▸ Hospital · WI · CCN 520136
Ascension SE Wisconsin Hospital - St. Joseph Campus
5000 WEST CHAMBERS STREET, MILWAUKEE, WI, 53210-
298 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
194
of 209 target codes
Payers
20
with negotiated rates
Rates published
8,378
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 | — | — | $1,502 | $6,062.23 | $14,464 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 4 | — | — | $156.01 | $156.01 | $440.5 |
| Psychiatric eval with medical services | CPT | 90792 | 4 | — | — | $156.01 | $156.01 | $486.98 |
| Psychotherapy 30 minutes | CPT | 90832 | 4 | — | — | $156.01 | $156.01 | $218.41 |
| Psychotherapy 45 minutes | CPT | 90834 | 4 | — | — | $156.01 | $156.01 | $284.51 |
| Psychotherapy 60 minutes | CPT | 90837 | 4 | — | — | $156.01 | $156.01 | $426.53 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 4 | — | — | $156.01 | $156.01 | $445.88 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 10 | $493 | $261.29 | $56.72 | $321 | $634 |
| ED visit level 2 | CPT | 99282 | 10 | $864 | $457.92 | $110.53 | $478.29 | $899 |
| ED visit level 3 | CPT | 99283 | 10 | $1,952 | $1,034.56 | $165.41 | $1,075 | $2,011 |
| ED visit level 4 | CPT | 99284 | 10 | $3,334 | $1,767.02 | $313.78 | $2,147 | $4,880 |
| ED visit level 5 | CPT | 99285 | 10 | $3,434 | $1,820.02 | $462.81 | $2,987 | $4,880 |
| Critical care, first hour | CPT | 99291 | 9 | $2,614 | $1,385.42 | $730.62 | $2,623.5 | $7,179 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 7 | $1,588 | $841.64 | $103.26 | $144.85 | $1,238.64 |
| CT head with contrast | CPT | 70460 | 7 | $1,604 | $850.12 | $172.86 | $242 | $1,251.12 |
| CT head with and without contrast | CPT | 70470 | 7 | $1,628 | $862.84 | $172.86 | $242 | $1,269.84 |
| CT neck with contrast | CPT | 70491 | 7 | $1,604 | $850.12 | $172.86 | $242 | $1,251.12 |
| MRI brain without contrast | CPT | 70551 | 7 | $2,523 | $1,337.19 | $234.71 | $328.59 | $1,967.94 |
| MRI brain with contrast | CPT | 70552 | 7 | $2,625 | $1,391.25 | $304.91 | $485.49 | $2,047.5 |
| MRI brain with and without contrast | CPT | 70553 | 7 | $2,692 | $1,426.76 | $346.78 | $485.49 | $2,099.76 |
| Chest X-ray single view | CPT | 71045 | 7 | $218 | $115.54 | $31.21 | $85.5 | $204 |
| Chest X-ray 2 views | CPT | 71046 | 7 | $323 | $171.19 | $37.34 | $93.64 | $251.94 |
| Chest X-ray 3 views | CPT | 71047 | 7 | $353 | $187.09 | $48.24 | $102.6 | $275.34 |
| CT chest without contrast | CPT | 71250 | 7 | $1,588 | $841.64 | $103.26 | $159.84 | $1,238.64 |
| CT chest with contrast | CPT | 71260 | 7 | $1,604 | $850.12 | $172.86 | $242 | $1,251.12 |
| CT chest with and without contrast | CPT | 71270 | 7 | $1,620 | $858.6 | $172.86 | $242 | $1,263.6 |
| MRI chest without contrast | CPT | 71550 | 7 | $2,523 | $1,337.19 | $234.71 | $328.59 | $1,967.94 |
| MRI chest with contrast | CPT | 71551 | 6 | — | — | $295.22 | $836 | $1,609.16 |
| MRI chest with and without contrast | CPT | 71552 | 7 | $2,692 | $1,426.76 | $346.78 | $485.49 | $2,099.76 |
| Lumbosacral spine X-ray | CPT | 72100 | 7 | $293 | $155.29 | $38.5 | $109.61 | $245.18 |
| CT cervical spine without contrast | CPT | 72125 | 7 | $1,620 | $858.6 | $103.26 | $164.12 | $1,263.6 |
| CT thoracic spine without contrast | CPT | 72128 | 7 | $1,588 | $841.64 | $103.26 | $158.02 | $1,238.64 |
| CT lumbar spine without contrast | CPT | 72131 | 7 | $1,588 | $841.64 | $103.26 | $158.02 | $1,238.64 |
| MRI cervical spine without contrast | CPT | 72141 | 7 | $2,523 | $1,337.19 | $234.71 | $328.59 | $1,967.94 |
| MRI thoracic spine without contrast | CPT | 72146 | 7 | $2,523 | $1,337.19 | $234.71 | $328.59 | $1,967.94 |
| MRI lumbar spine without contrast | CPT | 72148 | 7 | $2,532 | $1,341.96 | $234.71 | $328.59 | $1,974.96 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 7 | $2,617 | $1,387.01 | $305.64 | $485.49 | $2,041.26 |
