Community First Medical Center — Pricing
237 procedures published in this hospital's Machine-Readable File (MRF) — 232 with a comparable price, 5 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.
Procedures published 237
Lowest published price $9,337
Average published price $73,137
Highest published price $596,447
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.
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Find your insurer's rate
Choose your insurance company to add its median negotiated rate for each procedure as a column in the table below.
Rates come from the hospital's own published price file and are medians across that insurer's plans. Your specific plan, network tier, and benefit design can differ — confirm with your insurer.
Showing all 237 procedures
Published charges
Showing all 232 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.
| DRG | Description | Published price | Cash price | vs. IL median | vs. National median | vs Medicare | ||
|---|---|---|---|---|---|---|---|---|
| 457 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC | $596,447 | $298,224 | $225,488 | +165% | $107,355 | +456% | — |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $458,380 | $229,190 | $57,915 | +691% | $43,266 | +959% | — |
| 615 | ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC | $378,152 | $189,076 | $51,451 | +635% | $31,812 | +1089% | — |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $311,099 | $155,550 | $30,985 | +904% | $23,350 | +1232% | — |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $297,240 | $148,620 | $73,783 | +303% | $46,591 | +538% | — |
| 098 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC | $284,805 | $142,403 | $67,392 | +323% | $37,902 | +651% | — |
| 652 | KIDNEY TRANSPLANT | $239,056 | $119,528 | $258,233 | −7% | $54,720 | +337% | — |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $214,320 | $107,160 | $44,090 | +386% | $30,314 | +607% | — |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $207,008 | $103,504 | $31,597 | +555% | $23,734 | +772% | — |
| 458 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC | $194,395 | $97,198 | $136,226 | +43% | $83,441 | +133% | — |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $185,664 | $92,832 | $102,466 | +81% | $62,961 | +195% | — |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $176,713 | $88,357 | $41,092 | +330% | $27,934 | +533% | — |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $161,948 | $80,974 | $21,281 | +661% | $15,070 | +975% | — |
| 939 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC | $160,242 | $80,121 | $64,644 | +148% | $51,142 | +213% | — |
| 976 | HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC | $159,279 | $79,639 | $31,955 | +398% | $16,212 | +882% | — |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $156,143 | $78,072 | $33,008 | +373% | $20,968 | +645% | — |
| 746 | VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC | $149,111 | $74,555 | $59,433 | +151% | $29,916 | +398% | — |
| 714 | TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC | $144,423 | $72,212 | $31,755 | +355% | $17,108 | +744% | — |
| 881 | DEPRESSIVE NEUROSES | $143,874 | $71,937 | $15,521 | +827% | $15,058 | +855% | — |
| 734 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC | $134,053 | $67,027 | $85,111 | +58% | $35,686 | +276% | — |
| 184 | MAJOR CHEST TRAUMA WITH CC | $133,144 | $66,572 | $30,443 | +337% | $20,842 | +539% | — |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $131,593 | $65,797 | $77,074 | +71% | $36,242 | +263% | — |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $125,634 | $62,817 | $18,873 | +566% | $16,049 | +683% | — |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $123,387 | $61,694 | $39,722 | +211% | $32,689 | +277% | — |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $118,836 | $59,418 | $99,411 | +20% | $29,633 | +301% | — |
| 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | $118,560 | $59,280 | $85,758 | +38% | $43,080 | +175% | — |
| 571 | SKIN DEBRIDEMENT WITH CC | $116,912 | $58,456 | $45,052 | +160% | $34,901 | +235% | — |
| 666 | PROSTATECTOMY WITH CC | $115,234 | $57,617 | $44,512 | +159% | $30,016 | +284% | — |
| 673 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | $115,229 | $57,614 | $88,076 | +31% | $72,945 | +58% | — |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $114,689 | $57,344 | $20,935 | +448% | $14,166 | +710% | — |
| 592 | SKIN ULCERS WITH MCC | $113,882 | $56,941 | $34,370 | +231% | $32,662 | +249% | — |
