HMH Raritan Bay Medical Center — Pricing

792 procedures published in this hospital's Machine-Readable File (MRF) — 771 with a comparable price, 21 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 792
Lowest published price $1,728
Average published price $20,331
Highest published price $326,207

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 792 procedures

Published charges

Showing all 771 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 70 procedures, this hospital's negotiated rates average ≈133% of what Medicare pays.

DRG Description Published price Cash price vs. NJ median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY $326,207 $326,207 $391,526 −17% $498,715 −35% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $243,650 $243,650 $338,950 −28% $431,073 −43% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $205,197 $205,197 $236,577 −13% $306,087 −33% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $185,379 $185,379 $260,247 −29% $371,366 −50% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $122,221 $122,221 $170,027 −28% $245,241 −50% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $113,328 $113,328 $122,488 −7% $182,314 −38% —
007 Lung transplant $113,042 $113,042 $126,907 −11% $170,608 −34% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $95,318 $95,318 $114,404 −17% $169,977 −44% —
212 CONCOMITANT AORTIC AND MITRAL VALVE?PROCEDURES $94,230 $94,230 $102,715 −8% $171,338 −45% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $92,115 $92,115 $128,144 −28% $159,181 −42% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $91,643 $91,643 $116,471 −21% $191,314 −52% —
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $90,610 $90,610 $99,176 −9% $142,326 −36% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $83,480 $83,480 $113,415 −26% $175,437 −52% —
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $79,681 $79,681 $77,091 +3% $121,563 −34% —
231 CORONARY BYPASS WITH PTCA WITH MCC $73,297 $73,297 $105,048 −30% $146,474 −50% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $73,257 $73,257 $111,108 −34% $151,029 −51% —
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $72,144 $72,144 $72,481 −0% $120,174 −40% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $69,727 $69,727 $96,999 −28% $134,914 −48% —
010 Pancreas transplant $68,965 $68,965 $69,287 −0% $99,940 −31% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $68,569 $68,569 $69,210 −1% $105,228 −35% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $67,610 $67,610 $99,484 −32% $138,868 −51% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $66,928 $66,928 $88,104 −24% $143,242 −53% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $64,564 $64,564 $96,002 −33% $120,587 −46% —
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $61,437 $61,437 $60,256 +2% $121,728 −50% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $61,128 $61,128 $62,554 −2% $131,961 −54% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $60,172 $60,172 $81,678 −26% $138,008 −56% ≈138% of Medicare
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $59,063 $59,063 $59,339 −0% $105,612 −44% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $57,994 $57,994 $69,607 −17% $114,914 −50% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $57,771 $57,771 $56,660 +2% $89,353 −35% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $57,673 $57,673 $61,786 −7% $118,589 −51% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $55,940 $55,940 $56,462 −1% $116,058 −52% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $55,859 $55,859 $56,890 −2% $121,714 −54% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $54,704 $54,704 $76,100 −28% $109,331 −50% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $53,580 $53,580 $56,010 −4% $117,280 −54% —
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $53,511 $53,511 $74,441 −28% $94,988 −44% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $53,267 $53,267 $76,220 −30% $98,912 −46% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $53,081 $53,081 $77,989 −32% $108,472 −51% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $52,839 $52,839 $53,665 −2% $106,238 −50% —
028 SPINAL PROCEDURES WITH MCC $52,586 $52,586 $74,391 −29% $95,858 −45% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $52,209 $52,209 $70,720 −26% $98,260 −47% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $52,209 $52,209 $61,708 −15% $81,176 −36% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $51,819 $51,819 $71,503 −28% $113,855 −54% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $51,460 $51,460 $73,928 −30% $92,238 −44% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $51,421 $51,421 $71,534 −28% $80,018 −36% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $50,897 $50,897 $67,362 −24% $112,062 −55% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $50,362 $50,362 $71,838 −30% $96,192 −48% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $49,645 $49,645 $69,568 −29% $107,355 −54% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $49,348 $49,348 $74,760 −34% $106,778 −54% —
653 MAJOR BLADDER PROCEDURES WITH MCC $48,219 $48,219 $62,070 −22% $97,046 −50% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $47,810 $47,810 $57,383 −17% $101,235 −53% —
834 ACUTE LEUKEMIA WITH MCC $47,810 $47,810 $46,891 +2% $76,583 −38% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $47,609 $47,609 $66,231 −28% $105,899 −55% —
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $47,319 $47,319 $65,827 −28% $93,783 −50% —
008 Simultaneous pancreas/kidney transplant $47,064 $47,064 $53,926 −13% $86,459 −46% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $46,957 $46,957 $69,661 −33% $94,927 −51% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $46,717 $46,717 $46,936 −0% $78,582 −41% —
011 Tracheostomy for face,mouth & neck diagnoses w MCC $46,673 $46,673 $46,225 +1% $86,953 −46% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $46,668 $46,668 $46,886 −0% $82,527 −43% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $46,019 $46,019 $61,822 −26% $102,573 −55% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $45,815 $45,815 $47,356 −3% $102,177 −55% —
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $44,547 $44,547 $44,547 +0% $79,944 −44% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $44,399 $44,399 $59,897 −26% $99,423 −55% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $44,067 $44,067 $65,645 −33% $96,222 −54% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $43,932 $43,932 $59,697 −26% $80,747 −46% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $43,568 $43,568 $49,585 −12% $87,565 −50% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $43,311 $43,311 $43,716 −1% $70,735 −39% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $43,277 $43,277 $43,480 −0% $84,861 −49% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $43,260 $43,260 $66,300 −35% $87,018 −50% ≈115% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $43,104 $43,104 $57,822 −25% $96,905 −56% —
245 AICD generator procedures $42,270 $42,270 $61,075 −31% $72,076 −41% —
471 CERVICAL SPINAL FUSION WITH MCC $42,015 $42,015 $58,448 −28% $92,515 −55% —
006 LIVER TRANSPLANT WITHOUT MCC $41,945 $41,945 $48,936 −14% $84,407 −50% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $41,307 $41,307 $53,961 −23% $88,691 −53% —
799 SPLENIC PROCEDURES WITH MCC $41,128 $41,128 $63,003 −35% $78,821 −48% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $41,120 $41,120 $54,442 −24% $86,390 −52% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $40,695 $40,695 $56,801 −28% $92,217 −56% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $40,477 $40,477 $58,079 −30% $80,885 −50% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $40,238 $40,238 $49,595 −19% $91,329 −56% —
163 MAJOR CHEST PROCEDURES WITH MCC $39,869 $39,869 $54,801 −27% $88,341 −55% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $39,852 $39,852 $40,443 −1% $71,551 −44% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $39,725 $39,725 $54,333 −27% $90,331 −56% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $39,719 $39,719 $62,792 −37% $88,050 −55% ≈133% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $39,024 $39,024 $50,907 −23% $72,859 −46% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $38,792 $38,792 $44,319 −12% $76,954 −50% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $38,684 $38,684 $44,906 −14% $88,307 −56% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $38,323 $38,323 $37,586 +2% $68,847 −44% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $37,997 $37,997 $46,152 −18% $75,585 −50% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $37,427 $37,427 $33,230 +13% $59,352 −37% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $37,350 $37,350 $55,653 −33% $83,441 −55% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $36,897 $36,897 $52,759 −30% $82,561 −55% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $36,843 $36,843 $55,014 −33% $88,049 −58% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $36,582 $36,582 $34,907 +5% $60,098 −39% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $36,248 $36,248 $50,459 −28% $68,659 −47% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $36,239 $36,239 $51,316 −29% $72,945 −50% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $36,074 $36,074 $35,380 +2% $16,719 +116% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $35,989 $35,989 $42,533 −15% $83,065 −57% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $35,569 $35,569 $46,520 −24% $82,247 −57% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $35,549 $35,549 $41,582 −15% $66,853 −47% —
