Procedures & surgery prices at Shriners Children’s St. Louis
St. Louis, MO · every code in this section with a posted price and a Medicare benchmark.
400 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) | $15,341.34 | $15,341.34 | 4.3× |
| Adjt tis trns/reargmt f/c/c/m/n/a/g/h/f 10sqcm/< (14040) range across 3 matching MRF lines |
$4,611.75–$15,266.30 | $4,611.75–$15,266.30 | varies |
| Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) | $8,139.16 | $8,139.16 | 3.9× |
| Adjt/Rearrgmt Scalp/Arm/Leg 10.1-30.0 Sq Cm (14021) | $8,139.16 | $8,139.16 | 3.9× |
| Adjustment/Revj Xtrnl Fixation System Req Anes (20693) | $10,391.30 | $10,391.30 | 1.4× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect Local Flap (26952) | $14,037.93 | $14,037.93 | 4.3× |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) | $14,037.93 | $14,037.93 | 4.3× |
| Amputation, leg, through tibia and fibula; re-amputation (27886) | $9,223.50 | $9,223.50 | 2.8× |
| Anal Sp Inf Pmp W/Reprg&Fill (62369) | $604.50 | $604.50 | 2.0× |
| Anal/Urinary Muscle Study (51784) | $425.10 | $425.10 | 3.3× |
| Appl Clubfoot Cast Molding/Manj Long/Short Leg (29450) range across 2 matching MRF lines |
$687.40–$942.10 | $687.40–$942.10 | varies |
| Appl Hip Spica Cast One&One-Half Spica/Both Legs (29325) range across 2 matching MRF lines |
$1,206.73–$16,453.50 | $1,206.73–$16,453.50 | varies |
| Application cast elbow finger short arm (29075) | $1,177.80 | $1,177.80 | 4.2× |
| Application Cast Finger (29086) | $687.40 | $687.40 | 4.2× |
| Application Cast Shoulder Spica (29055) | $1,131.42 | $1,131.42 | 4.0× |
| Application Finger Splint Dynamic (29131) | $291.10 | $291.10 | 4.9× |
| Application finger splint static (29130) | $547.57 | $547.57 | 4.1× |
| Application Hip Spica Cast 1 Leg (29305) | $1,252.48 | $1,252.48 | 4.5× |
| Application long arm splint shoulder hand (29105) | $687.40 | $687.40 | 4.2× |
| Application Long Leg Cast Walker/Ambulatory Type (29355) range across 2 matching MRF lines |
$1,177.80–$1,347.60 | $1,177.80–$1,347.60 | varies |
| Application Long Leg Splint (29505) | $687.40 | $687.40 | 4.2× |
| Application of cylinder cast (thigh to ankle) (29365) | $1,177.80 | $1,177.80 | 4.2× |
| Application of long leg cast (29345) | $1,177.80 | $1,177.80 | 4.2× |
| Application of rigid total contact leg cast (29445) | $1,177.80 | $1,177.80 | 4.2× |
| Application Patellar Tendon Bearing Cast (29435) | $1,177.80 | $1,177.80 | 4.2× |
| Application risser jacket localizer body only (29010) | $10,975.20 | $10,975.20 | 39.2× |
| Application Short Arm Splint Dynamic (29126) | $533.70 | $533.70 | 4.0× |
| Application short arm splint forearm-hand static (29125) | $547.57 | $547.57 | 4.1× |
| Application short leg splint calf foot (29515) | $687.40 | $687.40 | 4.2× |
| Application uniplane external fixation system (20690) | $17,027.77 | $17,027.77 | 2.3× |
| Apply hand/wrist cast (29085) | $687.40 | $687.40 | 4.2× |
| Apply long arm cast (29065) | $1,177.80 | $1,177.80 | 4.2× |
| Apply Short Leg Cast (29405) range across 5 matching MRF lines |
$1,014.30–$11,633.40 | $1,014.30–$11,633.40 | varies |
| Apply short leg cast (29425) range across 3 matching MRF lines |
$1,131.42–$2,262.84 | $1,131.42–$2,262.84 | varies |
| Arrest Epiphyseal Distal Femur (27475) | $8,055.70 | $8,055.70 | 1.1× |
| Arrest Epiphyseal Open Distal Tibia (27730) | $4,903.70 | $4,903.70 | 1.5× |
| Arrst Hemiepiphysl Dstl Femur/Prox Tibia/Fibula (27485) range across 3 matching MRF lines |
$9,223.50–$18,089.46 | $9,223.50–$18,089.46 | varies |
| Arterial puncture (36600) | $573.98 | $573.98 | 4.3× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) | $1,282.23 | $1,282.23 | 4.2× |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) | $3,038.71 | $3,038.71 | 4.3× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) range across 2 matching MRF lines |
$1,282.23–$11,842.92 | $1,282.23–$11,842.92 | varies |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) | $1,392.12 | $1,392.12 | 4.5× |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) | $1,282.23 | $1,282.23 | 4.2× |
| Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments Facility (22800) likely a partial charge, not the full procedure |
$4,660.05 | $4,660.05 | 0.3× |
