Procedures & surgery prices at Shriners Children's Hawaiʻi

Honolulu, HI · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) $18,386.18 $18,386.18 4.4×
Adjt tis trns/reargmt f/c/c/m/n/a/g/h/f 10sqcm/< (14040) $9,754.56 $9,754.56 4.0×
Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) $9,754.56 $9,754.56 4.0×
Adjt/Rearrgmt Scalp/Arm/Leg 10.1-30.0 Sq Cm (14021) $9,754.56 $9,754.56 4.0×
Amp F/Th 1/2 Jt/Phalanx W/Neurect Local Flap (26952) $16,824.08 $16,824.08 4.4×
Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) $16,824.08 $16,824.08 4.4×
Anal Sp Inf Pmp W/Reprg&Fill (62369) $1,563.63 $1,563.63 4.3×
Anal/Urinary Muscle Study (51784) $472.70 $472.70 3.1×
Appl Clubfoot Cast Molding/Manj Long/Short Leg (29450)
range across 2 matching MRF lines		 $766.60–$823.84 $766.60–$823.84 varies
Appl Hip Spica Cast One&One-Half Spica/Both Legs (29325) $1,446.23 $1,446.23 4.4×
Application cast elbow finger short arm (29075)
range across 3 matching MRF lines		 $1,411.70–$2,823.40 $1,411.70–$2,823.40 varies
Application Cast Finger (29086) $823.84 $823.84 4.3×
Application Cast Shoulder Spica (29055) $1,355.97 $1,355.97 4.1×
Application Finger Splint Dynamic (29131) $348.80 $348.80 5.0×
Application finger splint static (29130) $656.25 $656.25 4.2×
Application Hip Spica Cast 1 Leg (29305) $1,501.06 $1,501.06 4.5×
Application long arm splint shoulder hand (29105) $823.84 $823.84 4.3×
Application Long Leg Cast Walker/Ambulatory Type (29355)
range across 2 matching MRF lines		 $1,411.70–$1,615.06 $1,411.70–$1,615.06 varies
Application Long Leg Splint (29505) $823.84 $823.84 4.3×
Application of cylinder cast (thigh to ankle) (29365) $1,411.70 $1,411.70 4.3×
Application of long leg cast (29345) $1,411.70 $1,411.70 4.3×
Application of rigid total contact leg cast (29445) $1,411.70 $1,411.70 4.3×
Application Patellar Tendon Bearing Cast (29435) $1,411.70 $1,411.70 4.3×
Application Short Arm Splint Dynamic (29126) $639.60 $639.60 4.1×
Application short arm splint forearm-hand static (29125) $656.25 $656.25 4.2×
Application short leg splint calf foot (29515) $823.84 $823.84 4.3×
Apply hand/wrist cast (29085) $823.84 $823.84 4.3×
Apply long arm cast (29065) $1,411.70 $1,411.70 4.3×
Apply Short Leg Cast (29405)
range across 5 matching MRF lines		 $766.60–$6,131.80 $766.60–$6,131.80 varies
Apply short leg cast (29425)
range across 4 matching MRF lines		 $736.50–$1,446.23 $736.50–$1,446.23 varies
Arrest Epiphyseal Open Distal Tibia (27730)
range across 2 matching MRF lines		 $8,250.20–$12,339.40 $8,250.20–$12,339.40 varies
Arrst Hemiepiphysl Dstl Femur/Prox Tibia/Fibula (27485)
range across 2 matching MRF lines		 $6,887.13–$10,952.40 $6,887.13–$10,952.40 varies
Arterial puncture (36600) $687.90 $687.90 4.4×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $718.50 $718.50 2.0×
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $3,641 $3,641 4.4×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610)
range across 2 matching MRF lines		 $383.30–$1,536.72 $383.30–$1,536.72 varies
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $1,668.41 $1,668.41 4.6×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $1,536.72 $1,536.72 4.2×
