▸ Hospital · IA · CCN 160016
Trinity Regional Medical Center
802 KENYON ROAD, FORT DODGE, IA, 50501
44 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
200
of 209 target codes
Payers
10
with negotiated rates
Rates published
42,349
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | — | — | $10,790 | $12,355 | $20,078 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 8 | $405 | $324 | $136.94 | $207.92 | $421.64 |
| Psychiatric eval with medical services | CPT | 90792 | 8 | $453 | $362.4 | $136.94 | $235.7 | $421.64 |
| Psychotherapy 30 minutes | CPT | 90832 | 8 | $210 | $168 | $67.55 | $144.02 | $421.64 |
| Psychotherapy 45 minutes | CPT | 90834 | 8 | $262 | $209.6 | $89.14 | $146.59 | $421.64 |
| Psychotherapy 60 minutes | CPT | 90837 | 8 | $392 | $313.6 | $131.89 | $195.9 | $421.64 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 8 | $409 | $327.2 | $127.19 | $189.7 | $421.64 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 8 | $160.2 | $128.16 | $10.3 | $48.56 | $231.08 |
| ED visit level 2 | CPT | 99282 | 10 | $297.05 | $237.64 | $25.47 | $97.08 | $415.56 |
| ED visit level 3 | CPT | 99283 | 10 | $520.9 | $416.72 | $25.47 | $145.66 | $726.62 |
| ED visit level 4 | CPT | 99284 | 10 | $810.53 | $648.43 | $25.47 | $266.24 | $1,117.44 |
| ED visit level 5 | CPT | 99285 | 10 | $1,163.81 | $931.05 | $25.47 | $386.61 | $1,608.91 |
| Critical care, first hour | CPT | 99291 | 10 | $2,519.34 | $2,015.48 | $194 | $718.17 | $2,211.21 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 10 | $1,901.73 | $1,521.39 | $37.24 | $102.95 | $1,616.47 |
| CT head with contrast | CPT | 70460 | 10 | $3,178.24 | $2,542.6 | $49.4 | $172.34 | $2,701.5 |
| CT head with and without contrast | CPT | 70470 | 10 | $3,178.24 | $2,542.6 | $55.55 | $172.34 | $2,701.5 |
| CT neck with contrast | CPT | 70491 | 10 | $2,684.38 | $2,147.51 | $60.29 | $176.48 | $2,281.72 |
| MRI brain without contrast | CPT | 70551 | 10 | $3,319.74 | $2,655.8 | $64.56 | $234.01 | $2,821.78 |
| MRI brain with contrast | CPT | 70552 | 10 | $4,755.4 | $3,804.32 | $77.96 | $345.74 | $4,042.09 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $5,087.87 | $4,070.3 | $100.21 | $345.74 | $4,324.69 |
| Chest X-ray single view | CPT | 71045 | 10 | $192.69 | $154.16 | $8.04 | $31.02 | $231.05 |
| Chest X-ray 2 views | CPT | 71046 | 10 | $356.04 | $284.84 | $9.63 | $40 | $302.63 |
| Chest X-ray 3 views | CPT | 71047 | 10 | $356.04 | $284.84 | $12.13 | $50.17 | $302.63 |
| CT chest without contrast | CPT | 71250 | 10 | $1,905.04 | $1,524.04 | $47.19 | $127.85 | $1,619.28 |
| CT chest with contrast | CPT | 71260 | 10 | $2,772.34 | $2,217.88 | $50.96 | $172.34 | $2,356.49 |
| CT chest with and without contrast | CPT | 71270 | 10 | $2,915.74 | $2,332.6 | $54.61 | $194.99 | $2,478.38 |
| MRI chest without contrast | CPT | 71550 | 10 | $3,477.82 | $2,782.26 | $63.91 | $382.74 | $2,956.15 |
| MRI chest with contrast | CPT | 71551 | 10 | $4,401.63 | $3,521.31 | $75.45 | $664 | $3,741.39 |
| MRI chest with and without contrast | CPT | 71552 | 10 | $5,230.94 | $4,184.76 | $98.95 | $527.87 | $4,446.3 |
| Lumbosacral spine X-ray | CPT | 72100 | 10 | $410.28 | $328.23 | $9.92 | $52.31 | $348.74 |
| CT cervical spine without contrast | CPT | 72125 | 10 | $2,995.33 | $2,396.27 | $43.57 | $125.93 | $2,546.03 |
