Hospital · CCN 260214

Belton Regional Medical Center

17065 S 71 Highway, Belton, MO 64012 · Cass County
Part of HCA Healthcare · 62 beds · 5
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

15 admission types 26 outpatient services price file: ok 3 Medicare-file findings

Billed per dollar paid, all admissions

8.32×

$26.1M billed against $3.1M paid across 314 Medicare discharges; the national figure is 5.03×.

8.1%

of adults in Cass County have medical debt in collections

8.9%

uninsured in the county · state 10.2%

$85K

median household income

8.3×

billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (1 in the inpatient or outpatient file)ⓘ

38.0%

obesity in the countyⓘ

11.5%

diagnosed diabetes (PLACES)

6.4%

coronary heart disease (PLACES)

—

median age · — below poverty (ACS)

01 · Admissions

What it billed Medicare, by admission type

Average charge submitted and average total payment per discharge, 2024. Rows under 11 discharges are suppressed by CMS. The last column is the hospital's ratio against its state's for the same admission.

DRG

Admission

Discharges

Charge

Paid

Billed ÷ paid

871

Septicemia or severe sepsis without mv >96 hours with mcc

$96,956

$13,274

7.3× st 4.6×

193

Simple pneumonia and pleurisy with mcc

$69,026

$8,229

8.4× st 4.5×

291

Heart failure and shock with mcc

$76,492

$8,427

9.1× st 4.4×

683

Renal failure with cc

$61,248

$6,042

10.1× st 4.5×

690

Kidney and urinary tract infections without mcc

$59,953

$6,801

8.8× st 4.5×

872

Septicemia or severe sepsis without mv >96 hours without mcc

$63,425

$6,941

9.1× st 4.6×

682

Renal failure with mcc

$83,300

$9,434

8.8× st 4.4×

884

Organic disturbances and intellectual disability

$73,256

$10,326

7.1× st 3.4×

689

Kidney and urinary tract infections with mcc

$65,514

$7,408

8.8× st 4.5×

640

Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc

$73,186

$8,793

8.3× st 4.4×

470

Major hip and knee joint replacement or reattachment of lower extremity without mcc

$136,253

$12,291

11.1× st 4.5×

481

Hip and femur procedures except major joint with cc

$160,525

$13,533

11.9× st 4.9×

603

Cellulitis without mcc

$56,294

$5,708

9.9× st 4.0×

392

Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc

$69,120

$10,702

6.5× st 4.8×

177

Respiratory infections and inflammations with mcc

$74,206

$11,256

6.6× st 4.5×

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

179

$47,328

$2,359

20.1×

5115

Level 5 Musculoskeletal Procedures

$103,601

$11,480

9.0×

5361

Level 1 Laparoscopy and Related Services

$61,854

$5,039

12.3×

5072

Level 2 Excision/ Biopsy/ Incision and Drainage

$26,613

$1,416

18.8×

5183

Level 3 Vascular Procedures

$40,755

$2,784

14.6×

5114

Level 4 Musculoskeletal Procedures

$81,354

$6,248

13.0×

5113

Level 3 Musculoskeletal Procedures

—

5073

Level 3 Excision/ Biopsy/ Incision and Drainage

—

5362

Level 2 Laparoscopy and Related Services

—

5372

Level 2 Urology and Related Services

—

5374

Level 4 Urology and Related Services

—

5375

Level 5 Urology and Related Services

—

5414

Level 4 Gynecologic Procedures

—

5431

Level 1 Nerve Procedures

—

5465

Level 5 Neurostimulator and Related Procedures

—

5341

Level 1 Abdominal/Peritoneal/Biliary and Related Procedures

—

5331

Complex GI Procedures

—

5112

Level 2 Musculoskeletal Procedures

—

5116

Level 6 Musculoskeletal Procedures

—

5165

Level 5 ENT Procedures

—

5182

Level 2 Vascular Procedures

—

5092

Level 2 Breast/Lymphatic Surgery and Related Procedures

—

5222

Level 2 Pacemaker and Similar Procedures

—

5091

Level 1 Breast/Lymphatic Surgery and Related Procedures

—

5313

Level 3 Lower GI Procedures

—

5302

Level 2 Upper GI Procedures

—

03 · Its own price file

What the hospital's price-transparency file says

Found via /cms-hpt.txt, the file itself ↗ read as json, last updated 2026-03-01, template 3.0.0, 249,604 rows scanned, 15,826 distinct code–setting items kept. 12,031 findings against it.

Service

Code

Listed

Cash

Negotiated

Rates

Checks

Red blood cell antigen typing, DNA, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common RBC alleles reported

CPT 0001U

$429

$440

105

clean

Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algo

CPT 0002M

—

$383

clean

CPT 0003M

—

$383

clean

Oncology (prostate) gene expression profile by real-time RT-PCR of 3 genes (ERG, PCA3, and SPDEF), urine, algorithm reported as risk score

CPT 0005U

—

$578

clean

Oncology (urothelial), mRNA, gene expression profiling by real-time quantitative PCR of five genes (MDK, HOXA13, CDC2 ºCDK1», IGFBP5, and CXCR2), utilizing urine, algorithm reported as a risk score fo

CPT 0012M

—

$578

clean

CPT 0013M

—

$578

clean

Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical ster

CPT 0015M

—

$993

clean

Oncology (bladder), mRNA, microarray gene expression profiling of 219 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as molecular subtype (luminal, luminal infiltrated, b

