Procedures & surgery prices at Salem Memorial District Hospital
Salem, MO · every code in this section with a posted price and a Medicare benchmark.
279 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Appl Mltlayr Compres Sys Uparm Lwarm Hand&Fing (29584) range across 6 matching MRF lines |
$149.63–$216.75 | $199.50–$289 | varies |
| Application cast elbow finger short arm (29075) | $575.25 | $767 | 2.1× |
| Application finger splint static (29130) range across 2 matching MRF lines |
$75–$273.75 | $100–$365 | varies |
| Application long arm splint shoulder hand (29105) range across 2 matching MRF lines |
$145.69–$337.50 | $194.25–$450 | varies |
| Application Long Leg Splint (29505) range across 2 matching MRF lines |
$141.75–$337.50 | $189–$450 | varies |
| Application short arm splint forearm-hand static (29125) range across 2 matching MRF lines |
$106.31–$273.75 | $141.75–$365 | varies |
| Application short leg splint calf foot (29515) range across 2 matching MRF lines |
$141.75–$337.50 | $189–$450 | varies |
| Apply Multlay Comprs Lwr Leg (29581) | $216.75 | $289 | 1.3× |
| Apply Short Leg Cast (29405) | $369.75 | $493 | 1.3× |
| Apply short leg cast (29425) | $575.25 | $767 | 2.1× |
| Arterial puncture (36600) | $172.50 | $230 | 1.3× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) range across 2 matching MRF lines |
$76.50–$400.50 | $102–$534 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 2 matching MRF lines |
$145.69–$664.50 | $194.25–$886 | varies |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) | $600 | $800 | 2.0× |
| Aspirate pleura w/ imaging (32555) range across 2 matching MRF lines |
$281.25–$1,347 | $375–$1,796 | varies |
| Aspirate Pleura W/O Imaging (32554) | $366.75 | $489 | 0.6× |
| Avulsion nail plate partial/complete simple 1 (11730) range across 2 matching MRF lines |
$174.75–$429 | $233–$572 | varies |
| Bladder Irrigation (51700) range across 2 matching MRF lines |
$116.25–$529.50 | $155–$706 | varies |
| Blood Transfusion Service (36430) range across 3 matching MRF lines |
$236.25–$608.25 | $315–$811 | varies |
| Catheter aspiration nasotracheal spx (31720) | $288 | $384 | 1.3× |
| Change Cystostomy Tube Simple (51705) range across 3 matching MRF lines |
$146.25–$408 | $195–$544 | varies |
| Chemical Cautery Tissue (17250) | $337.50 | $450 | 1.7× |
| Chemical Pleurodesis (32560) | $1,346.25 | $1,795 | 2.1× |
| Chest tube placement (32551) range across 2 matching MRF lines |
$574.88–$3,433.50 | $766.50–$4,578 | varies |
| Circumcision w/clamp/oth dev w/block (54150) | $2,742.75 | $3,657 | 1.3× |
| Cl Tx Scapular Fx; W Manip (23575) | $2,133.75 | $2,845 | 1.3× |
| Clear outer ear canal (69200) range across 2 matching MRF lines |
$141.75–$273.75 | $189–$365 | varies |
| Closed Treatment Sternum Fracture (21820) | $505.50 | $674 | 2.0× |
| Closed tx ankle dislocation w/o anesthesia (27840) range across 2 matching MRF lines |
$505.50–$523.50 | $674–$698 | varies |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) range across 2 matching MRF lines |
$898.50–$3,600.75 | $1,198–$4,801 | varies |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) | $570.94 | $761.25 | 2.3× |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) | $736.31 | $981.75 | 3.0× |
| Closed tx knee dislocation w/o anesthesia (27550) | $505.50 | $674 | 2.0× |
| Closed tx metatarsal fracture w/o manipulation (28470) | $505.50 | $674 | 2.0× |
| Closed tx patellar dislocation w/o anesthesia (27560) range across 2 matching MRF lines |
$505.50–$856.04 | $674–$1,141.39 | varies |
| Closed Tx Patellar Fracture W/O Manipulation (27520) | $505.50 | $674 | 2.0× |
| Closed tx radial head/neck fx w/manipulation (24655) | $2,250 | $3,000 | 1.4× |
