Pomona Valley Hospital Medical Center — Pricing

770 procedures published in this hospital's Machine-Readable File (MRF) — 251 with a comparable price, 519 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 770
Lowest published price $1,383
Average published price $39,827
Highest published price $418,969

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 770 procedures

Published charges

Showing all 251 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. Cash-pay prices not published for this hospital.

Across 52 procedures, this hospital's negotiated rates average ≈259% of what Medicare pays.

DRG Description Published price vs. CA median vs. National median vs Medicare
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $418,969 $248,521 +69% $248,521 +69% ≈268% of Medicare
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $379,296 $371,366 +2% $371,366 +2% ≈256% of Medicare
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $236,469 $75,103 +215% $75,103 +215% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $223,841 $101,662 +120% $89,207 +151% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $217,409 $136,374 +59% $120,573 +80% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $214,002 $107,269 +100% $80,018 +167% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $184,752 $191,314 −3% $208,939 −12% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $169,491 $79,939 +112% $73,120 +132% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $155,447 $116,058 +34% $116,058 +34% ≈248% of Medicare
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $141,789 $148,686 −5% $148,686 −5% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $136,090 $106,778 +27% $106,778 +27% ≈250% of Medicare
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $129,005 $144,569 −11% $144,569 −11% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $128,688 $131,961 −2% $131,961 −2% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $124,495 $125,675 −1% $102,600 +21% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $121,928 $82,247 +48% $82,247 +48% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $121,316 $124,290 −2% $148,832 −18% ≈271% of Medicare
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $120,239 $77,041 +56% $61,832 +94% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $115,040 $71,014 +62% $71,014 +62% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $109,181 $112,062 −3% $112,062 −3% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $94,157 $102,573 −8% $102,573 −8% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $92,073 $65,325 +41% $65,325 +41% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $88,619 $33,424 +165% $33,424 +165% —
472 CERVICAL SPINAL FUSION WITH CC $87,483 $59,537 +47% $59,537 +47% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $86,346 $94,937 −9% $93,172 −7% ≈249% of Medicare
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $86,100 $59,790 +44% $59,790 +44% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $83,057 $86,699 −4% $76,001 +9% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $82,376 $90,331 −9% $90,331 −9% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $81,669 $90,775 −10% $90,775 −10% ≈329% of Medicare
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $81,636 $60,959 +34% $81,706 −0% ≈124% of Medicare
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $80,787 $88,050 −8% $88,050 −8% ≈286% of Medicare
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $79,051 $88,307 −10% $88,307 −10% —
163 MAJOR CHEST PROCEDURES WITH MCC $75,702 $88,341 −14% $90,195 −16% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $72,041 $50,624 +42% $50,624 +42% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $71,735 $79,225 −9% $79,225 −9% —
504 FOOT PROCEDURES WITH CC $70,704 $38,960 +81% $38,960 +81% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $70,478 $70,540 −0% $70,564 −0% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $67,505 $83,441 −19% $83,441 −19% —
201 PNEUMOTHORAX WITHOUT CC/MCC $65,698 $15,031 +337% $14,053 +368% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $65,506 $50,131 +31% $49,418 +33% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $65,184 $55,594 +17% $47,945 +36% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $63,301 $74,257 −15% $74,257 −15% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $62,040 $71,092 −13% $71,092 −13% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $61,856 $69,597 −11% $51,953 +19% —
252 OTHER VASCULAR PROCEDURES WITH MCC $60,711 $68,508 −11% $68,508 −11% ≈162% of Medicare
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $60,619 $68,421 −11% $70,847 −14% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $60,521 $33,137 +83% $33,393 +81% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $59,085 $66,819 −12% $71,464 −17% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $58,983 $42,881 +38% $42,881 +38% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $57,504 $43,378 +33% $38,861 +48% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $55,310 $60,905 −9% $49,710 +11% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $54,985 $65,573 −16% $65,573 −16% ≈155% of Medicare
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $47,051 $44,363 +6% $44,363 +6% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $46,831 $52,959 −12% $43,491 +8% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $46,812 $54,583 −14% $54,583 −14% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $46,304 $30,846 +50% $25,094 +85% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $45,459 $33,048 +38% $33,048 +38% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $44,728 $33,674 +33% $33,674 +33% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $42,846 $50,562 −15% $59,500 −28% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $40,868 $51,985 −21% $51,985 −21% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $40,853 $64,691 −37% $60,407 −32% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $40,718 $35,532 +15% $32,496 +25% ≈255% of Medicare
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $40,461 $29,596 +37% $32,841 +23% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $39,348 $50,777 −23% $53,451 −26% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $38,691 $43,483 −11% $38,666 +0% ≈255% of Medicare
885 PSYCHOSES $38,559 $30,968 +25% $21,729 +77% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $38,432 $45,703 −16% $52,751 −27% ≈259% of Medicare
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $38,248 $18,002 +112% $18,002 +112% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $38,193 $47,452 −20% $45,333 −16% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $37,427 $44,730 −16% $42,914 −13% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $37,250 $50,139 −26% $50,139 −26% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $37,075 $44,357 −16% $43,943 −16% ≈243% of Medicare
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $35,952 $27,492 +31% $28,320 +27% —
374 DIGESTIVE MALIGNANCY WITH MCC $35,727 $42,775 −16% $39,958 −11% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $35,603 $44,639 −20% $46,090 −23% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $35,195 $44,489 −21% $46,283 −24% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $34,908 $43,080 −19% $43,080 −19% —
100 SEIZURES WITH MCC $34,902 $40,653 −14% $35,481 −2% ≈252% of Medicare
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $34,787 $43,913 −21% $43,913 −21% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $34,784 $43,631 −20% $43,631 −20% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $34,725 $40,263 −14% $35,628 −3% ≈258% of Medicare
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $34,377 $27,470 +25% $26,580 +29% ≈256% of Medicare
791 PREMATURITY WITH MAJOR PROBLEMS $34,088 $70,373 −52% $42,679 −20% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $33,876 $40,719 −17% $39,106 −13% ≈275% of Medicare
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $33,718 $37,950 −11% $37,950 −11% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $33,206 $39,057 −15% $33,985 −2% ≈252% of Medicare
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $33,139 $43,800 −24% $43,800 −24% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $32,928 $40,213 −18% $40,213 −18% ≈239% of Medicare
505 FOOT PROCEDURES WITHOUT CC/MCC $32,630 $38,960 −16% $34,937 −7% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $32,025 $46,288 −31% $36,489 −12% ≈247% of Medicare
