▸ Hospital · NE · CCN 280061
Regional West Medical Center
4021 AVENUE B, SCOTTSBLUFF, NE, 69361
121 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
12
with negotiated rates
Rates published
36,717
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 | — | — | $13,278 | $13,942 | $33,360 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $333.14 | $199.89 | $136.22 | $192.04 | $308.43 |
| Psychiatric eval with medical services | CPT | 90792 | 12 | $377 | $226.2 | $154.66 | $231.99 | $349.83 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $153.01 | $91.81 | $68.93 | $119.16 | $276.47 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $202.53 | $121.52 | $91 | $164.12 | $276.47 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $298.89 | $179.34 | $134.22 | $188.92 | $278.52 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 12 | $425.06 | $255.04 | $128.28 | $199.39 | $354.22 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $382 | $229.2 | $10.27 | $91.94 | $842 |
| ED visit level 2 | CPT | 99282 | 12 | $711 | $426.6 | $37.69 | $167.41 | $1,125 |
| ED visit level 3 | CPT | 99283 | 12 | $1,361 | $816.6 | $64.6 | $297.63 | $2,107 |
| ED visit level 4 | CPT | 99284 | 12 | $1,820 | $1,092 | $109.81 | $454.95 | $2,809 |
| ED visit level 5 | CPT | 99285 | 12 | $2,890 | $1,734 | $159.7 | $649.32 | $3,163 |
| Critical care, first hour | CPT | 99291 | 12 | $5,288 | $3,172.8 | $186.94 | $900.63 | $4,917.84 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 12 | $3,055 | $1,833 | $37.6 | $117.38 | $2,841.15 |
| CT head with contrast | CPT | 70460 | 12 | $3,446 | $2,067.6 | $49.65 | $182.14 | $3,204.78 |
| CT head with and without contrast | CPT | 70470 | 12 | $4,119 | $2,471.4 | $55.87 | $200.22 | $3,830.67 |
| CT neck with contrast | CPT | 70491 | 12 | $3,812 | $2,287.2 | $60.77 | $210.18 | $3,545.16 |
| MRI brain without contrast | CPT | 70551 | 12 | $5,150 | $3,090 | $64.83 | $247.76 | $4,789.5 |
| MRI brain with contrast | CPT | 70552 | 12 | $5,583 | $3,349.8 | $78.37 | $362.27 | $5,192.19 |
| MRI brain with and without contrast | CPT | 70553 | 12 | $6,540 | $3,924 | $100.48 | $380.19 | $6,082.2 |
| Chest X-ray single view | CPT | 71045 | 12 | $320 | $192 | $7.99 | $33.87 | $297.6 |
| Chest X-ray 2 views | CPT | 71046 | 12 | $510 | $306 | $9.61 | $44.79 | $474.3 |
| Chest X-ray 3 views | CPT | 71047 | 12 | $667.7 | $400.62 | $12.2 | $55.75 | $620.96 |
| CT chest without contrast | CPT | 71250 | 12 | $3,528 | $2,116.8 | $47.24 | $145.5 | $3,281.04 |
| CT chest with contrast | CPT | 71260 | 12 | $3,953 | $2,371.8 | $51.27 | $197.3 | $3,676.29 |
| CT chest with and without contrast | CPT | 71270 | 12 | $4,258 | $2,554.8 | $54.89 | $241.81 | $3,959.94 |
| MRI chest without contrast | CPT | 71550 | 12 | $4,000 | $2,400 | $63.73 | $410.19 | $3,720 |
| MRI chest with contrast | CPT | 71551 | 12 | — | — | $76.08 | $452.7 | $1,221.03 |
| MRI chest with and without contrast | CPT | 71552 | 12 | $7,325 | $4,395 | $99.17 | $622.36 | $6,812.25 |
| Lumbosacral spine X-ray | CPT | 72100 | 12 | $693.4 | $416.04 | $9.92 | $54.96 | $644.86 |
| CT cervical spine without contrast | CPT | 72125 | 12 | $3,682 | $2,209.2 | $44.28 | $147.27 | $3,424.26 |
| CT thoracic spine without contrast | CPT | 72128 | 12 | $3,818 | $2,290.8 | $44.28 | $146.68 | $3,550.74 |
| CT lumbar spine without contrast | CPT | 72131 | 12 | $3,787 | $2,272.2 | $44.28 | $146.09 | $3,521.91 |
| MRI cervical spine without contrast | CPT | 72141 | 12 | $4,900 | $2,940 | $65.14 | $247.76 | $4,557 |
| MRI thoracic spine without contrast | CPT | 72146 | 12 | $5,239 | $3,143.4 | $65.14 | $247.76 | $4,872.27 |
| MRI lumbar spine without contrast | CPT | 72148 | 12 | $5,214 | $3,128.4 | $65.45 | $247.76 | $4,849.02 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 12 | $5,944 | $3,566.4 | $78.68 | $362.27 | $5,527.92 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $6,381 | $3,828.6 | $100.79 | $380.38 | $5,934.33 |
