HMH Riverview 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 $1,695
Average published price $19,940
Highest published price $319,936

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 93 procedures, this hospital's negotiated rates average ≈137% 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 $319,936 $319,936 $391,526 −18% $498,715 −36% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $238,965 $238,965 $338,950 −29% $431,073 −45% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $201,252 $201,252 $236,577 −15% $306,087 −34% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $181,815 $181,815 $260,247 −30% $371,366 −51% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $119,872 $119,872 $170,027 −29% $245,241 −51% —
014 ALLOGENEIC BONE MARROW TRANSPLANT $111,149 $111,149 $122,488 −9% $182,314 −39% —
007 Lung transplant $110,869 $110,869 $126,907 −13% $170,608 −35% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $93,485 $93,485 $114,404 −18% $169,977 −45% —
212 Concomitant Aortic and Mitral Valve Procedures $92,418 $92,418 $102,715 −10% $171,338 −46% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $90,344 $90,344 $128,144 −29% $159,181 −43% —
215 Other heart assist system implant $89,881 $89,881 $116,471 −23% $191,314 −53% —
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $88,868 $88,868 $99,176 −10% $142,326 −38% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $81,875 $81,875 $113,415 −28% $175,437 −53% —
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $78,149 $78,149 $77,091 +1% $121,563 −36% —
231 CORONARY BYPASS WITH PTCA WITH MCC $71,888 $71,888 $105,048 −32% $146,474 −51% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $71,848 $71,848 $111,108 −35% $151,029 −52% —
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $70,757 $70,757 $72,481 −2% $120,174 −41% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $68,386 $68,386 $96,999 −29% $134,914 −49% —
010 Pancreas transplant $67,639 $67,639 $69,287 −2% $99,940 −32% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $67,251 $67,251 $69,210 −3% $105,228 −36% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC $66,310 $66,310 $99,484 −33% $138,868 −52% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $65,641 $65,641 $88,104 −25% $143,242 −54% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $63,322 $63,322 $96,002 −34% $120,587 −47% —
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $60,256 $60,256 $60,256 +0% $121,728 −50% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $59,953 $59,953 $62,554 −4% $131,961 −55% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $59,015 $59,015 $81,678 −28% $138,008 −57% —
955 Craniotomy for multiple significant trauma $57,928 $57,928 $59,339 −2% $105,612 −45% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $56,879 $56,879 $69,607 −18% $114,914 −51% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $56,660 $56,660 $56,660 +0% $89,353 −37% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $56,564 $56,564 $61,786 −8% $118,589 −52% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $54,864 $54,864 $56,462 −3% $116,058 −53% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $54,785 $54,785 $56,890 −4% $121,714 −55% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $53,652 $53,652 $76,100 −29% $109,331 −51% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $52,550 $52,550 $56,010 −6% $117,280 −55% —
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $52,482 $52,482 $74,441 −29% $94,988 −45% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $52,243 $52,243 $76,220 −31% $98,912 −47% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $52,061 $52,061 $77,989 −33% $108,472 −52% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $51,823 $51,823 $53,665 −3% $106,238 −51% —
028 SPINAL PROCEDURES WITH MCC $51,575 $51,575 $74,391 −31% $95,858 −46% —
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $51,205 $51,205 $70,720 −28% $98,260 −48% —
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $51,205 $51,205 $61,708 −17% $81,176 −37% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC $50,823 $50,823 $71,503 −29% $113,855 −55% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $50,471 $50,471 $73,928 −32% $92,238 −45% —
790 Extreme immaturity or respiratory distress syndrome, neonate $50,433 $50,433 $71,534 −29% $80,018 −37% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $49,918 $49,918 $67,362 −26% $112,062 −55% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $49,393 $49,393 $71,838 −31% $96,192 −49% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $48,690 $48,690 $69,568 −30% $107,355 −55% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $48,399 $48,399 $74,760 −35% $106,778 −55% —
653 MAJOR BLADDER PROCEDURES WITH MCC $47,292 $47,292 $62,070 −24% $97,046 −51% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $46,891 $46,891 $57,383 −18% $101,235 −54% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $46,891 $46,891 $46,891 +0% $76,583 −39% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $46,694 $46,694 $66,231 −29% $105,899 −56% —
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $46,409 $46,409 $65,827 −29% $93,783 −51% —
008 Simultaneous pancreas/kidney transplant $46,159 $46,159 $53,926 −14% $86,459 −47% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $46,054 $46,054 $69,661 −34% $94,927 −51% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $45,819 $45,819 $46,936 −2% $78,582 −42% —
011 Tracheostomy for face,mouth & neck diagnoses w MCC $45,776 $45,776 $46,225 −1% $86,953 −47% —
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $45,771 $45,771 $46,886 −2% $82,527 −45% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC $45,134 $45,134 $61,822 −27% $102,573 −56% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $44,934 $44,934 $47,356 −5% $102,177 −56% —
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $43,691 $43,691 $44,547 −2% $79,944 −45% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $43,546 $43,546 $59,897 −27% $99,423 −56% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $43,220 $43,220 $65,645 −34% $96,222 −55% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $43,088 $43,088 $59,697 −28% $80,747 −47% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $42,730 $42,730 $49,585 −14% $87,565 −51% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $42,478 $42,478 $43,716 −3% $70,735 −40% —
278 Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC $42,445 $42,445 $43,480 −2% $84,861 −50% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $42,428 $42,428 $66,300 −36% $87,018 −51% ≈111% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $42,276 $42,276 $57,822 −27% $96,905 −56% —
245 AICD generator procedures $41,457 $41,457 $61,075 −32% $72,076 −42% —
471 CERVICAL SPINAL FUSION WITH MCC $41,207 $41,207 $58,448 −29% $92,515 −55% —
006 LIVER TRANSPLANT WITHOUT MCC $41,138 $41,138 $48,936 −16% $84,407 −51% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $40,513 $40,513 $53,961 −25% $88,691 −54% —
799 SPLENIC PROCEDURES WITH MCC $40,337 $40,337 $63,003 −36% $78,821 −49% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $40,330 $40,330 $54,442 −26% $86,390 −53% ≈116% of Medicare
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC $39,912 $39,912 $56,801 −30% $92,217 −57% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $39,698 $39,698 $58,079 −32% $80,885 −51% —
277 Cardiac Defibrillator Implant without MCC $39,464 $39,464 $49,595 −20% $91,329 −57% —
163 MAJOR CHEST PROCEDURES WITH MCC $39,102 $39,102 $54,801 −29% $88,341 −56% ≈133% of Medicare
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $39,086 $39,086 $40,443 −3% $71,551 −45% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $38,961 $38,961 $54,333 −28% $90,331 −57% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $38,955 $38,955 $62,792 −38% $88,050 −56% ≈142% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $38,274 $38,274 $50,907 −25% $72,859 −47% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $38,046 $38,046 $44,319 −14% $76,954 −51% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $37,941 $37,941 $44,906 −16% $88,307 −57% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $37,586 $37,586 $37,586 +0% $68,847 −45% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $37,266 $37,266 $46,152 −19% $75,585 −51% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $36,707 $36,707 $33,230 +10% $59,352 −38% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $36,632 $36,632 $55,653 −34% $83,441 −56% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $36,188 $36,188 $52,759 −31% $82,561 −56% —
323 Coronary Intravascular Lithotripsy with Intraluminal Device with MCC $36,135 $36,135 $55,014 −34% $88,049 −59% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $35,878 $35,878 $34,907 +3% $60,098 −40% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $35,551 $35,551 $50,459 −30% $68,659 −48% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $35,542 $35,542 $51,316 −31% $72,945 −51% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $35,380 $35,380 $35,380 +0% $16,719 +112% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $35,297 $35,297 $42,533 −17% $83,065 −58% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $34,885 $34,885 $46,520 −25% $82,247 −58% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $34,865 $34,865 $41,582 −16% $66,853 −48% —
