Hospital · CCN 310028

Newton Medical Center

175 High St, Newton, NJ 07860 · Sussex County
Part of Atlantic Health System · 139 beds · 1
Metropolitan area high commuting: primary flow 30% or more to a urbanized area of 50,000 and greater

65 admission types 42 outpatient services price file: ok 60 Medicare-file findings
Billed per dollar paid, all admissions
13.38×
$351.5M billed against $26.3M paid across 2,387 Medicare discharges; the national figure is 5.03×.
1.3%
of adults in Sussex County have medical debt in collections
5.4%
uninsured in the county · state 8.0%
$110K
median household income
13.4×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (1 in the inpatient or outpatient file)ⓘ
26.9%
obesity in the countyⓘ
9.5%
diagnosed diabetes (PLACES)
5.8%
coronary heart disease (PLACES)
—
median age · — below poverty (ACS)
01 · Admissions

What it billed Medicare, by admission type

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

DRG
Admission
Discharges
Charge
Paid
Billed ÷ paid
871
Septicemia or severe sepsis without mv >96 hours with mcc
287
$198,099
$15,585
12.7× st 6.8×
291
Heart failure and shock with mcc
189
$141,821
$10,227
13.9× st 7.6×
603
Cellulitis without mcc
92
$86,940
$7,337
11.9× st 7.0×
193
Simple pneumonia and pleurisy with mcc
89
$169,002
$10,878
15.5× st 7.6×
689
Kidney and urinary tract infections with mcc
81
$152,560
$9,550
16.0× st 7.5×
177
Respiratory infections and inflammations with mcc
78
$179,568
$12,941
13.9× st 7.3×
280
Acute myocardial infarction, discharged alive with mcc
76
$200,594
$12,538
16.0× st 7.3×
690
Kidney and urinary tract infections without mcc
74
$104,200
$6,687
15.6× st 7.8×
698
Other kidney and urinary tract diagnoses with mcc
72
$174,179
$14,373
12.1× st 6.8×
872
Septicemia or severe sepsis without mv >96 hours without mcc
65
$124,460
$8,480
14.7× st 7.3×
190
Chronic obstructive pulmonary disease with mcc
56
$160,202
$9,418
17.0× st 8.3×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
55
$86,374
$6,216
13.9× st 7.5×
378
Gastrointestinal hemorrhage with cc
54
$127,834
$7,681
16.6× st 7.9×
194
Simple pneumonia and pleurisy with cc
47
$101,728
$6,703
15.2× st 8.0×
853
Infectious and parasitic diseases with o.r. procedures with mcc
45
$440,617
$43,933
10.0× st 6.0×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
43
$89,832
$6,438
14.0× st 7.8×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
43
$128,726
$8,121
15.9× st 8.5×
309
Cardiac arrhythmia and conduction disorders with cc
42
$84,384
$5,767
14.6× st 8.0×
281
Acute myocardial infarction, discharged alive with cc
38
$108,503
$7,973
13.6× st 7.4×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
35
$114,955
$10,262
11.2× st 7.2×
682
Renal failure with mcc
32
$163,549
$11,386
14.4× st 7.3×
308
Cardiac arrhythmia and conduction disorders with mcc
30
$169,745
$9,502
17.9× st 8.3×
377
Gastrointestinal hemorrhage with mcc
29
$190,873
$13,669
14.0× st 7.2×
178
Respiratory infections and inflammations with cc
29
$130,670
$8,294
15.8× st 8.1×
312
Syncope and collapse
28
$105,724
$7,280
14.5× st 7.8×
683
Renal failure with cc
28
$106,606
$7,075
15.1× st 7.5×
552
Medical back problems without mcc
26
$105,572
$7,424
14.2× st 6.7×
602
Cellulitis with mcc
25
$167,941
$13,408
12.5× st 6.8×
812
Red blood cell disorders without mcc
23
$121,333
$7,168
16.9× st 7.6×
064
Intracranial hemorrhage or cerebral infarction with mcc
21
$158,007
$14,201
11.1× st 7.3×
175
Pulmonary embolism with mcc or acute cor pulmonale
21
$124,016
$10,923
11.4× st 7.4×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
21
$118,334
$9,250
12.8× st 6.9×
372
Major gastrointestinal disorders and peritoneal infections with cc
20
$102,898
$8,212
12.5× st 7.4×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
20
$191,235
$16,379
11.7× st 7.5×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
20
$132,487
$10,849
12.2× st 7.2×
699
Other kidney and urinary tract diagnoses with cc
20
$271,606
$17,027
16.0× st 6.6×
638
Diabetes with cc
19
$130,300
$7,681
17.0× st 7.8×
069
Transient ischemia without thrombolytic
19
$108,097
$6,332
17.1× st 7.8×
202
Bronchitis and asthma with cc/mcc
19
$109,008
$8,358
13.0× st 7.6×
191
Chronic obstructive pulmonary disease with cc
19
$95,151
$7,378
12.9× st 7.7×
481
Hip and femur procedures except major joint with cc
18
$157,408
$15,834
9.9× st 5.9×
884
Organic disturbances and intellectual disability
18
$129,574
$12,860
10.1× st 5.8×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
17
$82,322
$7,038
11.7× st 6.0×
389
Gastrointestinal obstruction with cc
17
$72,566
$6,804
10.7× st 7.3×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
17
$71,551
$4,517
15.8× st 7.8×
282
Acute myocardial infarction, discharged alive without cc/mcc
16
$90,031
$6,592
13.7× st 7.4×
813
Coagulation disorders
16
$148,287
$11,910
12.5× st 6.5×
394
Other digestive system diagnoses with cc
16
$114,035
$7,417
15.4× st 7.1×
432
Cirrhosis and alcoholic hepatitis with mcc
16
$207,832
$14,792
14.1× st 7.1×
536
Fractures of hip and pelvis without mcc
16
$85,239
$6,144
13.9× st 6.8×
637
Diabetes with mcc
15
$123,699
$11,002
11.2× st 6.8×
305
Hypertension without mcc
15
$85,343
$6,991
12.2× st 7.2×
176
Pulmonary embolism without mcc
14
$88,007
$6,364
13.8× st 7.2×
854
Infectious and parasitic diseases with o.r. procedures with cc
14
$155,425
$19,368
8.0× st 6.3×
149
Dysequilibrium
13
$110,918
$5,915
18.8× st 7.7×
522
Hip replacement with principal diagnosis of hip fracture without mcc
13
$186,065
$18,915
9.8× st 5.9×
092
Other disorders of nervous system with cc
13
$105,693
$7,966
13.3× st 6.9×
556
Signs and symptoms of musculoskeletal system and connective tissue without mcc
13
$85,833
$6,505
13.2× st 7.5×
811
Red blood cell disorders with mcc
12
$165,933
$10,618
15.6× st 7.3×
917
Poisoning and toxic effects of drugs with mcc
12
$130,863
$15,463
8.5× st 6.0×
543
Pathological fractures and musculoskeletal and connective tissue malignancy with cc
12
$117,190
$8,391
14.0× st 7.2×
057
Degenerative nervous system disorders without mcc
11
$110,202
$9,988
11.0× st 6.0×
371
Major gastrointestinal disorders and peritoneal infections with mcc
11
$146,429
$15,055
9.7× st 6.5×
445
Disorders of the biliary tract with cc
11
$132,081
$8,279
16.0× st 7.8×
315
Other circulatory system diagnoses with cc
