Procedures & surgery prices at Summit Healthcare Regional Medical Center

Show Low, AZ · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Ablate inf turbinate submuc (30802) $7,647.98
Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method; superficial (30801) $3,261.93
Amputation Finger/Thumb (26951) $5,735.36
Amputation of finger/thumb (26952) $4,203.44
Amputation toe interphalangeal joint (28825) $4,203.44
Anterior Tibial Tubercleplasty (27418) $16,288.88
Appl Mlt-Layer Venous Wound Compress Below Knee (29581) $383.84
Application Finger Splint Dynamic (29131) $215.74
Application finger splint static (29130) $299.42
Application long arm splint shoulder hand (29105) $599.34
Application Of Rigid Total Contact Leg Cast (29445) $332.96
Application Short Arm Splint Dynamic (29126) $470.70
Application short arm splint forearm-hand static (29125) $435.50
Apply multlay comprs arm/hand (29584) $527.51
Arterial puncture (36600) $322.16
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $1,017.70
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $1,947.02
Arthroscopically aided treat. intercondylar spine and/or tuberosity fx knee w/o int/ext. fix 29850 (29850) $8,933.32
Arthroscopy, shoulder, surgical; synovectomy, partial (29820) $8,304
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $37,300.66
Avulsion nail plate partial/complete simple 1 (11730) $588.01
Biopsy muscle percutaneous needle (20206) $4,284.25
Biopsy Salivary Gland,Needle (42400) $4,284.25
Bladder Instillation Anticarcinogenic Agent (51720) $734.36
Bladder Irrigation Simple (51700) $919.45
Bladder Scan (51798) $427.52
Blood patch (62273) $2,269.82
Blood transfusion service (36430) $1,847.70
Bone marrow aspiration only (38220) $5,341.94
Bone Marrow Biopsy (38221) $198.52
Bx breast 1st lesion us imag (19083) $3,542.76
Chemical Cautery Tissue (17250) $98.96
Chest tube placement (32551) $1,623.12
Chg Collect Blood From Catheter Venous Nos (36592) $423.81
Closed treatment nasal fracture w/stabilization (21320) $10,473.08
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $3,062.66
Closed Tx Lunate Dislocation W/Manipulation (25690) $5,178.16
Closed tx nasal fracture w/o stabilization (21315) $5,395.26
Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) $3,020.76
Cltx dstl fibular fx lat malls w/manj (27788) $1,521.21
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $997.80
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $3,332.51
Contrast Inj Cent Ven Cath, Inc Flouro (36598) $589.79
Control Nasal Hemorrhage Anterior Complex (30903) $609.50
Control Nasal Hemorrhage Anterior Simple (30901) $299.48
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $609.50
Debride nail 1-5 (11720) $42.80
Debridement subcutaneous tissue 20 sq cm/< (11042) $814.64
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $434.88
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $651.20
Declot vascular device (36593) $941.14
Delivery placenta separate procedure (59414) $6,070.98
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $2,499.22
Drainage External Ear Abscess/Hematoma Simple (69000) $6,482.85
Drainage of hematoma/fluid (10140) $310.63
Draw blood off venous device (36591) $585.90
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $372.48
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $308
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $148.88
Dry Needling 3+ Muscles (20561) $56.24
Egd place gastrostomy tube (43246) $4,438.28
Endoscopic Plantar Fasciotomy (29893) $7,362.58
Episiotomy or vaginal repair (59300) $5,871.28
Evacuation of subungual hematoma (11740) $234.93
External Cephalic Version (59412) $3,721.70
Fetal Contraction Stress Test (59020) $707.49
Fetal non-stress test (59025) $778.52
Fixation of knee joint (27570) $3,620.12
Fluid pressure muscle (20950) $2,354.54
Fluoro exam of g/colon tube (49465) $855.40
Hysteroscopy biopsy (58558) $617.40
I&d abscess simple (10060) $1,726.92
I&d perianal abscess superficial (46050) $2,328.40
Image Cath Fluid Colxn Visc (49405) $3,898.84
Incise finger tendon sheath (26055) $3,830.85
Incision & drainage abscess complicated/multiple (10061) $499.36
Incision & removal foreign body subq tiss simple (10120) $1,284.92
Incision and drainage of vulva or perineal abscess (56405) $283.61
Incisional biopsy skin single lesion (11106) $159.26
Inj,Anes Agent,Brachial Plexus,Single (64415) $172.72
Inj,Anes Agent,Femoral Nerve,Single (64447) $327.43
Inject Nerv Blck,Axillary Nerv (64417) $1,741.96
Inject Tendon Origin/Insert (20551) $988.70
Injection anes other peripheral nerve/branch (64450) $119.29
Injection, anesthetic agent; greater occipital nerve (64405) $1,058.42
Insert Bladder Cath Complex (51703) $533.09
Insert cervical dilator (59200) $1,009.80
Insert non-tunnel cv cath (36556) $4,079.68
Insert picc cath (36569) $1,029.15
Insert Picc W/O Sub-Q Port <5 Y/O (36568) $363.12
Insert Temp Bladder Cath (51702) $471.81