012 Tracheostomy for face,mouth & neck diagnoses w CC $35,496 $35,496 $35,828 −1% $73,029 −51% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $35,321 $35,321 $34,642 +2% $81,998 −57% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $35,182 $35,182 $48,943 −28% $72,011 −51% —
791 PREMATURITY WITH MAJOR PROBLEMS $35,117 $35,117 $45,159 −22% $39,563 −11% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $34,458 $34,458 $45,405 −24% $71,701 −52% —
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $34,434 $34,434 $47,902 −28% $57,521 −40% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $34,129 $34,129 $35,390 −4% $68,006 −50% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $34,059 $34,059 $47,381 −28% $61,832 −45% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $33,990 $33,990 $33,337 +2% $54,196 −37% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $33,840 $33,840 $33,189 +2% $75,492 −55% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $33,823 $33,823 $40,083 −16% $78,852 −57% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $33,636 $33,636 $33,950 −1% $72,908 −54% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $33,431 $33,431 $34,783 −4% $62,961 −47% —
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $33,398 $33,398 $33,398 +0% $55,097 −39% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $33,304 $33,304 $48,736 −32% $72,782 −54% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $33,063 $33,063 $35,111 −6% $75,103 −56% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $32,884 $32,884 $47,667 −31% $74,755 −56% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $32,628 $32,628 $44,874 −27% $74,257 −56% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $32,367 $32,367 $46,834 −31% $60,861 −47% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $31,560 $31,560 $36,817 −14% $62,524 −50% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $31,342 $31,342 $46,502 −33% $71,755 −56% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $31,008 $31,008 $30,575 +1% $59,425 −48% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $31,006 $31,006 $29,586 +5% $57,855 −46% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $31,001 $31,001 $31,290 −1% $64,776 −52% —
265 AICD LEAD PROCEDURES $30,856 $30,856 $31,144 −1% $56,695 −46% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $30,717 $30,717 $35,670 −14% $70,540 −56% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $30,537 $30,537 $48,061 −36% $62,404 −51% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $30,529 $30,529 $29,942 +2% $50,919 −40% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $30,452 $30,452 $43,922 −31% $56,964 −47% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $30,307 $30,307 $31,947 −5% $68,399 −56% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $30,298 $30,298 $38,991 −22% $65,383 −54% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $30,285 $30,285 $42,905 −29% $59,207 −49% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $30,232 $30,232 $29,651 +2% $51,953 −42% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $30,036 $30,036 $30,833 −3% $56,242 −47% —
332 RECTAL RESECTION WITH MCC $30,003 $30,003 $29,427 +2% $58,125 −48% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $29,971 $29,971 $30,877 −3% $49,065 −39% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $29,793 $29,793 $30,072 −1% $71,014 −58% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $29,747 $29,747 $30,024 −1% $62,269 −52% —
665 PROSTATECTOMY WITH MCC $29,700 $29,700 $41,317 −28% $54,072 −45% —
252 OTHER VASCULAR PROCEDURES WITH MCC $29,672 $29,672 $42,633 −30% $68,508 −57% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $29,627 $29,627 $42,906 −31% $68,880 −57% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $29,463 $29,463 $38,294 −23% $67,901 −57% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $29,340 $29,340 $43,918 −33% $70,132 −58% ≈110% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $29,035 $29,035 $28,756 +1% $64,152 −55% —
037 EXTRACRANIAL PROCEDURES WITH MCC $28,725 $28,725 $28,173 +2% $64,749 −56% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $28,561 $28,561 $28,012 +2% $52,908 −46% —
469 Major joint replacement or reattachment of lower extremity w MCC $28,274 $28,274 $33,894 −17% $65,254 −57% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $28,193 $28,193 $38,910 −28% $54,129 −48% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $28,181 $28,181 $28,474 −1% $64,465 −56% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $27,846 $27,846 $27,579 +1% $64,956 −57% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $27,717 $27,717 $40,209 −31% $57,277 −52% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $27,637 $27,637 $27,766 −0% $66,819 −59% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $27,584 $27,584 $27,054 +2% $49,710 −45% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $27,510 $27,510 $27,638 −0% $44,472 −38% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $27,454 $27,454 $26,927 +2% $51,142 −46% —
500 SOFT TISSUE PROCEDURES WITH MCC $27,409 $27,409 $27,145 +1% $57,479 −52% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $26,996 $26,996 $37,451 −28% $65,573 −59% —
662 MINOR BLADDER PROCEDURES WITH MCC $26,984 $26,984 $30,960 −13% $54,483 −50% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $26,869 $26,869 $37,378 −28% $65,325 −59% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $26,749 $26,749 $26,998 −1% $62,821 −57% —
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $26,693 $26,693 $26,180 +2% $65,216 −59% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $26,674 $26,674 $27,771 −4% $53,817 −50% —
652 KIDNEY TRANSPLANT $26,567 $26,567 $27,280 −3% $54,720 −51% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $26,543 $26,543 $32,419 −18% $53,555 −50% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $26,456 $26,456 $34,191 −23% $63,475 −58% —
570 SKIN DEBRIDEMENT WITH MCC $26,038 $26,038 $26,159 −0% $52,435 −50% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $25,830 $25,830 $25,951 −0% $46,402 −44% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $25,505 $25,505 $25,014 +2% $54,313 −53% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $25,439 $25,439 $36,997 −31% $63,984 −60% ≈117% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $25,370 $25,370 $26,562 −4% $60,140 −58% —
668 TRANSURETHRAL PROCEDURES WITH MCC $25,225 $25,225 $25,343 −0% $47,277 −47% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $25,212 $25,212 $35,073 −28% $67,764 −63% —
800 SPLENIC PROCEDURES WITH CC $25,204 $25,204 $25,439 −1% $49,184 −49% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $25,190 $25,190 $25,425 −1% $54,475 −54% —
472 CERVICAL SPINAL FUSION WITH CC $25,060 $25,060 $25,060 +0% $59,537 −58% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $24,800 $24,800 $24,323 +2% $58,968 −58% —
462 Bilateral or multiple major joint procs of lower extremity w/o MCC $24,771 $24,771 $29,422 −16% $56,758 −56% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $24,757 $24,757 $24,988 −1% $53,551 −54% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $24,722 $24,722 $24,247 +2% $49,055 −50% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $24,624 $24,624 $24,151 +2% $74,274 −67% —
654 MAJOR BLADDER PROCEDURES WITH CC $24,411 $24,411 $24,176 +1% $53,868 −55% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $24,292 $24,292 $24,059 +1% $58,043 −58% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $24,267 $24,267 $32,590 −26% $48,907 −50% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $23,669 $23,669 $23,780 −0% $48,358 −51% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $23,627 $23,627 $22,859 +3% $45,497 −48% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $23,584 $23,584 $23,568 +0% $44,973 −48% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $23,499 $23,499 $23,718 −1% $43,491 −46% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $23,384 $23,384 $28,045 −17% $57,963 −60% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $23,307 $23,307 $24,914 −6% $44,839 −48% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $23,214 $23,214 $22,768 +2% $52,405 −56% ≈129% of Medicare
263 VEIN LIGATION AND STRIPPING $23,200 $23,200 $23,200 +0% $44,938 −48% —
