Holmdel, NJ, 07733
The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.
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vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | vs nat'l | Neg max |
|---|---|---|---|---|---|---|---|---|---|
| behavioral | |||||||||
| Psychoses | MS-DRG | 885 | 15 | — | $11,958 | $2,297 | $11,208 | 0.87× | $53,266 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 6 | — | $16,875 | $5,778 | $36,534 | 1.8× | $79,174 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 6 | — | $8,626.85 | $5,778 | $20,161 | 1.9× | $43,691 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 6 | — | $5,839.18 | $5,056.93 | $14,205 | 1.9× | $30,785 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 14 | — | $13,714 | $5,778 | $14,396 | 0.93× | $77,971 |
| COPD w MCC | MS-DRG | 190 | 14 | — | $9,526.95 | $5,778 | $10,001 | 0.89× | $50,434 |
| COPD w CC | MS-DRG | 191 | 14 | — | $7,288.16 | $5,778 | $7,708 | 0.87× | $38,710 |
| COPD w/o CC/MCC | MS-DRG | 192 | 14 | — | $5,490.51 | $4,754.97 | $6,175.48 | 0.88× | $30,671 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 14 | — | $6,956.45 | $5,778 | $7,708 | 0.91× | $38,130 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 14 | — | $5,282.66 | $4,574.97 | $5,941.7 | 0.89× | $29,091 |
| AMI discharged alive w MCC | MS-DRG | 280 | 14 | — | $13,925 | $5,778 | $14,618 | 0.93× | $70,190 |
| AMI discharged alive w CC | MS-DRG | 281 | 14 | — | $7,820.07 | $5,778 | $8,209.3 | 0.85× | $41,493 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 14 | — | $6,151.37 | $5,322.81 | $6,918.79 | 0.89× | $31,725 |
| Heart failure & shock w MCC | MS-DRG | 291 | 14 | — | $11,069 | $5,778 | $11,620 | 0.91× | $56,987 |
| Heart failure & shock w CC | MS-DRG | 292 | 14 | — | $7,305.97 | $5,778 | $7,708 | 0.86× | $38,960 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 14 | — | $4,654.89 | $4,031.29 | $5,778 | 0.93× | $28,193 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 14 | — | $10,230 | $5,778 | $10,739 | 0.89× | $50,981 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 14 | — | $6,271.84 | $5,431.63 | $7,054.28 | 0.91× | $32,340 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 14 | — | $4,746.51 | $4,096.84 | $5,778 | 0.93× | $23,817 |
| GI hemorrhage w CC | MS-DRG | 378 | 14 | — | $8,363.86 | $5,778 | $8,780.15 | 0.88× | $41,946 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 14 | — | $5,401.43 | $4,674.24 | $6,075.29 | 0.89× | $27,668 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 14 | — | $6,619.66 | $5,608.21 | $7,445.51 | 0.93× | $31,996 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 14 | — | $12,936 | $5,778 | $13,580 | 0.89× | $64,827 |
| Kidney/UTI w MCC | MS-DRG | 689 | 14 | — | $9,928.22 | $5,778 | $10,422 | 0.90× | $47,084 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 14 | — | $6,808.84 | $5,778 | $7,658.28 | 0.92× | $33,636 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 14 | — | $16,645 | $5,778 | $17,474 | 0.94× | $78,632 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 14 | — | $8,746.47 | $5,778 | $9,181.8 | 0.89× | $44,598 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $22,932 | $22,932 | 0.83× | $22,932 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $14,587 | $14,587 | 0.80× | $14,587 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 14 | — | $38,955 | $6,542 | $40,894 | 0.95× | $211,476 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 14 | — | $20,052 | $6,542 | $21,050 | 0.91× | $106,879 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 14 | — | $14,006 | $6,542 | $14,703 | 0.90× | $71,782 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 14 | — | $14,069 | $6,542 | $14,769 | 0.90× | $70,491 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 14 | — | $11,178 | $6,542 | $11,734 | 0.87× | $55,242 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 14 | — | $29,942 | $6,542 | $31,433 | 0.97× | $148,995 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $49,390 | $49,390 | 1.00× | $49,390 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $28,853 | $28,853 | 0.86× | $28,853 |
| Major joint replacement w MCC | MS-DRG | 469 | 14 | — | $27,730 | $6,542 | $29,110 | 0.98× | $134,450 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 14 | — | $15,996 | $6,542 | $16,792 | 0.89× | $84,282 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 14 | — | $24,950 | $6,542 | $26,192 | 0.94× | $128,359 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 14 | — | $17,602 | $6,542 | $18,479 | 0.91× | $87,353 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 14 | — | $13,458 | $6,542 | $14,128 | 0.88× | $70,503 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 15 | — | $23,130 | $6,542 | $26,016 | 0.96× | $123,712 |
| OR procedure for obesity w CC | MS-DRG | 620 | 15 | — | $13,548 | $6,542 | $15,238 | 0.94× | $76,649 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 15 | — | $12,401 | $6,542 | $13,948 | 0.92× | $66,852 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 14 | — | $10,169 | $6,542 | $10,675 | 0.87× | $47,253 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 14 | — | $16,577 | $6,542 | $17,402 | 0.91× | $73,838 |
| Payer | Codes covered | Median rate |
|---|---|---|
| amerihealth | 47 | $9,837.85 |
| horizon | 43 | $17,441 |
| oxford | 43 | $40,254 |
| vaccn | 43 | $9,586.35 |
| brighton health plan | 43 | $40,926 |
| UnitedHealthcare | 43 | $16,314 |
| seoul medical group | 40 | $11,677 |
| WellCare | 40 | $10,426 |
| amerigroup | 40 | $10,426 |
| Blue Cross Blue Shield | 40 | $10,426 |
| Cigna | 40 | $37,670 |
| clover | 40 | $11,469 |
| karna | 40 | $15,577 |
| Aetna | 40 | $20,227 |
| qualcare | 4 | $42,304 |