012 Tracheostomy for face,mouth & neck diagnoses w CC $34,814 $34,814 $35,828 −3% $73,029 −52% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $34,642 $34,642 $34,642 +0% $81,998 −58% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $34,506 $34,506 $48,943 −29% $72,011 −52% —
791 PREMATURITY WITH MAJOR PROBLEMS $34,442 $34,442 $45,159 −24% $39,563 −13% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $33,796 $33,796 $45,405 −26% $71,701 −53% —
739 Uterine,adnexa proc for non-ovarian/adnexal malig w MCC $33,772 $33,772 $47,902 −29% $57,521 −41% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $33,473 $33,473 $35,390 −5% $68,006 −51% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $33,405 $33,405 $47,381 −29% $61,832 −46% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $33,337 $33,337 $33,337 +0% $54,196 −38% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $33,189 $33,189 $33,189 +0% $75,492 −56% —
273 PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $33,173 $33,173 $40,083 −17% $78,852 −58% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $32,990 $32,990 $33,950 −3% $72,908 −55% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $32,789 $32,789 $34,783 −6% $62,961 −48% —
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $32,756 $32,756 $33,398 −2% $55,097 −41% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $32,664 $32,664 $48,736 −33% $72,782 −55% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $32,427 $32,427 $35,111 −8% $75,103 −57% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $32,252 $32,252 $47,667 −32% $74,755 −57% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $32,001 $32,001 $44,874 −29% $74,257 −57% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $31,745 $31,745 $46,834 −32% $60,861 −48% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $30,954 $30,954 $36,817 −16% $62,524 −50% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $30,739 $30,739 $46,502 −34% $71,755 −57% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $30,412 $30,412 $30,575 −1% $59,425 −49% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $30,410 $30,410 $29,586 +3% $57,855 −47% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $30,405 $30,405 $31,290 −3% $64,776 −53% —
265 AICD lead procedures $30,262 $30,262 $31,144 −3% $56,695 −47% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $30,127 $30,127 $35,670 −16% $70,540 −57% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $29,950 $29,950 $48,061 −38% $62,404 −52% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $29,942 $29,942 $29,942 +0% $50,919 −41% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $29,867 $29,867 $43,922 −32% $56,964 −48% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $29,724 $29,724 $31,947 −7% $68,399 −57% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $29,715 $29,715 $38,991 −24% $65,383 −55% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $29,703 $29,703 $42,905 −31% $59,207 −50% —
264 Other circulatory system O.R. procedures $29,651 $29,651 $29,651 +0% $51,953 −43% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $29,459 $29,459 $30,833 −4% $56,242 −48% —
332 RECTAL RESECTION WITH MCC $29,427 $29,427 $29,427 +0% $58,125 −49% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $29,394 $29,394 $30,877 −5% $49,065 −40% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $29,221 $29,221 $30,072 −3% $71,014 −59% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $29,175 $29,175 $30,024 −3% $62,269 −53% —
665 PROSTATECTOMY WITH MCC $29,129 $29,129 $41,317 −29% $54,072 −46% —
252 OTHER VASCULAR PROCEDURES WITH MCC $29,102 $29,102 $42,633 −32% $68,508 −58% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $29,058 $29,058 $42,906 −32% $68,880 −58% ≈128% of Medicare
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $28,896 $28,896 $38,294 −25% $67,901 −57% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $28,776 $28,776 $43,918 −34% $70,132 −59% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $28,477 $28,477 $28,756 −1% $64,152 −56% —
037 EXTRACRANIAL PROCEDURES WITH MCC $28,173 $28,173 $28,173 +0% $64,749 −56% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $28,012 $28,012 $28,012 +0% $52,908 −47% —
469 Major joint replacement or reattachment of lower extremity w MCC $27,730 $27,730 $33,894 −18% $65,254 −58% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $27,651 $27,651 $38,910 −29% $54,129 −49% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $27,639 $27,639 $28,474 −3% $64,465 −57% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $27,311 $27,311 $27,579 −1% $64,956 −58% —
279 Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC $27,184 $27,184 $40,209 −32% $57,277 −53% —
324 Coronary Intravascular Lithotripsy with Intraluminal Device without MCC $27,106 $27,106 $27,766 −2% $66,819 −59% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $27,054 $27,054 $27,054 +0% $49,710 −46% —
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $26,981 $26,981 $27,638 −2% $44,472 −39% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $26,927 $26,927 $26,927 +0% $51,142 −47% —
500 SOFT TISSUE PROCEDURES WITH MCC $26,882 $26,882 $27,145 −1% $57,479 −53% —
274 PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $26,477 $26,477 $37,451 −29% $65,573 −60% —
662 MINOR BLADDER PROCEDURES WITH MCC $26,465 $26,465 $30,960 −15% $54,483 −51% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $26,352 $26,352 $37,378 −29% $65,325 −60% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $26,234 $26,234 $26,998 −3% $62,821 −58% —
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $26,180 $26,180 $26,180 +0% $65,216 −60% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $26,161 $26,161 $27,771 −6% $53,817 −51% —
652 Kidney transplant $26,056 $26,056 $27,280 −4% $54,720 −52% —
173 Ultrasound Accelerated and other Thrombolysis with Principal Diagnosis Pulmonary Embolism $26,032 $26,032 $32,419 −20% $53,555 −51% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $25,948 $25,948 $34,191 −24% $63,475 −59% —
570 SKIN DEBRIDEMENT WITH MCC $25,537 $25,537 $26,159 −2% $52,435 −51% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $25,333 $25,333 $25,951 −2% $46,402 −45% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $25,014 $25,014 $25,014 +0% $54,313 −54% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $24,950 $24,950 $36,997 −33% $63,984 −61% ≈123% of Medicare
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $24,882 $24,882 $26,562 −6% $60,140 −59% —
668 TRANSURETHRAL PROCEDURES WITH MCC $24,740 $24,740 $25,343 −2% $47,277 −48% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $24,727 $24,727 $35,073 −29% $67,764 −64% —
800 SPLENIC PROCEDURES WITH CC $24,719 $24,719 $25,439 −3% $49,184 −50% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $24,706 $24,706 $25,425 −3% $54,475 −55% —
472 CERVICAL SPINAL FUSION WITH CC $24,578 $24,578 $25,060 −2% $59,537 −59% ≈119% of Medicare
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $24,323 $24,323 $24,323 +0% $58,968 −59% —
462 Bilateral or multiple major joint procs of lower extremity w/o MCC $24,295 $24,295 $29,422 −17% $56,758 −57% —
325 Coronary Intravascular Lithotripsy without Intraluminal Device $24,281 $24,281 $24,988 −3% $53,551 −55% —
510 Shoulder,elbow or forearm proc,exc major joint proc w MCC $24,247 $24,247 $24,247 +0% $49,055 −51% —
321 Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices $24,151 $24,151 $24,151 +0% $74,274 −67% ≈111% of Medicare
654 MAJOR BLADDER PROCEDURES WITH CC $23,941 $23,941 $24,176 −1% $53,868 −56% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $23,825 $23,825 $24,059 −1% $58,043 −59% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $23,800 $23,800 $32,590 −27% $48,907 −51% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $23,214 $23,214 $23,780 −2% $48,358 −52% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $23,173 $23,173 $22,859 +1% $45,497 −49% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $23,130 $23,130 $23,568 −2% $44,973 −49% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $23,047 $23,047 $23,718 −3% $43,491 −47% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $22,934 $22,934 $28,045 −18% $57,963 −60% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $22,859 $22,859 $24,914 −8% $44,839 −49% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $22,768 $22,768 $22,768 +0% $52,405 −57% ≈126% of Medicare
263 VEIN LIGATION AND STRIPPING $22,754 $22,754 $23,200 −2% $44,938 −49% —
849 Radiotherapy $22,660 $22,660 $22,353 +1% $37,862 −40% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $22,590 $22,590 $22,590 +0% $45,432 −50% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $22,509 $22,509 $22,509 +0% $40,947 −45% —
