Hospital · CCN 150035

Northwest Health- Porter

85 East Us Hwy 6, Valparaiso, IN 46383 · Porter County
Part of Community Health Systems · 198 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

74 admission types 51 outpatient services price file: ok 13 Medicare-file findings
Billed per dollar paid, all admissions
8.75×
$304.4M billed against $34.8M paid across 2,609 Medicare discharges; the national figure is 5.03×.
2.3%
of adults in Porter County have medical debt in collections
6.9%
uninsured in the county · state 8.2%
$79K
median household income
8.7×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (1 in the inpatient or outpatient file)ⓘ
39.9%
obesity in the countyⓘ
12.5%
diagnosed diabetes (PLACES)
6.6%
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
268
$115,774
$14,081
8.2× st 4.1×
274
Percutaneous and other intracardiac procedures without mcc
182
$242,990
$22,532
10.8× st 5.6×
291
Heart failure and shock with mcc
161
$67,608
$8,955
7.6× st 4.0×
193
Simple pneumonia and pleurisy with mcc
101
$81,660
$9,364
8.7× st 4.1×
177
Respiratory infections and inflammations with mcc
100
$92,181
$12,001
7.7× st 4.0×
689
Kidney and urinary tract infections with mcc
78
$62,149
$8,850
7.0× st 4.0×
280
Acute myocardial infarction, discharged alive with mcc
70
$88,046
$11,279
7.8× st 4.5×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
66
$270,131
$33,825
8.0× st 5.9×
690
Kidney and urinary tract infections without mcc
64
$44,225
$6,037
7.3× st 4.1×
698
Other kidney and urinary tract diagnoses with mcc
60
$91,521
$11,167
8.2× st 4.1×
190
Chronic obstructive pulmonary disease with mcc
55
$75,664
$8,076
9.4× st 4.6×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
52
$50,034
$5,823
8.6× st 4.5×
872
Septicemia or severe sepsis without mv >96 hours without mcc
49
$61,393
$7,730
7.9× st 4.2×
378
Gastrointestinal hemorrhage with cc
47
$66,686
$7,506
8.9× st 4.9×
312
Syncope and collapse
43
$43,992
$6,193
7.1× st 4.5×
481
Hip and femur procedures except major joint with cc
42
$149,178
$16,998
8.8× st 5.4×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
42
$73,554
$9,527
7.7× st 4.1×
853
Infectious and parasitic diseases with o.r. procedures with mcc
41
$242,144
$35,154
6.9× st 4.4×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
40
$245,705
$22,405
11.0× st 6.3×
683
Renal failure with cc
37
$57,050
$6,233
9.2× st 4.1×
552
Medical back problems without mcc
37
$64,448
$9,059
7.1× st 4.0×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
36
$167,907
$12,488
13.4× st 7.6×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
35
$169,259
$13,338
12.7× st 6.0×
603
Cellulitis without mcc
34
$44,070
$6,904
6.4× st 3.7×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
33
$61,368
$7,100
8.6× st 4.8×
638
Diabetes with cc
33
$49,791
$6,245
8.0× st 4.5×
064
Intracranial hemorrhage or cerebral infarction with mcc
33
$118,983
$12,637
9.4× st 4.2×
682
Renal failure with mcc
33
$64,454
$10,099
6.4× st 3.9×
309
Cardiac arrhythmia and conduction disorders with cc
30
$43,171
$5,365
8.0× st 4.5×
377
Gastrointestinal hemorrhage with mcc
29
$123,359
$12,200
10.1× st 4.8×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
26
$50,568
$5,619
9.0× st 4.2×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
25
$309,532
$41,951
7.4× st 4.8×
637
Diabetes with mcc
23
$88,514
$10,138
8.7× st 4.5×
281
Acute myocardial infarction, discharged alive with cc
22
$54,655
$6,833
8.0× st 5.5×
069
Transient ischemia without thrombolytic
21
$50,880
$5,592
9.1× st 5.1×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
21
$126,012
$15,193
8.3× st 4.9×
480
Hip and femur procedures except major joint with mcc
19
$222,558
$20,821
10.7× st 5.2×
522
Hip replacement with principal diagnosis of hip fracture without mcc
19
$173,355
$14,249
12.2× st 5.7×
394
Other digestive system diagnoses with cc
19
$56,686
$6,511
8.7× st 4.5×
308
Cardiac arrhythmia and conduction disorders with mcc
19
$67,284
$8,566
7.9× st 4.7×
455
Combined anterior and posterior spinal fusion without cc/mcc
18
$407,881
$37,620
10.8× st 7.5×
870
Septicemia or severe sepsis with mv >96 hours
18
$276,983
$43,311
6.4× st 4.2×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
18
$68,983
$9,440
7.3× st 4.5×
699
Other kidney and urinary tract diagnoses with cc
18
$58,671
$8,620
6.8× st 4.4×
602
Cellulitis with mcc
17
$76,207
$10,173
7.5× st 4.3×
389
Gastrointestinal obstruction with cc
