▸ Hospital · NC · CCN 340021
Atrium Health Cleveland
201 EAST GROVER STREET, SHELBY, NC, 28150
308 bedsAcute Care Hospitals11
Compliance grade
A
100/100
Procedures tracked
198
of 209 target codes
Payers
28
with negotiated rates
Rates published
61,698
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $11,477 | $16,829 | $25,597 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 28 | $350.55 | $175.28 | $19.48 | $107.15 | $378.32 |
| Psychiatric eval with medical services | CPT | 90792 | 28 | $139.15 | $69.58 | $19.48 | $99.8 | $422.65 |
| Psychotherapy 30 minutes | CPT | 90832 | 28 | $162.95 | $81.48 | $22.81 | $88.98 | $164.66 |
| Psychotherapy 45 minutes | CPT | 90834 | 28 | $226.25 | $113.13 | $26.32 | $122.2 | $217.34 |
| Psychotherapy 60 minutes | CPT | 90837 | 28 | $219.4 | $109.7 | $30.72 | $133.95 | $321.15 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 28 | $219.4 | $109.7 | $30.72 | $122.43 | $350.62 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 28 | $356.65 | $178.33 | $10.53 | $178.33 | $1,552 |
| ED visit level 2 | CPT | 99282 | 28 | $657.15 | $328.58 | $36.65 | $297.63 | $1,552 |
| ED visit level 3 | CPT | 99283 | 28 | $3,038.1 | $1,519.05 | $54.86 | $1,301.75 | $2,886.2 |
| ED visit level 4 | CPT | 99284 | 28 | $3,181.25 | $1,590.63 | $104.11 | $1,377.48 | $3,022.19 |
| ED visit level 5 | CPT | 99285 | 28 | $3,364.05 | $1,682.03 | $153.4 | $1,404.49 | $3,195.85 |
| Critical care, first hour | CPT | 99291 | 28 | $5,617.85 | $2,808.93 | $197.56 | $2,345.46 | $5,336.96 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 28 | $2,537.8 | $1,268.9 | $35.42 | $753.22 | $2,410.91 |
| CT head with contrast | CPT | 70460 | 28 | $3,040.9 | $1,520.45 | $46.89 | $904.27 | $2,888.86 |
| CT head with and without contrast | CPT | 70470 | 28 | $3,884.8 | $1,942.4 | $52.71 | $1,021.55 | $3,690.56 |
| CT neck with contrast | CPT | 70491 | 28 | $3,334 | $1,667 | $57.15 | $989.53 | $3,167.3 |
| MRI brain without contrast | CPT | 70551 | 28 | $3,530.55 | $1,765.28 | $61.21 | $977.8 | $3,354.02 |
| MRI brain with contrast | CPT | 70552 | 28 | $4,534.45 | $2,267.23 | $73.83 | $1,201.63 | $4,307.73 |
| MRI brain with and without contrast | CPT | 70553 | 28 | $5,318.05 | $2,659.03 | $97.64 | $1,401.84 | $5,052.15 |
| Chest X-ray single view | CPT | 71045 | 28 | $373.65 | $186.83 | $7.67 | $93.05 | $354.97 |
| Chest X-ray 2 views | CPT | 71046 | 28 | $464.6 | $232.3 | $9.16 | $77.72 | $441.37 |
| Chest X-ray 3 views | CPT | 71047 | 28 | $387.9 | $193.95 | $11.82 | $122.33 | $368.51 |
| CT chest without contrast | CPT | 71250 | 28 | $2,700.05 | $1,350.03 | $47.69 | $662.32 | $2,565.05 |
| CT chest with contrast | CPT | 71260 | 28 | $3,217.95 | $1,608.98 | $51.33 | $906 | $3,057.05 |
| CT chest with and without contrast | CPT | 71270 | 28 | $4,210.8 | $2,105.4 | $55.2 | $1,021.55 | $4,000.26 |
| MRI chest without contrast | CPT | 71550 | 28 | $4,516.55 | $2,258.28 | $60.14 | $1,190.57 | $4,290.72 |
| MRI chest with contrast | CPT | 71551 | 28 | $4,848 | $2,424 | $71.2 | $1,277.94 | $4,605.6 |
| MRI chest with and without contrast | CPT | 71552 | 28 | $5,305.45 | $2,652.73 | $94.05 | $1,405.94 | $5,040.18 |
| Lumbosacral spine X-ray | CPT | 72100 | 28 | $556.8 | $278.4 | $9.08 | $89.95 | $528.96 |
| CT cervical spine without contrast | CPT | 72125 | 28 | $3,027.9 | $1,513.95 | $43.99 | $902.34 | $2,876.51 |
