Riverview Regional Medical Center — Pricing

718 procedures published in this hospital's Machine-Readable File (MRF) — 713 with a comparable price, 5 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 718
Lowest published price $2,237
Average published price $13,393
Highest published price $179,815

Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.

Showing all 718 procedures

Published charges

Showing all 713 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.

Across 41 procedures, this hospital's negotiated rates average ≈124% of what Medicare pays.

DRG Description Published price Cash price vs. AL median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $179,815 $298,766 $483,987 −63% $498,715 −64% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $162,683 $223,329 $554,063 −71% $431,073 −62% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $132,271 $188,194 $306,087 −57% $306,087 −57% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $109,457 $170,085 $514,267 −79% $371,366 −71% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $77,404 $112,375 $232,659 −67% $245,189 −68% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $72,027 $104,248 $171,028 −58% $182,314 −60% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $70,397 $28,141 $56,242 +25% $56,242 +25% —
007 LUNG TRANSPLANT $63,483 $103,988 $170,608 −63% $170,608 −63% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $62,241 $87,792 $155,461 −60% $169,977 −63% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $57,714 $54,665 $91,253 −37% $104,881 −45% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $53,308 $64,408 $106,929 −50% $135,380 −61% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $52,083 $84,865 $139,842 −63% $159,181 −67% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $51,826 $84,434 $223,526 −77% $191,314 −73% —
426 UnGrouped $51,477 $83,490 $137,630 −63% $142,326 −64% —
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $51,313 — $103,861 −51% $103,861 −51% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $46,095 $51,737 $92,943 −50% $121,714 −62% —
850 UnGrouped $45,523 $73,504 $121,563 −63% $121,563 −63% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $42,149 $44,382 $74,709 −44% $101,280 −58% —
231 CORONARY BYPASS WITH PTCA WITH MCC $41,833 $67,671 $194,975 −79% $145,864 −71% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $41,810 $67,634 $112,119 −63% $151,029 −72% —
429 UnGrouped $41,418 $66,617 $110,483 −63% $119,071 −65% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $41,364 $63,351 $105,228 −61% $105,228 −61% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $40,520 $30,907 $75,812 −47% $75,103 −46% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $40,059 $59,691 $99,339 −60% $120,573 −67% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $39,361 $44,382 $74,709 −47% $76,004 −48% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $38,735 $62,474 $144,689 −73% $138,868 −72% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $38,496 $32,843 $65,570 −41% $71,873 −46% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $38,363 $61,851 $197,223 −81% $143,242 −73% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $35,669 $48,977 $82,102 −57% $106,219 −66% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $35,589 $50,681 $84,844 −58% $109,331 −67% —
427 UnGrouped $35,585 $56,833 $94,742 −62% $121,728 −71% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $35,534 $40,962 $107,038 −67% $94,320 −62% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $35,417 $56,551 $237,515 −85% $131,961 −73% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $35,034 $55,678 $124,851 −72% $137,160 −74% ≈102% of Medicare
447 UnGrouped $33,710 $53,688 $146,642 −77% $114,665 −71% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $33,535 $53,395 $102,020 −67% $115,937 −71% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CCMCC $33,375 $53,484 $89,353 −63% $89,353 −63% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $32,377 $51,811 $86,661 −63% $116,058 −72% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $32,342 $49,368 $60,574 −47% $98,912 −67% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CCMCC $32,138 $48,402 $81,176 −60% $81,176 −60% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $32,090 $43,603 $73,455 −56% $95,375 −66% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $31,306 $49,654 $126,923 −75% $117,280 −73% —
317 UnGrouped $31,268 $49,591 $151,859 −79% $93,934 −67% —
028 SPINAL PROCEDURES WITH MCC $30,551 $48,746 $81,731 −63% $95,858 −68% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $30,405 $46,058 $77,406 −61% $107,355 −72% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $30,385 $34,361 $162,433 −81% $87,495 −65% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CCMCC $30,345 $48,402 $81,176 −63% $98,260 −69% —
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $30,193 $40,082 $113,799 −73% $96,905 −69% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CCMCC $29,937 $47,717 $80,075 −63% $92,238 −68% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $29,687 $43,339 $91,539 −68% $82,527 −64% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $29,519 $46,714 $78,460 −62% $96,192 −69% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $29,268 $45,787 $174,511 −83% $106,778 −73% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $28,994 $47,682 $41,101 −29% $80,018 −64% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $28,758 $42,745 $129,196 −78% $102,573 −72% —
653 MAJOR BLADDER PROCEDURES WITH MCC $28,350 $44,756 $75,310 −62% $97,028 −71% —
428 UnGrouped $28,053 $44,199 $74,414 −62% $105,899 −74% —
430 UnGrouped $27,895 $43,933 $155,528 −82% $93,783 −70% —
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $27,596 $43,701 $86,459 −68% $86,459 −68% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $27,587 $43,343 $73,038 −62% $86,953 −68% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $27,354 $43,384 $73,103 −63% $78,327 −65% —
450 UnGrouped $26,385 $41,401 $69,912 −62% $79,944 −67% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $26,364 $29,029 $49,721 −47% $59,425 −56% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $26,304 $41,265 $137,942 −81% $99,423 −74% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $25,836 $40,839 $75,528 −66% $80,747 −68% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $25,693 $40,240 $112,937 −77% $84,861 −70% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $25,638 $40,506 $72,728 −65% $87,575 −71% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $25,635 $31,127 $67,344 −62% $72,274 −65% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $25,498 $40,271 $68,095 −63% $70,779 −64% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $25,470 $40,225 $61,938 −59% $86,938 −71% ≈98% of Medicare
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $25,034 $31,244 $53,357 −53% $62,961 −60% —
245 AICD GENERATOR PROCEDURES $24,931 $39,320 $66,564 −63% $72,076 −65% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $24,775 $38,269 $64,874 −62% $84,825 −71% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $24,073 $37,880 $64,248 −63% $92,217 −74% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $24,038 $37,463 $155,387 −85% $91,329 −74% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $23,954 $37,681 $76,990 −69% $80,885 −70% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $23,827 $37,110 $62,992 −62% $71,551 −67% —
163 MAJOR CHEST PROCEDURES WITH MCC $23,623 $37,126 $63,017 −63% $88,341 −73% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CCMCC $23,545 $36,994 $115,547 −80% $90,331 −74% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CCMCC $23,366 $34,824 $59,237 −61% $83,441 −72% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $23,345 $35,415 $60,208 −61% $75,585 −69% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $23,163 $36,354 $61,750 −62% $72,843 −68% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $22,978 $36,044 $83,680 −73% $88,307 −74% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $22,963 $35,713 $51,322 −55% $68,847 −67% —
