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In most cases, physicians providing you with services related to your hospital stay or visit will bill you separately.
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Pricing information by hospital and center
UCHealth Broomfield Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $61 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $94-$99 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $110 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $110 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $133 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $53-$61 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $255-$270 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $157 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $249-$304 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $10-$84 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $90 |
| LAB UROLOGY | Urine pregnancy test | CPT 81025 | $88 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $90-$119 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $98 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $125 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $100 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $267 |
| PHYSICAL THERP | Therapy for help with walking (may include stair training as well) | CPT 97116 | $105 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $5,266 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $87 |
| LAB CHEMISTRY | Assay of lactic acid (Blood test to measure lactic acid levels, produced when oxygen levels in the blood drop) | CPT 83605 | $116-$123 |
| LAB HEMATOLOGY | Fibrin degradation quant (Blood test to check for blood clotting problems) | CPT 85379 | $70 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $18-$65 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $84 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $204 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Broomfield Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $268 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $505 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $985 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $2,274 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $3,359 |
UCHealth Broomfield Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $35,711-$45,237 | 1-2 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC (Nervous system disorder with gradual loss of function without serious complications or conditions) | MS-DRG 57 | $19,527-$40,244 | 7-14 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC (Follow up care for muscle, bones or connective tissue issues with complications or conditions) | MS-DRG 560 | $17,707-$36,051 | 7-13 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $41,991-$48,954 | 1 day |
| Follow up care in the hospital after surgery or an injury with complications or conditions or with major complications or condition | MS-DRG 949 | $16,903-$35,358 | 6-12 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC (Disease or disorder of the muscles, bones or connective (tissue that supports organs and bones) without complications or conditions or without major complications or conditions.) | MS-DRG 561 | $16,860-$27,773 | 7-9.5 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC (Disease or disorder of the nervous system (regulates and coordinates body activities) which are due to a loss in the function or structure of neurons (cells that send commands to muscles) of the brain or spinal cord that continues to get worse with major complications or conditions.) | MS-DRG 56 | $26,499-$57,151 | 9.5-19 days |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT (Replacement of hip, knee or ankle joint with man made joint or surgery to reattach a lower limb with major complications and conditions. ) | MS-DRG 469 | $52,257-$73,507 | 1-2.5 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $13,930-$29,104 | 2-5.75 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC (Disease or disorder of the muscles, bones or connective (tissue that supports organs and bones) with major complications or conditions.) | MS-DRG 559 | $27,079-$44,655 | 8-13.5 days |
| Follow up care in the hospital after surgery or an injury without complications or conditions or without major complications or condition | MS-DRG 950 | $15,985-$29,634 | 6-11 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $13,373-$24,237 | 2-4.75 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $7,769-$15,397 | 1.75-3 days |
| REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC (Operation to take out implant of hip or knee and replace with a new one without complications or conditions or serious complications or conditions) | MS-DRG 468 | $24,027-$49,642 | 1 day |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $11,922-$17,950 | 2-3 days |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC (Removal of or repair of man made device for hip or knee with complications and conditions.) | MS-DRG 467 | $43,832-$73,481 | 2-3.75 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $14,654-$22,495 | 2-7 days |
| SIGNS SYMPTOMS W/O MCC (Signs or symptoms of an illness without serious complications or conditions) | MS-DRG 948 | $20,656-$40,002 | 7.5-13 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Cherry Creek Surgery Center
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| GASTR INTS SVS | Colonoscopy and biopsy (Camera with light passed through the rectum to take pictures of the intestines, a tissue sample is taken for testing.) | CPT 45380 | $691 |
| GASTR INTS SVS | Colonoscopy w/lesion removal (Camera with light passed through the rectum to take pictures of the intestines, with a polyp taken by snare technique for testing.) | CPT 45385 | $691 |
| GASTR INTS SVS | EGD biopsy single/multiple (Camera with light passed through the mouth to take pictures of the stomach, swallowing tube and beginning of the small intestines as needed, tissue sample taken) | CPT 43239 | $541 |
| GASTR INTS SVS | Diagnostic colonoscopy (Camera with light passed through the rectum to take pictures of the intestines to diagnose a problem, a tissue sample may or may not be taken for testing.) | CPT 45378 | $526 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the wall in the nose that is between the nostrils | CPT 30520 | $1,803 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Resect inferior turbinate (Partial or complete removal of soft tissue of one the long thin bones on the inside of the nose) | CPT 30140 | $1,803 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Exam to see the inside of the bladder and urethra (tubes that carry urine away from bladder) using a scope. Any stones are shattered with sound waves and removed. | CPT 52356 | $2,913 |
| OR MINOR | The doctor examines the uterus using a thin, lighted tube with a camera that is placed into the vagina to examine the cervix and inside of the uterus. Tissue sample may be taken or lining of uterus may be removed. | CPT 58558 | $1,720 |
| TREATMENT ROOM | A small tube with a camera at the end of it is placed into the largest sinus cavity (air filled holes in the bones of the face). Area is examined and sample of tissue taken out or cleaned. | CPT 31267 | $3,746 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Procedure on the head using computer assistance to find the exact location. | CPT 61782 | $276 |
| TREATMENT ROOM | The affected lumbar (lower back) or sacral (tailbone) spinal nerve is destroyed using chemical, heat, electrical, or radiofrequency. These procedures are performed to treat chronic back pain. | CPT 64636 | $276 |
| TREATMENT ROOM | Repair of nasal blockage that makes breathing difficult through the nose. | CPT 30465 | $3,340 |
| GASTR INTS SVS | Colonoscopy submucous njx (Camera with light passed through the rectum to take pictures of the intestines with injection given into tissue) | CPT 45381 | $691 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | The doctor places a tube with a camera at the end into the nose and sinus area to see and examine the area. A tissue sample is removed to be examined. | CPT 31253 | $3,746 |
| TREATMENT ROOM | The esophagus (swallowing tube), stomach, duodenum (top of the small intestine), are viewed to find if bleeding, tumors, erosions, ulcers, or other problems are present. A sample of tissue may be taken by brushing or washing the esophageal lining with saline and removing the fluid. | CPT 43235 | $541 |
| SUPPLY IMPLANTS | Device used to provide more support to either a weakened area or damaged tissue. Placed during surgery. Made of either man-made material or animal tissue. | CPT C1781 | $248 |
| PROFESSIONAL FEES - OUTPATIENT SVCS | Also known as a lumpectomy, the doctor removes the cancerous tumor with a rim of normal tissue to cut beyond the border that might have cancer cells. | CPT 19301 | $2,086 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection or a shot given to either diagnose or treat a second problem in the facet joint in the lumbar area (lower back) or sacral area (tailbone) joints of the spine. Uses imaging or X-ray to guide to the correct spot. | CPT 64494 | $276 |
| TREATMENT ROOM | The doctor injects either a substance to diagnose or treat the facet joints using CT to find the correct spot in the cervical (neck) or thoracic (spine) on 2 levels of joints. Facet joints are pairs of small joints in between the vertebrae in the back of the spine. | CPT 64491 | $276 |
| OR MINOR | Thin tube placed into the urethra (tube that carries urine out of the body) and then into the bladder (sac that holds urine) and on to the ureter (tube that brings urine from kidneys to bladder). A stent (metal tube) is placed in the ureter to help provide stability and strength. | CPT 52332 | $2,078 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Procedure used to treat infections in the ethmoid sinus cavities. An endoscope (tube with a camera and light connected) used to help guide the surgeon. Sphenoid sinus also opened. | CPT 31257 | $270 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | This uses a special camera during surgery to look down the throat to see the voice box (larynx) and vocal cords. The vocal cords are stripped (outer layers are removed). A tumor may be removed as well. | CPT 31541 | $2,022 |
| TREATMENT ROOM | Shot given with either pain medicines or a steroid into the disc of the lower back. | CPT 64483 | $559 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection or a shot given to either diagnose or treat a problem in the facet joint in the lumbar area (lower back) or sacral area (tailbone) joints of the spine. Uses imaging or X-ray to guide to the correct spot. | CPT 64493 | $559 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to cut the carpal ligament (thick tissue at the wrist) to allow more space for the carpal nerve to move. | CPT 64721 | $1,184 |
UCHealth Grandview Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $55 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $84-$89 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $9-$75 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $99 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $99 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $120 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $230-$243 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $142 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $224-$274 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $81 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $81-$107 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $48-$55 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $184 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $113 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,739 |
| PHYSICAL THERP | Therapy for help with walking (may include stair training as well) | CPT 97116 | $94 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $95-$130 |
| LAB UROLOGY | Urine pregnancy test | CPT 81025 | $79 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $76 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $240 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $88 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $78 |
| LAB CHEMISTRY | Hepatic function panel (Liver Function blood test) | CPT 80076 | $98-$104 |
| LAB CHEMISTRY | Chorionic gonadotropin test (Blood pregnancy test) | CPT 84703 | $97-$102 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $29-$65 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Grandview Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $241 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $454 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $887 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $2,047 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $3,023 |
UCHealth Grandview Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $35,270-$39,847 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $12,389-$23,818 | 2-4 days |
| BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC (Procedures of both legs or several large joints of the legs without serious complications or conditions) | MS-DRG 462 | $53,727-$58,357 | 2-3 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $35,606-$42,663 | 1 day |
| REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC (Operation to take out implant of hip or knee and replace with a new one without complications or conditions or serious complications or conditions) | MS-DRG 468 | $38,189-$63,662 | 1-2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $13,508-$25,584 | 1-5 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $9,153-$14,145 | 2-3 days |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC (Removal of or repair of man made device for hip or knee with complications and conditions.) | MS-DRG 467 | $49,124-$67,366 | 2-3.25 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $9,779-$17,764 | 2.75-4.25 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $11,176-$22,617 | 2-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $7,888-$14,304 | 1-3 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $15,035-$21,323 | 2-4 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $12,470-$18,020 | 1-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $7,100-$14,080 | 1-2 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Greeley Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $70 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $28-$115 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $44 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $49 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $134 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $98 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $39 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $81 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $137 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $143 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $11-$27 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $36 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $33 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $68-$121 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $51-$71 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $21-$55 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $272 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $322 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $32-$41 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $244-$353 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $68 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $44 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $42 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $83 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $43 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Greeley Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $228 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $394 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $675 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $973 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $1,901 |
UCHealth Greeley Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $11,204-$14,819 | 2 days |
| Normal Newborn | MS-DRG 795 | $1,816-$2,870 | 1-2 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,100-$3,802 | 1-2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $18,851-$41,358 | 3-6 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $15,102-$35,545 | 2-6 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $14,044-$25,887 | 2-4 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $14,740-$30,641 | 2.25-6 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $11,859-$16,013 | 2-3 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $13,223-$21,345 | 2-3.75 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $16,055-$22,851 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $3,300-$9,925 | 2-3 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $46,291-$58,425 | 2 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $18,530-$29,147 | 2-3.5 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $13,172-$22,851 | 2-4 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $12,617-$35,261 | 2.25-5 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $45,695-$112,276 | 5-12 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $12,972-$18,145 | 2-3 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $14,570-$24,037 | 2-3.25 days |
| ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC (Patient with heart attack discharged alive with serious complications) | MS-DRG 280 | $19,579-$30,415 | 2-4.25 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $9,452-$26,023 | 2-4 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC (Other type of Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 698 | $14,692-$30,272 | 3-5 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $16,493-$36,030 | 2-3 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $74,535-$168,641 | 7-16 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $4,196-$10,485 | 2-4.25 days |
| SIMPLE PNEUMONIA PLEURISY W MCC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with serious complications or other conditions) | MS-DRG 193 | $15,004-$30,123 | 2-5.5 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $4,967-$15,660 | 2-4.75 days |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC (Inflammation of the liver caused by drinking alcohol (alcoholic hepatitis) and late stage of scarring (fibrosis) of the liver (cirrhosis) with major complications or conditions.) | MS-DRG 432 | $22,700-$53,970 | 3-8 days |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC (Group of long term lung diseases such as bronchitis or emphysema that block airflow and make it hard to breathe, with major complications or conditions) | MS-DRG 190 | $15,508-$30,747 | 2-5 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $16,910-$35,167 | 2-6 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $12,504-$22,482 | 2-5 days |
| POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE (Disease or disorder after birth or loss of baby without a procedure in the Operating Room.) | MS-DRG 776 | $6,850-$14,467 | 2 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $37,144-$44,883 | 3-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC (Major procedure on small and large intestines without complications or conditions or serious complications or conditions) | MS-DRG 331 | $39,733-$49,579 | 2-4 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC (Stroke caused by either bleeding or a blood clot with serious complications or conditions) | MS-DRG 64 | $22,860-$50,376 | 2.5-7.5 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC (Delivery of baby by vaginal birth that includes a procedure in the Operating Room but not having "tubes tied" (sterilization) - or a D&C (clears lining of uterus)) | MS-DRG 768 | $13,293-$18,954 | 2-3 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $12,283-$20,735 | 2-4 days |
| DELIVERY OF BABY BY C-SECTION (CUTTING INTO THE BELLY OF THE MOTHER) WITH MAJOR COMPLICATIONS OR CONDITIONS WITHOUT HAVING "TUBES TIED". | MS-DRG 786 | $20,463-$31,691 | 3-4 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $56,894-$100,326 | 4-10 days |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $44,165-$105,278 | 3.75-11 days |
| HEART FAILURE SHOCK W CC (The heart is unable to pump enough blood to the body, this causes shock to happen with complications and conditions) | MS-DRG 292 | $9,947-$22,589 | 2-4.5 days |
| OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC (Disease or disorder during period of time before delivery, not listed in other codes, without a procedure in the Operating Room without complications or conditions or without major complications or conditions.) | MS-DRG 833 | $6,097-$9,374 | 1-2 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $13,093-$26,084 | 2.5-5.5 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC (A disease that makes one crave alcohol or drugs and have to drink more to get the same feelings. Causes problems at work or in the family or school. No Rehab services used with serious complications or conditions). | MS-DRG 896 | $16,073-$47,805 | 3-10 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $16,987-$24,214 | 3-4.75 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine with major complications or conditions or in 4 or more vessels or using 4 or more stents) | MS-DRG 246 | $55,361-$95,152 | 2-6 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $22,906-$46,041 | 3-7 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W CC (Disease or disorder of the kidney or urinary tract system, not listed in other codes, with complications or conditions.) | MS-DRG 699 | $16,514-$34,367 | 3-6 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $13,614-$25,272 | 1.75-5 days |
| Disease of the pancreas except cancer without complications or conditions or without major complications or conditions | MS-DRG 440 | $12,435-$17,392 | 2-3 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $13,237-$22,872 | 2-3.25 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC (Disease from a parasite (living things that use other living things like your body for food and a place to live) that is infectious (caused by germs) and makes you sick and needs a procedure in the Operating Room with complications and conditions.) | MS-DRG 854 | $20,328-$36,034 | 2-4 days |
| CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and with tubes being tied. Without complications or conditions or serious complications) | MS-DRG 785 | $14,631-$18,397 | 2 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Highlands Ranch Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $49 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $75-$79 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $204-$216 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $88 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $8-$67 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $107 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $199-$244 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $264 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $88 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $163 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $72-$95 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $126 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $70 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $85-$116 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $42-$49 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $72 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,213 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $79 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $72-$79 |
| PATHOL HYSTOL | The staining process used to look at cells under a microscope, often used to look for cancer cells. This is for any samples after the first sample. | CPT 88341 | $229 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $14-$52 |
| PATHOL HYSTOL | Exam with both the bare eye and under a microscope of tumor tissue from the uterus (without cancer such as a fibroid) but not the uterus itself. | CPT 88307 | $402 |
| LAB UROLOGY | Urine pregnancy test | CPT 81025 | $70 |
| PATHOL HYSTOL | The staining process used to look at cells under a microscope, often used to look for cancer cells. This is for the first sample. | CPT 88342 | $229 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $214 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Highlands Ranch Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $214 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $404 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $788 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,820 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,687 |
UCHealth Highlands Ranch Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| Normal Newborn | MS-DRG 795 | $1,688-$2,675 | 1-2 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $6,144-$9,049 | 2-3 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,120-$3,285 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $16,361-$31,013 | 3-7 days |
| SEIZURES W/O MCC (Seizures without major complications or conditions) | MS-DRG 101 | $10,503-$19,297 | 2-4 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $16,273-$36,658 | 3-7 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $12,120-$16,090 | 2-4 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $6,536-$9,831 | 2-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $11,012-$19,525 | 2-4 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $32,083-$41,005 | 1 day |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $29,814-$32,427 | 1 day |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $15,893-$31,682 | 4-8 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $10,943-$18,451 | 2-4 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $12,014-$16,444 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $2,957-$8,057 | 2-4 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $7,671-$9,874 | 2-3 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $14,110-$29,891 | 2-5 days |
