Hospital · CCN 030117

Valley View Medical Center

5330 South Highway 95, Fort Mohave, AZ 86426 · Mohave County
Part of Lifepoint Health · 72 beds · 5
Secondary flow 30% to <50% to a urban cluster of 10,000 to 49,999

3 admission types 30 outpatient services price file: ok

Billed per dollar paid, all admissions

7.64×

$5.6M billed against $730K paid across 61 Medicare discharges; the national figure is 5.03×.

3.5%

of adults in Mohave County have medical debt in collections

14.1%

uninsured in the county · state 12.7%

$56K

median household income

8.9×

billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (5 in the inpatient or outpatient file)ⓘ

32.7%

obesity in the countyⓘ

14.2%

diagnosed diabetes (PLACES)

10.0%

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

$100,197

$14,864

6.7× st 5.0×

193

Simple pneumonia and pleurisy with mcc

$91,753

$9,913

9.3× st 5.1×

194

Simple pneumonia and pleurisy with cc

$66,562

$6,718

9.9× st 5.0×

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

8011

Comprehensive Observation Services

$43,754

$2,708

16.2×

5115

Level 5 Musculoskeletal Procedures

$170,550

$13,002

13.1×

5491

Level 1 Intraocular Procedures

$22,564

$2,000

11.3×

5116

Level 6 Musculoskeletal Procedures

$144,710

$18,397

7.9×

5113

Level 3 Musculoskeletal Procedures

$52,047

$3,203

16.3×

5114

Level 4 Musculoskeletal Procedures

$95,694

$7,079

13.5×

5373

Level 3 Urology and Related Services

$46,381

$2,015

23.0×

5191

Level 1 Endovascular Procedures

$69,781

$3,229

21.6×

5112

Level 2 Musculoskeletal Procedures

$30,438

$1,591

19.1×

5361

Level 1 Laparoscopy and Related Services

—

5372

Level 2 Urology and Related Services

—

5374

Level 4 Urology and Related Services

—

5375

Level 5 Urology and Related Services

—

5414

Level 4 Gynecologic Procedures

—

5415

Level 5 Gynecologic Procedures

—

5431

Level 1 Nerve Procedures

—

5503

Level 3 Extraocular, Repair, and Plastic Eye Procedures

—

5341

Level 1 Abdominal/Peritoneal/Biliary and Related Procedures

—

5302

Level 2 Upper GI Procedures

—

5073

Level 3 Excision/ Biopsy/ Incision and Drainage

—

5154

Level 4 Airway Endoscopy

—

5163

Level 3 ENT Procedures

—

5164

Level 4 ENT Procedures

—

5165

Level 5 ENT Procedures

—

5182

Level 2 Vascular Procedures

—

5183

Level 3 Vascular Procedures

—

5193

Level 3 Endovascular Procedures

—

5223

Level 3 Pacemaker and Similar Procedures

—

5231

Level 1 ICD and Similar Procedures

—

5072

Level 2 Excision/ Biopsy/ Incision and Drainage

—

03 · Its own price file

What the hospital's price-transparency file says

Found via /cms-hpt.txt, the file itself ↗ read as csv-tall, last updated 7/10/2026, template 3.0.0, 127,133 rows scanned, 2,570 distinct code–setting items kept. 2,674 findings against it.

