Hospital · CCN 100256
Hca Florida Bayonet Point Hospital
14000 Fivay Rd, Hudson, FL 34667 · Pasco County
Part of HCA Healthcare · 290 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
87 admission types 46 outpatient services price file: ok 59 Medicare-file findings
Billed per dollar paid, all admissions
10.96×
$441.2M billed against $40.3M paid across 2,551 Medicare discharges; the national figure is 5.03×.
3.8%
of adults in Pasco County have medical debt in collections
12.3%
uninsured in the county · state 13.9%
$72K
median household income
8.8×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (7 in the inpatient or outpatient file)ⓘ
31.8%
obesity in the countyⓘ
12.8%
diagnosed diabetes (PLACES)
7.7%
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
272
$173,112
$17,180
10.1× st 7.2×
291
Heart failure and shock with mcc
86
$107,846
$11,881
9.1× st 6.3×
274
Percutaneous and other intracardiac procedures without mcc
78
$206,788
$27,423
7.5× st 7.5×
064
Intracranial hemorrhage or cerebral infarction with mcc
64
$220,763
$16,350
13.5× st 7.8×
193
Simple pneumonia and pleurisy with mcc
63
$123,607
$11,945
10.3× st 7.2×
552
Medical back problems without mcc
59
$111,386
$9,153
12.2× st 7.8×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
56
$103,668
$7,912
13.1× st 7.5×
481
Hip and femur procedures except major joint with cc
56
$269,658
$18,185
14.8× st 8.8×
312
Syncope and collapse
56
$111,675
$8,428
13.3× st 7.6×
690
Kidney and urinary tract infections without mcc
50
$87,391
$7,415
11.8× st 6.6×
378
Gastrointestinal hemorrhage with cc
50
$98,184
$9,328
10.5× st 7.4×
280
Acute myocardial infarction, discharged alive with mcc
49
$158,566
$13,898
11.4× st 7.3×
309
Cardiac arrhythmia and conduction disorders with cc
42
$73,980
$7,199
10.3× st 6.9×
189
Pulmonary edema and respiratory failure
42
$107,926
$10,949
9.9× st 6.8×
177
Respiratory infections and inflammations with mcc
41
$163,563
$15,286
10.7× st 6.5×
698
Other kidney and urinary tract diagnoses with mcc
41
$131,592
$14,160
9.3× st 6.7×
683
Renal failure with cc
40
$96,498
$8,921
10.8× st 6.7×
682
Renal failure with mcc
40
$113,846
$12,963
8.8× st 7.0×
689
Kidney and urinary tract infections with mcc
39
$103,376
$9,728
10.6× st 6.4×
853
Infectious and parasitic diseases with o.r. procedures with mcc
37
$510,832
$41,039
12.4× st 7.5×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
37
$150,859
$9,549
15.8× st 8.8×
377
Gastrointestinal hemorrhage with mcc
37
$143,250
$15,438
9.3× st 7.2×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
36
$343,048
$40,761
8.4× st 7.2×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
33
$281,133
$17,374
16.2× st 9.7×
394
Other digestive system diagnoses with cc
32
$111,656
$9,390
11.9× st 7.3×
872
Septicemia or severe sepsis without mv >96 hours without mcc
32
$95,133
$9,147
10.4× st 7.0×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
31
$56,252
$6,569
8.6× st 7.1×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
30
$170,510
$10,556
16.2× st 8.9×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
30
$98,722
$11,625
8.5× st 6.7×
069
Transient ischemia without thrombolytic
29
$142,799
$7,718
18.5× st 10.3×
086
Traumatic stupor and coma <1 hour with cc
28
$141,986
$12,115
11.7× st 8.3×
281
Acute myocardial infarction, discharged alive with cc
26
$132,097
$8,996
14.7× st 8.5×
305
Hypertension without mcc
26
$80,007
$7,293
11.0× st 7.5×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
26
$428,431
$54,373
7.9× st 6.5×
313
Chest pain
25
$63,543
$7,229
8.8× st 7.3×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
24
$74,261
$7,273
10.2× st 6.9×
460
Spinal fusion except cervical without mcc
24
$223,481
$31,472
7.1× st 7.8×
389
Gastrointestinal obstruction with cc
24
$109,495
$7,827
14.0× st 7.1×
811
Red blood cell disorders with mcc
24
$125,389
$12,902
9.7× st 7.5×
884
Organic disturbances and intellectual disability
23
$80,010
$14,317