013 Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC $22,481 $22,481 $22,177 +1% $45,290 −50% —
503 FOOT PROCEDURES WITH MCC $22,452 $22,452 $23,106 −3% $43,901 −49% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $22,429 $22,429 $29,424 −24% $40,277 −44% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $22,255 $22,255 $22,797 −2% $54,929 −59% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $22,197 $22,197 $21,896 +1% $43,697 −49% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $21,960 $21,960 $21,960 +0% $41,703 −47% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $21,924 $21,924 $22,354 −2% $48,094 −54% ≈120% of Medicare
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $21,665 $21,665 $21,877 −1% $38,878 −44% —
253 OTHER VASCULAR PROCEDURES WITH CC $21,658 $21,658 $22,753 −5% $53,746 −60% —
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $21,618 $21,618 $22,247 −3% $57,149 −62% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $21,506 $21,506 $18,088 +19% $36,097 −40% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $21,437 $21,437 $21,147 +1% $39,657 −46% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $21,420 $21,420 $22,044 −3% $46,659 −54% —
164 MAJOR CHEST PROCEDURES WITH CC $21,353 $21,353 $21,353 +0% $53,141 −60% ≈128% of Medicare
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $21,243 $21,243 $20,668 +3% $39,409 −46% ≈143% of Medicare
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $21,227 $21,227 $21,745 −2% $55,162 −62% —
397 Appendix Procedures with MCC $21,020 $21,020 $21,532 −2% $52,319 −60% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $20,936 $20,936 $20,936 +0% $52,332 −60% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $20,782 $20,782 $20,782 +0% $11,633 +79% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $20,770 $20,770 $21,375 −3% $51,985 −60% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $20,599 $20,599 $20,599 +0% $54,824 −62% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $20,519 $20,519 $20,519 +0% $46,591 −56% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $20,455 $20,455 $20,655 −1% $40,065 −49% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $20,369 $20,369 $28,417 −28% $56,394 −64% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $20,337 $20,337 $20,337 +0% $47,583 −57% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $20,337 $20,337 $20,337 +0% $39,093 −48% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $20,161 $20,161 $28,596 −29% $52,313 −61% ≈118% of Medicare
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $20,084 $20,084 $20,281 −1% $50,624 −60% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $20,079 $20,079 $20,663 −3% $40,548 −50% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $20,052 $20,052 $20,052 +0% $58,832 −66% ≈134% of Medicare
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $20,020 $20,020 $20,508 −2% $47,546 −58% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $19,839 $19,839 $20,417 −3% $50,139 −60% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $19,683 $19,683 $19,683 +0% $36,237 −46% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $19,638 $19,638 $20,257 −3% $36,080 −46% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $19,619 $19,619 $19,811 −1% $51,339 −62% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $19,583 $19,583 $27,750 −29% $49,631 −61% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $19,462 $19,462 $19,273 +1% $37,080 −48% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $19,430 $19,430 $19,811 −2% $36,334 −47% ≈126% of Medicare
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $19,370 $19,370 $19,842 −2% $39,253 −51% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $19,334 $19,334 $19,713 −2% $43,586 −56% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $19,298 $19,298 $19,487 −1% $46,430 −58% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $19,224 $19,224 $19,224 +0% $37,064 −48% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $19,158 $19,158 $19,158 +0% $38,998 −51% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $19,157 $19,157 $19,533 −2% $44,989 −57% —
113 ORBITAL PROCEDURES WITH CC/MCC $19,144 $19,144 $19,331 −1% $35,642 −46% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $19,112 $19,112 $19,668 −3% $50,011 −62% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $19,105 $19,105 $19,570 −2% $48,682 −61% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $19,080 $19,080 $19,545 −2% $45,059 −58% —
709 PENIS PROCEDURES WITH CC/MCC $19,063 $19,063 $19,437 −2% $34,535 −45% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $18,939 $18,939 $18,682 +1% $44,053 −57% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $18,879 $18,879 $18,879 +0% $45,818 −59% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $18,776 $18,776 $19,498 −4% $44,600 −58% ≈127% of Medicare
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $18,659 $18,659 $18,841 −1% $38,382 −51% —
935 Non-extensive burns $18,633 $18,633 $18,633 +0% $29,458 −37% —
906 Hand procedures for injuries $18,515 $18,515 $18,264 +1% $31,520 −41% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $18,485 $18,485 $19,259 −4% $41,900 −56% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $18,403 $18,403 $18,584 −1% $37,902 −51% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $18,301 $18,301 $19,205 −5% $44,553 −59% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $18,269 $18,269 $18,627 −2% $38,357 −52% ≈122% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $18,227 $18,227 $18,227 +0% $34,900 −48% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $18,204 $18,204 $18,382 −1% $31,044 −41% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $18,191 $18,191 $18,191 +0% $36,850 −51% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $18,120 $18,120 $17,874 +1% $35,569 −49% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $18,119 $18,119 $18,560 −2% $40,232 −55% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $18,117 $18,117 $18,559 −2% $45,622 −60% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $18,083 $18,083 $18,686 −3% $37,654 −52% —
333 RECTAL RESECTION WITH CC $18,030 $18,030 $18,469 −2% $34,352 −48% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $17,993 $17,993 $18,345 −2% $46,477 −61% —
595 MAJOR SKIN DISORDERS WITH MCC $17,943 $17,943 $17,943 +0% $31,785 −44% —
336 PERITONEAL ADHESIOLYSIS WITH CC $17,920 $17,920 $21,904 −18% $49,470 −64% —
374 DIGESTIVE MALIGNANCY WITH MCC $17,912 $17,912 $18,263 −2% $38,885 −54% ≈142% of Medicare
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $17,912 $17,912 $17,669 +1% $38,420 −53% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $17,884 $17,884 $17,642 +1% $56,519 −68% ≈118% of Medicare
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $17,839 $17,839 $19,834 −10% $35,686 −50% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $17,786 $17,786 $17,896 −1% $46,066 −61% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $17,735 $17,735 $17,735 +0% $32,483 −45% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $17,623 $17,623 $17,623 +0% $41,651 −58% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $17,602 $17,602 $17,775 −1% $51,172 −66% ≈129% of Medicare
592 SKIN ULCERS WITH MCC $17,445 $17,445 $17,616 −1% $32,662 −47% —
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $17,369 $17,369 $17,710 −2% $34,089 −49% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $17,206 $17,206 $17,206 +0% $30,661 −44% —
539 OSTEOMYELITIS WITH MCC $17,157 $17,157 $17,157 +0% $33,746 −49% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $17,112 $17,112 $17,112 +0% $41,660 −59% —
548 SEPTIC ARTHRITIS WITH MCC $17,091 $17,091 $17,091 +0% $31,019 −45% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $17,073 $17,073 $17,073 +0% $30,940 −45% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $17,066 $17,066 $18,104 −6% $45,817 −63% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $16,953 $16,953 $16,953 +0% $44,363 −62% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $16,951 $16,951 $17,364 −2% $43,524 −61% ≈130% of Medicare
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $16,939 $16,939 $17,271 −2% $29,109 −42% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $16,875 $16,875 $16,875 +0% $35,714 −53% ≈137% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $16,863 $16,863 $17,194 −2% $35,139 −52% —
100 SEIZURES WITH MCC $16,842 $16,842 $17,172 −2% $35,194 −52% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $16,841 $16,841 $16,841 +0% $29,633 −43% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $16,781 $16,781 $17,190 −2% $43,398 −61% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $16,738 $16,738 $17,146 −2% $43,800 −62% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $16,729 $16,729 $17,136 −2% $43,775 −62% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $16,673 $16,673 $16,673 +0% $41,520 −60% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $16,645 $16,645 $16,645 +0% $35,237 −53% ≈128% of Medicare