Service

Code

Listed

Cash

Negotiated

Rates

Checks

Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as qu

CPT 0003M

$3,022

$1,813

$222

clean

Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nas

CPT 0202U

$1,838

$1,103

$500

clean

Fine needle aspiration biopsy, without imaging guidance; first lesion

CPT 10021

$1,178

$707

$1,060

clean

Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single

CPT 10060

$1,170

$702

$1,059

clean

Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple

CPT 10061

$1,184

$711

$1,496

clean

Incision and drainage of pilonidal cyst; simple

CPT 10080

$1,760

$1,056

$2,731

clean

Incision and drainage of pilonidal cyst; complicated

CPT 10081

$13,640

$8,184

$2,731

clean

Incision and removal of foreign body, subcutaneous tissues; simple

CPT 10120

$2,487

$1,492

$1,496

clean

Incision and removal of foreign body, subcutaneous tissues; complicated

CPT 10121

$34,315

$20,589

$6,354

clean

Incision and drainage of hematoma, seroma or fluid collection

CPT 10140

$8,070

$4,842

$6,173

clean

Puncture aspiration of abscess, hematoma, bulla, or cyst

CPT 10160

$1,348

$809

$1,059

clean

Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less

CPT 11042

$2,744

$1,646

$1,149

clean

Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less

CPT 11043

$2,476

$1,486

$1,677

clean

Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less

CPT 11044

$7,621

$4,572

$2,912

clean

Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

CPT 11045

$2,725

$1,635

$1,055

clean

Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

CPT 11046

$10,056

$6,034

$1,320

clean

Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

CPT 11047

$9,215

$5,529

$1,320

clean

Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion

CPT 11055

$1,043

$626

$1,019

clean

Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions

CPT 11056

$12,141

$7,285

$1,019

clean

Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion

CPT 11102

$1,866

$1,120

$1,924

clean

Punch biopsy of skin (including simple closure, when performed); single lesion

CPT 11104

$4,202

$2,521

$1,924

clean

Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure)

CPT 11105

$1,664

$999

$1,924

clean

Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion

CPT 11106

$2,341

$1,405

$4,393

clean

Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions

CPT 11200

$793

$476

$1,496

clean

Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm

CPT 11303

$1,459

$876

$1,066

clean

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm

CPT 11406

$34,996

$20,997

$6,354

clean

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm

CPT 11422

$31,738

$19,043

$2,731

clean

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

CPT 11423

$44,754

$26,852

$6,173

clean

Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm

CPT 11444

$50,005

$30,003

$2,731

clean

Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair

CPT 11450

$59,285

$35,571

$6,628

clean

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm

CPT 11606

$52,224

$31,334

$6,354

clean

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm

CPT 11626

$60,162

$36,097

$6,628

clean

Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm

CPT 11646

$19,416

$11,650

$6,628

clean

Debridement of nail(s) by any method(s); 6 or more

CPT 11721

$1,354

$812

$1,019

clean

Avulsion of nail plate, partial or complete, simple; single

CPT 11730

$774

$465

$1,019

clean

Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal

CPT 11750

$4,402

$2,641

$1,496

clean

Repair of nail bed

CPT 11760

$454

$273

$1,496

clean

Excision of pilonidal cyst or sinus; extensive

CPT 11771

$24,089

$14,454

$6,732

clean

Excision of pilonidal cyst or sinus; complicated

CPT 11772

$24,089

$14,454

$6,732

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less

CPT 12001

$956

$574

$1,052

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm

CPT 12002

$1,317

$790

$1,052

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

CPT 12004

$1,948

$1,169

$1,052

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm

CPT 12005

$1,267

$760

$1,052

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm

CPT 12006

$1,270

$762

$1,052

clean

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm

CPT 12007

$1,806

$1,083

$1,052

clean

Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less

CPT 12011

$952

$571

$1,052

clean

Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm

CPT 12013

$1,354

$812

$1,052

clean

Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm

CPT 12014

$1,435

$861

$1,052

clean

Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm

CPT 12015

$3,492

$2,095

$1,052

clean

Treatment of superficial wound dehiscence; simple closure

CPT 12020

$907

$544

$1,496

clean

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less

CPT 12031

$1,184

$711

$1,496

clean

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm

CPT 12032

$2,108

$1,265

$1,496

clean

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm

CPT 12035

$1,970

$1,182

$1,677

clean

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm

CPT 12036

$20,539

$12,323

$1,677

clean

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm

CPT 12037

$11,761

$7,057

$6,354

clean

Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less

CPT 12041

$968

$581

$1,496

clean

Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm

CPT 12042

$1,214

$728

$1,496

clean

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm

CPT 12052

$3,948

$2,369

$1,496

clean

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm

CPT 12053

$1,518

$911

$1,496

clean

Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less

CPT 14000

$44,971

$26,983

$6,354

clean

Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm

CPT 14001

$56,424

$33,855

$6,458

clean

Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less

CPT 14020

$27,437

$16,462

$6,458

clean

Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

CPT 15100

$28,333

$17,000

$6,354

clean

Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)

