ERMC Pricing
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ABC
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CPT CODEDESCRIPTIONPRICE
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99195THERAPEUTIC PHLEBOTOMY M/S$54.33
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96365IV MEDICATION INIT 1 HR OP/MS$220.18
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96366IV MEDICATION EA ADD HR OP/MS$126.01
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36430BLOOD/PLT TRANSFUSION 2 UNITS$1,088.49
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36430BLOOD/PLT TRANSFUSION-1 UNIT$734.44
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BONE MARROW ASPIR/BX/MED/SURG$145.31
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36430BLOOD/PLT TRANSFUSION 3 UNITS$1,442.54
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36430BLOOD/PLT TRANSFUSION 4 UNITS$1,796.56
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SIMPLE PROCEDURE M/S$203.25
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INTERMEDIATE PROCEDURE M/S$338.71
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COMPLEX PROCEDURE$609.61
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86891AUTOLOGOUS BLOOD REINFUSION$30.65
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96360IV HYDRATION INIT 31-60 OP/MS$220.18
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96361IV HYDRATION EA ADDIT HR OP/MS$126.01
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PROCEDURE MINOR$52.17
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36591PORT (IMPLANTABLE VAD) DRAW$41.74
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99211LEVEL 1 EVALUATION MANAGEMENT$85.07
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36569PICC LINE INSERTION (MOBILEX)$1,139.63
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PRIVATE ROOM$762.84
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ISOLATION ROOM$762.84
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SEMI PRIVATE ROOM$726.51
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51798BLADDER VOLUME/PV RESIDUAL$138.89
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MONITORED ROOM$980.80
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96365ALBUMIN TRANSFUSION 1ST HR$66.82
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96366ALBUMIN TRANSFUSION 2ND HOUR$66.82
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SWING BED$726.51
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96374IV PUSH SINGLE /INITIAL MS$247.39
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96375IV PUSH EACH ADDIT MS$93.20
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IV NS 500 ML (SUPPLY)$7.64
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IV NS 1000 ML (SUPPLY)$15.26
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96376IV PUSH ADD SME > 30 MS$97.11
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96372IM/SQ INJECTION MS$43.53
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36592PORT (CENTRAL/PERIPHERAL) DRAW$51.61
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36000-52PICC MIDLINE INSERTION$1,022.63
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99218OBSERVATION LOW LEVEL PER HOUR$30.28
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G0378OBSERVATION PER HR MCR/MCD$30.28
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96374IV PUSH SINGLE/INITIAL LOP$93.20
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96375IV PUSH EACH ADDIT LOP$93.20
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96372IM/SQ INJECTION LOP$43.53
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96376IV PUSH ADD SME SEQ >30 LOP$93.20
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96360IV HYDRATION INIT 31-60 MI LOP$220.18
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96361IV HYDRATION EA ADD MAX 8 LOP$126.01
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96365IV MEDICATION INIT 1 HR LOP$220.18
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96366IV MEDICATION EA ADD HR LOP$126.01
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96367IV MEDICATION CONCURRENT OP/MS$107.79
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96368IV MEDICATION SEQUEN 1HR OP/MS$49.64
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36584PICC/REPLACEMENT INSERTION$987.70
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PARACENTESIS/THORACENTESIS M/S$695.77
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96523PORT/PICC LINE FLUSH$54.66
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99220OBSERVATION HI LEVEL PER HOUR$30.28
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OBSERVATION MOD LEVEL PER HOUR$30.28
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99231RAPID RESPONSE TEAM LEVEL 3$64.70
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99232RAPID RESPONSE TEAM LEVEL 4$116.60
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99233RAPID RESPONSE TEAM LEVEL 5$167.26
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99291RAPID RESPONSE TEAM 30-74 MIN$435.08
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99292RAPID RESPONSE TEAM EA ADDL 30$217.17
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TREATMENT ROOM PER HOUR$30.03
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99406SMOKE/TOBACCO COUNSELING 3-10$23.97
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99407SMOKE/TOBACCO COUNSELING >10$49.39
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OBSERVATION NON-COVERED$30.28
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99211EST PATIENT MINIMUM$39.03
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AQUA PAD$30.26
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CATHETER FOLEY$4.20
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CENTRAL LINE KIT$212.15
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PICC LINE KIT$249.69
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THORACENTESIS$78.70
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CHEST TUBE KIT$93.37
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CENTRAL/PICC LINE DRESSING KIT$16.24
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BUCK'S TRACTION DISP BOOT$83.21
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DRESSING CHANGE MAJOR$65.73
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DRESSING CHANGE MINOR$46.33
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THROMBIN (FLO SEAL)$551.58
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CATHETER LEG BAG$4.07
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PARACENTESIS KIT M/S$253.29
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KCI WOUND VAC PUMP RENTAL$199.35
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AUTOLOGOUS BLOOD REINFUSN KIT$39.92
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STOCKING, TEDS ANTI EMBOLISM$20.63
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STOCKING, PAS PNEMATIC$50.83
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CPM MACH INITIAL 2-DAY RENTAL$51.25
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CPM MACH RENTAL-EACH ADD'L DAY$25.63
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AQUACEL FOAM DRESSING 3x3in.$6.70
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KCI INFOVAC CAN W/GEL 500 (5)$777.71
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KCI INFOVAC CAN W/GEL 500 (10)$1,414.01
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KCI SIMPLACE EX S DRESS KIT$791.91
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KCI SIMPLACE EX M DRESS KIT$997.67
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KCI GFOAM SILV S DRESS KIT -5$1,102.03
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KCI GFOAM SILV S DRESS KIT -10$1,912.61
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KCI GFOAM SILV M DRESS KIT -5$1,354.39
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KCI GFOAM SILV M DRESS KIT -10$1,598.78
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KCI GFOAM SILV L DRESS KIT -5$1,613.97
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KCI GFOAM SILV L DRESS KIT -10$1,935.36
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KCI WHITEFOAM S DRES FOAM ONLY$511.29
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KCI WHITEFOAM L DRES FOAM ONLY$490.30
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KCI FREEDOM CAN W/GEL 300 (5)$711.95
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KCI FREEDOM CAN W/GEL 300 (10)$1,291.05
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KCI GFOAM BRIDGE DRESS KIT -5$1,064.18
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KCI GFOAM BRIDGE DRESS KIT -10$1,928.50
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KCI GRANUFOAM BRIDGE XG DRESS$1,175.63
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