West Anaheim Medical Center — Pricing

725 procedures published in this hospital's Machine-Readable File (MRF) — 723 with a comparable price, 2 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 725
Lowest published price $3,244
Average published price $32,522
Highest published price $519,649

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 725 procedures

Published charges

Showing all 723 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 47 procedures, this hospital's negotiated rates average ≈114% 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 $519,649 $519,649 $641,743 −19% $498,715 +4% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $388,259 $388,259 $486,976 −20% $431,073 −10% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $327,063 $327,063 $412,183 −21% $306,087 +7% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $295,522 $295,522 $371,366 −20% $371,366 −20% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $180,854 $180,854 $227,681 −21% $182,314 −1% —
007 LUNG TRANSPLANT $180,399 $180,399 $230,667 −22% $170,608 +6% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $152,191 $152,191 $198,463 −23% $169,977 −10% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $150,460 $150,460 $196,346 −23% $171,338 −12% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $147,094 $147,094 $189,963 −23% $159,181 −8% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $146,342 $146,342 $191,314 −24% $191,314 −24% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $133,351 $133,351 $175,437 −24% $175,437 −24% —
850 UnGrouped $127,305 $127,305 $168,048 −24% $121,563 +5% —
231 CORONARY BYPASS WITH PTCA WITH MCC $117,146 $117,146 $155,631 −25% $146,474 −20% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $117,081 $117,081 $153,282 −24% $151,029 −22% —
429 UnGrouped $115,311 $115,311 $153,621 −25% $120,174 −4% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $111,463 $111,463 $148,686 −25% $134,914 −17% —
010 PANCREAS TRANSPLANT $110,250 $110,250 $144,934 −24% $99,940 +10% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $109,621 $109,621 $146,435 −25% $105,228 +4% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $108,095 $108,095 $144,569 −25% $138,868 −22% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $107,009 $107,009 $143,242 −25% $143,242 −25% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $103,246 $103,246 $136,374 −24% $120,587 −14% —
427 UnGrouped $98,270 $98,270 $132,794 −26% $121,728 −19% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $96,257 $96,257 $124,290 −23% $138,008 −30% ≈114% of Medicare
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $94,493 $94,493 $125,675 −25% $105,612 −11% —
447 UnGrouped $92,791 $92,791 $126,098 −26% $114,914 −19% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CCMCC $92,436 $92,436 $125,432 −26% $89,353 +3% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $89,522 $89,522 $116,058 −23% $116,058 −23% ≈114% of Medicare
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $89,394 $89,394 $121,714 −27% $121,714 −27% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $87,554 $87,554 $117,196 −25% $109,331 −20% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $85,766 $85,766 $117,280 −27% $117,280 −27% —
317 UnGrouped $85,656 $85,656 $117,146 −27% $94,988 −10% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $85,268 $85,268 $114,401 −25% $98,912 −14% —
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $84,972 $84,972 $114,040 −25% $108,472 −22% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $84,586 $84,586 $115,839 −27% $106,238 −20% —
028 SPINAL PROCEDURES WITH MCC $84,184 $84,184 $113,077 −26% $95,858 −12% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CCMCC $83,584 $83,584 $108,802 −23% $98,260 −15% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CCMCC $83,584 $83,584 $108,802 −23% $81,176 +3% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $82,963 $82,963 $113,855 −27% $113,855 −27% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CCMCC $82,392 $82,392 $113,157 −27% $92,238 −11% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $82,330 $82,330 $107,269 −23% $80,018 +3% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $81,496 $81,496 $112,062 −27% $112,062 −27% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $80,644 $80,644 $108,750 −26% $96,192 −16% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $79,503 $79,503 $107,355 −26% $107,355 −26% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $79,030 $79,030 $106,778 −26% $106,778 −26% —
653 MAJOR BLADDER PROCEDURES WITH MCC $77,234 $77,234 $104,583 −26% $97,046 −20% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $76,583 $76,583 $106,057 −28% $101,235 −24% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $76,583 $76,583 $100,245 −24% $76,583 +0% —
428 UnGrouped $76,264 $76,264 $105,899 −28% $105,899 −28% —
430 UnGrouped $75,801 $75,801 $105,333 −28% $93,783 −19% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $75,226 $75,226 $102,128 −26% $94,927 −21% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $74,844 $74,844 $101,662 −26% $78,582 −5% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $74,774 $74,774 $101,576 −26% $86,953 −14% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $74,766 $74,766 $101,566 −26% $82,527 −9% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $73,732 $73,732 $102,573 −28% $102,573 −28% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $73,408 $73,408 $102,177 −28% $102,177 −28% —
450 UnGrouped $71,390 $71,390 $99,943 −29% $79,944 −11% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $71,155 $71,155 $99,423 −28% $99,423 −28% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $70,626 $70,626 $96,507 −27% $96,222 −27% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $70,412 $70,412 $96,245 −27% $80,747 −13% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $69,423 $69,423 $91,495 −24% $70,735 −2% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $69,370 $69,370 $97,241 −29% $84,861 −18% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $69,342 $69,342 $94,937 −27% $87,018 −20% ≈116% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $69,094 $69,094 $96,905 −29% $96,905 −29% —
245 AICD GENERATOR PROCEDURES $67,766 $67,766 $95,281 −29% $72,076 −6% —
471 CERVICAL SPINAL FUSION WITH MCC $67,360 $67,360 $92,515 −27% $92,515 −27% —
006 LIVER TRANSPLANT WITHOUT MCC $67,248 $67,248 $92,378 −27% $84,407 −20% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $66,234 $66,234 $91,138 −27% $88,691 −25% —
799 SPLENIC PROCEDURES WITH MCC $65,949 $65,949 $90,790 −27% $78,821 −16% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $65,936 $65,936 $90,775 −27% $86,390 −24% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $65,259 $65,259 $92,217 −29% $92,217 −29% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $64,912 $64,912 $89,523 −27% $80,885 −20% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $64,532 $64,532 $91,329 −29% $91,329 −29% —
163 MAJOR CHEST PROCEDURES WITH MCC $63,944 $63,944 $88,341 −28% $88,341 −28% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $63,918 $63,918 $90,579 −29% $71,551 −11% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CCMCC $63,716 $63,716 $90,331 −29% $90,331 −29% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $63,706 $63,706 $88,050 −28% $88,050 −28% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $62,601 $62,601 $86,699 −28% $72,859 −14% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $62,230 $62,230 $86,246 −28% $76,954 −19% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $62,060 $62,060 $88,307 −30% $88,307 −30% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $61,484 $61,484 $85,334 −28% $68,847 −11% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $60,965 $60,965 $86,970 −30% $75,585 −19% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CCMCC $59,936 $59,936 $83,441 −28% $83,441 −28% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $59,216 $59,216 $82,561 −28% $82,561 −28% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $59,129 $59,129 $84,725 −30% $88,049 −33% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $58,713 $58,713 $84,217 −30% $60,098 −2% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $58,182 $58,182 $81,298 −28% $68,659 −15% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $58,168 $58,168 $81,281 −28% $72,945 −20% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $57,770 $57,770 $83,065 −30% $83,065 −30% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $57,101 $57,101 $82,247 −31% $82,247 −31% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $57,070 $57,070 $79,939 −29% $66,853 −15% —
