▸ Hospital · PA · CCN 390174
Thomas Jefferson University Hospital
111 SOUTH 11TH STREET, PHILADELPHIA, PA, 19107
866 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
202
of 209 target codes
Payers
30
with negotiated rates
Rates published
91,343
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 27 | — | $16,931 | $2,569 | $16,082 | $41,028 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 2 | $507 | $209.7 | $62.91 | $151.99 | $151.99 |
| Psychiatric eval with medical services | CPT | 90792 | 2 | — | — | $62.91 | $174.75 | $174.75 |
| Psychotherapy 30 minutes | CPT | 90832 | 1 | $572 | $209.7 | $70.34 | $70.34 | $70.34 |
| Psychotherapy 45 minutes | CPT | 90834 | 1 | $899 | $209.7 | $97.62 | $97.62 | $97.62 |
| Psychotherapy 60 minutes | CPT | 90837 | 1 | $1,138 | $209.7 | $137.23 | $137.23 | $137.23 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 1 | $158 | $209.7 | $132.9 | $132.9 | $132.9 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 6 | $1,573 | $99.62 | $20.8 | $1,308 | $2,391.15 |
| ED visit level 2 | CPT | 99282 | 6 | $2,095 | $181.4 | $39 | $1,308 | $2,391.15 |
| ED visit level 3 | CPT | 99283 | 6 | $2,435 | $322.51 | $96.2 | $1,308 | $2,484 |
| ED visit level 4 | CPT | 99284 | 6 | $3,088 | $492.99 | $153.4 | $1,308 | $2,484 |
| ED visit level 5 | CPT | 99285 | 5 | $3,754 | $703.6 | $233 | $1,544.5 | $3,709.12 |
| Critical care, first hour | CPT | 99291 | 9 | $5,400 | $975.93 | $197.12 | $1,308 | $7,623.86 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 29 | $1,953 | $123.52 | $91.84 | $120.84 | $843.1 |
| CT head with contrast | CPT | 70460 | 29 | $2,390 | $207.23 | $104 | $178.4 | $1,090.95 |
| CT head with and without contrast | CPT | 70470 | 29 | $2,779 | $207.23 | $130 | $188.13 | $1,342.85 |
| CT neck with contrast | CPT | 70491 | 29 | $3,785 | $207.23 | $107.25 | $178.75 | $1,296.1 |
| MRI brain without contrast | CPT | 70551 | 29 | $5,268 | $281.9 | $186.13 | $319.89 | $2,403.3 |
| MRI brain with contrast | CPT | 70552 | 29 | $6,843 | $412.18 | $239.71 | $403.22 | $2,649.15 |
| MRI brain with and without contrast | CPT | 70553 | 29 | $5,511 | $412.18 | $293.72 | $403.22 | $3,408.95 |
| Chest X-ray single view | CPT | 71045 | 29 | $400 | $102.82 | $10.54 | $82.07 | $327.88 |
| Chest X-ray 2 views | CPT | 71046 | 29 | $615 | $102.82 | $19.31 | $82.07 | $327.88 |
| Chest X-ray 3 views | CPT | 71047 | 29 | $676.5 | $102.82 | $24.57 | $84.08 | $327.88 |
| CT chest without contrast | CPT | 71250 | 29 | $2,307 | $123.52 | $91.84 | $120.84 | $1,090.95 |
| CT chest with contrast | CPT | 71260 | 29 | $2,874 | $207.23 | $113.75 | $186.51 | $1,353 |
| CT chest with and without contrast | CPT | 71270 | 29 | $3,401 | $207.23 | $134.55 | $188.13 | $1,706.5 |
| MRI chest without contrast | CPT | 71550 | 29 | $2,355 | $281.9 | $186.13 | $319.89 | $2,663.35 |
| MRI chest with contrast | CPT | 71551 | 29 | $3,060 | $926.17 | $239.71 | $775.57 | $2,966.05 |
| MRI chest with and without contrast | CPT | 71552 | 29 | $3,520 | $412.18 | $293.72 | $467.73 | $4,028.55 |
| Lumbosacral spine X-ray | CPT | 72100 | 29 | $551 | $123.52 | $24.64 | $98.6 | $393.92 |
| CT cervical spine without contrast | CPT | 72125 | 29 | $3,342 | $123.52 | $91.84 | $120.84 | $1,095 |
| CT thoracic spine without contrast | CPT | 72128 | 29 | $3,461 | $123.52 | $91.84 | $120.84 | $1,092.95 |
| CT lumbar spine without contrast | CPT | 72131 | 29 | $3,363 | $123.52 | $91.84 | $120.84 | $1,090.95 |
