Hospital · CCN 100166
Hca Florida Sarasota Doctors Hospital
5731 Bee Ridge Rd, Sarasota, FL 34233 · Sarasota County
Part of HCA Healthcare · 139 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
62 admission types 48 outpatient services price file: ok 47 Medicare-file findings
Billed per dollar paid, all admissions
10.87×
$224.9M billed against $20.7M paid across 1,829 Medicare discharges; the national figure is 5.03×.
1.9%
of adults in Sarasota County have medical debt in collections
13.5%
uninsured in the county · state 13.9%
$78K
median household income
6.9×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (4 in the inpatient or outpatient file)ⓘ
29.2%
obesity in the countyⓘ
13.0%
diagnosed diabetes (PLACES)
9.4%
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
208
$120,786
$13,261
9.1× st 7.2×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
141
$185,895
$13,379
13.9× st 9.1×
291
Heart failure and shock with mcc
87
$88,981
$8,882
10.0× st 6.3×
193
Simple pneumonia and pleurisy with mcc
55
$94,984
$8,932
10.6× st 7.2×
690
Kidney and urinary tract infections without mcc
52
$66,303
$5,960
11.1× st 6.6×
177
Respiratory infections and inflammations with mcc
52
$121,644
$12,070
10.1× st 6.5×
378
Gastrointestinal hemorrhage with cc
52
$80,202
$7,496
10.7× st 7.4×
280
Acute myocardial infarction, discharged alive with mcc
48
$100,951
$11,038
9.1× st 7.3×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
47
$69,926
$5,301
13.2× st 7.5×
683
Renal failure with cc
44
$68,912
$6,322
10.9× st 6.7×
483
Major joint or limb reattachment procedures of upper extremities
40
$197,617
$18,777
10.5× st 9.4×
872
Septicemia or severe sepsis without mv >96 hours without mcc
35
$79,577
$6,963
11.4× st 7.0×
682
Renal failure with mcc
34
$99,863
$9,981
10.0× st 7.0×
689
Kidney and urinary tract infections with mcc
34
$81,385
$7,907
10.3× st 6.4×
698
Other kidney and urinary tract diagnoses with mcc
31
$127,820
$10,858
11.8× st 6.7×
189
Pulmonary edema and respiratory failure
30
$79,930
$8,796
9.1× st 6.8×
329
Major small and large bowel procedures with mcc
30
$364,307
$34,295
10.6× st 7.5×
467
Revision of hip or knee replacement with cc
29
$254,739
$22,918
11.1× st 7.7×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
29
$111,789
$7,179
15.6× st 8.8×
853
Infectious and parasitic diseases with o.r. procedures with mcc
29
$297,192
$30,365
9.8× st 7.5×
377
Gastrointestinal hemorrhage with mcc
28
$139,937
$12,189
11.5× st 7.2×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
28
$67,093
$5,448
12.3× st 6.9×
305
Hypertension without mcc
27
$57,057
$5,379
10.6× st 7.5×
660
Kidney and ureter procedures for non-neoplasm with cc
27
$147,717
$10,275
14.4× st 8.1×
069
Transient ischemia without thrombolytic
25
$90,149
$5,388
16.7× st 10.3×
312
Syncope and collapse
24
$76,225
$6,352
12.0× st 7.6×
811
Red blood cell disorders with mcc
24
$108,227
$9,584
11.3× st 7.5×
309
Cardiac arrhythmia and conduction disorders with cc
23
$57,767
$5,089