511 Shoulder,elbow or forearm proc,exc major joint proc w CC $16,638 $16,638 $16,964 −2% $43,538 −62% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $16,620 $16,620 $16,783 −1% $36,933 −55% ≈133% of Medicare
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $16,589 $16,589 $16,589 +0% $35,014 −53% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $16,579 $16,579 $16,579 +0% $29,524 −44% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $16,577 $16,577 $16,902 −2% $33,050 −50% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $16,463 $16,463 $16,240 +1% $43,080 −62% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $16,443 $16,443 $16,604 −1% $36,202 −55% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,387 $16,387 $16,387 +0% $42,881 −62% —
380 COMPLICATED PEPTIC ULCER WITH MCC $16,325 $16,325 $16,722 −2% $36,641 −55% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,227 $16,227 $16,227 +0% $33,165 −51% —
711 TESTES PROCEDURES WITH CC/MCC $16,209 $16,209 $16,209 +0% $34,852 −53% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $16,098 $16,098 $16,567 −3% $42,126 −62% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $16,098 $16,098 $16,098 +0% $35,459 −55% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $16,062 $16,062 $16,062 +0% $36,280 −56% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $16,037 $16,037 $16,037 +0% $32,399 −51% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $16,015 $16,015 $16,015 +0% $32,204 −50% ≈137% of Medicare
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $15,997 $15,997 $15,997 +0% $32,981 −51% —
470 Major joint replacement or reattachment of lower extremity w/o MCC $15,996 $15,996 $16,152 −1% $49,197 −67% ≈129% of Medicare
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $15,995 $15,995 $16,152 −1% $45,963 −65% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $15,984 $15,984 $16,297 −2% $30,766 −48% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $15,823 $15,823 $15,978 −1% $35,114 −55% ≈141% of Medicare
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $15,813 $15,813 $15,813 +0% $41,380 −62% ≈137% of Medicare
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $15,748 $15,748 $15,902 −1% $30,974 −49% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $15,741 $15,741 $15,528 +1% $32,538 −52% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $15,728 $15,728 $15,515 +1% $22,698 −31% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $15,660 $15,660 $15,813 −1% $29,609 −47% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $15,627 $15,627 $16,156 −3% $28,375 −45% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $15,599 $15,599 $15,904 −2% $30,394 −49% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $15,551 $15,551 $15,340 +1% $40,694 −62% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $15,509 $15,509 $15,661 −1% $40,583 −62% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $15,501 $15,501 $15,653 −1% $40,563 −62% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $15,497 $15,497 $15,497 +0% $40,552 −62% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $15,479 $15,479 $15,782 −2% $37,950 −59% ≈125% of Medicare
919 COMPLICATIONS OF TREATMENT WITH MCC $15,470 $15,470 $15,622 −1% $29,031 −47% ≈131% of Medicare
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $15,465 $15,465 $15,616 −1% $36,375 −57% —
740 Uterine,adnexa proc for non-ovarian/adnexal malig w CC $15,426 $15,426 $15,426 +0% $36,597 −58% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $15,425 $15,425 $15,800 −2% $37,842 −59% ≈126% of Medicare
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $15,349 $15,349 $15,500 −1% $29,476 −48% ≈128% of Medicare
322 Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC $15,348 $15,348 $15,140 +1% $54,772 −72% ≈137% of Medicare
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $15,310 $15,310 $15,683 −2% $40,063 −62% —
789 Neonates, died or transferred to another acute care facility $15,292 $15,292 $15,085 +1% $14,284 +7% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $15,241 $15,241 $15,241 +0% $24,836 −39% —
501 SOFT TISSUE PROCEDURES WITH CC $15,140 $15,140 $15,581 −3% $37,975 −60% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $15,108 $15,108 $15,108 +0% $48,680 −69% —
896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC $15,107 $15,107 $15,107 +0% $30,275 −50% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $15,101 $15,101 $15,101 +0% $33,564 −55% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $15,065 $15,065 $15,065 +0% $31,909 −53% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $15,041 $15,041 $15,336 −2% $36,242 −58% —
199 PNEUMOTHORAX WITH MCC $14,976 $14,976 $15,123 −1% $31,491 −52% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $14,911 $14,911 $14,911 +0% $35,673 −58% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $14,911 $14,911 $15,203 −2% $39,018 −62% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $14,903 $14,903 $15,049 −1% $29,558 −50% —
509 Arthroscopy $14,903 $14,903 $14,903 +0% $25,994 −43% —
597 MALIGNANT BREAST DISORDERS WITH MCC $14,903 $14,903 $14,903 +0% $31,846 −53% —
504 FOOT PROCEDURES WITH CC $14,889 $14,889 $14,889 +0% $36,598 −59% —
505 FOOT PROCEDURES WITHOUT CC/MCC $14,889 $14,889 $14,889 +0% $31,716 −53% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $14,856 $14,856 $14,856 +0% $34,264 −57% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $14,841 $14,841 $14,950 −1% $38,836 −62% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $14,829 $14,829 $15,120 −2% $31,758 −53% —
180 RESPIRATORY NEOPLASMS WITH MCC $14,827 $14,827 $14,973 −1% $36,658 −60% ≈120% of Medicare
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $14,751 $14,751 $14,751 +0% $30,814 −52% —
915 ALLERGIC REACTIONS WITH MCC $14,743 $14,743 $14,888 −1% $30,944 −52% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $14,728 $14,728 $14,728 +0% $32,839 −55% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $14,667 $14,667 $14,811 −1% $29,826 −51% —
671 URETHRAL PROCEDURES WITH CC/MCC $14,623 $14,623 $14,623 +0% $27,233 −46% —
075 VIRAL MENINGITIS WITH CC/MCC $14,612 $14,612 $14,216 +3% $29,853 −51% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $14,558 $14,558 $14,843 −2% $38,094 −62% —
551 MEDICAL BACK PROBLEMS WITH MCC $14,476 $14,476 $14,618 −1% $31,086 −53% ≈130% of Medicare
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $14,431 $14,431 $14,431 +0% $43,266 −67% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $14,368 $14,368 $14,368 +0% $29,729 −52% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $14,340 $14,340 $14,340 +0% $28,578 −50% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $14,332 $14,332 $14,613 −2% $29,409 −51% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $14,290 $14,290 $14,290 +0% $31,128 −54% ≈124% of Medicare
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $14,260 $14,260 $14,260 +0% $30,058 −53% ≈130% of Medicare
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $14,206 $14,206 $14,485 −2% $29,916 −53% —
571 SKIN DEBRIDEMENT WITH CC $14,204 $14,204 $14,343 −1% $34,901 −59% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $14,169 $14,169 $14,169 +0% $25,208 −44% ≈113% of Medicare
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $14,167 $14,167 $14,167 +0% $33,607 −58% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $14,156 $14,156 $14,294 −1% $28,103 −50% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $14,152 $14,152 $14,152 +0% $30,930 −54% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $14,114 $14,114 $14,391 −2% $32,502 −57% —
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $14,104 $14,104 $13,994 +1% $27,548 −49% —
334 RECTAL RESECTION WITHOUT CC/MCC $14,071 $14,071 $14,071 +0% $32,213 −56% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $14,069 $14,069 $14,069 +0% $42,119 −67% ≈130% of Medicare
643 ENDOCRINE DISORDERS WITH MCC $14,060 $14,060 $14,060 +0% $32,996 −57% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $14,049 $14,049 $14,049 +0% $32,689 −57% ≈116% of Medicare
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $14,006 $14,006 $14,006 +0% $44,117 −68% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $13,982 $13,982 $13,793 +1% $25,197 −45% —
666 PROSTATECTOMY WITH CC $13,975 $13,975 $14,112 −1% $30,016 −53% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $13,936 $13,936 $13,936 +0% $31,566 −56% —
801 SPLENIC PROCEDURES WITHOUT CC/MCC $13,927 $13,927 $14,064 −1% $28,634 −51% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $13,925 $13,925 $14,198 −2% $28,967 −52% ≈130% of Medicare
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $13,910 $13,910 $13,910 +0% $28,134 −51% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $13,899 $13,899 $14,036 −1% $30,910 −55% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $13,893 $13,893 $13,893 +0% $36,333 −62% —
