▸ Hospital · MI · CCN 230216
Mclaren Port Huron
1221 PINE GROVE AVENUE, PORT HURON, MI, 230216
Compliance grade
A
100/100
Procedures tracked
192
of 209 target codes
Payers
30
with negotiated rates
Rates published
53,965
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | $18,492 | $9,246.23 | $3,710.91 | $10,389 | $16,622 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 27 | $301.1 | $150.6 | $54.97 | $125.18 | $185.64 |
| Psychiatric eval with medical services | CPT | 90792 | 29 | $396.5 | $198.25 | $54.97 | $134.94 | $297.38 |
| Psychotherapy 30 minutes | CPT | 90832 | 27 | $125.9 | $63 | $30.76 | $69.14 | $132.94 |
| Psychotherapy 45 minutes | CPT | 90834 | 29 | $201.2 | $100.6 | $55.3 | $98.11 | $250.72 |
| Psychotherapy 60 minutes | CPT | 90837 | 29 | $817.1 | $408.55 | $55.3 | $130.33 | $250.72 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 27 | $221.7 | $110.9 | $55.3 | $121.68 | $169.26 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 30 | $245.1 | $122.55 | $7.24 | $85.87 | $450 |
| ED visit level 2 | CPT | 99282 | 30 | $472.82 | $236.41 | $26.63 | $154.45 | $450 |
| ED visit level 3 | CPT | 99283 | 31 | $682.82 | $341.41 | $44.94 | $270.05 | $562 |
| ED visit level 4 | CPT | 99284 | 31 | $1,291 | $645.5 | $76.68 | $415.29 | $1,066 |
| ED visit level 5 | CPT | 99285 | 31 | $1,753 | $876.5 | $111.19 | $548.08 | $1,448 |
| Critical care, first hour | CPT | 99291 | 31 | $2,433.5 | $1,216.75 | $135.47 | $576.79 | $1,795 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 30 | $1,627.6 | $813.8 | $25.56 | $105.79 | $1,344.1 |
| CT head with contrast | CPT | 70460 | 28 | $1,826.4 | $913.2 | $33.87 | $173.62 | $1,508.2 |
| CT head with and without contrast | CPT | 70470 | 28 | $2,324.5 | $1,162.25 | $38.13 | $173.62 | $1,919.7 |
| CT neck with contrast | CPT | 70491 | 28 | $2,157.55 | $1,078.78 | $41.32 | $173.62 | $1,709.4 |
| MRI brain without contrast | CPT | 70551 | 30 | $2,160.6 | $1,080.3 | $44.3 | $235.74 | $1,784.3 |
| MRI brain with contrast | CPT | 70552 | 28 | $2,233 | $1,116.5 | $53.46 | $348.3 | $1,844.1 |
| MRI brain with and without contrast | CPT | 70553 | 28 | $3,141.1 | $1,570.55 | $69.01 | $348.3 | $2,594 |
| Chest X-ray single view | CPT | 71045 | 30 | $823.26 | $411.63 | $5.54 | $64.22 | $165 |
| Chest X-ray 2 views | CPT | 71046 | 30 | $216.1 | $108.05 | $6.6 | $67.56 | $178.2 |
| Chest X-ray 3 views | CPT | 71047 | 28 | $230.6 | $115.3 | $8.31 | $83.18 | $190.2 |
| CT chest without contrast | CPT | 71250 | 30 | $1,667.5 | $833.75 | $32.38 | $104.99 | $1,377.1 |
| CT chest with contrast | CPT | 71260 | 30 | $2,086.38 | $1,043.19 | $34.93 | $174.28 | $1,643.3 |
| CT chest with and without contrast | CPT | 71270 | 28 | $2,437 | $1,218.5 | $37.49 | $173.62 | $1,975 |
| MRI chest without contrast | CPT | 71550 | 28 | $1,878.9 | $939.45 | $43.88 | $235.74 | $1,551.6 |
| MRI chest with contrast | CPT | 71551 | 26 | $187.5 | $958.95 | $51.76 | $644.01 | $1,844.1 |
| MRI chest with and without contrast | CPT | 71552 | 28 | $2,731.4 | $1,365.7 | $68.16 | $348.3 | $2,255.7 |
| Lumbosacral spine X-ray | CPT | 72100 | 30 | $212.2 | $106.1 | $6.82 | $64.69 | $182.2 |
| CT cervical spine without contrast | CPT | 72125 | 30 | $1,882.8 | $941.4 | $29.82 | $105.79 | $1,554.9 |
| CT thoracic spine without contrast | CPT | 72128 | 30 | $1,833.6 | $916.8 | $29.82 | $104.19 | $1,514.2 |
| CT lumbar spine without contrast | CPT | 72131 | 30 | $1,882.8 | $941.4 | $29.82 | $105.79 | $1,554.9 |