11.4× st 6.9×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
23
$71,633
$9,128
7.8× st 6.7×
281
Acute myocardial infarction, discharged alive with cc
22
$79,358
$6,318
12.6× st 8.5×
552
Medical back problems without mcc
22
$82,762
$6,835
12.1× st 7.8×
389
Gastrointestinal obstruction with cc
20
$81,753
$5,360
15.3× st 7.1×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
20
$46,496
$3,735
12.5× st 7.1×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
19
$70,374
$6,148
11.4× st 7.1×
468
Revision of hip or knee replacement without cc/mcc
19
$192,682
$19,363
10.0× st 7.2×
603
Cellulitis without mcc
18
$61,072
$6,257
9.8× st 5.9×
481
Hip and femur procedures except major joint with cc
17
$161,446
$13,876
11.6× st 8.8×
394
Other digestive system diagnoses with cc
16
$90,180
$5,942
15.2× st 7.3×
036
Carotid artery stent procedures without cc/mcc
16
$122,282
$12,635
9.7× st 8.8×
208
Respiratory system diagnosis with ventilator support <=96 hours
16
$129,533
$17,648
7.3× st 7.3×
445
Disorders of the biliary tract with cc
16
$94,819
$7,517
12.6× st 7.9×
699
Other kidney and urinary tract diagnoses with cc
15
$76,630
$7,267
10.5× st 6.1×
308
Cardiac arrhythmia and conduction disorders with mcc
15
$69,636
$8,072
8.6× st 6.6×
269
Aortic and heart assist procedures except pulsation balloon without mcc
15
$282,741
$33,174
8.5× st 6.3×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
15
$113,029
$8,636
13.1× st 6.8×
330
Major small and large bowel procedures with cc
14
$211,493
$20,170
10.5× st 8.5×
064
Intracranial hemorrhage or cerebral infarction with mcc
14
$111,846
$12,021
9.3× st 7.8×
536
Fractures of hip and pelvis without mcc
14
$68,451
$5,541
12.4× st 7.4×
854
Infectious and parasitic diseases with o.r. procedures with cc
14
$200,067
$17,970
11.1× st 8.6×
444
Disorders of the biliary tract with mcc
14
$135,080
$11,602
11.6× st 7.0×
057
Degenerative nervous system disorders without mcc
13
$75,792
$7,950
9.5× st 6.1×
100
Seizures with mcc
13
$94,066
$13,371
7.0× st 6.7×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
13
$231,648
$20,092
11.5× st 9.0×
522
Hip replacement with principal diagnosis of hip fracture without mcc
13
$203,127
$14,255
14.3× st 8.7×
432
Cirrhosis and alcoholic hepatitis with mcc
13
$116,644
$12,136
9.6× st 6.9×
418
Laparoscopic cholecystectomy without c.d.e. with cc
11
$226,118
$11,625
19.5× st 9.6×
435
Malignancy of hepatobiliary system or pancreas with mcc
11
$132,780
$12,538
10.6× st 6.9×
460
Spinal fusion except cervical without mcc
11
$241,684
$23,229
10.4× st 7.8×
812
Red blood cell disorders without mcc
11
$68,288
$6,429
10.6× st 6.3×
480
Hip and femur procedures except major joint with mcc
11
$203,542
$20,130
10.1× st 8.6×
282
Acute myocardial infarction, discharged alive without cc/mcc
11
$93,480
$8,936
10.5× st 9.0×
194
Simple pneumonia and pleurisy with cc
11
$73,983
$5,410
13.7× st 6.9×
02 · Outpatient
Outpatient services
Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.
