Mercy Hospital, Inc

(620)-345-6391

info@mercyh.org

218 E Pack St, Moundridge Ks, 67107

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Select a category

Laboratory & Pathology

Medicine & Surgery

Occupational Therapy

Patient Visits for Evaluation & Management

Physical Therapy

Radiology

Speech Therapy

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Abdomen Series w/ Chest X-ray, 1 View


HCPCS: 74022

Abdomen w/ Decub/Erect X-ray


HCPCS: 74019

Abdomen X-ray, 1 View


HCPCS: 74018

Alanine Aminotransferase


HCPCS: 84460

Albumin Level


HCPCS: 82040

Ammonia Level


HCPCS: 82140

Amylase Level


HCPCS: 82150

Anaerobic Culture


HCPCS: 87075

Ankle X-ray, 2 Views, Bilateral


HCPCS: 73600

Ankle X-ray, Bilateral


HCPCS: 73610

Antibody ID - Red Cross


HCPCS: 86870

Antibody Screen GL


HCPCS: 86850

Antineutrophil Cytophasmic Antibodies (ANCA)


HCPCS: 86256

Antinuclear Antibody (ANA) Panel, Quantitative


HCPCS: 86225

Antinuclear Antibody (ANA) Screen


HCPCS: 86038

Aspartate Aminotransferase


HCPCS: 84450

Assay of Homocysteine


HCPCS: 83090

Assay pf Methylmalonic Acid, Serum


HCPCS: 83921

Automated urinalysis test


HCPCS: 81003

B-Type Natriuretic Peptide


HCPCS: 83880

Basic metabolic panel


HCPCS: 80048

Beta Human Chorionic Gonadotropin Quantitative


HCPCS: 84702

Bilirubin Total


HCPCS: 82247

Blood Culture


HCPCS: 87040

Blood test, clotting time


HCPCS: 85610

Blood test, thyroid stimulating hormone (TSH)


HCPCS: 84443

Blood typing serologic RH(D)


HCPCS: 86901

C-Reactive Protein


HCPCS: 86140

Calcium Ionized


HCPCS: 82330

Calcium Level Total


HCPCS: 82310

Canalith Repositioning Charge


HCPCS: 95992

Carbamazepine Level


HCPCS: 80156

Carcinoembryonic Antigen


HCPCS: 82378

Cerebrospinal Fluid Culture


HCPCS: 87205

Chest X-ray, 2 Views


HCPCS: 71046

Chest X-ray, 3 Views


HCPCS: 71047

Chlam/GC Nucleic Acid Screen


HCPCS: 87491

Cholesterol


HCPCS: 82465

Clavicle Bilateral X-ray


HCPCS: 73000

Colonoscopy, diagnostic, including collection of specimen(s)


HCPCS: 45378

Colonoscopy, with biopsy, single or multiple


HCPCS: 45380

Colonoscopy, with removal of polyp(s) by snare technique


HCPCS: 45385

Complete blood cell count, with differential white blood cells, automated


HCPCS: 85025

Complete blood count, automated


HCPCS: 85027

Comprehensive Metabolic Panel


HCPCS: 80053

Cortisol AM


HCPCS: 82533

Covid-19, Influenza A/B, RSV Panel


HCPCS: 87631

Creatine Kinase


HCPCS: 82550

Creatinine


HCPCS: 82565

Crystal Exam, Synovial Fluid


HCPCS: 89060

CT scan of abdomen and pelvis with contrast


HCPCS: 74177

CT scan, head or brain, without contrast


HCPCS: 70450

CT scan, pelvis, with contrast


HCPCS: 72193

Culture ID


HCPCS: 87076

D-Dimer


HCPCS: 85379

Digoxin Level


HCPCS: 80162

Direct Antiglobulin Test


HCPCS: 86880

E-STIM Manual/15min Units


HCPCS: 97032

Elbow Xray, 2 Views, Right


HCPCS: 73070

Electrical Stimulation Unattended Charge


HCPCS: G0283

Electrocardiogram (ECG), with at least 12 leads, without interpretation and report


