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NMMC- Gilmore CDM.Xlsx Facility Description Price AM PT‐Eval‐Other PT Sub 0.01 AM OT DIATHERMY 15 MIN 58 AM PRIVATE 1018 AM SEMI‐PRIVATE 930 AM SWING BED 472 AM SNF RUGS CODE AM OBSERVATION 56 AM SNF RUGS CODE AM INPT REHAB HIPPS CODE AM SWINGBED RUGS CODE 0 AM OBSERVATION 56 AM PRIVATE ROOM 872 AM L&D OBSERVATION 56 AM HIGH RISK 1938 AM PRIVATE OBSTETRICS 872 AM PRIVATE OBSTETRICS 872 AM WRR ROOM CHARGE 820 AM WSURG ROOM CHARGE 820 AM PEDIATRIC OBSERVATION 56 AM WOMENS OBSERVATION 56 AM OBSERVATION 56 AM OBSERVATION 56 AM OBSERVATION PER HOUR 56 AM RECOVERY PER HOUR 62 AM ADMIN OF FLU VACINE 61 AM BIOPSY CERVIX SINGLE 1832 AM BLADDER IRRIGATION/LAVAGE 594 AM BLADDER SCAN 711 AM BLD DRAW FROM CNTRAL LINE 422 AM BLOOD DRAW VAD 422 AM CHANGE CYSTOSTOMY TUBE 596 AM CHANGE GASTROSTOMY TUBE 1317 AM CHEMO IV AD SQ/SB TO 1 HR 333 AM CHEM TX IV PUSH EA ADDL 666 AM CHEMICAL CAUTERIZATION 647 AM CHEMO ADMIN IV FIRST HR 1180 AM CHEMO IV AD SQ/SB TO 1 HR 333 AM CHEMO IV SUB EA ADD HR 274 AM CHEMO TX IM/SQ HORMON 548 AM CHEMO TX IM/SQ NON‐HORM 548 AM CHEMO TX IV PUSH, INIT 760 AM DEBRID SKIN SUB‐Q MUSCLE 1914 AM DEBRID SKN S/Q MUSCL BONE 4297 AM DEBRID SKIN SUB‐Q TISSUE 1236 AM DILAT URETHRA FEMALE INIT 350 AM DILAT URTHR FLFRM MLE 1ST 2726 AM GASTRIC INTUBATION LAVAGE 640 AM GUIDEWIRES 400 AM I&D ABCESS COMPLICATED 1236 AM I&D ABCESS SIMPLE 649 AM I&D BATHOLINS GLADN, BL 711 AM I&D BATHOLINS GLAND, LT 473 AM I&D BATHOLINS GLAND, RT 473 AM I&D COMPLX POST OP INFECT 7467 AM I&D HEMATOMA, FLUID COLL 4297 AM I&D PERIANAL ABSCESS 1652 AM I&D PERIRECTAL ABSCESS 5594 AM INCIS SFT TIS ABSCES SUPR 649 AM INCIS THROMBO HEMORRHOID 683 AM INJ IM OR SQ 205 AM INJ IV EA ADD DIFF MED 269 AM INJ IV EA ADD SAME MED 246 AM INJ IV PUSH INITIAL 692 AM INSERT TUNNELED CV CATH 10789 AM INSRT INDWL BLDR CATH CMX 468 AM INSRT INDWL BLDR CATH SIM 434 AM INSRT NON‐INDWL BLDR CATH 422 AM INTRODUCER/SHEATH NON‐LAS 156 AM IV THRYP ADD/SEQ TO 1 HR 205 AM IV THRPY CONCURRENT 122 AM IV THRPY EA/ADD HR DX 190 AM IV THRPY EA/ADD HR HYDRTN 134 AM IV THRPY FIRST HR DX 691 AM IV THRPY FIRST HR HYDRTN 690 AM MARSUPILZ BARTHLN CYST BL 6537 AM MARSUPILZ BARTHLN CYST LT 4358 AM MARSUPILZ BARTHLN CYST RT 4358 AM NG INSRT V/SVAG/ASPRATION 640 AM PERITONEAL LAVAGE INITIAL 1604 AM PLACE CV CATH SUBCLV/JUG 6490 AM PLACE PICC LINE W/O PORT 8466 AM REM CTRL LINE W/O PORT 1883 AM REM IMPACTED CERUMEN 248 AM REMOVAL SKIN TAG 647 AM SELCT DEBRID 20 SQCM OR < 474 AM SPINAL PUNCTURE DRAIN CSF 2646 AM SPINAL PUNCTURE LUMBAR DX 2304 AM TRACHEAL TUBE CHANGE 748 AM TX WE DEHISCENCE