Self-Pay PricingExceptional care. Transparent pricing. No surprises.
We've designed our self-pay program for patients who value clarity and quality. Self- pay pricing is available to patients who do not have an insurance plan that we are contracted with. We encourage patients to consult with their insurers for specific questions about their coverage should they decide to consider self-pay pricing and have insurance. Prices listed are estimates for standard services. Additional diagnostic, supplies, or complexity may change the final cost. Please call (949) 586-3200 for more information.
- MRI
- OrthoBiologics
- Office Visits
- X-rays
- Foot
- Forearm & Wrist
- General Musculoskeletal
- Hand
- Hip & Pelvis
- Knee
- Leg & Ankle
- Shoulder
- Spine
- Upper Arm & Elbow
- In-Office Procedures
Top MRI Procedure Codes
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
72141
Cervical Spine without Contrast
$326.00
72146
Thoracic Spine without Contrast
$325.00
72148
Lumbar Spine without Contrast
$327.50
72195
Pelvis without Contrast
$392.00
72195
SI Joints/Sacrum without Contrast
$392.00
73218
Hand/Finger/Forearm/Humerus (Non-Joint) without Contrast
$527.00
73221
Wrist/Elbow/Shoulder Joint without Contrast
$352.50
73222
Wrist/Elbow/Shoulder Joint Arthrogram without Contrast
$541.00
73718
Foot/Toes/Leg/Thigh/Femur (Non-Joint)
$384.00
73721
Ankle/Knee/Hip Joint without Contrast
$351.00
73722
Ankle/Knee/Hip Joint Arthrogram
$545.50
Biologic Treatment
Cash Price
Platelet Rich Plasma (PRP), 30 cc
$750.00
Platelet Rich Plasm (PRP), 60 cc
$1,500.00
Bone Marrow Aspirate Concentrate (BMAC)
$2,400.00
High concentration Harvest PRP system and Arthrex PRP systems are used
Top Office Visits Procedure Codes
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
99204
New Patient
$290.00
99214
Established Patient
$223.50
All prices are listed as level. The may be changed based on the level of service provided.
Top X-rays Procedure Codes
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
72052
Cervical Spine
$54.50
72072
Thoracic Spine
$33.50
72114
Lumbar Spine
$53.50
73000
Clavicle
$29.00
73030
Shoulder
$31.00
73060
Humerus
$27.75
73080
Elbow
$28.50
73090
Forearm
$25.00
73110
Wrist
$37.25
73130
Hand
$33.25
73523
Hip
$53.25
73564
Knee
$43.00
73610
Anke
$32.25
73630
Foot
$29.50
All x-rays are performed by a certified radiology technician, and images are personally interpreted by the medical provider.
All x-rays are 3 views minimum.
Top 20 Surgical Procedure Codes — Foot
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
28080
Excision, interdigital (Morton) neuroma, single
$908.90
28118
Ostectomy, calcaneus
$1,006.18
28160
Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx
$745.55
28270
Capsulotomy, metatarsophalangeal joint, with or without tenorrhaphy
$992.46
28285
Correction, hammertoe (interphalangeal fusion or phalangectomy)
$1,285.37
28289
Hallux rigidus correction with cheilectomy, debridement, and/or capsulotomy
$1,137.47
28292
Correction, hallux valgus (bunionectomy) with resection of proximal phalanx base
$1,179.44
28296
Correction, hallux valgus (bunionectomy); with distal metatarsal osteotomy
$1,569.62
28297
Correction, hallux valgus; with first metatarsocuneiform joint arthrodesis (Lapidus)
$1,668.14
28298
Correction, hallux valgus; with proximal phalanx osteotomy
$1,380.60
28300
Osteotomy, calcaneus (e.g., Dwyer or Chambers type)
$1,026.36
28308
Osteotomy, metatarsal (other than first metatarsal), each
$1,296.54
28485
ORIF metatarsal fracture, each
$912.55
28615
ORIF tarsometatarsal joint dislocation (Lisfranc)
$2,764.96
28725
Arthrodesis, subtalar joint
$1,237.26
28730
Arthrodesis, midtarsal or tarsometatarsal joint
$1,146.04
28740
Arthrodesis, midtarsal or tarsometatarsal, multiple joints
$1,355.72
28750
Arthrodesis, great toe; metatarsophalangeal joint
$1,440.82
28810
Amputation, metatarsal, with toe; single
$778.86
28820
Amputation, toe; metatarsophalangeal joint
$588.72
Top 20 Surgical Procedure Codes — Forearm & Wrist
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
25000
Incision of tendon sheath, wrist (DeQuervein's)
$578.00
25028
Incision and drainage, forearm or wrist
$1,336.92
25107
Mini- Open TFCC Repair
$990.50
25111
Excision of ganglion, wrist
$542.34
25115
Radical excision of bursa, synovia of wrist or forearm tendon sheath
$1,202.71
25118
Synovectomy, extensor tendon sheath, wrist
$684.30
25210
Carpectomy; one bone
$907.62
25215
Carpectomy; all bones of proximal row
$998.54
25230
Radial styloidectomy
$691.46
25240
Excision distal ulna (Darrach procedure)
$699.75
25440
Repair of scaphois nonunion, with graft if needed
$1,175.89
25448
Thumb CMC joint Suspensionplasty/ LRTI or similar
$1,400.42
25600
Closed treatment, distal radial fracture; without manipulation
$634.21
25605
Closed treatment, distal radial fracture; with manipulation
$950.34
25607
ORIF distal radial fracture; extraarticular
$1,188.27
25608
ORIF distal radial fracture; intraarticular, 2-part
$1,308.18
25609
ORIF distal radial fracture; intraarticular, 3 or more parts
$1,624.48
25825
Arthrodesis, wrist; without bone graft
$1,293.00
29846
Arthroscopy, wrist with joint debridement
$811.40
64772
Wrist Dennervation (Neurectomy, per Nerve)
$1,477.42
Top 20 Surgical Procedure Codes — General Musculoskeletal
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
20103
Exploration wound; extremity, major
$949.00
20240
Biopsy, bone; superficial
$217.00
20245
Biopsy, bone; deep
$527.00
20520
Removal of foreign body in muscle or tendon sheath; simple
$359.00
20525
Removal of foreign body in muscle or tendon sheath; deep or complicated
$777.12
20526
Injection, therapeutic (carpal tunnel)
$177.56
20552
Injection, trigger point(s); 1 or 2 muscle groups
$84.50
20605
Arthrocentesis, aspiration or injection; intermediate joint
$93.80
20606
Arthrocentesis, intermediate joint; with ultrasound guidance
$157.47
20670
Removal of implant; superficial
$907.00
20680
Removal of implant; deep
$1,035.12
20690
Application of uniplane external fixator
$948.50
20692
Application of multiplane external fixator
$1,728.07
20694
Removal of external fixator under anesthesia
$745.54
20900
Bone graft, any donor area; minor or small
$1,219.92
20902
Bone graft, any donor area; major or large
$403.21
20930
Allograft for spine surgery; morselized
$250.00
20936
Autograft for spine surgery; local (e.g., ribs, spinous process, or laminar fragments)
$500.00
20950
Monitoring of interstitial fluid pressure in muscle compartment
$431.50
20985
Computer-assisted musculoskeletal surgical navigational orthopedic procedure
$190.00
Top 20 Surgical Procedure Codes — Hand
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
26020
Drainage of tendon sheath, digit or palm
$983.18
26040
Needle Fasciotomy (Dupuytren's Contracture)
$525.25
26055
Tendon sheath incision; trigger finger or trigger thumb release
$1,184.17
26113
Excision, tumor or vascular malformation, hand or finger; 1.5 cm or greater
$963.22
26115
Excision, soft tissue tumor, hand or finger; less than 1.5 cm
$967.78
26116
Excision, soft tissue tumor, hand or finger; 1.5 cm or greater
$829.50
26121
Fasciectomy, palm only, partial (Dupuytren's)
$997.39
26123
Fasciectomy, partial with PIP joint (Dupuytren's contracture)
$1,386.44
26125