| CT thoracic spine without contrast | CPT | 72128 | 28 | $2,851.7 | $1,425.85 | $43.99 | $855.23 | $2,709.12 |
| CT lumbar spine without contrast | CPT | 72131 | 28 | $3,008.1 | $1,504.05 | $43.99 | $899.4 | $2,857.7 |
| MRI cervical spine without contrast | CPT | 72141 | 28 | $3,895.15 | $1,947.58 | $65.55 | $1,021.31 | $3,700.39 |
| MRI thoracic spine without contrast | CPT | 72146 | 28 | $4,026.15 | $2,013.08 | $65.55 | $1,061.3 | $3,824.84 |
| MRI lumbar spine without contrast | CPT | 72148 | 28 | $4,026.15 | $2,013.08 | $61.21 | $990.43 | $3,824.84 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 28 | $4,831.35 | $2,415.68 | $73.83 | $1,273.55 | $4,589.78 |
| MRI cervical spine with and without contrast | CPT | 72156 | 28 | $5,059.1 | $2,529.55 | $101.73 | $1,333.58 | $4,806.15 |
| MRI lumbar spine with contrast | CPT | 72158 | 28 | $5,312.1 | $2,656.05 | $97.35 | $1,407.71 | $5,046.5 |
| CT pelvis without contrast | CPT | 72192 | 28 | $2,779.35 | $1,389.68 | $45.4 | $833.53 | $2,640.38 |
| CT pelvis with contrast | CPT | 72193 | 28 | $3,217.95 | $1,608.98 | $48.07 | $930.55 | $3,057.05 |
| Shoulder X-ray | CPT | 73030 | 28 | $558.55 | $279.28 | $7.6 | $85.58 | $530.62 |
| Humerus X-ray | CPT | 73060 | 28 | $463 | $231.5 | $7.01 | $109.81 | $439.85 |
| Hand X-ray 3 views | CPT | 73130 | 28 | $533 | $266.5 | $7.01 | $86.2 | $506.35 |
| MRI upper extremity joint without contrast | CPT | 73221 | 28 | $3,876.55 | $1,938.28 | $55.69 | $1,018.22 | $3,682.72 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 28 | $5,300.2 | $2,650.1 | $88.76 | $1,397.13 | $5,035.19 |
| Knee X-ray 1-2 views | CPT | 73560 | 28 | $433.3 | $216.65 | $7.01 | $86.82 | $411.64 |
| Ankle X-ray 3 views | CPT | 73610 | 28 | $549 | $274.5 | $7.01 | $81.7 | $521.55 |
| MRI lower extremity joint without contrast | CPT | 73721 | 28 | $3,844.6 | $1,922.3 | $55.69 | $976.91 | $3,652.37 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 28 | $4,990.75 | $2,495.38 | $89.05 | $1,227.72 | $4,741.21 |
| CT abdomen without contrast | CPT | 74150 | 28 | $2,726.7 | $1,363.35 | $49.26 | $817.74 | $2,590.37 |
| CT abdomen with contrast | CPT | 74160 | 28 | $3,217.95 | $1,608.98 | $52.99 | $930.55 | $3,057.05 |
| CT abdomen with and without contrast | CPT | 74170 | 28 | $4,286.65 | $2,143.33 | $58.04 | $1,021.55 | $4,072.32 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 28 | $5,749.65 | $2,874.83 | $68.89 | $1,294.82 | $5,462.17 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 28 | $6,434.35 | $3,217.18 | $72.25 | $1,446.44 | $6,112.63 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 28 | $7,620.45 | $3,810.23 | $79.91 | $1,716.13 | $7,239.43 |
| MRI abdomen without contrast | CPT | 74181 | 28 | $3,530.55 | $1,765.28 | $60.41 | $977.8 | $3,354.02 |
| MRI abdomen with and without contrast | CPT | 74183 | 28 | $5,036.8 | $2,518.4 | $93.49 | $1,301.18 | $4,784.96 |
| Abdominal ultrasound complete | CPT | 76700 | 28 | $1,330.7 | $665.35 | $33.38 | $266.95 | $1,264.17 |
| Abdominal ultrasound limited | CPT | 76705 | 28 | $946.4 | $473.2 | $24.57 | $158.43 | $899.08 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 28 | $1,105.65 | $552.83 | $30.51 | $232.99 | $1,050.37 |
| Obstetric ultrasound first trimester | CPT | 76801 | 28 | $653.45 | $326.73 | $40.5 | $198 | $620.78 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 28 | $958.6 | $479.3 | $40.23 | $255.61 | $910.67 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 28 | $1,106.1 | $553.05 | $76.25 | $335.15 | $1,050.8 |
