Baptist Health Lexington — 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.
Estimate your out-of-pocket cost
Enter what's left on your plan this year, then choose a procedure — click any row below or its “Estimate” button.
Leave blank if unsure — no cap will be applied.
No procedure selected yet — pick a row in the table below to see an estimate here.
Estimate only. Your plan's actual negotiated rate, network status, and benefit rules control what you pay — confirm with your insurer. Professional fees (surgeon, anesthesia) are usually billed separately.
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 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 83 procedures, this hospital's negotiated rates average ≈168% 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% | $61,217 | +439% | — |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES | $291,377 | $218,533 | $248,002 | +17% | $248,521 | +17% | — |
| 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% | $85,566 | +186% | — |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $234,559 | $175,919 | $170,239 | +38% | $148,832 | +58% | — |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $229,131 | $171,848 | $116,959 | +96% | $58,707 | +290% | ≈226% of Medicare |
| 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% | $49,418 | +333% | — |
| 096 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC | $211,017 | $158,263 | $125,467 | +68% | $41,620 | +407% | — |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $203,419 | $152,564 | $56,247 | +262% | $52,178 | +290% | — |
| 321 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES | $202,295 | $151,721 | $124,873 | +62% | $81,706 | +148% | ≈179% of Medicare |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $200,794 | $150,595 | $110,293 | +82% | $50,011 | +301% | ≈165% of Medicare |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $186,496 | $139,872 | $144,793 | +29% | $90,195 | +107% | ≈179% of Medicare |
| 242 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | $182,756 | $137,067 | $109,863 | +66% | $70,132 | +161% | ≈190% of Medicare |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $180,125 | $135,093 | $84,875 | +112% | $41,591 | +333% | — |
| 322 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | $179,957 | $134,968 | $90,850 | +98% | $58,809 | +206% | ≈217% of Medicare |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $179,689 | $134,767 | $40,375 | +345% | $34,192 | +426% | ≈166% of Medicare |
| 799 | SPLENIC PROCEDURES WITH MCC | $179,281 | $134,461 | $76,920 | +133% | $82,218 | +118% | — |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC | $175,746 | $131,810 | $99,124 | +77% | $62,264 | +182% | — |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $175,436 | $131,577 | $43,771 | +301% | $28,140 | +523% | — |
| 253 | OTHER VASCULAR PROCEDURES WITH CC | $174,917 | $131,188 | $88,518 | +98% | $57,454 | +204% | — |
| 485 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC | $169,369 | $127,027 | $111,366 | +52% | $72,424 | +134% | — |
| 082 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | $168,628 | $126,471 | $38,890 | +334% | $36,489 | +362% | — |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $160,937 | $120,702 | $114,909 | +40% | $90,775 | +77% | ≈203% of Medicare |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC | $155,129 | $116,347 | $65,200 | +138% | $52,075 | +198% | — |
| 250 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | $154,884 | $116,163 | $84,405 | +83% | $59,629 | +160% | — |
| 346 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $145,630 | $109,223 | $36,599 | +298% | $27,297 | +433% | — |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $141,224 | $105,918 | $55,519 | +154% | $66,685 | +112% | — |
| 271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | $141,141 | $105,856 | $119,602 | +18% | $71,014 | +99% | ≈92% of Medicare |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC | $138,008 | $103,506 | $49,318 | +180% | $39,887 | +246% | — |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $134,642 | $100,981 | $49,675 | +171% | $39,973 | +237% | — |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $133,729 | $100,297 | $21,563 | +520% | $26,280 | +409% | — |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $133,696 | $100,272 | $120,161 | +11% | $88,050 | +52% | ≈169% of Medicare |
| 548 | SEPTIC ARTHRITIS WITH MCC | $131,522 | $98,641 | $76,195 | +73% | $31,346 | +320% | — |
| 353 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC | $130,509 | $97,882 | $78,680 | +66% | $60,170 | +117% | — |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $127,425 | $95,569 | $110,649 | +15% | $93,172 | +37% | ≈142% 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 | $98,638 | +29% | $77,990 | +63% | — |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $126,393 | $94,795 | $77,090 | +64% | $93,390 | +35% | — |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $125,579 | $94,184 | $80,371 | +56% | $65,653 | +91% | ≈191% of Medicare |
