Amalgam 4 or > surfaces perm (CPT D2161)

D2161 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.

115 of 4255 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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HospitalLocationPosted cashPosted grossMedicare pays× Medicare
Uci Health-orange Orange, CA $26.40 $66 $831.49 0.0×
Adventist Health Lodi Memorial Lodi, CA $37.80 $540 $852.69 0.0×
West Jefferson Medical Center Marrero, LA $43.68 $273 $606.83 0.1×
Concord Hospital Concord, NH $45.90 $153 $690.29 0.1×
Concord Hospital – Laconia Laconia, NH $45.90 $153 $690.29 0.1×
Concord Hospital – Franklin Franklin, NH $45.90 $153 $690.29 0.1×
Mountains Community Hospital Lake Arrowhead, CA $50.40 $126 $831.49 0.1×
Boston Medical Center Boston, MA $50.85 $113 $774.78 0.1×
Washington County Hospital and Nursing Home Chatom, AL $54.17 — $583.69 0.1×
Aurelia Osborn Fox Memorial Hospital Oneonta, NY $62.65 $232.05 $807 0.1×
Touro New Orleans, LA $73.64 $526 $606.83 0.1×
Adventist Health Sonora Sonora, CA $91.80 $540 $831.49 0.1×
MetroHealth System
range across 2 matching MRF lines
Cleveland, OH $101.50–$458.85 $290–$1,311 $611.63 varies
Adventist Health Reedley Reedley, CA $102.60 $540 $831.49 0.1×
Adventist Health Ukiah Valley Ukiah, CA $108 $540 $831.49 0.1×
OHSU Hospital and Clinics Portland, OR $113.10 $174 $725.96 0.2×
University Medical Center New Orleans New Orleans, LA $128.70 $585 $585.39 0.2×
Manning Family Children's New Orleans, LA $131.22 $486 $606.83 0.2×
Bear Valley Community Hospital Big Bear Lake, CA $134.75 $192.50 $831.49 0.2×
Mammoth Hospital Mammoth Lakes, CA $138.60 $198 $831.49 0.2×
Magee General Hospital Magee, MS $145.05 $418 $583.69 0.2×
Adventist Health Tehachapi Valley Tehachapi, CA $145.80 $540 $831.49 0.2×
Adventist Health Howard Memorial Willits, CA $162 $540 $831.49 0.2×
Drumright Regional Hospital Drumright, OK $175.80 $293 $621.77 0.3×
Newark-Wayne Community Hospital Newark, NY $182 $280 $807 0.2×
Rochester General Hospital Rochester, NY $182 $280 $807 0.2×
Clifton Springs Hospital and Clinic Clifton Springs, NY $182 $280 $807 0.2×
Nebraska Medical Center Omaha, NE $182.65 $281 $671.31 0.3×
Bellevue Medical Center Bellevue, NE $182.65 $281 $671.31 0.3×
Contra Costa Regional Medical Center Martinez, CA $195 $195 $912.89 0.2×
Wynn Hospital Utica, NY $204 $340 $807 0.3×
Cincinnati Children's Hospital Medical Center Cincinnati, OH $210.36 $412.48 $630.01 0.3×
Plumas District Hospital Quincy, CA $216.80 $271 $831.49 0.3×
Strong Memorial Hospital
range across 2 matching MRF lines
Rochester, NY $221.85–$767.37 — $807 varies
Unity Hospital of Rochester Rochester, NY $224 $280 $807 0.3×
Unity Specialty Hospital Rochester, NY $224 $280 $807 0.3×
Westchester Medical Center Valhalla, NY $252 $252 $807 0.3×
Bayside Community Hospital Anahuac, TX $266 $266 $649.43 0.4×
Bellville Medical Center Bellville, TX $295 $295 $649.43 0.5×
El Campo Memorial Hospital El Campo, TX $295 $295 $649.43 0.5×
Palacios Community Medical Center Palacios, TX $295 $295 $649.43 0.5×
Charleston Area Medical Center Charleston, WV $327 $327 $620.15 0.5×
Lackey Memorial Hospital Forest, MS $356 $356 $583.69 0.6×
Adventist Health Mendocino Coast Fort Bragg, CA $356.40 $540 $831.49 0.4×
Roswell Park Comprehensive Cancer Center Buffalo, NY $416.67 $416.67 $807 0.5×
Kaleida Health Buffalo, NY $425 $425 $807 0.5×
Endeavor Health Clinical Operations Evanston, IL $515 $515 $692.79 0.7×
Swedish Hospital Chicago, IL $515 $515 $692.79 0.7×
Mount Sinai Hospital New York, NY $540 $600 $807 0.7×
Mount Sinai West New York, NY $540 $600 $807 0.7×
Mount Sinai Brooklyn Brooklyn, NY $540 $600 $807 0.7×
Maimonides Medical Center Brooklyn, NY $549 $549 $807 0.7×
Children's Minnesota - Minneapolis Hospital
range across 2 matching MRF lines
Minneapolis, MN $603–$1,234 $603–$1,234 $677.09 varies
Norwalk Hospital Norwalk, CT $727 $727 $775.02 0.9×
Highland Hospital Rochester, NY $767.37 — $807 1.0×
Valleywise Health Medical Center Phoenix, AZ $793.33 — $689.86 1.1×
Nyack Hospital Nyack, NY $807 — $807 1.0×
Montefiore St. Luke's Cornwall Newburgh, NY $807 — $807 1.0×