CPT 0016M

—

$2,654

clean

Oncology (thyroid), microRNA profiling by RT-PCR of 10 miRNA sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy

CPT 0018U

—

$2,283

clean

Oncology (acute myelogenous leukemia), DNA, genotyping of internal tandem duplication, p.D835, p.I836, using mononuclear cells, reported as detection or nondetection of FLT3 mutation and indication fo

CPT 0023U

—

$189

clean

Glycosylated acute phase proteins (GlycA), nuclear magnetic resonance spectroscopy, quantitative

CPT 0024U

—

$26

clean

Oncology (thyroid), DNA and mRNA of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule, algorithmic analysis reported as a categorical result ("Positive, high probability of

CPT 0026U

—

$2,738

clean

JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15

CPT 0027U

—

$93

clean

Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, CYP1A2, CYP2C19, CYP2C9, CYP2D6, CYP3A4, CYP3A5, CYP4F2, SLCO1B1, VKORC1 and rs12777823)

CPT 0029U

—

$565

clean

TPMT (thiopurine S-methyltransferase), NUDT15 (nudix hydroxylase 15) (eg, thiopurine metabolism), gene analysis, common variants (ie, TPMT *2, *3A, *3B, *3C, *4, *5, *6, *8, *12; NUDT15 *3, *4, *5)

CPT 0034U

—

$355

clean

Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative

CPT 0035U

—

$411

clean

Targeted genomic sequence analysis, solid organ neoplasm, DNA analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instabiit

CPT 0037U

—

$2,662

clean

Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, IgM

CPT 0041U

—

$13

clean

Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and m

CPT 0042T

$223

$90

clean

Borrelia burgdoferi, antibody detection of 12 recombinant protein groups, by immunoblot, IgG

CPT 0042U

—

$13

clean

Tick-borne relapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgM

CPT 0043U

—

$11

clean

Tick-borne replapsing fever Borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, IgG

CPT 0044U

—

$11

clean

Oncology (breast ductal carcinoma in situ), mRNA, gene expression progiling by real-time RT-PCR of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm

CPT 0045U

—

$2,945

clean

Oncology (prostate), mRNA, gene expression profiling by real-time RT-PCR of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm report as a risk scor

CPT 0047U

—

$2,945

clean

Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)

CPT 0054T

—

$3,158

clean

Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure)

CPT 0055T

—

$3,158

clean

Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus oncoprotein (small T antigen), serum, quantitative

CPT 0058U

—

$246

clean

Oncology (Merkel cell-carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative

CPT 0059U

—

$246

clean

Transcutaneous measurement of five biomarkers, using spatial frequency domain imaging (SFDI) and multi-spectral analysis

CPT 0061U

—

$19

clean

Antibody, Treponema pallidum, total and rapid plasma reagin (RPR), immunoassay, qualitative

CPT 0064U

—

$24

clean

Syphilis test, non-treponemal antibody, immunoassay, qualitative (RPR)

CPT 0065U

—

$14

clean

Candida species panel (C. albicans, C. glabrata, C. parapsilosis, C. kruseii, C. tropicalis, and C. auris), amplified probe technique with qualitative report of the presence or absence of each species

CPT 0068U

—

$108

clean

Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel

CPT 0075T

—

$11,043

clean

Immunoglobulin paraprotein (M-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype

CPT 0077U

—

$33

clean

Oncology (lung), mass spectrometric analysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein M130, with five clinical risk factors (age, smoking status, nodule diamet

CPT 0080U

—

$2,677

clean

Oncology (melanoma), gene expression profiling by RTqPCR, PRAME and LINC00518, superficial collection using adhesive patch(es)

CPT 0089U

—

$578

clean

Oncology (cutaneous melanoma), mRNA gene expression profiling by RT-PCR of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a categori

CPT 0090U

—

$1,483

clean

Extracorporeal shock wave involving musculoskeletal system, not otherwise specified

CPT 0101T

—

$8,388

clean

Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel utilizing a combination A of NGS, San

CPT 0101U

—

$1,170

clean

Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KI

CPT 0105U

—

$722

clean

Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rat

CPT 0106U

—

$665

clean

Gastroenterology (Barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-

CPT 0108U

—

$3,024

clean

Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene

CPT 0112U

—

$271

clean

Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donoe-derived cell-free DNA in the total cell-f

CPT 0118U

—

$2,094

clean

Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events

CPT 0119U

—

$64

clean

Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and eletion/duplication analysis panel (A

CPT 0129U

—

$992

clean

Infectious disease (bacteria, fungi, parasites, and DNA viruses), DNA, PCR and next-generation sequencing, plasma, detection of >1,000 potential microbial organisms for significant positive pathogens

CPT 0152U

—

$1,617

clean

Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results

CPT 0164U

—

$85

clean

Liver disease, 10 biochemical assays (a2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT, ALT, AST, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utili

CPT 0166U

—

$383

clean

Oncology (solid tumor as indicated by the label), somatic mutation analyis of BRCA1, BRCA2 and analysis of homologous recombination deficiency pathways, DNA, formalin-fixed paraffin-embedded tissue, a

CPT 0172U

—

$2,304

clean

Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 che

CPT 0174U

—

$993

clean

Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness)

CPT 0184T

—

$4,945

clean

Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, w

CPT 0200T

—

$6,995

clean

Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when

CPT 0201T

—

$8,388

clean

Posterior vertebral joint(s) arthroplasty (eg, facet jointºs» replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, i

