Shasta Regional Medical Center — Pricing

730 procedures published in this hospital's Machine-Readable File (MRF) — 714 with a comparable price, 16 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 730
Lowest published price $2,635
Average published price $29,838
Highest published price $473,702

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 730 procedures

Published charges

Showing all 714 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 56 procedures, this hospital's negotiated rates average ≈113% of what Medicare pays.

DRG Description Published price Cash price vs. CA median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $473,702 $473,702 $641,743 −26% $498,715 −5% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $353,847 $353,847 $486,976 −27% $431,073 −18% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $298,023 $298,023 $412,183 −28% $306,087 −3% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $269,252 $269,252 $371,366 −27% $371,366 −27% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $177,562 $177,562 $248,521 −29% $245,241 −28% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $164,651 $164,651 $227,681 −28% $182,314 −10% —
007 LUNG TRANSPLANT $164,236 $164,236 $230,667 −29% $170,608 −4% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $138,505 $138,505 $198,463 −30% $169,977 −19% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $136,925 $136,925 $196,346 −30% $171,338 −20% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $133,855 $133,855 $189,963 −30% $159,181 −16% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $133,169 $133,169 $191,314 −30% $191,314 −30% —
426 UnGrouped $131,670 $131,670 $189,537 −31% $142,326 −7% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $121,319 $121,319 $175,437 −31% $175,437 −31% —
850 UnGrouped $115,804 $115,804 $168,048 −31% $121,563 −5% —
231 CORONARY BYPASS WITH PTCA WITH MCC $106,536 $106,536 $155,631 −32% $146,474 −27% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $106,477 $106,477 $153,282 −31% $151,029 −29% —
429 UnGrouped $104,862 $104,862 $153,621 −32% $120,174 −13% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $101,353 $101,353 $148,686 −32% $134,914 −25% —
010 PANCREAS TRANSPLANT $100,246 $100,246 $144,934 −31% $99,940 +0% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $99,672 $99,672 $146,435 −32% $105,228 −5% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $98,280 $98,280 $144,569 −32% $138,868 −29% ≈114% of Medicare
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $97,289 $97,289 $143,242 −32% $143,242 −32% ≈105% of Medicare
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $93,857 $93,857 $136,374 −31% $120,587 −22% —
427 UnGrouped $89,318 $89,318 $132,794 −33% $121,728 −27% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $88,869 $88,869 $131,961 −33% $131,961 −33% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $87,482 $87,482 $124,290 −30% $138,008 −37% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $85,872 $85,872 $125,675 −32% $105,612 −19% —
447 UnGrouped $84,320 $84,320 $126,098 −33% $114,914 −27% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $83,854 $83,854 $125,242 −33% $118,589 −29% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $81,337 $81,337 $116,058 −30% $116,058 −30% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $81,220 $81,220 $121,714 −33% $121,714 −33% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $79,543 $79,543 $117,196 −32% $109,331 −27% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $77,912 $77,912 $117,280 −34% $117,280 −34% —
317 UnGrouped $77,811 $77,811 $117,146 −34% $94,988 −18% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $77,457 $77,457 $114,401 −32% $98,912 −22% —
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $77,187 $77,187 $114,040 −32% $108,472 −29% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $76,835 $76,835 $115,839 −34% $106,238 −28% —
028 SPINAL PROCEDURES WITH MCC $76,469 $76,469 $113,077 −32% $95,858 −20% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CCMCC $75,921 $75,921 $108,802 −30% $98,260 −23% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CCMCC $75,921 $75,921 $108,802 −30% $81,176 −6% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $75,355 $75,355 $113,855 −34% $113,855 −34% ≈102% of Medicare
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $74,777 $74,777 $107,269 −30% $80,018 −7% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $74,016 $74,016 $112,062 −34% $112,062 −34% ≈101% of Medicare
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $73,239 $73,239 $108,750 −33% $96,192 −24% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $72,198 $72,198 $107,355 −33% $107,355 −33% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $71,767 $71,767 $106,778 −33% $106,778 −33% —
653 MAJOR BLADDER PROCEDURES WITH MCC $70,128 $70,128 $104,583 −33% $97,046 −28% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $69,535 $69,535 $106,057 −34% $101,235 −31% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $69,535 $69,535 $100,245 −31% $76,583 −9% —
428 UnGrouped $69,243 $69,243 $105,899 −35% $105,899 −35% —
430 UnGrouped $68,821 $68,821 $105,333 −35% $93,783 −27% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $68,296 $68,296 $102,128 −33% $94,927 −28% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $67,949 $67,949 $101,662 −33% $78,582 −14% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $67,884 $67,884 $101,576 −33% $86,953 −22% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $66,934 $66,934 $102,573 −35% $102,573 −35% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $66,639 $66,639 $102,177 −35% $102,177 −35% —
450 UnGrouped $64,798 $64,798 $99,943 −35% $79,944 −19% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $64,583 $64,583 $99,423 −35% $99,423 −35% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $64,101 $64,101 $96,507 −34% $96,222 −33% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $63,905 $63,905 $96,245 −34% $80,747 −21% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $63,376 $63,376 $95,536 −34% $87,565 −28% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $63,003 $63,003 $91,495 −31% $70,735 −11% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $62,954 $62,954 $97,241 −35% $84,861 −26% —
245 AICD GENERATOR PROCEDURES $61,492 $61,492 $95,281 −35% $72,076 −15% —
471 CERVICAL SPINAL FUSION WITH MCC $61,121 $61,121 $92,515 −34% $92,515 −34% —
006 LIVER TRANSPLANT WITHOUT MCC $61,019 $61,019 $92,378 −34% $84,407 −28% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $60,094 $60,094 $91,138 −34% $88,691 −32% —
799 SPLENIC PROCEDURES WITH MCC $59,834 $59,834 $90,790 −34% $78,821 −24% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $59,823 $59,823 $90,775 −34% $86,390 −31% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $59,205 $59,205 $92,217 −36% $92,217 −36% ≈106% of Medicare
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $58,888 $58,888 $89,523 −34% $80,885 −27% —
163 MAJOR CHEST PROCEDURES WITH MCC $58,006 $58,006 $88,341 −34% $88,341 −34% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $57,982 $57,982 $90,579 −36% $71,551 −19% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CCMCC $57,797 $57,797 $90,331 −36% $90,331 −36% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $57,788 $57,788 $88,050 −34% $88,050 −34% ≈105% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $56,780 $56,780 $86,699 −35% $72,859 −22% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $56,442 $56,442 $86,246 −35% $76,954 −27% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $56,286 $56,286 $88,307 −36% $88,307 −36% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $55,762 $55,762 $85,334 −35% $68,847 −19% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $55,288 $55,288 $86,970 −36% $75,585 −27% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $54,461 $54,461 $80,049 −32% $59,352 −8% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $53,692 $53,692 $82,561 −35% $82,561 −35% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $53,613 $53,613 $84,725 −37% $88,049 −39% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $53,234 $53,234 $84,217 −37% $60,098 −11% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $52,749 $52,749 $81,298 −35% $68,659 −23% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $52,736 $52,736 $81,281 −35% $72,945 −28% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $52,497 $52,497 $57,323 −8% $16,719 +214% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $52,374 $52,374 $83,065 −37% $83,065 −37% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $51,763 $51,763 $82,247 −37% $82,247 −37% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $51,734 $51,734 $79,939 −35% $66,853 −23% —
