UNC REX Hospital — Pricing

721 procedures published in this hospital's Machine-Readable File (MRF) — 720 with a comparable price, 1 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 721
Lowest published price $2,396
Average published price $90,067
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 720 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 ≈175% 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% $498,715 +227% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $1,331,965 $799,179 $379,558 +251% $431,073 +209% —
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 $525,648 +78% $371,366 +152% —
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 $168,826 +404% $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 $161,964 +347% $94,927 +662% —
999 UNGROUPABLE $701,850 $421,110 $14,162 +4856% $28,822 +2335% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $595,375 $357,225 $560,182 +6% $169,977 +250% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $577,214 $346,328 $306,087 +89% $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 $388,023 +23% $245,241 +95% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $471,657 $282,994 $170,734 +176% $138,008 +242% ≈184% of Medicare
196 INTERSTITIAL LUNG DISEASE WITH MCC $385,082 $231,049 $47,330 +714% $30,766 +1152% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $382,952 $229,771 $88,070 +335% $57,855 +562% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $381,397 $228,838 $76,865 +396% $57,963 +558% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $375,536 $225,322 $132,314 +184% $75,585 +397% —
595 MAJOR SKIN DISORDERS WITH MCC $364,693 $218,816 $31,181 +1070% $31,785 +1047% —
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $361,541 $216,925 $121,563 +197% $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 $78,441 +332% $76,583 +343% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $334,855 $200,913 $35,147 +853% $54,129 +519% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $333,411 $200,047 $286,862 +16% $143,242 +133% ≈145% of Medicare
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $323,116 $193,869 $281,448 +15% $134,914 +139% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $312,642 $187,585 $151,545 +106% $86,953 +260% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $303,344 $182,007 $99,645 +204% $84,861 +257% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $302,634 $181,580 $57,989 +422% $65,383 +363% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $295,784 $177,470 $196,897 +50% $105,612 +180% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $294,303 $176,582 $93,172 +216% $87,018 +238% ≈192% of Medicare
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $292,526 $175,516 $201,505 +45% $120,174 +143% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $289,898 $173,939 $162,298 +79% $70,735 +310% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $288,214 $172,929 $174,917 +65% $109,331 +164% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $287,599 $172,559 $125,107 +130% $88,691 +224% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $273,318 $163,991 $585,410 −53% $182,314 +50% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $271,852 $163,111 $106,316 +156% $71,701 +279% ≈201% of Medicare
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $269,458 $161,675 $198,739 +36% $120,587 +123% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $268,712 $161,227 $268,712 +0% $171,338 +57% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $265,638 $159,383 $202,306 +31% $107,355 +147% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $260,891 $156,534 $223,102 +17% $114,914 +127% —
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 $223,937 +16% $106,778 +144% —
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% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $248,089 $148,853 $248,089 +0% $151,029 +64% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $245,968 $147,581 $245,968 +0% $175,437 +40% ≈189% of Medicare
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $242,865 $145,719 $182,059 +33% $98,260 +147% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $242,047 $145,228 $204,145 +19% $101,235 +139% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $238,027 $142,816 $130,101 +83% $81,176 +193% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $235,549 $141,330 $142,820 +65% $80,885 +191% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $233,304 $139,983 $79,477 +194% $56,519 +313% ≈192% of Medicare
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $227,756 $136,654 $219,681 +4% $138,868 +64% ≈134% of Medicare
215 OTHER HEART ASSIST SYSTEM IMPLANT $227,466 $136,480 $221,756 +3% $191,314 +19% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $225,933 $135,560 $138,711 +63% $71,551 +216% —
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% ≈162% of Medicare
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $215,216 $129,129 $63,535 +239% $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 $166,794 +20% $116,058 +72% —
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $195,081 $117,049 $195,081 +0% $121,728 +60% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $194,967 $116,980 $194,967 +0% $118,589 +64% —
028 SPINAL PROCEDURES WITH MCC $194,362 $116,617 $194,362 +0% $95,858 +103% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $194,123 $116,474 $57,719 +236% $49,197 +295% ≈185% of Medicare
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $192,794 $115,677 $113,837 +69% $82,561 +134% ≈180% of Medicare
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $191,238 $114,743 $24,891 +668% $14,861 +1187% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $189,813 $113,888 $104,530 +82% $62,404 +204% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $189,693 $113,816 $54,862 +246% $57,521 +230% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $188,591 $113,155 $115,634 +63% $72,859 +159% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $188,529 $113,118 $59,352 +218% $59,352 +218% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $188,277 $112,966 $111,050 +70% $105,899 +78% —
835 ACUTE LEUKEMIA WITH CC $187,195 $112,317 $30,915 +506% $35,569 +426% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $184,253 $110,552 $184,253 +0% $113,855 +62% ≈155% of Medicare
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $181,765 $109,059 $132,427 +37% $94,988 +91% —
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 $69,912 +151% $79,944 +120% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $175,482 $105,289 $395,416 −56% $59,425 +195% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $174,461 $104,676 $30,601 +470% $22,024 +692% ≈198% of Medicare
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $173,450 $104,070 $155,043 +12% $87,565 +98% ≈147% of Medicare
500 SOFT TISSUE PROCEDURES WITH MCC $171,811 $103,087 $70,494 +144% $57,479 +199% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $168,862 $101,317 $168,862 +0% $121,714 +39% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $168,014 $100,809 $117,171 +43% $65,573 +156% ≈148% of Medicare
711 TESTES PROCEDURES WITH CC/MCC $167,260 $100,356 $53,392 +213% $34,852 +380% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $166,737 $100,042 $76,824 +117% $72,945 +129% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $165,858 $99,515 $128,104 +29% $72,782 +128% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $164,871 $98,922 $61,169 +170% $43,524 +279% ≈191% of Medicare
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $162,227 $97,336 $97,218 +67% $62,961 +158% —