| Closed tx radial head/neck fx w/o manipulation (24650) | $450 | $600 | 1.8× |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) | $505.50 | $674 | 2.0× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) | $2,625 | $3,500 | 1.6× |
| Closed tx radial&ulnar shaft fractures w/o man (25560) | $505.50 | $674 | 2.0× |
| Closed tx talus fracture w/o manipulation (28430) | $505.50 | $674 | 2.0× |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) | $505.50 | $674 | 2.0× |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) | $505.50 | $674 | 2.0× |
| Closed tx ulnar shaft fracture w/o manipulation (25530) range across 2 matching MRF lines |
$402.75–$505.50 | $537–$674 | varies |
| Clsd tx acromioclavicular dislc w/manipulation (23545) | $505.50 | $674 | 2.0× |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) | $505.50 | $674 | 2.0× |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) | $2,133.75 | $2,845 | 1.3× |
| Clsd tx clavicular fracture w/o manipulation (23500) range across 2 matching MRF lines |
$480.75–$505.50 | $641–$674 | varies |
| Clsd tx shoulder dislc w/manipulation req anes (23655) | $1,875 | $2,500 | 1.2× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) range across 2 matching MRF lines |
$499.50–$505.50 | $666–$674 | varies |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) | $1,125 | $1,500 | 0.7× |
| Cltx Carpal Bone Fx W/O Manj Each Bone (25630) | $505.50 | $674 | 2.0× |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) | $505.50 | $674 | 2.0× |
| Cltx dstl fibular fx lat malls w/manj (27788) range across 2 matching MRF lines |
$505.50–$1,053 | $674–$1,404 | varies |
| Cltx dstl fibular fx lat malls w/o manj (27786) | $505.50 | $674 | 2.0× |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) | $505.50 | $674 | 2.0× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) range across 2 matching MRF lines |
$401.25–$505.50 | $535–$674 | varies |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) | $476.44 | $635.25 | 1.9× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) range across 3 matching MRF lines |
$1,053–$3,445.50 | $1,404–$4,594 | varies |
| Cltx Fem Fx Prox End Nck W/O Manj (27230) | $732.38 | $976.50 | 3.0× |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) range across 2 matching MRF lines |
$1,050–$2,025 | $1,400–$2,700 | varies |
| Cltx fx grt toe phlx/phlg w/manj (28495) | $505.50 | $674 | 2.0× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) range across 2 matching MRF lines |
$258.75–$505.50 | $345–$674 | varies |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) | $271.69 | $362.25 | 1.1× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) range across 2 matching MRF lines |
$250.50–$505.50 | $334–$674 | varies |
| Cltx Greater Trochanteric Fx W/O Manj (27246) | $505.50 | $674 | 2.0× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) | $505.50 | $674 | 2.0× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) | $505.50 | $674 | 2.0× |
| Cltx iphal jt dislc w/manj w/o anes (26770) range across 2 matching MRF lines |
$505.50–$523.50 | $674–$698 | varies |
| Cltx Medial Ankle Fx (27760) | $505.50 | $674 | 2.0× |
| Cltx metacarpal fx w/manipulation each bone (26605) | $505.50 | $674 | 2.0× |
| Cltx metacarpal fx w/o manipulation each bone (26600) | $505.50 | $674 | 2.0× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) range across 2 matching MRF lines |
$505.50–$523.50 | $674–$698 | varies |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) range across 2 matching MRF lines |
$473.32–$505.50 | $631.09–$674 | varies |
| Cltx prox fibula/shft fx w/o manj (27780) | $505.50 | $674 | 2.0× |
| Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) | $736.31 | $981.75 | 3.0× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) range across 2 matching MRF lines |
$220.50–$505.50 | $294–$674 | varies |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) | $1,875 | $2,500 | 1.2× |
| Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) | $505.50 | $674 | 2.0× |
| Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) | $505.50 | $674 | 2.0× |
| Cltx tibial fx proximal w/o manipulation (27530) | $505.50 | $674 | 2.0× |
| Cltx tibial shaft fx w/o manipulation (27750) range across 2 matching MRF lines |
$507.94–$937.50 | $677.25–$1,250 | varies |
| Cltx trimalleolar ankle fx w/manipulation (27818) range across 2 matching MRF lines |
$1,106.25–$3,445.50 | $1,475–$4,594 | varies |
| Cltx trimalleolar ankle fx w/o manipulation (27816) | $598.50 | $798 | 2.4× |
| Collect Blood From Catheter Venous Nos (36592) range across 2 matching MRF lines |
$172.50–$273.75 | $230–$365 | varies |
| Collection of venous blood by venipuncture (36415) range across 5 matching MRF lines |
$9.75–$37.50 | $13–$50 | varies |
| Colonoscopy thru stoma (44388) | $1,959 | $2,612 | 2.1× |
| Colonoscopy w/ablation (45388) | $2,529.75 | $3,373 | 2.1× |
| Colonoscopy w/submucosal inj (45381) | $2,529.75 | $3,373 | 2.1× |
| Colsc Flexible W/Control Bleeding Any Method (45382) | $2,529.75 | $3,373 | 2.1× |
| Colsc flx w/removal lesion by hot bx forceps (45384) | $2,529.75 | $3,373 | 2.1× |
| Control Nasal Hemorrhage Anterior Complex (30903) range across 2 matching MRF lines |
$273.75–$300 | $365–$400 | varies |
| Control Nasal Hemorrhage Anterior Simple (30901) range across 2 matching MRF lines |
$150–$241.50 | $200–$322 | varies |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) | $567 | $756 | 4.3× |
| Cysto w/removal of lesions small (52224) | $7,472.25 | $9,963 | 2.1× |
| Cysto W/Simple Removal Stone & Stent (52310) | $4,366.50 | $5,822 | 2.1× |
| Cysto w/ureteroscopy w/lithotripsy (52353) | $11,092.50 | $14,790 | 2.1× |
| Cysto W/Urtroscopy&/Pyeloscopy Dx (52351) | $7,473.75 | $9,965 | 2.1× |
| Cystourethroscopy inj chemodenervation bladder (52287) | $4,366.50 | $5,822 | 2.1× |
| Cystourethroscopy W/Dest &/Rmvl Tumor Large (52240) | $11,092.50 | $14,790 | 2.1× |
| Cystourethroscopy w/dil bladder general anesth (52260) | $4,366.50 | $5,822 | 2.1× |
| Cystourethroscopy with direct vision internal urethrotomy (52276) | $4,366.50 | $5,822 | 2.1× |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) range across 2 matching MRF lines |
$500.25–$572.25 | $667–$763 | varies |
| Deb Musc/Fascia 20 Sq Cm/< (11043) | $1,125 | $1,500 | 1.5× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) range across 2 matching MRF lines |
$196.50–$855 | $262–$1,140 | varies |
| Declot vascular device (36593) range across 3 matching MRF lines |
$48.75–$726 | $65–$968 | varies |
| Delivery of placenta (59414) | $4,019.25 | $5,359 | 1.2× |
| Diagnostic sigmoidoscopy (45330) | $1,959 | $2,612 | 2.1× |
| Drainage Abscess/Hematoma Nasal Septum (30020) | $693 | $924 | 1.3× |
| Drainage External Ear Abscess/Hematoma Simple (69000) | $750 | $1,000 | 1.1× |
| Drainage of finger abscess simple (26010) range across 2 matching MRF lines |
$337.50–$429 | $450–$572 | varies |
| Drainage of gum lesion (41800) range across 2 matching MRF lines |
$273.75–$444.75 | $365–$593 | varies |
| Drainage of hematoma/fluid (10140) | $2,155.50 | $2,874 | 1.3× |
| Drainage of scrotal wall abscess (55100) | $3,475.50 | $4,634 | 2.1× |
| Draw Blood Off Venous Device (36591) range across 2 matching MRF lines |
$74.81–$153.75 | $99.75–$205 | varies |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) | $487.50 | $650 | 0.7× |
