▸ Hospital · CA · CCN 050414
Mercy Hospital Of Folsom
1650 CREEKSIDE DRIVE, FOLSOM, CA, 93630
106 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
193
of 209 target codes
Payers
18
with negotiated rates
Rates published
7,040
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 | — | — | $7,705.65 | $12,075 | $12,438 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 13 | $1,242 | $869.4 | $35.19 | $302.26 | $1,242 |
| Psychiatric eval with medical services | CPT | 90792 | 13 | $1,242 | $869.4 | $35.19 | $250.12 | $1,242 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | $1,237 | $865.9 | $67.05 | $194.61 | $1,009.4 |
| Psychotherapy 45 minutes | CPT | 90834 | 13 | $663 | $464.1 | $85.18 | $188.94 | $541.01 |
| Psychotherapy 60 minutes | CPT | 90837 | 13 | $990 | $693 | $124.32 | $214.64 | $807.84 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 17 | $491 | $343.7 | $21.77 | $321.1 | $4,271 |
| ED visit level 2 | CPT | 99282 | 17 | $1,224 | $856.8 | $34.97 | $896.08 | $6,051 |
| ED visit level 3 | CPT | 99283 | 17 | $2,268 | $1,587.6 | $63.97 | $1,233.2 | $10,471 |
| ED visit level 4 | CPT | 99284 | 17 | $18,542 | $12,979 | $98.04 | $2,705.31 | $20,506 |
| ED visit level 5 | CPT | 99285 | 17 | $34,425 | $24,098 | $76.5 | $4,285.5 | $34,360 |
| Critical care, first hour | CPT | 99291 | 17 | $48,238 | $33,767 | $293 | $6,677.74 | $48,146 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $4,465 | $3,125.5 | $144.97 | $418.01 | $4,465 |
| CT head with contrast | CPT | 70460 | 13 | $6,697 | $4,687.9 | $209.04 | $523.72 | $6,697 |
| CT head with and without contrast | CPT | 70470 | 13 | $6,697 | $4,687.9 | $237.85 | $562.1 | $6,697 |
| CT neck with contrast | CPT | 70491 | 13 | $6,697 | $4,687.9 | $237.85 | $577.85 | $6,697 |
| MRI brain without contrast | CPT | 70551 | 13 | $5,092 | $3,564.4 | $283.78 | $718.02 | $9,286 |
| MRI brain with contrast | CPT | 70552 | 13 | $7,800 | $5,460 | $396.44 | $1,061.42 | $9,286 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $7,800 | $5,460 | $467.23 | $1,132.57 | $9,286 |
| Chest X-ray single view | CPT | 71045 | 15 | $1,054 | $737.8 | $17.67 | $128.06 | $1,054 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $1,054 | $737.8 | $27.48 | $148.42 | $1,054 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $1,054 | $737.8 | $35.27 | $148.42 | $1,054 |
| CT chest without contrast | CPT | 71250 | 13 | $4,465 | $3,125.5 | $144.97 | $505.17 | $4,465 |
| CT chest with contrast | CPT | 71260 | 13 | $6,697 | $4,687.9 | $237.85 | $584.69 | $6,697 |
| CT chest with and without contrast | CPT | 71270 | 13 | $6,697 | $4,687.9 | $237.85 | $629.74 | $6,697 |
| MRI chest without contrast | CPT | 71550 | 13 | $5,092 | $3,564.4 | $306.4 | $983.99 | $9,286 |
| MRI chest with contrast | CPT | 71551 | 13 | $8,000 | $5,600 | $395.33 | $1,200.28 | $9,286 |
| MRI chest with and without contrast | CPT | 71552 | 13 | $7,800 | $5,460 | $490.35 | $1,166.62 | $9,286 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $1,175 | $822.5 | $43.45 | $179.05 | $1,175 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $4,465 | $3,125.5 | $144.97 | $501.81 | $4,465 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $4,465 | $3,125.5 | $144.97 | $501.32 | $4,465 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $4,465 | $3,125.5 | $144.97 | $500.87 | $4,465 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $5,092 | $3,564.4 | $277.53 | $711.74 | $9,286 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $5,092 | $3,564.4 | $277.53 | $711.74 | $9,286 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $5,092 | $3,564.4 | $277.97 | $712.18 | $9,286 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $7,800 | $5,460 | $399.67 | $1,064.67 | $9,286 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $7,800 | $5,460 | $471.83 | $1,137.19 | $9,286 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $7,800 | $5,460 | $470.9 | $1,136.26 | $9,286 |