CPT 15120

$22,866

$13,720

$8,150

clean

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

CPT 15271

$9,901

$5,941

$6,354

clean

Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure

CPT 15272

$5,403

$3,242

$1,320

clean

Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area

CPT 15275

$9,371

$5,623

$6,354

clean

Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips

CPT 15630

$54,667

$32,800

$6,458

clean

Muscle, myocutaneous, or fasciocutaneous flap; trunk

CPT 15734

$15,966

$9,580

$8,253

clean

Muscle, myocutaneous, or fasciocutaneous flap; lower extremity

CPT 15738

$66,560

$39,936

$8,253

clean

Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area

CPT 15760

$29,392

$17,635

$6,354

clean

Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area

CPT 15839

$36,172

$21,703

$6,458

clean

Initial treatment, first degree burn, when no more than local treatment is required

CPT 16000

$1,155

$693

$1,019

clean

Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)

CPT 16020

$1,095

$657

$1,066

clean

Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)

CPT 16025

$1,159

$695

$1,066

clean

Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions

CPT 17110

$11,188

$6,713

$1,496

clean

Chemical cauterization of granulation tissue (ie, proud flesh)

CPT 17250

$1,374

$825

$1,496

clean

Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance

CPT 19083

$40,302

$24,181

$6,354

clean

Biopsy of breast; open, incisional

CPT 19101

$43,981

$26,388

$6,628

clean

Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct

CPT 19110

$34,492

$20,695

$6,628

clean

Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion

CPT 19125

$32,910

$19,746

$6,732

clean

Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance

CPT 19285

$22,723

$13,634

$2,731

clean

Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)

CPT 20552

$1,509

$905

$1,005

clean

Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance

CPT 20600

$2,109

$1,266

$1,496

clean

Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance

CPT 20605

$2,307

$1,384

$1,496

clean

Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance

CPT 20610

$2,605

$1,563

$1,496

clean

Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting

CPT 20611

$2,481

$1,488

$1,496

clean

Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)

CPT 20680

$38,149

$22,889

$6,732

clean

Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement)

CPT 20697

$27,669

$16,601

$3,015

clean

Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure)

CPT 20985

$35,055

$21,033

$1,239

clean

Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater

CPT 21012

$39,840

$23,904

$3,015

clean

Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater

CPT 21552

$28,296

$16,977

$6,628

clean

Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater

CPT 21931

$37,636

$22,582

$6,628

clean

Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater

CPT 22903

$39,890

$23,934

$6,924

clean

Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))

CPT 23472

$49,528

$29,717

$10,534

clean

Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)

CPT 23575

$2,622

$1,573

$1,496

clean

Closed treatment of shoulder dislocation, with manipulation; without anesthesia

CPT 23650

$2,248

$1,349

$1,496

clean

Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension

CPT 24546

$136,036

$81,621

$9,175

clean

Treatment of closed elbow dislocation; without anesthesia

CPT 24600

$999

$599

$1,496

clean

Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation

CPT 24640

$1,411

$847

$1,496

clean

Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater

CPT 25073

$32,434

$19,460

$6,732

clean

Open treatment of radial shaft fracture, includes internal fixation, when performed

CPT 25515

$32,111

$19,266

$8,844

clean

Closed treatment of radial and ulnar shaft fractures; without manipulation

CPT 25560

$30,695

$18,417

$1,071

clean

Closed treatment of radial and ulnar shaft fractures; with manipulation

CPT 25565

$32,469

$19,481

$1,677

clean

Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation

CPT 25605

$2,119

$1,272

$3,015

clean

Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation

CPT 25607

$57,165

$34,299

$9,175

clean

Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments

CPT 25608

$54,773

$32,864

$9,175

clean

Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments

CPT 25609

$57,682

$34,609

$9,175

clean

Drainage of finger abscess; simple

CPT 26010

$1,570

$942

$1,059

clean

Tendon sheath incision (eg, for trigger finger)

