$45

Suggested Office Visit Fee (if no insurance). Yes this is suggested. You can pay more or less if you feel the need to. This pays for our time. You add this to most items below (once per visit), but the items below are all required (not suggested) because they cost us money to provide.

$26

G0101+Q0091

Pap smear and gyn (woman) exam, including lab cost for basic pap (88164). This is in addition to our regular visit charge (so total cost is $71). You may need more labwork than just a basic pap, depending on your personal history.

99173

Vision Screening (if separate from a wellness exam)

Preventive counseling: 99401 (15min), 2 (30), 3 (45), 99404 (60).

$35

Labs drawn and sent out - thousands of tests available.
We charge $35 for a basic set of tests, including chemistry, cholesterol, and diabetes. If you need more or different tests, we add up each test cost. Prices are low but vary depending on the test.

$20

36415

If you need other tests (more than the $35 basic labs), we charge $20 plus our actual cost of the tests.

$20

Fit Kit colon cancer screening, stool test (no blood draw fee)

$60

83014

H. Pylori urea breath test, including administration and the 83013 lab test

99195

Therepeutic Phlebotomy

Labs done in clinic

82962

blood sugar (home glucometer)

82270

hemoccult guiac v76.51 (not MCR) (in house lab)

$10

83037

Hemoglobin A1C (home type machine)

81002

Urine dip (in house lab). $13 more to send to lab for culture.

$6

81025

Urine HCG pregnancy test (in house lab) - you can buy a preg test yourself for <$5 at the grocery store

87880

Rapid Strep test. $5 more to send to lab for culture.

87210

Microscopic Potassium Hydroxide (KOH OR Wet Prep)

Medications given in clinic

$20

86580 + V74.1

Tb (Tuberculosis) skin test (PPD). Includes placement and reading 2-3 days later (for readings, remember we are not open on weekends, so we can not place the test on Thursdays.)

PPD reading visit: included in the $20 above. 99211 + V74.1 (if neg) 795.51 (if +).

96372

IM injection code (for shots, eg bill along with Depo or Penicillin)

$60

J1050-FPx150

Depo-Provera (per 1 mg; x 150 for standard dose) (with 96372-FP)

$5

J0561

Penicillin per 100,000 Units (x12 for 1.2 Million Units = $60)

J7613

Albuterol Solution

$13

94640, J7613

Albuterol nebulizer treatment (i.e. the neb and the albuterol)

94664

Teach how to use an inhaler or nebulizer.

Procedures done in clinic. Remember: add our office visit charge to any of these.

69210

Earwax removal (cerumen disimpact) H61.23 (use 50 if 2 ears)

$13

93000

EKG with interpretation

$62

11730

Nail removal, partial (without matrix)

11750

Nail removal with matrix, partial or complete

11740

Trephination of a subungual hematoma (evacuation of a blood blister under nail)

58301

Remove IUD (intra uterine device birth control)

$63

11982-FP

Implantable Contraceptive Rod Removal (z30.46), eg Remove Implanon from arm

30901

Nosebleed cautery

$63

12001

Suture superficial wound <1 inch

12002

Suture superficial wound 1-3 inches

17110

Common or Plantar Wart (078.10)- destroy benign or premalignant eg freeze. #1-#14 (only once); OR 17111 (only once) for >14

11200

Skin tag (701.9) removal #1-15. Then also 11201 once again for ea addl 10.

17000

Actinic Keratosis (702.0) freeze 1. 17003 is for #2-13 (1 unit each), 17004 once (alone) if >13.

$111

11100

Biopsy (eg punch) - first biopsy only. This includes visit, biopsy, and lab pathology.

11401

Skin lesion Excision - Benign - trunk/arm/leg 0.6 - 1.0 cm lesion benign

11601

Skin lesion Excision - Malignant - trunk/arm/leg 0.6 - 1.0 cm

10120

removal of foreign body - simple (eg splinter)

16000

Initial dressing of 1st degree burn

$72

10060

I&D (Incision and Drainage) of abscess, simple or single

10061

I&D Skin abscess, complex or multiple

10140

I&D of hematoma/seroma

$35

20550

Trigger Finger Injection (includes lidocaine)

$35

20552

Trigger Point Injection 1-2 muscles (includes lidocaine)

20553

Trigger Point Injection 3+ muscles (includes lidocaine)

$35

20600

Inject or aspirate a small joint or bursa (fingers, toes), add steroid also.

$35

20605

Inject or aspirate a medium joint or bursa (wrist, elbow, ankle), add steroid also.

$35

20610

Inject or aspirate a large joint or bursa (shoulder, hip, knee), add steroid also.

J1030

Steroid (DepoMedrol) 40mg injection (eg 1ml of 40mg/ml). (+/- 96372).

J3301

Steroid (Triamcinolone) 10mg injection (eg 1ml of 10mg/ml). (+/- 96372).

