Visits & medical services prices at Sheridan Memorial Hospital

Sheridan, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acoustic immitance testing (92570) $104.80 $131 0.8×
Administration of chemotherapy into artery using push technique (96420) $292.80 $366 0.9×
Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord (96450) $1,030.40 $1,288 3.1×
Advance care planning first 30 mins (99497) $318.40 $398 3.1×
Aerosol inhalation pentamidine (94642) $239.20 $299 1.1×
Airway inhalation treatment (94640) $48 $60 0.2×
Allergy injection single (95115) $20.80 $26 0.4×
Appl on-body injector for timed subq injection (96377) $111.20 $139 2.3×
Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) $28 $35
Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) $68.80 $86
Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) $49.20 $61.50
Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) $39.20 $49
Application of a modality to 1 or more areas; vasopneumatic devices Other Outpatient (97016) $86.80 $108.50
Assessment of aphasia (96105) $228.40 $285.50
Behav assmt w/score & docd/stand instrument (96127) $15.60 $19.50 0.4×
Behavioral & qualit analysis voice and resonance (92524) $256.80 $321
Bfb training ea addl 15 min (90913) $105.60 $132
Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when… (90912) $237.60 $297
Bipap initial day (94660) $422.40 $528 1.9×
Breathing capacity test (94010) $80 $100 0.4×
Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) $208 $260 0.5×
Canalith repositioning (95992) $91.60 $114.50
Cardiovascular procedure unlisted (93799) $2,044 $2,555 15.5×
Cardiovascular stress test (93017) $463.60 $579.50 2.1×
Cardioversion elective external (92960) $828 $1,035 1.2×
Cardioversion elective internal (92961) $1,230.40 $1,538 1.8×
Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a… (99484) $84 $105 2.2×
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93460) $1,883.60 $2,354.50 0.6×
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93459) $1,953.20 $2,441.50 0.6×
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary… (93458) $3,033.60 $3,792 0.9×
Chemo anti-neopl sq/im (96401) $269.60 $337 3.7×
Chemo hormon antineopl sq/im (96402) $147.20 $184 2.0×
Chemo IV infus each addl seq (96417) $359.20 $449 4.9×
Chemo IV infusion addl hr (96415) $167.20 $209 2.3×
Chemo IV push addl drug (96411) $279.20 $349 3.8×
Chemother prolong infuse w/pump (96416) $702.40 $878 2.1×
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) $540 $675 1.6×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $368.80 $461 1.1×
Chest physiotherapy initial (94667) $68.80 $86 0.5×
Chron care mgmt srvc 20 min (99490) $79.20 $99 0.8×
Color/duplex Doppler, complete (93975) $549.20 $686.50 2.3×
Color/duplex Doppler, limited (93976) $343.20 $429 3.2×
Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) $55.20 $69
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) $250.40 $313 1.4×
Comprehensive hearing test (92557) $121.60 $152 0.9×
Conditioning play audiometry (92582) $181.60 $227 1.4×
Cont gluc mntr physician/qhp provided equipment (95250) $307.20 $384 2.3×
Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) $88 $110 0.6×
Coronary art/grft angio s&i (93455) $3,590.40 $4,488 1.1×
Coronary artery angio s&i (93454) $4,743.20 $5,929 1.4×
Cpr (92950) $962.40 $1,203 4.4×
Critical care ill/injured patient init 30-74 min (99291) $1,154 $1,442.50 1.4×
Debridement open wound 20 sq cm< (97597) $166.40 $208 0.8×
Developmental tst admin phys/qhp 1st hour (96112) $187.20 $234 1.4×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $162.40 $203 0.4×
Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) $552.80 $691 2.3×
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) $539.20 $674 2.2×
Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) $302.40 $378 2.8×
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) $551.20 $689 2.3×
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) $309.20 $386.50 2.9×
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) $570 $712.50 2.3×
Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) $280.80 $351 2.6×