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 $112,737 +43% $66,853 +140% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $160,160 $96,096 $160,160 +0% $102,177 +57% ≈142% of Medicare
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $159,772 $95,863 $68,265 +134% $80,747 +98% ≈132% of Medicare
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $159,001 $95,401 $59,883 +166% $55,097 +189% —
253 OTHER VASCULAR PROCEDURES WITH CC $157,732 $94,639 $113,961 +38% $53,746 +193% ≈178% of Medicare
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $157,713 $94,628 $131,675 +20% $78,852 +100% ≈135% of Medicare
813 COAGULATION DISORDERS $156,632 $93,979 $37,983 +312% $30,128 +420% ≈193% of Medicare
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 $162,376 −4% $99,423 +57% ≈171% of Medicare
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $155,351 $93,210 $47,114 +230% $30,358 +412% ≈158% of Medicare
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $154,976 $92,986 $89,366 +73% $65,254 +137% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $153,761 $92,256 $139,842 +10% $159,181 −3% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $153,253 $91,952 $69,289 +121% $86,390 +77% ≈250% of Medicare
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $152,969 $91,781 $36,604 +318% $29,484 +419% ≈159% of Medicare
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $152,834 $91,701 $100,691 +52% $54,824 +179% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $148,962 $89,377 $97,243 +53% $44,053 +238% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $144,048 $86,429 $144,048 +0% $102,573 +40% ≈155% of Medicare
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $143,856 $86,313 $72,194 +99% $56,394 +155% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $143,330 $85,998 $22,967 +524% $17,226 +732% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $141,411 $84,846 $24,118 +486% $24,118 +486% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $139,659 $83,796 $89,353 +56% $89,353 +56% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $136,241 $81,744 $106,663 +28% $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% $68,880 +97% ≈144% of Medicare
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $135,303 $81,182 $70,144 +93% $54,313 +149% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $134,739 $80,843 $60,052 +124% $49,710 +171% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $134,736 $80,842 $85,423 +58% $60,140 +124% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $133,868 $80,321 $133,868 +0% $88,049 +52% ≈134% of Medicare
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% $96,222 +38% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $132,515 $79,509 $57,456 +131% $37,950 +249% ≈179% of Medicare
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $132,375 $79,425 $84,005 +58% $93,783 +41% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $131,852 $79,111 $118,406 +11% $74,257 +78% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $131,838 $79,103 $148,324 −11% $83,065 +59% ≈120% of Medicare
662 MINOR BLADDER PROCEDURES WITH MCC $131,821 $79,092 $54,483 +142% $54,483 +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 $54,536 +137% $37,902 +241% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $127,808 $76,685 $71,229 +79% $48,680 +163% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $127,768 $76,661 $26,510 +382% $24,836 +414% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $127,355 $76,413 $108,569 +17% $40,277 +216% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $127,165 $76,299 $86,997 +46% $64,956 +96% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $127,022 $76,213 $48,165 +164% $36,375 +249% ≈195% of Medicare
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $126,735 $76,041 $94,936 +33% $73,029 +74% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $126,325 $75,795 $37,599 +236% $32,936 +284% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $125,956 $75,574 $125,956 +0% $66,819 +89% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $125,878 $75,527 $65,056 +93% $40,947 +207% —
163 MAJOR CHEST PROCEDURES WITH MCC $123,228 $73,937 $133,292 −8% $88,341 +39% ≈154% of Medicare
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $122,192 $73,315 $57,037 +114% $45,817 +167% ≈180% of Medicare
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $122,084 $73,250 $70,055 +74% $48,907 +150% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $121,646 $72,988 $103,464 +18% $81,998 +48% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $120,501 $72,301 $102,617 +17% $78,582 +53% —
252 OTHER VASCULAR PROCEDURES WITH MCC $120,467 $72,280 $120,467 +0% $68,508 +76% ≈175% of Medicare
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $119,957 $71,974 $119,957 +0% $71,014 +69% ≈167% of Medicare
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $119,647 $71,788 $101,959 +17% $68,006 +76% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $119,451 $71,670 $119,451 +0% $88,050 +36% ≈172% of Medicare
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $118,945 $71,367 $105,834 +12% $88,307 +35% ≈166% of Medicare
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $118,837 $71,302 $47,148 +152% $33,165 +258% —
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 $44,448 +167% $24,036 +393% —
644 ENDOCRINE DISORDERS WITH CC $117,357 $70,414 $29,544 +297% $22,941 +412% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $116,893 $70,136 $116,893 +0% $51,142 +129% —
038 EXTRACRANIAL PROCEDURES WITH CC $116,240 $69,744 $66,487 +75% $35,770 +225% ≈220% of Medicare
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $115,920 $69,552 $40,598 +186% $32,689 +255% ≈111% of Medicare
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $114,120 $68,472 $55,179 +107% $60,861 +88% —
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% $72,011 +57% —
037 EXTRACRANIAL PROCEDURES WITH MCC $112,687 $67,612 $103,899 +8% $64,749 +74% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $111,525 $66,915 $111,525 +0% $82,247 +36% ≈170% of Medicare
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $110,670 $66,402 $110,670 +0% $90,331 +23% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $110,347 $66,208 $55,656 +98% $32,981 +235% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $110,332 $66,199 $55,519 +99% $43,491 +154% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $109,919 $65,951 $42,833 +157% $29,371 +274% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $109,053 $65,432 $58,569 +86% $49,055 +122% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $108,791 $65,275 $85,869 +27% $64,776 +68% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $107,849 $64,710 $107,849 +0% $74,755 +44% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $105,834 $63,500 $89,377 +18% $63,984 +65% ≈149% of Medicare
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $104,902 $62,941 $107,896 −3% $70,540 +49% —
304 HYPERTENSION WITH MCC $104,704 $62,822 $28,318 +270% $24,185 +333% ≈194% of Medicare
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $103,507 $62,104 $51,718 +100% $44,989 +130% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $103,348 $62,009 $56,173 +84% $42,881 +141% ≈219% of Medicare
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $102,772 $61,663 $72,530 +42% $62,269 +65% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $102,608 $61,565 $79,086 +30% $54,929 +87% ≈188% of Medicare
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $102,531 $61,519 $79,396 +29% $43,800 +134% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $102,053 $61,232 $63,949 +60% $43,398 +135% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $101,188 $60,713 $36,370 +178% $19,317 +424% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $100,982 $60,589 $80,626 +25% $40,232 +151% —
