Baptist Health Hardin — Pricing
382 procedures published in this hospital's Machine-Readable File (MRF) — 381 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 382
Lowest published price $5,619
Average published price $62,350
Highest published price $571,309
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
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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 382 procedures
Published charges
Showing all 381 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 74 procedures, this hospital's negotiated rates average ≈170% of what Medicare pays.
| DRG | Description | Published price | Cash price | vs. KY median | vs. National median | vs Medicare | ||
|---|---|---|---|---|---|---|---|---|
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES | $571,309 | $428,482 | $343,325 | +66% | $371,366 | +54% | — |
| 325 | CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE | $329,976 | $247,482 | $145,959 | +126% | $53,551 | +516% | — |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES | $291,377 | $218,533 | $250,443 | +16% | $245,241 | +19% | — |
| 254 | OTHER VASCULAR PROCEDURES WITHOUT CC/MCC | $267,916 | $200,937 | $65,428 | +309% | $38,836 | +590% | — |
| 207 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | $248,140 | $186,105 | $147,096 | +69% | $116,058 | +114% | — |
| 834 | ACUTE LEUKEMIA WITH MCC | $245,046 | $183,784 | $74,709 | +228% | $76,583 | +220% | — |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $234,559 | $175,919 | $189,364 | +24% | $138,008 | +70% | — |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $229,131 | $171,848 | $129,077 | +78% | $57,149 | +301% | — |
| 270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | $215,311 | $161,483 | $146,941 | +47% | $99,423 | +117% | — |
| 041 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR | $213,916 | $160,437 | $91,063 | +135% | $44,989 | +375% | — |
| 096 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC | $211,017 | $158,263 | $155,184 | +36% | $39,093 | +440% | — |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $203,419 | $152,564 | $54,813 | +271% | $48,094 | +323% | — |
| 321 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES | $202,295 | $151,721 | $128,333 | +58% | $74,274 | +172% | ≈177% of Medicare |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $200,794 | $150,595 | $111,058 | +81% | $50,011 | +301% | ≈215% of Medicare |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $186,496 | $139,872 | $121,319 | +54% | $88,341 | +111% | — |
| 242 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | $182,756 | $137,067 | $109,863 | +66% | $70,132 | +161% | — |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $180,125 | $135,093 | $107,108 | +68% | $40,063 | +350% | — |
| 322 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | $179,957 | $134,968 | $102,313 | +76% | $54,772 | +229% | ≈231% of Medicare |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $179,689 | $134,767 | $40,240 | +347% | $32,689 | +450% | — |
| 799 | SPLENIC PROCEDURES WITH MCC | $179,281 | $134,461 | $76,920 | +133% | $78,821 | +127% | — |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC | $175,746 | $131,810 | $99,124 | +77% | $57,963 | +203% | — |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $175,436 | $131,577 | $37,502 | +368% | $28,140 | +523% | — |
| 253 | OTHER VASCULAR PROCEDURES WITH CC | $174,917 | $131,188 | $89,568 | +95% | $53,746 | +225% | — |
| 485 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC | $169,369 | $127,027 | $111,366 | +52% | $64,956 | +161% | — |
| 082 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | $168,628 | $126,471 | $34,797 | +385% | $36,237 | +365% | — |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $160,937 | $120,702 | $114,483 | +41% | $86,390 | +86% | ≈181% of Medicare |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC | $155,129 | $116,347 | $65,200 | +138% | $48,680 | +219% | ≈226% of Medicare |
| 250 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | $154,884 | $116,163 | $88,934 | +74% | $51,339 | +202% | — |
| 346 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $145,630 | $109,223 | $34,193 | +326% | $26,146 | +457% | — |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $141,224 | $105,918 | $53,357 | +165% | $62,961 | +124% | — |
| 271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | $141,141 | $105,856 | $119,602 | +18% | $71,014 | +99% | — |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC | $138,008 | $103,506 | $51,717 | +167% | $35,542 | +288% | — |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $134,642 | $100,981 | $43,892 | +207% | $39,409 | +242% | — |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $133,729 | $100,297 | $21,563 | +520% | $23,734 | +463% | — |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $133,696 | $100,272 | $120,476 | +11% | $88,050 | +52% | ≈148% of Medicare |
| 548 | SEPTIC ARTHRITIS WITH MCC | $131,522 | $98,641 | $103,858 | +27% | $31,019 | +324% | — |
| 353 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC | $130,509 | $97,882 | $78,680 | +66% | $60,140 | +117% | — |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $127,425 | $95,569 | $117,172 | +9% | $87,018 | +46% | ≈163% of Medicare |
| 095 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC | $126,893 | $95,170 | $88,128 | +44% | $47,583 | +167% | — |