157 DENTAL AND ORAL DISEASES WITH MCC $13,892 $13,892 $13,892 +0% $27,457 −49% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $13,797 $13,797 $13,610 +1% $24,465 −44% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $13,791 $13,791 $13,926 −1% $27,168 −49% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $13,784 $13,784 $14,054 −2% $26,020 −47% —
913 TRAUMATIC INJURY WITH MCC $13,729 $13,729 $13,729 +0% $24,198 −43% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,723 $13,723 $13,351 +3% $25,731 −47% ≈132% of Medicare
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $13,714 $13,714 $13,714 +0% $31,840 −57% ≈131% of Medicare
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $13,708 $13,708 $14,108 −3% $27,118 −49% —
038 EXTRACRANIAL PROCEDURES WITH CC $13,669 $13,669 $13,669 +0% $35,770 −62% —
606 MINOR SKIN DISORDERS WITH MCC $13,661 $13,661 $13,661 +0% $25,434 −46% —
512 Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC $13,640 $13,640 $13,640 +0% $35,692 −62% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $13,598 $13,598 $13,598 +0% $35,584 −62% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $13,548 $13,548 $14,418 −6% $35,453 −62% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $13,535 $13,535 $13,535 +0% $33,984 −60% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $13,518 $13,518 $13,518 +0% $35,375 −62% —
183 MAJOR CHEST TRAUMA WITH MCC $13,466 $13,466 $13,466 +0% $28,924 −53% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $13,458 $13,458 $13,458 +0% $39,747 −66% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $13,406 $13,406 $13,406 +0% $33,490 −60% —
186 PLEURAL EFFUSION WITH MCC $13,404 $13,404 $13,404 +0% $32,468 −59% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $13,376 $13,376 $13,487 −1% $29,371 −54% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $13,339 $13,339 $13,339 +0% $34,906 −62% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $13,312 $13,312 $13,312 +0% $32,936 −60% ≈130% of Medicare
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $13,302 $13,302 $13,302 +0% $31,059 −57% ≈124% of Medicare
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $13,279 $13,279 $13,279 +0% $32,490 −59% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $13,256 $13,256 $13,256 +0% $41,380 −68% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $13,159 $13,159 $13,417 −2% $34,434 −62% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $13,147 $13,147 $13,276 −1% $28,646 −54% —
813 Coagulation disorders $13,132 $13,132 $13,132 +0% $30,128 −56% ≈125% of Medicare
669 TRANSURETHRAL PROCEDURES WITH CC $13,128 $13,128 $13,128 +0% $34,354 −62% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $13,118 $13,118 $13,118 +0% $24,036 −45% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $13,114 $13,114 $13,114 +0% $25,484 −49% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $13,112 $13,112 $13,241 −1% $28,252 −54% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $13,023 $13,023 $13,340 −2% $36,239 −64% —
115 Extraocular procedures except orbit $12,988 $12,988 $13,243 −2% $24,879 −48% —
663 MINOR BLADDER PROCEDURES WITH CC $12,958 $12,958 $13,212 −2% $29,924 −57% —
945 REHABILITATION WITH CC/MCC $12,950 $12,950 $12,775 +1% $23,834 −46% —
533 FRACTURES OF FEMUR WITH MCC $12,936 $12,936 $12,936 +0% $25,945 −50% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $12,876 $12,876 $12,876 +0% $33,694 −62% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $12,869 $12,869 $12,869 +0% $30,972 −58% —
398 Appendix Procedures without MCC/CC $12,837 $12,837 $12,663 +1% $39,107 −67% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $12,809 $12,809 $12,810 −0% $24,229 −47% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $12,804 $12,804 $12,930 −1% $27,279 −53% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $12,773 $12,773 $13,023 −2% $33,424 −62% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $12,763 $12,763 $12,763 +0% $33,792 −62% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $12,759 $12,759 $12,884 −1% $35,528 −64% —
682 RENAL FAILURE WITH MCC $12,741 $12,741 $12,741 +0% $27,854 −54% ≈127% of Medicare
710 PENIS PROCEDURES WITHOUT CC/MCC $12,737 $12,737 $12,737 +0% $23,814 −47% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $12,726 $12,726 $12,726 +0% $25,854 −51% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $12,718 $12,718 $12,842 −1% $29,484 −57% ≈157% of Medicare
506 Major thumb or joint procedures $12,718 $12,718 $12,842 −1% $28,983 −56% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $12,703 $12,703 $12,703 +0% $24,450 −48% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $12,663 $12,663 $12,912 −2% $33,137 −62% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $12,629 $12,629 $12,753 −1% $31,062 −59% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $12,604 $12,604 $12,604 +0% $28,140 −55% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $12,577 $12,577 $12,700 −1% $32,911 −62% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $12,523 $12,523 $12,888 −3% $7,961 +57% —
865 VIRAL ILLNESS WITH MCC $12,521 $12,521 $12,521 +0% $26,088 −52% —
693 URINARY STONES WITH MCC $12,474 $12,474 $12,474 +0% $22,525 −45% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $12,470 $12,470 $12,592 −1% $28,780 −57% ≈130% of Medicare
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $12,466 $12,466 $12,466 +0% $25,152 −50% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $12,466 $12,466 $12,466 +0% $25,786 −52% —
602 CELLULITIS WITH MCC $12,464 $12,464 $12,464 +0% $29,347 −58% ≈129% of Medicare
562 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC $12,416 $12,416 $12,416 +0% $29,211 −57% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $12,407 $12,407 $12,529 −1% $25,149 −51% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $12,401 $12,401 $12,523 −1% $32,451 −62% —
637 DIABETES WITH MCC $12,354 $12,354 $12,597 −2% $28,819 −57% ≈129% of Medicare
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $12,343 $12,343 $12,175 +1% $24,941 −51% —
895 Alcohol/drug abuse or dependence w rehabilitation therapy $12,283 $12,283 $12,117 +1% $21,986 −44% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $12,267 $12,267 $12,387 −1% $29,663 −59% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $12,232 $12,232 $12,232 +0% $22,525 −46% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $12,209 $12,209 $12,424 −2% $25,243 −52% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $12,159 $12,159 $12,397 −2% $31,816 −62% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $12,157 $12,157 $12,276 −1% $31,812 −62% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $12,058 $12,058 $11,895 +1% $25,010 −52% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $12,041 $12,041 $12,041 +0% $21,615 −44% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $12,007 $12,007 $12,007 +0% $23,734 −49% —
088 CONCUSSION WITH MCC $11,968 $11,968 $11,968 +0% $24,402 −51% —
885 Psychoses $11,958 $11,958 $11,958 +0% $21,489 −44% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $11,954 $11,954 $12,188 −2% $29,757 −60% ≈130% of Medicare
811 RED BLOOD CELL DISORDERS WITH MCC $11,935 $11,935 $12,169 −2% $27,934 −57% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $11,918 $11,918 $11,918 +0% $35,542 −66% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $11,888 $11,888 $11,888 +0% $24,452 −51% —
137 MOUTH PROCEDURES WITH CC/MCC $11,865 $11,865 $11,981 −1% $24,348 −51% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $11,853 $11,853 $11,853 +0% $30,006 −60% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $11,820 $11,820 $11,500 +3% $25,666 −54% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $11,795 $11,795 $11,795 +0% $24,118 −51% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $11,788 $11,788 $11,903 −1% $24,561 −52% —
150 EPISTAXIS WITH MCC $11,726 $11,726 $11,841 −1% $21,133 −45% —
741 Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC $11,653 $11,653 $11,881 −2% $29,050 −60% —
139 Salivary gland procedures $11,648 $11,648 $11,648 +0% $21,014 −45% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $11,626 $11,626 $11,626 +0% $20,980 −45% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $11,624 $11,624 $11,624 +0% $30,418 −62% —
748 Female reproductive system reconstructive procedures $11,557 $11,557 $11,784 −2% $24,980 −54% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,496 $11,496 $11,609 −1% $29,374 −61% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $11,486 $11,486 $11,330 +1% $28,527 −60% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $11,424 $11,424 $11,648 −2% $23,723 −52% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $11,390 $11,390 $11,390 +0% $29,805 −62% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $11,368 $11,368 $11,645 −2% $30,358 −63% ≈151% of Medicare
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $11,320 $11,320 $11,320 +0% $25,426 −55% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $11,310 $11,310 $11,310 +0% $31,978 −65% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $11,282 $11,282 $11,503 −2% $23,350 −52% —
