Procedures & surgery prices at St. Bernards Five Rivers Medical Center

Pocahontas, AR · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $1,408.50 $1,565 1.7×
Ablation 1/> Liver Tumor Perq Cryoablation (47383) $8,077.50 $8,975 0.8×
Ablation renal tumor unilateral perq cryotherapy (50593) $12,546 $13,940 1.3×
Appl Mlt-Layer Venous Wound Compress Below Knee (29581) $261 $290 1.8×
Application cast elbow finger short arm (29075) $414 $460 1.6×
Application finger splint static (29130) $130.50 $145 1.1×
Application long arm splint shoulder hand (29105) $243 $270 1.6×
Application long leg splint thigh ankle/toes (29505) $243 $270 1.6×
Application of long leg cast (29345) $414 $460 1.6×
Application Of Rigid Total Contact Leg Cast (29445) $432 $480 1.7×
Application short arm splint forearm-hand static (29125) $198 $220 1.6×
Application short leg splint calf foot (29515) $243 $270 1.6×
Apply short leg cast (29405) $414 $460 1.6×
Arterial puncture (36600) $202.50 $225 1.7×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $481.50 $535 1.7×
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $686.25 $762.50 1.1×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $481.50 $535 1.7×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $357.75 $397.50 1.3×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $103.50 $115 0.4×
Aspirat/Injection Ganglion Cyst(S) (20612) $99 $110 0.4×
Avulsion nail plate partial/complete simple 1 (11730) $315 $350 1.7×
Banding of hemorrhoids using a flexible endoscope (sigmoidoscope) (45350) $2,025 $2,250 1.9×
Biopsy bone trocar/needle deep (20225) $2,227.50 $2,475 1.5×
Biopsy Bone Trocar/Needle Superficial (20220) $2,227.50 $2,475 1.5×
Biopsy muscle percutaneous needle (20206) $2,504.25 $2,782.50 1.7×
Biopsy Pancrea Percutaneous Needle (48102) $2,227.50 $2,475 1.5×
Biopsy soft tissue pelvis&hip deep/subfscal/im (27041) $2,227.50 $2,475 1.5×
Biopsy; nasopharynx, survey for unknown primary lesion (42806) $4,716 $5,240 1.6×
Bladder Irrigation Simple (51700) $423 $470 1.9×
Blood patch (62273) $976.50 $1,085 1.5×
Blood transfusion service (36430) $702 $780 1.7×
Bone marrow aspiration only (38220) $2,227.50 $2,475 1.5×
Bx abdl/retroperitoneal mass prq needle (49180) $2,227.50 $2,475 1.5×
Bx/exc lymph node needle superficial (38505) $2,504.25 $2,782.50 1.7×
Chemical Cautery Tissue (17250) $229.05 $254.50 1.3×
Chemodenerv 1 extrem 5/> mus (64644) $769.50 $855 1.2×
Chemodenerv 1 extremity 1-4 (64642) $744.75 $827.50 1.2×
Chemodenerv Musc Migraine (64615) $411.75 $457.50 1.5×
Chemodenerv Musc Neck Dyston (64616) $468 $520 1.7×
Chemodenerv trunk musc 6/> (64647) $1,188 $1,320 1.8×
Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) $416.25 $462.50 1.5×
Chest tube placement (32551) $2,938.50 $3,265 2.1×
Chg Collect Blood From Catheter Venous Nos (36592) $198 $220 1.6×
Circum 28 days or older (54161) $378 $420 0.2×
Circumcision (54150) $348.75 $387.50 0.2×
Circumcision Neonate (54160) $477 $530 0.8×
Closed tx patellar dislocation w/o anesthesia (27560) $391.50 $435 1.7×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $391.50 $435 1.7×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $391.50 $435 1.7×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $2,443.50 $2,715 1.7×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $391.50 $435 1.7×
Cltx post hip arthrp dislc w/o anes (27265) $391.50 $435 1.7×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $391.50 $435 1.7×
Colonoscopy Flexible With Decompression - Colonoscopy (45393) $2,025 $2,250 1.9×
Colonoscopy stoma w/balloon dilation (44405) $2,025 $2,250 1.9×
Colonoscopy through stoma; with directed submucosal injection(s), any substance (44404) $2,025 $2,250 1.9×
Contrast Inj Cent Ven Cath, Inc Flouro (36598) $369 $410 1.9×
Control Nasal Hemorrhage Anterior Simple (30901) $198 $220 1.6×
Debridement subcutaneous tissue 20 sq cm/< (11042) $576 $640 1.6×
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $1,044 $1,160 1.6×
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $2,700 $3,000 1.8×
Destroy cerv/thor facet jnt (64633) $3,312 $3,680 1.9×
Destroy lumb/sac facet jnt (64635) $3,312 $3,680 1.9×
Destruc Benign/Premal,15+ Lesions (17004) $258.75 $287.50 0.7×
Destruction benign lesions 15 or more (17111) $206.55 $229.50 1.1×
