▸ Hospital · OH · CCN 360090
Mclaren St Luke's
5901 MONCLOVA ROAD, MAUMEE, OH, 43537-
83 beds2
Compliance grade
A
100/100
Procedures tracked
185
of 209 target codes
Payers
17
with negotiated rates
Rates published
52,165
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 10 | $23,191 | $11,596 | $4,762.32 | $10,225 | $19,427 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 12 | $394.6 | $197.3 | $87.89 | $143.67 | $250.72 |
| Psychiatric eval with medical services | CPT | 90792 | 12 | $394.6 | $197.3 | $87.89 | $157.06 | $322.23 |
| Psychotherapy 30 minutes | CPT | 90832 | 12 | $200.2 | $100.1 | $45.87 | $87.89 | $250.72 |
| Psychotherapy 45 minutes | CPT | 90834 | 12 | $199.2 | $99.6 | $60.5 | $94.18 | $250.72 |
| Psychotherapy 60 minutes | CPT | 90837 | 12 | $221.7 | $110.9 | $87.89 | $138 | $250.72 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 12 | $221.7 | $110.9 | $86.77 | $132.17 | $250.72 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 14 | $228 | $114 | $7.24 | $48.16 | $450 |
| ED visit level 2 | CPT | 99282 | 15 | $311 | $155.5 | $26.63 | $86.62 | $450 |
| ED visit level 3 | CPT | 99283 | 15 | $540 | $270 | $44.94 | $151.46 | $513.09 |
| ED visit level 4 | CPT | 99284 | 14 | $899 | $449.5 | $76.68 | $232.92 | $789.06 |
| ED visit level 5 | CPT | 99285 | 14 | $1,199 | $599.5 | $111.19 | $335.37 | $1,136.09 |
| Critical care, first hour | CPT | 99291 | 14 | $1,798 | $899 | $135.47 | $460.91 | $1,561.38 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $1,402.6 | $701.3 | $25.56 | $59.04 | $1,145.36 |
| CT head with contrast | CPT | 70460 | 11 | $1,561.6 | $780.8 | $33.87 | $97.38 | $413.36 |
| CT head with and without contrast | CPT | 70470 | 12 | $1,767.4 | $883.7 | $38.13 | $97.38 | $935.31 |
| CT neck with contrast | CPT | 70491 | 12 | $1,673.4 | $836.7 | $41.32 | $97.38 | $1,366.5 |
| MRI brain without contrast | CPT | 70551 | 12 | $1,587.7 | $793.85 | $44.3 | $132.22 | $1,296.52 |
| MRI brain with contrast | CPT | 70552 | 11 | $2,330.1 | $1,165.05 | $53.46 | $195.35 | $808.39 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $2,549 | $1,274.5 | $69.01 | $198.28 | $2,081.51 |
| Chest X-ray single view | CPT | 71045 | 13 | $123.6 | $61.8 | $5.54 | $48.16 | $137.4 |
| Chest X-ray 2 views | CPT | 71046 | 14 | $214 | $107 | $6.6 | $48.16 | $174.75 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $217.3 | $108.65 | $8.31 | $48.16 | $137.4 |
| CT chest without contrast | CPT | 71250 | 13 | $1,572.1 | $786.05 | $32.38 | $66.07 | $1,283.78 |
| CT chest with contrast | CPT | 71260 | 13 | $1,650.8 | $825.4 | $34.93 | $97.38 | $1,348.04 |
| CT chest with and without contrast | CPT | 71270 | 12 | $1,767.4 | $883.7 | $37.49 | $97.38 | $1,237.18 |
| MRI chest without contrast | CPT | 71550 | 11 | $1,587.7 | $793.85 | $43.88 | $132.22 | $1,146.97 |
| MRI chest with contrast | CPT | 71551 | 11 | $2,330.1 | $1,165.05 | $51.76 | $432.16 | $1,258.44 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $2,549 | $1,274.5 | $68.16 | $195.35 | $1,561.76 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $285.6 | $142.8 | $6.82 | $58.17 | $233.22 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $1,764.9 | $882.45 | $29.82 | $66.79 | $1,441.22 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $1,764.9 | $882.45 | $29.82 | $63.6 | $1,441.22 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $1,764.9 | $882.45 | $29.82 | $66.79 | $1,441.22 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $1,587.7 | $793.85 | $44.52 | $132.22 | $1,296.52 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $1,587.7 | $793.85 | $44.52 | $132.22 | $1,296.52 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | $1,587.7 | $793.85 | $44.52 | $132.22 | $1,296.52 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $2,330.1 | $1,165.05 | $53.89 | $195.35 | $804.15 |