| 868 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC | $124,941 | $93,706 | $25,400 | +392% | $22,763 | +449% | — |
| 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 | $65,742 | +76% | $46,453 | +149% | — |
| 251 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC | $114,961 | $86,221 | $67,497 | +70% | $46,295 | +148% | — |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $111,373 | $83,529 | $70,030 | +59% | $52,405 | +113% | — |
| 103 | HEADACHES WITHOUT MCC | $110,170 | $82,628 | $20,630 | +434% | $21,280 | +418% | — |
| 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% | $52,751 | +101% | ≈215% of Medicare |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $103,982 | $77,986 | $26,362 | +294% | $18,640 | +458% | — |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $102,356 | $76,767 | $69,428 | +47% | $50,607 | +102% | — |
| 653 | MAJOR BLADDER PROCEDURES WITH MCC | $100,871 | $75,653 | $100,871 | +0% | $104,583 | −4% | — |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $100,074 | $75,055 | $100,074 | +0% | $70,467 | +42% | — |
| 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% | $87,761 | +14% | — |
| 907 | OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | $98,685 | $74,014 | $54,898 | +80% | $77,817 | +27% | — |
| 068 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $98,002 | $73,502 | $26,359 | +272% | $19,569 | +401% | — |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $96,933 | $72,700 | $36,090 | +169% | $37,387 | +159% | — |
| 956 | LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | $95,859 | $71,894 | $78,776 | +22% | $75,103 | +28% | — |
| 327 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | $95,537 | $71,653 | $94,359 | +1% | $59,421 | +61% | — |
| 515 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC | $95,340 | $71,505 | $64,691 | +47% | $62,821 | +52% | — |
| 335 | PERITONEAL ADHESIOLYSIS WITH MCC | $95,302 | $71,476 | $71,508 | +33% | $71,755 | +33% | — |
| 474 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC | $95,234 | $71,426 | $78,803 | +21% | $84,692 | +12% | — |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC | $93,356 | $70,017 | $78,561 | +19% | $36,431 | +156% | — |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $88,366 | $66,274 | $51,699 | +71% | $50,618 | +75% | — |
| 987 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $87,611 | $65,709 | $68,276 | +28% | $66,068 | +33% | — |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $87,341 | $65,506 | $30,644 | +185% | $27,543 | +217% | ≈159% of Medicare |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $87,107 | $65,330 | $87,107 | +0% | $70,564 | +23% | — |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $86,878 | $65,158 | $74,394 | +17% | $58,280 | +49% | ≈221% of Medicare |
| 264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $86,821 | $65,116 | $61,215 | +42% | $51,953 | +67% | — |
| 302 | ATHEROSCLEROSIS WITH MCC | $84,199 | $63,149 | $19,372 | +335% | $22,446 | +275% | — |
| 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 | $51,211 | +62% | $32,877 | +153% | — |
| 314 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | $83,018 | $62,264 | $39,353 | +111% | $38,666 | +115% | ≈157% of Medicare |
| 286 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | $82,901 | $62,176 | $54,337 | +53% | $46,283 | +79% | ≈164% of Medicare |
| 628 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC | $81,083 | $60,812 | $57,682 | +41% | $71,795 | +13% | — |
| 570 | SKIN DEBRIDEMENT WITH MCC | $80,872 | $60,654 | $60,276 | +34% | $52,435 | +54% | — |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $80,380 | $60,285 | $32,529 | +147% | $27,401 | +193% | — |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $80,287 | $60,215 | $80,287 | +0% | $47,711 | +68% | — |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $79,128 | $59,346 | $60,868 | +30% | $41,955 | +89% | — |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $79,114 | $59,336 | $18,755 | +322% | $17,620 | +349% | — |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $78,332 | $58,749 | $45,971 | +70% | $32,841 | +139% | — |
| 326 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | $77,786 | $58,340 | $77,786 | +0% | $80,793 | −4% | — |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $77,316 | $57,987 | $41,432 | +87% | $20,926 | +269% | — |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $76,662 | $57,496 | $41,406 | +85% | $36,658 | +109% | — |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $75,729 | $56,796 | $21,201 | +257% | $25,279 | +200% | — |
| 865 | VIRAL ILLNESS WITH MCC | $75,566 | $56,675 | $22,618 | +234% | $26,910 | +181% | — |
