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Sanford Worthington Medical Center Menu
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Treatment Room - Strapping, Unna Boot (1004204) | $213.00 |
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Treatment Room - Removal Of Tissue From Wounds, Per Session (1007044) | $101.00 |
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Treatment Room - Removal Of Tissue From 6 Or More Finger Or Toe Nails (1008217) | $134.00 |
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Treatment Room - Removal Of Tissue Beneath The Skin, Initial Amount (1005208) | $382.00 |
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Treatment Room - Removal Of 2 To 4 Non-Cancerous Thickened Skin Growths (1008211) | $201.00 |
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Treatment Room - Removal Of 1 Non-Cancerous Thickened Skin Growth (1008210) | $199.00 |
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Treatment Room - Negative Pressure Wound Therapy, Surface Area Less Than Or Equal To 50 Square Centimeters, Per Session (1002928) | $101.00 |
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Treatment Room - Negative Pressure Wound Therapy, Surface Area Greater Than 50 Square Centimeters, Per Session (1002929) | $124.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1009264) | $178.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1028030) | $117.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1012946) | $81.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 10 Minutes (1009269) | $279.00 |
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Treatment Room - Collection Of Blood Specimen From Implanted Venous Access Device (1010165) | $189.00 |
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Treatment Room - Collection Of Blood Specimen From Central Or Peripheral Venous Catheter (1025437) | $195.00 |
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Treatment Room - Application Of Vein Wound Compression System Upper Arm, Forearm, Hand, And Fingers (1024270) | $219.00 |
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Treatment Room - Application Of Vein Wound Compression System Lower Leg Below Knee Including Ankle And Foot (1010224) | $292.00 |
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Treatment Room - Application Of Skin Substitute To Trunk, Arms, Or Legs, Initial (1013002) | $1,186.00 |
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Treatment Room - Application Of Skin Substitute To Face, Scalp, Eyelids, Mouth, Neck, Ears, Eye Region, Genitals, Hands, Feet, Or Multiple Fingers Or Toes, Initial (1013006) | $499.00 |
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Treatment Room - Application Of Skin Substitute (1021559) | $732.00 |
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Treatment Room - Application Of Chemical Agent To Excessive Wound Tissue (1005215) | $270.00 |
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Trauma Response - Hospital Critical Care Service (1027813) | $1,317.00 |
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Trauma Response - Full Trauma Activation (1027810) | $1,317.00 |
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Therapeutic Services - Therapeutic Removal Of Whole Blood To Correct Blood Level Imbalance (1004588) | $117.00 |
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Therapeutic Services - Irrigation Of Implanted Venous Access Drug Delivery Device (1004718) | $101.00 |
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Telemedicine - Fee For Remote Healthcare Service (1009851) | $39.00 |
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Speech Therapy - Treatment Of Swallowing Or Oral Feeding Function (1002861) | $165.00 |
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Speech Therapy - Treatment Of Speech, Language, Voice, Communication, Or Hearing Processing Disorder, Individual (1002858) | $262.00 |
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Speech Therapy - Standardized Thought Processing Testing With Interpretation And Report, Per Hour Of Qualified Professional Time (1006830) | $274.00 |
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Speech Therapy - Fluoroscopic And Video Recorded Motion Evaluation Of Swallowing Function (1002872) | $246.00 |
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Speech Therapy - Evaluation Of Swallowing Function (1002860) | $261.00 |
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Speech Therapy - Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension And Expression (1021038) | $434.00 |
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Speech Therapy - Evaluation Of Speech Sound Production (1021037) | $229.00 |
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Speech Therapy - Evaluation Of Speech Fluency (1021036) | $309.00 |
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Speech Therapy - Behavioral And Qualitative Analysis Of Voice And Resonance (1021039) | $237.00 |
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Room & Board - Semi-Private (1008184) | $1,760.00 |
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Room & Board - Private Hospice (1004311) | $670.00 |
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Room & Board - Private (1000439) | $1,887.00 |
