Hospital · CCN 220110
Brigham And Women's Hospital
75 Francis Street, Boston, MA 02115 · Suffolk County
Part of Mass General Brigham · 826 beds · 1
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater
270 admission types 63 outpatient services price file: ok 1 Medicare-file findings
Billed per dollar paid, all admissions
3.92×
$1,627.1M billed against $414.7M paid across 11,164 Medicare discharges; the national figure is 5.03×.
0.9%
of adults in Suffolk County have medical debt in collections
3.1%
uninsured in the county · state 2.9%
$91K
median household income
3.2×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (14 in the inpatient or outpatient file)ⓘ
24.2%
obesity in the countyⓘ
9.3%
diagnosed diabetes (PLACES)
4.8%
coronary heart disease (PLACES)
—
median age · — below poverty (ACS)
01 · Admissions
What it billed Medicare, by admission type
Average charge submitted and average total payment per discharge, 2024. Rows under 11 discharges are suppressed by CMS. The last column is the hospital's ratio against its state's for the same admission.
DRG
Admission
Discharges
Charge
Paid
Billed ÷ paid
871
Septicemia or severe sepsis without mv >96 hours with mcc
382
$128,876
$28,764
4.5× st 2.3×
291
Heart failure and shock with mcc
309
$94,327
$18,556
5.1× st 2.3×
177
Respiratory infections and inflammations with mcc
216
$104,573
$22,724
4.6× st 2.3×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
185
$140,885
$55,727
2.5× st 2.6×
164
Major chest procedures with cc
178
$114,103
$29,260
3.9× st 3.0×
025
Craniotomy and endovascular intracranial procedures with mcc
174
$195,745
$52,037
3.8× st 2.8×
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
167
$85,392
$23,665
3.6× st 2.4×
219
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
158
$327,057
$93,788
3.5× st 3.0×
064
Intracranial hemorrhage or cerebral infarction with mcc
137
$101,775
$25,496
4.0× st 2.6×
274
Percutaneous and other intracardiac procedures without mcc
134
$106,478
$36,294
2.9× st 2.7×
330
Major small and large bowel procedures with cc
127
$107,510
$28,886
3.7× st 2.7×
698
Other kidney and urinary tract diagnoses with mcc
122
$83,542
$21,200
3.9× st 2.3×
460
Spinal fusion except cervical without mcc
121
$124,550
$44,521
2.8× st 2.4×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
120
$194,760
$36,500
5.3× st 3.3×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
114
$47,996
$10,894
4.4× st 2.5×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
103
$72,854
$16,784
4.3× st 2.5×
481
Hip and femur procedures except major joint with cc
102
$116,551
$25,251
4.6× st 2.7×
853
Infectious and parasitic diseases with o.r. procedures with mcc
101
$310,159
$68,282
4.5× st 2.4×
235
Coronary bypass without cardiac catheterization with mcc
98
$265,531
$65,162
4.1× st 2.9×
163
Major chest procedures with mcc
97
$231,951
$55,995
4.1× st 2.8×
393
Other digestive system diagnoses with mcc
96
$85,738
$21,566
4.0× st 2.7×
280
Acute myocardial infarction, discharged alive with mcc
96
$113,770
$21,437
5.3× st 2.5×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
93
$89,028
$20,476
4.3× st 2.4×
394
Other digestive system diagnoses with cc
92
$50,178
$12,938
3.9× st 2.6×
314
Other circulatory system diagnoses with mcc
91
$152,395
$33,187
4.6× st 2.7×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
90
$283,730
$77,365
3.7× st 2.8×
193
Simple pneumonia and pleurisy with mcc
90
$77,969
$17,624
4.4× st 2.2×
309
Cardiac arrhythmia and conduction disorders with cc
89
$40,016
$10,280
3.9× st 2.5×
165
Major chest procedures without cc/mcc
89
$93,507
$22,457
4.2× st 3.3×
454
Combined anterior and posterior spinal fusion with cc
88
$168,552
$71,423
2.4× st 2.1×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
81
$177,755
$35,983
4.9× st 3.7×
682
Renal failure with mcc
77
$90,544
$20,996
4.3× st 2.3×
205
Other respiratory system diagnoses with mcc
77
$145,141
$36,944
3.9× st 3.3×
377
Gastrointestinal hemorrhage with mcc
75
$117,687
$24,980
4.7× st 2.7×
699
Other kidney and urinary tract diagnoses with cc
73
$50,314
$13,090
3.8× st 2.4×
683
Renal failure with cc
73
$39,346
$12,134
3.2× st 2.2×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
72
$1,222,379
$305,848
4.0× st 3.1×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
71
$112,019
$22,494
5.0× st 4.0×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
69
$96,796
$15,861
6.1× st 3.7×
378
Gastrointestinal hemorrhage with cc
69
$53,958
$13,654
4.0× st 2.6×
840
Lymphoma and non-acute leukemia with mcc
68
$192,770
$45,589
4.2× st 3.2×
919
Complications of treatment with mcc
66
$124,251
$31,528
3.9× st 2.7×
690
Kidney and urinary tract infections without mcc
66
$42,191
$10,542
4.0× st 2.4×
847
Chemotherapy without acute leukemia as secondary diagnosis with cc
65
$58,254
$16,790
3.5× st 2.6×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
64
$64,411
$13,632
4.7× st 2.8×
327
Stomach, esophageal and duodenal procedures with cc
64
$154,583
$33,481
4.6× st 3.5×
308
Cardiac arrhythmia and conduction disorders with mcc
63
$90,135
$17,977
5.0× st 2.6×
654
Major bladder procedures with cc
61
$144,451
$35,600
4.1× st 4.1×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
61
$202,088
$66,835
3.0× st 2.5×
180
Respiratory neoplasms with mcc
61
$104,689
$25,853
4.0× st 2.9×
813
Coagulation disorders
60
$147,584
$35,779
4.1× st 2.6×
329
Major small and large bowel procedures with mcc
60
$170,485
$52,623
3.2× st 2.4×
552
Medical back problems without mcc
60
$50,102
$12,645
4.0× st 2.4×
435
Malignancy of hepatobiliary system or pancreas with mcc
59
$88,882
$23,517
3.8× st 2.8×
406
Pancreas, liver and shunt procedures with cc
58
$158,372
$34,917
4.5× st 3.5×
689
Kidney and urinary tract infections with mcc
58
$87,541
$17,196
5.1× st 2.3×
312
Syncope and collapse
58
$53,132
$11,085
4.8× st 2.6×
834
Acute leukemia with mcc
58
$283,061
$78,563
3.6× st 3.5×
326
Stomach, esophageal and duodenal procedures with mcc
57
$252,495
$61,765
4.1× st 3.0×
100
Seizures with mcc
56
$123,268
$26,496
4.7× st 2.7×
018
Chimeric antigen receptor (car) t-cell and other immunotherapies
55
$1,772,622
$431,392
4.1× st 4.0×