17
$42,396
$5,734
7.4× st 4.2×
189
Pulmonary edema and respiratory failure
17
$98,921
$11,577
8.5× st 4.0×
101
Seizures without mcc
16
$50,433
$7,568
6.7× st 4.3×
252
Other vascular procedures with mcc
16
$226,171
$23,803
9.5× st 5.2×
330
Major small and large bowel procedures with cc
15
$162,513
$17,158
9.5× st 5.2×
329
Major small and large bowel procedures with mcc
15
$258,689
$30,587
8.5× st 4.8×
149
Dysequilibrium
15
$42,005
$5,418
7.8× st 5.0×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
14
$85,305
$7,658
11.1× st 6.4×
313
Chest pain
14
$39,252
$5,800
6.8× st 5.3×
393
Other digestive system diagnoses with mcc
14
$113,009
$20,971
5.4× st 4.3×
178
Respiratory infections and inflammations with cc
13
$55,065
$6,859
8.0× st 4.3×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
13
$51,012
$6,134
8.3× st 3.8×
439
Disorders of pancreas except malignancy with cc
13
$75,684
$6,253
12.1× st 5.0×
083
Traumatic stupor and coma >1 hour with cc
13
$65,319
$9,642
6.8× st 4.3×
092
Other disorders of nervous system with cc
12
$47,870
$8,034
6.0× st 4.5×
460
Spinal fusion except cervical without mcc
12
$484,969
$38,584
12.6× st 8.0×
165
Major chest procedures without cc/mcc
12
$318,081
$19,683
16.2× st 7.6×
314
Other circulatory system diagnoses with mcc
12
$106,402
$17,827
6.0× st 4.4×
536
Fractures of hip and pelvis without mcc
12
$38,543
$5,298
7.3× st 4.3×
175
Pulmonary embolism with mcc or acute cor pulmonale
11
$74,812
$9,721
7.7× st 4.5×
813
Coagulation disorders
11
$83,816
$11,035
7.6× st 3.2×
194
Simple pneumonia and pleurisy with cc
11
$48,387
$5,789
8.4× st 4.4×
176
Pulmonary embolism without mcc
11
$46,062
$5,868
7.8× st 4.6×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
11
$29,297
$4,071
7.2× st 4.5×
270
Other major cardiovascular procedures with mcc
11
$289,096
$40,685
7.1× st 5.2×
372
Major gastrointestinal disorders and peritoneal infections with cc
11
$51,275
$7,331
7.0× st 4.3×
402
Single level combined anterior and posterior spinal fusion except cervical
11
$391,109
$29,761
13.1× st 7.3×
444
Disorders of the biliary tract with mcc
11
$106,140
$11,682
9.1× st 4.5×
917
Poisoning and toxic effects of drugs with mcc
11
$74,121
$11,249
6.6× st 4.1×
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
5491
Level 1 Intraocular Procedures
793
$16,932
$2,070
8.2×
8011
Comprehensive Observation Services
243
$26,043
$2,387
10.9×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
168
$16,169
$1,427
11.3×
5191
Level 1 Endovascular Procedures
162
$42,251
$2,873
14.7×
5115
Level 5 Musculoskeletal Procedures
136
$149,670
$11,576
12.9×
5302
Level 2 Upper GI Procedures
116
$18,873
$1,651
11.4×
5193
Level 3 Endovascular Procedures
114
$124,892
$9,433
13.2×
5183
Level 3 Vascular Procedures
95
$30,133
$2,821
10.7×
5361
Level 1 Laparoscopy and Related Services
88
$81,415
$5,100
16.0×
5194
Level 4 Endovascular Procedures
56
$131,790
$11,150
11.8×
5373
Level 3 Urology and Related Services
53
$22,547
$1,817
12.4×
5182
Level 2 Vascular Procedures
52
$15,138
$1,429
10.6×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
50
$31,175
$2,454
12.7×
5192
Level 2 Endovascular Procedures
47
$76,140
$5,098
14.9×
5375
Level 5 Urology and Related Services
39
$55,999
$4,522
12.4×
5374
Level 4 Urology and Related Services
36
$31,116
$3,110
10.0×
5213
Level 3 Electrophysiologic Procedures
35
$306,352
$20,574
14.9×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
34
$57,431
$3,014
19.1×
5114
Level 4 Musculoskeletal Procedures
32
$103,323
$6,381
16.2×
5113
Level 3 Musculoskeletal Procedures
31
$33,578
$2,813
11.9×
5223
Level 3 Pacemaker and Similar Procedures
29
$143,910
$9,258
15.5×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
28
$33,157
$3,400
9.8×
5116
Level 6 Musculoskeletal Procedures
27
$238,183
$16,588
14.4×
5154
Level 4 Airway Endoscopy
25
$55,110
$3,234
17.0×
5492
Level 2 Intraocular Procedures
25
$39,337
$3,511
11.2×
5224
Level 4 Pacemaker and Similar Procedures
23
$234,676
$16,659
14.1×
5313
Level 3 Lower GI Procedures
23
$34,801
$2,449
14.2×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
21
$54,637
$5,596
9.8×
5212
Level 2 Electrophysiologic Procedures
21
$86,934
$6,661
13.1×
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
20
$17,676
$2,084
8.5×
5155
Level 5 Airway Endoscopy
19
$66,643
$6,105
10.9×
5414
Level 4 Gynecologic Procedures
19
$38,363
$2,680
14.3×
5331
Complex GI Procedures