| Arthroplasty interposition intercarpal or carpometacarpal joints (25447) | $14,037.93 | $14,037.93 | 4.3× |
| Arthroscopy Elbow Surgical Debridement Extensive (29838) | $13,969 | $13,969 | 4.3× |
| Arthroscopy hip w/femoroplasty (29914) | $6,947.35 | $6,947.35 | 1.0× |
| Arthroscopy knee synovectomy limited spx (29875) | $4,903.70 | $4,903.70 | 1.5× |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) | $5,020.83 | $5,020.83 | 1.5× |
| Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Facility (29846) range across 2 matching MRF lines |
$5,487.60–$14,037.93 | $5,487.60–$14,037.93 | varies |
| Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888) range across 4 matching MRF lines |
$4,631.58–$32,145.81 | $4,631.58–$32,145.81 | varies |
| Arthrt Elbow Capsular Excision Capsular Rls Spx (24006) | $6,071.50 | $6,071.50 | 1.9× |
| Arthrt Pst Capsul Rls Ankle W/WO Achll Tdn Lngth (27612) range across 3 matching MRF lines |
$5,195.65–$15,125.14 | $5,195.65–$15,125.14 | varies |
| Aspirate Pleura W/O Imaging (32554) | $2,728.21 | $2,728.21 | 4.3× |
| Aspirate/Inj Ganglion Cyst (20612) | $1,282.23 | $1,282.23 | 4.2× |
| Aspiration and/or injection thyroid cyst (60300) | $3,060.54 | $3,060.54 | 4.3× |
| Avulsion nail plate partial/complete simple 1 (11730) | $966.69 | $966.69 | 4.8× |
| Biopsy Pleura Percutaneous Needle (32400) | $7,071.88 | $7,071.88 | 4.3× |
| Bladder Scan (51798) | $322.50 | $322.50 | 5.5× |
| Blood Transfusion Service (36430) | $1,845.50 | $1,845.50 | 4.2× |
| Capsulectomy or capsulotomy; interphalangeal joint, each joint (26525) | $3,658.40 | $3,658.40 | 2.3× |
| Capsulotomy Midfoot W/Tendon Lengthening (28261) | $3,035.75 | $3,035.75 | 1.9× |
| Capsulotomy, midfoot; medial release only (separate procedure) Facility (28260) | $4,242.30 | $4,242.30 | 1.3× |
| Carpal Tunnel Surgery (64721) | $8,477.10 | $8,477.10 | 4.3× |
| Catheter aspiration nasotracheal spx (31720) | $151.50 | $151.50 | 0.7× |
| Change of Windpipe Airway (31502) | $502.90 | $502.90 | 2.1× |
| Chemical Cautery Tissue (17250) | $314.60 | $314.60 | 1.6× |
| Chemodenerv 1 extrem 5/> mus (64644) | $3,038.71 | $3,038.71 | 4.3× |
| Chemodenerv 1 extremity 1-4 (64642) range across 2 matching MRF lines |
$3,038.71–$7,471.80 | $3,038.71–$7,471.80 | varies |
| Chemodenerv musc neck dyston (64616) | $1,282.23 | $1,282.23 | 4.2× |
| Chemodenerv Parotid&Submandibl Salivary Glnds (64611) | $1,282.23 | $1,282.23 | 4.2× |
| Chemodenerv trunk musc 1-5 (64646) | $604.50 | $604.50 | 0.9× |
| Chemodenerv trunk musc 6/> (64647) | $604.50 | $604.50 | 0.9× |
| Chemodenervation eccrine glands oth area per day (64653) | $1,282.23 | $1,282.23 | 4.2× |
| Chemodenervation of internal anal sphincter (46505) | $5,107 | $5,107 | 4.3× |
| Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) | $1,282.23 | $1,282.23 | 4.2× |
| Circumcision 28 days or older (54161) | $8,747.61 | $8,747.61 | 4.2× |
| Cl Tx Tib Shft Fx W Manip (27752) | $6,765.20 | $6,765.20 | 4.2× |
| Clear outer ear canal (69200) | $547.57 | $547.57 | 4.1× |
| Closed Rx Metacarpal Fx,Percut (26608) | $14,037.93 | $14,037.93 | 4.3× |
| Closed Rx Spontaneous Hip Disloc (27256) | $976.26 | $976.26 | 4.0× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) | $976.26 | $976.26 | 4.0× |
| Closed treatment of posterior malleolus fracture; with manipulation (27768) | $6,765.20 | $6,765.20 | 4.2× |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) | $976.26 | $976.26 | 4.0× |
| Closed Treatment Pst Malleolus Fracture W/O Manj (27767) | $976.26 | $976.26 | 4.0× |
| Closed Treatment Sesamoid Fracture (28530) | $976.26 | $976.26 | 4.0× |
| Closed Treatment Ulnar Styloid Fracture (25650) | $976.26 | $976.26 | 4.0× |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) | $6,765.20 | $6,765.20 | 4.2× |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) | $976.26 | $976.26 | 4.0× |
| Closed Tx Calcaneal Fracture W/Manipulation (28405) | $976.26 | $976.26 | 4.0× |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) range across 2 matching MRF lines |
$619.60–$976.26 | $619.60–$976.26 | varies |
| Closed tx carpal scaphoid fracture w/manj (25624) | $6,765.20 | $6,765.20 | 4.2× |
| Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) | $976.26 | $976.26 | 4.0× |
