Procedures & surgery prices at Potomac Valley Hospital

Keyser, WV · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $878.50 $1,757 1.0×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $1,193 $2,386 1.4×
Ablation Bone Tumor Rf Perq W/Img Gdn When Done (20982)
unusually low: confirm this is the full procedure		 $6,540 $13,080 0.4×
Adjt Tis Reargmt Eye/Nose/Ear/Lip 10.1-30.0 Sqcm (14061) $1,976.50 $3,953 1.0×
Adjt Tis Trnsfr/Reargmt Scalp/Arm/Leg 10 Sq Cm/< (14020) $1,976.50 $3,953 1.0×
Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) $1,976.50 $3,953 1.0×
Application cast elbow finger short arm (29075) $268 $536 1.0×
Application finger splint static (29130)
range across 2 matching MRF lines		 $127.50–$128 $255–$256 varies
Application long arm splint shoulder hand (29105) $248.50 $497 1.6×
Application Long Leg Splint (29505)
range across 2 matching MRF lines		 $200–$200.50 $400–$401 varies
Application of rigid total contact leg cast (29445) $268 $536 1.0×
Application Short Arm Splint Dynamic (29126) $127.50 $255 1.0×
Application short arm splint forearm-hand static (29125) $152.50 $305 1.2×
Application short leg splint calf foot (29515)
range across 2 matching MRF lines		 $260–$260.50 $520–$521 varies
Apply hand/wrist cast (29085) $156 $312 1.0×
Apply long arm cast (29065) $268 $536 1.0×
Apply Multlay Comprs Lwr Leg (29581) $226.50 $453 1.5×
Apply Short Leg Cast (29405) $268 $536 1.0×
Apply short leg cast (29425) $268 $536 1.0×
Arterial puncture (36600) $127.50 $255 1.0×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $294 $588 1.0×
Arthrocentesis aspir&/inj interm jt/burs w/us (20606)
range across 2 matching MRF lines		 $676.50–$679 $1,353–$1,358 varies
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $294 $588 1.0×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611)
range across 2 matching MRF lines		 $441.50–$442 $883–$884 varies
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $294 $588 1.0×
Aspirate pleura w/ imaging (32555)
range across 2 matching MRF lines		 $601–$1,444 $1,202–$2,888 varies
Aspirate Pleura W/O Imaging (32554) $608.50 $1,217 1.0×
Aspirate/Inj Ganglion Cyst (20612) $294 $588 1.0×
Avulsion nail plate partial/complete simple 1 (11730) $192.50 $385 1.0×
Biopsy Abdominal Mass (49180) $2,273.50 $4,547 1.4×
Biopsy external ear (69100) $227 $454 1.0×
Biopsy muscle percutaneous needle (20206) $1,586.50 $3,173 1.0×
Biopsy nail unit (11755) $678.50 $1,357 1.0×
Biopsy of liver, needle; percutaneous (47000) $1,586.50 $3,173 1.0×
Biopsy Prostate Any Approach Nonimaging-Guided (55705) $1,812.50 $3,625 0.5×
Biopsy Prostate Transrectal Ultrasound-Guided (55707) $3,376 $6,752 1.0×
Biopsy Vulva/Perineum 1 Lesion Spx (56605) $882 $1,764 1.0×
Bladder instillation anticarcinogenic agent (51720) $673 $1,346 1.0×
Bladder Irrigation (51700) $239.50 $479 1.0×
Bladder Scan (51798) $103 $206 1.8×
Blood Transfusion Service (36430) $423 $846 1.0×
Bx breast 1st lesion us imag (19083) $1,940.50 $3,881 1.2×
Canthotomy Separate Procedure (67715) $2,277.50 $4,555 1.0×
Change Cystostomy Tube Complicated (51710) $673 $1,346 1.0×
Change Cystostomy Tube Simple (51705) $239.50 $479 1.0×
Chemical Cautery Tissue (17250) $192.50 $385 1.0×
Chest tube placement (32551) $2,046 $4,092 1.4×
Chg onc prst8 ca alys all PSA structural isoforms (0359U) $250 $500 0.3×
Cholecystostomy Prq W/Imaging & Catheter Plmt (47490) $3,467.50 $6,935 1.0×
Clear outer ear canal (69200)
range across 2 matching MRF lines		 $127.50–$144 $255–$288 varies
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $236.50 $473 1.0×
Closed tx ankle dislocation w/o anesthesia (27840) $285 $570 1.2×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $236.50 $473 1.0×