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $56,986 $56,986 $79,836 −29% $73,029 −22% —
448 UnGrouped $56,708 $56,708 $81,998 −31% $81,998 −31% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $56,486 $56,486 $79,225 −29% $72,011 −22% —
791 PREMATURITY WITH MAJOR PROBLEMS $56,383 $56,383 $75,557 −25% $39,563 +43% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $55,334 $55,334 $77,817 −29% $71,701 −23% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $55,295 $55,295 $77,770 −29% $57,521 −4% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $54,811 $54,811 $77,178 −29% $68,006 −19% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $54,699 $54,699 $77,041 −29% $61,832 −12% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $54,589 $54,589 $76,907 −29% $54,196 +1% —
402 UnGrouped $54,349 $54,349 $79,116 −31% $75,492 −28% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $54,323 $54,323 $78,852 −31% $78,852 −31% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $53,700 $53,700 $75,820 −29% $62,961 −15% —
904 SKIN GRAFTS FOR INJURIES WITH CCMCC $53,646 $53,646 $75,754 −29% $55,097 −3% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $53,497 $53,497 $75,573 −29% $72,782 −26% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $53,113 $53,113 $75,103 −29% $75,103 −29% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $52,828 $52,828 $74,755 −29% $74,755 −29% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $52,421 $52,421 $74,257 −29% $74,257 −29% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $52,006 $52,006 $73,751 −29% $60,861 −15% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $50,722 $50,722 $68,639 −26% $62,524 −19% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $50,374 $50,374 $71,755 −30% $71,755 −30% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $49,842 $49,842 $71,106 −30% $59,425 −16% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $49,840 $49,840 $67,560 −26% $57,855 −14% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $49,831 $49,831 $71,092 −30% $64,776 −23% —
265 AICD LEAD PROCEDURES $49,600 $49,600 $70,810 −30% $56,695 −13% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $49,380 $49,380 $70,540 −30% $70,540 −30% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CCMCC $49,094 $49,094 $72,461 −32% $62,404 −21% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $49,081 $49,081 $70,175 −30% $50,919 −4% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $48,727 $48,727 $69,743 −30% $68,399 −29% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $48,712 $48,712 $69,724 −30% $65,383 −25% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $48,693 $48,693 $69,701 −30% $59,207 −18% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $48,608 $48,608 $69,597 −30% $51,953 −6% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $48,296 $48,296 $71,486 −32% $56,242 −14% —
332 RECTAL RESECTION WITH MCC $48,244 $48,244 $69,152 −30% $58,125 −17% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $48,192 $48,192 $69,089 −30% $49,065 −2% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $47,910 $47,910 $71,014 −33% $71,014 −33% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $47,835 $47,835 $68,653 −30% $62,269 −23% —
665 PROSTATECTOMY WITH MCC $47,761 $47,761 $68,562 −30% $54,072 −12% —
252 OTHER VASCULAR PROCEDURES WITH MCC $47,717 $47,717 $68,508 −30% $68,508 −30% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $47,645 $47,645 $68,421 −30% $68,880 −31% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $47,384 $47,384 $70,371 −33% $67,901 −30% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $47,188 $47,188 $70,132 −33% $70,132 −33% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $46,702 $46,702 $67,268 −31% $64,152 −27% —
037 EXTRACRANIAL PROCEDURES WITH MCC $46,210 $46,210 $66,666 −31% $64,749 −29% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $45,948 $45,948 $68,616 −33% $52,908 −13% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $45,491 $45,491 $65,788 −31% $65,254 −30% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $45,363 $45,363 $65,631 −31% $54,129 −16% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $45,344 $45,344 $65,608 −31% $64,465 −30% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $44,811 $44,811 $64,956 −31% $64,956 −31% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $44,606 $44,606 $66,976 −33% $57,277 −22% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $44,478 $44,478 $66,819 −33% $66,819 −33% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $44,394 $44,394 $60,905 −27% $49,710 −11% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $44,187 $44,187 $64,194 −31% $51,142 −14% —
500 SOFT TISSUE PROCEDURES WITH MCC $44,114 $44,114 $64,105 −31% $57,479 −23% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $43,458 $43,458 $65,573 −34% $65,573 −34% —
662 MINOR BLADDER PROCEDURES WITH MCC $43,438 $43,438 $63,279 −31% $54,483 −20% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $43,255 $43,255 $65,325 −34% $65,325 −34% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $43,064 $43,064 $62,821 −31% $62,821 −31% —
451 UnGrouped $42,976 $42,976 $65,216 −34% $65,216 −34% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CCMCC $42,946 $42,946 $62,677 −31% $53,817 −20% —
652 KIDNEY TRANSPLANT $42,775 $42,775 $62,468 −32% $54,720 −22% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $42,736 $42,736 $64,691 −34% $53,555 −20% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $42,599 $42,599 $64,523 −34% $63,475 −33% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $41,602 $41,602 $57,493 −28% $46,402 −10% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $41,084 $41,084 $60,402 −32% $54,313 −24% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $40,870 $40,870 $60,140 −32% $60,140 −32% —
668 TRANSURETHRAL PROCEDURES WITH MCC $40,640 $40,640 $59,859 −32% $47,277 −14% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $40,618 $40,618 $62,334 −35% $67,764 −40% —
800 SPLENIC PROCEDURES WITH CC $40,605 $40,605 $59,817 −32% $49,184 −17% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $40,583 $40,583 $59,790 −32% $54,475 −26% —
472 CERVICAL SPINAL FUSION WITH CC $40,377 $40,377 $59,537 −32% $59,537 −32% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $39,963 $39,963 $59,031 −32% $58,968 −32% —
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $39,917 $39,917 $58,975 −32% $56,758 −30% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $39,894 $39,894 $61,217 −35% $53,551 −26% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIESINTRALUMINAL DEVICES $39,683 $39,683 $60,959 −35% $74,274 −47% ≈105% of Medicare
654 MAJOR BLADDER PROCEDURES WITH CC $39,343 $39,343 $58,274 −32% $53,868 −27% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $39,154 $39,154 $58,043 −33% $58,043 −33% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $39,115 $39,115 $60,265 −35% $48,907 −20% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $38,163 $38,163 $56,832 −33% $48,358 −21% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $38,096 $38,096 $53,208 −28% $45,497 −16% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $38,027 $38,027 $58,935 −35% $44,973 −15% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $37,892 $37,892 $52,959 −28% $43,491 −13% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $37,709 $37,709 $52,735 −28% $57,963 −35% —
263 VEIN LIGATION AND STRIPPING $37,416 $37,416 $55,918 −33% $44,938 −17% —
849 RADIOTHERAPY $37,264 $37,264 $52,191 −29% $37,862 −2% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $37,150 $37,150 $55,594 −33% $45,432 −18% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $37,019 $37,019 $55,434 −33% $40,947 −10% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CCMCC $36,974 $36,974 $55,378 −33% $45,290 −18% —
