▸ Hospital · MS · CCN 250060
JEFFERSON COUNTY HOSPITAL
809 S. MAIN STREET, FAYETTE, MS, 39069-0577
12 beds9
Compliance grade
A
100/100
Procedures tracked
198
of 209 target codes
Payers
14
with negotiated rates
Rates published
5,129
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 13 | — | $2,486.25 | $57 | $92 | $28,633 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 14 | — | — | $35.1 | $87.5 | $584.24 |
| Psychiatric eval with medical services | CPT | 90792 | 14 | — | — | $35.1 | $87.5 | $584.24 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | — | — | $35.1 | $80 | $94 |
| Psychotherapy 45 minutes | CPT | 90834 | 13 | — | — | $35.1 | $80 | $94 |
| Psychotherapy 60 minutes | CPT | 90837 | 13 | — | — | $35.1 | $80 | $94 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 13 | — | — | $35.1 | $80 | $94 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $233 | $81.78 | $97.86 | $192.23 | $219.02 |
| ED visit level 2 | CPT | 99282 | 12 | $456 | $160.05 | $191.52 | $376.2 | $428.64 |
| ED visit level 3 | CPT | 99283 | 12 | $846 | $296.94 | $355.32 | $697.95 | $795.24 |
| ED visit level 4 | CPT | 99284 | 12 | $1,172 | $411.37 | $492.24 | $966.9 | $1,101.68 |
| ED visit level 5 | CPT | 99285 | 12 | $1,580 | $554.58 | $663.6 | $1,303.5 | $1,485.2 |
| Critical care, first hour | CPT | 99291 | 12 | $2,071 | $726.92 | $158.76 | $612.57 | $1,946.74 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $3,190 | $1,119.69 | $437.58 | $2,073.5 | $2,998.6 |
| CT head with contrast | CPT | 70460 | 13 | $3,430 | $1,203.93 | $437.58 | $2,229.5 | $3,224.2 |
| CT head with and without contrast | CPT | 70470 | 13 | $3,675 | $1,289.92 | $437.58 | $2,388.75 | $3,454.5 |
| CT neck with contrast | CPT | 70491 | 13 | $3,167 | $1,111.61 | $922.67 | $2,058.55 | $2,976.98 |
| MRI brain without contrast | CPT | 70551 | 14 | — | — | $35.1 | $87.5 | $2,439.26 |
| MRI brain with contrast | CPT | 70552 | 14 | — | — | $35.1 | $87.5 | $2,439.26 |
| MRI brain with and without contrast | CPT | 70553 | 14 | — | — | $35.1 | $87.5 | $2,439.26 |
| Chest X-ray single view | CPT | 71045 | 13 | $611 | $214.46 | $84.89 | $258.3 | $574.34 |
| Chest X-ray 2 views | CPT | 71046 | 13 | $484 | $169.88 | $84.89 | $313.65 | $454.96 |
| Chest X-ray 3 views | CPT | 71047 | 14 | — | — | $35.1 | $84.89 | $94 |
| CT chest without contrast | CPT | 71250 | 13 | $2,862 | $1,004.56 | $922.67 | $1,860.3 | $2,690.28 |
| CT chest with contrast | CPT | 71260 | 13 | $3,566 | $1,251.66 | $922.67 | $2,317.9 | $3,352.04 |
| CT chest with and without contrast | CPT | 71270 | 13 | $4,057 | $1,424 | $922.67 | $2,637.05 | $3,813.58 |
| MRI chest without contrast | CPT | 71550 | 14 | — | — | $35.1 | $87.5 | $3,195.03 |
| MRI chest with contrast | CPT | 71551 | 14 | — | — | $35.1 | $87.5 | $3,195.03 |
| MRI chest with and without contrast | CPT | 71552 | 14 | — | — | $35.1 | $87.5 | $3,195.03 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $522 | $183.22 | $84.89 | $339.3 | $490.68 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $3,042 | $1,067.74 | $767.01 | $1,977.3 | $2,859.48 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $2,963 | $1,040.01 | $767.01 | $1,925.95 | $2,785.22 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $2,963 | $1,040.01 | $767.01 | $1,925.95 | $2,785.22 |
| MRI cervical spine without contrast | CPT | 72141 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| MRI cervical spine with and without contrast | CPT | 72156 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | — | — | $35.1 | $87.5 | $1,376.37 |
| CT pelvis without contrast | CPT | 72192 | 13 | $2,893 | $1,015.44 | $1,133.17 | $1,880.45 | $2,719.42 |
