▸ Hospital · MS · CCN 250059
MONTFORT JONES MEMORIAL HOSPITAL
220 HIGHWAY 12 WEST, KOSCIUSKO, MS, 39090
61 beds9
Compliance grade
A
100/100
Procedures tracked
194
of 209 target codes
Payers
17
with negotiated rates
Rates published
33,683
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 6 | — | $13,458 | $7,239.61 | $13,458 | $13,458 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 15 | — | — | $54.82 | $159.82 | $580.19 |
| Psychiatric eval with medical services | CPT | 90792 | 10 | — | — | $64.33 | $237.3 | $580.19 |
| Psychotherapy 30 minutes | CPT | 90832 | 15 | — | — | $22.71 | $74.09 | $580.19 |
| Psychotherapy 45 minutes | CPT | 90834 | 15 | — | — | $29.08 | $98.23 | $580.19 |
| Psychotherapy 60 minutes | CPT | 90837 | 15 | — | — | $42.54 | $144.89 | $580.19 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 15 | — | — | $68.47 | $141.35 | $580.19 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 15 | $336 | $168 | $6.98 | $21.95 | $275.63 |
| ED visit level 2 | CPT | 99282 | 15 | $603 | $302 | $11.97 | $48.6 | $501.9 |
| ED visit level 3 | CPT | 99283 | 15 | $1,053 | $526 | $25.95 | $75.6 | $892.3 |
| ED visit level 4 | CPT | 99284 | 15 | $1,620 | $810 | $40.54 | $135.89 | $1,363.93 |
| ED visit level 5 | CPT | 99285 | 15 | $2,331 | $1,166 | $63.46 | $197.35 | $1,946.64 |
| Critical care, first hour | CPT | 99291 | 15 | $3,204 | $1,602 | $124.83 | $268.27 | $2,700.08 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 15 | $405 | $202 | $72.72 | $139.77 | $533.52 |
| CT head with contrast | CPT | 70460 | 15 | $678 | $339 | $87.87 | $234.5 | $644.67 |
| CT head with and without contrast | CPT | 70470 | 15 | $678 | $339 | $131.5 | $234.5 | $964.79 |
| CT neck with contrast | CPT | 70491 | 15 | $678 | $339 | $103.02 | $234.5 | $755.82 |
| MRI brain without contrast | CPT | 70551 | 15 | $918 | $459 | $239.24 | $416.89 | $2,223.01 |
| MRI brain with contrast | CPT | 70552 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| Chest X-ray single view | CPT | 71045 | 17 | $336 | $168 | $6.06 | $20.7 | $284.46 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $336 | $168 | $7.78 | $26.6 | $284.46 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $336 | $168 | $9.09 | $35.17 | $284.46 |
| CT chest without contrast | CPT | 71250 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| CT chest with contrast | CPT | 71260 | 15 | $678 | $339 | $103.02 | $234.5 | $755.82 |
| CT chest with and without contrast | CPT | 71270 | 15 | — | — | $153.92 | $256.54 | $1,129.29 |
| MRI chest without contrast | CPT | 71550 | 15 | $918 | $459 | $239.24 | $416.89 | $2,223.01 |
| MRI chest with contrast | CPT | 71551 | 15 | $3,003 | $1,502 | $303 | $1,041.64 | $2,562.44 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $405 | $202 | $7.94 | $30.91 | $341.73 |
| CT cervical spine without contrast | CPT | 72125 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $918 | $459 | $239.24 | $417.57 | $2,223.01 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $918 | $459 | $239.24 | $416.89 | $2,223.01 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $918 | $459 | $239.24 | $417.57 | $2,223.01 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| CT pelvis without contrast | CPT | 72192 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| CT pelvis with contrast | CPT | 72193 | 15 | $678 | $339 | $103.02 | $234.5 | $929.37 |
| Shoulder X-ray | CPT | 73030 | 17 | $336 | $168 | $6.75 | $26.83 | $284.46 |
| Humerus X-ray | CPT | 73060 | 17 | $336 | $168 | $5.99 | $22.72 | $284.46 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $336 | $168 | $6.25 | $27.01 | $284.46 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $918 | $459 | $239.24 | $416.89 | $2,223.01 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $336 | $168 | $5.99 | $23.03 | $284.46 |