467
Revision of hip or knee replacement with cc
55
$140,722
$39,629
3.6× st 2.7×
057
Degenerative nervous system disorders without mcc
54
$83,076
$21,010
4.0× st 2.4×
981
Extensive o.r. procedures unrelated to principal diagnosis with mcc
53
$282,919
$74,825
3.8× st 2.8×
388
Gastrointestinal obstruction with mcc
53
$106,783
$21,889
4.9× st 2.9×
846
Chemotherapy without acute leukemia as secondary diagnosis with mcc
53
$143,446
$35,201
4.1× st 2.9×
603
Cellulitis without mcc
52
$48,178
$11,760
4.1× st 2.1×
178
Respiratory infections and inflammations with cc
52
$60,388
$13,631
4.4× st 2.6×
389
Gastrointestinal obstruction with cc
52
$41,725
$10,859
3.8× st 2.5×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
51
$55,466
$11,477
4.8× st 2.4×
543
Pathological fractures and musculoskeletal and connective tissue malignancy with cc
51
$64,922
$13,825
4.7× st 2.6×
472
Cervical spinal fusion with cc
51
$129,644
$37,780
3.4× st 2.7×
091
Other disorders of nervous system with mcc
49
$80,363
$21,805
3.7× st 2.7×
374
Digestive malignancy with mcc
49
$103,586
$26,622
3.9× st 2.7×
444
Disorders of the biliary tract with mcc
48
$84,505
$22,379
3.8× st 3.0×
092
Other disorders of nervous system with cc
48
$65,296
$13,611
4.8× st 2.7×
480
Hip and femur procedures except major joint with mcc
47
$174,108
$35,216
4.9× st 2.6×
101
Seizures without mcc
47
$66,538
$11,817
5.6× st 2.9×
054
Nervous system neoplasms with mcc
46
$113,787
$25,490
4.5× st 3.0×
920
Complications of treatment with cc
45
$48,715
$13,933
3.5× st 2.8×
194
Simple pneumonia and pleurisy with cc
44
$52,425
$12,037
4.4× st 2.4×
315
Other circulatory system diagnoses with cc
44
$76,688
$14,621
5.2× st 3.1×
445
Disorders of the biliary tract with cc
43
$56,183
$14,708
3.8× st 3.0×
184
Major chest trauma with cc
42
$47,827
$14,350
3.3× st 2.6×
948
Signs and symptoms without mcc
42
$62,064
$11,297
5.5× st 3.1×
175
Pulmonary embolism with mcc or acute cor pulmonale
41
$89,340
$17,917
5.0× st 2.7×
281
Acute myocardial infarction, discharged alive with cc
41
$65,390
$11,312
5.8× st 3.2×
811
Red blood cell disorders with mcc
41
$81,525
$18,726
4.4× st 2.6×
299
Peripheral vascular disorders with mcc
40
$129,497
$24,885
5.2× st 2.9×
660
Kidney and ureter procedures for non-neoplasm with cc
40
$83,320
$18,348
4.5× st 2.7×
233
Coronary bypass with cardiac catheterization or open ablation with mcc
40
$350,100
$107,270
3.3× st 2.7×
027
Craniotomy and endovascular intracranial procedures without cc/mcc
40
$108,420
$28,653
3.8× st 3.2×
331
Major small and large bowel procedures without cc/mcc
40
$73,418
$21,057
3.5× st 2.7×
014
Allogeneic bone marrow transplant
40
$355,350
$148,347
2.4× st 2.2×
371
Major gastrointestinal disorders and peritoneal infections with mcc
39
$91,478
$24,709
3.7× st 2.7×
228
Other cardiothoracic procedures with mcc
38
$227,800
$68,695
3.3× st 2.8×
243
Permanent cardiac pacemaker implant with cc
38
$89,514
$26,587
3.4× st 2.7×
812
Red blood cell disorders without mcc
38
$65,791
$13,981
4.7× st 2.7×
190
Chronic obstructive pulmonary disease with mcc
38
$77,445
$16,208
4.8× st 2.2×
862
Postoperative and post-traumatic infections with mcc
37
$112,587
$28,647
3.9× st 2.7×
229
Other cardiothoracic procedures without mcc
37
$113,928
$37,222
3.1× st 3.0×
300
Peripheral vascular disorders with cc
37
$44,216
$13,451
3.3× st 2.3×
215
Other heart assist system implant
36
$375,973
$136,470
2.8× st 3.0×
863
Postoperative and post-traumatic infections without mcc
36
$39,080
$12,574
3.1× st 2.4×
026
Craniotomy and endovascular intracranial procedures with cc
36
$136,078
$35,139
3.9× st 3.0×
809
Major hematological and immunological diagnoses except sickle cell crisis and coagulatio
35
$63,978
$16,097
4.0× st 3.3×
870
Septicemia or severe sepsis with mv >96 hours
35
$357,251
$86,620
4.1× st 2.6×
375
Digestive malignancy with cc
34
$49,489
$17,564
2.8× st 2.7×
808
Major hematological and immunological diagnoses except sickle cell crisis and coagulatio
34
$150,063
$36,797
4.1× st 2.9×
522
Hip replacement with principal diagnosis of hip fracture without mcc
34
$117,020
$26,753
4.4× st 2.6×
542
Pathological fractures and musculoskeletal and connective tissue malignancy with mcc
34
$119,400
$23,168
5.2× st 2.7×
253
Other vascular procedures with cc
33
$164,245
$32,954
5.0× st 3.2×
519
Back and neck procedures except spinal fusion with cc
33
$107,722
$24,981
4.3× st 3.0×
056
Degenerative nervous system disorders with mcc
33
$93,002
$28,770
3.2× st 2.3×
643
Endocrine disorders with mcc
32
$86,265
$20,600
4.2× st 2.5×
872
Septicemia or severe sepsis without mv >96 hours without mcc
32
$59,398
$14,256
4.2× st 2.4×
082
Traumatic stupor and coma >1 hour with mcc
32
$139,108
$37,162
3.7× st 2.5×
737
Uterine and adnexa procedures for ovarian or adnexal malignancy with cc
32
$127,561
$25,189
5.1× st 4.0×
252
Other vascular procedures with mcc
31
$231,475
$50,653
4.6× st 2.8×
657
Kidney and ureter procedures for neoplasm with cc
31
$85,625
$24,454
3.5× st 3.3×
455
Combined anterior and posterior spinal fusion without cc/mcc
30
$121,340
$52,399
2.3× st 1.9×
441
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with mcc
30
$109,242
$26,270
4.2× st 2.8×
638
Diabetes with cc
30
$61,637
$12,355
5.0× st 2.4×
189
Pulmonary edema and respiratory failure
29
$93,858
$16,974
5.5× st 2.3×
837
Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy a
29
$292,357
$78,296
3.7× st 3.7×
074
Cranial and peripheral nerve disorders without mcc
29
$64,892
$14,019
4.6× st 3.0×
644
Endocrine disorders with cc
29
$41,364
$13,247
3.1× st 2.2×
841
Lymphoma and non-acute leukemia with cc
28
$93,785
$20,604
4.6× st 3.8×
457
Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive
28
$166,059
$70,122
2.4× st 2.7×
206
Other respiratory system diagnoses without mcc
28
$49,453
$11,613
4.3× st 3.1×
551
Medical back problems with mcc
28
$135,697
$28,783
4.7× st 2.6×
947
Signs and symptoms with mcc
27
$110,218
$24,113
4.6× st 3.7×
273
Percutaneous and other intracardiac procedures with mcc
27
$196,616
$50,410
3.9× st 3.2×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
27
$125,325
$28,651
4.4× st 2.8×
328