252 OTHER VASCULAR PROCEDURES WITH MCC $22,785 $27,809 $61,496 −63% $68,508 −67% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $22,680 $33,197 $80,267 −72% $82,247 −72% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $22,293 $34,894 $59,352 −62% $59,352 −62% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $22,046 $34,122 $60,955 −64% $60,098 −63% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $21,871 $30,743 $52,936 −59% $74,755 −71% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $21,650 $33,817 $57,584 −62% $68,590 −68% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $21,646 $33,809 $57,570 −62% $72,879 −70% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $21,453 $33,658 $20,848 +3% $16,708 +28% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $21,408 $31,881 $78,579 −73% $68,331 −69% —
448 UnGrouped $21,359 $32,971 $69,346 −69% $81,998 −74% —
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CCMCC $21,342 — $50,278 −58% $54,320 −61% —
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $21,241 $33,130 $56,456 −62% $73,029 −71% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CCMCC $21,211 $28,599 $49,015 −57% $62,404 −66% —
052 SPINAL DISORDERS AND INJURIES WITH CCMCC $20,803 $16,602 $30,673 −32% $30,940 −33% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $20,777 $31,817 $54,300 −62% $61,832 −66% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $20,676 $32,182 $54,898 −62% $71,519 −71% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $20,662 $32,160 $54,862 −62% $57,521 −64% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $20,634 $31,754 $32,855 −37% $54,196 −62% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $20,564 $25,247 $87,217 −76% $65,325 −69% —
402 UnGrouped $20,552 $31,617 $53,970 −62% $75,492 −73% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $20,471 $30,271 $42,976 −52% $60,861 −66% —
904 SKIN GRAFTS FOR INJURIES WITH CCMCC $20,098 $31,213 $53,307 −62% $55,002 −63% —
691 UnGrouped $20,076 — $10,183 — $31,905 −37% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $19,694 $23,941 $58,114 −66% $63,984 −69% ≈118% of Medicare
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $19,679 $30,509 $88,815 −78% $74,257 −73% —
332 RECTAL RESECTION WITH MCC $19,621 $28,111 $48,214 −59% $58,125 −66% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $19,433 $28,320 $59,020 −67% $51,953 −63% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $19,261 $28,380 $51,736 −63% $65,383 −71% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $19,258 $28,522 $48,887 −61% $56,964 −66% —
265 AICD LEAD PROCEDURES $19,025 $28,890 $28,051 −32% $56,216 −66% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $18,978 $29,334 $50,222 −62% $71,755 −74% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $18,795 $29,027 $49,718 −62% $57,855 −68% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $18,792 $29,023 $74,169 −75% $64,488 −71% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $18,638 $28,763 $95,151 −80% $70,540 −74% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $18,535 $28,592 $56,271 −67% $50,919 −64% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $18,348 $27,919 $47,899 −62% $71,014 −74% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $18,254 $27,768 $71,942 −75% $68,421 −73% —
037 EXTRACRANIAL PROCEDURES WITH MCC $18,238 $26,943 $70,105 −74% $64,749 −72% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $18,231 $28,081 $48,165 −62% $48,745 −63% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $18,109 $27,877 $75,430 −76% $61,353 −70% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $18,059 $24,001 $41,464 −56% $54,313 −67% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $17,955 $27,617 $47,403 −62% $67,215 −73% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $17,888 $27,505 $48,458 −63% $70,132 −74% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $17,784 $23,713 $46,886 −62% $54,475 −67% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CCMCC $17,743 $16,878 $29,767 −40% $34,089 −48% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $17,721 $27,226 $59,199 −70% $62,790 −72% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $17,704 $25,363 $57,741 −69% $65,573 −73% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $17,677 $26,793 $37,447 −53% $52,908 −67% —
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $17,612 — $42,725 −59% $50,815 −65% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $17,443 $25,782 $44,389 −61% $51,142 −66% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $17,428 $22,245 $38,581 −55% $44,973 −61% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $17,359 $21,592 $37,509 −54% $40,277 −57% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $17,307 $26,531 $45,618 −62% $64,468 −73% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $17,263 $26,457 $45,498 −62% $53,763 −68% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $17,256 $26,446 $75,272 −77% $64,465 −73% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $17,217 $26,022 $135,367 −87% $57,277 −70% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $17,173 $25,949 $44,663 −62% $66,819 −74% —
333 RECTAL RESECTION WITH CC $17,054 $17,494 $30,778 −45% $34,352 −50% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIESINTRALUMINAL DEVICES $16,998 $23,196 $100,617 −83% $74,274 −77% ≈112% of Medicare
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $16,961 $24,949 $43,021 −61% $53,555 −68% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CCMCC $16,891 $25,833 $44,472 −62% $44,472 −62% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $16,842 $23,733 $66,649 −75% $66,765 −75% —
582 MASTECTOMY FOR MALIGNANCY WITH CCMCC $16,763 $14,537 $89,127 −81% $34,158 −51% —
451 UnGrouped $16,659 $25,087 $43,247 −61% $65,216 −74% —
662 MINOR BLADDER PROCEDURES WITH MCC $16,604 $25,352 $43,683 −62% $54,483 −70% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $16,575 $22,323 $38,709 −57% $48,358 −66% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $16,494 $17,644 $24,963 −34% $36,850 −55% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $16,476 $25,137 $43,330 −62% $62,266 −74% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CCMCC $16,435 $25,069 $43,218 −62% $53,817 −69% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $16,317 $24,870 $47,607 −66% $63,310 −74% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $16,194 $23,877 $41,261 −61% $60,140 −73% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $16,091 $16,330 $28,868 −44% $41,847 −62% —
570 SKIN DEBRIDEMENT WITH MCC $16,089 $24,488 $42,263 −62% $51,501 −69% —
692 UnGrouped $16,020 — $16,020 — $25,916 −38% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $15,976 $24,298 $41,952 −62% $46,402 −66% —
668 TRANSURETHRAL PROCEDURES WITH MCC $15,646 $23,745 $55,341 −72% $47,126 −67% —
800 SPLENIC PROCEDURES WITH CC $15,634 $23,726 $41,012 −62% $49,184 −68% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $15,604 $23,317 $40,341 −61% $53,787 −71% —
472 CERVICAL SPINAL FUSION WITH CC $15,556 $23,594 $64,812 −76% $59,537 −74% —
263 VEIN LIGATION AND STRIPPING $15,508 $21,894 $33,529 −54% $44,938 −65% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $15,372 $23,285 $40,289 −62% $49,055 −69% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $15,281 $21,667 $37,631 −59% $40,947 −63% —
654 MAJOR BLADDER PROCEDURES WITH CC $15,202 $23,001 $76,059 −80% $53,868 −72% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $15,138 $22,893 $39,644 −62% $58,043 −74% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $15,124 $22,870 $53,113 −72% $48,907 −69% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $15,121 $21,376 $37,153 −59% $43,697 −65% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $14,926 $19,673 $51,300 −71% $56,394 −74% —