Fasciectomy; each additional digit (Dupuytren's)
$505.38
26160
Excision of finger or hand ganglion cyst
$1,088.44
26341
Manipulation post- Xiaflex, Dupuytren's
$199.74
26356
Flexor tendon repair, Zone 2
$1,785.65
26480
Hand or finger Tendon Transfer
$1,154.81
26525
Capsulectomy or capsulotomy; interphalangeal joint, each joint
$1,385.66
26615
ORIF metacarpal fracture; each bone
$1,118.56
26727
Percutaneous skeletal fixation of unstable phalangeal shaft fracture
$1,181.54
26735
ORIF phalangeal shaft fracture
$963.74
26746
ORIF articular fracture, base of middle or proximal phalanx
$1,182.66
26860
Arthrodesis, interphalangeal joint; each joint
$1,029.47
29848
Endoscopic Carpal Tunnel Release
$1,118.00
64708
Neuroplasty, major peripheral nerve, arm or leg
$815.20
64718
Cubital tunnel release
$978.12
64719
Guyon's Canal (ulnar nerve wrist) decompression
$663.90
64721
Mini-open carpal tunnel release
$761.18
64831
Suture of digital nerve, hand or foot; 1 nerve
$1,079.50
64912
Nerve repair with nerve allograft, each strand; first strand
$1,368.25
Top 20 Surgical Procedure Codes — Hip & Pelvis
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
27030
Arthrotomy, hip, with drainage
$1,452.88
27036
Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone
$1,623.00
27090
Removal of hip prosthesis (separate procedure)
$1,322.00
27091
Removal of hip prosthesis; complicated, including total hip prosthesis
$2,493.00
27093
Injection procedure for hip arthrography
$395.84
27122
Acetabuloplasty
$1,670.25
27130
Total hip arthroplasty (THA)
$1,968.30
27132
Conversion of previous hip surgery to total hip arthroplasty
$2,644.61
27134
Revision of total hip arthroplasty; both components
$3,045.34
27137
Revision of total hip arthroplasty; acetabular component only
$2,288.50
27138
Revision of total hip arthroplasty; femoral component only
$2,326.90
27197
Closed treatment of posterior pelvic ring fracture
$208.25
27220
ORIF acetabulum fracture; anterior column
$732.50
27230
Closed treatment of femoral fracture, proximal end, neck; without manipulation
$841.25
27235
Percutaneous skeletal fixation of femoral fracture, proximal end, neck
$1,403.34
27236
ORIF femoral fracture, proximal end, neck
$1,851.82
27238
Closed treatment of intertrochanteric fracture; with manipulation
$770.00
27244
Treatment of intertrochanteric fracture with plate/screw-type implant
$1,766.50
27245
Treatment of intertrochanteric fracture with intramedullary implant
$1,871.54
27266
Closed treatment of femoral fracture, proximal end, head
$933.00
Top 20 Surgical Procedure Codes — Knee
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
27301
Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee
$1,117.68
27380
Suture of quadriceps or hamstring muscle rupture; primary
$1,009.26
27385
Suture of quadriceps or hamstring muscle rupture; secondary reconstruction
$1,055.57
27405
Repair, primary, torn ligament and/or secondary repairs; cruciate ligaments
$1,097.10
27446
Arthroplasty, knee; medial or lateral compartment (unicompartmental)
$1,745.58
27447
Total knee arthroplasty (TKA), medial and lateral compartments
$1,959.35
27486
Revision of total knee arthroplasty; 1 component
$2,152.96
27487
Revision of total knee arthroplasty; femoral and entire tibial component
$2,702.92
27506
ORIF femoral shaft fracture with intramedullary implant
$2,037.74
27524
ORIF distal femoral fracture
$1,213.52
27570
Manipulation of knee joint under general anesthesia
$253.36
29855
Arthroscopically aided treatment of tibial plateau fracture; with internal fixation
$1,217.60
29874
Arthroscopy, knee; with removal of loose body or foreign body
$842.93
29875
