Hospital · CCN 060112
Hca Healthone Sky Ridge
10101 Ridgegate Pkwy, Lone Tree, CO 80124 · Douglas County
Part of HCA Healthcare · 273 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
58 admission types 52 outpatient services price file: ok 47 Medicare-file findings
Billed per dollar paid, all admissions
11.73×
$364.6M billed against $31.1M paid across 1,645 Medicare discharges; the national figure is 5.03×.
—
of adults in Douglas County have medical debt in collections — state bars medical debt from credit reports; the credit-bureau panel cannot see it
4.0%
uninsured in the county · state 8.4%
$145K
median household income
9.3×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (4 in the inpatient or outpatient file)ⓘ
25.3%
obesity in the countyⓘ
6.8%
diagnosed diabetes (PLACES)
4.3%
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
281
$189,750
$17,318
11.0× st 6.7×
454
Combined anterior and posterior spinal fusion with cc
72
$539,621
$53,474
10.1× st 7.6×
291
Heart failure and shock with mcc
64
$111,106
$11,888
9.3× st 6.5×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
63
$241,461
$15,927
15.2× st 9.6×
872
Septicemia or severe sepsis without mv >96 hours without mcc
51
$120,868
$9,268
13.0× st 7.1×
177
Respiratory infections and inflammations with mcc
44
$138,942
$13,628
10.2× st 6.4×
698
Other kidney and urinary tract diagnoses with mcc
43
$221,905
$16,886
13.1× st 7.8×
467
Revision of hip or knee replacement with cc
42
$384,790
$32,673
11.8× st 7.9×
683
Renal failure with cc
40
$95,639
$8,185
11.7× st 7.6×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
37
$89,887
$7,465
12.0× st 8.1×
193
Simple pneumonia and pleurisy with mcc
37
$117,555
$12,015
9.8× st 6.1×
312
Syncope and collapse
33
$92,142
$7,684
12.0× st 9.1×
682
Renal failure with mcc
32
$130,371
$15,166
8.6× st 7.8×
552
Medical back problems without mcc
31
$123,262
$11,650
10.6× st 9.0×
189
Pulmonary edema and respiratory failure
31
$108,765
$11,179
9.7× st 7.2×
378
Gastrointestinal hemorrhage with cc
29
$106,487
$8,803
12.1× st 7.0×
481
Hip and femur procedures except major joint with cc
28
$278,232
$17,299
16.1× st 7.7×
853
Infectious and parasitic diseases with o.r. procedures with mcc
28
$480,498
$38,624
12.4× st 7.0×
330
Major small and large bowel procedures with cc
26
$331,917
$20,252
16.4× st 8.0×
690
Kidney and urinary tract infections without mcc
26
$106,133
$7,306
14.5× st 8.1×
468
Revision of hip or knee replacement without cc/mcc
24
$298,919
$25,931
11.5× st 7.3×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
23
$426,335
$24,900
17.1× st 8.6×
516
Other musculoskeletal system and connective tissue o.r. procedures with cc
22
$213,093
$20,537
10.4× st 8.8×
460
Spinal fusion except cervical without mcc
21
$466,914
$35,185
13.3× st 7.9×
455
Combined anterior and posterior spinal fusion without cc/mcc
21
$539,491
$47,686
11.3× st 6.9×
394
Other digestive system diagnoses with cc
21
$102,687
$8,448
12.2× st 8.3×
389
Gastrointestinal obstruction with cc
21
$112,266
$7,394
15.2× st 8.2×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
21
$138,570
$11,193
12.4× st 7.2×
064
Intracranial hemorrhage or cerebral infarction with mcc
20
$186,155
$17,068
10.9× st 8.1×
427
Multiple level combined anterior and posterior spinal fusion except cervical with cc
19
$693,502
$60,810
11.4× st 7.9×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
18
$329,424
$16,084
20.5× st 8.7×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
18
$134,477
$8,754
15.4× st 8.6×
884
Organic disturbances and intellectual disability
18
$105,159
$14,121
7.4× st 6.5×
309
Cardiac arrhythmia and conduction disorders with cc
18
$100,642
$6,758
14.9× st 7.3×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
17
$184,861
$10,785
17.1× st 11.0×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
17
$103,893
$10,284
10.1× st 7.9×
699
Other kidney and urinary tract diagnoses with cc
17
$84,605
$9,055
9.3× st 7.4×
329
Major small and large bowel procedures with mcc
17
$757,608
$87,221
8.7× st 6.6×
522
Hip replacement with principal diagnosis of hip fracture without mcc
17
$315,074
$26,175
12.0× st 8.6×
086
Traumatic stupor and coma <1 hour with cc
16
$206,416
$11,310
18.3× st 9.4×
069
Transient ischemia without thrombolytic
16
$114,649
$7,161
