Project Crossfoot
Hospital · CCN 260034

Bates County Memorial Hospital

615 W Nursery St, Butler, MO 64730 · Bates County
Small town core: primary flow within an urban cluster of 2,500 to 9,999

2 admission types 22 outpatient services price file: ok
Billed per dollar paid, all admissions
1.92×
$991K billed against $517K paid across 29 Medicare discharges; the national figure is 5.03×.
12.3%
of adults in Bates County have medical debt in collections
13.4%
uninsured in the county · state 10.2%
$56K
median household income
1.9×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (1 in the inpatient or outpatient file)ⓘ
41.2%
obesity in the countyⓘ
13.8%
diagnosed diabetes (PLACES)
8.5%
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
193
Simple pneumonia and pleurisy with mcc
17
$29,848
$14,857
2.0× st 4.5×
871
Septicemia or severe sepsis without mv >96 hours with mcc
12
$40,327
$22,049
1.8× st 4.6×
02 · Outpatient

Outpatient services

Comprehensive APCs, Medicare's outpatient payment groups: submitted charge against what Medicare allowed, per service.

APC
Service
Services
Charge
Allowed
Billed ÷ allowed
8011
Comprehensive Observation Services
105
$19,196
$2,560
7.5×
5491
Level 1 Intraocular Procedures
53
$17,119
$2,180
7.9×
5372
Level 2 Urology and Related Services
29
$2,159
$639
3.4×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
12
$8,035
$1,516
5.3×
5222
Level 2 Pacemaker and Similar Procedures
11
$43,151
$7,371
5.9×
5183
Level 3 Vascular Procedures
11
$22,640
$2,981
7.6×
5493
Level 3 Intraocular Procedures
—
—
—
—
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
—
—
—
—
5431
Level 1 Nerve Procedures
—
—
—
—
5373
Level 3 Urology and Related Services
—
—
—
—
5112
Level 2 Musculoskeletal Procedures
—
—
—
—
5361
Level 1 Laparoscopy and Related Services
—
—
—
—
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5313
Level 3 Lower GI Procedures
—
—
—
—
5302
Level 2 Upper GI Procedures
—
—
—
—
5113
Level 3 Musculoskeletal Procedures
—
—
—
—
5182
Level 2 Vascular Procedures
—
—
—
—
5164
Level 4 ENT Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5115
Level 5 Musculoskeletal Procedures
—
—
—
—
5114
Level 4 Musculoskeletal 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 2026-04-20, template 3.0.0, 206,578 rows scanned, 3,343 distinct code–setting items kept. 893 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
BLEPHAROPLASY, PTOSIS REPAIR, ANY EYE LID RECONSTRUCTION
CPT 00103
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR PROCEDURES ON EXTERNAL, MIDDLE & INNER EAR INCLDING BX
CPT 00120
$1,238
$867
$1,053
8
clean
ANESTHESIA FOR PROCEDURES ON EYE; NOT OTHERWISE SPECIFIED
CPT 00140
$1,240
$868
$923
16
clean
CATARACT EXTRACTION WITH LENS IMPLANT
CPT 00142
$992
$694
$843
8
clean
CORNEAL TRANSPLANT
CPT 00144
$1,486
$1,040
$1,263
8
clean
PROCEDURES ON THE NOSE, NSR, SINUS SURGERY
CPT 00160
$1,240
$868
$1,054
8
clean
SOFT TISSUE BIOPSY OF THE NOSE
CPT 00164
$992
$694
$843
8
clean
TONSILLECTOMY, ADNOIDECTOMY, INTRAORAL PROCEDURES, PROCEDURES ON THE SKIN, MUSCLES OR NERVES OF THE HEAD, NECK AND POSTERIOR TRUNK.
CPT 00170
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR PROCEDURES ON FACIAL BONES OR SKULL; NOT OTHERWISE SPECIFIED
CPT 00190
$1,240
$868
$1,054
8
clean
BIOPSY, EXCISION OR LACERATION REPAIR
CPT 00300
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR ESOPHAGUS, THYROID, LARYNX, TRACHEA AND LYMPHATIC SYSTEM OF NECK; NOS
CPT 00320
$1,396
$977
$1,187
8
clean
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARY SYSTEM ON THE EXTREMITIES, ANTERIOR TRUNK A...
CPT 00400
$744
$521
$633
16
clean
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARY SYSTEM ON THE EXTREMITIES, ANTERIOR TRUNK A...
CPT 00404
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR ELECTRICAL CONVERSION OF ARRHYTHMIAS
CPT 00410
$992
$694
$843
8
clean
ANESTHESIA FOR PROCEDURES ON CLAVICLE AND SCAPULA; NOT OTHERWISE SPECIFIED
CPT 00450
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR CLOSED CHEST PROCEDURES; (INCLUDING BRONCHOSCOPY) NOT OTHERWISE SPECIFIED
CPT 00520
$1,396
$977
$1,187
8
clean
ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION
CPT 00532
$992
$694
$843
8
clean
ANESTH SPINE CORD SURGERY
CPT 00630
$1,985
$1,389
$1,687
8
clean
ANESTHESIA FOR PROCEDURES IN LUMBAR REGION
CPT 00635
$992
$694
$843
8
clean
ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED
CPT 00700
$992
$694
$843
8
clean
ANESTHESIA FOR UPPER GASTROINTESTINAL ENDOSCOPIC
CPT 00731
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; NOT OTHERWISE SPECIFIED
CPT 00750
$992
$694
$843
8
clean
ANESTHESIA FOR HERNIA REPAIRS IN UPPER ABDOMEN; LUMBAR AND VENTRAL (INCISIONAL) HERNIAS AN...
CPT 00752
$1,487
$1,041
$1,264
8
clean
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHE...