849 RADIOTHERAPY $23,104 $23,104 $22,353 +3% $37,862 −39% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $23,033 $23,033 $22,590 +2% $45,432 −49% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $22,950 $22,950 $22,509 +2% $40,947 −44% —
013 Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC $22,922 $22,922 $22,177 +3% $45,290 −49% —
503 FOOT PROCEDURES WITH MCC $22,893 $22,893 $23,106 −1% $43,901 −48% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $22,869 $22,869 $29,424 −22% $40,277 −43% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $22,691 $22,691 $22,797 −0% $54,929 −59% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $22,632 $22,632 $21,896 +3% $43,697 −48% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $22,391 $22,391 $21,960 +2% $41,703 −46% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $22,354 $22,354 $22,354 +0% $48,094 −54% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $22,090 $22,090 $21,877 +1% $38,878 −43% —
253 OTHER VASCULAR PROCEDURES WITH CC $22,083 $22,083 $22,753 −3% $53,746 −59% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $22,041 $22,041 $22,247 −1% $57,149 −61% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $21,928 $21,928 $18,088 +21% $36,097 −39% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $21,857 $21,857 $21,147 +3% $39,657 −45% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $21,840 $21,840 $22,044 −1% $46,659 −53% —
164 MAJOR CHEST PROCEDURES WITH CC $21,772 $21,772 $21,353 +2% $53,141 −59% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $21,660 $21,660 $20,668 +5% $39,409 −45% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $21,643 $21,643 $21,745 −0% $55,162 −61% —
397 APPENDIX PROCEDURES WITH MCC $21,432 $21,432 $21,532 −0% $52,319 −59% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $21,346 $21,346 $20,936 +2% $52,332 −59% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $21,189 $21,189 $20,782 +2% $11,633 +82% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $21,177 $21,177 $21,375 −1% $51,985 −59% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $21,003 $21,003 $20,599 +2% $54,824 −62% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $20,921 $20,921 $20,519 +2% $46,591 −55% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $20,855 $20,855 $20,655 +1% $40,065 −48% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $20,768 $20,768 $28,417 −27% $56,394 −63% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $20,735 $20,735 $20,337 +2% $47,583 −56% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $20,735 $20,735 $20,337 +2% $39,093 −47% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $20,556 $20,556 $28,596 −28% $52,313 −61% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $20,477 $20,477 $20,281 +1% $50,624 −60% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $20,472 $20,472 $20,663 −1% $40,548 −50% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $20,445 $20,445 $20,052 +2% $58,832 −65% ≈136% of Medicare
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $20,413 $20,413 $20,508 −0% $47,546 −57% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $20,228 $20,228 $20,417 −1% $50,139 −60% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $20,069 $20,069 $19,683 +2% $36,237 −45% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $20,023 $20,023 $20,257 −1% $36,080 −45% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $20,003 $20,003 $19,811 +1% $51,339 −61% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $19,967 $19,967 $27,750 −28% $49,631 −60% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $19,843 $19,843 $19,273 +3% $37,080 −46% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $19,811 $19,811 $19,811 +0% $36,334 −45% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $19,750 $19,750 $19,842 −0% $39,253 −50% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $19,713 $19,713 $19,713 +0% $43,586 −55% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $19,677 $19,677 $19,487 +1% $46,430 −58% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $19,600 $19,600 $19,224 +2% $37,064 −47% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $19,534 $19,534 $19,158 +2% $38,998 −50% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $19,533 $19,533 $19,533 +0% $44,989 −57% —
113 ORBITAL PROCEDURES WITH CC/MCC $19,519 $19,519 $19,331 +1% $35,642 −45% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $19,486 $19,486 $19,668 −1% $50,011 −61% ≈119% of Medicare
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $19,479 $19,479 $19,570 −0% $48,682 −60% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $19,454 $19,454 $19,545 −0% $45,059 −57% —
709 PENIS PROCEDURES WITH CC/MCC $19,437 $19,437 $19,437 +0% $34,535 −44% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $19,310 $19,310 $18,682 +3% $44,053 −56% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $19,249 $19,249 $18,879 +2% $45,818 −58% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $19,145 $19,145 $19,498 −2% $44,600 −57% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $19,024 $19,024 $18,841 +1% $38,382 −50% —
935 NON-EXTENSIVE BURNS $18,998 $18,998 $18,633 +2% $29,458 −36% —
906 HAND PROCEDURES FOR INJURIES $18,878 $18,878 $18,264 +3% $31,520 −40% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $18,847 $18,847 $19,259 −2% $41,900 −55% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $18,764 $18,764 $18,584 +1% $37,902 −50% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $18,660 $18,660 $19,205 −3% $44,553 −58% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $18,627 $18,627 $18,627 +0% $38,357 −51% ≈146% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $18,584 $18,584 $18,227 +2% $34,900 −47% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $18,561 $18,561 $18,382 +1% $31,044 −40% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $18,548 $18,548 $18,191 +2% $36,850 −50% —
835 ACUTE LEUKEMIA WITH CC $18,475 $18,475 $17,874 +3% $35,569 −48% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $18,474 $18,474 $18,560 −0% $40,232 −54% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $18,472 $18,472 $18,559 −0% $45,622 −60% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $18,438 $18,438 $18,686 −1% $37,654 −51% —
333 RECTAL RESECTION WITH CC $18,383 $18,383 $18,469 −0% $34,352 −46% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $18,345 $18,345 $18,345 +0% $46,477 −61% —
595 MAJOR SKIN DISORDERS WITH MCC $18,295 $18,295 $17,943 +2% $31,785 −42% —
336 PERITONEAL ADHESIOLYSIS WITH CC $18,271 $18,271 $21,904 −17% $49,470 −63% —
374 DIGESTIVE MALIGNANCY WITH MCC $18,263 $18,263 $18,263 +0% $38,885 −53% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $18,263 $18,263 $17,669 +3% $38,420 −52% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $18,235 $18,235 $17,642 +3% $56,519 −68% ≈124% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $18,189 $18,189 $19,834 −8% $35,686 −49% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $18,134 $18,134 $17,896 +1% $46,066 −61% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $18,082 $18,082 $17,735 +2% $32,483 −44% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $17,968 $17,968 $17,623 +2% $41,651 −57% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $17,947 $17,947 $17,775 +1% $51,172 −65% ≈122% of Medicare
592 SKIN ULCERS WITH MCC $17,787 $17,787 $17,616 +1% $32,662 −46% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $17,710 $17,710 $17,710 +0% $34,089 −48% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $17,543 $17,543 $17,206 +2% $30,661 −43% —
539 OSTEOMYELITIS WITH MCC $17,493 $17,493 $17,157 +2% $33,746 −48% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $17,447 $17,447 $17,112 +2% $41,660 −58% —
548 SEPTIC ARTHRITIS WITH MCC $17,426 $17,426 $17,091 +2% $31,019 −44% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $17,408 $17,408 $17,073 +2% $30,940 −44% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $17,401 $17,401 $18,104 −4% $45,817 −62% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $17,286 $17,286 $16,953 +2% $44,363 −61% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $17,283 $17,283 $17,364 −0% $43,524 −60% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $17,271 $17,271 $17,271 +0% $29,109 −41% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $17,206 $17,206 $16,875 +2% $35,714 −52% ≈125% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $17,194 $17,194 $17,194 +0% $35,139 −51% —
