Project Crossfoot
Hospital · CCN 250138

Merit Health River Oaks

1030 River Oaks Drive, Flowood, MS 39232 · Rankin County
Part of Community Health Systems · 158 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

29 admission types 46 outpatient services price file: ok 28 Medicare-file findings
Billed per dollar paid, all admissions
14.66×
$150.8M billed against $10.3M paid across 726 Medicare discharges; the national figure is 5.03×.
4.1%
of adults in Rankin County have medical debt in collections
10.9%
uninsured in the county · state 13.1%
$71K
median household income
13.6×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (3 in the inpatient or outpatient file)ⓘ
36.6%
obesity in the countyⓘ
12.1%
diagnosed diabetes (PLACES)
6.0%
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
470
Major hip and knee joint replacement or reattachment of lower extremity without mcc
106
$246,386
$12,864
19.2× st 7.0×
871
Septicemia or severe sepsis without mv >96 hours with mcc
97
$161,107
$12,099
13.3× st 4.6×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
33
$288,290
$18,702
15.4× st 7.5×
522
Hip replacement with principal diagnosis of hip fracture without mcc
30
$228,725
$13,994
16.3× st 4.9×
468
Revision of hip or knee replacement without cc/mcc
29
$324,231
$17,967
18.0× st 10.7×
193
Simple pneumonia and pleurisy with mcc
27
$118,686
$8,783
13.5× st 5.0×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
25
$82,249
$5,831
14.1× st 5.0×
455
Combined anterior and posterior spinal fusion without cc/mcc
24
$385,717
$32,157
12.0× st 9.9×
378
Gastrointestinal hemorrhage with cc
23
$88,921
$6,991
12.7× st 5.2×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
23
$202,056
$12,193
16.6× st 8.6×
280
Acute myocardial infarction, discharged alive with mcc
23
$110,186
$11,260
9.8× st 4.4×
481
Hip and femur procedures except major joint with cc
21
$225,558
$13,784
16.4× st 4.7×
274
Percutaneous and other intracardiac procedures without mcc
21
$288,176
$21,112
13.7× st 4.1×
291
Heart failure and shock with mcc
20
$100,435
$8,767
11.5× st 4.6×
467
Revision of hip or knee replacement with cc
20
$359,219
$19,815
18.1× st 5.5×
683
Renal failure with cc
18
$90,251
$6,421
14.1× st 4.4×
853
Infectious and parasitic diseases with o.r. procedures with mcc
18
$539,953
$40,920
13.2× st 4.5×
177
Respiratory infections and inflammations with mcc
18
$155,324
$11,312
13.7× st 4.6×
460
Spinal fusion except cervical without mcc
17
$286,728
$28,008
10.2× st 5.1×
472
Cervical spinal fusion with cc
16
$273,727
$19,392
14.1× st 5.3×
872
Septicemia or severe sepsis without mv >96 hours without mcc
16
$95,012
$7,412
12.8× st 4.5×
682
Renal failure with mcc
15
$121,463
$10,198
11.9× st 4.6×
482
Hip and femur procedures except major joint without cc/mcc
13
$142,849
$10,372
13.8× st 5.3×
473
Cervical spinal fusion without cc/mcc
13
$251,929
$17,754
14.2× st 14.2×
281
Acute myocardial infarction, discharged alive with cc
13
$99,805
$6,749
14.8× st 6.1×
194
Simple pneumonia and pleurisy with cc
13
$82,524
$6,099
13.5× st 5.2×
690
Kidney and urinary tract infections without mcc
12
$64,261
$5,914
10.9× st 4.1×
483
Major joint or limb reattachment procedures of upper extremities
11
$271,786
$16,521
16.5× st 7.0×
377
Gastrointestinal hemorrhage with mcc
11
$139,609
$12,114
11.5× st 4.7×
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
5302
Level 2 Upper GI Procedures
213
$28,711
$1,579
18.2×
5116
Level 6 Musculoskeletal Procedures
186
$271,930
$15,513
17.5×
5115
Level 5 Musculoskeletal Procedures
159
$212,181
$11,006
19.3×
5114
Level 4 Musculoskeletal Procedures
145
$141,959
$5,924
24.0×
5362
Level 2 Laparoscopy and Related Services
130
$197,948
$8,573
23.1×
5213
Level 3 Electrophysiologic Procedures
82
$229,865
$19,612
11.7×
5194
Level 4 Endovascular Procedures
41
$176,214
$13,977
12.6×
8011
Comprehensive Observation Services
39
$43,892
$2,245
19.6×
5191
Level 1 Endovascular Procedures
38
$44,396
$2,732
16.2×
5361
Level 1 Laparoscopy and Related Services
36
$114,421
$4,723
24.2×
5374
Level 4 Urology and Related Services
32
$70,452
$2,773
25.4×
5303
Level 3 Upper GI Procedures
32
$61,731
$3,127
19.7×
5331
Complex GI Procedures
31
$78,117
$4,771
16.4×
5183
Level 3 Vascular Procedures
31
$60,919
$2,668
22.8×
5193
Level 3 Endovascular Procedures
22
$103,576
$9,205
11.3×
5113
Level 3 Musculoskeletal Procedures
20
$80,682
$2,426
33.3×
5184
Level 4 Vascular Procedures
18
$112,218
$4,404
25.5×
5415
Level 5 Gynecologic Procedures
16
$128,189
$4,164
30.8×
5223
Level 3 Pacemaker and Similar Procedures
15
$121,239
$8,449
14.4×
5313
Level 3 Lower GI Procedures
14
$41,404
$2,350
17.6×
5222
Level 2 Pacemaker and Similar Procedures
14
$75,042
$7,112
10.6×
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5373
Level 3 Urology and Related Services
—
—
—
—
5377
Level 7 Urology and Related Services
—
—
—
—
5375