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $31,889 $19,584 +63% $16,699 +91% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $31,791 $38,187 −17% $32,859 −3% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $31,721 $23,749 +34% $23,749 +34% —
336 PERITONEAL ADHESIOLYSIS WITH CC $31,463 $46,332 −32% $50,463 −38% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $31,257 $40,694 −23% $40,694 −23% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $31,017 $37,764 −18% $43,477 −29% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $30,816 $57,323 −46% $18,649 +65% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $30,677 $30,083 +2% $30,083 +2% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $30,587 $40,552 −25% $40,552 −25% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $30,410 $40,163 −24% $58,809 −48% ≈200% of Medicare
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $30,248 $37,842 −20% $37,842 −20% ≈274% of Medicare
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $30,238 $38,836 −22% $38,836 −22% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $29,917 $37,526 −20% $29,079 +3% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $29,811 $35,591 −16% $34,273 −13% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $29,219 $36,651 −20% $44,117 −34% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $28,996 $34,867 −17% $30,828 −6% ≈254% of Medicare
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $28,957 $39,515 −27% $39,515 −27% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $28,819 $34,839 −17% $30,235 −5% —
919 COMPLICATIONS OF TREATMENT WITH MCC $28,668 $37,933 −24% $31,105 −8% —
186 PLEURAL EFFUSION WITH MCC $27,963 $33,834 −17% $33,834 −17% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $27,947 $36,816 −24% $44,606 −37% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $27,794 $41,855 −34% $47,711 −42% —
398 APPENDIX PROCEDURES WITH CC $27,137 $33,592 −19% $40,162 −32% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $27,134 $21,880 +24% $20,895 +30% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $26,549 $32,490 −18% $27,394 −3% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $26,384 $25,552 +3% $18,133 +46% —
200 PNEUMOTHORAX WITH CC $26,357 $24,586 +7% $21,368 +23% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $26,190 $35,349 −26% $33,876 −23% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $26,093 $40,365 −35% $40,365 −35% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $26,023 $22,641 +15% $21,275 +22% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $26,019 $24,644 +6% $18,459 +41% —
864 FEVER AND INFLAMMATORY CONDITIONS $25,579 $19,935 +28% $18,640 +37% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $25,097 $37,921 −34% $37,387 −33% —
637 DIABETES WITH MCC $24,755 $31,753 −22% $30,100 −18% ≈238% of Medicare
920 COMPLICATIONS OF TREATMENT WITH CC $24,570 $22,552 +9% $22,468 +9% —
915 ALLERGIC REACTIONS WITH MCC $24,316 $36,491 −33% $32,645 −26% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $23,723 $30,418 −22% $30,418 −22% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $23,715 $29,747 −20% $31,264 −24% —
811 RED BLOOD CELL DISORDERS WITH MCC $23,697 $30,922 −23% $28,226 −16% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $23,590 $32,473 −27% $30,502 −23% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $23,503 $29,481 −20% $25,463 −8% ≈276% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $23,383 $29,250 −20% $36,937 −37% —
103 HEADACHES WITHOUT MCC $23,096 $18,874 +22% $21,280 +9% —
291 HEART FAILURE AND SHOCK WITH MCC $22,927 $28,966 −21% $26,776 −14% ≈267% of Medicare
602 CELLULITIS WITH MCC $22,455 $31,970 −30% $30,598 −27% —
887 OTHER MENTAL DISORDER DIAGNOSES $22,069 $26,404 −16% $20,616 +7% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $21,882 $30,959 −29% $30,959 −29% ≈254% of Medicare
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $21,874 $51,189 −57% $59,651 −63% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $21,849 $29,117 −25% $27,043 −19% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $21,586 $19,842 +9% $19,842 +9% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $21,324 $16,592 +29% $12,895 +65% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $20,999 $26,611 −21% $30,784 −32% —
799 SPLENIC PROCEDURES WITH MCC $20,863 $90,790 −77% $82,218 −75% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $20,561 $26,770 −23% $26,770 −23% ≈292% of Medicare
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $20,432 $14,927 +37% $14,549 +40% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $20,416 $35,243 −42% $32,628 −37% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $20,308 $19,176 +6% $18,602 +9% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $20,119 $29,252 −31% $27,275 −26% ≈259% of Medicare
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $20,116 $25,034 −20% $25,034 −20% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $19,875 $14,880 +34% $16,288 +22% —
813 COAGULATION DISORDERS $19,717 $33,296 −41% $33,296 −41% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $19,651 $24,930 −21% $24,386 −19% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $19,576 $25,267 −23% $26,618 −26% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $19,309 $24,220 −20% $20,926 −8% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $19,202 $37,213 −48% $31,159 −38% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $19,183 $14,128 +36% $14,128 +36% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $18,947 $23,767 −20% $20,422 −7% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $18,854 $22,557 −16% $19,264 −2% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $18,776 $23,551 −20% $23,551 −20% —
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $18,615 $23,396 −20% $23,488 −21% ≈196% of Medicare
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $18,186 $28,515 −36% $28,050 −35% ≈248% of Medicare
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $18,008 $42,463 −58% $34,459 −48% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $17,987 $22,888 −21% $22,888 −21% ≈273% of Medicare
786 Cesarean Section Delivery $17,544 $35,872 −51% $27,152 −35% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $17,315 $22,575 −23% $23,940 −28% ≈286% of Medicare
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $16,921 $21,225 −20% $19,924 −15% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $16,901 $21,460 −21% $17,724 −5% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $16,758 $28,935 −42% $16,351 +2% —
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $16,426 $36,506 −55% $31,951 −49% ≈260% of Medicare
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $16,382 $21,449 −24% $21,449 −24% —
682 RENAL FAILURE WITH MCC $16,321 $32,520 −50% $29,064 −44% ≈259% of Medicare
445 DISORDERS OF THE BILIARY TRACT WITH CC $16,245 $24,075 −33% $23,319 −30% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $16,090 $21,396 −25% $21,396 −25% ≈298% of Medicare
378 GASTROINTESTINAL HEMORRHAGE WITH CC $16,022 $21,886 −27% $22,098 −27% ≈273% of Medicare
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $15,902 $53,274 −70% $49,423 −68% —
603 CELLULITIS WITHOUT MCC $15,588 $19,553 −20% $18,530 −16% —
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $15,390 $19,305 −20% $19,305 −20% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $15,318 $22,790 −33% $25,970 −41% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $15,269 $21,280 −28% $17,733 −14% —
101 SEIZURES WITHOUT MCC $15,174 $20,461 −26% $20,461 −26% ≈266% of Medicare
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $14,878 $23,141 −36% $23,141 −36% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $14,775 $17,522 −16% $17,620 −16% —
607 MINOR SKIN DISORDERS WITHOUT MCC $14,545 $19,185 −24% $15,889 −8% —
787 Cesarean Section Delivery $14,481 $23,571 −39% $23,571 −39% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $14,251 $19,638 −27% $15,452 −8% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $14,111 $17,700 −20% $17,700 −20% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $14,031 $16,654 −16% $19,037 −26% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $14,001 $20,506 −32% $20,506 −32% —
549 SEPTIC ARTHRITIS WITH CC $13,922 $26,753 −48% $24,056 −42% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $13,850 $18,126 −24% $18,126 −24% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $13,829 $17,347 −20% $17,038 −19% ≈265% of Medicare
