Pricing Transperancy
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CDM # Description Clinic Price Hopital Price Emergency Room Price Ancillary OP Price Nursery Price Professional Fees 120 ROOM/BED: Swingbed $3,028.00 121 ROOM/BED: Semi Private $3,452.00 $2,566.00 121 ROOM/BED: T.I.C $4,656.00 $3,646.00 122 ROOM/BED: Private $2,534.00 721 Amniofusion Charge $166.00 721 INDUCTION/PER HOUR CHARGE $227.00 721 MAG SULFATE/HOUR CHARGE $119.00 761 CATH FOR SPC COLLECT SGL PT CHARGE $64.00 10021 10021 FINE NEEDLE ASPIRATION BX;W/IMAGING; 1ST LESION CCC $564.00 10060 Drain Skin Abscess, Simple/Single Charge $562.00 10061 Drain Skin Abscess, Complex/Multiple Charge $938.00 10080 I&D Pilonidal Cyst; Simple Charge $858.00 Incision & Removal of Foreign Body, Subcutaneous Tissues; Simple 10120 Charge $694.00 Incision & Removal of Foreign Body, Subcutaneous Tissues; Complicated 10121 Charge $646.56 10140 Nipple exploration.excision $794.00 10160 Puncture Aspirtn of Abscess, Hematoma, Bulla, or Cyst Charge $644.00 10180 I&D, Complex, Postoperative Wound Infectn Charge $1,308.00 Debride of Extensive Eczematous or Infected Skin; Up to 10% of Body 11000 Surface Charge $524.00 Debridement Of Extensive Eczematous Or Infected Skin; Each Additional 11001 10% Of The Body Surface $116.00 11004 Debridement of skin for necrotizing soft tissue infection $3,140.00 11005 Debridement of abdominal wall, with or without fascial closure $4,080.00 Debridement of skin, subcutaneous tissue, external genitalia, perineum 11006 and abdominal wall $5,610.00 11008 Removal of prosthetic material or mesh, abdominal wall for infection $1,438.00 11010 Debride Skin/Tissue, Fx Charge $2,208.00 Debridement Incl Removal Of Foreign Material Associated With Open 11011 Fracture(S) And/Or Dislocation(S) $2,398.00 11012 Deb skin bone at fx site $3,388.00 Debridement, subcutaneous tissue first 20 sq cm or less Technical 11042 Charge $446.00 11043 Debride Skin/Tissue/Muscle Charge $982.00 11044 Debride Skin/Tissue/Muscle/Bone Charge $1,700.00 11045 11045 Debridement, subcutaneous tissue; each additional 20 sq cm $220.00 11046 11046 Debridement Muscle/Fascia, each additional 20 sq cm $392.00 11047 Debridement Skin-Bone +20 $802.00 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 11055 single lesion $418.00 11056 11056 PARING/CUTTING LES 2-4 $288.00 11100 Biopsy of Skin Lesion Charge $526.00 CDM # Description Clinic Price Hopital Price Emergency Room Price Ancillary OP Price Nursery Price Professional Fees 11101 Biopsy, Skin Subq/Mucous, Ea Add'l Charge $154.00 Removal of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up to & w/15 11200 Lesions Charge $432.00 11201 Removal of skin tags, multiple fibrocutaneous tags, any area; each 11201 additional ten lesions $132.00 Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 0.5 cm > 11300 Charge $353.49 Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 0.6 to 1.0 11301 cm Charge $474.00 11302 Shaving of epidermal or dermal lesion, single lesion, trunk, arms 11302 or legs; lesion 1.1 to 2.0cm $498.00 Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 11305 0.5 cm > Charge $353.49 Excision, benign lesion including margins, except skin tag, trunk, arms or 11400 legs; 0.5cm or less $602.00 Excision, benign lesion, trunk, arms or legs; excised diameter 0.6 to 1.0 11401 cm Technical Charge $736.00 11402 Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge $822.00 11403 Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge $944.00 11404 EXC TR-EXT 59+MARG 3.14-4CM $1,072.00 11406 EXC TR-EXT B9+MARG]4.0 CM-Clinic $1,530.00 11420 Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge $638.00 Excision, benign lesion, scalp, neck, hands, feet, genitalia; 0.6 to 1.0 cm 11421 Technical Charge $868.00 Excision, benign lesion scalp, neck, hands, feet, genitalia;1.1 to 2.0 cm 11422 Technical Charge $1,308.00 11423 Remove Lesion, Scalp/Neck/Hand/Foot 2.1 to 3.0 cm Charge $1,010.00 11424 Remove Lesion, Scalp/Neck/Hand/Foot 3.1 to 4.0 cm Charge $1,726.00 11426 Remove Lesion, Scalp/Neck/Hand/Foot >4.0 cm Charge $1,700.00 11440 Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge $458.00 11441 Remove Lesion, Face/Lid/Ear/Nose/Lip .6 to 1.0 cm Charge $1,028.00 11442 Remove Lesion, Face/Lid/Ear/Nose/Lip 1.1 to 2.0 cm Charge $1,608.00 Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; 11444 Diam 3.1 to 4.0 cm Charge $1,348.00 Excision Of Skin And Subcutaneous Tissue For Hidradenitis, Inguinal; w/ 11462 Simple Or Intermed Repair $2,080.00 Excision, malignant lesion, trunk, arms, or legs; 0.6 to 1.0 cm Technical 11601 Charge $1,140.00 Excision, malignant lesion, trunk, arms, or