HCPCS: 93005

Electrolyte Panel


HCPCS: 80051

Estradiol Level


HCPCS: 82670

Ethanol Level


HCPCS: 80320

Femur Min X-ray, 2 Views, Right


HCPCS: 73552

Ferritin


HCPCS: 82728

Finger Thumb Xray, Right


HCPCS: 73140

Flu vaccination


HCPCS: G0008

Folate Level


HCPCS: 82746

Follicle Stimulating Hormone


HCPCS: 83001

Foot X-ray, 2 Views, Right


HCPCS: 73620

Foot X-ray, Right


HCPCS: 73630

Forearm X-ray, 2 Views, Right


HCPCS: 73090

Gait Training Units


HCPCS: 97116

Gamma Glutamyl Transferase


HCPCS: 82977

GI Panel - Bio Fire


HCPCS: 87507

Giardia


HCPCS: 87329

Glucose Level


HCPCS: 82947

Group A Strep Culture


HCPCS: 87081

Hand X-ray, 2 Views, Right


HCPCS: 73120

Helicobacter IgG


HCPCS: 86677

Hemoglobin


HCPCS: 85018

Hemoglobin A1c


HCPCS: 83036

Hep B Surface Antibody


HCPCS: 86706

Hepatitis B Surface Antigen


HCPCS: 87340

Hepatitis C Total Ab


HCPCS: 86803

Hepatitis Panel RML


HCPCS: 80074

Herpes Simplex 1 or 2 AB


HCPCS: 87529

High Complex Units


HCPCS: 97167

High Complex Units


HCPCS: 97163

Hip X-ray, 1 View, Right


HCPCS: 73501

Hip X-ray, 2-3 Views, Right


HCPCS: 73502

HIV Screen


HCPCS: 86703

Humerus X-ray, Right


HCPCS: 73060

Immunoassay for tumor antigen


HCPCS: 86301

Immunoelectrophoresis Random, Urine


HCPCS: 86335

Immunoelectrophoresis, Serum


HCPCS: 84165

Immunoglobulins, Quant Serum


HCPCS: 82784

Influenza A and B MOL


HCPCS: 87502

Insertion of bladder catheter


HCPCS: 51701

Insertion of temporary indwelling bladder


HCPCS: 51702

Iontophoresis Charges


HCPCS: 97033

Iron Level


HCPCS: 83540

Kidney function panel test


HCPCS: 80069

Knee X-ray, 1 or 2 Views, Right


HCPCS: 73560

Knee X-ray, 3 Views, Right


HCPCS: 73562

Lactate Dehydrogenase


HCPCS: 83615

Lactic Acid


HCPCS: 83605

Lamotrigine


HCPCS: 80175

LDL Direct


HCPCS: 83721

Levetiracetam


HCPCS: 80177

Lipase Level


HCPCS: 83690

Lipid Panel Screen


HCPCS: 80061

Liver function blood test panel


HCPCS: 80076

Low Complex Units


HCPCS: 97165

Low Complex Units


HCPCS: 97161

Lower Back X-ray, minimum four views


HCPCS: 72110

Luteinizing Hormone


HCPCS: 83002

Magnesium Level


HCPCS: 83735

Manual Differential


HCPCS: 85007

Manual Therapy Charge Units


HCPCS: 97140

Manual urinalysis test with examination using microscope


HCPCS: 81001

Measles, IgG


HCPCS: 86765

Mechanical Traction Provided Units


