Hospital · CCN 100131
Hca Florida Aventura Hospital
20900 Biscayne Blvd, Aventura, FL 33180 · Miami-Dade County
Part of HCA Healthcare · 405 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
76 admission types 48 outpatient services price file: ok 21 Medicare-file findings
Billed per dollar paid, all admissions
9.45×
$399.1M billed against $42.2M paid across 2,484 Medicare discharges; the national figure is 5.03×.
2.5%
of adults in Miami-Dade County have medical debt in collections
16.1%
uninsured in the county · state 13.9%
$72K
median household income
5.9×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (21 in the inpatient or outpatient file)ⓘ
29.5%
obesity in the countyⓘ
15.4%
diagnosed diabetes (PLACES)
6.8%
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
390
$179,934
$18,322
9.8× st 7.2×
291
Heart failure and shock with mcc
126
$115,417
$12,995
8.9× st 6.3×
193
Simple pneumonia and pleurisy with mcc
99
$129,352
$13,444
9.6× st 7.2×
177
Respiratory infections and inflammations with mcc
82
$142,523
$16,377
8.7× st 6.5×
698
Other kidney and urinary tract diagnoses with mcc
80
$150,070
$15,915
9.4× st 6.7×
682
Renal failure with mcc
66
$119,659
$14,441
8.3× st 7.0×
853
Infectious and parasitic diseases with o.r. procedures with mcc
54
$487,050
$48,180
10.1× st 7.5×
280
Acute myocardial infarction, discharged alive with mcc
51
$126,827
$15,485
8.2× st 7.3×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
49
$89,375
$12,594
7.1× st 6.7×
064
Intracranial hemorrhage or cerebral infarction with mcc
47
$207,718
$18,202
11.4× st 7.8×
689
Kidney and urinary tract infections with mcc
46
$89,234
$11,366
7.9× st 6.4×
312
Syncope and collapse
43
$70,026
$8,971
7.8× st 7.6×
552
Medical back problems without mcc
43
$92,383
$9,857
9.4× st 7.8×
872
Septicemia or severe sepsis without mv >96 hours without mcc
43
$88,061
$10,887
8.1× st 7.0×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
41
$71,345
$8,944
8.0× st 7.5×
481
Hip and femur procedures except major joint with cc
40
$213,074
$18,861
11.3× st 8.8×
690
Kidney and urinary tract infections without mcc
37
$71,082
$8,692
8.2× st 6.6×
811
Red blood cell disorders with mcc
36
$120,566
$14,125
8.5× st 7.5×
190
Chronic obstructive pulmonary disease with mcc
35
$121,870
$12,014
10.1× st 6.5×
377
Gastrointestinal hemorrhage with mcc
35
$144,205
$16,667
8.7× st 7.2×
683
Renal failure with cc
34
$76,650
$11,500
6.7× st 6.7×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
33
$64,109
$8,481
7.6× st 6.9×
194
Simple pneumonia and pleurisy with cc
32
$86,561
$8,869
9.8× st 6.9×
884
Organic disturbances and intellectual disability
31
$86,016
$16,175
5.3× st 5.5×
178
Respiratory infections and inflammations with cc
30
$108,055
$10,496
10.3× st 6.4×
305
Hypertension without mcc
29
$54,833
$8,067
6.8× st 7.5×
394
Other digestive system diagnoses with cc
29
$78,963
$9,879
8.0× st 7.3×
189
Pulmonary edema and respiratory failure
28
$105,550
$11,825
8.9× st 6.8×
378
Gastrointestinal hemorrhage with cc
27
$107,325
$9,899
10.8× st 7.4×
069
Transient ischemia without thrombolytic
26
$101,745
$8,535
11.9× st 10.3×
191
Chronic obstructive pulmonary disease with cc
26
$88,498
$8,968
9.9× st 7.1×
522
Hip replacement with principal diagnosis of hip fracture without mcc
25
$197,989
$19,780
10.0× st 8.7×
202
Bronchitis and asthma with cc/mcc
25
$82,014
$10,222
8.0× st 6.4×
308
Cardiac arrhythmia and conduction disorders with mcc
24
$97,016
$12,575
7.7× st 6.6×
393
Other digestive system diagnoses with mcc
24
$175,158
$15,915
11.0× st 6.2×
870
Septicemia or severe sepsis with mv >96 hours
24
$741,681
$60,675
12.2× st 6.6×
309
Cardiac arrhythmia and conduction disorders with cc
22
$57,483
$8,489
6.8× st 6.9×
100
Seizures with mcc
21
$145,961
$17,703
8.2× st 6.7×
101
Seizures without mcc
20
$79,062
$9,298
8.5× st 7.2×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
20
$292,348
$17,333
16.9× st 9.7×
252
Other vascular procedures with mcc
20
$320,572
$31,527
10.2× st 7.2×
812
Red blood cell disorders without mcc
19
$92,548
$10,977
8.4× st 6.3×
603
Cellulitis without mcc
19
$69,152
$10,047
6.9× st 5.9×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
19
$376,944
$28,530
13.2× st 9.0×
389
Gastrointestinal obstruction with cc
18
$85,979
$8,671
9.9× st 7.1×
208
Respiratory system diagnosis with ventilator support <=96 hours
18
$279,092
$23,844
11.7× st 7.3×
896
Alcohol, drug abuse or dependence without rehabilitation therapy with mcc
17
$93,551
$15,018
6.2× st 6.0×
299
Peripheral vascular disorders with mcc
17
$185,153
$16,211
11.4× st 6.6×
637
Diabetes with mcc
16
$107,193
$13,863
7.7× st 6.8×
897
Alcohol, drug abuse or dependence without rehabilitation therapy without mcc
16
$58,949
$9,062
6.5× st 6.4×
638
Diabetes with cc
16
$71,569
$9,488
7.5× st 6.5×
056
Degenerative nervous system disorders with mcc
16
$106,650
$19,920
5.4× st 5.7×
329
Major small and large bowel procedures with mcc
15
$381,503
$42,862
8.9× st 7.5×
699
Other kidney and urinary tract diagnoses with cc
15
$97,610
$10,050
9.7× st 6.1×
085
Traumatic stupor and coma <1 hour with mcc
14
$201,089
$20,028
10.0× st 7.8×
885
Psychoses
14
$71,238
$14,102
5.1× st 3.2×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
14
$42,100
$6,332
6.6× st 7.1×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
14
$214,630
$22,465
9.6× st 9.0×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
13
$1,282,662
$117,135
11.0× st 5.9×
004
Tracheostomy with mv >96 hours or principal diagnosis except face, mouth and neck withou
13
$923,282
$99,228
9.3× st 6.3×
281
Acute myocardial infarction, discharged alive with cc
13
$82,054
$10,788
7.6× st 8.5×
300
Peripheral vascular disorders with cc
13
$73,914
$10,957
6.7× st 6.3×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
13
$156,193
$17,693
8.8× st 9.1×
149
Dysequilibrium
12
$75,062
$8,005
9.4× st 8.8×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
12
$87,928
$9,574
9.2× st 7.1×
184
Major chest trauma with cc
12
$122,145
$10,905
11.2× st 7.8×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
12
$136,988
$10,905
12.6× st 8.8×
480
Hip and femur procedures except major joint with mcc
12
$244,062
$25,680
9.5× st 8.6×
270
Other major cardiovascular procedures with mcc
12
$442,702
$59,557
7.4× st 7.2×
304
Hypertension with mcc
11
$65,676
$11,539
5.7× st 6.3×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
11
$732,551
$55,348
13.2× st 7.1×
551
Medical back problems with mcc
11
$142,187
$13,040
10.9× st 7.4×
313
Chest pain
11
$54,114
$7,891
6.9× st 7.3×
602
Cellulitis with mcc
11
$67,339
$13,142
5.1× st 5.9×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
11
$96,796
$12,932
7.5× st 6.8×
274
Percutaneous and other intracardiac procedures without mcc
11
$222,097
$29,472
7.5× st 7.5×
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
450
$39,002
$2,466
15.8×
5191
Level 1 Endovascular Procedures
41
$68,302
$2,907
23.5×
5114
Level 4 Musculoskeletal Procedures
35
$91,790
$6,480
14.2×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
29
$23,281
$1,469
15.9×
5115
Level 5 Musculoskeletal Procedures
27
$142,900
$11,532
12.4×
5375
Level 5 Urology and Related Services
25
$64,041
$4,687
13.7×
5361
Level 1 Laparoscopy and Related Services
24
$120,645
$5,227
23.1×
5465
Level 5 Neurostimulator and Related Procedures
23
$103,017
$28,046
3.7×
5302
Level 2 Upper GI Procedures
23
$31,123
$1,724
18.1×
5373
Level 3 Urology and Related Services
23
$53,134
$1,781
29.8×
5374
Level 4 Urology and Related Services
22
$72,158
$3,158
22.9×
5112
Level 2 Musculoskeletal Procedures
20
$31,061
$1,456
21.3×
5183
Level 3 Vascular Procedures
19
$41,321
$2,887
14.3×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
