UH Procedures and Services

Our Commitment to Quality

Helping ensure our patients receive the highest level of care, delivered with dignity and compassion, is our goal with every patient and family member, every time. Our Board challenges us to remain in the Top 10 percent of hospitals in the country in quality scores, and they meet monthly with physicians and clinical staff to analyze the data and develop a plan to better serve our patients. It is this goal-driven mindset that has earned us recognition in key areas for our quality strides. Learn more about our quality awards and recognition.

NOTE: Charges are displayed for the procedure only. These do not include any medications, supplies or pre-procedure laboratory tests that may be needed prior to the study (for example - CT Scan of the Abdomen with Contrast does not include the contrast medication given. If the contrast is IV, you may have additional charges for the IV supplies). Please contact Scheduling and Benefits for a more accurate estimate of what the procedure will cost.

University Hospital/University Summerville: 706-774-8209 or 706-774-8210
University Hospital McDuffie: 706-597-5219

Service Charge Code Charge Description Charge
Audiology 47100010 HC AIR AND BONE COND AUDIOGRAM $134
Audiology 47100011 HC SPEECH RECEPTION THRESHOLD $81
Audiology 47100012 HC SPEECH DISCRIMINATION $119
Audiology 47100013 HC COMPLETE AUDIOGRAM $244
Audiology 47100014 HC TYMPANOMETRY $112
Audiology 47100015 HC ACOUSTIC REFLEX $81
Audiology 47100016 HC VISUAL AUDIOMETRY(VRA) $146
Audiology 47100018 HC ABR BRAINSTEM EVOKED RESPONSE $598
Audiology 47100020 HC AUDITORY EVOKED POTENT COMP $1,076
Audiology 47100021 HC NEONATE HEARING TEST $304
Audiology 47100022 HC AUDITORY EVOKED POTENT LIMITED $395
Audiology 47100023 HC OTOACOUSTIC EMISS'N-DIAGNOSTIC $266
Audiology 47100024 HC ANALYSIS COCHLEAR IMPLANT <7YR $280
Audiology 47100025 HC REPRGRAM COCHLEAR IMPLANT <7YR $170
Audiology 47100026 HC ANALYSIS COCHLEAR IMPLANT >7YR $280
Audiology 47100027 HC CENTRAL AUDITORY FUNCTION SCAN $256
Audiology 47100028 HC STENGER PURE TONE $52
Audiology 47100029 HC ACOUSTIC IMMITTANCE TESTING $52
Audiology 47100030 HC STENGER SPEECH TEST $194
Audiology 47100031 HC CONDITIONING PLAY AUDIOMETRY $137
Audiology 47100032 HC SELECT PICTURE AUDIOMETRY $52
Audiology 47100033 HC HEARING AID EXAM BOTH EARS $130
Audiology 47100034 HC AUDIOLOGY CONSULT PER 15 MIN $64
Audiology 47100035 HC TINNITUS ASSESSMENT $137
Audiology 47100036 HC AUDITORY FUNCTION ADDTL 15 MIN $64
Audiology 47100037 HC EVAL AUD REHAB STATUS $194
Audiology 47100038 HC EVAL AUD STATUS EA ADDL 15 MIN $64
Procedurals 36000719 HC IMPLT SUBQ DEFIB INTEROGAT $197
Procedurals 36000720 HC IMPLT SUBQ DEFIB SYS DEV EVL $197
Cath Lab 48000002 HC TEMPORARY PACING TRANSCUTANEOUS $1,232
Cath Lab 48000005 HC MICROVOLT T-WAVE ALTERNANS $361
Cath Lab 48000006 HC ELEC ANALY PACE W/REPRO/SINGLE $215
Cath Lab 48000007 HC ELEC ANALY PACER W/REPROG/DUAL $238
