Co-founder of rivethealth.com here. Take however complicated you think medical billing is and multiply 5x. For starters. --- You are using a bit of a mixed e

Co-founder of rivethealth.com here. Take however complicated you think medical billing is and multiply 5x. For starters. --- You are using a bit of a mixed example with bandaids, aspirin, and duck bite. The simplest billing is FFS (fee for service). This associates a fee for each procedure/drug/product using a 5-digit CPT/HCPC code. For example, 29877 would be Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chrondroplasty). Add a 50 modifier to make it bilateral (both knees). Add an AS modifier if billing for an assistant surgeon. Add a 26 if the bill is only for the professional (human services) portion. And so on. The in-network price will be based on the health organization (9-digit tax ID), the rendering physician (10-digit NPI), the insurance plan/network (no standardized format), and the place of service (2-digit code, e.g. 24 Ambulatory Surgery Center). The price is further modified by a variety of adjustments, such as MPPR (multiple-procedure price reduction), MACRA, etc. W61.61XA (Bitten by duck, initial encounter) is a ICD10 diagnosis code. That is, a diagnosis of a condition, not a service. While you will always have a diagnosis, it's not relevant for FFS pricing. This is used in a whole other set of billing called DRG (diagnosis-related groups) typically used for inpatient care. And of course there are even more billing methods. --- This is all very, very complicated. A lot of it is essential complexity -- modern medicine is indeed very complex. And a lot of it is incidental complexity. Not unlike a certain software industry. /: