San Antonio Regional Hospital — Pricing

672 procedures published in this hospital's Machine-Readable File (MRF) — 671 with a comparable price, 1 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 672
Lowest published price $5,147
Average published price $142,717
Highest published price $1,300,763

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 672 procedures

Published charges

Showing all 671 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 70 procedures, this hospital's negotiated rates average ≈126% of what Medicare pays.

DRG Description Published price Cash price vs. CA median vs. National median vs Medicare
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $1,300,763 $1,326,778 $371,366 +250% $371,366 +250% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $1,224,358 $1,248,845 $486,976 +151% $431,073 +184% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $884,407 $902,096 $248,521 +256% $245,241 +261% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $690,444 $704,253 $102,128 +576% $94,927 +627% —
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $675,827 $689,343 $23,643 +2758% $86,864 +678% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $664,131 $677,414 $175,437 +279% $175,437 +279% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $641,316 $654,142 $196,346 +227% $171,338 +274% —
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $613,877 $626,155 $23,289 +2536% $103,861 +491% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $599,198 $611,182 $144,569 +314% $138,868 +331% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $567,995 $579,355 $131,961 +330% $131,961 +330% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $557,899 $569,057 $124,290 +349% $138,008 +304% ≈112% of Medicare
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $552,143 $563,186 $107,269 +415% $80,018 +590% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $529,771 $540,366 $74,257 +613% $74,257 +613% —
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $522,963 $533,422 $23,643 +2112% $80,427 +550% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $508,328 $518,495 $143,242 +255% $143,242 +255% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $498,836 $508,813 $49,765 +902% $39,657 +1158% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $497,200 $507,144 $117,280 +324% $117,280 +324% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $496,906 $506,844 $153,282 +224% $151,029 +229% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $495,346 $505,253 $107,355 +361% $107,355 +361% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $493,561 $503,432 $148,686 +232% $134,914 +266% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $472,654 $482,107 $91,329 +418% $91,329 +418% —
800 SPLENIC PROCEDURES WITH CC $471,335 — $59,817 +688% $49,184 +858% —
231 CORONARY BYPASS WITH PTCA WITH MCC $451,431 $460,460 $155,631 +190% $146,474 +208% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $443,528 $452,399 $99,423 +346% $99,423 +346% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $438,042 $446,803 $53,208 +723% $45,497 +863% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $432,354 $441,001 $189,963 +128% $159,181 +172% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $429,279 $437,865 $115,839 +271% $106,238 +304% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $423,122 $431,584 $73,751 +474% $60,861 +595% —
950 AFTERCARE WITHOUT CC/MCC $420,619 — $13,527 +3009% $13,527 +3009% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $417,440 $425,789 $191,314 +118% $191,314 +118% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $412,856 $421,113 $83,065 +397% $83,065 +397% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $411,378 $419,606 $89,523 +360% $80,885 +409% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $406,968 $415,108 $43,328 +839% $36,850 +1004% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $406,591 $414,722 $121,714 +234% $121,714 +234% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $401,020 $409,040 $94,937 +322% $87,018 +361% ≈120% of Medicare
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $397,806 $405,762 $97,241 +309% $84,861 +369% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $397,654 — $13,395 +2869% $10,039 +3861% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $393,423 $401,292 $106,778 +268% $106,778 +268% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $388,856 — $57,493 +576% $46,402 +738% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $379,350 $386,937 $88,307 +330% $88,307 +330% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $378,146 $385,709 $95,536 +296% $87,565 +332% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $377,485 $385,035 $78,852 +379% $78,852 +379% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $365,917 $373,236 $116,058 +215% $116,058 +215% ≈110% of Medicare
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $364,245 $371,530 $102,177 +256% $102,177 +256% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $361,726 $368,960 $112,062 +223% $112,062 +223% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $345,245 $352,149 $90,331 +282% $90,331 +282% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $345,053 $351,954 $90,775 +280% $86,390 +299% ≈111% of Medicare
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $343,188 $350,051 $84,725 +305% $88,049 +290% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $339,092 $345,874 $113,855 +198% $113,855 +198% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $338,729 $345,503 $113,157 +199% $92,238 +267% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $337,950 $344,709 $75,573 +347% $72,782 +364% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $331,582 $338,214 $96,245 +245% $80,747 +311% —
799 SPLENIC PROCEDURES WITH MCC $328,954 $335,533 $90,790 +262% $78,821 +317% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $325,652 $332,165 $71,755 +354% $71,755 +354% —
710 PENIS PROCEDURES WITHOUT CC/MCC $325,407 $331,915 $33,330 +876% $23,814 +1266% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $324,921 $331,419 $102,573 +217% $102,573 +217% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $316,155 $322,478 $125,432 +152% $89,353 +254% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $316,100 $322,422 $70,540 +348% $70,540 +348% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $315,689 $322,003 $82,247 +284% $82,247 +284% —
037 EXTRACRANIAL PROCEDURES WITH MCC $313,318 $319,584 $66,666 +370% $64,749 +384% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $312,620 $318,872 $46,317 +575% $38,420 +714% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $309,488 $315,678 $88,050 +251% $88,050 +251% ≈116% of Medicare
503 FOOT PROCEDURES WITH MCC $305,719 $311,833 $55,321 +453% $43,901 +596% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $303,270 $309,336 $64,956 +367% $64,956 +367% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $295,407 $301,315 $60,959 +385% $74,274 +298% ≈122% of Medicare
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $293,324 $299,190 $92,217 +218% $92,217 +218% ≈105% of Medicare
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $292,037 $297,878 $23,643 +1135% $57,380 +409% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $285,618 $291,330 $68,639 +316% $62,524 +357% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $284,057 $289,738 $86,246 +229% $76,954 +269% —
