UCHealth strongly encourages you to contact a financial counselor at 970-495-7222 to discuss payment options prior to receiving a health care service from a UCHealth facility, since prices for health care services posted on this site may not reflect the actual amount of your financial responsibility.
The pricing information on this site reflects the typical price for uninsured or self-pay patients for hospital services. All prices posted on this site already reflect the hospital’s uninsured discount. The prices do not reflect additional financial assistance discounts which patients may be eligible for.
In most cases, physicians providing you with services related to your hospital stay or visit will bill you separately.
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 | $58 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $88-$94 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $104 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $241-$255 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $9 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $104 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $126 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $148 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $85 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $235-$287 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $84-$112 |
| LAB CHEMISTRY | Urine pregnancy test | CPT 81025 | $83 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $118 |
| 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 | $93 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $17-$61 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $252 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,968 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $193 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $55-$58 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $82 |
| LABORATORY | Fibrin degradation quant (Blood test to check for blood clotting problems) | CPT 85379 | $66 |
| LAB CHEMISTRY | Assay of lactic acid (Blood test to measure lactic acid levels, produced when oxygen levels in the blood drop) | CPT 83605 | $109-$116 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $31-$69 |
| LAB CHEMISTRY | Assay of phosphorus (Blood test to measure phosphorus, found most in bones and teeth) | CPT 84100 | $49 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $79 |
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 | $252 |
| 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 | $476 |
| 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 | $930 |
| 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 | $2,146 |
| 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 | $3,169 |
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 replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $35,480-$47,896 | 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 | $16,285-$40,571 | 7-17 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC (Nervous system disorder with gradual loss of function without serious complications or conditions) | MS-DRG 57 | $18,343-$33,412 | 7-11.25 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 | $18,373-$32,236 | 7-12 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $40,521-$48,731 | 1 day |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC | MS-DRG 56 | $25,340-$38,100 | 8.75-14 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC | MS-DRG 559 | $17,224-$42,699 | 5.5-13.75 days |
| AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC | MS-DRG 561 | $17,634-$22,289 | 6.25-9 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 | $12,765-$18,602 | 1.5-4 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 | $11,282-$43,738 | 2-8.25 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 | $11,755-$25,328 | 5-10 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 | $14,086-$29,238 | 2-8.5 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth 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 | $52 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $80-$84 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $94 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $94 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $217-$230 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $134 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $76 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $113 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $8 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $211-$259 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $76-$101 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $106 |
| 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 | $83 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,471 |
| LAB CHEMISTRY | Urine pregnancy test | CPT 81025 | $75 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $71 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $227 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $49-$52 |
| CT SCAN HEAD | CAT scan of the head or brain without using dye | CPT 70450 | $1,557 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $173 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $227 |
| LAB CHEMISTRY | Chorionic gonadotropin test (Blood pregnancy test) | CPT 84703 | $91-$97 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $28-$62 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $90-$123 |
| LAB CHEMISTRY | Assay of lactic acid (Blood test to measure lactic acid levels, produced when oxygen levels in the blood drop) | CPT 83605 | $98-$104 |
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 | $227 |
| 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 | $428 |
| 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 | $837 |
| 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 | $1,931 |
| 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 | $2,852 |
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 replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $32,016-$37,207 | 1-2 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 | $49,438-$53,867 | 2-3 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $33,169-$41,770 | 1-2 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 | $6,442-$18,614 | 2-3 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 | $28,345-$55,669 | 1-2.25 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $7,727-$13,031 | 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 | $9,693-$21,774 | 1-3.75 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 | $7,723-$19,396 | 1.75-4.25 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 | $11,025-$14,701 | 2-3 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $8,045-$14,879 | 1-3 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 | $8,568-$13,815 | 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 | $8,395-$15,559 | 2-3 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 | $78 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $31 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $48 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $149 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $54 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $109 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $44 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $98 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $40 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $90 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $159 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $76-$135 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $57-$78 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $36 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $302 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $23-$61 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $12-$30 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $357 |
| 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 | $47 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $76 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $49 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $35-$45 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $92 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $3,706 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $322 |
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 | $253 |
| 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 | $438 |
| 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 | $749 |
| 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 | $1,080 |
| 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 | $2,149 |
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 | $12,218-$17,926 | 1-3 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 | $18,618-$45,045 | 3-6 days |
| Normal Newborn | MS-DRG 795 | $1,911-$2,969 | 1-2 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 | $15,916-$30,302 | 2-4 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $1,835-$4,114 | 1-2 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 | $13,861-$29,852 | 2-5 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 | $17,176-$35,375 | 3-6 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 | $13,805-$19,563 | 2-3 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | MS-DRG 177 | $13,175-$28,996 | 3-7 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 | $15,139-$36,136 | 2-4.5 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 | $14,708-$23,665 | 2-3 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 | $15,133-$29,832 | 2-4.5 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 | $16,170-$27,533 | 2-3.75 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $10,542-$22,898 | 2-4 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $12,614-$29,954 | 2-5.75 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $4,139-$9,325 | 2-3 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $17,406-$26,179 | 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 | $49,113-$70,678 | 1.25-2 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 | $14,806-$26,152 | 1-4 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $15,994-$42,414 | 2-5 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $15,467-$26,071 | 2-3 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 | $19,516-$27,732 | 3-4 days |
| ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC (Patient with heart attack discharged alive with serious complications) | MS-DRG 280 | $23,581-$58,192 | 2-7 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $12,027-$20,826 | 2-3.75 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $25,691-$46,881 | 3-5 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC (Removal of the gallbladder without checking the common duct and without complications or conditions or serious complications or conditions) | MS-DRG 419 | $27,173-$40,748 | 1-2 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 | $15,331-$29,529 | 2.25-5.5 days |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $25,212-$91,875 | 2-7 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 | $63,481-$164,158 | 5.25-12.75 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 | $48,279-$57,076 | 3-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $58,351-$98,376 | 5-9 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $5,862-$27,990 | 3-16 days |
| BRONCHITIS ASTHMA W CC/MCC (inflammation of airways for breathing with complications or conditions or serious complications or conditions) | MS-DRG 202 | $13,085-$20,380 | 1.5-3.5 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 | $11,500-$25,543 | 1-4 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $16,379-$37,342 | 2-5.5 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 | $27,534-$50,699 | 2-3.75 days |
| POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE | MS-DRG 776 | $10,561-$16,278 | 2-2.75 days |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC (Heart Attack, patient left hospital alive with complications or other conditions) | MS-DRG 281 | $17,815-$32,827 | 1.25-3.75 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $15,633-$23,854 | 3-4.75 days |
| PULMONARY EMBOLISM W/O MCC (blood clot in the lungs without serious complications) | MS-DRG 176 | $13,069-$21,889 | 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 | $14,221-$23,958 | 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 | $19,509-$36,256 | 2-4 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $4,042-$5,706 | 2-3 days |
| G.I. OBSTRUCTION W CC (Blockage in the bowel with complications and conditions) | MS-DRG 389 | $14,896-$22,494 | 2-4 days |
| NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC | MS-DRG 70 | $17,384-$38,360 | 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 | $12,353-$16,445 | 2-3 days |
| KIDNEY URINARY TRACT INFECTIONS W MCC (Kidney infection and infection of the urinary tract with major complications or conditions) | MS-DRG 689 | $18,438-$38,505 | 3-6.25 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $11,250-$14,897 | 2-3 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC (Heart rhythm problems with complications or conditions) | MS-DRG 309 | $11,027-$23,234 | 2 days |
| OTHER DIGESTIVE SYSTEM DIAGNOSES W CC | MS-DRG 394 | $16,870-$32,961 | 3-4.25 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 | $52 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $94 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $80-$84 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $217-$230 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $280 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $94 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $8 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $134 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $211-$259 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $113 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $76-$101 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $49-$52 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $76 |
| 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 | $83 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $106 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $227 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $37-$67 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $15-$55 |
| LAB CHEMISTRY | Vitamin B-12 shot | CPT 82607 | $119 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $74 |
| LAB CHEMISTRY | Assay of ferritin (Blood test to measure amount of iron) | CPT 82728 | $119 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $28-$62 |
| 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 | $243 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,471 |
| LAB CHEMISTRY | Fe test (Blood test to check Iron level in blood) | CPT 83540 | $67 |
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 | $227 |
| 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 | $428 |
| 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 | $837 |
| 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 | $1,931 |
| 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 | $2,852 |
UCHealth Longs Peak 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 | $5,739-$8,666 | 2 days |
| Normal Newborn | MS-DRG 795 | $1,739-$2,666 | 1-2 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,185-$3,829 | 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 | $17,082-$44,798 | 3-6 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 | $13,045-$17,045 | 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 | $6,182-$10,565 | 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 | $13,115-$22,596 | 2-5 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 | $11,887-$19,934 | 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 | $12,778-$24,406 | 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 | $48,820-$62,160 | 2-2.5 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 | $12,722-$24,037 | 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 | $12,910-$19,142 | 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 | $13,838-$18,266 | 2-4 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $14,084-$25,572 | 1.75-3 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $12,950-$21,386 | 2-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $11,012-$16,917 | 2-3 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $30,111-$40,458 | 1-4 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 | $12,053-$26,721 | 2-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $32,069-$47,856 | 3-6 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $9,993-$15,398 | 2-4 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $10,320-$17,672 | 2-3 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 | $25,896-$32,203 | 2-3 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $3,050-$28,164 | 2-10 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $11,848-$17,643 | 2-3 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $9,693-$23,213 | 1.75-4 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 | $11,825-$19,145 | 2-4 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 | $60,404-$90,050 | 2-4 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | MS-DRG 177 | $13,285-$35,720 | 3-7 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 | $15,957-$18,395 | 2-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellanous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $12,481-$28,405 | 2.75-6 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 | $40,009-$73,519 | 5-12 days |
| G.I. OBSTRUCTION W/O CC/MCC (Blockage in the bowel without complications and conditions or serious complications or conditions) | MS-DRG 390 | $12,451-$16,757 | 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 | $12,827-$29,886 | 2-4 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 | $24,224-$48,926 | 3-5.5 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 | $19,335-$26,009 | 1-3 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 | $17,864-$23,690 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $2,426-$14,835 | 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 | $12,020-$20,178 | 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 | $13,758-$29,239 | 3-7 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $43,452-$135,165 | 5-18 days |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $22,610-$61,769 | 2.75-6 days |
| CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC | MS-DRG 286 | $26,191-$43,233 | 2-5.75 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 | $61,321-$92,888 | 2-4 days |
| DIABETES W/O CC/MCC (Diabetes or high blood sugars without other complications) | MS-DRG 639 | $10,574-$12,479 | 1-2 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $15,235-$31,204 | 2-4.25 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 | $8,523-$13,327 | 2-3 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC (Heart rhythm problems with complications or conditions) | MS-DRG 309 | $11,044-$16,469 | 1.5-3 days |
| G.I. OBSTRUCTION W CC (Blockage in the bowel with complications and conditions) | MS-DRG 389 | $15,289-$29,304 | 3-5.5 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 | $26,245-$39,677 | 3-4 days |
| ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC (Patient with heart attack discharged alive with serious complications) | MS-DRG 280 | $18,520-$32,899 | 1.5-3.5 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC (Removal of the gallbladder without checking the common duct and without complications or conditions or serious complications or conditions) | MS-DRG 419 | $25,613-$41,191 | 2-3.5 days |
| SIMPLE PNEUMONIA PLEURISY W CC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with complications or other conditions) | MS-DRG 194 | $11,572-$19,041 | 2-3 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 | $52 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $94 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $80-$84 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $217-$230 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $8 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $211-$259 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $94 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $76-$101 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $113 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $280 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $134 |
| LAB CHEMISTRY | Metabolic panel ionized ca (Panel of blood tests with at least 8 measures including ionized calcium) | CPT 80047 | $51 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $74 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $49-$52 |
| 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 | $83 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $76 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $4,471 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $227 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $173 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $15-$55 |
| 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 | $243 |
| 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 | $427 |
| LAB CHEMISTRY | Urine pregnancy test | CPT 81025 | $75 |
| 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 | $243 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $106 |
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 | $227 |
| 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 | $428 |
| 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 | $837 |
| 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 | $1,931 |
| 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 | $2,852 |
UCHealth Highlands Ranch Hospital
Inpatient Services
| Description of Services | Billing Code | Self-Pay Price* | Length of Stay* |
|---|---|---|---|
| Normal Newborn | MS-DRG 795 | $2,164-$2,884 | 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 | $6,416-$8,610 | 2-3 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $32,117-$35,630 | 1 day |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,180-$3,362 | 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 | $17,517-$41,773 | 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 | $13,571-$17,629 | 3-4 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 | $6,884-$10,004 | 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 | $12,837-$18,558 | 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 | $11,124-$21,331 | 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 | $14,165-$17,273 | 3-4 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $35,519-$45,266 | 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 | $14,361-$25,141 | 2.75-5 days |
| MAJOR HEAD NECK PROCEDURES W CC/MCC OR MAJOR DEVICE | MS-DRG 129 | $35,154-$65,265 | 4-7 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $6,436-$21,801 | 2-4 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | MS-DRG 177 | $10,846-$27,492 | 2-7 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $10,289-$18,435 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $3,180-$5,426 | 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 | $10,320-$21,480 | 2-5 days |