16.0× st 10.1×
377
Gastrointestinal hemorrhage with mcc
15
$151,483
$15,682
9.7× st 7.1×
280
Acute myocardial infarction, discharged alive with mcc
14
$189,629
$14,357
13.2× st 6.9×
472
Cervical spinal fusion with cc
14
$293,671
$24,824
11.8× st 7.3×
469
Major hip and knee joint replacement or reattachment of lower extremity with mcc or tota
14
$338,677
$29,073
11.6× st 6.7×
092
Other disorders of nervous system with cc
12
$120,458
$8,910
13.5× st 9.5×
149
Dysequilibrium
12
$86,634
$6,709
12.9× st 13.0×
175
Pulmonary embolism with mcc or acute cor pulmonale
12
$99,933
$10,340
9.7× st 5.8×
811
Red blood cell disorders with mcc
12
$149,682
$12,415
12.1× st 8.3×
483
Major joint or limb reattachment procedures of upper extremities
12
$270,809
$20,849
13.0× st 10.7×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
11
$108,935
$11,541
9.4× st 7.6×
689
Kidney and urinary tract infections with mcc
11
$132,323
$11,907
11.1× st 7.1×
661
Kidney and ureter procedures for non-neoplasm without cc/mcc
11
$189,667
$9,786
19.4× st 19.4×
194
Simple pneumonia and pleurisy with cc
11
$152,151
$8,324
18.3× st 7.7×
517
Other musculoskeletal system and connective tissue o.r. procedures without cc/mcc
11
$193,944
$13,537
14.3× st 14.3×
466
Revision of hip or knee replacement with mcc
11
$527,877
$36,653
14.4× st 14.4×
372
Major gastrointestinal disorders and peritoneal infections with cc
11
$120,847
$9,426
12.8× st 7.8×
907
Other o.r. procedures for injuries with mcc
11
$305,851
$33,357
9.2× st 7.7×
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
5115
Level 5 Musculoskeletal Procedures
284
$240,882
$12,319
19.6×
8011
Comprehensive Observation Services
161
$75,907
$2,542
29.9×
5362
Level 2 Laparoscopy and Related Services
155
$219,035
$9,687
22.6×
5193
Level 3 Endovascular Procedures
89
$213,929
$10,463
20.4×
5114
Level 4 Musculoskeletal Procedures
81
$164,810
$6,676
24.7×
5376
Level 6 Urology and Related Services
70
$161,040
$8,767
18.4×
5361
Level 1 Laparoscopy and Related Services
68
$150,914
$5,428
27.8×
5183
Level 3 Vascular Procedures
65
$67,215
$2,999
22.4×
5116
Level 6 Musculoskeletal Procedures
63
$288,395
$17,481
16.5×
5375
Level 5 Urology and Related Services
61
$130,258
$4,861
26.8×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
57
$38,951
$1,543
25.2×
5191
Level 1 Endovascular Procedures
55
$127,630
$3,066
41.6×
5302
Level 2 Upper GI Procedures
52
$50,978
$1,784
28.6×
5113
Level 3 Musculoskeletal Procedures
44
$113,320
$3,026
37.5×
5374
Level 4 Urology and Related Services
36
$90,321
$3,319
27.2×
5184
Level 4 Vascular Procedures
27
$130,825
$5,231
25.0×
5182
Level 2 Vascular Procedures
24
$19,697
$1,525
12.9×
5112
Level 2 Musculoskeletal Procedures
23
$46,863
$1,530
30.6×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
20
$71,822
$2,705
26.6×
5414
Level 4 Gynecologic Procedures
19
$97,523
$2,976
32.8×
5194
Level 4 Endovascular Procedures
18
$295,310
$16,657
17.7×
5373
Level 3 Urology and Related Services
14
$63,829
$1,939
32.9×
5154
Level 4 Airway Endoscopy
13
$120,222
$3,565
33.7×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
12
$107,723
$3,293
32.7×
5223
Level 3 Pacemaker and Similar Procedures
12
$134,359
$10,156
13.2×
5155
Level 5 Airway Endoscopy
12
$192,702
$6,515
29.6×
5415
Level 5 Gynecologic Procedures
—
—
—
—
5165
Level 5 ENT Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5432
Level 2 Nerve Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5465
Level 5 Neurostimulator and Related Procedures
—
—
—
—
5491
Level 1 Intraocular Procedures
—
—
—
—
5627
Level 7 Radiation Therapy
—
—
—
—
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5192
Level 2 Endovascular Procedures
—
—
—
—
5222
Level 2 Pacemaker and Similar Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5313
Level 3 Lower GI Procedures
—
—
—
—
5331
Complex GI Procedures
—
—
—
—
5342
Level 2 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5094
Level 4 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5378
Level 8 Urology and Related Services
—
—
—
—
03 · Its own price file
What the hospital's price-transparency file says
Found via /cms-hpt.txt, the file itself ↗ read as json, last updated 2026-03-01, template 3.0.0, 286,985 rows scanned, 15,984 distinct code–setting items kept. 11,649 findings against it.