100 SEIZURES WITH MCC $17,172 $17,172 $17,172 +0% $35,194 −51% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $17,171 $17,171 $16,841 +2% $29,633 −42% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $17,110 $17,110 $17,190 −0% $43,398 −61% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $17,066 $17,066 $17,146 −0% $43,800 −61% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $17,057 $17,057 $17,136 −0% $43,775 −61% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $17,000 $17,000 $16,673 +2% $41,520 −59% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $16,972 $16,972 $16,645 +2% $35,237 −52% ≈125% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $16,964 $16,964 $16,964 +0% $43,538 −61% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $16,946 $16,946 $16,783 +1% $36,933 −54% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $16,914 $16,914 $16,589 +2% $35,014 −52% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $16,904 $16,904 $16,579 +2% $29,524 −43% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $16,902 $16,902 $16,902 +0% $33,050 −49% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $16,786 $16,786 $16,240 +3% $43,080 −61% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $16,765 $16,765 $16,604 +1% $36,202 −54% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,708 $16,708 $16,387 +2% $42,881 −61% —
380 COMPLICATED PEPTIC ULCER WITH MCC $16,645 $16,645 $16,722 −0% $36,641 −55% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,545 $16,545 $16,227 +2% $33,165 −50% —
711 TESTES PROCEDURES WITH CC/MCC $16,526 $16,526 $16,209 +2% $34,852 −53% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $16,414 $16,414 $16,567 −1% $42,126 −61% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $16,414 $16,414 $16,098 +2% $35,459 −54% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $16,377 $16,377 $16,062 +2% $36,280 −55% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $16,352 $16,352 $16,037 +2% $32,399 −50% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $16,329 $16,329 $16,015 +2% $32,204 −49% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $16,311 $16,311 $15,997 +2% $32,981 −51% —
470 Major joint replacement or reattachment of lower extremity w/o MCC $16,309 $16,309 $16,152 +1% $49,197 −67% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $16,308 $16,308 $16,152 +1% $45,963 −65% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $16,297 $16,297 $16,297 +0% $30,766 −47% ≈118% of Medicare
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $16,133 $16,133 $15,978 +1% $35,114 −54% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $16,123 $16,123 $15,813 +2% $41,380 −61% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $16,057 $16,057 $15,902 +1% $30,974 −48% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $16,050 $16,050 $15,528 +3% $32,538 −51% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $16,036 $16,036 $15,515 +3% $22,698 −29% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $15,967 $15,967 $15,813 +1% $29,609 −46% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $15,934 $15,934 $16,156 −1% $28,375 −44% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $15,904 $15,904 $15,904 +0% $30,394 −48% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $15,856 $15,856 $15,340 +3% $40,694 −61% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $15,813 $15,813 $15,661 +1% $40,583 −61% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $15,805 $15,805 $15,653 +1% $40,563 −61% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $15,801 $15,801 $15,497 +2% $40,552 −61% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $15,782 $15,782 $15,782 +0% $37,950 −58% —
919 COMPLICATIONS OF TREATMENT WITH MCC $15,774 $15,774 $15,622 +1% $29,031 −46% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $15,768 $15,768 $15,616 +1% $36,375 −57% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $15,728 $15,728 $15,426 +2% $36,597 −57% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $15,727 $15,727 $15,800 −0% $37,842 −58% ≈125% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $15,650 $15,650 $15,500 +1% $29,476 −47% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $15,649 $15,649 $15,140 +3% $54,772 −71% ≈144% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $15,610 $15,610 $15,683 −0% $40,063 −61% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $15,592 $15,592 $15,085 +3% $14,284 +9% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $15,539 $15,539 $15,241 +2% $24,836 −37% —
501 SOFT TISSUE PROCEDURES WITH CC $15,437 $15,437 $15,581 −1% $37,975 −59% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $15,404 $15,404 $15,108 +2% $48,680 −68% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $15,404 $15,404 $15,107 +2% $30,275 −49% ≈122% of Medicare
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $15,397 $15,397 $15,101 +2% $33,564 −54% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $15,360 $15,360 $15,065 +2% $31,909 −52% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $15,336 $15,336 $15,336 +0% $36,242 −58% —
199 PNEUMOTHORAX WITH MCC $15,269 $15,269 $15,123 +1% $31,491 −52% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $15,204 $15,204 $14,911 +2% $35,673 −57% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $15,203 $15,203 $15,203 +0% $39,018 −61% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $15,195 $15,195 $15,049 +1% $29,558 −49% —
509 ARTHROSCOPY $15,195 $15,195 $14,903 +2% $25,994 −42% —
597 MALIGNANT BREAST DISORDERS WITH MCC $15,195 $15,195 $14,903 +2% $31,846 −52% —
504 FOOT PROCEDURES WITH CC $15,180 $15,180 $14,889 +2% $36,598 −59% —
505 FOOT PROCEDURES WITHOUT CC/MCC $15,180 $15,180 $14,889 +2% $31,716 −52% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $15,147 $15,147 $14,856 +2% $34,264 −56% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $15,132 $15,132 $14,950 +1% $38,836 −61% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $15,120 $15,120 $15,120 +0% $31,758 −52% —
180 RESPIRATORY NEOPLASMS WITH MCC $15,118 $15,118 $14,973 +1% $36,658 −59% ≈119% of Medicare
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $15,040 $15,040 $14,751 +2% $30,814 −51% —
915 ALLERGIC REACTIONS WITH MCC $15,032 $15,032 $14,888 +1% $30,944 −51% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $15,017 $15,017 $14,728 +2% $32,839 −54% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $14,955 $14,955 $14,811 +1% $29,826 −50% —
671 URETHRAL PROCEDURES WITH CC/MCC $14,910 $14,910 $14,623 +2% $27,233 −45% —
075 VIRAL MENINGITIS WITH CC/MCC $14,898 $14,898 $14,216 +5% $29,853 −50% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $14,843 $14,843 $14,843 +0% $38,094 −61% —
551 MEDICAL BACK PROBLEMS WITH MCC $14,760 $14,760 $14,618 +1% $31,086 −53% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $14,714 $14,714 $14,431 +2% $43,266 −66% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $14,650 $14,650 $14,368 +2% $29,729 −51% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $14,622 $14,622 $14,340 +2% $28,578 −49% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $14,613 $14,613 $14,613 +0% $29,409 −50% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $14,570 $14,570 $14,290 +2% $31,128 −53% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $14,539 $14,539 $14,260 +2% $30,058 −52% ≈140% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $14,485 $14,485 $14,485 +0% $29,916 −52% —
571 SKIN DEBRIDEMENT WITH CC $14,482 $14,482 $14,343 +1% $34,901 −59% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $14,447 $14,447 $14,169 +2% $25,208 −43% ≈116% of Medicare
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $14,445 $14,445 $14,167 +2% $33,607 −57% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $14,433 $14,433 $14,294 +1% $28,103 −49% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $14,430 $14,430 $14,152 +2% $30,930 −53% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $14,391 $14,391 $14,391 +0% $32,502 −56% —
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $14,380 $14,380 $13,994 +3% $27,548 −48% —
334 RECTAL RESECTION WITHOUT CC/MCC $14,347 $14,347 $14,071 +2% $32,213 −55% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $14,345 $14,345 $14,069 +2% $42,119 −66% —
643 ENDOCRINE DISORDERS WITH MCC $14,335 $14,335 $14,060 +2% $32,996 −57% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $14,324 $14,324 $14,049 +2% $32,689 −56% ≈117% of Medicare
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $14,281 $14,281 $14,006 +2% $44,117 −68% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $14,257 $14,257 $13,793 +3% $25,197 −43% —
666 PROSTATECTOMY WITH CC $14,249 $14,249 $14,112 +1% $30,016 −53% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $14,209 $14,209 $13,936 +2% $31,566 −55% —
801 SPLENIC PROCEDURES WITHOUT CC/MCC $14,200 $14,200 $14,064 +1% $28,634 −50% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $14,198 $14,198 $14,198 +0% $28,967 −51% ≈132% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $14,183 $14,183 $13,910 +2% $28,134 −50% ≈150% of Medicare
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $14,172 $14,172 $14,036 +1% $30,910 −54% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $14,165 $14,165 $13,893 +2% $36,333 −61% —
