Decatur County Memorial Hospital — Pricing
206 procedures published in this hospital's Machine-Readable File (MRF) — 205 with a comparable price, 1 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.
Procedures published 206
Lowest published price $3,595
Average published price $27,661
Highest published price $143,321
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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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 206 procedures
Published charges
Showing all 205 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. IN median | vs. National median | ||
|---|---|---|---|---|---|---|---|
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES | $143,321 | $107,491 | $148,017 | −3% | $248,521 | −42% |
| 207 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | $129,707 | $97,280 | $93,613 | +39% | $116,058 | +12% |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $125,117 | $93,837 | $75,169 | +66% | $88,050 | +42% |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $108,592 | $81,444 | $72,364 | +50% | $65,653 | +65% |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $105,240 | $78,930 | $22,484 | +368% | $32,637 | +222% |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $83,725 | $62,794 | $64,448 | +30% | $50,607 | +65% |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $75,004 | $56,253 | $75,669 | −1% | $93,172 | −19% |
| 856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC | $72,859 | $54,644 | $49,576 | +47% | $76,001 | −4% |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $72,724 | $54,543 | $33,778 | +115% | $37,842 | +92% |
| 949 | AFTERCARE WITH CC/MCC | $71,015 | $53,261 | $19,197 | +270% | $23,953 | +196% |
| 462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC | $70,624 | $52,968 | $114,847 | −39% | $58,975 | +20% |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $70,024 | $52,518 | $38,221 | +83% | $40,213 | +74% |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $68,744 | $51,558 | $50,177 | +37% | $52,405 | +31% |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $65,534 | $49,151 | $84,330 | −22% | $70,467 | −7% |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $63,644 | $47,733 | $40,191 | +58% | $43,477 | +46% |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $62,102 | $46,577 | $47,197 | +32% | $51,985 | +19% |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | $61,535 | $46,151 | $16,367 | +276% | $19,842 | +210% |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $58,843 | $44,132 | $24,208 | +143% | $30,959 | +90% |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $53,550 | $40,162 | $57,107 | −6% | $52,751 | +2% |
| 380 | COMPLICATED PEPTIC ULCER WITH MCC | $53,130 | $39,847 | $28,005 | +90% | $39,627 | +34% |
| 540 | OSTEOMYELITIS WITH CC | $51,732 | $38,799 | $22,921 | +126% | $26,676 | +94% |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $51,665 | $38,748 | $46,231 | +12% | $43,943 | +18% |
| 857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | $50,909 | $38,181 | $49,793 | +2% | $45,333 | +12% |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $49,887 | $37,415 | $37,942 | +31% | $34,459 | +45% |
| 742 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | $48,812 | $36,609 | $42,892 | +14% | $40,552 | +20% |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $47,870 | $35,902 | $65,920 | −27% | $58,280 | −18% |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $45,378 | $34,033 | $29,400 | +54% | $27,426 | +65% |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $44,152 | $33,114 | $52,676 | −16% | $44,117 | +0% |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $43,484 | $32,613 | $43,841 | −1% | $39,211 | +11% |
| 398 | APPENDIX PROCEDURES WITH CC | $42,398 | $31,799 | $48,238 | −12% | $40,162 | +6% |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $42,361 | $31,771 | $36,194 | +17% | $30,784 | +38% |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $42,029 | $31,522 | $45,897 | −8% | $41,955 | +0% |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $40,495 | $30,371 | $30,168 | +34% | $39,106 | +4% |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $40,168 | $30,126 | $26,958 | +49% | $23,283 | +73% |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $39,550 | $29,662 | $25,731 | +54% | $25,034 | +58% |