399 APPENDIX PROCEDURES WITHOUT CC/MCC $13,658 $24,948 −45% $31,321 −56% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $13,636 $17,817 −23% $17,674 −23% ≈284% of Medicare
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $13,609 $31,982 −57% $30,571 −55% —
638 DIABETES WITH CC $13,544 $20,361 −33% $19,661 −31% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $13,531 $17,287 −22% $15,428 −12% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $13,467 $19,096 −29% $19,096 −29% —
785 Cesarean Section Delivery $13,333 $19,815 −33% $19,846 −33% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $13,217 $16,097 −18% $19,227 −31% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $13,054 $18,204 −28% $18,204 −28% ≈279% of Medicare
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $13,019 $17,322 −25% $17,322 −25% ≈257% of Medicare
788 Cesarean Section Delivery $12,914 $20,084 −36% $20,084 −36% —
643 ENDOCRINE DISORDERS WITH MCC $12,570 $35,135 −64% $33,563 −63% ≈263% of Medicare
153 OTITIS MEDIA AND URI WITHOUT MCC $12,437 $15,799 −21% $14,583 −15% —
683 RENAL FAILURE WITH CC $12,418 $19,733 −37% $19,130 −35% ≈274% of Medicare
797 Vaginal Delivery $12,251 $21,494 −43% $19,962 −39% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $12,232 $19,624 −38% $16,520 −26% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $12,171 $15,267 −20% $14,415 −16% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $12,155 $20,463 −41% $20,463 −41% ≈218% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $12,148 $15,839 −23% $12,454 −2% —
784 Cesarean Section Delivery $12,048 $24,042 −50% $23,283 −48% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $11,792 $16,412 −28% $17,303 −32% ≈256% of Medicare
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $11,766 $15,464 −24% $12,252 −4% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $11,727 $14,638 −20% $14,638 −20% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $11,708 $13,318 −12% $13,361 −12% —
176 PULMONARY EMBOLISM WITHOUT MCC $11,266 $18,081 −38% $18,081 −38% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $11,182 $15,280 −27% $20,781 −46% —
639 DIABETES WITHOUT CC/MCC $11,090 $13,910 −20% $13,910 −20% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $10,932 $23,312 −53% $22,763 −52% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $10,895 $77,178 −86% $71,795 −85% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $10,801 $56,278 −81% $39,173 −72% —
303 ATHEROSCLEROSIS WITHOUT MCC $10,688 $14,927 −28% $14,927 −28% —
311 ANGINA PECTORIS $10,389 $15,502 −33% $15,502 −33% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $10,374 $52,405 −80% $52,405 −80% ≈255% of Medicare
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $10,339 $54,273 −81% $52,178 −80% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $10,182 $13,683 −26% $15,183 −33% —
798 Vaginal Delivery $10,054 $21,494 −53% $18,452 −46% —
805 Vaginal Delivery $9,985 $22,155 −55% $15,370 −35% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $9,654 $24,337 −60% $16,846 −43% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $9,602 $13,824 −31% $13,824 −31% —
806 Vaginal Delivery $9,056 $16,064 −44% $13,275 −32% —
292 HEART FAILURE AND SHOCK WITH CC $8,649 $19,118 −55% $16,371 −47% —
807 Vaginal Delivery $8,287 $14,148 −41% $12,078 −31% —
597 MALIGNANT BREAST DISORDERS WITH MCC $7,846 $36,807 −79% $33,386 −76% —
595 MAJOR SKIN DISORDERS WITH MCC $7,799 $42,837 −82% $34,598 −77% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $7,707 $13,384 −42% $13,384 −42% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $7,682 $11,539 −33% $9,940 −23% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $7,648 $44,326 −83% $29,611 −74% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $7,617 $23,887 −68% $18,956 −60% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $7,480 $50,614 −85% $40,548 −82% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $7,288 $34,448 −79% $33,707 −78% ≈261% of Medicare
779 ABORTION WITHOUT D&C $5,793 $20,752 −72% $15,327 −62% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $5,328 $34,988 −85% $12,229 −56% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $3,671 $46,477 −92% $49,351 −93% —
795 NORMAL NEWBORN $2,614 $6,664 −61% $4,720 −45% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $2,045 $24,191 −92% $32,021 −94% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $2,029 $17,665 −89% $8,445 −76% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $1,749 $17,795 −90% $17,578 −90% ≈268% of Medicare
149 DYSEQUILIBRIUM $1,676 $16,594 −90% $18,096 −91% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $1,676 $19,072 −91% $18,807 −91% —
312 SYNCOPE AND COLLAPSE $1,654 $19,342 −91% $19,342 −91% ≈263% of Medicare
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $1,383 $15,837 −91% $15,837 −91% —

Procedures with negotiated rates only

These 519 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
028 SPINAL PROCEDURES WITH MCC $52,984 – $188,973 · median $63,093 4 plans
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $35,825 – $107,302 · median $50,022 4 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC $23,052 – $69,043 · median $31,081 4 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $50,623 – $307,689 · median $114,606 4 plans
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $50,623 – $206,806 · median $154,848 4 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $50,623 – $206,806 · median $117,289 4 plans
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $50,623 – $241,498 · median $108,770 4 plans
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $50,623 – $167,727 · median $86,445 4 plans
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $50,623 – $155,606 · median $66,491 4 plans
231 CORONARY BYPASS WITH PTCA WITH MCC $50,623 – $265,137 · median $81,628 4 plans
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $50,623 – $190,681 · median $69,277 4 plans
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $12,878 – $100,420 · median $28,184 4 plans
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $12,878 – $67,021 · median $40,718 4 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $12,878 – $56,849 · median $18,482 4 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $12,761 – $68,644 · median $32,515 4 plans
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $12,761 – $47,005 · median $28,232 4 plans
253 OTHER VASCULAR PROCEDURES WITH CC $24,658 – $81,637 · median $49,083 4 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $4,837 – $98,825 · median $14,014 4 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $3,493 – $63,599 · median $14,014 4 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $12,878 – $102,307 · median $17,075 4 plans
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $12,878 – $59,460 · median $22,649 4 plans
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $8,616 – $51,264 · median $14,014 4 plans
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $29,619 – $188,920 · median $128,808 4 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $29,619 – $145,261 · median $105,221 4 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $80,192 – $264,304 · median $88,244 4 plans
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $62,619 – $187,551 · median $96,405 4 plans
471 CERVICAL SPINAL FUSION WITH MCC $30,105 – $151,872 · median $50,706 4 plans
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $21,004 – $62,910 · median $26,298 4 plans
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $8,814 – $46,986 · median $15,687 4 plans
209 COMPLEX AORTIC ARCH PROCEDURES $111,321 – $355,999 · median $162,663 3 plans
213 ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES $96,498 – $179,493 · median $103,409 3 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $112,254 – $192,750 · median $170,943 3 plans
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $87,204 – $149,737 · median $128,353 3 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $117,993 – $216,324 · median $125,526 3 plans
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $73,344 – $132,828 · median $77,549 3 plans
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $88,952 – $165,950 · median $95,467 3 plans
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $42,286 – $80,297 · median $45,792 3 plans
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $45,112 – $129,755 · median $61,693 3 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $30,160 – $175,068 · median $66,964 3 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $39,201 – $113,428 · median $53,805 3 plans