503 FOOT PROCEDURES WITH MCC $36,927 $36,927 $55,321 −33% $43,901 −16% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $36,890 $36,890 $55,276 −33% $40,277 −8% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CCMCC $36,606 $36,606 $54,929 −33% $54,929 −33% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CCMCC $36,129 $36,129 $54,345 −34% $41,703 −13% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $36,070 $36,070 $54,273 −34% $48,094 −25% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $35,650 $35,650 $50,218 −29% $38,878 −8% —
253 OTHER VASCULAR PROCEDURES WITH CC $35,639 $35,639 $53,746 −34% $53,746 −34% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $35,573 $35,573 $53,666 −34% $57,149 −38% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $35,392 $35,392 $56,278 −37% $36,097 −2% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $35,279 $35,279 $49,765 −29% $39,657 −11% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CCMCC $35,252 $35,252 $53,274 −34% $46,659 −24% —
164 MAJOR CHEST PROCEDURES WITH CC $35,143 $35,143 $53,141 −34% $53,141 −34% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $34,965 $34,965 $49,382 −29% $39,409 −11% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CCMCC $34,939 $34,939 $55,162 −37% $55,162 −37% —
397 APPENDIX PROCEDURES WITH MCC $34,603 $34,603 $54,751 −37% $52,319 −34% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CCMCC $34,466 $34,466 $54,583 −37% $52,332 −34% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $34,217 $34,217 $34,603 −1% $11,633 +194% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $34,197 $34,197 $51,985 −34% $51,985 −34% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $33,919 $33,919 $51,645 −34% $54,824 −38% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $33,790 $33,790 $51,487 −34% $46,591 −27% —
135 SINUS AND MASTOID PROCEDURES WITH CCMCC $33,685 $33,685 $51,359 −34% $40,065 −16% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $33,546 $33,546 $51,189 −34% $56,394 −41% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $33,494 $33,494 $47,583 −30% $47,583 −30% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CCMCC $33,494 $33,494 $47,583 −30% $39,093 −14% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $33,209 $33,209 $50,777 −35% $52,313 −37% —
473 CERVICAL SPINAL FUSION WITHOUT CCMCC $33,084 $33,084 $50,624 −35% $50,624 −35% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $33,075 $33,075 $50,614 −35% $40,548 −18% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $33,033 $33,033 $50,562 −35% $58,832 −44% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $32,980 $32,980 $50,498 −35% $47,546 −31% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $32,687 $32,687 $50,139 −35% $50,139 −35% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $32,434 $32,434 $46,288 −30% $36,237 −10% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $32,360 $32,360 $51,387 −37% $36,080 −10% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $32,329 $32,329 $51,339 −37% $51,339 −37% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $32,271 $32,271 $49,631 −35% $49,631 −35% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $32,075 $32,075 $45,849 −30% $37,080 −13% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $32,022 $32,022 $45,785 −30% $36,334 −12% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $31,926 $31,926 $49,209 −35% $39,253 −19% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CCMCC $31,867 $31,867 $49,137 −35% $43,586 −27% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $31,809 $31,809 $49,066 −35% $46,430 −31% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $31,688 $31,688 $45,376 −30% $37,064 −15% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CCMCC $31,582 $31,582 $48,788 −35% $38,998 −19% —
113 ORBITAL PROCEDURES WITH CCMCC $31,558 $31,558 $48,760 −35% $35,642 −11% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $31,506 $31,506 $50,011 −37% $50,011 −37% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $31,495 $31,495 $48,682 −35% $48,682 −35% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $31,455 $31,455 $48,634 −35% $45,059 −30% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $31,225 $31,225 $48,353 −35% $44,053 −29% —
030 SPINAL PROCEDURES WITHOUT CCMCC $31,129 $31,129 $48,235 −35% $45,818 −32% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $30,962 $30,962 $44,489 −30% $44,600 −31% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $30,771 $30,771 $47,797 −36% $38,382 −20% —
935 NON-EXTENSIVE BURNS $30,730 $30,730 $43,274 −29% $29,458 +4% —
906 HAND PROCEDURES FOR INJURIES $30,538 $30,538 $47,513 −36% $31,520 −3% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $30,489 $30,489 $47,452 −36% $41,900 −27% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $30,357 $30,357 $43,749 −31% $37,902 −20% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $30,191 $30,191 $47,089 −36% $44,553 −32% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $30,139 $30,139 $43,483 −31% $38,357 −21% ≈112% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $30,070 $30,070 $47,696 −37% $34,900 −14% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $30,033 $30,033 $43,354 −31% $31,044 −3% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $30,012 $30,012 $43,328 −31% $36,850 −19% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $29,897 $29,897 $43,187 −31% $35,569 −16% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CCMCC $29,895 $29,895 $46,727 −36% $40,232 −26% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $29,893 $29,893 $46,724 −36% $45,622 −34% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $29,838 $29,838 $46,657 −36% $37,654 −21% —
333 RECTAL RESECTION WITH CC $29,751 $29,751 $46,551 −36% $34,352 −13% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $29,690 $29,690 $46,477 −36% $46,477 −36% —
595 MAJOR SKIN DISORDERS WITH MCC $29,610 $29,610 $42,837 −31% $31,785 −7% —
336 PERITONEAL ADHESIOLYSIS WITH CC $29,572 $29,572 $46,332 −36% $49,470 −40% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $29,560 $29,560 $46,317 −36% $38,420 −23% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $29,514 $29,514 $46,799 −37% $56,519 −48% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $29,354 $29,354 $46,066 −36% $46,066 −36% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $29,272 $29,272 $42,423 −31% $32,483 −10% —
655 MAJOR BLADDER PROCEDURES WITHOUT CCMCC $29,090 $29,090 $45,743 −36% $41,651 −30% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $29,057 $29,057 $45,703 −36% $51,172 −43% ≈107% of Medicare
592 SKIN ULCERS WITH MCC $28,801 $28,801 $41,848 −31% $32,662 −12% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CCMCC $28,679 $28,679 $45,240 −37% $34,089 −16% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $28,414 $28,414 $41,375 −31% $30,661 −7% —
539 OSTEOMYELITIS WITH MCC $28,334 $28,334 $41,277 −31% $33,746 −16% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $28,261 $28,261 $44,730 −37% $41,660 −32% —
548 SEPTIC ARTHRITIS WITH MCC $28,227 $28,227 $41,146 −31% $31,019 −9% —
052 SPINAL DISORDERS AND INJURIES WITH CCMCC $28,198 $28,198 $41,111 −31% $30,940 −9% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $28,187 $28,187 $44,639 −37% $45,817 −38% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $28,000 $28,000 $44,357 −37% $43,524 −36% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $27,981 $27,981 $44,326 −37% $29,109 −4% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $27,877 $27,877 $40,719 −32% $35,714 −22% ≈111% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $27,858 $27,858 $40,695 −32% $35,139 −21% —
100 SEIZURES WITH MCC $27,824 $27,824 $40,653 −32% $35,194 −21% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CCMCC $27,821 $27,821 $44,068 −37% $29,633 −6% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $27,725 $27,725 $43,913 −37% $43,398 −36% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $27,654 $27,654 $43,800 −37% $43,800 −37% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $27,639 $27,639 $43,775 −37% $43,775 −37% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CCMCC $27,550 $27,550 $43,631 −37% $41,520 −34% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $27,504 $27,504 $40,263 −32% $35,237 −22% ≈110% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $27,492 $27,492 $43,538 −37% $43,538 −37% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $27,463 $27,463 $40,213 −32% $36,933 −26% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $27,412 $27,412 $40,150 −32% $35,014 −22% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CCMCC $27,397 $27,397 $43,384 −37% $29,524 −7% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CCMCC $27,393 $27,393 $43,378 −37% $33,050 −17% —