Closed Tx Calcaneal Fracture W/O Manipulation (28400) $236.50 $473 1.0×
Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) $236.50 $473 1.0×
Closed Tx Knee Dislocation W/Anesthesia (27552) $1,556 $3,112 1.0×
Closed tx metatarsal fracture w/o manipulation (28470) $236.50 $473 1.0×
Closed tx patellar dislocation w/o anesthesia (27560) $285 $570 1.2×
Closed Tx Patellar Fracture W/O Manipulation (27520) $236.50 $473 1.0×
Closed tx radial head/neck fx w/o manipulation (24650) $236.50 $473 1.0×
Closed Tx Radial Shaft Fracture W/O Manipulation (25500) $236.50 $473 1.0×
Closed tx radial&ulnar shaft fractures w/o man (25560) $236.50 $473 1.0×
Closed tx talus fracture w/o manipulation (28430) $236.50 $473 1.0×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $285 $570 1.2×
Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) $236.50 $473 1.0×
Closed tx ulnar shaft fracture w/o manipulation (25530) $236.50 $473 1.0×
Clsd tx clavicular fracture w/o manipulation (23500) $236.50 $473 1.0×
Clsd Tx Pelvic Ring Fx W/O Manipulation (27197) $236.50 $473 1.0×
Clsd tx shoulder dislc w/manipulation req anes (23655) $1,972.50 $3,945 1.3×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $365.50 $731 1.5×
Cltx Acetabulum Hip/Sockt Fx W/O Manj (27220) $236.50 $473 1.0×
Cltx ankle dislc req anes w/wo prq skel fixj (27842) $2,467.50 $4,935 1.6×
Cltx Carpal Bone Fx W/O Manj Each Bone (25630) $236.50 $473 1.0×
Cltx dstl fibular fx lat malls w/o manj (27786) $236.50 $473 1.0×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $236.50 $473 1.0×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $236.50 $473 1.0×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605)
range across 2 matching MRF lines		 $1,540.50–$1,556.50 $3,081–$3,113 varies
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $236.50 $473 1.0×
Cltx fx grt toe phlx/phlg w/o manj (28490) $236.50 $473 1.0×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $236.50 $473 1.0×
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $236.50 $473 1.0×
Cltx greater humeral tuberosity fx w/o manj (23620) $236.50 $473 1.0×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660)
range across 2 matching MRF lines		 $236.50–$239 $473–$478 varies
Cltx iphal jt dislc w/manj w/o anes (26770) $285 $570 1.2×
Cltx Medial Ankle Fx (27760) $236.50 $473 1.0×
Cltx metacarpal fx w/o manipulation each bone (26600) $236.50 $473 1.0×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725)
range across 2 matching MRF lines		 $236.50–$239 $473–$478 varies
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $236.50 $473 1.0×
Cltx post hip arthrp dislc req anes (27266)
range across 2 matching MRF lines		 $1,540–$1,972.50 $3,080–$3,945 varies
Cltx post hip arthrp dislc w/o anes (27265) $364.50 $729 1.5×
Cltx prox fibula/shft fx w/o manj (27780) $236.50 $473 1.0×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640)
range across 2 matching MRF lines		 $236.50–$238.50 $473–$477 varies
Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) $236.50 $473 1.0×
Cltx tibial fx proximal w/o manipulation (27530) $236.50 $473 1.0×
Cltx tibial shaft fx w/o manipulation (27750) $236.50 $473 1.0×
Cltx trimalleolar ankle fx w/manipulation (27818) $2,105.50 $4,211 1.4×
Collect Blood From Catheter Venous Nos (36592) $127.50 $255 1.0×
Collection of venous blood by venipuncture (36415) $5.50 $11 0.6×
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $292 $584 1.0×
Colposcopy entire vagina w/cervix if present (57420) $292 $584 1.0×
Colposcopy Vulva W/Biopsy (56821) $292 $584 1.0×
Conjunctivorhinostomy Insj Tube/Stent (68750) $3,311 $6,622 0.9×
Control Nasal Hemorrhage Anterior Complex (30903) $159.50 $319 1.2×
Control Nasal Hemorrhage Anterior Simple (30901) $169.50 $339 1.3×