| Transvaginal ultrasound | CPT | 76830 | 28 | $983.15 | $491.58 | $28.16 | $211.05 | $933.99 |
| Pelvic ultrasound complete | CPT | 76856 | 28 | $1,287.6 | $643.8 | $28.44 | $218.81 | $1,223.22 |
| Scrotal ultrasound | CPT | 76870 | 28 | $956.6 | $478.3 | $26.65 | $271.68 | $908.77 |
| Diagnostic mammography unilateral | CPT | 77065 | 28 | $442.65 | $221.33 | $28.46 | $139.59 | $420.52 |
| Diagnostic mammography bilateral | CPT | 77066 | 28 | $885.2 | $442.6 | $35.19 | $279.15 | $840.94 |
| Screening mammography bilateral | CPT | 77067 | 28 | $639.85 | $319.93 | $28.46 | $201.78 | $607.86 |
| EKG complete | CPT | 93000 | 16 | — | — | $13.12 | $16.5 | $92.53 |
| EKG tracing only | CPT | 93005 | 28 | $581.55 | $290.78 | $5.61 | $223.32 | $552.47 |
| EKG interpretation only | CPT | 93010 | 26 | $27.45 | $13.73 | $7.29 | $15.83 | $33.69 |
| Transthoracic echocardiogram complete | CPT | 93306 | 28 | $3,560.1 | $1,780.05 | $58.27 | $512.75 | $3,382.1 |
| Transthoracic echocardiogram | CPT | 93307 | 12 | — | — | $40.29 | $104.51 | $239.04 |
| Stress echocardiogram | CPT | 93350 | 28 | $2,062.55 | $1,031.28 | $63.66 | $460.79 | $1,959.42 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 14 | — | — | $15,551 | $34,573 | $37,779 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 14 | — | — | $8,716.74 | $14,369 | $18,466 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 14 | — | — | $6,407.17 | $8,842.67 | $12,499 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 14 | — | — | $12,931 | $17,266 | $29,354 |
| COPD w MCC | MS-DRG | 190 | 14 | — | — | $9,462.45 | $11,758 | $20,393 |
| COPD w CC | MS-DRG | 191 | 14 | — | — | $7,607.63 | $9,844.55 | $15,600 |
| COPD w/o CC/MCC | MS-DRG | 192 | 14 | — | — | $6,118.3 | $7,432.08 | $11,753 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 14 | — | — | $7,332.82 | $8,843.69 | $14,890 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 14 | — | — | $5,078.28 | $6,033.54 | $11,308 |
| AMI discharged alive w MCC | MS-DRG | 280 | 14 | — | — | $13,106 | $17,608 | $29,806 |
| AMI discharged alive w CC | MS-DRG | 281 | 14 | — | — | $8,048.31 | $11,319 | $16,739 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 14 | — | — | $6,665.82 | $8,811.07 | $13,167 |
| Heart failure & shock w MCC | MS-DRG | 291 | 14 | — | — | $10,740 | $15,215 | $23,694 |
| Heart failure & shock w CC | MS-DRG | 292 | 14 | — | — | $7,622.4 | $12,169 | $15,639 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 14 | — | — | $4,398.1 | $5,489.14 | $9,963.84 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 14 | — | — | $10,045 | $17,932 | $21,898 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 14 | — | — | $6,765.62 | $9,424.63 | $13,425 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 14 | — | — | $5,501.9 | $6,317.06 | $10,160 |
| GI hemorrhage w CC | MS-DRG | 378 | 14 | — | — | $8,498.83 | $11,862 | $17,903 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 14 | — | — | $6,044.51 | $8,119.03 | $11,562 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 14 | — | — | $7,053.79 | $7,870.34 | $14,169 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 14 | — | — | $10,181 | $12,468 | $27,691 |
