Hospital · CCN 050231

Pomona Valley Hospital Medical Center

1798 N Garey Ave, Pomona, CA 91767 · Los Angeles County
Part of Pomona Valley Hospital Medical Center · 412 beds · 1
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

63 admission types 53 outpatient services price file: ok 13 Medicare-file findings
Billed per dollar paid, all admissions
8.78×
$458.7M billed against $52.2M paid across 2,288 Medicare discharges; the national figure is 5.03×.
—
of adults in Los Angeles County have medical debt in collections — state bars medical debt from credit reports; the credit-bureau panel cannot see it
9.4%
uninsured in the county · state 7.5%
$86K
median household income
6.6×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (73 in the inpatient or outpatient file)ⓘ
26.5%
obesity in the countyⓘ
12.6%
diagnosed diabetes (PLACES)
5.3%
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
435
$176,011
$20,299
8.7× st 6.2×
291
Heart failure and shock with mcc
144
$98,727
$13,612
7.3× st 6.5×
280
Acute myocardial infarction, discharged alive with mcc
109
$130,658
$17,055
7.7× st 6.6×
853
Infectious and parasitic diseases with o.r. procedures with mcc
92
$527,915
$52,764
10.0× st 6.2×
177
Respiratory infections and inflammations with mcc
76
$140,350
$17,039
8.2× st 6.6×
064
Intracranial hemorrhage or cerebral infarction with mcc
75
$230,297
$21,886
10.5× st 7.4×
682
Renal failure with mcc
70
$133,006
$15,766
8.4× st 6.1×
872
Septicemia or severe sepsis without mv >96 hours without mcc
55
$106,135
$11,318
9.4× st 6.1×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
54
$119,579
$10,996
10.9× st 7.9×
870
Septicemia or severe sepsis with mv >96 hours
54
$626,695
$65,575
9.6× st 6.2×
981
Extensive o.r. procedures unrelated to principal diagnosis with mcc
53
$229,816
$37,111
6.2× st 6.3×
689
Kidney and urinary tract infections with mcc
44
$97,335
$12,301
7.9× st 6.3×
377
Gastrointestinal hemorrhage with mcc
42
$155,380
$17,776
8.7× st 6.4×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
40
$113,308
$13,901
8.2× st 5.7×
698
Other kidney and urinary tract diagnoses with mcc
36
$179,922
$17,171
10.5× st 6.2×
481
Hip and femur procedures except major joint with cc
36
$168,937
$21,828
7.7× st 6.7×
193
Simple pneumonia and pleurisy with mcc
35
$121,451
$13,809
8.8× st 6.9×
378
Gastrointestinal hemorrhage with cc
35
$90,172
$10,806
8.3× st 6.8×
683
Renal failure with cc
32
$95,237
$9,481
10.0× st 6.7×
690
Kidney and urinary tract infections without mcc
30
$93,863
$9,262
10.1× st 6.6×
312
Syncope and collapse
28
$77,263
$9,585
8.1× st 7.2×
208
Respiratory system diagnosis with ventilator support <=96 hours
28
$247,793
$27,802
8.9× st 7.4×
189
Pulmonary edema and respiratory failure
27
$123,149
$13,204
9.3× st 6.7×
309
Cardiac arrhythmia and conduction disorders with cc
25
$67,358
$8,333
8.1× st 7.2×
637
Diabetes with mcc
24
$152,792
$16,562
9.2× st 6.3×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
24
$611,059
$62,359
9.8× st 6.2×
082
Traumatic stupor and coma >1 hour with mcc
23
$250,669
$24,502
10.2× st 7.7×
480
Hip and femur procedures except major joint with mcc
23
$258,862
$29,587
8.7× st 6.8×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
22
$80,581
$8,723
9.2× st 6.3×
070
Other cerebrovascular disorders with mcc
22
$151,814
$17,037
8.9× st 5.4×
281
Acute myocardial infarction, discharged alive with cc
21
$96,200
$10,146
9.5× st 7.8×
100
Seizures with mcc
21
$143,789
$20,242
7.1× st 6.2×
083
Traumatic stupor and coma >1 hour with cc
20
$147,776
$14,786
10.0× st 8.4×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
19
$399,972
$32,353
12.4× st 7.4×
432
Cirrhosis and alcoholic hepatitis with mcc
19
$163,152
$21,384
7.6× st 5.6×
207
Respiratory system diagnosis with ventilator support >96 hours
18
$545,393
$66,194
8.2× st 5.7×
389
Gastrointestinal obstruction with cc
18
$77,373
$8,772
8.8× st 6.9×
552
Medical back problems without mcc
17
$107,710
$12,178
8.8× st 7.5×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
