Procedures & surgery prices at Pacifica Hospital of the Valley

Sun Valley, CA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $2,993 $2,993 2.6×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $2,625 $2,625 2.3×
Adjacent Tissue Transfer/Reargmt Trunk 10 Sqcm/< (14000) $15 $15 0.0×
Application finger splint static (29130) $358 $358 2.1×
Application long arm splint shoulder hand (29105) $358 $358 1.7×
Application Long Leg Splint (29505) $358 $358 1.7×
Application short arm splint forearm-hand static (29125) $358 $358 2.1×
Application short leg splint calf foot (29515) $293 $293 1.4×
Apply short leg cast (29425) $501 $501 1.4×
Arterial puncture (36600) $139 $139 0.8×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $543 $543 1.4×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $469 $469 1.2×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $362 $362 0.9×
Arthrodesis triple (28715)
likely a partial charge, not the full procedure		 $84 $84 0.0×
Arthrotomy wrist joint with synovectomy (25105) $39 $39 0.0×
Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft (27130)
unusually low: confirm this is the full procedure		 $5,646 $5,646 0.3×
Aspirate pleura w/ imaging (32555) $1,553 $1,553 1.9×
Avulsion nail plate partial/complete simple 1 (11730) $263 $263 1.0×
Bladder instillation anticarcinogenic agent (51720) $19 $19 0.0×
Blood Transfusion Service (36430)
range across 2 matching MRF lines		 $856–$1,160 $856–$1,160 varies
Catheter aspiration nasotracheal spx (31720) $307 $307 1.1×
Change of Windpipe Airway (31502) $364 $364 1.2×
Chest tube placement (32551) $1,738 $1,738 0.9×
Clear outer ear canal (69200) $205 $205 1.2×
Closed tx knee dislocation w/o anesthesia (27550) $433 $433 1.4×
Clsd tx shoulder dislc w/manipulation req anes (23655) $4,113 $4,113 2.0×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $995 $995 3.1×
Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) $54 $54 0.0×
Cltx iphal jt dislc w/manj w/o anes (26770) $892 $892 2.8×
Collection of venous blood by venipuncture (36415) $23 $23 2.5×
Control Nasal Hemorrhage Anterior Complex (30903)
range across 2 matching MRF lines		 $367–$464 $367–$464 varies
Control Nasal Hemorrhage Anterior Simple (30901) $464 $464 2.7×
Core Needle Bx Lung/Mediastinum Perq W/Img (32408) $4,681 $4,681 2.2×
Cricopharyngeal myotomy (43030)
likely a partial charge, not the full procedure		 $134 $134 0.0×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $464 $464 2.7×
Cysto w/destruction of lesions (52214) $11 $11 0.0×
Cystometrogram W/Vp&Up (51729) $13 $13 0.0×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $194 $194 0.4×
Debride nail 1-5 (11720) $209 $209 2.8×
Destruction malignant lesion s/n/h/f/g 2.1-3.0cm (17273) $151 $151 0.3×
Diagnostic sigmoidoscopy (45330) $1,166 $1,166 1.0×
Dilate Urethra Stricture (53600) $7 $7 0.0×
Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction… (53605) $12 $12 0.0×
Drain shoulder bursa (23031) $32 $32 0.0×
Drainage of gum lesion (41800) $421 $421 2.5×
Drainage of hematoma/fluid (10140) $3,412 $3,412 1.6×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $380 $380 0.7×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $214 $214 0.8×
Dstrj nulyt w/worad mntr suprior hypogstr plexus (64681) $41 $41 0.0×
Dstrj Trigeminal Nrv Supraorb Infraorb Branch (64600) $372 $372 0.3×
Evacuation of subungual hematoma (11740) $87 $87 0.5×
Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod… (26415)
range across 2 matching MRF lines		 $26–$39 $26–$39 varies
Excision of gum lesion (41828) $5 $5 0.0×
Excision or curettage of bone cyst or benign tumor, humerus; with allograft Facility (24116)
likely a partial charge, not the full procedure		 $27 $27 0.0×
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; Facility (28100) $11 $11 0.0×
Fetal Contraction Stress Test (59020) $151 $151 0.6×
Fetal non-stress test (59025) $106 $106 0.4×
I&d abscess simple (10060) $458 $458 1.8×
I&d pilonidal cyst simple (10080) $1,785 $1,785 2.0×
Incision & drainage abscess complicated/multiple (10061) $507 $507 1.0×
Incision and drainage of vulva or perineal abscess (56405) $660 $660 1.7×
Incision of eardrum (69420) $19 $19 0.1×
Initial Tx 1st Degree Burn Local Tx (16000) $222 $222 0.9×
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $416 $416 0.4×
Injection aa&/strd axillary nerve w/img gdn (64417) $416 $416 0.4×
Injection aa&/strd intercostal nrv ea addl lvl (64421) $372 $372 0.3×
Injection, anesthetic agent; brachial plexus, single (64415) $416 $416 0.4×
Injx/Infus Neurolyt Sbst Epidural Lumbar/Sacral (62282) $416 $416 0.4×
Injx/Infusion Neurolytic Substance Subarachnoid (62280) $372 $372 0.3×
Insert Bladder Cath Complex (51703)