11
$88,233
$7,429
11.9× st 7.7×
02 · Outpatient

Outpatient services

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

APC
Service
Services
Charge
Allowed
Billed ÷ allowed
8011
Comprehensive Observation Services
361
$42,530
$2,834
15.0×
5375
Level 5 Urology and Related Services
83
$35,981
$5,313
6.8×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
82
$22,542
$1,684
13.4×
5373
Level 3 Urology and Related Services
69
$34,970
$2,078
16.8×
5374
Level 4 Urology and Related Services
56
$34,137
$3,598
9.5×
5361
Level 1 Laparoscopy and Related Services
49
$65,494
$6,041
10.8×
5191
Level 1 Endovascular Procedures
49
$40,337
$3,367
12.0×
5183
Level 3 Vascular Procedures
43
$29,970
$3,337
9.0×
5113
Level 3 Musculoskeletal Procedures
39
$35,380
$3,319
10.7×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
37
$45,611
$3,622
12.6×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
34
$28,811
$2,975
9.7×
5431
Level 1 Nerve Procedures
32
$16,731
$1,971
8.5×
5302
Level 2 Upper GI Procedures
29
$11,564
$1,992
5.8×
5112
Level 2 Musculoskeletal Procedures
25
$25,430
$1,683
15.1×
5114
Level 4 Musculoskeletal Procedures
22
$74,346
$7,490
9.9×
5182
Level 2 Vascular Procedures
22
$13,258
$1,677
7.9×
5115
Level 5 Musculoskeletal Procedures
22
$111,435
$13,755
8.1×
5414
Level 4 Gynecologic Procedures
15
$31,921
$3,273
9.8×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
11
$46,841
$3,991
11.7×
5362
Level 2 Laparoscopy and Related Services
—
—
—
—
5372
Level 2 Urology and Related Services
—
—
—
—
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5224
Level 4 Pacemaker and Similar Procedures
—
—
—
—
5465
Level 5 Neurostimulator and Related Procedures
—
—
—
—
5464
Level 4 Neurostimulator and Related Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5376
Level 6 Urology and Related Services
—
—
—
—
5154
Level 4 Airway Endoscopy
—
—
—
—
5342
Level 2 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5155
Level 5 Airway Endoscopy
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5165
Level 5 ENT Procedures
—
—
—
—
5153
Level 3 Airway Endoscopy
—
—
—
—
5193
Level 3 Endovascular Procedures
—
—
—
—
5194
Level 4 Endovascular Procedures
—
—
—
—
5222
Level 2 Pacemaker and Similar Procedures
—
—
—
—
5223
Level 3 Pacemaker and Similar Procedures
—
—
—
—
5303
Level 3 Upper GI Procedures
—
—
—
—
5313
Level 3 Lower GI Procedures
—
—
—
—
5331
Complex GI Procedures
—
—
—
—
5192
Level 2 Endovascular Procedures
—
—
—
—
5415
Level 5 Gynecologic 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 04/01/2026, template 3.0.0, 2,877,535 rows scanned, 9,525 distinct code–setting items kept. 5,137 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
RBC Dna Hea 35 Ag 11 Bld Grp Whl Bld Cmn Allel
$1,041
$978
$720
123
clean
Liver Dis 10 Assays Serum Algorithm W/Ash
$1,376
$643
$503
124
clean
Nash-Fibrotest Liver Dis 10 Assays
$5,352
$996
$503
124
clean
Nash-Fibrotest Liver Dis 10 Assays
$530
$530
$483
190
clean
Anesthesia Salivary Glands With Biopsy
$34,451
$6,864
$6,864
63
clean
Anesthesia Cleft Lip Involving Plastic Repair
$37,358
$6,864
$6,864
63
clean
Anesthesia Eyelid Reconstructive Procedure
$17,994
$2,707
$2,707
92
clean
Anesthesia Electroconvulsive Therapy
$6,062
$617
$616
79
clean
Anesthesia External Middle & Inner Ear W/Bx Nos
$26,281
$3,763
$3,763
92
clean
Anes External Middle & Inner Ear W/Bx Otoscopy
$16,598
$1,770
$1,770
63
clean
Anes Xtrnl Mid & Inner Ear W/Bx Tympanotomy
$22,583
$1,619
$1,619
92
clean
Anesthesia Eye Not Otherwise Specified
$15,445
$2,707
$2,707
63
clean
Anesthesia Eye Lens Surgery
$17,384
$2,646
$2,646
63
clean
Anesthesia Eye Corneal Transplant
$18,965
$4,376
$4,376
64
clean
Anesthesia Eye Vitreoretinal Surgery
$29,260
$4,668
$4,668
63
clean
Anesthesia Eye Ophthalmoscopy
$9,546
$2,707
$2,707
63
clean
Adrenal Cortical Tum Biochem Assay 25 Strd Mrk
$1,741
$1,512
$1,318
107
clean
Anesthesia Nose & Accessory Sinuses Nos
$47,368
$3,544
$3,544
103
clean
Anes Nose & Accessory Sinuses Radical Surgery
$78,783
$3,763
$3,763
63
clean
Anes Nose & Accessory Sinuses Biopsy Soft Tissue
$32,768
$1,719
$1,719
74
clean
Anesthesia Intraoral With Biopsy Nos
$39,589
$3,544
$3,544
63
clean
Anes Intraoral W/Biopsy Repair Cleft Palate
$41,285
$6,864
$6,864
74
clean
Anesthesia Intraoral W/Biopsy Radical Surgery
$67,075
$4,676
$2,323
56
clean
Anesthesia Facial Bones or Skull Nos
$23,368
$1,632
$1,418
63
clean
Anes Facial Bones/Skull Rad Surg W/Prognathism
$28,030
$6,865
$6,864
74
clean
Anesthesia Intracranial Procedure Nos
$27,207
$1,632
$1,418
64
clean
Anes Intracranial Craniotomy/Craniectomy Hmtma
$22,445
$2,779
$1,981
54
clean
Anes Intracranial Burr Holes W/Ventriculography
$44,057
$1,587
$389
56
clean
Anes Intracranial/Elevation Deprsd Skull Fx Xdrl
$40,066
$2,266
$2,266
73
clean
Anes Intracranial Procedure in Sitting Position
$19,374
$2,802
$2,380
62
clean
Anes Intracranial Cerebrospinal Fluid Shunting
$56,469
$7,646
$7,431
63
clean
Glyca Nuc MR Spectroscopy Quantitative
$1,686
$174
$34
124
clean
Rx Metab Advrs Rx Rxn & Rspse Trgt Seq Alys
$829
$829
$774
92
clean
Anes Integ Musc & Nrv Head Neck&Posterior Trunk
$50,838
$3,525
$3,127
74
clean
Anes Esoph Thyrd Larynx Trach & Lymph Neck 1yr
$32,258
$1,884
$1,884
74
clean
Anes Esoph Thyrd Larx Trach & Lymph Nck Bx Thyrd
$9,092
$816
$816
63
clean
Gene Tpmt Nudt15 Common Variants
$551
$536
$466
203
clean
Tpmt Nudt15 Gene Analysis Common Variants
$2,982
$633
$466
124
clean
Anesthesia Major Vessels Neck Nos
$56,125
$3,629
$2,347
63
clean
Anesthesia Major Vessels Neck Simple Ligation
$15,511
$1,880
$1,880
74
clean
Trgt Seq Analys Sld Orgn Neo Dna 324 Genes
$4,826
$4,826
$3,500
145
clean
Anes Integ Extremities Ant Trunk & Perineum Nos
$45,616
$4,383
$4,184
63
clean
Anesthesia Reconstruction Breast
$35,338
$7,567
$7,567
63
clean
Anesthesia Radical/Modified Radical Breast
$77,186
$7,958
$7,567
63
clean
Anes Integ Sys Elec Conversion Arrhythmias
$6,121
$759
$759
59
clean
CT Anlys Cerebral Perfusion
$7,931
$7,931
$4,283
115
clean
CT Anlys Cerebral Perfusion
$16,151
$505
$383
69
clean
Anesthesia Clavicle and Scapula Nos
$34,336
$8,686
$8,289
74
clean
Anesthesia Clavicle & Scapula Biopsy Clavicle
$30,613
$1,770
$1,770
63
clean
Anesthesia Partial Rib Resection Nos
$32,362
$949
$671
63
clean
Anesthesia Partial Rib Resection Thoracoplasty