CPT 26055

$23,578

$14,147

$6,354

clean

Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger

CPT 26160

$30,439

$18,264

$6,458

clean

Closed treatment of metacarpal fracture, single; with manipulation, each bone

CPT 26605

$1,411

$847

$1,677

clean

Percutaneous skeletal fixation of metacarpal fracture, each bone

CPT 26608

$33,252

$19,951

$6,924

clean

Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia

CPT 26670

$1,344

$806

$1,071

clean

Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each

CPT 26725

$30,032

$18,019

$1,496

clean

Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each

CPT 26742

$1,411

$847

$1,677

clean

Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia

CPT 26770

$1,344

$806

$1,071

clean

Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure

CPT 26951

$21,144

$12,686

$6,354

clean

Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed

CPT 27096

$914

$548

$1,064

clean

Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft

CPT 27130

$142,236

$85,342

$10,426

clean

Closed treatment of hip dislocation, traumatic; without anesthesia

CPT 27250

$1,251

$750

$1,496

clean

Closed treatment of post hip arthroplasty dislocation; without anesthesia

CPT 27265

$4,536

$2,722

$1,496

clean

Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater

CPT 27339

$37,505

$22,503

$6,732

clean

Suture of infrapatellar tendon; primary

CPT 27380

$71,642

$42,985

$7,969

clean

Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

CPT 27447

$42,090

$25,254

$12,573

clean

Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair

CPT 27524

$82,716

$49,630

$8,844

clean

Closed treatment of patellar dislocation; without anesthesia

CPT 27560

$999

$599

$1,496

clean

Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle

CPT 27630

$48,680

$29,208

$6,732

clean

Repair, secondary, Achilles tendon, with or without graft

CPT 27654

$35,999

$21,599

$8,654

clean

Repair, flexor tendon, leg; primary, without graft, each tendon

CPT 27658

$69,762

$41,857

$6,447

clean

Repair, dislocating peroneal tendons; without fibular osteotomy

CPT 27675

$53,919

$32,352

$6,628

clean

Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendo

CPT 27691

$36,493

$21,896

$8,847

clean

Repair, primary, disrupted ligament, ankle; collateral

CPT 27695

$62,256

$37,353

$8,150

clean

Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation

CPT 27810

$1,031

$619

$2,731

clean

Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed

CPT 27814

$100,486

$60,292

$8,844

clean

Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip

CPT 27822

$91,639

$54,984

$8,844

clean

Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation

CPT 27825

$37,855

$22,713

$6,354

clean

Closed treatment of proximal tibiofibular joint dislocation; without anesthesia

CPT 27830

$74,883

$44,930

$1,071

clean

Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater

CPT 28039

$45,466

$27,279

$6,628

clean

Excision, interdigital (Morton) neuroma, single, each

CPT 28080

$38,433

$23,060

$6,732

clean

Ostectomy, complete excision; other metatarsal head (second, third or fourth)

CPT 28112

$25,441

$15,265

$6,732

clean

Ostectomy, complete excision; fifth metatarsal head

CPT 28113

$22,240

$13,344

$6,732

clean

Ostectomy, calcaneus

CPT 28118

$31,718

$19,031

$6,924

clean

Ostectomy, calcaneus; for spur, with or without plantar fascial release

CPT 28119

$43,812

$26,287

$6,924

clean

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus

CPT 28122

$42,928

$25,757

$6,732

clean

Metatarsectomy

CPT 28140

$13,160

$7,896

$6,732

clean

Removal of foreign body, foot; subcutaneous

CPT 28190

$2,635

$1,581

$2,731

clean

Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon

CPT 28200

$36,493

$21,896

$6,732

clean

Repair, tendon, extensor, foot; primary or secondary, each tendon

CPT 28208

$24,284

$14,570

$6,732

clean

Tenotomy, open, extensor, foot or toe, each tendon

CPT 28234

$24,284

$14,570

$6,628

clean

Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)

CPT 28270

$56,231

$33,739

$6,732

clean

Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)