CPT 00790
$1,733
$1,213
$1,473
8
clean
ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED
CPT 00800
$992
$694
$843
8
clean
ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURE
CPT 00811
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR LOWER INTESTINAL ENDOSCOPIC PROCEDURE-SCREENING
CPT 00812
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR COMBINED UPPER AND LOWER GASTROINTESTINAL PROCEDURE
CPT 00813
$2,479
$1,735
$2,107
8
clean
ANESTHESIA FOR PROCEDURES ON LOWER POSTERIOR ABDOMINAL WALL
CPT 00820
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; NOT OTHERWISE SPECIFIED
CPT 00830
$992
$694
$843
8
clean
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; VENTRAL AND INCISIONAL HERNIAS
CPT 00832
$1,487
$1,041
$1,264
8
clean
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHE...
CPT 00840
$1,487
$1,041
$1,264
8
clean
ANESTHESIA FOR; ANORECTAL PROCEDURE
CPT 00902
$1,240
$868
$1,054
8
clean
ANESTH BLADDER SURGERY
CPT 00910
$744
$521
$633
8
clean
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); TRANSURETHRAL RESECTION OF BLADDER TUMOR(S)
CPT 00912
$1,191
$834
$1,012
8
clean
ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING URETHROCYSTOSCOPY); WITH FRAGMENTATION, MANIPULATION AND/OR REMOVAL OF URETERAL CALCULUS
CPT 00918
$1,144
$801
$973
8
clean
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); NOT OTHE...
CPT 00920
$744
$521
$633
8
clean
ANESTHESIA FOR PROCEDURES ON MALE GENITALIA (INCLUDING OPEN URETHRAL PROCEDURES); VASECTOMY, UNILATERAL OR BILATERAL
CPT 00921
$321
$225
$273
8
clean
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIU...
CPT 00940
$744
$521
$633
8
clean
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIU...
CPT 00942
$992
$694
$843
8
clean
ANESTHESIA FOR PROCEDURES ON BONY PELVIS
CPT 01120
$1,396
$977
$1,187
8
clean
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; NOT OTHERWISE SPECIFIED
CPT 01200
$1,487
$1,041
$1,264
8
clean
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; TOTAL HIP ARTHROPLASTY
CPT 01214
$1,981
$1,387
$1,684
8
clean
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; REVISION OF TOTAL HIP ARTHROPLASTY
CPT 01215
$1,981
$1,387
$1,684
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES INVOLVING UPPER TWO-THIRDS OF FEMUR
CPT 01220
$916
$641
$779
8
clean
ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER TWO-THIRDS OF FEMUR; NOT OTHERWISE SPECIFIE...
CPT 01230
$1,487
$1,041
$1,264
8
clean
ANESTHESIA FOR OPEN PROCEDURES INVOLVING UPPER TWO-THIRDS OF FEMUR; AMPUTATION
CPT 01232
$1,191
$834
$1,012
8
clean
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPPER LEG
CPT 01250
$992
$694
$843
8
clean
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF KNEE AND/...
CPT 01320
$992
$694
$843
8
clean
ANESTHESIA FOR ALL OPEN PROCEDURES ON LOWER ONE-THIRD OF FEMUR
CPT 01360
$1,191
$834
$1,012
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON KNEE JOINT
CPT 01380
$744
$521
$633
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA
CPT 01390
$715
$500
$608
8
clean
ANESTHESIA FOR ALL OPEN PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA
CPT 01392
$992
$694
$843
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT; NOT OTHERWISE SPECI...
CPT 01400
$992
$694
$843
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT; TOTAL KNEE ARTHROPL...
CPT 01402
$1,733
$1,213
$1,473
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER LEG, ANKLE, AND FOOT
CPT 01462
$744
$521
$633
8
clean
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND...
CPT 01470
$744
$521
$633
8
clean
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOOT; REPAIR OF RUPTURED ACHILLES TENDON, WITH OR WITHOUT GRAFT
CPT 01472
$1,191
$834
$1,012
8
clean
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; NOT OTHERWISE SPECI...
CPT 01480
$744
$521
$633
8
clean
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; RADICAL RESECTION (INCLUDING BELOW KNEE AMPUTATION)
CPT 01482
$992
$694
$843
8
clean
ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT
CPT 01484
$992
$694
$843
8
clean
TOTAL ANKLE REPLACEMENT
CPT 01486
$1,733
$1,213
$1,473
8
clean
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF SHOULDER ...
CPT 01610
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, ACR...
CPT 01620
$992
$694
$843
8
clean
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF SHOULDER JOINT
CPT 01622
$992
$694
$843
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL...
CPT 01630
$1,240
$868
$1,054
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCL...
CPT 01638
$2,477
$1,734
$2,105
8
clean
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPPER ARM AND...
CPT 01710
$744
$521
$633
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERUS AND ELBOW
CPT 01730
$744
$521
$633
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW; NOT OTHERWISE SPECIF...
CPT 01740
$992
$694
$843
8
clean
ANESTHESIA ARTHROSCOPIC ELBOW; OSTEOTOMY OF HUMERUS
CPT 01742
$1,238
$867
$1,053
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW
CPT 01744
$1,237
$866
$1,052
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES OF THE ELBOW; TOTAL ELBOW REPLACEM...
CPT 01760
$1,733
$1,213
$1,473
8
clean
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF FOREARM, ...
CPT 01810
$744
$521
$633
8
clean
ANESTHESIA FOR ALL CLOSED PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES
CPT 01820
$744
$521
$633
8
clean
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC/ENDOSCOPIC PROCEDURES ON DISTAL RADIUS, DISTA...
CPT 01830
$744
$521
$633
8
clean
OPEN OR SURGICAL ARTHROSCOPIC TOTAL WRIST REPLACEMENT
CPT 01832
$1,303
$912
$1,108
8
clean
ANESTHESIA FOR NON-INVASIVE IMAGING OR RADIATION THERAPY
CPT 01922
$1,733
$1,213
$1,473
8
clean
ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK OR INJECT...