18
$52,784
$5,084
10.4×
5232
Level 2 ICD and Similar Procedures
16
$327,578
$29,259
11.2×
5362
Level 2 Laparoscopy and Related Services
16
$134,849
$9,177
14.7×
5493
Level 3 Intraocular Procedures
14
$34,033
$4,662
7.3×
5222
Level 2 Pacemaker and Similar Procedures
14
$110,325
$7,578
14.6×
5184
Level 4 Vascular Procedures
11
$53,772
$4,902
11.0×
5165
Level 5 ENT Procedures
—
—
—
—
5504
Level 4 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5881
Ancillary Outpatient Services When Patient Dies
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5415
Level 5 Gynecologic Procedures
—
—
—
—
5112
Level 2 Musculoskeletal Procedures
—
—
—
—
5200
Implantation Wireless PA Pressure Monitor
—
—
—
—
5342
Level 2 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
03 · Its own price file

What the hospital's price-transparency file says

Found via /cms-hpt.txt, the file itself ↗ read as csv-wide, last updated 2026-04-01, template 3.0.0, 172,874 rows scanned, 3,396 distinct code–setting items kept. 2,578 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
IR Sacroplasty 1 or More Needles Left
$11,887
$3,209
$7,677
112
clean
IR Sacroplasty 2 or More Needles Bilat
$17,831
$4,814
$8,755
56
clean
IR Endo FemPop Art Rev IntraStent Place
$105,000
$28,350
$24,814
56
clean
NJX B1 SUB MTRL SBCHDRL DFCT
$88,305
$23,842
$7,616
56
clean
US-FNA W IMG 1ST LES
$3,208
$866
$1,498
432
clean
FNA BX W/FLUOR GDN 1ST LES
$90,485
$24,431
$8,964
61
clean
IR-CATH FLUID DRAIN - GL 169
$4,076
$1,101
$1,101
426
clean
IR CT Soft Tissue Loc Device Place 1 Les
$3,114
$841
$1,376
69
clean
DRAINAGE OF SKIN ABSCESS
$5,495
$1,484
$382
71
clean
DRAINAGE OF PILONIDAL CYST
$7,135
$1,926
$1,199
71
clean
REMOVE FOREIGN BODY
$4,434
$1,197
$688
71
clean
REMOVE FOREIGN BODY
$4,937
$1,333
$1,892
71
clean
DRAINAGE OF HEMATOMA/FLUID
$12,605
$3,403
$2,796
71
clean
PUNCTURE DRAINAGE OF LESION
$5,370
$1,450
$688
71
clean
COMPLEX DRAINAGE, WOUND
$33,667
$9,090
$4,610
71
clean
DEBRIDE INFECTED SKIN
$3,673
$992
$688
71
clean
DEBRIDE SKIN, FX
$72,224
$19,501
$5,395
71
clean
DEBRIDE SKIN/MUSCLE/BONE, FX
$29,789
$8,043
$4,610
71
clean
DEBRIDE SKIN/TISSUE
$12,168
$3,285
$1,095
71
clean
DEBRIDE TISSUE/MUSCLE
$14,405
$3,889
$1,729
71
clean
DEBRIDE TISSUE/MUSCLE/BONE
$38,643
$10,434
$2,796
71
clean
DBRDMT SUBQ TISS EACH ADDL
$25,080
$6,772
$6,972
39
clean
DBRDMT MUSC&/FSCA EA ADDL
$20,462
$5,525
$5,688
39
clean
DBRDMT BONE EACH ADDL
$29,056
$7,845
$8,077
39
clean
TRIM SKIN LESION
$8,046
$2,172
$865
71
clean
TRIM SKIN LESIONS, 2 TO 4
$8,117
$2,191
$865
71
clean
PUNCH BX SKIN SINGLE LESION
$12,012
$3,243
$688
71
clean
PUNCH BX SKIN EA SEP/ADDL
$17,516
$4,729
$8,522
28
clean
INCAL BX SKN SINGLE LES
$22,730
$6,137
$1,251
71
clean
REMOVAL OF SKIN TAGS
$64,137
$17,317
$425
71
clean
REMOVAL OF SKIN LESION
$100,344
$27,093
$7,440
71
clean
REMOVAL OF SKIN LESION
$30,743
$8,301
$774
71
clean
REMOVAL OF SKIN LESION
$29,125
$7,864
$1,199
71
clean
REMOVAL OF SKIN LESION
$22,035
$5,950
$1,199
71
clean
REMOVAL OF SKIN LESION
$40,537
$10,945
$3,145
71
clean
REMOVAL OF SKIN LESION
$26,369
$7,120
$2,796
71
clean
REMOVAL OF SKIN LESION
$21,049
$5,683
$2,667
71
clean
REMOVAL OF SKIN LESION
$15,023
$4,056
$1,199
71
clean
REMOVAL OF SKIN LESION
$19,748
$5,332
$2,667
71
clean
REMOVAL OF SKIN LESION
$65,034
$17,559
$3,145
71
clean
REMOVAL OF SKIN LESION
$18,169
$4,906
$2,796
71
clean
REMOVAL OF SKIN LESION
$32,368
$8,739
$4,610
71
clean
REMOVAL OF SKIN LESION
$16,211
$4,377
$1,199
71
clean
REMOVAL, SWEAT GLAND LESION
$20,181
$5,449
$4,610
71
clean
REMOVAL OF SKIN LESION
$22,080
$5,962
$1,199
71
clean
REMOVAL OF SKIN LESION
$30,390
$8,205
$1,045
71
clean
REMOVAL OF SKIN LESION
$51,171
$13,816
$1,349
71
clean
REMOVAL OF SKIN LESION
$41,584
$11,228
$3,145
71
clean
REMOVAL OF SKIN LESION
$10,996
$2,969
$1,199
71
clean
DEBRIDE NAIL, 1-5
$3,944
$1,065
$191
71
clean
DEBRIDE NAIL, 6 OR MORE
$8,911
$2,406
$286
71
clean
REMOVAL OF NAIL PLATE
$18,998
$5,129
$382
71
clean
DRAIN BLOOD FROM UNDER NAIL
$3,821
$1,032
$381
71
clean
REMOVAL OF NAIL BED
$21,295
$5,750
$688
71
clean
REPAIR OF NAIL BED
$3,711
$1,002
$1,045
71
clean
EXCISION OF NAIL FOLD, TOE
$10,600
$2,862
$1,045
71
clean
REMOVAL OF PILONIDAL LESION
$26,127
$7,054
$4,610
71
clean
REMOVAL OF PILONIDAL LESION
$31,248
$8,437
$4,610
71
clean
REMOVE DRUG IMPLANT DEVICE
$33,381
$9,013
$851
71
clean
REPAIR SUPERFICIAL WOUND(S)
$4,508
$1,217
$382
71
clean
