UNC Hospitals — Pricing

721 procedures published in this hospital's Machine-Readable File (MRF) — 719 with a comparable price, 2 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 721
Lowest published price $2,396
Average published price $90,183
Highest published price $1,632,447

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

Showing all 721 procedures

Published charges

Showing all 719 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 168 procedures, this hospital's negotiated rates average ≈105% of what Medicare pays.

DRG Description Published price Cash price vs. NC median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $1,632,447 $979,468 $1,422,622 +15% $573,534 +185% ≈64% of Medicare
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $1,331,965 $799,179 $461,389 +189% $461,389 +189% ≈89% of Medicare
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $937,652 $562,591 $678,931 +38% $371,366 +152% ≈84% of Medicare
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $895,039 $537,023 $163,664 +447% $80,018 +1019% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $851,657 $510,994 $199,473 +327% $96,192 +785% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $818,348 $491,009 $125,538 +552% $75,103 +990% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $723,548 $434,129 $161,928 +347% $102,128 +608% —
999 UNGROUPABLE $701,850 $421,110 $14,162 +4856% $29,674 +2265% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $595,375 $357,225 $560,182 +6% $194,769 +206% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $577,214 $346,328 $441,650 +31% $306,087 +89% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $477,712 $286,627 $355,728 +34% $248,521 +92% ≈106% of Medicare
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $471,657 $282,994 $170,734 +176% $148,832 +217% ≈98% of Medicare
196 INTERSTITIAL LUNG DISEASE WITH MCC $385,082 $231,049 $48,779 +689% $32,637 +1080% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $382,952 $229,771 $95,743 +300% $59,533 +543% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $381,397 $228,838 $76,865 +396% $62,264 +513% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $375,536 $225,322 $132,314 +184% $86,970 +332% —
595 MAJOR SKIN DISORDERS WITH MCC $364,693 $218,816 $31,181 +1070% $34,598 +954% —
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $361,541 $216,925 $241,552 +50% $121,563 +197% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $340,271 $204,163 $265,903 +28% $131,961 +158% —
834 ACUTE LEUKEMIA WITH MCC $338,921 $203,353 $93,528 +262% $85,566 +296% ≈146% of Medicare
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $334,855 $200,913 $35,147 +853% $58,745 +470% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $333,411 $200,047 $286,862 +16% $143,242 +133% ≈79% of Medicare
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $323,116 $193,869 $281,448 +15% $148,686 +117% ≈98% of Medicare
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $312,642 $187,585 $136,564 +129% $101,576 +208% ≈113% of Medicare
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $303,344 $182,007 $109,948 +176% $93,238 +225% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $302,634 $181,580 $57,989 +422% $66,068 +358% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $295,784 $177,470 $196,897 +50% $102,600 +188% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $294,303 $176,582 $93,172 +216% $93,172 +216% ≈127% of Medicare
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $292,526 $175,516 $292,526 +0% $144,774 +102% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $289,898 $173,939 $162,298 +79% $77,055 +276% ≈67% of Medicare
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $288,214 $172,929 $263,448 +9% $109,331 +164% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $287,599 $172,559 $106,135 +171% $90,724 +217% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $273,318 $163,991 $585,410 −53% $182,314 +50% ≈188% of Medicare
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $271,852 $163,111 $106,316 +156% $77,817 +249% ≈118% of Medicare
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $269,458 $161,675 $205,851 +31% $120,573 +123% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $268,712 $161,227 $268,712 +0% $196,346 +37% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $265,638 $159,383 $223,645 +19% $107,355 +147% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $260,891 $156,534 $241,996 +8% $126,098 +107% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $260,231 $156,138 $223,939 +16% $106,778 +144% ≈124% of Medicare
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $259,486 $155,692 $137,630 +89% $142,326 +82% —
652 KIDNEY TRANSPLANT $255,358 $153,215 $125,049 +104% $54,720 +367% ≈200% of Medicare
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $248,089 $148,853 $265,632 −7% $153,282 +62% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $245,968 $147,581 $245,968 +0% $188,171 +31% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $242,865 $145,719 $182,059 +33% $98,260 +147% ≈69% of Medicare
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $242,047 $145,228 $204,145 +19% $106,057 +128% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $238,027 $142,816 $179,026 +33% $81,176 +193% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $235,549 $141,330 $145,265 +62% $87,761 +168% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $233,304 $139,983 $79,477 +194% $58,280 +300% ≈126% of Medicare
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $227,756 $136,654 $219,702 +4% $144,569 +58% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $227,466 $136,480 $227,466 +0% $208,939 +9% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $225,933 $135,560 $138,711 +63% $71,551 +216% ≈148% of Medicare
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $221,420 $132,852 $72,392 +206% $47,583 +365% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $218,252 $130,951 $189,145 +15% $112,062 +95% ≈126% of Medicare
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $215,216 $129,129 $63,587 +238% $52,908 +307% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $212,352 $127,411 $38,998 +445% $38,998 +445% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $199,933 $119,960 $169,372 +18% $116,058 +72% —
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $195,081 $117,049 $195,081 +0% $132,794 +47% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $194,967 $116,980 $194,967 +0% $125,242 +56% —
028 SPINAL PROCEDURES WITH MCC $194,362 $116,617 $210,482 −8% $113,077 +72% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $194,123 $116,474 $57,719 +236% $50,607 +284% ≈123% of Medicare
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $192,794 $115,677 $121,712 +58% $82,561 +134% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $191,238 $114,743 $24,877 +669% $16,565 +1054% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $189,813 $113,888 $104,530 +82% $66,848 +184% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $189,693 $113,816 $54,862 +246% $62,300 +204% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $188,591 $113,155 $115,634 +63% $76,001 +148% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $188,529 $113,118 $123,941 +52% $59,352 +218% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $188,277 $112,966 $147,686 +27% $105,899 +78% —
835 ACUTE LEUKEMIA WITH CC $187,195 $112,317 $51,529 +263% $35,569 +426% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $184,253 $110,552 $201,810 −9% $113,855 +62% ≈101% of Medicare
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $181,765 $109,059 $181,765 +0% $88,566 +105% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $175,927 $105,556 $76,658 +129% $46,066 +282% —
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $175,639 $105,383 $122,776 +43% $99,943 +76% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $175,482 $105,289 $395,416 −56% $66,711 +163% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $174,461 $104,676 $31,191 +459% $22,024 +692% ≈116% of Medicare
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $173,450 $104,070 $155,053 +12% $93,390 +86% —
500 SOFT TISSUE PROCEDURES WITH MCC $171,811 $103,087 $70,494 +144% $61,872 +178% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $168,862 $101,317 $187,980 −10% $123,995 +36% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $168,014 $100,809 $117,171 +43% $65,573 +156% ≈106% of Medicare
