▸ Hospital · WI · CCN 520048
Ascension NE Wisconsin - Mercy Campus
500 S. OAKWOOD ROAD, OSHKOSH, WI, 54904
1
Compliance grade
A
100/100
Procedures tracked
198
of 209 target codes
Payers
18
with negotiated rates
Rates published
15,262
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 9 | — | — | $1,690 | $9,371.76 | $25,008 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 9 | $1,470 | $837.9 | $154.46 | $162.18 | $476.78 |
| Psychiatric eval with medical services | CPT | 90792 | 9 | $798 | $454.86 | $154.46 | $183.95 | $528.09 |
| Psychotherapy 30 minutes | CPT | 90832 | 9 | $551 | $314.07 | $74.83 | $154.46 | $324.37 |
| Psychotherapy 45 minutes | CPT | 90834 | 9 | $773 | $440.61 | $99.06 | $162.18 | $324.37 |
| Psychotherapy 60 minutes | CPT | 90837 | 9 | $890 | $507.3 | $146.18 | $162.18 | $464.04 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 8 | $1,296 | $738.72 | $141 | $158.32 | $484.52 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 14 | $462 | $263.34 | $11.83 | $86.77 | $444 |
| ED visit level 2 | CPT | 99282 | 14 | $809 | $461.13 | $43.4 | $156.05 | $778 |
| ED visit level 3 | CPT | 99283 | 14 | $1,386 | $790.02 | $73.88 | $272.85 | $1,537 |
| ED visit level 4 | CPT | 99284 | 14 | $2,197 | $1,252.29 | $125.71 | $429.84 | $2,890 |
| ED visit level 5 | CPT | 99285 | 14 | $3,434 | $1,957.38 | $182.14 | $604.15 | $3,383 |
| Critical care, first hour | CPT | 99291 | 13 | $2,432 | $1,386.24 | $222.55 | $810.05 | $4,444 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 9 | $1,225 | $698.25 | $42.89 | $107.34 | $391.59 |
| CT head with contrast | CPT | 70460 | 9 | $1,348 | $768.36 | $57.14 | $179.7 | $513.63 |
| CT head with and without contrast | CPT | 70470 | 9 | $1,470 | $837.9 | $64.27 | $179.7 | $518.95 |
| CT neck with contrast | CPT | 70491 | 9 | $668 | $380.76 | $69.8 | $179.7 | $635.98 |
| MRI brain without contrast | CPT | 70551 | 9 | $1,532 | $873.24 | $74.72 | $244 | $1,021.72 |
| MRI brain with contrast | CPT | 70552 | 9 | $1,694 | $965.58 | $89.95 | $360.5 | $1,140.74 |
| MRI brain with and without contrast | CPT | 70553 | 9 | $2,056 | $1,171.92 | $115.4 | $360.5 | $1,336.86 |
| Chest X-ray single view | CPT | 71045 | 8 | $99 | $56.43 | $8.97 | $72.76 | $177.77 |
| Chest X-ray 2 views | CPT | 71046 | 8 | $322 | $183.54 | $11.18 | $81.34 | $177.77 |
| Chest X-ray 3 views | CPT | 71047 | 8 | $355 | $202.35 | $14.11 | $84.65 | $177.77 |
| CT chest without contrast | CPT | 71250 | 9 | $659 | $375.63 | $54.56 | $141.78 | $498.17 |
| CT chest with contrast | CPT | 71260 | 9 | $834 | $475.38 | $58.97 | $179.7 | $622.83 |
| CT chest with and without contrast | CPT | 71270 | 9 | $1,001 | $570.57 | $63.04 | $179.7 | $755.05 |
| MRI chest without contrast | CPT | 71550 | 9 | $1,243 | $708.51 | $73.62 | $244 | $1,116.1 |
| MRI chest with contrast | CPT | 71551 | 9 | — | — | $87.37 | $797.51 | $1,595.01 |
| MRI chest with and without contrast | CPT | 71552 | 9 | $1,831 | $1,043.67 | $113.92 | $360.5 | $1,577.7 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $174 | $99.18 | $11.54 | $90.77 | $214.68 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $668 | $380.76 | $50.39 | $122.37 | $509.45 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $502 | $286.14 | $50.39 | $122.37 | $498.9 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $648 | $369.36 | $50.39 | $122.36 | $497.32 |
| MRI cervical spine without contrast | CPT | 72141 | 9 | $1,521 | $866.97 | $74.72 | $244 | $904.76 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $1,418 | $808.26 | $74.72 | $244 | $906.34 |
| MRI lumbar spine without contrast | CPT | 72148 | 9 | $2,547 | $1,451.79 | $75.07 | $244 | $892.44 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 9 | $2,647 | $1,508.79 | $90.07 | $360.5 | $1,124.85 |
| MRI cervical spine with and without contrast | CPT | 72156 | 9 | $1,878 | $1,070.46 | $115.76 | $360.5 | $1,337.67 |