5.6× st 5.5×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
23
$191,472
$19,715
9.7× st 7.0×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
23
$191,732
$16,609
11.5× st 9.1×
480
Hip and femur procedures except major joint with mcc
23
$404,217
$24,162
16.7× st 8.6×
522
Hip replacement with principal diagnosis of hip fracture without mcc
22
$261,997
$18,838
13.9× st 8.7×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
22
$129,455
$8,561
15.1× st 7.1×
699
Other kidney and urinary tract diagnoses with cc
20
$81,556
$9,093
9.0× st 6.1×
603
Cellulitis without mcc
20
$84,569
$10,290
8.2× st 5.9×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
19
$344,986
$25,160
13.7× st 9.0×
812
Red blood cell disorders without mcc
19
$96,858
$9,189
10.5× st 6.3×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
18
$142,777
$11,975
11.9× st 6.8×
243
Permanent cardiac pacemaker implant with cc
17
$267,568
$18,232
14.7× st 8.0×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
17
$499,583
$44,673
11.2× st 7.1×
025
Craniotomy and endovascular intracranial procedures with mcc
17
$471,765
$36,724
12.8× st 7.4×
083
Traumatic stupor and coma >1 hour with cc
16
$198,723
$12,745
15.6× st 8.5×
308
Cardiac arrhythmia and conduction disorders with mcc
16
$97,086
$11,165
8.7× st 6.6×
551
Medical back problems with mcc
16
$136,771
$16,463
8.3× st 7.4×
605
Trauma to the skin, subcutaneous tissue and breast without mcc
16
$109,790
$8,702
12.6× st 7.7×
100
Seizures with mcc
16
$154,763
$16,407
9.4× st 6.7×
194
Simple pneumonia and pleurisy with cc
16
$110,087
$10,121
10.9× st 6.9×
191
Chronic obstructive pulmonary disease with cc
15
$94,314
$8,488
11.1× st 7.1×
178
Respiratory infections and inflammations with cc
15
$96,183
$9,211
10.4× st 6.4×
208
Respiratory system diagnosis with ventilator support <=96 hours
15
$249,793
$23,649
10.6× st 7.3×
242
Permanent cardiac pacemaker implant with mcc
15
$325,281
$32,284
10.1× st 7.7×
087
Traumatic stupor and coma <1 hour without cc/mcc
14
$102,176
$8,304
12.3× st 10.0×
085
Traumatic stupor and coma <1 hour with mcc
14
$206,520
$17,306
11.9× st 7.8×
175
Pulmonary embolism with mcc or acute cor pulmonale
14
$139,590
$12,841
10.9× st 6.8×
253
Other vascular procedures with cc
14
$223,611
$22,397
10.0× st 7.4×
917
Poisoning and toxic effects of drugs with mcc
13
$145,309
$12,608
11.5× st 6.0×
329
Major small and large bowel procedures with mcc
13
$674,309
$44,402
15.2× st 7.5×
056
Degenerative nervous system disorders with mcc
13
$99,141
$17,420
5.7× st 5.7×
057
Degenerative nervous system disorders without mcc
13
$114,377
$11,193
10.2× st 6.1×
854
Infectious and parasitic diseases with o.r. procedures with cc
13
$297,149
$18,738
15.9× st 8.6×
945
Rehabilitation with cc/mcc
13
$92,357
$11,936
7.7× st 8.3×
092
Other disorders of nervous system with cc
13
$102,013
$11,047
9.2× st 6.9×
235
Coronary bypass without cardiac catheterization with mcc
13
$812,477
$70,455
11.5× st 8.1×
638
Diabetes with cc
12
$109,071
$9,022
12.1× st 6.5×
190
Chronic obstructive pulmonary disease with mcc
12
$85,887
$10,364
8.3× st 6.5×
270
Other major cardiovascular procedures with mcc
12
$503,604
$41,262
12.2× st 7.2×
393
Other digestive system diagnoses with mcc
12
$143,345
$14,397
10.0× st 6.2×
418
Laparoscopic cholecystectomy without c.d.e. with cc
12
$287,248
$24,184
11.9× st 9.6×
300
Peripheral vascular disorders with cc
11
$83,515
$9,453
8.8× st 6.3×
163
Major chest procedures with mcc
11
$404,562
$34,448
11.7× st 6.9×
184
Major chest trauma with cc
11
$143,664
$9,806
14.7× st 7.8×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
11
$301,280
$20,731
14.5× st 9.0×
637
Diabetes with mcc
11
$115,374
$12,013
9.6× st 6.8×
536
Fractures of hip and pelvis without mcc
11
$111,143
$7,539
14.7× st 7.4×
082
Traumatic stupor and coma >1 hour with mcc
11
$217,509
$20,225
10.8× st 6.8×
02 · Outpatient
Outpatient services
Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.
