MERCY HOSPITAL ARDMORE, INC — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
239	AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC	$134,150	$87,198	—	—	66
461	BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC	$90,147	$58,596	—	—	41
478	BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC	$73,147	$47,546	—	—	70
289	ACUTE AND SUBACUTE ENDOCARDITIS WITH CC	$67,103	$43,617	—	—	71
617	AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC	$62,506	$40,629	—	—	71
288	ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC	$55,408	$36,015	—	—	71
397	APPENDIX PROCEDURES WITH MCC	$55,307	$35,949	—	—	70
520	BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC	$54,790	$35,613	—	—	71
950	AFTERCARE WITHOUT CC/MCC	$54,775	$35,604	—	—	69
095	BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC	$53,850	$35,003	—	—	71
RX-191027	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$51,028	$33,169	—	—	114
475	AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC	$49,492	$32,170	—	—	72
559	AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC	$48,928	$31,803	—	—	70
CASE-77295	3-D Radiotx Plan, Includ Dose-Volume Histograms3d	$45,572	$29,622	—	—	61
CASE-29867	Arthroscopy Knee Osteochondral Allograft	$42,157	$27,402	—	—	57
302	ATHEROSCLEROSIS WITH MCC	$41,766	$27,148	—	—	72
560	AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC	$41,556	$27,011	—	—	70
282	ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC	$37,987	$24,692	—	—	72
398	APPENDIX PROCEDURES WITH CC	$37,792	$24,565	—	—	70
949	AFTERCARE WITH CC/MCC	$35,761	$23,245	—	—	72
PX-500001365	Arthrect Brachial Perc or Open Ea Vessel	$35,578	$23,126	—	—	61
RX-229308	ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION\|RX AMT DISCARD/NOT ADMIN TO PT	$35,443	$23,038	—	—	114
281	ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	$35,280	$22,932	—	—	72
PX-500001364	Arthrect Abd Aorta Perc or Open W S&I	$35,178	$22,866	—	—	61
725	BENIGN PROSTATIC HYPERTROPHY WITH MCC	$34,187	$22,221	—	—	72
CASE-29888	Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj	$33,730	$21,924	—	—	57
410	BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC	$33,717	$21,916	—	—	72
280	ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC	$33,477	$21,760	—	—	72
PX-600001190	Atherectomy W Stent & Angio Sgl Lc	$32,290	$20,989	—	—	100
PX-600001189	Atherectomy W Stent & Angio Sgl Rc	$32,290	$20,989	—	—	100
PX-600001192	Atherectomy W Stent & Angio Sgl Ri	$32,290	$20,989	—	—	100
PX-600001188	Atherectomy W Stent & Angio Sgl Ld	$32,290	$20,989	—	—	100
PX-600001191	Atherectomy W Stent & Angio Sgl Lm	$32,290	$20,989	—	—	100
CASE-38525	Bx/Exc Lymph Node Open Deep Axillary Node	$32,288	$20,987	—	—	58
SUP-DLPB	BUNDLE DUAL LEAD PERM DLPB	$32,000	$20,800	—	—	60
409	BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC	$31,914	$20,744	—	—	72
896	ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC	$31,755	$20,641	—	—	71
SUP-SLPB	BUNDLE NERVE STIM SNGL LEAD PERM SLPB	$31,000	$20,150	—	—	60
561	AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC	$29,287	$19,036	—	—	70
PX-600001563	Bpg Oth/Thn Vein Carotid-Contralat Carotid	$29,034	$18,872	—	—	61
RX-204465	ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION	$28,735	$18,678	—	—	114
308	CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC	$28,275	$18,379	—	—	72
240	AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC	$28,238	$18,355	—	—	72
399	APPENDIX PROCEDURES WITHOUT CC/MCC	$27,839	$18,095	—	—	70
303	ATHEROSCLEROSIS WITHOUT MCC	$27,113	$17,624	—	—	72
RX-224155	BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRINGE\|RX AMT DISCARD/NOT ADMIN TO PT	$26,312	$17,103	—	—	114
PX-500001362	Arthrectomy Renal Perc or Open W S&I	$25,863	$16,811	—	—	63
886	BEHAVIORAL AND DEVELOPMENTAL DISORDERS	$25,822	$16,784	—	—	71
SUP-MICRAAV2SYSTEM	BUNDLE/ PACEMAKER MICRA TRANSCATH SYS AV2 MICRAAV2SYSTEM	$24,440	$15,886	—	—	60
SUP-32147002	ALLOGRAFT OSTEOCHONDRAL LAT FEM 32147002	$22,850	$14,853	—	—	60

Showing top 50 of 2,669 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.