| Closed tx femoral fracture prox head w/o manj (27267) | $17,345.50 | $17,345.50 | 5.3× |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) | $976.26 | $976.26 | 4.0× |
| Closed tx knee dislocation w/o anesthesia (27550) | $976.26 | $976.26 | 4.0× |
| Closed tx metatarsal fracture w/o manipulation (28470) | $976.26 | $976.26 | 4.0× |
| Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) | $6,765.20 | $6,765.20 | 4.2× |
| Closed tx patellar dislocation w/o anesthesia (27560) | $976.26 | $976.26 | 4.0× |
| Closed Tx Patellar Fracture W/O Manipulation (27520) | $976.26 | $976.26 | 4.0× |
| Closed tx radial head/neck fx w/manipulation (24655) | $6,765.20 | $6,765.20 | 4.2× |
| Closed tx radial head/neck fx w/o manipulation (24650) | $976.26 | $976.26 | 4.0× |
| Closed tx radial shaft fracture w/manipulation (25505) | $14,037.93 | $14,037.93 | 8.7× |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) | $976.26 | $976.26 | 4.0× |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) range across 2 matching MRF lines |
$6,765.20–$11,049.50 | $6,765.20–$11,049.50 | varies |
| Closed tx radial&ulnar shaft fractures w/o man (25560) | $976.26 | $976.26 | 4.0× |
| Closed Tx Sternoclavicular Dislc W/Manipulation (23525) | $976.26 | $976.26 | 4.0× |
| Closed Tx Talus Fracture W/Manipulation (28435) | $6,765.20 | $6,765.20 | 4.2× |
| Closed tx talus fracture w/o manipulation (28430) | $976.26 | $976.26 | 4.0× |
| Closed Tx Ulnar Fracture Prox End W Manipulation (24675) | $6,765.20 | $6,765.20 | 4.2× |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) | $976.26 | $976.26 | 4.0× |
| Closed tx ulnar shaft fracture w/o manipulation (25530) | $976.26 | $976.26 | 4.0× |
| Clsd tx acromioclavicular dislc w/manipulation (23545) | $976.26 | $976.26 | 4.0× |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) | $976.26 | $976.26 | 4.0× |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) | $6,765.20 | $6,765.20 | 4.2× |
| Clsd tx clavicular fracture w/o manipulation (23500) | $976.26 | $976.26 | 4.0× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) | $976.26 | $976.26 | 4.0× |
| Cltx Carpal Bone Fx W/Manj Each Bone (25635) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Carpal Bone Fx W/O Manj Each Bone (25630) | $976.26 | $976.26 | 4.0× |
| Cltx dstl fibular fx lat malls w/manj (27788) | $976.26 | $976.26 | 4.0× |
| Cltx dstl fibular fx lat malls w/o manj (27786) | $976.26 | $976.26 | 4.0× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) | $976.26 | $976.26 | 4.0× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) range across 2 matching MRF lines |
$619.60–$976.26 | $619.60–$976.26 | varies |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) range across 3 matching MRF lines |
$6,765.20–$10,918.14 | $6,765.20–$10,918.14 | varies |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) | $976.26 | $976.26 | 4.0× |
| Cltx Fem Fx Prox End Nck W/Manj W/WO Skel Tracj (27232) | $976.26 | $976.26 | 0.6× |
| Cltx Fem Fx Prox End Nck W/O Manj (27230) | $976.26 | $976.26 | 4.0× |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx fx grt toe phlx/phlg w/manj (28495) | $976.26 | $976.26 | 4.0× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) | $976.26 | $976.26 | 4.0× |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) | $976.26 | $976.26 | 4.0× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) | $976.26 | $976.26 | 4.0× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) | $976.26 | $976.26 | 4.0× |
| Cltx greater humeral tuberosity fx w/o manj (23620) | $976.26 | $976.26 | 4.0× |
| Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx hip dislocation traumatic w/o anesthesia (27250) | $976.26 | $976.26 | 4.0× |
| Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) | $976.26 | $976.26 | 4.0× |
| Cltx humeral condylar fx medial/lateral w/manj (24577) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Humeral Epicondylar Fx Medial/Lat W/Manj (24565) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560) | $976.26 | $976.26 | 4.0× |
| Cltx inter/peri/subtrochanteric fem fx w/o manj (27238) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) | $1,131.42 | $1,131.42 | 4.0× |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) | $976.26 | $976.26 | 4.0× |
| Cltx iphal jt dislc w/manj w/o anes (26770) | $1,131.27 | $1,131.27 | 4.6× |