| MRI cervical spine without contrast | CPT | 72141 | 30 | $2,351.8 | $1,175.9 | $44.52 | $235.74 | $1,942.3 |
| MRI thoracic spine without contrast | CPT | 72146 | 29 | $2,351.8 | $1,175.9 | $44.52 | $225.73 | $1,942.3 |
| MRI lumbar spine without contrast | CPT | 72148 | 30 | $2,351.8 | $1,175.9 | $44.52 | $228.93 | $1,942.3 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 26 | $232.6 | $1,102.75 | $53.89 | $366.2 | $2,120.7 |
| MRI cervical spine with and without contrast | CPT | 72156 | 29 | $3,141.1 | $1,570.55 | $69.23 | $348.3 | $2,594 |
| MRI lumbar spine with contrast | CPT | 72158 | 28 | $3,141.1 | $1,570.55 | $69.23 | $348.3 | $2,594 |
| CT pelvis without contrast | CPT | 72192 | 29 | $1,683.1 | $841.55 | $32.59 | $103.95 | $1,389.9 |
| CT pelvis with contrast | CPT | 72193 | 28 | $2,461.6 | $1,230.8 | $34.72 | $173.62 | $2,032.9 |
| Shoulder X-ray | CPT | 73030 | 30 | $230.28 | $189.85 | $5.75 | $76.24 | $365.1 |
| Humerus X-ray | CPT | 73060 | 29 | $207.6 | $132.1 | $4.9 | $72.87 | $254 |
| Hand X-ray 3 views | CPT | 73130 | 30 | $223.29 | $154.9 | $5.33 | $76.45 | $297.9 |
| MRI upper extremity joint without contrast | CPT | 73221 | 30 | $2,160.6 | $1,172.95 | $40.68 | $494.38 | $2,255.7 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 28 | $2,731.4 | $1,365.7 | $64.97 | $583.82 | $2,255.7 |
| Knee X-ray 1-2 views | CPT | 73560 | 30 | $234.44 | $139.5 | $5.11 | $76.24 | $268.3 |
| Ankle X-ray 3 views | CPT | 73610 | 30 | $220.7 | $133.9 | $5.33 | $76.45 | $257.5 |
| MRI lower extremity joint without contrast | CPT | 73721 | 29 | $2,160.6 | $1,080.3 | $40.68 | $235.74 | $1,784.3 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 28 | $3,141.1 | $1,570.55 | $64.97 | $348.3 | $2,594 |
| CT abdomen without contrast | CPT | 74150 | 29 | $2,424.2 | $1,212.1 | $35.57 | $103.71 | $2,002 |
| CT abdomen with contrast | CPT | 74160 | 28 | $2,633.1 | $1,316.55 | $38.13 | $173.62 | $2,174.6 |
| CT abdomen with and without contrast | CPT | 74170 | 28 | $3,033.8 | $1,516.9 | $41.75 | $173.62 | $2,425.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 30 | $3,494.9 | $1,747.45 | $52.19 | $235.74 | $2,886.3 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 30 | $4,428.33 | $2,214.17 | $54.95 | $355.27 | $3,650.7 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 28 | $5,275.8 | $2,637.9 | $60.28 | $349.11 | $4,357.1 |
| MRI abdomen without contrast | CPT | 74181 | 28 | $1,878.9 | $939.45 | $43.67 | $235.74 | $1,551.6 |
| MRI abdomen with and without contrast | CPT | 74183 | 28 | $3,141.1 | $1,570.55 | $66.24 | $848.76 | $2,634.5 |
| Abdominal ultrasound complete | CPT | 76700 | 28 | $1,037.8 | $518.9 | $24.28 | $104.99 | $857 |
| Abdominal ultrasound limited | CPT | 76705 | 28 | $714.2 | $357.1 | $17.68 | $103.71 | $589.6 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 28 | $778.9 | $389.45 | $22.15 | $105.79 | $643.1 |
| Obstetric ultrasound first trimester | CPT | 76801 | 28 | $416 | $208 | $29.82 | $104.99 | $343.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 28 | $904.23 | $452.12 | $30.03 | $103.71 | $615.4 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 28 | $822.5 | $411.25 | $56.87 | $232.34 | $679.2 |
| Transvaginal ultrasound | CPT | 76830 | 28 | $668.1 | $334.05 | $20.87 | $105.79 | $551.6 |
| Pelvic ultrasound complete | CPT | 76856 | 28 | $851.9 | $425.95 | $20.66 | $105.79 | $703.4 |
| Scrotal ultrasound | CPT | 76870 | 29 | $667.4 | $333.7 | $19.17 | $107.96 | $551 |