| 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | $113,270 | $56,635 | $103,580 | +9% | $31,566 | +259% | — |
| 822 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC | $112,143 | $56,072 | $48,043 | +133% | $25,390 | +342% | — |
| 597 | MALIGNANT BREAST DISORDERS WITH MCC | $111,562 | $55,781 | $52,249 | +114% | $31,846 | +250% | — |
| 123 | NEUROLOGICAL EYE DISORDERS | $111,357 | $55,679 | $30,181 | +269% | $17,831 | +525% | — |
| 154 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC | $107,028 | $53,514 | $35,131 | +205% | $24,465 | +337% | — |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $106,756 | $53,378 | $33,438 | +219% | $20,371 | +424% | — |
| 151 | EPISTAXIS WITHOUT MCC | $102,366 | $51,183 | $27,028 | +279% | $13,032 | +686% | — |
| 380 | COMPLICATED PEPTIC ULCER WITH MCC | $100,593 | $50,296 | $58,065 | +73% | $36,641 | +175% | — |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $99,257 | $49,629 | $20,244 | +390% | $11,633 | +753% | — |
| 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | $99,130 | $49,565 | $64,209 | +54% | $32,911 | +201% | — |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $97,585 | $48,793 | $19,805 | +393% | $13,318 | +633% | — |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $96,671 | $48,335 | $39,202 | +147% | $21,062 | +359% | — |
| 072 | OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $95,317 | $47,659 | $30,079 | +217% | $16,654 | +472% | — |
| 642 | INBORN AND OTHER DISORDERS OF METABOLISM | $94,797 | $47,398 | $32,706 | +190% | $20,727 | +357% | — |
| 357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC | $94,656 | $47,328 | $67,596 | +40% | $48,682 | +94% | — |
| 157 | DENTAL AND ORAL DISEASES WITH MCC | $91,089 | $45,544 | $34,196 | +166% | $27,457 | +232% | — |
| 423 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC | $90,982 | $45,491 | $110,629 | −18% | $72,011 | +26% | — |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $89,509 | $44,755 | $30,759 | +191% | $27,118 | +230% | — |
| 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $89,331 | $44,665 | $11,086 | +706% | $10,975 | +714% | — |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES | $86,244 | $43,122 | $411,402 | −79% | $245,241 | −65% | — |
| 598 | MALIGNANT BREAST DISORDERS WITH CC | $84,541 | $42,270 | $38,327 | +121% | $19,073 | +343% | — |
| 799 | SPLENIC PROCEDURES WITH MCC | $84,445 | $42,222 | $88,461 | −5% | $78,821 | +7% | — |
| 949 | AFTERCARE WITH CC/MCC | $84,137 | $42,068 | $40,709 | +107% | $23,953 | +251% | — |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $84,062 | $42,031 | $27,509 | +206% | $17,700 | +375% | — |
| 136 | SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC | $83,330 | $41,665 | $44,059 | +89% | $15,890 | +424% | — |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $82,677 | $41,338 | $17,402 | +375% | $14,473 | +471% | — |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $81,716 | $40,858 | $40,582 | +101% | $24,177 | +238% | — |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $80,884 | $40,442 | $36,570 | +121% | $25,243 | +220% | — |
| 434 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $80,798 | $40,399 | $20,241 | +299% | $12,405 | +551% | — |
| 800 | SPLENIC PROCEDURES WITH CC | $79,513 | $39,757 | $71,712 | +11% | $49,184 | +62% | — |
| 538 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC | $79,143 | $39,572 | $21,885 | +262% | $11,909 | +565% | — |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $77,744 | $38,872 | $27,853 | +179% | $19,305 | +303% | — |
| 479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $76,345 | $38,173 | $51,392 | +49% | $31,909 | +139% | — |
| 895 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | $76,039 | $38,020 | $29,714 | +156% | $21,986 | +246% | — |
| 406 | PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC | $75,711 | $37,856 | $110,923 | −32% | $58,043 | +30% | — |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $74,820 | $37,410 | $28,539 | +162% | $22,781 | +228% | — |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $74,017 | $37,008 | $82,120 | −10% | $34,089 | +117% | — |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $73,731 | $36,865 | $17,733 | +316% | $13,824 | +433% | — |
| 412 | CHOLECYSTECTOMY WITH C.D.E. WITH CC | $72,383 | $36,192 | $90,255 | −20% | $37,654 | +92% | — |
| 489 | KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $72,118 | $36,059 | $38,480 | +87% | $27,492 | +162% | — |
| 414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC | $71,615 | $35,807 | $96,842 | −26% | $68,399 | +5% | — |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $71,571 | $35,786 | $204,360 | −65% | $138,008 | −48% | — |
