Hospital · CCN 050324
Scripps Memorial Hospital La Jolla
9888 Genesee Avenue, La Jolla, CA 92037 · San Diego County
Part of Scripps Health · 405 beds · 1
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
164 admission types 61 outpatient services price file: ok 15 Medicare-file findings
Billed per dollar paid, all admissions
7.31×
$1,057.2M billed against $144.7M paid across 6,291 Medicare discharges; the national figure is 5.03×.
—
of adults in San Diego County have medical debt in collections — state bars medical debt from credit reports; the credit-bureau panel cannot see it
7.3%
uninsured in the county · state 7.5%
$103K
median household income
5.9×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (16 in the inpatient or outpatient file)ⓘ
25.3%
obesity in the countyⓘ
10.0%
diagnosed diabetes (PLACES)
5.2%
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
558
$118,276
$19,071
6.2× st 6.2×
274
Percutaneous and other intracardiac procedures without mcc
365
$226,830
$31,919
7.1× st 5.6×
291
Heart failure and shock with mcc
338
$82,114
$12,695
6.5× st 6.5×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
208
$380,051
$47,660
8.0× st 5.4×
177
Respiratory infections and inflammations with mcc
139
$95,961
$16,374
5.9× st 6.6×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
102
$554,315
$68,220
8.1× st 5.5×
872
Septicemia or severe sepsis without mv >96 hours without mcc
100
$59,916
$10,150
5.9× st 6.1×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
91
$47,875
$8,118
5.9× st 6.8×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
82
$133,474
$20,286
6.6× st 7.8×
481
Hip and femur procedures except major joint with cc
81
$163,517
$19,548
8.4× st 6.7×
193
Simple pneumonia and pleurisy with mcc
81
$67,854
$12,538
5.4× st 6.9×
064
Intracranial hemorrhage or cerebral infarction with mcc
78
$151,777
$19,780
7.7× st 7.4×
552
Medical back problems without mcc
77
$73,705
$9,353
7.9× st 7.5×
378
Gastrointestinal hemorrhage with cc
75
$65,375
$10,370
6.3× st 6.8×
853
Infectious and parasitic diseases with o.r. procedures with mcc
73
$388,801
$52,637
7.4× st 6.2×
280
Acute myocardial infarction, discharged alive with mcc
72
$117,577
$15,487
7.6× st 6.6×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
72
$89,343
$10,043
8.9× st 7.9×
377
Gastrointestinal hemorrhage with mcc
69
$118,597
$18,114
6.5× st 6.4×
219
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
67
$691,069
$84,815
8.1× st 6.5×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
64
$210,847
$26,140
8.1× st 6.6×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
63
$160,384
$18,571
8.6× st 6.4×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
62
$240,816
$28,446
8.5× st 7.4×
189
Pulmonary edema and respiratory failure
59
$80,766
$11,935
6.8× st 6.7×
698
Other kidney and urinary tract diagnoses with mcc
59
$97,304
$15,649
6.2× st 6.2×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
59
$93,103
$10,883
8.6× st 7.7×
603
Cellulitis without mcc
57
$44,871
$8,583
5.2× st 5.9×
389
Gastrointestinal obstruction with cc
56
$44,322
$8,045
5.5× st 6.9×
543
Pathological fractures and musculoskeletal and connective tissue malignancy with cc
56
$66,209
$10,259
6.5× st 7.4×
683
Renal failure with cc
53
$58,010
$8,703
6.7× st 6.7×
690
Kidney and urinary tract infections without mcc
52
$44,543
$7,655
5.8× st 6.6×
309
Cardiac arrhythmia and conduction disorders with cc
51
$48,484
$7,709
6.3× st 7.2×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
50
$46,845
$7,420
6.3× st 6.3×
314
Other circulatory system diagnoses with mcc
49
$131,222
$20,724
6.3× st 6.1×
057
Degenerative nervous system disorders without mcc
