Rose Medical Center top charges
In compliance with federal law, please view pricing information for certain procedures and services at Rose Medical Center.
| 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 |
| CPT | Plain Language Description | Charge |
|---|---|---|
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | $759 |
| 99284 | Emergency department visit with moderate level of medical decision making | $9,985 |
| 80053 | Blood test, comprehensive group of blood chemicals | $1,939 |
| 93005 | Routine electrocardiogram (ECG) using at least 12 leads with tracing | $960 |
| 96374 | Injection of drug or substance into vein | $658 |
| 36415 | Insertion of needle into vein for collection of blood sample | $158 |
| 80048 | Blood test, basic group of blood chemicals (Calcium, total) | $1,396 |
| 77067 | Screening mammography | $1,513 |
| 77063 | Screening 3D breast mammography | $70 |
| 84484 | Troponin (protein) analysis, quantitative | $1,429 |
| 99283 | Emergency department visit with low level of medical decision making | $2,593 |
| 71045 | X-ray of chest, 1 view | $673 |
| 96375 | Injection of additional new drug or substance into vein | $656 |
| 83690 | Lipase (fat enzyme) level | $131 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | $152 |
| 59025 | Fetal test | $781 |
| 84703 | Gonadotropin (reproductive hormone) analysis | $358 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $201 |
| 74177 | CT scan of abdomen and pelvis with contrast | $18,374 |
| 81001 | Manual urinalysis test with examination using microscope, automated | $498 |
| 93798 | Outpatient heart rehabilitation with electrocardiogram (ECG) monitoring, quality health care professional services | $692 |
| 81003 | Automated urinalysis test | $389 |
| 96361 | Infusion into a vein for hydration, each additional hour | $724 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | $608 |
| 82077 | Measurement of alcohol level in specimen other than breath or urine | $304 |
CPT® copyright 2023 American Medical Association