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $81,085 – $210,304 · median $104,212 3 plans
318 PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE $36,632 – $76,183 · median $41,601 3 plans
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $62,951 – $140,367 · median $74,237 3 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $36,042 – $75,652 · median $41,130 3 plans
359 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC $36,632 – $108,151 · median $50,909 3 plans
360 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC $36,632 – $75,935 · median $41,528 3 plans
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $57,053 – $126,453 · median $67,060 3 plans
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $152,767 – $346,639 · median $181,904 3 plans
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $103,581 – $227,039 · median $121,010 3 plans
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $80,269 – $176,823 · median $94,031 3 plans
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $121,635 – $283,370 · median $146,980 3 plans
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $79,779 – $181,387 · median $95,100 3 plans
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $97,777 – $210,150 · median $113,015 3 plans
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $59,552 – $133,382 · median $70,402 3 plans
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $75,107 – $167,627 · median $88,617 3 plans
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $45,005 – $101,603 · median $53,438 3 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $46,115 – $168,602 · median $73,534 3 plans
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $37,273 – $83,662 · median $44,117 3 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $33,548 – $163,720 · median $65,455 3 plans
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $23,252 – $86,430 · median $37,492 3 plans
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $29,966 – $95,400 · median $43,661 3 plans
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $33,070 – $60,668 · median $35,194 3 plans
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $29,966 – $90,274 · median $42,168 3 plans
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $33,070 – $66,606 · median $36,923 3 plans
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $513,314 – $881,408 · median $697,361 2 plans
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $207,565 – $356,408 · median $281,986 2 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $188,857 – $324,286 · median $256,572 2 plans
006 LIVER TRANSPLANT WITHOUT MCC $84,936 – $145,843 · median $115,389 2 plans
007 LUNG TRANSPLANT $237,209 – $407,310 · median $322,259 2 plans
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $102,659 – $176,276 · median $139,468 2 plans
010 PANCREAS TRANSPLANT $56,231 – $96,554 · median $76,393 2 plans
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $99,903 – $171,542 · median $135,723 2 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $77,224 – $132,602 · median $104,913 2 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $52,786 – $90,638 · median $71,712 2 plans
014 ALLOGENEIC BONE MARROW TRANSPLANT $220,132 – $377,987 · median $299,059 2 plans
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $108,614 – $186,501 · median $147,558 2 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $88,623 – $152,174 · median $120,399 2 plans
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $790,979 – $1,358,185 · median $1,074,582 2 plans
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $121,390 – $208,439 · median $164,915 2 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $96,967 – $166,501 · median $131,734 2 plans
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $56,327 – $96,718 · median $76,522 2 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $71,654 – $123,037 · median $97,346 2 plans
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $56,951 – $97,791 · median $77,371 2 plans
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $82,069 – $140,921 · median $111,495 2 plans
032 VENTRICULAR SHUNT PROCEDURES WITH CC $39,034 – $67,024 · median $53,029 2 plans
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $30,459 – $52,302 · median $41,380 2 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $70,900 – $121,741 · median $96,320 2 plans
035 CAROTID ARTERY STENT PROCEDURES WITH CC $43,787 – $75,186 · median $59,486 2 plans
037 EXTRACRANIAL PROCEDURES WITH MCC $60,301 – $103,543 · median $81,922 2 plans
038 EXTRACRANIAL PROCEDURES WITH CC $29,721 – $51,034 · median $40,378 2 plans
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $31,646 – $54,340 · median $42,993 2 plans
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $32,619 – $56,010 · median $44,314 2 plans
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $17,936 – $30,798 · median $24,367 2 plans
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $42,552 – $73,066 · median $57,809 2 plans
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $23,732 – $40,749 · median $32,240 2 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $31,313 – $53,767 · median $42,540 2 plans
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $22,730 – $39,029 · median $30,879 2 plans
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $16,848 – $28,930 · median $22,889 2 plans
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $50,502 – $86,716 · median $68,609 2 plans
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $32,187 – $55,267 · median $43,727 2 plans
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $25,713 – $44,152 · median $34,933 2 plans
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $26,902 – $46,194 · median $36,548 2 plans
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $15,833 – $27,187 · median $21,510 2 plans
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $14,632 – $25,124 · median $19,878 2 plans
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $29,386 – $50,458 · median $39,922 2 plans
075 VIRAL MENINGITIS WITH CC/MCC $35,123 – $60,309 · median $47,716 2 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC $13,716 – $23,551 · median $18,634 2 plans
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $33,154 – $56,928 · median $45,041 2 plans
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $16,405 – $28,168 · median $22,287 2 plans
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $25,567 – $43,901 · median $34,734 2 plans
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $41,614 – $71,456 · median $56,535 2 plans
088 CONCUSSION WITH MCC $24,761 – $42,517 · median $33,639 2 plans
089 CONCUSSION WITH CC $20,123 – $34,553 · median $27,338 2 plans
090 CONCUSSION WITHOUT CC/MCC $15,079 – $25,891 · median $20,485 2 plans
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $18,738 – $32,175 · median $25,457 2 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $64,465 – $110,692 · median $87,579 2 plans
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $47,243 – $81,121 · median $64,182 2 plans
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $47,243 – $81,121 · median $64,182 2 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $66,157 – $113,598 · median $89,878 2 plans
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $42,036 – $72,179 · median $57,107 2 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $24,955 – $42,850 · median $33,903 2 plans
102 HEADACHES WITH MCC $20,532 – $35,255 · median $27,893 2 plans
113 ORBITAL PROCEDURES WITH CC/MCC $43,065 – $73,947 · median $58,506 2 plans
114 ORBITAL PROCEDURES WITHOUT CC/MCC $24,783 – $42,555 · median $33,669 2 plans
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $28,115 – $48,276 · median $38,195 2 plans
116 INTRAOCULAR PROCEDURES WITH CC/MCC $33,119 – $56,868 · median $44,994 2 plans
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $19,872 – $34,122 · median $26,997 2 plans
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $21,308 – $36,588 · median $28,948 2 plans
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $14,394 – $24,715 · median $19,554 2 plans
123 NEUROLOGICAL EYE DISORDERS $14,628 – $25,118 · median $19,873 2 plans
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $24,235 – $41,614 · median $32,925 2 plans
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $14,064 – $24,149 · median $19,106 2 plans