157 DENTAL AND ORAL DISEASES WITH MCC $14,164 $14,164 $13,892 +2% $27,457 −48% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $14,067 $14,067 $13,610 +3% $24,465 −43% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $14,061 $14,061 $13,926 +1% $27,168 −48% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $14,054 $14,054 $14,054 +0% $26,020 −46% —
913 TRAUMATIC INJURY WITH MCC $13,998 $13,998 $13,729 +2% $24,198 −42% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,992 $13,992 $13,351 +5% $25,731 −46% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $13,982 $13,982 $13,714 +2% $31,840 −56% ≈122% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $13,977 $13,977 $14,108 −1% $27,118 −48% —
038 EXTRACRANIAL PROCEDURES WITH CC $13,937 $13,937 $13,669 +2% $35,770 −61% —
606 MINOR SKIN DISORDERS WITH MCC $13,929 $13,929 $13,661 +2% $25,434 −45% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $13,907 $13,907 $13,640 +2% $35,692 −61% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $13,865 $13,865 $13,598 +2% $35,584 −61% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $13,814 $13,814 $14,418 −4% $35,453 −61% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $13,801 $13,801 $13,535 +2% $33,984 −59% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $13,783 $13,783 $13,518 +2% $35,375 −61% —
183 MAJOR CHEST TRAUMA WITH MCC $13,730 $13,730 $13,466 +2% $28,924 −53% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $13,722 $13,722 $13,458 +2% $39,747 −65% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $13,668 $13,668 $13,406 +2% $33,490 −59% —
186 PLEURAL EFFUSION WITH MCC $13,667 $13,667 $13,404 +2% $32,468 −58% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $13,638 $13,638 $13,487 +1% $29,371 −54% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $13,601 $13,601 $13,339 +2% $34,906 −61% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $13,573 $13,573 $13,312 +2% $32,936 −59% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $13,563 $13,563 $13,302 +2% $31,059 −56% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $13,540 $13,540 $13,279 +2% $32,490 −58% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $13,516 $13,516 $13,256 +2% $41,380 −67% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $13,417 $13,417 $13,417 +0% $34,434 −61% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $13,405 $13,405 $13,276 +1% $28,646 −53% —
813 COAGULATION DISORDERS $13,390 $13,390 $13,132 +2% $30,128 −56% —
669 TRANSURETHRAL PROCEDURES WITH CC $13,386 $13,386 $13,128 +2% $34,354 −61% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $13,375 $13,375 $13,118 +2% $24,036 −44% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $13,371 $13,371 $13,114 +2% $25,484 −48% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $13,369 $13,369 $13,241 +1% $28,252 −53% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $13,278 $13,278 $13,340 −0% $36,239 −63% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $13,243 $13,243 $13,243 +0% $24,879 −47% —
663 MINOR BLADDER PROCEDURES WITH CC $13,212 $13,212 $13,212 +0% $29,924 −56% —
945 REHABILITATION WITH CC/MCC $13,204 $13,204 $12,775 +3% $23,834 −45% —
533 FRACTURES OF FEMUR WITH MCC $13,190 $13,190 $12,936 +2% $25,945 −49% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $13,129 $13,129 $12,876 +2% $33,694 −61% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $13,121 $13,121 $12,869 +2% $30,972 −58% —
398 APPENDIX PROCEDURES WITH CC $13,089 $13,089 $12,663 +3% $39,107 −67% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $13,060 $13,060 $12,810 +2% $24,229 −46% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $13,055 $13,055 $12,930 +1% $27,279 −52% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $13,023 $13,023 $13,023 +0% $33,424 −61% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $13,014 $13,014 $12,763 +2% $33,792 −61% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $13,009 $13,009 $12,884 +1% $35,528 −63% —
682 RENAL FAILURE WITH MCC $12,991 $12,991 $12,741 +2% $27,854 −53% ≈128% of Medicare
710 PENIS PROCEDURES WITHOUT CC/MCC $12,987 $12,987 $12,737 +2% $23,814 −45% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $12,976 $12,976 $12,726 +2% $25,854 −50% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $12,967 $12,967 $12,842 +1% $29,484 −56% —
506 MAJOR THUMB OR JOINT PROCEDURES $12,967 $12,967 $12,842 +1% $28,983 −55% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $12,952 $12,952 $12,703 +2% $24,450 −47% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $12,912 $12,912 $12,912 +0% $33,137 −61% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $12,877 $12,877 $12,753 +1% $31,062 −59% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $12,851 $12,851 $12,604 +2% $28,140 −54% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $12,823 $12,823 $12,700 +1% $32,911 −61% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $12,769 $12,769 $12,888 −1% $7,961 +60% —
865 VIRAL ILLNESS WITH MCC $12,766 $12,766 $12,521 +2% $26,088 −51% —
693 URINARY STONES WITH MCC $12,719 $12,719 $12,474 +2% $22,525 −44% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $12,714 $12,714 $12,592 +1% $28,780 −56% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $12,710 $12,710 $12,466 +2% $25,152 −49% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $12,710 $12,710 $12,466 +2% $25,786 −51% —
602 CELLULITIS WITH MCC $12,708 $12,708 $12,464 +2% $29,347 −57% ≈135% of Medicare
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $12,659 $12,659 $12,416 +2% $29,211 −57% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $12,650 $12,650 $12,529 +1% $25,149 −50% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $12,644 $12,644 $12,523 +1% $32,451 −61% —
637 DIABETES WITH MCC $12,597 $12,597 $12,597 +0% $28,819 −56% ≈134% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $12,585 $12,585 $12,175 +3% $24,941 −50% —
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $12,524 $12,524 $12,117 +3% $21,986 −43% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $12,508 $12,508 $12,387 +1% $29,663 −58% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $12,472 $12,472 $12,232 +2% $22,525 −45% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $12,449 $12,449 $12,424 +0% $25,243 −51% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $12,397 $12,397 $12,397 +0% $31,816 −61% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $12,395 $12,395 $12,276 +1% $31,812 −61% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $12,295 $12,295 $11,895 +3% $25,010 −51% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $12,277 $12,277 $12,041 +2% $21,615 −43% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $12,242 $12,242 $12,007 +2% $23,734 −48% —
088 CONCUSSION WITH MCC $12,202 $12,202 $11,968 +2% $24,402 −50% —
885 PSYCHOSES $12,193 $12,193 $11,958 +2% $21,489 −43% ≈121% of Medicare
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $12,188 $12,188 $12,188 +0% $29,757 −59% —
811 RED BLOOD CELL DISORDERS WITH MCC $12,169 $12,169 $12,169 +0% $27,934 −56% ≈126% of Medicare
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $12,151 $12,151 $11,918 +2% $35,542 −66% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $12,121 $12,121 $11,888 +2% $24,452 −50% —
137 MOUTH PROCEDURES WITH CC/MCC $12,098 $12,098 $11,981 +1% $24,348 −50% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $12,085 $12,085 $11,853 +2% $30,006 −60% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $12,052 $12,052 $11,500 +5% $25,666 −53% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $12,027 $12,027 $11,795 +2% $24,118 −50% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $12,019 $12,019 $11,903 +1% $24,561 −51% —
150 EPISTAXIS WITH MCC $11,956 $11,956 $11,841 +1% $21,133 −43% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $11,881 $11,881 $11,881 +0% $29,050 −59% —
139 SALIVARY GLAND PROCEDURES $11,876 $11,876 $11,648 +2% $21,014 −43% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $11,854 $11,854 $11,626 +2% $20,980 −44% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $11,852 $11,852 $11,624 +2% $30,418 −61% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $11,784 $11,784 $11,784 +0% $24,980 −53% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,721 $11,721 $11,609 +1% $29,374 −60% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,711 $11,711 $11,330 +3% $28,527 −59% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $11,648 $11,648 $11,648 +0% $23,723 −51% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $11,613 $11,613 $11,390 +2% $29,805 −61% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $11,591 $11,591 $11,645 −0% $30,358 −62% ≈123% of Medicare
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $11,542 $11,542 $11,320 +2% $25,426 −55% ≈131% of Medicare
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $11,532 $11,532 $11,310 +2% $31,978 −64% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $11,503 $11,503 $11,503 +0% $23,350 −51% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $11,487 $11,487 $11,487 +0% $24,480 −53% ≈125% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $11,398 $11,398 $11,179 +2% $26,158 −56% ≈131% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $11,397 $11,397 $11,178 +2% $34,887 −67% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $11,345 $11,345 $10,976 +3% $23,115 −51% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $11,297 $11,297 $11,297 +0% $23,956 −53% —
