▸ Hospital · WA · CCN 500088
Valley Medical Center
400 SOUTH 43RD STREET, RENTON, WA, 98058-5010
283 bedsAcute Care Hospitals11
Compliance grade
A
100/100
Procedures tracked
188
of 209 target codes
Payers
30
with negotiated rates
Rates published
49,318
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 6 | $33,720 | $23,604 | $1,600 | $13,058 | $13,319 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 34 | $578 | $404.6 | $424.47 | $440.54 | $451.57 |
| Psychiatric eval with medical services | CPT | 90792 | 34 | $601.12 | $420.78 | $424.47 | $440.54 | $451.57 |
| Psychotherapy 30 minutes | CPT | 90832 | 34 | $406 | $284.2 | $424.47 | $440.54 | $451.57 |
| Psychotherapy 45 minutes | CPT | 90834 | 34 | $406 | $284.2 | $424.47 | $440.54 | $451.57 |
| Psychotherapy 60 minutes | CPT | 90837 | 34 | $406 | $284.2 | $424.47 | $440.54 | $451.57 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 34 | $190 | $133 | $424.47 | $440.54 | $451.57 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 44 | $653 | $457.1 | $8.46 | $245.31 | $357.41 |
| ED visit level 2 | CPT | 99282 | 43 | $1,011 | $707.7 | $178.3 | $451.91 | $650.8 |
| ED visit level 3 | CPT | 99283 | 44 | $11,629 | $8,140.3 | $74.51 | $788.37 | $9,303.2 |
| ED visit level 4 | CPT | 99284 | 41 | $13,109 | $9,176.3 | $126.57 | $1,223.8 | $5,229.18 |
| ED visit level 5 | CPT | 99285 | 40 | $14,631 | $10,242 | $183.62 | $1,774.77 | $5,836.31 |
| Critical care, first hour | CPT | 99291 | 44 | $14,729 | $10,310 | $160.05 | $2,362.44 | $2,926.48 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 42 | $2,686 | $1,880.2 | $121.4 | $303.78 | $443.12 |
| CT head with contrast | CPT | 70460 | 37 | $1,081 | $756.7 | $203.68 | $507.67 | $681.75 |
| CT head with and without contrast | CPT | 70470 | 36 | $1,297 | $907.9 | $203.68 | $507.67 | $621.42 |
| CT neck with contrast | CPT | 70491 | 41 | $1,658 | $1,160.6 | $203.68 | $507.67 | $681.75 |
| MRI brain without contrast | CPT | 70551 | 43 | $1,519 | $1,063.3 | $277.07 | $677.06 | $1,011.32 |
| MRI brain with contrast | CPT | 70552 | 37 | $1,975 | $1,382.5 | $405.13 | $1,062.62 | $1,289.82 |
| MRI brain with and without contrast | CPT | 70553 | 43 | $2,426 | $1,698.2 | $405.13 | $1,062.62 | $1,478.71 |
| Chest X-ray single view | CPT | 71045 | 41 | $346 | $242.2 | $101.06 | $251.08 | $368.86 |
| Chest X-ray 2 views | CPT | 71046 | 43 | $346 | $242.2 | $101.06 | $251.08 | $368.86 |
| Chest X-ray 3 views | CPT | 71047 | 36 | $299 | $209.3 | $103.08 | $251.08 | $308.31 |
| CT chest without contrast | CPT | 71250 | 43 | $1,597 | $1,117.9 | $96.93 | $303.78 | $443.12 |
| CT chest with contrast | CPT | 71260 | 43 | $2,249 | $1,574.3 | $203.68 | $507.67 | $743.44 |
| CT chest with and without contrast | CPT | 71270 | 35 | $1,394 | $975.8 | $489.15 | $507.67 | $577.31 |
| MRI chest without contrast | CPT | 71550 | 35 | $1,639 | $1,147.3 | $652.36 | $677.06 | $845.31 |
| MRI chest with contrast | CPT | 71551 | 34 | $1,632 | $1,142.4 | $2,131.64 | $2,212.35 | $2,267.74 |
| MRI chest with and without contrast | CPT | 71552 | 35 | $2,624 | $1,836.8 | $405.13 | $1,062.62 | $1,289.82 |
| Lumbosacral spine X-ray | CPT | 72100 | 42 | $474 | $331.8 | $121.4 | $303.78 | $443.12 |
| CT cervical spine without contrast | CPT | 72125 | 36 | $2,825 | $1,977.5 | $121.4 | $303.78 | $406.35 |
| CT thoracic spine without contrast | CPT | 72128 | 35 | $1,120 | $784 | $121.4 | $303.78 | $368.74 |