| Diagnostic mammography unilateral | CPT | 77065 | 27 | $396.1 | $198.05 | $24.28 | $104.71 | $327 |
| Diagnostic mammography bilateral | CPT | 77066 | 27 | $475.8 | $237.9 | $29.82 | $125.78 | $411.79 |
| Screening mammography bilateral | CPT | 77067 | 27 | $429.2 | $214.6 | $23 | $113.46 | $354.3 |
| EKG complete | CPT | 93000 | 25 | $34.2 | $28.1 | $13.97 | $27.43 | $54 |
| EKG tracing only | CPT | 93005 | 29 | $117 | $58.5 | $7.95 | $45 | $99.45 |
| EKG interpretation only | CPT | 93010 | 25 | $34.2 | $17.1 | $5.11 | $11.04 | $25 |
| Transthoracic echocardiogram complete | CPT | 93306 | 28 | $2,442.9 | $1,221.45 | $43.03 | $537.21 | $2,042.1 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $104.7 | $52.4 | $27.26 | $43.23 | $68.17 |
| Stress echocardiogram | CPT | 93350 | 26 | $653.8 | $837 | $43.03 | $476.37 | $1,609.6 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | $31,265 | $15,632 | $10,814 | $11,575 | $21,684 |
| COPD w MCC | MS-DRG | 190 | 5 | $24,051 | $12,026 | $7,665.13 | $8,321.65 | $16,217 |
| COPD w CC | MS-DRG | 191 | 5 | $19,976 | $9,988.12 | $5,833.44 | $6,499.36 | $14,431 |
| COPD w/o CC/MCC | MS-DRG | 192 | 5 | $22,061 | $11,031 | $4,442.55 | $4,991.81 | $10,588 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | $25,223 | $12,611 | $5,576.72 | $6,231.34 | $10,662 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 5 | $11,503 | $5,751.5 | $4,349.13 | $4,949.78 | $7,832.46 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | $34,636 | $17,318 | $11,100 | $11,998 | $24,664 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $26,563 | $13,282 | $6,360.05 | $7,049.12 | $17,153 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | $24,433 | $12,216 | $5,003.75 | $5,686.02 | $21,905 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | $30,227 | $15,113 | $8,883.72 | $9,671.33 | $22,005 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | $22,500 | $11,250 | $5,874.96 | $6,542.7 | $13,176 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | $30,583 | $15,291 | $8,331.52 | $9,010.22 | $18,443 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | $22,945 | $11,472 | $4,752.47 | $5,661.78 | $12,109 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | $14,831 | $7,415.27 | $3,917.33 | $4,449.11 | $9,309.62 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | $27,540 | $13,770 | $6,786.31 | $7,494.12 | $17,315 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 5 | $24,553 | $12,276 | $4,362.28 | $4,963.51 | $12,766 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | $21,540 | $10,770 | $5,394.72 | $5,975.68 | $11,462 |
| Kidney/UTI w MCC | MS-DRG | 689 | 5 | $26,285 | $13,143 | $8,029.12 | $8,791.57 | $15,892 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 5 | $20,372 | $10,186 | $5,601.63 | $6,189.47 | $10,061 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 6 | $40,564 | $20,282 | $13,442 | $14,550 | $28,868 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 5 | $23,866 | $11,933 | $6,735.28 | $7,718.18 | $13,348 |
| Initial hospital care, low complexity | CPT | 99221 | 9 | $358 | $179 | $52.4 | $75.96 | $113.01 |
| Initial hospital care, moderate complexity | CPT | 99222 | 26 | $520 | $260 | $82.64 | $135.37 | $273 |
| Initial hospital care, high complexity | CPT | 99223 | 25 | $675 | $337.5 | $97.18 | $176.57 | $297 |
| Hospital discharge, <30 min | CPT | 99238 | 9 | $342 | $171 | $51.55 | $75.37 | $128.89 |