| 415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC | $39,102 | $29,327 | $61,186 | −36% | $43,913 | −11% |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $38,576 | $28,932 | $21,721 | +78% | $24,177 | +60% |
| 416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC | $38,574 | $28,931 | $55,530 | −31% | $30,418 | +27% |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $35,766 | $26,825 | $44,694 | −20% | $36,937 | −3% |
| 198 | INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC | $35,627 | $26,720 | $15,844 | +125% | $15,549 | +129% |
| 983 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $34,931 | $26,199 | $41,471 | −16% | $34,607 | +1% |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $34,673 | $26,005 | $25,516 | +36% | $20,084 | +73% |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $34,415 | $25,811 | $18,351 | +88% | $14,128 | +144% |
| 602 | CELLULITIS WITH MCC | $34,377 | $25,783 | $23,631 | +45% | $30,598 | +12% |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $34,181 | $25,636 | $27,589 | +24% | $23,571 | +45% |
| 550 | SEPTIC ARTHRITIS WITHOUT CC/MCC | $33,787 | $25,340 | $29,499 | +15% | $19,138 | +77% |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $33,693 | $25,270 | $26,030 | +29% | $26,580 | +27% |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $32,938 | $24,704 | $36,381 | −9% | $31,264 | +5% |
| 256 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC | $32,579 | $24,434 | $34,438 | −5% | $32,944 | −1% |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $32,516 | $24,387 | $28,849 | +13% | $31,951 | +2% |
| 999 | UNGROUPABLE | $32,294 | $24,221 | $13,647 | +137% | $29,674 | +9% |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $32,232 | $24,174 | $35,063 | −8% | $38,101 | −15% |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $32,229 | $24,172 | $26,643 | +21% | $26,770 | +20% |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $32,174 | $24,130 | $32,245 | −0% | $35,628 | −10% |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $31,826 | $23,870 | $31,452 | +1% | $33,707 | −6% |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $31,660 | $23,745 | $26,502 | +19% | $19,846 | +60% |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $31,536 | $23,652 | $14,740 | +114% | $18,640 | +69% |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $30,782 | $23,087 | $29,397 | +5% | $27,152 | +13% |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $30,464 | $22,848 | $27,285 | +12% | $28,226 | +8% |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $30,126 | $22,594 | $17,175 | +75% | $19,096 | +58% |
| 338 | APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC | $29,888 | $22,416 | $29,025 | +3% | $30,138 | −1% |
| 603 | CELLULITIS WITHOUT MCC | $29,608 | $22,206 | $17,246 | +72% | $18,530 | +60% |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $29,293 | $21,970 | $31,233 | −6% | $32,628 | −10% |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC | $29,202 | $21,902 | $30,687 | −5% | $36,431 | −20% |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $28,243 | $21,182 | $40,977 | −31% | $31,321 | −10% |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $28,140 | $21,105 | $17,431 | +61% | $26,682 | +5% |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC | $28,138 | $21,103 | $43,545 | −35% | $58,228 | −52% |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $27,958 | $20,968 | $26,132 | +7% | $23,940 | +17% |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $27,439 | $20,579 | $24,761 | +11% | $24,386 | +13% |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $26,776 | $20,082 | $19,186 | +40% | $18,807 | +42% |
| 682 | RENAL FAILURE WITH MCC | $26,550 | $19,913 | $23,912 | +11% | $29,064 | −9% |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $26,258 | $19,693 | $23,983 | +9% | $23,141 | +13% |
| 557 | TENDONITIS, MYOSITIS AND BURSITIS WITH MCC | $26,172 | $19,629 | $28,853 | −9% | $32,877 | −20% |
| 539 | OSTEOMYELITIS WITH MCC | $25,789 | $19,342 | $28,715 | −10% | $37,609 | −31% |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $25,624 | $19,218 | $18,011 | +42% | $20,506 | +25% |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $25,311 | $18,983 | $21,192 | +19% | $22,888 | +11% |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $24,888 | $18,666 | $30,907 | −19% | $39,181 | −36% |
| 817 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC | $24,800 | $18,600 | $32,284 | −23% | $39,173 | −37% |