| 166 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC | $75,141 | $56,356 | $56,889 | +32% | $75,573 | −1% | — |
| 283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | $75,070 | $56,302 | $38,806 | +93% | $39,955 | +88% | — |
| 077 | HYPERTENSIVE ENCEPHALOPATHY WITH MCC | $74,901 | $56,176 | $57,682 | +30% | $24,550 | +205% | — |
| 503 | FOOT PROCEDURES WITH MCC | $73,699 | $55,274 | $73,699 | +0% | $47,540 | +55% | — |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $73,681 | $55,261 | $29,116 | +153% | $22,033 | +234% | — |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $72,980 | $54,735 | $47,008 | +55% | $42,914 | +70% | — |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $72,359 | $54,269 | $22,651 | +219% | $30,502 | +137% | — |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $72,139 | $54,104 | $54,567 | +32% | $33,555 | +115% | — |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $71,359 | $53,519 | $57,323 | +24% | $18,649 | +283% | — |
| 549 | SEPTIC ARTHRITIS WITH CC | $71,337 | $53,503 | $41,585 | +72% | $24,056 | +197% | — |
| 867 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC | $70,329 | $52,747 | $35,153 | +100% | $38,070 | +85% | — |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $70,196 | $52,647 | $32,091 | +119% | $30,235 | +132% | — |
| 205 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | $69,645 | $52,234 | $27,695 | +151% | $33,255 | +109% | — |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $69,627 | $52,220 | $52,078 | +34% | $37,842 | +84% | ≈162% of Medicare |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | $69,596 | $52,197 | $41,620 | +67% | $32,021 | +117% | ≈201% of Medicare |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $68,067 | $51,050 | $44,069 | +54% | $33,047 | +106% | — |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $67,964 | $50,973 | $37,644 | +81% | $39,958 | +70% | — |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $67,011 | $50,258 | $61,483 | +9% | $43,477 | +54% | — |
| 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 | $62,554 | +7% | $53,451 | +25% | — |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $66,386 | $49,790 | $34,755 | +91% | $31,951 | +108% | — |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $66,354 | $49,765 | $32,815 | +102% | $39,106 | +70% | ≈151% of Medicare |
| 398 | APPENDIX PROCEDURES WITH CC | $66,071 | $49,553 | $51,309 | +29% | $40,162 | +65% | — |
| 571 | SKIN DEBRIDEMENT WITH CC | $65,459 | $49,095 | $50,449 | +30% | $37,169 | +76% | — |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $63,265 | $47,449 | $53,565 | +18% | $33,653 | +88% | — |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $62,713 | $47,034 | $20,145 | +211% | $26,051 | +141% | — |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $62,558 | $46,918 | $40,467 | +55% | $30,828 | +103% | ≈167% of Medicare |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $61,939 | $46,454 | $35,896 | +73% | $32,496 | +91% | ≈151% of Medicare |
| 186 | PLEURAL EFFUSION WITH MCC | $61,473 | $46,105 | $41,699 | +47% | $33,834 | +82% | — |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $60,986 | $45,740 | $25,521 | +139% | $21,396 | +185% | ≈164% of Medicare |
| 542 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | $60,768 | $45,576 | $39,006 | +56% | $36,792 | +65% | — |
| 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 | $27,428 | +121% | $18,150 | +234% | — |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $60,369 | $45,277 | $28,685 | +110% | $33,633 | +79% | — |
| 252 | OTHER VASCULAR PROCEDURES WITH MCC | $60,309 | $45,232 | $60,309 | +0% | $68,508 | −12% | — |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $59,900 | $44,925 | $40,976 | +46% | $50,394 | +19% | — |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $59,769 | $44,827 | $22,268 | +168% | $17,921 | +234% | ≈161% of Medicare |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $59,500 | $44,625 | $59,500 | +0% | $59,500 | +0% | ≈121% of Medicare |
| 602 | CELLULITIS WITH MCC | $58,725 | $44,044 | $36,196 | +62% | $30,598 | +92% | ≈165% of Medicare |
| 078 | HYPERTENSIVE ENCEPHALOPATHY WITH CC | $58,587 | $43,940 | $58,134 | +1% | $17,698 | +231% | — |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $58,541 | $43,906 | $37,691 | +55% | $35,628 | +64% | ≈153% of Medicare |
| 643 | ENDOCRINE DISORDERS WITH MCC | $58,139 | $43,605 | $39,983 | +45% | $33,563 | +73% | — |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $58,109 | $43,582 | $29,543 | +97% | $20,181 | +188% | ≈184% of Medicare |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $57,663 | $43,247 | $31,922 | +81% | $33,707 | +71% | ≈153% of Medicare |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $57,572 | $43,179 | $57,572 | +0% | $44,606 | +29% | ≈165% of Medicare |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $57,221 | $42,916 | $29,026 | +97% | $30,083 | +90% | — |