$32,693
$919
$608
63
clean
Anesthesia Partial Rib Resection Radical
$41,396
$3,719
$3,321
74
clean
Anesthesia Esophagus
$24,909
$2,001
$2,001
63
clean
Anesthesia Closed Chest W/Bronchoscopy Nos
$22,328
$1,704
$1,697
63
clean
Anesthesia Closed Chest Pneumocentesis
$13,433
$1,697
$1,697
63
clean
Anes Mediastinoscopy&Thoracscopy W/O 1 Lung Vntj
$26,227
$6,770
$6,770
63
clean
Anes Mediastinoscopy&Thoracoscopy W/1 Lung Vnt
$45,440
$12,080
$12,080
64
clean
Anes Permanent Transvenous Pacemaker Insertion
$56,823
$12,143
$12,143
71
clean
Anesthesia Access Central Venous Circulation
$37,361
$3,439
$3,439
63
clean
Anes Transvenous Insj/Replacement Pacing Cvdfb
$122,220
$37,202
$37,202
68
clean
Anes Cardiac Electrophysiol Stdy W/Rf Ablation
$222,495
$28,465
$28,465
64
clean
Anes Thoracotomy & Thoracoscopy Nos
$35,779
$2,061
$917
56
clean
Anes Thoracotomy & Thoracoscopy W/1 Lung Vntj
$48,687
$1,205
$937
76
clean
Anes Thoracotomy &Thoracscopy Trachea & Bronchi
$35,640
$318
$212
63
clean
Cptr-Asst Muscskel Navigj Ortho Fluor Images
$63,098
$15,175
$14,930
89
clean
Anesthesia for Sternal Debridement
$50,405
$1,030
$725
63
clean
Cptr-Asst Muscskel Navigj Ortho CT/MRI
$53,898
$14,488
$14,242
102
clean
Anes Hrt Pericardial Sac& Grt Vesls W/O Pmp Oxt
$25,736
$3,652
$3,652
74
clean
Anes Hrt Prcrd Sac & Great Vsl W/Pump Oxtj Hypth
$55,913
$3,587
$2,163
61
clean
Onc Merkel Cell Carc Detcj Antb Serum Quan
$453
$371
$323
123
clean
Anesthesia Cervical Spine & Cord Nos
$7,672
$757
$757
63
clean
Anes Cervical Spine & Cord W/Patient Sitting
$150,158
$4,604
$1,527
81
clean
Anesthesia Thoracic Spine & Cord Nos
$179,031
$35,756
$35,359
59
clean
Anes Thrc Spine & Cord Ant Appr W/O 1 Lung Ventj
$92,678
$15,145
$14,930
89
clean
Anes Thoracic Spine & Cord Ant Appr W/1 Lng Vent
$103,335
$15,145
$14,930
88
clean
Anesthesia Lumbar Region Nos
$7,694
$973
$973
74
clean
Anes Diagnostic/Therapeutic Lumbar Puncture
$14,790
$1,840
$804
74
clean
Anes Manipulate Spine/Clsd Crv Thorc/Lumbr Spine
$23,341
$1,880
$1,880
63
clean
Anesthesia Extensive Spine & Spinal Cord
$77,754
$15,051
$14,930
89
clean
Anesthesia Upper Anterior Abdominal Wall Nos
$46,893
$4,055
$3,856
74
clean
Anes Upr Ant Abdl Wall Percutaneous Liver Bx
$12,448
$1,880
$1,880
74
clean
Anesthesia Upper Posterior Abdominal Wall
$15,931
$1,880
$1,880
63
clean
Anesthesia Upper GI Endoscopic Px Nos
$12,137
$1,024
$1,024
74
clean
Anesthesia Upper GI Endoscopic Px Ercp
$20,803
$4,414
$4,414
63
clean
Anesthesia Hernia Repair Upper Abdomen Nos
$44,061
$7,638
$7,240
63
clean
Anes Hrna Rpr Upr Abd Lmbr&Ventral Hernia&Dehisc
$55,344
$6,772
$6,375
63
clean
Ig Paraprotein Qual Imprcip&Ms Bld/UR W/Isotype
$21,021
$3,246
$48
111
clean
Anes Intraperitoneal Upper Abdomen W/Laps Nos
$54,629
$6,574
$6,375
63
clean
Anes Laps Partial Hepatectomy W/Mgmt Liver Hemor
$59,026
$4,224
$2,482
56
clean
Anes Ipr Upper Abdomen Laps Gastric Rstcv Mo
$54,003
$12,084
$12,080
64
clean
Anesthesia Lower Anterior Abdominal Wall Nos
$14,126
$2,377
$2,377
63
clean
Anes Lower Ant Abdominal Wall Panniculectomy
$41,421
$7,964
$7,567
103
clean
Anesthesia Lower Intst Endoscopic Px Nos
$11,679
$1,288
$1,288
63
clean
Anesthesia Lower Intst Endoscopic Px Scr Colsc
$8,184
$996
$996
63
clean
Anesthesia Combined Upper&Lower GI Endoscopic Px
$17,363
$1,801
$1,288
74
clean
Anesthesia Lower Posterior Abdominal Wall
$14,884
$3,321
$3,321
63
clean
Anesthesia Hernia Repair Lower Abdomen Nos
$45,961
$4,055
$3,856
74
clean
Anes Lwr Abd Ventral & Incisional Hernia Repair
$43,726
$7,017
$6,818
63
clean
Anes Hrna Rpr Lwr Abd Nos Infts <37wk Brth/50wk
$18,647
$4,095
$4,095
63
clean
Anesthesia Intraperitoneal Lower Abd W/Laps Nos
$56,381
$4,052
$3,856
74
clean
Anes Iper Lwr Abd W/Laps Tubal Ligation/Transect
$23,068
$6,770
$6,770
63
clean
Anes Extraperitoneal Lwr Abd W/Urinary Tract Nos
$36,888
$5,394
$5,394
74
clean
Anes Xtrprtl Lower Abd UR Tract Renal Don Nfrct
$34,953
$3,769
$3,769
103
clean
Anes Xtrprtl Lwr Abd W/Urinary Tract Rad Prstect
$69,748
$4,138
$948
50
clean
Anes Xtrprtl Lower Abd W/Urin Tract Adrenlectomy
$57,537
$2,587
$1,271
56
clean
Anes Xtrprtl Lwr Abd W/Urin Tract Cstolithotomy
$23,585
$5,899
$5,899
63
clean
Anes Lithotrp Xtrcorp Shock Wave W/Water Bath
$20,528
$4,002
$4,002
64
clean
Anes Lithotrp Xtrcorp Shock Wave W/O Water Bath
$20,123
$4,002
$4,002
64
clean
Anesthesia Major Lower Abdominal Vessels Nos
$90,962
$20,836
$20,836
62
clean
Anesthesia Anorectal Procedure
$42,105
$2,238
$2,238
63
clean
Anesthesia Radical Perineal Procedure
$22,059
$1,858
$1,185
56
clean
Anesthesia Vulvectomy
$17,127
$3,690
$3,689
63
clean
Onc C Melanoma Mrna Gene Xprs 23 Gene Alg
$2,718
$2,718
$1,950
145
clean
Anes Transurethral W/Urethrocystoscopy Nos
$33,847
$3,769
$3,769
63
clean
Anes Transurethral Resection of Bladder Tumor
$38,444
$3,769
$3,769
63
clean
Anesthesia Transurethral Resection of Prostate
$37,552
$5,555
$5,555
63
clean
Anes Trurl Post-Trurl Resection Bleeding
$31,483
$5,899
$5,899
63
clean
Anes Trurl Fragmntj Manj&/Rmvl Ureteral Calculus
$38,860
$7,279
$5,555
63
clean
Anesthesia Male Genitalia Incl Open Urethral Px
$33,193
$3,769
$3,769
63
clean
Anes Vasectomy Uni/Bi Incl Open Urethral Px
$15,001
$2,377
$2,377
63
clean
Anes Rad Orchiectomy Ingun Incl Open Urtl Px
$26,075
$4,095
$4,095
63
clean
Anes Orchiopexy Uni/Bi Incl Open Urethral Px
$16,763
$4,096
$4,095
74
clean
Anes Insj Penile Prosth Prnl Incl Open Urtl
$87,989
$23,356
$23,356
59
clean
Anesthesia Vaginal Procedure W/Biopsy Nos
$31,301
$3,475
$3,474
63
clean
Anes Colptmy Vagnc Colprphy Incl Bx W/Opn Urtl
$48,680
$8,081
$8,080
63
clean
Anesthesia Vaginal Hysterectomy Incl Biopsy
$84,099
$11,380
$11,376
63
clean
Anesthesia Cervical Cerclage Including Biopsy
$15,094
$3,689
$3,689
59
clean
Anes Hysteroscopy&/Hysterosalpingography W/Bx
$33,256
$3,475
$3,474
74
clean
Anes Bone Marrow Aspir&/Bx Ant/Pst Iliac Crest
$30,545
$3,127
$3,127
63
clean
Anesthesia on Bony Pelvis
$26,163
$3,765
$3,765
63
clean
Anesthesia Body Cast Application or Revision
$20,354
$308
$308
63
clean
Anes Radical Tumor Pelvis Xcp Hindquarter Amp
$42,067
$3,536
$3,321
63
clean
Anes Closed Symphysis Pubis/Sacroiliac Joint
$97,308
$21,459
$21,338
59
clean
Anes Open Symphysis Pubis/Sacroiliac Joint
$20,555
$3,442
$3,321
74
clean