| SIMPLE PNEUMONIA PLEURISY W CC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with complications or other conditions) | MS-DRG 194 | $9,300-$17,637 | 2-3 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $11,194-$21,891 | 1.75-3 days |
| PULMONARY EMBOLISM W/O MCC (blood clot in the lungs without serious complications) | MS-DRG 176 | $11,952-$22,509 | 1-3 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 | $13,093-$15,891 | 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 | $15,369-$21,301 | 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 | $34,537-$43,839 | 3-5 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC (Heart rhythm problems with complications or conditions) | MS-DRG 309 | $14,701-$26,591 | 1-4 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $3,225-$5,074 | 2-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC | MS-DRG 438 | $23,656-$52,215 | 4-9.25 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 | $39,108-$97,041 | 6-16.25 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 | $22,418-$31,562 | 1-2 days |
| ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC (A condition of the swallowing tube that causes it to become red, swollen or irritated. Other disorders related to digesting food with serious complications or conditions). | MS-DRG 391 | $15,564-$23,689 | 2-5 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 | $14,072-$39,699 | 1.5-4 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 | $8,115-$9,438 | 2-3 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $3,866-$11,572 | 3-9.5 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC | MS-DRG 768 | $7,395-$9,999 | 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 | $9,593-$16,589 | 1.25-3.75 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $12,063-$19,495 | 2-3.75 days |
| Complicated procedures on either the small or large intestine with major complications or conditions | MS-DRG 329 | $45,373-$96,191 | 8-15 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellanous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $10,952-$23,282 | 2-4 days |
| G.I. OBSTRUCTION W CC (Blockage in the bowel with complications and conditions) | MS-DRG 389 | $13,333-$15,676 | 2-4 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $34,804-$55,314 | 4-7 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $20,484-$47,642 | 4-7 days |
| INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC | MS-DRG 854 | $22,313-$35,743 | 2-5 days |
| OTHER DIGESTIVE SYSTEM DIAGNOSES W CC | MS-DRG 394 | $9,397-$18,779 | 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 | $46,406-$64,607 | 2-2.25 days |
| OTHER EAR NOSE MOUTH THROAT O.R. PROCEDURES W CC/MCC | MS-DRG 133 | $30,247-$58,214 | 2.75-6 days |
| POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE | MS-DRG 776 | $3,874-$8,766 | 1-2 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 | $16,468-$21,921 | 3-6.25 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 | $7,179-$14,289 | 2-3 days |
| 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 | $14,697-$47,916 | 3-5.25 days |
| LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC (Removal of the gallbladder without checking the common duct and without complications or conditions or serious complications or conditions) | MS-DRG 419 | $26,779-$46,348 | 2-3.5 days |
| MEDICAL BACK PROBLEMS W/O MCC (Back problems without serious complications or conditions) | MS-DRG 552 | $9,398-$17,706 | 1.5-4.5 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $17,138-$22,762 | 2.5-4 days |
| TRACHEOSTOMY FOR FACE MOUTH NECK DIAGNOSES OR LARYNGECTOMY W CC | MS-DRG 12 | $60,145-$102,802 | 7.5-14.5 days |
| MAJOR HEAD NECK PROCEDURES W/O CC/MCC | MS-DRG 130 | $25,908-$35,095 | 2-3.5 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W/O CC/MCC | MS-DRG 310 | $8,892-$12,182 | 1 day |
* 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 |
|---|---|---|---|
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $811 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $946 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $946 |
| 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 | $2,520 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Colonoscopy submucous njx (Camera with light passed through the rectum to take pictures of the intestines with injection given into tissue) | CPT 45381 | $946 |
| 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 | $352 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $3,607 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Shot given with either pain medicines or a steroid into the disc of the lower back. | CPT 64483 | $633 |
| 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 | $572 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $1,376 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Removal of sperm duct(s) (Removal of a section of the sperm duct or ducts) | CPT 55250 | $1,796 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $946 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $1,376 |
| 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 | $2,120 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | The use of high frequency sound (shock) waves to break up stones in your kidney | CPT 50590 | $2,422 |
| STERILE SUPPLY | 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 | $276 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the wall in the nose that is between the nostrils | CPT 30520 | $2,120 |
| 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 | $3,012 |
| 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 | $633 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | 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 | $693 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Injection (shot) given for pain into the sacroiliac joint (the joint between the sacrum (tailbone) and ilium (top of the hip bone). This area bears the weight of the trunk of the body. | CPT G0260 | $595 |
| 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 | $946 |
| 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 | $946 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Laparo cholecystectomy/graph (Removal of gallbladder through small incisions in the belly or abdomen area with pictures of bile ducts taken) | CPT 47563 | $3,802 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to take out the gallbladder using a small tube with a light at the end of the scope. Gallbladder is taken out through the tube. | CPT 47562 | $3,802 |
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 | $83 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $33 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $52 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $58 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $159 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $47 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $96 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $81-$144 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $38 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $116 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $169 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $104 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $43 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $75 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $24-$65 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $61-$84 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $13-$32 |
| DX XRAY CHEST | Chest X-Ray with 1 view from the front | CPT 71045 | $322 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $53 |
| 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 | $51 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $81 |
| LABORATORY | A blood test to diagnose heart failure. | CPT 83880 | $146-$239 |
| PATHOL CYTOLOGY | Flowcytometry/tc add-on (Test to evaluate characteristics of cells in the body, each marker characteristic) | CPT 88185 | $48-$100 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $381 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $37-$48 |
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 | $270 |
| 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 | $467 |
| 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 | $799 |
| 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 | $1,151 |
| 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 | $2,292 |
UCHealth Medical Center of the Rockies
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 | $11,030-$15,595 | 2 days |
| Normal Newborn | MS-DRG 795 | $1,917-$2,889 | 1-2 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $56,585-$65,060 | 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 | $26,007-$61,571 | 3-7 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,314-$3,840 | 1-2 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 | $61,896-$87,687 | 2 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 | $64,700-$101,449 | 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 | $15,032-$22,142 | 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 | $19,352-$38,732 | 2.75-5 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 | $17,334-$31,177 | 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 | $12,551-$17,526 | 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 | $16,111-$39,976 | 2-5 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 | $17,445-$30,558 | 2-5 days |
| PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC (Heart procedure performed with needle passed through the skin without serious complications or conditions) | MS-DRG 274 | $63,786-$71,394 | 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 | $110,120-$122,310 | 1 day |
| 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 | $72,498-$118,336 | 2-5 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $68,280-$104,155 | 4-7.5 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 | $17,076-$22,735 | 2-3.75 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 | $21,510-$38,427 | 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 | $74,958-$101,685 | 1-3 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $18,509-$30,211 | 2-3 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $46,477-$51,950 | 1-2 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 | $18,112-$29,626 | 2-4 days |
| MEDICAL BACK PROBLEMS W/O MCC (Back problems without serious complications or conditions) | MS-DRG 552 | $14,106-$29,807 | 2-5 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 | $40,676-$61,547 | 3-6 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 | $18,856-$37,241 | 2-4.5 days |
| ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC (Patient with heart attack discharged alive with serious complications) | MS-DRG 280 | $27,194-$54,379 | 3-6.5 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 | $78,587-$168,295 | 6-14 days |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC (Replacement of heart valve performed through the skin with serious complications or conditions) | MS-DRG 266 | $117,158-$171,004 | 1-6 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 | $16,873-$32,709 | 2-5 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 | $74,841-$126,274 | 3-10 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 | $228,549-$413,799 | 7-14.5 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 | $35,551-$72,067 | 3.25-8 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $15,586-$31,498 | 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 | $178,560-$244,611 | 5-8 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $14,480-$31,239 | 2-4 days |
| CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC (Heart rhythm problems with complications or conditions) | MS-DRG 309 | $12,963-$26,521 | 2-3 days |
| MAJOR CHEST PROCEDURES W/CC (Major surgery or procedures in the chest with complications or other conditions) | MS-DRG 164 | $64,191-$96,934 | 3-5 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $4,510-$12,667 | 2-3 days |
| Bleeding in the digestive tract (stomach, intestines, colon, rectum or anus) with major complications and conditions | MS-DRG 377 | $36,960-$62,713 | 3-6.75 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 | $21,770-$54,833 | 3-6 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | MS-DRG 177 | $16,934-$43,443 | 3-6 days |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC (Heart Attack, patient left hospital alive with complications or other conditions) | MS-DRG 281 | $16,025-$33,791 | 2-3 days |
| VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC | MS-DRG 768 | $13,586-$21,923 | 2-3 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 | $58,380-$86,205 | 2-3 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $19,106-$34,684 | 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 | $16,728-$42,834 | 2-5 days |
| LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC (Procedure or surgery on the lower leg or upper arm does not include the hip, foot or thigh bone with complications or conditions). | MS-DRG 493 | $41,001-$72,165 | 3-6 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 | $17,091-$20,611 | 2-3 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 | $160,019-$211,295 | 5-8 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 |
|---|---|---|---|
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $65 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $23-$30 |
| 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 | $99 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $204 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $48-$53 |
| LAB CHEMISTRY | Metabolic panel ionized ca (Panel of blood tests with at least 8 measures including ionized calcium) | CPT 80047 | $49 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $90 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $84 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $239-$254 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $106 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $60 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $104 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $55-$69 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $79 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $17 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $50 |
| LAB CHEMISTRY | Hepatic function panel (Liver Function blood test) | CPT 80076 | $41-$43 |
| OTHER | Level 2 Office/outpatient visit established patient | CPT 99212 | $180-$205 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $40 |
| SUPPLY IMPLANTS | Human tissue cells for grafting | CPT Q4116 | $32 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $81-$86 |
| LAB IMMUNOLOGY | Allergy testing | CPT 86003 | $18-$54 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $41-$55 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $19-$25 |
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 | $250 |
| 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 | $516 |
| 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 | $935 |
| 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 | $1,727 |
| 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 | $3,313 |
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 | $8,392-$13,732 | 2-3 days |
| Normal Newborn | MS-DRG 795 | $2,496-$3,852 | 1-2 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $3,078-$5,184 | 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 | $20,023-$46,192 | 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 | $17,338-$26,769 | 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 | $10,167-$16,633 | 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 | $16,252-$32,342 | 3-6 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 | $16,278-$31,572 | 2-5 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 | $14,601-$27,618 | 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 | $15,344-$30,461 | 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 | $12,137-$24,123 | 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 | $55,847-$70,268 | 1-2 days |
| BRONCHITIS ASTHMA W/O CC/MCC (inflammation of airways for breathing without complications or conditions or serious complications or conditions) | MS-DRG 203 | $6,558-$13,616 | 2-3 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $39,231-$52,702 | 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 | $61,305-$151,439 | 6-16 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $4,314-$12,688 | 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 | $10,889-$22,804 | 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 | $19,844-$31,352 | 2-4 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $18,548-$31,199 | 2-4 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $13,389-$27,920 | 2-4 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $4,079-$10,006 | 2-5 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $11,549-$21,347 | 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 | $22,886-$36,770 | 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 | $17,431-$24,761 | 2-3 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $40,882-$65,225 | 3-8 days |
| NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY (A baby 4 weeks old or less that died or is moved to another hospital for care) | MS-DRG 789 | $1,265-$11,338 | 1 day |
| 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 | $17,292-$32,496 | 2-5 days |
| BRONCHITIS ASTHMA W CC/MCC (inflammation of airways for breathing with complications or conditions or serious complications or conditions) | MS-DRG 202 | $12,019-$28,338 | 2-4.25 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $15,179-$26,336 | 2-5 days |
| PULMONARY EMBOLISM W MCC (blood clot in the lungs with serious complications) | MS-DRG 175 | $17,584-$31,757 | 2-5 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $42,924-$50,796 | 1-2 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $13,659-$23,099 | 2-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $12,003-$20,780 | 1.5-3 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 | $12,085-$21,169 | 2-3.5 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $6,476-$62,980 | 3-18 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 | $92,593-$180,328 | 2-3 days |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC (Nervous system disorder with gradual loss of function without serious complications or conditions) | MS-DRG 57 | $24,315-$55,507 | 6.25-17 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 | $37,702-$58,739 | 3-6 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $17,158-$35,372 | 3-6 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 | $27,719-$62,535 | 3-9 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 | $22,694-$44,389 | 3-5 days |
| SIMPLE PNEUMONIA PLEURISY W/O CC/MCC (Simple pneumonia - responds well to treatment- and inflammation of the space between the lungs and the chest wall, without complications or other conditions) | MS-DRG 195 | $6,654-$12,921 | 2-3 days |
| SEIZURES W/O MCC (Seizures without major complications or conditions) | MS-DRG 101 | $11,767-$25,106 | 1-3 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 | $16,018-$35,205 | 2-4 days |
| SIMPLE PNEUMONIA PLEURISY W CC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with complications or other conditions) | MS-DRG 194 | $11,653-$20,812 | 2-4 days |
| POISONING TOXIC EFFECTS OF DRUGS W/O MCC (Effects from drugs that are poison-like or causing harm without major complications or conditions) | MS-DRG 918 | $9,906-$17,655 | 1-3 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $13,780-$25,570 | 2-4.25 days |
| ILLNESS OF THE LUNGS THAT REQUIRES BEING PUT ON THE BREATHING MACHINE FOR LESS THAN OR EQUAL TO 96 HOURS. | MS-DRG 208 | $39,692-$78,266 | 3-9 days |
| PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC (Heart procedure performed with needle passed through the skin without serious complications or conditions) | MS-DRG 274 | $79,334-$81,312 | 1 day |
| MEDICAL BACK PROBLEMS W/O MCC (Back problems without serious complications or conditions) | MS-DRG 552 | $17,259-$32,393 | 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 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 | $87 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $47 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $66 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $142 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $108 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $316 |
| 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 | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $70 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $370 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $78 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $164 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $111 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $45 |
| LABORATORY | Assay of troponin quant (Blood test to measure troponin level to check for heart muscle damage as with a heart attack) | CPT 84484 | $127-$167 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $108 |
| DX XRAY CHEST | Xray of the chest with 2 views, from the front and the side. | CPT 71046 | $333 |
| LAB CHEMISTRY | Assay of lipase (Lipase level as blood test of pancreas) | CPT 83690 | $29 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $125 |
| CT SCAN BODY | CT abd and pelv w/contrast (CAT scan of belly and hip area using IV dye) | CPT 74177 | $2,974 |
| LAB BACT MICRO | Influenza assay w/optic (Rapid Flu test done with swab of nose to test for flu) | CPT 87804 | $100 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $29 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $17 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $276-$292 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $100 |
| 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 | $132 |
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 | $133 |
| 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 | $466 |
| 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 | $666 |
| 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 | $1,332 |
| 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 | $1,997 |
UCHealth Pikes Peak Regional 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 replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $45,595-$50,855 | 3 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 | $8,820-$14,334 | 2-3 days |
| SIMPLE PNEUMONIA PLEURISY W CC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with complications or other conditions) | MS-DRG 194 | $6,448-$13,387 | 1.5-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $4,294-$12,991 | 2-3.75 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 | $8,211-$17,061 | 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 | $4,266-$15,891 | 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 | $8,373-$17,128 | 3 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 | $7,151-$14,647 | 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 | $7,411-$11,998 | 2.5-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $9,711-$12,916 | 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.