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $51,658 $51,658 $79,836 −35% $73,029 −29% —
448 UnGrouped $51,404 $51,404 $81,998 −37% $81,998 −37% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $51,202 $51,202 $79,225 −35% $72,011 −29% —
791 PREMATURITY WITH MAJOR PROBLEMS $51,108 $51,108 $75,557 −32% $39,563 +29% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $50,151 $50,151 $77,817 −36% $71,701 −30% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $50,116 $50,116 $77,770 −36% $57,521 −13% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $49,674 $49,674 $77,178 −36% $68,006 −27% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $49,572 $49,572 $77,041 −36% $61,832 −20% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $49,472 $49,472 $76,907 −36% $54,196 −9% —
402 UnGrouped $49,253 $49,253 $79,116 −38% $75,492 −35% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $49,229 $49,229 $78,852 −38% $78,852 −38% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $48,958 $48,958 $76,219 −36% $72,908 −33% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $48,660 $48,660 $75,820 −36% $62,961 −23% —
904 SKIN GRAFTS FOR INJURIES WITH CCMCC $48,611 $48,611 $75,754 −36% $55,097 −12% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $48,476 $48,476 $75,573 −36% $72,782 −33% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $47,865 $47,865 $74,755 −36% $74,755 −36% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $47,494 $47,494 $74,257 −36% $74,257 −36% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $47,116 $47,116 $73,751 −36% $60,861 −23% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $45,944 $45,944 $68,639 −33% $62,524 −27% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $45,626 $45,626 $71,755 −36% $71,755 −36% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $45,142 $45,142 $71,106 −37% $59,425 −24% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $45,139 $45,139 $67,560 −33% $57,855 −22% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $45,132 $45,132 $71,092 −37% $64,776 −30% —
265 AICD LEAD PROCEDURES $44,921 $44,921 $70,810 −37% $56,695 −21% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CCMCC $44,459 $44,459 $72,461 −39% $62,404 −29% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $44,447 $44,447 $70,175 −37% $50,919 −13% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $44,336 $44,336 $70,026 −37% $56,964 −22% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $44,125 $44,125 $69,743 −37% $68,399 −35% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $44,111 $44,111 $69,724 −37% $65,383 −33% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $44,093 $44,093 $69,701 −37% $59,207 −26% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $44,015 $44,015 $69,597 −37% $51,953 −15% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $43,732 $43,732 $71,486 −39% $56,242 −22% —
332 RECTAL RESECTION WITH MCC $43,684 $43,684 $69,152 −37% $58,125 −25% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $43,636 $43,636 $69,089 −37% $49,065 −11% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $43,379 $43,379 $71,014 −39% $71,014 −39% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $43,311 $43,311 $68,653 −37% $62,269 −30% —
665 PROSTATECTOMY WITH MCC $43,243 $43,243 $68,562 −37% $54,072 −20% —
252 OTHER VASCULAR PROCEDURES WITH MCC $43,203 $43,203 $68,508 −37% $68,508 −37% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $43,138 $43,138 $68,421 −37% $68,880 −37% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $42,899 $42,899 $70,371 −39% $67,901 −37% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $42,721 $42,721 $70,132 −39% $70,132 −39% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $42,277 $42,277 $67,268 −37% $64,152 −34% —
037 EXTRACRANIAL PROCEDURES WITH MCC $41,828 $41,828 $66,666 −37% $64,749 −35% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $41,589 $41,589 $68,616 −39% $52,908 −21% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $41,172 $41,172 $65,788 −37% $65,254 −37% ≈105% of Medicare
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $41,056 $41,056 $65,631 −37% $54,129 −24% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $41,038 $41,038 $65,608 −37% $64,465 −36% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $40,552 $40,552 $64,956 −38% $64,956 −38% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $40,365 $40,365 $66,976 −40% $57,277 −30% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $40,248 $40,248 $66,819 −40% $66,819 −40% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $40,171 $40,171 $60,905 −34% $49,710 −19% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CCMCC $40,063 $40,063 $66,572 −40% $44,472 −10% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $39,983 $39,983 $64,194 −38% $51,142 −22% —
500 SOFT TISSUE PROCEDURES WITH MCC $39,917 $39,917 $64,105 −38% $57,479 −31% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $39,318 $39,318 $65,573 −40% $65,573 −40% ≈107% of Medicare
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $39,133 $39,133 $65,325 −40% $65,325 −40% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $38,958 $38,958 $62,821 −38% $62,821 −38% —
451 UnGrouped $38,878 $38,878 $65,216 −40% $65,216 −40% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CCMCC $38,850 $38,850 $62,677 −38% $53,817 −28% —
652 KIDNEY TRANSPLANT $38,695 $38,695 $62,468 −38% $54,720 −29% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $38,660 $38,660 $64,691 −40% $53,555 −28% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $38,534 $38,534 $64,523 −40% $63,475 −39% —
570 SKIN DEBRIDEMENT WITH MCC $37,926 $37,926 $63,709 −40% $52,435 −28% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $37,625 $37,625 $57,493 −35% $46,402 −19% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $37,153 $37,153 $60,402 −38% $54,313 −32% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $37,057 $37,057 $60,274 −39% $63,984 −42% ≈121% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $36,957 $36,957 $60,140 −39% $60,140 −39% —
668 TRANSURETHRAL PROCEDURES WITH MCC $36,747 $36,747 $59,859 −39% $47,277 −22% —
800 SPLENIC PROCEDURES WITH CC $36,716 $36,716 $59,817 −39% $49,184 −25% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $36,696 $36,696 $59,790 −39% $54,475 −33% —
472 CERVICAL SPINAL FUSION WITH CC $36,507 $36,507 $59,537 −39% $59,537 −39% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIESINTRALUMINAL DEVICES $35,874 $35,874 $60,959 −41% $74,274 −52% ≈105% of Medicare
654 MAJOR BLADDER PROCEDURES WITH CC $35,564 $35,564 $58,274 −39% $53,868 −34% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $35,392 $35,392 $58,043 −39% $58,043 −39% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $35,356 $35,356 $60,265 −41% $48,907 −28% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $34,488 $34,488 $56,832 −39% $48,358 −29% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $34,426 $34,426 $53,208 −35% $45,497 −24% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $34,364 $34,364 $58,935 −42% $44,973 −24% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $34,241 $34,241 $52,959 −35% $43,491 −21% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $34,074 $34,074 $52,735 −35% $57,963 −41% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $33,962 $33,962 $56,127 −39% $44,839 −24% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $33,827 $33,827 $52,405 −35% $52,405 −35% ≈107% of Medicare
263 VEIN LIGATION AND STRIPPING $33,806 $33,806 $55,918 −40% $44,938 −25% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $33,564 $33,564 $55,594 −40% $45,432 −26% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $33,444 $33,444 $55,434 −40% $40,947 −18% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CCMCC $33,403 $33,403 $55,378 −40% $45,290 −26% —