APC
Service
Services
Charge
Allowed
Billed ÷ allowed
8011
Comprehensive Observation Services
283
$59,380
$2,472
24.0×
5191
Level 1 Endovascular Procedures
236
$68,843
$2,947
23.4×
5213
Level 3 Electrophysiologic Procedures
109
$272,525
$21,459
12.7×
5193
Level 3 Endovascular Procedures
99
$171,293
$9,957
17.2×
5115
Level 5 Musculoskeletal Procedures
55
$165,934
$11,347
14.6×
5194
Level 4 Endovascular Procedures
38
$159,962
$15,852
10.1×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
38
$31,377
$1,438
21.8×
5183
Level 3 Vascular Procedures
36
$60,622
$2,823
21.5×
5223
Level 3 Pacemaker and Similar Procedures
22
$113,844
$9,666
11.8×
5153
Level 3 Airway Endoscopy
22
$48,100
$1,503
32.0×
5375
Level 5 Urology and Related Services
20
$82,266
$4,687
17.6×
5192
Level 2 Endovascular Procedures
19
$130,684
$5,177
25.2×
5114
Level 4 Musculoskeletal Procedures
19
$122,027
$6,209
19.7×
5113
Level 3 Musculoskeletal Procedures
15
$84,297
$2,932
28.8×
5154
Level 4 Airway Endoscopy
15
$86,143
$3,392
25.4×
5222
Level 2 Pacemaker and Similar Procedures
12
$59,804
$7,696
7.8×
5302
Level 2 Upper GI Procedures
11
$32,261
$1,724
18.7×
5374
Level 4 Urology and Related Services
11
$73,203
$3,158
23.2×
5182
Level 2 Vascular Procedures
11
$30,943
$1,451
21.3×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
—
—
—
—
5376
Level 6 Urology and Related Services
—
—
—
—
5373
Level 3 Urology and Related Services
—
—
—
—
5362
Level 2 Laparoscopy and Related Services
—
—
—
—
5378
Level 8 Urology and Related Services
—
—
—
—
5414
Level 4 Gynecologic Procedures
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
5465
Level 5 Neurostimulator and Related Procedures
—
—
—
—
5471
Implantation of Drug Infusion Device
—
—
—
—
5491
Level 1 Intraocular Procedures
—
—
—
—
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5361
Level 1 Laparoscopy and Related Services
—
—
—
—
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5165
Level 5 ENT Procedures
—
—
—
—
5184
Level 4 Vascular Procedures
—
—
—
—
5116
Level 6 Musculoskeletal Procedures
—
—
—
—
5211
Level 1 Electrophysiologic Procedures
—
—
—
—
5212
Level 2 Electrophysiologic Procedures
—
—
—
—
5112
Level 2 Musculoskeletal Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5313
Level 3 Lower GI Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related 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, 260,304 rows scanned, 16,816 distinct code–setting items kept. 14,285 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
42
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
29
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
29
clean
Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score Other Outpatient
—
—
$768
40
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
—
—
$768
40
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
—
—
$768
40
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
—
—
$1,318
40
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
—
—
$3,525
40
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
—
—
$3,032
40
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
42
clean
Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative
—
—
$35
40
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
—
—
$3,636
40
clean
JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15
—
—
$123
40
clean
Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823)
—
—
$750
40
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)
—
—
$471
40
clean
Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative
—
—
$546
40
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
42
clean
Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM Other Outpatient
—
—
$17
40
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
$27,245
$27,245
$4,822
30
clean
Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG
—
—
$17
40
clean
Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM
—
—
$15
40
clean
Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG
—
—
$15
40
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
—
—
$3,912
40
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
—
—
$3,912
40
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
—
—
$326
40
clean
Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative
—
—
$326
40
clean
Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis
—
—
$25
40
clean
Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative
—
—
$31
42
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
42
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
42
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
—
—
$3,555
40
clean
Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)
—
—
$768
40
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
—
—
$1,970
40
clean
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified
—
—
$7,558
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
—
—
$1,761
40
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
—
—
$960
40
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
42
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-
—
—
$5,000
40
clean
Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene
—
—
$360
40
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
—
—
$2,781
40
clean
Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events
—
—
$85
40
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
—
—
$1,317
40
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
—
—
$2,147
40
clean
Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results
—
—
$113
40
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
—
—
$508
40
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
42
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
—
—
$1,318
40
clean
Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness)
—
—
$7,558
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
—
—
$7,558
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
—
—
$7,558
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
42
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
—
—
$14,791
94
clean
Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel
—
—
$14,791
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
42
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
42
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
—
—
$1,279
40
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
42
clean
Implantation or replacement of carotid sinus baroreflex activation device; pulse generator only (includes intra-operative interrogation, programming, and repositioning, when performed)
—
—
$14,852
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
—
—
$11,876
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
—
—
$3,912
40
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
—
—
$5,489
40
clean
Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD
—
—
$395
40
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
—
—
$395
40
clean
Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi
—
—
$8
42
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
—
—
$849
40
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
—
—
$8,585
40
clean
Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection
—
—
$2,677