Cath Lab 48000008 HC ELEC ANALY AICD/SING/W/REPROG $175
Cath Lab 48000009 HC ELEC ANALY AICD/DUAL/W/REPROG $197
Cath Lab 48000010 HC ELEC ANALY AICD/MULT/W/REPROG $197
Cath Lab 48000011 HC ELECTRONIC ANALYSIS LOOP (ILR) $534
Cath Lab 48000012 HC PM DEVICE INTERROGATION $175
Cath Lab 48000013 HC ICD DEVICE INTERROGATION $133
Cardiac Diagnostics 48000014 HC ECHO CONGENITAL ANOMALIES COMPLETE $1,880
Cardiac Diagnostics 48000015 HC ECHO CONGENITAL ANOMALIES LIMITED $658
Cardiac Diagnostics 48000016 HC ECHOCARDIOGRAM COMPLETE $1,709
Cardiac Diagnostics 48000017 HC ECHOCARDIOGRAM 2D ONLY $684
Cardiac Diagnostics 48000018 HC ECHOCARDOGRAM LIMITED STUDY $658
Cardiac Diagnostics 48000019 HC TRANSESOPHAGEAL ECHOCARDIOGRAM $1,260
Cardiac Diagnostics 48000020 HC CARDIAC PULSED WAVE DOPPLER $599
Cardiac Diagnostics 48000021 HC COLOR FLOW MAPPING $599
Cardiac Diagnostics 48000022 HC STRESS ECHOCARDIOGRAM $1,878
Cath Lab 48000023 HC DILUTION STUDY W/CARDIAC OTPUT $104
Cath Lab 48000029 HC EP FOLLOW-UP $4,447
Cath Lab 48000030 HC EVAL/CARDIO-DEFIB LEADS;INTRAO $1,746
Cardiac Diagnostics 48000038 HC BLOOD PRESSURE MONITORING 24HR $472
Cardiac Diagnostics 48000039 HC BLOOD PRESSURE ANALYSIS/REPORT $164
Cath Lab 48000040 HC ASPIRATION THROMBECTOMY $4,141
Cardiac Diagnostics 48000041 HC TEE INCOMPLETE $918
Cardiac Diagnostics 48000042 HC TEE WITH CONTRAST $1,353
Cardiac Diagnostics 48000043 HC TTE COMPLETE WITH CONTRAST $2,088
Cardiac Diagnostics 48000044 HC ECHOCARDIOGRAM COMPLETE $1,709
Cardiac Diagnostics 48000045 HC ECHOCARDIOGRAM 2D ONLY $684
Cardiac Diagnostics 48000046 HC ECHOCARDOGRAM LIMITED STUDY $658
Cardiac Diagnostics 48000047 HC CARDIAC PULSED WAVE DOPPLER $599
Cardiac Diagnostics 48000048 HC COLOR FLOW MAPPING $599
Cardiac Diagnostics 48000049 HC TTE COMPLETE WITH CONTRAST $2,088
Cardiac Diagnostics 48000053 HC ECHOCARDOGRAM LIMITED STUDY $658
Cardiac Diagnostics 48000054 HC PM PHONE DEVICE EVAL=<90 DAYS $133
Cardiac Diagnostics 48000055 HC PM/ICD REMOTE TECH SERV =<90 DAYS $133
Cardiac Diagnostics 48000056 HC ICM/ILR REMOTE TECH SERV =<30 DAYS $133
Cardiac Diagnostics 48000057 HC ICM DEVICE EVAL PER PT ENCOUNTER $133
Cath Lab 48000059 HC ELEC ANALY AICD/MULT/W/REPROG $197
Cath Lab 48000060 HC ECHOCARDOGRAM LIMITED STUDY $658
Cath Lab 48000061 HC EVAL/CARDIO-DEFIB LEADS;INTRAO $1,746
Cath Lab 48000062 HC PM DEVICE INTERROGATION $175
Cardiac Diagnostics 48000063 HC ICD DEVICE INTERROGATION $133
Cath Lab 48000064 HC ELEC ANALY AICD/DUAL/W/REPROG $197
Cath Lab 48000065 HC INTRACARD ECHO DURING INTERVEN $4,425
Cardiac Diagnostics 48000067 HC PRE-OP PM DEVICE EVAL $133
Cardiac Diagnostics 48000068 HC PRE-OP ICD DEVICE EVAL $133
Cardiac Diagnostics 48000069 HC ILR DEVICE INTERROGATE $133
Cardiac Diagnostics 48000070 HC WCD DEVICE INTERROGATE $133
Cath Lab 48000071 HC ELEC ANALY AICD/SING/W/REPROG $175
Cath Lab 48000072 HC EVAL/CARD-DEFIB W/TEST,P/GEN $2,230
Cath Lab 48000073 HC ELEC ANALY PACE W/REPRO/SINGLE $215
