Hospital · CCN 390138

Wellspan Waynesboro Hospital

501 East Main St, Waynesboro, PA 17268 · Franklin County
Part of Wellspan Health · 57 beds · 1
Micropolitan area core: primary flow within an urban cluster of 10,000 to 49,999

17 admission types 16 outpatient services price file: ok
Billed per dollar paid, all admissions
2.59×
$14.8M billed against $5.7M paid across 465 Medicare discharges; the national figure is 5.03×.
3.0%
of adults in Franklin County have medical debt in collections
8.5%
uninsured in the county · state 6.5%
$76K
median household income
3.3×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (2 in the inpatient or outpatient file)ⓘ
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
109
$37,547
$17,805
2.1× st 5.2×
291
Heart failure and shock with mcc
75
$30,935
$11,639
2.7× st 5.2×
189
Pulmonary edema and respiratory failure
30
$35,102
$11,985
2.9× st 5.9×
872
Septicemia or severe sepsis without mv >96 hours without mcc
29
$23,839
$12,776
1.9× st 5.5×
689
Kidney and urinary tract infections with mcc
25
$27,985
$10,056
2.8× st 5.3×
177
Respiratory infections and inflammations with mcc
24
$42,071
$14,505
2.9× st 5.2×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
21
$21,463
$7,302
2.9× st 5.7×
308
Cardiac arrhythmia and conduction disorders with mcc
21
$44,064
$10,395
4.2× st 5.4×
690
Kidney and urinary tract infections without mcc
19
$19,934
$7,893
2.5× st 5.3×
682
Renal failure with mcc
18
$29,076
$12,579
2.3× st 5.4×
683
Renal failure with cc
17
$28,061
$7,778
3.6× st 5.4×
193
Simple pneumonia and pleurisy with mcc
16
$35,805
$11,734
3.1× st 5.3×
312
Syncope and collapse
13
$35,692
$9,182
3.9× st 5.8×
603
Cellulitis without mcc
13
$24,099
$7,686
3.1× st 4.9×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
12
$21,431
$6,780
3.2× st 5.7×
190
Chronic obstructive pulmonary disease with mcc
12
$22,950
$9,563
2.4× st 5.5×
638
Diabetes with cc
11
$24,128
$7,868
3.1× st 5.2×
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
242
$21,149
$2,722
7.8×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
32
$7,827
$1,567
5.0×
5491
Level 1 Intraocular Procedures
26
$10,538
$2,325
4.5×
5431
Level 1 Nerve Procedures
21
$9,014
$1,926
4.7×
5361
Level 1 Laparoscopy and Related Services
16
$31,862
$5,757
5.5×
5302
Level 2 Upper GI Procedures
13
$8,331
$1,898
4.4×
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5492
Level 2 Intraocular Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5414
Level 4 Gynecologic Procedures
—
—
—
—
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
—
—
—
—
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
—
—
—
—
5182
Level 2 Vascular Procedures
—
—
—
—
5115
Level 5 Musculoskeletal Procedures
—
—
—
—
5113
Level 3 Musculoskeletal Procedures
—
—
—
—
5112
Level 2 Musculoskeletal Procedures
—
—
—
—
03 · Its own price file

What the hospital's price-transparency file says

Found via /cms-hpt.txt, the file itself ↗ read as csv-tall, last updated 1/1/2026, template 3.0.0, 81,817 rows scanned, 1,716 distinct code–setting items kept. 1,026 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
Testing for Presence of Prion Protein in Cerebrospinal Fluid
$2,813
$2,250
$920
30
clean
Detect Respiratory Disease-Causing Organisms Nose/Throat W Coronavirus 2
$980
$784
$445
16
clean
Digitization of Glass Microscope Slides for Level III Surg Path
$15
$12
$12
8
clean
Digitization of Glass Microscope Slides for Level IV Surg Path
$15
$12
$12
8
clean
Digitization of Glass Microscope Slides for Ihc/Icc Stain per Spec Init
$15
$12
$12
8
clean
Digitization of Glass Microscope Slides for Ihc/Icc Stain per Spec Addl
$15
$12
$12
8
clean
Fine Needle Aspiration Biopsy, First Growth
$3,098
$2,478
$791
37
clean
Fine Needle Aspiration Biopsy, Each Add'l Growth
$3,098
$2,478
$2,082
13
clean
Drainage of Fluid Collection in Soft Tissue Using Imaging Guidance
$2,362
$1,890
$791
37
clean
Placement of Soft Tissue Locating Device Using X-Ray, First Growth
$1,502
$1,202
$791
37
clean
Placement of Soft Tissue Locating Device Using X-Ray, Each Add'l Growth
$751
$601
$505
13
clean
Simple or Single Drainage of Skin Abscess
$787
$630
$324
69
clean
Complicated or Multiple Drainage of Skin Abscess
$1,083
$866
$449
37
clean
Simple Drainage of Cyst of Tailbone
$1,037
$830
$788
37
clean
Complicated Drainage of Cyst of Tailbone
$669
$535
$750
37
clean
Removal of Foreign Body From Tissue, Accessed Beneath the Skin, Simple
$1,558
$1,246
$652
69
clean
Drainage of Blood or Fluid Accumulation
$5,551
$4,441
$1,822
37
clean
Aspiration of Abscess, Blood, or Cyst
$793
$634
$449
37
clean
Removal of Skin and Tissue, 20.0 Sq Cm or Less
$1,954
$1,563
$532
69
clean
Removal of Muscle and/or Tissue, 20.0 Sq Cm or Less
$1,790
$1,432
$816
69
clean
Removal of Bone, 20.0 Sq Cm or Less
$1,311
$1,049
$1,822
69
clean
Removal of Skin and Tissue, Each Additional 20.0 Sq Cm or Less
$746
$597
$591
9
clean
Removal of Noncancer Thickened Skin Growth, 2-4 Growths
$281
$225
$222
37
clean
Biopsy of Related Skin Growth, First Growth
$772
$618
$223
37
clean
Punch Biopsy, First Skin Growth
$945
$756
$449
37
clean
Punch Biopsy, Each Additional Skin Growth
$124
$99
$83
13
clean
Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm
—
—
$677
32
clean
Removal of Noncancer Skin Growth of Body, Arms, or Legs, 1.1-2.0 Cm
—
—
$970
32
clean
Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm
—
—
$970
32
clean
Removal of noncancer skin growth of body, arms, or legs, 3.1-4.0 cm
—
—
$1,797
32
clean