503 FOOT PROCEDURES WITH MCC $33,360 $33,360 $55,321 −40% $43,901 −24% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $33,326 $33,326 $55,276 −40% $40,277 −17% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CCMCC $33,068 $33,068 $54,929 −40% $54,929 −40% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $32,982 $32,982 $54,815 −40% $43,697 −25% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CCMCC $32,632 $32,632 $54,345 −40% $41,703 −22% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $32,578 $32,578 $54,273 −40% $48,094 −32% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $32,195 $32,195 $50,218 −36% $38,878 −17% —
253 OTHER VASCULAR PROCEDURES WITH CC $32,185 $32,185 $53,746 −40% $53,746 −40% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $32,125 $32,125 $53,666 −40% $57,149 −44% ≈113% of Medicare
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $31,960 $31,960 $56,278 −43% $36,097 −11% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $31,857 $31,857 $49,765 −36% $39,657 −20% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CCMCC $31,832 $31,832 $53,274 −40% $46,659 −32% —
164 MAJOR CHEST PROCEDURES WITH CC $31,733 $31,733 $53,141 −40% $53,141 −40% ≈118% of Medicare
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $31,571 $31,571 $49,382 −36% $39,409 −20% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CCMCC $31,547 $31,547 $55,162 −43% $55,162 −43% —
397 APPENDIX PROCEDURES WITH MCC $31,241 $31,241 $54,751 −43% $52,319 −40% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $30,888 $30,888 $34,603 −11% $11,633 +166% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $30,870 $30,870 $51,985 −41% $51,985 −41% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $30,617 $30,617 $51,645 −41% $54,824 −44% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $30,499 $30,499 $51,487 −41% $46,591 −35% —
135 SINUS AND MASTOID PROCEDURES WITH CCMCC $30,403 $30,403 $51,359 −41% $40,065 −24% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $30,276 $30,276 $51,189 −41% $56,394 −46% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CCMCC $30,229 $30,229 $47,583 −36% $39,093 −23% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $29,969 $29,969 $50,777 −41% $52,313 −43% ≈110% of Medicare
473 CERVICAL SPINAL FUSION WITHOUT CCMCC $29,854 $29,854 $50,624 −41% $50,624 −41% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $29,847 $29,847 $50,614 −41% $40,548 −26% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $29,808 $29,808 $50,562 −41% $58,832 −49% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $29,760 $29,760 $50,498 −41% $47,546 −37% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $29,493 $29,493 $50,139 −41% $50,139 −41% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $29,194 $29,194 $51,387 −43% $36,080 −19% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $29,166 $29,166 $51,339 −43% $51,339 −43% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $29,113 $29,113 $49,631 −41% $49,631 −41% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $28,934 $28,934 $45,849 −37% $37,080 −22% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $28,886 $28,886 $45,785 −37% $36,334 −20% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $28,798 $28,798 $49,209 −41% $39,253 −27% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CCMCC $28,744 $28,744 $49,137 −42% $43,586 −34% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $28,692 $28,692 $49,066 −42% $46,430 −38% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $28,581 $28,581 $45,376 −37% $37,064 −23% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CCMCC $28,484 $28,484 $48,788 −42% $38,998 −27% —
113 ORBITAL PROCEDURES WITH CCMCC $28,463 $28,463 $48,760 −42% $35,642 −20% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $28,415 $28,415 $50,011 −43% $50,011 −43% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $28,405 $28,405 $48,682 −42% $48,682 −42% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $28,369 $28,369 $48,634 −42% $45,059 −37% —
709 PENIS PROCEDURES WITH CCMCC $28,344 $28,344 $48,600 −42% $34,535 −18% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $28,159 $28,159 $48,353 −42% $44,053 −36% —
030 SPINAL PROCEDURES WITHOUT CCMCC $28,071 $28,071 $48,235 −42% $45,818 −39% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $27,919 $27,919 $44,489 −37% $44,600 −37% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $27,745 $27,745 $47,797 −42% $38,382 −28% —
935 NON-EXTENSIVE BURNS $27,707 $27,707 $43,274 −36% $29,458 −6% —
906 HAND PROCEDURES FOR INJURIES $27,532 $27,532 $47,513 −42% $31,520 −13% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $27,487 $27,487 $47,452 −42% $41,900 −34% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $27,367 $27,367 $43,749 −37% $37,902 −28% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $27,216 $27,216 $47,089 −42% $44,553 −39% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $27,168 $27,168 $43,483 −38% $38,357 −29% ≈120% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $27,105 $27,105 $47,696 −43% $34,900 −22% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $27,072 $27,072 $43,354 −38% $31,044 −13% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $27,053 $27,053 $43,328 −38% $36,850 −27% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $26,947 $26,947 $43,187 −38% $35,569 −24% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CCMCC $26,946 $26,946 $46,727 −42% $40,232 −33% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $26,943 $26,943 $46,724 −42% $45,622 −41% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $26,893 $26,893 $46,657 −42% $37,654 −29% —
333 RECTAL RESECTION WITH CC $26,814 $26,814 $46,551 −42% $34,352 −22% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $26,759 $26,759 $46,477 −42% $46,477 −42% —
595 MAJOR SKIN DISORDERS WITH MCC $26,686 $26,686 $42,837 −38% $31,785 −16% —
336 PERITONEAL ADHESIOLYSIS WITH CC $26,651 $26,651 $46,332 −42% $49,470 −46% —
374 DIGESTIVE MALIGNANCY WITH MCC $26,640 $26,640 $42,775 −38% $38,885 −31% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $26,598 $26,598 $46,799 −43% $56,519 −53% ≈109% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CCMCC $26,532 $26,532 $46,172 −43% $35,686 −26% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $26,452 $26,452 $46,066 −43% $46,066 −43% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $26,377 $26,377 $42,423 −38% $32,483 −19% —
655 MAJOR BLADDER PROCEDURES WITHOUT CCMCC $26,211 $26,211 $45,743 −43% $41,651 −37% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $26,181 $26,181 $45,703 −43% $51,172 −49% ≈112% of Medicare
592 SKIN ULCERS WITH MCC $25,948 $25,948 $41,848 −38% $32,662 −21% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CCMCC $25,836 $25,836 $45,240 −43% $34,089 −24% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $25,595 $25,595 $41,375 −38% $30,661 −17% —
539 OSTEOMYELITIS WITH MCC $25,522 $25,522 $41,277 −38% $33,746 −24% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $25,455 $25,455 $44,730 −43% $41,660 −39% —
548 SEPTIC ARTHRITIS WITH MCC $25,424 $25,424 $41,146 −38% $31,019 −18% —
052 SPINAL DISORDERS AND INJURIES WITH CCMCC $25,398 $25,398 $41,111 −38% $30,940 −18% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $25,388 $25,388 $44,639 −43% $45,817 −45% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $25,217 $25,217 $44,357 −43% $43,524 −42% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $25,199 $25,199 $44,326 −43% $29,109 −13% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $25,105 $25,105 $40,719 −38% $35,714 −30% ≈112% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $25,088 $25,088 $40,695 −38% $35,139 −29% —
100 SEIZURES WITH MCC $25,056 $25,056 $40,653 −38% $35,194 −29% ≈111% of Medicare
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CCMCC $25,054 $25,054 $44,068 −43% $29,633 −15% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $24,966 $24,966 $43,913 −43% $43,398 −42% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $24,902 $24,902 $43,800 −43% $43,800 −43% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $24,888 $24,888 $43,775 −43% $43,775 −43% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CCMCC $24,806 $24,806 $43,631 −43% $41,520 −40% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $24,765 $24,765 $40,263 −38% $35,237 −30% ≈110% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $24,753 $24,753 $43,538 −43% $43,538 −43% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $24,727 $24,727 $40,213 −39% $36,933 −33% ≈109% of Medicare