CPT 01992
$1,240
$868
$1,054
8
clean
DX SP SACROPLASTY UNILAT
CPT 0200T
$7,870
$5,509
$7,268
12
clean
DX SP SACROPLASTY BILAT
CPT 0201T
$6,839
$4,787
$7,268
12
clean
RESPIRATORY PROFILE PCR - BCMH
CPT 0202U
$770
$539
$417
24
clean
US SP GUIDED FLUID COLLECTION DRAINAGE PF
CPT 10005
$225
$157
$84
15
clean
US SP SEROMA DRAINAGE
CPT 10005
$1,579
$1,105
$709
24
clean
US SP NECK ASP BIOPSY FNA EA ADD'L
CPT 10006
$790
$553
$57
12
clean
FINE NEEDLE ASPIRATION BIOPSY, INCLUDING ULTRASOUND GUIDANCE; EACH ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
CPT 10006
$153
$107
$42
12
clean
FINE NEEDLE ASPIRATION WO IMAGING GUIDANCE
CPT 10021
$323
$226
$407
12
clean
US SP GUIDED FLUID COLLECTION DRAINAGE
CPT 10030
$754
$528
$709
12
clean
US SP CYST ASPIRATION PF
CPT 10030
$385
$270
$327
15
clean
PLACEMENT OF SOFT TISSUE LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET, WIRE/NEEDLE, RADIOACTIVE SEEDS), PERCUTANEOUS, INCLUDING IMAGING GUIDANCE; FIRST LESION
CPT 10035
$257
$180
$219
15
clean
INC & DRAIN OF ABSCESS
CPT 10060
$506
$354
$201
24
clean
INC & DRAIN OF ABSCESS
CPT 10060
$290
$203
$93
15
clean
INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SU...
CPT 10061
$811
$568
$407
12
clean
INCISION & DRAINAGE PILONDIAL CYST SIMPLE
CPT 10080
$800
$560
$709
12
clean
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE
CPT 10120
$933
$653
$407
24
clean
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED
CPT 10121
$505
$353
$162
15
clean
INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION
CPT 10140
$3,131
$2,192
$1,654
24
clean
PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST
CPT 10160
$263
$184
$85
30
clean
PUNCTURE DRAINAGE OF LESION
CPT 10160
$453
$317
$407
24
clean
DEB SUBQ TISSUE 1ST SQ CM/<
CPT 11042
$445
$312
$407
12
clean
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS
CPT 11042
$145
$102
$79
15
clean
DEBRIDEMENT, MUSCLE AND/OR FASCIA; FIRST 20 SQ CM OR LESS
CPT 11043
$676
$473
$740
12
clean
DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS
CPT 11043
$365
$256
$141
15
clean
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION
CPT 11055
$60
$42
$44
15
clean
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION
CPT 11055
$221
$155
$201
12
clean
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); 2 TO 4 LESIONS
CPT 11056
$181
$127
$201
12
clean
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); 2 TO 4 LESIONS
CPT 11056
$65
$46
$50
15
clean
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN 4 LESION...
CPT 11057
$181
$127
$201
12
clean
TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION
CPT 11102
$459
$321
$407
12
clean
TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION
CPT 11102
$110
$77
$29
12
clean
PUNCH BIOPSY OF SKIN (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION
CPT 11104
$573
$401
$407
12
clean
INC BIOPSY OF SKIN (EG, WEDGE) (INCL SIMPLE CLOSURE, WHEN PERF); SINGLE LESION PF
CPT 11106
$165
$116
$95
15
clean
INCISIONAL BIOPSY OF SKIN (EG, WEDGE) (INCLUDING SIMPLE CLOSURE, WHEN PERFORMED); SINGLE LESION
CPT 11106
$1,496
$1,047
$740
12
clean
REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15
CPT 11200
$459
$321
$201
24
clean
REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS UP TO 15
CPT 11200
$209
$146
$64
15
clean
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.6 TO 1.0 CM
CPT 11401
$285
$200
$95
15
clean
EXC SKIN LESION EXCEPT SKIN TAGS
CPT 11421
$594
$416
$709
12
clean
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS
CPT 11440
$290
$203
$89
15
clean
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.5 CM OR LESS
CPT 11440
$1,907
$1,335
$709
12
clean
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.6 TO 1.0 CM
CPT 11441
$1,907
$1,335
$709
12
clean
EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; EXCISED DIAMETER 0.6 TO 1.0 CM
CPT 11441
$367
$257
$111
15
clean
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED DIAMETER 2.1 TO 3.0 CM
CPT 11643
$3,449
$2,414
$1,654
12
clean
EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED DIAMETER 2.1 TO 3.0 CM
CPT 11643
$639
$447
$190
15
clean
TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER
CPT 11719
$25
$18
$9
15
clean
TRIM NAIL(S) ANY NUMBER
CPT 11719
$86
$60
$59
24
clean
NAIL DEBRIDEMENT 1-5
CPT 11720
$82
$57
$59
12
clean
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5
CPT 11720
$40
$28
$20
15
clean
DEBRIDE NAIL 6 OR MORE
CPT 11721
$206
$144
$59
12
clean
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORE
CPT 11721
$58
$40
$27
15
clean
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE
CPT 11730
$128
$90
$70
15
clean
REMOVAL OF NAIL PLATE
CPT 11730
$397
$278
$201
24
clean
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH ADDITIONAL NAIL PLATE (LIST SEPA...
CPT 11732
$275
$193
$30
24
clean
AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH ADDITIONAL NAIL PLATE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
CPT 11732
$42
$29
$21
15
clean
RELEASE OF SUB HEMA.