CPT 0202T

—

$17,672

clean

Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qua

CPT 0202U

$1,458

$366

105

clean

Neurology Alzheimer Disease Cell Aggregation

CPT 0206U

—

$1,685

clean

Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral

CPT 0207T

—

$3,158

clean

Neurology Alzheimer Disease Quantitative Imaging

CPT 0207U

—

$389

clean

Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed

CPT 0232T

—

$1,941

clean

Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel

CPT 0237T

—

$4,945

clean

Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel

CPT 0238T

—

$8,707

clean

Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free DNA, analysis of 311 or more genes, interrogation for sequence variants, including substitutions, insertions, deletions, selec

CPT 0239U

—

$2,662

clean

Inf dis, pathogen spec DNA/RNA, 21 targets, SARS-CoV-2, ampol probe tec, incl multplx rev tx to RNA targ, ea analyte rep as det or not det

CPT 0240U

$98

$72

clean

Inf dis, pathogen-spec RNA, 4 targ SARS-CoV-2, Influ A, B, RSV, Upper resp spec, ea pathogen rep as det or not det

CPT 0241U

$98

$72

clean

Targeted genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 55-74 genes, interrogation for sequence variants, gene copy number amplifications, and gene rearra

CPT 0242U

—

$3,803

clean

Oncology (thyroid), mutation analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers using next-generation sequencing, fine needle aspirate, report includes associated risk of maligna

CPT 0245U

—

$963

clean

Oncology (Solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for somatic alterations, microsatellite instability and tumor-mutation burden

CPT 0250U

—

$2,220

clean

Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, unde

CPT 0275T

—

$8,388

clean

Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)

CPT 0278T

—

$1,261

clean

Oncology (lung), mRNA, quantitative PCR analysis of 11 genes (BAG1,BRCA1,CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR, WNT3A) and 3 reference genes (ESD, TBP, YAP1), formalin-fixed paraffin emb

CPT 0288U

—

$2,945

clean

Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicpathologic factors, utilizing fo

CPT 0295U

—

$3,321

clean

Cardiology (Coronary Artery Disease), analysis of 3 proteins with 3 clinical parameters, plasma, algorithm reported as a risk score for obstructive CAD

CPT 0308U

—

$297

clean

Cardiology (cardiovascular disease), analysis of 4 proteins (NT-proBNP, osteopontin, tissue inhibitor of metalloproteinase-1 [TIMP-1], and kidney injury molecule-1 [KIM-1]), plasma, algorithm reported

CPT 0309U

—

$297

clean

Infectious disease (bacterial), quantitative antimicrobial susceptibility reported as phenotypic minimum inhibitory concentration (MIC)??based antimicrobial susceptibility for each organisms identifi

CPT 0311U

—

clean

Autoimmune diseases (eg, systemic lupus erythematosus [SLE]), analysis of 8 IgG autoantibodies and 2 cell-bound complement activation products using enzyme-linked immunosorbent immunoassay (ELISA), fl

CPT 0312U

—

$639

clean

Oncology (cutaneous squamous cell carcinoma), mRNA gene expression profiling by RT-PCR of 40 genes (34 content and 6 housekeeping), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm

CPT 0315U

—

$6,464

clean

Nephrology (renal transplant), RNA expression by select transcriptome sequencing, using posttransplant peripheral blood, algorithm reported as a risk score for acute cellular rejection

CPT 0320U

—

$2,015

clean

Target genomic sequence analysis panel, solid organ neoplasm, cell-free circulating DNA analysis of 83 or more genes, iterrogation for sequence variants, gene copy number amplifications, gene rearrang

CPT 0326U

—

$3,803

clean

Oncology (neoplasia), exome and transcriptome sequence analysis for sequence variants, gene copy number amplifications and deletions, gene rearrangements, microsatellite instability and tumor mutation

CPT 0329U

—

$2,615

clean

Oncology (solid organ), target geonomic sequence analysis, FFPE tumor tissue, DNA analysis, 84 or more genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements,

CPT 0334U

—

$3,465

clean

Oncology (Plasma cell disorders and myeloma), circulating plasma cell immunologic selection, id, morphological characterization, and enumeration of plasma cells based on differential CD138, CD38, CD19

CPT 0337U

—

$1,852

clean

Oncology (Solid Tumor), circulating tumor cell selection, id, morphological characterization, detection and enumeration based on differential EpCAM, cytokeratins 8, 18 and 19, and CD45 protein biomark

CPT 0338U

—

$1,852

clean

Transcatheter renal sympathetic denervation, percutaneous approach including arterial puncture, selective catheter placement(s) renal artery(ies), fluoroscopy, contrast injection(s), intraprocedural r

CPT 0339T

—

$10,003

clean

Oncology (prostate), mRNA expression profiling of HOXC6 and DLX1, reverse transcription polymerase chain reaction (RT-PCR), first void urine following digital rectal examination, algorithn reporteed a

CPT 0339U

—

$578

clean

Oncology (pan-cancer), analysis of MRD from plasma, with assays personalized to each patient based on prior next generation sequencing of the patient's tumor and germline DNA, reported as absence or p

CPT 0340U

—

$2,730

clean

Hepatology (nonalcoholic fatty liver disease), semiquantitative evaluation of 28 lipid markers by liquid chromatography with tandem mass spectometry, serum, reported as at-risk for nonalcoholic steato

CPT 0344U

—

$602

clean

Psychiatry (eg, depression, anxiety, ADHD), genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6

CPT 0345U

—

$1,016

clean

Beta amyloid, AB40 and AB42 by liquid chromatography with tandem mass spectromety, ratio, plasma