HCPCS: 97012

Microalbumin Level Urine


HCPCS: 82043

Microalbumin/Creatinine Ratio, Urine


HCPCS: 82570

Moderate Complex Units


HCPCS: 97166

Moderate Complex Units


HCPCS: 97162

Morphine Confirmation


HCPCS: 80363

Mumps Ab, IgG/IgM


HCPCS: 86735

Neuromuscular Reeducation Units


HCPCS: 97112

Osmolality, Serum


HCPCS: 83930

Osmolality, Urine


HCPCS: 83935

Ova and Parasite Exam


HCPCS: 87209

Pelvis X-ray, 1 or 2 Views


HCPCS: 72170

Pelvis X-ray, Minimum 3 Views


HCPCS: 72190

Phenytoin Level


HCPCS: 80185

Phosphorus Level


HCPCS: 84100

Physical therapy, therapeutic exercise


HCPCS: 97110

Potassium Level


HCPCS: 84132

Prealbumin Level


HCPCS: 84134

Progesterone Level


HCPCS: 84144

Prolactin Level


HCPCS: 84146

Prostate Specific Antigen Screen


HCPCS: G0103

Protein 24 Hour Urine


HCPCS: 84156

Protein electrophoresis, Urine Random


HCPCS: 84166

Protein Total


HCPCS: 84155

PSA (Prostate Specific Antigen)


HCPCS: 84154

Rapid Clostridium Difficile Toxin A/B with QC


HCPCS: 87493

Rapid Mono Screen with QC


HCPCS: 86308

Rapid Occult Blood Diagnostic Stool


HCPCS: 82274

Rapid Occult Blood Screen Stool


HCPCS: 82270

Rapid Pregnancy Test Urine with QC


HCPCS: 81025

Rapid Pregnancy Test with QC


HCPCS: 84703

Rapid Respiratory Synctial Virus Screen with QC


HCPCS: 87807

Rapid Strep A Screen with QC


HCPCS: 87880

Rapid Urease Test with QC


HCPCS: 87077

Repair of groin hernia patient age 5 years or older


HCPCS: 49505

Repair of incarcerated Hernia


HCPCS: 49561

Respiratory Virus Panel-PCR


HCPCS: 87633

Reticulocyte Count Automated


HCPCS: 85045

Rheumatoid Factor


HCPCS: 86431

Ribs X-ray, 2 Views, Right


HCPCS: 71100

Rubella IgG


HCPCS: 86762

Sedimentation Rate


HCPCS: 85652

Self Care, Home Management Charges


HCPCS: 97535

Serum Protein Electrophoresis(SPEP)


HCPCS: 86334

Shigella typing


HCPCS: 87070

Shoulder X-ray, Right


HCPCS: 73030

Speech Behavral Qualit Analys Voice Units


HCPCS: 92524

Speech Eval of Speech Fluency Units


HCPCS: 92521

Speech Eval Speech Production Units


HCPCS: 92522

Speech Sound Language Comprehen Eval Units


HCPCS: 92523

Spine Cervical X-ray, 2 or 3 Views


HCPCS: 72040

Spine Lumbosacral X-ray, 2 or 3 Views


HCPCS: 72100

Spine Thoracic X-ray, 2 Views


HCPCS: 72070

Stool Culture with Shiga toxin


HCPCS: 87045

Swallow Evaluation Charge


HCPCS: 92610

Tacrolimus (Prograf)