| CT pelvis without contrast | CPT | 72192 | 13 | $4,465 | $3,125.5 | $144.97 | $505.55 | $4,465 |
| CT pelvis with contrast | CPT | 72193 | 13 | $6,697 | $4,687.9 | $237.85 | $640.2 | $6,697 |
| Shoulder X-ray | CPT | 73030 | 15 | $1,054 | $737.8 | $37.09 | $148.42 | $1,054 |
| Humerus X-ray | CPT | 73060 | 15 | $1,054 | $737.8 | $29.81 | $148.42 | $1,054 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $1,054 | $737.8 | $36.06 | $146.4 | $1,054 |
| MRI upper extremity joint without contrast | CPT | 73221 | 13 | $5,092 | $3,564.4 | $295.44 | $729.74 | $9,286 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 13 | $7,800 | $5,460 | $408.36 | $1,073.4 | $9,286 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $1,054 | $737.8 | $27.28 | $145 | $1,054 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $1,054 | $737.8 | $36.06 | $146.4 | $1,054 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $7,091 | $4,963.7 | $294.53 | $3,545.25 | $9,286 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $7,800 | $5,460 | $407.06 | $1,072.1 | $9,286 |
| CT abdomen without contrast | CPT | 74150 | 13 | $4,465 | $3,125.5 | $144.97 | $510.24 | $4,465 |
| CT abdomen with contrast | CPT | 74160 | 13 | $6,697 | $4,687.9 | $237.85 | $646.42 | $6,697 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $6,697 | $4,687.9 | $237.85 | $688.05 | $6,697 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $5,921 | $4,144.7 | $178.43 | $349.41 | $5,921 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $8,837 | $6,185.9 | $281.8 | $551.01 | $8,837 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $8,837 | $6,185.9 | $319.24 | $624.11 | $8,837 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $5,092 | $3,564.4 | $287.28 | $721.54 | $9,286 |
| MRI abdomen with and without contrast | CPT | 74183 | 13 | $7,800 | $5,460 | $351.25 | $1,016.01 | $9,286 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $1,874 | $1,311.8 | $119.34 | $343.81 | $1,874 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $1,874 | $1,311.8 | $87.13 | $309.19 | $1,874 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $1,874 | $1,311.8 | $115.78 | $343.81 | $1,874 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $1,874 | $1,311.8 | $78.42 | $316.39 | $1,874 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $1,250 | $875 | $135.29 | $320.49 | $1,250 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 15 | $2,793 | $1,955.1 | $159.03 | $429.77 | $2,793 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $1,874 | $1,311.8 | $97.04 | $334.66 | $1,874 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $1,874 | $1,311.8 | $97.04 | $334.01 | $1,874 |
| Scrotal ultrasound | CPT | 76870 | 15 | $1,874 | $1,311.8 | $85.75 | $336.64 | $1,874 |
| Diagnostic mammography unilateral | CPT | 77065 | 9 | $557 | $389.9 | $91.12 | $437.38 | $557 |
| Diagnostic mammography bilateral | CPT | 77066 | 9 | $716 | $501.2 | $117.13 | $562.23 | $716 |
| EKG complete | CPT | 93000 | 8 | $505 | $353.5 | $52.21 | $378.75 | $505 |
| EKG tracing only | CPT | 93005 | 13 | $529 | $370.3 | $29.84 | $135.56 | $529 |
| Transthoracic echocardiogram complete | CPT | 93306 | 14 | $3,050 | $2,135 | $239.76 | $2,085 | $3,050 |
| Transthoracic echocardiogram | CPT | 93307 | 13 | $1,068 | $747.6 | $181.56 | $409.08 | $1,068 |
| Stress echocardiogram | CPT | 93350 | 13 | $4,164 | $2,914.8 | $137.87 | $682.3 | $4,164 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 7 | — | — | $11,990 | $17,777 | $18,311 |
| COPD w MCC | MS-DRG | 190 | 7 | — | — | $7,252.96 | $11,006 | $11,336 |
| COPD w CC | MS-DRG | 191 | 7 | — | — | $5,660.36 | $8,754.2 | $9,016.83 |