| Cltx Med Ankle Fx W/Mnpj (27762) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Medial Ankle Fx (27760) | $976.26 | $976.26 | 4.0× |
| Cltx metacarpal fx w/manipulation each bone (26605) | $976.26 | $976.26 | 4.0× |
| Cltx metacarpal fx w/o manipulation each bone (26600) | $976.26 | $976.26 | 4.0× |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) | $976.26 | $976.26 | 4.0× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) | $976.26 | $976.26 | 4.0× |
| Cltx post hip arthrp dislc w/o anes (27265) | $976.26 | $976.26 | 4.0× |
| Cltx prox fibula/shft fx w/manj (27781) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx prox fibula/shft fx w/o manj (27780) | $976.26 | $976.26 | 4.0× |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) | $976.26 | $976.26 | 4.0× |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) | $976.26 | $976.26 | 4.0× |
| Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) | $976.26 | $976.26 | 4.0× |
| Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) | $976.26 | $976.26 | 4.0× |
| Cltx tibial fx proximal w/o manipulation (27530) | $976.26 | $976.26 | 4.0× |
| Cltx tibial shaft fx w/o manipulation (27750) | $976.26 | $976.26 | 4.0× |
| Cltx trimalleolar ankle fx w/manipulation (27818) | $6,765.20 | $6,765.20 | 4.2× |
| Cltx trimalleolar ankle fx w/o manipulation (27816) | $976.26 | $976.26 | 4.0× |
| Collection of venous blood by venipuncture (36415) | $16.70 | $16.70 | 1.8× |
| Complex Cystometrogram (51726) | $1,228.80 | $1,228.80 | 4.9× |
| Construct thumb replacement (26550) | $11,559.10 | $11,559.10 | 3.5× |
| Corrj Hlx Vlgs Bncty Sesmdc Joint Arthrodesis (28297) | $7,239.30 | $7,239.30 | 0.6× |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (28292) | $7,239.30 | $7,239.30 | 2.2× |
| Csf shunt reprogram (62252) | $1,304.68 | $1,304.68 | 4.2× |
| Cystometrogram W/Up (51727) | $2,949.10 | $2,949.10 | 4.2× |
| Cystometrogram W/Vp (51728) | $2,949.10 | $2,949.10 | 4.2× |
| Cystometrogram W/Vp&Up (51729) | $3,359.68 | $3,359.68 | 4.8× |
| Cystourethroscopy (52000) | $3,359.68 | $3,359.68 | 4.8× |
| Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) | $12,182.61 | $12,182.61 | 4.2× |
| Deb Musc/Fascia 20 Sq Cm/< (11043) | $9,223.50 | $9,223.50 | 12.5× |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) | $7,071.88 | $7,071.88 | 4.3× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) | $1,759.40 | $1,759.40 | 4.3× |
| Delay Flap/Sectioning Flap Trunk (15600) | $15,341.34 | $15,341.34 | 4.3× |
| Destruct B9 Lesion 1-14 (17110) | $851.62 | $851.62 | 4.2× |
| Destruction Lesions Vulva Simple (56501) | $8,139.16 | $8,139.16 | 3.9× |
| Destruction premalignant lesion 1st (17000) | $851.62 | $851.62 | 4.2× |
| Drain Cerebro Spinal Fluid (62272) | $2,992.02 | $2,992.02 | 4.2× |
| Drain/inj small joint/bursa w/us (20604) | $1,478.94 | $1,478.94 | 4.8× |
| Drainage external auditory canal abscess (69020) | $3,060.54 | $3,060.54 | 4.3× |
| Drainage external ear abscess/hematoma cmplx (69005) | $7,071.88 | $7,071.88 | 4.3× |
| Drainage External Ear Abscess/Hematoma Simple (69000) | $3,060.54 | $3,060.54 | 4.3× |
| Dressing Change Under Anesthesia (15852) | $2,739.76 | $2,739.76 | 3.7× |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) | $3,060.54 | $3,060.54 | 4.3× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) | $1,759.40 | $1,759.40 | 4.3× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) | $314.60 | $314.60 | 1.6× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) | $314.60 | $314.60 | 1.6× |
| Dstrj Cutaneous Vascular Lesions >50.0 Sq Cm (17108) | $8,626.65 | $8,626.65 | 4.2× |
| Elec Anlys Implt Ithcl/Edrl Pmp W/Repr Phys/Qhp (62370) | $1,304.68 | $1,304.68 | 4.2× |
| Elect Analys Implt Ithcl/Edrl Pump W/Reprgrmg (62368) | $1,304.68 | $1,304.68 | 4.2× |
| Electro-Uroflowmetry First (51741) | $425.10 | $425.10 | 2.0× |
| Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur Facility (27185) | $4,903.70 | $4,903.70 | 1.5× |
| Evacuation of subungual hematoma (11740) | $607.90 | $607.90 | 4.6× |
| Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) | $4,319.80 | $4,319.80 | 2.6× |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Face-Mm B9+Marg 0.5 Cm/< (11440) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) | $7,071.88 | $7,071.88 | 4.3× |