17
$259,341
$21,676
12.0× st 7.8×
004
Tracheostomy with mv >96 hours or principal diagnosis except face, mouth and neck withou
17
$1,130,749
$130,415
8.7× st 6.6×
101
Seizures without mcc
17
$79,754
$9,944
8.0× st 6.8×
314
Other circulatory system diagnoses with mcc
17
$212,421
$22,185
9.6× st 6.1×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
16
$77,476
$8,751
8.9× st 6.8×
441
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with mcc
16
$134,154
$18,269
7.3× st 5.5×
308
Cardiac arrhythmia and conduction disorders with mcc
16
$155,290
$12,795
12.1× st 6.9×
071
Other cerebrovascular disorders with cc
15
$173,617
$14,672
11.8× st 6.1×
180
Respiratory neoplasms with mcc
15
$173,716
$18,783
9.2× st 6.9×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
15
$107,118
$13,896
7.7× st 6.5×
522
Hip replacement with principal diagnosis of hip fracture without mcc
14
$156,408
$22,642
6.9× st 6.9×
252
Other vascular procedures with mcc
14
$225,405
$35,823
6.3× st 5.7×
854
Infectious and parasitic diseases with o.r. procedures with cc
13
$188,309
$21,905
8.6× st 6.7×
812
Red blood cell disorders without mcc
13
$111,709
$10,065
11.1× st 6.4×
393
Other digestive system diagnoses with mcc
13
$163,339
$19,001
8.6× st 5.8×
274
Percutaneous and other intracardiac procedures without mcc
12
$184,495
$34,032
5.4× st 5.6×
069
Transient ischemia without thrombolytic
12
$91,089
$8,877
10.3× st 9.5×
673
Other kidney and urinary tract procedures with mcc
12
$238,015
$39,385
6.0× st 5.8×
643
Endocrine disorders with mcc
12
$144,081
$16,664
8.6× st 6.5×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
11
$1,667,423
$208,458
8.0× st 5.9×
305
Hypertension without mcc
11
$77,624
$8,411
9.2× st 7.3×
551
Medical back problems with mcc
11
$139,816
$15,782
8.9× st 7.0×
194
Simple pneumonia and pleurisy with cc
11
$76,815
$9,335
8.2× st 7.5×
329
Major small and large bowel procedures with mcc
11
$367,613
$41,728
8.8× st 6.5×
175
Pulmonary embolism with mcc or acute cor pulmonale
11
$106,867
$14,623
7.3× st 7.2×
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
8011
Comprehensive Observation Services
384
$53,548
$3,332
16.1×
5491
Level 1 Intraocular Procedures
200
$44,542
$2,831
15.7×
5191
Level 1 Endovascular Procedures
75
$89,422
$4,013
22.3×
5492
Level 2 Intraocular Procedures
73
$51,192
$4,999
10.2×
5115
Level 5 Musculoskeletal Procedures
68
$87,250
$15,947
5.5×
5302
Level 2 Upper GI Procedures
64
$27,298
$2,339
11.7×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
54
$19,226
$1,975
9.7×
5183
Level 3 Vascular Procedures
52
$32,132
$3,802
8.5×
5361
Level 1 Laparoscopy and Related Services
37
$58,715
$7,094
8.3×
5114
Level 4 Musculoskeletal Procedures
37
$66,143
$8,792
7.5×
5184
Level 4 Vascular Procedures
35
$47,972
$6,756
7.1×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
31
$40,622
$4,254
9.6×
5192
Level 2 Endovascular Procedures
29
$87,963
$7,027
12.5×
5113
Level 3 Musculoskeletal Procedures
28
$49,112
$3,980
12.3×
5375
Level 5 Urology and Related Services
25
$42,502
$6,362
6.7×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
25
$66,722
$8,017
8.3×
5374
Level 4 Urology and Related Services
24
$37,664
$4,161
9.1×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
23
$31,762
$3,494
9.1×
5193
Level 3 Endovascular Procedures
21
$156,311
$13,503
11.6×
5493
Level 3 Intraocular Procedures
20
$61,350
$6,426
9.5×
5213
Level 3 Electrophysiologic Procedures
19
$207,502
$29,114
7.1×
5182
Level 2 Vascular Procedures
15
$15,607
$1,838
8.5×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
14
$37,062
$4,468
8.3×
5414
Level 4 Gynecologic Procedures
14
$33,408
$3,844
8.7×
5154
Level 4 Airway Endoscopy
14
$69,840
$4,604
15.2×
5373
Level 3 Urology and Related Services
13
$40,710
$2,504
16.3×
5194
Level 4 Endovascular Procedures
12
$201,841
$21,503
9.4×
5112
Level 2 Musculoskeletal Procedures
11
$19,669
$1,976
10.0×
5313
Level 3 Lower GI Procedures
11
$39,149
$3,452
11.3×
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5881