CPT 28285

$35,879

$21,527

$6,732

clean

Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type procedure)

CPT 28286

$23,242

$13,945

$6,924

clean

Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head

CPT 28288

$16,137

$9,682

$6,732

clean

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant

CPT 28289

$53,777

$32,266

$6,732

clean

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant

CPT 28291

$60,018

$36,011

$8,844

clean

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method

CPT 28292

$38,456

$23,074

$8,150

clean

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method

CPT 28296

$45,111

$27,067

$8,253

clean

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method

CPT 28297

$73,539

$44,123

$8,253

clean

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method

CPT 28298

$16,137

$9,682

$8,253

clean

Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method

CPT 28299

$16,013

$9,608

$8,584

clean

Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each

CPT 28308

$52,187

$31,312

$6,628

clean

Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)

CPT 28313

$29,193

$17,516

$6,628

clean

Sesamoidectomy, first toe (separate procedure)

CPT 28315

$26,940

$16,164

$6,924

clean

Repair, nonunion or malunion; tarsal bones

CPT 28320

$23,500

$14,100

$9,037

clean

Closed treatment of talus fracture; with manipulation

CPT 28435

$2,691

$1,615

$6,354

clean

Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each

CPT 28465

$38,444

$23,067

$8,844

clean

Open treatment of metatarsal fracture, includes internal fixation, when performed, each

CPT 28485

$67,199

$40,319

$9,037

clean

Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each

CPT 28515

$1,411

$847

$1,071

clean

Closed treatment of interphalangeal joint dislocation; requiring anesthesia

CPT 28665

$1,366

$820

$1,496

clean

Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse

CPT 28730

$81,298

$48,779

$9,037

clean

Arthrodesis, midtarsal or tarsometatarsal, single joint

CPT 28740

$69,518

$41,711

$9,037

clean

Arthrodesis, great toe; metatarsophalangeal joint

CPT 28750

$64,746

$38,848

$9,037

clean

Arthrodesis, great toe; interphalangeal joint

CPT 28755

$52,679

$31,607

$6,924

clean

Amputation, metatarsal, with toe, single

CPT 28810

$52,917

$31,750

$6,628

clean

Amputation, toe; metatarsophalangeal joint

CPT 28820

$44,390

$26,634

$6,628

clean

Application of long arm splint (shoulder to hand)

CPT 29105

$453

$272

$1,036

clean

Application of short arm splint (forearm to hand); static

CPT 29125

$419

$251

$1,036

clean

Application of finger splint; static

CPT 29130

$366

$220

$1,036

clean

Strapping; shoulder (eg, Velpeau)

CPT 29240

$951

$571

$1,036

clean

Strapping; elbow or wrist

CPT 29260

$1,023

$614

$1,036

clean

Application of long leg splint (thigh to ankle or toes)

CPT 29505

$999

$599

$1,036

clean

Application of short leg splint (calf to foot)

CPT 29515

$982

$589

$1,036

clean

Strapping; knee

CPT 29530

$995

$597

$1,036

clean

Strapping; Unna boot

CPT 29580

$1,975

$1,185

$1,036

clean

Application of multi-layer compression system; leg (below knee), including ankle and foot

CPT 29581

$2,100

$1,260

$1,036

clean

Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed

CPT 29881

$63,410

$38,046

$8,446

clean

Drainage abscess or hematoma, nasal septum

CPT 30020

$750

$450

$1,496

clean

Biopsy, intranasal

CPT 30100

$25,803

$15,482

$6,173

clean

Excision or destruction (eg, laser), intranasal lesion; internal approach

CPT 30117

$28,333

$17,000

$6,458

clean

Submucous resection inferior turbinate, partial or complete, any method

CPT 30140

$20,623

$12,374

$6,628

clean

Removal foreign body, intranasal; office type procedure

CPT 30300

$598

$359

$1,006

clean

Rhinoplasty, primary; including major septal repair

CPT 30420

$20,623

$12,374

$8,985

clean

Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)

