▸ Hospital · WI · CCN 520205
Midwest Orthopedic Specialty Hospital
10101 S 27TH ST, FRANKLIN, WI, 53132-
16 bedsAcute Care Hospitals6
Compliance grade
A
100/100
Procedures tracked
194
of 209 target codes
Payers
20
with negotiated rates
Rates published
8,374
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 | $5,382.05 | $12,560 |
| 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 | — | — | $56.72 | $266 | $634 |
| ED visit level 2 | CPT | 99282 | 10 | — | — | $110.53 | $396.65 | $899 |
| ED visit level 3 | CPT | 99283 | 10 | — | — | $165.41 | $906 | $2,011 |
| ED visit level 4 | CPT | 99284 | 10 | — | — | $313.78 | $1,968.5 | $4,880 |
| ED visit level 5 | CPT | 99285 | 10 | — | — | $462.81 | $2,546.5 | $4,880 |
| Critical care, first hour | CPT | 99291 | 9 | — | — | $730.62 | $3,464 | $7,179 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 7 | $1,588 | $841.64 | $103.26 | $145.14 | $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 | $101.78 | $251.94 |
| Chest X-ray 3 views | CPT | 71047 | 7 | $353 | $187.09 | $48.24 | $119.7 | $275.34 |
| CT chest without contrast | CPT | 71250 | 7 | $1,588 | $841.64 | $103.26 | $175.12 | $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 | $955.01 | $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 | $115.95 | $245.18 |
| CT cervical spine without contrast | CPT | 72125 | 7 | $1,620 | $858.6 | $103.26 | $183.68 | $1,263.6 |
| CT thoracic spine without contrast | CPT | 72128 | 7 | $1,588 | $841.64 | $103.26 | $171.47 | $1,238.64 |
| CT lumbar spine without contrast | CPT | 72131 | 7 | $1,588 | $841.64 | $103.26 | $171.47 | $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 | $186.16 | $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 | $95.67 | $233.22 |
| Humerus X-ray | CPT | 73060 | 7 | $279 | $147.87 | $28.74 | $95.53 | $217.62 |
| Hand X-ray 3 views | CPT | 73130 | 7 | $323 | $171.19 | $29.98 | $101.5 | $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 | $102.64 | $217.62 |
| Ankle X-ray 3 views | CPT | 73610 | 7 | $299 | $158.47 | $29.98 | $103.88 | $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 | $203.93 | $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 | 6 | — | — | $103.26 | $158 | $519 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 6 | — | — | $103.26 | $158.34 | $519 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 6 | — | — | $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 | 6 | — | — | $103.26 | $131.07 | $519 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | — | — | $36.64 | $133.14 | $445.46 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | — | — | $44.99 | $164 | $565.28 |
| Screening mammography bilateral | CPT | 77067 | 8 | — | — | $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 | — | — | $10,037 | $10,037 | $14,051 |
| COPD w MCC | MS-DRG | 190 | 3 | — | — | $7,114.31 | $7,114.31 | $9,960.03 |
| COPD w CC | MS-DRG | 191 | 3 | — | — | $5,414.25 | $5,414.25 | $7,579.95 |
| COPD w/o CC/MCC | MS-DRG | 192 | 3 | — | — | $4,123.31 | $4,123.31 | $5,772.63 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | — | — | $5,175.97 | $5,175.97 | $7,246.36 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 3 | — | — | $4,036.6 | $4,036.6 | $5,651.24 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | — | — | $10,302 | $10,302 | $14,423 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | — | — | $5,903.01 | $5,903.01 | $8,264.21 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 3 | — | — | $4,644.18 | $4,644.18 | $6,501.85 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | — | — | $8,245.33 | $8,245.33 | $11,543 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | — | — | $5,452.79 | $5,452.79 | $7,633.91 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | — | — | $3,635.19 | $3,635.19 | $5,089.27 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | — | — | $7,732.81 | $7,732.81 | $10,826 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | — | — | $4,725.11 | $4,725.11 | $6,615.15 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | — | — | $3,635.83 | $3,635.83 | $5,090.16 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | — | — | $6,298.64 | $6,298.64 | $8,818.1 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 3 | — | — | $4,048.81 | $4,048.81 | $5,668.33 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | — | — | $5,007.06 | $5,007.06 | $7,009.88 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 3 | — | — | $10,069 | $10,069 | $14,096 |