Cardiology Ceramides Liq Chrom Tandem Ms Plasma
$2,837
$449
$84
124
clean
Anesthesia Closed Hip Joint Procedure
$24,340
$1,324
$1,021
63
clean
Anesthesia Arthroscopic Hip Joint Procedure
$53,680
$8,488
$8,289
63
clean
Anesthesia Open Hip Joint Procedure Nos
$25,744
$3,519
$3,321
103
clean
Anesthesia Open Total Hip Arthroplasty
$64,574
$15,175
$14,930
89
clean
Anesthesia Open Revision Total Hip Arthroplasty
$77,997
$2,234
$1,805
89
clean
Anesthesia Closed Procedures Upper 2/3 Femur
$29,270
$8,289
$8,289
63
clean
Anesthesia Open Procedures Upper 2/3 Femur Nos
$28,882
$1,687
$1,332
64
clean
Anes Upper 2/3 Femur Radical Rescection
$39,704
$3,321
$3,321
64
clean
Anes Nerve Musc Tendon Fascia & Bursae Upper Leg
$26,574
$4,444
$4,443
63
clean
Anes Veins of Upper Leg Including Exploration
$24,814
$780
$779
63
clean
Anesthesia Arteries Upper Leg Incl Bypass Graft
$113,355
$3,439
$3,439
61
clean
Anes Nerve Musc Tendon Fascia&Bursa Knee&/Poplt
$25,712
$8,485
$8,289
63
clean
Anesthesia Closed Procedures Lower 1/3 Femur
$23,009
$8,488
$8,289
74
clean
Anesthesia Open Procedures Lower 1/3 Femur
$31,338
$8,488
$8,289
74
clean
Anesthesia Closed Procedures Knee Joint
$12,054
$1,857
$1,857
74
clean
Anesth Diagnostic Arthroscopic Proc Knee Joint
$17,896
$3,765
$3,765
74
clean
Anes Closed Proc Upper End Tibia Fibula/Patella
$41,518
$3,765
$3,765
60
clean
Anes Open Proc Upper Ends Tibia Fibula&/Patella
$37,086
$1,943
$1,041
61
clean
Anes Open/Surg Arthroscopic Proc Knee Joint Nos
$31,850
$3,546
$3,545
74
clean
Anesth Open/Surg Arthrs Total Knee Arthroplasty
$118,374
$14,673
$14,060
89
clean
Anesthesia Veins Knee & Popliteal Area Nos
$19,548
$3,652
$3,652
63
clean
Anes Arteries of Knee & Popliteal Area Nos
$141,187
$19,621
$19,621
63
clean
Anesthesia Closed Proc Lower Leg Ankle & Foot
$16,340
$3,765
$3,765
74
clean
Anesthesia Arthroscopic Procedure Ankle & Foot
$20,736
$3,964
$3,765
74
clean
Anes Nrv/Mus/Tnd/Fasc Lower Leg/Ankle/Foot Nos
$26,030
$8,488
$8,289
63
clean
Anes Rpr Ruptured Achilles Tendon W/WO Graft
$30,822
$8,289
$8,289
74
clean
Anesthesia Gastrocnemius Recession
$18,757
$3,963
$3,765
63
clean
Anes Open Proc Bones Lower Leg/Ankle/Foot Nos
$59,293
$7,807
$7,806
63
clean
Anes Radical Resecj Incl Below Knee Amputation
$39,553
$1,758
$765
63
clean
Anes Open Osteotomy/Osteoplasty Tibia&/Fibula
$18,773
$8,488
$8,289
63
clean
Anesthesia Open Total Ankle Replacement
$150,532
$21,981
$21,338
59
clean
Anes Lower Leg Cast Application Removal/Repair
$13,160
$1,207
$691
103
clean
Anesthesia Arteries Lower Leg W/Bypass Graft Nos
$185,748
$20,836
$20,836
63
clean
Anesthesia Veins of Lower Leg Nos
$22,429
$3,652
$3,652
63
clean
Nfct Ds Dna Untrgt Ngnrj Seq
$2,250
$2,250
$1,913
145
clean
Anes Nrv Musc Tndn Fscia Bursa Shoulder & Axilla
$36,518
$7,567
$7,567
63
clean
Anes Closed Humrl H/N Strnclav Joint& Sho Joint
$8,602
$1,857
$1,857
74
clean
Anes Diag Arthroscopic Shoulder Joint Proc Nos
$20,499
$3,765
$3,765
74
clean
Anes Arthrs Humeral H/N Strnclav & Shoulder Nos
$69,488
$7,806
$7,806
74
clean
Anes Arthroscopic Total Shoulder Replacement
$85,041
$21,752
$21,338
99
clean
Anesthesia Arteries Shoulder & Axilla Nos
$18,888
$3,652
$3,652
63
clean
Anes Nrv Musc Tdn Fsca&Brs Upr Arm/Elbow Nos
$20,240
$3,765
$3,765
63
clean
Anesthesia Open Tenotomy Elbow to Shoulder
$21,032
$3,765
$3,765
63
clean
Anesthesia Tenoplasty Elbow to Shoulder
$30,192
$8,290
$8,289
74
clean
Anesthesia Biceps Tenodesis Rupture Long Tendon
$43,600
$8,488
$8,289
77
clean
Anesthesia Closed Procedures Humerus & Elbow
$14,392
$8,290
$8,289
64
clean
Anesthesia Elbow Joint Diagnostic Arthroscopic
$30,137
$3,765
$3,765
74
clean
Anes Open/Surg Arthroscopic Elbow Proc Nos
$36,895
$8,488
$8,289
63
clean
Anesthesia Open/Surg Arthrs Osteotomy Humerus
$29,210
$8,389
$8,289
64
clean
Anes Open/Surg Arthrs Reprs Non/Malunion Humerus
$43,991
$14,363
$14,242
74
clean
Anesthesia Open/Surg Arthrs Radical Proc Elbow
$106,122
$8,485
$8,289
60
clean
Anesth Open/Surg Arthrs Exc Cyst/Tumor Humerus
$21,126
$8,289
$8,289
74
clean
Anesth Open/Surg Arthrs Total Elbow Replacement
$79,580
$21,661
$21,338
59
clean
Anesthesia Arteries Upper Arm & Elbow Nos
$20,507
$3,652
$3,652
63
clean
Anesthesia Veins Upper Arm & Elbow Nos
$40,382
$6,272
$6,272
74
clean
Anes Nerve Muscle Tdn Fascia&Bursa Forearm Wrist
$25,255
$2,134
$2,134
74
clean
Anes Radius Ulna Wrist/Hand Bones Closed Px
$16,029
$280
$278
63
clean
Anes Arthrs/Endscpy Dstl Radius Ulna/Wrist/Hand
$27,511
$8,289
$8,289
78
clean
Anesthesia Arthrs/Endoscpic Total Wrist Replcmt
$106,536
$21,338
$21,338
59
clean
Anesthesia Arteries Forearm Wrist & Hand Nos
$24,797
$6,272
$6,272
63
clean
Anes Arteries Forearm Wrist & Hand Embolectomy
$22,968
$5,907
$5,907
63
clean
Anesthesia Vascular Shunt/Shunt Revision
$26,914
$3,652
$3,652
63
clean
Anesthesia Veins Forearm Wrist & Hand Nos
$12,119
$1,880
$1,880
63
clean
Anesthesia Diagnostic Arteriography/Venograph
$125,315
$6,272
$6,272
76
clean
Anes C-Cathj W/C Angiography & Ventriculography
$36,676
$3,732
$3,732
82
clean

Showing the first 200 of 9,525 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
1,444 of 8,933 comparable items (16%) fail this check the same way — the column does not mean what the template says it means, for this file or for this reader; e.g. highest negotiated rate $88 exceeds the gross charge $60
warn
mrf_rate_without_estimate
786,643 of 786,643 percentage/algorithm rates across 7,792 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
MS-DRG 602/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $591,862; the same hospital's average submitted charge to Medicare for this DRG is $167,941 (3.5×)
MS-DRG 603/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $657,652; the same hospital's average submitted charge to Medicare for this DRG is $86,940 (7.6×)
MS-DRG 640/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $36,321; the same hospital's average submitted charge to Medicare for this DRG is $114,955 (0.3×)
MS-DRG 690/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $674,996; the same hospital's average submitted charge to Medicare for this DRG is $104,200 (6.5×)
MS-DRG 699/i
warn
mrf_vs_medicare_charge
price file lists a gross charge of $87,714; the same hospital's average submitted charge to Medicare for this DRG is $271,606 (0.3×)