| Exc Face-Mm B9+Marg 3.1-4 Cm (11444) | $7,071.88 | $7,071.88 | 4.3× |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) | $3,060.54 | $3,060.54 | 4.3× |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) | $7,071.88 | $7,071.88 | 4.3× |
| Exc Hand Les Sc < 1.5 Cm (26115) range across 2 matching MRF lines |
$4,611.75–$7,071.88 | $4,611.75–$7,071.88 | varies |
| Exc Neurofibroma/Neurolemmoma Cutan Nrv (64788) | $8,477.10 | $8,477.10 | 4.3× |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) | $7,071.88 | $7,071.88 | 4.3× |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) | $7,071.88 | $7,071.88 | 4.3× |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) | $1,759.40 | $1,759.40 | 4.3× |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) | $3,060.54 | $3,060.54 | 4.3× |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) | $7,071.88 | $7,071.88 | 4.3× |
| Excision Lingual Frenum Frenectomy (41115) | $6,985.72 | $6,985.72 | 4.5× |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) | $3,060.54 | $3,060.54 | 4.3× |
| Excision of constricting ring of finger, with multiple Z-plasties Facility (26596) | $4,319.80 | $4,319.80 | 1.3× |
| Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision Facility (20150) | $6,071.50 | $6,071.50 | 1.9× |
| Excision of neuroma; sciatic nerve Facility (64786) | $10,975.20 | $10,975.20 | 3.2× |
| Excision or curettage of bone cyst or benign tumor of femur; (27355) range across 2 matching MRF lines |
$4,242.30–$4,656.33 | $4,242.30–$4,656.33 | varies |
| Excision Radial Head (24130) | $4,903.70 | $4,903.70 | 1.5× |
| Excision/curettage cyst/tumor phalanx finger (26210) range across 4 matching MRF lines |
$4,611.75–$11,799.31 | $4,611.75–$11,799.31 | varies |
| Excision; trochanteric bursa or calcification (27062) | $5,487.60 | $5,487.60 | 1.7× |
| Fasciotomy, foot and/or toe (28008) range across 2 matching MRF lines |
$4,242.30–$5,195.65 | $4,242.30–$5,195.65 | varies |
| Fine needle aspiration without imaging guidance (10021) | $1,759.40 | $1,759.40 | 4.3× |
| Finger tendon transfer (26497) | $9,807.40 | $9,807.40 | 3.0× |
| Fluid Pressure Muscle (20950) | $3,318.13 | $3,318.13 | 4.7× |
| Fna Bx W/Fluor Gdn 1St Les (10007) | $267.70 | $267.70 | 0.4× |
| Frmj Dir/Tube Pedcl W/Wotr Fh/Ch/Ch/M/N/Ax/G/H/F (15574) | $8,139.16 | $8,139.16 | 3.9× |
| Fth/gft free w/direct closure s/a/l 20 cm/< (15220) | $4,903.70 | $4,903.70 | 2.4× |
| Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/< (15200) | $8,139.16 | $8,139.16 | 3.9× |
| Fusion of knuckle (26850) unusually low: confirm this is the full procedure |
$3,463.78 | $3,463.78 | 0.5× |
| Gastrocnemius recession (27687) range across 3 matching MRF lines |
$4,027.85–$17,814 | $4,027.85–$17,814 | varies |
| Hip arthro w/labral repair (29916) | $6,947.35 | $6,947.35 | 1.0× |
| I&d abscess peritonsillar (42700) | $980.13 | $980.13 | 4.1× |
| I&d abscess simple (10060) | $314.60 | $314.60 | 1.6× |
| I&d pilonidal cyst simple (10080) | $3,060.54 | $3,060.54 | 4.3× |
| Impression and custom preparation; interim obturator prosthesis Facility (21079) | $15,294.32 | $15,294.32 | 4.6× |
| Incise finger tendon sheath (26055) | $4,027.85 | $4,027.85 | 2.5× |
| Incision & drainage abscess complicated/multiple (10061) | $1,759.40 | $1,759.40 | 4.3× |
| Incision extensor tendon sheath wrist (25000) | $6,765.20 | $6,765.20 | 4.2× |
| Incision of hip tendon (27001) | $2,662.16 | $2,662.16 | 0.8× |
| Incision of lingual frenum (frenotomy) (41010) | $6,985.72 | $6,985.72 | 4.5× |
| Incision of tibia & fibula (27709) range across 2 matching MRF lines |
$2,662.16–$12,143 | $2,662.16–$12,143 | varies |
| Initial Tx 1st Degree Burn Local Tx (16000) | $851.62 | $851.62 | 4.2× |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) | $4,018.88 | $4,018.88 | 4.5× |
| Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) | $4,261.51 | $4,261.51 | 4.8× |
| Injection 1 tendon sheath/ligament aponeurosis (20550) | $1,282.23 | $1,282.23 | 4.2× |
| Injection single tendon origin/insertion (20551) | $1,282.23 | $1,282.23 | 4.2× |
| Injection single/mlt trigger point 1/2 muscles (20552) | $1,282.23 | $1,282.23 | 4.2× |
| Injection single/mlt trigger point 3/> muscles (20553) | $1,282.23 | $1,282.23 | 4.2× |