Level 5 Urology and Related Services
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5378
Level 8 Urology and Related Services
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5465
Level 5 Neurostimulator and Related Procedures
—
—
—
—
5414
Level 4 Gynecologic Procedures
—
—
—
—
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5112
Level 2 Musculoskeletal Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5154
Level 4 Airway Endoscopy
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5182
Level 2 Vascular Procedures
—
—
—
—
5192
Level 2 Endovascular Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
—
—
—
—
5232
Level 2 ICD and Similar Procedures
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
—
—
—
—
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, 52,284 rows scanned, 2,819 distinct code–setting items kept. 1,740 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
BONE SRGRY CMPTR CT/MRI IMAG
CPT 0055T
$212,520
$38,254
$127,512
31
clean
S-TRL PERI ATH ILIAC[MSMH]
CPT 0238T
$77,953
$14,032
$24,106
112
clean
IR Endo FemPop Art Rev IntraStent Place
CPT 0505T
$48,905
$8,803
$15,153
56
clean
S-3-D FFR MAPPING (INCLUDES ALL FFR/IFR/DFR)[MSMH]
CPT 0523T
$11,717
$2,109
$7,791
30
clean
P-TCAT INS 1CHAMB LDLS PM R ATR PM CMPN[MSMH]
CPT 0823T
$82,387
$14,830
$25,401
56
clean
US Fine Needle Asp w Img 1st Lesion
CPT 10005
$2,099
$378
$650
254
clean
FNA BX W/US GDN EA ADDL
CPT 10006
$14,030
$2,525
$8,067
32
clean
FNA BX W/CT GDN 1ST LES
CPT 10009
$9,518
$1,713
$969
64
clean
IR Drain Soft Tissue
CPT 10030
$4,696
$845
$935
126
clean
DRAINAGE OF SKIN ABSCESS
CPT 10060
$8,154
$1,468
$295
64
clean
DRAINAGE OF SKIN ABSCESS
CPT 10061
$5,432
$978
$551
64
clean
DRAINAGE OF PILONIDAL CYST
CPT 10080
$2,985
$537
$847
64
clean
REMOVE FOREIGN BODY
CPT 10120
$16,133
$2,904
$587
64
clean
DRAINAGE OF HEMATOMA/FLUID
CPT 10140
$84,651
$15,237
$2,642
64
clean
PUNCTURE DRAINAGE OF LESION
CPT 10160
$4,043
$728
$551
64
clean
DEBRIDE SKIN/TISSUE
CPT 11042
$74,119
$13,341
$635
64
clean
DEBRIDE TISSUE/MUSCLE
CPT 11043
$74,848
$13,473
$1,151
64
clean
DEBRIDE TISSUE/MUSCLE/BONE
CPT 11044
$85,630
$15,413
$2,572
64
clean
DBRDMT SUBQ TISS EACH ADDL
CPT 11045
$81,015
$14,583
$46,584
32
clean
INCAL BX SKN SINGLE LES
CPT 11106
$95,485
$17,187
$1,255
64
clean
INCAL BX SKN EA SEP/ADDL
CPT 11107
$95,485
$17,187
$54,904
32
clean
REMOVAL OF SKIN TAGS
CPT 11200
$37,870
$6,817
$314
64
clean
REMOVAL OF SKIN LESION
CPT 11401
$66,976
$12,056
$635
64
clean
REMOVAL OF SKIN LESION
CPT 11402
$128,528
$23,135
$1,277
64
clean
REMOVAL OF SKIN LESION
CPT 11403
$41,883
$7,539
$1,139
64
clean
REMOVAL OF SKIN LESION
CPT 11406
$60,584
$10,905
$2,642
64
clean
REMOVAL OF SKIN LESION
CPT 11420
$54,699
$9,846
$2,572
64
clean
REMOVAL OF SKIN LESION
CPT 11421
$74,849
$13,473
$1,139
64
clean
REMOVAL OF SKIN LESION
CPT 11422
$215,347
$38,762
$8,110
64
clean
REMOVAL OF SKIN LESION
CPT 11426
$105,242
$18,944
$4,839
64
clean
REMOVAL, SWEAT GLAND LESION
CPT 11450
$115,922
$20,866
$4,842
64
clean
REMOVAL, SWEAT GLAND LESION
CPT 11463
$153,059
$27,551
$4,985
64
clean
REMOVAL OF SKIN LESION
CPT 11606
$132,345
$23,822
$2,773
64
clean
REMOVAL OF SKIN LESION
CPT 11622
$91,734
$16,512
$1,139
64
clean
REMOVAL OF SKIN LESION
CPT 11626
$147,333
$26,520
$4,988
64
clean
REMOVAL OF SKIN LESION
CPT 11640
$75,122
$13,522
$1,139
64
clean
REMOVAL OF SKIN LESION
CPT 11643
$82,485
$14,847
$2,572
64
clean
REMOVAL OF NAIL PLATE
CPT 11730
$12,764
$2,297
$295
64
clean
DRAIN BLOOD FROM UNDER NAIL
CPT 11740
$4,663
$839
$191
64
clean
REMOVAL OF NAIL BED
CPT 11750
$3,439
$619
$547
64
clean
REPAIR OF NAIL BED
CPT 11760
$3,941
$709
$829
64
clean
REMOVAL OF PILONIDAL LESION
CPT 11772
$120,642
$21,716
$4,986
64
clean
INSERTION DRUG DLVR IMPLANT
CPT 11981
$116,187
$20,914
$236
64
clean
REMOVE DRUG IMPLANT DEVICE
CPT 11982
$59,174
$10,651
$696
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12001
$7,935
$1,428
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12002
$8,775
$1,580
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12004
$8,815
$1,587
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12005
$12,900
$2,322
$587
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12011
$9,335
$1,680
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12013
$14,218
$2,559
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12014
$12,636
$2,275
$295
64
clean
REPAIR SUPERFICIAL WOUND(S)
CPT 12015
$25,902
$4,662
$295
64
clean
CLOSURE OF SPLIT WOUND
CPT 12020
$75,706
$13,627
$1,151
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12031
$72,266
$13,008
$635
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12032
$21,617
$3,891
$587
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12034
$7,207
$1,297
$587
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12041
$6,212
$1,118
$587
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12042