711 TESTES PROCEDURES WITH CC/MCC $167,260 $100,356 $53,392 +213% $38,343 +336% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $166,737 $100,042 $76,824 +117% $77,990 +114% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $165,858 $99,515 $128,104 +29% $75,573 +119% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $164,871 $98,922 $58,653 +181% $43,943 +275% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $162,227 $97,336 $58,687 +176% $66,685 +143% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $161,149 $96,689 $107,615 +50% $50,919 +216% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $160,682 $96,409 $127,440 +26% $73,120 +120% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $160,160 $96,096 $164,594 −3% $111,320 +44% ≈97% of Medicare
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $159,772 $95,863 $68,265 +134% $80,793 +98% ≈89% of Medicare
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $159,001 $95,401 $59,883 +166% $59,594 +167% —
253 OTHER VASCULAR PROCEDURES WITH CC $157,732 $94,639 $113,961 +38% $57,454 +175% ≈116% of Medicare
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $157,713 $94,628 $131,675 +20% $78,852 +100% —
813 COAGULATION DISORDERS $156,632 $93,979 $34,947 +348% $33,296 +370% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $156,601 $93,961 $167,196 −6% $117,280 +34% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $156,207 $93,724 $168,543 −7% $99,423 +57% ≈125% of Medicare
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $155,351 $93,210 $47,114 +230% $31,264 +397% ≈115% of Medicare
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $154,976 $92,986 $78,013 +99% $65,788 +136% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $153,761 $92,256 $153,761 +0% $164,641 −7% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $153,253 $91,952 $69,289 +121% $90,775 +69% ≈130% of Medicare
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $152,969 $91,781 $30,650 +399% $30,502 +401% ≈109% of Medicare
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $152,834 $91,701 $100,691 +52% $59,421 +157% ≈99% of Medicare
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $148,962 $89,377 $97,243 +53% $47,789 +212% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $144,048 $86,429 $154,205 −7% $102,573 +40% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $143,856 $86,313 $88,387 +63% $59,651 +141% ≈110% of Medicare
596 MAJOR SKIN DISORDERS WITHOUT MCC $143,330 $85,998 $21,959 +553% $17,226 +732% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $141,411 $84,846 $24,118 +486% $27,285 +418% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $139,659 $83,796 $114,506 +22% $89,353 +56% ≈39% of Medicare
335 PERITONEAL ADHESIOLYSIS WITH MCC $136,241 $81,744 $121,663 +12% $71,755 +90% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $135,827 $81,496 $112,669 +21% $60,098 +126% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $135,779 $81,467 $95,410 +42% $70,847 +92% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $135,303 $81,182 $70,144 +93% $58,228 +132% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $134,739 $80,843 $60,052 +124% $49,710 +171% ≈75% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $134,736 $80,842 $85,423 +58% $60,170 +124% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $133,868 $80,321 $133,868 +0% $101,510 +32% —
949 AFTERCARE WITH CC/MCC $133,552 $80,131 $36,227 +269% $23,953 +458% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $133,032 $79,819 $132,032 +1% $96,507 +38% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $132,515 $79,509 $54,859 +142% $37,950 +249% ≈127% of Medicare
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $132,375 $79,425 $94,024 +41% $101,618 +30% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $131,852 $79,111 $106,659 +24% $74,257 +78% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $131,838 $79,103 $148,324 −11% $85,159 +55% ≈83% of Medicare
662 MINOR BLADDER PROCEDURES WITH MCC $131,821 $79,092 $54,483 +142% $54,562 +142% —
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $129,200 $77,520 $129,200 +0% $96,905 +33% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $129,169 $77,502 $46,765 +176% $42,901 +201% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $127,808 $76,685 $71,229 +79% $52,075 +145% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $127,768 $76,661 $26,510 +382% $26,510 +382% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $127,355 $76,413 $111,445 +14% $41,422 +207% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $127,165 $76,299 $86,974 +46% $72,424 +76% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $127,022 $76,213 $43,586 +191% $37,387 +240% ≈130% of Medicare
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $126,735 $76,041 $94,936 +33% $79,836 +59% ≈96% of Medicare
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $126,325 $75,795 $37,599 +236% $33,653 +275% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $125,956 $75,574 $125,956 +0% $71,464 +76% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $125,878 $75,527 $65,056 +93% $44,222 +185% —
163 MAJOR CHEST PROCEDURES WITH MCC $123,228 $73,937 $133,292 −8% $90,195 +37% ≈118% of Medicare
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $122,192 $73,315 $57,037 +114% $46,090 +165% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $122,084 $73,250 $70,055 +74% $52,986 +130% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $121,646 $72,988 $79,254 +53% $81,998 +48% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $120,501 $72,301 $95,645 +26% $89,207 +35% —
252 OTHER VASCULAR PROCEDURES WITH MCC $120,467 $72,280 $120,467 +0% $68,508 +76% ≈107% of Medicare
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $119,957 $71,974 $119,957 +0% $71,014 +69% ≈114% of Medicare
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $119,647 $71,788 $117,337 +2% $71,795 +67% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $119,451 $71,670 $119,451 +0% $88,050 +36% ≈120% of Medicare
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $118,945 $71,367 $105,834 +12% $88,307 +35% ≈137% of Medicare
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $118,837 $71,302 $49,701 +139% $34,459 +245% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $118,780 $71,268 $160,364 −26% $83,441 +42% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $118,463 $71,078 $51,373 +131% $24,550 +383% —
644 ENDOCRINE DISORDERS WITH CC $117,357 $70,414 $29,273 +301% $23,198 +406% ≈82% of Medicare
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $116,893 $70,136 $116,893 +0% $55,289 +111% —
038 EXTRACRANIAL PROCEDURES WITH CC $116,240 $69,744 $60,827 +91% $35,770 +225% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $115,920 $69,552 $40,598 +186% $34,192 +239% ≈72% of Medicare
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $114,120 $68,472 $58,596 +95% $61,470 +86% —
471 CERVICAL SPINAL FUSION WITH MCC $113,322 $67,993 $113,322 +0% $92,515 +22% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $113,027 $67,816 $113,027 +0% $79,225 +43% —
037 EXTRACRANIAL PROCEDURES WITH MCC $112,687 $67,612 $103,899 +8% $66,666 +69% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $111,525 $66,915 $117,955 −5% $82,247 +36% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $110,670 $66,402 $166,424 −34% $90,331 +23% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $110,347 $66,208 $55,656 +98% $37,844 +192% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $110,332 $66,199 $108,895 +1% $43,491 +154% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $109,919 $65,951 $42,250 +160% $32,697 +236% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $109,053 $65,432 $58,569 +86% $49,839 +119% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $108,791 $65,275 $85,866 +27% $71,092 +53% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $107,849 $64,710 $107,849 +0% $74,755 +44% ≈149% of Medicare
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $105,834 $63,500 $90,438 +17% $65,653 +61% ≈106% of Medicare
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $104,902 $62,941 $116,549 −10% $70,564 +49% —
304 HYPERTENSION WITH MCC $104,704 $62,822 $28,318 +270% $26,080 +301% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $103,507 $62,104 $60,571 +71% $49,418 +109% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $103,348 $62,009 $56,173 +84% $42,881 +141% ≈95% of Medicare
