SGMC HEALTH — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C1767	GENERATOR NEUROSTIMULATOR THK7MM 18GM 10ML VAGUS NERVE DUAL PIN CYBERNETIC PROSTHESIS DEMIPULSE	$95,409	$71,557	—	—	16
CPT® 33270	Hc Ins Subq Defib 33270	$77,591	$58,193	—	—	16
CPT® 33231	HC INSERT PULSE GEN W/MULTI LEADS	$75,358	$56,519	—	—	16
CPT® 33264	Hc Rpl Bvi Icd 33264	$62,053	$46,540	—	—	16
C1882	ICD DUAL CHAMBER IPERIA HF-T DF-4 PRO MRI	$61,544	$46,158	—	—	16
J9359	LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR	$59,436	$44,577	—	—	16
CPT® 33249	Hc Insr Icd Sys 33249	$58,669	$44,002	—	—	16
CPT® 33262	Hc Rpl Sng Icd 1 Ld 33262	$56,083	$42,062	—	—	16
CPT® 33263	Hc Rpl Dl Icd 2 Ld 33263	$56,083	$42,062	—	—	16
J9266	PEGASPARGASE 750 UNIT/ML IJ SOLN	$55,616	$41,712	—	—	16
CPT® 33230	HC INSERT PULSE GEN W/DUAL LEADS	$52,903	$39,677	—	—	16
CPT® 33240	HC INSERT PULSE GEN W/SINGLE LEAD	$52,903	$39,677	—	—	16
J9229	INOTUZUMAB OZOGAMICIN 0.9 MG IV SOLR	$51,873	$38,905	—	—	16
CPT® 93653	HC COMPRE EP EVAL ABLAT J 3D MAPPING TX SVT	$49,230	$36,923	—	—	16
CPT® 93654	HC COMPRE EP EVAL ABLAT J 3D MAPPING TX VT	$49,230	$36,923	—	—	16
CPT® 93656	HC COMPRE EP EVAL ABLAT J ATRIAL FIB PULM VEIN ISOLATION	$49,230	$36,923	—	—	16
CPT® 35371	Hc Endar Fem Art 35371	$49,032	$36,774	—	—	16
CPT® 0238T	Hc Arthr Perip Iliacart0238t	$46,517	$34,888	—	—	16
J2507	PEGLOTICASE 8 MG/ML IV SOLN	$46,468	$34,851	—	—	16
C1721	ICD DUAL CHAMBER IPERIA 7 DR-T	$45,373	$34,030	—	—	16
C1722	ICD SINGLE ILIVIA 7 VR-T	$44,745	$33,559	—	—	16
C1784	GRAFT ENDOVASCULAR STENT L12CM DIA23X14.5MM RECOMMENDED INTRODUCER SHEATH 15FR EPTFE FEP NITINOL CON	$42,776	$32,082	—	—	16
CPT® C9607	Hc Pci Des Cto Any C9607	$42,511	$31,883	—	—	16
C1813	PROSTHESIS PENILE L14cm Dia12.5mm INFLATABLE TWO PIECE W PREFILLED PRECONNECTED IMPLANTS AMS AMBICOR	$41,538	$31,154	—	—	16
CPT® 93655	HC INTRACARD CATHETER ABLAT ARRHYTHMIA ADD-ON	$40,169	$30,127	—	—	16
J9309	POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR	$39,010	$29,258	—	—	16
CPT® 33274	HC TCAT INSERT/REPL PERM LDLS PM W/IMG	$36,845	$27,634	—	—	16
CPT® 93622	HC COMPRE ELECTRPHYSIOL XM W/LT VENTRIC PACING & RECORDING	$36,465	$27,349	—	—	16
CPT® 36906	Hc Thrmbc/nfs Dialy Cir Ir	$36,003	$27,002	—	—	16
CPT® 93462	HC LT HEART CATH BY TRANSEPTAL PUNCTURE	$35,420	$26,565	—	—	16
CPT® 33229	Hc Gen Chg Biv Pcmk 33229	$34,425	$25,819	—	—	16
C2622	CYLINDER PENILE PROSTHESIS L12CM DIA12MM CONCEALABLE SPECTRA	$34,290	$25,717	—	—	16
CPT® C9602	Hc Atherec/stent Des C9602	$33,831	$25,373	—	—	16
CPT® C9606	Hc Pci Des Mi Culprit C9606	$32,707	$24,530	—	—	16
CPT® 93609	HC INTRAVENTRIC &/OR ATRIAL MAPPING TACHYCARD W/CATH MA	$30,994	$23,246	—	—	16
CPT® 37241	Hc Vasc Emb/occ Ven 37241	$30,378	$22,784	—	—	16
CPT® 37242	Hc Vasc Emb/occ Art 37242	$30,378	$22,784	—	—	16
CPT® 37243	Hc Vas Emb Artven Infrc37243	$30,378	$22,784	—	—	16
CPT® 37244	Hc Vas Emb Artven Hemg 37244	$30,378	$22,784	—	—	16
CPT® 37215	Hc Trncth Stnt W Embo 37215	$30,319	$22,739	—	—	16
CPT® 37230	Hc Tib/per Revasc W/stent 37230	$29,739	$22,304	—	—	16
CPT® 37227	Hc Fem/pop Revasc Stnt & Ather 37227	$29,739	$22,304	—	—	16
CPT® 37229	Hc Tib/per Revasc W Ther 37229	$29,739	$22,304	—	—	16
CPT® 37231	Hc Tib/per Revasc Stent & Ather 37231	$29,739	$22,304	—	—	16
C1820	SPACER SPINAL 8MM GOLD INDIRECT DECOMPRESSION STERILE SUPERION	$28,260	$21,195	—	—	16
CPT® 92924	Hc Ather Ptca Init 92924	$27,761	$20,821	—	—	16
CPT® 92937	Hc Pci Grft Sng Vsl 92937	$27,761	$20,821	—	—	16
C1778	LEAD NEUROSTIMULATOR L43CM ID2MM LEFT VAGUS NERVE STIMULATION BIPOLAR SILICONE VNS THERAPY	$27,340	$20,505	—	—	16
J7170	EMICIZUMAB-KXWH 105 MG/0.7ML SC SOLN	$25,530	$19,148	—	—	16
CPT® 36903	Hc Dialys Cth&insr Stnt 36903	$24,941	$18,706	—	—	16

Showing top 50 of 4,443 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.