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $24,681 $24,681 $40,150 −39% $35,014 −30% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CCMCC $24,667 $24,667 $43,384 −43% $29,524 −16% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CCMCC $24,663 $24,663 $43,378 −43% $33,050 −25% —
707 MAJOR MALE PELVIC PROCEDURES WITH CCMCC $24,495 $24,495 $43,080 −43% $43,080 −43% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CCMCC $24,465 $24,465 $43,027 −43% $36,202 −32% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $24,382 $24,382 $42,881 −43% $42,881 −43% —
380 COMPLICATED PEPTIC ULCER WITH MCC $24,290 $24,290 $39,627 −39% $36,641 −34% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $24,146 $24,146 $42,463 −43% $33,165 −27% —
711 TESTES PROCEDURES WITH CCMCC $24,118 $24,118 $42,414 −43% $34,852 −31% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $23,955 $23,955 $42,126 −43% $42,126 −43% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $23,955 $23,955 $42,126 −43% $35,459 −32% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $23,901 $23,901 $39,105 −39% $36,280 −34% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $23,864 $23,864 $39,057 −39% $32,399 −26% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $23,832 $23,832 $39,013 −39% $32,204 −26% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $23,805 $23,805 $38,978 −39% $32,981 −28% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $23,803 $23,803 $41,857 −43% $49,197 −52% ≈111% of Medicare
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CCMCC $23,802 $23,802 $41,855 −43% $45,963 −48% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $23,785 $23,785 $38,951 −39% $30,766 −23% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $23,547 $23,547 $38,631 −39% $35,114 −33% ≈118% of Medicare
165 MAJOR CHEST PROCEDURES WITHOUT CCMCC $23,533 $23,533 $41,380 −43% $41,380 −43% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $23,436 $23,436 $38,483 −39% $30,974 −24% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CCMCC $23,426 $23,426 $41,191 −43% $32,538 −28% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $23,406 $23,406 $38,443 −39% $22,698 +3% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $23,306 $23,306 $38,308 −39% $29,609 −21% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $23,258 $23,258 $40,894 −43% $28,375 −18% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $23,215 $23,215 $38,187 −39% $30,394 −24% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CCMCC $23,145 $23,145 $40,694 −43% $40,694 −43% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $23,082 $23,082 $40,583 −43% $40,583 −43% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $23,071 $23,071 $40,563 −43% $40,563 −43% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CCMCC $23,064 $23,064 $40,552 −43% $40,552 −43% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $23,038 $23,038 $37,950 −39% $37,950 −39% —
919 COMPLICATIONS OF TREATMENT WITH MCC $23,026 $23,026 $37,933 −39% $29,031 −21% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $23,017 $23,017 $37,921 −39% $36,375 −37% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $22,959 $22,959 $40,365 −43% $36,597 −37% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $22,958 $22,958 $37,842 −39% $37,842 −39% ≈112% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $22,846 $22,846 $37,692 −39% $29,476 −22% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $22,845 $22,845 $40,163 −43% $54,772 −58% ≈120% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CCMCC $22,788 $22,788 $40,063 −43% $40,063 −43% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $22,762 $22,762 $32,578 −30% $14,284 +59% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $22,685 $22,685 $37,477 −39% $24,836 −9% —
501 SOFT TISSUE PROCEDURES WITH CC $22,537 $22,537 $39,619 −43% $37,975 −41% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $22,489 $22,489 $37,214 −40% $48,680 −54% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $22,488 $22,488 $37,213 −40% $30,275 −26% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $22,478 $22,478 $39,515 −43% $33,564 −33% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $22,425 $22,425 $39,422 −43% $31,909 −30% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $22,390 $22,390 $39,360 −43% $36,242 −38% —
199 PNEUMOTHORAX WITH MCC $22,293 $22,293 $36,952 −40% $31,491 −29% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $22,198 $22,198 $39,020 −43% $35,673 −38% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CCMCC $22,197 $22,197 $39,018 −43% $39,018 −43% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $22,185 $22,185 $38,998 −43% $29,558 −25% —
509 ARTHROSCOPY $22,185 $22,185 $38,998 −43% $25,994 −15% —
597 MALIGNANT BREAST DISORDERS WITH MCC $22,185 $22,185 $36,807 −40% $31,846 −30% —
504 FOOT PROCEDURES WITH CC $22,164 $22,164 $38,960 −43% $36,598 −39% —
505 FOOT PROCEDURES WITHOUT CCMCC $22,164 $22,164 $38,960 −43% $31,716 −30% —
582 MASTECTOMY FOR MALIGNANCY WITH CCMCC $22,116 $22,116 $38,876 −43% $34,264 −35% —
254 OTHER VASCULAR PROCEDURES WITHOUT CCMCC $22,094 $22,094 $38,836 −43% $38,836 −43% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $22,076 $22,076 $36,661 −40% $31,758 −30% —
180 RESPIRATORY NEOPLASMS WITH MCC $22,074 $22,074 $36,658 −40% $36,658 −40% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $21,961 $21,961 $36,506 −40% $30,814 −29% —
915 ALLERGIC REACTIONS WITH MCC $21,949 $21,949 $36,491 −40% $30,944 −29% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $21,836 $21,836 $36,340 −40% $29,826 −27% —
671 URETHRAL PROCEDURES WITH CCMCC $21,771 $21,771 $38,265 −43% $27,233 −20% —
075 VIRAL MENINGITIS WITH CCMCC $21,755 $21,755 $36,230 −40% $29,853 −27% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $21,674 $21,674 $38,094 −43% $38,094 −43% —
551 MEDICAL BACK PROBLEMS WITH MCC $21,554 $21,554 $35,961 −40% $31,086 −31% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $21,487 $21,487 $37,764 −43% $43,266 −50% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $21,394 $21,394 $37,599 −43% $29,729 −28% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $21,353 $21,353 $37,526 −43% $28,578 −25% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $21,340 $21,340 $35,675 −40% $29,409 −27% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $21,278 $21,278 $35,591 −40% $31,128 −32% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $21,234 $21,234 $35,532 −40% $30,058 −29% ≈112% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CCMCC $21,155 $21,155 $37,175 −43% $29,916 −29% —
571 SKIN DEBRIDEMENT WITH CC $21,151 $21,151 $37,169 −43% $34,901 −39% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $21,099 $21,099 $35,352 −40% $25,208 −16% —
116 INTRAOCULAR PROCEDURES WITH CCMCC $21,079 $21,079 $37,042 −43% $28,103 −25% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $21,074 $21,074 $37,033 −43% $30,930 −32% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $21,018 $21,018 $35,243 −40% $32,502 −35% ≈113% of Medicare
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CCMCC $21,003 $21,003 $36,907 −43% $27,548 −24% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $20,951 $20,951 $36,816 −43% $42,119 −50% —
643 ENDOCRINE DISORDERS WITH MCC $20,937 $20,937 $35,135 −40% $32,996 −37% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $20,921 $20,921 $35,113 −40% $32,689 −36% ≈110% of Medicare
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $20,858 $20,858 $36,651 −43% $44,117 −53% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CCMCC $20,823 $20,823 $36,589 −43% $25,197 −17% —
666 PROSTATECTOMY WITH CC $20,812 $20,812 $36,569 −43% $30,016 −31% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CCMCC $20,754 $20,754 $36,467 −43% $31,566 −34% —
801 SPLENIC PROCEDURES WITHOUT CCMCC $20,741 $20,741 $36,445 −43% $28,634 −28% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $20,738 $20,738 $34,867 −41% $28,967 −28% ≈113% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $20,716 $20,716 $34,839 −41% $28,134 −26% ≈111% of Medicare
157 DENTAL AND ORAL DISEASES WITH MCC $20,689 $20,689 $34,802 −41% $27,457 −25% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $20,548 $20,548 $34,613 −41% $24,465 −16% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CCMCC $20,539 $20,539 $36,087 −43% $27,168 −24% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $20,529 $20,529 $34,588 −41% $26,020 −21% —