CPT 20932/o
info
mrf_cash_under_tenth_of_gross
cash price $2,841 is 5% of the gross charge $55,762
CPT 37186/o
info
mrf_cash_under_tenth_of_gross
cash price $3,652 is 6% of the gross charge $65,648
CPT 64713/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 6% of the gross charge $36,200
CPT 73201/b
info
mrf_cash_under_tenth_of_gross
cash price $390 is 5% of the gross charge $8,174
CPT 78580/b
info
mrf_cash_under_tenth_of_gross
cash price $466 is 10% of the gross charge $4,670
CPT 82374/o
info
mrf_cash_under_tenth_of_gross
cash price $161 is 3% of the gross charge $5,208
CPT 84182/o
info
mrf_cash_under_tenth_of_gross
cash price $182 is 5% of the gross charge $3,918
CPT 86340/b
info
mrf_cash_under_tenth_of_gross
cash price $17 is 2% of the gross charge $1,024
CPT 93925/o
info
mrf_cash_under_tenth_of_gross
cash price $264 is 8% of the gross charge $3,133
CPT J7510/o
info
mrf_cash_under_tenth_of_gross
cash price $245 is 2% of the gross charge $13,175
CPT 20936/o
info
mrf_cash_under_tenth_of_gross
cash price $3,810 is 4% of the gross charge $98,092
CPT 37187/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 8% of the gross charge $161,819
CPT 50390/o
info
mrf_cash_under_tenth_of_gross
cash price $816 is 6% of the gross charge $12,851
CPT 64721/o
info
mrf_cash_under_tenth_of_gross
cash price $2,134 is 8% of the gross charge $25,339
CPT 78582/b
info
mrf_cash_under_tenth_of_gross
cash price $588 is 10% of the gross charge $6,144
CPT 84206/b
info
mrf_cash_under_tenth_of_gross
cash price $31 is 6% of the gross charge $485
CPT 86340/o
info
mrf_cash_under_tenth_of_gross
cash price $133 is 7% of the gross charge $1,896
CPT 93926/b
info
mrf_cash_under_tenth_of_gross
cash price $116 is 4% of the gross charge $2,902
MS-DRG 605/i
info
mrf_cash_under_tenth_of_gross
cash price $9,426 is 8% of the gross charge $114,686
CPT 11440/o
info
mrf_cash_under_tenth_of_gross
cash price $816 is 7% of the gross charge $12,203
CPT 20974/o
info
mrf_cash_under_tenth_of_gross
cash price $3,765 is 6% of the gross charge $61,642
CPT 50400/o
info
mrf_cash_under_tenth_of_gross
cash price $4,003 is 9% of the gross charge $43,478
CPT 64727/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 3% of the gross charge $78,326
CPT 73201/o
info
mrf_cash_under_tenth_of_gross
cash price $414 is 6% of the gross charge $6,533
CPT 78582/o
info
mrf_cash_under_tenth_of_gross
cash price $588 is 7% of the gross charge $8,200
CPT 84206/o
info
mrf_cash_under_tenth_of_gross
cash price $171 is 8% of the gross charge $2,214
CPT 93926/o
info
mrf_cash_under_tenth_of_gross
cash price $116 is 4% of the gross charge $2,902
CPT J7512/o
info
mrf_cash_under_tenth_of_gross
cash price $4,869 is 8% of the gross charge $64,082
CPT 20999/o
info
mrf_cash_under_tenth_of_gross
cash price $4,163 is 9% of the gross charge $48,270
CPT 37197/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 8% of the gross charge $155,278
CPT 64772/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 9% of the gross charge $26,146
CPT 73202/b
info
mrf_cash_under_tenth_of_gross
cash price $207 is 2% of the gross charge $8,783
CPT 78598/b
info
mrf_cash_under_tenth_of_gross
cash price $625 is 8% of the gross charge $7,436
CPT 86341/o
info
mrf_cash_under_tenth_of_gross
cash price $206 is 7% of the gross charge $3,144
CPT 93930/b
info
mrf_cash_under_tenth_of_gross
cash price $280 is 9% of the gross charge $3,133
CPT J7515/o
info
mrf_cash_under_tenth_of_gross
cash price $102 is 1% of the gross charge $18,087
CPT 21050/o
info
mrf_cash_under_tenth_of_gross
cash price $21,537 is 8% of the gross charge $273,797
CPT 37200/o
info
mrf_cash_under_tenth_of_gross
cash price $6,272 is 10% of the gross charge $63,951
CPT 64774/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 6% of the gross charge $35,287
CPT 73202/o
info
mrf_cash_under_tenth_of_gross
cash price $207 is 5% of the gross charge $4,318
CPT 78630/o
info
mrf_cash_under_tenth_of_gross
cash price $2,148 is 10% of the gross charge $22,501
CPT 82378/o
info
mrf_cash_under_tenth_of_gross
cash price $340 is 9% of the gross charge $3,808
CPT 84207/o
info
mrf_cash_under_tenth_of_gross
cash price $284 is 4% of the gross charge $6,689
CPT 93931/b
info
mrf_cash_under_tenth_of_gross
cash price $118 is 4% of the gross charge $2,902
CPT A9555/o
info
mrf_cash_under_tenth_of_gross
cash price $2,611 is 8% of the gross charge $32,197
CPT J0360/o
info
mrf_cash_under_tenth_of_gross
cash price $1,770 is 4% of the gross charge $50,258
CPT 21070/o
info
mrf_cash_under_tenth_of_gross
cash price $21,537 is 8% of the gross charge $273,797
CPT 73206/b
info
mrf_cash_under_tenth_of_gross
cash price $207 is 4% of the gross charge $5,678
CPT 78645/o
info
mrf_cash_under_tenth_of_gross
cash price $625 is 9% of the gross charge $6,613
CPT 84210/b
info
mrf_cash_under_tenth_of_gross
cash price $17 is 5% of the gross charge $349
CPT 86356/o
info
mrf_cash_under_tenth_of_gross
cash price $177 is 9% of the gross charge $1,915
CPT 93931/o
info
mrf_cash_under_tenth_of_gross
cash price $123 is 10% of the gross charge $1,277
CPT J9000/o
info
mrf_cash_under_tenth_of_gross
cash price $1,454 is 2% of the gross charge $75,793
CPT 11451/o
info
mrf_cash_under_tenth_of_gross
cash price $3,321 is 9% of the gross charge $35,129
CPT 21079/o
info
mrf_cash_under_tenth_of_gross
cash price $3,763 is 5% of the gross charge $78,783
CPT 50432/o
info
mrf_cash_under_tenth_of_gross
cash price $2,238 is 7% of the gross charge $30,416
CPT 64784/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 9% of the gross charge $24,602
CPT 73206/o
info
mrf_cash_under_tenth_of_gross
cash price $207 is 5% of the gross charge $4,263
CPT 78707/b
info
mrf_cash_under_tenth_of_gross
cash price $625 is 10% of the gross charge $6,535
CPT 82379/o
info
mrf_cash_under_tenth_of_gross
cash price $198 is 5% of the gross charge $3,957
CPT 84210/o
info
mrf_cash_under_tenth_of_gross
cash price $40 is 10% of the gross charge $423
CPT 87640/o
info
mrf_cash_under_tenth_of_gross
cash price $141 is 3% of the gross charge $4,041
CPT 93971/b
info
mrf_cash_under_tenth_of_gross
cash price $116 is 6% of the gross charge $2,098
CPT A9562/o
info
mrf_cash_under_tenth_of_gross
cash price $588 is 7% of the gross charge $8,910
CPT J9022/b
info
mrf_cash_under_tenth_of_gross
cash price $10,923 is 6% of the gross charge $198,373