Cath Lab 48000074 HC ELEC ANALY PACER W/REPROG/DUAL $238
Cath Lab 48000075 HC ELEC ANALY AICD/DUAL/W/REPROG $197
Cath Lab 48000076 HC ELECTRONIC ANALYSIS LOOP (ILR) $534
Cardiac Diagnostics 48000077 HC PM DEVICE INTERROGATION $175
Cardiac Diagnostics 48000078 HC ICD DEVICE INTERROGATION $133
Cardiac Diagnostics 48000079 HC ELEC ANALY AICD/SING/W/REPROG $175
Cardiac Diagnostics 48000080 HC ELEC ANALY AICD/MULT/W/REPROG $172
Cardiac Diagnostics 48000081 HC PROG EVAL IN PERSON LEADLESS PM $47
Cardiac Diagnostics 48000082 HC INTERROG DEVICE EVAL IN PERSON LEADLESS PM $47
Procedurals 48000083 HC INTERROGATION VAD IN PERSON $290
Cardiac Diagnostics 48000084 HC IMPLT SUBQ DEFIB INTEROGATION $197
Cardiac Diagnostics 48000085 HC IMPLT SUBQ DEFIB SYS DEVICE EVAL $197
Cardiac Diagnostics 48000086 HC AHFC REMOTE ICM <= 30 DAYS $133
Procedurals 48000087 HC HEART FAILURE FLUID MONITORING $133
Cardiac Diagnostics 48000088 HC INTRAOP TEE $3,046
Cardiac Diagnostics 48000089 HC PROGRAM DEVICE EVAL PPM LEADLS IN PERSON $46
Cath Lab 48000090 HC PERIPROCEDURAL EVAL PPM LEADLS $46
Cardiac Diagnostics 48000091 HC INTERROGATION DEVICE EVAL PPM LEADLS $46
Cardiac Diagnostics 48000003 HC CARDIOVERSION/ELECTIVE/EXTERNAL $914
Cath Lab 48000004 HC CORONARY ULTRASOUND, INITIAL $4,035
Cath Lab 48000024 HC DOPPL VELO/ PRES COR FLOW MEAS $4,035
Cath Lab 48000025 HC PRES FLOW MEAS EA ADD'L VESSEL $4,035
Cath Lab 48000026 HC INTRAVENTRICULAR PACING (RV) $4,902
Cath Lab 48000027 HC 3 DIMENSION MAPPING $6,601
Cath Lab 48000028 HC COM EP EVAL W/LT ATRIAL RECORD $7,286
Cath Lab 48000031 HC EVAL/CARD-DEFIB W/TEST,P/GEN $2,543
Cath Lab 48000032 HC EP EVAL/CARDIOVERTER-DEFIB $2,125
Cath Lab 48000033 HC ABLATION OF AV NODE FUNCTION $9,143
Cardiac Diagnostics 48000036 HC TILT TABLE EVALUATION $1,007
Cath Lab 48000037 HC INTRACARD ECHO DURING INTERVEN $4,425
Procedurals 48000050 HC CDU CARDIOVERSION/ELECTIVE/EXTERNAL $914
Cath Lab 48000052 HC CARDIOVERSION/ELECTIVE/EXTERNAL $914
Cath Lab 48000058 HC CARDIOVERSION/ELECTIVE/EXTERNAL $914
Cardiac Diagnostics 48000066 HC PM DEVICE PROGR EVAL MULTI $175
Cath Lab 48100001 HC THROMBECTOMY $3,632
Cath Lab 48100002 HC BRACHYTHERAPY CATHETER PLACEME $5,200
Cath Lab 48100003 HC LEFT HRT W/THROMBOLYTICS USED $1,188
Cath Lab 48100004 HC INTRACOR IV INFUSION W/THROMBOLYSIS $302
Cath Lab 48100005 HC ADD'L VESSEL CORONARY U/S $4,035
Cath Lab 48100010 HC VALVULOPLASTY AORTIC $6,087
Cath Lab 48100013 HC TEE $1,260
Cath Lab 48100014 HC RIGHT HEART CATH $4,109
Cath Lab 48100015 HC LEFT HRT CATH W/VENTRCLGRPHY $4,297
Cath Lab 48100016 HC R&L HRT CATH W/VENTRICLGRPHY $4,989
Cath Lab 48100017 HC CORONARY ARTERY ANGIO S&I $4,305
Cath Lab 48100018 HC CORONARY ART/GRFT ANGIO S&I $4,555
Cath Lab 48100019 HC R HRT CORONARY ARTERY ANGIO $4,493
Cath Lab 48100020 HC R HRT ART/GRFT ANGIO $4,743
Cath Lab 48100021 HC L HRT ARTERY/VENTRICLE ANGIO $4,493
Cath Lab 48100022 HC L HRT ART/GRFT ANGIO $4,743
