Hospital · CCN 010040

Gadsden Regional Medical Center

1007 Goodyear Avenue, Gadsden, AL 35903 · Etowah County
Part of Community Health Systems · 175 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

38 admission types 46 outpatient services price file: ok 38 Medicare-file findings
Billed per dollar paid, all admissions
16.01×
$156.5M billed against $9.8M paid across 1,047 Medicare discharges; the national figure is 5.03×.
8.3%
of adults in Etowah County have medical debt in collections
11.3%
uninsured in the county · state 10.5%
$53K
median household income
10.9×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (2 in the inpatient or outpatient file)ⓘ
43.8%
obesity in the countyⓘ
16.3%
diagnosed diabetes (PLACES)
8.5%
coronary heart disease (PLACES)
—
median age · — below poverty (ACS)
01 · Admissions

What it billed Medicare, by admission type

Average charge submitted and average total payment per discharge, 2024. Rows under 11 discharges are suppressed by CMS. The last column is the hospital's ratio against its state's for the same admission.

DRG
Admission
Discharges
Charge
Paid
Billed ÷ paid
871
Septicemia or severe sepsis without mv >96 hours with mcc
109
$208,847
$12,946
16.1× st 5.5×
885
Psychoses
81
$120,215
$9,610
12.5× st 5.4×
291
Heart failure and shock with mcc
65
$144,862
$8,896
16.3× st 4.5×
280
Acute myocardial infarction, discharged alive with mcc
64
$150,690
$10,808
13.9× st 6.1×
193
Simple pneumonia and pleurisy with mcc
39
$137,014
$8,720
15.7× st 5.1×
689
Kidney and urinary tract infections with mcc
39
$152,510
$8,276
18.4× st 5.1×
683
Renal failure with cc
38
$98,745
$6,433
15.4× st 4.9×
682
Renal failure with mcc
36
$149,983
$9,971
15.0× st 5.3×
177
Respiratory infections and inflammations with mcc
35
$213,777
$11,282
18.9× st 5.0×
690
Kidney and urinary tract infections without mcc
35
$107,696
$5,936
18.1× st 4.3×
190
Chronic obstructive pulmonary disease with mcc
31
$127,582
$7,469
17.1× st 5.3×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
26
$138,118
$8,523
16.2× st 5.9×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
26
$111,503
$6,304
17.7× st 5.2×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
25
$119,496
$8,827
13.5× st 4.8×
378
Gastrointestinal hemorrhage with cc
25
$143,177
$7,145
20.0× st 5.9×
312
Syncope and collapse
25
$109,425
$6,420
17.0× st 5.3×
064
Intracranial hemorrhage or cerebral infarction with mcc
24
$180,647
$12,031
15.0× st 6.1×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
22
$78,588
$5,816
13.5× st 4.3×
309
Cardiac arrhythmia and conduction disorders with cc
22
$107,730
$5,597
19.2× st 4.9×
872
Septicemia or severe sepsis without mv >96 hours without mcc
21
$135,244
$7,764
17.4× st 4.9×
281
Acute myocardial infarction, discharged alive with cc
20
$100,327
$6,285
16.0× st 7.2×
377
Gastrointestinal hemorrhage with mcc
19
$215,519
$12,784
16.9× st 5.8×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
19
$219,127
$13,017
16.8× st 7.1×
313
Chest pain
18
$88,567
$5,531
16.0× st 4.8×
389
Gastrointestinal obstruction with cc
16
$114,952
$5,959
19.3× st 5.2×
189
Pulmonary edema and respiratory failure
15
$123,857
$8,768
14.1× st 5.6×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
15
$272,790
$14,455
18.9× st 8.9×
853
Infectious and parasitic diseases with o.r. procedures with mcc
15
$449,354
$28,349
15.9× st 5.8×
522
Hip replacement with principal diagnosis of hip fracture without mcc
14
$217,536
$13,914
15.6× st 5.9×
698
Other kidney and urinary tract diagnoses with mcc
14
$170,563
$10,900
15.6× st 5.0×
101
Seizures without mcc
13
$129,348
$10,746
12.0× st 4.9×
069
Transient ischemia without thrombolytic
12
$105,193
$6,013
17.5× st 6.7×
308
Cardiac arrhythmia and conduction disorders with mcc
12
$166,398
$8,613
19.3× st 5.0×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
12
$79,136
$4,527
17.5× st 5.0×
603
Cellulitis without mcc
12
$108,259
$6,536
16.6× st 4.0×
282
Acute myocardial infarction, discharged alive without cc/mcc
11
$84,088
$5,455
15.4× st 9.7×
390
Gastrointestinal obstruction without cc/mcc
11
$69,613
$4,476
15.6× st 7.5×
394
Other digestive system diagnoses with cc
11
$136,235
$7,214
18.9× st 5.2×
02 · Outpatient