Arthroscopy, knee; synovectomy, limited (less than 2 compartments)
$796.44
29876
Arthroscopy, knee; synovectomy, major, 2 or more compartments
$1,008.98
29879
Arthroscopy, knee; abrasion arthroplasty or multiple drilling or microfracture
$1,032.14
29880
Arthroscopy, knee; with meniscectomy, medial and lateral
$890.67
29881
Arthroscopy, knee; with meniscectomy, medial or lateral
$860.61
29882
Arthroscopy, knee; with meniscus repair, medial or lateral
$1,072.30
29888
Arthroscopy, knee; ACL repair/reconstruction with or without meniscectomy
$1,486.36
Top 20 Surgical Procedure Codes — Leg & Ankle
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
27606
Tenotomy, percutaneous, Achilles tendon
$425.56
27650
Repair, primary, open or percutaneous, ruptured Achilles tendon
$1,042.56
27654
Repair, secondary, Achilles tendon, with or without graft
$1,138.22
27658
Repair, flexor tendon, leg; primary
$632.36
27687
Gastrocnemius recession (e.g., Strayer procedure)
$731.74
27691
Transfer or transplant of single tendon with muscle redirection or rerouting
$1,197.50
27695
Repair, primary, disrupted ligament, ankle; collateral
$767.34
27696
Repair, secondary, disrupted ligament, ankle; both collateral ligaments
$861.10
27698
Repair, secondary, disrupted ligament, ankle; collateral
$1,006.78
27702
Arthroplasty, ankle; with implant (total ankle replacement)
$1,486.53
27759
Treatment of tibial shaft fracture with intramedullary implant
$1,547.28
27766
ORIF medial malleolus fracture
$957.66
27792
ORIF distal fibular fracture
$1,016.56
27814
ORIF bimalleolar ankle fracture
$1,192.21
27822
ORIF trimalleolar ankle fracture; without posterior lip
$1,378.22
27828
ORIF distal tibiofibular joint instability
$2,026.96
27829
ORIF distal fibular fracture with fixation of syndesmosis disruption
$1,124.49
27870
Arthrodesis, ankle, open
$1,546.70
29891
Arthroscopy, ankle; with excision of osteochondral defect of talus or distal tibia
$1,055.28
29898
Arthroscopy, ankle; debridement, extensive
$867.75
Top 20 Surgical Procedure Codes — Shoulder
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
23020
Capsular contracture release, shoulder
$1,087.07
23066
Excision, soft tissue tumor, shoulder area; 5 cm or greater
$984.40
23120
Claviculectomy; partial
$952.78
23350
Injection procedure for shoulder arthrography
$266.24
23430
Tenodesis of long tendon of biceps
$1,166.36
23440
Resection or transplantation of long tendon of biceps
$1,178.50
23472
Arthroplasty, glenohumeral joint; total shoulder replacement
$2,177.70
23474
Revision of total shoulder replacement; both components
$2,609.95
23515
ORIF clavicular fracture
$1,142.52
23615
ORIF proximal humeral fracture
$1,349.94
23630
ORIF greater tuberosity fracture
$1,227.95
23700
Manipulation under anesthesia, shoulder joint
$316.08
29806
Arthroscopy, shoulder; capsulorrhaphy (Bankart repair)
$1,693.12
29819
Arthroscopy, shoulder; with removal of loose body or foreign body
$928.65
29823
Arthroscopy, shoulder; debridement, extensive
$934.70
29824
Arthroscopy, shoulder; distal claviculectomy (Mumford procedure)
$1,069.54
29825
Arthroscopy, shoulder; with lysis and resection of adhesions (frozen shoulder release)
$942.55
29826
Arthroscopy, shoulder; decompression of subacromial space with partial acromioplasty
$248.82
29827
Arthroscopy, shoulder; with rotator cuff repair
$1,672.12
29828
Arthroscopy, shoulder; biceps tenodesis
$1,411.11
Top 20 Surgical Procedure Codes — Spine
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
22551
Arthrodesis, anterior interbody, cervical below C2 (ACDF)
$2,562.16
22552
ACDF; each additional interspace
$745.00
22554
