Average Cost of An ER Visit

Even though you might not expect to get sick, injured or suffer from some type of catastrophic event that calls for a visit to the emergency room, it can happen. Regardless of what you are seen for, the cost of an ER visit can vary significantly from one extreme to the next. You might be surprised to learn just how much some of these seemingly simple procedures and diagnoses cost, especially when you are responsible for paying the bill out of your own pocket.

For example, let’s say you start having chest pains that don’t seem to be getting any better. You head into the emergency department because you aren’t sure if you are having a heart attack or something else is going on. Long story short, you find out that you have nothing more than indigestion that was causing the pains in your chest. Now, here is the funny thing: your bill. Can you imagine getting hit with a bill that costs more than a semester of college? How are you ever going to pay for it all?

These outlandish prices are seen across the board. The average costs of an ER visit is 40 percent more than most Americans pay for their monthly rent payment. Since discrepancies is so vast in what one ER department is going to charge over another, the patient has no way of guessing how much they are going to be billed for their visit. Regardless of state, city and hospital, expect the price of services to vary across the board.

Based on a study of more than 8,000 individuals who visited the emergency room in the United States, the average cost of an ER visit was $2,168. When you look at the top ten reasons why people pay a visit to the emergency room, treating kidney stones topped the list on average. It also tended to be the most variable in terms of treatment cost. All of the various charges, representing the total bill for individuals between 18 and 64 years of age, that came in with a single diagnosis followed the same patterns.

Kidney stones averaged around $4,247, while a sprain or strain averaged $1,498. If a woman were to go in for a normal pregnancy or delivery, she could expect to spend around $2,008. Headache sufferers are only going to have more of a headache when they see their $1,727 bill for going in to the emergency room to be evaluated. Back pain sufferers will receive an average bill of around $1,476.
If you have an open wound on any of your extremities, you can expect to spend an average of $1,650 at your visit. Other injuries of an unclassified nature average $2,103. Something as simple as an upper respiratory infection can cost $1,101m while a urinary tract infection is $2,598 and intestinal infections are $2,398.

When you look at the extensive cost of going to the ER is going to be, it can add up rather quickly. Since every hospital has their own prices, you never can tell just how much you are going to be stuck paying for your visit.

hospital pricing transparency

How to Read a Hospital Bill

How to Read a Hospital Bill

Taking care of our health is one of the most important things that we are obliged to do in this life. If we don’t do it, we’re not being a steward of the gift of life that’s given to us. When we take steps in taking care of our health, we have to expect that along with this is the fact that expenses are involved. It’s an investment and definitely needs to be given the importance. And because we need to pay for it, we will be faced with hospital bills and other things to spend for. Spending for our health can also be quite costly depending on the type of medical examinations that you go through. That is why, it is important to learn how to read a hospital bill to make sure that you don’t lose track of what you’re supposed to pay for. Most people have difficulty with reading a hospital bill. It could be kind of confusing sometimes especially when you don’t know how to read it yourself. But in this article, you will learn how to do it the easiest way. Once you’ve finished reading through, you can be sure to know it yourself and be able to share it with others who need to learn how to read them too.

There are three paper works that you need to be aware of and learn how to compare. The first one which is the list of services performed. This paperwork is given to you once you leave the office of your doctor or the place wherein the test was performed. The next one is the bill. This could come from the health facility where the test was conducted or from your doctor. On this paperwork, you will see all the list of services done that were indicated on the first paperwork but this time the prices will also be included in it. The next one, which is the third paperwork, is called the EOB or explanation of benefits. This is the paperwork that comes from whoever paid for the services. It could be a payer, insurer or Medicare, depending on who took care of it for you. In these three papers, you will also find the codes and terminologies which will inform you of the services that were done in your medical exams. It is a way wherein you can be assured that no services are billed to you even if they weren’t performed.

Learning how to read a hospital bill is very easy and once you do, it will be even easier for you to handle them again. Hospital bills are pretty detailed only because they want to make sure that you are aware of all the tests that were conducted and to be transparent with everything that you, as the patient should know. From the services performed to the prices that you need to pay for, a medical bill lays it all out for you. Now you won’t have to worry about anything else but to only make sure that you are well and healthy through the right tests conducted on you.

Understanding CPT Codes

Understanding CPT Codes

Ever heard of CPT Codes before? This topic could be very complicated especially for those who aren’t really informed about medical terminologies. The people who very well understand this topic are medical practitioners and insurers. It is something that they know so surely because this is something very relevant in their job. However, that does not excuse anyone for not wanting to know what these codes actually mean. Understanding CPT Codes are important not just for those who are in the medical field but as well as anyone – most especially those who have insurers who take care of their medical bills. If you don’t understand yet the whole importance and relevance of these codes then you should definitely read on. This will be a very helpful learning thought as you take care of your medical needs.

CPT or Current Procedural Terminology codes are numbers that are assigned to every medical, diagnostic as well as surgical service. These codes can be provided by a medical practitioner to a patient and are then used by the insurers in order to determine how much they would need to reimburse the practitioner. These codes are uniformly used so you can be sure to never go wrong with them. These codes which were copyrighted by the American Medical Association had been developed and at the same time maintained for the said purpose. These codes are maintained for as long as no changes are made or developed for new services. If any changes took place, these codes may be revised or discarded as desired by the Association. CPT codes are always updated. The codes that are in use are updated every year to make sure that they are usable and are still valid. The editorial boards of AMA or American Medical Association are the ones who are in charge of overseeing them. The amount that practitioners get reimbursed for through these codes is not always the same. Despite the fact that they are uniformly made, the reimbursements may differ. So in this sense, you can’t really expect that the same doctors get the same amount of reimbursements given by the insurance company for the checkup that was performed. The codes are also used differently by different medical insurance company. Medicare still uses CPT codes but they do it differently. They use Healthcare Common Procedure Coding System unlike how other insurers do.