Service
Code
Listed
Cash
Negotiated
Rates
Checks
Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported
—
—
$720
102
clean
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo
—
—
$503
25
clean
Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo
—
—
$503
25
clean
Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score
—
—
$760
102
clean
Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 ºCDK1», IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo
—
—
$760
102
clean
Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 ºCDK1», IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo
—
—
$760
102
clean
Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical ster
—
—
$1,305
102
clean
Oncology (bladder), mRNA, microarray gene expression profiling of 219 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as molecular subtype (luminal, luminal infiltrated, b
—
—
$3,490
102
clean
Oncology (thyroid), microRNA profiling by RT-PCR of 10 miRNA sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy
—
—
$3,002
102
clean
Oncology (acute myelogenous leukemia), DNA, genotyping of internal tandem duplication, p.D835, p.I836, using mononuclear cells, reported as detection or nondetection of FLT3 mutation and indication fo
—
—
$249
102
clean
Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative
—
—
$34
102
clean
Oncology (thyroid), DNA and mRNA of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule, algorithmic analysis reported as a categorical result ("Positive, high probability of
—
—
$3,600
102
clean
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15
—
—
$122
102
clean
Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823)
—
—
$742
102
clean
TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15) (eg, thiopurine metabolism), gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5)
—
—
$466
102
clean
Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative
—
—
$541
102
clean
Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instabiit
—
—
$3,500
102
clean
Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM
—
—
$17
102
clean
Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and m
$20,426
$20,426
$13,870
45
clean
Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG
—
—
$17
102
clean
Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM
—
—
$15
102
clean
Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG
—
—
$15
102
clean
Oncology (breast ductal carcinoma in situ), mRNA, gene expression progiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm
—
—
$3,873
102
clean
Oncology (prostate), mRNA, gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm report as a risk scor
—
—
$3,873
102
clean
Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)
—
—
$3,189
57
clean
Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure)
—
—
$3,189
57
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative
—
—
$323
102
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative
—
—
$323
102
clean
Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis
—
—
$25
102
clean
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative
—
—
$31
102
clean
Candida species panel (C. albicans, C. glabrata, C. parapsilosis, C. kruseii, C. tropicalis, and C. auris), amplified probe technique with qualitative report of the presence or absence of each species
—
—
$143
102
clean
Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel
—
—
$5,680
92
clean
Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype
—
—
$43
102
clean
Oncology (lung), mass spectrometric analysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein M130, with five clinical risk factors (age, smoking status, nodule diamet
—
—
$3,520
102
clean
Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)
—
—
$760
102
clean
Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a categori
—
—
$1,950
102
clean
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified
—
—
$6,162
95
clean
Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel utilizing a combination A of NGS, San
—
—
$1,744
102
clean
Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KI
—
—
$950
102
clean
Quantitative sensory testing (QST), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation
—
—
$64
3
clean
Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rat
—
—
$874
102
clean
Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli to assess large diameter fiber sensation
—
—
$64
3
clean
Quantitative sensory testing (QST), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia
—
—
$98
3
clean
Gastroenterology (Barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-
—
—
$4,950
102
clean
Quantitative sensory testing (QST), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia
—
—
$64
3
clean
Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene
—
—
$356
102
clean
Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donoe-derived cell-free DNA in the total cell-f
—
—
$2,753
102
clean
Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events
—
—
$84
102
clean
Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and eletion/duplication analysis panel (A
—
—
$1,304
102
clean
Infectious disease (bacteria, fungi, parasites, and DNA viruses), DNA, PCR and next-generation sequencing, plasma, detection of >1,000 potential microbial organisms for significant positive pathogens
—
—
$2,126
102
clean
Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results
—
—
$112
102
clean
Liver disease, 10 biochemical assays (a2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT, ALT, AST, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utili
—
—
$503
102
clean
Oncology (solid tumor as indicated by the label), somatic mutation analyis of BRCA1, BRCA2 and analysis of homologous recombination deficiency pathways, DNA, formalin-fixed paraffin-embedded tissue, a
—
—
$3,030
102
clean
Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 che
—
—
$1,305
102
clean
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness)
—
—
$6,699
128
clean
Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, w
—
—
$9,421
95
clean
Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when
—
—
$9,421
95
clean
Posterior vertebral joint(s) arthroplasty (eg, facet jointºs» replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, i
—
—
$10,063
146
clean
Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua
—
—
$417
98
clean
Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral
—
—
$3,189
96
clean
Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
—
—
$2,720
128
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel
—
—
$8,132
128
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel
—
—
$14,327
128
clean
Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free DNA, analysis of 311 or more genes, interrogation for sequence variants, including substitutions, insertions, deletions, selec
—
—
$3,500
102
clean