Stomach, esophageal and duodenal procedures without cc/mcc
27
$95,807
$20,079
4.8× st 2.9×
637
Diabetes with mcc
26
$75,771
$17,554
4.3× st 2.5×
270
Other major cardiovascular procedures with mcc
26
$374,470
$79,827
4.7× st 3.1×
208
Respiratory system diagnosis with ventilator support <=96 hours
26
$208,969
$42,490
4.9× st 2.9×
216
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization wit
26
$455,017
$116,733
3.9× st 2.8×
372
Major gastrointestinal disorders and peritoneal infections with cc
26
$63,303
$13,974
4.5× st 2.5×
196
Interstitial lung disease with mcc
25
$124,208
$28,056
4.4× st 2.9×
176
Pulmonary embolism without mcc
25
$47,649
$11,006
4.3× st 2.8×
554
Bone diseases and arthropathies without mcc
25
$44,119
$11,532
3.8× st 2.4×
907
Other o.r. procedures for injuries with mcc
25
$211,318
$55,989
3.8× st 3.0×
908
Other o.r. procedures for injuries with cc
24
$121,826
$23,594
5.2× st 3.4×
884
Organic disturbances and intellectual disability
24
$112,653
$30,238
3.7× st 2.5×
181
Respiratory neoplasms with cc
24
$68,166
$16,016
4.3× st 3.5×
856
Postoperative or post-traumatic infections with o.r. procedures with mcc
24
$198,652
$52,294
3.8× st 3.2×
982
Extensive o.r. procedures unrelated to principal diagnosis with cc
23
$127,143
$32,482
3.9× st 2.7×
442
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with cc
23
$55,185
$14,259
3.9× st 2.9×
614
Adrenal and pituitary procedures with cc/mcc
23
$99,224
$27,088
3.7× st 3.3×
545
Connective tissue disorders with mcc
23
$209,244
$49,976
4.2× st 3.2×
083
Traumatic stupor and coma >1 hour with cc
23
$59,385
$17,867
3.3× st 2.4×
917
Poisoning and toxic effects of drugs with mcc
22
$99,489
$23,594
4.2× st 2.7×
303
Atherosclerosis without mcc
22
$45,967
$9,727
4.7× st 3.3×
438
Disorders of pancreas except malignancy with mcc
22
$94,778
$20,188
4.7× st 3.3×
029
Spinal procedures with cc or spinal neurostimulators
22
$147,169
$40,828
3.6× st 3.4×
354
Hernia procedures except inguinal and femoral with cc
22
$84,486
$23,463
3.6× st 2.9×
468
Revision of hip or knee replacement without cc/mcc
22
$92,539
$32,378
2.9× st 2.2×
673
Other kidney and urinary tract procedures with mcc
21
$251,018
$60,986
4.1× st 2.6×
827
Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedur
21
$121,911
$30,727
4.0× st 4.2×
166
Other respiratory system o.r. procedures with mcc
21
$160,746
$43,146
3.7× st 2.5×
305
Hypertension without mcc
21
$48,468
$10,498
4.6× st 2.5×
402
Single level combined anterior and posterior spinal fusion except cervical
21
$117,165
$46,871
2.5× st 2.3×
464
Wound debridement and skin graft except hand for musculoskeletal and connective tissue d
20
$176,658
$38,831
4.5× st 3.3×
202
Bronchitis and asthma with cc/mcc
20
$51,155
$12,925
4.0× st 2.3×
242
Permanent cardiac pacemaker implant with mcc
20
$153,155
$41,898
3.7× st 2.7×
356
Other digestive system o.r. procedures with mcc
20
$213,722
$55,616
3.8× st 3.0×
085
Traumatic stupor and coma <1 hour with mcc
20
$102,312
$28,234
3.6× st 2.7×
033
Ventricular shunt procedures without cc/mcc
20
$75,182
$19,059
3.9× st 3.7×
271
Other major cardiovascular procedures with cc
19
$169,488
$44,953
3.8× st 2.9×
521
Hip replacement with principal diagnosis of hip fracture with mcc
19
$186,178
$37,716
4.9× st 2.7×
436
Malignancy of hepatobiliary system or pancreas with cc
19
$69,180
$14,242
4.9× st 3.5×
451
Single level spinal fusion except cervical without mcc
19
$116,607
$37,341
3.1× st 3.0×
167
Other respiratory system o.r. procedures with cc
19
$111,583
$23,292
4.8× st 3.1×
459
Spinal fusion except cervical with mcc
19
$153,791
$71,066
2.2× st 2.2×
405
Pancreas, liver and shunt procedures with mcc
19
$199,280
$57,364
3.5× st 3.0×
001
Heart transplant or implant of heart assist system with mcc
19
$1,507,223
$397,882
3.8× st 3.6×
020
Intracranial vascular procedures with principal diagnosis hemorrhage with mcc
19
$296,119
$100,848
2.9× st 2.1×
276
Cardiac defibrillator implant with mcc or carotid sinus neurostimulator
18
$299,740
$75,313
4.0× st 3.0×
857
Postoperative or post-traumatic infections with o.r. procedures with cc
18
$113,986
$27,730
4.1× st 3.4×
004
Tracheostomy with mv >96 hours or principal diagnosis except face, mouth and neck withou
18
$665,337
$133,246
5.0× st 3.5×
821
Lymphoma and leukemia with major o.r. procedures with cc
18
$120,749
$28,920
4.2× st 4.2×
183
Major chest trauma with mcc
18
$65,775
$20,153
3.3× st 2.8×
032
Ventricular shunt procedures with cc
18
$92,201
$24,988
3.7× st 3.3×
418
Laparoscopic cholecystectomy without c.d.e. with cc
17
$101,430
$21,897
4.6× st 3.0×
336
Peritoneal adhesiolysis with cc
17
$119,434
$29,852
4.0× st 2.8×
607
Minor skin disorders without mcc
17
$42,921
$11,404
3.8× st 3.2×
016
Autologous bone marrow transplant with cc/mcc
17
$207,784
$92,227
2.3× st 2.3×
292
Heart failure and shock with cc
17
$50,365
$12,924
3.9× st 2.7×
835
Acute leukemia with cc
17
$142,204
$33,203
4.3× st 4.3×
602
Cellulitis with mcc
17
$82,856
$19,184
4.3× st 2.4×
277
Cardiac defibrillator implant without mcc
17
$201,512
$58,365
3.5× st 2.5×
987
Non-extensive o.r. procedures unrelated to principal diagnosis with mcc
17
$208,905
$47,553
4.4× st 2.9×
814
Reticuloendothelial and immunity disorders with mcc
17
$149,700
$33,865
4.4× st 4.3×
864
Fever and inflammatory conditions
17
$48,675
$11,200
4.3× st 3.5×
517
Other musculoskeletal system and connective tissue o.r. procedures without cc/mcc
16
$80,632
$22,203
3.6× st 3.7×
843
Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with mc
16
$153,116
$33,825
4.5× st 4.5×
466
Revision of hip or knee replacement with mcc
16
$166,065
$53,344
3.1× st 3.0×
880
Acute adjustment reaction and psychosocial dysfunction
16
$44,488
$11,939
3.7× st 3.0×
036
Carotid artery stent procedures without cc/mcc
16
$89,324
$20,661
4.3× st 2.8×
191
Chronic obstructive pulmonary disease with cc
15
$45,567
$10,963
4.2× st 2.4×
007
Lung transplant
15
$877,982
$189,219
4.6× st 4.9×
471
Cervical spinal fusion with mcc
15
$205,417
$61,643
3.3× st 2.6×
199
Pneumothorax with mcc
15
$98,619
$25,453
3.9× st 2.7×
740
Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with cc
15
$113,191