| MRI cervical spine with and without contrast | CPT | 72156 | 12 | $2,549 | $1,274.5 | $69.23 | $195.35 | $1,784.3 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | $2,549 | $1,274.5 | $69.23 | $195.35 | $2,081.51 |
| CT pelvis without contrast | CPT | 72192 | 12 | $1,572.1 | $786.05 | $32.59 | $63.18 | $1,100.47 |
| CT pelvis with contrast | CPT | 72193 | 11 | $1,650.8 | $825.4 | $34.72 | $97.38 | $1,155.56 |
| Shoulder X-ray | CPT | 73030 | 14 | $339.4 | $169.7 | $5.75 | $48.16 | $277.15 |
| Humerus X-ray | CPT | 73060 | 13 | $310.4 | $155.2 | $4.9 | $48.16 | $253.47 |
| Hand X-ray 3 views | CPT | 73130 | 13 | $318.5 | $159.25 | $5.33 | $48.16 | $260.09 |
| MRI upper extremity joint without contrast | CPT | 73221 | 14 | $2,148.1 | $1,074.05 | $40.68 | $132.22 | $1,754.14 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $3,448.6 | $1,724.3 | $64.97 | $195.35 | $1,220.35 |
| Knee X-ray 1-2 views | CPT | 73560 | 13 | $94.9 | $47.45 | $5.11 | $48.16 | $137.4 |
| Ankle X-ray 3 views | CPT | 73610 | 14 | $288.9 | $144.45 | $5.33 | $48.16 | $235.92 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $2,148.1 | $1,074.05 | $40.68 | $132.22 | $1,754.14 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 12 | $3,448.6 | $1,724.3 | $64.97 | $195.35 | $1,216.11 |
| CT abdomen without contrast | CPT | 74150 | 11 | $2,387.3 | $1,193.65 | $35.57 | $70.07 | $1,949.47 |
| CT abdomen with contrast | CPT | 74160 | 11 | $2,581.1 | $1,290.55 | $38.13 | $97.38 | $2,107.73 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $2,901.3 | $1,450.65 | $41.75 | $97.38 | $2,369.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $4,514.3 | $2,257.15 | $52.19 | $132.22 | $3,686.38 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 14 | $4,714.8 | $2,357.4 | $54.95 | $195.35 | $3,850.11 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $5,180.3 | $2,590.15 | $60.28 | $195.35 | $4,230.23 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $2,147.6 | $1,073.8 | $43.67 | $132.22 | $1,753.73 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $3,448.1 | $1,724.05 | $66.24 | $195.35 | $2,815.72 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $1,239.9 | $619.95 | $24.28 | $58.17 | $1,012.5 |
| Abdominal ultrasound limited | CPT | 76705 | 12 | $995.5 | $497.75 | $17.68 | $58.17 | $810.56 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 12 | $1,239.9 | $619.95 | $22.15 | $58.17 | $1,012.5 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $288.8 | $144.4 | $29.82 | $59 | $294.85 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,197.8 | $598.9 | $30.03 | $58.17 | $978.12 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $497.9 | $248.95 | $56.87 | $132.22 | $377.19 |
| Transvaginal ultrasound | CPT | 76830 | 11 | $847.1 | $423.55 | $20.87 | $58.17 | $691.74 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,311 | $655.5 | $20.66 | $58.17 | $1,070.56 |
| Scrotal ultrasound | CPT | 76870 | 12 | $1,329.9 | $664.95 | $19.17 | $58.17 | $1,086 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $369.5 | $184.75 | $24.28 | $44.06 | $371.03 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $473 | $236.5 | $29.82 | $54.14 | $472.62 |
| Screening mammography bilateral | CPT | 77067 | 11 | $379.4 | $189.7 | $23 | $43.03 | $390.79 |
| EKG complete | CPT | 93000 | 8 | $34.2 | $17.1 | $14.67 | $16.87 | $31.16 |
| EKG tracing only | CPT | 93005 | 12 | $176.6 | $88.3 | $32.49 | $57.93 | $144.21 |
| EKG interpretation only | CPT | 93010 | 9 | $34.2 | $17.1 | $5.11 | $8.4 | $11.3 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $19,286 | $9,643.23 | $43.03 | $299.92 | $930.96 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $1,987 | $993.5 | $27.26 | $132.22 | $680.39 |
| Stress echocardiogram | CPT | 93350 | 9 | $653.8 | $326.9 | $43.03 | $67.74 | $107.59 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | $38,240 | $19,120 | $10,633 | $11,411 | $18,233 |