| COPD w/o CC/MCC | MS-DRG | 192 | 7 | — | — | $4,496.34 | $6,989.39 | $7,199.07 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | — | — | $5,633.73 | $8,563.41 | $8,820.31 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 7 | — | — | $4,324.51 | $6,710.69 | $6,912.01 |
| AMI discharged alive w MCC | MS-DRG | 280 | 7 | — | — | $10,340 | $15,161 | $15,978 |
| AMI discharged alive w CC | MS-DRG | 281 | 7 | — | — | $6,141.57 | $9,187.22 | $9,462.84 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 7 | — | — | $4,678.3 | $7,274.64 | $9,285 |
| Heart failure & shock w MCC | MS-DRG | 291 | 7 | — | — | $8,532.38 | $12,346 | $12,716 |
| Heart failure & shock w CC | MS-DRG | 292 | 7 | — | — | $5,740.88 | $8,559.67 | $8,816.46 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 7 | — | — | $4,154.61 | $6,000.84 | $6,180.87 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 7 | — | — | $7,530.03 | $11,715 | $12,067 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 7 | — | — | $4,794.94 | $7,502.84 | $7,727.93 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 7 | — | — | $3,545.96 | $5,713.72 | $5,885.13 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | — | — | $6,264.55 | $9,775.48 | $10,069 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 7 | — | — | $4,093.74 | $6,443.21 | $6,636.51 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 7 | — | — | $4,827.92 | $7,645.93 | $7,875.31 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $9,252.6 | $13,729 | $14,141 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $7,091.92 | $10,904 | $11,231 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $5,013.67 | $7,909.67 | $8,146.96 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $11,832 | $17,993 | $18,533 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $6,589.17 | $10,082 | $10,385 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 14 | $479 | $335.3 | $7.98 | $34.49 | $502.04 |
| General health panel | CPT | 80050 | 10 | $481 | $336.7 | $81.77 | $354.29 | $504.14 |
| Electrolyte panel | CPT | 80051 | 14 | $371 | $259.7 | $6.61 | $28.56 | $388.85 |
| Comprehensive metabolic panel | CPT | 80053 | 14 | $953 | $667.1 | $9.96 | $43.03 | $998.84 |
| Lipid panel | CPT | 80061 | 14 | $325 | $227.5 | $1.36 | $11.98 | $340.64 |
| Renal function panel | CPT | 80069 | 14 | $248 | $173.6 | $8.19 | $35.36 | $259.93 |
| Hepatic function panel | CPT | 80076 | 14 | $234 | $163.8 | $7.7 | $33.27 | $245.26 |
| Urinalysis non-automated | CPT | 81002 | 14 | $39 | $27.3 | $3.08 | $9.27 | $40.88 |
| Urinalysis automated | CPT | 81003 | 14 | $90 | $63 | $2.12 | $48.16 | $94.33 |
| Glucose quantitative | CPT | 82947 | 14 | $130 | $91 | $3.71 | $21.28 | $136.26 |
| Hemoglobin A1c | CPT | 83036 | 14 | $544 | $380.8 | $9.16 | $153.37 | $570.17 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 14 | $231 | $161.7 | $15.84 | $44.77 | $242.12 |
| Complete blood count with automated differential | CPT | 85025 | 14 | $185 | $129.5 | $7.33 | $31.45 | $193.9 |
| Complete blood count without differential | CPT | 85027 | 14 | $148 | $103.6 | $6.1 | $25.16 | $155.12 |
| Urine culture bacterial | CPT | 87086 | 14 | $143 | $100.1 | $7.61 | $24.31 | $149.88 |
| Urine culture identification | CPT | 87088 | 14 | $147 | $102.9 | $7.63 | $41.43 | $154.08 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $620 | $434 | $5.66 | $62.71 | $620 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 17 | $861 | $602.7 | $32.7 | $429.86 | $23,269 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 5 | — | — | $1,994.02 | $6,242.74 | $23,269 |
| Vaginal delivery only | CPT | 59409 | 10 | — | — | $780.72 | $4,207 | $23,269 |
| Vaginal delivery with postpartum | CPT | 59410 | 5 | — | — | $3,393.68 | $6,547.74 | $23,269 |
| Routine obstetric care with C-section | CPT | 59510 | 5 | — | — | $1,995.21 | $7,134.55 | $23,269 |