UCHealth Poudre Valley Hospital
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| LABORATORY | Routine blood sample drawn | CPT 36415 | $33 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $83 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $58 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $52 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $96 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $81-$144 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $159 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $47 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $39-$79 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $96 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $38 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $116 |
| LABORATORY | Culture aerobic identify (Blood test to identify type of bacteria) | CPT 87077 | $58-$69 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $94 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $75 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $68 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $104 |
| LABORATORY | Assay iga/igd/igg/igm each (Test to measure the amount of proteins known as antibodies, made by the body in response to foreign proteins known as antigens.) | CPT 82784 | $35-$177 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $169 |
| LABORATORY | Test of urine to find which antibiotic works best to treat infection caused by bacteria. | CPT 87186 | $108 |
| LAB IMMUNOLOGY | C-reactive protein (Blood test to check for inflammation in the body) | CPT 86140 | $53 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $43 |
| LAB CHEMISTRY | Vitamin d 25 hydroxy (Vitamin D level blood test) | CPT 82306 | $183 |
| LABORATORY | Assay of free thyroxine (Blood test to measure thyroid hormone levels) | CPT 84439 | $100 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $13-$32 |
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 | $270 |
| 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 | $467 |
| 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 | $799 |
| 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 | $1,151 |
| 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 | $2,292 |
UCHealth Poudre Valley 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 replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $53,907-$64,384 | 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 | $8,956-$17,467 | 2-5 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 | $12,086-$17,256 | 2-3 days |
| PSYCHOSES (condition of having lost touch with reality) | MS-DRG 885 | $6,480-$14,616 | 3-6 days |
| Normal Newborn | MS-DRG 795 | $1,985-$2,965 | 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 | $22,836-$60,211 | 3-7 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,308-$4,011 | 2 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $44,573-$51,750 | 1 day |
| 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 | $16,264-$25,417 | 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 | $13,462-$21,453 | 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 | $15,876-$32,826 | 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 | $21,110-$40,178 | 3-7 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 | $90,980-$97,064 | 3 days |
| PREMATURITY W MAJOR PROBLEMS (Baby born too early with major problems) | MS-DRG 791 | $38,341-$107,965 | 12-30 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 | $15,586-$28,458 | 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 | $16,067-$36,088 | 2-5 days |
| DEPRESSIVE NEUROSES (Mental disorder with anxiety, fear or depression) | MS-DRG 881 | $4,766-$9,617 | 2-4 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $4,447-$31,167 | 2-8 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 | $15,094-$34,146 | 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 | $17,580-$29,833 | 3-4 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $18,450-$32,863 | 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 | $21,917-$52,015 | 3-4 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $14,558-$29,135 | 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 | $25,937-$53,121 | 7-15 days |
| EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE ( Baby born very early or with lungs not mature enough for breathing well) | MS-DRG 790 | $51,178-$127,230 | 11.5-34 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 | $16,008-$31,511 | 2-4 days |
| BRONCHITIS ASTHMA W/O CC/MCC (inflammation of airways for breathing without complications or conditions or serious complications or conditions) | MS-DRG 203 | $4,641-$12,644 | 1-3 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $14,463-$32,374 | 2-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $15,121-$31,552 | 2-4 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 | $69,651-$180,796 | 6-18 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $15,627-$32,168 | 1-3 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellanous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $16,356-$44,003 | 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 | $18,521-$35,847 | 2-4 days |
| POISONING TOXIC EFFECTS OF DRUGS W/O MCC (Effects from drugs that are poison-like or causing harm without major complications or conditions) | MS-DRG 918 | $10,686-$24,083 | 1-3 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 | $38,279-$78,669 | 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 | $13,620-$23,472 | 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 | $63,076-$83,374 | 1-2 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 | $21,520-$47,977 | 6-13 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 | $20,639-$50,245 | 2-5 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 | $35,968-$54,075 | 3-5 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 | $16,695-$21,916 | 2-3 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 | $19,020-$40,077 | 5-11 days |
| BRONCHITIS ASTHMA W CC/MCC (inflammation of airways for breathing with complications or conditions or serious complications or conditions) | MS-DRG 202 | $10,174-$21,991 | 1-4 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $14,094-$29,372 | 2-4.25 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 | $15,404-$27,034 | 2-3 days |
| NEUROSES EXCEPT DEPRESSIVE (Mental disorder with anxiety or fear but not depression) | MS-DRG 882 | $4,706-$11,981 | 2-5.5 days |
| OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC | MS-DRG 833 | $5,648-$12,417 | 1-2.75 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 | $21,282-$38,811 | 3-6 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 | $62,069-$92,640 | 2-3 days |
| DIABETES W/O CC/MCC (Diabetes or high blood sugars without other complications) | MS-DRG 639 | $15,004-$24,376 | 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 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 | $178 |
| OTHER | Level 3 Office/outpatient visit established patient | CPT 99213 | $122 |
| 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 |
| OTHER | Home or Outpatient monitoring of blood thinning medicine program for a new patient. | CPT 93793 | $22 |
| OTHER | Subsequent hospital care (Follow up visit for patient in hospital with moderate complexity, at least 25 minutes) | CPT 99232 | $115 |
| 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 |
| LAB UROLOGY | Urinalysis auto w/o scope (Urine test by machine without microscope) | CPT 81003 | $4 |
| OTHER | Electrocardiogram (EKG) Heart tracing | CPT 93010 | $17 |
| OTHER | Subsequent hospital care | CPT 99233 | $165 |
| 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 | Level 5 Office/outpatient visit established patient | CPT 99215 | $239 |
| LAB BACT MICRO | Influenza assay w/optic (Rapid Flu test done with swab of nose to test for flu) | CPT 87804 | $26 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $72 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $7 |
| 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 |
| ALLERGY TEST OTH DX SVCS | Percut allergy skin tests (Allergy testing with skin pricks) | CPT 95004 | $10 |
| LAB BACT MICRO | Strep a assay w/optic (Rapid strep test throat culture) | CPT 87880 | $26 |
| OTHER | Electrocardiogram complete | CPT 93000 | $30 |
| TREATMENT ROOM | Ther/proph/diag inj sc/im (Medicine or substance given into skin or into muscle as a shot) | CPT 96372 | $41 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $72 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $20 |
| 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 | $2,550 |
| 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 | $5,404 |
| 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 | $1,134 |
| 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 | $5,404 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to take out a deep implant such as a pin, screw or wire. | CPT 20680 | $2,241 |
