Hospital · CCN 510022

Charleston Area Medical Center

501 Morris Street, Charleston, WV 25301 · Kanawha County
Part of CAMC Health System · 803 beds · 1
Metropolitan area core: primary flow within an urbanized area of 50,000 and greater

154 admission types 61 outpatient services price file: ok 1 Medicare-file findings
Billed per dollar paid, all admissions
5.15×
$598.1M billed against $116.2M paid across 6,561 Medicare discharges; the national figure is 5.03×.
10.1%
of adults in Kanawha County have medical debt in collections
7.5%
uninsured in the county · state 7.4%
$57K
median household income
5.1×
billed ÷ paid, inpatient, summed over the county's hospitals in the Medicare file (4 in the inpatient or outpatient file)ⓘ
40.3%
obesity in the countyⓘ
15.6%
diagnosed diabetes (PLACES)
8.7%
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
785
$79,694
$18,057
4.4× st 3.8×
291
Heart failure and shock with mcc
281
$59,281
$12,561
4.7× st 3.7×
872
Septicemia or severe sepsis without mv >96 hours without mcc
183
$49,875
$9,979
5.0× st 4.0×
853
Infectious and parasitic diseases with o.r. procedures with mcc
147
$209,795
$45,567
4.6× st 3.8×
280
Acute myocardial infarction, discharged alive with mcc
129
$79,566
$16,007
5.0× st 3.9×
683
Renal failure with cc
124
$41,772
$9,229
4.5× st 3.6×
193
Simple pneumonia and pleurisy with mcc
119
$53,265
$11,764
4.5× st 4.0×
392
Esophagitis, gastroenteritis and miscellaneous digestive disorders without mcc
115
$40,145
$7,535
5.3× st 4.0×
690
Kidney and urinary tract infections without mcc
113
$39,719
$8,251
4.8× st 3.8×
190
Chronic obstructive pulmonary disease with mcc
112
$55,381
$10,482
5.3× st 4.6×
322
Percutaneous cardiovascular procedures with intraluminal device without mcc
101
$120,865
$17,928
6.7× st 6.1×
698
Other kidney and urinary tract diagnoses with mcc
96
$79,125
$16,615
4.8× st 3.8×
065
Intracranial hemorrhage or cerebral infarction with cc or tpa in 24 hours
94
$48,880
$9,223
5.3× st 4.1×
189
Pulmonary edema and respiratory failure
91
$58,744
$11,511
5.1× st 3.9×
481
Hip and femur procedures except major joint with cc
88
$100,151
$17,488
5.7× st 4.6×
064
Intracranial hemorrhage or cerebral infarction with mcc
86
$86,572
$16,784
5.2× st 3.9×
309
Cardiac arrhythmia and conduction disorders with cc
85
$34,374
$7,524
4.6× st 3.7×
321
Percutaneous cardiovascular procedures with intraluminal device with mcc or 4+ arteries/
85
$168,179
$24,948
6.7× st 5.7×
177
Respiratory infections and inflammations with mcc
82
$66,441
$14,691
4.5× st 3.7×
287
Circulatory disorders except ami, with cardiac catheterization without mcc
80
$52,396
$9,801
5.3× st 4.9×
682
Renal failure with mcc
77
$55,140
$12,859
4.3× st 3.5×
378
Gastrointestinal hemorrhage with cc
76
$47,686
$9,509
5.0× st 4.4×
266
Endovascular cardiac valve replacement and supplement procedures with mcc
74
$301,754
$52,399
5.8× st 5.1×
689
Kidney and urinary tract infections with mcc
73
$51,681
$10,506
4.9× st 3.6×
274
Percutaneous and other intracardiac procedures without mcc
73
$185,348
$24,654
7.5× st 5.2×
312
Syncope and collapse
69
$41,686
$8,234
5.1× st 4.0×
281
Acute myocardial infarction, discharged alive with cc
67
$46,749
$9,232
5.1× st 4.3×
308
Cardiac arrhythmia and conduction disorders with mcc
63
$55,278
$10,858
5.1× st 4.2×
641
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without mcc
62
$37,154
$7,727
4.8× st 3.8×
603
Cellulitis without mcc
57
$33,563
$8,038
4.2× st 3.3×
194
Simple pneumonia and pleurisy with cc
57
$37,935
$7,549
5.0× st 4.2×
640
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with mcc
55
$61,983
$11,497
5.4× st 3.7×
267
Endovascular cardiac valve replacement and supplement procedures without mcc
54
$261,929
$40,137
6.5× st 4.5×
377
Gastrointestinal hemorrhage with mcc
52
$84,992
$16,104
5.3× st 4.2×
310
Cardiac arrhythmia and conduction disorders without cc/mcc
51
$28,837
$5,593
5.2× st 3.9×
286
Circulatory disorders except ami, with cardiac catheterization with mcc
50
$94,836
$20,187
4.7× st 3.8×
236
Coronary bypass without cardiac catheterization without mcc
49
$223,840
$45,074
5.0× st 4.7×
552
Medical back problems without mcc
47
$39,045
$9,402
4.2× st 3.5×
522
Hip replacement with principal diagnosis of hip fracture without mcc
46
$96,543
$19,148
5.0× st 4.5×
981
Extensive o.r. procedures unrelated to principal diagnosis with mcc
46
$221,875
$41,960
5.3× st 4.7×
854
Infectious and parasitic diseases with o.r. procedures with cc
45
$111,090
$23,155
4.8× st 4.4×
175
Pulmonary embolism with mcc or acute cor pulmonale
42
$79,610
$14,953
5.3× st 4.0×
389
Gastrointestinal obstruction with cc
41
$39,287
$8,810
4.5× st 3.7×
101
Seizures without mcc
40
$37,576
$8,353
4.5× st 3.6×
948
Signs and symptoms without mcc
40
$45,225
$8,121
5.6× st 4.0×
270
Other major cardiovascular procedures with mcc
40
$272,192
$50,717
5.4× st 4.4×
391
Esophagitis, gastroenteritis and miscellaneous digestive disorders with mcc
39
$60,636
$11,394
5.3× st 3.7×
273
Percutaneous and other intracardiac procedures with mcc
39
$196,817
$32,452
6.1× st 5.0×
313
Chest pain
38
$42,549
$7,383
5.8× st 4.2×
330
Major small and large bowel procedures with cc
38
$108,416
$23,971
4.5× st 4.8×
066
Intracranial hemorrhage or cerebral infarction without cc/mcc
36
$44,579
$7,642
5.8× st 5.0×
870
Septicemia or severe sepsis with mv >96 hours
35
$226,650
$51,053
4.4× st 3.4×
699
Other kidney and urinary tract diagnoses with cc
35
$68,388
$10,830
6.3× st 3.9×
329
Major small and large bowel procedures with mcc
34
$179,190
$39,467
4.5× st 4.2×
811
Red blood cell disorders with mcc
33
$62,849
$12,658
5.0× st 4.1×
638
Diabetes with cc
33
$40,106
$9,096
4.4× st 3.4×
100
Seizures with mcc
32
$67,316
$18,319
3.7× st 4.0×
234
Coronary bypass with cardiac catheterization or open ablation without mcc
32
$309,583
$52,771
5.9× st 5.3×
282
Acute myocardial infarction, discharged alive without cc/mcc
32
$38,084
$6,343
6.0× st 5.5×
305
Hypertension without mcc
30
$41,189
$8,107
5.1× st 4.1×
652
Kidney transplant
30
$359,237
$26,302
13.7× st 13.7×
812
Red blood cell disorders without mcc
30
$48,568
$9,916
4.9× st 4.4×
039
Extracranial procedures without cc/mcc
29
$86,694
$9,988
8.7× st 6.6×
300
Peripheral vascular disorders with cc
29
$44,064
$9,533
4.6× st 4.0×
036
Carotid artery stent procedures without cc/mcc
28
$90,337
$14,946
6.0× st 4.7×
208
Respiratory system diagnosis with ventilator support <=96 hours
27
$103,221
$25,631
4.0× st 3.9×
314
Other circulatory system diagnoses with mcc
27
$89,589
$20,116
4.5× st 3.0×
092
Other disorders of nervous system with cc
27
$44,452
$12,553
3.5× st 3.4×
069
Transient ischemia without thrombolytic
26
$47,260
$7,805
6.1× st 5.0×
164
Major chest procedures with cc
26
$108,767
$19,565
5.6× st 4.2×
233
Coronary bypass with cardiac catheterization or open ablation with mcc
26
$352,085
$67,050
5.3× st 4.4×
178
Respiratory infections and inflammations with cc
25
$40,250
$8,821
4.6× st 4.1×
229
Other cardiothoracic procedures without mcc
25
$151,052
$27,094
5.6× st 5.2×
235
Coronary bypass without cardiac catheterization with mcc
25
$299,474
$49,478
6.1× st 4.4×
243
Permanent cardiac pacemaker implant with cc
25
$88,311