| MRI lumbar spine with contrast | CPT | 72158 | 9 | $1,931 | $1,100.67 | $115.76 | $360.5 | $1,308.41 |
| CT pelvis without contrast | CPT | 72192 | 9 | $585 | $333.45 | $54.94 | $132.98 | $412.69 |
| CT pelvis with contrast | CPT | 72193 | 9 | $752 | $428.64 | $58.62 | $179.7 | $649.54 |
| Shoulder X-ray | CPT | 73030 | 9 | $182 | $103.74 | $9.69 | $78.69 | $177.77 |
| Humerus X-ray | CPT | 73060 | 9 | $124 | $70.68 | $8.23 | $74.35 | $177.77 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $182 | $103.74 | $8.96 | $82.88 | $177.77 |
| MRI upper extremity joint without contrast | CPT | 73221 | 9 | $1,852 | $1,055.64 | $68.68 | $244 | $658.68 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 9 | $2,052 | $1,169.64 | $108.99 | $360.5 | $1,281.31 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $25.86 | $68.72 | $94.58 |
| Knee X-ray 1-2 views | CPT | 73560 | 9 | $125 | $71.25 | $8.59 | $79.46 | $177.77 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $182 | $103.74 | $8.96 | $82.88 | $177.77 |
| MRI lower extremity joint without contrast | CPT | 73721 | 9 | $1,626 | $926.82 | $68.68 | $244 | $658.68 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $1,838 | $1,047.66 | $108.63 | $360.5 | $1,280.51 |
| CT abdomen without contrast | CPT | 74150 | 9 | $543 | $309.51 | $60.09 | $143.12 | $421.07 |
| CT abdomen with contrast | CPT | 74160 | 9 | $771 | $439.47 | $64.27 | $179.7 | $661.03 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $917 | $522.69 | $70.54 | $179.7 | $761.12 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $1,251 | $713.07 | $87.75 | $244 | $544.08 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $1,418 | $808.26 | $91.8 | $360.5 | $818.18 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $1,501 | $855.57 | $101.15 | $360.5 | $957.81 |
| MRI abdomen without contrast | CPT | 74181 | 9 | $1,356 | $772.92 | $73.62 | $244 | $893.85 |
| MRI abdomen with and without contrast | CPT | 74183 | 9 | $2,547 | $1,451.79 | $110.85 | $360.5 | $1,374.53 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $752 | $428.64 | $40.68 | $107.34 | $335.12 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $721 | $410.97 | $29.5 | $107.34 | $257.75 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $721 | $410.97 | $37.36 | $107.34 | $315.83 |
| Obstetric ultrasound first trimester | CPT | 76801 | 9 | $258 | $147.06 | $50.25 | $121.47 | $302.71 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 9 | $317 | $180.69 | $50.6 | $121.47 | $353.52 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 9 | — | — | $97.38 | $232.38 | $488 |
| Transvaginal ultrasound | CPT | 76830 | 9 | $289 | $164.73 | $35.01 | $107.34 | $295.64 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $444 | $253.08 | $34.66 | $107.34 | $296.97 |
| Scrotal ultrasound | CPT | 76870 | 9 | $408 | $232.56 | $32.08 | $107.34 | $296.46 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $1,000 | $570 | $41.04 | $92.24 | $321.38 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $1,249 | $711.93 | $50.39 | $115.42 | $405.5 |
| Screening mammography bilateral | CPT | 77067 | 8 | $551 | $314.07 | $38.46 | $91.54 | $327.96 |
| EKG complete | CPT | 93000 | 4 | — | — | $15.15 | $15.15 | $55.09 |
| EKG tracing only | CPT | 93005 | 9 | $253 | $144.21 | $6.55 | $57.1 | $119.91 |
| EKG interpretation only | CPT | 93010 | 4 | — | — | $8.6 | $8.6 | $28.09 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $3,024 | $1,723.68 | $73.25 | $527.11 | $1,106.93 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $2,798 | $1,594.86 | $46.09 | $232.38 | $488 |
| Stress echocardiogram | CPT | 93350 | 9 | $1,419 | $808.83 | $73.25 | $527.11 | $1,106.93 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | — | — | $10,209 | $14,293 | $31,323 |
| COPD w MCC | MS-DRG | 190 | 6 | — | — | $7,236.57 | $10,131 | $20,169 |