| Hospital discharge, >30 min | CPT | 99239 | 25 | $368 | $184 | $72.85 | $119.04 | $270 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 29 | $103.5 | $51.75 | $4.63 | $12.96 | $85.3 |
| General health panel | CPT | 80050 | 20 | — | $166.75 | $32.55 | $175.27 | $320.7 |
| Electrolyte panel | CPT | 80051 | 27 | $52 | $26 | $3.83 | $7.23 | $50 |
| Comprehensive metabolic panel | CPT | 80053 | 28 | $174 | $87 | $5.78 | $16.49 | $143.5 |
| Lipid panel | CPT | 80061 | 28 | $91.3 | $45.65 | $5.73 | $15.5 | $75.2 |
| Renal function panel | CPT | 80069 | 26 | $128.5 | $64.25 | $4.75 | $9.86 | $106 |
| Hepatic function panel | CPT | 80076 | 26 | $137.2 | $68.6 | $4.47 | $8.26 | $113.2 |
| Urinalysis non-automated | CPT | 81002 | 26 | $5.2 | $4.15 | $1.9 | $3.4 | $25 |
| Urinalysis automated | CPT | 81003 | 29 | $22 | $11 | $1.23 | $4.02 | $25 |
| Glucose quantitative | CPT | 82947 | 28 | $52.9 | $26.45 | $1.56 | $5.85 | $15.7 |
| Hemoglobin A1c | CPT | 83036 | 27 | $71 | $43.15 | $1.8 | $14.24 | $83 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 28 | $139.59 | $69.8 | $9.19 | $19.13 | $112.5 |
| Complete blood count with automated differential | CPT | 85025 | 29 | $52.6 | $30.15 | $4.25 | $14.33 | $58 |
| Complete blood count without differential | CPT | 85027 | 29 | $42.8 | $21.4 | $3.54 | $10.67 | $45 |
| Urine culture bacterial | CPT | 87086 | 27 | $145.09 | $72.55 | $4.41 | $8.12 | $58.4 |
| Urine culture identification | CPT | 87088 | 22 | — | $34 | $4.93 | $14.7 | $65.4 |
| Tissue exam by pathologist level IV | CPT | 88305 | 28 | $916.8 | $458.4 | $16.52 | $60.15 | $525.42 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 28 | $360.9 | $180.45 | $9.22 | $131.5 | $313.92 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 9 | $7,617.5 | $3,808.8 | $2,043 | $2,260.13 | $3,504.67 |
| Vaginal delivery only | CPT | 59409 | 26 | $4,672.3 | $5,054.92 | $729.76 | $2,598.66 | $10,110 |
| Vaginal delivery with postpartum | CPT | 59410 | 9 | $5,081.4 | $2,540.7 | $984.03 | $1,014.27 | $1,980.33 |
| Routine obstetric care with C-section | CPT | 59510 | 9 | $8,039.1 | $4,019.6 | $2,309 | $2,533.33 | $3,780.59 |
| C-section delivery only | CPT | 59514 | 10 | $5,092.4 | $2,546.2 | $834.27 | $877.84 | $1,706.1 |
| C-section with postpartum | CPT | 59515 | 9 | $5,821.9 | $2,911 | $1,221.92 | $1,267.79 | $1,980.33 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 27 | $741.83 | $370.92 | $29.82 | $93.98 | $200 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 29 | $48,468 | $24,234 | $46.03 | $117.31 | $255 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 29 | $46,162 | $23,081 | $49.65 | $144.74 | $319 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 29 | $473 | $236.5 | $55.62 | $184.28 | $406 |
| Office visit, established patient, 5 min | CPT | 99211 | 26 | $179.1 | $89.55 | $5.54 | $78.03 | $154 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 27 | $215.3 | $107.65 | $21.87 | $93.98 | $185 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 28 | $48,848 | $24,424 | $41.96 | $109.51 | $218 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 28 | $36,494 | $18,247 | $49.91 | $124.24 | $255 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 26 | $207 | $165.9 | $55.62 | $147.16 | $319 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 29 | $5,408.63 | $2,704.32 | $77.75 | $643.78 | $1,624.2 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 29 | $5,447.2 | $2,723.6 | $87.33 | $649.56 | $1,747.6 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 29 | $3,412.48 | $1,706.24 | $36.42 | $511.72 | $1,422.68 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 29 | $4,972.15 | $2,486.08 | $46.22 | $592.08 | $1,422.68 |