$21,072
$3,793
$587
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12051
$2,479
$446
$522
64
clean
LAYER CLOSURE OF WOUND(S)
CPT 12052
$2,529
$455
$523
64
clean
LATE CLOSURE OF WOUND
CPT 13160
$69,574
$12,523
$4,799
64
clean
SKIN TISSUE REARRANGEMENT
CPT 14020
$111,985
$20,157
$3,019
64
clean
SKIN TISSUE REARRANGEMENT
CPT 14040
$107,140
$19,285
$2,833
64
clean
TIS TRNFR ANY 30.1-60 SQ CM
CPT 14301
$128,349
$23,103
$5,674
64
clean
TIS TRNFR ADDL 30 SQ CM
CPT 14302
$128,349
$23,103
$73,800
32
clean
SKIN FULL GRAFT
CPT 15260
$82,485
$14,847
$2,833
64
clean
SKIN SUB GRAFT TRNK/ARM/LEG
CPT 15271
$178,069
$32,052
$6,603
62
clean
Suture or Staple Removal
CPT 15853
$672
$121
$370
64
clean
Suture and Staple Removal
CPT 15854
$950
$171
$523
64
clean
INITIAL TREATMENT OF BURN(S)
CPT 16000
$4,218
$759
$295
64
clean
TREATMENT OF BURN(S)
CPT 16020
$4,800
$864
$295
64
clean
TREATMENT OF BURN(S)
CPT 16025
$17,371
$3,127
$295
64
clean
INCISION OF BREAST LESION
CPT 19020
$87,517
$15,753
$2,872
64
clean
REMOVAL OF BREAST LESION
CPT 19120
$63,759
$11,477
$5,779
64
clean
MAST SIMPLE COMPLETE
CPT 19303
$335,910
$60,464
$13,270
64
clean
BREAST RECONSTRUCTION
CPT 19357
$335,910
$60,464
$19,682
62
clean
DEEP MUSCLE BIOPSY
CPT 20205
$66,512
$11,972
$4,524
64
clean
REMOVAL OF FOREIGN BODY
CPT 20520
$144,373
$25,987
$2,742
64
clean
NJX 1/MLT TRIGGER POINTS 3/>
CPT 20553
$75,116
$13,521
$491
64
clean
NDL WO INJ 1 2 M PT - REDOC 181
CPT 20560
$146
$26
$39
57
clean
NDL WO INJ 3PL M PT - REDOC 181
CPT 20561
$146
$26
$39
57
clean
DRAIN/INJECT, JOINT/BURSA
CPT 20600
$59,586
$10,726
$491
64
clean
DRAIN/INJECT, JOINT/BURSA
CPT 20605
$23,381
$4,209
$443
64
clean
20610 - Arthrocentesis, aspiration and/or injectio
CPT 20610
$2,555
$460
$390
574
clean
DRAIN/INJ JOINT/BURSA W/US
CPT 20611
$14,956
$2,692
$443
64
clean
REMOVAL OF SUPPORT IMPLANT
CPT 20680
$119,190
$21,454
$4,864
64
clean
MNL PREP&INSJ DP RX DLVR DEV
CPT 20700
$123,852
$22,293
$71,215
32
clean
REMOVAL OF BONE FOR GRAFT
CPT 20900
$225,037
$40,507
$10,482
62
clean
REMOVAL OF FASCIA FOR GRAFT
CPT 20922
$126,518
$22,773
$3,635
64
clean
SPINAL BONE ALLOGRAFT
CPT 20931
$233,302
$41,994
$134,149
32
clean
SPINAL BONE AUTOGRAFT
CPT 20937
$327,117
$58,881
$188,092
32
clean
BONE MARROW ASPIR BONE GRFG
CPT 20939
$225,556
$40,600
$129,695
32
clean
CPTR-ASST DIR MS PX
CPT 20985
$208,993
$37,619
$120,171
32
clean
MUSCULOSKELETAL SURGERY
CPT 20999
$108,034
$19,446
$486
63
clean
EXC FACE LES SBQ 2 CM/>
CPT 21012
$78,530
$14,135
$2,572
64
clean
EXCISION OF BONE, LOWER JAW
CPT 21025
$146,358
$26,344
$8,552
64
clean
RECONSTRUCT MIDFACE, LEFORT
CPT 21141
$185,091
$33,316
$9,633
57
clean
LOWER JAW BONE GRAFT
CPT 21215
$146,358
$26,344
$8,017
62
clean
TREAT LOWER JAW FRACTURE
CPT 21461
$131,079
$23,594
$8,017
62
clean
TREAT LOWER JAW FRACTURE
CPT 21462
$111,669
$20,100
$8,017
62
clean
TREAT LOWER JAW FRACTURE
CPT 21465
$112,061
$20,171
$8,017
62
clean
RESET DISLOCATED JAW
CPT 21480
$9,618
$1,731
$356
64
clean
DRAIN NECK/CHEST LESION
CPT 21501
$26,022
$4,684
$4,006
64
clean
EXC NECK LES SC 3 CM/>
CPT 21552
$53,504
$9,631
$4,842
64
clean
EXC NECK TUM DEEP 5 CM/>
CPT 21554
$62,816
$11,307
$4,839
64
clean
REMOVE LESION, BACK OR FLANK
CPT 21930
$109,723
$19,750
$2,774
64
clean
EXC BACK LES SC 3 CM/>
CPT 21931
$81,806
$14,725
$2,873
64
clean
TREAT SPINE FRACTURE
CPT 22325
$170,174
$30,631
$19,349
57
clean
PERQ VERTEBRAL AUGMENTATION
CPT 22513
$121,571
$21,883
$10,491
64
clean
ARTHRD ANT NTRBDY CERVICAL
CPT 22551
$197,355
$35,524
$17,820
62
clean
ARTHRD ANT NTRBD CERVICAL EA
CPT 22552
$220,991
$39,778
$127,070
32
clean
NECK SPINE FUSION
CPT 22554
$164,049
$29,529
$17,519
62
clean
THORAX SPINE FUSION
CPT 22556
$301,092
$54,197
$26,912
57
clean
THORAX SPINE FUSION
CPT 22610
$358,957
$64,612
$26,912
57
clean
LUMBAR SPINE FUSION
CPT 22612
$237,249
$42,705
$23,746
62
clean
SPINE FUSION, EXTRA SEGMENT
CPT 22614
$352,857
$63,514
$202,893
32
clean
LUMBAR SPINE FUSION
CPT 22630
$292,259
$52,607
$34,132
56
clean
SPINE FUSION, EXTRA SEGMENT
CPT 22632
$344,328
$61,979
$184,216
32
clean
ARTHRD CMBN 1NTRSPC LUMBAR
CPT 22633
$295,912
$53,264
$37,124
56
clean
ARTHRD CMBN 1NTRSPC EA ADDL
CPT 22634
$398,316
$71,697
$229,032
32
clean
FUSION OF SPINE
CPT 22810
$225,301
$40,554
$24,933
57
clean
INSERT SPINE FIXATION DEVICE
CPT 22840
$280,191
$50,434
$149,902
32
clean
INSERT SPINE FIXATION DEVICE
CPT 22842
$395,222
$71,140
$211,444
32
clean
INSERT SPINE FIXATION DEVICE
CPT 22845
$194,012
$34,922
$103,796
32
clean
INSERT SPINE FIXATION DEVICE
CPT 22846
$238,788
$42,982
$100,291
32
clean
REMOVE SPINE FIXATION DEVICE
CPT 22850
$130,237
$23,443
$11,465
59
clean
INSJ BIOMECHANICAL DEVICE
CPT 22853
$259,884
$46,779
$149,433
32
clean
INSJ BIOMECHANICAL DEVICE
CPT 22854
$271,534
$48,876
$156,132
32
clean
REMOVE SPINE FIXATION DEVICE
CPT 22855
$229,107
$41,239
$14,282
59
clean