$27,210
4.2× st 4.2×
086
Traumatic stupor and coma <1 hour with cc
15
$59,423
$16,301
3.6× st 2.2×
620
O.r. procedures for obesity with cc
15
$67,782
$19,769
3.4× st 3.3×
546
Connective tissue disorders with cc
14
$76,326
$16,875
4.5× st 3.8×
708
Major male pelvic procedures without cc/mcc
14
$71,652
$19,371
3.7× st 2.9×
482
Hip and femur procedures except major joint without cc/mcc
14
$87,143
$18,859
4.6× st 2.5×
652
Kidney transplant
14
$371,332
$36,637
10.1× st 6.2×
453
Combined anterior and posterior spinal fusion with mcc
14
$227,274
$98,262
2.3× st 1.9×
040
Peripheral, cranial nerve and other nervous system procedures with mcc
14
$232,438
$53,012
4.4× st 4.2×
390
Gastrointestinal obstruction without cc/mcc
14
$24,260
$7,791
3.1× st 2.4×
469
Major hip and knee joint replacement or reattachment of lower extremity with mcc or tota
14
$162,732
$38,563
4.2× st 2.8×
615
Adrenal and pituitary procedures without cc/mcc
14
$71,919
$16,965
4.2× st 4.2×
306
Cardiac congenital and valvular disorders with mcc
14
$103,034
$19,695
5.2× st 2.9×
380
Complicated peptic ulcer with mcc
14
$131,370
$27,763
4.7× st 3.5×
427
Multiple level combined anterior and posterior spinal fusion except cervical with cc
14
$165,043
$84,177
2.0× st 2.0×
659
Kidney and ureter procedures for non-neoplasm with mcc
14
$213,848
$46,130
4.6× st 2.9×
669
Transurethral procedures with cc
14
$64,353
$18,586
3.5× st 3.4×
068
Precerebral occlusion without infarction without mcc
14
$62,772
$11,041
5.7× st 3.9×
031
Ventricular shunt procedures with mcc
13
$161,439
$46,535
3.5× st 3.4×
239
Amputation for circulatory system disorders except upper limb and toe with mcc
13
$372,484
$80,590
4.6× st 3.2×
483
Major joint or limb reattachment procedures of upper extremities
13
$120,968
$29,291
4.1× st 2.7×
368
Major esophageal disorders with mcc
13
$83,980
$20,962
4.0× st 4.0×
313
Chest pain
13
$54,093
$9,506
5.7× st 3.0×
605
Trauma to the skin, subcutaneous tissue and breast without mcc
13
$42,139
$11,420
3.7× st 2.5×
304
Hypertension with mcc
13
$50,140
$14,834
3.4× st 3.0×
039
Extracranial procedures without cc/mcc
13
$77,491
$13,348
5.8× st 3.6×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
13
$43,507
$11,005
4.0× st 2.3×
520
Back and neck procedures except spinal fusion without cc/mcc
13
$66,486
$16,651
4.0× st 3.5×
335
Peritoneal adhesiolysis with mcc
13
$182,531
$45,481
4.0× st 2.5×
501
Soft tissue procedures with cc
13
$134,780
$23,819
5.7× st 3.8×
264
Other circulatory system o.r. procedures
13
$213,585
$44,639
4.8× st 3.3×
515
Other musculoskeletal system and connective tissue o.r. procedures with mcc
13
$179,663
$39,835
4.5× st 2.8×
516
Other musculoskeletal system and connective tissue o.r. procedures with cc
13
$92,143
$33,613
2.7× st 3.0×
038
Extracranial procedures with cc
12
$140,679
$19,357
7.3× st 4.0×
357
Other digestive system o.r. procedures with cc
12
$127,249
$24,151
5.3× st 3.9×
432
Cirrhosis and alcoholic hepatitis with mcc
12
$159,848
$30,773
5.2× st 2.7×
963
Other multiple significant trauma with mcc
12
$115,613
$33,826
3.4× st 2.9×
815
Reticuloendothelial and immunity disorders with cc
12
$69,460
$13,461
5.2× st 4.9×
606
Minor skin disorders with mcc
12
$97,750
$18,248
5.4× st 5.4×
865
Viral illness with mcc
12
$93,943
$20,796
4.5× st 3.0×
055
Nervous system neoplasms without mcc
12
$50,967
$14,969
3.4× st 3.4×
448
Multiple level spinal fusion except cervical without mcc
12
$117,221
$49,294
2.4× st 2.6×
103
Headaches without mcc
12
$52,808
$11,455
4.6× st 2.8×
742
Uterine and adnexa procedures for non-malignancy with cc/mcc
12
$109,751
$21,822
5.0× st 4.7×
269
Aortic and heart assist procedures except pulsation balloon without mcc
12
$172,222
$47,338
3.6× st 2.9×
828
Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedur
12
$99,091
$22,204
4.5× st 3.9×
829
Myeloproliferative disorders or poorly differentiated neoplasms with other procedures wi
12
$124,255
$41,125
3.0× st 4.0×
283
Acute myocardial infarction, expired with mcc
12
$130,384
$25,177
5.2× st 3.2×
186
Pleural effusion with mcc
12
$87,280
$20,015
4.4× st 2.5×
141
Major head and neck procedures with cc
12
$114,349
$34,661
3.3× st 2.4×
838
Chemotherapy with acute leukemia as secondary diagnosis with cc or high dose chemotherap
12
$60,949
$24,393
2.5× st 3.0×
656
Kidney and ureter procedures for neoplasm with mcc
12
$194,531
$53,112
3.7× st 3.6×
579
Other skin, subcutaneous tissue and breast procedures with mcc
11
$108,507
$36,149
3.0× st 3.2×
463
Wound debridement and skin graft except hand for musculoskeletal and connective tissue d
11
$248,090
$68,722
3.6× st 3.3×
207
Respiratory system diagnosis with ventilator support >96 hours
11
$455,448
$99,619
4.6× st 3.4×
707
Major male pelvic procedures with cc/mcc
11
$92,425
$22,812
4.1× st 4.1×
324
Coronary intravascular lithotripsy with intraluminal device without mcc
11
$146,852
$37,354
3.9× st 3.6×
070
Other cerebrovascular disorders with mcc
11
$99,256
$30,667
3.2× st 2.3×
824
Lymphoma and non-acute leukemia with other procedures with cc
11
$112,719
$26,932
4.2× st 4.4×
694
Urinary stones without mcc
11
$43,748
$12,021
3.6× st 2.6×
653
Major bladder procedures with mcc
11
$288,896
$73,532
3.9× st 3.9×
885
Psychoses
11
$155,814
$32,451
4.8× st 2.8×
518
Back and neck procedures except spinal fusion with mcc or disc device or neurostimulator
11
$224,896
$49,400
4.6× st 4.6×
577
Skin graft except for skin ulcer or cellulitis with cc
11
$87,344
$31,805
2.7× st 3.4×
988
Non-extensive o.r. procedures unrelated to principal diagnosis with cc
11
$92,016
$20,914
4.4× st 3.7×
02 · Outpatient
Outpatient services
Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.
APC
Service
Services
Charge
Allowed
Billed ÷ allowed
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
1,552
$6,429
$1,723
3.7×
8011
Comprehensive Observation Services
1,113
$19,420
$2,906
6.7×
5183
Level 3 Vascular Procedures
873
$16,195
$3,412
4.7×
5302
Level 2 Upper GI Procedures
694
$9,687
$2,015
4.8×
5373
Level 3 Urology and Related Services
516
$8,815
$2,076
4.2×
5191
Level 1 Endovascular Procedures
473
$30,753
$3,473
8.9×
5213
Level 3 Electrophysiologic Procedures