913 TRAUMATIC INJURY WITH MCC $20,448 $20,448 $34,479 −41% $24,198 −15% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $20,439 $20,439 $34,467 −41% $25,731 −21% ≈124% of Medicare
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $20,425 $20,425 $34,448 −41% $31,840 −36% ≈108% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $20,417 $20,417 $35,872 −43% $27,118 −25% —
038 EXTRACRANIAL PROCEDURES WITH CC $20,360 $20,360 $35,770 −43% $35,770 −43% —
606 MINOR SKIN DISORDERS WITH MCC $20,347 $20,347 $34,344 −41% $25,434 −20% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CCMCC $20,316 $20,316 $35,692 −43% $35,692 −43% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $20,254 $20,254 $35,584 −43% $35,584 −43% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $20,180 $20,180 $35,453 −43% $35,453 −43% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CCMCC $20,161 $20,161 $35,419 −43% $33,984 −41% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CCMCC $20,136 $20,136 $35,375 −43% $35,375 −43% —
183 MAJOR CHEST TRAUMA WITH MCC $20,058 $20,058 $33,957 −41% $28,924 −31% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CCMCC $20,047 $20,047 $35,217 −43% $39,747 −50% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $19,969 $19,969 $35,080 −43% $33,490 −40% —
186 PLEURAL EFFUSION WITH MCC $19,967 $19,967 $33,834 −41% $32,468 −39% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CCMCC $19,871 $19,871 $34,906 −43% $34,906 −43% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $19,831 $19,831 $33,653 −41% $32,936 −40% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $19,816 $19,816 $33,633 −41% $31,059 −36% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CCMCC $19,782 $19,782 $34,749 −43% $32,490 −39% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $19,748 $19,748 $34,689 −43% $41,380 −52% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CCMCC $19,604 $19,604 $34,434 −43% $34,434 −43% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $19,586 $19,586 $33,325 −41% $28,646 −32% —
813 COAGULATION DISORDERS $19,565 $19,565 $33,296 −41% $30,128 −35% —
669 TRANSURETHRAL PROCEDURES WITH CC $19,558 $19,558 $34,354 −43% $34,354 −43% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $19,543 $19,543 $33,267 −41% $24,036 −19% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CCMCC $19,537 $19,537 $34,316 −43% $25,484 −23% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $19,535 $19,535 $33,256 −41% $28,252 −31% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CCMCC $19,403 $19,403 $34,078 −43% $36,239 −46% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $19,351 $19,351 $33,987 −43% $24,879 −22% —
663 MINOR BLADDER PROCEDURES WITH CC $19,306 $19,306 $33,907 −43% $29,924 −35% —
945 REHABILITATION WITH CCMCC $19,295 $19,295 $32,934 −41% $23,834 −19% —
533 FRACTURES OF FEMUR WITH MCC $19,275 $19,275 $32,907 −41% $25,945 −26% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CCMCC $19,186 $19,186 $33,694 −43% $33,694 −43% —
398 APPENDIX PROCEDURES WITH CC $19,128 $19,128 $33,592 −43% $39,107 −51% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CCMCC $19,086 $19,086 $33,519 −43% $24,229 −21% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $19,079 $19,079 $33,506 −43% $27,279 −30% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $19,019 $19,019 $33,399 −43% $33,792 −44% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CCMCC $19,012 $19,012 $33,388 −43% $35,528 −46% —
682 RENAL FAILURE WITH MCC $18,986 $18,986 $32,520 −42% $27,854 −32% ≈112% of Medicare
710 PENIS PROCEDURES WITHOUT CCMCC $18,980 $18,980 $33,330 −43% $23,814 −20% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $18,963 $18,963 $32,490 −42% $25,854 −27% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $18,951 $18,951 $32,473 −42% $29,484 −36% —
506 MAJOR THUMB OR JOINT PROCEDURES $18,951 $18,951 $33,279 −43% $28,983 −35% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $18,929 $18,929 $32,445 −42% $24,450 −23% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CCMCC $18,870 $18,870 $33,137 −43% $33,137 −43% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $18,820 $18,820 $33,048 −43% $31,062 −39% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $18,782 $18,782 $32,248 −42% $28,140 −33% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CCMCC $18,742 $18,742 $32,911 −43% $32,911 −43% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $18,663 $18,663 $16,713 +12% $7,961 +134% —
865 VIRAL ILLNESS WITH MCC $18,659 $18,659 $32,083 −42% $26,088 −28% —
693 URINARY STONES WITH MCC $18,590 $18,590 $31,990 −42% $22,525 −17% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $18,584 $18,584 $31,982 −42% $28,780 −35% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CCMCC $18,578 $18,578 $32,620 −43% $25,152 −26% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $18,578 $18,578 $31,974 −42% $25,786 −28% —
602 CELLULITIS WITH MCC $18,575 $18,575 $31,970 −42% $29,347 −37% ≈112% of Medicare
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $18,504 $18,504 $31,874 −42% $29,211 −37% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CCMCC $18,482 $18,482 $32,451 −43% $32,451 −43% —
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $18,396 $18,396 $31,730 −42% $24,941 −26% —
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $18,308 $18,308 $31,612 −42% $21,986 −17% —
713 TRANSURETHRAL PROSTATECTOMY WITH CCMCC $18,284 $18,284 $32,100 −43% $29,663 −38% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $18,232 $18,232 $31,511 −42% $22,525 −19% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CCMCC $18,199 $18,199 $31,950 −43% $25,243 −28% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CCMCC $18,123 $18,123 $31,816 −43% $31,816 −43% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CCMCC $18,121 $18,121 $31,812 −43% $31,812 −43% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $17,975 $17,975 $31,166 −42% $25,010 −28% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CCMCC $17,949 $17,949 $31,508 −43% $21,615 −17% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $17,898 $17,898 $31,063 −42% $23,734 −25% —
088 CONCUSSION WITH MCC $17,841 $17,841 $30,986 −42% $24,402 −27% —
885 PSYCHOSES $17,827 $17,827 $30,968 −42% $21,489 −17% —
811 RED BLOOD CELL DISORDERS WITH MCC $17,793 $17,793 $30,922 −42% $27,934 −36% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CCMCC $17,767 $17,767 $30,887 −42% $35,542 −50% —
137 MOUTH PROCEDURES WITH CCMCC $17,689 $17,689 $31,048 −43% $24,348 −27% —
502 SOFT TISSUE PROCEDURES WITHOUT CCMCC $17,671 $17,671 $31,017 −43% $30,006 −41% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CCMCC $17,622 $17,622 $30,693 −43% $25,666 −31% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $17,586 $17,586 $30,645 −43% $24,118 −27% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $17,574 $17,574 $30,846 −43% $24,561 −28% —
150 EPISTAXIS WITH MCC $17,483 $17,483 $30,507 −43% $21,133 −17% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CCMCC $17,375 $17,375 $30,493 −43% $29,050 −40% —
139 SALIVARY GLAND PROCEDURES $17,367 $17,367 $30,480 −43% $21,014 −17% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $17,335 $17,335 $30,308 −43% $20,980 −17% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CCMCC $17,332 $17,332 $30,418 −43% $30,418 −43% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $17,233 $17,233 $30,242 −43% $24,980 −31% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $17,142 $17,142 $30,083 −43% $29,374 −42% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CCMCC $17,127 $17,127 $30,056 −43% $28,527 −40% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $17,036 $17,036 $29,894 −43% $23,723 −28% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CCMCC $16,985 $16,985 $29,805 −43% $29,805 −43% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $16,953 $16,953 $29,747 −43% $30,358 −44% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CCMCC $16,867 $16,867 $29,596 −43% $31,978 −47% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $16,826 $16,826 $29,523 −43% $23,350 −28% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $16,802 $16,802 $29,481 −43% $24,480 −31% ≈115% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $16,673 $16,673 $29,252 −43% $26,158 −36% ≈110% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CCMCC $16,672 $16,672 $29,250 −43% $34,887 −52% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $16,596 $16,596 $29,117 −43% $23,115 −28% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $16,526 $16,526 $28,993 −43% $23,956 −31% —