18
$52,772
$2,574
20.5×
5113
Level 3 Musculoskeletal Procedures
17
$59,891
$2,932
20.4×
5223
Level 3 Pacemaker and Similar Procedures
14
$66,270
$9,666
6.9×
5193
Level 3 Endovascular Procedures
14
$178,997
$9,958
18.0×
5213
Level 3 Electrophysiologic Procedures
12
$194,120
$21,459
9.0×
5376
Level 6 Urology and Related Services
—
—
—
—
5378
Level 8 Urology and Related Services
—
—
—
—
5092
Level 2 Breast/Lymphatic Surgery and Related 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
—
—
—
—
5463
Level 3 Neurostimulator and Related Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5627
Level 7 Radiation Therapy
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5182
Level 2 Vascular Procedures
—
—
—
—
5184
Level 4 Vascular Procedures
—
—
—
—
5154
Level 4 Airway Endoscopy
—
—
—
—
5194
Level 4 Endovascular Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5222
Level 2 Pacemaker and Similar Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5116
Level 6 Musculoskeletal Procedures
—
—
—
—
5331
Complex GI Procedures
—
—
—
—
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5362
Level 2 Laparoscopy and Related Services
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
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, 350,881 rows scanned, 16,862 distinct code–setting items kept. 15,638 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
44
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 Other Outpatient
—
—
$529
32
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 Other Outpatient
—
—
$529
32
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
43
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
43
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
43
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
43
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
43
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
43
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
44
clean
Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative
—
—
$34
43
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
43
clean
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15
—
—
$122
43
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
43
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
43
clean
Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative
—
—
$541
43
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
44
clean
Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM
—
—
$17
43
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
$12,142
$12,142
$3,157
69
clean
Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG
—
—
$17
43
clean
Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM Other Outpatient
—
—
$15
43
clean
Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG
—
—
$15
43
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
43
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
43
clean
Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)
—
—
$1,575
36
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)
—
—
$1,575
28
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative
—
—
$323
43
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative
—
—
$323
43
clean
Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis
—
—
$25
43
clean
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative
—
—
$31
44
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
44
clean
Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel
—
—
$8,080
8
clean
Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype
—
—
$43
44
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
43
clean
Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)
—
—
$760
43
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
43
clean
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified
—
—
$8,392
36
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
43
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
43
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
44
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
43
clean
Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene
—
—
$356
43
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 Other Outpatient
—
—
$2,753
43
clean
Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events
—
—
$84
43
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 Other Outpatient
—
—
$1,304
43
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
43
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
43
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
43
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
44
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
43
clean
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness)
—
—
$8,392
36
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
—
—
$8,392
36
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
—
—
$8,392
36
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
—
—
$14,140
8
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
44
clean
Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral
—
—
$1,575
36
clean
Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
—
—
$1,575
36
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel
—
—
$13,140
135
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel Complex Surgery
—
—
$13,140
135
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
44
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
—
—
$142
1
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
—
—
$142
1
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 Other Outpatient
—
—
$5,000
44
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
43
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
44
clean
Implantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed)
—
—
$15,190
28
clean
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde
—
—
$11,883
28
clean
Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)
—
—
$1,575
36
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
43
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
43
clean
Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD
—
—
$391
43
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
43
clean
Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi Other Outpatient
—
—
$8
44
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
43
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
43
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
43
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
44
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
43
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, Other Outpatient
—
—
$3,500
43
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
43
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
44
clean
Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r
—
—
$8,392
36
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
43
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 Other Outpatient
—
—
$3,877
43
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
43
clean
Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,336
43
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
43
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes
—
—
$742
43
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
43
clean
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed)
—
—
$182
8
clean
Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; real-time intraoperative
—
—
—
0
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
44
clean
Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred
—
—
$2,186
8
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
43
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
