▸ Hospital · WI · CCN 520051
Ascension Columbia St. Mary's Hospital Milwaukee (incl Columbia St. Mary's Women's Hosp.)
2323 NORTH LAKE DRIVE, MILWAUKEE, WI, 53211-
360 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
16
with negotiated rates
Rates published
18,663
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 15 | — | — | $1,435 | $14,695 | $23,062 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 7 | $864 | $457.92 | $156.41 | $344.1 | $521.92 |
| Psychiatric eval with medical services | CPT | 90792 | 7 | $766 | $405.98 | $156.41 | $344.1 | $578.09 |
| Psychotherapy 30 minutes | CPT | 90832 | 7 | $393 | $208.29 | $110.7 | $231.31 | $344.1 |
| Psychotherapy 45 minutes | CPT | 90834 | 7 | $411 | $217.83 | $146.54 | $307.53 | $344.1 |
| Psychotherapy 60 minutes | CPT | 90837 | 7 | $459 | $243.27 | $156.41 | $344.1 | $507.97 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 7 | $422 | $223.66 | $156.41 | $344.1 | $530.4 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 7 | $493 | $261.29 | $18.41 | $70.39 | $188.56 |
| ED visit level 2 | CPT | 99282 | 7 | $864 | $457.92 | $66.88 | $154.16 | $571 |
| ED visit level 3 | CPT | 99283 | 7 | $1,952 | $1,034.56 | $114.58 | $215.07 | $593.01 |
| ED visit level 4 | CPT | 99284 | 7 | $3,300 | $1,749 | $193.92 | $359.58 | $911.97 |
| ED visit level 5 | CPT | 99285 | 7 | $3,434 | $1,820.02 | $281.26 | $523.07 | $1,313.05 |
| Critical care, first hour | CPT | 99291 | 8 | $8,469 | $4,488.57 | $342.91 | $820.26 | $6,109 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 8 | $1,608 | $852.24 | $66.66 | $188.75 | $374.33 |
| CT head with contrast | CPT | 70460 | 8 | $1,765 | $935.45 | $88.62 | $276.91 | $523.24 |
| CT head with and without contrast | CPT | 70470 | 8 | $2,386 | $1,264.58 | $99.6 | $331.65 | $618.64 |
| CT neck with contrast | CPT | 70491 | 8 | $2,321 | $1,230.13 | $108.68 | $346.53 | $762.06 |
| MRI brain without contrast | CPT | 70551 | 8 | $3,811 | $2,019.83 | $116.26 | $385.82 | $745.41 |
| MRI brain with contrast | CPT | 70552 | 8 | $4,932 | $2,613.96 | $139.93 | $570.51 | $1,032.17 |
| MRI brain with and without contrast | CPT | 70553 | 8 | $5,740 | $3,042.2 | $179.52 | $650.32 | $1,220.37 |
| Chest X-ray single view | CPT | 71045 | 8 | $250 | $132.5 | $14.38 | $42.47 | $188.56 |
| Chest X-ray 2 views | CPT | 71046 | 8 | $259 | $137.27 | $17.24 | $62.58 | $188.56 |
| Chest X-ray 3 views | CPT | 71047 | 8 | $269 | $142.57 | $21.76 | $79.77 | $188.56 |
| CT chest without contrast | CPT | 71250 | 8 | $1,684 | $892.52 | $84.64 | $227.74 | $582.23 |
| CT chest with contrast | CPT | 71260 | 8 | $2,025 | $1,073.25 | $91.44 | $347.42 | $741.12 |
| CT chest with and without contrast | CPT | 71270 | 8 | $2,376 | $1,259.28 | $97.72 | $381.26 | $888.15 |
| MRI chest without contrast | CPT | 71550 | 8 | $3,081 | $1,632.93 | $114.56 | $517.68 | $1,335.14 |
| MRI chest with contrast | CPT | 71551 | 8 | $3,186 | $1,688.58 | $135.41 | $913.92 | $1,692.04 |
| MRI chest with and without contrast | CPT | 71552 | 8 | $3,350 | $1,775.5 | $177.24 | $764.85 | $1,867.36 |
| Lumbosacral spine X-ray | CPT | 72100 | 8 | $388 | $205.64 | $17.78 | $75.17 | $245.18 |
| CT cervical spine without contrast | CPT | 72125 | 8 | $1,911 | $1,012.83 | $78.03 | $227.74 | $596.27 |
| CT thoracic spine without contrast | CPT | 72128 | 8 | $1,749 | $926.97 | $78.03 | $227.74 | $582.13 |
| CT lumbar spine without contrast | CPT | 72131 | 8 | $1,965 | $1,041.45 | $78.03 | $227.74 | $579.82 |
| MRI cervical spine without contrast | CPT | 72141 | 8 | $3,777 | $2,001.81 | $116.26 | $370.65 | $723.16 |
| MRI thoracic spine without contrast | CPT | 72146 | 8 | $3,825 | $2,027.25 | $116.26 | $370.65 | $724.3 |
| MRI lumbar spine without contrast | CPT | 72148 | 8 | $3,900 | $2,067 | $116.26 | $371.57 | $719.71 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 8 | $5,000 | $2,650 | $139.93 | $575.14 | $1,035.15 |