| MRI cervical spine with and without contrast | CPT | 72156 | 7 | $2,692 | $1,426.76 | $346.78 | $485.49 | $2,099.76 |
| MRI lumbar spine with contrast | CPT | 72158 | 7 | $2,719 | $1,441.07 | $346.78 | $485.49 | $2,120.82 |
| CT pelvis without contrast | CPT | 72192 | 7 | $1,588 | $841.64 | $103.26 | $165.36 | $1,238.64 |
| CT pelvis with contrast | CPT | 72193 | 7 | $1,637 | $867.61 | $172.86 | $242 | $1,276.86 |
| Shoulder X-ray | CPT | 73030 | 7 | $299 | $158.47 | $32.4 | $90.59 | $233.22 |
| Humerus X-ray | CPT | 73060 | 7 | $279 | $147.87 | $28.74 | $90.52 | $217.62 |
| Hand X-ray 3 views | CPT | 73130 | 7 | $323 | $171.19 | $29.98 | $93.5 | $251.94 |
| MRI upper extremity joint without contrast | CPT | 73221 | 7 | $2,557 | $1,355.21 | $232.67 | $328.59 | $1,994.46 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 7 | $2,800 | $1,484 | $346.78 | $485.49 | $2,184 |
| Knee X-ray 1-2 views | CPT | 73560 | 7 | $279 | $147.87 | $28.74 | $94.07 | $217.62 |
| Ankle X-ray 3 views | CPT | 73610 | 7 | $299 | $158.47 | $29.98 | $94.69 | $233.22 |
| MRI lower extremity joint without contrast | CPT | 73721 | 7 | $2,557 | $1,355.21 | $232.67 | $328.59 | $1,994.46 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 7 | $2,692 | $1,426.76 | $346.78 | $485.49 | $2,099.76 |
| CT abdomen without contrast | CPT | 74150 | 7 | $1,588 | $841.64 | $103.26 | $174.25 | $1,238.64 |
| CT abdomen with contrast | CPT | 74160 | 7 | $1,604 | $850.12 | $172.86 | $242 | $1,251.12 |
| CT abdomen with and without contrast | CPT | 74170 | 7 | $1,628 | $862.84 | $172.86 | $242 | $1,269.84 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 7 | $2,287 | $1,212.11 | $234.71 | $328.59 | $1,783.86 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 7 | $2,405 | $1,274.65 | $312.23 | $485.49 | $1,875.9 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 7 | $2,405 | $1,274.65 | $343.48 | $485.49 | $1,875.9 |
| MRI abdomen without contrast | CPT | 74181 | 7 | $2,532 | $1,341.96 | $234.71 | $328.59 | $1,974.96 |
| MRI abdomen with and without contrast | CPT | 74183 | 7 | $2,692 | $1,426.76 | $346.78 | $485.49 | $2,099.76 |
| Abdominal ultrasound complete | CPT | 76700 | 7 | $784 | $415.52 | $103.26 | $144.56 | $611.52 |
| Abdominal ultrasound limited | CPT | 76705 | 7 | $707 | $374.71 | $100.98 | $144.56 | $551.46 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 7 | $963 | $510.39 | $103.26 | $144.56 | $751.14 |
| Obstetric ultrasound first trimester | CPT | 76801 | 7 | $693 | $367.29 | $103.26 | $158 | $540.54 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 7 | $693 | $367.29 | $103.26 | $158.34 | $540.54 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 7 | $764 | $404.92 | $234.71 | $328.59 | $613.38 |
| Transvaginal ultrasound | CPT | 76830 | 7 | $886 | $469.58 | $103.26 | $144.56 | $691.08 |
| Pelvic ultrasound complete | CPT | 76856 | 7 | $700 | $371 | $103.26 | $144.56 | $546 |
| Scrotal ultrasound | CPT | 76870 | 7 | $728 | $385.84 | $103.26 | $131.07 | $567.84 |
| Diagnostic mammography unilateral | CPT | 77065 | 9 | $513 | $271.89 | $36.64 | $133.14 | $445.46 |
| Diagnostic mammography bilateral | CPT | 77066 | 9 | $720 | $381.6 | $44.99 | $164 | $565.28 |
| Screening mammography bilateral | CPT | 77067 | 9 | $489 | $259.17 | $34.34 | $126.24 | $456.3 |
| EKG complete | CPT | 93000 | 1 | — | — | $55.83 | $55.83 | $55.83 |
| EKG tracing only | CPT | 93005 | 4 | $491 | $260.23 | $27.44 | $57.68 | $80.75 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $28.39 | $28.39 | $28.39 |
| Transthoracic echocardiogram complete | CPT | 93306 | 4 | $5,824 | $3,086.72 | $214.17 | $532.41 | $750.65 |
| Transthoracic echocardiogram | CPT | 93307 | 4 | $2,657 | $1,408.21 | $152.52 | $234.71 | $430.1 |
| Stress echocardiogram | CPT | 93350 | 4 | $4,180 | $2,215.4 | $239.46 | $532.41 | $793.42 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 3 | — | — | $11,559 | $11,559 | $16,182 |