43
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
43
clean
Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy
—
—
$841
43
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
43
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer
—
—
$897
43
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer
—
—
$897
43
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
44
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
43
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
43
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
43
clean
Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative
—
—
$541
44
clean
Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative
—
—
$199
43
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
44
clean
Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed
—
—
$2,194
36
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
43
clean
Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression
—
—
$323
44
clean
Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer
—
—
$760
43
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
44
clean
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator
—
—
$15,124
69
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
43
clean
Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,336
43
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
43
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
42
clean
Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative Other Outpatient
—
—
$62
43
clean
Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative
—
—
$37
43
clean
Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative
—
—
$37
43
clean
Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer
—
—
$760
43
clean
Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes
—
—
$417
43
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)
—
—
$1,575
36
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
—
—
$11,883
36
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
—
—
$11,883
36
clean
Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid
—
—
$116
42
clean
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training
—
—
$1,575
36
clean
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision
—
—
$1,575
36
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
—
—
$1,575
36
clean
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device
—
—
$11,883
36
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 Other Outpatient
—
—
$4,500
44
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
43
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
—
—
$3,848
8
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
—
—
$2,020
8
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed
—
—
$8,080
8
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)
—
—
$8,080
8
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
42
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
—
—
$8,080
8
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
—
—
$8,080
8
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
—
—
$18,180
8
clean
Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound
—
—
$2,020
8
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)
—
—
$2,020
8
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
—
—
$2,020
8
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
—
—
$18,180
8
clean
Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report
—
—
—
0
clean
Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide
—
—
$125
8
clean
Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure)
—
—
—
0
clean
Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral
—
—
$2,020
8
clean
Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis Cardiac Cath
—
—
$9,333
41
clean
Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure)
—
—
$9,333
41
clean
Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation thre
—
—
$78,780
8
clean
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral
—
—
$7,197
8
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
8
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous
—
—
$14,140
8
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, including fluoroscopic and ultrasound guidance, when performed, open
—
—
$14,140
8
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
8
clean
Remote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency-derived pulmonary fluid levels, heart rate, respiration rate, activity, posture,
—
—
—
0
clean
Remote monitoring of an external continuous pulmonary fluid monitoring system, including measurement of radiofrequency-derived pulmonary fluid levels, heart rate, respiration rate, activity, posture,
—
—
—
0
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
—
—
$18,180
8
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and
—
—
—
0
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and
—
—
—
0
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; computerized analysi
—
—
—
0
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; review of computeriz
—
—
—
0
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level
—
—
$14,140
8
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
—
—
$2,020
8
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level
—
—
$14,140
8
clean
Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s)
—
—
$828
6
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
—
—
—
0
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
—
—
$11,438
41
clean
Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ve Cardiac Cath and In
—
—
$9,333
41
clean
Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report
—
—
$5,344
8
clean
Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep
—
—
$518
10
clean
Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep
—
—
$1,737
2
clean
Programming device evaluation (remote) of subcutaneous cardiac rhythm monitor system, with iterative adjustment of the implantable device to test the function of the device and select optimal permanen
—
—
—
0
clean
Esophagogastroduodenoscopy, flexible, transnasal; with insertion of intraluminal tube or catheter
—
—
$5,344
8
clean
Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging
—
—
$7,197
8
clean
Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score
—
—
$125
8
clean
Implantation of anterior segment intraocular nonbiodegradable drug-eluting system, internal approach
—
—
$12,120
8
clean
Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more
—
—
$7,197
8
clean
Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance
—
—
$5,344
8
clean
Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance
—
—
$28,126
1
clean
Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue,
—
—
—
0
clean
Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance a
—
—
$10,100
8
clean
Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) exam
—
—
—
0
clean
Digitization of glass microscope slides for level II, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure)
—
—
—
0
clean
Digitization of glass microscope slides for level III, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure)
—
—
—
0
clean
Digitization of glass microscope slides for level IV, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure)
—
—
—
0
clean
Digitization of glass microscope slides for level V, surgical pathology, gross and microscopic examination (List separately in addition to code for primary procedure)
—
—
—
0
clean
Digitization of glass microscope slides for special stain, including interpretation and report, group I, for microorganisms (eg, acid fast, methenamine silver) (List separately in addition to code for
—
—
—
0
clean
