Compare real prices at Ssm Health St. Mary's Hospital - Jefferson City in Jefferson City, MO. Taven tracks 345 procedures at this hospital using data from their publicly filed transparency report. Last updated March 2026.
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345
Procedures Tracked
with pricing data
⭐
3/5
Star Rating
CMS Care Compare
💰
3.4x
Markup Ratio
Avg = 3.0x
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Grade C
Data Quality
Moderate data coverage
✓
CMS v3.0 Compliant
This hospital's pricing data meets the latest CMS v3.0 requirements, including actual allowed amounts from insurer remittance data.
Attested by: DAVID NEUENDORFOrg NPI: 1841334836
🔒 De-identification Notice: All pricing data shown on this page is derived from publicly available hospital machine-readable files and insurer transparency data as mandated by federal law. No individual patient data, protected health information (PHI), or personally identifiable information is collected, stored, or displayed. Aggregate statistics (such as allowed amount medians and percentiles) are calculated from de-identified claim payment data reported by hospitals per CMS requirements.
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Procedure Prices at Ssm Health St. Mary's Hospital - Jefferson City
345 procedures with pricing data. Prices reflect negotiated rates across insurance payers compared to the Jefferson City, MO metro average. Includes actual allowed amounts from insurer remittance data (CMS v3.0).
Last updated: March 26, 2026
| Procedure | Cash Price | Avg Negotiated | Median Allowed | Range (10th–90th) | Jefferson City Avg | vs. Avg | Payers |
|---|---|---|---|---|---|---|---|
| Debridement - Subcutaneous Tissue CPT 11042 Wound debridement — removal of dead, damaged, or infected tissue from a wound to promote healing. |
$844 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Biopsy (Tangential, Single Lesion) CPT 11102 Skin biopsy, tangential — removal of a thin layer of skin tissue for microscopic examination to diagnose skin conditions or suspicious lesions. |
$303 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Biopsy (Punch, Single Lesion) CPT 11104 Skin punch biopsy — removal of a small, full-thickness circular sample of skin for laboratory analysis to diagnose skin conditions. |
$595 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Graft Preparation CPT 15002 Skin Graft Preparation — CPT code 15002 covers skin graft preparation performed in a clinical or hospital setting. |
$1,081 | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Split-Thickness Skin Graft CPT 15100 Split-Thickness Skin Graft — CPT code 15100 covers split-thickness skin graft performed in a clinical or hospital setting. |
$1,124 | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Skin Substitute Graft (≤25 sq cm) CPT 15271 Skin Substitute Graft (≤25 sq cm) — CPT code 15271 covers skin substitute graft (≤25 sq cm) performed in a clinical or hospital setting. |
$3,431 | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Skin Substitute Graft (≤100 sq cm) CPT 15275 Skin Substitute Graft (≤100 sq cm) — CPT code 15275 covers skin substitute graft (≤100 sq cm) performed in a clinical or hospital setting. |
$1,959 | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Destruction of Premalignant Lesion (First) CPT 17000 Destruction of precancerous skin lesion — removal of a precancerous growth (actinic keratosis) using freezing, chemicals, or other methods. |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Wart Removal (Up to 14 Lesions) CPT 17110 Destruction of benign skin lesions, up to 14 — removal of warts, skin tags, or other non-cancerous growths. |
$167 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Breast Excision CPT 19120 Surgical removal of a breast lump or abnormal tissue. This procedure removes a specific area of concern while preserving as much healthy breast tissue as possible. |
$4,624 | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Partial Mastectomy (Lumpectomy) CPT 19301 Surgical removal of a breast tumor along with a small margin of surrounding tissue. Also called a lumpectomy, this breast-conserving surgery removes the cancer while keeping most of the breast intact. |
— | $2,162 | — | — | $2,162 | avg | 5 |
| Simple Mastectomy CPT 19303 Complete surgical removal of one breast. This procedure removes all breast tissue to treat or prevent breast cancer. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Joint Injection (small joint) CPT 20600 Small joint injection — injection of medication into a small joint like a finger or toe to reduce pain and inflammation. |
$390 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Joint Injection (medium joint) CPT 20605 Medium joint injection — injection of medication into a medium-sized joint like the elbow, wrist, or ankle to reduce pain and inflammation. |
$402 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Joint Injection (Major Joint) CPT 20610 Large joint injection — injection of medication (such as cortisone) into a large joint like the knee, shoulder, or hip to reduce pain and inflammation. |
$415 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Joint Injection with Ultrasound (Major Joint) CPT 20611 Ultrasound — joint injection with ultrasound (major joint). This imaging test uses sound waves to create pictures of organs and structures inside the body. |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Le Fort I Osteotomy CPT 21141 Le Fort I Osteotomy — CPT code 21141 covers le fort i osteotomy performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Lumbar Spinal Fusion (Posterior) CPT 22612 Lumbar spinal fusion (lower back) — surgery to permanently join two vertebrae in the lower spine to treat conditions like degenerative disc disease or spondylolisthesis. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Lumbar Spinal Fusion (Posterior Interbody) CPT 22630 Posterior lumbar interbody fusion (PLIF) — spinal fusion through the back where a damaged disc is removed and replaced with a bone graft or cage to stabilize the spine. |
— | $3,900 | $3,900 | $3,900–$3,900 | $3,900 | avg | 1 |
| Rotator Cuff Repair CPT 23412 Rotator Cuff Repair — CPT code 23412 covers rotator cuff repair performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Shoulder Replacement (Arthroplasty) CPT 23472 Shoulder Replacement (Arthroplasty) — CPT code 23472 covers shoulder replacement (arthroplasty) performed in a clinical or hospital setting. |
— | $3,900 | $3,900 | $3,900–$3,900 | $3,900 | avg | 1 |
| Trigger Finger Release CPT 26055 Trigger finger release — a procedure to free a finger tendon that has become stuck, causing the finger to catch or lock when bending. |
$445 | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Open Fracture Treatment - Metacarpal CPT 26615 Open Fracture Treatment - Metacarpal — CPT code 26615 covers open fracture treatment - metacarpal performed in a clinical or hospital setting. |
$895 | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Total Hip Replacement CPT 27130 Total hip replacement surgery where the damaged hip joint is replaced with an artificial implant to relieve pain and improve mobility. |
— | $7,194 | — | — | $7,194 | avg | 4 |
| Open Treatment Hip Fracture CPT 27236 Surgical repair of a broken hip using metal pins, screws, or plates to hold the bone fragments together while they heal. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Total Knee Replacement - Unicompartmental CPT 27446 Partial knee replacement surgery that replaces only the damaged compartment of the knee joint with an artificial implant, preserving healthy bone and tissue. |
— | $3,900 | $3,900 | $3,900–$3,900 | $3,900 | avg | 1 |
| Total Knee Replacement CPT 27447 Full knee replacement surgery where the damaged knee joint is replaced with artificial metal and plastic components to relieve pain and restore function. |
— | $7,194 | — | — | $7,194 | avg | 4 |
| Knee Realignment Osteotomy CPT 27477 Surgical reshaping of the leg bones around the knee to redistribute weight and relieve pain, typically used for patients with arthritis affecting one side of the knee. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Closed Treatment Tibial Fracture CPT 27750 Treatment of a broken shinbone (tibia) without surgery, using a cast or brace to hold the bone in place while it heals. |
