Procedures & surgery prices at San Luis Valley Health Regional Medical Center

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

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $715.82 $1,301.50 0.7×
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $125.95 $229 0.1×
Acne Surgery (10040) $175.45 $319 0.8×
Appl Mlt-Layer Venous Wound Compress Below Knee (29581) $137.50 $250 0.8×
Application cast elbow finger short arm (29075) $235.40 $428 0.8×
Application cast shoulder hand long arm (29065) $235.40 $428 0.8×
Application finger splint static (29130) $155.10 $282 1.1×
Application long arm splint shoulder hand (29105) $182.60 $332 1.1×
Application long leg splint thigh ankle/toes (29505) $136.95 $249 0.8×
Application short arm splint forearm-hand static (29125) $210.10 $382 1.5×
Application short leg splint calf foot (29515) $66 $120 0.4×
Apply short leg cast (29405) $235.40 $428 0.8×
Arterial puncture (36600) $129.80 $236 0.9×
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) $311.85 $567 1.0×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $254.10 $462 0.8×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $254.10 $462 0.8×
Aspirat/Injection Ganglion Cyst(S) (20612) $254.10 $462 0.8×
Avulsion nail plate partial/complete simple 1 (11730) $104.50 $190 0.5×
Biopsy bone trocar/needle deep (20225) $299.75 $545 0.2×
Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) $73.15 $133 0.1×
Biopsy external ear (69100) $45.65 $83 0.2×
Biopsy of lip (40490) $206.25 $375 0.8×
Biopsy of mouth lesion (40808) $440.55 $801 0.8×
Biopsy of tongue (41100) $440.55 $801 0.8×
Biopsy of uterus lining (58100) $61.60 $112 0.3×
Bladder Instillation Anticarcinogenic Agent (51720) $163.90 $298 0.2×
Bladder Irrigation Simple (51700) $259.60 $472 1.0×
Bladder Scan (51798) $52.52 $95.50 0.8×
Blood transfusion service (36430) $330 $600 0.7×
Bx breast 1st lesion strtctc (19081) $2,122.45 $3,859 1.2×
Bx breast 1st lesion us imag (19083) $2,046.55 $3,721 1.2×
Change Cystostomy Tube Simple (51705) $60.50 $110 0.2×
Chemical Cautery Tissue (17250) $175.45 $319 0.8×
Chg Collect Blood From Catheter Venous Nos (36592) $80.85 $147 0.6×
Circumcision Neonate (54160) $282.70 $514 0.4×
Closed Rx Gr Tuberosity Hum Fx (23620) $201.30 $366 0.8×
Closed Rx Humeral Supracondylar Fx (24530) $219.45 $399 0.8×
Closed Rx Med Malleolus Fx (27760) $200.75 $365 0.8×
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $1,354.65 $2,463 0.8×
Closed Rx Tibial Plateau Fx (27530) $201.30 $366 0.8×
Closed Rx Trimalleolar Fx (27816) $200.75 $365 0.8×
Closed Treat Vert Body Fract (22310) $218.90 $398 0.8×
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation (24576) $218.90 $398 0.8×
Closed Treatment Ulnar Styloid Fracture (25650) $219.45 $399 0.8×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $1,091.75 $1,985 0.6×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $201.30 $366 0.8×
Closed tx calcaneal fracture w/o manipulation (28400) $334.40 $608 1.3×
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 patellar fracture w/o manipulation (27520) $210.65 $383 0.8×
Closed tx radial head/neck fx w/o manipulation (24650) $201.30 $366 0.8×
Closed tx scapular fracture w/o manipulation (23570) $201.30 $366 0.8×
Closed tx ulnar fracture prox end w/o manipulate (24670) $162.80 $296 0.6×
Closed tx ulnar shaft fracture w/o manipulation (25530) $201.30 $366 0.8×
Clsd tx clavicular fracture w/o manipulation (23500) $201.02 $365.50 0.8×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $446.05 $811 1.7×
Cltx dstl fibular fx lat malls w/o manj (27786) $201.02 $365.50 0.8×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $201.30 $366 0.8×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $237.32 $431.50 0.9×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,283.70 $2,334 0.8×