The most important use of understanding CPT codes is very related to the insurance and doctor’s billings especially for someone who is a patient. Back then most patients would find a lot of trouble understanding what they exactly mean that they would need to go through the hassle of contacting their insurance company or even asking their doctor for explanation of what these codes really are. But these days, it has become something that people really want to learn about and actually understand as they are very useful in many ways. And you reading through this article will definitely know what they are and how they can be useful to you and your family.

CPT Codes For Hospital Billing


INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services:

86152 Cell enumeration &id
86153 Cell enumeration phys interp
86890 Autologous blood process
86891 Autologous blood op salvage
86927 Plasma fresh frozen
86930 Frozen blood prep
86931 Frozen blood thaw
86932 Frozen blood freeze/thaw
86945 Blood product/irradiation
86950 Leukacyte transfusion
86960 Vol reduction of blood/prod
86965 Pooling blood platelets
86985 Split blood or products

INCLUDE the following CPT and HCPCS Level 2 codes for other clinical laboratory services:

0058T Cryopreservation ovary tiss
0059T Cryopreservation oocyte
0103T Holotranscobalamin
0111T RBC membranes fatty acids
36415 Routine venipuncture
78110 Plasma volume single
78111 Plasma volume multiple
78120 Red cell mass single
78121 Red cell mass multiple
78122 Blood volume
78130 Red cell survival study
78191 Platelet survival
78267 Breath tst attain/anal c-14
78268 Breath test analysis c-14
78270 Vit B-12 absorption exam
78271 Vit B-12 absrp exam int fac
78272 Vit B-12 absorp combined
78725 Kidney function study
G0027 Semen analysis
G0103 Psa screening
G0123 Screen cerv/vag thin layer
G0124 Screen c/v thin layer by MD
G0141 Scr c/v cyto,autosys and md
G0143 Scr c/v cyto,thinlayer,rescr
G0144 Scr c/v cyto,thinlayer,rescr
G0145 Scr c/v cyto,thinlayer,rescr
G0147 Scr c/v cyto, automated sys
G0148 Scr c/v cyto, autosys, rescr
G0306 CBC/diffwbc w/o platelet
G0307 CBC without platelet
G0328 Fecal blood scrn immunoassay
G0416 Sat biopsy prostate 1-20 spc
G0417 Sat biopsy prostate 21-40
G0418 Sat biopsy prostate 41-60
G0419 Sat biopsy prostate: >60
G0431 Drug screen single class
G0432 EIA HIV-1/HIV-2 screen
G0433 ELISA HIV-1/HIV-2 screen
G0434 Drug screen multi drug clas
G0435 Oral HIV-1/HIV-2 screen
G9143 Warfarin respon genetic test
P2028 Cephalin floculation test
P2029 Congo red blood test
P2033 Blood thymol turbidity
P2038 Blood mucoprotein
P3000 Screen pap by tech w md supv
P3001 Screening pap smear by phys
P9612 Catheterize for urine spec
P9615 Urine specimen collect mult
Q0111 Wet mounts/ w preparations
Q0112 Potassium hydroxide preps
Q0113 Pinworm examinations
Q0114 Fern test
Q0115 Post-coital mucous exam


INCLUDE the following CPT and HCPCS codes for physical therapy/occupational therapy/outpatient speech-language pathology services:

0019T Extracorp shock wv tx ms nos
0183T Wound ultrasound
64550 Apply neurostimulator
90901 Biofeedback train any meth
90911 Biofeedback peri/uro/rectal
92506 Speech/hearing evaluation
92507 Speech/hearing therapy
92508 Speech/hearing therapy
92520 Laryngeal function studies
92526 Oral function therapy
92597 Oral speech device eval
92607 Ex for speech device rx 1hr
92608 Ex for speech device rx addl
92609 Use of speech device service
92610 Evaluate swallowing function
92611 Motion fluoroscopy/swallow
92612 Endoscopy swallow tst (fees)
92614 Laryngoscopic sensory test
92616 Fees w/laryngeal sense test
93797 Cardiac rehab
93798 Cardiac rehab/monitor
95831 Limb muscle testing manual
95832 Hand muscle testing manual
95833 Body muscle testing manual
95834 Body muscle testing manual
95851 Range of motion measurements
95852 Range of motion measurements
95992 Canalith repositioning proc
96000 Motion analysis video/3d
96001 Motion test w/ft press meas
96002 Dynamic surface emg
96003 Dynamic fine wire emg
96105 Assessment of aphasia
96111 Developmental testing
96125 Cognitive test by HC pro
97001 Pt evaluation
97002 Pt re-evaluation
97003 Ot evaluation
97004 Ot re-evaluation
97010 Hot or cold packs therapy
97012 Mechanical traction therapy
97016 Vasopneumatic device therapy
97018 Paraffin bath therapy
97022 Whirlpool therapy
97024 Diathermy eg microwave
97026 Infrared therapy
97028 Ultraviolet therapy
97032 Electrical stimulation
97033 Electric current therapy
97034 Contrast bath therapy
97035 Ultrasound therapy
97036 Hydrotherapy
97039 Physical therapy treatment
97110 Therapeutic exercises
97112 Neuromuscular reeducation
97113 Aquatic therapy/exercises
97116 Gait training therapy
97124 Massage therapy
97139 Physical medicine procedure
97140 Manual therapy
97150 Group therapeutic procedures
97530 Therapeutic activities
97532 Cognitive skills development
97533 Sensory integration
97535 Self care mngment training
97537 Community/work reintegration
97542 Wheelchair mngment training
97545 Work hardening
97546 Work hardening add-on
97597 RMVL devital tis 20cm/<
97598 RMVL devital tis addl 20 cm<
97602 Wound(s) care non-selective
97605 Neg press wound tx < 50 cm
97606 Neg press wound tx > 50 cm
97750 Physical performance test
97755 Assistive technology assess
97760 Orthotic mgmt and training
97761 Prosthetic training
97762 C/O for orthotic/prosth use
97799 Physical medicine procedure
G0281 Elec stim unattend for press
G0283 Elec stim other than wound
G0329 Electromagntic tx for ulcers
G0451 Development test interp & rep


