Good Samaritan Hospital
2425 Samaritan Drive
San Jose, CA 95124
Acute Care Hospitals
Overview
- CMS rating★★☆☆☆
- CCN050380
Procedures & prices
- Contact layer >16<= 48 sq inA6207$10cashGross $100 payers
- HC ALGINATE DRESSING <=16 SQ INA6196$10cashGross $180 payers
- Cast sup shrt leg ped plsterQ4039$10cashGross $100 payers
- HC NEG PRESS WOUND TX >50 CM97606$10cashGross $100 payers
- Forensic cytopathology88125$10cashGross $100 payers
- 9501595015$10cashGross $100 payers
- Factor xiii anti-hem factorJ7180$10cashGross $460 payers
- Solid skin barrier 6x6A5121$10cashGross $100 payers
- Fibrinolytic plasminogen85421$10cashGross $100 payers
- HC FOAM DRSG <=16 SQ IN W/O BDRA6209$10cashGross $100 payers
| Procedure | Code | Cash↑ | Gross | Negotiated range | Payers |
|---|---|---|---|---|---|
| Contact layer >16<= 48 sq in | A6207 | $10 | $10 | — | 0 |
| HC ALGINATE DRESSING <=16 SQ IN | A6196 | $10 | $18 | — | 0 |
| Cast sup shrt leg ped plster | Q4039 | $10 | $10 | — | 0 |
| HC NEG PRESS WOUND TX >50 CM | 97606 | $10 | $10 | — | 0 |
| Forensic cytopathology | 88125 | $10 | $10 | — | 0 |
| 95015 | 95015 | $10 | $10 | — | 0 |
| Factor xiii anti-hem factor | J7180 | $10 | $46 | — | 0 |
| Solid skin barrier 6x6 | A5121 | $10 | $10 | — | 0 |
| Fibrinolytic plasminogen | 85421 | $10 | $10 | — | 0 |
| HC FOAM DRSG <=16 SQ IN W/O BDR | A6209 | $10 | $10 | — | 0 |
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