$142 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Hammertoe Correction CPT 28285 Surgical correction of a hammertoe — a toe that has become bent or curled. The procedure straightens the toe by removing bone or releasing tight tendons. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Bunionectomy with Metatarsal Osteotomy CPT 28296 Surgical correction of a bunion (hallux valgus) that includes cutting and realigning the metatarsal bone to straighten the big toe and relieve pain. |
— | $2,109 | — | — | $2,109 | avg | 5 |
| Shoulder Arthroscopy - Debridement CPT 29823 Minimally invasive shoulder surgery using a small camera (arthroscope) to clean out damaged tissue, bone spurs, or loose fragments from the shoulder joint. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Arthroscopic Rotator Cuff Repair CPT 29827 Arthroscopic repair of a torn rotator cuff — the group of tendons that stabilize the shoulder. The surgeon reattaches the torn tendon to the bone using small anchors. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Knee Arthroscopy Medial & Lateral CPT 29880 Arthroscopic knee surgery to treat torn meniscus cartilage on both the inner and outer sides of the knee. Uses a small camera and tools to trim or repair the damaged cartilage. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Knee Arthroscopy (Meniscus Surgery) CPT 29881 Arthroscopic knee surgery to treat a torn meniscus on one side of the knee. The surgeon trims or repairs the damaged cartilage through small incisions. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Septoplasty (Deviated Septum Repair) CPT 30520 Septoplasty (Deviated Septum Repair) — CPT code 30520 covers septoplasty (deviated septum repair) performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Nasal Endoscopy (diagnostic) CPT 31231 Nasal Endoscopy (diagnostic) — CPT code 31231 covers nasal endoscopy (diagnostic) performed in a clinical or hospital setting. |
$280 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Nasal Endoscopy - Surgical Debridement CPT 31237 Nasal Endoscopy - Surgical Debridement — CPT code 31237 covers nasal endoscopy - surgical debridement performed in a clinical or hospital setting. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Ethmoidectomy - Partial CPT 31254 Ethmoidectomy - Partial — CPT code 31254 covers ethmoidectomy - partial performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Sinus Surgery - Ethmoidectomy CPT 31255 Sinus Surgery - Ethmoidectomy — CPT code 31255 covers sinus surgery - ethmoidectomy performed in a clinical or hospital setting. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Sinus Surgery - Frontal CPT 31276 Sinus Surgery - Frontal — CPT code 31276 covers sinus surgery - frontal performed in a clinical or hospital setting. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| TAVR - Transcatheter Aortic Valve Replacement CPT 33361 Replacement of a diseased aortic heart valve without open-heart surgery. A new valve is delivered through a catheter (thin tube) inserted through the leg artery. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Mitral Valve Repair CPT 33430 Open-heart surgery to repair a damaged mitral valve — the valve between the upper and lower left chambers of the heart — restoring normal blood flow. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Coronary Artery Bypass (CABG) - Single CPT 33533 Coronary artery bypass surgery (CABG) using a single graft. A healthy blood vessel from another part of the body is used to reroute blood around a blocked heart artery. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Central Venous Catheter CPT 36556 Insertion of a central venous catheter (a thin, flexible tube) into a large vein to deliver medications, fluids, or nutrition directly into the bloodstream. |
$4,208 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Central Venous Access Device CPT 36571 Central Venous Access Device — CPT code 36571 covers central venous access device performed in a clinical or hospital setting. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Central Venous Access - Jugular CPT 36573 Insertion of a central venous catheter into the jugular vein (in the neck) for direct access to the central bloodstream for medications or monitoring. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Arterial Line Placement CPT 36620 Placement of a thin tube (catheter) into an artery, usually in the wrist, to continuously monitor blood pressure during surgery or critical care. |
$518 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Tonsillectomy & Adenoidectomy (Under 12) CPT 42820 Surgical removal of the tonsils and adenoids. This procedure treats chronic infections, breathing problems, or sleep apnea caused by enlarged tonsils and adenoids. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Tonsillectomy (Age 12+) CPT 42826 Surgical removal of the tonsils for patients age 12 and older. This procedure treats chronic tonsillitis, recurrent infections, or breathing problems caused by enlarged tonsils. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Upper Endoscopy (EGD) Diagnostic CPT 43235 Upper endoscopy (EGD) — a flexible tube with a camera is passed through the mouth to visually examine the esophagus, stomach, and upper intestine. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Upper Endoscopy (EGD) with Biopsy CPT 43239 Upper endoscopy with biopsy — a flexible tube with a camera is passed through the mouth to examine the esophagus, stomach, and upper intestine, and tissue samples are taken for analysis. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Upper Endoscopy with Dilation CPT 43249 Upper endoscopy with dilation — a flexible scope is used to stretch a narrowed area of the esophagus or stomach to improve swallowing. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Upper GI Endoscopy with Polypectomy CPT 43251 Upper GI Endoscopy with Polypectomy — CPT code 43251 covers upper gi endoscopy with polypectomy performed in a clinical or hospital setting. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Upper GI Endoscopy with Band Ligation CPT 43270 Upper GI Endoscopy with Band Ligation — CPT code 43270 covers upper gi endoscopy with band ligation performed in a clinical or hospital setting. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Laparoscopic Hiatal Hernia Repair CPT 43282 Laparoscopic Hiatal Hernia Repair — CPT code 43282 covers laparoscopic hiatal hernia repair performed in a clinical or hospital setting. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Gastric Bypass (Laparoscopic Roux-en-Y) CPT 43644 Gastric Bypass (Laparoscopic Roux-en-Y) — CPT code 43644 covers gastric bypass (laparoscopic roux-en-y) performed in a clinical or hospital setting. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) CPT 43775 Gastric Sleeve (Laparoscopic Sleeve Gastrectomy) — CPT code 43775 covers gastric sleeve (laparoscopic sleeve gastrectomy) performed in a clinical or hospital setting. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Gastric Bypass - Open CPT 43846 Gastric Bypass - Open — CPT code 43846 covers gastric bypass - open performed in a clinical or hospital setting. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Gastric Bypass with Small Intestine CPT 43847 Gastric Bypass with Small Intestine — CPT code 43847 covers gastric bypass with small intestine performed in a clinical or hospital setting. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Small Bowel Resection CPT 44120 Small bowel resection �� surgical removal of a portion of the small intestine to treat disease, obstruction, or injury. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Laparoscopic Small Bowel Enterostomy CPT 44180 Laparoscopic Small Bowel Enterostomy — CPT code 44180 covers laparoscopic small bowel enterostomy performed in a clinical or hospital setting. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Laparoscopic Appendectomy CPT 44970 Laparoscopic appendectomy — minimally invasive surgical removal of the appendix, typically performed for appendicitis. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Colonoscopy (diagnostic) CPT 45378 Diagnostic colonoscopy — a flexible tube with a camera is inserted through the rectum to examine the entire large intestine for polyps, cancer, or other abnormalities. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Biopsy CPT 45380 Colonoscopy with biopsy — examination of the large intestine with a camera, during which tissue samples are taken from suspicious areas for laboratory analysis. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Polyp Removal CPT 45385 Colonoscopy with polyp removal — examination of the large intestine during which precancerous growths (polyps) are found and removed to prevent colon cancer. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Gallbladder Removal (Laparoscopic) CPT 47562 Minimally invasive removal of the gallbladder (laparoscopic cholecystectomy). Small incisions and a camera are used to remove the gallbladder, typically for gallstones or inflammation. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Gallbladder Removal with Cholangiography CPT 47563 Laparoscopic gallbladder removal with X-ray imaging of the bile ducts (cholangiography) to check for gallstones in the ducts during surgery. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Cholecystectomy - Open CPT 47600 Open cholecystectomy — surgical removal of the gallbladder through a larger incision in the abdomen. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Inguinal Hernia Repair CPT 49505 Inguinal hernia repair — surgical repair of a hernia in the groin area where tissue pushes through a weak spot in the abdominal muscles. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Inguinal Hernia Repair (Incarcerated) CPT 49507 Inguinal Hernia Repair (Incarcerated) — CPT code 49507 covers inguinal hernia repair (incarcerated) performed in a clinical or hospital setting. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Laparoscopic Inguinal Hernia Repair CPT 49650 Laparoscopic inguinal hernia repair — minimally invasive repair of a groin hernia using small incisions and a camera. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Lithotripsy (Kidney Stone Treatment) CPT 50590 Lithotripsy — shock waves are used to break kidney stones into small pieces that can pass naturally through the urinary tract. |
$10,920 | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Bladder Aspiration/Drainage CPT 51102 Bladder Aspiration/Drainage — CPT code 51102 covers bladder aspiration/drainage performed in a clinical or hospital setting. |
$3,732 | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Cystoscopy (Bladder Exam) CPT 52000 Cystoscopy — a thin scope with a camera is inserted through the urethra to examine the inside of the bladder and urinary tract. |
$1,040 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| TURP (Prostate Resection) CPT 52601 Transurethral resection of the prostate (TURP) — surgical removal of prostate tissue through the urethra to treat enlarged prostate and improve urinary flow. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Robotic Prostatectomy CPT 55866 Robotic Prostatectomy — CPT code 55866 covers robotic prostatectomy performed in a clinical or hospital setting. |
— | $3,900 | $3,900 | $3,900–$3,900 | $3,900 | avg | 1 |
| Colposcopy with Biopsy (Cervical) CPT 57454 Colposcopy with Biopsy (Cervical) — CPT code 57454 covers colposcopy with biopsy (cervical) performed in a clinical or hospital setting. |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Endometrial Biopsy CPT 58100 Endometrial Biopsy — CPT code 58100 covers endometrial biopsy performed in a clinical or hospital setting. |
$328 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Total Hysterectomy - Abdominal CPT 58150 Total Hysterectomy - Abdominal — CPT code 58150 covers total hysterectomy - abdominal performed in a clinical or hospital setting. |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| IUD Insertion CPT 58300 IUD Insertion — CPT code 58300 covers iud insertion performed in a clinical or hospital setting. |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| IUD Removal CPT 58301 IUD Removal — CPT code 58301 covers iud removal performed in a clinical or hospital setting. |
$191 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laparoscopic Hysterectomy (250g or Less) CPT 58571 Total laparoscopic hysterectomy including removal of the cervix — minimally invasive complete removal of the uterus and cervix. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Laparoscopic Ovarian Cyst/Adnexal Removal CPT 58661 Laparoscopic removal of the uterus (hysterectomy) — minimally invasive surgery using small incisions and a camera to remove the uterus. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Fetal Non-Stress Test CPT 59025 Fetal non-stress test — monitoring the baby's heart rate in response to its own movements to assess fetal wellbeing. |
$359 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Vaginal Delivery (routine, global) CPT 59400 Routine obstetric care including prenatal visits, vaginal delivery, and postpartum care — comprehensive maternity care package. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Vaginal Delivery Only CPT 59409 Vaginal Delivery Only — CPT code 59409 covers vaginal delivery only performed in a clinical or hospital setting. |
$2,177 | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| C-Section Delivery (global) CPT 59510 Routine obstetric care including prenatal visits, cesarean delivery, and postpartum care — comprehensive maternity care package with C-section. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| VBAC Delivery CPT 59610 VBAC Delivery — CPT code 59610 covers vbac delivery performed in a clinical or hospital setting. |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Lumbar Epidural Injection CPT 62322 Lumbar or sacral epidural injection — injection of medication into the epidural space of the lower spine for pain relief. |
$1,269 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Lumbar Epidural - Fluoroscopic CPT 62323 Lumbar or sacral epidural injection with imaging guidance — a precisely targeted spinal injection using X-ray or fluoroscopy for accurate placement. |
$1,404 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Lumbar Laminotomy CPT 63030 Lumbar laminotomy — surgical removal of a small portion of the vertebral bone (lamina) in the lower back to relieve pressure on spinal nerves, typically for a herniated disc. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Lumbar Laminectomy (Single Level) CPT 63047 Lumbar laminectomy — surgical removal of the bony arch (lamina) of a vertebra in the lower back to create more space for the spinal cord and nerves. |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Transforaminal Epidural Injection CPT 64483 Lumbar epidural steroid injection — injection of anti-inflammatory medication into the space around spinal nerves in the lower back to relieve pain. |
$3,716 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Facet Joint Injection - Lumbar CPT 64493 Lumbar facet joint injection — injection of medication into the small joints of the lower spine to diagnose and treat back pain. |
$3,006 | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Facet Joint Destruction - Lumbar CPT 64635 Facet Joint Destruction - Lumbar — CPT code 64635 covers facet joint destruction - lumbar performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Carpal Tunnel Release CPT 64721 Carpal tunnel release — surgery to relieve pressure on the median nerve in the wrist, treating numbness, tingling, and weakness in the hand. |
$5,108 | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Glaucoma Laser Surgery CPT 65855 Glaucoma Laser Surgery — CPT code 65855 covers glaucoma laser surgery performed in a clinical or hospital setting. |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Glaucoma Filter Surgery CPT 66170 Glaucoma Filter Surgery — CPT code 66170 covers glaucoma filter surgery performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| YAG Laser Capsulotomy CPT 66821 YAG Laser Capsulotomy — CPT code 66821 covers yag laser capsulotomy performed in a clinical or hospital setting. |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Complex Cataract Surgery CPT 66982 CT scan — complex cataract surgery. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Cataract Surgery CPT 66984 Cataract surgery with lens implant — removal of the clouded natural lens of the eye and replacement with a clear artificial lens to restore vision. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Strabismus Surgery CPT 67311 Strabismus Surgery — CPT code 67311 covers strabismus surgery performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Eyelid Repair - Blepharoplasty CPT 67904 Eyelid Repair - Blepharoplasty — CPT code 67904 covers eyelid repair - blepharoplasty performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Eyelid Repair - Lower Lid CPT 67917 Eyelid Repair - Lower Lid — CPT code 67917 covers eyelid repair - lower lid performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Tear Duct Probing CPT 68810 CT scan — tear duct probing. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Ear Wax Removal CPT 69210 Ear Wax Removal — CPT code 69210 covers ear wax removal performed in a clinical or hospital setting. |
