Procedures & surgery prices at Summit Pacific Medical Center

Elma, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $1,215
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $302
Acne surgery (10040) $633
Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) $2,575
Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) $1,762
Amputation Finger/Thumb (26951) $4,245.50
Amputation toe interphalangeal joint (28825) $954.50
Amputation toe metatarsophalangeal joint (28820) $968
Anoscopy diagnostic (46600) $298
Appl Mltlayr Compres Leg Below Knee W/Ankle Foot (29581) $304.50
Application cast elbow finger short arm (29075) $475
Application cast shoulder hand long arm (29065) $899.50
Application Finger Splint Dynamic (29131) $430
Application finger splint static (29130) $210
Application long arm splint shoulder hand (29105) $431
Application of rigid total contact leg cast (29445) $675
Application short arm splint forearm-hand static (29125) $289
Apply long leg splint (29505) $363
Apply short leg cast (29405) $586.50
Apply short leg cast (29425) $512
Apply short leg splint (29515) $361
Arterial puncture (36600) $151
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $270
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $272.50
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $335
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $446
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $259
Arthrotomy ankle w/expl drainage/removal fb (27610) $2,259
Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening Facility (27612) $2,063
Aspirate pleura w/ imaging (32555) $739
Aspirate/Inj Ganglion Cyst (20612) $240.50
Aspiration bladder insert suprapubic catheter (51102) $1,927
Avulsion nail plate partial/complete simple 1 (11730) $288.50
Biopsy bone open deep (20245) $2,234.50
Biopsy bone open superficial (20240) $886
Biopsy bone trocar/needle deep (20225) $1,122
Biopsy Bone Trocar/Needle Superficial (20220) $532
Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) $566
Biopsy Nail Unit Separate Procedure (11755) $162
Biopsy of mouth lesion (40808) $143
Biopsy of tongue (41100) $200
Biopsy soft tissue leg/ankle area superficial (27613) $1,614.50
Biopsy Vulva/Perineum 1 Lesion Spx (56605) $245
Bladder Irrigation Simple (51700) $469.50
Blepharotomy drain absc eyelid (67700) $1,506.50
Blood transfusion service (36430) $933
Bone graft, any donor area; minor or small (eg, dowel or button) Facility (20900) $485
Bx Low Leg Soft Tissue,Deep (27614) $4,017.50
Change of cystostomy tube simple (51705) $353
Chemical cautery tissue (17250) $244
Chemodenerv Eccrine Glands (64650) $100
Chemodenerv musc migraine (64615) $2,451.50
Chemodenerv trunk musc 1-5 (64646) $2,302.50
Chemodenerv trunk musc 6/> (64647) $2,689.50
Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day Facility (64653) $126
Circumcision (54150) $329
Circumcision Neonate (54160) $490
Closed Rx Radial Shaft Fx (25500) $3,258.50
Closed treatment of trimalleolar ankle fracture with manipulation (27818) $5,658.50
Closed tx ankle dislocation w/o anesthesia (27840) $5,013.50
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $5,528
Closed Tx Calcaneal Fracture W/Manipulation (28405) $3,508
Closed tx patellar dislocation w/o anesthesia (27560) $4,080
Closed tx radial shaft fracture w/manipulation (25505) $5,995.50
Closed tx radial&ulnar shaft fractures w/manj (25565) $6,121
Closed tx temporomandibular dislocation 1st/sbsq (21480) $419
Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) $2,209
Clsd tx shoulder dislc w/manipulation req anes (23655) $5,236
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $2,065
Cltx ankle dislc req anes w/wo prq skel fixj (27842) $1,894
Cltx Carpal Bone Fx W/Manj Each Bone (25635) $5,728.50
Cltx dstl fibular fx lat malls w/manj (27788) $1,420
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $560.50
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $4,024.50
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $6,686.50
Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) $4,067.50
Cltx fx grt toe phlx/phlg w/manj (28495) $716
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $1,870
Cltx hip dislocation traumatic w/o anesthesia (27250) $2,380.50
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $1,248.50
Cltx Iphal Jt Dislc W/Manj Req Anes (26775) $4,494.50
Cltx iphal jt dislc w/manj w/o anes (26770) $3,302
Cltx medial malls fx w/manj w/wo skn/skel tracj (27762) $4,827.50
Cltx metacarpal fx w/manipulation each bone (26605) $769
Cltx metatarsophlngl jt dislc w/o anes (28630) $541.50
