Procedures & surgery prices at Prague Regional Memorial Hospital

Prague, OK · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083) $860 $860 1.0×
Anoscopy diagnostic (46600) $246 $246 1.9×
Application Finger Splint Dynamic (29131) $29.36 $98 0.5×
Application finger splint static (29130) $24.41 $166 0.2×
Application long arm splint shoulder hand (29105) $35.83 $353 0.2×
Application Long Leg Splint (29505) $50.81 $461 0.3×
Application Short Arm Splint Dynamic (29126) $212 $212 1.7×
Application short arm splint forearm-hand static (29125)
range across 2 matching MRF lines		 $38.09–$180 $180–$319 varies
Application short leg splint calf foot (29515)
range across 2 matching MRF lines		 $46.51–$200 $200–$319 varies
Apply long arm cast (29065) $269 $269 1.0×
Arterial puncture (36600) $207.42 $207.42 1.6×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $30.68 $216 0.1×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $37.74 $238 0.1×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $30.01 $94 0.1×
Avulsion nail plate partial/complete simple 1 (11730)
range across 2 matching MRF lines		 $46.88–$917 $255–$917 varies
Biopsy nail unit (11755) $52.55 $159 0.1×
Blood Transfusion Service (36430)
range across 4 matching MRF lines		 $400–$644 $400–$644 varies
Catheter aspiration nasotracheal spx (31720) $198 $198 0.9×
Change Cystostomy Tube Simple (51705)
range across 2 matching MRF lines		 $44.74–$444 $105–$444 varies
Change of Windpipe Airway (31502)
range across 2 matching MRF lines		 $150–$648.21 $150–$648.21 varies
Chemical Cautery Tissue (17250)
range across 2 matching MRF lines		 $33.10 $349–$387 0.2×
Chest tube placement (32551) $136.11 $546 0.1×
Clear outer ear canal (69200) $39.54 $709 0.3×
Closed tx metatarsal fracture w/o manipulation (28470) $595 $595 2.5×
Closed tx patellar dislocation w/anesthesia (27562) $441.33 $1,409 1.9×
Closed tx patellar dislocation w/o anesthesia (27560) $365.91 $1,253 1.5×
Closed tx radial head/neck fx w/o manipulation (24650) $237.16 $483 1.0×
Closed tx tarsometatarsal dislocation w/o anes (28600) $147.46 $578.82 0.6×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $28.75 $313 0.1×
Closure Laceration Vestibule Mouth 2.5 Cm/< (40830) $754 $754 3.3×
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $300 $300 1.3×
Clsd tx clavicular fracture w/o manipulation (23500) $224.87 $835 0.9×
Clsd Tx Pelvic Ring Fx W/O Manipulation (27197) $306 $306 1.3×
Clsd tx shoulder dislc w/manipulation req anes (23655) $386.66 $921 0.3×
Clsd tx shoulder dislc w/manipulation w/o anes (23650)
range across 2 matching MRF lines		 $337.51 $626–$662 1.4×
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $315.04 $1,249 0.2×
Cltx dstl fibular fx lat malls w/o manj (27786) $270.59 $500 1.1×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $312.98 $630 1.3×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $507.11 $840 0.3×
Cltx fx grt toe phlx/phlg w/o manj (28490) $401 $401 1.7×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $342 $342 1.4×
Cltx greater humeral tuberosity fx w/o manj (23620) $249.46 $738 1.1×
Cltx hip dislocation traumatic w/o anesthesia (27250)
range across 2 matching MRF lines		 $165.80–$631.50 $526.68–$631.50 varies
Cltx Iphal Jt Dislc W/Manj Req Anes (26775) $1,071 $1,071 4.0×
Cltx iphal jt dislc w/manj w/o anes (26770) $283.01 $1,086 1.2×
Cltx Medial Ankle Fx (27760) $300 $300 1.3×
Cltx metacarpal fx w/manipulation each bone (26605) $286.76 $793 1.2×
Cltx metacarpal fx w/o manipulation each bone (26600) $275.62 $600 1.2×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $296.86 $1,516 1.3×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $187.89 $350 0.8×
Cltx post hip arthrp dislc w/o anes (27265) $454.04 $1,171.98 1.9×
Cltx prox fibula/shft fx w/o manj (27780) $300 $300 1.3×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $67.92 $523 0.3×
Cltx tibial fx proximal w/o manipulation (27530) $275.91 $450 1.2×
Collection of venous blood by venipuncture (36415)
range across 2 matching MRF lines		 $21–$25 $21–$25 varies
Colonoscopy stoma rmvl les by hot biopsy forceps (44392) $170.48 $250 0.1×
Colonoscopy w/submucosal inj (45381) $169.45 $496 0.1×
Colsc flx w/removal lesion by hot bx forceps (45384) $193.47 $548 0.2×
Control Nasal Hemorrhage Anterior Complex (30903) $66.61 $146.26 0.5×