Core Needle Bx Lung/Mediastinum Perq W/Img (32408) $2,380 $4,760 1.5×
Correction Trichiasis Inccision Lid Margin (67830) $955 $1,910 1.0×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $194.50 $389 1.5×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $227 $454 1.0×
Cysto w/irrig & evac multple obstructing clots (52001) $2,881 $5,762 0.9×
Cystourethroscopy (52000) $571 $1,142 0.9×
Dcmprn perq nucleus pulposus 1/> levels lumbar (62287) $1,870.50 $3,741 1.0×
Dcmprn perq prtl rmvl liga flavm bi 1ntrspc lmbr (62330) $4,834 $9,668 0.7×
Deb Musc/Fascia 20 Sq Cm/< (11043) $708 $1,416 1.0×
Debride nail 1-5 (11720) $90.50 $181 1.6×
Debride nail 6 or more (11721) $99 $198 1.7×
Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) $1,582 $3,164 1.0×
Debridement subcutaneous tissue 20 sq cm/< (11042) $389.50 $779 1.0×
Declot vascular device (36593) $449 $898 1.4×
Destruct B9 Lesion 1-14 (17110) $341 $682 1.8×
Destruction Internal Hemorrhoid Thermal Energy (46930) $1,146.50 $2,293 1.0×
Destruction premalignant lesion 1st (17000) $196 $392 1.0×
Diagnostic anoscopy (46601) $428 $856 1.0×
Dilat Urethral Strix Filiform & Follwr Male Sbsq (53621) $239.50 $479 1.0×
Dilate Urethra Stricture (53620) $668 $1,336 1.0×
Dilate Urethra Stricture (53600) $239.50 $479 1.0×
Drain Cerebro Spinal Fluid (62272) $1,193.50 $2,387 1.8×
Drain Spinal Cord Cyst (62268) $847.50 $1,695 1.0×
Drain/inj small joint/bursa w/us (20604) $294 $588 1.0×
Drainage of finger abscess simple (26010) $192.50 $385 1.0×
Drainage of hematoma/fluid (10140)
range across 2 matching MRF lines		 $1,596.50–$1,597 $3,193–$3,194 varies
Drainage of hydrocele (55000) $678.50 $1,357 1.0×
Draw Blood Off Venous Device (36591) $127.50 $255 1.0×
Dressing Change Under Anesthesia (15852) $708 $1,416 1.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $192.50 $385 1.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $325.50 $651 1.7×
Dx Bronchoscope/Lavage (31624) $2,011 $4,022 1.2×
Dx gastr intub w/asp spec (43754) $411.50 $823 2.0×
Dx lmbr spi pnxr w/fluor/CT (62328) $1,115 $2,230 1.6×
Egd place gastrostomy tube (43246) $3,611.50 $7,223 2.0×
Electro-Uroflowmetry First (51741) $207 $414 1.0×
Epidural Blood Patch (62273) $676 $1,352 1.0×
Evacuation of subungual hematoma (11740)
range across 2 matching MRF lines		 $127.50–$128 $255–$256 varies
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $2,554 $5,108 1.6×
Exc back tum deep < 5 cm (21932) $2,782 $5,564 1.0×
Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) $678.50 $1,357 1.0×
Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) $678.50 $1,357 1.0×
Exc F/E/E/N/L Mal+Mrg 3.1-4 (11644) $1,582 $3,164 1.0×
Exc Face-Mm B9+Marg 1.1-2 Cm (11442) $876 $1,752 1.3×
Exc ganglion wrist recurrent (25112) $1,540.50 $3,081 1.0×
Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) $685 $1,370 1.0×
Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) $1,582 $3,164 1.0×
Exc Lesion/Tumor Dentoalveolar Strux W/O Rpr (41825) $3,321.50 $6,643 1.0×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $678.50 $1,357 1.0×
Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) $1,582 $3,164 1.0×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $1,582 $3,164 1.0×
Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) $1,582 $3,164 1.0×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $1,582 $3,164 1.0×
Exc thigh/knee les sc 3 cm/> (27337) $2,782.50 $5,565 1.0×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $714 $1,428 1.8×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $685 $1,370 1.0×
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $1,582 $3,164 1.0×
Exc tumor soft tissue pelvis & hip subq <3cm (27047) $2,782.50 $5,565 1.0×
Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) $678.50 $1,357 1.0×
Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) $678.50 $1,357 1.0×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $678.50 $1,357 1.0×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $389.50 $779 1.0×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $678.50 $1,357 1.0×
Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) $1,582 $3,164 1.0×
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $1,582 $3,164 1.0×
Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) $678.50 $1,357 1.0×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $678.50 $1,357 1.0×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $1,582 $3,164 1.0×
Fetal non-stress test (59025) $588.50 $1,177 3.0×
Fine needle aspiration without imaging guidance (10021) $389.50 $779 1.0×
Fna bx w/us gdn 1st les (10005) $1,439 $2,878 2.1×
I&d abscess peritonsillar (42700) $286 $572 1.3×
I&d abscess simple (10060)
range across 2 matching MRF lines		 $265.50–$266 $531–$532 varies
I&d perianal abscess superficial (46050) $1,403 $2,806 1.6×
I&d pilonidal cyst simple (10080)
range across 2 matching MRF lines		 $851.50–$852 $1,703–$1,704 varies
Image Cath Fluid Peri/Retro (49406) $1,586.50 $3,173 1.0×
Implant Periph/Gastric Neurostim/Receiver (64590)
likely a partial charge, not the full procedure		 $3,697.50 $7,395 0.2×
Incise external hemorrhoid (46083) $470.50 $941 2.0×
Incision & drainage abscess complicated/multiple (10061)
range across 2 matching MRF lines		 $389.50–$404.50 $779–$809 varies
Incision & removal foreign body subq tiss simple (10120)
range across 2 matching MRF lines		 $392.50–$393 $785–$786 varies
Incision and drainage of vulva or perineal abscess (56405)
range across 2 matching MRF lines		 $292–$294.50 $584–$589 varies
Incision of Foot Tendon (28234) $1,540 $3,080 1.0×
Incision of rectal abscess (46040) $1,957 $3,914 1.7×
Incision&Drainage Upper Arm/Elbow Bursa (23931)
range across 2 matching MRF lines		 $1,582–$1,586.50 $3,164–$3,173 varies
Incisional biopsy skin single lesion (11106) $708 $1,416 1.0×
Injection 1 tendon sheath/ligament aponeurosis (20550) $294 $588 1.0×
Injection aa&/strd axillary nerve w/img gdn (64417) $847.50 $1,695 1.0×
Injection aa&/strd genicular nrv branches w/img (64454) $676.50 $1,353 1.0×
Injection Aa&/Strd Lumbar Plexus Cont Nfs Cath (64449) $1,140 $2,280 1.3×
Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445)
range across 2 matching MRF lines		 $1,072.50–$1,073 $2,145–$2,146 varies
Injection Anes Agent Sphenopalatine Ganglion (64505) $509.50 $1,019 1.7×
Injection anesthetic agent suprascapular nerve (64418)
range across 2 matching MRF lines		 $676.50–$678.50 $1,353–$1,357 varies
Injection enzyme palmar fascial cord (20527) $294 $588 1.0×
Injection medication/other subst tenon capsule (67515) $304.50 $609 1.0×
Injection procedure for peyronie disease (54200) $239.50 $479 1.0×
Injection single tendon origin/insertion (20551) $294 $588 1.0×
Injection single/mlt trigger point 1/2 muscles (20552) $294 $588 1.0×
Injection single/mlt trigger point 3/> muscles (20553) $294 $588 1.0×
Injection therapeutic carpal tunnel (20526) $294 $588 1.0×
Injection, anesthetic agent; brachial plexus, single (64415)
range across 2 matching MRF lines		 $1,390.50–$1,391 $2,781–$2,782 varies
Injection, anesthetic agent; femoral nerve, single (64447)
range across 2 matching MRF lines		 $676.50–$678.50 $1,353–$1,357 varies
Injection, anesthetic agent; other peripheral nerve or branch (64450)
range across 2 matching MRF lines		 $676.50–$679 $1,353–$1,358 varies
Injection, intralesional; up to and including 7 lesions (11900) $192 $384 1.0×
Ins/Rep Subq Defibrillator (33270)