| CT lumbar spine without contrast | CPT | 72131 | 37 | $2,340 | $1,638 | $121.4 | $303.78 | $406.35 |
| MRI cervical spine without contrast | CPT | 72141 | 42 | $1,519 | $1,063.3 | $277.07 | $677.06 | $1,011.32 |
| MRI thoracic spine without contrast | CPT | 72146 | 41 | $1,606 | $1,124.2 | $277.07 | $677.06 | $927.39 |
| MRI lumbar spine without contrast | CPT | 72148 | 41 | $1,470 | $1,029 | $277.07 | $677.06 | $927.39 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 34 | $1,668 | $1,167.6 | $1,023.85 | $1,062.62 | $1,089.22 |
| MRI cervical spine with and without contrast | CPT | 72156 | 39 | $2,523 | $1,766.1 | $405.13 | $1,062.62 | $1,355.99 |
| MRI lumbar spine with contrast | CPT | 72158 | 38 | $2,523 | $1,766.1 | $405.13 | $1,062.62 | $1,355.99 |
| CT pelvis without contrast | CPT | 72192 | 37 | $2,381 | $1,666.7 | $121.4 | $303.78 | $406.35 |
| CT pelvis with contrast | CPT | 72193 | 38 | $2,515 | $1,760.5 | $203.68 | $507.67 | $681.75 |
| Shoulder X-ray | CPT | 73030 | 36 | $656 | $459.2 | $101.06 | $251.08 | $308.31 |
| Humerus X-ray | CPT | 73060 | 35 | $353 | $247.1 | $101.06 | $251.08 | $308.31 |
| Hand X-ray 3 views | CPT | 73130 | 35 | $343 | $240.1 | $101.06 | $251.08 | $308.31 |
| MRI upper extremity joint without contrast | CPT | 73221 | 35 | $2,163 | $1,514.1 | $277.07 | $677.06 | $845.31 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 34 | $2,419 | $1,693.3 | $405.13 | $1,062.62 | $1,089.22 |
| Knee X-ray 1-2 views | CPT | 73560 | 35 | $409 | $286.3 | $101.06 | $251.08 | $308.31 |
| Ankle X-ray 3 views | CPT | 73610 | 35 | $445 | $311.5 | $101.06 | $251.08 | $308.31 |
| MRI lower extremity joint without contrast | CPT | 73721 | 35 | $1,461 | $1,022.7 | $277.07 | $677.06 | $845.31 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 35 | $2,161 | $1,512.7 | $405.13 | $1,062.62 | $1,235.98 |
| CT abdomen without contrast | CPT | 74150 | 38 | $2,850 | $1,995 | $121.4 | $303.78 | $370.38 |
| CT abdomen with contrast | CPT | 74160 | 37 | $1,285 | $899.5 | $203.68 | $507.67 | $681.75 |
| CT abdomen with and without contrast | CPT | 74170 | 40 | $1,514 | $1,059.8 | $203.68 | $507.67 | $681.75 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 42 | $5,404.88 | $3,783.42 | $277.07 | $677.06 | $1,011.32 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 42 | $5,143 | $3,600.1 | $405.13 | $1,062.62 | $1,478.71 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 40 | $4,525 | $3,167.5 | $405.13 | $1,062.62 | $1,355.99 |
| MRI abdomen without contrast | CPT | 74181 | 36 | $1,505 | $1,053.5 | $277.07 | $677.06 | $845.31 |
| MRI abdomen with and without contrast | CPT | 74183 | 43 | $2,488 | $1,741.6 | $405.13 | $1,062.62 | $1,478.71 |
| Abdominal ultrasound complete | CPT | 76700 | 42 | $1,146 | $802.2 | $121.4 | $303.78 | $457.14 |
| Abdominal ultrasound limited | CPT | 76705 | 42 | $917 | $641.9 | $121.4 | $303.78 | $443.12 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 43 | $1,210 | $847 | $121.4 | $303.78 | $482.67 |
| Obstetric ultrasound first trimester | CPT | 76801 | 39 | $981 | $686.7 | $121.4 | $303.78 | $443.12 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 38 | $1,277 | $893.9 | $194.24 | $303.78 | $509.4 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 39 | $1,760 | $1,232 | $443.32 | $677.06 | $1,011.32 |
| Transvaginal ultrasound | CPT | 76830 | 43 | $1,065 | $745.5 | $121.4 | $303.78 | $852 |