SIMPLE 1914 AM TX WD DEHISCENCE W/PACKIN 1236 AM DIRECT REFER OBS ASSESMT 1951 AM ADMIN OF PNEUMONIA VACINE 61 AM LARNGOSCP FLEX F‐OPTIC DX 896 AM IMMUNIZATION 1ST VAC 205 AM EST PATIENT LEVEL ONE 410 AM EST PATIENT LEVEL TWO 425 AM REMOVE CUFFED CHEST TUBE 2805 AM BAKRI BALLOON FOR PP HEMR 661 AM ENDOMTRL BX W/WO ENDOCERV 420 AM IUD REMOVAL 618 AM SWING BED ROOM 572 AM IV THRPY FIRST HR DX 691 AM IV THRPY EA/ADD HR DX 190 AM IV THRPY ADD/SEQ TO 1 HR 205 AM IV THRPY CONCURRENT 122 AM IV THRPY FIRST HR HYDRTN 690 AM IV THRPY EA/ADD HR HYDRTN 134 AM INJ IV EA ADD DIFF MED 269 AM RECOVERY PER HOUR 280 AM MINOR PROCEDURE 1627 AM ARTERIAL LINE PLACEMENT 463 AM COMPLEX CYSTOMETROGRAM 1511 AM VOIDING PRESSURE STUDY 1511 AM ELECTROMYOGRAPHY STUDY 455 AM COMPLEX UROFLOWMETRY 500 AM INJ EPIDURAL BLOOD PATCH 2850 AM EST PATIENT LEVEL TWO 425 AM EST PATIENT LEVEL ONE 410 AM INJ IV PUSH INITIAL 692 AM IMMUNIZATION 1ST VAC 205 AM BLADDER SCAN 711 AM ADDITIONAL CPT CODE 0 AM PRIVATE ROOM 872 AM INTERMEDIATE CARE 2079 AM DIABETIC EDU/TRAIN EA 30 132 AM OBSERVATION PER HOUR 56 AM RECOVERY PER HOUR 62 AM ADMIN OF FLU VACINE 61 AM BIOPSY CERVIX SINGLE 1832 AM BIOPSY VAGINAL SIMPLE 1830 AM BLADDER IRRIGATION/LAVAGE 594 AM BLADDER SCAN 711 AM BLD DRAW FROM CNTRAL LINE 422 AM BLOOD DRAW VAD 422 AM BONE MARROW ASPIRATION 2585 AM CHANGE CYSTOSTOMY TUBE 596 AM CHANGE GASTROSTOMY TUBE 1317 AM CHEMO AD SQ/SB TO 1 HR 333 AM CHEM TX IV PUSH EA ADDL 666 AM CHEMICAL CAUTERIZATION 647 AM CHEMO ADMIN IV FIRST HR 1180 AM CHEMO IV AD SQ/SB TO 1 HR 333 AM CHEMO IV SUB EA ADD HR 274 AM CHEMO TX IM/SQ HORMON 548 AM CHEMO TX IM/SQ NON‐HORM 548 AM CHEMO TX IV PUSH, INIT 760 AM CHNG SUPUBIC CATHTR CMPX 1511 AM CULDOCENTESIS/COLPOCNTSIS 4357 AM DEBRID SKIN SUB‐Q MUSCLE 1914 AM DEBRID SKN S/Q MUSCL BONE 4297 AM DEBRID SKIN SUB‐Q TISSUE 1236 AM DILAT URETHRA FEMALE INIT 350 AM DILAT URTHR FLFRM MLE 1ST 2726 AM ENDOMTRL BX W/WO ENDOCERV 420 AM GASTRIC INTUBATION LAVAGE 640 AM GUIDEWIRE 400 AM I&D ABCESS COMPLICATED 1236 AM I&D ABCESS SIMPLE 649 AM I&D BATHOLINS GLAND, BL 711 AM I&D BATHOLINS GLAND, LT 473 AM I&D BATHOLINS GLAND, RT 473 AM I&D COMPLX POST OP INFECT 7467 AM I&D HEMATOMA, FLUID COLL 4297 AM I&D PERIANAL ABSCESS 1652 AM I&D PERIRECTAL ABSCESS 5594 AM INCIS SFT TIS ABCES SUPRF 649 AM INCIS THROMBO HEMORRHOID 683 AM INJ IM OR SQ 205 AM INJ IV EA ADD DIFF MED 269 AM INJ IV EA ADD SAME MED 246 AM INJ IV PUSH INITIAL 692 AM INSERT TUNNELED CV CATH 10789 AM INSRT INDWL BLDR CATH CMX 468 AM INSRT INDWL BLDR CATH SIM 434 AM INSRT NON‐INDWL BLDR CATH 422 AM INTRODUCR/SHETH NON‐LASR 156 AM IV THRPY