Inf dis, pathogen spec DNA/RNA, 21 targets, SARS-CoV-2, ampol probe tec, incl multplx rev tx to RNA targ, ea analyte rep as det or not det
—
—
$408
3
clean
Inf dis, pathogen-spec RNA, 4 targ SARS-CoV-2, Influ A, B, RSV, Upper resp spec, ea pathogen rep as det or not det
—
—
$408
3
clean
Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearra
—
—
$5,000
102
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 maligna
—
—
$1,266
102
clean
Oncology (Solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for somatic alterations, microsatellite instability and tumor-mutation burden
—
—
$2,920
102
clean
Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programmin
—
—
$21,053
71
clean
Implantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed)
—
—
$21,053
71
clean
Interrogation device evaluation (in person), carotid sinus baroreflex activation system, including telemetric iterative communication with the implantable device to monitor device diagnostics and prog
—
—
$2,716
39
clean
Interrogation device evaluation (in person), carotid sinus baroreflex activation system, including telemetric iterative communication with the implantable device to monitor device diagnostics and prog
—
—
$2,716
39
clean
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde
—
—
$9,701
71
clean
Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)
—
—
$2,720
63
clean
Oncology (lung), mRNA, quantitative PCR analysis of 11 genes (BAG1,BRCA1,CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR, WNT3A) and 3 reference genes (ESD, TBP, YAP1), formalin-fixed paraffin emb
—
—
$3,873
102
clean
Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicpathologic factors, utilizing fo
—
—
$5,435
102
clean
Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD
—
—
$391
102
clean
Cardiology (cardiovascular disease), analysis of 4 proteins (NT-proBNP, osteopontin, tissue inhibitor of metalloproteinase-1 [TIMP-1], and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported
—
—
$391
102
clean
Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi
—
—
$8
102
clean
Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), fl
—
—
$841
102
clean
Oncology (cutaneous squamous cell carcinoma), mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm
—
—
$8,500
98
clean
Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection
—
—
$2,650
98
clean
Target genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 83 or more genes, iterrogation for sequence variants, gene copy number amplifications, gene rearrang
—
—
$5,000
98
clean
Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutation
—
—
$3,438
98
clean
Tear film imaging, unilateral or bilateral, with interpretation and report
—
—
$64
3
clean
Oncology (solid organ), target geonomic sequence analysis, FFPE tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements,
—
—
$3,500
102
clean
Oncology (Plasma cell disorders and myeloma), circulating plasma cell immunologic selection, id, morphological characterization, and enumeration of plasma cells based on differential CD138, CD38, CD19
—
—
$2,435
98
clean
Oncology (Solid Tumor), circulating tumor cell selection, id, morphological characterization, detection and enumeration based on differential EpCAM, cytokeratins 8, 18 and 19, and CD45 protein biomark
—
—
$2,435
98
clean
Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r
—
—
$9,421
128
clean
Oncology (prostate), mRNA expression profiling of HOXC6 and DLX1, reverse transcription polymerase chain reaction (RT-PCR), first void urine following digital rectal examination, algorithn reporteed a
—
—
$760
102
clean
Oncology (pan-cancer), analysis of MRD from plasma, with assays personalized to each patient based on prior next generation sequencing of the patient's tumor and germline DNA, reported as absence or p
—
—
$3,920
102
clean
Hepatology (nonalcoholic fatty liver disease), semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectometry, serum, reported as at-risk for nonalcoholic steato
—
—
$792
98
clean
Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,336
102
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes
—
—
$1,336
102
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes
—
—
$742
102
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interactions
—
—
$742
102
clean
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed)
—
—
$182
31
clean
Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor related apoptosis-inducing ligand interferon gamma induced protein-10, and C-reactive protein, serum, algorithm repor
—
—
$261
102
clean
Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred
—
—
$2,186
24
clean
Infectious disease (bact vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-assoc bacteria, algorithm reported as detected or not detected and separate
—
—
$96
4
clean
Infectious agent detection by nucleic acid, Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technque, urine, vaginal, pharyngeal or rectal, each pathogen reported as detecte
—
—
$47
4
clean
Oncology evaluation of 17 DNA biomarkers using droplet digital PCR, cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence
—
—
$1,800
98
clean
Bioelectrical impedance analysis whole body composition assessment, with interpretation and report
—
—
$48
3
clean
Neurology (mild cognitive impairment), analysis of b-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative
—
—
$261
98
clean
Oncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer
—
—
$760
98
clean
Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy
—
—
$841
98
clean
Oncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of 5 genes (mdk, hoxa13, cdc2 ºcdk1», igfbp5, and cxcr2), utilizing urine, algorithm incorporates age, sex, smoking
—
—
$760
98
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer
—
—
$897
98
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer
—
—
$897
98
clean
Oncology (ovarian), biochemical assays of 7 proteins (follicle stimulating hormone, human epididymis protein 4, apolipoprotein A-1, transferrin, beta-2 macroglobulin, prea0lbumin, and cancer antigen 1
—
—
$897
98
clean
Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prostate cancer-specific morta
—
—
$706
98
clean
Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; technical suppor
—
—
$64
3
clean
Targeted genomic sequence analysis panel, solid organ neoplasm, DNA (523 genes) and RNA (55 genes) by next-gen seq, interrogation for sequence variants, gene copy number amplifications, gene rearrange
—
—
$3,289
98
clean
Oncology, next-generation sequencing with ident of single nucleotide variants, copy number variants, insertions and deletions, and scructural variants in 37 cancer related genes, plasma, with report f
—
—
$3,500
98
clean
Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative
—
—
$541
98
clean
High dose rate electronic brachytherapy, skin surface application, per fraction, includes basic dosimetry, when performed
—
—
$431