Arthrodesis, anterior interbody, lumbar
$1,944.31
22558
Arthrodesis, anterior interbody, lumbar; each additional interspace
$2,321.90
22585
Arthrodesis, anterior interbody; each additional interspace
$666.30
22612
Arthrodesis, posterior, lumbar or lumbosacral
$2,397.04
22614
Arthrodesis, posterior; each additional vertebral segment
$626.35
22630
Arthrodesis, posterior interbody, lumbar or lumbosacral
$2,384.45
22632
Arthrodesis, posterior interbody; each additional interspace
$460.00
22633
Arthrodesis, combined posterior/anterior interbody, lumbar
$2,699.00
22840
Posterior non-segmental instrumentation (e.g., Harrington rod)
$1,083.23
22842
Posterior segmental instrumentation, pedicle fixation; 3-6 vertebral segments
$1,108.71
22845
Anterior instrumentation; 2-3 vertebral segments
$1,040.91
22846
Anterior instrumentation; 4-7 vertebral segments
$1,214.30
22850
Removal of posterior non-segmental instrumentation
$1,153.29
22852
Removal of posterior segmental instrumentation
$1,122.00
22853
Insertion of interbody biomechanical device(s), lumbar
$532.18
22856
Total disc arthroplasty, cervical, single level
$2,342.50
63030
Laminotomy for decompression of nerve root, 1 interspace; lumbar
$2,864.66
63035
Laminotomy for decompression; each additional interspace, cervical or lumbar
$655.02
63047
Laminectomy, facetectomy and foraminotomy with decompression; single vertebral segment, lumbar
$1,698.08
63048
Laminectomy, facetectomy and foraminotomy; each additional segment
$338.16
63056
Transpedicular approach with decompression of spinal cord or nerve root(s); lumbar
$2,230.61
63075
Discectomy, anterior, with decompression of spinal cord/nerve root; cervical, single interspace
$2,062.59
63076
Discectomy, anterior, cervical; each additional interspace
$611.65
63081
Vertebral corpectomy (body resection), anterior approach; cervical, single segment
$2,659.07
63082
Vertebral corpectomy, anterior approach; cervical, each additional segment
$578.25
63090
Vertebral corpectomy, anterior approach; thoracolumbar, single segment
$2,954.43
Top 20 Surgical Procedure Codes — Upper Arm & Elbow
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
24006
Arthrotomy of elbow, with exploration, drainage, or removal of foreign body
$1,331.50
24073
Excision, soft tissue tumor, upper arm or elbow; 5 cm or greater
$1,264.00
24075
Excision, tumor, soft tissue, upper arm or elbow; less than 3 cm
$1,056.29
24076
Excision, tumor, soft tissue, upper arm or elbow; 3 cm or greater
$1,101.25
24105
Excision olecranon bursa
$614.10
24130
Excision of head of radius
$842.00
24160
Implant removal, elbow joint
$1,982.50
24300
Manipulation, elbow, under general anesthesia
$746.50
24305
Tendon lengthening, upper arm or elbow, each tendon
$908.25
24341
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle
$1,195.00
24342
Reinsertion of ruptured biceps or triceps tendon, distal
$1,215.02
24343
Repair lateral collateral ligament, elbow, with or without tissue graft
$1,137.20
24358
Tenotomy, elbow; lateral or medial, open
$854.02
24359
Tenotomy, elbow; open with tendon repair
$1,094.32
24363
Arthroplasty, elbow; with distal humeral prosthesis
$2,279.00
24366
Arthroplasty, elbow; total elbow replacement
$1,066.00
24515
ORIF humeral shaft fracture with plate/screws
$1,418.18
24650
Closed treatment, radial head or neck fracture; without manipulation
$472.50
24666
Replacement of radial head with implant
$1,161.88
24685
ORIF distal humeral fracture
$1,042.68
Top In-Office Procedure Codes
SCOS OrthoWest | Physicians Only | Sorted by CPT Code (Ascending)
CPT Code
Procedure Description
Cash Price
11750
Nail bed debridement
$265.50
11755
