Price Checker / CPT 31255
How much does Nsl/sins Ndsc W/tot Ethmdct cost?
CPT 31255 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 78x the fair price — among the most extreme markups. Dispute this.
Fair price
$410–$820
What this should cost
With insurance
~$4,000
Typical out-of-pocket
Overcharged if over
$1,050
Push back above this
The average hospital charge of $48,445 is $47,825 over the fair price (about 78x the fair rate).
What hospitals charge for Nsl/sins Ndsc W/tot Ethmdct
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| John Muir Health Walnut Creek Medical Center , CA | $132,030 | $59,414 | 48224% |
| John Muir Health Behavioral Health Center , CA | $128,390 | $57,776 | 46891% |
| John Muir Health Concord Medical Center , CA | $128,390 | $57,776 | 46891% |
| ST RITA'S MEDICAL CENTER Lima, OH | $108,035 | — | 24893% |
| AdventHealth Lenexa City Center , KS | $59,793 | $29,897 | 21785% |
| AdventHealth Overland Park , KS | $59,793 | $29,897 | 21785% |
| AdventHealth Shawnee Mission SHAWNEE MISSION, KS | $59,793 | $29,897 | 21785% |
| The Christ Hospital Inpatient Psychiatry , OH | $39,570 | $14,292 | 14383% |
| The Christ Hospital Inpatient Rehab , OH | $39,570 | $14,292 | 14383% |
| The Christ Hospital Liberty , OH | $39,570 | $14,292 | 14383% |
| The Christ Hospital , OH | $39,570 | $14,292 | 14383% |
| St. Anne Hospital , WA | — | — | 11462% |
| Huntington Hospital PASADENA, NY | — | $9,188 | 9376% |
| Inova Alexandria Hospital ALEXANDRIA, VA | — | — | 9151% |
| Inova Fair Oaks Hospital FAIRFAX, VA | — | — | 9151% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Nsl/sins Ndsc W/tot Ethmdct
CPT code 31255 refers to nsl/sins ndsc w/tot ethmdct (billing description: "Nsl/sins ndsc w/tot ethmdct"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $273 in a facility (hospital or surgery center) and $273 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.