| MRI lumbar spine with contrast | CPT | 72158 | 12 | $6,682 | $4,009.2 | $100.79 | $380.38 | $6,214.26 |
| CT pelvis without contrast | CPT | 72192 | 12 | $3,896.1 | $2,337.66 | $47.57 | $144.91 | $3,623.37 |
| CT pelvis with contrast | CPT | 72193 | 12 | $4,005 | $2,403 | $50.96 | $285.05 | $3,724.65 |
| Shoulder X-ray | CPT | 73030 | 12 | $75.04 | $45.03 | $8.6 | $34.74 | $135.55 |
| Humerus X-ray | CPT | 73060 | 12 | $561.4 | $336.84 | $7.63 | $44.46 | $522.1 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $604.1 | $362.46 | $8.27 | $53.3 | $561.81 |
| MRI upper extremity joint without contrast | CPT | 73221 | 12 | $582.9 | $349.74 | $60.39 | $220.62 | $564.66 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 12 | $4,956 | $2,973.6 | $95.09 | $496.85 | $4,609.08 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $534.5 | $320.7 | $7.63 | $47.7 | $497.09 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $585.3 | $351.18 | $7.96 | $51.44 | $544.33 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $3,405 | $2,043 | $60.08 | $249.61 | $3,166.65 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $4,778 | $2,866.8 | $94.78 | $494.51 | $4,443.54 |
| CT abdomen without contrast | CPT | 74150 | 12 | $3,817 | $2,290.2 | $52.27 | $142.58 | $3,549.81 |
| CT abdomen with contrast | CPT | 74160 | 12 | $4,334 | $2,600.4 | $55.87 | $293.99 | $4,030.62 |
| CT abdomen with and without contrast | CPT | 74170 | 12 | $5,399 | $3,239.4 | $61.44 | $307.88 | $5,021.07 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 12 | $6,256 | $3,753.6 | $76.42 | $247.22 | $5,818.08 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 12 | $7,839 | $4,703.4 | $79.93 | $380.38 | $7,290.27 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 12 | $8,306 | $4,983.6 | $88.56 | $425.74 | $7,724.58 |
| MRI abdomen without contrast | CPT | 74181 | 12 | $4,351 | $2,610.6 | $63.73 | $247.76 | $4,046.43 |
| MRI abdomen with and without contrast | CPT | 74183 | 12 | $6,299 | $3,779.4 | $96.88 | $410.74 | $5,858.07 |
| Abdominal ultrasound complete | CPT | 76700 | 12 | $1,472 | $883.2 | $35.83 | $130.59 | $1,368.96 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $1,043 | $625.8 | $26.23 | $134.66 | $969.99 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $1,430.6 | $858.36 | $32.57 | $122.66 | $1,330.46 |
| Obstetric ultrasound first trimester | CPT | 76801 | 12 | $940.2 | $564.12 | $44.44 | $118.17 | $874.39 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 12 | $1,145.9 | $687.54 | $44.75 | $147.85 | $1,065.69 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 12 | $455.81 | $273.49 | $83.93 | $170.77 | $405.66 |
| Transvaginal ultrasound | CPT | 76830 | 12 | $1,146.8 | $688.08 | $30.9 | $142.96 | $1,066.52 |
| Pelvic ultrasound complete | CPT | 76856 | 12 | $1,367.8 | $820.68 | $30.9 | $122.07 | $1,272.05 |
| Scrotal ultrasound | CPT | 76870 | 12 | $1,110 | $666 | $28.3 | $117.06 | $1,032.3 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $559 | $335.4 | $35.96 | $147.46 | $519.87 |
| Diagnostic mammography bilateral | CPT | 77066 | 12 | $423.52 | $254.12 | $44.28 | $149.24 | $376.92 |
| Screening mammography bilateral | CPT | 77067 | 12 | $493 | $295.8 | $33.55 | $155.72 | $458.49 |
| EKG complete | CPT | 93000 | 12 | $48.53 | $29.12 | $14.25 | $21.38 | $40.44 |
| EKG tracing only | CPT | 93005 | 12 | $437 | $262.2 | $6.29 | $62.79 | $406.41 |
| EKG interpretation only | CPT | 93010 | 12 | $18.86 | $11.32 | $7.96 | $11.94 | $16.28 |
| Transthoracic echocardiogram complete | CPT | 93306 | 12 | $3,638.3 | $2,182.98 | $65.02 | $243.01 | $3,383.62 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | — | — | $41.54 | $137.75 | $371.64 |