| 739 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC | $71,159 | $35,580 | $111,032 | −36% | $57,521 | +24% | — |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $70,928 | $35,464 | $70,361 | +1% | $44,553 | +59% | — |
| 503 | FOOT PROCEDURES WITH MCC | $69,722 | $34,861 | $91,758 | −24% | $43,901 | +59% | — |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $69,668 | $34,834 | $70,563 | −1% | $52,313 | +33% | — |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC | $69,539 | $34,769 | $68,659 | +1% | $54,313 | +28% | — |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $69,520 | $34,760 | $32,226 | +116% | $25,474 | +173% | — |
| 695 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC | $68,830 | $34,415 | $37,348 | +84% | $20,741 | +232% | — |
| 099 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC | $68,367 | $34,183 | $40,969 | +67% | $25,666 | +166% | — |
| 487 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $67,423 | $33,712 | $36,087 | +87% | $33,490 | +101% | — |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $66,961 | $33,481 | $72,598 | −8% | $58,832 | +14% | — |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $66,821 | $33,410 | $24,212 | +176% | $23,571 | +183% | — |
| 946 | REHABILITATION WITHOUT CC/MCC | $66,668 | $33,334 | $23,652 | +182% | $17,685 | +277% | — |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $66,375 | $33,188 | $59,785 | +11% | $45,963 | +44% | — |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $66,317 | $33,158 | $51,179 | +30% | $34,887 | +90% | — |
| 709 | PENIS PROCEDURES WITH CC/MCC | $66,002 | $33,001 | $74,876 | −12% | $34,535 | +91% | — |
| 321 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES | $65,444 | $32,722 | $99,374 | −34% | $74,274 | −12% | — |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $65,255 | $32,628 | $16,306 | +300% | $12,013 | +443% | — |
| 602 | CELLULITIS WITH MCC | $65,232 | $32,616 | $36,275 | +80% | $29,347 | +122% | — |
| 667 | PROSTATECTOMY WITHOUT CC/MCC | $65,047 | $32,523 | $45,563 | +43% | $16,703 | +289% | — |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $63,981 | $31,990 | $25,119 | +155% | $17,388 | +268% | — |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $63,975 | $31,988 | $43,743 | +46% | $30,006 | +113% | — |
| 075 | VIRAL MENINGITIS WITH CC/MCC | $63,948 | $31,974 | $39,565 | +62% | $29,853 | +114% | — |
| 600 | NON-MALIGNANT BREAST DISORDERS WITH CC/MCC | $63,523 | $31,762 | $20,784 | +206% | $16,418 | +287% | — |
| 495 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC | $62,954 | $31,477 | $91,241 | −31% | $56,964 | +11% | — |
| 603 | CELLULITIS WITHOUT MCC | $62,839 | $31,419 | $22,842 | +175% | $18,530 | +239% | — |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $62,419 | $31,210 | $37,818 | +65% | $33,424 | +87% | — |
| 885 | PSYCHOSES | $62,398 | $31,199 | $22,187 | +181% | $21,489 | +190% | — |
| 540 | OSTEOMYELITIS WITH CC | $62,173 | $31,087 | $31,469 | +98% | $23,494 | +165% | — |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $61,769 | $30,885 | $29,002 | +113% | $23,749 | +160% | — |
| 409 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC | $61,191 | $30,595 | $74,515 | −18% | $46,066 | +33% | — |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $61,116 | $30,558 | $25,186 | +143% | $14,128 | +333% | — |
| 599 | MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $60,337 | $30,168 | $8,614 | +600% | $14,290 | +322% | — |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $60,118 | $30,059 | $19,787 | +204% | $16,571 | +263% | — |
| 506 | MAJOR THUMB OR JOINT PROCEDURES | $60,091 | $30,046 | $41,258 | +46% | $28,983 | +107% | — |
| 124 | OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT | $60,042 | $30,021 | $37,445 | +60% | $21,029 | +186% | — |
| 137 | MOUTH PROCEDURES WITH CC/MCC | $58,918 | $29,459 | $38,624 | +53% | $24,348 | +142% | — |
| 928 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC | $58,597 | $29,298 | $89,353 | −34% | $89,353 | −34% | — |
| 779 | ABORTION WITHOUT D&C | $57,799 | $28,899 | $15,327 | +277% | $15,327 | +277% | — |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $57,336 | $28,668 | $89,321 | −36% | $70,540 | −19% | — |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $57,185 | $28,593 | $38,960 | +47% | $26,020 | +120% | — |