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $3,946
Cltx post ankle fx w/mnpj (27768) $5,751
Cltx post hip arthrp dislc w/o anes (27265) $891.50
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $665
Cltx trimalleolar ankle fx w/o manipulation (27816) $3,737.50
Collect Blood From Catheter Venous Nos (36592) $392
Colonoscopy flex w/inj submuc (45381) $1,527
Colonoscopy flex w/rem forcep (45384) $1,729
Colonoscopy Thru Stoma,Lesn Rmvl W/Snare - Colonoscopy (44394) $1,713
Colonoscopy w/ablation (45388) $2,004
Colonoscopy w/fb removal (45379) $1,810
Colonoscopy, flexible; with control of bleeding, any method (45382) $1,963
Colonoscopy, flexible; with endoscopic mucosal resection (45390) $2,497
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $299
Colposcopy cervix upper/adjacent vagina (57452) $194
Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx (57455) $256
Colposcopy cervix vag eltrd conization cervix (57461) $439
Colposcopy Cervix Vag Loop Eltrd Bx Cervix (57460) $363
Colposcopy entire vagina w/cervix if present (57420) $206
Colposcopy,Cervix W/Adj Vagina, Curettag (57456) $236
Colposcopy,Entire Vagina,W/Biopsy(S) (57421) $282
Control Nasal Hemorrhage Anterior Complex (30903) $2,030.50
Control Nasal Hemorrhage Anterior Simple (30901) $416
Correction Trichiasis Epilation Forceps Only (67820) $43
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $1,443.50
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $87
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $3,100
Debride Assoc Open Fx/Disloc Skin/Subq (11010) $856
Debride nail 1-5 (11720) $108
Debride nail 6 or more (11721) $109
Debride skin musc at fx site (11011) $771
Debride tissue/muscle (11043) $1,129
Debridement subcutaneous tissue 20 sq cm/< (11042) $349.50
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $502
Declot vascular device (36593) $344
Delay flap/sectioning flap f/c/c/n/ax/g/h/f (15620) $1,416
Destroy cerv/thor facet jnt (64633) $4,453
Destroy lumb/sac facet jnt (64635) $4,392
Destruction Benign Lesions 15/> (17111) $346
Destruction Benign Lesions Up To 14 (17110) $502
Destruction by neurolytic agent, intercostal nerve (64620) $3,357.50
Destruction by neurolytic agent; other peripheral nerve or branch (64640) $1,818.50
Destruction by neurolytic agent; plantar common digital nerve (64632) $497
Destruction Lesions Vulva Simple (56501) $460
Destruction neurolytic agt genicular nerve w/img (64624) $2,881.50
Destruction Premalignant Lesion 15/> (17004) $402
Destruction premalignant lesion 1st (17000) $214
Diagnostic sigmoidoscopy (45330) $415
Drain Mouth Absc/Cyst/Hematoma,Simpl (40800) $941
Drain/inj small joint/bursa w/us (20604) $899.50
Drainage external auditory canal abscess (69020) $1,972.50
Drainage External Ear Abscess/Hematoma Simple (69000) $332
Drainage Finger Abscess Complicated (26011) $2,415
Drainage Finger Abscess Simple (26010) $1,791
Drainage of gum lesion (41800) $1,100
Drainage of hematoma/fluid (10140) $505
Drainage of scrotal wall abscess (55100) $2,181.50
Draw blood off venous device (36591) $75
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $876
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $729
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $394
Dstrj Lesion Penis Simple Cryosurgery (54056) $556
Egd balloon dilation esophagus <30 mm diam (43249) $1,176
Egd control bleeding any (43255) $1,526
Egd dilate stricture (43245) $1,344
Egd flexible foreign body removal (43247) $1,353
Egd guide wire insertion (43248) $1,272
Egd remove lesion snare (43251) $1,527
Endometrial Biopsy (58100) $320
Endoscopy bowel pouch/biop (44386) $699
Esophagoscopy Flexible Transoral Diagnostic (43200) $691
Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) $802
Evacuation of subungual hematoma (11740) $236
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $577
Exc B9 Lesion Mrgn Xcp Sk Tg S/N/H/F/G 0.5 Cm/< (11420) $343
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $623
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $784
Exc b9 lesion mrgn xcp sk tg t/a/l 1.1-2.0 cm (11402) $460
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $475
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $553
Exc lesion tendon sheath/capsule w/synvct foot (28090) $1,111
Exc lesion tendon sheath/capsule w/synvct toe ea (28092) $1,053
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $433
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $323
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $600
Exc Skin Benig >4 Cm Remaindr Body (11426) $867