707 MAJOR MALE PELVIC PROCEDURES WITH CCMCC $27,208 $27,208 $43,080 −37% $43,080 −37% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CCMCC $27,175 $27,175 $43,027 −37% $36,202 −25% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $27,084 $27,084 $42,881 −37% $42,881 −37% —
380 COMPLICATED PEPTIC ULCER WITH MCC $26,984 $26,984 $39,627 −32% $36,641 −26% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $26,826 $26,826 $42,463 −37% $33,165 −19% —
711 TESTES PROCEDURES WITH CCMCC $26,795 $26,795 $42,414 −37% $34,852 −23% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $26,616 $26,616 $42,126 −37% $42,126 −37% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $26,616 $26,616 $42,126 −37% $35,459 −25% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $26,557 $26,557 $39,105 −32% $36,280 −27% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $26,517 $26,517 $39,057 −32% $32,399 −18% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $26,481 $26,481 $39,013 −32% $32,204 −18% ≈113% of Medicare
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $26,453 $26,453 $38,978 −32% $32,981 −20% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $26,450 $26,450 $41,857 −37% $49,197 −46% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CCMCC $26,448 $26,448 $41,855 −37% $45,963 −42% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $26,431 $26,431 $38,951 −32% $30,766 −14% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $26,169 $26,169 $38,631 −32% $35,114 −25% —
165 MAJOR CHEST PROCEDURES WITHOUT CCMCC $26,154 $26,154 $41,380 −37% $41,380 −37% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $26,048 $26,048 $38,483 −32% $30,974 −16% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CCMCC $26,037 $26,037 $41,191 −37% $32,538 −20% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $25,905 $25,905 $38,308 −32% $29,609 −13% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $25,806 $25,806 $38,187 −32% $30,394 −15% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CCMCC $25,728 $25,728 $40,694 −37% $40,694 −37% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $25,660 $25,660 $40,583 −37% $40,583 −37% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CCMCC $25,640 $25,640 $40,552 −37% $40,552 −37% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $25,611 $25,611 $37,950 −33% $37,950 −33% —
919 COMPLICATIONS OF TREATMENT WITH MCC $25,598 $25,598 $37,933 −33% $29,031 −12% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $25,588 $25,588 $37,921 −33% $36,375 −30% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $25,525 $25,525 $40,365 −37% $36,597 −30% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $25,523 $25,523 $37,842 −33% $37,842 −33% ≈113% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $25,401 $25,401 $37,692 −33% $29,476 −14% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $25,399 $25,399 $40,163 −37% $54,772 −54% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CCMCC $25,338 $25,338 $40,063 −37% $40,063 −37% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $25,309 $25,309 $32,578 −22% $14,284 +77% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $25,225 $25,225 $37,477 −33% $24,836 +2% —
501 SOFT TISSUE PROCEDURES WITH CC $25,062 $25,062 $39,619 −37% $37,975 −34% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $25,010 $25,010 $37,214 −33% $48,680 −49% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $25,009 $25,009 $37,213 −33% $30,275 −17% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $24,997 $24,997 $39,515 −37% $33,564 −26% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $24,940 $24,940 $39,422 −37% $31,909 −22% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $24,901 $24,901 $39,360 −37% $36,242 −31% —
199 PNEUMOTHORAX WITH MCC $24,795 $24,795 $36,952 −33% $31,491 −21% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $24,691 $24,691 $39,020 −37% $35,673 −31% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CCMCC $24,689 $24,689 $39,018 −37% $39,018 −37% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $24,677 $24,677 $38,998 −37% $29,558 −17% —
509 ARTHROSCOPY $24,677 $24,677 $38,998 −37% $25,994 −5% —
597 MALIGNANT BREAST DISORDERS WITH MCC $24,677 $24,677 $36,807 −33% $31,846 −23% —
504 FOOT PROCEDURES WITH CC $24,653 $24,653 $38,960 −37% $36,598 −33% —
505 FOOT PROCEDURES WITHOUT CCMCC $24,653 $24,653 $38,960 −37% $31,716 −22% —
582 MASTECTOMY FOR MALIGNANCY WITH CCMCC $24,601 $24,601 $38,876 −37% $34,264 −28% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $24,557 $24,557 $36,661 −33% $31,758 −23% —
180 RESPIRATORY NEOPLASMS WITH MCC $24,554 $24,554 $36,658 −33% $36,658 −33% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $24,430 $24,430 $36,506 −33% $30,814 −21% —
915 ALLERGIC REACTIONS WITH MCC $24,418 $24,418 $36,491 −33% $30,944 −21% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $24,393 $24,393 $38,541 −37% $32,839 −26% —
075 VIRAL MENINGITIS WITH CCMCC $24,205 $24,205 $36,230 −33% $29,853 −19% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $24,116 $24,116 $38,094 −37% $38,094 −37% —
551 MEDICAL BACK PROBLEMS WITH MCC $23,984 $23,984 $35,961 −33% $31,086 −23% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $23,911 $23,911 $37,764 −37% $43,266 −45% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $23,809 $23,809 $37,599 −37% $29,729 −20% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CCMCC $23,764 $23,764 $37,526 −37% $28,578 −17% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $23,750 $23,750 $35,675 −33% $29,409 −19% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $23,681 $23,681 $35,591 −33% $31,128 −24% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $23,633 $23,633 $35,532 −33% $30,058 −21% ≈114% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CCMCC $23,547 $23,547 $37,175 −37% $29,916 −21% —
571 SKIN DEBRIDEMENT WITH CC $23,542 $23,542 $37,169 −37% $34,901 −33% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $23,486 $23,486 $35,352 −34% $25,208 −7% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $23,483 $23,483 $35,349 −34% $33,607 −30% ≈106% of Medicare
116 INTRAOCULAR PROCEDURES WITH CCMCC $23,464 $23,464 $37,042 −37% $28,103 −17% —
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CCMCC $23,380 $23,380 $36,907 −37% $27,548 −15% —
334 RECTAL RESECTION WITHOUT CCMCC $23,326 $23,326 $36,820 −37% $32,213 −28% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $23,324 $23,324 $36,816 −37% $42,119 −45% —
643 ENDOCRINE DISORDERS WITH MCC $23,308 $23,308 $35,135 −34% $32,996 −29% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $23,291 $23,291 $35,113 −34% $32,689 −29% ≈111% of Medicare
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $23,222 $23,222 $36,651 −37% $44,117 −47% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CCMCC $23,183 $23,183 $36,589 −37% $25,197 −8% —
666 PROSTATECTOMY WITH CC $23,171 $23,171 $36,569 −37% $30,016 −23% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CCMCC $23,107 $23,107 $36,467 −37% $31,566 −27% —
801 SPLENIC PROCEDURES WITHOUT CCMCC $23,094 $23,094 $36,445 −37% $28,634 −19% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $23,090 $23,090 $34,867 −34% $28,967 −20% ≈115% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $23,066 $23,066 $34,839 −34% $28,134 −18% ≈139% of Medicare
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $23,048 $23,048 $34,817 −34% $30,910 −25% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $23,037 $23,037 $36,354 −37% $36,333 −37% —
157 DENTAL AND ORAL DISEASES WITH MCC $23,036 $23,036 $34,802 −34% $27,457 −16% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $22,882 $22,882 $34,613 −34% $24,465 −6% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CCMCC $22,872 $22,872 $36,087 −37% $27,168 −16% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $22,861 $22,861 $34,588 −34% $26,020 −12% —
913 TRAUMATIC INJURY WITH MCC $22,772 $22,772 $34,479 −34% $24,198 −6% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $22,762 $22,762 $34,467 −34% $25,731 −12% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $22,747 $22,747 $34,448 −34% $31,840 −29% ≈106% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $22,739 $22,739 $35,872 −37% $27,118 −16% —