| Injection therapeutic carpal tunnel (20526) | $1,282.23 | $1,282.23 | 4.2× |
| Injection, anesthetic agent; femoral nerve, single (64447) | $653.21 | $653.21 | 0.9× |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) | $3,038.71 | $3,038.71 | 4.3× |
| Injection, intralesional; up to and including 7 lesions (11900) | $851.62 | $851.62 | 4.2× |
| Insert and remove bone pin (20650) | $14,037.93 | $14,037.93 | 4.3× |
| Insert Temp Bladder Cath (51702) | $702.90 | $702.90 | 5.3× |
| Insert,Non-Indwelling Bladder Catheter (51701) | $247.40 | $247.40 | 1.9× |
| Insertion Picc W/Rs&I 5 Yr/> (36573) | $7,689.20 | $7,689.20 | 4.9× |
| Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) | $7,326.02 | $7,326.02 | 4.6× |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) | $24,580.50 | $24,580.50 | 4.1× |
| Laryngoscopy flexible diagnostic (31575) | $842.99 | $842.99 | 4.2× |
| Laryngoscopy Flx/Rgd Telescopic W/Stroboscopy (31579) | $1,778.59 | $1,778.59 | 4.5× |
| Lateral Canthopexy (21282) | $13,417.16 | $13,417.16 | 4.0× |
| Lateral retinacular release open (27425) | $4,631.56 | $4,631.56 | 1.4× |
| Ligamentous Reconstruction Knee Extra-Articular (27427) range across 3 matching MRF lines |
$4,631.58–$20,255.94 | $4,631.58–$20,255.94 | varies |
| Low Back Disk Surgery (63030) range across 2 matching MRF lines |
$8,736.20–$23,332.35 | $8,736.20–$23,332.35 | varies |
| Manipulation hip joint general anesthesia (27275) | $5,816.70 | $5,816.70 | 3.6× |
| Musc myocutaneous/fasciocutaneous flap uxtr (15736) | $8,139.16 | $8,139.16 | 3.9× |
| Nasal Endoscopy Dx (31231) | $314.60 | $314.60 | 1.6× |
| Ndl Emg Stds Emg Anal/Urtl Sphnctr Any Tq (51785) | $779.30 | $779.30 | 3.1× |
| Needle insertion w/o injection 1 or 2 muscles (20560) | $137.10 | $137.10 | 4.7× |
| Needle insertion w/o injection 3 or more muscles (20561) | $137.10 | $137.10 | 4.7× |
| Neurp Major Prph Nrv Arm/Leg Opn Oth/Thn Spec (64708) | $4,903.70 | $4,903.70 | 2.5× |
| Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) | $1,965.53 | $1,965.53 | 4.7× |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) | $4,018.88 | $4,018.88 | 4.5× |
| Open treatment fracture distal tibia only (27827) | $15,527.08 | $15,527.08 | 1.2× |
| Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including… (21365) | $25,181.88 | $25,181.88 | 4.2× |
| Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant Facility (21390) | $25,181.88 | $25,181.88 | 4.2× |
| Open treatment of talotarsal joint dislocation, includes internal fixation, when performed Facility (28585) range across 2 matching MRF lines |
$6,655.40–$19,398.30 | $6,655.40–$19,398.30 | varies |
| Open Tx Humeral Epicondylar Fracture (24575) range across 2 matching MRF lines |
$4,903.70–$13,969 | $4,903.70–$13,969 | varies |
| Open Tx Intercondylar Spine/Tubrst Fracture Knee (27540) | $13,385.10 | $13,385.10 | 1.8× |
| Open Tx Tibial Fracture Proximal Unicondylar (27535) | $17,760.79 | $17,760.79 | 2.4× |
| Osteoplasty Radius/Ulna Shortening (25390) | $5,487.60 | $5,487.60 | 0.8× |
| Osteot w/wo lngth shrt/corrj 1st metar (28306) | $4,242.30 | $4,242.30 | 0.6× |
| Osteotomy calcaneus w/wo internal fixation (28300) | $5,779.55 | $5,779.55 | 0.8× |
| Osteotomy Phalanx Finger Each (26567) range across 2 matching MRF lines |
$3,463.76–$9,223.50 | $3,463.76–$9,223.50 | varies |
| Osteotomy radius distal third (25350) | $14,991.80 | $14,991.80 | 2.1× |
| Osteotomy tarsal bones oth/thn calcaneus/talus (28304) range across 2 matching MRF lines |
$4,641.49–$4,826.20 | $4,641.49–$4,826.20 | varies |
| Osteotomy Tibia (27705) | $4,826.20 | $4,826.20 | 0.7× |
| Osteotomy, femur, shaft or supracondylar; with fixation Facility (27450) | $13,310.80 | $13,310.80 | 1.8× |
| Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast Facility (27165) | $16,304.60 | $16,304.60 | 2.2× |
| Prq Skel Fixj Dstl Phlngl Fx Fngr/Thmb Ea (26756) | $4,027.85 | $4,027.85 | 1.2× |
| Prq Skeletal Fix Carpo/Metacarpal Fx Dislc Thumb (26650) | $14,037.93 | $14,037.93 | 4.3× |
| Puncture aspiration abscess hematoma bulla/cyst (10160) | $1,759.40 | $1,759.40 | 4.3× |
| Quadricepsplasty (eg, Bennett or Thompson type) Facility (27430) | $12,662.18 | $12,662.18 | 1.7× |
| Rcnstj Dislocating Patella (27420) | $4,631.56 | $4,631.56 | 0.6× |