likely a partial charge, not the full procedure		 $9,019.50 $18,039 0.3×
Insert 1 Electrode Pm-Defib (33216)
unusually low: confirm this is the full procedure		 $2,620 $5,240 0.3×
Insert Bladder Cath Complex (51703) $236.50 $473 1.9×
Insert cath pleura w/ image (32557) $1,979.50 $3,959 1.3×
Insert non-tunnel cv cath (36556)
range across 2 matching MRF lines		 $2,426–$2,426.50 $4,852–$4,853 varies
Insert Pacing Lead & Connect (33224)
unusually low: confirm this is the full procedure		 $4,363 $8,726 0.4×
Insert pulse gen dual leads (33213)
unusually low: confirm this is the full procedure		 $4,363 $8,726 0.4×
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines		 $127.50–$132 $255–$264 varies
Insert,Non-Indwelling Bladder Catheter (51701)
range across 2 matching MRF lines		 $127.50–$128 $255–$256 varies
Insertion Picc W/Rs&I 5 Yr/> (36573)
range across 2 matching MRF lines		 $1,577–$1,577.50 $3,154–$3,155 varies
Insertion subq cardiac rhythm monitor w/prgrmg (33285)
unusually low: confirm this is the full procedure		 $2,619.50 $5,239 0.3×
Insj 2 Transvns Eltrd Perm Pacemaker/Impltbl Dfb (33217)
unusually low: confirm this is the full procedure		 $2,620 $5,240 0.3×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) $2,046 $4,092 1.4×
Insj Subq Impltbl Dfb Elctrd (33271)
unusually low: confirm this is the full procedure		 $2,620 $5,240 0.3×
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $2,387.50 $4,775 0.8×
Insj/rplcmt temp transvns 2chmbr pacg eltrds spx (33211)
unusually low: confirm this is the full procedure		 $2,620 $5,240 0.3×
Intraoral i&d tongue/floor sublngl supfc (41005) $227 $454 1.0×
Intubation endotracheal emergency procedure (31500) $310 $620 1.4×
Irrigation of corpora cavernosa for priapism (54220) $295.50 $591 1.2×
Laryngoscopy flexible diagnostic (31575) $286.50 $573 1.5×
Laryngoscopy W/WO Tracheoscopy Dx Newborn (31520) $382.50 $765 1.0×
Low Back Disk Surgery (63030) $4,834 $9,668 0.7×
Manipulation knee joint under general anesthesia (27570) $1,540.50 $3,081 1.0×
Maternity Care Procedure (59899) $196 $392 1.0×
Myelography Lumbar Injection (62304) $1,291 $2,582 1.7×
Myelography via lumbar injection rs&i cervical (62302) $752 $1,504 1.0×
N Block Inj Pudendal (64430) $847.50 $1,695 1.0×
N Block Lumbar/Thoracic (64520) $847.50 $1,695 1.0×
Nasal/Orogastric W/Tube Plmt (43752) $519.50 $1,039 1.2×
Needle Biopsy Lymph Nodes (38505) $2,380 $4,760 1.5×
Needle insertion w/o injection 1 or 2 muscles (20560) $53.50 $107 1.9×
Needle insertion w/o injection 3 or more muscles (20561) $64 $128 2.3×
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $534 $1,068 1.3×
Njx Anes Trigeminal Nrv Any Div/Branch (64400) $374 $748 1.3×
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) $1,073 $2,146 1.6×
Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62320)
range across 2 matching MRF lines		 $1,072.50–$1,073 $2,145–$2,146 varies
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62324) $847 $1,694 1.0×
Occipital Nerve Block (64405)
range across 2 matching MRF lines		 $294–$385 $588–$770 varies
Onc Sld Org Neo Trgt Gen Seq Dna Alys 505 Genes (0250U) $2,250 $4,500 0.8×
Ostectomy, complete excision; fifth metatarsal head (28113) $3,134 $6,268 1.0×
Pericardiocentesis W/Imaging (33016) $2,708.50 $5,417 1.8×
Perq Cervicothoracic Inject (22510)
range across 2 matching MRF lines		 $3,134–$3,166.50 $6,268–$6,333 varies
Perq device breast 1st imag (19281) $1,725 $3,450 1.1×
Perq Lumbosacral Injection (22511) $3,134 $6,268 1.0×
Perq sft tiss loc device plmt 1st les w/gdnce (10035) $693 $1,386 1.0×
Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) $4,834 $9,668 0.7×
Perq Vertebral Augmentation (22513) $4,834 $9,668 0.7×
