Repair of a superficial wound, 7.6 to 12.5 cm at Avera DeSmet

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Repair Lac Simple 7.6-12.5 CM

De Smet, SD

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How this price compares nationally

Avera DeSmet’s median price of $274 is 6% below the median hospital's median price ($290), higher than 48% of the 2,402 hospitals reporting CPT 12004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 12004 at Avera DeSmet

Negotiated rates from the hospital’s own file: 4 payers, 15 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Medica com fee schedule · both	$146	$146	—	—	—	$146 – $146
2	Medica ind fee schedule · both	$146	$146	—	—	—	$146 – $146
3	Healthpartners com fee schedule · both	$157	$157	—	—	—	$157 – $157
4	Wellmark ppo fee schedule · both	$159	$159	—	—	—	$159 – $159
5	UnitedHealthcare com fee schedule · both	$200	$200	—	—	—	$200 – $200
6	Medica ind percent of total billed charges · inpatientfrom % of charges	$244	$244	—	—	—	$244 – $244
7	Medica ind percent of total billed charges · outpatientfrom % of charges	$249	$249	—	—	—	$249 – $249
8	Wellmark ppo percent of total billed charges · inpatientfrom % of charges	$274	$274	—	—	—	$274 – $274
9	Wellmark ppo percent of total billed charges · outpatientfrom % of charges	$274	$274	—	—	—	$274 – $274
10	Medica com percent of total billed charges · inpatientfrom % of charges	$290	$290	—	—	—	$290 – $290
11	Medica com percent of total billed charges · outpatientfrom % of charges	$296	$296	—	—	—	$296 – $296
12	UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges	$320	$320	—	—	—	$320 – $320
13	UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges	$320	$320	—	—	—	$320 – $320
14	Healthpartners com percent of total billed charges · inpatientfrom % of charges	$356	$356	—	—	—	$356 – $356
15	Healthpartners com percent of total billed charges · outpatientfrom % of charges	$356	$356	—	—	—	$356 – $356

Last updated: Apr 1, 2026

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