Cath Lab 48100023 HC R&L HRT ART/VENTRICLE ANGIO $5,185
Cath Lab 48100024 HC R&L HRT ART/VENTRICLE ANGIO $5,435
Cath Lab 48100025 HC L HRT CATH TRNSPTL PUNCTURE $4,370
Cath Lab 48100026 HC DRUG ADMIN DURING CARD CATH $284
Cath Lab 48100027 HC SWANZ-GANZ $1,889
Cath Lab 48100028 HC CORONARIES ONLY $93
Cath Lab 48100029 HC INJECTION INTERNAL GRAFTS $126
Cath Lab 48100030 HC INJ LEFT VENTRI OR ATRIAL $85
Cath Lab 48100031 HC INJ RIGHT VENTRI OR ATRIAL $85
Cath Lab 48100032 HC ROOT SHOT - AORTOGRAM $82
Cath Lab 48100033 HC INJECTION-PULMONARY ANGIOGRAPH $107
Cath Lab 48100034 HC BUNDLE OF HIS RECORDING $6,601
Cath Lab 48100035 HC INTRA-ATRIAL RECORDING $6,601
Cath Lab 48100036 HC RT VENTRICULAR RECORDING $6,601
Cath Lab 48100037 HC MAPPING OF TACHYCARDIA SITES $6,601
Cath Lab 48100038 HC INTRA-ATRIAL PACING $6,601
Cath Lab 48100039 HC ESOPHAGEAL RECORDING $6,601
Cath Lab 48100040 HC ESOPHAGEAL RECORDING W/PACING $6,601
Cath Lab 48100041 HC INDUCTION OF ARRHYTHMIA $6,601
Cath Lab 48100042 HC COMPREHENSIVE EP EVALUATION $7,286
Cath Lab 48100043 HC COMP EP EVAL W/INDUCT ARRHYTHM $7,286
Cath Lab 48100044 HC COMP EP EVAL W/VENTRIC RECORD $7,286
Cath Lab 48100045 HC STIM/PACING AFTER IV DRUG INFU $6,601
Cardiac Diagnostics 48100046 HC EVAL CARD DEFIB TEST PULSE GEN $2,543
Cath Lab 48100047 HC OCCLUSIVE DEV PLACEMENT OF $915
Cath Lab 48100049 HC NONSEL ILIAC ANGIOGRM W/LT HRT $914
Cath Lab 48100052 HC RT HRT TRANSSEPTAL LT HRT CATH $4,370
Cath Lab 48100053 HC INJECTION PULMONARY ANGIOGRAPH $107
Cath Lab 48100054 HC INJECTION PULMONARY ANGIOGRAPH $107
Cath Lab 48100055 HC PRQ CARDIAC ANGIOPLAST 1 ART $7,039
Cath Lab 48100056 HC PRQ CARDIAC ANGIO ADDL ART $7,039
Cath Lab 48100057 HC PRQ CARD ANGIO/ATHRECT 1 ART $12,529
Cath Lab 48100058 HC PRQ CARD ANGIO/ATHRECT ADDL $12,529
Cath Lab 48100059 HC PRQ CARD STENT W/ANGIO 1 VSL $12,529
Cath Lab 48100060 HC PRQ CARD STENT W/ANGIO ADDL $12,529
Cath Lab 48100061 HC PRQ CARD STENT/ATH/ANGIO $18,990
Cath Lab 48100062 HC PRQ CARD STENT/ATH/ANGIO $18,990
Cath Lab 48100063 HC PRQ REVASC BYP GRAFT 1 VSL $12,529
Cath Lab 48100064 HC PRQ REVASC BYP GRAFT ADDL $12,529
Cath Lab 48100065 HC PRQ CARD REVASC MI 1 VSL $12,529
Cath Lab 48100066 HC PRQ CARD REVASC CHRONIC 1VSL $12,529
Cath Lab 48100067 HC PRQ CARD REVASC CHRONIC ADDL $12,529
Cath Lab 48100068 HC EP & ABLATE SUPRAVENT ARRHYT $9,143
Cath Lab 48100069 HC EP & ABLATE VENTRIC TACHY $9,143
Cath Lab 48100070 HC ABLATE ARRHYTHMIA ADD ON $9,143
Cath Lab 48100071 HC TX ATRIAL FIB PULM VEIN ISOL $9,143
Cath Lab 48100072 HC TX L/R ATRIAL FIB ADDL $9,143
Cath Lab 48100073 HC PERC DRUG-EL COR STENT SING $12,529
Cath Lab 48100074 HC PERC DRUG-EL COR STENT BRAN $12,529
Cath Lab 48100075 HC PERC D-E COR STENT ATHER S $12,529
Cath Lab 48100076 HC PERC D-E COR STENT ATHER BR $12,529
Cath Lab 48100077 HC PERC D-E COR REVASC T CABG S $12,529
Cath Lab 48100078 HC PERC D-E COR REVASC T CABG B $12,529
Cath Lab 48100079 HC PERC D-E COR REVASC W AMI S $12,529