| Pelvic ultrasound complete | CPT | 76856 | 41 | $1,142 | $799.4 | $121.4 | $303.78 | $455.54 |
| Scrotal ultrasound | CPT | 76870 | 42 | $959 | $671.3 | $121.4 | $303.78 | $443.12 |
| Diagnostic mammography unilateral | CPT | 77065 | 46 | $654 | $457.8 | $103.55 | $252.92 | $377.96 |
| Diagnostic mammography bilateral | CPT | 77066 | 46 | $655 | $458.5 | $131.96 | $324.35 | $481.65 |
| Screening mammography bilateral | CPT | 77067 | 47 | $498 | $348.6 | $109.19 | $267.4 | $398.54 |
| EKG complete | CPT | 93000 | 2 | $44 | — | $17.42 | $27.82 | $30.07 |
| EKG tracing only | CPT | 93005 | 43 | $416 | $291.2 | $5.37 | $169.01 | $250.04 |
| EKG interpretation only | CPT | 93010 | 6 | $21 | — | $9.28 | $16.06 | $16.06 |
| Transthoracic echocardiogram complete | CPT | 93306 | 49 | $4,618 | $3,232.6 | $116.07 | $1,524.33 | $2,255.84 |
| Transthoracic echocardiogram | CPT | 93307 | 42 | $1,644 | $1,150.8 | $24.67 | $677.06 | $694.01 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | $49,207 | $34,445 | $14,509 | $14,509 | $23,880 |
| COPD w MCC | MS-DRG | 190 | 5 | $43,404 | $30,383 | $7,323 | $10,528 | $10,739 |
| COPD w CC | MS-DRG | 191 | 5 | $28,110 | $19,677 | $1,600 | $8,212.3 | $8,376.55 |
| COPD w/o CC/MCC | MS-DRG | 192 | 4 | $31,376 | $21,963 | $1,600 | $6,453.65 | $6,518.19 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | $32,546 | $22,782 | $1,600 | $7,887.7 | $17,581 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 4 | $28,971 | $20,280 | $1,600 | $6,398.91 | $13,711 |
| AMI discharged alive w MCC | MS-DRG | 280 | 7 | $54,959 | $38,471 | $14,872 | $14,872 | $34,993 |
| AMI discharged alive w CC | MS-DRG | 281 | 6 | $45,325 | $31,728 | $8,878.13 | $8,966.91 | $20,050 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | $39,514 | $27,660 | $7,163.24 | $7,234.87 | $10,384 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | $45,562 | $31,893 | $12,069 | $12,069 | $28,006 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | $35,320 | $24,724 | $8,264.81 | $8,347.46 | $8,430.11 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | $23,951 | $16,766 | $1,600 | $5,846.6 | $10,161 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 4 | $47,713 | $33,399 | $11,371 | $11,598 | $26,265 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 6 | $34,569 | $24,198 | $6,978 | $7,273.5 | $10,565 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 4 | $23,915 | $16,740 | $1,600 | $5,847.49 | $12,349 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | $40,064 | $28,045 | $7,377 | $9,417.1 | $17,607 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 2 | $29,336 | $20,535 | $6,352.16 | $6,383.92 | $6,415.68 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | $31,405 | $21,984 | $1,600 | $7,657.59 | $17,007 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 2 | $14,925 | $10,448 | $1,600 | $8,076.51 | $14,553 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | $38,956 | $27,269 | $1,600 | $10,989 | $20,831 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | $34,673 | $24,271 | $1,600 | $7,919.19 | $11,624 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | $61,944 | $43,361 | $17,832 | $17,921 | $42,376 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 4 | $35,344 | $24,741 | $9,789.85 | $9,887.75 | $22,323 |
| Initial hospital care, low complexity | CPT | 99221 | 3 | $272 | — | $62.37 | $78.9 | $80.73 |
| Initial hospital care, moderate complexity | CPT | 99222 | 4 | $370 | — | $98.66 | $112.51 | $127.42 |