| CT pelvis with contrast | CPT | 72193 | 13 | $3,100 | $1,088.1 | $1,133.17 | $2,015 | $2,914 |
| Shoulder X-ray | CPT | 73030 | 13 | $848 | $551.2 | $84.89 | $281.45 | $407.02 |
| Humerus X-ray | CPT | 73060 | 13 | $791 | $277.64 | $84.89 | $427.14 | $743.54 |
| Hand X-ray 3 views | CPT | 73130 | 13 | $744 | $483.6 | $84.89 | $247.65 | $358.14 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | — | — | $35.1 | $87.5 | $1,553.85 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 14 | — | — | $35.1 | $87.5 | $1,553.85 |
| Knee X-ray 1-2 views | CPT | 73560 | 13 | $810 | $526.5 | $84.89 | $267.8 | $387.28 |
| Ankle X-ray 3 views | CPT | 73610 | 13 | $751 | $488.15 | $84.89 | $249.6 | $360.96 |
| MRI lower extremity joint without contrast | CPT | 73721 | 14 | — | — | $35.1 | $87.5 | $1,553.85 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 14 | — | — | $35.1 | $87.5 | $1,553.85 |
| CT abdomen without contrast | CPT | 74150 | 13 | $2,940 | $1,031.94 | $1,133.17 | $1,911 | $2,763.6 |
| CT abdomen with contrast | CPT | 74160 | 13 | $3,510 | $1,232.01 | $1,133.17 | $2,281.5 | $3,299.4 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $3,630 | $1,274.13 | $1,133.17 | $2,359.5 | $3,412.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $4,709 | $1,652.85 | $1,133.17 | $3,202.12 | $4,426.46 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $5,093 | $1,787.64 | $1,133.17 | $3,463.24 | $4,787.42 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $5,093 | $1,787.64 | $1,133.17 | $3,316.8 | $4,787.42 |
| MRI abdomen without contrast | CPT | 74181 | 14 | — | — | $35.1 | $87.5 | $3,646.16 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | — | — | $35.1 | $87.5 | $3,646.16 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $1,097 | $385.04 | $413.95 | $713.05 | $1,031.18 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $1,304 | $457.7 | $413.95 | $847.6 | $1,225.76 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 13 | $1,089 | $382.23 | $413.95 | $707.85 | $1,023.66 |
| Obstetric ultrasound first trimester | CPT | 76801 | 13 | $654 | $229.55 | $274.68 | $425.1 | $614.76 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 13 | $654 | $229.55 | $274.68 | $425.1 | $614.76 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 14 | — | — | $35.1 | $87.5 | $316.69 |
| Transvaginal ultrasound | CPT | 76830 | 13 | $937 | $328.88 | $393.54 | $637.16 | $880.78 |
| Pelvic ultrasound complete | CPT | 76856 | 13 | $1,008 | $353.8 | $413.95 | $655.2 | $947.52 |
| Scrotal ultrasound | CPT | 76870 | 13 | $674 | $236.57 | $283.08 | $539.2 | $649.93 |
| Diagnostic mammography unilateral | CPT | 77065 | 14 | — | — | $35.1 | $87.5 | $938.37 |
| Diagnostic mammography bilateral | CPT | 77066 | 14 | — | — | $35.1 | $87.5 | $938.37 |
| Screening mammography bilateral | CPT | 77067 | 14 | — | — | $35.1 | $87.5 | $938.37 |
| EKG complete | CPT | 93000 | 14 | — | — | $35.1 | $59.5 | $94 |
| EKG tracing only | CPT | 93005 | 13 | $500 | $175.5 | $36.97 | $270 | $470 |
| EKG interpretation only | CPT | 93010 | 13 | — | — | $35.1 | $80 | $94 |
| Transthoracic echocardiogram complete | CPT | 93306 | 13 | $3,305 | $1,160.05 | $984.09 | $2,148.25 | $3,106.7 |
| Transthoracic echocardiogram | CPT | 93307 | 14 | — | — | $35.1 | $87.5 | $1,545.09 |
| Stress echocardiogram | CPT | 93350 | 14 | — | — | $35.1 | $87.5 | $1,545.09 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 13 | — | $2,486.25 | $57 | $92 | $42,709 |
| COPD w MCC | MS-DRG | 190 | 13 | — | $2,486.25 | $57 | $92 | $26,013 |
| COPD w CC | MS-DRG | 191 | 13 | — | $2,486.25 | $57 | $92 | $20,439 |
