Pricing: Physician’s Office vs Hospital

Medical procedure pricing is deliberately difficult to obtain and varies widely based on the site of service for the procedure. As an example, let’s look at an epidural steroid injection, code 64483, Medicare fee schedule. This data is taken from the American Society of Interventional Pain Physicians web site:

64483 performed in a hospital the hospital gets $764.80 plus $114.96 for the physician performing the procedure totaling $879.76. This does not include the additional charges for sedation plus the CRNA fee.

The same procedure performed in a physician’s office costs $232.09!

This is only the Medicare allowable fee schedule. The hospital charges much more than this minimum allowed by Medicare. This has implications for patients that have health insurance as well as those without insurance. Private insurers pay much more than Medicare rates to hospitals. You are responsible for a copay and deductible on your plan.

Your out of pocket cost using health insurance may be thousands of dollars while it would cost a few hundred paying cash for your procedure in our office based practice.

You are free to chose where you wish to be treated. You are not limited to a facility that the referring doctor has a financial interest in or is employed by a group that also owns the treatment facility. We believe in transparency and patient choice. Our fee schedule is listed below.

Sphenopalatine Ganglion Block $50 (99499)
Brachial Plexus $100 (64415)
Ilioinguinal Nerve $120 (64425)
New Patient Visit $95 (99204)
Follow up Visit $75 (99214)
Greater and Lesser Occipital Nerve Blocks $120 (64405 and 64450)
Trigger Point Inj 1-2 levels $40 (20552)
Trigger Point inj 3+ levels $45 (20553)

The following procedure prices all include fluoroscopic guidance:

Lumbar Sympathetic $240 (64520)

Cervical Epidural $220 (62321)

Lumbar Epidural  $220 (62323)

Intercostal Nerve Block $200 (64421)

Z joint Cervical $175 first level (64490) $85 added additional level (64491)

Lumbar RFA $400 first level (64635) $150 added additional level (64636)

Genicular RFA $275 (64640)

Genicular Diagnostic $150 (64450)

Greater and Lesser Occipital Nerve Blocks $120 (64405 and 64450)

Small Joint injection $100 (20600)

Medium Joint injection $100 (20605)

Large Joint injection/ Trochanteric Bursa $100 (20610)

SI joint injection $140 (27096)

Transforaminal Epidural  $200 first level (64483) add $100 additional levels (64484)

Facet injection Lumbar $160 first level (64493) add $80 each additional level (64494, 64495)

Suprascapular RFA $275 (64640)

Suprascapular Diagnostic $130 (64418)

Pudential Nerve $190 (64430)