APC
Service
Services
Charge
Allowed
Billed ÷ allowed
5115
Level 5 Musculoskeletal Procedures
581
$159,015
$11,906
13.4×
5302
Level 2 Upper GI Procedures
248
$27,537
$1,709
16.1×
5361
Level 1 Laparoscopy and Related Services
184
$113,067
$5,227
21.6×
5375
Level 5 Urology and Related Services
144
$96,606
$4,635
20.8×
5116
Level 6 Musculoskeletal Procedures
142
$170,190
$16,845
10.1×
5191
Level 1 Endovascular Procedures
113
$72,157
$2,920
24.7×
5114
Level 4 Musculoskeletal Procedures
78
$112,043
$6,480
17.3×
8011
Comprehensive Observation Services
60
$47,573
$2,479
19.2×
5193
Level 3 Endovascular Procedures
60
$170,984
$9,957
17.2×
5362
Level 2 Laparoscopy and Related Services
52
$160,678
$9,319
17.2×
5153
Level 3 Airway Endoscopy
49
$24,450
$1,537
15.9×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
49
$96,159
$3,134
30.7×
5374
Level 4 Urology and Related Services
45
$66,685
$3,158
21.1×
5303
Level 3 Upper GI Procedures
44
$54,109
$3,469
15.6×
5183
Level 3 Vascular Procedures
39
$57,427
$2,769
20.7×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
36
$32,612
$1,469
22.2×
5373
Level 3 Urology and Related Services
31
$68,572
$1,798
38.1×
5194
Level 4 Endovascular Procedures
29
$274,619
$15,852
17.3×
5184
Level 4 Vascular Procedures
27
$101,542
$4,978
20.4×
5313
Level 3 Lower GI Procedures
27
$33,940
$2,543
13.3×
5331
Complex GI Procedures
26
$63,713
$5,162
12.3×
5154
Level 4 Airway Endoscopy
24
$41,163
$3,392
12.1×
5414
Level 4 Gynecologic Procedures
24
$65,854
$2,832
23.3×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
20
$52,410
$2,497
21.0×
5222
Level 2 Pacemaker and Similar Procedures
20
$59,375
$7,696
7.7×
5112
Level 2 Musculoskeletal Procedures
18
$32,361
$1,391
23.3×
5113
Level 3 Musculoskeletal Procedures
18
$78,525
$2,932
26.8×
5182
Level 2 Vascular Procedures
13
$15,941
$1,362
11.7×
5465
Level 5 Neurostimulator and Related Procedures
11
$161,647
$28,046
5.8×
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5377
Level 7 Urology and Related Services
—
—
—
—
5376
Level 6 Urology and Related Services
—
—
—
—
5165
Level 5 ENT Procedures
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5223
Level 3 Pacemaker and Similar Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5192
Level 2 Endovascular Procedures
—
—
—
—
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5431
Level 1 Nerve 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, 280,288 rows scanned, 16,814 distinct code–setting items kept. 14,422 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
37
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
—
—
$529
24
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
24
clean
Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score
—
—
$775
35
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
—
—
$775
35
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
—
—
$775
35
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
—
—
$1,331
35
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
—
—
$3,559
35
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
—
—
$3,062
35
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
37
clean
Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative
—
—
$35
35
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
—
—
$3,672
35
clean
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15
—
—
$124
35
clean
Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823)
—
—
$757
35
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)
—
—
$475
35
clean
Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative
—
—
$552
35
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
37
clean
Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM
—
—
$18
35
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
$3,640
$3,640
$928
33
clean
Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG
—
—
$18
35
clean
Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM
—
—
$15
35
clean
Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG
—
—
$15
35
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
—
—
$3,950
35
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
—
—
$3,950
35
clean
Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)
—
—
$2,564
28
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)
—
—
$2,564
28
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative
—
—
$329
35
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative
—
—
$329
35
clean
Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis
—
—
$26
35
clean
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative
—
—
$31
37
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
37
clean
Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel
—
—
$7,564
8
clean
Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype
—
—
$43
37
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
—
—
$3,590
35
clean
Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)
—
—
$775
35
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
—
—
$1,989
35
clean
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified
—
—
$8,417
28
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 Other Outpatient
—
—
$1,779
35
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
—
—
$969
35
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
37
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-
—
—
$5,049
35
clean
Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene
—
—
$363
35
clean
Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donoe-derived cell-free DNA in the total cell-f
—
—
$2,808
35
clean
Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events Other Outpatient
—
—
$85
35
clean
Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and eletion/duplication analysis panel (A
—
—
$1,330
35
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
—
—
$2,169
35
clean
Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results
—
—
$114
35
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
—
—
$513
35
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
37
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
—
—
$1,331
35
clean
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness)
—
—
$8,417
28
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
—
—
$8,417
28
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
—
—
$8,417
28
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
—
—
$11,800
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
37
clean
Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral
—
—
$2,564
28
clean
Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed
—
—
$2,564
28
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel
—
—
$14,540
94
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel
—
—
$14,540
94
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
37
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
—
—
$131
2
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
—
—
$131
2
clean
Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearra
—
—
$5,000
37
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
—
—
$1,291
35
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
37
clean
Implantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed)
—
—
$16,461
20
clean
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde
—
—
$13,135
20
clean
Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)
—
—
$2,564
28
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
—
—
$3,950
35
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
—
—
$5,544
35
clean
Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD
—
—
$399
35
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
—
—
$399
35
clean
Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi
—
—
$8
37
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
—
—
$857
35
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
—
—
$8,670
35
clean
Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection
—
—
$2,703
35
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
37
clean
Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutation
—
—
$3,507
35
clean
Oncology (solid organ), target geonomic sequence analysis, FFPE tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements,
—
—
$3,570
35
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
—
—
$2,484
35
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
37
clean
Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r
—
—
$8,417
28
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
—
—
$775
35
clean
Oncology (pan-cancer), analysis of MRD from plasma, with assays personalized to each patient based on prior next generation sequencing of the patient's tumor and germline DNA, reported as absence or p
—
—
$3,877
35
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
—
—
$808
35
clean
Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,363
35
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes
—
—
$1,363
35
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes
—
—
$757
35
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
—
—
$757
35
clean
Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed) Other Diagnostic Radiology FS
—
—
$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
37
clean
Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred Other Diagnostic Radiology FS
—
—
$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
—
—
$1,836
35
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 Other Outpatient
—
—
$266
35
clean
Oncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer
—
—
$775
35
clean
Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy
—
—
$857
35
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
—
—
$775
35
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer
—
—
$915
35
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer Other Outpatient
—
—
$915
35
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
37
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
—
—
$720
35
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
—
—
$3,354
35
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
—
—
$3,570
35
clean
Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative
—
—
$541
37
clean
Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative
—
—
$203
35
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
37
clean
Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed
—
—
$3,448
28
clean
Oncology (Prostate), mRNA, gene expression peofiling of 18 genes, first-catch, algorithm reported as percentage of likelihood of detecting clinical significant prostate cancer
—
—
$775
35
clean
Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression Other Outpatient
—
—
$323
37
clean
Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer
—
—
$775
35
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
37
clean
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator
—
—
$18,432
31
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
—
—
$2,978
35
clean
Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,363
35
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
—
—
$399
35
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
—
—
$1,982
35
clean
Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative
—
—
$63
35
clean
Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative
—
—
$37
35
clean
Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative
—
—
$37
35
clean
Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer
—
—
$775
35
clean
Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes
—
—
$425
35
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)
—
—
$2,564
28
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
—
—
$11,918
28
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
—
—
$11,918
28
clean
Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid Other Outpatient
—
—
$119
35
clean
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training
—
—
$2,564
28
clean
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision
—
—
$2,564
28
clean
Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation
—
—
$2,564
28
clean
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device
—
—
$11,918
28
clean
Oncology (solid tumor),nextgeneration sequencing (NGS) of DNA from formalin-fixed paraffinembedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen (blood or saliva), 68
—
—
$4,500
37
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
—
—
$1,330
35
clean
Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children
—
—
$2,671
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
—
—
$2,564
8
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed
—
—
$7,564
8
clean
Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)
—
—
$7,564
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
—
—
$3,722
35
clean
Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservatio
—
—
$7,564
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
—
—
$7,564
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
—
—
$15,088
8
clean
Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound
—
—
$2,564
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)
—
—
$2,564
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
—
—
$2,564
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
—
—
$15,088
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 Other Diagnostic Radiology FS
—
—
$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
—
—
$2,564
8
clean
Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis
—
—
$7,564
11
clean
Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure)
—
—
$7,564
11
clean
Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation thre
—
—
$41,326
8
clean
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral
—
—
$5,675
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) Other Diagnostic Ra
—
—
$595
8
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous
—
—
$11,800
8
clean
Ablation, irreversible electroporation; 1 or more tumors per organ, including fluoroscopic and ultrasound guidance, when performed, open
—
—
$11,800
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 Other Diagnostic Ra
—
—
$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
—
—
$15,088
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
—
—
$11,800
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
—
—
$2,564
8
clean
Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level
—
—
$11,800
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
—
—
$11,800
11
clean
Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ve
—
—
$7,564
11
clean
Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report
—
—
$3,611
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 Other Diagnostic Ra
—
—
$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
—
—
$1,826
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
—
—
$3,611
8
clean
Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging
—
—
$5,675
8
clean
Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score Other Diagnostic Radiology FS
—
—
$125
8
clean
Implantation of anterior segment intraocular nonbiodegradable drug-eluting system, internal approach
—
—
$10,309
8
clean
Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more
—
—
$5,675
8
clean
Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance
—
—
$3,611
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
—
—
$7,558
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
—
—
$2,564
8
clean
Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (List separately in addition to code for primary procedure)
—
—
—
0
clean
Showing the first 200 of 16,814 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
337 of 1,429 comparable items (24%) 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 $8,253 exceeds the gross charge $390
warn
mrf_rate_without_estimate