Arthroplasty interposition intercarpal or carpometacarpal joints (25447) $16,824.08 $16,824.08 4.4×
Arthroscopy knee synovectomy limited spx (29875) $10,952.40 $10,952.40 2.8×
Arthroscopy shoulder surgical capsulorrhaphy (29806) $15,806.90 $15,806.90 1.8×
Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Facility (29883)
range across 2 matching MRF lines		 $6,887.13–$9,290.45 $6,887.13–$9,290.45 varies
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882)
range across 2 matching MRF lines		 $8,943.70–$13,726.40 $8,943.70–$13,726.40 varies
Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement Facility (29846) $16,824.08 $16,824.08 4.4×
Arthrs aided ant cruciate ligm rpr/agmntj/rcnstj (29888)
range across 3 matching MRF lines		 $9,290.45–$38,525.90 $9,290.45–$38,525.90 varies
Arthrs Aided Pst Cruciate Ligm Rpr/Agmntj/Rcnstj (29889) $9,290.45 $9,290.45 0.6×
Arthrs Ankle Exc Ostchndrl Dfct W/Drlg Dfct (29891) $14,419.90 $14,419.90 3.7×
Arthrs Knee Abrasion Arthrp/Mlt Drlg/Microfx (29879) $12,339.40 $12,339.40 3.2×
Arthrs knee debridement/shaving artclr crtlg (29877) $11,645.90 $11,645.90 3.0×
Arthrt Pst Capsul Rls Ankle W/WO Achll Tdn Lngth (27612) $20,661.40 $20,661.40 5.3×
Aspirate Pleura W/O Imaging (32554) $3,269.68 $3,269.68 4.4×
Aspirate/Inj Ganglion Cyst (20612) $1,536.72 $1,536.72 4.2×
Aspiration and/or injection thyroid cyst (60300) $3,667.98 $3,667.98 4.4×
Avulsion nail plate partial/complete simple 1 (11730) $1,158.55 $1,158.55 4.9×
Biopsy Pleura Percutaneous Needle (32400) $8,475.46 $8,475.46 4.3×
Biopsy Salivary Gland Incisional (42405) $6,516.45 $6,516.45 3.6×
Bladder Scan (51798) $373.90 $373.90 5.4×
Blood Transfusion Service (36430) $2,212 $2,212 4.2×
Carpal Tunnel Surgery (64721) $10,159.58 $10,159.58 4.4×
Change of Windpipe Airway (31502) $597 $597 2.1×
Chemical Cautery Tissue (17250) $373.90 $373.90 1.6×
Chemodenerv 1 extrem 5/> mus (64644)
range across 2 matching MRF lines		 $3,641.81–$4,782.70 $3,641.81–$4,782.70 varies
Chemodenerv 1 extremity 1-4 (64642)
range across 2 matching MRF lines		 $3,641.81–$4,435.95 $3,641.81–$4,435.95 varies
Chemodenerv musc neck dyston (64616) $1,536.72 $1,536.72 4.2×
Chemodenerv Parotid&Submandibl Salivary Glnds (64611) $1,536.72 $1,536.72 4.2×
Chemodenerv trunk musc 1-5 (64646) $3,641.81 $3,641.81 4.4×
Chemodenerv trunk musc 6/> (64647) $718.50 $718.50 0.9×
Chemodenervation eccrine glands oth area per day (64653) $1,536.72 $1,536.72 4.2×
Chemodenervation of internal anal sphincter (46505) $6,120.61 $6,120.61 4.3×
Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) $1,536.72 $1,536.72 4.2×
Circumcision 28 days or older (54161) $10,483.78 $10,483.78 4.2×
Cl Tx Tib Shft Fx W Manip (27752) $8,107.91 $8,107.91 4.3×
Clear outer ear canal (69200) $656.25 $656.25 4.2×
Closed Rx Metacarpal Fx,Percut (26608) $16,824.08 $16,824.08 4.4×
Closed Rx Spontaneous Hip Disloc (27256) $1,170.02 $1,170.02 4.0×
Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) $1,170.02 $1,170.02 4.0×
Closed treatment of posterior malleolus fracture; with manipulation (27768) $8,107.91 $8,107.91 4.3×
Closed treatment of ulnar shaft fracture; with manipulation (25535) $1,170.02 $1,170.02 4.0×