Ear and throat examination (92502) $353.60 $442 0.6×
ECG monit/reprt up to 48 hrs (93226) $561.60 $702 9.3×
ECG/monitoring and analysis (93271) $1,657.60 $2,072 17.1×
Echo transesophageal (93312) $387.60 $484.50 0.7×
Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) $525.20 $656.50 0.9×
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed,… (93307) $406.40 $508 1.7×
EEG 41-60 minutes (95812) $523.60 $654.50 2.4×
EEG awake & asleep (95819) $659.60 $824.50 3.0×
EEG awake/drowsy (95816) $579.20 $724 2.6×
EEG extended monitoring 61-119 minutes (95813) $669.60 $837 3.0×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $2,148 $2,685 5.6×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $1,792.80 $2,241 4.7×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $1,496.80 $1,871 6.8×
EEG w/o video by tech 2-12 hr unmonitored (95705) $100.80 $126 0.5×
EKG 12 lead tracing only (93005) $91.60 $114.50 1.5×
EKG rhythm strip (93041) $83.20 $104 1.4×
Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes… (93642) $1,249.20 $1,561.50 1.0×
Emergency department visit high mdm (99285) $1,051.20 $1,314 1.7×
Emergency department visit low mdm (99283) $434.80 $543.50 1.6×
Emergency department visit may not req phys/qhp (99281) $164 $205 1.9×
Emergency department visit moderate mdm (99284) $684 $855 1.6×
Emergency department visit straightforward mdm (99282) $296.80 $371 1.9×
End tidal co2 mntrng (crbn dxde exp gas dtrmntn by infrared analyzer) (94799) $165.60 $207 1.3×
Endoscopy swallow (fees) vid (92612) $470.40 $588
Eval aud funcj cand/po surg implt dev 1st hr (92626) $213.20 $266.50 1.6×
Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) $240.80 $301
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $100.80 $126
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) $306.80 $383.50
Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face… (92605) $220 $275
Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face… (92618) $110.40 $138
Evaluation of central auditory function, with report; initial 60 minutes (92620) $184 $230 1.4×
Evaluation of speech fluency (92521) $258.40 $323
Evaluation of speech sound production articulate (92522) $259.20 $324
Evoked auditory test limited (92587) $191.20 $239 0.9×
External ECG rec>48hr<7d recording (93242) $46.40 $58 1.2×
External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) $448 $560 3.3×
Flexible endo swallow w/o c/v eval - eval of swallowing function w/o video & w/ endoscope (92700) $68.80 $86 2.3×
Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; Other Outpatient (92614) $400.80 $501
Flexible ndsc eval swlng&laryn sens c/v rec (92616) $528 $660
Fluidotherapy (97022) $102.40 $128
Imm admn sarscov2 vaccine single dose (90480) $54.40 $68 1.3×
Immunization administration (90471) $75.60 $94.50 1.0×
Infrared therapy (97026) $74.40 $93
Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health… (99492) $256 $320 2.5×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $84 $105 1.8×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $186.40 $233 0.9×
Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath (93503) $253.60 $317 0.2×
Interrog dev eval pm/ldls pm phys/qhp in person (93288) $168 $210 4.4×
Interrog device eval heart (93289) $512 $640 13.4×
Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health… (93291) $148.80 $186 5.0×
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless… (93296) $67.20 $84 1.8×
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) $19.20 $24 0.3×
Irrigaj implntd venous access drug delivery syst (96523) $147.60 $184.50 2.4×
IV infusion hydration each additional hour (96361) $116.80 $146 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $344 $430 1.6×
IV infusion ther proph addl sequential to 1 hr (96367) $156.80 $196 2.1×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $330.40 $413 1.5×
IV tx, each additional hour (96366) $104 $130 2.2×
Laryngeal function studies (ie, aerodynamic testing and acoustic testing) Other Outpatient (92520) $276 $345 2.0×