Removal of noncancer skin growth of body, arms, or legs, more than 4.0 cm
—
—
$1,797
32
clean
Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm
—
—
$1,797
32
clean
Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm
—
—
$1,797
32
clean
Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm
—
—
$1,797
32
clean
Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm
—
—
$3,174
32
clean
Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm
—
—
$970
32
clean
Removal of Fingernails or Toenails, 6 or More Nails
$194
$155
$67
37
clean
Simple Separation of Fingernail or Toenail From Nail Bed, First Nail
$863
$690
$684
37
clean
Removal of Blood Accumulation Under Fingernail or Toenail
$355
$284
$145
37
clean
Permanent Removal Fingernail or Toenail
$995
$796
$652
31
clean
Repair of Fingernail or Toenail Bed
$1,293
$1,034
$689
37
clean
Simple removal of cyst of tailbone
—
—
$3,174
32
clean
Removal of Drug Delivery Implant From Tissue
—
—
$425
29
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 2.5cm or Less
$669
$535
$224
37
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 2.6-7.5 Cm
$904
$723
$224
37
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 7.6-12.5 Cm
$1,403
$1,122
$224
37
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 12.6-20.0cm
$1,560
$1,248
$449
37
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg 20.1-30.0 Cm
$1,840
$1,472
$449
37
clean
Simple Repair Surface Wound Scalp/Neck/Underarm/Trunk/Arm/Leg Over 30.0 Cm
$1,985
$1,588
$224
37
clean
Simple Repair Surface Wound of Face/Ear/Eyelid/Nose/Lip/Mouth 2.5cm or Less
$669
$535
$224
37
clean
Simple Repair Surface Wound of Face/Ear/Eyelid/Nose/Lip/Mouth 2.6-5.0 Cm
$904
$723
$224
37
clean
Simple Repair Surface Wound of Face/Ear/Eyelid/Nose/Lip/Mouth 5.1-7.5 Cm
$1,102
$882
$224
37
clean
Simple Closure of Surface Wound Reopening
$1,242
$994
$689
37
clean
Intermediate Repair Wound Scalp/Underarm/Trunk/Arm/Leg 2.5 Cm or Less
$1,407
$1,126
$449
37
clean
Intermediate Repair Wound Scalp/Underarm/Trunk/Arm/Leg 2.6-7.5 Cm
$1,450
$1,160
$449
37
clean
Intermediate Repair Wound Scalp/Underarm/Trunk/Arm/Leg 7.6-12.5 Cm
$1,644
$1,315
$449
37
clean
Intermediate Repair Wound Scalp/Underarm/Trunk/Arm/Leg 12.6-20.0 Cm
$1,801
$1,441
$449
37
clean
Intermediate Repair Wound Neck/Hands/Feet/Genitals 2.5 Cm or Less
$1,293
$1,034
$449
37
clean
Intermediate Repair of Wound of Neck, Hands, Feet, or Genitals, 2.6-7.5 Cm
$1,450
$1,160
$449
37
clean
Intermediate Repair of Wound of Neck, Hands, Feet, or Genitals, 7.6-12.5 Cm
$1,644
$1,315
$688
37
clean
Intermediate Repair Wound Neck/Hands/Feet/Genitals 12.6-20.0 Cm
$1,801
$1,441
$689
37
clean
Intermediate Repair Wound Face/Ear/Eyelid/Nose/Lip/Mouth 2.5 Cm or Less
$1,271
$1,017
$449
37
clean
Intermediate Repair Wound Face/Ear/Eyelid/Nose/Lip/Mouth 2.6-5.0 Cm
$1,450
$1,160
$449
37
clean
Intermediate Repair Wound Face/Ear/Eyelid/Nose/Lip/Mouth 5.1-7.5 Cm
$1,566
$1,253
$449
37
clean
Apply Skin Subs Face/Scalp/Mouth/Neck/Ear/Eye/Genital/Hand/Feet 25sqcm
$2,381
$1,905
$2,048
31
clean
First Degree Burn Treatment
$695
$556
$224
37
clean
Dressing Change or Removal Burn Tissue Less Than 5% of Total Body Surface
$571
$457
$224
37
clean
Application of Chemical to Stop Tissue Regrowth in Wound
$890
$712
$224
37
clean
Aspiration of Cyst of Breast, First Cyst
$2,641
$2,113
$791
37
clean
Biopsy Breast/Placement Locating Device Using X-Ray With Needle 1st Growth
$4,890
$3,912
$1,822
37
clean
Biopsy Breast/Place Locating Device Using X-Ray With Needle, Ea Addl Growth
$1,084
$867
$728
13
clean
Biopsy Breast Place Locating Device Using Ultrasound, First Growth
$5,125
$4,100
$1,822
37
clean
Biopsy Breast/Place Locating Device Using Ultrasound, Each Addl Growth
$3,430
$2,744
$2,305
13
clean
Deep biopsy of muscle
—
—
$3,174
32
clean
Needle Biopsy of Muscle
$5,516
$4,413
$1,822
37
clean
Biopsy of Surface Bone
$5,842
$4,674
$3,204
69
clean
Injection Into Tendon or Ligament
$528
$422
$332
37
clean
Injection of Trigger Points, 1-2 Muscles
$686
$549
$393
69
clean
Injection of Trigger Points, 3 or More Muscles
$686
$549
$332
37
clean
Aspiration and/or Injection of Fluid From Small Joint
$658
$526
$332
37
clean
Aspiration and/or Injection of Fluid From Medium Joint
$1,302
$1,042
$482
69
clean
Aspiration and/or Injection of Fluid Medium Joint With Ultrasound Guidance
$3,496
$2,797
$779
37
clean
Aspiration and/or Injection of Fluid From Large Joint
$1,311
$1,049
$393
69
clean
Aspiration and/or Injection of Fluid Large Joint Using Ultrasound Guidance
$1,556
$1,245
$332
37
clean
Aspirate or Inject Ganglion Cyst
$601
$481
$332
36
clean
Removal of deep implant from bone
—
—
$3,174
32
clean
Closed Treatment of Dislocated Jaw Joint
$860
$688
$270
37
clean
Removal of growth of soft tissue under skin of neck or front of chest, 3.0 cm or more
—
—
$3,174
32
clean
Removal of growth under skin of neck or front of chest, less than 3.0 cm
—
—
$1,797
32
clean
Removal of growth of muscle of neck or front of chest, less than 5.0 cm
—
—
$3,174
32
clean
Removal of growth of muscle of back or lower sides, less than 5.0 cm
—
—
$3,174
32
clean
Treatment of Broken Lower Spine Bone With Placement of Stabilizing Device
$34,829
$27,863
$8,032
63
clean
Injection of Contrast for Imaging of Shoulder Joint
$278
$222
$187
13
clean
Closed Treatment of Broken Collar Bone
$563
$450
$270
37
clean
Closed Treatment of Broken Shoulder Blade
$656
$525
$270
37
clean
Closed Treatment Upper Arm Broken at Shoulder Joint With Manipulation
$1,688
$1,350