640 Nutritional & misc metabolic disorders w MCC $11,266 $11,266 $11,487 −2% $24,480 −54% ≈141% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $11,179 $11,179 $11,179 +0% $26,158 −57% ≈141% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $11,178 $11,178 $11,178 +0% $34,887 −68% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $11,127 $11,127 $10,976 +1% $23,115 −52% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $11,079 $11,079 $11,297 −2% $23,956 −54% —
291 HEART FAILURE AND SHOCK WITH MCC $11,069 $11,069 $11,286 −2% $25,020 −56% ≈142% of Medicare
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $11,062 $11,062 $11,062 +0% $21,029 −47% —
540 OSTEOMYELITIS WITH CC $10,978 $10,978 $11,086 −1% $23,494 −53% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $10,949 $10,949 $10,801 +1% $22,811 −52% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $10,939 $10,939 $11,047 −1% $23,920 −54% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $10,930 $10,930 $10,930 +0% $23,924 −54% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $10,927 $10,927 $10,927 +0% $24,316 −55% —
947 SIGNS AND SYMPTOMS WITH MCC $10,911 $10,911 $11,018 −1% $25,474 −57% ≈150% of Medicare
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $10,897 $10,897 $10,897 +0% $27,244 −60% ≈138% of Medicare
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $10,830 $10,830 $11,094 −2% $22,557 −52% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC $10,780 $10,780 $10,780 +0% $19,686 −45% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $10,780 $10,780 $10,780 +0% $22,275 −52% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $10,760 $10,760 $10,760 +0% $28,156 −62% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $10,748 $10,748 $10,748 +0% $25,623 −58% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $10,725 $10,725 $10,725 +0% $26,634 −60% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $10,711 $10,711 $10,566 +1% $19,894 −46% —
348 ANAL AND STOMAL PROCEDURES WITH CC $10,680 $10,680 $10,889 −2% $27,947 −62% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $10,564 $10,564 $10,668 −1% $26,146 −60% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $10,563 $10,563 $10,663 −1% $19,354 −45% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $10,560 $10,560 $10,664 −1% $21,860 −52% —
642 Inborn errors of metabolism $10,529 $10,529 $10,529 +0% $20,727 −49% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $10,507 $10,507 $10,507 +0% $22,032 −52% ≈146% of Medicare
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $10,506 $10,506 $10,506 +0% $27,492 −62% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $10,497 $10,497 $10,497 +0% $25,704 −59% ≈132% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $10,451 $10,451 $10,451 +0% $20,147 −48% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $10,441 $10,441 $10,441 +0% $27,321 −62% —
375 DIGESTIVE MALIGNANCY WITH CC $10,424 $10,424 $10,526 −1% $27,219 −62% ≈150% of Medicare
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $10,418 $10,418 $10,418 +0% $19,132 −46% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $10,380 $10,380 $10,380 +0% $26,322 −61% —
593 SKIN ULCERS WITH CC $10,373 $10,373 $10,474 −1% $20,470 −49% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $10,342 $10,342 $10,444 −1% $23,588 −56% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $10,298 $10,298 $10,399 −1% $23,297 −56% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $10,230 $10,230 $10,431 −2% $26,488 −61% ≈143% of Medicare
549 SEPTIC ARTHRITIS WITH CC $10,223 $10,223 $10,085 +1% $20,938 −51% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $10,169 $10,169 $10,169 +0% $27,369 −63% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $10,139 $10,139 $10,139 +0% $20,421 −50% —
887 Other mental disorder diagnoses $10,090 $10,090 $10,090 +0% $20,602 −51% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $10,051 $10,051 $10,150 −1% $20,842 −52% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $10,028 $10,028 $10,028 +0% $19,598 −49% —
304 HYPERTENSION WITH MCC $9,966 $9,966 $10,162 −2% $24,185 −59% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $9,928 $9,928 $9,928 +0% $22,982 −57% ≈143% of Medicare
302 ATHEROSCLEROSIS WITH MCC $9,869 $9,869 $10,062 −2% $20,844 −53% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $9,868 $9,868 $9,868 +0% $18,291 −46% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $9,867 $9,867 $9,867 +0% $21,062 −53% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $9,848 $9,848 $9,848 +0% $22,532 −56% —
102 HEADACHES WITH MCC $9,837 $9,837 $10,029 −2% $22,544 −56% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $9,821 $9,821 $9,688 +1% $24,202 −59% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,803 $9,803 $9,899 −1% $25,307 −61% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $9,764 $9,764 $9,405 +4% $18,133 −46% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $9,703 $9,703 $9,798 −1% $25,390 −62% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $9,692 $9,692 $9,692 +0% $24,432 −60% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $9,660 $9,660 $9,755 −1% $24,452 −60% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $9,656 $9,656 $9,394 +3% $25,267 −62% ≈146% of Medicare
152 OTITIS MEDIA AND URI WITH MCC $9,627 $9,627 $9,627 +0% $19,795 −51% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $9,568 $9,568 $9,661 −1% $20,741 −54% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $9,567 $9,567 $9,567 +0% $24,017 −60% ≈160% of Medicare
399 APPENDIX PROCEDURES WITHOUT CC/MCC $9,534 $9,534 $9,534 +0% $30,314 −69% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $9,527 $9,527 $9,714 −2% $24,190 −61% ≈152% of Medicare
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $9,526 $9,526 $9,526 +0% $19,317 −51% —
946 REHABILITATION WITHOUT CC/MCC $9,472 $9,472 $9,323 +2% $17,685 −46% —
181 RESPIRATORY NEOPLASMS WITH CC $9,419 $9,419 $9,512 −1% $22,431 −58% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $9,418 $9,418 $9,602 −2% $18,459 −49% —
200 PNEUMOTHORAX WITH CC $9,395 $9,395 $9,580 −2% $20,573 −54% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $9,379 $9,379 $9,379 +0% $24,544 −62% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $9,354 $9,354 $9,354 +0% $25,162 −63% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $9,339 $9,339 $9,346 −0% $17,483 −47% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $9,300 $9,300 $11,271 −17% $17,103 −46% —
672 URETHRAL PROCEDURES WITHOUT CC/MCC $9,284 $9,284 $8,828 +5% $17,398 −47% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $9,255 $9,255 $9,255 +0% $19,868 −53% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $9,244 $9,244 $9,426 −2% $31,190 −70% —
381 COMPLICATED PEPTIC ULCER WITH CC $9,239 $9,239 $9,239 +0% $24,177 −62% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $9,200 $9,200 $9,291 −1% $21,806 −58% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $9,188 $9,188 $12,774 −28% $22,560 −59% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $9,171 $9,171 $9,261 −1% $17,226 −47% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $9,160 $9,160 $9,250 −1% $18,126 −49% —
949 AFTERCARE WITH CC/MCC $9,154 $9,154 $9,243 −1% $23,953 −62% —
598 MALIGNANT BREAST DISORDERS WITH CC $9,153 $9,153 $9,153 +0% $19,073 −52% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $9,150 $9,150 $9,026 +1% $17,193 −47% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $9,128 $9,128 $9,128 +0% $17,943 −49% —
089 CONCUSSION WITH CC $9,095 $9,095 $8,849 +3% $18,293 −50% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $9,082 $9,082 $9,260 −2% $19,579 −54% ≈159% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $9,076 $9,076 $9,254 −2% $23,749 −62% —
712 TESTES PROCEDURES WITHOUT CC/MCC $9,074 $9,074 $8,951 +1% $18,898 −52% —
184 MAJOR CHEST TRAUMA WITH CC $9,061 $9,061 $9,061 +0% $20,842 −57% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $9,008 $9,008 $9,775 −8% $23,571 −62% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $9,000 $9,000 $9,000 +0% $23,496 −62% ≈155% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $8,981 $8,981 $9,069 −1% $24,136 −63% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $8,941 $8,941 $8,941 +0% $23,396 −62% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $8,931 $8,931 $8,689 +3% $18,478 −52% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $8,924 $8,924 $8,924 +0% $17,550 −49% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $8,909 $8,909 $9,083 −2% $22,231 −60% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $8,843 $8,843 $8,843 +0% $23,141 −62% —
644 ENDOCRINE DISORDERS WITH CC $8,767 $8,767 $8,939 −2% $22,941 −62% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $8,746 $8,746 $8,918 −2% $22,781 −62% ≈151% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $8,732 $8,732 $8,732 +0% $22,850 −62% ≈135% of Medicare
667 PROSTATECTOMY WITHOUT CC/MCC $8,719 $8,719 $8,805 −1% $16,703 −48% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $8,709 $8,709 $8,880 −2% $24,022 −64% —
