/o graft each (26418) $1,188 $1,485 0.7×
Repair forearm tendon sheath (25275) $1,618 $2,022.50 0.5×
Repair hallux rigidus (28289) $3,350.40 $4,188 1.0×
Repair inguinal hernia, sliding, any age (49525) $8,481.60 $10,602 2.2×
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) $5,924 $7,405 1.6×
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,100 $1,375 2.6×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $420 $525 1.0×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $452.80 $566 1.1×
Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) $1,209.60 $1,512 2.8×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $674 $842.50 1.6×
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $443.20 $554 1.0×
Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) $1,332 $1,665 3.1×
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $1,129.60 $1,412 1.4×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $572.80 $716 1.3×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $926.40 $1,158 2.2×
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $250.40 $313 0.3×
Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) $1,544.80 $1,931 0.7×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $649.60 $812 1.5×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $358.40 $448 0.8×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $460.80 $576 1.1×
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $700.80 $876 0.9×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $435.20 $544 1.0×
Repair intermediate s/a/t/e >30.0 cm (12037) $1,240 $1,550 0.6×
Repair of ankle ligament (27695) $5,442.40 $6,803 0.7×
Repair of knee cartilage (27403) $4,763.60 $5,954.50 0.6×
Repair of leg tendon each (27665)
likely a partial charge, not the full procedure
$1,291.60 $1,614.50 0.2×
Repair of nail bed (11760) $251.20 $314 0.3×
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic (23412) $5,873.60 $7,342 0.8×
Repair of shoulder (23420) $8,223.20 $10,279 1.1×
Repair rotator cuff acute (23410) $7,537.60 $9,422 1.0×
Repair secondary achilles tendon w/wo graft (27654) $7,016 $8,770 0.9×
Repair tympanic membrane (69610) $4,490.40 $5,613 2.7×
Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon (28200) $4,259.20 $5,324 1.2×
Rerepair ing hernia blocked (49521) $5,308.40 $6,635.50 0.8×
Rerepair ing hernia reduce (49520) $4,943.60 $6,179.50 1.3×
Revise finger joint (26535) $4,312.40 $5,390.50 1.2×
Revise median n/carpal tunnel surg (64721) $2,242 $2,802.50 1.1×
Revise ulnar nerve at elbow (64718) $2,902.40 $3,628 1.4×
Revise/implant finger joint (26536) $14,056 $17,570 1.8×
Revision of foot (28116) $4,932 $6,165 1.4×
Revision of total hip arthroplasty; both components, with or without autograft or allograft (27134)
unusually low: confirm this is the full procedure
$6,468 $8,085 0.5×
Revision of total knee arthroplasty with or without allograft; femoral and entire tibial component (27487) $10,106 $12,632.50 0.5×
Revision of total knee arthroplasty, with or without allograft; one component (27486)
unusually low: confirm this is the full procedure
$5,662.40 $7,078 0.4×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $165.60 $207 0.4×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $249.60 $312 1.8×
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $2,034.40 $2,543 1.2×
Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) $6,368 $7,960 1.0×
Rpr aa hernia 1st 3-10 cm reducible (49593) $5,932.80 $7,416 0.9×
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) $4,520 $5,650 0.7×
Rpr aa hernia 1st < 3 cm reducible (49591) $7,856.80 $9,821 2.1×
Rpr blood vessel direct lower extremity (35226) $4,956 $6,195 6.6×
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $1,242.40 $1,553 1.6×
Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms (27696) $4,514 $5,642.50 0.6×
Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) $1,172.80 $1,466 0.9×
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $92.80 $116 0.4×
Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) $181.60 $227 0.4×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $92.80 $116 0.4×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $354.40 $443 1.7×