$1,706
37
clean
Closed Treatment of Dislocated Shoulder With Manipulation
$1,158
$926
$270
37
clean
Removal of growth under skin of upper arm or elbow, 3.0 cm or more
—
—
$3,174
32
clean
Removal of cyst or growth of elbow or upper forearm bone
—
—
$3,632
33
clean
Injection of Contrast for Imaging of Elbow Joint
$340
$272
$228
13
clean
Closed Treatment of Upper Arm Bone Broken at Elbow With Manipulation
$1,062
$850
$1,706
37
clean
Closed Treatment of Broken Outer Part of Upper Arm Bone at Elbow
$1,015
$812
$270
37
clean
Repair of Dislocated Elbow
$1,125
$900
$270
37
clean
Closed Treatment Dislocated Forearm, Thumb Side at Elbow With Manip, Child
$1,125
$900
$270
37
clean
Closed Treatment of Broken Forearm Bone on Thumb Side at Elbow
$605
$484
$270
37
clean
Treatment of broken forearm bone on small finger side at elbow
—
—
$7,921
32
clean
Injection of Contrast for Imaging of Wrist
$336
$269
$226
13
clean
Closed Treatment Broken Midpart of Forearm on Thumb Side With Manipulation
—
—
$1,792
33
clean
Closed Treatment of Broken Midpart of Both Forearm Bones
$1,019
$815
$270
37
clean
Closed Treatment of Broken Midpart of Both Forearm Bones With Manipulation
$1,158
$926
$1,723
70
clean
Closed Treatment Broken Forearm, Wrist Area, Thumb Side Wrist Without Manip
$888
$710
$270
37
clean
Closed Treatment Broke/Growth Plate Separate of Forearm at Wrist With Manip
$2,918
$2,334
$1,792
70
clean
Treatment of 2 broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device
—
—
$7,921
32
clean
Closed Treatment of Broken Wrist Bone Near Base of Thumb
$1,712
$1,370
$270
37
clean
Simple Drainage of Abscess of Finger
$657
$526
$223
37
clean
Complicated Drainage of Abscess in Finger
$3,104
$2,483
$1,822
37
clean
Incision of tendon covering of finger
—
—
$1,792
34
clean
Replacement of finger joint
—
—
$3,632
33
clean
Closed Treatment of Broken Hand Bone
$500
$400
$270
37
clean
Treatment of broken finger bone with stabilizing device accessed through skin
—
—
$3,632
33
clean
Closed Treatment of Broken Finger or Thumb at Midportion or Part Near Hand
$1,014
$811
$270
37
clean
Closed Treatment Broken Finger/Thumb at Midportion or Near Hand With Manip
$565
$452
$270
37
clean
Closed Treatment of Broken End of Finger or Thumb
$1,028
$822
$270
37
clean
Closed Treatment of Dislocated Finger Joint With Manipulation
$968
$774
$270
37
clean
Removal of growth under skin of pelvis and hip, 3.0 cm or more
—
—
$3,204
33
clean
Injection of Contrast for Imaging of Hip Joint
$331
$265
$222
13
clean
Injection Anesthetic/Steroid Joint Between Lower Spine/Hip With Image Guide
—
—
$133
30
clean
Removal of growth under skin of thigh or knee, 3.0 cm or more
—
—
$3,204
33
clean
Removal of growth under skin of thigh or knee, less than 3.0 cm
—
—
$3,204
33
clean
Injection of Contrast for Imaging of Knee Joint
$826
$661
$555
13
clean
Closed Treatment of Broken Kneecap
$1,298
$1,038
$270
37
clean
Closed Treatment of Broken Shin Bone
$1,807
$1,446
$270
37
clean
Closed Treatment of Dislocated Kneecap
$1,087
$870
$270
37
clean
Closed Treatment of Broken Middle or Upper End of Outside Lower Leg Bone
$742
$594
$407
30
clean
Closed Treatment of Broken Outside Lower Leg Bone at Ankle
$648
$518
$270
37
clean
Closed Treatment of Broken Outside Lower Leg Bone at Ankle With Manip
$1,279
$1,023
$270
37
clean
Closed Treatment of 3 Broken Lower Leg Bones at Ankle With Manipulation
$2,918
$2,334
$1,792
37
clean
Closed Treatment of Broken Shin Bone at Lower Weight Bearing Joint
$1,125
$900
$270
36
clean
Closed Treatment of Dislocated Ankle
$1,125
$900
$270
36
clean
Partial removal of toe bone
—
—
$3,632
33
clean
Removal of Foreign Body of Foot Tissue, Accessed Beneath the Skin
$3,701
$2,961
$791
37
clean
Closed Treatment of Broken Heel Bone
$642
$514
$270
37
clean
Closed Treatment of Broken Bone in Forefoot or Midfoot
$508
$406
$270
37
clean
Closed Treatment of Broken Great Toe
$325
$260
$263
37
clean
Closed Treatment of Broken Toe
$940
$752
$407
30
clean
Closed Treatment of Broken Toe With Manipulation
$972
$778
$270
36
clean
Amputation of toe at joint between forefoot and toes
—
—
$3,632
33
clean
Application of Lower and Upper Arm Splint
$711
$569
$177
36
clean
Application of Nonmoveable Forearm to Hand Splint
$756
$605
$145
37
clean
Application of Nonmoveable Finger Splint
$519
$415
$191
30
clean
Application of Long Leg Splint From Thigh to Ankle or Toe
$573
$458
$177
37
clean
Application of Short Leg Splint From Calf to Foot
$733
$586
$177
37
clean
Strapping, Unna Boot
$579
$463
$234
30
clean
Application of Vein Wound Compression Bandages on Lower Leg, Ankle, Foot
$616
$493
$177
73
clean
Drainage of Abscess or Blood Accumulation of Nose
$433
$346
$260
37
clean
Removal of Foreign Body in Nose
$207
$166
$144
37
clean
Simple Control of Nose Bleed
$1,672
$1,338
$145
37
clean
Complex Control of Nose Bleed
$748
$598
$145
37
clean
Initial Control of Nose Bleed and Insertion of Packing
$767
$614
$145
37
clean
Subsequent Control of Nosebleed and Insertion of Packing
$511
$409
$261
37
clean
Emergent Insertion of Breathing Tube Into Windpipe Using an Endoscope
$1,097
$878
$261
37
clean
Diagnostic Exam of Voice Box Using a Flexible Endoscope
$676
$541
$218
37
clean
Insertion of Tube Into Airway for Aspiration of Secretions
$310
$248
$228
37
clean
Insertion of Indwelling Tube for Drainage of Lung Fluid
$6,295
$5,036
$4,230
31
clean
Removal of Fluid From Between Lung and Chest Cavity
$2,726
$2,181
$1,739
37
clean
Aspiration of Fluid From Chest Cavity Using Imaging Guidance