| COPD w MCC | MS-DRG | 190 | 3 | — | — | $8,193.11 | $8,193.11 | $11,470 |
| COPD w CC | MS-DRG | 191 | 3 | — | — | $6,235.26 | $6,235.26 | $8,729.36 |
| COPD w/o CC/MCC | MS-DRG | 192 | 3 | — | — | $4,748.56 | $4,748.56 | $6,647.98 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | — | — | $5,960.85 | $5,960.85 | $8,345.19 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 3 | — | — | $4,648.71 | $4,648.71 | $6,508.19 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | — | — | $11,865 | $11,865 | $16,611 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | — | — | $6,798.13 | $6,798.13 | $9,517.38 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 3 | — | — | $5,348.42 | $5,348.42 | $7,487.79 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | — | — | $9,495.64 | $9,495.64 | $13,294 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | — | — | $6,279.64 | $6,279.64 | $8,791.5 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | — | — | $4,186.42 | $4,186.42 | $5,860.99 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | — | — | $8,905.4 | $8,905.4 | $12,468 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | — | — | $5,441.61 | $5,441.61 | $7,618.25 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | — | — | $4,187.16 | $4,187.16 | $5,862.02 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | — | — | $7,253.76 | $7,253.76 | $10,155 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 3 | — | — | $4,662.76 | $4,662.76 | $6,527.86 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | — | — | $5,766.32 | $5,766.32 | $8,072.85 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 3 | — | — | $11,596 | $11,596 | $16,234 |
| Kidney/UTI w MCC | MS-DRG | 689 | 3 | — | — | $8,582.17 | $8,582.17 | $12,015 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 3 | — | — | $5,987.47 | $5,987.47 | $8,382.46 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 3 | — | — | $14,368 | $14,368 | $20,115 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 3 | — | — | $7,568.85 | $7,568.85 | $10,596 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $269.34 | $269.34 | $269.34 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $365.38 | $365.38 | $365.38 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $540.36 | $540.36 | $540.36 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $193.86 | $193.86 | $193.86 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $286.93 | $286.93 | $286.93 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $96 | $50.88 | $8.46 | $11.84 | $39.74 |
| General health panel | CPT | 80050 | 4 | $344 | $182.32 | $59.01 | $61.78 | $149.9 |
| Electrolyte panel | CPT | 80051 | 13 | $79 | $41.87 | $7.01 | $9.81 | $32.95 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $124 | $65.72 | $10.56 | $14.78 | $49.65 |
| Lipid panel | CPT | 80061 | 13 | $96 | $50.88 | $13.39 | $18.68 | $87.35 |
| Renal function panel | CPT | 80069 | 13 | $108 | $57.24 | $8.68 | $12.15 | $40.81 |
| Hepatic function panel | CPT | 80076 | 13 | $98 | $51.94 | $8.17 | $11.44 | $38.4 |
| Urinalysis non-automated | CPT | 81002 | 13 | $26 | $13.78 | $3.48 | $4.45 | $12.01 |
| Urinalysis automated | CPT | 81003 | 13 | $17 | $9.01 | $2.25 | $3.15 | $10.63 |
| Glucose quantitative | CPT | 82947 | 13 | $49 | $25.97 | $3.93 | $5.5 | $18.46 |
| Hemoglobin A1c | CPT | 83036 | 13 | $72 | $38.16 | $9.71 | $13.59 | $45.61 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $120 | $63.6 | $16.8 | $23.52 | $78.97 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $60 | $31.8 | $7.77 | $10.88 | $36.54 |
| Complete blood count without differential | CPT | 85027 | 13 | $46 | $24.38 | $6.47 | $9.06 | $30.39 |
| Urine culture bacterial | CPT | 87086 | 13 | $74 | $39.22 | $8.07 | $11.3 | $37.95 |
