▸ Hospital · · CCN 459808

Baylor University Medical Center

Compliance grade
B
87/100
Procedures tracked
77
of 209 target codes
Payers
21
with negotiated rates
Rates published
8,497
last crawl 2026-05-24

Procedures & rates

ProcedureTypeCodePayersGrossCashNeg minNeg medianNeg max
behavioral
PsychosesMS-DRG88519$1,458$14,129$30,480
imaging
EKG tracing onlyCPT9300515$53.14$58.74$892
inpatient
Intracranial hemorrhage/CVA w MCCMS-DRG06419$2,778$19,084$42,370
Intracranial hemorrhage/CVA w CCMS-DRG06519$2,778$10,946$23,559
Intracranial hemorrhage/CVA w/o CC/MCCMS-DRG06619$2,778$8,255.23$17,768
Respiratory infections & inflammations w MCCMS-DRG17719$2,778$16,000$34,431
COPD w MCCMS-DRG19019$2,778$11,814$25,429
COPD w CCMS-DRG19119$2,778$9,653.69$20,778
COPD w/o CC/MCCMS-DRG19219$2,778$7,918.72$17,044
Simple pneumonia & pleurisy w CCMS-DRG19419$2,778$9,333.54$20,089
Simple pneumonia & pleurisy w/o CC/MCCMS-DRG19519$2,778$7,718.11$16,612
AMI discharged alive w MCCMS-DRG28020$12,261$16,394$34,962
AMI discharged alive w CCMS-DRG28120$6,885.67$10,167$26,466
AMI discharged alive w/o CC/MCCMS-DRG28220$5,416.36$8,556.52$19,849
Heart failure & shock w MCCMS-DRG29119$2,778$13,303$28,633
Heart failure & shock w CCMS-DRG29219$2,778$9,670.87$20,815
Heart failure & shock w/o CC/MCCMS-DRG29319$2,778$7,112.23$15,308
Cardiac arrhythmia w MCCMS-DRG30819$2,778$12,493$26,890
Cardiac arrhythmia w CCMS-DRG30919$2,778$8,672.79$18,667
Cardiac arrhythmia w/o CC/MCCMS-DRG31019$2,778$7,200.65$15,499
GI hemorrhage w CCMS-DRG37819$2,778$10,692$23,013
GI hemorrhage w/o CC/MCCMS-DRG37919$2,778$7,832.75$16,859
Esophagitis/gastroenteritis w/o MCCMS-DRG39219$2,778$9,008.51$19,390
Fractures of femur w/o MCCMS-DRG53319$2,778$15,168$32,512
Kidney/UTI w MCCMS-DRG68919$2,778$12,202$26,263
Kidney/UTI w/o MCCMS-DRG69019$2,778$9,191.09$19,783
Septicemia or severe sepsis w MV 96+ hrsMS-DRG87119$2,778$18,875$41,793
Septicemia or severe sepsis w/o MV 96+ hrsMS-DRG87219$2,778$11,061$23,808
lab
Basic metabolic panel (BMP)CPT8004815$8.04$8.88$41.37
Tissue exam by pathologist level IVCPT8830515$47.08$52.04$241.91
maternity
Vaginal delivery with postpartumCPT594102$1,726.42$3,371.91$3,901
preventive
Upper GI endoscopy diagnosticCPT4323517$334.95$974.1$4,042
Upper GI endoscopy with biopsyCPT4323917$334.95$974.1$5,016
Sigmoidoscopy diagnosticCPT4533016$130.67$877.65$4,042
Sigmoidoscopy with biopsyCPT4533116$328.5$961.24$4,042
Colonoscopy diagnosticCPT4537817$328.5$982.14$5,016
Colonoscopy with biopsyCPT4538017$429.26$1,268.1$5,016
Colonoscopy with polyp removalCPT4538517$429.26$1,268.1$5,016
surgery
Total shoulder arthroplastyCPT2347216$2,417.79$17,044$35,280
Hip hemiarthroplastyCPT271254$1,886.14$6,546$16,721
Total hip replacementCPT2713017$6,546$13,842$40,224
Total knee replacementCPT2744717$6,546$13,842$40,224
Knee revision arthroplasty single componentCPT274864$2,337.65$6,546$16,721