| 673 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | $126,799 | $95,099 | $121,510 | +4% | $72,945 | +74% | — |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $126,393 | $94,795 | $80,870 | +56% | $87,565 | +44% | — |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $125,579 | $94,184 | $80,371 | +56% | $63,984 | +96% | ≈211% of Medicare |
| 868 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC | $124,941 | $93,706 | $23,492 | +432% | $22,231 | +462% | — |
| 272 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC | $118,849 | $89,137 | $118,849 | +0% | $55,162 | +115% | — |
| 255 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC | $115,694 | $86,770 | $60,685 | +91% | $43,697 | +165% | — |
| 251 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC | $114,961 | $86,221 | $67,497 | +70% | $41,380 | +178% | — |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $111,373 | $83,529 | $67,948 | +64% | $52,405 | +113% | ≈174% of Medicare |
| 103 | HEADACHES WITHOUT MCC | $110,170 | $82,628 | $17,811 | +519% | $20,111 | +448% | — |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $108,476 | $81,357 | $42,329 | +156% | $51,985 | +109% | — |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $106,185 | $79,638 | $78,716 | +35% | $51,172 | +108% | ≈224% of Medicare |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $103,982 | $77,986 | $17,337 | +500% | $17,412 | +497% | — |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $102,356 | $76,767 | $79,739 | +28% | $49,197 | +108% | — |
| 653 | MAJOR BLADDER PROCEDURES WITH MCC | $100,871 | $75,653 | $100,871 | +0% | $97,046 | +4% | — |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $100,074 | $75,055 | $100,074 | +0% | $67,764 | +48% | ≈210% of Medicare |
| 790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $99,899 | $74,924 | $80,018 | +25% | $80,018 | +25% | — |
| 823 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC | $99,813 | $74,860 | $99,813 | +0% | $80,885 | +23% | — |
| 907 | OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | $98,685 | $74,014 | $54,898 | +80% | $71,701 | +38% | — |
| 068 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $98,002 | $73,502 | $33,415 | +193% | $19,569 | +401% | — |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $96,933 | $72,700 | $34,724 | +179% | $36,375 | +166% | — |
| 956 | LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | $95,859 | $71,894 | $87,317 | +10% | $75,103 | +28% | — |
| 327 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | $95,537 | $71,653 | $94,948 | +1% | $54,824 | +74% | — |
| 515 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC | $95,340 | $71,505 | $56,159 | +70% | $62,821 | +52% | — |
| 335 | PERITONEAL ADHESIOLYSIS WITH MCC | $95,302 | $71,476 | $80,880 | +18% | $71,755 | +33% | — |
| 474 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC | $95,234 | $71,426 | $80,515 | +18% | $76,954 | +24% | — |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC | $93,356 | $70,017 | $78,561 | +19% | $36,280 | +157% | — |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $88,366 | $66,274 | $47,283 | +87% | $45,497 | +94% | — |
| 987 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $87,611 | $65,709 | $68,276 | +28% | $65,383 | +34% | — |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $87,341 | $65,506 | $27,768 | +215% | $25,426 | +244% | — |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $87,107 | $65,330 | $87,107 | +0% | $70,540 | +23% | — |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $86,878 | $65,158 | $75,489 | +15% | $56,519 | +54% | ≈215% of Medicare |
| 264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $86,821 | $65,116 | $56,308 | +54% | $51,953 | +67% | — |
| 302 | ATHEROSCLEROSIS WITH MCC | $84,199 | $63,149 | $18,292 | +360% | $20,844 | +304% | — |
| 356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC | $83,430 | $62,572 | $83,430 | +0% | $82,561 | +1% | — |
| 557 | TENDONITIS, MYOSITIS AND BURSITIS WITH MCC | $83,192 | $62,394 | $48,972 | +70% | $28,646 | +190% | — |
| 314 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | $83,018 | $62,264 | $38,186 | +117% | $38,357 | +116% | ≈161% of Medicare |
| 286 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | $82,901 | $62,176 | $59,023 | +40% | $44,600 | +86% | — |
| 628 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC | $81,083 | $60,812 | $56,832 | +43% | $68,006 | +19% | — |
| 570 | SKIN DEBRIDEMENT WITH MCC | $80,872 | $60,654 | $48,653 | +66% | $52,435 | +54% | — |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $80,380 | $60,285 | $26,052 | +209% | $25,474 | +216% | — |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $80,287 | $60,215 | $80,287 | +0% | $45,963 | +75% | — |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $79,128 | $59,346 | $60,868 | +30% | $39,747 | +99% | ≈226% of Medicare |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $79,114 | $59,336 | $17,227 | +359% | $17,522 | +352% | — |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $78,332 | $58,749 | $50,105 | +56% | $31,978 | +145% | — |
| 326 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | $77,786 | $58,340 | $77,786 | +0% | $80,747 | −4% | — |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $77,316 | $57,987 | $45,324 | +71% | $19,868 | +289% | — |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $76,662 | $57,496 | $41,406 | +85% | $36,658 | +109% | ≈173% of Medicare |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $75,729 | $56,796 | $20,537 | +269% | $24,452 | +210% | — |