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $38,744 – $66,527 · median $52,636 2 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $18,597 – $31,933 · median $25,265 2 plans
137 MOUTH PROCEDURES WITH CC/MCC $27,351 – $46,964 · median $37,158 2 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC $16,233 – $27,873 · median $22,053 2 plans
139 SALIVARY GLAND PROCEDURES $22,138 – $38,013 · median $30,075 2 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $78,128 – $134,152 · median $106,140 2 plans
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $39,951 – $68,600 · median $54,276 2 plans
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $29,241 – $50,210 · median $39,726 2 plans
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $68,626 – $117,838 · median $93,232 2 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $31,742 – $54,503 · median $43,122 2 plans
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $22,023 – $37,815 · median $29,919 2 plans
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $38,784 – $66,596 · median $52,690 2 plans
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $23,290 – $39,991 · median $31,641 2 plans
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $14,600 – $25,070 · median $19,835 2 plans
150 EPISTAXIS WITH MCC $24,389 – $41,878 · median $33,134 2 plans
151 EPISTAXIS WITHOUT MCC $13,445 – $23,086 · median $18,265 2 plans
152 OTITIS MEDIA AND URI WITH MCC $21,654 – $37,183 · median $29,418 2 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $28,639 – $49,175 · median $38,907 2 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $16,788 – $28,826 · median $22,807 2 plans
157 DENTAL AND ORAL DISEASES WITH MCC $31,447 – $53,997 · median $42,722 2 plans
158 DENTAL AND ORAL DISEASES WITH CC $16,665 – $28,615 · median $22,640 2 plans
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $12,978 – $22,284 · median $17,631 2 plans
164 MAJOR CHEST PROCEDURES WITH CC $46,232 – $79,385 · median $62,808 2 plans
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $35,062 – $60,205 · median $47,634 2 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $68,463 – $117,558 · median $93,011 2 plans
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $33,033 – $56,721 · median $44,877 2 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $25,028 – $42,976 · median $34,002 2 plans
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $17,877 – $30,697 · median $24,287 2 plans
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $13,829 – $23,746 · median $18,788 2 plans
180 RESPIRATORY NEOPLASMS WITH MCC $32,348 – $55,544 · median $43,946 2 plans
181 RESPIRATORY NEOPLASMS WITH CC $19,618 – $33,685 · median $26,651 2 plans
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $13,628 – $23,400 · median $18,514 2 plans
183 MAJOR CHEST TRAUMA WITH MCC $28,023 – $48,118 · median $38,071 2 plans
184 MAJOR CHEST TRAUMA WITH CC $19,491 – $33,468 · median $26,480 2 plans
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $14,406 – $24,737 · median $19,572 2 plans
187 PLEURAL EFFUSION WITH CC $18,117 – $31,109 · median $24,613 2 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC $13,137 – $22,557 · median $17,847 2 plans
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $11,760 – $20,192 · median $15,976 2 plans
196 INTERSTITIAL LUNG DISEASE WITH MCC $34,568 – $59,356 · median $46,962 2 plans
197 INTERSTITIAL LUNG DISEASE WITH CC $17,385 – $29,851 · median $23,618 2 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $13,119 – $22,526 · median $17,822 2 plans
199 PNEUMOTHORAX WITH MCC $32,313 – $55,484 · median $43,899 2 plans
204 RESPIRATORY SIGNS AND SYMPTOMS $14,789 – $25,394 · median $20,092 2 plans
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $33,538 – $57,589 · median $45,564 2 plans
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $17,238 – $29,599 · median $23,419 2 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $199,181 – $342,012 · median $270,597 2 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $90,151 – $154,797 · median $122,474 2 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $25,358 – $43,542 · median $34,450 2 plans
245 AICD GENERATOR PROCEDURES $83,569 – $143,497 · median $113,533 2 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $49,408 – $84,839 · median $67,123 2 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $31,100 – $53,402 · median $42,251 2 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $20,006 – $34,352 · median $27,179 2 plans
263 VEIN LIGATION AND STRIPPING $56,002 – $96,161 · median $76,082 2 plans
265 AICD LEAD PROCEDURES $66,275 – $113,800 · median $90,037 2 plans
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $36,282 – $62,300 · median $49,291 2 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $12,679 – $21,771 · median $17,225 2 plans
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $10,970 – $18,837 · median $14,903 2 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $49,569 – $85,115 · median $67,342 2 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $31,265 – $53,685 · median $42,475 2 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $17,029 – $29,241 · median $23,135 2 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $10,367 – $17,802 · median $14,085 2 plans
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $28,609 – $49,125 · median $38,867 2 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC $11,421 – $19,610 · median $15,515 2 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $8,336 – $14,314 · median $11,325 2 plans
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $29,906 – $51,352 · median $40,629 2 plans
302 ATHEROSCLEROSIS WITH MCC $21,918 – $37,635 · median $29,777 2 plans
304 HYPERTENSION WITH MCC $21,797 – $37,428 · median $29,613 2 plans
305 HYPERTENSION WITHOUT MCC $13,831 – $23,749 · median $18,790 2 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $28,864 – $49,562 · median $39,213 2 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $16,727 – $28,722 · median $22,725 2 plans
313 CHEST PAIN $13,188 – $22,645 · median $17,917 2 plans
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $17,645 – $30,298 · median $23,971 2 plans
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $12,494 – $21,453 · median $16,974 2 plans
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $79,265 – $136,105 · median $107,685 2 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $58,805 – $100,974 · median $79,889 2 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $91,354 – $156,864 · median $124,109 2 plans
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $44,770 – $76,875 · median $60,823 2 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $29,349 – $50,396 · median $39,872 2 plans
332 RECTAL RESECTION WITH MCC $66,320 – $113,878 · median $90,099 2 plans
333 RECTAL RESECTION WITH CC $42,902 – $73,667 · median $58,284 2 plans
334 RECTAL RESECTION WITHOUT CC/MCC $30,001 – $51,515 · median $40,758 2 plans
335 PERITONEAL ADHESIOLYSIS WITH MCC $65,408 – $112,312 · median $88,860 2 plans
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $28,117 – $48,279 · median $38,198 2 plans
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $47,309 – $81,234 · median $64,272 2 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $21,728 – $37,308 · median $29,518 2 plans
348 ANAL AND STOMAL PROCEDURES WITH CC $23,973 – $41,164 · median $32,569 2 plans
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $15,947 – $27,382 · median $21,664 2 plans
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $45,644 – $78,375 · median $62,010 2 plans
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $27,924 – $47,949 · median $37,936 2 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $21,391 – $36,730 · median $29,060 2 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $53,156 – $91,274 · median $72,215 2 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $80,463 – $138,162 · median $109,313 2 plans
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $42,596 – $73,142 · median $57,869 2 plans
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $18,321 – $31,458 · median $24,889 2 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $12,837 – $22,042 · median $17,439 2 plans
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $32,478 – $55,768 · median $44,123 2 plans
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $18,702 – $32,112 · median $25,407 2 plans
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $13,324 – $22,878 · median $18,101 2 plans