849 RADIOTHERAPY $14,844 $21,807 $37,862 −61% $37,862 −61% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CCMCC $14,815 $21,641 $37,588 −61% $45,558 −67% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $14,775 $22,285 $38,070 −61% $45,497 −68% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $14,706 $22,168 $36,691 −60% $43,491 −66% —
135 SINUS AND MASTOID PROCEDURES WITH CCMCC $14,648 $19,752 $34,487 −58% $40,065 −63% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $14,643 $22,063 $67,385 −78% $57,030 −74% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $14,601 $21,992 $41,200 −65% $44,839 −67% —
253 OTHER VASCULAR PROCEDURES WITH CC $14,597 $20,874 $42,816 −66% $53,746 −73% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $14,551 $21,908 $38,027 −62% $52,405 −72% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CCMCC $14,445 $20,652 $35,964 −60% $46,659 −69% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $14,356 $20,668 $42,062 −66% $39,657 −64% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CCMCC $14,266 $21,430 $66,707 −79% $54,929 −74% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $14,230 $17,384 $53,625 −73% $37,839 −62% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $14,152 $12,363 $10,682 +32% $7,896 +79% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CCMCC $14,124 $13,679 $28,957 −51% $31,566 −55% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CCMCC $14,102 $21,155 $38,075 −63% $41,596 −66% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $14,082 $21,121 $42,371 −67% $47,574 −70% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $14,064 $20,732 $36,097 −61% $36,097 −61% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $13,938 $20,880 $36,339 −62% $38,878 −64% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CCMCC $13,909 $20,472 $35,670 −61% $55,162 −75% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $13,827 $18,079 $31,740 −56% $38,382 −64% —
397 APPENDIX PROCEDURES WITH MCC $13,794 $20,280 $35,850 −62% $52,319 −74% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $13,776 $15,367 $27,287 −50% $30,681 −55% —
164 MAJOR CHEST PROCEDURES WITH CC $13,765 $20,589 $38,030 −64% $53,141 −74% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CCMCC $13,753 $16,385 $28,958 −53% $29,598 −54% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $13,708 $17,095 $37,703 −64% $50,998 −73% ≈119% of Medicare
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $13,704 $20,487 $32,497 −58% $39,409 −65% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $13,670 $19,887 $51,769 −74% $54,681 −75% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $13,626 $18,974 $79,418 −83% $51,339 −73% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CCMCC $13,606 $20,201 $46,057 −70% $52,332 −74% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $13,441 $20,046 $34,970 −62% $51,985 −74% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $13,398 $19,812 $32,981 −59% $45,937 −71% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $13,351 $18,742 $50,453 −74% $39,253 −66% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $13,200 $19,643 $56,817 −77% $47,583 −72% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CCMCC $13,200 $19,643 $34,307 −62% $39,093 −66% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $13,103 $19,479 $34,039 −62% $51,950 −75% —
473 CERVICAL SPINAL FUSION WITHOUT CCMCC $13,060 $19,407 $33,920 −61% $50,624 −74% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $13,057 $19,402 $34,332 −62% $40,548 −68% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $13,042 $19,378 $61,205 −79% $58,713 −78% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $13,040 $15,437 $32,818 −60% $34,886 −63% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $13,026 $18,991 $28,922 −55% $35,806 −64% —
374 DIGESTIVE MALIGNANCY WITH MCC $12,978 $17,384 $34,408 −62% $38,885 −67% —
399 APPENDIX PROCEDURES WITHOUT CCMCC $12,972 $9,578 $21,695 −40% $30,259 −57% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $12,961 $16,596 $37,028 −65% $45,594 −72% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CCMCC $12,934 $16,230 $34,205 −62% $41,520 −69% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CCMCC $12,930 $10,739 $16,308 −21% $19,686 −34% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $12,924 $19,179 $44,288 −71% $50,139 −74% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $12,915 $14,995 $48,419 −73% $54,772 −76% ≈124% of Medicare
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CCMCC $12,886 $15,361 $48,863 −74% $32,538 −60% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $12,837 $19,034 $33,308 −61% $36,237 −65% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $12,782 $18,941 $55,732 −77% $49,631 −74% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $12,762 $18,501 $61,267 −79% $50,011 −74% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $12,715 $18,828 $32,969 −61% $37,080 −66% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CCMCC $12,697 $18,708 $32,773 −61% $43,313 −71% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $12,697 $18,798 $32,919 −61% $36,195 −65% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $12,624 $18,675 $44,664 −72% $46,306 −73% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $12,607 $17,577 $51,483 −76% $35,569 −65% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $12,582 $18,606 $46,379 −73% $36,318 −65% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CCMCC $12,573 $12,955 $23,326 −46% $34,434 −63% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CCMCC $12,546 $18,545 $32,504 −61% $38,998 −68% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $12,545 $18,544 $69,202 −82% $44,989 −72% —
113 ORBITAL PROCEDURES WITH CCMCC $12,538 $18,531 $32,482 −61% $35,642 −65% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $12,516 $18,495 $39,801 −69% $48,682 −74% —
709 PENIS PROCEDURES WITH CCMCC $12,493 $18,456 $32,359 −61% $34,535 −64% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $12,424 $18,340 $32,168 −61% $44,022 −72% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $12,398 $15,067 $26,794 −54% $35,989 −66% —
030 SPINAL PROCEDURES WITHOUT CCMCC $12,391 $18,285 $32,077 −61% $45,842 −73% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $12,334 $18,189 $39,656 −69% $44,600 −72% ≈113% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $12,304 $16,197 $40,626 −70% $43,538 −72% —
595 MAJOR SKIN DISORDERS WITH MCC $12,282 $17,413 $30,646 −60% $31,772 −61% —
935 NON-EXTENSIVE BURNS $12,254 $18,055 $26,681 −54% $29,458 −58% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $12,213 $20,057 $15,797 −23% $11,633 +5% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CCMCC $12,208 $16,142 $28,559 −57% $29,524 −59% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $12,172 $17,917 $40,850 −70% $41,114 −70% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $12,134 $16,290 $28,801 −58% $43,252 −72% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $12,126 $17,841 $31,349 −61% $37,681 −68% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $12,110 $17,677 $48,656 −75% $34,900 −65% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $12,097 $17,358 $57,185 −79% $55,147 −78% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $12,070 $17,746 $31,193 −61% $44,553 −73% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CCMCC $12,067 $16,015 $41,835 −71% $36,202 −67% —
334 RECTAL RESECTION WITHOUT CCMCC $12,053 $13,805 $31,864 −62% $32,213 −63% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $12,052 $17,716 $31,144 −61% $38,166 −68% —
711 TESTES PROCEDURES WITH CCMCC $12,023 $15,797 $36,693 −67% $34,846 −65% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $12,016 $17,656 $31,044 −61% $31,044 −61% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $11,968 $17,575 $30,912 −61% $44,719 −73% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $11,949 $17,543 $30,860 −61% $37,654 −68% —
592 SKIN ULCERS WITH MCC $11,860 $16,948 $35,974 −67% $32,662 −64% —
336 PERITONEAL ADHESIOLYSIS WITH CC $11,858 $17,391 $42,937 −72% $49,071 −76% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $11,819 $14,048 $25,121 −53% $29,409 −60% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $11,817 $16,151 $35,472 −67% $35,108 −66% —