CPT 21121/o
info
mrf_cash_under_tenth_of_gross
cash price $3,763 is 2% of the gross charge $177,343
CPT 50433/o
info
mrf_cash_under_tenth_of_gross
cash price $4,002 is 10% of the gross charge $40,038
CPT 64788/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 10% of the gross charge $23,675
CPT 73218/b
info
mrf_cash_under_tenth_of_gross
cash price $264 is 6% of the gross charge $4,426
CPT 78708/b
info
mrf_cash_under_tenth_of_gross
cash price $588 is 9% of the gross charge $6,561
CPT 82380/b
info
mrf_cash_under_tenth_of_gross
cash price $11 is 1% of the gross charge $735
CPT 84220/o
info
mrf_cash_under_tenth_of_gross
cash price $116 is 9% of the gross charge $1,251
CPT 87641/o
info
mrf_cash_under_tenth_of_gross
cash price $141 is 3% of the gross charge $4,041
CPT 93971/o
info
mrf_cash_under_tenth_of_gross
cash price $116 is 6% of the gross charge $2,098
CPT A9567/o
info
mrf_cash_under_tenth_of_gross
cash price $588 is 7% of the gross charge $8,200
CPT J9022/o
info
mrf_cash_under_tenth_of_gross
cash price $15,581 is 4% of the gross charge $352,710
CPT 21137/o
info
mrf_cash_under_tenth_of_gross
cash price $3,763 is 9% of the gross charge $42,520
CPT 73218/o
info
mrf_cash_under_tenth_of_gross
cash price $264 is 6% of the gross charge $4,426
CPT 78708/o
info
mrf_cash_under_tenth_of_gross
cash price $588 is 7% of the gross charge $8,910
CPT 82380/o
info
mrf_cash_under_tenth_of_gross
cash price $172 is 8% of the gross charge $2,189
CPT 93975/b
info
mrf_cash_under_tenth_of_gross
cash price $264 is 8% of the gross charge $3,329
CPT A9569/b
info
mrf_cash_under_tenth_of_gross
cash price $1,040 is 9% of the gross charge $12,054
CPT 21141/o
info
mrf_cash_under_tenth_of_gross
cash price $3,763 is 3% of the gross charge $110,679
CPT 37215/b
info
mrf_cash_under_tenth_of_gross
cash price $1,145 is 2% of the gross charge $53,949
CPT 50545/o
info
mrf_cash_under_tenth_of_gross
cash price $1,993 is 3% of the gross charge $70,934
CPT 64795/o
info
mrf_cash_under_tenth_of_gross
cash price $2,267 is 9% of the gross charge $23,948
CPT 73220/b
info
mrf_cash_under_tenth_of_gross
cash price $390 is 6% of the gross charge $6,372
CPT 78709/o
info
mrf_cash_under_tenth_of_gross
cash price $588 is 7% of the gross charge $8,273
CPT 82382/o
info
mrf_cash_under_tenth_of_gross
cash price $59 is 8% of the gross charge $788
CPT 84238/o
info
mrf_cash_under_tenth_of_gross
cash price $148 is 5% of the gross charge $2,719
CPT 86360/o
info
mrf_cash_under_tenth_of_gross
cash price $314 is 10% of the gross charge $3,244
CPT 93975/o
info
mrf_cash_under_tenth_of_gross
cash price $264 is 8% of the gross charge $3,329
CPT A9570/b
info
mrf_cash_under_tenth_of_gross
cash price $1,031 is 7% of the gross charge $14,162
CPT J0485/b
info
mrf_cash_under_tenth_of_gross
cash price $972 is 6% of the gross charge $15,312
CPT J9024/b
info
mrf_cash_under_tenth_of_gross
cash price $11,863 is 6% of the gross charge $198,373
CPT 11604/o
info
mrf_cash_under_tenth_of_gross
cash price $1,172 is 9% of the gross charge $12,648
CPT 21146/o
info
mrf_cash_under_tenth_of_gross
cash price $3,764 is 3% of the gross charge $137,001
CPT 37215/o
info
mrf_cash_under_tenth_of_gross
cash price $6,272 is 3% of the gross charge $248,718
CPT 50546/o
info
mrf_cash_under_tenth_of_gross
cash price $2,243 is 3% of the gross charge $77,343
CPT 64820/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 8% of the gross charge $27,656
CPT 73220/o
info
mrf_cash_under_tenth_of_gross
cash price $390 is 5% of the gross charge $7,873
CPT 78804/o
info
mrf_cash_under_tenth_of_gross
cash price $3,321 is 3% of the gross charge $101,064
CPT 82383/b
info
mrf_cash_under_tenth_of_gross
cash price $33 is 3% of the gross charge $1,177
CPT 87660/b
info
mrf_cash_under_tenth_of_gross
cash price $23 is 7% of the gross charge $332
CPT 93976/b
info
mrf_cash_under_tenth_of_gross
cash price $116 is 4% of the gross charge $2,628
CPT A9572/b
info
mrf_cash_under_tenth_of_gross
cash price $1,915 is 7% of the gross charge $28,091
CPT J9024/o
info
mrf_cash_under_tenth_of_gross
cash price $11,941 is 6% of the gross charge $199,354
CPT 21196/o
info
mrf_cash_under_tenth_of_gross
cash price $3,763 is 3% of the gross charge $110,679
CPT 37217/o
info
mrf_cash_under_tenth_of_gross
cash price $1,405 is 3% of the gross charge $45,208
CPT 50548/o
info
mrf_cash_under_tenth_of_gross
cash price $6,770 is 8% of the gross charge $85,835
CPT 73221/b
info
mrf_cash_under_tenth_of_gross
cash price $264 is 6% of the gross charge $4,426
CPT 79005/b
info
mrf_cash_under_tenth_of_gross
cash price $260 is 9% of the gross charge $2,926
CPT 82383/o
info
mrf_cash_under_tenth_of_gross
cash price $179 is 8% of the gross charge $2,295
CPT 84244/o
info
mrf_cash_under_tenth_of_gross
cash price $150 is 9% of the gross charge $1,694
CPT 86362/b
info
mrf_cash_under_tenth_of_gross
cash price $14 is 1% of the gross charge $968
CPT 87662/o
info
mrf_cash_under_tenth_of_gross
cash price $99 is 8% of the gross charge $1,210
CPT 93976/o
info
mrf_cash_under_tenth_of_gross
cash price $116 is 2% of the gross charge $4,797
CPT A9572/o
info
mrf_cash_under_tenth_of_gross
cash price $3,341 is 9% of the gross charge $37,505
CPT J0490/o
info
mrf_cash_under_tenth_of_gross
cash price $7,083 is 6% of the gross charge $110,719
CPT 21209/o
info
mrf_cash_under_tenth_of_gross
cash price $6,864 is 2% of the gross charge $356,841
CPT 29305/o
info
mrf_cash_under_tenth_of_gross
cash price $308 is 2% of the gross charge $15,167
CPT 37220/o
info
mrf_cash_under_tenth_of_gross
cash price $6,616 is 9% of the gross charge $72,822
CPT 64911/o
info
mrf_cash_under_tenth_of_gross
cash price $7,431 is 9% of the gross charge $79,220
CPT 73221/o
info
mrf_cash_under_tenth_of_gross
cash price $264 is 6% of the gross charge $4,426
CPT 79101/b
info
mrf_cash_under_tenth_of_gross
cash price $260 is 9% of the gross charge $2,926
CPT 84252/b
info
mrf_cash_under_tenth_of_gross
cash price $23 is 2% of the gross charge $1,404
CPT 86366/b
info
mrf_cash_under_tenth_of_gross
cash price $21 is 5% of the gross charge $462
CPT 93978/o
info
mrf_cash_under_tenth_of_gross
cash price $528 is 9% of the gross charge $6,120
CPT J0491/b
info
mrf_cash_under_tenth_of_gross
cash price $5,431 is 6% of the gross charge $91,770
CPT J9025/o
info
