Visits & medical services prices at Rio Grande Hospital

Del Norte, CO · every code in this section with a posted price and a Medicare benchmark.

101 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) $110.92 $147.90 1.0×
Airway inhalation treatment (94640) $65.91 $87.88 0.3×
Allergy injection single (95115) $20.22 $26.96 0.4×
Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) $28.13 $37.50
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $48.71 $64.94
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $36.54 $48.72
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $48.71 $64.94
Assmt & care pln pt cog imp (99483) $414.63 $552.84 3.9×
Behav assmt w/score & docd/stand instrument (96127) $30.60 $40.80 0.8×
Bipap initial day (94660) $483.37 $644.49 2.1×
Breathing capacity test (94010) $82.80 $110.40 0.4×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $132.49 $176.65 0.3×
Canalith repositioning (95992) $71.18 $94.91
Cardiovascular stress test (93017) $355.05 $473.40 1.6×
Cardioversion elective external (92960) $351.53 $468.71 0.5×
Caregiver hlth risk assmt score doc stnd instrm (96161) $30.60 $40.80 0.8×
Chron care mgmt srvc 20 min (99490) $41.40 $55.20 0.4×
Color/duplex Doppler, limited (93976) $535.21 $713.61 4.9×
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) $122.40 $163.20 0.7×
Cpr (92950) $440.30 $587.06 1.9×
Critical care ill/injured patient init 30-74 min (99291) $1,021.20 $1,361.60 1.2×
Debridement open wound 20 sq cm< (97597) $244.28 $325.71 1.2×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $773.36 $1,031.15 3.1×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $743.50 $991.33 3.0×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $630.11 $840.15 5.7×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $644.16 $858.88 2.6×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $465.77 $621.03 4.2×
ECG monit/reprt up to 48 hrs (93226) $290 $386.67 4.7×
EKG 12 lead tracing only (93005) $103.70 $138.27 1.7×
Emergency department visit high mdm (99285) $675.81 $901.08 1.1×
Emergency department visit low mdm (99283) $191.14 $254.86 0.7×
Emergency department visit may not req phys/qhp (99281) $69.86 $93.15 0.8×
Emergency department visit moderate mdm (99284) $359 $478.66 0.8×
Emergency department visit straightforward mdm (99282) $132.70 $176.94 0.8×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $296.16 $394.88
Evaluate pt use of inhaler (94664) $36.03 $48.04 0.2×
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $160.82 $214.42 1.1×
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $93.16 $124.21 0.4×
Hot/cold pack (97010) $8.79 $11.72
Im adm intransl/oral 1 vaccine (90473) $19.35 $25.80 0.3×
Imm admn sarscov2 vaccine single dose (90480) $26.78 $35.70 0.6×
Immunization administration (90471) $26.78 $35.70 0.4×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $78.23 $104.31 1.6×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $119.51 $159.34 0.5×
Irrigaj implntd venous access drug delivery syst (96523) $96.67 $128.89 1.6×
IV infusion hydration each additional hour (96361) $64.16 $85.54 1.3×
IV infusion hydration initial 31 min-1 hour (96360) $190.70 $254.27 0.8×
IV infusion ther proph addl sequential to 1 hr (96367) $53.60 $71.48 0.7×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $189.82 $253.10 0.8×
IV tx, each additional hour (96366) $64.16 $85.54 1.3×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $78.23 $104.31 0.6×
Mechanical traction therapy (97012) $36.54 $48.72
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $28.13 $37.50
Negative pressure wound therapy dme </= 50 sq cm (97605) $112 $149.33 0.5×
Occupational therapy eval high complex 60 mins (97167) $139.36 $185.81
Occupational therapy eval mod complex 45 mins (97166) $135.14 $180.18
Oral function therapy (92526) $193.34 $257.79
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $43.06 $57.41
Osteopath manj 1-2 regions (98925) $61.54 $82.05 2.7×
Osteopath manj 3-4 regions (98926) $79.10 $105.47 3.5×
Osteopathic manipulative tx 5-6 body regions (98927) $93.17 $124.22 4.1×
Osteopathic manipulative tx 7-8 body regions (98928) $122.15 $162.87 5.4×
Ot manual therapy ea 15 min (97140) $52.58 $70.11
Ot neuromuscular re-education (97112) $72.07 $96.09
OT Therapeutic Activities Charges (97530) $72.07 $96.09
Ot wheelchair management (97542) $64.94 $86.59
Outpatient cardiac rehab w/cont ECG monitoring (93798) $62.10 $82.80 0.5×
Patch or application test(s) (specify number of tests) (95044) $7.96 $10.61 0.0×
Phlebotomy therapeutic (99195) $103.70 $138.27 0.7×
Phy/qhp op pulm rhb w/mntr (94626) $69 $92 1.1×
Physical therapy evaluation high complex 45 mins (97163) $149.90 $199.87
Physical therapy evaluation low complex 20 mins (97161) $149.90 $199.87
Physical therapy evaluation mod complex 30 mins (97162) $149.90 $199.87
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $2,288.48 $3,051.31 2.5×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $118.25 $157.66 2.4×
Professional services for allergen immunotherapy; 2 or more injections (95117) $27.24 $36.32 0.6×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $70.63 $94.17
Pt gait training 15 min (97116) $48.71 $64.94
Pt re-evaluation (97164) $81.18 $108.24
Pt-focused hlth risk assmt score doc stnd instrm (96160) $30.60 $40.80 0.8×
Pulmonary stress testing (94618) $142.07 $189.42 1.0×
Remote 30 day ECG rev/report (93270) $70.31 $93.74 1.8×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $40.59 $54.12
Speech sound lang comprehen (92523) $318.36 $424.48
Stress tte only (93350) $445.57 $594.09 0.8×
Temp transcutaneous pacing (92953) $231.13 $308.18 0.3×
Test for hearing various pitches using earphone (92552) $43.06 $57.41 0.3×
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $36.54 $48.72
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $48.71 $64.94
Therapeutic prophylactic/dx injection subq/im (96372) $33.40 $44.53 0.4×
Tobacco use cessation intensive >10 minutes (99407) $44.82 $59.76 1.1×
Tobacco use cessation intermediate 3-10 minutes (99406) $21.96 $29.28 0.6×
Tte congenital complete (93303) $1,040.54 $1,387.38 1.8×
Tte f-up or lmtd (93308) $380.54 $507.38 1.5×
Tte w/doppler complete (93306) $1,080.96 $1,441.28 1.9×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $149.41 $199.21
Unlisted modality (specify type and time if constant attendance) (97039) $54.44 $72.58
Upr/l xtremity art 2 levels (93922) $253.38 $337.84 1.8×
Ventilation ip/obs initial day (94002) $680.21 $906.95 1.0×
Ventilator subsequent day (94003) $680.21 $906.95 1.0×
Wound(s) care non-selective (97602) $132.49 $176.65 0.6×