Outpatient services

Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.

APC
Service
Services
Charge
Allowed
Billed ÷ allowed
5374
Level 4 Urology and Related Services
134
$84,567
$2,812
30.1×
5375
Level 5 Urology and Related Services
110
$75,484
$4,105
18.4×
5191
Level 1 Endovascular Procedures
104
$59,203
$2,650
22.3×
8011
Comprehensive Observation Services
96
$72,394
$2,093
34.6×
5302
Level 2 Upper GI Procedures
96
$38,422
$1,516
25.3×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
71
$35,326
$1,272
27.8×
5373
Level 3 Urology and Related Services
68
$60,663
$1,623
37.4×
5115
Level 5 Musculoskeletal Procedures
68
$189,943
$10,627
17.9×
5361
Level 1 Laparoscopy and Related Services
57
$108,712
$4,608
23.6×
5114
Level 4 Musculoskeletal Procedures
41
$120,942
$5,611
21.6×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
24
$58,205
$2,356
24.7×
5113
Level 3 Musculoskeletal Procedures
20
$79,044
$2,684
29.5×
5183
Level 3 Vascular Procedures
20
$54,032
$2,537
21.3×
5116
Level 6 Musculoskeletal Procedures
18
$215,264
$15,421
14.0×
5193
Level 3 Endovascular Procedures
18
$172,833
$8,701
19.9×
5223
Level 3 Pacemaker and Similar Procedures
14
$119,206
$8,850
13.5×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
14
$94,414
$2,868
32.9×
5112
Level 2 Musculoskeletal Procedures
11
$53,259
$1,333
40.0×
5362
Level 2 Laparoscopy and Related Services
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5376
Level 6 Urology and Related Services
—
—
—
—
5378
Level 8 Urology and Related Services
—
—
—
—
5627
Level 7 Radiation Therapy
—
—
—
—
5414
Level 4 Gynecologic Procedures
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5165
Level 5 ENT Procedures
—
—
—
—
5182
Level 2 Vascular Procedures
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5184
Level 4 Vascular Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5192
Level 2 Endovascular Procedures
—
—
—
—
5194
Level 4 Endovascular Procedures
—
—
—
—
5222
Level 2 Pacemaker and Similar Procedures
—
—
—
—
5154
Level 4 Airway Endoscopy
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5313
Level 3 Lower GI Procedures
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
03 · Its own price file