40
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
42
clean
Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutation
—
—
$3,472
40
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,
—
—
$3,535
40
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
—
—
$2,459
40
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
42
clean
Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r
—
—
$7,558
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
—
—
$768
40
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
—
—
$3,895
40
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
—
—
$800
40
clean
Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,349
40
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes
—
—
$1,349
40
clean
Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes
—
—
$750
40
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
—
—
$750
40
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
42
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
—
—
$1,818
40
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
—
—
$263
40
clean
Oncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer
—
—
$768
40
clean
Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy
—
—
$849
40
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
—
—
$768
40
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer
—
—
$906
40
clean
Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer
—
—
$906
40
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
42
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
—
—
$713
40
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
—
—
$3,321
40
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
—
—
$3,535
40
clean
Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative
—
—
$541
42
clean
Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative Other Outpatient
—
—
$201
40
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 Other Outpatient
—
—
$1,755
42
clean
Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed
—
—
$3,178
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
—
—
$768
40
clean
Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression
—
—
$323
42
clean
Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer
—
—
$768
40
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
42
clean
Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator
—
—
$16,989
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
—
—
$2,949
40
clean
Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6
—
—
$1,349
40
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
—
—
$395
40
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
—
—
$1,963
40
clean
Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative
—
—
$62
40
clean
Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative Other Outpatient
—
—
$37
40
clean
Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative
—
—
$37
40
clean
Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer
—
—
$768
40
clean
Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes
—
—
$421
40
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
—
—
$10,523
28
clean
Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)
—
—
$10,523
28
clean
Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid
—
—
$117
40
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
—
—
$10,523
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
42
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
—
—
$1,317
40
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
—
—
$3,686
40
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
$3,800
$3,800
$722
33
clean
Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; computerized analysi
$3,800
$3,800
$836
31
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 Cardiac Cath
—
—
$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 16,816 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
229 of 1,102 comparable items (21%) 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 $7,480 exceeds the gross charge $811
warn
mrf_rate_without_estimate
22,943 of 22,943 percentage/algorithm rates across 5,011 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 0265T/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 0532U/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 13132/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 19085/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 21282/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 23172/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 25274/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 26700/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 27498/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 28293/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 30545/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 32556/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 33620/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 35190/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 36515/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 38228/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 43113/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 44180/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 46761/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 49596/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 52204/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 55605/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 58950/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 61737/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 64418/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 65767/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 69105/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 73201/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 77075/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 80280/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 81371/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 82696/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 84431/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 86357/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 87207/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 91112/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 93462/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 96113/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 A4349/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 A6534/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 C8902/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 E0786/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 E2391/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 J0725/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 J2508/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 J9047/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 L0464/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 L3050/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 L5711/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 L8485/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 