49
$62,399
$13,266
4.7× st 5.7×
480
Hip and femur procedures except major joint with mcc
48
$196,269
$27,430
7.2× st 6.8×
243
Permanent cardiac pacemaker implant with cc
47
$179,721
$22,793
7.9× st 6.7×
682
Renal failure with mcc
44
$78,723
$14,222
5.5× st 6.1×
178
Respiratory infections and inflammations with cc
39
$53,983
$10,297
5.2× st 7.1×
070
Other cerebrovascular disorders with mcc
38
$93,801
$15,785
5.9× st 5.4×
308
Cardiac arrhythmia and conduction disorders with mcc
37
$64,841
$12,966
5.0× st 6.9×
522
Hip replacement with principal diagnosis of hip fracture without mcc
36
$163,890
$22,533
7.3× st 6.9×
394
Other digestive system diagnoses with cc
35
$61,401
$10,293
6.0× st 6.9×
330
Major small and large bowel procedures with cc
35
$235,576
$24,309
9.7× st 6.9×
071
Other cerebrovascular disorders with cc
35
$61,421
$10,217
6.0× st 6.1×
086
Traumatic stupor and coma <1 hour with cc
35
$165,930
$12,808
13.0× st 7.9×
056
Degenerative nervous system disorders with mcc
34
$87,769
$20,485
4.3× st 5.9×
317
Concomitant left atrial appendage closure and cardiac ablation
34
$344,336
$58,833
5.9× st 5.9×
418
Laparoscopic cholecystectomy without c.d.e. with cc
33
$185,268
$15,927
11.6× st 7.9×
329
Major small and large bowel procedures with mcc
33
$337,185
$44,582
7.6× st 6.5×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
33
$82,851
$12,588
6.6× st 6.5×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
32
$70,012
$13,146
5.3× st 5.7×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
31
$182,608
$22,623
8.1× st 6.5×
273
Percutaneous and other intracardiac procedures with mcc
31
$284,483
$40,134
7.1× st 6.5×
184
Major chest trauma with cc
31
$120,104
$12,233
9.8× st 8.8×
312
Syncope and collapse
30
$45,350
$9,555
4.7× st 7.2×
194
Simple pneumonia and pleurisy with cc
30
$48,814
$9,143
5.3× st 7.5×
183
Major chest trauma with mcc
30
$134,261
$15,226
8.8× st 7.7×
101
Seizures without mcc
29
$53,409
$9,926
5.4× st 6.8×
229
Other cardiothoracic procedures without mcc
29
$243,262
$30,498
8.0× st 5.9×
281
Acute myocardial infarction, discharged alive with cc
28
$76,638
$8,952
8.6× st 7.8×
417
Laparoscopic cholecystectomy without c.d.e. with mcc
28
$234,125
$23,756
9.9× st 7.5×
536
Fractures of hip and pelvis without mcc
28
$58,440
$8,160
7.2× st 7.0×
551
Medical back problems with mcc
27
$124,269
$36,532
3.4× st 7.0×
092
Other disorders of nervous system with cc
27
$96,800
$11,519
8.4× st 6.8×
083
Traumatic stupor and coma >1 hour with cc
27
$111,828
$17,821
6.3× st 8.4×
699
Other kidney and urinary tract diagnoses with cc
27
$73,872
$9,687
7.6× st 6.1×
981
Extensive o.r. procedures unrelated to principal diagnosis with mcc
27
$325,727
$44,069
7.4× st 6.3×
542
Pathological fractures and musculoskeletal and connective tissue malignancy with mcc
27
$90,216
$15,997
5.6× st 7.0×
220
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
26
$580,170
$54,228
10.7× st 6.7×
242
Permanent cardiac pacemaker implant with mcc
25
$276,245
$35,241
7.8× st 6.5×
884
Organic disturbances and intellectual disability
25
$57,385
$15,315
3.7× st 5.3×
235
Coronary bypass without cardiac catheterization with mcc
25
$615,557
$60,700
10.1× st 7.3×
175
Pulmonary embolism with mcc or acute cor pulmonale
25
$78,428
$14,216
5.5× st 7.2×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
25
$52,487
$8,616
6.1× st 6.9×
324
Coronary intravascular lithotripsy with intraluminal device without mcc
25
$230,116
$28,950
7.9× st 6.5×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
24
$40,585
$5,483
7.4× st 7.6×
082
Traumatic stupor and coma >1 hour with mcc
24
$168,022
$22,634
7.4× st 7.7×
870