| COPD w MCC | MS-DRG | 190 | 6 | $29,865 | $14,932 | $7,537.27 | $8,193.96 | $13,096 |
| COPD w CC | MS-DRG | 191 | 6 | $19,798 | $9,899.2 | $5,736.14 | $6,419.63 | $10,107 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | $13,758 | $6,879.18 | $4,368.45 | $4,905.57 | $7,838.1 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 6 | $20,356 | $10,178 | $5,483.69 | $6,153.73 | $9,688.56 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | $18,349 | $9,174.41 | $4,276.59 | $4,848.99 | $15,383 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | $39,574 | $19,787 | $10,915 | $12,329 | $19,189 |
| AMI discharged alive w CC | MS-DRG | 281 | 7 | $26,618 | $13,309 | $6,253.96 | $7,471.01 | $15,087 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | $17,988 | $8,993.95 | $4,920.29 | $5,635.21 | $11,219 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | $30,521 | $15,260 | $8,735.54 | $9,710.43 | $20,590 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | $17,419 | $8,709.43 | $5,776.97 | $6,462.63 | $10,175 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | $11,496 | $5,748 | $3,851.31 | $4,434.36 | $6,980.04 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 7 | $38,951 | $19,475 | $8,192.54 | $9,006.93 | $25,752 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 6 | $17,539 | $8,769.41 | $4,752.47 | $5,567.2 | $8,895.99 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 7 | $13,673 | $6,836.26 | $3,851.99 | $4,376.02 | $11,991 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | $28,074 | $14,037 | $6,673.11 | $7,668.33 | $56,954 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | $19,981 | $9,990.64 | $4,289.51 | $4,895.91 | $8,557.64 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 7 | $19,243 | $9,621.5 | $3,924.3 | $5,877.19 | $10,085 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | $32,357 | $16,178 | $7,895.19 | $8,693.72 | $13,690 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | $21,252 | $10,626 | $5,508.19 | $6,088.32 | $9,729.21 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | $49,875 | $24,937 | $13,218 | $14,658 | $26,744 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | $25,932 | $12,966 | $6,735.28 | $7,817.09 | $25,568 |
| Initial hospital care, low complexity | CPT | 99221 | 9 | $358 | $179 | $52.4 | $75.96 | $113.01 |
| Initial hospital care, moderate complexity | CPT | 99222 | 10 | $520 | $260 | $82.64 | $119.43 | $170.65 |
| Initial hospital care, high complexity | CPT | 99223 | 9 | $675 | $337.5 | $110.12 | $158.79 | $226.05 |
| Hospital discharge, <30 min | CPT | 99238 | 9 | $342 | $171 | $51.55 | $75.37 | $128.89 |
| Hospital discharge, >30 min | CPT | 99239 | 9 | $368 | $184 | $72.85 | $107.3 | $182.15 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $83.9 | $41.95 | $4.63 | $8.25 | $68.51 |
| Electrolyte panel | CPT | 80051 | 10 | $54.4 | $27.2 | $3.83 | $6.84 | $50 |
| Comprehensive metabolic panel | CPT | 80053 | 12 | $104 | $52 | $5.78 | $10.3 | $84.93 |
| Lipid panel | CPT | 80061 | 12 | $100.9 | $50.45 | $7.32 | $13.06 | $82.39 |
| Renal function panel | CPT | 80069 | 8 | $86.4 | $43.2 | $4.75 | $8.47 | $45.72 |
| Hepatic function panel | CPT | 80076 | 10 | $83.9 | $41.95 | $4.47 | $7.97 | $68.51 |
| Urinalysis non-automated | CPT | 81002 | 10 | $25 | $12.5 | $1.9 | $3.39 | $25 |
| Urinalysis automated | CPT | 81003 | 13 | $29.8 | $14.9 | $1.23 | $2.19 | $25 |
| Glucose quantitative | CPT | 82947 | 10 | $49.9 | $24.95 | $2.15 | $3.83 | $40.75 |
| Hemoglobin A1c | CPT | 83036 | 12 | $93.5 | $46.75 | $5.31 | $9.47 | $76.35 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 12 | $164.6 | $82.3 | $9.19 | $16.38 | $134.41 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $85.2 | $42.6 | $4.25 | $7.58 | $69.57 |
| Complete blood count without differential | CPT | 85027 | 13 | $40.6 | $20.3 | $3.54 | $6.31 | $45 |
