Outpatient major cardiothoracic procedures with cardiac catheterization
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Outpatient major cardiothoracic procedures with cardiac catheterization Standard Service Package (SSP CA013). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS C1887 | Facility Fee | Intravascular-catheter Guided Infusion/Perfusion |
| HCPCS C1769 | Facility Fee | Controlled Insertion of Thin Wire for Diagnostic Mapping |
| HCPCS C1894 | Facility Fee | Insertion of Non-intracardiac Diagnostic/Therapeutic Device/Sheath |
| HCPCS 99152 | Facility Fee | Moderate Sedation with Monitor, Initial 15min, Age 5+ |
| HCPCS Q9967 | Facility Fee | Non-ionic low osmolar contrast, 300-399mg/ml iodine concentration per ml |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J1644 | Facility Fee | Intramuscular Injection of Anti-coagulant Heparin 1000 Units |
| HCPCS J2250 | Facility Fee | Intramuscular injection of 1mg midazolam hydrochloride |
| HCPCS 93452 | Facility Fee | Left Heart Catheterization with Imaging and Interpretation |
| HCPCS 93452 | Professional Fee | Left Heart Catheterization with Imaging and Interpretation |
| HCPCS 99152 | Professional Fee | Moderate Sedation with Monitor, Initial 15min, Age 5+ |
| HCPCS 80048 | Facility Fee | Basic metabolic panel including calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and BUN |