| MRI cervical spine without contrast | CPT | 72141 | 29 | $3,688 | $281.9 | $186.13 | $319.89 | $2,116.85 |
| MRI thoracic spine without contrast | CPT | 72146 | 29 | $3,688 | $281.9 | $186.13 | $275.76 | $2,167.65 |
| MRI lumbar spine without contrast | CPT | 72148 | 29 | $3,688 | $281.9 | $186.13 | $275.76 | $2,165.65 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 29 | $4,790 | $412.18 | $239.71 | $403.22 | $2,641 |
| MRI cervical spine with and without contrast | CPT | 72156 | 29 | $5,511 | $412.18 | $293.72 | $403.22 | $3,356.1 |
| MRI lumbar spine with contrast | CPT | 72158 | 29 | $5,511 | $412.18 | $293.72 | $403.22 | $3,352.05 |
| CT pelvis without contrast | CPT | 72192 | 29 | $2,955 | $123.52 | $87.75 | $120.83 | $1,034.05 |
| CT pelvis with contrast | CPT | 72193 | 29 | $3,165 | $207.23 | $112.45 | $182.12 | $1,283.95 |
| Shoulder X-ray | CPT | 73030 | 29 | $711 | $102.82 | $21.45 | $82.07 | $327.88 |
| Humerus X-ray | CPT | 73060 | 29 | $656 | $102.82 | $14.95 | $82.07 | $327.88 |
| Hand X-ray 3 views | CPT | 73130 | 29 | $664 | $102.82 | $14.95 | $82.07 | $327.88 |
| MRI upper extremity joint without contrast | CPT | 73221 | 29 | $5,090 | $281.9 | $186.13 | $319.89 | $2,279.4 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 29 | $2,625 | $412.18 | $293.72 | $467.73 | $3,356.1 |
| Knee X-ray 1-2 views | CPT | 73560 | 29 | $475 | $102.82 | $21.45 | $82.07 | $327.88 |
| Ankle X-ray 3 views | CPT | 73610 | 29 | $678 | $102.82 | $24.35 | $82.07 | $327.88 |
| MRI lower extremity joint without contrast | CPT | 73721 | 29 | $5,268 | $281.9 | $186.13 | $319.89 | $2,328.15 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 29 | $7,874 | $412.18 | $293.72 | $467.73 | $3,345.95 |
| CT abdomen without contrast | CPT | 74150 | 29 | $3,398 | $123.52 | $91.84 | $120.84 | $1,025.9 |
| CT abdomen with contrast | CPT | 74160 | 29 | $3,825 | $207.23 | $117 | $186.51 | $1,460.7 |
| CT abdomen with and without contrast | CPT | 74170 | 29 | $4,715 | $207.23 | $144.95 | $199.59 | $1,997 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 29 | $2,998 | $281.9 | $131.39 | $238.26 | $1,542.95 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 29 | $3,296 | $412.18 | $250.55 | $356.03 | $2,102.7 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 29 | $3,921 | $412.18 | $306.45 | $403.22 | $2,854.3 |
| MRI abdomen without contrast | CPT | 74181 | 29 | $5,268 | $281.9 | $186.13 | $319.89 | $2,120.95 |
| MRI abdomen with and without contrast | CPT | 74183 | 29 | $7,874 | $412.18 | $293.72 | $467.73 | $3,534.9 |
| Abdominal ultrasound complete | CPT | 76700 | 29 | $1,779 | $123.52 | $52.97 | $111.17 | $536.78 |
| Abdominal ultrasound limited | CPT | 76705 | 29 | $1,156 | $123.52 | $48.75 | $104.4 | $401.8 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 29 | $2,537 | $123.52 | $52.97 | $106.34 | $501.8 |
| Obstetric ultrasound first trimester | CPT | 76801 | 29 | $1,532 | $123.52 | $49.91 | $107.11 | $533.67 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 29 | $354 | $123.52 | $52.97 | $106.34 | $1,169 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 29 | $351 | $281.9 | $83.67 | $239.34 | $898.99 |
| Transvaginal ultrasound | CPT | 76830 | 29 | $398 | $123.52 | $52.97 | $104.4 | $550.13 |
| Pelvic ultrasound complete | CPT | 76856 | 29 | $398 | $123.52 | $52.97 | $104.4 | $485.5 |
| Scrotal ultrasound | CPT | 76870 | 29 | $1,178 | $123.52 | $52.97 | $104.4 | $471.3 |