INCLUDE the following CPT and HCPCS codes:

0042T Ct perfusion w/contrast cbf
0159T Cad breast mri
0174T Cad cxr with interp
0175T Cad cxr remote
51798 Us urine capacity measure
70100 X-ray exam of jaw
70110 X-ray exam of jaw
70120 X-ray exam of mastoids
70130 X-ray exam of mastoids
70134 X-ray exam of middle ear
70140 X-ray exam of facial bones
70150 X-ray exam of facial bones
70160 X-ray exam of nasal bones
70190 X-ray exam of eye sockets
70200 X-ray exam of eye sockets
70210 X-ray exam of sinuses
70220 X-ray exam of sinuses
70240 X-ray exam pituitary saddle
70250 X-ray exam of skull
70260 X-ray exam of skull
70300 X-ray exam of teeth
70310 X-ray exam of teeth
70320 Full mouth x-ray of teeth
70328 X-ray exam of jaw joint
70330 X-ray exam of jaw joints
70336 Magnetic image jaw joint
70350 X-ray head for orthodontia
70355 Panoramic x-ray of jaws
70360 X-ray exam of neck
70370 Throat x-ray & fluoroscopy
70371 Speech evaluation complex
70380 X-ray exam of salivary gland
70450 Ct head/brain w/o dye
70460 Ct head/brain w/dye
70470 Ct head/brain w/o & w/dye
70480 Ct orbit/ear/fossa w/o dye
70481 Ct orbit/ear/fossa w/dye
70482 Ct orbit/ear/fossa w/o&w/dye
70486 Ct maxillofacial w/o dye
70487 Ct maxillofacial w/dye
70488 Ct maxillofacial w/o & w/dye
70490 Ct soft tissue neck w/o dye
70491 Ct soft tissue neck w/dye
70492 Ct sft tsue nck w/o & w/dye
70496 Ct angiography head
70498 Ct angiography neck
70540 Mri orbit/face/neck w/o dye
70542 Mri orbit/face/neck w/dye
70543 Mri orbt/fac/nck w/o & w/dye
70544 Mr angiography head w/o dye
70545 Mr angiography head w/dye
70546 Mr angiograph head w/o&w/dye
70547 Mr angiography neck w/o dye
70548 Mr angiography neck w/dye
70549 Mr angiograph neck w/o&w/dye
70551 Mri brain w/o dye
70552 Mri brain w/dye
70553 Mri brain w/o & w/dye
70554 Fmri brain by tech
70555 Fmri brain by phys/psych
71010 Chest x-ray
71015 Chest x-ray
71020 Chest x-ray
71021 Chest x-ray
71022 Chest x-ray
71023 Chest x-ray and fluoroscopy
71030 Chest x-ray
71034 Chest x-ray and fluoroscopy
71035 Chest x-ray
71100 X-ray exam of ribs
71101 X-ray exam of ribs/chest
71110 X-ray exam of ribs
71111 X-ray exam of ribs/chest
71120 X-ray exam of breastbone
71130 X-ray exam of breastbone
71250 Ct thorax w/o dye
71260 Ct thorax w/dye
71270 Ct thorax w/o & w/dye
71275 Ct angiography chest
71550 Mri chest w/o dye
71551 Mri chest w/dye
71552 Mri chest w/o & w/dye
71555 Mri angio chest w or w/o dye
72010 X-ray exam of spine
72020 X-ray exam of spine
72040 X-ray exam of neck spine
72050 X-ray exam of neck spine
72052 X-ray exam of neck spine
72069 X-ray exam of trunk spine
72070 X-ray exam of thoracic spine
72072 X-ray exam of thoracic spine
72074 X-ray exam of thoracic spine
72080 X-ray exam of trunk spine
72090 X-ray exam of trunk spine
72100 X-ray exam of lower spine
72110 X-ray exam of lower spine
72114 X-ray exam of lower spine
72120 X-ray exam of lower spine
72125 Ct neck spine w/o dye
72126 Ct neck spine w/dye
72127 Ct neck spine w/o & w/dye
72128 Ct chest spine w/o dye
72129 Ct chest spine w/dye
72130 Ct chest spine w/o & w/dye
72131 Ct lumbar spine w/o dye
72132 Ct lumbar spine w/dye
72133 Ct lumbar spine w/o & w/dye
72141 Mri neck spine w/o dye
72142 Mri neck spine w/dye
72146 Mri chest spine w/o dye
72147 Mri chest spine w/dye
72148 Mri lumbar spine w/o dye
72149 Mri lumbar spine w/dye
72156 Mri neck spine w/o & w/dye
72157 Mri chest spine w/o & w/dye
72158 Mri lumbar spine w/o & w/dye
72159 Mr angio spine w/o&w/dye
72170 X-ray exam of pelvis
72190 X-ray exam of pelvis
72191 Ct angiograph pelv w/o&w/dye
72192 Ct pelvis w/o dye
72193 Ct pelvis w/dye
72194 Ct pelvis w/o & w/dye
72195 Mri pelvis w/o dye
72196 Mri pelvis w/dye
72197 Mri pelvis w/o & w/dye
72198 Mr angio pelvis w/o & w/dye
72200 X-ray exam sacroiliac joints
72202 X-ray exam sacroiliac joints
72220 X-ray exam of tailbone
73000 X-ray exam of collar bone
73010 X-ray exam of shoulder blade
73020 X-ray exam of shoulder
73030 X-ray exam of shoulder
73050 X-ray exam of shoulders
73060 X-ray exam of humerus
73070 X-ray exam of elbow
73080 X-ray exam of elbow
73090 X-ray exam of forearm
73092 X-ray exam of arm infant
73100 X-ray exam of wrist
73110 X-ray exam of wrist
73120 X-ray exam of hand
73130 X-ray exam of hand
73140 X-ray exam of finger(s)
73200 Ct upper extremity w/o dye
73201 Ct upper extremity w/dye
73202 Ct uppr extremity w/o&w/dye
73206 Ct angio upr extrm w/o&w/dye
73218 Mri upper extremity w/o dye
73219 Mri upper extremity w/dye
73220 Mri uppr extremity w/o&w/dye
73221 Mri joint upr extrem w/o dye
73222 Mri joint upr extrem w/dye
73223 Mri joint upr extr w/o&w/dye
73225 Mr angio upr extr w/o&w/dye
73500 X-ray exam of hip
73510 X-ray exam of hip
73520 X-ray exam of hips
73540 X-ray exam of pelvis & hips
73550 X-ray exam of thigh
73560 X-ray exam of knee 1 or 2
73562 X-ray exam of knee 3
73564 X-ray exam knee 4 or more
73565 X-ray exam of knees
73590 X-ray exam of lower leg
73592 X-ray exam of leg infant
73600 X-ray exam of ankle
73610 X-ray exam of ankle
73620 X-ray exam of foot
73630 X-ray exam of foot
73650 X-ray exam of heel
73660 X-ray exam of toe(s)
73700 Ct lower extremity w/o dye
73701 Ct lower extremity w/dye
73702 Ct lwr extremity w/o&w/dye
73706 Ct angio lwr extr w/o&w/dye
73718 Mri lower extremity w/o dye
73719 Mri lower extremity w/dye
73720 Mri lwr extremity w/o&w/dye
73721 Mri jnt of lwr extre w/o dye