Cath Lab 48100080 HC PERC D-E COR REVASC CHRO SIN $12,529
Cath Lab 48100081 HC PERC D-E CORREVASC CHRO ADD $12,529
Cath Lab 48100082 HC CARDIOVERSION ELECTIVE, INTERNAL $914
Procedurals 48100083 HC IMPLANT PRESSURE SENSOR W/ANGIO (CARDIOMEMS) $37,921
Procedurals 48100084 HC ENDOMYOCARDIAL BIOPSY $3,035
Cath Lab 48100085 HC INSERT/REPLACE PPM LEADLESS (MICRA) $18,991
Cath Lab 48100086 HC REMOVAL PPM LEADLESS (MICRA) $3,033
Stress Test 48200001 HC CARDIOVASCULAR STRESS TEST $830
Stress Test 48200003 HC CVP CARDIOVASCULAR STRESS TEST $830
Stress Test 48300001 HC ECHO LTD/FOLLOW-UP W/ CONTRAST $909
Stress Test 48200004 HC CARDIOVASCULAR STRESS TEST $730
General Outpatient Clinic 51000001 99201 OFFICE/OUTPATIENT VISIT NEW PATIENT $127
General Outpatient Clinic 51000003 99202 OFFICE/OUTPATIENT VISIT NEW PATIENT $142
General Outpatient Clinic 51000005 99203 OFFICE/OUTPATIENT VISIT NEW PATIENT $160
General Outpatient Clinic 51000007 99204 OFFICE/OUTPATIENT VISIT NEW PATIENT $177
General Outpatient Clinic 51000009 99205 OFFICE/OUTPATIENT VISIT NEW PATIENT $193
General Outpatient Clinic 51000010 99211 OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT $127
General Outpatient Clinic 51000012 99212 OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT $142
General Outpatient Clinic 51000015 99213 OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT $160
General Outpatient Clinic 51000017 99214 OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT $177
General Outpatient Clinic 51000019 99215 OFFICE/OUTPATIENT VISIT ESTABLISHED PATIENT $193
General Outpatient Clinic 51000021 HC ASTHMA/COPD/TB EDUCATION INITIAL $157
General Outpatient Clinic 51000022 HC ASTHMA/COPD/TB EDUCATION FOLLOWUP $79
MRI 61000001 HC MRI TEMPOROMANDIBULAR JOINT $2,611
MRI 61000002 HC MRI MRA BRAIN (COMPONENT) $1,362
MRI 61000003 HC MRI BRAIN W/WO CONTRAST $3,335
MRI 61000004 HC MRI CHEST $2,832
MRI 61000005 HC MRI CHEST WITH CONTRAST(S) $2,876
MRI 61000006 HC MRI CHEST W,W/O CONTRAST(S) $3,335
MRI 61000007 HC MRI CERVICAL W/WO CONTRAST $3,335
MRI 61000008 HC MRI THORACIC W/WO CONTRAST $3,335
MRI 61000009 HC MRI LUMBAR W/WO CONTRAST $3,335
MRI 61000010 HC MRI PELVIS $2,613
MRI 61000011 HC MRI PELVIS/LIMITED BONE $1,362
MRI 61000012 HC MRI PELVIS WITH CONTRAST(S) $2,969
MRI 61000013 HC MRI PELVIS W/WO CONTRAST(S) $3,335
MRI 61000014 HC MRI MRA PELVIS $2,613
MRI 61000015 HC MRI UPPER EXTR.(NO JOINT) $2,611
MRI 61000016 HC MRI UPPER EXTR (NO JOINT) WITH $2,975
MRI 61000017 HC MRI UPPER EXTREMITY $2,611
MRI 61000018 HC MRI UPPER EXTREMITY W/WO CONTR $3,335
MRI 61000019 HC MRI SHOULDER $2,611
MRI 61000020 HC MRI JOINT UPPER EXTREMITY $2,722
MRI 61000021 HC MRI JOINT UPPER EXTREM WITH $2,976
MRI 61000022 HC MRI JOINT UPPER EXT W/WO CONTR $3,335
MRI 61000023 HC MRI MRA UPPER EXTREMITY W CONTRAST $2,613
MRI 61000024 HC MRI LOWER EXTREMITY $2,611
MRI 61000025 HC MRI LOWER EXT (NOT JOINT) WITH $2,975
MRI 61000026 HC MRI LOWER EXTREMITY W/WO CONTR $3,335