HCPCS: 80197

Tease mount


HCPCS: 87086

Testosterone Level Total


HCPCS: 84403

THC GC/MS Confirmaiton


HCPCS: 80349

Therapeutic Activities Charge


HCPCS: 97530

Therapeutic Drug Assay


HCPCS: 80299

Thromboplastin time, partial (PTT); plasma or whole blood


HCPCS: 85730

Thyroglobulin Ab screen


HCPCS: 86376

Thyroglobulin, Tumor Marker


HCPCS: 84432

Thyroxine


HCPCS: 84436

Thyroxine Free


HCPCS: 84439

Tibia/Fibula X-ray, Right


HCPCS: 73590

Toe(s) X-ray


HCPCS: 73660

Treatment of Speech, Language, Voice Units


HCPCS: 92507

Treatment of Swallowing Dysfunction Unit


HCPCS: 92526

Triglycerides


HCPCS: 84478

Triiodothyronine Free


HCPCS: 84481

Triiodothyronine Reverse T3


HCPCS: 84482

Troponin-I


HCPCS: 84484

Type and Screen GL


HCPCS: 86900

UA Microscopic


HCPCS: 81015

Ultrasound Units


HCPCS: 97035

Uric Acid


HCPCS: 84550

Urine Drug Screen


HCPCS: 80305

Vaginitis Panel


HCPCS: 87660

Valproic Acid


HCPCS: 80164

Vanco Level


HCPCS: 80202

Venous Draw


HCPCS: 36415

Vitamin B12 Level


HCPCS: 82607

Vitamin D 25 Hydroxy Level


HCPCS: 82306

Vitamin D,1,25-Dihydroxy


HCPCS: 82652

Wrist X-ray, 2 Views, Bilateral


HCPCS: 73100

Wrist X-ray, Right


HCPCS: 73110

Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus


HCPCS: 76805

PROCEDURE UNAVAILABLE

Biopsy of prostate gland


HCPCS: 55700

PROCEDURE UNAVAILABLE

Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope


HCPCS: 43239

PROCEDURE UNAVAILABLE

Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities


DRG: 216

PROCEDURE UNAVAILABLE

Carotid Doppler Bilateral


HCPCS: 93880

PROCEDURE UNAVAILABLE

Cervical spinal fusion without comorbid conditions (CC) or major comorbid conditions or complications (MCC)


DRG: 473

PROCEDURE UNAVAILABLE

Chemo anti-neopl


HCPCS: 96401

PROCEDURE UNAVAILABLE

Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope


HCPCS: 43235

PROCEDURE UNAVAILABLE

Echo Doppler


HCPCS: 93320

PROCEDURE UNAVAILABLE

Electrocardiogram tracing


HCPCS: 93017

PROCEDURE UNAVAILABLE

Electrocardiogram, routine, with interpretation and report


HCPCS: 93000

PROCEDURE UNAVAILABLE

Esophagoscopy w/Biopsy


HCPCS: 43202

PROCEDURE UNAVAILABLE

Family psychotherapy, including patient, 50 min


HCPCS: 90847

PROCEDURE UNAVAILABLE

Family psychotherapy, not including patient, 50 min


HCPCS: 90846

PROCEDURE UNAVAILABLE

Group psychotherapy


HCPCS: 90853

PROCEDURE UNAVAILABLE

Hearing screening


HCPCS: 92587

PROCEDURE UNAVAILABLE

Immunotheropy injections


HCPCS: 95117

PROCEDURE UNAVAILABLE

Initial new patient preventive medicine evaluation (18-39 years)


HCPCS: 99385

PROCEDURE UNAVAILABLE

Initial new patient preventive medicine evaluation (40-64 years)


HCPCS: 99386

PROCEDURE UNAVAILABLE

Injection of substance into spinal canal of lower back or sacrum using imaging guidance


HCPCS: 62323

PROCEDURE UNAVAILABLE

Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance


HCPCS: 64483

PROCEDURE UNAVAILABLE

Insertion of catheter into left heart for diagnosis


HCPCS: 93452

PROCEDURE UNAVAILABLE

Irrigation of implanted venous access device for drug delivery systems


HCPCS: 96523

PROCEDURE UNAVAILABLE

Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications (MCC)


