▸ Hospital · CA · CCN 050150
Sierra Nevada Memorial Hospital
155 GLASSON WAY, GRASS VALLEY, CA, 95945
104 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
182
of 209 target codes
Payers
13
with negotiated rates
Rates published
5,103
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $12,306 | $12,306 | $12,306 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 13 | $557 | $389.9 | $21.77 | $409.96 | $3,104 |
| ED visit level 2 | CPT | 99282 | 13 | $1,114 | $779.8 | $34.97 | $819.91 | $5,298 |
| ED visit level 3 | CPT | 99283 | 13 | $1,838 | $1,286.6 | $63.97 | $1,352.77 | $7,062 |
| ED visit level 4 | CPT | 99284 | 13 | $3,622 | $2,535.4 | $98.04 | $2,665.8 | $11,349 |
| ED visit level 5 | CPT | 99285 | 13 | $5,571 | $3,899.7 | $155.03 | $4,100.26 | $15,755 |
| Critical care, first hour | CPT | 99291 | 13 | $8,021 | $5,614.7 | $265 | $6,007.74 | $18,322 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $4,152 | $2,906.4 | $149.03 | $381.17 | $4,089.72 |
| CT head with contrast | CPT | 70460 | 12 | $6,228 | $4,359.6 | $209.04 | $451.53 | $6,134.58 |
| CT head with and without contrast | CPT | 70470 | 12 | $6,228 | $4,359.6 | $247.23 | $534.02 | $6,134.58 |
| CT neck with contrast | CPT | 70491 | 12 | $6,228 | $4,359.6 | $250.76 | $567.86 | $6,134.58 |
| MRI brain without contrast | CPT | 70551 | 12 | $4,736 | $3,315.2 | $283.78 | $1,116.18 | $4,664.96 |
| MRI brain with contrast | CPT | 70552 | 12 | $7,254 | $5,077.8 | $396.44 | $1,237.85 | $7,145.19 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $7,254 | $5,077.8 | $467.23 | $1,314.31 | $7,145.19 |
| Chest X-ray single view | CPT | 71045 | 12 | $980 | $686 | $17.67 | $114.22 | $965.3 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $980 | $686 | $27.48 | $114.22 | $965.3 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $980 | $686 | $35.27 | $114.22 | $965.3 |
| CT chest without contrast | CPT | 71250 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| CT chest with contrast | CPT | 71260 | 12 | $6,228 | $4,359.6 | $238.02 | $514.12 | $6,134.58 |
| CT chest with and without contrast | CPT | 71270 | 12 | $6,228 | $4,359.6 | $250.76 | $610.96 | $6,134.58 |
| MRI chest without contrast | CPT | 71550 | 12 | $4,736 | $3,315.2 | $323.03 | $1,366.09 | $4,664.96 |
| MRI chest with contrast | CPT | 71551 | 12 | $7,440 | $5,208 | $395.33 | $1,314.82 | $7,328.4 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $7,254 | $5,077.8 | $501.11 | $1,350.9 | $7,145.19 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $1,093 | $765.1 | $43.45 | $153.73 | $1,076.61 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $4,736 | $3,315.2 | $277.53 | $1,109.43 | $4,664.96 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $4,736 | $3,315.2 | $277.53 | $1,109.43 | $4,664.96 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $4,736 | $3,315.2 | $277.97 | $1,109.91 | $4,664.96 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $7,254 | $5,077.8 | $399.67 | $1,241.34 | $7,145.19 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $7,254 | $5,077.8 | $471.83 | $1,319.27 | $7,145.19 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $7,254 | $5,077.8 | $470.9 | $1,318.27 | $7,145.19 |
| CT pelvis without contrast | CPT | 72192 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| CT pelvis with contrast | CPT | 72193 | 12 | $6,228 | $4,359.6 | $250.76 | $633.44 | $6,134.58 |
| Shoulder X-ray | CPT | 73030 | 12 | $980 | $686 | $37.09 | $114.22 | $965.3 |
| Humerus X-ray | CPT | 73060 | 12 | $980 | $686 | $29.81 | $114.22 | $965.3 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $980 | $686 | $36.06 | $114.22 | $965.3 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $4,736 | $3,315.2 | $295.44 | $1,128.77 | $4,664.96 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $7,254 | $5,077.8 | $408.36 | $1,250.73 | $7,145.19 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $980 | $686 | $27.28 | $114.22 | $965.3 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $980 | $686 | $36.06 | $114.22 | $965.3 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $6,594 | $4,615.8 | $294.53 | $2,550.5 | $6,495.09 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $7,254 | $5,077.8 | $407.06 | $1,249.32 | $7,145.19 |
| CT abdomen without contrast | CPT | 74150 | 12 | $4,152 | $2,906.4 | $152.84 | $450.63 | $4,089.72 |
