Visits & medical services prices at Sibley Memorial Hospital

Washington, DC · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Acoustic immittance testing (92570) $343 $343 2.5×
Acoustic reflex testing (92568) $243 $243 6.1×
Acupunct w/stimul 15 min (97813) $320 $320 10.4×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $218 $218 7.1×
Aep hearing status deter broadband stimuli i&r (92651) $287 $287 1.2×
Aep neurodiagnostic interpretation and report (92653) $337 $337 1.5×
Aep threshold estimation mlt frequencies i&r (92652) $337 $337 1.5×
Aerosol inhalation pentamidine (94642) $776 $776 3.3×
Airway inhalation treatment (94640) $109 $109 0.5×
Analyze neurostim simple (95971) $193 $193 1.9×
Appl on-body injector for timed subq injection (96377) $251 $251 5.0×
Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) $265 $265 18.9×
Assessment of aphasia (96105) $924 $924 9.5×
Behavioral & qualit analysis voice and resonance (92524) $609 $609 5.6×
Bfb training 1st 15 min (90912) $131 $131 1.6×
Bfb training ea addl 15 min (90913) $54 $54 1.6×
Biofeedback training any modality (90901) $184 $184 4.5×
Caloric vestibular test w/rec bi bithermal (92537) $768 $768 5.6×
Caloric vestibular test w/rec bi monothermal (92538) $768 $768 3.3×
Canalith repositioning (95992) $200 $200 4.9×
Cardiac stress test (93017) $1,526 $1,526 6.6×
Cardiopulmonary exercise testing (94621) $1,992 $1,992 5.0×
Cardioversion elective external (92960) $3,010 $3,010 4.3×
Carotid duplex scan; bilat (93880) $1,215 $1,215 4.8×
Carotid duplex scan; unil/limit (93882) $741 $741 6.7×
Chemo cns (intrathecal) w lp (96450) $1,209 $1,209 3.4×
Chemo hormon antineopl sq/im (96402) $202.50 $202.50 2.6×
Chemo intralesional 1-7 lesions (96405) $381 $381 5.0×
Chemo intralesional over 7 (96406) $660 $660 2.9×
Chemo IV infus each addl seq (96417) $442 $442 5.8×
Chemo IV infusion addl hr (96415) $357.50 $357.50 4.7×
Chemother prolong infuse w/pump (96416) $4,460 $4,460 12.7×
Chemother, IV infusion, 1 hr (96413) $658 $658 1.9×
Chemother, IV push,ea add drug (96411) $662 $662 8.6×
Chemother,non-hormone anti-neopl, sub-q/im (96401) $516 $516 6.7×
Chemotherapy admin intra-arterial push tq (96420) $2,161 $2,161 6.1×
Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours),… (96425) $1,318 $1,318 3.7×
Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) $495 $495 1.4×
Chemotx admn pertl cavity implanted port/cath (96446) $1,237 $1,237 3.5×
Color/duplex Doppler, complete (93975) $1,999 $1,999 7.9×
Color/duplex Doppler, limited (93976) $1,933 $1,933 17.4×
Comprehensive hearing test (92557) $831 $831 6.1×
Conditioning play audiometry (92582) $343 $343 2.5×
Continuous inhalation tx, 1st hr (94644) $214 $214 1.5×
Cpap/bipap daily (94660) $840 $840 3.6×
Cpr (92950) $1,276 $1,276 5.6×
Cpt initial (94667) $112 $112 0.8×
Cpt subsequent (94668) $230 $230 1.6×
Critical care first hour (99291) $3,558 $3,558 4.0×
Distrt prod evokd otoacoustic emsns comp/dx eval (92588) $859 $859 2.2×
Dup-scan artl infl&ven o/f pen vsl compl (93980) $1,999 $1,999 18.0×
Duplex a ivc il/bpg; compl (93978) $2,032 $2,032 8.0×
Duplex a ivc il/bpg; unil/lim (93979) $2,032 $2,032 18.3×
Duplex ext veins; bilat (93970) $1,015 $1,015 4.0×
Duplex hemodialysis access (93990) $1,206 $1,206 10.8×
Duplex le art/bpg; bilat (93925) $1,076 $1,076 4.2×
Duplex le art/bpg; unil/limit (93926) $652 $652 5.9×
Duplex ue art/bpg; bilat (93930) $1,076 $1,076 4.2×
