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RUBRICWARD AI DOSSIER // TIER 2 AUTOPILOT (#01–#06, #11)
MS
MSDOI-MRF-CPT-29881
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Mississippi Insurance Department (MID) & CMS TiC Payer MRF Index
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Hinds County, MS
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Filing / IDR Window: 2026-11-21
MS Commercial Payer TiC MRF & Federal NSA IDR Cohort — Multi-Specialty RCM
Commercial payer TiC MRF negotiated rate audit, CMS Medicare MPFS RVU/GPCI locality repricing, and ERISA 29 CFR § 2560.503-1 / Federal No Surprises Act (45 CFR § 149.510) IDR arbitration package for Multi-Specialty Surgical, ASC & E/M in MS (CPT 29881 Arthroscopy, CPT 45380 Endoscopy & CPT 99285 High-Severity E/M).
Cohort MRF 75th-Pct Value
$1,810,000
Target % of Medicare
206.0% MPFS
Statutory Authority
MS-GPCI-2026 (Miss. Code Ann. § 83-9-5 (18% Prompt-Pay))
ERISA / Timely-Filing Window
120 Days
1. Commercial Payer TiC MRF Allowed-Amount Benchmarks (API #02)
| CPT / DRG Code | Clinical Procedure Description | Unit | Cohort Claims | MRF 25th Pct | MRF Median (QPA) | MRF 75th Pct |
|---|---|---|---|---|---|---|
| CPT 29881 | CPT 29881 Arthroscopy, CPT 45380 Endoscopy & CPT 99285 High-Severity E/M | CLAIM | 420 | $940.00 | $1,485.00 | $2,140.00 |
| CPT-99285 | Level 5 Emergency Department Visit (High Complexity) | CLAIM | 580 | $334.65 | $819.65 | $1,057.30 |
| CPT-00100 | Anesthesia for Salivary Gland / Complex Surgical Base + Time | CLAIM | 215 | $485.24 | $1,188.49 | $1,533.08 |
2. Regional Peer Specialty Groups & EIN/NPI MRF Comparables (API #11)
Hattiesburg ClinicMS Regional Multi-Specialty Surgical, ASC Associates PAMS Ambulatory Multi-Specialty Surgical, ASC Center LLC