Ancillary Outpatient Services When Patient Dies
—
—
—
—
5504
Level 4 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5212
Level 2 Electrophysiologic Procedures
—
—
—
—
5222
Level 2 Pacemaker and Similar Procedures
—
—
—
—
5223
Level 3 Pacemaker and Similar Procedures
—
—
—
—
5116
Level 6 Musculoskeletal Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5331
Complex GI Procedures
—
—
—
—
5093
Level 3 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5362
Level 2 Laparoscopy and Related Services
—
—
—
—
5165
Level 5 ENT 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-tall, last updated 8/6/2026, template 3.0.0, 137,984 rows scanned, 16,950 distinct code–setting items kept. 440 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
Rbc dna hea 35 ag 11 bld grp
—
—
$2,050
3
clean
LIVER DIS 10 ASSAYS W/ASH
—
—
$1,433
3
clean
LIVER DIS 10 ASSAYS W/NASH
—
$375
$1,433
3
clean
ONCO PRST8 3 GENE UR ALG
—
—
$5,961
6
clean
ONC MRNA 5 GEN RSK URTHL CA
—
—
$2,164
3
clean
ONC MRNA 5 GEN RECR URTHL CA
—
—
$2,164
3
clean
ADRNL CORTCL TUM BCHM ASY 25
—
—
$3,716
3
clean
ONC BLADDER MRNA 219 GEN ALG
—
—
$9,935
3
clean
ONC THYR 10 MICRORNA SEQ ALG
—
—
$8,547
3
clean
ONC AML DNA DETCJ/NONDETCJ
—
—
$708
3
clean
GLYCA NUC MR SPECTRSC QUAN
—
—
$238
6
clean
ONC THYR DNA&MRNA 112 GENES
—
—
$29,235
6
clean
JAK2 GENE TRGT SEQ ALYS
—
—
$1,625
6
clean
RX METAB ADVRS TRGT SEQ ALYS
—
—
$2,113
3
clean
TPMT NUDT15 GENES
—
—
$4,420
6
clean
NEURO CSF PRION PRTN QUAL
—
$532
$1,540
3
clean
TRGT GEN SEQ DNA 324 GENES
—
—
$27,317
6
clean
B BRGDRFERI ANTB 5 PRTN IGM
—
—
$49
3
clean
CT HEAD PERFUSION ANALYSIS
—
$430
—
0
clean
B BRGDRFERI ANTB 12 PRTN IGG
—
—
$49
3
clean
TBRF B GRP ANTB 4 PRTN IGM
—
—
$42
3
clean
TBRF B GRP ANTB 4 PRTN IGG
—
—
$42
3
clean
ONC BRST DUX CARC IS 12 GENE
—
—
$30,228
6
clean
ONC PRST8 MRNA 17 GENE ALG
—
—
$30,228
6
clean
BONE SRGRY CMPTR FLUOR IMAGE
—
—
$1,657
4
clean
BONE SRGRY CMPTR CT/MRI IMAG
—
—
$1,657
4
clean
ONC MERKEL CLL CARC SRM QUAN
—
—
$2,801
6
clean
ONC MERKEL CLL CARC SRM +/-
—
—
$2,801
6
clean
TC MEAS 5 BMRK SFDI M-S ALYS
—
—
$217
6
clean
ANTB TP TOTAL&RPR IA QUAL
—
—
$246
6
clean
SYFLS TST NONTREPONEMAL ANTB
—
—
$142
6
clean
CANDIDA SPECIES PNL AMP PRB
—
—
$1,119
6
clean
PERQ STENT/CHEST VERT ART
—
—
$1,643
3
clean
IG PARAPROTEIN QUAL BLD/UR
—
—
$124
3
clean
ONC LNG 5 CLIN RSK FACTR ALG
—
—
$27,607
6
clean
ONC MLNMA PRAME & LINC00518
—
—
$5,961
6
clean
ONC CUTAN MLNMA MRNA 23 GENE
—
—
$14,817
6
clean
ESW MUSCSKEL SYS NOS
—
—
$6,157
5
clean
HERED COLON CA DO 15 GENES
—
—
$10,579
6
clean
NEPH CKD MULT ECLIA TUM NEC
—
—
$7,451
6
clean
TOUCH QUANT SENSORY TEST
—
—
$207
1
clean
GSTR EMPTG 7 TIMED BRTH SPEC
—
—
$2,490
3
clean
VIBRATE QUANT SENSORY TEST
—
—
$355
1
clean
COOL QUANT SENSORY TEST
—
—
$355
1
clean
GI BARRETT ESOPH 9 PRTN BMRK
—
—
$14,093
3
clean
HEAT QUANT SENSORY TEST
—
—
$162
1
clean
IADI 16S&18S RRNA GENES
—
—
$1,014
3
clean
TRNSPLJ DON-DRV CLL-FR DNA
—
—
$7,838
3
clean
CRD CERAMIDES LIQ CHROM PLSM
—
—
$238
3
clean
HERED BRST CA RLTD DO PANEL
—
—
$9,223
6
clean
NFCT DS DNA UNTRGT NGNRJ SEQ
—
$2,000
$6,053
3
clean
GI IBS IA ANTICDTB&VINCULIN
—
—
$319
3
clean
LIVER DS 10 BIOCHEM ASY SRM
—
—
$3,434
6
clean
ONC SLD TUM ALYS BRCA1 BRCA2
—
—
$20,668
6
clean
ONC SOLID TUMOR 30 PRTN TRGT
—
—
$3,716
3
clean
EXC RECTAL TUMOR ENDOSCOPIC
—
—
$5,279
7
clean
PERQ SACRAL AUGMT UNILAT INJ
—
—
$5,690
8
clean
PERQ SACRAL AUGMT BILAT INJ
—
—
$5,690
8
clean
POST VERT ARTHRPLST 1 LUMBAR
—
—
$7,557
4
clean
NFCT DS 22 TRGT SARS-COV-2
—
$479
$4,499
4
clean
NEURO ALZHEIMER CELL AGGREGJ
—
—
$6,307
3
clean
CLEAR EYELID GLAND W/HEAT
—
—
$1,373
7
clean
NEURO ALZHEIMER QUAN IMAGING
—
—
$1,455
3
clean
NJX PLATELET PLASMA
—
—
$1,414
6
clean
TRLUML PERIP ATHRC BRCHIOCPH
—
—
$10,304
7
clean
TRLUML PERIP ATHRC ILIAC ART
—
—
$10,304
7
clean
TRGT GEN SEQ ALYS PNL 311+
—
—
$24,305
6
clean
NFCT DS VIR RESP RNA 3 TRGT
—
—
$1,540
4
clean
NFCT DS VIR RESP RNA 4 TRGT
—
$164
$1,540
4
clean
TRGT GEN SEQ ALYS PNL 55-74
—
—
$34,722
6
