Distal claviculectomy descomprension of subacoromial space with partial acromioplasty/Shaving of shoulder bone using an endoscope
| DETAIL FOR SERVICES: | Surgery Procedure | Hospital Stay (One day) | Anesthesia | Physician Services |
| 2020 CPT/HCPCS Primary Code | 29826 (in conjunction with 29806-29825,29827,29828) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Negotiated Private Fee | $3,854.00 | $522.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) |
| Prossam | $1,140.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Champva | Diagnostic Related Group (DRG) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| First Medical | $650.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| First Medical Vital | $603.75 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Plan de Salud Menonita | $900.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Menonita Vital | $630.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Humana Gold Plus / Gold Choice | Diagnostic Related Group (DRG) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Humana | $615.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Mapfre | $749.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Mcsclassicare | $937.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| MCS Life | $785.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Medicare | Diagnostic Related Group (DRG) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| MMM | $845.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| MMM Vital | $603.75 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Panamerican Life | $688.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| PMC | $845.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Tricare | Diagnostic Related Group (DRG) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Triple S Salud | $800.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Triple S Vital | $630.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Triple S Advantage | Diagnostic Related Group (DRG) | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Negotiated Minimum Charge | $603.75 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Negotiated Maximum Charge | $1,140.00 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) | |
| Discounted Cash Price | $3,083.20 | $417.60 | Not provided by Hospital (may be billed separately) | Not provided by Hospital (may be billed separately) |
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