Septicemia or severe sepsis with mv >96 hours
24
$544,513
$69,397
7.8× st 6.2×
854
Infectious and parasitic diseases with o.r. procedures with cc
24
$198,404
$21,719
9.1× st 6.7×
066
Intracranial hemorrhage or cerebral infarction without cc/mcc
24
$63,274
$6,744
9.4× st 8.8×
372
Major gastrointestinal disorders and peritoneal infections with cc
24
$69,853
$11,155
6.3× st 6.5×
315
Other circulatory system diagnoses with cc
23
$70,700
$9,405
7.5× st 6.7×
644
Endocrine disorders with cc
23
$64,289
$10,279
6.3× st 6.5×
689
Kidney and urinary tract infections with mcc
23
$63,114
$11,243
5.6× st 6.3×
331
Major small and large bowel procedures without cc/mcc
21
$191,601
$16,060
11.9× st 6.6×
605
Trauma to the skin, subcutaneous tissue and breast without mcc
21
$52,406
$8,890
5.9× st 6.9×
323
Coronary intravascular lithotripsy with intraluminal device with mcc
21
$267,087
$39,795
6.7× st 6.2×
244
Permanent cardiac pacemaker implant without cc/mcc
21
$140,705
$17,529
8.0× st 7.6×
305
Hypertension without mcc
21
$53,305
$7,355
7.2× st 7.3×
393
Other digestive system diagnoses with mcc
20
$92,034
$17,574
5.2× st 5.8×
300
Peripheral vascular disorders with cc
20
$51,858
$10,116
5.1× st 6.3×
643
Endocrine disorders with mcc
20
$122,658
$17,046
7.2× st 6.5×
085
Traumatic stupor and coma <1 hour with mcc
20
$191,001
$22,789
8.4× st 7.1×
919
Complications of treatment with mcc
20
$142,073
$19,984
7.1× st 6.0×
236
Coronary bypass without cardiac catheterization without mcc
20
$549,991
$42,166
13.0× st 7.2×
521
Hip replacement with principal diagnosis of hip fracture with mcc
19
$197,262
$27,166
7.3× st 7.1×
025
Craniotomy and endovascular intracranial procedures with mcc
19
$607,975
$60,692
10.0× st 6.5×
270
Other major cardiovascular procedures with mcc
19
$425,608
$52,134
8.2× st 6.4×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
19
$1,501,010
$244,169
6.1× st 5.9×
069
Transient ischemia without thrombolytic
19
$57,713
$8,491
6.8× st 9.5×
176
Pulmonary embolism without mcc
19
$61,902
$8,954
6.9× st 7.9×
374
Digestive malignancy with mcc
18
$121,946
$20,092
6.1× st 7.0×
445
Disorders of the biliary tract with cc
18
$71,366
$11,463
6.2× st 7.0×
091
Other disorders of nervous system with mcc
18
$102,322
$16,546
6.2× st 6.0×
228
Other cardiothoracic procedures with mcc
18
$345,267
$49,515
7.0× st 5.8×
482
Hip and femur procedures except major joint without cc/mcc
17
$109,898
$15,192
7.2× st 6.7×
190
Chronic obstructive pulmonary disease with mcc
17
$54,268
$10,955
5.0× st 7.1×
454
Combined anterior and posterior spinal fusion with cc
17
$580,315
$61,424
9.4× st 5.5×
299
Peripheral vascular disorders with mcc
17
$88,991
$16,454
5.4× st 6.4×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
17
$459,378
$63,024
7.3× st 6.2×
544
Pathological fractures and musculoskeletal and connective tissue malignancy without cc/m
17
$50,638
$7,510
6.7× st 6.7×
180
Respiratory neoplasms with mcc
17
$93,838
$15,784
5.9× st 6.9×
252
Other vascular procedures with mcc
16
$355,424
$42,608
8.3× st 5.7×
277
Cardiac defibrillator implant without mcc
16
$252,464
$41,938
6.0× st 6.0×
896
Alcohol, drug abuse or dependence without rehabilitation therapy with mcc
16
$97,570
$19,251
5.1× st 5.5×
637
Diabetes with mcc
16
$100,880
$13,572
7.4× st 6.3×
602
Cellulitis with mcc
16
$51,967
$13,412
3.9× st 5.7×
419
Laparoscopic cholecystectomy without c.d.e. without cc/mcc
16
$143,151
$14,017
10.2× st 7.4×
326
Stomach, esophageal and duodenal procedures with mcc
15
$368,929
$47,288
7.8× st 6.1×
388
Gastrointestinal obstruction with mcc
15
$81,541
$13,636
6.0× st 6.5×
164
Major chest procedures with cc
15
$282,269
$24,477
11.5× st 6.3×