| Procedure on the uterus or close structures such as ovaries, tubes or ligaments without complications or conditions or without major complications or conditions, not for cancer | MS-DRG 743 | $21,313-$25,719 | 1 day |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $2,891-$7,998 | 2-4 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $9,808-$20,627 | 2-5.25 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $10,388-$16,033 | 2-3.75 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $25,709-$60,079 | 3-8 days |
| PULMONARY EMBOLISM W/O MCC (blood clot in the lungs without serious complications) | MS-DRG 176 | $12,241-$20,101 | 1-3 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC (Delivery of baby by vaginal birth that includes a procedure in the Operating Room but not having "tubes tied" (sterilization) - or a D&C (clears lining of uterus)) | MS-DRG 768 | $8,403-$11,975 | 2.25-3 days |
| MAJOR HEAD AND NECK PROCEDURES WITH CC (Procedures performed on the head and neck (such as carotid artery, eye or ear) with complications and conditions.) | MS-DRG 141 | $29,380-$54,639 | 3-6 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $4,732-$58,290 | 3-18.5 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $39,500-$52,375 | 1.75-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $10,463-$17,428 | 1-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $10,705-$20,678 | 2-4.5 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $13,139-$23,315 | 2-4 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC (A disease that makes one crave alcohol or drugs and have to drink more to get the same feelings. Causes problems at work or in the family or school. No Rehab services used with serious complications or conditions). | MS-DRG 896 | $14,429-$36,559 | 3-8 days |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS (Disease of the respiratory system (related to breathing) that requires being on a breathing machine (ventilator) for longer than 96 hours.) | MS-DRG 207 | $91,001-$252,897 | 10-25 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $17,437-$33,855 | 2-5 days |
| UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC (Procedures for disorders of the womb (uterus) or female genitals, not for cancer but with complications and conditions or major complications and conditions.) | MS-DRG 742 | $23,624-$31,216 | 1-2.25 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC (Other type of Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 698 | $10,468-$20,971 | 2-4.25 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $10,632-$17,986 | 2-4 days |
| SYNCOPE AND COLLAPSE (Fainting and falling to the ground.) | MS-DRG 312 | $11,035-$20,342 | 1-4.5 days |
| G.I. OBSTRUCTION W CC (Blockage in the bowel with complications and conditions) | MS-DRG 389 | $11,903-$24,759 | 2-5.5 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $8,913-$15,619 | 2-4.5 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $12,830-$22,524 | 1.25-3 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $44,825-$96,687 | 7-13.75 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $26,372-$37,420 | 3-4.75 days |
| SIMPLE PNEUMONIA PLEURISY W MCC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with serious complications or other conditions) | MS-DRG 193 | $14,518-$22,780 | 3-5 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC (Heart rhythm problems with complications or conditions) | MS-DRG 309 | $11,548-$19,105 | 2-3 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $39,692-$103,974 | 6-14 days |
| OTHER DIGESTIVE SYSTEM DIAGNOSES W CC (Disorder of the digestive system (organs involved in the process of digesting food) not listed in other codes with complications and conditions.) | MS-DRG 394 | $11,054-$19,729 | 2-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC (Disease of the pancreas (except cancer) with major complications or conditions.) | MS-DRG 438 | $12,921-$34,480 | 3-9 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $10,123-$28,099 | 2-6.5 days |
| DELIVERY OF BABY BY C-SECTION (CUTTING INTO THE BELLY OF THE MOTHER) WITH MAJOR COMPLICATIONS OR CONDITIONS WITHOUT HAVING "TUBES TIED". | MS-DRG 786 | $14,008-$17,166 | 3-4 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC (Gallbladder taken out using a thin, lighted tube that lets the doctor see inside your belly. 4 small cuts are made in the belly area. The scope is placed in 1 of them and the gallbladder is taken out. No dye is used to look at the common bile duct for stones with complications or other conditions). | MS-DRG 418 | $25,091-$28,653 | 2-3.5 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $12,310-$34,699 | 2-4.5 days |
| TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (Opening made into the windpipe (trachea) to allow a tube for breathing to be placed or if all the voice box (larynx) is removed when diagnosis is for face, mouth or neck issues with major complications and conditions. ) | MS-DRG 11 | $44,720-$89,477 | 6.5-15 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Longs Peak Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $55 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $99 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $84-$89 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $9-$75 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $230-$243 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $296 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $99 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $224-$274 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $142 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $120 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $81-$107 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $240 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $39-$71 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $81 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $16-$58 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $113 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $48-$55 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $88 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $78 |
| LAB CHEMISTRY | Vitamin B-12 shot | CPT 82607 | $126 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $184 |
| LAB CHEMISTRY | Assay of ferritin (Blood test to measure amount of iron) | CPT 82728 | $48-$126 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $29-$65 |
| PATHOL HYSTOL | The staining process used to look at cells under a microscope, often used to look for cancer cells. This is for the first sample. | CPT 88342 | $257 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,739 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Longs Peak Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $241 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $454 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $887 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $2,047 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $3,023 |
UCHealth Longs Peak Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| Normal Newborn | MS-DRG 795 | $1,791-$2,759 | 1-2 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $5,748-$8,199 | 1-2.5 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,277-$3,416 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $14,369-$32,163 | 2-6.25 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $19,623-$44,500 | 3-7 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $12,102-$15,498 | 2-3 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $13,982-$22,340 | 2-5 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $6,146-$8,257 | 2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $14,904-$24,271 | 2-4 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $52,101-$65,130 | 2 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $11,289-$17,863 | 2-4 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $11,545-$20,502 | 2-4 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $12,768-$21,162 | 1-3 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $16,965-$25,253 | 1.75-3 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $31,185-$38,282 | 1-2 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $15,665-$26,173 | 2-5 days |
| COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC (Surgery to join the bones of the front and back of the spine without complications or conditions or serious complications or conditions) | MS-DRG 455 | $61,464-$99,009 | 2-4 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $13,333-$15,849 | 2-3 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $12,103-$20,346 | 2-4 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $18,934-$47,602 | 2-5 days |
| COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC (Surgery to join 2 or more bones in the spine so there is no movement. Can be done through the front of the neck or belly or through the back of the spinal canal with complications and conditions). | MS-DRG 454 | $77,819-$116,834 | 3-6.25 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $3,684-$29,722 | 2-11.25 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $41,095-$105,061 | 4-11 days |
| SPINAL FUSION EXCEPT CERVICAL W/O MCC (Surgery to join the bones of the back, not the neck, without serious complications or conditions) | MS-DRG 460 | $45,714-$74,212 | 1-4 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $33,145-$49,389 | 3-6.75 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $2,994-$6,135 | 2-3 days |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC (Inflammation of the liver caused by drinking alcohol (alcoholic hepatitis) and late stage of scarring (fibrosis) of the liver (cirrhosis) with major complications or conditions.) | MS-DRG 432 | $21,263-$43,220 | 3-8 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC (Major procedure on small and large intestines without complications or conditions or serious complications or conditions) | MS-DRG 331 | $26,049-$33,973 | 2-3 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine with major complications or conditions or in 4 or more vessels or using 4 or more stents) | MS-DRG 246 | $60,343-$99,763 | 2-4.5 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $15,935-$26,686 | 2-5 days |
| G.I. OBSTRUCTION W/O CC/MCC (Blockage in the bowel without complications and conditions or serious complications or conditions) | MS-DRG 390 | $13,260-$18,166 | 2-3 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $10,646-$20,876 | 2-4 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $16,878-$35,300 | 2-5 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $15,879-$23,148 | 2-3 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $14,281-$21,874 | 2-3 days |
| HEART FAILURE SHOCK W CC (The heart is unable to pump enough blood to the body, this causes shock to happen with complications and conditions) | MS-DRG 292 | $12,301-$20,388 | 2-5 days |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC (Group of long term lung diseases such as bronchitis or emphysema that block airflow and make it hard to breathe, with major complications or conditions) | MS-DRG 190 | $17,468-$24,397 | 2-5 days |
| CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and with tubes being tied. Without complications or conditions or serious complications) | MS-DRG 785 | $15,363-$17,131 | 2 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC (Gallbladder taken out using a thin, lighted tube that lets the doctor see inside your belly. 4 small cuts are made in the belly area. The scope is placed in 1 of them and the gallbladder is taken out. No dye is used to look at the common bile duct for stones with complications or other conditions). | MS-DRG 418 | $25,132-$43,696 | 2-5 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $12,934-$23,909 | 2-3 days |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC (Heart Attack, patient left hospital alive with complications or other conditions) | MS-DRG 281 | $15,298-$24,417 | 1-3 days |
| DIABETES W MCC (A disease where the body either does not make insulin (hormone made by the body to use glucose) or does not use insulin it makes with major complications or conditions.) | MS-DRG 637 | $14,086-$31,427 | 2-4.25 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $13,784-$24,042 | 2-3.25 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $6,709-$8,576 | 2-3 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC (A disease that makes one crave alcohol or drugs and have to drink more to get the same feelings. Causes problems at work or in the family or school. No Rehab services used with serious complications or conditions). | MS-DRG 896 | $15,667-$41,595 | 3-8.25 days |
| CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC (Diseases of the blood vessels except not a heart attack with a cardiac catheterization without serious complications or conditions) | MS-DRG 287 | $17,662-$25,311 | 1-3 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC (Disease of the pancreas (except cancer) with major complications or conditions.) | MS-DRG 438 | $24,594-$41,279 | 3.5-6.5 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $12,887-$24,037 | 2-4.5 days |
| CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC (Disease of the circulatory system (cardiovascular system or heart) except for an acute myocardial infarction (heart attack). Does include having a cardiac catherization (long thin tube placed into blood vessel with dye given. Looks at blood vessels of the heart and how the heart pumps) with major complications and conditions.) | MS-DRG 286 | $25,666-$31,652 | 2-4.5 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $16,782-$29,318 | 2-6 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC (Stroke caused by either bleeding or a blood clot with serious complications or conditions) | MS-DRG 64 | $16,327-$29,631 | 1.25-4 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Longs Peak Surgery Center
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| GASTR INTS SVS | Colonoscopy and biopsy (Camera with light passed through the rectum to take pictures of the intestines, a tissue sample is taken for testing.) | CPT 45380 | $691 |
| GASTR INTS SVS | EGD biopsy single/multiple (Camera with light passed through the mouth to take pictures of the stomach, swallowing tube and beginning of the small intestines as needed, tissue sample taken) | CPT 43239 | $541 |
| GASTR INTS SVS | Colonoscopy w/lesion removal (Camera with light passed through the rectum to take pictures of the intestines, with a polyp taken by snare technique for testing.) | CPT 45385 | $691 |
| GASTR INTS SVS | Colonoscopy submucous njx (Camera with light passed through the rectum to take pictures of the intestines with injection given into tissue) | CPT 45381 | $691 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Cataract surg w/iol 1 stage (Removal of a cataract with an artificial lens being placed in the eye) | CPT 66984 | $1,392 |
| INTRAOCULAR LENS | Surgery to take out the natural lens of the eye during cataract surgery and replace it with an artificial one. The lens bends light rays that come into the eye to help you to see. | CPT V2632 | $317 |
| GASTR INTS SVS | Esoph EGD dilation <30 mm (Camera with a light is passed through the mouth to the stomach and beginning of small intestine to examine the stomach and swallowing tube. Swallowing tube is enlarged with balloon less than 30 mm in diameter) | CPT 43249 | $1,072 |
| GASTR INTS SVS | Diagnostic colonoscopy (Camera with light passed through the rectum to take pictures of the intestines to diagnose a problem, a tissue sample may or may not be taken for testing.) | CPT 45378 | $526 |
| GASTR INTS SVS | Test to look at the lining of the swallowing tube, stomach and first part of the small intestine. A small tube with a camera at the end is passed through the mouth and into the stomach. The doctor removed a piece of tissue using a loop to cut off the piece of tissue. | CPT 43251 | $1,072 |
| INTRAOCULAR LENS | Surgery to take out the natural lens of the eye during cataract surgery and replace it with an artificial one to correct astigmatism (This is when the eye does not focus light evenly into the retina.) The lens bends light rays that come into the eye to help you to see. | CPT V2787 | $515 |
| TREATMENT ROOM | Removal of sperm duct(s) (Removal of a section of the sperm duct or ducts) | CPT 55250 | $1,220 |
| GASTR INTS SVS | Test to look at the lining of the swallowing tube, stomach and first part of the small intestine. A small tube with a camera at the end is passed through the mouth and into the stomach. The doctor injects a substance like saline or salt water to be able to see an area better. | CPT 43236 | $541 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | The use of high frequency sound (shock) waves to break up stones in your kidney | CPT 50590 | $2,078 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Resect inferior turbinate (Partial or complete removal of soft tissue of one the long thin bones on the inside of the nose) | CPT 30140 | $1,803 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Drain placed in the eye during cataract surgery. Increases the ability of the eye to drain fluid and keeps the pressure in the eye lower, preventing glaucoma. | CPT 0191T | $2,629 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the wall in the nose that is between the nostrils | CPT 30520 | $1,803 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to cut the carpal ligament (thick tissue at the wrist) to allow more space for the carpal nerve to move. | CPT 64721 | $1,184 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your knee. | CPT 29881 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Exam to see the inside of the bladder and urethra (tubes that carry urine away from bladder) using a scope. Any stones are shattered with sound waves and removed. | CPT 52356 | $2,913 |
| GASTR INTS SVS | Test done with a camera with light passed through the rectum to take pictures of the intestines in someone with a higher than normal risk for having disease. | CPT G0105 | $526 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | An intraocular (in the eye) pressure lowering implant device that is used for the treatment of glaucoma (disease that damages the nerve in the eye and causes a buildup of pressure in the eye). | CPT C1783 | $1,087 |
| TREATMENT ROOM | Shot given with either pain medicines or a steroid into the disc of the lower back. | CPT 64483 | $559 |
| SUPPLY IMPLANTS | Device used to provide more support to either a weakened area or damaged tissue. Placed during surgery. Made of either man-made material or animal tissue. | CPT C1781 | $248 |
| TREATMENT ROOM | Placement of a second drain for fluid control in the eye and to reduce pressure in the eye with glaucoma (fluid pressure in the eye that damages the optic nerve). | CPT 0376T | $276 |
| TREATMENT ROOM | A small tube with a camera at the end of it is placed into the largest sinus cavity (air filled holes in the bones of the face). Area is examined and sample of tissue taken out or cleaned. | CPT 31267 | $3,746 |
UCHealth Medical Center of the Rockies
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $81 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $33-$132 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $50 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $56 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $155 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $45 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $114 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $165 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $38 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $79-$140 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $94 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $73 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $158 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $24-$64 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $59-$82 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $12-$32 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $41 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $314 |
| LAB CHEMISTRY | A blood test to diagnose heart failure. | CPT 83880 | $142-$233 |
| PATHOL CYTOLOGY | Flowcytometry/tc add-on (Test to evaluate characteristics of cells in the body, each marker characteristic) | CPT 88185 | $46-$98 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $51 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $49 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $3,854 |
| IV THERAPY | An additional hour of medicine given by IV (Intravenous infusion) for therapy, to prevent a problem, or to diagnose a disease. | CPT 96366 | $156 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $37-$47 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Medical Center of the Rockies
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $264 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $455 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $779 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,123 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,194 |
UCHealth Medical Center of the Rockies
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| Normal Newborn | MS-DRG 795 | $1,726-$2,749 | 1-2 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $11,253-$15,971 | 1-2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $24,852-$61,238 | 3-8 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,062-$3,837 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $22,846-$50,191 | 3-8 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $60,552-$80,708 | 1-2 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $14,721-$22,022 | 2-3 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $21,075-$43,013 | 3-7 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $13,035-$18,302 | 2-3 days |
| PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC (Heart procedure performed with needle passed through the skin without serious complications or conditions) | MS-DRG 274 | $59,292-$66,004 | 1 day |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC (Procedure on a heart valve performed through the skin without serious complications or conditions) | MS-DRG 267 | $104,727-$114,687 | 1 day |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $55,919-$64,160 | 1-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $17,779-$39,181 | 2-5 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine with major complications or conditions or in 4 or more vessels or using 4 or more stents) | MS-DRG 246 | $69,955-$115,448 | 2-4 days |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC (Replacement of heart valve performed through the skin with serious complications or conditions) | MS-DRG 266 | $110,750-$174,044 | 1-7 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $22,789-$38,707 | 2-3 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $40,775-$64,706 | 3-6 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $16,008-$24,335 | 2-4 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $16,903-$48,215 | 2-6 days |
| MEDICAL BACK PROBLEMS W/O MCC (Back problems without serious complications or conditions) | MS-DRG 552 | $18,821-$33,839 | 2-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $61,548-$108,281 | 3-6 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $20,591-$38,132 | 2-5 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC (Stroke caused by either bleeding or a blood clot with serious complications or conditions) | MS-DRG 64 | $31,976-$79,201 | 3-10 days |
| ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC (Patient with heart attack discharged alive with serious complications) | MS-DRG 280 | $22,656-$54,203 | 2-7.5 days |
| SPINAL FUSION EXCEPT CERVICAL W/O MCC (Surgery to join the bones of the back, not the neck, without serious complications or conditions) | MS-DRG 460 | $67,132-$105,970 | 2-3.5 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $88,623-$224,073 | 7.5-18.5 days |
| TRAUMATIC STUPOR COMA COMA <1 HR W CC (Unresponsive from trauma or in a coma for less than 1 hour with complications or conditions) | MS-DRG 86 | $18,480-$39,053 | 2-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC (Major procedure on small and large intestines without complications or conditions or serious complications or conditions) | MS-DRG 331 | $62,044-$84,140 | 2-4 days |
| CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC (Procedure on heart valve or other serious procedure of heart or chest without cardiac catheterization with complications or conditions) | MS-DRG 220 | $172,857-$260,043 | 5-9 days |
| CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC (Open brain surgery or brain procedure on the vessels performed through the skin with serious complications or conditions) | MS-DRG 25 | $63,972-$122,197 | 3-9.25 days |
| CORONARY BYPASS W/O CARDIAC CATH W/O MCC (heart bypass surgery without a heart catheterization and without major complications or conditions) | MS-DRG 236 | $175,884-$223,922 | 6-9 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $43,018-$49,914 | 1 day |
| CARDUIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC (Improper beating of the heart, may be irregular, too fast, or too slow and disorder of how electrical signals travel through the heart with serious complications) | MS-DRG 308 | $19,805-$35,417 | 3-4 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC (Gallbladder taken out using a thin, lighted tube that lets the doctor see inside your belly. 4 small cuts are made in the belly area. The scope is placed in 1 of them and the gallbladder is taken out. No dye is used to look at the common bile duct for stones with complications or other conditions). | MS-DRG 418 | $44,498-$72,431 | 3-5 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC (Other type of Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 698 | $19,969-$38,573 | 3-6 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC (Delivery of baby by vaginal birth that includes a procedure in the Operating Room but not having "tubes tied" (sterilization) - or a D&C (clears lining of uterus)) | MS-DRG 768 | $14,382-$19,669 | 2-3 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $18,678-$30,467 | 2-5 days |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS (Disease of the respiratory system (related to breathing) that requires being on a breathing machine (ventilator) for longer than 96 hours.) | MS-DRG 207 | $161,082-$313,477 | 12-26.75 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $18,489-$37,449 | 3-5 days |
| G.I. OBSTRUCTION W CC (Blockage in the bowel with complications and conditions) | MS-DRG 389 | $14,020-$23,866 | 2-4 days |
| COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC (Surgery to join the bones of the front and back of the spine without complications or conditions or serious complications or conditions) | MS-DRG 455 | $75,307-$123,773 | 1-3 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $75,578-$203,402 | 6-16.5 days |
| CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC (Heart valve procedure or other heart procedure without having a heart catherization with serious complications or conditions) | MS-DRG 219 | $225,962-$340,962 | 8-14 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $3,701-$10,771 | 2-3 days |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $44,783-$93,598 | 2-7 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $20,705-$38,846 | 2-5 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $20,960-$55,217 | 3-7 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $24,008-$55,126 | 3-6 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $24,002-$73,865 | 3-9 days |
| SIMPLE PNEUMONIA PLEURISY W MCC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with serious complications or other conditions) | MS-DRG 193 | $18,715-$39,135 | 3-6 days |
| AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC (Procedures on the aorta (large blood vessel that carries blood from the left ventricle of the heart to the rest of the body) and on the heart to help it work properly except for a balloon pump device.) | MS-DRG 269 | $107,466-$132,986 | 1-2.75 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Memorial Hospital Central and Memorial Hospital North
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| LABORATORY | Routine blood sample drawn | CPT 36415 | $10 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $105 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $24-$32 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $51-$66 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $89 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $64 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $58-$73 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $43 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $44-$59 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $53 |
| OTHER | Level 2 Office/outpatient visit established patient | CPT 99212 | $217 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $110 |
| LAB IMMUNOLOGY | Allergy testing | CPT 86003 | $52-$58 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $180-$184 |
| LABORATORY | Assay of free thyroxine (Blood test to measure thyroid hormone levels) | CPT 84439 | $33-$55 |
| LAB CHEMISTRY | Vitamin d 25 hydroxy (Vitamin D level blood test) | CPT 82306 | $90-$158 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $76 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $96 |
| PHYSICAL THERP | Neuromuscular reeducation (Exercise to help re-educate the body part to perform a function or task that it was able to do in its pre-injury state) | CPT 97112 | $105 |
| CARDIOLOGY - ECHOCARDIOLOGY | Tte w/doppler complete (Transthoracic - through the chest wall - Echocardiogram - ultrasound- with color ultrasound doppler to view blood flow of heart) | CPT 93306 | $2,475 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $74 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $20-$26 |
| CARDIOLOGY | PM/ICD remote tech serv (Remote check or receiving of data for pacemaker or defibrillator with technician review) | CPT 93296 | $158 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $169 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $16-$39 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Memorial Hospital Central and Memorial Hospital North
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $265 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $547 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $991 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,830 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $3,512 |
UCHealth Memorial Hospital Central and Memorial Hospital North
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $8,264-$12,858 | 1-2 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $3,325-$5,180 | 1-2 days |
| Normal Newborn | MS-DRG 795 | $2,647-$4,094 | 1-2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $22,217-$53,862 | 3-7 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $19,320-$39,651 | 3-7 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $17,481-$25,742 | 2-3 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $9,214-$15,414 | 2-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $16,920-$29,935 | 2-4 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $17,513-$35,006 | 3-6 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $4,241-$8,713 | 2-3 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $54,957-$150,446 | 6-16 days |
| A BABY 4 WEEKS OLD OR LESS THAT DIED OR IS MOVED TO ANOTHER HOSPITAL FOR CARE. | MS-DRG 789 | $1,239-$1,933 | 1 day |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $57,951-$76,960 | 1-2 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $17,223-$32,767 | 2-5 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $15,284-$26,685 | 2-4 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $19,907-$29,933 | 2-4 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $13,230-$25,299 | 2-4 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $20,469-$30,391 | 2-4 days |
| SIMPLE PNEUMONIA PLEURISY W MCC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with serious complications or other conditions) | MS-DRG 193 | $16,918-$32,912 | 2-5 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $10,954-$17,172 | 2-3 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $22,632-$36,935 | 2-4 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $14,138-$29,751 | 2-5 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC (Nervous system disorder with gradual loss of function without serious complications or conditions) | MS-DRG 57 | $21,611-$56,449 | 5-16 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $38,005-$63,472 | 3-8 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $15,803-$29,746 | 2-4 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $42,380-$64,712 | 3-6 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $4,192-$7,162 | 2-3 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $41,684-$63,852 | 2-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $12,251-$20,366 | 2-3 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $17,307-$46,231 | 2-5 days |
| COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC (Surgery to join the bones of the front and back of the spine without complications or conditions or serious complications or conditions) | MS-DRG 455 | $109,978-$178,012 | 2-3 days |
| DELIVERY OF BABY BY C-SECTION (CUTTING INTO THE BELLY OF THE MOTHER) WITH MAJOR COMPLICATIONS OR CONDITIONS WITHOUT HAVING "TUBES TIED". | MS-DRG 786 | $23,437-$36,161 | 3-5 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC (Stroke caused by either bleeding or a blood clot with serious complications or conditions) | MS-DRG 64 | $31,114-$67,391 | 2-9 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $18,456-$34,108 | 2-4 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC (Disease from a parasite (living things that use other living things like your body for food and a place to live) that is infectious (caused by germs) and makes you sick and needs a procedure in the Operating Room with complications and conditions.) | MS-DRG 854 | $29,996-$63,675 | 3-8 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $14,350-$25,621 | 2-4 days |
| CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and with tubes being tied. Without complications or conditions or serious complications) | MS-DRG 785 | $16,812-$24,021 | 2-3 days |
| OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC (Disease or disorder during period of time before delivery, not listed in other codes, without a procedure in the Operating Room without complications or conditions or without major complications or conditions.) | MS-DRG 833 | $7,243-$12,544 | 1-3 days |
| PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC (Heart procedure performed with needle passed through the skin without serious complications or conditions) | MS-DRG 274 | $83,251-$85,884 | 1 day |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $15,402-$25,948 | 2-4 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $44,352-$51,908 | 1 day |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $34,116-$80,205 | 3-7 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $49,731-$125,387 | 5-13.75 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC (Delivery of baby by vaginal birth that includes a procedure in the Operating Room but not having "tubes tied" (sterilization) - or a D&C (clears lining of uterus)) | MS-DRG 768 | $10,676-$20,281 | 2-3 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $26,960-$54,184 | 3-6 days |
| OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC (Disease or disorder during period of time before delivery, not listed in other codes, without a procedure in the Operating Room with complications or conditions.) | MS-DRG 832 | $7,969-$19,117 | 1-4 days |
| DIABETES W MCC (A disease where the body either does not make insulin (hormone made by the body to use glucose) or does not use insulin it makes with major complications or conditions.) | MS-DRG 637 | $19,198-$36,707 | 2-5 days |
| MEDICAL BACK PROBLEMS W/O MCC (Back problems without serious complications or conditions) | MS-DRG 552 | $22,867-$37,662 | 2-5 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $19,802-$45,987 | 3-8 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $20,268-$39,837 | 2-6 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $6,157-$50,352 | 3-15 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC (Major procedure on small and large intestines without complications or conditions or serious complications or conditions) | MS-DRG 331 | $29,118-$50,850 | 2-4 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Pikes Peak Regional Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $91 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $49 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $59-$69 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $114 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $149 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $332 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $73 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $116 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $105 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $102 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $389 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $47 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $172 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $82 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $134-$176 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $114 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $266 |
| CARDIAC REHAB OTH RX SVCS | A qualified health care professional supervises program for patients with heart (cardiac) in areas of exercise, diet, and related treatments. | CPT 93798 | $226 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $30 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $3,123 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $290-$306 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $18 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $30 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $131 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine or substance given before by IV into a vein) | CPT 96376 | $138 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Pikes Peak Regional Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $140 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $489 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $699 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,398 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,097 |
UCHealth Pikes Peak Regional Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $12,392-$22,500 | 2-4.75 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $9,358-$18,353 | 2 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $11,872-$21,981 | 2-6.25 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $7,621-$14,952 | 1-3 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC (Follow up care for muscle, bones or connective tissue issues with complications or conditions) | MS-DRG 560 | $10,996-$32,532 | 4.5-18.5 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Poudre Valley Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $81 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $33-$132 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $56 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $50 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $155 |
| LAB IMMUNOLOGY | Allergy testing | CPT 86003 | $19-$33 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $45 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $94 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $114 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $92 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $38-$77 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $79-$140 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $73 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $94 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $38 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $66 |
