“Self Pay” Office Charge List
| Office Visit Type | CPT code | Premier ‘Self pay’ Charge |
|---|---|---|
| New patient visit level 2 | 99202 | $ 75 |
| New patient visit level 3 | 99203 | $ 105 |
| Recheck level 2 | 99212 | $ 45 |
| Recheck level 3 | 99213 | $ 70 |
| Injection (not including medication) | 20610 | $ 60 |
| X-ray Foot | 73630 | $ 30 |
| X-ray Ankle | 73610 | $ 30 |
| X-ray Knee | 73562 | $ 35 |
| X-ray Hip/Pelvis | 73522 | $ 45 |
| X-ray Shoulder | 73030 | $ 30 |
| X-ray Hand | 73130 | $ 30 |
DME/Bracing
We work with local bracing and equipment suppliers to obtain the highest quality braces and durable medical equipment (DME) made in the U.S.A. for the best price and then pass that savings on to our patients. While no medical office can carry every type of brace, Premier Orthopedic Specialists of Tulsa carries a wide variety of braces for the most common orthopedic conditions. If we do not carry the proper brace for you, we can usually order the proper brace with the help of customized bracing suppliers, however we have no control over pricing for braces supplied outside our office. The following is a current list of braces that we carry and the charge for them.
| Brace Type | Premier Orthopedics Charge |
|---|---|
| Knee – Patellofemoral Stabiliz. | $ 40 |
| Knee – Patellar Tendon Strap | $ 15 |
| Knee – Neoprene Hinged | $ 75 |
| Ankle Lace-up | $ 25 |
| Rigid Shoe | $ 15 |
| Tibial Walker | $ 40 |
| Toe Splint | $ 10 |
| Bunion Splint | $ 30 |
| Heel Wedge | $ 15 |
| Wrist Lace-up | $ 25 |
| Finger Strap | $ 5 |
| Shoulder Sling | $ 15 |
| Back Brace | $ 120 |
Zerocard/FastPass
We at Premier orthopedic Specialists of Tulsa are honored to have partnered with Zerocard to provide orthopedic services to their participants. We are Fastpass providers which means that Zerocard participants can contact Premier Orthopedics directly and schedule appointments and in office services without preauthorization or a copay.
Contact your Zerocard representative at www.zerocard.com for any questions.
Bundling
Bundling is the process by which surgical services (Hospital charge, surgeon’s fee, anesthesia fee) are grouped together as one price for the costs of a surgical procedure. Various companies encourage this practice, which can significantly lower the overall cost of inpatient or outpatient procedures. Premier Orthopedics Specialists of Tulsa actively participates with Oklahoma Surgical Hospital in bundling with a variety of participating companies. We are always happy to discuss these options that are available to patients that have this option with their insurance plan or that chose this option if paying with cash/credit card outside of an insurance plan.