| CT thoracic spine without contrast | CPT | 72128 | 10 | $2,995.33 | $2,396.27 | $43.57 | $125.93 | $2,546.03 |
| CT lumbar spine without contrast | CPT | 72131 | 10 | $2,998.14 | $2,398.52 | $43.57 | $125.09 | $2,548.42 |
| MRI cervical spine without contrast | CPT | 72141 | 10 | $2,488.82 | $1,991.06 | $64.86 | $234.01 | $2,115.5 |
| MRI thoracic spine without contrast | CPT | 72146 | 10 | $3,651.71 | $2,921.37 | $64.86 | $234.01 | $3,103.95 |
| MRI lumbar spine without contrast | CPT | 72148 | 10 | $3,651.71 | $2,921.37 | $64.86 | $234.01 | $3,103.95 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 10 | $4,860.96 | $3,888.77 | $78.25 | $345.74 | $4,131.82 |
| MRI cervical spine with and without contrast | CPT | 72156 | 10 | $3,906.02 | $3,124.82 | $100.51 | $345.74 | $3,320.12 |
| MRI lumbar spine with contrast | CPT | 72158 | 10 | $5,596.67 | $4,477.34 | $100.51 | $345.74 | $4,757.17 |
| CT pelvis without contrast | CPT | 72192 | 10 | $2,124.92 | $1,699.94 | $47.51 | $127.88 | $1,806.18 |
| CT pelvis with contrast | CPT | 72193 | 10 | $2,804.39 | $2,243.52 | $50.66 | $220.15 | $2,383.73 |
| Shoulder X-ray | CPT | 73030 | 10 | $293.05 | $234.44 | $8.33 | $44 | $249.09 |
| Humerus X-ray | CPT | 73060 | 10 | $293.05 | $234.44 | $7.1 | $41.7 | $249.09 |
| Hand X-ray 3 views | CPT | 73130 | 10 | $281.22 | $224.98 | $7.71 | $49.7 | $239.04 |
| MRI upper extremity joint without contrast | CPT | 73221 | 10 | $3,651.71 | $2,921.37 | $59.32 | $234.01 | $3,103.95 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 10 | $5,595.54 | $4,476.44 | $94.35 | $412.16 | $4,756.21 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $287.08 | $229.67 | $7.39 | $44.5 | $244.02 |
| Ankle X-ray 3 views | CPT | 73610 | 10 | $281.22 | $224.98 | $7.71 | $48.19 | $239.04 |
| MRI lower extremity joint without contrast | CPT | 73721 | 10 | $3,651.71 | $2,921.37 | $59.32 | $234.01 | $3,103.95 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 10 | $5,230.94 | $4,184.76 | $94.35 | $411.3 | $4,446.3 |
| CT abdomen without contrast | CPT | 74150 | 10 | $2,139 | $1,711.2 | $51.93 | $134.03 | $1,818.15 |
| CT abdomen with contrast | CPT | 74160 | 10 | $2,953.5 | $2,362.8 | $55.55 | $220.2 | $2,510.48 |
| CT abdomen with and without contrast | CPT | 74170 | 10 | $3,015.46 | $2,412.37 | $60.94 | $249.33 | $2,563.14 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 10 | $4,466.96 | $3,573.57 | $76.07 | $226.5 | $3,796.92 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 10 | $5,320.21 | $4,256.17 | $79.84 | $345.74 | $4,522.18 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 10 | $5,388.08 | $4,310.47 | $87.76 | $345.74 | $4,579.87 |
| MRI abdomen without contrast | CPT | 74181 | 10 | $3,651.71 | $2,921.37 | $63.62 | $262.22 | $3,103.95 |
| MRI abdomen with and without contrast | CPT | 74183 | 10 | $5,330.18 | $4,264.15 | $96.27 | $468.46 | $4,530.65 |
| Abdominal ultrasound complete | CPT | 76700 | 10 | $917.31 | $733.85 | $35.36 | $108.76 | $779.71 |
| Abdominal ultrasound limited | CPT | 76705 | 10 | $644.78 | $515.83 | $25.73 | $102.95 | $548.06 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 10 | $644.78 | $515.83 | $32.21 | $102.95 | $548.06 |