mrf_cash_under_tenth_of_gross
cash price $78 is 4% of the gross charge $1,818
CPT 21243/o
info
mrf_cash_under_tenth_of_gross
cash price $21,537 is 8% of the gross charge $273,797
CPT 37232/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 9% of the gross charge $147,208
CPT 64913/o
info
mrf_cash_under_tenth_of_gross
cash price $20,188 is 7% of the gross charge $284,400
CPT 80048/b
info
mrf_cash_under_tenth_of_gross
cash price $10 is 6% of the gross charge $160
CPT 82390/b
info
mrf_cash_under_tenth_of_gross
cash price $12 is 2% of the gross charge $696
CPT 84255/b
info
mrf_cash_under_tenth_of_gross
cash price $29 is 5% of the gross charge $637
CPT 86366/o
info
mrf_cash_under_tenth_of_gross
cash price $102 is 6% of the gross charge $1,848
CPT 93979/b
info
mrf_cash_under_tenth_of_gross
cash price $123 is 5% of the gross charge $2,628
CPT A9575/o
info
mrf_cash_under_tenth_of_gross
cash price $390 is 5% of the gross charge $7,879
CPT J0491/o
info
mrf_cash_under_tenth_of_gross
cash price $5,661 is 6% of the gross charge $92,710
CPT J9029/b
info
mrf_cash_under_tenth_of_gross
cash price $63,431 is 6% of the gross charge $1,000,800
CPT 21299/o
info
mrf_cash_under_tenth_of_gross
cash price $269 is 1% of the gross charge $18,099
CPT 29325/o
info
mrf_cash_under_tenth_of_gross
cash price $308 is 1% of the gross charge $27,469
CPT 37237/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 8% of the gross charge $170,352
CPT 73223/b
info
mrf_cash_under_tenth_of_gross
cash price $390 is 6% of the gross charge $6,372
CPT 80048/o
info
mrf_cash_under_tenth_of_gross
cash price $61 is 4% of the gross charge $1,645
CPT 82390/o
info
mrf_cash_under_tenth_of_gross
cash price $132 is 2% of the gross charge $7,158
CPT 84255/o
info
mrf_cash_under_tenth_of_gross
cash price $436 is 4% of the gross charge $9,699
CPT 87799/o
info
mrf_cash_under_tenth_of_gross
cash price $187 is 3% of the gross charge $6,184
CPT 93979/o
info
mrf_cash_under_tenth_of_gross
cash price $280 is 7% of the gross charge $3,801
CPT A9581/o
info
mrf_cash_under_tenth_of_gross
cash price $390 is 5% of the gross charge $8,635
CPT J0561/b
info
mrf_cash_under_tenth_of_gross
cash price $352 is 6% of the gross charge $5,756
CPT J9034/b
info
mrf_cash_under_tenth_of_gross
cash price $1,312 is 5% of the gross charge $27,543
CPT 11641/o
info
mrf_cash_under_tenth_of_gross
cash price $1,172 is 6% of the gross charge $18,061
CPT 37241/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 8% of the gross charge $170,924
CPT 73223/o
info
mrf_cash_under_tenth_of_gross
cash price $390 is 6% of the gross charge $6,636
CPT 80051/b
info
mrf_cash_under_tenth_of_gross
cash price $8 is 4% of the gross charge $215
CPT 82397/b
info
mrf_cash_under_tenth_of_gross
cash price $16 is 7% of the gross charge $237
CPT 84260/b
info
mrf_cash_under_tenth_of_gross
cash price $36 is 6% of the gross charge $578
CPT 86376/o
info
mrf_cash_under_tenth_of_gross
cash price $176 is 4% of the gross charge $4,153
CPT 87806/o
info
mrf_cash_under_tenth_of_gross
cash price $992 is 5% of the gross charge $19,497
CPT 93990/b
info
mrf_cash_under_tenth_of_gross
cash price $123 is 6% of the gross charge $2,189
CPT A9582/b
info
mrf_cash_under_tenth_of_gross
cash price $2,075 is 8% of the gross charge $27,160
CPT J9034/o
info
mrf_cash_under_tenth_of_gross
cash price $3,738 is 9% of the gross charge $43,001
CPT 37243/o
info
mrf_cash_under_tenth_of_gross
cash price $13,159 is 9% of the gross charge $146,384
CPT 73502/b
info
mrf_cash_under_tenth_of_gross
cash price $96 is 9% of the gross charge $1,019
CPT 80051/o
info
mrf_cash_under_tenth_of_gross
cash price $51 is 7% of the gross charge $738
CPT 82397/o
info
mrf_cash_under_tenth_of_gross
cash price $778 is 8% of the gross charge $9,260
CPT 84260/o
info
mrf_cash_under_tenth_of_gross
cash price $111 is 8% of the gross charge $1,352
CPT 86381/o
info
mrf_cash_under_tenth_of_gross
cash price $191 is 3% of the gross charge $6,528
CPT 87807/b
info
mrf_cash_under_tenth_of_gross
cash price $15 is 2% of the gross charge $681
CPT 93990/o
info
mrf_cash_under_tenth_of_gross
cash price $123 is 6% of the gross charge $1,945
CPT A9582/o
info
mrf_cash_under_tenth_of_gross
cash price $3,321 is 3% of the gross charge $101,064
CPT J0585/b
info
mrf_cash_under_tenth_of_gross
cash price $650 is 6% of the gross charge $10,859
CPT J9035/b
info
mrf_cash_under_tenth_of_gross
cash price $730 is 6% of the gross charge $13,244
MS-DRG 934/i
info
mrf_cash_under_tenth_of_gross
cash price $25,529 is 10% of the gross charge $255,590
CPT 21343/o
info
mrf_cash_under_tenth_of_gross
cash price $2,266 is 6% of the gross charge $40,066
CPT 37246/o
info
mrf_cash_under_tenth_of_gross
cash price $6,616 is 8% of the gross charge $79,216
CPT 73503/o
info
mrf_cash_under_tenth_of_gross
cash price $123 is 9% of the gross charge $1,367
CPT 80053/b
info
mrf_cash_under_tenth_of_gross
cash price $12 is 3% of the gross charge $382
CPT 82435/b
info
mrf_cash_under_tenth_of_gross
cash price $5 is 2% of the gross charge $222
CPT 86406/o
info
mrf_cash_under_tenth_of_gross
cash price $158 is 8% of the gross charge $1,902
CPT 94002/o
info
mrf_cash_under_tenth_of_gross
cash price $3,739 is 4% of the gross charge $91,550
CPT A9584/b
info
mrf_cash_under_tenth_of_gross
cash price $1,388 is 10% of the gross charge $13,984
CPT J0585/o
info
mrf_cash_under_tenth_of_gross
cash price $2,238 is 6% of the gross charge $38,497
CPT 21365/o
info
mrf_cash_under_tenth_of_gross
cash price $6,864 is 10% of the gross charge $69,461
CPT 37248/o
info
mrf_cash_under_tenth_of_gross
cash price $6,616 is 8% of the gross charge $82,065
CPT 50728/o
info
mrf_cash_under_tenth_of_gross
cash price $1,280 is 2% of the gross charge $67,111
CPT 66991/o
info
mrf_cash_under_tenth_of_gross
cash price $2,646 is 10% of the gross charge $27,029
CPT 73522/o
info
mrf_cash_under_tenth_of_gross
cash price $116 is 3% of the gross charge $3,527
CPT 80053/o
info
mrf_cash_under_tenth_of_gross
cash price $84 is 3% of the gross charge $2,443
CPT 82435/o
info
mrf_cash_under_tenth_of_gross
cash price $80 is 8% of the gross charge $951
CPT 84270/o
info
mrf_cash_under_tenth_of_gross
cash price $241 is 7% of the gross charge $3,625

Showing the first 200 of 5,137 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service
Severity
Rule
