Every number on this site traces to a public federal source and a retrieval date. This page describes exactly how the figures are produced, including the judgment calls and their limitations.
Since April 1, 2026, CMS requires every hospital to publish a machine-readable file of its standard charges (45 CFR Part 180, schema v3.0), including payer-specific negotiated rates and, where applicable, actual allowed amounts derived from 835 remittance data. We retrieve each hospital's file from the location it publishes in the required cms-hpt.txt pointer at its website root, parse it, and extract rates for a fixed basket of 107 common procedures (32 inpatient MS-DRGs, 75 outpatient CPT/HCPCS codes). The commercial median shown is the median of the hospital's published negotiated dollar rates across commercial plans, excluding Medicare Advantage, Medicaid, and other government program rates. For inpatient DRGs, only case-rate contract rows are compared; per-diem rows are excluded because they price a day, not an episode. Plan-row counts are always displayed: a median over 40 published plan rates is sturdier than one over 2.
Inpatient DRG benchmarks are each hospital's own average Medicare payment per DRG from CMS's Medicare inpatient claims data (2024, the most recent year published); where a hospital has too few Medicare cases to appear, the Colorado median for that DRG is used and flagged in the data. Maternity DRGs have no Medicare benchmark because Medicare rarely pays for deliveries. Outpatient benchmarks are the July 2026 OPPS Addendum B national rate, wage-adjusted to each hospital using its FY2026 wage index (60% labor share). Laboratory codes use the 2026 Clinical Lab Fee Schedule, which is national and not wage-adjusted.
Cost estimates multiply the hospital's published gross charge by its operating cost-to-charge ratio from the FY2026 CMS impact file. This is the standard cost-report method used by MedPAC and NASHP, applied at the hospital level. It is an estimate, always labeled as such, and is least precise for imaging and laboratory services where department-level markup differs most from the hospital average; those cells are marked with a tilde (~). Department-level ratios from full HCRIS worksheets are a planned upgrade. Critical access hospitals are not in the impact file (they are paid on cost) and currently show no cost estimate.
A small share of hospital-procedure cells (about 2%) publish commercial rates far below Medicare across their entire plan set, which indicates partial or component-level pricing in the hospital's file rather than a true episode price. Cells whose commercial median falls below 60% of the Medicare benchmark are flagged, excluded from cross-hospital charts and summary statistics, and shown in tables with a visible data flag.
Actual allowed amounts (medians and percentiles from remittance data) are used only when the hospital publishes a remittance count of 11 or more; masked or missing counts are suppressed. Every parsed file produces an exclusion log: rows dropped for missing dollar values, malformed data, or algorithm-only pricing are counted, not hidden. Seven rural Colorado hospitals currently publish broken, empty, or inaccessible files; they are absent from this site and noted in our compliance tracking.
2026-08-25: the basket expanded from 41 to 107 procedures — every remaining code on CMS’s 70-service shoppable list plus nineteen high-volume MS-DRGs (stroke, AMI, cardiac valve surgery, coronary bypass, hip fracture, bariatric surgery, and others). All original codes were retained, so pre-expansion figures are unchanged; new codes simply appear as hospitals’ files are re-parsed. Every added DRG was verified two ways: its official title against CMS’s Medicare claims data, and its actual publication against a sample of Colorado hospital files. Missing something? Request a procedure or DRG and it will be triaged into the next refresh.
This is analysis of federally published data. It is not medical advice, legal advice, benefits advice, or a guarantee of what any patient will pay. Hospital-published files contain known quality problems; where the data cannot support a conclusion, no number is shown.
The published methodology and analysis code are open. Questions, corrections, and data problems: andrew@rexroadanalytics.com. Related publication: The American Healthcare Conundrum (americanhealthcareconundrum.com).