3
clean
Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative
—
—
$199
98
clean
High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed
—
—
$1,811
7
clean
Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation lesion, intracranial for movement disorder including stereotactic navigation and frame placement when
—
—
$11,402
71
clean
Gastroenterology (Barret esophagus), P16, RUNX3,HPP1, & FBN1 DNA methylation analysis using PCR, FFPE tissue, algorithm reported as risk score for progression to high-grade dysplasia or cancer
—
—
$1,755
98
clean
Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed
—
—
$3,889
128
clean
Oncology (Prostate), mRNA, gene expression peofiling of 18 genes, first-catch, algorithm reported as percentage of likelihood of detecting clinical significant prostate cancer
—
—
$760
98
clean
Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression
—
—
$323
98
clean
Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer
—
—
$760
98
clean
Nephrology (diabetic chronic kidney disease), multiplex electrochiluminescent immunoassay of soluble tumor necrosis factor receptor 1, 2, and kidney injury molecule 1 combined with clinical data, plas
—
—
$950
98
clean
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator
—
—
$27,100
98
clean
Oncology (solid tumor), DNA (80 genes) & RNA (36 genes), by next-generation sequencing from plasma, including single nucleotide variants, insertions, deletions, copy number alterations, microsatellite
—
—
$2,920
98
clean
Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,336
98
clean
Cardiovascular disease , IL-16, FAS, FASLigand, HGF, CTACK, EOTAXIN, and MCP-3 by immunoassay combined with age, sex, family history, and personal history of diabetes, blood, algorithm reported as a 5
—
—
$391
98
clean
Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including
—
—
$60
3
clean
Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter, implantable cardiac contractility modulation syste
—
—
$60
3
clean
Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or
—
—
$6,158
104
clean
Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-treatment cell-free circulating D
—
—
$1,943
98
clean
Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative
—
—
$62
98
clean
Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative
—
—
$37
98
clean
Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative
—
—
$37
98
clean
Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer
—
—
$760
98
clean
Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes
—
—
$417
98
clean
Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure)
—
—
$3,189
57
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
—
—
$6,169
128
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
—
—
$6,169
128
clean
Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid
—
—
$116
98
clean
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training
—
—
$2,720
128
clean
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision
—
—
$2,720
128
clean
Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation
—
—
$2,720
128
clean
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device
—
—
$6,699
128
clean
Visual evoked potential, testing for glaucoma, with interpretation and report
—
—
$250
3
clean
Oncology (solid tumor),nextgeneration sequencing (NGS) of DNA from formalin-fixed paraffinembedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen (blood or saliva), 68
—
—
$4,500
98
clean
Hereditary prostate cancer-related disorders,genomic sequence analysis panel using next-generation sequencing (NGS),Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA),and array
—
—
$1,304
98
clean
Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children
—
—
$2,909
128
clean
Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part ther
—
—
$3,189
57
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed
—
—
$9,449
92
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)
—
—
$7,644
92
clean
Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral
—
—
$64
3
clean
Oncology (solid tumor), cell-free DNA and RNA by next-generation sequencing, interpretative report for germline mutations, clonal hematopoiesis of indeterminate potential, and tumor-derived single-nuc
—
—
$3,649
98
clean
Optical coherence tomography (OCT) of middle ear, with interpretation and report; bilateral
—
—
$64
3
clean
Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservatio
—
—
$7,644
92
clean
Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pu
—
—
$9,449
60
clean
Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultraso
—
—
$8,799
128
clean
Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report
—
—
$98
3
clean
Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound
—
—
$2,125
95
clean
Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure)
—
—
$2,720
24
clean
Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interp
—
—
$2,720
24
clean
Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; complete system
—
—
$12,161
128
clean
Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values, with analysis, review, and report
—
—
$60
3
clean
Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis, review, and report
—
—
$60
3
clean
Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous
—
—
$2,716
39
clean
Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional
—
—
$1,288
32
clean
Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide
—
—
$125
27
clean
Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral
—
—
$2,720
128
clean
Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis
—
—
$9,449
95
clean
Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure)
—
—
$9,449
95
clean
Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation thre
—
—
$14,327
128
clean
Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with iterative adjustment of the implantable device to test the function of the de
—
—
$60
3
clean
Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care p
—
—
$60
3
clean
Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, t
—
—
$60
3
clean
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral
—
—
$6,416
128
clean
Electronic analysis with complex programming of implanted integrated neurostimulation system for bladder dysfunction (eg, electrode array and receiver), including contact group(s), amplitude, pulse wi
—
—
$155
3
clean
Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and measure wound size, per session; first anatomic site (eg, lower extremity, right leg)
—
—
$595
27
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous
—
—
$7,856
128
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, including fluoroscopic and ultrasound guidance, when performed, open
—
—
$8,132
128
clean
Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; remote surveillance center technical su
—
—
$84
27
clean