291 HEART FAILURE AND SHOCK WITH MCC $11,286 $11,286 $11,286 +0% $25,020 −55% ≈126% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $11,278 $11,278 $11,062 +2% $21,029 −46% —
540 OSTEOMYELITIS WITH CC $11,194 $11,194 $11,086 +1% $23,494 −52% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $11,163 $11,163 $10,801 +3% $22,811 −51% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,154 $11,154 $11,047 +1% $23,920 −53% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $11,144 $11,144 $10,930 +2% $23,924 −53% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $11,141 $11,141 $10,927 +2% $24,316 −54% —
947 SIGNS AND SYMPTOMS WITH MCC $11,125 $11,125 $11,018 +1% $25,474 −56% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $11,111 $11,111 $10,897 +2% $27,244 −59% ≈121% of Medicare
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $11,042 $11,042 $11,094 −0% $22,557 −51% —
836 ACUTE LEUKEMIA WITHOUT CC/MCC $10,991 $10,991 $10,780 +2% $19,686 −44% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $10,991 $10,991 $10,780 +2% $22,275 −51% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $10,971 $10,971 $10,760 +2% $28,156 −61% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $10,958 $10,958 $10,748 +2% $25,623 −57% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $10,935 $10,935 $10,725 +2% $26,634 −59% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $10,921 $10,921 $10,566 +3% $19,894 −45% —
348 ANAL AND STOMAL PROCEDURES WITH CC $10,889 $10,889 $10,889 +0% $27,947 −61% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $10,772 $10,772 $10,668 +1% $26,146 −59% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $10,770 $10,770 $10,663 +1% $19,354 −44% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $10,767 $10,767 $10,664 +1% $21,860 −51% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $10,735 $10,735 $10,529 +2% $20,727 −48% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $10,713 $10,713 $10,507 +2% $22,032 −51% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $10,712 $10,712 $10,506 +2% $27,492 −61% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $10,703 $10,703 $10,497 +2% $25,704 −58% ≈128% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $10,656 $10,656 $10,451 +2% $20,147 −47% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $10,646 $10,646 $10,441 +2% $27,321 −61% —
375 DIGESTIVE MALIGNANCY WITH CC $10,628 $10,628 $10,526 +1% $27,219 −61% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $10,622 $10,622 $10,418 +2% $19,132 −44% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $10,584 $10,584 $10,380 +2% $26,322 −60% —
593 SKIN ULCERS WITH CC $10,576 $10,576 $10,474 +1% $20,470 −48% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $10,545 $10,545 $10,444 +1% $23,588 −55% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $10,500 $10,500 $10,399 +1% $23,297 −55% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $10,431 $10,431 $10,431 +0% $26,488 −61% ≈137% of Medicare
549 SEPTIC ARTHRITIS WITH CC $10,424 $10,424 $10,085 +3% $20,938 −50% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $10,368 $10,368 $10,169 +2% $27,369 −62% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $10,338 $10,338 $10,139 +2% $20,421 −49% —
887 OTHER MENTAL DISORDER DIAGNOSES $10,288 $10,288 $10,090 +2% $20,602 −50% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $10,248 $10,248 $10,150 +1% $20,842 −51% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $10,225 $10,225 $10,028 +2% $19,598 −48% —
304 HYPERTENSION WITH MCC $10,162 $10,162 $10,162 +0% $24,185 −58% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $10,123 $10,123 $9,928 +2% $22,982 −56% ≈127% of Medicare
302 ATHEROSCLEROSIS WITH MCC $10,062 $10,062 $10,062 +0% $20,844 −52% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $10,061 $10,061 $9,868 +2% $18,291 −45% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $10,061 $10,061 $9,867 +2% $21,062 −52% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $10,041 $10,041 $9,848 +2% $22,532 −55% —
102 HEADACHES WITH MCC $10,029 $10,029 $10,029 +0% $22,544 −56% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $10,014 $10,014 $9,688 +3% $24,202 −59% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,995 $9,995 $9,899 +1% $25,307 −61% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $9,956 $9,956 $9,405 +6% $18,133 −45% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $9,893 $9,893 $9,798 +1% $25,390 −61% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $9,882 $9,882 $9,692 +2% $24,432 −60% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $9,850 $9,850 $9,755 +1% $24,452 −60% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $9,845 $9,845 $9,394 +5% $25,267 −61% —
152 OTITIS MEDIA AND URI WITH MCC $9,816 $9,816 $9,627 +2% $19,795 −50% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $9,755 $9,755 $9,661 +1% $20,741 −53% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $9,754 $9,754 $9,567 +2% $24,017 −59% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $9,721 $9,721 $9,534 +2% $30,314 −68% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $9,714 $9,714 $9,714 +0% $24,190 −60% ≈131% of Medicare
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $9,713 $9,713 $9,526 +2% $19,317 −50% —
946 REHABILITATION WITHOUT CC/MCC $9,657 $9,657 $9,323 +4% $17,685 −45% —
181 RESPIRATORY NEOPLASMS WITH CC $9,604 $9,604 $9,512 +1% $22,431 −57% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $9,602 $9,602 $9,602 +0% $18,459 −48% —
200 PNEUMOTHORAX WITH CC $9,580 $9,580 $9,580 +0% $20,573 −53% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $9,563 $9,563 $9,379 +2% $24,544 −61% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $9,537 $9,537 $9,354 +2% $25,162 −62% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $9,523 $9,523 $9,346 +2% $17,483 −46% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $9,483 $9,483 $11,271 −16% $17,103 −45% —
672 URETHRAL PROCEDURES WITHOUT CC/MCC $9,466 $9,466 $8,828 +7% $17,398 −46% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $9,437 $9,437 $9,255 +2% $19,868 −53% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $9,426 $9,426 $9,426 +0% $31,190 −70% ≈175% of Medicare
381 COMPLICATED PEPTIC ULCER WITH CC $9,420 $9,420 $9,239 +2% $24,177 −61% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $9,381 $9,381 $9,291 +1% $21,806 −57% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $9,368 $9,368 $12,774 −27% $22,560 −58% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $9,351 $9,351 $9,261 +1% $17,226 −46% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $9,340 $9,340 $9,250 +1% $18,126 −48% —
949 AFTERCARE WITH CC/MCC $9,333 $9,333 $9,243 +1% $23,953 −61% —
598 MALIGNANT BREAST DISORDERS WITH CC $9,332 $9,332 $9,153 +2% $19,073 −51% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $9,330 $9,330 $9,026 +3% $17,193 −46% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $9,307 $9,307 $9,128 +2% $17,943 −48% —
089 CONCUSSION WITH CC $9,273 $9,273 $8,849 +5% $18,293 −49% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $9,260 $9,260 $9,260 +0% $19,579 −53% ≈137% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $9,254 $9,254 $9,254 +0% $23,749 −61% —
712 TESTES PROCEDURES WITHOUT CC/MCC $9,252 $9,252 $8,951 +3% $18,898 −51% —
184 MAJOR CHEST TRAUMA WITH CC $9,239 $9,239 $9,061 +2% $20,842 −56% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $9,184 $9,184 $9,775 −6% $23,571 −61% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $9,177 $9,177 $9,000 +2% $23,496 −61% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $9,158 $9,158 $9,069 +1% $24,136 −62% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $9,116 $9,116 $8,941 +2% $23,396 −61% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $9,106 $9,106 $8,689 +5% $18,478 −51% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $9,099 $9,099 $8,924 +2% $17,550 −48% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $9,083 $9,083 $9,083 +0% $22,231 −59% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $9,017 $9,017 $8,843 +2% $23,141 −61% —
644 ENDOCRINE DISORDERS WITH CC $8,939 $8,939 $8,939 +0% $22,941 −61% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $8,918 $8,918 $8,918 +0% $22,781 −61% ≈136% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $8,903 $8,903 $8,732 +2% $22,850 −61% —
667 PROSTATECTOMY WITHOUT CC/MCC $8,890 $8,890 $8,805 +1% $16,703 −47% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $8,880 $8,880 $8,880 +0% $24,022 −63% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $8,864 $8,864 $8,779 +1% $16,495 −46% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $8,822 $8,822 $8,737 +1% $20,732 −57% ≈148% of Medicare