| Drg Lymph Node Absc/Lymphadenitis Smpl (38300) | $3,632.25 | $4,843 | 1.2× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) | $346.50 | $462 | 0.9× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) | $287.44 | $383.25 | 1.4× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) range across 3 matching MRF lines |
$145.69–$429 | $194.25–$572 | varies |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) | $4,079.25 | $5,439 | 2.1× |
| Egd control bleeding any (43255) | $4,079.25 | $5,439 | 2.1× |
| Egd Flexible Foreign Body Removal (43247) | $1,943.25 | $2,591 | 2.1× |
| Egd guide wire insertion (43248) | $1,943.25 | $2,591 | 2.1× |
| Egd place gastrostomy tube (43246) | $4,079.25 | $5,439 | 2.1× |
| Egd Varices Ligation (43244) | $4,079.25 | $5,439 | 2.1× |
| Endometrial Biopsy (58100) | $90 | $120 | 0.4× |
| Endoscopy Upper Small Intestine (44360) | $4,079.25 | $5,439 | 2.1× |
| Endoscopy upper small intestine w/biopsy (44361) | $4,079.25 | $5,439 | 2.1× |
| Esophagogastroduodenoscopy Submucosal Injection (43236) | $1,943.25 | $2,591 | 2.1× |
| Esophagoscopy Flexible Transoral Diagnostic (43200) | $1,943.25 | $2,591 | 2.1× |
| Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) | $4,079.25 | $5,439 | 2.1× |
| Evacuation of subungual hematoma (11740) range across 2 matching MRF lines |
$65.25–$273.75 | $87–$365 | varies |
| Expl penetrating wound spx abdomen/flank/back (20102) | $1,500 | $2,000 | 0.7× |
| Exploration penetrating wound spx chest (20101) | $2,624.25 | $3,499 | 1.3× |
| Exploration penetrating wound spx extremity (20103) | $861 | $1,148 | 0.5× |
| Exploration Penetrating Wound Spx Neck (20100) | $1,179 | $1,572 | 2.2× |
| Fetal Contraction Stress Test (59020) | $261 | $348 | 1.3× |
| Fetal non-stress test (59025) | $261 | $348 | 1.3× |
| Fine needle aspiration without imaging guidance (10021) range across 2 matching MRF lines |
$136.45–$855 | $181.93–$1,140 | varies |
| Foreskin manipulation (54450) | $529.50 | $706 | 2.1× |
| I&d abscess peritonsillar (42700) | $292.50 | $390 | 1.2× |
| I&d abscess simple (10060) range across 3 matching MRF lines |
$188.25–$429 | $251–$572 | varies |
| I&d perianal abscess superficial (46050) | $1,875 | $2,500 | 2.0× |
| I&d pilonidal cyst complicated (10081) | $531.75 | $709 | 0.7× |
| I&d pilonidal cyst simple (10080) range across 2 matching MRF lines |
$262.50–$1,508.25 | $350–$2,011 | varies |
| Incise external hemorrhoid (46083) | $529.50 | $706 | 2.1× |
| Incision & drainage abscess complicated/multiple (10061) range across 2 matching MRF lines |
$375–$855 | $500–$1,140 | varies |
| Incision & removal foreign body subq tiss compl (10121) | $401.25 | $535 | 0.2× |
| Incision & removal foreign body subq tiss simple (10120) range across 2 matching MRF lines |
$227.25–$855 | $303–$1,140 | varies |
| Incision and drainage of bartholin's gland abscess (56420) | $322.88 | $430.50 | 1.6× |
| Incision and drainage of vulva or perineal abscess (56405) range across 2 matching MRF lines |
$310.50–$687.75 | $414–$917 | varies |
| Incision of rectal abscess (46040) | $1,950.75 | $2,601 | 1.6× |
| Initial Tx 1st Degree Burn Local Tx (16000) range across 2 matching MRF lines |
$114.75–$125.25 | $153–$167 | varies |
| Injection 1 tendon sheath/ligament aponeurosis (20550) | $337.50 | $450 | 1.1× |
| Injection single/mlt trigger point 1/2 muscles (20552) | $400.50 | $534 | 1.3× |
| Injection single/mlt trigger point 3/> muscles (20553) | $400.50 | $534 | 1.3× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) range across 2 matching MRF lines |
$114–$1,482.75 | $152–$1,977 | varies |
| Insert Bladder Cath Complex (51703) range across 2 matching MRF lines |