Detail
MS-DRG 280
info
inp_charge_10x_payment
average charge $200,594 is 16.0× the total payment
MS-DRG 281
info
inp_charge_10x_payment
average charge $108,503 is 13.6× the total payment
MS-DRG 282
info
inp_charge_10x_payment
average charge $90,031 is 13.7× the total payment
MS-DRG 286
info
inp_charge_10x_payment
average charge $191,234 is 11.7× the total payment
MS-DRG 287
info
inp_charge_10x_payment
average charge $118,334 is 12.8× the total payment
MS-DRG 291
info
inp_charge_10x_payment
average charge $141,821 is 13.9× the total payment
MS-DRG 305
info
inp_charge_10x_payment
average charge $85,343 is 12.2× the total payment
MS-DRG 308
info
inp_charge_10x_payment
average charge $169,745 is 17.9× the total payment
MS-DRG 309
info
inp_charge_10x_payment
average charge $84,384 is 14.6× the total payment
MS-DRG 310
info
inp_charge_10x_payment
average charge $71,551 is 15.8× the total payment
MS-DRG 312
info
inp_charge_10x_payment
average charge $105,724 is 14.5× the total payment
MS-DRG 315
info
inp_charge_10x_payment
average charge $88,233 is 11.9× the total payment
MS-DRG 372
info
inp_charge_10x_payment
average charge $102,898 is 12.5× the total payment
MS-DRG 377
info
inp_charge_10x_payment
average charge $190,873 is 14.0× the total payment
MS-DRG 378
info
inp_charge_10x_payment
average charge $127,834 is 16.6× the total payment
MS-DRG 389
info
inp_charge_10x_payment
average charge $72,566 is 10.7× the total payment
MS-DRG 391
info
inp_charge_10x_payment
average charge $132,487 is 12.2× the total payment
MS-DRG 392
info
inp_charge_10x_payment
average charge $86,374 is 13.9× the total payment
MS-DRG 394
info
inp_charge_10x_payment
average charge $114,035 is 15.4× the total payment
MS-DRG 432
info
inp_charge_10x_payment
average charge $207,832 is 14.1× the total payment
MS-DRG 445
info
inp_charge_10x_payment
average charge $132,081 is 16.0× the total payment
MS-DRG 536
info
inp_charge_10x_payment
average charge $85,239 is 13.9× the total payment
MS-DRG 543
info
inp_charge_10x_payment
average charge $117,190 is 14.0× the total payment
MS-DRG 552
info
inp_charge_10x_payment
average charge $105,572 is 14.2× the total payment
MS-DRG 556
info
inp_charge_10x_payment
average charge $85,833 is 13.2× the total payment
MS-DRG 563
info
inp_charge_10x_payment
average charge $82,322 is 11.7× the total payment
MS-DRG 602
info
inp_charge_10x_payment
average charge $167,941 is 12.5× the total payment
MS-DRG 603
info
inp_charge_10x_payment
average charge $86,940 is 11.8× the total payment
MS-DRG 637
info
inp_charge_10x_payment
average charge $123,699 is 11.2× the total payment
MS-DRG 638
info
inp_charge_10x_payment
average charge $130,300 is 17.0× the total payment
MS-DRG 640
info
inp_charge_10x_payment
average charge $114,955 is 11.2× the total payment
MS-DRG 641
info
inp_charge_10x_payment
average charge $89,832 is 14.0× the total payment
MS-DRG 682
info
inp_charge_10x_payment
average charge $163,549 is 14.4× the total payment
MS-DRG 683
info
inp_charge_10x_payment
average charge $106,606 is 15.1× the total payment
MS-DRG 689
info
inp_charge_10x_payment
average charge $152,560 is 16.0× the total payment
MS-DRG 690
info
inp_charge_10x_payment
average charge $104,200 is 15.6× the total payment
MS-DRG 698
info
inp_charge_10x_payment
average charge $174,179 is 12.1× the total payment
MS-DRG 699
info
inp_charge_10x_payment
average charge $271,606 is 16.0× the total payment
MS-DRG 811
info
inp_charge_10x_payment
average charge $165,933 is 15.6× the total payment
MS-DRG 812
info
inp_charge_10x_payment
average charge $121,333 is 16.9× the total payment
MS-DRG 813
info
inp_charge_10x_payment
average charge $148,287 is 12.5× the total payment
MS-DRG 853
info
inp_charge_10x_payment
average charge $440,617 is 10.0× the total payment
MS-DRG 871
info
inp_charge_10x_payment
average charge $198,099 is 12.7× the total payment
MS-DRG 872
info
inp_charge_10x_payment
average charge $124,460 is 14.7× the total payment
MS-DRG 884
info
inp_charge_10x_payment
average charge $129,574 is 10.1× the total payment
MS-DRG 057
info
inp_charge_10x_payment
average charge $110,202 is 11.0× the total payment
MS-DRG 064
info
inp_charge_10x_payment
average charge $158,007 is 11.1× the total payment
MS-DRG 065
info
inp_charge_10x_payment
average charge $128,726 is 15.8× the total payment
MS-DRG 069
info
inp_charge_10x_payment
average charge $108,097 is 17.1× the total payment
MS-DRG 092
info
inp_charge_10x_payment
average charge $105,693 is 13.3× the total payment
MS-DRG 149
info
inp_charge_10x_payment
average charge $110,918 is 18.8× the total payment
MS-DRG 175
info
inp_charge_10x_payment
average charge $124,016 is 11.4× the total payment
MS-DRG 176
info
inp_charge_10x_payment
average charge $88,007 is 13.8× the total payment
MS-DRG 177
info
inp_charge_10x_payment
average charge $179,568 is 13.9× the total payment
MS-DRG 178
info
inp_charge_10x_payment
average charge $130,670 is 15.8× the total payment
MS-DRG 190
info
inp_charge_10x_payment
average charge $160,202 is 17.0× the total payment
MS-DRG 191
info
inp_charge_10x_payment
average charge $95,151 is 12.9× the total payment
MS-DRG 193
info
inp_charge_10x_payment
average charge $169,002 is 15.5× the total payment
MS-DRG 194
info
inp_charge_10x_payment
average charge $101,728 is 15.2× the total payment
MS-DRG 202
info
inp_charge_10x_payment
average charge $109,008 is 13.0× the total payment

Sources for this hospital

the files read, as fetched — not our copy of them
  1. MUP_INP_RY26_P03_V10_DY24_PrvSvc.CSV · 38.0M bytes · fetched 2026-08-21 · sha256 2ab6da15be4c… · publisher's page · public domain (US federal)
  2. MUP_OUT_RY26_P04_V10_DY24_Prov_Svc.csv · 28.1M bytes · fetched 2026-08-21 · sha256 f293918edbf6… · publisher's page · public domain (US federal)
  3. chsp-hospital-linkage-2023.csv · 1.5M bytes · fetched 2026-08-21 · sha256 a86146f10c8d… · publisher's page · public; cite AHRQ Compendium of U.S. Health Systems
  4. 2020 ZCTA to County relationship file · US Census Bureau · 2020
    tab20_zcta520_county20_natl.txt · 6.8M bytes · fetched 2026-08-21 · sha256 3ed41278d637… · publisher's page · public domain (US federal)
  5. · csv-tall · 917.8M bytes · fetched 2026-08-23 · sha256 cac8b378c22b…

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.