| 798 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC | $24,594 | $18,445 | $19,870 | +24% | $18,452 | +33% |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $24,367 | $18,275 | $19,687 | +24% | $23,617 | +3% |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $24,301 | $18,226 | $23,406 | +4% | $30,235 | −20% |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $24,122 | $18,091 | $19,816 | +22% | $21,449 | +12% |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $24,035 | $18,026 | $9,072 | +165% | $12,336 | +95% |
| 144 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC | $24,032 | $18,024 | $19,895 | +21% | $30,553 | −21% |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $23,953 | $17,965 | $24,026 | −0% | $27,275 | −12% |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $23,288 | $17,466 | $23,288 | +0% | $37,950 | −39% |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $23,235 | $17,426 | $35,359 | −34% | $33,653 | −31% |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $23,217 | $17,413 | $29,266 | −21% | $33,555 | −31% |
| 192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | $23,206 | $17,404 | $15,718 | +48% | $14,368 | +62% |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $23,010 | $17,258 | $29,532 | −22% | $34,192 | −33% |
| 186 | PLEURAL EFFUSION WITH MCC | $22,998 | $17,249 | $25,115 | −8% | $33,834 | −32% |
| 137 | MOUTH PROCEDURES WITH CC/MCC | $22,670 | $17,002 | $40,250 | −44% | $27,861 | −19% |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $22,526 | $16,895 | $18,000 | +25% | $18,204 | +24% |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $22,368 | $16,776 | $22,368 | +0% | $22,506 | −1% |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $22,197 | $16,647 | $22,270 | −0% | $22,098 | +0% |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $22,057 | $16,543 | $14,548 | +52% | $18,602 | +19% |
| 644 | ENDOCRINE DISORDERS WITH CC | $22,023 | $16,517 | $19,358 | +14% | $23,198 | −5% |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $21,892 | $16,419 | $22,927 | −5% | $32,496 | −33% |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $21,824 | $16,368 | $21,824 | +0% | $26,776 | −18% |
| 204 | RESPIRATORY SIGNS AND SYMPTOMS | $21,793 | $16,345 | $17,480 | +25% | $18,004 | +21% |
| 548 | SEPTIC ARTHRITIS WITH MCC | $21,405 | $16,053 | $41,712 | −49% | $31,346 | −32% |
| 922 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC | $21,197 | $15,898 | $28,580 | −26% | $31,563 | −33% |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $21,005 | $15,753 | $19,278 | +9% | $22,850 | −8% |
| 556 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | $20,995 | $15,746 | $14,449 | +45% | $18,126 | +16% |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $20,483 | $15,362 | $23,145 | −12% | $17,700 | +16% |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $20,465 | $15,349 | $19,453 | +5% | $25,463 | −20% |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $20,315 | $15,236 | $16,523 | +23% | $17,724 | +15% |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $20,179 | $15,134 | $23,231 | −13% | $30,571 | −34% |
| 805 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC | $20,041 | $15,030 | $14,799 | +35% | $15,370 | +30% |
| 643 | ENDOCRINE DISORDERS WITH MCC | $19,881 | $14,911 | $33,829 | −41% | $33,563 | −41% |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $19,868 | $14,901 | $18,567 | +7% | $34,017 | −42% |
| 312 | SYNCOPE AND COLLAPSE | $19,855 | $14,891 | $20,238 | −2% | $19,342 | +3% |
| 593 | SKIN ULCERS WITH CC | $19,852 | $14,889 | $20,208 | −2% | $22,886 | −13% |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $19,765 | $14,824 | $22,350 | −12% | $32,859 | −40% |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $19,714 | $14,786 | $24,773 | −20% | $34,273 | −42% |
| 356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC | $19,694 | $14,770 | $83,430 | −76% | $82,561 | −76% |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $19,690 | $14,768 | $21,488 | −8% | $22,024 | −11% |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $19,475 | $14,606 | $17,772 | +10% | $17,303 | +13% |