What the hospital's price-transparency file says

Found via /cms-hpt.txt, the file itself ↗ read as csv-wide, last updated 2026-04-01, template 3.0.0, 65,262 rows scanned, 3,571 distinct code–setting items kept. 3,050 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
BONE SRGRY CMPTR FLUOR IMAGE
$226,155
$27,139
$150,393
20
clean
BONE SRGRY CMPTR CT/MRI IMAG
$204,902
$24,588
$136,260
20
clean
NJX B1 SUB MTRL SBCHDRL DFCT
$116,291
$13,955
$3,784
42
clean
FNA BX W/FLUOR GDN 1ST LES
$119,979
$14,398
$794
49
clean
FNA BX W/CT GDN 1ST LES
$119,979
$14,398
$794
49
clean
FNA BX W/O IMG GDN 1ST LES
$114,675
$13,761
$501
46
clean
DRAINAGE OF SKIN ABSCESS
$13,896
$1,667
$253
48
clean
DRAINAGE OF SKIN ABSCESS
$56,508
$6,781
$410
48
clean
DRAINAGE OF PILONIDAL CYST
$14,176
$1,701
$652
48
clean
REMOVE FOREIGN BODY
$23,371
$2,805
$374
48
clean
REMOVE FOREIGN BODY
$74,766
$8,972
$1,730
48
clean
DRAINAGE OF HEMATOMA/FLUID
$61,365
$7,364
$1,693
48
clean
PUNCTURE DRAINAGE OF LESION
$5,904
$708
$384
45
clean
COMPLEX DRAINAGE, WOUND
$67,582
$8,110
$2,892
48
clean
DEBRIDE INFECTED SKIN
$76,082
$9,130
$544
45
clean
DEBRIDE SKIN/MUSCLE/BONE, FX
$85,056
$10,207
$2,717
48
clean
DEBRIDE SKIN/TISSUE
$31,841
$3,821
$446
48
clean
DEBRIDE TISSUE/MUSCLE
$39,192
$4,703
$691
48
clean
DEBRIDE TISSUE/MUSCLE/BONE
$71,321
$8,559
$1,545
48
clean
DBRDMT SUBQ TISS EACH ADDL
$65,576
$7,869
$39,346
21
clean
DBRDMT MUSC&/FSCA EA ADDL
$88,339
$10,601
$53,003
21
clean
DBRDMT BONE EACH ADDL
$106,081
$12,730
$63,649
21
clean
PUNCH BX SKIN SINGLE LESION
$60,967
$7,316
$547
45
clean
PUNCH BX SKIN EA SEP/ADDL
$81,445
$9,773
$48,867
21
clean
INCAL BX SKN SINGLE LES
$78,118
$9,374
$994
45
clean
REMOVAL OF SKIN TAGS
$56,890
$6,827
$270
45
clean
REMOVE SKIN TAGS ADD-ON
$36,456
$4,375
$21,874
21
clean
REMOVAL OF SKIN LESION
$67,160
$8,059
$953
45
clean
REMOVAL OF SKIN LESION
$57,456
$6,895
$547
45
clean
REMOVAL OF SKIN LESION
$51,170
$6,140
$953
45
clean
REMOVAL OF SKIN LESION
$51,225
$6,147
$731
48
clean
REMOVAL OF SKIN LESION
$46,612
$5,593
$1,730
48
clean
REMOVAL OF SKIN LESION
$61,198
$7,344
$1,825
48
clean
REMOVAL OF SKIN LESION
$53,109
$6,373
$1,852
45
clean
REMOVAL OF SKIN LESION
$47,030
$5,644
$953
45
clean
REMOVAL OF SKIN LESION
$46,308
$5,557
$1,852
45
clean
REMOVAL OF SKIN LESION
$58,533
$7,024
$1,730
48
clean
REMOVAL OF SKIN LESION
$54,679
$6,562
$1,730
48
clean
REMOVAL OF SKIN LESION
$59,033
$7,084
$2,892
48
clean
REMOVAL OF SKIN LESION
$50,633
$6,076
$953
45
clean
REMOVAL OF SKIN LESION
$63,503
$7,620
$953
45
clean
REMOVAL OF SKIN LESION
$48,445
$5,813
$1,852
45
clean
REMOVAL OF SKIN LESION
$83,115
$9,974
$1,611
48
clean
REMOVAL OF SKIN LESION
$79,692
$9,563
$2,892
48
clean
REMOVAL, SWEAT GLAND LESION
$89,309
$10,717
$2,892
48
clean
REMOVAL, SWEAT GLAND LESION
$73,061
$8,767
$2,892
48
clean
REMOVAL OF SKIN LESION
$39,388
$4,727