| 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% | $43,943 | +30% | ≈192% of Medicare |
| 336 | PERITONEAL ADHESIOLYSIS WITH CC | $56,208 | $42,156 | $51,108 | +10% | $50,463 | +11% | — |
| 606 | MINOR SKIN DISORDERS WITH MCC | $55,926 | $41,944 | $33,799 | +65% | $27,975 | +100% | — |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $55,888 | $41,916 | $47,529 | +18% | $49,351 | +13% | — |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $55,055 | $41,291 | $55,055 | +0% | $42,679 | +29% | — |
| 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% | $27,043 | +102% | — |
| 813 | COAGULATION DISORDERS | $54,460 | $40,845 | $24,365 | +124% | $33,296 | +64% | — |
| 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% | $28,226 | +92% | ≈159% of Medicare |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $54,197 | $40,648 | $38,406 | +41% | $34,273 | +58% | — |
| 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 | $40,406 | +33% | $32,628 | +65% | — |
| 654 | MAJOR BLADDER PROCEDURES WITH CC | $53,779 | $40,335 | $53,779 | +0% | $58,274 | −8% | — |
| 152 | OTITIS MEDIA AND URI WITH MCC | $53,388 | $40,041 | $17,922 | +198% | $20,247 | +164% | — |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $53,244 | $39,933 | $29,948 | +78% | $31,159 | +71% | — |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $53,202 | $39,901 | $29,332 | +81% | $34,017 | +56% | — |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $52,993 | $39,745 | $23,406 | +126% | $20,422 | +159% | — |
| 783 | CESAREAN SECTION WITH STERILIZATION WITH MCC | $52,850 | $39,637 | $37,387 | +41% | $29,221 | +81% | — |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $52,716 | $39,537 | $29,985 | +76% | $37,950 | +39% | ≈194% of Medicare |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $52,600 | $39,450 | $20,533 | +156% | $14,583 | +261% | — |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $52,471 | $39,353 | $33,054 | +59% | $23,940 | +119% | ≈217% of Medicare |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $51,962 | $38,972 | $51,962 | +0% | $44,117 | +18% | ≈182% of Medicare |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $51,725 | $38,793 | $33,589 | +54% | $27,843 | +86% | — |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $51,680 | $38,760 | $12,771 | +305% | $12,559 | +312% | — |
| 637 | DIABETES WITH MCC | $51,632 | $38,724 | $32,615 | +58% | $30,100 | +72% | ≈156% of Medicare |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $51,429 | $38,572 | $45,317 | +13% | $26,770 | +92% | ≈159% of Medicare |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $51,056 | $38,292 | $32,985 | +55% | $30,243 | +69% | — |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $50,885 | $38,163 | $32,631 | +56% | $26,580 | +91% | ≈188% of Medicare |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $50,618 | $37,964 | $22,313 | +127% | $23,488 | +116% | ≈187% of Medicare |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $50,521 | $37,891 | $28,603 | +77% | $22,024 | +129% | ≈187% of Medicare |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $50,502 | $37,876 | $29,140 | +73% | $20,463 | +147% | ≈261% of Medicare |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $50,224 | $37,668 | $32,942 | +52% | $40,213 | +25% | — |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $50,046 | $37,535 | $49,941 | +0% | $50,046 | +0% | — |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $49,601 | $37,201 | $33,107 | +50% | $24,552 | +102% | — |
| 100 | SEIZURES WITH MCC | $49,277 | $36,958 | $34,570 | +43% | $35,481 | +39% | ≈156% of Medicare |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $48,482 | $36,362 | $48,482 | +0% | $39,006 | +24% | — |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $48,372 | $36,279 | $36,329 | +33% | $31,105 | +56% | — |
| 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 | $40,222 | +20% | $33,787 | +42% | — |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $47,895 | $35,921 | $24,572 | +95% | $22,458 | +113% | — |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $47,784 | $35,838 | $42,046 | +14% | $33,985 | +41% | — |
| 810 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC | $47,319 | $35,489 | $40,293 | +17% | $18,316 | +158% | — |
| 655 | MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | $47,191 | $35,393 | $47,191 | +0% | $43,174 | +9% | — |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $46,213 | $34,660 | $15,326 | +202% | $14,648 | +215% | ≈189% of Medicare |
| 080 | NONTRAUMATIC STUPOR AND COMA WITH MCC | $46,114 | $34,586 | $35,307 | +31% | $36,249 | +27% | — |