| 865 | VIRAL ILLNESS WITH MCC | $75,566 | $56,675 | $22,350 | +238% | $26,088 | +190% | — |
| 166 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC | $75,141 | $56,356 | $56,889 | +32% | $72,782 | +3% | ≈112% of Medicare |
| 283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | $75,070 | $56,302 | $38,806 | +93% | $35,014 | +114% | — |
| 077 | HYPERTENSIVE ENCEPHALOPATHY WITH MCC | $74,901 | $56,176 | $53,215 | +41% | $24,036 | +212% | — |
| 503 | FOOT PROCEDURES WITH MCC | $73,699 | $55,274 | $73,699 | +0% | $43,901 | +68% | — |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $73,681 | $55,261 | $25,610 | +188% | $20,968 | +251% | — |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $72,980 | $54,735 | $47,008 | +55% | $41,660 | +75% | — |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $72,359 | $54,269 | $22,651 | +219% | $29,484 | +145% | — |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $72,139 | $54,104 | $49,467 | +46% | $31,758 | +127% | — |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $71,359 | $53,519 | $57,323 | +24% | $16,719 | +327% | — |
| 549 | SEPTIC ARTHRITIS WITH CC | $71,337 | $53,503 | $40,728 | +75% | $20,938 | +241% | — |
| 867 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC | $70,329 | $52,747 | $31,025 | +127% | $36,850 | +91% | — |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $70,196 | $52,647 | $32,091 | +119% | $28,134 | +150% | — |
| 205 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | $69,645 | $52,234 | $27,695 | +151% | $32,204 | +116% | — |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $69,627 | $52,220 | $52,815 | +32% | $37,842 | +84% | ≈184% of Medicare |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | $69,596 | $52,197 | $40,534 | +72% | $31,190 | +123% | — |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $68,067 | $51,050 | $38,914 | +75% | $30,974 | +120% | — |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $67,964 | $50,973 | $37,644 | +81% | $38,885 | +75% | — |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $67,011 | $50,258 | $67,011 | +0% | $43,266 | +55% | — |
| 988 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $66,641 | $49,981 | $46,455 | +43% | $38,094 | +75% | — |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $66,620 | $49,965 | $66,620 | +0% | $52,313 | +27% | — |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $66,386 | $49,790 | $32,778 | +103% | $30,814 | +115% | — |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $66,354 | $49,765 | $30,568 | +117% | $35,714 | +86% | ≈143% of Medicare |
| 398 | APPENDIX PROCEDURES WITH CC | $66,071 | $49,553 | $56,455 | +17% | $39,107 | +69% | — |
| 571 | SKIN DEBRIDEMENT WITH CC | $65,459 | $49,095 | $43,162 | +52% | $34,901 | +88% | — |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $63,265 | $47,449 | $51,909 | +22% | $32,936 | +92% | — |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $62,713 | $47,034 | $20,145 | +211% | $23,956 | +162% | — |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $62,558 | $46,918 | $38,677 | +62% | $28,967 | +116% | ≈165% of Medicare |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $61,939 | $46,454 | $35,019 | +77% | $30,058 | +106% | ≈162% of Medicare |
| 186 | PLEURAL EFFUSION WITH MCC | $61,473 | $46,105 | $39,289 | +56% | $32,468 | +89% | — |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $60,986 | $45,740 | $24,326 | +151% | $21,213 | +188% | ≈158% of Medicare |
| 542 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | $60,768 | $45,576 | $34,579 | +76% | $35,114 | +73% | — |
| 621 | O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC | $60,761 | $45,571 | $44,110 | +38% | $32,451 | +87% | — |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $60,582 | $45,436 | $21,697 | +179% | $18,150 | +234% | — |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $60,369 | $45,277 | $28,178 | +114% | $31,059 | +94% | — |
| 252 | OTHER VASCULAR PROCEDURES WITH MCC | $60,309 | $45,232 | $60,309 | +0% | $68,508 | −12% | ≈142% of Medicare |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $59,900 | $44,925 | $40,976 | +46% | $49,631 | +21% | — |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $59,769 | $44,827 | $20,826 | +187% | $17,727 | +237% | ≈174% of Medicare |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $59,500 | $44,625 | $59,500 | +0% | $58,832 | +1% | ≈118% of Medicare |
| 602 | CELLULITIS WITH MCC | $58,725 | $44,044 | $33,511 | +75% | $29,347 | +100% | ≈170% of Medicare |
| 078 | HYPERTENSIVE ENCEPHALOPATHY WITH CC | $58,587 | $43,940 | $58,587 | +0% | $17,434 | +236% | — |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $58,541 | $43,906 | $35,355 | +66% | $35,237 | +66% | ≈146% of Medicare |
| 643 | ENDOCRINE DISORDERS WITH MCC | $58,139 | $43,605 | $36,315 | +60% | $32,996 | +76% | — |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $58,109 | $43,582 | $24,815 | +134% | $18,918 | +207% | — |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $57,663 | $43,247 | $28,666 | +101% | $31,840 | +81% | ≈148% of Medicare |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $57,572 | $43,179 | $57,572 | +0% | $42,119 | +37% | ≈161% of Medicare |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $57,221 | $42,916 | $29,026 | +97% | $29,374 | +95% | — |