435
Malignancy of hepatobiliary system or pancreas with mcc
15
$89,874
$17,038
5.3× st 6.8×
472
Cervical spinal fusion with cc
15
$251,115
$28,214
8.9× st 6.1×
292
Heart failure and shock with cc
15
$47,284
$8,363
5.7× st 5.8×
100
Seizures with mcc
15
$110,683
$18,981
5.8× st 6.2×
356
Other digestive system o.r. procedures with mcc
15
$358,218
$49,118
7.3× st 6.8×
390
Gastrointestinal obstruction without cc/mcc
15
$33,783
$5,478
6.2× st 7.0×
743
Uterine and adnexa procedures for non-malignancy without cc/mcc
14
$153,635
$12,535
12.3× st 12.4×
216
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit
14
$767,250
$96,020
8.0× st 5.4×
920
Complications of treatment with cc
14
$80,159
$10,017
8.0× st 6.7×
250
Percutaneous cardiovascular procedures without intraluminal device with mcc
14
$175,818
$21,449
8.2× st 10.7×
375
Digestive malignancy with cc
14
$77,357
$15,737
4.9× st 6.9×
386
Inflammatory bowel disease with cc
14
$62,660
$9,482
6.6× st 11.4×
494
Lower extremity and humerus procedures except hip, foot and femur without cc/mcc
14
$146,942
$18,007
8.2× st 7.1×
638
Diabetes with cc
13
$48,271
$9,906
4.9× st 6.3×
813
Coagulation disorders
13
$90,052
$14,444
6.2× st 5.8×
199
Pneumothorax with mcc
13
$230,898
$16,494
14.0× st 7.7×
516
Other musculoskeletal system and connective tissue o.r. procedures with cc
13
$174,925
$21,670
8.1× st 6.7×
441
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with mcc
13
$93,856
$19,116
4.9× st 5.5×
492
Lower extremity and humerus procedures except hip, foot and femur with mcc
13
$346,318
$37,721
9.2× st 7.9×
054
Nervous system neoplasms with mcc
13
$78,738
$14,263
5.5× st 7.6×
885
Psychoses
13
$90,688
$13,305
6.8× st 3.1×
455
Combined anterior and posterior spinal fusion without cc/mcc
13
$448,368
$44,141
10.2× st 5.5×
948
Signs and symptoms without mcc
13
$38,796
$7,656
5.1× st 7.3×
812
Red blood cell disorders without mcc
13
$52,207
$10,093
5.2× st 6.4×
282
Acute myocardial infarction, discharged alive without cc/mcc
13
$53,999
$7,047
7.7× st 9.0×
856
Postoperative or post-traumatic infections with o.r. procedures with mcc
12
$383,462
$44,943
8.5× st 5.8×
467
Revision of hip or knee replacement with cc
12
$251,094
$33,253
7.6× st 6.1×
520
Back and neck procedures except spinal fusion without cc/mcc
12
$131,603
$13,822
9.5× st 8.3×
208
Respiratory system diagnosis with ventilator support <=96 hours
12
$266,896
$28,378
9.4× st 7.4×
862
Postoperative and post-traumatic infections with mcc
12
$110,449
$20,312
5.4× st 5.9×
460
Spinal fusion except cervical without mcc
12
$322,122
$38,307
8.4× st 5.6×
200
Pneumothorax with cc
12
$111,377
$10,515
10.6× st 9.3×
964
Other multiple significant trauma with cc
11
$165,076
$14,529
11.4× st 8.1×
336
Peritoneal adhesiolysis with cc
11
$145,870
$23,224
6.3× st 6.7×
917
Poisoning and toxic effects of drugs with mcc
11
$115,659
$15,456
7.5× st 6.2×
517
Other musculoskeletal system and connective tissue o.r. procedures without cc/mcc
11
$132,938
$16,342
8.1× st 6.6×
897
Alcohol, drug abuse or dependence without rehabilitation therapy without mcc
11
$68,535
$7,971
8.6× st 5.7×
660
Kidney and ureter procedures for non-neoplasm with cc
11
$97,568
$13,002
7.5× st 7.1×
233
Coronary bypass with cardiac catheterization or open ablation with mcc
11
$684,875
$157,941
4.3× st 7.0×
205
Other respiratory system diagnoses with mcc
11
$121,100
$17,395
7.0× st 6.2×
196
Interstitial lung disease with mcc
11
$113,099
$18,039
6.3× st 7.0×
518
Back and neck procedures except spinal fusion with mcc or disc device or neurostimulator
11
$220,245
$37,466
5.9× st 6.4×
741
Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy without cc/mcc