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $8,822 $8,822 $8,652 +2% $16,571 −47% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $8,820 $8,820 $8,651 +2% $21,545 −59% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $8,819 $8,819 $8,819 +0% $20,080 −56% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $8,817 $8,817 $8,732 +1% $19,091 −54% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $8,802 $8,802 $8,633 +2% $22,713 −61% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $8,796 $8,796 $8,711 +1% $23,469 −63% ≈131% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $8,789 $8,789 $8,620 +2% $18,017 −51% —
920 COMPLICATIONS OF TREATMENT WITH CC $8,787 $8,787 $8,787 +0% $21,181 −59% —
187 PLEURAL EFFUSION WITH CC $8,684 $8,684 $8,517 +2% $21,467 −60% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $8,677 $8,677 $8,510 +2% $17,078 −49% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $8,676 $8,676 $8,278 +5% $16,212 −46% —
697 URETHRAL STRICTURE $8,665 $8,665 $8,499 +2% $17,705 −51% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $8,649 $8,649 $8,483 +2% $20,007 −57% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $8,632 $8,632 $10,576 −18% $15,370 −44% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $8,632 $8,632 $8,351 +3% $17,434 −50% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $8,585 $8,585 $8,420 +2% $20,968 −59% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $8,581 $8,581 $8,416 +2% $22,024 −61% ≈138% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $8,563 $8,563 $8,399 +2% $20,106 −57% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $8,528 $8,528 $8,364 +2% $21,886 −61% ≈137% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $8,525 $8,525 $8,361 +2% $18,282 −53% —
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $8,468 $8,468 $8,305 +2% $15,901 −47% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $8,461 $8,461 $8,380 +1% $15,890 −47% —
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $8,375 $8,375 $8,598 −3% $19,001 −56% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $8,375 $8,375 $10,124 −17% $18,238 −54% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $8,362 $8,362 $8,281 +1% $17,273 −52% ≈105% of Medicare
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $8,357 $8,357 $8,357 +0% $21,449 −61% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $8,337 $8,337 $8,176 +2% $21,213 −61% ≈142% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $8,324 $8,324 $8,164 +2% $20,777 −60% —
882 NEUROSES EXCEPT DEPRESSIVE $8,321 $8,321 $8,241 +1% $15,680 −47% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $8,292 $8,292 $8,292 +0% $15,636 −47% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $8,274 $8,274 $8,195 +1% $16,418 −50% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $8,270 $8,270 $8,111 +2% $18,191 −55% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $8,267 $8,267 $8,108 +2% $20,371 −59% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $8,262 $8,262 $8,103 +2% $19,326 −57% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $8,261 $8,261 $8,181 +1% $15,589 −47% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $8,233 $8,233 $8,075 +2% $18,428 −55% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $8,142 $8,142 $7,986 +2% $18,918 −57% —
158 DENTAL AND ORAL DISEASES WITH CC $8,136 $8,136 $7,980 +2% $17,700 −54% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $8,128 $8,128 $8,050 +1% $17,108 −52% —
779 ABORTION WITHOUT D&C $8,086 $8,086 $7,930 +2% $15,327 −47% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $8,075 $8,075 $7,998 +1% $16,642 −51% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $8,013 $8,013 $7,859 +2% $18,608 −57% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $7,990 $7,990 $7,990 +0% $19,287 −59% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $7,983 $7,983 $7,983 +0% $20,488 −61% ≈136% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $7,973 $7,973 $7,820 +2% $20,463 −61% ≈160% of Medicare
101 SEIZURES WITHOUT MCC $7,973 $7,973 $7,819 +2% $19,954 −60% ≈131% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $7,970 $7,970 $7,893 +1% $20,309 −61% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $7,949 $7,949 $7,873 +1% $16,352 −51% —
638 DIABETES WITH CC $7,934 $7,934 $7,934 +0% $18,821 −58% ≈152% of Medicare
076 VIRAL MENINGITIS WITHOUT CC/MCC $7,931 $7,931 $7,779 +2% $15,474 −49% —
914 TRAUMATIC INJURY WITHOUT MCC $7,927 $7,927 $7,850 +1% $15,593 −49% —
881 DEPRESSIVE NEUROSES $7,907 $7,907 $7,831 +1% $15,058 −47% ≈132% of Medicare
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $7,894 $7,894 $7,742 +2% $17,585 −55% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $7,835 $7,835 $7,835 +0% $17,731 −56% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $7,826 $7,826 $7,676 +2% $15,077 −48% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $7,825 $7,825 $8,017 −2% $20,084 −61% —
864 FEVER AND INFLAMMATORY CONDITIONS $7,768 $7,768 $7,618 +2% $17,412 −55% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $7,731 $7,731 $7,583 +2% $18,803 −59% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $7,719 $7,719 $7,571 +2% $21,261 −64% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $7,715 $7,715 $7,566 +2% $15,764 −51% —
683 RENAL FAILURE WITH CC $7,689 $7,689 $7,689 +0% $18,620 −59% ≈135% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $7,653 $7,653 $7,506 +2% $16,391 −53% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $7,652 $7,652 $7,504 +2% $15,045 −49% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $7,646 $7,646 $7,499 +2% $15,869 −52% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $7,638 $7,638 $7,491 +2% $15,608 −51% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $7,631 $7,631 $7,484 +2% $16,049 −52% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $7,625 $7,625 $7,478 +2% $19,569 −61% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $7,620 $7,620 $7,620 +0% $19,854 −62% —
603 CELLULITIS WITHOUT MCC $7,619 $7,619 $7,472 +2% $18,530 −59% ≈137% of Medicare
541 OSTEOMYELITIS WITHOUT CC/MCC $7,568 $7,568 $7,495 +1% $14,549 −48% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $7,556 $7,556 $10,545 −28% $19,815 −62% —
312 SYNCOPE AND COLLAPSE $7,537 $7,537 $7,537 +0% $19,342 −61% ≈133% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $7,522 $7,522 $7,377 +2% $19,305 −61% —
607 MINOR SKIN DISORDERS WITHOUT MCC $7,475 $7,475 $7,475 +0% $15,284 −51% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,472 $7,472 $7,328 +2% $17,367 −57% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $7,457 $7,457 $7,314 +2% $16,156 −54% —
292 HEART FAILURE AND SHOCK WITH CC $7,449 $7,449 $7,306 +2% $16,212 −54% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $7,441 $7,441 $7,369 +1% $19,096 −61% ≈164% of Medicare
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $7,431 $7,431 $7,431 +0% $18,278 −59% ≈130% of Medicare
090 CONCUSSION WITHOUT CC/MCC $7,415 $7,415 $7,344 +1% $14,873 −50% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $7,395 $7,395 $7,253 +2% $14,290 −48% —
103 HEADACHES WITHOUT MCC $7,354 $7,354 $7,213 +2% $20,111 −63% —
594 SKIN ULCERS WITHOUT CC/MCC $7,341 $7,341 $7,271 +1% $14,209 −48% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $7,244 $7,244 $7,131 +2% $14,064 −48% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $7,238 $7,238 $7,169 +1% $14,055 −48% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $7,219 $7,219 $7,219 +0% $18,253 −60% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $7,142 $7,142 $7,073 +1% $15,876 −55% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $7,093 $7,093 $7,093 +0% $18,204 −61% ≈153% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $7,083 $7,083 $7,015 +1% $13,822 −49% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $7,072 $7,072 $6,936 +2% $18,150 −61% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $7,068 $7,068 $6,744 +5% $16,837 −58% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $7,063 $7,063 $6,927 +2% $17,715 −60% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $7,063 $7,063 $6,927 +2% $17,928 −61% —
176 PULMONARY EMBOLISM WITHOUT MCC $7,045 $7,045 $7,045 +0% $18,081 −61% —
534 FRACTURES OF FEMUR WITHOUT MCC $7,041 $7,041 $6,906 +2% $17,195 −59% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $7,037 $7,037 $6,969 +1% $17,383 −60% —
204 RESPIRATORY SIGNS AND SYMPTOMS $7,015 $7,015 $7,015 +0% $16,866 −58% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $7,014 $7,014 $6,879 +2% $18,002 −61% ≈154% of Medicare
123 NEUROLOGICAL EYE DISORDERS $6,948 $6,948 $6,881 +1% $17,831 −61% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $6,942 $6,942 $6,809 +2% $17,466 −60% ≈139% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $6,934 $6,934 $6,800 +2% $17,388 −60% ≈140% of Medicare