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $993
Exc Skin Malig >4 Cm Remaindr Body (11626) $849
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $299
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $77
Exc tumor soft tissue foot/toe subfasc 1.5+cm (28041) $1,449
Exc tumor soft tissue foot/toe subfasc <1.5cm (28045) $1,177
Exc Tumor Soft Tissue Leg/Ankle Subfasc 5 Cm/> (27634) $2,098
Exc tumor soft tissue leg/ankle subq <3cm (27618) $3,167
Exc/curtg bone cyst/b9 tumortarsal/metatarsal (28104) $1,262
Exc/Curtg Cst/B9 Tum Phalanges Foot (28108) $1,046
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $660
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $301
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $338
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $744
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $469
Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) $547
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $608
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $703
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $762
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $539
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $570
Excision of thrombosed hemorrhoid, external (46320) $2,194.50
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; Facility (28100) $1,557
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft Facility (28103) $1,156
Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes… (28102) $1,669
Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or… (28106) $1,264
Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft Facility (27638) $2,488
Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft) Facility (27637) $2,692
Excision tumor soft tis foot/toe subq 1.5 cm/> (28039) $1,063
Excision tumor soft tissue foot/toe subq <1.5cm (28043) $2,452
Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater (27632) $1,355
Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm Facility (27619) $1,557
Explo/Drain Breast Abscess (19020) $4,002
Exploration penetrating wound spx extremity (20103) $1,028
Fasciotomy foot and/or toe (28008) $2,717.50
Fetal non-stress test (59025) $546.50
Filleted finger/toe flap (14350) $2,022
Fine needle aspiration without imaging guidance (10021) $600
Fit/Insert Intravag Support Device (57160) $121
Flap; neurovascular pedicle (15750) $3,206
Fluid pressure muscle (20950) $303
Gastric Intubation/Aspiration, Therapeutic (43753) $72
I&D Abscess Peritonsillar (42700) $2,145.50
I&d abscess simple (10060) $716
I&D Below Fascia Foot 1 Bursal Space (28002) $804.50
I&d pilonidal cyst simple (10080) $779
I&d vulva/perineal abscess (56405) $489
Incise external hemorrhoid (46083) $773
Incision & drainage abscess complicated/multiple (10061) $721
Incision & drainage pilonidal cyst complicated (10081) $2,214
Incision & removal foreign body subq tiss compl (10121) $2,426.50
Incision & removal foreign body subq tiss simple (10120) $584
Incision and drainage of bartholin's gland abscess (56420) $556
Incision and drainage perianal abscess superficial (46050) $708
Incision and drainage, complex, postoperative wound infection (10180) $986
Incision of lingual frenum (frenotomy) (41010) $463
Incision of rectal abscess (46040) $753
Incisional biopsy skin single lesion (11106) $541
Initial tx 1st degree burn local tx (16000) $299
Inj paravert f jnt c/t 1 lev (64490) $2,093
Inj tendon sheath/ligament (20550) $176
Inj,Anes Agent,Brachial Plexus,Single (64415) $1,273.50
Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) $2,595
Inject Nerv Blck,Axillary Nerv (64417) $1,389
Inject Nerv Blck,Celiac Plexus (64530) $1,804.50
Inject Nerv Blck,Intercost,Multpl (64421) $1,798
Inject Nerv Blck,Intercostal,One (64420) $1,335
Inject Nerv Blck,Paravert Sympath (64520) $1,587.50
Inject Tendon Origin/Insert (20551) $176
Injection aa&/strd genicular nrv branches w/img (64454) $1,608.50
Injection aa&/strd nerves nrvtg si joint w/img (64451) $1,561
Injection Aa&/Strd Other Peripheral Nerve/Branch (64450) $338
Injection aa&/strd trigeminal nerve each branch (64400) $933.50
Injection Anes Agent Sphenopalatine Ganglion (64505) $1,703.50
Injection anesthetic agent femoral nerve single (64447) $1,294.50
Injection anesthetic agent suprascapular nerve (64418) $1,492
Injection into skin lesions (11900) $129
Injection single/mlt trigger point 1/2 muscles (20552) $278
Injection single/mlt trigger point 3/> muscles (20553) $314
Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter… (64446) $1,546