245 AICD GENERATOR PROCEDURES $281,197 $286,821 $95,281 +195% $72,076 +290% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $280,995 $286,615 $66,819 +321% $66,819 +321% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $280,247 $285,852 $71,014 +295% $71,014 +295% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $277,303 $282,849 $32,467 +754% $25,149 +1003% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $274,824 $280,320 $65,631 +319% $54,129 +408% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $272,163 $277,606 $34,817 +682% $30,910 +781% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $269,137 $274,520 $50,218 +436% $38,878 +592% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $265,532 $270,843 $47,583 +458% $47,583 +458% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $265,363 $270,670 $50,624 +424% $50,624 +424% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $265,334 $270,641 $101,576 +161% $86,953 +205% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $263,774 $269,049 $74,755 +253% $74,755 +253% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $263,767 $269,042 $49,382 +434% $39,409 +569% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $261,052 $266,273 $37,033 +605% $30,930 +744% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $260,916 $266,135 $41,380 +531% $41,380 +531% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $260,868 $266,085 $46,066 +466% $46,066 +466% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $258,871 $264,049 $60,905 +325% $49,710 +421% —
471 CERVICAL SPINAL FUSION WITH MCC $258,483 $263,652 $92,515 +179% $92,515 +179% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $257,474 $262,623 $32,248 +698% $28,140 +815% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $251,766 $256,801 $36,340 +593% $29,826 +744% —
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $251,670 $256,704 $23,643 +964% $59,206 +325% —
163 MAJOR CHEST PROCEDURES WITH MCC $250,742 $255,757 $88,341 +184% $88,341 +184% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $245,792 $250,708 $43,749 +462% $37,902 +548% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $244,673 $249,567 $81,281 +201% $72,945 +235% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $244,055 $248,936 $67,560 +261% $57,855 +322% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $243,903 $248,781 $77,817 +213% $71,701 +240% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $243,334 $248,200 $69,597 +250% $51,953 +368% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $238,160 $242,923 $46,288 +415% $36,237 +557% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $236,746 $241,481 $70,132 +238% $70,132 +238% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $229,977 $234,577 $79,225 +190% $72,011 +219% —
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $229,217 $233,801 $96,905 +137% $96,905 +137% —
606 MINOR SKIN DISORDERS WITH MCC $229,207 $233,791 $34,344 +567% $25,434 +801% —
791 PREMATURITY WITH MAJOR PROBLEMS $224,046 $228,527 $75,557 +197% $39,563 +466% —
164 MAJOR CHEST PROCEDURES WITH CC $223,679 $228,153 $53,141 +321% $53,141 +321% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $223,192 $227,656 $70,371 +217% $67,901 +229% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $222,744 $227,199 $50,131 +344% $44,989 +395% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $221,636 $226,069 $68,421 +224% $68,880 +222% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $221,433 $225,862 $86,699 +155% $72,859 +204% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $221,314 $225,740 $51,645 +329% $54,824 +304% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $220,206 $224,610 $52,405 +320% $52,405 +320% ≈126% of Medicare
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $218,996 $223,376 $82,561 +165% $82,561 +165% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $217,966 $222,326 $59,790 +265% $54,475 +300% —
472 CERVICAL SPINAL FUSION WITH CC $215,885 $220,203 $59,537 +263% $59,537 +263% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $215,877 $220,194 $49,209 +339% $39,253 +450% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $214,772 $219,068 $77,178 +178% $68,006 +216% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $214,480 $218,769 $69,724 +208% $65,383 +228% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $213,920 $218,198 $52,735 +306% $57,963 +269% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $212,898 $217,156 $40,150 +430% $35,014 +508% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $212,358 $216,605 $69,701 +205% $59,207 +259% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $212,199 $216,442 $85,334 +149% $68,847 +208% —
668 TRANSURETHRAL PROCEDURES WITH MCC $211,174 $215,397 $59,859 +253% $47,277 +347% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $207,998 $212,158 $40,719 +411% $35,714 +482% ≈151% of Medicare
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $206,848 $210,985 $65,325 +217% $65,325 +217% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $205,834 $209,951 $40,163 +412% $54,772 +276% ≈129% of Medicare
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $205,356 $209,463 $23,643 +769% $33,983 +504% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $204,947 $209,046 $108,750 +88% $96,192 +113% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $203,823 $207,899 $45,376 +349% $37,064 +450% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $201,574 $205,606 $40,563 +397% $40,563 +397% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $201,521 $205,551 $61,217 +229% $53,551 +276% —
643 ENDOCRINE DISORDERS WITH MCC $200,629 $204,642 $35,135 +471% $32,996 +508% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $199,651 $203,644 $60,140 +232% $60,140 +232% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $196,674 $200,607 $75,103 +162% $75,103 +162% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $196,037 $199,957 $69,743 +181% $68,399 +187% —
253 OTHER VASCULAR PROCEDURES WITH CC $195,753 $199,668 $53,746 +264% $53,746 +264% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $195,320 $199,226 $54,815 +256% $43,697 +347% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $194,604 $198,497 $62,334 +212% $67,764 +187% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $194,074 $197,955 $50,139 +287% $50,139 +287% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $193,394 $197,261 $25,822 +649% $18,291 +957% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $190,615 $194,427 $50,498 +277% $47,546 +301% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $190,072 $193,873 $75,820 +151% $62,961 +202% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $189,950 $193,749 $71,092 +167% $64,776 +193% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $188,610 $192,383 $54,273 +248% $48,094 +292% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $187,782 $191,537 $51,339 +266% $51,339 +266% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $186,032 $189,753 $45,849 +306% $37,080 +402% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $185,544 $189,255 $44,489 +317% $44,600 +316% ≈119% of Medicare
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $184,095 $187,777 $50,011 +268% $50,011 +268% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $182,234 $185,879 $65,573 +178% $65,573 +178% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $180,030 $183,631 $81,298 +121% $68,659 +162% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $179,502 $183,092 $76,219 +136% $72,908 +146% —
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $178,832 $182,409 $23,643 +656% $56,960 +214% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $178,461 $182,030 $56,832 +214% $48,358 +269% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $178,313 $181,879 $33,633 +430% $31,059 +474% —
252 OTHER VASCULAR PROCEDURES WITH MCC $176,719 $180,253 $68,508 +158% $68,508 +158% ≈109% of Medicare
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $176,218 $179,743 $50,562 +249% $58,832 +200% ≈115% of Medicare
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $174,465 $177,955 $34,906 +400% $34,906 +400% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $174,322 $177,808 $51,487 +239% $46,591 +274% —
597 MALIGNANT BREAST DISORDERS WITH MCC $174,019 $177,500 $36,807 +373% $31,846 +446% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $172,138 $175,581 $58,043 +197% $58,043 +197% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $171,440 $174,869 $67,268 +155% $64,152 +167% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $171,257 $174,682 $59,031 +190% $58,968 +190% —