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CCMCC $11,813 $17,316 $30,486 −61% $35,381 −67% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $11,783 $17,266 $35,037 −66% $46,066 −74% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CCMCC $11,780 $12,692 $40,056 −71% $33,694 −65% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $11,755 $17,218 $32,677 −64% $32,506 −64% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $11,748 $14,417 $25,727 −54% $32,839 −64% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $11,642 $16,477 $23,560 −51% $29,109 −60% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $11,628 $13,098 $17,978 −35% $32,804 −65% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CCMCC $11,538 $16,140 $33,751 −66% $32,901 −65% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $11,462 $16,726 $29,518 −61% $30,661 −63% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $11,438 $16,418 $30,079 −62% $35,714 −68% ≈117% of Medicare
539 OSTEOMYELITIS WITH MCC $11,434 $16,680 $29,443 −61% $33,614 −66% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $11,412 $16,281 $34,880 −67% $43,775 −74% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $11,409 $16,638 $34,781 −67% $41,660 −73% —
548 SEPTIC ARTHRITIS WITH MCC $11,398 $16,619 $21,947 −48% $31,019 −63% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CCMCC $11,340 $15,184 $34,321 −67% $40,694 −72% —
504 FOOT PROCEDURES WITH CC $11,332 $14,567 $25,972 −56% $36,519 −69% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $11,320 $16,488 $29,127 −61% $43,444 −74% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CCMCC $11,290 $14,960 $55,770 −80% $40,063 −72% —
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $11,271 $16,407 $33,182 −66% $35,139 −68% —
100 SEIZURES WITH MCC $11,260 $16,387 $28,961 −61% $35,194 −68% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $11,204 $15,145 $52,218 −79% $40,583 −72% —
165 MAJOR CHEST PROCEDURES WITHOUT CCMCC $11,185 $15,428 $62,167 −82% $41,380 −73% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $11,175 $16,180 $28,621 −61% $36,880 −70% —
505 FOOT PROCEDURES WITHOUT CCMCC $11,172 $14,567 $25,972 −57% $31,716 −65% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $11,150 $16,204 $30,658 −64% $34,876 −68% ≈116% of Medicare
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CCMCC $11,140 $15,597 $41,729 −73% $45,916 −76% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $11,080 $15,255 $22,780 −51% $28,375 −61% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $11,006 $15,963 $28,264 −61% $42,881 −74% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $11,005 $15,694 $51,311 −79% $42,126 −74% —
380 COMPLICATED PEPTIC ULCER WITH MCC $10,972 $15,905 $28,169 −61% $36,537 −70% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $10,926 $14,709 $26,206 −58% $36,355 −70% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $10,918 $15,814 $27,634 −60% $33,236 −67% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $10,866 $13,365 $17,834 −39% $35,584 −69% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $10,854 $15,348 $15,243 −29% $22,698 −52% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $10,847 $13,046 $55,854 −81% $40,801 −73% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $10,846 $15,694 $27,823 −61% $35,029 −69% —
501 SOFT TISSUE PROCEDURES WITH CC $10,827 $14,802 $29,594 −63% $37,975 −71% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $10,826 $15,660 $27,767 −61% $36,241 −70% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $10,812 $15,637 $34,271 −68% $31,913 −66% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $10,800 $15,616 $27,695 −61% $31,743 −66% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $10,793 $13,089 $27,720 −61% $30,224 −64% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $10,792 $14,361 $25,633 −58% $29,826 −64% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $10,790 $15,600 $27,668 −61% $32,976 −67% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $10,789 $15,598 $55,708 −81% $48,801 −78% ≈116% of Medicare
196 INTERSTITIAL LUNG DISEASE WITH MCC $10,783 $15,587 $27,647 −61% $30,362 −64% —
254 OTHER VASCULAR PROCEDURES WITHOUT CCMCC $10,775 $14,523 $36,870 −71% $38,836 −72% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $10,751 $14,588 $62,845 −83% $35,673 −70% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $10,656 $12,912 $24,470 −56% $28,252 −62% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CCMCC $10,611 $12,413 $22,435 −53% $32,911 −68% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $10,603 $15,285 $40,652 −74% $29,609 −64% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CCMCC $10,589 $13,290 $32,590 −68% $35,375 −70% —
116 INTRAOCULAR PROCEDURES WITH CCMCC $10,574 $13,884 $24,851 −57% $28,103 −62% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $10,569 $15,228 $28,912 −63% $29,867 −65% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $10,515 $15,137 $33,895 −69% $40,563 −74% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CCMCC $10,512 $15,134 $26,903 −61% $40,552 −74% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $10,502 $15,117 $44,648 −76% $37,950 −72% —
919 COMPLICATIONS OF TREATMENT WITH MCC $10,498 $15,109 $27,399 −62% $29,031 −64% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $10,494 $15,103 $26,853 −61% $35,990 −71% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $10,492 $14,943 $9,850 +7% $14,121 −26% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $10,472 $15,066 $25,827 −59% $37,842 −72% ≈122% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $10,430 $14,996 $26,677 −61% $29,476 −65% —
157 DENTAL AND ORAL DISEASES WITH MCC $10,421 $13,638 $36,475 −71% $27,457 −62% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $10,396 $14,580 $18,469 −44% $29,558 −65% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $10,296 $14,772 $64,386 −84% $47,635 −78% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CCMCC $10,234 $12,583 $22,714 −55% $35,528 −71% —
199 PNEUMOTHORAX WITH MCC $10,223 $14,648 $33,873 −70% $31,085 −67% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $10,189 $13,645 $36,463 −72% $30,768 −67% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CCMCC $10,187 $14,587 $26,006 −61% $39,018 −74% —
509 ARTHROSCOPY $10,182 $14,580 $25,994 −61% $25,994 −61% —
597 MALIGNANT BREAST DISORDERS WITH MCC $10,182 $14,580 $30,109 −66% $31,846 −68% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $10,141 $14,511 $25,881 −61% $31,627 −68% —
180 RESPIRATORY NEOPLASMS WITH MCC $10,140 $14,510 $25,879 −61% $36,658 −72% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $10,098 $14,439 $25,761 −61% $30,814 −67% —
915 ALLERGIC REACTIONS WITH MCC $10,094 $14,432 $36,882 −73% $30,944 −67% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $10,056 $13,318 $30,924 −67% $35,453 −72% —
671 URETHRAL PROCEDURES WITH CCMCC $10,027 $14,319 $25,566 −61% $27,233 −63% —
075 VIRAL MENINGITIS WITH CCMCC $10,021 $14,309 $25,549 −61% $29,751 −66% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $10,014 $13,467 $20,702 −52% $27,118 −63% —
666 PROSTATECTOMY WITH CC $10,011 $13,716 $24,574 −59% $30,016 −67% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $9,991 $14,259 $52,138 −81% $38,094 −74% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $9,988 $13,897 $24,871 −60% $25,146 −60% —
038 EXTRACRANIAL PROCEDURES WITH CC $9,986 $13,431 $42,944 −77% $35,770 −72% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $9,973 $13,639 $42,054 −76% $36,333 −73% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CCMCC $9,957 $13,403 $27,031 −63% $35,692 −72% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $9,956 $14,141 $45,717 −78% $43,266 −77% —