447
$103,252
$25,223
4.1×
5154
Level 4 Airway Endoscopy
408
$22,325
$3,975
5.6×
5431
Level 1 Nerve Procedures
381
$10,549
$2,065
5.1×
5374
Level 4 Urology and Related Services
309
$21,479
$3,734
5.8×
5361
Level 1 Laparoscopy and Related Services
263
$38,195
$6,143
6.2×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
253
$16,303
$3,593
4.5×
5193
Level 3 Endovascular Procedures
221
$64,586
$11,799
5.5×
5362
Level 2 Laparoscopy and Related Services
220
$57,927
$10,914
5.3×
5375
Level 5 Urology and Related Services
208
$41,974
$5,515
7.6×
5114
Level 4 Musculoskeletal Procedures
196
$45,153
$7,652
5.9×
5115
Level 5 Musculoskeletal Procedures
194
$60,723
$13,866
4.4×
5182
Level 2 Vascular Procedures
192
$6,045
$1,709
3.5×
5113
Level 3 Musculoskeletal Procedures
165
$24,914
$3,416
7.3×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
158
$19,273
$2,986
6.5×
5155
Level 5 Airway Endoscopy
152
$37,701
$7,273
5.2×
5112
Level 2 Musculoskeletal Procedures
134
$9,893
$1,716
5.8×
5184
Level 4 Vascular Procedures
132
$37,477
$4,355
8.6×
5223
Level 3 Pacemaker and Similar Procedures
127
$31,110
$11,332
2.7×
5331
Complex GI Procedures
123
$24,887
$6,081
4.1×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
123
$37,674
$4,094
9.2×
5165
Level 5 ENT Procedures
115
$44,557
$6,246
7.1×
5303
Level 3 Upper GI Procedures
113
$15,547
$4,113
3.8×
5222
Level 2 Pacemaker and Similar Procedures
104
$34,843
$9,048
3.9×
5194
Level 4 Endovascular Procedures
103
$79,551
$18,788
4.2×
5414
Level 4 Gynecologic Procedures
100
$17,207
$3,331
5.2×
5372
Level 2 Urology and Related Services
95
$5,015
$734
6.8×
5153
Level 3 Airway Endoscopy
92
$15,484
$1,791
8.6×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
89
$54,349
$7,003
7.8×
5627
Level 7 Radiation Therapy
87
$40,920
$8,285
4.9×
5463
Level 3 Neurostimulator and Related Procedures
85
$34,367
$14,603
2.4×
5313
Level 3 Lower GI Procedures
76
$15,246
$2,920
5.2×
5224
Level 4 Pacemaker and Similar Procedures
66
$56,410
$20,874
2.7×
5232
Level 2 ICD and Similar Procedures
62
$86,074
$35,221
2.4×
5465
Level 5 Neurostimulator and Related Procedures
57
$108,735
$33,246
3.3×
5192
Level 2 Endovascular Procedures
50
$40,145
$6,077
6.6×
5378
Level 8 Urology and Related Services
35
$78,484
$21,608
3.6×
5462
Level 2 Neurostimulator and Related Procedures
35
$30,138
$6,086
5.0×
5116
Level 6 Musculoskeletal Procedures
33
$74,537
$19,410
3.8×
5471
Implantation of Drug Infusion Device
31
$73,829
$17,981
4.1×
5376
Level 6 Urology and Related Services
31
$50,429
$9,142
5.5×
5164
Level 4 ENT Procedures
26
$21,487
$3,246
6.6×
5415
Level 5 Gynecologic Procedures
25
$52,780
$5,342
9.9×
5231
Level 1 ICD and Similar Procedures
23
$51,896
$25,244
2.1×
5432
Level 2 Nerve Procedures
22
$54,667
$7,154
7.6×
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5881
Ancillary Outpatient Services When Patient Dies
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5212
Level 2 Electrophysiologic Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5093
Level 3 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5200
Implantation Wireless PA Pressure Monitor
—
—
—
—
5377
Level 7 Urology and Related Services
—
—
—
—
5094
Level 4 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5166
Cochlear Implant Procedure
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5342
Level 2 Abdominal/Peritoneal/Biliary 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 csv-tall, last updated 2026-03-27, template 3.0.0, 109,293 rows scanned, 5,204 distinct code–setting items kept. 1,556 findings against it.
Service
Code
Listed
Cash
Negotiated
Rates
Checks
Showing the first 200 of 5,204 code–setting items in the file, verified codes first — every row as JSON →
Findings
Service
Severity
Rule
Detail
CPT 21235/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,059 exceeds the gross charge $4,242
CPT 85097/b
warn
mrf_negotiated_above_gross
highest negotiated rate $970 exceeds the gross charge $569
CPT 86870/b
warn
mrf_negotiated_above_gross
highest negotiated rate $534 exceeds the gross charge $340
CPT 86885/b
warn
mrf_negotiated_above_gross
highest negotiated rate $203 exceeds the gross charge $118
CPT 54150/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,432 exceeds the gross charge $1,034
CPT 86886/b
warn
mrf_negotiated_above_gross
highest negotiated rate $254 exceeds the gross charge $185
CPT 86900/b
warn
mrf_negotiated_above_gross
highest negotiated rate $191 exceeds the gross charge $103
CPT 86902/b
warn
mrf_negotiated_above_gross
highest negotiated rate $534 exceeds the gross charge $192
CPT 86905/b
warn
mrf_negotiated_above_gross
highest negotiated rate $427 exceeds the gross charge $221
CPT 55873/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,980 exceeds the gross charge $8,143
CPT 55920/b
warn
mrf_negotiated_above_gross
highest negotiated rate $6,038 exceeds the gross charge $3,269
CPT 55920/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,718 exceeds the gross charge $3,269
CPT 88184/b
warn
mrf_negotiated_above_gross
highest negotiated rate $534 exceeds the gross charge $255
CPT 88319/b
warn
mrf_negotiated_above_gross
highest negotiated rate $970 exceeds the gross charge $325
CPT 27447/b
warn
mrf_negotiated_above_gross
highest negotiated rate $16,036 exceeds the gross charge $6,120
CPT 29827/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,903 exceeds the gross charge $7,382
CPT 11470/b
warn
mrf_negotiated_above_gross
highest negotiated rate $3,399 exceeds the gross charge $2,927
CPT 31573/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,048 exceeds the gross charge $1,175
CPT 58561/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,862 exceeds the gross charge $2,372
CPT 58561/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,718 exceeds the gross charge $2,372
CPT 95044/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,208 exceeds the gross charge $107
MS-DRG 341/i
warn
mrf_negotiated_above_gross
highest negotiated rate $21,874 exceeds the gross charge $12,197
CPT 31628/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,473 exceeds the gross charge $4,090