199 PNEUMOTHORAX WITH MCC $100,774 $60,465 $42,335 +138% $31,491 +220% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $99,638 $59,783 $99,638 +0% $67,901 +47% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $99,421 $59,653 $67,353 +48% $29,409 +238% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $99,336 $59,601 $83,660 +19% $61,832 +61% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $98,073 $58,844 $5,399 +1716% $11,633 +743% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $97,995 $58,797 $97,995 +0% $75,492 +30% —
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $97,914 $58,749 $75,684 +29% $43,538 +125% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $97,298 $58,379 $27,152 +258% $29,609 +229% —
653 MAJOR BLADDER PROCEDURES WITH MCC $97,063 $58,238 $97,063 +0% $97,046 +0% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $96,059 $57,636 $75,345 +27% $45,497 +111% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $95,386 $57,231 $62,645 +52% $30,972 +208% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $95,161 $57,097 $56,538 +68% $33,607 +183% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $95,110 $57,066 $103,961 −9% $74,274 +28% ≈158% of Medicare
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $95,021 $57,012 $116,842 −19% $91,329 +4% ≈141% of Medicare
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $95,011 $57,007 $54,091 +76% $41,900 +127% ≈155% of Medicare
919 COMPLICATIONS OF TREATMENT WITH MCC $94,496 $56,698 $41,533 +128% $29,031 +226% ≈132% of Medicare
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $94,235 $56,541 $94,235 +0% $53,551 +76% —
374 DIGESTIVE MALIGNANCY WITH MCC $93,074 $55,844 $46,856 +99% $38,885 +139% ≈184% of Medicare
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $92,897 $55,738 $92,897 +0% $68,659 +35% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $91,781 $55,069 $90,788 +1% $70,132 +31% ≈129% of Medicare
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $91,632 $54,979 $85,282 +7% $54,475 +68% ≈179% of Medicare
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 $90,501 +0% $76,954 +18% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $90,442 $54,265 $85,788 +5% $62,821 +44% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $90,039 $54,024 $103,833 −13% $53,817 +67% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $90,005 $54,003 $69,519 +29% $50,139 +80% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $89,056 $53,433 $85,978 +4% $52,313 +70% ≈149% of Medicare
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $88,777 $53,266 $58,637 +51% $38,420 +131% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $88,532 $53,119 $107,983 −18% $92,217 −4% ≈139% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $88,504 $53,103 $88,504 +0% $64,152 +38% —
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 $71,159 +24% $65,216 +35% ≈182% of Medicare
472 CERVICAL SPINAL FUSION WITH CC $87,747 $52,648 $87,747 +0% $59,537 +47% ≈163% of Medicare
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $87,592 $52,555 $46,252 +89% $30,940 +183% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $86,734 $52,041 $40,015 +117% $29,757 +191% ≈211% of Medicare
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $86,510 $51,906 $35,133 +146% $37,064 +133% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $86,470 $51,882 $4,889 +1668% $14,284 +505% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $85,803 $51,482 $43,413 +98% $32,399 +165% ≈214% of Medicare
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $85,495 $51,297 $50,001 +71% $38,357 +123% ≈198% of Medicare
545 CONNECTIVE TISSUE DISORDERS WITH MCC $85,383 $51,230 $43,112 +98% $39,657 +115% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $84,712 $50,827 $84,712 +0% $45,622 +86% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $84,069 $50,441 $68,185 +23% $30,910 +172% —
503 FOOT PROCEDURES WITH MCC $83,535 $50,121 $54,558 +53% $43,901 +90% —
504 FOOT PROCEDURES WITH CC $83,487 $50,092 $45,088 +85% $36,598 +128% —
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 $42,709 +95% $36,237 +129% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $83,026 $49,816 $49,776 +67% $45,290 +83% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $82,669 $49,601 $80,523 +3% $42,126 +96% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $81,873 $49,124 $36,102 +127% $26,020 +215% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $81,369 $48,821 $62,731 +30% $36,333 +124% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $81,168 $48,701 $77,367 +5% $51,339 +58% ≈118% of Medicare
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $81,168 $48,701 $59,374 +37% $43,266 +88% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $81,119 $48,671 $81,538 −1% $67,764 +20% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $80,748 $48,449 $46,972 +72% $30,930 +161% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $80,543 $48,326 $32,902 +145% $24,480 +229% ≈212% of Medicare
637 DIABETES WITH MCC $80,433 $48,260 $34,031 +136% $28,819 +179% ≈150% of Medicare
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $80,172 $48,103 $80,027 +0% $49,631 +62% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $79,691 $47,814 $44,418 +79% $33,050 +141% —
186 PLEURAL EFFUSION WITH MCC $79,436 $47,661 $41,882 +90% $32,468 +145% —
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 $24,687 +221% $19,073 +315% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $79,080 $47,448 $49,956 +58% $37,842 +109% ≈165% of Medicare
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $78,998 $47,399 $40,964 +93% $29,374 +169% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $78,721 $47,233 $53,399 +47% $44,839 +76% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $78,347 $47,008 $52,403 +50% $36,850 +113% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $78,243 $46,946 $78,243 +0% $58,043 +35% ≈149% of Medicare
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $77,924 $46,755 $19,785 +294% $13,303 +486% —
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 $55,313 +41% $39,093 +99% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $77,113 $46,268 $25,314 +205% $17,522 +340% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $76,982 $46,189 $69,228 +11% $34,264 +125% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $76,492 $45,895 $32,457 +136% $25,704 +198% ≈163% of Medicare
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $76,292 $45,775 $60,048 +27% $41,520 +84% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $76,167 $45,700 $43,132 +77% $33,564 +127% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $76,167 $45,700 $17,773 +329% $18,133 +320% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $75,920 $45,552 $31,948 +138% $29,109 +161% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $75,715 $45,429 $75,715 +0% $59,207 +28% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $75,680 $45,408 $75,680 +0% $37,654 +101% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $75,504 $45,303 $51,842 +46% $36,933 +104% ≈177% of Medicare
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $75,475 $45,285 $57,598 +31% $51,985 +45% ≈135% of Medicare
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $75,365 $45,219 $73,402 +3% $50,624 +49% —
164 MAJOR CHEST PROCEDURES WITH CC $75,087 $45,052 $71,934 +4% $53,141 +41% ≈152% 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% $31,566 +135% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $74,061 $44,436 $70,940 +4% $44,600 +66% ≈204% of Medicare