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $201.30 $366 0.8×
Cltx fx grt toe phlx/phlg w/o manj (28490) $335.50 $610 1.3×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $201.02 $365.50 0.8×
Cltx iphal jt dislc w/manj w/o anes (26770) $339.90 $618 1.3×
Cltx metacarpal fx w/manipulation each bone (26605) $219.45 $399 0.8×
Cltx metacarpal fx w/o manipulation each bone (26600) $221.92 $403.50 0.9×
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $394.90 $718 1.5×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $497.75 $905 1.9×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $201.30 $366 0.8×
Cltx Post Hip Arthrp Dislc Req Anes (27266) $2,061.95 $3,749 1.2×
Cltx post hip arthrp dislc w/o anes (27265) $364.10 $662 1.4×
Cltx prox fibula/shft fx w/o manj (27780) $200.75 $365 0.8×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $219.45 $399 0.8×
Cltx tibial shaft fx w/manj w/wo skel tracj (27752) $2,631.75 $4,785 1.6×
Cltx trimalleolar ankle fx w/manipulation (27818) $970.20 $1,764 0.6×
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $78.65 $143 0.2×
Colposcopy entire vagina w/cervix if present (57420) $66.55 $121 0.2×
Colposcopy vulva (56820) $50.60 $92 0.2×
Complex Uroflowmetry (51741) $135.85 $247 0.6×
Control Nasal Hemorrhage Anterior Complex (30903) $113.30 $206 0.8×
Control Nasal Hemorrhage Anterior Simple (30901) $96.25 $175 0.7×
Core Needle Bx Lung/Mediastinum Perq W/Img (32408) $1,368.95 $2,489 0.8×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $109.45 $199 0.8×
Cysto W/Simple Removal Stone & Stent (52310) $182.05 $331 0.1×
Cystourethroscopy (52000) $559.35 $1,017 0.8×
Debride nail 1-5 (11720) $54.45 $99 0.9×
Debride nail 6 or more (11721) $54.45 $99 0.9×
Debridement subcutaneous tissue 20 sq cm/< (11042) $337.15 $613 0.8×
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $637.45 $1,159 0.8×
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $1,368.95 $2,489 0.8×
Declot vascular device (36593) $97.35 $177 0.3×
Destruc Benign/Premal,15+ Lesions (17004) $337.15 $613 0.8×
Destruction Benign Lesions Up To 14 (17110) $175.45 $319 0.8×
Destruction mal lesion trunk/arm/leg 0.6-1.0 cm (17261) $170.50 $310 0.8×
Destruction mal lesion trunk/arm/leg 3.1-4.0cm (17264) $337.15 $613 0.8×
Destruction premalignant lesion 1st (17000) $175.45 $319 0.8×
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $419.10 $762 0.6×
Drainage of gum lesion (41800) $224.40 $408 1.6×
Drainage of hematoma/fluid (10140) $256.85 $467 0.1×
Draw blood off venous device (36591) $107.80 $196 0.8×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $343.75 $625 0.8×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $216.70 $394 1.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $216.70 $394 1.0×
Dry Needling 3+ Muscles (20561) $64.35 $117 2.1×
Evacuation of subungual hematoma (11740) $20.90 $38 0.1×
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $1,368.95 $2,489 0.8×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $605.55 $1,101 0.8×
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $337.15 $613 0.8×
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $605.55 $1,101 0.8×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $605.55 $1,101 0.8×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $1,368.95 $2,489 0.8×
Exc Skin Malig >4 Cm Face,Facial (11646) $2,113.65 $3,843 0.7×
Exc Skin Malig >4 Cm Remaindr Body (11626) $2,305.05 $4,191 0.8×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $1,368.95 $2,489 0.8×
Exc tr-ext b9+marg 0.5 cm or less (11400) $605.55 $1,101 0.8×
Exc tumor soft tissue neck/ant thorax subq <3cm (21555) $1,368.95 $2,489 0.8×
Excise/repair mouth lesion (40812) $1,371.87 $2,494.31 0.8×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $235.95 $429 0.6×