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $188 $235 0.9×
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $236.80 $296 0.6×
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $175.20 $219 0.4×
Shldr arthroscop,lyse adhesns (29825) $4,969.20 $6,211.50 1.4×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $111.20 $139 0.5×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $157.60 $197 0.4×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $96.80 $121 0.5×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $106.40 $133 0.5×
Sigmoidoscopy flx w/rmvl tumor by hot bx forceps (45333) $718.80 $898.50 0.7×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $180.80 $226 0.4×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $240.80 $301 1.1×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $311.20 $389 1.5×
Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) $859.20 $1,074 2.0×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $164 $205 0.8×
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $393.60 $492 1.9×
Simple repair f/e/e/n/l/m >30.0 cm (12018) $944.80 $1,181 4.5×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $135.20 $169 0.6×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $856.80 $1,071 4.0×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $377.60 $472 1.8×
Skin sub graft face/nk/hf/g (15275) $358.40 $448 0.5×
Skin sub graft trnk/arm/leg (15271) $367.20 $459 0.5×
Skin tissue rearrangement (14040) $2,468.40 $3,085.50 1.1×
Skn sub grft f/n/hf/g child (15277) $540 $675 0.2×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $197.60 $247 0.9×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $537.60 $672 1.3×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $644.80 $806 1.5×
Spinal puncture lumbar diagnostic (62270) $413.60 $517 0.6×
Spinal Puncture Therapeutic (62272) $76.80 $96 0.1×
Strapping ankle (29540) $37.60 $47 0.2×
Strapping knee (29530) $108 $135 0.8×
Strapping toes (29550) $40 $50 0.6×
Suture/repair testicular injury (54670) $852.80 $1,066 0.2×
Tangential biopsy skin single lesion (11102) $83.20 $104 0.2×
Tenodesis long tendon biceps (23430) $6,391.60 $7,989.50 0.8×
Tenolysis ext tendon,hand/finger,ea (26445) $4,824 $6,030 1.4×
Tenotomy abductors&/extensor hip open spx (27006) $1,705.20 $2,131.50 0.5×
Tenotomy Percutaneous Toe Single Tendon (28010) $1,432 $1,790 0.8×
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $228 $285 0.3×
Thoracentesis needle/cath pleura w/o imaging (32554) $188 $235 0.3×
Thrombolytic Therapy, Stroke (37195) $798.40 $998 2.3×
Tis trnfr trunk 10.1-30sqcm (14001) $3,471.60 $4,339.50 1.6×
Tonsillectomy and adenoidectomy; age 12 or over (42821) $4,574.40 $5,718 1.3×
Total hip arthroplasty (27130) $7,956.40 $9,945.50 0.6×
Total knee arthroplasty (27447) $7,109.60 $8,887 0.5×
Tracheostomy emergency cricothyroid membrane (31605) $2,753.60 $3,442 11.0×
Treat finger dislocation (26775) $654.80 $818.50 2.2×
Treat fx distal radial (25606) $3,953.60 $4,942 1.1×
Treatment closed elbow dislocation w/o anes (24600) $428.80 $536 1.6×
Treatment of ankle fracture (27792)
unusually low: confirm this is the full procedure
$3,036.80 $3,796 0.4×
Treatment of foot infection (28003) $2,670 $3,337.50 0.8×
Trim skin lesion (11055) $102 $127.50 0.5×
Trim skin lesions 2 to 4 (11056) $150 $187.50 0.7×
Trimming Of Nondystrophic Nails, Any Number (11719) $28.80 $36 0.5×
Tx anal fstl trans/supra/xtrasphnctrc incl seton (46280) $2,998.40 $3,748 1.0×
Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) $764 $955 0.5×
Unlisted procedure foot or toes (28899) $200 $250 0.8×
Unlisted procedure, male genital system (55899) $516.80 $646 2.0×
Vaginal delivery only (59409) $682.40 $853 0.2×
Vasectomy (55250) $1,629.20 $2,036.50 0.7×
Venipuncture (36415) $36.80 $46 3.9×
Ventilating tube removal requiring general anesthesia (69424) $1,965.60 $2,457 0.6×
Wound Prep F/N/Hf/G (15004) $1,213.60 $1,517 2.8×
Wound prep trk/arm/leg 1st 100 sq cm (15002) $1,626.80 $2,033.50 2.1×