| C-section delivery only | CPT | 59514 | 5 | — | — | $781.35 | $6,808.11 | $23,269 |
| C-section with postpartum | CPT | 59515 | 5 | — | — | $3,878.49 | $7,631.66 | $23,269 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 11 | $1,856 | $1,299.2 | $49.2 | $305.58 | $7,969 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 10 | $397 | $277.9 | $60.86 | $278.01 | $397 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 11 | $3,410 | $2,387 | $68 | $349.87 | $7,969 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 10 | $505 | $353.5 | $77.86 | $370.07 | $505 |
| Office visit, established patient, 5 min | CPT | 99211 | 11 | $1,856 | $1,299.2 | $17.21 | $224.4 | $7,969 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 10 | $316 | $221.2 | $16.37 | $203 | $316 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 10 | $358 | $250.6 | $34.43 | $203 | $358 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 11 | $3,410 | $2,387 | $53.79 | $326.4 | $7,969 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 10 | $486 | $340.2 | $77.86 | $344.21 | $486 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 10 | — | — | $405.42 | $3,143.69 | $10,296 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | — | — | $423.61 | $3,918 | $10,296 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | — | — | $99 | $2,793 | $9,151 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | — | — | $130.65 | $2,793 | $9,151 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | — | — | $534.04 | $3,393.68 | $10,296 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | — | — | $597.36 | $3,393.68 | $10,296 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | — | — | $723.96 | $3,393.68 | $10,296 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 9 | — | — | $2,359.38 | $16,419 | $26,461 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 7 | — | — | $20,116 | $28,857 | $30,595 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 7 | — | — | $12,900 | $18,398 | $19,506 |
| Hip hemiarthroplasty | CPT | 27125 | 7 | — | — | $1,885.66 | $6,332.3 | $23,349 |
| Total hip replacement | CPT | 27130 | 10 | — | — | $2,693.8 | $13,555 | $26,461 |
| Total knee replacement | CPT | 27447 | 10 | — | — | $2,693.8 | $14,871 | $26,461 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | — | — | $2,608.21 | $7,729.32 | $26,461 |
| Knee revision arthroplasty all components | CPT | 27487 | 7 | — | — | $2,584.03 | $8,695.58 | $26,461 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $605.06 | $6,227 | $13,068 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 10 | — | — | $623.03 | $8,844.69 | $23,349 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | — | — | $790.35 | $5,945.28 | $15,566 |
| ACL reconstruction | CPT | 29888 | 10 | — | — | $1,220.29 | $7,751 | $23,349 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 7 | — | — | $31,112 | $46,182 | $47,567 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | — | — | $16,020 | $24,326 | $25,056 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 7 | — | — | $10,710 | $16,481 | $16,976 |
| CABG single arterial graft | CPT | 33533 | 6 | — | — | $3,386.12 | $12,217 | $23,269 |
| CABG 2 arterial grafts | CPT | 33534 | 6 | — | — | $3,807.69 | $14,451 | $23,269 |
| CABG 3 arterial grafts | CPT | 33535 | 6 | — | — | $4,228.6 | $14,737 | $23,269 |
| CABG 4+ arterial grafts | CPT | 33536 | 6 | — | — | $4,650.86 | $15,406 | $23,269 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 7 | — | — | $10,581 | $16,280 | $16,769 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | — | — | $8,285.12 | $12,785 | $13,169 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 7 | — | — | $21,777 | $33,372 | $34,373 |