| Urine culture identification | CPT | 87088 | 13 | $69 | $36.57 | $8.09 | $11.33 | $38.05 |
| Tissue exam by pathologist level IV | CPT | 88305 | 8 | $950 | $503.5 | $33.88 | $53.33 | $247.09 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 5 | $1,111 | $588.83 | $65.83 | $195.34 | $866.58 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $7,480.78 | $7,480.78 | $7,480.78 |
| Vaginal delivery only | CPT | 59409 | 1 | — | — | $2,919.47 | $2,919.47 | $2,919.47 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $3,720.3 | $3,720.3 | $3,720.3 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $8,280.97 | $8,280.97 | $8,280.97 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $3,284.04 | $3,284.04 | $3,284.04 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $4,514.49 | $4,514.49 | $4,514.49 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 2 | — | — | $68.79 | $133.83 | $198.87 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 2 | — | — | $105.67 | $196.08 | $286.49 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 2 | — | — | $158.64 | $297.99 | $437.33 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 2 | — | — | $209.02 | $378.79 | $548.55 |
| Office visit, established patient, 5 min | CPT | 99211 | 2 | $432 | $228.96 | $22.35 | $37.63 | $52.91 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 2 | $432 | $228.96 | $53.91 | $84.91 | $115.9 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 2 | $450 | $238.5 | $86.74 | $140.27 | $193.8 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 2 | $606 | $321.18 | $122.48 | $204.22 | $285.95 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 1 | $659 | $349.27 | $385.16 | $385.16 | $385.16 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 4 | — | — | $910.39 | $910.39 | $1,274.55 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 4 | — | — | $910.39 | $910.39 | $1,438.7 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | — | — | $603.74 | $885.29 | $1,239.41 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | — | — | $885.29 | $885.29 | $1,239.41 |
| Colonoscopy diagnostic | CPT | 45378 | 4 | — | — | $885.29 | $885.29 | $1,371.04 |
| Colonoscopy with biopsy | CPT | 45380 | 1 | — | — | $1,697.78 | $1,697.78 | $1,697.78 |
| Colonoscopy with polyp removal | CPT | 45385 | 1 | — | — | $1,779.51 | $1,779.51 | $1,779.51 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 2 | — | — | $5,281.9 | $16,161 | $27,040 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | — | — | $4,113.26 | $27,090 | $40,016 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $4,917.26 | $27,040 | $40,016 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $4,916.21 | $27,040 | $40,016 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $5,098.31 | $27,040 | $40,016 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | — | — | $6,366.44 | $27,090 | $40,016 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $633.47 | $633.47 | $633.47 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 1 | — | — | $3,858.5 | $3,858.5 | $3,858.5 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 1 | — | — | $1,968.84 | $1,968.84 | $1,968.84 |
| ACL reconstruction | CPT | 29888 | 1 | — | — | $3,575.24 | $3,575.24 | $3,575.24 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 3 | — | — | $33,998 | $33,998 | $47,597 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | — | — | $17,731 | $17,731 | $24,823 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 3 | — | — | $12,448 | $12,448 | $17,427 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $6,761.15 | $6,761.15 | $6,761.15 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $7,945.91 | $7,945.91 | $7,945.91 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $8,852.89 | $8,852.89 | $8,852.89 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $9,538.28 | $9,538.28 | $9,538.28 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 3 | — | — | $12,512 | $12,512 | $17,517 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 3 | — | — | $10,102 | $10,102 | $14,143 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 3 | — | — | $25,201 | $25,201 | $35,281 |