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $1,170.02 $1,170.02 4.0×
Closed Treatment Sesamoid Fracture (28530) $1,170.02 $1,170.02 4.0×
Closed Treatment Ulnar Styloid Fracture (25650) $1,170.02 $1,170.02 4.0×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $8,107.91 $8,107.91 4.3×
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $1,170.02 $1,170.02 4.0×
Closed Tx Calcaneal Fracture W/Manipulation (28405) $1,170.02 $1,170.02 4.0×
Closed Tx Calcaneal Fracture W/O Manipulation (28400) $1,170.02 $1,170.02 4.0×
Closed tx carpal scaphoid fracture w/manj (25624) $8,107.91 $8,107.91 4.3×
Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) $1,170.02 $1,170.02 4.0×
Closed tx femoral fracture prox head w/o manj (27267) $20,788.11 $20,788.11 5.4×
Closed Tx Femoral Shaft Fx W/O Manipulation (27500) $1,170.02 $1,170.02 4.0×
Closed tx knee dislocation w/o anesthesia (27550) $1,170.02 $1,170.02 4.0×
Closed tx metatarsal fracture w/o manipulation (28470) $1,170.02 $1,170.02 4.0×
Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) $8,107.91 $8,107.91 4.3×
Closed tx patellar dislocation w/o anesthesia (27560) $1,170.02 $1,170.02 4.0×
Closed Tx Patellar Fracture W/O Manipulation (27520) $1,170.02 $1,170.02 4.0×
Closed tx radial head/neck fx w/manipulation (24655) $8,107.91 $8,107.91 4.3×
Closed tx radial head/neck fx w/o manipulation (24650) $1,170.02 $1,170.02 4.0×
Closed tx radial shaft fracture w/manipulation (25505) $16,824.08 $16,824.08 8.9×
Closed Tx Radial Shaft Fracture W/O Manipulation (25500) $1,170.02 $1,170.02 4.0×
Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) $8,107.91 $8,107.91 4.3×
Closed tx radial&ulnar shaft fractures w/o man (25560) $1,170.02 $1,170.02 4.0×
Closed Tx Sternoclavicular Dislc W/Manipulation (23525) $1,170.02 $1,170.02 4.0×
Closed Tx Talus Fracture W/Manipulation (28435) $8,107.91 $8,107.91 4.3×
Closed tx talus fracture w/o manipulation (28430) $1,170.02 $1,170.02 4.0×
Closed Tx Ulnar Fracture Prox End W Manipulation (24675) $8,107.91 $8,107.91 4.3×
Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) $1,170.02 $1,170.02 4.0×
Closed tx ulnar shaft fracture w/o manipulation (25530) $1,170.02 $1,170.02 4.0×
Clsd tx acromioclavicular dislc w/manipulation (23545) $1,170.02 $1,170.02 4.0×
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $1,170.02 $1,170.02 4.0×
Clsd Tx Clavicular Fracture W/Manipulation (23505) $8,107.91 $8,107.91 4.3×
Clsd tx clavicular fracture w/o manipulation (23500) $1,170.02 $1,170.02 4.0×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $1,170.02 $1,170.02 4.0×
Cltx Carpal Bone Fx W/Manj Each Bone (25635) $8,107.91 $8,107.91 4.3×
Cltx Carpal Bone Fx W/O Manj Each Bone (25630) $1,170.02 $1,170.02 4.0×
Cltx dstl fibular fx lat malls w/manj (27788) $1,170.02 $1,170.02 4.0×
Cltx dstl fibular fx lat malls w/o manj (27786) $1,170.02 $1,170.02 4.0×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $1,170.02 $1,170.02 4.0×
Cltx dstl radial fx/epiphysl sep w/o manj (25600)
range across 2 matching MRF lines		 $736.50–$1,170.02 $736.50–$1,170.02 varies
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $8,107.91 $8,107.91 4.3×
Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) $8,107.91 $8,107.91 4.3×
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $1,170.02 $1,170.02 4.0×
Cltx Fem Fx Prox End Nck W/Manj W/WO Skel Tracj (27232) $1,170.02 $1,170.02 0.6×
Cltx Fem Fx Prox End Nck W/O Manj (27230) $1,170.02 $1,170.02 4.0×
Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) $8,107.91 $8,107.91 4.3×
Cltx fx grt toe phlx/phlg w/manj (28495) $1,170.02 $1,170.02 4.0×
Cltx fx grt toe phlx/phlg w/o manj (28490) $1,170.02 $1,170.02 4.0×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $1,170.02 $1,170.02 4.0×
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $1,170.02 $1,170.02 4.0×
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $8,107.91 $8,107.91 4.3×
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $1,170.02 $1,170.02 4.0×
Cltx greater humeral tuberosity fx w/o manj (23620) $1,170.02 $1,170.02 4.0×
Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) $8,107.91 $8,107.91 4.3×
Cltx hip dislocation traumatic w/o anesthesia (27250) $1,170.02 $1,170.02 4.0×
Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) $1,170.02 $1,170.02 4.0×
Cltx humeral condylar fx medial/lateral w/manj (24577) $8,107.91 $8,107.91 4.3×
Cltx Humeral Epicondylar Fx Medial/Lat W/Manj (24565) $8,107.91 $8,107.91 4.3×
Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560) $1,170.02 $1,170.02 4.0×
Cltx inter/peri/subtrochanteric fem fx w/o manj (27238) $8,107.91 $8,107.91 4.3×
Cltx Interphalangeal Joint Dislocation Req Anes (28665) $1,355.97 $1,355.97 4.1×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $1,170.02 $1,170.02 4.0×
Cltx iphal jt dislc w/manj w/o anes (26770) $1,355.80 $1,355.80 4.7×
Cltx Med Ankle Fx W/Mnpj (27762) $8,107.91 $8,107.91 4.3×
Cltx Medial Ankle Fx (27760) $1,170.02 $1,170.02 4.0×
Cltx metacarpal fx w/manipulation each bone (26605) $1,170.02 $1,170.02 4.0×
Cltx metacarpal fx w/o manipulation each bone (26600) $1,170.02 $1,170.02 4.0×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $1,170.02 $1,170.02 4.0×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $1,170.02 $1,170.02 4.0×
Cltx post hip arthrp dislc w/o anes (27265) $1,170.02 $1,170.02 4.0×
Cltx prox fibula/shft fx w/manj (27781) $8,107.91 $8,107.91 4.3×
Cltx prox fibula/shft fx w/o manj (27780) $1,170.02 $1,170.02 4.0×
Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) $8,107.91 $8,107.91 4.3×
Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) $1,170.02 $1,170.02 4.0×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $1,170.02 $1,170.02 4.0×
Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) $8,107.91 $8,107.91 4.3×
Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) $8,107.91 $8,107.91 4.3×
Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) $8,107.91 $8,107.91 4.3×
Cltx sprcndylr/transcndylr humeral fx w/manj (24535) $8,107.91 $8,107.91 4.3×
Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) $1,170.02 $1,170.02 4.0×
Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) $1,170.02 $1,170.02 4.0×
Cltx tibial fx proximal w/o manipulation (27530) $1,170.02 $1,170.02 4.0×
Cltx tibial shaft fx w/o manipulation (27750) $1,170.02 $1,170.02 4.0×