$547
45
clean
REMOVAL OF SKIN LESION
$62,478
$7,497
$953
45
clean
REMOVAL OF SKIN LESION
$23,894
$2,867
$662
48
clean
REMOVAL OF SKIN LESION
$65,922
$7,911
$1,825
48
clean
REMOVAL OF SKIN LESION
$97,734
$11,728
$953
45
clean
REMOVAL OF SKIN LESION
$83,796
$10,056
$953
45
clean
REMOVAL OF SKIN LESION
$66,898
$8,028
$1,852
45
clean
REMOVAL OF SKIN LESION
$75,591
$9,071
$2,892
48
clean
REMOVAL OF SKIN LESION
$91,648
$10,998
$953
45
clean
REMOVAL OF SKIN LESION
$94,047
$11,286
$1,852
45
clean
REMOVAL OF SKIN LESION
$52,507
$6,301
$1,730
48
clean
REMOVAL OF SKIN LESION
$62,534
$7,504
$2,892
48
clean
REMOVAL OF NAIL PLATE
$30,450
$3,654
$270
45
clean
DRAIN BLOOD FROM UNDER NAIL
$16,456
$1,975
$126
45
clean
REMOVAL OF NAIL BED
$58,757
$7,051
$446
48
clean
REPAIR OF NAIL BED
$74,417
$8,930
$829
45
clean
EXCISION OF NAIL FOLD, TOE
$50,481
$6,058
$456
45
clean
REMOVAL OF PILONIDAL LESION
$54,279
$6,514
$2,892
48
clean
REMOVAL OF PILONIDAL LESION
$67,527
$8,103
$2,892
48
clean
REMOVAL OF PILONIDAL LESION
$86,881
$10,426
$2,892
48
clean
INSERTION DRUG DLVR IMPLANT
$170,358
$20,443
$262
48
clean
REMOVE DRUG IMPLANT DEVICE
$81,516
$9,782
$429
48
clean
REPAIR SUPERFICIAL WOUND(S)
$13,604
$1,632
$225
45
clean
REPAIR SUPERFICIAL WOUND(S)
$15,725
$1,887
$225
45
clean
REPAIR SUPERFICIAL WOUND(S)
$29,468
$3,536
$270
45
clean
REPAIR SUPERFICIAL WOUND(S)
$21,320
$2,558
$374
48
clean
REPAIR SUPERFICIAL WOUND(S)
$23,355
$2,803
$374
48
clean
REPAIR SUPERFICIAL WOUND(S)
$7,228
$867
$270
48
clean
REPAIR SUPERFICIAL WOUND(S)
$17,058
$2,047
$225
45
clean
REPAIR SUPERFICIAL WOUND(S)
$21,612
$2,593
$225
45
clean
REPAIR SUPERFICIAL WOUND(S)
$21,803
$2,616
$225
45
clean
REPAIR SUPERFICIAL WOUND(S)
$48,159
$5,779
$270
45
clean
LAYER CLOSURE OF WOUND(S)
$26,266
$3,152
$437
45
clean
LAYER CLOSURE OF WOUND(S)
$53,719
$6,446
$446
48
clean
LAYER CLOSURE OF WOUND(S)
$26,432
$3,172
$380
48
clean
LAYER CLOSURE OF WOUND(S)
$64,105
$7,693
$446
48
clean
REPAIR OF WOUND OR LESION
$44,278
$5,313
$446
48
clean
REPAIR OF WOUND OR LESION
$91,856
$11,023
$448
48
clean
REPAIR OF WOUND OR LESION
$100,570
$12,068
$448
48
clean
REPAIR WOUND/LESION ADD-ON
$100,570
$12,068
$60,342
21
clean
LATE CLOSURE OF WOUND
$62,464
$7,496
$3,315
48
clean
SKIN TISSUE REARRANGEMENT
$76,636
$9,196
$2,131
48
clean
WOUND PREP TRK/ARM/LEG
$51,871
$6,225
$911
48
clean
SKIN SPLIT GRAFT
$131,801
$15,816
$3,623
48
clean
SKIN SUB GRAFT TRNK/ARM/LEG
$53,477
$6,417
$763
46
clean
SKIN SUB GRAFT FACE/NK/HF/G
$68,339
$8,201
$763
46
clean
RMV SUTURE OR STAPLE
$1,703
$204
$1,047
24
clean
TREATMENT OF BURN(S)
$16,452
$1,974
$270
48
clean
TREATMENT OF BURN(S)
$24,447
$2,934
$380
48
clean
DESTRUCT LESION, 1-14
$53,015
$6,362
$270
45
clean
DESTRUCT LESION, 15 OR MORE
$84,815
$10,178
$287
48
clean
SKIN TISSUE PROCEDURE
$99,687
$11,962
$319
44
clean
INCISION OF BREAST LESION
$47,258
$5,671