$175 | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Ear Tube Placement (Tympanostomy) CPT 69436 Ear Tube Placement (Tympanostomy) — CPT code 69436 covers ear tube placement (tympanostomy) performed in a clinical or hospital setting. |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Coronary Stent Placement CPT 92928 Coronary Stent Placement — CPT code 92928 covers coronary stent placement performed in a clinical or hospital setting. |
$11,554 | $10,319 | $10,319 | $2,000–$18,638 | $10,319 | avg | 2 |
| Left Heart Catheterization CPT 93458 Left Heart Catheterization — CPT code 93458 covers left heart catheterization performed in a clinical or hospital setting. |
$10,913 | $6,240 | $6,240 | $1,800–$10,679 | $6,240 | avg | 2 |
| Anesthesia - Chest CPT 00400 Anesthesia - Chest — CPT code 00400 covers anesthesia - chest performed in a clinical or hospital setting. |
— | $67 | $67 | $53–$80 | $67 | -1% | 1 |
| Epidural/Spinal Daily Management CPT 01996 Epidural/Spinal Daily Management — CPT code 01996 covers epidural/spinal daily management performed in a clinical or hospital setting. |
— | $240 | $240 | $240–$240 | $240 | avg | 1 |
| Debridement of Skin (infected) CPT 11000 Debridement of extensively eczematous or infected skin |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Lesion Paring (single) CPT 11055 Paring or cutting of benign hyperkeratotic lesion |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Lesion Paring (2-4) CPT 11056 Paring or cutting of benign hyperkeratotic lesions, 2 to 4 |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Tag Removal (up to 15) CPT 11200 Removal of skin tags, multiple fibrocutaneous tags |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Lesion Shave (0.5 cm or less) CPT 11300 Shave removal of epidermal or dermal lesion, trunk/extremities |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Lesion Shave (0.6-1.0 cm) CPT 11301 Shave removal of epidermal or dermal lesion, trunk/extremities |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Skin Lesion Shave - Scalp/Neck (0.5 cm) CPT 11305 Shave removal of epidermal or dermal lesion, scalp/neck/hands/feet |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Excision of Benign Skin Lesion (0.5 cm or less) CPT 11400 Excision of benign lesion, trunk/arms/legs |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Excision of Benign Skin Lesion (0.6-1.0 cm) CPT 11401 Excision of benign lesion, trunk/arms/legs, 0.6-1.0 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Excision of Benign Skin Lesion (1.1-2.0 cm) CPT 11402 Excision of benign lesion, trunk/arms/legs, 1.1-2.0 cm |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Excision Benign Lesion - Face (0.5 cm) CPT 11440 Excision of benign lesion, face/ears/eyelids/nose/lips |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Excision Malignant Lesion (0.5 cm or less) CPT 11600 Excision of malignant lesion, trunk/arms/legs |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Excision Malignant Lesion (0.6-1.0 cm) CPT 11601 Excision of malignant lesion, trunk/arms/legs, 0.6-1.0 cm |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Excision Malignant Lesion (1.1-2.0 cm) CPT 11602 Excision of malignant lesion, trunk/arms/legs, 1.1-2.0 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Nail Removal (partial or complete) CPT 11730 Avulsion of nail plate, partial or complete |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Permanent Nail Removal CPT 11750 Excision of nail and nail matrix, permanent removal |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Destruction of Premalignant Lesions (2-14) CPT 17003 Destruction of premalignant lesions, second through 14th lesion |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Destruction of Skin Lesions (15+) CPT 17004 Destruction of premalignant lesions, 15 or more lesions |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Destruction Malignant Lesion (trunk) CPT 17260 Destruction of malignant lesion, trunk, any method |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Mohs Surgery (first stage) CPT 17311 Mohs micrographic surgery, first stage, up to 5 tissue blocks |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Tendon Sheath Injection CPT 20550 Injection of tendon sheath, ligament, or trigger point |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Hardware Removal (deep) CPT 20680 Removal of implant, deep (plate, screw, rod) |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Shoulder Injection with Imaging CPT 23350 Injection for shoulder arthrography |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Tennis Elbow Repair CPT 24341 Repair of lateral collateral ligament, elbow |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Closed Treatment Distal Radius Fracture CPT 25600 Closed treatment of distal radial fracture without manipulation |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Closed Treatment Distal Radius Fracture (with manipulation) CPT 25605 Closed treatment of distal radial fracture with manipulation |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Intertrochanteric Fracture Treatment CPT 27245 Treatment of intertrochanteric femoral fracture with plate/screws |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Knee Manipulation Under Anesthesia CPT 27570 Manipulation of knee joint under general anesthesia |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Open Treatment Ankle Fracture (bimalleolar) CPT 27792 Open treatment of distal fibula fracture, bimalleolar |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Amputation - Toe CPT 28820 Amputation of toe at metatarsophalangeal joint |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Endoscopic Carpal Tunnel Release CPT 29848 Endoscopy of wrist, carpal tunnel release |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Shoulder Arthroscopy - Acromioplasty CPT 29826 Arthroscopy, shoulder, surgical, decompression of subacromial space |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Knee Arthroscopy with Meniscus Repair CPT 29882 Arthroscopy, knee, surgical, meniscus repair |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| ACL Reconstruction (Knee Ligament Repair) CPT 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Esophagoscopy (diagnostic) CPT 43191 Esophagoscopy, flexible, diagnostic |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| EGD with Stent Placement CPT 43210 Esophagogastroduodenoscopy with stent placement |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| EGD with Gastrostomy Tube CPT 43246 Upper GI endoscopy with gastrostomy tube placement |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| EGD with Foreign Body Removal CPT 43247 Upper GI endoscopy with removal of foreign body |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| EGD with Hemostasis CPT 43255 Upper GI endoscopy with control of bleeding |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Sigmoidoscopy (diagnostic) CPT 45330 Sigmoidoscopy, flexible, diagnostic |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Sigmoidoscopy with Biopsy CPT 45331 Sigmoidoscopy, flexible, with biopsy |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Colonoscopy with Control of Bleeding CPT 45382 Colonoscopy with control of bleeding |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Lesion Removal (hot biopsy) CPT 45384 Colonoscopy with removal of tumor by hot biopsy forceps |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Ablation CPT 45388 Colonoscopy