11
$214,580
$12,694
16.9× st 11.0×
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
788
$34,779
$3,358
10.4×
5191
Level 1 Endovascular Procedures
660
$48,189
$4,004
12.0×
5213
Level 3 Electrophysiologic Procedures
528
$203,871
$29,016
7.0×
5193
Level 3 Endovascular Procedures
421
$118,665
$13,475
8.8×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
301
$17,087
$1,993
8.6×
5492
Level 2 Intraocular Procedures
292
$56,665
$4,999
11.3×
5222
Level 2 Pacemaker and Similar Procedures
199
$43,354
$10,435
4.2×
5491
Level 1 Intraocular Procedures
193
$46,071
$2,865
16.1×
5194
Level 4 Endovascular Procedures
186
$155,517
$21,397
7.3×
5223
Level 3 Pacemaker and Similar Procedures
168
$85,036
$13,039
6.5×
5192
Level 2 Endovascular Procedures
161
$76,051
$6,992
10.9×
5302
Level 2 Upper GI Procedures
127
$17,237
$2,310
7.5×
5115
Level 5 Musculoskeletal Procedures
121
$156,838
$16,028
9.8×
5361
Level 1 Laparoscopy and Related Services
115
$98,375
$7,094
13.9×
5224
Level 4 Pacemaker and Similar Procedures
98
$138,253
$23,670
5.8×
5232
Level 2 ICD and Similar Procedures
95
$195,776
$40,316
4.9×
5362
Level 2 Laparoscopy and Related Services
94
$204,075
$12,520
16.3×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
93
$53,070
$8,017
6.6×
5414
Level 4 Gynecologic Procedures
79
$24,030
$3,805
6.3×
5183
Level 3 Vascular Procedures
74
$46,441
$3,866
12.0×
5114
Level 4 Musculoskeletal Procedures
67
$98,032
$8,344
11.7×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
58
$30,973
$3,493
8.9×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
57
$27,267
$4,621
5.9×
5313
Level 3 Lower GI Procedures
47
$22,964
$3,451
6.7×
5113
Level 3 Musculoskeletal Procedures
41
$21,383
$3,907
5.5×
5415
Level 5 Gynecologic Procedures
40
$61,080
$6,115
10.0×
5112
Level 2 Musculoskeletal Procedures
33
$21,117
$1,976
10.7×
5093
Level 3 Breast/Lymphatic Surgery and Related Procedures
29
$134,017
$11,575
11.6×
5331
Complex GI Procedures
29
$53,891
$6,572
8.2×
5303
Level 3 Upper GI Procedures
27
$35,912
$4,708
7.6×
5374
Level 4 Urology and Related Services
26
$40,048
$4,286
9.3×
5373
Level 3 Urology and Related Services
24
$39,796
$2,504
15.9×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
24
$65,352
$4,253
15.4×
5493
Level 3 Intraocular Procedures
24
$85,697
$6,227
13.8×
5416
Level 6 Gynecologic Procedures
23
$99,265
$9,285
10.7×
5182
Level 2 Vascular Procedures
23
$25,030
$1,969
12.7×
5094
Level 4 Breast/Lymphatic Surgery and Related Procedures
22
$198,575
$21,610
9.2×
5184
Level 4 Vascular Procedures
20
$62,425
$6,756
9.2×
5165
Level 5 ENT Procedures
20
$86,178
$7,200
12.0×
5231
Level 1 ICD and Similar Procedures
18
$127,604
$28,895
4.4×
5116
Level 6 Musculoskeletal Procedures
14
$252,999
$22,851
11.1×
5154
Level 4 Airway Endoscopy
13
$33,633
$4,604
7.3×
5212
Level 2 Electrophysiologic Procedures
12
$82,062
$9,177
8.9×
5375
Level 5 Urology and Related Services
11
$61,241
$6,362
9.6×
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5465
Level 5 Neurostimulator and Related Procedures
—
—
—
—
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5881
Ancillary Outpatient Services When Patient Dies
—
—
—
—
5504
Level 4 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5166
Cochlear Implant Procedure
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5342
Level 2 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5200
Implantation Wireless PA Pressure Monitor
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
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 2026-03-30, template 3.0.0, 1,218,901 rows scanned, 4,175 distinct code–setting items kept. 1,604 findings against it.