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $73,393 $44,036 $73,393 +0% $51,172 +43% ≈162% of Medicare
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $72,806 $43,683 $74,218 −2% $40,694 +79% ≈144% of Medicare
123 NEUROLOGICAL EYE DISORDERS $72,240 $43,344 $20,417 +254% $17,831 +305% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $72,195 $43,317 $69,395 +4% $48,682 +48% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $72,134 $43,281 $27,178 +165% $20,968 +244% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $71,901 $43,141 $39,632 +81% $39,409 +82% ≈339% of Medicare
035 CAROTID ARTERY STENT PROCEDURES WITH CC $71,884 $43,130 $71,884 +0% $46,430 +55% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $71,704 $43,022 $43,820 +64% $41,660 +72% —
935 NON-EXTENSIVE BURNS $71,665 $42,999 $29,361 +144% $29,458 +143% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $71,620 $42,972 $39,014 +84% $52,405 +37% ≈147% of Medicare
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $71,615 $42,969 $65,375 +10% $43,697 +64% —
397 APPENDIX PROCEDURES WITH MCC $71,597 $42,958 $71,597 +0% $52,319 +37% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $71,514 $42,908 $51,347 +39% $20,842 +243% —
506 MAJOR THUMB OR JOINT PROCEDURES $71,129 $42,677 $40,543 +75% $28,983 +145% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $71,120 $42,672 $33,894 +110% $32,204 +121% ≈131% of Medicare
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $70,894 $42,536 $29,362 +141% $29,729 +138% —
597 MALIGNANT BREAST DISORDERS WITH MCC $70,697 $42,418 $44,796 +58% $31,846 +122% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $70,679 $42,407 $78,348 −10% $54,772 +29% ≈165% of Medicare
540 OSTEOMYELITIS WITH CC $70,567 $42,340 $31,763 +122% $23,494 +200% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $70,499 $42,299 $38,064 +85% $24,879 +183% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $70,498 $42,299 $70,498 +0% $29,633 +138% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $70,177 $42,106 $152,630 −54% $68,847 +2% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $70,126 $42,076 $74,617 −6% $58,832 +19% ≈153% of Medicare
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $70,126 $42,075 $70,126 +0% $72,908 −4% —
654 MAJOR BLADDER PROCEDURES WITH CC $69,871 $41,922 $69,871 +0% $53,868 +30% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $69,824 $41,894 $67,823 +3% $45,059 +55% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $69,817 $41,890 $74,020 −6% $50,011 +40% ≈162% of Medicare
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $69,772 $41,863 $62,230 +12% $45,963 +52% —
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $69,588 $41,753 $38,606 +80% $21,029 +231% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $68,596 $41,157 $39,181 +75% $36,334 +89% ≈155% of Medicare
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $68,074 $40,844 $30,537 +123% $28,140 +142% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $68,009 $40,806 $68,009 +0% $46,477 +46% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $67,986 $40,791 $15,535 +338% $11,955 +469% —
245 AICD GENERATOR PROCEDURES $67,840 $40,704 $67,840 +0% $72,076 −6% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $67,750 $40,650 $64,694 +5% $52,332 +29% —
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% $30,058 +123% ≈189% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $66,680 $40,008 $66,233 +1% $40,063 +66% ≈161% of Medicare
336 PERITONEAL ADHESIOLYSIS WITH CC $66,175 $39,705 $70,773 −6% $49,470 +34% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $66,079 $39,648 $45,388 +46% $31,758 +108% ≈145% of Medicare
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $65,980 $39,588 $65,980 +0% $38,382 +72% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $65,944 $39,566 $65,842 +0% $48,094 +37% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $65,826 $39,496 $26,562 +148% $25,854 +155% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $65,613 $39,368 $58,452 +12% $36,280 +81% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $65,471 $39,283 $44,472 +47% $44,472 +47% —
265 AICD LEAD PROCEDURES $65,384 $39,230 $76,543 −15% $56,695 +15% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $65,373 $39,224 $65,373 +0% $57,149 +14% ≈176% of Medicare
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $65,146 $39,088 $28,762 +126% $20,007 +226% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $65,143 $39,086 $48,986 +33% $39,253 +66% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $65,109 $39,065 $49,731 +31% $35,114 +85% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $64,872 $38,923 $64,872 +0% $62,524 +4% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $64,704 $38,822 $56,325 +15% $45,432 +42% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $64,487 $38,692 $33,852 +90% $25,731 +151% ≈126% of Medicare
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $64,322 $38,593 $59,686 +8% $43,775 +47% —
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 $64,067 +0% $63,475 +1% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $64,024 $38,414 $61,165 +5% $43,586 +47% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $63,863 $38,318 $63,863 +0% $41,651 +53% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $63,757 $38,254 $43,335 +47% $35,237 +81% ≈174% of Medicare
333 RECTAL RESECTION WITH CC $63,363 $38,018 $63,363 +0% $34,352 +84% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $63,313 $37,988 $52,557 +20% $36,242 +75% ≈191% of Medicare
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $62,977 $37,786 $62,977 +0% $64,465 −2% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $62,732 $37,639 $31,399 +100% $34,089 +84% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $62,707 $37,624 $62,199 +1% $47,546 +32% —
113 ORBITAL PROCEDURES WITH CC/MCC $62,517 $37,510 $61,854 +1% $35,642 +75% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $62,241 $37,345 $52,791 +18% $25,149 +147% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $61,225 $36,735 $29,507 +107% $21,806 +181% ≈207% of Medicare
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $61,085 $36,651 $52,350 +17% $49,065 +24% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $60,775 $36,465 $32,814 +85% $32,483 +87% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $60,771 $36,463 $29,518 +106% $32,502 +87% —
505 FOOT PROCEDURES WITHOUT CC/MCC $60,733 $36,440 $46,679 +30% $31,716 +91% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $60,105 $36,063 $60,105 +0% $38,836 +55% ≈195% of Medicare
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $60,059 $36,035 $49,551 +21% $30,814 +95% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $59,665 $35,799 $27,175 +120% $21,545 +177% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $59,254 $35,552 $45,521 +30% $31,840 +86% ≈161% of Medicare
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $59,206 $35,524 $59,206 +0% $44,363 +33% —
849 RADIOTHERAPY $59,196 $35,517 $59,196 +0% $37,862 +56% —
799 SPLENIC PROCEDURES WITH MCC $59,066 $35,440 $67,322 −12% $78,821 −25% —
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 $28,043 +108% $39,563 +48% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $58,400 $35,040 $58,415 −0% $41,380 +41% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $58,279 $34,968 $40,724 +43% $35,714 +63% ≈231% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $58,238 $34,943 $47,200 +23% $29,916 +95% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $57,940 $34,764 $36,815 +57% $29,211 +98% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $57,928 $34,757 $42,360 +37% $31,059 +87% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $57,766 $34,660 $56,867 +2% $41,380 +40% ≈208% of Medicare