375 DIGESTIVE MALIGNANCY WITH CC $22,156 – $38,044 · median $30,100 2 plans
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $16,930 – $29,071 · median $23,001 2 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $11,547 – $19,827 · median $15,687 2 plans
380 COMPLICATED PEPTIC ULCER WITH MCC $35,942 – $61,715 · median $48,828 2 plans
381 COMPLICATED PEPTIC ULCER WITH CC $19,846 – $34,078 · median $26,962 2 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $14,665 – $25,180 · median $19,923 2 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $25,290 – $43,426 · median $34,358 2 plans
385 INFLAMMATORY BOWEL DISEASE WITH MCC $28,983 – $49,767 · median $39,375 2 plans
386 INFLAMMATORY BOWEL DISEASE WITH CC $17,883 – $30,707 · median $24,295 2 plans
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $29,294 – $50,301 · median $39,798 2 plans
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $17,139 – $29,430 · median $23,284 2 plans
397 APPENDIX PROCEDURES WITH MCC $43,867 – $75,324 · median $59,596 2 plans
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $100,203 – $172,058 · median $136,131 2 plans
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $53,123 – $91,217 · median $72,170 2 plans
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $40,656 – $69,811 · median $55,234 2 plans
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $65,311 – $112,145 · median $88,728 2 plans
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $39,882 – $68,480 · median $54,181 2 plans
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $29,082 – $49,936 · median $39,509 2 plans
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $60,507 – $103,895 · median $82,201 2 plans
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $38,511 – $66,128 · median $52,320 2 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $30,415 – $52,226 · median $41,321 2 plans
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $65,256 – $112,051 · median $88,654 2 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $62,408 – $107,160 · median $84,784 2 plans
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $31,826 – $54,648 · median $43,237 2 plans
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $25,635 – $44,017 · median $34,826 2 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $40,076 – $68,814 · median $54,445 2 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $27,481 – $47,187 · median $37,334 2 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $13,051 – $22,410 · median $17,730 2 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $15,630 – $26,838 · median $21,234 2 plans
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $12,816 – $22,007 · median $17,412 2 plans
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $57,052 – $97,964 · median $77,508 2 plans
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $33,405 – $57,359 · median $45,382 2 plans
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $78,633 – $135,020 · median $106,827 2 plans
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $41,684 – $71,575 · median $56,630 2 plans
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $21,618 – $37,120 · median $29,369 2 plans
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $63,278 – $108,654 · median $85,966 2 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $34,049 – $58,466 · median $46,258 2 plans
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $53,345 – $91,598 · median $72,471 2 plans
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $29,875 – $51,298 · median $40,587 2 plans
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $50,773 – $87,182 · median $68,977 2 plans
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $59,111 – $101,499 · median $80,305 2 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $28,688 – $49,260 · median $38,974 2 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $66,412 – $114,036 · median $90,224 2 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $21,096 – $36,223 · median $28,659 2 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $36,905 – $63,369 · median $50,137 2 plans
500 SOFT TISSUE PROCEDURES WITH MCC $57,970 – $99,539 · median $78,754 2 plans
501 SOFT TISSUE PROCEDURES WITH CC $32,020 – $54,981 · median $43,501 2 plans
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $24,653 – $42,331 · median $33,492 2 plans
503 FOOT PROCEDURES WITH MCC $51,125 – $87,786 · median $69,455 2 plans
506 MAJOR THUMB OR JOINT PROCEDURES $21,973 – $37,730 · median $29,851 2 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $33,088 – $56,815 · median $44,951 2 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $27,739 – $47,631 · median $37,685 2 plans
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $55,327 – $95,001 · median $75,164 2 plans
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $38,088 – $65,401 · median $51,745 2 plans
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $30,322 – $52,066 · median $41,194 2 plans
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $18,725 – $32,153 · median $25,439 2 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $58,374 – $100,234 · median $79,304 2 plans
533 FRACTURES OF FEMUR WITH MCC $28,716 – $49,307 · median $39,011 2 plans
534 FRACTURES OF FEMUR WITHOUT MCC $14,765 – $25,353 · median $20,059 2 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC $23,482 – $40,321 · median $31,902 2 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $17,480 – $30,015 · median $23,747 2 plans
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $13,194 – $22,655 · median $17,924 2 plans
539 OSTEOMYELITIS WITH MCC $36,079 – $61,951 · median $49,015 2 plans
540 OSTEOMYELITIS WITH CC $23,744 – $40,771 · median $32,258 2 plans
541 OSTEOMYELITIS WITHOUT CC/MCC $14,132 – $24,265 · median $19,198 2 plans
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $32,357 – $55,560 · median $43,958 2 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $13,822 – $23,734 · median $18,778 2 plans
545 CONNECTIVE TISSUE DISORDERS WITH MCC $45,457 – $78,054 · median $61,756 2 plans
546 CONNECTIVE TISSUE DISORDERS WITH CC $21,127 – $36,277 · median $28,702 2 plans
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $15,317 – $26,300 · median $20,808 2 plans
548 SEPTIC ARTHRITIS WITH MCC $35,368 – $60,731 · median $48,049 2 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $16,011 – $27,492 · median $21,752 2 plans
551 MEDICAL BACK PROBLEMS WITH MCC $30,701 – $52,717 · median $41,709 2 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $23,744 – $40,771 · median $32,258 2 plans
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $15,205 – $26,108 · median $20,657 2 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $24,211 – $41,573 · median $32,892 2 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $27,236 – $46,766 · median $37,001 2 plans
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $34,159 – $58,655 · median $46,407 2 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $20,627 – $35,418 · median $28,022 2 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $14,725 – $25,284 · median $20,005 2 plans
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $26,098 – $44,813 · median $35,455 2 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $28,274 – $48,549 · median $38,412 2 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $17,848 – $30,647 · median $24,247 2 plans
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $13,725 – $23,567 · median $18,646 2 plans
570 SKIN DEBRIDEMENT WITH MCC $53,872 – $92,503 · median $73,188 2 plans
571 SKIN DEBRIDEMENT WITH CC $30,947 – $53,138 · median $42,042 2 plans
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $20,997 – $36,053 · median $28,525 2 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $120,002 – $206,055 · median $163,028 2 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $63,586 – $109,182 · median $86,384 2 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $89,775 – $154,153 · median $121,964 2 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $59,320 – $101,857 · median $80,588 2 plans
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $31,652 – $54,349 · median $43,000 2 plans
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $26,433 – $45,388 · median $35,911 2 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $35,290 – $60,595 · median $47,942 2 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $31,586 – $54,236 · median $42,911 2 plans