INSJ BIOMECHANICAL DEVICE
CPT 22859
$328,169
$59,070
$188,697
32
clean
ABDOMEN SURGERY PROCEDURE
CPT 22999
$142,841
$25,711
$5,720
63
clean
RELEASE SHOULDER JOINT
CPT 23020
$178,893
$32,201
$7,523
64
clean
EXC SHOULDER LES SC 3 CM/>
CPT 23071
$53,248
$9,585
$2,873
64
clean
EXC SHOULDER TUM DEEP 5 CM/>
CPT 23073
$71,612
$12,890
$4,840
64
clean
REMOVE SHOULDER JOINT LINING
CPT 23105
$193,984
$34,917
$11,301
64
clean
S-INJ SHOULDER ARTH
CPT 23350
$651
$117
$553
96
clean
RELEASE OF SHOULDER LIGAMENT
CPT 23415
$96,634
$17,394
$9,835
64
clean
REPAIR OF SHOULDER
CPT 23420
$156,831
$28,230
$10,491
64
clean
REPAIR BICEPS TENDON
CPT 23430
$161,487
$29,068
$9,835
64
clean
RECONSTRUCT SHOULDER JOINT
CPT 23470
$249,589
$44,926
$17,820
62
clean
RECONSTRUCT SHOULDER JOINT
CPT 23472
$219,990
$39,598
$22,982
62
clean
REVISION OF COLLAR BONE
CPT 23485
$125,425
$22,577
$17,519
62
clean
TREAT CLAVICLE FRACTURE
CPT 23515
$112,260
$20,207
$9,835
62
clean
TREAT CLAVICLE DISLOCATION
CPT 23550
$96,040
$17,287
$9,827
62
clean
TREAT SCAPULA FRACTURE
CPT 23585
$81,882
$14,739
$9,827
62
clean
TREAT HUMERUS FRACTURE
CPT 23615
$147,904
$26,623
$17,519
62
clean
TREAT SHOULDER DISLOCATION
CPT 23650
$16,799
$3,024
$356
64
clean
TREAT SHOULDER DISLOCATION
CPT 23655
$21,357
$3,844
$2,379
64
clean
FIXATION OF SHOULDER
CPT 23700
$33,507
$6,031
$2,493
64
clean
SHOULDER SURGERY PROCEDURE
CPT 23929
$111,255
$20,026
$486
63
clean
DRAINAGE OF ARM LESION
CPT 23930
$59,244
$10,664
$4,836
64
clean
DRAINAGE OF ARM BURSA
CPT 23931
$2,994
$539
$1,516
64
clean
EXPLORATORY ELBOW SURGERY
CPT 24000
$102,511
$18,452
$5,484
64
clean
EXC ARM/ELBOW LES SC 3 CM/>
CPT 24071
$75,735
$13,632
$4,841
64
clean
REMOVE ARM/ELBOW LESION
CPT 24075
$71,217
$12,819
$2,642
64
clean
REMOVAL OF ELBOW BURSA
CPT 24105
$80,815
$14,547
$5,238
64
clean
REMOVAL OF HEAD OF RADIUS
CPT 24130
$236,147
$42,506
$9,112
64
clean
PARTIAL REMOVAL OF ELBOW
CPT 24147
$88,683
$15,963
$5,511
64
clean
S-INJ ELBOW ARTHRO
CPT 24220
$643
$116
$466
64
clean
MNPJ ELBOW UNDER ANES
CPT 24300
$54,916
$9,885
$2,575
64
clean
TENOLYSIS TRICEPS
CPT 24332
$72,431
$13,038
$5,518
64
clean
REPAIR OF BICEPS TENDON
CPT 24340
$174,959
$31,493
$11,301
64
clean
REPAIR ARM TENDON/MUSCLE
CPT 24341
$148,604
$26,749
$10,491
64
clean
REPAIR OF RUPTURED TENDON
CPT 24342
$118,473
$21,325
$9,835
64
clean
REPR ELBOW LAT LIGMNT W/TISS
CPT 24343
$68,177
$12,272
$5,353
64
clean
REPAIR ELBOW W/DEB OPEN
CPT 24358
$93,557
$16,840
$5,462
64
clean
REPAIR ELBOW DEB/ATTCH OPEN
CPT 24359
$98,269
$17,688
$5,442
64
clean
REPAIR OF HUMERUS
CPT 24430
$176,984
$31,857
$17,763
62
clean
TREAT HUMERUS FRACTURE
CPT 24505
$13,273
$2,389
$2,178
64
clean
TREAT HUMERUS FRACTURE
CPT 24515
$147,012
$26,462
$17,519
62
clean
TREAT HUMERUS FRACTURE
CPT 24516
$144,815
$26,067
$17,519
62
clean
TREAT HUMERUS FRACTURE
CPT 24545
$233,058
$41,950
$17,820
62
clean
TREAT HUMERUS FRACTURE
CPT 24546
$210,444
$37,880
$17,820
62
clean
TREAT ELBOW DISLOCATION
CPT 24600
$22,714
$4,089
$363
64
clean
TREAT ELBOW DISLOCATION
CPT 24605
$124,198
$22,356
$2,642
64
clean
TREAT ELBOW FRACTURE
CPT 24620
$7,260
$1,307
$2,058
64
clean
TREAT ELBOW DISLOCATION
CPT 24640
$4,666
$840
$356
64
clean
TREAT RADIUS FRACTURE
CPT 24666
$129,212
$23,258
$17,519
62
clean
TREAT ULNAR FRACTURE
CPT 24685
$123,163
$22,169
$9,835
62
clean
INCISION OF TENDON SHEATH
CPT 25000
$88,947
$16,010
$2,727
64
clean
REMOVE WRIST TENDON LESION
CPT 25111
$57,400
$10,332
$2,727
64
clean
EXCISE WRIST TENDON SHEATH
CPT 25118
$61,686
$11,104
$2,727
64
clean
REMOVAL OF WRIST BONES
CPT 25215
$184,498
$33,210
$7,634
64
clean
REVISE WRIST JOINT
CPT 25332
$184,498
$33,210
$7,568
62
clean
REPAIR RADIUS OR ULNA
CPT 25400
$87,605
$15,769
$9,827
62
clean
REPAIR WRIST JOINT(S)
CPT 25447
$124,985
$22,497
$5,587
64
clean
TREAT FRACTURE OF RADIUS
CPT 25515
$113,105
$20,359
$9,835
62
clean
TREAT FRACTURE OF ULNA
CPT 25545
$113,280
$20,390
$9,835
62
clean
TREAT FRACTURE RADIUS/ULNA
CPT 25575
$139,992
$25,199
$9,835
62
clean
TREAT FRACTURE RADIUS/ULNA
CPT 25605
$22,676
$4,082
$2,239
64
clean
OPTX DST RD XARTC FX/EPI SEP
CPT 25607
$124,390
$22,390
$9,835
62
clean
OPTX DST RD XART FX/EPI SEP2
CPT 25608
$99,556
$17,920
$9,835
62
clean
OPTX DST RD XART FX/EP SEP3+
CPT 25609
$108,091
$19,456
$9,835
62
clean
FOREARM OR WRIST SURGERY
CPT 25999
$184,498
$33,210
$7,376
63
clean
DRAINAGE OF FINGER ABSCESS
CPT 26010
$5,310
$956
$296
64
clean
DRAINAGE OF FINGER ABSCESS
CPT 26011
$3,144
$566
$1,516
64
clean
INCISE FINGER TENDON SHEATH
CPT 26055
$55,791
$10,042
$2,575
64
clean
EXC HAND TUM DEEP 1.5 CM/>
CPT 26113
$66,115
$11,901
$2,871
64
clean
RELEASE PALM CONTRACTURE
CPT 26123
$100,737
$18,133
$5,515
64
clean
TENDON EXCISION, PALM/FINGER
CPT 26145
$67,448
$12,141
$2,575
64
clean

Showing the first 200 of 2,819 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
CPT 86226/o
warn
mrf_negotiated_above_gross
