Periodic oral evaluation (CPT D0120)
D0120 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.
47 of 2110 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.
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| Hospital | Location | Cash price | Gross charge | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| Touro | New Orleans, LA | $17.08 | $122 | $124.97 | 0.1× |
| West Jefferson Medical Center | Marrero, LA | $20.64 | $129 | $124.97 | 0.2× |
| North Sunflower Medical Center | Ruleville, MS | $22.50 | $45 | $114.78 | 0.2× |
| Leonard J. Chabert Medical Center | Houma, LA | $26.32 | $56 | $124.01 | 0.2× |
| University Medical Center New Orleans | New Orleans, LA | $29.92 | $136 | $120.55 | 0.2× |
| Manning Family Children's | New Orleans, LA | $30.24 | $112 | $124.97 | 0.2× |
| Baylor University Medical Center (Baylor Scott & White) | Dallas, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott and White Medical Center Irving | Irving, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott and White All Saints Medical Center | Fort Worth, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott & White Medical Center- Waxahachie | Waxahachie, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott & White Medical Center Grapevine | Grapevine, TX | $36 | $60 | $133.96 | 0.3× |
| Baylor Scott and White Medical Center Lake Pointe | Rowlett, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott & White Heart and Vascular Hospital | Dallas, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott & White Medical Center - Centennial | Frisco, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Regional Medical Center at Plano | Plano, TX | $36 | $60 | $133.74 | 0.3× |
| The Heart Hospital Baylor Denton | Denton, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott & White The Heart Hospital Plano | Plano, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott and White Medical Center Mckinney | Mc Kinney, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott and White Medical Center Frisco at Pg | Frisco, TX | $36 | $60 | $133.74 | 0.3× |
| Baylor Scott and White The Heart Hospital Corinth | Denton, TX | $36 | $60 | $133.74 | 0.3× |
| Nebraska Medical Center | Omaha, NE | $53.30 | $82 | $138.25 | 0.4× |
| Bellevue Medical Center | Bellevue, NE | $53.30 | $82 | $138.25 | 0.4× |
| Washington County Hospital and Nursing Home | Chatom, AL | $54.17 | — | $114.74 | 0.5× |
| Arkansas Children's Hospital | Little Rock, AR | $59.99 | $66.66 | $125.09 | 0.5× |
| Mcbride Orthopedic Hospital | Oklahoma City, OK | $65 | $65 | $128.05 | 0.5× |
| Prisma Health Blount Memorial Hospital | Maryville, TN | $99.82 | $322 | $127.03 | 0.8× |
| Norwalk Hospital | Norwalk, CT | $128 | $128 | $159.61 | 0.8× |
| Lakeside Medical Center | Belle Glade, FL | $129.36 | — | $139.03 | 0.9× |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $141.50 | — | $120.91 | 1.2× |
| Griffin Hospital | Derby, CT | $154.06 | — | $159.61 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $163.38 | — | $142.07 | 1.1× |
| Hilton Head Medical Center | Hilton Head Island, SC | $179.60 | — | $123.83 | 1.5× |
| East Cooper Medical Center | Mount Pleasant, SC | $179.60 | — | $123.83 | 1.5× |
| Coastal Carolina Medical Center | Hardeeville, SC | $179.60 | — | $123.83 | 1.5× |
| Prisma Health Oconee Memorial Hospital | Seneca, SC | $209.30 | $322 | $127.21 | 1.6× |
| Prisma Health Baptist Easley Hospital | Easley, SC | $209.30 | $322 | $127.21 | 1.6× |
| Prisma Health Greer Memorial Hospital | Greer, SC | $209.30 | $322 | $127.52 | 1.6× |
| Prisma Health Hillcrest Hospital | Simpsonville, SC | $209.30 | $322 | $127.52 | 1.6× |
| Prisma Health Laurens County Hospital | Clinton, SC | $209.30 | $322 | $126.85 | 1.6× |
| Prisma Health Greenville Memorial Hospital | Greenville, SC | $209.30 | $322 | $126.85 | 1.6× |
| Prisma Health Patewood Hospital | Greenville, SC | $209.30 | $322 | $127.52 | 1.6× |
| Duncan Regional Hospital, Inc | Duncan, OK | $262.74 | — | $128.05 | 2.1× |
| Baptist Hospital of Miami | Miami, FL | $347.10 | $534 | $139.03 | 2.5× |
| Northwest Surgical Hospital | Oklahoma City, OK | $384.15 | — | $128.05 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $384.15 | — | $128.05 | 3.0× |
| West Carroll Memorial Hospital | Oak Grove, LA | — | $52 | $120.55 | — |
| Jackson Memorial Hospital | Miami, FL | — | $183 | $139.03 | — |
"Medicare pays" is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. "—" means Medicare has no comparable facility rate.