| COPD w CC | MS-DRG | 191 | 6 | — | — | $5,507.29 | $7,710.21 | $15,538 |
| COPD w/o CC/MCC | MS-DRG | 192 | 6 | — | — | $4,194.17 | $5,871.84 | $11,746 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 6 | — | — | $5,264.92 | $7,370.89 | $15,048 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 6 | — | — | $4,105.97 | $5,748.36 | $11,450 |
| AMI discharged alive w MCC | MS-DRG | 280 | 6 | — | — | $10,480 | $14,671 | $29,036 |
| AMI discharged alive w CC | MS-DRG | 281 | 6 | — | — | $6,004.45 | $8,406.23 | $16,710 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 6 | — | — | $4,723.99 | $6,613.59 | $13,143 |
| Heart failure & shock w MCC | MS-DRG | 291 | 6 | — | — | $8,387.03 | $11,742 | $23,498 |
| Heart failure & shock w CC | MS-DRG | 292 | 6 | — | — | $5,546.49 | $7,765.09 | $15,676 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 6 | — | — | $3,697.66 | $5,176.72 | $10,277 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 6 | — | — | $7,865.7 | $11,012 | $22,003 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 6 | — | — | $4,806.31 | $6,728.83 | $13,630 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 6 | — | — | $3,698.31 | $5,177.63 | $10,121 |
| GI hemorrhage w CC | MS-DRG | 378 | 6 | — | — | $6,406.88 | $8,969.63 | $18,006 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 6 | — | — | $4,118.38 | $5,765.73 | $11,589 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 6 | — | — | $5,093.1 | $7,130.34 | $14,378 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 6 | — | — | $10,242 | $14,338 | $29,858 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | — | — | $7,580.21 | $10,612 | $21,494 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | — | — | $5,288.44 | $7,403.82 | $14,768 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 6 | — | — | $12,690 | $17,766 | $36,286 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | — | — | $6,685.19 | $9,359.27 | $18,849 |
| Initial hospital care, low complexity | CPT | 99221 | 4 | — | — | $86.18 | $86.18 | $221.19 |
| Initial hospital care, moderate complexity | CPT | 99222 | 4 | — | — | $137.23 | $137.23 | $300.69 |
| Initial hospital care, high complexity | CPT | 99223 | 4 | — | — | $182.93 | $182.93 | $443.71 |
| Hospital discharge, <30 min | CPT | 99238 | 4 | — | — | $85.82 | $85.82 | $160.17 |
| Hospital discharge, >30 min | CPT | 99239 | 4 | — | — | $121.25 | $121.25 | $235.51 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $117 | $66.69 | $8.46 | $11.67 | $59.96 |
| General health panel | CPT | 80050 | 3 | $161 | $91.77 | $55.18 | $61.92 | $61.92 |
| Electrolyte panel | CPT | 80051 | 13 | $63 | $35.91 | $7.01 | $9.67 | $49.74 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $138 | $78.66 | $10.56 | $14.57 | $74.89 |
| Lipid panel | CPT | 80061 | 13 | $89 | $50.73 | $13.39 | $18.75 | $94.94 |
| Renal function panel | CPT | 80069 | 13 | $114 | $64.98 | $8.68 | $11.98 | $61.56 |
| Hepatic function panel | CPT | 80076 | 13 | $114 | $64.98 | $8.17 | $11.27 | $31.54 |
| Urinalysis non-automated | CPT | 81002 | 13 | $7 | $3.99 | $3.48 | $3.65 | $13.43 |
| Urinalysis automated | CPT | 81003 | 13 | $24 | $13.68 | $2.25 | $3.11 | $15.91 |
| Glucose quantitative | CPT | 82947 | 13 | $17 | $9.69 | $3.93 | $5.5 | $27.85 |
| Hemoglobin A1c | CPT | 83036 | 13 | $60 | $34.2 | $9.71 | $13.59 | $68.86 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $104 | $59.28 | $16.8 | $23.52 | $119.17 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $49 | $27.93 | $7.77 | $10.88 | $49.56 |
| Complete blood count without differential | CPT | 85027 | 13 | $41 | $23.37 | $6.47 | $8.93 | $24.97 |
| Urine culture bacterial | CPT | 87086 | 13 | $76 | $43.32 | $8.07 | $11.14 | $31.15 |
| Urine culture identification | CPT | 87088 | 13 | $37 | $21.09 | $8.09 | $11.16 | $31.23 |