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $6,926 $6,926 $6,793 +2% $13,586 −49% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $6,921 $6,921 $6,696 +3% $20,278 −66% ≈169% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $6,896 $6,896 $6,896 +0% $17,700 −61% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $6,872 $6,872 $6,872 +0% $17,727 −61% —
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $6,832 $6,832 $6,267 +9% $13,445 −49% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $6,827 $6,827 $6,762 +1% $17,522 −61% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $6,792 $6,792 $6,661 +2% $13,385 −49% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $6,759 $6,759 $6,629 +2% $16,745 −60% ≈146% of Medicare
694 URINARY STONES WITHOUT MCC $6,759 $6,759 $6,629 +2% $16,531 −59% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $6,749 $6,749 $6,685 +1% $17,322 −61% ≈138% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $6,736 $6,736 $6,671 +1% $14,166 −52% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $6,727 $6,727 $6,727 +0% $15,858 −58% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $6,658 $6,658 $6,594 +1% $14,444 −54% —
151 EPISTAXIS WITHOUT MCC $6,557 $6,557 $6,494 +1% $13,032 −50% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $6,537 $6,537 $6,537 +0% $16,776 −61% —
305 HYPERTENSION WITHOUT MCC $6,493 $6,493 $6,493 +0% $17,144 −62% ≈143% of Medicare
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $6,489 $6,489 $6,364 +2% $16,654 −61% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $6,481 $6,481 $6,357 +2% $16,634 −61% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $6,471 $6,471 $6,409 +1% $14,337 −55% —
149 DYSEQUILIBRIUM $6,466 $6,466 $6,256 +3% $17,203 −62% ≈149% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $6,465 $6,465 $6,341 +2% $12,895 −50% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $6,454 $6,454 $6,330 +2% $14,861 −57% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $6,439 $6,439 $6,315 +2% $13,892 −54% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $6,409 $6,409 $6,286 +2% $13,282 −52% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $6,395 $6,395 $6,333 +1% $16,865 −62% ≈141% of Medicare
188 PLEURAL EFFUSION WITHOUT CC/MCC $6,351 $6,351 $6,229 +2% $14,110 −55% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,302 $6,302 $6,242 +1% $12,650 −50% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $6,275 $6,275 $6,154 +2% $16,104 −61% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $6,272 $6,272 $6,272 +0% $18,623 −66% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $6,264 $6,264 $6,144 +2% $12,593 −50% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $6,259 $6,259 $9,343 −33% $13,090 −52% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $6,224 $6,224 $6,105 +2% $12,537 −50% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $6,172 $6,172 $6,053 +2% $12,381 −50% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $6,171 $6,171 $6,171 +0% $15,607 −60% —
313 CHEST PAIN $6,171 $6,171 $6,171 +0% $15,962 −61% ≈138% of Medicare
153 OTITIS MEDIA AND URI WITHOUT MCC $6,156 $6,156 $6,038 +2% $14,473 −57% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $6,093 $6,093 $5,976 +2% $12,336 −51% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $6,078 $6,078 $6,020 +1% $15,600 −61% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $6,058 $6,058 $6,058 +0% $13,654 −56% —
311 ANGINA PECTORIS $6,040 $6,040 $5,924 +2% $15,165 −60% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $6,038 $6,038 $5,921 +2% $15,072 −60% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $6,025 $6,025 $6,025 +0% $12,279 −51% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $6,025 $6,025 $5,829 +3% $12,405 −51% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $6,005 $6,005 $5,889 +2% $13,303 −55% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $5,984 $5,984 $5,984 +0% $14,441 −59% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $5,954 $5,954 $5,839 +2% $19,483 −69% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,948 $5,948 $5,948 +0% $14,012 −58% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $5,905 $5,905 $5,792 +2% $12,797 −54% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $5,867 $5,867 $5,754 +2% $11,997 −51% —
201 PNEUMOTHORAX WITHOUT CC/MCC $5,857 $5,857 $5,857 +0% $13,081 −55% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $5,816 $5,816 $5,760 +1% $13,198 −56% —
303 ATHEROSCLEROSIS WITHOUT MCC $5,816 $5,816 $5,704 +2% $14,927 −61% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $5,808 $5,808 $5,697 +2% $11,909 −51% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $5,798 $5,798 $5,798 +0% $14,880 −61% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $5,767 $5,767 $5,589 +3% $11,847 −51% —
916 ALLERGIC REACTIONS WITHOUT MCC $5,744 $5,744 $5,634 +2% $13,890 −59% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $5,705 $5,705 $5,651 +1% $13,368 −57% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $5,704 $5,704 $5,704 +0% $13,485 −58% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $5,598 $5,598 $5,598 +0% $14,368 −61% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $5,536 $5,536 $5,562 −0% $14,208 −61% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $5,513 $5,513 $8,897 −38% $12,044 −54% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $5,507 $5,507 $5,559 −1% $14,134 −61% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,505 $5,505 $5,399 +2% $14,128 −61% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $5,483 $5,483 $5,483 +0% $11,421 −52% —
639 DIABETES WITHOUT CC/MCC $5,420 $5,420 $5,316 +2% $13,910 −61% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $5,398 $5,398 $5,424 −0% $12,013 −55% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $5,386 $5,386 $5,283 +2% $13,824 −61% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $5,320 $5,320 $5,370 −1% $15,070 −65% —
684 RENAL FAILURE WITHOUT CC/MCC $5,254 $5,254 $5,153 +2% $13,623 −61% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,250 $5,250 $5,274 −0% $11,071 −53% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $5,186 $5,186 $5,186 +0% $10,975 −53% —
950 AFTERCARE WITHOUT CC/MCC $5,070 $5,070 $5,117 −1% $13,527 −63% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $4,904 $4,904 $4,950 −1% $9,385 −48% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $4,856 $4,856 $4,763 +2% $10,039 −52% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,840 $4,840 $4,793 +1% $13,384 −64% ≈172% of Medicare
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $4,746 $4,746 $4,790 −1% $11,955 −60% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $4,733 $4,733 $4,642 +2% $13,318 −64% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $4,496 $4,496 $4,496 +0% $9,076 −50% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $3,821 $3,821 $3,989 −4% $8,927 −57% —
795 NORMAL NEWBORN $1,728 $1,728 $3,492 −51% $4,530 −62% —

Procedures with negotiated rates only

These 21 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
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $67,833 – $67,833 · median $67,833 2 plans
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $50,039 – $50,039 · median $50,039 2 plans
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $59,303 – $59,303 · median $59,303 2 plans
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $45,324 – $45,324 · median $45,324 2 plans
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $53,259 – $53,259 · median $53,259 2 plans
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $42,305 – $42,305 · median $42,305 2 plans
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $25,178 – $25,178 · median $25,178 2 plans
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $16,015 – $16,015 · median $16,015 2 plans
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $25,566 – $25,566 · median $25,566 2 plans
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $15,138 – $15,138 · median $15,138 2 plans
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $22,545 – $22,545 · median $22,545 2 plans
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $13,653 – $13,653 · median $13,653 2 plans
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,895 – $9,895 · median $9,895 2 plans
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $18,657 – $18,657 · median $18,657 2 plans
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $11,544 – $11,544 · median $11,544 2 plans
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $8,936 – $8,936 · median $8,936 2 plans
453 Combined anterior/posterior spinal fusion w MCC $74,055 – $74,055 · median $74,055 2 plans
454 Combined anterior/posterior spinal fusion w CC $49,121 – $49,121 · median $49,121 2 plans
455 Combined anterior/posterior spinal fusion w/o CC/MCC $38,592 – $38,592 · median $38,592 2 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $54,225 – $54,225 · median $54,225 2 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $31,678 – $31,678 · median $31,678 2 plans
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