Hamilton, OH, 45013-2767
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 | 14 | — | — | $11,232 | $17,360 | 1.4× | $29,657 |
| inpatient | |||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 14 | — | — | $15,735 | $24,319 | 1.2× | $41,853 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 14 | — | — | $8,398.62 | $12,980 | 1.2× | $21,399 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 14 | — | — | $6,009.24 | $8,822.63 | 1.2× | $14,483 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 14 | — | — | $12,449 | $19,239 | 1.2× | $34,013 |
| COPD w MCC | MS-DRG | 190 | 14 | — | — | $9,112.73 | $14,084 | 1.3× | $23,635 |
| COPD w CC | MS-DRG | 191 | 14 | — | — | $7,172.04 | $11,012 | 1.2× | $18,076 |
| COPD w/o CC/MCC | MS-DRG | 192 | 14 | — | — | $5,698.37 | $8,295.81 | 1.2× | $13,618 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 14 | — | — | $6,900.03 | $10,511 | 1.2× | $17,254 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 14 | — | — | $5,599.4 | $7,983.05 | 1.2× | $13,158 |
| AMI discharged alive w MCC | MS-DRG | 280 | 14 | — | — | $12,752 | $19,708 | 1.3× | $34,539 |
| AMI discharged alive w CC | MS-DRG | 281 | 14 | — | — | $7,729.98 | $11,816 | 1.2× | $19,396 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 14 | — | — | $6,292.97 | $9,294.33 | 1.2× | $15,257 |
| Heart failure & shock w MCC | MS-DRG | 291 | 14 | — | — | $10,404 | $16,079 | 1.3× | $27,456 |
| Heart failure & shock w CC | MS-DRG | 292 | 14 | — | — | $7,216.03 | $11,040 | 1.2× | $18,123 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 14 | — | — | $5,141.17 | $7,037.08 | 1.1× | $12,081 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 14 | — | — | $9,818.76 | $15,175 | 1.3× | $25,375 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 14 | — | — | $6,385.35 | $9,476.35 | 1.2× | $15,556 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 14 | — | — | $5,141.9 | $7,171.67 | 1.2× | $12,083 |
| GI hemorrhage w CC | MS-DRG | 378 | 14 | — | — | $8,181.61 | $12,637 | 1.3× | $20,744 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 14 | — | — | $5,613.33 | $8,159.94 | 1.2× | $13,395 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 14 | — | — | $6,707.21 | $10,002 | 1.2× | $16,418 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 14 | — | — | $12,485 | $19,296 | 1.3× | $32,083 |
| Kidney/UTI w MCC | MS-DRG | 689 | 14 | — | — | $9,498.37 | $14,680 | 1.3× | $24,626 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 14 | — | — | $6,926.43 | $10,288 | 1.2× | $16,888 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 14 | — | — | $15,233 | $23,543 | 1.3× | $41,289 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 14 | — | — | $8,493.93 | $13,127 | 1.3× | $21,693 |
| surgery | |||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 5 | — | — | $38,395 | $55,484 | 2.0× | $63,026 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 5 | — | — | $24,476 | $35,370 | 1.9× | $40,178 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 14 | — | — | $34,691 | $53,616 | 1.2× | $96,614 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 14 | — | — | $18,567 | $28,695 | 1.2× | $49,735 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 14 | — | — | $13,330 | $20,601 | 1.3× | $34,739 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 14 | — | — | $13,394 | $20,700 | 1.3× | $34,897 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 14 | — | — | $11,005 | $16,889 | 1.2× | $27,724 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 14 | — | — | $25,971 | $40,138 | 1.2× | $74,258 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 5 | — | — | $85,013 | $122,850 | 2.5× | $139,550 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 5 | — | — | $46,887 | $67,755 | 2.0× | $76,966 |
| Major joint replacement w MCC | MS-DRG | 469 | 14 | — | — | $23,230 | $35,902 | 1.2× | $68,773 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 14 | — | — | $15,133 | $23,389 | 1.2× | $39,673 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 14 | — | — | $22,343 | $34,532 | 1.2× | $61,882 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 14 | — | — | $16,348 | $25,265 | 1.2× | $43,658 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 14 | — | — | $12,949 | $20,013 | 1.3× | $33,379 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 14 | — | — | $22,161 | $34,250 | 1.3× | $57,366 |
| OR procedure for obesity w CC | MS-DRG | 620 | 14 | — | — | $12,724 | $19,665 | 1.2× | $33,600 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 14 | — | — | $12,051 | $18,624 | 1.2× | $30,756 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 14 | — | — | $10,088 | $15,364 | 1.3× | $25,220 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 14 | — | — | $16,015 | $24,751 | 1.3× | $41,112 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Cigna | 47 | $16,145 |
| Blue Cross Blue Shield | 47 | $15,954 |
| medical mutual | 47 | $19,057 |
| UnitedHealthcare | 47 | $19,637 |
| Aetna | 47 | $17,721 |
| Humana | 43 | $10,404 |
| medigold | 43 | $10,404 |
| Molina | 43 | $15,097 |
| perennial advantage | 43 | $10,924 |
| valor health plan | 43 | $10,404 |
| buckeye health plan | 43 | $13,045 |
| CareSource | 43 | $12,738 |
| custom design benefits inc. | 43 | $24,448 |
| devoted health | 43 | $10,404 |