25,041 of 25,041 percentage/algorithm rates across 5,286 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 30930/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 32650/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 33688/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 35261/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 36561/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 38531/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 43200/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 44238/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 46948/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 49654/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 52290/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 55812/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 59050/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 61860/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 64461/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 65865/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 69424/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 73562/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 77062/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 80184/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 81318/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 82441/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 84100/o
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85660/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 86808/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 87557/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 90622/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 92627/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 94453/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 98971/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 A5054/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 A9538/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 E0442/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 E1806/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 J0185/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 J1720/o
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7198/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 K0037/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 L1990/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 L5105/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 L6689/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 Q4012/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 V2218/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 243/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 543/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 869/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 0009U/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 0281U/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 0546U/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 14041/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 19283/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 21338/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 23331/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 25335/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 26756/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 27514/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 28308/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 30999/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 32651/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 33690/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 35266/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 36563/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 38542/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 43201/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 44239/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 46999/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 49655/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 52300/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 55815/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 59051/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 61862/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 64462/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 65870/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 69433/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 73564/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 77063/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 80185/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 81319/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 82465/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 84105/o
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85670/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 86812/o
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 87560/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 90623/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 92630/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 94610/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 98972/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 A5055/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 A9539/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 E0443/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 E1807/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 J0202/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 J1740/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 J7200/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 K0038/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 L2000/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 L5150/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 L6690/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 Q4013/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 V2219/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 244/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 544/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 870/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 0010U/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 0282U/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 0547U/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 14060/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 19284/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 21339/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 23332/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 25337/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 26765/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 27516/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 28309/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 31000/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 32652/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 33692/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 35271/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 36565/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 38550/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 43202/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 44300/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 47000/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 49656/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 52301/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 55821/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 59070/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 61863/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 64463/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 65875/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 69436/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 73565/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 77065/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 80186/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 81320/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 85675/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 86813/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 