CPT 11740
$130
$91
$133
12
clean
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPL
CPT 11750
$650
$455
$407
24
clean
EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), FOR PERMANENT REMOVAL
CPT 11750
$237
$166
$97
15
clean
BIOPSY NAIL UNIT
CPT 11755
$750
$525
$709
12
clean
BIOPSY OF NAIL UNIT (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS) (SEPARATE PROCEDURE)
CPT 11755
$145
$102
$75
15
clean
REPAIR OF NAIL BED
CPT 11760
$1,029
$720
$740
12
clean
EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
CPT 11771
$6,987
$4,891
$2,909
12
clean
INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS
CPT 11900
$506
$354
$201
12
clean
INJECTION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS PRO FEE
CPT 11900
$70
$49
$34
15
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS
CPT 12001
$519
$363
$201
24
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...
CPT 12002
$528
$369
$201
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND...
CPT 12004
$527
$369
$201
12
clean
RPR S/N/A/GEN/TRK12.6-20.0CM
CPT 12005
$644
$450
$407
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBR...
CPT 12011
$513
$359
$201
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBR...
CPT 12013
$543
$380
$201
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBR...
CPT 12014
$606
$424
$201
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 7.6 CM TO 12.5 CM
CPT 12015
$517
$362
$201
12
clean
SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES, 20.1 CM TO 30.0 CM
CPT 12017
$1,030
$721
$407
12
clean
TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
CPT 12020
$807
$565
$740
12
clean
INTMD RPR S/A/T/EXT 2.5 CM/<
CPT 12031
$935
$655
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS ...
CPT 12032
$1,008
$705
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS ...
CPT 12034
$675
$472
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 12.6 CM TO 20.0 CM
CPT 12035
$991
$694
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 20.1 CM TO 30.0 CM
CPT 12036
$3,142
$2,199
$740
12
clean
REPAIR INTERMEDIATE NECK, HANDS, FEET 2.5CM OR LESS
CPT 12041
$572
$401
$407
24
clean
REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO 7.5...
CPT 12042
$642
$449
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO 12.5 CM
CPT 12044
$691
$484
$740
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS
CPT 12051
$933
$653
$407
24
clean
REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR LESS PRO FEE
CPT 12051
$472
$330
$173
15
clean
REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2...
CPT 12052
$691
$484
$407
12
clean
REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 5.1 CM TO 7.5 CM
CPT 12053
$1,233
$863
$407
12
clean
REPAIR COMPLEX TRUNK 2.6-7.5CM
CPT 13101
$1,568
$1,098
$740
12
clean
REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM
CPT 13120
$1,618
$1,133
$407
12
clean
CMPLX RPR S/A/L 2.6-7.5 CM
CPT 13121
$1,942
$1,359
$407
12
clean
CMPLX RPR S/A/L ADDL 5 CM/>
CPT 13122
$556
$389
$118
12
clean
CMPLX RPR F/C/C/M/N/AX/G/H/F
CPT 13132
$1,087
$761
$407
12
clean
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM
CPT 13152
$1,393
$975
$740
12
clean
SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE
CPT 13160
$5,902
$4,132
$3,549
12
clean
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF OPEN WOUNDS, BURN ESCHAR, OR SCAR (INCLUDING SUBCUTANEOUS TISSUES), OR INCISIONAL RELEASE OF SCAR CONTRACTURE, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR 1% OF
CPT 15002
$607
$425
$211
15
clean
APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA
CPT 15271
$233
$163
$94
15
clean
APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, OR MULTIPLE DIGITS 1ST 25 SQ CM OR LESS
CPT 15275
$2,673
$1,871
$740
12
clean
REMOVAL OF SUTURES OR STAPLES NOT REQUIRING ANESTH
CPT 15853
$75
$53
$12
12
clean
REMOVAL OF SUTURES OR STAPLES NOT REQUIRING ANESTH
CPT 15853
$25
$18
$12
12
clean
INITIAL TREATMENT, FIRST DEGREE BURN, WHEN NO MORE THAN LOCAL TREATMENT IS REQUIRED
CPT 16000
$290
$203
$201
12
clean
DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; SMALL (LES...
CPT 16020
$270
$189
$201
24
clean
DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; MEDIUM (EG...