Duplex ue art/bpg; unil/limit (93931) $652 $652 5.9×
Duplex venous ext unilat/lmtd (93971) $846 $846 7.6×
ECG monit/reprt up to 48 hrs (93226) $1,115 $1,115 17.8×
ECG up to 48 hrs recording (93225) $533 $533 3.8×
Echo transesophageal (93312) $2,988 $2,988 5.1×
Echo Transthoracic - Congenital Tte Complete (93303) $4,121 $4,121 7.1×
Echo Transthoracic - Congenital Tte Limited (93304) $4,121 $4,121 7.1×
EEG awake & asleep (95819) $920 $920 4.0×
EEG awake/drowsy (95816) $920 $920 4.0×
EEG cerebral death eval (95824) $1,055 $1,055 2.7×
EEG coma or sleep only (95822) $920 $920 4.0×
EEG cont rec w/video by tech min 8 channels (95700) $1,569 $1,569 6.8×
EEG w/o vid by tech ea incr 12-26 hr intmt mntr (95709) $2,538 $2,538 6.4×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $2,247 $2,247 5.7×
EEG w/o vid tech ea incr 12-26 hr cont r-t mntr (95710) $4,213 $4,213 10.6×
EEG w/o video by tech 2-12 hr intermittent mntr (95706) $1,759 $1,759 7.7×
EEG w/o video by tech 2-12 hr unmonitored (95705) $1,569 $1,569 6.8×
EEG w/o video by tech 2-12hr continuous r-t mntr (95707) $1,954 $1,954 8.5×
Eeg,Extended Monitoring,41-60 Minutes - Eeg (95812) $1,372 $1,372 6.0×
Electrocardiogram (93005) $389.50 $389.50 6.2×
Electrocochleography (92584) $1,420 $1,420 10.4×
Electroconvulsive therapy (90870) $1,009 $1,009 1.1×
Emergency department visit high mdm (99285) $1,882 $1,882 3.0×
Emergency department visit low mdm (99283) $1,039 $1,039 3.6×
Emergency department visit may not req phys/qhp (99281) $406 $406 4.5×
Emergency department visit moderate mdm (99284) $1,451 $1,451 3.3×
Emergency department visit straightforward mdm (99282) $707 $707 4.3×
EMG one extremity (95860) $339 $339 2.4×
EMG three extremities (95863) $560 $560 4.1×
EMG two extremities (95861) $440 $440 3.1×
Endoscopy swallow (fees) vid (92612) $699 $699 3.5×
Eval aud funcj cand/po surg implt dev 1st hr (92626) $484 $484 3.5×
Evaluate pt use of inhaler (94664) $316 $316 1.4×
Evaluate speech production (92522) $609 $609 5.4×
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) $332 $332 7.0×
Evaluation of speech fluency (92521) $609 $609 4.6×
Evoked auditory test limited (92587) $501.50 $501.50 2.2×
Exercise tst brncspsm (94617) $2,585 $2,585 18.2×
Flow volume loop (94375) $955 $955 4.2×
Full field electroretinography w/i&r (92273) $761 $761 3.3×
Gait training 15 min (97116) $228 $228 7.8×
Gas dilut/washout lung vol w/wo distrib vent&vol (94727) $524 $524 2.3×
Gi tract capsule endoscopy (91110) $5,601 $5,601 5.8×
Hemodialysis procedure w/ phys/qhp evaluation (90935) $2,550 $2,550 3.5×
Icd Ck W Reprog Mult (93284) $430 $430 10.8×
Icd device prog eval, 1 single (93282) $430 $430 10.8×
Icd device progr eval, dual (93283) $430 $430 10.8×
Im adm intransl/oral 1 vaccine (90473) $94 $94 1.2×
Imm admn sarscov2 vaccine single dose (90480) $270 $270 6.2×
Immunization Admin (90471) $157.71 $157.71 2.1×
Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) $170 $170 3.4×
Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) $287 $287 1.3×
Insertion flow directed catheter for monitoring (93503) $2,716 $2,716 1.6×
Interrog device eval heart (93289) $487 $487 12.3×
Intrapulmonary surfactant administj phys/qhp (94610) $967 $967 4.1×
Irrigaj implntd venous access drug delivery syst (96523) $210 $210 3.3×
IV hydration each add'l hr (96361) $132 $132 2.6×
IV infusion hydration initial 31 min-1 hour (96360) $484 $484 2.1×
