Procedures & surgery prices at San Luis Valley Health Conejos County Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis (49082) $125.95 $229 0.1×
Abd paracentesis w/imaging (49083) $284.90 $518 0.3×
Application finger splint static (29130) $155.10 $282 1.1×
Application of long leg splint (thigh to ankle or toes) (29505) $136.95 $249 0.8×
Application of short arm splint (forearm to hand); static (29125) $208.18 $378.50 1.5×
Application of short leg splint (calf to foot) (29515) $66 $120 0.4×
Apply long arm splint (29105) $227.70 $414 1.3×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $255.20 $464 0.8×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $39.05 $71 0.1×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $815.10 $1,482 2.5×
Avulsion of nail plate, partial or complete, simple; single (11730) $33.55 $61 0.2×
Bladder irrigation (51700) $259.60 $472 1.0×
Chest tube placement (32551) $216.15 $393 0.1×
Closed rx humer epicondylr fx,manip (24565) $1,395.35 $2,537 0.8×
Closed treatment of calcaneal fracture; without manipulation (28400) $334.40 $608 1.3×
Closed treatment of clavicular fracture; without manipulation (23500) $201.30 $366 0.8×
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) $201.30 $366 0.8×
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) $201.30 $366 0.8×
Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) $1,284.25 $2,335 0.8×
Closed treatment of knee dislocation; without anesthesia (27550) $308 $560 1.2×
Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) $242.55 $441 0.9×
Closed treatment of patellar fracture, without manipulation (27520) $210.65 $383 0.8×
Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) $497.75 $905 1.9×
Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) $201.30 $366 0.8×
Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) $200.75 $365 0.8×
Closed treatment of proximal humeral fracture; without manipulation (23600) $201.30 $366 0.8×
Closed treatment of radial head or neck fracture; without manipulation (24650) $201.30 $366 0.8×
Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) $219.45 $399 0.8×
Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) $446.05 $811 1.7×
Closed tx bimalleolar ankle fracture w/o manip (27808) $201.30 $366 0.8×
Closed tx metatarsal fracture w/o manipulation (28470) $201.30 $366 0.8×
Closed tx patellar dislocation w/o anesthesia (27560) $212.85 $387 0.8×
Closed tx vert fx w/o manj (22310) $218.90 $398 0.8×
Clsd tx shoulder dislc w/manipulation req anes (23655) $2,156.55 $3,921 1.3×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $273.35 $497 1.1×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,212.75 $2,205 0.7×
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $201.30 $366 0.8×
CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) $2,631.75 $4,785 1.6×
Collect blood from implant venous access device (36591) $107.80 $196 0.8×
Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) $113.30 $206 0.8×
Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) $83.05 $151 0.6×
Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) $67.65 $123 0.1×
Drainage of tonsil abscess (42700) $206.25 $375 0.8×
Ed proc remve fb nasal- hospital (30300) $68.75 $125 0.5×
Ed prof burn medium - hospital (16025) $216.70 $394 1.0×
Ed prof burn small - hospital (16020) $216.70 $394 1.0×
Ed prof catheterization/straight (51701) $97.35 $177 0.7×
Ed prof drain dental abscess-hospital (41800) $224.40 $408 1.6×
Ed prof insert foley cath simple (51702) $121.55 $221 0.9×
Ed prof insert non tunnel cv cath >5 (36556) $1,832.60 $3,332 0.6×
Ed prof int lac 7.6-12.5cm bd - hospital (12034) $94.05 $171 0.2×
Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) $263.45 $479 0.6×
Er inj anesthetic agent, peripheral nerve or branch (64450) $145.75 $265 0.2×
Evac subungual hematoma (11740) $20.90 $38 0.1×
I&d abscess simple/single (10060) $218.90 $398 1.0×
I&d pilonidal cyst simple (10080) $73.15 $133 0.1×
Incision and drainage, perianal abscess, superficial (46050) $1,619.20 $2,944 1.7×
Incision and removal of foreign body, subcutaneous tissues; simple (10120) $337.15 $613 0.8×
Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) $748 $1,360 1.8×
Infusion of drug to dissolve blood clot in brain (37195) $326.15 $593 0.9×
Initial treatment, first degree burn, when no more than local treatment is required (16000) $170.50 $310 0.8×
Injection aa&/strd trigeminal nerve each branch (64400) $73.15 $133 0.2×
Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) $254.10 $462 0.8×
Insertion picc w/o img gdn 5 yr/> (36569) $1,364.55 $2,481 0.8×
Intubation endotracheal (31500) $207.90 $378 0.8×
Lumbar puncture (62270) $608.30 $1,106 0.8×
Meas post-voiding residual urine&/bladder cap (51798) $88 $160 1.4×
Needle insertion w/o injection 1 or 2 muscles (20560) $57.75 $105 1.9×
Needle insertion w/o injection 3 or more muscles (20561) $64.35 $117 2.1×
Perq drainage pleura insert cath w/o imaging (32556) $227.70 $414 0.1×
Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) $56.65 $103 0.1×
Removal foreign body shoulder subcutaneous (23330) $1,500.40 $2,728 0.9×
Removal impacted cerumen irrigation/lvg unilat (69209) $23.10 $42 0.4×
Removal impacted cerumen requiring instrumentation, unilateral (69210) $53.90 $98 0.9×
Removal of foreign body, external eye; conjunctival superficial (65205) $42.90 $78 0.3×
Removal of foreign body, external eye; corneal, without slit lamp (65220) $55 $100 0.1×
Removal of nail bed (11750) $178.75 $325 0.4×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $311.30 $566 0.7×
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) $343.20 $624 0.8×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $510.40 $928 1.2×
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) $78.65 $143 0.2×
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) $337.15 $613 0.8×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $78.65 $143 0.2×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $337.15 $613 0.8×
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) $78.65 $143 0.2×
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) $136.95 $249 0.3×
Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) $184.80 $336 0.4×
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) $520.85 $947 0.7×
RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) $52.80 $96 0.4×
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $1,673.65 $3,043 0.5×
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) $63.80 $116 0.3×
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) $86.35 $157 0.4×
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) $175.45 $319 0.8×
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) $175.45 $319 0.8×
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) $56.10 $102 0.3×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $246.95 $449 1.2×
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) $246.95 $449 1.2×
Strapping unna boot (29580) $43.45 $79 0.3×
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) $892.65 $1,623 1.3×
Transfusion, blood or blood components (36430) $330 $600 0.7×
Treatment of closed elbow dislocation; without anesthesia (24600) $455.40 $828 1.8×
Venipuncture (36415) $15.40 $28 1.6×