REPAIR SUPERFICIAL WOUND(S)
$6,343
$1,713
$648
71
clean
REPAIR SUPERFICIAL WOUND(S)
$5,982
$1,615
$865
71
clean
REPAIR SUPERFICIAL WOUND(S)
$6,257
$1,689
$1,095
71
clean
REPAIR SUPERFICIAL WOUND(S)
$28,634
$7,731
$1,095
71
clean
REPAIR SUPERFICIAL WOUND(S)
$7,086
$1,913
$865
71
clean
REPAIR SUPERFICIAL WOUND(S)
$6,422
$1,734
$382
71
clean
REPAIR SUPERFICIAL WOUND(S)
$10,040
$2,711
$648
71
clean
REPAIR SUPERFICIAL WOUND(S)
$16,936
$4,573
$648
71
clean
REPAIR SUPERFICIAL WOUND(S)
$16,532
$4,464
$865
71
clean
REPAIR SUPERFICIAL WOUND(S)
$19,009
$5,132
$1,095
71
clean
REPAIR SUPERFICIAL WOUND(S)
$3,055
$825
$1,032
71
clean
CLOSURE OF SPLIT WOUND
$2,823
$762
$1,242
71
clean
LAYER CLOSURE OF WOUND(S)
$5,900
$1,593
$688
71
clean
LAYER CLOSURE OF WOUND(S)
$15,506
$4,187
$1,045
71
clean
LAYER CLOSURE OF WOUND(S)
$54,063
$14,597
$1,729
71
clean
LAYER CLOSURE OF WOUND(S)
$9,268
$2,502
$1,095
71
clean
LAYER CLOSURE OF WOUND(S)
$3,721
$1,005
$688
71
clean
LAYER CLOSURE OF WOUND(S)
$22,660
$6,118
$1,045
71
clean
LAYER CLOSURE OF WOUND(S)
$2,970
$802
$1,032
71
clean
LATE CLOSURE OF WOUND
$72,498
$19,574
$5,999
71
clean
SKIN TISSUE REARRANGEMENT
$28,243
$7,626
$3,493
71
clean
WOUND PREP TRK/ARM/LEG
$33,632
$9,081
$1,729
71
clean
WOUND PREP F/N/HF/G
$57,793
$15,604
$1,729
71
clean
SKIN SUB GRAFT TRNK/ARM/LEG
$44,187
$11,930
$1,408
69
clean
SKIN SUB GRAFT T/A/L ADD-ON
$79,849
$21,559
$22,198
39
clean
SKIN SUB GRAFT FACE/NK/HF/G
$35,252
$9,518
$1,408
69
clean
SKIN SUB GRAFT F/N/HF/G ADDL
$31,473
$8,498
$8,750
39
clean
MUSCLE-SKIN GRAFT, TRUNK
$24,987
$6,746
$5,624
71
clean
REVISION OF LOWER EYELID
$18,146
$4,899
$3,493
71
clean
REVISION OF UPPER EYELID
$19,742
$5,330
$3,493
71
clean
Suture or Staple Removal
$727
$196
$364
106
clean
REMOVE SACRUM PRESSURE SORE
$24,987
$6,746
$3,493
71
clean
INITIAL TREATMENT OF BURN(S)
$1,981
$535
$382
71
clean
TREATMENT OF BURN(S)
$5,795
$1,565
$382
71
clean
TREATMENT OF BURN(S)
$6,707
$1,811
$382
71
clean
TREATMENT OF BURN(S)
$3,677
$993
$1,032
71
clean
DESTROY BENIGN/PREMAL LESION
$11,968
$3,231
$382
71
clean
DESTRUCT LESION, 1-14
$14,815
$4,000
$382
71
clean
DESTRUCT LESION, 15 OR MORE
$18,378
$4,962
$382
71
clean
CHEMICAL CAUTERY, TISSUE
$8,566
$2,313
$382
71
clean
SKIN TISSUE PROCEDURE
$34,416
$9,292
$3,687
69
clean
DRAINAGE OF BREAST LESION
$4,094
$1,105
$1,124
71
clean
DRAIN BREAST LESION ADD-ON
$4,610
$1,245
$1,281
39
clean
INJECTION FOR BREAST X-RAY
$2,958
$799
$1,028
39
clean
MG Breast Biopsy w Loc w Stereo 1 Lsn Lt
$11,463
$3,095
$2,796
205
clean
BR - BRST BX LOC CLIP A
$11,463
$3,095
$5,577
56
clean
US Breast Biopsy w Loc 1 Lesion Left
$7,173
$1,937
$2,738
493
clean
US-BRST BX LOC CLIP A
$7,173
$1,937
$3,490
56
clean
REMOVAL OF BREAST LESION
$25,201
$6,804
$6,048
71
clean
EXCISION, BREAST LESION
$37,985
$10,256
$5,696
72
clean
EXCISION, ADDL BREAST LESION
$43,159
$11,653
$11,826
40
clean
MG Mammo Loc Device Place 1 Lesion Left
$8,264
$2,231
$2,208
70
clean
BR-PLC LOC DVCE ADD
$5,252
$1,418
$2,450
28
clean
BR-BLC LOC DV AD STR
$5,395
$1,457
$2,625
28
clean
US Breast Loc Device Place 1 Lesion Lt
$5,193
$1,402
$1,246
339
clean
US-PLC LOC DVCE ADD
$2,076
$561
$1,010
28
clean
PARTIAL MASTECTOMY
$51,378
$13,872
$6,272
71
clean
P-MASTECTOMY W/LN REMOVAL
$69,283
$18,706
$10,538
71
clean
MAST SIMPLE COMPLETE
$75,020
$20,255
$10,538
71
clean
EXPLORE WOUND, EXTREMITY
$12,798
$3,456
$2,667
71
clean
DEEP MUSCLE BIOPSY
$26,425
$7,135
$4,610
71
clean
NEEDLE BIOPSY, MUSCLE
$6,470
$1,747
$2,184
71
clean
S-BX BONE SUPRFCL
$4,723
$1,275
$2,088
213
clean
BONE BIOPSY, TROCAR/NEEDLE
$18,238
$4,924
$2,796
71
clean
BONE BIOPSY, EXCISIONAL
$26,087
$7,043
$4,610
71
clean
OPEN BONE BIOPSY
$113,987
$30,777
$12,283
71
clean
REMOVAL OF FOREIGN BODY
$6,622
$1,788
$2,184
71
clean
THER INJECTION CARP TUNNEL
$34,813
$9,399
$585
71
clean
INJECT TENDON/LIGAMENT/CYST
$33,695
$9,098
$585
71
clean
NJX 1 TENDON ORIGIN/INSJ
$69,834
$18,855
$5,141
71
clean
S-JOINT ASP-INJ SM
$2,350
$635
$574
142
clean
S-JOINT ASP-INJ IM
$2,460
$664
$543
142
clean
IR US Guided Arthrocentesis Medium Joint
$3,341
$902
$1,056
142
clean
S-JNT ASP INJ MAJ UN
$2,526
$682
$543
284
clean
US Guided Arthrocentesis Major Joint
$3,401
$918
$650
131
clean
REMOVAL OF SUPPORT IMPLANT
$87,781
$23,701
$4,917
71
clean
APPLY BONE FIXATION DEVICE
$105,141
$28,388
$21,734
69
clean
REMOVE BONE FIXATION DEVICE
$93,647
$25,285
$7,132
71
clean
REMOVAL OF BONE FOR GRAFT
$153,808