570 SKIN DEBRIDEMENT WITH MCC $170,133 $173,536 $63,709 +167% $52,435 +224% —
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $169,790 $173,186 $37,175 +357% $29,916 +468% —
100 SEIZURES WITH MCC $169,684 $173,078 $40,653 +317% $35,194 +382% ≈130% of Medicare
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $168,901 $172,279 $55,162 +206% $55,162 +206% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $168,097 $171,459 $51,985 +223% $51,985 +223% —
180 RESPIRATORY NEOPLASMS WITH MCC $166,841 $170,178 $36,658 +355% $36,658 +355% —
075 VIRAL MENINGITIS WITH CC/MCC $166,776 $170,112 $36,230 +360% $29,853 +459% —
947 SIGNS AND SYMPTOMS WITH MCC $166,143 $169,466 $28,553 +482% $25,474 +552% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $165,789 $169,105 $33,048 +402% $31,062 +434% —
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $164,905 $168,203 $23,643 +597% $21,663 +661% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $164,033 $167,314 $46,477 +253% $46,477 +253% —
336 PERITONEAL ADHESIOLYSIS WITH CC $163,945 $167,224 $46,332 +254% $49,470 +231% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $163,822 $167,098 $31,108 +427% $24,452 +570% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $163,354 $166,621 $50,777 +222% $52,313 +212% —
711 TESTES PROCEDURES WITH CC/MCC $163,312 $166,579 $42,414 +285% $34,852 +369% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $162,590 $165,842 $30,887 +426% $35,542 +357% —
500 SOFT TISSUE PROCEDURES WITH MCC $160,259 $163,464 $64,105 +150% $57,479 +179% —
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $159,963 $163,162 $36,506 +338% $30,814 +419% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $159,859 $163,056 $64,523 +148% $63,475 +152% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $159,354 $162,541 $35,675 +347% $29,409 +442% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $158,845 $162,022 $60,274 +164% $63,984 +148% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $158,194 $161,358 $33,779 +368% $29,371 +439% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $157,615 $160,767 $49,137 +221% $43,586 +262% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $157,022 $160,162 $39,105 +302% $36,280 +333% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $156,415 $159,543 $33,267 +370% $24,036 +551% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $156,271 $159,396 $43,483 +259% $38,357 +307% ≈116% of Medicare
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $155,602 $158,714 $37,599 +314% $29,729 +423% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $154,936 $158,035 $40,263 +285% $35,237 +340% ≈124% of Medicare
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $154,588 $157,680 $68,653 +125% $62,269 +148% —
836 ACUTE LEUKEMIA WITHOUT CC/MCC $153,273 $156,338 $28,209 +443% $19,686 +679% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $153,177 $156,241 $27,634 +454% $21,860 +601% —
334 RECTAL RESECTION WITHOUT CC/MCC $152,210 $155,254 $36,820 +313% $32,213 +373% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $152,014 $155,054 $54,583 +178% $52,332 +190% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $151,904 $154,943 $49,631 +206% $49,631 +206% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $151,804 $154,840 $18,592 +716% $14,064 +979% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $151,262 $154,287 $37,950 +299% $37,950 +299% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $151,115 $154,138 $37,214 +306% $48,680 +210% —
654 MAJOR BLADDER PROCEDURES WITH CC $150,957 $153,976 $58,274 +159% $53,868 +180% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $150,803 — $14,368 +950% $14,368 +950% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $150,388 $153,396 $52,959 +184% $43,491 +246% —
157 DENTAL AND ORAL DISEASES WITH MCC $150,044 $153,045 $34,802 +331% $27,457 +446% —
834 ACUTE LEUKEMIA WITH MCC $149,959 $152,959 $100,245 +50% $76,583 +96% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $148,410 $151,378 $48,682 +205% $48,682 +205% —
595 MAJOR SKIN DISORDERS WITH MCC $147,453 $150,402 $42,837 +244% $31,785 +364% —
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $146,736 $149,671 $31,730 +362% $24,941 +488% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $146,358 $149,285 $106,057 +38% $101,235 +45% —
607 MINOR SKIN DISORDERS WITHOUT MCC $146,251 $149,176 $19,185 +662% $15,284 +857% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $146,197 $149,121 $38,951 +275% $30,766 +375% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $145,765 $148,680 $35,532 +310% $30,058 +385% ≈135% of Medicare
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $145,398 $148,306 $48,634 +199% $45,059 +223% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $145,361 $148,268 $47,089 +209% $44,553 +226% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $145,217 $148,121 $35,591 +308% $31,128 +367% —
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $144,387 $147,275 $23,499 +514% $50,815 +184% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $143,810 $146,687 $40,063 +259% $40,063 +259% —
665 PROSTATECTOMY WITH MCC $143,550 $146,421 $68,562 +109% $54,072 +165% —
076 VIRAL MENINGITIS WITHOUT CC/MCC $143,049 $145,910 $20,355 +603% $15,474 +824% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $142,060 $144,901 $37,921 +275% $36,375 +291% ≈124% of Medicare
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $141,283 $144,109 $71,106 +99% $59,425 +138% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $139,507 $142,297 $91,138 +53% $88,691 +57% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $139,480 $142,270 $31,816 +338% $31,816 +338% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $139,028 $141,809 $30,959 +349% $29,757 +367% ≈165% of Medicare
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $138,985 $141,764 $43,913 +217% $43,398 +220% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $138,455 $141,224 $35,113 +294% $32,689 +324% ≈127% of Medicare
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $138,216 $140,981 $34,867 +296% $28,967 +377% ≈140% of Medicare
398 APPENDIX PROCEDURES WITH CC $138,149 $140,912 $33,592 +311% $39,107 +253% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $137,550 $140,301 $47,696 +188% $34,900 +294% —
551 MEDICAL BACK PROBLEMS WITH MCC $137,175 $139,918 $35,961 +281% $31,086 +341% —
637 DIABETES WITH MCC $136,593 $139,324 $31,753 +330% $28,819 +374% ≈152% of Medicare
028 SPINAL PROCEDURES WITH MCC $135,974 $138,693 $113,077 +20% $95,858 +42% —
915 ALLERGIC REACTIONS WITH MCC $135,402 $138,110 $36,491 +271% $30,944 +338% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $134,938 $137,636 $54,345 +148% $41,703 +224% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $134,658 $137,351 $38,187 +253% $30,394 +343% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $134,446 $137,135 $40,583 +231% $40,583 +231% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $133,516 $136,186 $77,770 +72% $57,521 +132% —
137 MOUTH PROCEDURES WITH CC/MCC $132,956 $135,615 $31,048 +328% $24,348 +446% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $132,935 $135,594 $54,929 +142% $54,929 +142% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $132,930 $135,589 $40,213 +231% $36,933 +260% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $132,469 $135,119 $39,057 +239% $32,399 +309% ≈114% of Medicare
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $132,309 $134,955 $45,240 +192% $34,089 +288% —
397 APPENDIX PROCEDURES WITH MCC $131,967 $134,606 $54,751 +141% $52,319 +152% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $131,543 $134,173 $38,094 +245% $38,094 +245% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $130,818 $133,435 $20,725 +531% $16,642 +686% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $130,470 $133,079 $53,666 +143% $57,149 +128% —
183 MAJOR CHEST TRAUMA WITH MCC $129,678 $132,272 $33,957 +282% $28,924 +348% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $129,496 $132,086 $46,799 +177% $56,519 +129% ≈119% of Medicare
