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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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $860 $860 1.0×
Anoscopy diagnostic (46600) $246 $246 1.9×
Application cast shoulder hand long arm (29065) $269 $269 1.0×
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 thigh ankle/toes (29505) $50.81 $461 0.3×
Application Short Arm Splint Dynamic (29126) $212 $212 1.7×
Application short arm splint forearm-hand static (29125) $109.04 $249.50 0.9×
Application short leg splint calf foot (29515) $123.26 $259.50 0.8×
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) $481.94 $586 2.5×
Biopsy of nail unit (11755) $52.55 $159 0.1×
Blood transfusion service (36430) $550 $550 1.3×
Catheter Aspiration Nasotracheal Spx (31720) $198 $198 0.9×
Change Cystostomy Tube Simple (51705) $244.37 $274.50 1.0×
Chemical Cautery Tissue (17250) $33.10 $368 0.2×
Chest tube placement (32551) $136.11 $546 0.1×
Close Rx Fingr Articular Fx,Manip (26742) $315.04 $1,249 0.2×
Closed Rx Gr Tuberosity Hum Fx (23620) $249.46 $738 1.1×
Closed Rx Med Malleolus Fx (27760) $300 $300 1.3×
Closed Rx Tibial Plateau Fx (27530) $275.91 $450 1.2×
Closed treatment of tarsometatarsal joint dislocation; without anesthesia (28600) $147.46 $578.82 0.6×
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 temporomandibular dislocation 1st/sbsq (21480) $28.75 $313 0.1×
Closure of laceration, vestibule of mouth; 2.5 cm or less (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) $337.51 $644 1.4×
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 hip dislocation traumatic w/o anesthesia (27250) $398.65 $579.09 1.7×
Cltx iphal jt dislc w/manj w/o anes (26770) $283.01 $1,086 1.2×
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 metacarpophalangeal dislc w/manj w/o anes (26700) $321.21 $311 1.4×
Cltx metatarsophlngl jt dislc w/o anes (28630) $104.01 $530 0.4×
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×
Colonoscopy flex w/rem forcep (45384) $193.47 $548 0.2×
Colonoscopy stoma rmvl les by hot biopsy forceps (44392) $170.48 $250 0.1×
Colsc flx with directed submucosal njx any sbst (45381) $169.45 $496 0.1×
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) $814.18 $884.90 2.1×
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $342.45 $2,467 0.1×
Debride Assoc Open Fx/Disloc Skin/Subq (11010) $1,388.34 $1,548.58 2.0×
Debride nail 1-5 (11720) $12.33 $32 0.2×
Debride nail 6 or more (11721) $20.79 $52 0.4×
Debridement subcutaneous tissue 20 sq cm/< (11042) $393.20 $510.30 1.0×
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $131.26 $341.80 0.2×
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $191.37 $1,513.50 0.1×
Destruction premalignant lesion 1st (17000) $917 $917 4.8×
Diagnostic sigmoidoscopy (45330) $50.49 $128 0.1×
Dilation esoph unguided sound/bougie 1/mult pass (43450) $69.21 $179 0.1×
Dilation Esophagus Guide Wire (43453) $73.40 $193 0.0×
Drainage Finger Abscess Simple (26010) $133.90 $762 0.7×
Drainage mouth roof lesion (42000) $92.36 $277.08 0.4×
Drainage of gum lesion (41800) $172.25 $139.93 1.3×
Drainage of hematoma/fluid (10140) $107.89 $542 0.1×
Draw blood off venous device (36591) $175 $175 1.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $96 $432.50 0.5×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $50.62 $187.50 0.3×
Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd (43270) $188.85 $499 0.1×
Egd balloon dilation esophagus <30 mm diam (43249) $129.82 $334 0.1×
Egd Dilation Gastric/Duodenal Stricture - Egd (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 place gastrostomy tube (43246) $169.62 $435 0.1×
Egd rem tumr/polyp forcep (43250) $145.05 $368 0.1×
Egd remove lesion snare (43251) $165.07 $426 0.1×
Egd Transoral Control Bleeding Any Method - Egd (43255) $168.97 $436 0.1×
Esoph endoscopy dilation (43226) $111.09 $284 0.1×
Esoph scope w/submucous inj (43201) $87.47 $224 0.0×
Esophagogastroduodenoscopy submucosal injection (43236) $117.64 $302 0.1×
Esophagoscopy flex biopsy (43202) $88.41 $225 0.0×
Esophagoscopy Flexib Lesion Removal Tumor Snare - Esophagoscopy (43217) $135.66 $350 0.1×
Esophagoscopy flexible removal foreign body (43215) $121.05 $303 0.1×
Esophagoscopy flexible transoral diagnostic (43200) $75.11 $191 0.1×
Esophagoscopy, flexible, transoral; with control of bleeding, any method (43227) $139.92 $361 0.1×
Esphgsc rgd/flx w/balo dilat < 30 mm diam (43220) $100.51 $258 0.1×
Evacuation of subungual hematoma (11740) $29.21 $180 0.2×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $134.39 $309 0.1×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $154.56 $354 0.1×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $90.61 $201 0.1×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $149.26 $351 0.1×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $92.74 $219 0.1×
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $88.26 $203 0.2×