$17,720
5.0× st 4.9×
025
Craniotomy and endovascular intracranial procedures with mcc
24
$184,622
$35,614
5.2× st 3.9×
191
Chronic obstructive pulmonary disease with cc
23
$36,004
$7,238
5.0× st 4.0×
660
Kidney and ureter procedures for non-neoplasm with cc
23
$61,598
$11,863
5.2× st 3.9×
659
Kidney and ureter procedures for non-neoplasm with mcc
22
$117,538
$23,225
5.1× st 4.1×
331
Major small and large bowel procedures without cc/mcc
22
$72,322
$13,435
5.4× st 5.2×
163
Major chest procedures with mcc
22
$221,887
$41,828
5.3× st 4.1×
324
Coronary intravascular lithotripsy with intraluminal device without mcc
22
$185,032
$26,868
6.9× st 6.7×
439
Disorders of pancreas except malignancy with cc
21
$40,572
$7,940
5.1× st 4.6×
390
Gastrointestinal obstruction without cc/mcc
21
$25,712
$5,542
4.6× st 3.6×
493
Lower extremity and humerus procedures except hip, foot and femur with cc
20
$100,206
$18,713
5.4× st 4.0×
057
Degenerative nervous system disorders without mcc
20
$54,267
$11,697
4.6× st 3.4×
165
Major chest procedures without cc/mcc
20
$97,356
$18,036
5.4× st 4.9×
327
Stomach, esophageal and duodenal procedures with cc
20
$101,775
$18,530
5.5× st 4.9×
637
Diabetes with mcc
20
$59,127
$14,075
4.2× st 3.7×
445
Disorders of the biliary tract with cc
19
$64,968
$10,334
6.3× st 4.4×
303
Atherosclerosis without mcc
19
$32,189
$6,222
5.2× st 4.0×
083
Traumatic stupor and coma >1 hour with cc
19
$56,578
$11,946
4.7× st 4.0×
394
Other digestive system diagnoses with cc
19
$45,071
$8,618
5.2× st 3.9×
918
Poisoning and toxic effects of drugs without mcc
18
$49,546
$8,130
6.1× st 6.1×
393
Other digestive system diagnoses with mcc
18
$58,492
$14,169
4.1× st 3.8×
023
Craniotomy with major device implant or acute complex cns principal diagnosis with mcc o
18
$202,475
$39,134
5.2× st 4.0×
884
Organic disturbances and intellectual disability
18
$52,362
$15,330
3.4× st 2.9×
673
Other kidney and urinary tract procedures with mcc
18
$129,473
$31,978
4.0× st 3.8×
919
Complications of treatment with mcc
17
$95,131
$17,366
5.5× st 4.2×
242
Permanent cardiac pacemaker implant with mcc
17
$149,497
$26,890
5.6× st 4.1×
086
Traumatic stupor and coma <1 hour with cc
17
$43,205
$11,213
3.9× st 3.7×
684
Renal failure without cc/mcc
17
$34,096
$5,977
5.7× st 5.5×
252
Other vascular procedures with mcc
17
$142,512
$26,730
5.3× st 4.3×
982
Extensive o.r. procedures unrelated to principal diagnosis with cc
17
$158,110
$26,239
6.0× st 4.6×
418
Laparoscopic cholecystectomy without c.d.e. with cc
17
$95,503
$16,227
5.9× st 5.3×
166
Other respiratory system o.r. procedures with mcc
16
$164,567
$33,333
4.9× st 4.0×
644
Endocrine disorders with cc
16
$43,403
$12,050
3.6× st 3.4×
070
Other cerebrovascular disorders with mcc
16
$88,539
$17,250
5.1× st 4.7×
328
Stomach, esophageal and duodenal procedures without cc/mcc
16
$74,596
$12,838
5.8× st 5.1×
480
Hip and femur procedures except major joint with mcc
16
$120,510
$22,255
5.4× st 4.2×
856
Postoperative or post-traumatic infections with o.r. procedures with mcc
15
$147,122
$41,940
3.5× st 3.6×
035
Carotid artery stent procedures with cc
15
$120,269
$18,250
6.6× st 5.4×
441
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with mcc
15
$89,885
$17,596
5.1× st 4.6×
220
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
15
$312,757
$46,961
6.7× st 4.9×
472
Cervical spinal fusion with cc
15
$143,055
$29,051
4.9× st 4.4×
521
Hip replacement with principal diagnosis of hip fracture with mcc
15
$134,357
$23,951
5.6× st 4.5×
304
Hypertension with mcc
14
$55,368
$9,947
5.6× st 5.6×
987
Non-extensive o.r. procedures unrelated to principal diagnosis with mcc
14
$162,460
$32,366
5.0× st 5.0×
074
Cranial and peripheral nerve disorders without mcc
14
$46,209
$8,554
5.4× st 3.3×
186
Pleural effusion with mcc
14
$97,357
$17,272
5.6× st 5.6×
602
Cellulitis with mcc
14
$61,579
$14,909
4.1× st 3.6×
087
Traumatic stupor and coma <1 hour without cc/mcc
14
$30,559
$7,683
4.0× st 3.8×
617
Amputation of lower limb for endocrine, nutritional and metabolic disorders with cc
14
$103,384
$17,582
5.9× st 4.8×
253
Other vascular procedures with cc
14
$106,225
$26,391
4.0× st 4.3×
442
Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with cc
14
$49,199
$9,171
5.4× st 4.2×
536
Fractures of hip and pelvis without mcc
14
$31,148
$7,776
4.0× st 3.5×
920
Complications of treatment with cc
13
$35,874
$9,257
3.9× st 3.5×
176
Pulmonary embolism without mcc
13
$44,388
$7,709
5.8× st 4.5×
336
Peritoneal adhesiolysis with cc
13
$103,528
$17,709
5.8× st 5.8×
419
Laparoscopic cholecystectomy without c.d.e. without cc/mcc
13
$77,711
$11,286
6.9× st 6.9×
605
Trauma to the skin, subcutaneous tissue and breast without mcc
13
$34,146
$9,452
3.6× st 3.2×
202
Bronchitis and asthma with cc/mcc
13
$40,226
$7,348
5.5× st 4.9×
003
Ecmo or tracheostomy with mv >96 hours or principal diagnosis except face, mouth and nec
13
$602,977
$112,380
5.4× st 3.9×
643
Endocrine disorders with mcc
12
$62,488
$13,555
4.6× st 3.0×
563
Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc
12
$46,729
$8,530
5.5× st 3.5×
885
Psychoses
12
$95,252
$22,798
4.2× st 2.7×
558
Tendonitis, myositis and bursitis without mcc
12
$50,483
$10,173
5.0× st 5.0×
482
Hip and femur procedures except major joint without cc/mcc
12
$76,246
$13,069
5.8× st 5.9×
004
Tracheostomy with mv >96 hours or principal diagnosis except face, mouth and neck withou
12
$333,593
$101,574
3.3× st 3.6×
433
Cirrhosis and alcoholic hepatitis with cc
12
$64,087
$10,082
6.4× st 4.5×
219
Cardiac valve and other major cardiothoracic procedures without cardiac catheterization
12
$355,416
$84,206
4.2× st 3.9×
038
Extracranial procedures with cc
12
$80,389
$12,696
6.3× st 6.8×
180
Respiratory neoplasms with mcc
12
$67,227
$14,614
4.6× st 4.5×
071
Other cerebrovascular disorders with cc
12
$32,598
$8,286
3.9× st 3.9×
084
Traumatic stupor and coma >1 hour without cc/mcc
11
$39,386
$8,307
4.7× st 4.7×
696
Kidney and urinary tract signs and symptoms without mcc
11
$44,076
$7,288
6.0× st 4.9×
371
Major gastrointestinal disorders and peritoneal infections with mcc
11
$71,642
$14,951
4.8× st 4.8×
511
Shoulder, elbow or forearm procedures, except major joint procedures with cc
11
$96,374
$15,549
6.2× st 6.2×
184
Major chest trauma with cc
11
$56,366
$11,064
5.1× st 4.3×
917
Poisoning and toxic effects of drugs with mcc
11
$49,650
$12,163
4.1× st 4.1×
897
Alcohol, drug abuse or dependence without rehabilitation therapy without mcc
11
$37,605
$8,438
4.5× st 4.2×
857
Postoperative or post-traumatic infections with o.r. procedures with cc
11
$154,291
$23,623
6.5× st 5.2×
054
Nervous system neoplasms with mcc
11
$55,196
$12,680
4.4× st 3.9×
988
Non-extensive o.r. procedures unrelated to principal diagnosis with cc
11
$58,474
$14,163
4.1× st 4.1×
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
700
$21,340
$2,261
9.4×
5373
Level 3 Urology and Related Services
476
$10,700
$1,632
6.6×
5191
Level 1 Endovascular Procedures
453
$20,536
$2,716
7.6×
5372
Level 2 Urology and Related Services
442
$3,156
$541
5.8×
5072
Level 2 Excision/ Biopsy/ Incision and Drainage
430
$8,390
$1,342
6.3×
5375
Level 5 Urology and Related Services
223
$30,467
$4,325