CPT 16025
$542
$380
$201
12
clean
DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE (EG, MORE THAN 1% EXTREMITY, OR GREATER THAN 10% TOTAL BODY SURFACE AREA)
CPT 16030
$685
$480
$407
12
clean
DESTRUCTION OF SKIN LESIONS UP TO 14 LESIONS
CPT 17110
$311
$218
$201
12
clean
DESTRUCTION (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY, SURGICAL CURETTEMENT), OF BENIGN LESIONS OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; UP TO 14 LESIONS
CPT 17110
$157
$110
$69
15
clean
CHEMICAL CAUTERY TISSUE
CPT 17250
$460
$322
$201
12
clean
US SP ASPIRATION BREAST CYST
CPT 19000
$1,816
$1,271
$709
12
clean
PUNCTURE ASPIRATION OF CYST OF BREAST
CPT 19000
$124
$86
$63
15
clean
US SP ASPIRATION BREAST CYST, EA ADD'L
CPT 19001
$790
$553
$25
12
clean
US MG BREAST BIOPSY INITIAL
CPT 19083
$2,503
$1,752
$1,654
12
clean
BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET), WHEN PERFORMED, AND IMAGING OF THE BIOPSY SPECIMEN, WHEN PERFORMED, PERCUTANEOUS; FIRST LESION, INCLUDING ULTRASOUND GUIDANCE
CPT 19083
$442
$309
$316
15
clean
US MG BREAST BIOPSY EA ADDITIONAL
CPT 19084
$1,257
$880
$316
12
clean
BIOPSY, BREAST, WITH PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET), WHEN PERFORMED, AND IMAGING OF THE BIOPSY SPECIMEN, WHEN PERFORMED, PERCUTANEOUS; EACH ADDITIONAL LESION, INCLUDING ULTRASOUND
CPT 19084
$222
$155
$189
15
clean
US GUIDED PLACEMENT
CPT 19285
$2,551
$1,786
$709
12
clean
EXPLORE WOUND EXTREMITY
CPT 20103
$2,137
$1,496
$1,654
12
clean
DX SP PERCUTANEOUS MUSCLE BIOPSY
CPT 20206
$1,652
$1,156
$1,654
12
clean
DX PERCUTANEOUS MUSCLE BIOPSY PF
CPT 20206
$164
$115
$139
15
clean
DX SP BONE BIOPSY SUPERFICIAL
CPT 20220
$1,914
$1,340
$1,654
12
clean
DX SP BONE SUPERFICIAL BIOPSY PF
CPT 20220
$267
$187
$146
15
clean
DX BONE DEEP BIOPSY PF
CPT 20225
$363
$254
$309
15
clean
DX SP BONE BIOPSY, DEEP
CPT 20225
$2,650
$1,855
$1,654
12
clean
REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE
CPT 20520
$4,344
$3,041
$1,654
12
clean
ASP INJ. INJ-CARPAL TUNNEL (OR
CPT 20526
$127
$89
$50
15
clean

Showing the first 200 of 3,343 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
CPT 92550/o
warn
mrf_negotiated_above_gross
highest negotiated rate $216 exceeds the gross charge $161
CPT 92552/b
warn
mrf_negotiated_above_gross
highest negotiated rate $35 exceeds the gross charge $30
CPT 92553/b
warn
mrf_negotiated_above_gross
highest negotiated rate $42 exceeds the gross charge $35
CPT 76536/b
warn
mrf_negotiated_above_gross
highest negotiated rate $97 exceeds the gross charge $78
CPT 92555/o
warn
mrf_negotiated_above_gross
highest negotiated rate $59 exceeds the gross charge $40
CPT 92556/b
warn
mrf_negotiated_above_gross
highest negotiated rate $40 exceeds the gross charge $35
CPT 92565/o
warn
mrf_negotiated_above_gross
highest negotiated rate $59 exceeds the gross charge $35
CPT 71111/b
warn
mrf_negotiated_above_gross
highest negotiated rate $46 exceeds the gross charge $45
CPT 71120/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $28
CPT 92977/o
warn
mrf_negotiated_above_gross
highest negotiated rate $486 exceeds the gross charge $377
CPT 71270/b
warn
mrf_negotiated_above_gross
highest negotiated rate $175 exceeds the gross charge $171
CPT 76706/b
warn
mrf_negotiated_above_gross
highest negotiated rate $94 exceeds the gross charge $75
CPT 72040/b
warn
mrf_negotiated_above_gross
highest negotiated rate $35 exceeds the gross charge $33
CPT 72050/b
warn
mrf_negotiated_above_gross
highest negotiated rate $49 exceeds the gross charge $40
CPT 76830/b
warn
mrf_negotiated_above_gross
highest negotiated rate $105 exceeds the gross charge $95
CPT 93880/b
warn
mrf_negotiated_above_gross
highest negotiated rate $167 exceeds the gross charge $109
CPT 72052/b
warn
mrf_negotiated_above_gross
highest negotiated rate $56 exceeds the gross charge $42
CPT 76831/b
warn
mrf_negotiated_above_gross
highest negotiated rate $104 exceeds the gross charge $100
CPT 93882/b
warn
mrf_negotiated_above_gross
highest negotiated rate $110 exceeds the gross charge $68
CPT 93922/b
warn
mrf_negotiated_above_gross
highest negotiated rate $73 exceeds the gross charge $34
CPT 72072/b
warn
mrf_negotiated_above_gross
highest negotiated rate $34 exceeds the gross charge $33
CPT 93925/b
warn
mrf_negotiated_above_gross
highest negotiated rate $209 exceeds the gross charge $107
CPT 72074/b
warn
mrf_negotiated_above_gross
highest negotiated rate $39 exceeds the gross charge $34
CPT 93926/b
warn
mrf_negotiated_above_gross
highest negotiated rate $114 exceeds the gross charge $66
CPT 72080/b
warn
mrf_negotiated_above_gross
highest negotiated rate $31 exceeds the gross charge $29
CPT 93930/b
warn
mrf_negotiated_above_gross
highest negotiated rate $176 exceeds the gross charge $109
CPT 72081/b
warn
mrf_negotiated_above_gross
highest negotiated rate $40 exceeds the gross charge $36
CPT 93931/b
warn
mrf_negotiated_above_gross
highest negotiated rate $107 exceeds the gross charge $68
CPT 72082/b
warn
mrf_negotiated_above_gross
highest negotiated rate $63 exceeds the gross charge $44
CPT 77003/b
warn
mrf_negotiated_above_gross
highest negotiated rate $93 exceeds the gross charge $87
CPT 93970/b
warn
mrf_negotiated_above_gross
highest negotiated rate $162 exceeds the gross charge $94
CPT 72084/b
warn
mrf_negotiated_above_gross
highest negotiated rate $87 exceeds the gross charge $58
CPT 93971/b
warn
mrf_negotiated_above_gross
highest negotiated rate $102 exceeds the gross charge $61
CPT 72100/b
warn
mrf_negotiated_above_gross
highest negotiated rate $36 exceeds the gross charge $33
CPT 93975/b
warn