| Obstetric ultrasound first trimester | CPT | 76801 | 10 | $559.66 | $447.73 | $43.54 | $110.38 | $475.71 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 10 | $559.66 | $447.73 | $43.84 | $126.65 | $475.71 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 10 | $621.39 | $497.12 | $77.82 | $206.02 | $634.33 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $621.39 | $497.12 | $30.44 | $110.72 | $528.18 |
| Pelvic ultrasound complete | CPT | 76856 | 10 | $559.66 | $447.73 | $30.15 | $102.95 | $475.71 |
| Scrotal ultrasound | CPT | 76870 | 10 | $480.77 | $384.62 | $27.94 | $95.15 | $408.65 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $349.14 | $279.32 | $35.36 | $114.98 | $296.77 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $442.91 | $354.33 | $43.57 | $145.05 | $376.47 |
| Screening mammography bilateral | CPT | 77067 | 8 | $357.32 | $285.86 | $33.44 | $117.85 | $303.72 |
| EKG complete | CPT | 93000 | 6 | $47 | $37.6 | $12.88 | $33.44 | $42.87 |
| EKG tracing only | CPT | 93005 | 10 | $235.68 | $188.55 | $5.46 | $50.62 | $200.33 |
| EKG interpretation only | CPT | 93010 | 6 | $24 | $19.2 | $7.42 | $16 | $21.83 |
| Transthoracic echocardiogram complete | CPT | 93306 | 10 | $2,236.46 | $1,789.17 | $63.17 | $349.42 | $1,900.99 |
| Transthoracic echocardiogram | CPT | 93307 | 10 | $1,246.75 | $997.4 | $39.95 | $217.4 | $1,059.74 |
| Stress echocardiogram | CPT | 93350 | 10 | $754.59 | $603.68 | $63.17 | $308.64 | $1,438.87 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $15,201 | $17,422 | $27,695 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $7,801.69 | $8,922.13 | $14,918 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $5,300.99 | $6,049.5 | $10,600 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $12,365 | $14,164 | $22,797 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $8,609.12 | $9,849.64 | $16,312 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $6,600.81 | $7,542.64 | $12,844 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $4,988.21 | $5,690.2 | $10,060 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $6,303.23 | $7,200.81 | $12,331 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $4,801.75 | $5,476.02 | $9,737.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $12,554 | $14,381 | $23,124 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $7,077.95 | $8,090.75 | $13,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $5,581.03 | $6,371.2 | $11,084 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $9,992.66 | $11,439 | $18,701 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $6,616.78 | $7,560.99 | $12,872 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $4,238.61 | $4,829.12 | $8,765.54 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $9,240 | $10,574 | $17,402 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $5,689.1 | $6,495.34 | $11,270 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $4,320.8 | $4,923.53 | $8,907.5 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $7,565.77 | $8,651.12 | $14,511 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $4,908.3 | $5,598.41 | $9,921.97 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $6,001.11 | $6,853.76 | $11,809 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $11,668 | $13,363 | $21,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $8,969.08 | $10,263 | $16,934 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $6,170.83 | $7,048.71 | $12,102 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $14,995 | $17,185 | $27,338 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $7,909 | $9,045.39 | $15,103 |