7.0×
5491
Level 1 Intraocular Procedures
217
$14,519
$1,928
7.5×
5374
Level 4 Urology and Related Services
208
$17,354
$2,913
6.0×
5193
Level 3 Endovascular Procedures
203
$86,826
$9,131
9.5×
5183
Level 3 Vascular Procedures
191
$19,834
$2,668
7.4×
5302
Level 2 Upper GI Procedures
169
$14,524
$1,563
9.3×
5192
Level 2 Endovascular Procedures
128
$34,974
$4,785
7.3×
5361
Level 1 Laparoscopy and Related Services
118
$37,722
$4,838
7.8×
5362
Level 2 Laparoscopy and Related Services
108
$54,932
$8,482
6.5×
5073
Level 3 Excision/ Biopsy/ Incision and Drainage
107
$17,533
$2,359
7.4×
5113
Level 3 Musculoskeletal Procedures
89
$25,049
$2,673
9.4×
5153
Level 3 Airway Endoscopy
89
$13,910
$1,419
9.8×
5115
Level 5 Musculoskeletal Procedures
81
$83,304
$10,500
7.9×
5194
Level 4 Endovascular Procedures
74
$110,389
$14,480
7.6×
5341
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures
72
$28,359
$2,872
9.9×
5182
Level 2 Vascular Procedures
72
$5,837
$1,340
4.4×
5223
Level 3 Pacemaker and Similar Procedures
71
$35,499
$9,048
3.9×
5114
Level 4 Musculoskeletal Procedures
66
$54,628
$5,992
9.1×
5213
Level 3 Electrophysiologic Procedures
61
$111,275
$19,479
5.7×
5154
Level 4 Airway Endoscopy
61
$35,214
$3,175
11.1×
5232
Level 2 ICD and Similar Procedures
52
$147,391
$26,806
5.5×
5092
Level 2 Breast/Lymphatic Surgery and Related Procedures
52
$44,168
$5,443
8.1×
5414
Level 4 Gynecologic Procedures
51
$14,711
$2,650
5.6×
5431
Level 1 Nerve Procedures
50
$10,036
$1,615
6.2×
5112
Level 2 Musculoskeletal Procedures
45
$10,787
$1,314
8.2×
5184
Level 4 Vascular Procedures
44
$35,780
$4,490
8.0×
5091
Level 1 Breast/Lymphatic Surgery and Related Procedures
42
$24,557
$3,047
8.1×
5465
Level 5 Neurostimulator and Related Procedures
41
$180,554
$25,649
7.0×
5164
Level 4 ENT Procedures
38
$30,358
$2,672
11.4×
5165
Level 5 ENT Procedures
34
$33,203
$4,673
7.1×
5313
Level 3 Lower GI Procedures
32
$25,183
$2,321
10.9×
5303
Level 3 Upper GI Procedures
26
$24,653
$3,247
7.6×
5376
Level 6 Urology and Related Services
24
$46,257
$7,810
5.9×
5331
Complex GI Procedures
21
$40,349
$4,831
8.4×
5415
Level 5 Gynecologic Procedures
20
$29,526
$4,217
7.0×
5224
Level 4 Pacemaker and Similar Procedures
17
$88,931
$16,483
5.4×
5222
Level 2 Pacemaker and Similar Procedures
16
$41,808
$6,844
6.1×
5116
Level 6 Musculoskeletal Procedures
14
$116,501
$14,757
7.9×
5464
Level 4 Neurostimulator and Related Procedures
14
$131,909
$18,501
7.1×
5155
Level 5 Airway Endoscopy
12
$55,846
$5,802
9.6×
5378
Level 8 Urology and Related Services
12
$84,641
$15,862
5.3×
5492
Level 2 Intraocular Procedures
12
$15,973
$3,236
4.9×
5503
Level 3 Extraocular, Repair, and Plastic Eye Procedures
—
—
—
—
5166
Cochlear Implant Procedure
—
—
—
—
5432
Level 2 Nerve Procedures
—
—
—
—
5627
Level 7 Radiation Therapy
—
—
—
—
5231
Level 1 ICD and Similar Procedures
—
—
—
—
5462
Level 2 Neurostimulator and Related Procedures
—
—
—
—
5461
Level 1 Neurostimulator and Related Procedures
—
—
—
—
5212
Level 2 Electrophysiologic Procedures
—
—
—
—
5163
Level 3 ENT Procedures
—
—
—
—
5416
Level 6 Gynecologic Procedures
—
—
—
—
5377
Level 7 Urology and Related Services
—
—
—
—
5093
Level 3 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5094
Level 4 Breast/Lymphatic Surgery and Related Procedures
—
—
—
—
5463
Level 3 Neurostimulator and Related Procedures
—
—
—
—
03 · Its own price file

What the hospital's price-transparency file says

Found via camc.org/cms-hpt.txt, the file itself ↗ read as csv-wide, last updated 4/1/2026, template 3.0.0, 61,859 rows scanned, 10,039 distinct code–setting items kept. 3,647 findings against it.

Service
Code
Listed
Cash
Negotiated
Rates
Checks
NASH FIBRO TEST-MAYO
$1,065
$1,065
$858
29
clean
TPMT GENOTYPE-MAYO
$675
$675
$544
29
clean
CT CEREBRAL PERFUSION STUDY
$2,642
$2,642
$1,389
58
clean
0055T - PF ADDON COMPUTER-ASSISTED SURG ORTHO PROC W/CT/MRI IMAGES
$408
$408
$180
29
clean
0075T - PF TRANSCATHETER PLACEMENT EXTRACRANIAL VERTEBRAL ARTERY STENT INITIAL VESSEL
$2,987
$2,987
$2,257
203
clean
M-PROTEIN ISOTYPE MALDI-TOF MS-MAYO
$164
$164
$68
203
clean
0184T - PF EXCISION RECTAL TUMOR TRANSANAL ENDOSCOPIC APPROACH INCLUDES MUSCULARIS PROPRIA
$12,066
$12,066
$6,513
29
clean
VIRAL RESPIRATORY PNL W/ COVID-19-PCR
$605
$605
$487
29
clean
0232T - PRP INJECTION PACKAGE
$490
$490
$306
87
clean
0232T - PF INJECTION PLATELET RICH PLASMA ANY SITE INCLUDES IMAGE GUIDANCE/HARVEST/PREPARATION
$166
$166
$164
29
clean
TRANSLUMINAL PERIPHERAL ATHERECTOMY OPEN/PERC ILIAC ARTERY EACH VESSEL - CCL
$35,236
$35,236
$19,665
87
clean
AMBULATORY POC COVID/FLU/RSV PANEL
$221
$221
$135
87
clean
0266T - PF IMPLANT/REPLACE CAROTID SINUS BAROREFLEX ACTIVATION DEVICE
$3,494
$3,494
$11,400
58
clean
IMPLANT/REPLACE CAROTID SINUS BAROREFLEX PULSE GENERATOR ONLY ? CCL
$56,111
$56,111
$7,272
58
clean
0275T - PF PERC LAMINOTOMY/LAMINECTOMY W/INDIRECT IMAGE GUIDANCE LUMBAR
$3,551
$3,551
$1,287
29
clean
TRANSCATHETER RENAL SYMPATHETIC DENERVATION PERC BILATERAL - CCL
$16,505
$16,505
$4,408
58
clean
0421T - PF TRANSURETHRAL WATERJET ABLATION PROSTATE COMPLICATED
$2,273
$2,273
$824
29
clean
KLHL11-IGG CBA, S-MAYO
$103
$103
$62
29
clean
0437T - PF ADDON IMPLANTATION NON-BIOLOGIC/SYNTHETIC IMPLANT FOR FASCIAL REINFORCEMENT ABDOMINAL WAL
$400
$400
$145
29
clean
CT CRYONEUROLYSIS (IR)
$6,347
$6,347
$1,582
87
clean
0446T - PF CREATION SUBSTANCE POCKET W/INSERT IMPLANT INTERSTITIAL GLUCOSE SENSOR W/PATIENT TRAINING
$161
$161
$58
29
clean
0446T - CREATION SUBSTANCE POCKET W/INSERT IMPLANT INTERSTITIAL GLUCOSE SENSOR W/PATIENT TRAINING
$161
$161
$4,251
87
clean
0447T - PF REMOVE IMPLANTABLE INTERSTITIAL GLUCOSE SENSOR SUBQ POCKET VIA INCISION
$189
$189
$69
29
clean
0448T - PF REMOVE/INSERT IMPLANTABLE INTERSTITIAL GLUCOSE SENSOR DIFFERENT ANATOMIC SITE
$268
$268
$97
29
clean
0448T - REMOVE/INSERT IMPLANTABLE INTERSTITIAL GLUCOSE SENSOR DIFFERENT ANATOMIC SITE
$268
$268
$4,251
87
clean
IR TRANSCATHETER MITRAL VALVE IMPLANT/REPLACE W/PROSTHETIC VALVE PERC
$11,850
$11,850
$4,820
87
clean
0484T - PF TRANSCATHETER MITRAL VALVE IMPLANT/REPLACEMENT W/PROSTHETIC VALVE
$7,855
$7,855
$2,829
29
clean
IR ENDOVENOUS FEM-POP ARTERIAL REVASCULARIZATION W/TRANSCATHETER STENT PLACEMENT W/IMAGING
$22,610
$22,610
$17,055
87
clean
TRANSCATHETER TRICUSPID VALVE REPAIR PERC APPROACH INITIAL PROSTHESIS - CCL
$11,867
$11,867
$4,666
87
clean
IR ADDON TRANSCATHETER TRICUSPID VALVE REPAIR PERC EA ADDNL PROSTHESIS SAME SESSION
$5,996
$5,996
$2,923
87
clean
CT ABLATION BREAST CRYO - REPORT
$620
$620
$2,105
58
clean
0620T - PF ENDOVASCULAR VENOUS ARTERIALIZATION TIBIAL/PERONEAL VEIN
$5,500
$5,500
$9,630
58
clean
CTA CORONARY HEARTFLOW PLAQUE ANALYSIS
$1,548
$1,548
$929
29
clean
0627T - PF STELLATE GANGLION BLOCK INJECTION FIRST LEVEL
$281
$281
$102
116
clean
0628T - PF ADDON PERC INJ ALLOGENEIC CELLULAR/TISSUE BASED PRODUCT LUMBAR EA ADDNL LEVEL
$281
$281
$102
29
clean
IR REMOVAL TCAT/DEBULKING INTRACARDIAC MASS VIA SUCTION DEVICE PERC
$10,621
$10,621
$5,223
58
clean
IR TRANSCATHETER TRICUSPID VALVE IMPLANT/REPLACEMENT W/RIGHT HEART CATH/ANGIOGRAPH
$11,850
$11,850
$4,016
58
clean
TCAT INSERT PERMANENT DUAL-CHAMBER LEADLESS PACEMAKER COMPLETE SYSTEM - CCL