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $8,694 $8,694 $8,779 −1% $16,495 −47% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $8,652 $8,652 $8,737 −1% $20,732 −58% ≈139% of Medicare
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $8,652 $8,652 $8,652 +0% $16,571 −48% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $8,651 $8,651 $8,651 +0% $21,545 −60% ≈152% of Medicare
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $8,650 $8,650 $8,819 −2% $20,080 −57% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $8,647 $8,647 $8,732 −1% $19,091 −55% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $8,633 $8,633 $8,633 +0% $22,713 −62% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $8,627 $8,627 $8,711 −1% $23,469 −63% ≈148% of Medicare
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $8,620 $8,620 $8,620 +0% $18,017 −52% —
920 COMPLICATIONS OF TREATMENT WITH CC $8,618 $8,618 $8,787 −2% $21,181 −59% —
187 PLEURAL EFFUSION WITH CC $8,517 $8,517 $8,517 +0% $21,467 −60% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $8,510 $8,510 $8,510 +0% $17,078 −50% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $8,509 $8,509 $8,278 +3% $16,212 −48% —
697 Urethral stricture $8,499 $8,499 $8,499 +0% $17,705 −52% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $8,483 $8,483 $8,483 +0% $20,007 −58% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $8,467 $8,467 $10,576 −20% $15,370 −45% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $8,466 $8,466 $8,351 +1% $17,434 −51% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $8,420 $8,420 $8,420 +0% $20,968 −60% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $8,416 $8,416 $8,416 +0% $22,024 −62% ≈162% of Medicare
197 INTERSTITIAL LUNG DISEASE WITH CC $8,399 $8,399 $8,399 +0% $20,106 −58% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $8,364 $8,364 $8,364 +0% $21,886 −62% ≈144% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $8,361 $8,361 $8,361 +0% $18,282 −54% —
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $8,305 $8,305 $8,305 +0% $15,901 −48% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $8,299 $8,299 $8,380 −1% $15,890 −48% —
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $8,214 $8,214 $8,598 −4% $19,001 −57% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $8,214 $8,214 $10,124 −19% $18,238 −55% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $8,201 $8,201 $8,281 −1% $17,273 −53% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $8,197 $8,197 $8,357 −2% $21,449 −62% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $8,176 $8,176 $8,176 +0% $21,213 −61% ≈145% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $8,164 $8,164 $8,164 +0% $20,777 −61% —
882 Neuroses except depressive $8,161 $8,161 $8,241 −1% $15,680 −48% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $8,132 $8,132 $8,292 −2% $15,636 −48% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $8,115 $8,115 $8,195 −1% $16,418 −51% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $8,111 $8,111 $8,111 +0% $18,191 −55% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $8,108 $8,108 $8,108 +0% $20,371 −60% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $8,103 $8,103 $8,103 +0% $19,326 −58% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $8,102 $8,102 $8,181 −1% $15,589 −48% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $8,075 $8,075 $8,075 +0% $18,428 −56% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $7,986 $7,986 $7,986 +0% $18,918 −58% ≈150% of Medicare
158 DENTAL AND ORAL DISEASES WITH CC $7,980 $7,980 $7,980 +0% $17,700 −55% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $7,972 $7,972 $8,050 −1% $17,108 −53% —
779 ABORTION WITHOUT D&C $7,930 $7,930 $7,930 +0% $15,327 −48% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $7,920 $7,920 $7,998 −1% $16,642 −52% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $7,859 $7,859 $7,859 +0% $18,608 −58% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $7,836 $7,836 $7,990 −2% $19,287 −59% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $7,829 $7,829 $7,983 −2% $20,488 −62% ≈146% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $7,820 $7,820 $7,820 +0% $20,463 −62% ≈152% of Medicare
101 SEIZURES WITHOUT MCC $7,819 $7,819 $7,819 +0% $19,954 −61% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $7,817 $7,817 $7,893 −1% $20,309 −62% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $7,796 $7,796 $7,873 −1% $16,352 −52% —
638 DIABETES WITH CC $7,781 $7,781 $7,934 −2% $18,821 −59% ≈218% of Medicare
076 VIRAL MENINGITIS WITHOUT CC/MCC $7,779 $7,779 $7,779 +0% $15,474 −50% —
914 TRAUMATIC INJURY WITHOUT MCC $7,774 $7,774 $7,850 −1% $15,593 −50% —
881 Depressive neuroses $7,755 $7,755 $7,831 −1% $15,058 −49% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $7,742 $7,742 $7,742 +0% $17,585 −56% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $7,684 $7,684 $7,835 −2% $17,731 −57% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $7,676 $7,676 $7,676 +0% $15,077 −49% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $7,675 $7,675 $8,017 −4% $20,084 −62% —
864 FEVER AND INFLAMMATORY CONDITIONS $7,618 $7,618 $7,618 +0% $17,412 −56% ≈158% of Medicare
563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC $7,583 $7,583 $7,583 +0% $18,803 −60% ≈165% of Medicare
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $7,571 $7,571 $7,571 +0% $21,261 −64% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $7,566 $7,566 $7,566 +0% $15,764 −52% —
683 RENAL FAILURE WITH CC $7,541 $7,541 $7,689 −2% $18,620 −60% ≈152% of Medicare
866 VIRAL ILLNESS WITHOUT MCC $7,506 $7,506 $7,506 +0% $16,391 −54% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $7,504 $7,504 $7,504 +0% $15,045 −50% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $7,499 $7,499 $7,499 +0% $15,869 −53% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $7,491 $7,491 $7,491 +0% $15,608 −52% —
897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC $7,484 $7,484 $7,484 +0% $16,049 −53% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $7,478 $7,478 $7,478 +0% $19,569 −62% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $7,473 $7,473 $7,620 −2% $19,854 −62% —
603 CELLULITIS WITHOUT MCC $7,472 $7,472 $7,472 +0% $18,530 −60% ≈157% of Medicare
541 OSTEOMYELITIS WITHOUT CC/MCC $7,422 $7,422 $7,495 −1% $14,549 −49% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $7,410 $7,410 $10,545 −30% $19,815 −63% —
312 SYNCOPE AND COLLAPSE $7,392 $7,392 $7,537 −2% $19,342 −62% ≈143% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $7,377 $7,377 $7,377 +0% $19,305 −62% —
607 MINOR SKIN DISORDERS WITHOUT MCC $7,331 $7,331 $7,475 −2% $15,284 −52% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,328 $7,328 $7,328 +0% $17,367 −58% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $7,314 $7,314 $7,314 +0% $16,156 −55% —
292 HEART FAILURE AND SHOCK WITH CC $7,306 $7,306 $7,306 +0% $16,212 −55% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $7,297 $7,297 $7,369 −1% $19,096 −62% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $7,288 $7,288 $7,431 −2% $18,278 −60% —
090 CONCUSSION WITHOUT CC/MCC $7,273 $7,273 $7,344 −1% $14,873 −51% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $7,253 $7,253 $7,253 +0% $14,290 −49% —
103 HEADACHES WITHOUT MCC $7,213 $7,213 $7,213 +0% $20,111 −64% —
594 SKIN ULCERS WITHOUT CC/MCC $7,200 $7,200 $7,271 −1% $14,209 −49% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $7,105 $7,105 $7,131 −0% $14,064 −49% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $7,099 $7,099 $7,169 −1% $14,055 −49% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $7,080 $7,080 $7,219 −2% $18,253 −61% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $7,005 $7,005 $7,073 −1% $15,876 −56% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $6,956 $6,956 $7,093 −2% $18,204 −62% ≈153% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $6,947 $6,947 $7,015 −1% $13,822 −50% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $6,936 $6,936 $6,936 +0% $18,150 −62% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $6,932 $6,932 $6,744 +3% $16,837 −59% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $6,927 $6,927 $6,927 +0% $17,715 −61% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $6,927 $6,927 $6,927 +0% $17,928 −61% —
176 PULMONARY EMBOLISM WITHOUT MCC $6,910 $6,910 $7,045 −2% $18,081 −62% —
534 FRACTURES OF FEMUR WITHOUT MCC $6,906 $6,906 $6,906 +0% $17,195 −60% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $6,901 $6,901 $6,969 −1% $17,383 −60% —
204 RESPIRATORY SIGNS AND SYMPTOMS $6,880 $6,880 $7,015 −2% $16,866 −59% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $6,879 $6,879 $6,879 +0% $18,002 −62% —
123 Neurological eye disorders $6,814 $6,814 $6,881 −1% $17,831 −62% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $6,809 $6,809 $6,809 +0% $17,466 −61% ≈150% of Medicare
389 GASTROINTESTINAL OBSTRUCTION WITH CC $6,800 $6,800 $6,800 +0% $17,388 −61% ≈154% of Medicare