Insert tun ip cath perc (49418) $9,209.02
Insert tunneled cv cath (36561) $5,867.44
Insert,Non-Indwelling Bladder Catheter (51701) $309.25
Insertion Picc W/Rs&I 5 Yr/> (36573) $216.55
Insj tunneled ctr vad w/subq port under 5 yr (36560) $910.10
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $685.08
Intubation endotracheal emergency procedure (31500) $216.31
Laryngoscopy Flexible Diagnostic (31575) $457.03
Lip Surgery Procedure (40799) $550.79
Manipulation finger joint under anes each joint (26340) $3,620.12
Manipulation, elbow, under anesthesia (24300) $3,620.12
Myelography Lumbar Injection (62305) $5,882.45
Myelography Lumbar Injection (62304) $3,947.21
Myelography Via Lumbar Injection Rs&I Cervical (62302) $3,947.21
Myelography via lumbar injection rs&i thoracic (62303) $4,144.58
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $1,022.95
Needle insertion w/o injection 1 or 2 muscles (20560) $45
Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) $12,432.54
Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62324) $246.15
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $2,499.22
Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) $2,256.71
Occlude fallopian tube(s) (58615) $8,628.81
Open treatment of clavicular fracture, includes internal fixation, when performed (23515) $16,288.88
Partial excision bone talus/calcaneus (28120) $3,085.24
Peritoneal Lavage (49084) $3,018.31
Perq dev breast 1st us imag (19285) $2,224.39
Perq device breast 1st imag (19281) $2,354.54
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $6,151.68
Place Interst Rad Ther Guide, Intraabd/Intrapelv/Retroper,1+,Perc (49411) $4,979.45
Plmt nephrostomy cath prq new access rs&i (50432) $3,858.15
Plmt Urtrl Stent Prq New Access W/Sep Nfros Cath (50695) $6,666.65
Plmt urtrl stent prq pre-existing nfros tract (50693) $6,666.65
Prq skel fixj sprcndylr/transcndylr humeral fx (24538) $16,288.88
Punch biopsy skin single lesion (11104) $130.97
Puncture Aspiration (10160) $506.05
Reconstruction of nose (30400) $13,223.74
Removal impacted cerumen irrigation/lvg unilat (69209) $310.44
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $94.80
Removal of intrauterine device (iud) (58301) $177.40
Removal of nail bed (11750) $533.68
Removal of sesamoid bone (28315) $51,871.81
Remove wrist tendon lesion (25111) $2,523.85
Remv&replc cvd gen mult lead (33264) $59,870.83
Repair initial femoral hernia, any age; reducible (49550) $8,276.87
Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon (28200) $5,381.26
Replace g/c tube perc (49450) $3,008.06
Reposition pacing-defib lead (33215) $9,893.86
Revise external ear (69300) $10,671.93
Revise median n/carpal tunnel surg (64721) $2,907.68
Revision of penis (54300) $3,898.17
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $3,868.42
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $2,384.14
Rpr Coltrl Ligm Mtcarphlngl/Iphal Jt (26540) $5,735.58
Rpr Lip Full Thickness Vermilion Only (40650) $1,681.68
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $515.76
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $118.70
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $682.52
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $450.88
Skin sub graft face/nk/hf/g (15275) $277.84
Skin sub graft trnk/arm/leg (15271) $240.40
Skin Sub Grft T/Arm/Lg Child (15273) $511.37
Skn sub grft f/n/hf/g child (15277) $580.37
Sling operation for stress incontinence (eg, fascia or synthetic) (57288) $11,848.19
Spinal puncture lumbar diagnostic (62270) $603.98
Strapping ankle (29540) $527.51
Strapping Hip (29520) $334.91
Strapping knee (29530) $353.86
Strapping toes (29550) $334.91
Strapping unna boot (29580) $527.51
Tangential biopsy skin single lesion (11102) $104.36
Tenodesis long tendon biceps (23430) $13,316.32
Tenolysis flexor foot single tendon (28220) $2,821.16
Ther Apheresis W/Extracorporeal Immunoadsorption (36516) $16,056.78
Ther Apheresis,Plasma Pheresis (36514) $5,684.99
Ther Apheresis,Platelets (36513) $5,684.99
Ther Apheresis,Red Blood Cells (36512) $5,684.99
Ther Apheresis,White Blood Cells (36511) $5,684.99
Thrombolytic Therapy, Stroke (37195) $1,176.39
Transabdominal Amnioinfusion W/Ultrsnd Guidance (59070) $1,000.52
Treat fx distal radial (25606) $3,873.69
Treatment of ankle fracture (27822) $16,288.88
Trim skin lesion (11055) $44.88
Trim skin lesions 2 to 4 (11056) $63.60
Trim skin lesions over 4 (11057) $83.36
Trimming Of Nondystrophic Nails, Any Number (11719) $22
Tx Superficial Wound Dehiscence Simple Closure (12020) $486.66
Unlisted Procedure Casting/Strapping (29799) $536.42
Unlisted procedure neck or thorax (21899) $788.89
Unlisted Procedure Nervous System (64999) $976.06
Unlisted Procedure Rectum (45999) $3,054.34
Unlisted procedure, abdomen, peritoneum and omentum (49999) $3,210.64
Unlisted procedure, hands or fingers (26989) $538.23
Venipuncture (36415) $46.54