| Stress echocardiogram | CPT | 93350 | 12 | $2,277 | $1,366.2 | $65.02 | $212.94 | $2,117.61 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $19,085 | $20,039 | $48,029 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $9,623.71 | $10,105 | $24,129 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $6,648.38 | $6,980.8 | $16,346 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $14,846 | $15,589 | $37,322 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $10,545 | $11,072 | $26,455 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $8,042.01 | $8,444.11 | $20,133 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $6,330.67 | $6,647.2 | $15,333 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $7,691.23 | $8,075.79 | $19,247 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $6,229.52 | $6,541 | $15,010 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $15,238 | $16,000 | $38,311 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $8,761.48 | $9,199.55 | $21,951 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $6,938.34 | $7,285.26 | $17,270 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $12,209 | $12,820 | $30,661 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $8,098.72 | $8,503.66 | $20,277 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $5,761.22 | $6,049.28 | $13,518 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $11,455 | $12,028 | $28,755 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $7,032.76 | $7,384.4 | $17,571 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $5,761.97 | $6,050.07 | $13,520 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $9,343.86 | $9,811.05 | $23,422 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $6,243.77 | $6,555.96 | $15,056 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $7,442.61 | $7,814.74 | $18,619 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $14,894 | $15,638 | $37,441 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $11,042 | $11,594 | $27,711 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $7,725.28 | $8,111.54 | $19,333 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $18,437 | $19,359 | $46,393 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $9,746.61 | $10,234 | $24,439 |
| Initial hospital care, low complexity | CPT | 99221 | 12 | $209.38 | $125.63 | $69.48 | $104.22 | $186.34 |
| Initial hospital care, moderate complexity | CPT | 99222 | 12 | $284.89 | $170.94 | $110.4 | $165.6 | $259.39 |
| Initial hospital care, high complexity | CPT | 99223 | 12 | $422.12 | $253.28 | $148.18 | $222.28 | $375.69 |
| Hospital discharge, <30 min | CPT | 99238 | 12 | $173.7 | $104.22 | $70.73 | $106.1 | $161.87 |
| Hospital discharge, >30 min | CPT | 99239 | 12 | $245.51 | $147.31 | $100.96 | $151.44 | $228.79 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 12 | $221 | $132.6 | $7.1 | $15.03 | $205.53 |
| General health panel | CPT | 80050 | 9 | $665 | $399 | $22.98 | $545.3 | $618.45 |
| Electrolyte panel | CPT | 80051 | 12 | $151 | $90.6 | $5.88 | $14.29 | $140.43 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $276 | $165.6 | $8.86 | $19.09 | $256.68 |
| Lipid panel | CPT | 80061 | 12 | $220 | $132 | $11.23 | $23.71 | $204.6 |
| Renal function panel | CPT | 80069 | 12 | $301 | $180.6 | $7.28 | $17.69 | $279.93 |
| Hepatic function panel | CPT | 80076 | 12 | $205 | $123 | $6.85 | $16.65 | $190.65 |
| Urinalysis non-automated | CPT | 81002 | 12 | $7.72 | $4.64 | $3.28 | $3.72 | $6.37 |
| Urinalysis automated | CPT | 81003 | 12 | $78 | $46.8 | $2.25 | $4.06 | $72.54 |
| Glucose quantitative | CPT | 82947 | 12 | $95 | $57 | $3.88 | $20.35 | $88.35 |
| Hemoglobin A1c | CPT | 83036 | 12 | $139 | $83.4 | $8.14 | $41.24 | $129.27 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $219 | $131.4 | $14.08 | $63.97 | $203.67 |
| Complete blood count with automated differential | CPT | 85025 | 12 | $169 | $101.4 | $3.9 | $13.88 | $157.17 |
| Complete blood count without differential | CPT | 85027 | 12 | $139 | $83.4 | $5.42 | $12.36 | $129.27 |