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $57,624 $34,574 $26,253 +119% $21,261 +171% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $57,556 $34,534 $72,817 −21% $68,399 −16% —
571 SKIN DEBRIDEMENT WITH CC $57,445 $34,467 $25,326 +127% $34,901 +65% —
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% $39,107 +44% —
947 SIGNS AND SYMPTOMS WITH MCC $56,316 $33,790 $33,290 +69% $25,474 +121% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $56,127 $33,676 $56,127 +0% $36,239 +55% ≈139% of Medicare
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $56,000 $33,600 $48,792 +15% $29,050 +93% —
906 HAND PROCEDURES FOR INJURIES $55,989 $33,594 $42,058 +33% $31,520 +78% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $55,623 $33,374 $28,567 +95% $30,974 +80% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $55,527 $33,316 $55,527 +0% $44,553 +25% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $55,121 $33,072 $30,459 +81% $21,213 +160% ≈212% of Medicare
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $55,090 $33,054 $44,221 +25% $30,661 +80% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $54,994 $32,997 $43,524 +26% $31,812 +73% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $54,949 $32,970 $49,525 +11% $31,816 +73% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $54,871 $32,923 $24,630 +123% $17,434 +215% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $54,418 $32,651 $43,425 +25% $24,316 +124% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $54,235 $32,541 $57,547 −6% $42,119 +29% ≈153% of Medicare
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $54,127 $32,476 $42,829 +26% $24,229 +123% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $53,933 $32,360 $53,797 +0% $46,591 +16% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $53,878 $32,327 $53,878 +0% $35,542 +52% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $53,804 $32,282 $36,617 +47% $31,128 +73% ≈150% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $53,657 $32,194 $53,657 +0% $34,900 +54% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $53,638 $32,183 $52,784 +2% $35,459 +51% —
089 CONCUSSION WITH CC $53,310 $31,986 $27,042 +97% $18,293 +191% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $53,190 $31,914 $24,922 +113% $13,282 +300% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $53,153 $31,892 $56,307 −6% $39,747 +34% ≈171% of Medicare
157 DENTAL AND ORAL DISEASES WITH MCC $53,125 $31,875 $41,338 +29% $27,457 +93% —
643 ENDOCRINE DISORDERS WITH MCC $53,038 $31,823 $41,195 +29% $32,996 +61% ≈187% of Medicare
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $52,937 $31,762 $52,937 +0% $23,924 +121% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $52,673 $31,604 $52,673 +0% $35,584 +48% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $52,615 $31,569 $45,825 +15% $38,878 +35% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $52,614 $31,569 $37,550 +40% $28,134 +87% —
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 $52,534 +0% $34,906 +50% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $52,372 $31,423 $45,451 +15% $30,006 +75% —
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% $30,394 +72% ≈149% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $52,190 $31,314 $26,380 +98% $19,001 +175% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $51,902 $31,141 $46,222 +12% $31,190 +66% ≈198% of Medicare
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $51,830 $31,098 $51,830 +0% $41,703 +24% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $51,729 $31,037 $50,739 +2% $36,597 +41% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $51,407 $30,844 $39,240 +31% $28,527 +80% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $51,399 $30,839 $28,348 +81% $28,967 +77% ≈165% of Medicare
672 URETHRAL PROCEDURES WITHOUT CC/MCC $51,356 $30,814 $20,565 +150% $17,398 +195% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $51,140 $30,684 $28,370 +80% $20,777 +146% ≈214% of Medicare
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $51,038 $30,623 $24,144 +111% $19,326 +164% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $50,379 $30,227 $19,416 +159% $19,579 +157% ≈205% of Medicare
076 VIRAL MENINGITIS WITHOUT CC/MCC $50,352 $30,211 $15,094 +234% $15,474 +225% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $50,149 $30,089 $38,798 +29% $23,297 +115% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $50,038 $30,023 $18,691 +168% $16,642 +201% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $49,887 $29,932 $32,566 +53% $26,158 +91% ≈153% of Medicare
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $49,839 $29,903 $49,779 +0% $28,646 +74% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $49,646 $29,787 $29,713 +67% $25,426 +95% ≈105% of Medicare
184 MAJOR CHEST TRAUMA WITH CC $49,611 $29,766 $26,116 +90% $20,842 +138% —
548 SEPTIC ARTHRITIS WITH MCC $49,553 $29,732 $32,344 +53% $31,019 +60% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $49,503 $29,702 $30,021 +65% $19,483 +154% ≈242% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $49,361 $29,617 $12,640 +291% $12,381 +299% —
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $49,342 $29,605 $51,019 −3% $34,887 +41% ≈203% of Medicare
102 HEADACHES WITH MCC $49,330 $29,598 $25,874 +91% $22,544 +119% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $49,317 $29,590 $37,440 +32% $20,080 +146% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $49,195 $29,517 $49,195 +0% $40,583 +21% —
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 $29,055 +69% $24,450 +101% ≈119% of Medicare
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $48,888 $29,333 $31,311 +56% $23,920 +104% —
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 $30,064 +62% $26,634 +83% —
180 RESPIRATORY NEOPLASMS WITH MCC $48,657 $29,194 $38,001 +28% $36,658 +33% ≈209% of Medicare
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $48,646 $29,188 $41,439 +17% $29,558 +65% —
380 COMPLICATED PEPTIC ULCER WITH MCC $48,643 $29,186 $44,130 +10% $36,641 +33% —
183 MAJOR CHEST TRAUMA WITH MCC $48,610 $29,166 $39,667 +23% $28,924 +68% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $48,570 $29,142 $38,598 +26% $23,469 +107% ≈230% of Medicare
619 O.R. PROCEDURES FOR OBESITY WITH MCC $48,212 $28,927 $58,107 −17% $44,973 +7% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $47,910 $28,746 $30,330 +58% $19,091 +151% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $47,892 $28,735 $28,476 +68% $22,850 +110% ≈177% of Medicare
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $47,828 $28,697 $33,872 +41% $26,322 +82% —
501 SOFT TISSUE PROCEDURES WITH CC $47,828 $28,697 $47,828 +0% $37,975 +26% —
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 $47,288 +0% $33,424 +41% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $47,198 $28,319 $27,174 +74% $25,208 +87% ≈107% of Medicare
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $47,155 $28,293 $82,225 −43% $58,968 −20% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $47,075 $28,245 $40,947 +15% $22,275 +111% —
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $47,017 $28,210 $51,589 −9% $35,686 +32% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $46,920 $28,152 $46,920 +0% $24,465 +92% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $46,870 $28,122 $46,870 +0% $35,375 +32% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $46,801 $28,081 $47,889 −2% $45,818 +2% —
334 RECTAL RESECTION WITHOUT CC/MCC $46,744 $28,046 $45,782 +2% $32,213 +45% —
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% $27,168 +72% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $46,359 $27,816 $66,342 −30% $44,117 +5% ≈171% of Medicare