| Tissue exam by pathologist level IV | CPT | 88305 | 10 | $676 | $385.32 | $39.5 | $53.12 | $165.29 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 9 | — | — | $28.86 | $169.43 | $406.14 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $2,425.82 | $2,425.82 | $5,571.02 |
| Vaginal delivery only | CPT | 59409 | 4 | — | — | $788.43 | $788.43 | $2,110.56 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $1,069.8 | $1,069.8 | $2,721.49 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $2,670.36 | $2,670.36 | $6,132.4 |
| C-section delivery only | CPT | 59514 | 4 | — | — | $885.84 | $885.84 | $2,369.03 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $1,316.09 | $1,316.09 | $3,290 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 4 | $244 | $139.08 | $49.93 | $49.93 | $164.91 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 4 | $351 | $200.07 | $85.89 | $85.89 | $233.8 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 4 | $537 | $306.09 | $140.21 | $140.21 | $357.24 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 4 | $668 | $380.76 | $190.58 | $190.58 | $451.68 |
| Office visit, established patient, 5 min | CPT | 99211 | 4 | $228 | $129.96 | $9.33 | $9.33 | $50.56 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 4 | $340 | $193.8 | $37.18 | $37.18 | $98.51 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 4 | $369 | $210.33 | $69.68 | $69.68 | $163.26 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 4 | $393 | $224.01 | $102.92 | $102.92 | $237.46 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 4 | $469 | $267.33 | $152.42 | $152.42 | $319.23 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $2,787 | $1,588.59 | $126.8 | $901.33 | $1,892.79 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | — | — | $143.11 | $901.33 | $1,892.79 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | — | — | $58.84 | $876.48 | $1,840.61 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | — | — | $75.04 | $876.48 | $1,840.61 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | — | — | $189.87 | $876.48 | $1,840.61 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | — | — | $206.66 | $206.66 | $1,547.7 |
| Colonoscopy with polyp removal | CPT | 45385 | 4 | — | — | $261.49 | $261.49 | $1,614.68 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 4 | — | — | $1,482.79 | $1,482.79 | $5,185.46 |
| Hip hemiarthroplasty | CPT | 27125 | 7 | — | — | $1,164.81 | $3,237.89 | $40,016 |
| Total hip replacement | CPT | 27130 | 7 | $17,245 | $9,829.65 | $1,315.64 | $3,962.39 | $40,016 |
| Total knee replacement | CPT | 27447 | 7 | $12,091 | $6,891.87 | $1,313.97 | $4,064.77 | $40,016 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | $11,031 | $6,287.67 | $1,439.88 | $4,020.97 | $40,016 |
| Knee revision arthroplasty all components | CPT | 27487 | 7 | $14,495 | $8,262.15 | $1,790.3 | $5,020.59 | $40,016 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $173.24 | $173.24 | $620.93 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | — | — | $1,104.34 | $1,104.34 | $3,824.63 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | — | — | $567.3 | $567.3 | $1,936.69 |
| ACL reconstruction | CPT | 29888 | 4 | — | — | $1,007.95 | $1,007.95 | $3,505.13 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 6 | — | — | $30,029 | $42,040 | $82,666 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 6 | — | — | $15,661 | $21,925 | $43,414 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 6 | — | — | $10,994 | $15,392 | $30,601 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $1,830.61 | $1,830.61 | $6,542.78 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $2,148.65 | $2,148.65 | $7,686 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $2,387.66 | $2,387.66 | $8,568.11 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $2,572.45 | $2,572.45 | $9,233.29 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 6 | — | — | $11,051 | $15,472 | $29,918 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 6 | — | — | $8,922.73 | $12,492 | $24,034 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 6 | — | — | $22,258 | $31,162 | $58,581 |