| Kidney/UTI w MCC | MS-DRG | 689 | 14 | — | — | $9,794.9 | $12,563 | $21,251 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 14 | — | — | $7,065.98 | $7,571.25 | $14,574 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 14 | — | — | $15,360 | $21,577 | $35,630 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 14 | — | — | $8,815.82 | $10,141 | $18,722 |
| Initial hospital care, low complexity | CPT | 99221 | 15 | — | — | $76.15 | $90.3 | $211.13 |
| Initial hospital care, moderate complexity | CPT | 99222 | 15 | — | — | $120.58 | $124.97 | $371.72 |
| Initial hospital care, high complexity | CPT | 99223 | 15 | — | — | $160.87 | $181.35 | $518.92 |
| Hospital discharge, <30 min | CPT | 99238 | 15 | — | — | $64.61 | $77.8 | $152.38 |
| Hospital discharge, >30 min | CPT | 99239 | 15 | — | — | $95.33 | $110.25 | $312.56 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 28 | $354.05 | $177.03 | $8.63 | $153.3 | $336.35 |
| General health panel | CPT | 80050 | 13 | — | — | $11.16 | $11.33 | $88.78 |
| Electrolyte panel | CPT | 80051 | 28 | $172.65 | $86.33 | $7.15 | $83.31 | $164.02 |
| Comprehensive metabolic panel | CPT | 80053 | 28 | $489.45 | $244.73 | $8.58 | $200.48 | $464.98 |
| Lipid panel | CPT | 80061 | 28 | $375.45 | $187.73 | $13.6 | $153.78 | $356.68 |
| Renal function panel | CPT | 80069 | 28 | $226.7 | $113.35 | $8.85 | $109.39 | $215.37 |
| Hepatic function panel | CPT | 80076 | 28 | $397 | $198.5 | $8.33 | $171.9 | $377.15 |
| Urinalysis non-automated | CPT | 81002 | 28 | $74.35 | $37.18 | $3.05 | $30.17 | $70.63 |
| Urinalysis automated | CPT | 81003 | 28 | $104.75 | $52.38 | $2.16 | $42.51 | $99.51 |
| Glucose quantitative | CPT | 82947 | 28 | $76.65 | $38.33 | $3.77 | $33.19 | $72.82 |
| Hemoglobin A1c | CPT | 83036 | 28 | $273.4 | $136.7 | $9.31 | $115.18 | $259.73 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 28 | $373.95 | $186.98 | $17.14 | $161.92 | $355.25 |
| Complete blood count with automated differential | CPT | 85025 | 28 | $270.95 | $135.48 | $7.93 | $101.88 | $257.4 |
| Complete blood count without differential | CPT | 85027 | 28 | $132.85 | $66.43 | $6.6 | $52.21 | $126.21 |
| Urine culture bacterial | CPT | 87086 | 28 | $238.45 | $119.23 | $8.23 | $110.88 | $226.53 |
| Urine culture identification | CPT | 87088 | 28 | $68.65 | $34.33 | $8.25 | $33.13 | $65.22 |
| Tissue exam by pathologist level IV | CPT | 88305 | 28 | $692.6 | $346.3 | $30.25 | $164.25 | $657.97 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 28 | $1,015.8 | $507.9 | $18.19 | $146.07 | $965.01 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 13 | — | — | $1,747.98 | $2,206.65 | $5,050.56 |
| Vaginal delivery only | CPT | 59409 | 28 | $6,683.85 | $3,341.93 | $697.93 | $3,144.25 | $6,349.66 |
| Vaginal delivery with postpartum | CPT | 59410 | 13 | — | — | $859.8 | $984.6 | $2,105.56 |
| Routine obstetric care with C-section | CPT | 59510 | 13 | — | — | $1,747.98 | $2,465.65 | $5,569.11 |
| C-section delivery only | CPT | 59514 | 13 | — | — | $697.93 | $762.71 | $2,155.94 |
| C-section with postpartum | CPT | 59515 | 13 | — | — | $859.8 | $1,203.91 | $2,536.51 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 15 | — | — | $43.57 | $68.16 | $149.18 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 16 | — | — | $74.98 | $107.82 | $312.8 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 16 | — | — | $123.71 | $162.07 | $445.66 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 15 | — | — | $165.62 | $212.48 | $567.6 |