CPT 0346U

—

$57

clean

Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 16 gene report, with variant analysis and reported phenotypes

CPT 0347U

—

$1,016

clean

Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 25 gene report, with variant analysis and reported phenotypes

CPT 0348U

—

$565

clean

Drug metabolism or processing (mult conditions), whole blood or buccal specimen, DNA analysis, 27 gene report, with variant analysis, including reported phenotypes and impacted gene-drug interactions

CPT 0349U

—

$565

clean

Radiologic examination, radiostereometric analysis (RSA); lower extremity(ies), (includes hip, proximal femur, knee, and ankle, when performed)

CPT 0350T

—

$120

clean

Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor related apoptosis-inducing ligand interferon gamma induced protein-10, and C-reactive protein, serum, algorithm repor

CPT 0351U

—

$198

clean

Optical coherence tomography of breast or axillary lymph node, excised tissue, each specimen; interpretation and report, real-time or referred

CPT 0352T

—

$2,186

clean

Infectious disease (bact vaginosis and vaginitis), multiplex amplified probe technique, for detection of bacterial vaginosis-assoc bacteria, algorithm reported as detected or not detected and separate

CPT 0352U

—

$87

clean

Infectious agent detection by nucleic acid, Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technque, urine, vaginal, pharyngeal or rectal, each pathogen reported as detecte

CPT 0353U

—

$43

clean

Apol1 (apolipoprotein l1) (eg, chronic kidney disease), risk variants

CPT 0355U

—

$104

clean

Oncology evaluation of 17 DNA biomarkers using droplet digital PCR, cell-free DNA, algorithm reported as a prognostic risk score for cancer recurrence

CPT 0356U

—

$1,800

clean

Neurology (mild cognitive impairment), analysis of b-amyloid 1-42 and 1-40, chemiluminescence enzyme immunoassay, cerebral spinal fluid, reported as positive, likely positive, or negative

CPT 0358U

—

$198

clean

Oncology (prostate cancer), analysis of all prostate-specific antigen (psa) structural isoforms by phase separation and immunoassay, plasma, algorithm reports risk of cancer

CPT 0359U

—

$578

clean

Oncology (lung), enzyme-linked immunosorbent assay of 7 autoantibodies, plasma, algorithm reported as a categorical result for risk of malignancy

CPT 0360U

—

$639

clean

Oncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of 5 genes (mdk, hoxa13, cdc2 ºcdk1», igfbp5, and cxcr2), utilizing urine, algorithm incorporates age, sex, smoking

CPT 0363U

—

$578

clean

Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of bladder cancer

CPT 0365U

—

$682

clean

Oncology (bladder), analysis of 10 protein biomarkers by immunoassays, urine, algorithm reported as a probability of recurrent bladder cancer

CPT 0366U

—

$682

clean

Oncology (ovarian), biochemical assays of 7 proteins (follicle stimulating hormone, human epididymis protein 4, apolipoprotein A-1, transferrin, beta-2 macroglobulin, prea0lbumin, and cancer antigen 1

CPT 0375U

—

$682

clean

Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prostate cancer-specific morta

CPT 0376U

—

$537

clean

Targeted genomic sequence analysis panel, solid organ neoplasm, DNA (523 genes) and RNA (55 genes) by next-gen seq, interrogation for sequence variants, gene copy number amplifications, gene rearrange

CPT 0379U

—

$3,289

clean

Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis, 20 gene variants and CYP2D6 deletion or duplication anaylsis with reported genotype and phenotype

CPT 0380U

—

$255

clean

Oncology, next-generation sequencing with ident of single nucleotide variants, copy number variants, insertions and deletions, and scructural variants in 37 cancer related genes, plasma, with report f

CPT 0388U

—

$3,500

clean

Neurology, cerebrospinal fluid, detection of misfolded a-synuclein protein by see amplification assay, qualitative

CPT 0393U

—

$411

clean

High dose rate electronic brachytherapy, skin surface application, per fraction, includes basic dosimetry, when performed

CPT 0394T

—

$355

clean

Perfluroalkyl substances, 16 PFAS compounds by liquid chromatography with tandem mass spectrometry, plasma or serum, quantitative

CPT 0394U

—

$151

clean

High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, includes basic dosimetry, when performed

CPT 0395T

—

$948

clean

Gastroenterology (Barret esophagus), P16, RUNX3,HPP1, & FBN1 DNA methylation analysis using PCR, FFPE tissue, algorithm reported as risk score for progression to high-grade dysplasia or cancer

CPT 0398U

—

$1,755

clean

Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed

CPT 0402T

—

$3,701

clean

Oncology (Prostate), mRNA, gene expression peofiling of 18 genes, first-catch, algorithm reported as percentage of likelihood of detecting clinical significant prostate cancer

CPT 0403U

—

$578

clean

Oncology (breast), semiquantitative measurement of thymidine kinase activity by immunoassay, serum, results as risk of disease progression

CPT 0404U

—

$246

clean

Oncology (lung), flow cytometry, sputum, 5 markers (meso-tetra porphyrin (TCPP), CD206, CD66b, CD3, CD19), algorithm reported as likelihood of lung cancer

CPT 0406U

—

$578

clean

Nephrology (diabetic chronic kidney disease), multiplex electrochiluminescent immunoassay of soluble tumor necrosis factor receptor 1, 2, and kidney injury molecule 1 combined with clinical data, plas