$3,035
$2,428
$695
37
clean
Drainage of Fluid From Chest Cavity With Insertion of Indwelling Tube
$3,155
$2,524
$2,124
36
clean
Drain Fluid From Chest Cavity With Insert Indwelling Tube With Image Guide
$1,540
$1,232
$1,656
37
clean
Insertion of Tube Into Vena Cava
$2,006
$1,605
$1,348
13
clean
Insert Tube Into Abdominal, Pelvic, Leg Artery, Initial Third Order Branch
$2,628
$2,102
$1,766
13
clean
Insertion of Needle Into Vein for Collection of Blood Sample
$19
$5
$11
26
clean
Transfollowupsion of Blood or Blood Products
$2,143
$1,714
$492
37
clean
Insert Non-Tunneled Central Venous Tube for Infusion (5 Years or Older)
$4,959
$3,967
$3,524
37
clean
Insertion of Central Venous Tube With Port (5 Years or Older)
—
—
$3,524
33
clean
Insertion of Tube for Infusion (5 Years or Older)
$3,728
$2,982
$1,747
37
clean
Insert Tube for Infusion With Image Guide Over 5 Yr
$5,072
$4,058
$1,747
74
clean
Removal of Central Venous Tube With Port or Pump
$3,745
$2,996
$1,739
70
clean
Collection of Blood Sample From Implanted Device
$479
$100
$191
26
clean
Collection of Blood Sample From Central Venous Tube
$195
$100
$145
26
clean
Declotting of Central Venous Tube
$1,565
$1,252
$373
37
clean
Artery Puncture Collection of Blood Sample
$156
$125
$140
37
clean
Insertion of Artery Tube for Blood Sampling or Infusion Through Skin
$2,235
$1,788
$1,502
13
clean
Insertion of Needle for Infollowupsion Into Bone
$850
$680
$449
37
clean
Remove/Dissolve Bloodclot Vein With Fluoroscopic Guide, Initial Treatment
$13,160
$10,528
$12,454
31
clean
Insertion of Vena Cava Filter With Review by Radiologist
$10,316
$8,253
$6,932
31
clean
Occlusion of Artery or Vein Bleeding With Review by Radiologist
$15,513
$12,410
$12,454
37
clean
Ultrasound Evaluation Blood Vessel With Review by Radiology, Initial Vessel
$5,276
$4,221
$4,569
10
clean
Needle Biopsy or Removal of Surface Lymph Nodes
$4,283
$3,426
$1,822
37
clean
Repair of Lip and Border
$3,060
$2,448
$573
37
clean
Repair of Vertical Lip Wound Extending to Half of Lip
$2,471
$1,977
$573
37
clean
Repair of Lacerated Mouth, 2.5 Cm or Less
$763
$610
$261
37
clean
Drainage of Abscess, Cyst, or Blood Accumulation of Dental Bone
$922
$738
$145
37
clean
Needle Biopsy of Saliva Gland
$1,500
$1,200
$791
37
clean
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, 3.0 cm or more
—
—
$2,103
34
clean
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope
—
—
$1,052
34
clean
Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope
—
—
$1,052
34
clean
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
—
—
$1,052
34
clean
Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope
—
—
$897
34
clean
Insertion of guide wire with dilation of esophagus using a flexible endoscope
—
—
$897
34
clean
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm
—
—
$2,103
34
clean

Showing the first 200 of 1,716 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
warn
mrf_negotiated_above_gross_systematic
937 of 1,367 comparable items (69%) 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 $1,721 exceeds the gross charge $980
warn
mrf_rate_without_estimate
1,915 of 1,915 percentage/algorithm rates across 291 items carry no estimated dollar amount, which the template has required since 1 January 2025 — none of them do
CPT J1010/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1100/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1163/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1171/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1335/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 82947/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their cash differ, so no cross-line comparison was made for this item
CPT J1447/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J1644/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 J1650/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 J1756/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1805/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J1815/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 J1956/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J2003/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 J2004/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 J2185/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J2250/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 J2270/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 J2312/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 J2543/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 J2919/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 J3010/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 J3373/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 J3374/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J3430/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J3475/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 J3480/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 J3489/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J3490/o
info
mrf_item_fields_vary
this code and setting cover at least 9 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 74185/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min differ, so no cross-line comparison was made for this item
