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Rose Medical Center top charges

In compliance with federal law, please view pricing information for certain procedures and services at Rose Medical Center.

Top 50 DRGs
DRG Plain Language Description Average Charge
795 Normal newborn $2,424.61
621 O.R. procedures for obesity without comorbidity/complication $54,120.39
807 Vaginal delivery without sterilization or D&C without comorbidity/complication $9,127.89
871 Septicemia or severe sepsis without MV >96 hours with complication $19,990.91
794 Neonate with other significant problems $4,554.77
806 Vaginal delivery without sterilization or D&C with comorbidity $10,511.36
787 Cesarean section without sterilization with comorbidity $18,313.60
470 Major hip and knee joint replacement or reattachment of lower extremity without complication $17,403.02
792 Prematurity without major problems $26,642.53
788 Cesarean section without sterilization without comorbidity/complication $16,879.63
872 Septicemia or severe sepsis without MV >96 hours without complication $9,164.97
793 Full term neonate with major problems $11,034.07
620 O.R. procedures for obesity with comorbidity $48,381.33
177 Respiratory infections and inflammations with complication $14,855.39
768 Vaginal delivery with O.R. procedures except sterilization and/or D&C $12,650.74
805 Vaginal delivery without sterilization or D&C with complication $11,705.41
331 Major small and large bowel procedures without comorbidity/complication $16,591.12
640 Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication $1,450.88
853 Infectious and parasitic diseases with O.R. procedures with complication $55,849.37
280 Acute myocardial infarction, discharged alive with complication $8,931.43
189 Pulmonary edema and respiratory failure $8,386.58
786 Vaginal delivery without sterilization/dace with comorbidity $25,541.96
193 Simple pneumonia and pleurisy with complication $10,350.11
791 Prematurity with major problems $66,321.71
483 Major joint or limb reattachment procedures of upper extremities $21,828.26
291 Heart failure and shock with complication $8,957.50
784 Cesarean section with sterilization with complication or comorbidity $14,915.29
392 Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication $10,713.23
455 Combined anterior and posterior spinal fusion without comorbidity/complication $53,596.68
790 Extreme immaturity or respiratory distress syndrome, neonate $131,784.49
247 Percutaneous cardiovascular procedures with drug-eluting stent without complication $27,168.48
683 Renal failure with comorbidity $8,595.20
330 Major small and large bowel procedures with comorbidity $26,266.99
682 Renal failure with complication $11,416.23
785 Vaginal delivery without sterilization with complication $17,632.91
776 Postpartum and post abortion diagnoses without O.R. procedures $8,627.68
812 Red blood cell disorders without complication $7,342.98
246 Percutaneous cardiovascular procedures with drug-eluting stent with complication or 4+ arteries or stents $31,580.94
743 Uterine and adnexa procedures for non-malignancy without comorbidity/complication $10,873.70
175 Pulmonary embolism with complication or acute cor pulmonale $10,838.74
329 Major small and large bowel procedures with complication $40,453.72
560 Aftercare, musculoskeletal system and connective tissue with comorbidity $3,130.26
432 Cirrhosis and alcoholic hepatitis with complication $24,023.30
469 Major hip and knee joint replacement or reattachment of lower extremity with complication or total ankle replacement $8,167.51
698 Other kidney and urinary tract diagnoses with complication $10,888.19
282 Acute myocardial infarction, discharged alive without comorbidity/complication $9,950.59
389 Gastrointestinal obstruction with comorbidity $7,646.58
454 Combined anterior and posterior spinal fusion with comorbidity $66,841.26
194 Simple pneumonia and pleurisy with comorbidity $6,602.54
Top 25 CPT
CPT Plain Language Description Charge
85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) $828
99284 Level 4 Emergency Room Visit $6,468
80053 Comprehensive metabolic panel $2,113
96374 Therapeutic, prophylactic, or diagnostic injection $747
93005 Electrocardiogram, routine ECG with at least 12 leads $1,056
80048 Basic metabolic panel (Calcium, total) $1,521
36415 Collection of venous blood by venipuncture $160
77067 Screening mammography, bilateral (2-view study of each breast) $1,665
77063 Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure) $77
99283 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making $2,852
97140 Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes $247
84484 Troponin, quantitative $1,558
71045 Radiologic examination, chest; single view $740
96375 Therapeutic, prophylactic, or diagnostic injection $722
96361 Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure) $806
97110 Therapeutic procedure, 1 or more areas, each 15 minutes; $247
83690 Lipase level $144
84703 Gonadotropin, chorionic (hCG); qualitative $391
74177 Computed tomography, abdomen and pelvis; with contrast material(s) $18,251
81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy $543
59025 Fetal non-stress test $859
81003 Urinalysis, without microscopy $424
88305 Tissue Exam by Pathologist $663
93798 Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session) $761
99285 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making $15,530

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