73722 Mri joint of lwr extr w/dye
73723 Mri joint lwr extr w/o&w/dye
73725 Mr ang lwr ext w or w/o dye
74000 X-ray exam of abdomen
74010 X-ray exam of abdomen
74020 X-ray exam of abdomen
74022 X-ray exam series abdomen
74150 Ct abdomen w/o dye
74160 Ct abdomen w/dye
74170 Ct abdomen w/o & w/dye
74174 Ct angio abd&pelv w/o&w/dye
74175 Ct angio abdom w/o & w/dye
74176 Ct abd & pelvis
74177 Ct abd & pelv w/contrast
74178 Ct abd & pelv 1/>regns
74181 Mri abdomen w/o dye
74182 Mri abdomen w/dye
74183 Mri abdomen w/o & w/dye
74185 Mri angio abdom w orw/o dye
74210 Contrst x-ray exam of throat
74220 Contrast x-ray esophagus
74230 Cine/vid x-ray throat/esoph
74240 X-ray exam upper gi tract
74241 X-ray exam upper gi tract
74245 X-ray exam upper gi tract
74246 Contrst x-ray uppr gi tract
74247 Contrst x-ray uppr gi tract
74249 Contrst x-ray uppr gi tract
74250 X-ray exam of small bowel
74261 Ct colonography dx
74262 Ct colonography dx w/dye
74290 Contrast x-ray gallbladder
74291 Contrast x-rays gallbladder
74710 X-ray measurement of pelvis
75557 Cardiac MRI for morph
75559 Cardiac MRI w/stress img
75561 Cardiac MRI for morph w/dye
75563 Card MRI w/stress img & dye
75565 Card MRI veloc flow mapping
75571 Ct hrt w/o dye w/ca test
75572 Ct hrt w/3d image
75573 Ct hrt w/3d image congen
75574 Ct angio hrt w/3d image
75635 Ct angio abdominal arteries
76000 Fluoroscope examination
76010 X-ray nose to rectum
76100 X-ray exam of body section
76101 Complex body section x-ray
76102 Complex body section x-rays
76120 Cine/video x-rays
76125 Cine/video x-rays add-on
76376 3d render w/o postprocess
76377 3d rendering w/postprocess
76380 CAT scan follow-up study
76499 Radiographic procedure
76506 Echo exam of head
76510 Ophth us b & quant a
76511 Ophth us quant a only
76512 Ophth us b w/non-quant a
76513 Echo exam of eye water bath
76514 Echo exam of eye thickness
76516 Echo exam of eye
76519 Echo exam of eye
76536 Us exam of head and neck
76604 Us exam chest
76645 Us exam breast(s)
76700 Us exam abdom complete
76705 Echo exam of abdomen
76770 Us exam abdo back wall comp
76775 Us exam abdo back wall lim
76776 Us exam k transpl w/Doppler
76800 Us exam spinal canal
76801 Ob us < 14 wks single fetus
76802 Ob us < 14 wks addl fetus
76805 Ob us >/= 14 wks sngl fetus
76810 Ob us >/= 14 wks addl fetus
76811 Ob us detailed sngl fetus
76812 Ob us detailed addl fetus
76815 Ob us limited fetus(s)
76816 Ob us follow-up per fetus
76818 Fetal biophys profile w/nst
76819 Fetal biophys profil w/o nst
76820 Umbilical artery echo
76821 Middle cerebral artery echo
76825 Echo exam of fetal heart
76826 Echo exam of fetal heart
76827 Echo exam of fetal heart
76828 Echo exam of fetal heart
76856 Us exam pelvic complete
76857 Us exam pelvic limited
76870 Us exam scrotum
76881 Us xtr non-vasc complete
76882 Us xtr non-vasc lmtd
76885 Us exam infant hips dynamic
76886 Us exam infant hips static
76970 Ultrasound exam follow-up
76977 Us bone density measure
76999 Echo examination procedure
77051 Computer dx mammogram add-on
77052 Comp screen mammogram add-on
77055 Mammogram one breast
77056 Mammogram both breasts
77057 Mammogram screening
77058 Mri one breast
77059 Mri both breasts
77071 X-ray stress view
77072 X-rays for bone age
77073 X-rays bone length studies
77074 X-rays bone survey limited
77075 X-rays bone survey complete
77076 X-rays bone survey infant
77077 Joint survey single view
77078 Ct bone density axial
77080 Dxa bone density axial
77081 Dxa bone density/peripheral
77082 Dxa bone density vert fx
77084 Magnetic image bone marrow
78012 Thyroid uptake measurement
78013 Thyroid imaging w/blood flow
78014 Thyroid imaging w/blood flow
78015 Thyroid met imaging
78016 Thyroid met imaging/studies
78018 Thyroid met imaging body
78020 Thyroid met uptake
78070 Parathyroid nuclear imaging
78071 Parathyrd planar w/wo subtrj
78072 Parathyrd planar w/spect&ct
78075 Adrenal nuclear imaging
78099 Endocrine nuclear procedure
78102 Bone marrow imaging ltd
78103 Bone marrow imaging mult
78104 Bone marrow imaging body
78135 Red cell survival kinetics
78140 Red cell sequestration
78185 Spleen imaging
78190 Platelet survival kinetics
78195 Lymph system imaging
78199 Blood/lymph nuclear exam
78201 Liver imaging
78202 Liver imaging with flow
78205 Liver imaging (3D)
78206 Liver image (3d) with flow
78215 Liver and spleen imaging
78216 Liver & spleen image/flow
78226 Hepatobiliary system imaging
78227 Hepatobil syst image w/drug
78230 Salivary gland imaging
78231 Serial salivary imaging
78232 Salivary gland function exam
78258 Esophageal motility study
78261 Gastric mucosa imaging
78262 Gastroesophageal reflux exam
78264 Gastric emptying study
78278 Acute GI blood loss imaging
78282 GI protein loss exam
78290 Meckels divert exam
78291 Leveen/shunt patency exam
78299 GI nuclear procedure
78300 Bone imaging limited area
78305 Bone imaging multiple areas
78306 Bone imaging whole body
78315 Bone imaging 3 phase
78320 Bone imaging (3D)
78399 Musculoskeletal nuclear exam
78428 Cardiac shunt imaging
78445 Vascular flow imaging
78451 Ht muscle image spect sing
78452 Ht muscle image spect mult
78453 Ht muscle image planar sing
78454 Ht musc image planar mult
78456 Acute venous thrombus image
78457 Venous thrombosis imaging
78458 Ven thrombosis images bilat
78459 Heart muscle imaging (PET)
78466 Heart infarct image