| Office visit, established patient, 5 min | CPT | 99211 | 15 | — | — | $8.13 | $14.34 | $46.95 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 15 | — | — | $24.98 | $38.34 | $115.61 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 16 | — | — | $50.41 | $77.77 | $186.29 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 16 | — | — | $77.28 | $119.46 | $269.47 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 16 | — | — | $109.21 | $169.33 | $395.83 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $112.05 | $301.29 | $927.16 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $126.08 | $357.51 | $927.16 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 28 | $2,568.25 | $1,284.13 | $47.36 | $1,112.05 | $2,439.84 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 28 | $2,703.25 | $1,351.63 | $57.49 | $1,128.61 | $2,568.09 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $84.41 | $174.44 | $901.59 |
| Colonoscopy with biopsy | CPT | 45380 | 16 | — | — | $183.07 | $491.1 | $1,166 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $231.16 | $643.44 | $1,166 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 12 | — | — | $1,117.84 | $1,140.2 | $18,186 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $31,218 | $31,218 | $31,218 |
| Hip hemiarthroplasty | CPT | 27125 | 12 | — | — | $830.95 | $847.57 | $1,097.3 |
| Total hip replacement | CPT | 27130 | 12 | — | — | $1,072.82 | $1,094.28 | $12,724 |
| Total knee replacement | CPT | 27447 | 12 | — | — | $1,148.49 | $1,171.46 | $12,724 |
| Knee revision arthroplasty single component | CPT | 27486 | 12 | — | — | $1,047.31 | $1,068.26 | $1,358.75 |
| Knee revision arthroplasty all components | CPT | 27487 | 12 | — | — | $1,322.92 | $1,349.38 | $1,691.06 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 12 | — | — | $156.46 | $490.03 | $499.83 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | — | — | $802.4 | $818.45 | $7,064.46 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | — | — | $465.87 | $475.19 | $3,208.6 |
| ACL reconstruction | CPT | 29888 | 12 | — | — | $732.27 | $746.92 | $7,064.46 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 14 | — | — | $33,844 | $54,261 | $83,384 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 14 | — | — | $18,183 | $23,859 | $42,922 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 14 | — | — | $13,173 | $16,516 | $29,981 |
| CABG single arterial graft | CPT | 33533 | 14 | — | — | $1,503.79 | $1,703.17 | $10,105 |
| CABG 2 arterial grafts | CPT | 33534 | 15 | — | — | $1,749.22 | $2,030.2 | $11,882 |
| CABG 3 arterial grafts | CPT | 33535 | 13 | — | — | $1,942.85 | $2,201.8 | $13,248 |
| CABG 4+ arterial grafts | CPT | 33536 | 13 | — | — | $2,082.43 | $2,236.11 | $7,702.02 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 14 | — | — | $13,225 | $15,841 | $30,115 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 14 | — | — | $10,830 | $13,855 | $23,926 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 14 | — | — | $22,946 | $26,764 | $64,092 |
| Open appendectomy | CPT | 44950 | 12 | — | — | $461.9 | $528.25 | $6,170.51 |
| Laparoscopic appendectomy | CPT | 44970 | 15 | — | — | $424.1 | $842.55 | $5,769.62 |