with ablation of tumor or polyp |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Foreign Body Removal CPT 45390 Colonoscopy with removal of foreign body |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Colonoscopy with Endoscopic Ultrasound CPT 45391 Colonoscopy with endoscopic ultrasound examination |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Laceration Repair - Simple (2.5 cm or less) CPT 12001 Simple repair of superficial wounds, scalp/neck/extremities |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Simple (2.6-7.5 cm) CPT 12002 Simple repair of superficial wounds, 2.6-7.5 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Simple (7.6-12.5 cm) CPT 12004 Simple repair of superficial wounds, 7.6-12.5 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Face (2.5 cm or less) CPT 12011 Simple repair of superficial wounds of face, 2.5 cm or less |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Face (2.6-5.0 cm) CPT 12013 Simple repair of superficial wounds of face, 2.6-5.0 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Intermediate (2.5 cm or less) CPT 12031 Repair, intermediate, wounds of scalp/trunk/extremities |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Intermediate (2.6-7.5 cm) CPT 12032 Repair, intermediate, wounds of scalp/trunk/extremities |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Intermediate Face (2.5 cm) CPT 12051 Repair, intermediate, wounds of face, 2.5 cm or less |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Laceration Repair - Intermediate Face (2.6-5.0 cm) CPT 12052 Repair, intermediate, wounds of face, 2.6-5.0 cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Burn Dressing (small) CPT 16020 Dressings and/or debridement of partial-thickness burns, small |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Burn Dressing (medium) CPT 16025 Dressings and/or debridement of partial-thickness burns, medium |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Closed Treatment Radial Head Fracture CPT 24640 Closed treatment of radial head subluxation (nursemaid elbow) |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Short Arm Splint CPT 29125 Application of short arm splint, forearm to hand |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Finger Splint CPT 29130 Application of finger splint |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Long Leg Splint CPT 29505 Application of long leg splint, thigh to ankle |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Short Leg Splint CPT 29515 Application of short leg splint, calf to foot |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Nasal Foreign Body Removal CPT 30300 Removal of foreign body from intranasal, office type |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Anterior Nasal Packing (nosebleed) CPT 30901 Control nasal hemorrhage, anterior, simple |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Anterior Nasal Packing (complex) CPT 30903 Control nasal hemorrhage, anterior, complex |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Endotracheal Intubation CPT 31500 Intubation, endotracheal, emergency procedure |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Chest Tube Insertion CPT 32551 Tube thoracostomy, insertion of chest tube |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| IV Line Placement (peripheral) CPT 36000 Introduction of needle or intracatheter, vein |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Ear Foreign Body Removal CPT 69200 Removal of foreign body from external auditory canal |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Ear Wax Removal (Irrigation) CPT 69209 Removal impacted cerumen using irrigation/lavage |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Breast Biopsy (stereotactic) CPT 19081 Biopsy, breast, with placement of breast localization device, stereotactic guidance |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Breast Biopsy (ultrasound-guided) CPT 19083 Biopsy, breast, with placement of breast localization device, ultrasound guidance |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Breast Biopsy (MRI-guided) CPT 19084 Biopsy, breast, with placement of breast localization device, MRI guidance |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Mastopexy (Breast Lift) CPT 19316 Mastopexy |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Breast Augmentation (Implant) CPT 19325 Mammaplasty, augmentative |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Breast Implant Removal CPT 19328 Removal of intact mammary implant |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Breast Reconstruction (immediate) CPT 19340 Immediate insertion of breast prosthesis following mastopexy or mastectomy |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Vulvectomy (partial) CPT 56620 Vulvectomy, simple, partial |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Colposcopy (diagnostic) CPT 57420 Colposcopy of entire vagina, with cervix if present |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Colposcopy with Biopsy (cervix) CPT 57452 Colposcopy of cervix including upper adjacent vagina |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| LEEP Procedure (cervix) CPT 57460 Colposcopy with loop electrode excision procedure of cervix |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Cervical Biopsy CPT 57500 Biopsy of cervix, single or multiple, or local excision |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Cervical Conization CPT 57520 Conization of cervix, with or without fulguration |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Dilation and Curettage (D&C) CPT 58120 Dilation and curettage, diagnostic and/or therapeutic |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Vaginal Hysterectomy CPT 58260 Vaginal hysterectomy, for uterus 250g or less |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Vaginal Hysterectomy with Tube/Ovary Removal CPT 58262 Vaginal hysterectomy with removal of tube(s) and/or ovary(s) |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Vaginal Hysterectomy (>250g) CPT 58291 Vaginal hysterectomy, for uterus greater than 250g |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Hysterosalpingography (HSG) CPT 58340 Catheterization and introduction of saline for sonohysterography |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Hysteroscopy (diagnostic) CPT 58555 Hysteroscopy, diagnostic, separate procedure |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Hysteroscopy with Biopsy/Polypectomy CPT 58558 Hysteroscopy, surgical, with sampling of endometrium |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Hysteroscopy with Ablation CPT 58563 Hysteroscopy, surgical, with endometrial ablation |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Tubal Ligation CPT 58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Laparoscopy with Lysis of Adhesions CPT 58660 Laparoscopy, lysis of adhesions |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Laparoscopic Endometriosis Excision CPT 58662 Laparoscopy with fulguration or excision of lesions of ovary/peritoneum |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Laparoscopic Tubal Ligation CPT 58670 Laparoscopy, surgical, with fulguration of oviducts |
— | $2,000 | $2,000 | $2,000–$2,000 | $2,000 | avg | 1 |