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Room & Board - Nursery (1004623) | $2,237.00 |
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Room & Board - Nursery (1004622) | $1,641.00 |
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Room & Board - Nursery (1000438) | $1,311.00 |
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Room & Board - Intensive Care (1000441) | $3,368.00 |
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Respiratory Services - Ventilation Management In Hospital - Initial Day (1003236) | $1,334.00 |
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Respiratory Services - Test For Exercise-Induced Lung Stress (1027651) | $283.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011525) | $210.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011849) | $123.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006717) | $112.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011850) | $107.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011526) | $105.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1004474) | $101.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006731) | $81.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009222) | $51.00 |
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009221) | $51.00 |
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Respiratory Services - Overnight Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1002093) | $358.00 |
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Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003249) | $141.00 |
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Respiratory Services - Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003265) | $85.00 |
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Respiratory Services - Measurement Of Lung Stretching Capacity (1003335) | $235.00 |
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Respiratory Services - Measurement Of Lung Diffusing Capacity (1003337) | $243.00 |
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Respiratory Services - Measurement And Graphic Recording Of Total And Timed Exhaled Air Capacity (1003239) | $149.00 |
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Respiratory Services - Measurement And Graphic Recording Of The Amount And Speed Of Breathed Air, Before And Following Medication Administration (1001533) | $273.00 |
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Respiratory Services - Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003254) | $92.00 |
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1006722) | $842.00 |
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020782) | $842.00 |
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020783) | $561.00 |
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1006723) | $561.00 |
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Respiratory Services - Inhaled Pneumonia Treatment (1006745) | $350.00 |
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Respiratory Services - Determination Of Lung Volumes Using Plethysmography (Instrumentation) (1003336) | $238.00 |
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1011848) | $129.00 |
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1001534) | $100.00 |
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Respiratory Services - Demonstration Or Evaluation Of Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003278) | $149.00 |
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Recreational Therapy - Community Or Work Reintegration Training, Each 15 Minutes (1002916) | $97.00 |
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Recovery Room For Same Day Surgery (1004672) | $992.00 |
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Recovery Room Additional Sds (1004673) | $115.00 |
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Recovery - Post Anesthesia Services (1001874) | $14.00 |
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Recovery - Floor 2 Hours (1011685) | $465.00 |
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Radiopharmaceuticals - Technetium Sulfur Colloid (Radioactive Imaging Agent) (1003542) | $360.00 |
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Radiopharmaceuticals - Technetium Sestamibi (Radioactive Imaging Agent) (1003575) | $388.00 |
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Radiopharmaceuticals - Technetium Pentetate (Radioactive Imaging Agent) (1010432) | $189.00 |
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Radiopharmaceuticals - Technetium Mertiatide (Radioactive Imaging Agent) (1005454) | $744.00 |
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Radiopharmaceuticals - Technetium Medronate (Radioactive Imaging Agent) (1009453) | $145.00 |
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Radiopharmaceuticals - Technetium Mebrofenin (Radioactive Imaging Agent) (1005436) | $201.00 |
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Radiopharmaceuticals - Technetium Macroaggregated Albumin (Radioactive Imaging Agent) (1005439) | $113.00 |
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Radiopharmaceuticals - Iodine I-123 Sodium Iodide (Radioactive Imaging Agent) (1007048) | $113.00 |