mrf_negotiated_above_gross
highest negotiated rate $229 exceeds the gross charge $158
CPT 72110/b
warn
mrf_negotiated_above_gross
highest negotiated rate $47 exceeds the gross charge $39
CPT 93976/b
warn
mrf_negotiated_above_gross
highest negotiated rate $128 exceeds the gross charge $109
CPT 77066/b
warn
mrf_negotiated_above_gross
highest negotiated rate $140 exceeds the gross charge $136
CPT 0201T/o
warn
mrf_negotiated_above_gross
highest negotiated rate $7,268 exceeds the gross charge $6,839
CPT 72114/b
warn
mrf_negotiated_above_gross
highest negotiated rate $55 exceeds the gross charge $43
CPT 94010/o
warn
mrf_negotiated_above_gross
highest negotiated rate $216 exceeds the gross charge $203
CPT 77067/b
warn
mrf_negotiated_above_gross
highest negotiated rate $112 exceeds the gross charge $105
CPT 72120/b
warn
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $31
CPT 10021/o
warn
mrf_negotiated_above_gross
highest negotiated rate $407 exceeds the gross charge $323
CPT 10030/b
warn
mrf_negotiated_above_gross
highest negotiated rate $450 exceeds the gross charge $385
CPT 77075/b
warn
mrf_negotiated_above_gross
highest negotiated rate $87 exceeds the gross charge $76
CPT 10035/b
warn
mrf_negotiated_above_gross
highest negotiated rate $307 exceeds the gross charge $257
CPT 77080/b
warn
mrf_negotiated_above_gross
highest negotiated rate $35 exceeds the gross charge $29
CPT 95115/o
warn
mrf_negotiated_above_gross
highest negotiated rate $47 exceeds the gross charge $40
CPT 72127/b
warn
mrf_negotiated_above_gross
highest negotiated rate $175 exceeds the gross charge $173
CPT 78014/b
warn
mrf_negotiated_above_gross
highest negotiated rate $184 exceeds the gross charge $72
CPT 78071/b
warn
mrf_negotiated_above_gross
highest negotiated rate $273 exceeds the gross charge $171
CPT 11043/o
warn
mrf_negotiated_above_gross
highest negotiated rate $740 exceeds the gross charge $676
CPT 11056/o
warn
mrf_negotiated_above_gross
highest negotiated rate $201 exceeds the gross charge $181
CPT 78226/b
warn
mrf_negotiated_above_gross
highest negotiated rate $250 exceeds the gross charge $107
CPT 11057/o
warn
mrf_negotiated_above_gross
highest negotiated rate $201 exceeds the gross charge $181
CPT 11421/o
warn
mrf_negotiated_above_gross
highest negotiated rate $709 exceeds the gross charge $594
CPT 72133/b
warn
mrf_negotiated_above_gross
highest negotiated rate $175 exceeds the gross charge $173
CPT 78227/b
warn
mrf_negotiated_above_gross
highest negotiated rate $335 exceeds the gross charge $130
CPT 78264/b
warn
mrf_negotiated_above_gross
highest negotiated rate $254 exceeds the gross charge $114
CPT 11740/o
warn
mrf_negotiated_above_gross
highest negotiated rate $133 exceeds the gross charge $130
CPT 78306/b
warn
mrf_negotiated_above_gross
highest negotiated rate $228 exceeds the gross charge $124
CPT 78315/b
warn
mrf_negotiated_above_gross
highest negotiated rate $267 exceeds the gross charge $146
CPT 12044/o
warn
mrf_negotiated_above_gross
highest negotiated rate $740 exceeds the gross charge $691
CPT 78452/b
warn
mrf_negotiated_above_gross
highest negotiated rate $377 exceeds the gross charge $352
CPT 19084/b
warn
mrf_negotiated_above_gross
highest negotiated rate $266 exceeds the gross charge $222
CPT 20225/b
warn
mrf_negotiated_above_gross
highest negotiated rate $440 exceeds the gross charge $363
CPT 78580/b
warn
mrf_negotiated_above_gross
highest negotiated rate $184 exceeds the gross charge $120
CPT 72193/b
warn
mrf_negotiated_above_gross
highest negotiated rate $200 exceeds the gross charge $158
CPT 78582/b
warn
mrf_negotiated_above_gross
highest negotiated rate $256 exceeds the gross charge $153
CPT 78707/b
warn
mrf_negotiated_above_gross
highest negotiated rate $185 exceeds the gross charge $136
CPT 72200/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $24
CPT 78709/b
warn
mrf_negotiated_above_gross
highest negotiated rate $288 exceeds the gross charge $200
CPT 72202/b
warn
mrf_negotiated_above_gross
highest negotiated rate $34 exceeds the gross charge $31
CPT 78800/b
warn
mrf_negotiated_above_gross
highest negotiated rate $203 exceeds the gross charge $94
CPT 72220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $24
CPT 78803/b
warn
mrf_negotiated_above_gross
highest negotiated rate $295 exceeds the gross charge $154
CPT 25605/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,611 exceeds the gross charge $1,576
CPT 78815/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,365 exceeds the gross charge $350
CPT 78816/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,367 exceeds the gross charge $353
CPT 27818/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,611 exceeds the gross charge $1,576
CPT 73000/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $25
CPT 28092/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,611 exceeds the gross charge $1,347
CPT 78831/b
warn
mrf_negotiated_above_gross
highest negotiated rate $546 exceeds the gross charge $259
CPT 28208/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,277 exceeds the gross charge $3,149
CPT 73030/b
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $28
CPT 73040/b
warn
mrf_negotiated_above_gross
highest negotiated rate $119 exceeds the gross charge $83
CPT 29705/o
warn
mrf_negotiated_above_gross
highest negotiated rate $280 exceeds the gross charge $204
CPT 73060/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $24
CPT 30468/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,773 exceeds the gross charge $480
CPT 73070/b
warn
mrf_negotiated_above_gross
highest negotiated rate $26 exceeds the gross charge $23