clean
Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of malignancy expressed as a p
—
—
$3,605
2
clean
ONC SLD ORG NEO DNA 505 GENE
—
—
$22,898
6
clean
IMPLT/RPL CRTD SNS DEV TOTAL
—
—
$10,040
6
clean
IMPLT/RPL CRTD SNS DEV GEN
—
—
$5,279
6
clean
Interrogate crtd sns dev
—
—
$1,066
3
clean
Interrogate crtd sns w/pgrmg
—
—
$1,066
3
clean
PERQ LAMOT/LAM LUMBAR
—
—
$9,263
8
clean
Tempr
—
—
$1,066
5
clean
ONC LUNG MRNA QUAN PCR 11&3
—
—
$11,026
3
clean
ONC BRST DUX CARC 7 PROTEINS
—
—
$5,401
3
clean
CRD CAD ALYS 3 PRTN 3 PARAM
—
—
$3,065
6
clean
CRD CV DS ALY 4 PRTN PLM ALG
—
—
$3,065
6
clean
NFCT DS BCT QUAN ANTMCRB SC
—
—
$63
6
clean
AI DS SLE ALYS 8 IGG AUTOANT
—
—
$6,593
6
clean
ONC CUTAN SQ CLL CA MRNA 40
—
—
$8,438
1
clean
NEPH RNA PSTTRNSPL PERPH BLD
—
—
$1,133
1
clean
TRGT GEN SEQ ALYS PNL 83+
—
—
$10,893
1
clean
ONC NEO XOME&TRNS SEQ ALYS
—
—
$1,772
1
clean
ONC SLD ORGN TGSA DNA 84/+
—
—
$22,898
6
clean
ONC PLSM CELL DO&MYELOMA ID
—
—
$661
1
clean
ONC SLD TUM CRCG TUM CL SLCT
—
—
$661
1
clean
TRNSCTH RENAL SYMP DENRV BIL
—
—
$5,810
9
clean
ONC PRST8 MRNA HOXC6 & DLX1
—
—
$5,961
6
clean
ONC PAN CA ALYS MRD PLASMA
—
—
$30,744
6
clean
HEP NAFLD SEMIQ EVL 28 LIPID
—
—
$1,097
1
clean
PSYC GENOM ALYS PNL 15 GEN
—
—
$10,479
6
clean
BETA AMYL A?40&A?42 LC-MS/MS
—
—
$249
1
clean
RX METAB/PCX DNA 16 GEN ALYS
—
—
$10,479
6
clean
RX METAB/PCX DNA 25 GEN ALYS
—
—
$5,822
6
clean
RX METAB/PCX DNA 27GEN RX IA
—
—
$5,822
6
clean
RSA LOWER EXTR EXAM
—
—
$448
3
clean
INTRAOP OCT BRST/NODE SPEC
—
—
$7,938
1
clean
NFCT DS BCT/VIRAL TRAIL IP10
—
—
$2,043
6
clean
OCT BRST/NODE I&R PER SPEC
—
—
$7,938
1
clean
NFCT DS BV&VAGINITIS AMP PRB
—
—
$406
3
clean
IADNA CHLMYD&GONORR AMP PRB
—
—
$200
3
clean
APOL1 RISK VARIANTS
—
—
$1,831
1
clean
NEURO ALYS ?-AMYL 1-42&1-40
—
—
$916
1
clean
ONC PRST8 CA ALYS ALL PSA
—
—
$1,656
1
clean
ONC LUNG ELISA 7 AUTOANT ALG
—
—
$1,414
1
clean
ONC URTHL MRNA 5 GEN ALG
—
—
$1,089
1
clean
ONC BLDR 10 UR HRBR URTHL CA
—
—
$9,683
4
clean
ONC BLDR 10 PRB RECR BLDR CA
—
—
$9,683
4
clean
ONC OVRN BCHM ASY 7 PRTN ALG
—
—
$9,683
4
clean
ONC PRST8 CA IMG ALYS 128
—
—
$7,624
4
clean
VIS FIELD ASSMNT TECH SUPPT
—
—
$6,528
3
clean
RX METB ADVRS TRGT SQ ALY 20
—
—
$4,499
4
clean
NEU PRKSN MSFL ?-SYNCLN PRTN
—
—
$5,840
4
clean
HDR ELCTRNC SKN SURF BRCHYTX
—
—
$10,578
5
clean
PFAS 16 PFAS COMPND LC MS/MS
—
—
$2,145
4
clean
HDR ELCTR NTRST/NTRCV BRCHTX
—
—
$10,578
5
clean
MRGFUS STRTCTC LES ABLTJ
—
—
$1,858
1
clean
COLGN CRS-LINK CRN&PACHYMTRY
—
—
$3,452
9
clean
ONC PRST8 MRNA 18 GEN 1ST UR
—
—
$8,204
4
clean
ONC BRST SEMIQ MEAS THYM KN
—
—
$3,486
4
clean
ONC LUNG FLOW CYTMTRY 5 MRK
—
—
$8,204
4
clean
NEPH DBTC CKD MULT ECLIA ALG
—
—
$8,204
4
clean
INSJ/RPLC CARDIAC MODULJ SYS
—
—
$5,878
8
clean
ONC SLD TUM DNA 80 & RNA 36
—
—
$31,517
4
clean
PSYC GENOM ALYS PNL 15 GEN
—
—
$14,423
4
clean
CV DS ACS BLD ALG 5 YR SCORE
—
—
$4,218
4
clean
WATERJET PROSTATE ABLTJ CMPL
—
—
$3,925
7
clean
ONC PAN SOLID TUM ALYS DNA
—
—
$62
1
clean
GI MALABS AAT CALPRO PNCRTC
—
—
$664
4
clean
GLY RCPTR ALPHA1 IGG SRM/CSF
—
—
$395
4
clean
KLHL11 ANTB SR/CSF ASY QUAL
—
—
$395
4
clean
ONC PRST8 5 DNA REG MRK PCR
—
—
$8,204
4
clean
RX METAB ADVRS VRNTALYS 25
—
—
$4,499
4
clean
IMPLTJ SYNTH RNFCMT ABDL WAL
—
—
$1,657
4
clean
#N/A
—
—
$5,279
7
clean
#N/A
—
—
$5,279
7
clean
INSJ IMPLTBL GLUCOSE SENSOR
—
—
$3,658
6
clean
RMVL IMPLTBL GLUCOSE SENSOR
—
—
$1,414
6
clean
REMVL INSJ IMPLTBL GLUC SENS
—
—
$3,658
6
clean
INSJ AQUEOUS DRAIN DEV 1ST
—
—
$3,452
7
clean
ONC SLD TUM BLD/SLV 648 GENE
—
—
$48,578
3
clean
HERED PRST8 CA GSAP 23 GENES
—
—
$14,076
3
clean
#N/A
—
—
$3,660
9
clean
#N/A
—
—
$2,002
7
clean
TMVI PERCUTANEOUS APPROACH
—
—
$3,042
6
clean
TMVI TRANSTHORACIC EXPOSURE
—
—
$3,042
6
clean
OCT MID EAR I&R UNILATERAL
—
—
$563
1
clean
OCT MID EAR I&R BILATERAL
—
—
$1,127
1
clean
PREP & CANNULJ CDVR DON LUNG
—
—
$3,042
6
clean
INIT & MNTR CDVR DON LNG ORGN PRFUJ SYS 1ST 2 HR
—
—
$1,595
2
clean
EV FEMPOP ARTL REVSC
—
—
$5,849
7
clean
Near ifr 2img mibmn glnd i&r