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $102,772 $61,663 $88,155 +17% $68,653 +50% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $102,608 $61,565 $85,697 +20% $54,929 +87% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $102,531 $61,519 $54,690 +87% $43,800 +134% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $102,053 $61,232 $73,760 +38% $43,913 +132% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $101,188 $60,713 $36,370 +178% $19,815 +411% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $100,982 $60,589 $80,626 +25% $46,727 +116% —
199 PNEUMOTHORAX WITH MCC $100,774 $60,465 $42,335 +138% $33,787 +198% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $99,638 $59,783 $111,341 −11% $70,371 +42% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $99,421 $59,653 $71,679 +39% $31,563 +215% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $99,336 $59,601 $83,640 +19% $61,832 +61% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $98,073 $58,844 $5,399 +1716% $12,229 +702% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $97,995 $58,797 $97,995 +0% $79,116 +24% —
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $97,914 $58,749 $84,140 +16% $43,538 +125% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $97,298 $58,379 $44,609 +118% $30,243 +222% —
653 MAJOR BLADDER PROCEDURES WITH MCC $97,063 $58,238 $100,861 −4% $104,583 −7% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $96,059 $57,636 $75,345 +27% $50,618 +90% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $95,386 $57,231 $64,233 +49% $33,674 +183% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $95,161 $57,097 $56,538 +68% $33,876 +181% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $95,110 $57,066 $108,418 −12% $81,706 +16% ≈120% of Medicare
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $95,021 $57,012 $116,842 −19% $91,329 +4% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $95,011 $57,007 $54,091 +76% $45,333 +110% —
919 COMPLICATIONS OF TREATMENT WITH MCC $94,496 $56,698 $31,120 +204% $31,105 +204% ≈53% of Medicare
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $94,235 $56,541 $94,235 +0% $61,217 +54% —
374 DIGESTIVE MALIGNANCY WITH MCC $93,074 $55,844 $45,291 +105% $39,958 +133% ≈93% of Medicare
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $92,897 $55,738 $92,897 +0% $72,962 +27% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $91,781 $55,069 $91,781 +0% $70,132 +31% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $91,632 $54,979 $85,282 +7% $59,790 +53% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $91,526 $54,916 $93,180 −2% $65,325 +40% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $90,501 $54,301 $93,464 −3% $84,692 +7% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $90,442 $54,265 $90,442 +0% $62,821 +44% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $90,039 $54,024 $90,039 +0% $53,864 +67% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $90,005 $54,003 $76,409 +18% $50,139 +80% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $89,056 $53,433 $85,978 +4% $53,451 +67% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $88,777 $53,266 $61,508 +44% $43,650 +103% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $88,532 $53,119 $141,583 −37% $92,217 −4% ≈101% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $88,504 $53,103 $90,621 −2% $67,268 +32% —
570 SKIN DEBRIDEMENT WITH MCC $88,368 $53,021 $101,088 −13% $52,435 +69% —
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $88,222 $52,933 $75,564 +17% $65,216 +35% —
472 CERVICAL SPINAL FUSION WITH CC $87,747 $52,648 $87,747 +0% $59,537 +47% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $87,592 $52,555 $46,252 +89% $32,031 +173% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $86,734 $52,041 $40,015 +117% $30,959 +180% ≈126% of Medicare
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $86,510 $51,906 $35,133 +146% $41,892 +107% ≈71% of Medicare
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $86,470 $51,882 $4,889 +1668% $16,351 +429% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $85,803 $51,482 $36,795 +133% $33,985 +152% ≈100% of Medicare
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $85,495 $51,297 $40,116 +113% $38,666 +121% ≈101% of Medicare
545 CONNECTIVE TISSUE DISORDERS WITH MCC $85,383 $51,230 $50,208 +70% $40,362 +112% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $84,712 $50,827 $84,712 +0% $46,724 +81% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $84,069 $50,441 $71,743 +17% $33,661 +150% —
503 FOOT PROCEDURES WITH MCC $83,535 $50,121 $54,558 +53% $47,540 +76% —
504 FOOT PROCEDURES WITH CC $83,487 $50,092 $43,650 +91% $38,960 +114% —
913 TRAUMATIC INJURY WITH MCC $83,441 $50,065 $24,198 +245% $24,198 +245% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $83,299 $49,979 $30,482 +173% $20,980 +297% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $83,137 $49,882 $35,666 +133% $36,489 +128% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $83,026 $49,816 $51,473 +61% $48,687 +71% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $82,669 $49,601 $82,669 +0% $42,126 +96% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $81,873 $49,124 $43,821 +87% $27,617 +196% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $81,369 $48,821 $62,731 +30% $36,354 +124% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $81,168 $48,701 $81,168 +0% $59,629 +36% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $81,168 $48,701 $59,374 +37% $43,477 +87% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $81,119 $48,671 $83,323 −3% $70,467 +15% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $80,748 $48,449 $46,342 +74% $34,607 +133% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $80,543 $48,326 $32,902 +145% $25,463 +216% ≈120% of Medicare
637 DIABETES WITH MCC $80,433 $48,260 $34,484 +133% $30,100 +167% ≈107% of Medicare
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $80,172 $48,103 $80,027 +0% $50,394 +59% ≈114% of Medicare
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $79,691 $47,814 $40,124 +99% $38,861 +105% —
186 PLEURAL EFFUSION WITH MCC $79,436 $47,661 $43,109 +84% $33,834 +135% —
800 SPLENIC PROCEDURES WITH CC $79,372 $47,623 $65,879 +20% $49,184 +61% —
598 MALIGNANT BREAST DISORDERS WITH CC $79,124 $47,474 $23,178 +241% $19,073 +315% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $79,080 $47,448 $49,956 +58% $37,842 +109% ≈59% of Medicare
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $78,998 $47,399 $40,964 +93% $30,083 +163% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $78,721 $47,233 $59,187 +33% $44,546 +77% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $78,347 $47,008 $52,403 +50% $38,070 +106% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $78,243 $46,946 $78,648 −1% $58,043 +35% ≈110% of Medicare
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $77,924 $46,755 $19,191 +306% $14,797 +427% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $77,767 $46,660 $56,403 +38% $38,094 +104% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $77,759 $46,655 $45,133 +72% $41,620 +87% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $77,113 $46,268 $25,314 +205% $17,620 +338% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $76,982 $46,189 $69,228 +11% $35,849 +115% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $76,492 $45,895 $31,521 +143% $26,580 +188% ≈89% of Medicare
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $76,292 $45,775 $58,215 +31% $43,631 +75% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $76,167 $45,700 $43,132 +77% $39,515 +93% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $76,167 $45,700 $17,734 +329% $18,133 +320% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $75,920 $45,552 $38,164 +99% $29,611 +156% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $75,715 $45,429 $75,715 +0% $62,583 +21% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $75,680 $45,408 $75,377 +0% $42,906 +76% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $75,504 $45,303 $44,870 +68% $40,213 +88% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $75,475 $45,285 $50,832 +48% $51,985 +45% ≈75% of Medicare
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $75,365 $45,219 $70,578 +7% $50,624 +49% —
164 MAJOR CHEST PROCEDURES WITH CC $75,087 $45,052 $71,945 +4% $56,755 +32% ≈99% of Medicare
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $75,060 $45,036 $43,588 +72% $46,402 +62% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $74,335 $44,601 $112,168 −34% $35,831 +107% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $74,061 $44,436 $70,940 +4% $46,283 +60% ≈117% of Medicare
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $73,393 $44,036 $74,133 −1% $52,751 +39% ≈103% of Medicare