CPT J7500/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT J7507/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J7512/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 J7517/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J7999/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 76376/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 76377/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 88142/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 P9011/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT Q2009/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT Q5106/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 Q9968/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT S5010/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT V2787/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 10060/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 10120/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their min, max differ, so no cross-line comparison was made for this item
CPT 11042/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item
CPT 11044/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item
CPT 93306/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 93312/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 20552/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their max differ, so no cross-line comparison was made for this item
CPT 20605/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 96125/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 20610/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 22514/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 97014/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 97035/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT 25565/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 25605/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 97535/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT A9270/o
info
mrf_item_fields_vary
this code and setting cover at least 126 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 C1713/o
info
mrf_item_fields_vary
this code and setting cover at least 16 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 36573/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash differ, so no cross-line comparison was made for this item
CPT C1751/o
info
mrf_item_fields_vary
this code and setting cover at least 8 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT C1755/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 36590/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 C1758/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT C1778/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT C1781/o
info
mrf_item_fields_vary
this code and setting cover at least 17 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 C1782/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT C1889/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 C1894/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT G0378/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min differ, so no cross-line comparison was made for this item
CPT G0480/o
info
mrf_item_fields_vary
this code and setting cover at least 9 distinct chargemaster lines (modifier, billing class or unit); their min differ, so no cross-line comparison was made for this item
CPT J0283/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0290/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 J0295/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT 58300/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 J0613/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0650/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J0665/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0688/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 J0692/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, min, max differ, so no cross-line comparison was made for this item
CPT J0696/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 J0736/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 J0885/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, max differ, so no cross-line comparison was made for this item
CPT J0896/o
info
mrf_item_fields_vary
this code and setting cover at least 2 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT 70543/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,470 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 82747/o
info
mrf_negotiated_above_gross
highest negotiated rate $162 exceeds the gross charge $92 — part of a file-wide pattern, counted once at the file level
CPT 86905/o
info
mrf_negotiated_above_gross
highest negotiated rate $1,472 exceeds the gross charge $322 — part of a file-wide pattern, counted once at the file level
CPT J0897/o
info
mrf_negotiated_above_gross
highest negotiated rate $6,766 exceeds the gross charge $6,592 — part of a file-wide pattern, counted once at the file level
CPT 70544/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,886 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 82784/o
info
mrf_negotiated_above_gross
highest negotiated rate $88 exceeds the gross charge $49 — part of a file-wide pattern, counted once at the file level
CPT 87015/o
info
mrf_negotiated_above_gross
highest negotiated rate $63 exceeds the gross charge $42 — part of a file-wide pattern, counted once at the file level
CPT 70547/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,886 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 82785/o
info
mrf_negotiated_above_gross
highest negotiated rate $155 exceeds the gross charge $85 — part of a file-wide pattern, counted once at the file level