| Colonoscopy diagnostic | CPT | 45378 | 29 | $3,847.07 | $1,923.54 | $116.72 | $774.03 | $1,598.3 |
| Colonoscopy with biopsy | CPT | 45380 | 29 | $4,752.97 | $2,376.49 | $126.95 | $980.2 | $2,020 |
| Colonoscopy with polyp removal | CPT | 45385 | 29 | $4,938.25 | $2,469.13 | $159.96 | $980.2 | $2,014.3 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 26 | $6,417.2 | $3,950.45 | $931.66 | $4,037.81 | $12,251 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | $3,689.7 | $1,844.9 | $732.93 | $1,042.58 | $1,832.68 |
| Total hip replacement | CPT | 27130 | 28 | $42,368 | $21,184 | $829.21 | $12,400 | $36,251 |
| Total knee replacement | CPT | 27447 | 26 | $11,257 | $14,737 | $828.14 | $12,079 | $29,475 |
| Knee revision arthroplasty single component | CPT | 27486 | 9 | $10,055 | $5,027.5 | $907.38 | $1,286.59 | $2,268.88 |
| Knee revision arthroplasty all components | CPT | 27487 | 9 | $13,281 | $6,640.3 | $1,128.9 | $1,593.68 | $3,101.03 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 9 | $889.5 | $444.8 | $109.7 | $151.18 | $247.15 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | $3,937.2 | $1,968.6 | $691.61 | $981.48 | $1,729.35 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 28 | $12,203 | $6,101.26 | $354.43 | $2,776.3 | $5,636.88 |
| ACL reconstruction | CPT | 29888 | 26 | $8,601.5 | $10,552 | $630.48 | $5,621.52 | $21,105 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 5 | $93,466 | $46,733 | $31,807 | $33,615 | $62,405 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 5 | $56,964 | $28,482 | $16,588 | $17,727 | $37,831 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | $45,664 | $22,832 | $11,645 | $12,567 | $27,726 |
| CABG single arterial graft | CPT | 33533 | 9 | $7,204.2 | $3,602.1 | $1,178.1 | $1,802.84 | $2,945.81 |
| CABG 2 arterial grafts | CPT | 33534 | 9 | $8,297.6 | $4,148.8 | $1,383.86 | $2,115.76 | $3,460.3 |
| CABG 3 arterial grafts | CPT | 33535 | 9 | $9,146.1 | $4,573.1 | $1,537.22 | $2,348.18 | $3,857.27 |
| CABG 4+ arterial grafts | CPT | 33536 | 9 | $9,785.4 | $4,892.7 | $1,655.86 | $2,529.15 | $4,146.09 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 5 | $42,021 | $21,010 | $11,706 | $12,630 | $29,386 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 5 | $34,754 | $17,377 | $9,451.15 | $10,374 | $29,454 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 5 | $10,472 | $5,236 | $23,577 | $25,023 | $72,904 |
| Open appendectomy | CPT | 44950 | 26 | $2,952 | $8,332.59 | $413.65 | $2,635.84 | $16,665 |
| Laparoscopic appendectomy | CPT | 44970 | 28 | $27,084 | $13,542 | $389.58 | $5,690.13 | $18,623 |
| Major joint replacement w MCC | MS-DRG | 469 | 5 | $49,033 | $24,517 | $20,989 | $22,322 | $61,332 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 5 | $50,780 | $25,390 | $13,348 | $14,344 | $32,540 |
| Laparoscopic cholecystectomy | CPT | 47562 | 28 | $18,782 | $9,391.05 | $427.28 | $4,963.73 | $11,036 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 26 | $3,083.3 | $6,922.42 | $464.55 | $4,000.57 | $13,845 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 5 | $53,535 | $26,768 | $20,153 | $21,448 | $55,520 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 5 | $47,835 | $23,917 | $14,494 | $15,540 | $35,431 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 5 | $43,247 | $21,623 | $11,286 | $12,192 | $27,158 |