| Amniocentesis CPT 59000 Amniocentesis, diagnostic |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Chorionic Villus Sampling CPT 59015 Chorionic villus sampling, any method |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Delivery of Placenta CPT 59414 Delivery of placenta (separate procedure) |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Incomplete Abortion Treatment CPT 59812 Treatment of incomplete abortion, any trimester, surgical |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Missed Abortion Treatment (first trimester) CPT 59820 Treatment of missed abortion, completed surgically, first trimester |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Maternity Care (unlisted) CPT 59899 Unlisted procedure, maternity care and delivery |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Incision and Drainage of Abscess (simple) CPT 10060 Incision and drainage of abscess, simple or single |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Incision and Drainage of Abscess (complex) CPT 10061 Incision and drainage of abscess, complicated or multiple |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Foreign Body Removal (skin, simple) CPT 10120 Incision and removal of foreign body, subcutaneous tissues, simple |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Foreign Body Removal (skin, complex) CPT 10121 Incision and removal of foreign body, subcutaneous tissues, complicated |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Incision and Drainage of Hematoma CPT 10140 Incision and drainage of hematoma, seroma, or fluid collection |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Aspiration of Abscess/Cyst CPT 10160 Puncture aspiration of abscess, hematoma, bulla, or cyst |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Debridement - Muscle/Fascia CPT 11043 Debridement, muscle and/or fascia, first 20 sq cm |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Breast Biopsy (needle, percutaneous) CPT 19100 Biopsy of breast, percutaneous, needle core |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Soft Tissue Excision (back/flank) CPT 21931 Excision, tumor, soft tissue of back or flank, subcutaneous |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Knee Cartilage Removal (arthrotomy) CPT 27332 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Pacemaker Insertion CPT 33208 Insertion of new or replacement of permanent pacemaker |
— | $6,000 | $6,000 | $6,000–$6,000 | $6,000 | avg | 1 |
| ICD (Defibrillator) Insertion CPT 33249 Insertion or replacement of permanent implantable defibrillator system |
— | $10,200 | $10,200 | $10,200–$10,200 | $10,200 | avg | 1 |
| Bone Marrow Aspiration CPT 38220 Diagnostic bone marrow aspiration(s) |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Bone Marrow Biopsy CPT 38221 Diagnostic bone marrow biopsy(ies) |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Lymph Node Biopsy/Excision (superficial) CPT 38500 Biopsy or excision of lymph node(s), superficial |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Lymph Node Biopsy/Excision (deep) CPT 38510 Biopsy or excision of lymph node(s), deep cervical |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Lip Biopsy CPT 40490 Biopsy of lip, vermilion |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Tongue Biopsy (anterior 2/3) CPT 41100 Biopsy of tongue, anterior two-thirds |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Salivary Stone Removal (Sialolithotomy) CPT 42330 Sialolithotomy, submandibular or sublingual, intraoral |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Drainage of Peritonsillar Abscess CPT 42700 Incision and drainage, abscess, peritonsillar |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Lysis of Abdominal Adhesions (open) CPT 44005 Enterolysis, freeing of intestinal adhesion |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Partial Colectomy CPT 44140 Colectomy, partial, with anastomosis |
— | $900 | $900 | $900–$900 | $900 | avg | 1 |
| Laparoscopic Partial Colectomy CPT 44204 Laparoscopic partial colectomy with anastomosis |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Appendectomy (open) CPT 44950 Appendectomy |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Liver Biopsy (needle) CPT 47000 Biopsy of liver, needle, percutaneous |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Exploratory Laparotomy CPT 49000 Exploratory laparotomy, exploratory celiotomy |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Diagnostic Laparoscopy CPT 49320 Laparoscopy, abdomen, diagnostic |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Kidney Biopsy (needle) CPT 50200 Renal biopsy, percutaneous, by trocar or needle |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Kidney Stone Removal (percutaneous) CPT 50080 Percutaneous nephrostolithotomy or pyelostolithotomy |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Cystoscopy with Ureteral Catheter CPT 52005 Cystourethroscopy, with ureteral catheterization |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Cystoscopy with Stent Removal CPT 52310 Cystourethroscopy, with removal of foreign body or ureteral stent |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Cystoscopy with Stent Insertion CPT 52332 Cystourethroscopy, with insertion of indwelling ureteral stent |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Cystoscopy with Lithotripsy CPT 52353 Cystourethroscopy, with lithotripsy |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Hydrocelectomy (excision) CPT 55040 Excision of hydrocele, unilateral |
— | $1,400 | $1,400 | $1,400–$1,400 | $1,400 | avg | 1 |
| Vasectomy CPT 55250 Vasectomy, unilateral or bilateral |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| I&D of Bartholin Gland Abscess CPT 56405 Incision and drainage of vulva or perineal abscess |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Lumbar Puncture (spinal tap) CPT 62270 Lumbar puncture (spinal tap), diagnostic |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Electroconvulsive Therapy (ECT) CPT 90870 Electroconvulsive therapy |
— | $657 | $657 | $657–$657 | $657 | avg | 1 |
| Cervical Epidural Injection CPT 62320 Injection, including indwelling catheter placement, cervical or thoracic |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Cervical Epidural with Imaging CPT 62321 Injection, cervical or thoracic with imaging guidance |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Trigeminal Nerve Block CPT 64400 Injection, anesthetic agent; trigeminal nerve |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Greater Occipital Nerve Block CPT 64405 Injection, anesthetic agent; greater occipital nerve |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Brachial Plexus Block CPT 64415 Injection, anesthetic agent; brachial plexus, single |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Femoral Nerve Block CPT 64447 Injection, anesthetic agent; femoral nerve, single |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Peripheral Nerve Block CPT 64450 Injection, anesthetic agent; other peripheral nerve or branch |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Cervical Transforaminal Epidural CPT 64479 Injection, anesthetic agent and/or steroid, transforaminal epidural, cervical or thoracic |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Transforaminal Epidural (additional level) CPT 64484 Injection, transforaminal epidural, lumbar or sacral, each additional level |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Facet Joint Injection - Cervical (first level) CPT 64490 Injection, diagnostic or therapeutic agent, paravertebral facet joint, cervical or thoracic, first level |
— | $625 | $625 | $625–$625 | $625 | avg | 1 |
| Facet Joint Injection - Cervical (second level) CPT 64491 Injection, paravertebral facet joint, cervical or thoracic, second level |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Facet Joint Injection - Lumbar (second level) CPT 64494 Injection, paravertebral facet joint, lumbar or sacral, second level |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Botox Injection for Migraine CPT 64615 Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, for chronic migraine |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Intercostal Nerve Destruction CPT 64625 Destruction by neurolytic agent, intercostal nerve |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Facet Joint Destruction - Cervical (first level) CPT 64633 Destruction by neurolytic agent, paravertebral facet joint nerve, cervical or thoracic, single level |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Facet Joint Destruction - Cervical (additional level) CPT 64634 Destruction by neurolytic agent, paravertebral facet joint nerve, cervical or thoracic, each additional level |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Facet Joint Destruction - Lumbar (additional level) CPT 64636 Destruction by neurolytic agent, paravertebral facet joint nerve, lumbar or sacral, each additional level |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Pacemaker Insertion (ventricular) CPT 33207 Insertion of new or replacement of permanent pacemaker, ventricular |
— | $3,900 | $3,900 | $3,900–$3,900 | $3,900 | avg | 1 |
| Leadless Pacemaker Insertion CPT 33274 Transcatheter insertion or replacement of permanent leadless pacemaker |
— | $7,300 | $7,300 | $7,300–$7,300 | $7,300 | avg | 1 |