| Rcnstj Pst Tibl Tdn W/Exc Accessory Tarsl Navclr (28238) | $8,639.60 | $8,639.60 | 1.2× |
| Reconstruct extra finger (26587) range across 3 matching MRF lines |
$10,975.20–$17,902.35 | $10,975.20–$17,902.35 | varies |
| Reconstruction Toe Polydactyly (28344) | $4,242.30 | $4,242.30 | 1.3× |
| Removal impacted cerumen irrigation/lvg unilat (69209) | $280.13 | $280.13 | 4.7× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) | $271.08 | $271.08 | 4.6× |
| Removal Implant Deep (20680) range across 6 matching MRF lines |
$2,160.10–$14,217.77 | $2,160.10–$14,217.77 | varies |
| Removal Implant Superficial Separate Procedure (20670) range across 2 matching MRF lines |
$7,071.88–$7,471.80 | $7,071.88–$7,471.80 | varies |
| Removal of humerus lesion (23150) | $15,597.42 | $15,597.42 | 4.8× |
| Removal of implant from finger or hand (26320) | $7,471.80 | $7,471.80 | 4.5× |
| Removal of nail bed (11750) | $4,027.85 | $4,027.85 | 9.9× |
| Removal or bivalving full arm or full leg cast (29705) | $1,131.42 | $1,131.42 | 4.0× |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) range across 2 matching MRF lines |
$314.60–$8,639.60 | $314.60–$8,639.60 | varies |
| Removal Sutures/Staples Requiring Anesthesia (15851) range across 2 matching MRF lines |
$7,471.80–$8,628.06 | $7,471.80–$8,628.06 | varies |
| Removal, under anesthesia, of external fixation system (20694) range across 2 matching MRF lines |
$7,471.80–$11,365.22 | $7,471.80–$11,365.22 | varies |
| Remove Lower Leg Bone Lesion (27635) range across 3 matching MRF lines |
$4,242.30–$14,767.49 | $4,242.30–$14,767.49 | varies |
| Remove Nasal Foreign Body (30300) | $547.57 | $547.57 | 4.1× |
| Remove tissue expander (11971) | $12,182.61 | $12,182.61 | 4.2× |
| Repair arm/leg nerve (64857) | $29,138.51 | $29,138.51 | 8.5× |
| Repair complex trunk 2.6-7.5 cm (13101) | $2,739.76 | $2,739.76 | 3.7× |
| Repair Finger/Hand Tendon (26350) | $14,037.93 | $14,037.93 | 4.3× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) | $1,759.40 | $1,759.40 | 4.3× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) | $1,759.40 | $1,759.40 | 4.3× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) | $1,759.40 | $1,759.40 | 4.3× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) | $1,759.40 | $1,759.40 | 4.3× |
| Repair of nail bed (11760) | $4,027.85 | $4,027.85 | 5.4× |
| Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Facility (25405) | $14,971.88 | $14,971.88 | 2.1× |
| Repair of web finger (26562) range across 2 matching MRF lines |
$3,181.74–$4,242.30 | $3,181.74–$4,242.30 | varies |
| Repair of web finger (26560) | $12,217.30 | $12,217.30 | 7.6× |
| Repair of web finger (26561) range across 3 matching MRF lines |
$3,181.72–$10,391.30 | $3,181.72–$10,391.30 | varies |
| Repair/Graft Wrist Bone (25440) | $13,873.08 | $13,873.08 | 1.9× |
| Replace g/c tube perc (49450) | $4,421.53 | $4,421.53 | 4.9× |
| Repr elbow lat ligmnt w/tiss (24343) | $4,903.70 | $4,903.70 | 1.5× |
| Respir iadna 18 viral&2 bact (0115U) | $1,298.55 | $1,298.55 | 4.7× |
| Revise lower leg tendon (27690) range across 3 matching MRF lines |
$2,662.16–$4,641.47 | $2,662.16–$4,641.47 | varies |
| Revise radius & ulna (25365) | $9,807.40 | $9,807.40 | 0.8× |
| Revision of big toe (28310) unusually low: confirm this is the full procedure |
$2,662.16 | $2,662.16 | 0.4× |
| Revision of foot and ankle (28262) range across 3 matching MRF lines |
$3,269.13–$5,779.55 | $3,269.13–$5,779.55 | varies |
| Revision of foot fascia (28250) | $3,035.75 | $3,035.75 | 0.9× |
| Revision of humerus (24400) | $14,562.01 | $14,562.01 | 2.0× |
| Revision of lower leg tendon (27685) range across 5 matching MRF lines |
$2,662.16–$13,923.89 | $2,662.16–$13,923.89 | varies |
| Rhinp Prim Complete Xtrnl Parts (30410) | $25,181.88 | $25,181.88 | 4.2× |
| Rmvl/Bivalv Sho/Hip Spica Minerva/Risser Jacket (29710) | $1,206.73 | $1,206.73 | 4.3× |
| Rplc Gtube No Revj Trc (43762) | $1,013.33 | $1,013.33 | 4.0× |
| Rpr Tdn/Musc Xtnsr F/Arm&/Wrist Prim 1 Ea Tdn (25270) | $14,037.93 | $14,037.93 | 4.3× |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) | $14,037.93 | $14,037.93 | 4.3× |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26357) | $14,037.93 | $14,037.93 | 4.3× |