ADD/SEQ TO 1 HR 205 AM IV THRPY CONCURRENT 122 AM IV THRPY EA/ADD HR DX 190 AM IV THRPY EA/ADD HR HYDRTN 134 AM IV THRPY FIRST HR DX 691 AM IV THRPY FIRST HR HYDRTN 690 AM MARSUPILZ BARTHLN CYST BL 6537 AM MARSUPILZ BARTHLN CYST LT 4358 AM MARSUPILZ BARTHLN CYST RT 4358 AM NG INSRT W/LVAG/ASPRATION 640 AM PERCUTNS PLAC GASTRO TUBE 3262 AM PERITONEAL LAVAGE INITIAL 1604 AM PLACE CV CATH SUBCLV/JUG 6490 AM PLACE PICC LINE W/O PORT 8466 AM REM CTRL LINE W/O PORT 1883 AM REM IMPACTED CERUMEN 248 AM REMOVAL SKIN TAG 647 AM SCREENING PAP SMEAR 33 AM SELCT DEBRID 20 SQCM OR < 474 AM SPINAL PUNCTURE DRAIN CSF 2646 AM SPINAL PUNCTURE LUMBAR DX 2304 AM TRACHEAL TUBE CHANGE 748 AM TX WD DEHISCENCE SIMPLE 1914 AM TX WD DEHISCENCE W/PACK 1236 AM DIRECT REFER OBS ASSESMT 1951 AM ADMIN OF PNEUMONIA VACINE 61 AM LARNGOSCP FLEX F‐OPTIC DX 896 AM IMMUNIZATION 1ST VAC 205 AM EST PATIENT LEVEL ONE 410 AM EST PATIENT LEVEL TWO 425 AM MISC. PROCEDURE AM REMOVE CUFFED CHEST TUBE 2805 AM RPR CMPX LID/N/L 2.6‐7.5 1914 AM RPR CMPX LID/N/ E/A 5CM/< 1053 AM TUBE THORACOSTOMY 6490 AM REMOVE CUFFED CHEST TUBE 2805 AM CRITICAL CARE 3429 AM PRIVATE 828 AM ICU OBS 56 AM ICU OBS 56 AM PRIVATE ROOM 872 AM STEP DOWN 2034 AM MED ICU 3429 AM PRIVATE ROOM 872 AM NURSERY 1200 AM NURSERY OBSERVATION 56 AM CIRC TRAY 91 AM NURSERY OBS 56 AM OBSERVATION PER HOUR 56 AM DIRECT REFER OBS ASSESMT 1951 AM BIOPSY CERVIX SINGLE 1832 AM BIOPSY VAGINAL SIMPLE 1830 AM BLADDER IRRIGATION/LAVAGE 594 AM BLOOD DRAW VAD 422 AM CATHETER, INFUSION A79 AM CHANGE CYSTOSTOMY TUBE 596 AM CHANGE GASTROSTOMY TUBE 1317 AM CULDOCNTESIS/COLPOCNTESIS 4357 AM MARSUP BARTHLIN CYST BL 6537 AM DEBRID SKIN SUB‐Q TISSUE 1236 AM APP FINGER SPLINT LT 231 AM DEBRD SKN/SUB OPN FX/DIS 1483 AM BLADDER SCAN 711 AM MOD SEDATION 1ST 15 MIN 399 AM MOD SEDATON EA/ADD 15 MNS 53 AM DILAT URETHRA,FEMALE INIT 350 AM DILT URETRAL MALE INITL 2726 AM E&M LEVEL 1 EST PATIENT 410 AM E&M LEVEL 1 EST PATIENT P 410 AM E&M LEVEL II EST PATIENT 425 AM E&M LEVEL II EST PAT P 425 AM E&M LEVEL 3 EST PATIENT 440 AM E&M LEVEL 3 EST PATIENT P 440 AM E&M LEVEL 4 EST PATIENT 460 AM E&M LEVEL 4 EST PATIENT P 460 AM E&M LEVEL 5 EST PATIENT 485 AM E&M LEVEL 5 EST PATIENT P 485 AM ENDOMTRL BX W/WO ENDOCERV 420 AM FINE NDL ASPRTION WO/IMAG 1238 AM GASTRIC INTUBATION LAVAGE 640 AM GUIDEWIRES 400 AM I&D ABCESS COMPLICATED 1236 AM I&D ABCESS SIMPLE 649 AM I&D BATHOLINS GLAND, LT 473 AM I&D BATHOLINS GLAND, RT 473 AM I&D HEMATOMA,FLUID COLL 4297 AM I&D PERIANAL ABSCESS 1652 AM I&D PERIRECTAL ABSCESS 5594 AM INCIS SOFT TISS ABSCESS 649 AM INCIS THROMBO HEMORRHOID 683 AM IV THRPY EA/ADD