| CT abdomen with contrast | CPT | 74160 | 12 | $6,228 | $4,359.6 | $250.76 | $646.81 | $6,134.58 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $6,228 | $4,359.6 | $250.76 | $736.28 | $6,134.58 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $5,507 | $3,854.9 | $178.43 | $385.41 | $5,424.4 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $8,218 | $5,752.6 | $281.8 | $608.69 | $8,094.73 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $8,218 | $5,752.6 | $319.24 | $689.56 | $8,094.73 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $4,736 | $3,315.2 | $287.28 | $1,119.96 | $4,664.96 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $7,254 | $5,077.8 | $351.25 | $1,189.05 | $7,145.19 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,743 | $1,220.1 | $119.34 | $257.77 | $1,716.86 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $1,743 | $1,220.1 | $87.13 | $188.2 | $1,716.86 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $1,743 | $1,220.1 | $115.78 | $250.08 | $1,716.86 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $1,743 | $1,220.1 | $78.42 | $169.39 | $1,716.86 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $1,163 | $814.1 | $135.29 | $292.23 | $1,145.56 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $2,597 | $1,817.9 | $159.03 | $343.5 | $2,558.05 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $1,743 | $1,220.1 | $97.04 | $209.61 | $1,716.86 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $1,743 | $1,220.1 | $97.04 | $209.61 | $1,716.86 |
| Scrotal ultrasound | CPT | 76870 | 12 | $1,743 | $1,220.1 | $85.75 | $185.22 | $1,716.86 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $518 | $362.6 | $117.89 | $479.45 | $518 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $666 | $466.2 | $149.36 | $617.13 | $666 |
| Screening mammography bilateral | CPT | 77067 | 8 | $541 | $378.7 | $120.94 | $462.93 | $541 |
| EKG tracing only | CPT | 93005 | 12 | $441 | $308.7 | $29.84 | $159.39 | $434.39 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $3,640 | $2,548 | $239.76 | $682.3 | $3,585.4 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | $2,172 | $1,520.4 | $215.3 | $394.99 | $2,139.42 |
| Stress echocardiogram | CPT | 93350 | 12 | $2,796 | $1,957.2 | $137.87 | $682.3 | $2,754.06 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 7 | — | — | $18,168 | $18,168 | $18,168 |
| COPD w MCC | MS-DRG | 190 | 7 | — | — | $11,207 | $11,207 | $11,207 |
| COPD w CC | MS-DRG | 191 | 7 | — | — | $8,891.69 | $8,891.69 | $8,891.69 |
| COPD w/o CC/MCC | MS-DRG | 192 | 7 | — | — | $7,077.43 | $7,077.43 | $7,077.43 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | — | — | $8,695.55 | $8,695.55 | $8,695.55 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 7 | — | — | $6,790.91 | $6,790.91 | $6,790.91 |
| AMI discharged alive w MCC | MS-DRG | 280 | 7 | — | — | $15,839 | $15,839 | $15,839 |
| AMI discharged alive w CC | MS-DRG | 281 | 7 | — | — | $9,336.84 | $9,336.84 | $9,336.84 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 7 | — | — | $7,370.67 | $7,370.67 | $7,370.67 |
| Heart failure & shock w MCC | MS-DRG | 291 | 7 | — | — | $12,584 | $12,584 | $12,584 |
| Heart failure & shock w CC | MS-DRG | 292 | 7 | — | — | $8,691.71 | $8,691.71 | $8,691.71 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 7 | — | — | $6,061.17 | $6,061.17 | $6,061.17 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 7 | — | — | $11,936 | $11,936 | $11,936 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 7 | — | — | $7,605.26 | $7,605.26 | $7,605.26 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 7 | — | — | $5,766.01 | $5,766.01 | $5,766.01 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | — | — | $9,941.59 | $9,941.59 | $9,941.59 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 7 | — | — | $6,515.94 | $6,515.94 | $6,515.94 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 7 | — | — | $7,752.37 | $7,752.37 | $7,752.37 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $14,006 | $14,006 | $14,006 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $11,102 | $11,102 | $11,102 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $8,023.5 | $8,023.5 | $8,023.5 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $18,390 | $18,390 | $18,390 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $10,257 | $10,257 | $10,257 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $1,106 | $774.2 | $8.46 | $47.81 | $1,083.88 |
