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
Rcnstj Pst Tibl Tdn W/Exc Accessory Tarsl Navclr|RIGHT SIDE
Low
$40
Average
$1.6k
Median
$432
High
$6.1k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
36 hospitals; the 90th percentile is 55.3× 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.
Filter by billing methodology
Filter by billing class
44 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · outpatient | 1 | $3.7k | $3.7k | — | — | 1–10 | $3.7k – $3.7k |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $329 | $329 | — | — | — | $329 – $329 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 4 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $393 | $393 | — | — | — | $393 – $393 |
| 6 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $472 | $472 | — | — | — | $472 – $472 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $509 | $509 | — | — | — | $509 – $509 |
| 9 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $336 | $336 | — | — | — | $336 – $336 |
| 10 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 1 | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 11 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $329 | $329 | — | — | — | $329 – $329 |
| 12 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 13 | Kirksville Missouri Hospital Co LLC PO Box C8502 Kirksville, MO facility · fee schedule · outpatient | 1 | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 14 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 15 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 16 | Longview Medical Center LP Longview, TX facility · fee schedule · outpatient | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 17 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · other · outpatient | 2 | $1.7k | $1.7k | $220 | 13% | — | $1.5k – $1.9k |
| 18 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 19 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 20 | NYU Langone New York, NY case rate · both | 15 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 21 | NYU Langone Mineola, NY case rate · both | 15 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 22 | NYU Langone Brooklyn, NY case rate · both | 15 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 23 | NYU Langone New York, NY case rate · both | 15 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 24 | NYU Langone Hospital?Suffolk Patchogue, NY case rate · both | 15 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 25 | North Memorial Health Care Robbinsdale, MN professional · fee schedule · both | 1 | $357 | $357 | — | — | — | $357 – $357 |
← Payers reporting CPT 28238 · Snapshot 20261112T181611Z-3fa9fb76