Monroe County Medical Center — Pricing

225 procedures published in this hospital's Machine-Readable File (MRF) — 216 with a comparable price, 9 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 225
Lowest published price $147
Average published price $9,245
Highest published price $43,626

Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.

Showing all 225 procedures

Published charges

Showing all 216 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 10 procedures, this hospital's negotiated rates average ≈162% of what Medicare pays.

DRG Description Published price Cash price vs. KY median vs. National median vs Medicare
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $43,626 $36,210 $22,651 +93% $29,484 +48% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $34,031 $28,246 $43,892 −22% $39,409 −14% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $30,482 $25,300 $27,647 +10% $30,766 −1% —
597 MALIGNANT BREAST DISORDERS WITH MCC $29,733 $24,678 $28,079 +6% $31,846 −7% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $29,484 $24,472 $29,484 +0% $25,704 +15% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $24,642 $20,453 $21,605 +14% $21,545 +14% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $24,374 $20,231 $27,668 −12% $32,981 −26% —
920 COMPLICATIONS OF TREATMENT WITH CC $22,585 $18,745 $24,091 −6% $21,181 +7% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $22,226 $18,448 $28,666 −22% $31,840 −30% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $21,696 $18,007 $23,559 −8% $22,850 −5% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $21,687 $18,000 $41,516 −48% $36,334 −40% —
180 RESPIRATORY NEOPLASMS WITH MCC $20,796 $17,261 $41,406 −50% $36,658 −43% —
593 SKIN ULCERS WITH CC $20,458 $16,980 $28,252 −28% $20,470 −0% —
682 RENAL FAILURE WITH MCC $20,271 $16,825 $34,605 −41% $27,854 −27% —
374 DIGESTIVE MALIGNANCY WITH MCC $20,106 $16,688 $37,644 −47% $38,885 −48% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $19,872 $16,494 $20,537 −3% $24,452 −19% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $19,785 $16,422 $25,121 −21% $29,409 −33% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $19,498 $16,183 $13,385 +46% $13,385 +46% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $19,494 $16,180 $30,568 −36% $35,714 −45% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $19,041 $15,804 $35,433 −46% $32,502 −41% —
292 HEART FAILURE AND SHOCK WITH CC $17,215 $14,289 $21,278 −19% $16,212 +6% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $16,993 $14,105 $38,186 −55% $38,357 −56% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $16,865 $13,998 $25,939 −35% $22,024 −23% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $16,558 $13,743 $34,724 −52% $36,375 −54% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $16,428 $13,635 $31,101 −47% $27,244 −40% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $16,297 $13,526 $12,055 +35% $12,797 +27% —
602 CELLULITIS WITH MCC $16,169 $13,420 $33,511 −52% $29,347 −45% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $15,661 $12,999 $29,296 −47% $21,886 −28% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $15,601 $12,949 $28,893 −46% $24,190 −36% ≈168% of Medicare
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $15,552 $12,908 $17,477 −11% $16,865 −8% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $15,551 $12,908 $31,025 −50% $36,850 −58% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $15,122 $12,551 $21,039 −28% $18,204 −17% ≈240% of Medicare
291 HEART FAILURE AND SHOCK WITH MCC $15,034 $12,479 $25,512 −41% $25,020 −40% ≈142% of Medicare
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $14,905 $12,372 $28,178 −47% $31,059 −52% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $14,721 $12,219 $13,288 +11% $15,858 −7% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $14,493 $12,029 $31,173 −54% $24,136 −40% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $14,451 $11,994 $28,258 −49% $26,158 −45% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $14,220 $11,802 $21,367 −33% $17,273 −18% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $13,921 $11,554 $37,880 −63% $24,017 −42% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $13,861 $11,505 $16,382 −15% $18,017 −23% —
811 RED BLOOD CELL DISORDERS WITH MCC $13,758 $11,419 $24,733 −44% $27,934 −51% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $13,713 $11,382 $52,815 −74% $37,842 −64% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $13,659 $11,337 $40,130 −66% $33,165 −59% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $13,481 $11,189 $27,183 −50% $18,278 −26% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $13,441 $11,156 $30,767 −56% $28,780 −53% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $13,414 $11,133 $14,825 −10% $13,318 +1% —
865 VIRAL ILLNESS WITH MCC $13,405 $11,127 $22,350 −40% $26,088 −49% —
947 SIGNS AND SYMPTOMS WITH MCC $13,324 $11,059 $26,052 −49% $25,474 −48% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $13,261 $11,007 $23,492 −44% $22,231 −40% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $13,243 $10,991 $33,098 −60% $31,128 −57% —