| Diagnostic mammography unilateral | CPT | 77065 | 9 | $393 | $103.22 | $80.12 | $198.12 | $572.14 |
| Diagnostic mammography bilateral | CPT | 77066 | 9 | $658 | $132.47 | $101.46 | $253.42 | $722.95 |
| Screening mammography bilateral | CPT | 77067 | 9 | $207 | $109.22 | $82.03 | $209.31 | $583.37 |
| EKG complete | CPT | 93000 | 5 | — | — | $24.99 | $53.62 | $602 |
| EKG tracing only | CPT | 93005 | 7 | $564 | $69.7 | $13.6 | $18.72 | $602 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $511 | $556.5 | $602 |
| Transthoracic echocardiogram complete | CPT | 93306 | 8 | $3,798 | $645.57 | $127.58 | $314.22 | $2,399 |
| Transthoracic echocardiogram | CPT | 93307 | 8 | $2,229 | $281.9 | $123.5 | $265.05 | $2,422 |
| Stress echocardiogram | CPT | 93350 | 8 | $1,645 | $645.57 | $60.45 | $213.44 | $3,357 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 27 | — | $18,856 | $12,783 | $18,892 | $77,669 |
| COPD w MCC | MS-DRG | 190 | 27 | — | $13,578 | $9,000.93 | $13,391 | $45,791 |
| COPD w CC | MS-DRG | 191 | 27 | — | $10,507 | $6,978.56 | $10,191 | $36,486 |
| COPD w/o CC/MCC | MS-DRG | 192 | 27 | — | $8,175.26 | $5,354.68 | $7,761.16 | $27,207 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 27 | — | $10,077 | $6,678.92 | $9,742.55 | $37,828 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 27 | — | $8,018.65 | $5,166.93 | $7,597.95 | $26,903 |
| AMI discharged alive w MCC | MS-DRG | 280 | 27 | — | $19,336 | $12,974 | $19,392 | $69,441 |
| AMI discharged alive w CC | MS-DRG | 281 | 27 | — | $11,390 | $7,459.05 | $11,111 | $44,062 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 27 | — | $9,116.04 | $5,951.66 | $8,741.58 | $31,006 |
| Heart failure & shock w MCC | MS-DRG | 291 | 27 | — | $15,620 | $10,394 | $15,520 | $55,396 |
| Heart failure & shock w CC | MS-DRG | 292 | 27 | — | $10,577 | $6,994.66 | $10,264 | $36,933 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 27 | — | $7,293.64 | $4,599.83 | $6,842.39 | $26,316 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 27 | — | $14,695 | $9,636.24 | $14,555 | $46,215 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 27 | — | $9,262.2 | $6,060.48 | $8,893.9 | $31,120 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 27 | — | $7,294.8 | $4,682.6 | $6,843.6 | $21,652 |
| GI hemorrhage w CC | MS-DRG | 378 | 27 | — | $12,104 | $7,950.28 | $11,856 | $37,437 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 27 | — | $8,040.69 | $5,274.21 | $7,620.92 | $27,222 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 27 | — | $9,771.45 | $6,374.69 | $9,424.6 | $26,244 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 27 | — | $18,914 | $12,081 | $18,952 | $59,275 |
| Kidney/UTI w MCC | MS-DRG | 689 | 27 | — | $14,188 | $9,363.42 | $14,027 | $45,965 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 27 | — | $10,118 | $6,545.59 | $9,786.07 | $29,228 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 27 | — | $23,261 | $15,431 | $23,483 | $69,911 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 27 | — | $12,598 | $8,295.9 | $12,371 | $42,298 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $85.4 | $85.4 | $85.4 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $134.44 | $134.44 | $134.44 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $177.86 | $177.86 | $177.86 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $83.48 | $83.48 | $83.48 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $117.72 | $117.72 | $117.72 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 29 | $464 | $9.73 | $5.92 | $9.77 | $59.22 |