MRI 61000027 HC MRI JOINT(S) FOR PROSTH WRKUP $439
MRI 61000028 HC MRI JOINT LOWER EXTREMITY $2,722
MRI 61000029 HC MRI JOINT LOWER EXTREMITY WITH $2,975
MRI 61000030 HC MRI JOINT LOWER EXT W/WO CONTR $3,335
MRI 61000031 HC MRI ABDOMEN KIDNEY SIZE $2,015
MRI 61000032 HC MRI ABDOMEN WITHOUT CONTRAST $2,832
MRI 61000033 HC MRI ABDOMEN WITH CONTRAST $2,975
MRI 61000034 HC MRI ABDOMEN W/WO CONTRAST $3,335
MRI 61000035 HC MRI CARDIAC FOR MORPHOLOGY $2,613
MRI 61000036 HC MRI 3-D RENDERING,AT MODALITY $555
MRI 61000037 HC MRI 3-D RENDERING,REMOTE WKSTN $555
MRI 61000038 HC MRI NOVA QUANT. BLD FLOW $502
MRI 61000038 HC MRI NOVA QUANT. BLD FLOW $502
MRI 61000039 HC MRI GUIDED NEEDLE PLACEMENT $2,613
MRI 61000040 HC MRI BREAST CAD $110
MRI 61000041 HC MRI MRA ABDOMEN WITH CONTRAST $2,613
MRI 61000042 HC MRI MRA ABDOMEN $2,613
MRI 61000043 HC MRI MRA ABDOMEN W/WO CONTRAST $2,613
MRI 61000044 HC MRI BREAST UNILAT W/WO CONTRAS $2,613
MRI 61000045 HC MRI BREAST BILAT W/WO CONTRAST $3,042
MRI 61000046 HC MRI MRA CHEST WITH CONTRAST $2,613
MRI 61000047 HC MRI MRA CHEST $2,613
MRI 61000048 HC MRI MRA CHEST W/WO CONTRAST $2,613
MRI 61000049 HC MRI MRA LOWER EXTREM WITH CONT $2,613
MRI 61000050 HC MRI MRA LOWER EXTREMITY $2,613
MRI 61000051 HC MRI MRA LOWER EXTREM W/WO CONT $2,613
MRI 61000052 HC MRI MRA PELVIS WITH CONTRAST $2,613
MRI 61000053 HC MRI MRA PELVIS WO CONTR $2,613
MRI 61000054 HC MRI MRA PELVIS WITH,W/O CONTR. $2,613
MRI 61000055 HC CARDIAC MRI W/STRESS IMG $2,613
MRI 61000056 HC CARDIAC MRI FOR MORPH W/DYE $2,824
MRI 61000057 HC CARD MRI W/STRESS IMG & DYE $2,824
MRI 61000058 HC MRI FOR TISSUE ABLATION $2,613
MRI MRA 61000059 HC MRI MRA UPPER EXTREMITY WO CONTRAST $2,613
MRI MRA 61000060 HC MRI MRA UPPER EXTREMITY W & WO CONTRAST $2,613
MRI 61000061 HC MRI FETAL SINGLE-1ST GESTATION $364
MRI 61000062 HC MRI FETA EA ADD'L GESTATION $364
MRI 61000063 HC CARD MRI VELOCITY FLW MAP ADD-ON $2,824
MRI 61100001 HC MRI ORBITS, FACE AND NECK $2,832
MRI 61100002 HC MRI INT AUDITORY CANALS $3,335
MRI 61100003 HC MRI ORBIT,FACE,NECK WITH CONT $2,832
MRI 61100004 HC MRI ORBIT,FACE,NECK W,W/O CONT $3,053
MRI 61100005 HC MRI STEALTH BRAIN PROTOCOL $1,639
MRI 61100006 HC MRI BRAIN WITHOUT CONTRAST $2,722
MRI 61100007 HC MRI BRAIN WITH CONTRAST $2,876
MRI 61200002 HC MRI CERVICAL WITHOUT CONTRAST $2,722
MRI 61200003 HC MRI CERVICAL WITH CONTRAST $2,876
MRI 61200005 HC MRI THORACIC WITHOUT CONTRAST $2,722
MRI 61200006 HC MRI THORACIC WITH CONTRAST $2,876
MRI 61200008 HC MRI LUMBAR WITHOUT CONTRAST $2,722
MRI 61200009 HC MRI LUMBAR WITH CONTRAST $2,876
MRI MRA 61200010 HC MRI CERVICAL MET W/WO CONTRAST $3,012
MRI MRA 61200011 HC MRI THORACIC MET W/WO CONTRAST $3,012
MRI MRA 61200012 HC MRI LUMBAR MET W/WO CONTRAST $2,895
MRI 61400001 HC MRI BREAST UNILAT WITH CONTRAS $2,613
MRI 61400002 HC MRI BREAST UNILATERAL $2,613
MRI 61400003 HC MRI BREAST BILAT WITH CONTRAST $3,042
MRI 61400004 HC MRI BREAST BILATERAL $3,042