| Kidney/UTI w MCC | MS-DRG | 689 | 3 | — | — | $7,452.14 | $7,452.14 | $10,433 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 3 | — | — | $5,199.09 | $5,199.09 | $7,278.73 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 3 | — | — | $12,476 | $12,476 | $17,466 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 3 | — | — | $6,572.25 | $6,572.25 | $9,201.15 |
| 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 | $11.8 | $39.74 |
| General health panel | CPT | 80050 | 4 | $344 | $182.32 | $59.01 | $59.82 | $149.9 |
| Electrolyte panel | CPT | 80051 | 13 | $79 | $41.87 | $7.01 | $9.78 | $32.95 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $124 | $65.72 | $10.56 | $14.73 | $49.65 |
| Lipid panel | CPT | 80061 | 13 | $96 | $50.88 | $13.39 | $18.6 | $87.35 |
| Renal function panel | CPT | 80069 | 13 | $108 | $57.24 | $8.68 | $12.11 | $40.81 |
| Hepatic function panel | CPT | 80076 | 13 | $98 | $51.94 | $8.17 | $11.4 | $38.4 |
| Urinalysis non-automated | CPT | 81002 | 13 | $26 | $13.78 | $3.48 | $4.4 | $12.01 |
| Urinalysis automated | CPT | 81003 | 13 | $17 | $9.01 | $2.25 | $3.13 | $10.63 |
| Glucose quantitative | CPT | 82947 | 13 | $49 | $25.97 | $3.93 | $5.48 | $18.46 |
| Hemoglobin A1c | CPT | 83036 | 13 | $72 | $38.16 | $9.71 | $13.54 | $45.61 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $120 | $63.6 | $16.8 | $23.43 | $78.97 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $60 | $31.8 | $7.77 | $10.84 | $36.54 |
| Complete blood count without differential | CPT | 85027 | 13 | $46 | $24.38 | $6.47 | $9.02 | $30.39 |
| Urine culture bacterial | CPT | 87086 | 13 | $74 | $39.22 | $8.07 | $11.26 | $37.95 |
| Urine culture identification | CPT | 87088 | 13 | $69 | $36.57 | $8.09 | $11.29 | $38.05 |
| Tissue exam by pathologist level IV | CPT | 88305 | 8 | $950 | $503.5 | $33.88 | $58.53 | $247.09 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 4 | — | — | $65.83 | $195.34 | $273.48 |
| 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 | $214 | $113.42 | $22.35 | $37.63 | $52.91 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 2 | $363 | $192.39 | $53.91 | $84.91 | $115.9 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 2 | $434 | $230.02 | $86.74 | $140.27 | $193.8 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 2 | $582 | $308.46 | $122.48 | $204.22 | $285.95 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 1 | $646 | $342.38 | $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 | $27,040 | $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 | — | — | $29,521 | $29,521 | $41,330 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | — | — | $15,396 | $15,396 | $21,555 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 3 | — | — | $10,809 | $10,809 | $15,132 |
| 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 | — | — | $10,864 | $10,864 | $15,210 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 3 | — | — | $8,771.99 | $8,771.99 | $12,281 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 3 | — | — | $21,882 | $21,882 | $30,635 |
| 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 | — | — | $19,481 | $19,481 | $27,273 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 4 | — | — | $12,389 | $14,866 | $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 | — | — | $18,705 | $18,705 | $26,186 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 3 | — | — | $13,452 | $13,452 | $18,833 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 3 | — | — | $10,475 | $10,475 | $14,665 |
| 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 | — | — | $18,545 | $18,545 | $25,962 |
| OR procedure for obesity w CC | MS-DRG | 620 | 3 | — | — | $10,278 | $10,278 | $14,389 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 3 | — | — | $9,687.85 | $9,687.85 | $13,563 |
| 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 | — | — | $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 | — | — | $7,968.52 | $7,968.52 | $11,156 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 4 | — | — | $7,637 | $13,161 | $18,425 |
| PCI single major coronary artery | CPT | 92920 | 3 | $16,837 | $8,923.61 | $1,790.2 | $25,724 | $57,395 |
| PCI with drug-eluting stent | CPT | 92928 | 3 | $17,147 | $9,087.91 | $1,987.1 | $25,724 | $57,395 |
| PCI bypass graft | CPT | 92937 | 3 | $17,147 | $9,087.91 | $1,984.72 | $25,724 | $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 |
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 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 | 54 | $1,269.84 |
| Anthem BCBS | 32 | $61.78 |
| 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 |
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