| General health panel | CPT | 80050 | 9 | $864 | — | $18.48 | $78.56 | $321.09 |
| Electrolyte panel | CPT | 80051 | 29 | $267 | $8.06 | $4.91 | $8.06 | $49.07 |
| Comprehensive metabolic panel | CPT | 80053 | 29 | $864 | $12.14 | $7.39 | $12.2 | $73.92 |
| Lipid panel | CPT | 80061 | 29 | $536 | $15.4 | $9.37 | $15.4 | $93.73 |
| Renal function panel | CPT | 80069 | 29 | $134 | $9.98 | $6.08 | $9.98 | $60.76 |
| Hepatic function panel | CPT | 80076 | 29 | $400 | $9.4 | $5.72 | $9.44 | $57.19 |
| Urinalysis non-automated | CPT | 81002 | 29 | $37 | $4 | $2.44 | $4 | $24.36 |
| Urinalysis automated | CPT | 81003 | 29 | $33 | $2.59 | $1.58 | $2.59 | $15.75 |
| Glucose quantitative | CPT | 82947 | 29 | $57 | $4.52 | $2.75 | $4.56 | $27.51 |
| Hemoglobin A1c | CPT | 83036 | 29 | $149 | $11.17 | $6.8 | $10.49 | $67.97 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 29 | $423 | $19.32 | $11.76 | $19.4 | $117.6 |
| Complete blood count with automated differential | CPT | 85025 | 29 | $81 | $8.94 | $5.44 | $8.47 | $54.39 |
| Complete blood count without differential | CPT | 85027 | 29 | $64 | $7.44 | $4.53 | $7.44 | $45.29 |
| Urine culture bacterial | CPT | 87086 | 29 | $101 | $9.28 | $5.65 | $9.28 | $56.49 |
| Urine culture identification | CPT | 87088 | 29 | $101 | $9.3 | $5.66 | $9.3 | $56.63 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $384 | $61.57 | $11.7 | $43.69 | $360.64 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 6 | $831 | $238.86 | $6.14 | $23.21 | $353 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $2,321.8 | $3,716.04 | $5,792.04 |
| Vaginal delivery only | CPT | 59409 | 6 | $8,482 | $3,824.55 | $794.32 | $3,459.28 | $9,360 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $2,422 | $3,777.43 | $5,750 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $2,321.8 | $3,716.04 | $5,792.04 |
| C-section delivery only | CPT | 59514 | 3 | — | — | $3,348 | $7,800 | $9,360 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $2,665 | $4,802.43 | $10,510 |
| Cesarean section w CC/MCC | MS-DRG | 765 | 3 | — | — | $5,090 | $8,105 | $42,025 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 3 | — | — | $5,090 | $8,105 | $28,538 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 3 | — | — | $5,090 | $8,105 | $26,062 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 3 | — | — | $5,090 | $8,105 | $24,978 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 5 | $206 | — | $39.67 | $79.59 | $167.4 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 5 | $247.2 | — | $52.32 | $97.11 | $167.4 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 5 | $301 | — | $71.73 | $137.64 | $252.13 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 5 | $385 | — | $78 | $167.4 | $327.94 |
| Office visit, established patient, 5 min | CPT | 99211 | 5 | $130 | — | $8.98 | $79.59 | $167.4 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 5 | $130 | — | $36.38 | $79.59 | $167.4 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 5 | $144 | — | $39.67 | $79.59 | $167.4 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 5 | $150 | — | $52.32 | $100.02 | $167.4 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 5 | $322 | — | $71.73 | $139.71 | $217.76 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 8 | $2,601 | $1,071.57 | $162.79 | $1,342.41 | $6,300 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 8 | $2,759 | $1,071.57 | $193.15 | $1,563.5 | $7,560 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 8 | $2,618 | $1,098.72 | $69.1 | $1,413.56 | $6,300 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 8 | $3,740 | $1,098.72 | $82.77 | $1,260.11 | $6,300 |