948 SIGNS AND SYMPTOMS WITHOUT MCC $46,217 $27,730 $25,689 +80% $17,727 +161% ≈224% of Medicare
149 DYSEQUILIBRIUM $46,114 $27,668 $27,340 +69% $17,203 +168% ≈247% of Medicare
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $46,029 $27,617 $18,322 +151% $15,607 +195% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $46,020 $27,612 $34,059 +35% $19,287 +139% —
100 SEIZURES WITH MCC $45,910 $27,546 $42,679 +8% $35,194 +30% ≈168% of Medicare
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $45,810 $27,486 $41,097 +11% $31,909 +44% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $45,801 $27,481 $61,102 −25% $40,563 +13% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $45,689 $27,414 $37,630 +21% $24,136 +89% ≈220% of Medicare
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $45,619 $27,371 $31,888 +43% $24,017 +90% —
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% $26,488 +72% ≈209% of Medicare
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $45,407 $27,244 $24,925 +82% $18,002 +152% ≈210% of Medicare
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 $45,050 +0% $34,434 +31% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $44,770 $26,862 $40,433 +11% $36,097 +24% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $44,737 $26,842 $22,482 +99% $22,698 +97% —
539 OSTEOMYELITIS WITH MCC $44,725 $26,835 $42,316 +6% $33,746 +33% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $44,722 $26,833 $37,839 +18% $27,244 +64% ≈158% 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 $30,420 +46% $30,944 +44% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $44,471 $26,682 $44,471 +0% $13,385 +232% —
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 $19,715 +124% $14,110 +213% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $44,086 $26,451 $31,555 +40% $17,731 +149% ≈157% of Medicare
811 RED BLOOD CELL DISORDERS WITH MCC $44,037 $26,422 $33,985 +30% $27,934 +58% ≈173% of Medicare
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $43,701 $26,221 $29,636 +47% $22,032 +98% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $43,616 $26,170 $48,272 −10% $33,984 +28% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $43,597 $26,158 $43,597 +0% $27,369 +59% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $43,556 $26,134 $27,494 +58% $23,115 +88% —
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 $45,639 −5% $32,451 +34% ≈184% of Medicare
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $43,086 $25,852 $47,377 −9% $33,792 +28% —
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% $27,279 +57% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $42,837 $25,702 $31,765 +35% $24,452 +75% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $42,793 $25,676 $41,258 +4% $22,532 +90% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $42,765 $25,659 $36,088 +19% $28,780 +49% ≈189% of Medicare
592 SKIN ULCERS WITH MCC $42,760 $25,656 $40,204 +6% $32,662 +31% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $42,349 $25,410 $34,035 +24% $21,062 +101% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $42,277 $25,366 $30,572 +38% $17,550 +141% —
864 FEVER AND INFLAMMATORY CONDITIONS $42,150 $25,290 $24,049 +75% $17,412 +142% —
197 INTERSTITIAL LUNG DISEASE WITH CC $41,917 $25,150 $33,908 +24% $20,106 +108% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $41,813 $25,088 $41,813 +0% $28,103 +49% —
292 HEART FAILURE AND SHOCK WITH CC $41,671 $25,002 $27,360 +52% $16,212 +157% ≈224% of Medicare
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $41,566 $24,939 $29,075 +43% $23,396 +78% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $41,480 $24,888 $52,805 −21% $28,578 +45% —
551 MEDICAL BACK PROBLEMS WITH MCC $41,232 $24,739 $38,941 +6% $31,086 +33% ≈117% of Medicare
914 TRAUMATIC INJURY WITHOUT MCC $41,226 $24,736 $26,297 +57% $15,593 +164% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $41,181 $24,709 $41,181 +0% $36,202 +14% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $40,754 $24,452 $29,702 +37% $16,654 +145% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $40,686 $24,411 $22,523 +81% $14,444 +182% ≈131% of Medicare
181 RESPIRATORY NEOPLASMS WITH CC $40,664 $24,398 $24,396 +67% $22,431 +81% —
593 SKIN ULCERS WITH CC $40,651 $24,390 $27,448 +48% $20,470 +99% —
200 PNEUMOTHORAX WITH CC $40,593 $24,356 $22,299 +82% $20,573 +97% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $40,539 $24,323 $35,833 +13% $22,982 +76% ≈177% of Medicare
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $40,423 $24,254 $42,298 −4% $24,452 +65% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $40,303 $24,182 $29,079 +39% $16,156 +149% —
885 PSYCHOSES $40,283 $24,170 $18,408 +119% $21,489 +87% ≈386% of Medicare
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $40,231 $24,138 $53,246 −24% $37,080 +8% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $40,155 $24,093 $46,028 −13% $30,314 +32% —
684 RENAL FAILURE WITHOUT CC/MCC $40,074 $24,045 $21,444 +87% $13,623 +194% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $39,939 $23,964 $39,939 +0% $25,666 +56% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $39,897 $23,938 $50,838 −22% $40,065 −0% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $39,853 $23,912 $23,838 +67% $17,715 +125% ≈112% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $39,846 $23,907 $25,101 +59% $19,305 +106% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $39,687 $23,812 $37,464 +6% $24,432 +62% —
682 RENAL FAILURE WITH MCC $39,474 $23,685 $32,167 +23% $27,854 +42% ≈207% of Medicare
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $39,432 $23,659 $34,677 +14% $23,588 +67% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $39,424 $23,654 $26,257 +50% $17,585 +124% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $39,409 $23,645 $34,552 +14% $25,010 +58% —
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% $20,111 +95% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $39,107 $23,464 $36,165 +8% $19,868 +97% —
381 COMPLICATED PEPTIC ULCER WITH CC $39,026 $23,415 $32,085 +22% $24,177 +61% —
887 OTHER MENTAL DISORDER DIAGNOSES $38,996 $23,397 $18,631 +109% $20,602 +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% $15,858 +144% —
602 CELLULITIS WITH MCC $38,678 $23,207 $38,507 +0% $29,347 +32% ≈147% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $38,677 $23,206 $27,003 +43% $18,017 +115% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $38,501 $23,100 $39,527 −3% $25,267 +52% ≈210% of Medicare
088 CONCUSSION WITH MCC $38,292 $22,975 $38,292 +0% $24,402 +57% —
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $38,243 $22,946 $35,762 +7% $35,139 +9% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $38,177 $22,906 $30,661 +25% $24,190 +58% ≈174% of Medicare
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $38,120 $22,872 $38,120 +0% $25,152 +52% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $38,068 $22,841 $22,508 +69% $16,776 +127% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $38,060 $22,836 $38,060 +0% $23,723 +60% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $38,001 $22,801 $38,001 +0% $24,544 +55% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $37,996 $22,798 $23,003 +65% $20,147 +89% —
663 MINOR BLADDER PROCEDURES WITH CC $37,661 $22,597 $37,661 +0% $29,924 +26% —
865 VIRAL ILLNESS WITH MCC $37,532 $22,519 $31,371 +20% $26,088 +44% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $37,422 $22,453 $37,422 +0% $25,243 +48% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $37,383 $22,430 $35,673 +5% $23,749 +57% ≈171% of Medicare
