Code: 12017

Description:
HC SMPL RPR SUPFC F/E/E/N/L/M 20.1CM-30.0 CM
Other Descriptions:
RSW SIMPLE FACE 20.1CM-30CM
SIM LAC FACE-EAR 20.1-30CM
Rpr fe/e/en/l/m 20.1-30.0 cm
SMP LAC.FCE/EAR 20.1-30CM
REPAIR SIM B 20.1+AC0-30.0CM PF
Rpr fe/e/en/l/m 20.1+AC0-30.0 cm
Related codes:
Code: 12011
HC SMPL RPR SUPFC F/E/E/N/L/M 2.5CM/<
Code: 12013
HC SMPL RPR SUPFC F/E/E/N/L/M 2.6CM-5.0CM
Code: 12014
HC SMPL RPR SUPFC F/E/E/N/L/M 5.1CM-7.5CM
Code: 12015
HC SMPL RPR SUPFC F/E/E/N/L/M 7.6CM-12.5CM
Code: 12016
HC SMPL RPR SUPFC F/E/E/N/L/M 12.6CM-20.0CM
Code: 12018
HC SMPL RPR SUPFC F/E/E/N/L/M > 30.0CM
Wisconsin
Hospital Address Code Price Last Updated
Tomah Memorial Hospital 501 Gopher Dr, Tomah 12017 $92 [source] 3 years ago
River Falls Area Hospital , River Falls 12017 $431 [source] 3 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton 12017 $449 [source] 3 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand 12017 $509 [source] 3 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown 12017 $633 [source] 3 years ago
Howard Young Medical Center Inc Of Woodruff Wisconsin 240 Maple Street, Woodruff 12017 $832 [source] 3 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee 12017 $949 [source] 3 years ago
Ascension Sacred Heart Rehabilitation Hospital 2323 N Lake Dr, Milwaukee 12017 $1,093 [source] 3 years ago
Ascension St Francis Hospital 3237 S 16Th St, Milwaukee 12017 $1,265 [source] 3 years ago
Ascension Se Wisconsin Hospital-St Joseph Campus 5000 W Chambers St, Milwaukee 12017 $1,265 [source] 3 years ago
Midwest Orthopedic Specialty Hospital, Llc 10101 S 27Th St, Franklin 12017 $1,265 [source] 3 years ago
Ascension All Saints Hospital 1320 Wisconsin Ave, Racine 12017 $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.