highest negotiated rate $27 exceeds the gross charge $17
CPT 81276/o
warn
mrf_negotiated_above_gross
highest negotiated rate $435 exceeds the gross charge $320
CPT 81329/o
warn
mrf_negotiated_above_gross
highest negotiated rate $236 exceeds the gross charge $21
CPT 81408/o
warn
mrf_negotiated_above_gross
highest negotiated rate $4,500 exceeds the gross charge $4,229
CPT 86615/o
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $13
CPT 82075/o
warn
mrf_negotiated_above_gross
highest negotiated rate $68 exceeds the gross charge $45
CPT 95938/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,744 exceeds the gross charge $1,598
CPT 96367/o
warn
mrf_negotiated_above_gross
highest negotiated rate $493 exceeds the gross charge $434
CPT 82261/o
warn
mrf_negotiated_above_gross
highest negotiated rate $38 exceeds the gross charge $21
CPT 86720/o
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $8
CPT 99000/o
warn
mrf_negotiated_above_gross
highest negotiated rate $22 exceeds the gross charge $10
CPT 86794/o
warn
mrf_negotiated_above_gross
highest negotiated rate $493 exceeds the gross charge $151
CPT 20560/o
warn
mrf_negotiated_above_gross
highest negotiated rate $176 exceeds the gross charge $146
CPT 20561/o
warn
mrf_negotiated_above_gross
highest negotiated rate $176 exceeds the gross charge $146
CPT 86812/o
warn
mrf_negotiated_above_gross
highest negotiated rate $58 exceeds the gross charge $35
CPT 99407/o
warn
mrf_negotiated_above_gross
highest negotiated rate $169 exceeds the gross charge $142
CPT 86902/o
warn
mrf_negotiated_above_gross
highest negotiated rate $789 exceeds the gross charge $690
CPT 31502/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,605 exceeds the gross charge $1,386
CPT 82595/o
warn
mrf_negotiated_above_gross
highest negotiated rate $15 exceeds the gross charge $9
CPT 86905/o
warn
mrf_negotiated_above_gross
highest negotiated rate $789 exceeds the gross charge $55
CPT 51600/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,605 exceeds the gross charge $1,060
CPT 32557/o
warn
mrf_negotiated_above_gross
highest negotiated rate $7,008 exceeds the gross charge $3,627
CPT 82760/o
warn
mrf_negotiated_above_gross
highest negotiated rate $25 exceeds the gross charge $21
CPT 82776/o
warn
mrf_negotiated_above_gross
highest negotiated rate $26 exceeds the gross charge $21
CPT 87184/o
warn
mrf_negotiated_above_gross
highest negotiated rate $16 exceeds the gross charge $7
CPT 87220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $10 exceeds the gross charge $6
CPT 87389/o
warn
mrf_negotiated_above_gross
highest negotiated rate $54 exceeds the gross charge $24
CPT 83088/o
warn
mrf_negotiated_above_gross
highest negotiated rate $66 exceeds the gross charge $30
CPT 36014/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,939 exceeds the gross charge $2,768
CPT 23931/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,355 exceeds the gross charge $2,994
CPT 36215/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,833 exceeds the gross charge $3,480
CPT 36217/o
warn
mrf_negotiated_above_gross
highest negotiated rate $6,527 exceeds the gross charge $5,881
CPT 87660/o
warn
mrf_negotiated_above_gross
highest negotiated rate $45 exceeds the gross charge $27
CPT 24220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,605 exceeds the gross charge $643
CPT 83704/o
warn
mrf_negotiated_above_gross
highest negotiated rate $68 exceeds the gross charge $30
CPT 36246/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,094 exceeds the gross charge $2,808
CPT 36247/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,291 exceeds the gross charge $3,510
CPT 87902/o
warn
mrf_negotiated_above_gross
highest negotiated rate $579 exceeds the gross charge $323
CPT 83789/o
warn
mrf_negotiated_above_gross
highest negotiated rate $47 exceeds the gross charge $21
CPT 88237/o
warn
mrf_negotiated_above_gross
highest negotiated rate $323 exceeds the gross charge $273
CPT 88239/o
warn
mrf_negotiated_above_gross
highest negotiated rate $332 exceeds the gross charge $221
CPT 84143/o
warn
mrf_negotiated_above_gross
highest negotiated rate $51 exceeds the gross charge $43
CPT 84145/o
warn
mrf_negotiated_above_gross
highest negotiated rate $61 exceeds the gross charge $27
CPT 88360/o
warn
mrf_negotiated_above_gross
highest negotiated rate $376 exceeds the gross charge $343
CPT 36905/o
warn
mrf_negotiated_above_gross
highest negotiated rate $23,451 exceeds the gross charge $13,801
CPT 88365/o
warn
mrf_negotiated_above_gross
highest negotiated rate $376 exceeds the gross charge $343
CPT G0379/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,406 exceeds the gross charge $2,046
CPT 84202/o
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $17
CPT 84238/o
warn
mrf_negotiated_above_gross
highest negotiated rate $82 exceeds the gross charge $52