| Coronary Angioplasty (single vessel) CPT 92920 Percutaneous transluminal coronary angioplasty, single vessel |
— | $10,319 | $10,319 | $2,000–$18,638 | $10,319 | avg | 2 |
| Right Heart Catheterization CPT 93451 Right heart catheterization |
— | $6,240 | $6,240 | $1,800–$10,679 | $6,240 | avg | 2 |
| Coronary Angiography CPT 93454 Catheter placement in coronary artery for coronary angiography |
— | $6,240 | $6,240 | $1,800–$10,679 | $6,240 | avg | 2 |
| Bronchoscopy with Lavage CPT 31624 Bronchoscopy with bronchial alveolar lavage |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Bronchoscopy with Biopsy CPT 31625 Bronchoscopy with bronchial or endobronchial biopsy |
— | $825 | $825 | $825–$825 | $825 | avg | 1 |
| Intravitreal Injection CPT 67028 Intravitreal injection of a pharmacologic agent |
— | $95 | $95 | $95–$95 | $95 | avg | 1 |
| Corneal Transplant (lamellar) CPT 65710 Keratoplasty (corneal transplant), lamellar |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Major Hip and Knee Joint Replacement without MCC CPT 469 Total hip or knee replacement without major complications |
— | $34,788 | $34,788 | $34,788–$34,788 | $34,788 | avg | 1 |
| Major Hip and Knee Joint Replacement without CC/MCC CPT 470 Total hip or knee replacement without complications or comorbidities |
— | $22,123 | $22,123 | $22,123–$22,123 | $22,123 | avg | 1 |
| Major Hip and Knee Joint Replacement with MCC CPT 468 Total hip or knee replacement with major complications |
— | $31,517 | $31,517 | $31,517–$31,517 | $31,517 | avg | 1 |
| Hip and Femur Procedures without MCC CPT 480 Hip fracture repair or femur procedures without major complications |
— | $33,401 | $33,401 | $33,401–$33,401 | $33,401 | avg | 1 |
| Hip and Femur Procedures without CC/MCC CPT 481 Hip fracture repair or femur procedures without complications |
— | $24,022 | $24,022 | $24,022–$24,022 | $24,022 | avg | 1 |
| Hip and Femur Procedures with MCC CPT 479 Hip fracture repair or femur procedures with major complications |
— | $21,320 | $21,320 | $21,320–$21,320 | $21,320 | avg | 1 |
| Cervical Spinal Fusion without CC/MCC CPT 473 Cervical spine fusion surgery without complications |
— | $27,999 | $27,999 | $27,999–$27,999 | $27,999 | avg | 1 |
| Cervical Spinal Fusion without MCC CPT 472 Cervical spine fusion without major complications |
— | $33,789 | $33,789 | $33,789–$33,789 | $33,789 | avg | 1 |
| Cervical Spinal Fusion with MCC CPT 471 Cervical spine fusion with major complications |
— | $55,380 | $55,380 | $55,380–$55,380 | $55,380 | avg | 1 |
| Bilateral or Multiple Major Joint Procedures CPT 461 Bilateral joint replacement or multiple major joint procedures |
— | $63,343 | $63,343 | $63,343–$63,343 | $63,343 | avg | 1 |
| Coronary Bypass without MCC CPT 236 CABG surgery without major complications |
— | $48,041 | $48,041 | $48,041–$48,041 | $48,041 | avg | 1 |
| Coronary Bypass with MCC CPT 235 CABG surgery with major complications |
— | $67,307 | $67,307 | $67,307–$67,307 | $67,307 | avg | 1 |
| Heart Failure and Shock with MCC CPT 291 Inpatient treatment for heart failure with major complications |
— | $14,724 | $14,724 | $14,724–$14,724 | $14,724 | avg | 1 |
| Heart Failure and Shock with CC CPT 292 Inpatient treatment for heart failure with complications |
— | $9,737 | $9,737 | $9,737–$9,737 | $9,737 | avg | 1 |
| Heart Failure and Shock without CC/MCC CPT 293 Inpatient treatment for heart failure without complications |
— | $6,491 | $6,491 | $6,491–$6,491 | $6,491 | avg | 1 |
| Cardiac Valve Procedures with CC CPT 216 Heart valve repair or replacement with complications |
— | $112,199 | $112,199 | $112,199–$112,199 | $112,199 | avg | 1 |
| Vaginal Delivery with OR Procedures CPT 768 Vaginal delivery requiring operating room procedures |
— | $12,290 | $12,290 | $12,290–$12,290 | $12,290 | avg | 1 |
| Respiratory Infections and Inflammations with MCC CPT 177 Pneumonia or respiratory infections with major complications |
— | $17,923 | $17,923 | $17,923–$17,923 | $17,923 | avg | 1 |
| Respiratory Infections and Inflammations with CC CPT 178 Pneumonia or respiratory infections with complications |
— | $11,194 | $11,194 | $11,194–$11,194 | $11,194 | avg | 1 |
| Simple Pneumonia and Pleurisy with MCC CPT 193 Uncomplicated pneumonia with major complications |
— | $15,075 | $15,075 | $15,075–$15,075 | $15,075 | avg | 1 |
| Simple Pneumonia and Pleurisy with CC CPT 194 Uncomplicated pneumonia with complications |
— | $9,243 | $9,243 | $9,243–$9,243 | $9,243 | avg | 1 |
| Simple Pneumonia and Pleurisy without CC/MCC CPT 195 Uncomplicated pneumonia without complications |
— | $7,208 | $7,208 | $7,208–$7,208 | $7,208 | avg | 1 |
| Major Small and Large Bowel Procedures with MCC CPT 329 Bowel resection or major intestinal surgery with major complications |
— | $52,717 | $52,717 | $52,717–$52,717 | $52,717 | avg | 1 |
| Major Small and Large Bowel Procedures with CC CPT 330 Bowel resection or major intestinal surgery with complications |
— | $27,493 | $27,493 | $27,493–$27,493 | $27,493 | avg | 1 |
| Major Small and Large Bowel Procedures without CC/MCC CPT 331 Bowel resection without complications |
— | $19,301 | $19,301 | $19,301–$19,301 | $19,301 | avg | 1 |
| GI Hemorrhage with MCC CPT 377 Gastrointestinal bleeding with major complications |
— | $20,965 | $20,965 | $20,965–$20,965 | $20,965 | avg | 1 |
| GI Hemorrhage with CC CPT 378 Gastrointestinal bleeding with complications |
— | $11,248 | $11,248 | $11,248–$11,248 | $11,248 | avg | 1 |
| Intracranial Hemorrhage or Cerebral Infarction with MCC CPT 064 Stroke with major complications |
— | $23,064 | $23,064 | $23,064–$23,064 | $23,064 | avg | 1 |
| Intracranial Hemorrhage or Cerebral Infarction with CC CPT 065 Stroke with complications |
— | $11,587 | $11,587 | $11,587–$11,587 | $11,587 | avg | 1 |
| Intracranial Hemorrhage or Cerebral Infarction without CC/MCC CPT 066 Stroke without complications |
— | $7,849 | $7,849 | $7,849–$7,849 | $7,849 | avg | 1 |
| Renal Failure with MCC CPT 682 Acute or chronic kidney failure with major complications |
— | $16,986 | $16,986 | $16,986–$16,986 | $16,986 | avg | 1 |
| Renal Failure with CC CPT 683 Acute or chronic kidney failure with complications |
— | $10,045 | $10,045 | $10,045–$10,045 | $10,045 | avg | 1 |
| Renal Failure without CC/MCC CPT 684 Acute or chronic kidney failure without complications |
— | $6,885 | $6,885 | $6,885–$6,885 | $6,885 | avg | 1 |
| Septicemia or Severe Sepsis with MV >96 Hours CPT 870 Severe sepsis requiring extended ventilator support |
— | $79,271 | $79,271 | $79,271–$79,271 | $79,271 | avg | 1 |
| Septicemia or Severe Sepsis without MV >96 Hours with MCC CPT 871 Sepsis with major complications |
— | $22,279 | $22,279 | $22,279–$22,279 | $22,279 | avg | 1 |
| Septicemia or Severe Sepsis without MV >96 Hours without MCC CPT 872 Sepsis without major complications |
— | $11,736 | $11,736 | $11,736–$11,736 | $11,736 | avg | 1 |
| Rehabilitation with CC/MCC CPT 945 Inpatient rehabilitation with complications |
— | $17,761 | $17,761 | $17,761–$17,761 | $17,761 | avg | 1 |
| Rehabilitation without CC/MCC CPT 946 Inpatient rehabilitation without complications |
— | $13,153 | $13,153 | $13,153–$13,153 | $13,153 | avg | 1 |
| Hip Replacement with Hip Fracture with MCC CPT 521 Hip replacement after hip fracture with major complications |
— | $32,918 | $32,918 | $32,918–$32,918 | $32,918 | avg | 1 |
| Hip Replacement with Hip Fracture without MCC CPT 522 Hip replacement after hip fracture without major complications |
— | $24,288 | $24,288 | $24,288–$24,288 | $24,288 | avg | 1 |
| Respiratory System Diagnosis with Ventilator Support >96 Hours CPT 207 Extended ventilator support for respiratory failure |
— | $73,800 | $73,800 | $73,800–$73,800 | $73,800 | avg | 1 |
| Respiratory System Diagnosis with Ventilator Support ≤96 Hours CPT 208 Short-term ventilator support for respiratory failure |
— | $31,525 | $31,525 | $31,525–$31,525 | $31,525 | avg | 1 |
| Septicemia/Severe Sepsis w/o MV >96hrs w MCC MS-DRG 871 Medicare Severity Diagnosis Related Group DRG-871 — Septicemia/Severe Sepsis w/o MV >96hrs w MCC. Inpatient hospital payment classification for cases involving septicemia/severe sepsis w/o mv >96hrs w mcc. |
— | $13,946 | — | — | $13,946 | avg | 1 |
