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 | $17,671.62 |
| 795 | Normal newborn | $2,815.92 |
| 807 | Vaginal delivery without sterilization or D&C without comorbidity/complication | $10,153.07 |
| 872 | Septicemia or severe sepsis without MV >96 hours without complication | $12,166.27 |
| 454 | Combined anterior and posterior spinal fusion with comorbidity | $69,587.33 |
| 621 | O.R. procedures for obesity without comorbidity/complication | $47,577.78 |
| 794 | Neonate with other significant problems | $5,095.07 |
| 392 | Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication | $10,516.13 |
| 455 | Combined anterior and posterior spinal fusion without comorbidity/complication | $73,371.27 |
| 853 | Infectious and parasitic diseases with O.R. procedures with complication | $66,859.05 |
| 330 | Major small and large bowel procedures with comorbidity | $23,280.26 |
| 177 | Respiratory infections and inflammations with complication | $15,587.08 |
| 792 | Prematurity without major problems | $21,723.25 |
| 552 | Medical back problems without complication | $8,882.07 |
| 329 | Major small and large bowel procedures with complication | $46,334.20 |
| 189 | Pulmonary edema and respiratory failure | $8,705.73 |
| 787 | Cesarean section without sterilization with comorbidity | $21,605.29 |
| 806 | Vaginal delivery without sterilization or D&C with comorbidity | $11,801.96 |
| 788 | Cesarean section without sterilization without comorbidity/complication | $17,935.20 |
| 460 | Spinal fusion except cervical without complication | $44,564.98 |
| 247 | Percutaneous cardiovascular procedures with drug-eluting stent without complication | $16,183.48 |
| 193 | Simple pneumonia and pleurisy with complication | $10,098.01 |
| 467 | Revision of hip or knee replacement with comorbidity | $34,443.32 |
| 470 | Major hip and knee joint replacement or reattachment of lower extremity without complication | $18,257.02 |
| 793 | Full term neonate with major problems | $9,584.98 |
| 246 | Percutaneous cardiovascular procedures with drug-eluting stent with complication or 4+ arteries or stents | $25,087.44 |
| 331 | Major small and large bowel procedures without comorbidity/complication | $19,385.94 |
| 517 | Other musculoskeletal system and connective tissue O.R. procedures without comorbidity/complication | $29,954.20 |
| 640 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication | $2,259.89 |
| 472 | Cervical spinal fusion with comorbidity | $26,329.01 |
| 481 | Hip and femur procedures except major joint with comorbidity | $30,325.22 |
| 683 | Renal failure with comorbidity | $8,225.31 |
| 389 | Gastrointestinal obstruction with comorbidity | $7,927.84 |
| 291 | Heart failure and shock with complication | $9,611.36 |
| 768 | Vaginal delivery with O.R. procedures except sterilization and/or D&C | $13,307.84 |
| 854 | Infectious and parasitic diseases with O.R. procedures with comorbidity | $20,367.04 |
| 641 | Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without complication | $7,446.07 |
| 682 | Renal failure with complication | $11,115.75 |
| 896 | Alcohol, drug abuse or dependence without rehabilitation therapy with complication | $20,196.11 |
| 280 | Acute myocardial infarction, discharged alive with complication | $13,590.98 |
| 708 | Major male pelvic procedures without comorbidity/complication | $12,863.34 |
| 791 | Prematurity with major problems | $31,193.66 |
| 661 | Kidney and ureter procedures for non-neoplasm without comorbidity/complication | $10,807.22 |
| 065 | Intracranial hemorrhage or cerebral infarction with comorbidity or tPA in 24 hours | $9,805.22 |
| 784 | Cesarean section with sterilization with complication or comorbidity | $15,205.05 |
| 394 | Other digestive system diagnoses with comorbidity | $14,467.44 |
| 064 | Intracranial hemorrhage or cerebral infarction with complication | $17,889.86 |
| 516 | Other musculoskeletal system and connective tissue O.R. procedures with comorbidity | $26,464.21 |
| 805 | Vaginal delivery without sterilization or D&C with complication | $12,593.50 |
| 698 | Other kidney and urinary tract diagnoses with complication | $11,221.92 |
| CPT | Plain Language Description | Charge |
|---|---|---|
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | $541 |
| 99284 | Emergency department visit with moderate level of medical decision making | $10,909 |
| 80053 | Blood test, comprehensive group of blood chemicals | $1,263 |
| 93005 | Routine electrocardiogram (ECG) using at least 12 leads with tracing | $1,351 |
| 80048 | Blood test, basic group of blood chemicals (Calcium, total) | $1,040 |
| 96374 | Injection of drug or substance into vein | $889 |
| 84484 | Troponin (protein) analysis, quantitative | $1,078 |
| 99283 | Emergency department visit with low level of medical decision making | $6,509 |
| 71045 | X-ray of chest, 1 view | $1,269 |
| 96375 | Injection of additional new drug or substance into vein | $450 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | $318 |
| 83690 | Lipase (fat enzyme) level | $824 |
| 77412 | Delivery of complex radiation treatment | $6,504 |
| 81001 | Manual urinalysis test with examination using microscope, automated | $707 |
| 81003 | Automated urinalysis test | $197 |
| 84703 | Gonadotropin (reproductive hormone) analysis | $493 |
| 86900 | Blood group typing (ABO) | $306 |
| 86901 | Blood typing for Rh (D) antigen | $306 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $318 |
| 99285 | Emergency department visit with high level of medical decision making | $17,730 |
| 86850 | Screening test for red blood cell antibodies | $533 |
| 74177 | CT scan of abdomen and pelvis with contrast | $16,282 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | $2,576 |
| 36591 | Collection of blood sample from implanted device | $148 |
| 85610 | Blood test, clotting time | $240 |
CPT® copyright 2023 American Medical Association