| 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 | $44,022 | +4% | $42,881 | +7% | ≈158% of Medicare |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $45,701 | $34,276 | $29,466 | +55% | $27,316 | +67% | — |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $45,583 | $34,187 | $19,117 | +138% | $18,488 | +147% | — |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $45,448 | $34,086 | $26,858 | +69% | $23,617 | +92% | ≈177% of Medicare |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $45,412 | $34,059 | $39,586 | +15% | $31,321 | +45% | — |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $45,398 | $34,049 | $45,398 | +0% | $35,030 | +30% | — |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $45,327 | $33,995 | $29,080 | +56% | $23,141 | +96% | — |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $45,310 | $33,982 | $26,787 | +69% | $33,424 | +36% | — |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $45,264 | $33,948 | $31,283 | +45% | $23,319 | +94% | — |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $44,484 | $33,363 | $20,876 | +113% | $20,781 | +114% | ≈207% of Medicare |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $44,310 | $33,233 | $44,310 | +0% | $39,211 | +13% | — |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $44,105 | $33,079 | $34,854 | +27% | $38,101 | +16% | — |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $44,071 | $33,053 | $32,532 | +35% | $19,227 | +129% | — |
| 682 | RENAL FAILURE WITH MCC | $43,912 | $32,934 | $35,346 | +24% | $29,064 | +51% | ≈162% of Medicare |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $43,861 | $32,896 | $31,466 | +39% | $27,275 | +61% | ≈157% of Medicare |
| 539 | OSTEOMYELITIS WITH MCC | $43,860 | $32,895 | $39,199 | +12% | $37,609 | +17% | — |
| 149 | DYSEQUILIBRIUM | $43,745 | $32,809 | $21,737 | +101% | $18,096 | +142% | — |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $43,697 | $32,773 | $27,950 | +56% | $26,776 | +63% | ≈155% of Medicare |
| 922 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC | $43,694 | $32,770 | $25,121 | +74% | $31,563 | +38% | — |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $43,650 | $32,738 | $41,620 | +5% | $27,426 | +59% | — |
| 101 | SEIZURES WITHOUT MCC | $43,591 | $32,694 | $17,956 | +143% | $20,461 | +113% | ≈205% of Medicare |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $43,196 | $32,397 | $43,196 | +0% | $33,661 | +28% | — |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | $43,156 | $32,367 | $22,205 | +94% | $23,551 | +83% | — |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $43,107 | $32,330 | $33,854 | +27% | $32,859 | +31% | — |
| 693 | URINARY STONES WITH MCC | $43,048 | $32,286 | $31,040 | +39% | $23,892 | +80% | — |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $42,919 | $32,190 | $25,981 | +65% | $22,148 | +94% | — |
| 311 | ANGINA PECTORIS | $42,516 | $31,887 | $19,453 | +119% | $15,502 | +174% | — |
| 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 | $56,996 | −26% | $76,001 | −44% | — |
| 187 | PLEURAL EFFUSION WITH CC | $42,148 | $31,611 | $22,677 | +86% | $21,789 | +93% | — |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $41,980 | $31,485 | $26,590 | +58% | $16,351 | +157% | — |
| 351 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC | $41,895 | $31,421 | $41,895 | +0% | $36,505 | +15% | — |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $41,674 | $31,255 | $31,730 | +31% | $28,050 | +49% | ≈150% of Medicare |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $41,581 | $31,186 | $39,472 | +5% | $30,959 | +34% | ≈145% of Medicare |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $41,516 | $31,137 | $41,516 | +0% | $39,181 | +6% | — |
| 915 | ALLERGIC REACTIONS WITH MCC | $41,366 | $31,024 | $41,366 | +0% | $32,645 | +27% | — |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $41,271 | $30,953 | $27,659 | +49% | $21,056 | +96% | ≈227% of Medicare |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $41,006 | $30,755 | $32,757 | +25% | $25,463 | +61% | ≈151% of Medicare |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $40,894 | $30,671 | $40,991 | −0% | $59,790 | −32% | — |
| 167 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC | $40,642 | $30,482 | $40,642 | +0% | $40,642 | +0% | — |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $40,486 | $30,364 | $22,879 | +77% | $20,901 | +94% | — |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $40,470 | $30,352 | $24,871 | +63% | $26,682 | +52% | — |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $40,369 | $30,277 | $25,095 | +61% | $20,506 | +97% | — |
| 075 | VIRAL MENINGITIS WITH CC/MCC | $40,312 | $30,234 | $39,006 | +3% | $30,447 | +32% | — |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $40,212 | $30,159 | $17,559 | +129% | $17,559 | +129% | — |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $40,130 | $30,098 | $40,130 | +0% | $34,459 | +16% | — |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $39,628 | $29,721 | $38,329 | +3% | $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% | $49,423 | −20% | — |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $39,550 | $29,663 | $32,483 | +22% | $24,177 | +64% | — |