Injection, anesthetic agent; paracervical (uterine) nerve (64435) $338
Insert Bladder Cath Complex (51703) $877.50
Insert cath pleura w/o image (32556) $1,422
Insert Drug Implant Device (11981) $235
Insert non-tunnel cv cath (36556) $921
Insert Temp Bladder Cath (51702) $281.50
Insert,Non-Indwelling Bladder Catheter (51701) $316
Insj picc rs&i 5 yr+ (36573) $428
Insj Tun Vad Req 2 Cath 2 Sits W/Subq Port (36566) $4,358
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $2,025
Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) $2,025
Intraoral i&d tongue/floor lingual (41000) $1,449
Intubation endotracheal emergency procedure (31500) $1,445
Irrigation of corpora cavernosa for priapism (54220) $1,762
Island pedicle flap graft (15740) $2,984
Laryngoscopy flexible diagnostic (31575) $964
Lyse chest fibrin init day (32561) $776
Metatarsectomy (28140) $1,224
Monocyte distribution width whole blood (0427U) $38
Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Facility (15738) $6,639
N Block Inj Ilio-Ing/Hypogi (64425) $1,825.50
N Block Inj, Plantar Digit (64455) $253
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $776
Njx aa&/strd sciatic nerve (64445) $1,417.50
Njx anes stellate ganglion crv sympathetic (64510) $1,444
Njx c/p/a cavernosa w/pharmacologic agt (54235) $988.50
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $1,791.50
Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) $2,139
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $1,969
Occipital Nerve Block (64405) $460
Open treatment interphalangeal joint dislocation (28675) $1,590
Open treatment metatarsal fracture each (28485) $2,211
Open tx fracture phalanx/phalanges not great toe (28525) $1,522
Open tx tarsal fracture xcp talus & calcaneus ea (28465) $907
Ostectomy calcaneus (28118) $4,106
Ostectomy complete 5th metatarsal head (28113) $4,344.50
Ostectomy, complete excision; other metatarsal head (second, third or fourth) Facility (28112) $3,037.50
Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula Facility (27641) $2,176
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28120) $4,685
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28122) $4,045
Partial excision bone tibia (27640) $6,212.50
Partical Excision Bone Phalanx Toe (28124) $3,255.50
Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation Facility (28496) $1,398
Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each Facility (28456) $2,015
Perq replacement gtube not req revj gstrst trc (43762) $508
Picc line placement (36569) $2,641
Placement of needle for intraosseous infusion (36680) $772.50
Prq skel fixj metar fx w/manj (28476) $1,979
Punch biopsy skin single lesion (11104) $346
Puncture aspiration of abscess hematoma bulla or cyst (10160) $680
Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) $3,807.50
Removal Foreign Body Foot Complicated (28193) $3,194
Removal foreign body foot deep (28192) $1,069
Removal foreign body foot subcutaneous (28190) $543
Removal foreign body intranasal (30300) $767
Removal foreign body muscle/tendon sheath simple (20520) $1,580.50
Removal foreign body pharynx (42809) $1,626.50
Removal impacted cerumen irrigation/lvg unilat (69209) $94
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $242
Removal implant deep (20680) $3,956
Removal Implant Superficial Separate Procedure (20670) $1,601
Removal Implantable Contraceptive Capsules (11976) $214
Removal of ankle implant (27704) $2,047
Removal of bone for graft (20902) $713
Removal of foreign body, external eye; corneal, without slit lamp (65220) $305
Removal of iud (58301) $488
Removal of nail bed (11750) $663.50
Removal skn tags mlt fibrq tags any area upw/15 (11200) $474
Removal, under anesthesia, of external fixation system (20694) $1,381
Removal/bivalving gauntlet boot/body cast (29700) $217
Remove drug implant device (11982) $407
Remove foreign body from eye (65235) $2,843
Remove Lower Leg Bone Lesion (27635) $2,080
Remove/Insert Drug Implant (11983) $702
Remv Ext Canal Foreign Body (69200) $347
Remv F.B.,Eye,Superf Conjunc (65205) $318
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $3,778.50
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $3,797
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $3,288.50
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $2,288
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $3,098.50
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $3,521
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $1,245
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $2,677.50
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $2,856.50