| 504 | FOOT PROCEDURES WITH CC | $57,119 | $28,559 | $57,176 | −0% | $36,598 | +56% | — |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $57,077 | $28,538 | $48,869 | +17% | $27,369 | +109% | — |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $56,804 | $28,402 | $22,382 | +154% | $18,002 | +216% | — |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $56,749 | $28,374 | $26,814 | +112% | $19,326 | +194% | — |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $56,231 | $28,116 | $70,552 | −20% | $63,984 | −12% | — |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $56,126 | $28,063 | $26,804 | +109% | $16,719 | +236% | — |
| 115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $55,977 | $27,989 | $53,313 | +5% | $24,879 | +125% | — |
| 935 | NON-EXTENSIVE BURNS | $55,357 | $27,679 | $20,254 | +173% | $29,458 | +88% | — |
| 594 | SKIN ULCERS WITHOUT CC/MCC | $55,298 | $27,649 | $15,665 | +253% | $14,209 | +289% | — |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $54,751 | $27,375 | $40,966 | +34% | $28,134 | +95% | — |
| 876 | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS | $54,106 | $27,053 | $75,273 | −28% | $54,196 | −0% | — |
| 512 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC | $53,729 | $26,864 | $42,407 | +27% | $35,692 | +51% | — |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $53,456 | $26,728 | $20,801 | +157% | $15,045 | +255% | — |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $53,208 | $26,604 | $57,203 | −7% | $49,197 | +8% | — |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $52,993 | $26,496 | $59,012 | −10% | $49,631 | +7% | — |
| 152 | OTITIS MEDIA AND URI WITH MCC | $52,962 | $26,481 | $32,070 | +65% | $19,795 | +168% | — |
| 076 | VIRAL MENINGITIS WITHOUT CC/MCC | $52,588 | $26,294 | $26,099 | +101% | $15,474 | +240% | — |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $51,951 | $25,976 | $35,797 | +45% | $27,244 | +91% | — |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $51,873 | $25,936 | $34,070 | +52% | $25,208 | +106% | — |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $51,389 | $25,694 | $52,481 | −2% | $30,974 | +66% | — |
| 619 | O.R. PROCEDURES FOR OBESITY WITH MCC | $50,855 | $25,428 | $53,431 | −5% | $44,973 | +13% | — |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $50,493 | $25,246 | $41,862 | +21% | $28,140 | +79% | — |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $50,426 | $25,213 | $20,662 | +144% | $14,284 | +253% | — |
| 687 | KIDNEY AND URINARY TRACT NEOPLASMS WITH CC | $50,393 | $25,197 | $28,183 | +79% | $18,478 | +173% | — |
| 507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC | $49,716 | $24,858 | $66,698 | −25% | $36,202 | +37% | — |
| 014 | ALLOGENEIC BONE MARROW TRANSPLANT | $49,546 | $24,773 | $337,167 | −85% | $182,314 | −73% | — |
| 606 | MINOR SKIN DISORDERS WITH MCC | $49,537 | $24,769 | $55,489 | −11% | $25,434 | +95% | — |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $49,399 | $24,699 | $37,347 | +32% | $29,031 | +70% | — |
| 797 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC | $48,490 | $24,245 | $32,064 | +51% | $19,001 | +155% | — |
| 761 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC | $48,448 | $24,224 | $16,944 | +186% | $11,421 | +324% | — |
| 744 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC | $48,376 | $24,188 | $64,986 | −26% | $33,050 | +46% | — |
| 582 | MASTECTOMY FOR MALIGNANCY WITH CC/MCC | $48,170 | $24,085 | $93,483 | −48% | $34,264 | +41% | — |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $48,029 | $24,015 | $43,673 | +10% | $24,432 | +97% | — |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $47,786 | $23,893 | $49,057 | −3% | $35,375 | +35% | — |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $47,712 | $23,856 | $7,478 | +538% | $7,961 | +499% | — |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $47,669 | $23,834 | $114,258 | −58% | $88,050 | −46% | — |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $47,342 | $23,671 | $19,013 | +149% | $20,084 | +136% | — |
| 570 | SKIN DEBRIDEMENT WITH MCC | $47,325 | $23,662 | $60,987 | −22% | $52,435 | −10% | — |
| 987 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $46,442 | $23,221 | $61,607 | −25% | $65,383 | −29% | — |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $45,797 | $22,898 | $17,835 | +157% | $14,441 | +217% | — |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $45,757 | $22,878 | $24,051 | +90% | $14,880 | +207% | — |
| 668 | TRANSURETHRAL PROCEDURES WITH MCC | $44,763 | $22,381 | $57,575 | −22% | $47,277 | −5% | — |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $44,281 | $22,140 | $73,436 | −40% | $54,929 | −19% | — |