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $72,806 $43,683 $74,218 −2% $40,694 +79% ≈95% of Medicare
123 NEUROLOGICAL EYE DISORDERS $72,240 $43,344 $20,417 +254% $19,745 +266% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $72,195 $43,317 $60,207 +20% $48,682 +48% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $72,134 $43,281 $21,795 +231% $22,033 +227% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $71,901 $43,141 $38,980 +84% $39,973 +80% ≈214% of Medicare
035 CAROTID ARTERY STENT PROCEDURES WITH CC $71,884 $43,130 $71,884 +0% $49,066 +47% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $71,704 $43,022 $42,974 +67% $42,914 +67% ≈48% of Medicare
935 NON-EXTENSIVE BURNS $71,665 $42,999 $29,361 +144% $31,701 +126% ≈76% of Medicare
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $71,620 $42,972 $39,014 +84% $52,405 +37% ≈81% of Medicare
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $71,615 $42,969 $63,680 +12% $46,453 +54% —
397 APPENDIX PROCEDURES WITH MCC $71,597 $42,958 $52,855 +35% $53,257 +34% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $71,514 $42,908 $51,347 +39% $25,712 +178% —
506 MAJOR THUMB OR JOINT PROCEDURES $71,129 $42,677 $34,520 +106% $30,557 +133% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $71,120 $42,672 $33,894 +110% $33,255 +114% ≈77% of Medicare
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $70,894 $42,536 $29,362 +141% $32,944 +115% —
597 MALIGNANT BREAST DISORDERS WITH MCC $70,697 $42,418 $57,714 +22% $33,386 +112% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $70,679 $42,407 $79,373 −11% $58,809 +20% ≈108% of Medicare
540 OSTEOMYELITIS WITH CC $70,567 $42,340 $29,401 +140% $26,676 +165% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $70,499 $42,299 $44,600 +58% $25,703 +174% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $70,498 $42,299 $70,498 +0% $32,574 +116% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $70,177 $42,106 $152,630 −54% $70,177 +0% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $70,126 $42,076 $74,617 −6% $59,500 +18% ≈102% of Medicare
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $70,126 $42,075 $70,126 +0% $76,219 −8% —
654 MAJOR BLADDER PROCEDURES WITH CC $69,871 $41,922 $79,317 −12% $58,274 +20% ≈81% of Medicare
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $69,824 $41,894 $61,626 +13% $47,737 +46% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $69,817 $41,890 $74,020 −6% $50,011 +40% ≈107% of Medicare
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $69,772 $41,863 $62,201 +12% $47,711 +46% —
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $69,588 $41,753 $38,606 +80% $21,894 +218% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $68,596 $41,157 $39,181 +75% $39,181 +75% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $68,074 $40,844 $38,654 +76% $28,140 +142% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $68,009 $40,806 $68,009 +0% $49,351 +38% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $67,986 $40,791 $15,157 +349% $12,999 +423% —
245 AICD GENERATOR PROCEDURES $67,840 $40,704 $104,346 −35% $72,076 −6% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $67,750 $40,650 $64,694 +5% $54,583 +24% ≈118% of Medicare
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $67,123 $40,274 $57,229 +17% $43,080 +56% —
671 URETHRAL PROCEDURES WITH CC/MCC $67,085 $40,251 $37,773 +78% $27,233 +146% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $67,080 $40,248 $39,789 +69% $32,496 +106% ≈116% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $66,680 $40,008 $66,680 +0% $41,591 +60% —
336 PERITONEAL ADHESIOLYSIS WITH CC $66,175 $39,705 $70,773 −6% $50,463 +31% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $66,079 $39,648 $45,388 +46% $33,555 +97% ≈72% of Medicare
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $65,980 $39,588 $65,980 +0% $41,608 +59% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $65,944 $39,566 $65,842 +0% $52,178 +26% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $65,826 $39,496 $35,742 +84% $27,394 +140% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $65,613 $39,368 $52,577 +25% $36,431 +80% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $65,471 $39,283 $54,972 +19% $44,472 +47% —
265 AICD LEAD PROCEDURES $65,384 $39,230 $85,580 −24% $63,171 +4% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $65,373 $39,224 $65,373 +0% $58,707 +11% ≈130% of Medicare
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $65,146 $39,088 $28,762 +126% $20,957 +211% ≈125% of Medicare
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $65,143 $39,086 $65,143 +0% $42,415 +54% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $65,109 $39,065 $38,570 +69% $36,792 +77% ≈136% of Medicare
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $64,872 $38,923 $77,910 −17% $68,639 −5% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $64,704 $38,822 $56,325 +15% $47,945 +35% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $64,487 $38,692 $33,852 +90% $27,316 +136% ≈68% of Medicare
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $64,322 $38,593 $59,686 +8% $44,139 +46% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $64,295 $38,577 $46,449 +38% $28,156 +128% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $64,067 $38,440 $66,260 −3% $64,523 −1% ≈140% of Medicare
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $64,024 $38,414 $61,165 +5% $48,349 +32% ≈86% of Medicare
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $63,863 $38,318 $63,863 +0% $43,174 +48% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $63,757 $38,254 $42,652 +49% $35,628 +79% ≈106% of Medicare
333 RECTAL RESECTION WITH CC $63,363 $38,018 $63,363 +0% $37,154 +71% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $63,313 $37,988 $52,557 +20% $38,101 +66% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $62,977 $37,786 $62,977 +0% $65,608 −4% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $62,732 $37,639 $47,881 +31% $35,030 +79% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $62,707 $37,624 $62,199 +1% $50,498 +24% —
113 ORBITAL PROCEDURES WITH CC/MCC $62,517 $37,510 $61,854 +1% $36,167 +73% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $62,241 $37,345 $52,791 +18% $31,170 +100% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $61,225 $36,735 $29,507 +107% $23,319 +163% ≈114% of Medicare
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $61,085 $36,651 $52,350 +17% $52,036 +17% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $60,775 $36,465 $48,039 +27% $33,851 +80% ≈69% of Medicare
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $60,771 $36,463 $29,518 +106% $32,628 +86% —
505 FOOT PROCEDURES WITHOUT CC/MCC $60,733 $36,440 $50,640 +20% $34,937 +74% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $60,105 $36,063 $60,105 +0% $38,836 +55% ≈133% of Medicare
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $60,059 $36,035 $49,551 +21% $31,951 +88% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $59,665 $35,799 $27,175 +120% $22,506 +165% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $59,254 $35,552 $45,521 +30% $33,707 +76% ≈106% of Medicare
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $59,206 $35,524 $59,206 +0% $44,363 +33% ≈140% of Medicare
849 RADIOTHERAPY $59,196 $35,517 $59,196 +0% $37,862 +56% —
799 SPLENIC PROCEDURES WITH MCC $59,066 $35,440 $67,322 −12% $82,218 −28% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $58,684 $35,210 $62,875 −7% $55,162 +6% —
791 PREMATURITY WITH MAJOR PROBLEMS $58,470 $35,082 $30,459 +92% $42,679 +37% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $58,400 $35,040 $62,317 −6% $46,295 +26% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $58,279 $34,968 $40,724 +43% $39,106 +49% ≈158% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $58,238 $34,943 $46,206 +26% $29,916 +95% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $57,940 $34,764 $36,815 +57% $29,743 +95% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $57,928 $34,757 $42,360 +37% $33,633 +72% ≈108% of Medicare
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $57,766 $34,660 $56,867 +2% $46,340 +25% ≈124% of Medicare
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $57,624 $34,574 $26,253 +119% $22,148 +160% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $57,556 $34,534 $82,004 −30% $69,743 −17% —
571 SKIN DEBRIDEMENT WITH CC $57,445 $34,467 $25,326 +127% $37,169 +55% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $56,842 $34,105 $56,842 +0% $25,390 +124% —
398 APPENDIX PROCEDURES WITH CC $56,441 $33,865 $53,293 +6% $40,162 +41% —