Destruction Benign Lesions Up To 14 (17110) $188.10 $209 1.0×
Destruction by neurolytic agent, intercostal nerve (64620) $1,561.50 $1,735 1.9×
Destruction by neurolytic agent; other peripheral nerve or branch (64640) $978.75 $1,087.50 1.2×
Destruction neurolytic agt genicular nerve w/img (64624) $3,312 $3,680 1.9×
Destruction premalignant lesion 1st (17000) $123.30 $137 0.7×
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $1,188 $1,320 1.8×
Drainage Finger Abscess Simple (26010) $315 $350 1.7×
Drainage of hematoma/fluid (10140) $1,498.50 $1,665 1.0×
Draw blood off venous device (36591) $198 $220 1.6×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $670.50 $745 1.8×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $319.50 $355 1.7×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $324 $360 1.8×
Evacuation of subungual hematoma (11740) $198 $220 1.6×
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $1,170 $1,300 1.8×
Exc Thrombosed Hemorrhoid Xtrnl (46320) $1,809 $2,010 1.7×
Fluoro exam of g/colon tube (49465) $418.50 $465 1.9×
Gastric Intubation/Aspiration, Therapeutic (43753) $459 $510 2.3×
I&d abscess simple (10060) $265.50 $295 1.5×
I&d perianal abscess superficial (46050) $288.90 $321 0.3×
I&d pilonidal cyst simple (10080) $328.50 $365 0.5×
Image Cath Fluid Peri/Retro (49406) $2,227.50 $2,475 1.5×
Incision & drainage abscess complicated/multiple (10061) $479.25 $532.50 1.3×
Incision & drainage pilonidal cyst complicated (10081) $432 $480 0.7×
Incision & removal foreign body subq tiss compl (10121) $505.80 $562 0.3×
Incision & removal foreign body subq tiss simple (10120) $576 $640 1.6×
Incision and drainage of bartholin's gland abscess (56420) $301.50 $335 1.6×
Incisional biopsy skin single lesion (11106) $204.30 $227 0.3×
Inj paravert f jnt c/t 1 lev (64490) $983.25 $1,092.50 1.2×
Inj tendon sheath/ligament (20550) $108.45 $120.50 0.4×
Inj,Anes Agent,Brachial Plexus,Single (64415) $1,480.50 $1,645 1.8×
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $1,041.75 $1,157.50 1.3×
Inject Nerv Blck,Axillary Nerv (64417) $978.75 $1,087.50 1.2×
Inject Nerv Blck,Celiac Plexus (64530) $1,356.75 $1,507.50 1.7×
Inject Nerv Blck,Ilioingu/Iliohyp (64425) $1,080 $1,200 1.7×
Inject Nerv Blck,Intercost,Multpl (64421) $949.50 $1,055 1.2×
Inject Nerv Blck,Intercostal,One (64420) $765 $850 1.2×
Inject Nerv Blck,Paravert Sympath (64520) $1,516.50 $1,685 1.9×
Inject Rx Celiac Plexus Nerve (64680) $1,118.25 $1,242.50 1.4×
Inject Tendon Origin/Insert (20551) $495 $550 1.8×
Injection aa&/strd genicular nrv branches w/img (64454) $1,183.50 $1,315 1.8×
Injection aa&/strd nerves nrvtg si joint w/img (64451) $785.25 $872.50 1.2×
Injection aa&/strd sciatic nerve w/img gdn (64445) $918 $1,020 1.4×
Injection aa&/strd suprascapular nerve (64418) $1,183.50 $1,315 1.8×
Injection aa&/strd trigeminal nerve each branch (64400) $396 $440 1.4×
Injection anes other peripheral nerve/branch (64450) $1,129.50 $1,255 1.8×
Injection Anes Superior Hypogastric Plexus (64517) $985.50 $1,095 1.2×
Injection of agent to destroy presacral nerve bundle (64681) $1,561.50 $1,735 1.9×
Injection single/mlt trigger point 1/2 muscles (20552) $301.50 $335 1.1×
Injection single/mlt trigger point 3/> muscles (20553) $481.50 $535 1.7×
Injection therapeutic carpal tunnel (20526) $481.50 $535 1.7×
Injection, anesthetic agent; greater occipital nerve (64405) $175.50 $195 0.6×
Injection, anesthetic agent; sphenopalatine ganglion (64505) $380.25 $422.50 1.4×
Injection, Intralesional; More Than 7 Lesions (11901) $122.40 $136 0.7×
Injection, intralesional; up to and including 7 lesions (11900) $91.80 $102 0.5×
Insert Bladder Cath Complex (51703) $252 $280 2.2×
Insert non-tunnel cv cath (36556) $3,928.50 $4,365 1.4×
Insert Temp Bladder Cath (51702) $198 $220 1.6×
Insert,Non-Indwelling Bladder Catheter (51701) $198 $220 1.6×
Intubation endotracheal emergency procedure (31500) $369 $410 1.7×
Liver Biopsy (47000) $2,227.50 $2,475 1.5×
Myelography Lumbar Injection (62305) $1,372.50 $1,525 1.9×
Myelography Lumbar Injection (62304) $1,372.50 $1,525 1.9×
Myelography Via Lumbar Injection Rs&I Cervical (62302) $1,372.50 $1,525 1.9×
Myelography via lumbar injection rs&i thoracic (62303) $1,372.50 $1,525 1.9×
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $684 $760 1.7×
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $751.50 $835 1.8×