| LAB BACT MICRO | Culture aerobic identify (Blood test to identify type of bacteria) | CPT 87077 | $56-$67 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $158 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $12-$32 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $165 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $281-$408 |
| PATHOL CYTOLOGY | Flowcytometry/tc add-on (Test to evaluate characteristics of cells in the body, each marker characteristic) | CPT 88185 | $46-$98 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $41 |
| LAB BACT MICRO | Test of urine to find which antibiotic works best to treat infection caused by bacteria. | CPT 87186 | $106 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $49 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Poudre Valley Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $264 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $455 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $779 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,123 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,194 |
UCHealth Poudre Valley Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $8,905-$18,743 | 3-5 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $11,707-$16,182 | 1-2 days |
| Normal Newborn | MS-DRG 795 | $1,809-$2,821 | 1-2 days |
| PSYCHOSES (condition of having lost touch with reality) | MS-DRG 885 | $7,378-$14,998 | 3-7 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $23,522-$56,776 | 3-7 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,286-$4,051 | 1-2 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $56,668-$66,170 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $19,471-$48,225 | 3-7 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $15,498-$23,597 | 2-4 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $43,018-$52,915 | 1 day |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $13,578-$18,955 | 2-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $17,331-$31,772 | 2-4 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $19,414-$41,331 | 3-6 days |
| EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE ( Baby born very early or with lungs not mature enough for breathing well) | MS-DRG 790 | $51,204-$125,716 | 12-34.75 days |
| BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC (Procedures of both legs or several large joints of the legs without serious complications or conditions) | MS-DRG 462 | $93,916-$102,661 | 2-3 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $14,913-$26,452 | 2-4 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $17,002-$35,601 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $3,872-$21,624 | 2-5 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $17,904-$26,991 | 2-4 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $18,729-$33,953 | 2-4 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC (Nervous system disorder with gradual loss of function without serious complications or conditions) | MS-DRG 57 | $25,545-$50,460 | 7.25-14 days |
| DEPRESSIVE NEUROSES (Mental disorder with anxiety, fear or depression) | MS-DRG 881 | $5,626-$11,015 | 2.25-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $14,645-$28,962 | 2-4 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $20,865-$36,829 | 2-5 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $75,035-$164,837 | 6-14.75 days |
| CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC (Chemo without having acute leukemia as a diagnosis with complications or conditions) | MS-DRG 847 | $29,250-$42,215 | 4-5 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $13,391-$30,178 | 2-4 days |
| Follow up care in the hospital after surgery or an injury with complications or conditions or with major complications or condition | MS-DRG 949 | $23,847-$42,838 | 7-11.5 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $17,434-$44,425 | 2-5 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $14,316-$26,104 | 2-4.25 days |
| NEUROSES EXCEPT DEPRESSIVE (Mental disorder with anxiety or fear but not depression) | MS-DRG 882 | $5,822-$12,131 | 2-5 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC (A disease that makes one crave alcohol or drugs and have to drink more to get the same feelings. Causes problems at work or in the family or school. No Rehab services used with serious complications or conditions). | MS-DRG 896 | $19,399-$48,812 | 3-7 days |
| DELIVERY OF BABY BY C-SECTION (CUTTING INTO THE BELLY OF THE MOTHER) WITH MAJOR COMPLICATIONS OR CONDITIONS WITHOUT HAVING "TUBES TIED". | MS-DRG 786 | $21,144-$35,752 | 3-5 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $38,047-$50,736 | 3-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $50,935-$85,873 | 3.25-8 days |
| SIMPLE PNEUMONIA PLEURISY W MCC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with serious complications or other conditions) | MS-DRG 193 | $16,290-$34,600 | 2-5 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $19,822-$92,404 | 5.75-29 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $13,927-$20,575 | 2-3 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $17,103-$33,825 | 1-3 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $18,622-$34,294 | 2-4 days |
| PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC (heart procedure done through the skin and placing a stent to support the vessel that gives off medicine without major complications or conditions) | MS-DRG 247 | $61,324-$82,836 | 1-2 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC (Follow up care for muscle, bones or connective tissue issues with complications or conditions) | MS-DRG 560 | $23,136-$44,310 | 6-12 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC (Other type of Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 698 | $23,871-$46,465 | 3-6.25 days |
| REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC (Operation to take out implant of hip or knee and replace with a new one without complications or conditions or serious complications or conditions) | MS-DRG 468 | $37,540-$89,861 | 2-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $20,494-$59,245 | 3-8 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $13,266-$24,358 | 2-4 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $11,119-$24,936 | 2-4 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $27,981-$52,593 | 3-6 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC (Delivery of baby by vaginal birth that includes a procedure in the Operating Room but not having "tubes tied" (sterilization) - or a D&C (clears lining of uterus)) | MS-DRG 768 | $14,909-$27,891 | 2-3 days |
| CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and with tubes being tied. Without complications or conditions or serious complications) | MS-DRG 785 | $17,973-$22,209 | 2-3 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $22,691-$44,772 | 3-6 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Medical Group
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OTHER | Level 4 Office/outpatient visit established patient | CPT 99214 | $195 |
| OTHER | Level 3 Office/outpatient visit established patient | CPT 99213 | $134 |
| DRUGS RADIOLOGY | Contrast dye used for testing during exams such as a CT scan. | CPT Q9967 | $0 |
| OTHER | Level 3 Office/outpatient visit new patient | CPT 99203 | $178 |
| OTHER | Level 4 Office/outpatient visit new patient | CPT 99204 | $270 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $5 |
| ADMIN VACCINE | Immunization admin (Giving a vaccine) | CPT 90471 | $37 |
| OTHER | Subsequent hospital care (Follow up visit for patient in hospital with moderate complexity, at least 25 minutes) | CPT 99232 | $115 |
| OTHER | Level 5 Office/outpatient visit established patient | CPT 99215 | $263 |
| OTHER | Vaccine given to child less than 18 years of age. Face to face counsel by provider. Vaccine with only 1 part. | CPT 90460 | $37 |
| OTHER | Home or Outpatient monitoring of blood thinning medicine program for a new patient. | CPT 93793 | $22 |
| OTHER | Subsequent hospital care | CPT 99233 | $165 |
| LAB UROLOGY | Urinalysis auto w/o scope (Urine test by machine without microscope) | CPT 81003 | $4 |
| PHARMACY DRUGS REQ DETAIL | Flu vaccine supply of a preservative free, split virus influenza vaccine 0.5 mL dose that is given to the patient. | CPT 90686 | $23 |
| PROFESSIONAL FEES - EKG | Electrocardiogram (EKG) Heart tracing | CPT 93010 | $17 |
| ALLERGY TEST OTH DX SVCS | Percut allergy skin tests (Allergy testing with skin pricks) | CPT 95004 | $10 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $72 |
| CARDIOLOGY - ECHOCARDIOLOGY | Tte w/doppler complete (Transthoracic - through the chest wall - Echocardiogram - ultrasound- with color ultrasound doppler to view blood flow of heart) | CPT 93306 | $120-$363 |
| OTHER | Prev visit est age 40-64 (Preventive medicine visit for patient ages 40 to 64, known to doctor already) | CPT 99396 | $60-$200 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $18 |
| OTHER | Electrocardiogram complete | CPT 93000 | $31 |
| OTHER | Level 2 Office/outpatient visit established patient | CPT 99212 | $79 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $72 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $41 |
| OTHER | Personalized prevention plan of service (Yearly "well" visit to plan for needed care during the year for a patient already known to the provider. | CPT G0439 | $186 |
UCHealth Inverness Orthopedics and Spine Surgery Center
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your knee. | CPT 29881 | $1,885 |
| TREATMENT ROOM | Shot given with either pain medicines or a steroid into the disc of the lower back. | CPT 64483 | $559 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to repair the anterior cruciate ligament (strong fiber that connects the thigh to shinbone and runs down the front of the knee). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29888 | $4,119 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the synovium (tissue that lines a joint) in at least 2 areas such as the medial (inside) or lateral (outside) of the knee. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29876 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. | CPT 29826 | $932 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to take out a deep implant such as a pin, screw or wire. | CPT 20680 | $1,597 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to cut the tendon sheath of the finger or thumb, allowing the tendon to move easily through the sheath (holds the tendon close to the finger bone). | CPT 26055 | $933 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix a torn tendon in the shoulder. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29827 | $4,119 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to cut the carpal ligament (thick tissue at the wrist) to allow more space for the carpal nerve to move. | CPT 64721 | $1,184 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the meniscus (provides a cushion and stabilizes the knee joint). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29882 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to smooth away the head on the hip bone. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29914 | $158 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to trim or smooth away a large amount of tissue from the ankle joints. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29898 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the meniscus (provides a cushion and stabilizes the knee joint) and shave off damaged cartilage of the knee (chondroplasty). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29880 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix a tear in the labrum (cushions the hip joint and holds the hip bone in the socket). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29916 | $68 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery on a joint that doesn’t have a specific code to describe the procedure. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29999 | $990 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to trim or smooth away a large amount of tissue in the shoulder joint. Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29823 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery that uses a tiny camera to look inside your knee. Small cuts are made to place the camera and small tools into your knee for the procedure to release the tight ligaments (bands of tissue) on the outside of the kneecap to let it slide to the correct place. | CPT 29873 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection or a shot given to either diagnose or treat a problem in the facet joint in the lumbar area (lower back) or sacral area (tailbone) joints of the spine. Uses imaging or X-ray to guide to the correct spot. | CPT 64493 | $559 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix a tear in the bicep tendon (muscle on the front of the upper arm) by sewing the end of the tendon to a bone. | CPT 23430 | $4,119 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection or a shot given to either diagnose or treat a second problem in the facet joint in the lumbar area (lower back) or sacral area (tailbone) joints of the spine. Uses imaging or X-ray to guide to the correct spot. | CPT 64494 | $276 |