87561/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 90632/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 92633/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 94617/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 98975/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 A9540/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 E0444/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 E1808/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 J0206/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 J1741/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 J7201/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 K0039/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 L2005/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 L5160/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 L6691/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 Q4014/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 V2220/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 245/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 545/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 871/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 0011M/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 0283U/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 0548U/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 14061/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 19285/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 21340/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 23333/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 25350/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 26770/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 27517/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 28310/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 31002/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 32653/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 33694/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 35276/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 36566/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 38555/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 43204/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 44310/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 47001/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 49657/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 52305/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 55831/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 59072/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 61864/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 64466/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 65880/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 69440/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 73580/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 77066/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 80187/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 81321/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 82480/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 84106/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 85705/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 86816/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 87562/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 90633/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 92640/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 98976/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 A5056/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 14,422 findings, errors first — every finding as JSON →
04 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 065
info
inp_charge_10x_payment
average charge $111,789 is 15.6× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $90,149 is 16.7× the total payment
MS-DRG 177
info
inp_charge_10x_payment
average charge $121,644 is 10.1× the total payment
MS-DRG 193
info
inp_charge_10x_payment
average charge $94,984 is 10.6× the total payment
MS-DRG 194
info
inp_charge_10x_payment
average charge $73,983 is 13.7× the total payment
MS-DRG 281
info
inp_charge_10x_payment
average charge $79,358 is 12.6× the total payment
MS-DRG 282
info
inp_charge_10x_payment
average charge $93,480 is 10.5× the total payment
MS-DRG 291
info
inp_charge_10x_payment
average charge $88,981 is 10.0× the total payment
MS-DRG 305
info
inp_charge_10x_payment
average charge $57,057 is 10.6× the total payment
MS-DRG 309
info
inp_charge_10x_payment
average charge $57,767 is 11.4× the total payment
MS-DRG 310
info
inp_charge_10x_payment
average charge $46,496 is 12.4× the total payment
MS-DRG 312
info
inp_charge_10x_payment
average charge $76,225 is 12.0× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $231,648 is 11.5× the total payment
MS-DRG 329
info
inp_charge_10x_payment
average charge $364,307 is 10.6× the total payment
MS-DRG 330
info
inp_charge_10x_payment
average charge $211,493 is 10.5× the total payment
MS-DRG 377
info
inp_charge_10x_payment
average charge $139,937 is 11.5× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $80,202 is 10.7× the total payment
MS-DRG 389
info
inp_charge_10x_payment
average charge $81,753 is 15.3× the total payment
MS-DRG 391
info
inp_charge_10x_payment
average charge $113,029 is 13.1× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $69,926 is 13.2× the total payment
MS-DRG 394
info
inp_charge_10x_payment
average charge $90,180 is 15.2× the total payment
MS-DRG 418
info
inp_charge_10x_payment
average charge $226,118 is 19.5× the total payment
MS-DRG 435
info
inp_charge_10x_payment
average charge $132,780 is 10.6× the total payment
MS-DRG 444
info
inp_charge_10x_payment
average charge $135,080 is 11.6× the total payment
MS-DRG 445
info
inp_charge_10x_payment
average charge $94,819 is 12.6× the total payment
MS-DRG 460
info
inp_charge_10x_payment
average charge $241,684 is 10.4× the total payment
MS-DRG 467
info
inp_charge_10x_payment
average charge $254,739 is 11.1× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $185,895 is 13.9× the total payment
MS-DRG 480
info
inp_charge_10x_payment
average charge $203,542 is 10.1× the total payment
MS-DRG 481
info
inp_charge_10x_payment
average charge $161,446 is 11.6× the total payment
MS-DRG 483
info
inp_charge_10x_payment
average charge $197,617 is 10.5× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $203,127 is 14.2× the total payment
MS-DRG 536
info
inp_charge_10x_payment
average charge $68,451 is 12.4× the total payment
MS-DRG 552
info
inp_charge_10x_payment
average charge $82,762 is 12.1× the total payment
MS-DRG 563
info
inp_charge_10x_payment
average charge $70,374 is 11.4× the total payment
MS-DRG 641
info
inp_charge_10x_payment
average charge $67,093 is 12.3× the total payment
MS-DRG 660
info
inp_charge_10x_payment
average charge $147,717 is 14.4× the total payment
MS-DRG 682
info
inp_charge_10x_payment
average charge $99,863 is 10.0× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $68,912 is 10.9× the total payment
MS-DRG 689
info
inp_charge_10x_payment
average charge $81,385 is 10.3× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $66,303 is 11.1× the total payment
MS-DRG 698
info
inp_charge_10x_payment
average charge $127,820 is 11.8× the total payment
MS-DRG 699
info
inp_charge_10x_payment
average charge $76,630 is 10.5× the total payment
MS-DRG 811
info
inp_charge_10x_payment
average charge $108,227 is 11.3× the total payment
MS-DRG 812
info
inp_charge_10x_payment
average charge $68,288 is 10.6× the total payment
MS-DRG 854
info
inp_charge_10x_payment
average charge $200,067 is 11.1× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $79,577 is 11.4× 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 Sarasota Doctors Hospital — standard charges file · FL · updated 2026-03-01· json · 435.9M bytes · fetched 2026-08-23 · sha256 1dae5a46b92d…
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.