| Initial hospital care, high complexity | CPT | 99223 | 5 | $547 | — | $131.43 | $206.77 | $295.26 |
| Hospital discharge, <30 min | CPT | 99238 | 2 | $197 | — | $57.25 | $70.09 | $82.92 |
| Hospital discharge, >30 min | CPT | 99239 | 3 | $291 | — | $84.32 | $84.32 | $118.15 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 46 | $122 | $85.4 | $7.95 | $24.53 | $48.67 |
| General health panel | CPT | 80050 | 3 | $328 | $229.6 | $61.82 | $61.82 | $104.43 |
| Electrolyte panel | CPT | 80051 | 46 | $53 | $37.1 | $6.59 | $20.33 | $25.59 |
| Comprehensive metabolic panel | CPT | 80053 | 47 | $94 | $65.8 | $9.93 | $30.62 | $75.2 |
| Lipid panel | CPT | 80061 | 46 | $96 | $67.2 | $12.59 | $38.83 | $48.87 |
| Renal function panel | CPT | 80069 | 46 | $33 | $23.1 | $8.16 | $25.17 | $31.68 |
| Hepatic function panel | CPT | 80076 | 46 | $41 | $28.7 | $7.68 | $23.69 | $29.82 |
| Urinalysis non-automated | CPT | 81002 | 46 | $24 | $16.8 | $3.27 | $10.09 | $12.7 |
| Urinalysis automated | CPT | 81003 | 46 | $68.4 | $47.88 | $2.12 | $6.53 | $8.21 |
| Glucose quantitative | CPT | 82947 | 46 | $70 | $49 | $3.69 | $11.4 | $14.34 |
| Hemoglobin A1c | CPT | 83036 | 46 | $109 | $76.3 | $9.13 | $28.16 | $43.48 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 46 | $106 | $74.2 | $15.79 | $48.72 | $61.32 |
| Complete blood count with automated differential | CPT | 85025 | 47 | $93 | $65.1 | $7.3 | $22.53 | $74.4 |
| Complete blood count without differential | CPT | 85027 | 46 | $71 | $49.7 | $6.08 | $18.76 | $28.32 |
| Urine culture bacterial | CPT | 87086 | 46 | $62 | $43.4 | $7.59 | $23.4 | $29.46 |
| Urine culture identification | CPT | 87088 | 46 | $79 | $55.3 | $7.6 | $23.46 | $29.53 |
| Tissue exam by pathologist level IV | CPT | 88305 | 41 | $328 | $229.6 | $60.51 | $149.73 | $262.4 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 14 | $6,689 | $4,682.3 | $31.83 | $80.91 | $856.91 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | $5,343 | — | $952.1 | $952.1 | $952.1 |
| Vaginal delivery only | CPT | 59409 | 34 | $7,944 | $5,560.8 | $313.61 | $6,493.72 | $6,493.72 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | $2,634 | — | $415.57 | $415.57 | $415.57 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | $5,898 | — | $1,046.93 | $1,046.93 | $1,046.93 |
| C-section with postpartum | CPT | 59515 | 1 | $3,191 | — | $510.73 | $510.73 | $510.73 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 14 | $534.15 | $232.4 | $1.3 | $57.53 | $146.51 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | $379 | $265.3 | $56.13 | $85.62 | $203.46 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 15 | $432 | $302.4 | $50 | $139.72 | $339.92 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 15 | $486 | $340.2 | $65 | $190.21 | $452.66 |
| Office visit, established patient, 5 min | CPT | 99211 | 15 | $181 | $126.7 | $6.63 | $11.95 | $49.06 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 14 | $324 | $226.8 | $24.21 | $37.57 | $152.28 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 15 | $346 | $242.2 | $36 | $69.11 | $184.31 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 16 | $505 | $353.5 | $36 | $101.67 | $261.61 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 16 | $559 | $391.3 | $50 | $150.77 | $370.11 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 10 | $5,079 | $3,555.3 | $60.17 | $1,053.23 | $3,744.43 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | $9,800.4 | $6,860.28 | $67.8 | $1,053.23 | $6,381.85 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 8 | $3,458 | $2,420.6 | $27.6 | $1,079.9 | $3,839.27 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $3,960.1 | $2,772.07 | $84.22 | $1,079.9 | $3,294.68 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | $5,457 | $3,819.9 | $90.56 | $1,079.9 | $3,839.27 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | $7,552.7 | $5,286.89 | $418.48 | $1,403.48 | $4,940.26 |
