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
Exc Branchial Cleft Cyst Below Subq Tiss&/Phrynx
The 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.
Filter by billing methodology
Filter by billing class
49 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $65.00 | $65.00 – $65.00 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $421.82 | $421.82 – $421.82 |
| 3 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $65.00 | $65.00 – $65.00 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $294.00 | $294.00 – $294.00 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $431.20 | $431.20 – $431.20 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $25.85 | $25.85 – $25.85 |
| 7 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $248.52 | $248.52 – $248.52 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $248.52 | $248.52 – $248.52 |
| 9 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $605.06 | $605.06 – $605.06 |
| 10 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $294.00 | $294.00 – $294.00 |
| 11 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $2,245 | $2,245 – $2,245 |
| 12 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $415.92 | $415.92 – $415.92 |
| 13 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $369.07 | $369.07 – $369.07 |
| 14 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 1 | $2,973 | $2,973 – $2,973 |
| 15 | Greater Baltimore Medical Center Towson, MD professional · fee schedule · both | 1 | $449.56 | $449.56 – $449.56 |
| 16 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $421.82 | $421.82 – $421.82 |
| 17 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $715.14 | $197.28 – $1,233 |
| 18 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $2,820 | $2,820 – $2,820 |
| 19 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $2,245 | $2,245 – $2,245 |
| 20 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · fee schedule · outpatient | 1 | $415.92 | $415.92 – $415.92 |
| 21 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $344.79 | $84.51 – $605.06 |
| 22 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $3,536 | $297.00 – $5,268 |
| 23 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 3 | $3,536 | $297.00 – $5,268 |
| 24 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · fee schedule · outpatient | 3 | $3,536 | $297.00 – $5,268 |
| 25 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient | 1 | $408.74 | $408.74 – $408.74 |
← Payers reporting CPT 42815 · Snapshot 20261108T203506Z-bb90dbab