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or intraocular lens, without insertion of intraocular lens
—
—
$8,538
104
clean
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of intraocular lens
—
—
$8,734
104
clean
Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or intraocular lens exchange
—
—
$8,734
104
clean
Cystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, including transrectal ultrasound and fluoroscopy, when performed
—
—
$6,194
104
clean
Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ul
—
—
$8,799
128
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; computerized analysi
—
—
$1,600
3
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level
—
—
$8,068
128
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separ
—
—
$3,189
57
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level
—
—
$8,068
128
clean
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s)
—
—
$828
18
clean
Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisit
—
—
$64
3
clean
Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated bloo
—
—
$8,819
98
clean
Showing the first 200 of 15,984 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
CPT 75885/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $8,148
CPT 86975/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,284 exceeds the gross charge $724
CPT 75887/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $6,433
CPT 81220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,644 exceeds the gross charge $566
CPT 75891/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $11,238
CPT 92511/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,833 exceeds the gross charge $1,693
CPT 86985/o
warn
mrf_negotiated_above_gross
highest negotiated rate $709 exceeds the gross charge $423
CPT 75898/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $10,392
CPT 76015/o
warn
mrf_negotiated_above_gross
highest negotiated rate $277 exceeds the gross charge $81
CPT 76098/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,028 exceeds the gross charge $906
CPT 87149/o
warn
mrf_negotiated_above_gross
highest negotiated rate $95 exceeds the gross charge $92
CPT 99292/o
warn
mrf_negotiated_above_gross
highest negotiated rate $15,317 exceeds the gross charge $8,803
CPT A4100/o
warn
mrf_negotiated_above_gross
highest negotiated rate $382 exceeds the gross charge $132
CPT J7330/o
warn
mrf_negotiated_above_gross
highest negotiated rate $251,179 exceeds the gross charge $1
CPT 50384/o
warn
mrf_negotiated_above_gross
highest negotiated rate $8,538 exceeds the gross charge $8,227
CPT 78803/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,350 exceeds the gross charge $2,110
CPT M0249/o
warn
mrf_negotiated_above_gross
highest negotiated rate $758 exceeds the gross charge $681
CPT 0648T/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,352 exceeds the gross charge $1,137
CPT 0649T/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,352 exceeds the gross charge $1,137
CPT J0630/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,300 exceeds the gross charge $58
CPT A4437/o
warn
mrf_negotiated_above_gross
highest negotiated rate $29 exceeds the gross charge $21
CPT 81292/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,208 exceeds the gross charge $2,420
CPT J7504/o
warn
mrf_negotiated_above_gross
highest negotiated rate $15,924 exceeds the gross charge $11,176
CPT 86355/o
warn
mrf_negotiated_above_gross
highest negotiated rate $179 exceeds the gross charge $138
CPT A5122/o
warn
mrf_negotiated_above_gross
highest negotiated rate $19 exceeds the gross charge $7
CPT 93600/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $16,160
CPT 93602/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $16,160
CPT 88319/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,117 exceeds the gross charge $1,038
CPT 93609/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $10,790
CPT P9612/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,833 exceeds the gross charge $249
CPT 93610/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $16,160
CPT 93612/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $21,330
CPT 88329/o
warn
mrf_negotiated_above_gross
highest negotiated rate $161 exceeds the gross charge $130
CPT 93613/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $16,170
CPT 88331/o
warn
mrf_negotiated_above_gross
highest negotiated rate $709 exceeds the gross charge $223
CPT A9541/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,254 exceeds the gross charge $1,448
CPT 93623/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $22,639
CPT Q0166/o
warn
mrf_negotiated_above_gross
highest negotiated rate $177 exceeds the gross charge $23
CPT 93624/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40,585 exceeds the gross charge $33,947
CPT A9558/o
warn
mrf_negotiated_above_gross
highest negotiated rate $919 exceeds the gross charge $590
CPT J8510/o
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $26
CPT 87428/o
warn
mrf_negotiated_above_gross
highest negotiated rate $350 exceeds the gross charge $178
CPT 93799/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,720 exceeds the gross charge $655
CPT J0841/o
warn
mrf_negotiated_above_gross
highest negotiated rate $14,775 exceeds the gross charge $7,920
CPT 87483/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,980 exceeds the gross charge $1,776
CPT Q4124/o
warn
mrf_negotiated_above_gross
highest negotiated rate $381 exceeds the gross charge $152
CPT J2690/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,034 exceeds the gross charge $864
CPT 80235/o
warn
mrf_negotiated_above_gross
highest negotiated rate $129 exceeds the gross charge $55
CPT 81372/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,917 exceeds the gross charge $1,423
CPT 87502/o
warn
mrf_negotiated_above_gross
highest negotiated rate $455 exceeds the gross charge $164
CPT 29125/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,764 exceeds the gross charge $2,186
CPT 94150/o
warn
mrf_negotiated_above_gross
highest negotiated rate $250 exceeds the gross charge $218
CPT 29130/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,764 exceeds the gross charge $1,697
CPT 36514/o
warn
mrf_negotiated_above_gross
highest negotiated rate $8,538 exceeds the gross charge $8,192
CPT 82938/o
warn
mrf_negotiated_above_gross
highest negotiated rate $84 exceeds the gross charge $72
CPT 81383/o
warn
mrf_negotiated_above_gross
highest negotiated rate $518 exceeds the gross charge $460
CPT 95800/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,579 exceeds the gross charge $1,691
CPT G0379/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,030 exceeds the gross charge $912
CPT 86769/o
warn
mrf_negotiated_above_gross
highest negotiated rate $200 exceeds the gross charge $93
CPT G0382/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,029 exceeds the gross charge $3,840
CPT 36592/o
warn
mrf_negotiated_above_gross