CPT 30450

$63,415

$38,049

$9,431

clean

Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

CPT 30520

$14,988

$8,993

$6,924

clean

Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)

CPT 30802

$27,478

$16,487

$6,173

clean

Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method

CPT 30901

$1,451

$870

$1,038

clean

Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method

CPT 30903

$2,297

$1,378

$1,038

clean

Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial

CPT 30905

$1,088

$653

$1,038

clean

Nasal/sinus endoscopy, surgical; with concha bullosa resection

CPT 31240

$14,988

$8,993

$6,628

clean

Showing the first 200 of 2,570 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service

Severity

Rule

Detail

MS-DRG 793/i

warn

mrf_negotiated_above_gross

highest negotiated rate $9,300 exceeds the gross charge $7,737

CPT 12007/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,806

CPT 12011/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $952

CPT 88000/o

warn

mrf_negotiated_above_gross

highest negotiated rate $278 exceeds the gross charge $160

CPT 12013/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,354

CPT 88005/o

warn

mrf_negotiated_above_gross

highest negotiated rate $324 exceeds the gross charge $191

CPT 43250/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $10,282

CPT 12014/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,435

CPT 88007/o

warn

mrf_negotiated_above_gross

highest negotiated rate $340 exceeds the gross charge $223

CPT 88012/o

warn

mrf_negotiated_above_gross

highest negotiated rate $278 exceeds the gross charge $160

CPT 12020/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $907

CPT 43762/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,333

CPT 12031/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,184

CPT 88020/o

warn

mrf_negotiated_above_gross

highest negotiated rate $479 exceeds the gross charge $379

CPT 88025/o

warn

mrf_negotiated_above_gross

highest negotiated rate $463 exceeds the gross charge $411

CPT 12041/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $968

CPT 12042/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,214

CPT 45381/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $8,501

CPT 88099/o

warn

mrf_negotiated_above_gross

highest negotiated rate $83 exceeds the gross charge $33

CPT 12053/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,518

CPT 45388/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $11,129

CPT 88125/o

warn

mrf_negotiated_above_gross

highest negotiated rate $220 exceeds the gross charge $122

MS-DRG 203/i

warn

mrf_negotiated_above_gross

highest negotiated rate $5,501 exceeds the gross charge $5,237

CPT 15271/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $9,901

MS-DRG 207/i

warn

mrf_negotiated_above_gross

highest negotiated rate $68,279 exceeds the gross charge $20,385

CPT 15275/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $9,371

CPT 47531/o

warn

mrf_negotiated_above_gross

highest negotiated rate $14,869 exceeds the gross charge $2,025

CPT 16000/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,155

MS-DRG 244/i

warn

mrf_negotiated_above_gross

highest negotiated rate $25,851 exceeds the gross charge $7,426

CPT 16020/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,095

CPT 16025/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,159

CPT 49082/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $2,505

MS-DRG 951/i

warn

mrf_negotiated_above_gross

highest negotiated rate $5,315 exceeds the gross charge $4,950

CPT 17250/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,374

CPT 97597/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,338

CPT 20552/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,509

CPT 51700/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,798

CPT 51702/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $598

CPT 51703/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $602

CPT 51705/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $673

CPT 51798/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $258

CPT 24600/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $999

CPT 88291/o

warn

mrf_negotiated_above_gross

highest negotiated rate $64 exceeds the gross charge $40

CPT 24640/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,411

CPT 25605/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,119

CPT 99408/o

warn

mrf_negotiated_above_gross

highest negotiated rate $82 exceeds the gross charge $18

CPT 26010/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,570

CPT 26605/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,411

CPT 88333/o

warn

mrf_negotiated_above_gross

highest negotiated rate $353 exceeds the gross charge $194

CPT 26670/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,344

CPT 26742/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,411

CPT 54220/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,172

CPT 26770/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,344

CPT 55100/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $1,105

CPT 27096/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $914

CPT 56405/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,514