—
—
$1,066
3
clean
ESW INTEG WND HLG 1ST WND
—
—
$1,414
8
clean
ESW INTEG WND HLG EA ADDL
—
—
$1,455
3
clean
NTRAPX C FFR W/3D FUNCJL MAP
—
—
$1,373
3
clean
#N/A
—
—
$6,528
7
clean
PRGRMG DEV EVAL IIMS IP
—
—
$940
4
clean
INTERROG DEV EVAL IIMS IP
—
—
$940
4
clean
CAR-T CLL ADMN AUTOLOGOUS
—
—
$1,858
1
clean
LOW-LEVEL LASER THERAPY
—
—
$3,660
2
clean
EVAC MEIBOMIAN GLND HEAT BI
—
—
$1,066
8
clean
TTVR PERQ APPR 1ST PROSTH
—
—
$1,306
6
clean
TTVR PERQ EA ADDL PROSTH
—
—
$1,306
6
clean
INSJ/RPLCMT ICDS SS ELTRD
—
—
$5,849
7
clean
Programming Dev Eval Icds W/Ss Eltrd In Person
—
—
$1,066
3
clean
Interrogation Dev Eval Icds W/Ss Eltrd In Person
—
—
$1,066
3
clean
Rem Interrog Dev Eval Ss Ld Icds <90D Phy/Qhp
—
—
$1,066
3
clean
Rem Interrog Dev Eval Ss Ld Icds < 90D Tech
—
—
$1,066
3
clean
ABLTJ MAL BRST TUM PERQ CRTX
—
—
$3,925
7
clean
ABLT IRE 1+ O/T LV/PRST8 PRQ
—
—
$5,569
7
clean
IRE ABLTJ 1+TUMORS OPEN
—
—
$5,569
7
clean
INSERTION OF IRIS PROSTHESIS
—
—
$6,587
4
clean
INSJ IRIS PROSTH W/RMVL&INSJ
—
—
$6,587
4
clean
INSJ IRIS PROSTH SEC IO LENS
—
—
$6,587
4
clean
CYSTO W/PRST8 COMMISSUROTOMY
—
—
$5,041
9
clean
EVASC VEN ARTLZ TIBL/PRNL VN
—
—
$5,569
7
clean
PERQ NJX ALGC FLUOR LMBR 1ST
—
—
$2,002
7
clean
PERQ NJX ALGC FLUOR LMBR EA
—
—
$1,373
7
clean
PERQ NJX ALGC CT LMBR 1ST
—
—
$2,002
7
clean
CT BREAST W/3D BI C-/C+
—
—
$1,901
3
clean
TCAT RMVL/DBLK ICAR MAS PERQ
—
—
$4,448
6
clean
TTVI/RPLCMT W/PRSTC VLV PERQ
—
—
$1,066
5
clean
INSJ GTUBE PERQ MAG GASTRPXY
—
—
$1,595
8
clean
Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained withou
—
—
$4,905
2
clean
Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with d
—
—
$4,905
2
clean
EGD FLX TRANSNASAL TUBE/CATH
—
—
$1,595
8
clean
TPRNL FOCAL ABLTJ MAL PRST8
—
—
$4,204
8
clean
IMPLT ANT SGM IO NBIO RX SYS
—
—
$6,362
8
clean
SCALP COOL PLMT MNTR RMVL
—
—
$1,066
3
clean
INSJ ANT SGM AQ DRG DEV 1+
—
—
$5,041
9
clean
ABLTJ B9 THYR NDUL PERQ LASR
—
—
$1,643
9
clean
HISTOTRIPSY MAL HEPATCEL TIS
—
—
$1,066
5
clean
QUAN US TIS CHARAC W/DX US
—
—
$659
1
clean
BDY SURF MAPG PM/CVDFB F/UP
—
—
$319
1
clean
NJX B1 SUB MTRL SBCHDRL DFCT
—
—
$3,656
9
clean

Showing the first 200 of 16,950 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
warn
mrf_rate_without_estimate
19,329 of 19,329 percentage/algorithm rates across 6,441 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 84157/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT G0483/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84166/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT L8606/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84181/b
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT P9011/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84182/b
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT U0002/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84202/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT Z7610/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84210/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84238/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84255/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84302/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84311/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84376/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84378/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84402/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84403/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84425/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84432/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84436/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84439/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84450/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84460/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84481/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84484/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84585/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84591/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84600/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84630/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84702/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 