| 472 | CERVICAL SPINAL FUSION WITH CC | $44,265 | $22,133 | $87,420 | −49% | $59,537 | −26% | — |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $44,114 | $22,057 | $90,646 | −51% | $68,880 | −36% | — |
| 415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC | $44,096 | $22,048 | $64,724 | −32% | $43,398 | +2% | — |
| 424 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC | $42,839 | $21,420 | $81,694 | −48% | $39,253 | +9% | — |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $42,742 | $21,371 | $18,105 | +136% | $13,892 | +208% | — |
| 573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC | $42,638 | $21,319 | $105,573 | −60% | $98,912 | −57% | — |
| 934 | FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY | $42,599 | $21,299 | $31,020 | +37% | $31,044 | +37% | — |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $42,596 | $21,298 | $24,489 | +74% | $18,282 | +133% | — |
| 508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC | $42,512 | $21,256 | $43,022 | −1% | $22,811 | +86% | — |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $41,840 | $20,920 | $24,472 | +71% | $17,466 | +140% | ≈123% of Medicare |
| 410 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC | $41,572 | $20,786 | $76,875 | −46% | $34,434 | +21% | — |
| 795 | NORMAL NEWBORN | $41,188 | $20,594 | $5,293 | +678% | $4,530 | +809% | — |
| 907 | OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | $40,874 | $20,437 | $80,673 | −49% | $71,701 | −43% | — |
| 042 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC | $40,560 | $20,280 | $57,568 | −30% | $39,018 | +4% | — |
| 465 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $40,440 | $20,220 | $73,049 | −45% | $32,839 | +23% | — |
| 116 | INTRAOCULAR PROCEDURES WITH CC/MCC | $40,177 | $20,088 | $51,076 | −21% | $28,103 | +43% | — |
| 510 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC | $39,942 | $19,971 | $100,855 | −60% | $49,055 | −19% | — |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $39,782 | $19,891 | $21,132 | +88% | $17,727 | +124% | — |
| 349 | ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC | $39,569 | $19,784 | $30,520 | +30% | $19,854 | +99% | — |
| 950 | AFTERCARE WITHOUT CC/MCC | $39,134 | $19,567 | $13,555 | +189% | $13,527 | +189% | — |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $38,811 | $19,406 | $25,725 | +51% | $13,303 | +192% | — |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $38,285 | $19,143 | $24,009 | +59% | $19,091 | +101% | — |
| 539 | OSTEOMYELITIS WITH MCC | $37,628 | $18,814 | $51,245 | −27% | $33,746 | +12% | — |
| 683 | RENAL FAILURE WITH CC | $37,252 | $18,626 | $24,785 | +50% | $18,620 | +100% | ≈114% of Medicare |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $36,700 | $18,350 | $26,497 | +39% | $20,732 | +77% | — |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $36,553 | $18,276 | $37,843 | −3% | $30,275 | +21% | — |
| 420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC | $36,287 | $18,144 | $81,876 | −56% | $50,919 | −29% | — |
| 408 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC | $36,265 | $18,133 | $94,194 | −61% | $59,207 | −39% | — |
| 324 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC | $35,852 | $17,926 | $124,395 | −71% | $66,819 | −46% | — |
| 798 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC | $35,831 | $17,916 | $28,115 | +27% | $18,238 | +96% | — |
| 684 | RENAL FAILURE WITHOUT CC/MCC | $35,315 | $17,658 | $17,994 | +96% | $13,623 | +159% | — |
| 477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $35,270 | $17,635 | $67,631 | −48% | $62,269 | −43% | — |
| 566 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC | $34,833 | $17,416 | $14,351 | +143% | $14,337 | +143% | — |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $34,733 | $17,367 | $54,607 | −36% | $44,117 | −21% | — |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $34,645 | $17,323 | $100,833 | −66% | $86,390 | −60% | — |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $34,290 | $17,145 | $37,821 | −9% | $34,354 | −0% | — |
| 940 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC | $32,140 | $16,070 | $62,841 | −49% | $38,420 | −16% | — |
| 686 | KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC | $32,126 | $16,063 | $42,506 | −24% | $32,981 | −3% | — |
| 498 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC | $32,019 | $16,010 | $85,781 | −63% | $46,659 | −31% | — |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $31,884 | $15,942 | $46,334 | −31% | $37,950 | −16% | — |