CPT 73080/b
warn
mrf_negotiated_above_gross
highest negotiated rate $29 exceeds the gross charge $26
CPT 73085/b
warn
mrf_negotiated_above_gross
highest negotiated rate $86 exceeds the gross charge $75
CPT 32408/b
warn
mrf_negotiated_above_gross
highest negotiated rate $592 exceeds the gross charge $465
CPT 73090/b
warn
mrf_negotiated_above_gross
highest negotiated rate $26 exceeds the gross charge $24
CPT 32551/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,577 exceeds the gross charge $1,314
CPT 32555/b
warn
mrf_negotiated_above_gross
highest negotiated rate $362 exceeds the gross charge $334
CPT 32557/b
warn
mrf_negotiated_above_gross
highest negotiated rate $538 exceeds the gross charge $456
CPT 73100/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $23
CPT 33285/b
warn
mrf_negotiated_above_gross
highest negotiated rate $3,057 exceeds the gross charge $1,082
CPT 73110/b
warn
mrf_negotiated_above_gross
highest negotiated rate $38 exceeds the gross charge $26
CPT 36556/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,163 exceeds the gross charge $2,860
CPT 73115/b
warn
mrf_negotiated_above_gross
highest negotiated rate $118 exceeds the gross charge $78
CPT 36573/b
warn
mrf_negotiated_above_gross
highest negotiated rate $265 exceeds the gross charge $232
CPT 36590/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,577 exceeds the gross charge $744
CPT 73120/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $23
CPT 73130/b
warn
mrf_negotiated_above_gross
highest negotiated rate $34 exceeds the gross charge $26
CPT 37191/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,418 exceeds the gross charge $561
CPT 37191/o
warn
mrf_negotiated_above_gross
highest negotiated rate $5,573 exceeds the gross charge $4,809
CPT 37193/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,033 exceeds the gross charge $889
CPT 73140/b
warn
mrf_negotiated_above_gross
highest negotiated rate $35 exceeds the gross charge $21
CPT 37799/o
warn
mrf_negotiated_above_gross
highest negotiated rate $628 exceeds the gross charge $112
CPT 38222/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,909 exceeds the gross charge $1,921
CPT 73201/b
warn
mrf_negotiated_above_gross
highest negotiated rate $178 exceeds the gross charge $158
CPT 73218/b
warn
mrf_negotiated_above_gross
highest negotiated rate $268 exceeds the gross charge $198
CPT 45388/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,916 exceeds the gross charge $741
CPT 47531/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,586 exceeds the gross charge $2,659
CPT 73220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $361 exceeds the gross charge $316
CPT 49020/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,426 exceeds the gross charge $613
CPT 49418/b
warn
mrf_negotiated_above_gross
highest negotiated rate $869 exceeds the gross charge $563
CPT 49418/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,586 exceeds the gross charge $3,537
CPT 49440/b
warn
mrf_negotiated_above_gross
highest negotiated rate $575 exceeds the gross charge $541
CPT 73222/b
warn
mrf_negotiated_above_gross
highest negotiated rate $277 exceeds the gross charge $237
CPT 49440/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,922 exceeds the gross charge $1,265
CPT 73223/b
warn
mrf_negotiated_above_gross
highest negotiated rate $341 exceeds the gross charge $316
CPT L1820/o
warn
mrf_negotiated_above_gross
highest negotiated rate $153 exceeds the gross charge $143
CPT L1843/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,097 exceeds the gross charge $266
CPT 73501/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $26
CPT L1845/o
warn
mrf_negotiated_above_gross
highest negotiated rate $939 exceeds the gross charge $720
CPT 52332/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,531 exceeds the gross charge $2,278
CPT 55100/o
warn
mrf_negotiated_above_gross
highest negotiated rate $1,654 exceeds the gross charge $790
CPT 73502/b
warn
mrf_negotiated_above_gross
highest negotiated rate $43 exceeds the gross charge $33
CPT L3809/o
warn
mrf_negotiated_above_gross
highest negotiated rate $278 exceeds the gross charge $146
CPT 73503/b
warn
mrf_negotiated_above_gross
highest negotiated rate $55 exceeds the gross charge $39
CPT 59409/o
warn
mrf_negotiated_above_gross
highest negotiated rate $3,242 exceeds the gross charge $3,060
CPT L4386/o
warn
mrf_negotiated_above_gross
highest negotiated rate $194 exceeds the gross charge $172
CPT 73521/b
warn
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $31
CPT L4387/o
warn
mrf_negotiated_above_gross
highest negotiated rate $194 exceeds the gross charge $105
CPT 73522/b
warn
mrf_negotiated_above_gross
highest negotiated rate $48 exceeds the gross charge $43
CPT 73523/b
warn
mrf_negotiated_above_gross
highest negotiated rate $54 exceeds the gross charge $44
CPT M0240/o
warn
mrf_negotiated_above_gross
highest negotiated rate $495 exceeds the gross charge $450
CPT M0243/o
warn
mrf_negotiated_above_gross
highest negotiated rate $495 exceeds the gross charge $450
CPT 73525/b
warn
mrf_negotiated_above_gross
highest negotiated rate $118 exceeds the gross charge $81
CPT M0247/o
warn
mrf_negotiated_above_gross
highest negotiated rate $495 exceeds the gross charge $475
CPT M0249/o
warn
mrf_negotiated_above_gross
highest negotiated rate $495 exceeds the gross charge $475
CPT 73552/b
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $27
CPT 73560/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $25
CPT 85097/o
warn
mrf_negotiated_above_gross