78468 Heart infarct image (ef)
78469 Heart infarct image (3D)
78472 Gated heart planar single
78473 Gated heart multiple
78481 Heart first pass single
78483 Heart first pass multiple
78491 Heart image (pet) single
78492 Heart image (pet) multiple
78494 Heart image spect
78496 Heart first pass add-on
78499 Cardiovascular nuclear exam
78579 Lung ventilation imaging
78580 Lung perfusion imaging
78582 Lung ventilat&perfus imaging
78597 Lung perfusion differential
78598 Lung perf&ventilat diferentl
78599 Respiratory nuclear exam
78600 Brain image < 4 views
78601 Brain image w/flow < 4 views
78605 Brain image 4+ views
78606 Brain image w/flow 4 + views
78607 Brain imaging (3D)
78608 Brain imaging (PET)
78610 Brain flow imaging only
78630 Cerebrospinal fluid scan
78635 CSF ventriculography
78645 CSF shunt evaluation
78647 Cerebrospinal fluid scan
78650 CSF leakage imaging
78660 Nuclear exam of tear flow
78699 Nervous system nuclear exam
78700 Kidney imaging morphol
78701 Kidney imaging with flow
78707 K flow/funct image w/o drug
78708 K flow/funct image w/drug
78709 K flow/funct image multiple
78710 Kidney imaging (3D)
78730 Urinary bladder retention
78740 Ureteral reflux study
78761 Testicular imaging w/flow
78799 Genitourinary nuclear exam
78800 Tumor imaging limited area
78801 Tumor imaging mult areas
78802 Tumor imaging whole body
78803 Tumor imaging (3D)
78804 Tumor imaging whole body
78805 Abscess imaging ltd area
78806 Abscess imaging whole body
78807 Nuclear localization/abscess
78811 PET image ltd area
78812 PET image skull-thigh
78813 PET image full body
78814 PET image w/ct lmtd
78815 PET image w/ct skull-thigh
78816 PET image w/ct full body
78999 Nuclear diagnostic exam
91110 Gi tract capsule endoscopy
91111 Esophageal capsule endoscopy
92132 Cpmtr ophth dx img ant segmt
92133 Cmptr ophth img optic nerve
92134 Cptr ophth dx img post segmt
92227 Remote dx retinal imaging
92228 Remote retinal imaging mgmt
93303 Echo transthoracic
93304 Echo transthoracic
93306 TTE w/Doppler complete
93307 TTE w/o Doppler complete
93308 TTE f-up or lmtd
93320 Doppler echo exam heart [if used in conjunction with 93303-93304]
93321 Doppler echo exam heart [if used in conjunction with 93303, 93304, 93308]
93325 Doppler color flow add-on [if used in conjunction with 76825, 76826, 76827,76828, 93303, 93304, 93308]
93875 Extracranial study
93880 Extracranial study
93882 Extracranial study
93886 Intracranial study
93888 Intracranial study
93890 Tcd vasoreactivity study
93892 Tcd emboli detect w/o inj
93922 Upr/l xtremity art 2 levels
93923 Upr/lxtr art stdy 3+ lvls
93924 Lwr xtr vasc stdy bilat
93925 Lower extremity study
93926 Lower extremity study
93930 Upper extremity study
93931 Upper extremity study
93965 Extremity study
93970 Extremity study
93971 Extremity study
93975 Vascular study
93976 Vascular study
93978 Vascular study
93979 Vascular study
93980 Penile vascular study
93981 Penile vascular study
93990 Doppler flow testing
93998 Noninvas vasc dx study proc
A4641 Radiopharm dx agent noc
A4642 In111 satumomab
A9500 Tc99m sestamibi
A9501 Technetium TC-99m teboroxime
A9502 Tc99m tetrofosmin
A9503 Tc99m medronate
A9504 Tc99m apcitide
A9505 TL201 thallium
A9507 In111 capromab
A9508 I131 iodobenguate, dx
A9509 Iodine I-123 sod iodide mil
A9510 Tc99m disofenin
A9512 Tc99m pertechnetate
A9516 Iodine I-123 sod iodide mic
A9521 Tc99m exametazime
A9524 I131 serum albumin, dx
A9526 Nitrogen N-13 ammonia
A9528 Iodine I-131 iodide cap, dx
A9529 I131 iodide sol, dx
A9531 I131 max 100uCi
A9532 I125 serum albumin, dx
A9536 TC99m depreotide
A9537 Tc99m mebrofenin
A9538 Tc99m pyrophosphate
A9539 Tc99m pentetate
A9540 Tc99m MAA
A9541 Tc99m sulfur colloid
A9542 In111 ibritumomab, dx
A9544 I131 tositumomab, dx
A9546 CO57/58
A9547 In111 oxyquinoline
A9548 In111 pentetate
A9550 Tc99m gluceptate
A9551 Tc99m succimer
A9552 F18 fdg
A9553 Cr51 chromate
A9554 I125 iothalamate, dx
A9555 Rb82 rubidium
A9556 Ga67 gallium
A9557 Tc99m bicisate
A9558 Xe133 xenon 10mci
A9559 Co57 cyano
A9560 Tc99m labeled rbc
A9561 Tc99m oxidronate
A9562 Tc99m mertiatide
A9566 Tc99m fanolesomab
A9567 Technetium TC-99m aerosol
A9568 Technetium tc99m arcitumomab
A9569 Technetium TC-99m auto WBC
A9570 Indium In-111 auto WBC
A9571 Indium In-111 auto platelet
A9572 Indium In-111 pentetreotide
A9576 Inj prohance multipack
A9577 Inj multihance
A9578 Inj multihance multipack
A9579 Gad-base MR contrast NOS,1ml
A9580 Sodium fluoride F-18
A9584 Iodine I-123 ioflupane
A9700 Echocardiography contrast
G0130 Single energy x-ray study
G0202 Screeningmammographydigital
G0204 Diagnosticmammographydigital
G0206 Diagnosticmammographydigital
G0288 Recon, CTA for surg plan
G0389 Ultrasound exam AAA screen
Q0092 Set up port xray equipment
Q9951 LOCM>=400 mg/ml iodine,1ml
Q9953 Inj Fe-based MR contrast,1ml
Q9954 Oral MR contrast, 100ml
Q9955 Inj perflexane lip micros,ml
Q9956 Inj octafluoropropane mic,ml
Q9957 Inj perflutren lip micros,ml
Q9958 HOCM <=149 mg/ml iodine, 1ml
Q9959 HOCM 150-199mg/ml iodine,1ml
Q9960 HOCM 200-249mg/ml iodine,1ml
Q9961 HOCM 250-299mg/ml iodine,1ml
Q9962 HOCM 300-349mg/ml iodine,1ml
Q9963 HOCM 350-399mg/ml iodine,1ml
Q9964 HOCM>= 400mg/ml iodine, 1ml
Q9965 LOCM 100-199mg/ml iodine,1ml
Q9966 LOCM 200-299mg/ml iodine,1ml
Q9967 LOCM 300-399mg/ml iodine,1ml
R0070 Transport portable x-ray
R0075 Transport port x-ray multipl