| 504 | FOOT PROCEDURES WITH CC | $39,089 | $29,317 | $39,089 | +0% | $38,960 | +0% | — |
| 181 | RESPIRATORY NEOPLASMS WITH CC | $38,503 | $28,877 | $29,493 | +31% | $23,573 | +63% | — |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $38,378 | $28,784 | $34,988 | +10% | $12,229 | +214% | — |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $37,880 | $28,410 | $37,880 | +0% | $25,034 | +51% | — |
| 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 | $20,530 | +83% | $19,842 | +89% | ≈198% of Medicare |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $37,431 | $28,073 | $30,021 | +25% | $24,127 | +55% | — |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $37,398 | $28,049 | $20,809 | +80% | $21,363 | +75% | ≈175% of Medicare |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $37,356 | $28,017 | $29,232 | +28% | $24,386 | +53% | ≈160% of Medicare |
| 313 | CHEST PAIN | $37,240 | $27,930 | $17,918 | +108% | $16,440 | +127% | — |
| 102 | HEADACHES WITH MCC | $37,228 | $27,921 | $18,243 | +104% | $25,740 | +45% | — |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $36,969 | $27,727 | $25,241 | +46% | $16,288 | +127% | — |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $36,937 | $27,703 | $36,937 | +0% | $36,937 | +0% | — |
| 304 | HYPERTENSION WITH MCC | $36,823 | $27,618 | $21,518 | +71% | $26,080 | +41% | — |
| 663 | MINOR BLADDER PROCEDURES WITH CC | $36,581 | $27,436 | $36,581 | +0% | $33,103 | +11% | — |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $36,448 | $27,336 | $15,310 | +138% | $18,528 | +97% | — |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $36,384 | $27,288 | $36,384 | +0% | $30,784 | +18% | — |
| 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 | $21,410 | +69% | $21,449 | +69% | — |
| 816 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC | $36,242 | $27,182 | $11,752 | +208% | $14,638 | +148% | — |
| 950 | AFTERCARE WITHOUT CC/MCC | $35,936 | $26,952 | $25,102 | +43% | $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% | $58,228 | −39% | — |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $35,467 | $26,600 | $24,661 | +44% | $22,888 | +55% | ≈164% 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% | $89,207 | −60% | — |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $35,212 | $26,409 | $24,273 | +45% | $18,204 | +93% | ≈219% of Medicare |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $35,051 | $26,289 | $29,825 | +18% | $23,749 | +48% | — |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $34,721 | $26,041 | $24,091 | +44% | $22,468 | +55% | — |
| 312 | SYNCOPE AND COLLAPSE | $34,451 | $25,838 | $22,612 | +52% | $19,342 | +78% | ≈180% of Medicare |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $34,428 | $25,821 | $29,306 | +17% | $15,889 | +117% | — |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $34,330 | $25,748 | $29,153 | +18% | $26,932 | +27% | — |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $34,308 | $25,731 | $18,064 | +90% | $18,002 | +91% | ≈213% of Medicare |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $34,165 | $25,624 | $34,165 | +0% | $31,264 | +9% | ≈181% of Medicare |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $33,876 | $25,407 | $29,372 | +15% | $33,876 | +0% | — |
| 866 | VIRAL ILLNESS WITHOUT MCC | $33,845 | $25,384 | $14,678 | +131% | $17,081 | +98% | — |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $33,470 | $25,103 | $19,048 | +76% | $18,459 | +81% | — |
| 644 | ENDOCRINE DISORDERS WITH CC | $33,402 | $25,051 | $20,072 | +66% | $23,198 | +44% | — |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $33,295 | $24,971 | $33,295 | +0% | $24,914 | +34% | ≈151% of Medicare |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $33,279 | $24,959 | $33,279 | +0% | $22,098 | +51% | ≈152% of Medicare |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $33,073 | $24,805 | $33,073 | +0% | $20,911 | +58% | — |
| 683 | RENAL FAILURE WITH CC | $32,985 | $24,739 | $16,816 | +96% | $19,130 | +72% | ≈173% of Medicare |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $32,726 | $24,545 | $32,399 | +1% | $30,571 | +7% | — |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $32,620 | $24,465 | $15,986 | +104% | $20,895 | +56% | — |
| 638 | DIABETES WITH CC | $32,614 | $24,461 | $19,243 | +69% | $19,661 | +66% | ≈163% of Medicare |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $32,586 | $24,440 | $21,581 | +51% | $17,303 | +88% | ≈217% of Medicare |
| 593 | SKIN ULCERS WITH CC | $32,176 | $24,132 | $29,409 | +9% | $22,886 | +41% | — |
| 301 | PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC | $31,937 | $23,953 | $15,461 | +107% | $15,837 | +102% | — |
| 501 | SOFT TISSUE PROCEDURES WITH CC | $31,927 | $23,945 | $31,927 | +0% | $39,619 | −19% | — |