$38,764
$38,764
$5,624
58
clean
10004 - PF FINE NEEDLE ASPIRATION BX W/O IMAGING GUIDANCE EACH ADDITIONAL LESION
$148
$148
$55
29
clean
10004 - FINE NEEDLE ASPIRATION BX W/O IMAGING GUIDANCE EACH ADDITIONAL LESION
$148
$148
$144
58
clean
10005 - FINE NEEDLE ASPIRATION BX INCLUDES US FIRST LESION
$891
$891
$180
118
clean
US FINE NEEDLE ASPIRATION BX 1ST LESION
$790
$790
$425
207
clean
10006 - ADDON FINE NEEDLE ASPIRATION BX INCLUDES US EACH ADDITIONAL LESION
$184
$184
$133
59
clean
10006 - PF ADDON FINE NEEDLE ASPIRATION BX INCLUDES US EACH ADDITIONAL LESION
$184
$184
$111
118
clean
10007 - PF FINE NEEDLE ASPIRATION BX INCLUDES FLUORO FIRST LESION
$184
$184
$180
29
clean
10007 - FINE NEEDLE ASPIRATION BX INCLUDES FLUORO FIRST LESION
$891
$891
$191
58
clean
10009 - PF FINE NEEDLE ASPIRATION BX INCLUDES CT FIRST LESION
$184
$184
$193
87
clean
CT FINE NEEDLE ASPIRATION BX EACH ADDL
$485
$485
$184
87
clean
10011 - PF FINE NEEDLE ASPIRATION BX INCLUDES MRI FIRST LESION
$184
$184
$182
29
clean
10012 - PF ADDON FINE NEEDLE ASPIRATION BX INCLUDES MRI EACH ADDITIONAL LESION
$184
$184
$69
29
clean
PHY-FINE NEEDLE ASPIRATION BX W/O IMAGING GUIDANCE FIRST LESION
$264
$264
$241
118
clean
10021 - PF FINE NEEDLE ASPIRATION BX W/O IMAGING GUIDANCE FIRST LESION
$194
$194
$98
58
clean
PHY-IMAGE GUIDED FLUID COLLECTION DRAINAGE BY CATHETER SOFT TISSUE PERC
$387
$387
$377
58
clean
CT DRAIN SOFT TISSUE FLUID W/CATH PERC
$1,229
$1,229
$406
261
clean
10035 - PF PLACEMENT SOFT TISSUE LOCALIZATION DEVICE PERC INCLUDES IMAGING FIRST LESION
$252
$252
$249
29
clean
10040 - PF ACNE SURGERY
$482
$482
$107
29
clean
10060 - PF INCISION/DRAINAGE ABSCESS SIMPLE/SINGLE
$254
$254
$205
58
clean
10060 - INCISION/DRAINAGE ABSCESS SIMPLE OR SINGLE
$814
$814
$205
116
clean
10061 - INCISION/DRAINAGE ABSCESS COMPLICATED OR MULTIPLE
$475
$475
$415
116
clean
10061 - PF INCISION/DRAINAGE ABSCESS COMPLICATED/MULTIPLE
$393
$393
$218
29
clean
PHY-INCISION/DRAINAGE PILONIDAL CYST SIMPLE
$272
$272
$272
116
clean
10080 - PF INCISION/DRAINAGE PILONIDAL CYST SIMPLE
$272
$272
$243
29
clean
10081 - PF INCISION/DRAINAGE PILONIDAL CYST COMPLICATED
$456
$456
$350
29
clean
PHY-INCISION/DRAINAGE PILONIDAL CYST COMPLICATED
$929
$929
$456
116
clean
10120 - INCISION/REMOVAL FOREIGN BODY SUBCUTANEOUS TISSUES SIMPLE
$272
$272
$387
145
clean
10120 - PF INCISION/REMOVAL FOREIGN BODY SUBCUTANEOUS TISSUES SIMPLE
$272
$272
$149
29
clean
10121 - INCISION/REMOVAL FOREIGN BODY SUBCUTANEOUS TISSUES COMPLICATED
$2,718
$2,718
$489
116
clean
10121 - PF INCISION/REMOVAL FOREIGN BODY SUBCUTANEOUS TISSUES COMPLICATED
$502
$502
$1,046
58
clean
INCISION DRAINAGE HEMATOMA/SEROMA/FLUID COLLECTION - CCL
$8,601
$8,601
$1,702
87
clean
PHY-INCISION/DRAINAGE HEMATOMA SEROMA/FLUID COLLECTION
$313
$313
$305
116
clean
PHY-PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST
$516
$516
$250
116
clean
10160 - PF PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST
$256
$256
$250
116
clean
10180 - INCISION/DRAINAGE COMPLEX POSTOPERATIVE WOUND INFECTION
$3,518
$3,518
$471
58
clean
INCISION/DRAINAGE COMPLEX POSTOP WOUND INFECTION - CCL
$10,029
$10,029
$471
58
clean
PHY-DEBRIDEMENT EXTENSIVE ECZEMATOUS OR INFECTED SKIN UP TO TEN PERCENT BODY SURFACE
$83
$83
$82
116
clean
11000 - PF DEBRIDEMENT EXTENSIVE ECZEMATOUS OR INFECTED SKIN UP TO TEN PERCENT BODY SURFACE
$83
$83
$55
29
clean
PHY-DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION EXTERNAL GENITALIA AND PERINEUM
$1,641
$1,641
$453
58
clean
11004 - PF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION EXTERNAL GENITALIA AND PERINEUM
$1,641
$1,641
$668
29
clean
11005 - PF DEBRIDEMENT FOR NECROTIZING SOFT TISSUE INFECTION ABDOMINAL WALL W/WO FASCIAL CLOSURE
$2,251
$2,251
$918
29
clean
11006 - PF DEBRIDE SKIN/SUBQ TISSUE/MUSCLE/FASCIA NECROTIZING INFECTION GENITALIA/PERINEUM/ABDOMEN
$2,006
$2,006
$829
29
clean
11008 - PF ADDON REMOVAL OF PROSTHETIC MATERIAL/MESH ABDOMINAL WALL FOR INFECTION
$790
$790
$324
29
clean
11010 - DEBRIDEMENT W/REMOVAL FOREIGN MATERIAL FROM SKIN/TISSUE OPEN FX/DISLOCATION
$764
$764
$714
58
clean
11010 - PF DEBRIDEMENT SKIN/TISSUE INCLUDES REMOVAL FB OPEN FX/DISLOCATION SITE
$764
$764
$453
29
clean
11011 - PF DEBRIDEMENT SKIN/TISSUE/MUSCLE INCLUDES REMOVAL FB OPEN FX/DISLOCATION SITE
$834
$834
$506
29
clean
PHY-DEBRIDEMENT SKIN/SUBQ TISSUE/MUSCLE/BONE OPEN FRACTURE/DISLOCATION INCLUDES FOREIGN BODY
$1,189
$1,189
$1,159
58
clean
11012 - PF DEBRIDEMENT SKIN/SUBQ TISSUE/MUSCLE/BONE OPEN FX/DISLOCATION INCLUDES FOREIGN BODY
$1,189
$1,189
$670
29
clean
PHY-DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20SQ CM OR LESS
$169
$169
$167
116
clean
IR DEBRIDEMENT SUBQ TISSUE FIRST 20SQ CM <
$748
$748
$167
58
clean
PHY-DEBRIDEMENT MUSCLE/FASCIA FIRST 20SQ CM OR LESS
$1,184
$1,184
$420
116
clean
11043 - PF DEBRIDEMENT MUSCLE/FASCIA FIRST 20SQ CM OR LESS
$431
$431
$755
87
clean
IR DEBRIDEMENT BONE, FIRST 20CM/<
$2,586
$2,586
$1,687
87
clean
11044 - DEBRIDEMENT BONE FIRST 20SQ CM OR LESS
$2,586
$2,586
$628
116
clean
11045 - ADDON DEBRIDEMENT SUBCUTANEOUS TISSUE EACH ADDITIONAL 20SQ CM
$1,507
$1,507
$75
116
clean
IR ADDON DEBRIDEMENT SUBCUTANEOUS TISSUE EACH ADDITIONAL 20SQ CM
$1,507
$1,507
$75
58
clean
11046 - ADDON DEBRIDEMENT MUSCLE/FASCIA EACH 20SQ CM
$162
$162
$157
58
clean
11046 - PF ADDON DEBRIDEMENT MUSCLE/FASCIA EACH 20SQ CM
$162
$162
$78
29
clean
11047 - PF ADDON DEBRIDEMENT BONE EACH ADDITIONAL 20SQ CM OR PART THEREOF
$285
$285
$132
29
clean
11047 - ADDON DEBRIDEMENT BONE EACH ADDITIONAL 20SQ CM
$1,813
$1,813
$276
58
clean
11055 - PARING/CUTTING BENIGN HYPERKERATOTIC SINGLE LESION
$47
$47
$49
58
clean
11055 - PF PARING/CUTTING BENIGN HYPERKERATOTIC SINGLE LESION
$47
$47
$46
29
clean
11056 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2 TO 4 LESIONS
$65
$65
$68
58
clean
11057 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION OVER 4 LESIONS
$85
$85
$85
58
clean
11102 - PF TANGENTIAL SKIN BX SINGLE LESION
$136
$136
$87
29
clean
11102 - TANGENTIAL SKIN BX SINGLE LESION SHAVE/SCOOP/SAUCERIZE/CURETTE
$681
$681
$133
58
clean
11103 - ADDON TANGENITAL BX SKIN EA ADDNL LESION
$913
$913
$71
58
clean
11103 - PF ADDON TANGENITAL BX SKIN EACH ADDITIONAL LESION
$73
$73
$45
29
clean
11104 - PUNCH BX SKIN SINGLE LESION
$681
$681
$548
29
clean
11104 - PF PUNCH BX SKIN SINGLE LESION
$136
$136
$132
87
clean
11105 - PF ADDON PUNCH BX SKIN EACH ADDITIONAL LESION
$73
$73
$56
29
clean
11105 - ADDON PUNCH BX SKIN EACH ADDITIONAL SEPARATE LESION
$913
$913
$72
58
clean
11106 - INCISIONAL BX OF SKIN SINGLE LESION
$1,101
$1,101
$141
58
clean
11106 - PF INCISIONAL BX SKIN SINGLE LESION
$136
$136
$133
29
clean
11107 - ADDON INCISIONAL BX OF SKIN EA ADDNL LESION
$73
$73
$73
58
clean
11107 - PF ADDON INCISIONAL BX OF SKIN EACH ADDITIONAL LESION
$73
$73
$65
29
clean
11200 - REMOVAL SKIN TAG/MULTIPLE FIBROCUTANEOUS TAGS INCLUDES 15 LESIONS
$191
$191
$191
116
clean
11200 - PF REMOVAL SKIN TAG/MULTIPLE FIBROCUTANEOUS TAGS INCLUDES 15 LESIONS
$191
$191
$89
29
clean
11201 - ADDON REMOVAL SKIN TAG/MULTIPLE FIBROCUTANEOUS TAGS EACH ADDITIONAL 10 LESIONS
$991
$991
$48
58
clean
11201 - PF ADDON REMOVAL SKIN TAG/MULTIPLE FIBROCUTANEOUS TAGS EACH ADDITIONAL 10 LESIONS