Njx anes stellate ganglion crv sympathetic (64510) $283.50 $315 0.4×
Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) $5,935.50 $6,595 1.8×
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $879.75 $977.50 1.1×
Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) $859.50 $955 1.3×
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $535.50 $595 0.8×
Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) $1,170 $1,300 1.8×
Percut Drain/Inject Renal Cyst (50390) $859.50 $955 1.3×
Perq replacement gtube not req revj gstrst trc (43762) $423 $470 1.9×
Place Interst Rad Ther Guide, Intraabd/Intrapelv/Retroper,1+,Perc (49411) $1,917 $2,130 1.5×
Placement of needle for intraosseous infusion (36680) $657 $730 1.6×
Prq Aspir Pulposus/Intervertebral Disc/Pvrt Tiss (62267) $972 $1,080 1.5×
Punch biopsy skin single lesion (11104) $168.30 $187 0.5×
Puncture Aspiration (10160) $382.50 $425 1.0×
Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) $3,312 $3,680 1.9×
Removal fb intranasal (30300) $270 $300 2.2×
Removal foreign body foot subcutaneous (28190) $438.30 $487 0.7×
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $318.15 $353.50 0.2×
Removal foreign body pharynx (42809) $657 $730 1.6×
Removal impacted cerumen irrigation/lvg unilat (69209) $22.05 $24.50 0.4×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $74.25 $82.50 1.4×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $153 $170 0.8×
Remove drug implant device (11982) $63 $70 0.2×
Remove Eyelid Foreign Body (67938) $445.50 $495 1.5×
Remv Ext Canal Foreign Body (69200) $173.25 $192.50 1.4×
Remv F.B.,Eye,Superf Conjunc (65205) $112.50 $125 0.9×
Renal biopsy (50200) $2,227.50 $2,475 1.5×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $576 $640 1.6×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $895.50 $995 2.4×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $895.50 $995 2.4×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $576 $640 1.6×
Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) $576 $640 1.6×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $576 $640 1.6×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $427.95 $475.50 1.2×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $576 $640 1.6×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $576 $640 1.6×
Repair of nail bed (11760) $895.50 $995 1.3×
Reposition gastrostomy tube (43761) $423 $470 1.9×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $121.50 $135 0.3×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $198 $220 1.6×
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $1,093.50 $1,215 0.4×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $450 $500 1.2×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $256.50 $285 1.4×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $211.50 $235 1.2×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $283.50 $315 1.6×
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $279 $310 1.5×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $306 $340 1.7×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $324 $360 1.8×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $225 $250 1.2×
Skin sub graft face/nk/hf/g (15275) $3,105 $3,450 4.6×
Skin sub graft trnk/arm/leg (15271) $3,105 $3,450 4.6×
Skin Sub Grft T/Arm/Lg Child (15273) $5,359.50 $5,955 2.9×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $207 $230 1.1×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $422.10 $469 1.1×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $315 $350 0.9×
Spinal puncture lumbar diagnostic (62270) $1,129.50 $1,255 1.8×
Strapping unna boot (29580) $261 $290 1.8×
Tangential biopsy skin single lesion (11102) $324 $360 0.9×
Therapeutic spinal pnxr drainage csf w/fluor/CT (62329) $1,188 $1,320 1.8×
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $1,138.50 $1,265 2.0×
Thoracentesis needle/cath pleura w/o imaging (32554) $289.80 $322 0.5×
Thyroid biopsy (60100) $972 $1,080 1.5×
Treat finger dislocation (26775) $414 $460 1.6×
Treat pleurodesis w/agent (32560) $1,233 $1,370 2.2×
Trim skin lesion (11055) $324 $360 1.8×
Trim skin lesions 2 to 4 (11056) $324 $360 1.8×
Trim skin lesions over 4 (11057) $324 $360 1.8×
Vaginal delivery only (59409) $4,500 $5,000 1.5×
Venipuncture (36415) $9 $10 1.0×