84999/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85049/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85240/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85245/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85250/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85300/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85301/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85306/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85335/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85362/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85397/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85597/b
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85610/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85613/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85730/b
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85732/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 85810/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86001/b
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86003/b
info
mrf_item_fields_vary
this code and setting cover at least 44 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86003/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86008/b
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86021/b
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86022/b
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86023/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86038/b
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86060/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86147/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86160/b
info
mrf_item_fields_vary
this code and setting cover at least 13 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86161/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86171/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86225/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86226/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86235/b
info
mrf_item_fields_vary
this code and setting cover at least 18 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86255/b
info
mrf_item_fields_vary
this code and setting cover at least 27 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86256/b
info
mrf_item_fields_vary
this code and setting cover at least 21 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86300/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86301/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86305/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86316/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86317/b
info
mrf_item_fields_vary
this code and setting cover at least 12 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86331/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86332/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86334/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86335/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86337/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86341/b
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86355/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86359/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86376/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86403/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86406/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0253T/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 86431/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0440T/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 86592/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0441T/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 86592/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0442T/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 86603/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0444T/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 86606/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0445T/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 86609/b
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0474T/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 86611/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0479T/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 86612/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0480T/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 86615/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0481T/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 86617/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0489T/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 86618/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0490T/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 86628/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0515T/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 86635/b
info
mrf_item_fields_vary
this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0516T/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 86638/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0517T/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 86644/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0518T/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 86645/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0519T/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 86658/b
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0520T/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 86665/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0524T/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 86666/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0525T/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 86671/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0526T/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 86677/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0527T/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 86682/b
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0530T/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 86692/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0531T/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 86694/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0532T/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 86695/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0813T/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 86696/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0814T/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 86698/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0823T/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 86705/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0824T/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 86706/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0825T/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 86710/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0861T/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 86711/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0862T/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 86713/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0863T/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 86727/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 0864T/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 86735/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 73222/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86738/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 76497/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86753/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80158/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86757/b