Cltx trimalleolar ankle fx w/manipulation (27818) $8,107.91 $8,107.91 4.3×
Cltx trimalleolar ankle fx w/o manipulation (27816) $1,170.02 $1,170.02 4.0×
Collection of venous blood by venipuncture (36415) $20 $20 2.1×
Complex Cystometrogram (51726) $1,214.45 $1,214.45 4.1×
Csf shunt reprogram (62252) $1,563.63 $1,563.63 4.3×
Cystometrogram W/Up (51727) $3,534.42 $3,534.42 4.3×
Cystometrogram W/Vp (51728) $3,534.42 $3,534.42 4.3×
Cystometrogram W/Vp&Up (51729) $4,026.49 $4,026.49 4.9×
Cystourethroscopy (52000) $4,026.48 $4,026.48 4.9×
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $14,600.53 $14,600.53 4.3×
Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) $8,475.46 $8,475.46 4.3×
Debridement subcutaneous tissue 20 sq cm/< (11042) $2,108.59 $2,108.59 4.4×
Delay Flap/Sectioning Flap Trunk (15600) $18,386.18 $18,386.18 4.4×
Destruct B9 Lesion 1-14 (17110) $1,020.64 $1,020.64 4.3×
Destruction Lesions Vulva Simple (56501) $9,754.56 $9,754.56 4.0×
Destruction premalignant lesion 1st (17000) $1,020.64 $1,020.64 4.3×
Drain Cerebro Spinal Fluid (62272) $3,585.85 $3,585.85 4.3×
Drain/inj small joint/bursa w/us (20604) $1,772.47 $1,772.47 4.9×
Drainage external auditory canal abscess (69020) $3,667.98 $3,667.98 4.4×
Drainage external ear abscess/hematoma cmplx (69005) $8,475.46 $8,475.46 4.3×
Drainage External Ear Abscess/Hematoma Simple (69000) $3,667.98 $3,667.98 4.4×
Dressing Change Under Anesthesia (15852) $2,567.30 $2,567.30 2.9×
Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) $3,667.98 $3,667.98 4.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $2,108.59 $2,108.59 4.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $373.90 $373.90 1.6×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $373.90 $373.90 1.6×
Dstrj Cutaneous Vascular Lesions >50.0 Sq Cm (17108) $10,338.81 $10,338.81 4.2×
Elec Anlys Implt Ithcl/Edrl Pmp W/Repr Phys/Qhp (62370) $1,563.63 $1,563.63 4.3×
Elect Analys Implt Ithcl/Edrl Pump W/Reprgrmg (62368) $1,563.63 $1,563.63 4.3×
Electro-Uroflowmetry First (51741) $472.70 $472.70 1.9×
Evacuation of subungual hematoma (11740) $728.54 $728.54 4.6×
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $3,667.98 $3,667.98 4.4×
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $3,667.98 $3,667.98 4.4×
Exc Face-Mm B9+Marg 0.6-1 Cm (11441) $3,667.98 $3,667.98 4.4×
Exc Face-Mm B9+Marg 1.1-2 Cm (11442) $3,667.98 $3,667.98 4.4×
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $8,475.46 $8,475.46 4.3×
Exc Face-Mm B9+Marg 3.1-4 Cm (11444) $8,475.46 $8,475.46 4.3×
Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) $3,667.98 $3,667.98 4.4×
Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) $8,475.46 $8,475.46 4.3×
Exc Hand Les Sc < 1.5 Cm (26115) $8,475.46 $8,475.46 4.3×
Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) $10,258.90 $10,258.90 5.4×
Exc Neurofibroma/Neurolemmoma Cutan Nrv (64788) $10,159.58 $10,159.58 4.4×
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $3,667.98 $3,667.98 4.4×
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $8,475.46 $8,475.46 4.3×
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $8,475.46 $8,475.46 4.3×
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) $2,108.59 $2,108.59 4.4×