551 MEDICAL BACK PROBLEMS WITH MCC $9,945 $14,183 $25,341 −61% $31,067 −68% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CCMCC $9,934 $13,544 $31,862 −69% $27,074 −63% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $9,930 $12,552 $22,664 −56% $25,854 −62% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $9,886 $14,082 $36,232 −73% $29,671 −67% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $9,870 $14,056 $25,133 −61% $28,578 −65% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $9,842 $14,009 $25,056 −61% $31,029 −68% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CCMCC $9,834 $9,870 $18,260 −46% $22,532 −56% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $9,825 $13,981 $26,027 −62% $29,929 −67% —
887 OTHER MENTAL DISORDER DIAGNOSES $9,824 $10,096 $10,999 −11% $20,557 −52% —
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CCMCC $9,796 $13,931 $24,739 −60% $29,916 −67% —
571 SKIN DEBRIDEMENT WITH CC $9,794 $13,929 $24,925 −61% $34,773 −72% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $9,774 $13,895 $24,869 −61% $33,339 −71% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $9,765 $13,881 $24,846 −61% $30,930 −68% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $9,744 $13,845 $24,787 −61% $32,417 −70% —
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CCMCC $9,739 $13,836 $24,771 −61% $27,277 −64% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $9,719 $13,803 $30,365 −68% $42,119 −77% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $9,708 $13,784 $21,833 −56% $32,689 −70% ≈113% of Medicare
905 SKIN GRAFTS FOR INJURIES WITHOUT CCMCC $9,671 $13,723 $24,586 −61% $25,197 −62% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $9,639 $13,669 $22,571 −57% $28,802 −67% ≈123% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $9,631 $13,655 $18,248 −47% $28,001 −66% —
533 FRACTURES OF FEMUR WITH MCC $9,585 $12,748 $22,986 −58% $25,945 −63% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CCMCC $9,576 $13,234 $41,156 −77% $39,675 −76% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $9,568 $13,550 $24,302 −61% $24,465 −61% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $9,561 $13,538 $26,112 −63% $25,998 −63% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CCMCC $9,551 $12,023 $31,853 −70% $31,816 −70% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $9,543 $11,242 $20,513 −53% $25,412 −62% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $9,527 $13,481 $24,189 −61% $25,596 −63% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $9,522 $13,472 $25,820 −63% $31,754 −70% ≈120% of Medicare
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $9,505 $12,625 $33,406 −72% $26,998 −65% —
606 MINOR SKIN DISORDERS WITH MCC $9,493 $13,423 $23,208 −59% $25,434 −63% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CCMCC $9,438 $12,913 $23,257 −59% $25,484 −63% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CCMCC $9,423 $13,306 $23,902 −61% $33,962 −72% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CCMCC $9,413 $12,249 $22,167 −58% $32,451 −71% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CCMCC $9,389 $12,022 $21,793 −57% $31,812 −70% —
183 MAJOR CHEST TRAUMA WITH MCC $9,384 $13,241 $23,796 −61% $28,924 −68% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CCMCC $9,362 $13,067 $35,132 −73% $32,189 −71% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $9,351 $13,185 $23,703 −61% $33,425 −72% —
186 PLEURAL EFFUSION WITH MCC $9,350 $13,184 $23,701 −61% $32,385 −71% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $9,334 $13,158 $37,084 −75% $29,891 −69% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $9,334 $11,463 $19,595 −52% $24,928 −63% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $9,305 $14,895 $14,283 −35% $24,447 −62% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CCMCC $9,274 $10,290 $18,949 −51% $22,920 −60% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $9,252 $12,796 $23,065 −60% $24,879 −63% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CCMCC $9,238 $9,434 $25,928 −64% $24,544 −62% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $9,231 $14,771 $29,934 −69% $30,275 −70% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $9,207 $12,944 $23,307 −60% $28,385 −68% —
813 COAGULATION DISORDERS $9,199 $12,931 $21,647 −58% $30,128 −69% —
669 TRANSURETHRAL PROCEDURES WITH CC $9,197 $12,927 $46,946 −80% $34,354 −73% —
949 AFTERCARE WITH CCMCC $9,184 $9,224 $17,198 −47% $23,953 −62% —
865 VIRAL ILLNESS WITH MCC $9,173 $12,361 $29,161 −69% $26,088 −65% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CCMCC $9,138 $12,829 $29,617 −69% $35,961 −75% —
663 MINOR BLADDER PROCEDURES WITH CC $9,102 $12,768 $32,018 −72% $29,924 −70% —
088 CONCUSSION WITH MCC $9,100 $11,846 $21,503 −58% $24,402 −63% —
945 REHABILITATION WITH CCMCC $9,098 $12,761 $23,834 −62% $23,834 −62% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CCMCC $9,052 $12,685 $22,882 −60% $30,888 −71% —
947 SIGNS AND SYMPTOMS WITH MCC $9,037 $10,862 $19,887 −55% $25,474 −65% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CCMCC $9,020 $12,630 $22,791 −60% $24,229 −63% —
502 SOFT TISSUE PROCEDURES WITHOUT CCMCC $9,007 $11,739 $23,192 −61% $29,777 −70% —
710 PENIS PROCEDURES WITHOUT CCMCC $8,979 $12,562 $22,681 −60% $23,814 −62% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $8,969 $12,544 $28,296 −68% $29,049 −69% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $8,969 $11,062 $37,826 −76% $23,039 −61% —
506 MAJOR THUMB OR JOINT PROCEDURES $8,969 $12,544 $32,182 −72% $28,983 −69% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $8,961 $12,531 $22,628 −60% $24,450 −63% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $8,920 $12,462 $22,516 −60% $31,062 −71% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CCMCC $8,908 $9,410 $17,505 −49% $25,038 −64% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $8,905 $12,438 $23,189 −62% $27,597 −68% —
796 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH MCC $8,854 $10,786 $16,434 −46% $22,557 −61% —
693 URINARY STONES WITH MCC $8,833 $12,317 $20,218 −56% $22,525 −61% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $8,831 $12,313 $22,272 −60% $28,403 −69% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CCMCC $8,829 $12,309 $22,265 −60% $25,152 −65% —
602 CELLULITIS WITH MCC $8,828 $12,308 $17,925 −51% $29,347 −70% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $8,801 $12,263 $37,153 −76% $29,011 −70% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CCMCC $8,796 $12,255 $22,175 −60% $25,149 −65% —
637 DIABETES WITH MCC $8,767 $12,206 $22,095 −60% $28,772 −70% ≈114% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $8,760 $12,195 $22,077 −60% $24,874 −65% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $8,740 $10,484 $28,136 −69% $27,492 −68% —
039 EXTRACRANIAL PROCEDURES WITHOUT CCMCC $8,734 $9,692 $30,958 −72% $25,267 −65% —
713 TRANSURETHRAL PROSTATECTOMY WITH CCMCC $8,718 $12,125 $21,961 −60% $29,630 −71% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $8,699 $12,092 $14,978 −42% $22,525 −61% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $8,668 $9,696 $17,973 −52% $24,277 −64% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CCMCC $8,624 $11,233 $22,807 −62% $31,978 −73% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CCMCC $8,605 $10,896 $31,030 −72% $22,811 −62% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $8,603 $11,930 $21,642 −60% $25,071 −66% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CCMCC $8,593 $11,914 $23,878 −64% $21,615 −60% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $8,574 $11,882 $21,563 −60% $23,734 −64% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $8,545 $11,833 $21,483 −60% $29,521 −71% ≈128% of Medicare
811 RED BLOOD CELL DISORDERS WITH MCC $8,534 $11,816 $21,454 −60% $27,674 −69% ≈113% of Medicare
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CCMCC $8,524 $11,799 $30,017 −72% $35,693 −76% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CCMCC $8,508 $11,771 $18,439 −54% $23,456 −64% —