Wound Care coding

Immunizations - Shots - Vaccines - Jabs

$14

90471/2

Vaccine administration fee. You do not have to pay this extra, unless you are a child who qualifies for VFC but not Medicaid (we rarely see this), or you are an adult who qualifies for shots from the Merck program. We record all shots in the state immunization registry

Adult Shots
1. If you have Medicaid or other insurance, you get these free.
2. Medicare only covers flu, pneumonia (ppsv23), and hepB (and zoster but not by an outpatient doctor).
3. CICP and uninsured have to pay these prices, but you may qualify to get some of these discounted to $25 (includes the $14 shot fee), based on your income (the ones with ***). This is handy for Green Card shots. Most adults need Varicella x2, MMR x2, Td x3 (one being TdaP), and flu if September-March. That is, you need MMR+Var+Tdap, then at least 1 month later MMR+Var+Td, then at least 6 months later Td (+ maybe flu); but you may not need to wait the 6 months for the last shot to apply for your card.

90658

Flu (fluzone; G0008 Q2038 for MCR), required for Green Card Oct-Mar

$64

90707

MMR*** Green card requires 2 doses (2nd is 1 month later) - this is the cost of 1 dose.

$105

90716

Varicella (Varivax)*** Green card requires the full 2 dose series (2nd is 1 month later). This is the cost of one dose.

$35

90714

Td If adult has never had, then needs 3 doses (2nd after 1 month. 3rd 6 months after 2nd. But one of the three should be TdaP instead). This is the cost of one dose.

$50

90715

$75

90632

Adult HepA 2 dose series (2nd is 6 months later - can be done when you return from trip). This is the cost of one dose. Adults do not require for Green Card.

$72

90746

Adult HepB*** (G0010 for Medicare) 3 dose series (2nd is 1 month later. 3rd is 2 months after 2nd AND 4 months after 1st). This is the cost of one dose. Adults do not require for Green Card.

$100

90732

Pneumonia PPSV23 Pneumovax*** (G0009 for MCR)

$194

90736

Zostavax - we do not carry this. Go get it from King Soopers, where it is about $220 or they bill your insurance. Not required for Green Card.

Kids Shots
1. Free for Medicaid (using VFC), and for CHP or private insurance (using private supply)
2. CICP or underinsured up to and including age 18 may have to pay $14 per shot.
3. Since that covers everyone, most prices are not listed here; this is mostly for our own coding.

90700

Dtap (Sanofi)

90696

Dtap/IPV (Kinrix GSK)

90723

Dtap/IPV/HepB (Pediarix GSK)

90657

Flu (6mo-3yo)

90658

Flu (over age 3)

90648

Hib (4 dose) (ActHib)

90649

HPV quadrivalent (Merck Gardasil)

90633

Kids HepA (Vaqta; Merck)

90744

Kids HepB (Recombivax; Merck)

90734

Meningitis (Menactra)

90707

MMR (Merck)

90713

Polio (IPV IPOL)

90670

Pneumococcal Conjugate (Prevnar 13, Wyeth)

90680

Rotavirus (Rotateq 3 doses required- first at age 6-12 wk; last before 32wk) (Merck)

90714

Td (Sanofi)

90715

Tdap (Boostrix; GSK)

90716

Varicella (Varivax; Merck)

90698

Dtap/IPV/Hib (Pentacel) (we don't carry, we use above combos)

90748

HIB/HepB (Comvax; we don't carry, we use above combos)

90650

HPV bivalent (GSK Cervarix) (we don't carry this, we use Gardasil)

Other well child visit services

0-2: D0145

Dental eval/counsel + D1206 Fluoride varnish

3-4: D0999

Dental eval/counsel + D1206 Fluoride varnish

0-4: 96110

Child development screening (eg PEDS, ASQ). If +, add eg ICD 313-315 or 783s. MCD covers 3/yr for 0-2yo, 2/yr for 3-4 yo.

11-20: 99420

Risk Assessment (eg PHQ9 for Depression: V40.0 if +, V79.8 if neg). MCD covers 11-20yo.

Travel Shots
Most insurances do NOT pay for these if given only for travel reasons. You have to pay the prices below, and also our standard visit fee, but that includes some great travel advice!

$125

90734

Menactra MCV4 Meningitis

$244

90738

Japanese Encephalitis IM - special order

$439

90675

Rabies - special order

$164

90717

Yellow Fever - we don't do this right now, try Tri County.

$75

90632

Adult HepA. 2 dose series (2nd is 6 months later- can be done when you return from trip). This is the cost of one dose.

$72

90746

Adult HepB. 3 dose series. This is the cost of one dose.

$50

90715

Tdap

Typhoid - we can give you a prescription for the four pill series. The four pills will cost you $56 at Walmart, $61 at Walgreen, and $62 at King Soopers (we last checked May 2011). The pills will protect you 5 years. Or, you can get the shot for about $60 from the Jefferson County Travel Clinic, and that will protect you 2 years.

Care Coordination and Transitions

Complex Care Coordination (no visit): 31-75 min for doctor (99487) or staff (99488); and ea addl 30 min for either (99489).

Transitional care mgmt: contact pt or caregiver w/in 2 days p/ d/c: and have a pt visit w/in 7 d w high MDM (99496), or w/in 14d and mod MDM (99495)

Medicare Home Health Supervision, patient not present:

G0180

G0179

G0181