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Radiopharmaceuticals - Fluorodeoxyglucose F-18 (Radioactive Imaging Agent) (1005446) | $2,231.00 |
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Professional Services - Insertion Of Needle Into Vein, Patient 3 Years Or Older (1008501) | $31.00 |
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Professional Services - Injection Of Blood Or Blood Clot Into Spinal Canal (1007976) | $675.00 |
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Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1008136) | $84.00 |
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Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1007692) | $74.00 |
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Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1011895) | $56.00 |
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Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1007673) | $56.00 |
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Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1007672) | $48.00 |
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Physical Therapy - Wheelchair Management, Each 15 Minutes (1005422) | $100.00 |
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Physical Therapy - Water Pool Therapy With Therapeutic Exercises To 1 Or More Areas, Each 15 Minutes (1002903) | $114.00 |
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Physical Therapy - Walking Training To 1 Or More Areas, Each 15 Minutes (1002904) | $97.00 |
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Physical Therapy - Therapeutic Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes (1002902) | $97.00 |
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Physical Therapy - Repositioning Maneuvers For Treatment Of Vertigo, Per Day (1009796) | $141.00 |
N/A
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Physical Therapy - Re-Evaluation Of Physical Therapy, Typically 20 Minutes (1026788) | $116.00 |
N/A
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Physical Therapy - Evaluation Of Physical Therapy, Typically 45 Minutes (1026787) | $207.00 |
N/A
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Physical Therapy - Evaluation Of Physical Therapy, Typically 30 Minutes (1026786) | $194.00 |
N/A
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Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (1026785) | $187.00 |
N/A
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Physical Therapy - Application Of Medication Through Skin Using Electrical Current, Each 15 Minutes (1002897) | $125.00 |
N/A
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Physical Therapy - Application Of Mechanical Traction To 1 Or More Areas (1002885) | $97.00 |
N/A
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Physical Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Unattended By Physical Therapist (1002886) | $97.00 |
N/A
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Pathology - Special Stained Specimen Slides To Examine Tissue Including Interpretation And Report (Group I For Microorganisms) (1006359) | $196.00 |
N/A
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Pathology - Special Stained Specimen Slides To Examine Tissue (Initial Single Slide Or Stain) (1006381) | $310.00 |
N/A
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Pathology - Special Stained Specimen Slides To Examine Tissue (Each Additional Slide Or Stain) (1024653) | $266.00 |
N/A
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Pathology - Preparation Of Tissue For Exam By Removing Any Calcium Present (1006358) | $100.00 |
N/A
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Pathology - Pathology Exam Of Tissue During Surgery (First Block With Frozen Section) (1006376) | $310.00 |
N/A
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Pathology - Pap Smear (Thin Layer Prep With Automated Screening And Manual Rescreening) (1006967) | $146.00 |
N/A
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Pathology - Microscopic Genetic Analysis Of Tumor Specimen (Manual Tumor Immunohistochemistry) (1010667) | $334.00 |
N/A
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Pathology - Level Vi Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or High Complexity) (1006357) | $749.00 |
N/A
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Pathology - Level V Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderately High Complexity) (1006356) | $553.00 |
N/A
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Pathology - Level Iv Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Intermediate Complexity) (1006355) | $345.00 |
N/A
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Pathology - Level Iii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderatley Low Complexity) (1006354) | $265.00 |
N/A
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Pathology - Level Ii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Low Complexity) (1006353) | $198.00 |
N/A
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Pathology - Level I Pathology Exam Of Tissue Using Visual Inspection (1006352) | $118.00 |
N/A
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Pathology - Genetic Testing Interpretation And Report (1006350) | $144.00 |
N/A