| 305 | HYPERTENSION WITHOUT MCC | $31,906 | $23,929 | $27,094 | +18% | $18,086 | +76% | ≈206% of Medicare |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $31,644 | $23,733 | $19,935 | +59% | $17,038 | +86% | ≈193% of Medicare |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $31,580 | $23,685 | $19,874 | +59% | $15,019 | +110% | — |
| 540 | OSTEOMYELITIS WITH CC | $31,282 | $23,462 | $31,282 | +0% | $26,676 | +17% | — |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $31,279 | $23,459 | $18,375 | +70% | $17,601 | +78% | — |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $31,100 | $23,325 | $17,494 | +78% | $17,674 | +76% | ≈181% of Medicare |
| 292 | HEART FAILURE AND SHOCK WITH CC | $31,071 | $23,303 | $22,544 | +38% | $16,371 | +90% | ≈156% of Medicare |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $30,995 | $23,246 | $30,775 | +1% | $34,354 | −10% | — |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $30,886 | $23,164 | $24,272 | +27% | $15,495 | +99% | — |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $30,716 | $23,037 | $16,076 | +91% | $18,602 | +65% | — |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $30,636 | $22,977 | $17,527 | +75% | $16,767 | +83% | — |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $30,494 | $22,871 | $37,242 | −18% | $54,929 | −44% | ≈101% of Medicare |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $30,486 | $22,865 | $24,353 | +25% | $18,081 | +69% | ≈172% of Medicare |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $30,304 | $22,728 | $30,304 | +0% | $25,970 | +17% | — |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $30,019 | $22,514 | $21,605 | +39% | $22,506 | +33% | — |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $29,617 | $22,213 | $20,526 | +44% | $14,927 | +98% | — |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $29,480 | $22,110 | $25,422 | +16% | $22,850 | +29% | ≈153% of Medicare |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $29,377 | $22,033 | $22,569 | +30% | $20,488 | +43% | ≈162% of Medicare |
| 964 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC | $29,086 | $21,815 | $23,966 | +21% | $27,394 | +6% | — |
| 629 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC | $28,912 | $21,684 | $32,385 | −11% | $47,737 | −39% | — |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $28,770 | $21,577 | $21,446 | +34% | $27,163 | +6% | — |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $28,652 | $21,489 | $22,232 | +29% | $17,724 | +62% | ≈171% of Medicare |
| 749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC | $28,639 | $21,479 | $36,791 | −22% | $45,167 | −37% | — |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $28,291 | $21,218 | $21,120 | +34% | $19,096 | +48% | — |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $28,160 | $21,120 | $28,160 | +0% | $31,017 | −9% | — |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $28,112 | $21,084 | $22,138 | +27% | $21,275 | +32% | ≈158% of Medicare |
| 516 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | $28,020 | $21,015 | $29,304 | −4% | $46,090 | −39% | — |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $27,560 | $20,670 | $16,819 | +64% | $15,452 | +78% | — |
| 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% | $18,807 | +45% | ≈155% of Medicare |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $27,118 | $20,339 | $27,118 | +0% | $27,152 | −0% | — |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $26,949 | $20,212 | $26,949 | +0% | $14,415 | +87% | — |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $26,593 | $19,945 | $24,270 | +10% | $27,277 | −3% | — |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $26,308 | $19,731 | $26,308 | +0% | $34,937 | −25% | — |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $25,998 | $19,499 | $25,998 | +0% | $27,617 | −6% | — |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $25,774 | $19,330 | $23,734 | +9% | $25,303 | +2% | — |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $25,609 | $19,207 | $20,048 | +28% | $15,038 | +70% | — |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $25,235 | $18,926 | $31,193 | −19% | $45,877 | −45% | — |