375 DIGESTIVE MALIGNANCY WITH CC $129,353 $131,940 $27,277 +374% $27,219 +375% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $129,349 $131,936 $30,645 +322% $24,118 +436% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $129,300 $131,886 $44,639 +190% $45,817 +182% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $128,839 $131,416 $96,507 +34% $96,222 +34% —
038 EXTRACRANIAL PROCEDURES WITH CC $128,625 $131,197 $35,770 +260% $35,770 +260% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $128,615 $131,187 $47,452 +171% $41,900 +207% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $128,551 $131,122 $26,533 +384% $20,421 +530% —
374 DIGESTIVE MALIGNANCY WITH MCC $128,515 $131,085 $42,775 +200% $38,885 +231% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $127,640 $130,193 $35,243 +262% $32,502 +293% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $127,573 $130,125 $34,448 +270% $31,840 +301% ≈118% of Medicare
333 RECTAL RESECTION WITH CC $127,384 $129,932 $46,551 +174% $34,352 +271% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $127,370 $129,917 $42,881 +197% $42,881 +197% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $127,335 $129,881 $51,189 +149% $56,394 +126% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $127,005 $129,545 $60,402 +110% $54,313 +134% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $126,098 $128,620 $36,816 +243% $42,119 +199% ≈138% of Medicare
504 FOOT PROCEDURES WITH CC $125,409 $127,917 $38,960 +222% $36,598 +243% —
662 MINOR BLADDER PROCEDURES WITH MCC $125,081 $127,583 $63,279 +98% $54,483 +130% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $125,062 $127,563 $65,788 +90% $65,254 +92% —
882 NEUROSES EXCEPT DEPRESSIVE $124,843 $127,340 $21,356 +485% $15,680 +696% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $124,822 $127,318 $44,357 +181% $43,524 +187% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $124,683 $127,177 $34,839 +258% $28,134 +343% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $124,429 $126,917 $37,842 +229% $37,842 +229% ≈113% of Medicare
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $124,291 $126,777 $24,191 +414% $31,190 +298% ≈144% of Medicare
682 RENAL FAILURE WITH MCC $124,059 $126,540 $32,520 +281% $27,854 +345% ≈129% of Medicare
669 TRANSURETHRAL PROCEDURES WITH CC $123,987 $126,467 $34,354 +261% $34,354 +261% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $123,928 $126,406 $38,483 +222% $30,974 +300% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $123,728 $126,203 $16,175 +665% $12,650 +878% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $123,308 $125,774 $40,694 +203% $40,694 +203% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $122,006 $124,447 $45,703 +167% $51,172 +138% ≈116% of Medicare
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $121,733 $124,168 $31,812 +283% $31,812 +283% —
263 VEIN LIGATION AND STRIPPING $121,021 $123,442 $55,918 +116% $44,938 +169% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $120,950 $123,369 $32,578 +271% $14,284 +747% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $119,846 $122,242 $27,163 +341% $26,322 +355% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $119,589 $121,981 $36,087 +231% $27,168 +340% —
919 COMPLICATIONS OF TREATMENT WITH MCC $118,862 $121,239 $37,933 +213% $29,031 +309% —
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $118,547 $120,918 $23,289 +409% $18,474 +542% —
864 FEVER AND INFLAMMATORY CONDITIONS $118,076 $120,438 $19,935 +492% $17,412 +578% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $117,759 $120,114 $33,653 +250% $32,936 +258% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $117,380 $119,728 $26,770 +338% $26,488 +343% ≈147% of Medicare
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $117,064 $119,405 $64,194 +82% $51,142 +129% —
592 SKIN ULCERS WITH MCC $116,696 $119,030 $41,848 +179% $32,662 +257% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $116,467 $118,796 $84,217 +38% $60,098 +94% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $116,337 $118,664 $28,515 +308% $27,244 +327% ≈138% of Medicare
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $115,347 $117,654 $27,641 +317% $19,354 +496% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $114,674 $116,967 $21,716 +428% $15,890 +622% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $114,651 $116,944 $43,027 +166% $36,202 +217% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $114,622 $116,914 $34,434 +233% $34,434 +233% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $114,395 $116,683 $43,800 +161% $43,800 +161% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $112,721 $114,975 $45,743 +146% $41,651 +171% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $112,260 $114,505 $22,575 +397% $23,469 +378% ≈168% of Medicare
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $111,638 $113,871 $43,080 +159% $43,080 +159% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $111,377 $113,605 $36,661 +204% $31,758 +251% ≈120% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $111,356 $113,583 $46,172 +141% $35,686 +212% —
813 COAGULATION DISORDERS $111,222 $113,447 $33,296 +234% $30,128 +269% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $110,342 $112,549 $36,651 +201% $44,117 +150% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $110,116 $112,318 $33,325 +230% $28,646 +284% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $109,798 $111,994 $37,764 +191% $43,266 +154% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $109,295 $111,481 $14,638 +647% $13,485 +710% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $108,934 $111,113 $69,089 +58% $49,065 +122% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $108,563 $110,734 $25,267 +330% $25,267 +330% —
113 ORBITAL PROCEDURES WITH CC/MCC $107,944 $110,103 $48,760 +121% $35,642 +203% —
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $107,575 $109,727 $36,907 +191% $27,548 +290% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $107,107 $109,249 $47,797 +124% $38,382 +179% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $106,949 $109,088 $29,117 +267% $23,115 +363% —
602 CELLULITIS WITH MCC $106,810 $108,946 $31,970 +234% $29,347 +264% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $106,395 $108,523 $51,387 +107% $36,080 +195% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $106,368 $108,495 $32,490 +227% $25,854 +311% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $106,138 $108,261 $36,354 +192% $36,333 +192% —
913 TRAUMATIC INJURY WITH MCC $106,050 $108,171 $34,479 +208% $24,198 +338% —
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $106,037 $108,157 $23,396 +353% $23,396 +353% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $105,221 $107,325 $36,467 +189% $31,566 +233% —
571 SKIN DEBRIDEMENT WITH CC $104,989 $107,089 $37,169 +182% $34,901 +201% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $104,725 $106,820 $31,982 +227% $28,780 +264% ≈114% of Medicare
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $104,495 $106,585 $23,887 +337% $17,943 +482% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $104,418 $106,507 $32,911 +217% $32,911 +217% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $104,294 $106,380 $24,930 +318% $24,190 +331% ≈141% of Medicare
951 OTHER FACTORS INFLUENCING HEALTH STATUS $104,268 $106,353 $13,425 +677% $9,385 +1011% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $103,682 $105,756 $39,360 +163% $36,242 +186% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $103,479 $105,549 $38,978 +165% $32,981 +214% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $103,334 $105,401 $25,034 +313% $24,017 +330% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $103,259 $105,324 $34,078 +203% $36,239 +185% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $103,134 $105,196 $32,473 +218% $29,484 +250% —
380 COMPLICATED PEPTIC ULCER WITH MCC $102,931 $104,990 $39,627 +160% $36,641 +181% —