CPT 0407U

—

$722

clean

Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator

CPT 0408T

—

$4,764

clean

Oncology (solid tumor), DNA (80 genes) & RNA (36 genes), by next-generation sequencing from plasma, including single nucleotide variants, insertions, deletions, copy number alterations, microsatellite

CPT 0409U

—

$2,220

clean

Psychiatry (eg depression, anxiety, ADHD) genomic analysis panel, variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6

CPT 0411U

—

$1,016

clean

Cardiovascular disease , IL-16, FAS, FASLigand, HGF, CTACK, EOTAXIN, and MCP-3 by immunoassay combined with age, sex, family history, and personal history of diabetes, blood, algorithm reported as a 5

CPT 0415U

—

$297

clean

Transurethral waterjet ablation of prostate, including control of post-operative bleeding, including ultrasound guidance, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or

CPT 0421T

—

$4,907

clean

Oncology (pan-solid tumor), analysis of DNA biomarker response to anti-cancer therapy using cell-free circulating DNA, biomarker comparison to a previous baseline pre-treatment cell-free circulating D

CPT 0422U

—

$1,943

clean

Gastroenterology, malabsorption evaluation of alpha-1-antitrypsin, calprotectin, pancreatic elastase and reducing substances, feces, quantitative

CPT 0430U

—

$62

clean

Glycine receptor alpha1 IgG, serum or cerebrospinal fluid, live cell-binding assay, qualitative

CPT 0431U

—

$37

clean

Kelch-like protein 11 antibody, serum or cerebrospinal fluid, cell-binding assay, qualitative

CPT 0432U

—

$37

clean

Oncology (prostate), 5 DNA regulatory markers by quantitative PCR, whole blood, algorithm, including prostate-specific antigen, reported as likelihood of cancer

CPT 0433U

—

$760

clean

Drug metabolism (adverse drug reactions and drug response), genomic analysis panel, variant analysis of 25 genes with reported phenotypes

CPT 0434U

—

$417

clean

Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure)

CPT 0437T

—

$3,158

clean

Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve

CPT 0441T

—

$3,701

clean

Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)

CPT 0442T

—

$4,907

clean

Neurofilament light chain, ultra-sensitive immunoassay, serum or cerebrospinal fluid

CPT 0443U

—

$116

clean

Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training

CPT 0446T

—

$3,351

clean

Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision

CPT 0447T

—

$2,255

clean

Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation

CPT 0448T

—

$3,351

clean

Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device

CPT 0449T

—

$7,194

clean

Oncology (solid tumor),nextgeneration sequencing (NGS) of DNA from formalin-fixed paraffinembedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen (blood or saliva), 68

CPT 0473U

—

$4,500

clean

Hereditary prostate cancer-related disorders,genomic sequence analysis panel using next-generation sequencing (NGS),Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA),and array

CPT 0475U

—

$1,304

clean

Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children

CPT 0479T

—

$3,158

clean

Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part ther

CPT 0480T

—

$3,158

clean

Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed

CPT 0483T

—

$11,043

clean

Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)

CPT 0484T

—

$11,043

clean

Oncology (solid tumor), cell-free DNA and RNA by next-generation sequencing, interpretative report for germline mutations, clonal hematopoiesis of indeterminate potential, and tumor-derived single-nuc

CPT 0485U

—

$3,649

clean

Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservatio

CPT 0494T

—

$11,043

clean

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pu

CPT 0495T

—

$11,043

clean

Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultraso

CPT 0505T

—

$10,043

clean

Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound

CPT 0512T

—

$2,583

clean

Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure)

CPT 0513T

—

$1,261

clean

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interp

CPT 0523T

—

$1,261

clean

Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; complete system

CPT 0525T

—

$7,106

clean

Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional

CPT 0552T

—

$2,810

clean

Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide

CPT 0561T

—

$125

clean

Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral

CPT 0563T

—

$2,255

clean

Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis

CPT 0569T

—

$11,043

clean

Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure)

CPT 0570T

—

$11,043

clean

Insertion or replacement of implantable cardioverter-defibrillator system with substernal electrode(s), including all imaging guidance and electrophysiological evaluation (includes defibrillation thre

CPT 0571T

—

$12,152

clean

Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral

CPT 0581T

—

$7,459

clean

Real-time fluorescence wound imaging with clinical darkness, to identify location of bacterial wound pathogens and measure wound size, per session; first anatomic site (eg, lower extremity, right leg)

CPT 0598T

—

$595

clean

Ablation, irreversible electroporation; 1 or more tumors per organ, other than liver or prostate, including imaging guidance, when performed, percutaneous

CPT 0600T

—

$10,043

clean

Ablation, irreversible electroporation; 1 or more tumors per organ, including fluoroscopic and ultrasound guidance, when performed, open

CPT 0601T

—

$8,710

clean

Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; remote surveillance center technical su

CPT 0605T

—

$84

clean

Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; without removal of crystalline lens or intraocular lens, without insertion of intraocular lens

CPT 0616T

—

$8,945

clean

Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of intraocular lens

CPT 0617T

—

$8,945

clean

Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or intraocular lens exchange

CPT 0618T

—

$8,945

clean

Cystourethroscopy with transurethral anterior prostate commissurotomy and drug delivery, including transrectal ultrasound and fluoroscopy, when performed

CPT 0619T

—

$7,996

clean

Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ul

CPT 0620T

—

$10,043

clean

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level

CPT 0627T

—

$3,701

clean

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separ

CPT 0628T

—

$3,158

clean

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level

CPT 0629T

—

$3,701

clean

Computed tomography, breast, including 3D rendering, when performed, bilateral; without contrast, followed by contrast material(s)