IV infusion ther proph addl sequential to 1 hr (96367) $191 $191 2.5×
IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) $638 $638 2.8×
IV tx, each additional hour (96366) $202 $202 4.1×
Laryngeal function studies (92520) $719 $719 5.1×
Loop Recorder Ck Wo Prog (93291) $487 $487 15.8×
Lwr xtr vasc stdy bilat (93924) $1,290 $1,290 5.6×
Manual therapy ea 15 min (97140) $153.50 $153.50 5.5×
Massage therapy ea 15 mins (97124) $134 $134 4.5×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $63 $63 2.0×
Med nutr tx group ea 30 m (97804) $102 $102 6.0×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $63 $63 1.7×
Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) $699 $699 7.6×
Multifocal electroretinography w/i&r (92274) $410 $410 3.0×
Multiple sleep latency test (95805) $3,612 $3,612 4.0×
Nasopharyngoscopy (92511) $604 $604 2.8×
Neg pressure wound therapy non dme </= 50 sq cm (97607) $518 $518 1.2×
Neg pressure wound therapy non dme >50 sq cm (97608) $518 $518 1.2×
Negative pressure wound therapy dme </= 50 sq cm (97605) $333 $333 1.6×
Negative pressure wound therapy dme >50 sq cm (97606) $518 $518 1.2×
Non-invasive physiologic study extremity 3 levels (93923) $3,241 $3,241 14.1×
Oral speech device eval (92597) $652 $652 9.2×
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) $344 $344 7.5×
Osteopathic manipulative tx 1-2 body regions (98925) $246 $246 10.7×
Ot eval high complex 60 min (97167) $729 $729 7.3×
Ot eval low complex 30 min (97165) $380 $380 3.8×
Ot eval mod complex 45 min (97166) $553 $553 5.5×
Ot group therapy procedures (97150) $151.50 $151.50 8.4×
Ot mechanical traction (97012) $204 $204 14.2×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $228 $228 4.6×
Ot Prosthetic Training, Each 15 Min (97761) $228 $228 5.6×
Ot re-eval est plan care (97168) $737 $737 10.8×
Ot Sensory Integrative Techniques Each 15 Minutes (97533) $265 $265 4.4×
Ot wheelchair management (97542) $265 $265 8.5×
Paraffin bath therapy (97018) $238 $238 39.6×
Phlebotomy therapeutic (99195) $542 $542 3.8×
Photochemotherapy puva (96912) $319 $319 5.1×
Pm device eval in person (93288) $487 $487 12.3×
Pm device progr eval multi (93281) $430 $430 10.8×
Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) $7,670 $7,670 8.4×
Polysom <6 yrs 4/> paramtrs (95782) $3,837 $3,837 4.2×
Polysom <6 yrs cpap/bilvl (95783) $3,837 $3,837 4.2×
Prgrmg dev eval pm/ldls pm (93279) $430 $430 10.8×
Program eval implantable in persn dual ld pacer (93280) $430 $430 10.8×
Pt Aquatic Therapy/Exercises (97113) $228 $228 6.2×
Pt Debridement Open Wound 20 Sq Cm< (97597) $319 $319 1.5×
Pt Electric Current Therapy (97033) $228 $228 12.0×
Pt Electrical Stimulation (97032) $228 $228 15.5×
Pt eval high complex 45 min (97163) $729 $729 7.4×
Pt eval low complex 20 min (97161) $380 $380 3.9×
Pt infrared therapy (97026) $19 $19 2.8×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $228 $228 7.0×
Pt Physical Performance Test (97750) $371 $371 11.0×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $553 $553 5.7×
Pt re-eval est plan care (97164) $737 $737 10.9×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $265 $265 8.2×
Pt Therapeut Actvity Direct Pt Contact Each 15 Min (97530) $265 $265 7.6×
Pt Whirlpool Therapy (97022) $379 $379 24.1×
Pulmonary service/procedure (94799) $200 $200 1.5×
Pulmonary stress testing (94618) $2,585 $2,585 18.2×
Pulse oximetry continuous (94762) $920 $920 6.7×