509 ARTHROSCOPY $102,783 $104,839 $38,998 +164% $25,994 +295% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $101,930 $103,969 $13,855 +636% $12,013 +749% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $101,564 $103,595 $27,470 +270% $25,704 +295% ≈135% of Medicare
347 ANAL AND STOMAL PROCEDURES WITH MCC $101,462 $103,492 $50,614 +100% $40,548 +150% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $101,308 $103,334 $33,388 +203% $35,528 +185% —
291 HEART FAILURE AND SHOCK WITH MCC $101,305 $103,331 $28,966 +250% $25,020 +305% ≈125% of Medicare
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $101,220 $103,244 $22,024 +360% $22,024 +360% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $100,898 $102,916 $41,855 +141% $45,963 +120% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $100,128 $102,131 $34,613 +189% $24,465 +309% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $100,070 $102,071 $33,256 +201% $28,252 +254% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $99,774 $101,769 $21,363 +367% $20,777 +380% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $99,714 $101,709 $42,463 +135% $33,165 +201% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $99,458 $101,447 $41,857 +138% $49,197 +102% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $99,235 $101,220 $37,213 +167% $30,275 +228% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $98,956 $100,935 $37,692 +163% $29,476 +236% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $98,937 $100,916 $62,677 +58% $53,817 +84% —
501 SOFT TISSUE PROCEDURES WITH CC $98,496 $100,466 $39,619 +149% $37,975 +159% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $98,452 $100,421 $66,976 +47% $57,277 +72% —
181 RESPIRATORY NEOPLASMS WITH CC $98,329 $100,296 $24,648 +299% $22,431 +338% —
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $98,133 $100,096 $29,250 +235% $34,887 +181% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $98,076 $100,037 $44,363 +121% $44,363 +121% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $98,029 $99,989 $29,252 +235% $26,158 +275% ≈124% of Medicare
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $98,022 $99,982 $39,515 +148% $33,564 +192% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $97,865 $99,822 $51,359 +91% $40,065 +144% —
186 PLEURAL EFFUSION WITH MCC $97,791 $99,747 $33,834 +189% $32,468 +201% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $97,630 $99,583 $39,018 +150% $39,018 +150% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $97,457 $99,406 $42,423 +130% $32,483 +200% —
709 PENIS PROCEDURES WITH CC/MCC $97,391 $99,339 $48,600 +100% $34,535 +182% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $97,278 $99,224 $23,369 +316% $18,478 +426% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $96,631 $98,564 $25,980 +272% $22,982 +320% ≈129% of Medicare
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $96,195 $98,119 $43,631 +120% $41,520 +132% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $96,186 $98,110 $41,191 +134% $32,538 +196% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $95,810 $97,727 $18,150 +428% $18,150 +428% —
506 MAJOR THUMB OR JOINT PROCEDURES $95,005 $96,905 $33,279 +185% $28,983 +228% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $94,873 $96,770 $32,445 +192% $24,450 +288% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $94,748 $96,643 $44,730 +112% $41,660 +127% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $94,644 $96,537 $22,635 +318% $20,080 +371% —
666 PROSTATECTOMY WITH CC $94,219 $96,103 $36,569 +158% $30,016 +214% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $94,089 $95,971 $77,041 +22% $61,832 +52% —
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $93,427 $95,296 $114,040 −18% $108,472 −14% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $92,789 $94,645 $55,594 +67% $45,432 +104% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $92,728 $94,582 $23,551 +294% $23,496 +295% —
811 RED BLOOD CELL DISORDERS WITH MCC $91,847 $93,684 $30,922 +197% $27,934 +229% ≈125% of Medicare
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $91,818 $93,655 $15,280 +501% $19,483 +371% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $91,645 $93,478 $43,775 +109% $43,775 +109% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $90,877 $92,694 $45,785 +98% $36,334 +150% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $90,384 $92,191 $16,634 +443% $16,634 +443% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $90,379 $92,187 $25,390 +256% $25,390 +256% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $90,324 $92,130 $21,449 +321% $21,449 +321% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $90,056 $91,857 $40,552 +122% $40,552 +122% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $90,036 $91,837 $35,217 +156% $39,747 +127% ≈117% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $89,883 $91,681 $20,463 +339% $20,463 +339% ≈166% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $89,706 $91,500 $35,872 +150% $27,118 +231% —
201 PNEUMOTHORAX WITHOUT CC/MCC $89,308 $91,094 $15,031 +494% $13,081 +583% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $89,236 $91,021 $27,492 +225% $27,492 +225% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $88,798 $90,574 $22,637 +292% $21,545 +312% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $88,755 $90,530 $25,037 +254% $20,741 +328% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $88,364 $90,131 $28,125 +214% $25,623 +245% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $88,245 $90,009 $23,503 +275% $24,136 +266% ≈141% of Medicare
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $88,129 $89,892 $62,821 +40% $62,821 +40% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $88,038 $89,799 $28,156 +213% $28,156 +213% —
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $87,751 $89,506 $23,289 +277% $25,628 +242% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $87,685 $89,439 $19,072 +360% $18,278 +380% —
305 HYPERTENSION WITHOUT MCC $87,413 $89,161 $16,665 +425% $17,144 +410% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $87,333 $89,080 $48,235 +81% $45,818 +91% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $87,331 $89,077 $39,422 +122% $31,909 +174% —
539 OSTEOMYELITIS WITH MCC $87,309 $89,055 $41,277 +112% $33,746 +159% —
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $87,158 $88,901 $19,569 +345% $19,569 +345% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $86,921 $88,660 $37,526 +132% $28,578 +204% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $86,427 $88,155 $19,096 +353% $19,096 +353% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $86,345 $88,072 $20,401 +323% $16,352 +428% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $86,110 $87,832 $34,588 +149% $26,020 +231% —
088 CONCUSSION WITH MCC $85,800 $87,516 $30,986 +177% $24,402 +252% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $85,571 $87,282 $30,418 +181% $30,418 +181% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $85,522 $87,233 $38,631 +121% $35,114 +144% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $85,350 $87,057 $34,467 +148% $25,731 +232% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $85,046 $86,747 $22,790 +273% $24,022 +254% —
348 ANAL AND STOMAL PROCEDURES WITH CC $84,979 $86,679 $27,947 +204% $27,947 +204% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $84,680 $86,373 $31,974 +165% $25,786 +228% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $84,635 $86,328 $23,767 +256% $19,579 +332% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $84,564 $86,255 $17,522 +383% $17,522 +383% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $84,346 $86,033 $23,352 +261% $17,550 +381% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $84,289 $85,975 $57,323 +47% $16,719 +404% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $84,274 $85,959 $15,600 +440% $15,600 +440% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $84,269 $85,954 $39,013 +116% $32,204 +162% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $84,091 $85,772 $29,623 +184% $25,426 +231% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $83,986 $85,666 $24,477 +243% $25,162 +234% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $83,852 $85,529 $35,375 +137% $35,375 +137% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $83,839 $85,516 $33,399 +151% $33,792 +148% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $83,320 $84,987 $33,987 +145% $24,879 +235% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $83,201 $84,865 $24,644 +238% $18,459 +351% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $82,733 $84,387 $42,126 +96% $35,459 +133% —