| 603 | CELLULITIS WITHOUT MCC | $25,137 | $18,853 | $21,796 | +15% | $18,530 | +36% | ≈167% of Medicare |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $25,129 | $18,847 | $25,129 | +0% | $23,283 | +8% | — |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $25,116 | $18,837 | $16,503 | +52% | $13,361 | +88% | — |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $25,085 | $18,814 | $17,650 | +42% | $15,600 | +61% | — |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $24,932 | $18,699 | $19,734 | +26% | $20,957 | +19% | — |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $24,774 | $18,580 | $20,206 | +23% | $17,118 | +45% | — |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $24,340 | $18,255 | $15,868 | +53% | $17,298 | +41% | — |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $24,207 | $18,155 | $17,357 | +39% | $16,565 | +46% | — |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $24,179 | $18,134 | $10,553 | +129% | $10,160 | +138% | — |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $24,084 | $18,063 | $24,084 | +0% | $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 | $17,991 | +32% | $17,578 | +36% | ≈171% 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 | $14,615 | +60% | $13,824 | +70% | ≈211% of Medicare |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $23,407 | $17,555 | $18,806 | +24% | $17,322 | +35% | ≈168% 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 | $20,851 | +10% | $15,855 | +45% | — |
| 094 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC | $22,814 | $17,111 | $50,550 | −55% | $68,639 | −67% | — |
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $22,803 | $17,103 | $17,725 | +29% | $16,846 | +35% | — |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $22,785 | $17,089 | $20,885 | +9% | $13,384 | +70% | ≈234% of Medicare |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $22,580 | $16,935 | $22,580 | +0% | $24,944 | −9% | — |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $22,484 | $16,863 | $27,647 | −19% | $32,637 | −31% | — |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $22,058 | $16,543 | $15,085 | +46% | $13,275 | +66% | — |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $22,038 | $16,529 | $17,275 | +28% | $15,183 | +45% | — |
| 694 | URINARY STONES WITHOUT MCC | $22,004 | $16,503 | $22,004 | +0% | $17,345 | +27% | — |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $21,775 | $16,331 | $21,775 | +0% | $19,846 | +10% | — |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $21,014 | $15,761 | $10,316 | +104% | $12,999 | +62% | — |
| 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% | $21,368 | −4% | — |
| 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 | $13,284 | +50% | $13,642 | +46% | — |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $19,778 | $14,834 | $19,778 | +0% | $18,466 | +7% | — |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $19,594 | $14,695 | $16,474 | +19% | $19,594 | +0% | — |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $19,404 | $14,553 | $15,788 | +23% | $14,689 | +32% | — |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $18,400 | $13,800 | $15,311 | +20% | $16,968 | +8% | — |
| 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% | $12,078 | +42% | — |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $16,987 | $12,741 | $20,001 | −15% | $26,510 | −36% | — |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | $16,923 | $12,692 | $16,923 | +0% | $21,941 | −23% | — |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $16,588 | $12,441 | $28,958 | −43% | $32,574 | −49% | — |
| 885 | PSYCHOSES | $15,934 | $11,950 | $21,489 | −26% | $21,729 | −27% | — |
| 769 | POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES | $15,775 | $11,831 | $21,228 | −26% | $25,094 | −37% | — |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $15,461 | $11,596 | $14,675 | +5% | $15,428 | +0% | — |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $15,322 | $11,492 | $15,322 | +0% | $13,942 | +10% | — |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $15,240 | $11,430 | $15,240 | +0% | $8,445 | +80% | — |
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | $15,040 | $11,280 | $17,159 | −12% | $18,956 | −21% | — |
| 817 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC | $14,393 | $10,795 | $36,097 | −60% | $39,173 | −63% | — |
| 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% | $12,454 | +10% | — |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $13,574 | $10,180 | $13,574 | +0% | $16,699 | −19% | — |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $12,960 | $9,720 | $12,960 | +0% | $23,206 | −44% | — |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $12,545 | $9,409 | $15,243 | −18% | $17,733 | −29% | — |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $12,324 | $9,243 | $11,294 | +9% | $12,324 | +0% | — |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $11,579 | $8,684 | $12,204 | −5% | $14,797 | −22% | — |
| 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% | $16,450 | −31% | — |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $11,319 | $8,489 | $18,290 | −38% | $23,443 | −52% | — |
| 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% | $9,940 | +2% | — |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $10,171 | $7,629 | $10,171 | +0% | $14,250 | −29% | — |
| 201 | PNEUMOTHORAX WITHOUT CC/MCC | $9,196 | $6,897 | $11,982 | −23% | $14,053 | −35% | — |
| 795 | NORMAL NEWBORN | $8,109 | $6,082 | $7,412 | +9% | $4,720 | +72% | — |
| 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.