Cibola General Hospital Grants, NM $819.06 $1,023.82 $640 1.3×
Henry Ford Macomb Hospital Clinton Township, MI $888.94 — $644.16 1.4×
Henry Ford Hospital Detroit, MI $888.94 — $644.16 1.4×
Henry Ford Wyandotte Hospital Wyandotte, MI $888.94 — $644.16 1.4×
Henry Ford West Bloomfield Hospital West Bloomfield, MI $888.94 — $644.16 1.4×
Monroe Regional Hospital Aberdeen, MS $978.50 $978.50 $557.37 1.8×
Summit Medical Center, LLC Edmond, OK $1,019.18 — $621.77 1.6×
Hilton Head Medical Center Hilton Head Island, SC $1,071.79 — $601.28 1.8×
East Cooper Medical Center Mount Pleasant, SC $1,071.79 — $601.28 1.8×
Coastal Carolina Medical Center Hardeeville, SC $1,071.79 — $601.28 1.8×
Dunes Surgical Hospital Dakota Dunes, SD $1,347.69 — $660.49 2.0×
Lakeside Medical Center Belle Glade, FL $1,668.91 — $675.11 2.5×
Our Lady of the Lake Surgical Hospital Slidell, LA $1,825.64 — $587.10 3.1×
Northwest Surgical Hospital Oklahoma City, OK $1,865.31 — $621.77 3.0×
Community Hospital, LLC Oklahoma City, OK $1,865.31 — $621.77 3.0×
University Medical Center Las Vegas, NV $1,929.30 $6,431 $706.66 2.7×
Lincoln Medical & Mental Health Center Bronx, NY $1,967.49 $292.30 $807 2.4×
Jacobi Medical Center Bronx, NY $1,967.49 $292.30 $807 2.4×
Elmhurst Hospital Center Elmhurst, NY $1,967.49 $292.30 $807 2.4×
NYC Health + Hospitals/South Brooklyn Health Brooklyn, NY $1,967.49 $292.30 $807 2.4×
Metropolitan Hospital Center New York, NY $1,967.49 $292.30 $807 2.4×
Kings County Hospital Center Brooklyn, NY $1,967.49 $292.30 $807 2.4×
Bellevue Hospital Center New York, NY $1,967.49 $292.30 $807 2.4×
Queens Hospital Center Jamaica, NY $1,967.49 $292.30 $807 2.4×
Harlem Hospital Center New York, NY $1,967.49 $292.30 $807 2.4×
Woodhull Medical & Mental Health Center Brooklyn, NY $1,967.49 $292.30 $807 2.4×
Griffin Hospital Derby, CT $1,987.64 — $775.02 2.6×
Kaiser Foundation Hospital - South San Francisco South San Francisco, CA $2,352 $4,200 $938.69 2.5×
Kaiser Foundation Hospital-santa Clara Santa Clara, CA $2,352 $4,200 $934.49 2.5×
Kaiser Foundation Hospital - Walnut Creek Walnut Creek, CA $2,352 $4,200 $917.92 2.6×
Kaiser Foundation Hospital and Rehab Center Vallejo, CA $2,352 $4,200 $949.78 2.5×
Kaiser Foundation Hospital - Oakland/richmond Oakland, CA $2,352 $4,200 $945.70 2.5×
Kaiser Foundation Hospital - San Francisco San Francisco, CA $2,352 $4,200 $934.49 2.5×
Kaiser Foundation Hospital - Sacramento Sacramento, CA $2,352 $4,200 $917.92 2.6×
Kaiser Foundation Hospital San Rafael, CA $2,352 $4,200 $916.97 2.6×
Kaiser Foundation Hospital - Fremont Fremont, CA $2,352 $4,200 $934.49 2.5×
Kaiser Foundation Hospital - Redwood City Redwood City, CA $2,352 $4,200 $938.69 2.5×
Kaiser Foundation Hospital-san Jose San Jose, CA $2,352 $4,200 $950.89 2.5×
Kaiser Foundation Hosp So Sacramento Sacramento, CA $2,352 $4,200 $917.92 2.6×
Kaiser Foundation Hospital-santa Rosa Santa Rosa, CA $2,352 $4,200 $888.99 2.6×
Kaiser Foundation Hospital - Fresno Fresno, CA $2,352 $4,200 $831.49 2.8×
Kaiser Foundation Hospital Manteca Manteca, CA $2,352 $4,200 $905.91 2.6×
Kaiser Foundation Hospital - Antioch Antioch, CA $2,352 $4,200 $912.89 2.6×
Kaiser Foundation Hospital - Vacaville Vacaville, CA $2,352 $4,200 $949.78 2.5×
Kaiser Foundation Hospital - Roseville Roseville, CA $2,352 $4,200 $839.02 2.8×
Kaiser Foundation Hospital - San Leandro San Leandro, CA $2,352 $4,200 $934.61 2.5×
Duncan Regional Hospital, Inc Duncan, OK $3,389.76 — $621.77 5.5×
Stony Brook University Hospital Stony Brook, NY $13,690 $13,690 $807 17.0×
MercyOne North Iowa Medical Center Mason City, IA $45,472.90 — $650.62 69.9×
St. Francis Hospital, Roslyn Roslyn, NY — $316 $807 —
St. Charles Hospital Port Jefferson, NY — $316 $807 —
Mercy Medical Center Rockville Centre, NY — $316 $807 —
Good Samaritan Hospital Medical Center West Islip, NY — $316 $807 —
St. Joseph Hospital Bethpage, NY — $316 $807 —
St. Catherine of Siena Hospital Smithtown, NY — $316 $807 —
Erie County Medical Center Buffalo, NY — $319 $807 —
Upstate University Hospital Syracuse, NY — $368 $807 —

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.

"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.