291 HEART FAILURE AND SHOCK WITH MCC $16,511 $16,511 $28,966 −43% $25,020 −34% ≈117% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $16,499 $16,499 $28,946 −43% $21,029 −22% —
540 OSTEOMYELITIS WITH CC $16,376 $16,376 $28,728 −43% $23,494 −30% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CCMCC $16,332 $16,332 $28,651 −43% $22,811 −28% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $16,319 $16,319 $28,626 −43% $23,920 −32% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CCMCC $16,305 $16,305 $28,602 −43% $23,924 −32% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $16,300 $16,300 $28,593 −43% $24,316 −33% —
947 SIGNS AND SYMPTOMS WITH MCC $16,277 $16,277 $28,553 −43% $25,474 −36% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $16,256 $16,256 $28,515 −43% $27,244 −40% ≈117% of Medicare
796 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH MCC $16,157 $16,157 $28,340 −43% $22,557 −28% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CCMCC $16,083 $16,083 $28,209 −43% $19,686 −18% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $16,083 $16,083 $28,209 −43% $22,275 −28% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CCMCC $16,052 $16,052 $28,156 −43% $28,156 −43% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CCMCC $16,035 $16,035 $28,125 −43% $25,623 −37% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $16,001 $16,001 $28,065 −43% $26,634 −40% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $15,981 $15,981 $28,029 −43% $19,894 −20% —
348 ANAL AND STOMAL PROCEDURES WITH CC $15,934 $15,934 $27,947 −43% $27,947 −43% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $15,764 $15,764 $27,645 −43% $26,146 −40% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $15,761 $15,761 $27,641 −43% $19,354 −19% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $15,757 $15,757 $27,634 −43% $21,860 −28% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $15,711 $15,711 $27,552 −43% $20,727 −24% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $15,678 $15,678 $27,494 −43% $22,032 −29% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $15,677 $15,677 $27,492 −43% $27,492 −43% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $15,664 $15,664 $27,470 −43% $25,704 −39% ≈110% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CCMCC $15,595 $15,595 $27,348 −43% $20,147 −23% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CCMCC $15,582 $15,582 $27,323 −43% $27,321 −43% —
375 DIGESTIVE MALIGNANCY WITH CC $15,555 $15,555 $27,277 −43% $27,219 −43% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CCMCC $15,546 $15,546 $27,261 −43% $19,132 −19% —
593 SKIN ULCERS WITH CC $15,480 $15,480 $27,143 −43% $20,470 −24% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CCMCC $15,435 $15,435 $27,063 −43% $23,588 −35% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $15,269 $15,269 $26,770 −43% $26,488 −42% ≈120% of Medicare
549 SEPTIC ARTHRITIS WITH CC $15,259 $15,259 $26,753 −43% $20,938 −27% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CCMCC $15,178 $15,178 $26,611 −43% $27,369 −45% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $15,134 $15,134 $26,533 −43% $20,421 −26% —
887 OTHER MENTAL DISORDER DIAGNOSES $15,062 $15,062 $26,404 −43% $20,602 −27% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CCMCC $15,004 $15,004 $26,302 −43% $20,842 −28% —
114 ORBITAL PROCEDURES WITHOUT CCMCC $14,970 $14,970 $26,242 −43% $19,598 −24% —
304 HYPERTENSION WITH MCC $14,878 $14,878 $26,080 −43% $24,185 −38% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $14,822 $14,822 $25,980 −43% $22,982 −36% ≈111% of Medicare
302 ATHEROSCLEROSIS WITH MCC $14,734 $14,734 $25,825 −43% $20,844 −29% —
121 ACUTE MAJOR EYE INFECTIONS WITH CCMCC $14,733 $14,733 $25,822 −43% $18,291 −19% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $14,731 $14,731 $25,820 −43% $21,062 −30% —
102 HEADACHES WITH MCC $14,686 $14,686 $25,740 −43% $22,544 −35% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $14,636 $14,636 $25,652 −43% $25,307 −42% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $14,579 $14,579 $25,552 −43% $18,133 −20% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $14,488 $14,488 $25,390 −43% $25,390 −43% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $14,425 $14,425 $25,279 −43% $24,452 −41% —
039 EXTRACRANIAL PROCEDURES WITHOUT CCMCC $14,419 $14,419 $25,267 −43% $25,267 −43% —
152 OTITIS MEDIA AND URI WITH MCC $14,376 $14,376 $25,192 −43% $19,795 −27% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $14,288 $14,288 $25,037 −43% $20,741 −31% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $14,287 $14,287 $25,034 −43% $24,017 −41% —
399 APPENDIX PROCEDURES WITHOUT CCMCC $14,238 $14,238 $24,948 −43% $30,314 −53% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $14,228 $14,228 $24,930 −43% $24,190 −41% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $14,227 $14,227 $24,928 −43% $19,317 −26% —
946 REHABILITATION WITHOUT CCMCC $14,146 $14,146 $24,786 −43% $17,685 −20% —
181 RESPIRATORY NEOPLASMS WITH CC $14,068 $14,068 $24,648 −43% $22,431 −37% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $14,066 $14,066 $24,644 −43% $18,459 −24% —
200 PNEUMOTHORAX WITH CC $14,033 $14,033 $24,586 −43% $20,573 −32% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CCMCC $14,009 $14,009 $24,544 −43% $24,544 −43% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CCMCC $13,972 $13,972 $24,477 −43% $25,162 −44% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CCMCC $13,950 $13,950 $24,439 −43% $17,483 −20% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION ANDOR D&C $13,893 $13,893 $24,337 −43% $17,103 −19% —
672 URETHRAL PROCEDURES WITHOUT CCMCC $13,869 $13,869 $24,295 −43% $17,398 −20% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $13,826 $13,826 $24,220 −43% $19,868 −30% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $13,810 $13,810 $24,191 −43% $31,190 −56% —
381 COMPLICATED PEPTIC ULCER WITH CC $13,802 $13,802 $24,177 −43% $24,177 −43% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $13,744 $13,744 $24,075 −43% $21,806 −37% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $13,726 $13,726 $24,042 −43% $22,560 −39% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $13,702 $13,702 $24,000 −43% $17,226 −20% —
664 MINOR BLADDER PROCEDURES WITHOUT CCMCC $13,685 $13,685 $23,971 −43% $18,126 −25% —
949 AFTERCARE WITH CCMCC $13,675 $13,675 $23,953 −43% $23,953 −43% —
598 MALIGNANT BREAST DISORDERS WITH CC $13,674 $13,674 $23,951 −43% $19,073 −28% —
117 INTRAOCULAR PROCEDURES WITHOUT CCMCC $13,670 $13,670 $23,944 −43% $17,193 −20% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $13,638 $13,638 $23,887 −43% $17,943 −24% —
089 CONCUSSION WITH CC $13,589 $13,589 $23,800 −43% $18,293 −26% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $13,570 $13,570 $23,767 −43% $19,579 −31% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $13,560 $13,560 $23,749 −43% $23,749 −43% —
712 TESTES PROCEDURES WITHOUT CCMCC $13,557 $13,557 $23,745 −43% $18,898 −28% —
184 MAJOR CHEST TRAUMA WITH CC $13,538 $13,538 $23,711 −43% $20,842 −35% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $13,459 $13,459 $23,571 −43% $23,571 −43% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $13,448 $13,448 $23,551 −43% $23,496 −43% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $13,420 $13,420 $23,503 −43% $24,136 −44% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $13,360 $13,360 $23,396 −43% $23,396 −43% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $13,345 $13,345 $23,369 −43% $18,478 −28% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $13,312 $13,312 $23,312 −43% $22,231 −40% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $13,216 $13,216 $23,141 −43% $23,141 −43% —
644 ENDOCRINE DISORDERS WITH CC $13,103 $13,103 $22,941 −43% $22,941 −43% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $13,073 $13,073 $22,888 −43% $22,781 −43% ≈120% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $13,051 $13,051 $22,850 −43% $22,850 −43% —