highest negotiated rate $20,116 exceeds the gross charge $210
CPT 90380/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,142 exceeds the gross charge $1,772
CPT J3030/o
warn
mrf_negotiated_above_gross
highest negotiated rate $568 exceeds the gross charge $23
CPT 90381/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,142 exceeds the gross charge $1,772
CPT 36600/o
warn
mrf_negotiated_above_gross
highest negotiated rate $20,116 exceeds the gross charge $1,002
CPT 36640/o
warn
mrf_negotiated_above_gross
highest negotiated rate $20,116 exceeds the gross charge $14,903
CPT 81455/o
warn
mrf_negotiated_above_gross
highest negotiated rate $13,868 exceeds the gross charge $13,703
CPT 87593/o
warn
mrf_negotiated_above_gross
highest negotiated rate $243 exceeds the gross charge $107
CPT 90678/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,149 exceeds the gross charge $987
CPT 81162/o
warn
mrf_negotiated_above_gross
highest negotiated rate $8,668 exceeds the gross charge $8,225
CPT 90698/o
warn
mrf_negotiated_above_gross
highest negotiated rate $424 exceeds the gross charge $307
CPT 87634/o
warn
mrf_negotiated_above_gross
highest negotiated rate $333 exceeds the gross charge $164
CPT G0483/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,173 exceeds the gross charge $455
CPT 87636/o
warn
mrf_negotiated_above_gross
highest negotiated rate $678 exceeds the gross charge $196
CPT 87637/o
warn
mrf_negotiated_above_gross
highest negotiated rate $678 exceeds the gross charge $164
CPT 59025/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,720 exceeds the gross charge $1,270
CPT 90746/o
warn
mrf_negotiated_above_gross
highest negotiated rate $225 exceeds the gross charge $156
CPT 96377/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,833 exceeds the gross charge $164
CPT 86902/o
warn
mrf_negotiated_above_gross
highest negotiated rate $576 exceeds the gross charge $314
CPT 86905/o
warn
mrf_negotiated_above_gross
highest negotiated rate $576 exceeds the gross charge $446
CPT 75805/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $8,605
CPT 75807/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $8,605
CPT 75810/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $10,392
CPT 86927/o
warn
mrf_negotiated_above_gross
highest negotiated rate $709 exceeds the gross charge $211
CPT 75840/o
warn
mrf_negotiated_above_gross
highest negotiated rate $12,007 exceeds the gross charge $6,953
CPT 75842/o
warn
mrf_negotiated_above_gross
highest negotiated rate $8,812 exceeds the gross charge $8,072
CPT 81210/o
warn
mrf_negotiated_above_gross
highest negotiated rate $833 exceeds the gross charge $599
CPT 86965/o
warn
mrf_negotiated_above_gross
highest negotiated rate $709 exceeds the gross charge $579
warn
mrf_rate_without_estimate
34,685 of 34,685 percentage/algorithm rates across 4,887 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 0141U/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 0368U/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 0574T/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 10180/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15819/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21025/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22634/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 24670/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26483/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27391/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28108/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29898/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 32442/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 33647/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 35361/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 37218/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 42330/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43880/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 46606/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49614/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 52300/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 56420/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59812/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62270/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 64732/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 67414/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 70542/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 75880/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 78351/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 81215/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 82009/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 83825/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85810/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 86971/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 87913/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 91299/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 97113/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 C7528/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0221/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1640/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J7100/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J9332/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
MS-DRG 004/i
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 321/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 638/i
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 0142U/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 0371U/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 0575U/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 11000/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15820/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21026/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22800/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 24675/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26485/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27392/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28110/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29899/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 32445/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 33660/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 35363/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 37220/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 42335/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43881/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 46607/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49615/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 52301/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 56440/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 59820/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 62272/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 64734/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 67415/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 70543/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 78399/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 81216/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 82010/o