| Simple Cystometrogram (51725) | $1,228.80 | $1,228.80 | 4.9× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) | $851.62 | $851.62 | 4.2× |
| Skin Full Grft Face/Genit/Hf (15240) range across 2 matching MRF lines |
$5,045.60–$8,139.16 | $5,045.60–$8,139.16 | varies |
| Skin sub graft face/nk/hf/g (15275) | $8,626.65 | $8,626.65 | 11.7× |
| Skin Tissue Procedure (17999) | $2,739.76 | $2,739.76 | 13.6× |
| Skn sub grft f/n/hf/g child (15277) | $9,941.19 | $9,941.19 | 4.8× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) | $851.62 | $851.62 | 4.2× |
| Spinal puncture lumbar diagnostic (62270) | $2,992.02 | $2,992.02 | 4.2× |
| Split Agrft F/S/N/H/F/G/M/D Gt 1st 100 Cm/</1 % (15120) | $15,341.34 | $15,341.34 | 4.3× |
| Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) | $8,139.16 | $8,139.16 | 3.9× |
| Strapping ankle (29540) | $708.01 | $708.01 | 4.4× |
| Strapping elbow or wrist (29260) | $274.85 | $274.85 | 4.7× |
| Strapping hand/finger (29280) | $274.85 | $274.85 | 4.7× |
| Strapping knee (29530) | $573.98 | $573.98 | 4.3× |
| Strapping shoulder (29240) | $573.98 | $573.98 | 4.3× |
| Strapping toes (29550) | $291.10 | $291.10 | 4.9× |
| Subcutaneous Injection Filling Material 1 Cc/< (11950) | $851.62 | $851.62 | 4.2× |
| Subcutaneous injection filling matrl 1.1-5.0 cc (11951) | $2,739.76 | $2,739.76 | 3.7× |
| Surgery to stop leg growth (27477) | $8,639.60 | $8,639.60 | 1.2× |
| Tattooing incl micropigmentation 6.1-20.0 cm (11921) | $2,739.76 | $2,739.76 | 3.7× |
| Tendon lengthening upper arm/elbow ea tendon (24305) | $6,071.50 | $6,071.50 | 1.9× |
| Tendon shortening (26477) | $13,175.44 | $13,175.44 | 4.0× |
| Tenolysis, extensor tendon, hand or finger, each tendon (26445) | $14,037.93 | $14,037.93 | 4.3× |
| Tenotomy Flexor Finger Open Each Tendon (26455) range across 2 matching MRF lines |
$2,078.26–$3,658.40 | $2,078.26–$3,658.40 | varies |
| Tenotomy Prq Achilles Tendon Spx General Anes (27606) range across 2 matching MRF lines |
$6,655.40–$14,954.19 | $6,655.40–$14,954.19 | varies |
| Tenotomy Prq Achilles Tendon Spx Local Anes (27605) range across 3 matching MRF lines |
$6,765.20–$8,639.60 | $6,765.20–$8,639.60 | varies |
| Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg Facility (27391) | $2,662.16 | $2,662.16 | 0.8× |
| Thyroid biopsy (60100) | $3,060.54 | $3,060.54 | 4.3× |
| Tis Trnfr E/N/E/L 10 Sq Cm/< (14060) | $8,626.65 | $8,626.65 | 4.2× |
| Treat humerus fracture (24500) | $976.26 | $976.26 | 4.0× |
| Treat Humerus Fracture (24505) | $6,765.20 | $6,765.20 | 4.2× |
| Treat humerus fracture (23600) | $976.26 | $976.26 | 4.0× |
| Treat knee fracture (27532) | $14,037.93 | $14,037.93 | 4.3× |
| Treat Knee Fracture(S) (27538) | $976.26 | $976.26 | 4.0× |
| Treat Metatarsal Fracture (28475) | $976.26 | $976.26 | 4.0× |
| Treat toe dislocation (28630) | $976.26 | $976.26 | 4.0× |
| Treatment closed elbow dislocation w/o anes (24600) | $976.26 | $976.26 | 4.0× |
| Tx open tendon flexor toe 1 tendon spx (28232) | $2,662.16 | $2,662.16 | 1.7× |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) | $976.26 | $976.26 | 4.0× |
| Unlisted Procedure External Ear (69399) | $1,095.15 | $1,095.15 | 4.6× |
| Unlisted procedure foot or toes (28899) range across 2 matching MRF lines |
$3,269.13–$17,691.11 | $3,269.13–$17,691.11 | varies |
| Unlisted Procedure Hands/Fingers (26989) range across 2 matching MRF lines |
$976.26–$12,231.33 | $976.26–$12,231.33 | varies |
| Unlisted procedure humerus/elbow (24999) | $976.26 | $976.26 | 4.0× |
| Unlisted procedure spine (22899) range across 3 matching MRF lines |
$619.60–$16,888.50 | $619.60–$16,888.50 | varies |
| Urinary Reflex Study (51792) | $404.90 | $404.90 | 6.9× |
| Wedge excision skin nail fold (11765) | $1,759.40 | $1,759.40 | 4.3× |
| Wedging of cast (29740) | $1,131.42 | $1,131.42 | 4.0× |
| Windowing of cast (29730) | $687.40 | $687.40 | 4.2× |
| Wound Prep F/N/Hf/G (15004) range across 2 matching MRF lines |
$2,739.76–$5,045.60 | $2,739.76–$5,045.60 | varies |
| Wound Prep Trk/Arm/Leg (15002) | $4,903.70 | $4,903.70 | 6.6× |
| Xfer Single Deep Low Leg Tendon (27691) | $4,826.20 | $4,826.20 | 0.7× |
| Xtrnl fixj w/strtctc adjustment exchange strut (20697) | $7,547.53 | $7,547.53 | 4.7× |
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.