| 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 | $2,550 |
| RECOVERY ROOM | Medical service provided during the hours of 10 pm to 8 am in a facility that is open 24 hours a day. | CPT 99053 | $351 |
| 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 | $2,550 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the meniscus (provides a cushion and stablizes 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 | $2,550 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to fix the meniscus (provides a cushion and stablizes 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 | $2,550 |
| 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 | $2,550 |
| 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 | $5,404 |
| 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 | $5,404 |
| 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 | $5,404 |
| 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 | $3,607 |
| 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 | $1,350 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery to trim or smooth away a small 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 29822 | $2,550 |
| 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 | $1,423 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Shot given with either pain medicines or a steroid into the disc of the lower back. | CPT 64483 | $633 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Repair of ligament (tough connective tissue that holds bones together) at the ankle or leg area. | CPT 27698 | $5,404 |
| 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 | $2,550 |
| 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 | $5,404 |
| AMBULATORY SURGICAL CARE - GENERAL CLASSIFICATION | Surgery (either by cutting open the skin or by placing stitches on the outside of the skin) to fix a tear in the Achilles tendon (connects calf muscles to the heel bone). | CPT 27650 | $4,716 |
| 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 | $2,550 |
| 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 | $5,404 |
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 |
| OTHER | Vasopneumatic device therapy (Use of a device to apply pressure to lower swelling in an area) | CPT 97016 | $72 |
| EVAL REEVAL PHYS THER | PT eval low complex 20 min (Physical Therapy assessment for 20 minutes of low complexity) | CPT 97161 | $135 |
| 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 | 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 re-eval est plan care (Physical Therapy re-evaluation for established patient for new plan of care, lasting about 20 minutes) | CPT 97164 | $92 |
| EVAL REEVAL OCCUP THER | OT eval low complex 30 min (Occupational Therapy assessment for 30 minutes of low complexity patient) | CPT 97165 | $146 |
| PHYSICAL THERP | Electric stimulation therapy (Electical stimulation to muscle group used for wound healing) | CPT 97014 | $23 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $65 |
| EVAL REEVAL PHYS THER | Pt eval mod complex 30 min (Physical Therapy evaluation of moderately complex patient, lasting 30 minutes) | CPT 97162 | $135 |
| PHYSICAL THERP | 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 | Ultrasound therapy (Ultrasound use of deep heat as therapy in a certain place for pain or flexibility) | CPT 97035 | $41 |
| OTHER | Elec stim other than wound (Electical stimulation to muscle group without constant attention by provider, not for wound healing) | CPT G0283 | $24 |
| 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 |
| OTHER | Upper ext fx orthosis wrist (Brace used on a wrist for a break to keep it from moving during healing.) | CPT L3984 | $556 |
| 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 |
| PROSTHETIC DEV | WHFO - rigid w/o joints (Wrist, hand, finger brace that does not move, allows fingers to move) | CPT L3808 | $513 |
| PROSTHETIC DEV | WHFO w/o joints pre cst (Wrist, hand, finger premade brace that does not bend, customized to fit the patient) | CPT L3807 | $354 |
| PHYSICAL THERP | Therapy for help with walking (may include stair training as well) | CPT 97116 | $54 |
| PROSTHETIC DEV | WHO w/o joints cf (Wrist or hand brace that does not bend, custom made for a specific patient) | CPT L3906 | $575 |
| PROSTHETIC DEV | HFO w/o joints cf (Hand, finger brace that does not move, custom made for a patient) | CPT L3913 | $383 |
| OTHER | Hfo without joints pre cst (Brace for the hand or fingers, premade but adjusted for the patient's needs.) | CPT L3923 | $122 |
| 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 |
| PHYSICAL THERP | Orthotic mgmt and training (Training and management for use of a brace) | CPT 97760 | $76 |
UCHealth Radiology Freestanding Clinic – Broomfield
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| DX XRAY | X-ray exam of foot | CPT 73630 | $17-$57 |
| DX XRAY | X-ray exam of finger(s) | CPT 73140 | $14-$60 |
| DX XRAY | X-ray exam of ankle | CPT 73610 | $16-$60 |
| DX XRAY | X-ray exam of wrist | CPT 73110 | $16-$68 |
| DX XRAY | X-ray exam of hand | CPT 73130 | $16-$60 |
| DX XRAY | X-ray of one hip with the pelvis (area between the hip bones), 2 to 3 views taken. | CPT 73502 | $23-$82 |
| DX XRAY | X-ray of the knee with 4 or more views taken. | CPT 73564 | $22-$77 |
| DX XRAY | X-ray exam of knee | CPT 73562 | $18-$68 |
| DX XRAY | X-ray of the wrist with 2 views, from the front to back and from the side view | CPT 73100 | $16-$63 |
| DX XRAY | X-rays of the lower part of the spine. This area includes the lumbar (lower back) region and the sacrum, the area that connects the spine to the pelvis with at least 4 views taken. | CPT 72110 | $32-$92 |
| DX XRAY | X-ray of the elbow with at least 3 views taken. | CPT 73080 | $16-$60 |
| DX XRAY | X-ray of the cervical spine (neck area) with at least 4 or 5 views. | CPT 72050 | $32-$90 |
| DX XRAY | X-ray exam of lower leg | CPT 73590 | $17-$55 |
| DX XRAY | X-rays of the lower part of the spine. This area includes the lumbar (lower back) region and the sacrum, the area that connects the spine to the pelvis with 2 or 3 views taken while bending over. | CPT 72120 | $22-$77 |
| DX XRAY | X-ray of the cervical spine (neck area) with 2 to 3 views taken. | CPT 72040 | $22-$66 |
| DX XRAY | X-rays of the lower part of the spine. This area includes the lumbar (lower back) region and the sacrum, the area that connects the spine to the pelvis with 2 or 3 views taken. | CPT 72100 | $22-$66 |
| DX XRAY | X-ray of the femur (thighbone) with at least 2 views | CPT 73552 | $19-$67 |
| DX XRAY | X-ray of the knee with 1 or 2 views taken. | CPT 73560 | $17-$60 |
| DX XRAY | X-ray of the pelvis (area between the hip bones) with 2 views taken. | CPT 72170 | $17-$59 |
UCHealth Radiology Freestanding Clinic – Inverness
Outpatient Services
| Billing Code Type | Description of Services | Billing Code | Self-Pay Price |
|---|---|---|---|
| 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 | $239-$814 |
| 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 | $233-$797 |
| 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 | $273-$808 |
| MAGNETIC RESONANCE TECHNOLOGY MRT - MRI - OTHER | MRI uses a large magnet and radiowaves to look at a lower extremity (not a joint) such as the legs without using dye. | CPT 73718 | $204-$794 |
| MRI SPINAL CORD | MRI uses a large magnet and radiowaves to look at bones of the spine at the neck area without using dye. | CPT 72141 | $267-$791 |
| MAGNETIC RESONANCE TECHNOLOGY MRT - MRI - OTHER | MRI uses a large magnet and radiowaves to look at an extremity (not a joint) such as the arms without using dye. | CPT 73218 | $179-$780 |
| MRI BRAIN | MRI uses a large magnet and radiowaves to look at the brain and brain stem (controls breathing and heart beat) without using dye. | CPT 70551 | $290-$884 |
| MAGNETIC RESONANCE TECHNOLOGY MRT - MRI - OTHER | MRI of the pelvis (area between the hip bones) without any contrast dye | CPT 72195 | $220-$813 |
UCHealth Radiology Freestanding Clinic – Highlands Ranch
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 | $77-$278 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $46-$112 |
| 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 | $38-$178 |
| ULTRASOUND | Ultrasound test (uses sound waves to get pictures) of 1 breast, including under the arm pit. | CPT 76642 | $69-$179 |
| 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 | $83-$273 |
| DX XRAY | X-ray exam of shoulder | CPT 73030 | $18-$56 |
| 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 | $102-$345 |
| DX XRAY | X-ray of one hip with the pelvis (area between the hip bones), 2 to 3 views taken. | CPT 73502 | $23-$82 |
| MAMMOGRAPHY | Special xray of 1 breast where thin slices or images are taken and then made into a 3D image to look for signs of cancer. | CPT 77061 | $62-$232 |