038 EXTRACRANIAL PROCEDURES WITH CC $22,675 $22,675 $35,770 −37% $35,770 −37% —
606 MINOR SKIN DISORDERS WITH MCC $22,661 $22,661 $34,344 −34% $25,434 −11% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $22,560 $22,560 $35,584 −37% $35,584 −37% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CCMCC $22,458 $22,458 $35,419 −37% $33,984 −34% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CCMCC $22,430 $22,430 $35,375 −37% $35,375 −37% —
183 MAJOR CHEST TRAUMA WITH MCC $22,345 $22,345 $33,957 −34% $28,924 −23% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CCMCC $22,332 $22,332 $35,217 −37% $39,747 −44% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $22,247 $22,247 $35,080 −37% $33,490 −34% —
186 PLEURAL EFFUSION WITH MCC $22,244 $22,244 $33,834 −34% $32,468 −31% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $22,199 $22,199 $33,779 −34% $29,371 −24% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CCMCC $22,140 $22,140 $34,906 −37% $34,906 −37% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $22,096 $22,096 $33,653 −34% $32,936 −33% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $22,079 $22,079 $33,633 −34% $31,059 −29% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CCMCC $22,042 $22,042 $34,749 −37% $32,490 −32% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $22,005 $22,005 $34,689 −37% $41,380 −47% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CCMCC $21,846 $21,846 $34,434 −37% $34,434 −37% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $21,827 $21,827 $33,325 −35% $28,646 −24% —
813 COAGULATION DISORDERS $21,804 $21,804 $33,296 −35% $30,128 −28% —
669 TRANSURETHRAL PROCEDURES WITH CC $21,797 $21,797 $34,354 −37% $34,354 −37% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $21,780 $21,780 $33,267 −35% $24,036 −9% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CCMCC $21,773 $21,773 $34,316 −37% $25,484 −15% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $21,771 $21,771 $33,256 −35% $28,252 −23% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CCMCC $21,626 $21,626 $34,078 −37% $36,239 −40% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $21,570 $21,570 $33,987 −37% $24,879 −13% —
945 REHABILITATION WITH CCMCC $21,508 $21,508 $32,934 −35% $23,834 −10% —
533 FRACTURES OF FEMUR WITH MCC $21,486 $21,486 $32,907 −35% $25,945 −17% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CCMCC $21,388 $21,388 $33,694 −37% $33,694 −37% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CCMCC $21,376 $21,376 $33,674 −37% $30,972 −31% —
398 APPENDIX PROCEDURES WITH CC $21,325 $21,325 $33,592 −37% $39,107 −45% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CCMCC $21,279 $21,279 $33,519 −37% $24,229 −12% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $21,271 $21,271 $33,506 −37% $27,279 −22% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CCMCC $21,220 $21,220 $33,424 −37% $33,424 −37% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $21,205 $21,205 $33,399 −37% $33,792 −37% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CCMCC $21,198 $21,198 $33,388 −37% $35,528 −40% —
682 RENAL FAILURE WITH MCC $21,169 $21,169 $32,520 −35% $27,854 −24% ≈113% of Medicare
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $21,144 $21,144 $32,490 −35% $25,854 −18% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $21,131 $21,131 $32,473 −35% $29,484 −28% —
506 MAJOR THUMB OR JOINT PROCEDURES $21,131 $21,131 $33,279 −37% $28,983 −27% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CCMCC $21,043 $21,043 $33,137 −36% $33,137 −36% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $20,987 $20,987 $33,048 −36% $31,062 −32% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $20,946 $20,946 $32,248 −35% $28,140 −26% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CCMCC $20,902 $20,902 $32,911 −36% $32,911 −36% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $20,815 $20,815 $16,713 +25% $7,961 +161% —
865 VIRAL ILLNESS WITH MCC $20,811 $20,811 $32,083 −35% $26,088 −20% —
693 URINARY STONES WITH MCC $20,736 $20,736 $31,990 −35% $22,525 −8% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $20,729 $20,729 $31,982 −35% $28,780 −28% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CCMCC $20,722 $20,722 $32,620 −36% $25,152 −18% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $20,722 $20,722 $31,974 −35% $25,786 −20% —
602 CELLULITIS WITH MCC $20,719 $20,719 $31,970 −35% $29,347 −29% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $20,641 $20,641 $31,874 −35% $29,211 −29% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CCMCC $20,627 $20,627 $32,467 −36% $25,149 −18% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CCMCC $20,617 $20,617 $32,451 −36% $32,451 −36% —
637 DIABETES WITH MCC $20,541 $20,541 $31,753 −35% $28,819 −29% ≈116% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $20,522 $20,522 $31,730 −35% $24,941 −18% —
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $20,426 $20,426 $31,612 −35% $21,986 −7% —
713 TRANSURETHRAL PROSTATECTOMY WITH CCMCC $20,400 $20,400 $32,100 −36% $29,663 −31% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $20,343 $20,343 $31,511 −35% $22,525 −10% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CCMCC $20,306 $20,306 $31,950 −36% $25,243 −20% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CCMCC $20,223 $20,223 $31,816 −36% $31,816 −36% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CCMCC $20,221 $20,221 $31,812 −36% $31,812 −36% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $20,061 $20,061 $31,166 −36% $25,010 −20% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CCMCC $20,032 $20,032 $31,508 −36% $21,615 −7% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $19,977 $19,977 $31,063 −36% $23,734 −16% —
088 CONCUSSION WITH MCC $19,914 $19,914 $30,986 −36% $24,402 −18% —
885 PSYCHOSES $19,899 $19,899 $30,968 −36% $21,489 −7% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $19,892 $19,892 $30,959 −36% $29,757 −33% —
811 RED BLOOD CELL DISORDERS WITH MCC $19,861 $19,861 $30,922 −36% $27,934 −29% ≈112% of Medicare
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CCMCC $19,832 $19,832 $30,887 −36% $35,542 −44% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CCMCC $19,784 $19,784 $31,108 −36% $24,452 −19% —
137 MOUTH PROCEDURES WITH CCMCC $19,747 $19,747 $31,048 −36% $24,348 −19% —
502 SOFT TISSUE PROCEDURES WITHOUT CCMCC $19,728 $19,728 $31,017 −36% $30,006 −34% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CCMCC $19,674 $19,674 $30,693 −36% $25,666 −23% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $19,634 $19,634 $30,645 −36% $24,118 −19% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $19,622 $19,622 $30,846 −36% $24,561 −20% —
150 EPISTAXIS WITH MCC $19,521 $19,521 $30,507 −36% $21,133 −8% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CCMCC $19,403 $19,403 $30,493 −36% $29,050 −33% —
139 SALIVARY GLAND PROCEDURES $19,395 $19,395 $30,480 −36% $21,014 −8% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $19,359 $19,359 $30,308 −36% $20,980 −8% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CCMCC $19,356 $19,356 $30,418 −36% $30,418 −36% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $19,247 $19,247 $30,242 −36% $24,980 −23% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $19,148 $19,148 $30,083 −36% $29,374 −35% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CCMCC $19,132 $19,132 $30,056 −36% $28,527 −33% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $19,031 $19,031 $29,894 −36% $23,723 −20% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CCMCC $18,976 $18,976 $29,805 −36% $29,805 −36% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $18,940 $18,940 $29,747 −36% $30,358 −38% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $18,863 $18,863 $29,623 −36% $25,426 −26% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CCMCC $18,847 $18,847 $29,596 −36% $31,978 −41% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $18,801 $18,801 $29,523 −36% $23,350 −19% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $18,775 $18,775 $29,481 −36% $24,480 −23% ≈110% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $18,633 $18,633 $29,252 −36% $26,158 −29% ≈110% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CCMCC $18,632 $18,632 $29,250 −36% $34,887 −47% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $18,549 $18,549 $29,117 −36% $23,115 −20% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $18,472 $18,472 $28,993 −36% $23,956 −23% —