CPT 87040/o
info
mrf_negotiated_above_gross
highest negotiated rate $97 exceeds the gross charge $64 — part of a file-wide pattern, counted once at the file level
CPT J1050/o
info
mrf_negotiated_above_gross
highest negotiated rate $314 exceeds the gross charge $86 — part of a file-wide pattern, counted once at the file level
CPT 70551/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,891 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 82787/o
info
mrf_negotiated_above_gross
highest negotiated rate $89 exceeds the gross charge $50 — part of a file-wide pattern, counted once at the file level
CPT 87045/o
info
mrf_negotiated_above_gross
highest negotiated rate $89 exceeds the gross charge $59 — part of a file-wide pattern, counted once at the file level
CPT 70552/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,548 exceeds the gross charge $2,350 — part of a file-wide pattern, counted once at the file level
CPT 82800/o
info
mrf_negotiated_above_gross
highest negotiated rate $125 exceeds the gross charge $69 — part of a file-wide pattern, counted once at the file level
CPT 87070/o
info
mrf_negotiated_above_gross
highest negotiated rate $81 exceeds the gross charge $54 — part of a file-wide pattern, counted once at the file level
CPT J1160/o
info
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $12 — part of a file-wide pattern, counted once at the file level
CPT 70553/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,484 exceeds the gross charge $4,256 — part of a file-wide pattern, counted once at the file level
CPT 82803/o
info
mrf_negotiated_above_gross
highest negotiated rate $182 exceeds the gross charge $162 — part of a file-wide pattern, counted once at the file level
CPT 87071/o
info
mrf_negotiated_above_gross
highest negotiated rate $89 exceeds the gross charge $61 — part of a file-wide pattern, counted once at the file level
CPT J1162/o
info
mrf_negotiated_above_gross
highest negotiated rate $19,836 exceeds the gross charge $14,146 — part of a file-wide pattern, counted once at the file level
CPT 71045/o
info
mrf_negotiated_above_gross
highest negotiated rate $498 exceeds the gross charge $366 — part of a file-wide pattern, counted once at the file level
CPT 82810/o
info
mrf_negotiated_above_gross
highest negotiated rate $129 exceeds the gross charge $51 — part of a file-wide pattern, counted once at the file level
CPT 87075/o
info
mrf_negotiated_above_gross
highest negotiated rate $89 exceeds the gross charge $59 — part of a file-wide pattern, counted once at the file level
CPT 71046/o
info
mrf_negotiated_above_gross
highest negotiated rate $498 exceeds the gross charge $403 — part of a file-wide pattern, counted once at the file level
CPT 82941/o
info
mrf_negotiated_above_gross
highest negotiated rate $169 exceeds the gross charge $110 — part of a file-wide pattern, counted once at the file level
CPT 87076/o
info
mrf_negotiated_above_gross
highest negotiated rate $60 exceeds the gross charge $50 — part of a file-wide pattern, counted once at the file level
CPT 71270/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,833 exceeds the gross charge $2,645 — part of a file-wide pattern, counted once at the file level
CPT 82945/o
info
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $25 — part of a file-wide pattern, counted once at the file level
CPT 87077/o
info
mrf_negotiated_above_gross
highest negotiated rate $60 exceeds the gross charge $42 — part of a file-wide pattern, counted once at the file level
CPT 71275/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,916 exceeds the gross charge $2,649 — part of a file-wide pattern, counted once at the file level
CPT 82947/o
info
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $25 — part of a file-wide pattern, counted once at the file level
CPT 87081/o
info
mrf_negotiated_above_gross
highest negotiated rate $60 exceeds the gross charge $42 — part of a file-wide pattern, counted once at the file level
CPT J1364/o
info
mrf_negotiated_above_gross
highest negotiated rate $242 exceeds the gross charge $229 — part of a file-wide pattern, counted once at the file level
CPT 71550/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,881 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 87086/o
info
mrf_negotiated_above_gross
highest negotiated rate $76 exceeds the gross charge $60 — part of a file-wide pattern, counted once at the file level
CPT 71552/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,458 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 82950/o
info
mrf_negotiated_above_gross
highest negotiated rate $50 exceeds the gross charge $25 — part of a file-wide pattern, counted once at the file level
CPT 87101/o
info
mrf_negotiated_above_gross
highest negotiated rate $73 exceeds the gross charge $41 — part of a file-wide pattern, counted once at the file level
CPT J1450/o
info
mrf_negotiated_above_gross
highest negotiated rate $50 exceeds the gross charge $26 — part of a file-wide pattern, counted once at the file level
CPT 71555/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,545 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 82951/o
info
mrf_negotiated_above_gross
highest negotiated rate $121 exceeds the gross charge $80 — part of a file-wide pattern, counted once at the file level
CPT 87102/o
info
mrf_negotiated_above_gross
highest negotiated rate $79 exceeds the gross charge $52 — part of a file-wide pattern, counted once at the file level