| TREATMENT ROOM | Cyst or tumor taken out of lower leg (tibia or fibula). Bone graft may or may not be needed. | CPT 27635 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to shave off damaged cartilage of the knee (chondroplasty). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29877 | $1,885 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix a tear in a ligament ( a band of tissue that connects one bone to another) of the ankle | CPT 27695 | $4,119 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection or a shot given to either diagnose or treat a problem in the facet joint in the cervical (neck) or thoracic (chest) joints of the spine. Uses imaging or X-ray to guide to the correct spot. | CPT 64490 | $559 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix a tear in the joint capsule of the shoulder (strong tissue that supports and protects the joint). Done by placing a thin tube through the skin that has a camera on the end. Allows doctor to see inside joint without making a large cut (incision). | CPT 29806 | $4,119 |
UCHealth Physical Therapy and Rehabilitation at Castle Rock, Sterling Ranch, and Steadman Hawkins Clinic - Denver
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $72 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $72 |
| EVAL REEVAL PHYS THER | PT eval low complex 20 min (Physical Therapy assessment for 20 minutes of low complexity) | CPT 97161 | $141 |
| PHYSICAL THERP | Vasopneumatic device therapy (Use of a device to apply pressure to lower swelling in an area) | CPT 97016 | $72 |
| PHYSICAL THERP | Neuromuscular reeducation (Exercise to help re-educate the body part to perform a function or task that it was able to do in its pre-injury state) | CPT 97112 | $84 |
| OTHER RX SVCS | Also known as "dry needling", a thin solid wire is placed into 1 or 2 muscles to relieve pain. No medication or shot given during this treatment. | CPT 20560 | $42 |
| OTHER RX SVCS | Also known as "dry needling", a thin solid wire is placed into 3 or more muscles to relieve pain. No medication or shot given during this treatment. | CPT 20561 | $62 |
| EVAL REEVAL PHYS THER | Pt re-eval est plan care (Physical Therapy re-evaluation for established patient for new plan of care, lasting about 20 minutes) | CPT 97164 | $97 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $65 |
| EVAL REEVAL OCCUP THER | OT eval low complex 30 min (Occupational Therapy assessment for 30 minutes of low complexity patient) | CPT 97165 | $146 |
| OCCUPATION THER | Direct patient teaching for home care and life skills with adaptive tools for areas such as the kitchen, bath or car. Billed in 15 minute segments. | CPT 97535 | $57 |
| PHYSICAL THERP | Electric stimulation therapy (Electrical stimulation to muscle group used for wound healing) | CPT 97014 | $23 |
| OTHER | Hot or cold packs therapy (Use of hot or cold packs for pain relief or to increase blood flow as part of a treatment) | CPT 97010 | $10 |
| EVAL REEVAL PHYS THER | Pt eval mod complex 30 min (Physical Therapy evaluation of moderately complex patient, lasting 30 minutes) | CPT 97162 | $141 |
| PROSTHETIC DEV | HFO w/o joints cf (Hand, finger brace that does not move, custom made for a patient) | CPT L3913 | $383 |
| PHYSICAL THERP | Therapy for help with walking (may include stair training as well) | CPT 97116 | $54 |
| OTHER | Upper ext fx orthosis rad/ul (Brace used on radius or ulna (bones of the forearm) for a break to keep it from moving during healing.) | CPT L3982 | $538 |
| OCCUPATION THER | The fitting or training of a patient in the use of an upper or lower extremity (arm or leg) orthotic or prothesis such as a brace or articial limb. Billed in time use of 15 minute segments. | CPT 97763 | $81 |
| PHYSICAL THERP | Ultrasound therapy (Ultrasound use of deep heat as therapy in a certain place for pain or flexibility) | CPT 97035 | $41 |
| PHYSICAL THERP | Elec stim other than wound (Electrical stimulation to muscle group without constant attention by provider, not for wound healing) | CPT G0283 | $24 |
| OCCUPATION THER | Orthotic mgmt and training (Training and management for use of a brace) | CPT 97760 | $76 |
| PROSTHETIC DEV | WHFO - rigid w/o joints (Wrist, hand, finger brace that does not move, allows fingers to move) | CPT L3808 | $513 |
| PROSTHETIC DEV | FO w/o joints cf (Finger brace that does not move, custom made for a patient, maybe ring style or splint style) | CPT L3933 | $302 |
| PROSTHETIC DEV | WHO w/o joints cf (Wrist or hand brace that does not bend, custom made for a specific patient) | CPT L3906 | $575 |
| EVAL REEVAL OCCUP THER | Occupational Therapy evaluation that is moderately complex, reviews medical history and finds 3 to 5 areas that need to be addressed. Takes about 45 minutes to complete. | CPT 97166 | $146 |
UCHealth Radiology Freestanding Clinics
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $223 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $89 |
| MAGNETIC RESONANCE TECHNOLOGY MRT - MRI - OTHER | MRI uses a large magnet and radiowaves to look at a joint of a lower extremity such as on the legs without using dye. | CPT 73721 | $536 |
| DX XRAY | A special type of x-ray of your bones. Uses a very low amount of radiation to find how strong or weak your bones are. At least 1 view of the bones that form the trunk of the body such as the hips or spine. | CPT 77080 | $64 |
| DX XRAY | X-ray exam of foot | CPT 73630 | $56 |
| ULTRASOUND | Ultrasound test (uses sound waves to get pictures) of 1 breast, including under the arm pit. | CPT 76642 | $145 |
| DX XRAY | X-ray exam of knee | CPT 73562 | $67 |
| DX XRAY | X-ray of one hip with the pelvis (area between the hip bones), 2 to 3 views taken. | CPT 73502 | $77 |
| MRI | MRI uses a large magnet and radiowaves to look at a joint of an upper extremity such as on the arms without using dye. | CPT 73221 | $536 |
| DX XRAY | X-ray exam of shoulder | CPT 73030 | $56 |
| DX XRAY | X-ray exam of ankle | CPT 73610 | $60 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $550 |
| MAMMOGRAPHY | Special low dose xray on one breast to look for cancer. Uses the computer to look for dense or thick areas of tissue that might be cancer. | CPT 77065 | $218 |
| DX XRAY | X-ray exam of hand | CPT 73130 | $60 |
| DX XRAY | X-ray of the knee with 4 or more views taken. | CPT 73564 | $76 |
| LAB CHEMISTRY | Assay of creatinine (Measure of waste products in the blood to monitor kidney function) | CPT 82565 | $8 |
| MRI SPINAL CORD | MRI uses a large magnet and radiowaves to look at bones of the spine at the lumbar area (lower back) without using dye. | CPT 72148 | $536 |
| ULTRASOUND | A limited view ultrasound of the arteries and veins in the belly (abdomina), pelvis (area between the hip bones), or genitals or rectum (genitorectal) areas to look at vascular blood flow to the area. | CPT 93976 | $268 |
| ULTRASOUND | A test that uses sound waves to create a picture (also known as a sonogram) of the area near the kidneys behind the other organs in the belly area. No radiation is used. It can also show parts of the body in motion, such as a heart beating or blood flowing through blood vessels. | CPT 76700 | $201 |
| DX XRAY | X-ray exam of wrist | CPT 73110 | $67 |
| MAMMOGRAPHY | Special low dose xray on both breasts to look for cancer. Uses the computer to look for dense or thick areas of tissue that might be cancer. | CPT 77066 | $275 |
| ULTRASOUND | Ultrasound or sound wave test of the pelvic area (area between the hip bones) with limited views or as a follow up to look at a specific area. | CPT 76857 | $140 |
| DX XRAY | X-ray exam of finger(s) | CPT 73140 | $62 |
| ULTRASOUND | Ultrasound or sound wave test done through the vagina (womb) done but not related to pregnancy. | CPT 76830 | $206 |
| OTHER | Electrocardiogram complete | CPT 93000 | $28 |
UCHealth University of Colorado Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $191 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $48-$53 |
| LAB IMMUNOLOGY | COVID-19 testing using DNA or RNA with equipment that is able to process up to 200 tests a day. | CPT U0003 | $34 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $19-$63 |
| TELEMEDICINE - GENERAL CLASSIFICATION | The charge for when a hospital provides services on a computer or mobile device (telehealth) to a registered outpatient of the hospital | CPT Q3014 | $30 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $167-$175 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $139-$140 |
| OTHER | Level 3 Office/outpatient visit established patient | CPT 99213 | $80 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $164-$165 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $97 |
| LABORATORY | COVID-19 testing using DNA or RNA with equipment that is able to process up to 200 tests a day, completed within 2 calendar days of collecting specimen. | CPT U0005 | $10 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $94-$104 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $88-$104 |
| OTHER | Level 4 Office/outpatient visit established patient | CPT 99214 | $100 |
| OTHER | Level 2 Office/outpatient visit established patient | CPT 99212 | $58 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $253-$267 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $72 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $11-$42 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $17-$37 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $43-$88 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $18-$122 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $18-$77 |
| LAB CHEMISTRY | Assay of phosphorus (Blood test to measure phosphorus, found most in bones and teeth) | CPT 84100 | $12-$22 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $18-$51 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $34 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth University of Colorado Hospital
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $219 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $403 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $800 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,942 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,623 |
UCHealth University of Colorado Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $17,838-$38,242 | 3-7 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $24,222-$62,695 | 3-9 days |
| Normal Newborn | MS-DRG 795 | $2,657-$5,544 | 1-2 days |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $12,748-$17,910 | 2-3 days |
| HEART FAILURE SHOCK W MCC (The heart is unable to pump enough blood to the body, this causes shock to happen with serious complications and conditions) | MS-DRG 291 | $19,387-$40,997 | 3-7 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $15,789-$30,620 | 2-5 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $14,910-$22,372 | 2-4 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $17,226-$26,558 | 3-5 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $12,956-$25,387 | 2-4 days |
| CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC (Open brain surgery or brain procedure on the vessels performed through the skin with serious complications or conditions) | MS-DRG 25 | $67,796-$139,794 | 4-12 days |
| CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC (Open brain surgery or brain procedure on the vessels performed through the skin without complications or conditions or serious complications or conditions) | MS-DRG 27 | $47,411-$78,516 | 1-3 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY (Alcohol, drug abuse or dependence with rehab treatment) | MS-DRG 895 | $27,024-$49,518 | 9-20 days |
| SEIZURES W/O MCC (Seizures without major complications or conditions) | MS-DRG 101 | $15,338-$30,079 | 2-4 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $31,073-$67,683 | 3-8 days |
| VAGINAL BIRTH WITH MAJOR COMPLICATIONS OR CONDITIONS, WITHOUT GETTING "TUBES TIED" OR HAVING A D&C (DILATION AND CURETTAGE - WHERE THE UTERUS HAS TISSUE CLEANED OUT). | MS-DRG 805 | $13,503-$19,154 | 2-3 days |
| CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC (Chemo without having acute leukemia as a diagnosis with complications or conditions) | MS-DRG 847 | $14,672-$25,569 | 4-5 days |
| ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE MOUTH NECK W MAJ O.R. ( Use of artifial heart lung machine or tracheostomy with breathing machine for more than 96 hours with procedure in operating room) | MS-DRG 3 | $363,537-$770,852 | 22.75-49.25 days |
| Kidney Transplant | MS-DRG 652 | $137,484-$164,472 | 3-4 days |
