Sky Ridge Medical Center top charges
In compliance with federal law, please view pricing information for certain procedures and services at Sky Ridge Medical Center.
| DRG | Plain Language Description | Average Charge |
|---|---|---|
| 871 | Septicemia or severe sepsis without MV >96 hours with complication | $19,636 |
| 795 | Normal newborn | $2,512 |
| 454 | Combined anterior and posterior spinal fusion with comorbidity | $70,969 |
| 872 | Septicemia or severe sepsis without MV >96 hours without complication | $11,628 |
| 807 | Vaginal delivery without sterilization or D&C without comorbidity/complication | $10,751 |
| 455 | Combined anterior and posterior spinal fusion without comorbidity/complication | $69,874 |
| 392 | Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication | $12,176 |
| 794 | Neonate with other significant problems | $5,077 |
| 621 | O.R. procedures for obesity without comorbidity/complication | $47,763 |
| 330 | Major small and large bowel procedures with comorbidity | $32,249 |
| 552 | Medical back problems without complication | $11,612 |
| 481 | Hip and femur procedures except major joint with comorbidity | $25,618 |
| 853 | Infectious and parasitic diseases with O.R. procedures with complication | $83,999 |
| 560 | Aftercare, musculoskeletal system and connective tissue with comorbidity | $12,751 |
| 470 | Major hip and knee joint replacement or reattachment of lower extremity without complication | $19,842 |
| 193 | Simple pneumonia and pleurisy with complication | $16,288 |
| 460 | Spinal fusion except cervical without complication | $40,692 |
| 806 | Vaginal delivery without sterilization or D&C with comorbidity | $11,656 |
| 788 | Cesarean section without sterilization without comorbidity/complication | $19,215 |
| 792 | Prematurity without major problems | $12,762 |
| 640 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication | $2,485 |
| 787 | Cesarean section without sterilization with comorbidity | $20,236 |
| 331 | Major small and large bowel procedures without comorbidity/complication | $23,687 |
| 683 | Renal failure with comorbidity | $9,453 |
| 189 | Pulmonary edema and respiratory failure | $10,150 |
| 467 | Revision of hip or knee replacement with comorbidity | $34,978 |
| 280 | Acute myocardial infarction, discharged alive with complication | $14,307 |
| 329 | Major small and large bowel procedures with complication | $66,885 |
| 291 | Heart failure and shock with complication | $11,399 |
| 682 | Renal failure with complication | $11,566 |
| 603 | Cellulitis without complication | $8,267 |
| 472 | Cervical spinal fusion with comorbidity | $28,311 |
| 177 | Respiratory infections and inflammations with complication | $11,870 |
| 793 | Full term neonate with major problems | $12,946 |
| 516 | Other musculoskeletal system and connective tissue O.R. procedures with comorbidity | $26,500 |
| 394 | Other digestive system diagnoses with comorbidity | $10,601 |
| 854 | Infectious and parasitic diseases with O.R. procedures with comorbidity | $21,721 |
| 439 | Disorders of pancreas except malignancy with comorbidity | $14,488 |
| 064 | Intracranial hemorrhage or cerebral infarction with complication | $16,721 |
| 175 | Pulmonary embolism with complication or acute cor pulmonale | $12,506 |
| 327 | Stomach, esophageal and duodenal procedures with comorbidity | $28,440 |
| 389 | Gastrointestinal obstruction with comorbidity | $7,641 |
| 690 | Kidney and urinary tract infections without complication | $7,266 |
| 791 | Prematurity with major problems | $39,808 |
| 768 | Vaginal delivery with O.R. procedures except sterilization and/or D&C | $14,019 |
| 896 | Alcohol, drug abuse or dependence without rehabilitation therapy with complication | $28,220 |
| 309 | Cardiac arrhythmia and conduction disorders with comorbidity | $6,250 |
| 391 | Esophagitis, gastroenteritis and miscellaneous digestive disorders with complication | $24,283 |
| 785 | Vaginal delivery without sterilization with complication | $15,068 |
| 518 | Back and neck procedures except spinal fusion with complication or disc device or neurostimulator | $41,526 |
| CPT | Plain Language Description | Charge |
|---|---|---|
| 85027 | Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | $596 |
| 80053 | Comprehensive metabolic panel | $1,389 |
| 99284 | Level 4 Emergency Room Visit | $12,000 |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $1,487 |
| 80048 | Basic metabolic panel | $1,144 |
| 96374 | Therapeutic, prophylactic, or diagnostic injection | $513 |
| 84484 | Troponin, quantitative | $1,186 |
| 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 | $7,160 |
| 96375 | Therapeutic, prophylactic, each additional sequential intravenous push of a new substanceedure) | $495 |
| 71045 | Radiologic examination, chest; single view | $1,396 |
| 97140 | Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes | $350 |
| 83690 | Lipase | $907 |
| 81001 | Lab test to examine urine | $778 |
| 81003 | Urine test without microscope | $260 |
| 86900 | Blood typing, serologic; ABO | $337 |
| 86901 | Blood typing, serologic; Rh (D) | $337 |
| 84703 | Gonadotropin, chorionic (hCG); qualitative | $510 |
| 86850 | Antibody screen, RBC, each serum technique | $586 |
| 36591 | Collection of blood specimen from a completely implantable venous access device | $163 |
| 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 | $19,503 |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material(s) | $16,881 |
| 97110 | Therapeutic procedure, 1 or more areas, each 15 minutes; | $350 |
| 88305 | Tissue Exam by Pathologist | $2,834 |
| 77412 | Radiation treatment delivery | $7,154 |
| 77386 | Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex | $14,365 |
CPT® copyright 2023 American Medical Association