| Colonoscopy with polyp removal | CPT | 45385 | 14 | $6,687.5 | $4,681.25 | $527.1 | $1,389.59 | $4,940.26 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 38 | $87,117 | $60,982 | $1,547.88 | $38,709 | $62,119 |
| Total hip replacement | CPT | 27130 | 35 | $75,774 | $53,042 | $1,376.7 | $27,337 | $27,337 |
| Total knee replacement | CPT | 27447 | 39 | $80,033 | $56,023 | $2,749.7 | $27,337 | $49,902 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | $72,315 | $50,620 | $1,509.15 | $3,586.19 | $14,909 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | $144,526 | $101,168 | $1,870.78 | $4,093.55 | $4,445.53 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 37 | $66,124 | $46,287 | $179.05 | $14,860 | $14,860 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 37 | $68,872 | $48,210 | $2,312.26 | $14,860 | $14,860 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 37 | $58,944 | $41,261 | $1,199.82 | $6,723.19 | $6,723.19 |
| ACL reconstruction | CPT | 29888 | 37 | $86,474 | $60,532 | $2,107.64 | $14,860 | $14,860 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | $168,537 | $117,976 | $41,053 | $41,874 | $100,273 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 7 | $119,681 | $83,777 | $21,811 | $21,920 | $52,295 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | $106,051 | $74,235 | $15,561 | $15,717 | $36,712 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 4 | $112,596 | $78,817 | $15,637 | $20,042 | $36,902 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | $103,206 | $72,244 | $24,520 | $27,158 | $29,795 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 3 | $72,960 | $51,072 | $30,647 | $30,647 | $30,953 |
| Open appendectomy | CPT | 44950 | 34 | $30,233 | $21,163 | $3,245.65 | $15,714 | $25,163 |
| Laparoscopic appendectomy | CPT | 44970 | 44 | $40,838 | $28,586 | $296.25 | $11,985 | $24,959 |
| Major joint replacement w MCC | MS-DRG | 469 | 1 | $129,584 | $90,709 | $27,923 | $27,923 | $27,923 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 4 | $97,787 | $68,451 | $1,600 | $17,890 | $34,630 |
| Laparoscopic cholecystectomy | CPT | 47562 | 43 | $32,834 | $22,984 | $4.64 | $11,985 | $24,959 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 43 | $41,205 | $28,843 | $2.32 | $11,985 | $24,959 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 5 | $143,884 | $100,719 | $26,318 | $26,318 | $26,844 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | $121,078 | $84,754 | $10,626 | $19,162 | $37,603 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 6 | $103,635 | $72,545 | $11,478 | $15,107 | $29,281 |
| Open umbilical hernia repair | CPT | 49560 | 1 | $52,683 | $36,878 | $3,245.65 | $3,245.65 | $3,245.65 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 4 | $37,143 | $26,000 | $1,375.58 | $1,634.4 | $3,245.65 |
| Lap inguinal hernia repair | CPT | 49650 | 38 | $38,313 | $26,819 | $932.82 | $11,985 | $23,498 |