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80164/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86762/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80178/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86765/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80299/b
info
mrf_item_fields_vary
this code and setting cover at least 47 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86769/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80299/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86777/b
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80307/b
info
mrf_item_fields_vary
this code and setting cover at least 16 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86778/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80339/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86780/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80346/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86787/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80354/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86789/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80357/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86790/b
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80358/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86794/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 80365/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86800/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81206/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86803/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81207/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86812/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81210/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86813/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81219/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86886/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81220/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 86941/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81225/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 87015/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81229/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 87046/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81235/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 87070/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81244/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 87075/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 81259/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT 87076/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item

Showing the first 200 of 440 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 $230,297 is 10.5× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $119,579 is 10.9× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $91,089 is 10.3× the total payment
MS-DRG 071
info
inp_charge_10x_payment
average charge $173,617 is 11.8× the total payment
MS-DRG 082
info
inp_charge_10x_payment
average charge $250,669 is 10.2× the total payment
MS-DRG 308
info
inp_charge_10x_payment
average charge $155,290 is 12.1× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $399,972 is 12.4× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $259,341 is 12.0× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $95,237 is 10.0× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $93,863 is 10.1× the total payment
MS-DRG 698
info
inp_charge_10x_payment
average charge $179,922 is 10.5× the total payment
MS-DRG 812
info
inp_charge_10x_payment
average charge $111,709 is 11.1× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $527,915 is 10.0× 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-tall · 18.0M bytes · fetched 2026-08-25 · sha256 2b928bde9f8e…

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.