| Open appendectomy | CPT | 44950 | 1 | — | — | $2,312.94 | $2,312.94 | $2,312.94 |
| Laparoscopic appendectomy | CPT | 44970 | 1 | — | — | $2,165.12 | $2,165.12 | $2,165.12 |
| Major joint replacement w MCC | MS-DRG | 469 | 3 | — | — | $22,435 | $22,435 | $31,409 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 4 | — | — | $14,267 | $17,121 | $21,712 |
| Laparoscopic cholecystectomy | CPT | 47562 | 1 | — | — | $2,366.57 | $2,366.57 | $2,366.57 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 1 | — | — | $2,569.41 | $2,569.41 | $2,569.41 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 3 | — | — | $21,541 | $21,541 | $30,157 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 3 | — | — | $15,492 | $15,492 | $21,689 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 3 | — | — | $12,064 | $12,064 | $16,889 |
| Lap inguinal hernia repair | CPT | 49650 | 1 | — | — | $1,540.27 | $1,540.27 | $1,540.27 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $3,654.69 | $3,654.69 | $3,654.69 |
| Vaginal hysterectomy | CPT | 58260 | 1 | — | — | $2,985.9 | $2,985.9 | $2,985.9 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 1 | — | — | $3,186.5 | $3,186.5 | $3,186.5 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 1 | — | — | $3,565.25 | $3,565.25 | $3,565.25 |
| Lap salpingo-oophorectomy | CPT | 58661 | 1 | — | — | $2,344.04 | $2,344.04 | $2,344.04 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 3 | — | — | $21,357 | $21,357 | $29,899 |
| OR procedure for obesity w CC | MS-DRG | 620 | 3 | — | — | $11,837 | $11,837 | $16,571 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 3 | — | — | $11,157 | $11,157 | $15,620 |
| Complex cataract surgery | CPT | 66982 | 1 | — | — | $2,894.03 | $2,894.03 | $2,894.03 |
| Cataract surgery with lens implant | CPT | 66984 | 1 | — | — | $2,306.33 | $2,306.33 | $2,306.33 |
| Intravitreal injection | CPT | 67028 | 4 | $1,219 | $646.07 | $322.08 | $322.08 | $450.91 |
| Vitrectomy mechanical | CPT | 67042 | 1 | — | — | $4,216.28 | $4,216.28 | $4,216.28 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 3 | — | — | $9,176.85 | $9,176.85 | $12,848 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 4 | — | — | $7,637 | $15,156 | $21,219 |
| PCI single major coronary artery | CPT | 92920 | 3 | $16,837 | $8,923.61 | $1,790.2 | $26,696 | $57,395 |
| PCI with drug-eluting stent | CPT | 92928 | 3 | $17,147 | $9,087.91 | $1,987.1 | $26,737 | $57,395 |
| PCI bypass graft | CPT | 92937 | 3 | $17,147 | $9,087.91 | $1,984.72 | $26,737 | $57,395 |
| Left heart catheterization | CPT | 93452 | 2 | $15,799 | $8,373.47 | $832.15 | $7,668 | $23,664 |
| Coronary angiography with cath | CPT | 93455 | 2 | $11,358 | $6,019.74 | $971.48 | $7,668 | $23,664 |
| Coronary angiography with bypass cath | CPT | 93458 | 2 | $20,891 | $11,072 | $1,026.87 | $7,668 | $23,664 |
Payer mix (top 20)
| Payer | Codes covered | Median rate |
|---|---|---|
| wps | 155 | $379.47 |
| Medicare | 136 | $172.86 |
| smart health | 136 | $242 |
| VA Health | 136 | $172.86 |
| UnitedHealthcare | 87 | $245.18 |
| trilogy | 62 | $724 |
| Cigna | 62 | $1,251.12 |
| Anthem BCBS | 32 | $87.41 |
| network health | 27 | $22.16 |
| cchp | 23 | $19.97 |
| sehn | 20 | $9 |
| centivo nw3 | 15 | $9.38 |
| alliance | 15 | $18.75 |
| centivo nw1 | 15 | $10.36 |
| centivo nw2 | 15 | $9.87 |
| wisconsin well woman | 12 | $85 |
| health payment systems | 6 | $2,894.5 |
| wisconsin physician services 20190701 tlk baseline | 1 | $1,502 |
| smarthealth employees 20191001 tlk adj - model | 1 | $21,712 |
| arise | 1 | $1,522 |