Control Nasal Hemorrhage Anterior Simple (30901) $47.53 $607 0.4×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $93.94 $315 0.7×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000)
range across 2 matching MRF lines		 $23.69–$1,604.67 $165.12–$1,604.67 varies
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $342.45 $2,467 0.1×
Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010)
range across 2 matching MRF lines		 $234.52–$2,542.16 $555–$2,542.16 varies
Deb Musc/Fascia 20 Sq Cm/< (11043)
range across 4 matching MRF lines		 $131.26–$5,115.49 $225–$5,115.49 varies
Debride nail 1-5 (11720) $12.33 $32 0.2×
Debride nail 6 or more (11721) $20.79 $52 0.4×
Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044)
range across 4 matching MRF lines		 $191.37–$7,184.95 $583.84–$7,184.95 varies
Debridement subcutaneous tissue 20 sq cm/< (11042)
range across 4 matching MRF lines		 $52.81–$2,677.96 $238.88–$2,677.96 varies
Destruction premalignant lesion 1st (17000) $917 $917 4.8×
Diagnostic sigmoidoscopy (45330) $50.49 $128 0.1×
Dilate Esophagus 1/Mult Pass (43450) $69.21 $179 0.1×
Dilation Esophagus Guide Wire (43453) $73.40 $193 0.0×
Drainage Mouth Roof Lesion (42000) $92.36 $277.08 0.4×
Drainage of finger abscess simple (26010) $133.90 $762 0.7×
Drainage of gum lesion (41800) $172.25 $139.93 1.3×
Drainage of hematoma/fluid (10140)
range across 2 matching MRF lines		 $107.89 $513–$571 0.1×
Draw Blood Off Venous Device (36591) $175 $175 1.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025)
range across 2 matching MRF lines		 $96 $410–$455 0.5×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020)
range across 2 matching MRF lines		 $50.62 $139–$236 0.3×
Egd Balloon Dilation Esophagus <30 Mm Diam (43249) $129.82 $334 0.1×
Egd cautery tumor polyp (43250) $145.05 $368 0.1×
Egd control bleeding any (43255) $168.97 $436 0.1×
Egd dilation gastric/duodenal stricture (43245) $149.28 $380 0.1×
Egd Flexible Foreign Body Removal (43247) $149.84 $381 0.2×
Egd guide wire insertion (43248) $140.97 $363 0.2×
Egd lesion ablation (43270) $188.85 $499 0.1×
Egd place gastrostomy tube (43246) $169.62 $435 0.1×
Egd remove lesion snare (43251) $165.07 $426 0.1×
Esoph Scope W/Submucous Inj (43201) $87.47 $224 0.0×
Esophagogastroduodenoscopy Submucosal Injection (43236) $117.64 $302 0.1×
Esophagoscopy Flex Balloon Dilat <30 Mm Diam (43220) $100.51 $258 0.1×
Esophagoscopy Flexib Lesion Removal Tumor Snare (43217) $135.66 $350 0.1×
Esophagoscopy Flexible Guide Wire Dilation (43226) $111.09 $284 0.1×
Esophagoscopy Flexible Transoral Diagnostic (43200) $75.11 $191 0.1×
Esophagoscopy Flexible W/Bleeding Control (43227) $139.92 $361 0.1×
Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) $88.41 $225 0.0×
Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) $121.05 $303 0.1×
Esphagoscopy Flex Lesion Removal Hot Bx Forceps (43216) $113.56 $294 0.1×
Evacuation of subungual hematoma (11740) $29.21 $180 0.2×
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $71.02 $155 0.1×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $134.39 $309 0.1×
Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) $126.77 $309 0.2×
Exc F/E/E/N/L Mal+Mrg 1.1-2 (11642) $146.05 $365 0.2×
Exc F/E/E/N/L Mal+Mrg 3.1-4 (11644) $226.99 $571 0.1×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $90.61 $201 0.1×
Exc Face-Mm B9+Marg 0.6-1 Cm (11441) $111.97 $257 0.2×
Exc Face-Mm B9+Marg 1.1-2 Cm (11442) $123.15 $285 0.2×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $149.26 $351 0.1×
Exc Face-Mm B9+Marg 3.1-4 Cm (11444) $188.11 $450 0.1×
Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) $71.15 $160 0.0×
Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) $92.74 $219 0.1×
Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) $116 $265 0.1×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $126.53 $288 0.2×
Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) $154.56 $354 0.1×
Exc Skin Benig >4 Cm Remaindr Body (11426) $230.41 $544 0.1×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $213.20 $486 0.1×
Exc Skin Benig >4cm Face,Facial (11446) $266.43 $649 0.1×
Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) $168.04 $422 0.1×
