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Surgical Procedures

For the time period: 10/01/16 - 9/30/17

Surgical Procedures: CPT Codes 50000-59999

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.

Note

The pricing on this page is for the surgical procedures listed. It is the average charge for the total procedure including any supplies, testing and other charges associated with the procedure.
Charging is based on the length of stay, amount of supplies used, therapies provided, testing given as well as other care provided.
This pricing is an average charge and not intended to be the exact charge for any particular patient.
The average charge shown is an estimate and actual charges for the service depend on the circumstances at the time the service is provided and the patient.
Any insurance discount is negotiated by the insurance carrier. Most insurance providers should be able to tell their members what financial responsibility they will have.
The charges shown below is only for patients without insurance.

List of Surgical Procedures: CPT Codes 50000-59999
CPT	DESCRIPTION	PLAIN LANGUAGE DESCRIPTION	Self-Pay Price
50435	EXCHANGE NEPHROSTOMY CATH	EXCHANGE NEPHROSTOMY CATHETER, PERCUTANEOUS INCLUDING DAINOSTIC NEPHROSTOGRAM, IMAGING GUIDANCE; SUPRVISION AND INTERPRETATION	$3,216.41
50590	FRAGMENTING OF KIDNEY STONE	FRAGMENTING OF KIDNEY STONE (LITHOTRISY, EXTRACORPOREAL SHOCK WAVE)	$8,511.35
51040	INCISE DRAIN BLADDER	INCISE DRAIN BLADDER ( CYSTOSTOMY, CISOTOMY, W/DRAINAGE	$6,736.53
51102	DRAIN BL W/CATH INSERTION	CYSTOTOMY; FOR SIMPLE EXCISION OF VESSEL NECK (SEPARATE PROCEDURE)	$5,675.75
51600	INJECTION FOR BLADDER X-RAY	INJECTION PROCEDURE FOR CYSTOGRAPHY	$3,341.54
51700	IRRIGATION OF BLADDER	BLADDER IRRIGATION; SIMPLE LAVAGE &/OR INSTILLATION	$5,902.24
51701	INSERT BLADDER CATHETER	INSERTION OF NON-INDWELLING CATHETER FOR RESIDUAL URINE	$4,606.94
51705	CHANGE OF BLADDER TUBE	CHANGE OF CYSTOSTMY TUBE, SIMPLE	$3,889.79
51715	ENDOSCOPIC INJECTION/IMPLANT	ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO SUBMUCOSAL TISSUE OF THE URETHRA	$7,502.12
51720	TREATMENT OF BLADDER LESION	BLADDER INSTILLATION OF ANTI CARCINOGENIC AGENT	$1,329.52
52000	CYSTOSCOPY	CYSTOURETHROSCOPY	$7,317.30
52005	CYSTOSCOPY URETER CATHETER	CYSTOURETHROSCOPY, W/URETERAL CATHETERIZATION	$8,040.30
52204	CYSTOSCOPY W/BIOPSY(S)	CYSTOURETHROSCOPY W/BIOPSY(S)	$5,764.13
52234	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OR TREATMENT .5 CM OR LESS	$7,649.06
52235	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) MEDIUM BLADDER SURGERY 2.0 - 5.0 CM	$7,659.96
52240	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) LARGE BLADDER TUMOR(S)	$10,462.40
52260	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/DILATION OF BLADDER	$9,770.24
52276	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/DIRECT VISION INTERNAL URETHROTOMY	$6,413.81
52287	CYSTOSCOPY CHEMODENERVATION	CYSTOURETHROSCOPY, W/INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER	$6,983.50
52310	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY, W/REMOVAL OF FOREIGN BODY CALCULUS, OR URETERAL STENT	$7,762.72
52317	REMOVE BLADDER STONE	LITHOLAPAXY (REMOVE OR BREAK UP BLADDER STONE)	$8,534.44
52320	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION) W/REMOVAL OF URERTAL CALCULAS (STONE)	$9,871.40
52325	CYSTOSCOPY STONE REMOVAL	CYSTOURETHROSCOPY W/FRAGMENTATION OF CALCULUS (E.G. ULTRASONIC OR ELECTRO HYDRAULIC TECHNIQUE)	$9,268.10
52332	CYSTOSCOPY AND TREATMENT	CYSTOURETHROSCOPY W/INSERTION OF INDWELLING URETERAL STENT	$8,530.44