$41,528
$13,471
69
clean
REMOVAL OF BONE FOR GRAFT
$195,185
$52,700
$16,682
71
clean
SPINAL BONE ALLOGRAFT
$280,745
$75,801
$136,583
28
clean
ABLATE BONE TUMOR(S) PERQ
$74,338
$20,071
$20,071
71
clean
MUSCULOSKELETAL SURGERY
$81,870
$22,105
$6,405
69
clean
EXC FACE TUM DEEP 2 CM/>
$22,847
$6,169
$4,610
71
clean
TREATMENT OF NOSE FRACTURE
$11,624
$3,138
$3,648
71
clean
BIOPSY OF NECK/CHEST
$15,279
$4,125
$2,796
71
clean
EXC NECK LES SC 3 CM/>
$18,802
$5,077
$4,513
71
clean
REMOVE LESION, NECK/CHEST
$17,868
$4,824
$2,796
71
clean
PARTIAL REMOVAL OF STERNUM
$153,508
$41,447
$13,052
71
clean
REPAIR OF STERNUM SEPARATION
$153,508
$41,447
$13,448
69
clean
BIOPSY SOFT TISSUE OF BACK
$113,987
$30,777
$8,620
71
clean
REMOVE LESION, BACK OR FLANK
$27,708
$7,481
$2,796
71
clean
EXC BACK LES SC 3 CM/>
$24,899
$6,723
$2,796
71
clean
EXC BACK TUM DEEP 5 CM/>
$22,079
$5,961
$4,610
71
clean
TREAT SPINE FRACTURE
$283,566
$76,563
$26,103
69
clean
IR Perc Vertebroplasty Cervicothoracic
$17,457
$4,713
$6,924
71
clean
IR Perc Vertebroplasty Lumbosacral
$17,457
$4,713
$7,068
142
clean
PERQ VERTEBRAL AUGMENTATION
$53,157
$14,353
$13,052
71
clean
PERQ VERTEBRAL AUGMENTATION
$63,835
$17,235
$13,052
71
clean
ARTHRD ANT NTRBDY CERVICAL
$207,424
$56,004
$21,734
69
clean
ARTHRD ANT NTRBD CERVICAL EA
$213,278
$57,585
$103,760
28
clean
LUMBAR SPINE FUSION
$283,566
$76,563
$29,682
69
clean
ARTHRD CMBN 1NTRSPC LUMBAR
$351,757
$94,974
$45,933
69
clean
INSERT SPINE FIXATION DEVICE
$305,758
$82,555
$148,751
28
clean
INSERT SPINE FIXATION DEVICE
$446,291
$120,499
$217,121
28
clean
INSERT SPINE FIXATION DEVICE
$206,774
$55,829
$100,596
28
clean
INSJ BIOMECHANICAL DEVICE
$240,731
$64,997
$117,116
28
clean
TOT DISC ARTHRP 1NTRSPC CRV
$138,038
$37,270
$29,682
69
clean
EXC ABDL TUM DEEP 5 CM/>
$17,004
$4,591
$4,081
71
clean
EXC ABD LES SC 3 CM/>
$23,442
$6,329
$4,610
71
clean
BIOPSY SHOULDER TISSUES
$4,851
$1,310
$1,859
71
clean
EXC SHOULDER TUM DEEP 5 CM/>
$22,376
$6,041
$4,610
71
clean
REMOVAL OF SHOULDER LESION
$23,378
$6,312
$4,610
71
clean
S-INJ SHOULDER ARTH
$1,290
$348
$581
117
clean
INCISION OF TENDON & MUSCLE
$196,193
$52,972
$16,760
71
clean
REPAIR BICEPS TENDON
$150,640
$40,673
$13,225
71
clean
RECONSTRUCT SHOULDER JOINT
$222,894
$60,181
$29,682
69
clean
REVIS RECONST SHOULDER JOINT
$138,885
$37,499
$26,103
69
clean
REVIS RECONST SHOULDER JOINT
$130,015
$35,104
$26,103
69
clean
TREAT SHOULDER DISLOCATION
$13,457
$3,633
$1,028
71
clean
TREAT SHOULDER DISLOCATION
$32,805
$8,857
$2,722
71
clean
S-INJ ELBOW ARTHRO
$734
$198
$355
156
clean
REPAIR ARM TENDON/MUSCLE
$41,937
$11,323
$10,065
71
clean
REPAIR OF RUPTURED TENDON
$37,643
$10,164
$9,596
71
clean
REPAIR OF HUMERUS
$171,538
$46,315
$21,734
69
clean
TREAT HUMERUS FRACTURE
$59,340
$16,022
$16,497
69
clean
TREAT HUMERUS FRACTURE
$43,522
$11,751
$10,445
71
clean
TREAT HUMERUS FRACTURE
$51,171
$13,816
$14,263
69
clean
TREAT ELBOW DISLOCATION
$7,522
$2,031
$1,028
71
clean
TREAT ELBOW DISLOCATION
$5,005
$1,351
$1,918
71
clean
TREAT ELBOW DISLOCATION
$3,720
$1,004
$1,004
71
clean
TREAT ULNAR FRACTURE
$63,389
$17,115
$12,283
69
clean
EXC FOREARM TUM DEEP 3 CM/>
$14,534
$3,924
$3,842
71
clean
REMOVE WRIST TENDON LESION
$21,210
$5,727
$2,722
71
clean
EXCISE WRIST TENDON SHEATH
$14,060
$3,796
$2,722
71
clean
S-INJ WRIST ARTHRO
$944
$255
$456
156
clean
TRANSPLANT FOREARM TENDON
$36,130
$9,755
$5,193
71
clean
REPAIR WRIST JOINT(S)
$29,483
$7,960
$5,193
71
clean
TREAT FRACTURE RADIUS & ULNA
$19,370
$5,230
$2,552
71
clean
TREAT FRACTURE RADIUS/ULNA
$53,530
$14,453
$12,283
69
clean

Showing the first 200 of 3,396 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
321 of 2,310 comparable items (14%) 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 $31,288 exceeds the gross charge $11,887
warn
mrf_rate_without_estimate