| Initial hospital care, low complexity | CPT | 99221 | 6 | $227 | $181.6 | $74.73 | $135.5 | $226.16 |
| Initial hospital care, moderate complexity | CPT | 99222 | 6 | $308 | $246.4 | $118.66 | $213.8 | $307.11 |
| Initial hospital care, high complexity | CPT | 99223 | 6 | $453 | $362.4 | $158.4 | $284.9 | $452.74 |
| Hospital discharge, <30 min | CPT | 99238 | 6 | $185 | $148 | $73.92 | $133.3 | $162.91 |
| Hospital discharge, >30 min | CPT | 99239 | 6 | $262 | $209.6 | $104.69 | $188.4 | $239.49 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 8 | $85.7 | $68.56 | $5.08 | $11 | $72.85 |
| General health panel | CPT | 80050 | 7 | $88 | $70.4 | $25.73 | $42.85 | $72.85 |
| Electrolyte panel | CPT | 80051 | 8 | $85.7 | $68.56 | $4.21 | $9.11 | $72.85 |
| Comprehensive metabolic panel | CPT | 80053 | 8 | $85.7 | $68.56 | $6.34 | $13.73 | $72.85 |
| Lipid panel | CPT | 80061 | 8 | $85.7 | $68.56 | $8.03 | $17.41 | $72.85 |
| Renal function panel | CPT | 80069 | 8 | $85.7 | $68.56 | $5.21 | $11.28 | $72.85 |
| Hepatic function panel | CPT | 80076 | 8 | $85.7 | $68.56 | $4.9 | $10.62 | $72.85 |
| Urinalysis non-automated | CPT | 81002 | 8 | $32.14 | $25.72 | $3.48 | $4.52 | $27.32 |
| Urinalysis automated | CPT | 81003 | 8 | $32.14 | $25.72 | $2.25 | $2.93 | $27.32 |
| Glucose quantitative | CPT | 82947 | 8 | $41.96 | $33.57 | $3.93 | $5.11 | $35.67 |
| Hemoglobin A1c | CPT | 83036 | 8 | $41.96 | $33.57 | $5.83 | $12.62 | $35.67 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 8 | $68.75 | $55 | $10.08 | $21.84 | $58.44 |
| Complete blood count with automated differential | CPT | 85025 | 8 | $41.96 | $33.57 | $4.66 | $10.1 | $35.67 |
| Complete blood count without differential | CPT | 85027 | 8 | $41.96 | $33.57 | $3.88 | $8.41 | $35.67 |
| Urine culture bacterial | CPT | 87086 | 8 | $48.22 | $38.58 | $4.84 | $10.49 | $40.99 |
| Urine culture identification | CPT | 87088 | 8 | $48.22 | $38.58 | $4.85 | $10.52 | $40.99 |
| Tissue exam by pathologist level IV | CPT | 88305 | 10 | $205 | $164 | $28.96 | $66.62 | $182.28 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 10 | $271.36 | $217.09 | $17.87 | $80.4 | $527.93 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 6 | $5,690 | $4,552 | $2,106.28 | $3,299.55 | $5,372.16 |
| Vaginal delivery only | CPT | 59409 | 10 | $6,998.42 | $5,598.74 | $691.99 | $2,709.95 | $8,343.81 |
| Vaginal delivery with postpartum | CPT | 59410 | 6 | $2,641 | $2,112.8 | $936.78 | $1,592 | $2,640.42 |
| Routine obstetric care with C-section | CPT | 59510 | 6 | $5,924 | $4,739.2 | $2,322.97 | $3,666.23 | $5,923.56 |
| C-section delivery only | CPT | 59514 | 6 | $2,305 | $1,844 | $778.91 | $1,333.3 | $2,304.69 |
| C-section with postpartum | CPT | 59515 | 6 | $3,196 | $2,556.8 | $1,153.4 | $1,974.7 | $3,195.11 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 6 | $167 | $133.6 | $42.93 | $66.3 | $112.29 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 6 | $237 | $189.6 | $74.5 | $116 | $168.46 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 6 | $362 | $289.6 | $121.61 | $188.8 | $288.21 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 6 | $459 | $367.2 | $165.2 | $257 | $376.67 |