Service
Code
Listed
Cash
Negotiated
Rates
Checks
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs <=0.5 Cm
$2,121
$530
$911
261
clean
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs 0.6-1.0 Cm
$2,323
$581
$556
261
clean
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs 1.1-2.0 Cm
$8,527
$2,132
$1,194
133
clean
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs 2.1-3.0 Cm
$2,848
$712
$911
133
clean
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs 3.1-4.0 Cm
$8,575
$2,144
$2,124
133
clean
HC Excision Benign Lesion Mrgn Xcp Skn Tag Trunk/Arms/Legs >4.0 Cm
$14,901
$3,725
$2,503
269
clean
HC Rep Simple Face/Ears/Eyelids/Nose/Lips/Muc Mem 7.6 to 12.5cm
$3,405
$851
$341
132
clean
HC Rep Simple Face/Ears/Eyelids/Nose/Lips/Muc Mem 12.6 to 20.0cm
$4,759
$1,190
$690
132
clean
HC Rep Interm Face/Ears/Eyelids/Nose/Lips/Muc Mem 7.6 - 12.5cm
$4,759
$1,190
$690
132
clean
Skin Transfer Forehead/Cheek/Chin/Mouth/Neck/Axil/Genitl/Hand/Ft <=10sqcm
$8,750
$2,188
$2,654
269
clean
HC High Cost Appl Skin Substitute T/a/L Up to 100 Sq Cm, 1st 25 Sq Cm or Less
$16,305
$4,076
$951
214
clean
HC Low Cost Appl Skin Substitute T/a/L Area Up to 100 Sq Cm, Ea Addl 25 Sq Cm
$757
$189
$288
145
clean
HC High Cost Appl Skin Substitute T/a/L >= 100 Sq Cm, 1st 100 Sq Cm
$38,450
$9,613
$3,357
206
clean
HC High Cost Appl Skin Substitute T/a/L >= 100 Sq Cm, Ea Addl 100 Sq Cm
$5,544
$1,386
$832
145
clean
HC High Cost Appl Skin Substitute F/S/N/H/F/G/M/D Up to 100 Sq Cm, 1st 25 Sq Cm or Less
$5,165
$1,291
$896
214
clean
HC High Cost Appl Skin Substitute F/S/N/H/F/G/M/D Up to 100 Sq Cm, Ea Addl 25 Sq Cm
$1,325
$331
$154
145
clean
HC High Cost Appl Skin Substitute F/S/N/H/F/G/M/D >= 100 Sq Cm, 1st 100 Sq Cm
$18,702
$4,676
$2,654
206
clean
Showing the first 200 of 4,175 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
884 of 3,489 comparable items (25%) fail this check the same way — the column does not mean what the template says it means, for this file or for this reader; e.g. highest negotiated rate $1,800 exceeds the gross charge $262
warn
mrf_rate_without_estimate
15,878 of 15,878 percentage/algorithm rates across 687 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 12044/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 82570/b
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 C1777/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 12051/b
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 82803/b
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 C1778/b
info
mrf_item_fields_vary
this code and setting cover at least 7 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 13100/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 64910/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 82805/b
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 C1781/b
info
mrf_item_fields_vary
this code and setting cover at least 48 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 13101/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 28515/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 64999/b
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 differ, so no cross-line comparison was made for this item
CPT 82810/b
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 C1785/b
info
mrf_item_fields_vary
this code and setting cover at least 5 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 13102/b
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 82945/b
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 C1786/b
info
mrf_item_fields_vary
this code and setting cover at least 8 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 13120/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 82950/b
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 C1788/b
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 13121/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT C1789/b
info
mrf_item_fields_vary
this code and setting cover at least 15 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 13122/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 83520/b
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 C1817/b
info
mrf_item_fields_vary
this code and setting cover at least 7 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 13131/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 83605/b
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 C1819/b
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 13132/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 83615/b
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 C1820/b
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 13151/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 83690/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT C1874/b
info
mrf_item_fields_vary
this code and setting cover at least 34 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 13152/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 83986/b
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 C1876/b
info
mrf_item_fields_vary
this code and setting cover at least 29 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 13153/b
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 29125/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 84132/b
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 C1880/b
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 13160/b
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 differ, so no cross-line comparison was made for this item
CPT 65855/b
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 differ, so no cross-line comparison was made for this item
CPT C1882/b
info
mrf_item_fields_vary
this code and setting cover at least 9 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 14020/b
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 differ, so no cross-line comparison was made for this item
CPT 43247/b
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 65900/b
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 84157/b
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 C1884/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 14021/b
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 differ, so no cross-line comparison was made for this item
CPT 84295/b
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 C1886/b
info
mrf_item_fields_vary
this code and setting cover at least 5 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 14040/b
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 84520/b
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 C1887/b