HR DX 202 AM IV THRPY IFRST HR DX 691 AM INJ IM OR SQ 205 AM INJ IV PUSH INITIAL 692 AM INSRT INDWL BLDR CATH CMX 468 AM INSRT INDWL BLDR CATH SIM 434 AM INSRT NON‐INDWL BLDR CATH 422 AM INTRDUCR/SHEATH NON‐LASER 719 AM MARSUP BARTHLIN CYST LT 4358 AM MARSUP BARTHLIN CYST RT 4358 AM MISC PROCEDURE AM PERITONEAL LAVAGE INITIAL 1604 AM PLACE CV CATH SUBCLV/JUG 6490 AM PLACE PICC LINE W/O PORT 8466 AM REM CTRL LINE W/O PORT 1883 AM REM FECAL IMPACTION/FB 966 AM REM IMPACTED CERUMEN 248 AM REMOVE SKIN TAG 647 AM SCREENING PAP SMEAR 33 AM SHUNTS/DRAINS CATHS A 442 AM SPINAL PUNCTURE DRAIN CSF 2646 AM SPINAL PUNCTURE LUMBAR DX 2304 AM TRACHEOSTOMY TUBE CHANGE 748 AM TX WD DEHISCENCE SIMPLE 1914 AM BONE MARROW ASPIRATION 2585 AM IV THRPY ADD/SEQ TO 1 HR 205 AM IV THRPY CONCURRENT 122 AM IV THRPY FIRST HR HYDRTN 690 AM IV THRPY EA/ADD HR HYDRTN 134 AM INJ IV EA ADD DIFF MED 288 AM INJ IV EA ADD SAME MED 246 AM BLD DRAW FROM CNTRAL LINE 422 AM IMMUNIZATION 1ST VAC 205 AM IMMUNIZATION EA ADD VAC 205 AM IRRIGATION OF A VAD 231 AM APP LONG ARM SPLINT LT 576 AM APP LONG ARM SPLINT RT 576 AM APP SHORT ARM SPLINT LT 484 AM APP SHORT ARM SPLINT RT 484 AM APP FINGER SPLINT RT 231 AM APP LONG LEG SPLINT LT 557 AM APP LONG LEG SPLINT RT 557 AM APP SHORT LEG SPLINT LT 529 AM APP SHORT LEG SPLINT RT 529 AM OTHER SPLINT 529 AM ANKLE ORTHOSIS 37 AM KO IMMOBLIZR CNVS PREFAB 67 AM POST OF SHOE 27 AM WHO COCK‐UP PREFAB 37 AM EST PATIENT LEVEL ONE 410 AM EST PATIENT LEVEL TWO 425 AM APP LONG ARM SPLINT 50 865 AM APP SHORT ARM SPLINT BL 726 AM APP FINGER SPLINT BIL 346 AM APP LONG LEG SPLINT BL 793 AM APP SHORT LEG SPLINT BL 793 AM I&D BATHOLINS GLAND LT 473 AM I&D BATHOLINS GLAND RT 473 AM I&D BATHOLINS GLAND BL 711 AM PARACENTESIS W/O ULTRSOND 1893 AM PARACENTESIS W/ULTRASOUND 2030 AM EX FCE LD NSE LIP 2.1‐3CM 2585 AM SELCT DEBRID 20 SQCM OR < 474 AM PT DEBRID ADD 20 SQCM 198 AM REMOVE CUFFED CHEST TUBE 2805 AM TUBE THORACOSTOMY LT 6490 AM TUBE THORACOSTOMY RT 2893 AM THORCEN INS TUBE W/O GUID 2893 AM PICC LINE REMOVAL 1883 AM DECLOT CATHETER/PORT/VAD 1181 AM EXC NAIL & MATRX PRMNT 1236 AM BX MUSCLE/SOFT TISSUE 2585 AM CHEMODENERVATION MUSCLE 776 AM INJ ANES FEMRAL NRV SINGL 1577 AM INJ FEMORAL NERVE BILAT 2366 AM CLSD TX SHOULDER DISLOCAT 4278 AM ENDOMTRL BX W/WO ENDOCERV 420 AM DESTRUCT MALIG LESN FACE 989 AM IR, MIDLINE PLACEMENT 5900 AM PERCUTANS NEEDLE BX LIVER 3937 AM INJ PLATLET RICH PLASMA 829 AM PICC LINE W/O PRT W/O IMA 4893 AM INTUBATN ENDOTRACHEL EMRG 1444 AM ADMIN INFLUENZA VACINE 61 AM ADMIN OF PNEUMONIA VACINE 61 AM MISC.
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