| Office visit, established patient, 5 min | CPT | 99211 | 6 | $51 | $40.8 | $8.04 | $12.3 | $20.76 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 6 | $104 | $83.2 | $32.24 | $49.59 | $66.6 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $201 | $160.8 | $60.36 | $93.2 | $124.66 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $240 | $192 | $88.83 | $137.3 | $184.05 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $332 | $265.6 | $131.48 | $203 | $272.53 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 8 | $859 | $687.2 | $109.69 | $385.3 | $2,460.37 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 8 | $1,143 | $914.4 | $123.53 | $435.4 | $2,460.37 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 8 | $534 | $427.2 | $50.95 | $174.48 | $2,392.53 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 8 | $840 | $672 | $64.93 | $224.58 | $2,392.53 |
| Colonoscopy diagnostic | CPT | 45378 | 8 | $1,017 | $813.6 | $82.56 | $459.12 | $2,392.53 |
| Colonoscopy with biopsy | CPT | 45380 | 8 | $1,309 | $1,047.2 | $179.1 | $664.1 | $3,094.18 |
| Colonoscopy with polyp removal | CPT | 45385 | 8 | $1,371 | $1,096.8 | $226.39 | $814.61 | $3,094.18 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 8 | $8,950 | $7,160 | $1,290.01 | $4,475 | $48,260 |
| Hip hemiarthroplasty | CPT | 27125 | 6 | $6,968 | $5,574.4 | $1,013.18 | $2,208.3 | $3,483.37 |
| Total hip replacement | CPT | 27130 | 8 | $8,344 | $6,675.2 | $1,146 | $4,171.24 | $33,766 |
| Total knee replacement | CPT | 27447 | 8 | $8,336 | $6,668.8 | $1,144.67 | $4,167.04 | $33,766 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | $8,660 | $6,928 | $1,254.09 | $3,137.6 | $11,191 |
| Knee revision arthroplasty all components | CPT | 27487 | 6 | $10,830 | $8,664 | $1,560.09 | $3,923 | $14,049 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 6 | $1,326 | $1,060.8 | $151.83 | $330.5 | $538.56 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 8 | $6,590 | $5,272 | $958.1 | $3,294.92 | $18,747 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 8 | $3,324 | $2,659.2 | $490.7 | $1,661.93 | $8,514.6 |
| ACL reconstruction | CPT | 29888 | 8 | $6,040 | $4,832 | $874.13 | $3,019.58 | $18,747 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $35,008 | $40,175 | $61,895 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $18,051 | $20,696 | $32,616 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $12,627 | $14,465 | $23,250 |
| CABG single arterial graft | CPT | 33533 | 6 | $5,709 | $4,567.2 | $1,610.12 | $3,690.6 | $5,708.4 |
| CABG 2 arterial grafts | CPT | 33534 | 6 | $6,708 | $5,366.4 | $1,891.26 | $4,335.1 | $6,707.71 |
| CABG 3 arterial grafts | CPT | 33535 | 6 | $7,481 | $5,984.8 | $2,102.11 | $4,815.5 | $7,480.06 |
| CABG 4+ arterial grafts | CPT | 33536 | 6 | $8,063 | $6,450.4 | $2,263.84 | $5,187.2 | $8,062.01 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $12,684 | $14,530 | $23,348 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $10,090 | $11,551 | $18,869 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $26,923 | $30,887 | $47,935 |
| Open appendectomy | CPT | 44950 | 8 | $1,971 | $1,576.8 | $565.44 | $1,970.89 | $16,375 |