667 PROSTATECTOMY WITHOUT CCMCC $13,032 $13,032 $22,817 −43% $16,703 −22% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CCMCC $13,017 $13,017 $22,790 −43% $24,022 −46% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CCMCC $12,995 $12,995 $22,750 −43% $16,495 −21% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $12,933 $12,933 $22,641 −43% $16,571 −22% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $12,931 $12,931 $22,637 −43% $21,545 −40% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CCMCC $12,929 $12,929 $22,635 −43% $20,080 −36% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $12,926 $12,926 $22,628 −43% $19,091 −32% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $12,904 $12,904 $22,590 −43% $22,713 −43% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $12,896 $12,896 $22,575 −43% $23,469 −45% ≈118% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $12,885 $12,885 $22,557 −43% $18,017 −28% —
920 COMPLICATIONS OF TREATMENT WITH CC $12,883 $12,883 $22,552 −43% $21,181 −39% —
187 PLEURAL EFFUSION WITH CC $12,733 $12,733 $22,288 −43% $21,467 −41% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $12,722 $12,722 $22,268 −43% $17,078 −26% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CCMCC $12,721 $12,721 $22,266 −43% $16,212 −22% —
697 URETHRAL STRICTURE $12,706 $12,706 $22,239 −43% $17,705 −28% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $12,682 $12,682 $22,197 −43% $20,007 −37% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $12,658 $12,658 $22,155 −43% $15,370 −18% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $12,657 $12,657 $22,153 −43% $17,434 −27% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $12,589 $12,589 $22,033 −43% $20,968 −40% —
197 INTERSTITIAL LUNG DISEASE WITH CC $12,558 $12,558 $21,977 −43% $20,106 −38% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $12,506 $12,506 $21,886 −43% $21,886 −43% ≈115% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CCMCC $12,502 $12,502 $21,880 −43% $18,282 −32% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CCMCC $12,410 $12,410 $21,716 −43% $15,890 −22% —
797 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH CC $12,284 $12,284 $21,494 −43% $19,001 −35% —
798 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITHOUT CCMCC $12,284 $12,284 $21,494 −43% $18,238 −33% —
202 BRONCHITIS AND ASTHMA WITH CCMCC $12,265 $12,265 $21,460 −43% $17,273 −29% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $12,259 $12,259 $21,449 −43% $21,449 −43% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $12,229 $12,229 $21,396 −43% $21,213 −42% ≈121% of Medicare
882 NEUROSES EXCEPT DEPRESSIVE $12,206 $12,206 $21,356 −43% $15,680 −22% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $12,163 $12,163 $21,280 −43% $15,636 −22% —
600 NON-MALIGNANT BREAST DISORDERS WITH CCMCC $12,138 $12,138 $21,236 −43% $16,418 −26% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CCMCC $12,132 $12,132 $21,225 −43% $18,191 −33% —
670 TRANSURETHRAL PROCEDURES WITHOUT CCMCC $12,127 $12,127 $21,216 −43% $20,371 −40% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CCMCC $12,121 $12,121 $21,205 −43% $19,326 −37% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $12,118 $12,118 $21,201 −43% $15,589 −22% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CCMCC $12,078 $12,078 $21,129 −43% $18,428 −34% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $11,946 $11,946 $20,896 −43% $18,918 −37% —
158 DENTAL AND ORAL DISEASES WITH CC $11,937 $11,937 $20,881 −43% $17,700 −33% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CCMCC $11,926 $11,926 $20,861 −43% $17,108 −30% —
779 ABORTION WITHOUT D&C $11,865 $11,865 $20,752 −43% $15,327 −23% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $11,725 $11,725 $20,506 −43% $19,287 −39% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $11,715 $11,715 $20,488 −43% $20,488 −43% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $11,701 $11,701 $20,463 −43% $20,463 −43% ≈118% of Medicare
101 SEIZURES WITHOUT MCC $11,700 $11,700 $20,461 −43% $19,954 −41% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CCMCC $11,696 $11,696 $20,455 −43% $20,309 −42% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CCMCC $11,666 $11,666 $20,401 −43% $16,352 −29% —
638 DIABETES WITH CC $11,644 $11,644 $20,361 −43% $18,821 −38% —
076 VIRAL MENINGITIS WITHOUT CCMCC $11,640 $11,640 $20,355 −43% $15,474 −25% —
881 DEPRESSIVE NEUROSES $11,605 $11,605 $20,293 −43% $15,058 −23% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $11,586 $11,586 $20,259 −43% $17,585 −34% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $11,500 $11,500 $20,108 −43% $17,731 −35% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $11,488 $11,488 $20,086 −43% $15,077 −24% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CCMCC $11,487 $11,487 $20,084 −43% $20,084 −43% —
864 FEVER AND INFLAMMATORY CONDITIONS $11,402 $11,402 $19,935 −43% $17,412 −35% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $11,350 $11,350 $19,842 −43% $18,803 −40% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CCMCC $11,332 $11,332 $19,811 −43% $21,261 −47% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CCMCC $11,326 $11,326 $19,914 −43% $15,764 −28% —
683 RENAL FAILURE WITH CC $11,288 $11,288 $19,733 −43% $18,620 −39% ≈119% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $11,237 $11,237 $19,642 −43% $16,391 −31% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $11,234 $11,234 $19,638 −43% $15,045 −25% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CCMCC $11,227 $11,227 $19,624 −43% $15,869 −29% —
376 DIGESTIVE MALIGNANCY WITHOUT CCMCC $11,214 $11,214 $19,602 −43% $15,608 −28% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $11,204 $11,204 $19,584 −43% $16,049 −30% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $11,195 $11,195 $19,569 −43% $19,569 −43% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CCMCC $11,188 $11,188 $19,854 −44% $19,854 −44% —
603 CELLULITIS WITHOUT MCC $11,186 $11,186 $19,553 −43% $18,530 −40% ≈120% of Medicare
541 OSTEOMYELITIS WITHOUT CCMCC $11,112 $11,112 $19,422 −43% $14,549 −24% —
312 SYNCOPE AND COLLAPSE $11,067 $11,067 $19,342 −43% $19,342 −43% ≈119% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $11,046 $11,046 $19,305 −43% $19,305 −43% —
607 MINOR SKIN DISORDERS WITHOUT MCC $10,978 $10,978 $19,185 −43% $15,284 −28% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $10,973 $10,973 $19,176 −43% $17,367 −37% —
550 SEPTIC ARTHRITIS WITHOUT CCMCC $10,952 $10,952 $19,138 −43% $16,156 −32% —
292 HEART FAILURE AND SHOCK WITH CC $10,940 $10,940 $19,118 −43% $16,212 −33% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $10,928 $10,928 $19,096 −43% $19,096 −43% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $10,914 $10,914 $19,072 −43% $18,278 −40% —
090 CONCUSSION WITHOUT CCMCC $10,891 $10,891 $19,032 −43% $14,873 −27% —
599 MALIGNANT BREAST DISORDERS WITHOUT CCMCC $10,861 $10,861 $18,978 −43% $14,290 −24% —
103 HEADACHES WITHOUT MCC $10,802 $10,802 $18,874 −43% $20,111 −46% —
594 SKIN ULCERS WITHOUT CCMCC $10,783 $10,783 $18,841 −43% $14,209 −24% —
182 RESPIRATORY NEOPLASMS WITHOUT CCMCC $10,643 $10,643 $18,592 −43% $14,064 −24% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CCMCC $10,634 $10,634 $18,577 −43% $14,055 −24% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $10,606 $10,606 $18,528 −43% $18,253 −42% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $10,495 $10,495 $18,330 −43% $15,876 −34% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $10,423 $10,423 $18,204 −43% $18,204 −43% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $10,409 $10,409 $18,179 −43% $13,822 −25% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $10,393 $10,393 $18,150 −43% $18,150 −43% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $10,387 $10,387 $18,139 −43% $16,837 −38% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $10,379 $10,379 $18,126 −43% $17,715 −41% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CCMCC $10,379 $10,379 $18,126 −43% $17,928 −42% —
176 PULMONARY EMBOLISM WITHOUT MCC $10,354 $10,354 $18,081 −43% $18,081 −43% —
534 FRACTURES OF FEMUR WITHOUT MCC $10,348 $10,348 $18,070 −43% $17,195 −40% —
138 MOUTH PROCEDURES WITHOUT CCMCC $10,341 $10,341 $19,492 −47% $17,383 −41% —