| 876 | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS | $57,170 | $42,877 | $57,170 | +0% | $54,196 | +5% | — |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $56,995 | $42,746 | $56,995 | +0% | $43,524 | +31% | ≈155% of Medicare |
| 336 | PERITONEAL ADHESIOLYSIS WITH CC | $56,208 | $42,156 | $53,658 | +5% | $49,470 | +14% | — |
| 606 | MINOR SKIN DISORDERS WITH MCC | $55,926 | $41,944 | $24,094 | +132% | $25,434 | +120% | — |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $55,888 | $41,916 | $51,708 | +8% | $46,477 | +20% | — |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $55,055 | $41,291 | $55,055 | +0% | $39,563 | +39% | — |
| 357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC | $54,902 | $41,177 | $44,618 | +23% | $48,682 | +13% | — |
| 086 | TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | $54,509 | $40,882 | $32,559 | +67% | $23,115 | +136% | — |
| 813 | COAGULATION DISORDERS | $54,460 | $40,845 | $24,365 | +124% | $30,128 | +81% | — |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $54,398 | $40,798 | $50,570 | +8% | $12,336 | +341% | — |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $54,200 | $40,650 | $24,733 | +119% | $27,934 | +94% | — |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $54,197 | $40,648 | $33,098 | +64% | $31,128 | +74% | — |
| 665 | PROSTATECTOMY WITH MCC | $54,072 | $40,554 | $54,072 | +0% | $54,072 | +0% | — |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $53,792 | $40,344 | $35,433 | +52% | $32,502 | +66% | — |
| 654 | MAJOR BLADDER PROCEDURES WITH CC | $53,779 | $40,335 | $53,779 | +0% | $53,868 | −0% | — |
| 152 | OTITIS MEDIA AND URI WITH MCC | $53,388 | $40,041 | $17,922 | +198% | $19,795 | +170% | — |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $53,244 | $39,933 | $29,948 | +78% | $30,275 | +76% | — |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $53,202 | $39,901 | $29,332 | +81% | $31,086 | +71% | — |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $52,993 | $39,745 | $19,203 | +176% | $19,579 | +171% | — |
| 783 | CESAREAN SECTION WITH STERILIZATION WITH MCC | $52,850 | $39,637 | $35,986 | +47% | $28,375 | +86% | — |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $52,716 | $39,537 | $29,405 | +79% | $37,950 | +39% | — |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $52,600 | $39,450 | $16,482 | +219% | $14,473 | +263% | — |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $52,471 | $39,353 | $32,206 | +63% | $23,469 | +124% | ≈213% of Medicare |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $51,962 | $38,972 | $51,962 | +0% | $44,117 | +18% | ≈153% of Medicare |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $51,725 | $38,793 | $31,207 | +66% | $25,162 | +106% | — |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $51,680 | $38,760 | $12,771 | +305% | $12,537 | +312% | — |
| 637 | DIABETES WITH MCC | $51,632 | $38,724 | $32,199 | +60% | $28,819 | +79% | ≈175% of Medicare |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $51,429 | $38,572 | $38,517 | +34% | $26,488 | +94% | ≈103% of Medicare |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $51,056 | $38,292 | $32,985 | +55% | $29,609 | +72% | — |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $50,885 | $38,163 | $29,484 | +73% | $25,704 | +98% | ≈170% of Medicare |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $50,618 | $37,964 | $21,120 | +140% | $23,396 | +116% | — |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $50,521 | $37,891 | $25,939 | +95% | $22,024 | +129% | ≈175% of Medicare |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $50,502 | $37,876 | $27,917 | +81% | $20,463 | +147% | ≈216% of Medicare |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $50,224 | $37,668 | $28,621 | +75% | $36,933 | +36% | — |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $50,046 | $37,535 | $49,835 | +0% | $46,591 | +7% | — |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $49,601 | $37,201 | $27,668 | +79% | $23,350 | +112% | — |
| 100 | SEIZURES WITH MCC | $49,277 | $36,958 | $34,570 | +43% | $35,194 | +40% | ≈151% of Medicare |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $48,482 | $36,362 | $48,482 | +0% | $35,375 | +37% | — |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $48,372 | $36,279 | $36,329 | +33% | $29,031 | +67% | — |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $48,172 | $36,129 | $44,584 | +8% | $49,710 | −3% | — |
| 199 | PNEUMOTHORAX WITH MCC | $48,079 | $36,059 | $38,824 | +24% | $31,491 | +53% | — |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $47,895 | $35,921 | $21,421 | +124% | $22,032 | +117% | — |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $47,784 | $35,838 | $39,660 | +20% | $32,399 | +47% | ≈146% of Medicare |
| 810 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC | $47,319 | $35,489 | $43,806 | +8% | $18,428 | +157% | — |
| 655 | MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | $47,191 | $35,393 | $47,191 | +0% | $41,651 | +13% | — |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $46,213 | $34,660 | $13,184 | +251% | $14,444 | +220% | — |
| 080 | NONTRAUMATIC STUPOR AND COMA WITH MCC | $46,114 | $34,586 | $28,993 | +59% | $35,139 | +31% | — |
