Pawtucket, RI, 02860-
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 | 9 | — | — | $10,622 | $15,988 | 1.2× | $25,937 |
| inpatient | |||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $16,348 | $17,754 | 1.2× | $36,855 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $10,574 | $12,910 | 1.2× | $26,124 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $8,116.19 | $10,092 | 1.1× | $19,881 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $6,430.61 | $7,951.89 | 1.1× | $15,141 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $7,994.52 | $9,696.9 | 1.1× | $19,006 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $6,099.35 | $7,808.16 | 1.2× | $14,823 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $14,716 | $18,195 | 1.2× | $37,831 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $8,699.66 | $10,902 | 1.1× | $21,676 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $6,651.74 | $8,815.34 | 1.1× | $17,054 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $11,948 | $14,785 | 1.2× | $30,277 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $8,168.59 | $10,156 | 1.1× | $20,023 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $5,911.08 | $7,142.73 | 1.1× | $13,349 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $10,689 | $13,935 | 1.2× | $28,395 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $6,780.51 | $8,949.49 | 1.2× | $17,351 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $4,993.69 | $7,143.8 | 1.2× | $13,351 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $8,794.69 | $11,558 | 1.2× | $23,129 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $5,800.96 | $7,828.39 | 1.1× | $14,867 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $6,708.58 | $9,416.89 | 1.2× | $18,386 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $13,592 | $17,808 | 1.2× | $36,973 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $9,871.93 | $13,470 | 1.2× | $27,365 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $7,052.27 | $9,735.22 | 1.2× | $19,091 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $16,486 | $21,798 | 1.2× | $45,812 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $9,350.63 | $12,012 | 1.2× | $24,134 |
| surgery | |||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $44,339 | $50,055 | 1.2× | $108,404 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $22,409 | $26,639 | 1.1× | $56,536 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $15,050 | $19,034 | 1.2× | $39,690 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $14,779 | $19,127 | 1.2× | $39,895 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $11,582 | $15,658 | 1.2× | $32,211 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $31,239 | $37,391 | 1.2× | $80,353 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $56,702 | $56,702 | 1.1× | $56,702 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $35,856 | $35,856 | 1.1× | $35,856 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $28,190 | $33,410 | 1.1× | $71,535 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $17,671 | $21,653 | 1.1× | $45,491 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $26,912 | $32,123 | 1.1× | $68,684 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $18,315 | $23,416 | 1.2× | $49,397 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $14,782 | $18,482 | 1.2× | $38,466 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $25,938 | $31,858 | 1.2× | $68,096 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $16,071 | $18,155 | 1.1× | $37,741 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $14,017 | $17,176 | 1.1× | $35,574 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $9,907.45 | $14,326 | 1.2× | $29,261 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $15,011 | $22,933 | 1.2× | $48,326 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 42 | $11,765 |
| Cigna | 40 | $15,222 |
| commonwealth care alliance | 40 | $15,222 |
| neighborhood health plan - ri | 40 | $15,222 |
| tufts health plan | 40 | $15,222 |
| UnitedHealthcare | 40 | $17,754 |
| va community care | 40 | $15,222 |
| Aetna | 40 | $19,557 |
| WellCare | 40 | $15,222 |