CPT 0638T

—

$509

106

clean

Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated bloo

CPT 0644T

—

$11,870

clean

Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ve

CPT 0646T

—

$11,043

clean

Insertion of gastrostomy tube, percutaneous, with magnetic gastropexy, under ultrasound guidance, image documentation and report

CPT 0647T

—

$7,194

clean

Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and rep

CPT 0648T

—

$1,319

101

clean

CPT 0649T

—

$1,319

clean

Esophagogastroduodenoscopy, flexible, transnasal; with insertion of intraluminal tube or catheter

CPT 0654T

—

$4,907

clean

Transperineal focal laser ablation of malignant prostate tissue, including transrectal imaging guidance, with MR-fused images or other enhanced ultrasound imaging

CPT 0655T

—

$5,620

clean

Electrical impedance spectroscopy of 1 or more skin lesions for automated melanoma risk score

CPT 0658T

—

$125

clean

Implantation of anterior segment intraocular nonbiodegradable drug-eluting system, internal approach

CPT 0660T

—

$7,500

clean

Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more

CPT 0671T

—

$7,194

clean

Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance

CPT 0673T

—

$3,701

clean

Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance

CPT 0686T

—

$10,043

clean

Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance a

CPT 0707T

—

$5,687

clean

Quantitative magnetic resonance cholangiopancreatography (QMRCP), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (MRI) exam

CPT 0724T

—

$1,319

clean

Real-time pressure-sensing epidural guidance system (List separately in addition to code for primary procedure)

CPT 0777T

—

$3,701

clean

Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract

CPT 0780T

—

$3,158

clean

Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venograp

CPT 0795T

—

$11,039

clean

CPT 0796T

—

$10,043

clean

CPT 0797T

—

$12,237

clean

Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies

CPT 0810T

—

$8,710

clean

Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, program

CPT 0816T

—

$4,907

clean

CPT 0817T

—

$4,907

clean

Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous

CPT 0818T

—

$4,111

clean

Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculogr

CPT 0823T

—

$11,039

clean

Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy

CPT 0864T

—

$2,255

clean

Quantitative magnetic resonance image (MRI) analysis of the brain with comparison to prior magnetic resonance (MR) study(ies), including lesion detection, characterization, and quantification, with br

CPT 0866T

—

$324

clean

Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion

CPT 0894T

—

$11,043

clean

Showing the first 200 of 15,826 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service

Severity

Rule

Detail

CPT 87507/o

warn

mrf_negotiated_above_gross

highest negotiated rate $967 exceeds the gross charge $926

CPT 0042T/o

warn

mrf_negotiated_above_gross

highest negotiated rate $811 exceeds the gross charge $223

CPT 99282/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,600 exceeds the gross charge $1,336

CPT 99283/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,765 exceeds the gross charge $2,298

CPT 93312/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30,000 exceeds the gross charge $12,202

CPT 99284/o

warn

mrf_negotiated_above_gross

highest negotiated rate $6,885 exceeds the gross charge $5,409

CPT 99285/o

warn

mrf_negotiated_above_gross

highest negotiated rate $10,715 exceeds the gross charge $9,816

CPT Q4104/o

warn

mrf_negotiated_above_gross

highest negotiated rate $210 exceeds the gross charge $111

CPT 29581/o

warn

mrf_negotiated_above_gross

highest negotiated rate $7,365 exceeds the gross charge $115

CPT 81415/o

warn

mrf_negotiated_above_gross

highest negotiated rate $11,090 exceeds the gross charge $2,363

CPT 81416/o

warn

mrf_negotiated_above_gross

highest negotiated rate $27,840 exceeds the gross charge $784

CPT 85055/o

warn

mrf_negotiated_above_gross

highest negotiated rate $83 exceeds the gross charge $10

CPT A2008/o

warn

mrf_negotiated_above_gross

highest negotiated rate $210 exceeds the gross charge $94

CPT 75571/o

warn

mrf_negotiated_above_gross

highest negotiated rate $811 exceeds the gross charge $303

CPT 29584/o

warn

mrf_negotiated_above_gross

highest negotiated rate $7,365 exceeds the gross charge $106

CPT 93325/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30,000 exceeds the gross charge $3,812

CPT 36500/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,111 exceeds the gross charge $1,181

CPT Q4114/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,670 exceeds the gross charge $3,637

CPT J8560/o

warn

mrf_negotiated_above_gross

highest negotiated rate $143 exceeds the gross charge $28

CPT A4385/o

warn

mrf_negotiated_above_gross

highest negotiated rate $8 exceeds the gross charge $2

CPT Q4116/o

warn

mrf_negotiated_above_gross

highest negotiated rate $210 exceeds the gross charge $80

CPT A4409/o

warn

mrf_negotiated_above_gross

highest negotiated rate $9 exceeds the gross charge $4

CPT A5056/o

warn

mrf_negotiated_above_gross

highest negotiated rate $7 exceeds the gross charge $3

CPT A5063/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4 exceeds the gross charge $3

CPT J2690/o

warn

mrf_negotiated_above_gross

highest negotiated rate $568 exceeds the gross charge $125

CPT A5200/o

warn

mrf_negotiated_above_gross

highest negotiated rate $17 exceeds the gross charge $14

CPT A9508/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,572 exceeds the gross charge $541

