Code: 12004

Description:
HC SMPL RPR SUPFC S/N/AX/G/T 7.6CM-12.5CM
Other Descriptions:
SIM LAC SCLP-BDY 7.6-12.5CM
RSW SIMP H/N/T/E 7.6-12.5CM
PC WOUND GEN 7.6 - 12.5CM
ER REPA-SUTUR 2IN TO 3IN
REPAIR SW SCALP/NECK 7.6-
SIMP.LAC.RPR 7.6-12.5CM
SIMP RPR SCP AX GN TNK EXT PHY
REPAIR SIM A 7.6+AC0-12.5CM PF
Rpr s/n/ax/gen/trk7.6+AC0-12.5cm
Related codes:
Code: 12001
PRO-SIMPLE REPAIR SCALP
Code: 12002
HC SMPL RPR SUPFC S/N/AX/G/T 2.6CM-7.5CM
Code: 12005
HC SMPL RPR SUPFC S/N/AX/G/T 12.6CM-20.0CM
Code: 12006
HC SMPL RPR SUPFC S/N/AX/G/T 20.1CM-30.0CM
Code: 12007
HC SMPL RPR SUPFC S/N/AX/G/T > 30.0CM
Wisconsin
Hospital Address Code Price Last Updated
Tomah Memorial Hospital 501 Gopher Dr, Tomah 12004 $71 [source] 3 years ago
Aspirus Medford Hospital 135 S Gibson St, Medford 12004 $142 [source] 3 years ago
Aspirus Langlade Hospital 110 E 5Th Ave, Antigo 12004 $142 [source] 3 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton 12004 $217 [source] 3 years ago
River Falls Area Hospital , River Falls 12004 $337 [source] 3 years ago
Upland Hills Health 800 Compassion Way, Dodgeville 12004 $355 [source] 3 years ago
Essentia Health St. Mary's Hospital-Superior 3500 Tower Ave, Superior 12004 $372 [source] 3 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand 12004 $400 [source] 3 years ago
Prairie Ridge Health 1515 Park Ave, Columbus 12004 $422 [source] 3 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown 12004 $488 [source] 3 years ago
Howard Young Medical Center Inc Of Woodruff Wisconsin 240 Maple Street, Woodruff 12004 $555 [source] 3 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids 12004 $595 [source] 3 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, 12004 $595 [source] 3 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau 12004 $595 [source] 3 years ago
Aspirus Divine Savior Hospital 2817 New Pinery Rd, Portage 12004 $607 [source] 3 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee 12004 $949 [source] 3 years ago
Ascension Sacred Heart Rehabilitation Hospital 2323 N Lake Dr, Milwaukee 12004 $1,093 [source] 3 years ago
Ascension St Francis Hospital 3237 S 16Th St, Milwaukee 12004 $1,265 [source] 3 years ago
Ascension Se Wisconsin Hospital-St Joseph Campus 5000 W Chambers St, Milwaukee 12004 $1,265 [source] 3 years ago
Midwest Orthopedic Specialty Hospital, Llc 10101 S 27Th St, Franklin 12004 $1,265 [source] 3 years ago
Ascension All Saints Hospital 1320 Wisconsin Ave, Racine 12004 $1,265 [source] 3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.