$49
$49
$19
29
clean
11300 - SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 0.5CM OR LESS
$516
$516
$99
58
clean
11300 - PF SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 0.5CM OR LESS
$99
$99
$88
29
clean
11301 - PF SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 0.6CM TO 1.0CM
$150
$150
$106
29
clean
11301 - SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 0.6CM TO 1.0CM
$469
$469
$148
58
clean
11302 - SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 1.1CM TO 2.0CM
$469
$469
$172
58
clean
11302 - PF SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER 1.1CM TO 2.0CM
$175
$175
$124
29
clean
11303 - SHAVE SINGLE SKIN LESION TRUNK/ARM/LEGS DIAMETER OVER 2.0CM
$208
$208
$204
58
clean
11305 - SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 0.5CM OR LESS
$111
$111
$111
58
clean
11305 - PF SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 0.5CM OR LESS
$111
$111
$93
29
clean
11306 - SHAVE EPIDERMAL/DERMAL SINGLE LESION SCALP/NECK/HAND/FEET/GENITALIA 0.6 - 1CM DIAMETER
$469
$469
$146
58
clean
11306 - PF SHAVE EPIDERMAL/DERMAL SINGLE LESION SCALP/NECK/HAND/FEET/GENITALIA 0.6 - 1CM DIAMETER
$147
$147
$108
29
clean
11307 - PF SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 1.1CM TO 2.0CM
$186
$186
$122
29
clean
11307 - SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 1.1CM TO 2.0CM
$186
$186
$183
58
clean
11308 - SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER OVER 2.0CM
$205
$205
$201
58
clean
11308 - PF SHAVE SINGLE SKIN LESION SCALP/NECK/HANDS/FEET/GENITAL DIAMETER OVER 2.0CM
$205
$205
$74
29
clean
11310 - SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 0.5CM OR LESS
$131
$131
$131
58
clean
11310 - PF SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 0.5CM OR LESS
$131
$131
$102
29
clean
11311 - PF SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 0.6CM TO 1.0CM
$184
$184
$122
29
clean
11311 - SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 0.6CM TO 1.0 CM
$887
$887
$181
58
clean
11312 - SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 1.1CM TO 2.0CM
$217
$217
$213
58
clean
11312 - PF SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE 1.1CM TO 2.0CM
$217
$217
$143
29
clean
11313 - SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE OVER 2.0CM
$278
$278
$271
58
clean
11313 - PF SHAVE SINGLE SKIN LESION FACE/EARS/EYELID/NOSE/LIPS/MUCOUS MEMBRANE OVER 2.0CM
$278
$278
$167
29
clean
11400 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS 0.5CM OR LESS
$214
$214
$121
29
clean
PHY-LESION EXCISION, SIMPLE
$1,885
$1,885
$210
116
clean
11401 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS 0.6-1CM
$276
$276
$147
29
clean
11401 - EXCISION BENIGN LESION TRUNK/ARMS/LEGS 0.6 - 1CM DIAMETER
$1,885
$1,885
$269
58
clean
11402 - EXCISION BENIGN LESION TRUNK/ARMS/LEGS 1.1-2CM
$1,885
$1,885
$297
58
clean
11402 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS 1.1-2CM
$305
$305
$163
29
clean
11403 - EXCISION BENIGN LESION TRUNK/ARMS/LEGS 2.1-3CM
$393
$393
$383
58
clean
11403 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS 2.1-3CM
$393
$393
$195
29
clean
11404 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS 3.1-4CM
$435
$435
$227
29
clean
11404 - EXCISION BENIGN LESION TRUNK/ARMS/LEGS 3.1-4CM
$435
$435
$424
58
clean
11406 - EXCISION BENIGN LESION TRUNK/ARMS/LEGS GREATER THAN 4CM
$5,532
$5,532
$654
58
clean
11406 - PF EXCISION BENIGN LESION TRUNK/ARMS/LEGS GREATER THAN 4CM
$671
$671
$333
29
clean
11420 - EXC BENIGN LESION W/MARGINS SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 0.5CM OR LESS
$3,719
$3,719
$207
116
clean
11420 - PF EXCISION BENIGN LESION W/MARGINS SCALP/NECK/HANDS/FEET/GENITAL DIAMETER 0.5CM OR LESS
$216
$216
$118
29
clean
11421 - PF EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 0.6-1CM
$293
$293
$152
29
clean
11421 - EXCISION BENIGN LESION SCALP/NECK/HAND/FEET/GENITALIA 0.6 - 1CM DIAMETER
$293
$293
$286
58
clean
11422 - EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 1.1-2.0CM
$3,683
$3,683
$350
58
clean
11422 - PF EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 1.1-2.0CM
$359
$359
$176
29
clean
11423 - EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 2.1-3.0CM
$3,683
$3,683
$2,966
29
clean
11423 - PF EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 2.1-3.0CM
$418
$418
$205
58
clean
11424 - PF EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 3.1-4.0CM
$484
$484
$241
58
clean
11424 - EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA 3.1-4.0CM
$5,532
$5,532
$3,375
29
clean
11426 - EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA GREATER THAN 4CM
$751
$751
$732
58
clean
11426 - PF EXCISION BENIGN LESION SCALP/NECK/HANDS/FEET/GENITALIA GREATER THAN 4CM
$751
$751
$341
29
clean
11440 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 0.5CM OR LESS
$268
$268
$261
116
clean
11440 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 0.5CM OR LESS
$268
$268
$136
29
clean
11441 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 0.6-1CM
$346
$346
$169
29
clean
11441 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 0.6-1CM
$1,885
$1,885
$337
58
clean
11442 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 1.1-2CM
$3,683
$3,683
$376
58
clean
11442 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 1.1-2CM
$386
$386
$189
29
clean
11443 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES 2.1-3CM
$3,683
$3,683
$464
58
clean
11443 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 2.1-3CM
$476
$476
$226
29
clean
11444 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 3.1-4CM
$611
$611
$286
29
clean
11444 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA 3.1-4CM
$611
$611
$596
58
clean
11446 - PF EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANESTHESIA GREATER THAN 4CM
$882
$882
$398
29
clean
11446 - EXCISION BENIGN LESION FACE/EARS/EYELIDS/NOSE/LIPS/MUCOUS MEMBRANES GREATER THAN 4CM
$5,532
$5,532
$860
58
clean
11450 - PF EXCISION SKIN/TISSUE HIDRADENITIS AXILLARY W/SIMPLE OR INTERMEDIATE REPAIR
$681
$681
$428
29
clean
11451 - PF EXCISION SKIN/TISSUE HIDRADENITIS AXILLARY W/COMPLEX REPAIR
$883
$883
$537
29
clean
11462 - PF EXCISION SKIN/TISSUE HIDRADENITIS INGUINAL W/SIMPLE OR INTERMEDIATE REPAIR
$786
$786
$428
29
clean
11463 - PF EXCISION SKIN/TISSUE HIDRADENITIS INGUINAL W/COMPLEX REPAIR
$890
$890
$534
29
clean
11470 - PF EXCISION SKIN/TISSUE HIDRADENITIS PERIANUAL/PERINEAL/UMBILICAL SIMPLE/INTERMEDIATE REPAIR
$765
$765
$466
29
clean
11471 - PF EXCISION SKIN/TISSUE HIDRADENITIS PERIANAL/PERINEAL/UMBILICAL W/COMPLEX REPAIR
$946
$946
$563
29
clean
11600 - PF EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0.5CM OR LESS
$342
$342
$189
29
clean
11601 - EXC MALIGNANT LESION TRUNK/ARMS/LEGS DIAMETER 0.6CM TO 1.0CM
$1,885
$1,885
$390
58
clean
11601 - PF EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS DIAMETER 0.6CM TO 1.0CM
$400
$400
$217
29
clean
11602 - EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS 1.1-2CM
$439
$439
$415
58
clean
11602 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS 1.1-2CM
$439
$439
$229
29
clean
11603 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS 2.1-3CM