Q4229/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 057/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 376/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 689/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 0265U/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 0533U/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 13133/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 19086/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 21295/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 23174/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 25275/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 26705/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 27499/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 28294/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 30560/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 32557/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 33621/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 35201/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 36516/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 38230/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 43116/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 44186/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 46762/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 49600/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 52214/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 55650/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 58951/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 61750/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 64420/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 65770/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 69110/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 73202/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 77076/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 80285/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 81372/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 82705/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 86359/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 87209/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 88261/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 91117/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 93463/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 96116/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 A4351/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 A6535/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 C8903/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 E0791/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 E2392/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 J0735/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 J2515/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 J9049/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 L0466/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 L3060/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 L5712/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 L8500/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 Q4232/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 058/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 377/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 690/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 0266U/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 0535U/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 13150/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 19100/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 21296/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 23180/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 25280/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 26706/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 27500/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 28295/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 30580/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 32560/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 33622/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 35206/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 36520/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 38232/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 43117/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 44187/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 46900/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 49605/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 52224/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 55680/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 58952/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 61751/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 64421/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 65771/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 69120/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 73206/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 77077/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 80299/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 81373/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 82710/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 84432/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 86360/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 87210/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 88262/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 91120/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 93464/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 96121/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 A4352/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 A6536/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 C8905/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 E0840/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 E2394/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 J0736/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 J2540/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 J9050/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 L0467/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 L3070/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 L5714/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 Q4234/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 059/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 378/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 693/i
info
mrf_item_fields_vary