| 964 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC | $19,439 | $14,579 | $21,556 | −10% | $27,394 | −29% |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $19,292 | $14,469 | $19,292 | +0% | $19,227 | +0% |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $19,236 | $14,427 | $16,674 | +15% | $20,181 | −5% |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $19,224 | $14,418 | $15,999 | +20% | $17,322 | +11% |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $19,194 | $14,395 | $20,030 | −4% | $20,488 | −6% |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $19,170 | $14,378 | $17,464 | +10% | $23,319 | −18% |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $19,079 | $14,309 | $13,967 | +37% | $14,583 | +31% |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $19,044 | $14,283 | $33,180 | −43% | $37,387 | −49% |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $19,032 | $14,274 | $20,244 | −6% | $21,396 | −11% |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $18,976 | $14,232 | $21,815 | −13% | $28,050 | −32% |
| 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | $18,796 | $14,097 | $60,582 | −69% | $35,831 | −48% |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $18,594 | $13,946 | $25,326 | −27% | $23,749 | −22% |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $18,533 | $13,900 | $14,907 | +24% | $17,578 | +5% |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $18,503 | $13,877 | $28,256 | −35% | $39,973 | −54% |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $18,350 | $13,763 | $17,731 | +3% | $18,488 | −1% |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $18,333 | $13,750 | $8,829 | +108% | $12,999 | +41% |
| 683 | RENAL FAILURE WITH CC | $18,322 | $13,742 | $17,869 | +3% | $19,130 | −4% |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $17,934 | $13,450 | $22,628 | −21% | $21,056 | −15% |
| 638 | DIABETES WITH CC | $17,901 | $13,426 | $18,991 | −6% | $19,661 | −9% |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $17,602 | $13,202 | $16,290 | +8% | $17,674 | −0% |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $17,330 | $12,998 | $15,703 | +10% | $16,565 | +5% |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $17,309 | $12,981 | $22,647 | −24% | $27,277 | −37% |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $17,134 | $12,850 | $17,693 | −3% | $18,081 | −5% |
| 305 | HYPERTENSION WITHOUT MCC | $16,897 | $12,673 | $16,897 | +0% | $18,086 | −7% |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $16,894 | $12,670 | $14,751 | +15% | $17,038 | −1% |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $16,816 | $12,612 | $16,174 | +4% | $21,275 | −21% |
| 637 | DIABETES WITH MCC | $16,425 | $12,319 | $28,920 | −43% | $30,100 | −45% |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $16,376 | $12,282 | $13,914 | +18% | $13,361 | +23% |
| 292 | HEART FAILURE AND SHOCK WITH CC | $16,371 | $12,278 | $15,730 | +4% | $16,371 | +0% |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $16,327 | $12,245 | $15,157 | +8% | $13,824 | +18% |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $16,234 | $12,176 | $15,264 | +6% | $15,183 | +7% |
| 813 | COAGULATION DISORDERS | $16,031 | $12,023 | $20,984 | −24% | $33,296 | −52% |
| 807 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | $15,887 | $11,915 | $12,519 | +27% | $12,078 | +32% |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $15,743 | $11,807 | $15,345 | +3% | $13,275 | +19% |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $15,717 | $11,788 | $15,819 | −1% | $15,889 | −1% |
| 667 | PROSTATECTOMY WITHOUT CC/MCC | $15,639 | $11,730 | $91,046 | −83% | $16,703 | −6% |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $15,567 | $11,675 | $24,904 | −37% | $24,914 | −38% |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $15,473 | $11,605 | $34,877 | −56% | $49,710 | −69% |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $15,401 | $11,551 | $23,597 | −35% | $33,985 | −55% |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $15,342 | $11,507 | $30,641 | −50% | $39,958 | −62% |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $15,294 | $11,471 | $17,215 | −11% | $20,926 | −27% |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $15,208 | $11,406 | $16,912 | −10% | $17,118 | −11% |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $14,997 | $11,247 | $22,019 | −32% | $27,401 | −45% |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $14,983 | $11,237 | $14,806 | +1% | $18,002 | −17% |
| 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $14,942 | $11,207 | $20,750 | −28% | $15,589 | −4% |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $14,685 | $11,014 | $15,663 | −6% | $17,921 | −18% |