| COPD w/o CC/MCC | MS-DRG | 192 | 13 | — | $2,486.25 | $57 | $92 | $16,083 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 13 | — | $2,486.25 | $57 | $92 | $19,974 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 13 | — | $2,486.25 | $57 | $92 | $15,391 |
| AMI discharged alive w MCC | MS-DRG | 280 | 13 | — | $2,486.25 | $57 | $92 | $37,638 |
| AMI discharged alive w CC | MS-DRG | 281 | 13 | — | $2,486.25 | $57 | $92 | $21,573 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 13 | — | $2,486.25 | $57 | $92 | $16,792 |
| Heart failure & shock w MCC | MS-DRG | 291 | 13 | — | $2,486.25 | $57 | $92 | $31,035 |
| Heart failure & shock w CC | MS-DRG | 292 | 13 | — | $2,486.25 | $57 | $92 | $20,717 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 13 | — | $2,486.25 | $57 | $92 | $15,104 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 13 | — | $2,486.25 | $57 | $92 | $27,758 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 13 | — | $2,486.25 | $57 | $92 | $17,345 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 13 | — | $2,486.25 | $57 | $92 | $12,924 |
| GI hemorrhage w CC | MS-DRG | 378 | 13 | — | $2,486.25 | $57 | $92 | $22,988 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 13 | — | $2,486.25 | $57 | $92 | $14,746 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 13 | — | $2,486.25 | $57 | $92 | $17,692 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 13 | — | $2,486.25 | $57 | $92 | $32,695 |
| Kidney/UTI w MCC | MS-DRG | 689 | 13 | — | $2,486.25 | $57 | $92 | $25,721 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 13 | — | $2,486.25 | $57 | $92 | $18,335 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 13 | — | $2,486.25 | $57 | $92 | $43,239 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 13 | — | $2,486.25 | $57 | $92 | $23,645 |
| Initial hospital care, low complexity | CPT | 99221 | 12 | $115 | $40.36 | $48.3 | $94.88 | $108.1 |
| Initial hospital care, moderate complexity | CPT | 99222 | 12 | $181 | $63.53 | $76.02 | $149.33 | $170.14 |
| Initial hospital care, high complexity | CPT | 99223 | 12 | $241 | $84.59 | $101.22 | $198.83 | $226.54 |
| Hospital discharge, <30 min | CPT | 99238 | 12 | $113 | $39.66 | $47.46 | $93.23 | $106.22 |
| Hospital discharge, >30 min | CPT | 99239 | 12 | $159 | $55.8 | $66.78 | $131.18 | $149.46 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $90.09 | $31.62 | $5.08 | $58.55 | $84.68 |
| General health panel | CPT | 80050 | 14 | — | — | $35.1 | $59.5 | $94 |
| Electrolyte panel | CPT | 80051 | 13 | $114.66 | $40.24 | $4.21 | $74.52 | $107.78 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $120.54 | $42.3 | $6.34 | $41.91 | $113.3 |
| Lipid panel | CPT | 80061 | 13 | $84 | $29.48 | $8.03 | $58.3 | $78.96 |
| Renal function panel | CPT | 80069 | 13 | $292 | $102.49 | $5.21 | $189.8 | $274.48 |
| Hepatic function panel | CPT | 80076 | 13 | $175 | $61.42 | $4.9 | $113.75 | $164.5 |
| Urinalysis non-automated | CPT | 81002 | 13 | $33 | $11.58 | $2.09 | $21.45 | $31.02 |
| Urinalysis automated | CPT | 81003 | 13 | $53.66 | $18.83 | $1.35 | $34.87 | $50.44 |
| Glucose quantitative | CPT | 82947 | 13 | $94.92 | $33.31 | $2.36 | $61.69 | $89.22 |
| Hemoglobin A1c | CPT | 83036 | 13 | $164 | $57.56 | $5.83 | $106.6 | $154.16 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $132.41 | $46.47 | $10.08 | $63.12 | $124.46 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $70 | $24.57 | $4.66 | $45.5 | $65.8 |
| Complete blood count without differential | CPT | 85027 | 13 | $59.54 | $20.89 | $3.88 | $38.7 | $55.96 |
| Urine culture bacterial | CPT | 87086 | 13 | $106 | $37.2 | $4.84 | $76.84 | $99.64 |
| Urine culture identification | CPT | 87088 | 13 | $54 | $18.95 | $4.85 | $35.1 | $50.76 |