| Open appendectomy | CPT | 44950 | 10 | — | — | $724.63 | $4,492.62 | $23,269 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | — | — | $494.31 | $7,144.95 | $23,349 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 7 | — | — | $43,442 | $63,458 | $65,362 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 7 | — | — | $25,109 | $37,245 | $38,363 |
| Major joint replacement w MCC | MS-DRG | 469 | 7 | — | — | $19,907 | $29,345 | $30,225 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 7 | — | — | $12,480 | $18,256 | $18,804 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | — | — | $843.15 | $9,384.85 | $23,349 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | — | — | $970.44 | $9,384.85 | $23,349 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 7 | — | — | $19,137 | $28,782 | $29,646 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | — | — | $13,237 | $20,087 | $20,690 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 7 | — | — | $10,431 | $15,876 | $16,352 |
| Open umbilical hernia repair | CPT | 49560 | 10 | — | — | $839.12 | $5,945.28 | $15,566 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 10 | — | — | $534.04 | $5,945.28 | $15,566 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | — | — | $379.7 | $7,144.95 | $23,349 |
| Lap incisional hernia repair | CPT | 49652 | 10 | — | — | $524.57 | $7,359.3 | $23,349 |
| Total abdominal hysterectomy | CPT | 58150 | 7 | — | — | $1,162.9 | $4,731.82 | $23,269 |
| Vaginal hysterectomy | CPT | 58260 | 10 | — | — | $1,162.9 | $6,190.41 | $16,907 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | — | — | $838.74 | $10,189 | $23,349 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | — | — | $616.65 | $12,504 | $23,349 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | — | — | $701.38 | $7,144.95 | $23,349 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $19,518 | $29,118 | $29,992 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $11,378 | $16,969 | $17,478 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $9,966.49 | $15,421 | $15,883 |
| Complex cataract surgery | CPT | 66982 | 10 | — | — | $1,272.35 | $8,663 | $18,071 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $1,818.32 | $8,663 | $18,071 |
| Intravitreal injection | CPT | 67028 | 10 | — | — | $424.58 | $2,793 | $8,864 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | — | $1,186.9 | $5,529.91 | $18,681 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $7,281.5 | $11,078 | $11,411 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $11,035 | $17,275 | $17,793 |
| PCI single major coronary artery | CPT | 92920 | 14 | $17,500 | $12,250 | $435.12 | $7,103.65 | $23,349 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | $36,094 | $25,266 | $483.05 | $13,553 | $29,453 |
| PCI bypass graft | CPT | 92937 | 13 | $36,094 | $25,266 | $482.46 | $13,375 | $29,453 |
| Left heart catheterization | CPT | 93452 | 14 | $36,933 | $25,853 | $967.53 | $9,302.93 | $30,137 |
| Coronary angiography with cath | CPT | 93455 | 14 | $34,066 | $23,846 | $1,166.18 | $9,514.45 | $27,798 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | $41,919 | $29,343 | $1,204.89 | $9,514.45 | $34,206 |
Payer mix (top 18)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 193 | $1,449.43 |
| Aetna | 180 | $1,120.59 |
| Blue Cross Blue Shield | 177 | $4,304.94 |
| Kaiser Permanente | 166 | $597.65 |
| Medicare | 166 | $601.15 |
| commercial | hill physicians | all plans | 166 | $601.15 |
| Medicaid | 144 | $392.12 |
| UnitedHealthcare | 128 | $2,949.35 |
| commercial | wcmg | all plans | 105 | $179.18 |
| First Health | 105 | $790.5 |
| commercial | sutter health | all plans | 105 | $843.2 |
| commercial | healthsmart | all plans | 105 | $793.77 |
| Multiplan | 105 | $860.07 |
| Cigna | 95 | $2,067.9 |
| Humana | 95 | $2,105.94 |
| commercial | western health advantage | all plans | 44 | $8,892.49 |
| commercial | connected care intel | all plans | 17 | $4,828.33 |
| Health Net | 7 | $1,234.04 |