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List of All Oregon State Hospital Charges

Below is a list of services and associated costs provided by Oregon State Hospital, per the Centers for Medicare and Medicaid Services (CMS) requirements. These are costs for which a patient could potentially be billed before insurance payments or ability-to-pay determinations.

If you have a question about your bill or your ability to pay, please contact the Patient Account Coordinators at 503.947.0244.

This table applies only to inpatient services, as Oregon State Hospital does not offer outpatient services.

List of All Oregon State Hospital Charges – 01/01/21

Service Description

Billing Code

Standard Charge

Room & board (Certified)

0124

$888.00

Room & board (SRTF/RTF)

1001

$611.00

Fine needle aspiration without image guidance

10021

$69.25

Incision-drainage simple/single abscess

10060

$97.32

Treatment of fluid-filled lesions

10061

$179.13

Incision and drainage of pilonidal cyst

10080

$102.21

Drainage of pilonidal cyst

10081

$169.44

Remove foreign body

10120

$103.91

Puncture drainage of lesion

10160

$95.06

Debride infected skin

11000

$28.73

Removal of infected/devitalized tissue

11042

$62.04

Excise single benign hypertrophic lesion

11055

$16.18

Trim skin lesions 2-4

11056

$22.86

Trim skin lesions over 4

11057

$30.13

Biopsy of skin, single lesion

11100

$49.06

Punch biopsy skin single lesion

11104

$48.67

Removal skin tags

11200

$73.43

Shave skin lesion, trunk & limbs <0.5cm

11300

$34.48

Shave skin lesion >2.0 cm

11303

$74.52

Shave skin lesion <0.5 cm

11310

$47.65

Shave skin lesion 0.6-1.0 cm

11311

$65.75

Excision, benign lesion, except skin tag (unless listed elsewhere),
   trunk and limb; 0.6 to 1.0 cm

11401

$102.60

Skin lesion removal, trunk & limb 2.1-3cm

11403

$145.94

Excision, benign lesion, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; <.5 cm

11420

$81.21

Skin lesion removal, extremities 2.1-3cm

11423

$153.88

Skin lesion removal, benign

11441

$131.10

Excision, malignant lesion, trunk, arms, or legs; 1.1-2.0 cm

11602

$160.74

Skin lesion removal, malignant

11642

$183.77

Trimming of nondystrophic nails

11719

$7.74

Debridement nail 1 to 5

11720

$14.76

Debride nail 6 or more

11721

$25.17

Removal of nail plate

11730

$56.07

Inject skin lesions

11900

$31.32

Injection, intralesional; 7+ lesions

11901

$48.70

Insert drug implant device

11981

$83.68

Remove drug implant device

11982

$100.15

Remove/insert drug implant

11983

$179.24

Simple repair superficial wound <2.5 cm

12001

$44.21

Repair superficial wounds 2.6-7.5 cm

12002

$58.84

Repair superficial wounds 7.6-12.5 cm

12004

$73.21

Repair simple/superficial face, ears, eyelids, nose, lips,
   mucous membranes <2.5 cm

12011

$55.00

Destruction-vascular proliferative lesion

17110

$69.63

Chemical cauterization of granulation, tissue

17250

$37.38

Therapeutic injection carp tunnel

20526

$56.73

Injection tendon sheath/ligament

20550

$39.22

Injection, single/multiple trigger point

20552

$38.05

Inject trigger points 3

20553

$43.58

Drain/inject joint/bursa

20605

$37.65

Joint injection or aspiration

20610

$46.19

Application of paste boot

29580

$27.28

Remove nasal foreign body

30300

$111.85

Incise external hemorrhoid

46083

$106.88

Destruction penis lesion(s)

54065

$173.83

Biopsy, prostate; needle or punch

55700

$132.31

Removal of intrauterine device (IUD)

58301

$66.94

Drain external ear lesion

69000

$118.05

Removal foreign body from external canal

69200

$47.00

Remove impacted ear wax uni

69209

$13.71

Remove impacted ear wax uni

69210

$33.13

Interactive complexity add-on

90785

$13.80

Diagnostic evaluation (no medical)

90791

$125.79

Diagnostic evaluation (with medical)

90792

$141.41

Psychotherapy 30 (16-37) minutes

90832

$62.58

Psychotherapy 45 (38-52) minutes

90834

$83.42

Psychotherapy 60 (53+) minutes

90837

$125.44

Psychotherapy for crisis, first 60 min

90839

$130.78

Psychotherapy add-on for crisis

90840

$62.58

Psychoanalysis

90845

$89.71

Family psychotherapy w/o client present

90846

$101.04

Family psychotherapy-client present

90847

$105.30

Multiple family group-client present

90849

$31.29

Group psychotherapy

90853

$24.75

Electroconvulsive therapy

90870

$110.46

Electrocardiogram report

93010

$8.50

Neurobehavioral status exam

96116

$85.25

Brief emotional/behavioral assessment

96127

$6.20

Neuropsychological testing evaluation services by physician or
other qualified healthcare professional (1st 30 minutes)

96132

$108.39

Neuropsychological testing evaluation services by physician or
other qualified healthcare professional (each subsequent)

96133

$83.07

Psychological/neuropsychological test administration/scoring by physician
or other qualified healthcare professional (1st 30 minutes)

96136

$24.71

Removal devital tissue <20 cm

97597

$24.17

Removal devital tissue additional <20cm

97598

$11.37

Osteopathic manipulation 1-2 regions

98925

$23.87

CMT spinal 3-4 regions

98941

$34.60

Detailed/comprehensive history

99221

$100.31

Comprehensive history, comprehensive exam moderate

99222

$135.58

Comprehensive history, comprehensive exam high

99223

$201.23

Subsequent hospital care

99231

$38.90

Problem focused history/exam moderate

99232

$72.25

Detailed history or exam high

99233

$103.49

Discharge services (30 min or less)

99238

$72.57

Discharge services (more than 30 mins)

99239

$107.02

Prolonged evaluation/management first full hour beyond usual

99356

$91.61

Prolonged evaluation/management full half hour beyond first hour

99357

$91.96

Advanced care plan 30 min

99497

$78.84

Psychotherapy add-on 90833 90836 90838

9083X

$108.65

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