CPT 26011/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,355 exceeds the gross charge $3,144
CPT 75825/o
warn
mrf_negotiated_above_gross
highest negotiated rate $11,650 exceeds the gross charge $3,262
CPT 89220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $376 exceeds the gross charge $302
CPT L0120/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40 exceeds the gross charge $18
CPT 37220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $35,113 exceeds the gross charge $34,544
CPT 75827/o
warn
mrf_negotiated_above_gross
highest negotiated rate $7,008 exceeds the gross charge $6,432
CPT 89320/o
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $14
CPT L0172/o
warn
mrf_negotiated_above_gross
highest negotiated rate $184 exceeds the gross charge $82
CPT 90378/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,770 exceeds the gross charge $0
CPT L0174/o
warn
mrf_negotiated_above_gross
highest negotiated rate $475 exceeds the gross charge $211
CPT L0190/o
warn
mrf_negotiated_above_gross
highest negotiated rate $277 exceeds the gross charge $123
CPT L0625/o
warn
mrf_negotiated_above_gross
highest negotiated rate $81 exceeds the gross charge $36
CPT 90611/o
warn
mrf_negotiated_above_gross
highest negotiated rate $211 exceeds the gross charge $0
CPT L1832/o
warn
mrf_negotiated_above_gross
highest negotiated rate $788 exceeds the gross charge $350
CPT 90620/o
warn
mrf_negotiated_above_gross
highest negotiated rate $194 exceeds the gross charge $0
CPT L3650/o
warn
mrf_negotiated_above_gross
highest negotiated rate $137 exceeds the gross charge $61
CPT 90621/o
warn
mrf_negotiated_above_gross
highest negotiated rate $162 exceeds the gross charge $0
CPT L3660/o
warn
mrf_negotiated_above_gross
highest negotiated rate $260 exceeds the gross charge $162
CPT 90633/o
warn
mrf_negotiated_above_gross
highest negotiated rate $44 exceeds the gross charge $0
CPT L3670/o
warn
mrf_negotiated_above_gross
highest negotiated rate $52 exceeds the gross charge $23
CPT 90648/o
warn
mrf_negotiated_above_gross
highest negotiated rate $34 exceeds the gross charge $0
CPT L3908/o
warn
mrf_negotiated_above_gross
highest negotiated rate $112 exceeds the gross charge $50
CPT 90651/o
warn
mrf_negotiated_above_gross
highest negotiated rate $257 exceeds the gross charge $0
CPT L4350/o
warn
mrf_negotiated_above_gross
highest negotiated rate $272 exceeds the gross charge $137
CPT 90656/o
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $0
CPT L4386/o
warn
mrf_negotiated_above_gross
highest negotiated rate $315 exceeds the gross charge $140
CPT 90658/o
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $0
CPT L4398/o
warn
mrf_negotiated_above_gross
highest negotiated rate $215 exceeds the gross charge $128
CPT 90660/o
warn
mrf_negotiated_above_gross
highest negotiated rate $31 exceeds the gross charge $0
CPT 90661/o
warn
mrf_negotiated_above_gross
highest negotiated rate $40 exceeds the gross charge $0
CPT 90670/o
warn
mrf_negotiated_above_gross
highest negotiated rate $386 exceeds the gross charge $0
CPT 90671/o
warn
mrf_negotiated_above_gross
highest negotiated rate $420 exceeds the gross charge $0
CPT 90675/o
warn
mrf_negotiated_above_gross
highest negotiated rate $719 exceeds the gross charge $0
CPT 90677/o
warn
mrf_negotiated_above_gross
highest negotiated rate $451 exceeds the gross charge $0
CPT 90680/o
warn
mrf_negotiated_above_gross
highest negotiated rate $92 exceeds the gross charge $0
CPT 84540/o
warn
mrf_negotiated_above_gross
highest negotiated rate $13 exceeds the gross charge $7
CPT 90681/o
warn
mrf_negotiated_above_gross
highest negotiated rate $166 exceeds the gross charge $0
CPT 90684/o
warn
mrf_negotiated_above_gross
highest negotiated rate $598 exceeds the gross charge $0
CPT 90690/o
warn
mrf_negotiated_above_gross
highest negotiated rate $61 exceeds the gross charge $0
CPT 90696/o
warn
mrf_negotiated_above_gross
highest negotiated rate $68 exceeds the gross charge $0
CPT 90697/o
warn
mrf_negotiated_above_gross
highest negotiated rate $43 exceeds the gross charge $0
CPT 90700/o
warn
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $0
CPT 90707/o
warn
mrf_negotiated_above_gross
highest negotiated rate $71 exceeds the gross charge $0
CPT 41010/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,363 exceeds the gross charge $997
CPT 90710/o
warn
mrf_negotiated_above_gross
highest negotiated rate $210 exceeds the gross charge $0
CPT 90713/o
warn
mrf_negotiated_above_gross
highest negotiated rate $38 exceeds the gross charge $0
CPT 41100/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,254 exceeds the gross charge $405
CPT 90714/o
warn
mrf_negotiated_above_gross
highest negotiated rate $44 exceeds the gross charge $0
CPT 90715/o
warn
mrf_negotiated_above_gross
highest negotiated rate $61 exceeds the gross charge $0
CPT 90716/o
warn
mrf_negotiated_above_gross