$158.25–$335.25 | $211–$447 | varies |
| Insert Drug Implant Device (11981) | $174 | $232 | 1.3× |
| Insert non-tunnel cv cath (36556) range across 2 matching MRF lines |
$330.75–$3,000 | $441–$4,000 | varies |
| Insert Temp Bladder Cath (51702) range across 3 matching MRF lines |
$93.75–$273.75 | $125–$365 | varies |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) unusually low: confirm this is the full procedure |
$1,841.25 | $2,455 | 0.3× |
| Insert,Non-Indwelling Bladder Catheter (51701) range across 2 matching MRF lines |
$74.81–$273.75 | $99.75–$365 | varies |
| Insertion Picc W/Rs&I 5 Yr/> (36573) | $1,125 | $1,500 | 0.7× |
| Insj Non-Tunneled Central Venous Cath Age < 5 Y (36555) | $4,385.25 | $5,847 | 1.4× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) | $3,433.50 | $4,578 | 2.2× |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) | $825 | $1,100 | 2.0× |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) | $838.69 | $1,118.25 | 2.1× |
| Intubation endotracheal emergency procedure (31500) range across 3 matching MRF lines |
$315–$523.50 | $420–$698 | varies |
| Laparoscopy, surgical, appendectomy (44970) | $12,369.75 | $16,493 | 2.0× |
| Laser vaporization of prostate (52648) | $11,092.50 | $14,790 | 2.1× |
| Ligj Divj &/Excj Varicose Vein Cluster 1 Leg (37785) | $4,050 | $5,400 | 1.3× |
| Litholapaxy comp/lg > 2.5 cm (52318) range across 2 matching MRF lines |
$4,125–$7,473.75 | $5,500–$9,965 | varies |
| Litholapaxy smpl/sm <2.5 cm (52317) range across 2 matching MRF lines |
$3,375–$7,473.75 | $4,500–$9,965 | varies |
| Lithotripsy, extracorporeal shock wave (50590) range across 2 matching MRF lines |
$7,473.75–$8,953.88 | $9,965–$11,938.50 | varies |
| Nasal/Orogastric W/Tube Plmt (43752) range across 2 matching MRF lines |
$149.63–$853.50 | $199.50–$1,138 | varies |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) range across 2 matching MRF lines |
$139.50–$400.50 | $186–$534 | varies |
| Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) | $252 | $336 | 0.1× |
| Placement of needle for intraosseous infusion (36680) range across 2 matching MRF lines |
$126–$853.50 | $168–$1,138 | varies |
| Prostate laser enucleation (52649) | $11,092.50 | $14,790 | 2.1× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) range across 2 matching MRF lines |
$236.25–$855 | $315–$1,140 | varies |
| Removal foreign body foot deep (28192) | $2,155.50 | $2,874 | 1.3× |
| Removal Foreign Body Foot Subcutaneous (28190) | $368.25 | $491 | 0.5× |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) | $330.75 | $441 | 0.2× |
| Removal impacted cerumen irrigation/lvg unilat (69209) range across 2 matching MRF lines |
$39.48–$131.25 | $52.64–$175 | varies |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) | $74.81 | $99.75 | 1.3× |
| Removal of nail bed (11750) | $529.50 | $706 | 1.3× |
| Removal or bivalving full arm or full leg cast (29705) | $369.75 | $493 | 1.3× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) | $275.25 | $367 | 1.4× |
| Removal/bivalving gauntlet boot/body cast (29700) | $369.75 | $493 | 1.3× |
| Remove drug implant device (11982) | $262.50 | $350 | 0.6× |
| Remove foreign body from eye (65205) | $106.31 | $141.75 | 0.8× |
| Remove Intrauterine Device (58301) | $400.50 | $534 | 1.3× |
| Remove Nasal Foreign Body (30300) range across 2 matching MRF lines |
$204.75–$321.75 | $273–$429 | varies |
| Remove prostate regrowth (52630) | $11,092.50 | $14,790 | 2.1× |