info
mrf_item_fields_vary
this code and setting cover at least 66 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 14041/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 66761/b
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 84560/b
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 C1889/b
info
mrf_item_fields_vary
this code and setting cover at least 111 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 14060/b
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 C1892/b
info
mrf_item_fields_vary
this code and setting cover at least 12 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 14061/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 67105/b
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 85384/b
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 C1893/b
info
mrf_item_fields_vary
this code and setting cover at least 12 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 14301/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 85576/b
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 C1894/b
info
mrf_item_fields_vary
this code and setting cover at least 73 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 14302/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 67221/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max 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 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 C1896/b
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 15002/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 67400/b
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 differ, so no cross-line comparison was made for this item
CPT C1898/b
info
mrf_item_fields_vary
this code and setting cover at least 5 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 15004/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT C1900/b
info
mrf_item_fields_vary
this code and setting cover at least 5 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 15100/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 86850/b
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
CPT C2617/b
info
mrf_item_fields_vary
this code and setting cover at least 8 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 15120/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT C2618/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 15135/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 86870/b
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 differ, so no cross-line comparison was made for this item
CPT C2621/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 15220/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 86880/b
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 C2623/b
info
mrf_item_fields_vary
this code and setting cover at least 9 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 15221/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT C2625/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 15240/b
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 C2627/b
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 15260/b
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 67900/b
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 differ, so no cross-line comparison was made for this item
CPT 86905/b
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
CPT C2628/b
info
mrf_item_fields_vary
this code and setting cover at least 7 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 15271/b
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 C2630/b
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 15272/b
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 30130/b
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 differ, so no cross-line comparison was made for this item
CPT 67903/b
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 differ, so no cross-line comparison was made for this item
CPT 86922/b
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 differ, so no cross-line comparison was made for this item
CPT C9352/b
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 15273/b
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 30140/b
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
CPT 67904/b
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 differ, so no cross-line comparison was made for this item
CPT C9399/b
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 15274/b
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 C9482/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
CPT 15275/b
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 30400/b
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 differ, so no cross-line comparison was made for this item
CPT 67908/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 86965/b
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 differ, so no cross-line comparison was made for this item
CPT 15276/b
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 43450/b
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
CPT 15277/b
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 87205/b
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 15733/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 87210/b
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 G0390/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 15734/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 88108/b
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 differ, so no cross-line comparison was made for this item
CPT J0165/b
info
mrf_item_fields_vary
this code and setting cover at least 5 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 43762/b
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
CPT J0169/b
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 43763/b
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 88177/b
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 J0248/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 43775/b
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
CPT 67924/b
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 differ, so no cross-line comparison was made for this item
CPT 88300/b
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 J0278/b
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 15821/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 88302/b
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 differ, so no cross-line comparison was made for this item
CPT J0281/b
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 15822/b
