Procedures & surgery prices at Ranken Jordan Pediatric Bridge Hospital

Maryland Heights, MO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Analyze infusn pump+reprogram (62368) $217.80 $272.25 0.7×
Analyze spine infus pump (62367) $217.80 $272.25 0.7×
Application cast elbow finger short arm (29075) $286.40 $358 1.0×
Application Cast Finger (29086) $286.40 $358 1.8×
Application Cast Hand & Lower Forearm Gauntlet (29085) $286.40 $358 1.8×
Application cast shoulder hand long arm (29065) $260 $325 0.9×
Application Long Leg Cast Walker/Ambulatory Type (29355) $286.40 $358 1.0×
Application of cylinder cast (thigh to ankle) (29365) $286.40 $358 1.0×
Application of long leg cast (29345) $286.40 $358 1.0×
Application Of Rigid Total Contact Leg Cast (29445) $286.40 $358 1.0×
Apply of clubfoot cast (29450) $286.40 $358 1.8×
Apply patella tendon bearing cast (29435) $286.40 $358 1.0×
Apply short leg cast (29405) $286.40 $358 1.0×
Apply short leg cast (29425) $286.40 $358 1.0×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $169.84 $212.30 0.6×
Avulsion nail plate partial/complete simple 1 (11730) $396 $495 2.0×
Biliary ndsc prq t-tube dilat strix w/stent (47556)
likely a partial charge, not the full procedure
$2,024 $2,530 0.2×
Bronchosc dx w/w/o fluor&wash (31622) $4,151.84 $5,189.80 2.3×
Chemical Cautery Tissue (17250) $163.68 $204.60 0.8×
Chemodenerv 1 extrem 5/> mus (64644) $435.60 $544.50 0.6×
Chemodenerv 1 extremity 1-4 (64642) $408.32 $510.40 0.6×
Chemodenerv Musc Neck Dyston (64616) $324.72 $405.90 1.1×
Chemodenerv trunk musc 1-5 (64646) $462 $577.50 0.7×
Chemodenerv trunk musc 6/> (64647) $484 $605 0.7×
Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) $357.28 $446.60 1.2×
Closure of gastrostomy surgical (43870) $3,402.96 $4,253.70 0.9×
Complete replacement picc rs&i (36584) $3,328.16 $4,160.20 2.1×
Complex Cystometrogram (51726) $1,395.68 $1,744.60 5.6×
Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral… (51727) $1,451.12 $1,813.90 2.1×
Cystometrogram w/vp (51728) $1,451.12 $1,813.90 2.1×
Cystometrogram W/Vp&Up (51729) $1,187.12 $1,483.90 1.7×
Debride nail 1-5 (11720) $224.40 $280.50 3.8×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $242 $302.50 0.6×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $220 $275 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $198 $247.50 1.0×
Egd place gastrostomy tube (43246) $892.32 $1,115.40 0.5×
Elec Anlys Implt Ithcl/Edrl Pmp W/Repr Phys/Qhp (62370) $334.40 $418 1.1×
EMG stds anal/urtl sphnctr oth/thn ndl (51784) $293.92 $367.40 2.3×
Ercp Stent Exchange W/Dilate (43276)
unusually low: confirm this is the full procedure
$2,530 $3,162.50 0.4×
Esophagoscopy flex biopsy (43202) $770 $962.50 0.4×
Fluoro exam of g/colon tube (49465) $1,826.88 $2,283.60 7.6×
I&d abscess simple (10060) $264 $330 1.3×
Incision of eardrum (69420) $743.60 $929.50 3.1×
Inj tendon sheath/ligament (20550) $196.24 $245.30 0.6×
Injection single/mlt trigger point 1/2 muscles (20552) $164.56 $205.70 0.5×
Injection single/mlt trigger point 3/> muscles (20553) $168.08 $210.10 0.5×
Insert Duodenostomy/Jejunostomy Tube Percutaneous (49441) $3,747.92 $4,684.90 2.0×
Insert Gastrostomy Tube Percutaneous (49440) $1,117.60 $1,397 0.6×
Insert picc cath (36569) $1,503.92 $1,879.90 1.0×
Insert Picc W/O Sub-Q Port <5 Y/O (36568) $1,584 $1,980 1.0×
Insert tunneled cv cath (36561) $3,652 $4,565 1.2×
Insert tunneled cvc w/o subq port/pmp age <5 yr (36557)
unusually low: confirm this is the full procedure
$2,200 $2,750 0.4×
Insj tunneled ctr vad w/subq port under 5 yr (36560) $3,828 $4,785 1.2×
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $1,980 $2,475 0.6×
Laryngoscopy Flexible Diagnostic (31575) $870.32 $1,087.90 4.4×
Laryngoscopy Indirect Diagnostic Spx (31505) $813.12 $1,016.40 4.1×
Laryngoscopy,Direct,Diagnostic (31525) $2,072.40 $2,590.50 1.2×
Liver Biopsy (47000) $1,496 $1,870 0.9×
Nasal surgery procedure (30999) $893.20 $1,116.50 3.8×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $182.16 $227.70 0.4×
Ndl Emg Stds Emg Anal/Urtl Sphnctr Any Tq (51785) $293.92 $367.40 1.2×
Perq replacement gtube not req revj gstrst trc (43762) $131.12 $163.90 0.5×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $66 $82.50 1.1×
Removal/bivalving full arm/full leg cast (29705) $286.40 $358 1.0×
Removal/bivalving gauntlet boot/body cast (29700) $286.40 $358 1.0×
Replace g/c tube perc (49450) $3,743.52 $4,679.40 4.1×
Replacement gastro-jejunostomy tube percutaneous (49452) $3,569.28 $4,461.60 3.9×
Rmvl fecal impaction/fb spx under anes (45915) $1,163.36 $1,454.20 1.0×
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $599.28 $749.10 1.0×
Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) $940.72 $1,175.90 1.5×
Simple Cystometrogram (51725) $1,326.16 $1,657.70 5.3×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $308 $385 1.5×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $220 $275 1.1×
Trach Tube Change (31502) $79.20 $99 0.3×
Tracheobrnchsc Thru Est Trachs Inc (31615) $1,438.80 $1,798.50 2.7×