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $39,211 – $67,329 · median $53,270 2 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $35,335 – $60,674 · median $48,005 2 plans
592 SKIN ULCERS WITH MCC $35,449 – $60,869 · median $48,159 2 plans
593 SKIN ULCERS WITH CC $21,729 – $37,312 · median $29,520 2 plans
594 SKIN ULCERS WITHOUT CC/MCC $15,877 – $27,263 · median $21,570 2 plans
596 MAJOR SKIN DISORDERS WITHOUT MCC $19,828 – $34,047 · median $26,937 2 plans
598 MALIGNANT BREAST DISORDERS WITH CC $20,722 – $35,582 · median $28,152 2 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $13,430 – $23,061 · median $18,245 2 plans
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $19,079 – $32,760 · median $25,920 2 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $11,082 – $19,028 · median $15,055 2 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $26,964 – $46,300 · median $36,632 2 plans
606 MINOR SKIN DISORDERS WITH MCC $27,717 – $47,593 · median $37,655 2 plans
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $40,147 – $68,936 · median $54,542 2 plans
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $25,631 – $44,011 · median $34,821 2 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $63,879 – $109,686 · median $86,782 2 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $25,979 – $44,608 · median $35,294 2 plans
619 O.R. PROCEDURES FOR OBESITY WITH MCC $52,889 – $90,815 · median $71,852 2 plans
620 O.R. PROCEDURES FOR OBESITY WITH CC $29,313 – $50,333 · median $39,823 2 plans
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $27,629 – $47,442 · median $37,536 2 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $65,194 – $111,944 · median $88,569 2 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $22,931 – $39,375 · median $31,153 2 plans
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $55,319 – $94,988 · median $75,154 2 plans
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $27,465 – $47,159 · median $37,312 2 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $24,330 – $41,778 · median $33,054 2 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $39,909 – $68,528 · median $54,218 2 plans
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $26,734 – $45,904 · median $36,319 2 plans
642 INBORN AND OTHER DISORDERS OF METABOLISM $26,049 – $44,728 · median $35,388 2 plans
644 ENDOCRINE DISORDERS WITH CC $18,775 – $32,238 · median $25,507 2 plans
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $86,116 – $147,868 · median $116,992 2 plans
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $67,879 – $116,555 · median $92,217 2 plans
652 KIDNEY TRANSPLANT $59,155 – $101,574 · median $80,364 2 plans
653 MAJOR BLADDER PROCEDURES WITH MCC $95,182 – $163,437 · median $129,310 2 plans
654 MAJOR BLADDER PROCEDURES WITH CC $51,275 – $88,044 · median $69,659 2 plans
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $38,770 – $66,571 · median $52,671 2 plans
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $58,318 – $100,137 · median $79,227 2 plans
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $33,520 – $57,557 · median $45,539 2 plans
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $28,424 – $48,807 · median $38,616 2 plans
662 MINOR BLADDER PROCEDURES WITH MCC $56,078 – $96,290 · median $76,184 2 plans
663 MINOR BLADDER PROCEDURES WITH CC $27,846 – $47,813 · median $37,829 2 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $19,176 – $32,927 · median $26,052 2 plans
665 PROSTATECTOMY WITH MCC $57,171 – $98,168 · median $77,670 2 plans
666 PROSTATECTOMY WITH CC $32,042 – $55,019 · median $43,530 2 plans
667 PROSTATECTOMY WITHOUT CC/MCC $20,262 – $34,792 · median $27,527 2 plans
668 TRANSURETHRAL PROCEDURES WITH MCC $53,486 – $91,840 · median $72,663 2 plans
669 TRANSURETHRAL PROCEDURES WITH CC $28,428 – $48,814 · median $38,621 2 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $17,901 – $30,738 · median $24,320 2 plans
671 URETHRAL PROCEDURES WITH CC/MCC $32,879 – $56,456 · median $44,668 2 plans
672 URETHRAL PROCEDURES WITHOUT CC/MCC $19,773 – $33,952 · median $26,863 2 plans
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $76,961 – $132,149 · median $104,555 2 plans
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $42,836 – $73,554 · median $58,195 2 plans
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $30,066 – $51,625 · median $40,845 2 plans
684 RENAL FAILURE WITHOUT CC/MCC $10,996 – $18,881 · median $14,938 2 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $33,038 – $56,730 · median $44,884 2 plans
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $19,193 – $32,955 · median $26,074 2 plans
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $14,476 – $24,857 · median $19,666 2 plans
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $21,253 – $36,494 · median $28,873 2 plans
693 URINARY STONES WITH MCC $24,627 – $42,287 · median $33,457 2 plans
694 URINARY STONES WITHOUT MCC $14,318 – $24,586 · median $19,452 2 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $20,951 – $35,975 · median $28,463 2 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $12,620 – $21,670 · median $17,145 2 plans
697 URETHRAL STRICTURE $19,742 – $33,899 · median $26,821 2 plans
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $12,637 – $21,699 · median $17,168 2 plans
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $28,102 – $48,254 · median $38,178 2 plans
709 PENIS PROCEDURES WITH CC/MCC $42,625 – $73,192 · median $57,909 2 plans
710 PENIS PROCEDURES WITHOUT CC/MCC $25,666 – $44,071 · median $34,868 2 plans
711 TESTES PROCEDURES WITH CC/MCC $38,169 – $65,540 · median $51,854 2 plans
712 TESTES PROCEDURES WITHOUT CC/MCC $20,143 – $34,588 · median $27,365 2 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $27,538 – $47,285 · median $37,411 2 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $19,368 – $33,257 · median $26,313 2 plans
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $40,981 – $70,368 · median $55,674 2 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $26,944 – $46,266 · median $36,605 2 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $34,628 – $59,460 · median $47,044 2 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $24,602 – $42,243 · median $33,422 2 plans
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $33,148 – $56,919 · median $45,033 2 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $20,931 – $35,940 · median $28,436 2 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $11,205 – $19,239 · median $15,222 2 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $21,435 – $36,805 · median $29,120 2 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $13,225 – $22,708 · median $17,967 2 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $27,162 – $46,640 · median $36,901 2 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $14,859 – $25,514 · median $20,186 2 plans
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $19,392 – $33,298 · median $26,345 2 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $12,309 – $21,136 · median $16,722 2 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $39,015 – $66,993 · median $53,004 2 plans
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $24,646 – $42,319 · median $33,482 2 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $64,591 – $110,909 · median $87,750 2 plans
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $26,122 – $44,854 · median $35,488 2 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $20,836 – $35,777 · median $28,306 2 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $31,818 – $54,635 · median $43,227 2 plans
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $15,377 – $26,404 · median $20,891 2 plans
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $25,411 – $43,633 · median $34,522 2 plans
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $47,031 – $80,756 · median $63,893 2 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $27,032 – $46,417 · median $36,725 2 plans
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $33,734 – $57,925 · median $45,830 2 plans
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $17,593 – $30,210 · median $23,902 2 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $26,228 – $45,036 · median $35,632 2 plans
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $17,932 – $30,792 · median $24,362 2 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $12,155 – $20,872 · median $16,513 2 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $10,433 – $17,915 · median $14,174 2 plans