CPT 31631/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,220 exceeds the gross charge $7,106
CPT 31634/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,220 exceeds the gross charge $1,676
CPT 31634/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,887 exceeds the gross charge $1,676
CPT 31636/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,220 exceeds the gross charge $6,967
CPT 31638/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,467 exceeds the gross charge $7,106
CPT 31645/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,048 exceeds the gross charge $1,176
CPT 31645/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,566 exceeds the gross charge $1,176
CPT 31648/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,378 exceeds the gross charge $1,791
CPT 31652/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,473 exceeds the gross charge $4,947
CPT 31653/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,509 exceeds the gross charge $2,475
CPT 31653/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,134 exceeds the gross charge $2,475
CPT C9602/b
warn
mrf_negotiated_above_gross
highest negotiated rate $20,896 exceeds the gross charge $18,651
CPT C9607/b
warn
mrf_negotiated_above_gross
highest negotiated rate $20,896 exceeds the gross charge $18,720
CPT 33228/b
warn
mrf_negotiated_above_gross
highest negotiated rate $12,800 exceeds the gross charge $9,433
CPT C9784/b
warn
mrf_negotiated_above_gross
highest negotiated rate $12,363 exceeds the gross charge $8,047
CPT 33228/o
warn
mrf_negotiated_above_gross
highest negotiated rate $11,298 exceeds the gross charge $9,433
CPT C9785/b
warn
mrf_negotiated_above_gross
highest negotiated rate $12,363 exceeds the gross charge $4,466
CPT 11646/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,720 exceeds the gross charge $2,490
CPT 33229/b
warn
mrf_negotiated_above_gross
highest negotiated rate $22,646 exceeds the gross charge $9,814
CPT 96002/b
warn
mrf_negotiated_above_gross
highest negotiated rate $370 exceeds the gross charge $184
CPT 33229/o
warn
mrf_negotiated_above_gross
highest negotiated rate $20,217 exceeds the gross charge $9,814
CPT 33233/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,827 exceeds the gross charge $8,746
CPT 33249/b
warn
mrf_negotiated_above_gross
highest negotiated rate $47,589 exceeds the gross charge $41,969
CPT 33262/b
warn
mrf_negotiated_above_gross
highest negotiated rate $27,453 exceeds the gross charge $26,837
CPT 33263/b
warn
mrf_negotiated_above_gross
highest negotiated rate $27,453 exceeds the gross charge $21,131
CPT 33263/o
warn
mrf_negotiated_above_gross
highest negotiated rate $25,154 exceeds the gross charge $21,131
CPT 33264/b
warn
mrf_negotiated_above_gross
highest negotiated rate $38,071 exceeds the gross charge $27,751
CPT 33264/o
warn
mrf_negotiated_above_gross
highest negotiated rate $35,057 exceeds the gross charge $27,751
CPT 33270/b
warn
mrf_negotiated_above_gross
highest negotiated rate $38,071 exceeds the gross charge $19,300
CPT G0379/b
warn
mrf_negotiated_above_gross
highest negotiated rate $728 exceeds the gross charge $134
CPT 33270/o
warn
mrf_negotiated_above_gross
highest negotiated rate $35,057 exceeds the gross charge $19,300
CPT 33274/b
warn
mrf_negotiated_above_gross
highest negotiated rate $23,325 exceeds the gross charge $15,016
CPT 33289/b
warn
mrf_negotiated_above_gross
highest negotiated rate $33,757 exceeds the gross charge $8,900
CPT 36556/b
warn
mrf_negotiated_above_gross
highest negotiated rate $3,850 exceeds the gross charge $3,026
CPT 37187/b
warn
mrf_negotiated_above_gross
highest negotiated rate $13,197 exceeds the gross charge $12,628
CPT J1950/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,696 exceeds the gross charge $1,515
CPT 38220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,359 exceeds the gross charge $542
CPT J3240/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,008 exceeds the gross charge $1,880
CPT 43212/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,281 exceeds the gross charge $1,396
CPT 43233/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,320 exceeds the gross charge $1,769
CPT 43265/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,069 exceeds the gross charge $6,870
CPT 43274/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,281 exceeds the gross charge $7,027
CPT 43276/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,281 exceeds the gross charge $7,163
CPT 64628/b
warn
mrf_negotiated_above_gross
highest negotiated rate $15,279 exceeds the gross charge $3,576
CPT 64628/o
warn
mrf_negotiated_above_gross
highest negotiated rate $13,524 exceeds the gross charge $3,576
CPT 15852/b
warn
mrf_negotiated_above_gross
highest negotiated rate $727 exceeds the gross charge $350
CPT 44381/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,253 exceeds the gross charge $1,649
CPT 15852/o
warn
mrf_negotiated_above_gross
highest negotiated rate $552 exceeds the gross charge $350
CPT 44381/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,696 exceeds the gross charge $1,649
CPT 45347/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,142 exceeds the gross charge $1,589
CPT Q9969/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10 exceeds the gross charge $1
CPT 46607/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,120 exceeds the gross charge $503
CPT 47383/b
warn
mrf_negotiated_above_gross
highest negotiated rate $12,734 exceeds the gross charge $3,559
CPT 47383/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,815 exceeds the gross charge $3,559
CPT 47531/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,316 exceeds the gross charge $585
CPT 47531/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,370 exceeds the gross charge $585
CPT 47534/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,191 exceeds the gross charge $3,293
CPT 47534/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,370 exceeds the gross charge $3,293
CPT 47535/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,191 exceeds the gross charge $2,042
CPT 47536/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,316 exceeds the gross charge $1,200