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $6,793 $6,793 $6,793 +0% $13,586 −50% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $6,788 $6,788 $6,696 +1% $20,278 −67% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $6,764 $6,764 $6,896 −2% $17,700 −62% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $6,740 $6,740 $6,872 −2% $17,727 −62% ≈159% of Medicare
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $6,700 $6,700 $6,267 +7% $13,445 −50% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $6,696 $6,696 $6,762 −1% $17,522 −62% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $6,661 $6,661 $6,661 +0% $13,385 −50% —
641 Nutritional & misc metabolic disorders w/o MCC $6,629 $6,629 $6,629 +0% $16,745 −60% ≈160% of Medicare
694 URINARY STONES WITHOUT MCC $6,629 $6,629 $6,629 +0% $16,531 −60% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $6,620 $6,620 $6,685 −1% $17,322 −62% ≈157% of Medicare
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $6,606 $6,606 $6,671 −1% $14,166 −53% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $6,598 $6,598 $6,727 −2% $15,858 −58% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $6,530 $6,530 $6,594 −1% $14,444 −55% —
151 EPISTAXIS WITHOUT MCC $6,430 $6,430 $6,494 −1% $13,032 −51% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $6,411 $6,411 $6,537 −2% $16,776 −62% —
305 HYPERTENSION WITHOUT MCC $6,369 $6,369 $6,493 −2% $17,144 −63% —
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $6,364 $6,364 $6,364 +0% $16,654 −62% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $6,357 $6,357 $6,357 +0% $16,634 −62% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $6,346 $6,346 $6,409 −1% $14,337 −56% —
149 Dysequilibrium $6,341 $6,341 $6,256 +1% $17,203 −63% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $6,341 $6,341 $6,341 +0% $12,895 −51% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $6,330 $6,330 $6,330 +0% $14,861 −57% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $6,315 $6,315 $6,315 +0% $13,892 −55% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $6,286 $6,286 $6,286 +0% $13,282 −53% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $6,272 $6,272 $6,333 −1% $16,865 −63% ≈156% of Medicare
188 PLEURAL EFFUSION WITHOUT CC/MCC $6,229 $6,229 $6,229 +0% $14,110 −56% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,181 $6,181 $6,242 −1% $12,650 −51% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $6,154 $6,154 $6,154 +0% $16,104 −62% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $6,151 $6,151 $6,272 −2% $18,623 −67% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $6,144 $6,144 $6,144 +0% $12,593 −51% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $6,139 $6,139 $9,343 −34% $13,090 −53% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $6,105 $6,105 $6,105 +0% $12,537 −51% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $6,053 $6,053 $6,053 +0% $12,381 −51% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $6,052 $6,052 $6,171 −2% $15,607 −61% —
313 Chest pain $6,052 $6,052 $6,171 −2% $15,962 −62% —
153 OTITIS MEDIA AND URI WITHOUT MCC $6,038 $6,038 $6,038 +0% $14,473 −58% —
297 CARDIAC ARREST, UNEXPLAINED WITH CC $5,976 $5,976 $5,976 +0% $12,336 −52% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $5,961 $5,961 $6,020 −1% $15,600 −62% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $5,942 $5,942 $6,058 −2% $13,654 −56% —
311 Angina pectoris $5,924 $5,924 $5,924 +0% $15,165 −61% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $5,921 $5,921 $5,921 +0% $15,072 −61% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $5,910 $5,910 $6,025 −2% $12,279 −52% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $5,909 $5,909 $5,829 +1% $12,405 −52% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $5,889 $5,889 $5,889 +0% $13,303 −56% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $5,869 $5,869 $5,984 −2% $14,441 −59% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $5,839 $5,839 $5,839 +0% $19,483 −70% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,834 $5,834 $5,948 −2% $14,012 −58% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $5,792 $5,792 $5,792 +0% $12,797 −55% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $5,754 $5,754 $5,754 +0% $11,997 −52% —
201 PNEUMOTHORAX WITHOUT CC/MCC $5,744 $5,744 $5,857 −2% $13,081 −56% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $5,704 $5,704 $5,760 −1% $13,198 −57% —
303 ATHEROSCLEROSIS WITHOUT MCC $5,704 $5,704 $5,704 +0% $14,927 −62% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $5,697 $5,697 $5,697 +0% $11,909 −52% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $5,686 $5,686 $5,798 −2% $14,880 −62% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $5,656 $5,656 $5,589 +1% $11,847 −52% —
916 ALLERGIC REACTIONS WITHOUT MCC $5,634 $5,634 $5,634 +0% $13,890 −59% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $5,596 $5,596 $5,651 −1% $13,368 −58% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $5,594 $5,594 $5,704 −2% $13,485 −59% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $5,491 $5,491 $5,598 −2% $14,368 −62% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $5,429 $5,429 $5,562 −2% $14,208 −62% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $5,407 $5,407 $8,897 −39% $12,044 −55% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $5,401 $5,401 $5,559 −3% $14,134 −62% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,399 $5,399 $5,399 +0% $14,128 −62% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $5,378 $5,378 $5,483 −2% $11,421 −53% —
639 DIABETES WITHOUT CC/MCC $5,316 $5,316 $5,316 +0% $13,910 −62% —
894 Alcohol/drug abuse or dependence, left AMA $5,295 $5,295 $5,424 −2% $12,013 −56% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $5,283 $5,283 $5,283 +0% $13,824 −62% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $5,218 $5,218 $5,370 −3% $15,070 −65% —
684 RENAL FAILURE WITHOUT CC/MCC $5,153 $5,153 $5,153 +0% $13,623 −62% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,149 $5,149 $5,274 −2% $11,071 −53% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $5,086 $5,086 $5,186 −2% $10,975 −54% —
950 AFTERCARE WITHOUT CC/MCC $4,972 $4,972 $5,117 −3% $13,527 −63% —
951 Other factors influencing health status $4,810 $4,810 $4,950 −3% $9,385 −49% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $4,763 $4,763 $4,763 +0% $10,039 −53% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,747 $4,747 $4,793 −1% $13,384 −65% ≈196% of Medicare
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $4,655 $4,655 $4,790 −3% $11,955 −61% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $4,642 $4,642 $4,642 +0% $13,318 −65% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $4,410 $4,410 $4,496 −2% $9,076 −51% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $3,747 $3,747 $3,989 −6% $8,927 −58% —
795 Normal newborn $1,695 $1,695 $3,492 −51% $4,530 −63% —

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
453 Combined anterior/posterior spinal fusion w MCC $67,405 – $95,295 · median $67,405 3 plans
454 Combined anterior/posterior spinal fusion w CC $44,710 – $66,270 · median $44,710 3 plans
455 Combined anterior/posterior spinal fusion w/o CC/MCC $35,126 – $50,297 · median $35,126 3 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $49,356 – $71,726 · median $49,356 3 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $28,833 – $40,276 · median $28,833 3 plans
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $61,741 – $61,741 · median $61,741 2 plans
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $45,545 – $45,545 · median $45,545 2 plans
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $53,978 – $53,978 · median $53,978 2 plans
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $41,254 – $41,254 · median $41,254 2 plans
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $48,476 – $48,476 · median $48,476 2 plans
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $38,505 – $38,505 · median $38,505 2 plans
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $22,917 – $22,917 · median $22,917 2 plans
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $14,577 – $14,577 · median $14,577 2 plans
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $23,270 – $23,270 · median $23,270 2 plans
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $13,779 – $13,779 · median $13,779 2 plans
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $20,520 – $20,520 · median $20,520 2 plans
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $12,427 – $12,427 · median $12,427 2 plans
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,006 – $9,006 · median $9,006 2 plans
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $16,982 – $16,982 · median $16,982 2 plans
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $10,507 – $10,507 · median $10,507 2 plans
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $8,134 – $8,134 · median $8,134 2 plans
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