| Urine culture bacterial | CPT | 87086 | 12 | $168 | $100.8 | $6.77 | $16.45 | $156.24 |
| Urine culture identification | CPT | 87088 | 12 | $168 | $100.8 | $6.79 | $16.48 | $156.24 |
| Tissue exam by pathologist level IV | CPT | 88305 | 12 | $415 | $249 | $32.19 | $66.25 | $385.95 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 12 | $761 | $456.6 | $19.24 | $64.12 | $707.73 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 12 | $4,885.34 | $2,931.21 | $1,947.13 | $2,920.8 | $4,552.53 |
| Vaginal delivery only | CPT | 59409 | 12 | $4,672.6 | $2,803.56 | $630 | $3,504.45 | $5,042.12 |
| Vaginal delivery with postpartum | CPT | 59410 | 12 | $2,161.62 | $1,296.98 | $852.05 | $1,278.17 | $2,014.37 |
| Routine obstetric care with C-section | CPT | 59510 | 12 | $5,377.58 | $3,226.55 | $2,151.82 | $3,227.73 | $5,011.23 |
| C-section delivery only | CPT | 59514 | 12 | $1,833.05 | $1,099.83 | $710.28 | $1,065.61 | $1,669.28 |
| C-section with postpartum | CPT | 59515 | 12 | $2,657.8 | $1,594.68 | $1,056.96 | $1,585.43 | $2,476.73 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $105.18 | $63.11 | $39.04 | $74.01 | $105.72 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 12 | $174.1 | $104.46 | $67.18 | $115.21 | $164.58 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 12 | $284.19 | $170.52 | $110.22 | $175.34 | $264.85 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 12 | $386.17 | $231.71 | $150.43 | $236.39 | $359.87 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $19.42 | $11.66 | $7.37 | $16.95 | $34.18 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $75.68 | $45.41 | $29.38 | $51.41 | $83.38 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 12 | $141.29 | $84.78 | $54.73 | $91.81 | $134.35 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 12 | $208.68 | $125.21 | $80.39 | $131.28 | $194.47 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 12 | $308.9 | $185.34 | $119.3 | $190 | $287.86 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $510 | $306 | $102.92 | $259.5 | $1,412.71 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $3,454.76 | $2,072.86 | $115.14 | $988.9 | $3,212.93 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $3,646.84 | $2,188.11 | $49.56 | $1,013.95 | $3,391.56 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $210 | $126 | $61.96 | $151.96 | $1,448.49 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $726.16 | $435.7 | $76.41 | $219.98 | $1,448.49 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $3,935.26 | $2,361.16 | $165.29 | $1,304.71 | $3,659.79 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $974.38 | $584.63 | $208.43 | $583.68 | $1,863.88 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | $45,975 | $27,585 | $1,176.31 | $19,117 | $42,757 |
| Hip hemiarthroplasty | CPT | 27125 | 12 | $2,813.34 | $1,688.01 | $935.16 | $2,120.4 | $19,997 |
| Total hip replacement | CPT | 27130 | 12 | $32,167 | $19,300 | $1,047.84 | $13,998 | $29,915 |
| Total knee replacement | CPT | 27447 | 12 | $3,364.01 | $2,018.41 | $1,046.35 | $2,512.26 | $19,997 |
| Knee revision arthroplasty single component | CPT | 27486 | 12 | $3,492.52 | $2,095.52 | $1,150.51 | $2,622.62 | $19,997 |
| Knee revision arthroplasty all components | CPT | 27487 | 12 | $4,367.04 | $2,620.23 | $1,419.13 | $3,263.16 | $27,311 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | $1,330.49 | $798.3 | $133.24 | $199.86 | $1,108.74 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | $2,643.83 | $1,586.3 | $884.7 | $2,009.93 | $11,302 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | $1,343.98 | $806.39 | $468.44 | $1,055.18 | $5,096.44 |
| ACL reconstruction | CPT | 29888 | 12 | $2,442.84 | $1,465.71 | $806.95 | $1,834.72 | $11,302 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $43,529 | $45,705 | $109,778 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $22,736 | $23,873 | $57,252 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $15,983 | $16,782 | $40,193 |