this code and setting cover at least 10 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 0267U/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 0536U/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 13151/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 19101/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 21299/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 23182/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 25290/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 26715/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 27501/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 28296/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 30600/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 32561/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 33641/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 35207/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 36521/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 38240/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 43118/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 44188/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 46910/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 49606/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 52234/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 55700/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 58953/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 61760/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 64425/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 65772/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 69140/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 73218/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 77078/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 80305/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 81374/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 82715/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 84433/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 87220/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 88263/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 91122/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
Showing the first 200 of 14,285 findings, errors first — every finding as JSON →
04 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 023
info
inp_charge_10x_payment
average charge $499,583 is 11.2× the total payment
MS-DRG 025
info
inp_charge_10x_payment
average charge $471,765 is 12.8× the total payment
MS-DRG 057
info
inp_charge_10x_payment
average charge $114,377 is 10.2× the total payment
MS-DRG 064
info
inp_charge_10x_payment
average charge $220,763 is 13.5× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $150,859 is 15.8× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $142,799 is 18.5× the total payment
MS-DRG 082
info
inp_charge_10x_payment
average charge $217,509 is 10.8× the total payment
MS-DRG 083
info
inp_charge_10x_payment
average charge $198,723 is 15.6× the total payment
MS-DRG 085
info
inp_charge_10x_payment
average charge $206,520 is 11.9× the total payment
MS-DRG 086
info
inp_charge_10x_payment
average charge $141,986 is 11.7× the total payment
MS-DRG 087
info
inp_charge_10x_payment
average charge $102,176 is 12.3× the total payment
MS-DRG 163
info
inp_charge_10x_payment
average charge $404,562 is 11.7× the total payment
MS-DRG 175
info
inp_charge_10x_payment
average charge $139,590 is 10.9× the total payment
MS-DRG 177
info
inp_charge_10x_payment
average charge $163,563 is 10.7× the total payment
MS-DRG 178
info
inp_charge_10x_payment
average charge $96,183 is 10.4× the total payment
MS-DRG 184
info
inp_charge_10x_payment
average charge $143,664 is 14.7× the total payment
MS-DRG 191
info
inp_charge_10x_payment
average charge $94,314 is 11.1× the total payment
MS-DRG 193
info
inp_charge_10x_payment
average charge $123,607 is 10.3× the total payment
MS-DRG 194
info
inp_charge_10x_payment
average charge $110,086 is 10.9× the total payment
MS-DRG 208
info
inp_charge_10x_payment
average charge $249,793 is 10.6× the total payment
MS-DRG 235
info
inp_charge_10x_payment
average charge $812,477 is 11.5× the total payment
MS-DRG 242
info
inp_charge_10x_payment
average charge $325,281 is 10.1× the total payment
MS-DRG 243
info
inp_charge_10x_payment
average charge $267,568 is 14.7× the total payment
MS-DRG 270
info
inp_charge_10x_payment
average charge $503,604 is 12.2× the total payment
MS-DRG 280
info
inp_charge_10x_payment
average charge $158,566 is 11.4× the total payment
MS-DRG 281
info
inp_charge_10x_payment
average charge $132,097 is 14.7× the total payment
MS-DRG 287
info
inp_charge_10x_payment
average charge $170,510 is 16.2× the total payment
MS-DRG 305
info
inp_charge_10x_payment
average charge $80,007 is 11.0× the total payment
MS-DRG 309
info
inp_charge_10x_payment
average charge $73,980 is 10.3× the total payment
MS-DRG 312
info
inp_charge_10x_payment
average charge $111,675 is 13.2× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $344,986 is 13.7× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $281,133 is 16.2× the total payment
MS-DRG 329
info
inp_charge_10x_payment
average charge $674,309 is 15.2× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $98,184 is 10.5× the total payment
MS-DRG 389
info
inp_charge_10x_payment
average charge $109,495 is 14.0× the total payment
MS-DRG 391
info
inp_charge_10x_payment
average charge $142,777 is 11.9× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $103,668 is 13.1× the total payment
MS-DRG 394
info
inp_charge_10x_payment
average charge $111,656 is 11.9× the total payment
MS-DRG 418
info
inp_charge_10x_payment
average charge $287,248 is 11.9× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $191,732 is 11.5× the total payment
MS-DRG 480
info
inp_charge_10x_payment
average charge $404,217 is 16.7× the total payment
MS-DRG 481
info
inp_charge_10x_payment
average charge $269,658 is 14.8× the total payment
MS-DRG 493
info
inp_charge_10x_payment
average charge $301,280 is 14.5× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $261,997 is 13.9× the total payment
MS-DRG 536
info
inp_charge_10x_payment
average charge $111,143 is 14.7× the total payment
MS-DRG 552
info
inp_charge_10x_payment
average charge $111,386 is 12.2× the total payment
MS-DRG 563
info
inp_charge_10x_payment
average charge $129,455 is 15.1× the total payment
MS-DRG 605
info
inp_charge_10x_payment
average charge $109,790 is 12.6× the total payment
MS-DRG 638
info
inp_charge_10x_payment
average charge $109,071 is 12.1× the total payment
MS-DRG 641
info
inp_charge_10x_payment
average charge $74,261 is 10.2× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $96,498 is 10.8× the total payment
MS-DRG 689
info
inp_charge_10x_payment
average charge $103,376 is 10.6× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $87,391 is 11.8× the total payment
MS-DRG 812
info
inp_charge_10x_payment
average charge $96,858 is 10.5× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $510,832 is 12.4× the total payment
MS-DRG 854
info
inp_charge_10x_payment
average charge $297,149 is 15.9× the total payment
MS-DRG 871
info
inp_charge_10x_payment
average charge $173,112 is 10.1× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $95,133 is 10.4× the total payment
MS-DRG 917
info
inp_charge_10x_payment
average charge $145,309 is 11.5× 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 Bayonet Point Hospital — standard charges file · FL · updated 2026-03-01· json · 422.6M bytes · fetched 2026-08-23 · sha256 91f6b62c5f5e…
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.