| Open umbilical hernia repair | CPT | 49560 | 22 | — | $1,937.5 | $1,219.15 | $2,299.32 | $3,726 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 22 | — | $3,685.34 | $1,135 | $4,201.29 | $7,370.69 |
| Lap inguinal hernia repair | CPT | 49650 | 26 | $2,091.2 | $6,998.95 | $281.59 | $4,098.21 | $13,998 |
| Lap incisional hernia repair | CPT | 49652 | 22 | — | $7,692.55 | $2,326 | $8,769.51 | $15,385 |
| Total abdominal hysterectomy | CPT | 58150 | 25 | $5,253.9 | $5,756.16 | $653.91 | $3,591.56 | $11,512 |
| Vaginal hysterectomy | CPT | 58260 | 26 | $4,733.9 | $4,753.43 | $538.04 | $3,084.62 | $9,506.86 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 26 | $3,544.5 | $7,316.63 | $566.58 | $4,583.31 | $14,633 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 26 | $3,734.8 | $9,347.66 | $629.84 | $5,829.73 | $18,695 |
| Lap salpingo-oophorectomy | CPT | 58661 | 28 | $14,086 | $7,343.7 | $418.55 | $4,963.73 | $14,687 |
| OR procedure for obesity w CC | MS-DRG | 620 | 5 | $47,344 | $23,672 | $11,074 | $11,970 | $27,369 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 5 | $44,297 | $22,148 | $10,438 | $11,306 | $24,901 |
| Complex cataract surgery | CPT | 66982 | 26 | $2,797.4 | $2,854.14 | $470.52 | $2,039.42 | $5,708.28 |
| Cataract surgery with lens implant | CPT | 66984 | 28 | $7,805.33 | $3,902.67 | $343.57 | $2,114.85 | $4,421.23 |
| Vitrectomy mechanical | CPT | 67042 | 9 | $2,797.4 | $1,398.7 | $719.51 | $950.47 | $1,937.43 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 5 | $14,230 | $7,115 | $8,585.48 | $9,372.39 | $20,501 |
| PCI single major coronary artery | CPT | 92920 | 28 | $12,314 | $6,157 | $178.37 | $3,339.03 | $8,896.93 |
| PCI with drug-eluting stent | CPT | 92928 | 28 | $22,389 | $11,195 | $366.57 | $8,114.01 | $18,996 |
| PCI bypass graft | CPT | 92937 | 26 | $1,833.8 | $7,933.65 | $366.36 | $8,296.32 | $15,257 |
| Left heart catheterization | CPT | 93452 | 28 | $8,079.1 | $4,039.55 | $146.76 | $2,505.29 | $6,672.4 |
| Coronary angiography with cath | CPT | 93455 | 28 | $3,806.2 | $4,119.25 | $173.17 | $2,709.66 | $7,921.6 |
| Coronary angiography with bypass cath | CPT | 93458 | 28 | $16,769 | $8,384.55 | $182.75 | $2,843.62 | $8,919.6 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 192 | $133.2 |
| Blue Cross Blue Shield | 192 | $320.84 |
| Medicare | 191 | $202.11 |
| Humana | 187 | $156.7 |
| Aetna | 159 | $154.56 |
| Medicaid | 156 | $111.1 |
| priority health | 149 | $145.57 |
| hap hmo op rate | 138 | $172.52 |
| hap ppo op rate | 138 | $217.27 |
| hcap op rate | 138 | $257.55 |
| health plus hmo op rate | 138 | $319.57 |
| health plus ppo op rate | 138 | $345.48 |
| auto-cofinity op rate | 138 | $291.89 |
| CHAMPVA | 138 | $103.36 |
| Cigna | 138 | $200.89 |
| cofinity op rate | 138 | $239.86 |
| First Health | 138 | $267.85 |
| hap ahl op rate | 138 | $174.45 |
| mclaren health op rate | 138 | $112.36 |
| Multiplan | 138 | $275.82 |
| priority health op rate | 138 | $206.56 |
| theramatrix physical therapy op rate | 138 | $343.4 |
| mclaren commercial ins | 137 | $118.13 |
| u of m health plan | 135 | $96.3 |
| bcn op rate | 135 | $258.92 |
| TRICARE | 133 | $349.91 |
| Medicare Advantage | 122 | $176.14 |
| mi amish medical board | 97 | $173.62 |
| workers compensation | 47 | $72.65 |
| cofinity auto | 35 | $163.16 |