| 496 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC | $45,946 | $34,459 | $45,946 | +0% | $43,800 | +5% | — |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $45,806 | $34,354 | $42,239 | +8% | $42,881 | +7% | — |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $45,701 | $34,276 | $27,970 | +63% | $25,731 | +78% | — |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $45,583 | $34,187 | $18,969 | +140% | $17,731 | +157% | — |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $45,448 | $34,086 | $25,832 | +76% | $22,982 | +98% | ≈170% of Medicare |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $45,412 | $34,059 | $42,499 | +7% | $30,314 | +50% | — |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $45,398 | $34,049 | $45,398 | +0% | $34,089 | +33% | — |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $45,327 | $33,995 | $28,969 | +56% | $23,141 | +96% | — |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $45,310 | $33,982 | $24,382 | +86% | $33,424 | +36% | — |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $45,264 | $33,948 | $31,283 | +45% | $21,806 | +108% | — |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $44,484 | $33,363 | $19,242 | +131% | $19,483 | +128% | ≈213% of Medicare |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $44,310 | $33,233 | $44,310 | +0% | $36,239 | +22% | — |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $44,105 | $33,079 | $34,854 | +27% | $36,242 | +22% | — |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $44,071 | $33,053 | $32,532 | +35% | $18,623 | +137% | — |
| 682 | RENAL FAILURE WITH MCC | $43,912 | $32,934 | $34,605 | +27% | $27,854 | +58% | ≈149% of Medicare |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $43,861 | $32,896 | $28,258 | +55% | $26,158 | +68% | ≈151% of Medicare |
| 539 | OSTEOMYELITIS WITH MCC | $43,860 | $32,895 | $38,824 | +13% | $33,746 | +30% | — |
| 149 | DYSEQUILIBRIUM | $43,745 | $32,809 | $19,068 | +129% | $17,203 | +154% | ≈189% of Medicare |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $43,697 | $32,773 | $25,512 | +71% | $25,020 | +75% | ≈149% of Medicare |
| 922 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC | $43,694 | $32,770 | $25,121 | +74% | $29,409 | +49% | — |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $43,650 | $32,738 | $38,017 | +15% | $26,634 | +64% | — |
| 101 | SEIZURES WITHOUT MCC | $43,591 | $32,694 | $15,448 | +182% | $19,954 | +118% | ≈227% of Medicare |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $43,196 | $32,397 | $43,196 | +0% | $30,910 | +40% | — |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | $43,156 | $32,367 | $21,261 | +103% | $23,496 | +84% | — |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $43,107 | $32,330 | $32,891 | +31% | $30,394 | +42% | — |
| 693 | URINARY STONES WITH MCC | $43,048 | $32,286 | $31,040 | +39% | $22,525 | +91% | — |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $42,919 | $32,190 | $25,981 | +65% | $21,261 | +102% | — |
| 311 | ANGINA PECTORIS | $42,516 | $31,887 | $18,257 | +133% | $15,165 | +180% | — |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $42,338 | $31,754 | $34,577 | +22% | $17,700 | +139% | — |
| 856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC | $42,210 | $31,657 | $52,243 | −19% | $72,859 | −42% | — |
| 187 | PLEURAL EFFUSION WITH CC | $42,148 | $31,611 | $19,451 | +117% | $21,467 | +96% | — |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $41,980 | $31,485 | $26,590 | +58% | $14,284 | +194% | — |
| 351 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC | $41,895 | $31,421 | $41,895 | +0% | $33,792 | +24% | — |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $41,674 | $31,255 | $31,101 | +34% | $27,244 | +53% | ≈157% of Medicare |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $41,581 | $31,186 | $37,362 | +11% | $29,757 | +40% | ≈146% of Medicare |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $41,516 | $31,137 | $41,516 | +0% | $36,334 | +14% | — |
| 915 | ALLERGIC REACTIONS WITH MCC | $41,366 | $31,024 | $41,366 | +0% | $30,944 | +34% | — |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $41,271 | $30,953 | $25,562 | +61% | $20,278 | +104% | ≈259% of Medicare |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $41,006 | $30,755 | $29,730 | +38% | $24,480 | +68% | ≈149% of Medicare |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $40,894 | $30,671 | $40,991 | −0% | $54,475 | −25% | — |
| 167 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC | $40,642 | $30,482 | $40,642 | +0% | $40,563 | +0% | — |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $40,486 | $30,364 | $17,477 | +132% | $19,091 | +112% | — |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $40,470 | $30,352 | $24,871 | +63% | $25,208 | +61% | — |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $40,369 | $30,277 | $21,475 | +88% | $19,287 | +109% | — |
| 075 | VIRAL MENINGITIS WITH CC/MCC | $40,312 | $30,234 | $32,930 | +22% | $29,853 | +35% | — |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $40,212 | $30,159 | $17,559 | +129% | $17,195 | +134% | — |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $40,130 | $30,098 | $40,130 | +0% | $33,165 | +21% | — |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $39,628 | $29,721 | $37,030 | +7% | $27,947 | +42% | — |
| 498 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC | $39,624 | $29,718 | $39,624 | +0% | $46,659 | −15% | — |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $39,550 | $29,663 | $26,381 | +50% | $24,177 | +64% | — |
| 504 | FOOT PROCEDURES WITH CC | $39,089 | $29,317 | $39,089 | +0% | $36,598 | +7% | — |