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $605.55 $1,101 0.8×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $605.55 $1,101 0.8×
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $605.55 $1,101 0.8×
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $2,098.25 $3,815 1.2×
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $605.55 $1,101 0.8×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $1,368.95 $2,489 0.8×
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $86.90 $158 0.1×
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $605.55 $1,101 0.8×
Excision of lesion other than skin tag </= 0.5 cm (11420) $1,368.95 $2,489 0.8×
External Cephalic Version (59412) $485.10 $882 0.1×
Fetal non-stress test (59025) $364.10 $662 1.7×
Fine needle aspiration bx w/us gdn 1st lesion (10005) $875.05 $1,591 1.2×
Fluid pressure muscle (20950) $652.30 $1,186 0.9×
Fluoro exam of g/colon tube (49465) $500.50 $910 2.0×
Guide Cathet Fluid Drainage (10030) $2,094.95 $3,809 2.8×
I&D Abscess Peritonsillar (42700) $206.25 $375 0.8×
I&d abscess simple (10060) $194.70 $354 0.9×
I&d epididymis tstis&/scrotal space (54700) $1,744.05 $3,171 0.8×
I&d perianal abscess superficial (46050) $1,619.20 $2,944 1.7×
I&d pilonidal cyst simple (10080) $73.15 $133 0.1×
Incision & drainage abscess complicated/multiple (10061) $273.90 $498 0.6×
Incision & removal foreign body subq tiss simple (10120) $337.15 $613 0.8×
Incision and drainage of bartholin's gland abscess (56420) $326.70 $594 1.5×
Incision and drainage of vulva or perineal abscess (56405) $273.90 $498 0.9×
Incision thrombosed hemorrhoid external (46083) $96.80 $176 0.4×
Incisional biopsy skin single lesion (11106) $401.50 $730 0.5×
Initial tx 1st degree burn local tx (16000) $170.50 $310 0.8×
Inj tendon sheath/ligament (20550) $317.90 $578 1.0×
Inj,Anes Agent,Femoral Nerve,Single (64447) $168.85 $307 0.2×
Injection aa&/strd trigeminal nerve each branch (64400) $73.15 $133 0.2×
Injection anes other peripheral nerve/branch (64450) $145.75 $265 0.2×
Injection single/mlt trigger point 1/2 muscles (20552) $254.10 $462 0.8×
Injection single/mlt trigger point 3/> muscles (20553) $254.10 $462 0.8×
Injection therapeutic carpal tunnel (20526) $254.10 $462 0.8×
Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or… (62325) $188.10 $342 0.2×
Injection, anesthetic agent; sphenopalatine ganglion (64505) $235.40 $428 0.7×
Injection, intralesional; up to and including 7 lesions (11900) $175.45 $319 0.8×
Insert Bladder Cath Complex (51703) $383.90 $698 2.8×
Insert cervical dilator (59200) $297 $540 0.9×
Insert Drug Implant Device (11981) $109.45 $199 0.8×
Insert non-tunnel cv cath (36556) $1,832.60 $3,332 0.6×
Insert pessary/other device (57160) $36.85 $67 0.2×
Insert picc cath (36569) $1,364.55 $2,481 0.8×
Insert Temp Bladder Cath (51702) $121.55 $221 0.9×
Insert,Non-Indwelling Bladder Catheter (51701) $97.35 $177 0.7×
Insertion Picc W/Rs&I 5 Yr/> (36573) $1,562 $2,840 0.9×
Intubation endotracheal emergency procedure (31500) $207.90 $378 0.8×
Laryngoscopy Flexible Diagnostic (31575) $160.05 $291 0.8×
Ligation of hemorrhoid(s) (46221) $507.38 $922.50 0.5×
Liver Biopsy (47000) $1,644.50 $2,990 0.9×
Nasal Endoscopy Diagnostic Uni/Bi Spx (31231) $160.05 $291 0.8×
Nasal/Sinus Ndsc Surg W/Bx Polypc/Dbrdmt Spx (31237) $1,101.65 $2,003 0.6×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $263.45 $479 0.6×
Needle insertion w/o injection 1 or 2 muscles (20560) $57.75 $105 1.9×
Neuroeltrd stim post tibial (64566) $45.65 $83 0.1×
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $748 $1,360 1.8×
Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) $435.05 $791 0.1×
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $1,419.55 $2,581 1.9×
Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) $485.10 $882 0.5×
Perq dev breast 1st strtctc (19283) $970.20 $1,764 1.3×