highest negotiated rate $147 exceeds the gross charge $0
CPT 90717/o
warn
mrf_negotiated_above_gross
highest negotiated rate $157 exceeds the gross charge $0
CPT 90723/o
warn
mrf_negotiated_above_gross
highest negotiated rate $96 exceeds the gross charge $0
CPT 90732/o
warn
mrf_negotiated_above_gross
highest negotiated rate $203 exceeds the gross charge $0
CPT 90734/o
warn
mrf_negotiated_above_gross
highest negotiated rate $170 exceeds the gross charge $0
CPT 90736/o
warn
mrf_negotiated_above_gross
highest negotiated rate $178 exceeds the gross charge $0
CPT 90738/o
warn
mrf_negotiated_above_gross
highest negotiated rate $241 exceeds the gross charge $0
CPT 90744/o
warn
mrf_negotiated_above_gross
highest negotiated rate $49 exceeds the gross charge $0
CPT 85247/o
warn
mrf_negotiated_above_gross
highest negotiated rate $52 exceeds the gross charge $33
CPT 93242/o
warn
mrf_negotiated_above_gross
highest negotiated rate $472 exceeds the gross charge $172
CPT 80050/o
warn
mrf_negotiated_above_gross
highest negotiated rate $237 exceeds the gross charge $14
CPT 80055/o
warn
mrf_negotiated_above_gross
highest negotiated rate $223 exceeds the gross charge $26
CPT 93325/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,055 exceeds the gross charge $970
CPT 80158/o
warn
mrf_negotiated_above_gross
highest negotiated rate $41 exceeds the gross charge $25
CPT 93623/o
warn
mrf_negotiated_above_gross
highest negotiated rate $963 exceeds the gross charge $601
CPT 93642/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,473 exceeds the gross charge $409
warn
mrf_rate_without_estimate
12,404 of 12,404 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 10080/o
info
mrf_item_fields_vary
this code and setting cover at least 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 44366/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 69210/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 80320/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 86225/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 93924/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 10120/o
info
mrf_item_fields_vary
this code and setting cover at least 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 44369/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 69436/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 80323/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 93925/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 10140/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28485/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 44376/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 69620/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 81000/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 86231/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 93926/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 10160/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28630/o
info
mrf_item_fields_vary
this code and setting cover at least 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 69631/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 81001/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 86235/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 93930/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 11042/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28725/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70110/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 81002/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 86255/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 93931/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 11043/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28730/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70150/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 81003/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 86256/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 93970/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 11044/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28740/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70160/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 81015/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 86258/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 93971/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 11106/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28750/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70210/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 81025/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 86300/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 93978/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 11200/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28820/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70220/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 