Exc Skin Malig >4 Cm Remaindr Body (11626) $240.09 $590 0.1×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $260 $639 0.2×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $88.26 $203 0.2×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $95.91 $224 0.1×
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $141.68 $318 0.1×
Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) $154.40 $387 0.2×
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $120.83 $294 0.2×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $129 $323 0.3×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $171.16 $428 0.3×
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $104.08 $309 0.2×
Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) $182.93 $460 0.1×
Excision Malignant Lesion F/E/E/N/L >4.0 Cm (11646) $315.50 $795 0.1×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $135.95 $339 0.2×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $192.10 $479 0.1×
Excision of pilonidal cyst or sinus; simple (11770) $168.56 $365 0.1×
Exploration penetrating wound spx extremity (20103) $2,517 $2,517 1.6×
I&d abscess simple (10060)
range across 2 matching MRF lines		 $93.53–$917 $214–$917 varies
I&D Deep Absc/Hematoma Neck/Chest (21501) $3,907 $3,907 1.4×
Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd (44380) $50.11 $137 0.1×
Incision & drainage abscess complicated/multiple (10061) $1,765 $1,765 4.5×
Incision & removal foreign body subq tiss compl (10121) $161.38 $370 0.1×
Incision & removal foreign body subq tiss simple (10120)
range across 2 matching MRF lines		 $94.98 $195.12–$232.75 0.2×
Incision and drainage of vulva or perineal abscess (56405) $417 $417 1.4×
Initial Tx 1st Degree Burn Local Tx (16000) $326 $326 1.7×
Injection 1 tendon sheath/ligament aponeurosis (20550) $32.09 $272 0.1×
Injection single/mlt trigger point 1/2 muscles (20552) $33.93 $244 0.1×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $36.64 $263 0.1×
Insert Bladder Cath Complex (51703) $322 $322 2.6×
Insert non-tunnel cv cath (36556) $8,771 $8,771 2.9×
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines		 $21.76–$220 $220–$386 varies
Insert,Non-Indwelling Bladder Catheter (51701) $166 $166 1.3×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) $82.29 $271.68 0.1×
Intmd Rpr Face/Mm 12.6-20 Cm (12055) $275.06 $846 0.7×
Intubation endotracheal emergency procedure (31500)
range across 2 matching MRF lines		 $127.32–$1,781.57 $177–$1,781.57 varies
Laryngoscopy diagnostic (31505) $180 $180 0.9×
Nasal/Orogastric W/Tube Plmt (43752) $33.20 $110.70 0.1×
Placement of needle for intraosseous infusion (36680) $54.89 $200 0.1×
Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) $42.55 $109 0.0×
Punch biopsy skin single lesion (11104) $536 $536 1.4×
Puncture aspiration abscess hematoma bulla/cyst (10160)
range across 2 matching MRF lines		 $85.47–$1,765 $456–$1,765 varies
Removal Foreign Body Deep Thigh/Knee (27372) $4,621 $4,621 1.7×
Removal Foreign Body Foot Subcutaneous (28190) $120.13 $271 0.2×
Removal impacted cerumen irrigation/lvg unilat (69209) $15.17 $40.56 0.3×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $26 $188 0.5×
Removal of nail bed (11750)
range across 2 matching MRF lines		 $89.07–$1,765 $665–$1,765 varies
Removal skn tags mlt fibrq tags any area upw/15 (11200) $64.29 $143 0.3×
Removal sweat gland lesion (11450) $236.01 $492 0.1×
Removal/bivalving gauntlet boot/body cast (29700) $28.50 $166.08 0.1×
Remove foreign body from eye (65205) $23.41 $319 0.2×
Remove Intrauterine Device (58301) $240 $240 0.8×
Remove Nasal Foreign Body (30300) $106.37 $325 0.8×
Remove Shoulder Foreign Body (23330) $153.60 $558.32 0.1×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $898 $898 2.3×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $204.62 $580.95 0.5×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $140.32 $327 0.4×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $162.90 $356 0.4×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $176.56 $1,474 0.5×
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $250.18 $536 0.4×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $121.79 $309 0.3×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $158.89 $516 0.4×
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $179.72 $569 0.3×