INCLUDE the following CPT and HCPCS codes:

0073T Delivery comp imrt
0182T HDR elect brachytherapy
0190T Place intraoc radiation src
0197T Intrafraction track motion
19296 Place po breast cath for rad
19297 Place breast cath for rad
19298 Place breast rad tube/caths
20555 Place ndl musc/tis for rt
31643 Diag bronchoscope/catheter
32553 Ins mark thor for rt perq
32701 Thorax stereo rad targetw/tx
41019 Place needles h&n for rt
49327 Lap ins device for rt
49411 Ins mark abd/pel for rt perq
49412 Ins device for rt guide open
55875 Transperi needle place pros
55876 Place rt device/marker pros
55920 Place needles pelvic for rt
57155 Insert uteri tandems/ovoids
57156 Ins vag brachytx device
58346 Insert heyman uteri capsule
61770 Incise skull for treatment
61796 SRS cranial lesion simple
61797 SRS cran les simple addl
61798 SRS cranial lesion complex
61799 SRS cran les complex addl
61800 Apply SRS headframe add-on
63620 SRS spinal lesion
63621 SRS spinal lesion addl
77261 Radiation therapy planning
77262 Radiation therapy planning
77263 Radiation therapy planning
77280 Set radiation therapy field
77285 Set radiation therapy field
77290 Set radiation therapy field
77295 Set radiation therapy field
77299 Radiation therapy planning
77300 Radiation therapy dose plan
77301 Radiotherapy dose plan imrt
77305 Teletx isodose plan simple
77310 Teletx isodose plan intermed
77315 Teletx isodose plan complex
77321 Special teletx port plan
77326 Brachytx isodose calc simp
77327 Brachytx isodose calc interm
77328 Brachytx isodose plan compl
77331 Special radiation dosimetry
77332 Radiation treatment aid(s)
77333 Radiation treatment aid(s)
77334 Radiation treatment aid(s)
77336 Radiation physics consult
77338 Design mlc device for imrt
77370 Radiation physics consult
77371 Srs multisource
77372 Srs linear based
77373 Sbrt delivery
77399 External radiation dosimetry
77401 Radiation treatment delivery
77402 Radiation treatment delivery
77403 Radiation treatment delivery
77404 Radiation treatment delivery
77406 Radiation treatment delivery
77407 Radiation treatment delivery
77408 Radiation treatment delivery
77409 Radiation treatment delivery
77411 Radiation treatment delivery
77412 Radiation treatment delivery
77413 Radiation treatment delivery
77414 Radiation treatment delivery
77416 Radiation treatment delivery
77417 Radiology port film(s)
77418 Radiation tx delivery imrt
77421 Stereoscopic x-ray guidance
77422 Neutron beam tx simple
77423 Neutron beam tx complex
77427 Radiation tx management x5
77431 Radiation therapy management
77432 Stereotactic radiation trmt
77435 Sbrt management
77470 Special radiation treatment
77499 Radiation therapy management
77520 Proton trmt simple w/o comp
77522 Proton trmt simple w/comp
77523 Proton trmt intermediate
77525 Proton treatment complex
77600 Hyperthermia treatment
77605 Hyperthermia treatment
77610 Hyperthermia treatment
77615 Hyperthermia treatment
77620 Hyperthermia treatment
77750 Infuse radioactive materials
77761 Apply intrcav radiat simple
77762 Apply intrcav radiat interm
77763 Apply intrcav radiat compl
77776 Apply interstit radiat simpl
77777 Apply interstit radiat inter
77778 Apply interstit radiat compl
77785 HDR brachytx 1 channel
77786 HDR brachytx 2-12 channel
77787 HDR brachytx over 12 chan
77789 Apply surface radiation
77790 Radiation handling
77799 Radium/radioisotope therapy
79005 Nuclear rx oral admin
79101 Nuclear rx iv admin
79200 Nuclear rx intracav admin
79300 Nuclr rx interstit colloid
79403 Hematopoietic nuclear tx
79440 Nuclear rx intra-articular
79445 Nuclear rx intra-arterial
79999 Nuclear medicine therapy
92974 Cath place cardio brachytx
A4650 Implant radiation dosimeter
A9517 I131 iodide cap, rx
A9527 Iodine I-125 sodium iodide
A9530 I131 iodide sol, rx
A9543 Y90 ibritumomab, rx
A9545 I131 tositumomab, rx
A9563 P32 Na phosphate
A9564 P32 chromic phosphate
A9600 Sr89 strontium
A9604 Sm 153 lexidronam
A9699 Radiopharm rx agent noc
C1716 Brachytx, non-str, Gold-198
C1717 Brachytx, non-str,HDR Ir-192
C1719 Brachytx, NS, Non-HDRIr-192
C2616 Brachytx, non-str,Yttrium-90
C2634 Brachytx, non-str, HA, I-125
C2635 Brachytx, non-str, HA, P-103
C2636 Brachy linear, non-str,P-103
C2638 Brachytx, stranded, I-125
C2639 Brachytx,non-stranded,I-125
C2640 Brachytx, stranded, P-103
C2641 Brachytx, non-stranded,P-103
C2642 Brachytx, stranded, C-131
C2643 Brachytx, non-stranded,C-131
C2698 Brachytx, stranded, NOS
C2699 Brachytx, non-stranded, NOS
G0173 Linear acc stereo radsur com
G0251 Linear acc based stero radio
G0339 Robot lin-radsurg com, first
G0340 Robt lin-radsurg fractx 2-5
Q3001 Brachytherapy Radioelements