| Ankle X-ray 3 views | CPT | 73610 | 17 | $336 | $168 | $6.25 | $27.01 | $284.46 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $918 | $459 | $239.24 | $417.57 | $2,223.01 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| CT abdomen without contrast | CPT | 74150 | 15 | $405 | $202 | $84.84 | $141.4 | $622.44 |
| CT abdomen with contrast | CPT | 74160 | 15 | $678 | $339 | $103.02 | $234.5 | $922.3 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | $678 | $339 | $153.92 | $256.54 | $1,129.29 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $918 | $459 | $41.63 | $169.66 | $779.93 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | $1,359 | $680 | $65.41 | $266.58 | $1,165.93 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $1,359 | $680 | $82.86 | $330.28 | $1,315.54 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $918 | $459 | $239.24 | $416.89 | $2,223.01 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $1,359 | $680 | $303 | $505 | $2,223.01 |
| Abdominal ultrasound complete | CPT | 76700 | 17 | $405 | $202 | $28.99 | $100.01 | $408.71 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $405 | $202 | $20.8 | $74.53 | $341.73 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 17 | $405 | $202 | $26.11 | $92.5 | $385.77 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $405 | $202 | $33.33 | $124.99 | $368.52 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $405 | $202 | $33.33 | $124.99 | $459.89 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 15 | $918 | $459 | $43.63 | $177.84 | $779.93 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $405 | $202 | $36.36 | $130.29 | $449.3 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $449 | $267.74 | $33.33 | $119.44 | $382.2 |
| Scrotal ultrasound | CPT | 76870 | 17 | $405 | $202 | $18.18 | $75.88 | $368.11 |
| Diagnostic mammography unilateral | CPT | 77065 | 15 | $212 | $106 | $58.78 | $97.14 | $463.39 |
| Diagnostic mammography bilateral | CPT | 77066 | 15 | $272 | $136 | $58.78 | $104.86 | $590.47 |
| Screening mammography bilateral | CPT | 77067 | 15 | $225 | $112 | $58.78 | $97.97 | $488.52 |
| EKG complete | CPT | 93000 | 17 | $201 | $119.86 | $10.12 | $15.15 | $116.52 |
| EKG tracing only | CPT | 93005 | 17 | $225 | $112 | $4.25 | $8.01 | $192.83 |
| EKG interpretation only | CPT | 93010 | 15 | $26 | $15.5 | $5.87 | $8.13 | $20.03 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $2,085 | $1,042 | $49.86 | $186.56 | $1,786.09 |
| Transthoracic echocardiogram | CPT | 93307 | 15 | — | — | $54.54 | $204.52 | $779.93 |
| Stress echocardiogram | CPT | 93350 | 15 | $2,085 | $1,042 | $72.72 | $272.7 | $1,786.09 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | — | $15,015 | $8,099.47 | $15,015 | $15,015 |
| COPD w MCC | MS-DRG | 190 | 6 | — | $10,746 | $5,741.21 | $10,746 | $10,746 |
| COPD w CC | MS-DRG | 191 | 6 | — | $8,261.59 | $4,369.27 | $8,261.59 | $8,261.59 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | — | $6,375.41 | $3,327.49 | $6,375.41 | $6,375.41 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 6 | — | $7,913.45 | $4,176.98 | $7,913.45 | $7,913.45 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | — | $6,248.72 | $3,257.52 | $6,248.72 | $6,248.72 |
| AMI discharged alive w MCC | MS-DRG | 280 | 6 | — | $15,404 | $8,314.05 | $15,404 | $15,404 |
| AMI discharged alive w CC | MS-DRG | 281 | 6 | — | $8,975.71 | $4,763.7 | $8,975.71 | $8,975.71 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | — | $7,136.45 | $3,747.83 | $7,136.45 | $7,136.45 |