204 RESPIRATORY SIGNS AND SYMPTOMS $10,310 $10,310 $18,004 −43% $16,866 −39% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $10,309 $10,309 $18,002 −43% $18,002 −43% —
123 NEUROLOGICAL EYE DISORDERS $10,212 $10,212 $17,831 −43% $17,831 −43% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $10,192 $10,192 $17,795 −43% $17,388 −41% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CCMCC $10,181 $10,181 $17,775 −43% $13,586 −25% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $10,173 $10,173 $17,762 −43% $20,278 −50% ≈124% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CCMCC $10,138 $10,138 $17,700 −43% $17,700 −43% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $10,103 $10,103 $17,638 −43% $17,727 −43% —
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CCMCC $10,044 $10,044 $17,533 −43% $13,445 −25% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CCMCC $10,037 $10,037 $17,522 −43% $17,522 −43% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CCMCC $9,986 $9,986 $17,431 −43% $13,385 −25% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $9,938 $9,938 $17,347 −43% $16,745 −41% ≈125% of Medicare
694 URINARY STONES WITHOUT MCC $9,938 $9,938 $17,347 −43% $16,531 −40% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $9,924 $9,924 $17,322 −43% $17,322 −43% ≈126% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CCMCC $9,904 $9,904 $17,287 −43% $14,166 −30% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CCMCC $9,791 $9,791 $17,087 −43% $14,444 −32% —
151 EPISTAXIS WITHOUT MCC $9,644 $9,644 $16,827 −43% $13,032 −26% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CCMCC $9,615 $9,615 $16,776 −43% $16,776 −43% —
305 HYPERTENSION WITHOUT MCC $9,553 $9,553 $16,665 −43% $17,144 −44% ≈130% of Medicare
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CCMCC $9,546 $9,546 $16,654 −43% $16,654 −43% —
382 COMPLICATED PEPTIC ULCER WITHOUT CCMCC $9,535 $9,535 $16,634 −43% $16,634 −43% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CCMCC $9,520 $9,520 $16,607 −43% $14,337 −34% —
149 DYSEQUILIBRIUM $9,513 $9,513 $16,594 −43% $17,203 −45% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $9,511 $9,511 $16,592 −43% $12,895 −26% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $9,496 $9,496 $16,565 −43% $14,861 −36% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $9,474 $9,474 $16,525 −43% $13,892 −32% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $9,431 $9,431 $16,450 −43% $13,282 −29% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $9,410 $9,410 $16,412 −43% $16,865 −44% ≈130% of Medicare
188 PLEURAL EFFUSION WITHOUT CCMCC $9,346 $9,346 $16,299 −43% $14,110 −34% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $9,275 $9,275 $16,175 −43% $12,650 −27% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CCMCC $9,235 $9,235 $16,104 −43% $16,104 −43% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CCMCC $9,231 $9,231 $16,097 −43% $18,623 −50% ≈130% of Medicare
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CCMCC $9,220 $9,220 $16,077 −43% $12,593 −27% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $9,212 $9,212 $16,064 −43% $13,090 −30% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CCMCC $9,162 $9,162 $15,975 −43% $12,537 −27% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $9,086 $9,086 $15,839 −43% $12,381 −27% —
313 CHEST PAIN $9,084 $9,084 $15,837 −43% $15,962 −43% —
153 OTITIS MEDIA AND URI WITHOUT MCC $9,063 $9,063 $15,799 −43% $14,473 −37% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $8,971 $8,971 $15,637 −43% $12,336 −27% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CCMCC $8,950 $8,950 $15,600 −43% $15,600 −43% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CCMCC $8,921 $8,921 $15,549 −43% $13,654 −35% —
311 ANGINA PECTORIS $8,895 $8,895 $15,502 −43% $15,165 −41% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CCMCC $8,891 $8,891 $15,495 −43% $15,072 −41% —
203 BRONCHITIS AND ASTHMA WITHOUT CCMCC $8,873 $8,873 $15,464 −43% $12,279 −28% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CCMCC $8,872 $8,872 $15,462 −43% $12,405 −28% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CCMCC $8,843 $8,843 $15,411 −43% $13,303 −34% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $8,813 $8,813 $15,358 −43% $14,441 −39% —
921 COMPLICATIONS OF TREATMENT WITHOUT CCMCC $8,762 $8,762 $15,267 −43% $14,012 −37% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CCMCC $8,699 $8,699 $15,156 −43% $12,797 −32% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CCMCC $8,644 $8,644 $15,058 −43% $11,997 −28% —
201 PNEUMOTHORAX WITHOUT CCMCC $8,628 $8,628 $15,031 −43% $13,081 −34% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CCMCC $8,569 $8,569 $14,927 −43% $13,198 −35% —
303 ATHEROSCLEROSIS WITHOUT MCC $8,569 $8,569 $14,927 −43% $14,927 −43% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CCMCC $8,558 $8,558 $14,907 −43% $11,909 −28% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CCMCC $8,543 $8,543 $14,880 −43% $14,880 −43% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CCMCC $8,498 $8,498 $14,800 −43% $11,847 −28% —
916 ALLERGIC REACTIONS WITHOUT MCC $8,465 $8,465 $14,743 −43% $13,890 −39% —
159 DENTAL AND ORAL DISEASES WITHOUT CCMCC $8,409 $8,409 $14,643 −43% $13,368 −37% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CCMCC $8,253 $8,253 $14,368 −43% $14,368 −43% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $8,163 $8,163 $14,208 −43% $14,208 −43% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CCMCC $8,129 $8,129 $14,148 −43% $12,044 −33% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CCMCC $8,121 $8,121 $14,134 −43% $14,134 −43% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $8,117 $8,117 $14,128 −43% $14,128 −43% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CCMCC $8,086 $8,086 $14,072 −43% $11,421 −29% —
639 DIABETES WITHOUT CCMCC $7,994 $7,994 $13,910 −43% $13,910 −43% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $7,963 $7,963 $13,855 −43% $12,013 −34% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CCMCC $7,945 $7,945 $13,824 −43% $13,824 −43% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CCMCC $7,850 $7,850 $13,683 −43% $15,070 −48% —
684 RENAL FAILURE WITHOUT CCMCC $7,753 $7,753 $13,642 −43% $13,623 −43% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $7,747 $7,747 $13,639 −43% $11,071 −30% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CCMCC $7,654 $7,654 $13,599 −44% $10,975 −30% —
950 AFTERCARE WITHOUT CCMCC $7,486 $7,486 $13,527 −45% $13,527 −45% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CCMCC $7,176 $7,176 $13,395 −46% $10,039 −29% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CCMCC $7,152 $7,152 $13,384 −47% $13,384 −47% ≈137% of Medicare
293 HEART FAILURE AND SHOCK WITHOUT CCMCC $7,016 $7,016 $13,326 −47% $11,955 −41% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CCMCC $6,653 $6,653 $11,539 −42% $9,076 −27% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CCMCC $5,672 $5,672 $12,751 −56% $8,927 −36% —
795 NORMAL NEWBORN $2,635 $2,635 $6,880 −62% $4,530 −42% —

Procedures with negotiated rates only

These 16 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
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $128,428 – $155,361 · median $131,000 3 plans
454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC $70,303 – $131,000 · median $107,233 3 plans
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CCMCC $51,173 – $131,000 · median $80,747 3 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $58,768 – $131,000 · median $116,280 3 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $41,558 – $131,000 · median $64,132 3 plans
222 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
223 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
224 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
225 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
226 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
227 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
230 UnGrouped $109,534 – $109,534 · median $109,534 1 plans
246 UnGrouped $16,413 – $16,413 · median $16,413 1 plans
247 UnGrouped $16,413 – $16,413 · median $16,413 1 plans
248 UnGrouped $16,413 – $16,413 · median $16,413 1 plans
249 UnGrouped $16,413 – $16,413 · median $16,413 1 plans
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