187 PLEURAL EFFUSION WITH CC $82,674 $84,328 $22,288 +271% $21,467 +285% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $82,448 $84,097 $29,523 +179% $23,350 +253% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $82,327 $83,973 $20,086 +310% $15,077 +446% —
304 HYPERTENSION WITH MCC $82,294 $83,940 $26,080 +216% $24,185 +240% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $81,987 $83,626 $27,645 +197% $26,146 +214% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $81,948 $83,587 $38,836 +111% $38,836 +111% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $81,849 $83,485 $16,097 +408% $18,623 +340% ≈169% of Medicare
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $81,833 $83,469 $34,689 +136% $41,380 +98% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $81,827 $83,464 $35,349 +131% $33,607 +143% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $81,411 $83,040 $17,762 +358% $20,278 +301% —
103 HEADACHES WITHOUT MCC $81,338 $82,965 $18,874 +331% $20,111 +304% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $80,984 $82,604 $101,662 −20% $78,582 +3% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $80,953 $82,572 $24,948 +224% $30,314 +167% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $80,451 $82,060 $34,749 +132% $32,490 +148% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $80,351 $81,958 $31,017 +159% $30,006 +168% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $80,070 $81,671 $29,596 +171% $31,978 +150% —
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $79,731 $81,326 $43,538 +83% $43,538 +83% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $79,668 $81,262 $22,850 +249% $22,850 +249% ≈124% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $79,570 $81,161 $18,179 +338% $13,822 +476% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $79,367 $80,954 $21,396 +271% $21,213 +274% ≈145% of Medicare
534 FRACTURES OF FEMUR WITHOUT MCC $79,083 $80,664 $18,070 +338% $17,195 +360% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $78,992 $80,571 $28,065 +181% $26,634 +197% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $78,804 $80,380 $31,950 +147% $25,243 +212% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $78,785 $80,361 $21,225 +271% $18,191 +333% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $78,667 $80,240 $91,495 −14% $70,735 +11% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $78,410 $79,978 $33,674 +133% $30,972 +153% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $78,094 $79,656 $35,692 +119% $35,692 +119% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $78,007 $79,567 $30,242 +158% $24,980 +212% —
302 ATHEROSCLEROSIS WITH MCC $78,004 $79,564 $25,825 +202% $20,844 +274% —
914 TRAUMATIC INJURY WITHOUT MCC $77,981 $79,540 $20,344 +283% $15,593 +400% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $77,584 $79,136 $43,354 +79% $31,044 +150% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $77,336 $78,883 $56,127 +38% $44,839 +72% —
199 PNEUMOTHORAX WITH MCC $77,283 $78,828 $36,952 +109% $31,491 +145% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $76,731 $78,266 $22,153 +246% $17,434 +340% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $76,599 $78,131 $22,197 +245% $20,007 +283% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $76,493 $78,023 $19,492 +292% $17,383 +340% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $76,254 $77,779 $68,616 +11% $52,908 +44% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $76,165 $77,688 $19,624 +288% $15,869 +380% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $76,140 $77,663 $22,033 +246% $20,968 +263% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $75,970 $77,489 $23,141 +228% $23,141 +228% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $75,790 $77,306 $38,541 +97% $32,839 +131% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $75,736 $77,251 $53,274 +42% $46,659 +62% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $75,681 $77,195 $33,424 +126% $33,424 +126% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $75,584 $77,096 $22,888 +230% $22,781 +232% ≈132% of Medicare
184 MAJOR CHEST TRAUMA WITH CC $75,536 $77,047 $23,711 +219% $20,842 +262% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $75,181 $76,684 $19,811 +279% $21,261 +254% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $75,088 $76,590 $24,075 +212% $21,806 +244% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $75,020 $76,520 $26,948 +178% $23,297 +222% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $75,015 $76,515 $40,365 +86% $36,597 +105% —
312 SYNCOPE AND COLLAPSE $74,632 $76,125 $19,342 +286% $19,342 +286% ≈147% of Medicare
693 URINARY STONES WITH MCC $74,564 $76,055 $31,990 +133% $22,525 +231% —
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $74,429 $75,917 $23,643 +215% $34,146 +118% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $74,252 $75,737 $70,175 +6% $50,919 +46% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $74,179 $75,663 $35,584 +108% $35,584 +108% —
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $74,162 $75,645 $23,289 +218% $16,240 +357% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $74,050 $75,531 $15,837 +368% $15,607 +374% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $73,944 $75,423 $28,602 +159% $23,924 +209% —
123 NEUROLOGICAL EYE DISORDERS $73,778 $75,254 $17,831 +314% $17,831 +314% —
644 ENDOCRINE DISORDERS WITH CC $73,731 $75,206 $22,941 +221% $22,941 +221% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $73,477 $74,946 $29,747 +147% $30,358 +142% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $73,338 $74,804 $31,166 +135% $25,010 +193% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $72,986 $74,446 $27,494 +165% $22,032 +231% ≈117% of Medicare
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $72,436 $73,885 $14,927 +385% $13,198 +449% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $72,225 $73,669 $31,874 +127% $29,211 +147% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $71,909 $73,347 $70,026 +3% $56,964 +26% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $71,651 $73,084 $46,727 +53% $40,232 +78% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $71,616 $73,048 $19,602 +265% $15,608 +359% —
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $71,526 $72,957 $23,643 +203% $72,618 −2% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $71,346 $72,773 $22,590 +216% $22,713 +214% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $71,279 $72,704 $25,361 +181% $24,432 +192% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $71,264 $72,690 $46,724 +53% $45,622 +56% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $71,082 $72,504 $22,628 +214% $19,091 +272% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $71,062 $72,483 $18,204 +290% $18,204 +290% ≈145% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $71,042 $72,463 $21,977 +223% $20,106 +253% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $70,785 $72,200 $30,846 +129% $24,561 +188% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $70,489 $71,899 $26,611 +165% $27,369 +158% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $70,457 $71,866 $23,749 +197% $23,749 +197% —
381 COMPLICATED PEPTIC ULCER WITH CC $70,363 $71,771 $24,177 +191% $24,177 +191% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $70,017 $71,417 $31,511 +122% $22,525 +211% —
866 VIRAL ILLNESS WITHOUT MCC $69,650 $71,043 $19,642 +255% $16,391 +325% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $69,547 $70,938 $25,552 +172% $18,133 +284% —