81050/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 86301/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 93979/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 11401/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 28825/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 45334/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 70250/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 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 86304/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 93986/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11402/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29075/o
info
mrf_item_fields_vary
this code and setting cover at least 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 70260/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 81243/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 86308/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 93990/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11403/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29105/o
info
mrf_item_fields_vary
this code and setting cover at least 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
CPT 70360/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 81256/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 86316/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 94002/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11406/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 29125/o
info
mrf_item_fields_vary
this code and setting cover at 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 1,740 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service
Severity
Rule
Detail
MS-DRG 177
info
inp_charge_10x_payment
average charge $155,324 is 13.7× the total payment
MS-DRG 193
info
inp_charge_10x_payment
average charge $118,686 is 13.5× the total payment
MS-DRG 194
info
inp_charge_10x_payment
average charge $82,524 is 13.5× the total payment
MS-DRG 274
info
inp_charge_10x_payment
average charge $288,176 is 13.7× the total payment
MS-DRG 281
info
inp_charge_10x_payment
average charge $99,805 is 14.8× the total payment
MS-DRG 291
info
inp_charge_10x_payment
average charge $100,435 is 11.5× the total payment
MS-DRG 321
info
inp_charge_10x_payment
average charge $288,290 is 15.4× the total payment
MS-DRG 322
info
inp_charge_10x_payment
average charge $202,056 is 16.6× the total payment
MS-DRG 377
info
inp_charge_10x_payment
average charge $139,609 is 11.5× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $88,921 is 12.7× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $82,249 is 14.1× the total payment
MS-DRG 455
info
inp_charge_10x_payment
average charge $385,717 is 12.0× the total payment
MS-DRG 460
info
inp_charge_10x_payment
average charge $286,728 is 10.2× the total payment
MS-DRG 467
info
inp_charge_10x_payment
average charge $359,219 is 18.1× the total payment
MS-DRG 468
info
inp_charge_10x_payment
average charge $324,231 is 18.0× the total payment
MS-DRG 470
info
inp_charge_10x_payment
average charge $246,386 is 19.2× the total payment
MS-DRG 472
info
inp_charge_10x_payment
average charge $273,726 is 14.1× the total payment
MS-DRG 473
info
inp_charge_10x_payment
average charge $251,929 is 14.2× the total payment
MS-DRG 481
info
inp_charge_10x_payment
average charge $225,558 is 16.4× the total payment
MS-DRG 482
info
inp_charge_10x_payment
average charge $142,849 is 13.8× the total payment
MS-DRG 483
info
inp_charge_10x_payment
average charge $271,786 is 16.5× the total payment
MS-DRG 522
info
inp_charge_10x_payment
average charge $228,725 is 16.3× the total payment
MS-DRG 682
info
inp_charge_10x_payment
average charge $121,463 is 11.9× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $90,251 is 14.1× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $64,261 is 10.9× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $539,953 is 13.2× the total payment
MS-DRG 871
info
inp_charge_10x_payment
average charge $161,107 is 13.3× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $95,012 is 12.8× the total payment

Sources for this hospital

the files read, as fetched — not our copy of them
  1. Medicare Inpatient Hospitals - by Provider and Service · CMS · 2024
    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. Medicare Outpatient Hospitals - by Provider and Service · CMS · 2024
    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. AHRQ Compendium of U.S. Health Systems — hospital linkage file · AHRQ · 2023
    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. Merit Health River Oaks — standard charges file · MS · updated 2026-04-01
    · csv-wide · 405.9M bytes · fetched 2026-08-25 · sha256 62a673a6dab2…

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.