$530
$530
$268
29
clean
11603 - EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS 2.1-3CM
$530
$530
$517
58
clean
11604 - EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 3.1-4.0CM
$1,476
$1,476
$571
58
clean
11604 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS 3.1-4CM
$586
$586
$300
29
clean
11606 - EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS OVER 4CM
$5,532
$5,532
$860
58
clean
11606 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/TRUNK/ARMS/LEGS OVER 4CM
$882
$882
$453
29
clean
11620 - PF EXCISION MALIGNANT LESION SCALP/NECK/HANDS/FEET/GENITALIA DIAMETER 0.5CM OR LESS
$325
$325
$189
29
clean
11620 - EXC MALIGNANT LESION SCALP/NECK/HANDS/FEET/GENITALIA DIAMETER 0.5CM OR LESS
$325
$325
$317
58
clean
11621 - EXCISION MALIGNANT LESION INCLUDES MARGINS/SCALP/NECK/HANDS/FEET/GENITALIA 0.6-1CM
$3,683
$3,683
$395
58
clean
11621 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/SCALP/NECK/HANDS/FEET/GENITALIA 0.6-1CM
$405
$405
$218
29
clean
11622 - EXCISION MALIGNANT LESION INCLUDES MARGINS/SCALP/NECK/HANDS/FEET/GENITALIA 1.1-2CM
$3,683
$3,683
$451
58
clean
11622 - PF EXCISION MALIGNANT LESION INCLUDES MARGINS/SCALP/NECK/HANDS/FEET/GENITALIA 1.1-2CM
$463
$463
$239
29
clean

Showing the first 200 of 10,039 code–setting items in the file, verified codes first — every row as JSON →

Findings

Service
Severity
Rule
Detail
CPT 43270/b
warn
mrf_negotiated_above_gross
highest negotiated rate $702 exceeds the gross charge $669
CPT 43290/b
warn
mrf_negotiated_above_gross
highest negotiated rate $553 exceeds the gross charge $527
CPT 43659/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $4,634
CPT 69706/b
warn
mrf_negotiated_above_gross
highest negotiated rate $735 exceeds the gross charge $700
CPT 12056/b
warn
mrf_negotiated_above_gross
highest negotiated rate $261 exceeds the gross charge $249
CPT 43762/b
warn
mrf_negotiated_above_gross
highest negotiated rate $142 exceeds the gross charge $135
CPT 43763/b
warn
mrf_negotiated_above_gross
highest negotiated rate $142 exceeds the gross charge $135
CPT 81415/b
warn
mrf_negotiated_above_gross
highest negotiated rate $4,433 exceeds the gross charge $4,222
CPT 81416/b
warn
mrf_negotiated_above_gross
highest negotiated rate $11,159 exceeds the gross charge $10,628
CPT 44238/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $2,414
CPT 44382/b
warn
mrf_negotiated_above_gross
highest negotiated rate $234 exceeds the gross charge $223
CPT 44386/b
warn
mrf_negotiated_above_gross
highest negotiated rate $314 exceeds the gross charge $299
CPT 58340/b
warn
mrf_negotiated_above_gross
highest negotiated rate $165 exceeds the gross charge $157
CPT 31626/b
warn
mrf_negotiated_above_gross
highest negotiated rate $708 exceeds the gross charge $674
CPT 44979/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $2,110
CPT 31627/b
warn
mrf_negotiated_above_gross
highest negotiated rate $377 exceeds the gross charge $359
CPT 36465/b
warn
mrf_negotiated_above_gross
highest negotiated rate $366 exceeds the gross charge $349
CPT 31652/b
warn
mrf_negotiated_above_gross
highest negotiated rate $853 exceeds the gross charge $812
CPT 36466/b
warn
mrf_negotiated_above_gross
highest negotiated rate $475 exceeds the gross charge $452
CPT 31653/b
warn
mrf_negotiated_above_gross
highest negotiated rate $944 exceeds the gross charge $899
CPT 58563/b
warn
mrf_negotiated_above_gross
highest negotiated rate $936 exceeds the gross charge $891
CPT 81515/b
warn
mrf_negotiated_above_gross
highest negotiated rate $225 exceeds the gross charge $214
CPT A9600/b
warn
mrf_negotiated_above_gross
highest negotiated rate $3,786 exceeds the gross charge $3,606
CPT P9044/b
warn
mrf_negotiated_above_gross
highest negotiated rate $127 exceeds the gross charge $121
CPT 45330/b
warn
mrf_negotiated_above_gross
highest negotiated rate $163 exceeds the gross charge $155
CPT 58565/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,218 exceeds the gross charge $1,160
CPT 45334/b
warn
mrf_negotiated_above_gross
highest negotiated rate $414 exceeds the gross charge $394
CPT 45335/b
warn
mrf_negotiated_above_gross
highest negotiated rate $265 exceeds the gross charge $252
CPT 58999/b
warn
mrf_negotiated_above_gross
highest negotiated rate $330 exceeds the gross charge $249
CPT 45340/b
warn
mrf_negotiated_above_gross
highest negotiated rate $337 exceeds the gross charge $321
CPT 45346/b
warn
mrf_negotiated_above_gross
highest negotiated rate $843 exceeds the gross charge $803
CPT 45388/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,377 exceeds the gross charge $1,311
CPT 45499/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $1,577
CPT 36514/b
warn
mrf_negotiated_above_gross
highest negotiated rate $290 exceeds the gross charge $276
CPT 32560/b
warn
mrf_negotiated_above_gross
highest negotiated rate $234 exceeds the gross charge $223
CPT 45999/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,520 exceeds the gross charge $412
CPT 36557/b
warn
mrf_negotiated_above_gross
highest negotiated rate $957 exceeds the gross charge $911
CPT 36560/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,147 exceeds the gross charge $1,092
CPT 36563/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,118 exceeds the gross charge $1,085
CPT 46604/b
warn
mrf_negotiated_above_gross
highest negotiated rate $251 exceeds the gross charge $239
CPT 94640/o
warn
mrf_negotiated_above_gross
highest negotiated rate $143 exceeds the gross charge $136
CPT 36566/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,137 exceeds the gross charge $1,083
CPT 46606/b
warn
mrf_negotiated_above_gross
highest negotiated rate $226 exceeds the gross charge $215
CPT 46611/b
warn
mrf_negotiated_above_gross
highest negotiated rate $230 exceeds the gross charge $227
CPT 46917/b
warn
mrf_negotiated_above_gross
highest negotiated rate $386 exceeds the gross charge $368
CPT 46999/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,520 exceeds the gross charge $1,147
CPT 47379/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $1,436
CPT 94728/b
warn
mrf_negotiated_above_gross
highest negotiated rate $36 exceeds the gross charge $34
CPT 95805/b
warn
mrf_negotiated_above_gross
highest negotiated rate $167 exceeds the gross charge $159
CPT 27086/b
warn
mrf_negotiated_above_gross
highest negotiated rate $215 exceeds the gross charge $205
CPT 90473/b
warn
mrf_negotiated_above_gross
highest negotiated rate $58 exceeds the gross charge $55
CPT 90473/o
warn
mrf_negotiated_above_gross
highest negotiated rate $58 exceeds the gross charge $55
CPT 27095/b
warn
mrf_negotiated_above_gross
highest negotiated rate $244 exceeds the gross charge $232
CPT 15824/b
warn
mrf_negotiated_above_gross
highest negotiated rate $3,541 exceeds the gross charge $3,226
CPT 95819/o
warn
mrf_negotiated_above_gross
highest negotiated rate $165 exceeds the gross charge $157
CPT 0232T/b
warn
mrf_negotiated_above_gross
highest negotiated rate $730 exceeds the gross charge $166
CPT 15876/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,793 exceeds the gross charge $3,999
CPT 15877/b
warn
mrf_negotiated_above_gross
highest negotiated rate $6,082 exceeds the gross charge $5,348