| Lap incisional hernia repair | CPT | 49652 | 12 | $36,567 | $25,597 | $5,061.04 | $5,061.04 | $8,603.77 |
| Total abdominal hysterectomy | CPT | 58150 | 8 | $72,488 | $50,742 | $425.99 | $1,009.39 | $4,345.6 |
| Vaginal hysterectomy | CPT | 58260 | 35 | $80,040 | $56,028 | $37.36 | $10,331 | $10,331 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 36 | $58,585 | $41,010 | $9.28 | $11,985 | $11,985 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 36 | $68,300 | $47,810 | $8,525.24 | $21,381 | $41,316 |
| Lap salpingo-oophorectomy | CPT | 58661 | 41 | $30,352 | $21,246 | $274.25 | $17,977 | $21,418 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 1 | $494,965 | $346,476 | $26,100 | $26,100 | $26,100 |
| Complex cataract surgery | CPT | 66982 | 37 | $26,903 | $18,832 | $1,607.34 | $4,840.36 | $4,840.36 |
| Cataract surgery with lens implant | CPT | 66984 | 38 | $23,986 | $16,790 | $1,175.84 | $4,840.36 | $4,840.36 |
| Intravitreal injection | CPT | 67028 | 38 | $16,637 | $11,646 | $196.92 | $935.77 | $959.2 |
| Vitrectomy mechanical | CPT | 67042 | 39 | $17,468 | $12,228 | $2,448.96 | $8,445.1 | $14,644 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 2 | $82,160 | $57,512 | $22,274 | $24,670 | $27,066 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 1 | $70,992 | $49,695 | $19,140 | $19,140 | $19,140 |
| PCI single major coronary artery | CPT | 92920 | 33 | $16,710 | $11,697 | $11,872 | $11,872 | $11,872 |
| PCI with drug-eluting stent | CPT | 92928 | 33 | $16,612 | $11,628 | $22,850 | $22,850 | $22,850 |
| PCI bypass graft | CPT | 92937 | 33 | $16,612 | $11,628 | $22,850 | $22,850 | $22,850 |
| Left heart catheterization | CPT | 93452 | 34 | $20,080 | $14,056 | $6,768.31 | $6,768.31 | $9,229.12 |
| Coronary angiography with cath | CPT | 93455 | 34 | $15,051 | $10,536 | $6,768.31 | $6,768.31 | $9,229.12 |
| Coronary angiography with bypass cath | CPT | 93458 | 40 | $26,862 | $18,803 | $140.35 | $6,768.31 | $13,384 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 172 | $507.67 |
| Aetna | 152 | $370.38 |
| Blue Cross Blue Shield | 133 | $489.15 |
| Humana | 125 | $174.52 |
| first choice health administrators [150110] | 117 | $507.67 |
| first choice [150134] | 116 | $677.06 |
| carpenters trust [150122] | 115 | $677.06 |
| benefit md [150113] | 115 | $677.06 |
| cement masons and plasterers [150127] | 115 | $677.06 |
| employee benefit management services [150108] | 115 | $677.06 |
| fc moda health [150139] | 115 | $677.06 |
| first choice health comp [150112] | 115 | $677.06 |
| Health Net | 115 | $677.06 |
| here [150114] | 115 | $677.06 |
| hotel employees health trust [150115] | 115 | $677.06 |
| international longshore & warehouse union [150116] | 115 | $677.06 |
| kitsap physician services [150118] | 115 | $677.06 |
| loomis benefits west [150119] | 115 | $677.06 |
| mega [150120] | 115 | $677.06 |
| midwest [150121] | 115 | $677.06 |
| nw administrators [150123] | 115 | $677.06 |
| operating engineers [150125] | 115 | $677.06 |
| painters trust [150126] | 115 | $677.06 |
| puget sound electric [150131] | 115 | $677.06 |
| seattle plumb and pipe [150132] | 115 | $677.06 |
| trusteed plan [150101] | 115 | $677.06 |
| washington bakers trust [150102] | 115 | $677.06 |
| washington employers trust [150103] | 115 | $677.06 |
| washington state health ins pool [150104] | 115 | $677.06 |
| welfare pension administration services [150105] | 115 | $677.06 |