| 181 | RESPIRATORY NEOPLASMS WITH CC | $38,503 | $28,877 | $29,794 | +29% | $22,431 | +72% | — |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $38,378 | $28,784 | $34,988 | +10% | $11,633 | +230% | — |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $37,880 | $28,410 | $37,880 | +0% | $24,017 | +58% | — |
| 949 | AFTERCARE WITH CC/MCC | $37,741 | $28,306 | $37,741 | +0% | $23,953 | +58% | — |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | $37,492 | $28,119 | $19,381 | +93% | $18,803 | +99% | — |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $37,431 | $28,073 | $30,021 | +25% | $23,723 | +58% | — |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $37,398 | $28,049 | $17,614 | +112% | $20,777 | +80% | ≈163% of Medicare |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $37,356 | $28,017 | $28,893 | +29% | $24,190 | +54% | ≈156% of Medicare |
| 313 | CHEST PAIN | $37,240 | $27,930 | $17,918 | +108% | $15,962 | +133% | — |
| 102 | HEADACHES WITH MCC | $37,228 | $27,921 | $18,243 | +104% | $22,544 | +65% | — |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $36,969 | $27,727 | $23,842 | +55% | $14,880 | +148% | — |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $36,937 | $27,703 | $36,937 | +0% | $34,887 | +6% | — |
| 304 | HYPERTENSION WITH MCC | $36,823 | $27,618 | $20,946 | +76% | $24,185 | +52% | — |
| 663 | MINOR BLADDER PROCEDURES WITH CC | $36,581 | $27,436 | $36,581 | +0% | $29,924 | +22% | — |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $36,448 | $27,336 | $15,310 | +138% | $18,253 | +100% | — |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $36,384 | $27,288 | $36,384 | +0% | $27,369 | +33% | — |
| 347 | ANAL AND STOMAL PROCEDURES WITH MCC | $36,341 | $27,255 | $36,341 | +0% | $40,548 | −10% | — |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $36,279 | $27,209 | $20,531 | +77% | $21,449 | +69% | ≈183% of Medicare |
| 816 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC | $36,242 | $27,182 | $11,752 | +208% | $13,485 | +169% | — |
| 950 | AFTERCARE WITHOUT CC/MCC | $35,936 | $26,952 | $21,013 | +71% | $13,527 | +166% | — |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC | $35,747 | $26,811 | $41,464 | −14% | $54,313 | −34% | — |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $35,467 | $26,600 | $18,680 | +90% | $22,781 | +56% | ≈173% of Medicare |
| 463 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC | $35,451 | $26,588 | $73,103 | −52% | $78,582 | −55% | — |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $35,212 | $26,409 | $21,039 | +67% | $18,204 | +93% | ≈225% of Medicare |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $35,051 | $26,289 | $25,500 | +37% | $23,749 | +48% | — |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $34,721 | $26,041 | $24,091 | +44% | $21,181 | +64% | — |
| 312 | SYNCOPE AND COLLAPSE | $34,451 | $25,838 | $19,517 | +77% | $19,342 | +78% | ≈174% of Medicare |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $34,428 | $25,821 | $29,306 | +17% | $15,284 | +125% | — |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $34,330 | $25,748 | $29,153 | +18% | $25,243 | +36% | — |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $34,308 | $25,731 | $18,064 | +90% | $18,002 | +91% | — |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $34,165 | $25,624 | $34,165 | +0% | $30,358 | +13% | — |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $33,876 | $25,407 | $24,869 | +36% | $33,607 | +1% | — |
| 866 | VIRAL ILLNESS WITHOUT MCC | $33,845 | $25,384 | $14,678 | +131% | $16,391 | +106% | — |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $33,470 | $25,103 | $18,325 | +83% | $18,459 | +81% | — |
| 644 | ENDOCRINE DISORDERS WITH CC | $33,402 | $25,051 | $19,384 | +72% | $22,941 | +46% | — |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $33,295 | $24,971 | $31,173 | +7% | $24,136 | +38% | — |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $33,279 | $24,959 | $29,296 | +14% | $21,886 | +52% | ≈160% of Medicare |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $33,073 | $24,805 | $33,073 | +0% | $20,371 | +62% | — |
| 683 | RENAL FAILURE WITH CC | $32,985 | $24,739 | $16,455 | +100% | $18,620 | +77% | ≈165% of Medicare |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $32,726 | $24,545 | $30,767 | +6% | $28,780 | +14% | — |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $32,620 | $24,465 | $15,986 | +104% | $18,282 | +78% | — |
| 638 | DIABETES WITH CC | $32,614 | $24,461 | $18,552 | +76% | $18,821 | +73% | ≈154% of Medicare |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $32,586 | $24,440 | $17,477 | +86% | $16,865 | +93% | ≈203% of Medicare |
| 593 | SKIN ULCERS WITH CC | $32,176 | $24,132 | $28,252 | +14% | $20,470 | +57% | — |
| 301 | PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC | $31,937 | $23,953 | $15,461 | +107% | $15,607 | +105% | — |
| 501 | SOFT TISSUE PROCEDURES WITH CC | $31,927 | $23,945 | $31,562 | +1% | $37,975 | −16% | — |
| 305 | HYPERTENSION WITHOUT MCC | $31,906 | $23,929 | $22,806 | +40% | $17,144 | +86% | — |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $31,644 | $23,733 | $17,630 | +79% | $16,745 | +89% | ≈200% of Medicare |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $31,580 | $23,685 | $16,365 | +93% | $13,892 | +127% | — |
| 540 | OSTEOMYELITIS WITH CC | $31,282 | $23,462 | $31,282 | +0% | $23,494 | +33% | — |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $31,279 | $23,459 | $17,601 | +78% | $16,571 | +89% | — |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $31,100 | $23,325 | $17,494 | +78% | $17,466 | +78% | ≈181% of Medicare |