highest negotiated rate $807 exceeds the gross charge $672
CPT 73562/b
warn
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $28
CPT 73564/b
warn
mrf_negotiated_above_gross
highest negotiated rate $44 exceeds the gross charge $34
CPT 73580/b
warn
mrf_negotiated_above_gross
highest negotiated rate $104 exceeds the gross charge $91
CPT 73590/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $24
CPT 73592/b
warn
mrf_negotiated_above_gross
highest negotiated rate $27 exceeds the gross charge $22
CPT 73600/b
warn
mrf_negotiated_above_gross
highest negotiated rate $29 exceeds the gross charge $22
CPT 73610/b
warn
mrf_negotiated_above_gross
highest negotiated rate $33 exceeds the gross charge $26
CPT 73620/b
warn
mrf_negotiated_above_gross
highest negotiated rate $26 exceeds the gross charge $23
CPT 73630/b
warn
mrf_negotiated_above_gross
highest negotiated rate $30 exceeds the gross charge $25
CPT 64581/o
warn
mrf_negotiated_above_gross
highest negotiated rate $6,383 exceeds the gross charge $4,974
CPT 73650/b
warn
mrf_negotiated_above_gross
highest negotiated rate $25 exceeds the gross charge $22
CPT 73660/b
warn
mrf_negotiated_above_gross
highest negotiated rate $25 exceeds the gross charge $20
CPT 73702/b
warn
mrf_negotiated_above_gross
highest negotiated rate $174 exceeds the gross charge $166
CPT 65220/o
warn
mrf_negotiated_above_gross
highest negotiated rate $447 exceeds the gross charge $419
CPT 73718/b
warn
mrf_negotiated_above_gross
highest negotiated rate $198 exceeds the gross charge $185
CPT 73722/b
warn
mrf_negotiated_above_gross
highest negotiated rate $279 exceeds the gross charge $237
CPT 69801/b
warn
mrf_negotiated_above_gross
highest negotiated rate $543 exceeds the gross charge $355
CPT 70030/b
warn
mrf_negotiated_above_gross
highest negotiated rate $29 exceeds the gross charge $27
CPT 73723/b
warn
mrf_negotiated_above_gross
highest negotiated rate $339 exceeds the gross charge $316
CPT 70110/b
warn
mrf_negotiated_above_gross
highest negotiated rate $38 exceeds the gross charge $35
CPT 70150/b
warn
mrf_negotiated_above_gross
highest negotiated rate $42 exceeds the gross charge $36
CPT 70160/b
warn
mrf_negotiated_above_gross
highest negotiated rate $33 exceeds the gross charge $24
CPT 86885/o
warn
mrf_negotiated_above_gross
highest negotiated rate $171 exceeds the gross charge $160
CPT 86900/o
warn
mrf_negotiated_above_gross
highest negotiated rate $133 exceeds the gross charge $130
CPT 74160/b
warn
mrf_negotiated_above_gross
highest negotiated rate $205 exceeds the gross charge $174
CPT 86905/o
warn
mrf_negotiated_above_gross
highest negotiated rate $359 exceeds the gross charge $303
CPT 70220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $34 exceeds the gross charge $31
CPT 74170/b
warn
mrf_negotiated_above_gross
highest negotiated rate $217 exceeds the gross charge $191
CPT 86971/o
warn
mrf_negotiated_above_gross
highest negotiated rate $171 exceeds the gross charge $157
CPT 70250/b
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $25
CPT 74174/b
warn
mrf_negotiated_above_gross
highest negotiated rate $337 exceeds the gross charge $302
CPT 70330/b
warn
mrf_negotiated_above_gross
highest negotiated rate $47 exceeds the gross charge $32
CPT 70360/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $25
CPT 74177/b
warn
mrf_negotiated_above_gross
highest negotiated rate $268 exceeds the gross charge $251
CPT 74178/b
warn
mrf_negotiated_above_gross
highest negotiated rate $301 exceeds the gross charge $275
CPT 70481/b
warn
mrf_negotiated_above_gross
highest negotiated rate $161 exceeds the gross charge $156
CPT 74182/b
warn
mrf_negotiated_above_gross
highest negotiated rate $267 exceeds the gross charge $247
CPT 70482/b
warn
mrf_negotiated_above_gross
highest negotiated rate $186 exceeds the gross charge $173
CPT 74230/b
warn
mrf_negotiated_above_gross
highest negotiated rate $106 exceeds the gross charge $73
CPT 74280/b
warn
mrf_negotiated_above_gross
highest negotiated rate $188 exceeds the gross charge $172
CPT 74300/b
warn
mrf_negotiated_above_gross
highest negotiated rate $50 exceeds the gross charge $38
CPT 88309/o
warn
mrf_negotiated_above_gross
highest negotiated rate $807 exceeds the gross charge $672
CPT 70544/b
warn
mrf_negotiated_above_gross
highest negotiated rate $191 exceeds the gross charge $174
CPT 88381/o
warn
mrf_negotiated_above_gross
highest negotiated rate $164 exceeds the gross charge $106
CPT 70546/b
warn
mrf_negotiated_above_gross
highest negotiated rate $290 exceeds the gross charge $229
CPT 74450/b
warn
mrf_negotiated_above_gross
highest negotiated rate $76 exceeds the gross charge $45
CPT 70547/b
warn
mrf_negotiated_above_gross
highest negotiated rate $191 exceeds the gross charge $175
CPT 75571/o
warn
mrf_negotiated_above_gross
highest negotiated rate $87 exceeds the gross charge $68
CPT 70549/b
warn
mrf_negotiated_above_gross
highest negotiated rate $305 exceeds the gross charge $262
warn
mrf_rate_without_estimate
17,702 of 17,702 percentage/algorithm rates across 1,842 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT 70553/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 76080/b
info
mrf_item_fields_vary
this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

Showing the first 200 of 893 findings, errors first — every finding as JSON →

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. Bates County Memorial Hospital — standard charges file · MO · updated 2026-04-20
    · csv-tall · 50.7M bytes · fetched 2026-08-26 · sha256 1a74d3581997…

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.