137 MOUTH PROCEDURES WITH CCMCC $8,495 $11,750 $22,770 −63% $24,348 −65% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CCMCC $8,470 $11,708 $21,277 −60% $25,666 −67% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $8,456 $11,685 $26,303 −68% $24,118 −65% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $8,427 $10,688 $19,602 −57% $26,616 −68% —
150 EPISTAXIS WITH MCC $8,418 $11,620 $21,133 −60% $21,133 −60% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CCMCC $8,377 $11,552 $21,022 −60% $29,029 −71% —
139 SALIVARY GLAND PROCEDURES $8,374 $11,548 $21,014 −60% $21,014 −60% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $8,362 $11,527 $20,980 −60% $20,980 −60% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CCMCC $8,361 $11,525 $20,978 −60% $30,418 −73% —
114 ORBITAL PROCEDURES WITHOUT CCMCC $8,337 $10,039 $18,536 −55% $19,598 −57% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $8,290 $11,406 $29,453 −72% $29,374 −72% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CCMCC $8,284 $11,397 $35,579 −77% $28,509 −71% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $8,250 $11,339 $19,002 −57% $23,646 −65% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CCMCC $8,231 $11,307 $20,619 −60% $29,805 −72% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $8,196 $11,018 $29,176 −72% $23,956 −66% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CCMCC $8,188 $8,796 $16,495 −50% $16,495 −50% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $8,187 $10,876 $20,976 −61% $23,646 −65% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $8,171 $11,207 $27,967 −71% $22,874 −64% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $8,162 $11,192 $20,430 −60% $24,244 −66% ≈123% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CCMCC $8,156 $11,110 $27,907 −71% $34,564 −76% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $8,114 $11,111 $20,296 −60% $25,766 −69% ≈120% of Medicare
291 HEART FAILURE AND SHOCK WITH MCC $8,053 $11,009 $18,994 −58% $24,932 −68% ≈119% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $8,049 $11,001 $20,117 −60% $21,029 −62% —
089 CONCUSSION WITH CC $8,007 $9,169 $17,109 −53% $18,293 −56% —
540 OSTEOMYELITIS WITH CC $8,003 $10,924 $20,712 −61% $23,494 −66% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $7,981 $10,888 $28,559 −72% $23,920 −67% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CCMCC $7,976 $10,879 $19,916 −60% $23,474 −66% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $7,957 $10,848 $19,865 −60% $27,041 −71% ≈128% of Medicare
882 NEUROSES EXCEPT DEPRESSIVE $7,946 $8,299 $12,723 −38% $15,680 −49% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CCMCC $7,881 $10,720 $19,655 −60% $28,156 −72% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $7,866 $10,142 $20,808 −62% $20,148 −61% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CCMCC $7,865 $10,424 $19,169 −59% $27,319 −71% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CCMCC $7,850 $8,245 $15,591 −50% $19,326 −59% —
348 ANAL AND STOMAL PROCEDURES WITH CC $7,837 $10,646 $19,533 −60% $27,947 −72% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $7,773 $10,538 $19,357 −60% $26,146 −70% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $7,772 $10,537 $19,354 −60% $19,354 −60% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $7,770 $10,534 $19,350 −60% $21,860 −64% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $7,753 $10,505 $16,640 −53% $20,727 −63% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $7,736 $10,476 $28,922 −73% $24,603 −69% ≈124% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CCMCC $7,710 $10,432 $22,342 −65% $20,147 −62% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CCMCC $7,701 $10,060 $16,207 −52% $20,837 −63% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CCMCC $7,691 $10,402 $19,132 −60% $19,132 −60% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $7,671 $10,367 $19,764 −61% $26,158 −71% —
593 SKIN ULCERS WITH CC $7,666 $10,360 $17,058 −55% $20,470 −63% —
090 CONCUSSION WITHOUT CCMCC $7,608 $7,472 $19,839 −62% $14,873 −49% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $7,587 $10,227 $18,845 −60% $26,098 −71% ≈125% of Medicare
549 SEPTIC ARTHRITIS WITH CC $7,583 $10,221 $18,835 −60% $20,808 −64% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $7,542 $9,793 $7,960 −5% $18,133 −58% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $7,503 $9,256 $15,808 −53% $22,587 −67% —
885 PSYCHOSES $7,482 $11,837 $20,878 −64% $21,489 −65% —
304 HYPERTENSION WITH MCC $7,441 $9,981 $19,848 −63% $23,945 −69% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $7,424 $9,610 $17,832 −58% $20,741 −64% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $7,419 $9,946 $18,383 −60% $22,870 −68% ≈121% of Medicare
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $7,403 $9,088 $16,388 −55% $23,571 −69% —
302 ATHEROSCLEROSIS WITH MCC $7,386 $9,890 $18,292 −60% $20,810 −65% —
121 ACUTE MAJOR EYE INFECTIONS WITH CCMCC $7,386 $9,889 $12,071 −39% $18,291 −60% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $7,385 $9,889 $18,290 −60% $21,025 −65% —
102 HEADACHES WITH MCC $7,368 $9,860 $18,243 −60% $21,983 −66% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $7,360 $9,846 $17,298 −57% $24,146 −70% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $7,350 $9,829 $18,191 −60% $25,206 −71% —
572 SKIN DEBRIDEMENT WITHOUT CCMCC $7,302 $9,725 $18,021 −59% $24,426 −70% —
152 OTITIS MEDIA AND URI WITH MCC $7,252 $9,665 $17,922 −60% $19,657 −63% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $7,219 $9,609 $20,885 −65% $24,017 −70% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $7,197 $9,572 $17,770 −60% $24,103 −70% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $7,196 $9,571 $17,768 −60% $19,317 −63% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $7,191 $9,308 $27,842 −74% $31,190 −77% ≈130% of Medicare
151 EPISTAXIS WITHOUT MCC $7,183 $6,687 $12,854 −44% $13,032 −45% —
946 REHABILITATION WITHOUT CCMCC $7,166 $9,520 $17,685 −59% $17,685 −59% —
181 RESPIRATORY NEOPLASMS WITH CC $7,137 $9,471 $17,604 −59% $22,065 −68% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $7,136 $9,470 $17,602 −59% $18,459 −61% —
200 PNEUMOTHORAX WITH CC $7,123 $9,449 $17,568 −59% $20,573 −65% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CCMCC $7,092 $9,397 $17,483 −59% $17,483 −59% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION ANDOR D&C $7,071 $9,361 $13,658 −48% $17,006 −58% —
672 URETHRAL PROCEDURES WITHOUT CCMCC $7,062 $9,346 $17,398 −59% $17,398 −59% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $7,046 $9,319 $17,144 −59% $19,868 −65% —
381 COMPLICATED PEPTIC ULCER WITH CC $7,037 $9,304 $22,552 −69% $24,177 −71% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $7,020 $8,624 $14,157 −50% $17,078 −59% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $7,015 $9,267 $17,269 −59% $21,666 −68% —
697 URETHRAL STRICTURE $7,013 $8,614 $14,855 −53% $17,705 −60% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $6,999 $9,240 $13,290 −47% $17,226 −59% —
598 MALIGNANT BREAST DISORDERS WITH CC $6,989 $9,223 $17,977 −61% $19,073 −63% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $6,975 $9,200 $17,159 −59% $17,719 −61% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $6,968 $7,909 $21,492 −68% $17,585 −60% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $6,950 $9,158 $14,861 −53% $19,448 −64% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $6,946 $9,151 $17,079 −59% $23,749 −71% —
712 TESTES PROCEDURES WITHOUT CCMCC $6,945 $9,150 $17,076 −59% $18,898 −63% —
184 MAJOR CHEST TRAUMA WITH CC $6,938 $9,138 $17,057 −59% $20,842 −67% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $6,877 $8,733 $16,392 −58% $22,610 −70% ≈129% of Medicare
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $6,871 $9,026 $16,872 −59% $23,396 −71% ≈130% of Medicare
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $6,865 $9,016 $14,396 −52% $18,000 −62% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CCMCC $6,862 $9,010 $16,847 −59% $17,308 −60% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $6,853 $8,995 $16,823 −59% $22,231 −69% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $6,817 $8,935 $15,061 −55% $23,141 −71% ≈128% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH CC $6,794 $8,348 $21,514 −68% $19,001 −64% —
