Price
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CPT
|
|
$45
|
|
Office Visit Fee If no insurance. This is
for all new (first time) visits, and all established
(not first time) "99214" visits. Less complicated
established visits (99213) are $20. Established
patients who were previously insured get 1 month of
free visits (free office visit, nothing below free),
starting at the first uninsured visit, and after that
must pay for the office visit.
If you think you will soon have insurance: We can try to backbill visits when insurance gets reinstated; if we are paid we can then refund you (so credit card is easier for us). |
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.
|
|
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99173
|
Vision Screening (if separate from a wellness exam)
|
|
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Preventive counseling: 99401 (15min), 2 (30), 3
(45), 99404 (60).
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Smoking
Counseling 99406 (3-10 min), 99407 (>10 min) |
||
Q3014 |
Televisit (originating). If
pt at home use place of service 12 (not office = 11) |
|
$35 (5 tests)
or $10 each |
99000 + 36415 |
Labs drawn and sent out - thousands of tests available. For CBC, CMP, Lipids, A1C, and TSH (includes chemistry, cholesterol, and diabetes). Price is $35 for all 5, or $10 each separately. If you need more or different tests, we add each actual test cost. |
$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) single test
|
|
82270
|
hemoccult guiac v76.51 (not MCR) (in house lab)
|
$20
(+$30) |
87804 (+QW) |
Influenza
test A and B. Bill 2 units with QW. (self pay separate $30 if send
out) |
$10
|
83037
|
Hemoglobin A1C (home type machine)
|
|
81002
|
Urine dip (in house lab). $13 more to send to lab
for culture.
|
$5
|
81025
|
Urine HCG pregnancy test (in house lab) - you can
buy the same pregnancy test yourself for <$5 at the
grocery store ($1 at Dollar Tree).
|
|
87880
|
Rapid Strep test. $5
more to send to lab for culture.
|
$20 |
86328 |
Coronavirus (Covid 19)
Antibody Rapid Test |
|
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.) Does not include
the visit fee above.
|
|
|
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, Rocephin, Penicillin)
|
$50
|
J1050-FPx150
|
Depo-Provera (per 1 mg; x 150 for standard dose)
(with 96372-FP)
|
$60 for full
|
J0561
|
Penicillin per 100,000 Units (x12 for 1.2 Million
Units = $60)
|
|
J7613
|
Albuterol Solution
|
$10
|
94640, J7613
|
Albuterol nebulizer treatment (i.e. the neb and the
albuterol)
|
|
94664
|
Teach how to use an inhaler or nebulizer.
|
$50 |
96360+J7030 |
IV +
Normal Saline 1 Liter |
$10 |
J1885 |
Toradol,
per 15 mg (2 units for 30mg) |
$10 |
J1200 |
Benadryl
25 mg |
$10 |
J0696 |
Rocephin
250mg |
$10 |
J0696x4 |
Rocephin
1g |
|
|
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)
|
$25
|
93000
|
EKG with interpretation
|
11719 |
Trim
nails (any number) |
|
$60
|
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)
|
$1,000 |
11981-FP |
Nexplanon
insertion
z30.017 with J7307 for device. This is so expensive that
no one pays cash. Just take pills until you have
insurance. |
$55
|
11982-FP
|
Implantable Contraceptive Rod Removal (z30.46), eg
Remove Implanon from arm
|
$1055 |
11983-FP |
Remove
rod and put a new Nexplanon in. |
|
30901
|
Nosebleed cautery
|
$55
|
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.
|
$115
|
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
|
$55
|
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).
|
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J3301
|
Steroid (Triamcinolone) 10mg injection (eg 1ml of
10mg/ml). (+/- 96372).
|
|
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Wound Care coding
|
$25 | Wrist
Splint (prefab), short arm: S8451 for splint and 29125
for application. 29105 for long arm. 29505 for long leg,
29515 for short leg. |
|
28190 |
Foreign
body removal (eg spinter) for foot |
|
|
|
Immunizations - Shots - Vaccines - Jabs We record all shots immediately directly in the state immunization registry |
|
90471 - 90472
|
|
|
|
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. Uninsured (and cicp) have to pay these prices, but you may qualify to get MMR and Varicella discounted to $25, 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. |
$20
|
90658
|
Flu (fluzone; G0008 Q2038 for MCR), required
for Green Card Oct-Mar
|
$65
|
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
|
Tdap
|
$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.
|
$75
|
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.
|
$140 |
90734 |
Meningococcal (MCV4) |
$210 |
90651 |
HPV |
$100
|
90732
|
Pneumonia PPSV23 Pneumovax*** (G0009 for
MCR)
|
$200 |
90670 |
Pneumonia
PCV13 Prevnar |
|
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 Free for Medicaid (using VFC), and for CHP and uninsured. Private insurance (using private supply) kids are usually free, but we may take a deposit of the amounts here. |
|
90700
|
Dtap (Sanofi)
|
|
90696
|
Dtap/IPV (Kinrix GSK)
|
|
90723
|
Dtap/IPV/HepB (Pediarix GSK)
|
$20
|
90657
|
Flu (6mo-3yo)
|
$20
|
90658
|
Flu (over age 3)
|
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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
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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 In addition to the shots above, you may wantYellow Fever, Rabies, Japanese Encephalitis - we don't do these. Try the Denver Health travel clinic or Tri County. |
|
|
Malaria - we can give you a prescription and you
can buy from pharmacy.
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
|
Certify HHC on CMS 485 form |
|
G0179
|
REcertify HHC on CMS 485 every 60 days |
|
G0181
|
Care Plan Oversight of HHC work |