The physician self-referral prohibition does not apply to the following codes for dialysis-related drugs furnished in or by an ESRD facility if the conditions in §411.355(g) are satisfied:

No codes reported at this time.


The physician self-referral prohibition does not apply to the following tests if they are performed for screening purposes and satisfy the conditions in §411.355(h):

77052 Comp screen mammogram add-on
77057 Mammogram screening
80061 Lipid panel [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V81.2]
82270 Occult blood feces
82465 Assay bld/serum cholesterol [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V81.2]
82947 Assay glucose blood quant [only when billed with ICD-9-CM code V77.1]
82950 Glucose test [only when billed with ICD-9-CM code V77.1]
82951 Glucose tolerance test (GTT) [only when billed with ICD-9-CM code V77.1]
83718 Assay of lipoprotein [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V81.2]
84478 Assay of triglycerides [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V81.2]
G0103 PSA screening
G0106 Colon CA screen;barium enema
G0118 Glaucoma scrn hgh risk direc
G0120 Colon ca scrn; barium enema
G0123 Screen cerv/vag thin layer
G0124 Screen c/v thin layer by MD
G0141 Scr c/v cyto,autosys and md
G0143 Scr c/v cyto,thinlayer,rescr
G0144 Scr c/v cyto,thinlayer,rescr
G0145 Scr c/v cyto,thinlayer,rescr
G0147 Scr c/v cyto, automated sys
G0148 Scr c/v cyto, autosys, rescr
G0202 Screeningmammographydigital
G0328 Fecal blood scrn immunoassay
G0389 Ultrasound exam AAA screen
P3000 Screen pap by tech w md supv
P3001 Screening pap smear by phys

The physician self-referral prohibition does not apply to the following immunization and vaccine codes if they satisfy the conditions in §411.355(h):

90654 Flu vaccine no preserv, ID
90655 Flu vaccine no preserv 6-35m
90656 Flu vaccine no preserv 3 & >
90657 Flu vaccine 3 yrs im
90660 Flu vaccine nasal
90662 Flu vacc prsv free inc antig
90669 Pneumococcal vacc 7 val im
90670 Pneumococcal vacc 13 val im
90672 Flu vaccine 4 valent nasal
90732 Pneumococcal vaccine
90740 Hepb vacc ill pat 3 dose im
90743 Hep b vacc adol 2 dose im
90744 Hepb vacc ped/adol 3 dose im
90746 Hep b vaccine adult im
90747 Hepb vacc ill pat 4 dose im
G0432 EIA HIV-1/HIV-2 screen
G0433 ELISA HIV-1/HIV-2 screen
G0435 Oral HIV-1/HIV-2 screen
Q2034 Agriflu vaccine
Q2035 Afluria vacc, 3 yrs & >, im
Q2036 Flulaval vacc, 3 yrs & >, im
Q2037 Fluvirin vacc, 3 yrs & >, im
Q2038 Fluzone vacc, 3 yrs & >, im
Q2039 NOS flu vacc, 3 yrs & >, im