| Heart failure & shock w MCC | MS-DRG | 291 | 6 | — | $12,398 | $6,653.94 | $12,398 | $12,398 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | — | $8,317.9 | $4,400.37 | $8,317.9 | $8,317.9 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | — | $5,662.22 | $2,933.58 | $5,662.22 | $5,662.22 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 6 | — | $11,649 | $6,240.33 | $11,649 | $11,649 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 6 | — | $7,254.69 | $3,813.13 | $7,254.69 | $7,254.69 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 6 | — | $5,663.16 | $2,934.1 | $5,663.16 | $5,663.16 |
| GI hemorrhage w CC | MS-DRG | 378 | 6 | — | $9,553.77 | $5,082.97 | $9,553.77 | $9,553.77 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | — | $6,266.55 | $3,267.36 | $6,266.55 | $6,266.55 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 6 | — | $7,666.65 | $4,040.67 | $7,666.65 | $7,666.65 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 6 | — | $15,062 | $8,125.39 | $15,062 | $15,062 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | — | $11,239 | $6,013.83 | $11,239 | $11,239 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | — | $7,947.23 | $4,195.64 | $7,947.23 | $7,947.23 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 6 | — | $18,579 | $10,068 | $18,579 | $18,579 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | — | $9,953.53 | $5,303.76 | $9,953.53 | $9,953.53 |
| Initial hospital care, low complexity | CPT | 99221 | 15 | $233 | $138.94 | $28.49 | $79.18 | $203.44 |
| Initial hospital care, moderate complexity | CPT | 99222 | 15 | $315 | $187.83 | $47.26 | $122.58 | $319.71 |
| Initial hospital care, high complexity | CPT | 99223 | 15 | $462 | $275.49 | $65.86 | $166.44 | $426.74 |
| Hospital discharge, <30 min | CPT | 99238 | 15 | $167 | $99.58 | $29.62 | $73.21 | $198.48 |
| Hospital discharge, >30 min | CPT | 99239 | 15 | $245 | $146.09 | $40.38 | $103.49 | $281.36 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $117 | $65 | $4.97 | $8.46 | $19.19 |
| General health panel | CPT | 80050 | 2 | $97 | $48 | $18.14 | $41.03 | $43.48 |
| Electrolyte panel | CPT | 80051 | 15 | $44 | $23.26 | $4.12 | $7.01 | $15.92 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $69 | $40.55 | $6.2 | $10.56 | $23.97 |
| Lipid panel | CPT | 80061 | 15 | $87 | $50.09 | $6.1 | $12.59 | $30.39 |
| Renal function panel | CPT | 80069 | 15 | $20 | $10 | $5.09 | $8.68 | $19.71 |
| Hepatic function panel | CPT | 80076 | 15 | $44 | $23.26 | $4.8 | $8.17 | $16.69 |
| Urinalysis non-automated | CPT | 81002 | 17 | $23 | $13.12 | $1.5 | $3.15 | $6.96 |
| Urinalysis automated | CPT | 81003 | 17 | $23 | $13.71 | $1.32 | $2.14 | $5.09 |
| Glucose quantitative | CPT | 82947 | 17 | $27 | $14.91 | $2.3 | $3.93 | $8.92 |
| Hemoglobin A1c | CPT | 83036 | 17 | $64 | $37.57 | $4.08 | $9.71 | $22.04 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 17 | $108 | $63.21 | $7.06 | $15.09 | $38.14 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $49 | $26.83 | $3.2 | $7.2 | $15.86 |
| Complete blood count without differential | CPT | 85027 | 15 | $49 | $28.03 | $3.2 | $6.08 | $13.2 |
| Urine culture bacterial | CPT | 87086 | 17 | $52 | $31.01 | $3.39 | $8.07 | $18.16 |
| Urine culture identification | CPT | 87088 | 17 | $55 | $32.8 | $3.4 | $8.09 | $18.2 |
| Tissue exam by pathologist level IV | CPT | 88305 | 17 | $204 | $102 | $8.98 | $52.3 | $175.06 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 17 | $765 | $382 | $9.09 | $37.89 | $1,512 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 10 | $4,965 | $2,960.63 | $1,420.74 | $2,157.48 | $5,817.45 |
| Vaginal delivery only | CPT | 59409 | 15 | $1,946 | $1,160.4 | $563.86 | $841.8 | $10,581 |
| Vaginal delivery with postpartum | CPT | 59410 | 10 | $2,475 | $1,475.84 | $730.12 | $1,018.97 | $2,566.95 |