16,062 of 16,062 percentage/algorithm rates across 766 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 11750/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 28124/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 43450/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 63030/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 74280/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 81240/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 85007/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 87400/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 94642/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11760/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28192/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 43659/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 63042/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 74420/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 81241/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 85014/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 87425/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 94644/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 J0174/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11765/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28200/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 43752/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 63047/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 74430/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 81256/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 85018/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 87426/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 94660/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 11770/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 28208/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 43762/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 63267/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 74450/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 81263/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 85025/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 87427/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 J0175/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 11771/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 28225/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 43999/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 64400/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 74455/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 81270/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 85027/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 87428/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 94664/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 11982/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 28232/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 44180/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 64415/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 81279/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 87430/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 94667/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 J0178/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 12001/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 28238/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 44238/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 64417/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 74485/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 81291/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 85041/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 87449/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 J0248/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 12002/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 28250/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 44372/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 64445/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 74740/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 81301/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 85046/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 87480/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 94668/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 12004/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 28270/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 44388/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 64447/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 75557/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 81305/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 85048/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 87481/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 J0256/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 12005/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 28285/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 44389/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 64450/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 75561/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 81339/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 85049/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 87491/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 94669/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 J0349/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 12006/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 28286/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 44394/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 64454/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 75571/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 81352/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 85055/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 87493/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 12007/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 28288/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 64455/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 75574/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 81376/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 87496/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 94726/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 J0401/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 12011/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 28289/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 44500/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 75580/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 81381/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 85097/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 87497/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 12013/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 28291/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 44950/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 64479/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 81382/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 85210/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 87498/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 94727/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 J0402/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 12014/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 28292/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 44970/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 64483/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 75605/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 81400/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 85230/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 12015/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 28296/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 45100/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 64493/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 75625/o
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 85240/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 87502/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 94760/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT J0585/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 12016/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 28297/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 45171/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 64520/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 81401/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 85245/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 87506/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 12017/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 28299/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 45172/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 64561/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 75630/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 81403/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 85246/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 J0739/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 28300/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 