DRG: 470

PROCEDURE UNAVAILABLE

Mammography of both breasts


HCPCS: 77066

PROCEDURE UNAVAILABLE

Mammography of one breast


HCPCS: 77065

PROCEDURE UNAVAILABLE

Mammography, screening, bilateral


HCPCS: 77067

PROCEDURE UNAVAILABLE

MRI scan of brain before and after contrast


HCPCS: 70553

PROCEDURE UNAVAILABLE

MRI scan of leg joint


HCPCS: 73721

PROCEDURE UNAVAILABLE

MRI scan of lower spinal canal


HCPCS: 72148

PROCEDURE UNAVAILABLE

New patient office of other outpatient visit, typically 45 min


HCPCS: 99204

PROCEDURE UNAVAILABLE

New patient office of other outpatient visit, typically 60 min


HCPCS: 99205

PROCEDURE UNAVAILABLE

New patient office or other outpatient visit, typically 30 min


HCPCS: 99203

PROCEDURE UNAVAILABLE

Obstetric blood test panel


HCPCS: 80055

PROCEDURE UNAVAILABLE

Patient office consultation, typically 40 min


HCPCS: 99243

PROCEDURE UNAVAILABLE

Patient office consultation, typically 60 min


HCPCS: 99244

PROCEDURE UNAVAILABLE

Psychotherapy, 30 min


HCPCS: 90832

PROCEDURE UNAVAILABLE

Psychotherapy, 45 min


HCPCS: 90834

PROCEDURE UNAVAILABLE

Psychotherapy, 60 min


HCPCS: 90837

PROCEDURE UNAVAILABLE

Removal of 1 or more breast growth, open procedure


HCPCS: 19120

PROCEDURE UNAVAILABLE

Removal of cataract with insertion of lens


HCPCS: 66984

PROCEDURE UNAVAILABLE

Removal of gallbladder using an endoscope


HCPCS: 47562

PROCEDURE UNAVAILABLE

Removal of one knee cartilage using an endoscope


HCPCS: 29881

PROCEDURE UNAVAILABLE

Removal of recurring cataract in lens capsule using laser


HCPCS: 66821

PROCEDURE UNAVAILABLE

Removal of tonsils and adenoid glands patient younger than age 12


HCPCS: 42820

PROCEDURE UNAVAILABLE

Routine obstetric care for cesarean delivery, including pre-and post-delivery care


HCPCS: 59510

PROCEDURE UNAVAILABLE

Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care


HCPCS: 59610

PROCEDURE UNAVAILABLE

Routine obstetric care for vaginal delivery, including pre-and post-delivery care


HCPCS: 59400

PROCEDURE UNAVAILABLE

Shaving of shoulder bone using an endoscope


HCPCS: 29826

PROCEDURE UNAVAILABLE

Sleep study


HCPCS: 95810

PROCEDURE UNAVAILABLE

Spinal fusion except cervical without major comorbid conditions or complications (MCC)


DRG: 460

PROCEDURE UNAVAILABLE

Surgical removal of prostate and surrounding lymph nodes using an endoscope


HCPCS: 55866

PROCEDURE UNAVAILABLE

Ultrasound examination of lower large bowel using an endoscope


HCPCS: 45391

PROCEDURE UNAVAILABLE

Ultrasound of abdomen


HCPCS: 76700

PROCEDURE UNAVAILABLE

Ultrasound pelvis through vagina


HCPCS: 76830

PROCEDURE UNAVAILABLE

Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC)


DRG: 743

PROCEDURE UNAVAILABLE

Summary

Mercy Hospital

218 E Pack St

Moundridge, KS 67107

Insurance:

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Procedure(s):

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Estimated Patient Responsibility

$0.00

Deductible remaining

$0.00

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Coinsurance

0%

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Out-of-pocket maximum remaining

$0.00

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Co-payment

$0.00

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Estimated Patient Responsibility

$0.00

Unable to calculate because missing data in a required field

To schedule an appointment, please call our office at (620) 345-6391

If you are interested in financial assistance or payment options please visit https://www.mercyh.org/financial-assistance. You can also call our office at (620) 345-6391 or email info@mercyh.org.

Notice: This is just an estimate and not a guarantee of final billed charges. This estimate is based on Mercy Hospital’s set charges and contracts Mercy Hospital has in place with insurance coverage providers. Secondary insurance payors are not taken into consideration in this quote. If you have secondary insurance coverage, any balance showing as patient responsibility will be sent to this payor for processing before the bill is sent to the patient. This estimate may vary based on patient health condition, unknown circumstances or complications, final diagnosis and recommended treatment ordered by your physician. Patients with insurance are encouraged to contact their insurance plan for the most accurate information regarding benefits, deductible and co-payment amounts. Professional fees for physicians, including radiologist and pathologist are not included in this estimate.