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $37,244 $22,346 $27,658 +35% $16,495 +126% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $37,187 $22,312 $30,719 +21% $28,375 +31% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $37,172 $22,303 $29,363 +27% $19,096 +95% ≈174% of Medicare
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $37,163 $22,298 $30,204 +23% $22,781 +63% ≈159% of Medicare
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $37,144 $22,287 $39,617 −6% $32,911 +13% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $37,115 $22,269 $27,750 +34% $12,797 +190% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $36,988 $22,193 $35,724 +4% $22,713 +63% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $36,875 $22,125 $36,875 +0% $25,162 +47% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $36,853 $22,112 $18,063 +104% $13,368 +176% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $36,793 $22,076 $27,628 +33% $18,918 +94% ≈188% of Medicare
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $36,655 $21,993 $16,337 +124% $18,478 +98% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $36,549 $21,929 $21,843 +67% $16,745 +118% ≈184% of Medicare
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $36,520 $21,912 $38,165 −4% $23,956 +52% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $36,257 $21,754 $31,306 +16% $23,141 +57% ≈184% of Medicare
920 COMPLICATIONS OF TREATMENT WITH CC $36,104 $21,663 $17,295 +109% $21,181 +70% ≈189% of Medicare
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $36,065 $21,639 $37,257 −3% $32,538 +11% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $35,802 $21,481 $25,679 +39% $20,732 +73% ≈192% of Medicare
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $35,789 $21,473 $43,003 −17% $35,528 +1% ≈198% of Medicare
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $35,746 $21,448 $9,715 +268% $9,076 +294% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $35,722 $21,433 $39,407 −9% $31,978 +12% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $35,598 $21,359 $37,465 −5% $12,650 +181% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $34,860 $20,916 $25,676 +36% $20,371 +71% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $34,599 $20,759 $34,599 +0% $30,418 +14% —
801 SPLENIC PROCEDURES WITHOUT CC/MCC $34,498 $20,699 $37,623 −8% $28,634 +20% —
694 URINARY STONES WITHOUT MCC $34,474 $20,684 $24,767 +39% $16,531 +109% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $34,420 $20,652 $25,096 +37% $18,126 +90% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $34,374 $20,624 $34,374 +0% $25,623 +34% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $34,192 $20,515 $34,686 −1% $24,022 +42% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $34,192 $20,515 $22,581 +51% $14,880 +130% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $34,135 $20,481 $29,370 +16% $18,459 +85% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $34,112 $20,467 $79,612 −57% $15,890 +115% —
075 VIRAL MENINGITIS WITH CC/MCC $34,016 $20,410 $26,570 +28% $29,853 +14% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $33,980 $20,388 $27,554 +23% $18,238 +86% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $33,955 $20,373 $30,042 +13% $17,928 +89% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $33,800 $20,280 $32,199 +5% $23,496 +44% ≈196% of Medicare
378 GASTROINTESTINAL HEMORRHAGE WITH CC $33,652 $20,191 $33,652 +0% $21,886 +54% ≈195% of Medicare
291 HEART FAILURE AND SHOCK WITH MCC $33,277 $19,966 $31,339 +6% $25,020 +33% ≈177% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $33,166 $19,900 $25,625 +29% $20,309 +63% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $33,059 $19,836 $38,458 −14% $33,137 −0% —
305 HYPERTENSION WITHOUT MCC $32,806 $19,684 $26,555 +24% $17,144 +91% ≈216% of Medicare
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $32,620 $19,572 $17,658 +85% $15,636 +109% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $32,512 $19,507 $26,249 +24% $18,803 +73% ≈134% of Medicare
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $32,343 $19,406 $30,275 +7% $30,275 +7% —
311 ANGINA PECTORIS $32,194 $19,317 $21,118 +52% $15,165 +112% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $32,180 $19,308 $14,430 +123% $14,012 +130% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $31,918 $19,151 $31,918 +0% $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% $19,954 +60% ≈138% of Medicare
152 OTITIS MEDIA AND URI WITH MCC $31,809 $19,086 $25,826 +23% $19,795 +61% —
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 $26,599 +19% $21,615 +46% —
375 DIGESTIVE MALIGNANCY WITH CC $31,512 $18,907 $33,783 −7% $27,219 +16% ≈176% of Medicare
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $31,469 $18,881 $31,469 +0% $27,321 +15% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $31,409 $18,846 $20,998 +50% $25,786 +22% —
549 SEPTIC ARTHRITIS WITH CC $30,943 $18,566 $22,825 +36% $20,938 +48% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $30,813 $18,488 $8,962 +244% $16,719 +84% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $30,772 $18,463 $31,917 −4% $20,463 +50% ≈198% of Medicare
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $30,555 $18,333 $30,555 +0% $28,252 +8% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $30,382 $18,229 $20,168 +51% $24,202 +26% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $30,293 $18,176 $30,293 +0% $27,118 +12% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $30,263 $18,158 $28,192 +7% $25,307 +20% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $30,154 $18,093 $36,465 −17% $31,062 −3% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $30,125 $18,075 $30,125 +0% $20,488 +47% ≈176% of Medicare
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $30,037 $18,022 $30,314 −1% $18,623 +61% ≈222% of Medicare
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $30,031 $18,019 $30,031 +0% $20,278 +48% ≈175% of Medicare
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $29,975 $17,985 $24,680 +21% $18,253 +64% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $29,783 $17,870 $35,010 −15% $32,839 −9% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $29,624 $17,774 $25,509 +16% $15,070 +97% —
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% $13,822 +110% —
139 SALIVARY GLAND PROCEDURES $28,909 $17,346 $28,909 +0% $21,014 +38% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $28,889 $17,334 $28,889 +0% $21,449 +35% ≈233% of Medicare
638 DIABETES WITH CC $28,772 $17,263 $27,043 +6% $18,821 +53% ≈117% of Medicare
312 SYNCOPE AND COLLAPSE $28,759 $17,255 $28,759 +0% $19,342 +49% ≈173% of Medicare
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $28,758 $17,255 $23,872 +20% $18,278 +57% ≈197% of Medicare
882 NEUROSES EXCEPT DEPRESSIVE $28,319 $16,991 $14,551 +95% $15,680 +81% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $28,313 $16,988 $34,562 −18% $35,014 −19% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $28,189 $16,913 $25,811 +9% $17,383 +62% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $28,130 $16,878 $21,957 +28% $23,350 +20% —
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% $17,367 +61% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $27,843 $16,706 $23,954 +16% $20,421 +36% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $27,783 $16,670 $26,993 +3% $17,388 +60% ≈173% 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% $18,620 +47% ≈181% of Medicare
176 PULMONARY EMBOLISM WITHOUT MCC $27,128 $16,277 $27,128 +0% $18,081 +50% ≈193% of Medicare
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $27,087 $16,252 $27,087 +0% $18,204 +49% ≈188% of Medicare