539 OSTEOMYELITIS WITH MCC $13,108 $10,879 $38,824 −66% $33,746 −61% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $13,084 $10,860 $18,064 −28% $18,002 −27% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $13,054 $10,834 $19,581 −33% $14,368 −9% ≈252% of Medicare
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $12,780 $10,607 $18,680 −32% $22,781 −44% —
375 DIGESTIVE MALIGNANCY WITH CC $12,620 $10,475 $24,270 −48% $27,219 −54% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $12,589 $10,448 $44,584 −72% $49,710 −75% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $12,514 $10,387 $79,739 −84% $49,197 −75% —
598 MALIGNANT BREAST DISORDERS WITH CC $12,444 $10,328 $17,197 −28% $19,073 −35% —
158 DENTAL AND ORAL DISEASES WITH CC $12,428 $10,315 $19,778 −37% $17,700 −30% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $12,382 $10,277 $12,234 +1% $12,405 −0% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $12,295 $10,205 $16,396 −25% $14,128 −13% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $12,270 $10,184 $12,235 +0% $12,279 −0% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $12,175 $10,105 $13,825 −12% $13,824 −12% ≈273% of Medicare
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $12,069 $10,017 $32,206 −63% $23,469 −49% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $11,841 $9,828 $25,562 −54% $20,278 −42% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $11,642 $9,663 $25,500 −54% $23,749 −51% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $11,560 $9,595 $23,768 −51% $16,776 −31% —
181 RESPIRATORY NEOPLASMS WITH CC $11,437 $9,492 $29,794 −62% $22,431 −49% —
637 DIABETES WITH MCC $11,331 $9,405 $32,199 −65% $28,819 −61% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $11,316 $9,392 $17,527 −35% $16,104 −30% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $11,269 $9,353 $19,528 −42% $14,134 −20% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $11,200 $9,296 $27,768 −60% $25,426 −56% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $11,176 $9,276 $38,677 −71% $28,967 −61% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $11,088 $9,203 $24,871 −55% $25,208 −56% —
813 COAGULATION DISORDERS $11,058 $9,178 $24,365 −55% $30,128 −63% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $11,007 $9,136 $32,091 −66% $28,134 −61% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $10,931 $9,073 $25,832 −58% $22,982 −52% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $10,877 $9,028 $22,569 −52% $20,488 −47% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $10,816 $8,977 $19,242 −44% $19,483 −44% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $10,804 $8,968 $35,355 −69% $35,237 −69% —
176 PULMONARY EMBOLISM WITHOUT MCC $10,790 $8,956 $18,635 −42% $18,081 −40% —
302 ATHEROSCLEROSIS WITH MCC $10,732 $8,908 $18,292 −41% $20,844 −49% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $10,698 $8,880 $17,227 −38% $17,522 −39% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $10,651 $8,840 $12,173 −13% $14,441 −26% —
303 ATHEROSCLEROSIS WITHOUT MCC $10,553 $8,759 $20,270 −48% $14,927 −29% —
551 MEDICAL BACK PROBLEMS WITH MCC $10,392 $8,625 $29,332 −65% $31,086 −67% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $10,354 $8,594 $20,206 −49% $16,837 −39% —
305 HYPERTENSION WITHOUT MCC $10,304 $8,553 $22,806 −55% $17,144 −40% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $10,296 $8,546 $28,621 −64% $36,933 −72% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $10,162 $8,434 $10,316 −1% $11,955 −15% ≈240% of Medicare
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $9,958 $8,265 $27,695 −64% $32,204 −69% —
312 SYNCOPE AND COLLAPSE $9,945 $8,254 $19,517 −49% $19,342 −49% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $9,836 $8,164 $29,153 −66% $25,243 −61% —
153 OTITIS MEDIA AND URI WITHOUT MCC $9,797 $8,132 $16,482 −41% $14,473 −32% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $9,762 $8,102 $15,484 −37% $17,388 −44% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $9,460 $7,852 $12,771 −26% $12,537 −25% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $9,418 $7,817 $17,494 −46% $17,466 −46% ≈155% of Medicare
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $9,313 $7,730 $38,517 −76% $26,488 −65% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $9,251 $7,678 $37,362 −75% $29,757 −69% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $9,234 $7,664 $12,903 −28% $14,337 −36% —
149 DYSEQUILIBRIUM $8,990 $7,461 $19,068 −53% $17,203 −48% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $8,887 $7,376 $19,381 −54% $18,803 −53% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $8,729 $7,245 $35,990 −76% $39,657 −78% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $8,707 $7,227 $17,630 −51% $16,745 −48% ≈136% of Medicare
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $8,686 $7,209 $18,325 −53% $18,459 −53% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $8,624 $7,158 $13,184 −35% $14,444 −40% —