CPT J1205/o

warn

mrf_negotiated_above_gross

highest negotiated rate $96 exceeds the gross charge $86

CPT A9516/o

warn

mrf_negotiated_above_gross

highest negotiated rate $200 exceeds the gross charge $197

CPT 90619/o

warn

mrf_negotiated_above_gross

highest negotiated rate $350 exceeds the gross charge $269

CPT 90620/o

warn

mrf_negotiated_above_gross

highest negotiated rate $497 exceeds the gross charge $344

CPT 90621/o

warn

mrf_negotiated_above_gross

highest negotiated rate $447 exceeds the gross charge $388

CPT A9538/o

warn

mrf_negotiated_above_gross

highest negotiated rate $66 exceeds the gross charge $26

CPT 81162/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,234 exceeds the gross charge $1,372

CPT A9541/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,240 exceeds the gross charge $76

CPT 75860/o

warn

mrf_negotiated_above_gross

highest negotiated rate $6,439 exceeds the gross charge $4,512

CPT A9553/o

warn

mrf_negotiated_above_gross

highest negotiated rate $3,165 exceeds the gross charge $745

CPT 87636/o

warn

mrf_negotiated_above_gross

highest negotiated rate $331 exceeds the gross charge $98

CPT A9562/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,309 exceeds the gross charge $201

CPT 87637/o

warn

mrf_negotiated_above_gross

highest negotiated rate $331 exceeds the gross charge $98

CPT 36600/o

warn

mrf_negotiated_above_gross

highest negotiated rate $10,852 exceeds the gross charge $276

CPT 75893/o

warn

mrf_negotiated_above_gross

highest negotiated rate $10,733 exceeds the gross charge $6,155

CPT 36620/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30,000 exceeds the gross charge $3,849

CPT 75898/o

warn

mrf_negotiated_above_gross

highest negotiated rate $6,439 exceeds the gross charge $5,340

CPT 86885/o

warn

mrf_negotiated_above_gross

highest negotiated rate $139 exceeds the gross charge $54

CPT 90675/o

warn

mrf_negotiated_above_gross

highest negotiated rate $528 exceeds the gross charge $490

CPT J1410/o

warn

mrf_negotiated_above_gross

highest negotiated rate $646 exceeds the gross charge $267

CPT J3030/o

warn

mrf_negotiated_above_gross

highest negotiated rate $313 exceeds the gross charge $297

CPT 71271/o

warn

mrf_negotiated_above_gross

highest negotiated rate $811 exceeds the gross charge $703

CPT 93621/o

warn

mrf_negotiated_above_gross

highest negotiated rate $35,496 exceeds the gross charge $1,083

CPT 90698/o

warn

mrf_negotiated_above_gross

highest negotiated rate $233 exceeds the gross charge $136

CPT 93641/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30,000 exceeds the gross charge $2,857

CPT 86927/o

warn

mrf_negotiated_above_gross

highest negotiated rate $175 exceeds the gross charge $69

CPT 90713/o

warn

mrf_negotiated_above_gross

highest negotiated rate $94 exceeds the gross charge $85

CPT 93660/o

warn

mrf_negotiated_above_gross

highest negotiated rate $8,300 exceeds the gross charge $2,495

CPT J3250/o

warn

mrf_negotiated_above_gross

highest negotiated rate $95 exceeds the gross charge $84

CPT 90732/o

warn

mrf_negotiated_above_gross

highest negotiated rate $220 exceeds the gross charge $122

CPT 93662/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30,000 exceeds the gross charge $3,408

CPT 86971/o

warn

mrf_negotiated_above_gross

highest negotiated rate $291 exceeds the gross charge $61

CPT 90734/o

warn

mrf_negotiated_above_gross

highest negotiated rate $350 exceeds the gross charge $210

CPT 81220/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,291 exceeds the gross charge $387

CPT 86976/o

warn

mrf_negotiated_above_gross

highest negotiated rate $112 exceeds the gross charge $82

CPT 86985/o

warn

mrf_negotiated_above_gross

highest negotiated rate $149 exceeds the gross charge $110

CPT 81229/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,691 exceeds the gross charge $1,110

CPT 91010/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,111 exceeds the gross charge $2,605

CPT 86078/o

warn

mrf_negotiated_above_gross

highest negotiated rate $149 exceeds the gross charge $110

CPT J1610/o

warn

mrf_negotiated_above_gross

highest negotiated rate $272 exceeds the gross charge $219

CPT 87150/o

warn

mrf_negotiated_above_gross

highest negotiated rate $81 exceeds the gross charge $33

CPT 94760/o

warn

mrf_negotiated_above_gross

highest negotiated rate $533 exceeds the gross charge $522

CPT J1742/o

warn

mrf_negotiated_above_gross

highest negotiated rate $328 exceeds the gross charge $112

CPT 95806/o

warn

mrf_negotiated_above_gross

highest negotiated rate $2,348 exceeds the gross charge $1,677

CPT J1750/o

warn

mrf_negotiated_above_gross

highest negotiated rate $30 exceeds the gross charge $22

CPT J0572/o

warn

mrf_negotiated_above_gross

highest negotiated rate $10 exceeds the gross charge $3

CPT 92552/o

warn

mrf_negotiated_above_gross

highest negotiated rate $77 exceeds the gross charge $70

CPT 96377/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,111 exceeds the gross charge $232