$1,937
48
clean
BIOPSY OF BREAST
$49,056
$5,887
$1,798
49
clean
BIOPSY OF BREAST
$74,849
$8,982
$3,628
49
clean
NIPPLE EXPLORATION
$69,963
$8,396
$3,663
48
clean
REMOVAL OF BREAST LESION
$56,783
$6,814
$3,628
49
clean
EXCISION, BREAST LESION
$86,823
$10,419
$3,628
49
clean
PERQ DEVICE BREAST 1ST IMAG
$132,455
$15,895
$1,679
44
clean
PARTIAL MASTECTOMY
$108,578
$13,029
$3,799
48
clean
MAST SIMPLE COMPLETE
$155,485
$18,658
$6,114
48
clean
MAST MOD RAD
$146,351
$17,562
$6,212
48
clean
BONE BIOPSY, EXCISIONAL
$71,874
$8,625
$2,892
48
clean
OPEN BONE BIOPSY
$76,364
$9,164
$6,727
48
clean
INJECT TENDON/LIGAMENT/CYST
$153,197
$18,384
$413
45
clean
NJX 1/MLT TRIGGER POINT 1/2
$74,192
$8,903
$413
45
clean
NJX 1/MLT TRIGGER POINTS 3/>
$156,144
$18,737
$413
45
clean
NDL WO INJ 1 2 M PT
$286
$34
$43
46
clean
NDL WO INJ 3PL M PT
$521
$63
$52
46
clean
S-JOINT ASP-INJ SM
$1,273
$153
$290
45
clean
US-DRN INJ SMAL JT W
$7,383
$886
$288
48
clean
DRAIN/INJECT, JOINT/BURSA
$106,564
$12,788
$346
48
clean
US-DRN INJ INTM JT W
$7,383
$886
$660
48
clean
DRAIN/INJECT, JOINT/BURSA
$12,294
$1,475
$288
48
clean
US-DRN INJ MAJR JT W
$7,383
$886
$288
48
clean
REMOVAL OF SUPPORT IMPLANT
$105,570
$12,668
$3,148
48
clean
MNL PREP&INSJ DP RX DLVR DEV
$117,439
$14,093
$70,463
21
clean
SPINAL BONE ALLOGRAFT
$202,691
$24,323
$121,614
21
clean
CPTR-ASST DIR MS PX
$177,869
$21,344
$112,057
21
clean
MUSCULOSKELETAL SURGERY
$234,834
$28,180
$3,758
44
clean
EXC FACE LES SC <2 CM
$20,104
$2,412
$1,521
48
clean
EXC FACE LES SBQ 2 CM/>
$64,386
$7,726
$1,706
48
clean
REMOVE EXOSTOSIS, MANDIBLE
$101,664
$12,200
$3,900
45
clean
EAR CARTILAGE GRAFT
$147,398
$17,688
$5,398
48
clean
CRANIO/MAXILLOFACIAL SURGERY
$110,879
$13,306
$430
44
clean
TREATMENT OF NOSE FRACTURE
$47,833
$5,740
$3,102
48
clean
TREATMENT OF NOSE FRACTURE
$117,136
$14,056
$5,451
48
clean
TREAT NASAL SEPTAL FRACTURE
$87,396
$10,488
$3,379
48
clean
DRAIN NECK/CHEST LESION
$49,849
$5,982
$3,141
48
clean
BIOPSY OF NECK/CHEST
$25,726
$3,087
$1,545
48
clean
EXC NECK LES SC 3 CM/>
$71,528
$8,583
$3,141
48
clean
EXC NECK TUM DEEP 5 CM/>
$90,755
$10,891
$3,141
48
clean
REMOVE LESION, NECK/CHEST
$60,938
$7,313
$1,825
48
clean
REMOVE LESION, NECK/CHEST
$68,005
$8,161
$3,141
48
clean
EXC BACK LES SC 3 CM/>
$65,746
$7,889
$2,037
48
clean
EXC BACK TUM DEEP < 5 CM
$57,160
$6,859
$2,717
48
clean
EXC BACK TUM DEEP 5 CM/>
$45,079
$5,410
$2,892
48
clean
PERQ VERTEBRAL AUGMENTATION
$100,273
$12,033
$6,727
48
clean
PERQ VERTEBRAL AUGMENTATION
$94,339
$11,321
$6,727
48
clean
PERQ VERTEBRAL AUGMENTATION
$108,143
$12,977
$64,886
21
clean
ARTHRD ANT NTRBDY CERVICAL
$202,651
$24,318
$11,816
46
clean
ARTHRD ANT NTRBD CERVICAL EA
$226,579
$27,190
$135,948
21
clean
NECK SPINE FUSION
$251,285
$30,154
$12,112
43
clean
ADDITIONAL SPINAL FUSION
$244,680
$29,362
$146,808
21
clean
LUMBAR SPINE FUSION