Negotiate Medical Bills Collections

Filing for bankruptcy is undoubtedly not the best option if you are faced with a towering hospital bill. You will be faced with a bad record on your credit report while at the same time limit your chances of getting a loan or even a job in the future. The credit card payment is merely a backup arrangement since the medical bills are transferred to a different source. Previously, you have a debt to the health care provider, but now you have a credit card company to deal with.
If you are finding difficulties in lowering down your costly medical bills due to lack of funding, one way to lower it down to a tolerable level is to negotiate medical bills. Just make sure that you will carry it out in an appropriate manner.
Initially, you can negotiate medical bills by going through the detailed statement of your bill in order to check that you are going to pay for the services that you availed. All you have to do is to check if the medical provider did not charge you with any additional services. Do not forget to know the expenses included in the medical bill that will be paid by your insurance provider.

The second step is to negotiate medical bills in a particular approach that is carried out in a delicate manner yet firm. Do not forget that acting inappropriately such as misbehaving or shouting with the service representatives will not make any things beneficial for you. The best move is to focus on trying to emphasize your point that the medical bill is too expensive for you and your limited finances. If you are going to negotiate medical bills, make sure that you are honest. Do not forget to bring all the records of your previous conversations regarding the issue along with the name of the officers that you have spoken to. Remember to avoid negotiating medical bills using the phone.
Lastly, you have to make it a point to be highly accurate in what you are striving for. During the negotiation process, it is important to be clear in your mind on what you want from the hospital or the other involved healthcare providers.
With these methods on negotiating your medical bills, it can greatly help you in case you have a limited budget or simply not yet prepared with a large amount for the payment of your medical bills.

Help With Hospital Bills

There are a number of issues in our lives that we are not prepared to deal with. One of the events that can catch us unprepared is during an illness or accident that would require hospitalization as well as other healthcare procedures that are expensive. Of course, those who are blessed with enough funding can easily pay out costly medical bills. On the other hand, those who have limited funding will find it difficult to pay off the medical bills. Majority of individuals need help with hospital bills that continue to pile up unless they are dealt with earlier. Due to lack of money to pay out these hospital bills, it will only become a source of stress and anxiety. Depending on the state where you are residing, there are certain options that you can choose from in order to help with hospital bills.

The best place to start searching for help with hospital bills is by enlisting the services of a medical billing provider. It is basically a third party that provides assistance in refining out hospital bills that are unpaid in order to ensure that there are no whatsoever errors. Additionally, they also make it a point to check if the pricing is reasonable on all the medical procedures while at the same time negotiating your debt when paying the hospital bills.

You can also look for help with hospital bills from your state, which is also a good option if there are programs being offered. A lot of states typically provide protection for their citizens against overly harsh practices on collection, particularly on medical bills. In some cases, certain states declared it unlawful to add wages as well as utilize collection practices that are aggressive for the retrieval of hospital bills that are unpaid. There are other states that offer health coverage to persons who do not have coverage that complies with the qualifications. For patients who are disabled or diagnosed with an incurable illness, the state as well as the federal governments typically offers programs that have full coverage.

Help with hospital bills are no longer needed if you will look for free medical help if possible. Take note that there are free medical clinics that typically provide services to any individual who require medical attention. There are even free prescription programs that help deal with the expenses on the medications. Nevertheless, medical attention is usually unexpected and occurs without any warning. It is best to make the most out of the free clinics and medications if possible.

Northbay Healthcare And Blue Cross

The saga continues… one year after my $6400 outragious bill from Nothbay Healthcare, Vacavalley Hospital, and Northbay Medical Center.

today i get a notice about how Blue Cross has set up a renegotiation with northbay healthcare because of thier rediculous scam prices…

if you notice on my post below about Northbay they are over DOUBLE the price of other hospitals and like to make up thier own ideas of how bad a patient is.

I guess thats pretty easy to do in an area where Kaiser is your only other option.

So it looks like blue cross wants to pay the normal hospital rates because they are offering northbay 30-50% of the normal rate.

Of course… northbay healthcare will get thier money somehow so i expect my next stomach ache to be at least $12,000!

They will most likely just install a credit card machine just to get in the door!

Heres an idea… why dont you charge normal rates and stop monopolizing!

PS: one of northbays employees told me i should just be uninsured so i dont have to pay… another said that i have to pay for uninsured patients and thats why its so high.

What Is Your Number One Question About Hospital Scams?

Email Address:

Vaca Valley Hospital Billing Update…

Ok… so its been over 10 months since i started dealing with the billing procedures and have found out that vaca valley hospital overcharges BIG TIME… no surprise there right.

Just in passing people have brought it up to me in random places… one gal i met said she just finished paying $1000 to vaca valley ER for her son… and she HAS FULL COVERAGE… they just told her there was a little extra there.

look at these stats…

the above shows that north bay and vaca valley is WAY out of line with their charges…  one lady who took me in the “i have a question on my bill” interrogation room actually suggested that i go uninsured.

the average price in san fransisco for a level 2 er visit is $481 (cpt code 99282) vaca valley = $1185

the average price for a CBC with auto diff (only found a 2006 price guide on a government health website) $115 vaca valley = $481

and on and on the list goes… they wanted over $4,000 for my previous ER level of 4… which since they have changed to a 2 since there was nothing wrong and nothing critical.

Has anyone else had issues with vaca valley hospital billing and overcharging… share your story below.