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $95.91 $224 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 Face,Facial (11444) $188.11 $450 0.1×
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $141.68 $318 0.1×
Exc Skin Benig >4 Cm Face,Facial (11446) $266.43 $649 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 Malig 2.1-3 Cm Face,Facial (11643) $182.93 $460 0.1×
Exc Skin Malig >4 Cm Face,Facial (11646) $315.50 $795 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 0.5 cm or less (11400) $71.02 $155 0.1×
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 2.1-3.0 Cm (11603) $154.40 $387 0.2×
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 0.6-1.0 cm (11641) $126.77 $309 0.2×
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $146.05 $365 0.2×
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $226.99 $571 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 2.1-3.0 Cm (11623) $168.04 $422 0.1×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $192.10 $479 0.1×
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $111.97 $257 0.2×
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $123.15 $285 0.2×
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $116 $265 0.1×
Excision of lesion other than skin tag </= 0.5 cm (11420) $71.15 $160 0.0×
Excision of nail fold toe (11765) $83.54 $185 0.2×
Excision of pilonidal cyst or sinus; simple (11770) $168.56 $365 0.1×
Excision of skin/subcutaneous tissue for hidradenitis, axillary; w/ simple or interm repair (11450) $236.01 $492 0.1×
Exploration penetrating wound spx extremity (20103) $2,517 $2,517 1.6×
I&d abscess simple (10060) $505.26 $565.50 2.6×
I&D Deep Absc/Hematoma Neck/Chest (21501) $3,907 $3,907 1.4×
Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd - Enteroscopy (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) $94.98 $213.94 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×
Inj tendon sheath/ligament (20550) $32.09 $272 0.1×
Injection anes other peripheral nerve/branch (64450) $36.64 $263 0.1×
Injection single/mlt trigger point 1/2 muscles (20552) $33.93 $244 0.1×
Insert Bladder Cath Complex (51703) $322 $322 2.6×
Insert non-tunnel cv cath (36556) $8,771 $8,771 2.9×
Insert picc cath (36569) $82.29 $271.68 0.1×
Insert Temp Bladder Cath (51702) $120.88 $303 0.9×
Insert,Non-Indwelling Bladder Catheter (51701) $166 $166 1.3×
Intubation endotracheal emergency procedure (31500) $954.44 $979.28 4.2×
Laryngoscopy Indirect Diagnostic Spx (31505) $180 $180 0.9×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $33.20 $110.70 0.1×
Placement of needle for intraosseous infusion (36680) $54.89 $200 0.1×
Proctosigmoidoscopy,Rigid,Diagnos - Endoscopy Sigmoid (45300) $42.55 $109 0.0×
Punch biopsy skin single lesion (11104) $536 $536 1.4×
Puncture Aspiration (10160) $925.24 $1,110.50 2.4×
Removal fb intranasal (30300) $106.37 $325 0.8×
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 intrauterine device (iud) (58301) $240 $240 0.8×
Removal of nail bed (11750) $927.04 $1,215 2.4×
Removal of polyps or growths of esophagus using a flexible endo (43216) $113.56 $294 0.1×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $64.29 $143 0.3×
Removal/bivalving gauntlet boot/body cast (29700) $28.50 $166.08 0.1×
Remove foreign body from eye (65210) $230 $230 0.5×
Remove shoulder foreign body (23330) $153.60 $558.32 0.1×
Remv Ext Canal Foreign Body (69200) $39.54 $709 0.3×
Remv F.B.,Eye,Superf Conjunc (65205) $23.41 $319 0.2×
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 12.6-20.0cm (12055) $275.06 $846 0.7×
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 Tun Cvc W/O Subq Port/Pmp (36589) $1,335.22 $1,534.18 2.2×
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×
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×
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $26.63 $71 0.1×
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 flx w/biopsy single/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 f/e/e/n/l/m 7.6cm-12.5 cm (12015) $85.73 $1,044 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) $80.75 $1,286 0.1×
Skin sub graft trnk/arm/leg (15271) $71.52 $1,222 0.1×
Skin Sub Grft T/Arm/Lg Child (15273) $163.10 $870.41 0.1×
Skn sub grft f/n/hf/g child (15277) $187.46 $1,286 0.1×
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) $98.98 $198.50 0.6×
Strapping elbow/wrist (29260) $114.65 $159.50 2.0×
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) $132.52 $245 1.0×
Strapping thorax (29200) $226 $226 1.4×
Strapping toes (29550) $91.72 $132.50 1.6×
Strapping unna boot (29580) $121.27 $564.50 0.8×
Trach Tube Change (31502) $399.10 $399.10 1.8×
Treat finger dislocation (26775) $1,071 $1,071 4.0×
Treat humerus fracture (24500) $320.55 $610 1.4×
Treat humerus fracture (23600) $300 $300 1.3×
Treat Metatarsal Fracture (28475) $209.40 $500 0.9×
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×
Venipuncture (36415) $23 $23 2.5×
Wound prep trk/arm/leg 1st 100 sq cm (15002) $8,746.30 $8,746.30 12.3×