CPT 27250/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,251

CPT 27560/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $999

CPT A9570/o

warn

mrf_negotiated_above_gross

highest negotiated rate $8,569 exceeds the gross charge $2,141

CPT A9572/o

warn

mrf_negotiated_above_gross

highest negotiated rate $13,566 exceeds the gross charge $3,315

MS-DRG 420/i

warn

mrf_negotiated_above_gross

highest negotiated rate $56,237 exceeds the gross charge $38,024

CPT 27810/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $1,031

MS-DRG 426/i

warn

mrf_negotiated_above_gross

highest negotiated rate $82,728 exceeds the gross charge $32,342

CPT A9604/o

warn

mrf_negotiated_above_gross

highest negotiated rate $38,923 exceeds the gross charge $4,315

CPT 90658/o

warn

mrf_negotiated_above_gross

highest negotiated rate $49 exceeds the gross charge $36

CPT C1726/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,026 exceeds the gross charge $247

CPT 28190/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,635

CPT 59200/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,355

MS-DRG 463/i

warn

mrf_negotiated_above_gross

highest negotiated rate $57,356 exceeds the gross charge $49,237

CPT 64400/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,869

CPT 86927/o

warn

mrf_negotiated_above_gross

highest negotiated rate $130 exceeds the gross charge $85

CPT C1764/o

warn

mrf_negotiated_above_gross

highest negotiated rate $13,000 exceeds the gross charge $9,786

CPT 64420/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,809

CPT 28435/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $2,691

CPT 64421/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,715

CPT C1769/o

warn

mrf_negotiated_above_gross

highest negotiated rate $475 exceeds the gross charge $196

CPT 86965/o

warn

mrf_negotiated_above_gross

highest negotiated rate $150 exceeds the gross charge $102

CPT 64450/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,230

CPT 28515/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,411

CPT 64455/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,185

CPT 28665/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,366

CPT 64479/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $4,096

CPT 64480/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $241

CPT 86985/o

warn

mrf_negotiated_above_gross

highest negotiated rate $150 exceeds the gross charge $82

CPT 64483/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,715

CPT 64484/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $202

CPT 29105/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $453

CPT C1788/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,224 exceeds the gross charge $873

CPT 29125/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $419

CPT 92977/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,848

CPT 64492/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,735

CPT 29130/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $366

CPT 64493/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,715

CPT 76014/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,627 exceeds the gross charge $98

CPT C1874/o

warn

mrf_negotiated_above_gross

highest negotiated rate $5,717 exceeds the gross charge $3,216

CPT 29240/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $951

CPT 64494/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,854

CPT 76015/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,627 exceeds the gross charge $25

CPT L8047/o

warn

mrf_negotiated_above_gross

highest negotiated rate $3,333 exceeds the gross charge $608

CPT 29260/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,023

CPT 93040/o

warn

mrf_negotiated_above_gross

highest negotiated rate $38 exceeds the gross charge $29

CPT 64495/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,735

CPT L8699/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,221 exceeds the gross charge $1,718

CPT 29505/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $999

CPT 29515/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $982

CPT 65205/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $988

CPT 29530/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $995

CPT 65220/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $988

MS-DRG 581/i

warn

mrf_negotiated_above_gross

highest negotiated rate $21,263 exceeds the gross charge $8,770

CPT 30020/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $750

CPT 67715/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,826 exceeds the gross charge $9,946

MS-DRG 592/i

warn

mrf_negotiated_above_gross

highest negotiated rate $22,416 exceeds the gross charge $9,463

CPT 69200/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $602

CPT 30300/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $598

CPT 69209/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $598

CPT 69210/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $569

MS-DRG 614/i

warn

mrf_negotiated_above_gross

highest negotiated rate $32,577 exceeds the gross charge $4,497

CPT 30901/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,451

CPT 10021/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,178

CPT Q0138/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2 exceeds the gross charge $1