45330/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 64590/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 75635/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 81407/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 85247/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 87507/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 94762/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 12020/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 28302/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 45331/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 64640/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 75705/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 81445/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 85250/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 87510/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 J0741/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 12031/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 28304/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 45332/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 64704/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 81450/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 85260/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 87517/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 94780/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 12032/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 28306/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 45333/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 64708/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 75710/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 81455/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 85270/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 87522/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 J0775/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 12034/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 28308/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 45335/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 64718/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 81479/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 85280/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 87529/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 12035/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 28322/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 45338/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

Showing the first 200 of 2,578 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service
Severity
Rule
Detail
MS-DRG 165
info
inp_charge_10x_payment
average charge $318,080 is 16.2× the total payment
MS-DRG 274
info
inp_charge_10x_payment
average charge $242,990 is 10.8× the total payment
MS-DRG 287
info
inp_charge_10x_payment
average charge $85,305 is 11.1× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $245,705 is 11.0× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $167,907 is 13.4× the total payment
MS-DRG 377
info
inp_charge_10x_payment
average charge $123,359 is 10.1× the total payment
MS-DRG 402
info
inp_charge_10x_payment
average charge $391,109 is 13.1× the total payment
MS-DRG 439
info
inp_charge_10x_payment
average charge $75,684 is 12.1× the total payment
MS-DRG 455
info
inp_charge_10x_payment
average charge $407,881 is 10.8× the total payment
MS-DRG 460
info
inp_charge_10x_payment
average charge $484,969 is 12.6× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $169,259 is 12.7× the total payment
MS-DRG 480
info
inp_charge_10x_payment
average charge $222,558 is 10.7× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $173,355 is 12.2× the total payment

Sources for this hospital

the files read, as fetched — not our copy of them
  1. MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
  2. 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)
  3. 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
  4. 2020 ZCTA to County relationship file · US Census Bureau · 2020
    tab20_zcta520_county20_natl.txt · 6.8M bytes · fetched 2026-08-21 · sha256 3ed41278d637… · publisher's page · public domain (US federal)
  5. · csv-wide · 599.9M bytes · fetched 2026-08-26 · sha256 92fcefaafb6d…

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.