| General health panel | CPT | 80050 | 7 | $2,774 | $1,941.8 | $174.89 | $2,135.98 | $2,718.52 |
| Electrolyte panel | CPT | 80051 | 11 | $764 | $534.8 | $7.01 | $39.59 | $748.72 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $1,622 | $1,135.4 | $10.56 | $59.65 | $1,589.56 |
| Lipid panel | CPT | 80061 | 11 | $616 | $431.2 | $5.73 | $13.38 | $603.68 |
| Renal function panel | CPT | 80069 | 11 | $1,323 | $926.1 | $8.68 | $49.02 | $1,296.54 |
| Hepatic function panel | CPT | 80076 | 11 | $876 | $613.2 | $8.17 | $46.12 | $858.48 |
| Urinalysis non-automated | CPT | 81002 | 11 | $127 | $88.9 | $3.08 | $14.45 | $124.46 |
| Urinalysis automated | CPT | 81003 | 11 | $267 | $186.9 | $2.25 | $54.91 | $261.66 |
| Glucose quantitative | CPT | 82947 | 11 | $263 | $184.1 | $3.93 | $23.71 | $257.74 |
| Hemoglobin A1c | CPT | 83036 | 11 | $503 | $352.1 | $9.71 | $244.35 | $492.94 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $745 | $521.5 | $16.8 | $378.96 | $730.1 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $709 | $496.3 | $7.77 | $43.89 | $694.82 |
| Complete blood count without differential | CPT | 85027 | 11 | $523 | $366.1 | $6.47 | $36.55 | $512.54 |
| Urine culture bacterial | CPT | 87086 | 11 | $338 | $236.6 | $8.07 | $45.58 | $331.24 |
| Urine culture identification | CPT | 87088 | 11 | $338 | $236.6 | $8.09 | $20 | $331.24 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $855 | $598.5 | $22.16 | $64.91 | $842.18 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 13 | $404 | $282.8 | $32.7 | $328.39 | $7,899 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 3 | — | — | $1,994.02 | $4,340.9 | $9,605 |
| Vaginal delivery only | CPT | 59409 | 9 | — | — | $780.72 | $3,704.81 | $15,008 |
| Vaginal delivery with postpartum | CPT | 59410 | 3 | — | — | $3,286.37 | $5,021 | $9,605 |
| Routine obstetric care with C-section | CPT | 59510 | 3 | — | — | $1,995.21 | $4,961.03 | $9,605 |
| C-section delivery only | CPT | 59514 | 3 | — | — | $781.35 | $4,961.03 | $9,605 |
| C-section with postpartum | CPT | 59515 | 3 | — | — | $3,755.85 | $6,447 | $11,048 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $600 | $420 | $49.2 | $256.1 | $591 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $397 | $277.9 | $82.05 | $305.69 | $391.05 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $3,410 | $2,387 | $98.83 | $391.05 | $3,358.85 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $564 | $394.8 | $118.62 | $476.9 | $555.54 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $294 | $205.8 | $17.21 | $220.5 | $289.59 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $312 | $218.4 | $16.37 | $240.24 | $307.32 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $397 | $277.9 | $34.43 | $266.42 | $391.05 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $486 | $340.2 | $53.79 | $379.23 | $478.71 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $600 | $420 | $82.05 | $482.6 | $591 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | — | — | $405.42 | $1,142.58 | $11,058 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | — | — | $423.61 | $1,142.58 | $11,058 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | — | — | $99 | $1,120.59 | $9,875 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | — | — | $130.65 | $1,120.59 | $9,875 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | — | — | $534.04 | $1,137.06 | $11,058 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | — | — | $597.36 | $1,464.28 | $11,058 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | — | — | $723.96 | $1,514.02 | $11,058 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 8 | — | — | $1,676.4 | $17,361 | $31,598 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 7 | — | — | $30,428 | $30,428 | $30,428 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 7 | — | — | $19,361 | $19,361 | $19,361 |
| Hip hemiarthroplasty | CPT | 27125 | 5 | — | — | $1,885.66 | $5,655.32 | $27,648 |
| Total hip replacement | CPT | 27130 | 9 | — | — | $2,693.8 | $15,684 | $31,598 |
| Total knee replacement | CPT | 27447 | 9 | — | — | $2,693.8 | $16,840 | $31,598 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | — | — | $1,853.2 | $6,811 | $31,598 |