291 HEART FAILURE AND SHOCK WITH MCC $18,456 $18,456 $28,966 −36% $25,020 −26% ≈114% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $18,443 $18,443 $28,946 −36% $21,029 −12% —
540 OSTEOMYELITIS WITH CC $18,309 $18,309 $28,728 −36% $23,494 −22% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CCMCC $18,260 $18,260 $28,651 −36% $22,811 −20% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CCMCC $18,245 $18,245 $28,626 −36% $23,920 −24% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CCMCC $18,230 $18,230 $28,602 −36% $23,924 −24% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $18,225 $18,225 $28,593 −36% $24,316 −25% —
796 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH MCC $18,068 $18,068 $28,340 −36% $22,557 −20% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CCMCC $17,986 $17,986 $28,209 −36% $19,686 −9% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $17,986 $17,986 $28,209 −36% $22,275 −19% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CCMCC $17,953 $17,953 $28,156 −36% $28,156 −36% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CCMCC $17,934 $17,934 $28,125 −36% $25,623 −30% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $17,897 $17,897 $28,065 −36% $26,634 −33% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $17,875 $17,875 $28,029 −36% $19,894 −10% —
348 ANAL AND STOMAL PROCEDURES WITH CC $17,824 $17,824 $27,947 −36% $27,947 −36% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CCMCC $17,637 $17,637 $27,645 −36% $26,146 −33% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $17,634 $17,634 $27,641 −36% $19,354 −9% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $17,630 $17,630 $27,634 −36% $21,860 −19% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $17,543 $17,543 $27,494 −36% $22,032 −20% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CCMCC $17,542 $17,542 $27,492 −36% $27,492 −36% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $17,528 $17,528 $27,470 −36% $25,704 −32% ≈111% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CCMCC $17,452 $17,452 $27,348 −36% $20,147 −13% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CCMCC $17,437 $17,437 $27,323 −36% $27,321 −36% —
375 DIGESTIVE MALIGNANCY WITH CC $17,408 $17,408 $27,277 −36% $27,219 −36% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CCMCC $17,399 $17,399 $27,261 −36% $19,132 −9% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $17,338 $17,338 $27,163 −36% $26,322 −34% —
593 SKIN ULCERS WITH CC $17,326 $17,326 $27,143 −36% $20,470 −15% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CCMCC $17,276 $17,276 $27,063 −36% $23,588 −27% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CCMCC $17,205 $17,205 $26,948 −36% $23,297 −26% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $17,094 $17,094 $26,770 −36% $26,488 −35% —
549 SEPTIC ARTHRITIS WITH CC $17,083 $17,083 $26,753 −36% $20,938 −18% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CCMCC $16,995 $16,995 $26,611 −36% $27,369 −38% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $16,947 $16,947 $26,533 −36% $20,421 −17% —
887 OTHER MENTAL DISORDER DIAGNOSES $16,867 $16,867 $26,404 −36% $20,602 −18% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CCMCC $16,804 $16,804 $26,302 −36% $20,842 −19% —
304 HYPERTENSION WITH MCC $16,666 $16,666 $26,080 −36% $24,185 −31% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $16,604 $16,604 $25,980 −36% $22,982 −28% ≈116% of Medicare
302 ATHEROSCLEROSIS WITH MCC $16,508 $16,508 $25,825 −36% $20,844 −21% —
121 ACUTE MAJOR EYE INFECTIONS WITH CCMCC $16,507 $16,507 $25,822 −36% $18,291 −10% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $16,505 $16,505 $25,820 −36% $21,062 −22% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CCMCC $16,474 $16,474 $25,769 −36% $22,532 −27% —
102 HEADACHES WITH MCC $16,456 $16,456 $25,740 −36% $22,544 −27% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $16,431 $16,431 $25,700 −36% $24,202 −32% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CCMCC $16,401 $16,401 $25,652 −36% $25,307 −35% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $16,339 $16,339 $25,552 −36% $18,133 −10% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CCMCC $16,238 $16,238 $25,390 −36% $25,390 −36% —
572 SKIN DEBRIDEMENT WITHOUT CCMCC $16,220 $16,220 $25,361 −36% $24,432 −34% —
039 EXTRACRANIAL PROCEDURES WITHOUT CCMCC $16,162 $16,162 $25,267 −36% $25,267 −36% —
152 OTITIS MEDIA AND URI WITH MCC $16,116 $16,116 $25,192 −36% $19,795 −19% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $16,019 $16,019 $25,037 −36% $20,741 −23% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $16,018 $16,018 $25,034 −36% $24,017 −33% —
399 APPENDIX PROCEDURES WITHOUT CCMCC $15,964 $15,964 $24,948 −36% $30,314 −47% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $15,953 $15,953 $24,930 −36% $24,190 −34% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $15,952 $15,952 $24,928 −36% $19,317 −17% —
946 REHABILITATION WITHOUT CCMCC $15,864 $15,864 $24,786 −36% $17,685 −10% —
181 RESPIRATORY NEOPLASMS WITH CC $15,778 $15,778 $24,648 −36% $22,431 −30% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $15,776 $15,776 $24,644 −36% $18,459 −15% —
200 PNEUMOTHORAX WITH CC $15,740 $15,740 $24,586 −36% $20,573 −23% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CCMCC $15,714 $15,714 $24,544 −36% $24,544 −36% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CCMCC $15,672 $15,672 $24,477 −36% $25,162 −38% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CCMCC $15,649 $15,649 $24,439 −36% $17,483 −10% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION ANDOR D&C $15,586 $15,586 $24,337 −36% $17,103 −9% —
672 URETHRAL PROCEDURES WITHOUT CCMCC $15,560 $15,560 $24,295 −36% $17,398 −11% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $15,513 $15,513 $24,220 −36% $19,868 −22% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $15,495 $15,495 $24,191 −36% $31,190 −50% —
381 COMPLICATED PEPTIC ULCER WITH CC $15,487 $15,487 $24,177 −36% $24,177 −36% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $15,423 $15,423 $24,075 −36% $21,806 −29% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $15,403 $15,403 $24,042 −36% $22,560 −32% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $15,376 $15,376 $24,000 −36% $17,226 −11% —
664 MINOR BLADDER PROCEDURES WITHOUT CCMCC $15,359 $15,359 $23,971 −36% $18,126 −15% —
949 AFTERCARE WITH CCMCC $15,348 $15,348 $23,953 −36% $23,953 −36% —
598 MALIGNANT BREAST DISORDERS WITH CC $15,346 $15,346 $23,951 −36% $19,073 −20% —
117 INTRAOCULAR PROCEDURES WITHOUT CCMCC $15,342 $15,342 $23,944 −36% $17,193 −11% —
089 CONCUSSION WITH CC $15,253 $15,253 $23,800 −36% $18,293 −17% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $15,232 $15,232 $23,767 −36% $19,579 −22% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $15,221 $15,221 $23,749 −36% $23,749 −36% —
712 TESTES PROCEDURES WITHOUT CCMCC $15,218 $15,218 $23,745 −36% $18,898 −19% —
184 MAJOR CHEST TRAUMA WITH CC $15,198 $15,198 $23,711 −36% $20,842 −27% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $15,111 $15,111 $23,571 −36% $23,571 −36% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $15,098 $15,098 $23,551 −36% $23,496 −36% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $15,068 $15,068 $23,503 −36% $24,136 −38% ≈118% of Medicare
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $15,002 $15,002 $23,396 −36% $23,396 −36% ≈110% of Medicare
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $14,985 $14,985 $23,369 −36% $18,478 −19% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CCMCC $14,974 $14,974 $23,352 −36% $17,550 −15% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $14,950 $14,950 $23,312 −36% $22,231 −33% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $14,844 $14,844 $23,141 −36% $23,141 −36% ≈116% of Medicare
644 ENDOCRINE DISORDERS WITH CC $14,720 $14,720 $22,941 −36% $22,941 −36% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $14,687 $14,687 $22,888 −36% $22,781 −36% ≈113% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $14,663 $14,663 $22,850 −36% $22,850 −36% —