Loudness balance test, alternate binaural or monaural (92562) $71.20 $89 0.3×
Low frequency non-thermal us (97610) $33.60 $42 0.2×
Lwr xtr vasc stdy bilat (93924) $454.40 $568 2.1×
Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) $68.80 $86 0.5×
Maximum voluntary ventilation (94200) $129.60 $162 2.2×
Measurement of adequacy of hearing protection device (92596) $128 $160 3.4×
Mechanical traction therapy (97012) $88 $110
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $60.80 $76
Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) $50.40 $63
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $225.60 $282
Multi-family group psychotherapy - psychologist (90849) $75.20 $94 0.4×
Muscle test 3 limbs (95863) $467.20 $584 3.6×
Nasopharyngoscopy (92511) $289.20 $361.50 1.4×
Needle electromyography 2 extremities with or without related paraspinal areas 95861 (95861) $127.20 $159 0.9×
Neg pressure wound therapy non dme </= 50 sq cm (97607) $416 $520 1.0×
Neg pressure wound therapy non dme >50 sq cm (97608) $440.80 $551 1.1×
Negative pressure wound therapy dme </= 50 sq cm (97605) $133.60 $167 0.7×
Negative pressure wound therapy dme >50 sq cm (97606) $218.80 $273.50 0.5×
Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, ºeg, acquired knowledge,… (96116) $152 $190 0.7×
Neuromuscular junction test (95937) $200.80 $251 1.5×
Non-invasive physiologic study extremity 3 levels (93923) $262.40 $328 1.2×
Noninvasive ear/pulse oximetry overnight monitor (94762) $165.60 $207 1.3×
Occupational therapy eval high complex 60 mins (97167) $295.20 $369
Occupational therapy eval low complex 30 mins (97165) $187.20 $234
Occupational therapy eval mod complex 45 mins (97166) $244.80 $306
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92002) $233.60 $292 1.7×
Oral function therapy (92526) $155.20 $194
Oral speech device eval (92597) $306.40 $383
Orthc/prostc mgmt sbsq enc (97763) $159.20 $199
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $91.20 $114
Osteopath manj 1-2 regions (98925) $76.80 $96 3.5×
Osteopath manj 3-4 regions (98926) $80 $100 3.6×
Osteopathic manipulative tx 5-6 body regions (98927) $104.80 $131 4.8×
Ot manual therapy ea 15 min (97140) $100.80 $126
Ot neuromuscular re-education (97112) $108 $135
Ot paraffin bath (97018) $24.80 $31
Ot re-evaluation (97168) $144.80 $181
OT Therapeutic Activities Charges (97530) $97.60 $122
Ot wheelchair management (97542) $85.60 $107
Outpatient cardiac rehab w/cont ECG monitoring (93798) $221.60 $277 1.7×
Pdt dstr prmlg les skn illum/activj per day (96567) $332 $415 1.6×
Percutaneous tests w/allergenic extracts (95004) $10.80 $13.50 0.0×
Phlebotomy therapeutic (99195) $214.40 $268 1.6×
Phy/qhp op pulm rhb w/mntr (94626) $227.20 $284 3.8×
Physical therapy evaluation high complex 45 mins (97163) $237.60 $297
Physical therapy evaluation low complex 20 mins (97161) $150.80 $188.50
Physical therapy evaluation mod complex 30 mins (97162) $217.20 $271.50
Pm device progr eval multi (93281) $131.20 $164 3.4×
Pr tympanometry and reflex threshold measurements (92550) $67.20 $84 0.3×
Prepj& allergen immunotherapy 1/mlt antigen (95165) $28 $35 0.6×
Prgrmg dev eval pm/ldls pm (93279) $111.20 $139 2.9×
Professional services for allergen immunotherapy; 2 or more injections (95117) $28.40 $35.50 0.6×
Program eval implantable in persn dual ld pacer (93280) $128.80 $161 3.4×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) $180.80 $226 4.7×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93285) $181.60 $227 4.8×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93284) $247.20 $309 6.5×
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) $164 $205 4.3×
Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) $84 $105
Prq trl rvs ch occ ant&rtrgr (92945) $7,588.80 $9,486 0.6×
Prq trluml coronary angioplasty one art/branch (92920) $7,332.40 $9,165.50 1.3×
Prq trluml coronary byp grft revasc one vessel (92937)
likely a partial charge — not the full procedure
$1,657.60 $2,072 0.1×
Prq trluml coronary stent w/angio one art/brnch (92928) $6,918.40 $8,648 0.6×
Prq trluml coronry chronic occlus revasc one vsl (92943) $10,307.20 $12,884 0.9×