| 292 | HEART FAILURE AND SHOCK WITH CC | $31,071 | $23,303 | $21,278 | +46% | $16,212 | +92% | — |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $30,995 | $23,246 | $30,556 | +1% | $34,354 | −10% | — |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $30,886 | $23,164 | $19,353 | +60% | $15,072 | +105% | — |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $30,716 | $23,037 | $15,641 | +96% | $17,367 | +77% | — |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $30,636 | $22,977 | $17,527 | +75% | $16,104 | +90% | — |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $30,494 | $22,871 | $37,242 | −18% | $54,929 | −44% | — |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $30,486 | $22,865 | $18,635 | +64% | $18,081 | +69% | — |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $30,304 | $22,728 | $30,304 | +0% | $24,022 | +26% | — |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $30,019 | $22,514 | $21,605 | +39% | $21,545 | +39% | — |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $29,617 | $22,213 | $20,270 | +46% | $14,927 | +98% | — |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $29,480 | $22,110 | $23,559 | +25% | $22,850 | +29% | ≈170% of Medicare |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $29,377 | $22,033 | $22,569 | +30% | $20,488 | +43% | ≈190% of Medicare |
| 964 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC | $29,086 | $21,815 | $23,966 | +21% | $25,854 | +13% | — |
| 629 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC | $28,912 | $21,684 | $32,385 | −11% | $45,059 | −36% | — |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $28,770 | $21,577 | $20,261 | +42% | $26,322 | +9% | — |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $28,652 | $21,489 | $21,367 | +34% | $17,273 | +66% | ≈161% of Medicare |
| 749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC | $28,639 | $21,479 | $33,278 | −14% | $41,703 | −31% | — |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $28,291 | $21,218 | $17,711 | +60% | $19,096 | +48% | ≈172% of Medicare |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $28,160 | $21,120 | $28,160 | +0% | $30,006 | −6% | — |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $28,112 | $21,084 | $18,398 | +53% | $20,732 | +36% | ≈169% of Medicare |
| 516 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | $28,020 | $21,015 | $29,304 | −4% | $45,817 | −39% | — |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $27,560 | $20,670 | $16,819 | +64% | $15,045 | +83% | — |
| 805 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC | $27,403 | $20,552 | $14,535 | +89% | $15,370 | +78% | — |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $27,183 | $20,387 | $27,183 | +0% | $18,278 | +49% | ≈166% of Medicare |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $27,118 | $20,339 | $27,118 | +0% | $27,118 | +0% | — |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $26,949 | $20,212 | $26,949 | +0% | $14,012 | +92% | — |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $26,593 | $19,945 | $24,270 | +10% | $27,219 | −2% | — |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $26,308 | $19,731 | $26,308 | +0% | $31,716 | −17% | — |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $25,998 | $19,499 | $25,998 | +0% | $26,020 | −0% | — |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $25,774 | $19,330 | $21,693 | +19% | $22,713 | +13% | — |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $25,609 | $19,207 | $19,528 | +31% | $14,134 | +81% | — |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $25,235 | $18,926 | $31,193 | −19% | $44,553 | −43% | — |
| 603 | CELLULITIS WITHOUT MCC | $25,137 | $18,853 | $19,438 | +29% | $18,530 | +36% | ≈162% of Medicare |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $25,129 | $18,847 | $25,129 | +0% | $22,560 | +11% | — |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $25,116 | $18,837 | $14,825 | +69% | $13,318 | +89% | ≈243% of Medicare |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $25,085 | $18,814 | $12,314 | +104% | $15,600 | +61% | — |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $24,932 | $18,699 | $19,462 | +28% | $20,007 | +25% | — |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $24,774 | $18,580 | $20,206 | +23% | $16,837 | +47% | — |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $24,340 | $18,255 | $14,889 | +63% | $15,876 | +53% | — |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $24,207 | $18,155 | $17,357 | +39% | $14,861 | +63% | — |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $24,179 | $18,134 | $9,887 | +145% | $9,385 | +158% | — |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $24,084 | $18,063 | $19,282 | +25% | $19,305 | +25% | — |
| 079 | HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC | $24,001 | $18,001 | $24,001 | +0% | $11,847 | +103% | — |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $23,835 | $17,877 | $15,484 | +54% | $17,388 | +37% | ≈165% of Medicare |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $23,768 | $17,826 | $16,396 | +45% | $14,128 | +68% | — |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC | $23,768 | $17,826 | $23,768 | +0% | $16,776 | +42% | — |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $23,447 | $17,585 | $13,825 | +70% | $13,824 | +70% | ≈193% of Medicare |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $23,407 | $17,555 | $14,600 | +60% | $17,322 | +35% | ≈179% of Medicare |