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $2,842
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $3,546
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $1,091
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $627
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $2,645.50
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $3,154.50
Repair intermediate s/a/t/e 2.5 cm/< (12031) $1,109
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $1,415
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $3,664
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $1,498
Repair intermediate s/a/t/e >30.0 cm (12037) $4,289.50
Repair of nail bed (11760) $842
Repair Tendon Extensor Foot 1/2 Each Tendon (28208) $1,196
Repair tongue laceration (41252) $2,745
Repair Tongue Laceration (41250) $1,872.50
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $679
Rmvl Fb Xtrnl Eye Embed Scjncl/Scleral Nonperfor (65210) $502.50
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $2,295
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $321
Rpr Lip Full Thickness Vermilion Only (40650) $4,312
Shave skin lesion 0.5 cm/< (11300) $143
Shave skin lesion 0.5 cm/< (11305) $161
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $194
Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) $236
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $210
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $319
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $220
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $301
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $256
Sigmoidoscopy w/biopsy (45331) $530
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $400
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $421
Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) $1,982.50
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $979.50
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $1,259.50
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $324
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $529
Skin splt grft trnk/arm/leg (15100) $2,186
Skin sub graft face/nk/hf/g (15275) $433
Skin sub graft trnk/arm/leg (15271) $2,253.50
Skin sub grft t/arm/lg child (15273) $608
Skin tissue rearrangement (14040) $1,836
Skn splt a-grft fac/nck/hf/g (15120) $2,289
Skn sub grft f/n/hf/g child (15277) $2,845.50
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $423
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $734
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $1,521.50
Spinal puncture lumbar diagnostic (62270) $569
Spinal Puncture Therapeutic (62272) $852
Strapping unna boot (29580) $259
Talectomy (astragalectomy) Facility (28130) $2,111
Tangential biopsy skin single lesion (11102) $357
Tenolysis flexor foot single tendon (28220) $1,051
Tenolysis, extensor, foot; multiple tendons Facility (28226) $1,693
Tenotomy open extensor foot/toe each tendon (28234) $1,109
Tenotomy Percutaneous Toe Single Tendon (28010) $799
Tenotomy Prq Achilles Tendon Spx Local Anes (27605) $1,607.50
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) (28232) $2,418
Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia Facility (27606) $2,350
Tenotomy, Percutaneous, Toe; Multiple Tendons (28011) $985
Thoracentesis needle/cath pleura w/o imaging (32554) $833.50
Thrombolytic Therapy Stroke (37195) $1,478
Thrombolytic Venous Therapy (37212) $6,792
Treat Big Toe Fracture (28505) $1,715
Treat Metatarsal Fracture (28475) $2,554
Treatment closed elbow dislocation req anes (24605) $1,426.50
Treatment closed elbow dislocation w/o anes (24600) $4,334.50
Treatment of foot infection (28003) $476
Trim skin lesion (11055) $186
Trim skin lesions 2 to 4 (11056) $196
Trim skin lesions over 4 (11057) $217
Trimming Of Nondystrophic Nails, Any Number (11719) $57
Tube thoracostomy includes water seal (32551) $1,553
Tx Opn Tendon Flexor Foot Single/Mult Tendon Spx (28230) $2,683
Tx Superficial Wound Dehiscence Simple Closure (12020) $431
Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj (28455) $2,452
Unlisted procedure dentoalveolar structures (41899) $1,098
Unlisted procedure nervous system (64999) $351.50
Us urine capacity measure (51798) $549
Vaginal delivery only (59409) $3,622
Vaginal Delivery Only, After Previous Cesarean Delivery (59612) $3,356
Vasectomy uni/bi spx w/postop semen exams (55250) $473
Venipuncture (36415) $39
Wedge excision skin nail fold (11765) $675
Wound Prep F/N/Hf/G (15004) $1,139
Wound prep trk/arm/leg 1st 100 sq cm (15002) $938