| Tissue exam by pathologist level IV | CPT | 88305 | 13 | $149 | $52.29 | $62.58 | $96.85 | $140.06 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | — | — | $35.1 | $87.5 | $688.68 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 13 | — | — | $35.1 | $80 | $94 |
| Vaginal delivery only | CPT | 59409 | 14 | — | — | $35.1 | $87.5 | $7,932 |
| Vaginal delivery with postpartum | CPT | 59410 | 14 | — | — | $35.1 | $87.5 | $7,932 |
| Routine obstetric care with C-section | CPT | 59510 | 13 | — | — | $35.1 | $80 | $94 |
| C-section delivery only | CPT | 59514 | 14 | — | — | $35.1 | $87.5 | $21,359 |
| C-section with postpartum | CPT | 59515 | 13 | — | — | $35.1 | $80 | $94 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 13 | — | — | $35.1 | $80 | $94 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | — | — | $35.1 | $80 | $94 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | — | — | $35.1 | $80 | $94 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | — | — | $35.1 | $80 | $94 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $589 | $206.73 | $40.74 | $92.82 | $553.66 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $146 | $51.24 | $58.38 | $117.48 | $137.24 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $218 | $76.51 | $87.36 | $175.6 | $204.92 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $291 | $102.14 | $116.34 | $234.13 | $273.54 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 12 | $365 | $128.11 | $146.16 | $293.9 | $343.1 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $2,302 | $808 | $966.84 | $2,071.8 | $3,949.64 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $1,989 | $698.13 | $835.38 | $1,790.1 | $3,949.64 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | — | — | $35.1 | $87.5 | $5,148.03 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | — | — | $35.1 | $87.5 | $5,664.44 |
| Colonoscopy diagnostic | CPT | 45378 | 14 | — | — | $35.1 | $87.5 | $4,113.57 |
| Colonoscopy with biopsy | CPT | 45380 | 14 | — | — | $35.1 | $87.5 | $4,113.57 |
| Colonoscopy with polyp removal | CPT | 45385 | 14 | — | — | $35.1 | $87.5 | $6,688.74 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $35.1 | $87.5 | $53,188 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $49,305 | $51,899 | $72,344 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $31,362 | $33,012 | $46,017 |
| Hip hemiarthroplasty | CPT | 27125 | 14 | — | — | $35.1 | $87.5 | $26,362 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $35.1 | $87.5 | $53,188 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $35.1 | $87.5 | $53,188 |
| Knee revision arthroplasty single component | CPT | 27486 | 14 | — | — | $35.1 | $87.5 | $26,362 |
| Knee revision arthroplasty all components | CPT | 27487 | 14 | — | — | $35.1 | $87.5 | $26,362 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 14 | — | — | $35.1 | $87.5 | $15,878 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 14 | — | — | $35.1 | $87.5 | $34,938 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 14 | — | — | $35.1 | $87.5 | $15,878 |
| ACL reconstruction | CPT | 29888 | 14 | — | — | $35.1 | $87.5 | $34,938 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 13 | — | $2,486.25 | $57 | $92 | $112,260 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 13 | — | $2,486.25 | $57 | $92 | $58,765 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 13 | — | $2,486.25 | $57 | $92 | $39,580 |
| CABG single arterial graft | CPT | 33533 | 14 | — | — | $35.1 | $87.5 | $55,275 |
| CABG 2 arterial grafts | CPT | 33534 | 14 | — | — | $35.1 | $87.5 | $55,275 |