| MRI cervical spine with and without contrast | CPT | 72156 | 8 | $6,362 | $3,371.86 | $179.52 | $657.74 | $1,226.1 |
| MRI lumbar spine with contrast | CPT | 72158 | 8 | $5,747 | $3,045.91 | $179.52 | $655.9 | $1,222.65 |
| CT pelvis without contrast | CPT | 72192 | 8 | $1,606 | $851.18 | $85.22 | $227.74 | $471.41 |
| CT pelvis with contrast | CPT | 72193 | 8 | $2,044 | $1,083.32 | $90.9 | $381.26 | $729.23 |
| Shoulder X-ray | CPT | 73030 | 8 | $333 | $176.49 | $14.93 | $61.44 | $188.56 |
| Humerus X-ray | CPT | 73060 | 8 | $314 | $166.42 | $13.23 | $64.86 | $188.56 |
| Hand X-ray 3 views | CPT | 73130 | 8 | $308 | $163.24 | $13.8 | $69.45 | $188.56 |
| MRI upper extremity joint without contrast | CPT | 73221 | 8 | $4,066 | $2,154.98 | $106.95 | $418.29 | $762.56 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 8 | $5,843 | $3,096.79 | $169.08 | $764.85 | $1,514.67 |
| Knee X-ray 1-2 views | CPT | 73560 | 8 | $289 | $153.17 | $13.23 | $71.76 | $188.56 |
| Ankle X-ray 3 views | CPT | 73610 | 8 | $322 | $170.66 | $13.8 | $71.76 | $188.56 |
| MRI lower extremity joint without contrast | CPT | 73721 | 8 | $3,134 | $1,661.02 | $106.4 | $418.29 | $763.7 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 8 | $5,949 | $3,152.97 | $168.54 | $764.85 | $1,518.09 |
| CT abdomen without contrast | CPT | 74150 | 8 | $1,700 | $901 | $93.18 | $227.74 | $484.11 |
| CT abdomen with contrast | CPT | 74160 | 8 | $2,315 | $1,226.95 | $99.6 | $381.26 | $744.74 |
| CT abdomen with and without contrast | CPT | 74170 | 8 | $2,753 | $1,459.09 | $109.28 | $381.26 | $846.98 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 8 | $2,825 | $1,497.25 | $136.53 | $292.68 | $647.29 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 8 | $3,582 | $1,898.46 | $142.78 | $613.19 | $1,006.51 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 8 | $4,202 | $2,227.06 | $157.01 | $695.82 | $1,139.54 |
| MRI abdomen without contrast | CPT | 74181 | 8 | $3,722 | $1,972.66 | $114.56 | $394.79 | $1,073.78 |
| MRI abdomen with and without contrast | CPT | 74183 | 8 | $4,054 | $2,148.62 | $171.96 | $732.95 | $1,634 |
| Abdominal ultrasound complete | CPT | 76700 | 8 | $1,431 | $758.43 | $63.26 | $213.79 | $399.79 |
| Abdominal ultrasound limited | CPT | 76705 | 8 | $1,098 | $581.94 | $46.21 | $160.89 | $297.04 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 8 | $1,037 | $549.61 | $57.58 | $198.94 | $368.47 |
| Obstetric ultrasound first trimester | CPT | 76801 | 8 | $1,169 | $619.57 | $78.01 | $188.72 | $403.27 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 8 | $1,173 | $621.69 | $78.56 | $227.74 | $462.4 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 8 | $1,232 | $652.96 | $140.28 | $254.55 | $595.6 |
| Transvaginal ultrasound | CPT | 76830 | 8 | $983 | $520.99 | $54.71 | $227.74 | $396.84 |
| Pelvic ultrasound complete | CPT | 76856 | 8 | $1,140 | $604.2 | $54.16 | $196.15 | $357.88 |
| Scrotal ultrasound | CPT | 76870 | 8 | $1,094 | $579.82 | $50.18 | $166.38 | $275.47 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $365 | $193.45 | $63.26 | $178.22 | $432.55 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $455 | $241.15 | $78.03 | $227.26 | $548.9 |
| Screening mammography bilateral | CPT | 77067 | 8 | $455 | $241.15 | $59.82 | $188.19 | $443.07 |
| EKG complete | CPT | 93000 | 4 | — | — | $23.29 | $60.31 | $60.31 |
| EKG tracing only | CPT | 93005 | 7 | $660 | $349.8 | $10.03 | $43.69 | $127.2 |
| EKG interpretation only | CPT | 93010 | 4 | — | — | $13.26 | $30.75 | $30.75 |
| Transthoracic echocardiogram complete | CPT | 93306 | 7 | $6,607 | $3,501.71 | $112.74 | $499.04 | $1,174.27 |
| Transthoracic echocardiogram | CPT | 93307 | 7 | — | — | $71.23 | $252.36 | $517.68 |
| Stress echocardiogram | CPT | 93350 | 7 | — | — | $112.74 | $477.67 | $1,174.27 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 15 | — | — | $10,022 | $15,202 | $25,801 |