Digitization of glass microscope slides for special stain, including interpretation and report, group II, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituen
—
—
—
0
clean
Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (List separately in addition to code for primary procedur
—
—
—
0
clean
Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (List separately in addition to code for primary
—
—
—
0
clean
Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (List separately in addition to code for primary procedur
—
—
—
0
clean
Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen,
—
—
—
0
clean
Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract
—
—
$2,020
8
clean
Showing the first 200 of 16,862 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
1,379 of 1,382 comparable items (100%) 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 $14,570 exceeds the gross charge $12,142
warn
mrf_rate_without_estimate
54,707 of 54,707 percentage/algorithm rates across 11,083 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 0005U/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 0257U/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 0452U/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 11755/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15944/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21087/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22838/o
info
mrf_item_fields_vary
this code and setting cover at least 7 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 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26477/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27357/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28055/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29868/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 31730/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 33410/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 34705/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 36148/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 37286/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 42340/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43773/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 45805/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49322/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 51060/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 54380/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 58300/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 61550/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 63196/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 64865/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 67911/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 74181/o
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
CPT 76881/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 78635/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 81180/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 81514/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 85651/o
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
CPT 86727/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 90970/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 93298/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 95056/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 A4614/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 A7503/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 C8937/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 E0855/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 E2397/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0630/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J1815/o
info
mrf_item_fields_vary
this code and setting cover at least 13 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J3473/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J9228/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 L0710/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 L3550/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 L5925/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 L8658/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 Q4222/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 021/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 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 619/i
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 969/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 0006M/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 0258U/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 0453U/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 11760/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15945/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21088/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22840/o
info
mrf_item_fields_vary
this code and setting cover at least 7 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 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26478/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27358/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28060/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29870/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 31750/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 33411/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 34706/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 36160/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 37287/o
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
CPT 42400/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43774/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 45820/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49323/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 51065/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 54385/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 58301/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 61552/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 63197/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 64866/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 67912/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 70545/o
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
CPT 76882/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 81181/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 81515/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 82787/o
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
CPT 84210/o
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
CPT 85652/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 86732/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 87389/o
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
CPT 88304/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 93303/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 95060/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 97760/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT A4615/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 A7504/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 E0856/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 E2398/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J3475/o
info
mrf_item_fields_vary
this code and setting cover at least 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 J9229/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 L0720/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 L3560/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 L5926/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 L8659/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 Q4225/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 022/i