| Laparoscopic appendectomy | CPT | 44970 | 8 | $1,841 | $1,472.8 | $532.67 | $1,840.94 | $15,311 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $24,938 | $28,607 | $44,508 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $14,412 | $16,515 | $26,332 |
| Laparoscopic cholecystectomy | CPT | 47562 | 8 | $2,018 | $1,614.4 | $583.24 | $2,017.34 | $15,311 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 8 | $2,196 | $1,756.8 | $633.75 | $2,195.8 | $15,311 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $22,444 | $25,743 | $40,202 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $15,853 | $18,171 | $28,821 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $12,136 | $13,901 | $22,402 |
| Open umbilical hernia repair | CPT | 49560 | 1 | — | — | $1,405 | $1,405 | $1,652 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $854 | $854 | $1,005 |
| Lap inguinal hernia repair | CPT | 49650 | 8 | $2,632 | $2,105.6 | $384.86 | $1,315.76 | $15,311 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $1,356 | $1,356 | $1,596 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | $3,151 | $2,520.8 | $912.58 | $2,235.6 | $7,412.9 |
| Vaginal hysterectomy | CPT | 58260 | 8 | $2,609 | $2,087.2 | $751.29 | $2,608.44 | $12,954 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 8 | $2,758 | $2,206.4 | $791.18 | $2,757.27 | $15,311 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 8 | $3,073 | $2,458.4 | $879.56 | $3,072.25 | $27,321 |
| Lap salpingo-oophorectomy | CPT | 58661 | 8 | $4,064 | $3,251.2 | $584.08 | $2,031.54 | $15,311 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $20,812 | $23,867 | $37,383 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $12,216 | $13,993 | $22,541 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $11,187 | $12,811 | $20,764 |
| Complex cataract surgery | CPT | 66982 | 8 | $4,656 | $3,724.8 | $669.56 | $2,029.44 | $5,985.16 |
| Cataract surgery with lens implant | CPT | 66984 | 8 | $3,394 | $2,715.2 | $488.93 | $1,699.34 | $5,985.16 |
| Intravitreal injection | CPT | 67028 | 8 | $630 | $504 | $83.2 | $282.7 | $870.43 |
| Vitrectomy mechanical | CPT | 67042 | 8 | $7,152 | $5,721.6 | $1,024.83 | $3,428.74 | $10,557 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $9,185.2 | $10,511 | $17,307 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $14,933 | $17,114 | $27,232 |
| PCI single major coronary artery | CPT | 92920 | 10 | $9,659.71 | $7,727.77 | $452.43 | $4,859.49 | $14,962 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | $13,516 | $10,813 | $502.96 | $8,650.16 | $29,760 |
| PCI bypass graft | CPT | 92937 | 10 | $13,516 | $10,813 | $502.63 | $8,650.16 | $29,760 |
| Left heart catheterization | CPT | 93452 | 10 | $8,483.55 | $6,786.84 | $203.9 | $1,670 | $8,440.61 |
| Coronary angiography with cath | CPT | 93455 | 10 | $9,173.14 | $7,338.52 | $240.23 | $1,925 | $8,440.61 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | $9,917.89 | $7,934.32 | $253.81 | $1,986.4 | $8,440.61 |
Payer mix (top 10)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 200 | $188.9 |
| Aetna | 197 | $284.15 |
| health partners open network | 197 | $281.87 |
| UnitedHealthcare | 197 | $233.29 |
| Humana | 196 | $155.54 |
| Cigna | 154 | $261.09 |
| iowa total care | 147 | $777.06 |
| amerigroup | 147 | $777.06 |
| medica exchange insure | 135 | $1,471.53 |
| medica exchange inspire | 92 | $779.71 |