CPT 47579/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $1,648
CPT 62365/b
warn
mrf_negotiated_above_gross
highest negotiated rate $259 exceeds the gross charge $247
CPT 15953/b
warn
mrf_negotiated_above_gross
highest negotiated rate $344 exceeds the gross charge $328
CPT 90868/b
warn
mrf_negotiated_above_gross
highest negotiated rate $84 exceeds the gross charge $80
CPT 90869/b
warn
mrf_negotiated_above_gross
highest negotiated rate $84 exceeds the gross charge $80
CPT 0335T/b
warn
mrf_negotiated_above_gross
highest negotiated rate $11,861 exceeds the gross charge $7,753
CPT 63650/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,255 exceeds the gross charge $1,195
CPT 76873/b
warn
mrf_negotiated_above_gross
highest negotiated rate $165 exceeds the gross charge $157
CPT 0511T/b
warn
mrf_negotiated_above_gross
highest negotiated rate $11,861 exceeds the gross charge $7,753
CPT 49329/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $3,085
CPT 91037/b
warn
mrf_negotiated_above_gross
highest negotiated rate $151 exceeds the gross charge $144
CPT 91111/b
warn
mrf_negotiated_above_gross
highest negotiated rate $182 exceeds the gross charge $173
CPT 91200/b
warn
mrf_negotiated_above_gross
highest negotiated rate $32 exceeds the gross charge $31
CPT 10007/b
warn
mrf_negotiated_above_gross
highest negotiated rate $193 exceeds the gross charge $184
CPT 49659/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $1,896
CPT 92242/b
warn
mrf_negotiated_above_gross
highest negotiated rate $185 exceeds the gross charge $176
CPT 49900/b
warn
mrf_negotiated_above_gross
highest negotiated rate $470 exceeds the gross charge $448
CPT 10011/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,158 exceeds the gross charge $184
CPT 95926/b
warn
mrf_negotiated_above_gross
highest negotiated rate $96 exceeds the gross charge $91
CPT 95927/b
warn
mrf_negotiated_above_gross
highest negotiated rate $88 exceeds the gross charge $84
CPT 19286/b
warn
mrf_negotiated_above_gross
highest negotiated rate $129 exceeds the gross charge $123
CPT 19296/b
warn
mrf_negotiated_above_gross
highest negotiated rate $633 exceeds the gross charge $603
CPT 19499/b
warn
mrf_negotiated_above_gross
highest negotiated rate $6,400 exceeds the gross charge $4,204
CPT 10035/b
warn
mrf_negotiated_above_gross
highest negotiated rate $265 exceeds the gross charge $252
CPT 20101/b
warn
mrf_negotiated_above_gross
highest negotiated rate $603 exceeds the gross charge $587
CPT 64555/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,301 exceeds the gross charge $1,239
MS-DRG 148/i
warn
mrf_negotiated_above_gross
highest negotiated rate $5,688 exceeds the gross charge $5,557
CPT 50549/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $3,789
CPT 64634/b
warn
mrf_negotiated_above_gross
highest negotiated rate $227 exceeds the gross charge $216
CPT 27880/b
warn
mrf_negotiated_above_gross
highest negotiated rate $762 exceeds the gross charge $726
CPT 50949/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $3,789
CPT 27899/b
warn
mrf_negotiated_above_gross
highest negotiated rate $403 exceeds the gross charge $295
CPT 96138/o
warn
mrf_negotiated_above_gross
highest negotiated rate $38 exceeds the gross charge $36
CPT 51101/b
warn
mrf_negotiated_above_gross
highest negotiated rate $149 exceeds the gross charge $146
CPT 92612/b
warn
mrf_negotiated_above_gross
highest negotiated rate $112 exceeds the gross charge $107
CPT 11055/b
warn
mrf_negotiated_above_gross
highest negotiated rate $49 exceeds the gross charge $47
CPT 20950/b
warn
mrf_negotiated_above_gross
highest negotiated rate $262 exceeds the gross charge $250
CPT 92700/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $27
CPT D0150/b
warn
mrf_negotiated_above_gross
highest negotiated rate $200 exceeds the gross charge $125
CPT D0270/b
warn
mrf_negotiated_above_gross
highest negotiated rate $45 exceeds the gross charge $27
CPT D0272/b
warn
mrf_negotiated_above_gross
highest negotiated rate $69 exceeds the gross charge $43
CPT 11106/b
warn
mrf_negotiated_above_gross
highest negotiated rate $143 exceeds the gross charge $136
CPT D0274/b
warn
mrf_negotiated_above_gross
highest negotiated rate $98 exceeds the gross charge $61
CPT D4273/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,488 exceeds the gross charge $930
CPT D4355/b
warn
mrf_negotiated_above_gross
highest negotiated rate $366 exceeds the gross charge $229
CPT 21215/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,569 exceeds the gross charge $2,447
CPT D7140/b
warn
mrf_negotiated_above_gross
highest negotiated rate $353 exceeds the gross charge $210
CPT D7210/b
warn
mrf_negotiated_above_gross
highest negotiated rate $581 exceeds the gross charge $346
CPT D7220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $712 exceeds the gross charge $424
CPT 21268/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,597 exceeds the gross charge $1,521
CPT 51726/b
warn
mrf_negotiated_above_gross
highest negotiated rate $249 exceeds the gross charge $237
CPT D7230/b
warn
mrf_negotiated_above_gross
highest negotiated rate $912 exceeds the gross charge $543
CPT D7240/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,062 exceeds the gross charge $632
CPT D7241/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,057 exceeds the gross charge $684
CPT 51728/b
warn
mrf_negotiated_above_gross
highest negotiated rate $304 exceeds the gross charge $290
CPT D7250/b
warn
mrf_negotiated_above_gross
highest negotiated rate $689 exceeds the gross charge $410
CPT D7261/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,057 exceeds the gross charge $890
CPT 38589/b
warn
mrf_negotiated_above_gross
highest negotiated rate $9,882 exceeds the gross charge $3,646
CPT D9930/b
warn
mrf_negotiated_above_gross
highest negotiated rate $155 exceeds the gross charge $97
CPT 78226/b
warn
mrf_negotiated_above_gross
highest negotiated rate $104 exceeds the gross charge $99
CPT 96446/b
warn
mrf_negotiated_above_gross
highest negotiated rate $230 exceeds the gross charge $219
CPT D9944/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,043 exceeds the gross charge $652
CPT D9950/b
warn
mrf_negotiated_above_gross
highest negotiated rate $466 exceeds the gross charge $291
CPT 51797/b
warn
mrf_negotiated_above_gross
highest negotiated rate $119 exceeds the gross charge $113
CPT 65778/b
warn
mrf_negotiated_above_gross
highest negotiated rate $164 exceeds the gross charge $156
CPT 51999/b
warn
mrf_negotiated_above_gross
highest negotiated rate $10,376 exceeds the gross charge $3,789
CPT 21743/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,349 exceeds the gross charge $4,090
CPT 52214/b
warn
mrf_negotiated_above_gross
highest negotiated rate $517 exceeds the gross charge $492
CPT 52224/b
warn
mrf_negotiated_above_gross
highest negotiated rate $597 exceeds the gross charge $569
CPT 22310/b
warn
mrf_negotiated_above_gross
highest negotiated rate $92 exceeds the gross charge $88
CPT 40806/b
warn
mrf_negotiated_above_gross
highest negotiated rate $91 exceeds the gross charge $87
CPT 22510/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,310 exceeds the gross charge $1,248
CPT 22512/b
warn
mrf_negotiated_above_gross
highest negotiated rate $634 exceeds the gross charge $604
CPT 22513/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,580 exceeds the gross charge $1,505
CPT 22514/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,937 exceeds the gross charge $1,845
CPT 22515/b
warn
mrf_negotiated_above_gross
highest negotiated rate $670 exceeds the gross charge $638
CPT 52441/b
warn
mrf_negotiated_above_gross
highest negotiated rate $626 exceeds the gross charge $596
CPT 22850/o
warn
mrf_negotiated_above_gross
highest negotiated rate $2,274 exceeds the gross charge $2,166
CPT 52442/b
warn
mrf_negotiated_above_gross
highest negotiated rate $152 exceeds the gross charge $145
CPT 67700/b
warn
mrf_negotiated_above_gross
highest negotiated rate $261 exceeds the gross charge $249
CPT 40899/b
warn
mrf_negotiated_above_gross
highest negotiated rate $387 exceeds the gross charge $225
CPT 23200/b
warn
mrf_negotiated_above_gross
highest negotiated rate $82 exceeds the gross charge $78
CPT 78761/b
warn
mrf_negotiated_above_gross
highest negotiated rate $102 exceeds the gross charge $97
CPT 53854/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,421 exceeds the gross charge $1,353
CPT 74190/b
warn
mrf_negotiated_above_gross
highest negotiated rate $68 exceeds the gross charge $65
CPT 41130/b
warn
mrf_negotiated_above_gross
highest negotiated rate $598 exceeds the gross charge $570
CPT 97607/b
warn
mrf_negotiated_above_gross
highest negotiated rate $108 exceeds the gross charge $103
CPT 29581/b
warn
mrf_negotiated_above_gross
highest negotiated rate $39 exceeds the gross charge $37
CPT 93321/b
warn
mrf_negotiated_above_gross
highest negotiated rate $22 exceeds the gross charge $21
CPT G2082/b
warn
mrf_negotiated_above_gross
highest negotiated rate $101 exceeds the gross charge $96
CPT G2083/b
warn
mrf_negotiated_above_gross
highest negotiated rate $101 exceeds the gross charge $96
CPT 41820/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,420 exceeds the gross charge $2,763
CPT 41899/b
warn
mrf_negotiated_above_gross
highest negotiated rate $387 exceeds the gross charge $236
CPT 35631/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,308 exceeds the gross charge $1,246
CPT 55873/b
warn
mrf_negotiated_above_gross
highest negotiated rate $2,200 exceeds the gross charge $2,095
CPT 86923/b
warn
mrf_negotiated_above_gross
highest negotiated rate $155 exceeds the gross charge $148
CPT 35633/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,510 exceeds the gross charge $1,438
CPT 55874/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,327 exceeds the gross charge $1,264
CPT 86927/b
warn
mrf_negotiated_above_gross
highest negotiated rate $86 exceeds the gross charge $82
CPT L0120/b
warn
mrf_negotiated_above_gross
highest negotiated rate $28 exceeds the gross charge $27
CPT 68399/b
warn
mrf_negotiated_above_gross
highest negotiated rate $519 exceeds the gross charge $306
CPT 30468/b
warn
mrf_negotiated_above_gross
highest negotiated rate $510 exceeds the gross charge $486
CPT 86985/b
warn
mrf_negotiated_above_gross
highest negotiated rate $182 exceeds the gross charge $173
CPT 75600/b
warn
mrf_negotiated_above_gross
highest negotiated rate $76 exceeds the gross charge $72
CPT 30903/b
warn
mrf_negotiated_above_gross
highest negotiated rate $239 exceeds the gross charge $228
CPT 30905/b
warn
mrf_negotiated_above_gross
highest negotiated rate $317 exceeds the gross charge $302
CPT 31000/b
warn
mrf_negotiated_above_gross
highest negotiated rate $35 exceeds the gross charge $33
CPT 43200/b
warn
mrf_negotiated_above_gross
highest negotiated rate $272 exceeds the gross charge $262
CPT 43202/b
warn
mrf_negotiated_above_gross
highest negotiated rate $364 exceeds the gross charge $347
CPT 43220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $418 exceeds the gross charge $398
CPT 81220/b
warn
mrf_negotiated_above_gross
highest negotiated rate $285 exceeds the gross charge $271
CPT 93594/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,299 exceeds the gross charge $1,150
CPT L3763/b
warn
mrf_negotiated_above_gross
highest negotiated rate $236 exceeds the gross charge $225
CPT 31231/b
warn
mrf_negotiated_above_gross
highest negotiated rate $185 exceeds the gross charge $182
CPT 43226/b
warn
mrf_negotiated_above_gross
highest negotiated rate $396 exceeds the gross charge $386
CPT 43227/b
warn
mrf_negotiated_above_gross
highest negotiated rate $505 exceeds the gross charge $481
CPT 93597/b
warn
mrf_negotiated_above_gross
highest negotiated rate $5,299 exceeds the gross charge $1,150
CPT 43229/b
warn
mrf_negotiated_above_gross
highest negotiated rate $700 exceeds the gross charge $667
CPT L3901/b
warn
mrf_negotiated_above_gross
highest negotiated rate $1,311 exceeds the gross charge $1,249
CPT 99489/b
warn
mrf_negotiated_above_gross
highest negotiated rate $77 exceeds the gross charge $74
CPT 75807/b
warn
mrf_negotiated_above_gross
highest negotiated rate $195 exceeds the gross charge $186
CPT 31255/b
warn
mrf_negotiated_above_gross
highest negotiated rate $163 exceeds the gross charge $155
CPT 31295/b
warn
mrf_negotiated_above_gross
highest negotiated rate $475 exceeds the gross charge $452
CPT 43245/b
warn
mrf_negotiated_above_gross
highest negotiated rate $536 exceeds the gross charge $510
CPT 43249/b
warn
mrf_negotiated_above_gross
highest negotiated rate $468 exceeds the gross charge $446
CPT 81324/b
warn
mrf_negotiated_above_gross
highest negotiated rate $715 exceeds the gross charge $681
CPT 43255/b
warn
mrf_negotiated_above_gross
highest negotiated rate $607 exceeds the gross charge $578
CPT 12053/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 25535/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 31502/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 36224/b
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 57460/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 69620/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 75833/b
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 81342/b
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 87529/b
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 93622/b
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 A4300/b
info
mrf_item_fields_vary
this code and setting cover at least 6 distinct chargemaster lines (modifier, billing class or unit); their gross, cash, max differ, so no cross-line comparison was made for this item
CPT J0696/b
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 L4386/b
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 12054/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 25560/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

Showing the first 200 of 3,647 findings, errors first — every finding as JSON →

04 · Checks

Where the Medicare rows do not agree with themselves

Service
Severity
Rule
Detail
MS-DRG 652
info
inp_charge_10x_payment
average charge $359,237 is 13.7× 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. found via cms-hpt.txt · csv-wide · 79.0M bytes · fetched 2026-08-21 · sha256 c15e9658f7dd…

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.