947 SIGNS AND SYMPTOMS WITH MCC $56,316 $33,790 $33,290 +69% $27,401 +106% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $56,127 $33,676 $56,127 +0% $39,211 +43% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $56,000 $33,600 $48,553 +15% $30,493 +84% —
906 HAND PROCEDURES FOR INJURIES $55,989 $33,594 $42,058 +33% $32,065 +75% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $55,623 $33,374 $28,567 +95% $33,047 +68% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $55,527 $33,316 $53,121 +5% $45,877 +21% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $55,121 $33,072 $33,585 +64% $21,396 +158% ≈112% of Medicare
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $55,090 $33,054 $44,221 +25% $31,134 +77% ≈65% of Medicare
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $54,994 $32,997 $43,524 +26% $32,833 +67% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $54,949 $32,970 $54,949 +0% $35,465 +55% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $54,871 $32,923 $24,630 +123% $17,698 +210% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $54,418 $32,651 $43,425 +25% $26,870 +103% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $54,235 $32,541 $57,547 −6% $44,606 +22% ≈100% of Medicare
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $54,127 $32,476 $42,218 +28% $30,770 +76% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $53,933 $32,360 $53,797 +0% $50,046 +8% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $53,878 $32,327 $53,878 +0% $39,887 +35% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $53,804 $32,282 $34,273 +57% $34,273 +57% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $53,657 $32,194 $56,402 −5% $37,267 +44% ≈112% of Medicare
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $53,638 $32,183 $43,163 +24% $40,562 +32% —
089 CONCUSSION WITH CC $53,310 $31,986 $27,042 +97% $18,821 +183% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $53,190 $31,914 $24,922 +113% $16,450 +223% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $53,153 $31,892 $56,307 −6% $41,955 +27% —
157 DENTAL AND ORAL DISEASES WITH MCC $53,125 $31,875 $45,924 +16% $31,300 +70% —
643 ENDOCRINE DISORDERS WITH MCC $53,038 $31,823 $38,587 +37% $33,563 +58% ≈105% of Medicare
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $52,937 $31,762 $52,937 +0% $25,748 +106% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $52,673 $31,604 $49,732 +6% $35,584 +48% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $52,615 $31,569 $52,615 +0% $38,878 +35% ≈60% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $52,614 $31,569 $37,673 +40% $30,235 +74% ≈103% of Medicare
347 ANAL AND STOMAL PROCEDURES WITH MCC $52,597 $31,558 $52,597 +0% $40,548 +30% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $52,534 $31,520 $58,694 −10% $34,906 +50% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $52,372 $31,423 $44,319 +18% $31,017 +69% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $52,321 $31,393 $52,321 +0% $29,524 +77% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $52,227 $31,336 $24,432 +114% $32,859 +59% ≈81% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $52,190 $31,314 $26,380 +98% $19,962 +161% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $51,902 $31,141 $46,222 +12% $32,021 +62% ≈115% of Medicare
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $51,830 $31,098 $51,830 +0% $45,167 +15% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $51,729 $31,037 $50,739 +2% $40,365 +28% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $51,407 $30,844 $42,273 +22% $29,949 +72% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $51,399 $30,839 $28,348 +81% $30,828 +67% ≈108% of Medicare
672 URETHRAL PROCEDURES WITHOUT CC/MCC $51,356 $30,814 $23,732 +116% $17,398 +195% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $51,140 $30,684 $25,586 +100% $21,363 +139% ≈119% of Medicare
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $51,038 $30,623 $24,144 +111% $19,594 +160% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $50,379 $30,227 $19,416 +159% $20,422 +147% ≈121% of Medicare
076 VIRAL MENINGITIS WITHOUT CC/MCC $50,352 $30,211 $17,627 +186% $17,135 +194% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $50,149 $30,089 $38,798 +29% $26,948 +86% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $50,038 $30,023 $26,438 +89% $16,968 +195% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $49,887 $29,932 $32,566 +53% $27,275 +83% ≈95% of Medicare
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $49,839 $29,903 $44,595 +12% $32,877 +52% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $49,646 $29,787 $33,673 +47% $27,543 +80% ≈66% of Medicare
184 MAJOR CHEST TRAUMA WITH CC $49,611 $29,766 $28,391 +75% $22,432 +121% ≈84% of Medicare
548 SEPTIC ARTHRITIS WITH MCC $49,553 $29,732 $32,344 +53% $31,346 +58% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $49,503 $29,702 $30,021 +65% $20,781 +138% ≈109% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $49,361 $29,617 $12,640 +291% $12,454 +296% —
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $49,342 $29,605 $51,019 −3% $36,937 +34% —
102 HEADACHES WITH MCC $49,330 $29,598 $25,874 +91% $25,740 +92% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $49,317 $29,590 $37,440 +32% $22,635 +118% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $49,195 $29,517 $50,370 −2% $43,298 +14% ≈114% of Medicare
665 PROSTATECTOMY WITH MCC $49,143 $29,486 $102,095 −52% $54,072 −9% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $49,046 $29,428 $30,731 +60% $24,586 +99% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $48,888 $29,333 $31,314 +56% $27,989 +75% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $48,775 $29,265 $26,597 +83% $20,727 +135% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $48,702 $29,221 $30,689 +59% $27,426 +78% —
180 RESPIRATORY NEOPLASMS WITH MCC $48,657 $29,194 $38,001 +28% $36,658 +33% ≈127% of Medicare
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $48,646 $29,188 $42,274 +15% $30,553 +59% —
380 COMPLICATED PEPTIC ULCER WITH MCC $48,643 $29,186 $44,130 +10% $39,627 +23% —
183 MAJOR CHEST TRAUMA WITH MCC $48,610 $29,166 $48,610 +0% $29,933 +62% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $48,570 $29,142 $36,783 +32% $23,940 +103% ≈144% of Medicare
619 O.R. PROCEDURES FOR OBESITY WITH MCC $48,212 $28,927 $58,723 −18% $51,746 −7% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $47,910 $28,746 $30,330 +58% $20,901 +129% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $47,892 $28,735 $28,476 +68% $22,850 +110% ≈93% of Medicare
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $47,828 $28,697 $37,100 +29% $27,163 +76% —
501 SOFT TISSUE PROCEDURES WITH CC $47,828 $28,697 $47,828 +0% $39,619 +21% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $47,486 $28,491 $50,414 −6% $40,552 +17% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $47,288 $28,373 $42,273 +12% $33,424 +41% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $47,198 $28,319 $27,174 +74% $26,682 +77% ≈68% of Medicare
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $47,155 $28,293 $82,225 −43% $59,031 −20% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $47,075 $28,245 $24,822 +90% $23,498 +100% ≈72% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $47,017 $28,210 $51,589 −9% $42,795 +10% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $46,920 $28,152 $46,920 +0% $27,633 +70% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $46,870 $28,122 $46,870 +0% $39,006 +20% ≈67% of Medicare
030 SPINAL PROCEDURES WITHOUT CC/MCC $46,801 $28,081 $47,889 −2% $45,866 +2% —
334 RECTAL RESECTION WITHOUT CC/MCC $46,744 $28,046 $45,782 +2% $36,820 +27% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $46,703 $28,022 $48,590 −4% $35,453 +32% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $46,674 $28,004 $35,646 +31% $28,202 +65% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $46,359 $27,816 $66,342 −30% $44,117 +5% ≈106% of Medicare
948 SIGNS AND SYMPTOMS WITHOUT MCC $46,217 $27,730 $25,689 +80% $17,921 +158% ≈123% of Medicare
149 DYSEQUILIBRIUM $46,114 $27,668 $27,340 +69% $18,096 +155% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $46,029 $27,617 $18,322 +151% $15,837 +191% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $46,020 $27,612 $34,148 +35% $20,506 +124% —
100 SEIZURES WITH MCC $45,910 $27,546 $38,584 +19% $35,481 +29% ≈96% of Medicare