Pure tone audiometry air & bone (92553) $390 $390 2.8×
Pure tone audiometry, air only (92552) $264 $264 1.9×
Refill/maint pump/resvr syst (96522) $903 $903 4.0×
Refill/maint, portable pump (96521) $1,862 $1,862 8.2×
Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain… (95990) $889 $889 2.5×
Rem interrog icpms <30 d phys/qhp (93297) $487 $487 12.3×
Rem interrog scrms <30 d phys/qhp (93298) $487 $487 12.3×
Repet tms tx initial w/map/motr threshld/del&m (90867) $341 $341 1.5×
Rfl&main implt pmp/rsvr dlvr spi/brn phy/qhp (95991) $993 $993 3.0×
Select picture audiometry (92583) $544 $544 8.7×
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording… (95926) $985 $985 4.3×
Sleep study unattended (95806) $1,290 $1,290 5.6×
Sleep study unattended (95800) $924 $924 4.0×
Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis… (95801) $924 $924 14.7×
Slp evaloral pharyngeal swallow function (92610) $809 $809 9.5×
Speech audiometry threshold (92555) $243 $243 3.9×
Speech sound lang comprehen (92523) $609 $609 2.7×
Spirometry (94010) $513 $513 2.2×
Spirometry with bronchodilator (94060) $1,033 $1,033 2.6×
Ssep upper limbs (95925) $985 $985 4.3×
St eval speech comm device 1st hr (92607) $527 $527 4.3×
Standardized cognitive performance testing (96125) $676 $676 6.6×
Stenger test, pure tone (92565) $188 $188 3.0×
Stress echocardiogram (93350) $4,121 $4,121 7.1×
Temp transcutaneous pacing (92953) $817 $817 1.2×
Test for ability to detect and repeat spoken words with speech recognition (92556) $343 $343 5.5×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $214 $214 9.6×
Ther ivntj cog funcj cntct ea addl 15 minutes (97130) $214 $214 10.2×
Therap repetitive tms tx subseq delivery & mng (90868) $894 $894 3.9×
Therapeutic prophylactic/dx injection subq/im (96372) $126 $126 1.6×
Therapeutic sp device service (92609) $435 $435 4.2×
Tilt table evaluation (93660) $3,622 $3,622 9.1×
Tinnitus assessment (92625) $573 $573 4.2×
Transcranial doppler stdy intracranial art compl (93886) $3,041 $3,041 12.0×
Treat swallowing dysfunction (92526) $265 $265 3.1×
Tte f-up or lmtd (93308) $1,481 $1,481 5.8×
Tte W/Doppler Complete - Tte Complete (93306) $4,121 $4,121 7.1×
Tte w/o doppler complete (93307) $1,970 $1,970 7.8×
Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) $265 $265 3.5×
Tx speech language voice commj auditry 2/>indiv (92508) $280 $280 11.6×
Tympanometry (92567) $243 $243 6.1×
Tympanometry and reflex threshold measurements (92550) $271 $271 1.2×
Ultrasound therapy ea 15 mins (97035) $228 $228 15.9×
Upr/l xtremity art 2 levels (93922) $390 $390 2.8×
Us transcranial doppler lmtd (93888) $2,031 $2,031 18.2×
Vasopneumatic device therapy (97016) $228 $228 19.0×
Veeg by tech 2-12 hours unmonitored (95711) $1,569 $1,569 6.8×
Veeg by tech 2-12 hr continuous r-t monitoring (95713) $2,999 $2,999 7.5×
Veeg by tech 2-12 hr intermittent monitoring (95712) $1,759 $1,759 4.4×
Veeg by tech ea incr 12-26 hr cont r-t mntr (95716) $5,613 $5,613 6.1×
Veeg by tech ea incr 12-26 hr intermittent mntr (95715) $3,383 $3,383 8.5×
Veeg by tech ea incr 12-26 hr unmonitored (95714) $2,999 $2,999 7.5×
Ventilator initial day (94002) $1,054 $1,054 1.6×
Ventilator subsequent day (94003) $872 $872 1.3×
Visual ep testing cns except glaucoma w/i&r (95930) $577 $577 2.5×
Visual reinforcement audiometry (vra) (92579) $443 $443 1.9×
Vital capacity total (94150) $257 $257 1.9×
Wound care non-selective (97602) $319 $319 1.5×