CPT 77063/o

warn

mrf_negotiated_above_gross

highest negotiated rate $89 exceeds the gross charge $67

CPT 92568/o

warn

mrf_negotiated_above_gross

highest negotiated rate $41 exceeds the gross charge $27

CPT 92577/o

warn

mrf_negotiated_above_gross

highest negotiated rate $234 exceeds the gross charge $51

CPT 88319/o

warn

mrf_negotiated_above_gross

highest negotiated rate $656 exceeds the gross charge $559

CPT 92583/o

warn

mrf_negotiated_above_gross

highest negotiated rate $94 exceeds the gross charge $63

CPT 0240U/o

warn

mrf_negotiated_above_gross

highest negotiated rate $126 exceeds the gross charge $98

CPT 0241U/o

warn

mrf_negotiated_above_gross

highest negotiated rate $126 exceeds the gross charge $98

CPT 88333/o

warn

mrf_negotiated_above_gross

highest negotiated rate $656 exceeds the gross charge $136

CPT 88334/o

warn

mrf_negotiated_above_gross

highest negotiated rate $102 exceeds the gross charge $75

CPT L1830/o

warn

mrf_negotiated_above_gross

highest negotiated rate $75 exceeds the gross charge $25

CPT 0001U/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,094 exceeds the gross charge $429

CPT C9363/o

warn

mrf_negotiated_above_gross

highest negotiated rate $210 exceeds the gross charge $122

CPT 92620/o

warn

mrf_negotiated_above_gross

highest negotiated rate $117 exceeds the gross charge $98

CPT 87426/o

warn

mrf_negotiated_above_gross

highest negotiated rate $65 exceeds the gross charge $36

CPT 74190/o

warn

mrf_negotiated_above_gross

highest negotiated rate $1,086 exceeds the gross charge $657

CPT 87428/o

warn

mrf_negotiated_above_gross

highest negotiated rate $107 exceeds the gross charge $50

CPT 88377/o

warn

mrf_negotiated_above_gross

highest negotiated rate $745 exceeds the gross charge $257

CPT 97597/o

warn

mrf_negotiated_above_gross

highest negotiated rate $4,111 exceeds the gross charge $799

CPT 29105/o

warn

mrf_negotiated_above_gross

highest negotiated rate $7,365 exceeds the gross charge $1,204

CPT 29125/o

warn

mrf_negotiated_above_gross

highest negotiated rate $7,365 exceeds the gross charge $822

CPT 81374/o

warn

mrf_negotiated_above_gross

highest negotiated rate $172 exceeds the gross charge $121

CPT Q2026/o

warn

mrf_negotiated_above_gross

highest negotiated rate $576 exceeds the gross charge $182

CPT J7525/o

warn

mrf_negotiated_above_gross

highest negotiated rate $433 exceeds the gross charge $276

CPT 36415/o

warn

mrf_negotiated_above_gross

highest negotiated rate $3,508 exceeds the gross charge $72

CPT J0841/o

warn

mrf_negotiated_above_gross

highest negotiated rate $8,127 exceeds the gross charge $2,668

CPT Q2038/o

warn

mrf_negotiated_above_gross

highest negotiated rate $92 exceeds the gross charge $88

warn

mrf_rate_without_estimate

30,945 of 30,945 percentage/algorithm rates across 5,358 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do

CPT 0039U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0290U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0524T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item

CPT 0973T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item

CPT 15300/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 20661/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 21813/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 24140/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 26030/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 27198/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 27752/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 29355/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 31577/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 33279/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 34101/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 36420/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 38227/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 43116/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 44212/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 46999/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 50075/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 52353/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 56441/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 59525/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 62252/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 64629/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 67042/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 69990/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 74425/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item

CPT 77770/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 80375/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 81382/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 82820/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 84999/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 86698/o

info

mrf_item_fields_vary

this code and setting cover at least 7 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 87506/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 89259/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 93017/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item

CPT 99211/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item

CPT C9781/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J0870/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J2407/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J7608/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 Q2042/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 065/i

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 381/i

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 698/i

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0040U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0291U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0525T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0974T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item

CPT 15301/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 20662/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 21820/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 24145/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 26034/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 27200/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 27756/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 29358/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 31578/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 33280/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 34111/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 36425/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 38228/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 43117/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 44213/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 47000/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 50080/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 52354/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 56442/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 59610/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 62256/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 64630/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 67043/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 70010/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 74430/o

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item

CPT 77771/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 80376/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item

CPT 81383/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 82930/o

info

mrf_item_fields_vary

this code and setting cover at least 4 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 85002/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 86701/o

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 89260/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 93041/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 99212/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 C9782/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J0872/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J2410/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT J7611/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT Q2043/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 066/i

info

mrf_item_fields_vary

this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 382/i

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

MS-DRG 699/i

info

mrf_item_fields_vary

this code and setting cover at least 5 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0041U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0292U/o

info

mrf_item_fields_vary

this code and setting cover at least 3 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0526T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item

CPT 0975T/o

info

mrf_item_fields_vary

this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item

CPT 15320/o

info

mrf_item_fields_vary

this code and setting cover at 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 12,031 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service

Severity

Rule

Detail

MS-DRG 470

info

inp_charge_10x_payment

average charge $136,253 is 11.1× the total payment

MS-DRG 481

info

inp_charge_10x_payment

average charge $160,525 is 11.9× the total payment

MS-DRG 683

info

inp_charge_10x_payment

average charge $61,248 is 10.1× the total payment

Sources for this hospital

the files read, as fetched — not our copy of them

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)
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)
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
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)
Belton Regional Medical Center — standard charges file · MO · updated 2026-03-01
· json · 388.8M bytes · fetched 2026-08-24 · sha256 b15925f06228…

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.