667 PROSTATECTOMY WITHOUT CCMCC $14,643 $14,643 $22,817 −36% $16,703 −12% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CCMCC $14,626 $14,626 $22,790 −36% $24,022 −39% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CCMCC $14,601 $14,601 $22,750 −36% $16,495 −11% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $14,534 $14,534 $22,641 −36% $20,732 −30% ≈109% of Medicare
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $14,534 $14,534 $22,641 −36% $16,571 −12% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $14,531 $14,531 $22,637 −36% $21,545 −33% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CCMCC $14,530 $14,530 $22,635 −36% $20,080 −28% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $14,526 $14,526 $22,628 −36% $19,091 −24% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $14,502 $14,502 $22,590 −36% $22,713 −36% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $14,493 $14,493 $22,575 −36% $23,469 −38% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $14,482 $14,482 $22,557 −36% $18,017 −20% —
920 COMPLICATIONS OF TREATMENT WITH CC $14,479 $14,479 $22,552 −36% $21,181 −32% —
187 PLEURAL EFFUSION WITH CC $14,315 $14,315 $22,288 −36% $21,467 −33% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CCMCC $14,303 $14,303 $22,268 −36% $17,078 −16% —
697 URETHRAL STRICTURE $14,285 $14,285 $22,239 −36% $17,705 −19% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $14,259 $14,259 $22,197 −36% $20,007 −29% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $14,232 $14,232 $22,155 −36% $15,370 −7% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $14,231 $14,231 $22,153 −36% $17,434 −18% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $14,157 $14,157 $22,033 −36% $20,968 −32% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $14,151 $14,151 $22,024 −36% $22,024 −36% ≈117% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $14,122 $14,122 $21,977 −36% $20,106 −30% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $14,066 $14,066 $21,886 −36% $21,886 −36% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CCMCC $14,062 $14,062 $21,880 −36% $18,282 −23% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CCMCC $13,960 $13,960 $21,716 −36% $15,890 −12% —
797 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITH CC $13,822 $13,822 $21,494 −36% $19,001 −27% —
798 VAGINAL DELIVERY WITH STERILIZATION ANDOR D&C WITHOUT CCMCC $13,822 $13,822 $21,494 −36% $18,238 −24% —
202 BRONCHITIS AND ASTHMA WITH CCMCC $13,802 $13,802 $21,460 −36% $17,273 −20% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $13,795 $13,795 $21,449 −36% $21,449 −36% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $13,762 $13,762 $21,396 −36% $21,213 −35% ≈123% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $13,741 $13,741 $21,363 −36% $20,777 −34% —
882 NEUROSES EXCEPT DEPRESSIVE $13,737 $13,737 $21,356 −36% $15,680 −12% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $13,690 $13,690 $21,280 −36% $15,636 −12% —
600 NON-MALIGNANT BREAST DISORDERS WITH CCMCC $13,663 $13,663 $21,236 −36% $16,418 −17% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CCMCC $13,656 $13,656 $21,225 −36% $18,191 −25% —
670 TRANSURETHRAL PROCEDURES WITHOUT CCMCC $13,650 $13,650 $21,216 −36% $20,371 −33% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CCMCC $13,643 $13,643 $21,205 −36% $19,326 −29% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $13,641 $13,641 $21,201 −36% $15,589 −12% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CCMCC $13,596 $13,596 $21,129 −36% $18,428 −26% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $13,452 $13,452 $20,896 −36% $18,918 −29% ≈116% of Medicare
158 DENTAL AND ORAL DISEASES WITH CC $13,442 $13,442 $20,881 −36% $17,700 −24% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CCMCC $13,430 $13,430 $20,861 −36% $17,108 −21% —
779 ABORTION WITHOUT D&C $13,362 $13,362 $20,752 −36% $15,327 −13% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $13,346 $13,346 $20,725 −36% $16,642 −20% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $13,247 $13,247 $20,566 −36% $18,608 −29% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $13,210 $13,210 $20,506 −36% $19,287 −32% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $13,199 $13,199 $20,488 −36% $20,488 −36% ≈108% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $13,184 $13,184 $20,463 −36% $20,463 −36% —
101 SEIZURES WITHOUT MCC $13,182 $13,182 $20,461 −36% $19,954 −34% ≈116% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CCMCC $13,178 $13,178 $20,455 −36% $20,309 −35% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CCMCC $13,145 $13,145 $20,401 −36% $16,352 −20% —
638 DIABETES WITH CC $13,120 $13,120 $20,361 −36% $18,821 −30% ≈118% of Medicare
076 VIRAL MENINGITIS WITHOUT CCMCC $13,116 $13,116 $20,355 −36% $15,474 −15% —
914 TRAUMATIC INJURY WITHOUT MCC $13,109 $13,109 $20,344 −36% $15,593 −16% —
881 DEPRESSIVE NEUROSES $13,077 $13,077 $20,293 −36% $15,058 −13% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CCMCC $13,057 $13,057 $20,259 −36% $17,585 −26% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $12,963 $12,963 $20,108 −36% $17,731 −27% ≈113% of Medicare
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $12,949 $12,949 $20,086 −36% $15,077 −14% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CCMCC $12,948 $12,948 $20,084 −36% $20,084 −36% —
864 FEVER AND INFLAMMATORY CONDITIONS $12,856 $12,856 $19,935 −36% $17,412 −26% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $12,798 $12,798 $19,842 −36% $18,803 −32% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CCMCC $12,779 $12,779 $19,811 −35% $21,261 −40% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CCMCC $12,772 $12,772 $19,914 −36% $15,764 −19% —
683 RENAL FAILURE WITH CC $12,731 $12,731 $19,733 −35% $18,620 −32% ≈114% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $12,674 $12,674 $19,642 −35% $16,391 −23% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $12,671 $12,671 $19,638 −35% $15,045 −16% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CCMCC $12,663 $12,663 $19,624 −35% $15,869 −20% —
376 DIGESTIVE MALIGNANCY WITHOUT CCMCC $12,649 $12,649 $19,602 −35% $15,608 −19% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $12,638 $12,638 $19,584 −35% $16,049 −21% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $12,629 $12,629 $19,569 −35% $19,569 −35% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CCMCC $12,620 $12,620 $19,854 −36% $19,854 −36% —
603 CELLULITIS WITHOUT MCC $12,619 $12,619 $19,553 −35% $18,530 −32% ≈117% of Medicare
541 OSTEOMYELITIS WITHOUT CCMCC $12,538 $12,538 $19,422 −35% $14,549 −14% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CCMCC $12,519 $12,519 $19,815 −37% $19,815 −37% —
312 SYNCOPE AND COLLAPSE $12,488 $12,488 $19,342 −35% $19,342 −35% ≈117% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $12,465 $12,465 $19,305 −35% $19,305 −35% —
607 MINOR SKIN DISORDERS WITHOUT MCC $12,391 $12,391 $19,185 −35% $15,284 −19% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $12,385 $12,385 $19,176 −35% $17,367 −29% —
550 SEPTIC ARTHRITIS WITHOUT CCMCC $12,362 $12,362 $19,138 −35% $16,156 −23% —
292 HEART FAILURE AND SHOCK WITH CC $12,349 $12,349 $19,118 −35% $16,212 −24% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $12,336 $12,336 $19,096 −35% $19,096 −35% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $12,320 $12,320 $19,072 −35% $18,278 −33% —
090 CONCUSSION WITHOUT CCMCC $12,296 $12,296 $19,032 −35% $14,873 −17% —
599 MALIGNANT BREAST DISORDERS WITHOUT CCMCC $12,263 $12,263 $18,978 −35% $14,290 −14% —
103 HEADACHES WITHOUT MCC $12,198 $12,198 $18,874 −35% $20,111 −39% —
594 SKIN ULCERS WITHOUT CCMCC $12,177 $12,177 $18,841 −35% $14,209 −14% —
182 RESPIRATORY NEOPLASMS WITHOUT CCMCC $12,023 $12,023 $18,592 −35% $14,064 −15% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CCMCC $12,013 $12,013 $18,577 −35% $14,055 −15% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $11,983 $11,983 $18,528 −35% $18,253 −34% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $11,861 $11,861 $18,330 −35% $15,876 −25% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $11,782 $11,782 $18,204 −35% $18,204 −35% ≈116% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CCMCC $11,767 $11,767 $18,179 −35% $13,822 −15% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CCMCC $11,749 $11,749 $18,150 −35% $18,150 −35% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $11,742 $11,742 $18,139 −35% $16,837 −30% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $11,734 $11,734 $18,126 −35% $17,715 −34% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CCMCC $11,734 $11,734 $18,126 −35% $17,928 −35% —