Knee revision arthroplasty all componentsCPT274875$2,925.22$7,702$29,741
Shoulder arthroscopy with decompressionCPT298264$1,772$5,668$11,704
Shoulder arthroscopy with rotator cuff repairCPT2982718$2,398.52$7,687.7$20,219
Knee arthroscopy with meniscectomyCPT2988118$1,088.27$3,633.7$13,821
ACL reconstructionCPT2988818$3,300.05$7,197$20,219
Major small/large bowel procedures w MCCMS-DRG32919$6,182$41,894$97,807
Major small/large bowel procedures w CCMS-DRG33019$6,182$22,392$50,347
Major small/large bowel procedures w/o CC/MCCMS-DRG33119$6,182$16,138$35,166
Laparoscopic cholecystectomy w/o CDE w MCCMS-DRG41819$6,182$16,198$35,324
Laparoscopic cholecystectomy w/o CDE w CCMS-DRG41919$6,182$13,408$28,859
Laparoscopic cholecystectomy w/o CDE w/o CC/MCCMS-DRG42019$6,182$31,518$75,178
Open appendectomyCPT4495016$4,974.94$7,265.01$14,322
Laparoscopic appendectomyCPT4497016$5,013.07$6,235$16,338
Spinal fusion (non-cervical) w MCCMS-DRG4597$35,308$80,553$103,364
Spinal fusion (non-cervical) w/o MCCMS-DRG4607$35,174$44,427$62,455
Major joint replacement w MCCMS-DRG46921$24,417$34,770$69,623
Major joint replacement w/o MCCMS-DRG47021$14,084$20,637$40,161
Laparoscopic cholecystectomyCPT4756216$1,888.85$6,068.46$16,338
Lap cholecystectomy with cholangiographyCPT4756316$1,888.85$6,068.46$16,338
Hip & femur procedures except major joint w MCCMS-DRG48020$9,144$26,700$62,643
Hip & femur procedures except major joint w CCMS-DRG48120$9,144$19,608$44,195
Hip & femur procedures except major joint w/o CC/MCCMS-DRG48220$9,144$15,609$33,790
Lap inguinal hernia repairCPT4965017$1,888.85$6,151.73$16,338
Total abdominal hysterectomyCPT581504$1,677.98$5,369$16,163
Vaginal hysterectomyCPT5826016$1,526.99$5,231.2$15,605
Lap-assisted vaginal hysterectomyCPT5855017$1,888.85$6,200.38$16,721
Lap-assisted vaginal hysterectomy >250gCPT5855216$3,110.01$9,884.78$28,436
Lap salpingo-oophorectomyCPT5866117$1,888.85$6,200.38$16,338
OR procedure for obesity w MCCMS-DRG61920$6,182$26,491$58,074
OR procedure for obesity w CCMS-DRG62020$6,182$15,951$34,016
OR procedure for obesity w/o CC/MCCMS-DRG62120$6,182$14,600$31,400
Vitrectomy mechanicalCPT6704216$1,533.49$4,276.16$15,605
Uterine & adnexa procedures w CC/MCCMS-DRG74319$6,182$12,434$26,763
Uterine & adnexa procedures w/o CC/MCCMS-DRG74419$6,182$18,618$41,620
Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 21)

PayerCodes coveredMedian rate
Aetna77$12,657
Blue Cross Blue Shield76$12,014
UnitedHealthcare74$14,985
Humana71$6,888.41
Cigna71$9,741.09
baylor scott & white health plan69$11,404
corvel69$9,648.76
procare advantage69$9,670.87
superior health plan69$7,832.75
triwest69$9,210.35
Ambetter69$20,778
wellpoint (fka amerigroup)69$7,683.55
healthspring69$9,670.87
american health plan69$9,670.87
Molina69$9,670.87
prime health services69$9,648.76
healthsmart57$10,081
employers health network45$13,367
university of mary hardin-baylor43$11,228
private health care system13$28,880
optum10$29,741