Billing / Facility Charges and Average Reimbursement

 

Regulatory

Patients and prospective patients may request from the facility and other health care providers, a more personalized estimate of charges and other information. Patients should contact each health care practitioner who will provide services at ASC to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.
– For More information, Please Contact: Florida Spine Institute at 727-797-7463 ext. 5149

 

Patients and prospective patients may be provided services in the health care facility by the facility as well as by other health care providers who may separately bill the patient and that such health care providers may or may not participate with the same health insurers or health maintenance organizations as the facility. Estimates for services are available
– For More information, Please Contact: Florida Spine Institute at 727-797-7463 ext. 5149

 

Health-related data, including quality measures and statistics that are disseminated by the agency pursuant to s.408.05
http://www.ahca.myflorida.com

 

Billing
List of CPT Codes, Facility Charges and Reimbursements

 

CPT	Procedure Description		Facility Charges	Facility Reimbursements
G0260	Injection, sacroiliac joint,		$2,117.70	$310.53
20610	Drain/inject major joint or bursa		$1,680.00	$27.52
20611	Drain/inject major joint or bursa w/ultsou		$276.24	$45.87
27096	Injection, sacroiliac joint		$1,600.00	$310.53
62310	Inject, spine, cervical/thoracic		$2,117.70	$310.53
62311	Inject, spine, lumbar/sacral		$2,117.70	$310.53
63650	Implant epidural neuroelectrodes		$21,126.24	$3,790.21
63685	Inplant spinal neuroreceiver		$52,650.00	$20,474.37
64420	Inject nerve block, intercostal		$1,119.06	$310.53
64447	Inject nerve block, femoral, single		$356.70	$64.90
64450	Inject nerve block, peripheral		$1,600.00	$49.60
64483	Inject foramin, lumb/sacral, single		$2,117.70	$310.53
64484	Inject foramin, lumb/sacral, ea add		$934.68	$155.27
64490	Inject paravert, cerv/thor, 1 level		$2,117.70	$436.26
64491	Inject paravert, cerv/thor, 2nd level		$585.06	$218.13
64492	Inject paravert, cerv/thor, 3+ levels		$585.06	$218.13
64493	Inject paravert, lumb/sacral, 1 level		$2,117.70	$436.26
64494	Inject paravert, lumb/sacral, 2nd level		$585.06	$218.13
64495	Inject paravert, lumb/sacral, 3+ levels		$585.06	$218.13
64510	Inject nerve block, cerv sympathetic		$2,117.70	$310.53
64520	Inject nerve block, vert sympathetic		$2,117.70	$310.53
64555	Percu implnt neurelecd,peripheral		$7,320.72	$3,790.21
64633	Destroy paravert nrv cerv/thor sngl		$4,884.30	$738.99
64634	Destroy paravert nrv cerv/thor, add		$585.06	$310.53
64635	Destroy paravert nerv lumb/sac sngl		$4,884.30	$738.99
64636	Destroy paravert nerv lumb/sac, add		$1,812.54	$217.47
64640	Destroy w/neurlytc oth periphrl nrv		$500.22	$83.93

 

Attention: If you speak one of the following languages, assistance is available to you free of charge. Please ask for assistance from a staff member.

Spanish: Atención: Si hablas uno de los siguientes idiomas, asistencia está disponible para usted de forma gratuita. Por favor pida ayuda a un miembro del personal.

French Creole: Koute: Si w pale yonn nan lang sa yo, asistans disponib pou ou pa bezwen peye pri. Souple mande pou asistans nan yon manm pèsonèl la.

Vietnamese: Chú ý: Nếu bạn nói một trong các ngôn ngữ sau, hỗ trợ có sẵn cho bạn miễn phí. Hãy yêu cầu để được giúp đỡ từ một nhân viên.

Portuguege: Atenção: Se você fala de um dos seguintes idiomas, assistência está disponível a você gratuitamente. Por favor, pedi a ajuda de um membro do pessoal.

Chinese: 注意︰ 如果你說話以下語言之一，援助是提供給你免費。 請從一名工作人員尋求説明。

French: ATTENTION : Si vous parlez une des langues suivantes, une assistance est disponible pour vous gratuitement. S’il vous plaît, demander de l’aide d’un membre du personnel.

Tagalog: Paunawa: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.

Russian: Внимание: Если вы говорите на одном из следующих языков, помощь предоставляется вам бесплатно. Пожалуйста попросите помощь от сотрудника.

Arabic: تنبيه: إذا كنت تتحدث إحدى اللغات التالية، المساعدة متاح لك مجاناً. الرجاء طلب المساعدة من أحد موظفين.

Italian: Attenzione: Se parli una delle seguenti lingue, assistenza a vostra disposizione gratuitamente. Si prega di chiedere assistenza da un membro del personale.

German: Achtung: Wenn Sie eine der folgenden Sprachen sprechen, ist Hilfe Ihnen unentgeltlich zur Verfügung. Bitte fordern Sie Hilfe von einem Mitarbeiter.

Korean: 주의: 다음 언어 중 하나를 말하는 경우에 도움을 무료로 사용할 수입니다. 직원에서 도움 요청 하시기 바랍니다.

Polish: Uwagi: Jeśli mówisz, że jednym z poniższych języków, pomoc jest dostępna dla Ciebie bezpłatnie. Należy zwrócić się o pomoc od pracownika.

Gujarati: ધ્યાન: તમે નીચેની ભાષાઓમાં એક વાત તો મદદ તમારા માટે ઉપલબ્ધ વિના મૂલ્યે છે. એક સ્ટાફ સભ્ય પાસેથી સહાય મેળવવા માટે પૂછો.

Thai: ความสนใจ: ถ้าคุณพูดภาษาต่อไปนี้อย่างใดอย่างหนึ่ง มีบริการช่วยเหลือให้คุณฟรี กรุณาขอความช่วยเหลือจากพนักงาน