638 DIABETES WITH CC $8,583 $7,124 $18,552 −54% $18,821 −54% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $8,552 $7,098 $11,308 −24% $14,064 −39% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $8,540 $7,088 $25,610 −67% $20,968 −59% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $8,272 $6,866 $29,730 −72% $24,480 −66% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $8,141 $6,757 $17,226 −53% $17,226 −53% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $8,136 $6,753 $20,826 −61% $17,727 −54% ≈123% of Medicare
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $8,105 $6,727 $28,969 −72% $23,141 −65% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $8,098 $6,721 $39,660 −80% $32,399 −75% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $7,819 $6,490 $15,247 −49% $17,550 −55% —
683 RENAL FAILURE WITH CC $7,806 $6,479 $16,455 −53% $18,620 −58% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $7,750 $6,433 $11,752 −34% $13,485 −43% —
684 RENAL FAILURE WITHOUT CC/MCC $7,679 $6,374 $11,868 −35% $13,623 −44% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $7,623 $6,327 $17,711 −57% $19,096 −60% —
639 DIABETES WITHOUT CC/MCC $7,601 $6,309 $18,007 −58% $13,910 −45% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $7,573 $6,286 $17,809 −57% $13,384 −43% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $7,509 $6,233 $34,797 −78% $36,237 −79% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $7,404 $6,145 $16,139 −54% $15,070 −51% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $7,305 $6,063 $15,311 −52% $16,642 −56% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $7,106 $5,898 $15,310 −54% $18,253 −61% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $6,897 $5,724 $31,283 −78% $21,806 −68% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $6,887 $5,716 $50,550 −86% $62,524 −89% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $6,857 $5,692 $21,697 −68% $18,150 −62% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $6,810 $5,652 $23,842 −71% $14,880 −54% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $6,748 $5,601 $27,917 −76% $20,463 −67% —
603 CELLULITIS WITHOUT MCC $6,675 $5,540 $19,438 −66% $18,530 −64% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $6,606 $5,483 $14,600 −55% $17,322 −62% ≈115% of Medicare
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $6,600 $5,478 $29,405 −78% $37,950 −83% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $6,584 $5,464 $15,641 −58% $17,367 −62% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $6,399 $5,311 $13,574 −53% $16,049 −60% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $6,351 $5,271 $11,329 −44% $13,282 −52% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $6,202 $5,148 $14,654 −58% $15,608 −60% —
313 CHEST PAIN $6,151 $5,105 $17,918 −66% $15,962 −61% —
089 CONCUSSION WITH CC $6,145 $5,100 $17,109 −64% $18,293 −66% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $6,080 $5,047 $21,261 −71% $23,496 −74% —
540 OSTEOMYELITIS WITH CC $6,040 $5,013 $31,282 −81% $23,494 −74% —
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $6,002 $4,981 $32,778 −82% $30,814 −81% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $5,700 $4,731 $40,240 −86% $32,689 −83% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $5,577 $4,629 $13,791 −60% $17,715 −69% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $5,206 $4,321 $11,421 −54% $11,421 −54% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $5,146 $4,271 $24,326 −79% $21,213 −76% —
607 MINOR SKIN DISORDERS WITHOUT MCC $5,040 $4,184 $29,306 −83% $15,284 −67% —
187 PLEURAL EFFUSION WITH CC $4,975 $4,129 $19,451 −74% $21,467 −77% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $4,871 $4,043 $37,502 −87% $28,140 −83% —
592 SKIN ULCERS WITH MCC $4,818 $3,999 $29,882 −84% $32,662 −85% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $4,757 $3,948 $17,614 −73% $20,777 −77% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $4,697 $3,898 $16,925 −72% $16,654 −72% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $4,604 $3,822 $34,577 −87% $17,700 −74% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $4,579 $3,801 $43,196 −89% $30,910 −85% —
204 RESPIRATORY SIGNS AND SYMPTOMS $4,578 $3,800 $13,720 −67% $16,866 −73% —
864 FEVER AND INFLAMMATORY CONDITIONS $4,518 $3,750 $17,337 −74% $17,412 −74% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $4,381 $3,636 $31,349 −86% $37,902 −88% —
949 AFTERCARE WITH CC/MCC $4,184 $3,473 $37,741 −89% $23,953 −83% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $4,067 $3,376 $12,919 −69% $16,634 −76% —
311 ANGINA PECTORIS $3,993 $3,314 $18,257 −78% $15,165 −74% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $3,703 $3,074 $32,532 −89% $18,623 −80% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $3,655 $3,034 $15,461 −76% $15,607 −77% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $3,637 $3,018 $15,986 −77% $18,282 −80% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $3,577 $2,969 $21,421 −83% $22,032 −84% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $3,562 $2,956 $29,948 −88% $30,275 −88% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $3,544 $2,942 $15,603 −77% $18,191 −81% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $3,523 $2,924 $11,484 −69% $12,895 −73% —