| 097 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC | $14,446 | $10,835 | $52,123 | −72% | $59,533 | −76% |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $14,205 | $10,654 | $22,038 | −36% | $20,781 | −32% |
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $14,064 | $10,548 | $14,064 | +0% | $16,846 | −17% |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $13,544 | $10,158 | $20,754 | −35% | $23,488 | −42% |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $13,400 | $10,050 | $13,400 | +0% | $13,384 | +0% |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $13,062 | $9,797 | $15,535 | −16% | $16,699 | −22% |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $12,973 | $9,730 | $17,194 | −25% | $16,968 | −24% |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $12,349 | $9,262 | $19,589 | −37% | $27,163 | −55% |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $12,230 | $9,173 | $20,270 | −40% | $27,316 | −55% |
| 076 | VIRAL MENINGITIS WITHOUT CC/MCC | $12,161 | $9,121 | $19,534 | −38% | $17,135 | −29% |
| 836 | ACUTE LEUKEMIA WITHOUT CC/MCC | $12,046 | $9,035 | $13,857 | −13% | $19,686 | −39% |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $11,949 | $8,962 | $18,107 | −34% | $17,620 | −32% |
| 102 | HEADACHES WITH MCC | $11,896 | $8,922 | $21,983 | −46% | $25,740 | −54% |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $11,445 | $8,584 | $18,211 | −37% | $15,038 | −24% |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $11,298 | $8,473 | $14,740 | −23% | $16,288 | −31% |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $10,859 | $8,144 | $20,236 | −46% | $19,594 | −45% |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $10,804 | $8,103 | $18,645 | −42% | $22,033 | −51% |
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | $10,779 | $8,084 | $22,893 | −53% | $24,586 | −56% |
| 639 | DIABETES WITHOUT CC/MCC | $10,227 | $7,671 | $15,521 | −34% | $13,910 | −26% |
| 185 | MAJOR CHEST TRAUMA WITHOUT CC/MCC | $9,487 | $7,115 | $16,983 | −44% | $17,124 | −45% |
| 950 | AFTERCARE WITHOUT CC/MCC | $8,828 | $6,621 | $14,382 | −39% | $13,527 | −35% |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $8,783 | $6,587 | $20,747 | −58% | $14,648 | −40% |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $8,748 | $6,561 | $19,305 | −55% | $42,679 | −80% |
| 915 | ALLERGIC REACTIONS WITH MCC | $8,499 | $6,374 | $22,178 | −62% | $32,645 | −74% |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $7,996 | $5,997 | $23,022 | −65% | $18,150 | −56% |
| 200 | PNEUMOTHORAX WITH CC | $7,686 | $5,764 | $16,159 | −52% | $21,368 | −64% |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $7,565 | $5,674 | $15,836 | −52% | $14,415 | −48% |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $7,465 | $5,598 | $13,839 | −46% | $18,649 | −60% |
| 831 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC | $7,378 | $5,533 | $12,861 | −43% | $18,133 | −59% |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $7,344 | $5,508 | $13,215 | −44% | $17,559 | −58% |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $6,378 | $4,783 | $5,773 | +10% | $8,445 | −24% |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $6,283 | $4,712 | $45,434 | −86% | $39,006 | −84% |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $6,244 | $4,683 | $15,247 | −59% | $15,428 | −60% |
| 833 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC | $5,864 | $4,398 | $8,572 | −32% | $9,940 | −41% |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $5,703 | $4,278 | $9,040 | −37% | $16,351 | −65% |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $5,559 | $4,169 | $18,396 | −70% | $21,363 | −74% |
| 795 | NORMAL NEWBORN | $5,087 | $3,816 | $4,894 | +4% | $4,720 | +8% |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $4,728 | $3,546 | $10,367 | −54% | $12,229 | −61% |
| 779 | ABORTION WITHOUT D&C | $4,706 | $3,530 | $12,448 | −62% | $15,327 | −69% |
| 776 | POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES | $4,551 | $3,413 | $10,601 | −57% | $12,454 | −63% |
| 977 | HIV WITH OR WITHOUT OTHER RELATED CONDITION | $3,595 | $2,696 | $8,783 | −59% | $22,525 | −84% |
Procedures with negotiated rates only
These 1 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.
| DRG | Description | Insurance rate range | Payers |
|---|---|---|---|
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | — | 13 plans |
No procedures match that keyword.