Nail bed and plate biopsy
$201.00
11760
Repair of nail bed
$315.50
11762
Reconstruction of nail bed
$493.00
11765
Ingrown Nail Treatment
$278.50
20525
Foreign body removal, hand
$841.00
20670
Superficial Wire Removal
$638.00
20680
Deep Buried Wire Removal
$1,052.50
23075
Excision of shoulder mass
$932.00
24075
Excision of arm or elbow mass
$958.00
24201
Foreign body removal, arm or elbow
$1,126.50
25000
First Dorsal Compartment/ Dequervain's Release
$563.00
25075
Excision of forearm mass
$932.00
26011
Drainage of finger abscess
$891.50
26055
Trigger finger release
$1,081.00
26115
Excision of hand/ finger mass
$997.50
26121
Dupuytren's fasciectomy (palm)
$906.50
26123
Dupuytren's fasciectomy (palm and finger)
$1,259.00
26356
Flexor tendon repair (each tendon)
$1,225.00
26410
Extensor tendon repair (each tendon)
$1,006.50
26160
Mucous Cyst/ Ganglion Cyst Excision Finger
$1,126.00
64721
Carpal tunnel Release
$796.50
Self-Pay Pricing – Frequently Asked Questions
What does "self-pay" mean?
Self-pay means you are choosing to pay for your care directly, rather than using insurance. This may apply if you do not have insurance we are contracted with, or if you prefer not to use your insurance benefits.
What is included in the listed price?
The listed price includes professional fees for SCOS physicians only.
What is NOT included in the price?
The listed price does not include charges from other providers or facilities. These may include:
- Surgical facility or hospital fees (if applicable). In-office procedure pricing is inclusive of facility fees.
- Physical therapy or hand therapy
- Durable Medical Equipment
- Splints or Casts
These services are billed separately and are your responsibility.
Will you bill my insurance if I choose self-pay?
No. By choosing self-pay, you are agreeing that we will not bill your insurance for these services.
Can I submit the bill to my insurance myself?
You may choose to submit your bill to your insurance; however, reimbursement is not guaranteed and depends entirely on your insurance plan. We do not guarantee any reimbursement.
What if I have insurance but still want self-pay pricing?
You are welcome to elect self-pay. However, we strongly recommend checking with your insurance provider first, as using self-pay may affect your benefits and reimbursement eligibility.
Will I receive a cost estimate before my procedure?
Yes. Under the No Surprises Act, you have the right to receive a Good Faith Estimate outlining expected charges before your service.
Can the final cost change from the estimate?
Yes. Prices are based on standard procedures. Your final cost may vary depending on your specific medical needs, complexity of the consultation, or any additional services required.
When is payment due?
Payment is typically required in full the same day of your consultation and treatment.
Are deposits required?
Yes, deposits may be required to schedule certain procedures. Details will be provided during scheduling.
What if additional services are needed during my procedure?
If additional medically necessary services are required, they may result in additional charges that are not included in your initial estimate.
Do you offer refunds if I cancel my procedure?
Cancellation and refund policies may apply. Depending on timing, deposits may be non-refundable or subject to administrative fees.
Are results guaranteed?
No. All medical procedures carry risks, and outcomes cannot be guaranteed.
Who can I contact for more information or a detailed estimate?
Please call 949-586-3200 or email info@scosortho.com to request a Good Faith Estimate or speak with our team.