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $69,174 $70,557 $23,289 +197% $13,735 +404% —
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $68,954 $70,333 $40,695 +69% $35,139 +96% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $68,911 $70,290 $35,352 +95% $25,208 +173% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $68,205 $69,569 $33,519 +103% $24,229 +181% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $68,143 $69,505 $20,259 +236% $17,585 +288% —
292 HEART FAILURE AND SHOCK WITH CC $67,755 $69,110 $19,118 +254% $16,212 +318% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $67,408 $68,756 $14,800 +355% $11,847 +469% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $67,243 $68,588 $30,493 +121% $29,050 +131% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $66,821 $68,157 $43,378 +54% $33,050 +102% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $66,806 $68,142 $34,316 +95% $25,484 +162% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $66,767 $68,102 $18,126 +268% $17,715 +277% —
152 OTITIS MEDIA AND URI WITH MCC $66,698 $68,032 $25,192 +165% $19,795 +237% —
683 RENAL FAILURE WITH CC $66,556 $67,887 $19,733 +237% $18,620 +257% ≈132% of Medicare
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $66,455 $67,784 $14,208 +368% $14,208 +368% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $66,139 $67,462 $22,641 +192% $20,732 +219% ≈120% of Medicare
378 GASTROINTESTINAL HEMORRHAGE WITH CC $65,981 $67,301 $21,886 +201% $21,886 +201% ≈122% of Medicare
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $65,865 $67,182 $58,880 +12% $49,055 +34% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $65,809 $67,125 $16,565 +297% $14,861 +343% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $65,804 $67,120 $41,375 +59% $30,661 +115% —
149 DYSEQUILIBRIUM $65,769 $67,085 $16,594 +296% $17,203 +282% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $65,443 $66,752 $18,528 +253% $18,253 +259% —
176 PULMONARY EMBOLISM WITHOUT MCC $65,158 $66,461 $18,081 +260% $18,081 +260% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $65,116 $66,418 $30,083 +116% $29,374 +122% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $65,100 $66,402 $32,100 +103% $29,663 +119% —
139 SALIVARY GLAND PROCEDURES $64,790 $66,086 $30,480 +113% $21,014 +208% —
684 RENAL FAILURE WITHOUT CC/MCC $64,777 $66,072 $13,642 +375% $13,623 +375% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $64,606 $65,899 $20,861 +210% $17,108 +278% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $64,489 $65,779 $23,571 +174% $23,571 +174% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $63,951 $65,230 $15,267 +319% $14,012 +356% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $63,930 $65,209 $17,347 +269% $16,745 +282% ≈143% of Medicare
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $63,808 $65,085 $19,176 +233% $17,367 +267% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $63,776 $65,051 $38,998 +64% $29,558 +116% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $63,698 $64,972 $24,042 +165% $22,560 +182% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $63,602 $64,874 $21,205 +200% $19,326 +229% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $63,354 $64,621 $19,842 +219% $18,803 +237% —
540 OSTEOMYELITIS WITH CC $63,214 $64,478 $28,728 +120% $23,494 +169% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $63,210 $64,474 $17,795 +255% $17,388 +264% ≈134% of Medicare
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $63,188 $64,452 $44,068 +43% $29,633 +113% —
712 TESTES PROCEDURES WITHOUT CC/MCC $62,687 $63,941 $23,745 +164% $18,898 +232% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $62,633 $63,885 $16,412 +282% $16,865 +271% ≈136% of Medicare
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $62,473 $63,723 $56,278 +11% $36,097 +73% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $62,220 $63,464 $17,700 +252% $17,700 +252% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $62,044 $63,285 $18,330 +238% $15,876 +291% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $61,845 $63,081 $28,209 +119% $22,275 +178% —
663 MINOR BLADDER PROCEDURES WITH CC $61,491 $62,721 $33,907 +81% $29,924 +105% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $61,428 $62,657 $21,460 +186% $17,273 +256% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $61,145 $62,367 $17,817 +243% $17,466 +250% ≈133% of Medicare
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $60,859 $62,076 $21,280 +186% $15,636 +289% —
303 ATHEROSCLEROSIS WITHOUT MCC $60,291 $61,497 $14,927 +304% $14,927 +304% —
920 COMPLICATIONS OF TREATMENT WITH CC $60,270 $61,475 $22,552 +167% $21,181 +185% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $59,605 $60,797 $16,104 +270% $16,104 +270% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $59,435 $60,623 $28,029 +112% $19,894 +199% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $59,290 $60,475 $38,876 +53% $34,264 +73% —
101 SEIZURES WITHOUT MCC $59,246 $60,431 $20,461 +190% $19,954 +197% ≈112% of Medicare
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $58,987 $60,166 $24,220 +144% $19,868 +197% —
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $58,927 $60,105 $19,305 +205% $19,305 +205% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $58,560 $59,732 $17,638 +232% $17,727 +230% ≈124% of Medicare
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $58,435 $59,603 $28,593 +104% $24,316 +140% —
313 CHEST PAIN $58,401 $59,569 $15,837 +269% $15,962 +266% ≈140% of Medicare
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $58,232 $59,396 $15,549 +275% $13,654 +326% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $58,224 $59,389 $20,488 +184% $20,488 +184% ≈117% of Medicare
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $58,047 $59,208 $18,139 +220% $16,837 +245% —
865 VIRAL ILLNESS WITH MCC $57,069 $58,210 $32,083 +78% $26,088 +119% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $56,943 $58,082 $33,506 +70% $27,279 +109% —
694 URINARY STONES WITHOUT MCC $56,926 $58,064 $17,347 +228% $16,531 +244% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $56,890 $58,028 $17,322 +228% $17,322 +228% ≈127% of Medicare
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $56,835 $57,971 $17,431 +226% $13,385 +325% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $56,623 $57,756 $20,896 +171% $18,918 +199% ≈122% of Medicare
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $56,161 $57,284 $26,302 +114% $20,842 +169% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $56,088 $57,209 $33,137 +69% $33,137 +69% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $55,838 $56,955 $16,450 +239% $13,282 +320% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $55,811 $56,927 $15,156 +268% $12,797 +336% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $55,692 $56,806 $15,411 +261% $13,303 +319% —
204 RESPIRATORY SIGNS AND SYMPTOMS $55,518 $56,629 $18,004 +208% $16,866 +229% —
638 DIABETES WITH CC $55,461 $56,570 $20,361 +172% $18,821 +195% ≈129% of Medicare
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $55,458 $56,567 $19,854 +179% $19,854 +179% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $55,265 $56,370 $22,750 +143% $16,495 +235% —
885 PSYCHOSES $55,196 $56,300 $30,968 +78% $21,489 +157% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $54,893 $55,990 $25,700 +114% $24,202 +127% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $54,880 $55,978 $23,971 +129% $18,126 +203% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $54,870 $55,967 $40,894 +34% $28,375 +93% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $54,548 $55,639 $20,084 +172% $20,084 +172% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $54,327 $55,414 $19,815 +174% $19,815 +174% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $54,154 $55,237 $18,002 +201% $18,002 +201% ≈126% of Medicare
835 ACUTE LEUKEMIA WITH CC $54,143 $55,226 $43,187 +25% $35,569 +52% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $54,061 $55,142 $29,481 +83% $24,480 +121% ≈122% of Medicare