Placement of needle for intraosseous infusion (36680) $522 $1,044 1.2×
Probe Nasolacrimal Duct W/WO Irrg Insj Tube/Stnt (68815) $2,277.50 $4,555 1.0×
Prq Impltj Neurostimulator Eltrd Peripheral Nrv (64555)
unusually low: confirm this is the full procedure		 $3,018 $6,036 0.5×
Punch biopsy skin single lesion (11104) $389.50 $779 1.0×
Puncture aspiration abscess hematoma bulla/cyst (10160) $389.50 $779 1.0×
Puncture Aspiration Cyst Breast (19000)
range across 2 matching MRF lines		 $678.50–$685 $1,357–$1,370 varies
Pvb Thoracic Single Injection Site W/Img Gid (64461) $1,073 $2,146 1.6×
Rbc DNA gntyp 12 bld grp gen (0282U) $285 $570 0.4×
Rdctj torsion tstis w/wo fixj clat testis (54600) $3,557 $7,114 1.1×
Relocation Pocket Pacemaker (33222) $1,976.50 $3,953 1.0×
Removal Anal Seton Other Marker (46030) $1,146.50 $2,293 1.0×
Removal Embedded Foreign Body Eyelid (67938) $304.50 $609 1.0×
Removal Foreign Body Foot Subcutaneous (28190) $684.50 $1,369 1.0×
Removal impacted cerumen irrigation/lvg unilat (69209)
range across 2 matching MRF lines		 $95.50–$100 $191–$200 varies
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210)
range across 2 matching MRF lines		 $95–$95.50 $190–$191 varies
Removal impacted vag fb spx w/anes oth/thn local (57415) $3,279.50 $6,559 1.1×
Removal of anal fissure (46200) $2,759.50 $5,519 1.0×
Removal of nail bed (11750) $389.50 $779 1.0×
Removal skn tags mlt fibrq tags any area upw/15 (11200) $192.50 $385 1.0×
Remove drug implant device (11982) $428 $856 1.0×
Remove foreign body from eye (65205) $211.50 $423 1.7×
Remove Intrauterine Device (58301) $292 $584 1.0×
Remove Nasal Foreign Body (30300) $159.50 $319 1.2×
Remove/Insert Drug Implant (11983) $428 $856 1.0×
Repair Blood Vessel Direct Upper Extremity (35206) $2,388 $4,776 0.8×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $389.50 $779 1.0×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $389.50 $779 1.0×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $823 $1,646 2.1×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121)
range across 2 matching MRF lines		 $886–$886.50 $1,772–$1,773 varies
Repair Ectropion Excision Tarsal Wedge (67916) $2,277.50 $4,555 1.0×
Repair extensor tendon finger w/o graft each (26418) $1,972.50 $3,945 1.3×
Repair Hand Tendon (26410) $1,556 $3,112 1.0×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $389.50 $779 1.0×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $389.50 $779 1.0×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053)
range across 2 matching MRF lines		 $490–$513.50 $980–$1,027 varies
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $389.50 $779 1.0×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $513.50 $1,027 1.3×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $513.50 $1,027 1.3×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $389.50 $779 1.0×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $585.50 $1,171 1.5×
Repair Laceration Palate >2 Cm/Complex (42182) $6,042 $12,084 1.1×
Repair lead pace-defib dual (33220) $2,625.50 $5,251 0.7×
Repair Lead Pace-Defib One (33218) $2,625.50 $5,251 0.7×
Repair of nail bed (11760) $772.50 $1,545 1.1×
Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) $7,367 $14,734 1.1×
Repos Previously Implanted Subq Implantable Dfb (33273) $2,625.50 $5,251 0.7×
Revj incl rplcmt nstim eltrd prq ra incl fluor (63663)
unusually low: confirm this is the full procedure		 $3,018 $6,036 0.5×
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $1,135.50 $2,271 1.3×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $807.50 $1,615 1.9×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $257 $514 2.0×
Rmvl of subq implantable defibrillator electrode (33272) $2,625.50 $5,251 0.7×