CPT 47536/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,370 exceeds the gross charge $1,200
CPT 47537/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,147 exceeds the gross charge $748
CPT 47537/o
warn
mrf_negotiated_above_gross
highest negotiated rate $871 exceeds the gross charge $748
CPT 47538/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,256 exceeds the gross charge $2,442
CPT 19281/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,885 exceeds the gross charge $753
CPT 47554/b
warn
mrf_negotiated_above_gross
highest negotiated rate $12,363 exceeds the gross charge $6,229
CPT 19285/b
warn
mrf_negotiated_above_gross
highest negotiated rate $819 exceeds the gross charge $646
CPT 49185/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,982 exceeds the gross charge $917
CPT 75705/b
warn
mrf_negotiated_above_gross
highest negotiated rate $6,419 exceeds the gross charge $2,298
CPT 49505/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,570 exceeds the gross charge $2,770
CPT 49505/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,056 exceeds the gross charge $2,770
CPT 49591/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,623 exceeds the gross charge $1,618
CPT 49591/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,935 exceeds the gross charge $1,618
CPT 49592/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,420 exceeds the gross charge $2,245
CPT 49592/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,790 exceeds the gross charge $2,245
CPT 49593/b
warn
mrf_negotiated_above_gross
highest negotiated rate $8,173 exceeds the gross charge $2,704
CPT 0442T/o
warn
mrf_negotiated_above_gross
highest negotiated rate $6,864 exceeds the gross charge $3,069
CPT 49593/o
warn
mrf_negotiated_above_gross
highest negotiated rate $9,844 exceeds the gross charge $2,704
MS-DRG 945/i
warn
mrf_negotiated_above_gross
highest negotiated rate $18,714 exceeds the gross charge $18,208
CPT 0823T/b
warn
mrf_negotiated_above_gross
highest negotiated rate $22,646 exceeds the gross charge $13,271
CPT 49594/b
warn
mrf_negotiated_above_gross
highest negotiated rate $7,420 exceeds the gross charge $3,515
CPT 0823T/o
warn
mrf_negotiated_above_gross
highest negotiated rate $20,023 exceeds the gross charge $13,271
CPT 49594/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,790 exceeds the gross charge $3,515
CPT 50431/b
warn
mrf_negotiated_above_gross
highest negotiated rate $777 exceeds the gross charge $496
CPT C1717/b
warn
mrf_negotiated_above_gross
highest negotiated rate $353 exceeds the gross charge $333
CPT 50432/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,095 exceeds the gross charge $1,613
CPT 50434/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,384 exceeds the gross charge $1,555
CPT 50435/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,384 exceeds the gross charge $753
CPT 10035/b
warn
mrf_negotiated_above_gross
highest negotiated rate $819 exceeds the gross charge $638
CPT 50435/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,984 exceeds the gross charge $753
CPT 78999/b
warn
mrf_negotiated_above_gross
highest negotiated rate $477 exceeds the gross charge $360
warn
mrf_rate_without_estimate
398 of 398 percentage/algorithm rates across 228 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
MS-DRG 165/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $346,290; the same hospital's average submitted charge to Medicare for this DRG is $93,507 (3.7×)
MS-DRG 167/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $365,952; the same hospital's average submitted charge to Medicare for this DRG is $111,583 (3.3×)
MS-DRG 178/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $563,664; the same hospital's average submitted charge to Medicare for this DRG is $60,388 (9.3×)
MS-DRG 181/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $329,884; the same hospital's average submitted charge to Medicare for this DRG is $68,166 (4.8×)
MS-DRG 191/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $197,378; the same hospital's average submitted charge to Medicare for this DRG is $45,567 (4.3×)
MS-DRG 205/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $26,937; the same hospital's average submitted charge to Medicare for this DRG is $145,141 (0.2×)
MS-DRG 207/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $78,971; the same hospital's average submitted charge to Medicare for this DRG is $455,448 (0.2×)
MS-DRG 233/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $59,495; the same hospital's average submitted charge to Medicare for this DRG is $350,100 (0.2×)
MS-DRG 304/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $372,273; the same hospital's average submitted charge to Medicare for this DRG is $50,140 (7.4×)
MS-DRG 305/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $169,590; the same hospital's average submitted charge to Medicare for this DRG is $48,468 (3.5×)
MS-DRG 312/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $1,499,038; the same hospital's average submitted charge to Medicare for this DRG is $53,132 (28.2×)
MS-DRG 326/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $82,763; the same hospital's average submitted charge to Medicare for this DRG is $252,495 (0.3×)
MS-DRG 690/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $423,199; the same hospital's average submitted charge to Medicare for this DRG is $42,191 (10.0×)
MS-DRG 841/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $675,854; the same hospital's average submitted charge to Medicare for this DRG is $93,785 (7.2×)
MS-DRG 863/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $628,379; the same hospital's average submitted charge to Medicare for this DRG is $39,080 (16.1×)
CPT 10160/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 differ, so no cross-line comparison was made for this item
CPT 21025/o
info
mrf_item_fields_vary
this code and setting cover at least 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 51703/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 81240/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 C1732/o