| 831 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC | $23,234 | $17,425 | $18,133 | +28% | $18,133 | +28% | — |
| 914 | TRAUMATIC INJURY WITHOUT MCC | $22,970 | $17,228 | $17,969 | +28% | $15,593 | +47% | — |
| 094 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC | $22,814 | $17,111 | $50,550 | −55% | $62,524 | −64% | — |
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $22,803 | $17,103 | $17,725 | +29% | $17,103 | +33% | — |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $22,785 | $17,089 | $17,809 | +28% | $13,384 | +70% | ≈210% of Medicare |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $22,580 | $16,935 | $22,580 | +0% | $24,432 | −8% | — |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $22,484 | $16,863 | $27,647 | −19% | $30,766 | −27% | — |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $22,058 | $16,543 | $15,085 | +46% | $13,090 | +69% | — |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $22,038 | $16,529 | $16,139 | +37% | $15,070 | +46% | — |
| 694 | URINARY STONES WITHOUT MCC | $22,004 | $16,503 | $22,004 | +0% | $16,531 | +33% | — |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $21,775 | $16,331 | $21,775 | +0% | $19,815 | +10% | — |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $21,014 | $15,761 | $10,316 | +104% | $11,955 | +76% | — |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $20,571 | $15,429 | $20,571 | +0% | $23,571 | −13% | — |
| 200 | PNEUMOTHORAX WITH CC | $20,548 | $15,411 | $17,568 | +17% | $20,573 | −0% | — |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $20,139 | $15,104 | $20,139 | +0% | $20,084 | +0% | — |
| 684 | RENAL FAILURE WITHOUT CC/MCC | $19,984 | $14,988 | $11,868 | +68% | $13,623 | +47% | — |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $19,778 | $14,834 | $19,778 | +0% | $17,700 | +12% | — |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $19,594 | $14,695 | $16,033 | +22% | $19,326 | +1% | — |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $19,404 | $14,553 | $12,173 | +59% | $14,441 | +34% | — |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $18,400 | $13,800 | $15,311 | +20% | $16,642 | +11% | — |
| 639 | DIABETES WITHOUT CC/MCC | $18,007 | $13,505 | $18,007 | +0% | $13,910 | +29% | — |
| 807 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | $17,133 | $12,849 | $14,153 | +21% | $12,044 | +42% | — |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $16,987 | $12,741 | $20,001 | −15% | $24,836 | −32% | — |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | $16,923 | $12,692 | $16,923 | +0% | $20,106 | −16% | — |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $16,588 | $12,441 | $28,958 | −43% | $29,633 | −44% | — |
| 885 | PSYCHOSES | $15,934 | $11,950 | $21,489 | −26% | $21,489 | −26% | ≈183% of Medicare |
| 769 | POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES | $15,775 | $11,831 | $21,228 | −26% | $24,561 | −36% | — |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $15,461 | $11,596 | $13,889 | +11% | $14,166 | +9% | — |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $15,322 | $11,492 | $15,322 | +0% | $13,890 | +10% | — |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $15,240 | $11,430 | $15,240 | +0% | $7,961 | +91% | — |
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | $15,040 | $11,280 | $17,159 | −12% | $17,943 | −16% | — |
| 817 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC | $14,393 | $10,795 | $36,097 | −60% | $36,097 | −60% | — |
| 881 | DEPRESSIVE NEUROSES | $14,026 | $10,519 | $14,026 | +0% | $15,058 | −7% | — |
| 642 | INBORN AND OTHER DISORDERS OF METABOLISM | $13,749 | $10,312 | $17,545 | −22% | $20,727 | −34% | — |
| 776 | POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES | $13,682 | $10,261 | $12,454 | +10% | $12,381 | +11% | — |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $13,574 | $10,180 | $13,574 | +0% | $16,049 | −15% | — |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $12,960 | $9,720 | $12,960 | +0% | $22,698 | −43% | — |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $12,545 | $9,409 | $15,636 | −20% | $15,636 | −20% | — |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $12,324 | $9,243 | $11,294 | +9% | $12,013 | +3% | — |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $11,579 | $8,684 | $12,204 | −5% | $13,303 | −13% | — |
| 832 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC | $11,484 | $8,613 | $11,484 | +0% | $12,895 | −11% | — |
| 284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC | $11,329 | $8,497 | $11,329 | +0% | $13,282 | −15% | — |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $11,319 | $8,489 | $18,290 | −38% | $21,062 | −46% | — |
| 882 | NEUROSES EXCEPT DEPRESSIVE | $10,585 | $7,939 | $10,585 | +0% | $15,680 | −32% | — |
| 833 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC | $10,180 | $7,635 | $9,940 | +2% | $9,076 | +12% | — |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $10,171 | $7,629 | $10,171 | +0% | $14,208 | −28% | — |
| 201 | PNEUMOTHORAX WITHOUT CC/MCC | $9,196 | $6,897 | $11,982 | −23% | $13,081 | −30% | — |
| 795 | NORMAL NEWBORN | $8,109 | $6,082 | $7,385 | +10% | $4,530 | +79% | — |
| 779 | ABORTION WITHOUT D&C | $5,619 | $4,214 | $15,327 | −63% | $15,327 | −63% | — |
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 |
|---|---|---|---|
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | — | 27 plans |
No procedures match that keyword.