Visits & medical services prices at Plains Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $113 $150 1.1×
Airway inhalation treatment (94640) $381 $508 1.7×
Assessment of aphasia (96105) $207 $276 2.1×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $66 $88 1.7×
Behav assmt w/score & docd/stand instrument (96127) $25 $33 0.7×
Behavioral and qualitative analysis of voice and resonance (92524) $174 $232 1.6×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $295.50 $394 0.8×
Canalith Repositioning (95992) $41 $54 1.0×
Cardiopulmonary resuscitation (92950) $561 $748 2.6×
Cardioversion (92960) $1,163 $1,550 1.8×
Cbt 1st hour (94644) $228 $304 1.7×
Chemo IV push addl drug (96411) $94 $125 1.3×
Chemother, IV infusion, 1 hr (96413) $283 $377 0.9×
Chemother, IV infusion, ea add hr (96415) $45 $60 0.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $94 $125 1.3×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $110 $147 1.1×
Color/duplex Doppler, complete (93975) $438 $584 1.8×
Color/duplex Doppler, limited (93976) $352 $469 3.4×
Complx chron care coord w/o pt vst 1st hr per mo (99487) $239 $319 1.3×
Cpt initial (94667) $68 $90 0.5×
Critical care (99291) $990 $1,319.50 1.2×
Debridement Open Wound 20 Sq Cm< (97597) $135 $180 0.7×
Demo &/or eval,pt use,aerosol device (94664) $113 $150 0.5×
Developmental tst admin phys/qhp 1st hour (96112) $266 $355 2.1×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $438 $584 1.8×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $438 $584 1.8×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $352 $469 3.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $352 $469 1.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $352 $469 3.4×
Dup-scan xtr veins unilateral/limited study (93971) $352 $469 3.4×
Duplex scan extracranial art compl bi study (93880) $438 $584 1.8×
EKG (93005) $110 $146 1.9×
Er level 1 (99281) $158 $211 1.9×
Er level ii (99282) $293 $390 1.9×
Er level iii (99283) $510 $680 1.9×
Er level IV (99284) $791 $1,055 1.9×
Er level v (99285) $1,148 $1,530 1.9×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $187 $249 2.6×
Evaluation of speech fluency (92521) $160 $213 1.2×
Evaluation of speech sound production (92522) $199 $265 1.8×
Evaluation of swallowing function (92610) $176 $234 2.1×
Group Therapeutic Procedures (97150) $55 $73 3.0×
Holter Monitor Recording (93225) $228 $304 1.7×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $11 $14 0.3×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $11 $14 0.2×
Immunization Admin (90471) $68 $90.50 0.9×
Immunotherapy, 2+ Injections (95117) $85 $113 1.8×
Inital newborn e/m (99460) $2,789 $3,718 20.9×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $114 $152 1.9×
IV infusion hydration each additional hour (96361) $85 $113 1.8×
IV infusion hydration initial 31 min-1 hour (96360) $383 $511 1.8×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $126 $168 1.7×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $383 $511 1.8×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $85 $113 1.8×
IV push initial (96374) $383 $511 1.8×
Manual therapy 15 min (97140) $65 $87 2.3×
Massage 15 min (97124) $47 $63 1.6×
Mechanical traction (97012) $49 $65 3.4×
Multiple Family Group Psychotherapy (90849) $26 $35 0.1×
Negative Pressure Wound Therapy Dme >50 Sq Cm (97606) $191 $254 0.5×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $352 $469 2.6×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $352 $469 1.6×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98972) $75 $100 2.2×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98970) $27 $36 2.2×
Nonphysician qualified health care professional online digital assessment and management, for an established patient,… (98971) $48 $64 2.1×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $69 $92 1.5×
Osteopathic manipulative tx 1-2 body regions (98925) $73 $97.50 3.4×
Osteopathic manipulative tx 3-4 body regions (98926) $103 $137 4.7×
Osteopathic manipulative tx 5-6 body regions (98927) $81 $108 3.7×
Ot Contrast Bath Ea 15 Min (97034) $44 $58 3.1×
Ot eval high complex 60 min (97167) $348 $464 3.5×
Ot eval low complex 30 min (97165) $174 $232 1.7×
Ot eval mod complex 45 min (97166) $261 $348 2.6×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $84 $112 1.7×
Ot Prosthetic Training, Each 15 Min (97761) $60 $80 1.5×
Ot re-eval est plan care (97168) $128 $170 1.9×
Paraffin bath (97018) $44 $58 7.3×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $85 $113 1.8×
Psych diag eval w/med srvcs (90792) $285 $380 1.6×
Psychiatric diagnostic evaluation (90791) $285 $380 1.6×
Pt Aquatic Therapy/Exercises (97113) $77 $103 2.1×
Pt Electric Current Therapy (97033) $58 $77 3.0×
Pt Electrical Stimulation (97032) $49 $65 3.3×
Pt eval high complex 45 min (97163) $348 $464 3.6×
Pt eval low complex 20 min (97161) $183 $244 1.9×
Pt Gait Training Therapy (97116) $58 $77 2.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $61 $81 1.9×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $261 $348 2.7×
Pt re-evaluation (97164) $118 $157 1.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $63 $84 1.9×
Pt Ultrasound Therapy (97035) $44 $58 3.1×
Pt Whirlpool Therapy (97022) $49 $65 3.1×
Pulmonary stress testing (94618) $152 $203 1.1×
Rem mntr physiol param 1st dev supply ea 30 days (99454) $77 $102 2.1×
Rem mntr physiol param 1st set up pt educaj eqp (99453) $35 $47 0.3×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $158 $210 0.8×
Rt Chest Wall Manipulation,Subsequent (94668) $38 $50 0.3×
Sensory Integration Ea 15 Min (97533) $63 $84 1.0×
Smoking cessation > 10 min (99407) $26 $35 0.7×
Speech sound lang comprehen (92523) $347 $463 1.5×
Spirometry (94010) $83 $110 0.4×
Standardized Cognitive Performance Testing (96125) $208 $277.50 2.0×
Temp transcutaneous pacing (92953) $312 $416 0.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $47 $62.50 2.1×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $45 $60 2.1×
Ther/Proph/Diag Inj Sc/Im (96372) $126 $168 1.7×
Therapeutic Activities (97530) $67 $89 1.9×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $14 $18 0.4×
Trans Care Mgmt 14 Day Disch (99495) $366 $488 2.7×
Trans Care Mgmt 7 Day Disch (99496) $496 $661 3.7×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $986 $1,314 1.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $185 $246 2.4×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $188 $250 2.2×
Tx/Pro/Dx Inj New Drug Addon (96375) $85 $113 1.8×
Vasc Duplex Extrem Venous,Bilat (93970) $438 $584 1.8×
Vasopneumatic device (97016) $49 $65 4.1×
Wheelchair Mgmt Ea 15 Min (97542) $74 $99 2.4×