| COPD w MCC | MS-DRG | 190 | 15 | — | — | $8,313.03 | $15,202 | $21,788 |
| COPD w CC | MS-DRG | 191 | 15 | — | — | $6,326.52 | $15,027 | $21,788 |
| COPD w/o CC/MCC | MS-DRG | 192 | 15 | — | — | $4,818.06 | $15,027 | $21,788 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 15 | — | — | $6,048.09 | $15,027 | $21,788 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 15 | — | — | $4,716.75 | $15,027 | $21,788 |
| AMI discharged alive w MCC | MS-DRG | 280 | 15 | — | — | $10,022 | $15,202 | $26,484 |
| AMI discharged alive w CC | MS-DRG | 281 | 15 | — | — | $6,897.63 | $15,182 | $21,788 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 15 | — | — | $5,426.7 | $15,027 | $21,788 |
| Heart failure & shock w MCC | MS-DRG | 291 | 15 | — | — | $9,634.62 | $15,202 | $21,788 |
| Heart failure & shock w CC | MS-DRG | 292 | 15 | — | — | $6,371.55 | $15,027 | $21,788 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 15 | — | — | $4,247.7 | $15,027 | $21,788 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 15 | — | — | $9,035.74 | $15,202 | $21,788 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 15 | — | — | $5,521.26 | $15,027 | $21,788 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 15 | — | — | $4,248.45 | $15,027 | $21,788 |
| GI hemorrhage w CC | MS-DRG | 378 | 15 | — | — | $7,359.93 | $15,202 | $21,788 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 15 | — | — | $4,731.01 | $15,027 | $21,788 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 15 | — | — | $5,850.72 | $15,027 | $21,788 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 15 | — | — | $10,022 | $15,202 | $25,884 |
| Kidney/UTI w MCC | MS-DRG | 689 | 15 | — | — | $8,707.78 | $15,202 | $21,788 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 15 | — | — | $6,075.11 | $15,027 | $21,788 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 15 | — | — | $10,022 | $15,202 | $32,072 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 15 | — | — | $7,679.63 | $15,202 | $21,788 |
| Initial hospital care, low complexity | CPT | 99221 | 4 | — | — | $132.74 | $241.74 | $261.48 |
| Initial hospital care, moderate complexity | CPT | 99222 | 4 | — | — | $210.14 | $328.63 | $354.71 |
| Initial hospital care, high complexity | CPT | 99223 | 4 | — | — | $281.32 | $484.94 | $524.58 |
| Hospital discharge, <30 min | CPT | 99238 | 4 | — | — | $131.09 | $175.05 | $188.2 |
| Hospital discharge, >30 min | CPT | 99239 | 4 | — | — | $185.49 | $257.4 | $278.56 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 10 | $132 | $69.96 | $8.46 | $17.41 | $38.59 |
| General health panel | CPT | 80050 | 6 | $164 | $86.92 | $57.26 | $59.11 | $145.56 |
| Electrolyte panel | CPT | 80051 | 10 | $141 | $74.73 | $7.01 | $14.43 | $31.99 |
| Comprehensive metabolic panel | CPT | 80053 | 10 | $213 | $112.89 | $10.56 | $21.74 | $48.21 |
| Lipid panel | CPT | 80061 | 10 | $203 | $107.59 | $13.39 | $27.55 | $84.82 |
| Renal function panel | CPT | 80069 | 10 | $136 | $72.08 | $8.68 | $17.85 | $39.63 |
| Hepatic function panel | CPT | 80076 | 10 | $167 | $88.51 | $8.17 | $16.8 | $37.29 |
| Urinalysis non-automated | CPT | 81002 | 10 | $26 | $13.78 | $3.48 | $5.26 | $11.66 |
| Urinalysis automated | CPT | 81003 | 10 | $32 | $16.96 | $2.25 | $4.62 | $10.32 |
| Glucose quantitative | CPT | 82947 | 10 | $78 | $41.34 | $3.93 | $8.06 | $17.92 |
| Hemoglobin A1c | CPT | 83036 | 10 | $159 | $84.27 | $9.71 | $19.97 | $44.29 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 10 | $207 | $109.71 | $16.8 | $34.56 | $76.68 |
| Complete blood count with automated differential | CPT | 85025 | 10 | $129 | $68.37 | $7.77 | $15.99 | $35.48 |
| Complete blood count without differential | CPT | 85027 | 10 | $120 | $63.6 | $6.47 | $13.31 | $29.51 |
| Urine culture bacterial | CPT | 87086 | 10 | $122 | $64.66 | $8.07 | $16.6 | $36.85 |
| Urine culture identification | CPT | 87088 | 10 | $126 | $66.78 | $8.09 | $16.66 | $36.95 |