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $45,810 $27,486 $41,097 +11% $34,276 +34% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $45,801 $27,481 $61,102 −25% $40,642 +13% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $45,689 $27,414 $37,630 +21% $24,914 +83% ≈120% of Medicare
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $45,619 $27,371 $31,888 +43% $25,034 +82% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $45,591 $27,354 $42,205 +8% $29,805 +53% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $45,438 $27,263 $30,579 +49% $26,770 +70% ≈108% of Medicare
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $45,407 $27,244 $22,742 +100% $18,002 +152% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $45,067 $27,040 $45,810 −2% $39,018 +16% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $45,050 $27,030 $47,628 −5% $34,434 +31% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $44,770 $26,862 $44,770 +0% $39,173 +14% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $44,737 $26,842 $22,482 +99% $23,206 +93% —
539 OSTEOMYELITIS WITH MCC $44,725 $26,835 $42,316 +6% $37,609 +19% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $44,722 $26,833 $36,344 +23% $28,050 +59% ≈96% of Medicare
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $44,655 $26,793 $104,212 −57% $25,197 +77% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $44,601 $26,760 $41,381 +8% $29,826 +50% —
915 ALLERGIC REACTIONS WITH MCC $44,522 $26,713 $32,645 +36% $32,645 +36% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $44,471 $26,682 $44,471 +0% $14,014 +217% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $44,411 $26,646 $49,303 −10% $54,196 −18% —
188 PLEURAL EFFUSION WITHOUT CC/MCC $44,139 $26,484 $19,721 +124% $14,514 +204% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $44,086 $26,451 $29,239 +51% $18,488 +138% ≈88% of Medicare
811 RED BLOOD CELL DISORDERS WITH MCC $44,037 $26,422 $32,589 +35% $28,226 +56% ≈110% of Medicare
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $43,701 $26,221 $27,707 +58% $22,458 +95% ≈89% of Medicare
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $43,616 $26,170 $53,766 −19% $35,419 +23% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $43,597 $26,158 $43,597 +0% $30,784 +42% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $43,556 $26,134 $35,459 +23% $27,043 +61% —
712 TESTES PROCEDURES WITHOUT CC/MCC $43,504 $26,103 $39,220 +11% $18,898 +130% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $43,339 $26,003 $45,696 −5% $32,451 +34% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $43,086 $25,852 $43,086 +0% $36,505 +18% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $43,002 $25,801 $51,289 −16% $51,953 −17% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $42,931 $25,759 $45,423 −5% $33,454 +28% ≈122% of Medicare
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $42,837 $25,702 $31,265 +37% $25,279 +69% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $42,793 $25,676 $42,025 +2% $21,230 +102% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $42,765 $25,659 $35,222 +21% $30,571 +40% ≈102% of Medicare
592 SKIN ULCERS WITH MCC $42,760 $25,656 $40,195 +6% $33,246 +29% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $42,349 $25,410 $34,030 +24% $23,443 +81% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $42,277 $25,366 $42,277 +0% $19,657 +115% —
864 FEVER AND INFLAMMATORY CONDITIONS $42,150 $25,290 $20,117 +110% $18,640 +126% ≈83% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $41,917 $25,150 $22,530 +86% $21,941 +91% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $41,813 $25,088 $42,596 −2% $29,126 +44% —
292 HEART FAILURE AND SHOCK WITH CC $41,671 $25,002 $27,360 +52% $16,371 +155% ≈117% of Medicare
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $41,566 $24,939 $29,075 +43% $23,488 +77% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $41,480 $24,888 $52,805 −21% $29,079 +43% —
551 MEDICAL BACK PROBLEMS WITH MCC $41,232 $24,739 $37,053 +11% $34,017 +21% —
914 TRAUMATIC INJURY WITHOUT MCC $41,226 $24,736 $22,256 +85% $15,855 +160% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $41,181 $24,709 $60,720 −32% $37,240 +11% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $40,754 $24,452 $30,617 +33% $19,037 +114% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $40,686 $24,411 $22,043 +85% $14,648 +178% —
181 RESPIRATORY NEOPLASMS WITH CC $40,664 $24,398 $27,133 +50% $23,573 +73% ≈77% of Medicare
593 SKIN ULCERS WITH CC $40,651 $24,390 $27,448 +48% $22,886 +78% —
200 PNEUMOTHORAX WITH CC $40,593 $24,356 $22,299 +82% $21,368 +90% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $40,539 $24,323 $35,833 +13% $23,617 +72% ≈103% of Medicare
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $40,423 $24,254 $42,298 −4% $22,393 +81% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $40,303 $24,182 $29,079 +39% $19,138 +111% —
885 PSYCHOSES $40,283 $24,170 $18,408 +119% $21,729 +85% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $40,231 $24,138 $53,246 −24% $40,108 +0% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $40,155 $24,093 $46,028 −13% $31,321 +28% —
684 RENAL FAILURE WITHOUT CC/MCC $40,074 $24,045 $21,444 +87% $13,642 +194% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $39,939 $23,964 $42,314 −6% $27,119 +47% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $39,897 $23,938 $58,281 −32% $42,186 −5% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $39,853 $23,912 $23,838 +67% $18,126 +120% —
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $39,846 $23,907 $24,507 +63% $19,305 +106% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $39,687 $23,812 $36,258 +9% $24,944 +59% —
682 RENAL FAILURE WITH MCC $39,474 $23,685 $32,167 +23% $29,064 +36% ≈126% of Medicare
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $39,432 $23,659 $34,677 +14% $25,581 +54% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $39,424 $23,654 $26,257 +50% $20,259 +95% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $39,409 $23,645 $27,741 +42% $27,808 +42% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $39,313 $23,588 $28,730 +37% $18,150 +117% —
103 HEADACHES WITHOUT MCC $39,264 $23,559 $29,265 +34% $21,280 +85% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $39,107 $23,464 $33,527 +17% $20,926 +87% —
381 COMPLICATED PEPTIC ULCER WITH CC $39,026 $23,415 $31,494 +24% $24,177 +61% —
887 OTHER MENTAL DISORDER DIAGNOSES $38,996 $23,397 $20,006 +95% $20,616 +89% —
639 DIABETES WITHOUT CC/MCC $38,746 $23,247 $19,853 +95% $13,910 +179% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $38,685 $23,211 $20,657 +87% $17,124 +126% —
602 CELLULITIS WITH MCC $38,678 $23,207 $37,206 +4% $30,598 +26% ≈102% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $38,677 $23,206 $29,165 +33% $19,264 +101% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $38,501 $23,100 $41,370 −7% $26,618 +45% ≈117% of Medicare
088 CONCUSSION WITH MCC $38,292 $22,975 $40,071 −4% $24,402 +57% —
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $38,243 $22,946 $35,762 +7% $36,249 +6% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $38,177 $22,906 $30,661 +25% $24,386 +57% ≈108% of Medicare
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $38,120 $22,872 $40,602 −6% $25,073 +52% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $38,068 $22,841 $25,394 +50% $16,776 +127% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $38,060 $22,836 $38,060 +0% $24,127 +58% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $38,001 $22,801 $45,061 −16% $24,544 +55% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $37,996 $22,798 $23,003 +65% $19,270 +97% —
663 MINOR BLADDER PROCEDURES WITH CC $37,661 $22,597 $37,661 +0% $33,103 +14% —
865 VIRAL ILLNESS WITH MCC $37,532 $22,519 $30,489 +23% $26,910 +39% ≈72% of Medicare
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $37,422 $22,453 $38,993 −4% $26,932 +39% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $37,383 $22,430 $35,673 +5% $23,749 +57% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $37,244 $22,346 $27,658 +35% $18,348 +103% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $37,187 $22,312 $30,719 +21% $29,221 +27% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $37,172 $22,303 $29,363 +27% $19,096 +95% ≈111% of Medicare
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $37,163 $22,298 $29,733 +25% $22,888 +62% ≈90% of Medicare