MS-DRG 621/i

warn

mrf_negotiated_above_gross

highest negotiated rate $19,517 exceeds the gross charge $16,675

CPT 10060/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,170

CPT 30905/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,088

MS-DRG 622/i

warn

mrf_negotiated_above_gross

highest negotiated rate $40,792 exceeds the gross charge $15,090

CPT 10061/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,184

MS-DRG 626/i

warn

mrf_negotiated_above_gross

highest negotiated rate $19,655 exceeds the gross charge $7,566

CPT 10080/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $1,760

CPT 32551/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,312

CPT 32554/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,319

MS-DRG 640/i

warn

mrf_negotiated_above_gross

highest negotiated rate $13,543 exceeds the gross charge $6,078

CPT 10140/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $8,070

CPT 32555/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,377

CPT 10160/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,348

CPT Q4133/o

warn

mrf_negotiated_above_gross

highest negotiated rate $319 exceeds the gross charge $267

CPT Q4186/o

warn

mrf_negotiated_above_gross

highest negotiated rate $365 exceeds the gross charge $235

CPT 11055/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,043

CPT 33286/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $3,660

CPT 11102/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,866

CPT 33967/o

warn

mrf_negotiated_above_gross

highest negotiated rate $17,401 exceeds the gross charge $12,180

CPT 11105/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,664

CPT 11106/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $2,341

CPT G0127/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $318

CPT 11200/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $793

CPT 11303/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,459

CPT 36569/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,393 exceeds the gross charge $4,140

CPT 36573/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,278 exceeds the gross charge $1,523

CPT 36591/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $448

CPT 36592/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $518

CPT 11721/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,354

CPT 36600/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $342

CPT 77078/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,576 exceeds the gross charge $364

CPT 11730/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $774

CPT 37195/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,295 exceeds the gross charge $2,320

CPT 11760/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $454

CPT G0480/o

warn

mrf_negotiated_above_gross

highest negotiated rate $185 exceeds the gross charge $142

CPT 40652/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,270

CPT 12001/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $956

CPT 12002/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,317

MS-DRG 789/i

warn

mrf_negotiated_above_gross

highest negotiated rate $12,764 exceeds the gross charge $8,962

MS-DRG 103/i

warn

mrf_negotiated_above_gross

highest negotiated rate $8,619 exceeds the gross charge $6,801

MS-DRG 790/i

warn

mrf_negotiated_above_gross

highest negotiated rate $69,756 exceeds the gross charge $7,242

CPT 12005/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,267

MS-DRG 792/i

warn

mrf_negotiated_above_gross

highest negotiated rate $10,731 exceeds the gross charge $6,804

CPT 12006/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,924 exceeds the gross charge $1,270

warn

mrf_rate_without_estimate

111,000 of 111,000 percentage/algorithm rates across 2,564 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do

CPT 12006/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 42830/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 71550/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 77318/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 82784/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 86021/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 87880/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 96110/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item

CPT J0283/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item

MS-DRG 139/i

info

mrf_item_fields_vary

this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 43235/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 71551/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 77321/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item

CPT 82785/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 86022/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 87899/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 96116/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item

CPT J0290/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, max differ, so no cross-line comparison was made for this item

MS-DRG 140/i

info

mrf_item_fields_vary

this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 793/i

info

mrf_item_fields_vary

this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 12007/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 43239/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 71552/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 77331/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item

CPT 82787/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 86023/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 87902/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 96125/o

info

mrf_item_fields_vary

this code and setting cover at least 2 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 J0295/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item

MS-DRG 141/i

info

mrf_item_fields_vary

this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 794/i

info

mrf_item_fields_vary

this code and setting cover at least 9 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 72020/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, max differ, so no cross-line comparison was made for this item

CPT 77332/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item

CPT 82800/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

Showing the first 200 of 2,674 findings, errors first — every finding as JSON →

Sources for this hospital

the files read, as fetched — not our copy of them

Medicare Inpatient Hospitals - by Provider and Service · CMS · 2024
MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
Medicare Outpatient Hospitals - by Provider and Service · CMS · 2024
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)
AHRQ Compendium of U.S. Health Systems — hospital linkage file · AHRQ · 2023
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
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)
Valley View Medical Center — standard charges file · AZ · updated 7/10/2026
· csv-tall · 1.7M bytes · fetched 2026-08-26 · sha256 33cd16a44b8c…

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.