Perq dev breast 1st us imag (19285) $425.70 $774 0.6×
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $227.70 $414 0.1×
Perq replacement gtube not req revj gstrst trc (43762) $229.35 $417 0.9×
Placement of needle for intraosseous infusion (36680) $354.20 $644 0.8×
Punch biopsy skin single lesion (11104) $642.20 $1,167.63 1.5×
Puncture Aspiration (10160) $196.90 $358 0.5×
Puncture Aspiration Cyst Breast (19000) $661.65 $1,203 0.9×
Removal fb intranasal (30300) $68.75 $125 0.5×
Removal impacted cerumen irrigation/lvg unilat (69209) $38.78 $70.50 0.6×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $54.18 $98.50 0.9×
Removal Implant Superficial Separate Procedure (20670) $1,368.95 $2,489 0.8×
Removal of intrauterine device (iud) (58301) $273.90 $498 0.9×
Removal of nail bed (11750) $257.95 $469 0.6×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $175.45 $319 0.8×
Removal/bivalving gauntlet boot/body cast (29700) $235.40 $428 0.8×
Remove drug implant device (11982) $263.45 $479 0.6×
Remv Ext Canal Foreign Body (69200) $52.80 $96 0.4×
Remv F.B.,Eye,Superf Conjunc (65205) $42.90 $78 0.3×
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $520.85 $947 0.7×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $510.40 $928 0.7×
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 (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&/muc 2.5 cm/< (12051) $207.90 $378 0.5×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $337.15 $613 0.8×
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/< (12031) $337.15 $613 0.8×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $237.05 $431 0.6×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $215.60 $392 0.5×
Repair intermediate s/a/t/e >30.0 cm (12037) $278.85 $507 0.1×
Repair of nail bed (11760) $510.40 $928 0.7×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $55 $100 0.1×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $109.45 $199 0.8×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $63.80 $116 0.3×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $86.35 $157 0.4×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $175.45 $319 0.8×
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $175.45 $319 0.8×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $115.78 $210.50 0.5×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $178.20 $324 0.8×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $246.95 $449 1.2×
Skin sub graft face/nk/hf/g (15275) $1,668.70 $3,034 2.1×
Skin sub graft trnk/arm/leg (15271) $1,578.50 $2,870 2.0×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $246.95 $449 1.2×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $138.05 $251 0.3×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $163.90 $298 0.4×
Spinal puncture lumbar diagnostic (62270) $608.30 $1,106 0.8×
Strapping unna boot (29580) $137.50 $250 0.8×
Tangential biopsy skin single lesion (11102) $175.45 $319 0.4×
Tenotomy Percutaneous Toe Single Tendon (28010) $1,354.65 $2,463 0.8×
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $1,146.75 $2,085 1.7×
Thoracentesis needle/cath pleura w/o imaging (32554) $212.30 $386 0.3×
Transabdominal Amnioinfusion W/Ultrsnd Guidance (59070) $515.90 $938 1.6×
Treat Fracture Radius & Ulna (25560) $201.30 $366 0.8×
Treat humerus fracture (24500) $158.40 $288 0.6×
Treat humerus fracture (23600) $201.02 $365.50 0.8×
Treat wrist bone fracture (25622) $200.75 $365 0.8×
Treat Wrist Bone Fracture (25630) $201.30 $366 0.8×
Treatment closed elbow dislocation w/o anes (24600) $455.40 $828 1.8×
Trim skin lesion (11055) $175.45 $319 0.8×
Trim skin lesions 2 to 4 (11056) $175.45 $319 0.8×
Trimming Of Nondystrophic Nails, Any Number (11719) $54.45 $99 0.9×
Tympanostomy (69433) $449.35 $817 0.8×
Vasectomy (55250) $256.30 $466 0.1×
Venipuncture (36415) $15.40 $28 1.6×