| Remove/Insert Drug Implant (11983) | $412.50 | $550 | 0.9× |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) | $802.50 | $1,070 | 1.1× |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) | $802.50 | $1,070 | 1.1× |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) | $590.25 | $787 | 1.4× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) | $988.31 | $1,317.75 | 2.4× |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) | $541.50 | $722 | 1.3× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) range across 2 matching MRF lines |
$681.19–$1,346.25 | $908.25–$1,795 | varies |
| Repair complex trunk 1.1-2.5 cm (13100) | $519 | $692 | 0.7× |
| Repair complex trunk 2.6-7.5 cm (13101) | $605.25 | $807 | 0.8× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) range across 2 matching MRF lines |
$432–$855 | $576–$1,140 | varies |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) range across 2 matching MRF lines |
$480–$900 | $640–$1,200 | varies |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) range across 2 matching MRF lines |
$554.25–$656.25 | $739–$875 | varies |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) | $626.06 | $834.75 | 1.5× |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) | $838.69 | $1,118.25 | 2.1× |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) | $626.06 | $834.75 | 0.8× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) range across 2 matching MRF lines |
$409.50–$855 | $546–$1,140 | varies |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) range across 2 matching MRF lines |
$401.25–$855 | $535–$1,140 | varies |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) | $579 | $772 | 0.8× |
| Repair Intermediate N/H/F/Xtrnl Gent >30.0 Cm (12047) | $3,375 | $4,500 | 1.6× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) range across 2 matching MRF lines |
$591.75–$855 | $789–$1,140 | varies |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) range across 2 matching MRF lines |
$310.50–$855 | $414–$1,140 | varies |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) range across 2 matching MRF lines |
$459.75–$855 | $613–$1,140 | varies |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) | $1,125 | $1,500 | 1.5× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) range across 2 matching MRF lines |
$508.50–$855 | $678–$1,140 | varies |
| Repair intermediate s/a/t/e >30.0 cm (12037) range across 2 matching MRF lines |
$750–$3,909.75 | $1,000–$5,213 | varies |
| Repair of nail bed (11760) range across 2 matching MRF lines |
$174.75–$1,346.25 | $233–$1,795 | varies |
| Repair tongue laceration (41250) range across 2 matching MRF lines |
$315.75–$624 | $421–$832 | varies |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) range across 2 matching MRF lines |
$86.25–$562.50 | $115–$750 | varies |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) | $273.75 | $365 | 2.1× |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) range across 2 matching MRF lines |
$97.85–$562.50 | $130.46–$750 | varies |
| Rmvl fecal impaction/fb spx under anes (45915) | $2,475 | $3,300 | 2.1× |
| Rplc Gtube No Revj Trc (43762) range across 3 matching MRF lines |
$355.50–$529.50 | $474–$706 | varies |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) range across 2 matching MRF lines |
$239.33–$429.19 | $319.10–$572.25 | varies |
| Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) | $1,346.25 | $1,795 | 1.8× |
| Rpr Lip Full Thickness Vermilion Only (40650) | $1,179 | $1,572 | 2.2× |
| Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) | $2,529.75 | $3,373 | 2.1× |
| Sigmoidoscopy Flx With With Band Ligation(S) (45350) | $2,529.75 | $3,373 | 2.1× |
| Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) | $1,959 | $2,612 | 2.1× |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) | $527.63 | $703.50 | 1.3× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) range across 2 matching MRF lines |