CPT J1561/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,074 exceeds the gross charge $2,920 — part of a file-wide pattern, counted once at the file level
CPT 72020/o
info
mrf_negotiated_above_gross
highest negotiated rate $498 exceeds the gross charge $337 — part of a file-wide pattern, counted once at the file level
CPT 82952/o
info
mrf_negotiated_above_gross
highest negotiated rate $27 exceeds the gross charge $25 — part of a file-wide pattern, counted once at the file level
CPT 87106/o
info
mrf_negotiated_above_gross
highest negotiated rate $97 exceeds the gross charge $64 — part of a file-wide pattern, counted once at the file level
CPT J1580/o
info
mrf_negotiated_above_gross
highest negotiated rate $9 exceeds the gross charge $6 — part of a file-wide pattern, counted once at the file level
CPT 72081/o
info
mrf_negotiated_above_gross
highest negotiated rate $498 exceeds the gross charge $466 — part of a file-wide pattern, counted once at the file level
CPT 82955/o
info
mrf_negotiated_above_gross
highest negotiated rate $91 exceeds the gross charge $51 — part of a file-wide pattern, counted once at the file level
CPT 87107/o
info
mrf_negotiated_above_gross
highest negotiated rate $97 exceeds the gross charge $64 — part of a file-wide pattern, counted once at the file level
CPT 72120/o
info
mrf_negotiated_above_gross
highest negotiated rate $602 exceeds the gross charge $350 — part of a file-wide pattern, counted once at the file level
CPT 82977/o
info
mrf_negotiated_above_gross
highest negotiated rate $68 exceeds the gross charge $37 — part of a file-wide pattern, counted once at the file level
CPT 87109/o
info
mrf_negotiated_above_gross
highest negotiated rate $145 exceeds the gross charge $80 — part of a file-wide pattern, counted once at the file level
CPT 72127/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,833 exceeds the gross charge $2,645 — part of a file-wide pattern, counted once at the file level
CPT 82985/o
info
mrf_negotiated_above_gross
highest negotiated rate $137 exceeds the gross charge $87 — part of a file-wide pattern, counted once at the file level
CPT 87116/o
info
mrf_negotiated_above_gross
highest negotiated rate $102 exceeds the gross charge $68 — part of a file-wide pattern, counted once at the file level
CPT J1670/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,276 exceeds the gross charge $1,836 — part of a file-wide pattern, counted once at the file level
CPT 72130/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,833 exceeds the gross charge $2,645 — part of a file-wide pattern, counted once at the file level
CPT 83001/o
info
mrf_negotiated_above_gross
highest negotiated rate $175 exceeds the gross charge $97 — part of a file-wide pattern, counted once at the file level
CPT 87147/o
info
mrf_negotiated_above_gross
highest negotiated rate $49 exceeds the gross charge $32 — part of a file-wide pattern, counted once at the file level
CPT J1750/o
info
mrf_negotiated_above_gross
highest negotiated rate $139 exceeds the gross charge $125 — part of a file-wide pattern, counted once at the file level
CPT 72133/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,833 exceeds the gross charge $2,645 — part of a file-wide pattern, counted once at the file level
CPT 83002/o
info
mrf_negotiated_above_gross
highest negotiated rate $175 exceeds the gross charge $97 — part of a file-wide pattern, counted once at the file level
CPT 87150/o
info
mrf_negotiated_above_gross
highest negotiated rate $325 exceeds the gross charge $219 — part of a file-wide pattern, counted once at the file level
CPT 72141/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,890 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 83003/o
info
mrf_negotiated_above_gross
highest negotiated rate $157 exceeds the gross charge $86 — part of a file-wide pattern, counted once at the file level
CPT 87153/o
info
mrf_negotiated_above_gross
highest negotiated rate $1,067 exceeds the gross charge $600 — part of a file-wide pattern, counted once at the file level
CPT J1800/o
info
mrf_negotiated_above_gross
highest negotiated rate $37 exceeds the gross charge $9 — part of a file-wide pattern, counted once at the file level
CPT 72142/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,548 exceeds the gross charge $2,350 — part of a file-wide pattern, counted once at the file level
CPT 83010/o
info
mrf_negotiated_above_gross
highest negotiated rate $119 exceeds the gross charge $66 — part of a file-wide pattern, counted once at the file level
CPT 87168/o
info
mrf_negotiated_above_gross
highest negotiated rate $62 exceeds the gross charge $27 — part of a file-wide pattern, counted once at the file level
CPT 72146/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,892 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 83013/o
info
mrf_negotiated_above_gross
highest negotiated rate $409 exceeds the gross charge $350 — part of a file-wide pattern, counted once at the file level
CPT 87169/o
info
mrf_negotiated_above_gross
highest negotiated rate $80 exceeds the gross charge $23 — part of a file-wide pattern, counted once at the file level
CPT J1807/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,024 exceeds the gross charge $1,848 — part of a file-wide pattern, counted once at the file level
CPT 72147/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,551 exceeds the gross charge $2,350 — part of a file-wide pattern, counted once at the file level