range across 3 matching MRF lines		 $9–$311 $9–$311 varies
Insert non-tunnel cv cath (36556) $3,536 $3,536 0.9×
Insert Temp Bladder Cath (51702) $205 $205 1.2×
Insert,Non-Indwelling Bladder Catheter (51701) $205 $205 1.2×
Insertion Picc W/Rs&I 5 Yr/> (36573) $2,375 $2,375 1.2×
Insj Non-Tunneled Central Venous Cath Age < 5 Y (36555) $3,536 $3,536 0.9×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 2 matching MRF lines		 $2,090–$2,461 $2,090–$2,461 varies
Intubation endotracheal emergency procedure (31500) $802 $802 2.6×
Island pedicle flap graft (15740)
range across 4 matching MRF lines		 $2–$5 $2–$5 varies
Lavage cannulation sphenoid sinus (31002)
range across 5 matching MRF lines		 $5–$53 $5–$53 varies
Lengthening of tendon, extensor, hand or finger, each tendon Facility (26476)
range across 11 matching MRF lines		 $10–$52 $10–$52 varies
Lengthening of tendon, flexor, hand or finger, each tendon Facility (26478)
range across 8 matching MRF lines		 $11–$49 $11–$49 varies
N Block Inj Celiac Pelus (64530) $584 $584 0.5×
N block inj intercost sng (64420) $372 $372 0.4×
N Block Inj Pudendal (64430) $372 $372 0.3×
N Block Lumbar/Thoracic (64520) $466 $466 0.4×
Nasal/Orogastric W/Tube Plmt (43752) $1,103 $1,103 1.9×
Ndl Emg Stds Emg Anal/Urtl Sphnctr Any Tq (51785) $37 $37 0.1×
Njx anes stellate ganglion crv sympathetic (64510) $372 $372 0.3×
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $1,550 $1,550 1.7×
Njx Px Antegrde Nfrosgrm &/Urtrgrm Exstng Acess (50431) $236 $236 0.3×
Opponensplasty Supfcis Tdn Tr Typ Ea Tdn (26490) $281 $281 0.1×
Osteoplasty Humerus (24420)
likely a partial charge, not the full procedure		 $24 $24 0.0×
Removal impacted cerumen irrigation/lvg unilat (69209) $171 $171 2.3×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $190 $190 2.5×
Removal of sesamoid bone (28315) $18 $18 0.0×
Remove Nasal Foreign Body (30300) $168 $168 1.0×
Repair extensor tendon finger w/o graft each (26418) $41 $41 0.0×
Repair of nail bed (11760) $173 $173 0.2×
Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to… (49491)
likely a partial charge, not the full procedure		 $18 $18 0.0×
Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures… (54352)
likely a partial charge, not the full procedure		 $19 $19 0.0×
Rmvl FB Xtrnl Auditory Canal Anes (69205) $4,165 $4,165 2.0×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $237 $237 0.4×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $260 $260 1.5×
Rplc Gtube No Revj Trc (43762) $3,076 $3,076 9.6×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $754 $754 2.9×
Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) $1,207 $1,207 1.5×
Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus Facility (24134)
likely a partial charge, not the full procedure		 $3 $3 0.0×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $235 $235 0.4×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $758 $758 2.9×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $761 $761 2.9×
Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) $552 $552 1.1×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $754 $754 2.9×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $312 $312 1.2×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $461 $461 1.8×
Skin Pinch Graft (15050) $133 $133 0.1×
Slitting of prepuce (54001) $6 $6 0.0×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $762 $762 3.0×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $370 $370 0.7×
Spinal puncture lumbar diagnostic (62270) $1,337 $1,337 1.5×
Strapping ankle (29540) $180 $180 0.9×
Strapping elbow or wrist (29260) $129 $129 1.7×
Strapping hand/finger (29280) $123 $123 1.6×
Strapping Hip (29520) $123 $123 0.7×
Strapping knee (29530) $161 $161 0.9×
Strapping shoulder (29240) $168 $168 1.0×
Strapping thorax (29200) $129 $129 0.6×
Tendon shortening (26477)
range across 5 matching MRF lines		 $12–$25 $12–$25 varies
Tendon transfer with graft (26492)
range across 2 matching MRF lines		 $11–$40 $11–$40 varies
Tenotomy shoulder area single tendon (23405)
likely a partial charge, not the full procedure		 $4 $4 0.0×
Total Knee Arthroplasty (27447)
unusually low: confirm this is the full procedure		 $7,087 $7,087 0.4×
Treatment of slipped femoral epiphysis; by traction, without reduction Facility (27175) $12 $12 0.0×
Tx Gastro Intub W/Asp (43753) $344 $344 1.2×
Unlisted Procedure Casting/Strapping (29799) $166 $166 0.8×
Unlisted procedure nervous system (64999) $372 $372 0.9×
Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) Facility (54318) $43 $43 0.0×
Vaginal Delivery After Cesarean Delivery (59612) $407 $407 0.1×

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.