| Urine culture bacterial | CPT | 87086 | 12 | $77.9 | $38.95 | $4.41 | $7.87 | $63.61 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $637 | $318.5 | $29.23 | $52.11 | $520.17 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 13 | $466.1 | $233.05 | $18.53 | $110.04 | $380.62 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 9 | $7,617.5 | $3,808.8 | $2,043 | $2,260.13 | $3,504.67 |
| Vaginal delivery only | CPT | 59409 | 9 | $4,672.3 | $2,336.2 | $729.76 | $761.65 | $1,706.1 |
| Vaginal delivery with postpartum | CPT | 59410 | 9 | $5,081.4 | $2,540.7 | $984.03 | $1,014.27 | $1,980.33 |
| Routine obstetric care with C-section | CPT | 59510 | 9 | $8,039.1 | $4,019.6 | $2,309 | $2,533.33 | $3,780.59 |
| C-section delivery only | CPT | 59514 | 10 | $5,092.4 | $2,546.2 | $834.27 | $877.84 | $1,706.1 |
| C-section with postpartum | CPT | 59515 | 9 | $5,821.9 | $2,911 | $1,221.92 | $1,267.79 | $1,980.33 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 12 | $272 | $136 | $29.82 | $50.22 | $200.06 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 14 | $291 | $145.5 | $49.31 | $81.72 | $264.4 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 14 | $361 | $180.5 | $53.18 | $122.25 | $353.69 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | $409 | $204.5 | $64.45 | $163.91 | $428.68 |
| Office visit, established patient, 5 min | CPT | 99211 | 12 | $228 | $114 | $5.54 | $8.91 | $159.6 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 12 | $272 | $136 | $21.87 | $35.45 | $222.12 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 13 | $291 | $145.5 | $41.96 | $67.91 | $237.63 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 13 | $361 | $180.5 | $48.76 | $90.16 | $294.79 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 10 | $409 | $204.5 | $57.34 | $125.56 | $216.44 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | $10,441 | $5,220.66 | $77.75 | $450 | $1,463.01 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | $4,467.61 | $2,233.81 | $87.33 | $450 | $1,463.01 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | $5,698.03 | $2,849.02 | $36.42 | $498.71 | $1,422.68 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | $3,378.01 | $1,689.01 | $46.22 | $498.71 | $1,422.68 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | $3,394.38 | $1,697.19 | $116.72 | $450 | $1,422.68 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | $4,144.04 | $2,072.02 | $126.95 | $644.96 | $1,839.89 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | $3,459.83 | $1,729.92 | $159.96 | $644.96 | $1,839.89 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | $56,832 | $28,416 | $931.66 | $10,059 | $28,697 |
| Hip hemiarthroplasty | CPT | 27125 | 9 | $3,689.7 | $1,844.9 | $732.93 | $1,042.58 | $1,832.68 |
| Total hip replacement | CPT | 27130 | 11 | $55,231 | $27,615 | $829.21 | $7,038.15 | $20,078 |
| Total knee replacement | CPT | 27447 | 11 | $57,354 | $28,677 | $828.14 | $7,038.15 | $20,078 |
| Knee revision arthroplasty single component | CPT | 27486 | 9 | $10,055 | $5,027.5 | $907.38 | $1,286.59 | $2,268.88 |
| Knee revision arthroplasty all components | CPT | 27487 | 9 | $13,281 | $6,640.3 | $1,128.9 | $1,593.68 | $3,101.03 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 9 | $889.5 | $444.8 | $109.7 | $151.18 | $247.15 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | $3,937.2 | $1,968.6 | $691.61 | $981.48 | $1,729.35 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | $9,451.52 | $4,725.76 | $354.43 | $1,774.8 | $5,063.05 |
| ACL reconstruction | CPT | 29888 | 11 | $36,051 | $18,025 | $630.48 | $3,907.62 | $11,147 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 6 | $85,083 | $42,541 | $31,277 | $33,321 | $52,485 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 6 | $61,563 | $30,781 | $16,312 | $17,803 | $35,219 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 6 | $47,301 | $23,651 | $11,451 | $12,439 | $19,590 |