176 PULMONARY EMBOLISM WITHOUT MCC $11,706 $11,706 $18,081 −35% $18,081 −35% —
534 FRACTURES OF FEMUR WITHOUT MCC $11,700 $11,700 $18,070 −35% $17,195 −32% —
138 MOUTH PROCEDURES WITHOUT CCMCC $11,693 $11,693 $19,492 −40% $17,383 −33% —
204 RESPIRATORY SIGNS AND SYMPTOMS $11,658 $11,658 $18,004 −35% $16,866 −31% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $11,657 $11,657 $18,002 −35% $18,002 −35% —
123 NEUROLOGICAL EYE DISORDERS $11,551 $11,551 $17,831 −35% $17,831 −35% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $11,543 $11,543 $17,817 −35% $17,466 −34% ≈120% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $11,529 $11,529 $17,795 −35% $17,388 −34% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CCMCC $11,516 $11,516 $17,775 −35% $13,586 −15% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $11,508 $11,508 $17,762 −35% $20,278 −43% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CCMCC $11,470 $11,470 $17,700 −35% $17,700 −35% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $11,431 $11,431 $17,638 −35% $17,727 −36% —
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CCMCC $11,366 $11,366 $17,533 −35% $13,445 −15% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CCMCC $11,360 $11,360 $17,522 −35% $17,522 −35% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CCMCC $11,303 $11,303 $17,431 −35% $13,385 −16% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $11,251 $11,251 $17,347 −35% $16,745 −33% ≈122% of Medicare
694 URINARY STONES WITHOUT MCC $11,251 $11,251 $17,347 −35% $16,531 −32% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $11,236 $11,236 $17,322 −35% $17,322 −35% ≈126% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CCMCC $11,214 $11,214 $17,287 −35% $14,166 −21% —
185 MAJOR CHEST TRAUMA WITHOUT CCMCC $11,200 $11,200 $17,265 −35% $15,858 −29% —
151 EPISTAXIS WITHOUT MCC $10,929 $10,929 $16,827 −35% $13,032 −16% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CCMCC $10,897 $10,897 $16,776 −35% $16,776 −35% —
305 HYPERTENSION WITHOUT MCC $10,828 $10,828 $16,665 −35% $17,144 −37% ≈131% of Medicare
382 COMPLICATED PEPTIC ULCER WITHOUT CCMCC $10,809 $10,809 $16,634 −35% $16,634 −35% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CCMCC $10,792 $10,792 $16,607 −35% $14,337 −25% —
149 DYSEQUILIBRIUM $10,784 $10,784 $16,594 −35% $17,203 −37% ≈125% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $10,783 $10,783 $16,592 −35% $12,895 −16% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CCMCC $10,766 $10,766 $16,565 −35% $14,861 −28% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $10,741 $10,741 $16,525 −35% $13,892 −23% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $10,671 $10,671 $16,412 −35% $16,865 −37% ≈124% of Medicare
188 PLEURAL EFFUSION WITHOUT CCMCC $10,601 $10,601 $16,299 −35% $14,110 −25% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $10,524 $10,524 $16,175 −35% $12,650 −17% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CCMCC $10,480 $10,480 $16,104 −35% $16,104 −35% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CCMCC $10,476 $10,476 $16,097 −35% $18,623 −44% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CCMCC $10,463 $10,463 $16,077 −35% $12,593 −17% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $10,455 $10,455 $16,064 −35% $13,090 −20% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CCMCC $10,400 $10,400 $15,975 −35% $12,537 −17% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $10,316 $10,316 $15,839 −35% $12,381 −17% —
313 CHEST PAIN $10,315 $10,315 $15,837 −35% $15,962 −35% ≈116% of Medicare
153 OTITIS MEDIA AND URI WITHOUT MCC $10,291 $10,291 $15,799 −35% $14,473 −29% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $10,191 $10,191 $15,637 −35% $12,336 −17% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CCMCC $10,167 $10,167 $15,600 −35% $15,600 −35% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CCMCC $10,136 $10,136 $15,549 −35% $13,654 −26% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CCMCC $10,103 $10,103 $15,495 −35% $15,072 −33% —
203 BRONCHITIS AND ASTHMA WITHOUT CCMCC $10,083 $10,083 $15,464 −35% $12,279 −18% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CCMCC $10,082 $10,082 $15,462 −35% $12,405 −19% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CCMCC $10,050 $10,050 $15,411 −35% $13,303 −24% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $10,017 $10,017 $15,358 −35% $14,441 −31% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CCMCC $9,969 $9,969 $15,280 −35% $19,483 −49% —
921 COMPLICATIONS OF TREATMENT WITHOUT CCMCC $9,961 $9,961 $15,267 −35% $14,012 −29% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CCMCC $9,892 $9,892 $15,156 −35% $12,797 −23% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CCMCC $9,831 $9,831 $15,058 −35% $11,997 −18% —
201 PNEUMOTHORAX WITHOUT CCMCC $9,815 $9,815 $15,031 −35% $13,081 −25% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CCMCC $9,750 $9,750 $14,927 −35% $13,198 −26% —
303 ATHEROSCLEROSIS WITHOUT MCC $9,750 $9,750 $14,927 −35% $14,927 −35% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CCMCC $9,738 $9,738 $14,907 −35% $11,909 −18% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CCMCC $9,721 $9,721 $14,880 −35% $14,880 −35% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CCMCC $9,672 $9,672 $14,800 −35% $11,847 −18% —
916 ALLERGIC REACTIONS WITHOUT MCC $9,636 $9,636 $14,743 −35% $13,890 −31% —
159 DENTAL AND ORAL DISEASES WITHOUT CCMCC $9,574 $9,574 $14,643 −35% $13,368 −28% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CCMCC $9,571 $9,571 $14,638 −35% $13,485 −29% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CCMCC $9,403 $9,403 $14,368 −35% $14,368 −35% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CCMCC $9,304 $9,304 $14,208 −35% $14,208 −35% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CCMCC $9,267 $9,267 $14,148 −34% $12,044 −23% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CCMCC $9,259 $9,259 $14,134 −34% $14,134 −34% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $9,255 $9,255 $14,128 −34% $14,128 −34% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CCMCC $9,220 $9,220 $14,072 −34% $11,421 −19% —
639 DIABETES WITHOUT CCMCC $9,120 $9,120 $13,910 −34% $13,910 −34% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $9,085 $9,085 $13,855 −34% $12,013 −24% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CCMCC $9,066 $9,066 $13,824 −34% $13,824 −34% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CCMCC $8,961 $8,961 $13,683 −35% $15,070 −41% —
684 RENAL FAILURE WITHOUT CCMCC $8,855 $8,855 $13,642 −35% $13,623 −35% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CCMCC $8,849 $8,849 $13,639 −35% $11,071 −20% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CCMCC $8,747 $8,747 $13,599 −36% $10,975 −20% —
950 AFTERCARE WITHOUT CCMCC $8,562 $8,562 $13,527 −37% $13,527 −37% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $8,299 $8,299 $13,425 −38% $9,385 −12% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CCMCC $8,222 $8,222 $13,395 −39% $10,039 −18% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CCMCC $8,196 $8,196 $13,384 −39% $13,384 −39% —
293 HEART FAILURE AND SHOCK WITHOUT CCMCC $8,047 $8,047 $13,326 −40% $11,955 −33% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CCMCC $8,027 $8,027 $13,318 −40% $13,318 −40% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CCMCC $7,650 $7,650 $11,539 −34% $9,076 −16% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CCMCC $6,574 $6,574 $12,751 −48% $8,927 −26% —
795 NORMAL NEWBORN $3,244 $3,244 $6,880 −53% $4,530 −28% —

Procedures with negotiated rates only

These 2 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
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $59,001 – $119,824 · median $89,413 2 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $41,723 – $66,086 · median $53,904 2 plans
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