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Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, First Marker) (1006317) | $218.00 |
N/A
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Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, Each Additional Marker) (1006323) | $132.00 |
N/A
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Pathology - Chromosome Analysis For Genetic Defects (Each Dna Probe) (1006338) | $138.00 |
N/A
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Pathology - Cellular Exam Of Specimen Using Concentration Technique (Smears) (1006417) | $205.00 |
N/A
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Pathology - Cellular Exam Of Non-Gynecologic Specimen Using Cellular Enhancement Technique (1009034) | $223.00 |
N/A
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Pathology - Cellular Exam Of Fine Needle Aspirate (Physician Interpretation And Report) (1006424) | $293.00 |
N/A
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Operating Room - Umbilical Hernia (1002407) | $2,516.00 |
N/A
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Operating Room - Ulnar Nerve (1002402) | $3,092.00 |
N/A
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Operating Room - Tying Of Vas Deferens (1004727) | $2,142.00 |
N/A
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Operating Room - Tying Of Fallopian Tubes Using Endoscope (1001520) | $2,695.00 |
N/A
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Operating Room - Tying Of Fallopian Tubes (1002380) | $2,279.00 |
N/A
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Operating Room - Treatment Of Broken Nose Without Incision (1005074) | $2,279.00 |
N/A
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Operating Room - Transfer Or Repair Of Tendon (1002300) | $2,294.00 |
N/A
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Operating Room - Transfer Of Ankle Tendon (1006635) | $4,684.00 |
N/A
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Operating Room - Suction Removal Of Uterine Tissue (1026403) | $1,894.00 |
N/A
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Operating Room - Skin Lesion (1002086) | $2,695.00 |
N/A
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Operating Room - Skin Graft (1002083) | $5,045.00 |
N/A
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Operating Room - Scraping Of Uterine Tissue Using Endoscope (1020856) | $4,578.00 |
N/A
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Operating Room - Replacement Of Knee With Artificial Joint (1002335) | $5,084.00 |
N/A
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Operating Room - Replacement Of Hip With Artificial Joint (1002333) | $5,481.00 |
N/A
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Operating Room - Repair Of Wounds (1001926) | $1,894.00 |
N/A
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Operating Room - Repair Of Wound (1002531) | $3,490.00 |
N/A
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Operating Room - Repair Of Hernia Using Endoscope (1001515) | $3,490.00 |
N/A
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Operating Room - Removal Or Insertion Of Feeding Tube (1001198) | $2,695.00 |
N/A
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Operating Room - Removal Of Uterus Through Vagina (1002447) | $3,490.00 |
N/A
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Operating Room - Removal Of Uterus Through Abdominal Incision (1000463) | $4,287.00 |
N/A
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Operating Room - Removal Of Tubal Pregnancy (1001115) | $3,490.00 |
N/A
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Operating Room - Removal Of Tonsils And Adenoids (1002272) | $2,294.00 |
N/A
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Operating Room - Removal Of Tonsils (1002328) | $1,894.00 |
N/A
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Operating Room - Removal Of Tissue (1001019) | $3,490.00 |
N/A
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Operating Room - Removal Of Ovaries And Fallopian Tubes Using Endoscope (1006621) | $3,092.00 |
N/A
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Operating Room - Removal Of Ovaries And Fallopian Tubes (1001979) | $2,294.00 |
N/A
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Operating Room - Removal Of Nerve Bundle Growth (1005046) | $2,294.00 |
N/A
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Operating Room - Removal Of Intestine (1000708) | $5,084.00 |
N/A
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Operating Room - Removal Of Internal Hardware (1001327) | $1,529.00 |
N/A
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Operating Room - Removal Of Gallbladder Using Endoscope (1001514) | $6,415.00 |
N/A
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Operating Room - Removal Of Gallbladder (1000875) | $7,540.00 |
N/A
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Operating Room - Removal Of Foreskin (1000880) | $2,083.00 |
N/A
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Operating Room - Removal Of Foreign Body (1001230) | $2,695.00 |
N/A
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Operating Room - Removal Of Fluid From Chest Cavity With Imaging Guidance (1012841) | $1,080.00 |
N/A