| Tissue exam by pathologist level IV | CPT | 88305 | 10 | $992 | $525.76 | $37.48 | $53.12 | $239.93 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 7 | $990 | $524.7 | $32.47 | $111.77 | $430.83 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $3,679.41 | $6,106.32 | $7,260.16 |
| Vaginal delivery only | CPT | 59409 | 4 | — | — | $1,212.34 | $2,313.36 | $2,833.37 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $1,608.9 | $2,982.98 | $3,610.59 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $4,030.28 | $6,721.64 | $8,036.76 |
| C-section delivery only | CPT | 59514 | 4 | — | — | $1,360.12 | $2,596.66 | $3,187.19 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $1,963.45 | $3,606.13 | $4,381.36 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 4 | — | — | $77.47 | $180.24 | $193.06 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 4 | — | — | $132.46 | $255.52 | $278.13 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 4 | — | — | $214.69 | $390.43 | $424.56 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 4 | — | — | $291.52 | $493.65 | $532.53 |
| Office visit, established patient, 5 min | CPT | 99211 | 4 | $346 | $183.38 | $14.38 | $55.25 | $55.25 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 4 | $576 | $305.28 | $57.29 | $107.67 | $112.52 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 4 | $806 | $427.18 | $106.79 | $178.43 | $188.14 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 4 | $900 | $477 | $158.01 | $259.52 | $277.6 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 4 | $1,261 | $668.33 | $232.24 | $348.89 | $373.92 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 7 | — | — | $193.51 | $1,103.02 | $2,007.94 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 7 | — | — | $218.45 | $1,440.5 | $2,007.94 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 7 | — | — | $88.88 | $791.49 | $1,952.57 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 7 | — | — | $114.17 | $998.43 | $1,952.57 |
| Colonoscopy diagnostic | CPT | 45378 | 7 | — | — | $290.63 | $1,309.34 | $1,952.57 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | — | — | $316.47 | $1,692.15 | $1,692.15 |
| Colonoscopy with polyp removal | CPT | 45385 | 4 | — | — | $400.74 | $1,765.38 | $1,765.38 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 4 | — | — | $2,270.62 | $5,669.44 | $5,669.44 |
| Hip hemiarthroplasty | CPT | 27125 | 5 | — | — | $3,991.96 | $4,417.71 | $28,491 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $4,772.25 | $5,280.96 | $28,491 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $4,771.23 | $5,275.8 | $28,491 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $4,947.96 | $5,485.76 | $28,491 |
| Knee revision arthroplasty all components | CPT | 27487 | 5 | — | — | $6,178.69 | $6,852.86 | $28,491 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $267.05 | $678.88 | $678.88 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | — | — | $1,688.64 | $4,181.59 | $4,181.59 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | — | — | $864.13 | $2,117.45 | $2,117.45 |
| ACL reconstruction | CPT | 29888 | 4 | — | — | $1,542.14 | $3,832.27 | $3,832.27 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 15 | — | — | $10,022 | $16,883 | $75,891 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 15 | — | — | $10,022 | $16,883 | $39,579 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 15 | — | — | $10,022 | $15,202 | $27,786 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $2,812.68 | $7,153.43 | $7,153.43 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $3,301.89 | $8,403.36 | $8,403.36 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $3,671.66 | $9,367.8 | $9,367.8 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $3,950.85 | $10,095 | $10,095 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 15 | — | — | $10,022 | $15,202 | $27,929 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 15 | — | — | $10,022 | $15,202 | $22,550 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 15 | — | — | $10,022 | $16,883 | $56,253 |