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 323/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 620/i
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 970/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 0007M/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 0259U/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 0454U/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 11762/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15946/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21089/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22841/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 24685/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26479/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27360/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28062/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29871/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 31755/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 33412/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 34707/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 36200/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 37288/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 42405/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43775/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 45825/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49324/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 51080/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 54390/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 58321/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 61556/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 63198/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 64868/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 67914/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 74182/o
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
CPT 76883/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 78645/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 81182/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 81517/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 82800/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 87390/o
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 91010/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 93304/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 95065/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 A4616/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item
CPT A7505/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 E0860/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 E2402/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J0636/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT J1817/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 J3480/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 L0810/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 L3570/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 L5930/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 L8670/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 Q4227/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 023/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 324/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 621/i
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
MS-DRG 974/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 0007U/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 0260U/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 0455U/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 11765/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 15950/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 21100/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 22842/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 24800/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 26480/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 27364/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28070/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29873/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 31760/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 33413/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 34708/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 36215/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 37289/o
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
CPT 42408/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 43800/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 45900/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 49325/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 51100/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 54400/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 58322/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 61557/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 63199/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 64870/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 67915/o
info
mrf_item_fields_vary
this code and setting cover at least 7 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 70546/o
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
CPT 76885/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 78650/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 81183/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 15,638 findings, errors first — every finding as JSON →
04 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 003
info
inp_charge_10x_payment
average charge $1,282,662 is 10.9× the total payment
MS-DRG 023
info
inp_charge_10x_payment
average charge $732,551 is 13.2× the total payment
MS-DRG 064
info
inp_charge_10x_payment
average charge $207,718 is 11.4× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $136,988 is 12.6× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $101,745 is 11.9× the total payment
MS-DRG 085
info
inp_charge_10x_payment
average charge $201,089 is 10.0× the total payment
MS-DRG 178
info
inp_charge_10x_payment
average charge $108,055 is 10.3× the total payment
MS-DRG 184
info
inp_charge_10x_payment
average charge $122,145 is 11.2× the total payment
MS-DRG 190
info
inp_charge_10x_payment
average charge $121,870 is 10.1× the total payment
MS-DRG 208
info
inp_charge_10x_payment
average charge $279,092 is 11.7× the total payment
MS-DRG 252
info
inp_charge_10x_payment
average charge $320,572 is 10.2× the total payment
MS-DRG 299
info
inp_charge_10x_payment
average charge $185,153 is 11.4× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $376,944 is 13.2× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $292,348 is 16.9× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $107,325 is 10.8× the total payment
MS-DRG 393
info
inp_charge_10x_payment
average charge $175,158 is 11.0× the total payment
MS-DRG 481
info
inp_charge_10x_payment
average charge $213,074 is 11.3× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $197,989 is 10.0× the total payment
MS-DRG 551
info
inp_charge_10x_payment
average charge $142,187 is 10.9× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $487,050 is 10.1× the total payment
MS-DRG 870
info
inp_charge_10x_payment
average charge $741,681 is 12.2× 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 Florida Aventura Hospital — standard charges file · FL · updated 2026-03-01· json · 520.6M bytes · fetched 2026-08-23 · sha256 83a59ed14c9b…
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.