$465,818
$55,898
$16,041
43
clean
LUMBAR SPINE FUSION
$334,694
$40,163
$24,712
42
clean
SPINE FUSION, EXTRA SEGMENT
$423,504
$50,821
$254,103
21
clean
ARTHRD CMBN 1NTRSPC LUMBAR
$361,122
$43,335
$24,712
42
clean
EXPLORATION OF SPINAL FUSION
$286,219
$34,346
$6,852
45
clean
INSERT SPINE FIXATION DEVICE
$354,525
$42,543
$212,715
21
clean
INSERT SPINE FIXATION DEVICE
$341,723
$41,007
$205,034
21
clean
INSERT SPINE FIXATION DEVICE
$216,790
$26,015
$117,934
24
clean
INSERT SPINE FIXATION DEVICE
$290,751
$34,890
$174,450
21
clean
INSJ BIOMECHANICAL DEVICE
$253,370
$30,404
$152,022
21
clean
INSJ BIOMECHANICAL DEVICE
$286,219
$34,346
$171,731
21
clean
INSJ BIOMECHANICAL DEVICE
$269,430
$32,332
$161,658
21
clean
REMOVE ABDOMINAL WALL LESION
$151,469
$18,176
$2,892
48
clean
EXC ABD LES SC < 3 CM
$82,937
$9,952
$1,825
48
clean
EXC ABD LES SC 3 CM/>
$108,110
$12,973
$2,892
48
clean
EXC SHOULDER LES SC 3 CM/>
$62,276
$7,473
$2,037
48
clean
REMOVAL OF SHOULDER LESION
$67,414
$8,090
$1,825
48
clean
PARTIAL REMOVAL, COLLAR BONE
$251,790
$30,215
$3,784
48
clean
REMOVAL OF BONE LESION
$85,283
$10,234
$3,379
48
clean
S-INJ SHOULDER ARTH
$3,077
$369
$2,154
48
clean
REPAIR OF TENDON(S)
$185,706
$22,285
$6,681
48
clean
REPAIR OF TENDON(S)
$175,063
$21,008
$6,681
48
clean
REPAIR BICEPS TENDON
$158,843
$19,061
$6,681
48
clean
RECONSTRUCT SHOULDER JOINT
$225,366
$27,044
$15,896
46
clean
TREAT CLAVICLE FRACTURE
$139,530
$16,744
$6,681
46
clean
TREAT CLAVICLE DISLOCATION
$188,563
$22,628
$6,681
46
clean
TREAT CLAVICLE DISLOCATION
$109,597
$13,152
$6,681
46
clean
TREAT HUMERUS FRACTURE
$213,842
$25,661
$11,702
46
clean
TREAT SHOULDER DISLOCATION
$22,778
$2,733
$305
45
clean
FIXATION OF SHOULDER
$98,394
$11,807
$1,658
48
clean
SHOULDER SURGERY PROCEDURE
$155,768
$18,692
$429
44
clean
EXC ARM/ELBOW LES SC 3 CM/>
$71,058
$8,527
$2,892
48
clean
REMOVAL OF ELBOW BURSA
$82,048
$9,846
$3,065
48
clean
REMOVAL OF ARM FOREIGN BODY
$12,116
$1,454
$1,531
45
clean
REMOVAL OF ARM FOREIGN BODY
$37,448
$4,494
$2,657
48
clean
S-INJ ELBOW ARTHRO
$1,870
$224
$1,383
42
clean
REPAIR OF BICEPS TENDON
$130,758
$15,691
$6,681
48
clean
REPAIR ARM TENDON/MUSCLE
$126,013
$15,122
$6,681
48
clean
REPAIR OF RUPTURED TENDON
$142,930
$17,152
$6,681
48
clean
REPR ELBOW LAT LIGMNT W/TISS
$112,878
$13,545
$3,900
45
clean
REPAIR ELBOW DEB/ATTCH OPEN
$115,657
$13,879
$3,379
48
clean
REPAIR OF HUMERUS
$202,764
$24,332
$11,816
46
clean
TREAT HUMERUS FRACTURE
$170,200
$20,424
$11,702
46
clean
TREAT HUMERUS FRACTURE
$105,873
$12,705
$341
48
clean
TREAT HUMERUS FRACTURE
$86,738
$10,409
$11,644
46
clean
TREAT ELBOW DISLOCATION
$39,408
$4,729
$338
48
clean
TREAT ELBOW DISLOCATION
$48,070
$5,768
$1,658
48
clean
TREAT ELBOW DISLOCATION
$10,553
$1,266
$277
45
clean
TREAT RADIUS FRACTURE
$37,645
$4,517
$1,481
48
clean
TREAT ULNAR FRACTURE
$131,747
$15,810
$6,681
46
clean