| Open appendectomy | CPT | 44950 | 4 | — | — | $988.43 | $2,480.01 | $2,480.01 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | — | — | $931.7 | $2,321.3 | $2,321.3 |
| Major joint replacement w MCC | MS-DRG | 469 | 15 | — | — | $10,022 | $16,883 | $50,080 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 15 | — | — | $10,022 | $15,202 | $31,847 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | — | — | $1,017.79 | $2,541.75 | $2,541.75 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | — | — | $1,108.2 | $2,765.74 | $2,765.74 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 15 | — | — | $10,022 | $16,883 | $48,084 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 15 | — | — | $10,022 | $15,719 | $34,581 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 15 | — | — | $10,022 | $15,202 | $26,929 |
| Open umbilical hernia repair | CPT | 49560 | 1 | — | — | $1,152.43 | $1,152.43 | $1,152.43 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 1 | — | — | $704.07 | $704.07 | $704.07 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | — | — | $672.62 | $1,663.17 | $1,663.17 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $1,161.07 | $1,161.07 | $1,161.07 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,606.6 | $3,983.72 | $3,983.72 |
| Vaginal hysterectomy | CPT | 58260 | 4 | — | — | $1,334.89 | $3,300.87 | $3,300.87 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | — | — | $1,400.19 | $3,487.46 | $3,487.46 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | — | — | $1,556.57 | $3,884.71 | $3,884.71 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | — | — | $1,033.55 | $2,567.01 | $2,567.01 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 15 | — | — | $10,022 | $16,883 | $47,672 |
| OR procedure for obesity w CC | MS-DRG | 620 | 15 | — | — | $10,022 | $15,202 | $26,422 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 15 | — | — | $10,022 | $15,202 | $24,904 |
| Complex cataract surgery | CPT | 66982 | 4 | — | — | $1,199.3 | $2,983.78 | $2,983.78 |
| Cataract surgery with lens implant | CPT | 66984 | 4 | — | — | $876.11 | $2,175.79 | $2,238.32 |
| Intravitreal injection | CPT | 67028 | 7 | $1,185 | $628.05 | $147.34 | $381.53 | $710.36 |
| Vitrectomy mechanical | CPT | 67042 | 4 | — | — | $1,835.35 | $4,577.94 | $4,577.94 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 15 | — | — | $9,311.17 | $15,202 | $21,788 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 15 | — | — | $10,022 | $15,378 | $33,832 |
| PCI single major coronary artery | CPT | 92920 | 5 | $28,870 | $15,301 | $791.49 | $21,594 | $48,843 |
| PCI with drug-eluting stent | CPT | 92928 | 5 | $31,027 | $16,444 | $881.3 | $22,406 | $48,843 |
| PCI bypass graft | CPT | 92937 | 5 | $29,950 | $15,874 | $880.17 | $22,406 | $48,843 |
| Left heart catheterization | CPT | 93452 | 5 | $19,907 | $10,551 | $359.09 | $2,411.14 | $22,129 |
| Coronary angiography with cath | CPT | 93455 | 5 | $31,536 | $16,714 | $421.91 | $2,712.73 | $22,129 |
| Coronary angiography with bypass cath | CPT | 93458 | 5 | $36,920 | $19,568 | $446.32 | $2,764.68 | $22,129 |
Payer mix (top 16)
| Payer | Codes covered | Median rate |
|---|---|---|
| network health plan | 197 | $211.06 |
| Humana | 194 | $401.74 |
| UnitedHealthcare | 194 | $421.58 |
| alliance | 194 | $426.06 |
| Molina | 136 | $381.26 |
| Medicare | 136 | $173.3 |
| VA Health | 136 | $173.3 |
| cchp marketplace | 114 | $517.79 |
| Anthem BCBS | 63 | $13,670 |
| sehn c89 | 57 | $13,878 |
| centivo | 40 | $17,688 |
| arise | 40 | $17,737 |
| smarthealth | 40 | $11,771 |
| wps | 40 | $19,707 |
| health payment systems | 40 | $15,215 |
| trilogy | 5 | $28,491 |