CPT 83018/o
info
mrf_negotiated_above_gross
highest negotiated rate $207 exceeds the gross charge $114 — part of a file-wide pattern, counted once at the file level
CPT 87176/o
info
mrf_negotiated_above_gross
highest negotiated rate $55 exceeds the gross charge $36 — part of a file-wide pattern, counted once at the file level
CPT J1808/o
info
mrf_negotiated_above_gross
highest negotiated rate $110 exceeds the gross charge $73 — part of a file-wide pattern, counted once at the file level
CPT 72148/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,892 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 83020/o
info
mrf_negotiated_above_gross
highest negotiated rate $120 exceeds the gross charge $67 — part of a file-wide pattern, counted once at the file level
CPT 87177/o
info
mrf_negotiated_above_gross
highest negotiated rate $84 exceeds the gross charge $47 — part of a file-wide pattern, counted once at the file level
CPT 72149/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,548 exceeds the gross charge $2,350 — part of a file-wide pattern, counted once at the file level
CPT 83036/o
info
mrf_negotiated_above_gross
highest negotiated rate $91 exceeds the gross charge $75 — part of a file-wide pattern, counted once at the file level
CPT 87184/o
info
mrf_negotiated_above_gross
highest negotiated rate $65 exceeds the gross charge $47 — part of a file-wide pattern, counted once at the file level
CPT J1939/o
info
mrf_negotiated_above_gross
highest negotiated rate $133 exceeds the gross charge $16 — part of a file-wide pattern, counted once at the file level
CPT 72156/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,488 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 83050/o
info
mrf_negotiated_above_gross
highest negotiated rate $44 exceeds the gross charge $43 — part of a file-wide pattern, counted once at the file level
CPT 87185/o
info
mrf_negotiated_above_gross
highest negotiated rate $45 exceeds the gross charge $25 — part of a file-wide pattern, counted once at the file level
CPT J1953/o
info
mrf_negotiated_above_gross
highest negotiated rate $9 exceeds the gross charge $6 — part of a file-wide pattern, counted once at the file level
CPT 72157/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,491 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 83088/o
info
mrf_negotiated_above_gross
highest negotiated rate $278 exceeds the gross charge $154 — part of a file-wide pattern, counted once at the file level
CPT 87186/o
info
mrf_negotiated_above_gross
highest negotiated rate $81 exceeds the gross charge $66 — part of a file-wide pattern, counted once at the file level
CPT 72158/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,488 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 83090/o
info
mrf_negotiated_above_gross
highest negotiated rate $159 exceeds the gross charge $112 — part of a file-wide pattern, counted once at the file level
CPT 87205/o
info
mrf_negotiated_above_gross
highest negotiated rate $89 exceeds the gross charge $27 — part of a file-wide pattern, counted once at the file level
CPT J2002/o
info
mrf_negotiated_above_gross
highest negotiated rate $74 exceeds the gross charge $35 — part of a file-wide pattern, counted once at the file level
CPT 72195/o
info
mrf_negotiated_above_gross
highest negotiated rate $2,883 exceeds the gross charge $2,225 — part of a file-wide pattern, counted once at the file level
CPT 83497/o
info
mrf_negotiated_above_gross
highest negotiated rate $120 exceeds the gross charge $68 — part of a file-wide pattern, counted once at the file level
CPT 87206/o
info
mrf_negotiated_above_gross
highest negotiated rate $44 exceeds the gross charge $33 — part of a file-wide pattern, counted once at the file level
CPT 72196/o
info
mrf_negotiated_above_gross
highest negotiated rate $3,541 exceeds the gross charge $2,350 — part of a file-wide pattern, counted once at the file level
CPT 83498/o
info
mrf_negotiated_above_gross
highest negotiated rate $256 exceeds the gross charge $170 — part of a file-wide pattern, counted once at the file level
CPT 87207/o
info
mrf_negotiated_above_gross
highest negotiated rate $56 exceeds the gross charge $37 — part of a file-wide pattern, counted once at the file level
CPT 72197/o
info
mrf_negotiated_above_gross
highest negotiated rate $4,472 exceeds the gross charge $2,646 — part of a file-wide pattern, counted once at the file level
CPT 83516/o
info
mrf_negotiated_above_gross
highest negotiated rate $104 exceeds the gross charge $72 — part of a file-wide pattern, counted once at the file level
CPT 87209/o
info
mrf_negotiated_above_gross
highest negotiated rate $169 exceeds the gross charge $94 — part of a file-wide pattern, counted once at the file level
CPT J2175/o
info
mrf_negotiated_above_gross
highest negotiated rate $50 exceeds the gross charge $10 — part of a file-wide pattern, counted once at the file level
CPT 72200/o
info
mrf_negotiated_above_gross
highest negotiated rate $602 exceeds the gross charge $390 — part of a file-wide pattern, counted once at the file level
CPT 83519/o
info
mrf_negotiated_above_gross
highest negotiated rate $127 exceeds the gross charge $96 — part of a file-wide pattern, counted once at the file level

Showing the first 200 of 1,026 findings, errors first — every finding as JSON →

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 · 15.2M bytes · fetched 2026-08-23 · sha256 474dbe7036db…

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.