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) $3,667.98 $3,667.98 4.4×
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $8,475.46 $8,475.46 4.3×
Excision Lingual Frenum Frenectomy (41115) $8,372.19 $8,372.19 4.6×
Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) $3,667.98 $3,667.98 4.4×
Excision prepatellar bursa (27340) $10,952.40 $10,952.40 2.8×
Excision/curettage cyst/tumor phalanx finger (26210) $8,107.91 $8,107.91 4.3×
Fine needle aspiration without imaging guidance (10021) $2,108.59 $2,108.59 4.4×
Fluid Pressure Muscle (20950) $3,976.69 $3,976.69 4.8×
Fna Bx W/Fluor Gdn 1St Les (10007) $267.70 $267.70 0.3×
Frmj Dir/Tube Pedcl W/Wotr Fh/Ch/Ch/M/N/Ax/G/H/F (15574) $9,754.56 $9,754.56 4.0×
Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/< (15200) $9,754.56 $9,754.56 4.0×
I&d abscess peritonsillar (42700) $1,174.66 $1,174.66 4.2×
I&d abscess simple (10060) $373.90 $373.90 1.6×
I&d pilonidal cyst simple (10080) $3,667.98 $3,667.98 4.4×
Impression and custom preparation; interim obturator prosthesis Facility (21079) $18,329.83 $18,329.83 4.7×
Incise finger tendon sheath (26055) $10,258.90 $10,258.90 5.4×
Incision & drainage abscess complicated/multiple (10061) $2,108.59 $2,108.59 4.4×
Incision extensor tendon sheath wrist (25000) $8,107.91 $8,107.91 4.3×
Incision of lingual frenum (frenotomy) (41010) $8,372.19 $8,372.19 4.6×
Initial Tx 1st Degree Burn Local Tx (16000) $1,020.64 $1,020.64 4.3×
Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) $4,816.52 $4,816.52 4.6×
Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) $5,107.31 $5,107.31 4.9×
Injection 1 tendon sheath/ligament aponeurosis (20550) $1,536.72 $1,536.72 4.2×
Injection single tendon origin/insertion (20551) $1,536.72 $1,536.72 4.2×
Injection single/mlt trigger point 1/2 muscles (20552) $1,536.72 $1,536.72 4.2×
Injection single/mlt trigger point 3/> muscles (20553) $1,536.72 $1,536.72 4.2×
Injection therapeutic carpal tunnel (20526) $1,536.72 $1,536.72 4.2×
Injection, anesthetic agent; femoral nerve, single (64447) $782.86 $782.86 0.9×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $3,641.81 $3,641.81 4.4×
Injection, intralesional; up to and including 7 lesions (11900) $1,020.64 $1,020.64 4.3×
Insert and remove bone pin (20650) $16,824.08 $16,824.08 4.4×
Insert Temp Bladder Cath (51702) $842.70 $842.70 5.4×
Insert,Non-Indwelling Bladder Catheter (51701) $289.10 $289.10 1.8×
Insertion Picc W/Rs&I 5 Yr/> (36573) $7,689.20 $7,689.20 4.1×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) $8,780.04 $8,780.04 4.7×
Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) $29,459.07 $29,459.07 4.1×
Laryngoscopy flexible diagnostic (31575) $1,010.30 $1,010.30 4.3×
Laryngoscopy Flx/Rgd Telescopic W/Stroboscopy (31579) $2,131.60 $2,131.60 4.6×
Lateral Canthopexy (21282) $16,080.11 $16,080.11 4.1×
Ligamentous Reconstruction Knee Extra-Articular (27427) $15,113.40 $15,113.40 1.8×
Musc myocutaneous/fasciocutaneous flap uxtr (15736) $9,754.56 $9,754.56 4.0×
Nasal Endoscopy Dx (31231) $373.90 $373.90 1.6×
Ndl Emg Stds Emg Anal/Urtl Sphnctr Any Tq (51785) $866.50 $866.50 2.9×
Needle insertion w/o injection 1 or 2 muscles (20560) $164.40 $164.40 4.8×