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $53,765 $54,840 $16,654 +223% $16,654 +223% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $53,719 $54,794 $20,506 +162% $19,287 +179% —
603 CELLULITIS WITHOUT MCC $53,570 $54,641 $19,553 +174% $18,530 +189% ≈125% of Medicare
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $53,343 $54,409 $15,464 +245% $12,279 +334% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $53,112 $54,174 $17,087 +211% $14,444 +268% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $52,984 $54,044 $21,880 +142% $18,282 +190% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $52,808 $53,864 $19,584 +170% $16,049 +229% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $52,295 $53,341 $13,683 +282% $15,070 +247% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $52,005 $53,045 $22,557 +131% $18,017 +189% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $51,806 $52,842 $14,880 +248% $14,880 +248% —
311 ANGINA PECTORIS $51,196 $52,220 $15,502 +230% $15,165 +238% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $50,749 $51,764 $24,000 +111% $17,226 +195% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $50,599 $51,611 $29,805 +70% $29,805 +70% —
158 DENTAL AND ORAL DISEASES WITH CC $50,104 $51,106 $20,881 +140% $17,700 +183% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $49,877 $50,875 $18,978 +163% $14,290 +249% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $49,451 $50,440 $21,129 +134% $18,428 +168% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $49,234 $50,219 $14,128 +248% $14,128 +248% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $49,204 $50,188 $17,287 +185% $14,166 +247% —
541 OSTEOMYELITIS WITHOUT CC/MCC $48,782 $49,758 $19,422 +151% $14,549 +235% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $48,698 $49,672 $16,525 +195% $13,892 +251% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $48,427 $49,395 $13,384 +262% $13,384 +262% ≈162% of Medicare
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $48,410 $49,378 $17,265 +180% $15,858 +205% —
598 MALIGNANT BREAST DISORDERS WITH CC $48,271 $49,236 $23,951 +102% $19,073 +153% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $47,711 $48,665 $30,693 +55% $25,666 +86% —
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $47,106 $48,048 $23,643 +99% $20,610 +129% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $46,601 $47,533 $13,824 +237% $13,824 +237% —
906 HAND PROCEDURES FOR INJURIES $46,099 $47,020 $47,513 −3% $31,520 +46% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $45,972 $46,891 $13,318 +245% $13,318 +245% ≈151% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $45,734 $46,648 $21,494 +113% $19,001 +141% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $45,561 $46,472 $14,134 +222% $14,134 +222% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $44,977 $45,877 $21,494 +109% $18,238 +147% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $44,282 $45,168 $20,108 +120% $17,731 +150% —
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $44,039 $44,920 $58,975 −25% $56,758 −22% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $43,648 $44,521 $34,603 +26% $11,633 +275% —
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $43,514 $44,384 $28,946 +50% $21,029 +107% —
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $43,421 $44,289 $23,289 +86% $19,454 +123% —
153 OTITIS MEDIA AND URI WITHOUT MCC $43,382 $44,249 $15,799 +175% $14,473 +200% —
639 DIABETES WITHOUT CC/MCC $43,246 $44,111 $13,910 +211% $13,910 +211% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $42,325 $43,172 $27,348 +55% $20,147 +110% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $41,925 $42,764 $15,358 +173% $14,441 +190% —
200 PNEUMOTHORAX WITH CC $41,725 $42,559 $24,586 +70% $20,573 +103% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $41,708 $42,543 $19,638 +112% $15,045 +177% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $41,519 $42,349 $38,308 +8% $29,609 +40% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $41,461 $42,290 $44,326 −6% $29,109 +42% —
949 AFTERCARE WITH CC/MCC $41,246 $42,071 $23,953 +72% $23,953 +72% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $41,087 $41,908 $20,566 +100% $18,608 +121% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $40,508 $41,319 $16,607 +144% $14,337 +183% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $38,220 $38,984 $18,126 +111% $17,928 +113% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $37,900 $38,658 $32,620 +16% $25,152 +51% —
697 URETHRAL STRICTURE $37,667 $38,420 $22,239 +69% $17,705 +113% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $37,558 $38,309 $16,592 +126% $12,895 +191% —
150 EPISTAXIS WITH MCC $36,174 $36,897 $30,507 +19% $21,133 +71% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $35,570 $36,281 $13,326 +167% $11,955 +198% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $35,510 $36,220 $14,072 +152% $11,421 +211% —
998 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS $33,556 $34,227 $17,953 +87% $15,655 +114% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $33,426 $34,094 $26,242 +27% $19,598 +71% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $32,026 $32,667 $24,337 +32% $17,103 +87% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $31,176 $31,800 $22,155 +41% $15,370 +103% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $29,306 $29,892 $22,641 +29% $16,571 +77% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $29,297 $29,883 $15,058 +95% $11,997 +144% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $29,251 $29,836 $24,928 +17% $19,317 +51% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $28,820 $29,396 $25,652 +12% $25,307 +14% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $28,766 $29,341 $29,894 −4% $23,723 +21% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $27,886 $28,444 $13,599 +105% $10,975 +154% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $27,654 $28,207 $16,064 +72% $13,090 +111% —
916 ALLERGIC REACTIONS WITHOUT MCC $27,389 $27,937 $14,743 +86% $13,890 +97% —
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $26,175 $26,699 $23,289 +12% $30,138 −13% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $26,025 $26,546 $27,323 −5% $27,321 −5% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $25,382 $25,889 $14,643 +73% $13,368 +90% —
533 FRACTURES OF FEMUR WITH MCC $24,967 $25,466 $32,907 −24% $25,945 −4% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $23,509 $23,979 $25,279 −7% $24,452 −4% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $23,395 $23,862 $14,148 +65% $12,044 +94% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $23,291 $23,757 $15,839 +47% $12,381 +88% —
779 ABORTION WITHOUT D&C $23,254 $23,719 $20,752 +12% $15,327 +52% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $23,015 $23,475 $15,975 +44% $12,537 +84% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $21,020 $21,441 $11,539 +82% $9,076 +132% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $20,903 $21,321 $15,495 +35% $15,072 +39% —
935 NON-EXTENSIVE BURNS $19,393 $19,781 $43,274 −55% $29,458 −34% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $17,247 $17,592 $21,201 −19% $15,589 +11% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $17,152 $17,495 $28,626 −40% $23,920 −28% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $16,930 $17,269 $16,713 +1% $7,961 +113% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $15,009 $15,309 $12,751 +18% $8,927 +68% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $13,196 $13,460 $16,077 −18% $12,593 +5% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $10,164 $10,367 $17,775 −43% $13,586 −25% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $8,678 $8,852 $125,675 −93% $105,612 −92% —
795 NORMAL NEWBORN $5,147 $5,250 $6,880 −25% $4,530 +14% —

Procedures with negotiated rates only

These 1 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
593 SKIN ULCERS WITH CC — 70 plans
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