Showing the first 200 of 3,571 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
243 of 2,406 comparable items (10%) fail this check the same way — the column does not mean what the template says it means, for this file or for this reader; e.g. highest negotiated rate $441 exceeds the gross charge $286
warn
mrf_rate_without_estimate
5,323 of 5,323 percentage/algorithm rates across 766 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 11403/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27524/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43246/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59300/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75600/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82043/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 84702/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87149/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92524/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97598/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J3473/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11404/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27535/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43247/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75605/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82077/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 84703/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87158/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92526/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97602/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0583/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3475/o
info
mrf_item_fields_vary
this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11406/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27540/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43249/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59412/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75625/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82085/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 84999/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87168/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92558/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97605/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3480/o
info
mrf_item_fields_vary
this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11420/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27560/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43251/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59414/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75630/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82088/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85002/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87169/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92607/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97606/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0585/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3485/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11421/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27570/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43255/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59812/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75635/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82103/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85004/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87172/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92609/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97607/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0592/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3486/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11422/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27594/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43264/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59820/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75710/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82104/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85007/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87176/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92610/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97608/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0595/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3489/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11423/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27599/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43270/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 60100/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75716/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82105/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85008/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87177/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92611/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97610/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0601/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3490/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11424/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27603/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43274/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 60220/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82106/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85014/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87181/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92650/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97750/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0602/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7030/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11426/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27619/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43275/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 60240/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75726/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82108/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85018/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87184/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97760/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0612/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7040/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11441/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27632/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43280/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 60500/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75741/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82128/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85025/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87185/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92651/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97761/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0615/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7042/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11442/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27635/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43282/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62270/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 82131/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85027/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87186/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97763/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0616/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7050/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11443/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27650/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43499/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75743/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82135/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85041/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87190/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92653/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97802/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0618/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7060/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11444/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27654/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43752/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 62272/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82139/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85045/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87205/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92920/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97803/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0630/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7070/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11446/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27664/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43753/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62273/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 75746/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82140/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85048/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87206/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0636/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7100/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11462/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27695/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43762/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62302/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82150/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85049/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87207/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92924/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97804/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0637/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7120/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11463/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27698/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43763/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62303/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75756/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82157/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87209/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92928/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0640/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7121/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11602/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27766/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 44050/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62304/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75774/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82164/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85097/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87210/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 98970/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0650/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 11603/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27788/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 44180/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62305/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75809/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 82172/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 85220/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87220/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 92930/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0665/o
info
mrf_item_fields_vary
this code and setting cover at least 16 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item