798 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITHOUT CCMCC $6,794 $8,348 $16,722 −59% $18,038 −62% —
644 ENDOCRINE DISORDERS WITH CC $6,774 $8,863 $16,607 −59% $22,941 −70% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $6,763 $8,845 $16,575 −59% $22,623 −70% ≈133% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $6,755 $8,831 $24,529 −72% $22,850 −70% —
667 PROSTATECTOMY WITHOUT CCMCC $6,748 $8,819 $16,534 −59% $16,703 −60% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $6,711 $8,757 $16,431 −59% $20,732 −68% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $6,711 $8,757 $10,057 −33% $16,431 −59% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $6,710 $8,755 $16,429 −59% $21,499 −69% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CCMCC $6,709 $8,754 $16,427 −59% $20,076 −67% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $6,708 $8,752 $16,423 −59% $19,091 −65% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $6,700 $8,739 $16,402 −59% $22,590 −70% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $6,693 $8,727 $12,204 −45% $18,005 −63% —
920 COMPLICATIONS OF TREATMENT WITH CC $6,692 $8,725 $16,379 −59% $20,879 −68% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CCMCC $6,672 $8,427 $15,890 −58% $15,890 −58% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CCMCC $6,663 $7,846 $15,127 −56% $20,084 −67% —
187 PLEURAL EFFUSION WITH CC $6,636 $8,631 $17,721 −63% $21,467 −69% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $6,635 $8,272 $15,636 −58% $15,636 −58% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CCMCC $6,631 $8,623 $16,212 −59% $16,212 −59% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $6,616 $8,599 $16,171 −59% $20,007 −67% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $6,607 $8,583 $16,146 −59% $17,268 −62% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $6,582 $8,540 $16,076 −59% $20,917 −69% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $6,580 $8,537 $16,070 −59% $22,024 −70% —
197 INTERSTITIAL LUNG DISEASE WITH CC $6,570 $8,520 $16,043 −59% $20,105 −67% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CCMCC $6,554 $7,658 $14,627 −55% $19,854 −67% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $6,551 $8,488 $17,086 −62% $21,886 −70% ≈127% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CCMCC $6,549 $8,486 $15,986 −59% $18,199 −64% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CCMCC $6,516 $7,600 $15,454 −58% $19,815 −67% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $6,499 $7,981 $17,210 −62% $20,463 −68% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $6,446 $8,313 $14,941 −57% $20,632 −69% ≈134% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $6,439 $8,302 $15,684 −59% $20,716 −69% —
881 DEPRESSIVE NEUROSES $6,416 $7,921 $11,399 −44% $15,058 −57% —
670 TRANSURETHRAL PROCEDURES WITHOUT CCMCC $6,408 $8,249 $15,598 −59% $20,371 −69% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CCMCC $6,407 $7,745 $14,770 −57% $15,764 −59% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $6,405 $8,244 $13,655 −53% $15,589 −59% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CCMCC $6,390 $8,219 $15,547 −59% $18,316 −65% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CCMCC $6,371 $7,978 $13,305 −52% $20,313 −69% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $6,340 $8,136 $18,455 −66% $18,815 −66% —
158 DENTAL AND ORAL DISEASES WITH CC $6,337 $8,130 $13,237 −52% $17,751 −64% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $6,304 $8,075 $20,261 −69% $16,622 −62% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CCMCC $6,288 $7,959 $22,525 −72% $16,352 −62% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CCMCC $6,271 $7,749 $19,391 −68% $21,323 −71% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $6,270 $8,018 $15,217 −59% $18,323 −66% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $6,257 $7,996 $15,183 −59% $19,287 −68% —
101 SEIZURES WITHOUT MCC $6,248 $7,981 $15,157 −59% $19,930 −69% —
076 VIRAL MENINGITIS WITHOUT CCMCC $6,225 $7,943 $15,094 −59% $15,474 −60% —
914 TRAUMATIC INJURY WITHOUT MCC $6,223 $7,939 $10,952 −43% $15,586 −60% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $6,173 $7,855 $14,755 −58% $17,731 −65% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $6,168 $7,847 $14,937 −59% $15,007 −59% —
864 FEVER AND INFLAMMATORY CONDITIONS $6,136 $7,793 $12,155 −50% $17,412 −65% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $6,117 $7,760 $14,795 −59% $18,243 −66% —
683 RENAL FAILURE WITH CC $6,093 $7,721 $14,731 −59% $18,322 −67% ≈133% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $6,074 $7,689 $14,678 −59% $16,348 −63% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CCMCC $6,070 $7,683 $21,443 −72% $15,818 −62% —
376 DIGESTIVE MALIGNANCY WITHOUT CCMCC $6,066 $7,675 $14,654 −59% $15,608 −61% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $6,059 $7,663 $16,832 −64% $19,569 −69% —
541 OSTEOMYELITIS WITHOUT CCMCC $6,027 $7,611 $12,594 −52% $14,549 −59% —
312 SYNCOPE AND COLLAPSE $6,011 $7,582 $14,502 −59% $19,342 −69% ≈142% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $6,006 $7,569 $14,480 −59% $19,305 −69% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $6,006 $7,158 $15,601 −62% $18,150 −67% —
607 MINOR SKIN DISORDERS WITHOUT MCC $5,977 $7,526 $14,410 −59% $15,276 −61% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $5,975 $7,523 $12,704 −53% $17,296 −65% —
550 SEPTIC ARTHRITIS WITHOUT CCMCC $5,967 $7,510 $14,383 −59% $16,156 −63% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CCMCC $5,966 $7,149 $15,777 −62% $17,851 −67% —
292 HEART FAILURE AND SHOCK WITH CC $5,963 $7,502 $14,372 −59% $15,878 −62% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $5,953 $7,486 $14,344 −58% $18,104 −67% —
599 MALIGNANT BREAST DISORDERS WITHOUT CCMCC $5,933 $7,453 $14,290 −58% $14,290 −58% —
103 HEADACHES WITHOUT MCC $5,911 $7,416 $15,688 −62% $20,076 −71% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CCMCC $5,904 $7,024 $10,505 −44% $13,586 −57% —
594 SKIN ULCERS WITHOUT CCMCC $5,904 $7,404 $10,788 −45% $14,209 −58% —
182 RESPIRATORY NEOPLASMS WITHOUT CCMCC $5,851 $7,315 $14,064 −58% $14,064 −58% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $5,838 $7,292 $16,554 −65% $17,579 −67% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $5,796 $7,222 $13,911 −58% $15,876 −63% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $5,769 $7,177 $14,119 −59% $18,204 −68% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $5,764 $7,168 $13,822 −58% $13,822 −58% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $5,755 $7,154 $20,349 −72% $16,622 −65% —
176 PULMONARY EMBOLISM WITHOUT MCC $5,743 $7,133 $13,765 −58% $17,693 −68% —
534 FRACTURES OF FEMUR WITHOUT MCC $5,741 $7,129 $13,759 −58% $17,194 −67% —
138 MOUTH PROCEDURES WITHOUT CCMCC $5,738 $7,125 $13,752 −58% $17,383 −67% —
204 RESPIRATORY SIGNS AND SYMPTOMS $5,726 $7,106 $17,742 −68% $16,804 −66% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $5,726 $7,105 $13,719 −58% $17,754 −68% —
123 NEUROLOGICAL EYE DISORDERS $5,690 $7,044 $18,892 −70% $17,831 −68% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $5,687 $7,039 $13,611 −58% $17,379 −67% ≈138% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $5,682 $7,031 $13,598 −58% $17,345 −67% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $5,680 $6,975 $13,506 −58% $17,719 −68% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $5,675 $7,020 $13,579 −58% $20,253 −72% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CCMCC $5,662 $6,997 $13,542 −58% $17,700 −68% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $5,642 $6,415 $11,355 −50% $13,090 −57% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CCMCC $5,624 $6,934 $12,331 −54% $17,522 −68% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CCMCC $5,622 $6,136 $12,127 −54% $19,483 −71% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CCMCC $5,613 $6,902 $13,385 −58% $13,385 −58% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $5,598 $6,603 $11,490 −51% $12,895 −57% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $5,587 $6,872 $13,336 −58% $16,718 −67% ≈136% of Medicare