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 83835/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 86000/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 86972/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 88000/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 92018/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 97116/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT C7529/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0222/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J1642/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7120/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J9333/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
MS-DRG 005/i
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 322/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 639/i
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 0152U/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 0372U/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 0576U/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 11001/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 15821/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21029/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22802/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 24685/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26489/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27393/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28111/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29900/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 32480/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 33665/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 35371/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 37221/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 42340/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43882/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT 46608/o
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49616/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 52305/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 56441/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
Showing the first 200 of 11,649 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 $186,155 is 10.9× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $134,477 is 15.4× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $114,649 is 16.0× the total payment
MS-DRG 086
info
inp_charge_10x_payment
average charge $206,416 is 18.2× the total payment
MS-DRG 092
info
inp_charge_10x_payment
average charge $120,458 is 13.5× the total payment
MS-DRG 149
info
inp_charge_10x_payment
average charge $86,634 is 12.9× the total payment
MS-DRG 177
info
inp_charge_10x_payment
average charge $138,942 is 10.2× the total payment
MS-DRG 194
info
inp_charge_10x_payment
average charge $152,151 is 18.3× the total payment
MS-DRG 280
info
inp_charge_10x_payment
average charge $189,629 is 13.2× the total payment
MS-DRG 287
info
inp_charge_10x_payment
average charge $184,861 is 17.1× the total payment
MS-DRG 309
info
inp_charge_10x_payment
average charge $100,642 is 14.9× the total payment
MS-DRG 312
info
inp_charge_10x_payment
average charge $92,142 is 12.0× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $426,335 is 17.1× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $329,424 is 20.5× the total payment
MS-DRG 330
info
inp_charge_10x_payment
average charge $331,917 is 16.4× the total payment
MS-DRG 372
info
inp_charge_10x_payment
average charge $120,847 is 12.8× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $106,487 is 12.1× the total payment
MS-DRG 389
info
inp_charge_10x_payment
average charge $112,266 is 15.2× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $89,887 is 12.0× the total payment
MS-DRG 394
info
inp_charge_10x_payment
average charge $102,687 is 12.2× the total payment
MS-DRG 427
info
inp_charge_10x_payment
average charge $693,502 is 11.4× the total payment
MS-DRG 454
info
inp_charge_10x_payment
average charge $539,621 is 10.1× the total payment
MS-DRG 455
info
inp_charge_10x_payment
average charge $539,491 is 11.3× the total payment
MS-DRG 460
info
inp_charge_10x_payment
average charge $466,914 is 13.3× the total payment
MS-DRG 466
info
inp_charge_10x_payment
average charge $527,877 is 14.4× the total payment
MS-DRG 467
info
inp_charge_10x_payment
average charge $384,790 is 11.8× the total payment
MS-DRG 468
info
inp_charge_10x_payment
average charge $298,918 is 11.5× the total payment
MS-DRG 469
info
inp_charge_10x_payment
average charge $338,677 is 11.6× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $241,461 is 15.2× the total payment
MS-DRG 472
info
inp_charge_10x_payment
average charge $293,671 is 11.8× the total payment
MS-DRG 481
info
inp_charge_10x_payment
average charge $278,232 is 16.1× the total payment
MS-DRG 483
info
inp_charge_10x_payment
average charge $270,808 is 13.0× the total payment
MS-DRG 516
info
inp_charge_10x_payment
average charge $213,093 is 10.4× the total payment
MS-DRG 517
info
inp_charge_10x_payment
average charge $193,944 is 14.3× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $315,074 is 12.0× the total payment
MS-DRG 552
info
inp_charge_10x_payment
average charge $123,262 is 10.6× the total payment
MS-DRG 640
info
inp_charge_10x_payment
average charge $138,570 is 12.4× the total payment
MS-DRG 641
info
inp_charge_10x_payment
average charge $103,893 is 10.1× the total payment
MS-DRG 661
info
inp_charge_10x_payment
average charge $189,667 is 19.4× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $95,639 is 11.7× the total payment
MS-DRG 689
info
inp_charge_10x_payment
average charge $132,323 is 11.1× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $106,133 is 14.5× the total payment
MS-DRG 698
info
inp_charge_10x_payment
average charge $221,905 is 13.1× the total payment
MS-DRG 811
info
inp_charge_10x_payment
average charge $149,682 is 12.1× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $480,498 is 12.4× the total payment
MS-DRG 871
info
inp_charge_10x_payment
average charge $189,750 is 11.0× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $120,868 is 13.0× 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)
- Hca Healthone Sky Ridge — standard charges file · CO · updated 2026-03-01· json · 615.2M bytes · fetched 2026-08-23 · sha256 fcb3c55fe404…
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.