| Knee revision arthroplasty all components | CPT | 27487 | 5 | — | — | $2,584.03 | $6,544.12 | $31,598 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $605.06 | $5,307.22 | $9,259 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | — | — | $623.03 | $8,844.69 | $27,648 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 9 | — | — | $790.35 | $3,998.92 | $18,959 |
| ACL reconstruction | CPT | 29888 | 9 | — | — | $1,220.29 | $8,844.69 | $27,648 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 7 | — | — | $47,368 | $47,368 | $47,368 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | — | — | $24,900 | $24,900 | $24,900 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 7 | — | — | $16,835 | $16,835 | $16,835 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $3,386.12 | $9,414 | $22,909 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $3,807.69 | $13,095 | $22,909 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $4,228.6 | $13,095 | $22,909 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $4,650.86 | $13,095 | $22,909 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 7 | — | — | $16,628 | $16,628 | $16,628 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | — | — | $13,036 | $13,036 | $13,036 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 7 | — | — | $34,199 | $34,199 | $34,199 |
| Open appendectomy | CPT | 44950 | 9 | — | — | $724.63 | $4,492.62 | $18,959 |
| Laparoscopic appendectomy | CPT | 44970 | 9 | — | — | $494.31 | $7,144.95 | $27,648 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 7 | — | — | $65,129 | $65,129 | $65,129 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 7 | — | — | $38,181 | $38,181 | $38,181 |
| Major joint replacement w MCC | MS-DRG | 469 | 7 | — | — | $30,059 | $30,059 | $30,059 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 7 | — | — | $18,660 | $18,660 | $18,660 |
| Laparoscopic cholecystectomy | CPT | 47562 | 9 | — | — | $843.15 | $7,144.95 | $27,648 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 9 | — | — | $970.44 | $7,144.95 | $27,648 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 7 | — | — | $29,481 | $29,481 | $29,481 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | — | — | $20,543 | $20,543 | $20,543 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 7 | — | — | $16,213 | $16,213 | $16,213 |
| Open umbilical hernia repair | CPT | 49560 | 9 | — | — | $839.12 | $4,492.62 | $18,959 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 9 | — | — | $534.04 | $4,492.62 | $18,959 |
| Lap inguinal hernia repair | CPT | 49650 | 9 | — | — | $379.7 | $7,144.95 | $27,648 |
| Lap incisional hernia repair | CPT | 49652 | 9 | — | — | $524.57 | $7,144.95 | $27,648 |
| Total abdominal hysterectomy | CPT | 58150 | 5 | — | — | $1,162.9 | $5,767.19 | $18,959 |
| Vaginal hysterectomy | CPT | 58260 | 9 | — | — | $1,162.9 | $6,226.62 | $18,959 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 9 | — | — | $838.74 | $7,144.95 | $27,648 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 9 | — | — | $616.65 | $12,577 | $27,648 |
| Lap salpingo-oophorectomy | CPT | 58661 | 9 | — | — | $701.38 | $7,144.95 | $27,648 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $29,826 | $29,826 | $29,826 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $17,337 | $17,337 | $17,337 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $15,745 | $15,745 | $15,745 |
| Complex cataract surgery | CPT | 66982 | 9 | — | — | $1,272.35 | $2,932.34 | $18,073 |
| Cataract surgery with lens implant | CPT | 66984 | 9 | — | — | $1,818.32 | $3,429.96 | $18,073 |
| Intravitreal injection | CPT | 67028 | 9 | — | — | $447.62 | $1,063.86 | $7,899 |
| Vitrectomy mechanical | CPT | 67042 | 9 | — | — | $1,186.9 | $5,529.91 | $22,909 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $11,281 | $11,281 | $11,281 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $17,651 | $17,651 | $17,651 |
Payer mix (top 13)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 182 | $1,167 |
| Aetna | 170 | $1,101.62 |
| Kaiser Permanente | 168 | $519.99 |
| Blue Cross Blue Shield | 166 | $2,463.69 |
| Humana | 155 | $519.99 |
| commercial | hill physicians | all plans | 155 | $519.99 |
| Medicare | 155 | $519.99 |
| Medicaid | 133 | $292.75 |
| UnitedHealthcare | 117 | $1,160.84 |
| First Health | 94 | $632.7 |
| Multiplan | 94 | $652.68 |
| commercial | healthsmart | all plans | 94 | $652.68 |
| Health Net | 7 | $1,838 |