694 URINARY STONES WITHOUT MCC $5,587 $6,872 $13,336 −58% $16,451 −66% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $5,582 $6,863 $13,321 −58% $17,322 −68% ≈144% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CCMCC $5,574 $6,850 $13,300 −58% $14,166 −61% —
185 MAJOR CHEST TRAUMA WITHOUT CCMCC $5,569 $6,843 $13,288 −58% $15,858 −65% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CCMCC $5,532 $6,779 $13,738 −60% $14,411 −62% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $5,506 $6,454 $12,650 −56% $12,650 −56% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CCMCC $5,466 $6,669 $13,002 −58% $16,776 −67% —
305 HYPERTENSION WITHOUT MCC $5,442 $6,629 $12,937 −58% $16,897 −68% ≈138% of Medicare
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CCMCC $5,440 $6,625 $13,855 −61% $16,654 −67% —
382 COMPLICATED PEPTIC ULCER WITHOUT CCMCC $5,436 $6,618 $12,919 −58% $16,634 −67% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CCMCC $5,430 $6,609 $13,259 −59% $14,337 −62% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $5,421 $6,594 $12,770 −58% $14,861 −64% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CCMCC $5,413 $6,427 $12,605 −57% $18,288 −70% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $5,413 $6,579 $16,113 −66% $13,892 −61% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $5,397 $6,552 $11,423 −53% $13,278 −59% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $5,389 $6,539 $12,789 −58% $16,645 −68% ≈147% of Medicare
188 PLEURAL EFFUSION WITHOUT CCMCC $5,365 $6,499 $11,352 −53% $14,252 −62% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CCMCC $5,365 $6,420 $12,593 −57% $12,593 −57% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CCMCC $5,351 $6,232 $9,714 −45% $13,654 −61% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CCMCC $5,323 $6,429 $12,609 −58% $16,104 −67% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CCMCC $5,296 $6,383 $12,534 −58% $12,536 −58% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $5,267 $6,335 $12,049 −56% $12,205 −57% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CCMCC $5,267 $6,334 $12,555 −58% $15,598 −66% —
313 CHEST PAIN $5,267 $6,334 $12,453 −58% $15,837 −67% ≈143% of Medicare
153 OTITIS MEDIA AND URI WITHOUT MCC $5,240 $6,321 $12,431 −58% $14,251 −63% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $5,224 $6,263 $24,097 −78% $12,336 −58% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CCMCC $5,216 $6,250 $20,027 −74% $15,600 −67% —
311 ANGINA PECTORIS $5,195 $6,215 $12,257 −58% $15,165 −66% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CCMCC $5,194 $6,213 $17,037 −70% $15,072 −66% —
203 BRONCHITIS AND ASTHMA WITHOUT CCMCC $5,187 $6,202 $9,986 −48% $12,275 −58% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CCMCC $5,187 $6,201 $13,655 −62% $12,405 −58% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CCMCC $5,176 $6,183 $7,651 −32% $13,303 −61% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $5,165 $6,164 $12,713 −59% $14,210 −64% —
921 COMPLICATIONS OF TREATMENT WITHOUT CCMCC $5,145 $6,131 $22,099 −77% $14,012 −63% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CCMCC $5,122 $6,092 $12,055 −58% $12,794 −60% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CCMCC $5,101 $6,057 $10,255 −50% $11,997 −57% —
201 PNEUMOTHORAX WITHOUT CCMCC $5,095 $6,047 $13,796 −63% $13,081 −61% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CCMCC $5,073 $6,010 $9,622 −47% $13,198 −62% —
303 ATHEROSCLEROSIS WITHOUT MCC $5,073 $6,010 $11,508 −56% $14,927 −66% ≈151% of Medicare
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CCMCC $5,069 $6,003 $8,981 −44% $11,909 −57% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CCMCC $5,063 $5,994 $14,630 −65% $14,880 −66% —
159 DENTAL AND ORAL DISEASES WITHOUT CCMCC $5,057 $5,909 $15,886 −68% $13,362 −62% —
916 ALLERGIC REACTIONS WITHOUT MCC $5,034 $5,945 $11,813 −57% $13,890 −64% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CCMCC $5,020 $5,733 $10,563 −52% $11,957 −58% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CCMCC $5,012 $5,908 $11,752 −57% $13,485 −63% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $4,997 $7,668 $14,644 −66% $15,923 −69% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CCMCC $4,955 $5,811 $11,594 −57% $14,368 −66% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CCMCC $4,905 $5,728 $11,458 −57% $14,134 −65% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $4,904 $5,726 $8,067 −39% $14,128 −65% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CCMCC $4,892 $5,706 $10,354 −53% $11,421 −57% —
639 DIABETES WITHOUT CCMCC $4,858 $5,648 $11,928 −59% $13,910 −65% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CCMCC $4,839 $5,617 $11,276 −57% $13,747 −65% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CCMCC $4,803 $5,557 $11,177 −57% $14,770 −67% —
684 RENAL FAILURE WITHOUT CCMCC $4,767 $5,497 $14,391 −67% $13,455 −65% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $4,765 $5,493 $11,071 −57% $11,071 −57% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CCMCC $4,730 $5,434 $10,975 −57% $10,975 −57% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $4,574 $5,177 $10,553 −57% $9,385 −51% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CCMCC $4,550 $5,133 $10,131 −55% $10,039 −55% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CCMCC $4,541 $5,118 $10,456 −57% $13,384 −66% ≈134% of Medicare
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CCMCC $4,483 $5,021 $10,296 −56% $13,318 −66% —
293 HEART FAILURE AND SHOCK WITHOUT CCMCC $4,442 $5,033 $10,316 −57% $11,826 −62% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CCMCC $4,005 $4,804 $8,022 −50% $9,063 −56% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CCMCC $3,986 $4,187 $8,927 −55% $8,927 −55% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $3,781 $5,629 $11,294 −67% $12,013 −69% —
998 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS $3,407 — $9,703 −65% $15,594 −78% —
999 UNGROUPABLE $3,407 — $93,765 −96% $28,387 −88% —
129 UnGrouped $2,980 — $2,980 — $23,289 −87% —
130 UnGrouped $2,980 — $2,980 — $23,289 −87% —
131 UnGrouped $2,980 — $2,980 — $23,289 −87% —
132 UnGrouped $2,980 — $2,980 — $23,289 −87% —
133 UnGrouped $2,980 — $2,980 — $23,289 −87% —
134 UnGrouped $2,980 — $2,980 — $23,289 −87% —
226 UnGrouped $2,980 — $72,618 −96% $72,618 −96% —
237 UnGrouped $2,980 — $2,980 — $49,435 −94% —
248 UnGrouped $2,980 — $34,146 −91% $34,146 −91% —
249 UnGrouped $2,980 — $20,610 −86% $20,610 −86% —
338 UnGrouped $2,980 — $30,138 −90% $30,138 −90% —
341 UnGrouped $2,980 — $25,628 −88% $25,628 −88% —
342 UnGrouped $2,980 — $16,487 −82% $19,454 −85% —
343 UnGrouped $2,980 — $12,397 −76% $13,735 −78% —
484 UnGrouped $2,980 — $2,980 — $23,289 −87% —
490 UnGrouped $2,980 — $2,980 — $26,452 — —
491 UnGrouped $2,980 — $1,550 — $2,203 — —
685 UnGrouped $2,980 — $2,980 — $21,385 −86% —
774 UnGrouped $2,980 — $3,032 −2% $3,032 −2% —
775 UnGrouped $2,980 — $3,032 −2% $3,242 −8% —
778 UnGrouped $2,980 — $2,980 — $10,997 −73% —
781 UnGrouped $2,980 — $2,980 — $16,875 −82% —
782 UnGrouped $2,980 — $2,980 — $10,599 −72% —
984 UnGrouped $2,980 — $2,980 — $23,289 −87% —
985 UnGrouped $2,980 — $2,980 — $23,289 −87% —
986 UnGrouped $2,980 — $2,980 — $23,289 −87% —
795 NORMAL NEWBORN $2,237 $2,275 $4,397 −49% $4,521 −51% —

Procedures with negotiated rates only

These 5 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.

DRG Description Insurance rate range Payers
222 UnGrouped — 2 plans
224 UnGrouped $2,980 – $24,857 · median $13,918 2 plans
225 UnGrouped $2,980 – $5,402 · median $4,191 2 plans
227 UnGrouped $2,980 – $3,604 · median $3,292 2 plans
246 UnGrouped $2,980 – $47,919 · median $25,449 2 plans
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