| Heart Failure and Shock w MCC MS-DRG 291 Medicare Severity Diagnosis Related Group DRG-291 — Heart Failure and Shock w MCC. Inpatient hospital payment classification for cases involving heart failure and shock w mcc. |
— | $8,591 | — | — | $8,591 | avg | 1 |
| Respiratory Infections/Inflammations w MCC MS-DRG 177 Medicare Severity Diagnosis Related Group DRG-177 — Respiratory Infections/Inflammations w MCC. Inpatient hospital payment classification for cases involving respiratory infections/inflammations w mcc. |
— | $12,997 | — | — | $12,997 | avg | 1 |
| Simple Pneumonia and Pleurisy w MCC MS-DRG 193 Medicare Severity Diagnosis Related Group DRG-193 — Simple Pneumonia and Pleurisy w MCC. Inpatient hospital payment classification for cases involving simple pneumonia and pleurisy w mcc. |
— | $10,767 | — | — | $10,767 | avg | 1 |
| Septicemia/Severe Sepsis w/o MV >96hrs w/o MCC MS-DRG 872 Medicare Severity Diagnosis Related Group DRG-872 — Septicemia/Severe Sepsis w/o MV >96hrs w/o MCC. Inpatient hospital payment classification for cases involving septicemia/severe sepsis w/o mv >96hrs w/o mcc. |
— | $7,336 | — | — | $7,336 | avg | 1 |
| Pulmonary Edema and Respiratory Failure MS-DRG 189 Medicare Severity Diagnosis Related Group DRG-189 — Pulmonary Edema and Respiratory Failure. Inpatient hospital payment classification for cases involving pulmonary edema and respiratory failure. |
— | $8,752 | — | — | $8,752 | avg | 1 |
| Esophagitis/Gastroenteritis/Misc Digestive w/o MCC MS-DRG 392 Medicare Severity Diagnosis Related Group DRG-392 — Esophagitis/Gastroenteritis/Misc Digestive w/o MCC. Inpatient hospital payment classification for cases involving esophagitis/gastroenteritis/misc digestive w/o mcc. |
— | $5,900 | — | — | $5,900 | avg | 1 |
| Kidney/Urinary Tract Infections w/o MCC MS-DRG 690 CT scan — kidney/urinary tract infections w/o mcc. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $5,806 | — | — | $5,806 | avg | 1 |
| Acute Myocardial Infarction, Discharged Alive w MCC MS-DRG 280 Medicare Severity Diagnosis Related Group DRG-280 — Acute Myocardial Infarction, Discharged Alive w MCC. Inpatient hospital payment classification for cases involving acute myocardial infarction, discharged alive w mcc. |
— | $10,216 | — | — | $10,216 | avg | 1 |
| GI Hemorrhage w CC MS-DRG 378 Medicare Severity Diagnosis Related Group DRG-378 — GI Hemorrhage w CC. Inpatient hospital payment classification for cases involving gi hemorrhage w cc. |
— | $7,186 | — | — | $7,186 | avg | 1 |
| Infectious/Parasitic Diseases w OR Procedures w MCC MS-DRG 853 Medicare Severity Diagnosis Related Group DRG-853 — Infectious/Parasitic Diseases w OR Procedures w MCC. Inpatient hospital payment classification for cases involving infectious/parasitic diseases w or procedures w mcc. |
— | $33,621 | — | — | $33,621 | avg | 1 |
| Renal Failure w CC MS-DRG 683 Medicare Severity Diagnosis Related Group DRG-683 — Renal Failure w CC. Inpatient hospital payment classification for cases involving renal failure w cc. |
— | $6,391 | — | — | $6,391 | avg | 1 |
| Renal Failure w MCC MS-DRG 682 Medicare Severity Diagnosis Related Group DRG-682 — Renal Failure w MCC. Inpatient hospital payment classification for cases involving renal failure w mcc. |
— | $11,742 | — | — | $11,742 | avg | 1 |
| Kidney/Urinary Tract Infections w MCC MS-DRG 689 CT scan — kidney/urinary tract infections w mcc. This imaging test uses X-rays and a computer to create detailed cross-sectional images of the body. |
— | $8,139 | — | — | $8,139 | avg | 1 |
| Major Hip/Knee Joint Replacement MS-DRG 470 Medicare Severity Diagnosis Related Group DRG-470 — Major Hip/Knee Joint Replacement. Inpatient hospital payment classification for cases involving major hip/knee joint replacement. |
— | $12,810 | — | — | $12,810 | avg | 1 |
| Intracranial Hemorrhage/Cerebral Infarction w CC MS-DRG 065 Medicare Severity Diagnosis Related Group DRG-065 — Intracranial Hemorrhage/Cerebral Infarction w CC. Inpatient hospital payment classification for cases involving intracranial hemorrhage/cerebral infarction w cc. |
— | $8,320 | — | — | $8,320 | avg | 1 |
| Hip/Femur Procedures Except Major Joint w CC MS-DRG 481 Medicare Severity Diagnosis Related Group DRG-481 — Hip/Femur Procedures Except Major Joint w CC. Inpatient hospital payment classification for cases involving hip/femur procedures except major joint w cc. |
— | $13,835 | — | — | $13,835 | avg | 1 |
| Cardiac Arrhythmia/Conduction Disorders w CC MS-DRG 309 Medicare Severity Diagnosis Related Group DRG-309 — Cardiac Arrhythmia/Conduction Disorders w CC. Inpatient hospital payment classification for cases involving cardiac arrhythmia/conduction disorders w cc. |
— | $5,543 | — | — | $5,543 | avg | 1 |
| Simple Pneumonia and Pleurisy w CC MS-DRG 194 Medicare Severity Diagnosis Related Group DRG-194 — Simple Pneumonia and Pleurisy w CC. Inpatient hospital payment classification for cases involving simple pneumonia and pleurisy w cc. |
— | $6,163 | — | — | $6,163 | avg | 1 |
| Syncope and Collapse MS-DRG 312 Medicare Severity Diagnosis Related Group DRG-312 — Syncope and Collapse. Inpatient hospital payment classification for cases involving syncope and collapse. |
— | $6,338 | — | — | $6,338 | avg | 1 |
| Rhinoplasty - Nose Job (Primary, Tip/Cartilage) CPT 30400 Rhinoplasty - Nose Job (Primary, Tip/Cartilage) — CPT code 30400 covers rhinoplasty - nose job (primary, tip/cartilage) performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Rhinoplasty - Nose Job (Primary, Complete) CPT 30410 Rhinoplasty - Nose Job (Primary, Complete) — CPT code 30410 covers rhinoplasty - nose job (primary, complete) performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Septorhinoplasty (Nose Job with Septal Repair) CPT 30420 Septorhinoplasty (Nose Job with Septal Repair) — CPT code 30420 covers septorhinoplasty (nose job with septal repair) performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Revision Rhinoplasty - Minor (Nose Job Revision) CPT 30430 Revision Rhinoplasty - Minor (Nose Job Revision) — CPT code 30430 covers revision rhinoplasty - minor (nose job revision) performed in a clinical or hospital setting. |
— | $1,100 | $1,100 | $1,100–$1,100 | $1,100 | avg | 1 |
| Revision Rhinoplasty - Intermediate (Nose Job Revision) CPT 30435 Revision Rhinoplasty - Intermediate (Nose Job Revision) — CPT code 30435 covers revision rhinoplasty - intermediate (nose job revision) performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
| Revision Rhinoplasty - Major (Nose Job Revision) CPT 30450 Revision Rhinoplasty - Major (Nose Job Revision) — CPT code 30450 covers revision rhinoplasty - major (nose job revision) performed in a clinical or hospital setting. |
— | $1,800 | $1,800 | $1,800–$1,800 | $1,800 | avg | 1 |
Prices are typical ranges based on Ssm Health St. Mary's Hospital - Jefferson City's published transparency data, including actual allowed amounts calculated from insurer remittance (ERA) data per CMS v3.0 requirements. Your actual cost depends on your specific plan, deductible status, and clinical details.
Search all procedures at Ssm Health St. Mary's Hospital - Jefferson City →
Insurance Plans with Negotiated Rates
Taven has payer-specific negotiated rate data from 5 insurers at Ssm Health St. Mary's Hospital - Jefferson City. The "Avg Negotiated" rate in the table above represents the average across all payers. Individual payer rates may be higher or lower.
Aetna (CVS Health)
BCBS (Various Licensees)
Cigna Healthcare
Humana
UnitedHealthcare (UHC)
Negotiated rates vary by insurance plan. The prices shown are aggregated from this hospital's publicly filed machine-readable file. Your actual rate depends on your specific insurance plan and network tier. Use our price comparison tool to see payer-specific breakdowns.
Your Billing Rights
Under the No Surprises Act and hospital price transparency rules, you have the right to receive a Good Faith Estimate before scheduled care, protection from surprise out-of-network bills in emergencies, and access to the hospital's published pricing data.
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▸ Technical Details
Type
Acute Care Hospitals
Ownership
Proprietary
Health System
SSM Health
Medicare Provider #
260011
Emergency Services
Yes
Metro Area
Jefferson City, MO
Procedures Tracked
345
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