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $1,508 $3,016 1.0×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $1,117 $2,234 1.9×
Rplc Gtube No Revj Trc (43762) $458.50 $917 1.9×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $246.50 $493 1.3×
Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) $708 $1,416 1.0×
Rpr lac cjnc w/wo nonperfor lac sclera dir clsr (65270) $2,277.50 $4,555 1.0×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305)
range across 2 matching MRF lines		 $192.50–$230.50 $385–$461 varies
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $192.50 $385 1.0×
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $389.50 $779 1.0×
Shoulder Arthroscopy/Surgery (29825) $3,188 $6,376 1.0×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $192.50 $385 1.0×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $192.50 $385 1.0×
Simple Cystometrogram (51725) $239.50 $479 1.0×
Simple repair f/e/e/n/l/m 2.5cm/< (12011)
range across 2 matching MRF lines		 $195–$344.50 $390–$689 varies
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013)
range across 2 matching MRF lines		 $248–$248.50 $496–$497 varies
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $341 $682 1.8×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $237 $474 1.2×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004)
range across 2 matching MRF lines		 $192.50–$341 $385–$682 varies
Skin sub graft face/nk/hf/g (15275) $1,200 $2,400 1.7×
Skin sub graft trnk/arm/leg (15271) $1,200 $2,400 1.7×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002)
range across 2 matching MRF lines		 $253.50–$265.50 $507–$531 varies
Spinal puncture lumbar diagnostic (62270) $678.50 $1,357 1.0×
Strapping Unna Boot (29580) $227 $454 1.5×
Suprachoroidal space njx pharmacologic agent (67516) $424 $848 1.3×
Tangential biopsy skin single lesion (11102) $389.50 $779 1.0×
Tenotomy Percutaneous Single Each Digit (26060) $1,540 $3,080 1.0×
Tenotomy, Percutaneous, Toe; Multiple Tendons (28011) $1,540.50 $3,081 1.0×
Thermal dstrj intraosseous bvn 1st 2 lmbr/sac (64628) $6,332 $12,664 0.5×
Thrombolytic Therapy Stroke (37195) $333.50 $667 1.1×
Tis Trnfr E/N/E/L 10 Sq Cm/< (14060) $1,976.50 $3,953 1.0×
Tracheostoma revj smpl w/o flap rotation (31613) $3,175.50 $6,351 1.0×
Tracheostomy Emergency Cricothyroid Membrane (31605) $252 $504 1.1×
Tracheostomy planned (31600) $3,175.50 $6,351 1.0×
Treat Hip Socket Fracture (27222) $261.50 $523 1.1×
Treat humerus fracture (24500) $236.50 $473 1.0×
Treat Humerus Fracture (24505) $1,540.50 $3,081 1.0×
Treat humerus fracture (23600) $236.50 $473 1.0×
Trim skin lesion (11055) $270 $540 1.4×
Trim skin lesions 2 to 4 (11056) $192.50 $385 1.0×
Trim skin lesions over 4 (11057) $192.50 $385 1.0×
Trimming Nondystrophic Nails Any Number (11719)
range across 2 matching MRF lines		 $95–$95.50 $190–$191 varies
Tx Superficial Wound Dehiscence Simple Closure (12020) $708 $1,416 1.0×
Tx superficial wound dehiscence w/packing (12021) $389.50 $779 1.0×
Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) $236.50 $473 1.0×
Unlisted procedure colon (45399) $1,143 $2,286 1.3×
Unlisted Procedure Conjunctiva (68399) $304 $608 1.0×
Unlisted procedure nervous system (64999) $294 $588 1.0×
Unlisted px female genital system nonobstetrical (58999) $245 $490 1.3×
Upgrade of pacemaker system (33214)
unusually low: confirm this is the full procedure		 $4,363 $8,726 0.4×
Vaginal Delivery After Cesarean Delivery (59612) $3,279.50 $6,559 1.1×
Wedge excision skin nail fold (11765) $389.50 $779 1.0×
Wound Prep F/N/Hf/G (15004)
range across 2 matching MRF lines		 $389.50–$602.50 $779–$1,205 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.