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $37,144 $22,287 $39,617 −6% $36,988 +0% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $37,115 $22,269 $27,750 +34% $13,651 +172% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $36,988 $22,193 $35,392 +5% $25,303 +46% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $36,875 $22,125 $36,875 +0% $27,843 +32% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $36,853 $22,112 $22,093 +67% $13,633 +170% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $36,793 $22,076 $27,628 +33% $20,181 +82% ≈109% of Medicare
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $36,655 $21,993 $16,337 +124% $20,232 +81% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $36,549 $21,929 $21,355 +71% $17,038 +115% ≈101% of Medicare
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $36,520 $21,912 $38,165 −4% $26,051 +40% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $36,257 $21,754 $31,306 +16% $23,141 +57% —
920 COMPLICATIONS OF TREATMENT WITH CC $36,104 $21,663 $17,295 +109% $22,468 +61% ≈68% of Medicare
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $36,065 $21,639 $37,257 −3% $36,670 −2% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $35,802 $21,481 $25,679 +39% $21,275 +68% ≈91% of Medicare
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $35,789 $21,473 $42,812 −16% $36,253 −1% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $35,746 $21,448 $9,715 +268% $9,940 +260% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $35,722 $21,433 $39,391 −9% $32,841 +9% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $35,598 $21,359 $37,465 −5% $12,768 +179% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $34,860 $20,916 $25,676 +36% $20,911 +67% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $34,599 $20,759 $38,853 −11% $30,418 +14% —
801 SPLENIC PROCEDURES WITHOUT CC/MCC $34,498 $20,699 $37,623 −8% $36,445 −5% —
694 URINARY STONES WITHOUT MCC $34,474 $20,684 $26,930 +28% $17,345 +99% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $34,420 $20,652 $25,096 +37% $22,314 +54% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $34,374 $20,624 $34,374 +0% $28,125 +22% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $34,192 $20,515 $34,439 −1% $25,970 +32% ≈103% of Medicare
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $34,192 $20,515 $22,581 +51% $16,288 +110% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $34,135 $20,481 $24,948 +37% $18,459 +85% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $34,112 $20,467 $79,612 −57% $17,404 +96% —
075 VIRAL MENINGITIS WITH CC/MCC $34,016 $20,410 $26,570 +28% $30,447 +12% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $33,980 $20,388 $27,554 +23% $18,452 +84% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $33,955 $20,373 $30,042 +13% $18,126 +87% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $33,800 $20,280 $30,132 +12% $23,551 +44% ≈118% of Medicare
378 GASTROINTESTINAL HEMORRHAGE WITH CC $33,652 $20,191 $33,652 +0% $22,098 +52% ≈114% of Medicare
291 HEART FAILURE AND SHOCK WITH MCC $33,277 $19,966 $31,308 +6% $26,776 +24% ≈113% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $33,166 $19,900 $24,777 +34% $20,455 +62% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $33,059 $19,836 $38,458 −14% $33,393 −1% —
305 HYPERTENSION WITHOUT MCC $32,806 $19,684 $26,555 +24% $18,086 +81% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $32,620 $19,572 $18,315 +78% $17,733 +84% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $32,512 $19,507 $24,594 +32% $19,842 +64% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $32,343 $19,406 $30,275 +7% $31,159 +4% —
311 ANGINA PECTORIS $32,194 $19,317 $20,944 +54% $15,502 +108% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $32,180 $19,308 $13,947 +131% $14,415 +123% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $31,918 $19,151 $44,938 −29% $14,055 +127% —
950 AFTERCARE WITHOUT CC/MCC $31,907 $19,144 $22,706 +41% $13,527 +136% —
101 SEIZURES WITHOUT MCC $31,863 $19,118 $23,267 +37% $20,461 +56% ≈83% of Medicare
152 OTITIS MEDIA AND URI WITH MCC $31,809 $19,086 $27,012 +18% $20,247 +57% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $31,698 $19,019 $31,698 +0% $19,854 +60% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $31,583 $18,950 $31,583 +0% $22,620 +40% —
375 DIGESTIVE MALIGNANCY WITH CC $31,512 $18,907 $33,946 −7% $27,277 +16% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $31,469 $18,881 $31,469 +0% $27,323 +15% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $31,409 $18,846 $20,998 +50% $26,463 +19% —
549 SEPTIC ARTHRITIS WITH CC $30,943 $18,566 $24,261 +28% $24,056 +29% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $30,813 $18,488 $8,962 +244% $18,649 +65% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $30,772 $18,463 $33,736 −9% $20,463 +50% ≈112% of Medicare
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $30,555 $18,333 $30,555 +0% $30,010 +2% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $30,382 $18,229 $19,745 +54% $25,700 +18% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $30,293 $18,176 $30,293 +0% $27,152 +12% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $30,263 $18,158 $30,263 +0% $25,652 +18% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $30,154 $18,093 $36,216 −17% $33,048 −9% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $30,125 $18,075 $30,125 +0% $20,488 +47% ≈96% of Medicare
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $30,037 $18,022 $30,314 −1% $19,227 +56% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $30,031 $18,019 $29,920 +0% $21,056 +43% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $29,975 $17,985 $23,114 +30% $18,528 +62% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $29,783 $17,870 $44,349 −33% $32,443 −8% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $29,624 $17,774 $25,509 +16% $15,183 +95% —
151 EPISTAXIS WITHOUT MCC $29,198 $17,519 $16,459 +77% $13,032 +124% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $29,069 $17,441 $16,604 +75% $14,501 +100% —
139 SALIVARY GLAND PROCEDURES $28,909 $17,346 $28,647 +1% $23,612 +22% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $28,889 $17,334 $28,889 +0% $21,449 +35% ≈107% of Medicare
638 DIABETES WITH CC $28,772 $17,263 $27,043 +6% $19,661 +46% ≈74% of Medicare
312 SYNCOPE AND COLLAPSE $28,759 $17,255 $28,759 +0% $19,342 +49% ≈93% of Medicare
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $28,758 $17,255 $23,872 +20% $18,807 +53% ≈116% of Medicare
882 NEUROSES EXCEPT DEPRESSIVE $28,319 $16,991 $14,798 +91% $15,680 +81% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $28,313 $16,988 $34,204 −17% $39,955 −29% ≈76% of Medicare
138 MOUTH PROCEDURES WITHOUT CC/MCC $28,189 $16,913 $25,814 +9% $19,119 +47% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $28,130 $16,878 $21,957 +28% $24,552 +15% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $28,057 $16,834 $34,210 −18% $19,598 +43% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $28,035 $16,821 $13,756 +104% $18,602 +51% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $27,843 $16,706 $23,954 +16% $21,847 +27% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $27,783 $16,670 $26,993 +3% $17,578 +58% ≈87% of Medicare
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $27,610 $16,566 $24,654 +12% $15,600 +77% —
683 RENAL FAILURE WITH CC $27,304 $16,382 $26,395 +3% $19,130 +43% ≈103% of Medicare
176 PULMONARY EMBOLISM WITHOUT MCC $27,128 $16,277 $27,128 +0% $18,081 +50% ≈141% of Medicare
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $27,087 $16,252 $27,087 +0% $18,204 +49% ≈99% of Medicare
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $27,035 $16,221 $299,897 −91% $90,401 −70% —
137 MOUTH PROCEDURES WITH CC/MCC $26,958 $16,175 $26,958 +0% $27,861 −3% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $26,912 $16,147 $26,297 +2% $24,566 +10% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $26,809 $16,086 $16,366 +64% $19,412 +38% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $26,787 $16,072 $27,554 −3% $20,084 +33% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $26,783 $16,070 $25,748 +4% $17,303 +55% ≈112% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $26,693 $16,016 $34,177 −22% $32,433 −18% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $26,682 $16,009 $18,172 +47% $17,700 +51% —
669 TRANSURETHRAL PROCEDURES WITH CC $26,537 $15,922 $34,700 −24% $34,354 −23% —
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $26,516 $15,910 $29,133 −9% $22,557 +18% —
668 TRANSURETHRAL PROCEDURES WITH MCC $26,191 $15,715 $84,080 −69% $51,608 −49% —
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $26,014 $15,608 $26,014 +0% $19,569 +33% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $25,969 $15,582 $18,520 +40% $11,071 +135% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $25,899 $15,539 $18,978 +36% $17,118 +51% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $25,770 $15,462 $49,112 −48% $34,749 −26% —