| Routine obstetric care with C-section | CPT | 59510 | 10 | $5,496 | $3,277.26 | $1,420.74 | $2,390.18 | $6,416.42 |
| C-section delivery only | CPT | 59514 | 10 | $2,197 | $1,310.07 | $635.9 | $853.05 | $2,187.94 |
| C-section with postpartum | CPT | 59515 | 10 | $2,997 | $1,787.11 | $735.82 | $1,200.71 | $3,150.23 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 15 | $258 | $153.85 | $31.06 | $53.12 | $177.16 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 15 | $321 | $191.41 | $45.54 | $86.83 | $274.23 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 15 | $451 | $268.93 | $69.13 | $137.07 | $408.14 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 15 | $536 | $319.62 | $86.68 | $177.55 | $538.85 |
| Office visit, established patient, 5 min | CPT | 99211 | 15 | $237 | $118 | $5.69 | $12.56 | $148.5 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 15 | $389 | $194 | $18.07 | $37.08 | $148.5 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 15 | $453 | $226 | $29.93 | $64.67 | $221.41 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 15 | $543 | $272 | $44.94 | $95.42 | $313.46 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 15 | $629 | $314 | $60.64 | $135.78 | $439.59 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | $3,564 | $1,782 | $67.2 | $253.68 | $2,964.71 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | $3,564 | $1,782 | $84 | $329.08 | $2,964.71 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | $382 | $158.02 | $24.7 | $158.74 | $3,039.8 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | $614 | $138.94 | $29.69 | $244.5 | $3,039.8 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | $715 | $426.35 | $85.86 | $314.15 | $3,039.8 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | $470 | $279.07 | $134.4 | $395.09 | $3,911.52 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | $963 | $352.41 | $122.15 | $420.62 | $3,911.52 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 15 | $69,921 | $34,960 | $607.5 | $1,536.42 | $45,729 |
| Hip hemiarthroplasty | CPT | 27125 | 15 | $2,730 | $1,627.9 | $449.32 | $1,199.41 | $33,484 |
| Total hip replacement | CPT | 27130 | 15 | $3,465 | $2,066.18 | $579.91 | $1,429.94 | $33,484 |
| Total knee replacement | CPT | 27447 | 15 | $3,699 | $2,205.71 | $623 | $1,428.32 | $33,484 |
| Knee revision arthroplasty single component | CPT | 27486 | 15 | $3,227 | $1,924.26 | $568.34 | $1,493.78 | $41,966 |
| Knee revision arthroplasty all components | CPT | 27487 | 15 | $4,224 | $2,518.77 | $716.69 | $1,861.6 | $57,314 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | $4,947 | $2,474 | $122.11 | $180.46 | $1,368 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | $27,162 | $13,581 | $442.28 | $1,141.68 | $23,719 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | $12,336 | $6,168 | $256.22 | $582.6 | $10,695 |
| ACL reconstruction | CPT | 29888 | 15 | $2,383 | $1,420.98 | $399.19 | $1,039.92 | $23,719 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 6 | — | $43,484 | $23,824 | $43,484 | $43,484 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 6 | — | $22,846 | $12,425 | $22,846 | $22,846 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 6 | — | $16,143 | $8,722.47 | $16,143 | $16,143 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $1,294.44 | $1,294.44 | $1,294.44 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $1,532.32 | $1,532.32 | $1,532.32 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $1,661.52 | $1,661.52 | $1,661.52 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $1,789.51 | $1,789.51 | $1,789.51 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 6 | — | $16,225 | $8,767.56 | $16,225 | $16,225 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 6 | — | $13,168 | $7,078.94 | $13,168 | $13,168 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 6 | — | $32,323 | $17,659 | $32,323 | $32,323 |