Showing the first 200 of 3,050 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service
Severity
Rule
Detail
MS-DRG 064
info
inp_charge_10x_payment
average charge $180,647 is 15.0× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $138,118 is 16.2× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $105,193 is 17.5× the total payment
MS-DRG 101
info
inp_charge_10x_payment
average charge $129,348 is 12.0× the total payment
MS-DRG 177
info
inp_charge_10x_payment
average charge $213,777 is 18.9× the total payment
MS-DRG 189
info
inp_charge_10x_payment
average charge $123,857 is 14.1× the total payment
MS-DRG 190
info
inp_charge_10x_payment
average charge $127,582 is 17.1× the total payment
MS-DRG 193
info
inp_charge_10x_payment
average charge $137,014 is 15.7× the total payment
MS-DRG 280
info
inp_charge_10x_payment
average charge $150,690 is 13.9× the total payment
MS-DRG 281
info
inp_charge_10x_payment
average charge $100,327 is 16.0× the total payment
MS-DRG 282
info
inp_charge_10x_payment
average charge $84,088 is 15.4× the total payment
MS-DRG 291
info
inp_charge_10x_payment
average charge $144,862 is 16.3× the total payment
MS-DRG 308
info
inp_charge_10x_payment
average charge $166,398 is 19.3× the total payment
MS-DRG 309
info
inp_charge_10x_payment
average charge $107,730 is 19.2× the total payment
MS-DRG 310
info
inp_charge_10x_payment
average charge $79,136 is 17.5× the total payment
MS-DRG 312
info
inp_charge_10x_payment
average charge $109,425 is 17.0× the total payment
MS-DRG 313
info
inp_charge_10x_payment
average charge $88,567 is 16.0× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $272,790 is 18.9× the total payment
MS-DRG 377
info
inp_charge_10x_payment
average charge $215,519 is 16.9× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $143,177 is 20.0× the total payment
MS-DRG 389
info
inp_charge_10x_payment
average charge $114,952 is 19.3× the total payment
MS-DRG 390
info
inp_charge_10x_payment
average charge $69,613 is 15.6× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $111,503 is 17.7× the total payment
MS-DRG 394
info
inp_charge_10x_payment
average charge $136,235 is 18.9× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $219,127 is 16.8× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $217,536 is 15.6× the total payment
MS-DRG 603
info
inp_charge_10x_payment
average charge $108,259 is 16.6× the total payment
MS-DRG 640
info
inp_charge_10x_payment
average charge $119,496 is 13.5× the total payment
MS-DRG 641
info
inp_charge_10x_payment
average charge $78,588 is 13.5× the total payment
MS-DRG 682
info
inp_charge_10x_payment
average charge $149,983 is 15.0× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $98,745 is 15.3× the total payment
MS-DRG 689
info
inp_charge_10x_payment
average charge $152,510 is 18.4× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $107,696 is 18.1× the total payment
MS-DRG 698
info
inp_charge_10x_payment
average charge $170,563 is 15.6× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $449,354 is 15.9× the total payment
MS-DRG 871
info
inp_charge_10x_payment
average charge $208,847 is 16.1× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $135,244 is 17.4× the total payment
MS-DRG 885
info
inp_charge_10x_payment
average charge $120,215 is 12.5× the total payment

Sources for this hospital

the files read, as fetched — not our copy of them
  1. MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
  2. MUP_OUT_RY26_P04_V10_DY24_Prov_Svc.csv · 28.1M bytes · fetched 2026-08-21 · sha256 f293918edbf6… · publisher's page · public domain (US federal)
  3. chsp-hospital-linkage-2023.csv · 1.5M bytes · fetched 2026-08-21 · sha256 a86146f10c8d… · publisher's page · public; cite AHRQ Compendium of U.S. Health Systems
  4. 2020 ZCTA to County relationship file · US Census Bureau · 2020
    tab20_zcta520_county20_natl.txt · 6.8M bytes · fetched 2026-08-21 · sha256 3ed41278d637… · publisher's page · public domain (US federal)
  5. · csv-wide · 119.6M bytes · fetched 2026-08-26 · sha256 2deeea276770…

Every figure on this page is computed from these files by pipeline/prices/; the same rows are in the API.

Source rows for this hospital as JSON: inpatient · outpatient · price file. CMS, Medicare Inpatient and Outpatient Hospitals by Provider and Service, 2024.