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Pricing Transparency

Instructions

The following pages are a listing of DRG and CPT procedure codes and the average pricing that the hospital charged between October 1, 2016 and September 30, 2017. They are an average and a reasonable estimate could be inferred from these numbers. However, they are not an exact estimate and should never be construed as the price a person will be charged. Several factors must always be considered as to how charges are provided to each patient, these are but are not limited to the following:

  • Length of stay
  • Other conditions and complications that the individual has
  • Therapies provided to the individual
  • Medications and treatments
  • Diagnostic testing and studies provided

Because the listing is organized by DRG and CPT codes it is best that use these tables with information provided by the physician. Knowing what CPT codes match to the procedures can given approximation for what the hospital will be charging. Additionally, know a description of the patient's condition while in the hospital as an inpatient will aid in determining the DRG and therefore the approximate charge.

The tables are organized as follows:

Service
Codes
Pricing
Inpatient Services DRG


Outpatient Services
Codes
Pricing
Laboratory CPT Codes: 80000-89999 Per test
Radiology CPT Codes: 70000-79999 Per test
Other: diagnostic & therapeutic services CPT Codes: 90000-99999 Per test
Surgery CPT Codes: 10000-19999 Complete procedure all services
Surgery CPT Codes: 20000-29999 Complete procedure all services
Surgery CPT Codes: 30000-39999 Complete procedure all services
Surgery CPT Codes: 40000-49999 Complete procedure all services
Surgery CPT Codes: 50000-59999 Complete procedure all services
Surgery CPT Codes: 60000-69999 Complete procedure all services
Emergency Room CPT Codes: 99281-99292 Per visit - testing excluded

Diagnosis-Related Group (DRG):

A system that classifies inpatient cases into the one of 999 groups. A single patient may have from 1 to 30 diagnosis' which can be grouped into a single DRG. The purpose of the DRG grouping is to aid in providing statistical, epidemiological and reimbursement data for a user of the data. It is mostly commonly used for reimbursement by most government and commercial payers (insurance companies). What is provided in this table indicates what is charged according to that particular DRG. It is in no way an indication of what is paid.

CPT Codes (CPT)

Common Procedure Terminology (CPT) is a system of classifying outpatient hospital and medical procedures. It is mainly used for reimbursement but is also used for statistical and epidemiological research. CPT classifies the procedure by body system and test (or study). In reimbursement it is used to evaluate technical resources and professional skill. Because every payer is different payment can vary by region, their interpretation of the procedure and value placed on the need for the procedure.

IF YOU ARE COVERED BY HEALTH INSURANCE , YOU ARE STRONGLY ENCOURAGED TO CONSULT WITH YOUR HEALTH INSURER TO DETERMINE ACCURATE INFORMATION ABOUT YOUR FINANCIAL RESPONSIBILITY FOR A PARTICULAR HEALTH CARE SERVICE PROVIDED AT THIS HEALTHCARE FACILITY. IF YOU ARE NOT COVERED BY HEALTH INSURANCE YOU ARE STRONGLY ENCOURAGED TO CONTACT THE BUSINESS OFFICE AT (719)584-4508 OR TOLL FREE AT 800-543-4046 TO DISCUSS PAYMENT OPTIONS PRIOR TO RECEIVING A HEALTH CARE SERVICE FROM THIS HEALTH CARE FACILITY SINCE POSTED HEALTHCARE SERVICES MAY NOT REFLECT THE ACTUAL AMOUNT OF YOUR FINANCIAL RESPONSIBILITY.

Patients without insurance are afforded a discount that is equal to the discount of the insurance plan that receives the lowest discount at Parkview.

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400 West 16th Street, Pueblo, CO 81003

719.584.4000