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 differ, so no cross-line comparison was made for this item
CPT 67935/b
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
CPT 88304/b
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 J0282/b
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 15823/b
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 differ, so no cross-line comparison was made for this item
CPT 67950/b
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 differ, so no cross-line comparison was made for this item
CPT 88305/b
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 J0290/b
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 67961/b
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 differ, so no cross-line comparison was made for this item
CPT 88307/b
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 differ, so no cross-line comparison was made for this item
CPT J0295/b
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 J0457/b
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 15828/b
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 differ, so no cross-line comparison was made for this item
CPT 30901/b
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 J0571/b
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 J0602/b
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 30930/b
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
CPT 88331/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J0612/b
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 30999/b
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 differ, so no cross-line comparison was made for this item
CPT 88332/b
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 J0618/b
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 15836/b
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 31000/b
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 88333/b
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
CPT J0640/b
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 88334/b
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 J0665/b
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 15839/b
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 differ, so no cross-line comparison was made for this item
CPT J0690/b
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 15851/b
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
CPT J0692/b
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 89051/b
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 J0694/b
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 31231/b
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 44385/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 89060/b
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 J0696/b
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 15878/b
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 J0697/b
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 15879/b
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 differ, so no cross-line comparison was made for this item
CPT 31238/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J0713/b
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 90715/b
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 J0736/b
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 17110/b
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 31240/b
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
CPT 90744/b
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 J0743/b
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 17999/b
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 31253/b
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
CPT 91010/b
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 19000/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 31254/b
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
CPT 91034/b
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 J1071/b
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 19020/b
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 31255/b
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
CPT 91035/b
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 differ, so no cross-line comparison was made for this item
CPT J1100/b
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 19085/b
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
CPT 31256/b
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
Showing the first 200 of 1,604 findings, errors first — every finding as JSON →
04 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 235
info
inp_charge_10x_payment
average charge $615,557 is 10.1× the total payment
MS-DRG 236
info
inp_charge_10x_payment
average charge $549,991 is 13.0× the total payment
MS-DRG 331
info
inp_charge_10x_payment
average charge $191,601 is 11.9× the total payment
MS-DRG 418
info
inp_charge_10x_payment
average charge $185,268 is 11.6× the total payment
MS-DRG 419
info
inp_charge_10x_payment
average charge $143,151 is 10.2× the total payment
MS-DRG 455
info
inp_charge_10x_payment
average charge $448,368 is 10.2× the total payment
MS-DRG 741
info
inp_charge_10x_payment
average charge $214,580 is 16.9× the total payment
MS-DRG 743
info
inp_charge_10x_payment
average charge $153,635 is 12.3× the total payment
MS-DRG 964
info
inp_charge_10x_payment
average charge $165,076 is 11.4× the total payment
MS-DRG 025
info
inp_charge_10x_payment
average charge $607,975 is 10.0× the total payment
MS-DRG 086
info
inp_charge_10x_payment
average charge $165,930 is 13.0× the total payment
MS-DRG 164
info
inp_charge_10x_payment
average charge $282,269 is 11.5× the total payment
MS-DRG 199
info
inp_charge_10x_payment
average charge $230,898 is 14.0× the total payment
MS-DRG 200
info
inp_charge_10x_payment
average charge $111,377 is 10.6× the total payment
MS-DRG 220
info
inp_charge_10x_payment
average charge $580,170 is 10.7× the total payment
Sources for this hospital
the files read, as fetched — not our copy of them- MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
- 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)
- 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 · 2020tab20_zcta520_county20_natl.txt · 6.8M bytes · fetched 2026-08-21 · sha256 3ed41278d637… · publisher's page · public domain (US federal)
- Scripps Memorial Hospital La Jolla — standard charges file · CA · updated 2026-03-30· csv-tall · 632.2M bytes · fetched 2026-08-23 · sha256 81bb2b9f8ed5…
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.