MRI MRA 61500001 HC MRI MRA HEAD LIMITED/COMPONENT $1,362
MRI MRA 61500002 HC MRI MRA HEAD WITHOUT CONTRAST $2,613
MRI MRA 61500003 HC MRI MRA HEAD WITH CONTRAST $2,832
MRI MRA 61500004 HC MRI MRA HEAD WITH,W/O CONTRAST $3,053
MRI MRA 61500005 HC MRI MRA NECK $2,613
MRI MRA 61500006 HC MRI MRA NECK WITH CONTRAST $2,832
MRI MRA 61500007 HC MRI MRA NECK WITH,W/O CONTRAST $3,053
MRI MRA 61800001 HC MRI MRA SPINAL CANAL $2,613
Wound Therapy 63600002 HC APLIGRAF SKIN SUB PER 1 SQ CM $228
Wound Therapy 63600003 HC OASIS SKIN SUB 3X3.5 CM $285
Wound Therapy 63600004 HC OASIS SKIN SUB 3X7 CM $285
Wound Therapy 63600005 HC DERMAGRAFT SKIN SUB PER 1 SQ C $165
Wound Therapy 63600006 HC DERMAL (SUBSTITUTE) TISSUE OF HUMAN ORIG $333
Radiopharm 63600007 HC REGADENOSON 0.1 MG (LEXISCAN) $74
Wound Therapy 63600008 HC EPIFIX / EPICORD PER 1 SQ CM $795
Wound Therapy 63600009 HC PURAPLY AM PER SQ CM $563
Contrast 63600010 HC IOHEXOL (OMNIPAQUE) 300MG IODINE/ML SOLUTION $132
Wound Therapy 63600011 HC AMNIO WOUND PER SQ CM $550
Ortho Clinic 70000001 HC ARM TRACTION $75
Ortho Clinic 70000002 HC BALANCE TRACTION $70
Ortho Clinic 70000003 HC BUCK'S TRACTION $71
Ortho Clinic 70000004 HC CERVICAL TRACTION $54
Ortho Clinic 70000005 HC 90-90 TRACTION $75
Ortho Clinic 70000006 HC SKELETAL TRACTION $93
Ortho Clinic 70000007 HC DEBRIDEMENT $18
Ortho Clinic 70000008 HC LEVEL I PROCEDURE $132
Ortho Clinic 70000009 HC LEVEL II PROCEDURE $198
Ortho Clinic 70000010 HC LEVEL III PROCEDURE $262
Post-Op 71000001 HC RECOVERY ROOM UP TO 30 MINUTES $399
Post-Op 71000002 HC RECOVERY ROOM 30 MINUTES - 1 HOUR $531
Post-Op 71000003 HC RECOVERY ROOM 1 HOUR - 1 HOUR 30 MINUTES $670
Post-Op 71000004 HC RECOVERY ROOM 1 HOUR 30 MINUTES - 2 HOURS $813
Post-Op 71000005 HC RECOVERY ROOM 2 HOURS - 2 HOUR 30 MINUTES $957
Post-Op 71000006 HC RECOVERY ROOM 2 HOURS 30 MINUTES - 3 HOURS $1,093
Post-Op 71000007 HC RECOVERY ROOM 3 HOURS - 3 HOURS 30 MINUTES $1,233
Post-Op 71000008 HC RECOVERY ROOM 3 HOURS 30 MINUTES - 4 HOURS $1,375
Post-Op 71000009 HC RECOVERY ROOM 4 HOURS - 4 HOURS 30 MINUTES $1,514
Post-Op 71000010 HC RECOVERY ROOM 4 HOURS 30 MINUTES - 5 HOURS $1,659
Post-Op 71000011 HC RECOVERY ROOM 5 HOURS - 5 HOURS 30 MINUTES $1,798
Post-Op 71000012 HC RECOVERY ROOM 5 HOURS 30 MINUTES - 6 HOURS $1,936
Post-Op 71000013 HC RECOVERY ROOM 6 HOURS - 6 HOURS 30 MINUTES $2,075
Post-Op 71000014 HC RECOVERY ROOM 6 HOURS 30 MINUTES - 7 HOURS $2,214
Post-Op 71000015 HC RECOVERY ROOM 7 HOURS - 7 HOURS 30 MINUTES $2,355
Post-Op 71000016 HC RECOVERY ROOM 7 HOURS 30 MINUTES - 8 HOURS $2,493
Post-Op 71000017 HC RECOVERY ROOM 8 HOURS - 8 HOURS 30 MINUTES $2,632
Post-Op 71000018 HC RECOVERY ROOM 8 HOURS 30 MINUTES - 9 HOURS $2,651
Post-Op 71000019 HC RECOVERY ROOM 9 HOURS - 9 HOURS 30 MINUTES $2,782
Post-Op 71000031 HC PHASE II RECOVERY UP TO 30 MINUTES $200
Post-Op 71000032 HC PHASE II RECOVERY 30 MINUTES - 1 HOUR $266
Post-Op 71000033 HC PHASE II RECOVERY 1 HOUR - 1 HOUR 30 MINUTES $335