| Open appendectomy | CPT | 44950 | 15 | $1,423 | $848.53 | $242.82 | $661.5 | $21,161 |
| Laparoscopic appendectomy | CPT | 44970 | 15 | $1,361 | $807.99 | $222.75 | $619.73 | $19,761 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | — | $28,814 | $15,721 | $28,814 | $28,814 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 6 | — | $18,452 | $9,997.49 | $18,452 | $18,452 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | $1,490 | $884.31 | $277.43 | $676.05 | $19,761 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 15 | $1,619 | $965.41 | $285.86 | $736.75 | $19,761 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | — | $27,680 | $15,094 | $27,680 | $27,680 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 6 | — | $20,006 | $10,856 | $20,006 | $20,006 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 6 | — | $15,656 | $8,453.47 | $15,656 | $15,656 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | $987 | $588.55 | $160.98 | $444.99 | $19,761 |
| Total abdominal hysterectomy | CPT | 58150 | 15 | $2,424 | $1,445.43 | $395.94 | $912.56 | $2,487.84 |
| Vaginal hysterectomy | CPT | 58260 | 15 | $2,246 | $1,339.29 | $332.51 | $858.48 | $16,352 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | $2,149 | $1,281.45 | $356.6 | $903.73 | $19,761 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 15 | $2,388 | $1,423.96 | $392.54 | $1,006.04 | $34,746 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | $1,566 | $933.81 | $260.86 | $674.38 | $19,761 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 6 | — | $27,446 | $14,965 | $27,446 | $27,446 |
| OR procedure for obesity w CC | MS-DRG | 620 | 6 | — | $15,368 | $8,294.35 | $15,368 | $15,368 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 6 | — | $14,506 | $7,818.04 | $14,506 | $14,506 |
| Complex cataract surgery | CPT | 66982 | 11 | — | — | $551.8 | $3,085.36 | $7,543.7 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | — | — | $607.2 | $3,085.36 | $7,543.7 |
| Intravitreal injection | CPT | 67028 | 11 | — | — | $230 | $454.84 | $1,512 |
| Vitrectomy mechanical | CPT | 67042 | 11 | — | — | $761.61 | $5,526.02 | $13,511 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 6 | — | $11,994 | $6,430.55 | $11,994 | $11,994 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 6 | — | $19,580 | $10,620 | $19,580 | $19,580 |
| PCI single major coronary artery | CPT | 92920 | 10 | — | — | $284.77 | $7,609.12 | $18,604 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | — | — | $316.15 | $15,434 | $37,735 |
| PCI bypass graft | CPT | 92937 | 10 | — | — | $513.89 | $15,434 | $37,735 |
| Left heart catheterization | CPT | 93452 | 10 | — | — | $741.08 | $4,334.18 | $10,597 |
| Coronary angiography with cath | CPT | 93455 | 10 | — | — | $892.38 | $4,334.18 | $10,597 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | — | — | $922.59 | $4,334.18 | $10,597 |
Payer mix (top 17)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 194 | $216.72 |
| UnitedHealthcare | 190 | $129.08 |
| Medicare | 189 | $234.5 |
| Aetna | 189 | $286.5 |
| total senior care 1319 | 183 | $466.41 |
| Humana | 183 | $466.41 |
| Cigna | 149 | $244.27 |
| upmc health plan 5138 | 144 | $177.98 |
| Empire BCBS | 144 | $420.02 |
| mvp 2900 | 143 | $393.46 |
| independent health 5156 | 142 | $148.5 |
| Medicaid | 138 | $103.02 |
| fidelis 5155 | 138 | $103.82 |
| capital district physicians health plan (cdphp) 5149 | 83 | $277.8 |
| excellus 2201 | 83 | $131.6 |
| univera healthcare 1706 | 79 | $72.72 |
| Molina | 79 | $136.35 |