| CABG single arterial graft | CPT | 33533 | 12 | — | — | $1,559.05 | $2,338.68 | $4,080.63 |
| CABG 2 arterial grafts | CPT | 33534 | 12 | — | — | $1,827.52 | $2,741.28 | $4,796.56 |
| CABG 3 arterial grafts | CPT | 33535 | 12 | — | — | $2,026.7 | $3,040.05 | $5,350.24 |
| CABG 4+ arterial grafts | CPT | 33536 | 12 | — | — | $2,180.42 | $3,270.73 | $5,754.26 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $16,065 | $16,868 | $40,400 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $12,985 | $13,634 | $32,619 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $32,284 | $33,898 | $81,372 |
| Open appendectomy | CPT | 44950 | 12 | $1,578.83 | $947.3 | $538.01 | $1,178.2 | $10,084 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | $1,477.68 | $886.61 | $514.01 | $1,133.26 | $9,416.46 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $28,749 | $30,186 | $72,442 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $18,308 | $19,224 | $46,068 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | $1,617.02 | $970.22 | $560.81 | $1,214.33 | $9,416.46 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $18,917 | $11,350 | $606.92 | $6,591.52 | $17,593 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $27,606 | $28,986 | $69,554 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $19,874 | $20,868 | $50,023 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $15,492 | $16,267 | $38,953 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | $1,054.68 | $632.81 | $377.8 | $802.18 | $9,416.46 |
| Total abdominal hysterectomy | CPT | 58150 | 12 | $2,535.53 | $1,521.32 | $842.7 | $1,264.05 | $2,256.6 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $2,077.96 | $1,246.78 | $676.52 | $1,589.6 | $7,791.77 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | $2,205.17 | $1,323.11 | $716.19 | $1,669.85 | $9,416.46 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | $2,465.34 | $1,479.21 | $797.31 | $1,854.82 | $16,557 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | $1,626.4 | $975.84 | $530.75 | $1,232.82 | $9,416.46 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $27,370 | $28,739 | $68,960 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $15,202 | $15,962 | $38,220 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $14,333 | $15,050 | $36,025 |
| Complex cataract surgery | CPT | 66982 | 12 | — | — | $593.67 | $1,558.72 | $3,594.65 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | — | — | $435.9 | $1,123.41 | $3,594.65 |
| Intravitreal injection | CPT | 67028 | 12 | — | — | $71.27 | $203.39 | $514.48 |
| Vitrectomy mechanical | CPT | 67042 | 12 | $10,057 | $6,034.29 | $899.23 | $4,506.73 | $9,353.15 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $11,802 | $12,392 | $29,632 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $19,445 | $20,417 | $48,939 |
| PCI single major coronary artery | CPT | 92920 | 12 | — | — | $343.35 | $972.64 | $8,865.13 |
| PCI with drug-eluting stent | CPT | 92928 | 12 | — | — | $410.99 | $1,082.03 | $17,981 |
| PCI bypass graft | CPT | 92937 | 12 | — | — | $464.59 | $1,081.03 | $17,981 |
| Left heart catheterization | CPT | 93452 | 12 | — | — | $209.15 | $922.27 | $5,049.6 |
| Coronary angiography with cath | CPT | 93455 | 12 | — | — | $245.47 | $1,011.64 | $5,049.6 |
| Coronary angiography with bypass cath | CPT | 93458 | 12 | $22,485 | $13,491 | $259.51 | $1,390.01 | $20,911 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| medica | 197 | $195.88 |
| Aetna | 197 | $211.15 |
| UnitedHealthcare | 197 | $348.06 |
| naphcare | 197 | $222.27 |
| Ambetter | 197 | $239.16 |
| medica cost | 196 | $162.39 |
| Humana | 196 | $154.66 |
| WellCare | 196 | $162.39 |
| rci insurance group | 154 | $384.75 |
| Blue Cross Blue Shield | 154 | $325.7 |
| winhealth | 154 | $324.58 |
| Cigna | 154 | $385.45 |