| Major joint replacement w MCC | MS-DRG | 469 | 14 | — | — | $24,543 | $35,056 | $59,356 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 14 | — | — | $14,822 | $22,334 | $36,422 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | — | — | $528.57 | $950.41 | $5,769.62 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $541.29 | $680.24 | $5,769.62 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 14 | — | — | $22,240 | $29,145 | $53,406 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 14 | — | — | $16,153 | $21,117 | $37,678 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 14 | — | — | $12,719 | $15,311 | $28,807 |
| Lap inguinal hernia repair | CPT | 49650 | 13 | — | — | $302.65 | $397.78 | $5,769.62 |
| Total abdominal hysterectomy | CPT | 58150 | 14 | — | — | $752.09 | $955.23 | $3,253.35 |
| Vaginal hysterectomy | CPT | 58260 | 13 | — | — | $627.58 | $770.72 | $4,881.67 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | — | — | $671.12 | $684.54 | $5,769.62 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 13 | — | — | $740.98 | $829.17 | $10,296 |
| Lap salpingo-oophorectomy | CPT | 58661 | 13 | — | — | $491.66 | $605.62 | $5,769.62 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 14 | — | — | $18,309 | $21,364 | $49,511 |
| OR procedure for obesity w CC | MS-DRG | 620 | 14 | — | — | $12,794 | $18,038 | $29,000 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 14 | — | — | $11,844 | $14,711 | $26,545 |
| Complex cataract surgery | CPT | 66982 | 12 | — | — | $679.52 | $726.85 | $2,255.42 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | — | — | $496.09 | $520.69 | $2,255.42 |
| Intravitreal injection | CPT | 67028 | 28 | $2,653.15 | $1,326.58 | $84.5 | $1,230.53 | $2,520.49 |
| Vitrectomy mechanical | CPT | 67042 | 12 | — | — | $1,030.06 | $1,040.36 | $3,978.22 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 14 | — | — | $9,733.85 | $10,430 | $21,767 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 14 | — | — | $12,392 | $15,528 | $35,483 |
| PCI single major coronary artery | CPT | 92920 | 28 | $18,263 | $9,131.7 | $427.21 | $8,072.42 | $17,350 |
| PCI with drug-eluting stent | CPT | 92928 | 28 | $22,707 | $11,354 | $474.36 | $11,022 | $21,572 |
| PCI bypass graft | CPT | 92937 | 28 | $55,177 | $27,589 | $473.82 | $24,388 | $52,418 |
| Left heart catheterization | CPT | 93452 | 28 | $23,555 | $11,777 | $204.92 | $7,332.62 | $22,377 |
| Coronary angiography with cath | CPT | 93455 | 28 | $28,353 | $14,176 | $238.56 | $8,812.07 | $26,935 |
| Coronary angiography with bypass cath | CPT | 93458 | 28 | $29,307 | $14,653 | $252.12 | $5,519.89 | $27,841 |
Payer mix (top 28)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 197 | $212.31 |
| Cigna | 197 | $431.2 |
| Aetna | 197 | $330.9 |
| amerihealth caritas | 197 | $168.82 |
| WellCare | 196 | $168.22 |
| alliance | 196 | $191.08 |
| carolina complete health | 196 | $168.22 |
| healthy blue | 196 | $168.22 |
| Humana | 196 | $153.89 |
| partners | 196 | $168.22 |
| trillium | 196 | $166.55 |
| vaya | 196 | $168.22 |
| Blue Cross Blue Shield | 181 | $373.51 |
| Ambetter | 143 | $1,262.85 |
| choicecare | 126 | $459.4 |
| medcost | 125 | $424.22 |
| employers health network | 107 | $588.17 |
| beechstreet | 100 | $2,334.78 |
| physician reach out | 100 | $1,268.9 |
| private health care systems | 100 | $2,284.02 |
| First Health | 100 | $2,157.13 |
| healthgram | 100 | $2,030.24 |
| quik trip | 100 | $1,649.57 |
| lifesynch community choice care | 100 | $2,157.13 |
| Multiplan | 100 | $2,410.91 |
| gmmi | 100 | $1,649.57 |
| magellan | 99 | $1,540.95 |
| carolina behavioral health | 99 | $1,927.16 |