| Colonoscopy diagnostic | CPT | 45378 | 8 | $2,843 | $1,098.72 | $99.28 | $1,235.97 | $6,300 |
| Colonoscopy with biopsy | CPT | 45380 | 8 | $3,411 | $1,413.79 | $293.05 | $1,617.9 | $6,300 |
| Colonoscopy with polyp removal | CPT | 45385 | 8 | $3,411 | $1,413.79 | $348.5 | $1,892.6 | $8,609 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $7,547.52 | $11,615 | $24,614 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 4 | — | — | $55,247 | $78,674 | $117,378 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 4 | — | — | $35,431 | $50,455 | $72,505 |
| Hip hemiarthroplasty | CPT | 27125 | 5 | — | — | $5,975.12 | $9,518 | $13,703 |
| Total hip replacement | CPT | 27130 | 8 | — | — | $1,008.8 | $12,118 | $27,583 |
| Total knee replacement | CPT | 27447 | 8 | — | — | $1,008.8 | $12,118 | $27,583 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | — | — | $1,008.8 | $9,360 | $25,685 |
| Knee revision arthroplasty all components | CPT | 27487 | 5 | — | — | $6,604.08 | $9,732 | $25,685 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $5,332 | $8,302 | $10,200 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 7 | — | — | $1,008.8 | $7,415.04 | $13,334 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 7 | — | — | $706.55 | $2,600.28 | $12,000 |
| ACL reconstruction | CPT | 29888 | 7 | — | — | $1,008.8 | $8,302 | $10,200 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 27 | — | $54,048 | $35,585 | $55,567 | $194,887 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 27 | — | $28,536 | $18,509 | $28,980 | $94,725 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 27 | — | $20,250 | $13,047 | $20,345 | $60,488 |
| CABG single arterial graft | CPT | 33533 | 3 | — | — | $7,800 | $8,803.5 | $9,534 |
| CABG 2 arterial grafts | CPT | 33534 | 3 | — | — | $7,800 | $8,803.5 | $9,534 |
| CABG 3 arterial grafts | CPT | 33535 | 3 | — | — | $7,800 | $8,803.5 | $9,534 |
| CABG 4+ arterial grafts | CPT | 33536 | 3 | — | — | $7,800 | $8,803.5 | $9,534 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 27 | — | $20,351 | $13,104 | $20,450 | $62,012 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 27 | — | $16,572 | $10,492 | $16,511 | $42,977 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 27 | — | $40,251 | $27,443 | $41,189 | $156,157 |
| Open appendectomy | CPT | 44950 | 7 | — | — | $1,008.8 | $6,692.54 | $10,011 |
| Laparoscopic appendectomy | CPT | 44970 | 7 | — | — | $1,008.8 | $6,604.08 | $12,000 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 4 | — | — | $108,912 | $155,093 | $233,223 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 4 | — | — | $68,872 | $98,075 | $140,667 |
| Major joint replacement w MCC | MS-DRG | 469 | 27 | — | $35,914 | $25,444 | $36,668 | $126,201 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 27 | — | $23,104 | $14,844 | $25,237 | $78,162 |