| 748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $31,622 | $15,811 | $38,852 | −19% | $24,980 | +27% | — |
| 576 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC | $31,519 | $15,760 | $100,202 | −69% | $82,527 | −62% | — |
| 323 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC | $31,493 | $15,746 | $119,821 | −74% | $88,049 | −64% | — |
| 796 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC | $29,934 | $14,967 | $35,180 | −15% | $22,557 | +33% | — |
| 914 | TRAUMATIC INJURY WITHOUT MCC | $29,629 | $14,814 | $28,030 | +6% | $15,593 | +90% | — |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $29,415 | $14,708 | $27,967 | +5% | $12,537 | +135% | — |
| 541 | OSTEOMYELITIS WITHOUT CC/MCC | $29,000 | $14,500 | $19,079 | +52% | $14,549 | +99% | — |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $28,513 | $14,256 | $56,233 | −49% | $42,119 | −32% | — |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $28,332 | $14,166 | $26,510 | +7% | $24,836 | +14% | — |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $28,171 | $14,086 | $46,875 | −40% | $27,947 | +1% | — |
| 697 | URETHRAL STRICTURE | $27,883 | $13,941 | $30,131 | −7% | $17,705 | +57% | — |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $27,650 | $13,825 | $46,705 | −41% | $29,374 | −6% | — |
| 741 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC | $27,402 | $13,701 | $54,422 | −50% | $29,050 | −6% | — |
| 456 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC | $27,193 | $13,597 | $273,966 | −90% | $151,029 | −82% | — |
| 334 | RECTAL RESECTION WITHOUT CC/MCC | $27,182 | $13,591 | $35,824 | −24% | $32,213 | −16% | — |
| 461 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC | $27,027 | $13,514 | $93,471 | −71% | $108,472 | −75% | — |
| 397 | APPENDIX PROCEDURES WITH MCC | $26,783 | $13,391 | $61,356 | −56% | $52,319 | −49% | — |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $26,090 | $13,045 | $21,346 | +22% | $14,208 | +84% | — |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $25,377 | $12,688 | $117,872 | −78% | $88,341 | −71% | — |
| 694 | URINARY STONES WITHOUT MCC | $25,309 | $12,654 | $20,926 | +21% | $16,531 | +53% | — |
| 688 | KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC | $25,155 | $12,577 | $18,949 | +33% | $12,593 | +100% | — |
| 320 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC | $25,008 | $12,504 | $78,851 | −68% | $36,080 | −31% | — |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | $24,996 | $12,498 | $66,504 | −62% | $56,394 | −56% | — |
| 887 | OTHER MENTAL DISORDER DIAGNOSES | $24,111 | $12,056 | $35,038 | −31% | $20,602 | +17% | — |
| 411 | CHOLECYSTECTOMY WITH C.D.E. WITH MCC | $23,965 | $11,983 | $74,458 | −68% | $48,358 | −50% | — |
| 593 | SKIN ULCERS WITH CC | $23,878 | $11,939 | $28,533 | −16% | $20,470 | +17% | — |
| 729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC | $23,118 | $11,559 | $21,206 | +9% | $17,483 | +32% | — |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $22,395 | $11,197 | $34,165 | −34% | $30,058 | −25% | ≈115% of Medicare |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $21,348 | $10,674 | $23,756 | −10% | $17,322 | +23% | ≈113% of Medicare |
| 497 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC | $18,857 | $9,429 | $50,082 | −62% | $29,805 | −37% | — |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $15,798 | $7,899 | $20,451 | −23% | $16,642 | −5% | — |
| 421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC | $14,666 | $7,333 | $55,728 | −74% | $36,333 | −60% | — |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $12,628 | $6,314 | $25,678 | −51% | $18,918 | −33% | — |
| 114 | ORBITAL PROCEDURES WITHOUT CC/MCC | $11,059 | $5,530 | $28,289 | −61% | $19,598 | −44% | — |
| 735 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC | $10,848 | $5,424 | $29,971 | −64% | $23,297 | −53% | — |
| 173 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM | $9,337 | $4,669 | $97,106 | −90% | $53,555 | −83% | — |
Procedures with negotiated rates only
These 5 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.
| DRG | Description | Insurance rate range | Payers |
|---|---|---|---|
| 122 | ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC | — | 18 plans |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | — | 18 plans |
| 188 | PLEURAL EFFUSION WITHOUT CC/MCC | — | 18 plans |
| 307 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC | — | 18 plans |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $9,583 – $143,726 · median $10,665 | 18 plans |
No procedures match that keyword.