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Operating Room - Removal Of Fluid From Abdominal Cavity With Imaging Guidance (1007763) | $759.00 |
N/A
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Operating Room - Removal Of Fallopian Tubes Using Endoscope (1009890) | $3,055.00 |
N/A
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Operating Room - Removal Of Cyst (1000994) | $2,695.00 |
N/A
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Operating Room - Removal Of Connective Tissue Between Lips And Gums (1005045) | $1,497.00 |
N/A
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Operating Room - Removal Of Cataracts Using Fragmentation And Aspiration (1005017) | $2,701.00 |
N/A
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Operating Room - Removal Of Breast (1001591) | $4,287.00 |
N/A
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Operating Room - Removal Of Bone Spur From Toe (1007598) | $2,889.00 |
N/A
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Operating Room - Removal Of Bone Spur (1001175) | $2,294.00 |
N/A
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Operating Room - Removal Of Bone Spur (1000706) | $1,894.00 |
N/A
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Operating Room - Removal Of Bone Growth From Big Toe (1000734) | $2,695.00 |
N/A
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Operating Room - Removal Of Appendix Using Endoscope (1001513) | $4,035.00 |
N/A
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Operating Room - Removal Of Appendix (1000569) | $5,746.00 |
N/A
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Operating Room - Removal Of Adenoids (1000511) | $4,296.00 |
N/A
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Operating Room - Removal Of Abnormal Growth (1001590) | $2,695.00 |
N/A
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Operating Room - Removal Of Abnormal Bladder Growth Via Urethra (1002386) | $1,894.00 |
N/A
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Operating Room - Release Of Wrist Nerve (Carpal Tunnel Surgery) (1000764) | $1,894.00 |
N/A
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Operating Room - Release Of Soft Tissue Contracture Of Hand And Fingers (1005037) | $5,045.00 |
N/A
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Operating Room - Release Of Scar Tissue (1009197) | $2,192.00 |
N/A
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Operating Room - Release Of Finger Contracture (1004726) | $1,894.00 |
N/A
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Operating Room - Reinforcement Of Esophagus Muscle With Stomach Tissue Using Endoscope (1001510) | $4,684.00 |
N/A
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Operating Room - Rectal Procedure (1001343) | $1,894.00 |
N/A
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Operating Room - Reconstruction Of Anterior Knee Joint Using Arthroscope (1005005) | $11,827.00 |
N/A
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Operating Room - Placement Of Breast Localization Device Accessed Through The Skin, Mammography Guidance, First Lesion (1021075) | $292.00 |
N/A
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Operating Room - Ovarian Cyst (1001749) | $3,490.00 |
N/A
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Operating Room - Open Reduction (1001712) | $2,695.00 |
N/A
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Operating Room - Open Exploration Of Abdominal Cavity (1001521) | $7,214.00 |
N/A
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Operating Room - Miscellaneous Biopsy (1005071) | $2,294.00 |
N/A
|
|
||
Operating Room - Minor Repair Of Joint (1007755) | $4,684.00 |
N/A
|
|
||
Operating Room - Minor Fusion Of Joint (1007756) | $2,695.00 |
N/A
|
|
||
Operating Room - Minor Amputation (1007759) | $2,695.00 |
N/A
|
|
||
Operating Room - Manipulation Of Broken Bone Or Dislocated Joint Without Incision (1000887) | $2,160.00 |
N/A
|
|
||
Operating Room - Manipulation Injection (1001586) | $2,294.00 |
N/A
|
|
||
Operating Room - Introduction Of Saline Or X-Ray Contrast Material For Imaging Of The Uterus And Tubes (1001373) | $210.00 |
N/A
|
|
||
Operating Room - Insertion Or Removal Or Pe Tube (1001799) | $1,894.00 |
N/A
|
|
||
Operating Room - Insertion Of Pin Into Bone Or Joint Without Incision (1000886) | $2,294.00 |
N/A
|
|
||
Operating Room - Insertion Of Nail Into Hip Bone (1001355) | $4,007.00 |
N/A
|
|
||
Operating Room - Insertion Of Chest Tube (1000865) | $1,596.00 |
N/A
|
|
||
Operating Room - Insertion Of Catheter In Central Vein, Access Via Arm, Leg, Or Neck Vein, 5+ Years (1004760) | $1,884.00 |
N/A
|
|
||
Operating Room - Insertion Of Artificial Hip Joint (1001357) | $3,889.00 |
N/A
|
|
||
Operating Room - Insertion Of Access Site Into Vein (1002469) | $2,695.00 |
N/A
|
|
||
Operating Room - Insertion Of Access Site Into Vein (1000841) | $1,953.00 |
N/A
|
|
||
Operating Room - Insertion Of Abdominal Catheter Through The Skin Using Imaging Guidance (1010584) | $4,763.00 |
N/A
|
|
||
Operating Room - Injection Of Radioactive Dye For X-Ray Identification Of Lymph Node (1013112) | $193.00 |
N/A
|
|
||
Operating Room - Injection Of Chemical Agent Into Spider Veins Of Arm, Leg, Or Trunk (1020909) | $259.00 |
N/A
|
|
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