Post-Op 71000034 HC PHASE II RECOVERY 1 HOUR 30 MINUTES - 2 HOURS $407
Post-Op 71000035 HC PHASE II RECOVERY 2 HOURS - 2 HOUR 30 MINUTES $479
Post-Op 71000036 HC PHASE II RECOVERY 2 HOURS 30 MINUTES - 3 HOURS $547
Post-Op 71000037 HC PHASE II RECOVERY 3 HOURS - 3 HOURS 30 MINUTES $617
Post-Op 71000038 HC PHASE II RECOVERY 3 HOURS 30 MINUTES - 4 HOURS $688
Post-Op 71000039 HC PHASE II RECOVERY 4 HOURS - 4 HOURS 30 MINUTES $757
Post-Op 71000040 HC PHASE II RECOVERY 4 HOURS 30 MINUTES - 5 HOURS $830
Post-Op 71000041 HC PHASE II RECOVERY 5 HOURS - 5 HOURS 30 MINUTES $899
L&D 72000001 HC AMNIOCENTESIS, DIAGNOSTIC $308
L&D 72000002 HC AMNIO-REDUCTION $687
L&D 72000003 HC CORDOCENTESIS $308
L&D 72000004 HC EXT. CEPHALIC VERSION $1,783
L&D 72000005 HC INDUCTION/AUGMENTATION $105
L&D 72000006 HC EPIDURAL INJECTION $346
L&D 72000007 HC DELIVERY LEVEL I $972
L&D 72000008 HC DELIVERY LEVEL II $1,444
L&D 72000009 HC DELIVERY LEVEL III $1,687
L&D 72000010 HC DELIVERY LEVEL IV $1,715
Emergency Department 72000011 HC EMERGENCY VAGINAL DELIVERY $972
L&D Observation 72100001 HC MONITOR FETAL SCALP ELECTRODE $129
L&D Observation 72100002 HC LABOR INTENSIVE MONITOR(PER HR $48
L&D Observation 72100003 HC LBR INTENS MONITOR LVL II $55
L&D Observation 72100004 HC LDR TRIAGE ROOM/TX.ROOM-PER HR $117
L&D Observation 72100005 HC FETAL MONITORING $154
L&D Observation 72100006 HC LB/INTEN MONITOR UP TO 6 HOURS $415
L&D Observation 72100007 HC L/D RECOVERY ROOM/ 1ST HOUR $420
EKG 73000001 HC EKG $262
EKG 73000002 HC EKG WITH TRACING/RHYTHM STRIP $463
EKG 73000003 HC ERGONOVINE TEST $323
EKG 73000004 HC EVENT MONITOR-HOOK UP $168
EKG 73000005 HC SIGNALED AVERAGED EKG $463
EKG 73100001 HC HOLTER MONITOR-24 HOUR $621
EKG 73100002 HC HOLTER MONITOR-48 HOUR $810
EKG 73100003 HC SCANNING HOLTER MONITOR $533
EEG 74000001 HC EEG EXTENDED MONITOR 41-60 MIN $712
EEG 74000002 HC EEG GREATER THAN 1 HOUR $855
EEG 74000003 HC EEG AWAKE AND DROWSY $572
EEG 74000004 HC EEG AWAKE AND ASLEEP $572
EEG 74000005 HC SLEEP EEG $728
EEG 74000006 HC DEATH EEG $728
EEG 74000007 HC EEG 24 HOUR MONITORING $1,187
Neuro Diagnostic 74000008 HC DIGITAL ANALYSIS OF EEG $104
Neuro Diagnostic 74000009 HC EEG ALL NIGHT RECORDING $578
Endoscopy 75000001 HC CONVERT PERC G-TUBE > J-TUBE $1,113
Endoscopy 75000002 HC PERC GI TUBE PLACEMENT $1,810
Endoscopy 75000003 HC INSERTION OF NASOGASTRIC TUBE $240
Endoscopy 75000004 HC HEMORRHOID BANDING $360
Endoscopy 75000005 HC LARYNGSCOPY $360
Endoscopy 75000006 HC GASTRIC LAVAGE $360
Endoscopy 75000007 HC INSERTION OF CHEST TUBE $379
Endoscopy 75000008 HC PEG TUBE CHANGE/POSITIONING $450
Endoscopy 75000009 HC PROCTOSCOPY $503
Endoscopy 75000010 HC SIGMOIDOSCOPY FLEX NO STENT $773
Endoscopy 75000011 HC ESOPHAGEAL DILATION $890
Endoscopy 75000012 HC SIGMOIDOSCOPY WITH OTHER PROC $941
Endoscopy 75000013 HC SMALL INTESTINAL ENDOSCOPY $958
Endoscopy 75000014 HC 24 HOUR PH MONITORING $975

See Part 6 of this list.