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Comment by sl-dolt | Hacker News Reader

I'm as surprised as anyone to see this #1 on HN. Glad y'all like it. AMA.

Feedback, criticism, comments, directions to go, whatever.

> You have to hope your hospital uses CPT codes and not, say, DRG coding, or something else entirely, otherwise you'll need to look up those codes too.

This is a bit of a misunderstanding. CPT codes are part of professional services billing, while DRGs are exclusively for inpatient acute care billing. If you are admitted to a hospital, you’ll probably have to deal with both.

That's a great piece of information that I'd have never known about without an insider telling me. So thanks!

re the CPT codes-- 27486 and 27487 are for total knee revisions, not for a first-time replacement. 27486 is used if you only revise 1 component (ie the femoral side or the tibial side). 27487 is billed when both components are revised.

Thank you! I appreciate the correction, and this exactly shows how challenging it is for the average consumer to actually use these chargemasters in the first place to do their own research.

Might be a dumb question, but if I joint hospitals and prices, and filter to the couple nearby hospitals that I care about, and I get 0 rows, that means they're violating the transparency law, correct?

It's not quite that simple. Remember that this database was built collaboratively, and it's possible that our bounty hunters just didn't get to that hospital. We have fairly good coverage, but it's impossible to say if 1) they didn't find the chargemaster, but it exists or 2) they didn't look for it.

We'll probably run another price bounty in the future to capture the rest of the chargemasters.

I wanted to see how different the price for the knee replacement would be at different hospitals.

Good point. With the data as sparse and dirty as it is, it's hard to get a reliable analysis for specific procedures. Or at least one I consider publishable. That, plus, I don't have a good understanding of how medical billing works on the inside.

Some of that will hopefully change in the coming months as new data comes in (will write more about that in another blog.)

If you want to look at how prices for different procedures can vary between hospitals, you can get a rough idea from a previous blog post I wrote:

https://www.dolthub.com/blog/2022-05-06-the-most-expensive-h...

You can simply ask the hospital to give you good faith estimates:

https://www.cms.gov/nosurprises/consumers/understanding-cost...

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