| CABG single arterial graft | CPT | 33533 | 9 | $7,204.2 | $3,602.1 | $1,178.1 | $1,802.84 | $2,945.81 |
| CABG 2 arterial grafts | CPT | 33534 | 9 | $8,297.6 | $4,148.8 | $1,383.86 | $2,115.76 | $3,460.3 |
| CABG 3 arterial grafts | CPT | 33535 | 9 | $9,146.1 | $4,573.1 | $1,537.22 | $2,348.18 | $3,857.27 |
| CABG 4+ arterial grafts | CPT | 33536 | 9 | $9,785.4 | $4,892.7 | $1,655.86 | $2,529.15 | $4,146.09 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 6 | $48,656 | $24,328 | $11,510 | $12,502 | $19,698 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | $39,484 | $19,742 | $9,293.5 | $10,306 | $20,853 |
| Open appendectomy | CPT | 44950 | 9 | $2,952 | $1,476 | $413.65 | $616.8 | $1,034.31 |
| Laparoscopic appendectomy | CPT | 44970 | 11 | $21,990 | $10,995 | $389.58 | $3,191.39 | $9,104.22 |
| Major joint replacement w MCC | MS-DRG | 469 | 7 | $87,257 | $43,628 | $17,555 | $21,808 | $41,112 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 6 | $72,269 | $36,134 | $13,125 | $14,202 | $22,368 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | $22,364 | $11,182 | $427.28 | $3,191.39 | $9,104.22 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 11 | $20,772 | $10,386 | $464.55 | $3,191.39 | $9,104.22 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | $59,939 | $29,970 | $19,817 | $21,250 | $37,892 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | $54,662 | $27,331 | $12,307 | $15,389 | $28,782 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 7 | $46,695 | $23,348 | $11,098 | $12,234 | $19,004 |
| Lap inguinal hernia repair | CPT | 49650 | 11 | $14,027 | $7,013.51 | $281.59 | $3,191.39 | $9,104.22 |
| Total abdominal hysterectomy | CPT | 58150 | 9 | $5,253.9 | $2,627 | $653.91 | $948.82 | $1,635.08 |
| Vaginal hysterectomy | CPT | 58260 | 11 | $12,990 | $6,495.01 | $538.04 | $2,700.24 | $7,703.07 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 11 | $19,061 | $9,530.29 | $566.58 | $3,191.39 | $9,104.22 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 11 | $19,614 | $9,807.05 | $629.84 | $5,694.94 | $16,246 |
| Lap salpingo-oophorectomy | CPT | 58661 | 11 | $12,600 | $6,299.88 | $418.55 | $3,191.39 | $9,104.22 |
| Complex cataract surgery | CPT | 66982 | 11 | $5,241.89 | $2,620.95 | $470.52 | $1,247.56 | $5,098.44 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | $5,043.16 | $2,521.58 | $343.57 | $1,247.56 | $3,585.03 |
| Vitrectomy mechanical | CPT | 67042 | 9 | $2,797.4 | $1,398.7 | $719.51 | $950.47 | $1,937.43 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | $22,372 | $11,186 | $8,442.26 | $9,397.18 | $14,598 |
| PCI single major coronary artery | CPT | 92920 | 11 | $22,925 | $11,462 | $329.94 | $3,118.73 | $8,896.93 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $42,860 | $21,430 | $366.57 | $6,203.29 | $17,696 |
| PCI bypass graft | CPT | 92937 | 11 | $1,833.8 | $916.9 | $366.36 | $3,568.35 | $17,696 |
| Left heart catheterization | CPT | 93452 | 11 | $5,749.4 | $2,874.7 | $146.76 | $1,759.38 | $5,019.04 |
| Coronary angiography with cath | CPT | 93455 | 11 | $6,292.8 | $3,146.4 | $173.17 | $1,759.38 | $5,089.46 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $22,637 | $11,319 | $182.75 | $1,759.38 | $5,204.9 |
Payer mix (top 17)
| Payer | Codes covered | Median rate |
|---|---|---|
| Humana | 185 | $167.04 |
| UnitedHealthcare | 185 | $132.22 |
| Medicare | 185 | $235.74 |
| Blue Cross Blue Shield | 184 | $360.47 |
| priority health | 162 | $157.04 |
| Aetna | 155 | $160.14 |
| Medicaid | 150 | $97.38 |
| TRICARE | 147 | $349.91 |
| mi amish medical board | 147 | $348.3 |
| mclaren commercial ins | 139 | $118.8 |
| u of m health plan | 135 | $96.3 |
| workers compensation | 53 | $99.17 |
| cofinity auto | 50 | $197.05 |
| cofinity group 15892 & 15893 | 25 | $92.64 |
| hap - hmo | 25 | $127.95 |
| safe response program | 17 | $175 |
| bcccnp | 12 | $86.42 |