Needle insertion w/o injection 3 or more muscles (20561) $164.40 $164.40 4.8×
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $2,355.64 $2,355.64 5.7×
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $4,816.52 $4,816.52 4.6×
Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including… (21365) $30,179.81 $30,179.81 4.3×
Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant Facility (21390) $30,179.81 $30,179.81 4.3×
Open Treatment Radial Shaft Fracture (25515) $12,339.40 $12,339.40 1.4×
Prq skel fixj femoral fx prox end neck (27235) $10,952.40 $10,952.40 1.3×
Prq Skel Fixj Sprcndylr/Transcndylr Humeral Fx (24538) $10,258.90 $10,258.90 1.2×
Prq Skeletal Fix Carpo/Metacarpal Fx Dislc Thumb (26650) $16,824.08 $16,824.08 4.4×
Puncture aspiration abscess hematoma bulla/cyst (10160) $2,108.59 $2,108.59 4.4×
Reconstruct extra finger (26587) $11,645.90 $11,645.90 3.0×
Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell,… (27422) $17,193.90 $17,193.90 2.0×
Removal impacted cerumen irrigation/lvg unilat (69209) $335.72 $335.72 4.8×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $324.88 $324.88 4.7×
Removal Implant Deep (20680)
range across 2 matching MRF lines		 $2,567.30–$14,419.90 $2,567.30–$14,419.90 varies
Removal Implant Superficial Separate Procedure (20670) $8,475.46 $8,475.46 4.3×
Removal of humerus lesion (23150) $13,726.40 $13,726.40 3.6×
Removal or bivalving full arm or full leg cast (29705) $1,355.97 $1,355.97 4.1×
Removal skn tags mlt fibrq tags any area upw/15 (11200) $373.90 $373.90 1.6×
Removal Sutures/Staples Requiring Anesthesia (15851) $10,340.50 $10,340.50 4.2×
Remove Lower Leg Bone Lesion (27635)
range across 2 matching MRF lines		 $10,952.40–$11,645.90 $10,952.40–$11,645.90 varies
Remove Nasal Foreign Body (30300) $656.25 $656.25 4.2×
Remove tissue expander (11971) $14,600.53 $14,600.53 4.3×
Repair arm/leg nerve (64857) $34,921.73 $34,921.73 8.7×
Repair complex trunk 2.6-7.5 cm (13101) $3,283.53 $3,283.53 3.8×
Repair Finger/Hand Tendon (26350) $16,824.08 $16,824.08 4.4×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $2,108.59 $2,108.59 4.4×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $2,108.59 $2,108.59 4.4×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $2,108.59 $2,108.59 4.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $2,108.59 $2,108.59 4.4×
Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Facility (25405) $15,806.90 $15,806.90 1.8×
Repair of web finger (26561) $11,024.20 $11,024.20 2.9×
Replace g/c tube perc (49450) $5,299.09 $5,299.09 4.9×
Respir iadna 18 viral&2 bact (0115U) $1,556.28 $1,556.28 5.7×
Revision of lower leg tendon (27685)
range across 2 matching MRF lines		 $8,250.20–$12,339.40 $8,250.20–$12,339.40 varies
Rhinp Prim Complete Xtrnl Parts (30410) $30,179.81 $30,179.81 4.3×
Rmvl/Bivalv Sho/Hip Spica Minerva/Risser Jacket (29710) $1,446.23 $1,446.23 4.4×
Rplc Gtube No Revj Trc (43762) $1,214.45 $1,214.45 4.1×
Rpr Tdn/Musc Xtnsr F/Arm&/Wrist Prim 1 Ea Tdn (25270) $16,824.08 $16,824.08 4.4×
Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) $16,824.08 $16,824.08 4.4×
Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26357) $16,824.08 $16,824.08 4.4×
Simple Cystometrogram (51725) $1,366.40 $1,366.40 4.6×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $1,020.64 $1,020.64 4.3×
Skin Full Grft Face/Genit/Hf (15240)
range across 2 matching MRF lines		 $9,754.56–$11,024.20 $9,754.56–$11,024.20 varies
Skin sub graft face/nk/hf/g (15275) $10,338.81 $10,338.81 11.8×
Skin Tissue Procedure (17999) $3,283.53 $3,283.53 13.9×
Skn sub grft f/n/hf/g child (15277) $11,914.25 $11,914.25 4.9×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $1,020.64 $1,020.64 4.3×
Spinal puncture lumbar diagnostic (62270) $3,585.85 $3,585.85 4.3×
Split Agrft F/S/N/H/F/G/M/D Gt 1st 100 Cm/</1 % (15120) $18,386.18 $18,386.18 4.4×
Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) $9,754.56 $9,754.56 4.0×
Strapping ankle (29540) $848.53 $848.53 4.4×
Strapping elbow or wrist (29260) $329.40 $329.40 4.7×
Strapping hand/finger (29280) $329.39 $329.39 4.7×
Strapping knee (29530) $687.90 $687.90 4.4×
Strapping shoulder (29240) $687.90 $687.90 4.4×
Strapping toes (29550) $348.80 $348.80 5.0×
Subcutaneous Injection Filling Material 1 Cc/< (11950) $1,020.64 $1,020.64 4.3×
Subcutaneous injection filling matrl 1.1-5.0 cc (11951) $3,283.53 $3,283.53 3.8×
Tattooing incl micropigmentation 6.1-20.0 cm (11921) $3,283.53 $3,283.53 3.8×
Tenolysis, extensor tendon, hand or finger, each tendon (26445) $16,824.08 $16,824.08 4.4×
Tenotomy Prq Achilles Tendon Spx Local Anes (27605)
range across 2 matching MRF lines		 $8,107.91–$16,215.82 $8,107.91–$16,215.82 varies
Thyroid biopsy (60100) $3,667.98 $3,667.98 4.4×
Tis Trnfr E/N/E/L 10 Sq Cm/< (14060) $10,338.81 $10,338.81 4.2×
Tooth extraction (41899) $14,419.90 $14,419.90 51.5×
Treat Fx Rad Extra-Articul (25607)
range across 2 matching MRF lines		 $10,952.40–$13,726.40 $10,952.40–$13,726.40 varies
Treat humerus fracture (24500) $1,170.02 $1,170.02 4.0×
Treat Humerus Fracture (24505) $8,107.91 $8,107.91 4.3×
Treat humerus fracture (23600) $1,170.02 $1,170.02 4.0×
Treat knee fracture (27532) $16,824.08 $16,824.08 4.4×
Treat Knee Fracture(S) (27538) $1,170.02 $1,170.02 4.0×
Treat Metatarsal Fracture (28475) $1,170.02 $1,170.02 4.0×
Treat toe dislocation (28630) $1,170.02 $1,170.02 4.0×
Treatment closed elbow dislocation w/o anes (24600) $1,170.02 $1,170.02 4.0×
Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) $1,170.02 $1,170.02 4.0×
Unlisted procedure arthroscopy (29999) $8,943.70 $8,943.70 30.7×
Unlisted Procedure External Ear (69399) $1,312.51 $1,312.51 4.7×
Unlisted procedure forearm or wrist (25999) $13,726.40 $13,726.40 47.1×
Unlisted Procedure Hands/Fingers (26989) $1,170.02 $1,170.02 4.0×
Unlisted procedure humerus/elbow (24999) $1,170.02 $1,170.02 4.0×
Unlisted procedure spine (22899) $1,170.02 $1,170.02 4.0×
Urinary Reflex Study (51792) $461.20 $461.20 6.6×
Wedge excision skin nail fold (11765) $2,108.59 $2,108.59 4.4×
Wedging of cast (29740) $1,355.97 $1,355.97 4.1×
Windowing of cast (29730) $823.84 $823.84 4.3×
Wound Prep F/N/Hf/G (15004) $3,283.53 $3,283.53 6.8×
Xtrnl fixj w/strtctc adjustment exchange strut (20697) $9,045.52 $9,045.52 4.8×

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.