783 Cesarean Section Delivery $11,544 – $13,394 · median $12,379 2 plans
796 Vaginal Delivery $5,347 – $12,480 · median $8,690 2 plans
800 SPLENIC PROCEDURES WITH CC $51,460 – $88,361 · median $69,911 2 plans
801 SPLENIC PROCEDURES WITHOUT CC/MCC $34,965 – $60,039 · median $47,502 2 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $72,977 – $125,308 · median $99,142 2 plans
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $24,838 – $42,649 · median $33,743 2 plans
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $40,442 – $69,443 · median $54,942 2 plans
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $23,187 – $39,815 · median $31,501 2 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $19,171 – $32,918 · median $26,044 2 plans
812 RED BLOOD CELL DISORDERS WITHOUT MCC $16,819 – $28,879 · median $22,849 2 plans
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $38,955 – $66,889 · median $52,922 2 plans
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $19,310 – $33,157 · median $26,233 2 plans
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $15,751 – $27,046 · median $21,398 2 plans
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $107,426 – $184,460 · median $145,943 2 plans
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $41,004 – $70,408 · median $55,706 2 plans
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $22,054 – $37,868 · median $29,961 2 plans
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $83,980 – $144,201 · median $114,090 2 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $41,499 – $71,258 · median $56,378 2 plans
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $24,717 – $42,441 · median $33,579 2 plans
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $85,683 – $147,126 · median $116,405 2 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $42,334 – $72,692 · median $57,513 2 plans
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $31,209 – $53,588 · median $42,398 2 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $57,882 – $99,388 · median $78,635 2 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $27,567 – $47,335 · median $37,451 2 plans
834 ACUTE LEUKEMIA WITH MCC $100,559 – $172,668 · median $136,613 2 plans
835 ACUTE LEUKEMIA WITH CC $38,206 – $65,603 · median $51,904 2 plans
836 ACUTE LEUKEMIA WITHOUT CC/MCC $22,338 – $38,356 · median $30,347 2 plans
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $88,000 – $151,105 · median $119,553 2 plans
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $38,235 – $65,653 · median $51,944 2 plans
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $26,448 – $45,414 · median $35,931 2 plans
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $29,882 – $51,311 · median $40,597 2 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $18,508 – $31,779 · median $25,143 2 plans
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $36,539 – $62,740 · median $49,640 2 plans
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $22,299 – $38,290 · median $30,294 2 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $15,599 – $26,785 · median $21,192 2 plans
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $47,487 – $81,539 · median $64,513 2 plans
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $23,962 – $41,146 · median $32,554 2 plans
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $15,558 – $26,715 · median $21,137 2 plans
849 RADIOTHERAPY $49,630 – $85,219 · median $67,425 2 plans
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $158,616 – $272,359 · median $215,487 2 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $27,424 – $47,090 · median $37,257 2 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $25,514 – $43,809 · median $34,662 2 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $18,279 – $31,386 · median $24,832 2 plans
865 VIRAL ILLNESS WITH MCC $27,444 – $47,125 · median $37,284 2 plans
866 VIRAL ILLNESS WITHOUT MCC $15,928 – $27,351 · median $21,640 2 plans
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $38,341 – $65,835 · median $52,088 2 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $13,366 – $22,951 · median $18,158 2 plans
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $70,793 – $121,559 · median $96,176 2 plans
881 DEPRESSIVE NEUROSES $17,234 – $29,593 · median $23,414 2 plans
882 NEUROSES EXCEPT DEPRESSIVE $19,669 – $33,773 · median $26,721 2 plans
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $36,017 – $61,844 · median $48,930 2 plans
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $29,470 – $50,603 · median $40,037 2 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $38,013 – $65,272 · median $51,643 2 plans
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $11,300 – $19,403 · median $15,351 2 plans
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $25,930 – $44,523 · median $35,227 2 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $76,869 – $131,991 · median $104,430 2 plans
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $35,068 – $60,215 · median $47,641 2 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $21,424 – $36,786 · median $29,105 2 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $67,280 – $115,526 · median $91,403 2 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $26,226 – $45,033 · median $35,630 2 plans
906 HAND PROCEDURES FOR INJURIES $32,282 – $55,431 · median $43,856 2 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $70,324 – $120,754 · median $95,539 2 plans
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $24,045 – $41,287 · median $32,666 2 plans
913 TRAUMATIC INJURY WITH MCC $29,941 – $51,411 · median $40,676 2 plans
914 TRAUMATIC INJURY WITHOUT MCC $16,220 – $27,851 · median $22,035 2 plans
916 ALLERGIC REACTIONS WITHOUT MCC $12,205 – $20,956 · median $16,581 2 plans
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $32,044 – $55,022 · median $43,533 2 plans
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $18,641 – $32,009 · median $25,325 2 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $337,586 – $579,667 · median $458,626 2 plans
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $131,382 – $225,596 · median $178,489 2 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $58,995 – $101,301 · median $80,148 2 plans
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $69,910 – $120,043 · median $94,977 2 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $40,492 – $69,528 · median $55,010 2 plans
935 NON-EXTENSIVE BURNS $37,733 – $64,791 · median $51,262 2 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $66,463 – $114,124 · median $90,293 2 plans
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $42,805 – $73,500 · median $58,153 2 plans
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $37,141 – $63,775 · median $50,458 2 plans
945 REHABILITATION WITH CC/MCC $28,366 – $48,707 · median $38,536 2 plans
946 REHABILITATION WITHOUT CC/MCC $21,006 – $36,069 · median $28,538 2 plans
947 SIGNS AND SYMPTOMS WITH MCC $23,252 – $39,925 · median $31,588 2 plans
948 SIGNS AND SYMPTOMS WITHOUT MCC $14,663 – $25,177 · median $19,920 2 plans
949 AFTERCARE WITH CC/MCC $21,792 – $37,418 · median $29,605 2 plans
950 AFTERCARE WITHOUT CC/MCC $11,498 – $19,742 · median $15,620 2 plans
951 OTHER FACTORS INFLUENCING HEALTH STATUS $10,184 – $17,487 · median $13,836 2 plans
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $53,927 – $92,598 · median $73,262 2 plans
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $17,227 – $29,581 · median $23,404 2 plans
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $112,124 – $192,527 · median $152,325 2 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $48,309 – $82,952 · median $65,630 2 plans
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $52,863 – $90,770 · median $71,817 2 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC $23,721 – $40,730 · median $32,225 2 plans
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $16,385 – $28,134 · median $22,259 2 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $23,219 – $39,869 · median $31,544 2 plans
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $31,395 – $53,909 · median $42,652 2 plans
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $62,798 – $107,830 · median $85,314 2 plans
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $30,106 – $51,695 · median $40,900 2 plans
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $21,966 – $37,717 · median $29,841 2 plans
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