| PULMONARY EDEMA RESPIRATORY FAILURE (a build up of fluid in the lungs and not enough oxygen getting to the blood from the lungs) | MS-DRG 189 | $17,590-$42,462 | 2-6 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellaneous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $19,709-$45,081 | 3-7 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC (Infectious disease from a parasite with Operating Room procedure with serious complications or conditions) | MS-DRG 853 | $62,195-$169,060 | 7-21 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $6,145-$26,666 | 2-6 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $6,662-$22,616 | 2-5 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC (Other type of Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 698 | $19,937-$55,807 | 3-9 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC (Stroke caused by either bleeding or a blood clot with serious complications or conditions) | MS-DRG 64 | $32,790-$104,939 | 3-11 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellaneous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $12,803-$27,432 | 2-5 days |
| EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE ( Baby born very early or with lungs not mature enough for breathing well) | MS-DRG 790 | $70,026-$279,724 | 13.75-47.5 days |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS (Stroke caused by either bleeding or a blood clot with complications or conditions or needing a "clot buster" in 24 hours of admission) | MS-DRG 65 | $22,916-$40,478 | 2-5 days |
| CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC (Heart valve procedure or other heart procedure without having a heart catherization with serious complications or conditions) | MS-DRG 219 | $133,949-$256,890 | 7-13 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $12,788-$26,811 | 2-5 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $14,309-$27,516 | 2-4 days |
| SPINAL FUSION EXCEPT CERVICAL W/O MCC (Surgery to join the bones of the back, not the neck, without serious complications or conditions) | MS-DRG 460 | $68,306-$114,209 | 2-5 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $14,431-$46,600 | 2-8 days |
| POISONING TOXIC EFFECTS OF DRUGS W MCC (Effects from drugs that are poison-like or causing harm with major complications or conditions) | MS-DRG 917 | $18,213-$44,027 | 2-5 days |
| MAJOR CHEST PROCEDURES W/CC (Major surgery or procedures in the chest with complications or other conditions) | MS-DRG 164 | $36,379-$59,292 | 3-6 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $28,366-$108,309 | 6.75-22 days |
| DELIVERY OF BABY BY C-SECTION (CUTTING INTO THE BELLY OF THE MOTHER) WITH MAJOR COMPLICATIONS OR CONDITIONS WITHOUT HAVING "TUBES TIED". | MS-DRG 786 | $18,863-$29,966 | 3-5 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W CC (Disease or disorder of the kidney or urinary tract system, not listed in other codes, with complications or conditions.) | MS-DRG 699 | $13,154-$30,297 | 2-5 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $14,965-$31,640 | 2-6 days |
| Procedure on kidney or ureter (tube that carries urine from kidney to bladder), not for cancer, without complications or conditions or without major complications or condition | MS-DRG 661 | $25,452-$34,043 | 1-2 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $13,018-$22,085 | 2-4 days |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC (Procedures performed on the brain and in the brain with complications and conditions.) | MS-DRG 26 | $54,842-$95,880 | 2-5 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $10,954-$26,762 | 2-5 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC (A disease that makes one crave alcohol or drugs and have to drink more to get the same feelings. Causes problems at work or in the family or school. No Rehab services used with serious complications or conditions). | MS-DRG 896 | $17,548-$44,087 | 3-8 days |
| CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC (Disease of the circulatory system (cardiovascular system or heart) except for an acute myocardial infarction (heart attack). Does include having a cardiac catherization (long thin tube placed into blood vessel with dye given. Looks at blood vessels of the heart and how the heart pumps) with major complications and conditions.) | MS-DRG 286 | $46,333-$84,520 | 5-12 days |
| FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC (Third degree burn with skin grafts or injury to lungs (inhalation) with complications and conditions or major complications and conditions.) | MS-DRG 928 | $54,692-$126,085 | 12-22.25 days |
| COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC (Surgery to join 2 or more bones in the spine so there is no movement. Can be done through the front of the neck or belly or through the back of the spinal canal with complications and conditions). | MS-DRG 454 | $103,395-$192,720 | 3-7 days |
| CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC (Inflammation of the liver caused by drinking alcohol (alcoholic hepatitis) and late stage of scarring (fibrosis) of the liver (cirrhosis) with major complications or conditions.) | MS-DRG 432 | $22,375-$59,725 | 4-10 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC (Major procedure on small and large intestines without complications or conditions or serious complications or conditions) | MS-DRG 331 | $21,517-$44,670 | 2-5 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth Yampa Valley Medical Center
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $68-$77 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $68-$77 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $50 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $33 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $29 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $231 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $78 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $32-$63 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $71-$76 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $124 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $117-$124 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $23 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $293 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $41 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $40 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $176 |
| PHYSICAL THERP | Neuromuscular reeducation (Exercise to help re-educate the body part to perform a function or task that it was able to do in its pre-injury state) | CPT 97112 | $68-$76 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $32-$45 |
| EVAL REEVAL PHYS THER | PT eval low complex 20 min (Physical Therapy assessment for 20 minutes of low complexity) | CPT 97161 | $132 |
| LAB CHEMISTRY | Vitamin d 25 hydroxy (Vitamin D level blood test) | CPT 82306 | $139 |
| LAB CHEMISTRY | Blood test to check for prostate cancer in men | CPT 84153 | $87-$113 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $237-$247 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $19-$22 |
| LABORATORY | Assay of free thyroxine (Blood test to measure thyroid hormone levels) | CPT 84439 | $39-$56 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $38 |
When a patient visits an emergency department, facilities charge an emergency department fee to pay for the patient’s care. This fee provides for the nurses, staff, pharmacists, security, equipment, and other things the patient needs in the ER as well as the cost of keeping these services available 24 hours a day. The fee does not provide for the doctor or additional tests and treatments. These are billed separately.
UCHealth follows American College of Emergency Physicians guidelines for emergency department coding. Patients who need a higher level of care will be charged a higher facility fee. A level 1 or 2 emergency department fee might be charged for a very minor or simple condition like a minor viral infection or minor skin rash that requires little to no time in an ER, no tests or treatments and no prescription. Often, these conditions can be best cared for in an urgent care or primary care location. A level 4 or level 5 emergency department fee may be charged for a medical condition that requires multiple tests and screenings to diagnose and/or complex care to address.
Codes and prices represent the care, tests and treatments needed by the patient, not the resulting diagnosis. For example, a patient who has a serious headache might need advanced care and screenings to rule out a stroke or other potentially serious or life threatening conditions and thus be assessed at a level 4 or level 5, even if the resulting diagnosis is minor. A patient who presents with chest pain might need tests and screenings to rule out a heart attack and receive a level 4 or level 5 bill even if he or she is determined to not be experiencing a heart attack. The federal Emergency Medical Treatment and Labor Act (EMTALA) requires that we provide a medical screening examination to rule out an emergency medical condition, and provide stabilizing treatment if one does exist, to all patients who come to the emergency department, regardless of their ability to pay or their insurance status.
UCHealth Yampa Valley Medical Center
Emergency Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| ER | Level 1 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems usually self-limiting or minor) | CPT 99281 | $202 |
| ER | Level 2 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are low to moderate severity) | CPT 99282 | $383 |
| ER | Level 3 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are moderate severity) | CPT 99283 | $889 |
| ER | Level 4 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity but do not pose a threat to life or function) | CPT 99284 | $1,862 |
| ER | Level 5 Emergency Dept Visit (Evaluation and care of patient with coordination by other care providers, consistent with needs of patient. Problems are urgent and of high severity and pose an immediate threat to life or function) | CPT 99285 | $2,649 |
UCHealth Yampa Valley Medical Center
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITHOUT CC/MCC (Birth of a baby by vaginal delivery and without tubes being tied or uterus being cleaned out. Without complications or conditions or serious complications) | MS-DRG 807 | $9,443-$14,306 | 2-3 days |
| Normal Newborn | MS-DRG 795 | $1,736-$2,522 | 1-2 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,186-$3,135 | 2 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC (Birth of a baby by c-section and without tubes being tied. Without complications or conditions or serious complications) | MS-DRG 788 | $20,004-$31,389 | 2-4 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacement or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $42,195-$57,208 | 1-2 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacement or reattaching of arm or part of arm) | MS-DRG 483 | $44,555-$65,532 | 1 day |
| VAGINAL DELIVERY WITHOUT STERILIZATION/D&C WITH CC (Birth of a baby by vaginal delivery without tubes being tied or uterus being cleaned out. With complications or conditions) | MS-DRG 806 | $9,777-$16,420 | 2-3 days |
| SPINAL FUSION EXCEPT CERVICAL W/O MCC (Surgery to join the bones of the back, not the neck, without serious complications or conditions) | MS-DRG 460 | $59,411-$65,342 | 1-2 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC (Infection or inflammation in the lungs (such as pneumonia) with serious complications or conditions.) | MS-DRG 177 | $20,658-$37,612 | 2-4 days |
| HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC (Procedure on hip or thigh but not a major joint with complications or conditions) | MS-DRG 481 | $46,704-$66,623 | 3-5 days |
| CESAREAN SECTION WITHOUT STERILIZATION WITH CC (Birth of a baby by c-section and without tubes being tied. With complications or conditions) | MS-DRG 787 | $22,544-$29,906 | 3-4 days |
| ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC (Inflammation of the swallowing tube or stomach or other problems with digestion without serious complications or conditions) | MS-DRG 392 | $23,254-$29,809 | 2-3 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $2,911-$8,987 | 2-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours with major complications and conditions) | MS-DRG 871 | $17,244-$35,059 | 1-3.25 days |
| MAJOR MALE PELVIC PROCEDURES W/O CC/MCC (Serious procedures of the lower gut area of a male without complications or conditions or without serious complications or conditions) | MS-DRG 708 | $42,792-$51,525 | 1 day |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC (Alcohol, drug abuse or dependence without rehab treatment and without serious complications or conditions) | MS-DRG 897 | $15,855-$28,948 | 1-3 days |
| SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC (severe infection in the blood without being put on a breathing machine, lasting more than 96 hours without major complications and conditions) | MS-DRG 872 | $16,825-$31,731 | 1.5-3 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
While the self-pay pricing information posted on this site is a good faith estimate of prices, UCHealth cannot guarantee the accuracy of these prices. Prices are based on modeling of a range of patient visits and do not account for any unforeseen complications, additional tests or procedures, medical provider bills, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill or bills for services rendered may differ substantially from the information provided by this website, and UCHealth shall not be liable for any pricing disparities. All pricing is facility-specific and not transferrable to other facilities.