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $210.22 $1,125 0.5×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $125.09 $655 0.3×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $155.13 $521 0.4×
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $252.54 $561 0.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $169.62 $978 0.4×
Repair of nail bed (11760) $97.71 $681 0.1×
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $611 $611 0.7×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $35.82 $271 0.1×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $187 $187 1.5×
Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) $230 $230 0.5×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589)
range across 2 matching MRF lines		 $118.43–$2,552 $516.36–$2,552 varies
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $85.73 $1,044 0.4×
Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) $290.41 $608 0.4×
Rpr Lip Full Thickness Vermilion Only (40650) $322.30 $891.33 0.6×
Shave skin lesion 0.5 cm/< (11300) $26.63 $71 0.1×
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $35.03 $96 0.2×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $31.75 $80 0.2×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $39.44 $105 0.2×
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $825 $825 2.1×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $48.73 $132 0.3×
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $58.02 $158 0.1×
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $55.46 $151 0.1×
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $46.55 $126 0.2×
Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) $63.08 $152 0.1×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $116.13 $277 0.3×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $51.44 $306 0.3×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $53.02 $567 0.3×
Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) $145.86 $318 0.4×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $68.50 $445 0.4×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $41.60 $327 0.2×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $127.32 $849 0.7×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $68.15 $973 0.4×
Skin sub graft face/nk/hf/g (15275)
range across 3 matching MRF lines		 $80.75–$8,746.30 $1,158–$8,746.30 varies
Skin sub graft trnk/arm/leg (15271)
range across 4 matching MRF lines		 $71.52–$5,982.89 $286.50–$5,982.89 varies
Skin sub grft t/arm/lg child (15273)
range across 4 matching MRF lines		 $163.10–$17,981.10 $582–$17,981.10 varies
Skn sub grft f/n/hf/g child (15277)
range across 3 matching MRF lines		 $187.46–$8,746.30 $1,158–$8,746.30 varies
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $54.34 $403 0.3×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $85.43 $452 0.2×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $103.89 $249 0.3×
Strapping ankle (29540)
range across 2 matching MRF lines		 $14.96–$183 $183–$214 varies
Strapping elbow or wrist (29260)
range across 2 matching MRF lines		 $15.30–$214 $105–$214 varies
Strapping hand/finger (29280) $207 $207 3.6×
Strapping Hip (29520) $233 $233 1.8×
Strapping knee (29530) $220 $220 1.7×
Strapping shoulder (29240)
range across 2 matching MRF lines		 $15.04–$250 $240–$250 varies
Strapping thorax (29200) $226 $226 1.4×
Strapping toes (29550)
range across 2 matching MRF lines		 $9.43–$174 $91–$174 varies
Strapping Unna Boot (29580)
range across 4 matching MRF lines		 $22.54–$811.55 $220–$811.55 varies
Treat humerus fracture (24500) $320.55 $610 1.4×
Treat humerus fracture (23600) $300 $300 1.3×
Treat Knuckle Dislocation (26700) $321.21 $311 1.4×
Treat Metatarsal Fracture (28475) $209.40 $500 0.9×
Treat toe dislocation (28630) $104.01 $530 0.4×
Treatment closed elbow dislocation w/o anes (24600) $370.39 $1,599 1.6×
Trim skin lesions 2 to 4 (11056) $19.19 $261 0.1×
Trim skin lesions over 4 (11057) $24.73 $62 0.1×
Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) $4,268 $4,268 2.8×
Tx Superficial Wound Dehiscence Simple Closure (12020) $167.20 $1,191 0.2×
Vaginal delivery only (59409) $680.34 $1,526.94 0.2×
Wedge excision skin nail fold (11765) $83.54 $185 0.2×
Wound Prep Trk/Arm/Leg (15002) $8,746.30 $8,746.30 12.3×

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.