52351	CYSTOURETERO OR PYELOSCOPE	CYSTOURETHROSCOPY W/URTEROSCOPY &/OR PYLOSCOPY; DIAGNOSTIC	$8,529.87
52352	CYSTOURETERO W/STONE REMOVE	CYSTOURETHROSCOPY W/URTEROSCOPY &/OR PYLOSCOPY; W/REMOVAL OR MANIPULATION OF CALCULUS	$9,578.81
52354	CYSTOURETERO W/BIOPSY	CYSTOURETHROSCOPY W/URTEROSCOPY &/OR PYLOSCOPY; W/BIOPSY OR FULURATION OF URETRERAL OR RENAL PELVIC LESION	$10,242.73
52356	CYSTO/URETERO W/LITHOTRIPSY	CYSTOURETHROSCOPY W/URTEROSCOPY &/OR PYLOSCOPY; W/LITHOTRIPSY AND INSERTION OF STENT	$10,174.63
52601	PROSTATECTOMY (TURP)	TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE	$10,829.18
54161	CIRCUM 28 DAYS OR OLDER	CIRCUMCISION, SURGICAL; AGE 28 DAYS OR MORE	$6,700.11
55040	REMOVAL OF HYDROCELE	REMOVAL OF HYDROCELE	$7,768.16
55250	REMOVAL OF SPERM DUCT(S)	VASECTOMY, UNILATERAL OR BILATERAL	$7,312.13
55700	BIOPSY OF PROSTATE	BIOPSY OF PROSTATE; NEEDLE OR PUNCH; SINGLE OR MULTIPLE	$6,632.91
56405	I D OF VULVA/PERINEUM	INCISION AND DRAINAGE OF VULVA OR PERINEAL ABCESS	$1,602.62
57240	REPAIR BLADDER VAGINA	REPAIR BLADDER VAGINA	$16,801.19
57250	REPAIR RECTUM VAGINA	REPAIR RECTUM VAGINA	$17,235.34
57260	REPAIR OF VAGINA	REPAIR OF VAGINA	$17,465.36
57265	EXTENSIVE REPAIR OF VAGINA	EXTENSIVE REPAIR OF VAGINA	$25,040.56
57267	INSERT MESH/PELVIC FLR ADDON	INSERTION OF MESH FOR REPAIR OF PELVIC FLOOR DEFECT	$27,595.04
57268	REPAIR OF BOWEL BULGE	REPAIR OF BOWEL BULGE; VAGINA APPROACH	$11,228.58
57282	COLPOPEXY EXTRAPERITONEAL	COLPOPEXY VAGINA OR EXTRAPERITONEAL APPROACH	$22,618.83
57283	COLPOPEXY INTRAPERITONEAL	COLPOPEXY INTRAPERITONEAL APPROACH	$24,166.71
57288	REPAIR BLADDER DEFECT	SLING OPERATION FOR STRESS INCONTINENCE	$16,686.66
57425	LAPAROSCOPY SURG COLPOPEXY	LAPAROSCOPY SURGICAL COLPOPEXY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA	$23,744.48
57520	CONIZATION OF CERVIX	CONIZATION OF CERVIX	$9,072.45
58120	DILATION AND CURETTAGE	DILATION AND CURETTAGE; DIAGNOSTIC OR THERAPEUTIC	$8,716.69
58260	VAGINAL HYSTERECTOMY	VAGINAL HYSTERECTOMY	$12,662.77
58262	VAG HYST INCLUDING T/O	VAGINAL HYSTERACTOMY INCLUDING TUBES &/OR OVARIES	$14,066.47
58301	REMOVE INTRAUTERINE DEVICE	REMOVAL OF IUD	$8,958.56
58552	LAPARO-VAG HYST INCL T/O	LAPAROSCOPY, SURGICAL; VAGINA HYSTERECTOMY W/REMOVAL OF TUBES(S) &/OR OVARY(S)	$16,103.53
58558	HYSTEROSCOPY BIOPSY	HYSTEROSCOPY, SURGICAL; W/BIOPSY	$9,602.87
58561	HYSTEROSCOPY REMOVE MYOMA	HYSTEROSCOPY, SURGICAL; W/REMOVAL OF LEIOMYOMATA	$12,223.59
58563	HYSTEROSCOPY ABLATION	HYSTEROSCOPY, SURGICAL; W/ENODMETRIAL ABLATION	$12,471.25
58570	TLH UTERUS 250 G OR LESS	LAPRAOSCOPY, SURGICAL; TOTAL HYSTERECTOMY FOR UTERUS 250 GRAMS OR LESS	$17,807.06
58571	TLH W/T/O 250 G OR LESS	LAPRAOSCOPY, SURGICAL; TOTAL HYSTERECTOMY FOR UTERUS 250 GRAMS OR LESS, W/REMOVAL OF TUBE(S) &/OR OVARY(S)	$19,822.94
58600	DIVISION OF FALLOPIAN TUBE	LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S)	$7,818.82
58661	LAPAROSCOPY REMOVE ADNEXA	LAPRAOSCOPY, SURGICAL; W/REMOVAL OF ADNEXAL STRUCTURES	$12,125.12
58662	LAPAROSCOPY EXCISE LESIONS	LAPRAOSCOPY, SURGICAL; W/FULGURATIOJN OR EXCISION OF THE OVARY, PELVIC VISCERA OR PERTONEAL SURFACE	$14,319.96
58670	LAPAROSCOPY TUBAL CAUTERY	LAPRAOSCOPY, SURGICAL; W/CAUTERY OF TUBES	$10,314.04
58671	LAPAROSCOPY TUBAL BLOCK	LAPRAOSCOPY, SURGICAL; W/OCLUSION OF OVIDUCTS BY DEVICE (E.G. BAND, CLIP OR FALOPE RING)	$8,826.70
59025	FETAL NON-STRESS TEST	FETAL NON-STRESS TEST	$320.48
59812	TREATMENT OF MISCARRIAGE	TREATMENT OF MISCARRIAGE (ANY TRIMESTER)	$9,451.40
59820	CARE OF MISCARRIAGE	TREATMENT OF MISCARRIAGE, SURGICAL ; 1ST TRIMESTER	$7,093.02