| Laparoscopic cholecystectomy | CPT | 47562 | 7 | — | — | $1,008.8 | $9,721.5 | $22,668 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 7 | — | — | $1,008.8 | $9,721.5 | $22,668 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 27 | — | $34,511 | $22,933 | $35,207 | $109,024 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 27 | — | $25,025 | $16,296 | $25,320 | $69,668 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 27 | — | $19,648 | $12,552 | $19,717 | $57,147 |
| Lap inguinal hernia repair | CPT | 49650 | 7 | — | — | $1,010.09 | $6,692.54 | $12,000 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $7,800 | $9,360 | $11,938 |
| Vaginal hysterectomy | CPT | 58260 | 7 | — | — | $1,008.8 | $8,805.44 | $18,668 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 7 | — | — | $1,008.8 | $8,805.44 | $18,668 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 7 | — | — | $1,008.8 | $8,805.44 | $13,334 |
| Lap salpingo-oophorectomy | CPT | 58661 | 7 | — | — | $1,008.8 | $7,415.04 | $13,334 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 27 | — | $34,222 | $21,289 | $34,906 | $135,897 |
| OR procedure for obesity w CC | MS-DRG | 620 | 27 | — | $19,292 | $12,633 | $19,346 | $69,232 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 27 | — | $18,226 | $11,597 | $18,235 | $54,982 |
| Complex cataract surgery | CPT | 66982 | 7 | — | — | $2,150.2 | $8,805.44 | $18,002 |
| Cataract surgery with lens implant | CPT | 66984 | 7 | — | — | $783.29 | $4,614.66 | $18,002 |
| Intravitreal injection | CPT | 67028 | 7 | $714 | $390.24 | $119.39 | $897.5 | $5,750 |
| Vitrectomy mechanical | CPT | 67042 | 7 | — | — | $1,008.8 | $9,721.5 | $18,668 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 27 | — | $15,120 | $9,581.07 | $14,999 | $36,653 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 27 | — | $24,498 | $15,369 | $24,772 | $58,924 |
| PCI single major coronary artery | CPT | 92920 | 7 | $15,951 | $6,724.37 | $1,008.8 | $10,557 | $12,668 |
| PCI with drug-eluting stent | CPT | 92928 | 7 | $15,923 | $13,639 | $1,008.8 | $10,831 | $12,743 |
| PCI bypass graft | CPT | 92937 | 7 | $35,986 | $13,639 | $1,008.8 | $10,831 | $12,743 |
| Left heart catheterization | CPT | 93452 | 5 | $7,172 | $3,830.22 | $1,008.8 | $4,300 | $12,593 |
| Coronary angiography with cath | CPT | 93455 | 5 | $14,252 | $3,830.22 | $1,008.8 | $4,300 | $12,593 |
| Coronary angiography with bypass cath | CPT | 93458 | 5 | $27,310 | $3,830.22 | $1,008.8 | $4,300 | $12,593 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| ibc | 191 | $2,343 |
| Aetna | 182 | $1,627.75 |
| Cigna | 160 | $881.21 |
| upmc commercial | 160 | $3,270 |
| Medicaid | 134 | $143.2 |
| Blue Cross Blue Shield | 131 | $11,645 |
| pa health_wellness chc | 131 | $173.67 |
| keystone first | 130 | $373.86 |
| geisinger health plan | 122 | $1,314.49 |
| UnitedHealthcare | 118 | $381.4 |
| Medicare | 111 | $220.61 |
| Medicare Advantage | 109 | $338.7 |
| naphcare | 109 | $419.16 |
| optum va ccn | 109 | $220.61 |
| perennial | 109 | $255.91 |
| point of comfort refugee resettlement | 109 | $220.61 |
| provider partners health plan | 109 | $236.05 |
| st agnes | 109 | $220.61 |
| va_champus_tricare | 109 | $220.61 |
| allwell pa health_wellness ma | 109 | $242.67 |
| Ambetter | 109 | $319.89 |
| devoted health participation | 109 | $231.64 |
| Humana | 109 | $225.02 |
| ibc employee benefit | 109 | $275.76 |
| ibc main line health | 109 | $275.76 |
| innovage | 109 | $220.61 |
| inspira life | 109 | $220.61 |
| jefferson health plan aca qhp exchange | 109 | $209.58 |
| keystone first vip choice | 109 | $225.02 |
| qualcare jcc | 48 | $37,043 |