legs;1.1 to 2.0 cm Technical 11602 Charge $1,246.00 Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 11603 to 3.0 cm Charge $1,542.00 Remove Malig Lesion w/Margins, Trunk, Arms, or Legs; Diam 4.0+ cm 11606 Charge $2,302.00 CDM # Description Clinic Price Hopital Price Emergency Room Price Ancillary OP Price Nursery Price Professional Fees Excision, malignant lesion, scalp, neck, hands, feet, genitalia; 0.6 to 1.0 11621 cm Technical Charge $996.00 Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 11622 1.1 to 2.0 cm Charge $1,356.00 Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 11626 4.0+ cm Charge $2,344.00 Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised 11640 diam 0.5 cm or Less Charge $1,046.00 Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised 11641 diam 0.6 to 1.0 cm Charge $1,238.00 Excision, malignant lesion face, ears, eyelids, nose, lips; 1.1-2.0 cm 11642 Technical Charge $1,454.00 11730 Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge $524.00 11740 Evacuation of subungual hematoma Technical Charge $260.00 11750 Removal of nail Bed. $1,374.00 11765 Wedge Excise of Skin of Nail Fold (eg, For Ingrown toenail) Charge $916.00 11770 Excision of pilonidal cyst or sinus; simple $1,342.00 11900 11900 INJECT SKIN LESIONS - Clinic $288.00 11976 Removal, Implantable Contraceptive Capsules Charge $774.00 11980 Hormone Pellet Implant; Subcutaneous Charge $742.00 11981 Insertion, Non-Biodegradable Drug Delivery Implant $640.00 11982 Removal, non-biodegradable drug delivery implant $1,262.00 11983 11983 Remove w ins drug im $1,760.00 12001 Repair simple scalp, neck, axillae, ext genital $632.00 12002 Simple repair of superficial wounds of scalp, neck, axillae, external 12002 genitalia, trunk and/or $632.00 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 12011 2.5 cm > Charge $588.00 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 12011 2.5 cm or less Charge $588.00 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 12013 2.6 cm to 5.0 cm Charge $654.00 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 12014 5.1 cm to 7.5 cm Charge $654.00 12015 12015 SIMPLE REPAIR 7.6-12.5 CM FACE Clinic Charge $916.00 12020 12020 Treatment, superficial wound dehiscence; simple closure $1,486.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12031 Hands and Feet) 2.5 cm or Less $1,202.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12032 Hands and Feet) 2.6 cm to 07.5 $1,522.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12032 Hands/Feet) 2.6 -07.5 Tech Chg $1,522.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12034 Hands and Feet) 7.6 cm to 12.5 $1,638.00 CDM # Description Clinic Price Hopital Price Emergency Room Price Ancillary OP Price Nursery Price Professional Fees Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12035 Hands and Feet) 12.6 cm to 20. $2,054.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12037 Hands and Feet) over 30.0 cm C $1,996.00 Layer Closure of Wounds of Neck, Hands, Feet and/or Ext Genitalia; 2.5 12041 cm or Less Charge Tech Chg $1,238.00 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude 12041 Hands/Feet) 2.5 cm Tech Chg $1,238.00 Layer Closure of Wounds of Neck, Hands, Feet and/or Ext Genitalia; 2.6 12042 cm to 7.5 cm Charge $1,228.00 Layer Closure of Wounds of Face, Ear, Eyelid, Nose, Lip, Mucous 12051 Membrane 2.5 cm or Less Charge $1,701.32 Layer Closure of Wounds of Face, Ear, Eyelid, Nose, Lip, Mucous 12052 Membrane 2.6 cm to 05.0 cm Charge $1,248.00 Layer Closure of Wounds of Face, Ear, Eyelid, Nose, Lip, Mucous 12054 Membrane 7.6 cm to 12.5 cm Charge $1,962.00 13121 Repair Complex, Scalp, Arms, and/or Legs; 2.6 cm to 7.5 cm Charge $2,260.00 Repair Complex, Scalp, Arms, and/or Leg Each Additional 5cm or Less 13122 Charge $692.00 Repair Complex Forehead/Cheek/Mouth/Neck/Axillae/Genitalia/Hands/Feet 02.6 to 07.5 13132 cm Charge $2,972.00 13133 13133 COMPLEX REPAIR EACH ADD 5 CM FACE Clinic Charge $942.00 13160 13160 Repair, Complex, any area 2nd closure Charge $6,182.00 Adjacent Tissue Transfer or Rearrangement, Trunk; Defect 10 sq cm or 14000 Less Charge $3,980.00 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 14001 30.0 sq cm $5,178.00 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; 14020 defect 10 sq cm or less $4,512.00 Adj tissue xfer/rearrangement,scalp,arms or legs defect 10.1cm-30.0cm 14021 Tech Chg $5,698.00 Adjacent tissue xfer/rearrangement,forehead,cheek,chin,mouth, 14040 hands/feet,<10 sq cm $5,028.00 Adj tissue xfer/rearrangement,forehead,cheek,chin,mouth,hands/ft 10.1 14041 cm-30.0cm Tech Chg $6,166.00 Adjacent tissue transfer or rearrangement,