St. Luke's/Presbyterian Medical Center top charges
In compliance with federal law, please view pricing information for certain procedures and services at St. Luke's/Presbyterian Medical Center.
| DRG | Plain Language Description | Average Charge |
|---|---|---|
| 871 | Septicemia or severe sepsis without MV >96 hours with complication | $26,850.27 |
| 795 | Normal newborn | $3,172.16 |
| 454 | Combined anterior and posterior spinal fusion with comorbidity | $99,159.40 |
| 794 | Neonate with other significant problems | $10,503.81 |
| 806 | Vaginal delivery without sterilization or D&C with comorbidity | $12,348.46 |
| 189 | Pulmonary edema and respiratory failure | $20,348.18 |
| 834 | Acute leukemia without major O.R. procedures with complication | $141,393.66 |
| 807 | Vaginal delivery without sterilization or D&C without comorbidity/complication | $11,313.66 |
| 793 | Full term neonate with major problems | $72,273.37 |
| 392 | Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication | $11,188.65 |
| 847 | Chemotherapy without acute leukemia as secondary diagnosis with comorbidity | $26,663.22 |
| 203 | Bronchitis and asthma without comorbidity/complication | $12,060.74 |
| 016 | Autologous bone marrow transplant with comorbidity/complication | $135,342.13 |
| 640 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication | $2,627.79 |
| 787 | Cesarean section without sterilization with comorbidity | $41,035.19 |
| 193 | Simple pneumonia and pleurisy with complication | $24,358.20 |
| 330 | Major small and large bowel procedures with comorbidity | $52,850.30 |
| 014 | Allogeneic bone marrow transplant | $332,719.40 |
| 790 | Extreme immaturity or respiratory distress syndrome, neonate | $619,333.37 |
| 840 | Lymphoma and non-acute leukemia with complication | $75,903.58 |
| 194 | Simple pneumonia and pleurisy with comorbidity | $8,592.43 |
| 872 | Septicemia or severe sepsis without MV >96 hours without complication | $12,435.99 |
| 792 | Prematurity without major problems | $76,767.28 |
| 467 | Revision of hip or knee replacement with comorbidity | $45,203.83 |
| 331 | Major small and large bowel procedures without comorbidity/complication | $30,856.93 |
| 786 | Vaginal delivery without sterilization/dace with comorbidity | $49,909.23 |
| 177 | Respiratory infections and inflammations with complication | $22,111.24 |
| 202 | Bronchitis and asthma with comorbidity/complication | $16,866.17 |
| 144 | Other ear, nose, mouth and throat O.R. procedures with comorbidity | $10,019.67 |
| 846 | Chemotherapy without acute leukemia as secondary diagnosis with complication | $62,889.23 |
| 470 | Major hip and knee joint replacement or reattachment of lower extremity without complication | $15,662.40 |
| 460 | Spinal fusion except cervical without complication | $39,426.51 |
| 833 | Other antepartum diagnoses without O.R. procedures without comorbidity/complication | $14,708.24 |
| 788 | Cesarean section without sterilization without comorbidity/complication | $33,109.43 |
| 683 | Renal failure with comorbidity | $8,062.44 |
| 791 | Prematurity with major problems | $194,746.52 |
| 776 | Postpartum and post abortion diagnoses without O.R. procedures | $9,540.75 |
| 698 | Other kidney and urinary tract diagnoses with complication | $15,650.39 |
| 690 | Kidney and urinary tract infections without complication | $24,593.90 |
| 457 | Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions with comorbidity | $135,197.98 |
| 837 | Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy agent with complication | $141,611.33 |
| 857 | Postoperative or post-traumatic infections with O.R. procedures with comorbidity | $39,694.70 |
| 560 | Aftercare, musculoskeletal system and connective tissue with comorbidity | $3,977.36 |
| 853 | Infectious and parasitic diseases with O.R. procedures with complication | $99,266.33 |
| 809 | Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with comorbidity | $27,894.95 |
| 101 | Seizures without complication | $10,780.40 |
| 805 | Vaginal delivery without sterilization or D&C with complication | $25,208.78 |
| 314 | Other circulatory system diagnoses with complication | $92,588.03 |
| 603 | Cellulitis without complication | $17,494.97 |
| 432 | Cirrhosis and Alcoholic Hepatitis with MCC | $68,917.61 |
| CPT | Plain Language Description | Charge |
|---|---|---|
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | $530 |
| 80053 | Blood test, comprehensive group of blood chemicals | $1,696 |
| 83735 | Magnesium level | $222 |
| 84100 | Phosphate level | $222 |
| 82977 | Glutamyltransferase (liver enzyme) level | $222 |
| 83615 | Lactate dehydrogenase (enzyme) level | $222 |
| 84550 | Uric acid level, blood | $222 |
| 99283 | Emergency department visit with low level of medical decision making | $6,172 |
| 99284 | Emergency department visit with moderate level of medical decision making | $10,341 |
| 81001 | Manual urinalysis test with examination using microscope, automated | $897 |
| 96374 | Injection of drug or substance into vein | $777 |
| 80048 | Blood test, basic group of blood chemicals (Calcium, total) | $1,453 |
| 93005 | Routine electrocardiogram (ECG) using at least 12 leads with tracing | $751 |
| 85610 | Blood test, clotting time | $530 |
| 80197 | Tacrolimus level | $1,156 |
| 84484 | Troponin (protein) analysis, quantitative | $1,561 |
| 87496 | Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe technique | $2,250 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $196 |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | $214 |
| 71045 | X-ray of chest, 1 view | $874 |
| 87086 | Bacterial colony count, urine | $222 |
| 83690 | Lipase (fat enzyme) level | $701 |
| 96375 | Injection of additional new drug or substance into vein | $747 |
| 86900 | Blood group typing (ABO) | $373 |
| 86901 | Blood typing for Rh (D) antigen | $275 |
CPT® copyright 2023 American Medical Association