$204.75–$429 | $273–$572 | varies |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) range across 2 matching MRF lines |
$322.88–$429 | $430.50–$572 | varies |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) | $626.06 | $834.75 | 1.5× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) range across 2 matching MRF lines |
$337.50–$429 | $450–$572 | varies |
| Simple Repair F/E/E/N/L/M >30.0 Cm (12018) | $626.06 | $834.75 | 3.1× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) range across 2 matching MRF lines |
$192.94–$429 | $257.25–$572 | varies |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) | $900 | $1,200 | 4.5× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) range across 2 matching MRF lines |
$409.50–$429 | $546–$572 | varies |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) range across 2 matching MRF lines |
$263.81–$429 | $351.75–$572 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) range across 2 matching MRF lines |
$626.06–$855 | $834.75–$1,140 | varies |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) range across 2 matching MRF lines |
$246.75–$854.25 | $329–$1,139 | varies |
| Spinal puncture lumbar diagnostic (62270) | $1,482 | $1,976 | 2.1× |
| Strapping ankle (29540) range across 3 matching MRF lines |
$82.69–$216.75 | $110.25–$289 | varies |
| Strapping elbow or wrist (29260) range across 5 matching MRF lines |
$130.50–$141.75 | $174–$189 | varies |
| Strapping hand/finger (29280) range across 5 matching MRF lines |
$130.50–$141.75 | $174–$189 | varies |
| Strapping Hip (29520) | $172.50 | $230 | 1.3× |
| Strapping knee (29530) range across 7 matching MRF lines |
$82.69–$273.75 | $110.25–$365 | varies |
| Strapping shoulder (29240) | $172.50 | $230 | 1.3× |
| Strapping thorax (29200) | $216.75 | $289 | 1.3× |
| Strapping toes (29550) | $130.50 | $174 | 2.2× |
| Strapping Unna Boot (29580) | $141.75 | $189 | 0.9× |
| Tangential biopsy skin single lesion (11102) range across 2 matching MRF lines |
$93.75–$429 | $125–$572 | varies |
| Thrombolytic Therapy Stroke (37195) | $488.25 | $651 | 1.5× |
| Tracheostomy Emergency Cricothyroid Membrane (31605) | $921.38 | $1,228.50 | 3.9× |
| Transur electr resection of prostate (52601) | $11,092.50 | $14,790 | 2.1× |
| Treat humerus fracture (24500) | $598.50 | $798 | 2.4× |
| Treat humerus fracture (23600) | $409.50 | $546 | 1.7× |
| Treat Knee Fracture(S) (27538) | $505.50 | $674 | 2.0× |
| Treat Knuckle Dislocation (26700) | $505.50 | $674 | 2.0× |
| Treat Metatarsal Fracture (28475) | $505.50 | $674 | 2.0× |
| Treat Thumb Dislocation (26641) | $750 | $1,000 | 3.0× |
| Treat Thumb Fracture (26645) | $2,133.75 | $2,845 | 1.3× |
| Treat toe dislocation (28630) | $505.50 | $674 | 2.0× |
| Treatment closed elbow dislocation w/o anes (24600) range across 2 matching MRF lines |
$505.50–$847.50 | $674–$1,130 | varies |
| Tx Gastro Intub W/Asp (43753) | $149.63 | $199.50 | 0.7× |
| Tx superficial wound dehiscence w/packing (12021) | $268.50 | $358 | 0.7× |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj (28455) | $2,133.75 | $2,845 | 1.3× |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) | $505.50 | $674 | 2.0× |
| Unlisted Procedure Casting/Strapping (29799) | $216.75 | $289 | 1.3× |
| Vaginal delivery only (59409) range across 2 matching MRF lines |
$1,203–$7,154.25 | $1,604–$9,539 | varies |
| Venous Cutdown >1 Y/O (36425) | $315 | $420 | 0.7× |
| Wedge excision skin nail fold (11765) | $854.25 | $1,139 | 2.1× |
| Xcapsl ctrc rmvl insj io lens prosth insj 1+ (66991) range across 2 matching MRF lines |
$4,425–$11,204.25 | $5,900–$14,939 | 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.