CPT 21395
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
OPN TX ORBIT PERIORBT W/GRFT
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$5.2k
Median
$5.4k
High
$35k
Showing only prices reported under the other methodology. Choose another in the filter below to change the chart. 109 hospitals; the 90th percentile is 8.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
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Reflects a payer-specific billing methodology not covered by the standard categories.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Henry Ford Health Novi, MI | $1.1k | $1.2k | $97 | 8% | — | $1.1k – $1.4k |
| 2 | Northside Hospital, Inc. Lawrenceville, GA | $9.0k | $8.3k | $2.6k | 31% | — | $844 – $12k |
| 3 | Spohn Hospital Beeville Beeville, TX | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 4 | St Luke's Magic Valley Regional Medical Center, LTD Twin Falls, ID | $6.6k | $6.7k | $186 | 3% | — | $6.6k – $7.3k |
| 5 | Northside Hospital, Inc. Atlanta, GA | $9.1k | $8.4k | $2.7k | 32% | — | $844 – $12k |
| 6 | Spohn Hospital Alice Alice, TX | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 7 | St. Frances Cabrini Hospital Alexandria, LA | $5.3k | $5.3k | — | — | — | $5.3k – $5.3k |
| 8 | University Medical Center of Southern Nevada Las Vegas, NV | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 9 | Fairfield Medical Center Lancaster, OH | $9.0k | $9.0k | $2.2k | 25% | — | $6.8k – $11.2k |
| 10 | Nationwide Children's Hospital Columbus, OH | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
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