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $27,035 $16,221 $299,897 −91% $82,527 −67% —
137 MOUTH PROCEDURES WITH CC/MCC $26,958 $16,175 $26,958 +0% $24,348 +11% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $26,912 $16,147 $26,297 +2% $20,741 +30% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $26,809 $16,086 $16,366 +64% $18,291 +47% —
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% $16,865 +59% ≈229% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $26,693 $16,016 $34,177 −22% $29,476 −9% —
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 $40,685 −35% $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 $59,497 −56% $47,277 −45% —
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $26,014 $15,608 $28,873 −10% $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% $16,837 +54% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $25,770 $15,462 $47,635 −46% $32,490 −21% —
606 MINOR SKIN DISORDERS WITH MCC $25,434 $15,260 $34,720 −27% $25,434 +0% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $25,270 $15,162 $23,545 +7% $17,322 +46% ≈177% of Medicare
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $24,993 $14,996 $24,889 +0% $22,231 +12% —
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 $14,632 +70% $14,549 +71% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $24,675 $14,805 $24,675 +0% $18,191 +36% —
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% $17,466 +39% ≈157% of Medicare
603 CELLULITIS WITHOUT MCC $24,264 $14,558 $24,429 −1% $18,530 +31% ≈163% of Medicare
607 MINOR SKIN DISORDERS WITHOUT MCC $24,211 $14,527 $13,589 +78% $15,284 +58% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $23,981 $14,389 $22,158 +8% $14,441 +66% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $23,920 $14,352 $22,600 +6% $13,824 +73% ≈177% of Medicare
202 BRONCHITIS AND ASTHMA WITH CC/MCC $23,775 $14,265 $23,775 +0% $17,273 +38% ≈160% of Medicare
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $23,689 $14,213 $14,382 +65% $14,128 +68% ≈195% of Medicare
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $23,674 $14,204 $23,674 +0% $21,860 +8% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $23,537 $14,122 $19,272 +22% $16,104 +46% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $23,429 $14,057 $25,718 −9% $19,815 +18% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $23,291 $13,975 $20,962 +11% $14,208 +64% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $23,261 $13,956 $23,261 +0% $18,608 +25% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $23,126 $13,876 $20,878 +11% $16,049 +44% —
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% $16,571 +39% —
303 ATHEROSCLEROSIS WITHOUT MCC $22,922 $13,753 $20,298 +13% $14,927 +54% —
153 OTITIS MEDIA AND URI WITHOUT MCC $22,479 $13,487 $18,842 +19% $14,473 +55% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $22,037 $13,222 $28,585 −23% $22,560 −2% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $22,006 $13,204 $27,155 −19% $29,663 −26% —
866 VIRAL ILLNESS WITHOUT MCC $21,772 $13,063 $21,238 +3% $16,391 +33% —
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 $23,272 −8% $16,866 +27% —
187 PLEURAL EFFUSION WITH CC $21,290 $12,774 $24,444 −13% $21,467 −1% —
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% $13,318 +59% ≈229% of Medicare
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $21,114 $12,668 $21,114 +0% $17,103 +23% —
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% $14,134 +46% —
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% $17,078 +20% —
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% $16,352 +25% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $20,329 $12,197 $20,329 +0% $15,869 +28% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $20,247 $12,148 $54,215 −63% $46,659 −57% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $20,239 $12,143 $17,061 +19% $16,418 +23% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $20,206 $12,124 $36,067 −44% $26,146 −23% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $20,106 $12,064 $17,755 +13% $17,483 +15% —
302 ATHEROSCLEROSIS WITH MCC $20,025 $12,015 $32,132 −38% $20,844 −4% —
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 $19,566 +1% $12,405 +60% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $19,791 $11,875 $19,791 +0% $15,876 +25% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $19,738 $11,843 $19,649 +0% $15,045 +31% —
916 ALLERGIC REACTIONS WITHOUT MCC $19,370 $11,622 $13,510 +43% $13,890 +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 $24,486 −22% $17,943 +6% —
313 CHEST PAIN $18,736 $11,242 $22,190 −16% $15,962 +17% ≈210% of Medicare
533 FRACTURES OF FEMUR WITH MCC $18,488 $11,093 $22,986 −20% $25,945 −29% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $17,934 $10,760 $17,934 +0% $17,108 +5% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $17,471 $10,482 $31,044 −44% $31,044 −44% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $17,403 $10,442 $14,968 +16% $12,537 +39% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $16,889 $10,133 $18,498 −9% $13,090 +29% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $16,669 $10,001 $12,844 +30% $14,166 +18% —
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% $24,561 −34% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $16,244 $9,747 $16,244 +0% $13,485 +20% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $16,112 $9,667 $38,663 −58% $13,654 +18% —
201 PNEUMOTHORAX WITHOUT CC/MCC $15,722 $9,433 $15,949 −1% $13,081 +20% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $15,705 $9,423 $15,705 +0% $13,892 +13% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $14,896 $8,937 $14,896 +0% $12,013 +24% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $14,687 $8,812 $16,757 −12% $12,044 +22% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $14,515 $8,709 $15,445 −6% $13,384 +8% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $13,787 $8,272 $14,716 −6% $14,337 −4% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $13,778 $8,267 $16,940 −19% $18,282 −25% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $13,538 $8,123 $25,509 −47% $18,428 −27% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $13,528 $8,117 $13,528 +0% $12,279 +10% —
150 EPISTAXIS WITH MCC $13,437 $8,062 $25,823 −48% $21,133 −36% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $13,413 $8,048 $13,413 +0% $13,198 +2% —
534 FRACTURES OF FEMUR WITHOUT MCC $13,346 $8,007 $17,058 −22% $17,195 −22% —
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% $9,385 −3% ≈194% of Medicare
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 $8,934 +0% $12,593 −29% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $8,395 $5,037 $3,338 +152% $10,039 −16% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $8,231 $4,939 $32,033 −74% $23,734 −65% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $6,891 $4,134 $11,997 −43% $11,997 −43% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,559 $3,936 $6,559 +0% $15,589 −58% —
006 LIVER TRANSPLANT WITHOUT MCC $6,468 — $49,088 −87% $84,407 −92% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $5,340 $3,204 $4,134 +29% $7,961 −33% —
795 NORMAL NEWBORN $4,774 $2,864 $3,473 +37% $4,530 +5% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,537 $2,722 $10,975 −59% $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% $15,077 −78% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $2,396 $1,438 $30,418 −92% $15,608 −85% —

Procedures with negotiated rates only

These 1 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.

DRG Description Insurance rate range Payers
158 DENTAL AND ORAL DISEASES WITH CC $2,000 – $17,280 · median $8,235 35 plans
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