| DX XRAY | X-ray exam of knee | CPT 73562 | $18-$68 |
| MAMMOGRAPHY | Special xray of both breasts where thin slices or images are taken and then made into a 3D image to look for signs of cancer. | CPT 77062 | $53-$183 |
| DX XRAY | X-ray of the knee with 4 or more views taken. | CPT 73564 | $22-$77 |
| DX XRAY | A sample of breast tissue is taken to look for cancer with the placement of a clip or pellet to mark the site. Marker placed through the skin using an ultrasound to find the exact spot. | CPT 19083 | $1,361 |
| DX XRAY | X-ray exam of ankle | CPT 73610 | $16-$60 |
| DX XRAY | X-ray of the knee with 1 or 2 views taken. | CPT 73560 | $17-$60 |
| DX XRAY | X-ray exam of foot | CPT 73630 | $17-$57 |
| MAMMOGRAPHY | Diagnostic mammogram (no signs or symptoms of breast cancer) with view of either one or both sides of the breast. | CPT G0279 | $46-$99 |
| DX XRAY | X-ray to check leg length. Uses ruler on the x-ray to measure length of legs and find any differences in length. | CPT 77073 | $27-$80 |
| DX XRAY | A sample of breast tissue is taken to look for cancer with the placement of a clip or pellet to mark the site. Marker placed through the skin using a mammogram to find the exact spot. | CPT 19081 | $1,400 |
| DX XRAY | X-ray of breast tissue taken out during surgery to make sure the correct area was all removed. | CPT 76098 | $29-$77 |
| ULTRASOUND | Ultrasound test of a joint or joint space to examine a soft tissue mass. | CPT 76882 | $50-$117 |
| DX XRAY | X-rays of the lower part of the spine. This area includes the lumbar (lower back) region and the sacrum, the area that connects the spine to the pelvis with 2 or 3 views taken. | CPT 72100 | $22-$66 |
| DX XRAY | X-ray of the elbow with at least 3 views taken. | CPT 73080 | $16-$60 |
| DX XRAY | Placement of metal device such as a clip to mark the site of an area in the breast to be examined including the use of ultrasound. | CPT 19285 | $1,050 |
| DX XRAY | X-ray of both hips with the pelvis (area between the hip bones) with at least 3 to 4 views taken. | CPT 73522 | $28-$94 |
UCHealth Steadman Hawkins Clinic - Denver physical therapy services Outpatient Services
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 |
| OTHER | Vasopneumatic device therapy (Use of a device to apply pressure to lower swelling in an area) | CPT 97016 | $72 |
| EVAL REEVAL PHYS THER | PT eval low complex 20 min (Physical Therapy assessment for 20 minutes of low complexity) | CPT 97161 | $135 |
| 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 | 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 re-eval est plan care (Physical Therapy re-evaluation for established patient for new plan of care, lasting about 20 minutes) | CPT 97164 | $92 |
| EVAL REEVAL OCCUP THER | OT eval low complex 30 min (Occupational Therapy assessment for 30 minutes of low complexity patient) | CPT 97165 | $146 |
| PHYSICAL THERP | Electric stimulation therapy (Electical stimulation to muscle group used for wound healing) | CPT 97014 | $23 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $65 |
| EVAL REEVAL PHYS THER | Pt eval mod complex 30 min (Physical Therapy evaluation of moderately complex patient, lasting 30 minutes) | CPT 97162 | $135 |
| PHYSICAL THERP | 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 | Ultrasound therapy (Ultrasound use of deep heat as therapy in a certain place for pain or flexibility) | CPT 97035 | $41 |
| OTHER | Elec stim other than wound (Electical stimulation to muscle group without constant attention by provider, not for wound healing) | CPT G0283 | $24 |
| 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 |
| 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 |
| OTHER | Upper ext fx orthosis wrist (Brace used on a wrist for a break to keep it from moving during healing.) | CPT L3984 | $556 |
| PROSTHETIC DEV | WHFO - rigid w/o joints (Wrist, hand, finger brace that does not move, allows fingers to move) | CPT L3808 | $513 |
| PROSTHETIC DEV | WHFO w/o joints pre cst (Wrist, hand, finger premade brace that does not bend, customized to fit the patient) | CPT L3807 | $354 |
| PHYSICAL THERP | Therapy for help with walking (may include stair training as well) | CPT 97116 | $54 |
| PROSTHETIC DEV | WHO w/o joints cf (Wrist or hand brace that does not bend, custom made for a specific patient) | CPT L3906 | $575 |
| PROSTHETIC DEV | HFO w/o joints cf (Hand, finger brace that does not move, custom made for a patient) | CPT L3913 | $383 |
| OTHER | Hfo without joints pre cst (Brace for the hand or fingers, premade but adjusted for the patient's needs.) | CPT L3923 | $122 |
| 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 |
| PHYSICAL THERP | Orthotic mgmt and training (Training and management for use of a brace) | CPT 97760 | $76 |
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 | $180 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $46-$50 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $18-$59 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $156-$164 |
| OTHER | Level 3 Office/outpatient visit established patient | CPT 99213 | $78 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $131-$131 |
| LAB CHEMISTRY | Assay glucose blood quant (Blood glucose or blood sugar test except with testing on paper strip) | CPT 82947 | $10-$39 |
| PHYSICAL THERP | Manual therapy 1/> regions (Manual therapy such as lymph node drainage or traction in more than 1 area) | CPT 97140 | $154-$155 |
| OTHER | Level 2 Office/outpatient visit established patient | CPT 99212 | $56 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $89-$98 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $91 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $238-$251 |
| OTHER | Level 4 Office/outpatient visit established patient | CPT 99214 | $97 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $83-$98 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $68 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $16-$34 |
| LAB CHEMISTRY | Assay of creatinine (Measure of waste products in the blood to monitor kidney function) | CPT 82565 | $10-$21 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $41-$83 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $17-$115 |
| LAB CHEMISTRY | Assay of phosphorus (Blood test to measure phosphorus, found most in bones and teeth) | CPT 84100 | $12-$21 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $19-$48 |
| LAB CHEMISTRY | Assay of magnesium (Blood test to measure magnesium levels which helps control blood sugar level and immune system) | CPT 83735 | $17-$73 |
| LAB UROLOGY | Urinalysis auto w/scope (Urine test by machine with microscope) | CPT 81001 | $32 |
| PULMONARY FUNC | Measure blood oxygen level | CPT 94760 | $58 |
| LAB CHEMISTRY | Assay of urea nitrogen (Blood test to measure breakdown of protein into urea nitrogen to monitor kidney function) | CPT 84520 | $10-$50 |
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 | $212 |
| 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 | $390 |
| 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 | $773 |
| 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 | $1,877 |
| 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 | $2,536 |
UCHealth University of Colorado 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 | $12,619-$18,266 | 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 | $19,769-$51,926 | 3-8 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $3,814-$6,692 | 1-2 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $29,329-$37,650 | 1-3 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 | $13,403-$19,629 | 2-3 days |
| Normal Newborn | MS-DRG 795 | $3,814-$6,224 | 1-2 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 | $14,152-$26,568 | 2-5 days |
| SEIZURES W/O MCC (Seizures without major complications or conditions) | MS-DRG 101 | $18,011-$33,565 | 2-4 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 | $13,193-$24,428 | 4-5 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 | $19,516-$40,673 | 3-8 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 | $15,371-$25,122 | 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 | $12,103-$23,515 | 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 | $15,538-$34,761 | 2-6 days |
| MAJOR SMALL LARGE BOWEL PROCEDURES W CC (Major procedure on small and large intestines with complications or conditions) | MS-DRG 330 | $29,780-$62,191 | 3-8 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 | $61,612-$115,259 | 3-10 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 | $18,233-$29,654 | 3-4 days |
| Kidney Transplant | MS-DRG 652 | $119,164-$147,160 | 3-4 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 | $62,332-$215,547 | 8-25.75 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 | $16,531-$33,666 | 3-6 days |
| RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | MS-DRG 177 | $13,914-$33,194 | 3-7 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 | $48,309-$76,658 | 2-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $12,116-$21,884 | 2-4 days |
| RENAL FAILURE W CC (Kidney failure with complications or other conditions) | MS-DRG 683 | $12,647-$27,845 | 2-5 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W/O MCC (Miscellanous disorders affecting breakdown of food into energy without serious complications or conditions) | MS-DRG 641 | $11,774-$23,780 | 2-5 days |
| MISC DISORDERS OF NUTRITION METABOLISM FLUIDS/ELECTROLYTES W MCC (Miscellanous disorders affecting breakdown of food into energy with serious complications or conditions) | MS-DRG 640 | $15,421-$32,845 | 2-5 days |
| ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY (Alcohol, drug abuse or dependence with rehab treatment) | MS-DRG 895 | $23,997-$46,650 | 9-20.5 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 | $21,766-$37,978 | 3-5.5 days |
| CELLULITIS W/O MCC (Deep bacterial skin infection without serious complications) | MS-DRG 603 | $10,099-$20,650 | 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 | $15,521-$23,116 | 2-4 days |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC (Diseases of the Pancreas except cancer with complications and conditions) | MS-DRG 439 | $13,188-$25,788 | 2-5 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 | $63,661-$110,187 | 2-6 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 | $295,159-$726,777 | 19.5-46.5 days |
| G.I. HEMORRHAGE W CC (Excessive bleeding in the stomach or bowels with complications or conditions) | MS-DRG 378 | $12,809-$26,407 | 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 | $15,480-$31,646 | 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 | $20,961-$41,974 | 2-5.5 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 | $19,627-$38,285 | 2-4 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 | $96,751-$170,761 | 4-8 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 | $15,890-$31,183 | 3-6.25 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 | $20,688-$47,379 | 3-8 days |
| RENAL FAILURE W MCC (Kidney failure with serious complications or other conditions) | MS-DRG 682 | $17,291-$40,972 | 2-8 days |
| OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC (Diseases of the blood moving through the body with serious complications and conditions) | MS-DRG 314 | $21,856-$50,443 | 3-9 days |
| SIMPLE PNEUMONIA PLEURISY W CC (Simple pneumonia - responds well to treatment - and inflammation of the space between the lungs and the chest wall, with complications or other conditions) | MS-DRG 194 | $10,644-$24,097 | 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 | $32,272-$92,116 | 3-11 days |
| KIDNEY URINARY TRACT INFECTIONS W/O MCC (Kidney infection and infection of the urinary tract without major complications or conditions) | MS-DRG 690 | $11,581-$23,801 | 2-4 days |
| PREMATURITY W/O MAJOR PROBLEMS (Baby born too early but without major problems) | MS-DRG 792 | $4,659-$53,954 | 3-12.75 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $32,810-$40,753 | 1-2 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 | $14,969-$38,653 | 2-5 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $5,918-$18,694 | 2-5.5 days |
| EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE ( Baby born very early or with lungs not mature enough for breathing well) | MS-DRG 790 | $67,580-$291,518 | 15-58 days |
| OTHER KIDNEY URINARY TRACT DIAGNOSES W CC | MS-DRG 699 | $14,209-$35,363 | 2-6 days |
* Price and length-of-stay ranges represent 25th and 75th percentiles. Actual prices may be higher or lower than those listed here.
UCHealth 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 | $64-$74 |
| PHYSICAL THERP | Therapeutic exercises (Physical Therapy, Occupational Therapy or Rehab exercises taught to increase strength and flexibilty) | CPT 97110 | $64-$74 |
| LAB CHEMISTRY | Comprehen metabolic panel (Full panel of blood tests with at least 14 measurements) | CPT 80053 | $48 |
| LAB HEMATOLOGY | Complete cbc w/auto diff wbc (Complete blood count with count of types of cells by machine) | CPT 85025 | $32 |
| LABORATORY | Routine blood sample drawn | CPT 36415 | $27 |
| OBS ROOM | Hospital observation per hr (Observation of patient by providers, cost by hour) | CPT G0378 | $221 |
| PHYSICAL THERP | Therapeutic activities (Activities intended to improve functioning of patient) | CPT 97530 | $68-$72 |
| LAB CHEMISTRY | Assay thyroid stim hormone (Thyroid Stimulating Hormone - TSH- blood test) | CPT 84443 | $75 |
| LAB CHEMISTRY | Lipid panel (blood test for cholesterol levels) | CPT 80061 | $30-$60 |
| IV THERAPY | Hydrate IV infusion add-on (IV drip for additional hour) | CPT 96361 | $118 |
| PATHOL HYSTOL | Tissue exam by pathologist (Tissue sample examined by doctor (pathologist) for diagnosis) | CPT 88305 | $167 |
| IV THERAPY | Tx/pro/dx inj same drug adon (Another dose of a medicine given before by IV into a vein) | CPT 96375 | $112-$118 |
| LAB IMMUNOLOGY | Allergy testing | CPT 86003 | $21-$27 |
| LAB HEMATOLOGY | Complete cbc automated (Complete blood count by machine) | CPT 85027 | $23 |
| LAB CHEMISTRY | Metabolic panel total ca (Basic panel of blood tests with at least 8 measures including calcium) | CPT 80048 | $38 |
| 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 | $64-$72 |
| SCREENING MAMMOGRAPHY | Screening mamography on both breasts with computer aided detection | CPT 77067 | $279 |
| SCREENING MAMMOGRAPHY | Breast tomosynthesis bilateral (3D Mamogram on both breast) | CPT 77063 | $40 |
| LAB HEMATOLOGY | Prothrombin time (Protime test or INR for checking levels of the factors in blood that allow clotting) | CPT 85610 | $18-$21 |
| IV THERAPY | Ther/proph/diag inj iv push (Single dose or first dose of medicine by IV into a vein) | CPT 96374 | $225-$235 |
| EVAL REEVAL PHYS THER | PT eval low complex 20 min (Physical Therapy assessment for 20 minutes of low complexity) | CPT 97161 | $126 |
| LABORATORY | Blood test to check for prostate cancer in men | CPT 84153 | $83-$107 |
| LAB BACT MICRO | Urine culture/colony count (Urine test for bacteria with number of cells counted) | CPT 87086 | $36 |
| LAB CHEMISTRY | Glycosylated hemoglobin test (Hemoglobin A1C blood test for diabetes - this gives your average blood sugar level for 3 months) | CPT 83036 | $43 |
| EKG ECG | Electrocardiogram (EKG) Heart tracing | CPT 93005 | $194 |
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 | $192 |
| 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 | $365 |
| 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 | $847 |
| 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 | $1,773 |
| 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 | $2,523 |
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 | $8,926-$13,375 | 2-3 days |
| Normal Newborn | MS-DRG 795 | $2,206-$2,638 | 2 days |
| MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC (Major joint replacment or reattaching of leg or part of leg without serious complications or conditions) | MS-DRG 470 | $42,684-$51,427 | 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 | $16,064-$23,020 | 2-4 days |
| NEONATE W OTHER SIGNIFICANT PROBLEMS (newborn baby with serious sickness) | MS-DRG 794 | $2,206-$3,499 | 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 | $23,424-$51,230 | 2-5 days |
| MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES (Major joint replacment or reattaching of arm or part of arm) | MS-DRG 483 | $42,173-$50,260 | 1 day |
| 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 | $54,037-$68,750 | 1-2 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 | $56,995-$62,481 | 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 | $9,402-$12,882 | 2-3 days |
| FULL TERM NEONATE W MAJOR PROBLEMS (Full term baby with serious complications) | MS-DRG 793 | $2,624-$5,775 | 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 | $18,496-$26,877 | 2-3 days |
| CERVICAL SPINAL FUSION W/O CC/MCC (Surgery to join the bones of the neck without complications or conditions or serious complications or conditions) | MS-DRG 473 | $38,925-$50,761 | 1-2 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 | $14,723-$19,624 | 2-3 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 | $56,834-$75,318 | 1-2 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 | $16,254-$27,811 | 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 | $19,874-$37,814 | 2.25-4 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 | $16,699-$20,276 | 3-4 days |
| DIABETES W CC (Diabetes or high blood sugars with complications or conditions) | MS-DRG 638 | $17,158-$23,938 | 1-3 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 | $41,942-$45,779 | 1 day |
* 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.