info
mrf_item_fields_vary
this code and setting cover at least 11 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 173/i
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross differ, so no cross-line comparison was made for this item
CPT 10180/b
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 21026/b
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 differ, so no cross-line comparison was made for this item
CPT 51705/b
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 81265/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT C1733/b
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 174/i
info
mrf_item_fields_vary
this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their gross differ, so no cross-line comparison was made for this item
CPT 10180/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min differ, so no cross-line comparison was made for this item
CPT 51741/b
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 81404/b
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 C1733/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 175/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11042/b
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 21320/b
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 51741/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 81405/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT C1750/b
info
mrf_item_fields_vary
this code and setting cover at least 23 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 176/i
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11042/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 21552/b
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 51797/b
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 81479/b
info
mrf_item_fields_vary
this code and setting cover at least 399 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 C1750/o
info
mrf_item_fields_vary
this code and setting cover at least 23 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 177/i
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11043/b
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 21552/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 differ, so no cross-line comparison was made for this item
CPT 51797/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 81479/o
info
mrf_item_fields_vary
this code and setting cover at least 399 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 C1751/b
info
mrf_item_fields_vary
this code and setting cover at least 24 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 178/i
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11044/b
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 differ, so no cross-line comparison was made for this item
CPT 21554/b
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 52000/b
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 83520/b
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 C1751/o
info
mrf_item_fields_vary
this code and setting cover at least 24 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 179/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11044/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 differ, so no cross-line comparison was made for this item
CPT 21554/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 differ, so no cross-line comparison was made for this item
CPT 52000/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 differ, so no cross-line comparison was made for this item
CPT 83520/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 C1752/b
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
MS-DRG 180/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11045/b
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 21555/b
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 52310/b
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 84393/b
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 C1752/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
MS-DRG 181/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11045/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 21555/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 differ, so no cross-line comparison was made for this item
CPT 52310/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 differ, so no cross-line comparison was made for this item
CPT 84393/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 C1753/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 182/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11055/b
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 differ, so no cross-line comparison was made for this item
CPT 21556/b
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 54050/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 differ, so no cross-line comparison was made for this item
CPT C1753/o
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 183/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
CPT 11055/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 differ, so no cross-line comparison was made for this item
CPT 21556/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 54056/b
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 86849/b
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 C1758/b
info
mrf_item_fields_vary
this code and setting cover at least 13 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
MS-DRG 190/i
info
mrf_item_fields_vary
this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, min, max differ, so no cross-line comparison was made for this item
Showing the first 200 of 1,556 findings, errors first — every finding as JSON →
04 · Checks
Where the Medicare rows do not agree with themselves
Service
Severity
Rule
Detail
MS-DRG 652
info
inp_charge_10x_payment
average charge $371,332 is 10.1× 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)
- Brigham and Women's Hospital — standard charges file · MA · updated 2026-03-27· csv-tall · 2.9M bytes · fetched 2026-08-22 · sha256 188337340e25…
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.