950 AFTERCARE WITHOUT CC/MCC $3,398 $2,821 $21,013 −84% $13,527 −75% —
534 FRACTURES OF FEMUR WITHOUT MCC $3,367 $2,794 $17,559 −81% $17,195 −80% —
916 ALLERGIC REACTIONS WITHOUT MCC $3,284 $2,726 $15,322 −79% $13,890 −76% —
101 SEIZURES WITHOUT MCC $2,973 $2,467 $15,448 −81% $19,954 −85% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $2,905 $2,411 $14,668 −80% $15,869 −82% —
694 URINARY STONES WITHOUT MCC $2,861 $2,375 $22,004 −87% $16,531 −83% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,832 $2,351 $15,589 −82% $15,589 −82% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $2,787 $2,313 $88,128 −97% $47,583 −94% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $2,787 $2,313 $21,277 −87% $25,666 −89% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $2,757 $2,289 $27,810 −90% $29,211 −91% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $2,694 $2,236 $21,475 −87% $19,287 −86% —
103 HEADACHES WITHOUT MCC $2,660 $2,208 $17,811 −85% $20,111 −87% —
200 PNEUMOTHORAX WITH CC $2,599 $2,157 $17,568 −85% $20,573 −87% —
151 EPISTAXIS WITHOUT MCC $2,591 $2,151 $13,032 −80% $13,032 −80% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $2,589 $2,149 $12,314 −79% $15,600 −83% —
090 CONCUSSION WITHOUT CC/MCC $2,521 $2,093 $14,321 −82% $14,873 −83% —
304 HYPERTENSION WITH MCC $2,459 $2,041 $20,946 −88% $24,185 −90% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $2,456 $2,038 $18,398 −87% $20,732 −88% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $2,400 $1,992 $31,044 −92% $31,044 −92% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $2,382 $1,977 $32,891 −93% $30,394 −92% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $2,324 $1,929 $38,806 −94% $35,014 −93% —
123 NEUROLOGICAL EYE DISORDERS $2,291 $1,901 $13,618 −83% $17,831 −87% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $2,188 $1,816 $11,294 −81% $12,013 −82% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $2,138 $1,774 $11,909 −82% $11,909 −82% —
100 SEIZURES WITH MCC $1,989 $1,989 $34,570 −94% $35,194 −94% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $1,946 $1,615 $11,755 −83% $13,368 −85% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $1,628 $1,351 $9,940 −84% $9,076 −82% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $1,624 $1,348 $15,217 −89% $18,608 −91% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $1,612 $1,338 $80,018 −98% $80,018 −98% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $1,597 $1,325 $16,212 −90% $16,212 −90% —
998 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS $1,485 $1,233 $7,241 −79% $15,655 −91% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $1,382 $1,147 $25,981 −95% $21,261 −94% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $1,273 $1,057 $14,055 −91% $14,055 −91% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $1,163 $965 $11,071 −89% $11,071 −89% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $1,058 $878 $8,927 −88% $8,927 −88% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $1,039 $862 $13,586 −92% $13,586 −92% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $846 $846 $14,937 −94% $15,077 −94% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $827 $827 $17,601 −95% $16,571 −95% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $777 $777 $14,383 −95% $16,156 −95% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $747 $620 $20,001 −96% $24,836 −97% —
882 NEUROSES EXCEPT DEPRESSIVE $693 $576 $10,585 −93% $15,680 −96% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $673 $559 $12,593 −95% $12,593 −95% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $557 — $59,352 −99% $59,352 −99% —
541 OSTEOMYELITIS WITHOUT CC/MCC $480 $480 $14,549 −97% $14,549 −97% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $474 $474 $13,889 −97% $14,166 −97% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $471 — $12,650 −96% $12,650 −96% —
935 NON-EXTENSIVE BURNS $446 $446 $27,613 −98% $29,458 −98% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $351 $291 $9,887 −96% $9,385 −96% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $147 — $14,290 −99% $14,290 −99% —

Procedures with negotiated rates only

These 9 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
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC — 8 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC — 7 plans
152 OTITIS MEDIA AND URI WITH MCC — 7 plans
914 TRAUMATIC INJURY WITHOUT MCC — 7 plans
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC — 7 plans
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION — 5 plans
881 DEPRESSIVE NEUROSES — 5 plans
885 PSYCHOSES — 5 plans
887 OTHER MENTAL DISORDER DIAGNOSES — 5 plans
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