Psych diag eval w/med srvcs (90792) $320 $400 1.8×
Psychiatric diagnostic evaluation (90791) $285.60 $357 1.6×
Psytx crisis initial 60 min (90839) $240 $300 1.3×
Pt gait training 15 min (97116) $81.60 $102
Pt physical performance test (97750) $84 $105
Pt re-evaluation (97164) $136.80 $171
Pulm funct tst plethysmograp (94726) $306.40 $383 0.8×
Pulmonary stress testing (94618) $249.60 $312 1.8×
R hrt art/grft angio (93457) $7,649.20 $9,561.50 2.3×
R hrt coronary artery angio (93456) $7,277.60 $9,097 2.2×
R&l hrt art/ventricle angio (93461) $8,287.60 $10,359.50 2.5×
R&l hrt cath w/ventriclgrphy (93453) $5,794.80 $7,243.50 1.7×
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section… (95851) $106.68 $133.36
Rem interrog scrms <30 d phys/qhp (93298) $76.80 $96 2.0×
Remote 30 day ECG rev/report (93270) $428 $535 11.2×
Review patient spirometry (94016) $71.20 $89
Right heart cath o2 saturation & cardiac output (93451) $2,797.60 $3,497 0.8×
Select picture audiometry (92583) $69.60 $87 1.2×
Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) $84 $105
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) $70.40 $88
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95926) $240.80 $301 1.1×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95925) $275.20 $344 1.2×
Speech audiometry threshold (92555) $34.40 $43 0.6×
Speech sound lang comprehen (92523) $261.60 $327
Standardized cognitive performance testing (96125) $272.80 $341
Stenger test pure tone (92565) $31.20 $39 0.5×
Stenger test speech (92577) $57.60 $72 0.2×
Stress tte only (93350) $319.20 $399 0.6×
Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care… (99493) $259.60 $324.50 2.5×
Telephone assmt&mgmt svc nqhp est pt 5-10 min (98966) $32.80 $41
Temp transcutaneous pacing (92953) $371.60 $464.50 0.6×
Test for ability to detect and repeat spoken words with speech recognition (92556) $97.60 $122 1.6×
Test for hearing various pitches using earphone (92552) $76 $95 0.6×
Test for hearing various pitches using earphone and device placed against the bone (92553) $100 $125 0.8×
Test to assess middle ear muscle reflex (92568) $29.60 $37 0.8×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $43.20 $54
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $51.20 $64
Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) $42.40 $53
Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Other Outpatient (97113) $100.80 $126
Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement… (97124) $72.80 $91
Therapeutic prophylactic/dx injection subq/im (96372) $42.40 $53 0.6×
Therapeutic service(s) for the use of non-speech-generating device, including programming and modification (92606) $171.20 $214
Therapeutic services for the use of speech-generating device, including programming and modification Other Outpatient (92609) $216.80 $271
Tobacco use cessation intensive >10 minutes (99407) $58.80 $73.50 1.5×
Tobacco use cessation intermediate 3-10 minutes (99406) $37.20 $46.50 1.0×
Trans care mgmt 14 day disch (99495) $292 $365 2.1×
Trans care mgmt 7 day disch (99496) $399.60 $499.50 2.9×
Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition,… (93315) $801.60 $1,002 1.4×
Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes… (93293) $127.20 $159 3.3×
Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study Age Under 21 (93304) $422 $527.50 0.8×
Tte congenital complete (93303) $936.80 $1,171 1.7×
Tte f-up or lmtd (93308) $220 $275 0.9×
Tte w/doppler complete (93306) $383.20 $479 0.7×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $119.20 $149
Tx speech language voice commj auditry 2/>indiv (92508) $117.20 $146.50
Tympanometry (92567) $60.80 $76 1.6×
Unlisted allergy/clinical immunologic service or procedure (95199) $229.60 $287 7.8×
Upr/l xtremity art 2 levels (93922) $140.80 $176 1.0×
Ventilation ip/obs initial day (94002) $1,453.60 $1,817 2.3×
Ventilator subsequent day (94003) $1,302.40 $1,628 2.1×
Visual reinforcement audiometry (vra) (92579) $65.60 $82 0.3×
Wound(s) care non-selective (97602) $226.40 $283 1.1×