606 MINOR SKIN DISORDERS WITH MCC $25,434 $15,260 $36,265 −30% $27,975 −9% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $25,270 $15,162 $23,545 +7% $17,322 +46% ≈93% of Medicare
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $24,993 $14,996 $24,707 +1% $22,763 +10% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $24,922 $14,953 $27,710 −10% $23,571 +6% —
881 DEPRESSIVE NEUROSES $24,860 $14,916 $15,058 +65% $15,058 +65% —
541 OSTEOMYELITIS WITHOUT CC/MCC $24,856 $14,914 $14,549 +71% $15,215 +63% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $24,675 $14,805 $24,675 +0% $19,924 +24% —
594 SKIN ULCERS WITHOUT CC/MCC $24,379 $14,627 $16,834 +45% $14,209 +72% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $24,350 $14,610 $24,350 +0% $17,674 +38% ≈87% of Medicare
603 CELLULITIS WITHOUT MCC $24,264 $14,558 $24,429 −1% $18,530 +31% ≈97% of Medicare
607 MINOR SKIN DISORDERS WITHOUT MCC $24,211 $14,527 $13,589 +78% $15,889 +52% ≈83% of Medicare
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $23,981 $14,389 $20,313 +18% $14,689 +63% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $23,920 $14,352 $22,600 +6% $13,824 +73% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $23,775 $14,265 $23,775 +0% $17,724 +34% ≈90% of Medicare
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $23,689 $14,213 $14,382 +65% $14,128 +68% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $23,674 $14,204 $23,674 +0% $22,851 +4% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $23,537 $14,122 $19,272 +22% $16,767 +40% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $23,429 $14,057 $25,718 −9% $19,846 +18% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $23,291 $13,975 $20,648 +13% $14,250 +63% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $23,261 $13,956 $21,011 +11% $20,566 +13% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $23,126 $13,876 $21,806 +6% $16,699 +38% ≈140% of Medicare
836 ACUTE LEUKEMIA WITHOUT CC/MCC $23,002 $13,801 $37,883 −39% $19,686 +17% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $22,982 $13,789 $20,348 +13% $17,601 +31% —
303 ATHEROSCLEROSIS WITHOUT MCC $22,922 $13,753 $22,788 +1% $14,927 +54% —
153 OTITIS MEDIA AND URI WITHOUT MCC $22,479 $13,487 $18,842 +19% $14,583 +54% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $22,037 $13,222 $28,585 −23% $23,283 −5% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $22,006 $13,204 $27,155 −19% $32,100 −31% —
866 VIRAL ILLNESS WITHOUT MCC $21,772 $13,063 $21,238 +3% $17,081 +27% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $21,506 $12,904 $12,895 +67% $12,895 +67% —
204 RESPIRATORY SIGNS AND SYMPTOMS $21,359 $12,815 $23,130 −8% $18,004 +19% —
187 PLEURAL EFFUSION WITH CC $21,290 $12,774 $21,390 −0% $21,789 −2% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $21,258 $12,755 $25,506 −17% $11,909 +78% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $21,234 $12,740 $15,036 +41% $13,361 +59% ≈93% of Medicare
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $21,114 $12,668 $21,114 +0% $16,846 +25% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $21,073 $12,644 $20,849 +1% $15,370 +37% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $20,597 $12,358 $20,597 +0% $15,038 +37% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $20,572 $12,343 $20,340 +1% $11,421 +80% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $20,516 $12,310 $26,480 −23% $17,737 +16% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $20,505 $12,303 $18,396 +11% $14,368 +43% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $20,368 $12,221 $25,566 −20% $18,072 +13% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $20,329 $12,197 $23,065 −12% $16,520 +23% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $20,247 $12,148 $54,215 −63% $49,423 −59% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $20,239 $12,143 $17,061 +19% $16,700 +21% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $20,206 $12,124 $36,054 −44% $27,297 −26% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $20,106 $12,064 $17,530 +15% $17,483 +15% —
302 ATHEROSCLEROSIS WITH MCC $20,025 $12,015 $32,132 −38% $22,446 −11% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $19,799 $11,879 $31,748 −38% $13,586 +46% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $19,796 $11,877 $19,796 +0% $12,460 +59% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $19,791 $11,875 $27,354 −28% $17,298 +14% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $19,738 $11,843 $18,908 +4% $15,452 +28% —
916 ALLERGIC REACTIONS WITHOUT MCC $19,370 $11,622 $13,510 +43% $13,942 +39% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $19,264 $11,558 $32,239 −40% $16,634 +16% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $19,046 $11,428 $24,490 −22% $18,956 +0% —
313 CHEST PAIN $18,736 $11,242 $21,293 −12% $16,440 +14% —
533 FRACTURES OF FEMUR WITH MCC $18,488 $11,093 $24,541 −25% $25,945 −29% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $17,934 $10,760 $26,990 −34% $17,934 +0% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $17,471 $10,482 $43,675 −60% $31,044 −44% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $17,403 $10,442 $14,968 +16% $12,559 +39% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $16,889 $10,133 $18,498 −9% $13,275 +27% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $16,669 $10,001 $12,844 +30% $15,428 +8% —
779 ABORTION WITHOUT D&C $16,383 $9,830 $14,464 +13% $15,327 +7% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $16,264 $9,758 $39,801 −59% $25,094 −35% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $16,244 $9,747 $15,815 +3% $14,638 +11% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $16,112 $9,667 $38,663 −58% $15,549 +4% —
201 PNEUMOTHORAX WITHOUT CC/MCC $15,722 $9,433 $16,175 −3% $14,053 +12% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $15,705 $9,423 $15,705 +0% $15,019 +5% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $14,896 $8,937 $15,550 −4% $12,324 +21% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $14,687 $8,812 $16,757 −12% $12,078 +22% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $14,515 $8,709 $15,445 −6% $13,384 +8% ≈96% of Medicare
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $13,787 $8,272 $14,716 −6% $14,716 −6% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $13,778 $8,267 $16,940 −19% $20,895 −34% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $13,538 $8,123 $25,509 −47% $18,316 −26% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $13,528 $8,117 $13,528 +0% $12,252 +10% —
150 EPISTAXIS WITH MCC $13,437 $8,062 $25,823 −48% $23,171 −42% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $13,413 $8,048 $13,413 +0% $14,549 −8% —
534 FRACTURES OF FEMUR WITHOUT MCC $13,346 $8,007 $18,894 −29% $17,559 −24% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $12,660 $7,596 $21,908 −42% $22,525 −44% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $9,495 $5,697 $33,211 −71% $17,193 −45% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $9,126 $5,475 $8,532 +7% $10,160 −10% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $9,041 $5,425 $16,212 −44% $16,212 −44% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $8,934 $5,361 $10,764 −17% $12,593 −29% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $8,395 $5,037 $3,338 +152% $10,480 −20% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $8,231 $4,939 $31,237 −74% $26,280 −69% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $6,891 $4,134 $12,216 −44% $11,997 −43% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,559 $3,936 $7,557 −13% $15,589 −58% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $5,340 $3,204 $4,134 +29% $8,445 −37% —
795 NORMAL NEWBORN $4,774 $2,864 $3,473 +37% $4,720 +1% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,537 $2,722 $11,571 −61% $10,975 −59% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $3,519 $2,111 $25,464 −86% $14,064 −75% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $3,372 $2,023 $17,425 −81% $16,552 −80% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $2,396 $1,438 $30,418 −92% $16,998 −86% —

Procedures with negotiated rates only

These 2 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
158 DENTAL AND ORAL DISEASES WITH CC $2,000 – $17,280 · median $8,235 35 plans
006 LIVER TRANSPLANT WITHOUT MCC $31,310 – $90,661 · median $77,907 21 plans
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