| CABG 3 arterial grafts | CPT | 33535 | 14 | — | — | $35.1 | $87.5 | $55,275 |
| CABG 4+ arterial grafts | CPT | 33536 | 14 | — | — | $35.1 | $87.5 | $55,275 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 13 | — | $2,486.25 | $57 | $92 | $39,071 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 13 | — | $2,486.25 | $57 | $92 | $30,440 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 13 | — | $2,486.25 | $57 | $92 | $81,334 |
| Open appendectomy | CPT | 44950 | 14 | — | — | $35.1 | $87.5 | $16,912 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $35.1 | $87.5 | $22,203 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $106,187 | $111,775 | $155,808 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $62,034 | $65,299 | $91,022 |
| Major joint replacement w MCC | MS-DRG | 469 | 13 | — | $2,486.25 | $57 | $92 | $71,388 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 13 | — | $2,486.25 | $57 | $92 | $43,973 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $35.1 | $87.5 | $22,203 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $35.1 | $87.5 | $24,791 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 13 | — | $2,486.25 | $57 | $92 | $70,002 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 13 | — | $2,486.25 | $57 | $92 | $48,500 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 13 | — | $2,486.25 | $57 | $92 | $38,115 |
| Lap inguinal hernia repair | CPT | 49650 | 14 | — | — | $35.1 | $87.5 | $22,203 |
| Total abdominal hysterectomy | CPT | 58150 | 14 | — | — | $35.1 | $87.5 | $21,359 |
| Vaginal hysterectomy | CPT | 58260 | 14 | — | — | $35.1 | $87.5 | $21,359 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 14 | — | — | $35.1 | $87.5 | $24,791 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $35.1 | $87.5 | $24,791 |
| Lap salpingo-oophorectomy | CPT | 58661 | 14 | — | — | $35.1 | $87.5 | $22,203 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 13 | — | $2,486.25 | $57 | $92 | $70,849 |
| OR procedure for obesity w CC | MS-DRG | 620 | 13 | — | $2,486.25 | $57 | $92 | $40,761 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 13 | — | $2,486.25 | $57 | $92 | $36,949 |
| Complex cataract surgery | CPT | 66982 | 14 | — | — | $35.1 | $87.5 | $10,948 |
| Cataract surgery with lens implant | CPT | 66984 | 14 | — | — | $35.1 | $87.5 | $10,948 |
| Intravitreal injection | CPT | 67028 | 14 | — | — | $35.1 | $87.5 | $266.88 |
| Vitrectomy mechanical | CPT | 67042 | 14 | — | — | $35.1 | $87.5 | $22,316 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 13 | — | $2,486.25 | $57 | $92 | $26,207 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 13 | — | $2,486.25 | $57 | $92 | $41,522 |
| PCI single major coronary artery | CPT | 92920 | 14 | — | — | $35.1 | $87.5 | $56,656 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | — | — | $35.1 | $87.5 | $56,656 |
| PCI bypass graft | CPT | 92937 | 14 | — | — | $35.1 | $87.5 | $56,656 |
| Left heart catheterization | CPT | 93452 | 14 | — | — | $35.1 | $87.5 | $7,209.44 |
| Coronary angiography with cath | CPT | 93455 | 14 | — | — | $35.1 | $87.5 | $7,209.44 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | — | — | $35.1 | $87.5 | $7,209.44 |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 194 | $68 |
| preferred community choice | 194 | $92 |
| Aetna | 194 | $85 |
| Cigna | 194 | $90 |
| First Health | 194 | $90 |
| friday health plan | 194 | $78.36 |
| healthcare highways | 194 | $65 |
| healthsmart | 194 | $94 |
| Humana | 194 | $79.65 |
| medica | 194 | $61.95 |
| oklahoma health network (ohn) | 194 | $80 |
| osma health | 194 | $90 |
| Blue Cross Blue Shield | 170 | $3,236.94 |
| Self-Pay (Cash) | 84 | $35.1 |