| Open appendectomy | CPT | 44950 | 4 | — | — | $645.4 | $645.4 | $2,268.3 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | — | — | $609.18 | $609.18 | $2,123.14 |
| Major joint replacement w MCC | MS-DRG | 469 | 6 | — | — | $19,816 | $27,742 | $60,942 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 6 | — | — | $12,601 | $17,642 | $34,439 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | — | — | $665.89 | $665.89 | $2,324.78 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | — | — | $723.39 | $723.39 | $2,529.64 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 6 | — | — | $19,026 | $26,636 | $53,971 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 6 | — | — | $13,683 | $19,157 | $37,975 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 6 | — | — | $10,655 | $14,917 | $29,071 |
| Open umbilical hernia repair | CPT | 49560 | 3 | — | — | $1,571.27 | $3,304.47 | $3,304.47 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 3 | — | — | $955.14 | $1,999.87 | $1,999.87 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | — | — | $440.73 | $440.73 | $1,521.19 |
| Lap incisional hernia repair | CPT | 49652 | 3 | — | — | $1,517.22 | $3,330.25 | $3,330.25 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,052.32 | $1,052.32 | $3,643.65 |
| Vaginal hysterectomy | CPT | 58260 | 4 | — | — | $870.4 | $870.4 | $3,019.09 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | — | — | $913.99 | $913.99 | $3,189.75 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | — | — | $1,015.01 | $1,015.01 | $3,553.09 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | — | — | $674.48 | $674.48 | $2,347.88 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 6 | — | — | $18,863 | $26,409 | $50,888 |
| OR procedure for obesity w CC | MS-DRG | 620 | 6 | — | — | $10,455 | $14,637 | $29,690 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 6 | — | — | $9,854.33 | $13,796 | $27,770 |
| Complex cataract surgery | CPT | 66982 | 4 | — | — | $786.85 | $786.85 | $2,729.06 |
| Cataract surgery with lens implant | CPT | 66984 | 4 | — | — | $574.8 | $574.8 | $1,990.05 |
| Intravitreal injection | CPT | 67028 | 9 | — | — | $96.43 | $318.87 | $669.63 |
| Vitrectomy mechanical | CPT | 67042 | 4 | — | — | $1,202.61 | $1,202.61 | $4,187.14 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 6 | — | — | $8,105.46 | $11,348 | $21,267 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $1,790.68 | $14,056 | $34,452 |
| PCI single major coronary artery | CPT | 92920 | 5 | $21,084 | $12,018 | $514.98 | $790.9 | $21,365 |
| PCI with drug-eluting stent | CPT | 92928 | 5 | $40,726 | $23,214 | $573.01 | $878.69 | $22,700 |
| PCI bypass graft | CPT | 92937 | 5 | $40,726 | $23,214 | $572.76 | $877.86 | $22,700 |
| Left heart catheterization | CPT | 93452 | 4 | $7,820 | $4,457.4 | $233.2 | $760.53 | $2,963.14 |
| Coronary angiography with cath | CPT | 93455 | 4 | $19,207 | $10,948 | $274.26 | $893.68 | $3,371.79 |
| Coronary angiography with bypass cath | CPT | 93458 | 4 | $19,207 | $10,948 | $290.49 | $946.97 | $3,472.54 |
Payer mix (top 18)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 193 | $99.06 |
| centivo nw1 | 157 | $268.07 |
| centivo nw3 | 157 | $268.07 |
| cchp | 150 | $313.66 |
| smarthealth | 136 | $239.6 |
| WellCare | 136 | $179.7 |
| Medicare | 136 | $171.14 |
| Molina | 136 | $359.39 |
| VA Health | 136 | $171.14 |
| sehn | 22 | $17.66 |
| network health plan | 22 | $20.67 |
| alliance | 21 | $12.42 |
| Cigna | 20 | $33.08 |
| aca | 13 | $5,500 |
| UnitedHealthcare | 9 | $3,173 |
| trilogy | 5 | $29,489 |
| arise | 1 | $1,690 |
| wps | 1 | $1,690 |